Talking with Patients. Microabrasion.
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Dental Enamel↗
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Results for “TOOTH DISCOLORATION”
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Clinical studies on the appearance of natural anterior teeth in young and old adults.
OBJECTIVES: To evaluate the typical appearance of natural anterior teeth in young and elderly people and to develop guidelines for the natural appearance of dentures. DESIGN: Clinical examination and photography. Inclusion criteria were a dental state with natural anterior teeth and no more than two crowns. SUBJECTS: A study group (SG) consisting of 64 patients ranging in age from 60 to 86 years (67.3 +/- 5.8) and a control group (CG) composed of 64 dental students aged 21-33 years (25.8 +/- 2.4). SETTING: Dental schools of the Johannes-Gutenberg-University Mainz and the University of Leipzig. RESULTS: Most participants were content with the appearance of their own natural teeth. With relaxed lips a mean of 1.5 (+/-0.19) mm of upper incisors and 1.6 (+/-0.19) mm of lower incisors were visible in the SG compared with 2.5 (+/-0.16) and 0.4 (+/-0.07) mm in the CG, respectively. The subjects in the SG showed a greater diversity in position of teeth in the anterior arch and this was more often with incisors than with canines. Features such as stains, cracks and defects were much more noticeable in the SG. An inter-dental 'black triangle' seemed to be a typical feature of an aged dental appearance. CONCLUSION: The majority of people older than 60 years who still have their own natural anterior teeth would not wish for a change in appearance if they needed a prosthodontic reconstruction. Thus techniques for customisation should be promoted to obtain a natural appearance in dentures.
Adult↗
Age and perception of dental appearance and tooth colour.
OBJECTIVES: To determine the prevalence of satisfaction with dental appearance and own tooth colour in the UK and investigate the impact of ageing on these perceptions. METHODS: Data about ageing and satisfaction with dental appearance and tooth colour was gathered by means of a questionnaire completed at face-to-face interview. The questionnaire was first tested and then used by the Office of National Statistics (ONS) in a stratified random sample of adults drawn from the UK. A total of 3384 adults were interviewed. RESULTS: Three quarters of the population were satisfied with their own dental appearance and two-thirds were satisfied with their tooth colour. Subjects over the age of 55 were significantly more likely to be satisfied with their dental appearance and tooth colour (p < 0.05) compared with younger age groups. CONCLUSIONS: Ageing is not necessarily associated with negative self-perception of dental appearance or tooth colour. Greater dissatisfaction with dental appearance or colour in younger ages may suggest that perceived appearance is linked to cognitive factors other than social or cultural ones.
Adolescent↗
Apexification following gross overfilling of gutta-percha.
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Adolescent↗
Considerations in intracoronal bleaching.
Intracoronal bleaching is a simple, useful procedure for restoring the colour of discoloured root-filled teeth that are not extensively restored. It is important to minimise the extraradicular diffusion of hydrogen peroxide, as excessive levels of hydrogen peroxide in conjunction with existing inflammatory changes in the periodontium predispose the tooth to external root resorption. To keep the levels of extraradicular diffusion of hydrogen peroxide below the safety limit, it is imperative that an effective intermediate base cement of at least 2 mm be placed at the level of the buccal cemento-enamel junction over the root-filling prior to bleaching. The use of 35% carbamide peroxide as the intracoronal bleaching agent seems to combine the safety of sodium perborate together with the efficacy of 35% hydrogen peroxide. As bleaching agents may reduce the composite-tooth bond of some adhesive systems, the post-bleaching composite restoration should be delayed for at least three weeks.
Borates↗
In vitro computer analysis of crown discolouration from commonly used endodontic sealers.
The aim of this study was to assess the degree of staining of tooth crowns by commonly used endodontic sealers using a computer analysis method. Crown discolouration by root canal sealers AH26, Endofill, Tubliseal, Zinc oxide eugenol (ZnOE), Apatite root canal sealer III as well as gutta-percha and Cavizol (a filling material containing ZnOE) were tested on extracted human premolar teeth. The roots of the teeth were resected 3 mm below the cemento-enamel junction. The pulp chambers were then cleaned and irrigated. The samples were divided into nine groups of five samples each and filled with test materials. Ten teeth were used as control groups: five positive (amalgam) and five negative (distilled water). The degree of tooth discolouration was analysed at 3, 6 and 9 months. The crown discolouration was assessed by computer analysis of digital images taken from the samples using the CIE Lab colour system. Statistical analysis was carried out using anova, repeated measure anova and Tukey's HSD tests. All sealers caused a degree of tooth discolouration, which increased with time. Endofill and ZnOE caused the greatest discolouration and Apatite root canal sealer III caused the least discolouration after 9 months. The most discolouration during the test periods occurred in the cervical third of the crown.
Analysis of Variance↗
A review of chlorhexidine and its use in special populations.
The purpose of this paper is to review the mechanism of the action, safety, and side-effects of chlorhexidine, and to provide guidelines for its use in special populations. Chlorhexidine has been used orally since 1959, primarily for the control of dental plaque. Chlorhexidine is a safe material, with low toxicity potential when used correctly. The most conspicuous side-effects are the development of yellow-brown stains on the teeth, tongue, and at the margins of anterior restorations, and an alteration in taste sensation. The use of chlorhexidine is indicated in developmentally disabled, medically compromised patients, and in dependent elderly populations, since these groups are often physically unable to remove plaque by mechanical means. Clinicians should not prescribe chlorhexidine indiscriminately for all patients, however, until analyzing its efficacy, safety, and side-effects.
Aged↗
The effects of tobacco smoking on oral and dental tissues.
An attempt has been made in this paper to review the clinical problem of the effects of tobacco smoking on oral and dental tissues. Clinicians are alerted to the magnitude of the problem and to its serious sequelae. An appeal is made for clinicians to disseminate preventive information, to exercise increased clinical vigilance and to consider the management of suspected neoplastic lesions as emergency situations.
Adult↗
Conservative treatment of the stained dentition: vital bleaching.
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Dental Enamel Hypoplasia↗
Clinical evaluation of three amalgam alloys.
A total of 117 high-copper amalgams of three types (platinum-modified, palladium-modified and dispersed phase) was placed by two operators in 59 patients. Restorations were assessed for marginal fracture, tarnish, corrosion, and tooth staining on continuous linear photographic rating scales. After one year, the platinum- and palladium-modified alloys showed a significant amount of tarnish, and all three alloys had statistically significant marginal fracture. The only significant difference between alloys at one year was the greater tarnish of the platinum-modified alloy. There was no association between static creep and marginal fracture.
Analysis of Variance↗
An in vitro model to measure the effect of a silver fluoride and potassium iodide treatment on the permeability of demineralized dentine to Streptococcus mutans.
BACKGROUND: Diamine silver fluoride (Ag(NH3)2F), referred to as AgF, has been used to reduce the incidence of caries in primary dentitions but has been limited by the associated staining of both teeth and restorative materials. The application of potassium iodide (KI), following AgF prevents staining but its effects on the ability of AgF to reduce caries are not known. The aim of this study was to develop an in vitro model that would provide an indication of the permeability of demineralized dentine to Streptococcus mutans after treatment of the dentine with AgF followed by KI. METHODS: Forty dentine discs were bonded to the base of forty 5mL polycarbonate screw top vials (that had had their bases removed), filled with nutrient medium, sterilized and placed into a continuous culture of S. mutans. Samples were divided into four groups as follows: 10 samples of demineralized dentine as a control, 10 samples of demineralized dentine treated with AgF/KI, 10 samples of demineralized dentine treated with KI and 10 samples of demineralized dentine treated with AgF. After two weeks the optical density of the growth medium chambers was measured to determine bacterial penetration and growth. Cultures were plated out to determine migration through the discs by S. mutans. RESULTS: S. mutans migrated through all dentine discs. However, the samples treated with AgF and AgF/KI had significantly lower optical densities than the corresponding controls. The range of optical densities was least amongst demineralized samples treated with AgF/KI. CONCLUSIONS: Under the conditions of this study, treatment of demineralized dentine discs with AgF followed by KI allowed the penetration of S. mutans. Based on optical density measurements, the treatment resulted in significantly fewer microorganisms being present subjacent to the discs treated with AgF and KI than the control discs at the end of the experimental period.
Bacteriological Techniques↗
Doxycycline-induced staining of permanent adult dentition.
BACKGROUND: Doxycycline is the most effective antibiotic for managing brucellosis. Although it is relatively free from side effects, complications involving the skin, nails and teeth may rarely be encountered. METHODS: Four patients with brucellosis developed yellow-brown discolouration of teeth following a 30-45 day course of doxycycline therapy during summer at a dose of 200mg/day. RESULTS: All four patients were diagnosed as having doxycycline-induced staining of the permanent dentition. In all cases, the staining completely resolved and the teeth recovered their original colour following abrasive dental cleaning. CONCLUSIONS: These observations indicate that the incidence of staining of the permanent dentition, as a complication of doxycycline, may be much higher than the literature indicates, especially if treatment is administered during summer months. Fortunately, this complication is reversible and does not require termination of doxycycline therapy. Complete resolution following abrasive cleaning may suggest that an extrinsic mechanism within the dental milieu may be involved in its pathogenesis. Strict avoidance of sunlight exposure during high-dose, long-term doxycycline therapy might prevent the development of this complication.
Adolescent↗
Ion uptake into demineralized dentine from glass ionomer cement following pretreatment with silver fluoride and potassium iodide.
BACKGROUND: Diamine silver fluoride (Ag(NH3)2F), referred to as AgF, has been shown to provide a pronounced antimicrobial action against caries. The clinical application of this material has been limited by the staining associated with both teeth and tooth coloured restorative materials. The application of potassium iodide (KI) after AgF eliminates stain formation. The purpose of this study was to determine if a prior application of silver fluoride and potassium iodine to demineralized dentine affected the uptake of strontium and fluoride from a glass ionomer cement restoration. METHOD: Three cavities were prepared in each of five recently extracted human third molars. The cavities were demineralized and treated as follows. In each tooth, one cavity was left as a control, one cavity was restored with glass ionomer cement and one cavity was treated with 1.8M AgF and a saturated KI solution and then restored with glass ionomer cement. The penetration of the various elements into demineralized dentine was measured by their relative percentage weights using electron probe microanalysis (EPMA). RESULTS: Fluoride uptake was significantly higher in the AgF and KI treated samples compared to the other two samples and significantly higher in the glass ionomer restored sample compared to the control. The application of AgF and KI did not significantly interfere with the transfer of strontium from glass ionomer cement into dentine. Silver and iodine deposits were present in the demineralized dentine treated with AgF and KI. CONCLUSIONS: The application of AgF and KI onto dentine prior to the placement of glass ionomer cement did not significantly affect the strontium uptake into the subjacent demineralized dentine and the fluoride levels in this zone were significantly increased.
Anti-Infective Agents↗
Modern supragingival plaque control.
Supragingival plaque control is essential for the maintenance of oral health. Despite the many chemotherapeutic agents available as mouthrinses and toothpastes, mechanical plaque removal is still the best method to achieve effective plaque control. This is due, in part, to the lack of development of oral antimicrobials with the effectiveness and substantivity of chlorhexidine gluconate but without its adverse effects of dental staining and calculus formation. The use of the numerous mechanical (manual and electric) oral hygiene devices extant and their effectiveness, however, are dependent upon patient dexterity and compliance and concomitant active professional treatment for the monitoring of home care, oral hygiene instruction and patient motivation. This paper evaluates the current methods available to reduce plaque and gingivitis with emphasis on their effectiveness at both supragingival plaque control and disease prevention. In addition, recent studies on the newer oscillating/rotating electric plaque removers and interdental cleaning devices will be discussed as related to their efficacy and compliance.
Anti-Infective Agents↗
Guidance on the assessment of the efficacy of toothpastes. FDI Commission. Work Project (8-95).
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Cariostatic Agents↗
The efficacy of two prototype chewing gums for the removal of extrinsic tooth stain.
AIM: To compare the potential efficacy of two prototype chewing gums in extrinsic stain removal on natural teeth. SETTING: Dental school clinics. DESIGN: Double-blind, two groups, parallel design. PARTICIPANTS: 76 adult volunteers (32m, 44f, mean age: 20.6 years old). METHODS: Oral hard and soft tissue health was examined. The subjects were randomly assigned to use either Product A (without active ingredients) or Product B (with active ingredients). Each subject was asked to brush their teeth for one minute twice daily (mornings and nights) and chew the gums supplied for 15 min (2 dragees each time), three times daily, once after each meal (breakfast, lunch and dinner) for the entire four-week duration. Dental stain assessment was made on the 12 incisors using the Lobene Stain Index (LSI). RESULTS: The overall difference between the stain scores after 4-weeks' use of the chewing gums was statistically significant (p<0.01) for both test Product A (10.84) and Product B (7.77) with regard to the mean baseline stain scores (21.57). This difference represented a 48% reduction in stain scores for those subjects using Product A, while the reduction was 64% for the subjects using Product B. CONCLUSIONS: The results of this in vivo study suggest that chewing gums with and without active ingredients have potential effect on stain removal after regular use for one month.
Adolescent↗
Effect of toothpaste with natural calcium carbonate/perlite on extrinsic tooth stain.
OBJECTIVE: The current study was designed to determine the effect of natural calcium carbonate toothpaste containing Perlite and microgranules (Whitening toothpaste) on extrinsic tooth stain compared to a standard commercial toothpaste formulation with precipitated calcium carbonate (PCC) as abrasive and a commercial toothpaste with dicalcium phosphate dihydrate (DCPD) as abrasive. METHODS: The toothpastes were evaluated in a double blind, three-cell, stratified (tobacco use; baseline tooth stain level), parallel group design study involving 600 subjects with extrinsic tooth stain. Subjects brushed twice daily with their allocated toothpaste for four weeks. Extrinsic tooth stain was measured using the Macpherson modification of the Lobene stain index. RESULTS: ANCOVA showed significant differences between toothpastes (p=0.037). Subsequent multiple comparisons using pairwise t-tests, showed the Whitening toothpaste to be superior to the DCPD toothpaste (p=0.014) and the PCC toothpaste (p=0.067). When a Box-Cox transformation was made to the data (y0.6) to improve normality, these two differences were more accurately estimated at p=0.004 and p=0.03 respectively. CONCLUSION: The Whitening toothpaste has been shown to be significantly more effective in tooth stain removal than the two standard commercial toothpaste formulations.
Adult↗
A review of the clinical efficacy of the Oral-B oscillating/rotating power toothbrush and the Philips Sonicare toothbrush in normal subject populations.
Plaque removal by a toothbrush results from a physical scrubbing of bristles on the tooth surface that removes adherent plaque bacteria. Because of the frequency of brush head motion, some power toothbrushes generally remove plaque more effectively than a manual brush. One power toothbrush, Philips Sonicare, claims also to remove plaque as a result of dynamic fluid activity. This effect has been shown in laboratory studies but clinical evidence is currently lacking. This review evaluated the data from well-controlled clinical studies carried out in normal subjects from a general population comparing the Sonicare toothbrushes with the Oral-B oscillating/rotating power toothbrush technology. It focuses on plaque removal from approximal surfaces where it is difficult for toothbrush bristles to reach, as it is here that any dynamic fluid effect should be most apparent. Results from the review found no evidence to support a greater efficacy for the Sonicare toothbrushes either generally or at approximal surfaces. Data revealed that the oscillating/rotating toothbrush was more effective than the Sonicare toothbrushes with respect to plaque removal. It is possible that factors associated with the clinical situation such as damping resulting from bristle contact with the tooth surface and the high viscosity of saliva and dentifrice may counteract dynamic fluid activity in vivo. This review indicates that dynamic fluid activity beyond the reach of bristles as demonstrated in the laboratory is yet unproven in the clinical situation.
Acoustics↗