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PubMed2002

Thermal and chemical modification of dentin by 9-11-microm CO2 laser pulses of 5-100-micros duration.

BACKGROUND AND OBJECTIVES: Previous studies have shown that dentin can be thermally modified by pulsed CO(2) laser irradiation to form a more highly mineralized tissue. The implications are important for the potential laser modification or removal of dentinal and root caries and the transformation of dentin to a more acid resistant mineralized tissue. STUDY DESIGN/MATERIALS AND METHODS: Time resolved radiometry measurements with TEA CO(2) laser pulses were used to determine the magnitude of the absorption coefficients of dentin at the highly absorbed CO(2) laser wavelengths and to measure the temperature excursions during lambda = 9.3, 9.6, 10.3, and 10.6 microm laser irradiation at irradiation intensities of 0.1-8 J/cm(2) per pulse. In addition, photoacoustic and transient reflectance measurements were used to monitor the loss of water and organics and to detect the thresholds for surface modification and tissue ablation. RESULTS: The absorption coefficients were measured to be 5,000; 6,500; 1,200; and 800 cm(-1) at lambda = 9.3, 9.6, 10.3, and 10.6 microm, respectively. The surface temperatures of dentin were markedly higher than those measured on enamel for similar irradiation intensities due to the lower reflectance losses of dentin and the lower thermal diffusivity of dentin at the respective wavelengths. Hence, lower fluences are required for the thermal decomposition of dentin. Ablation typically occurred with the first few laser-pulses during multiple pulse irradiation and eventually ceased after modification of dentin to a more highly mineralized enamel-like tissue. The debris ejected during the initial laser pulses shielded the surface by as much as 60% at the low fluences employed in this study. Optical and electron microscopy and IR spectroscopy indicated that incident laser pulses with incident fluence as low as 0.5 J/cm(2) at 9.3 and 9.6 microm wavelengths with a duration of 5-8-micros were sufficient to induce chemical and morphological changes in dentin. CONCLUSIONS: In this study, the laser parameters for the efficient thermal modification of dentin with minimum heat deposition at CO(2) laser wavelengths were firmly established.

Dental Caries↗
PubMed1992

A new light-activated adhesive composite: shear bond strength and microleakage.

A new light-activated adhesive composite has been formulated. Its shear bond strength and marginal microleakage were compared with glass ionomer cements: Fuji Ionomer Type II, Ketac-Fil and Ketac-Bond. The new material showed significantly (p < 0.05) higher bond strength to non-etched enamel (7.9 MPa) and dentin (7.3 MPa) than commercially available materials. It also performed significantly better (p < 0.05) in the microleakage test. Ease of use and the excellent marginal sealing ability of the new material are expected to allow considerable innovation in restorations of root caries, cervical erosion and other conditions where the marginal seal of the gingival cavosurface is difficult.

Aluminum Silicates↗
PubMed2005

Inhibition of dentine demineralization by zinc oxide: in vitro and in situ studies.

OBJECTIVE: The objective of this study was to evaluate the inhibitory effect of zinc oxide on dentine demineralization in vitro and in situ. METHODS: In the in vitro study, dentine specimens treated with a zinc oxide suspension were demineralized in a pH 5 solution. In the in situ study, subjects wore dentine specimens on their teeth and instructed to rinse with zinc-containing toothpaste slurry three times a day for 14 days. The design of study was a crossover one. RESULTS: Microradiography employed in the in vitro study revealed the dentine surfaces treated with distilled water had a lower mineral content than those treated by zinc. Toothpaste with zinc had a statistically significant, 49% greater inhibitory efficacy on dentine demineralization over the control. In the in situ study, zinc-containing toothpaste was also confirmed to have an inhibitory effect on dentine demineralization when compared to the zinc-free toothpaste. These in vitro and in situ studies revealed that zinc oxide can have a significant effect on the inhibition of dentine demineralization, even when the zinc oxide is blended into toothpaste. SIGNIFICANCE: This suggests that zinc oxide may be effective in the prevention of root caries.

Adult↗
PubMed1998

Microleakage of Class V compomer and light-cured glass ionomer restorations.

STATEMENT OF PROBLEM: Resin-modified (light-cured) glass ionomer and polyacid-modified composite resin (compomer) restorations are popular choices for the restoration of root caries and cervical abrasion/erosion lesions, but clinical studies are relatively few and have been published primarily as abstracts. PURPOSE: In the absence of adequate clinical data, the marginal integrity of restorations of the above two types of material was compared in vitro. The microleakage of restorations of two light-cured glass ionomer restorative materials and of one compomer material was evaluated. METHODS AND MATERIAL: Restorations of the three materials were placed in facial and lingual Class V cavity preparations in bovine incisors. All preparations were centered on the cementoenamel junction and were prepared with 45-degree enamel bevels. After thermal cycling, teeth were immersed in methylene blue dye, then sections of the restorations (n = 16) were visually evaluated. RESULTS: Dye penetration was observed at approximately 20% of restoration margins for all three materials, with the greatest incidence of severe leakage in the compomer restorations. CONCLUSION: No significant difference in microleakage among the three materials (ANOVA; p > 0.05) was found.

Animals↗
PubMed2000

Inhibition of human gingival gelatinases (MMP-2 and MMP-9) by metal salts.

OBJECTIVES: The interaction between metal ions and the oral environment is a major subject matter in dental research. Matrix metalloproteinases (MMPs) have been implicated in several pathologic oral processes such as periodontal tissue destruction, root caries, tumour invasion and temporomandibular joint disorders. The aim of this work was to test the effect of Zn, Cu, Sn and Hg ions on the activity of the major gingival gelatinolytic MMPs. METHODS: Gingival explants were cultured overnight in DMEM and the activity of secreted enzymes was analyzed by gelatin zymography in buffers containing different metal ion concentrations. The major gelatinolytic proteinases present in the conditioned media were characterized as MMP-2 and MMP-9 by immunoprecipitation with specific antibodies. The eletrophoretic bands were scanned and the transmittance values were analyzed with the Sigmagel software (Sigma). RESULTS: ZnSO4 was a strong inhibitor of MMP-2 (I50 = 15 microM) and MMP-9 (I50 = 40 microM), whereas CuSO4, HgSO4 and SnCl2 showed less efficient inhibition potential. SIGNIFICANCE: Our findings show that the activity of oral tissue MMPs may be modulated by metal ions present in the oral environment. Therefore, the accumulation of metals in connective tissue may interfere with the formation and resorption of the extracellular matrix components.

Adult↗
PubMed2001

Inhibition of human gelatinases by metals released from dental amalgam.

The interaction between metal ions and the oral environment is a major subject matter in dental research. Matrix metalloproteinases (MMPs) have been implicated in pathologic oral processes such as periodontal tissue destruction, root caries, tumor invasion and temporomandibular joint disorders. The aim of this study was to test the effect of metal ions released from dental amalgam on the major gingival gelatinolytic MMPs. Gingival human explants were cultured overnight in DMEM and the activity of secreted enzymes was analyzed by gelatin zymography in buffers conditioned with dispersed phase or concentional phase dental amalgams. The major enzymes present in conditioned media were characterized as MMP-2 and MMP-9 by immunoprecipitation. The proteolytic activities of MMP-2 and MMP-9 were strongly inhibited by dispersed phase amalgams conditioned buffers. Inhibition of MMP-2 and MMP-9 activities was partly prevented by the addition of 1,10 phenanthroline, a divalent metal chelator, to the amalgam conditioned buffers. Dental amalgam conditioned buffer also inhibited the degradation of denatured type I collagen by purified MMP-2 on liquid phase assays. These findings suggest that the activity of oral tissue MMPs may be modulated by metal ions released from dental amalgam.

Adult↗
PubMed2004

Comparison of patient-based oral health outcome measures.

OBJECTIVES: This project examined psychometric characteristics of four measures of oral-specific health-related quality of life. METHODS: We selected participants from two samples of community-dwelling male veterans from Boston (USA): (1) 538 users of VA outpatient medical care from the Veterans Health Study (VHS: mean age = 62); and (2) 211 relatively healthy men from the VA Dental Longitudinal Study (DLS: mean age = 70). Patient-based measures included the Geriatric Oral Health Assessment Instrument, the Oral Health Impact Profile (OHIP), the Oral Health-related Quality of Life instrument and the single-item self-report of oral health. Clinical variables included number of teeth, coronal decayed surfaces (CDS), a modification of the Root Caries Index (RCI_D), and the Community Periodontal Index of Treatment Need (CPITN). RESULTS: Cronbach's alpha ranged from 0.73 to 0.97. Percent of participants with floor and ceiling scores varied widely by instrument and by item. Patient-based measures were associated with all clinical measures in the combined sample. Number of teeth was associated with patient-based measures (p < 0.001). However, CDS, RCI_D and CPITN scores were associated with patient-based scores in the VHS but not in the DLS. The Geriatric Oral Health Assessment Instrument, the OHIP, the Oral Health-related Quality of Life instrument were strongly linearly related to the single-item global self-report of oral health (p < 0.0001). CONCLUSION: All multi-item measures have high internal consistency and all are valid for measuring oral-specific health-related quality of life.

Aged↗
PubMed1990

Neoplasia masquerading as periapical infection.

Seven examples of neoplasia which presented as periapical radiolucencies are described. These were all initially treated for presumed periapical infection. The atypical features that should alert dentists to the possibility of a tumour presenting in this manner are: a vital tooth with minimal caries, root resorption and an irregular radiolucent outline, tooth mobility in the absence of generalised periodontal disease, regional nerve anaesthesia, and failure to respond to good endodontic therapy. All material removed at the time of apical surgery must be examined histologically to prevent neoplasia being overlooked.

Adolescent↗
PubMed1998

A 9-year longitudinal study of reported oral problems and dental and periodontal status in 70- and 79-year-old city cohorts in northern Sweden.

Before 1981 no representative studies of oral health in an elderly population in northern Sweden had been presented, and longitudinal studies of oral health in the aging person were in general rare. Thus the aim of this study was to investigate longitudinal changes in oral health in a representative sample of an elderly city population in northern Sweden. Reported oral problems and treatment needs were noted, and dental and periodontal status was registered in clinical examinations. The frequency of reported annual dental visits and of being called by the dentist increased in the younger but not in the older cohort during the 9-year period. In 1990 all the 79- and 88-year-olds with annual visits reported that they were recalled by the dentist. The clinical investigation showed an increasing amount of tooth loss, root caries, and periodontal disease with increasing age. Among dentulous persons 1.7 teeth per subject were lost from 1981 to 1990 in the younger cohort, compared with 2.6 teeth per subject in the older cohort. The number of sound teeth decreased very little in the younger cohort (from 3.44 to 3.34) but more evidently in the older cohort (from 3.47 to 2.65) during the 9-year period. The frequency of surfaces with attachment level > 3 mm increased statistically significantly from 1981 to 1990 in the older cohort. Subjects with annual visits had in general fewer oral problems.

Aged↗
PubMedDate not supplied

Long-term effects of chemotherapy on dental status in children treated for nephroblastoma.

Dental abnormalities among children treated at a young age for Wilms tumor are reported. The authors retrospectively reviewed the dental records and panoramic radiographs of 27 children treated for nephroblastoma between 1994 and 1998. They evaluated the frequency of apparent microdontia, excessive caries, root stunting, hypodontia, and enamel hypoplasia and compared this group to a control group of 78 children. Seventy percent of the children developed dental abnormalities, comprising root stunting (44%), enamel hypoplasia (22%), microdontia (18%), and hypodontia (7%). Results of control subjects were significantly different regarding dental abnormalities, especially microdontia and taurodontia. These results indicate that chemotherapy in children may lead to troubles affecting teeth growing at the time of treatment. Information and prospective dental care are needed, and further investigations are required.

Antineoplastic Agents↗
PubMed2004

Baseline characteristics of participants in the oral health component of the Women's Interagency HIV Study.

OBJECTIVES: This study described baseline sociodemographic and oral health characteristics of a subset of HIV sero-positive and sero-negative women who participated in the oral health component of the Women's Interagency HIV Study (WIHS). METHODS: In 1995-96, 584 HIV sero-positive and 151 sero-negative women from five WIHS core sites were enrolled in the oral study. Data on oral mucosa, salivary glands, dentition and periodontium, along with demographics, socioeconomics, and behavioral characteristics, were used to characterize this population. RESULTS: Mean (SD) age was 37 (8) years for HIV sero-positive and 36 (8) years for sero-negative women; 27% of sero-positive women had CD4 counts < or =200 and 34% had viral loads >50,000 copies/ml. Sero-positive and sero-negative women were similar demographically, as well as on plaque index, gingival bleeding, linear gingival banding, and numbers of DMF teeth and surfaces, but sero-positive women had more abnormal gingival papilla (P = 0.004) and fewer teeth (P = 0.01). Among sero-positive women, those with <200 CD4 counts had more DMF teeth (P = 0.007), and the number of DMF surfaces increased with decreasing CD4 counts (P = 0.04). Sero-positive women who fit the Center for Disease Control (CDC) AIDS criteria were also more likely to have more DMF teeth (P = 0.004), DMF surfaces (P = 0.003), and decayed and/or filled (DF) root surfaces (P = 0.0002) compared to sero-positive women without AIDS. CONCLUSIONS: Dental and periodontal variables showed little difference between HIV sero-positive and sero-negative women. Among sero-positive women, there were significant differences in coronal and root caries by AIDS diagnostic criteria, but no periodontal indicators by either AIDS diagnostic criteria or CD4 status, were observed.

Adolescent↗
PubMed2004

Inhibition of human pulpal gelatinases (MMP-2 and MMP-9) by zinc oxide cements.

The interaction between metal ions and the oral environment is a major subject matter in dental research. Matrix metalloproteinases (MMPs) have been implicated in several pathological and physiological processes such as, periodontal tissue destruction, root caries, dentin calcification and pulpal inflammation. The aim of this work was to test the effect of zinc released from zinc oxide-eugenol (ZOE) cements, on the activity of the major pulpal gelatinolytic MMPs. Pulpal explants were cultured overnight in Dulbecco's Modified Eagle Medium and the activity of secreted enzymes was analysed by gelatin zymography in buffer conditioned with diverse ZOE cements. Phenanthroline, a zinc chelator, was used to revert the inhibition of MMPs caused by zinc. The major gelatinolytic proteinases present in the conditioned media were characterized as MMP-2 and MMP-9 by immunoprecipitation. All ZOE cements inhibited MMPs activity, whereas phenanthroline could partially revert the inhibition caused by plain ZOE and Intermediate Restorative Material (IRM).

Chelating Agents↗
PubMed1993

Oral health problems and needs of nursing home residents.

The problem of dental neglect and high levels of unmet dental needs among elderly residents of long term care facilities has been widely documented in literature. A survey was conducted of 1063 residents in 31 nursing homes throughout Washington (representing 11% of all facilities in the state). The greatest single need among dentate elderly was for routine oral hygiene (72%), while for denture wearers adjustment of loose dentures was the primary need (46.4%). Periodontal problems were slightly more prevalent than root caries (43% and 36% respectively) among dentate elderly. Dry mouth was found in 10% of residents. Oral conditions were worse in larger facilities located in rural and moderate size communities, and those under a proprietary corporation. These results suggest that daily oral hygiene and regular check-ups by a dental professional are most needed by frail elderly, especially in large, proprietary homes in rural and moderate size communities. Education of nursing home staff and the elderly themselves in the importance and methods of home care are also critical needs.

Aged↗
PubMed1985

Cavity preparation for restorative resins used with dentin adhesives.

The marginal adaptation of Silux used with and without previous application of different dentin adhesives was analyzed for correlation between maximum marginal contraction gap (MG) and different combinations of one or more of the following variables: area of cavity walls (A), the total area of cavity bottom and cavity walls (B), cavity depth (h), area of cavity surface (S) and cavity volume (V). The best fit to linear regression was found with MG = a + b . V/A with the mean of the correlation coefficients being 0.907. The statistical analysis showed that in order to maintain the V/A ratio at a minimum, root caries lesions should not be prepared after excavation if the retention of the restorative resin can be ensured with an effective dentin adhesive. The greatest influence on the V/A ratio was found to be exerted by the radius of the cavity bottom; variation of the radius of the surface of the cavity also influenced the V/A ratio, but to a minor degree.

Adhesives↗
PubMed1989

Influence of glutardialdehyde on dentin demineralization in vitro and in vivo.

In this paper the results are presented on the action of glutardialdehyde (GDA) on the in vitro demineralization of human dentin and on the in vivo demineralization of dentin using the Ogaard orthodontic banding system. The results show that a 2 min application of a 2% GDA solution at pH = 3.6 reduces dentin demineralization in vitro and in vivo substantially. Microradiography shows a percentage reduction of lesion depth and mineral loss in vitro of 20 and 36%, respectively. After 2 wk in vivo demineralization the same percentage reductions are 60 and 44%, respectively. The mechanism of action of GDA on dentin is not certain yet. Presumably the in vitro action is due to surface cross-linking of the dentin matrix causing reduced Ca and phosphate transport out of the dentin. In vivo an additional effect may be a rather short term influence of GDA on plaque or on plaque accumulation. The results of this paper indicate that glutardialdehyde is an interesting agent to consider in the reduction of root caries.

Aldehydes↗
PubMed1994

Closing of dentinal tubules by glutardialdehyde treatment, a scanning electron microscopy study.

The properties of dentin are strongly influenced by the so-called smear layer. This layer is always present on the dentin surface after cutting, drilling, sawing, etc. The smear layer can be removed by various chemical treatments, such as those of acid etching or ethylenediaminetetraacetic acid (EDTA). These treatments remove the smear layer and open the tubules. In this paper, the effect on the smear layer of human dentin of treatment with a 2% glutardialdehyde (GDA) solution at pH 3.5 for 2 min and a 0.5-M EDTA solution at pH 7.4 for 4 min was investigated by scanning electron microscope (SEM). The dentin samples were dried by air or critical-point drying before SEM photography was employed. The number of open dentin tubules was quantified on micrographs of EDTA- and GDA+EDTA-treated dentin. The results show that the GDA treatment fixed part of the smear layer and the superficial dentin surface in such a way that at least 50% of the tubules remained closed after EDTA treatment. By closing the dentinal tubules, the GDA-fixed layer might have a positive effect on dentin hypersensitivity, root caries, and bonding of composite to dentin.

Adolescent↗
PubMed1995

Oral health status of a population of community-dwelling older Canadians.

A sample of 170 responsive residents of seniors housing centres in Winnipeg, Canada, were studied, (>65 years, mean 82 years), with the objectives of relating their dental state to their perception of need and uptake of service. Only 6% rated their oral health as poor, 46% reported a dental visit within the previous year and 68% felt they needed dental treatment. A lack of perceived need (88%) was the primary reason why dental care was not sought more frequently. Hygiene practices revealed that only 7% brushed < 1 time/day, 60% never flossed, 14% cleaned their dentures <1 time/day, and 42% slept with their dentures. Dental histories showed that examination (94%), prosthodontic treatment (76%), and restorative services (65%) were the most commonly sought treatments. Perceived dental needs included prosthodontic treatment (39%), periodontal/prophylactic treatment (10%), restorative treatment (9%) and pain relief (9%). Study subjects had 2.8 decayed teeth, a DMFT of 25.1, and a Root Caries Index of 38%. CPITN scores of 3 or 4 in at least one sextant were found in 80% of subjects. Of the 41% edentulous, all wore complete dentures but 15% of complete upper dentures and 51% of complete lower dentures fitted poorly. Of the partial dentures, 20% fitted poorly. Soft tissue anomalies were seen in 67% of subjects and 47% had TMJ anomalies. Overall, 77% of edentulous subjects and all dentate subjects required some dental treatment even though 46% had seen a dentist within the preceding year. It is concluded that appropriate management of such people needs further attention.

Aged↗