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PubMed2005

[Detection of early fissure caries with clinical, radiologic, and laser fluorescence methods].

PURPOSE: The aim of study was to compare the diagnostic efficacy of the newly introduced DIAGNOdent laser fluorescence with traditional methods for detection of molar caries, namely visual inspection and bitewing radiographs. MATERIAL AND METHODS: Discolored fissures of 134 permanent molars were studied in 103 patients aged 12-18 years. RESULTS: The results indicate that visual examination and bitewing radiographs showed very high or high sensitivity and specificity for the detection of early fissure caries. Combination of these two methods decreased the number of false positive and negative results. Diagnostic accuracy of DIAGNOdent was significantly inferior to that of clinical examination or bitewing radiographs. CONCLUSION: However, the diagnostic accuracy of DIAGNOdent was increased by combining it with one of the two traditional methods studied.

Adolescent↗

PubMed2006

Black stains in the mixed dentition: a PCR microbiological study of the etiopathogenic bacteria.

The aim of this work is to emphasize that particular stains on the third cervical of the buccal and lingual surfaces in mixed dentition, called "black stain." Previous research showed the microbiological etiology of this discoloration by chromogen bacterias. Our study shows bacteria spp involved in stains by means of PCR process and electrophoresis gel on the agarose medium. Sample was formed by 100 subject with black stain and 100 control subjects stain-free. A statistical analysis (SPSS 10.0) using X2 was performed in this study. Porphyromonas gingivalis and Prevotella melaninogenica, were not involved in both in black stain subjects and in the control. On the contrary, Actinomyces could be involved in the pigmentation process.

Actinomyces↗

PubMed1992

Dental findings of patients who underwent liver transplantation.

Cyclosporin-induced gingival enlargement was presented. Enlargement was noted at several sites in the mouth of five patients taking Cyclosporin following liver transplantation. Papillary gingival enlargement was observed to affect the entire maxilla and mandible. Enlargement was particularly marked in the interdental papillary region on the labial side of the anterior teeth of the maxilla. Discoloration of the teeth was observed. Radiographic findings were unremarkable. Oral management of these patients is the prevention of dental caries and infection originating in the area of gingival enlargement. It is important to begin proper brushing as early as possible for suppressing progression of gingival enlargement. For prevention of dental caries, prophylaxis is more important in the case of liver transplantation than with normal patients. It should be stressed to the patients or their parents that periodic examination, topical application of fluoride and pit and fissure sealants are of special importance.

Child, Preschool↗

PubMed1976

Reddening of the upper central incisors associated with periapical granuloma in lepromatous leprosy.

Four years after starting treatment for lepromatous leprosy in England a male Pakistani aged 26 was found to have red discoloration of the upper central incisor teeth. A radiograph suggested periapical abscess on the right with haziness in a corresponding area on the left. Right apicectomy was performed with removal of a solid mass attached to the apex, sections revealing a lepromatous infiltrate with acid-fast fragments of Mycobacterium leprae in the cytoplasm of foamy macrophages. Clinical and archaeological evidence for the frequent involvement of these teeth in lepromatous leprosy is reviewed. The upper incisor area is relatively cool, a factor which may be of critical importance for the lodgement and multiplication of this bacillus, as it is in other body sites in lepromatous leprosy.

Adult↗

PubMed2000

Nightguard vital bleaching: dark stains and long-term results.

Since its introduction to dentistry in 1989, nightguard vital bleaching has proven to be a simple and safe procedure for lightening discolored teeth. Efficacy of the technique is 98% for non-tetracycline-stained teeth, and with extended treatment time, tetracycline-stained teeth can be expected to lighten in 86% of cases. Satisfactory retention of the shade change without additional treatment can be expected in 63% of patients 3 years post-treatment and in at least 42% of patients at 7 years. Side effects are usually mild and transient, disappearing within days of treatment completion. Patients report that they are glad they went through the procedure and 98% recommend the procedure to a friend.

Anti-Bacterial Agents↗

PubMed2002

Clinical evaluation of Dyract AP restorative in permanent molars: 2-year results.

PURPOSE: To evaluate the clinical behavior of a compomer restorative system, Dyract AP, placed in combination with Non-Rinse Conditioner and Prime&Bond NT in permanent posterior teeth. MATERIALS AND METHODS: Fifty Class II and 41 Class I restorations were placed in 39 patients in a dental teaching hospital. The restorations were evaluated directly at baseline and after 6, 12 and 24 months using the modified USPHS-Ryge criteria. Clinical photographs, polyvinylsiloxane impressions and bitewing radiographs of each restoration were taken for indirect assessment. RESULTS: After 2 years, all 76 restorations were evaluated in situ. Color matching ability and surface characteristics were excellent. A gradual deterioration in marginal discoloration and marginal integrity was noted. The percentages of Alfa scores for each criterion at the 24-month evaluation were: color match 96%, marginal discoloration 50%, marginal integrity 26%, anatomic form 97% and surface texture 95%. Five of the restorations (6%) had experienced partial fracture or recurrent caries. After 6, 12 and 24 months, the net mean occlusal wear values were 18.5 microm, 35.7 microm and 55.9 microm, respectively. There was no statistically significant difference between Class I and II restorations for each criterion (Fisher's exact test, P > 0.05).

Adult↗

PubMed1996

Incidence of pulp necrosis subsequent to pulp canal obliteration from trauma of permanent incisors.

Little long-term data are available on the frequency by which pulp canal obliteration (PCO) subsequent to trauma leads to pulp necrosis (PN). In this study, 82 concussed, subluxated, extruded, laterally luxated, and intruded permanent incisors presenting with PCO were followed for a period of 7 to 22 yr (mean 16 yr). At final clinical examination, 51% of the observed teeth responded normally to electric pulp testing (EPT). An additional 40% of the teeth although not responding to EPT were clinically and radiographically within normal limits. Yellow discoloration was a frequent finding. During the observation period, periapical bone lesions suggesting PN developed in seven teeth (8.5%). Twenty-yr pulp survival rate was 84%, as determined from life-table calculations. There was no higher frequency of PN in obliterated teeth subjected to caries, new trauma, orthodontic treatment, or complete crown coverage than intact teeth. Although the incidence of PN in teeth displaying PCO seems to increase over the course of time, prophylactic endodontic intervention on a routine basis does not seem justified.

Chi-Square Distribution↗

PubMed2005

A comparative study of white and grey mineral trioxide aggregate as pulp capping agents in dog's teeth.

Mineral trioxide aggregate (MTA) is widely used for different perforation repairs, root-end filling, pulp capping and many other endodontic procedures. Because of potential discoloration effect of gray MTA, white MTA has been introduced into endodontic treatment for the same purposes. This study examined the dental pulp responses in dogs to both types of MTA used as a pulp-capping agent. The pulps of 24 teeth of four male dogs were exposed with a No.1 round bur and capped with either gray or white MTA. Histologic analysis was performed one and 2 weeks after treatment. Calcified bridge could be seen 1 week after treatment with both types of MTA, with no significant differences between the two treatments.

Aluminum Compounds↗

PubMed1994

Clinical diagnosis of occlusal dentin caries.

An occlusal restoration is usually considered necessary when a lesion extends into the dentin. This study aimed to assess the relationship between the clinical appearance of occlusal caries and the lesion depth. Special attention was paid to differentiate the inner, partly demineralitzed layer of carious dentin that should be preserved from the outer carious layer that should be removed before placing a restoration. Fissures in extracted premolars and molars were classified clinically by the authors. The mean pairwise interobserver agreement, weighted Cohen's kappa (kappa), was 0.73, which indicated 'substantial agreement'. The depth of zones revealing softness by probing and/or discoloration was assessed on ground surfaces. Of the carious fissures that were scored sound by clinical examination (n = 17), 76% revealed enamel lesions on the ground surfaces. Of those occlusal surfaces with a discoloration only but no cavitation (n = 57), 13 showed dentin lesions, but only 5 of these revealed softness by probing. Of those lesions with very small cavitations (n = 60), 19 were confined to enamel, 41 showed dentin lesions and of these 32 revealed softness by probing. All but 1 of the lesions with small cavitations (n = 28) showed dentin involvement and all but 2 of these revealed softness. If cavitation in the occlusal lesion was used as a criterion for identifying dentin lesions with softness, the sensitivity and specificity values were 0.92 and 0.69, which means a relatively high frequency of overregistration.

Bicuspid↗

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↗

PubMed1994

Influence of acid-etched splinting methods on discoloration of dental enamel in four media: an in vitro study.

The aim of this in vitro study was to assess the staining of enamel in relation to fixation of luxated teeth. Color changes induced by chlorhexidine, red wine, tea, and coffee were detected with a Minolta Chroma Meter (CR-121) after extracted teeth were treated to simulate construction of dental splinting. L*a*b* color readings were made before and after 7 days of incubation in the above-mentioned media in teeth treated 1) by acid-etching, 2) by acid-etching followed by resin, 3) by resin and composite, 4) by Triad Gel, and 5) by Protemp. L* is an indicator of black (0) and white (100). The a* values relate to the red (+100)-green (-100) color axes, and the b* values to the yellow (+100) and blue (-100) axes. Untreated teeth served as controls. One-way analysis of variance of mean L* values revealed no statistically significant differences in treatment. Discoloration was observed in all teeth, including the control ones. However, Protemp yielded the largest changes in mean L* values. Analysis of variance of mean L* values revealed statistically significant differences between incubation liquids because no increase in staining of enamel was noted after 7 days' incubation in chlorhexidine. Red wine increased the mean L* values more than coffee or tea. Changes in a*b* readings were toward red (+a*) after incubation in red wine, except in the case of teeth treated with resin. The color of all such teeth changed more toward yellow (+b*), because the resin used was yellow.(ABSTRACT TRUNCATED AT 250 WORDS)

Acid Etching, Dental↗

PubMed1988

Composite laminate veneers: a clinical study.

A 2-year clinical trial of a composite laminate veneer system for masking discoloration or hypoplasia on the anterior teeth of patients has been undertaken. Three hundred and twenty restorations were placed in seventy-nine patients, of these 273 restorations in sixty-eight patients have been followed over a 2-year period. The technique produced an acceptable improvement in the aesthetics of the patients in the trial. However, the veneers were susceptible to chipping (52% of lateral incisor veneers and 79% of central incisor and canine veneers showed some evidence of material loss after 2 years) and marginal staining (75% of veneers showed some evidence of marginal staining after 2 years) during function. The veneer restorations had a deleterious affect upon the gingival health of the teeth on which they were placed.

Adolescent↗

PubMed1981

Use of oral irrigators as vehicle for the application of antimicrobial agents in chemical plaque control.

The purpose of the present investigation was to study the topographical distribution of plaque formation using chlorhexidine digluconate (CH) as a mouthrinse and in oral irrigators during experimental gingivitis. Forty dental students (aged 22--26) with clean teeth and healthy gingivae abolished oral hygiene for a period of 3 weeks (Löe et al. 1965). During this period the participants were randomly assigned to one of five groups. Group A rinsed daily with 30 ml of a placebo and Group B with 30 ml 0.1% chlorhexidine digluconate. In Groups C and E a fractionated jet irrigator was used for the daily application of 600 ml placebo (C) or 0.05% CH (E); 600 ml of 0.05% CH was also used in a monojet irrigator (Group D). At the start, after 1, 2 and 3 weeks of no oral hygiene and 1 week following reinstituted oral hygiene, plaque was assessed using the Plaque Index (Silness & Löe 1964) and gingival health was scored according to the criteria of the Gingival Index (Löe & Silness 1963). The discoloration of the teeth was determined using a set of color photos. During the experiment all groups reached plaque levels that were significantly different from each other. The highest PlI were seen in the placebo rinsing group (A) following by placebo irrigation (C). Plaque was significantly reduced in the CH groups. However, rinsing group (A) followed by placebo irrigation (C). Plaque was significantly reduced in the CH groups. However, rinsing (B) formed significantly more plaque than using the oral irrigator (D, E). Group E showed the least amount of plaque. In addition, the interproximal PlI were equally low as the buccal and lingual. With CH (B, D, E), gingivitis did not develop except for some interproximals in Group B. A fractionated jet irrigator was more effective for the application of CH than rinsing.

Adult↗

PubMed2004

Chlorhexidine with an Anti Discoloration System. A comparative study.

UNLABELLED: Correct oral hygiene is believed to be the basis of primary and secondary prevention. Sometimes, using a toothbrush or other mechanical instruments for oral hygiene may be difficult and it may become necessary to use an antiseptic. Chlorhexidine is an essential component in many available preparations on sale, because of its marked antiseptic qualities. One of the most frequent side-effects is the appearance of stains on the teeth and mucous membranes, which particularly disturbs the patient. A new mouthwash containing chlorhexidine has recently become available, besides maintaining its antiseptic qualities, also avoids the side-effect of staining. OBJECTIVES: The aim of this study was to check the capacity of the new mouthwash, which contains chlorhexidine and Anti Discoloration System (ADS), not only to prevent plaque formation like the other mouthwashes containing chlorhexidine but also to avoid staining that is one of the most frequent side-effects. STUDY DESIGN: The comparative study was carried out on a sample of 15 patients treated with two mouthwashes both containing 0.2% chlorhexidine, but different in that the first does not contain ADS, which is instead present in the second, a new product. The results obtained show that in the 15 patients treated, there is no statistically significant difference in the ability of the mouthwash to prevent bacterial plaque, however evidence of the stain was much less with the new mouthwash.

Adult↗

PubMed1994

In vitro comparison of various types of sodium perborate used for intracoronal bleaching of discolored teeth.

Fifty-eight extracted incisors were artificially stained to compare the efficacy of sodium perborate preparations used for intracoronal bleaching. All teeth were bleached for a 6-day period and the bleaching pastes replaced at days 1 and 3 (walking bleach technique). Sodium perborate-monohydrate, trihydrate, or tetrahydrate in conjunction with 30% H2O2 as well as tetrahydrate, either mixed with H2O or prepared as an experimental gel, were placed intracoronally at a level of 1-mm below the vestibular cementoenamel junction. Standardized slides were used to evaluate the color changes during bleaching. Success rates between 46 and 77% could be achieved, but no significant differences in final bleaching results between any of the sodium perborate types were observed. The use of the experimental gel resulted in comparable esthetic results (54%), although the portion of tetrahydrate in the gel was lower than that of the other preparations. In contrast to general recommendations that bleaching agents be left for 3 to 7 days in the access cavity before replacement, shorter bleaching intervals did not seem to affect the success.

Borates↗

PubMed1999

Seventeen-year clinical study of ultraviolet-cured posterior composite Class I and II restorations.

OBJECTIVES: To compare the clinical performance of four commercial ultraviolet light-cured composite materials, and to evaluate curing-system effects on long-term wear resistance of Class I and II restorations. MATERIALS AND METHODS: Approximately 32 samples of each of four different ultraviolet light-cured composites (n = 130) were inserted into conventional Class I and II cavity preparations by two clinicians. Cavosurface margins of the preparations were not beveled. Enamel walls of the preparation were etched, and the respective bonding agent was applied. Each restoration was evaluated by two clinicians at 5, 10, and 17 years. Direct evaluations were performed using modified United States Public Health Service (USPHS) criteria. Indirect evaluations were performed using the Leinfelder cast evaluation method. RESULTS: After 17 years, 65% of the restorations were recalled and pooled direct evaluations were conducted for color matching (94% alfa), marginal discoloration (100% alfa), marginal integrity (100% alfa), secondary caries (92% alfa), surface texture (72% alfa), and anatomic form (22% alfa). Mean occlusal wear from indirect evaluations at 5, 10, and 17 years was 197 +/- 85 microns, 235 +/- 72 microns, and 264 +/- 80 microns, respectively. For direct and indirect evaluations there were significant differences (p < or = .05) between the baseline and 5-year recall evaluations. CLINICAL SIGNIFICANCE: This study demonstrated that the mean pooled occlusal wear of four ultraviolet light-cured posterior composites at 17 years was 264 microns (approximately 0.25 mm), and that most wear (75%) occurred in the first 5 years. Of all recalled restorations, 76% were judged clinically acceptable at 17 years, and 22% of those exhibited no clinically detectable wear.

Analysis of Variance↗

PubMed2006

Two-year clinical evaluation of repair versus replacement of composite restorations.

PURPOSE: To investigate the effectiveness of alternative treatments to the replacement of resin-based composite (RBC) restorations through a prospective longitudinal cohort clinical study. MATERIALS AND METHODS: Forty patients aged 27 to 77 years (mean=55) with 88 RBC restorations, with one or more features that deviated from ideal, participated in the study. They were assigned to five treatment groups: repair (N=25), sealing of defective margins (N=13), resurfacing (N=18), replacement (N=16), and the no-treatment group (N=16). The replacement and no-treatment groups served as comparison groups and received random assignment. Two clinicians examined the quality of the restorations (N=88) prior to the assigned treatment, and at subsequent recalls (1 and 2 years) using a modified Ryge criteria (Alfa, Bravo, and Charlie, meaning clinically excellent, clinically acceptable with one or more features that deviated from ideal, and clinically unacceptable, respectively) that observed (1) color, (2) marginal adaptation, (3) anatomic form, (4) surface roughness, (5) marginal staining, (6) bulk discoloration, (7) contact, (8) secondary caries, (9) postoperative sensitivity, and (10) luster. RESULTS: At 1- and 2-year recalls, 66 (75%) and 58 (66%) restorations were examined. Kruskal-Wallis Test showed significant differences for marginal adaptation and marginal staining for both 1- and 2-year recall exams (p < .05). The repair, sealant, and replacement groups presented significant improvement when compared with the no-treatment group for marginal adaptation. The repair and replacement groups showed superior results when compared with the no-treatment group for marginal staining. CONCLUSION: RBC restorations that present less-than-ideal marginal adaptation and stained margins are better off being repaired. CLINICAL SIGNIFICANCE: Repair of resin-based composite (RBC) restorations is a conservative option for treatment of RBC restorations with inadequate marginal adaptation and marginal staining.

Adult↗

PubMed1996

Grey discoloration for the diagnosis of secondary caries in teeth with class II amalgam restorations: an in vitro study.

Grey discolouration around occlusal amalgam restorations has been found to be useful for the diagnosis of secondary caries. The aim of the present in vitro study was to establish the validity of grey discolouration of buccal and lingual enamel next to the approximal amalgam of class II restorations for the diagnosis of secondary caries. One hundred buccal and lingual areas next to the approximal parts of a class II filling in molars and premolars were included in the study. Fifty-one areas showed grey discolouration. Validation was performed against radiographs of transverse sections. Both radiolucencies and radiopacities were scored as being caries. The results were: sensitivity 92%, specificity 55%, positive predictive value 22% and negative predictive value 98%. It was concluded that grey discolouration of the approximal walls next to class II amalgam fillings is not useful for the detection of secondary caries, but the absence of grey discolouration gives a good prediction for the absence of secondary caries. This is in contrast to grey discolouration around occlusal amalgam restorations, which was considered to be useful for the diagnosis of secondary caries.

Bicuspid↗