Friday, January 30, 2015

Tooth bleaching with hydrogen peroxide and nano-hydroxyapatite: a 9-month follow-up randomized clinical trial.

Int J Dent Hygiene DOI: 10.1111/idh.12123 Vano M, Derchi G, Barone A, Genovesi A, Covani U. Tooth bleaching with hydrogen peroxide and nano-hydroxyapatite: a 9-month follow-up randomized clinical trial.

Abstract

Objectives

The aim of this study was to compare the amount of tooth colour change, rebound rate and tooth sensitivity in patients submitted to a bleaching technique with 6% hydrogen peroxide (HP) with or without 2% nano-hydroxyapatite (n-HA).

Methods

Sixty subjects were included in this examiner-blinded, randomized clinical trial using a 6% HP gel with or without 2% n-HA. Tooth colour and tooth sensitivity were analysed before and after treatment. All data were analysed statistically.

Results

After bleaching, both treatments demonstrated significant improvements in tooth shade (P < 0.05 for both groups). At the 9-month recall, tooth shade remained significantly lighter than at baseline (P < 0.05 for both groups). However, a relapse of the tooth shade was observed compared with the immediate post-bleaching result (P < 0.05). 6% HP with 2% n-HA produced significantly lower sensitivity (P < 0.05) than the bleaching product without n-HA. Colour change evaluation resulted in no difference between the two groups.

Conclusion

Both treatments demonstrated significant improvements in tooth shade. The bleaching effectiveness of the tested products was comparable. The use of 6% HP with 2% n-HA reduced the incidence of sensitivity during the bleaching treatment compared to a bleaching agent that did not contain n-HA.

Thursday, January 29, 2015

PeriRx, LLC Kicks-Off 2015 with Debut at Yankee Dental Congress

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Company will Feature its SaliMark™ OSCC Salivary Test for Oral Cancer,
Present a Free CE Course on Oral Cancer Risk Assessment,
and Participate in Dr. Paul Feuerstein’s “High-Tech Playground”

Broomall, PA – January 20  2015 – PeriRx LLC, a premier developer of breakthrough, non-invasive, oral diagnostic technology, will kick-off 2015 with its first-time participation at the first major dental meeting of the year; The Yankee Dental Congress in Boston.  The company will be exhibiting at booth #1746 from January 29th to January 31st  

“We’re very excited to start the year strong at the Yankee Dental Congress,” said Stephen M. Swanick, CEO and founder of PeriRx, LLC. “The new year represents a fresh start and a time to consider making progressive and positive changes. We strongly believe this applies to raising the bar on how we detect oral cancer, the sixth most prevalent form of cancer in the United States with more than 43,000 newly-diagnosed cases per year.” 1
The mortality rate for oral cancer is alarmingly high, with more than 8,000 deaths every year which equates to 1 person dying every hour, 24 hours per day.2 “Earlier detection via molecular DNA testing can reverse these statistics,” added Swanick.
More than a decade of National Institute of Dental and Craniofacial Research and National Institute of Health- supported research make SaliMark™ OSCC the world’s most scientifically-validated molecular DNA biomarker test for oral squamous cell carcinoma.
PeriRx will employ several ways to inform Yankee Dental Congress attendees about SaliMark™ OSCC, which is scheduled to ship via several national dental distributors before the end of Q1.
In addition to exhibiting at booth #1746, PeriRx will be introducing SaliMark™ OSCC in the following ways:
·       Free CE Course: "Oral Cancer Risk Assessment: Ready for Primetime" (course code 215TL) will provide 2 CE credits and will be presented by PeriRx Chief Medical Officer Jack Martin, MD on Thursday, 1/29/15 from 2:00 PM – 4:00 PM in Room #260

·       Free SaliMark OSCC Test Kit: Any dental practice owner who pre-registers and creates a PeriRx online ordering account, will receive one free SaliMark™ test Kit in order to get familiar with the test, the protocol, and the lab results. Simply visit http://perirxsecure.com/register.php to register your practice and set up an account. 

·      Dr. Paul Feuerstein’s High-Tech Playground: Every year at Yankee, leading dental technology expert Dr. Paul Feuerstein assembles the latest dental equipment and technology in an informal, no pressure setting right on the exhibit hall floor (Booth # 444). PeriRx will be proudly participating during the following times:

o   Thursday, 1/29/15: Tabletop 2:00 PM - 4:00 PM with 10-minute presentation at 2:30 PM
o   Saturday, 1/31/15: Tabletop 10:00 AM -12:30 PM with 10-minute presentation at 10:00 AM
For more information about PeriRx, LLC or its SaliMark™ OSCC salivary test for oral cancer, visit www.PeriRx.com, call 610-544-3500 or send an email to info@PeriRx.com.
References 1 & 2 : National Cancer Institute. SEER Stat Fact Sheets: Oral Cavity and Pharynx Cancer. Bethesda, MD: National Cancer Institute; 2012. Accessed at http://seer.cancer.gov/statfacts/html/oralcav.html. Archived by WebCite® at http://www.webcitation.org/6Rbi0VGeW)

About SaliMark™ OSCC
Development of this simple-to-use, painless and noninvasive test was based on the strong scientific foundation of NIH-funded research with initial discovery and pre-validation work conducted by Dr. David Wong of the University of California at Los Angeles. The SaliMark OSCC test also has the distinction of being the first of its kind assay in the world to aid in the identification and early detection of oral lesions at the highest risk for cancer.  Recently, the SaliMark OSCC test underwent a PRoBE (prospective-specimen-collection, retrospective-blinded-evaluation) design study which is the most rigorous biomarker validation available. In addition, PeriRx successfully completed a validation of the mRNA markers at the University of Michigan, Michigan State University and the St. Johns Providence Health System in Detroit.
About PeriRx LLC:

Based in Broomall, Pennsylvania, PeriRx LLC is a premier developer of breakthrough, non- invasive oral diagnostic technology that will help clinical professionals detect and treat diseases
sooner and enhance the practice of wellness management.  
The company was founded in 2008 to explore, innovate, and develop novel therapeutics or devices focused on the oral inflammatory/systemic connection. The PeriRx executive team consists of CEO and founder Stephen M. Swanick, an entrepreneur and experienced drug and device development professional; Dr. Neil Gottehrer, a practicing dentist; and Dr. Jack Martin, a cardiologist.
PeriRx obtained its patented and patent-pending technologies from inventor Dr. David Wong’s firm RNAmeTRIX and the Regents of the University of California at Los Angeles. PeriRx and RNAmeTrix have ongoing agreements which ensure the continuing research and development necessary to advance product development from clinical trial, through regulatory approval, and into commercialization.
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Wednesday, January 28, 2015

ATLANTA, Jan. 27, 2015 /PRNewswire/ -- In its effort to continually innovate how dental professionals connect and create teams that excel, DentalPost, the dental industry's premier online and mobile job board, announces today it has launched a new Candidate Matching feature for its members. A first of its kind for the industry, the system uses sophisticated algorithms to match job seekers' skills and culture preferences with relevant job openings.
Using the Candidate Matching feature, dental offices can input job requirements, information about the office's culture, use of technology, values and more in order to find the best candidate for the open position. Candidates are matched based on skill set as well as work environment preferences, behavior style, personality traits and other attributes. The algorithm will score and rank each resume against the employer's specific criteria, significantly narrowing down the list of qualified candidates and shaving many hours off the hiring process. Additionally, members get ongoing updates of new candidates that may be a match for their office.
"Our goal has always been to help dental professionals be more effective and efficient. Using data to hire better is critical to the long-term effectiveness of the industry. If your office culture is healthy, it means happier teams and a more successful bottom line," says Tonya Lanthier, founder and CEO of DentalPost.  "Even though using our standard job board has worked well for our members, it requires a lot of mental calculations, note taking and reading, which, with up to 1,000 resumes to review, can become overwhelming for the employer. Our new Candidate Matching feature eliminates this 'needle in a haystack' search and allows employers to hire for culture, as well as for skills, saving time and ensuring a longer-term, more effective employee."
Members can take advantage of the DentalPost Candidate Matching feature for less than $360 per use.  For more information visit www.dentalpost.net.
About DentalPostBased in Atlanta, DentalPost is the dental industry's premier online and mobile job board. With more than 450,000 registered job seekers nationwide, DentalPost connects dental professionals with dental offices to help create dental teams that excel. DentalPost leads the industry in metric-based career matching including personality tests as well as values, skills and work culture assessments to assist in selecting the best match for each position.  For further information on DentalPost, download the app on Android and iOS or visit www.dentalpost.net

Tuesday, January 27, 2015

Internet Brands announced that it has acquired Seattle-based Sesame Communications

Best-in-Class, Cloud-Based Patient Engagement Solutions Firm a Valuable Addition to Internet Brands’ Rapidly Growing Health Portfolio
LOS ANGELES, CA–(Jan 26, 2015) – Internet Brands today announced that it has acquired Seattle-based Sesame Communications, a leading provider of cloud-based patient engagement and digital marketing solutions for the dental and orthodontic industries.
Founded in 1999, Sesame Communications is one of the fastest-growing technology companies in the United States. It serves thousands of dental and orthodontic practices with products and services that help them grow their practices.
Sesame Communications joins Internet Brands’ rapidly growing Health portfolio, which includes the Internet’s leading collection of web presence solution providers for health professionals. These include Officite, eDoctors, TherapySites, iMatrix, and Baystone Media.
“Sesame has built an incredibly nimble and innovative business that owns its category and has literally transformed the way dental practices do business,” said Bob Brisco, CEO of Internet Brands. “Sesame’s best-in-class products and services are a valuable addition to our Health portfolio.”
Differentiating Sesame Communications in its category is the company’s proprietary suite of patient engagement and communications solutions. These include patient scheduling and appointment reminder systems, online bill pay and financial reminders, and portals that allow patients to view their appointments and full online health histories. The company also offers traditional web presence services including website design, SEO, and social media support.
Sesame Communications will continue to operate from its Seattle headquarters following the acquisition. The company was represented by Cascadia Capital LLC in the transaction.
About Internet Brands
Headquartered in El Segundo, Calif., Internet Brands® is a fully integrated online media and software services organization focused on four high-value vertical categories: Automotive, Health, Legal and Home / Travel. The company’s award-winning consumer websites lead their categories and serve more than 100 million monthly visitors, while a full range of web presence offerings has established deep, long-term relationships with SMB and enterprise clients. Internet Brands’ powerful, propriety operating platform provides the flexibility and scalability to fuel the company’s continued growth. For more information, please visit www.internetbrands.com.
About Sesame Communications
Sesame Communications helps dental and orthodontic practices harness the power of the Internet to accelerate new patient acquisition and transform the patient experience. The company supports thousands of practices in their efforts to grow and increase profitability in the digital age. The Sesame 24-7 platform provides an end-to-end, HIPAA-compliant system tailored to the unique and specific needs of dentistry. An Inc. 500|5000 company and 4-time winner of the Pride “Best of Class” Technology Award, Sesame is recognized as one of the fastest growing technology companies in the United States. For more information about Sesame, visit www.sesamecommunications.com.
- See more at: http://www.sesamecommunications.com/news/internet-brands-acquires-sesame-communications/#sthash.xGVfmKUn.dpuf

Monday, January 26, 2015

NYU Researchers Develop New Assessment Tool to Combat Oral-Systemic Disease Across the Lifespan


The Interprofessional Oral Health Grant Team Challenges the Medical Profession to “Put the Mouth Back in the Head” in the American Journal of Public Health

Improving oral health is a leading population health goal; however, curricula preparing health professionals have a dearth of oral health content and clinical experiences. Funded by a grant from the Health Resources and Service Administration (HRSA), New York University College of Nursing’s (NYUCN) Teaching Oral-Systemic Health (TOSH) Program is working to build interprofessional oral health workforce capacity which addresses a significant public health issue, increases oral health care access, and improves oral–systemic health across the lifespan.

TOSH educators and clinicians have developed an educational and clinical innovation transitioning the traditional head, ears, eyes, nose, and throat (HEENT) examination to the addition of the teeth, gums, mucosa, tongue, and palate examination (HEENOT) for assessment, diagnosis, and treatment of oral–systemic health problems. They detail their findings in a paper, “Putting the Mouth Back in the Head: HEENT to HEENOT,” published in the American Journal of Public Health.

“At TOSH, we are challenging the medical profession, including nurses, nurse practitioners, midwives, physicians, and physician assistants to ‘Put the Mouth Back in the Head’ by transitioning from the traditional HEENT exam to the HEENOT exam,” said Dr. Judith Haber, Associate Dean for Graduate Programs and Principal Investigator for the TOSH Program. “Incorporating ‘O’ for oral cavity assessment, adds a comprehensive focus on the oral-systemic history and physical examination of the teeth, gums, mucosa, gums and palate.”

For the majority of primary care providers, the traditional HEENT exam excludes examination of the oral cavity, as well as omitting oral health and its linkages to overall health in the patients’ health history, physical examination, risk assessment and management plan. The HEENOT approach means that educators and clinicians cannot omit oral health from the history and physical examination performed by health professionals.

"The integration of the HEENOT approach in primary care is a simple and effective method to decrease oral health disparities by increasing interprofessional oral health workforce capacity,” said Dr. Erin Hartnett, TOSH Program Director. “The TOSH program, using the HEENOT approach, develops the nurse practitioner, midwifery and medical students' oral health knowledge and clinical practice skills to identify oral problems, educate patients about the links between oral health and their overall health and refer patients to dental providers.

The aim of the TOSH program is develop innovative simulation and “live” interprofessional clinical experiences that focus on oral-systemic health for nurse practitioner, midwifery, medical and dental students. The HEENOT paradigm shift has been a cornerstone of these unique collaborative experiences.

“The TOSH program has dramatically enhanced the interprofessional collaboration between the nurse practitioner, dental, and medical students,” said Dr. Ken Allen, Associate Chair and Clinical Associate Professor, Department of Cariology and Comprehensive Care at NYU College of Dentistry. “Working together, they have formed a unique bond while teaching and promoting the concept of including the oral examination as an integral part of every patient assessment, something that was often overlooked in the past."

The TOSH team notes the importance of using the HEENOT approach as an integral component of primary care:

--Early childhood caries (cavities) are the most common chronic disease of childhood in 5-17 year olds, 5 times more common than asthma

--Application of fluoride varnish can reduce the incidence of caries in children by up to 50%

--Oral cancer morbidity and mortality rates have not declined over the past 10 years, at least, in part, related to absent or inadequate oral exams

--Human papillomavirus (HPV) is associated with the recent rise in the incidence of oropharyngeal cancer

--Linkages between diabetes and periodontal disease are established

--Older adults taking multiple medications for chronic health problems often have xerostomia (dry mouth) increasing their risk for tooth decay and poor nutrition

The Health Resources and Service Administration (HRSA) recent report, Integrating Oral Health and Primary Care Practice, highlights the importance of the primary care workforce developing interprofessional oral health core competencies that increase consumer access to preventive oral health care from multiple non-dental professions including but not limited to physicians, nurses, nurse practitioners, midwives, physician assistants, and pharmacists.

“NYU Nursing’s innovative partnership with NYU’s College of Dentistry provided a unique opportunity for the TOSH Program to be a strong voice for advancing an interprofessional oral health agenda”, said Dr. Haber. “The exposure to interprofessional oral health HEENOT classroom, simulation, and clinical experiences was associated with increased dental–primary care referrals.”

With oral health becoming recognized as integral to the general health of populations across the life span, clinical education programs preparing the next generation of health professionals can rectify the dearth of oral health content and clinical experiences by adopting the HEENOT approach as a standard component of the curriculum.


About New York University College of Nursing

NYU College of Nursing is a global leader in nursing education, research, and practice. It offers a Bachelor of Science in Nursing, a Master of Science and Post-Master’s Certificate Programs, a Doctor of Philosophy in Research Theory and Development, and a Doctor of Nursing Practice degree. For more information, visit https://nursing.nyu.edu/

About New York University College of Dentistry

New York University College of Dentistry (NYUCD) is the third oldest and the largest dental school in the US, educating more than 8 percent of all dentists. NYUCD has a significant global reach and provides a level of national and international diversity among its students that is unmatched by any other dental school. http://www.nyu.edu/dental/

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Friday, January 23, 2015

Evaluation of a New Protocol for Removing Metal Retainers from Multirooted Teeth

Journal of Endodontics
Publication stage: In Press Corrected Proof

 

Abstract

Introduction

The aim of this study was to evaluate in vitro a new protocol for removing intraradicular retainers from multirooted teeth applying ultrasonic vibration.

Methods

Forty mandibular molars were endodontically treated to receive cast intraradicular retainers, which were distributed into the following 4 groups: group 1: control without a slot and without ultrasound, group 2: control with a slot and without ultrasound, group 3: ultrasonic vibration in the core without a slot, and group 4: ultrasonic vibration in the core with a slot. After the intraradicular retainers were cemented with zinc phosphate, ultrasonic vibration was applied for 1 minute. The test specimens were then submitted to the traction test in the universal testing machine at a speed of 1 mm/min. The maximum traction force required to remove the intraradicular retainer was recorded in newtons, and the data were statistically analyzed using analysis of variance and the Tukey-Kramer test (P < .05).

Results

The results showed statistically significant differences among the groups tested (group 1 = 234.34 N, group 2 = 201.67 N, group 3 = 139.57 N, and group 4 = 83.23 N). The lowest mean value of traction force recorded was when ultrasonic vibration was applied on the core with a slot.

Conclusions

Creating a slot in the core and the ultrasound application on all surfaces and inside the slot reduced the force required for removing intraradicular metal retainers from multirooted teeth cemented with zinc phosphate.


Thursday, January 22, 2015

Genotoxic potential of 10% and 16% Carbamide Peroxide in dental bleaching

Braz. oral res. vol.29 no.1 São Paulo  2015 Epub Jan 13, 2015
http://dx.doi.org/10.1590/1807-3107BOR-2015.vol29.0021 

Dental bleaching has become one of the most frequently requested esthetic treatments in dental offices. Despite the high clinical success observed with this procedure, some adverse effects have been reported, including a potential for developing premalignant lesions, root resorption and tooth sensitivity, especially when misused. The aim of this study was to evaluate the genotoxic response using a micronucleus (MN) assay, after the application of two concentrations of carbamide peroxide. Thirty-seven patients were divided into two groups and randomly received either a 10% carbamide peroxide (CP) (19) or a 16% carbamide peroxide (18) concentration for 21 days in individual dental trays. Gingival margin cells were collected immediately before the first use (baseline), and then 15 and 45 days after baseline. The cells were placed on a histological slide, stained by the Feulgen technique, and evaluated by an experienced blinded examiner. One thousand cells per slide were counted, and the MN rate was determined. The two groups were analyzed by the Wilcoxon rank-sum test and the Kruskal-Wallis equality-of-populations rank test. A slight increase in MN was observed for both groups, in comparison with the baseline, at 15 days. However, no difference was observed between the two groups (10% and 16%), at either 15 or 45 days (p = 0.90). When bleaching is not prolonged or not performed very frequently, bleaching agents containing carbamide peroxide alone will not cause mutagenic stress on gingival epithelial cells.

Wednesday, January 21, 2015

Comparison of Smear Layer Removal Using the Nd:YAG Laser, Ultrasound, ProTaper Universal System, and CanalBrush Methods: An In Vitro Study

Publication stage: In Press Corrected Proof

 

Abstract

Introduction

The aim of this study was to compare the efficacy of the Nd:YAG laser, ultrasound, the ProTaper Universal system (Dentsply Maillefer, Ballaigues, Switzerland), and the CanalBrush (Coltene Whaledent, Langenau, Germany) methods for the removal of the smear layer from the apical third of root canals.

Methods

Fifty distal root canals from extracted human mandibular first molars were instrumented up to ProTaper Universal F5 and divided randomly into 5 groups (n = 10) according to the following final irrigation agitation techniques: no agitation (control), ProTaper Universal file, ultrasound, CanalBrush, and Nd:YAG laser. Specimens were observed under a scanning electron microscope. The presence of the smear layer was evaluated using a 3-grade scoring system. The data were analyzed with Cohen kappa, Kruskal-Wallis, and Mann-Whitney U tests. A level of significance of .05 was adopted.

Results

The ultrasound group performed significantly better than the rest of the groups; 56.6% of the specimens revealed no smear layer, 44.4% showed the presence of a moderate smear layer, and no heavy smear layers were observed. In the Nd:YAG laser group, 30% of the specimens presented with no smear layer, 70% showed the presence of a moderate smear layer, and no heavy smear layers were observed. In contrast, a heavy smear layer was observed on the surfaces of the root canals in the CanalBrush (23.4%), ProTaper Universal (13.4%), and control (86.6%) groups. Statistically significant differences were observed (P < .05).

Conclusions

None of the agitation methods completely removed the smear layer. However, the ultrasound method performed significantly better followed by the Nd:YAG laser, the CanalBrush, and the ProTaper Universal system. Agitation of the irrigant improved smear layer removal in the apical third of the canal.


Tuesday, January 20, 2015

Evaluation of remineralizing potential of commercially available child formula dentifrices: An in vitro study





ORIGINAL ARTICLE



Year : 2015  |  Volume : 33  |  Issue : 1  |  Page : 28-34



Aim: The aim of this in vitro study is to evaluate the remineralizing potential of commercially available low fluoride child formula dentifrice on primary teeth. Materials and Methods: Total 30 primary teeth were placed in demineralizing solution for 96 hours to produce artificial carious lesions of approximately 100 μm depth, and then cut longitudinally into 30 sections of 100-150 μm thickness and randomly assigned to three groups. Sections were treated with dentifrices containing Colgate ® (anti tooth decay) 500 ppm NaF, Cheerio gel ® 458 ppm MFP and Vicco ® non-fluoridated dentifrice. Lesions were evaluated using polarized light microscopy. Results: Colgate ® (anti tooth decay) 500 ppm NaF sections exhibited a statistically significant decrease in lesion depth (P < 0.05, paired t-test), whereas those in Cheerio gel ® 458 ppm MFP showed a decrease in lesion depth but was not statistically significant. Vicco ® non-fluoridated dentifrice showed increase in lesion depth. Statistics: A paired t-test is used to evaluate pre- and post-treatment lesion depth measurements, and Newman-Keuls multiple post hoc procedures was carried out to compare pair-wise difference of pre- and post-treatment lesion depth. Conclusion: The Colgate ® (anti tooth decay) 500 ppm NaF dentifrice and Cheerio gel ® 458 ppm MFP demonstrated remineralization of carious lesions by virtue of decrease in lesion depth, whereas Vicco ® non-fluoridated dentifrice showed increase in lesion depth.

Monday, January 19, 2015

The use of prophylactic antibiotics prior to dental procedures in patients with prosthetic joints: Evidence-based clinical practice guideline for dental practitioners-a report of the American Dental Association Council on Scientific Affairs.

J Am Dent Assoc. 2015 Jan;146(1):11-16.e8. doi: 10.1016/j.adaj.2014.11.012. Epub 2014 Dec 18.

Abstract

BACKGROUND:

A panel of experts (the 2014 Panel) convened by the American Dental Association Council on Scientific Affairs developed an evidence-based clinical practice guideline (CPG) on the use of prophylactic antibiotics in patients with prosthetic joints who are undergoing dental procedures. This CPG is intended to clarify the "Prevention of Orthopaedic Implant Infection in Patients Undergoing Dental Procedures: Evidence-based Guideline and Evidence Report," which was developed and published by the American Academy of Orthopaedic Surgeons and the American Dental Association (the 2012 Panel).

TYPES OF STUDIES REVIEWED:

The 2014 Panel based the current CPG on literature search results and direct evidence contained in the comprehensive systematic review published by the 2012 Panel, as well as the results from an updated literature search. The 2014 Panel identified 4 case-control studies.

RESULTS:

The 2014 Panel judged that the current best evidence failed to demonstrate an association between dental procedures and prosthetic joint infection (PJI). The 2014 Panel also presented information about antibiotic resistance, adverse drug reactions, and costs associated with prescribing antibiotics for PJI prophylaxis.

PRACTICAL IMPLICATIONS AND CONCLUSIONS:

The 2014 Panel made the following clinical recommendation: In general, for patients with prosthetic joint implants, prophylactic antibiotics are not recommended prior to dental procedures to prevent prosthetic joint infection. The practitioner and patient should consider possible clinical circumstances that may suggest the presence of a significant medical risk in providing dental care without antibiotic prophylaxis, as well as the known risks of frequent or widespread antibiotic use. As part of the evidence-based approach to care, this clinical recommendation should be integrated with the practitioner's professional judgment and the patient's needs and preferences.

Friday, January 16, 2015

A practical approach to evidence-based dentistry: III: How to appraise and use an article about therapy.

J Am Dent Assoc. 2015 Jan;146(1):42-49.e1. doi: 10.1016/j.adaj.2014.11.010. Epub 2014 Dec 18.
Abstract

BACKGROUND AND OVERVIEW:

Dental practitioners spend most of their time administering treatments. To ensure that their clinical decisions are informed by the best available evidence, dental practitioners need to be skilled in critically appraising studies addressing therapy issues. Randomized controlled trials offer the optimal study design to inform decisions regarding therapy. The critical appraisal of randomized controlled trials involves assessing the risk of bias, results, and applicability. In this article, the authors present these concepts and provide guidance for this type of appraisal.

PRACTICAL IMPLICATIONS:

Dentists who wish to inform their clinical decisions regarding therapy and prevention questions can use these guidelines to decide what type of studies to search, define the specific question of interest to search efficiently for these studies, and critically appraise an article about therapy or prevention.

Thursday, January 15, 2015

Prospective evaluation of zirconia based tooth- and implant-supported fixed dental prostheses: 3-Year results

Journal of Dentistry 2015, 43 (1): 87-93
 
OBJECTIVES:
This prospective clinical study compared the performance of implant-retained (study group) and tooth-retained (control) zirconia based fixed dental prostheses (FDPs) with at least 4 units. The null-hypothesis stated that complication rates in both groups are equally distributed.

METHODS:
 The study included patients in need of one 4- to 6-unit implant- or tooth-retained FDP each. All patients were examined 2 weeks after insertion (baseline) and then at 6 month intervals up to 3 years. At follow-up all restorations were examined for framework fracture, chipping, marginal integrity, surface roughness and biological complications. Kaplan-Meier estimation was used for data analysis.

RESULTS:
  20 patients received tooth-retained and 7 patients implant-retained FDPs. The study was halted early when differences in chipping rates reached a statistically significant level. One FDP in the study group was lost due to implant abutment failure. FDP related chipping rates were 71% in the study group (mean observation time 32 months) and 15% in the control (mean observation time 34 months). Unit (abutment crown/pontic) related chipping rates were 32% in the study group and 6% in the control. Chipping rates differed statistically significant (log-rank test, p<.05). However, all ceramic defects could be corrected by grinding and polishing. No framework fracture was detected.

CONCLUSIONS:
Within the study limitations, survival rates seem satisfactorily in both implant- and tooth retained long-span zirconia based FDPs. However, implant-supported FDPs seem more susceptible to veneering ceramic chippings.

CLINICAL SIGNIFICANCE:
  The high chipping rates found in this study discourage the use of long-span implant-retained FDPs with zirconia frameworks. The study was registered in ClinicalTrials.gov with the ID Number NCT02220764.

Wednesday, January 14, 2015

Influence of CAD/CAM on the fit accuracy of implant-supported zirconia and cobalt-chromium fixed dental prostheses

Abstract

Statement of problem

Relatively little information is available on the accuracy of the abutment-implant interface in computer-aided design and computer-aided manufacturing (CAD/CAM)-fabricated zirconia and cobalt-chromium frameworks.

Purpose

The purpose of this study was to compare the fit accuracy of CAD/CAM-fabricated zirconia and cobalt-chromium frameworks and conventionally fabricated cobalt-chromium frameworks.

Material and methods

Four groups of 3-unit, implant-supported, screw-retained frameworks were fabricated to fit an in vitro model with 3 implants. Eight frameworks were fabricated with the CAD/CAM system: 4 in zirconia and 4 in cobalt-chromium. Another 8 were cast in cobalt-chromium with conventional casting, including 4 with premachined abutments and 4 with castable abutments. The vertical misfit at the implant-framework interface was measured with scanning electron microscopy when only 1 screw was tightened and when all screws were tightened. Data were analyzed with the Kruskal-Wallis and Mann-Whitney tests (α=.05).

Results

The mean vertical misfit values when all screws were tightened was 5.9 ±3.6 μm for CAD/CAM-fabricated zirconia, 1.2 ±2.2 μm for CAD/CAM-fabricated cobalt-chromium frameworks, 11.8 ±9.8 μm for conventionally fabricated cobalt-chromium frameworks with premachined abutments, and 12.9 ±11.0 μm for the conventionally fabricated frameworks with castable abutments; the Mann-Whitney test found significant differences (P<.05) among all frameworks, except between the conventionally fabricated frameworks (P=.619). No significant differences were found among the groups for passive fit gap measurements (P>.05).

Conclusions

When all of the screws were tightened, the CAD/CAM frameworks exhibited better fit accuracy compared with the conventionally fabricated frameworks. High levels of passive fit were achieved for the evaluated techniques.
Supported by Neodent and Laboratory LTN.

Tuesday, January 13, 2015

Rheumatoid Arthritis and Periodontal Disease: A Rheumatologist's Perspective


Abstract

Despite advances in our understanding of the inflammatory events that underlie rheumatoid arthritis (RA), which have led to targeted therapies that more effectively control the condition, the etiology of RA is not fully understood. With the discovery that serum antibodies to citrullinated peptides (ACPA) are highly specific for RA and that Porphyromonas gingivalis, the major pathogen responsible for periodontitis (PD), contains the enzyme responsible for the citrullination of peptides, a plausible explanation for observations of increased incidence and severity of PD in RA patients and an appreciation of pathogenic similarities between the two conditions has emerged. Studies of the effect of RA treatment on the severity of PD have been limited and conflicting, especially with respect to anti-TNF agents, but indicate the potential for IL-6 as a therapeutic target for both conditions. PD treatment appears to improve clinical and laboratory evidence of RA disease activity, and the response of RA to anti-TNF therapy is abrogated by the presence of PD. Thus, evaluation and treatment of PD can be recommended for all RA patients.

Monday, January 12, 2015

Brasseler USA® Updates Aluminum Bur Blocks with Silicone Inserts New Silicone Inserts Provide Superior Storage and Organization





SAVANNAH, GA (January 6, 2015) – Brasseler USA®, a leading manufacturer of quality instrumentation, is pleased to introduce an updated version of its standard aluminum bur block. Brasseler USA now offers aluminum bur blocks equipped with silicone inserts for optimum security and organization.

The newly added silicone inserts provide a number of benefits making custom rotary procedure organization efficient and easy. The burs rest within the silicone inserts inside the aluminum block providing enhanced instrument retention, securing the bur firmly in place to avoid common slip or fall-out incidents.  

The new and improved aluminum bur blocks with silicone inserts are available for both clinical and laboratory rotary procedure instruments. The bur blocks are available in a wide variety of colors making rotary procedure organization completely customizable for each unique individual practice requirement. 

Available in a wide variety of sizes and slot numbers, the updated aluminum bur blocks have a versatile layout design with silicone inserts ready to accept any size or shape bur. The bur blocks are fully autoclavable and are validated for both block and instrument sterility.   


Moreover, the updated aluminum bur blocks are completely customizable to include laser-etched clinician or practice name, procedure, bur numbers and silhouette. Users can simply match up shapes, colors, and/or customized laser-etched bur blocks to experience unprecedented rotary procedure organization for custom-made configuration of burs and diamonds.

For more information about Brasseler’s updated aluminum bur blocks, please visit www.BrasselerUSADental.com or call 800-841-4522.

About Brasseler USA®

Brasseler USA® is a leading ISO Certified healthcare company, providing quality instrumentation to healthcare professionals for use in restorative dentistry, endodontics, oral surgery and oral hygiene. Over the past 35 years, Brasseler USA
has developed a reputation as an innovative market leader in diamonds, carbides, polishers, endodontics, hand instruments and handpieces. Today, Brasseler USA offers the most comprehensive assortment of instruments and power systems under one brand in the world. For more information, please visit www.BrasselerUSA.com.    


Friday, January 09, 2015

Diagnostic accuracy of conventional and digital radiography for detecting misfit between the tooth and restoration in metal-restored teeth

Abstract

Statement of problem

Although the postprocessing of digital images with enhancement filters could lead to the presence of artifacts and result in false-positive diagnoses, no study has analyzed whether the use of digital radiographs and/or postprocessing of digital images interferes with the diagnosis of marginal adaptation in metal-restored teeth.

Purpose

The purpose of this study was to compare the diagnostic accuracy of conventional and digital radiographic images with and without filters for detecting a misfit between the tooth and restoration in metal-restored teeth.

Material and methods

Forty teeth with mesial-occlusal-distal inlays and 40 with complete crowns (each with a perfect fit, 20 with a 0.2-mm gap and 20 with a 0.4-mm gap) were imaged with conventional film and digital phosphor plate systems. Digital radiographs were exported as original images and with edge enhancement (high and low), inversion, and pseudo-3-dimensional filters. Four examiners assessed the presence of gaps by using a categorical scale (fit, misfit, cannot decide). Sensitivity, specificity, and overall accuracy were calculated for each variable. In addition, time spent scoring the images was recorded. A multivariate logistic regression was performed with accuracy as the dependent variable.

Results

Of the images, 6.2% received the score “cannot decide,” most of them with a high edge enhancement filter and in the crown group. A tendency for higher sensitivity (range 0.67-0.83), specificity (range 0.81-0.92), and accuracy (range 0.73-0.86) values was found in conventional and digital original images. Results of a logistic regression found that restoration type, gap size, and high enhancement and inversion filters had a statistically significant impact on accuracy (P<.05).

Conclusions

Original nonfiltered images should be used to assess teeth with metal restorations. High enhancement filters and image inversion should be avoided, especially when metal crowns are present.

Thursday, January 08, 2015

Brasseler USA® Expands its Feather Lite™ Family with New Intra-Oral Composite Polisher: the DiaComp™ Feather Lite™

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SAVANNAH, GA (January 5, 2015) – Brasseler USA®, a leading manufacturer of quality instrumentation, is pleased to expand its Feather Lite line of polishers with a new versatile intra-oral composite polisher, the DiaComp Feather Lite.   

The DiaComp Feather Lite is a simple two-step diamond infused polishing system that provides consistent and reliable results for the polishing of the widest variety of composite materials. The highly efficient DiaComp Feather Lite is extremely versatile and works well on all types of classic restorative composite materials as well as new hybrid composites.

The unique finger design and flexible spirals of the DiaComp Feather Lite create an esthetically pleasing enamel-like finish while respecting existing surface differentiation. In addition, the DiaComp Feather Lite delivers a quick high-shine luster on every surface including hard-to-reach locations such as the occlusion region, leaving behind a complete finished surface area.

The DiaComp Feather Lite works most efficiently at lower speed ranges (5,000-6,000 rpm) while using light pressure. After using the ET® Carbides and Diamonds to finish your composites, using Diacomp Feather Lite will maintain surface differentiation and restore a natural finish.

Using the DiaComp Feather Lite results in well-polished restorations that resist the formation of plaque, calculus and staining, are easily cleaned, minimize irritation of soft tissue, and considerably increase the durability and service life of the restoration. 

For more information about the DiaComp Feather Lite, please visit www.BrasselerUSADental.com or call 800-841-4522.

About Brasseler USA®

Brasseler USA® is a leading ISO Certified healthcare company, providing quality instrumentation to healthcare professionals for use in restorative dentistry, endodontics, oral surgery and oral hygiene. Over the past 35 years, Brasseler USA
has developed a reputation as an innovative market leader in diamonds, carbides, polishers, endodontics, hand instruments and handpieces. Today, Brasseler USA offers the most comprehensive assortment of instruments and power systems under one brand in the world. For more information, please visit www.BrasselerUSA.com.    

Wednesday, January 07, 2015

Henry Schein Expands Dental Equipment Product Offering With A-dec Line Of Dental Products

January 06, 2015
MELVILLE, N.Y., Jan. 6, 2015 /PRNewswire/ -- Henry Schein, Inc. (NASDAQ: HSIC), the world's largest provider of health care products and services to office-based dental, animal health and medical practitioners, announced today that effective second quarter of 2015, the Company will expand its dental equipment product offering and begin to distribute the entire line of A-dec dental equipment in North America.  A-dec is a leading manufacturer of dental chairs, delivery systems, and dental lights. 
Henry Schein's commitment to its dental customers has always been to provide the widest possible selection of products, equipment, and value-added services to create customized solutions that meet practice needs.  The addition of the A-dec product line, combined with products manufactured by Henry Schein's other valued equipment supplier partners, furthers this commitment by providing greater access to the broadest range of dental equipment. 
Henry Schein does not expect this to have a material impact on its 2015 financial results.
About A-dec Inc. As the world's leading manufacturer of dental chairs, delivery systems, and dental lights, A-dec provides reliable dental equipment solutions to better the lives of dentists and their patients worldwide.
The 50-acre A-dec campus in Newberg, Oregon, includes state-of-the-art manufacturing facilities and the A-dec Education Center dedicated to learning and discovery. A-dec facilities in the United Kingdom, Australia, and China help support an extensive network of authorized dealers in more than 100 countries worldwide.
About Henry Schein, Inc.Henry Schein, Inc. is the world's largest provider of health care products and services to office-based dental, animal health and medical practitioners.  The Company also serves dental laboratories, government and institutional health care clinics, and other alternate care sites.  A Fortune 500® Company and a member of the NASDAQ 100® Index, Henry Schein employs more than 17,000 Team Schein Members and serves more than 800,000 customers. The Company offers a comprehensive selection of products and services, including value-added solutions for operating efficient practices and delivering high-quality care.

Tuesday, January 06, 2015

A 15-month evaluation of bond failures of orthodontic brackets bonded with direct versus indirect bonding technique: a clinical trial

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Abstract

Background

The purpose of this clinical longitudinal study was to investigate the effectiveness of indirect bonding technique evaluating the number of bond failures which occurred during treatment.

Methods

Fifty-two patients were selected and divided into two groups: group A (33 patients) bonded with the direct technique and group B (19 patients) bonded with the indirect technique. The number and date of bracket failure were recorded for over 15 months. Moreover, also the effect of crowding level on bracket failures was calculated. Statistical analysis was performed by means of t-test, Kaplan-Meier survival estimates and chi-squared test.

Results

No statistically significant differences were found in the total bond failure rate between direct and indirect techniques, also when comparing the upper and lower arches. The only significant difference was found comparing the posterior segment of the lower arches, in which a higher percentage of detachments were recorded in group B, bonded with the indirect technique. Moreover, no significant differences between direct and indirect bonding were found when evaluating crowding level.

Conclusions

Orthodontic practitioners can safely use the indirect bonding technique, even in patients with severe crowding, because it does not influence the adhesive quality and the bracket survival rate.

Monday, January 05, 2015

Immediate vs. delayed loading in the posterior mandible: a split-mouth study with up to 15 years of follow-up

Romanos GE, Aydin E, Locher K, Nentwig G-H. Immediate vs. delayed loading in the posterior mandible: a split-mouth study with up to 15 years of follow-up. Clin. Oral Impl. Res. 00, 2014, 16 doi: 10.1111/clr.12542

 

Abstract

Purpose

The aim of this study was to evaluate the long-term clinical and radiographic outcomes of implants that were immediately loaded in a prospective, randomized, split-mouth clinical trial in the posterior mandible.

Materials and methods

Patients with alveolar ridges that were bilaterally edentulous distal to the canines were enrolled to participate. On one randomly selected side of each patient's jaw, three implants (control group) with platform switching and a progressive thread design were placed, allowed to heal for 3 months, uncovered, and loaded occlusally using resin-splinted crowns, which then were replaced 6 weeks later by final prostheses. Three additional implants (test group) of the same size and design were placed on the contralateral side of each patient in symmetrical locations. The test implants were connected to their final abutments immediately after placement and immediately loaded. Periodontal indices and bone loss were evaluated at regular intervals.

Results

After a mean loading period of 12.14 (±0.89) years for the test group and 12.40 (±0.89) years for controls, differences between the immediately and delayed loaded implants were not statistically significant (P > 0.05). The crestal bone loss was (mesial) 0.70 (±1.09) mm (test group) and 1.17 (±1.27) mm (control group) and the distal bone loss was 0.43 (±1.02) mm (test group) and 1.06 (±1.33) mm (control group) (P > 0.05). The maximum crestal bone loss was 3.12 mm for the test group and 3.78 mm for the controls after 10.125/10.397 years, respectively.

Conclusion

Immediate loading does not negatively influence the long-term prognosis of dental implants in the posterior mandible, improves the implant stability, and is associated with minimal crestal bone loss when platform switching and a one-abutment concept with a Morse-tapered connection are used.

Friday, January 02, 2015

Survival characteristics of composite restorations in primary teeth

Date: 31 Dec 2014

Abstract

Objectives

This retrospective study analyzed restoration survival of composite fillings in children with at high caries risk in relation to age, sex, operator, tooth type, filling extension, and material used.

Materials and methods

Among 667 children treated in 2004–2012 in a university setting without sedation or general anesthesia, 2388 composite fillings were included. Relevant data from regular recall intervals were retrieved from patients’ records. Either total-etch or a self-etch adhesive combined with flowable and/or (nano)hybrid composite was used. The Kaplan-Meier estimator and Cox proportional hazard analysis with backward elimination model were applied for survival analysis.

Results

For the observation period of 8 years (mean 1.7 years), the cumulative failure rate was 17.2 % with annual failure rates of 10.0 %. In 8.8 % of the cases, fillings failed due to secondary caries. In 8.3 % technical failure due to total filling loss, loosening, marginal gaps, or tooth fracture occurred. Tooth type, filling extension, age, operator, dental dam, and type of adhesive were significant for survival (p < 0.05).

Conclusions

Filling survival was comparably lower to composite restorations observed in prospective clinical studies on permanent teeth and other tooth-colored restoratives used in primary teeth. Due to the very high caries risk and young age of the population, frequent loss due to secondary caries was observed. With respect to the high caries risk, composite restorations can be used to treat carious primary teeth, though a strict caries prevention regimen should be followed to minimize restoration failure.

Clinical relevance

Filling loss of composites in the primary dentition is associated with secondary caries on the long term.