Showing papers in "European Journal of Oral Sciences in 2004"

The adhesion between fiber posts and root canal walls: comparison between microtensile and push-out bond strength measurements.

Abstract: Aim of the study was to compare the trimming and non-trimming variants of the microtensile technique with the 'micro' push-out test in the ability to measure accurately the bond strength of fiber posts luted inside root canals. In 15 endodontically treated teeth (Group A), fiber posts were cemented with Excite DSC in combination with Variolink II (Ivoclar-Vivadent). In 15 roots RelyX Unicem (3M-ESPE) was used for fiber post luting (Group B). Within each group, the bond strength of cemented fiber posts was assessed with the trimming and non-trimming microtensile technique, as well as with the push-out test. The great number of premature failures (16.9% in Group A, 27.5% in Group B) and the finding of high standard deviation values make questionable the reliability of the trimming microtensile technique. With the non-trimming microtensile technique, only five sticks were obtained from a total of six roots. The remaining specimens failed prematurely during the cutting phase. With the push-out test no premature failure occurred, the variability of the data distribution was acceptable, and regional differences in bond strength among root levels could be assessed. Relatively low values of bond strength were, in general, recorded for luted fiber posts. In conclusion, when measuring the bond strength of luted fiber posts, the push-out test appears to be more dependable than the microtensile technique.

A multivariate analysis of the outcome of endodontic treatment

Abstract: In the present study, multivariate analyses were performed on clinical and treatment variables that may influence the outcome of endodontic treatment. Data collected in a previous clinical-radiographic follow-up study were used. Of 810 treated, 675 roots in 498 teeth were followed for 6 months to 4 yr. Of these, 192 (the CAP group) had pre-existing, chronic apical periodontitis and 483 (the NAP group) had not. Root canal treatment followed a standard procedure with one of three sealers chosen at random. Demographic, clinical and radiographic variables were recorded at the start of, and during treatment. The periapical index (PAI) score was used to record the outcome of treatment, and applied in two different endpoint modes (END1 and END2) as the dependent variable for multivariate statistical analyses using logistic regression and the general model. The modes reflected increasing PAI scores (END1) and conventional success/failure assessment (END2). Dropouts were largely similar to the cases followed up. A total of 10 preoperative and peroperative variables were found to be significantly associated with treatment outcome by the multivariate analyses of either the total material or the NAP or CAP subgroups. Several of these were not significant in univariate analyses (e.g. the effect of sealer). Conventional success/failure analyses (END2) identified fewer of the influential variables and had low explanatory power, whereas PAI scores on an ordinal scale (END1) were most sensitive in identifying variables of influence on the treatment outcome.

Color stability of resin matrix restorative materials as a function of the method of light activation.

Abstract: The purpose was to investigate the influence of curing devices and curing times on the yellow value (b-value) of composites, ormocers and compomers after performing a suntest (EN ISO 7491). Eight samples of Charisma (CH), Durafill (DU), Definite (DE), and Dyract AP (DY) each were light cured with Translux Energy (tungsten halogen light) for 20, 40 or 60 s and with Apollo 95-E (plasma light) for 3, 10 or 20 s. All samples were subjected to a suntest. Before and after the suntest the yellow values (b-values) were determined and the change (Delta b) was calculated. When cured with Translux Energy for 20 and 40 s DU, CH, and DY revealed significantly negative Delta b-values. The b-value of DE remained nearly constant. When cured for 60 s, DU and DE shifted to more yellow while CH and DY still bleached a little. When cured with Apollo 95-E, a dramatic bleaching process of all materials investigated occurred after the suntest (significant negative Delta b). It may be concluded that the bleaching of composites, ormocers and compomers depends on (i) the used light curing device and (ii) the chosen curing times. The tungsten halogen light provided highly significantly superior results.

Chewing behavior and salivary secretion.

Abstract: We determined the salivary flow rate in 16 healthy subjects in rest and while chewing artificial and natural foods (Parafilm, Melba toast with and without margarine, and three different volumes of breakfast cake and cheese). We also determined the duration of a chewing cycle, the number of chewing cycles until swallowing, and the time until swallowing. The physical characteristics of the foods were quantified from force-deformation experiments. The flow rates of the saliva as obtained without stimulation, with Parafilm stimulation, and with chewing on the various foods were significantly correlated. An increase in chewing cycle duration, number of chewing cycles until swallowing, and time until swallowing was observed as a function of the volume of the food. More chewing cycles were required for Melba toast than for an equal volume of cake or cheese. This may be caused by the low water and fat percentage of the Melba toast. The number of chewing cycles and the time until swallowing significantly decreased when the Melba toast was buttered. The decrease may be caused by facilitation in bolus formation and lubrication of the food due to buttering the toast. The number of chewing cycles until swallowing was not correlated to the salivary flow rate.

Influence of drinking method on tooth-surface pH in relation to dental erosion.

Abstract: The aim of this investigation was to study the intraoral pH response on tooth surfaces in relation to dental erosion during and after drinking a sugar-free cola-type soft drink. Six different methods of drinking were tested in a randomized order: holding; short-sipping; long-sipping; gulping; nipping; and sucking. Two methods of pH measurement were used in two series of individuals. In the first series, pH was measured by using the microtouch method in 12 healthy adults at three dental erosion-prone sites: 11 palatally; 11 buccally; and at the mesiobuccal cusp tip of 16. In the second series, pH was measured by using the telemetric method in 6 healthy individuals, producing continuous recordings of pH by means of a glass electrode in a specified approximal area. The two series showed similar results, although the telemetric method generally recorded larger pH falls. Holding the drink in the mouth before swallowing led to the most pronounced pH drop, followed by the long-sipping method. Gulping resulted in only a small decrease of pH. No differences among the three intraoral sites were found when analyzed by using the microtouch method. The conclusion from this study is that the drinking method strongly affects tooth-surface pH and thereby the risk for dental erosion. It therefore seems appropriate to include advice on the method of drinking in dietary counseling related to dental erosion.

In vitro antibacterial effect of calcium hydroxide combined with chlorhexidine or iodine potassium iodide on Enterococcus faecalis.

Abstract: Several studies have shown a higher success rate of root canal therapy when the canal is free from bacteria at the time of obturation. Treatment strategies that are designed to eliminate this microflora should include agents that can effectively disinfect the root canal. Enterococcus faecalis is often associated with persistent endodontic infections. While in vivo studies have indicated calcium hydroxide to be the most effective all-purpose intracanal medicament, iodine potassium iodide (IKI) and chlorhexidine (CHX) may be able to kill calcium hydroxide-resistant bacteria. Supplementing the antibacterial activity of calcium hydroxide with IPI or CHX preparations was studied in bovine dentine blocks. While calcium hydroxide was unable to kill E. faecalis in the dentine, calcium hydroxide combined with IKI or CHX effectively disinfected the dentine. The addition of CHX or IKI did not affect the alkalinity of the calcium hydroxide suspensions. It may be assumed that combinations also have the potential to be used as long-term medication. Cytotoxicity tests using the neutral red method indicated that the combinations were no more toxic than their pure components.

In vivo degradation of resin-dentin bonds produced by a self-etch vs. a total-etch adhesive system.

Abstract: The purpose of this study was to evaluate the long-term durability of in vivo bond strengths and the morphological changes of interfaces between dentin and two adhesive systems. Class V preparations were prepared on the facial surfaces of 14 intact teeth of two monkeys and restored with a combination of Unifil Bond/Z250 or Single Bond/Z250. One year later, 10 additional teeth were restored with the same materials and the monkeys were killed after 24 h. All of the restored teeth were subjected to microtensile bond strength ( micro TBS) testing. The debonded surfaces of the dentin sides were morphologically observed using Fe-scanning electron microscopy (SEM), as were the polished cross-sections of resin-dentin interfaces. For both Unifil Bond and Single Bond, the micro TBS at 24 h was significantly higher than that at 1 yr. Fe-SEM observations of polished cross-sectioned and fractured surfaces showed that porosity within the hybrid layers produced by Single Bond increased over time. However, the interface produced by Unifil Bond revealed no noticeable changes in morphology between 24-h and 1-yr specimens. It is concluded that even though the bond strengths of both adhesive systems declined over time, the bonding interface using self-etching primers was relatively stable over time compared to the wet bonding system.

Detection of dentin sialoprotein in rat periodontium.

Abstract: Cloning and sequencing of the cDNA indicates that dentin sialophosphoprotein (DSPP) is a precursor of both dentin sialoprotein (DSP) and dentin phosphoprotein (DPP). Dentin sialophosphoprotein must be proteolytically processed to form these two extracellular matrix (ECM) proteins. Numerous studies led us to conclude that DSP (and DSPP) are exclusively expressed by odontoblasts and preameloblasts. However, recent observations suggest a wider distribution. To test this hypothesis, we conducted systematic studies on rat first molar during root formation with immunohistochemical techniques using specific anti-DSP polyclonal and monoclonal antibodies. We also performed in situ hybridization, using high-stringency RNA probes to detect DSP transcripts. Immunohistochemical studies demonstrated that DSP is not only localized in odontoblasts, dentin ECM and preameloblasts, but also in alveolar bone, cellular cementum, osteocytes, cementocytes, and their matrices. The results of in situ hybridization were consistent with those from immunohistochemistry, showing the expression of DSP transcripts in osteoblasts of alveolar bone, fibroblasts in periodontal ligament and cementoblasts in cellular cementum. Together, these observations suggest that DSP is involved in formation of the periodontium as well as tooth structures.

Curing efficiency of various types of light-curing units.

Abstract: This study compared monomer conversion (DC), the per cent linear polymerization shrinkage (%LS), the wall-to-wall contraction pattern (per cent of peripheral opening, %DM, and maximal marginal gap, MG) and depth of cure (DOC), of a hybrid resin composite (Spectrum TPH) exposed to different types of light-curing units and exposure modes (Virtuoso-PAC, Elipar TriLight-QTH, and FreeLight-LED). The QTH and LED units were used in two curing modes: the exponential ramp and the continuous output modes. Monomer conversion was investigated by micro Multiple Internal Reflection (MIR)-Fourier-transform infrared (FTIR) spectroscopy and %LS was measured by the deflective disc method. The wall-to-wall contraction method used a cylindrical cavity model in extracted human teeth. The per cent debonded margins relative to the cavity periphery (%DM) and the width of maximum gap (MG) was evaluated. The DOC was determined using Vickers microhardness measurements (200 g load, 20 s) at the top surface (H0), at 2 mm (H2) and at 4 mm (H4) depths, and the results expressed as H2/H0 and H4/H0 ratios. Significantly lower %DC and %LS values were provided by PAC and LED units. No differences were found in %DM among the curing units and PAC exhibited the highest MG. No significant differences were noted among light-curing groups in terms of H2/H0 microhardness values. The QTH, operated in exponential mode, resulted in the highest H4/H0 value. The exponential mode of the QTH demonstrated superior performance for the total of the characteristics evaluated.

Microbiological evaluation of dental unit water systems in general dental practice in Europe.

Abstract: A range of opportunistic pathogens have been associated with dental unit water systems (DUWS), particularly in the biofilms that can line the tubing. This study therefore aimed to assess the microbiology of DUWS and biofilms in general dental practices across seven European countries, including the United Kingdom (UK), Ireland (IRL), Greece (GR), Spain (ES), Germany (D), Denmark (DK) and the Netherlands (NL). Water supplied by 51% of 237 dental unit water lines exceeded current American Dental Association recommendations of < or = 200 colony-forming units (CFU) ml(-1). Microbiological loading of the source waters was between 0 (Denmark, the Netherlands and Spain) and 4.67 (IRL) log CFU ml(-1); water line samples from the DUWS ranged from 1.52 (ES) to 2.79 (GR) log CFU ml(-1); and biofilm counts ranged from 1.49 (GR) to 3.22 (DK) log CFU.cm(-2). Opportunistic pathogens such as legionellae (DK and ES), including Legionella pneumophila SG1 (DK and GR), and Mycobacterium spp. (DK, NL, GR, D and ES) were recovered occasionally. Presumptive oral streptococci (ES and NL), oral anaerobes (GR), Candida spp. (UK, NL and ES) and blood (GR and IRL) were detected at relatively low frequencies, but their presence indicated a failure of the 3-in-1 antiretraction valve, leading to back siphonage of oral fluids into the water and biofilm phase. These findings confirm that a substantial proportion of DUWS have high levels of microbial contamination, irrespective of country, type of equipment and source water. The study emphasizes the need for effective mechanisms to reduce the microbial burden within DUWS, and highlights the risk of occupational exposure and cross-infection in general dental practice.

Do different implant surfaces exposed in the oral cavity of humans show different biofilm compositions and activities

Abstract: Osseointegrated dental implants play an important role in restorative dentistry. However, plaque accumulation may cause inflammatory reactions around the implants, sometimes leading to implant failure. In this in vivo study the influence of two physical hard coatings on bacterial adhesion was examined in comparison with a pure titanium surface. Thin glass sheets coated with titanium nitride (TiN), zirconium nitride (ZrN) or pure titanium were mounted on removable intraoral splints in two adults. After 60 h of intraoral exposure, the biofilms were analyzed to determine the number of bacteria, the types of bacteria [by applying single-strand conformation polymorphism (SSCP analysis) of 16S rRNA genes], and whether or not the bacteria were active (by SSCP analysis of 16S rRNA). The results showed that bacterial cell counts were higher on the pure titanium-coated glass sheets than on the glass sheets coated with TiN or ZrN. The lowest number of bacterial cells was present on the ZrN-coated glass. However, the metabolic activity (RNA fingerprints) of bacteria on TiN- and ZrN-coated glass sheets seemed to be lower than the activity of bacteria on the titanium-coated surfaces, whereas SSCP fingerprints based on 16S rDNA revealed that the major 16S bands are common to all of the fingerprints, independently of the surface coating.

Protective effect of salivary nitrate and microbial nitrate reductase activity against caries

Abstract: To test the hypothesis that a combination of high salivary nitrate and high nitrate-reducing capacity are protective against dental caries, 209 children attending the Dental Institute, Barts and The London NHS Trust were examined. Salivary nitrate and nitrite levels, counts of Streptococcus mutans and Lactobacillus spp., and caries experience were recorded. Compared with control subjects, a significant reduction in caries experience was found in patients with high salivary nitrate and high nitrate-reducing ability. Production of nitrite from salivary nitrate by commensal nitrate-reducing bacteria may limit the growth of cariogenic bacteria as a result of the production of antimicrobial oxides of nitrogen, including nitric oxide.

Survival rate of mono‐ceramic and ceramic‐core CAD/CAM‐generated anterior crowns over 2–5 years

Abstract: Anterior mono-ceramic (Mk II, n = 18) and ceramic core (In-Ceram Spinell, n = 18) crowns were CAD/CAM-fabricated using Vitablocs with the Cerec 2 CAD/CAM system and bonded in 24 patients. All crowns were rated using modified United States Public Health Services (USPHS) criteria at baseline and after a service time of 2-5 years. Survival of the crowns, regarding fracture, was analysed (Kaplan-Meier) after 44.7 +/- 10.3 months. Gingival health at crowns was assessed using plaque and bleeding scores. One core crown and one mono-ceramic crown had fractured after 42.5 months and 12 months, respectively, with survival rates of 91.7% for In-Ceram Spinell and 94.4% for Mk II; the difference was not statistically significant. Between baseline and follow-up examinations, non-significant shifts from A- to B-ratings occurred, particularly for marginal adaptation, for both crown types. Plaque and bleeding scores did not differ between the ceramic crown types but showed significantly less plaque and less bleeding at ceramic crowns than at control teeth at follow-up. The clinical performance of mono-ceramic crowns was judged to be similar to that of ceramic core crowns.

Leached components from dental composites and their effects on fertility of female mice.

Abstract: This study investigated the effects of leached components from a resin-based dental composite (Z-100) and bisphenol A (BPA) on female mouse fertility. Leached components or BPA (5, 25 and 100 microg kg(-1)) were administered intragastrically daily to the test and distilled water to the control groups for 28 d. Female mice were then mated with sexually mature untreated males and their fertility was assessed. The results revealed a significant reduction in the number of pregnancies--54.5% vs. 100% (control)--in mice treated with the leached components from the dental composite, which also showed an increase of 142% in relative ovary weights. Exposure to 25 and 100 microg kg(-1) BPA resulted in significant increases in the total number of resorptions out of the total number of implantations and significant increases in relative uterine weights. Relative ovarian weights were significantly increased at the highest dose. High performance liquid chromatography analysis showed that tri-(ethylene glycol)-dimethacrylate (TEG-DMA) was the major leached component (total: 5945 microg ml(-1)) from the composite, followed by bisphenol A glycerolate dimethacrylate (BIS-GMA) (total: 2097 microg ml(-1)) and BPA (total: 78 microg ml(-1)). The results suggest that leached components from the dental composite used and commercially purchased BPA have adverse effects on the fertility and reproductive system of female mice.

Dental trait anxiety and pain sensitivity as predictors of expected and experienced pain in stressful dental procedures.

Abstract: A prevailing hypothesis suggests that exaggerated pain expectations in dentally anxious and pain-sensitive patients might usually be disconfirmed by a lower level of pain experienced during treatment. The present study was conducted to investigate whether this contention also holds during stressful dental procedures. Patients reporting high and low levels of dental fear and of pain sensitivity were compared in their expected and experienced pain and in the concordance between the two measures. Participants were 97 patients undergoing extraction and root canal treatment. The measuring instruments used were the Dental Anxiety Scale (DAS), the Pain Sensitivity Index (PSI), affective and sensory pain descriptor scales, and a numerical pain-intensity scale. The results demonstrated that patients, in general, expected more pain than they subsequently experienced. Subjects with a high DAS score both expected and experienced more pain than those with a low DAS score. Within the group of subjects with a high DAS score, those indicating high pain sensitivity expected and experienced more pain than their counterparts; additionally, only those reporting low pain sensitivity disconfirmed their high pain expectancies. The results suggest that during stressful dental procedures, patients indicating dental anxiety and pain sensitivity above median levels are especially at risk of stabilizing exaggerated pain expectations and dental fear.

Mechanical properties across hypomineralized/hypoplastic enamel of first permanent molar teeth

Abstract: The aims of the present study were to investigate the mechanical properties of first permanent molars affected with enamel hypomineralization or hypoplasia, and to describe the appearance of these lesions under scanning electron microscopy. Eight first permanent molar test teeth and two unaffected premolars (controls) were enclosed in resin, then sectioned axially and polished. The hardness and modulus of elasticity was determined from a single array of indentations made parallel to the amelo-dentinal junction using an Ultra-Micro-Indentation system. The teeth were then examined using the scanning electron microscope. The mechanical properties of the test teeth in the unaffected cervical region (hardness and modulus range, 2.03-4.99 GPa and 50.39-96.87 GPa, respectively) were similar to those of the control enamel (hardness and modulus range, 2.71-4.15 GPa and 62.06-95.77 GPa, respectively). Between the unaffected cervical enamel and the hypomineralized region there was a transitional area of 500-600 microm where the mechanical properties in the experimental teeth decreased linearly. The mechanical properties of the hypomineralized region of each experimental tooth were significantly lower than those of the control or cervical regions (hardness and modulus range, 0.07-1.74 GPa and 3.26-40.96 GPa, respectively). The scanning electron microscopy views revealed disorganized enamel with poorly demarcated prism boundaries in the affected regions. In conclusion, the hardness and modulus of elasticity of hypomineralized enamel in first permanent molars is significantly less than in unaffected areas of the same tooth. The reason for this is unclear but may be related to the lack of organization of the enamel crystals.

Susceptibility of deciduous and permanent enamel to dietary acid-induced erosion studied with atomic force microscopy nanoindentation

Abstract: The initial stages of dental enamel demineralization by dietary acids are of particular clinical relevance. Some authors have reported a difference in the susceptibility of deciduous and permanent enamel to erosion, although other studies could not confirm these findings. The aim of the present study was therefore to investigate whether there are differences in the susceptibility of deciduous and permanent enamel to dietary acid induced erosion (demineralization). Nanoindentation combined with atomic force microscopy was used to investigate the erosive effect of four different drinks (cola, lemonade, juice drink, and water) on enamel at early stages in vitro. Surface nanohardness and reduced elastic modulus were obtained for the soft drink-treated enamel samples as a function of the exposure time. The results obtained showed that the four drinks had widely differing erosive effects due to their diverse compositions. Water did not show statistically significant changes in nanomechanical properties for all exposure times compared with untreated enamel. Exposure of enamel to cola, lemonade and the juice drink led to a statistically significant surface softening of the enamel with cola and the lemonade having a much stronger softening effect than the juice drink. For longer exposure times enamel softening increased for cola and lemonade and stayed unchanged for the juice drink. Deciduous enamel was not found to be more susceptible to erosion than permanent enamel under the conditions of the present study.

Four-year water degradation of a resin-modified glass-ionomer adhesive bonded to dentin.

Abstract: Glass-ionomers are auto-adhesive to tooth tissue through combined micro-mechanical and chemical bonding. How much each of the two bonding components contributes to the actual bonding effectiveness is, however, not known and there is not much information available on long-term stability. The objective of this study was to assess the bonding effectiveness of a resin-modified glass-ionomer adhesive to dentin after 4 yr of water storage. Fuji Bond LC (GC) was applied without (i) and with pretreatment using (ii) a polyalkenoic acid conditioner and (iii) a 37.5% phosphoric acid etchant. The etchant was used to exclude any chemical interaction with hydroxyapatite. The micro-tensile bond strength ( microTBS) to dentin decreased significantly over the 4 yr period in all three experimental groups. After 24 h and 4 yr, the lowest micro TBS was recorded when dentin was not pretreated. The highest micro TBS was obtained following polyalkenoic acid pretreatment, although this was not significantly different from specimens that were pretreated using phosphoric acid. Pretreating dentin with phosphoric acid intensified micromechanical interlocking at the expense of chemical bonding potential to hydroxyapatite. Nevertheless, correlating the micro TBS data with failure analysis through scanning electron microscopy and transmission electron microscopy indicated that combined micro-mechanical and chemical bonding involving pretreatment with the polyalkenoic acid conditioner yielded the most durable bond.

Undermining of enamel as a mechanism of abfraction lesion formation: a finite element study.

Abstract: Many workers have suggested that abfraction lesion formation is caused by the physical overloading of enamel. However, an alternative mechanism, involving undermining of the cervical enamel along the amelodentinal junction (ADJ), may be a more realistic explanation. The aim of this study was to examine what effect undermining of the buccal cervical enamel would have on the stress distribution in upper teeth. Two-dimensional plain strain finite element meshes of an upper incisor, canine and first premolar and the supporting periodontal ligament and alveolar bone were developed. Each tooth was loaded with an oblique 100 N load, and the nodal maximum principal stresses (MPS) along a buccal horizontal sampling plane 1.1 mm above the amelo-cemental junction was measured. A discontinuity between the cervical enamel and dentine elements was then introduced (0.1 mm wide) using gap elements. The vertical extent of this defect varied from 0.1 to 0.5 mm. The value of the MPS varied from 1.8 to 209 Mpa, and the lowest values were found for the intact teeth (range 0.6-30.3 MPa). The discontinuity caused a dramatic increase in the numerical values of the MPS, and in many instances these exceeded the known failure stress for enamel.

Apical periodontitis development and bacterial response to endodontic treatment. Experimental root canal infections in monkeys with selected bacterial strains.

Abstract: In six monkeys, 160 root canals were inoculated with a combination of four bacterial strains belonging to species Streptococcus milleri, Peptostreptococcus anaerobius, Prevotella oralis, and Fusobacterium nucleatum. In two other monkeys, 24 root canals were inoculated with a five-strain combination consisting of these strains and a strain of Enterococcus faecalis. All strains were previously isolated from an infected monkey root canal. After 8-12 months, survival of the strains was recorded bacteriologically, and the reaction in the periapical region was radiographed. From 180 of 184 root canals, one or more of the bacterial strains were reisolated. The two facultative strains were more frequently reisolated than the anaerobic strains. Apical periodontitis was registered in the periapical region of more than 96% of root canals with reisolated bacteria but in none of those without reisolated bacteria. Endodontic treatment was carried out in two sessions with an interval of 14 d without interappointment dressings, and the effect was evaluated bacteriologically before and after each treatment. The chemo-mechanical treatment reduced significantly the number of strains and bacterial cells. The facultative bacteria were more resistant to the treatment than the anaerobic bacteria. The five-strain combination had a higher survival rate than the four-strain combination.

Correlation of stress and strain profiles and the distribution of osteoclastic cells induced by orthodontic loading in rat.

Abstract: The aim of this study was to investigate whether stress or strain within the periodontal ligament (PDL), or rather in the bone, plays a role in initiating biological responses in orthodontic tooth movement. The upper first molars of 11 Wistar rats were moved mesially with a closed nickel titanium alloy coil spring for 3-12 d and three rats served as controls. After preparation of the maxillae for paraffin histology, tartrate-resistant acid phosphatase (TRAP) activity was evaluated to detect osteoclasts and their mononuclear precursors in four regions around the mesial root. Based on histological sections, finite element models were developed. The stress/strain distributions associated with the orthodontic loading were determined in the alveolar bone and in the PDL and compared with the osteoclast distributions. In the PDL, the normal stresses and strains were compressive (negative) in regions where the number of osteoclasts was highest, whereas the positive normal tensile stresses and strains were coincident with regions with small numbers of osteoclasts. The results indicate a direct correlation of the calculated stress/strain values in the PDL with the distributions of osteoclasts in the alveolar bone and PDL. Thus, these seem to be the dominant mechanical factor of tissue reaction to orthodontic force application, whereas the mechanical loading of the bone does not seem to play a role in orthodontic bone remodeling.

Cytotoxicity and sealing properties of four classes of endodontic sealers evaluated by succinic dehydrogenase activity and confocal laser scanning microscopy.

Abstract: The objectives of this study were to evaluate the cytotoxicity and sealing properties of four classes of endodontic sealers (PCS/Kerr, RoekoSeal/Roeko, TopSeal/Dentsply, and EndoREZ/Ultradent). For cytotoxicity testing (MTT method), the materials were either placed immediately in contact with cultured cells or 24 h after setting, then evaluated at three subsequent time points (24 h, 48 h, or 1 wk). For the leakage study, extracted human roots were obturated with acrylic cones and sealers and immersed for 48 h into rhodamine-labeled lipopolysaccharide. The roots were then observed under a confocal laser scanning microscope to estimate (semiquantitatively) the presence of the rhodamine-lipopolysaccharide (LPS) inside the canal. The results showed that cytotoxicity generally increased with time, and that most materials pose significant cytotoxic risks, particularly in the freshly mixed condition. Further, all materials showed significant leakage although there was large variation among teeth. Overall, the silicon-based material (Roeko Seal) was less cytotoxic and more effective in sealing root canals against LPS leakage than other materials.

Primary and secondary cartilages of the neonatal rat: the femoral head and the mandibular condyle

Abstract: Primary and secondary cartilages differ in embryonic origin and in histological organization, and are generally considered to have a different mode of growth. However, few studies have directly compared the two types of cartilage of the same animal at the same age. Therefore, we analysed several histological and biochemical differences between secondary cartilage of the mandibular condyle and primary cartilage of the femoral head of 4-d-old rats. We evaluated the tissue organization, the level of DNA and glycosaminoglycan (GAG) synthesis, and the GAG and collagen content. The expression of collagen types I, II and III and of receptors for insulin-like growth factor (IGF)-I, fibroblast growth factor (FGF), and transforming growth factor (TGF)-beta were investigated by immunohistochemistry. The ex vivo DNA and GAG synthesis as well as the GAG content of femoral heads were much higher than that of mandibular condyles. Mandibular condyles expressed both collagen types I and II, while femoral heads expressed only type II collagen. In the mandibular condyles, receptors for IGF-I, FGF, and TGF-beta were observed mainly in the superficial layers, whereas they were found throughout the entire femoral head. In conclusion, major differences were found between both types of cartilage, which might be related to their specific functional demands.

The effect of a self-etching primer on the continuous demineralization of dentin.

Abstract: Self-etching primers (SEP), used for adhesion of resin restorations, contain an acidic monomer that is not rinsed off after application; therefore, residual acid could further demineralize dentin, jeopardizing adhesion. This study evaluated whether dentin demineralization continues after a 20-s application of a SEP and also after polymerization of the adhesive. Surface recession was measured, using atomic force microscopy (AFM), between the masked surface and dentin etched with SEP (Clearfil SE Bond) or phosphoric acid (pH 1.94) immediately, 5 min, 2 h or 12 h after application. AFM-based nanoindentations were performed to determine mechanical property profiles across resin-bonded interfaces of two sequence groups: SG 1, where the adhesive was applied and polymerized immediately after application of the primer and specimens were immersed in Hank's solution after 5 min, 2 h and 12 h; or SG 2, where specimens were placed in an incubator before the application of the adhesive, for the same time periods. Significant surface recession occurred over time for all groups, except for SEP before desiccation. Nanoindentations yielded decreased hardness and elastic modulus below the hybrid layer after application of the initial primer, even after polymerization of the adhesive. The results reveal a demineralized dentin zone below the hybrid layer formed by the SEP, not fully protected by the adhesive, which could jeopardize bond strength.

Collinearity in linear regression is a serious problem in oral health research.

Abstract: The aim of this article is to encourage good practice in the statistical analysis of dental research data. Our objective is to highlight the statistical problems of collinearity and multicollinearity. These are among the most common statistical pitfalls in oral health research when exploring the relationship between clinical variables using multiple regression analysis. We hope that this article will show why these problems arise and how they can be avoided and overcome. Examples from the periodontal literature will be used to illustrate how collinearity and multicollinearity can seriously distort the model development process as a result of the phenomenon of mathematical coupling. Knowledge of these problems can help to eliminate misleading results and improve any subsequent interpretations. Regression analyses are useful tools in oral health research when their limitations are recognized. However, care is required in planning and it is worthwhile seeking statistical advice when formulating the study's research questions.

Involvement of matrix metalloproteinases in the onset of dentin mineralization

Abstract: In order to study the involvement of matrix metalloproteinases (MMPs) on dentin formation and mineralization, day 18 embryonic mouse tooth germs were cultured for 10 d in the presence or absence of Marimastat, a general MMP inhibitor, or CT(1166), a more selective inhibitor of gelatinases (MMP-2 and MMP-9) and stromelysin-1 (MMP-3). With Marimastat a dose-dependent increase in thickness of the predentin layer and a decreased mineralization of dentin were observed. At the highest concentration of the inhibitor used, enamel formation had ceased. With CT(1166), these effects were already apparent at the lowest concentration used. Western blot analyses demonstrated that the two inhibitors inhibited the expression of enamelysin (MMP-20). These observations indicate that MMPs (possibly MMP-2, -3, -9 and/or -20) play a role in the onset of dentin mineralization. The lack of enamel formation was possibly due to diffusion of amelogenin from its normal site of apposition. The protein clearly was not retained at the surface of the non-mineralized dentin layer, and immunopositive amelogenin accumulated in the odontoblast compartment. The diffusion of enamel proteins and the accumulation revealed by immunolabeling of two small leucine-rich proteoglycans, decorin and biglycan, in the predentin may have contributed to impaired dentin mineralization.

Class II restorations in primary teeth: 7-year study on three resin-modified glass ionomer cements and a compomer.

Abstract: The aim of this randomized study was to compare the longevity and cariostatic effects of 1565 class II restorations in primary teeth placed by 15 clinicians in the Danish Public Dental Health Service in 971 children, aged 3.6-14.9 yr. The restorations were performed using three resin-modified glass ionomer cements and one compomer (polyacid-modified composite resin) with and without their respective cavity conditioners. The restorations were in contact with 1023 unrestored proximal surfaces in 853 primary and 170 permanent teeth. The study was terminated after 7 yr with 1% of the restorations in function, 7% patient dropouts, 18% failed restorations, and operative treatment on 24% of the adjacent surfaces. Multivariate survival analyses showed that the restorative material and cavity conditioning influenced the survival of restorations but not the progression of caries on adjacent surfaces. The 50% survival times were estimated to exceed 5 yr for the restorations and 4.5 yr for the adjacent unfilled surfaces in all treatment groups. It was concluded that resin-modified glass ionomer cement and compomer are both appropriate materials for class II restorations in primary teeth. The differences in longevity and cariostatic effects among the four materials used with and without conditioner were less than the intra-individual differences between clinicians.

The relation of tobacco smoking to tooth loss among young adults

Abstract: Earlier studies have associated smoking with a higher rate of dental caries, periodontal disease and tooth loss. The aim of this cross-sectional study was to determine whether smoking is associated with tooth loss among young adults. The data consist of the 1966 birth cohort of Northern Finland, which is an unselected general population birth cohort (n = 12 058). The data were collected using a postal questionnaire in 1997-98 (n = 8690). Prevalence odds ratios and confidence intervals were estimated by applying a logistic regression model. It was found that smoking was associated with tooth loss in an exposure-dependent manner. The odds for those who smoked 16 or more pack-years were 5.30 (CI = 2.35-11.2) after adjustment for socio-economic and behavioral factors. Differences in socio-economic or health behavior are not likely to explain the findings since an exposure-response pattern was seen even when data was stratified according to sex, education and health-oriented lifestyle. A possible explanation for this association is a combination of treatment decisions and dental diseases, which are most likely associated with smoking in an exposure-dependent manner.

Effects of additional and extended acid etching on bonding to caries‐affected dentine

Abstract: This study evaluated the effects of additional and extended acid etching on microtensile bond strength ( micro TBS) of two adhesive systems to sound (SD) and caries-affected dentine (CAD). Flat surfaces of CAD surrounded by SD of 36 extracted carious third molars were assigned to four treatments (i): self-etching adhesive system (Clearfil SE Bond) applied to dentine surfaces following manufacturer's instructions (MI); (ii) after additional etching for 15 s (35% phosphoric acid, PA); (iii) total-etch one-bottle adhesive (Single Bond) applied to dentine surfaces following MI; or (iv), after etching for 45 s with PA. Composite 'blocks' were built on bonded surfaces and restored teeth were vertically sectioned to obtain bonded slices of 0.7 mm thick. Slices were trimmed to create hourglass-shaped specimens (cross-sectional area of 1 mm(2)), which were tested under tension in a universal testing machine. Additional CAD and SD samples were prepared for scanning electron microscopy observations. Additional and extended etching significantly increased micro TBS to CAD; however, micro TBS of both adhesives to CAD were significantly lower than to SD. Additional and extended etching can improve bonding to CAD; however, adhesives applied on SD showed the best results for bonding.

Relation of different measures of psychological characteristics to oral health habits, diabetes adherence and related clinical variables among diabetic patients.

Abstract: Among diabetic patients, oral health status and oral health behavior have been found to relate to metabolic control. The aim was to analyse which psychological characteristics, i.e. intention, self-efficacy, locus of control or self-esteem related to health behavior most comprehensively explain oral health habits, diabetes adherence, dental caries, deepened periodontal pockets, and the metabolic parameter HbA1c (glycosylated hemoglobin). The study subjects consisted of a group of 149 insulin-dependent diabetic patients. Data were obtained from self-completed questionnaires. The proportions of variance explained by the linear regression model were used as measures in the comparisons. It was found that oral health habits and diabetes adherence correlated. Both dental and diabetes self-efficacy scores were related to oral health habits and diabetes adherence. This indicates that self-efficacy is the best overall determinant of various health behavior practices. The ability of psychological characteristics to explain oral health was limited. Improvement of self-efficacy therefore may have a positive effect on various aspects of health behaviors.