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As dental pulp contains the stem cells necessary for regeneration, the tooth should hold the intrinsic capacity for self-repair. A triphasic hybrid dental biocomposite (3HB) composed of biocompatible biopolymers to provide strength, antibacterial properties and protein-based cell support could provide a conducive microenvironment for the regeneration of dental structures. 3HB was incorporated into Mineral Trioxide Aggregate (ProRoot MTA) to construct a malleable injectable implant. Human tooth pulp cells (hDPCs) significantly increased proliferation in the presence of 3HB+MTA compared to 3HB or MTA alone. Cell viability decreased with MTA alone but increased with 3HB and 3HB+MTA. 3HB+MTA was implanted into the residual tooth of drilled Wistar rat M2 molars for up to 45 days. Stereological analysis from micro-CT images showed the volume of the tooth remaining. Histologically, regenerative pulpal architecture was seen invading 3HB. A continuous odontoblastic profile lined a deposit of dentin-like material suggesting reparative dentinogenesis. Overall, no infection or encapsulation was seen. Immunohistochemically, odontoblasts were seen along the margins of the wounded tooth undergoing repair. Mesenchymal cells (MSCs) were seen at the base of the drilled tooth and by 21 days had translocated into the implant itself. Cells stimulating remineralization were highly expressed in the tooth undergoing repair. CD146-positive MSCs were seen in the center of the implant, possibly stimulating remineralization. In conclusion, behavior of 3HB+ in vitro and in vivo provided a promising start as 3HB+MTA may serve as a viable regenerative scaffold for pulp regeneration; however, this should be further studied before clinical use can be considered. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this scoping review was to map evidence of electrolysed oxidising water (EOW) as a biocide for dental applications of relevance to older people and identify research gaps. Background: EOW is an emerging, "green," and cost‐effective biocide. There are no reviews on the landscape of EOW research as either an antiseptic or disinfectant in dental healthcare or its suitability for the oral healthcare of older people. Materials and Methods: The review follows the PRISMA Extension for Scoping Reviews (PRISMA‐ScR) guidelines. Database searches (Google Scholar, PubMed, Web of Science, Ovid, Scopus and Science Direct) were undertaken using MESH terms and Boolean operators with no date restrictions, to identify full‐text, original reports published in English‐language peer‐reviewed journals. Results: The search yielded 114 papers that met the inclusion/exclusion criteria. Dental applications of EOW include its use as an endodontic irrigant (39%); mouth rinse/surgical irrigant (21%); disinfectant for dental unit water lines (19%) and dental biomaterials (17%); and for antimicrobial efficacy, effects on oral tissues and on dental material properties. Most studies (83%) evaluated a single EOW formulation (acidic, moderately acidic or neutral) that was either generated at 'point‐of‐use' (POU; 72%), bottled ('ready‐to‐use', RTU; 24%) or from unspecified (3%) sources. Six reports evaluated storage‐related parameters and 25 evaluated clinical applications; 89 were in vitro studies and one investigated the cost‐effectiveness of POU EOW. Conclusions: Neutral‐pH, EOW is effective as an antimicrobial agent without deleterious effects on oral tissues. However, research on the impact of storage conditions, anti‐Candida biofilm efficacy and mechanism of action against yeasts, long‐term effects on denture materials and cost‐effectiveness is required to establish the suitability of EOW as a multipurpose biocide for dental healthcare, including infection‐control requirements relating to older people. [ABSTRACT FROM AUTHOR]

Objective : The aim of the study was to investigate the microbial colonization (by Candida species, anaerobic and facultative anaerobic bacteria) of maxillary obturators used for the restoration of maxillary defects, including during radiotherapy. Design: Retrospective cohort study. Participants : Fifteen patients requiring a maxillary obturator prosthesis had swabs of their obturators and adjacent tissues taken at different stages of their treatment over a period of 8 years. Method : Identification of microbial species from the swabs was carried out using randomly amplified polymorphic DNA polymerase chain reaction (RAPD PCR) analysis, checkerboard DNA–DNA hybridization, CHROMagar Candida chromogenic agar, and DNA sequencing. Results : Candida species were detected in all patients and all patients developed mucositis and candidiasis during radiotherapy which was associated with an increase in colonization of surfaces with Candida spp., particularly C albicans. Microbial colonization increased during radiotherapy and as an obturator aged, and decreased following a reline, delivery of a new prosthesis, or antifungal treatment during radiotherapy. Conclusions : Microbial colonization of maxillary obturators was related to the stage of treatment, age of the obturator material, radiotherapy and antifungal medications, and antifungal treatment may be recommended if C albicans colonization of palatal tissues is greater than 105 colony-forming units per cm2 following the first week of radiotherapy. [ABSTRACT FROM AUTHOR]

The high aesthetic demands of patients have increased their requests to align their teeth using clear aligners, including Invisalign. Patients also want to have their teeth whitened for the same purpose; the use of Invisalign as a bleaching tray at night has been reported in few studies. However, whether 10% carbamide peroxide affects the physical properties of Invisalign is unknown. Therefore, the objective of this study was to evaluate the effect of 10% carbamide peroxide on the physical properties of Invisalign when used as a bleaching tray at night. Twenty-two unused Invisalign aligners (Santa Clara, CA, USA) were used to prepare 144 specimens to test their tensile strength, hardness, surface roughness, and translucency. The specimens were divided into four groups: a testing group at baseline (TG1), a testing group after application of bleaching material at 37 °C for 2 weeks (TG2), a control group at baseline (CG1), and a control group after immersion in distilled water at 37 °C for 2 weeks (CG2). Statistical analysis was conducted using a paired t-test, Wilcoxon signed rank test, independent samples t-test, and Mann–Whitney test to compare samples in CG2 to CG1, TG2 to TG1, and TG2 to CG2. Statistical analysis showed no statistically significant difference between the groups for all physical properties, except for hardness (p-value < 0.001) and surface roughness (p-value = 0.007 and p-value < 0.001 for the internal and external surface roughness, respectively), which revealed a reduction in hardness values (from 4.43 ± 0.86 N/mm2 to 2.2 ± 0.29 N/mm2) and an increase in surface roughness (from 1.6 ± 0.32 Ra to 1.93 ± 0.28 Ra and from 0.58 ± 0.12 Ra to 0.68 ± 0.13 Ra for the internal and external surface roughness, respectively) after 2 weeks of dental bleaching. Results showed that Invisalign can be used for dental bleaching without excessive distortion or degradation of the aligner material. However, future clinical trials are required to further assess the feasibility of using Invisalign for dental bleaching. [ABSTRACT FROM AUTHOR]

Purpose: To retrospectively assess implant stability quotient (ISQ) values in patients who were followed up between 1998 and 2014 and to evaluate any correlations between ISQ and clinical parameters, such as change in marginal bone level (MBL).Materials and Methods: A total of 173 participants (65 men and 108 women; age range 21 to 85 years) and 383 implants were included. Implant location, MBL, and ISQ were recorded at surgery and at various recall times for statistical analysis. Mixed-model analysis was applied to evaluate the impact of clinical and demographic variables (time, implant location, patient gender) on ISQ and the correlation between ISQ and MBL. The level of significance was set at P < .05.Results: Of the 21 failed implants, 20 failed within 1 year of functional loading, resulting in a 10-year cumulative implant survival estimate of 95%. The failed implants had lower ISQs at surgery (52.3 ± 7.03) and baseline (52.5 ± 4.20) when compared to surviving implants (63.0 ± 10.74 at surgery and 62.3 ± 8.30 at baseline), and the difference was statistically significant at surgery (P < .05). The mean ISQs generally increased over time, but there were various patterns of changes between implants when grouped according to patient gender and implant location. There was no statistically significant correlation between the changes in ISQ and MBL (P = .211), despite an inverse relationship.Conclusion: Low initial ISQ values may help to identify implants at higher risk of failure. There may be various patterns of change over time in addition to an overall increase in ISQ values. Both similar and contradictory findings were found when compared to earlier literature, and a correlation between resonance frequency analysis and MBL change could not be identified. Despite limitations, the present study provides an overview of the clinical performance of RFA based on long-term clinical data. [ABSTRACT FROM AUTHOR]

Purpose: To assess any correlations between resonance frequency analysis (RFA) and other clinical measurements, namely changes in marginal bone level.Materials and Methods: A systematic review was performed to investigate the relationship between RFA and changes in marginal bone level. Clinical studies published up to May 1, 2018, were searched in electronic databases, including PubMed/MEDLINE, Embase, and Cochrane, using the following MeSH terms: resonance frequency analysis; implant stability quotient; RFA; and ISQ, in combination with marginal bone level; marginal bone loss; and marginal bone resorption.Results: A total of 62 articles were included in this review after all abstracts and full-text articles were examined according to the inclusion/exclusion criteria. The Results and Discussion sections of investigations reporting both marginal bone level changes and RFA measurements were presented. Relevant findings regarding relationships between RFA and bone quality or insertion torque were also summarized. Most articles reported an overall increase in ISQs over the observation time; however, contradictory findings were found regarding the relationships between RFA measurements, marginal bone loss, and other parameters.Conclusion: A definitive conclusion could not be made, as mixed results were found in the few articles that reported significant associations and correlations between RFA measurements and bone loss, while others concluded the opposite. Heterogeneity between the studies further complicated interpretation. Longitudinal RFA measurements may still be valuable for evaluating implant stability when applied as a supplementary tool to radiographic assessments and other clinical examinations. [ABSTRACT FROM AUTHOR]

Introduction: An increasingly older population demands major remodeling of our health care system. Older adults are most likely to be affected by the oral‐systemic connection due to their impairment in functional capacity and reduced ability to undertake routine oral care. An economic way to improve oral health outcomes in older populations is by involving nurses and caregivers in ensuring the maintenance of oral health for older adults. This study aimed to investigate the present educational content relevant to the oral health of older adults, the oral‐systemic connection, and assessment methods in New Zealand nursing education. Methods: A cross‐sectional survey was conducted among nursing educators to understand the extent of oral health care education. Quantitative descriptive data were analyzed using SPSS software and qualitative data were analyzed descriptively and presented as themes. Results: The results indicated that the majority of oral health topics were already incorporated into nursing education, however most important topics such as risk factors associated with dental caries, periodontal health, and risk factors are not taught in almost 40% of the schools. The four themes identified in qualitative analyses are "no barrier", "lack of expertise", "no space for more content" and oral health content "already included". Conclusion: Educators reported that oral health topics are already incorporated into New Zealand undergraduate nursing curricula. However, the quantity and quality of oral health content relevant to older adults need to be improved and updated to suit the current oral health care needs of the growing older population. [ABSTRACT FROM AUTHOR]