Tuesday, August 30, 2016

Pain and discomfort following immediate and delayed loading by overdentures in the single mandibular implant study (SMIS)

Clinical Oral Investigations
pp 1-8
First online:




This randomized clinical trial compares immediate and delayed loading of single implants to support mandibular overdentures. The aim of this preliminary analysis is to test the hypothesis whether patients with immediate loading will experience less pain and discomfort through the intervention than patients with delayed loading.

Materials and methods

Edentulous patients in nine German dental schools received a midline implant with a length of 11 mm. Implants with a minimum insertion torque of 30 Ncm and an implant stability quotient of ≥60 were randomly allocated to group A for immediate loading using ball attachments or to group B for delayed loading after 3 months. Patients completed questionnaires with 100-mm visual analogue scales about the items pain, pain during chewing, swelling, bleeding, and perception of the intervention at the day of surgery and 1, 2, 3, and 7 days, thereafter. Groups were compared by Wilcoxon–Mann–Whitney tests (P ≤ 0.05).


The questionnaires of 81 patients in group A and 74 patients in group B were completed. The medians for pain and discomfort were moderate (<30 a="" after="" and="" b.="" between="" day="" differences="" felt="" first="" from="" group="" groups.="" implantation="" individual="" interventions="" more="" no="" of="" p="" pain="" participants="" perception="" showed="" significant="" significantly="" swelling="" than="" the="" third="">


Immediate loading evoked more postoperative pain and swelling than the two stages of delayed loading.

Clinical relevance

Immediate loading of a single mandibular midline implant supporting overdentures should be carefully considered.

Monday, August 29, 2016

Traumatic dental injuries and socioeconomic position – findings from the Children's Dental Health Survey 2013

Community Dentistry and Oral Epidemiology 

First published:



The aim of this study was to assess whether traumatic dental injuries (TDI) were socially graded among children and adolescents in England, Wales and Northern Ireland, using nationally representative data from the Children's Dental Health Survey (CDHS) 2013.


This cross-sectional study used data from the Children's Dental Health Survey 2013 which was conducted among a nationally representative sample of schoolchildren in England, Wales and Northern Ireland. Children's family socioeconomic position (SEP) was measured through free school meal eligibility and relative area deprivation using the Indices of Multiple Deprivation. The analytical sample included 6707 schoolchildren aged 8, 12 and 15. Multiple logistic regression was used to model the associations between experience of TDI and the two markers of SEP, after adjusting for sex and age.


The overall prevalence of traumatic dental injuries to permanent incisors was 9% (n = 590). There were no statistically significant associations between TDI and either SEP measure. Further subgroup analyses (n = 2650) showed also no significant associations between TDI and additional SEP markers (parental education and social class). The odds of having sustained a traumatic dental injury were higher for boys than for girls and were greater in older age groups.


This study found no significant relationships between the experience of traumatic dental injuries and two markers of family socioeconomic position among children living in England, Wales and Northern Ireland. This implies that rather than specifically targeting the more deprived sectors of society, TDI prevention policies should use upstream public health strategies incorporating a whole-population approach.

Friday, August 26, 2016

The association between oral health literacy and missed dental appointments.

J Am Dent Assoc. 2016 Aug 3. pii: S0002-8177(16)30505-0. doi: 10.1016/j.adaj.2016.05.011. [Epub ahead of print]



In this study, the author identified associations among demographic characteristics, dental risk factors, health-seeking behaviors, oral health literacy level, and failure to keep dental appointments.


The author conducted an unmatched 1:2 case-control study at a university-based dental clinic from February through April 2015. The author used the Comprehensive Measure of Oral Health Knowledge questionnaire to record the oral health literacy of the respondents. The author obtained additional information about the various covariates using a questionnaire and checking the patients' electronic medical records. The author used a multivariate logistic regression analysis to test the associations between missed appointments and other risk factors in addition to oral health literacy.


Data from 150 (50 case patients and 100 control patients) respondents were included in the analysis. The case and control patients were comparable in terms of sociodemographic characteristics and dental risk factors. The Comprehensive Measure of Oral Health Knowledge score was used to categorize the sample into low (≤ 18) and high (> 18) oral health literacy groups. Low oral health literacy was associated with a 2-fold increase in the risk of having missed appointments (adjusted odds ratio, 2.38; 95% confidence interval, 1.05-5.40). Age was also independently associated with missed appointments (adjusted odds ratio, 1.03; 95% confidence interval, 1.01-1.06).


After adjusting for the various demographic and dental risk factors, poor oral health literacy was found to be independently associated with missed dental appointments. Insights into the role of oral health literacy and clinic attendance could play an important role in addressing the problem of missed dental appointments.


Considering the effects of missed appointments on treatment outcomes, predictors of patient compliance behaviors may be useful in circumventing cancellations and no shows.

Thursday, August 25, 2016

Green Tea Intake as an Adjunct to Mechanical Periodontal Therapy for the Management of Mild to Moderate Chronic Periodontitis: A Randomized Controlled Clinical Trial

Oral Health Prev Dent 14 (2016), No. 4  (09.08.2016)

Page 293-303, doi:10.3290/j.ohpd.a36100, PubMed:27175448

Purpose: To evaluate and compare the beneficial effects of green tea intake on the total antioxidant capacity of gingival crevicular fluid (GCF) and plasma, and to examine its role as an adjunct to nonsurgical periodontal therapy for the management of chronic periodontitis.

Materials and Methods: 120 subjects with mild to moderate chronic periodontitis were divided equally into two groups. After scaling and root planing in all subjects, green tea supplements were given to the case group and a placebo to the control group. The clinical parameters gingival index, plaque index, clinical probing depth, clinical attachment loss, percentage of sites with bleeding on probing, along with total antioxidant capacity of GCF and plasma were recorded at baseline, one and three months.

Results: There was a significant improvement in all clinical parameters along with an 8-fold greater antioxidant capacity in GCF in the case group than in the control group.
Conclusion: Green tea intake as a component of nonsurgical periodontal therapy is promising for superior and rapid resolution of the disease process. Green tea increases the total antioxidant capacity of GCF and plasma along with potent anti-inflammatory, astringent and anti-plaque effects.

Wednesday, August 24, 2016

Malpractice claims related to tooth extractions



The aim of this study was to analyze malpractice claims related to tooth extractions in order to identify areas requiring emphasis and eventually to reduce the number of complications.

Material and methods

We compiled a file of all malpractice claims related to tooth extractions (EBA code) between 1997 and 2010 from the Finnish Patient Insurance Centre. We then examined the data with respect to date, tooth, surgery, injury diagnosis, and the authority’s decision on the case.


The material consisted of 852 completed patient cases. Most of the teeth were third molars (66 %), followed by first molars (8 %), and second molars (7 %). The majority of claims were related to operative extraction (71 %) followed by ordinary extraction (17 %) and apicoectomy of a single-rooted tooth (7 %) or multi-rooted tooth (2 %). The most common diagnosis was injury of the lingual or inferior alveolar nerve. According to the authority’s decision, the patient received compensation more often in cases involving a third molar than other teeth (56 vs. 46 %, P < 0.05).


The removal of a mandibular third molar was the basis for the majority of malpractice claims.

Clinical relevance

To reduce the numbers of lingual and inferior alveolar nerve injuries, the removal of mandibular third molars necessitates recent and high-quality panoramic radiograph, preoperative assessment of the difficulty of removal, and consciousness of the variable anatomical course of the lingual nerve.

Tuesday, August 23, 2016

Does dentifrice use help to remove plaque? -A Systematic Review.

J Clin Periodontol. 2016 Aug 11. doi: 10.1111/jcpe.12615. [Epub ahead of print]



The aim of this systematic review was to establish the efficacy of brushing with and without a dentifrice for dental plaque removal.


MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched. The inclusion criteria were randomized controlled trials and controlled clinical trials and subjects ≥18years of age with good general health. Papers that evaluated the effect of toothbrushing with a dentifrice compared to brushing without a dentifrice were included. Data were extracted from the eligible studies, and a meta-analysis was performed where feasible.


The search was conducted until June 2016 and retrieved 10 eligible publications that included 20 comparisons. On average, 49,2% of plaque was removed when brushing was performed with a dentifrice, and 50.3% of plaque was removed when toothbrushing was performed without a dentifrice. The descriptive analysis indicated that the majority of the comparisons did not show an additional effect of dentifrice use. Regarding the meta-analysis of post-brushing scores, no significant difference was observed between toothbrushing with and without a dentifrice (DiffM 0.00, 95%CI [-0.05: 0.05],p=0.91). The meta-analysis of incremental data(as means or percentages) supported and strengthened these findings.


The cumulative evidence for this systematic review demonstrates, that there is moderate certainty that toothbrushing with a dentifrice does not provide an added effect for the mechanical removal of dental plaque. This article is protected by copyright. All rights reserved.

Friday, August 19, 2016

Dental Hygiene Thought Leader Debra Zafiropoulos, RDH Launches National Cancer Network

New Non-Profit’s Mission is to Reduce Mortality Rates of a Variety of Cancers via Earlier Detection by Vigilant Dental Professionals

Hobe Sound, FL – August 17, 2016 – Debra Zafiropoulos, RDH, a leading dental hygiene key opinion leader known for her tireless advocacy for the early detection of oral cancer is broadening her efforts to include other forms of cancer with the formation of the National Cancer Network, a non-profit 501 (c) (3) organization.

According to Zafiropoulos, commonly known as “Debbie Z”, “Dental professionals are the early warning system of the healthcare profession because we see our patients on an average of once a year and they spend a lot of time in our chairs. In addition to conducting a thorough oral exam, we can be paying closer attention to any abnormalities we notice on the patient’s skin or any complaints described in their patient history form such as persistent sore throat, cough, zone tingling or tenderness, etc.”

When something suspicious is discovered, Zafiropoulos says it is the responsibility of all dental professionals to integrate with other allied health professionals and make the appropriate qualified referrals sooner rather than later. “By taking the initiative to break down the silos between the various health care disciplines, we can significantly reduce the mortality rates of a wide variety of cancers.

Two of the cornerstones of the National Cancer Network are consumer awareness and professional training in the form of live patient screening events and professional training courses throughout the country.

What’s more, at the heart of NCN’s consumer and clinician awareness campaign is the introduction of a new exam protocol called “Screening for Oral and Skin Abnormalities” or SOSA™. 

The first event of this type is being held in conjunction with the First District Dental Hygiene Society component of the Tennessee Dental Hygiene Association on September 16th in Kingsport, TN. The event will be based around one of Debbie Z’s most popular lectures, “HPV: It’s Not the Hanky-Panky Virus the Media Says it Is”.

To learn more about this and other upcoming NCN events, visit http://nationalcancernetwork.org/hpv/. For more information on how you or your organization can support NCN, contact Debra Zafiropoulos at DebbieZ@NationalCancerNetwork.org.  Individual and corporate donations are can be made via PayPal at http://nationalcancernetwork.org/donate/

About the National Cancer Network:

The National Cancer Network is a non-profit 501 (c) (3) organization founded by dental hygiene thought leader and early cancer detection crusader Debra Zafiropoulos, RDH, widely known in the dental industry as Debbie Z. 

The mission of NCN is to raise awareness to prevent late stage diagnosis of all cancers through multiple platforms of prevention, protection, screening and referrals by creating a community of caring interdisciplinary professionals dedicated to disease prevention.

NationalCancerNetwork™.org was designed to be a membership website that is fully accessible with resources and information such as the latest screening, diagnostic, active therapy, disease management, and nutrition as well as spiritual and emotional support.

This information will generate a resource library and a more informed opportunity for you to reach out to a practitioner, organization or manufacturer to serve your specific needs. So whether you are a patient looking for a caring practitioner, a service provider looking to associate with an agency, or a caregiver seeking resources and solutions to assist those we love in fight of their life the National CancerNetwork™.org will be the resource to come to first!
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