Association of Endodontic Infection with Detection of an Initial Lesion to the Cardiovascular System

Journal of Endodontics
Volume 37, Issue 12 , Pages 1624-1629, December 2011

Abstract 

Introduction

Dental infections might predispose toward the onset of cardiovascular disease (CVD). To date, only a few studies, yielding inconclusive findings, have investigated the potential correlation between apical periodontitis (AP) and CVD. The aim of this study (as the first part of a prospective study) was to evaluate, in the absence of CV risk factors, whether subjects with AP were more exposed to the pathogenetic indices of an atherosclerotic lesion.

Methods

Forty men between the ages of 20 and 40 years who were free from periodontal disease, CVD, and traditional CV risk factors were enrolled in the study; 20 subjects had AP, and 20 acted as controls. All subjects underwent dental examination and complete cardiac assessment: physical examination, electrocardiogram, conventional and tissue Doppler echocardiography, and measurement of endothelial flow reserve (EFR). The following laboratory parameters were tested: interleukins -1, -2, and -6 (IL-1, IL-2, IL-6), tumor necrosis factor alpha, and asymmetrical dimethylarginine (ADMA). Data were analyzed by using the 2-tailed Student's t test, Pearson t test (or Spearman t test for nonparametric variables), and multivariate linear regression analysis.

Results

Echocardiography revealed no abnormalities in any of the subjects studied. ADMA levels were inversely correlated with EFR (P < .05) and directly correlated with IL-2 (P < .001). Patients with AP presented with significantly greater blood concentrations of IL-1 (P < .05), IL-2 (P < .01), IL-6 (P < .05), and ADMA (P < .05) and a significant reduction of EFR (P < .05).

Conclusions

Increased ADMA levels and their relationship with poor EFR and increased IL-2 might suggest the existence of an early endothelial dysfunction in young adults with AP.

Dental Services Group™ Provides Rebate and Placement Program for CEREC® AC Connect Users

Charlotte, NC (November 30, 2011) – Sirona Dental Systems, LLC announced today that Dental Services Group™ (DSG), a network of 25 North American laboratories, is now providing CEREC® and CEREC® AC Connect users with an attractive rebate and placement program.

Both new and existing CEREC AC Connect users who choose to use Dental Services Group for any laboratory needs will earn a generous rebate to help cover the cost of their CEREC AC Connect digital impression system. Rebates are issued in the form of laboratory credits, and are applied to the user’s DSG lab invoice. Rebates range in size based on monthly DSG lab bills, and can cover all financing costs, service contracts, and provide savings on restorations at the highest level. The program is based on incremental business done with DSG.

In addition, DSG created a Placement Program for dental professionals interested in having a CEREC AC Connect placed in their practice with no up-front costs. Interested parties simply commit to a certain amount of incremental annual lab work with DSG, and DSG will cover the cost of the scanner.

"Our goal at DSG is to provide services that help make our lab customers successful,” according to Buddy Pickle, Dental Services Group CEO. “Providing CEREC milling capabilities and including the CEREC AC Connect in our rebate and placement programs are services we offer to help achieve that goal."

“We are very excited about DSG’s digital impression program for CEREC and CEREC AC Connect users,” remarked Norbert Ulmer, Director of Laboratory CAD/CAM for Sirona. “We consider DSG to be an active driver in expanding the usage of digital impression technology. By providing these attractive incentives, DSG is striving to elevate dental care and introduce efficiencies to the entire restorative process. The programs are substantial steps towards making digital impressions a reality for all, and, in turn, will benefit patients, dentists, and ultimately the entire dental community.”

For more information, please contact your DSG representative, call Sirona at 855-465-2248, or visit www.inLab.com.

About Sirona Dental Systems, LLC

Recognized as a leading global manufacturer of technologically advanced, high-quality dental equipment, Sirona has served equipment dealers and dentists worldwide for more than 125 years. Sirona develops, manufactures, and markets a complete line of dental products, including CAD/CAM restoration equipment (CEREC® and inLab®); digital and film-based intraoral, panoramic, and cephalometric X-ray imaging systems; dental treatment centers; and handpieces. Visit www.sirona.com for more information about Sirona and its products.

About Dental Services Group™

Dental Services Group™ is a network of quality-focused, local labs throughout North America. Partnering with one of DSG’s 25 laboratories provides the personal relationship and care of a local laboratory—combined with the technical expertise and full suite of offerings of a national laboratory. While the foundation of their business is providing high-quality restorations and dental appliances, DSG labs go a step beyond by offering ways to support and grow dental practices. Their vision is to provide relevant services and solutions that will help make practitioners more successful. Learn more at www.dentalservices.net.

NYUCD awarded $2.2 million NIH grant to decode genome of caries-causing bacteria

Whole genome sequencing to be used to identify strains of Lactobacilli bacteria which contribute to the development of severe early childhood caries

Severe early childhood caries can destroy most of a child's teeth by age three, and disproportionately affects underserved populations, including American Indians and Alaskan natives. Although the link between Lactobacilli bacteria (Lb) and severe early childhood caries has been known for almost a century, progress in delineating which of 140 Lb species are responsible for the disease has remained elusive.
The recent development of whole genome sequencing has made it much easier to identify destructive bacteria. Now, an New York University dental research team has received a four-year, $2.2 million dollar grant from the National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institutes of Health (NIH), to use whole genome sequencing to identify those strains of Lb that contribute to the development of severe early childhood caries.
The study's principal investigators, Dr. Page W. Caufield, professor of cariology and comprehensive care, and Dr. Yihong Li, professor of basic science and craniofacial biology, will analyze several hundred bacteria samples from children with severe early childhood caries and their parents, and from caries-free children and their parents. Sampling and collection will take place at Bellevue Hospital Center in New York.
Sequencing will be conducted by co-investigators at University College in Ireland and at the Wellcome Trust Sanger Institute in the United Kingdom. Drs. Caufield and Li will collaborate with experts on bacterial genome evolution at the American Museum of Natural History to identify sequences common to children with severe early childhood caries and to their parents.
Earlier research led by Drs. Caufield and Li identified virulent strains of Streptoccocus mutans, another group of bacteria commonly associated with severe early childhood caries. Dr. Caufield, a microbiologist and infectious disease specialist, and Dr. Li, a molecular epidemiologist, demonstrated that these bacteria are transmitted from mother to infant during intimate contact.
"The findings from our new study, as well as the earlier research on Streptoccocus mutans, will help propel the development of a diagnostic test that dentists can administer chairside to identify those at risk," said Dr. Caufield.
"Severe early childhood caries is one of the most prevalent chronic diseases in underprivileged populations," added Dr. Li. "Much still needs to be learned about how the disease develops, and how it can be prevented. Our study will help to fill those gaps."
Co-investigators on the Lb study include Dr. Silvia Argimon, research scientist in cariology and comprehensive care; Dr. Charles Larsen, clinical assistant professor of pediatric dentistry, Dr. Untray T. Brown, clinical associate professor of pediatric dentistry; Dr. Robert Norman, research associate professor of epidemiology & health promotion; and Dr. Peter Catapano, Jr., clinical associate professor of pediatric dentistry, all of the NYU College of Dentistry. Dr. Catapano is also a clinical associate professor of pediatrics at the NYU School of Medicine and director of the pediatric dental clinic at Bellevue Hospital Center.
Additional co-investigators include Dr. Paul O'Toole, senior scientist at University College, Ireland; Dr. Julian Parkhill, senior scientist at the Wellcome Trust Sanger Institute; Dr. Rob Desalle, curator of the Sackler Institute for Comparative Genomics of the American Museum of Natural History; and Dr. Paul J. Planet, a research associate at the American Museum of Natural History and a fellow in the pediatric infectious disease division of the Columbia College of Physicians and Surgeons Children's Hospital of New York.
Drs. Caufield and Li are also focusing on how severe early childhood caries affects children living on American Indian reservations. They are participating in a series of outreaches to Indian reservations, under the auspices of the American Dental Association, and will incorporate their observations into the NIH study.

Assessment of a prototype computer colour matching system to reproduce natural tooth colour on ceramic restorations

Journal of Dentistry

 doi:10.1016/j.jdent.2011.11.009

Abstract

Objectives

The aim of this study was to assess the accuracy of a prototype computer colour matching (CCM) system for dental ceramics targeting the colour of natural maxillary central incisors employing a dental spectrophotometer and the Kubelka–Munk theory.

Methods

Seventeen human volunteers with natural intact maxillary central incisors were selected to participate in this study. One central incisor from each subject was measured in the body region by a spectrophotometer and the reflectance values were used by the CCM system in order to generate a prescription for a ceramic mixture to reproduce the target tooth's colour. Ceramic discs were fabricated based on these prescriptions and layered on a zirconia ceramic core material of a specified colour. The colour match of each two-layered specimen to the target natural tooth was assessed by CIELAB colour coordinates (ΔE^*, ΔL^*, Δa^* and Δb^*).

Results

The average colour difference ΔE^* value was 2.58 ± 84 for the ceramic specimen–natural tooth (CS–NT) pairs. ΔL^* values ranged from 0.17 to 2.71, Δa^* values ranged from −1.70 to 0.61, and Δb^* values ranged from −1.48 to 3.81. There was a moderate inverse correlation (R = −0.44, p-value = 0.0721) between L^* values for natural target teeth and ΔE^* values; no such correlation was found for a^* and b^* values.

Conclusion

The newly developed prototype CCM system has the potential to be used as an efficient tool in the reproduction of natural tooth colour.

Fracture strength of incisor crowns after intracoronal bleaching with sodium percarbonate

Kuga, M. C., dos Santos Nunes Reis, J. M., Fabrício, S., Bonetti-Filho, I., de Campos, E. A. and Faria, G. (2011), Fracture strength of incisor crowns after intracoronal bleaching with sodium percarbonate. Dental Traumatology. doi: 10.1111/j.1600-9657.2011.01077.x

Abstract – Objectives:  To compare the fracture resistance of bovine teeth after intracoronal bleaching with sodium percarbonate (SPC) or sodium perborate (SP) mixed with water or 20% hydrogen peroxide (HP). Materials and methods: Fifty extracted bovine teeth were divided into four experimental groups (G1–G4) and one control (n = 10) after endodontic treatment. Following root canal obturation, a glass ionomer barrier was placed at the cemento–enamel junction. After that, the pulp chambers were filled with: G1 – SP with water; G2 – SP with 20% HP; G3 – SPC with water; and G4 – SPC with 20% HP. No bleaching agent was used in the control group. Coronal access cavities were sealed with glass ionomer and specimens were immersed in artificial saliva. The bleaching agents were replaced after 7 days, and teeth were kept in artificial saliva for an additional 7 days, after which the pastes were removed and the coronal access cavities were restored with glass ionomer. Crowns were subjected to compressive load at a cross head speed of 0.5 mm min⁻¹ applied at 135° to the long axis of the root by an EMIC DL2000 testing machine, until coronal fracture. Data were statistically analysed by anova and Tukey test. Results: No differences in fracture resistance were observed between the experimental groups (P > 0.05). However, all experimental groups presented lower fracture resistance than the control group (P < 0.05). Conclusion: SPC and SP led to equal reduction on fracture resistance of dental crowns, regardless of being mixed with water or 20% HP.

New Casey Education Presentations

ST. PAUL, Minn. – (November 22, 2011) – Patterson Dental Supply, Inc. announces new updates to CAESY Cloud, its online portal that gives users instant access to CAESY Patient Education multimedia presentations via the Cloud. Six new Orthodontics presentations are now available to help practices keep patients informed:
Braces Care for Adults, Early Intervention, Retainers, Molar Uprighting, Invisalign Teen, and Identifying Oral Habits for Kids. Additionally, a number of existing presentations have already been updated, including Orthodontic Alternatives, Invisible Braces Alternatives, Adult Braces Procedure, Child Braces Procedure and
Invisalign for Adults.

Launched in July 2011, CAESY Cloud currently offers more than 280 multimedia presentations, which dental offices can access on PC and Mac desktop computers, Smartphones, and the iPad, iPhone and iPod. In addition to the new Orthodontics content, the latest updates to the online system include a new banner at the
login page that immediately notifies users of updates or new features. With all content accessible through the Cloud, subscribers just need to log in to access the latest videos and updates.

CAESY Cloud requires no installation. All that is needed to access CAESY Cloud is an Internet connection—networked connections between participating computers are not required. Dental professionals can simply sign up for the service by visiting www.CAESYCloud.com and gain access to the presentations for immediate use
from anywhere. After subscribing, users simply visit the website to access the full library of CAESY’s robust patient education presentations. A low monthly subscription fee makes CAESY Cloud available to dental practices with little initial investment.

CAESY Education Systems has been dentistry’s premier developer of leading-edge patient education technology and content since 1993. Patterson Dental Supply, Inc. acquired CAESY in May 2004. The award-winning multimedia information on preventive, restorative and esthetic treatment options helps dental practices worldwide educate their patients and grow their practices. The CAESY content is distributed via video and computer networks, DVD players and CAESY Cloud throughout the clinical and reception areas of the dental practice. The family of products includes CAESY Cloud, CAESY DVD, Smile Channel DVD, and CAESY Enterprise, which includes CAESY, Smile Channel and ShowCase. For more information, visit www.caesy.com.

Take 5 With Marty- Happy Thanksgiving

  

 

Dental Industry Thought Leader Dr. Marty Jablow Launching

“Take Five with Marty” Web Video Series

Woodbridge, NJ – November 23, 2011 – Dr. Marty Jablow, nationally-known dental industry thought leader, author and lecturer is preparing to launch a web video series entitled “Take Five with Marty” in early 2012.

Dr. Jablow, a full-time practicing clinician  who is known for his “tell it like it is” evaluations, explanations and demonstrations of new dental products ranging from advanced dental technology to the latest dental materials, will take the same no-nonsense approach during his “Take Five with Marty” segments.

According to Dr. Jablow, “Those that have seen my live presentations know that although I don’t pull any punches, I like to have fun as well. I’ll never fit into the stuffy college professor category. Maybe it’s my New Jersey attitude.”

 “Take Five with Marty” will feature reports on the hottest dental industry news, hands-on product demonstrations, though proving interviews and clinical spotlights – all in five minutes or less.” A video preview is available online and interested dental professionals can sign up to be the first to receive bulletins on upcoming “Take Five with Marty segments.

“I know how busy dental professionals are,” commented Jablow. “My role is to inform, pique interest and be the catalyst for ongoing discussion.”

About Dr. Marty Jablow:Martin Jablow, DMD, Americaʼs Dental Technology Coach is a clinician, speaker and author. He presents and publishes worldwide on many topics, including state of the art dental technology and dental materials. His recurring columns can be found on DrBicuspid.com and Dental- LearningHub.com’s Apex Magazine. Dr. Jablow is president of Dental Technology Solutions, a lecture and consulting company.

Dental Hygiene and Oral Care Market in US Examined in New iData Research Report

LONDON, Nov 08, 2011 (BUSINESS WIRE) -- Recovering from the global economic recession, the U.S. dental hygiene and oral care market reached over USD 1.6 billion last year. Forecasts say the market, and the professional teeth whitening segment in particularly, will cross USD 2 billion mark by 2017, driven by the fast-growing digital caries/cavity detection, professional teeth whitening and fluoride varnish segments. In the U.S., dental caries/cavities affect more than 95% of the adult population.

Association between carotid area calcifications and periodontal risk: a cross sectional study of panoramic radiographic findings

BMC Cardiovascular Disorders 2011, 11:67doi:10.1186/1471-2261-11-67

Background
The aim was to investigate the extent to which it is possible to diagnose suspected carotid calcification from dental panoramic radiography (PR) and to establish an association to periodontal risk.

Methods

824 PRs from one dental practice were investigated. Parameters considered were gender, age, bone loss - age index, tooth loss, periodontal risk and suspected carotid calcification (left, right, both sides). Periodontal risk was classified: low risk (under 4 missing teeth, bone loss - age index under 0.5), moderate risk (5 to 8 missing teeth and/or bone loss - age index 0.5 to 1.0) and high risk (more than 9 missing teeth and or bone loss - age index greater than 1.0).

Results

Of 824 patients, 349 were male (42.4%) and 475 female (57.6%); the mean age was 48.32+/-16.52 years. In 9.0% (n=74) of PRs, suspected carotid calcification was diagnosed (right: 5.5%, left: 2.3%, both sides: 1.2%). The mean tooth loss was 4.16+/-5.39 teeth. In the case of 282 patients (34.2%), there was a low, in 335 patients (40.7%) a moderate, and in 207 patients (25.1%) a high periodontal risk. There was a significant correlation found between number of cases of suspected carotid calcification and periodontal risk, tooth loss and age (p=0.0001). However, only age showed a significant association (OR: 4.9; CI: 2.4-9.8; p<0.0001) in contrast to periodontal risk (OR 1.4; CI: 0.9-2.4).

Conclusion

PR can provides indication of carotid calcification as a secondary (chance) finding. In addition, periodontal risk may be correlated with positive findings of carotid calcification.

Mathematics Provides Better Attachment For Dental Crowns

Dental treatment involving crown replacements costs the Swedish tax payers hundreds of millions SEK each year. Researchers at Chalmers University of Technology are developing a new method for determining exactly how to optimally prepare a tooth to place a crown on it. The method is expected to result in significantly cheaper and faster treatment, and improved quality and reliability of the crown replacements.

Each year, dentists put hundreds of thousands of new dental crowns into the mouths of Swedish patients. They firstly have to grind the teeth to which the crowns are to be attached. This is a procedure that is still much of an art and depends completely on the individual dentist's skill. But dentists will soon benefit from a computer program being produced by a group of researchers at Chalmers, at the initiative of the company Nobel Biocare. The researchers are now planning to run clinical tests.

"With current software, you can measure the damaged tooth's dimensions by laser scanning," explains Chalmers researcher Evan Shellshear. "The software then computes the optimal shape of the ground tooth, and the output is a 3-D visualisation of it. You also get a 3-D animation showing precise suggestions for manoeuvring the cutting tool in order to achieve the final tooth shape safely."

The software is based on advanced mathematical models and on state-of-the-art visualisation technology. The researchers have based their computations on roughly a dozen international guidelines for how teeth should be shaped before being fitted with dental crowns.

The guidelines cover things like the ratios between the height and width of the tooth, and how thick a layer needs to be ground down in order to leave enough space for the crown. The researchers have converted every guideline into an equation, dividing each tooth into tens of thousands of sections. From that, the software performs an optimisation, leaving the patient with as much of the healthy tooth as possible.

"Most dentists are very skilful, but no human being can achieve this sort of optimisation as efficiently as a computer program," says the Chalmers researcher and dentist Matts Andersson. "If the tooth does not have a good fit with the crown, bacteria can accumulate in the gaps, resulting in caries and loosening of the teeth. A bad fit can also lead to problems with the jaw joint or that the dental crown simply falls off."

The researchers' new method should therefore reduce the risk of patients suffering such problems. It would also shorten the time needed for treatment, and save large amounts of money.

"I estimate that the treatment sessions would be 10% shorter," says Matts Andersson. "That would result in savings of SEK 176 million per year. But the biggest benefit would probably be an improvement in quality, increasing the life of the dental crowns and reducing the number of remakes."

The Chalmers researchers have also produced 3-D software that dental students can use for learning how to grind teeth. Currently, students have no access to simulation programs with defined objectives. In the new software, the objective is the optimum tooth shape, and those undergoing training will know how close to the objective their effort has come.

Effect of JPEG compression on the diagnostic accuracy of periapical images in the detection of root fracture

Noujeim, M., Geha, H., Shintaku, W., Bechara, B. and Kashi, K. A. (2011), Effect of JPEG compression on the diagnostic accuracy of periapical images in the detection of root fracture. Dental Traumatology. doi: 10.1111/j.1600-9657.2011.01076.x

Abstract –  The ability of a periapical radiograph to exhibit the fracture depends on many factors including, but not limited to, the resolution of the image. The quality can be reduced by the image compression. The purpose of this study is to evaluate the effect of Joint Photographic Experts Group (JPEG) compressions on the diagnostic capability of periapical images in the detection of root fractures. Ten dry human mandibles containing 151 teeth were used in this study. Mandibles were radiographed with direct digital imaging sensor using the paralleling technique. Four observers detected root fracture on the images saved in one uncompressed and two compressed formats. Receiver operating characteristic (ROC) and anova analyses were performed to compare the performance of the three different systems and evaluate the effect of the compression on the accuracy of root fracture detection. Results did not show any statistically significant difference between the original, large images presented in tagged image file format (TIFF) and the two compressed images (JPEG medium file and JPEG small file images) in the detection of root fractures. The intra-rater comparison showed a significant consistency in the detection of the fracture. The compression reduced the file size considerably (from 1.77 MB to 453 and 95 Kb), but it did not affect the accuracy of root fracture detection. The file size reduction, on the other hand, is very beneficial for image electronic storage and mainly in teleradiology.

Prediction and diagnosis of clinical outcomes affecting restoration margins

DENNISON, J. B. and SARRETT, D. C. (2011), Prediction and diagnosis of clinical outcomes affecting restoration margins. Journal of Oral Rehabilitation. doi: 10.1111/j.1365-2842.2011.02267.x

Summary  The longevity of dental restorations is largely dependent on the continuity at the interface between the restorative material and adjacent tooth structure (the restoration margin). Clinical decisions on restoration repair or replacement are usually based upon the weakest point along that margin interface. Physical properties of a restorative material, such as polymerisation shrinkage, water sorption, solubility, elastic modulus and shear strength, all have an effect on stress distribution and can significantly affect margin integrity. This review will focus on two aspects of margin deterioration in the oral environment: the in vitro testing of margin seal using emersion techniques to simulate the oral environment and to predict clinical margin failure and the relationship between clinically observable microleakage and secondary caries. The many variables associated with in vitro testing of marginal leakage and the interpretation of the data are presented in detail. The most recent studies of marginal leakage mirror earlier methodology and lack validity and reliability. The lack of standardised testing procedures makes it impossible to compare studies or to predict the clinical performance of adhesive materials. Continual repeated in vitro studies contribute little to the science in this area. Clinical evidence is cited to refute earlier conclusions that clinical microleakage (penetrating margin discoloration) leads to caries development and is an indication for restoration replacement. Margin defects, without visible evidence of soft dentin on the wall or base of the defect, should be monitored, repaired or resealed, in lieu of total restoration replacement.

Pitt Offers Dental Informatics Program

Pittsburgh, pA:  November 15, 2011- The University of Pittsburgh is seeking applicants for MS, PhD, and postdoctoral positions for its training program in dental informatics. These programs provide training in a cutting-edge discipline which is focused on the application of computer and information science to improve dental practice, research, education, and management.  A full scholarship, stipend, and health insurance are being offered by the National Institutes of Health (NIH) to eligible individuals.

Dental informatics is a relatively new field with significant potential for affecting the future of dentistry.  The program is based on the premise that information technology has the potential to help dentistry improve individual and general oral health systematically and consistently. Advances in the integration, miniaturization, and sophistication of computer technology, as well as innovations in digital imaging, signal processing, data visualization, and human factors design can fundamentally improve the delivery of dental care.

The Center for Dental Informatics at the University of Pittsburgh’s School of Dental Medicine provides training to individuals from a variety of backgrounds (DDS, DMD, MD, computer science, etc.).  Students conduct innovative research on human-computer interaction, reuse of clinical data for research, evidence-based dentistry, electronic dental records, decision support, and teledentistry.  The program is highly multidisciplinary and can lead to unique career opportunities in software development, information technology management, academic teaching and research, and consulting. 

Applications for these positions are currently being accepted; the program starts in August 2012.  For more information, go to: http://di.dental.pitt.edu/postgrad.php, or email Titus Schleyer, DMD, PhD, at titus@pitt.edu

Patient responses to Er:YAG laser when used for conservative dentistry

Lasers in Medical Science

DOI: 10.1007/s10103-011-1012-0

Abstract

The utilization of laser technology in conservative dentistry offers several advantages compared with traditional instruments, but one of the still unsolved problems is the difficulty in describing and explaining these advantages to patients. The aims of this study were to verify the efficacy of the way patients are informed and to evaluate their satisfaction with laser-assisted treatment. Before treatment, 100 patients were given a brochure that explained the relevant laser-assisted dental procedures, and after dental treatment an 11-item questionnaire was administered to the patients to evaluate their satisfaction with the treatment. Statistical analysis showed high levels of satisfaction for all the questions, especially those regarding the choice between laser therapy and traditional instruments (100%), choosing laser in the future (89%), and recommending it to family and friends (84%). This study may be relevant when determining the overall satisfaction of patients with this new technology.

Immediate loading of 2 (all-on-2) versus 4 (all-on-4) implants placed with a flapless technique supporting mandibular cross-arch fixed prostheses: preliminary results from a pilot randomised controlled trial.

Eur J Oral Implantol. 2011 Autumn;4(3):205-17.

Abstract

Purpose: To evaluate the clinical outcome of 2 implants versus 4 implants placed flapless in fully edentulous mandibles and immediately restored with metal-resin screw-retained cross-arch prostheses. Materials and methods: Sixty patients from two different centres were randomised: 30 to the allon- 2 group and 30 to the all-on-4 group. To be immediately loaded, implants had to be inserted with a minimum torque of 40 Ncm. Outcome measures were prosthesis and implant failures, and biological and biomechanical complications. Results: Flaps were raised in 18 patients. Two implants in 2 patients did not reach the planned insertion torque and were immediately replaced by larger diameter ones. Four months after loading, no drop-out or implant failure occurred. One biomechanical complication occurred in the all-on-2 group versus 4 in the all-on-4 group. There were no statistically significant differences between groups for complications. There were no differences between centres. Conclusions: These very preliminary results, just 4 months after loading, suggest that immediately loaded mandibular cross-arch fixed dental prostheses can be supported by only 2 dental implants. Longer follow-ups (around 10 years) are needed to understand whether cross-arch mandibular prostheses can be successfully supported by only 2 dental implants.

Treatment of the atrophic edentulous maxilla: short implants versus bone augmentation for placing longer implants. Five-month post-loading results of a pilot randomised controlled trial.

Eur J Oral Implantol. 2011 Autumn;4(3):191-202.

Abstract

Purpose: To evaluate whether short (5 to 8.5 mm) dental implants could be a suitable alternative to longer (>11.5 mm) implants placed in atrophic maxillae augmented with autogenous bone for supporting dental prostheses. Materials and methods: Twenty-eight patients with fully edentulous atrophic maxillae having 5 to 9 mm of residual crestal bone height at least 5 mm thick, as measured on computerised tomography scans, were randomised into two groups either to receive 4 to 8 short (5 to 8.5 mm) implants (15 patients) or autogenous bone from the iliac crest to allow the placement of at least 11.5 mmlong implants (13 patients). Bone blocks and the windows at maxillary sinuses were covered with rigid resorbable barriers. Grafts were left to heal for 4 months before placing implants, which were submerged. After 4 months, provisional reinforced acrylic prostheses or bar-retained overdentures were delivered. Provisional prostheses were replaced, after 4 months, by definitive screw-retained metal-resin cross-arch fixed dental prostheses. Outcome measures were: prosthesis and implant failures, any complications (including prolonged postoperative pain) and patient satisfaction. All patients were followed for 5 months after loading. Results: All patients could be rehabilitated with implant-supported prostheses and none dropped out. One bilateral sinus lift procedure failed due to infection, though short implants could be placed. One implant failed in the augmented group versus 2 short implants in 2 patients. All failures occurred before loading. Significantly more complications occurred in augmented patients: 8 complications occurred in 5 augmented patients (all complained of pain 1 month after bone harvesting from the iliac crest). No complications occurred in the short implant group. All patients were fully satisfied with the treatment and would do it again. Conclusions: This pilot study suggests that short implants may be a suitable, cheaper and faster alternative to longer implants placed in bone augmented with autogenous bone for rehabilitating edentulous atrophic maxillae. However, these preliminary results need to be confirmed by larger trials with follow-ups of at least 5 years.

Marginal analysis of resin composite restorative systems using optical coherence tomography

Dental Materials
Volume 27, Issue 12 , Pages e213-e223, December 2011

Abstract 

Objectives

To analyze marginal integrity of resin composites dental restorations using optical coherence tomography (OCT).

Methods

Thirty extracted human premolars had occlusal cavities prepared and were randomly divided according to the restorative systems evaluated: Filtek P90™/P90 Adhesive System™, Filtek Z350™, and Filtek Z250™/Single Bond™ (3M/ESPE). The teeth were then stored in the dark for 24h in 0.9% saline solution. Restorations were finished and polished and stored again for 24h before thermocycling (500 cycles, 5–55°C). A commercially available OCT system was used (SR-OCT: OCP930SR/Thorlabs) with 930nm central wavelength. Cross-sectional images were obtained every 250μm and evaluated using Image J. A-scans were analyzed using the Origin 8.0 program, after a filter treatment using Matlab.

Results

The qualitative analysis of the internal margins did not observe gaps even after A-scan examination, although distinctive patterns were found for each restorative system. Penetration of Single Bond and Filtek P90 self-etch primer into dentin was also observed. A thick adhesive layer was found for Filtek P90 bonding agent.

Significance

Considering the characteristics of the OCT system, the setup used in this study was capable of evaluating the marginal integrity of resin composite restorations and detecting some interaction between dental bonding agents and dental substrates. OCT can be considered a promising method for the evaluation of the internal margins of restorations in vivo.

Sunstar Americas, Inc. Challenges Consumers to Address the Diabetes, Dental Health and Diet Connection

CHICAGO, Nov. 3, 2011 /PRNewswire/ -- In honor of National Diabetes Awareness Month, oral healthcare company Sunstar Americans, Inc., manufacturer of GUM® branded oral care products, has partnered with celebrity nutritionist, author and motivational speaker Robert Ferguson to create The GUMline to Waistline Challenge.
The GUMline to Waistline Challenge is an exciting eight-week initiative focusing on the correlation between oral health and diabetes management.
Starting November 1, 2011, registered participants will be provided with the information and tools needed to improve their oral health, reduce fat and embrace a healthier lifestyle.
Participants will receive step by step instructions on establishing and achieving realistic weight loss goals, a Diet Free Life Workbook and Journal, daily nutrition and exercise tips, and optional additional support by SMS and email.
"For everyone, the link between oral health and overall health is important to consider – but this relationship is particularly crucial when patients are at high risk for diabetes," said Dan Descary, Managing Director of Sunstar Americas, Inc. "The GUMline to Waistline Challenge is an opportunity for patients to learn about this link while challenging themselves to adopt changes and new habits that can help manage or prevent the onset of diabetes."
Registration is currently open to individuals, groups and families. To register, log on to www.dietfreelife.com and become a member using the discount code: GUM - or call (805) 642-8440. The outcome? Better oral health and a healthier you!
Participants in the GUMline to Waistline Challenge as well as other interested parties are encouraged to listen and participate in weekly radio webinars hosted online at www.dietfreelife.com. Sunstar Americas, Inc. and Robert Ferguson are excited to raise awareness of the relationship between oral health and total health, and to offer a plan that connects the dots between the gumline and the waistline.
About Sunstar Americas, Inc.Chicago-based Sunstar Americas, Inc., (formerly, John O. Butler Company) is a member of the Sunstar Group of companies, a global organization headquartered in Switzerland that serves oral health care professionals and consumers in 90 countries around the world. Sunstar's mission is to enhance the health and well-being of people everywhere via its four business areas: mouth and body, healthy and beauty, healthy home, and safety and technology.

New Techniques for Visual Caries Detection

Join me for this webinar tonight:

	New Techniques for Visual Caries Detection Presenter: Dr. Martin Jablow    CE Credits: 1 Webinar Begins:  11/9/11  8:00 PM ET,  5:00 PM PT Learn the latest advances in visual caries detection. How the use of state of the art imaging can improve caries detection and removal. What is the latest and future in caries detection? Sign up and receive CE credit by clicking here

RecordLinc Enables Sharing of Patient Dental Records to Maximize Quality of Patient Care

Electronic Record Technology Revolutionizes the Dental Industry

SILICON VALLEY, CA (November 3, 2011) – RecordLinc Inc., a company created by dental professionals dedicated to providing communication solutions for fellow dental professionals, has released an innovative electronic dental record solution for patient file-sharing, dentist-to-dentist communication, and dental practitioner collaboration that will increase efficiency and improve patient care.  

RecordLinc software creates a bridge between dental practices so general dentists, dental specialists, treatment coordinators, dental labs, and all dental office team members can share and collaborate on patients’ files through an HIPAA-compliant application.  The software can be easily accessed anywhere with an Internet connection and enables real-time discussions and patient file-sharing.

This convenient and safe access program allows doctors to upload dental records, collaborate on patient cases, and even form study groups that will improve patient care across the industry.  Dr. Gregory Burnett, DDS, a leading California orthodontist, designed the Internet-based application in order to maximize quality of patient care by making records more accessible.

RecordLinc’s  exclusive network of dental professionals is the largest in the world, which makes it easy for the dentist to collaborate on treatment plans and connect with colleagues they may know from school, study clubs, or simply afar.

At first glance, RecordLinc looks like a professional networking tool, but the real power of the system is the ability to integrate into various practice management systems.  Therefore, doctors can easily send patient referrals and transfers, as well as join the largest online network of associations, alumni groups, and study clubs.

According to CEO and Co-Founder Travis Rodgers, “Our goal is for RecordLinc to be considered the backbone for the exchange of dental records and doctor collaboration around the world.”

Over 600 thousand dental professional profiles are currently loaded in the RecordLinc system, and the new software continues to be implemented in many leading practices throughout the country and the world.  

“It’s time for a change,” says Rodgers.  “The medical field is moving in this direction; why shouldn’t the dental industry?  This is a huge time saver for all dental practitioners.  We feel our product has the potential to revolutionize and improve the dental industry.”

Future updates of the RecordLinc software are already under development.  Forthcoming enhancements for the product will likely include patient and guardian access to the system, e-filing for insurance claims, pre-treatment forms, online prescriptions, and an application to allow full integration into all leading practice management software programs.

About RecordLinc

Dr. Greg Burnett (orthodontist) and Dr. Bruce Bohannan (oral surgeon) envisioned a product that would save time, money, and resources.  The result was RecordLinc — a product that effectively elevates customer care to a new level of excellence.  Created by a dental professional for dental professionals, RecordLinc is a unique technology that creates living patient files online.  These files are able to last for the lifetime of each patient, and can be transferred from doctor to doctor as each patient's needs change.  RecordLinc users have access to images, communication, and the ability to respond, in real time, with the messaging system.  From Dr. Burnett’s commitment to improving the field of dentistry, he recruited leading software developers to turn existing needs into a functional product and an innovative solution.  Simply put, RecordLinc was born through forward-thinking design, application development expertise, and healthcare industry knowledge directed at facilitating industry-wide needs. 

For more information please visit RecordLinc online at www.RecordLinc.com.

Stay updated on future developments and product news by following RecordLinc on Facebook.

The effect of autoclaving on torsional moment of two nickel–titanium endodontic files

I am a Sybronendo Twisted File user and love the files.  I do endo using just 1 or 2 files in most cases. MJ

King, J. B., Roberts, H. W., Bergeron, B. E. and Mayerchak, M. J. (2011), The effect of autoclaving on torsional moment of two nickel–titanium endodontic files. International Endodontic Journal. doi: 10.1111/j.1365-2591.2011.01958.x

Abstract

Aim  To evaluate the effects of repeated autoclaving on torsional strength of two nickel–titanium (NiTi) rotary endodontic files: Twisted Files (SybronEndo, Orange, CA, USA) and GT Series X files (Dentsply Tulsa Dental Specialties, Tulsa, OK, USA).

Methodology  Four groups of 20 GT Series X (size 20, .06 taper) and four groups of 20 Twisted Files (size 25, .06 taper) were subjected to 0, 1, 3 or 7 autoclave cycles. The nonautoclaved files served as controls. Failure in torsion was recorded using a torsiometer according to ANSI/ADA 58 and ISO 3630-1 standards. Mean results were analysed using analysis of variance (anova) at a 95% confidence level. Dunnett’s procedure was used for post hoc analysis.

Results  There was no significant difference in torsional moment between the number of autoclave cycles for Twisted Files. However, the mean torque at failure was significantly lower for GT Series X files after three (P < 0.001) and seven (P < 0.001) autoclave cycles. For Twisted Files, there was a significant increase (P < 0.001) in mean number of degrees of rotation to failure with more autoclave cycles compared to nonautoclaved files. For GT Series X files, there was no significant association (P = 0.527) between the number of autoclave cycles and the degrees of rotation to failure.

Conclusions  Repeat autoclaving of unused GT Series X files between three and seven times resulted in a significant reduction in torsional strength, whilst there was no effect observed for Twisted Files.