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PubMed2005

Characterization of dentin, enamel, and carious lesions by a polarization-sensitive optical coherence tomography system.

Enamel and dentin are the primary components of human teeth. Both of them have a strong polarization effect. We designed a polarization-sensitive optical coherence tomography (PSOCT) system to study the spatially resolved scattering and polarization phenomena of teeth. The system is constructed in free space to avoid the complexity of polarization control in fiber-based PSOCT. The structural features of enamel were evaluated in five human teeth that had no visible evidence of caries. The teeth were subsequently sectioned in mesial distal orientation and coronal orientation. Then the structural aspects of dentin were evaluated. OCT images were made of the mantel dentin near the dentin-enamel junction. Five teeth with interproximal and occlusal caries were also studied. With two channel and phase-retardation images, PSOCT provided better functional contrast and more detailed structural information than conventional OCT. For a better description of the measured PSOCT data, we classify these features by two types, i.e., the local textural features and the global structural features. This study indicates that PSOCT has the potential to be a powerful tool for research of dental formation and caries diagnosis.

Algorithms↗
PubMed2002

Long-term effects of Le Fort I osteotomy for resection of juvenile nasopharyngeal angiofibroma on maxillary growth and dental sensation.

OBJECTIVE: To analyze the long-term effects of the Le Fort I osteotomy approach for the resection of juvenile nasopharyngeal angiofibroma (JNA) on maxillary growth and dental sensation. DESIGN: Prospective collection of structured data. SETTING: Tertiary care academic teaching hospital. PATIENTS: Between 1993 and 1998, 5 adolescents (aged 10-14 years) constituted the evaluable cohort among 14 patients who underwent Le Fort I osteotomy for JNA resection. Mean follow-up was 47.2 months. INTERVENTIONS: The Le Fort I osteotomy approach was used to resect JNA. Cephalometric x-ray films were taken at various postoperative intervals to assess maxillary growth. The results were matched against age-correlated predictions from Dentofacial Planner software. MAIN OUTCOME MEASURES: Horizontal and vertical maxillary growth were each measured anteriorly and posteriorly by comparing interval postoperative cephalometric x-ray films. Dental sensation was longitudinally evaluated by performing interval pulp testing postoperatively. RESULTS: (1) Average vertical growth of the maxilla achieved 30% of predicted growth anteriorly (P =.02). (2) Average horizontal growth matched predicted growth in all patients. (3) All patients demonstrated long-term maxillary dental denervation. CONCLUSIONS: Le Fort I osteotomy provides excellent surgical exposure for resection of JNA in the growing facial skeleton. Although it significantly affects vertical but not horizontal growth, its cosmetic effect is negligible. It also causes long-term dental denervation, which in most cases is undetected by patients.

Adolescent↗
PubMed2000

Effect of HeNe and pulsed Nd:YAG laser irradiation on intradental nerve responses to mechanical stimulation of dentine.

BACKGROUND AND OBJECTIVE: Our study aimed to determine how lasing affected intradental nerve responses to dentine stimulation. Study Design/Materials and Methods Intradental nerve activity was recorded from canine teeth of anaesthetised ferrets. Dentine exposed at the tip of the tooth was stimulated with a glass probe. After determining baseline responses to mechanical stimulation, dentine was lased using a pulsed Nd:YAG laser at 60-150mJ/pulse and 10-30 pulses/sec (total power = 0.3-3.0 W). RESULTS: The HeNe aiming beam alone and Nd:YAG laser at 0.3 W (+ HeNe) had no effect on intradental nerve responses to dentine stimulation. Lasing at 0.6-1. 5 W could either enhance or suppress intradental nerve responses. Lasing at more than or equal to 2.0 W or repeated lasing at lower intensities depressed intradental nerve responses. Lasing often induced intradental nerve firing. CONCLUSION: HeNe lasing had no effect on intradental nerve excitability. The Nd:YAG laser could depress intradental nerve responses to dentine stimulation.

Action Potentials↗
PubMed2000

Pulsed Nd:YAG laser irradiation of the tooth pulp in the cat: I. Effect of spot lasing.

BACKGROUND AND OBJECTIVE: The purpose of the present study was to evaluate physiologically pulpal nerve responses and to elucidate histopathologically the pulp tissue reactions to "spot irradiation" with a pulsed Nd:YAG laser. STUDY DESIGN/MATERIALS AND METHODS: Antidromic compound action potentials and the pulpal blood flow (PBF) were recorded from the canine tooth of a sodium pentobarbitone-anesthetized cat. The laser irradiation-induced pulp tissue changes were histologically investigated. RESULTS: The coronal antidromic compound action potentials disappeared in all the teeth tested during lasing, and the time needed to erase them was significantly shortened with increases in lasing power (P < 0.05). The radicular PBF increased when spot irradiation was performed, and the coronal PBF also temporarily increased with low-powered lasing. Histologic investigation revealed that spot irradiation with the laser produced severe damage in the pulp tissue in a dose-dependent manner. CONCLUSION: The present study suggests that spot irradiation with a pulsed Nd:YAG laser risks producing nerve injury and irreversible tissue damage in the pulp with lasing for the purpose of desensitizing hypersensitive dentin.

Action Potentials↗
PubMed2001

Oral health status of workers exposed to acid fumes in phosphate and battery industries in Jordan.

OBJECTIVES: To investigate the prevalence and nature of oral health problems among workers exposed to acid fumes in two industries in Jordan. SETTING: Jordan's Phosphate Mining Company and a main private battery factory. DESIGN: Comparison of general and oral health conditions between workers exposed to acid fumes and control group from the same workplace. SUBJECTS AND METHODS: The sample consisted of 68 subjects from the phosphate industry (37 acid workers and 31 controls) drawn as a sample of convenience and 39 subjects from a battery factory (24 acid workers and 15 controls). Structured questionnaires on medical and dental histories were completed by interview. Clinical examinations were carried out to assess dental erosion, oral hygiene, and gingival health using the appropriate indices. Data were statistically analysed using Wilcoxon rank-sum test to assess the significance of differences between results attained by acid workers and control groups for the investigated parameters. RESULTS: Differences in the erosion scores between acid workers in both industries and their controls were highly significant (P<0.05). In both industries, acid workers showed significantly higher oral hygiene scores, obtained by adding the debris and calculus scores, and gingival index scores than their controls (P<0.05). The single most common complaint was tooth hypersensitivity (80%) followed by dry mouth (77%) on average. CONCLUSION: Exposure to acid fumes in the work place was significantly associated with dental erosion and deteriorated oral health status. Such exposure was also detrimental to general health. Findings pointed to the need of establishing appropriate educational, preventive and treatment measures coupled with efficient surveillance and environmental monitoring for detection of acid fumes in the workplace atmosphere.

Acids↗
PubMed2003

Treatment of cervical dentin hypersensitivity using neodymium: Yttrium-aluminum-garnet laser. Clinical evaluation.

BACKGROUND AND OBJECTIVE: The incidence of cervical dentinal hypersensitivity is related to the high number of non-carious cervical lesions. This clinical research was developed in order to evaluate the Nd:YAG laser treatment of cervical dentin hypersensitivity after attempting the removal and control of etiologic factor after two different stimuli. STUDY DESIGN/MATERIALS AND METHODS: Twenty patients participated in this study in a total of 145 teeth, where 104 received the Nd:YAG laser treatment and 41 remained as control. RESULTS: The results showed that there was statistically significant reduction of hypersensitivity as for the groups that received the treatment with Nd:YAG laser, as for the control teeth. However, the reduction of cervical dentinal hypersensitivity was statistically greater when there was the association of the removal of etiologic factors with the application of Nd:YAG laser. CONCLUSIONS: We concluded that the laser irradiation was effective in the treatment of cervical dentin hypersensitivity after 6 months.

Adult↗
PubMed2005

Qualitative microanalysis of ions and ultrastructural changes in dentin exposed to laser irradiation and to metal salts solution.

BACKGROUND AND OBJECTIVES: This study evaluated the ultrastructural changes in dentin after treatment with the Nd:YAG laser and/or metal salt solutions and verified the presence of Sn++, Sr++, and F- in dentin structure. STUDY DESIGNS/MATERIALS AND METHODS: Sixty dentin disks were randomly divided into groups (n = 10): (I) control (no treatment), (II) Nd:YAG (1.5 W, 100 mJ, 15 Hz, 125 J/cm2), (III) 10% SnF2 aqueous solution for 30 minutes, (IV) Nd:YAG+10% SnF2 aqueous solution for 30 minutes, (V) 10% SrCl2 toothpaste for 30 minutes, (VI) Nd:YAG+10% SrCl2 toothpaste for 30 minutes. Then, all samples were prepared for scanning electron microscopy (SEM) and the samples from Groups I to IV for the energy dispersive X-ray microanalysis (EDX). RESULTS: SEM evaluation revealed occluded dentinal tubules and a dentin surface altered by the laser irradiation. The EDX microanalysis revealed Sn++ at a depth of 250 microm in Group IV and not deeper than 100 microm in Group III. In Group V, Sr++ was not deeper than 50 microm, but it could be detected at a depth of 500 microm in Group VI. F- was found only in Group IV. CONCLUSIONS: Ultrastructural changes caused by laser irradiation can increase dentin uptake of Sn++, Sr++, and F-.

Dentifrices↗
PubMed2003

Oral manifestations in a group of young patients with anorexia nervosa.

Anorexia nervosa (AN) is an eating disorder (ED) identified using DSM-IV criteria. Eating disorders are occurring increasingly earlier in childhood and can lead to a series of oral manifestations. The aim of this study was to evaluate the correlation between stomatognathic lesions and eating disorders in 80 young patients (76 females and 4 males aged 9-18 years) with restricting or binge-eating/purging AN. The results confirm the close correlation between ED and oral lesions, the most common of which were dental erosion, dentinal hypersensitivity, the extrusion of amalgam restorations and xerostomia. The authors conclude by emphasising the importance of involving dentists in the diagnosis and treatment of ED.

Adolescent↗
PubMed2003

One-year evaluation of an Ormocer restorative-a multipractice clinical trial.

The purpose of this ongoing prospective long-term study was to evaluate the clinical performance of Ormocer restorative material in combination with a self-conditioning adhesive. Five operators at five clinics placed 356 restorations (48 class I, 150 class II, 63 class III, 32 class IV, and 63 class V) in 117 patients aged 17 to 65 years. All fillings were placed with cotton roll isolation and clear matrix bands for class III and IV restorations, and metal matrix bands and an incremental placement technique were used for class II restorations. In follow-up examinations after 6 and 12 months, modified Ryge criteria were recorded on all restorations. With 33 randomly selected class I and II restorations, measurements of occlusal wear (via 3D laser scanner) and qualitative and quantitative marginal analysis (via scanning electron microscope) were performed using a replica technique. After placing the fillings, patients reported postoperative hypersensitivity corresponding to B scores in 19 cases and to C scores in four cases. At 12-month recall, 328 restorations were available for evaluation. Losses in the five cavity classes (I, II, III, IV, V) numbered 0, 2, 0, 1, and 6, respectively. The percentages of retained restorations for clinical parameters in four categories (Alpha, Beta, Charlie, Delta) were: 94.7, 5, 0.3, and 0 (marginal integrity), 81.2, 18.8, 0, and 0 (marginal discoloration), 75.2, 24.8, 0, and 0 (anatomic form), and 95, 4.7, 0.3, and 0 (fracture), respectively. Marginal analysis showed 48.7% "continuous margin" initially and 17.7% at 12 months (difference statistically significant, P=0.05). The occlusal wear at 12 months was 10.0 microm (SD 11.6) for premolars and 22.0 microm (SD 24.1) for molars. Over the 12-month observation period, the Ormocer restorative was clinically effective in combination with a self-conditioning adhesive, and concern persists related to the marginal quality and retention of class V restorations.

Adolescent↗
PubMed2003

Long-term clinical performance and longevity of gold alloy vs ceramic partial crowns.

Cast gold partial crowns (CGPC) are an accepted means of restoring posterior teeth. For aesthetic reasons, gold alloys are being increasingly substituted with ceramics. The aim of the present study was to investigate retrospectively the long-term clinical performance and survival of CGPC and compare the results to the ones already reported for ceramic partial crowns (CPC). The CGPC group consisted of 42 patients (24 male, 18 female) randomly sampled from a total of 106 patients with CGPC, with one restoration per patient. The CPC group consisted of 22 patients with a total of 42 restorations. Both types of restoration were done by one experienced dentist. Another two experienced dentists who were not involved in performing the restorations rated both kinds of partial crowns using the modified United State Public Health Service (USPHS) criteria [14]. The Median age of the CGPC was 57 months (range 3-157) and of the CPC and 63 months (range 24-72). Forty-one (98%) of the CGPC and 27 (64%) of the CPC were placed in molars, the rest in premolars. In each group, 40 (95%) restorations were still functioning without any necessity of replacement. Two teeth with CGPC, in situ for 4.5 and 11 years, respectively, had been extracted for periodontal reasons. Two CPC fractured and had to be replaced after 2 and 6.5 years in situ. The USPHS criteria results were similarly good for the gold and ceramic groups. Kaplan-Meier analysis revealed survival probabilities of 72+/-21% and 96+/-4% after 13 and 7 years, respectively, for the CGPC. Survival of the CPC was 81+/-15% after 7 years. No statistically significant difference among survival functions of CGPC and CPC was found. From this data, it can be concluded that the longevity of CPC is not inferior to that of gold alloys. However, more long-term studies comparing the clinical performance and longevity of these two types of indirect restoration in the posterior region with larger numbers of restorations are desirable.

Bicuspid↗
PubMed2006

Two-year clinical performance of cast gold vs ceramic partial crowns.

Cast gold partial crowns (CGPC) are an accepted means of restoring posterior teeth with extended lesions. However, for esthetic reasons, CGPC are being increasingly substituted with partial ceramic crowns (PCC). The aim of the present prospective split-mouth study was to compare the clinical performance of PCC and CGPC. There were 29 patients (male 12, female 17) who participated in the investigation for a total of 58 restorations. In each patient, one CGPC (Degulor C) and one PCC (Vita MarkII/Cerec III) were placed. CGPC were inserted using conventional zinc-phosphate cement (Harvard); PCC were adhesively luted to the cavities (Variolink II/Excite). The restorations were clinically rated using modified United States Public Health Service (USPHS) criteria at baseline and 1 and 2 years after placement. The median patient age was 38 years (range 25-54). There were 29 of the CGPC and 14 PCC placed in molars, while 15 PCC were placed in premolars. All patients were available for the 1- and the 2-year recall. One PCC (1.7%) failed and had to be replaced after 2 years in situ. The rest of the restorations were functional without need of replacement. The evaluation using USPHS criteria revealed no statistically significant differences between CGPC and PCC with the exception of anatomic form: PCC showed occlusal chipping in two cases without need of replacement. From these data, it can be concluded that PCC may provide an esthetic and tissue-conservative alternative to CGPC. However, long-term studies comparing the clinical performance and longevity of cast gold and ceramic partial crowns for posterior teeth are desirable.

Adult↗
PubMed2001

Clinical performance and margin analysis of ariston pHc versus Solitaire I as posterior restorations after 1 year.

The resin composite Ariston pHc (pHc means pH control) was introduced as an alternative for fast amalgam replacement. The aim of the present study was to evaluate clinically the behaviour of this non-bonded resin composite material, promising the release of fluoride, calcium, and hydroxy ions, in comparison to a bonded resin composite (Solitaire I) in class I and II cavities. Ninety-nine cavities in 31 patients were restored in a controlled prospective clinical study. Fifty fillings were placed with Ariston pHc as per the manufacturer's instructions, i.e. neither with enamel etching nor with the use of rubber dam. The same patients received 49 Solitaire I restorations totally bonded with Solidbond using rubber dam. At baseline, after 6 months, and after 12 months, two investigators given the same instructions examined the restorations, according to modified USPHS codes and criteria. Forty selected restorations (20 Ariston, 20 Solitaire) were additionally analysed via replicas, using a stereo light microscope (SV 11, Zeiss, Germany) at 130x magnification. After 12 months, 95 restorations were rated clinically acceptable (6% failure rate for Ariston pHc; 2% for Solitaire). Statistically significant differences were computed for both materials regarding the criterion "filling integrity". Further statistically significant deterioration for Ariston pHc between the three evaluations has been detected for the criteria "tooth integrity" (enamel cracks) and "marginal adaptation" (gap formation/Friedman 2-way ANOVA; p<0.05). With Ariston the criterion "hypersensitivity" also increased significantly after 1 year in comparison to Solitaire. The microscopic margin analysis revealed significantly increasing marginal deficiencies over time for both materials regarding the criteria "perfect margin", "gap formation", and "negative step" (P<0.05; Friedman 2-way ANOVA).

Adult↗
PubMed2005

Clinical evaluation of a new bleaching product "Polanight" in a Japanese population.

Home bleaching techniques have been applied as a safe and effective bleaching procedure. Many manufacturers are now marketing home tooth-bleaching products. The purpose of this study was to compare a new bleaching product, Polanight (PN) with a widely used home bleaching product, Opalescence (OP). Fifty-eight healthy Japanese volunteers of both sexes (18 to 47 years of age) were selected. Using a simultaneous split-mouth protocol, custom-made trays with PN and OP were applied to the maxillary right anterior teeth and left anterior teeth, respectively. The shades of the maxillary canine teeth were measured with a portable chromameter (Shade Eye Ex) at the first examination and at 4 weeks (after 2-week bleaching and 2-week rest). Tooth shade changes were analyzed using the Commission Internationale d'Eclairage (CIE) Lab units. Means of whiteness-blackness difference (DeltaL*), redness-greenness difference (Deltaa*), and yellowness-blueness difference (Deltab*) were 4.00, -1.28 and -7.53 for PN, and 2.54, -0.99, and -5.56 for OP, respectively. Means of color difference (DeltaE*) were 9.23 and 7.78 for PN and OP, respectively. Treatment with either agent demonstrated significant bleaching effects produced by the treatment. The new product, PN, showed significant differences in DeltaL* (P < 0.05) and Deltab* (P < 0.005), but not in the redness-greenness (a*) value when compared with OP. Bleaching with PN was considered more effective than that with OP in the young patient group and in the women.

Adolescent↗