Monday, February 29, 2016

Efficacy of three different pulpotomy agents in primary molars – A randomised control trial

International Endodontic Journal
Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future




To compare the clinical and radiographic efficacy of Biodentine, ProRoot® White Mineral Trioxide Aggregate (WMTA) and Tempophore as pulpotomy medicaments in the treatment of carious primary molars.


A parallel design, randomised controlled trial was developed. Patients above three years of age with carious primary teeth with vital pulps without spontaneous pain or history of swelling were included. Fifty eight patients (82 teeth) with a mean age of 4.79 ± 1.23 years were included. The teeth were randomised, blinded and allocated to one of the three groups (Biodentine, ProRoot® WMTA or Tempophore) for pulpotomy treatment. All teeth were followed up clinically and radiographically (after 6, 12 and 18 months) by two blinded calibrated investigators. A generalised estimating equation (GEE), Wald chi-square test and an intention to treat analysis (ITT) with ′last carried forward′ approach was performed using Statistical Package for Social Sciences v 21.0 (IBM Corp., Armonk, NK, USA).


Forty six patients and 69 teeth were available for follow up after 18 months. Clinical success (radiographic success in parenthesis) was 95.24% (94.4%), 100% (90.9%) and 95.65% (82.4%) in the Biodentine, ProRoot® MTA and Tempophore groups respectively, but the difference was not significant. Pulp canal obliteration was significantly different among the experimental groups as the Biodentine group exhibited significantly more pulp canal obliteration when compared to the ProRoot® MTA group at 6 months (p = 0.008) and 18 months (p = 0.003).


After 18 months follow up, there was no significant difference between Biodentine in comparison to ProRoot® WMTA or Tempophore.

Sunday, February 28, 2016

3M Lava Zirconia Marks Significant Milestone Zirconia pioneer celebrates 15 years by showcasing clinical successes

ST. PAUL‚ Minn. – (February 23, 2016) – Since Lava Zirconia was introduced in 2001, the material has improved the smiles of millions of patients worldwide – with scientific studies showing excellent strength, esthetics and clinical performance. Now the brand is celebrating 15 years of success, and 3M is taking an opportunity to highlight Lava cases from clinicians and labs across the globe. At LAB DAY Chicago on February 26 and 27, 3M will launch a new website dedicated to showcasing dentist and lab-submitted case photos that demonstrate the beauty and strength of Lava brand zirconia restorations for crowns and bridges.

In its 15 years of clinical use, the pioneering Lava brand has become trusted by dentists and labs, with millions of zirconia restorations placed in over 40 countries.[i] 3M has continued to innovate, being the first to match all 16 VITA® Classic shades, the first zirconia system with shading liquids and one of the most studied zirconias available today.[ii] With the recent introduction of Lava™ Plus High Translucency Zirconia in a disc format, Lava branded zirconia material is easier to access than ever.

“Thousands of skilled clinicians and lab technicians have allowed 3M to offer the benefits of zirconia to patients around the world,” said Jennifer Van Ranst, U.S. marketing manager. “We are looking forward to using this website to showcase the clinical success our customers have achieved with this material.”

Whether it’s a beautifully layered porcelain case, a high translucency all-zirconia bridge or simply a highly esthetic outcome that helped improve a patient’s smile, clinicians and dental labs are encouraged to upload their favorite cases. The site will showcase these before and after photos for visitors to view, “like” and share.

To upload cases to the website, clinicians and dental labs can visit


About 3M Oral Care3M Oral Care promotes lifelong oral wellness through inventive solutions that help oral care professionals achieve greater clinical, professional and personal success. Learn more at (dental) or (orthodontics).

3M is a trademark of 3M or 3M Deutschland GmbH. Used under license in Canada. © 3M 2016. All rights reserved.

About 3M
At 3M, we apply science in collaborative ways to improve lives daily. With $32 billion in sales, our 90,000 employees connect with customers all around the world. Learn more about 3M’s creative solutions to the world’s problems at or on Twitter @3M or @3MNewsroom.

Friday, February 26, 2016

Efficacy of dental unit waterlines disinfectants on a polymicrobial biofilm

Volume 91, 15 March 2016, Pages 38–44


Due to their high surface-volume ratio, their laminar flow and frequent stagnation periods, dental unit waterlines (DUWL) foster the attachment of microorganisms and the development of biofilm, resulting in the continuous contamination of the outlet water from dental units; this contamination may be responsible for a potential risk of infection due to the exposure of patients and medical staff to droplet inhalation or splashed water. In this study, the anti-biofilm activity of three disinfectants recommended by dental unit manufacturers –Calbenium©, Oxygenal 6© and Sterispray© – was evaluated. A dynamic model simulating DUWL conditions was developed and polymicrobial biofilms containing bacteria (Pseudomonas aeruginosa), fungi (Candida albicans) and Free Living Amoeba (FLA: Vermamoeba vermiformis) were allowed to form. The ability of disinfectants to reduce biofilm formation or to eradicate an already formed biofilm was evaluated. Results showed the various effects of the tested disinfectants according to their composition, concentration and the targeted species. V. vermiformis was resistant to disinfectants, regardless of the tested concentrations and the concentrations recommended by manufacturers were not the most appropriate. Results also showed that Calbenium© was the most effective disinfectant to reduce already formed biofilms; its maximum efficiency was observed from 0.5% on both P. aeruginosa and C. albicans compared to 2 and 3% respectively for Sterispray©. The maximum efficiency of Oxygenal© was observed from 3% on P. aeruginosa but Oxygenal© was unable to totally eliminate C. albicans in the tested conditions, contrary to other disinfectants. Calbenium© was able to prevent biofilm formation efficiently even if it displayed no prophylactic activity against V. vermiformis. Overall, the FLA survival may contribute to maintaining other species. Finally the tested disinfectants were partially active against sessile microorganisms and more suitable concentrations could be used to increase their efficacy. Their use in a prophylactic rather than curative way should be recommended.

Thursday, February 25, 2016

Antibiotic prescribing by dentists has increased: Why?

J Am Dent Assoc. 2016 Feb 4. pii: S0002-8177(15)01213-1. doi: 10.1016/j.adaj.2015.12.014. [Epub ahead of print]



Although the overall rate of antibiotic prescribing has been declining in British Columbia, Canada, the authors conducted a study to explain the increased rate of prescribing by dentists.


The authors obtained anonymized, line-listed data on outpatient prescriptions from 1996 to 2013 from a centralized, population-based prescription database, including a variable coding prescriber licensing body. Analyses used Anatomical Therapeutic Classification standard codes and defined daily dose (DDD) values. The authors normalized prescribing rates to the population and expressed the rates in DDDs per 1,000 inhabitants per day (DID). The Canadian Dental Association released a webinar that invited correspondence from dentists about the drivers of the trend.


From 1996 to 2013, overall antibiotic use declined from 18.24 DID to 15.91 DID, and physician prescribing declined 18.2%, from 17.25 DID to 14.11 DID. However, dental prescribing increased 62.2%, from 0.98 DID to 1.59 DID, and its proportionate contribution increased from 6.7% to 11.3% of antibiotic prescriptions. The rate of prescribing increased the most for dental patients 60 years or older. Communication from dentists in Canada and the United States identified the following explanatory themes: unnecessary prescriptions for periapical abscess and irreversible pulpitis; increased prescribing associated with dental implants and their complications; slow adoption of guidelines calling for less perioperative antibiotic coverage for patients with valvular heart disease and prosthetic joints; emphasis on cosmetic practices reducing the surgical skill set of average dentists; underinsurance practices driving antibiotics to be a substitute for surgery; the aging population; and more dental registrants per capita.


Emerging themes for dental prescribing should be explored further in future studies; however, themes already identified may guide priorities in antibiotic stewardship for continuing dental education sessions.


Antibiotic prescribing should be reviewed to make sure that we are compliant with guidelines. Most practitioners will find opportunities to prescribe less often and for shorter durations.

Wednesday, February 24, 2016

Health Compliance Team Announces HIPAA Security Assessment Tool for Dental Practices

Summary: Health Compliance Team and PCIHIPAA announcde its partnership to help dental practices meet the newly mandated annual HIPAA security assessment requirement with their comprehensive online evaluation tool to provide an overall assessment of risks and key vulnerabilities.

New York, NY — February 23, 2016 Industry leaders, Health Compliance Team®, and PCIHIPAA® today announced its partnership to help dental practices meet the newly mandated annual HIPAA security assessment requirement, with their complimentary online tool designed to assist practices in a matter of minutes, with the information they need to evaluate their compliance risk, and avoid a data breach. This tool provides practices with compliance guidance, a 22-page custom report noting key vulnerabilities, an overall assessment of their level of risk, and risk score.

HIPAA Section Code 164.308(a)(1)(ii)(A) now mandates health care providers complete an annual security risk assessment to reveal key vulnerabilities and help prevent data breaches. Confusion over HIPAA requirements and aggressive targeting of medical practices by cyber criminals have increased incidences of data breaches and threats to cyber security and heightened the concern surrounding the safety of PHI (Protected Health Information).

“Our mission is to simply help dental practices easily and affordably navigate HIPAA requirements and provide solutions they need to protect themselves and their patients," said Dr. Donald Cohen CEO of Health Compliance Team. “ The risk assessment tool by PCIHIPAA is designed to help medical and dental practices complete HIPAA’s risk assessment requirement and also help uncover key vulnerabilities to address.  It’s the right first step for every medical or dental practice to take the mandatory risk assessment.”

“As cyber security threats remain a paramount concern among many Americans, HIPAA compliance enforcement will likely increase,” said Jeff Broudy CEO of PCIHIPAA. “In fact, The Department of Health and Human Services' Office for Civil Rights has announced they are resuming the random HIPAA audit program. At PCIHIPAA, we are passionate about helping medical and dental practices quickly and easily navigate HIPAA requirements, and delivering solutions to protect patient health information.  We are excited to partner with Dr. Cohen and the Health Compliance Team. 

To access the evaluation tool, and receive your customized assessment visit: My HIPAA Assessment
About Health Compliance Team: Health Compliance Team (HCT) is the leading provider in dental practice compliance. HCT helps practices understand and navigate compliance issues related to their practice by delivering real-time consulting on a variety of services to help practices reach full compliance in all mandated areas. For more information visit HCT
About PCIHIPAA: PCIHIPAA is an industry leader in medical and dental compliance by providing turnkey, customizable solutions for its clients. PCIHIPAA minimizes the complexities of navigating financial and legal compliance to ensure that medical and dental practices are compliant, trained and prepared. Learn more at

Tuesday, February 23, 2016

Comparative CBCT evaluation of the efficacy of Nd:YAG laser and K3 rotary system in non-surgical root canal retreatment.

Minerva Stomatol. 2016 Feb;65(1):11-6.



The aim of the present study was to compare the efficacy of Nd:YAG laser and K3 rotary system in the non-surgical root canal retreatment.


Sixty-one rooted human teeth were divided into two groups of 30 after root canal therapy. In groups 1 and 2 root canal retreatments were carried out using K3 rotary system and Nd:YAG laser, respectively. CBCT images were used to evaluate canal transportation and root canal debridement at coronal, middle and apical canal cross-sections. In addition, the time necessary for canal debridement and the temperature on the external root surface were calculated. Mann-Whitney U test was used for statistical analysis of data with SPSS 17 after means ± SD were calculated. Shapiro-Wilk test was used to evaluate normal distribution of data. Statistical significance was defined at P<0 .05.="" p="">


The mean time necessary for the debridement of root canals in the laser group was significantly shorter than that in the K3 group (P=0.001). However, there were no significant differences in external root surface temperatures between the two groups (P=0.17). The coronal third of the canals was cleaner in the laser group significantly (p=0.01). Less canal transportation was seen in the laser group compared to the K3 group, significantly (P=0.04).


Nd:YAG is superior to K3 rotary system in the non-surgical root canal retreatment because it is faster and results in less canal transportation in the middle and apical thirds of the canals.

Monday, February 22, 2016

Diagnostic validity of self-reported measures of sleep bruxism using an ambulatory single-channel EMG device

Journal of Prosthodontic Research - February 12, 2016



Self-reported measures have been widely used to indicate the presence of possible and probable sleep bruxism (SB) in both research and clinical situations. However, few studies have attempted to assess the diagnostic validity of this approach. The aim of this study was to estimate the diagnostic validity of self-reported measures of SB using an ambulatory single-channel electromyographic (EMG) device.


A total of 115 participants were enrolled and examined by standardized Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) including two questions related to SB: self-reported SB and morning-jaw symptoms. An ambulatory single-channel EMG device (GrindCare3™, Medotech A/S) was used for measuring jaw–muscle EMG activity during sleep for seven consecutive nights. Cut-off values for different measures of EMG activity (average, maximum and minimum) and the coefficient of variation (CV) were selected to divide participants into two groups, with higher or lower EMG activity or CV values. The sensitivity and specificity for each question and combination of them were calculated.


Self-reported SB had the highest sensitivity (compared with morning-jaw symptoms) for all measures of EMG activity and CV, although the values were low to modest (average: 76.0%, maximum: 76.9%, minimum: 77.3%, CV: 61.0%). The specificity was low for both the questions related to the different measures of EMG activity and CV (35.1–52.4%).


This study indicated that the diagnostic validity of self-reported measures of SB was low to modest using an ambulatory EMG device assessment as a reference. Using only self-reported measures for the assessment of SB may not have a high validity, which should be taken into consideration in the clinical evaluation of patients.

Friday, February 19, 2016

Approximal and occlusal caries lesions: Restorative treatment decisions by California dentists.

J Am Dent Assoc. 2016 Feb 9. pii: S0002-8177(15)01037-5. doi: 10.1016/j.adaj.2015.10.006. [Epub ahead of print]



Investigators use questionnaire surveys to evaluate treatment philosophies in dental practices. The aim of this study was to evaluate the management strategies California dentists use for approximal and occlusal caries lesions.


In May 2013, the authors e-mailed a questionnaire that addressed approximal and occlusal caries lesion management (detection and restorative threshold, preferred preparation type, and restorative materials) to 16,960 dentists in California. The authors performed a χ2 statistical analysis to investigate the relationship between management strategies and respondent demographic characteristics.


The authors received responses from 1,922 (11.3%) dentists; 42.6% of the respondents would restore approximal lesions at the dentinoenamel junction, and 33.4% would wait until the lesion reached the outer one-third of dentin. The preferred preparation type was the traditional Class II preparation. Dentists who graduated more recently (20 years or less) were more likely to delay approximal restorations (P < .0001); 49.9% of the more recent graduates would wait to restore an occlusal lesion until the outer one-third of dentin was involved, and 42.6% would restore a lesion confined to enamel.


There is wide variety among California dentists regarding their restorative treatment decisions, with most dentists restoring a tooth earlier than the literature would advise. More recent dental graduates were more likely to place their restorative threshold at deeper lesions for approximal caries lesions.


Clinical evidence shows that noncavitated caries lesions can be remineralized; therefore, early restorative treatment may no longer be necessary or appropriate. Noninvasive and minimally invasive measures should be taken into consideration.

Thursday, February 18, 2016

Fotona Launches the new ST PRO Lightwalker Dental Laser at the 151st Midwinter Meeting of the Chicago Dental Society Booth #4815

DALLAS, Feb. 10, 2016 /PRNewswire/ -- Fotona, based in the U.S. and Europe, announced that it will launch its new ST PRO Lightwalker dental laser at the upcoming 151st Midwinter Meeting of the Chicago Dental Society from 25-27 February, 2016 in booth #4815. The ST PRO is a full featured hard and soft tissue dental laser with many of the features of the award winning, industry leading Lightwalker ATS. At an introductory price of $49,900, the ST PRO competitive price will be very attractive to many dentists hesitating to incorporate lasers into their practices because of the cost of higher priced and less advanced competitive systems.

The new ST PRO Lightwalker Dental Laser

The ST PRO is an ultra fast Er:YAG dental laser capable of removing cavities without the need for shots and local anesthetic, especially for children, in most cases. The ST PRO also performs the patented and widely researched and acclaimed PIPS laser root canals, a wide range of atraumatic bone procedures and non-invasive, blood and suture free soft tissue procedures.
The ST PRO includes features not available in competing systems including:
Powerful 12 watts of Er:YAG energy for Ultra Fast cutting;
Large, User Friendly Touch Screen with a wide range of Easy-To-Use presets;
The highly reliable, ergonomic and efficient Optoflex delivery system;
High Visibility Green aiming beam;
Built-in air supply, eliminating the need for external air connections/supplies;
Optional Quantum Square Pulse (QSP) and SMOOTH mode for Advanced Clinical Procedures such as the non-invasive Nightlase snoring treatment

Fotona ( has sold over 25,000 lasers around the world, with direct sales in the U.S, and distribution in over 60 countries. Fotona produces award winning lasers in dentistry, aesthetics, dermatology, gynecology & other medical fields. Fotona has one of the most highly educated workforces in the industry, with an exceptionally high number of PhDs specializing in laser and medical technology. Strong R&D capabilities have always been a key competitive advantage of the company, resulting in many patented solutions, including the Optoflex® articulated arm, QSP (Quantum Square Pulse) and VSP (Variable Square Pulse) technologies, Fotona SMOOTH® mode, Vacuum Cell technology, and many more.

Wednesday, February 17, 2016


Red Bank, NJ: February 9, 2016 - The American Association of Dental Office Management, (AADOM), is pleased to announce that former Office Manager of the Year and AADOM Fellow, Lisa Spradley will facilitate upcoming national AADOM Day events. These popular events bring together practice leaders to discuss the most current topics faced in dental offices.

AADOM Days will take place at the following locations in 2016:
  • April 8 - Austin, TX AADOM Chapter Meeting
  • June 16 - Pacific Northwest Dental Conference
  • October 14 - Des Moines, IA Henry Schein Fall Festival
  • November 11 - Wisconsin Dells, WI Henry Schein Fall Festival
  • November 28 - Greater New York Dental Meeting
President Heather Colicchio is excited that dental practice administrators and business team members across the country will be able to gather to learn from an AADOM Ambassador as well as from each other. "The networking at the AADOM Days we've hosted at Yankee Dental Congress and the Greater New York meeting has been so empowering. We're happy to be able to share this momentum more in 2016 and beyond."

Lisa Spradley is the Official Facilitator of AADOM Days. She was AADOM's 2014 Office Manager of the Year and has been trained as an AADOM Ambassador. This training is offered at AADOM's Annual Conference each year. The 12th Annual Dental Management Conference will be held September 15-17th in Boca Raton, FL.  Pre-registration is now available at the AADOM website.
About AADOM:
The american Association of Dental Office Management, (AADOM), is the nation's largest educational and networking association dedicated to serving dental practice management professionals. Our mission is to provide our members with networking, resources and education to help them achieve the highest level of professional development. For more information visit or call 732.842.9977.

Tuesday, February 16, 2016

Oravital Inc. Launching its BiofilmDNA® Oral Microbial Salivary Test During its Chicago Midwinter Meeting Debut

New Diagnostic Test Provides a Whole-Mouth Picture of Patient’s Oral Health

Toronto, CA – February 8, 2016 – Oravital Inc., the manufacturer of the Oravital® System for the diagnosis and treatment of periodontal disease and halitosis, will be making its debut at the Chicago Midwinter Dental Meeting at the McCormick Convention Center at booth #4537 from February 25th  through February 27th.  During this time, the company will also unveil its latest weapon in the war against oral infections – the BiofilmDNA® oral microbial salivary test.

BiofilmDNA® is a highly-sensitive DNA test that detects both the presence and thresholds of specific pathogens via the collection of salivary, subgingival, and tongue biofilm samples. This advanced and accurate biofilm analysis provides the dental clinician with a detailed, multi-panel, whole-mouth picture of the patient’s oral health.

Oravital’s new BiofilmDNA® test is a powerful compliment to its BiofilmGS® test, which uses site-specific Gram stain analysis to determine the exact type and location of oral infection. Both the BiofilmDNA® and BiofilmGS® tests are analyzed in Oravital’s on-site, state-of-the-art lab facility, with reports available within two days of receiving the samples. Used together, the two biofilm tests will help the dental clinician accurately identify the following:

·       Periodontal disease pathogens
·       Opportunistic parasites
·       Caries pathogens
·       Yeasts
·       Inflammatory response

According to company president and CEO Dr. Jim Hyland, “The Oravital® System effectively closes the diagnosis/treatment loop by identifying the exact cause and location of oral infection, then providing a highly-effective regimen of antibiotic and antimicrobial rinses specifically prescribed for the patient’s personal diagnosis.”

Throughout the Chicago Midwinter Meeting, Oravital® will be offering the BiofilmDNA® test for an introductory price of $75.00 each for the first 10 tests (Regularly $85.00 each). Which is a $100.00 savings! In addition, dentist can sign up their teams for the Oravital Platinum Coaching Package for $995.00 (normally $1,295.00) and save $300.00. In addition, there will be a drawing for a free iPad Mini.

Dr. Hyland, DDS BSc, and his clinical management team consisting of Chief Science Officer Anne Bosy, RRDH, MEd, MSc, and Clinical Hygiene Educator Kerry Lepicek, RDH, will be on hand to explain the efficacy and application of the proprietary Oravital® System, which consists of the following five steps:

1.    Diagnosis
2.    Treatment
3.    Evaluation  
4.    Maintenance
5.    Monitoring

“Undiagnosed and untreated oral infections are a North American epidemic,” explains Hyland. “We also know that periodontal disease is a contributing factor to many systemic conditions such as cardiovascular disease, diabetes, and Alzheimer’s disease, because the infection spreads via both tissues and the blood stream. With the introduction of BiofilmDNA®, now more than ever, the Oravital® system can have a positive impact on not just the oral health, but the overall health of the patient.”

For more information on the Oravital® System and how your dental practice can become a Certified Oravital® Clinic, visit or call 1-800-909-6468.
About Oravital Inc.

Oravital Inc. was established in the fall of 2007 in Toronto, Canada. The company licenses proprietary technology called the Oravital® System to certified dental clinics throughout North America for the most advanced, effective and painless diagnosis and treatment of oral infections available today.
With recent studies linking oral infections with systemic conditions such as heart disease and diabetes, periodontal disease is now considered a medical condition that dental professionals should treat. What’s more, given that 75% of the population continues to have signs of periodontal disease in spite of our best efforts, diagnosis and predictable treatment of this infection has become extremely important.   
Oravital’s proprietary protocol of inexpensive biofilm testing and the use of prescribed antibiotic and antimicrobial rinses dramatically halt the progress of periodontal disease and breath odor.  Bleeding is reduced by 87%, and pocket depths shrink by 76 to 84% within a few weeks. Oravital® proprietary rinses treat the entire oral complex and are non-systemic.  The Oravital® System is the only system to predictably treat the oral-systemic link.
The science of Oravital® evolved from 15 years of ground-breaking research and successful clinical treatment by Anne Bosy, RRDH, MEd, MSc, co-founder of Toronto's Fresh Breath Clinic. Dr. Walter Loesche, who was a respected authority on periodontal disease treatment at the University of Michigan, validated the effectiveness of the antibiotic therapy developed by Anne Bosy.  

Oravital Inc. also provides a comprehensive, dynamic and scientifically-grounded training program to its certified clinics. Oravital® certified dental professionals are authorized experts in providing Oravital® diagnostic analysis, individualized treatment, and dedicated long-term support. For more information, visit or call 1-800-909-6468.
# # #

Monday, February 15, 2016

The Effect of Sodium Hypochlorite and Chlorhexidine as Irrigant Solutions for Root Canal Disinfection: A Systematic Review of Clinical Trials

Journal  of Endodontics


  • Of the 172 potential articles, only 4 randomized clinical trials and 1 nonrandomized clinical trial were included in this systematic review.
  • The laboratory methods used to evaluate root canal disinfection were heterogeneous among studies (culture techniques and molecular methods).
  • The 5 studies compared sodium hypochlorite and chlorhexidine by collecting samples from the root canal before and after the protocol treatments.
  • Randomization was conducted in 4 of the 5 studies.
  • There was a lack of agreement between the findings of the selected studies.



This systematic review aimed to compare the effectiveness of sodium hypochlorite and chlorhexidine for root canal disinfection during root canal therapy.


A literature search for clinical trials was made on the PubMed (MEDLINE), Web of Knowledge, SCOPUS, and Science Direct databases and in the reference lists of the identified articles up to January 2015. Quality assessment of the selected studies was performed according to the Consolidated Standards of Reporting Trials statement.


One clinical trial and 4 randomized clinical trials were selected from the 172 articles initially identified. There was heterogeneity in the laboratory methods used to assess the root canal disinfection as well as in the concentrations of the irrigants used. Therefore, meta-analysis was not performed. Two studies reported effective and similar reductions in bacterial levels for both irrigants. Sodium hypochlorite was more effective than chlorhexidine in reducing microorganisms in 1 study, and another reported opposite findings. Both root irrigants were ineffective in eliminating endotoxins from necrotic pulp root canals in 1 study. Trial design and information regarding randomization procedures were not clearly described in the clinical trials. No study compared laboratory results with clinical outcomes.


The available evidence on this topic is scarce, and the findings of studies were not consistent. Additional randomized clinical trials using clinical outcomes to compare the use of sodium hypochlorite and chlorhexidine during root canal therapy are needed.

Friday, February 12, 2016

Utilization of computer-aided detection system in diagnosing unilateral maxillary sinusitis on panoramic radiographs.

Another type of CAD is Carestream's Logicon for caries detection. MJ
Dentomaxillofac Radiol. 2016 Feb 3:20150419. [Epub ahead of print]



It is unclear whether computer-aided detection (CAD) systems for panoramic radiography can help inexperienced dentists to diagnose maxillary sinusitis. The aim of this study was to clarify whether a CAD system for panoramic radiography can contribute to improved diagnostic performance for maxillary sinusitis by inexperienced dentists.


The panoramic radiographs of 49 patients with maxillary sinusitis and 49 patients with healthy sinuses were evaluated in this study. The diagnostic performance of the CAD system was determined. Twelve inexperienced dentists and four expert oral and maxillofacial radiologists observed the total of 98 panoramic radiographs and judged the presence or absence of maxillary sinusitis, under conditions with and without support of the CAD system. The receiver-operating characteristic (ROC) curves of the two groups were compared.


The CAD system provided sensitivity of 77.6%, specificity of 69.4%, and accuracy of 73.5%. The diagnostic performance of the inexperienced dentists increased with support of the CAD system. When the inexperienced dentists diagnosed maxillary sinusitis with CAD support, the area under the curve (AUC) was significantly higher than that without CAD support. When the focus was only on panoramic radiographs in which CAD support led to a correct diagnosis, the AUC of the inexperienced dentists increased to an equivalent level to that of the experienced radiologists.


The CAD system supported the inexperienced dentists in diagnosing maxillary sinusitis on the panoramic radiographs. If the accuracy of the CAD system can be increased, the benefits of CAD support will be further enhanced.

Thursday, February 11, 2016

CDC Estimate: High Periodontal Disease Prevalence Found Among Southern U.S. States

Highest Incidence Found in New Mexico, Hawaii: New Data Emphasizes Need for Oral Health Literacy, Access to Care in Largely Affected Regions

Top 10 States with
Highest Periodontitis Prevalence
New Mexico
South Carolina
*Estimated prevalence for US adults ages 30 to 79
CHICAGO (February 4, 2016)—In a recent study published by the Journal of Dental Research, the Centers for Disease Control and Prevention (CDC) estimates that at 52.79% and 51.10% respectively, New Mexico an d Hawaii have the United States’ highest prevalence of periodontal disease.

The study, entitled “Predicting Periodontitis at State and Local Levels in the United States,” also indicates high prevalence among southeastern and southwestern states, including areas along the Mississippi Delta, the U.S.-Mexico border, and among Native American reservations.
The objective of the study was to estimate the prevalence of periodontitis at state and local levels across the United States by using a novel, small-area estimation method. Extended multilevel analyses were applied among adults aged 30-79 at state, county, district, and census tract levels. 
Other areas with an estimated high prevalence were southern Florida and remote areas of western Alaska. Overall, similar geographic patterns were determined for severe periodontitis as well. The states with the lowest prevalence include Utah (37.69%) and New Hampshire (40.51%).  
Additional key statistical findings noted in the study include:
  • The prevalence of periodontitis among the states ranged from 37.7% in Utah to 52.7% in New Mexico, representing an estimated 15% disparity in prevalence among states.
    • Severe periodontitis ranged from 6.4% in New Hampshire to 11.3% in Louisiana among the states.
  • County estimates ranged from 33.7% to 68%, representing a much larger disparity of 34% in prevalence among counties.
    • Severe periodontitis ranged from 5.2% to 17.9% among counties.
  • National estimates had a mean and median state prevalence of 45.1% and 44.9%, respectively, and 46.6% and 45.9%, respectively, for counties.
    • These summary measures compare with the estimated national prevalence of periodontitis among U.S. adults of 44.8% from NHANES 2009-2012.
    • Similarly, summary measures for severe periodontitis at state and county levels compared with the estimated national prevalence of severe periodontitis.
The areas estimated to have the greatest concentration of periodontitis directly correlate with regions that also see high incidence of cardiovascular disease and diabetes, systemic conditions often associated with periodontitis. Moreover, the latest findings are in line with early CDC reports that periodontitis disproportionately affects ethnic minorities, tobacco users, those of lower socio-economic status, and those in areas with sparse access to dental care.
“This is the first study to model the distribution of adult periodontitis in states and local areas in the United States,” says Dr. Paul Eke, CDC epidemiologist and lead author of the study. Dr. Eke goes on to say, “We found the estimated geographic distribution of adult periodontitis to be highest among southeastern and southwestern states, with concentrated pockets along the southeast, in the Mississippi Delta, along the U.S.-Mexico border, and among Native American reservations. Given how closely associated the risk for periodontitis is with other chronic conditions, such as diabetes or cardiovascular disease, the prevention and treatment of periodontitis represents an opportunity for dental and medical professionals to work together to improve the public’s health.”

The figures are the latest reported by the CDC to determine the burden on periodontitis on the U.S. adult population. The American Academy of Periodontology (AAP) and the CDC, which have collaborated since 2003 to determine periodontitis prevalence, have found that nearly half of all U.S. adults age 30 and above have some form of periodontal disease.

“Periodontal disease continues to be a major health concern for people of all backgrounds,” remarked Dr. Wayne Aldredge, president of the AAP. “The AAP is committed to increasing public awareness of periodontal health and will continue to work with allied dental organizations, educational institutions, and government agencies to reduce incidence of periodontitis in the U.S. adult population.”
The AAP recommends regular flossing, brushing twice a day, and undergoing yearly comprehensive periodontal evaluations for the prevention of periodontal disease, which is treatable and often reversible with proper and timely care from a periodontist. “Individuals who suspect they may have gum disease should schedule an appointment with a general dentist in their area,” continued Dr. Aldredge. “General dentists can provide a referral to a nearby periodontist if disease is present.”
The complete “Predicting Periodontitis at State and Local Levels in the United States” study can be accessed by visiting
For more information about periodontal disease, please visit
About the American Academy of Periodontology
The American Academy of Periodontology (AAP) represents over 8,000 periodontists—specialists in the prevention, diagnosis, and treatment of inflammatory diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontics is one of the nine dental specialties recognized by the American Dental Association.