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PubMed1984

The use of composites as core material in root-filled teeth. II. Clinical investigation.

49 patients who during a period of 10 years have been provided with gold crowns and composite cores, both as separate crowns and in bridges, have been followed up. The composite cores have been reinforced and retained in their roots, almost in every case by screw-posts. The basis for evaluation has been radiographs taken before the commencement of treatment and at the follow-up 2-10 years later together with clinical examination of the restorations. The aim has been to determine whether the restorations continue to function satisfactorily or if failures have occurred. Of the 51 teeth which were available for reexamination 43 were found to be functioning satisfactorily at the follow-up. In one case only the gold crown had loosened from its core. In the remaining seven unsuccessful cases the cement retention between the crowns and cores were intact and the teeth had been lost because of root fracture, secondary caries and/or inadequate post retention.

Adult↗
PubMed1995

Anticaries efficacy of an improved stannous fluoride toothpaste.

A series of laboratory and animal studies were conducted to confirm the anticaries potential of a new, stabilized stannous fluoride (SnF2) dentifrice relative to clinically proven SnF2 controls. Included in this series of assessments were fluoride uptake into demineralized human enamel, remineralization/inhibition of demineralization for both human enamel and roots, and animal caries studies. Each of these studies demonstrate the new, stabilized SnF2 dentifrice (Crest Gum Care toothpaste) is effective at inhibiting and reversing the caries process. These data confirm that this new dentifrice, formulated with a combination of SnF2, and hydrated silica, is predicted to be highly effective against caries. These tests predict that this new stabilized SnF2 dentifrice (Crest Gum Care toothpaste) provides a level of anticaries activity that is equivalent to Crest Regular toothpaste, a sodium fluoride (NaF)/silica product. The data suggest that this new formulation provides enhanced anticaries efficacy relative to previous, unstabilized SnF2 formulations as a result of improved fluoride bioavailability.

Analysis of Variance↗
PubMed1996

Interobserver variability in radiographic interpretation of pediatric dental diseases: a pilot study.

Interobserver variability in radiographic interpretation of dental disease may be a result of clinical bias, education, training, experience or other factors, and may potentially lead to misdiagnosis of disease. Few studies have investigated variability related to dental specialty. The purpose of this pilot study was to determine interob-server variability in radiographic interpretation of pediatric dental diseases using a small number of observers, consisting of a pedodontist, an orthodontist and an oral radiologist. These specialists interpreted initial radiographic surveys of 200 pediatric patients (4.5 to 15.5 years old). The results showed no differences in interpretations of radiographic signs of dental abnormalities except for caries, abnormal primary root resorption due to the eruptive path of a permanent tooth and presence of a congenital/developmental tooth abnormality. These findings will be used to design future studies which will include a larger number of observers from different dental specialties.

Adolescent↗
PubMed1998

Argon laser irradiation effects on sound root surfaces: in vitro scanning electron microscopic observations.

OBJECTIVE: The purpose of this in vitro scanning electron microscopy (SEM) study was to evaluate the effect of low fluence (energy density of 11.5 J/cm2 and 100 J/cm2) argon laser irradiation on the surface morphology of sound root surfaces. SUMMARY BACKGROUND DATA: Previous laboratory investigations have shown that argon laser irradiation of root surfaces provided a protective effect against in vitro cariogenic challenges. METHODS: Root surfaces of extracted human molars were sectioned into treatment quarters: 1) mesiobuccal--no treatment control; 2) mesiolingual--low fluence argon laser irradiation (0.231 Watts, 11.5 J/cm2 for 10 seconds); 3) distobuccal--no treatment control; and 4) distolingual--higher fluence argon laser irradiation (2.0 Watts, 100 J/cm2 for 10 seconds). All surfaces were critical-point dried, coated with platinum and paladium under vacuum, and evaluated qualitatively for intactness, surface morphology, surface deposits, and porosities in a blinded fashion by scanning electron microscope. RESULTS: The argon lased root surfaces demonstrated alterations of root surfaces with creation of surface globular particulate material, microporosities, and depressions. Both low- and high-fluence lased root surfaces showed areas with plaque-like plates with fine punctuate oval particulate material on their surfaces. CONCLUSIONS: Argon laser irradiated root surfaces produce surface granular to globular deposits that may provide readily mobilized tooth mineral, which may become redeposited into the underlying root surface during a cariogenic challenge and enhance resistance to caries formation. In addition, microporosities created by the argon laser may provide a means for bonding fluoride-releasing restorative and preventive materials to root surfaces and further improve the root surfaces' ability to resist cariogenic challenges.

Argon↗
PubMed2005

Causes and prevention of dental caries: a perspective on cases and incidence.

PURPOSE: The purpose of the present paper is: 1) to review recent concepts of the causes of caries; 2) to illustrate parameters of causes of cases and of incidence; and 3) to outline the consequences for caries prevention and oral health promotion. The paper is divided in three sections. Section 1 reviews recent theories of the causes of caries and summarizes that it is necessary to make a clear distinction between the causes of a case of caries and causes of occurrence of caries in populations. Cases relate to the reasons why individuals get sick, while incidence relates to why so many (or so few) within a population get sick. In section 2 the difference between the causes of a case and of the occurrence in a population is illustrated. A new social epidemiology moves beyond the focus on individual level risk factors to a multi-level perspective. Applied to oral diseases the paradigm of social epidemiology bridges our understanding of the biological determinants of caries with an understanding of the societal determinants of caries. Social epidemiology is the branch of epidemiology that studies the social distribution and social determinants of states of health. Individuals are embedded in societies and populations. In section 3 the insight acquired above is applied to the choice of disease-preventive and oral health-promotive strategies. Prevention of caries and promotion of oral health must be rooted in the understanding of caries as it occurs in populations.

Cariogenic Agents↗
PubMed2006

The evaluation of the carbon fiber post system on restoration of teeth defect in children.

BACKGROUND: Post and post-core systems are used to restore extensively damaged teeth. Among these systems, cast alloy post and core, prefabricated threaded alloy post and prefabricated simple alloy post are most frequently applied in China nowadays. In Europe and North America a combined application of the fiber post, resin-core and crown has been applied to restore seriously destructed teeth with satisfactory results in recent years. This study was intended to evaluate the clinical effect of carbon fiber post system on restoration of child anterior tooth defect after root canal therapy, based on 3 - 5 years' observation. METHODS: One hundred and six children with incompletely established occlusion were observed and followed for an average of 42 months (ranging from 36 to 60 months). Eighty-five upper teeth and forty-one lower teeth were restored with carbon fiber post system and composite jacket crown. Periodic check-up was conducted for periodontal condition and restoration effect. RESULTS: One hundred and twenty-one (96.2%) restorations were successful. Four jacket crowns (3.0%) were lost. One tooth (0.8%) had slight gingival inflammation. Tooth root or post fracture and gingival stain were not observed. X-ray showed there was no obvious change in aspects including the width of periodontal membrane, the density of alveolar bone and the height of alveolar ridge crest. CONCLUSIONS: Carbon-fiber post system can satisfy the clinical requirements of young patients who have residual anterior crown and root caused by trauma or caries, and have incomplete occlusion and have completed root canal therapy. This system helps realize good esthetic result for patients and easy practice for dentists. Carbon fiber post is safe and convenient, especially for sick children.

Adolescent↗
PubMed1991

On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults.

In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.

Adult↗
PubMed2006

Root canal treatment in Denmark is most often carried out in carious vital molar teeth and retreatments are rare.

AIM: To study the reasons given by a representative sample of Danish general dental practitioners (GDPs) for undertaking root canal treatment and, to investigate their confidence in performing root canal treatment on molar teeth. METHODOLOGY: A questionnaire was sent to 600 Danish GDPs randomly selected from the roster of the Danish Dental Association. They were asked to recall various factors about their experience of the last root filling they completed, including the reason for treatment and the pulp diagnosis. Self-assessments on 100-mm visual analogue scales (VAS) were reported concerning the confidence in performing root canal treatment of a molar. End-point definitions were 'very easy' (0) and 'very difficult' (100), respectively. Time reports of molar treatments were given in categorized groups. RESULTS: The most frequent reason for performing root canal treatment was caries within the tooth involved (55%). The majority of treatments involved teeth with vital pulps (54%). Retreatments were carried out in 2% of the cases. The confidence in performing root canal treatment varied but was relatively high, expressed as VAS-values below 50. The creation of an aseptic working field was regarded as the most difficult procedure followed by root canal preparation. Fifty-six percent of the responders stated a time frame of 46-75 min to complete root filling in a molar tooth. CONCLUSIONS: Root canal treatment in Denmark was reported to be undertaken most often because of caries. Treatment was typically performed in molar teeth with vital pulp. Even though apical periodontitis was frequently noted in root filled teeth, retreatments were rare. From a subjective perspective root canal treatment was not considered to be very difficult and was carried out relatively rapidly.

Analysis of Variance↗
PubMed1992

Vascular pathways within pulpal tissue of human primary teeth.

The vascular distribution within pulps of human primary teeth has not been as well studied as those within human permanent teeth. Such information is useful to those who diagnose and treat dental conditions in children. The purpose of this study was to determine the architecture of the vascular structures, in contrast to the histological appearances, of noncarious human primary teeth during root completion, root resorption and dental caries attack. Following extraction, primary teeth were perfused with an opaque injection mass and photographed to trace the courses of the arterioles, venules and capillaries within the crowns and roots. The architectural morphology of similar vascular structures in permanent pulps are included to provide a comparative reference. Arterioles entered the apical foramina and traveled throughout the root canal(s) to the pulpal chamber, giving off branches which passed toward the dentinal walls. Within the pulpal chamber, the arterioles passed toward the occlusal and proximal surfaces and arborized profusely to form a subodontoblastic plexus of capillaries. The capillaries lead to larger diameter venules, which exited the pulp through apical foramina. Many unusual vascular pathways existed within the root structure. No communication existed between the pulp chamber and periodontal membrane through the furcation dentin and cementum. Many lateral canals were seen along the root structures.

Child↗
PubMed1991

In vivo study of fluoride chewing gum for the remineralization of human root lesions.

The purpose of this study was to study the efficacy of a fluoride-containing chewing gum (0.1 mg F/stick chewed 5 x/day) in the remineralization of artificial caries lesions in abraded root surfaces compared to sorbitol-containing chewing gum and a no gum control group in vivo. Root specimens were cut from human root surfaces and polished. The specimens were demineralized in a buffered lactate solution with low concentration of fluoride in order to preserve an intact surface layer. Six healthy subjects wore mandibular Hawley-type appliances containing up to fourteen slabs for each of one control and two experimental periods. The experimental protocol included chewing five pieces of gums per day and brushing with fluoride-free dentifrice for each 21 days period. All three regimens were analyzed for fluoride uptake and microradiography. The results indicate that fluoride-containing chewing gum has a highly significant fluoride uptake and remineralization compared to sorbitol gum and control regimens, suggesting that fluoride chewing gum may provide another vehicle for fluoride delivery.

Chewing Gum↗
PubMed1993

Effect of intermittent delivery of fluoride to solution on root hard-tissue de- and remineralization measured by 125I absorptiometry.

The effect of intermittent fluoride levels on root hard-tissue de- and remineralization was studied once daily for 21 days in a pH-cycling caries model with simulated fluoride clearance curves. Four root hard-tissue blocks, from each of 12 human teeth, were cut out parallel to the cementum surface. During a daily 15-hour period, the blocks were subjected 12 times to pH changes similar to those which occur in plaque after a carbohydrate intake. The fluoride was delivered immediately before a daily nine-hour remineralization period. Four experiments were independently carried out: One block from each tooth was subjected to pH-cycling without and with fluoride delivery, simulating a rinse with 0.025, 0.2, and 1.0% sodium fluoride (NaF), respectively. The mineral change in the blocks was monitored by 125I absorptiometry and expressed as the change in transmission (delta T). The surface between the data points (delta T values) and the x axis (time points) was used as a summary measure, i.e., the area under the curve (AUC). When no fluoride was delivered, the delta T increased over 21 days, indicating loss of mineral. The AUC was, on average, 5.85 +/- 0.68 (mean +/- S.E.) %.day. In the 0.025% NaF-rinse experiment, there was a marked reduction in mineral loss, indicated by an average AUC of 1.66 +/- 0.59%.day. In both the 0.2 and 1.0% NaF-rinse experiments, a decrease in delta T, indicating gain of mineral, was observed from day 2. Negative delta T values occurred after 7 and 3 days, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMedDate not supplied

Ten-year incidence of dental caries in adult and elderly Chinese.

Only very few longitudinal studies on dental caries are available in adults and elderly. Therefore, the aim of the present study was to describe the patterns of lesion progression in a group of adult and elderly Chinese followed over a 10-year period of time. In 1984, 587 persons aged 20-80 years were examined and by 1994, 440 of these were still available and re-examined by the same two examiners. All restorations, periodontal conditions and dental caries were recorded for all teeth and surfaces. Only caries data are reported here. Dental caries on coronal surfaces was classified as sound, non-cavitated, cavitated without or with pulp involvement or filled. On root surfaces, lesions were classified as sound, active caries or restored. Prior to analysis of the data, a series of drop-out analyses was carried out showing that most of the drop-outs were above 60 years of age at baseline, and death of participants was the major drop-out reason. A total of 2,114 teeth were lost, 36% of which had a deep dentin lesion at baseline. The distribution of persons according to number of new lesions/restorations over 10 years was highly skewed in all age groups, the prevalence increasing with age. Molars had the highest risk of becoming carious/restored over the 10-year period, and a remarkably low proportion of teeth had the same caries diagnosis after 10 years, indicative of lesion progression. When comparing the 1984 DFT/DMFT with the figures for 1994, there were no statistically significant differences indicating that the period and cohort effects cancel out each other. There was a significant increase with age of the number of new DFT. It can be concluded that dental caries is a major health problem in contemporary adult and elderly Chinese populations, and that caries incidence increases with old age.

Adult↗
PubMed1994

Unusual external resorption of a maxillary lateral.

This article defines an unusual previously unreported entity afflicting a maxillary lateral incisor. Labial idiopathic external root resorption just apical to the cemento-enamel presented as a gingival (periodontal) problem and was misinterpreted as cervical dental caries. This report defines a new possibility for a radicular defect in a maxillary lateral incisor that may cause periodontal problems.

Adult↗
PubMed2005

Effect of topical fluoride and fluoride varnish on in vitro root surface lesions.

PURPOSE: To evaluate the effect of a fluoride varnish on demineralization and remineralization of root surfaces in vitro. METHODS: 80 caries-free teeth were selected from a large pool of extracted anterior and premolar teeth from elderly patients. Acid resistant nail varnish was painted on all surfaces except for a window (l x 4 mm) on the buccal or lingual root surfaces. Teeth were randomly divided into four treatment groups: CONTROL: washed with deionized/distilled water; Daily gel: treated with Karigel-N (5,000 ppm) for 4 minutes daily; Weekly gel: treated with Karigel-N for 4 minutes weekly; and Weekly varnish: treated with Duraflor (22,600 ppm) weekly (the varnish was removed 24 hours after each application). Teeth were then placed in a cycle of demineralization (6 hours at pH 4.3) and remineralization (17 hours at pH 7.0) for 21 days. Half the specimens of each group were brushed with no dentifrice for 10 seconds twice daily. Specimens were evaluated under polarized light microscopy and contact microradiography. The depth of each lesion and width of the remineralization bands were measured. An ANOVA model was used to assess the effect of different treatments. RESULTS: The control group had the deepest lesions and the daily gel group had the shallowest lesions. The weekly varnish group was found to have significantly shallower lesions than the weekly gel group. The varnish brushing subgroup had significantly deeper lesions than varnish non-brushing subgroup (P = 0.01). Remineralization bands were detectable in most lesions. There was no significant difference in band width between different groups (F = 0.634, P = 0.594). However, a significant difference was found when remineralization bands were calculated as percentage of lesion depth between different groups (F = 4.24, P = 0.001). The varnish non-brushing subgroup had significantly higher percentage than the control group, but daily gel non-brushing had the highest percentage. Brushing was a significant factor in the varnish group. Lesions were significantly shallower in the non-brushing varnish subgroup.

Aged↗
PubMedDate not supplied

Fluoride releasing materials: their anti-cariogenic properties tested in in vitro caries models.

The anti-cariogenic properties of three fluoride-releasing materials on root surfaces were evaluated using two different caries models. Standardized cavities were prepared in dentin specimens and restored with either glass-ionomer, resin-modified glass-ionomer, polyacid-modified resin composite or resin composite material. Two groups of 56 specimens were demineralized using a microbial caries model for three days, while another 56 specimens were demineralized using a chemical demineralization model for three days. Lesions around the restorations were measured with a confocal laser scanning microscope. Glass ionomers demonstrated significant anti-cariogenic properties when exposed to the chemical model. However, no significant anti-cariogenic properties were observed with the microbial caries model. In conclusion, the fluoride releasing materials showed different anti-cariogenic properties in root surfaces under the different caries models, suggesting that caution should be exercised when trying to extrapolate the results of in vitro studies to the clinical situation.

Cariostatic Agents↗
PubMed1990

Effects of processed cheese on human plaque pH and demineralization and remineralization.

This two-part study was undertaken to examine the effects of processed cheese on human plaque pH and de- and remineralization of enamel and root lesions in a human in situ caries model system. In the first part of the study the selected processed cheese (Kraft American Singles Processed Cheese Food) was eaten alone and followed by a 10% sucrose rinse after the acidogenicity of the plaque was demonstrated. A 10% sucrose rinse alone resulted in a mean minimum pH of 4.26. The cheese alone showed a mean minimum pF of 6.32 and cheese followed by sucrose resulted in a mean minimum pH of 6.48. The plaque pH of cheese eaten alone stayed at pH above 5.7 (the "safe for teeth" level). Cheese consumption also prevented the acid challenge when followed by sucrose. The second part of the study utilized the thin-sections of artificially created caries-like lesions on enamel and root, and sound root sections. One-month periods were used in a cross-over design to examine the effect of eating the cheese q.i.d. Polarized light microscopy was used to determine changes in the size of lesion areas. The addition of the processed cheese to the diet resulted in statistically significant reductions in enamel lesion size as well as a reduction in progression of root lesions. Lesions created on the sound root surfaces were approximately one-third the size of those created during the control period. This study indicates that processed cheese is hypoacidogenic, anti-acidogenic, and prevents demineralization as well as enhances remineralization.

Adult↗
PubMed2000

Periapical status of root-filled teeth exposed to the oral environment by loss of restoration or caries.

OBJECTIVE: Studies in vitro carried out on extracted teeth have demonstrated that bacterial elements may penetrate root fillings from the coronal to the apical end after a period of exposure to artificial saliva or bacterial culture. To address the clinical significance of this so-called issue of coronal leakage, a retrospective cohort analysis was conducted of 55 patients with root fillings that had been exposed to the oral environment because of caries or absent restorations. STUDY DESIGN: Cases were matched 1-to-1 with regard to initial pulpal and periapical diagnosis, period after completion of endodontic therapy, tooth type, age of the patient, and the technical quality of the root filling. Only cases with a follow-up period of 3 years or more were included. Radiographs taken at the last follow-up examination were subjected to a masked evaluation. RESULTS: A total of 14 osteolytic lesions were recorded. In 43 of the 55 matched pairs (78%), there were identical periapical conditions. In 9 pairs, a periapical lesion was present in the "open" tooth category, whereas in 3 pairs, a periapical lesion was seen exclusively in the "intact" tooth. Though the odds-ratio for a lesion to be present in the "open group" was 3. 0, this was not a statistically significant result (P >.10). CONCLUSIONS: Data suggest that the problem of coronal leakage may not be of such a great clinical importance as implicated by numerous studies in vitro, provided instrumentation and root fillings are carefully performed.

Adolescent↗