Thursday, July 31, 2014

Dental fear affects adolescent perception of interaction with dental staff

Jaakkola S, Lahti S, Räihä H, Saarinen M, Tolvanen M, Aromaa M, Sillanpää M, Suominen S, Mattila M-L, Rautava P. Dental fear affects adolescent perception of interaction with dental staff. Eur J Oral Sci 2014; 00: 000000. © 2014 Eur J Oral Sci
The main purpose of this study was to explore whether subjective perception of interaction with dental staff is associated with dental fear in a population-based sample of 18-yr-old adolescents (= 773). The interaction was measured using the Patient Dental Staff Interaction Questionnaire (PDSIQ), validated with exploratory and confirmatory factor analyses, which yielded the factors of ‘kind atmosphere and mutual communication’, ‘roughness’, ‘insecurity’, ‘trust and safety’, and ‘shame and guilt’. Dental fear was measured using the Modified Dental Anxiety Scale (MDAS). Gender and sense of coherence (SOC) were included as potential confounding variables. Adolescents with high dental fear more often perceived their interaction with dental staff negatively and more often felt insecure than others. This difference persisted after adjustment for gender and SOC. In conclusion, adolescents with high dental fear may perceive their interaction with dental staff more positively if the staff succeed in creating a positive, trusting, approving, and supportive atmosphere with kindness, calmness, and patience. The communication and interaction skills of dental staff may play a particularly important role when encountering highly fearful dental patients.

Wednesday, July 30, 2014

Fresh extraction socket: spontaneous healing vs. immediate implant placement

Discepoli N, Vignoletti F, Laino L, de Sanctis M, Muñoz F, Sanz M. Fresh extraction socket: spontaneous healing vs. immediate implant placement. Clin. Oral Impl. Res. 00, 2014, 16 doi: 10.1111/clr.12447




To evaluate the impact that immediate implant placement may have on bone remodelling in comparison with adjacent sockets left to heal spontaneously.

Materials and methods

In a beagle dog model (N = 16 dogs), mandibular premolars were extracted, and implants were placed in each distal socket (test) with the corresponding mesial site left to heal undisturbed (control). Healing was assessed measuring both the vertical distance between buccal and lingual crest (B'L') and the width of buccal and lingual walls at different levels. Five healing periods were evaluated. Differences between means for each variable and for each healing period between test and control were compared (Kruskal–Wallis test; Friedman test).


At 2 and 8 weeks of healing, the B'L' distance revealed significant higher values at test compared to control sites, being this difference three times higher at the end of the study (P < 0.05). In the test group, the width of the crest was reduced between baseline (0.37 [0.04]) and 8 weeks healing (0.13 [0.64]), demonstrating a 62% reduction of the initial width. These differences were not observed in the control group.


Immediate implant placement into fresh extraction sockets may jeopardize the vertical bone remodelling of the socket. Furthermore, a tendency towards greater buccal horizontal resorption was observed in the most coronal aspect of the buccal bone crest.

Tuesday, July 29, 2014

Gingival bleeding on probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse

Gonzalez S., Cohen C. L., Galván M., Alonaizan F. A., Rich S. K., Slots J. Gingival bleeding on probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse. J Periodont Res 2014; doi: 10.1111/jre.12219. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

Background and Objective

This study evaluated the potential of gingival bleeding on probing to serve as a predictor of future periodontal breakdown. It also assessed the ability of 0.25% sodium hypochlorite twice-a-week oral rinse to convert periodontal pockets showing bleeding on probing to nonbleeding sites.

Material and Methods

The study was performed as a randomized, single-blinded, clinical trial in parallel groups. Seven periodontitis patients rinsed twice-weekly for 3 mo with 15 mL of a fresh solution of 0.25% sodium hypochlorite, and five periodontitis patients rinsed with water. The 12 study patients received no subgingival or supragingival scaling. Clorox® Regular-Bleach was the source of sodium hypochlorite. At baseline and 3-mo visits, gingival bleeding was assessed within 30 s after probing to full pocket depth using an approximate force of 0.75 N.


A total of 470 (38%) of 1230 periodontal pockets in the bleach-rinse group revealed bleeding on probing at the initial visit but not at the 3-mo visit; only 71 (9%) of 828 pockets in the control group became bleeding-negative during the study (< 0.001). Bleeding on probing in 4- to 7-mm-deep pockets decreased by 53% in the bleach-rinse group but increased by 6% in the water-rinse group (< 0.001). Ninety-seven pockets showed depth increases of ≥ 2 mm after 3 mo: 60 (62%) of those pockets exhibited bleeding on probing at both the initial and the 3-mo visits; 24 (25%) bled at only one of the two visits; and 13 (13%) never demonstrated gingival bleeding (< 0.001).


Persistent gingival bleeding on probing was associated with an increased risk for periodontal breakdown, and the absence of gingival bleeding seemed to be a useful, although not perfect, indicator of disease stability. Twice-weekly oral rinsing with dilute bleach (0.25% sodium hypochlorite) produced a significant reduction in bleeding on probing, even in deep unscaled pockets. Sodium hypochlorite constitutes a valuable antiseptic in periodontal self-care.

Monday, July 28, 2014

Cost estimation of single-implant treatment in the periodontally healthy patient after 16–22 years of follow-up

Dierens M, Vandeweghe S, Kisch J, Nilner K, Cosyn J, De Bruyn H. Cost estimation of single-implant treatment in the periodontally healthy patient after 16–22 years of follow-up. Clin. Oral Impl. Res. 00, 2014; 19.



Costs for single-implant treatment are mostly described for the initial treatment. Information on the additional cost related to aftercare is scarce.


To make an estimation of complication costs of single implants in periodontally healthy patients after 16–22 years and to compare costs for various prosthetic designs.

Materials and methods

Patients with a single implant were recalled for a clinical examination and file investigation. Prosthetic designs included single-tooth (ST) and CeraOne (CO) abutments supporting a porcelain-fused-to-metal (PFM), all-ceramic (CER), or gold-acrylic (ACR) crown. Costs related to failures or technical, biologic, and aesthetic complications were retrieved from patient's records. Total and yearly additional complication costs were calculated as a percentage relative to the initial cost. Chair time needed to solve the complication was recorded and prosthetic designs were compared by Kruskal–Wallis tests.


Fifty patients with 59 surviving implants were clinically investigated. Additional complication costs after a mean follow-up of 18.5 years amounted to 23% (range 0–110%) of the initial treatment cost. In total, 39% of implants presented with no costs, whereas 22% and 8% encountered additional costs over 50% and 75%, respectively. In 2%, the complication costs exceeded the initial cost. The mean yearly additional cost was 1.2% (range 0–6%) and mean complication time per implant was 67 min (range 0–345 min). Differences between prosthetic designs (CO, ST-PFM, ST-ACR) were statistically significant for total cost (P = 0.011), yearly cost (P = 0.023), and time (P = 0.023). Pairwise comparison revealed significant lower costs for CO compared with ST-ACR reconstructions.


Patients should be informed about additional costs related to complications with single implants. The mean additional cost spent on complications was almost one-quarter of the initial treatment price. A majority of implants presented with lower additional costs, whereas the highest complication costs were related to a smaller group with 22% of the implants needing more than half of the initial cost for complication management. Expenses were significantly different for various prosthetic designs.

Friday, July 25, 2014

Accelerated, continuous, 17-month, Associate in Applied Science (AAS) degree in dental hygiene.

NYU College of Dentistry Launches 17-Month Fast-Track AAS Degree in Dental Hygiene--First of its Kind in NYS
Fast-Track Students to Learn in Integrated, State-of-the Art Clinical Settings Alongside NYU Dental Students and Faculty
New York University College of Dentistry (NYUCD) is pleased to announce that, effective January 2015, it will offer an accelerated, continuous, 17-month, Associate in Applied Science (AAS) degree in dental hygiene.

The Fast-Track AAS degree program, the first of its kind in New York State, is designed specifically to enable highly-motivated students to gain access to the same innovative, high quality education as that offered by the traditional two-to-three year course of study, but in a more concentrated period.

US News and World Report
ranks dental hygiene in the top 10 on their list of Best Jobs of 2014. Dental hygienists make yearly starting salaries of more than $70,000, and the prediction is for 33.3 percent employment growth in this field within the next decade.

“The new Fast-Track program addresses the readiness of high school graduates -- and those who already hold college degrees but desire to change careers -- to enter one of the most personally fulfilling and professionally rewarding health professions within the shortest possible time,” said Dr. Cheryl Westphal Theile, assistant dean for allied health programs at NYUCD. “As key members of the healthcare team, dental hygienists work together with dentists to meet the oral health needs of patients and thereby improve patients’ quality of life.”

NYU offers the only dental hygiene programs housed within a dental college in New York State. This gives Fast-Track students the opportunity to learn in integrated clinical settings alongside NYU dental students, as well as with NYU faculty members from dental hygiene, dentistry, and dental specialty areas (orthodontics, periodontics, prosthodontics, implant dentistry, pediatric dentistry, and oral surgery) in state-of-the-art facilities that attract the largest, most diverse patient population in the nation. Community-based rotations further enable students to gain valuable clinical experience while helping to educate patients about the importance of oral health and promoting a lifetime of good health habits.

Graduates of the program are qualified to take the clinical board examinations and the dental hygiene national boards, which are requirements for state licensure. The NYU Fast-Track dental hygiene program is fully accredited by the American Dental Association Commission on Dental Accreditation for Dental Hygiene Education Programs.

Professional opportunities following graduation include clinical practice, public health careers, research, and health-care management. Financial aid is available.

The Fast-Track AAS Program is currently accepting applications for January 2015. The deadline for submission of applications is November 1, 2014. For more information and to apply, please go to and click on “Application Process.”
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.


Thursday, July 24, 2014 wins Pride Institute Best of Class Award

July 20th, 2014 - Fort Collins, Colorado - has received the Pride Institute’s “Best of Class” Technology Award - now in its sixth year. “This honor is not taken lightly by us at”, said Jason Laurie, Chief Operations Officer.  “Our goal is to provide the dental community with the highest quality TV programming for their practices.”

The “Best of Class” founder, Lou Shuman, DMD, CAGS, stated that “The foundation for our success is, and has always been, our formula: technology leadership in dentistry, unbiased, and not for profit. The commitment of the distinguished panel and our partners at the American Dental Association help us maintain the integrity that creates true value.”

Laurie goes on to explain, With, you have the power of your own personal internet television station at your fingertips!” blends entertainment, internal and external marketing, and patient education into a broadcast that runs on a Google TV or Smart TV. lets dental practices outfit reception rooms and operatories with professional industry content  that is constantly updated with short videos, news, weather, traffic alerts, social media and interactive trivia. Unlike traditional television, users can interact with the broadcast through’s mobile app, which allows them to customize video playlists, share videos over social networks, and play interactive trivia games to win prizes.”

“It's possible to have TellCast.TV in a dental practice for free,” said Laurie, “and for a small monthly fee, each practice can add on screen marketing and education.” 

For more information on TellCast.TV, log on, send an email to info@Tellcast.TV or call (888) 519-1142.



Wednesday, July 23, 2014

Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains – a clinical trial

Int J Dent Hygiene DOI: 10.1111/idh.12090 Patil PA, Ankola AV, Hebbal MI, Patil AC. Comparison of effectiveness of abrasive and enzymatic action of whitening toothpastes in removal of extrinsic stains – a clinical trial.



To compare the effectiveness of abrasive component (perlite/calcium carbonate) and enzymatic component (papain and bromelain) of whitening toothpaste in removal of extrinsic stains.


This study is a randomized, triple blind and parallel group study in which 90 subjects aged 18–40 years were included. At baseline, stains scores were assessed by Macpherson's modification of Lobene Stain Index and subjects were randomly assigned to two groups with 45 subjects in each. Group 1 used whitening toothpaste with enzymatic action and group 2 with abrasive action. After 1 month, stain scores were assessed for the effectiveness of the two toothpastes and 2 months later to check the stain prevention efficacy. Wilcoxson's test was used to compare between baseline 1 and 2 months stain scores, and Mann–Witney U-test was applied for intragroup comparison.


The mean baseline total stain score for the subjects allocated to the enzymatic toothpaste was 37.24 ± 2.11 which reduced to 30.77 ± 2.48 in 1 month, and for the abrasive paste, total stain reduced from 35.08 ± 2.96 to 32.89 ± 1.95. The reductions in total stain scores with both the pastes were significant compared with baseline stain scores (at 1 month Group 1, P = 0.0233 and Group 2, P = 0.0324; at 2 months, Group 1 P = 0.0356). Both the toothpastes proved to be equally good in removal of extrinsic stains; however, the enzymatic paste showed better results as compared to abrasive toothpaste.


Whitening toothpaste with abrasive action and enzymatic action are equally effective in removal of extrinsic stains; however, whitening toothpaste with abrasive action needs to be used with caution.

Monday, July 21, 2014

Sesame Communications Wins Prestigious 2014 Pride “Best of Class” Technology Award

SEATTLE, WA — July 22, 2014 — Sesame Communications, the leading provider of cloud-based solutions to help dental care providers accelerate new patient acquisition and build patient loyalty, is pleased to announce it has received a 2014 Pride “Best of Class” Technology Award. This milestone marks an unprecedented 4th win for Sesame in the past 6 years. This year the company was once again recognized for innovations surrounding its Sesame 24-7™ digital marketing and patient communications system.
“The Pride Institute ‘Best of Class’ Technology Awards are determined by a distinguished panel of industry leaders who both speak nationally and actively see patients,” said, Dr. Lou Shuman, President of Pride Institute. “For Sesame Communications, this 4th award is a testament to their commitment to continuous innovation and contribution to advancing the state-of-the-art in the areas of digital marketing and patient communications for dentistry.”
In the past year Sesame 24-7, the dental industry’s only end-to-end digital marketing and patient engagement system, introduced two ground breaking innovations to help dental practices expand growth and profitability:
·       Healthgrades Enhanced Profiles™ for Dentistry – is the most trafficked health portal in the United States with more than 225 million annual visitors per year. Healthgrades Enhanced Profiles, which are only available in the field of dentistry from Sesame, give practices a distinct competitive advantage for new patient acquisition through automatic publishing of post appointment patient reviews, featured provider placement and front page positioning of contact information. Other features include a tracked phone number, a click to request an appointment link and a practice website link.
·       Mobile Optimized Responsive Design – The world has gone mobile and practices that want to attract and engage patients need to optimize all their patient engagement technologies to all devices including desktops, smartphones and tablets. All Sesame websites and Patient Portals feature responsive design and provide an outstanding user experience for existing and prospective patients.
Practices using Sesame 24-7 routinely experience increased new patient flow, reduced no-show rates, higher production, and increased profitability.
“As technology continues to play an ever-increasing role in practice success, the Pride ‘Best of Class’ Technology Awards help dental practices better understand which companies are on the forefront of innovation with an objective, informed assessment of the best technologies in the industry,” said Diana P. Friedman, CEO of Sesame Communications. “We’re honored to receive this prestigious award for an unprecedented 4th time and gratified the industry recognizes the substantial investments we continue to make in our state-of-the-art technology.”
About Sesame Communications
Sesame Communications helps dental care providers 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 and Deloitte Technology Fast 500™ company, Sesame is recognized as one of the fastest growing technology companies in the United States. For more information about Sesame, visit

The ‘Sharpen’ filter improves the radiographic detection of vertical root fractures

Nascimento HAR, Ramos ACA, Neves FS, de-Azevedo-Vaz SL, Freitas DQ. The ‘Sharpen’ filter improves the radiographic detection of vertical root fractures. International Endodontic Journal.



To compare the diagnostic accuracy of digital enhancement filters in the diagnosis of vertical root fractures.


The sample consisted of 40 single-rooted teeth randomly divided into two groups: experimental and control. Vertical root fractures were induced in the experimental group using a universal testing machine. All teeth were individually radiographed with three different horizontal angles using the Digora Optime® digital system. Three observers separately examined the original and filtered images (3D Emboss, Negative, Sharpen and Shadow). The area under Receiver Operating Characteristic curve values (Az) for each protocol were compared by one-way anova with post hoc Bonferroni test. The significance level was set at 5%.


The highest Az value was obtained using the Sharpen filter, with significant differences from the original and other filtered images (P < 0.05). The 3D Emboss filter had the lowest Az value, which was significantly different from the other filtered images (P < 0.05).


When using the Digora Optime® system, the ‘Sharpen’ filter is recommended to improve the radiographic detection of vertical root fractures.

Friday, July 18, 2014

Optimal number of oral implants for fixed reconstructions: A review of the literature.

Eur J Oral Implantol. 2014 Summer;7(2):133-53.


Background and aim: So far there is little evidence from randomised clinical trials (RCT) or systematic reviews on the preferred or best number of implants to be used for the support of a fixed prosthesis in the edentulous maxilla or mandible, and no consensus has been reached. Therefore, we reviewed articles published in the past 30 years that reported on treatment outcomes for implant-supported fixed prostheses, including survival of implants and survival of prostheses after a minimum observation period of 1 year. Material and methods: MEDLINE and EMBASE were searched to identify eligible studies. Short and long-term clinical studies were included with prospective and retrospective study designs to see if relevant information could be obtained on the number of implants related to the prosthetic technique. Articles reporting on implant placement combined with advanced surgical techniques such as sinus floor elevation (SFE) or extensive grafting were excluded. Two reviewers extracted the data independently. Results: A primary search was broken down to 222 articles. Out of these, 29 studies comprising 26 datasets fulfilled the inclusion criteria. From all studies, the number of planned and placed implants was available. With two exceptions, no RCTs were found, and these two studies did not compare different numbers of implants per prosthesis. Eight studies were retrospective; all the others were prospective. Fourteen studies calculated cumulative survival rates for 5 and more years. From these data, the average survival rate was between 90% and 100%. The analysis of the selected articles revealed a clear tendency to plan 4 to 6 implants per prosthesis. For supporting a cross-arch fixed prosthesis in the maxilla, the variation is slightly greater. Conclusions: In spite of a dispersion of results, similar outcomes are reported with regard to survival and number of implants per jaw. Since the 1990s, it was proven that there is no need to install as many implants as possible in the available jawbone. The overwhelming majority of articles dealing with standard surgical procedures to rehabilitate edentulous jaws uses 4 to 6 implants. Conflict of interest statement: The authors declare that they have no conflict of interest.

Thursday, July 17, 2014

Immediately loaded distally cantilevered fixed mandibular prostheses supported by four implants placed in both in fresh extraction and healed sites: 2-year results from a prospective study.

Eur J Oral Implantol. 2014 Summer;7(2):173-84.


Objectives: To evaluate the outcome of immediately loaded distally cantilevered mandibular full-arch prostheses according to the 'all-on-four' concept supported by implants placed in both fresh extraction and healed sites. Material and methods: A prospective study was conducted in 24 patients with extraction of all remaining mandibular teeth and placement of 4 implants per patient (2 mesial axial and 2 distal tilted) for full-arch mandibular restorations. Implants were inserted in fresh extraction sockets 2.3 ± 1.0 per patient and 1.7 ± 1.0 implants in healed sites. Implants placed in fresh extraction sites (n = 55) were significantly (P <0 -0.14="" -0.18="" -0.20="" -0.40="" -0.57="" .01="" 0.20="" 0.28="" 0.29="" 0.35="" 0.36="" 0.42="" 0.45="" 0.48="" 0.4="" 0.51="" 0.55="" 0.5="" 0.6="" 0.7="" 0.8="" 0.92="" 1-="" 1.00="" 1.17="" 1.21="" 10="" 12-and="" 12="" 15="" 18="" 1st="" 2-year="" 24-month="" 24="" 2nd="" 3="" 4.6="" 4.7="" 5="" a="" acrylic="" after="" all="" alveolar="" an="" and="" assessed="" assessment.="" at="" be="" between="" bleeding="" bone="" both="" but="" by="" calculus="" camlog="" can="" compared="" conclusion:="" conduct="" conflict="" crest:="" deeply="" definite="" dental="" depth="" differences="" efforts="" evaluated="" evaluation="" examinations="" extraction="" failed="" five="" fixed="" follow-up="" for="" foundation="" four="" fracture="" fractures="" framework.="" fresh="" from="" full-arch="" gerald="" gingival="" grant="" had="" healed="" high="" higher="" immediate="" immediately="" implant-supported="" implant="" implants="" in="" indices="" inserted="" interest="" into="" items="" krennmair="" later="" level="" limits="" loaded="" maintenance="" marginal="" metal="" mm="" months="" more="" n="41)" need="" no="" of="" p="" patient="" patients="" peri-implant="" placed="" plaque="" pocket="" post-extractive="" presented="" prof="" prostheses.="" prostheses="" prosthesis="" prosthodontic="" provisional="" rating="" rebased.="" received="" renewed="" repaired="" representing="" research.="" resin="" results:="" satisfaction.="" satisfaction="" score:="" score="" significantly="" simultaneously="" sites.="" sites="" st="" stable.="" statement:="" study="" subjective="" success="" supported="" teeth="" than="" the="" there="" this="" to="" veneered="" versus="" vs="" was="" were="" with="" within="" year:="" year="">

Wednesday, July 16, 2014

Pride Technology 2014 Award Winners

As a member of the the panel who helps select the award winners. I present to you the 2014 Pride Technology Award winners. Head on over to the DPR web site to see the list.

Tuesday, July 15, 2014

Prophylactic antibiotic regimen and dental implant failure: a meta-analysis

Chrcanovic, B. R., Albrektsson, T. and Wennerberg, A. (2014), Prophylactic antibiotic regimen and dental implant failure: a meta-analysis. Journal of Oral Rehabilitation. doi: 10.1111/joor.12211


The aim of this meta-analysis was to investigate whether there are any positive effects of prophylactic antibiotic regimen on implant failure rates and post-operative infection when performing dental implant treatment in healthy individuals. An electronic search without time or language restrictions was undertaken in March 2014. Eligibility criteria included clinical human studies, either randomised or not. The search strategy resulted in 14 publications. The I2 statistic was used to express the percentage of the total variation across studies due to heterogeneity. The inverse variance method was used with a fixed- or random-effects model, depending on the heterogeneity. The estimates of relative effect were expressed in risk ratio (RR) with 95% confidence interval. Six studies were judged to be at high risk of bias, whereas one study was considered at moderate risk, and six studies were considered at low risk of bias. The test for overall effect showed that the difference between the procedures (use versus non-use of antibiotics) significantly affected the implant failure rates (= 0·0002), with a RR of 0·55 (95% CI 0·41–0·75). The number needed to treat (NNT) to prevent one patient having an implant failure was 50 (95% CI 33–100). There were no apparent significant effects of prophylactic antibiotics on the occurrence of post-operative infections in healthy patients receiving implants (= 0·520). A sensitivity analysis did not reveal difference when studies judged as having high risk of bias were not considered. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.

Monday, July 14, 2014

In vitro assessment of artifacts induced by titanium, titanium–zirconium and zirconium dioxide implants in cone-beam computed tomography

Sancho-Puchades M, Hämmerle CHF, Benic GI. In vitro assessment of artifacts induced by titanium, titanium–zirconium and zirconium dioxide implants in cone-beam computed tomography. Clin. Oral Impl. Res. 00, 2014; 17. doi: 10.1111/clr.12438




The aim of this study was to test whether or not the intensity of artifacts around implants in cone-beam computed tomography (CBCT) differs between titanium, titanium–zirconium and zirconium dioxide implants.

Materials and methods

Twenty models of a human mandible, each containing one implant in the single-tooth gap position 45, were cast in dental stone. Five test models were produced for each of the following implant types: titanium 4.1 mm diameter (Ti4.1), titanium 3.3 mm diameter (Ti3.3), titanium–zirconium 3.3 mm diameter (TiZr3.3) and zirconium dioxide 3.5–4.5 mm diameter (ZrO3.5–4.5) implants. For control purposes, three models without implants were produced. Each model was scanned using a CBCT device. Gray values (GV) were recorded at eight circumferential positions around the implants at 0.5 mm, 1 mm and 2 mm from the implant surface (GVTest). GV were assessed in the corresponding volumes of interest (VOI) in the control models without implants (GVControl). Differences of gray values (ΔGV) between GVTest and GVControl were calculated as percentages. One-way ANOVA and post hoc tests were applied to detect differences between implant types.


Mean ΔGV for ZrO3.5–4.5 presented the highest absolute values, generally followed by TiZr3.3, Ti4.1 and Ti3.3 implants. The differences of ΔGV between ZrO3.5–4.5 and the remaining groups were statistically significant in the majority of the VOI (P ≤ 0.0167). ΔGV for TiZr3.3, Ti4.1 and Ti3.3 implants did not differ significantly in the most VOI. For all implant types, ΔGV showed positive values buccally, mesio-buccally, lingually and disto-lingually, whereas negative values were detected mesially and distally.


Zirconium dioxide implants generate significantly more artifacts as compared to titanium and titanium–zirconium implants. The intensity of artifacts around zirconium dioxide implants exhibited in average the threefold in comparison with titanium implants.

Friday, July 11, 2014

Accuracy of electronic apex locators in primary teeth: a meta-analysis

Ahmad IA, Pani SC. Accuracy of electronic apex locators in primary teeth: a meta-analysis. International Endodontic Journal.



To conduct a meta-analysis on the accuracy of electronic apex locators (EALs) in determining working length in human primary teeth.


An electronic literature search was conducted using a combination of the terms ‘primary teeth’, ‘root canal length’ and ‘electronic apex locators’. Additional eligible articles were identified using a manual search. The full texts of identified articles were screened according to inclusion criteria.


Overall, 19 studies met the inclusion criteria and were subjected to further data extraction. Meta-analysis of studies that reported mean lengths and difference in mean lengths between EAL and actual root canal length (ARCL) revealed a significant difference (P = 0.015) between the two readings whilst those studies that evaluated intraclass correlation (ICC) suggested a high correlation (P < 0.0001) between the EAL and ARCL readings. A subgroup analysis revealed that the presence of root resorption did not affect the accuracy of EALs (P = 0.567).


Electronic apex locators offer an acceptable level of accuracy in the measurement of root canal length in primary teeth.

Thursday, July 10, 2014

Color Recovery Effect of Commercial Mouth Rinses on a Discolored Composite

Harorlı, O. T. and Barutcigil, Ç. (2014), Color Recovery Effect of Commercial Mouth Rinses on a Discolored Composite. Journal of Esthetic and Restorative Dentistry. doi: 10.1111/jerd.12107


Statement of the Problem

Several mouth rinses promising whiter smiles are on the market today.


The aim of this study was to investigate the in vitro color recovery effects of six commercial mouth rinses on a stained universal composite resin.

Materials and Methods

Sixty composite resin specimens were prepared with a universal composite resin (Filtek Z250), and baseline Commission Internationale de l'Eclairage L*a*b* color coordinates were measured by spectrophotometry. Specimens were subjected to two cycles of staining with coffee and cherry juice for 2 weeks, followed by immersion into mouth rinses (Listerine Whitening Vibrant, Scope White, Crest 3D White, Signal White Now, Oral-B 3D White, and Colgate Optic White). Changes in color coordinates were measured after staining and after 24- and 72-hour immersion periods. Color alterations were calculated both by CIEDE2000 and CIELAB formulas. Data were submitted to analysis of variance for repeated measures and Tukey's multiple comparison test. (α = 0.05).


Immersion in colorant beverages caused perceptible discolorations on composite resin samples (ΔE00 > 2.25 and ΔEab* > 3.46). Immersion period and mouth rinses were significant factors for the color recovery procedure (p < 0.001). The interaction between immersion time and WMR was also significant (p < 0.001).


The color recovery of composite resin was affected by the brand of mouth rinse and the period of immersion.

Clinical Significance

This in vitro study revealed that tested mouth rinses are capable of recovering discolored composite resin colors after a prolonged exposure period.

Wednesday, July 09, 2014

Clinical and radiographic outcomes of the use of Low-Level Laser Therapy in vital pulp of primary teeth

International Journal of Paediatric Dentistry 2014


This study aimed to compare the clinical and radiographic effectiveness of Low Level Laser Therapy in vital pulp of human primary teeth.


Sixty mandibular primary molars of children aged between 5–9 years were assigned into four groups: Diluted Formocresol (FC), Calcium Hydroxide (CH), Low Level Laser Therapy (LLLT) and Calcium Hydroxide preceded by Low Level Laser Therapy (LLLT + CH). The clinical and radiographic evaluations were performed at 6, 12 and 18 post-operative months.


All the groups studied were successful in the clinical evaluation over the follow-up period. At 6 months, the radiographic success rate for FC group was 100%, 60% for CH group, 80% for LLLT group and 85.7% for LLLT + CH group. After 12 months, the radiographic success rate was 100% for FC group, 50% for CH group, 80% for LLLT group and 78.6% for LLLT + CH group. At the 18 months follow-up, 100% of the FC group, 66.7% of CH group, 73.3% of the LLLT group and 75% of the LLLT + CH group.


These findings suggest that Low Level Laser Therapy may be considered as an adjuvant alternative for vital pulp therapy on human primary teeth. Low Level Laser Therapy preceding the use of calcium hydroxide showed satisfactory results.

Tuesday, July 08, 2014

Factors affecting peri-implant bone loss: a post-five-year retrospective study

Vázquez Álvarez R, Pérez Sayáns M, Gayoso Diz P, García García A. Factors affecting peri-implant bone loss: a post-five-year retrospective study. Clin. Oral Impl. Res. 00, 2014, 19 doi: 10.1111/clr.12416



Although peri-implant bone loss is one of the parameters included in the criteria for determining implant success, its prevention is of vital importance. The goal of this article is to assess the factors that affect peri-implant bone loss.

Material and methods

An observational, longitudinal, retrospective study was conducted in 148 partially edentulous patients rehabilitated with implants and with a follow-up period of 5 years or more. A total of 585 implants were included in the study. Radiographic peri-implant bone loss was compared with radiographic periodontal bone loss, and other characteristics such as prosthesis design, hygiene, and implant size were studied as potential peri-implant bone loss modification factors.


In the univariate analysis, a statistically significant relationship between peri-implant bone loss and gender (P < 0.05), implant system (P < 0.01), reason for extraction (P < 0.05), splinting (P < 0.0001), and distance between the implant platform and the horizontal component of the prosthesis (P < 0.0001) were observed. In multivariate analysis, the relationship between this peri-implant loss and gender (P < 0.05), implant system (P < 0.05), splinting (P < 0.001), and the aforementioned distance (P < 0.01) remains.


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Monday, July 07, 2014

Use of dentifrices to prevent erosive tooth wear: harmful or helpful?

Braz. oral res. vol.28 no.spe São Paulo  2014 Epub Jan 14, 2014 

Dental erosion is the loss of dental hard tissues caused by non-bacterial acids. Due to acid contact, the tooth surface becomes softened and more prone to abrasion from toothbrushing. Dentifrices containing different active agents may be helpful in allowing rehardening or in increasing surface resistance to further acidic or mechanical impacts. However, dentifrices are applied together with brushing and, depending on how and when toothbrushing is performed, as well as the type of dentifrice and toothbrush used, may increase wear. This review focuses on the potential harmful and helpful effects associated with the use of dentifrices with regard to erosive wear. While active ingredients like fluorides or agents with special anti-erosive properties were shown to offer some degree of protection against erosion and combined erosion/abrasion, the abrasive effects of dentifrices may increase the surface loss of eroded teeth. However, most evidence to date comes from in vitro and in situ studies, so clinical trials are necessary for a better understanding of the complex interaction of active ingredients and abrasives and their effects on erosive tooth wear.

Thursday, July 03, 2014

American Academy of Periodontology Holds Think Tank on Regenerative Treatments

Three-day consensus workshop provides clinical recommendations for treating advanced gum disease

CHICAGO (June 30, 2014) – The American Academy of Periodontology (AAP) held its first-ever consensus workshop on regenerative therapies for periodontal disease titled “Enhancing Periodontal Health Through Regenerative Approaches” on June 1-4, 2014, at the Gleacher Center in downtown Chicago. Fifty-two periodontal experts hailing from the United States, Brazil, Japan, Switzerland, Spain, and Italy conducted a systematic review of treatment techniques, culminating in the development of consensus reports and practical applications to aid practitioners in the clinical environment.
Workshop attendees evaluated the latest periodontal studies to determine how findings could be applied in practice settings. Participants also noted priorities for future research. Topics included tissue engineering and the regeneration of bone and gum lost as a result of advanced periodontal disease.
Proceedings from the workshop will be published in the Journal of Periodontology in early 2015 and will include interpretive conclusions and treatment recommendations derived from each systematic review. The reports will also feature evidence-based summaries for various clinical cases and implications for patient-reported outcomes. Practical applications reports will act as a guide for dental professionals as they assess treatment options for their patients. The practical applications reports will be published in Clinical Advances in Periodontics in early 2015.
The workshop was spearheaded by an AAP-designated organizing committee, co-chaired by William Giannobile, DDS, MS, DMSc, and Pamela McClain, DDS. The AAP Foundation, Colgate, the Osteology Foundation, and Geistlich provided support of the workshop’s programming.
The AAP regularly organizes consensus workshops on issues surrounding the science and practice of periodontics. Past sessions include the 2010 Workshop on Inflammation and a 2012 joint session with the European Federation of Periodontology on periodontal disease and systemic diseases.
About the American Academy of Periodontology:
The American Academy of Periodontology (AAP) is the professional organization for periodontists – specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members world-wide.

Wednesday, July 02, 2014

Effect of nonsurgical periodontal therapy verses oral hygiene instructions on Type 2 diabetes subjects with chronic periodontitis: a randomised clinical trial

BMC Oral Health 2014, 14:79  doi:10.1186/1472-6831-14-79
Published: 25 June 2014


Abstract (provisional)


40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals.


40 subjects with type 2 diabetes and moderate to severe CP were randomly distributed to groups receiving either NSPT or OHI. Periodontal parameters, glycosylated haemoglobin (HbA1c) and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline, 2- and 3-months intervals.


15 subjects from NSPT group and 17 from OHI group completed the study. The difference in plaque index (PI) between NSPT and OHI groups were significant at 2 months recall (p = 0.013). There was no significant difference between NSPT and OHI group for all other clinical periodontal parameters, HbA1c and CRP levels. At 3 months post-therapy, periodontal parameters improved significantly in both groups with sites with probing pocket depth (PPD) < 4 mm reported as 98 +/- 1.8% in NSPT group and 92 +/- 14.9% in OHI group. Mean PPD and mean probing attachment loss (PAL) within the NSPT group reduced significantly from baseline (2.56 +/- 0.57 mm, 3.35 +/- 0.83 mm) to final visit (1.94 +/- 0.26 mm, 2.92 +/- 0.72 mm) (p = 0.003, p < 0.001). For OHI group, improvements in mean PPD and mean PAL were also seen from baseline (2.29 +/- 0.69 mm, 2.79 +/- 0.96 mm) to final visit (2.09 +/- 0.72 mm, 2.62 +/- 0.97 mm) (p < 0.001 for both). Similarly, HbA1c levels decreased in both groups with NSPT group recording statistically significant reduction (p = 0.038). Participants who demonstrated >= 50% reduction in PPD showed significant reductions of HbA1c and hs-CRP levels (p = 0.004 and p = 0.012).


NSPT significantly reduced PI at 2 months post-therapy as compared to OHI. Both NSPT and OHI demonstrated improvements in other clinical parameters as well as HbA1c and CRP levels.

Tuesday, July 01, 2014

A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation




To determine the incidence of asymptomatic pulp necrosis following crown preparation as well as the positive predictive value of the electric pulp testing.


A total of 120 teeth with healthy pulps scheduled to receive fixed crowns (experimental teeth) were included. Teeth were divided into 2 groups according to the preoperative crown condition (intact teeth and teeth with preoperative caries, restorations or crowns) and into 4 groups according to tooth type (maxillary anterior teeth, maxillary posterior teeth, mandibular anterior teeth and mandibular posterior teeth). Experimental and control teeth were submitted to electric pulp testing on 3 different sessions: before treatment commencement (stage 0), at the impression making session (stage 1), and just before the final cementation of the crown (stage 2). Teeth that were considered to contain necrotic pulps were submitted to root canal treatment. Upon access, absence of bleeding was considered as a confirmation of pulp necrosis. Data were analyzed using bivariate (chi-square) and multivariate analysis (logistic regression). All reported probability values (p-values) were based on two-sided tests and compared to a significance level of 5%.


The overall incidence of pulp necrosis was 9%. Intact teeth had a significantly lower incidence of pulp necrosis (5%) compared with preoperatively structurally compromised teeth (13%) [(OR: 9.113, p=0.035)]. No significant differences were found among the 4 groups with regard to tooth type (p=0.923). The positive predictive value of the electric pulp testing was 1.00.


The incidence of asymptomatic pulp necrosis of teeth following crown preparation is noteworthy. The presence of preoperative caries, restorations or crowns of experimental teeth correlated with a significantly higher incidence of pulp necrosis. Electric pulp testing remains a useful diagnostic instrument for pulp condition during clinical examination.