In vitro wear of three bulk fill composites and enamel
Jean-François Roulet, Nader Abdulhameed, Chiayi Shen (abstract)Introduction: This in vitro study aimed at testing the hypotheses that (1) there is no difference in wear in vitro among 3 bulk-fill composites investigated and their respective antagonists, and (2) the tested bulk-fill wear is not different from enamel. Methodology: X-tra fil (Voco; [X]), Tetric-N-Ceram Bulkfill (Ivoclar Vivadent; [T]), QuiXX (Dentsply; [Q]), and enamel [E] specimens (Ø=8 mm, depth=1.5 mm, n=8/material) were subjected to wear in a chewing simulator (CS 4.8, SD Mechatronik) with steatite antagonists (Ø=6mm). 1.2×105 cycles (0-49 N, 0.7 mm lateral movement, 1 Hz) were performed while simultaneously thermocycling (5/55°C) every 90 s. The volumetric wear of the materials was measured with a 3D laser scanner. Results: The total wear of bulk-fills was: [X]: 0.64±0.07 mm3; [T]: 0.66±0.08 mm3; [Q]: 1.58±0.14 mm3. The total wear of enamel (0.24±0.03 mm3) was significantly lower than that of the bulk-fills (p<0.0001). The total wear of the antagonists was: [X]: 0.32±0.02 mm3; [T]: 0.24±0.04 mm3; [Q]: 0.27±0.02 mm3; [E]: 0.12 ±0.01 mm3. The wear of the antagonists by [X] was significantly higher than by [T] and [Q] (p<0.001). Enamel produced the lowest wear of the antagonists (p<0.0001). The wear was linear between 5×103 and 1.2×105 wear-cycles. A negative correlation between the wear of the composite materials and that of the antagonists was found. Conclusion: In vitro wear of Tetric-N-Ceram Bulkfill was in the expected range and equal to X-tra fil. QuiXX wear was 2.7 times higher. The antagonist wear was significantly lower, less than 50% of the wear of the composites and the enamel. Both hypotheses were rejected. Keywords: chewing simulator, wear, bulk-fill composite, thermocycling, enamel. | (read pdf) | (read xml)
Knowledge and patterns of antibiotic prescription among dental practitioners in Hail, Saudi Arabia
Hazza A. Alhobeira, Juma Alkhabuli, Maleeha Fraih (abstract)Introduction: Presence of various bacterial strains resistant to antibiotics is a genuine issue to medical professionals. Unjustified over prescription of antibiotics by dental practitioners (DP) is well recognized. The aim of this study was to explore the knowledge and patterns of antibiotic prescription and related antibiotic resistance among dental surgeons working in Hail, Saudi Arabia.
Methodology: A questionnaire was distributed to 150 DP working in the district of Hail, Saudi Arabia. The questionnaire sought answers to the common dental conditions for which antibiotic would be prescribed. The possible contributing factors in development of antibiotic resistance were also sought.
Results: Out of the 150 questionnaires sent out 101 (67%) were filled in by the DP. About 85% were males and 15% were females. Most of the DP would prescribe antibiotics for elevated temperature (86.1%), diffuse swelling (75.2%) and swelling causing eye closure (90.1%). Antibiotic prescription would be considered for pericoronitis, cellulitis and trismus by 68.3%, 89.1% and 40.6% of the DP respectively. However, 55.4% would prescribe antibiotics for fluctuant localized swelling, 75.2% to reduce postoperative complications and 73.3.8% for surgical extraction. Generally, amoxicillin was the most preferred drug of choice, and nearly 36% of the DP preferred amoxicillin-clavulanate in treatment of cellulitis. About 67% thought that the widespread use of antibiotics was the main contributing factor in development of antibiotic resistance.
Conclusion: Despite of the moderate knowledge of DP, a substantial percentage continue to prescribe antibiotics indiscriminately and irrationally. The results reveal that further work and efforts are required to acquaint the DP of the risk of unjustified antibiotic use and bacterial-resistance development.
Keywords: antimicrobial, dental practitioner, use of antibiotics, bacterial resistance. | (read pdf) | (read xml)
Impaction of teeth – frequency and most often treatment protocols
Greta Roussanova Jordanova-Kostova, Pavel Kirilov Stanimirov (abstract)Introduction: Tooth impaction is a biological phenomenon that can affect every tooth group, but most often third molars, canines and second premolars. Methodology: The aim of our survey is to find out the prevalence of impacted teeth in different tooth groups. Another aim is to prove the following hypothesis, namely that there is a relationship between impaction teeth and treatment protocols using the method of distalization of the upper molars with the Pendulum appliance and also releasing space in the arc by the extraction of permanent teeth. The study analyzed 182 patients diagnosed with impacted teeth and excluded patients with impacted third molars. The analysis used the statistics packet SPSS version 13.0. Results: The most common impacted teeth are the upper canines – 137 teeth, followed by upper second premolars – 50 teeth, the lower second premolars – 27 teeth, the lower canine – 20 teeth, the lower second molar – 11 teeth, the upper central incisor – 8 teeth, the lower lateral incisor – 3. Significant statistical relations were found between tooth agenesis, odonthoma collections and tooth transposition with impaction. Patients in the early growth period stand a better chance not to undergo non-extraction treatment than those for whom the formation of the constant dentition has been finalized and who have passed the peak of their puberty growth. Conclusion: The early diagnosis of the problem is an important factor for a successful treatment. The growth potential of the patient is the leading factor that supports the processes. Keywords: impaction teeth, tooth agenesis, tooth transposition, odontoma. | (read pdf) | (read xml)
Partial ceramic crowns. Esthetic and tissue conservative restorations – Part I: posterior teeth
Gottfried Schmalz, Marianne Federlin (abstract)Background: Partial ceramic crowns (PCCs) are more tooth conservative and potentially less stressful for the periodontium than full coverage crowns and meet the esthetic demands of patients. Objective: evidence shall be provided, if PCCs are a reliable treatment option, and under which conditions. Data sources: this review is based on own published data and experiences and on a review of the literature. Results: Longevity of PCCs is in the range of partial crowns from gold alloys. Failures due to chip fractures, bulk fractures, or debonding can be avoided/reduced by proper technique. Most clinical experience exists with leucite reinforced silicate or lithium disilicate ceramics, either pressed or CAD/CAM processed. Tooth preparation must respect the need for sufficient ceramic thickness of at least 1.5 mm. Residual buccal or oral cusps of less than 2 mm thickness should be included in the preparation. Cavity preparation should be defect oriented with few parallel walls as guidance for placement. Dual curing luting composites together with etch and rinse (E&R) adhesives are standard. Self-adhesive materials can be used but are sensitive to tooth desiccation before luting. Clinical experience with new universal adhesives is limited, but available results are promising. Light curing should be performed by applying 32 J/cm2 from oral, buccal and occlusal aspects (silicate based ceramics). Conclusions: PCCs are a reliable treatment option for extended defects in posterior teeth. Special guidelines must be followed including sufficient ceramic thickness and proper adhesive technique to avoid failures. Keywords: partial crowns, ceramic, light curing, luting composite. | (read pdf) | (read xml)
Complete prostheses treatment – present and future perspectives
Sorin Uram-Ţuculescu, Marian-Vladimir Constantinescu (abstract)Background: Tooth loss is a public health problem across the globe, especially in low-income populations. Traditional complete denture treatment is time consuming, and less embraced by general practitioners. Objective: The purpose of this paper is to review data on prevalence, future projections, and treatment modalities for edentulism. Most edentulous patients receiving care are treated with conventional, tissue-supported prostheses. Possible ways to improve efficiency in complete denture treatment, and ameliorate access to care are investigated. Data Sources: Information was obtained mainly from PubMed, American College of Proshodontists databases, and non-indexed sources. Study selection: Considering the scarcity of information on some topics (simplified complete denture fabrication methods, digital techniques), a wide range of papers were selected for analysis, from systematic reviews, randomized controlled trials, cross-sectional studies to case presentations, expert opinions, surveys, and dental organizations’ reports. Data extraction: The web search included the following key words: edentulism, demographic, implant, removable, denture, simplified, digital, denturist. Data synthesis: The future of traditional complete denture treatment remains questionable, considering the reduced appetite of general practitioners and patients for time consuming treatments. Simplified techniques deserve an increasing attention from practitioners and dental educators, as available data suggest that they produce similar outcomes, when compared to traditional methods. Digital technologies are expected to further improve treatment outcomes, within simplified protocols. As mid-level dental providers became a reality in some jurisdictions, denturism could be considered part of the solution, especially in underserved areas. Keywords: edentulism, prosthesis, simplified, digital, curriculum. | (read pdf) | (read xml)
Factors influencing the use of methamphetamine by dental patients in the United States
Lola K. Giusti, Swapandeep S. Mushiana, Mitchell A. Goodis (abstract)Aim: This literature review explores the multiplicity of issues affecting the use of methamphetamine by dental patients in the United States. Current sources investigating trends in availability of methamphetamine from nontraditional (non-dental) resources are presented. Strategies for communicating with addicted patients are presented. Summary: Issues of addiction and recovery from this highly addictive drug are explored, as well as its well-known destructive effects on the dentition. Key Learning Points: The review draws from current literature in the fields of addiction, substance abuse and recovery, dentistry and psychology. Treatment recommendations are drawn from evidence in interprofessional fields. Data Extraction, Data Synthesis: Not applicable in this article Keywords: methamphetamine, caries, periodontal disease, addiction, substance abuse. | (read pdf) | (read xml)
Endodontic retreatment using MTA-based sealants in a tooth with perforation and periapical lesion
Nayara Rodrigues Nascimento Oliveira Tavares, Maria Antonieta Veloso Carvalho de Oliveira, Lucas do Nascimento Tavares, Alexia da Mata Galvão, Cristiane Melo Caram, Gisele Rodrigues da Silva (abstract)Introduction: To report an endodontic retreatment with a root perforation and use of reparative cement and filling sealant based on mineral trioxide aggregate (MTA). Summary: Retreatment in teeth with root perforations can reduce the longevity of the treatment, because it depends on the rapid location and proper sealing, with biocompatible materials that promote tissue repair. A female patient came to the dental office complaining of pain in tooth 36, with an indication of retreatment on it. Radiographically, it presented thickening of the periodontal ligament and periapical lesion in the mesial and distal roots, leading to the diagnosis of chronic apical periodontitis. With the help of an operative microscope, it was possible to find a perforation in the most cervical portion in the furcation region of the mesio-vestibular root canal. To treat this perforation, it was filled with MTA HP Repair, to enable preparation of root canals and subsequent filling with MTA Fillapex, through the Schilder Plus technique and execution of a 12 mm relief on distal root for placement of the intra-radicular retainer. Rehabilitation of teeth with root perforations can be performed with MTA-based filling sealants, presenting satisfactory results for repairs in cases of perforations and periapical lesions. Key learning points:
– Root perforations are accidental unwanted complications that can occur in stages of the endodontic treatment;
– The prognosis for endodontic perforations depends on the size and location of the defect and how quickly the perforated area was sealed with biocompatible material. Keywords: mineral trioxide aggregate, root canal filling materials, periapical periodontitis. | (read pdf) | (read xml)
How to reach the gold standard in prophylaxis: Guided Biofilm Therapy