Search

To investigate the psychologic morbidities associated with tooth loss despite treatment with technically successful dentures.This cross-sectional questionnaire-based study compared the psychologic disturbance and functional difficulties in two groups: individuals with tooth loss who wore optimal-quality removable dentures (test group), and individuals with tooth loss who did not wear dentures (control group). The questionnaire used was developed and validated previously. The short-form revised Eysenck personality questionnaire was also used to assess the relationship with personality traits. A total of 138 participants were recruited (denture group = 70; control group = 68).There was a significant difference in body image dissatisfaction between the groups (χTooth loss and dentures could be associated with body image dissatisfaction and psychologic morbidity. Planning for patient-centered care is paramount prior to extracting any teeth and providing replacement options.

Purpose: To systematically review the available evidence on screening tools to detect the psychological disturbance in patients with tooth loss and technically successful removable dentures (partial and complete). Materials and Methods: The study protocol was registered with the National Institute of Health Research Database (I.D. CRD42017082125). The PICOS tool (patients, intervention, control, outcomes measure, and study design) was used to formulate an effective search strategy. Participants were adults (≥ 18), who were edentulous or had significant tooth loss (< 9 remaining teeth). The intervention included undergoing replacement with technically successful dentures (partial or complete). A control group of adults were either edentulous or had significant tooth loss and without dentures. Outcomes included assessing psychological disturbance due to treatment with dentures or due to no treatment using a validated tool. A structured search strategy was used to complete a standard systematic search of the electronic database without any date limit and/or language restriction. Only quantitative studies using a validated measuring tool to screen for psychological distress in adults with significant tooth loss were included. Two authors independently assessed the risk of bias in the included studies. Data homogeneity was assessed in regards to the screening tools to measure psychological disturbance following the management of tooth loss with dentures. The significant level was set at 0.05, using IBM SPSS Statistics 24.0 (SPSS Inc., New York, NY). The psychometric properties and the validation processes of the screening tools were assessed. Results: From the original 3510 studies identified, only eight studies were found to meet the inclusion criteria. All eight studies used the same questionnaire to screen for the emotional distress of tooth loss. In addition, one study also used the Patient Health Questionnaire-9 (PHQ-9) to screen for the association of depression with tooth loss. Six studies suggested that a significant number of patients have difficulties in accepting tooth loss, were less confident, and had emotional distress related to tooth loss. However, two studies reported no significant link. All studies found a marked impact on functional activities and social interaction. However, four studies had a potentially biased selection process, and the questionnaire used was assessed to be at high-risk of measurement bias, as the development and validation process was not clear. There was also a lack of well-defined control groups in all studies. Conclusion: Tooth loss could cause psychological disturbance in some patients. To date, there is a lack of available tools that are suitable to screen and measure psychological disturbance in patients with tooth loss. Additional research is required to develop tools to identify and measure such impact and to recommend suitable interventions when needed.

Objectives: To investigate the application of toothpaste either containing calcium sodium phospho-silicate bioglass (NovaMin) or calcium fluorosilicate bioglass (BioMinF) on the surface mineral composition and morphology of enamel after bleaching procedure. Methods: Thirty extracted noncarious human teeth were allocated into five groups (n = 6). Group 1: Bleaching using 40% hydrogen peroxide (HP) and fluoridated toothpaste containing bioactive glass (1450 ppm fluoride). Group 2: Bleaching using 40%HP and toothpaste containing calcium fluorosilicate bioglass (540 ppm fluoride). Group 3: Bleaching using 40%HP and fluoridated toothpaste (1450 ppm fluoride). Group 4: Bleaching alone using 40%HP. Group 5: Negative control with distilled water alone. The surface morphology was evaluated using Scanning Electron Microscope (SEM) and Scanning Probe Microscope (SPM). The concentration of elements as atomic percentages were determined by X-ray Photoelectron Spectroscopy (XPS) and Energy-Dispersive X-ray Spectroscopy (EDS). Results: This laboratory-based study reported that SPM and SEM detected minor changes on the surfaces of all toothpaste-treated enamel samples (Groups 1–3) after 45 days. Bioactive glass deposits were observed on enamel surfaces in Groups 1 and 2, whilst the bleaching-alone samples (Group 4) had rough enamel surfaces. XPS reported that toothpaste containing calcium fluorosilicate bioglass (Group 2) had a high atomic% of calcium and phosphate, whilst silicon values were high in the toothpaste containing bioactive glass and 1450 ppm fluoride (Group 1) after bleaching procedure when compared to other groups (p < 0.05). In addition, EDS detected the highest %F in Groups 1, 2 and 5. Conclusions: Within the limitations of this laboratory-based study, there was no significant decrease in the Ca%, P% values and surface properties of enamel after the bleaching procedure following the use of different formulations of toothpastes for a period of 45 days. However, the Ca% and P% values were significantly high for the toothpaste containing calcium fluorosilicate bioglass (BioMinF) on the bleached enamel. Clinical relevance: The bleaching process can provide optimum aesthetic outcomes, but the effect of peroxides on hard tissues is still in question. Toothpastes containing different formulations of fluoride and bioactive glass might have the potential to prevent mineral loss on bleached enamel. However, further laboratory-based studies and controlled double-blind randomised clinical trials are required to interpret the effects of toothpastes with different fluoride and bioactive glass formulations on enamel surfaces following bleaching procedures.

Objective To compare ion release characteristics of three different dental varnishes either containing CPP-ACP and fluoride (CPP-ACPF, MI Varnish GC, Japan), bioactive glass and fluoride (BGAF, Dentsply Sirona USA) or fluoride alone (NUPRO White, Dentsply Sirona USA) using fluoride-Ion Selective Electrode (F-ISE), Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES), X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR), 19F and 31P Magic Angle Spinning-Nuclear Magnetic Resonance (MAS-NMR). Methods A thin layer (0.0674 ± 0.0005 g) of each varnish (20 × 25 mm in area) was spread on a roughened glass slide (n = 7). They were separately immersed in 10 ml Tris buffer (0.06 M, pH = 7.30), and changed after 1, 2, 4, 6, 24 and 48 h. Fluoride-ion concentration at each time using the F-ISE, whilst calcium and phosphate release were investigated using ICP-OES. XRD, FTIR. MAS-NMR analyses were also performed before and after immersion. Results The cumulative F-ion release was significantly higher in CPP-ACPF (1.113 mmol/g) > BGAF(0.638) > F(0.112) (p Significance Both CPP-ACP and bioactive glass enhanced ion release without compromising the bioavailability of fluoride. The CPP-ACPF varnish had the most promising ion release.

The association between cardiovascular and periodontal diseases is characterized by chronic inflammatory processes, with a high prevalence worldwide and complex genetic-environment interactions. Although apolipoprotein E4 (ApoE4), one of the isoforms coded by a polymorphic APOE gene, has been widely recognized as a risk factor for cardiovascular diseases and as an immunoinflammatory factor, less is known regarding how ApoE4 affects atherosclerosis in periodontitis patients. The aim of this review was to investigate the potential underlying mechanisms related to APOE4 that could increase the risk of periodontal disease and, ultimately, of atherosclerosis. There have only been a few studies addressing apoE polymorphisms in patients with chronic periodontitis. To date, no studies have been performed that have assessed how ApoE4 affects atherosclerotic disease in chronic periodontitis patients. Although clinical studies are warranted, experimental studies have consistently documented the presence of periodontal pathogens, which are usually found in the oral cavity and saliva, in the atherosclerotic plaques of ApoE-deficient mice. In addition, in this review, the potential role of the APOE4 allele as an example of antagonistic pleiotropy during human evolution and its relation to oral health is discussed.

Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45–92 years) with primary root caries (n = 184 root carious lesions) and unstimulated salivary flow rate of n = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (n = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (n = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (n = 35) in group 2 (p < 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, n = 60, 83.3%) (group 2, n = 66, 74.2%) (p = 0.36), and (group 1, n = 60, 89.6%) (group 2, n = 67, 81.7%, n = 1 soft, 1.2%) (p = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (p < 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.

The aim of this study was to quantify surface roughness of carious dentine using noncontact optical profilometry (NCOP) in vitro. A total of 20 extracted teeth with root caries were examined according to clinical assessment criteria. NCOP (Proscan 2000, Scantron, Taunton, UK) was used to carry out the surface roughness measurements in vitro. Selection of sampling rate measurements were subsequently performed. Results showed that the surface roughness (Ra) values were most accurately obtained at a sampling rate of 30 Hz. All lesions had rough texture, with cavitation ranging from 0.5 to 4 mm. Most lesions were leathery, whilst remaining few were soft. There was a significant difference in surface roughness between the carious and sound dentine (p 0.05) whilst there was a significant correlation between the hardness and surface roughness (r 0.47, p = 0.04). There was an inverse relationship trend between surface roughness measurements and severity of root caries. There are limitations due to the sophisticated layout of collage network within the root carious dentine especially cavitated lesions. The NCOP could be considered for the quantification of surface roughness on noncavitated carious dentine in a laboratory setting. The effect of different oral health care products on root caries using the NCOP without causing any potential damage to the noncavitated root surface could be assessed prior to the large-scale clinical studies.

SUMMARY Objectives: The objective of this in vitro study was to quantify the amount of mineral change in demineralized dentin at pH 5.5 after the application of dental varnishes containing fluoride with casein phosphopeptide–amorphous calcium phosphate, fluoride and bioglass, or fluoride alone. Methods and Materials: A total of 12 extracted human sound mandibular premolar root samples were coated with an acid-resistant varnish, leaving a 2 × 3 mm window at the outer root surface. These root specimens were then randomly divided into four groups and separately subjected to the demineralizing cycle at a pH of 4.8 for five days to create artificial caries-like lesions in dentin. Subsequently, each sample was imaged using quantitative x-ray microtomography (XMT) at a 15-μm voxel size. Each test group then received one of the following treatments: dental varnish containing casein phosphopeptide–amorphous calcium phosphate and fluoride (CPP-ACP, MI varnish, GC Europe), bioglass and fluoride (BGA, Experimental, Dentsply Sirona), or fluoride alone (NUPRO, Dentsply Sirona), as well as a control group, which received no treatment. These samples were kept in deionized water for 12 hours. The thin layer of varnish was then removed. All samples including the nonvarnish group were subjected to the second demineralizing cycle at pH 5.5 for five days. The final XMT imaging was then carried out following the second demineralizing cycle. XMT scan was also carried out to varnish samples at 25 μm voxel size. The change in mineral concentration in the demineralized teeth was assessed using both qualitative and quantitative image analysis. Results: There was an increase in radiopacity in the subtracted images of all varnish groups; a significant increase in mineral content, 12% for the CPP-ACP and fluoride (p≤0.05 and p≤0.001), 25% BGA (p≤0.001), and 104% fluoride alone varnish (p≤0.001). There was an increase in the size of radiolucency in the lesion area with a significant decrease in mineral content in the nonvarnish group, 10% (p≤0.05 and p≤0.001). Conclusions: There was encouraging evidence of a remineralization effect following the application of dental varnish on dentin and also an observed resistance to demineralization during the acidic challenge in all cases. However, a dental varnish containing fluoride alone appeared to have a much greater effect on dentin remineralization when compared with CPP-ACP with fluoride and bioglass with fluoride.

Objectives To compare the efficacy of fluoride varnishes either casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) or bioglass particles on the severity index of root caries. Methods Visual-tactile assessments including lesion hardness was carried out to categorise the severity index of 80 extracted teeth with primary root caries. These teeth were randomly divided into four groups; CPP-ACP and fluoride, bioglass and fluoride, fluoride only, and no treatment. Standardised toothbrushing using a dentifrice containing 1450 ppm fluoride was carried out twice a day for all groups. All samples were stored in remineralising solution at 37°C for 45 days. Visual-tactile assessments were carried out at baseline, and after 45 days. Surface roughness measurements (Ra) were performed at baseline and after 7, 14, 30 and 45 days. X-ray Microtomography was performed at the baseline and after 45 days for three samples from each group to quantify the change in mineral contents in the lesion area. Results The Visual-tactile assessment results showed a reduction in the severity index of root caries, being 20% in CPP-ACP and fluoride, 100% in bioglass and fluoride, 80% in fluoride only, and 60% in non-varnish (toothbrushing only). Non-significant change in surface roughness was observed in all groups. X-ray Microtomography assessment showed a highly significant increase in the mineral deposition in all cases (p > .001). Conclusion The combination of bioglass with fluoride has a potentially superior effect than either CPP-ACP with fluoride or fluoride only to reverse and arrest the root caries in a laboratory setting. Clinical significance The combination of bioglass particles and fluoride formulation is likely to have a significant impact in reversing and arresting root caries in a minimally invasive approach. However, randomised controlled double-blinded clinical trials are required to translate these results into clinical practice.

Introduction: The aim of this systematic review is to analyse the effect of physico-chemical properties of calcium silicate-based sealers in comparison to epoxy resin sealers in permanent teeth using a single-cone obturation technique. Methods: The study was conducted according to the guidelines of Cochrane Handbook for Systematic Reviews of Interventions and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. Literature search was performed using the PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, DOAJ, Open Gray with no language restrictions until October 2020. Two reviewers assessed the studies for eligibility. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was carried out to assess the evidence. Meta-analysis of the pooled data with subgroups was performed using the RevMan software (p < 0.05). Results: Results from the 28 included studies showed that the mean difference in adaptation to root canal walls (marginal adaptation, interfacial gaps and void volume) for both sealers were non-significant. However, void volume values showed a significant mean difference (p < 0.00001) favouring the calcium silicate-based sealers. The pooled meta-analysis reported statistically significant differences for apical microleakage (p = 0.0007) whilst there were non-significant mean differences for fracture resistance (p = 0.09) and push-out bond strength (p = 0.63). The heterogeneity among the included studies was 97% (I2). Conclusions: Within the limitations of this review, calcium silicate-based sealers demonstrated a similar or superior performance in comparison to resin-based sealers in terms of the physico-chemical properties.

The aim of this laboratory-based study is to evaluate performance of the Light-Induced Fluorescence Evaluator (SoproLIFE) for early detection of coronal caries and to validate the findings using the International Caries Classification and Management System (ICCMS). A total of 56 freshly extracted teeth with coronal carious lesions were included. 74 regions of interest were identified. Visual assessments with International Caries Detection and Assessment Systems (ICDAS), radiographic information and SoproLIFE images were used to classify each region of interest according to the ICCMS as a reference standard. SoproLIFE specificity and sensitivity were calculated at the sound-enamel and dentine lesion levels. Inter and intra reproducibility of ICDAS were analysed and showed a moderate agreement (0.52) and (0.58) respectively. At the sound-initial caries level, the sensitivity and specificity for the SoproLIFE were 90.0%, 95.8% respectively, whilst for the dentine caries level, sensitivity was 100% with specificity of 53.8%. A low proportion of teeth with dental caries were classified as caries-free using the SoproLIFE (false negative=10%). As a conclusion, the performance of SoproLIFE was promising in distinguishing between early enamel carious lesions and sound surfaces. This detection tool could be suggested to be used with ICCMS to assist in the clinical decision-making process.

Objectives The objective of this study was to quantify the changes in mineral and selected element concentrations within residual carious dentine and restorative materials following incomplete carious lesion removal (ICLR) using different cavity liners, with non-destructive subtraction 3D-X-ray Microtomography (XMT, QMUL, London, UK). Materials and methods A total of 126 extracted teeth with deep dental caries were assessed using International Caries Risk and Assessment (ICDAS). Eight teeth were subsequently selected after radiographic evaluation. Each lesion was removed, leaving a thin layer of leathery dentine at the deepest part of cavity. Different cavity lining materials were placed; Mineral Trioxide Aggregate (MTA), calcium hydroxide, (Ca(OH)2), resin-based material (RBM). For each, the restorative material was an encapsulated glass ionomer (GIC) and the control group had a GIC restoration alone. Each tooth was immediately placed in Simulated Body Fluid (SBF). All samples were then imaged using XMT at baseline, and three weeks after treament. The XMT images were then subtracted to show the mineral concentration changes three weeks after treatment. Results There were significant increases in mineral concentrations within the residual demineralised dentine in individual teeth treated with Ca(OH)2, MTA, RBM, and GIC following immersion in SBF for three weeks. GIC group without any liners showed the greatest increase in mineral concentration, followed by MTA and Ca(OH)2. Conclusion Mineral changes in demineralised dentine and within restorative materials are quantifiable using non-destructive 3D-XMT subtraction methodology. This laboratory study suggested that calcium, phosphate and strontium ion-exchange occurs with GIC, MTA and Ca(OH)2 in deep dentinal lesions following ICLR. Clinical relevance In clinical practice, incomplete carious lesion removal could be performed to avoid the dental pulp exposure. 3D non-destructive XMT subtraction methodology in a laboratory setting is advantageous to provide evidence for different restorative materials on deep carious lesions prior to clinical investigations.

Objectives To develop and validate a self-reporting measure to assess the psychological disturbance in adult patients with tooth loss and dentures Methods: Ethical approval obtained from the Health Research Authority NHS England (Ref:17/NI/0098). 128 participants (100 patients - 28 clinicians) were recruited to participate in the development and validation of the questionnaire. Inclusion criteria included adults (age ≥18) with tooth loss/dentures. Exclusion criteria included patients with a history of psychotic mental illness or patients who had treatment with dental implants. The development processes included: Phase 1. Development of questionnaire: describing the aims/target population of the questionnaire, generating a pool of items, defining the constructs to be measured, adapting psychological morbidity screening tools, Items reduction and producing a preliminary questionnaire. Phase 2. Validation of questionnaire: content validation, face validation, establishing construct validity, pilot testing and establishing reliability. Results Face and content validation indicated that the questionnaire was an appropriate tool to measure the impact of tooth loss and related psychological morbidities. Reliability analysis (Test re-test reliability/internal consistency) indicated the questionnaire has satisfactory reliability (correlation >0.7). Testing the theoretical hypothesis structure of the impact of tooth loss has also enhanced the construct validity of the questionnaire (domains correlated mildly (r>5 & 5). Pilot testing confirmed the scale adequacy and wording clarity (>90 % of respondents). Results indicated that the developed questionnaire has adequate psychometric properties. Conclusion A disease-specific measure that assesses the psychological impact of tooth loss and the effectiveness of interventions (i.e. dentures) has been developed and validated. Clinical significant A patient outcome measure was developed which could be used to assess the psychological impact of tooth loss and compare the effectiveness of various interventions like dentures and implants.

Obiettivi La gestione della carie dentaria rappresenta da sempre una delle procedure odontoiatriche più comuni in età pediatrica. Da un lato, fattori quali le abitudini alimentari e la (spesso) scarsa propensione all’igiene orale da parte dei piccoli pazienti contribuiscono di più, in questa fascia di età, all’accumulo di placca e alla formazione di lesioni cariose. Dall’altro, la presenza di altri fattori di rischio quali la presenza di una dentizione mista o di dispositivi ortodontici fissi e mobili rendono le manovre di igiene più difficoltose e aumentano la tendenza alle demineralizzazioni. Materiali e Metodi Un’analisi della letteratura è stata eseguita per interpretare gli approcci più comuni ai pazienti pediatrici. Gli obiettivi dell’Organizza- zione Mondiale della Sanità (OMS) sono ormai da anni indirizzati a una drastica riduzione della patologia cariosa nel bambino, e questo richiede una sinergia fra tutte le figure professionali che si occupano della salute del paziente, mettendo in pratica misure preventive ancora più che trattando lesioni ormai instauratesi. Molti passi avanti sono stati fatti negli anni anche dai governi nazionali e in Italia esistono da tempo delle chiare linee guida nazionali per aiutare i professionisti in un corretto approccio ai pazienti di età pediatrica. Risultati L’analisi delle linee guida suggerisce misure profilattiche e preventive che sono di facile applicazione e sono indicate per tutti i soggetti in età pediatrica. L’identificazione dei fattori di rischio porta a terapie appropriate e alla corretta scelta dei materiali da impiegare. Conclusioni L’identificazione dei soggetti a rischio rappresenta uno dei passi fondamentali nel paziente pediatrico, poiché può pesantemente influenzare la scelta del materiale, dei periodi di richiamo o anche del momento ideale per intraprendere un trattamento. Un errore può costare la perdita degli elementi dentari, decidui e permanenti, con conseguenti danni futuri al sorriso del paziente.

The development of teaching in higher education towards a more learner‐orientated model has been supported by the literature on individual learning differences and on learning styles in particular. This has contributed to the evolution of university pedagogy away from a medieval transmission model than runs counter to contemporary understanding of learning. However, rather than solving problems of classroom practice, recognition of student learning differences has amplified a number of tensions within the system that have not been adequately resolved in practical terms for academic staff. Such tensions complicate the professional lives of university teachers and as a consequence may lead to cycles of non‐learning as teachers retreat towards the familiar transmission of content. A reconceptualisation of university pedagogy towards an expertise model allows the variation between complementary chains of practice and networks of understanding to be exploited as a positive characteristic of the learning experi...

The ability of ozone to kill micro-organisms associated with non-cavitated occlusal caries was investigated. The occlusal surfaces were treated with ozone (n = 53) or air (n = 49) for 40 s, and the underlying infected dentine was exposed. There was no significant difference between the number of bacteria recovered from the ozone-treated and the control sites (p > 0.1). Treatment of the exposed dentine with ozone resulted in a just significant (p = 0.044) reduction in bacterial counts. Ozone treatment of non-cavitated occlusal lesions for 40 s failed to significantly reduce the numbers of viable bacteria in infected dentine beneath the demineralized enamel.

A previous paper, recently published in Primary Dental Care, gave an overview of the medical uses of ozone and outlined some of its uses in dentistry. The current paper focuses on a description of use of ozone in the management of root caries and considers recent studies in this area. There has been relatively limited research into the non-invasive (pharmaceutical) management of root caries. The best management strategy still remains to be developed. Initial studies have indicated that an application of ozone for a period of either 10 or 20 seconds is capable of clinically reversing leathery root carious lesions. It is suggested that, subject to confirmation from extensive trials, this simple and non-invasive technique may benefit many patients with root caries throughout the world since this approach to treat root caries can easily be employed in primary care clinics and in the domiciliary treatment of home-bound elderly people and immobile patients in hospices and hospitals.

This study compared the ability of two sodium fluoride dentifrices, one containing 5,000 ppm fluoride (Prevident 5000 Plus) and the other 1,100 ppm fluoride (Winterfresh Gel), to reverse primary root caries lesions (PRCLs). A total of 201 subjects with at least one PRCL each entered the study and were randomly allocated to use one of the dentifrices. After 6 months, 186 subjects were included in statistical analyses. At baseline and after 3 and 6 months, the lesions were clinically assessed and their electrical resistance measured using an electrical caries monitor. After 3 months, 39 (38.2%) of the 102 subjects in the 5,000 ppm F– group and 9 (10.7%) of 84 subjects using the 1,100 ppm F– dentifrice, had one or more PRCLs which had hardened (p = 0.005). Between baseline and 3 months, the log10 mean ± SD resistance values of lesions for subjects in the 1,100 ppm F– group had decreased by 0.06±0.55, whereas those in the 5,000 ppm F– group had increased by 0.40±0.64 (p– group and 24 (28.6%) in the 1,100 ppm F– group had one or more PRCLs that had become hard (p = 0.002). Between baseline and 6 months, the log10 mean ± SD resistance values of lesions for subjects in the 1,100 ppm F– group decreased by 0.004±0.70, whereas in the 5,000 ppm F– group, they increased by 0.56±0.76 (p– group when compared with the 1,100 ppm F– group. The plaque index in the 5,000 ppm F– group was also significantly reduced when compared with the 1,100 ppm F– group. The colour of the lesions remained unchanged. It was concluded that the dentifrice containing 5,000 ppm F– was significantly better at remineralising PRCLs than the one containing 1,100 ppm F–.

The aims of this present study were (1) to assess the antimicrobial effect of ozone from a novel ozone–generating device (Heolozone, USA) [0.052% (v/v) in air delivered at a rate of 13.33 ml·s–1] on primary root carious lesions (PRCLs) and (2) to evaluate the efficacy of ozone specifically on Streptococcus mutans and Streptococcus sobrinus. In study 1, 40 soft PRCLs from freshly extracted teeth were randomly divided into two groups to test the antimicrobial effect on PRCLs from exposure to ozonated water for either 10 or 20 s. Half of a lesion was removed using a sterile excavator. Subsequently, the remaining lesion was exposed to the ozonised water for a period of either 10 or 20 s (corresponding to 0.069 or 0.138 ml of ozone, respectively). Using paired Student t tests, a significant (p10 3.57±0.37) or 20–second (log10 3.77±0.42) ozone application compared with the control groups (log10 5.91±0.15 and log10 6.18±0.21, respectively). In study 2, 40 sterile saliva–coated glass beads were randomly divided into two groups for each micro–organism. One glass bead was put into each bijou bottle with 3 ml of Todd–Hewitt broth. S. mutans and S. sobrinus were inoculated anaerobically overnight. Each glass bead was then washed with 2 ml of phosphate–buffered saline. Immediately, 10 s of ozone gas was applied to each glass bead in the test groups. There was a significant (pS. mutans (log10 1.01±0.27) and S. sobrinus (log10 1.09±0.36) compared with the control samples (log10 3.93±0.07 and log10 4.61±0.13, respectively). This treatment regime is an effective, quick, conservative and simple method to kill micro–organisms in PRCLs. Ozone gas application for a period of 10 s was also capable of reducing the numbers of S. mutans and S. sobrinus on saliva–coated glass beads in vitro.

Objectives The aim of this study was to investigate the possible association between the short form, 14-item Oral Health Impact Profile (OHIP-14) and 12-item General Health Questionnaire (GHQ-12) for patients requiring restorative dental work on Implant Assessment Clinic at Guy's Dental Institute. Methods A total of 216 patients aged 18–83 years old were recruited when attended the Implant Assessment Clinic. Restorative treatment needs were classified as hypodontia, trauma related missing teeth, edentulousness (complete denture wearers) and partially dentate (removable partial denture wearers). The OHIP-14, which assesses the adverse impact of oral conditions on quality of life and GHQ-12, a measure of global distress, were subsequently completed by the patients. Results Statistical analyses showed that there is a strong correlation between OHIP-14 and GHQ-12 within all the categories of treatment needs (p Conclusion The impact of oral health on the life quality of these patients seeking dental implant treatment was strongly associated with the General Health Questionnaire status.

Statement of Problem. Construction of dentures with permanent soft linings is time-consuming in the laboratory and extra costs are related to equipment and materials used. Purpose. The purpose of this in vitro study was to determine whether using microwave energy to activate the polymerization of a silicone rubber denture soft lining material affected its properties. Material and Methods. Tear energy and adhesive properties were measured in a tensile testing machine by using a pants leg tear test and peel specimens. Tear energy was measured for specimens polymerized conventionally (control) and for 3, 5, and 10 minutes in a microwave. Data were analyzed with one-way analysis of variance and a two-sample Student t test. Results. The multiple comparison test failed to show a significant difference in tear energy between 3 minutes microwave activation and conventional heat curing. However, 3 minutes microwave activation revealed a significantly stronger material when compared with 5 minutes and 10 minutes ( p t test failed to demonstrate a significant difference between microwave energy and conventional heat activation groups in the adhesion test. In adhesion testing, all specimens presented cohesive failure. Conclusions. This method of polymerization does not compromise the strength of a soft lining material and its adhesion to polymethyl methacrylate. This study suggests the use of 3 minutes 650W microwave energy for processing a silicone soft lining material. (J Prosthet Dent 1998;79:182-87.)

A 49-year-old Black African male, originally of Nigerian origin, was referred by his dentist regarding a bad taste in the mouth. He was seen in a general restorative clinic at Barts and the London NHS Trust. Clinical examination did not reveal any relevant abnormalities. A panoramic tomography, however, showed the presence of multiple supernumerary teeth, which were located in the maxillary right and left premolar and molar regions, and the mandibular left premolar region. The family's history was non-contributory. The patient was unaware of the supernumerary teeth and, as far as he knew, there were no other members of his family with a similar problem. Clinical Relevance: A decision regarding the appropriate management of supernumerary teeth should be considered carefully since surgical removal of the teeth may cause damage to adjacent structures, including bone. In this respect, it is interesting and rare to find multiple supernumerary teeth in individuals with no other associated diseases or syndromes elucidated by clinical and historical enquiry.

The aim of this study was to evaluate the effects of two different disinfection treatments--ozone and Nd:YAG laser application--on shear-bond strength (SBS) of self-etch adhesives to coronal and root dentin.Sixty extracted human canines were ground flat, exposing the coronal and root dentin surfaces, and randomly divided into three groups. The surfaces were untreated (Control) or treated with ozone (HealOzone, KaVo) or Nd:YAG laser (Fidelis III, Fotona). Coronal and root dentins of 10 teeth of each group were treated with a two-step self-etch adhesive (Clearfil SE Bond, Kuraray Medical; SE), whereas the remaining 10 teeth were treated with a one-step self-etch adhesive (Clearfil Tri-S Bond, Kuraray Medical; S3). A resin composite (Clearfil Majesty Esthetics, Kuraray Medical) was then placed, and SBS was tested with a universal testing machine. Failure modes were determined under a stereomicroscope. The mean SBS values of each group were calculated, and data were subjected to statistical analysis (p = 0.05).For the coronal dentin, Control/SE showed significantly higher values than Control/S3, Ozone/S3, and Nd:YAG/S3. Although Ozone/SE showed significantly higher values than Nd:YAG/S3 (p0.05), the differences within the other groups were not significant for the root dentin (p0.05). Comparison of two dentin substrates in each group did not show any significant difference except for Control/SE, in which coronal dentin showed higher SBS. The failure modes of all groups were mainly adhesive.Pretreatments with Ozone or Nd:YAG laser did not impair the SBS of both of the self-etch adhesives used to coronal and root dentin.

To assess the safety and efficacy of ozone either with or without a root sealant, for the management of leathery root caries.79 subjects with 220 root caries lesions were recruited into four study groups in this randomized, controlled trial. At baseline and after 1, 3, and 6 months, the ECM III and DIAGNOdent were employed. Subsequently, the root caries lesions were clinically assessed for color, hardness, cavitation, dimensions, distance from the gingival margin, and severity index. Modified USPHS criteria were also performed after 1, 3, and 6 months. These groups were as follows: Group 1: Ozone application was performed for a period of 10 seconds on caries lesions; Group 2: There was neither ozone nor root sealant application on root caries; Group 3: Ozone treatment and a root sealant were applied to root caries lesions; and Group 4: Only root sealant was applied to root caries.At the 6-month recall, 78 subjects were examined. There were no observed adverse events. 38.1% of lesions became hard in the ozone only group, while none of the lesions became hard in the control group (P0.001). Noncavitated lesions were more likely to reverse than cavitated lesions. 38.4% of noncavitated lesions became hard, while only 5.7% of cavitated lesions became hard in the ozone only group. Modified USPHS criteria revealed that there were 66.6% intact sealants in the ozone and sealant group and 45.5% intact sealants in the sealant only group (P0.05). After 1, 3, and 6 months, the ECM and DIAGNOdent readings showed improvements in the ozone only group when compared to the control group (P0.001). The ozone and sealant group also had greater improvements in the ECM and DIAGNOdent values when compared to the sealant only group (P0.05).

There is growing interest in the use of ozone in oral healthcare and the National Institute for Clinical Excellence (NICE) is at present reviewing the evidence for its effectiveness in the management of occlusal and plain surface caries. These are only two of the clinical problems for which ozone can, and has, been used; it has also been employed for a wide variety of other purposes in both dentistry and medicine. This pale blue-coloured gas plays an important role as a natural constituent in the higher layer of the Earth's atmosphere. There is growing evidence that it can be employed as a useful therapeutic agent. This paper reviews its therapeutic uses to date and suggests its possible future clinical applications. Consumer demands for this strong oxidant may increase as the general public becomes increasingly aware of its therapeutic capacity and the non-invasive manner in which it can be administered.

To assess the effect of ozone on the microbial flora and clinical severity of primary root caries.26 patients with 70 primary root carious lesions (PRCLs) were entered. Each PRCL was classified in terms of color, cavitation, size, hardness, distance from the gingival margin and severity. Overlying plaque was then removed and each lesion dried. A biopsy was taken from half of each PRCL using a sterile excavator. Subsequently, the remaining lesions were exposed to ozone gas for a period of either 10 seconds (n = 35) or 20 seconds (n = 35) and a further biopsy was taken.Using a paired Student t-test, a significant (P0.001) difference (mean +/- SE) in total micro-organisms was observed in the ozone-treated samples after either a 10 seconds (log10 4.35 +/- 0.49) or 20 seconds (log10 0.46 +/- 0.26) ozone application compared with the control samples (log10 7.00 +/- 0.24) and (log10 6.00 +/- 0.21) respectively. Using Pearson's correlation tests, there were significant correlations for the reduction in total micro-organisms after 10 seconds of ozone application with cavitation, size, distance from gingival margin and severity of PRCLs (P0.05). In conclusion, ozone application either for 10 or 20 seconds dramatically reduced most of the micro-organisms in PRCLs without any side effects recorded at recall intervals between 3 and 5.5 months. Out of the 65 PRCLs reviewed, 33 lesions had become hard, 27 lesions reversed to severity index 1 from severity index 2, and five lesions remained the same following ozone application for a period of either 10 or 20 seconds.

To relate the Electrical Caries Monitor (ECM) and Resilience Caries Monitor (RCM) readings with clinical criteria used to define primary root carious lesions (PRCLs) in vitro.PRCLs were classified according to color, texture, hardness, cavitation, size and severity before ECM and RCM readings were recorded.There was a poor but significant correlation between the ECM and RCM phase readings (P0.05). ECM readings for color, all five classes of severity and all three classes of hardness of lesions were significantly different from each other and from sound root tissue (P0.05). There was a significant correlation for ECM readings and cavitation (P0.05). There was a clear logarithmic relationship between ECM end values and size (P0.05). RCM amplitude measurements for hardness and all five classes of severity were significantly different from each other and from sound root tissue (P0.05). However, the RCM readings failed to correlate with color, cavitation or size (P0.05). In conclusion, the relationship between ECM and RCM data and some clinical detection criteria for PRCLs is promising and warrants further investigation in vitro and in vivo.The ECM is capable of distinguishing the severity of PRCLs since it is a less invasive but accurate method of detecting carious lesions when compared to tactile methods. The RCM was able to differentiate sound root dentine from soft lesions in vitro but this device is currently in a very early stage of development, and many mechanical and electronic problems must be solved prior to application of the device in clinical practice.

To assess a novel root sealant for cervical sensitivity.Clinical assessments, impressions and modified USPHS criteria (n = 24) were carried out at baseline, 3, 6 and 19 months. Plaque samplings were performed at baseline and after 3 and 19 months.At 19 months, 20 patients completed the clinical trial. There was a significant reduction for the sensitivity scores. The log10 of total colony-forming units (cfu + 1) from overlying plaque significantly reduced. The percentage of mutans streptococci reduced after 3 months (P0.01) and yeasts also reduced after 19 months (P0.01). The mean overall wear (+/- SD) (microm) on the sealant was 78.8 +/- 21.3 at 3 months; 95.4 +/- 7.3 after 6 months and 136.5 +/- 9.8 after 19 months. In conclusion, this sealant was capable of reducing sensitivity. Further wear on the cervical surface was prevented as the mean sealant thickness was 65.3 +/- 3.3 after 19 months.

Root caries is a widespread problem and can be quite serious in older populations. The restoration of root carious lesions is often difficult. Compared to enamel caries, there has been limited research into the pharmaceutical management of primary root caries lesions (PRCLs), and many of these studies have been carried out in vitro, with limited numbers of clinical trials. Fluoride is presently a cornerstone in dentifrice formulations for cost-effective and anticaries therapy. It is generally accepted that fluoride ions promote remineralization of tooth substances and reduce the rate of demineralization. The use of a dentifrice with a high fluoride content may be considered to reverse PRCLs, since more fluoride is required for the remineralization of roots than for enamel. This paper reviews the effects of dentifrices with high fluoride contents on the management of root caries.