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Biomedical subjects

David W Bartlett

Publications and source records attributed to David W Bartlett.

10 recordsLinked to original sources

The role of erosion in tooth wear: aetiology, prevention and management.

Tooth wear is a universal experience. The cause is usually a combination of erosion, attrition and abrasion. Attrition usually presents with flattened incisal and occlusal tooth surfaces which accurately inter-digitate. Erosion from dietary or gastric acids forms smooth lesions which typically appear as cupped occlusal/incisal and concave buccal/facial surfaces. When combined with attrition or abrasion, acids have the potential to cause significant wear. Wear reduces the thickness of enamel exposing the underlying dentine and changing the colour from the white of enamel to yellow of dentine. Acids causing erosion originate from the stomach or from the diet. Gastric acid is associated with reflux disease and eating disorders. The frequency of acidic foods and drinks and how they are consumed is important in dietary erosion. The progression of tooth wear is recognised to be slow with periods of activity and inactivity. Although restorations can be indicated, prevention and monitoring remain important strategies in maintaining the life of the teeth.

Beverages↗

Evaluation of the pH of a new carbonated soft drink beverage: an in vivo investigation.

PURPOSE: Recently, a modified version of a successful soft drink has been developed that aims to reduce the potential for dental erosion in consumers. The aim of this investigation was to compare the effect of the modified and original formula soft drink on the pH at various tooth surfaces during and after ingestion in subjects without erosion. MATERIALS AND METHODS: Fifteen subjects (10 female and 5 male) without dental erosion drank both a modified and an unmodified beverage for over 5 minutes in a randomized order. Oral pH was measured with antimony electrodes positioned on the labial and palatal surfaces of an incisor and premolar and held in place by a close-fitting vacuum-formed appliance. The results were compared (using the Wilcoxon signed rank test, with matched pairs) for the percentage and total time that pH fell below 4, 5, and 5.5. RESULTS: The percentage and total time that pH fell below 4 was significantly different between the drinks (P <0.02), but the total time that pH fell below 5 and 5.5 was not. The time taken for subjects to return to pre-exposure pH levels in the mouth showed considerable variation between individuals. CONCLUSIONS: The modified-formula drink appeared to have less erosive potential than the original formula when assessed by measuring pH at the tooth surface. Although the erosive potential has been reduced by modifying the soft drink, it has not been eliminated.

Adult↗

Direct core materials.

There are many materials that can be used for direct-placement cores. Although the scientific evidence is incomplete, some materials are better suited to this task than others. This article provides an overview of direct-placement core materials and highlights what clinicians should consider when assessing a new product.

Composite Resins↗

Safety issues when using carbamide peroxide to bleach vital teeth--a review of the literature.

Hydrogen Peroxide is used to bleach discoloured teeth but since its introduction in the late nineteenth century there have been concerns about its safety and efficacy. This paper reviews the literature on hydrogen peroxide and carbamide peroxide and assesses if these products can be recommended for clinical use. The authors used a Medline search to find the literature for review and from these the findings were divided into laboratory, animal and human studies. In conclusion no dental treatment is without risk but from the evidence it seems that bleaching teeth is comparatively safe.

Animals↗

Team training at an outreach dental unit.

A cohort of eighty nine undergraduate dental students worked for one year on two clinics completing a total of 3901 days work. Most of this time (63%) was spent at a site with shared nursing support, but despite this another site with dedicated nursing support produced approximately the same output. Students and nurses preferred working as a team rather than sharing; 98% of the students completed a questionnaire on the role of dental nurses and the majority identified chairside assistance as being the most important contribution to the increased throughput of patients.

Attitude of Health Personnel↗

The suitability of head-of-implant and conventional abutment impression techniques for implant-retained three unit bridges: an in vitro study.

This study compares the accuracy of master casts produced from impressions of implants using an abutment or a head-of-implant technique. The method used a Tandem Scanning Confocal Microscope to measure the dimensions of the gap between master casts produced by the two impression techniques and a custom made bridge. The median gap of 14 microns (interquartile range 10-17.9 microns) on the non-screwed side of the abutment impression was greater than the median gap of 7.5 microns (5-17.6 microns) for the head-of-implant impression and this difference was statistically significant (P < 0.005). In addition, the median gap on the screwed down side of the abutment impression of 10 microns, (6.3-12.1 microns) was greater than that of the head-of-implant of 5.5 microns (0.0-8.0 microns) and this difference was also statistically significant (P < 0.001). The head-of-implant impression produced a more accurate fit than the conventional abutment impression.

Dental Abutments↗

Three patient reports illustrating the use of dentin adhesives to cement crowns to severely worn teeth.

PURPOSE: Severely worn and broken down teeth present clinical treatment planning dilemmas. Extreme examples of worn teeth present in patients suffering from bulimia nervosa and dentinogenesis imperfecta. Bulimia nervosa typically presents early in adult life with a myriad of clinical features and a most important dental sign of eroded palatal surfaces on the maxillary teeth. Dentinogenesis imperfecta is a relatively uncommon disorder that presents with varying severity of unsupported enamel and results in teeth more susceptible to wear. MATERIALS AND METHODS: Dental treatment for both conditions when wear has resulted in the complete loss of the tooth can either be directed toward restoring remaining tooth tissue or extraction and replacement with implants or dentures. This article presents the clinical management of three case histories, each with one or more severely broken down teeth, which were restored with adhesively retained crowns. RESULTS: Treatment lasted nearly 10 years in one patient and failed after 6 years in another. The third patient was treated more recently. CONCLUSION: All three case histories serve as examples of using adhesive cements to retain indirect restorations as a possible prosthodontic management strategy.

Adult↗