Friday, January 31, 2014

A double-blind randomised clinical trial of two techniques for gingival displacement



Knowledge about security and the potential damage originated by the gingival displacement techniques has not been described through randomised clinical studies. This crossover, double-blind, randomised clinical trial evaluated clinical and immunological factors related to conventional and cordless gingival displacement (GD) techniques, and patients' perceptions in 12 subjects with the employment of 2 GD techniques: conventional (gingival cord + 25% AlCl3 astringent gel) and cordless (15% AlCl3 astringent-based paste). In each subject, two anterior teeth were treated and a 10-day wash-out period separated the two treatments. Periodontal indices were evaluated before (baseline) and 1 and 10 days after GD. Interleukin 1β, interleukin 6 and tumour necrosis factor α concentrations in gingival crevicular fluid were measured before and 1 day after GD. Subjective parameters (pain, unpleasant taste and stress) were also evaluated. Data were analysed by one-way repeated-measures analysis of variance and Tukey's test (immunological factors), the Friedman test (periodontal parameters) and Fisher's exact or chi-squared test (subjective parameters), with a significance level of 95%. Gingival bleeding index, probing depth and plaque index values did not differ significantly between groups at any timepoint. Neither technique resulted in worse periodontal indices. Both techniques yielded similar results for pain and unpleasant taste, but conventional GD was significantly more stressful than cordless GD for volunteers. Both treatments significantly increased mean concentrations of the three cytokines, with the conventional technique producing the highest cytokine levels. Cordless GD is less stressful for patients and results in lower post-treatment levels of inflammatory cytokines compared with conventional GD.

Thursday, January 30, 2014

Investigation of bacteremia induced by removal of orthodontic mini-implants

SUMMARY The aim of this study was to investigate potential occurrence of bacteremia in orthodontic patients after removal of miniscrews.The study group comprised 30 healthy subjects (17 males, 13 females) with a mean age of 24.1 years treated with self-ligating fixed appliances and mini-implant anchorage. Two 20ml venous blood samples were obtained prior to and 30–60 seconds after miniscrew explantation following an aseptic technique. Blood culturing in aerobic and anaerobic conditions was carried out by means of the BACTEC blood culture analyzer. Microbiological analysis showed that none of the pre- and post-operative samples exhibited detectable bacteremia. Future research should be focused on determining the collective bacteremic effect of a sequence of orthodontic procedures including miniscrew placement or removal, typically performed during a single treatment session.

Wednesday, January 29, 2014

Oral HPV infection in a clinic-based sample of Hispanic men

In my opinion you should always consider the patient to be HPV positive. MJ
BMC Oral Health 2014, 14:7  doi:10.1186/1472-6831-14-7
Published: 24 January 2014



Human papillomavirus (HPV) is associated to the pathogenesis of various cancers, such as oropharyngeal squamous cell carcinoma, which has a high incidence in Puerto Rican men. Despite the burden of oral cancer in Puerto Rico, little is known about the epidemiology of oral HPV infection, particularly in high-risk men. Therefore, this study is aimed at determining the prevalence of oral HPV infection, the genotype distribution and correlates associated with oral HPV infection in men of at least 16 years of age attending a sexually transmitted infection (STI) clinic in Puerto Rico.


A cross-sectional study consisting of 205 men was conducted. Participants provided a 30-second oral rinse and gargle with mouthwash. Following DNA extraction, HPV genotyping was performed in all samples using Innogenetics Line Price Assay (INNO-LiPA). A questionnaire was administered, which included a demographic, behavioral and a clinical assessment. Descriptive statistics and bivariate analysis were used to characterize the study sample. Variables that achieved statistical significance in the bivariate analysis (p < 0.05) were assessed in multivariate logistic regression models.


The mean age of the study sample was 38.5 +/- 14.2 years. Oral HPV prevalence among men was 20.0% (95.0%CI = 14.8%-26.1%) and of HPV type 16 was 2.4% (95.0%CI = 0.8%-5.6%). Oral HPV prevalence significantly increased over increasing age categories (p-trend = 0.001). Multivariate analysis showed that oral HPV was independently associated with number of sexual partners (adjusted OR = 1.02; 95%CI = 1.01-1.03) and lifetime use of cigarettes (adjusted OR = 3.00; 95%CI = 0.98-9.16).


Oral HPV among the sampled men in the STI clinic was high, regardless of the HIV status or sexual behavior. Interventions in STI clinics should include screening for HPV in the oral cavity for the early detection and reduction of long-term consequences of oral HPV infection, such as oropharyngeal cancer.

Tuesday, January 28, 2014

Influence of photo-curing distance on bond strength and nanoleakage of self-etching adhesive bonds to enamel and dentin.

Curing dental materials is not as simple as just turning on the light. Distance and light intensity do make a difference. MJ 
Acta Odontol Scand. 2014 Feb;72(2):113-9. doi: 10.3109/00016357.2013.805431. Epub 2013 Jul 3.


Abstract Objectives. To assess the influence of light-curing unit tip distance on the microtensile bond strength (μTBS) and nanoleakage of self-etching adhesives to enamel and dentin. Materials and methods. Flat buccal surfaces were prepared on 198 bovine incisors. The teeth were randomly assigned into nine groups for μTBS (n = 8) and nanoleakage (n = 3) testing according to the adhesive system (Clearfil Protect Bond, Clearfil Tri-S Bond or One Up Bond F Plus) and distance from the light-curing tip (0, 3 or 6 mm). The bonded samples were tested in tension (0.5 mm/min) and nanoleakage was analyzed using SEM. Results. Clearfil Protect Bond exhibited the highest tensile strength on both enamel and dentin. Leakage was higher in samples exposed at a distance of 6 mm on enamel and 0 mm on dentin. One Up Bond F Plus experienced the greatest amount of nanoleakage on both substrates. Conclusions. Light-curing unit distance did not influence the μTBS of the adhesives, but nanoleakage increased on enamel samples when photoactivation occurred at a distance of 6 mm.

Monday, January 27, 2014

Marginal bone loss evaluation around immediate non-occlusal microthreaded implants placed in fresh extraction sockets in the maxilla: a 3-year study

Calvo-Guirado JL, Gómez-Moreno G, Aguilar-Salvatierra A, Guardia J, Delgado-Ruiz RA, Romanos GE. Marginal bone loss evaluation around immediate non-occlusal microthreaded implants placed in fresh extraction sockets in the maxilla: a 3-year study. Clin. Oral Impl. Res. 00, 2014; 17.



To evaluate marginal bone loss over 3 years around immediate microthreaded implants placed in the maxillary anterior/esthetic zone and immediately restored with single crowns.

Material and methods

Seventy-one implants (with microthreads up to the platform – rough surface body and neck, internal connection and platform switching) were placed in fresh extraction sockets in the maxillary arches of 30 men and 23 women (mean age 37.85 ± 7.09 years, range 27–60). All subjects had at least 3 mm of soft tissue to allow the establishment of adequate biologic width and to reduce bone resorption. Each patient received a provisional restoration immediately after implant placement with slight occlusal contact. Mesial and distal bone height was evaluated using digital radiography on the day following implant placement (baseline) and after 1, 2, and 3 years. Primary stability was measured with resonance frequency analysis.


No implants failed, resulting in a cumulative survival rate of 100% after 3 years. Marginal bone loss from implant collar to bone crest measured at baseline (peri-implant bone defect at the fresh extraction socket) and after 3 years was 0.86 mm ± 0.29 mm. Mesial and distal site crestal bone loss ranged from 3.42 mm ± 1.2 mm at baseline to 3.51 mm ± 1.5 mm after 3 years (P = 0.063) and from 3.38 mm ± 0.9 mm at baseline to 3.49 mm ± 0.9 mm after 3 years, respectively (P = 0.086).


This prospective study found minimal marginal bone loss and a 100% implant survival rate over the 3-year follow-up for microthreaded immediate implants subjected to immediate non-occlusal loading.

Friday, January 24, 2014

Antibacterial Agent Boosts Toothpaste Effectiveness

Source: Health Behavior News Service

Regular use of fluoride toothpaste containing triclosan, an antibacterial agent, and a copolymer, which helps prevent the triclosan from being washed away by saliva, reduces plaque, gingivitis, and bleeding gums and slightly reduces tooth decay compared to fluoride toothpaste without those ingredients, finds a new review in The Cochrane Library.

"We are very confident that adding triclosan and copolymer to a fluoride toothpaste will lead to additional benefits, in terms of less plaque, inflammation, bleeding, and tooth decay," said Philip Riley, a researcher at the University of Manchester in England, and a co-author of the study. But he added, "We don’t know how important the effects are clinically."

Tooth decay and gingivitis are the main causes of tooth loss. Both are caused by plaque, the film of bacteria that builds up on teeth, and if left untreated, can lead to periodontitis, a more serious gum disease that can cause pain and loose teeth. A team from the Cochrane Oral Health Group reviewed 30 published studies of toothpastes containing triclosan and copolymer.

Their analysis of the combined data found a 22 percent reduction in plaque, a 22 percent reduction in gingivitis, a 48 percent reduction in bleeding gums, and a 5 percent reduction in tooth decay (cavities) compared to toothpaste with fluoride alone. However, they did not find significant evidence that triclosan/copolymer toothpaste reduced the incidence of periodontis more than toothpaste without the combination. No adverse reactions to triclosan or the copolymer were reported.

The findings of the review are not surprising, according to Clifford Whall, Ph.D., director of the American Dental Association's (ADA) Seal of Acceptance Program and Product Evaluations. The ADA's Council on Scientific Affairs has independently reviewed data on the safety and effectiveness of triclosan /copolymer for reducing cavities, plaque and gingivitis. The council concluded that there were sufficient clinical studies that showed these toothpastes reduced the incidence of cavities, the presence of plaque and gingivitis.

Most of the studies of toothpastes evaluated in the Cochrane report were directly or indirectly supported by companies that make toothpaste. Only three studies appeared to be independent, according to the reviewers. The independent or government-funded research community and industry should work together to research antibacterial agents in toothpastes, Riley noted. "But we would argue for complete independent control of the research, including study design, conducting the study, and ownership of the data."

Thursday, January 23, 2014

The Effect of Time between Handling and Photoactivation on Self-Adhesive Resin Cement Properties

da Silva Fonseca, A. S. Q., Mizrahi, J., Menezes, L. R., Valente, L. L., de Moraes, R. R. and Schneider, L. F. (2014), The Effect of Time between Handling and Photoactivation on Self-Adhesive Resin Cement Properties. Journal of Prosthodontics. doi: 10.1111/jopr.12108




To evaluate the degree of conversion, absorption, and solubility in water of self-adhesive resin cements subjected to different time intervals between material preparation and the photoactivation procedure.

Materials and Methods

Two dual self-adhesive resin cements were tested: RelyX Unicem and SmartCem2. The degree of conversion as a function of time was evaluated by Fourier-transformed infrared spectroscopy using the attenuated total reflectance technique. Three time intervals between handling and photoactivation were applied: Group 1 = immediately; Group 2 = a 1-minute interval; Group 3 = a 4-minute interval. All specimens were irradiated with a light-emitting diode source for 40 seconds. Thirty discs of each cement (1 mm thick × 6 mm diameter, n = 10) were prepared for the absorption and solubility tests. These specimens were stored in distilled water at 37°C for 90 days. The results were subjected to ANOVA with two factors (material and activation time intervals) and Tukey's test (95% significance).


The 4-minute interval significantly reduced the degree of conversion of SmartCem2 (30.6% ± 8.3%). No other significant changes were observed for the degree of conversion; however, the time intervals before photoactivation interfered significantly in the water absorption of the RelyX Unicem specimens but not the SmartCem2 specimens. The time intervals did not affect the solubility of either cement. In all cases, SmartCem2 had higher solubility than RelyX Unicem.


The time interval between handling and photoactivation significantly influenced the degree of conversion and water sorption of the resin-based cements. In general, one can say that the self-adhesive resin cements should be photoactivated as soon as possible after the material handling process.

Wednesday, January 22, 2014

Effects of tongue cleaning on bacterial flora in tongue coating and dental plaque: a crossover study

BMC Oral Health 2014, 14:4  doi:10.1186/1472-6831-14-4
Published: 14 January 2014


Abstract (provisional)


The effects of tongue cleaning on reconstruction of bacterial flora in dental plaque and tongue coating itself are obscure. We assessed changes in the amounts of total bacteria as well as Fusobacterium nucleatum in tongue coating and dental plaque specimens obtained with and without tongue cleaning.


We conducted a randomized examiner-blind crossover study using 30 volunteers (average 23.7 +/- 3.2 years old) without periodontitis. After dividing randomly into 2 groups, 1 group was instructed to clean the tongue, while the other did not. On days 1 (baseline), 3, and 10, tongue coating and dental plaque samples were collected after recording tongue coating score (Winkel tongue coating index: WTCI). After a washout period of 3 weeks, the same examinations were performed with the subjects allocated to the alternate group. Genomic DNA was purified from the samples and applied to SYBR(R) Green-based real-time PCR to quantify the amounts of total bacteria and F. nucleatum.


After 3 days, the WTCI score recovered to baseline, though the amount of total bacteria in tongue coating was significantly lower as compared to the baseline. In plaque samples, the bacterial amounts on day 3 and 10 were significantly lower than the baseline with and without tongue cleaning. Principal component analysis showed that variations of bacterial amounts in the tongue coating and dental plaque samples were independent from each other. Furthermore, we found a strong association between amounts of total bacteria and F. nucleatum in specimens both.


Tongue cleaning reduced the amount of bacteria in tongue coating. However, the cleaning had no obvious contribution to inhibit dental plaque formation. Furthermore, recovery of the total bacterial amount induced an increase in F. nucleatum in both tongue coating and dental plaque. Thus, it is recommended that tongue cleaning and tooth brushing should both be performed for promoting oral health.

Tuesday, January 21, 2014

New game helps kids brush their teeth for two minutes, twice a day

Troubling statistics show less than half of children in America brush their teeth twice a day. Additionally, dental decay is the nation’s most common chronic childhood disease.
The Ad Council and the Partnership for Healthy Mouths, Healthy Lives have released a new game that aims to change this. Toothsavers – which is available free on the web at and as a downloadable app for iOS and Android (both smartphones and tablets) – makes toothbrushing fun by encouraging kids to save an entire kingdom of characters with the swipe of their toothbrush.
Toothsavers’ overarching message aims to encourage kids to brush their teeth for two minutes, twice a day in real life to significantly reduce their risk of oral pain and dental decay. The game features:
·         10 colorful characters whose teeth kids can clean with swipes and taps.
·         10 two-minute animations to make brushing in real life fun.
·         10 colorful cartoon teeth that animate to your voice in two-player mode.
·         An interactive map to chart each day and night that kids brush with Toothsavers.
·         New characters unlocked by brushing two minutes, twice a day with Toothsavers.
·         A parents' section to designate daily brushing times and monitor kids’ brushing progress on a calendar.

Toothsavers is the first mobile app to be entirely created by the Ad Council — a nonprofit organization that has been producing public service campaigns since 1942. Through campaigns like Smokey Bear, McGruff the Crime Dog and “Friends Don’t Let Friends Drive Drunk,” we’ve endeavored to improve the lives of all Americans in the areas of education, health, family/community and safety. Toothsavers represents a huge milestone for us in the world of digital, interactive media. 
Since it launched in 2012, our Kids’ Healthy Mouths campaign has made tremendous progress improving children's oral health habits. A survey released in August indicated that more kids  now regularly brush their teeth, and many parents have seen the campaign’s Public Service Advertisements (PSAs) in both English and Spanish.

Monday, January 20, 2014

Dental Plan Details on Healthcare?.gov may be misleading for adults, says Analysts has released some examples of both pediatric and adult dental benefits that can be purchased on the web site. They have determined that consumers shopping for dental insurance on the will need to be careful while deciphering how cost sharing in the plans actually works. Under the Affordable Care Act, pediatric dental is now one of the essential health benefits that insurers need to include as part of their insurance offerings. For those under 18, dental coverage comes with out-of-pocket maximums that limited the amount policyholders need to contribute towards their dental costs.

I think it is imprortant that you and your staff at least take a look at this infomration.
See The Study Here        

Friday, January 17, 2014

Study Examines Treatment Responses in TMD Patients

Study Examines Treatment Responses in TMD Patients

Tempromandibular pain disorders (TMDs) are characterized by a dysfunction of the TMD joint and cause orofacial pain, masticatory dysfunction or both. A new study published in The Journal of Pain showed that standard treatment approaches yield modest to large improvement in pain, but the addition of cognitive behavioral therapy may be helpful. The Journal of Pain is published by the American Pain Society,

Some 10 to 36 million U.S. adults, primarily women, have TMD pain, making this condition the second most frequent pain disorder following low-back pain. MD pain usually can be managed with conservative treatment with non-steroidal anti-inflammatory pain medications (NSAIDS), supportive patient education, diet modifications and an intraoral splint and/or occlusal therapy. Not all patients benefit, however, and previous research has shown that many TMD patients benefit from cognitive behavioral therapy (CBT). But the reasons behind CBT treatment success or failure are unclear.

Researchers from the University of Connecticut Health Center evaluated 101 TMD patients on a daily basis for three months. Study subjects reported having TMD pain for an average of 6.7 years. They were randomly assigned to one of two treatment groups: standard conservative care and standard care with CBT added, which included coping skills training. The purpose of the study was to determine if specific subtypes of treatment nonresponsive TMD patients could be identified to determine if CBT could be helpful.

The authors hypothesized that certain CBT treatment-related outcomes, such as lower retention in treatment and less adaptive changes in coping, self efficacy and catastrophizing, might be predictive of treatment non-response.

Results showed that nonresponders scored higher on depression scores, exhibited lower self efficacy and coping ability, and catastrophized more than more adaptive patients. It was noted that nonresponsive patients did not show more joint pathology than patients who responded well to treatment. Despite lack of joint pathology, the nonresponsive subjects were more likely to report being disabled by their TMD pain.

The study concluded it is important to recognize the importance of the heterogeneous nature of TMD pain, and that treating TMD patients as a homogeneous group is likely to result in suboptimal therapy for many patients. Even though no treatment is successful for all TMD patients, certain psychosocial factors can make some patients unresponsive to CBT.

Thursday, January 16, 2014

Net Neutrality and What It May Mean To Your Dental Office

Many of you may heard about a recent appeals court decision that ruled the Federal Communications Commission does not have the authority to bar Internet service providers from favoring one type of traffic over another. So data is not data anymore. Your ISP can now determine what and how much it costs, you the consumer for different types of data. So surfing to would be different then watching a movie from Netflix. Previously the FCC had argued that it has the authority to require Internet services companies like Verizon, Comcast and AT&T to treat all Internet packets (data) crossing its network equally.

If you want to know more about Net Neutrality and the decision then surf on over to this article on Re/code.

Now how may this affect your dental office? For now nothing will change. Data will be treated as data. In the future you may potentially see longer upload times for your online backups, if your ISP thinks you are using too much bandwidth. They may charge you more for the increased use of bandwidth. This maybe similar to what we now see with cellular data, with data caps and slowing of speeds if you exceed your data cap. All your worries might go away if you are willing to pay more for the privilege. Other possibilities will be if you use specific data services you may be able to use this bandwidth but it will be paid for by someone else. The example of this type of arrangement is what Google does with most of its services such as Gmail. Give the service away in exchange for information.

So for now nothing changes but who knows what the future may bring.

Wednesday, January 15, 2014

CAESY Cloud 2.0 Enhances Patient Education Experience

New Version of CAESY Cloud Features Interactive 3D Animations, 3D models and 
E-mail Capability

ST. PAUL, Minn. (January 14, 2014) – Patterson Dental Supply, Inc. announces new updates to CAESY Cloud, its easy-to-use on-demand patient education system. Practices across the country can now access the new features, including interactive, 3D animations that function like a digital flip chart and 3D models used to educate patients with a 360-degree visual. Available as a separate resource, users can now use animations within the educational videos to further explain a procedure. CAESY videos have long provided patients with the foundation for a more in-depth discussion with their care provider.  Now, clinicians can use the same animation the patient has just seen, pulled out of the video, to bring additional clarity to the consultation. Additionally, practices now have the ability to insert video links onto their practice website, send video links directly to patients’ email or view videos right on their smart phone devices (including new Android devices), making CAESY Cloud even more accessible.

“The new CAESY Cloud features give patients a comprehensive experience from the time they enter the waiting room to the time they make decisions in their home,” said Jana Berghoff, technology marketing manager at Patterson Dental. “Our new animation and 3D model features can help patients better understand a treatment plan, ultimately resulting in enhanced patient-doctor communication, practice productivity and case acceptance.”

Much like a digital flip chart, the new animation feature in CAESY Cloud 2.0 allows the clinician to control the speed of the animation with the click of a mouse or cursor, giving the presenter the power to pause and provide greater emphasis on certain areas of the animation. Clinicians can now easily use animations to answer patient questions and ensure a patient fully understands treatment recommendations.

In addition, CAESY presentation videos can now be linked on practice websites or sent directly to patients through email, making it possible for patients to conveniently access the content from anywhere with an internet connection. An upgraded video player also enables the CAESY Cloud videos to play on new Android devices. These new features give patients a chance to share videos with influencers and decision makers such as family or friends.

Lastly, CAESY Cloud offers an enhanced patient education tool with new 3D model capability. With 60 models currently available, users simply click on the tooth figure to the right of a presentation title and an image appears, which can be rotated 360 degrees to give patients an optimal view.

CAESY Cloud continues to expand with more than 350 multimedia presentations, new features and content, but with the same affordable price. More updates to the patient education system are expected later this year.

The credible third-party resource, CAESY Cloud patient education systems, is backed by Patterson Dental’s renowned support and customer service and the team at the Patterson Technology Center. Customers can choose from a multitude of support options, including Live Help, Remote Support, email support and an FAQ online knowledge base. With more than 125 years of experience in the dental industry, Patterson has the resources and expertise to help customers use CAESY to its greatest potential.

For more information, visit

Tuesday, January 14, 2014

DEXIS Receives Repeated Accolades From The Dentaltown Community

Peer-based Townie Choice Awards for 2013 again go to DEXIS for three of its imaging products!

Hatfield, PA (December 26, 2013) DEXIS is proud to announce that Dentaltown has chosen its intra-oral sensor, digital image management software and intra-oral camera as winners of the 2013 Townie Choice awards. These awards are voted on by clinicians who use technology in everyday practice. DEXIS is appreciative of the recognition shown by these product owners whose votes reflect their acknowledgment of the products’ effectiveness and practice-building benefits.
Each of the winning products brings its own enhancements to the dental experience. The DEXIS® Platinum single-size sensor offers remarkable image quality, patient comfort, ease of use, and high-level portability. The DEXcam™ 3, a direct-USB intra-oral video camera, adds to the capabilities for patient education and communication.

Hallmarks of DEXIS imaging software are its ease-of-use and its seamless integration with practice management software and a variety of hardware. DEXIS is the imaging hub for all types of radiographic and photographic images for use in diagnostics, treatment and patient communication. An adjunct to DEXIS® Imaging Suite, new apps DEXIS go® and DEXIS photo™ both expand the use of DEXIS to iPad®s, iPhone®s and iPod®s. This forward-thinking view on development places DEXIS at the top of award programs year after year.

“DEXIS is grateful to all of the dental professionals who have provided positive feedback on these products—feedback that has allowed us to continue our reputation as the most highly awarded digital X-ray system,” states Carsten Franke, Sr. Director of Marketing for DEXIS. “Your votes of confidence encourage our pursuit of the development of new digital dental imaging solutions that aid in better dental care and a more successful practice.” 

For more information on these winning products, visit

DEXIS is an industry leader in developing high quality digital imaging solutions for the dental community. In 1997, DEXIS introduced digital radiography on laptop computers — making it the first truly portable and affordable digital X-ray system. In 2001, DEXIS became the first intra-oral digital radiography system to be accepted by the American Dental Association into the highly prestigious ADA Seal Program. Today, DEXIS is the most highly awarded intra-oral digital X-ray system with numerous awards from dental researchers and well-respected dental publications. For more information on the DEXIS® Imaging Suite of software products and the DEXIS® Platinum Sensor, visit

Monday, January 13, 2014

Cross-bite and oral health related quality of life in young people

Available online 25 December 2013




This study sought to assess the impact of posterior cross-bite on OHRQoL in young people aged 15–25 and to determine whether the impact on higher domains of Oral Health Impact Profile-14 (physical disability, psychological disability, social disability and handicap) is a direct function of the cross-bite or mediated through the lower domains of OHIP-14 (functional limitation, pain and discomfort).


One hundred and forty-five young adults [72 cross-bite cases and 73 controls] aged 15–25 years, attending orthodontic clinics at the Faculty of Dentistry, Universiti Teknologi MARA participated in this study. Participants completed the OHIP-14 and had a clinical examination for cross-bite. Data analyses included descriptive statistics, t-test and bivariate and multivariate regression modelling.


There was no significant difference between the case and control groups in gender, age and education level. The mean scores (±SD) for OHIP-14 total and all domains were significantly higher in cross-bite patients as compared to controls. The bivariate and multivariate regression analyses showed functional limitation was significantly associated with all the higher domains in all four models, whereas pain was only significantly associated with the psychological domain and discomfort was only significantly associated with the physical disability domain.


The possession of a posterior cross bite has a significant association with OHRQoL especially on the functional limitation and psychological disability domains, among 15–25 years old young people. The relationship of cross-bite and lower domains of OHIP-14 with higher domains of OHIP-14 was in agreement with the relationships proposed by Locker's conceptual model of oral health.

Clinical significance

Patients with a cross bite were more limited in their oral functions and experienced greater psychological discomfort than did controls. It is possible that part of patients’ rationale for seeking treatment would be to alleviate such impacts on their oral health related quality of life.

Friday, January 10, 2014

Bioactivity of zinc-doped dental adhesives

Available online 25 December 2013


Design of restorative materials should be focused on promoting not only adhesion but also dentine self-repair processes.


To ascertain if ZnO and ZnCl2-doped resins are materials able to induce calcium (Ca) and phosphate (P) deposition.


48 resin disks were prepared with the following materials: (1) single bond -3M/ESPE-, (2) single bond + ZnO particles 20 wt% and (3) single bond + ZnCl2 2 wt%. Specimens were polymerised and polished. Bioactivity was tested through a simulated body fluid solution (SBFS) immersion test. At time 24 h, 7 d and 21 d surfaces were analyzed by stereomicroscope, high resolution scanning electron microscope (HRSEM), energy-dispersive analysis (EDX), confocal laser Raman, and X-ray diffraction (XRD) for morphological and chemical composition.


Under the stereomicroscope, crystal formations were encountered in both zinc-doped resin adhesives after 7 d of immersion. It was, detected by EDX, that the ZnO-doped resin produced Zn, Ca and P deposition (globular formations were observed by HRSEM) after 7 d. Zn and P crystals were detected by HRSEM and EDX in the experimental ZnCl2-doped resin after 7 d and 21 d. Hopeite formation was identified by Raman on both Zn-doped resins. Single bond did not produce mineral or crystal precipitation.


ZnO-doped resin induced Ca and P deposition after SBFS immersion. On ZnCl2-doped resin hopeite formation was detected, if this hopeite may be further converted into apatite, after SBFS immersion, remains to be ascertained.

Thursday, January 09, 2014

The Overuse of the Implant Motor: Effect on the Output Torque in Overloading Condition

Lee, D.-H., Cho, S.-A., Lee, C.-H., Cho, J.-H. and Lee, K.-B. (2014), The Overuse of the Implant Motor: Effect on the Output Torque in Overloading Condition. Clinical Implant Dentistry and Related Research. doi: 10.1111/cid.12195



The overloading of the motor affects its performance. The output torque of the implant motor under overloading condition has not been reported.


The purpose of this study was to determine the reliability and the tendency of the output torque when an implant motor is consecutively used.

Materials and Methods

Three implant motors were evaluated: SurgicXT/X-SG20L (NSK), INTRAsurg300/CL3–09 (KaVo), and XIP10/CRB26LX (Saeshin). The output torque was measured using an electronic torque gauge fixed with jigs. For the 40 and 50 Ncm torque settings, 300 measurements were taken at 30 rpm. Repeated measures of analysis of variance (ANOVA) and one-way ANOVA were used to compare the torque values within each group and between the groups.


As repeating measures, the output torque values decreased gradually compared with the baseline. In within-group analysis, the different torque value from the first measurement appeared earliest in NSK motor, followed in order by Saeshin and KaVo motors. NSK motor showed a different torque decrease between 40 and 50 Ncm settings (p  < .05). Intergroup analysis revealed Saeshin motor to have the least deviation from the baseline, followed by KaVo motor. NSK motor had the most inconsistent torque at the 6, 8, 9, and 10 repeat counts (p < .05).


The actual torque decreases when the surgical motor is continuously used. The NSK motor showed more significant decreases in torque than KaVo and Saeshin motors in overloading condition.

Wednesday, January 08, 2014

The transcrestal hydrodynamic ultrasonic cavitational sinuslift

Results of a 2-year prospective multicentre study on 404 patients, 446 sinuslift sites and 637 inserted implants
Angelo Troedhan, Andreas Kurrek, Marcel Wainwright, Izabela Schlichting, Bianca Fischak-Treitl, Martin Ladentrog
Introduction: In 2006 an ultrasound-surgery-based method to hydrodynamically detach the sinus-membrane utilizing the ultrasonic cavitation effect—the tHUCSL—was developed and a surgical protocol established. The aim of the study was to determine the indication-range and success-rate of this novelty procedure. Materials & Methods: Between 2007 and 2009, 404 patients were treated by 6 oral surgeons of different experience-levels with the tHUCSL in 446 sinussites. 637 implants were inserted and then prosthodontically treated and observed and documented until December 2011. The subantral space was augmented via the 3 mm transcrestal approach with an augmentation volume of 1.9 ccm (+/? 0.988 ccm) and an augmentation height of 10.7 mm (+/? 2.85 mm). Results: Within the survey-period 15 (2.35%) of the 637 inserted implants were lost, mostly before implant loading due to postsurgical infection and nonosseointegration in the augmentation site. 1 implant was lost after implant loading and prosthetic treatment within 1 year after loading. The overall success rate with functional implants in site is 97.65% evenly distributed among the participating surgeons. 86% of the patients were observed with no postsurgical swelling and 87% no postsurgical pain. Discussion: The results suggest the tHUCSL to be a safe minimal-invasive alternative to traditional lateral approach and transcrestal osteotome sinuslift-procedures applicable to all anatomical situations.

Tuesday, January 07, 2014

Comparison of the shaping ability of GT® Series X, Twisted Files and AlphaKite rotary nickel-titanium systems in simulated canals

BMC Oral Health 2013, 13:72  doi:10.1186/1472-6831-13-72


Efforts to improve the performance of rotary NiTi instruments by enhancing the properties of NiTi alloy, or their manufacturing processes rather than changes in instrument geometries have been reported. The aim of this study was to compare in-vitro the shaping ability of three different rotary nickel-titanium instruments produced by different manufacturing methods.


Thirty simulated root canals with a curvature of 35˚ in resin blocks were prepared with three different rotary NiTi systems: AK- AlphaKite (Gebr. Brasseler, Germany), GTX- GT® Series X (Dentsply, Germany) and TF- Twisted Files (SybronEndo, USA).
The canals were prepared according to the manufacturers’ instructions. Pre- and post-instrumentation images were recorded and assessment of canal curvature modifications was carried out with an image analysis program (GSA, Germany).
The preparation time and incidence of procedural errors were recorded. Instruments were evaluated under a microscope with 15 × magnifications (Carl Zeiss OPMI Pro Ergo, Germany) for signs of deformation. The Data were statistically analyzed using SPSS (Wilcoxon and Mann–Whitney U-tests, at a confidence interval of 95%).


Less canal transportation was produced by TF apically, although the difference among the groups was not statistically significant. GTX removed the greatest amount of resin from the middle and coronal parts of the canal and the difference among the groups was statistically significant (p < 0.05). The shortest preparation time was registered with TF (444 s) and the longest with GTX (714 s), the difference among the groups was statistically significant (p < 0.05). During the preparation of the canals no instrument fractured. Eleven instruments of TF and one of AK were deformed.


Under the conditions of this study, all rotary NiTi instruments maintained the working length and prepared a well-shaped root canal. The least canal transportation was produced by AK. GTX displayed the greatest cutting efficiency. TF prepared the canals faster than the other two systems.

Monday, January 06, 2014

Accuracy and reproducibility of dental replica models reconstructed by different rapid prototyping techniques

American Journal of Orthodontics & Dentofacial Orthopedics
Volume 145, Issue 1 , Pages 108-115, January 2014


Rapid prototyping is a fast-developing technique that might play a significant role in the eventual replacement of plaster dental models. The aim of this study was to investigate the accuracy and reproducibility of physical dental models reconstructed from digital data by several rapid prototyping techniques.


Twelve mandibular and maxillary conventional plaster models from randomly chosen subjects were selected and served as the gold standard. The plaster models were scanned to form high-resolution 3-dimensional surface models in .stl files. These files were converted into physical models using 3 rapid prototyping techniques: digital light processing, jetted photopolymer, and 3-dimensional printing. Linear measurements on the plaster models were compared with linear measurements on the rapid prototyping models. One observer measured the height and width of the clinical crowns of all teeth (first molar to first molar) on all models (plaster and replicas) using a digital caliper. All models were measured 5 times with a 2-week interval between measurements.


The intraobserver agreement was high (intraclass correlation coefficient >0.94). The mean systematic differences for the measurements of the height of the clinical crowns were −0.02 mm for the jetted photopolymer models, 0.04 mm for the digital light processing models, and 0.25 mm for the 3-dimensional printing models. For the width of the teeth, the mean systematic differences were −0.08 mm for the jetted photopolymer models, −0.05 mm for the digital light processing models, and −0.05 mm for the 3-dimensional printing models.


Dental models reconstructed by the tested rapid prototyping techniques are considered clinically acceptable in terms of accuracy and reproducibility and might be appropriate for selected applications in orthodontics.

Friday, January 03, 2014

Technique to Obtain a Predictable Aesthetic Result through Appropriate Placement of the Prosthesis/Soft Tissue Junction in the Edentulous Patient with a Gingival Smile

Demurashvili, G., Davarpanah, K., Szmukler-Moncler, S., Davarpanah, M., Raux, D., Capelle-Ouadah, N. and Rajzbaum, P. (2013), Technique to Obtain a Predictable Aesthetic Result through Appropriate Placement of the Prosthesis/Soft Tissue Junction in the Edentulous Patient with a Gingival Smile. Clinical Implant Dentistry and Related Research. doi: 10.1111/cid.12192




Treating the edentulous patient with a gingival smile requires securing the prosthesis/soft tissue junction (PSTJ) under the upper lip.


To present a simple method that helps achieve a predictable aesthetic result when alveoplasty of the anterior maxilla is needed to place implants apical to the presurgical position of the alveolar ridge.

Materials and Methods

The maximum smile line of the patient is recorded and carved on a thin silicone bite impression as a soft tissue landmark. During the three-dimensional radiographic examination, the patient wears the silicone guide loaded with radiopaque markers. The NobelClinician® software is then used to bring the hard and soft tissue landmarks together in a single reading. Using the software, a line is drawn 5 mm apical to the smile line; it dictates the position of the crestal ridge to be reached following the alveoplasty. Subsequently, the simulated implant position and the simulated residual bone height following alveoplasty can be simultaneously evaluated on each transverse section.


An alveoplasty of the anterior maxilla was performed as simulated on the software, and implants were placed accordingly. The PSTJ was always under the upper lip, even during maximum smile events. The aesthetic result was, therefore, fully satisfactory.


This simple method permits the placement of the PSTJ under the upper lip with a predictable outcome; it ensures a reliable aesthetic result for the edentulous patient with a gingival smile.

Thursday, January 02, 2014

Stability of paramedian inserted palatal mini-implants at the initial healing period: a controlled clinical study

Nienkemper M, Pauls A, Ludwig B, Drescher D. Stability of paramedian inserted palatal mini-implants at the initial healing period: a controlled clinical study. Clin. Oral Impl. Res. 00, 2013; 16.



To assess the stability development of paramedian in comparison with midpalatal inserted mini-implants.

Material and methods

The test group consisted of 21 consecutively treated patients (13.7 ± 4.6 years). In each patient, a mini-implant was inserted paramedian in the anterior palate. Measurement of the insertion depth (ID), the maximum insertion torque (IT), and resonance frequency analysis (RFA) was performed at T0. RFA was repeated after 2 weeks (T1), 4 weeks (T2), and 6 weeks (T3). Correlations between measuring methods were calculated. RFA values at different times were tested for statistical differences. Data were compared with a group of patients who received median mini-implants of the same size.


Initial stability was 14.06 ± 4.35 Ncm (IT) and 26.60 ± 5.28 ISQ (RFA) with an ID of 7.02 ± 1.04 mm. RFA and IT (r = 0.49, = 0.023) showed a moderate significant correlation. Stability remained relatively constant, showing no significant differences between measurement times. Overall, RFA values decreased non-significantly by 2.25 ± 6.85 ISQ to a level of 24.35 ± 5.39 after 6 weeks. Comparing development of stability over time, it was found that significant differences were present at T0 and T1 (T0: −9.54 ISQ, P < 0.0001; T1: −3.69, P = 0.041).


Paramedian inserted mini-implants provided sufficient stability. Showing a lower primary stability, RFA values did not differ from the control group from week four on, as no significant decrease in stability occurred at the initial healing period.

Wednesday, January 01, 2014

Wishing Everyone a Happy, Healthy and Properous 2014

As 2014 starts we all get to look at what will be for the following year.
So for all of you that read the blog a BIG THANK YOU!

Wishing everyone good health both physically and in your dental practices but most importantly be happy! Happiness is contagious and is good for you and all around you.