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Purpose: To assess the effect of 10% carbamide peroxide and 10% hydrogen peroxide bleaching preparations on the surface free energy of resin composite with and without saliva bioflim coating. Methods: 72 light-cured resin composite samples were used. The samples were either coated with fresh human saliva or left uncoated. Each sample was placed in a plastic assay tube containing 2 ml of either 10% carbamide peroxide (CP), 10% hydrogen peroxide (HP), or phosphate buffer solution. The tubes containing the composite samples were then placed in a dry incubator at 37°C for 1and 3-day time intervals. After each time interval the samples were rinsed with distilled water and subjected to wetting measurements using a captive bubble technique. Measurements were taken in triplicate and determination of contact angles done by using film negatives on an enlarger. The differences between pre-treatment and post-treatment measurements and between samples coated with saliva and non-coated samples were analyzed statistically for each time period and treatment group. Results: 10% CP reduced octane contact angle of all exposed composite groups after 1 day of treatment regardless of saliva coating. Differences between the pre-bleached and post-bleached groups were statistically significant only for octane contact angles measured in saliva-coated samples (P< 0.05). 10% CP reduced both the octane and air contact angles of all exposed composite surfaces after 3 days of treatment. The reduction was statistically significant only for octane contact angles measured in the saliva-coated samples (P< 0.05). Additionally, 10% CP significantly reduced the surface free energy of saliva-coated samples after 1-day treatment as compared to non-coated samples. 10% HP reduced octane contact angle of all exposed composite groups after 1 day of treatment regardless of saliva coating. The differences between the pre-bleached and post-bleached groups were statistically significant only for octane contact angles measured in the salivacoated samples (P< 0.05). 10% HP reduced both the octane and air contact angles of all exposed resin composite surface samples after 3 days of treatment regardless of saliva coating. However, the differences between the groups were not statistically significant. [ABSTRACT FROM AUTHOR]

Purpose: To assess the opinions of dental professionals working within the Delta Dental insurance system regarding the predictability of initial endodontic treatment, expected long-term outcome and the importance of placing a coronal coverage after completion of treatment. Methods: An eight-item questionnaire was distributed among participants attending a continuing education course. The questionnaire included four items on practice profile and demographics and four multiple-choice questions regarding participants' opinions on endodontic treatment outcome. Results: 51% of participants responded that the expected retention rate of teeth 5-10 years after endodontic treatment was more than 90%. Sixty-eight percent of participants responded that the need for additional treatment was expected to occur within the first 3 years after initial endodontic treatment. 87% of participants responded that placing coronal coverage after completion of endodontic treatment was very important for long-term tooth retention. Ninety-three percent of participants responded that overall, endodontic treatment was a predictable procedure with long-term tooth retention rate. Statistically significant associations were found between (1) year of experience and expected rate of retention (P< 0.01 ); (2) participants' years of experience and their responses regarding the need for additional treatment (P< 0.05); and (3) their opinions that endodontic treatment was a predictable procedure with long-term tooth retention rate (P< 0.05 ). [ABSTRACT FROM AUTHOR]

Purpose: To assess, in vitro, the effects of aging and surface polishing on mercury release from dental amalgams exposed to 10% carbamide peroxide at two pH levels. Methods: Samples of fresh and aged amalgam, polished and unpolished, were treated with 10% carbamide peroxide at pH 4.5 and at pH 6.5 for periods of 1,4, 7, 10 and 13 days At each time period, mercury concentrations in solution were measured using a cold-vapor atomic absorption mercury analyzer system and compared to control samples treated with phosphate buffer. Results: Amalgam samples exposed to 10% carbamide peroxide released significantly more mercury in solution than samples exposed to phosphate buffer controls. Mercury release was time-dependent and significantly higher in aged amalgam than in fresh amalgam (P< 0.001). Mercury release was also pH-dependent and higher in unpolished amalgam. [ABSTRACT FROM AUTHOR]

Extraradicular leakage of oxidizing agents during bleaching is an undesirable event and thus need to be prevented. The effect of external cervical coating of ethyl cellulose (EC) and metacrylic acid copolymer (MAC) on the radicular penetration of hydrogen peroxide during intracoronal bleaching was examined. Single rooted human premolars extracted for orthodontic reasons were used. The cementum covering the cemento-enamel junction was mechanically removed and the teeth treated endodontically and bleached with 30% hydrogen peroxide. Radicular hydrogen peroxide penetration was measured before coating the teeth and after applications of 1-3 layers of EC or 3 layers of MAC external cervical coatings. It was found that the radicular penetration of 30% hydrogen peroxide was related to the number of layers of cervical EC coatings. Application of one layer of EC did not reduce the hydrogen peroxide penetration. Two and three layers of EC reduced the hydrogen peroxide penetration by 38% and 85% respectively. Three layers of MAC reduced the radicular hydrogen peroxide penetration in 83%. Statistically, a highly significant difference was found between the teeth coated with three layers of either EC or MAC and the noncoated teeth (p < 0.001). It was concluded that application of ethyl cellulose or metacrylic acid copolymer to exposed cervical root surfaces may effectively prevent extraradicular leakage of bleaching agents. [ABSTRACT FROM AUTHOR]

Trichloracetic acid is recommended for the treatment of external cervical root resorption. The present study examined the effect of 90% trichloracetic acid on the microhardness and surface morphology of human dentin and enamel. Intact extracted human teeth were sectioned and embedded in acrylic resin. Each tooth was grinded and highly polished exposing a flat surface of dentin and enamel. The teeth were treated with 90% trichloracetic acid for 30, 60 and 90 s. Vicker's microhardness of the dentin and enamel was assessed for each tooth before and after each treatment. In addition the surface morphology of a trichloracetic acid treated tooth was examined via SEM. The results showed that 90% trichloracetic acid caused a second order type reduction of the microhardness, as well as structural changes in both dentin and enamel. [ABSTRACT FROM AUTHOR]

Pulp injury may occur during orthodontic tooth movement particularly in previously traumatized teeth. There- fore the management of such cases requires specific therapeutic considerations. An extensive periradicular lesion was detected in an orthodontically treated maxillary incisor with an uncertain history of a previous traumatic incident. Conservative endodontic therapy resolved the periradicular lesion thus enabling the orthodontic treatment to continue uneventfully. It is essential to closely monitor the patients undergoing orthodontic treatment and those who are in retention, particularly if a history of trauma is suspected. [ABSTRACT FROM AUTHOR]

Fifty-eight bleached pulpless teeth were re-examined of the periods of 1-8 years. Recall examination included recording of the esthetic results, clinical findings and radiographs. External root resorption was found in 4 of the cases (6.8%), and was progressive in 2 cases and arrested in 2 cases. There had not been any pre- or postoperative trauma in any of the 4 cases. The occurrence of resorption was not related to the bleaching technique used. Resorptive lesions were found to have been initiated apical to and not at the cemento-enamel junction. Esthetically, the bleaching was considered successful in only 50% of the cases, acceptable in 29% and failed in 21%. These results caution against indiscriminate use of bleaching with hydrogen peroxide, and emphasize the importance of preventive measures and postoperative follow-up of bleached pulpless teeth. [ABSTRACT FROM AUTHOR]

Purpose: To examine the effect of toothbrushing with different brands of regular (Meridol, Colgate) and whitening toothpaste (Pearl Weiss, Rembrant, Email Diamant) on bacterial adhesion onto enamel surfaces in vitro. Materials and Methods: Extracted intact human teeth were brushed twice a day, for 3 minutes with the tested toothpaste for a period of 7 days. Sucrose dependent adhesion of Streptococcus mutans to the tested teeth was measured using pre-radioactive labeled bacteria. Results: S. mutans adhered more to enamel surfaces, pre-brushed with the tested toothpastes, th an to teeth which were not brushed. Different profiles of bacterial adhesion were recorded. Both Diamant and Rembrant toothpastes increased bacterial affinity toward the enamel surface as compared to the other toothpastes. Meridol and Pearl Weiss demonst rated a similar adhesion effect as the etching control while brushing with Colgate demonstrated the least bacterial adhesion. [ABSTRACT FROM AUTHOR]

Extracted human premolars were treated endodontically and bleached intracoronally. The teeth were bleached with 30% hydrogen peroxide for periods of 5, 20, 40 and 60 mm at temperatures of 24°C, 37°C and 47°C. A correlation for both bleaching time and temperature and the radicular penetration of hydrogen peroxide was found. No penetration was found after 5 mm bleaching at any of the temperatures tested. Prolonging the bleaching time after 5 mm increased the hydrogen peroxide penetration at each of the temperatures tested. A rise in the bleaching temperature also increased the hydrogen peroxide penetration although not significantly for all tested periods. It is therefore suggested to minimize the bleaching time and temperature when hydrogen peroxide is used as the oxidizing agent. Bleaching should be limited to separate 5-mm periods rather than being performed over a long continous period. [ABSTRACT FROM AUTHOR]

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Purpose: To assess the prevalence of periapical abscesses in patients with rheumatoid arthritis, and to evaluate the effect of commonly used antirheumatic medications on such prevalence., Methods: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for rheumatoid arthritis and periapical abscess was retrieved by searching the appropriate query in the database. The odd ratio (OR) of periapical abscesses, its association with rheumatoid arthritis and intake of three commonly prescribed antirheumatic medications were calculated and analyzed statistically., Results: The prevalence of periapical abscesses in patients with rheumatoid arthritis was 1.53% as compared to 0.51% in the general patient population of the hospital. The OR was 2.60 and the difference was statistically significant (P< 0.0001). In patients treated with either Methotrexate, Sulfasalazine, or Etanercept, the ORs were 2.88, 3.1, and 1.07, respectively. The differences between Methotrexate and Sulfasalazine were statistically significant (P< 0.0001). The OR for prevalence of periapical abscesses in patients treated with Etanercept was significantly lower than that of patients treated with either Methotrexate or Sulfasalazine (P< 0.005)., Clinical Significance: Oral healthcare providers should be aware of the possible association between rheumatoid arthritis and occurrence of periapical abscesses. Patients with rheumatoid arthritis, mainly women, may exhibit higher prevalence of periapical abscesses. Treatment with TNF alpha inhibitors may lower the prevalence of periapical abscesses in such patients., Competing Interests: The authors declared no conflict of interest., (Copyright©American Journal of Dentistry.)

Purpose: To assess the prevalence of periapical abscesses (PAs) in individuals with vitamin D deficiency who are not treated and in individuals treated with a vitamin D supplement (calciferol)., Methods: Integrated data of hospital patients was used. Data from the corresponding diagnosis codes for periapical abscess and vitamin D deficiency were retrieved by searching the appropriate query in the database. The Risk Ratio (RR) for periapical abscesses, its association with vitamin D deficiency and intake of calciferol were calculated and analyzed statistically., Results: The RR for prevalence of periapical abscesses in patients with vitamin D deficiency was 3.44. Presence of PAs was significantly higher in patients with vitamin D deficiency compared to patients without vitamin D deficiency (P< 0.0001). The RR and the prevalence of PAs for patients treated with calciferol were significantly lower compared to untreated patients (P< 0.0001)., Clinical Significance: Dentists should be aware of the possible association between vitamin D deficiency and occurrence of periapical abscesses. It appears that the prevalence of periapical abscesses is higher in patients with vitamin D deficiency. Calciferol supplement may reduce the prevalence of such periapical disease in these patients., Competing Interests: The authors declared no conflict of interest., (Copyright©American Journal of Dentistry.)

Aim: The aim of this study is to survey the opinion of endodontists in the United States regarding their approach to treatment of cracked teeth., Materials and Methods: A survey assessing the opinions of 3,500 endodontists in the United States was administered over a 4-week period. It consisted of a hypothetical clinical case and eight different treatment scenarios. Participants were asked to select one of the two treatment options: (A) informing the patient of the presence of a crack, reinforcing the tooth, and continuing with endodontic treatment; and (B) extraction of the tooth followed by replacement with an implant supported crown or fixed partial denture., Results: When the crack extended across the distal marginal ridge with no associated probing depths, 92.65% endodontists preferred to continue with endodontic treatment and reenforcing the tooth. When the crack extended across the distal marginal ridge and was associated with a probing depth of 6 mm, 80% preferred extraction of the tooth. When the crack extended across the mesial marginal ridge up to the orifice of the mesiolingual canal with no associated probing depth, 82.78% preferred to continue with the treatment. When the crack was associated with a 6-mm probing depth, 83.79% preferred tooth extraction. When the crack extended across the mesial marginal ridge and down into the mesiolingual canal with/without associated probing depth, 91.13% and 63.54% preferred tooth extraction, respectively. When the crack involved both mesial and distal marginal ridges and extended across the pulp chamber, 79.74% preferred tooth extraction. When a split tooth was presented, 98.48% preferred tooth extraction., Conclusion: It appears that the presence of a 6-mm periodontal pocket is considered an important factor by most American endodontists when deciding whether to preserve the cracked tooth or extract it., Clinical Significance: There is no consensus among dentists regarding the best approach to treat cracked teeth. Conclusive studies evaluating clinical approaches of endodontists regarding treatment of cracked teeth are lacking. Therefore, surveyed opinion of endodontists in the United States regarding their approach to treatment of cracked teeth was done to try to reach the best clinical decision regarding this dilemma.

Purpose: To assess the effect of 10% carbamide peroxide and 10% hydrogen peroxide bleaching preparations on the surface free energy of resin composite with and without saliva biofilm coating., Methods: 72 light-cured resin composite samples were used. The samples were either coated with fresh human saliva or left uncoated. Each sample was placed in a plastic assay tube containing 2 ml of either 10% carbamide peroxide (CP), 10% hydrogen peroxide (HP), or phosphate buffer solution. The tubes containing the composite samples were then placed in a dry incubator at 37 degrees C for 1- and 3-day time intervals. After each time interval the samples were rinsed with distilled water and subjected to wetting measurements using a captive bubble technique. Measurements were taken in triplicate and determination of contact angles done by using film negatives on an enlarger. The differences between pre-treatment and post-treatment measurements and between samples coated with saliva and non-coated samples were analyzed statistically for each time period and treatment group., Results: 10% CP reduced octane contact angle of all exposed composite groups after 1 day of treatment regardless of saliva coating. Differences between the pre-bleached and post-bleached groups were statistically significant only for octane contact angles measured in saliva-coated samples (P < 0.05). 10% CP reduced both the octane and air contact angles of all exposed composite surfaces after 3 days of treatment. The reduction was statistically significant only for octane contact angles measured in the saliva-coated samples (P < 0.05). Additionally, 10% CP significantly reduced the surface free energy of saliva-coated samples after 1-day treatment as compared to non-coated samples. 10% HP reduced octane contact angle of all exposed composite groups after 1 day of treatment regardless of saliva coating. The differences between the pre-bleached and post-bleached groups were statistically significant only for octane contact angles measured in the saliva-coated samples (P < 0.05). 10% HP reduced both the octane and air contact angles of all exposed resin composite surface samples after 3 days of treatment regardless of saliva coating. However, the differences between the groups were not statistically significant.