Double-blind clinical research was conducted to compare the clinical response of a thin, concentrated peroxide whitening strip (relative to a marketed control) among a teenage population with preceding safety and efficacy data. Informed... more
Double-blind clinical research was conducted to compare the clinical response of a thin, concentrated peroxide whitening strip (relative to a marketed control) among a teenage population with preceding safety and efficacy data. Informed consent and child assent was obtained from 48 teens, 13-17 years of age. After baseline measurements were taken, subjects were divded randomly into two groups, one using a thin 10% hydrogen peroxide whitening strip, the other using a 6.5% hydrogen peroxide strip with a thicker gel layer. Strip use was 30 minutes twice per day for 22 days on the maxillary arch, followed by 22 days on the mandibular arch. Efficacy was measured objectively based on L*a*b* color change from digital images taken every 11 days, where L* indicates lightness and b* indicates blue-to-yellow shade. The mean age was 15.1 (+/-1.5) years. Relative to baseline, both strip groups experienced significant (p < 0.0001) color improvement for yellowness (deltab*) and lightness/brightness (deltaL*) beginning at the first visit (Day 11). Continued use resulted in significant color improvement through Day 22. Groups did not differ significantly (p > 0.33) with respect to combined deltab* or deltaL* at end-of-treatment. Tooth sensitivity and oral irritation represented the most common adverse events. No subject discontinued early due to a treatment-related adverse event. Teenagers who used either 10% hydrogen peroxide gel or 6.5% hydrogen peroxide gel whitening strips twice a day for 44 days saw significant tooth whitening without serious adverse events.
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A prefabricated endodontic post was cemented with glass ionomer, then composite resin was used to build up a core and fabricate a crown restoration. This treatment has been successful through a 2-year observation period, and may represent... more
A prefabricated endodontic post was cemented with glass ionomer, then composite resin was used to build up a core and fabricate a crown restoration. This treatment has been successful through a 2-year observation period, and may represent a treatment alternative for certain clinical situations, in which traditional cast procedures are not acceptable to the patient. Further investigation is necessary to evaluate the longitudinal success of composite resin crowns.
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IntroductionEnamel demineralization adjacent to orthodontic brackets has been shown to be a consequence during orthodontic treatment. Fluoride-releasing resin-modified glass ionomer cements (RMGICs) have been shown to protect the enamel... more
IntroductionEnamel demineralization adjacent to orthodontic brackets has been shown to be a consequence during orthodontic treatment. Fluoride-releasing resin-modified glass ionomer cements (RMGICs) have been shown to protect the enamel from white spot lesions, but their bond strength has been proven inadequate. The purpose of this study was to evaluate ACTIVA BioACTIVE-RESTORATIVE, a bioactive material with strength superior to RMGICs, for inhibition of enamel demineralization surrounding orthodontic brackets.Materials and MethodsFifteen human teeth were sectioned and divided into two groups. One group was the control and had orthodontic brackets bonded with Transbond XT, while the second group had orthodontic brackets bonded with ACTIVA. The teeth were varnished within 2 mm of the bracket margins and immersed in an artificial caries solution for 3 days to create carious lesions. The teeth were sectioned and viewed under polarized light microscopy for the detection of enamel demineralization adjacent to the bracket, and then, the lesion areas were measured with a computer imaging system.ResultsThere was a statistically significant difference (P≤ 0.001) that ACTIVA had less enamel demineralization adjacent to the bracket when compared to the control group.ConclusionsThe results of this study have demonstrated that ACTIVA, a fluoride-releasing bioactive restorative material, inhibits demineralization of enamel adjacent to orthodontic brackets when compared to a nonfluoride-releasing control.
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Enamel demineralization is recognized as a possible side effect of bonding orthodontic brackets with composite resins. Fluoride-releasing restorative materials have been shown to inhibit tooth demineralization. The purpose of this study... more
Enamel demineralization is recognized as a possible side effect of bonding orthodontic brackets with composite resins. Fluoride-releasing restorative materials have been shown to inhibit tooth demineralization. The purpose of this study was to evaluate two fluoride-releasing hybrid glass ionomer bonding agents for inhibition of enamel demineralization surrounding orthodontic brackets under two experimental conditions. This in vitro study used 72 extracted human premolars. Twenty-four teeth were bonded with Advance resionomer, 24 were bonded with Fuji Ortho LC hybrid glass ionomer and 24 were bonded with Transbond XT composite resin as the control. The teeth were cycled in an artificial caries challenge three times daily for 30 days. Half of the teeth in each group were brushed twice daily with a fluoridated dentifrice, and the other half were not brushed. Demineralization of enamel surrounding orthodontic brackets was evaluated with polarized light microscopy. Enamel lesions were photographed under maximum illumination. Images were projected, and demineralized areas were traced. Both average depth and area were measured with a sonic digitizer. Analysis of variance (P <.0001) and Duncan's test (P <.05) indicated significant differences in depth and area of demineralized enamel such that lesion size was: Transbond XT no brush > Transbond XT brush > Advance no brush = Advance brush = Fuji Ortho LC no brush = Fuji Ortho brush. The promising results of this in vitro study warrant further clinical investigation of hybrid glass ionomer adhesives as orthodontic bonding agents to minimize enamel demineralization.
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Dentistry, Biomedical Engineering, Nonparametric Statistics, Medicine, Humans, and 15 moreFluorides, American, Composite resins, Demineralization, Analysis of Variance, Dentifrice, Acrylic Resins, Dental Bonding, In Vitro Studies, Dental Enamel, Composite Resin, Glass Ionomer Cement, Brush, Dentin bonding agents, and Bicuspid
The American Academy of Pediatric Dentistry sponsored the Pediatric Restorative Dentistry Consensus Conference in 2002. This paper will review the consensus statements that were issued as a result of the conference. Since the conference... more
The American Academy of Pediatric Dentistry sponsored the Pediatric Restorative Dentistry Consensus Conference in 2002. This paper will review the consensus statements that were issued as a result of the conference. Since the conference there have been advances in procedures, materials, and techniques that need to be considered in terms of some of the consensus statements. The introduction of the First Dental Home, interim therapeutic restoration and nanotechnology are examples of some of the materials and techniques that are now part of everyday pediatric dentistry. This paper will discuss the updates as it relates to each of the 2002 consensus statements.
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Dentistry, Risk assessment, Nanotechnology, Dental Materials, Medicine, and 15 moreHumans, Child, Pubmed, Dental Caries, Stainless Steel, Composite resins, Crowns, Risk Assessment, Restorative dentistry, Dental Amalgam, Dental Alloys, Interim, Pit and Fissure Sealants, Dental Cements, and Glass ionomer cements
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Molecular Biology, Biology, Immunohistochemistry, Medicine, Gene expression, and 15 moreCell line, Cell morphology, Mice, Animals, Osteoblast, Osteocalcin, Alkaline phosphatase, Osteonectin, Cell Proliferation, Osteoblasts, Bone Morphogenetic Protein Market, Biochemistry and cell biology, Gene Expression Regulation, Medical biochemistry and metabolomics, and Collagen type I
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Flow Cytometry, Biology, Immunohistochemistry, Cell Biology, Ligament, and 15 moreMedicine, Multidisciplinary, In Situ Hybridization, Biological Sciences, Cell Differentiation, Humans, Mice, Animals, Periodontal Ligament, Dentine, Differentiation, Analysis of Variance, Dentin, Cell Proliferation, and Periodontal
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El uso apropiado de los composites modernos preconiza la necesidad de enmascarar restauraciones de clase III por detras del esmalte labial residual. Con la adhesion micromecanica al esmalte, adhesion quimica a la dentina, y retencion... more
El uso apropiado de los composites modernos preconiza la necesidad de enmascarar restauraciones de clase III por detras del esmalte labial residual. Con la adhesion micromecanica al esmalte, adhesion quimica a la dentina, y retencion mecanica tradicional, pueden colocarse restauraciones de composite de clase III visibles que simulan exactamente el color y textura de las superficies naturales del esmalte. Estas restauraciones imperceptibles, si se realizan apropiadamente, pueden durar muchos anos. Este articulo presenta paso por paso una tecnica de restauracion de lesiones de caries de clase III con composite empleando acceso labial y un adhesivo dentinario y de esmalte introducido recientemente.
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Humanities and Art
This report describes the background, rationale and process for revision of training standards for advanced educational programs in pediatric dentistry in the United States.
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Dentistry, Orthodontics, Dental Research, Forecasting, Accreditation, and 15 moreCultural Diversity, Adolescent, Medicine, Curriculum, Humans, Child, Dental Caries, Infant, Advisory Committees, Certification, Clinical Competence, Child preschool, Delivery of Health Care, internship and residency, and Paediatrics and reproductive medicine
Purpose: To measure, over time, the release of fluoride from a resin-modified glass-ionomer cement, loaded with different levels of fluoride, then to evaluate the adjacent dentin demineralization inhibition relative to these fluoride... more
Purpose: To measure, over time, the release of fluoride from a resin-modified glass-ionomer cement, loaded with different levels of fluoride, then to evaluate the adjacent dentin demineralization inhibition relative to these fluoride levels. Materials and methods: (Phase I) 25 standardized discs were fabricated from a non-fluoridated resin-based composite (control), resin-modified glass-ionomer cement and resin-modified glass-ionomer cement loaded with sodium fluoride at 1%, 2% and 3% by weight fluoride. Fluoride release was evaluated over 30 days. (Phase II) 50 restorations, from the materials listed in Phase I, were placed as Class V restorations in teeth, the teeth were acid-challenged, then dentin margins adjacent to restoration margins were evaluated for demineralization. Results: As sodium fluoride additions increased, fluoride release increased. Evaluation of demineralization indicated the resin-modified glass-ionomer cement inhibited adjacent demineralization in a direct relationship with sodium fluoride concentration where 3% fluoride exhibited significantly less adjacent demineralization than all other groups; 2% and 1% fluoride exhibited significantly less adjacent demineralization than the non-loaded resin-modified glass-ionomer cement and non-fluoridated resin-based composite control (P< 0.05).
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Materials Science, Dentistry, Fluoride, Medicine, Humans, and 15 moreDiffusion, Pubmed, Dental Caries, Cement, Composite resins, Demineralization, Analysis of Variance, Time Factors, Cariostatic Agents, Dentin, Dental Enamel, Resin Cements, Sodium Fluoride, Glass Ionomer Cement, and Statistics as Topic
Purpose: The purpose of this study was to compare the efficacy and safety outcomes of a currently marketed, peroxide-containing, tray-based, tooth-whitening system to a peroxide-containing, "trayless" tooth-whitening system. Methods:... more
Purpose: The purpose of this study was to compare the efficacy and safety outcomes of a currently marketed, peroxide-containing, tray-based, tooth-whitening system to a peroxide-containing, "trayless" tooth-whitening system. Methods: Fifty-seven subjects, 12 to 17 years of age, participated in this study and were divided into 2 balanced groups. Twelve subjects received custom trays with 10% carbamide peroxide gel that they were instructed to wear overnight. Forty-five subjects received 10% hydrogen peroxide polyethylene strips to wear for 30 minutes twice a day. Teeth were bleached for 2 weeks. Digital image analysis measured color in B, L, and A color spaces, where B indicated yellowness, L indicated lightness, and A indicated redness. Oral examinations and interviews were used to ascertain any adverse events that may have occurred during treatment. Results: Fifty-one patients completed this study. Both whitening systems yielded significant (P<.001) color improvement, as evidenced by decreased yellowness, increased lightness, and decreased redness. Groups did not differ significantly (P>.39) regarding color improvement for B, L, or A on either the maxillary or mandibular teeth. Twelve subjects (27%) in the polyethylene strip group reported adverse events compared to 5 subjects (42%) in the tray-delivered group. Minor and transient tooth sensitivity and oral irritation were the most common adverse events. Conclusions: Both the daytime strip and overnight tray groups significantly (P<.0001) whitened teeth; there were no significant differences between the 2 groups in any of the color parameters; both whitening systems were well tolerated, and most adverse events were mild in severity.
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Dentistry, Adolescent, Medicine, Humans, Pubmed, and 15 moreDigital Image Analysis, Polyethylene, Hydrogen Peroxide, Gels, Pediatric dentistry, Color Space, Adverse Event, Pediatric Dentistry, Irritation, Oxidants, Adverse effect, Peroxides, Paediatrics and reproductive medicine, Carbamide peroxide, and Drug combinations
Although there are several case reports of vital tooth bleaching in children, there is limited clinical trial evidence of the safety or efficacy of this practice. Accordingly, a new clinical trial was conducted to evaluate the effects of... more
Although there are several case reports of vital tooth bleaching in children, there is limited clinical trial evidence of the safety or efficacy of this practice. Accordingly, a new clinical trial was conducted to evaluate the effects of 2 different bleaching systems, a 6.5% hydrogen peroxide strip system and a 10% carbamide peroxide tray system, in a population of preteens and teens. A total of 106 volunteers, aged 11 to 18 years, took part in this 8-week study. Patients were randomized by a ratio of 2:1 to the strip or tray groups, with each group treating the maxillary arch first and then the mandibular arch for 4 consecutive weeks each. Individuals assigned to the strip group used the system twice daily for 30 minutes (a total of 56 contact hours over the 8-week study). Those assigned to the tray group used that system overnight (approximately 448 contact hours). Digital images were obtained at baseline and after every 2-week treatment period. Average tooth color was determined in L*, a*, b* color space, where L* indicated lightness, a* indicated red-green, and b* indicated yellow-blue. Both systems significantly whitened teeth (P < 0.0001). While there were no significant differences between groups with respect to the primary whitening response (delta b*) on the maxillary teeth, 4 weeks of overnight treatment with the 10% carbamide peroxide tray (approximately 224 contact hours) yielded statistically significant whitening (P < 0.05) on the mandibular teeth compared with the 6.5% hydrogen peroxide strip used for 28 hours. Both tooth-whitening systems had similar sensitivity/irritation reported after instructed use. This research demonstrates that tooth whitening in teens may be safely accomplished using either the short-contact-time hydrogen peroxide bleaching strips or the overnight carbamide peroxide tray systems tested in this study.
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The purpose of this study was to evaluate cuspal flexure in posterior primary teeth following restoration with three dif- ferent materials. Twelve primary second molars were ob- tained. A precision strain gage was attached to the buccal... more
The purpose of this study was to evaluate cuspal flexure in posterior primary teeth following restoration with three dif- ferent materials. Twelve primary second molars were ob- tained. A precision strain gage was attached to the buccal surface of each tooth and balanced at zero. The teeth were mounted and then loaded with a 10 kg force; the strain appearing on the strain gage indicator was recorded. A mesiocclusodistal preparation was placed, and then each tooth was restored using amalgam, posterior composite resin, and glass ionomer silver. Following restoration placement, the tooth again was loaded with the lO-kg force. Each tooth was restored using all three materials. Results demonstrated that composite resin restorations recovered an average stiffness of 75% of the original intact tooth, glass ionomer silver recov- ered 52% of the original tooth stiffness, and amalgam recov- ered 34% of the uncut tooth stiffness. The analysis of variance demonstrated that significant differences in external cuspal deflection stress were associated with the different restorative materials. Scheffe's test demonstrated that loading a tooth restored with composite resin created significantly less strain than res toting the tooth with glass ionomer silver or amalgam. Loading a tooth restored with glass ionomer silver created significantly less strain than restoring the tooth with amal- gam (P < 0.001). During the past 10 years, many advances have oc- curred in pediatric operative dentistry. More recently, glass ionomer silver has become available for use as a posterior restorative material. The advantages of glass ionomer silver include: (1) the continual release fluoride ions; (2) ability to chemically bond to tooth structure; (3) a coefficient of thermal expansion near that of tooth structure; (4) radiopacity; (5) the capacity to etched for the mechanical bond of composite resin; and (6) resistance to abrasion with the addition of silver particles to the glass ionomer. 1
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Dentistry, Medicine, Humans, Silver, Pubmed, and 15 morePediatric dentistry, Posterior Teeth, Composite resins, Analysis of Variance, Pediatric Dentistry, Dental Stress Analysis, Dental Amalgam, Dental Alloys, Composite Resin, Glass Ionomer Cement, Coefficient of Thermal Expansion, Molar, Dental Cements, Paediatrics and reproductive medicine, and Glass ionomer cements
Both of bone morphogenetic proteins 2 and 4 (Bmp2 and Bmp4) are two closely related members of the transforming growth factor beta superfamily and play diverse roles in normal and pathological processes. However, detail understandings of... more
Both of bone morphogenetic proteins 2 and 4 (Bmp2 and Bmp4) are two closely related members of the transforming growth factor beta superfamily and play diverse roles in normal and pathological processes. However, detail understandings of mechanisms through which Bmp2 and Bmp4 exert their effects remain elusive due to their functional compensations each other. To study roles of Bmp2/Bmp4 in osteoblast differentiation and extracellular matrix (ECM) remodeling, calvarial osteoblasts from Bmp2/4 conditional mice with Cre recombinase recognition site (loxP) were isolated and transfected with simian virus 40 large T antigen to generate immortalized BMP2C/C4C/C (iBMP2 C/C/4C/C) osteoblast lines. The BMP2/4 genes in the iBMP2 C/C/4C/C cells were double knocked out by Ad-Cre recombinase infection. Differentiation and mineralization of iBMP2C/C/4C/C knock-out (iBmp2C/C/4C/C KO) cells were detected by alkaline phosphatase (ALP) and alizarin (ALZ) red S staining analyses. ECM remodeling was also observed in fluorescent microscope. Cell differentiation was dramatically decreased in the iBMP2C/C/4C/C KO cells compared to that of the iBMP2C/C/4C/C osteoblasts. Mineralization was also reduced in these KO cells by ALZ staining. Furthermore, Bmp2/4 double knock-out cells have major defects in remodeling the ECM as reflected by changes in collagen type I processing. Here we for the first time demonstrate the establishment of iBmp2C/C/4C/C KO osteoblasts. Cell differentiation and mineralization in the iBmp2C/C/4C/C KO cells were decreased. Furthermore, ECM processing in these KO cells was impaired. This indicates that BMP2/4 play important roles in osteoblast differentiation and ECM remodeling.
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The purpose of this study was to quantify the cuspal deflection produced by polymerization shrinkage, comparing 3 different tech- niques in the placement and polymerization of Class II posterior composite resin restorations in vivo.... more
The purpose of this study was to quantify the cuspal deflection produced by polymerization shrinkage, comparing 3 different tech- niques in the placement and polymerization of Class II posterior composite resin restorations in vivo. Thirty primary second molars in need of a Class II restoration were identified. An index, with a size º carbide round bur, was placed on the
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This study compared the caries inhibition and microleakage of two liners under amalgam restorations. Thirty-two molars received mesio-occlusal and disto-occlusal Class II cavity preparations. Calcium hydroxide was randomly placed as a... more
This study compared the caries inhibition and microleakage of two liners under amalgam restorations. Thirty-two molars received mesio-occlusal and disto-occlusal Class II cavity preparations. Calcium hydroxide was randomly placed as a liner in one preparation of each tooth and glass-ionomer cement liner was placed in the other. Amalgam restorations were placed. Teeth were axially loaded and an acid-protective varnish was placed. Teeth were placed into artificial saliva for 3 months, thermocycled, and cycled through a caries challenge. Sections were obtained from 20 teeth and photographed under polarized light. The remaining teeth were placed in 2% basic fuchsin and sectioned. A t-test indicated that restorations with glass-ionomer cement liners exhibited significantly less demineralization and microleakage than did restorations with calcium hydroxide liners.
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Space maintenance is critical in the developing dentition, and often affects the future dental needs of a pediatric patient. The premature loss of primary second molars can create a significant arch space/tooth size discrepancy. 1' ^... more
Space maintenance is critical in the developing dentition, and often affects the future dental needs of a pediatric patient. The premature loss of primary second molars can create a significant arch space/tooth size discrepancy. 1' ^ Mandibular permanent first molars have a mesiocclusal eruption pattern, guided by the distal surface of the primary second molar. If the primary second molar is lost prematurely, the permanent first molar may erupt in a more anterior position. The distal shoe space maintainer remains an acceptable standard of care, with an extension subgingivally to a location mesial to the unerupted first permanent molar.' This extension serves as a guide for the erupting first molar, and prevents mesial "drifting" of that tooth. Upon eruption of the permanent first molar, the subgingival extension is removed; bacteria might adhere to the extension. The next problem is that a lower lingual holding arch cannot be placed until the mandibular permanent central and lateral incisors have erupted. Often, a distal band/crown and loop space maintainer is placed, extending from the primary first molar to the permanent first molar, but this option creates the need for a new appliance. The only other option is to leave the distal shoe in place until the mandibular permanent central and lateral incisors have erupted, but the subgingival extension is undesirable. The purpose of this article is to present a modified distal shoe design. The appliance can be adjusted easily, intraorally, to maintain space following eruption of the permanent first molar, until all of the mandibular permanent incisors have erupted. Procedure
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We placed an MOD preparation in each of 12 permanent molars, then restored each tooth with a posterior composite resin by means of six different application techniques (I-polymerization as one complete unit; II-polymerization as one... more
We placed an MOD preparation in each of 12 permanent molars, then restored each tooth with a posterior composite resin by means of six different application techniques (I-polymerization as one complete unit; II-polymerization as one complete unit with glass inserts; IIIpolymerization in gingivo-occlusal increments; IV-polymerization in gingivo-occlusal increments with glass inserts; V-polymerization in bucco-lingual increments; and VI-polymerization in a gingival increment with glass inserts, then bucco-lingual increments). A precision strain gauge was attached to the buccal surface of each tooth and balanced at zero. After each increment was polymerized, the strain appearing on the strain gauge indicator was recorded. Each tooth was restored by use of all techniques; two teeth started with each technique. Results demonstrated the average microstrain units to be 127-1, 102-11, 105-III, 86-IV, 72-V, and 66-VI. A randomized block design was the format used for data evaluation. Scheffé's Test indicated that composite resin placement and polymerization in bucco-lingual increments (V) created significantly less cuspal deflection than polymerization as one complete unit, with or without glass inserts (I and II), p&lt;0.001, and gingivo-occlusal increments (III), p&lt;0.05. Placement and polymerization in a gingival increment with glass inserts, then bucco-lingual increments (VI), also created significantly less internal deflection than polymerization as one complete unit, with or without glass inserts (I and II), p&lt;0.001, and gingivo-occlusal increments (III), p &lt; 0_ 005.
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The authors retrospectively evaluated the clinical performance of one resin-modified glass ionomer cement as a restorative material in Class I, Class II, Class III and Class V restorations in primary teeth. A total of 306 patients who had... more
The authors retrospectively evaluated the clinical performance of one resin-modified glass ionomer cement as a restorative material in Class I, Class II, Class III and Class V restorations in primary teeth. A total of 306 patients who had received a total of 864 resin-modified glass ionomer restorations, which had been in their mouths for a minimum of three years, were included in this evaluation. The authors assessed the clinical observations recorded in patients&#39; records and used bitewing radiographs to assess Class II restorations. The authors found an overall restoration success rate of 93.0 percent, with Class I restorations having a 92.6 percent success rate, Class II restorations having a 93.3 percent success rate, Class III restorations having a 100 percent success rate, and Class V restorations having a 98.0 percent success rate. The resin-modified glass ionomer cement functioned well as a Class I, Class II, Class III and Class V restorative material in primary teeth. Resin-modified glass ionomer restorative cement is a durable and reliable material to use for Class I, Class II, Class III and Class V restorations in primary teeth. Therefore, dentists have a proven alternative to silver amalgam and resin-based composite for primary tooth restoration.
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Hidden caries is the term used to describe carious lesions that are not visualized clinically on erupted teeth but can be detected radiographically. The exact etiology remains an area of controversy. The purpose of the current case report... more
Hidden caries is the term used to describe carious lesions that are not visualized clinically on erupted teeth but can be detected radiographically. The exact etiology remains an area of controversy. The purpose of the current case report was to discuss the diagnosis and treatment of two mandibular premolars with hidden caries. After diagnosis was established, both premolars were treated with indirect pulp caps and resin-based composite restorations. A one year follow up appointment revealed both teeth to be free from signs and symptoms of inflammation.
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Early childhood caries (ECC) is one of the most prevalent diseases in children worldwide. ECC is driven by a dysbiotic state of oral microorganisms mainly caused by a sugar-rich diet. Additionally, poor oral hygiene or insufficient dental... more
Early childhood caries (ECC) is one of the most prevalent diseases in children worldwide. ECC is driven by a dysbiotic state of oral microorganisms mainly caused by a sugar-rich diet. Additionally, poor oral hygiene or insufficient dental plaque removal leads to the rapid progression of ECC. ECC leads not only to dental destruction and pain with children, but also affects the quality of life of the caregivers. Children with extensive ECC are at high risk to develop caries with the permanent dentition or will have other problems with speaking and/or eating. To prevent ECC, several strategies should be taken into account. Children should brush their teeth with toothpastes containing gentle ingredients, such as mild surfactants and agents showing antiadherent properties regarding oral microorganisms. Parents/caregivers have to help their children with brushing the teeth. Furthermore, remineralizing and nontoxic agents should be included into the toothpaste formulation. Two promising bi...
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This article presents a case report describing the indirect fabrication of composite resin crowns for the restoration of primary anterior teeth. A 3-year-old with a confirmed diagnosis of hypohidrotic ectodermal dysplasia was provided... more
This article presents a case report describing the indirect fabrication of composite resin crowns for the restoration of primary anterior teeth. A 3-year-old with a confirmed diagnosis of hypohidrotic ectodermal dysplasia was provided with composite resin crowns that were both esthetic and functional. The indirect method decreases clinical time, provides a durable restoration, and allows treatment of patients who lack the cooperative ability to endure prolonged direct bonding appointments. The indirect technique may be feasible for the restoration of carious teeth as well as the presented case.
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Generalidades. Los autores examinaron clinicamente dos materiales de restauracion para evaluar su eficacia en las restauraciones de clase II realizadas en los molares primarios, asi como su capacidad de inhibicion de la caries dental... more
Generalidades. Los autores examinaron clinicamente dos materiales de restauracion para evaluar su eficacia en las restauraciones de clase II realizadas en los molares primarios, asi como su capacidad de inhibicion de la caries dental recurrente. Metodos. Participaron en el estudio 40 pacientes que necesitaban la realizacion de dos restauraciones de clase II en los molares primarios. En cada paciente se llevo a cabo una restauracion de clase II con un cemento de ionomero de vidrio modificado con resina y otra con la utilizacion de amalgama. Los autores evaluaron las restauraciones en visitas de seguimiento a los 6 meses, al ano, a los 2 anos y a los 3 anos. Tras su caida, se recuperaron dientes con restauraciones experimentales y se examinaron al microscopio para demostrar la inhibicion de la desmineralizacion en los bordes de la restauracion. Resultados. Los resultados de la evaluacion clinica llevada a cabo no demostraron diferencias estadisticamente significativas entre las restau...
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Dentistry, Nephrology, Pediatrics, Evidence Based Medicine, Evidence Based Practice, and 15 moreAdolescent, Medicine, Periodontology, Clinical Practice, Humans, Child, Internal Medicine, Dental Caries, Antibiotic Prophylaxis, Periodontitis, Evidence based dentistry, GuideLine, Immune thrombocytopenia, Pit and Fissure Sealants, and Molar
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This study evaluated the caries inhibition of dentin primers with the addition of fluoride. Two standardized Class V preparations were placed in 20 molars, the gingival margin placed below the cementoenamel junction and the occlusal... more
This study evaluated the caries inhibition of dentin primers with the addition of fluoride. Two standardized Class V preparations were placed in 20 molars, the gingival margin placed below the cementoenamel junction and the occlusal margin placed in enamel. Two dentin primers (Syntac and ScotchPrep) were placed in equal numbers of 20 preparations, according to manufacturer's instructions. Ammonium fluoride (10% by weight) was then added to these primers and they were placed in the remaining 20 preparations, opposing the non-fluoridated primer of the same system. All teeth were then restored with a non-fluoridated resin composite. All teeth were subjected to an artificial caries challenge (pH 4.2) for 5 days. Sections of 100 microns were obtained, photographed under polarized light microscopy, then demineralized areas were quantitated by digitization. Results demonstrated the mean areas (mm2 +/- S.D.) demineralization at 0.25 mm, 0.5 mm and 1.0 mm from the restoration margin to be: Syntac/fluoride (1.44 +/- 0.49, 1.68 +/- 0.54, 3.72 +/- 0.74); Syntac (1.99 +/- 0.58, 1.50 +/- 0.35, 2.98 +/- 1.26); ScotchPrep/fluoride (1.23 +/- 0.68, 1.55 +/- 0.64, 3.08 +/- 1.16); ScotchPrep (1.90 +/- 0.83, 1.71 +/- .038, 3.36 +/- 0.62). A paired t-test indicated primers with fluoride to demonstrate significantly less demineralization 0.25 mm from the restoration margin (P < 0.07).
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Dental pit and fissure sealants have been shown to be effective in the prevention of dental caries. Currently, sealants are recommended to be placed on teeth that are considered to be &amp;amp;amp;amp;amp;amp;amp;amp;quot;at... more
Dental pit and fissure sealants have been shown to be effective in the prevention of dental caries. Currently, sealants are recommended to be placed on teeth that are considered to be &amp;amp;amp;amp;amp;amp;amp;amp;quot;at risk&amp;amp;amp;amp;amp;amp;amp;amp;quot; to develop caries, including teeth that present with incipient enamel lesions. This paper discusses the types of sealant materials available and the placement of the sealant, including appropriate tooth preparation, acid-etching, polymerization, and use of adhesives prior to sealant placement.
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PURPOSE To clinically evaluate the clinical success of a primary zirconia molar crown, compared with stainless steel crowns (SSCs). METHODS This randomized, controlled clinical trial was designed as a split-mouth study. 50 subjects... more
PURPOSE To clinically evaluate the clinical success of a primary zirconia molar crown, compared with stainless steel crowns (SSCs). METHODS This randomized, controlled clinical trial was designed as a split-mouth study. 50 subjects ranging in age from 3-7 years were recruited to provide a total of 50 paired teeth requiring primary molar crowns, each participant receiving a SSC and zirconia crown. Restorations were evaluated at 6-, 12-, 24-, and 36-month recall appointments examining the following criteria: gingival health, estimate of the degree crown was high in occlusion, surface roughness, staining on crown surface, wear of opposing arch tooth, color match, anatomic form, marginal integrity, marginal discoloration, proximal contact area, secondary caries at crown margin and parent/guardian satisfaction with crown appearance. RESULTS The 36-month follow up included 23 subjects (46%). 35 crowns (35%) were evaluated; of the 18 zirconia crowns and 17 SSCs, there were no failures at t...
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The purpose of this study was to evaluate the clinical success of a new primary zirconia molar crown compared with stainless steel crowns (SSCs). This randomized, controlled clinical trial was designed as a split-mouth study. Fifty three-... more
The purpose of this study was to evaluate the clinical success of a new primary zirconia molar crown compared with stainless steel crowns (SSCs). This randomized, controlled clinical trial was designed as a split-mouth study. Fifty three- to seven-year-old children were recruited to provide a total of 50 pairs of teeth requiring primary molar crowns, with each participant receiving a SSC and zirconia crown. Restorations were evaluated at six-month, 12-month, and 24-month recall appointments examining the following criteria: gingival health; estimate of extent the crown was high in occlusion; surface roughness; staining on crown surface; wear of opposing arch tooth; color match; anatomic form; marginal integrity; marginal discoloration; proximal contact area; secondary caries at crown margin; and parent/guardian satisfaction with crown appearance. The 24-month follow-up included 39 patients (78 percent). Seventy crowns (70 percent) were evaluated; of the 36 zirconia crowns and 34 SSC...
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The restoration of pulpally treated teeth is critical for the longitudinal success of maintaining the teeth within the oral cavity. There are a number of factors when choosing a restoration following pulp therapy such as the position of... more
The restoration of pulpally treated teeth is critical for the longitudinal success of maintaining the teeth within the oral cavity. There are a number of factors when choosing a restoration following pulp therapy such as the position of the tooth within the dental arch, which dictates the masticatory forces expected, as well as esthetics desired upon final restoration. The amount of tooth structure remaining after caries removal is important, and the clinician must remember that the clinical crown of the tooth becomes much more brittle after pulp therapy.
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Research Interests:
This study was designed to evaluate the amount of space loss (SL) caused by premature loss of primary second molars, determine whether the eruption status of permanent first molars is an important factor in the amount of SL, and evaluate... more
This study was designed to evaluate the amount of space loss (SL) caused by premature loss of primary second molars, determine whether the eruption status of permanent first molars is an important factor in the amount of SL, and evaluate the effectiveness of space maintainers (SMs) in SL prevention. SL associated with 100 prematurely extracted primary second molars was evaluated in 87 healthy patients. Teeth were divided into groups based on the use of SMs (36 with SM and 64 without SM). Bitewing and periapical radiographs taken before extraction and 6, 12, 24, 36, and 48 months after extraction were used to determine the amount of SL. Not every patient attended every recall appointment, so the sample size varied at different evaluation times. The most significant amount of SL occurred in the first 12 months after extraction. In patients who did not use an SM, at 6 months there was a mean SL of 2.12 mm (SD, 1.65 mm) and at 12 months there was a mean of 4.02 mm (SD, 1.65), with signi...
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Scientific Affairs convened a panel of experts to evaluate the collective evidence and develop evidence-based clinical recommendations on pit-andfissure sealants. This is the executive summary of the full report, “Evidence-Based Clinical... more
Scientific Affairs convened a panel of experts to evaluate the collective evidence and develop evidence-based clinical recommendations on pit-andfissure sealants. This is the executive summary of the full report, “Evidence-Based Clinical Recommendations for the Use of Pit-and-Fissure Sealants: A Report of the American Dental Association Council on Scientific Affairs,” which is published in the March 2008 issue of The Journal of the American Dental Association and which is available online at “jada.ada.org”. These recommendations regarding use of pit-andfissure sealants are provided as a resource to oral health care professionals. The purpose of this document is to provide a critical evaluation and summary of the relevant scientific evidence and to provide recommendations that will assist clinicians with their decisionmaking process. These recommendations are not a standard of care, but rather a useful tool that can be applied in making evidence-based decisions about sealant use. The recommendations should be integrated with the practitioner’s professional judgment and the individual patient’s needs and preferences.
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A randomized controlled clinical trial was conducted to compare two professional at-home tooth whitening systems in a teenage population. Informed consent and child assent were obtained from 60 teenagers aged 12-17 (mean age = 14.8).... more
A randomized controlled clinical trial was conducted to compare two professional at-home tooth whitening systems in a teenage population. Informed consent and child assent were obtained from 60 teenagers aged 12-17 (mean age = 14.8). After baseline measurements, subjects were randomized to one of two groups, using either 14% hydrogen peroxide whitening strips or 10% carbamide peroxide in a custom bleaching tray. Strips were used for 30 minutes twice daily, while the tray was worn overnight. Treatment took place for 14 days sequentially, first on the maxillary arch and then on the mandibular arch; all use was unsupervised. Efficacy was measured objectively by L*a*b* color change from digital images obtained at baseline and end of treatment, using combined color measures for both arches. Both professional whitening systems had significant (p < 0.0001) reductions in yellowness (Deltab*) and increased lightness (DeltaL*) after two weeks of treatment on each arch. At the end of treatment, Deltab* or DeltaL* did not differ significantly between the groups (p > 0.28). Tooth sensitivity and mild oral irritation represented the most common adverse events, with only one subject discontinuing treatment as a result. Teenagers who used either bleaching method for two weeks experienced significant tooth whitening without serious adverse events.
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Research Interests:
Dentistry, Medicine, Safety, Periodontology, Humans, and 15 morePlacebos, Drug Delivery Systems, Aged, Middle Aged, Anti-Bacterial Agents, Topical Drug Administration, Adult, Oral Hygiene, Doxycycline, Periodontitis, Polyesters, Biocompatible Materials, Scaling and Root Planing, Dental Scaling, and Periodontal Pocket
This study's purpose was to evaluate what is currently being taught in graduate pediatric dental programs regarding the human papillomavirus (HPV), the HPV vaccine, and risk factors associated with oropharyngeal cancer (OPC). A... more
This study's purpose was to evaluate what is currently being taught in graduate pediatric dental programs regarding the human papillomavirus (HPV), the HPV vaccine, and risk factors associated with oropharyngeal cancer (OPC). A 42-question survey was administered via paper-and-pen survey instrument to attendees at the 2016 American Academy of Pediatric Dentistry (AAPD) annual meeting for graduate and associate program directors. The survey included questions evaluating attitudes/beliefs toward the HPV vaccine and current training in graduate pediatric dentistry programs and aimed to define whether the directors believe that the discussion of HPV vaccination and associated risk factors was within the scope of practice for pediatric dentists. Sixty-four of 71 attendees completed the survey; 77 percent of respondents believe they should be discussing the HPV vaccine with patients/parents. Increased age of respondent was correlated with the idea of discussion of sexual health and it...
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BACKGROUND National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly onefourth of children and over one-half of adolescents experienced dental caries in their permanent teeth. The purpose... more
BACKGROUND National Health and Nutrition Examination Survey 2011-2012 data indicated that, in the United States, nearly onefourth of children and over one-half of adolescents experienced dental caries in their permanent teeth. The purpose of this review was to summarize the available clinical evidence regarding the effect of dental sealants for the prevention and management of pit-and-fissure occlusal carious lesions in primary and permanent molars, compared with a control without sealants, with fluoride varnishes, or with other head-to head comparisons. TYPE OF STUDIES REVIEWED The authors included parallel and split-mouth randomized controlled trials that included at least 2 years of follow-up, which they identified using MEDLINE (via PubMed), Embase, LILACS, the Cochrane Central Register of Controlled Trials, and registers of ongoing trials. Pairs of reviewers independently conducted the selection of studies, data extraction, risk of bias assessments, and quality of the evidence ...
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Research Interests:
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Recurrent caries is still considered the main reason restorations need to be replaced. There are different materials available now that promise to reduce the possibility of recurrent caries by releasing fluoride and inhibiting restoration... more
Recurrent caries is still considered the main reason restorations need to be replaced. There are different materials available now that promise to reduce the possibility of recurrent caries by releasing fluoride and inhibiting restoration marginal caries. The purpose of this in vitro study was to evaluate the demineralization inhibition potential of a non-fluoride-releasing resin (Z100TM 3M, St. Paul, MN, USA) and a glass containing resin-based composite (Tetric EvoCeram Bulk Fill, Ivoclar/Vivadent AG, Schaan, Liechtenstein), which contains fluoride. Class V preparations were placed on 22 premolars; the gingival margin was below the cementoenamel junction and the occlusal margin was placed above the cemento-enamel junction. Ten teeth were randomly selected to be restored with Z100 while the other 10 were restored with Tetric EvoCeram Bulk Fill. Both groups were restored following manufacturer’s instructions. All teeth had an acid resistant varnish placed within one millimeter of the...
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Dentin sialoprotein (DSP) is a dentin extracellular matrix protein. It is involved in dental mesenchymal cell lineages and dentin formation through regulation of its target gene expression. DSP mutations cause dentin genetic diseases.... more
Dentin sialoprotein (DSP) is a dentin extracellular matrix protein. It is involved in dental mesenchymal cell lineages and dentin formation through regulation of its target gene expression. DSP mutations cause dentin genetic diseases. However, mechanisms of DSP in controlling dental mesenchymal cell differentiation are unknown. Using DSP as bait, we screened a protein library from mouse odontoblastic cells and found that DSP is a ligand and binds to cell surface receptor, occludin. Further study identified that the C-terminal DSP domain(aa 363-458) interacts with the occludin extracellular loop 2(aa 194-241). The C-terminal DSP domain induced phosphorylation of occludin Ser(490) and focal adhesion kinase (FAK) Ser(722) and Tyr(576). Coexpression of DSP, occludin and FAK was detected in dental mesenchymal cells during tooth development. Occludin physically interacts with FAK, and occludin and FAK phosphorylation can be blocked by DSP and occludin antibodies. This DSP domain facilitat...