A Prospective Study of Clinical Outcomes Related to Third Molar Removal or Retention.

Am J Public Health. 2014 Feb 13. [Epub ahead of print]

Abstract

Objectives. We investigated outcomes of third molar removal or retention in adolescents and young adults. Methods. We recruited patients aged 16 to 22 years from a dental practice-based research network in the Pacific Northwest from May 2009 through September 2010 who had at least 1 third molar present and had never undergone third molar removal. Data were acquired via questionnaire and clinical examination at baseline, periodic online questionnaires, and clinical examination at 24 months. Results. A total of 801 patients participated. Among patients undergoing third molar removal, rates of paresthesia and jaw joint symptoms lasting more than 1 month were 6.3 and 34.3 per 100 person-years, respectively. Among patients not undergoing removal, corresponding rates were 0.7 and 8.8. Periodontal attachment loss at distal sites of second molars did not significantly differ by third molar removal status. Incident caries at the distal surfaces of second molars occurred in fewer than 1% of all sites. Conclusions. Rates of paresthesia and temporomandibular joint disorder were higher after third molar removal. Periodontal attachment loss and incident caries at the distal sites of second molars were not affected by extraction status. (Am J Public Health. Published online ahead of print February 13, 2014: e1-e7. doi:10.2105/AJPH.2013.301649).

AMERICAN ACADEMY OF PERIODONTOLOGY TO HOST ANNUAL SPRING CONFERENCE IN CHICAGO

Registration now open for “The Perio-Restorative Partnership: A Roadmap to Clinical Success”

Chicago, IL – March X, 2014 —The American Academy of Periodontology (AAP) will host its annual Spring Conference with the 2014 theme, “The Perio-Restorative Partnership: A Roadmap to Success,” at the Hilton Chicago from April 26 - April 27, 2014. Attendee registration is open, and all members of the dental team are encouraged to register to learn about the latest advancements and techniques in collaborative care while networking with peers.

According to AAP President Stuart J. Froum, DDS, attending the 2014 Spring Conference brings value to all dental professionals. “The Academy has secured leading experts in the field to provide nearly 10 hours of real-world, relevant clinical information to help us work together more efficiently and make our practices more successful,” said Dr. Froum. 

The two-day educational and interactive conference covers a variety of topics that promote professional growth and guide clinicians in providing the best possible periodontal care while also giving attendees the opportunity to earn continuing education (CE) credits.

Lecture topics include:

·       Periodontal and Implant Therapy

·       Periodontitis Risk-Assessment

·       Perio-Systemic Relationships

·       Predictable Esthetic Results

·       Techniques for Implant-Supported Restorations

“This year’s Spring Conference, encouraging the practice of collaborative care, offers a unique experience for many dental professionals to team-up in an educational and social setting that enables clinicians to engage in new, exciting ways,” says Froum. “The best in periodontal education combined with the diverse sights and sounds of Chicago make this a must-attend event!”

The American Academy of Periodontology would like to thank Henry Schein for their generous support of the 2014 Spring Conference.

To register or for more information visit: http://www.perio.org/meetings/sc14.htm, call 800-282-4867 x3213, or email meetings@perio.org.

About the American Academy of Periodontology:

The American Academy of Periodontology (AAP) is the professional organization for periodontists – specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,300 members worldwide.

NOTE: Members of the media are encouraged to attend the 2014 AAP Spring Conference. Media representatives must be currently employed by an established news outlet and must provide appropriate identification before being issued a press pass.

For more information or to obtain an application for press credentials, contact the Academy’s Public Affairs Department at 312-573-3243 or mame@perio.org.

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Byproducts of bacteria-causing gum disease incite oral cancer growth, study shows

X. Yu, A.-M. Shahir, J. Sha, Z. Feng, B. Eapen, S. Nithianantham, B. Das, J. Karn, A. Weinberg, N. F. Bissada, F. Ye. Short Chain Fatty Acids From Periodontal Pathogens Suppress HDACs, EZH2, and SUV39H1 to Promote Kaposi's Sarcoma-Associated Herpesvirus Replication. Journal of Virology, 2014; DOI: 10.1128/JVI.03326-13

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Researchers from Case Western Reserve University have discovered how byproducts in the form of small fatty acids from two bacteria prevalent in gum disease incite the growth of deadly Kaposi's sarcoma-related (KS) lesions and tumors in the mouth.

The discovery could lead to early saliva testing for the bacteria, which, if found, could be treated and monitored for signs of cancer and before it develops into a malignancy, researchers say.
"These new findings provide one of the first looks at how the periodontal bacteria create a unique microenvironment in the oral cavity that contributes to the replication the Kaposi's sarcoma Herpesvirus (KSHV) and development of KS," said Fengchun Ye, the study's lead investigator from Case Western Reserve School of Dental Medicine's Department of Biological Sciences.
The discovery is described in The Journal of Virology article, "Short Chain Fatty Acids from Periodontal Pathogens Suppress HDACs, EZH2, and SUV39H1 to Promote Kaposi's Sarcoma-Associated Herpesvirus Replication."
The research focuses on how the bacteria, Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn), which are associated with gum disease, contribute to cancer formation.
Ye said high levels of these bacteria are found in the saliva of people with periodontal disease, and at lower levels in those with good oral health -- further evidence of the link between oral and overall physical health.
KS impacts a significant number of people with HIV, whose immune systems lack the ability to fight off the herpesvirus and other infections, he said.
"These individual are susceptible to the cancer," Ye said.
KS first appears as lesions on the surface of the mouth that, if not removed, can grow into malignant tumors. Survival rates are higher when detected and treated early in the lesion state than when a malignancy develops.
Also at risk are people with compromised immune systems: people on medications to suppress rejection of transplants, cancer patients on chemotherapies and the elderly population whose immune systems naturally weaken with age.
The researchers wanted to learn why most people never develop this form of cancer and what it is that protects them.
The researchers recruited 21 patients, dividing them into two groups. All participants were given standard gum-disease tests.
The first group of 11 participants had an average age of 50 and had severe chronic gum disease. The second group of 10 participants, whose average age was about 26, had healthy gums, practiced good oral health and showed no signs of bleeding or tooth loss from periodontal disease.
The researchers also studied a saliva sample from each. Part of the saliva sample was separated into its components using a spinning centrifuge. The remaining saliva was used for DNA testing to track and identify bacteria present, and at what levels.
The researchers were interested in Pg's and Fn's byproducts of lipopolysaccharide, fimbriae, proteinases and at least five different short-chain fatty acids (SCFA): butyric acid, isobutryic acid, isovaleric acid, propionic acid and acetic acid.
After initially testing the byproducts, the researchers suspected that the fatty acids were involved in replicating KSHV. The researchers cleansed the fatty acids and then introduced them to cells with quiescent KSHV virus in a petri dish for monitoring the virus' reaction.
After introducing SCFA, the virus began to replicate. But the researchers saw that, while the fatty acids allowed the virus to multiple, the process also set in motion a cascade of actions that also inhibited molecules in the body's immune system from stopping the growth of KSHV.
"The most important thing to come out of this study is that we believe periodontal disease is a risk factor for Kaposi sarcoma tumor in HIV patients," Ye said.
With that knowledge, Ye said those with HIV must be informed about the importance of good oral health and the possible consequences of overlooking that area.

Introducing 3M™ True Definition Software 4.2

Latest version of 3M True Definition Software continues to advance the overall scanning experience

ST. PAUL, Minn. – (March 5, 2014) – 3M ESPE continues to advance the overall scanning experience of the 3M True Definition Scanner with its latest 4.2 software upgrade. This upgrade improves the ease of rotation when scanning over incisal edges and streamlines the installation process for chairside connections. The 3M True Definition Scanner allows dentists the flexibility to practice the way they want, using the digital workflows that they choose. This one device gives dentists unlimited options, with access to the broadest array of Open and Trusted Connections.

The upgrade will be available to all 3M True Definition Scanners and is another example of 3M’s commitment to continuously improve the user experience and offer the greatest value possible with its affordable monthly data plans.

“The newest software update for the 3M True Definition Scanner has definitely reduced the time it takes to complete a scan,” said Dr. Joseph Fox of Fox Family Dental in Sun City, Ariz.

“Our customers are pleased to see 3M providing continuous technology improvements without additional upgrade costs,” said David Frazee, VP and GM of 3M Digital Oral Care. “With 3M’s model, it is easy to get started now with something that is proven, and still be well positioned for future improvements.” 

The 3M True Definition Scanner continues to be more accurate—and more consistently accurate—than leading systems on the market¹. The outstanding accuracy leads to reduced seating times and has been clinically proven in thousands of cases in the past 12 months, with a fit rate of 99.7%². 

For more information about the 3M True Definition Scanner, visit www.3M.com/TrueDef.

Impact of digital impression techniques on the adaption of ceramic partial crowns in vitro

Journal of Dentistry

Available online 6 February 2014

Abstract

Objectives

To investigate the effects digital impression procedures can have on the three-dimensional fit of ceramic partial crowns in vitro.

Methods

An acrylic model of a mandibular first molar was prepared to receive a partial coverage all-ceramic crown (mesio-occlusal-distal inlay preparation with reduction of all cusps and rounded shoulder finish line of buccal wall). Digital impressions were taken using iTero (ITE), cara TRIOS (TRI), CEREC AC with Bluecam (CBC), and Lava COS (COS) systems, before restorations were designed and machined from lithium disilicate blanks. Both the preparation and the restorations were digitized using an optical reference-scanner. Data were entered into quality inspection software, which superimposed the records (best-fit-algorithm), calculated fit-discrepancies for every pixel, and colour-coded the results to aid visualization. Furthermore, mean quadratic deviations (RMS) were computed and analysed statistically with a 1-way ANOVA. Scheffé’s procedure was applied for multiple comparisons (n = 5, α=0.05).

Results

Mean marginal (internal) discrepancies were: ITE 90 (92) μm, TRI 128 (106) μm, CBC 146 (84) μm, and COS 109 (93) μm. Differences among impression systems were statistically significant at p < 0.001 (p = 0.039). Qualitatively, partial crowns were undersized especially around cusp tips or the occluso-approximal isthmus. By contrast, potential high-spots could be detected along the preparation finishline and at central occlusal boxes.

Conclusions

Marginal and internal fit of milled lithium disilicate partial crowns depended on the employed digital impression technique.

Clinical Significance. The investigated digital impression procedures demonstrated significant fit discrepancies. However, all fabricated restorations showed acceptable marginal and int

Effect of cariogenic challenge on the stability of dentin bonds

J. Appl. Oral Sci. vol.22 no.1 Bauru Jan./Feb. 2014

http://dx.doi.org/10.1590/1678-775720130011 

ABSTRACT

Objective:

The oral environment is subject to biofilm accumulation and cariogenic challenge, and few studies exist on the effect of these factors on the bond strength of adhesive systems. The aim of this study was to test if the exposure of adhesive interfaces to cariogenic challenge under biofilm accumulation could promote higher degradation than the exposure to biofilm accumulation alone.

Material And Methods:

Five molars were ground until exposure of medium dentin and then restored (Single Bond 2 and Z250 3M ESPE). The tooth/resin sets were cut to obtain beam-shaped specimens, which were distributed according to the aging conditions (n=20): water for 24 h (control); biofilm under cariogenic challenge for 3, 5 or 10 days; biofilm without cariogenic challenge for 10 days; and water for 3 months. Microcosm biofilms were formed from human saliva and grown in a saliva analogue medium, supplemented or not with sucrose to promote cariogenic challenge. Specimens were tested for microtensile bond strength, and failure modes were classified using light microscopy. Bond strength data were analyzed using ANOVA and failure modes were analyzed using ANOVA on ranks (α=0.05).

Results:

No significant differences in bond strength were detected among the aging methods (P=0.248). The aging period was associated with an increase in the frequency of adhesive failures for the groups aged for 10 days or longer (P<0 .001="" p="">

Conclusion:

Aging leads to a higher prevalence of interfacial adhesive failures, although this effect is not associated with cariogenic challenge or reduction in bond strengths.

Another piece to the Chartless/Paperless Dental Office

We have been doing the scan and shred technique for patient intake forms since we went chartless many years ago. There have been solutions to filling out forms online but none seemed to be the right fit. We have been struggling to get to the next step due to some limitations and have had things setup for a while but just never set a start date, mostly because we are comfortable in what we were doing. We needed to break through to the next level.

One problem was that we would need multiple tablet computers and everyone agreed that typing on a tablet is not easy when having to fill out multi page forms.  So instead of spending lots of money on iPads (which we did beta test),





 I decided to try a Google Chromebook. A Chromebook runs Googles Chrome OS. If any of you use Chrome as your browser you will be right at home. The Chromebook connects to the Internet via WiFi and looks and feels like a very lightweight laptop computer with a keyboard.

 

The Chromebook cost me under $200 on sale and I can deploy two of them for the price of an iPad along with the convenience of a keyboard. Looking forward to reducing the paper use along with time spent shredding!

Pulpdent Launches ACTIVA™ Bioactive Restorative and Base/Liner

Breakthrough bioactive materials partner with teeth and saliva to enhance dental health

WATERTOWN, MASSACHUSETTS February 20, 2014 —Dental professionals have become accustomed to seeing bold claims made on behalf of dozens of new dental products each year, yet few if any of those products end up living up to their promises or making a meaningful impact on the practice of dentistry. Every so often, however, a new product line truly deserves to be called a “breakthrough.” ACTIVA restorative and base/liner, which were launched today by Pulpdent Corporation at the Chicago Dental Society Midwinter Meeting, are one such product line.

Up until now, the materials available to dental professionals for restoring a tooth have done little more than plug a hole. Amalgam, composite and glass ionomer restoratives have had little in common with the tooth structure they replaced other than the shape and perhaps the color. Now ACTIVA bioactive restorative makes it possible to create restorations that actively release and exchange calcium, phosphate and fluoride ions while being dynamic with the function of the tooth.

Not only that, this new bioactive restorative:

• Delivers amazingly life-like aesthetics.
• Functions like real tooth structure by absorbing and dispersing forces to deliver exceptional strength.
• Seals with unmatched marginal integrity.
• Requires no bonding agents.
• Contains no Bisphenol A, no Bis-GMA and no BPA derivatives.

“ACTIVA isn't merely an incremental improvement over the status quo,” said Ken Berk, Pulpdent president. “It’s a true breakthrough that should, and we think will, change the future of dentistry.”

The key to performance of ACTIVA products is the fact that they are formulated with a bioactive resin matrix and bioactive fillers. In fact, ACTIVA is the only product the U.S. Food & Drug Administration has allowed to make this claim, which means that ACTIVA represents an entirely new category of bioactive dental products.

ACTIVA combines all the benefits of composites and glass inomers while eliminating the disadvantages associated with those materials. ACTIVA BioACTIVE-Restorative combines the esthetics, strength and resilience of composites with bioactive properties and fluoride release that are superior to glass ionomers. ACTIVA BioACTIVE-Base/Liner has greater fluoride release and bioactive properties than glass ionomers in a strong, resilient resin matrix that will not chip or crumble. It adheres to dentin and does not require etching or bonding agents. 1,2,3,4,5,6

ACTIVA products are also the first bioactive dental materials with an ionic resin matrix, a shock-absorbing resin component, and bioactive fillers that mimic the physical and chemical properties of natural teeth. They are durable and wear- and fracture-resistant, chemically bond to teeth, seal against bacterial microleakage, and release and recharge calcium, phosphate and fluoride ions with the surrounding teeth.

For more information about ACTIVA products, please visit www.activabioactive.com.

References

1. Fluoride ion release and recharge over time in three restoratives. University testing. Accepted for publication. Accepted for publication AADR 2014.
2. Zmener O, Pameijer CH, Hernandez S. Resistance against bacterial leakage of four luting agents used for cementation of complete cast crowns. Accepted for publication Am J Dent.
3. Zmener O, Pameijer CHH, et al. Marginal bacterial leakage in class I cavities filled with a new resin-modified glass ionomer restorative material. 2013.
4. Flexural strength and fatigue of new Activa RMGIs. University testing. Accepted for publication. Accepted for publication AADR 2014.
5. Deflection at break of restorative materials. University testing. Submitted for publication.
6. Comparison of Mechanical Properties of Dental Restorative Material. University testing. Accepted for publication. AADR 2014.