Friday, June 30, 2017

Repair may increase survival of direct posterior restorations – A practice based study

https://doi.org/10.1016/j.jdent.2017.06.002

Abstract

Objectives

To investigate repairs of direct restorations by a group of Dutch general dental practitioners (GDPs) and its consequences on longevity of restorations.

Methods

Data set was based on dental records of patients attending 11 general dental practices (24 Dentists) in the Netherlands. Patients that received Class II Amalgam or Composite restorations were included in the study. The outcomes were considered in two levels: “Success” – When no intervention was necessary on the original restoration, it was considered clinically acceptable. “Survival” – Repaired restorations were considered clinically acceptable. Kaplan–Meier statistics and Multivariate Cox regression were used to assess restorations longevity and factors associated with failures (p < 0.05).

Results

59,722 restorations placed in 21,988 patients were analyzed. There was a wide variation in the amount of repairs among GDPs when a restoration had failed (Level 1). Repairs of multi-surface restorations were more frequent (p < 0.001). A total of 9,253 restorations (Level 1) or 6,897 restorations (Level 2) had failed in a 12-year observation time. “Success” and “Survival” of the restorations reached 65.92% (AFR = 4.08%) and 74.61% (AFR = 2.88%) at 10 years, respectively. Patient (age, removable denture) and tooth/treatment-related factors (molars, >2 restored surfaces, endodontic treatment, Amalgam) were identified as risk factors for failure (p < 0.001).

Conclusion

Overall, the GDPs showed satisfactory rates of restoration longevity over 10 years. Repair can increase the survival of restorations although, substantial differences exist among practitioners in repair frequency and AFRs. Molars, multi-surface restorations, presence of an endodontic treatment and a removable denture were identified as risk factors for failure.

Clinical Significance

Repair, instead of total replacement of a defective restoration, is a Minimally Invasive procedure which can increase the survival of the original filling, reducing the risk for pulp complications and treatment costs.

Thursday, June 29, 2017

The Effect of Temporary Cement Cleaning Methods on the Retention of Crowns


Abstract

Purpose

To evaluate the effect of temporary cement cleaning methods on the retention of cemented crowns using zinc phosphate cement and resin-modified glass ionomer cement.

Materials and Methods

Forty titanium specimens were fabricated to simulate prepared molars with minimally retentive taper. The Ni-Cr cast crowns were fabricated, temporarily cemented, and separated. The specimens were divided into four groups according to the temporary cement cleaning method (n = 10) as follows: control group (no temporary cementation), orange solvent group, ultrasonic cleaning group, and air-abrasion group. After the cleaning procedures, the specimens were cemented with definitive cements (zinc phosphate cement and resin-modified glass ionomer, RMGI, cement) and subjected to thermocycling (5000 cycles, 5-55°C, dwell time, 10 seconds). The tensile bond strength of each specimen was measured using a universal testing machine, and the results were analyzed using the Kruskal-Wallis and Mann-Whitney U test (α = 0.05).

Results

When cemented with zinc phosphate cement, the statistical analysis showed that the value of the air-abrasion group was significantly higher than those of the other groups (p < 0.01). There was no statistically significant difference among the other groups. When cemented with RMGI cement, the air-abrasion group showed the lowest value, and the control group showed the highest value (p < 0.01). The difference between the ultrasonic cleaning group and the orange solvent group was not statistically significant.

Conclusion

The use of temporary cement did not have a significant influence on retention of permanently cemented crowns when zinc phosphate cement was used for permanent cementation. Airborne-particle abrasion after provisional cementation improved retention of crowns cemented with zinc phosphate cement; however, the use of temporary cement significantly decreased retention of permanently cemented crowns when RMGI cement was used regardless of the temporary cement cleaning method.

Wednesday, June 28, 2017

Effect of Split-File Digital Workflow on Crown Margin Adaptation


Abstract

Purpose

Computer-aided design/computer-aided manufacturing (CAD/CAM) is becoming increasingly integrated into dental practice workflow at a pace that exceeds scientific validation. The aim of this study is to evaluate a complete digital split-file protocol relative to segmental digital and analog techniques for restoring a single maxillary anterior edentulous space with custom abutment and crown.

Materials and Methods

Four treatment workflows were assessed: complete digital (CD), segmental digital (SD), milled wax (AM), and heat pressed and hand waxed (AH) and heat pressed. The CD workflow “split” an abutment and crown into separate files to fabricate a zirconia abutment and both zirconia/lithium disilicate crown restorations. The SD workflow scanned the existing abutment for design of segmental restorations in zirconia, lithium disilicate, and milled wax (AM). The AH specimens were conventionally hand waxed. Both the AM and AH specimens were heat pressed with lithium disilicate. All restorations were evaluated with standardized measurements using scanning electron microscopy (SEM) as manufactured without internal adjustments and after manual adjustment. The number of adjustments, adjustment time, and location of adjustments were recorded. One-way ANOVA with repeated measures was used to report geometric means with 95% confidence intervals.

Results

The mean marginal gap after adjustment of the CD group was 69 μm, with an upper bound (UB) of 79 μm and a lower bound (LB) of 60 μm. SD group mean was 26 μm with an UB of 31 μm and LB of 22 μm. The AM group mean was 32 μm, with an UB of 49 μm and a LB of 20 μm; AH group mean of 26 μm with an UB of 34 μm and a LB of 20 μm. The SD, AM, and AH workflows were statistically similar (p = 1.000), and the CD workflow was statistically greater than the other three (p < 0.001).

Conclusions

The split-file (CD) protocol results in marginal gap size within clinical standards after adjustment; however, 52 of the 60 digitally produced restorations showed a horizontal marginal offset that required adjustment for proper contours.

Tuesday, June 27, 2017

V-Posil Time-Optimized VPS Impression System



Maximum Precision in Up to 30% Less Chair Time

VOCO presents V-Posil, the maximum precision VPS impression system with optimized timing for reduced headaches and chair time.

V-Posil is flavorless and offers up to 2-minutes of adjustable working time, giving the practitioner control over the pace of the procedure while the abbreviated 2-minute thermo-activated set time improves patient comfort and limits procedural time.  Likewise, V-Posil’s rapid snap-set benefits both the practitioner and the patient by reducing the time spent in the critical zone by up to 50%, minimizing potential distortion due to human error, which results in less costly retakes. Through V-Posil’s optimized timing VOCO has been able to combine the working time of a regular-set with the short setting time of a fast-set in one single material.

With a low polyether-like contact angle of less than TEN degrees (<10 span="">°), V-Posil’s superior hydrophilicity displaces fluids (saliva, blood, etc.) to create an enhanced contact to the dental anatomy, yielding more precise impressions.  Additionally, V-Posil provides exceptional tear strength and elastic recovery (99.6%) to ensure dimensional accuracy of the impression after its removal.  Lab Technicians will appreciate V-Posil’s unique post-set contact angle of less than SIX degrees (<6 a="" accurate="" better="" ensures="" fitting="" for="" hydrophilicity="" models="" more="" post-set="" providing="" restorations.="" span="" stone="" that="">

Featuring four different viscosities including two tray materials in V-Posil Putty Fast and Heavy Soft Fast and two wash materials in V-Posil Light Fast and X-Light Fast, V-Posil’s indications include the full range of impression techniques as well as reline/rebase impressions and impressions for removable dental prostheses. All four viscosities are available in 50ml cartridge refills while the V-Posil Heavy Soft Fast, formulated for both easy loading and removal after it is set, is also available in the 380ml automix Dynamic Dispenser cartridge. 

Manufacturer:                         VOCO America Inc.
Contact Number:         1-888-658-2584
Contact Email:            infousa@voco.com

Monday, June 26, 2017

Taub Products Announces Release of New Eyewash station



Jersey City, NJ: June 22, 2017 - TAUB Products, a long-time manufacturer of dental laboratory and restorative products, has introduced a low-profile emergency eyewash station that adapts to a wide range of office and laboratory faucets. The new station provides instant access to a single aerated water jet, flushing the eyes and washing the face of chemical or particulate contamination.

Jordan Taub, Vice President of TAUB, stated, “The unique design allows water to flow normally downward for washing hands, and during an emergency, the user can quickly rotate it upwards, providing a soft stream of water that will wash the face. The user places the water stream on the brow of the nose and both eyes receive an effective rinse.”

Setting this apart from dual-jet designs, the key features of the product include a single rotating nozzle to wash eyes and face, a low-profile modern design that fits most standard faucets, a flow rate of 1.2 gallons per minute, which exceeds ANSI standards, and a design that prevents standing water, thus reducing the chance for mold development.

TAUB Products is celebrating its 65th year in business. TAUB provides innovative, high-quality solutions for dental professionals. For more information on TAUB and its products, call 800-828-2634, or go to www.taubdental.com.

Friday, June 23, 2017

A Novel Evidence-Based Periodontal Prognosis Model

,

Abstract

Objective

Patients with periodontal disease and the dental professionals responsible for their care want to know which teeth are expected to respond favorably to periodontal treatment and which teeth are likely to be lost in the short and long term. A number of different periodontal prognosis systems have been previously proposed but do not consider important patient-level factors, such as smoking and diabetic control, in the calculation of the expected outcome and often use subjective measures that introduce potential inaccuracies. The aim of this report is to translate the best available evidence on periodontal prognosis into a clinical model to facilitate decision-making and improve patient outcomes.

Methods

Criteria for an ideal prognostic system were proposed and used to assess the previously reported models. With an emphasis on the inclusion of patient-level modifiers (PLMs) and the exclusive use of objective parameters, a new evidence-based model was developed.

Results

This report proposes a new tooth-level prognosis model that uses 9 evidence-based quantifiable parameters to provide a prognosis of secure, doubtful, poor, or irrational to treat. Six tooth-level risk predictors (bone loss:age, pocket depth, furcation involvement, infrabony defects, anatomical factors, and mobility) and 3 PLMs (smoking, diabetes, and bleeding on probing) are used to determine the expected course of disease with specific reference to the suitability of the tooth for future dental treatment.

Conclusions

PLMs must be considered when determining the prognosis of a tooth with periodontal disease. The model proposed in this report is based on the best available evidence for factors affecting tooth survival and has been designed to be as simple and objective as possible to facilitate its adoption in clinical practice. It will be retrospectively and prospectively validated to determine its ability to accurately predict the course of disease.

Thursday, June 22, 2017

Erbium Laser Technology vs Traditional Drilling for Caries Removal: A Systematic Review with Meta-Analysis



Abstract

Objective

The study aimed to assess the efficacy of erbium laser technology compared with traditional drilling for caries removal.

Methods

A systematic search was conducted through Medline via PubMed, Embase, Cochrane databases, CNKI till December 2016. Randomised controlled trials, quasi-randomized controlled trials, or controlled clinical trials with data comparing the efficacy of erbium laser technology versus traditional drilling for caries removal were included.

Results

Fourteen studies were selected in our meta-analysis. Erbium laser technology showed an increased time when removing caries compared with drilling (mean difference: 3.48, 95% confidence interval: 1.90-5.06, P < .0001). However, erbium laser technology reduced the requirement for local anesthesia (risk ratio: 0.28, 95% confidence interval: 0.13-0.62, P = .002). Erbium laser technology was also not significantly different to traditional drilling with regard to restoration loss, pulpal vitality, and postoperative sensitivity.

Conclusions

Erbium laser technology showed an increased time for cavity preparation compared with traditional drilling. However, erbium laser technology reduced the requirement for local anesthesia. There was no significant difference between erbium laser technology and traditional drilling regarding restoration loss, pulpal vitality, and postoperative sensitivity.

Wednesday, June 21, 2017

CAD/CAM-fabricated ceramic implant-supported single crowns made from lithium disilicate: Final results of a 5-year prospective cohort study


Abstract

Background

All-ceramic bilayer systems suffer from technique-sensitivity, resulting in increased technical complication rates. This might be overcome by monolithic reconstructions, facilitating digital workflows.

Purpose

To evaluate the clinical and patient-reported outcome of CAD/CAM-fabricated implant-supported single crowns (ISCs) made of lithium disilicate (LS2) cemented on ceramic implants 5 years after implant installation.

Materials and methods

Twenty-four patients were included in the study. All participants received a one-piece ceramic implant in anterior (4 incisors) and posterior regions (10 premolars, 10 molars). LS2 crowns were computer-aided designed (CAD), manufactured (CAM) and adhesively luted onto the implants. Follow-ups were performed yearly up to 60 months after implant installation. The survival/success rates of the restorations were calculated according to modified US Public Health Service criteria as follows: Clinically relevant defects that could be repaired intraorally were accepted for survival, whereas small-area chippings, roughness (ø < 2 mm), slightly soundable marginal gaps, minimal undercontours/overcontours, and tolerable color deviations were accepted for success. Kaplan-Meier plots were used for the success/survival analyses. Furthermore, patient-reported outcome measures (PROMs) were assessed by applying visual analog scales (VAS). Linear (PROMs) and logistic (USPHS criteria) mixed models were fitted to evaluate time effects on response variables.

Results

Twenty-two ISCs could be evaluated 55.2 ± 4.2 months after prosthetic delivery. Two patients were reported as drop-outs (1 died, 1 moved abroad). No failures were observed, resulting in 100% survival. At two ISCs, a major-roughness had to be treated. This resulted in a Kaplan-Meier success estimate of 91.7% (95%CI: 70.6%-97.9%). Compared with pretreatment, all surveys at prosthetic delivery except for self-esteem (P = .375) showed significantly improved VAS scores. No decrease in satisfaction could be observed over time until the end of follow-up (P ≥ .056).

Conclusion

Concerning survival/success rates and PROMs, the evaluated crown-implant system showed favorable mid-term results. To date, there are no comparable data available for implant-supported ISCs made of LS2.

Tuesday, June 20, 2017

Comparison of dimensional accuracy of conventionally and digitally manufactured intracoronal restorations


The Journal of Prosthetic Dentistry


Available online 2 June 2017

Abstract

Statement of problem

Advances have been made in digital dentistry for the fabrication of dental prostheses, but evidence regarding the efficacy of digital techniques for the fabrication of intracoronal restorations is lacking.

Purpose

The purpose of this in vitro study was to compare the dimensional accuracy of intracoronal restorations fabricated with digital and conventional techniques.

Material and methods

A sound mandibular molar tooth received a standard onlay preparation, and onlays were fabricated with 1 of 3 fabrication techniques. In group CC, the onlays were made after conventional impression and conventional fabrication of a resin pattern. In group CP, the onlays were made after conventional impression and 3-dimensional (3D) printing of the pattern. In group IP, the onlays were made after intraoral scanning, and 3D printing produced the resin pattern. Ten specimens in each group (N=30) were evaluated. Glass-ceramic restorations were fabricated using the press technique. The replica technique was used to assess the marginal fit. Each replica was assessed at 8 points. One-way ANOVA was used to compare the marginal discrepancy among the 3 groups. The Tukey honest significant differences test was applied for pairwise comparisons of the groups (α=.05).

Results

No significant differences were noted in the marginal discrepancy at the gingival margin among the 3 groups (P=.342), but significant differences were noted among the 3 groups in the pulpal (P=.025) and lingual (P=.031) areas. Comparison of the absolute discrepancy among the 3 groups revealed that only groups CC and CP were significantly different (P=.020) from each other.

Monday, June 19, 2017

The efficacy of non-narcotic analgesics on post-operative endodontic pain: A systematic review and meta-analysis



Summary

The objective of this review was to evaluate the efficacy of non-narcotic analgesics including non-steroidal anti-inflammatory drugs (NSAIDs) and/or paracetamol in the treatment of post-operative endodontic pain. Additionally, we aimed to examine the possible association of study covariates on the pain scores using meta-regression analysis. An electronic search was performed in 2016. After data extraction and quality assessment of the included studies (n = 27, representing 2188 patients), meta-analysis was performed using a random-effect inverse variance method. Meta-regression analysis was conducted to examine the associations between effect sizes and study-level covariates (P < 0·05). The results showed that administration of non-narcotic analgesic was more effective than placebo in the management of post-operative pain, resulting in a lower pain scores with a standardised mean difference of −0·50 (95% CI= −0·70, −0·30), −0·76 (95%CI= −0·95, −0·56), −1·15 (95% CI= −1·52, −0·78), −0·65 (95% CI= −1·05, −0·26) for immediately after the procedure, 6−, 12− and 24 h post−operative follow-ups (test for statistical heterogeneity: P = 0·000, P = 0·000, P = 0·000 and P = 0·001), respectively. Our meta-regression analysis provided the evidence for association between some study covariates with treatment effect, each at different follow-ups. We concluded that the clinicians can manage post-operative endodontic pain by administration of NSAIDs and/or paracetamol. However, analgesic regimens should be considered as important determinants when prescribing a pharmacological adjuvant.

Friday, June 16, 2017

Canadian Dentists Turn to Financial Practice Management CE, Patient Financing and Promotion on Social Media as Dental Practice Consolidation Continues



Toronto, ON – June 6, 2017 – The fundamental shift in the make-up of the Canadian dental practice detected in previous reports is continuing, according to results from the DIAC (Dental Industry Association of Canada) Twenty-First Annual Future of Dentistry Survey. All of the following points may reflect on the impact of the current economic situation on the dental practice in Canada:
  •   There are now more dentists per practice on average, with a record 13% of practices with five or more dentists. This was 3.4% in 2016 and an average of 6.3% the last 14 years.
  •   There are now more operatories per practice (72% of respondents had four or more operatories. Of these, an all-time high of 30% had five or more). Almost 1⁄4 (22%) of respondents were planning on adding at least one operatory in the next two years.
  •   The number of hygiene days per practice is increasing overall (44% of respondents in 2017 had 5 or more hygiene days per week, as compared to 40.4% last year and the average of 38.5% the last ten years).
  •   At the same time, the average number of patients treated per day continues to decline. While influenced by specialist respondents, on an overall basis, dentists treated 12 patients in an average day as compared to the average of 12.5 patients over the last ten years.83% stated they treated less than 15 patients a day (as opposed an average of 77.5% over the last four years).
    It is little wonder that “Getting More Patients” was the top challenge that respondents intended to address in 2017 (as well as the Top Metric for Success in the opinion of 83%), with “Financial/paying bills/overhead” a close second.
    Many dentists have responded by moving into Multi-practice (Group Practice). While the majority (59%) of respondents stated they were in a solo practice, more than a third (36%) were now in a group practice and a further 4% in Corporate dentistry. The two key advantages of a multi-practice structure attracting those who were in that type of practice were Associate Support (51%) and Buying Power (30%).
    Dentists are also now focusing their Practice Management CE activities on Financial aspects. While all four of the highest rated Practice Management topics for 2017 related to building the business of the practice (Ranked in order from highest: Revenue Enhancement/Expense Management; Fraud Protection, Marketing the Practice, and Communication/Case Presentation), the top focus has switched from Marketing to “the Numbers”, which may be a reflection on the economic situation. At the same time, member in Study Clubs was up overall; with 45.1% of respondents stated they belonged to one or more as compared to the average 37.9% of the previous eight years.
The majority (65%) of dental practices now offer patient financing in some fashion. Almost one-half (47%) of respondents offered in-house financing while 19% used third party financing.
Social Media continues to climb the list of Practice-Building Tools utilized at 45% of respondents, now second to “Asking for referrals” and progressively trending upward from 13% in 2012 when the question was first asked. This movement to on-line promotion mirrors where dental patients are telling practitioners they are getting information on dental treatment options. According to the survey, Internet achieved an all-time high rating and was ranked as the top patient source for the second straight year. This was followed by the more traditional sources of Family members, friends, etc. and Dentist/Dental Team presentations.
A total of 335 practicing Canadian dentists responded to this year’s survey with a good proportional distribution across all regions of the country. Based on this response rate, overall 2017 survey results have an accuracy of +/- 5.4% 19 times out of 20.
Source: Twenty-First Annual Future of Dentistry Survey
Dental Industry Association of Canada / Eric P. Jones & Associates Inc.

Thursday, June 15, 2017

Comparison of dimensional accuracy of conventionally and digitally manufactured intracoronal restorations

The Journal of Prosthetic Dentistry

Abstract

Statement of problem

Advances have been made in digital dentistry for the fabrication of dental prostheses, but evidence regarding the efficacy of digital techniques for the fabrication of intracoronal restorations is lacking.

Purpose

The purpose of this in vitro study was to compare the dimensional accuracy of intracoronal restorations fabricated with digital and conventional techniques.

Material and methods

A sound mandibular molar tooth received a standard onlay preparation, and onlays were fabricated with 1 of 3 fabrication techniques. In group CC, the onlays were made after conventional impression and conventional fabrication of a resin pattern. In group CP, the onlays were made after conventional impression and 3-dimensional (3D) printing of the pattern. In group IP, the onlays were made after intraoral scanning, and 3D printing produced the resin pattern. Ten specimens in each group (N=30) were evaluated. Glass-ceramic restorations were fabricated using the press technique. The replica technique was used to assess the marginal fit. Each replica was assessed at 8 points. One-way ANOVA was used to compare the marginal discrepancy among the 3 groups. The Tukey honest significant differences test was applied for pairwise comparisons of the groups (α=.05).

Results

No significant differences were noted in the marginal discrepancy at the gingival margin among the 3 groups (P=.342), but significant differences were noted among the 3 groups in the pulpal (P=.025) and lingual (P=.031) areas. Comparison of the absolute discrepancy among the 3 groups revealed that only groups CC and CP were significantly different (P=.020) from each other.

Conclusions

Within the limitations of this in vitro study, the conventional method yielded more accuracy than the 3D printing method, and no differences were found between the methods which used the 3D printer (groups CP and IP).

Wednesday, June 14, 2017

Accuracy of four intraoral scanners in oral implantology: a comparative in vitro study

BMC Oral HealthBMC series – open, inclusive and trusted201717:92
DOI: 10.1186/s12903-017-0383-4
Received: 13 April 2017
Accepted: 23 May 2017
Published: 2 June 2017

Abstract

Background

Until now, only a few studies have compared the ability of different intraoral scanners (IOS) to capture high-quality impressions in patients with dental implants. Hence, the aim of this study was to compare the trueness and precision of four IOS in a partially edentulous model (PEM) with three implants and in a fully edentulous model (FEM) with six implants.

Methods

Two gypsum models were prepared with respectively three and six implant analogues, and polyether-ether-ketone cylinders screwed on. These models were scanned with a reference scanner (ScanRider®), and with four IOS (CS3600®, Trios3®, Omnicam®, TrueDefinition®); five scans were taken for each model, using each IOS. All IOS datasets were loaded into reverse-engineering software, where they were superimposed on the reference model, to evaluate trueness, and superimposed on each other within groups, to determine precision. A detailed statistical analysis was carried out.

Results

In the PEM, CS3600® had the best trueness (45.8 ± 1.6μm), followed by Trios3® (50.2 ± 2.5μm), Omnicam® (58.8 ± 1.6μm) and TrueDefinition® (61.4 ± 3.0μm). Significant differences were found between CS3600® and Trios3®, CS3600® and Omnicam®, CS3600® and TrueDefinition®, Trios3® and Omnicam®, Trios3® and TrueDefinition®. In the FEM, CS3600® had the best trueness (60.6 ± 11.7μm), followed by Omnicam® (66.4 ± 3.9μm), Trios3® (67.2 ± 6.9μm) and TrueDefinition® (106.4 ± 23.1μm). Significant differences were found between CS3600® and TrueDefinition®, Trios3® and TrueDefinition®, Omnicam® and TrueDefinition®. For all scanners, the trueness values obtained in the PEM were significantly better than those obtained in the FEM. In the PEM, TrueDefinition® had the best precision (19.5 ± 3.1μm), followed by Trios3® (24.5 ± 3.7μm), CS3600® (24.8 ± 4.6μm) and Omnicam® (26.3 ± 1.5μm); no statistically significant differences were found among different IOS. In the FEM, Trios3® had the best precision (31.5 ± 9.8μm), followed by Omnicam® (57.2 ± 9.1μm), CS3600® (65.5 ± 16.7μm) and TrueDefinition® (75.3 ± 43.8μm); no statistically significant differences were found among different IOS. For CS3600®, For CS3600®, Omnicam® and TrueDefinition®, the values obtained in the PEM were significantly better than those obtained in the FEM; no significant differences were found for Trios3®.

Conclusions

Significant differences in trueness were found among different IOS; for each scanner, the trueness was higher in the PEM than in the FEM. Conversely, the IOS did not significantly differ in precision; for CS3600®, Omnicam® and TrueDefinition®, the precision was higher in the PEM than in the FEM. These findings may have important clinical implications.

Tuesday, June 13, 2017

Response of carious enamel to TiF4 varnish treatment under diverse cariogenic activities in situ



Abstract

OBJECTIVE

To compare the effect of TiF4 and NaF varnishes on pre-demineralized bovine enamel under different cariogenic activities in situ.

METHODS

Twenty subjects participated of this in situ study with 3 crossover phases (14 days each), in which they wore palatal appliances containing demineralized bovine enamel samples (8 samples/appliance for phase) treated with TiF4, NaF (all with 2.45% F) or placebo varnish. The samples were subjected to different cariogenic conditions (1. absence of biofilm accumulation and sucrose exposure; 2. presence of biofilm and absence of sucrose exposure; 3. presence of biofilm and 20% sucrose exposure 4x/day; 4. presence of biofilm and 20% sucrose exposure 8x/day). All were exposed to fluoride dentifrice (2x/day). The mineral content and lesion depth were evaluated using transverse microradiography (TMR) and the data were subjected to RM two-way ANOVA/Bonferroni tests (p<0 .05="" p="">

RESULTS

TiF4 varnish significantly increased the remineralization of artificial carious lesions compared to placebo, regardless of the cariogenic activity. On the other hand, the remineralizing effect of NaF varnish was dependent on the cariogenic activity. For NaF, remineralization happened only in conditions 1 and 3 compared to placebo varnish (p < 0.0001). NaF was unable to prevent further demineralization under biofilm accumulation and sucrose exposure 8x/day (condition 4). In the absence of fluoride treatment, demineralization happened in all conditions, except in the condition 1.

CONCLUSION

Therefore, 4% TiF4 varnish was the only treatment able to improve enamel remineralization regardless of the cariogenic activity, while NaF varnish failed in preventing further demineralization under high cariogenic activity in situ.

CLINICAL SIGNIFICANCE

4% TiF4 varnish showed better remineralizing effect compared to NaF varnish, which was seen regardless of the cariogenic activity. This is a promising finding to support the indication of TiF4 in the clinic.

Monday, June 12, 2017

Antibiotic treatment to prevent post-extraction complications: a monocentric, randomized clinical trial. Preliminary outcomes.


Minerva Stomatol. 2017 May 31. doi: 10.23736/S0026-4970.17.04047-X. [Epub ahead of print]

Abstract

BACKGROUND:

Tooth extraction is a very common procedure in oral surgery. Despite this, very little information is available in the literature as to the antibiotic management of the patient. The aim of this study is to evaluate whether the antibiotic prophylaxis could be beneficial in preventing post- extraction local complications and whether the use of a probiotic could help reduce the antibiotic gastro-intestinal side effects.

MATERIALS AND METHODS:

111 patients meeting the inclusion criteria were initially included in this randomized clinical trial and randomly allocated to one of the three experimental groups according to a computer-generated randomization list. Patients allocated to the group 1 were given amoxicillin+clavulanic acid (2 grams/day for 6 days), patients allocated to the group 2 received antibiotic+ probiotic (Bifidobacterium longum + lactoferrin) and patients allocated to the group 3 received no antibiotic therapy after the extraction. To evaluate post-extractive complications, controls were performed at days 7, 14 and 21 after the extraction.

RESULTS:

At T1 pain at the surgical site was present in the 48%, 30% and 71.4% of the patients belonging respectively to the antibiotic alone group, to the antibiotic+probiotic group and to the control group. The mean Numeric Rating Score (NRS) score was 1.56±1.91, 1.08±1.93, 2.02±2.27 respectively (P=0.0498). Two patients belonging to the control group experienced dry socket. In addition, 9 patients (33.3%) in the antibiotic-alone group and 1 patient (2.7%) in the antibiotic+probiotic group reported intestinal distension (p=0.0012), 7 days after surgery. Finally, diarrhea was recorded in 5 patients of the antibiotic alone group (18.5%), on the other hand, no patients of the antibiotic+probiotic group and the control group reported diarrhea.

CONCLUSIONS:

Post-extractive complications observed in each group have been mild and fast to resolve. The antibiotic administration showed a decrease in pain suffered by patients but a higher incidence of gastro-intestinal side effects, such as abdominal distension and diarrhea, which seemed to be relieved by the concomitant use of the probiotic.

Friday, June 09, 2017

Evaluation of Compressive Strength and Sorption/Solubility of Four Luting Cements

Journal of Dental BioMaterials
Vol 4, No 2 (2017)

Abstract


Abstract:
Statement of Problem: Compressive strength (CS) and sorption/solubility of the luting cements are two associated factors. Searching a correlation between sorption/solubility and compressive strength of various luting cements is required.
Objectives: To measure the water sorption/solubility, and compressive strength of three resin-based and one conventional glass ionomer (CGI) luting cement after 1 and 24 h of immersion in distilled water and to determine if there is any correlation between those properties found.
Materials and Methods: Four luting cements were investigated. For each material, 10 disc shaped specimens were prepared for measuring the sorption/solubility. The specimens were cured according to the manufacturer’s instructions, and the sorption/solubility were measured in accordance with the ISO 4049’s. For testing the compression strength, for each material 16 cylindrical specimens were prepared by insertion of cements into a stainless steel split mould. The specimens were cured, divided into groups of 8, and then stored in distilled water at (37 ± 1)°C for 1 and 24 h. The test was performed using the universal testing machine, the maximum load was recorded and CS was calculated. The data were analysed using SPSS software version 18. One-way ANOVA, post-hoc Tukey’s test and Pearson’s correlation coefficient were performed.
Results: G-CEM had the highest mean CS (153.60± 25.15) and CGI luting had the lowest CS (21.36±5.37) (p <0 .001="" 24="" after="" all="" almost="" an="" cs="" except="" for="" h="" increase="" materials="" mean="" relyx="" showed="" sup="" values="">TM
U200 which showed a slight reduction. However, no statistically significant difference was founded (all p > 0.05). The lowest mean sorption/solubility value was for RelyXTM U200 and Panavia F, and the highest for CGI luting (all p < 0.001).Conclusions: The compressive strength of all cements did not necessarily increase after 24 h and varied depending on the materials. There was a strong reverse correlation between sorption and CS values after both 1 and 24 h immersion. It may be practical for clinician to use those cements with the less sorption / solubility and more stable compression strength over time.

Thursday, June 08, 2017

3M Expands its Prevention Portfolio with New Varnish


 

ST. PAUL, Minn. – (June 1, 2017) – 3M, a leader in fluoride varnishes, has launched a new fast-releasing fluoride varnish in new flavors and a unit dose tray, to give clinicians another option for their patient’s needs. 3M’s new varnish complements 3M™ Vanish™ 5% Sodium Fluoride White Varnish, which has been the number one fluoride varnish on the market for ten years. 3M Vanish White Varnish is formulated to remain on teeth longer for more effective protection; with extended fluoride release, added tri-calcium phosphate and a durable coating.   Although longer fluoride contact is beneficial, some patients aren’t as compliant during their treatments, so 3M created 3M Fast Release Varnish.

3M Fast Release Varnish releases most of its fluoride in the first two hours, so dental professionals can deliver quick protection to patients who may not always follow their patient care instructions. With 22,600 ppm sodium fluoride, a virtually invisible smooth coating, and popular, fun flavors including caramel, strawberry and mint, 3M Fast Release Varnish is an excellent choice for patients who may require a shorter treatment time.

“My go to varnish has been 3M’s Vanish™ White Varnish because it’s so durable and the longer fluoride is in contact with the teeth, the more effective it is,” said Kelli Swanson Jaecks, RDH, MA. "However, some patients simply don’t like the taste or feel of fluoride treatments, and tend to brush off or remove their coating too soon. The new 3M™ Fast Release Varnish gives clinicians an alternative for patients just like these. It has a fast fluoride release and a nice smooth coating, so for certain patients, I know I’m giving them the quick protection they need.”

3M Oral Care promotes lifelong oral wellness through inventive solutions that help oral care professionals achieve greater clinical, professional and personal success. Learn more at 3M.com/OralCare. For more information on 3M Fast Release Varnish or 3M Vanish White Varnish, visit 3M.com/PreventiveCare.

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About 3M
At 3M, we apply science in collaborative ways to improve lives daily. With $30 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 www.3M.com or on Twitter @3M or @3MNewsroom.
 
3M and Vanish are trademarks of 3M or 3M Deutschland GmbH. Used under license in Canada. © 3M 2017. All rights reserved. 

Wednesday, June 07, 2017

365 Days of Social Media Posts for Dentistry

From my friend Rachel Mele her new book 365 Days of Social Posts for Dentistry is now available for preorder. Books purchased before June 12th will be signed.

Click here to purchase

Tuesday, June 06, 2017

Minimally-invasive dental anesthesia: Patients' preferences and analysis of the willingness-to-pay index

Long time CCLAD user and it just works. Never thought to charge extra for it. MJ




Abstract

Aim

The aim of the present prospective study was to evaluate the impact of a computer-controlled anesthesia on patients' comfort and to investigate, through the willingness-to-pay (WTP) index, and patients' acceptance of this new technology.

Methods

Fifty patients undergoing a class I or II restorative procedure were enrolled. A computer-controlled device for anesthetic delivery was utilized, and a questionnaire on the level of discomfort and WTP was given to all patients.

Results

A total of 86% of participants declared less discomfort than that perceived during their last traditional procedure for pain control; 58% of patients were willing to pay an additional fee for a modern anesthesia technique, with a median WTP value of 20$.

Conclusions

Computer-controlled systems for local anesthesia represent a relevant tool for reducing patients' discomfort during dental treatment. The WTP index helps to quantify its relevance.

Monday, June 05, 2017

The effect of a tooth/tongue gel and mouthwash regimen on morning oral malodour

A 3-week single-blind randomized clinical trial


Abstract

Aim

To compare the effects of a regimen consisting of a tooth/tongue gel, tongue cleaner and mouthwash with the effects of using standard fluoride dentifrice on the organoleptic oral malodour score (ORG) and volatile sulphur compounds (VSCs).

Materials and methods

A total, 66 non-dental students participated in a 3-week parallel, single-blind, randomized, controlled clinical trial. The test group used a tongue cleaner, a tooth/tongue gel and mouthwash containing amine fluoride/stannous fluoride and zinc lactate as oral malodour counteractive. The control group used a standard fluoride dentifrice. Measurements were taken in the morning at baseline, at days 1, 7 and 21. The primary outcome was the ORG score. The secondary outcome, the VSC measurement, was assessed using OralChroma™ (H2S, CH3SH, (CH3)2S) and Halimeter®. Tongue coating thickness and tongue discoloration were scored. At baseline and day 21, the participants’ self-perceptions were assessed.

Results

At day 1 for the ORG, H2S, CH3SH and Halimeter® readings, a significant decrease was observed in the test group. At day 21, the decrease in H2S and the Halimeter® outcomes were maintained for the test group, and a significant increase in tongue surface discoloration was observed. The test group evaluated their “morning breath upon awakening” as significantly better (P=.001) after 21 days.

Conclusion

A significant overnight effect on morning oral malodour was observed for most of the parameters in favour of the test group. At day 21, the effect of prolonged use was significant for H2S and the Halimeter® readings, although not for the primary ORG outcome parameter.

Friday, June 02, 2017

Digital transillumination in caries detection versus radiographic and clinical methods: an in-vivo study.

Dentomaxillofac Radiol. 2017 Apr;46(4):20160417. doi: 10.1259/dmfr.20160417. Epub 2017 Apr 6.

Abstract

OBJECTIVES:

This article aimed to evaluate: (a) the agreement between a near-infrared light transillumination device and clinical and radiographic examinations in caries lesion detection and (b) the reliability of images captured by the transillumination device.

METHODS:

Two calibrated examiners evaluated the caries status in premolars and molars on 52 randomly selected subjects by comparing the transillumination device with a clinical examination for the occlusal surfaces and by comparing the transillumination device with a radiographic examination (bitewing radiographs) for the approximal surfaces. Forty-eight trained dental hygienists evaluated and reevaluated 30 randomly selected images 1-month later.

RESULTS:

A high concordance between transillumination method and clinical examination (kappa = 0.99) was detected for occlusal caries lesions, while for approximal surfaces, the transillumination device identified a higher number of lesions with respect to bitewing (kappa = 0.91). At the dentinal level, the two methods identified the same number of caries lesions (kappa = 1), whereas more approximal lesions were recorded using the transillumination device in the enamel (kappa = 0.24). The intraexaminer reliability was substantial/almost perfect in 59.4% of the participants.

CONCLUSIONS:

The transillumination method showed a high concordance compared with traditional methods (clinical examination and bitewing radiographs). Caries detection reliability using the transillumination device images showed a high intraexaminer agreement. Transillumination showed to be a reliable method and as effective as traditional methods in caries detection.

Thursday, June 01, 2017

Alternative methods to visual and radiographic examinations for approximal caries detection.

J Oral Sci. 2017 May 19. doi: 10.2334/josnusd.16-0595. [Epub ahead of print]

Abstract

A shift in caries prevalence from occlusal surfaces to approximal surfaces has been demonstrated by epidemiological studies. Two recent meta-analyses evaluated the performance of visual examination and radiography for carious lesion detection, and reported low sensitivity but high specificity for early approximal caries detection. This suggests that the conventional methods have a higher risk of failing to detect approximal lesions. Consequently, in caries susceptible populations, there is a risk of progression of non-cavitated lesions to irreversible tooth destruction before the lesions are detected. This paper aims to review the performance of unconventional and novel methods for approximal caries detection. In vitro and in vivo studies identified through a MEDLINE search using keywords such as caries detection, approximal caries detection, light fluorescence and dental caries, and transillumination and dental caries were reviewed. The unconventional methods known to be used for approximal caries detection and included in this review are: cone beam computed tomography, fiber-optic trans-illumination, digital imaging fiber optic trans-illumination, near-infrared digital imaging transillumination, optical coherence tomography, laser fluorescence, ultrasound, and LED reflection and refraction.