Biomedical subjects

A H Brook

Publications and source records attributed to A H Brook.

At least 19 recordsLinked to original sources

PubMed2006

A new technique for symmetry determination in tooth morphology using image analysis: application in the diagnosis of solitary maxillary median central incisor.

OBJECTIVE: To develop a new technique for determining symmetry in tooth morphology and to evaluate this in the investigation of a patient with a solitary maxillary median central incisor (SMMCI) and a control group. DESIGN: A 9-year-old Caucasian female presented with SMMCI. Clinically the tooth appeared symmetrical. Morphology measurements of the maxillary central incisor were made using an image analysis system. Symmetry was determined by outlining the tooth from labial and axial views. These images were block filled, duplicated, flipped horizontally and then superimposed on the original image. The coincident area and perimeter of the two images from both views were measured. The method was repeated for the maxillary central incisors of 20 sets of control study models for young adult patients from which reference intervals for comparison with the SMMCI case were prepared. RESULTS: From the labial view, the area and perimeter of the two images of the SMMCI tooth were 98.85% and 98.97% coincident, respectively. From the axial view the area of the two images was 96.17% coincident, while the perimeter was 99.03% coincident. In all but one comparison for coincidence the SMMCI was above the upper limit of the reference range from the control group. CONCLUSIONS: This new technique is a valid method of assessing symmetry and is a useful clinical tool in cases of SMMCI.

Adult↗

PubMed2006

A randomised controlled trial of the effect of outreach placement on treatment planning by dental students.

UNLABELLED: Undergraduate dental students' curricula are being supplemented with primary care placements. OBJECTIVE: To compare the effect of outreach placement and traditional hospital-based training alone on students' treatment planning ability. DESIGN: Randomised controlled trial.Setting Four existing primary care placements in England during 2004. SUBJECTS AND METHODS: At follow-up the fourth-year students took a history from a standard 'patient' then recorded a treatment plan. Interview skill was scored. The history and plan were assessed by clinicians blind to the intervention. INTERVENTION: Five-week block outreach placements for 25 of 49 students. MAIN OUTCOME MEASURES: Interviewing skill, quality of dental and social histories, the appropriateness of planned treatments and the consideration of wider issues. RESULTS: The two groups were similar in the scores for interviewing and taking a dental history. The outreach group scored higher for capturing a social history (outreach mean 4.4, SD = 2.1, n = 22 and hospital 2.8, SD = 1.9, n = 23; p = 0.01) and for developing an appropriate treatment plan (5.6 [SD = 2.1] and 3.9 [SD = 2.3]; p = 0.01). There were no differences in scores relating to the wider issues. CONCLUSION: Dental outreach training was significantly more effective than traditional training alone in improving students' ability to capture relevant points of social history from a patient and to consider them when planning treatment.

Clinical Clerkship↗

PubMed2006

Perspectives of staff on student outreach placements.

OBJECTIVE: To explore the perspectives of placement staff on outreach training. INTERVENTION: Block clinical placements in primary care settings for dental undergraduates and hygiene and therapy students. METHOD: After completion of the placements, 32 participating staff across nine primary care locations took part in qualitative interviews and focus groups. The staff provided data on placement organisation, the students' development and their supervision, and any effects on themselves as hosts. RESULTS: The major themes included the learning environment, supervision and communication. The staff saw benefits to students in working in a smaller primary care clinic with nursing support and immediately available supervision by a dental generalist. Other benefits included increased confidence, broader clinical experience and applying theoretical learning to new communities. Effective communication and adequate resourcing were critical success factors. There was some disruption of clinics' normal working, but many unanticipated benefits. Staff supported the outreach placements in primary care settings to enhance students' dental education. CONCLUSIONS: These findings provide a planning and evaluation framework for dental educators involved in outreach.

Attitude of Health Personnel↗

PubMed2006

Student perspectives on their recent dental outreach placement experiences.

BACKGROUND: Dental schools are developing new curricula, with outreach placements enhancing the hospital-based training. OBJECTIVES: To assess the students' experience of outreach as one component of determining the value and feasibility of outreach placements. INTERVENTION: Six-week block placements for 10 undergraduates and 3 weeks for 11 hygiene and hygiene and therapy students in existing primary care clinics, in areas of need, to work supervised by local dentists. METHODS: Semi-structured interviews with 20 students by staff independent of the course team. Interviews were audio-recorded, transcribed and content analysed before being verified by a second observer. Findings were triangulated against a peer-run focus group and students' clinical records. RESULTS: Students were very positive about their experience and the potential role of outreach training in dental education. They described: gaining greater experience of new types of patients and their communities; learning from broader clinical experience, alternative approaches and practicing or observing dentistry in different settings; the benefits of team working; and, acquiring a more holistic and pragmatic view of health care. Many students reported gaining greater confidence, wider awareness of potential careers in dentistry and a greater sense of realism in their experience. Some reflected on their own training needs. Students also discussed the importance of preparation for the placements and the merits of different styles of supervision. CONCLUSION: Dental outreach training can provide students with valuable learning experience in a range of areas. It requires careful management to ensure those experiences match individuals' needs and the programme's purposes.

Attitude of Health Personnel↗

PubMed2006

A digital SLR or intra-oral camera: preference for acquisition within an image analysis system for measurement of disclosed dental plaque area within clinical trials.

OBJECTIVES: The aim of this investigation was to compare the accuracy and reproducibility of images acquired from two types of camera (digital SLR camera, Kodak DCS410, KJP, UK and an intra-oral camera, Schick Technologies, UK) for application within an imaging system used for the quantification of disclosed dental plaque. METHODS: Subjects refrained from brushing their teeth for 24 h. Their teeth were then disclosed with Erythrosin FDC Red 3 and duplicate sets of images were obtained by each examiner of the upper central and lateral incisors. Images were then saved and measured for dental plaque area. These data were used to calculate reliability. RESULTS: No statistically significant bias in the measurements of plaque area was found. The reliability results showed the method was reliable. However, the image analysis system incorporating the 35 mm SRL camera was more reliable for both operators, as demonstrated by their intra-operator results. This was also collaborated by the inter-operator results. CONCLUSION: In this investigation the digital SLR camera combined with the image analysis system and frame permitted greater reliability of dental plaque surface area measurements than the digital intra-oral camera. This conclusion was derived both from the reliability data and from the perceived ease of use and flexibility of both camera types. When combined with the use of the custom-made frame, the images using the digital SLR camera were highly reproducible, confirming the systems application within clinical trials.

Adult↗

PubMed2006

Measurement of stain removal in vitro: a comparison of two instrumental methods.

AIM: The aim of this study was to compare an established spectrophotometrical approach for the measurement of stain removal in vitro with a new digital image analysis system. METHOD: Eighteen acrylic blocks were stained by cycling them through human saliva (2 min), chlorhexidine (2 min) and tea (1 h), rinsed with deionized water and left to air dry. The absorbance of each block was then measured at 395 nm using a single-beam spectrophotometer. The lightness (L-value) of the stained blocks (after a baseline correction) was measured using digital image analysis. Image acquisition and L-values were obtained using Adobe Photoshop software. The stain removal ability of two whitening toothpastes and deionized water was tested by immersing each stained block in a test slurry (15 g paste/60 ml deionized water) for 1 min, rinsing and finally left to air dry. This cycle was repeated until the blocks had 5 min exposure to the slurry. Absorbance values from spectrophotometry and L-values by image analysis were obtained after each cycle. RESULTS: Fleiss' coefficient of reliability for intra-operator repeatability of the image analysis system and spectrophotometry was 0.999 for both methods which shows excellent reliability. Pearson's correlation coefficients for the two methods (stain build-up) were 0.976. Test products A, B and C gave correlations of 0.962, 0.998 and 0.817 respectively (stain removal), significant at the 0.01 level. CONCLUSION: The image system is a reliable alternative measurement method validated here against spectrophotometry for stain removal in vitro, and can provide full colour measurement.

Anti-Infective Agents, Local↗

PubMed2006

Visual whiteness ranking of a Vitapan 3D Master shade guide by untrained assessors.

OBJECTIVE: This study was conducted to obtain the ranking order of a 29-tab (including three "bleaching tabs") Vita Shade Guide for perceived "whiteness" by untrained assessors, and to compare this ranking with both the shade guide manufacturer's rank order and a colorimetrically derived rank order. METHODOLOGY: A total of 85 people, not trained in color assessment by shade guides, were asked to rank order the tabs of a Vitapan 3D Master shade guide for perceived "whiteness" under standardized lighting conditions. A whiteness ranking was also obtained colorimetrically using a Minolta CM-2600d spectrophotometer calibrated to give CIE whiteness values. The data were analysed using means, standard deviations, and standard errors. RESULTS: The assessors varied more in their rankings for darker shades than the lighter ones. The order derived by the assessors and the colorimetry order did not match well with the manufacturer's order, especially toward the darker shades. CONCLUSION: For use in studies of whitening products, a new order of the Vitapan 3D Master shade guide tabs has been developed in relation to whiteness.

Adult↗

PubMed2005

The measurement of tooth whiteness by image analysis and spectrophotometry: a comparison.

Digital image capturing and analysis techniques have been used to measure the colour of teeth and to compare with spectrophotometric results and visual observations. A non-linear image analysis approach was developed and, for the colour range of human teeth, allows device-dependant digital camera colour data to be quantitatively transformed to Commission Internationale de l'Eclairage (CIE) colorimetric values. With reference to a CIE standard illuminant, two different lighting arrays have been used. For flat and non-translucent white and yellow surfaces, spectrophotometric results showed that this transformation achieves required accuracy. It was found, in all of the present studies, which included measurements on the VITA Lumin Vacuum shade guide and extracted teeth, that spectrophotometry invariably underestimated values of the CIE whiteness index. However, the results from these two types of measurement correlated well. There was also a reasonably good correlation between earlier data obtained by visual assessment and the present data by the two instrumental methods. For extracted teeth, both instrumental methods used in this work did not confirm a whitening effect for 2-min brushing with toothpaste, but did show significant whitening results for bleaching with 15% hydrogen peroxide.

Algorithms↗

PubMed2004

Tooth size in patients with supernumerary teeth and a control group measured by image analysis system.

OBJECTIVE: The aim of this study was to compare tooth size measurements between patients with supernumerary teeth and a control group. METHOD: The supernumerary group consisted of 56 subjects (21 females and 35 males) and the control group of 40 subjects (20 females and 20 males). All available permanent teeth on the dental casts were imaged and measured from both buccal and occlusal views using an image analysis system. Mesio-distal, bucco-lingual or occluso-gingival dimensions, area and perimeter were measured from each view. RESULTS: Supernumerary tooth patients tended to have larger tooth size measurements for almost all variables than controls. Significant differences (p<0.05) were found for the mesio-distal dimension of the upper and lower incisors and the bucco-lingual dimensions of the lower first premolars. CONCLUSIONS: The results are compatible with supernumerary teeth being a complex dental anomaly with a multifactorial aetiology in which both genetic and environmental factors are important. There is some evidence of a local effect with greater differences in tooth dimension adjacent to the site of the supernumeraries.

Adolescent↗

PubMed2004

Quantification of dental plaque on lingual tooth surfaces using image analysis: reliability and validation.

AIM: The aim of this study was to increase the versatility and further validate the method reported by Smith et al. (2001) by testing the reliability of plaque measurement against two well-known dental plaque quantification methodologies using image analysis in a clinical trial. METHOD: The teeth of 40 subjects were disclosed before digital images of the labial and lingual surfaces of their upper and lower incisors were acquired. The amount of plaque present was quantified using a modification of the method described by Smith et al. (2001). The method was modified for obtaining images of the lingual surfaces by incorporating the use of orthodontic occlusal mirrors and 5-mm pieces of moistened blue articulating paper used to enable calibration. Plaque measurements were made from 320 upper and lower anterior teeth from the 40 subjects by two operators. Fliess' coefficient of reliability was used to assess intra- and inter-operator reliability and the independent sample t test was used to assess statistical significance between test and control groups after checking the data for normality. For validation, measurements were recorded using the Turesky et al. (1970) (modification of the Quigley & Hein (1962) plaque index and the Addy et al. (1983) plaque area index. The results were compared with the image analysis method using Pearson's correlation coefficient. RESULTS: The results for reliability were within Fliess' range of "excellent" for both intra-operator repeatability and inter-operator reproducibility. Pearson's correlation coefficients showed highly significant values indicating the close similarity between all three methods. CONCLUSIONS: This method for the measurement of dental plaque on lingual surfaces of anterior teeth proved reliable. The combined results from the labial and lingual surfaces of anterior teeth using image analysis produced trial conclusions comparable with the alternate plaque quantification methods used, with less clinician time and further producing a permanent database of images for future use.

Adult↗

PubMed2003

Moderation of oral bacterial adhesion on saliva-coated hydroxyapatite by polyaspartate.

AIMS: Synthetic sodium alpha,beta-polyaspartate (PA) has been investigated as a moderator of adhesion and the subsequent biofilm formation by oral bacteria. METHODS AND RESULTS: The inhibition of bacterial adhesion by PA was assessed by (i) a 30-min incubation with Streptococcus sanguis in a microtitre assay with the wells coated with hydroxyapatite (HAP) and (ii) an 18-h challenge with human salivary microflora in a HAP disc assay. In contrast to HAP-coated surfaces, clean polystyrene surfaces in the microtitre assay exhibited no anti-adhesion properties. It has been found that PA significantly and similarly adsorbs onto HAP surfaces in the presence and absence of salivary coating. The HAP disc assay also showed that PA, both in aqueous solutions and in toothpaste, reduced the level of adhered microflora and this effect was enhanced by added propylene oxide-ethylene oxide copolymers. CONCLUSION: The principal finding from this work is the potential role for PA as an inhibitor of dental plaque formation. PA may significantly modify the salivary pellicle. SIGNIFICANCE AND IMPACT OF THE STUDY: This work indicates the use of PA in controlling the development of dental plaque and the formation of bacterial biofilm in general.

Adsorption↗

PubMed2002

Impact of landmark reliability on the planar Procrustes analysis of tooth shape.

In a recent study, the ideas of Procrustes analysis were introduced to the study of tooth shape for teeth represented as configurations of 'landmarks' from digital images. This study aimed to establish how well the method could be expected to perform (in its standard form) when used on surfaces from a variety of tooth types and, in particular, how much impact inconsistencies in the positioning of landmarks would have on investigations of shape. Using four different operators' images and landmarks from 10 different surfaces from each of 20 patients, the consequences of location inconsistency are evaluated by calculating its effect on the recorded variation in Procrustes fits, obtained for each set of multiple representations. The proportion of variation in shape attributable to actual differences between patients, rather than other sources of error, ranged from only 36 to 65% for the five buccal-surfaces considered and was no more than 30% for any of the five occlusal surfaces. Further examination of these results indicated that consistent orientation differences before imaging might be a particular source of error in obtaining any occlusal-landmark data, as might location ambiguities around the edges of the teeth. Orientation effects were also suggested for the buccal-surfaces of the molar teeth. In contrast, the relatively flatter buccal-surfaces of the incisors and canines produced the most reliable data. Methods of analysis need to accommodate these problems if landmark data are to be used to describe variations in tooth shape. Different surfaces each present their own particular difficulties and so a variety of solutions may be required.

Female↗

PubMed2002

Further studies of a model for the etiology of anomalies of tooth number and size in humans.

A multifactorial model based on an underlying continuous distribution of tooth size, with thresholds determining hypodontia and supernumeraries, has been proposed [1]. Our aim is to investigate this model by comparing tooth morphology of affected patients and their first degree relatives with normal controls. An image analysis system [2] was used to measure teeth on study models of controls, patients with hypodontia of varying degrees and location, first-degree relatives of hypodontia index cases, and patients with supernumerary teeth in the maxillary incisor region. Mesio-distal crown size in hypodontia patients was smaller than controls, and this difference was significant for all tooth types. There was a general pattern: the more severe the hypodontia, the smaller the size of the tooth formed. Patients with supernumerary teeth had permanent maxillary central and lateral incisors and canines that were significantly larger in mesio-distal width than controls. The maxillary central incisors also differed in taper in supernumerary patients compared to controls. Hypodontia prevalence was higher in first-degree relatives (22%) of hypodontia index cases than in the general population (4.4%), and unaffected relatives had smaller teeth than controls. Thus, there were generalized and localized effects within the dentition, and these findings are compatible with the statistical expectations of the proposed multifactorial model.

Adult↗

PubMed2002

Tooth dimensions in hypodontia patients, their unaffected relatives and a control group measured by a new image analysis system.

Tooth dimensions were compared between index patients with severe hypodontia (six or more congenitally missing teeth), their relatives with a full complement of teeth, and a control group. The groups consisted of 12 index cases (seven females and five males), 21 relatives without hypodontia (13 females and eight males), and a control group of 10 males and 10 females with complete dentitions, and no family history of hypodontia. All formed teeth were imaged buccally and occlusally from study models, with a digital camera linked to a computer. The images were acquired and measured using Adobe Photoshop and Image Pro Plus, respectively. Mesiodistal, buccolingual, or occlusogingival area and perimeter measurements were determined from each image. In the index hypodontia group tooth dimensions were significantly smaller (P < 0.001, Bonferroni corrected level) for maxillary and mandibular canines, and first premolars for all dimensions from the buccal view, and for maxillary and mandibular canines and first premolars, maxillary central incisors, maxillary first molars, mandibular lateral incisors, and mandibular second premolars for all dimensions from the occlusal view. In the relatives without hypodontia compared with the control group, mesiodistal dimensions from the buccal view were significantly smaller (P < 0.001) for the central incisors and maxillary first and second premolars, and for the maxillary and mandibular first premolars for all dimensions from the occlusal view. There was a trend for the tooth dimensions of all teeth in the index group to be smaller compared with the control group. The tooth dimensions of the relatives without hypodontia also tended to be smaller than the control group, but were larger than those of the index cases.

Analysis of Variance↗

PubMed2001

Selection of oral microbial adhesion antagonists using biotinylated Streptococcus sanguis and a human mixed oral microflora.

A microtitre assay has been developed using hydroxyapatite-coated wells and Streptococcus sanguis NCTC 10904 at 10(7) cells per ml. A number of models representing toothpaste and mouthwash usage were adopted to detect the anti-adherent efficacy of a polyvinylmethylether maleic acid copolymer (PVM/MA), polyoxypropylene/polyoxyethylene block copolymer (PO/EO), two casein-derived peptides and selected silicones. The results not only confirmed the anti-adherence property of the selected components but also indicated possible molecular interactions leading to the observed performance. To account for the diversity of oral microbial cells in vivo, a further testing system was developed. This involved submerging a hydroxyapatite disc in a mixed culture of human salivary microbial cells, and exposing it to different treatments using the active component either in an aqueous dispersion or in a toothpaste. The effect of toothpastes containing PO/EO, dimethicone copoyol or PVM/MA was investigated over a 4-h incubation with microflora. These tests showed that in a toothpaste formulation the anti-adherent efficacy may be reduced when compared with an aqueous dispersion containing the same or nearly the same concentration of the active component.

Bacterial Adhesion↗

PubMed2001

Planar Procrustes analysis of tooth shape.

Accurate quantification of variation in tooth shape is important in studies of dental development, which typically have involved measuring distances between subjectively identified landmarks, key points of correspondence on teeth. An established statistical framework now exists for the analysis of shape when objects are represented as configurations of landmark coordinates; allowing work with the full geometry of objects, which is otherwise lost. This approach was introduced here to the study of tooth morphology, demonstrating how after optimally matching shapes to account for the unwanted effects of location, scale and rotation, most standard descriptive and inferential statistical techniques can be adapted and applied successfully. The techniques are illustrated using a sample of buccal-surface images of central incisors from patients with hypodontia; a significant difference is found in mean buccal-surface shape (Hotelling's two-sample T(2)-test; P=0.004) when compared to a corresponding control group. Successful implementation of these methods depends on the accuracy and reliability with which the landmarks are collected; issues and problems to be addressed are discussed.

Algorithms↗

PubMed2001

The quantification of dental plaque using an image analysis system: reliability and validation.

AIM: Established clinical indices used to measure dental plaque have limitations. The aim of this study was to develop and evaluate a new method of quantitative plaque measurement, with increased sensitivity and reproducibility, using a purpose designed image analysis system. METHOD: After plaque disclosure, the patient was positioned in a cephalometric head holder mounted in a custom-built frame with standard lighting and camera position. A 32-bit Digital Camera grabbed the image of the patient's teeth, which was analysed using Adobe Photoshop (V5.02, Adobe Systems Ltd, Europe) and Image Pro Plus software (V4.0, Media Cybernetics, USA). Measurements were made on 120 incisors in 15 patients and reproducibility was assessed using Fliess' Coefficient of Reliability. Sensitivity was assessed by comparison of results of treatment effects from a clinical trial involving 30 patients. Analysis of covariance was used to compare the image analysis system with the Turesky modification of the Quigley and Hein plaque index and the Addy plaque area index. RESULTS: The results were within the 'Excellent Reliability' category, for inter-operator reproducibility and intra-operator repeatability. CONCLUSIONS: This new system provided accurate quantitative measurements of dental plaque and labial tooth surfaces and was shown to have increased sensitivity when compared with the Turesky modification of the Quigley and Hein plaque index and the Addy plaque area index. The stored images can be re-measured for reliability and comparability between studies.

Analysis of Variance↗

PubMed2001

Oral findings in Carpenter syndrome.

Acrocephalopolysyndactyly Type II (Carpenter Syndrome) is determined by autosomal recessive inheritance. Only some 40 cases have been described. Variable clinical signs have been described including prolonged retention of primary teeth and hypodontia. This paper describes the oral and dental findings in a family containing two affected brothers. The family pedigree is informative, as the mother has had children by three partners. The two affected individuals are full brothers. The first affected brother has delayed dental development, severe hypodontia and small tooth crown size. Mesio-distal and bucco-lingual dimensions were measured on the study models and compared with population data. The younger brother also has delayed dental development but only mild hypodontia. Their half sister has severe hypodontia but no signs of Carpenter Syndrome. This family study demonstrates two affected individuals with typical clinical features and a pedigree compatible with autosomal recessive inheritance. Small tooth crown size has been shown by standardized measurement and evidence advanced that hypodontia is not part of the syndrome but a coincidental finding which segregates independently. We have also shown that the marked delay in emergence of teeth is associated more with problems of tooth eruption, possibly related to the bony abnormalities, than to a generalized delay in dental development.

Acrocephalosyndactylia↗