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PubMed1987

In vitro caries-like lesion production by Streptococcus mutans and Actinomyces viscosus using sucrose and starch.

We investigated the formation of caries-like lesions on root and enamel sections by S. mutans and A. viscosus when grown in four different carbohydrate substrates. The substrates were: sucrose, starch + alpha-amylase, and a combination of starch and sucrose with and without alpha-amylase. Twenty-four sections with exposed windows on both the root and enamel surfaces were exposed to the individual bacterial species in each of the four substrates for three weeks. At three weeks, the sections were removed and lesion depths measured. When grown in sucrose alone, S. mutans produced significantly deeper lesions in both root and enamel surfaces when compared with A. viscosus. However, S. mutans failed to produce lesions when grown in "limited" sucrose with starch added, whereas A. viscosus in this same substrate produced lesions in the enamel and root surfaces. A viscosus also produced either similar or significantly deeper lesions in both root and enamel surfaces, when compared with S. mutans grown in the two substrates with amylase. Thus, under these in vitro conditions, it was demonstrated that A. viscosus could utilize starch, whereas utilization of starch by S. mutans was alpha-amylase-dependent.

Actinomyces↗
PubMed2003

Clinical complications in fixed prosthodontics.

The purpose of this article is to identify the incidence of complications and the most common complications associated with single crowns, fixed partial dentures, all-ceramic crowns, resin-bonded prostheses, and posts and cores. A Medline and an extensive hand search were performed on English-language publications covering the last 50 years. The searches focused on publications that contained clinical data regarding success/failure/complications. Within each type of prosthesis, raw data were combined from multiple studies and mean values calculated to determine what trends were noted in the studies. The lowest incidence of clinical complications was associated with all-ceramic crowns (8%). Posts and cores (10%) and conventional single crowns (11%) had comparable clinical complications incidences. Resin-bonded prostheses (26%) and conventional fixed partial dentures (27%) were found to have comparable clinical complications incidences. The 3 most common complications encountered with all-ceramic crowns were crown fracture (7%), loss of retention (2%), and need for endodontic treatment (1%). The 3 most common complications associated with posts and cores were post loosening (5%), root fracture (3%), and caries (2%). With single crowns, the 3 most common complications were need for endodontic treatment (3%), porcelain veneer fracture (3%), and loss of retention (2%). When fixed partial denture studies were reviewed, the 3 most commonly reported complications were caries (18% of abutments), need for endodontic treatment (11% of abutments), and loss of retention (7% of prostheses). The 3 most common complications associated with resin-bonded prostheses were prosthesis debonding (21%), tooth discoloration (18%), and caries (7%).

Adult↗
PubMed1994

Dental radiographic findings in the elderly in Helsinki, Finland.

A total of 169 dentate persons, aged 76, 81, and 86 years, living at home in Helsinki, Finland, were examined by means of panoramic radiography supplemented by intraoral radiographs. The older the age group, the fewer teeth remained. Altogether 75% of the subjects had radiographically detectable caries. A high proportion of the carious teeth (62%) was found in a relatively small number (24%) of subjects. The number of carious teeth and their percentage of the total number of teeth were greater in the older age groups. The proportion of endodontically treated teeth was 19% in the 76-year-olds and 26% in the 86-year-olds. Of the subjects 41% had periapical periodontitis, which was commoner in root-filled teeth (18%) than in other teeth (4%). Caries and periapical radiolucent and radiopaque findings were commoner in men. Vertical bone pockets (3 mm or deeper) were found in 51% and furcation lesions in 28% of the subjects. Compared with earlier Finnish studies, the results indicate an improving oral health status among elderly Finns.

Age Factors↗
PubMed1998

CO2 laser inhibitor of artificial caries-like lesion progression in dental enamel.

Several studies during the last 30 years have demonstrated the potential of laser pre-treatment of enamel or tooth roots to inhibit subsequent acid-induced dissolution or artificial caries-like challenge in the laboratory. The overall objective of ongoing studies in our laboratories is to determine, systematically, the optimum sets of parameters for carbon dioxide laser irradiation that will potentially effectively inhibit dental caries in enamel and tooth roots. The aim of the present study was to examine the roles of wavelength and fluence in the prevention of caries progression in vitro in enamel by means of a pH-cycling model. The hypothesis to be tested was that the highly absorbed 9.3- and 9.6-microm wavelengths would be efficiently converted to heat, creating a temperature sufficiently high to reduce the acid-reactivity of the mineral and inhibit caries-like lesion progression in dental enamel. One hundred and sixty caries-free tooth crowns were cleaned and varnished with acid-resistant varnish, leaving one exposed window of enamel. Twelve groups of 10 enamel samples were irradiated in their individual windows by one of the four wavelengths (9.3, 9.6, 10.3, or 10.6 microm) of a tunable CO2 laser. Energy per pulse was 25, 50, 100, 200, or 250 mJ (25 pulses). Repetition rate was 10 Hz, and beam diameter was 1.6 mm. Fluence conditions of 1 to 12.5 J/cm2 per pulse were produced. All teeth, including 40 non-irradiated controls, were subjected to pH-cycling to produce artificial caries-like lesions. Results were assessed by cross-sectional microhardness testing. Inhibition of caries progression of from 40% to 85% was achieved over the range of laser conditions tested. At 9.3 and 9.6 microm, 25 pulses at absorbed fluences of 1 to 3 J/cm2 produced inhibition on the order of 70% with minimal subsurface temperature elevation (< 1 degree C at 2 mm depth), comparable with inhibition produced in this model with daily fluoride dentifrice treatments. Safety and efficacy studies will be required in animals and humans before these promising laboratory results can be applied in clinical practice.

Absorption↗
PubMed2003

Risk indicators for apical periodontitis.

OBJECTIVES: The aim of the study was to identify risk indicators for apical periodontitis (AP) in the individual. A parameter was defined as a 'risk indicator' when its presence increased the individual's risk of exhibiting AP. Risk indicators may, but need not be directly associated with the disease. METHODS: The study included full-mouth surveys of 613 randomly selected individuals, who were 20-60 years old and living in Aarhus County. Logistic regression analyses were performed. The outcome variable was >or=1 AP/no AP. The independent variables were obtained from information on socioeconomic and dental status. RESULTS: It was found that smoking, no usage of services from the dentist, >or=2 secondary caries lesions, >or=3 inadequate coronal fillings and the presence of root filling(s) were statistically associated with AP. A separate analysis for individuals with no previous root fillings showed that individuals with regular dental visits as well as individuals who had all their teeth (third three molars excluded) were less likely to have AP, whereas individuals who had >or=3 inadequate coronal fillings were more likely to have AP. CONCLUSIONS: The results from the present study of a Danish population showed that the most important risk indicator of having AP in the individual was the radiographic evidence of root fillings. The presence of several caries lesions, the quality of the dental treatment, the regularity of dental visits and smoking were also statistically associated with AP. Further, the socioeconomic status of the individual did not provide much additional information on the periapical status.

Adult↗
PubMed1984

Root extrusion. Rationale and techniques.

The root extrusion techniques are easily mastered and are within the realm of every general practitioner. They can be applied in various situations in which restoration is very difficult or impossible. The dentist must first decide whether or not elevating the root up to 4 mm will help treatment. If the answer is yes, then many different methods can be used to accomplish this goal. Teeth that were formerly extracted can now be saved and restored routinely, leading to a functional and esthetically pleasing result.

Dental Caries↗
PubMed1995

Solution for the isolation of the working field in a difficult case of root canal therapy.

A technique for the isolation of a posterior tooth with large distogingival caries and which needed endodontic therapy is described. To ensure a perfect seal, avoiding contamination or infiltration of the chemicals used for irrigation during the root canal therapy, a direct resin temporary restoration was done before placing the rubber dam as required for endodontic treatment.

Dental Restoration, Temporary↗
PubMed2002

Fluoride-releasing restorative materials and secondary caries.

Secondary caries are responsible for 60% of all replacement restorations in the typical dental practice. Risk factors for secondary caries are similar to those for primary caries development. Unfortunately, it is not possible to predict accurately which patients are at risk for restoration failure. Fluoride-releasing dental materials provide for improved resistance against primary and secondary caries in coronal and root surfaces and have become a part of the dentist's armamentarium. This article discusses the improvement in the properties of dental materials with the ability to release fluoride. It is anticipated that in the near future, the vast majority of restorative procedures will employ fluoride-releasing dental materials as bonding agents, cavity liners, luting agents, adhesives for orthodontic brackets, and as definitive restoratives.

Dental Caries↗
PubMed2003

Inhibition of demineralization in vitro around fluoride releasing materials.

Replacement of restorations because of secondary caries is a continuing problem in restorative dentistry. This investigation assessed the capacity of fluoride-releasing restorative materials to resist caries in vitro when used in roots. Class 5 cavities were prepared in buccal and lingual surfaces of 30 extracted premolars and restored with one of three polyacid modified resin composites (F-2000, Hytac and Compoglass F), a resin modified glass-ionomer cement (Fuji II LC) a conventional glass ionomer (Ketac-Fil), and a resin composite (Z-100). After 5 weeks in an acid gel for caries-like lesion formation, the teeth were sectioned longitudinally and examined with polarized light. The results showed that restoration of caries with polyacid modified resin composites and resin modified glass ionomer cements may be of great importance in the prevention of secondary caries around the restorations in roots. Clinical Relevance Light cured fluoride-releasing restorations may inhibit caries-like lesions. Inhibition of demineralization in vitro around fluoride releasing materials.

Bicuspid↗
PubMed1992

A 3-year postoperative clinical evaluation of posts and cores beneath existing crowns.

Fabrication of posts and cores for fixed partial denture (FPD) and removable partial denture (RPD) abutment restorations is common in dentistry. The biocompatibility of various post and core techniques with the restorations was clinically evaluated according to location and function. In this study, 154 post and core constructions for 150 patients were observed for a 3-year period to determine if the function of the original restorations remained unsatisfactory. The following techniques were included: (1) screw post and light-curing composite resins, (2) cemented post with parallel sides and light-curing composite resins, and (3) a cast and core technique. Seventeen of the 154 restorations failed; four failures were attributed to root fractures, three to radicular caries, and five to crown dislodgement, while five failures were from detachment of the post and core from the root. The statistical analysis revealed that only the factor "type of abutment" (RPDs and FPDs) had some effect on the failure of the restorations.

Acrylic Resins↗
PubMed1999

1H-NMR analysis of microbial-derived organic acids in primary root carious lesions and saliva.

In addition to lowered pH values, the molecular profile and concentrations of microbial-derived organic acids in carious dentin are important demineralization parameters involved in the induction, development and progression of dental caries. High-resolution proton ((1)H) NMR spectroscopy was employed to examine the organic acid status of primary root carious lesions. (1)H-NMR analysis of post-neutralized perchloric acid extracts of active carious lesions revealed that at an operating frequency of 600 MHz, the (1)H-NMR-detectable organic acid composition of carious dentin samples (mean molecular percentage content +/- standard error; the mean molecular percentage content is defined here as the mean of the concentration of each (1)H-NMR-visible organic acid/anion expressed as a percentage of total (1)H-NMR-detectable organic acid/anion level in each sample) was acetate 51 +/- 2%, formate 37 +/- 2%, lactate 5 +/- 1%, propionate 3 +/- 0.8%, pyruvate 2.4 +/- 0.3%, n-butyrate 1.2 +/- 0.2%; succinate 0.1 +/- 0.1%; iso-butyrate, n- and iso-valerate, and n- and iso-caproate (total) <0.2%. Further components detectable included alanine, glycine, choline, phosphorylcholine, trimethylamine oxide, methanol, glycolate and assorted saccharides. In view of their high dissociation constants (K(a)), our results demonstrate that formic and pyruvic acids (K(a) = 1.77 x 10(-4) and 3.20 x 10(-3) mol/dm(3), respectively) contribute substantially to the decreased pH values associated with active caries lesions (cf. lactate K(a) = 1.40 x 10(-4) mol/dm(3)), and hence the pathogenesis of primary root caries.

Aged↗
PubMed1977

An overdenture survey: preliminary report.

The preliminary conclusions from this survey are listed: 1. The exceedingly high incidence of periodontal pathology seems to be the major problem in the long-term use of overdentures. 2. The incidence of caries is fairly low, but it remains a potential problem. 3. Subjective evaluations by the patients are favorable. 4. The overdenture technique as described by Lord and Teel seems to be practical and advantageous. 5. Additional research to find the most effective agent for inhibiting caries in overdenture support roots should be initiated. 6. Need exists for more surveys by other schools, institutions, or prosthodontists. 7. The overdenture is a valid alternative to complete denture therapy.

Adult↗
PubMed2004

Lethal photosensitisation of oral bacteria and its potential application in the photodynamic therapy of oral infections.

Chemical antibacterial agents are increasingly being used in prophylactic and therapeutic regimes for dental plaque-related diseases, which are among the most common human infections. As these agents are difficult to maintain at a therapeutic concentration in the oral cavity and can be rendered ineffective by resistance development in the target organisms, there is a need to develop alternative antimicrobial approaches. Bacteria and other microbes can be sensitised to light through prior treatment with a chemical photosensitising agent. Lethal photosensitisation of a wide range of bacteria responsible for caries, periodontal diseases and root canal infections has been demonstrated using red light in conjunction with a number of photosensitisers, including Toluidine Blue, phthalocyanines and chlorins. The advantages of this approach are that bacteria can be eradicated in very short periods of time (seconds or minutes), resistance development in the target bacteria is unlikely and damage to adjacent host tissues and disruption of the normal microflora can be avoided. This approach may be a useful alternative to antibiotics and antiseptics in eliminating cariogenic and periodontopathogenic bacteria from disease lesions and for the disinfection of root canals. Not only would this be of benefit for the treatment of these diseases but, by replacing the antimicrobial agents that are currently used for such purposes, it would help to conserve our dwindling supply of antimicrobial agents that are effective in the treatment of serious systemic infections.

Bacteria↗
PubMed2001

Comparison of nickel-titanium file distortion using electric and air-driven handpieces.

The use of rotary instrumentation has increased dramatically in endodontics. Air-driven and electric handpieces are both currently available for use with the nickel-titanium files. To date no studies have compared the frequency of instrument separation and/or distortion while using the two types of handpieces with rotary files. The purpose of this study was to determine whether there is a difference in the frequency of file separation/distortion when an electric handpiece is compared with an air-driven handpiece. Extracted human molar teeth were instrumented with nickel-titanium Profile ISO .04 taper rotary files (Dentsply Tulsa Dental Products, Tulsa, OK) under controlled conditions and the results examined for statistical significance. The teeth chosen for the study fit the following criteria: minimal caries, curvature of any root no greater than 60 degrees and at least one root with a minimum of 30-degree curvature. The air-driven handpiece was used at 167.67 rpm and the electric handpiece at 150 rpm per manufacturer's recommendations. Files were examined both before and after use to evaluate whether breakage or deformation had occurred. There was no significant difference in file breakage or distortion when the handpieces were compared. There were, however, a significantly greater number of file separations/ distortions noted in the #8 Profiles (ISO size 20) than with the other files. It may be prudent to view this file as a disposable instrument.

Air↗
PubMed1995

Specific and charge interactions mediate collagen recognition by oral lactobacilli.

The mechanisms by which oral lactobacilli, one of the three major genera of cariogenic bacteria, attach to tooth surfaces are unknown. We hypothesize that recognition of collagen, the major component of dentin, may be a mechanism which localizes these bacteria to exposed root surfaces as well as to carious lesions which have penetrated the dentin. We found that the majority of oral Lactobacillus spp. strains recognize and bind collagen type I. Binding of 125I-labeled collagen type I to two strains of L. casei rhamnosus has been characterized in some detail. These strains were previously characterized with respect to their attachment to dentin (Switalski and Butcher, 1994). The process of 125I-collagen binding was mediated via specific as well as charge interactions. The putative adhesin-mediated (specific) interaction involved a limited number of bacterial surface components (2 x 10(3)/cell). Under conditions conducive for non-specific interactions (low ionic strength), the binding was higher by an order of magnitude. Collagen binding strains were found to adhere to collagen-coated surfaces, while strains unable to bind collagen adhered to a much lesser extent. Adherence of bacteria to collagen-coated surfaces could be competitively inhibited with collagen. These interactions may target collagen-binding strains of lactobacilli to dentin collagen in the oral cavity and thus play a role in the pathogenesis of root surface and/or coronal caries. Interference with this collagen-mediated attachment of lactobacilli may provide effective means of caries control, particularly in view of the fact that other oral acidogenic microbiota also interact with collagen.

Adhesins, Bacterial↗
PubMedDate not supplied

Healing of dehiscence defects at delayed-immediate implant sites primarily closed by a rotated palatal flap following extraction.

In 21 patients, 28 maxillary teeth were extracted because of periapical or periodontal infection, root fracture, or untreatable caries. A rotated palatal flap procedure was used to achieve primary soft tissue closure over extraction sites. At 5 to 7 weeks postextraction, 28 implants were placed. Buccal dehiscence-type defects were treated with guided bone regeneration procedures using bovine bone mineral and resorbable collagen membranes. Mean defect area at the time of implant placement (23.7 mm2, SD 11.49) was significantly reduced at uncovering (0.7 mm2, SD 0.99). The mean percentage of defect reduction (clinical bone fill) was 97% (SD 4.26). Implants placed in compromised sites shortly postextraction according to the presented 2-stage protocol gave good short-term clinical results.

Adult↗