Wednesday, July 23, 2014

Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains – a clinical trial

Int J Dent Hygiene DOI: 10.1111/idh.12090 Patil PA, Ankola AV, Hebbal MI, Patil AC. Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains – a clinical trial.



To compare the effectiveness of abrasive component (perlite/calcium carbonate) and enzymatic component (papain and bromelain) of whitening toothpaste in removal of extrinsic stains.


This study is a randomized, triple blind and parallel group study in which 90 subjects aged 18–40 years were included. At baseline, stains scores were assessed by Macpherson's modification of Lobene Stain Index and subjects were randomly assigned to two groups with 45 subjects in each. Group 1 used whitening toothpaste with enzymatic action and group 2 with abrasive action. After 1 month, stain scores were assessed for the effectiveness of the two toothpastes and 2 months later to check the stain prevention efficacy. Wilcoxson's test was used to compare between baseline 1 and 2 months stain scores, and Mann–Witney U-test was applied for intragroup comparison.


The mean baseline total stain score for the subjects allocated to the enzymatic toothpaste was 37.24 ± 2.11 which reduced to 30.77 ± 2.48 in 1 month, and for the abrasive paste, total stain reduced from 35.08 ± 2.96 to 32.89 ± 1.95. The reductions in total stain scores with both the pastes were significant compared with baseline stain scores (at 1 month Group 1, P = 0.0233 and Group 2, P = 0.0324; at 2 months, Group 1 P = 0.0356). Both the toothpastes proved to be equally good in removal of extrinsic stains; however, the enzymatic paste showed better results as compared to abrasive toothpaste.


Whitening toothpaste with abrasive action and enzymatic action are equally effective in removal of extrinsic stains; however, whitening toothpaste with abrasive action needs to be used with caution.

Monday, July 21, 2014

Sesame Communications Wins Prestigious 2014 Pride “Best of Class” Technology Award

SEATTLE, WA — July 22, 2014 — Sesame Communications, the leading provider of cloud-based solutions to help dental care providers accelerate new patient acquisition and build patient loyalty, is pleased to announce it has received a 2014 Pride “Best of Class” Technology Award. This milestone marks an unprecedented 4th win for Sesame in the past 6 years. This year the company was once again recognized for innovations surrounding its Sesame 24-7™ digital marketing and patient communications system.
“The Pride Institute ‘Best of Class’ Technology Awards are determined by a distinguished panel of industry leaders who both speak nationally and actively see patients,” said, Dr. Lou Shuman, President of Pride Institute. “For Sesame Communications, this 4th award is a testament to their commitment to continuous innovation and contribution to advancing the state-of-the-art in the areas of digital marketing and patient communications for dentistry.”
In the past year Sesame 24-7, the dental industry’s only end-to-end digital marketing and patient engagement system, introduced two ground breaking innovations to help dental practices expand growth and profitability:
·       Healthgrades Enhanced Profiles™ for Dentistry – is the most trafficked health portal in the United States with more than 225 million annual visitors per year. Healthgrades Enhanced Profiles, which are only available in the field of dentistry from Sesame, give practices a distinct competitive advantage for new patient acquisition through automatic publishing of post appointment patient reviews, featured provider placement and front page positioning of contact information. Other features include a tracked phone number, a click to request an appointment link and a practice website link.
·       Mobile Optimized Responsive Design – The world has gone mobile and practices that want to attract and engage patients need to optimize all their patient engagement technologies to all devices including desktops, smartphones and tablets. All Sesame websites and Patient Portals feature responsive design and provide an outstanding user experience for existing and prospective patients.
Practices using Sesame 24-7 routinely experience increased new patient flow, reduced no-show rates, higher production, and increased profitability.
“As technology continues to play an ever-increasing role in practice success, the Pride ‘Best of Class’ Technology Awards help dental practices better understand which companies are on the forefront of innovation with an objective, informed assessment of the best technologies in the industry,” said Diana P. Friedman, CEO of Sesame Communications. “We’re honored to receive this prestigious award for an unprecedented 4th time and gratified the industry recognizes the substantial investments we continue to make in our state-of-the-art technology.”
About Sesame Communications
Sesame Communications helps dental care providers harness the power of the Internet to accelerate new patient acquisition and transform the patient experience. The company supports thousands of practices in their efforts to grow and increase profitability in the digital age. The Sesame 24-7 platform provides an end-to-end, HIPAA-compliant system tailored to the unique and specific needs of dentistry.  An Inc. 500|5000 and Deloitte Technology Fast 500™ company, Sesame is recognized as one of the fastest growing technology companies in the United States. For more information about Sesame, visit

The ‘Sharpen’ filter improves the radiographic detection of vertical root fractures

Nascimento HAR, Ramos ACA, Neves FS, de-Azevedo-Vaz SL, Freitas DQ. The ‘Sharpen’ filter improves the radiographic detection of vertical root fractures. International Endodontic Journal.



To compare the diagnostic accuracy of digital enhancement filters in the diagnosis of vertical root fractures.


The sample consisted of 40 single-rooted teeth randomly divided into two groups: experimental and control. Vertical root fractures were induced in the experimental group using a universal testing machine. All teeth were individually radiographed with three different horizontal angles using the Digora Optime® digital system. Three observers separately examined the original and filtered images (3D Emboss, Negative, Sharpen and Shadow). The area under Receiver Operating Characteristic curve values (Az) for each protocol were compared by one-way anova with post hoc Bonferroni test. The significance level was set at 5%.


The highest Az value was obtained using the Sharpen filter, with significant differences from the original and other filtered images (P < 0.05). The 3D Emboss filter had the lowest Az value, which was significantly different from the other filtered images (P < 0.05).


When using the Digora Optime® system, the ‘Sharpen’ filter is recommended to improve the radiographic detection of vertical root fractures.

Friday, July 18, 2014

Optimal number of oral implants for fixed reconstructions: A review of the literature.

Eur J Oral Implantol. 2014 Summer;7(2):133-53.


Background and aim: So far there is little evidence from randomised clinical trials (RCT) or systematic reviews on the preferred or best number of implants to be used for the support of a fixed prosthesis in the edentulous maxilla or mandible, and no consensus has been reached. Therefore, we reviewed articles published in the past 30 years that reported on treatment outcomes for implant-supported fixed prostheses, including survival of implants and survival of prostheses after a minimum observation period of 1 year. Material and methods: MEDLINE and EMBASE were searched to identify eligible studies. Short and long-term clinical studies were included with prospective and retrospective study designs to see if relevant information could be obtained on the number of implants related to the prosthetic technique. Articles reporting on implant placement combined with advanced surgical techniques such as sinus floor elevation (SFE) or extensive grafting were excluded. Two reviewers extracted the data independently. Results: A primary search was broken down to 222 articles. Out of these, 29 studies comprising 26 datasets fulfilled the inclusion criteria. From all studies, the number of planned and placed implants was available. With two exceptions, no RCTs were found, and these two studies did not compare different numbers of implants per prosthesis. Eight studies were retrospective; all the others were prospective. Fourteen studies calculated cumulative survival rates for 5 and more years. From these data, the average survival rate was between 90% and 100%. The analysis of the selected articles revealed a clear tendency to plan 4 to 6 implants per prosthesis. For supporting a cross-arch fixed prosthesis in the maxilla, the variation is slightly greater. Conclusions: In spite of a dispersion of results, similar outcomes are reported with regard to survival and number of implants per jaw. Since the 1990s, it was proven that there is no need to install as many implants as possible in the available jawbone. The overwhelming majority of articles dealing with standard surgical procedures to rehabilitate edentulous jaws uses 4 to 6 implants. Conflict of interest statement: The authors declare that they have no conflict of interest.

Thursday, July 17, 2014

Immediately loaded distally cantilevered fixed mandibular prostheses supported by four implants placed in both in fresh extraction and healed sites: 2-year results from a prospective study.

Eur J Oral Implantol. 2014 Summer;7(2):173-84.


Objectives: To evaluate the outcome of immediately loaded distally cantilevered mandibular full-arch prostheses according to the 'all-on-four' concept supported by implants placed in both fresh extraction and healed sites. Material and methods: A prospective study was conducted in 24 patients with extraction of all remaining mandibular teeth and placement of 4 implants per patient (2 mesial axial and 2 distal tilted) for full-arch mandibular restorations. Implants were inserted in fresh extraction sockets 2.3 ± 1.0 per patient and 1.7 ± 1.0 implants in healed sites. Implants placed in fresh extraction sites (n = 55) were significantly (P <0 -0.14="" -0.18="" -0.20="" -0.40="" -0.57="" .01="" 0.20="" 0.28="" 0.29="" 0.35="" 0.36="" 0.42="" 0.45="" 0.48="" 0.4="" 0.51="" 0.55="" 0.5="" 0.6="" 0.7="" 0.8="" 0.92="" 1-="" 1.00="" 1.17="" 1.21="" 10="" 12-and="" 12="" 15="" 18="" 1st="" 2-year="" 24-month="" 24="" 2nd="" 3="" 4.6="" 4.7="" 5="" a="" acrylic="" after="" all="" alveolar="" an="" and="" assessed="" assessment.="" at="" be="" between="" bleeding="" bone="" both="" but="" by="" calculus="" camlog="" can="" compared="" conclusion:="" conduct="" conflict="" crest:="" deeply="" definite="" dental="" depth="" differences="" efforts="" evaluated="" evaluation="" examinations="" extraction="" failed="" five="" fixed="" follow-up="" for="" foundation="" four="" fracture="" fractures="" framework.="" fresh="" from="" full-arch="" gerald="" gingival="" grant="" had="" healed="" high="" higher="" immediate="" immediately="" implant-supported="" implant="" implants="" in="" indices="" inserted="" interest="" into="" items="" krennmair="" later="" level="" limits="" loaded="" maintenance="" marginal="" metal="" mm="" months="" more="" n="41)" need="" no="" of="" p="" patient="" patients="" peri-implant="" placed="" plaque="" pocket="" post-extractive="" presented="" prof="" prostheses.="" prostheses="" prosthesis="" prosthodontic="" provisional="" rating="" rebased.="" received="" renewed="" repaired="" representing="" research.="" resin="" results:="" satisfaction.="" satisfaction="" score:="" score="" significantly="" simultaneously="" sites.="" sites="" st="" stable.="" statement:="" study="" subjective="" success="" supported="" teeth="" than="" the="" there="" this="" to="" veneered="" versus="" vs="" was="" were="" with="" within="" year:="" year="">

Wednesday, July 16, 2014

Pride Technology 2014 Award Winners

As a member of the the panel who helps select the award winners. I present to you the 2014 Pride Technology Award winners. Head on over to the DPR web site to see the list.

Tuesday, July 15, 2014

Prophylactic antibiotic regimen and dental implant failure: a meta-analysis

Chrcanovic, B. R., Albrektsson, T. and Wennerberg, A. (2014), Prophylactic antibiotic regimen and dental implant failure: a meta-analysis. Journal of Oral Rehabilitation. doi: 10.1111/joor.12211


The aim of this meta-analysis was to investigate whether there are any positive effects of prophylactic antibiotic regimen on implant failure rates and post-operative infection when performing dental implant treatment in healthy individuals. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomised or not. The search strategy resulted in 14 publications. The I2 statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used with a fixed- or random-effects model, depending on the heterogeneity. The estimates of relative effect were expressed in risk ratio (RR) with 95% confidence interval. Six studies were judged to be at high risk of bias, whereas one study was considered at moderate risk, and six studies were considered at low risk of bias. The test for overall effect showed that the difference between the procedures (use versus non-use of antibiotics) significantly affected the implant failure rates (= 0·0002), with a RR of 0·55 (95% CI 0·41–0·75). The number needed to treat (NNT) to prevent one patient having an implant failure was 50 (95% CI 33–100). There were no apparent significant effects of prophylactic antibiotics on the occurrence of post-operative infections in healthy patients receiving implants (= 0·520). A sensitivity analysis did not reveal difference when studies judged as having high risk of bias were not considered. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.

Monday, July 14, 2014

In vitro assessment of artifacts induced by titanium, titanium–zirconium and zirconium dioxide implants in cone-beam computed tomography

Sancho-Puchades M, Hämmerle CHF, Benic GI. In vitro assessment of artifacts induced by titanium, titanium–zirconium and zirconium dioxide implants in cone-beam computed tomography. Clin. Oral Impl. Res. 00, 2014; 17. doi: 10.1111/clr.12438




The aim of this study was to test whether or not the intensity of artifacts around implants in cone-beam computed tomography (CBCT) differs between titanium, titanium–zirconium and zirconium dioxide implants.

Materials and methods

Twenty models of a human mandible, each containing one implant in the single-tooth gap position 45, were cast in dental stone. Five test models were produced for each of the following implant types: titanium 4.1 mm diameter (Ti4.1), titanium 3.3 mm diameter (Ti3.3), titanium–zirconium 3.3 mm diameter (TiZr3.3) and zirconium dioxide 3.5–4.5 mm diameter (ZrO3.5–4.5) implants. For control purposes, three models without implants were produced. Each model was scanned using a CBCT device. Gray values (GV) were recorded at eight circumferential positions around the implants at 0.5 mm, 1 mm and 2 mm from the implant surface (GVTest). GV were assessed in the corresponding volumes of interest (VOI) in the control models without implants (GVControl). Differences of gray values (ΔGV) between GVTest and GVControl were calculated as percentages. One-way ANOVA and post hoc tests were applied to detect differences between implant types.


Mean ΔGV for ZrO3.5–4.5 presented the highest absolute values, generally followed by TiZr3.3, Ti4.1 and Ti3.3 implants. The differences of ΔGV between ZrO3.5–4.5 and the remaining groups were statistically significant in the majority of the VOI (P ≤ 0.0167). ΔGV for TiZr3.3, Ti4.1 and Ti3.3 implants did not differ significantly in the most VOI. For all implant types, ΔGV showed positive values buccally, mesio-buccally, lingually and disto-lingually, whereas negative values were detected mesially and distally.


Zirconium dioxide implants generate significantly more artifacts as compared to titanium and titanium–zirconium implants. The intensity of artifacts around zirconium dioxide implants exhibited in average the threefold in comparison with titanium implants.