Thursday, June 30, 2011

Summertime Memories of Camp and Dental Trauma

Here is an nice editorial on summertime dental trauma on the Dental Geek Blog.
Go take a look even if I am biased about the author.

Wednesday, June 29, 2011

ADA Comment On AAPHD Dental Therapist Curriculum Development

Lawmakers, charitable organizations and other stakeholders-some of them with very little experience in or understanding of oral health care-are proposing various models for so-called "midlevel" dental providers, non-dentists who would perform surgical/irreversible procedures. To date there has been no consensus on the specific prerequisites, scope or duration of educational program, or other critical attributes needed to define any academic model.

The American Association of Public Health Dentistry recently published a series of papers that seek to clarify that by describing a recommended curriculum for the training of dental therapists. While we appreciate the work that went into this, we disagree on a critical point: The ADA does not believe a non-dentist should perform surgical/irreversible procedures.

The ADA supports innovations in the dental team that would improve oral health among people who lack adequate access to care, provided that those innovations do not compromise the very system they seek to extend. Our own Community Dental Health Coordinator pilot project seeks to do that by training community health workers who specialize in oral health education and disease prevention, factors that ultimately are the nation's best hope of ending what we all agree are unacceptable levels of oral disease.

The majority of dentists who belong to the American Association of Public Health Dentistry are also members of the ADA; they provide valued perspective and resources to our advocacy on behalf of the nation's oral health. The ADA historically has been among their greatest supporters and advocates, and we will continue to be so. We will continue to work with the AAPHD and all interested stakeholders toward the goal we all share-a healthier more productive nation. But in doing so, the Association will not erode its unequivocal opposition to non-dentists performing surgical/irreversible procedures, or to other proposals that we believe run contrary to the public good.

Source:
American Dental Association

Tuesday, June 28, 2011

Programs May Prevent Tooth Decay In Tots

A toddler's tiny teeth are destined to fall out in later years as their permanent pearly whites grow in. But for some children, especially those from low-income families, cavities and poor oral health lead to complicated dental problems long before they even graduate from their cribs.

Programs designed to incorporate tooth decay prevention as part of a child's regular checkup with the doctor could be a big step toward improving infants' and toddlers' dental health, say University of Florida researchers, who received a $293,000 grant from the National Institutes of Health to study whether such programs in Florida and Texas are actually improving dental care in young children enrolled in Medicaid.

The American Academy of Pediatrics, the American Dental Association and the American Academy of Pediatric Dentistry recommend children visit the dentist for the first time by age 1, but many children do not receive preventive dental care until they are much older, if at all, said UF health economist Jill Boylston Herndon, Ph.D., the principal investigator on the two-year grant.

"There is also this attitude that baby teeth are not that important," said Frank Catalanotto, D.M.D., a professor of pediatric dentistry in the College of Dentistry who advocated for Florida to establish a program targeting early childhood caries. "But the reality is getting a cavity in a baby tooth can lead to an infection. And, in fact, several children have died over the last several years in this country of an untreated dental infection.

"The tragedy of this is that it is relatively easy to prevent early childhood caries with some simple measures of just toothbrushing using a fluoridated toothpaste, not putting a baby to bed with a bottle, and a dental visit with an application of a fluoride varnish," added Catalanotto, a co-investigator on the grant.

In 2008, Florida and Texas adopted policies to reimburse pediatricians for providing preventive services to young children receiving Medicaid and dental education for their parents. As part of a child's regular checkup, pediatricians provide dental education to parents about proper toothbrushing and oral care and apply a fluoride varnish to children's teeth. The doctors then refer the parents and child to a dentist.

"The research tells us that if they get these preventive services, they are less likely to have problems later," said Herndon, a research associate professor of health outcomes and policy in the College of Medicine. "In addition to reducing caries in their primary teeth, they are less likely to have caries in their permanent teeth when they are older."

Dental caries is the most prevalent disease in young children, affecting more than one-fourth of kids between 2 and 5, according to the Centers for Disease Control and Prevention. By their teen years, two-thirds of children from low-income homes have suffered tooth decay. Dentists can spot the first signs of caries and prevent cavities from forming, said Joel Berg, D.D.S., chairman of pediatric dentistry at the University of Washington and president-elect of the American Academy of Pediatric Dentistry. With training, pediatricians can spot these signs, too, Berg added.

At home, parents should aim for brushing their infant or toddler's teeth twice a day, or at least once before bed with a lentil-sized amount of fluoridated toothpaste. Although it is a common belief that parents should not use toothpaste with fluoride in children under 2, Catalanotto says this is a myth experts are trying to dispel.

"It's not a matter of if a child should use fluoride but how much," said Berg, who is not involved with the study. "With fluoride, it is important to have frequent exposure to small amounts."

Of course, a lack of parental understanding about oral care is not the only issue affecting children's teeth. There are few dentists who accept Medicaid and even fewer who will see very young patients, particularly those with dental problems, Catalanotto said. To address cavities and other problems, small children must frequently be put under sedation or admitted to a hospital and placed under general anesthesia.

"Getting some simple, inexpensive preventive procedures can cut a lot of dental costs down the line and prevent some big medical costs," Catalanotto said.

Including Florida, 33 states have established programs to involve pediatricians in dental prevention, but there is limited evidence about how well these programs actually work to improve oral health for small children, Herndon said.

As part of their study, UF researchers from the colleges of Medicine and Dentistry and the Institute of Child Health Policy will examine whether children who receive preventive dental services from pediatricians are more likely to subsequently see a dentist. They will also look at geographic and population differences to see which children are receiving services and where there are unmet needs, Herndon said.

Other researchers involved in the study include Scott Tomar, D.M.D., Dr.Ph., a professor of community dentistry in the College of Dentistry; and Elizabeth Shenkman, Ph.D., director of the Institute for Child Health Policy and chair of health outcomes and policy in the College of Medicine.

Source:
University of Florida Health Science Center

Monday, June 27, 2011

Healing Times For Dental Implants Could Be Cut

The technology used to replace lost teeth with titanium dental implants could be improved. By studying the surface structure of dental implants not only at micro level but also at nano level, researchers at the University of Gothenburg; Sweden, have come up with a method that could shorten the healing time for patients.

"Increasing the active surface at nano level and changing the conductivity of the implant allows us to affect the body's own biomechanics and speed up the healing of the implant," says Johanna Löberg at the University of Gothenburg's Department of Chemistry. "This would reduce the discomfort for patients and makes for a better quality of life during the healing process."

Dental implants have been used to replace lost teeth for more than 40 years now. Per-Ingvar Brånemark, who was recently awarded the prestigious European Inventor Award, was the first person to realise that titanium was very body-friendly and could be implanted into bone without being rejected. Titanium is covered with a thin layer of naturally formed oxide and it is this oxide's properties that determine how well an implant fuses with the bone.

It became clear at an early point that a rough surface was better than a smooth one, and the surface of today's implants is often characterised by different levels of roughness, from the thread to the superimposed nanostructures. Anchoring the implant in the bone exerts a mechanical influence on the bone tissue known as biomechanical stimulation, and this facilitates the formation of new bone. As the topography (roughness) of the surface is important for the formation of new bone, it is essential to be able to measure and describe the surface appearance in detail. But roughness is not the only property that affects healing.

Johanna Löberg has come up with a method that describes the implant's topography from micrometre to nanometre scale and allows theoretical estimations of anchoring in the bone by different surface topographies. The method can be used in the development of new dental implants to optimise the properties for increased bone formation and healing. She has also studied the oxide's conductivity, and the results show that a slightly higher conductivity results in a better cell response and earlier deposition of minerals that are important for bone formation.

The results are in line with animal studies and clinical trials of the commercial implant OsseoSpeed (Astra Tech AB), which show a slightly higher conductivity for the oxide and also an exchange between hydroxide and fluoride on the surface of the oxide. Surfaces with a well-defined nanostructure have a larger active area and respond quickly to the deposition of bone-forming minerals.

The project is a collaboration between the University of Gothenburg and Astra Tech AB in Mölndal, and will be further evaluated in follow-up studies.

The thesis Integrated Biomechanical, Electronic and Topographic Characterization of Titanium Dental Implants was successfully defended at the University of Gothenburg.

Sources: University of Gothenburg, AlphaGalileo Foundation.

Saturday, June 25, 2011

Dental Treatment May Help Prevent Obstructive Sleep Apnea In Children

According to new research that was presented Saturday, June 11, at the 20th Anniversary Meeting of the American Academy of Dental Sleep Medicine (AADSM), children with enlarged tonsils and adenoids who wore an oral appliance for six months experienced more favorable craniofacial growth, enlargement of pharyngeal dimensions, and improved breathing and snoring during sleep.

Enlarged tonsils and dental malocclusion have a strong relation with sleep disturbance in children. Its consequences can include abnormalities of craniofacial growth and facial morphology more suitable to the development of obstructive sleep apnea (OSA).

Forty children from the waiting list for adenotonsillectomy at the ENT Department of the University of São Paulo Medical School were included in the study. The children ranged from 6 to 9 years of age. All of them presented snoring, tonsil and adenoid enlargement grades III and IV, and dental malocclusion (constricted maxilla and/or jaw deficiency). Patients were divided into two randomized groups: 24 patients were treated with the Bioajusta X dental appliance and 16 were controls.

The researchers evaluated the craniofacial growth in children with enlarged tonsils and adenoids, after dental appliance (Bioajusta X) treatment. They also compared the prevalence of snoring before and after treatment.

"The primary finding of the study was the positive influence of this treatment on snoring in children with enlarged tonsils and adenoids and narrow maxillary arch," said principal investigator Walter R. Nunes Jr., DDS, MS, who is affiliated with the Otolaryngology Department of the University of São Paulo Medical School in Brazil.

"This method of treatment acted on the normalization of the respiratory function and sleep, which reflected positively on the quality of life of those children and their families, and also resulted in a better pattern of craniofacial growth," said Nunes. "This normalization on the growth pattern may possibly reduce the incidence of obstructive sleep apnea in the future."

Cephalometric analysis was used to access the growth direction comparing the vertical jaw relationship according to the angle of the palatal plane with the mandibular plane (ANS-PNS / ML). The parents filled out a questionnaire about respiratory symptoms. They were re-evaluated and compared after six months.

Cephalometry showed in the treated group a reduction on the palatal x mandibular angle of - 2,75 º : Media at T1 = 30.08 º (sd 3.8) ; Media at T2 = 27.33 º (sd 3.4) and an increase of this measurement in the untreated group of +1,25 º : Media at T1 = 28.38 º (sd 3.8) ; Media at T2 = 29.60 º (sd 3.5) at the untreated (p<0.001).

This abstract received the Graduate Student Research Award at the AADSM 20th Anniversary Meeting.

Abstract Title: SNORING CHILDREN TREATMENT WITH ORTHODONTIC AND ORTHOPEDIC APPLIANCE - RANDOMIZED CLINICAL TRIAL
Presentation Date: Saturday, June 11, 2011
Category: Graduate Student Research Award
Abstract ID: 009

Source:
Emilee McStay
American Academy of Sleep Medicine

Friday, June 24, 2011

PeriZone™, a New Oral Healthcare Product Line, and Debuts PerioPatch®, Oral Wound Relief Barrier

Fair Lawn, NJ (June 16, 2011) – MIS Implants Technologies, Ltd., a leading manufacturer of dental implants and superstructures, launched a new oral care products brand named PeriZone™, along with its first product, a unique topical patch created to absorb wound exudates, called PerioPatch®.
The development of PeriZone™ and the division’s overall business strategy are the primary responsibility of three key MIS Implants executives:
• Motti Weisman, MIS Implants Technologies, Inc. (USA), CEO – Motti was raised in northern Israel, which is where he first became affiliated with MIS Implants in 1996. He launched the MIS distributorship in Israel in 1998, which is currently the market leader in dental implant sales in that country. Following sustained success there, he chose to bring the company to the U.S., where he started MIS USA in 2003. Both businesses have seen continued strong growth, and he is honored to be bringing non-implant products to the dental industry under the MIS and PeriZone™ names.

• Gil Ishai, MIS Implants Technologies, Ltd. (Israel) Brand Manager – PeriZone™ –
Gil joined MIS Implants Technologies, Ltd. in the autumn of 2010, with extensive marketing and sales experience. As Brand Manager, Gil is responsible for current
and future launches, as well as leading the business of the brand and the products under it across all the countries in which MIS implants has representation. Prior to joining MIS, Gil worked for P&G, first as a regional customer manager, and then as a product manager. Gil feels proud to be a part of the first non-implant brand under
MIS, PeriZone™.

• Noel E. Wilford, RDH, MIS Implants Technologies, Inc. (USA), Director – Oral Health Division – Noel has been involved in dentistry her entire professional career. She is a graduate of the Forsyth School for Dental Hygienists and the University of Connecticut. As a clinician, she spent the majority of her time in a periodontal practice, although she has also been employed in general dentistry and prosthodontic practices. The corporate side of her career began when she joined CollaGenex Pharmaceuticals as a salesperson for the launch of Periostat®. She was selected to be a regional trainer and worked in that capacity at both regional and national sales meetings, in addition to training new reps in her territory. Noel joined MIS Implants four years ago. Here, she has worked with product-specific reps and in human resources, as well as taking on the role of Director of the Oral Health Division, which is now launching the PeriZone™ brand with its first product, PerioPatch®.
According to Noel Wilford, Director – Oral Health Division at MIS Implants, “For some time now, we’ve been exploring opportunities to expand our specialties beyond dental implant technologies and into the oral health sector. PerioPatch® incorporates breakthrough technology, and represents the first step toward our vision of establishing PeriZone™ as a leader in advanced oral health products.”
PeriZone™ PerioPatch® is ideal for patients with inflamed or irritated gums, wounds, injuries, and ulcerations, whether they are naturally occurring, or as the result of braces, dentures, or
dental procedures.
The patch forms a protective seal over the affected gingiva and oral mucosa, providing relief from pain while promoting natural healing. By gently but securely adhering to the gums, the patch also protects from further irritation that may be caused by eating or drinking.
“PeriZone™’s mission is to provide dental professionals and patients with state-of-the-art oral healthcare products that are unparalleled in their quality and performance and to deliver oral health solutions that dental professionals can use to treat their patients with the most advanced care possible,” explained Wilford.
About the Company:
MIS Implants Technologies, Ltd., headquartered in Israel, was founded in 1995 and has served as a leading high-tech research and dental implant production company for many years. The company spans the globe, with distribution in almost 70 countries worldwide, and specializes in the complete cycle of production – including the design, development, manufacturing, and marketing of an advanced comprehensive range of dental implants, superstructures, surgical kits, and tools, as well as the newly developed line of oral health products. MIS has been committed to providing the dental community with significant research and top-of-the-line products that continually keep their customers smiling.
The 2011 launch of PeriZone™, a division of MIS Implants, reflects this same commitment
to dental professionals and consumers worldwide. The oral health division’s goal is to
provide dental professionals with superior, innovative products to ensure the greatest
level of patient care.

Thursday, June 23, 2011

New Improved Sylc Prophy Therapy SmarTips

OSspray, Inc. is pleased to announce the newly improved Sylc™ Prophy Therapy
with SmarTip Technology System that delivers consistent performance and
increased ergonomics.

Available in June 2011, these improvements will allow clinicians to use the unit dose SmarTip Technology System with confidence and greater efficacy while at the same time delivering the innovative Sylc™ therapeutic prophy treatment.

And the best news is that OSspray is passing along all the improvements without increasing the retail price to your dental offices.

The SmarTip Technology System offers clinicians three key improvements:

1. Integrated pressure regulator to the SmarTip Adapter—this unique feature eliminates the need to adjust air pressure which provides a more consistent delivery of Sylc™ Therapeutic Prophy Powder.

2. Shortened Tip Length—this design enhancement to the back-end of the blister tip provides increased ergonomics for improved fulcrum and access inside the oral cavity during treatment.

3. More robust collar—the collar improvement ensures a secure prophy tip engagement to the SmarTip adapter.

Sylc™ SmarTip combined with Sylc™ Therapeutic Prophy Powder is the only system that removes mild to moderate stains, desensitizes, and restores the tooth structure to create an enamel like layer for long term protection from acid challenges in one simple procedure. The SmarTip Adapter with integrated pressure regulator is backed with a 2-year manufacturer’s warranty, providing dentists and hygienists piece of mind.

Tuesday, June 21, 2011

Catapult Your Practice- Save money on supplies and CE.

Practicing dentistry in today’s economic environment is more challenging than ever before and the rising costs of doing business has made it more difficult to have a successful and profitable practice. That is why Catapult and their Coterie of Dentists created CatapultYourPractice.com.

Catapult Your Practice (CYP) was created by practicing dentists with the goal of helping their peers grow their practices in a changing market place through unbiased product information, educational programs and substantial discounts on products and services; thus saving dentists time and money.

Benefits of Catapult Your Practice membership are:
• Discounted Products via the CYP Buying Group
• Free Continuing Education Credits
• Free Webinars
• Product Evaluations
• Free Product Samples
• Video Technique Tips from Industry KOLs

To experience the savings and benefits for one free month, go to www.catapultyourpractice.com and register with Promo Code: GGH4EU

Monday, June 20, 2011

Why disparities in dental care persist for African-Americans even when they have insurance coverage

Columbia University's Mailman School of Public Health

African Americans receive poorer dental care than white Americans, even when they have some dental insurance coverage. To better understand why this is so, researchers at Columbia University's Mailman School of Public Health and the College of Dental Medicine, surveyed African American adults with recent oral health symptoms, including toothaches and gum disease. Their findings provide insights into why disparities persist even among those with dental insurance and suggest strategies to removing barriers to dental care.

The findings are published online ahead of print in the American Journal of Public Health.

The study is a qualitative survey of 118 men and women intercepted on the street in Central Harlem. Although the majority (75%) of adults in the study reported at least some type of dental insurance coverage, this was largely limited to Medicaid (50%) rather than private coverage (21%) or other types of dental insurance (4%).

The findings indicated that insured participants reported insurance-related difficulties, such as insufficient coverage for needed treatments, inability to find a dentist who accepts their insurance, and having to wait for coverage to take effect.

"For the 25% of respondents who reported having no dental insurance coverage, the costs of dental care and the lack of insurance coverage were consistently noted as critical barriers to obtaining quality dental treatment of their dental symptoms," said Eric Schrimshaw, PhD, assistant professor of Sociomedical Sciences at the Mailman School, and first author. "Even among those who had some dental insurance – such as Medicaid -- it was often not enough to eliminate the obstacles to obtaining needed dental treatment," noted Dr. Schrimshaw.

For instance, one 58-year-old man with a toothache described his difficulty paying for out-of-pocket costs despite having dental coverage. Consequently, he sought only emergency dental care during the 5 years before his interview:

"The dental plan is only going to pay for so much. And then there are a lot of out-of-pocket expenses… If you don't have that dental care, you just go to the dentist on emergency when that teeth need to be come out or whatever. That's the only time you go."

The authors also report that even when participants were able to see a dentist with the limited insurance they had or while uninsured, many believed that because of their lack of private insurance they received a poorer quality of care than did others. For instance, one 46-year-old woman on Medicaid with pain and irritation of her gums who had not been to a dentist in nearly five years said this:

"I feel as though that they didn't give me the best service that they could, and that's only because I didn't have the money or medical coverage to pay for it. It's all about money. And they showed it . . . you can see how they treat you differently."

The finding that participants on Medicaid reported a number of impediments is particularly important, according to the researchers, as this program is often promoted as a means to meaningfully reduce barriers to care and health disparities. "Although Medicaid allowed some participants to obtain basic care such as dental cleanings, the barriers identified suggest that enhancements to the program would significantly improve many patients' ability to obtain treatment," Dr. Schrimshaw added. He suggested that efforts to increase the number of dentists participating in Medicaid and increase the types of services (for example, root canals rather than just tooth extractions) covered by Medicaid would improve individuals' ability to obtain needed treatment.

The Columbia researchers also point out that although publicly funded dental clinics would be one potential source of affordable dental care regardless of insurance status, all such city-funded dental clinics in the Harlem area were closed shortly after this study was completed because of city budget constraints, leaving only hospital-based emergency care.

"Many of the new and innovative models of healthcare provision and payment provided for in the Patient Protection and Affordable Care Act are designed to expand access, contain costs, and increase the quality of care provided. What is needed is for access to dental care be included in this healthcare reform; the expansion of affordable, quality dental care would be a great benefit to underserved communities like Harlem," said Dr. Schrimshaw.

"The lack of affordable dental care and insurance coverage lead many of our participants to postpone or do without dental treatment, often for years. But these untreated symptoms inevitably get more severe, resulting in people requiring treatment in the emergency department at a much greater public expense than if they had been provided dental treatment when the symptoms first occurred. Further, given the research evidence on the relationship between untreated oral symptoms and systemic health problems such as cardiovascular disease and stroke, providing better oral health treatment may not only reduce suffering but also may prevent expensive physical health problems in the future."

Saturday, June 18, 2011

Chocolate Makes Us Smile The Most

Chocolate has topped the poll for the thing that makes most people smile.

As this year's National Smile Month comes to an end today, the British Dental Health Foundation has been asking hundreds of people what makes them smile the most. In a close fought competition a simple bar of chocolate has topped the poll, followed by 'seeing a loved one'.

Food and 'relationships' were common inclusions in a bewildering array of things mentioned in the poll, which spontaneously gave people the 'Smile factor' - the theme of this year's National Smile Month campaign run by the British Dental Health Foundation.

Around half of respondents featured chocolate on their list of items, with 60 per cent of women making it their favourite choice. Men preferred a Sunday roast to chocolate, but both scored highly.

The contagious nature of smiling was also highlighted by around a third of people saying they smiled when they 'saw someone else smile'.

The Foundation also asked people to choose a colour which made them smile the most. The top polling answer was the nice summery colour yellow with around a third of votes.

Dr Nigel Carter, Chief Executive of the British Dental Health Foundation, said: "We hope this year's National Smile Month campaign has brought a smile to many people's faces and has helped to remind everyone about how to care for their teeth.

"It is clear the nation has a very sweet tooth and chocolate definitely has the smile factor. Chocolate may not be the best thing for your teeth, but if everyone follows the Foundation's three rules for good oral health, it's something that we can all continue to enjoy.

"As a final reminder for this year, we recommend adopting a simple routine of brushing for two minutes twice a day using a fluoride toothpaste, cutting down on how often you eat and drink sugary foods and drinks and visiting your dentist regularly, as often as they recommend," advised Dr Carter.

Source:
British Dental Health Foundation

Friday, June 17, 2011

Digital evaluation of the reproducibility of implant scanbody fit—an in vitro study

Clinical Oral Investigations
DOI: 10.1007/s00784-011-0564-5

Michael Stimmelmayr, Jan-Frederik Güth, Kurt Erdelt, Daniel Edelhoff and Florian Beuer
Abstract
Dental restorations are increasingly manufactured by CAD/CAM systems. Currently, there are two alternatives for digitizing dental implants: direct intra-oral data capturing or indirect from a master cast, both with transfer caps (scanbodies). The aim of this study was the evaluation of the fit of the scanbodies and their ability of reposition. At the site of the first molars and canines, implants were placed bilaterally in a polymer lower arch model (original model), and an impression was taken for fabricating a stone cast (stone model). Ten white-light scans were obtained from the original and the stone model with the scanbodies in place. The scanbodies were retrieved after each scan and re-attached to the same implant or lab analogue. The first scan of the series served as control in both groups. The subsequent nine scans and control were superimposed using inspection software to identify the discrepancies of the four scanbodies in both experimental groups. The systematic error of digitizing the models was 13 μm for the polymer and 5 μm for the stone model. The mean discrepancy of the scanbodies was 39 μm (±58 μm) on the original implants versus 11 μm (±17 μm) on the lab analogues. The difference in scanbody discrepancy between original implants and lab analogues was statistically significant (p < 0.05, Mann–Whitney U test). Scanbody discrepancy was higher on original implants than on lab analogues. Fit and reproducibility of the scanbodies on original implants should be improved to achieve higher accuracy of implant-supported CAD/CAM fabricated restorations.

Wednesday, June 15, 2011

Is there one optimal repair technique for all composites?

Dental Materials
Volume 27, Issue 7 , Pages 701-709, July 2011

Abstract 

Objectives

The aim of this study was to investigate the effectiveness of a variety of techniques to bond new composite to artificially aged composite of different compositions.

Methods

Composite resin blocks were made of five different commercially available composites (n=30) (Clearfil AP-X, Clearfil PhotoPosterior, Photo Clearfil Bright, Filtek Supreme XT and HelioMolar). After aging the composite blocks (thermo-cycling 5000×), blocks were subjected to one of 9 repair procedures: no treatment (control), diamond bur, sandblasting alumina particles, CoJet™, phosphoric acid, 3% hydrofluoric acid 20s or 120s, 9.6% hydrofluoric acid 20s or 120s. In addition, the cohesive strength of the tested composites was measured. Two-phase sandwiches (‘repaired composite’) were prepared using each of the 9 repair protocols, successively followed by silane and adhesive (OptiBond FL) treatment, prior to the application of the same composite. Specimens were subjected to micro-tensile bond strength testing. Data were analyzed using ANOVA and Tukey's HSD (p<0.05).

Results

For all composites the lowest bond strength was obtained when no specific repair protocol (control) was applied; the highest for the cohesive strength. Compared to the control for the microhybrid composite (Clearfil AP-X) five repair techniques resulted in a significantly higher repair strength (p<0.05), whereas for the nano-hybrid composite (Filtek Supreme XT) and hybrid composite containing quartz (Clearfil PhotoPosterior) only one repair technique significantly increased the bond strength (p<0.01).

Significance

None of the surface treatments can be recommended as a universally applicable repair technique for the different sorts of composites. To optimally repair composites, knowledge of the composition is helpful.

Tuesday, June 14, 2011

Two year clinical evaluation of a low-shrink resin composite material in UK general dental practices

Dental Materials
Volume 27, Issue 7 , Pages 622-630, July 2011

Abstract 

Objective

A novel resin composite system, Filtek Silorane (3M ESPE) with reduced polymerization shrinkage has recently been introduced. The resin contains an oxygen-containing ring molecule (‘oxirane’) and cures via a cationic ring-opening reaction rather than a linear chain reaction associated with conventional methacrylates and results in a volumetric shrinkage of ∼1%. The purpose of this study was to review the literature on a recently introduced resin composite material, Filtek Silorane, and evaluate the clinical outcome of restorations formed in this material.

Methods

Filtek Silorane restorations were placed where indicated in loadbearing situations in the posterior teeth of patients attending five UK dental practices. These were evaluated, after two years, using modified USPHS criteria.

Results

A total of 100 restorations, of mean age 25.7 months, in 64 patients, were examined, comprised of 30 Class I and 70 Class II. All restorations were found to be present and intact, there was no secondary caries. Ninety-seven per cent of the restorations were rated optimal for anatomic form, 84% were rated optimal for marginal integrity, 77% were rated optimal for marginal discoloration, 99% were rated optimal for color match, and 93%% of the restorations were rated optimal for surface quality. No restoration was awarded a “fail” grade. No staining of the restoration surfaces was recorded and no patients complained of post-operative sensitivity.

Significance

It is concluded that, within the limitations of the study, the two year assessment of 100 restorations placed in Filtek Silorane has indicated satisfactory clinical performance.

Monday, June 13, 2011

HPV related oral cancers continue to increase in the US

Source: International Medicine News
CHICAGO – Human papillomavirus infection was firmly linked to the recent rise in oropharyngeal cancers in the United States, based on data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results program.
If current trends continue, the incidence of HPV-related oral cancers will soon surpass that of cervical cancers, senior author Dr. Maura Gillison reported at the annual meeting of the American Society of Clinical Oncology.
The incidence of HPV-positive oropharyngeal cancers increased 225% – from 0.8 per 100,000 to 2.8 per 100,000 – between 1988 and 2004, the researchers found. At the same time, the incidence rate for HPV-negative oropharyngeal cancers, which are strongly related to tobacco and alcohol use, declined by 50% – from 2.0 per 100,000 to 1.0 per 100,000.
Consequently, the overall incidence of oropharyngeal cancers increased 28%.
Even by the conservative estimate that 70% of oropharyngeal cancers in 2020 will be HPV positive, the annual number of HPV-positive oral squamous cell carcinomas (8,653 cases) is expected to surpass cervical cancers (7,726 cases). Further, the majority will occur among men (7,426 cases), said Dr. Gillison, a medical oncologist and the Jeg Coughlin Chair in Cancer Research at Ohio State University Comprehensive Cancer Center in Columbus.
Changes in sexual behavior among recent birth cohorts and increased oral HPV exposure probably influenced the increases in incidence and prevalence, Dr. Gillison speculated. Having a high lifetime number of sexual partners is a known risk factor for HPV infection.
Although the rise in oral cancers in the United States has been attributed to HPV infection, the empirical evidence to back the contention was uncovered prior to the SEER study. A previous study by Dr. Gillison and her colleagues helped to establish that HPV infection causes an epidemiologically and clinically different form of oral cancer. Their findings documented a major increase in the incidence of HPV-related oral cancers in the United States, particularly among young, white men, and that survival rates are significantly higher in patients with HPV-related oral cancers than in those with HPV-negative cancers (J. Clin. Oncol. 2008;26:612-9).
The evidence surrounding HPV-related oral cancers has been mounting, “but I don’t think there is a lot of awareness in the general medical community,” Dr. Gillison said in an interview. Most of her head-and-neck cancer patients who are nonsmokers were referred to her after undergoing months of antibiotic therapy for presumed tonsillitis.
Screening the sexual partners of oropharyngeal cancer patients has been discussed, but there is no evidence to support the practice. The risk for oral cancer is fourfold higher in HPV-positive patients’ partners, but the absolute risk is low, Dr. Gillison said. Alternatively, there are now three or four case reports of husband-wife couples with HPV16-positive tonsillar cancer.
“Probably 80% of people have HPV exposures in their life and 99.1% clear the infections without consequence,” she said. “So, whatever [stable sexual partners] have swapped in terms of infection, they’ve already swapped. Just because they suddenly found that one of them got cancer from it doesn’t mean the other one will.”
The researchers called for more studies to evaluate the efficacy of HPV vaccines in preventing oral HPV infections.
Dr. Gillison worked for 3 years with Merck & Co., the maker of the HPV vaccine Gardasil, and commented that Merck will not likely pursue this indication. Merck was interested in studying the vaccine in prevention of oral cancers but saw the endeavor as too much of an uphill battle in part because oral cancers are not readily accessible visibly or through biopsy. Merck instead successfully opted to seek approval for the prevention of anal cancers, an indication that was approved in December 2010 for male and females 9-26 years old.
It was already approved in the same age groups for the prevention of cervical, vulvar, and vaginal cancer and of genital warts caused by HPV types 6, 11, 16, and 18 in females and for the prevention of genital warts caused by HPV types 6 and 11 in males.
Invited discussant Dr. Lisa Licitra of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, said that oral cancers are on the rise in Europe in both men and women and that a vaccine should be pursued. Data on oropharyngeal cancer from her institute did not find a greater contribution from men.
“A preventive vaccine is worth considering,” she said. “In particular, when we consider the European data, I think that in this direction, action should be taken.”
In their study, Dr. Gillison and her colleagues used four different assays to determine the HPV status for 271 oropharyngeal cancer cases collected from 1984 to 2004 by three population-based cancer registries of the National Cancer Institute’s Surveillance, Epidemiology, and End Results program in Hawaii, Iowa, and Los Angeles. Trends in HPV prevalence across four calendar periods were estimated using logistic regression.
The HPV prevalence in oropharyngeal cancer significantly increased across the time period, regardless of the assay used, and remained statistically significant, even after correcting for potential loss in assay sensitivity, Dr. Gillison reported. Genotyping with the Inno-LiPA assay appeared to be the most precise, detecting more than a fourfold increase in HPV prevalence from 16.3% in 1984-1989 to 72.7% in 2000-2004.
Median survival was significantly better for patients with HPV-positive cancer at 131 months vs. 20 months for HPV-negative patients (log rank P value less than .001). HPV-positive cases on all assays had a significant reduction in hazard of death compared with HPV-negative cases after adjustment for age, sex, race, registry, calendar period, stage, surgery, chemotherapy, and radiotherapy.
Survival of HPV-positive cases increased over the study period but remained unchanged for HPV-negative cases. Consequently, survival of all oropharyngeal cancer cases improved over time, according to the results of the study, which was led by Dr. Amil Chaturvedi, an investigator with the division of cancer epidemiology and genetics at the National Cancer Institute, Rockville, Md.
Dr. Gillison and Dr. Chaturvedi reported no conflicts of interest. A coauthor disclosed consultancy, research funding, and honoraria from Merck.
View on The News
‘Massive Increase’ Seen
The study demonstrates the massive increase taking place in the United States in HPV-related oropharyngeal cancer, and that this really will be the major form of head and neck cancer in the next decade.
The findings also support previous work from Sweden, although the two studies are not mirror images.
These are the kind of data that we need to inform the National Cancer Institute and the Centers for Disease Control and Prevention that more research support is needed to identify risks for this disease, to develop therapeutic vaccines, and to understand the immunity and carcinogenesis of this disease.
This disease really deserves research funding, because it is curable today with tools that are available and have not been effectively applied.
Dr. Marshall Posner is director of head and neck medical oncology and the office of cancer clinical trials at the Tisch Cancer Institute, Mount Sinai School of Medicine, New York. He made these comments in an interview and has no relevant financial conflicts of interest.
This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Saturday, June 11, 2011

Remineralization effects of casein phosphopeptide-amorphous calcium phosphate crème on artificial early enamel lesions of primary teeth

International Journal of Paediatric Dentistry 2011
Background.  Caries in children younger than 72 months is called early childhood caries (ECC). Sixty-six per cent of Chinese children younger than 5 years old have dental decay, and about 97% of them are untreated.
Aims.  This in vitro study was conducted to evaluate the remineralization effects of the casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) crème on the artificial early enamel lesions of the primary teeth and to assess its caries-prevention efficiency.
Design.  Enamel specimens with artificial early lesions were produced and were then randomly divided into Group A: distilled and deionized water, DDW, as negative control; Group B: CPP-ACP crème, test group; Group C: 500 ppm NaF solution, as positive control. The enamel surface microhardness (SMH) was measured before, after demineralization, and 30 days after remineralization. The results were analysed with the SPSS 13.0 software package. The enamel specimens were analysed by the scanning electron microscope.
Results.  The CPP-ACP crème increased SMH of the eroded enamel significantly more than 500 ppm NaF solution did. The morphology of the enamel was different in each group.
Conclusions.  The CPP-ACP crème is effective in remineralizing early enamel lesions of the primary teeth, a little more effective than 500 ppm NaF and can be used for the prevention of ECC.

Friday, June 10, 2011

Pulp response after application of two resin modified glass ionomer cements (RMGICs) in deep cavities of prepared human teeth

Dental Materials
Volume 27, Issue 7 , Pages e158-e170, July 2011

Abstract 

Objectives: This study evaluated the human pulp response to the application of two RMGICs in deep cavities in vivo. Methods: The cavity floor prepared on the buccal surface of 34 premolars was lined with VBP (VBP), Vitrebond (VB) or Dycal® (DY), and restored with composite resin. Additional teeth were used as an intact control group. After 7 or 30–60 days, the teeth were extracted and processed for histological evaluation. The following histological events were scored: inflammatory response, tissue disorganization, reactionary dentin formation and presence of bacteria. Results: At 7 days, VBP and VB elicited a mild inflammatory pulpal response in about 70% of specimens and in 1 specimen for DY. Only 1 specimen of each RMGICs exhibited moderate tissue disorganization. Bacteria and reactionary dentin formation were not found. At 30–60 days, about 20% of specimens lined with RMGICs showed a persistent mild inflammatory pulp response while no inflammatory reaction was observed for DY. Moderate tissue disorganization occurred with both materials. Bacteria were found only in 1 VBP specimen. The mean remaining dentin thickness (RDT) in specimens lined with VBP, VB or DY ranged from 342.3 to 436.1μm, and no statistically significant differences in RDT were found among materials or periods (two-way ANOVA, p>0.05). Comparison of the two RMGICs tested for the histological events at each period showed statistically similar results (Kruskal–Wallis, p>0.05). Significance: The use of the new Vitrebond formulation (VBP) in deep cavities in vivo caused mild initial pulp damage, which decreased with time, indicating acceptable biocompatibility.

Thursday, June 09, 2011

Kerr to lauch customer protection program

Jun. 7, 2011 (Business Wire) — Kerr Corporation, a leading manufacturer of technology for dental procedures, has announced the launch of a new customer protection program. The program has been created in the interest of protecting Kerr customers from fraudulent, counterfeit or grey market products and preserving the company’s reputation for quality across its entire spectrum of offerings.
“We are taking several steps designed to proactively prevent counterfeiters from being able to generate and/or distribute fraudulent product,” said Leo Pranitis, Kerr’s Vice President of Global Marketing and Innovation. “We’ll be rolling out our protection plan in several stages over the coming months with the ultimate goal being to discourage tampering and prevent reuse or placement of counterfeit items in Kerr packaging coming into the North American channel. By incorporating this program, both the reputation of the Kerr brand and our customers are protected.”
Pranitis added that the best way to be certain that products purchased are legitimate is to only buy from an authorized Kerr dealer (http://www.kerrdental.com/kerrdental-contact-2#dealers) or by contacting the company directly at 1-800-KERR-123.
“As our products are strictly regulated by the FDA and Health Canada, it is important that there is full traceability from manufacturer to distributor to clinician and ultimately to the patient,” said Pranitis. “That chain of custody is lost when products move outside authorized distribution channels. Our goal is to ensure lasting smiles for years to come.”
The infiltration of counterfeit and grey market dental products into North America is a growing issue of concern affecting the dental industry, and Kerr has chosen to proactively address it as a form of quality assurance for its customers. Counterfeit dental products pose obvious safety and efficacy risks, while grey market products are sourced from markets outside of the United States where storage times and conditions can be compromised.
“We’re very proud of our safety and efficiency records,” said Pranitis. “Proactive steps are being taken to protect that reputation as well as the reputations of the dentists with whom we work. All our constituents can rest assured that the Kerr Customer Protection Program will help prevent fraudulent, counterfeit and grey market products from getting into their hands.”

Wednesday, June 08, 2011

Patterson Dental Debuts PattLock



The highest level of security for dental practice information and data

ST.PAUL, Minn. – (June 2, 2011) – Patterson Dental Supply Inc. introduces PattLock, an online backup service that protects and secures patient and practice information. Compatible with all practice management software, including Eaglesoft Practice Management Software, as well as all file types, PattLock is an affordable and user-friendly addition to any existing backup solution.

PattLock uses an Internet connection to transmit data and store it in a safe location. This technology provides an array of notable features, including customizable scheduling for exactly when and how often data is backed up, data restoration in the same format as it was originally saved, and backup verification to confirm that all data was successfully transferred. The data is secured by username and password, allowing dental professionals to control who has access to files and accounts.

“Creating a secure system for backing up computer data was a natural fit for Patterson Dental,” says Jana Berghoff, corporate technology marketing manager. “At Patterson we are committed to supporting the dental community by providing the most innovative technology on the market. PattLock is a perfect extension of this commitment and to the Patterson Technology Suite as it brings another dependable service to dental practices everywhere.”

The service offers dental professionals the same dependability and ease of use they have come to expect from Patterson Dental. Powered by DataHEALTH, a fully accredited URAC HIPAA Security Business Associate, PattLock takes extensive steps to ensure the safeguard of all protected health information. Data storage equipment is housed in centers with high-tech security measures, fire suppression and climate control. As an added precaution, data is also backed up to a second storage center. With numerous security steps in place, PattLock allows dental practices to be at ease about the safety and security of their files.

For more information, call 1-800-294-8504, or visit: www.pattersondental.com.

Tuesday, June 07, 2011

STA Anesthesia machines on sale!

I am a big fan of the STA machine and use it everyday! If I did not have 2 already I would jump on this offer. MJ

(2) STA Units for $1595 ea!  
That's nearly $1000 off the new retail of $2495
        (1) STA Demo Unit for $500

STA Handpiece SALE!  $89/box of 50 pieces
(10) boxes of unbonded 
(10) boxes of 30g 1"

For Compudent users:

WAND handpieces $89/box of 50 pieces
30g 1/2"
30g 1"
27g 1 1/4"
multiple boxes of each available
 
For questions or to place an order by phone please call/email 
Jen Duffy, RDH at: 

Dental Resource Group                                                         609.291.5066     
Cell 609.558.1844                              
jd@dentalrg.com                                                
 
 

Monday, June 06, 2011

6 Month Smiles Seminar

This past weekend I attended the 6 Month Smiles seminar. It was 2 full days and was taught by Dr. Ryan Swain. I have zero orthodontic experience yet I felt on completing the course I had gained the knowledge to start treating some conservative orthodontic cases on the return to my practice.

The seminar provided the clinical training along with access to the tools and supplies to make the system work. So if you are looking to take a short term orthodontic course consider going to the next 6 Month Smiles course.

I am looking forward to starting my first case.

Saturday, June 04, 2011

Survival rate of sealed, refurbished and repaired defective restorations: 4-year follow-up.

Braz Dent J. 2011;22(2):134-9.

Source

Department of Operative Dentistry, Dental School, Universidad de Chile, Santiago, Chile.

Abstract

The most common treatment in general dental practice is the replacement of restorations affected by secondary caries or marginal deficiencies. Alternative treatments to replacement of defective restorations, such as marginal sealing, refurbishment and repair, have demonstrated improvement of their clinical properties with minimal intervention. The aim of this clinical study was to estimate the median survival time (MST) of marginal sealing, repair and refurbishment of amalgam and resin-based composite restorations with localized defects as a treatment to increase the restoration longevity. A cohort of 66 patients, with 271 class I and II restorations clinically diagnosed with localized defects was longitudinally assessed. Each restoration was assigned to one of the following 5 groups: Marginal Sealing (n=48), Refurbishment (n=73), Repair (n=27), Replacement (n=42), and Untreated (n=81). Two calibrated examiners assessed the restorations at baseline and annually during 4 years, using the modified Ryge criteria: marginal adaptation, anatomic form, roughness, secondary caries and luster. Fifty-two patients with 208 restorations were assessed after 4 years; the distribution of restorations in the groups was as follows: Marginal Sealing (n=36), Refurbishment (n=63), Repair (n=21), Replacement (n=28) and Untreated (n=60). Kaplan Meier test indicated that the Sealed margins group showed the lowest MST while the Repair group showed the highest MST for restorations examined after 4 years of follow up. Defective amalgam and resin-based composite restorations treated by sealing of marginal gaps, refurbishment of anatomic form, luster or roughness, and repair of secondary caries lesions, had their longevity increased.

Friday, June 03, 2011

It's dentistry that patients hate, not the dentist

‘I HATE dentists . . . no offence but I hate dentists.” “I hate being here.” “If I never see this place again, it’ll be too soon.”
Believe it or not, these lines occur more frequently than you’d imagine in the dental surgery. I can almost see a few heads nodding as you read them.
Some years back, I employed a new dental nurse. She had never worked in a surgery. When she heard a new patient to the practice say, “I hate dentists”, she was gob-smacked (pun intended), so I suggested she record how many times she heard the line. In her first month, she logged 25 times. I hadn’t even noticed one of them.
On starting practice as a new dental graduate, your head is filled with patient care, treatment planning, the fundamentals of restorative dentistry and the myriad of other clinical concerns which face you daily. For you, it’s your job. But for your patient, it’s often a leap of faith.
Why do patients feel this way? With my own patients, I often suggest that they may hate (though I prefer the word dislike) dentistry rather than dentists.

Read the rest

Thursday, June 02, 2011

Government Intervention Required On Whitening Products, BDA Believes, UK

The British Dental Association (BDA) is seeking an urgent meeting with the Department for Business, Innovation and Skills (BIS) to resolve concerns about the position trading standards officers are adopting in relation to the supply of teeth whitening products.

The BDA is aware that a current investigation by trading standards at Essex County Council is having a major impact on the availability of hydrogen peroxide-based whitening products to dentists, which adversely affects their ability to provide whitening treatments to patients. This supply problem could mean that patients instead seek whitening treatments from non-dental professionals, which is illegal and dangerous, the BDA believes.

The BDA would like to see the previous low-key approach to enforcement around the supply of whitening products to dental professionals previously advised by LACORS and taken by trading standards re-instated. The BDA is also seeking progress on the ongoing review of the European Union's review of the EU Cosmetics Directive, which it hopes will provide a sensible legal framework for the provision of tooth whitening products in the UK.

Stuart Johnston, Chair of the BDA's Representative Body, said:

"The recently-changed approach to the supply of whitening products, and particularly the impact the investigation being undertaken in Essex is having, is a significant concern for patient safety. This must be addressed as a matter of urgency and the previously adopted low-key approach to supply to dental professionals reinstated. A significant body of evidence demonstrates the safety of whitening products when used by trained dental professionals. We urge trading standards officers to adopt a pragmatic approach that recognises this and puts patient safety first."

Notes

1. The General Dental Council has this year successfully prosecuted a non-dental professional for performing whitening treatments.

Source:
British Dental Association (BDA)

Wednesday, June 01, 2011

Ultradent Launches Peak Universal Bond- The Complete “Adhesive Tool Kit”


SOUTH JORDAN, Utah, May 2011 – Ultradent will showcase its new addition to the adhesive line, Peak Universal Bond at the California Dental Association (CDA) meeting in Anaheim.  Peak Universal Bond is a light cure resin adhesive with Chlorhexidine (0.2%).  With its ability to bond to dentin, enamel, porcelain, metal, composite and zirconia, its versatility can’t be matched. 
Peak Universal Bond is the only light cure adhesive that contains Chlorhexidine which helps ensure long term bond strengths.  It’s the ideal agent for indirect and direct bonding, as well as post and core procedures, working equally well with self- and total-etch techniques.  With such versatility, there’s no need for multiple agents to complete either technique.   
Peak Universal Bond is syringe delivered with an optimal viscosity to ease application and minimize waste during use.  Units are available as a self- or total-etch kit or in single 1.2 ml refills.  For more information,  contact Ultradent’s customer service at 1-800-552-5212.