Showing papers in "Dentistry journal in 2014"

Ridge Preservation with Modified “Socket-Shield” Technique: A Methodological Case Series

Abstract: After tooth extraction, the alveolar bone undergoes a remodeling process, which leads to horizontal and vertical bone loss. These resorption processes complicate dental rehabilitation, particularly in connection with implants. Various methods of guided bone regeneration (GBR) have been described to retain the original dimension of the bone after extraction. Most procedures use filler materials and membranes to support the buccal plate and soft tissue, to stabilize the coagulum and to prevent epithelial ingrowth. It has also been suggested that resorption of the buccal bundle bone can be avoided by leaving a buccal root segment (socket shield technique) in place, because the biological integrity of the buccal periodontium (bundle bone) remains untouched. This method has also been described in connection with immediate implant placement. The present case report describes three consecutive cases in which a modified method was applied as part of a delayed implantation. The latter was carried out after six months, and during re-entry the new bone formation in the alveolar bone and the residual ridge was clinically evaluated as proof of principle. It was demonstrated that the bone was clinically preserved with this method. Possibilities and limitations are discussed and directions for future research are disclosed.

The in Vitro Antimicrobial Efficacy of Propolis against Four Oral Pathogens: A Review

Abstract: This study screened the available evidence for the in vitro antimicrobial efficacy of propolis, a natural herbal resin bee product, against a selection of three bacterial species of relevance to oral diseases. For this purpose, papers dealing with laboratory studies assessing minimum inhibitory concentration (MIC), minimum bactericidal concentrations (MBC) or the agar diffusion method to analyze the antimicrobial properties of propolis on three oral pathogens (S. mutans, P. gingivalis, F. nucleatum) and a yeast (C. albicans) are reviewed. Overall, a positive antimicrobial effect could be shown. However, when compared to the commonly used control substances (e.g., specific antibiotics, antiseptics and antifungals), propolis appeared less effective, depending on the bacterial strain, and required higher concentrations than the control substances, in order to show a measurable effect. Nevertheless, propolis as a natural herbal resin bee product can be considered as a natural antiseptic agent within the range of other herbal products, like sanguinarine. Therefore, it may be a valuable compound of non-synthetic, natural origin for patients seeking complementary agents and alternatives for “hard” chemicals.

Effects of Dental Rehabilitation under General Anesthesia on Children’s Oral-Health-Related Quality of Life: Saudi Arabian Parents’ Perspectives

Abstract: Aim: To determine whether dental treatment under general anesthesia (GA) would improve quality of life for children as reported by Saudi Arabian parents using a Parental-Caregivers Perceptions Questionnaire (P-CPQ) and a Family Impact Scale (FIS). Methods: Sixty-six parents completed P-CPQ and FIS scales four to eight weeks after their children (ages three to ten years) underwent comprehensive dental treatment under GA. Postoperative data were compared with baseline data gathered before GA using paired t-test at the 0.05 level of significance. The responsiveness of the P-CPQ and the FIS and the magnitude of changes in children's quality of life as a result of dental treatment were determined by calculating the effect size (ES). Cross-sectional construct validity and internal consistency were also examined using the pretreatment scores of the P-CPQ and the FIS scores. Results: The overall P-CPQ and FIS scores showed a significant decrease following treatment, concomitant with large ES in both scales and all their subscales with the exception of social wellbeing, which showed moderate ES (ES 0.59). The greatest relative changes were seen in the oral symptoms (ES 1.81) and the family activity (ES 1.57) subscales. Conclusion: Dental treatment under GA is associated with considerable improvement in children's quality of life as perceived by Saudi parents. The P-CPQ and the FIS scales are valid and responsive to changes resulting from dental treatment of young children affected by severe childhood caries.

Improving Oral Health Status of Children in Tabuk, Saudi Arabia

Abstract: This comprehensive community health intervention aimed to improve the oral health and reduce the incidence of dental caries in Tabuk schoolchildren. The program supports the public health pyramid that provides a framework to improve health and included creating and evaluating a school oral health surveillance system, applying fluoride varnish and dental sealants on high- and medium-caries risk children, and providing treatment for existing diseases. In a pilot phase, 48 children (26 males 22 females; mean age 6.42; dmft 9.33, Decayed, Missing, or Filled Primary and Permanent Teeth (DMFT) 3.27) received the dental services, both treatment and prevention. Three hundred seventy-eight composite resin or resin-modified light-cured glass ionomer restorations were placed. One-hundred and eighteen teeth received pulp therapy (pulpotomy or pulpectomy), ten of which received stainless steel crowns. A total of 72 teeth were extracted due to caries. To understand the effects of dental disease on children, as perceived by parents, an oral health-related quality of life survey was completed and analyzed. Results found an underestimation of the role the teeth play, particularly primary teeth, in the general health and wellbeing of the child. The program’s main evaluation effort focused on the process and outcome objectives, including the number of children received care, number of teeth received restorations and sealants, and number of children received fluoride varnish, etc. Analyzing the effect of the program on oral hygiene revealed an improvement in oral health, as a direct result of oral health educational sessions and one-to-one counseling. There is an urgent need to expand the program to include all primary schools.

High Birth Weight Is a Risk Factor of Dental Caries Increment during Adolescence in Sweden

Abstract: This study aimed to assess whether birth weight is associated with dental caries during the teenage period. In this register-based cohort study, all children of 13 years of age (n = 18,142) who resided in the county of Stockholm, Sweden, in 2000, were included. The cohort was followed until individuals were 19 years of age. Information regarding dental caries was collected from the Public Health Care Administration in Stockholm. Data concerning prenatal and perinatal factors and parental socio-demographic determinants were collected from the Swedish Medical Birth Register and National Registers at Statistics Sweden. The final logistic regression model showed that birth weight ≥4000 g, adjusted for potential confounders, was significantly associated with caries increment (DMFT ≥ 1 (D = decayed, M = missing, F = filled, T = teeth)) between 13 and 19 age (OR, 1.22; 95% CI = 1.09–1.36). The relatively enhanced risk OR was further increased from 1.22 to 1.43 in subjects with birth weight ≥4600 g. On the contrary, subjects with birth weight <2500 g exhibited a significantly lower risk (OR, 0.67; 95% CI = 0.50–0.89) for exhibiting caries experience (DMFT ≥ 4) at 19 years of age. In conclusion, high birth weight can be regarded as a predictor for dental caries, and especially, birth weight ≥4500 g is a risk factor for caries increment during adolescence.

Gingival Harmony in Anterior Aesthetic Restorations

Abstract: This article describes a case of gingival asymmetry with compromising aesthetics. A 25-year-old dental student presented to the department of prosthetic dentistry. She was concerned about the greyish transparency of the crown metal margin through the marginal gingiva. The crown was placed to restore her lateral incisor. A comprehensive examination revealed that this unaesthetic aspect was caused by a non-harmonious gingival architecture in the lateral incisor marked by an unaesthetic gingival Zenith. The treatment plan included a surgical crown lengthening followed by prosthetic therapy consisting in a Zirconia based crown replacing the old prosthesis. Thanks to a well-planned multi-disciplinary approach, the result was esthetically acceptable and the patient was satisfied.

Dental Hygienist Students’ Learning About Motivational Interviewing

Abstract: Objective: To investigate whether dental hygienist students through peer-learning can increase their ability to conduct motivational interviewing (MI) compared with students who follow the regular curriculum. The aim was also to get an insight into the process of learning of MI. Materials and Methods: Ten dental hygienist students were randomly selected to either the intervention group (IG) or the control group (CG). Students in the IG performed two MI sessions, which were discussed in a peer group and with a tutor. Thereafter the students performed the third MI sessions, which was evaluated by “Motivational Interviewing Treatment Integrity Code, Version 3.1”. The CG consisted of five students who followed the regular curriculum in the education and they conducted one MI session. A questionnaire was used to study how students reflected before and after these MI sessions. The analysis was performed by using descriptive statistics and for the comparison between groups the Mann-Whitney test was used. Results: The students in the IG used significantly more, simple and complex reflections (p < 0.05) compared to the CG. The IG gave also significantly less information during the counseling, and thereby asked more open-ended questions than the CG (p < 0.05). Both groups planned their MI sessions carefully by preparing questions before they met the patients. Conclusion: Dental hygienist students in the present study increased their skills in motivational interviewing by peer-learning from other students and from a tutor, compared to a control group.

Oronasal Fistula and Complete Edentulism: What to Do?

Abstract: Oronasal fistula is an internal fistula which represents an abnormal epitheliazed tract between oral and nasal cavity, thus impairing associated functions of deglutition and speech by nasal regurgitation of fluid and nasal speech respectively, besides risk of nasal infection resulting from food lodgement. This paper provides a brief yet definitive insight on the etiology, diagnosis and surgical closure of oronasal fistula along with a case report and discussion on prosthodontic rehabilitation of a 65 year old female with an iatrogenic oronasal fistula developed as a result of maxillary molar extraction using a complete metal based denture.

Dental Trauma and Mouthguard Usage among Soccer Players in Izmir, Turkey

Abstract: The aims of this study were to verify the occurrence of dental injuries in 343 amateur Turkish soccer players in Izmir and the level of knowledge of the teams’ soccer players about mouthguards. The soccer players were interviewed to determine the occurrence of dental trauma during soccer and mouthguard usage level. The data were analyzed with descriptive analysis to determine absolute and relative frequencies of answers for each one of the questions. Only 35 (10.2%) soccer players reported the occurrence of some type of dental injury during soccer practice. Regarding emergency conducts, approximately 84 players (24.48%) answered that replantation could be obtained after teeth avulsion, 23 players (27.38%) answered that successful replantation could be obtained within 2 hours immediately after injury, and 60.71% were not able to answer this question. Regarding mouthguard use, 61.8% of soccer players did not know about mouthguards. It was possible to conclude that dental injuries are common during amateur soccer practice and that there is a lack of information in the soccer players related to the emergency conducts and prevention of dental trauma.

Oral Health Condition of Children Living with HIV

Abstract: AIDS progression is faster in children than adults. Little is known about the oral health status of children living with HIV. Aim: To carry out a literature review about the oral health conditions of children living with HIV in order to observe if this specific population presents different oral health conditions compared to children without HIV infection. Methods: A documental study of literature review was carried out. Studies were searched at PubMed using “oral health”, “children”, “HIV” and “AIDS” as keywords. Papers published between 2001 and 2011 were included. After applying the exclusion criteria and complete reading of the selected studies, other articles were selected from the references lists of the first ones. Results: Firstly, 24 studies were identified. Among them, 65.5% were excluded according to the exclusion criteria. From the five selected articles, another five from the references of these were included. Only one article compared the oral health conditions of children living with HIV with controls without HIV infection. Conclusions: Only 10 papers contained information on the oral health conditions of children living with HIV, and just one compared the results with controls. The few studies found were insufficient to establish the oral health condition profile of children living with HIV. This lack of information could represent the lack of interest of researchers and health authorities in more integrative care and can result in neglect with this specific population of children.

SEM Evaluation of Internal Adaptation of Bases and Liners under Composite Restorations

Abstract: Aim: The aim of this study was to evaluate the interfacial microgaps generating between different materials and between materials and dentin after polymerization of the composite restorations, using SEM. Methods: The materials investigated were a composite, an adhesive, a RMGI, and a calcium hydroxide. Thirty third molars were selected and two circular class V cavities (5 mm × 3 mm) for each tooth were made. The teeth were randomly assigned into six groups and restored with a combination of the materials. The specimens were subjected to thermocycling and each tooth was sectioned mesiodistally in two halves. Each half was sectioned along the longitudinal axis through the center of the restorations to obtain a slice of 2 mm. The specimens were examined under SEM. The interfaces between the liners, the liners and dentin, and between the liners and the composite were examined for microgaps. Results: The results showed that there was not any significant difference in the mean width of microgaps in the interfaces between Dycal-dentin and Vitrebond-dentin

Factors Associated with Edentulism among Adult Users of Public Oral Health Services in Victoria, Australia

Abstract: This study examined edentulism (total absence of natural dentition) trends among adults’ users of public oral health care in Victoria, Australia and factors associated with these trends. The sample comprised 13,578 dental clients of public oral health care services, collected between July 2008 and June 2009, from which data were complete. The group of edentulous clients represented 6.8% of all clients. Older participants were more likely to be edentulous (OR = 3.95; 95% CI 3.53–4.43). By language spoken at home, those who spoke English were more likely to be edentulous than those who spoke other languages (OR = 1.29; 95% CI 1.02–1.63). Aboriginal clients were more likely to be edentulous than non-Aboriginal clients (OR = 2.21; 95% CI 1.15–4.27). By region of residence, clients living in rural locations were more likely to be edentulous than those living in urban regions (OR = 1.53; 95% CI 1.32–1.78). The full model explained 16.8% of the variance in being edentulous. Findings in edentulism were lower than what was reported by the National Survey of Adult Oral Health. However, despite this trend, significant variations existed across urban and rural locations. Innovative public health programs and services are essential to prevent inequalities in oral health diseases and conditions for rural populations.

Clinical and Radiological Outcome of Titanium Implants in Clinical Practice: A 5 Year, Prospective, Multicenter Case Series

Abstract: The objective of this prospective clinical case series was to confirm the 5-year clinical and radiographic performance of titanium implants occlusally loaded after 12 weeks. Periapical X-rays for quantitative bone level assessment were taken immediately post-surgery, after loading, 6 and 12 months, and 5 years after loading. Pocket depth (PD) and clinical attachment level (CAL) were measured. One-hundred and fourteen implants were inserted in 71 consecutive patients; 111 (97%) implants/69 (97%) patients were followed for 5 years. One implant was lost before loading (acute infection of unknown origin). Another patient developed peri-implantitis in the healing phase, and underwent successful surgical revision. Mesial median bone level at 6 and 12 months, and 5 years was 1.2 (SD ± 0.7), 1.3 (SD ± 0.7) and 1.1 (SD ± 0.6) mm; distal values were: 1.1 (SD ± 0.7), 1.4 (SD ± 0.7) and 1.2 (SD ± 0.6) mm; below implant shoulder. Stable CAL (1.2–1.6 mm) and PD (2.0–3.0 mm) were found. After 5 years no implant was lost. Three crowns and one abutment screw were defective and replaced. Implant survival (1 failure/114) as well as minimal peri-implant bone loss confirmed the favorable outcome of the used implant line. Five years post-loading, crestal bone stabilized slightly below the machined/rough border.

Comprehensive Implementation of the International Caries Detection and Assessment System (ICDAS) in a Dental School and University Oral Health Centre: A Stepwise Framework

Abstract: ICDAS (the International Caries Detection and Assessment System) is a new approach to the detection and classification of dental caries, starting with the stage showing the earliest visual changes. Methodology: This article describes the implementation of the ICDAS at the School of Dentistry, International Medical University, and Kuala Lumpur, Malaysia in a step-by-step systematically planned process. Beginning with the setting up of a Task Force in 2011 for the evaluation and preparation of the training resources and the running of exploratory training exercises, it finally culminated in carrying out training workshops for the entire staff and students. After the internal processes had been completed, an international expert (KE) was invited to evaluate the process and conduct another workshop using the resources developed within the University, including a reference set of carious teeth. The overall time taken was one and a half years. Conclusions: The implementation of the ICDAS has been comprehensively set into motion within the context of our local curriculum and oral healthcare delivery arrangements. However, this will be an ongoing process with further quality assurance measures being required clinically together with the continuing training of new staff. Sharing this ‘framework’ of the ICDAS implementation process should considerably ease the path and reduce the time period of future implementations by other dental teaching institutions.

Oral Mucosal Disorders in Pregnant versus Non-Pregnant Women

Abstract: The effects of pregnancy on the Oral Mucosa Disorder (OMD) have been sporadically documented in some developed countries. Less known is the status of OMD during pregnancy in less developed/developing countries. Iran is no exception. This study assesses the prevalence of OMD in 200 pregnant women and compares the findings with the findings from a 200 non-pregnant woman of similar age distribution in Iran. The participants had been referred to a clinic to receive reproductive age-related services. Participants suffering from systemic chronic diseases, those on medications/drugs, smokers, needing biopsies, and those with urgent Oral Mucosal Lesion (OML) treatments were excluded from the study. Oral mucosal of all 400 participants were examined. The participants’ age ranges were from 17 to 47; with the average age of 33.14 for one group; and 30.23 for the other group. Both groups had the same level of formal education. Out of 400 examined women; 62 had lesions, including 47 pregnant (23.5%); and 15 non-pregnant (7.5%) women. This result shows that the OMD rate of occurrence was significantly higher among the pregnant women. Higher OML prevalence in pregnant women, as compared to the non-pregnant women, indicates the importance of timely oral examination of pregnant women and subsequent treatment plans for them.