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PubMed2001

Eighteen-month clinical evaluation of a filled and unfilled dentin adhesive.

OBJECTIVE: The purpose of this study was to evaluate the performance of a filled (OptiBond Solo) and an unfilled (Prime & Bond 2.1) "one-bottle" adhesive in Class V restorations after 18 months of clinical service. METHODS: Thirty-three patients with non-carious cervical lesions were enrolled in the study. A total of 101 lesions were restored using one of the adhesives and a hybrid composite resin. Enamel was not beveled, nor was any mechanical retention placed. The restorations were evaluated at baseline, and at 6 and 18 months after placement using modified USPHS criteria. RESULTS: Cumulative 18-month retention rates were 93.6% for OptiBond Solo and 98.0% for Prime & Bond 2.1. The difference in retention rates was not statistically significant. For OptiBond Solo, the only notable problems were interfacial staining and marginal adaptation, both of which were less than ideal in 9% of restorations. Marginal problems were slightly less frequent for Prime & Bond 2.1 restorations, but the difference was not significant. CONCLUSIONS: Both adhesives provided Class V retention rates exceeding the 18-month, full acceptance guidelines set by the American Dental Association. Any additional benefit provided by the use of a filled adhesive was not detected in this 18-month clinical trial.

Adhesives↗
PubMed1990

So, how much do orthodontists earn?

A review is carried out on available data from the American Dental Association, the Journal of Clinical Orthodontics, and various proprietary publications in an effort to obtain reliable information on orthodontists' income. The results of this study indicate that no definite determination can be made.

Data Collection↗
PubMed1999

Prospective survey of percutaneous injuries in orthodontic assistants.

This prospective diary survey provides documentation concerning the occurrence of percutaneous injury among orthodontic chairside assistants in the United States and Canada. A 20-day period was used to collect data regarding exposure to injuries; 693 valid responses were received from orthodontic assistants. Most chairside assistants in this sample work in a solo practice and average 33 hours per week treating patients for 49 weeks per year. The study identified a percutaneous injury rate of 0.11 for chairside assistants during this period, a rate than can be extrapolated to 1.4 episodes of percutaneous injury per year per chairside assistant. The majority of these injuries occurred outside the mouth. Those assistants with longer orthodontic experience had a lower injury rate than those with less experience. The rate of percutaneous injury to dental assistants was slightly higher than the annual rate (0.99) for orthodontists monitored by means of a companion survey and slightly lower than the rate (1.9) for a smaller sample of orthodontists from the American Dental Association survey of 1995. The annual rate of percutaneous injury for orthodontic chairside assistants is less than half of that observed for dentists in general practice.

Canada↗
PubMed1995

Knowledge and adoption of radiographic quality assurance guidelines by general dentists in North Carolina.

OBJECTIVES/STUDY DESIGN: A random survey of equal proportions of urban and rural North Carolina general dentists was conducted to assess their knowledge and adoption of radiographic quality assurance guidelines of the American Dental Association. RESULTS: A total of 159 surveys were returned representing a response rate of 51%. A majority of respondents answered "don't know" to questions dealing with intraoral and panoramic radiography units and darkroom monitoring. Higher levels of knowledge (58% to 77%) and adoption (63% to 86%) of guidelines were seen with film-processing activities. Linear regression demonstrated substantial positive association between knowledge and adoption of guidelines (R = 0.50). Stepwise multiple regression revealed positive associations of the demographic variables of years in practice, urban location, and age with greater knowledge of guidelines (R2 = 0.33, p < 0.05). Urban location was associated with increased likelihood of adoption of guidelines (R2 = 0.09, p < 0.05).

Health Knowledge, Attitudes, Practice↗
PubMed2002

Correlation and examiner agreement between a new method of plaque scoring and a popular established plaque index, modelled in vitro.

BACKGROUND, AIMS: Scoring of supragingival plaque is common to epidemiological studies, oral hygiene assessments and clinical trials of oral hygiene products. These clinical practices utilize indices such as the Turesky et al. (1970, Journal of Periodontology 41, pp. 41-43) modification [Turesky Plaque Index (TPI)] of the Quigley & Hein (1962, Journal of the American Dental Association 65, pp. 26-29) plaque index for evaluating plaque extension. Whilst this index is in common use by clinicians, there is potential for ambiguity in the interpretation of scores by different examiners. The aims of this study were to compare examiner agreement between a new method of plaque scoring (NMPS) and TPI, and to determine if there was a correlation between the two indices. METHODS: Simulated plaque was scored from eight study casts, each consisting of 14 teeth. The two indices were both scored twice from the study casts by eight examiners experienced in plaque scoring. The first readings obtained were analysed for a correlation between the indices and between-examiner variability. Within-examiner variability was assessed using both first and second readings of each index. RESULTS: A positive correlation was found between the two indices (r = 0.717). The NMPS was found to have better inter- and intra-examiner agreement than TPI. CONCLUSION: The NMPS was found to have less variability within and between examiners than TPI: evaluation of NMPS in a clinical setting would now appear warranted.

Analysis of Variance↗
PubMed2003

Image file interoperability for data protection, communication and trans-system connectivity.

DICOM (Digital Imaging and Communication in Medicine) is a set of international imaging standards developed for medicine and extended to incorporate other professions. These standards encompass primary digital and secondary capture images made for dental diagnostic procedures. The standards provide a basis of interoperability for digital system outputs, providing portability and reducing the danger of obsolescence that would render valuable diagnostic information impossible to display. The American Dental Association, through the activities of its Working Group 12.1, is promoting interoperability within DICOM as the industry standard for digital imaging in dentistry.

Computer Communication Networks↗
PubMed2001

Heat-cured acrylic resin repaired with microwave-cured one: bond strength and surface texture.

This study evaluated the influence of chemical surface treatments in the repair strength of a heat-cured acrylic resin (Lucitone 550, (LU)). A total of 70 specimens were made with LU according to American Dental Association (ADA) specification No. 12. Of these, 14 remained intact and were used as a control group (GI). A total of 56 specimens were selected randomly. These specimens were cut in the middle (10 mm), repaired with a microwave acrylic resin (Acron MC (AC)), and processed in a microwave oven for 3 min at 500 W. Prior to the repair, the surface of the cut ends received different chemical treatments (GIII = AC monomer dipping/30 s; GIV = acetone dipping/30 s; GV = acetone dipping/15 s + blast of air + AC monomer dipping/15 s; GVI = no wetting treatment). However, 14 intact specimens made with AC formed a second control group (GII). The effect of the chemical treatments on the surface texture of LU was observed with scanning electron microscopy. Flexural test results were submitted to paired t-test and showed statistical differences (P < 0.05) only between the pairs GIV-GV and GIV-GVI. Strength mean values of repaired specimens were statistically lower (79-90%) than GII mean values. Strength mean values of GVI and GIV were 93 and 106%, respectively, of GI mean, showing no statistical differences. Scanning electron microscopic observations revealed various effects of the chemical treatments on the denture base resin surface. In conclusion, the wetting surface treatments affected the bond strength between the two acrylic resins, and no statistical differences in strength were observed between intact heat-cured denture base material and the same material repaired with microwave acrylic resin.

Acetone↗
PubMed2003

The prevalence and treatment needs of symptoms and signs of temporomandibular disorders among young adult males.

A temporomandibular disorder (TMD) screening history and screening examination was performed on 523 young adult males. The screening forms were similar to those TMD forms developed and formulated under the auspices of the American College of Prosthodontists. In turn, the substance of the latter forms was initially derived from the recommendations of the President's TMD Conference of the American Dental Association, with 62 eminent researchers, educators and clinicians as participants. Each subject was given a TMD self-administered screening history form to complete, formatted in a check - the block format. It included all items considered to be classic TMD symptoms. The screening examination was performed extraorally and included (i) range of jaw movement, (ii) digital palpation of selected masticatory muscles and palpation over the pre-auricular temporomandibula joint (TMJ) area and (iii) digital palpation for TMJ sounds during jaw movement. The subjects were categorized into the following four categories: 0 = no symptoms/signs, 1 = insignificant moderate symptoms and/or signs, 2 = significant moderate symptoms and/or signs, and 3 = severe symptoms and/or signs. The overall results showed that 75% of the subjects had TMD symptoms and/or signs. There were 6.9% in category 1, 51.4% in category 2, and 16.7% in category 3. It was recommended that subjects in category 2 and 3 should have a comprehensive TMD evaluation, in order to further identify the recommended need for TMD Therapy.

Adolescent↗
PubMed2003

A stochastic evaluation of the decision to specialize in orthodontics.

OBJECTIVE: The objective of this paper is to identify under different scenarios, and from a financial point of view, the conditions required to successfully switch from the general dentistry practice to orthodontics. STUDY DESIGN: A mail survey was used to collect the data from the practicing orthodontists. They estimated the income, at certain points, in the working life of an orthodontist. The general practitioner data were taken from the American Dental Association figures. Subsequently, a stochastic model was constructed. RESULTS AND CONCLUSION: Those who decide to buy an existing practice expect higher profits in the near future, and therefore the required minimum number of remaining years of practice is lower than for those deciding to start a new practice. For both scenarios, the 3-year residency will delay the profits compared with a 2-year residency. Thus, an increased number of remaining years of practice is required. There must be more than 10 working years left in the practitioner's life to make the switch profitable.

Decision Making↗
PubMed2001

Changes in properties of nonaqueous elastomeric impression materials after storage of components.

STATEMENT OF PROBLEM: Storage stability, or shelf life, is a critical property of perishable dental materials. PURPOSE: The purpose of this investigation was to document changes in the properties of nonaqueous elastomeric impression materials over time and on exposure to various environmental conditions. MATERIAL AND METHODS: Materials investigated included a polyether impression material, a polysulfide material (light, regular, and heavy consistencies), and an addition-reaction silicone material (light, regular, heavy, and putty consistencies). Tests included viscosity of individual pastes, elastic recovery, working and setting times, strain in compression, dimensional change, creep compliance, and tear energy. Means and standard deviations were calculated for each test interval. Statistical analysis included 2-way ANOVA (variables: time and storage condition) and comparison to baseline values using 1-way ANOVA (variable: time) and Scheffe's multiple comparison test (P < or = 0.05) within each material, consistency, and test. RESULTS: Results over 72 months revealed changes in viscosity, working/setting times, elastic recovery, and creep compliance. Separation of components was seen with polysulfide and addition silicone materials. Some batches of polysulfide base paste and polyether reactor paste solidified in the tube. CONCLUSION: Most batches of the materials and consistencies tested remained efficacious well past their designated shelf lives under a variety of storage and use conditions. Data for the addition-reaction silicone impression material changed little during the 72-month testing period; thus, the material may be considered relatively storage stable. Creep compliance was the most precise storage-stability indicator. The storage stability of perishable materials should be addressed in American Dental Association Specifications.

Analysis of Variance↗
PubMed2001

A review of temporomandibular disorder diagnostic techniques.

The American Dental Association has approved several devices as aids in the diagnosis of temporomandibular disorders. Concerns remain, however, about their safety and effectiveness. This article reviews the validity and use of several instruments that claim to serve as aids in the detection of masticatory muscle pain, trismus, joint noises, and limitation of jaw motion. A review of data from 62 published articles indicated that, although commercial devices that measure jaw muscle tenderness, muscle activity levels, joint noises, and jaw motion are safe and can document these phenomena, cost-benefit analyses of these devices have not yet been conducted. Moreover, these devices have not been shown to have stand-alone diagnostic value and, when tested, they have demonstrated unacceptable sensitivity and specificity levels. None of the instruments reviewed in this article can be said to provide more than ancillary documentation.

Auscultation↗
PubMedDate not supplied

Urinary porphyrin profiles as a biomarker of mercury exposure: studies on dentists with occupational exposure to mercury vapor.

Porphyrins are formed as intermediates in the biosynthesis of heme. In humans and other mammals, porphyrins with eight, seven, six, five, and four carboxyl groups are excreted in the urine in a well-established pattern. Mercury selectively alters porphyrin metabolism in kidney proximal tubule cells, leading to an altered urinary porphyrin excretion pattern. Previous studies in rats have shown that changes in the urinary porphyrin profile during exposure to mercury as methylmercury hydroxide are uniquely characterized by highly elevated (20- to 30-fold) levels of four- and five-carboxyl porphyrins and by the excretion of an atypical porphyrin ("precoproporphyrin"), which elutes on high performance liquid chromatography (HPLC) approximately midway between penta- and coproporphyrins. Changes in the urinary porphyrin profile are highly correlated with the dose and duration of mercury exposure and persist for up to 20 wk following cessation of mercury treatment. In the present studies, the utility of urinary porphyrin profile changes as a biomarker of mercury exposure in human subjects was evaluated. Urinary porphyrin concentrations were measured in dentists participating in the Health Screening Programs conducted during the 1991 and 1992 annual meetings of the American Dental Association and compared with urinary mercury levels measured in the same subjects. Among dentists with no detectable urinary mercury, mean concentrations of urinary porphyrins were within the established normal ranges for male human subjects. In contrast, among dentists with urinary mercury in excess of 20 micrograms/L, mean urinary concentrations of four- and five-carboxyl porphyrins as well as of precoproporphyrin were elevated three to four times those of unexposed subjects. Significant differences in urinary porphyrin concentrations remained when porphyrin concentrations in spot urine samples were adjusted for creatinine levels. These findings suggest that urinary porphyrin profiles may serve as a useful biomarker of mercury exposure in clinical or epidemiologic studies of mercury-related human health risks.

Animals↗
PubMed1995

The effect of sucrose in medicines on plaque pH.

An investigation into the acidogenic potential of six of the most commonly used sugar-containing and sugar-free paediatric medicines was carried out on 10 adult volunteers. The guidelines of the Food, Nutrition and Dental Health Committee of the American Dental Association were followed. Subjects refrained from brushing their teeth for 48 hours and did not eat or drink for at least 2 1/2 hours prior to each appointment. pH measurements were taken at baseline to determine 'resting' plaque pH and at time intervals of 5, 10, 15, 20, 25 and 30 minutes following a 1-minute rinse with each medication. A pooled sample of plaque was removed from the buccal surfaces of posterior teeth, thoroughly mixed with 20 microliters of distilled water and plaque pH was determined using a glass combination electrode. Data were compared with plaque pH changes after rinsing with control solutions of 10% sucrose and 10% sorbitol. An ANOVA test indicated all sucrose-containing preparations produced a significantly greater drop in plaque pH than their sucrose-free counterparts (P < 0.001). The study provided evidence in support of prescribing sugar-free preparations for children on long-term medication.

Acetaminophen↗
PubMed1987

The microstructural basis of creep of gamma 1 in dental amalgam.

A previous study has shown that the addition of small amounts of tin to gamma 1 leads to the formation of a SnHg intergranular precipitate. The purpose of this study was to determine the effect of this precipitate on the creep of gamma 1. Two groups of samples were investigated. Group I included a series of gamma 1 samples with 0, 1, 2, and 3 wt% Sn fabricated by a sintering technique at 55 degrees C and 125 mN/m2 for 72 h. Group II contained the same samples as in Group I that were further annealed at 60 degrees C for 2000 h. Annealing was carried out to allow gamma 1 grain growth and equilibrium distribution of Sn at grain boundaries. Creep tests were conducted according to the American Dental Association Specification 1. The microstructures of all samples were characterized by scanning electron microscopy. The creep of gamma 1 was found to be controlled by the intergranular precipitate when the Sn concentration was above 1%. For a specific concentration of Sn, i.e. the intergranular precipitate, creep was dependent on the distribution of Sn and not on the gamma 1 grain size. The more nearly continuous precipitates found in annealed samples favoured higher creep.

Chemical Phenomena↗
PubMed1989

Solubility of zinc oxide-eugenol and calcium hydroxide cements in simulated dentinal fluid.

The solubility of four dental cement bases was measured in simulated dentinal fluid and distilled water to evaluate the relevancy of the American Dental Association solubility test for cement bases in contact with vital dentine. A simulated dentinal fluid was formulated utilizing glucose, distilled water, and sterile human plasma. Cement-base samples were immersed in either distilled water or simulated dentinal fluid at 37 degrees C in a shaker water-bath for 1, 2, or 3 months. Weight loss values were compared utilizing a three-way analysis of variance. Zinc oxide-eugenol cements were significantly more soluble in simulated dentinal fluid than distilled water, while the calcium hydroxide cement bases were significantly more soluble in distilled water than simulated dentinal fluid.

Calcium Hydroxide↗
PubMed1998

The effect of noble metals on the mechanical properties of dispersed phase dental amalgam.

The effects of noble metals added as part of a Ag-Cu dispersant on the compressive strength and creep of dental amalgams was determined. The Ag-Cu eutectic used in high copper dispersant alloy L(0), was altered by adding 15 per cent by weight (wt%) of noble metal in place of Ag. In L(1) the noble metal was Pd. In L(2), Au and Pd were combined in equal proportions. In L(3), the noble metal content was Pd and Pt in equal proportions. A low copper lathe-cut amalgam, Aristalloy was used as the matrix. Amalgams S(0) and S(1) had the same composition as L(0) and L(1) except that the the low copper alloy matrix was Spheralloy, a low copper spherical amalgam. The compressive strength and creep were measured according to American Dental Association specification No. 1 and the results analysed by ANOVA. The addition of noble metals to the dispersant significantly lowered the 1-h compressive strength of amalgams. Compared to the control amalgam L(0), the 24-h compressive strength was increased for L(1) and L(2) but lowered for L(3). The ADA creep values were significantly lowered by addition of all combinations of noble metals. Reported microstructural changes such as an increase in unreacted particles, and a slowed setting reaction may account for the findings.

Compressive Strength↗
PubMed1996

Accuracy of wax, autopolymerized, and light-polymerized resin pattern materials.

PURPOSE: The marginal fit of MOD inlay and full-crown patterns fabricated from wax, autopolymerized acrylic resin, and two light-polymerized, diacrylate resin pattern materials was compared on standardized dies. MATERIALS AND METHODS: Four pattern materials were studied-two light-polymerized, diacrylate resin materials (Palavit G LC and Triad VLC Burnout Paste), an inlay wax, and an autopolymerized resin (Duralay). Patterns were fabricated using incremental and bulk techniques on stone dies made from addition silicone impressions of American Dental Association MOD and full-crown master dies. Gaps were measured with a measuring microscope in four marginal areas on the master dies at 1 and 24 hours after fabrication. RESULTS: For the MOD inlay patterns, marginal gaps ranged from 7 to 23 microns, and the light-polymerized, diacrylate resins and autopolymerized acrylic resin material had statistically smaller gaps than the inlay wax. For the full-crown patterns, marginal gaps ranged from 10 to 23 microns, with the exception of the autopolymerized acrylic resin prepared by the bulk technique (40 to 46 microns). With the incremental technique, the light-polymerized, diacrylate resins and inlay wax had statistically smaller gaps than the autopolymerized acrylic resin material. Overall, the incremental technique produced equal or smaller marginal gaps than the bulk technique for full-crown patterns. Generally, the patterns measured at 1 hour had smaller marginal gaps than at 24 hours. CONCLUSIONS: When measured on intra- and extracoronal master dies, the light-polymerized, diacrylate resins had equal or better marginal fit, compared with wax or autopolymerized acrylic resin, and were less affected by placement technique and storage. The marginal gaps of all four pattern materials ranged from 7 to 46 microns and are within the range of clinical acceptability.

Acrylic Resins↗