Monday, September 30, 2013

Delayed orthodontic extrusion of a traumatically intruded immature upper permanent incisor – a case report

Umesan, U. K., Chua, K. L. and Kok, E. C. (2013), Delayed orthodontic extrusion of a traumatically intruded immature upper permanent incisor – a case report. Dental Traumatology. doi: 10.1111/edt.12078


Dental injuries are probably the most common orofacial injuries sustained during sports and play. Intrusion or intrusive luxations occur when the teeth are driven into the alveolus by an axially directed impact. This article describes the clinical case of an 8-year-old patient who suffered complete intrusive luxation of an immature permanent central incisor following an accident. An attempt at spontaneous re-eruption failed to facilitate re-emergence of the tooth beyond 2 mm. The recommended wait-and-see strategy in anticipation of spontaneous re-eruption should cease to be an option when no further elongation can be observed. Orthodontic extrusion or surgical re-positioning is a valid treatment alternative when the former fails. In this case, although the recommended time period for effecting orthodontic extrusion had elapsed, this procedure was undertaken successfully presumably owing to the application of controlled, biologically optimal forces. A review of the extruded tooth a year later revealed no clinical or radiographic signs of loss of vitality. This was confirmed radiographically by the completion of root development, an intact lamina dura and no evident signs of resorption.

Friday, September 27, 2013

Toothache, a tumour and a new face

24 September 2013 Last updated at 23:53 BST
Jim Doyle, a theatre technician from the Royal Orthopaedic Hospital in Birmingham went to his dentist with what felt like a toothache.
The dentist removed four of Mr Doyle's teeth but the pain continued. After pushing for a referral, Mr Doyle discovered he had a tumour.
Consultants had to deconstruct Mr Doyle's jaw to remove the cancer and then rebuild the lower half of his face using tissue from his leg.
View the video

NASCAR Star Greg Biffle PutS children’s Dental Health ON THE FAST TRACK IN CHICAGO with american dental association’s “give kids a smile®” program


3M ESPE Dental and the ADA Host Give Kids A Smile Screening Event for St. Malachy’s Elementary Students at UIC College of Dentistry Department of Pediatric Dentistry

Biffle Finishes 16th in the NASCAR Sprint Cup™ Race at Chicagoland Speedway

ST. PAUL, Minn., (September 18, 2013) – This past race weekend, Greg Biffle, 3M Racing and 3M ESPE Dental had an opportunity to put smiles on lots of faces with a special ADA Give Kids A Smile® program for Chicago-area elementary school students and race fans of all ages.
As part of the NASCAR race week at Chicagoland Speedway, the American Dental Association's (ADA) Give Kids A Smile® program visited the UIC College of Dentistry - Department of Pediatric Dentistry for a special high-speed oral health screening event featuring members of the No. 16 3M Ford Fusion race team and the No. 16 3M race car.  Children from St. Malachy’s Elementary had a chance to rev up their dental health practices with a free check-up, cleaning and fluoride treatment, along with prizes, entertainment and high-speed fun.  Local dignitaries, faculty members and members of the ADA board of trustees also attended the event.

The ADA’s Give Kids A Smile program, ADA Foundation, Henry Schein, Inc. (NASDAQ:HSIC), CareCredit℠ and 3M ESPE Dental have teamed up with NASCAR star Greg Biffle for the third year to put good oral health on the fast track for young fans of NASCAR.  Across the country, Biffle, driver of the No. 16 3M Ford Fusion in the NASCAR Sprint Cup Series, is helping deliver the message to children about healthy habits like brushing for two minutes twice a day, flossing, visiting the dentist regularly and making smart food choices.

Thousands of race fans visited the 3M display in the midway for fun family activities, education about healthy dental habits, prizes and a chance to meet Biffle on Sunday morning. 

“This program is great in that it helps teach parents and kids about good dental care for children, and provides education, screenings and treatment for thousands of kids in need each year.  It’s an honor to be part of Give Kids A Smile,” said Biffle.

The weather on race day at Chicagoland Speedway was nothing to smile at, as rain delayed the start of the race and delivered a five-hour red flag mid-way through.  Biffle started the race in the seventh spot, and finished the long, soggy day in 16th.  He is now in the 10th position in the Chase for the Sprint Cup Championship.

Give Kids A Smile is a terrific program that helps us showcase the great work of dentists and their teams in helping provide care to people who need it,” said ADA President Robert A. Faiella, D.M.D., M.M.Sc. “It’s a shame that dental disease is the most common chronic childhood disease when it’s something that can be prevented with proper oral hygiene and regular dental visits.”

The yearlong ADA Give Kids A Smile education program, now in its 11th year, includes a national public service announcement featuring Greg Biffle and ongoing outreach to parents and children through dental offices, community events and media. Throughout the year, more than 1,700 Give Kids A Smile events will be held around the country, providing dental services to more than 400,000 underserved children.

“The Give Kids A Smile program loves having the opportunity to work with 3M ESPE Dental, Greg Biffle and NASCAR,” said Dr. Jeff Dalin, co-founder and chair of the ADA Give Kids A Smile National Advisory Committee.  “We spent a day at UIC Department of Pediatric Dentistry working with kids from a local elementary school and several days at Chicagoland Speedway giving out thousands of toothbrush kits and dental hygiene instructions to NASCAR fans.  We were able to touch thousands of lives with the important message about brushing twice a day for two minutes to prevent future dental problems.  This wouldn’t be possible without the support of our partners like Henry Schein, Inc., its supplier partners and CareCredit.”

In addition to following Biffle on the track, race fans of all ages can put themselves in victory lane with him.   Just visit to create a photo with Greg Biffle on pit road or with the race-winning trophy in Victory Lane.  For more smart dental tips, visit, and


About the American Dental Association
The not-for-profit ADA is the nation's largest dental association, representing more than 157,000 dentist members. The premier source of oral health information, the ADA has advocated for the public's health and promoted the art and science of dentistry since 1859. The ADA's state-of-the-art research facilities develop and test dental products and materials that have advanced the practice of dentistry and made the patient experience more positive. The public has long relied on the valuable and respected ADA Seal of Acceptance when choosing safe and effective consumer dental care products. The monthly Journal of the American Dental Association (JADA) is the ADA's flagship publication and the best-read scientific journal in dentistry. For more information about the ADA, visit the Association's Web site at

About the ADA Foundation
The ADA Foundation strives to improve human health through improved oral health. Since 1991, the ADA Foundation has disbursed nearly $37.5 million dollars to support such charitable activities. In addition to funding grants for dental research, education, scholarships and access to care, the Foundation supports Charitable Assistance Programs such as relief grants to dentists and their dependents who are unable to support themselves due to injury, a medical condition or advanced age; and grants to dentists who are victims of declared disasters.

About Henry Schein, Inc.
Henry Schein, Inc. is the world’s largest provider of health care products and services to office-based dental, medical and animal health practitioners.  The Company also serves dental laboratories, government and institutional health care clinics, and other alternate care sites.  A Fortune 500® Company and a member of the NASDAQ 100® Index, Henry Schein employs more than 15,000 Team Schein Members and serves more than 775,000 customers.  The Company offers a comprehensive selection of products and services, including value-added solutions for operating efficient practices and delivering high-quality care.  Henry Schein operates through a centralized and automated distribution network, with a selection of more than 96,000 branded products and Henry Schein private-brand products in stock, as well as more than 110,000 additional products available as special-order items. The Company also offers its customers exclusive, innovative technology solutions, including practice management software and e-commerce solutions, as well as a broad range of financial services.  Headquartered in Melville, N.Y., Henry Schein has operations or affiliates in 25 countries.  The Company’s sales reached a record $8.9 billion in 2012, and have grown at a compound annual rate of 17 percent since Henry Schein became a public company in 1995.  For more information, visit the Henry Schein Web site at

About CareCredit
For over 25 years CareCredit, a healthcare credit card, has been making it easy for patients to receive desired care. Today, CareCredit is available in over 160,000 enrolled healthcare practices and has been used by over 20 million patients. CareCredit is exclusively selected for their members by many state and national dental associations, including ADA Business ResourcesSM, AGD, AAOMS, and AAP, and is also recommended by leading practice management educators.

About 3M ESPE Dental
3M ESPE is a dental product manufacturer that markets more than 2,000 dental products and services. 3M ESPE dental products are designed to help dental professionals improve their patients' oral health care. The 3M Digital Oral Care Department, part of the 3M ESPE Division, aims to accelerate and strengthen 3M’s efforts to lead the digital transformation that is occurring in oral care. 3M Health Care, one of 3M’s five Business Groups, provides world-class innovative products and services to help health care professionals improve the practice and delivery of patient care in medical, oral care, drug delivery and health information markets. For more information on the complete 3M ESPE line of dental products, visit the 3M ESPE website at or call the 3M ESPE Technical Hotline at 1-800-634-2249. Products are available for purchase through authorized 3M ESPE distributors.

3M and ESPE are trademarks of 3M or 3M Deutschland GmbH.  

About 3M
3M captures the spark of new ideas and transforms them into thousands of ingenious products. Our culture of creative collaboration inspires a never-ending stream of powerful technologies that make life better. 3M is the innovation company that never stops inventing. With $30 billion in sales, 3M employs about 88,000 people worldwide and has operations in more than 70 countries. For more information, visit or follow @3MNews on Twitter.

Thursday, September 26, 2013

Findings suggest 'HIV-1 replication without integration' may help HIV-1 persist in vivo despite the application of antiviral drugs

New HIV-1 replication pathway discovered by NYU College of Dentistry researchers

Current drug treatments for HIV work well to keep patients from developing AIDS, but no one has found a way to entirely eliminate the virus from the human body, so patients continue to require lifelong treatment to prevent them from developing AIDS.

Now, a team of researchers led by Dr. David N. Levy, Associate Professor of Basic Science and Craniofacial Biology at the New York University College of Dentistry (NYUCD), have discovered a new way that HIV-1 reproduces itself which could advance the search for new ways to combat infection.

For decades, scientists have been confident that HIV-1, the virus that causes AIDS, must insert its genetic material into a cell's DNA in order to reproduce. This process, called "integration," makes the virus a permanent part of the cell. Some of these infected cells can remain as long as the person is alive, and this is one reason why HIV+ individuals must remain on anti-HIV drugs for life.

Dr. Levy's National Institutes of Health (NIH) funded research, "HIV-1 replication without integration," published today on-line in the Journal of Virology, with lead author Dr. Benjamin Trinité, a post-doctoral fellow in Dr. Levy's laboratory, has shown HIV-1 can sometimes skip this integration step entirely.

"Although this is not the virus' main method for replicating, having this option available can help HIV survive," said Dr. Levy. "These new findings suggest one mechanism by which HIV may be surviving in the face of antiviral drugs, and suggests new avenues for research into eliminating infection."

The integration step is highly inefficient and actually fails up to 99% of the time, leaving most viruses stranded outside of the safe harbor of cell's DNA. It has been assumed that these stranded, or "unintegrated" viruses were unable to reproduce, but Dr. Levy's team has found that if the conditions are right they can generate new viruses that infect new cells.

The team also found that the unintegrated viruses can survive for many weeks in cells, allowing HIV to "hide out" in a dormant state. The ability of HIV-1 to go dormant helps it avoid elimination by antiviral drugs and immune responses.

"There is intense interest by researchers in the idea that new drugs might be developed to help to completely eliminate the virus from infected individuals," said Dr. Levy. "We think that the new replication mechanism we have found could provide a target for drugs designed to eliminate infection."

Dr Levy notes, an interesting phenomenon which other researchers have observed is that some bacteria which live in our mouths can stimulate HIV-1 to emerge from its dormant state.

"NYUCD has some terrific groups of researchers who are expert in oral flora and HIV, so we'll be quite interested in working with them to find out how oral health might influence the new replication pathway my group has discovered," added Dr. Levy.

This study was supported by grants from NIH/NIAID: R01AI078783 (DNL) and R01AI093998 (DNL and DW).

About New York University College of Dentistry--New York University College of Dentistry (NYUCD) is the third oldest and the largest dental school in the US, educating more than 8 percent of all dentists. NYUCD has a significant global reach and provides a level of national and international diversity among its students that is unmatched by any other dental school.

Wednesday, September 25, 2013

DentalEZ® Group Launches New and Improved Identafi® Website


Malvern, PA – (September 20, 2013) – DentalEZ® Group, a supplier of innovative products and services for dental health professionals worldwide, has officially updated its Identafi® website for a more productive and user-friendly experience.  The enhanced Identafi website now offers various new tools for both clinicians and patients alike while further propelling the company’s goals to increase oral cancer awareness and promote the benefits of using the Identafi oral cancer screening device. 

The website’s newly-designed Research section is now arranged in an extremely well-organized manner.  Each research document is listed in chronological order by the year it was published, and each file is easily downloadable for simple reference and repurposing. 

In addition, an improved Patient section features a downloadable educational pamphlet that stresses the importance of early detection and explains how painless and easy the oral cancer test is when using Identafi.  Also included are educational videos and a new “Find an Identafi” tool that allows patients to locate participating dental practices or surgical centers that use the Identafi oral cancer screening device within any ZIP code nationwide.

Moreover, an enhanced Clinician section includes useful training videos, clinical images, downloadable patient education materials, and a multi-component marketing tool kit.  Clinicians are now provided with convenient Identafi-specific forms for warranty registration, literature requests, and newsletter sign-ups. They can also register as an Identafi-using practice so they can be found by patients looking for an advanced oral cancer screening device.  Simply go to and click on the Tools tab.

For more information, please visit or call 866-DTE-INFO.

About DentalEZ® Group

DentalEZ® Group is committed to advancing the practice of dentistry through innovative products and services.  Encompassing six distinct product brands — StarDental®, DentalEZ®, CustomAir®, RAMVAC®, NevinLabs, and Columbia Dentoform® — DentalEZ® Group manufactures everything in the operatory, from handpieces to chairs to vacuum systems to dental simulation models, creating a complete line of products to elevate the health, comfort, and efficiency of the dental operatory.  For more information, please visit

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Tuesday, September 24, 2013

Introducing 3M™ True Definition Software 4.1

Latest version of 3M True Definition Software allows dentists to more quickly and efficiently take digital impressions for challenging cases

ST. PAUL, Minn. – (September 19, 2013) – 3M ESPE announces 3M True Definition Scanner Software Version 4.1. This software upgrade improves the focal range of the scanning handpiece, making it easier to scan a full arch and capture challenging areas of the oral anatomy.  This upgrade will be automatically installed on all 3M True Definition Scanners, and is another example of 3M’s commitment to continuously improve the user experience and offer the greatest value possible with its affordable monthly data plan.
Practitioners who have used the new software in a clinical setting have emphasized its improved scan speed and ease of capturing incisal edges and interproximal spaces, resulting in more user control of the scanning experience and less overall chair time for the patient.
“The new software has improved the speed of capture,” said Dr. Nicholas Marongiu, DDS. “I was able to scan a full arch in about half the time as before.”   
“The new software makes it easier to scan quickly and efficiently for challenging patients; it allows me to get in and out,” said Dr. Brent Fredrickson, DDS. 
The 3M True Definition software upgrade also was praised for its ability to improve training of new users.   
“The new software will improve the training experience for new doctors and other clinical trainers like me,” said Jeanne Lavery, certified clinical trainer for the 3M True Definition Scanner. 
“Our customers are pleased to see 3M providing continuous technology improvements, such as easier scanning or expanded treatment options, without additional upgrade costs,” said David Frazee, VP and GM of 3M Digital Oral Care. “With 3M’s model, it is easy to get started now with something that is proven, and still be well positioned for future improvements.” 
The 3M True Definition Scanner continues to be more accurate—and more consistently accurate—than leading systems on the market¹. The outstanding accuracy leads to reduced seating times and has been clinically proven in thousands of cases in the past 12 months, with a fit rate of 99.7%2
For more information about the 3M True Definition Scanner, visit

Monday, September 23, 2013

Join me for a webinar - On Better Imagaing

Imaging for Better Diagnosis and Record Keeping
This webinar is sponsored by Air Techniques
Times: Tue  9/24/13  8:15 PM ET    5:15 PM PT

 9/25/13    0:15 AM UTC

I am going to discuss multiple methods of acquiring images and the benefits to having and using the images.

Click this link to sign up

Saturday, September 21, 2013

Delayed replantation of an avulsed maxillary premolar with open apex: A 24 months follow-up case report




Avulsion of permanent teeth is most serious of all dental injuries and accounts for 1-16% of all traumatic injuries, of which maxillary incisors are most commonly involved. However, in this report a rare case of isolated avulsed immature premolar has been described. The patient had reported more than 3 hours after the trauma with a tooth stored in dry condition and soil contamination. The prognosis depends on measures taken at the place of accident or the time immediately after avulsion. Replantation is the treatment of choice, but cannot always be performed immediately. An appropriate emergency management and treatment plan is important for good prognosis. In this report stepwise management of an avulsed immature maxillary premolar with extended period of dry storage has been described followed up for a period of 2 yrs.

Friday, September 20, 2013

Scanning electron microscope analysis of sealant penetration and adaptation in contaminated fissures

Objective: The objective of this study is to evaluate the penetration and adaptation of two different sealant materials applied under different conditions of contamination using scanning electron microscope (SEM) analysis.  

Materials and Methods: A total of 56 extracted human third molar teeth were randomly assigned into eight equal groups. The treatment groups were defined by the combination of two sealant materials (glass ionomer fissure sealant "Fuji Triage" or resin-based fissure sealant "Clinpro TM") and four surface conditions (dry condition, water contamination, saliva contamination or saliva contamination and air-drying). Penetration depth, sealant adaptation and fissure types were evaluated under SEM after sectioning the teeth. Tukey's test and multiple linear regression analyses were used for statistical analysis.  

Results: No significant difference in the sealant penetration and adaptation was found between both materials under dry conditions. However, under wet contaminations, resin-based sealant showed less adaptation and penetration with a significant difference when compared to glass ionomer sealant (P < 0.05). The multiple linear regression analyses revealed significant impact of different materials and types of contamination on the sealant penetration and adaptation.

 Conclusion: Glass ionomer sealant has better fissure penetration and more intimate adaptation than resin-based sealant under wet contamination conditions.

Thursday, September 19, 2013

Prosthetic restoration in the single-tooth gap: patient preferences and analysis of the WTP index

Augusti D, Augusti G, Re D. Prosthetic restoration in the single-tooth gap: patient preferences and analysis of the WTP index. Clin. Oral Impl. Res. 00, 2013; 18.



The objective of this study was to evaluate the preference of a patients' population, according to the index of willingness to pay (WTP), against two treatments to restore a single-tooth gap: the implant-supported crown (ISC) and the 3-unit fixed partial denture prosthesis (FPDP) on natural teeth.

Materials and methods

Willingness to pay values were recorded on 107 subjects by asking the WTP from a starting bid of €2000 modifiable through monetary increases or decreases (€100). Data were collected through an individually delivered questionnaire. The characteristics of the population and choices made, the median values and WTP associations with socio-demographic parameters (Mann–Whitney and Kruskal–Wallis tests), correlations between variables (chi-square test in contingency tables) and significant parameters for predicting WTP values obtained in a multiple linear regression model were revealed.


The 64% of patients expressed a preference for ISC, while the remaining 36% of the population chose the FPDP. The current therapeutic choice and those carried out in the past were generally in agreement (>70% of cases, P = 0.0001); a relationship was discovered between the anterior and posterior area to the same method of rehabilitation (101 of 107 cases, 94.4%). The WTP median values for ISC were of €3000 and of €2500 in the anterior and posterior areas, respectively. The smallest amount of money has been allocated for FPDP in posterior region (median of €1500). The “importance of oral care” for the patient was a significant predictor, in the regression model analysis, for the estimation of both anterior (P = 0.0003) and posterior (P < 0.0001) WTP values. The “previous therapy” variable reached and was just close to significance in anterior (P = 0.0367) and posterior (P = 0.0511) analyses, respectively.


Within the limitations of this study, most of the population (64%) surveyed indicated the ISC as a therapeutic solution for the replacement of a single missing tooth, showing a higher WTP index in the anterior area. Among investigated socio-demographic variables, the importance assigned by the patient to oral care appeared to influence WTP values of the rehabilitation, regardless the location of the single gap in the mouth.

Wednesday, September 18, 2013

Supplementation of soft drinks with metallic ions reduces dissolution of bovine enamel

Journal of Applied Oral Science
Print version ISSN 1678-7757
J. Appl. Oral Sci. vol.21 no.4 Bauru July/Aug. 2013

The aim of this study was to evaluate the effect of the addition of metallic ions to carbonated drinks on their erosive potential.
Powdered enamel was added to carbonated beverages (Coca-ColaTM or Sprite ZeroTM and shaken for 30 s. The samples were then immediately centrifuged and the supernatant removed. This procedure was repeated 5 times with the beverages containing Cu2+, Mg2+, Mn2+ or Zn2+ (1.25-60 mmol/L). For Coca-ColaTM, the concentration of each ion that exhibited the highest protection was also evaluated in combination with Fe2+. The phosphate or calcium released were analyzed spectrophotometrically. Data were analyzed using ANOVA and Tukey's test (p<0 .05="" p="">
For Coca-ColaTM, the best protective effect was observed for Zn2+ alone (10 mmol/L) or in combination (1 mmol/L) with other ions (12% and 27%, respectively, when compared with the control). Regarding Sprite ZeroTM, the best protective effect was observed for Cu2+ at 15 and 30 mmol/L, which decreased the dissolution by 22-23%. Zn2+ at 2.5 mmol/L also reduced the dissolution of powdered enamel by 8%.
The results suggest that the combination of metallic ions can be an alternative to reduce the erosive potential of Coca-ColaTM. Regarding Sprite ZeroTM, the addition of Cu2+ seems to be the best alternative.

Tuesday, September 17, 2013

The efficacy of the self-adjusting file and ProTaper for removal of calcium hydroxide from root canals

Journal of Applied Oral Science
Print version ISSN 1678-7757
J. Appl. Oral Sci. vol.21 no.4 Bauru July/Aug. 2013

The goal of this study was to evaluate the efficacy of the Self-Adjusting File (SAF) and ProTaper for removing calcium hydroxide [Ca(OH)2] from root canals.
Thirty-six human mandibular incisors were instrumented with the ProTaper system up to instrument F2 and filled with a Ca(OH)2-based dressing. After 7 days, specimens were distributed in two groups (n=15) according to the method of Ca(OH)2 removal. Group I (SAF) was irrigated with 5 mL of NaOCl and SAF was used for 30 seconds under constant irrigation with 5 mL of NaOCl using the Vatea irrigation device, followed by irrigation with 3 mL of EDTA and 5 mL of NaOCl. Group II (ProTaper) was irrigated with 5 mL of NaOCl, the F2 instrument was used for 30 seconds, followed by irrigation with 5 mL of NaOCl, 3 mL of EDTA, and 5 mL of NaOCl. In 3 teeth Ca(OH)2 was not removed (positive control) and in 3 teeth canals were not filled with Ca(OH)2 (negative control). Teeth were sectioned and prepared for the scanning electron microscopy. The amounts of residual Ca(OH)2 were evaluated in the middle and apical thirds using a 5-score system.
None of the techniques completely removed the Ca(OH)2 dressing. No difference was observed between SAF and ProTaper in removing Ca(OH)2 in the middle (P=0.11) and the apical (P=0.23) thirds.
The SAF system showed similar efficacy to rotary instrument for removal of Ca(OH)2 from mandibular incisor root canals.

Monday, September 16, 2013

Factors affecting the bond strength of denture base and reline acrylic resins to base metal materials

J. Appl. Oral Sci. vol.21 no.4 Bauru July/Aug. 2013

The shear bond strengths of two hard chairside reline resin materials and an auto-polymerizing denture base resin material to cast Ti and a Co-Cr alloy treated using four conditioning methods were investigated.
Disk specimens (diameter 10 mm and thickness 2.5 mm) were cast from pure Ti and Co-Cr alloy. The specimens were wet-ground to a final surface finish of 600 grit, air-dried, and treated with the following bonding systems: 1) air-abraded with 50-70-µm grain alumina (CON); 2) 1) + conditioned with a primer, including an acidic phosphonoacetate monomer (MHPA); 3) 1) + conditioned with a primer including a diphosphate monomer (MDP); 4) treated with a tribochemical system. Three resin materials were applied to each metal specimen. Shear bond strengths were determined before and after 10,000 thermocycles.
The strengths decreased after thermocycling for all combinations. Among the resin materials assessed, the denture base material showed significantly (p<0 .05="" 10="" 34.56="" 38.30="" after="" alloy.="" and="" base="" bond="" both="" cast="" co-cr="" con="" condition.="" decreased="" denture="" except="" for="" greater="" less="" material="" materials="" mdp="" metals.="" mpa="" of="" p="" reline="" shear="" strengths="" sufficient:="" than="" the="" thermocycles="" ti="" to="" two="" were="" with="">
Bonding of reline resin materials to metals assessed was clinically insufficient, regardless of metal type, surface treatment, and resin composition. For the relining of metal denture frameworks, a denture base material should be used.

Saturday, September 14, 2013

Fabrication and characterisation of polymer composites for endodontic use

International Endodontic Journal
Accepted Article




To develop a low density polyethylene-hydroxyapatite (HA-PE) composite with properties tailored to function as a potential root canal filling material.


Hydroxyapatite and polyethylene mixed with strontium oxide as a radiopacifier were extruded in a single screw extruder fitted with an appropriate die to form fibres. The composition of the composite was optimized with clinical handling and placement in the canal being the prime consideration. The fibres were characterised using Infrared spectroscopy (FTIR) and their thermal properties determined using differential scanning calorimetry (DSC). The tensile strength and elastic modulus of composite fibres and gutta-percha were compared, dry and after 1 month storage in simulated body fluid (SBF), using a universal testing machine. The radiopacity of the fibres was determined using digital radiography. The interaction of the composites with eugenol was evaluated and compared with gutta-percha. Data of the tensile strengths were submitted to two-way ANOVA and Bonferroni tests (P<0 .05="" p="">


The endothermic peaks obtained from the DSC studies showed that the melting point of the HA/PE composites ranged between 110.5 and 111.2°C, whereas gutta-percha exhibited a melting point at 52°C. The tensile strength and elastic modulus of the silanated HA/PE composites were significantly higher than those of gutta-percha (P<0 .0001="" 1="" a="" and="" composites="" conditions="" demonstrated="" dry="" eugenol="" evaluations="" fibres="" gutta-percha="" ha="" in="" increase="" mass="" molar="" month="" p="" polymer="" radiological="" radiopaque.="" sbf.="" showed="" significant="" silanated="" storage="" sufficiently="" that="" the="" unchanged.="" under="" were="" whereas="">


Promising materials for endodontic applications have been developed, offering relevant benefits over the traditional materials in terms of mechanical and chemical properties.

Friday, September 13, 2013

Liquorice root extracts as potent cariostatic agents in pediatric practice

Objective: The present study was designed to evaluate the in vitro as well as in vivo cariostatic efficacy of aqueous and ethanolic extracts of liquorice and assess their acceptability among child patients.  

Materials and Methods: Minimum bactericidal concentrations of aqueous and ethanolic extracts of liquorice against mutans streptococci were evaluated and their toxicity profiles were tested using the model organism Caenorhabditis elegans. The clinical trial was conducted as a double-blind pilot study where pediatric patients (N = 60), aged 7-14 years, were equally divided by randomization into three groups, namely, Group 1 using aqueous liquorice mouthwash (15%), Group 2 using ethanolic liquorice mouthwash (3.75%), and Group 3 using chlorhexidine gluconate (0.156%) as positive control. A baseline pre-rinse and three post-rinse saliva samples were evaluated for the changes in pH and mutans streptococci colony counts. Palatability of liquorice extracts was assessed through a self-designed questionnaire having structured categorical responses.  

Statistical Analysis: Parametric evaluations were done using Analysis of Variance (ANOVA) and Dunnett's "t" test.

 Results: The mean mutans streptococci colony counts in all three groups decreased significantly (P < 0.001) immediately after the oral rinsing. The reduction in colony counts was significant in ethanolic liquorice group as compared to the control (P < 0.01). Liquorice extracts also led to an immediate rise in salivary pH. The results showed an immediate antimicrobial action of liquorice extracts, with limited retentivity.

Conclusion: The study affirms that both aqueous and ethanolic liquorice extracts are potent cariostatic agents and are found to be palatable by child patients.

Effect of the topical application of 50% lignocaine hydrochloride on the sensitivity of dentine in man

Archives of Oral Biology
Volume 58, Issue 10 , Pages 1549-1555, October 2013



To determine the effect of topical applications of 50% (w/v) lignocaine HCl on the sensitivity of human dentine.


The experiments were carried out on 12 premolars scheduled for extraction as part of orthodontic treatment in nine subjects (ages: 16–29 years). Dentine was exposed by cutting a cavity at the tip of the buccal cusp of each tooth, and etched with 35% phosphoric acid. The sensitivity of the exposed dentine to probing and air-blast stimuli was assessed before and after applying either 50% (w/v) lignocaine HCl solution or distilled water to the exposed dentine for 10min. Changes in the sensitivity of the dentine were monitored for up to 160min. The subject indicated the intensity of any pain produced by marking a 100mm visual analogue scale (VAS).


Before treatment, both forms of stimulus evoked pain in all the teeth. The median VAS score with probing was 40mm and, with air-blast stimulation, 30mm. 50% lignocaine HCl produced a progressive fall in these scores and after 30min there was no response to either probing or air-blast stimulation. The responses started to return 30–160min after the lignocaine had been washed off. Water had no effect.


Lignocaine will diffuse into exposed dentine and block the pain evoked by probing and air-blast stimuli provided that a sufficiently steep diffusion gradient is created. A topical application of a 50% (w/v) solution of lignocaine HCl for 10min will anaesthetise dentine within 30min.

Thursday, September 12, 2013

Pull-out bond strength of a fibre-reinforced composite post system luted with self-adhesive resin cements

Available online 2 September 2013
In Press, Uncorrected Proof



Due to morphological differences along the root canal, serious structural damage, or extensive endodontic preparation, cement thickness of luted fibre-reinforced composite (FRC) post systems can largely vary. This study aimed at evaluating the effects of a self-etch (Multilink Automix, MLA) and various self-adhesive resin cements (G-Cem, GCM; Maxcem Elite, MXE; RelyX Unicem, RLX; SmartCem 2, SMC) on the pull-out bond strengths of FRC posts to root canal dentine, and to compare the effects of different cementation thicknesses.


100 bovine incisor roots were embedded in acrylic resin and randomly assigned to two groups. Root canals of group 1 were prepared with RelyX Fiber Post drill size one (Ø 1.3 mm), whereas in group 2 drill size three (Ø 1.9 mm) was used to attain different cement thicknesses (thicknesses 1 and 2). Each group was then subdivided into five subgroups (n = 10). RelyX Fiber Posts size one (Ø 0.70 mm) were luted with the respective resin cements. All specimens were subjected to pull-out evaluation using a universal testing machine. Post surface areas covered with cement were measured by means of stereomicroscopy.


RLX revealed the significantly highest pull-out bond strengths in both groups (p < 0.05), while MXE exhibited the significantly lowest pull-out bond strengths in group 2 (p < 0.05). Main failure modes were determined as adhesive at the cement-post surface for all examined groups (except for SMC, group 2).


The different resin cements influenced the pull-out bond strengths, whereas the cement thickness itself was not responsible for any differences.

Clinical significance

Self-adhesive resin cements can provide an acceptable retention of FRC posts even in case of use with wider post space conditions.

Wednesday, September 11, 2013

Are there universal restorative composites for anterior and posterior teeth?

Available online 31 August 2013
In Press, Uncorrected Proof



This retrospective, longitudinal clinical study investigated the longevity up to 20 years of posterior restorations placed with 3 universal composites (Charisma, Herculite XR, Z100) and of anterior restorations placed with 2 universal composites (Charisma, Herculite XR).


Records from 90 patients were retrieved from a private practice (374 posterior, 219 anterior restorations). Clinical evaluation was performed by the FDI criteria. Survival analysis was assessed using Kaplan–Meier method and Log-Rank test, and factors associated with failure by multivariate Cox regression with shared frailty.


In the first 10 years, almost 95% of the restorations were satisfactory, showing increased failure thereafter. Charisma showed the most failures in anterior and posterior areas. Annual failure rates varied between 0.3% and 2.5%, with slightly better performance for anterior restorations. Fracture (posterior) and aesthetics (anterior) were the main reasons for failure.

Clinical significance

Differences were observed between restorative materials with different properties, but these became apparent only after more than 10 years of clinical service. The present study provides evidence that in a patient group with low caries risk, anterior and posterior restorations placed with universal composites may have excellent long-term clinical performance.

Tuesday, September 10, 2013

The health insurance industry has been exempt from federal antitrust laws- Change That!

Ask Your Representative to End Unfair Insurance Practices by Supporting H.R. 911

For nearly 65 years, the health insurance industry has been exempt from federal antitrust laws – leaving consumers susceptible to unfair price fixing, bid rigging, and market allocation.  It’s time to restore competition within the health insurance market and protect consumers from these unfair practices.

The U. S. House of Representatives is currently considering H.R. 911, the Competitive Health Insurance Reform Act of 2013: this legislation would repeal the McCarran-Ferguson antitrust exemption granted to the health insurance industry decades ago. Repeal of McCarran-Ferguson would allow federal agencies like the U.S. Department of Justice to investigate and challenge collective action by insurance companies and enable those impacted by illegal and anticompetitive practices to seek remedies against those insurers.

In the absence of federal oversight, regulation of the insurance industry will continue to be left with the states, which often lack the time and resources to effectively investigate antitrust claims. As a result, anticompetitive activities remain effectively unchecked. This must change: increased competition is important for consumers since it encourages innovation and fosters variety in the marketplace.

It’s time for the health insurance industry to play by the same rules as virtually every other industry in our country. Contact your Representative today and urge them to support H.R. 911. 

Monday, September 09, 2013

CAO Group Launches The Most Technologically Advanced Diode Laser System; Available Exclusively Through Henry Schein Dental

The Precise® SHP Diode Laser perfectly pairs state-of-the-art laser technology with the cutting-edge operating system of an Apple® iPod touch®

SALT LAKE CITY, Sept. 5, 2013 /PRNewswire/ -- The CAO Group (CAO), a world-leading, high-technology dental company, has launched the latest in restorative dental products with the new Precise®SHP Diode Laser, equipped with the most sophisticated technology for diode laser procedures. The product will be available exclusively through Henry Schein Dental, the global dental business of Henry Schein, Inc. (NASDAQ: HSIC), the world's largest provider of health care products and services to dental, animal health and medical practitioners.

The Precise SHP Diode Laser, designed with state-of-the-art laser technology, is the first mobile touch-screen diode laser to feature the iPod touch®. This comprehensive laser system provides live support via FaceTime® and allows dentists to watch training videos and demos as well as stay current with unlimited updates.

"Our Precise SHP Diode Laser complements the advances in restorative dental materials and techniques and provides the latest in technology through the Apple iPod touch, offering dentists unlimited updates, training and real-time support for all their diode laser procedures," said Dr. Densen Cao, CEO and founder of CAO. "With a proven track record of introducing the latest technology to the dental marketplace, Henry Schein is the ideal partner to bring the Precise SHP Diode Laser to dentists."

"We are committed to providing our dental customers with a comprehensive offering of integrated, innovative technology solutions to enhance the quality of care they provide their patients and increase the efficiency of their practices," said Jim Breslawski, president and chief operating officer of Henry Schein, Inc., and CEO of Henry Schein's Global Dental Group. "The addition of CAO's Precise SHP Diode Laser expands our offering in this important category, and we are very pleased to exclusively offer this exciting new product."

The Precise SHP Diode Laser System is highly versatile with 21 presets covering a wide spectrum of specialties, making everyday dental procedures easier to perform with excellent outcomes. The SHP Laser also features access to step-by-step setup instructions, laser procedure demonstrations and training videos, all through the iPod touch. FaceTime can be used to directly contact CAO technical, clinical and customer support experts.

The Precise SHP Diode Laser provides temporary pain relief for soft tissue, joint and muscle pain, offers laser-assisted in-office professional teeth whitening and is ideal for a multitude of procedures to avoid the difficulties of scalpel use such as bleeding, swelling, infection and pain. Additionally, the Precise SHP is the first diode laser system to include sterilized, disposable fiber tips for every procedure.

The Precise SHP Diode Laser is currently available in the U.S. only.

For more information about the Precise SHP Diode Laser, visit or

Saturday, September 07, 2013

Longitudinal evaluation of simulated toothbrushing on the roughness and optical stability of microfilled, microhybrid and nanofilled resin-based composites



The aim of this study was to evaluate the influence of simulated toothbrushing over ten weeks on the roughness and optical stability (color, translucency and gloss) of microfilled–Mf (Durafil VS), microhybrid - Mh (Empress Direct) and nanofilled–Nf (Z 350) resin-based composites (RBC).


The roughness, color, translucency and gloss of each RBC were measured before and after storage in distilled water (DW) and propionic acid (PA) for ten weeks. The specimens were removed from the media each week, submitted to toothbrushing simulation and the properties measured. The obtained data were analyzed using a multifactor analysis of variance (MANOVA) and Tukey's HSD test (α = 0.05).


The roughness significantly increased after ten weeks for the three RBCs (p < 0.05), with the final values of roughness presenting no statistical differences among them (p > 0.05). Only Mf and Nf immersed in DW and Mh immersed in PA presented a change in color after ten weeks (p < 0.05), although the change in color was lower after immersion in PA for the three RBCs (p < 0.05). None of the RBCs presented significant changes in translucency after ten weeks (p > 0.05). Only Mh immersed in DW presented gloss stability after ten weeks (p > 0.05).


Toothbrushing increased the roughness and diminished the gloss of the three RBCs. The translucency was not influenced by the toothbrushing. The immersion in propionic acid produced lower alterations in color than did immersion in distilled water.
Clinical Significance: In general, the three RBCs presented similar optical behaviors after toothbrushing over ten weeks. Thus, it is possible that anterior restorations produced with these materials will not present perceptible differences over time.

Friday, September 06, 2013

Precision of intraoral digital dental impressions with iTero and extraoral digitization with the iTero and a model scanner

American Journal of Orthodontics & Dentofacial Orthopedics
Volume 144, Issue 3 , Pages 471-478, September 2013


Digital impression devices are used alternatively to conventional impression techniques and materials. The aims of this study were to evaluate the precision of digital intraoral scanning under clinical conditions (iTero; Align Technologies, San Jose, Calif) and to compare it with the precision of extraoral digitization.


One patient received 10 full-arch intraoral scans with the iTero and conventional impressions with a polyether impression material (Impregum Penta; 3M ESPE, Seefeld, Germany). Stone cast models manufactured from the impressions were digitized 10 times with an extraoral scanner (D250; 3Shape, Copenhagen, Denmark) and 10 times with the iTero. Virtual models provided by each method were roughly aligned, and the model edges were trimmed with cutting planes to create common borders (Rapidform XOR; Inus Technologies, Seoul, Korea). A second model alignment was then performed along the closest distances of the surfaces (Artec Studio software; Artec Group, Luxembourg, Luxembourg). To assess precision, deviations between corresponding models were compared. Repeated intraoral scanning was evaluated in group 1, repeated extraoral model scanning with the iTero was assessed in group 2, and repeated model scanning with the D250 was assessed in group 3. Deviations between models were measured and expressed as maximums, means, medians, and root mean square errors for quantitative analysis. Color-coded displays of the deviations allowed qualitative visualization of the deviations.


The greatest deviations and therefore the lowest precision were in group 1, with mean deviations of 50 μm, median deviations of 37 μm, and root mean square errors of 73 μm. Group 2 showed a higher precision, with mean deviations of 25 μm, median deviations of 18 μm, and root mean square errors of 51 μm. Scanning with the D250 had the highest precision, with mean deviations of 10 μm, median deviations of 5 μm, and root mean square errors of 20 μm. Intraoral and extraoral scanning with the iTero resulted in deviations at the facial surfaces of the anterior teeth and the buccal molar surfaces.


Scanning with the iTero is less accurate than scanning with the D250. Intraoral scanning with the iTero is less accurate than model scanning with the iTero, suggesting that the intraoral conditions (saliva, limited spacing) contribute to the inaccuracy of a scan. For treatment planning and manufacturing of tooth-supported appliances, virtual models created with the iTero can be used. An extended scanning protocol could improve the scanning results in some regions.

Thursday, September 05, 2013

Potential Correlation between Statins and Pulp Chamber CalcificationAbstract Introduction 3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are the first-line pharmaceuticals for the prevention and treatment of dyslipidemia. A recent investigation has shown that statins induced odontoblastic differentiation of dental pulp stem cells. Statins enhance the differentiation of human dental pulp cells by up-regulating mineralization nodules and odontogenic markers. This study tested the hypothesis that the systemic administration of statins results in increased dental pulp calcification. Methods This retrospective case-control study used digital bitewing radiographs of mandibular molars. Subjects (N = 90) aged ≥60 years were assigned to either test (n = 45) or control (n = 45) groups based on the systemic use of statins. The dimensions of the pulp chambers were measured using a standardized method for height and mesiodistal distances. The chi-square test was used to analyze the data. Multiple linear regression model analysis was performed to explore the association between statin intake and pulp calcification. Results Three of the 45 mandibular molars in the test group exhibited almost complete pulp chamber obliteration. There was a significant reduction in pulp chamber height ratio shown in the statin group compared with the control group (P < .0001). When the mesiodistal width was compared between the 2 groups, there was no significant difference (P = .3730). Conclusions The significant increase of calcification and loss of vertical height of the pulp chamber observed in mandibular molars in patients on statin medication indicated a possible increased odontoblastic activity. Therefore, systemic statins could be a contributing factor for pulp chamber calcification.

 Abstract Journal of Endodontics
Volume 39, Issue 9 , Pages 1119-1123, September 2013


3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are the first-line pharmaceuticals for the prevention and treatment of dyslipidemia. A recent investigation has shown that statins induced odontoblastic differentiation of dental pulp stem cells. Statins enhance the differentiation of human dental pulp cells by up-regulating mineralization nodules and odontogenic markers. This study tested the hypothesis that the systemic administration of statins results in increased dental pulp calcification.


This retrospective case-control study used digital bitewing radiographs of mandibular molars. Subjects (N = 90) aged ≥60 years were assigned to either test (n = 45) or control (n = 45) groups based on the systemic use of statins. The dimensions of the pulp chambers were measured using a standardized method for height and mesiodistal distances. The chi-square test was used to analyze the data. Multiple linear regression model analysis was performed to explore the association between statin intake and pulp calcification.


Three of the 45 mandibular molars in the test group exhibited almost complete pulp chamber obliteration. There was a significant reduction in pulp chamber height ratio shown in the statin group compared with the control group (P < .0001). When the mesiodistal width was compared between the 2 groups, there was no significant difference (P = .3730).


The significant increase of calcification and loss of vertical height of the pulp chamber observed in mandibular molars in patients on statin medication indicated a possible increased odontoblastic activity. Therefore, systemic statins could be a contributing factor for pulp chamber calcification.

Wednesday, September 04, 2013

A comparative evaluation of fracture resistance of endodontically treated teeth, with variable marginal ridge thicknesses, restored with composite resin and composite resin reinforced with Ribbond: An in vitro study

 Kalburge V, Yakub SS, Kalburge J, Hiremath H, Chandurkar A. A comparative evaluation of fracture resistance of endodontically treated teeth, with variable marginal ridge thicknesses, restored with composite resin and composite resin reinforced with Ribbond: An in vitro study. Indian J Dent Res 2013;24:193-8

Background: The anatomic shape of maxillary premolars show a tendency towards separation of their cusps during mastication after endodontic treatment. Preservation of the marginal ridge of endodontically treated and restored premolars can act as a strengthening factor and improve the fracture resistance.
Objectives: To evaluate the effect of varying thickness of marginal ridge on the fracture resistance of endodontically treated maxillary premolars restored with composite and Ribbond reinforced composites.
Materials and Methods: One hundred and twenty, freshly extracted, non carious human mature maxillary premolars were selected for this experimental in vitro study. The teeth were randomly assigned in to twelve groups ( n = 10). Group 1 received no preparation. All the premolars in other groups were root canal treated. In subgroups of 3 and 4, DO cavities were prepared while MOD cavities were prepared for all subgroups of group 2, the dimensions of the proximal boxes were kept uniform. In group 3 and 4 the dimensions of the mesial marginal ridge were measured using a digital Vernier caliper as 2 mm, 1.5 mm, 1 mm and 0.5 mm in the respective subgroups. All samples in groups 2.2 and all the subgroups of 3 were restored with a dentin bonding agent and resin composite. The teeth in group 2.3 and all subgroups of 4 were restored with composite reinforced with Ribbond fibers. The premolars were submitted to axial compression up to failure at 45 degree angle to a palatal cusp in universal testing machine. The mean load necessary to fracture was recorded in Newtons and the data was analysed.
Results: There was a highly significant difference between mean values of force required to fracture teeth in group 1 and all subgroups of group 2, 3 and 4 (i.e., P < 0.01)
Conclusion: On the basis of static loading, preserving the mesial marginal ridge with thicknesses of mm, 1.5 mm, 1 mm and 0.5 mm, composite restored and Ribbond reinforced composite restored maxillary premolars can help preserve the fracture resistance of teeth.

Tuesday, September 03, 2013

HPV infection linked to poor oral health, say cancer prevention researchers

Infection with oral human papillomavirus (HPV) - a main cause of throat cancer - could be linked to poor oral health, including gum disease, according to a study published in the journal Cancer Prevention Research.
Researchers from the University of Texas Health Sciences Center in Houston analyzed data from the 2009-2010 National Health and Nutrition Examination Survey (NHANES), which was carried out by the National Center for Health Statistics of the Centers for Disease Control and Prevention (CDC).
Some 3,439 participants were included in the data, aged between 30 and 69 years. Participants were chosen based on their available oral health data and the presence or absence of 19 low-risk HPV types, as well as 18 high-risk HPV types in the oral cavity.
The oral health data included the following four measures:
  • Self-rating of overall oral health
  • Presence of gum disease
  • Use of mouthwash to treat dental problems (within past 7 days of survey)
  • The number of teeth lost.
Factors that may influence HPV infection were also analyzed, including age, gender, marital status, marijuana use, cigarette smoking and oral sex habits.

Oral health an 'independent risk factor'

The findings showed that the participants who reported bad oral health had a 56% higher risk of developing oral HPV infection compared with those who had good oral health.
Those with gum disease showed a 51% higher risk of oral HPV infection, while those with dental problems had a 28% higher risk. The researchers were also able to link oral HPV infections to the number of teeth lost.
Additionally, the findings showed that males who smoked cigarettes, used marijuana and participated in oral sex regularly had increased risks of oral HPV infection.
They note that self-rated overall oral health was an independent risk factor for the infection, as the link did not vary regardless of whether the participant smoked or had multiple oral sex partners.
Thanh Cong Bui, postdoctoral research fellow in the School of Public Health at the University of Texas Health Sciences Center, says:
"Poor oral health is a new independent risk factor for oral HPV infection and, to our knowledge, this is the first study to examine this association.
The good news is, this risk factor is modifiable. By maintaining good oral hygiene and good oral health, one can prevent HPV infection and subsequent HPV-related cancers."

Call for more research on the causes

HPV is a virus that affects areas including the throat, mouth, feet, fingers, nails, anus and cervix - areas of the skin and the mucus membranes that line the body.
The study authors say that similar to genital HPV infection, oral HPV infection can be divided into two types. The first are low-risk HPV types that are not a cause of cancer, but cause benign tumors and warts in the oral cavity. The second are high-risk HPV types that can cause throat cancers.
According to the researchers, oral HPV infection causes 40-80% of oropharyngeal cancers (throat cancers). Medical News Today recently reported a study that suggests a certain strain of HPV is linked to a third of throat cancers.
The present study authors say that because HPV needs a wound in the mouth to enter and infect oral cavities, bad oral health could create an "entry portal" for HPV - mouth ulcers, mucosal disruption or chronic inflammation in particular.
They note, however, that there is not enough evidence at present to support this and further research is needed.
Thanh Cong Bui adds:
"Although more research is needed to confirm the causal relationship between oral health and oral HPV infection, people may want to maintain good oral health for a variety of health benefits. Oral hygiene is fundamental for oral health, so good oral hygiene practices should become a personal habit."
Although the majority of us know how to look after our oral health, the Mayo Clinic lists a few reminders on dental care basics:
  • Brush your teeth at least twice a day
  • Use a fluoride toothpaste and a soft-bristled brush that fits your mouth comfortably, and consider using an electric toothbrush - this can reduce plaque and gum disease
  • Practice good technique - remember to brush the outside, inside and chewing surfaces of your teeth, as well as your tongue
  • Keep your toothbrush clean - always rinse it with water after brushing, store in an upright position and allow it to air dry before using it again
  • Replace your toothbrush or toothbrush head every 3 to 4 months.
Whiteman, Honor. "HPV infection linked to poor oral health, say cancer prevention researchers." Medical News Today. MediLexicon, Intl., 22 Aug. 2013. Web.
25 Aug. 2013.