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PubMed2003

Portability of licensure in Canada based on accreditation and certification.

Although registration and licensure of dentists in Canada is the purview of the ten provincial licensing authorities in Canada, establishment of standards and certification of candidates has for fifty years been the responsibility of the National Dental Examining Board. The NDEB administers a validated set of written and objective standardized clinical examinations to educationally qualified candidates. Such candidates include those who have graduated from accredited Canadian and United States schools and graduates of non-accredited schools who have satisfactorily finished a qualifying program. The NDEB cooperates closely with U.S. educational and accreditation programs and the American Dental Association.

Accreditation↗
PubMed2003

Dentistry in the Department of Veterans Affairs.

The dental mission of the Department of Veterans Affairs includes care, typically hospital care, developing an educated cadre of oral health care professionals, and research. Its innovations emphasize the local nature of care requirements, and it enjoys a tradition of partnering with other branches of the federal services, the American Dental Association, and education.

Dental Health Services↗
PubMed1992

Computer simulation on creep of amalgam in Class I cavity.

The creep behavior of amalgam in Class I cavity was simulated by an axi-symmetric elastic creep finite element method. In this procedure, the stress and time dependencies of the creep strain of amalgam were incorporated. Exponents of stress and time dependencies were postulated as 2.0 and 1.0, respectively. Amalgam with 1.0% of creep value (tested by American Dental Association Specification No. 1) were selected for the material to calculate. Simulation was conducted for the occlusal force of 40, 100, and 150 N, respectively, on the caps of enamel and vertical direction to the axis of the tooth. Results show that creep strain of amalgam in the cavity did not increase linearly with time because the amalgam deformed to become stress-free and creep rate was a function of the stress. It was concluded that elastic deformation of the crown with no filling material in its cavity is an important factor in determining the creep strain and the gap between the cavity and the restorative material.

Biomechanical Phenomena↗
PubMed2003

Clinical effectiveness of a triclosan/copolymer/sodium-fluoride dentifrice in controlling oral malodor: a three-week clinical trial.

The purpose of this study was to compare the effectiveness of a commercially available, clinically proven, American Dental Association (ADA)-Accepted dentifrice containing 0.30% triclosan, 2% polyvinylmethylether/maleic acid (PVM/MA) copolymer, and 0.243% sodium fluoride in a 10% high-cleaning silica base (Colgate Total Advanced Fresh) to a commercially available, clinically proven, ADA-Accepted control dentifrice containing 0.243% sodium fluoride in a silica base (Colgate Cavity Protection Winterfresh Gel) for the management of oral malodor in a 3-week, randomized, double-blind longitudinal clinical trial. A panel of four expert judges used a nine-point hedonic scale to evaluate breath odor using a protocol designed in concordance with the ADA Draft Acceptance Program Guidelines for Products Used in the Management of Oral Malodor. After a baseline evaluation, prospective study subjects who scored above the threshold value for unpleasant breath odor were stratified by score and randomized into two treatment groups. Subjects were provided with a soft-bristled toothbrush and brushed their teeth thoroughly in their regular and customary manner for 1 minute with their assigned dentifrice, twice daily. Before oral-malodor evaluations, the subjects refrained from eating odorigenic foods and did not use dental hygiene procedures, breath mints, or mouth rinses. Eighty-one adult men and women from Chengdu, China, completed the study. Throughout the study, the mean breath-odor scores observed in the Colgate Total Advanced Fresh toothpaste group for both daytime and overnight were within the range of values associated with pleasant breath odor, were statistically significantly lower than the corresponding mean scores for the control group, and also represented statistically significant reductions from baseline. Relative to the baseline score, more than 80% of the subjects in the Colgate Total Advanced Fresh toothpaste group demonstrated a 3.2 or more unit reduction in organoleptic scores at every postbaseline breath-odor evaluation. Thus, the overall results of the double-blind clinical study support the conclusions that Colgate Total Advanced Fresh toothpaste is efficacious for the control of oral malodor for up to 12 hours in the daytime and up to 12 hours overnight.

Adolescent↗
PubMed2004

Why our ethics curricula don't work.

The impact our ethics curricula have on students seems marginal at best. Students take the ethics courses we offer and pass the tests we give, but no one's behavior changes as a result. We fundamentally see ourselves teaching about ethics, which is slightly different than teaching ethics--and expecting behavior to change as a result of what is taught. The premise of this article is that our ethics courses are inadequate in content and form to the extent that they do not cultivate an introspective orientation to professional life. In some cases they amount to little more than a study of various state dental practice acts or the Code of Ethics of the American Dental Association. Three specific weaknesses are identified in a typical ethics curriculum: 1) failure to recognize that more education is not the answer to everything; 2) ethics is boring; and 3) course content is qualitatively inadequate because it does not foster an introspective basis for true behavioral change. A fourth element, an innovation, is directed to this third weakness and entails implementing a precurriculum very early in the dental educational experience to address the disconnect between knowledge and action.

Curriculum↗
PubMed2004

Efficacy of A-dec's ICX dental unit waterline treatment solution in the prevention and treatment of microbial contamination in dental units.

OBJECTIVE: Even though some chemical agents can disinfect biofilms in dental unit waterlines, there remains concern that all remnants of the biofilm matrix are not eliminated. Even with periodic treatments, the bacterial populations in dental unit waterlines recur rapidly. In addition, with some previously tested products, patient safety, as well as toxic, caustic and corrosive residual chemicals are also a concern. This study evaluated ICX, A-dec's new water treatment solution, in a series of experiments for prevention, microbial spectrum of activity, minimum inhibitory time determination, and treatment of established biofilms. METHODOLOGY: New dental unit waterline tubing was treated continuously during simulated patient care over 28 days with municipal water. It was then treated with ICX. Effluents from lines with established biofilms (averaging > 10(4) CFU/ml at day 0) were treated to assess levels of CFU counts within 21 days of exposure to ICX. RESULTS: Tubing treated with ICX did not develop a detectable biofilm using ruthenium red staining, and microbes in effluents remained undetectable. CONCLUSION: ICX is effective in maintaining the effluent within the American Dental Association's and the Centers for Disease Control's recommendation for < 500 CFU/ml. In addition, considering the preliminary finding that ICX reduces microbial contamination of effluents from established biofilm lines, it may be useful in long-term treatment alone or when coupled with a shock treatment to assist in biofilm destruction.

Biofilms↗
PubMedDate not supplied

A randomized, controlled trial evaluating the three-year clinical effectiveness of two etch & rinse adhesives in cervical lesions.

A three-year randomized, controlled prospective study evaluated the clinical performance of two three-step etch & rinse adhesives (OptiBond FL, Kerr: O-FL; PermaQuick, Ultradent: PMQ) in Class V cervical erosion-abrasion lesions. The latter adhesive was also tested with two restorative composites with contrasting stiffness in order to evaluate the effect composite stiffness might have on the clinical longevity of cervical restorations. A total of 150 lesions were randomly restored in pairs of the three adhesive/composite combinations (PMQ combined with Amelogen Hybrid: PMQ/A-Hy, Ultradent; PMQ combined with Amelogen Microfill: PMQ/A-Mi, Ultradent; O-FL combined with Prodigy: O-FLJPro, Kerr) per patient and evaluated at baseline, after six months, one year, two years and three years of clinical service. After three years, the retention rate was 100% for O-FL/Pro and 98% for both PMQ/A-Hy and PMQ/A-Mi, thereby, satisfying the "full acceptance" guidelines specified by the American Dental Association. A pairwise comparison showed no significant difference in adhesive performance between restorations made using the microfilled and hybrid composite for any evaluation criteria (p>0.05).

Chi-Square Distribution↗
PubMed2004

Reduction of bacterial levels in dental unit waterlines.

OBJECTIVES: To test the efficacy of an intermittent use, dental unit waterline cleaner, containing 0.12% chlorhexidine, in a proprietary formulation, to reduce bacterial levels in three functioning dental units with independent water reservoir systems. METHOD AND MATERIALS: Baseline water samples were first taken from six units. Two ounces of the undiluted test product was run through lines, left overnight, and flushed out the next morning. This was repeated for 6 nights initially, and once a week thereafter for 12 weeks. Three control dental units did not have chemicals added. Weekly samples were collected in bottles containing sodium thiosulphate on the afternoon before overnight treatment, plated on R2A agar, and incubated at room temperature for 7 days. RESULTS: Mean colony-forming units per millimeter (CFU/mL) in treatment units declined from 23,389 (+/- 20,085) at baseline, to 6 (+/- 10) in week 4, to 5 (+/- 2) in week 12. Statistical analysis showed a significant difference between treatment and control units. CONCLUSION: Intermittent treatment of dental unit waterlines with 0.12% chlorhexidine gluconate (CHX), in a proprietary formulation, resulted in significantly reduced bacterial counts to levels that were consistently below the American Dental Association's goal of 200 CFU/mL for 8 weeks.

Anti-Infective Agents, Local↗
PubMed1994

The real issue of health care reform.

Perhaps a better title would be, Health Care Reform: Does it affect dentistry? This query arises because only one of the major legislative proposals includes dentistry to any significant degree and as of now the American Dental Association is opposed to the inclusion of dentistry (except for indigent children) in Health Care Reform. Of course, however, the answer to this question is yes. The suggested legislation will bring about changes of such magnitude that dentistry can't avoid their influence. We will briefly outline the main issues involved in health care reform and summarize what the proposals mean for dentistry.

Dentistry↗
PubMedDate not supplied

Effect of mixing technique on shrinkage rate of one polyether and two polyvinyl siloxane impression materials.

PURPOSE: Different mixing techniques may affect the quality of set impression materials. Therefore, dimensional accuracy is the most important factor when constructing a passive and accurate prosthesis. In this study, observation of the shrinkage rate of one polyether and two polyvinyl siloxane impression materials, which are both commercially available for cartridge- and hand-mix techniques, was used for comparative analysis. The hypothesis was that the cartridgemix technique would produce a more precise impression. The authors also sought to confirm the hypothesis that the studied materials would remain stable after setting. MATERIALS AND METHODS: The low-viscosity polyether material was Permadyne Garant 2:1, type 3 (ESPE). The polyvinyl siloxane materials were: (1) medium-viscosity Provil Novo Medium, cartridge- and hand-mix type 2 (Heraeus Kulzer); and (2) low-viscosity President, hand- and cartridge-mix type 3 (Coltène). Measurements were made according to American Dental Association specification No. 19. Ten specimens were made of each impression material; the same examiner measured each specimen 10 times. Shrinkage rates of the same materials mixed using different techniques were compared 30 minutes, 24 hours, and 72 hours after mixing. Dimensional changes at the different measuring times were also compared. The results were statistically analyzed and compared with the SPSS for Windows program package, version 11.0 (SPSS); a two-sample t test was applied to compare the mixing techniques at every measuring time; and a Friedman test was used to analyze the changes in shrinkage rate during the evaluation period (P > .05). RESULTS: Figure 1 shows the shrinkage rate data for all materials. Statistical analysis showed no significant difference at any measuring point when the mixing techniques of the polyvinyl siloxane materials were compared. However, analysis showed significant differences for both hand- and cartridge-mixed materials when measurements at 30 minutes, 24 hours, and 72 hours were compared; the shrinkage rate increased significantly as time passed. Statistical analysis of the results of the polyether material showed no significant difference at 30 minutes, but at 24 and 72 hours, the cartridge-mixed material produced a statistically higher shrinkage rate. Analysis also showed significant differences for both hand- and cartridge-mixed materials when measurements at 30 minutes, 24 hours, and 72 hours were compared; shrinkage rate also increased significantly as time passed. CONCLUSION: We could not detect significant differences in dimensional changes when hand- and cartridge-mix techniques were compared at the same measuring time for the tested polyvinyl siloxane materials. The cartridge-mix technique for the polyether material showed significantly higher shrinkage at 24 and 72 hours, while the mean shrinkage rate of all six materials showed a significant time-dependent increase.

Dental Impression Materials↗
PubMed2004

Effects of hydrogen peroxide bleaching strip gels on dental restorative materials in vitro: surface microhardness and surface morphology.

OBJECTIVE: This study examined the effects of peroxide tooth bleaching, including Crest Whitestrips hydrogen peroxide gel treatments, on the surface hardness and morphology of common dental restorative treatments. METHODOLOGY: American Dental Association (ADA) recommended dental restorative materials, including amalgam, dental gold, porcelain, glass ionomer, and composites, were prepared according to manufacturers' instructions. A cycling treatment methodology was employed which alternated ex vivo human salivary exposures with bleaching treatments under conditions of controlled temperature and durations of treatment. Bleaching treatments included commercial Crest Whitestrips bleaching gels, which utilize hydrogen peroxide as the in situ bleaching source, and several commercial carbamide peroxide bleaching gels. Control treatments included placebo gels and an untreated group. Crest Whitestrips bleaching included treatment exposures simulating recommended clinical exposures (14 hours), along with excess bleaching simulating exposure to five times suggested Crest Whitestrips use. At the conclusion of treatments, surface microhardness measures and surface morphological assessments with standard and variable pressure (VP-) SEMs were conducted to assess the effects of bleaching exposure on the surface morphology and structural integrity of the restoratives. RESULTS: Surface microhardness and SEM measures revealed no significant deleterious effects on the restoration surfaces from Whitestrips gels. CONCLUSION: These results confirm that tooth bleaching from the selected commercial hydrogen peroxide or carbamide peroxide bleaching systems does not produce changes in surface morphology or microhardness of common dental restorative materials. These results support the clinical safety of the selected commercial bleaching systems to the oral environment, matching results obtained from long-term use of these ingredients applied in dental offices and available in commercial formulations.

Carbamide Peroxide↗
PubMed2005

An evidence-based journal club for dental residents in a GPR program.

The journal club offers a significant opportunity to serve as both an educational experience but also as a real-world example of the application of the principles and practices of evidence-based dentistry (EBD). Designed around the American Dental Association's recommended four steps in the implementation of the EBD process, the journal clubs are held once per month for GPR residents. The structured process allows residents to formulate answerable clinical questions, track down with maximum efficiency the best evidence with which to answer the questions, critically appraise the evidence for its validity and usefulness, and apply the results of this appraisal in clinical practice as appropriate.

Databases as Topic↗
PubMed2005

Marginal microleakage around class V cavities restored with glass ceramic inserts of different coefficients of thermal expansion.

OBJECTIVE: Evaluate microleakage around Class V resin restorations restored with glass ceramic inserts of different coefficients of thermal expansion. METHODOLOGY: Sixty non-carious extracted human premolars (patient age range 12-20 years) were randomly assigned to three groups. Standard Class V preparations were cut in the buccal surface using customized Cerana burs, size 3. Glass ceramic inserts from two manufacturers (Cerana and Beta-Quartz) were used to restore the cavities, and were luted with a hybrid, high-viscous composite (Tetric Ceram) and a bonding agent (Excite). A control group, without inserts, was bulk-filled with a hybrid, high-viscous composite (Tetric Ceram). In accordance with American Dental Association (ADA) guidelines, half the preparation was in enamel and half in dentine/cementum, and had a mesio-distal width of 3 mm, an occluso-gingival height of 3 mm, and a depth of 2 mm. All margins had butt joints. The teeth were thermocycled 4000 times between water baths held at 5 degrees C and 55 degrees C, and the specimens prepared and examined for microleakage using 2.0% Procion Red dye, buffered at pH 7 as a marker. RESULTS: Microleakage was significantly less around cavities restored with Cerana glass ceramic inserts than around cavities restored with Beta Quartz glass ceramic inserts or the control cavities at both the occlusal and gingival margins, p = 0.003 and p = 0.014, respectively. Comparisons of both occlusal and gingival margins within both test groups and the control group showed there was significantly less microleakage at the enamel-resin interface than at the dentine-resin interface (p < 0.05 in all cases). CONCLUSION: The results strongly suggest that restorations restored with Cerana glass ceramic inserts, which have a coefficient of therml expansion approximating that of enamel, result in a decrease in marginal microleakage compared to Beta Quartz glass ceramic inserts and Tetric Ceram resin-based composite material.

Acrylic Resins↗
PubMed2005

Pathways in dental public health.

Dental public health is one of the nine specialties of dentistry recognized by the American Dental Association Commission on Dental Accreditation. Dental public health has been defined as the "science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than as an individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis." This article will describe the many career and educational pathways dentists may follow to become irvolved in the practice of dental public health.

California↗
PubMed2005

Long-term stability of prosthetic treatment of oronasal and oroantral communications.

This five-year prospective study demonstrates prosthetic treatment by multidisciplinary therapy: surgeon, orthodontist, and prosthodontist. 10 patients volunteered for the study (a group of 7 men and 3 women at an average age of 33.2 years). 10 obturators, 49 fixed dentures were inserted to the upper jaw. Based on ADA (American Dental Association) recommendation a special card was prepared containing relevant information on the patients. Clinical assessments were carried out in accordance with the US Public Health Service System. In a 5-year period only 50.0% of restorations were excellent, receiving 100% alpha rating. The marginal ridge contour and adaptation of obturator achieved 60.0% alpha rating. The anatomic form of dental arch was destroyed in 50.0%. The presence of caries was not detected. Six teeth were extracted due to periodontal disease. The general contour of the restoration followed the overall contour of the fixed denture in 95.9%. Plaque accumulation was found in 50%. The colour match of crowns was darker and translucent in 27.7%, but discoloration of removable denture was seen in 30.0%. The three case reports demonstrate the long-term stability of treatment (from alpha to charlie evaluation). Attachment retention, fixed and removable denture with metal base are the first method of choice, due to acceptable long-term stability.

Adult↗
PubMed2005

TRICARE; changes included in the National Defense Authorization Act for fiscal year 2005; TRICARE Dental Program. Interim final rule.

The Department is publishing this interim final rule to implement sections 711 and 715 of the Ronald W. Reagan National Defense Authorization Act for Fiscal Year 2005 (NDAA-05), Public Law 108-375. Specifically, that legislation makes young dependents of deceased Service members eligible for enrollment in the TRICARE Dental Program when the child was not previously enrolled because of age, and authorizes post-graduate dental residents in a dental treatment facility of the uniformed services under a graduate dental education program accredited by the American Dental Association to provide dental treatment to dependents who are 12 years of age or younger and who are covered by a dental plan established under 10 U.S.C. 1076a. This rule also corrects certain references in 32 CFR 199.13. The rule is being published as an interim final rule with comment period in order to comply with statutory effective dates. Public comments are invited and will be considered for possible revisions to the final rule.

Accreditation↗