Advertisements
April 2022 Abstracts
_______________________________________________________________________________________________________________
Research Article
_______________________________________________________________________________________________________________
Airborne
contamination of the dental operatory during activities
James
R. Collins, dds, Vanessa Warden, dds, Ana
Vargas, dds, Andrei
C. Ionescu, dds, phd,
Abstract: Purpose: To quantify the biological
contamination of a dental operatory environment using a biological tracer. Methods: A Streptococcus mutans suspension was infused into the mouth of a
phantom, and an operator performed standardized dental procedures using an air
turbine, a contra-angle handpiece, or an ultrasonic scaler either with windows
open or closed. The presence of the tracer was measured by placing Petri dishes
with a selective medium at 18 sites on the dental unit and 38 sites in the
surrounding operatory environment. Results: The contamination was drastically reduced when windows were opened, no
matter which handpiece was used. Air turbine spread significantly higher
contamination compared to contra-angle and scaler. All tested instruments
spread the tracer over the entire dental unit and the surrounding environment, including the walls and ceiling;
however, higher contamination levels were detected on the dental unit compared
to the operatory surfaces. Opening windows during dental operative procedures
greatly reduced contamination levels for all handpieces and can be recommended
for reducing airborne contamination levels. (Am J Dent 2022;35:63-68).
Clinical significance: The significant levels of airborne contamination produced when operating dental handpieces can be significantly reduced by natural ventilation, i.e., simply opening the windows.
Mail: Dr. James Collins, Department of Periodontology, Pontificia Universidad Católica Madre y Maestra, Av. Abraham Lincoln. esq. Av. Bolívar, Santo Domingo, Dominican Republic. E-mail: jamescollins@pucmm.edu.do
_______________________________________________________________________________________________________________
Research Article
_______________________________________________________________________________________________________________
Application of non-inferiority testing in microhardness
and its relationship
Eva Schneiderman, phd, Samuel
St. John, phd, Joel
Moore, bs, Donald J. White, phd, Austin
Hornsby, as,
Abstract: Purpose: To use
non-inferiority statistical testing with simple microhardness measurements (SMH)
as a prediction of potential erosive hard tissue damage of topical treatments
on enamel. Methods: Three
independent experiments of a simple acid cycling demineralization (ACD) model
were used to screen softening effects of various commercial beverages on dental
enamel. The cycling model consists of six repeated exposures of enamel slabs
with alternating treatments of artificial saliva over the course of 6 hours.
After six repeated cycles, effects on surface microhardness were measured. Softening
effects of beverages were evaluated using a statistical non-inferiority test of
the positive control (water) and negative control (1% citric acid). To confirm
whether softening effects as evaluated by a non-inferiority test translated to
like differences in enamel erosion susceptibility, selected beverages then
underwent more complex erosion cycling model (ECM) evaluation where enamel
blocks were cycled with beverages (vs. historically established citric acid)
and pooled saliva over a period of 5 days. The ECM also incorporated dentifrice
treatments, sodium fluoride (NaF, Crest Cavity Protection, negative control)
and a positive control stannous fluoride dentifrice (SnF2, Crest
Pro-Health Advanced), to confirm model performance against historically published
results of in situ erosion protection benefits of SnF2. Results: There was a spectrum of
softening properties of 16 commercial beverages in the ACD test, ranging from a
ΔSMH of -22.6 to -316 vs. baseline. Four beverages were evaluated further
in ECM testing. Despite a measurable change in SMH, Sprite and beer treatments
in the ACD passed the statistical non-inferiority test and both were evaluated
in erosion cycling, showing no enamel surface loss. Vinegar (~5% acetic acid)
and Gatorade also showed measurable changes in SMH in the ACD, but they failed
statistical non-inferiority testing. Both beverages subsequently showed
significant enamel tissue loss (erosion) in further erosion cycling testing.
This combined set of data suggests that simple surface microhardness evaluation
may be used as a proxy for potential erosion surface loss if properly
quantified. SnF2 dentifrice significantly reduced erosion from all
erosive beverages with greater efficacy than NaF control dentifrice, consistent
with prior clinical and in vitro evidence. (Am
J Dent 2022;35:69-74).
Clinical significance: The ACD model
with application of non-inferiority statistical testing is proposed as a simple
model of hard tissue safety assessment of treatments, including oral hygiene products.
Products that pass the non-inferiority test in ACD (surface softening) are
proposed as safe for enamel as there is no suggestion from this data that teeth
are at risk of tissue loss due to these products. On the other hand, products
failing the non-inferiority test require confirmatory safety qualification in
erosion cycling. Products equal or worse than citric acid with ACD or with
significant erosion in ECM are suggested to warrant reformulation unless
favorable safety data for enamel (lack of erosion) or the appropriate
justification are provided.
Mail: Dr.
Eva Schneiderman, The Procter & Gamble Company,
8700 Mason-Montgomery Road, Mason, OH, USA. E-mail: schneiderman.e@pg.com
________________________________________________________________________________________________________________
Research Article
________________________________________________________________________________________________________________
Retrospective
evaluation of failure rate of 1,000 immediate implants
Shirin
Amini, dds, Ali Salehi, dmd, msc, Rojin Shahmohammadi, dds & Paniz Ranji, dds
Abstract: Purpose: To evaluate the
failure rate of 1,000 immediately placed implants in fresh extraction sockets
and their risk factors. Methods: The
data comprised files of 1,000 fresh socket implants placed during the 2014-2019 interval in three Tehran-based private dental clinics.
The statistical method was survival analysis consisting of shared frailty and
intra-cluster correlation. Moreover, Chi-squared test and Mann-Whitney U test
were used to statistically analyze the rela-tionship between each independent variable and the response variable (immediate implant
failure). Results: 40 cases of
failures among the implants were found, accounting for a 4% failure rate.
Shared frailty survival model indicated that only the implant system
significantly affects the failure rate. Intra-clustered correlation was 0.41.
Chi-squared analysis showed that gender and implant system
both significantly affect immediate implant failure. None of the
quantitative variables were significantly related to immediate implant failure
according to the Mann-Whitney U test. (Am
J Dent 2022; 35:75-78).
Clinical significance: The data was gathered
using a relatively large sample size to perform a reliable evaluation on
success and predictability of implants placed into fresh extraction sites. A
brief review on articles focusing on fresh socket implant success or failure published
from years 2000-2020 is presented.
Mail: Dr. Paniz Ranji, Department of Oral and Maxillofacial Radiology, School
of Dentistry, Tehran University of Medical Science, Tehran, Iran. E-mail: r.paneez86@gmail.com
_______________________________________________________________________________________________________________
Research Article
_______________________________________________________________________________________________________________
Effect of chemical surface treatment of contaminated
CAD-CAM
Rintaro Sugai, dds, Mikihiro Kobayashi, dds, phd, Yuiko Niizuma, dds, phd, Yuki Iketani, dds,
Abstract: Purpose: To evaluate the
effects of four chemical treatment methods on the contaminated surfaces of VITA
ENAMIC (EN) and CERASMART (CS) resin composite computer-aided design-computer-aided
manufacturing blocks (RCBs). Methods: Each
RCB was contaminated with a handpiece oil for 1
minute. These contaminated surfaces were then chemically treated by Gel Etchant
(PA), Ivoclean (IC), Monobond Etch & Prime (MB), or Ceramics Etch (HF) reagents (n= 12), after which
their shear bond strengths, morphologies, failure modes, and surface free
energies were examined. Results: The
shear bond strengths of the HF-treated surfaces significantly exceeded those of
the specimens treated with the other reagents. Adhesive fractures were observed
for both the EN and CS blocks after 24 hours of treatment with lubricating oil,
PA, and IC. The largest numbers of mixed and cohesive fractures were detected
for the MB- and HA-treated specimens. The HF-treated EN and CS blocks possessed
the highest surface free energies. The bonding strengths of the resin
composites decreased after the contamination of their surfaces; however, the
adhesion properties of both blocks were considerably improved by chemical
treatment. (Am J Dent 2022;35:79-83).
Clinical significance: The lubricating oil contamination
of dental handpieces significantly reduces the adhesion between the CAD-CAM
resin composite block and the resin composite. Therefore, it is necessary to
remove contamination and improve the adhesiveness using an optimal chemical
surface treatment.
Mail: Dr.
Rintaro Sugai, Department of Conservation Dentistry, Division of Aesthetic and
Clinical Cariology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo,
145-8515, Japan. E-mail: rintaro@dent.showa-u.ac.jp
_______________________________________________________________________________________________________________
Research Article
_______________________________________________________________________________________________________________
Use of bulk fill resin composite and universal
adhesive for restoring primary teeth
Márcia
Gomes Massa, dds,
msc, phd, Giorgio Aldigueri Trentin, dds, Fernanda Coradini Noal, dds, msc,
Abstract: Purpose: To
investigate the survival of adhesive restorations after selective carious
tissue removal to soft dentin in primary molars. Methods: This two-arm randomized clinical trial included 62
subjects (5.9 years ± 1.7) and 144 primary molars presenting deep active dentin
carious lesions. The sample was randomly assigned based on restorative
material: universal adhesive (Scotchbond Universal)
plus bulk fill resin composite (Filtek Bulk Fill
Posterior Restorative) and resin-modified glass-ionomer cement (Vitremer). Two operators performed all restorative
procedures. Restorations were evaluated at 6, 12, and 18 months using the FDI
World Dental Federation criteria. Survival estimates for restorations’
longevity were evaluated with Kaplan-Meier method. Multivariate Cox regression
analysis with shared frailty was used to assess the factors associated with
failures (P< 0.05). Results: Restorative material did not influence the restorations’ survival (HR 1.56 95%
CI 0.78-3.13; P= 0.12). The survival rates at 18 months of follow-up were 62.9%
and 76.8% (AFR: 26.6% and 16.1%) for resin-modified glass-ionomer cement and
bulk fill resin composite restorations, respectively (long-rank P= 0.14). Boys
had higher risk of failure in their restorations (HR: 2.64, 95% CI: 1.29-5.40).
Restorations performed by a less experienced operator had 3.26 times more risk
of failure (P= 0.001). (Am J Dent 2022;35:97-102).
Clinical significance: The effectiveness of resin-modified glass-ionomer cement (Vitremer) and bulk fill resin composite (Filtek Bulk Fill Posterior Restorative) restorations after
selective removal of carious tissue to soft dentin in primary molars was
similar at 18 months of follow-up.
Mail: Dr. Giorgio Aldigueri Trentin, School of Dentistry, Post-Graduate
Program in Pediatric Dentistry, Federal University of Rio Grande do Sul, Ramiro
Barcelos 2492, 90035-003, Santa Cecília, Porto Alegre, RS, Brazil. E-mail: giorgiotrentin@hotmail.com
_______________________________________________________________________________________________________________
Research Article
_______________________________________________________________________________________________________________
In
vitro effect of an oral spray and mouthrinses on dual species
Parveez Ahamed Abdul Azees, phd, Hanzhou Wang, phd, Xiao-dong
Chen, md, phd, Chih-Ko Yeh, bds, phd
Abstract: Purpose: To determine the efficacy of an oral spray and oral
rinses to inhibit oral cariogenic dual species biofilm formation on
hydroxyapatite (HA) discs. Methods: The Streptococcus mutans (NCTC 10449, ATCC), Lactobacilli casei (NCIB
8820, ATCC) dual species biofilm formation and inhibition on HA disc was tested
using five antimicrobial products, i.e., oral spray (Oral Shield), Mouthrinse (Listerine Ultra Clean, Listerine Cool Mint,
Crest Pro-Health, ACT Restoring). An untreated group served as control. The
established biofilm on the surface of each disc was treated or untreated with
oral spray and mouthrinse for 2 minutes after 24 or
48 hours. The dual species biofilm formation and inhibition on HA discs was
determined using the spread plate method and colonies were counted and
expressed as colony forming units (CFU/mL). Further, the HA disc was subjected
to confocal laser scanning microscope (CLSM) examination to determine the viability
of cells using live-dead staining and a scanning electron microscope (SEM) to
examine the effect on bacteria biofilm and morphology. The cytotoxic effect of
test spray and mouthrinse was tested on OKF6/TERT-2
cells using the MTT method. Results: At each time point, 24- or 48-hours, S. mutans and L. casei mixed biofilm on HA discs had a significantly
(P> 0.001) fewer number of bacteria in the treated groups than the untreated
one. The oral spray and mouthrinses had a detrimental
effect on bacteria biofilm, morphology and cell wall, whereas no significant
changes were observed in the untreated group. Cytotoxic assay revealed that the
oral spray was safe for human oral keratinocyte cells. (Am J Dent 2022;35:103-108).
Clinical
significance: The tested oral spray could
offer potential to inhibit the cariogenic bacteria and protect the tooth enamel
from cariogenic bacterial biofilm.
Mail: Dr. Franklin Garcia-Godoy,
Department of Bioscience Research, College of Dentistry, University of
Tennessee Health Science Center, 875 Union Avenue, Memphis, TN 38163, USA. E-mail:
fgarciagodoy@gmail.com
________________________________________________________________________________________________________________
Review Article
________________________________________________________________________________________________________________
Side effects of
sodium lauryl sulfate applied in toothpastes:
Shaira Rahielah Kasi, msc, Mutlu Özcan, dds, dmd, phd & Albert Joseph Feilzer, dds, phd
Abstract: Purpose: To perform
a scoping review on the available literature regarding the side effects of sodium
lauryl sulfate (SLS) used in toothpastes. Methods: A scoping review was performed according to the PRISMA extension using PubMed.
The electronic search was supplemented with a manual search for a complete
overview. A customized data collection form was used to map data which was
developed to register the extracted relevant data. The results of the selected
articles were classified according to effects in the mouth, on the mucous
membrane or elsewhere in the body and the healing effects of SLS-free
toothpaste on aphthous ulcers. The outcomes from each category were reported in
separate data forms and the studies with incomplete information were excluded from
the assessment. Results: Possible
harmful effects of SLS were reported as mucosal desquamation, irritation or
inflammation of oral mucosa or the dorsal part of the tongue, ulcerations, and toxic
reactions in the oral cavity. (Am J Dent 2022;35:84-88).
Clinical
significance: There
is limited evidence that patients with recurrent aphthous ulcers can benefit
from the use of SLS-free toothpastes in terms of decrease in the number of
ulcerations, duration of the ulcerations and the intensity of the pain caused
by the ulcerations. It is essential to create awareness for the side effects of
SLS in toothpastes but further research is needed on its effect on oral and
gastrointestinal systems when used in toothpastes.
*: Shaira R. Kasi, Department of
Dental Materials Science, Academic Center for Dentistry Amsterdam, University
of Amsterdam, Gustav Mahlerlaan 3004, 1081LA
Amsterdam, The Netherlands. E-*: s.r.kasi@acta.nl
________________________________________________________________________________________________________________
Review Article
________________________________________________________________________________________________________________
Longevity of
bulk fill and ormocer composites in permanent
Nathalie Murielly Rolim de Abreu, dds, Frederico Barbosa de Sousa, phd,
Abstract: Purpose: To evaluate
the clinical longevity of bulk-fill resins and ormocer composites compared to conventional nanofill and
nanohybrid resins in posterior permanent teeth. Methods: PubMed, Web of
Science, Scopus, Science Direct, Cochrane Library, and Scielo were electronically searched for randomized clinical trials, without language
restrictions. The extracted data were analyzed using Review Manager, comparing
the clinical behavior of bulk fill or ormocer restorations with nanofill or nanohybrid resins.
Statistical analysis was performed with a significance level of 5% for all
analyses (P= 0.05). The risk of bias was assessed using the Cochrane assessment
tool. Results: 11 randomized clinical trials were included, with an
average follow-up time of 40.36 months. A total of 812 restorations were
evaluated and 58 failures were analyzed: 18 of the 253 bulk-fill restorations
(7.11%), 21 of the 173 (12.3%) ormocer restorations,
and 20 of the 386 (5.18%) control group (nanofill or
nanohybrid composites) restorations failed. In the meta-analysis, there was no
significant difference between the bulk-fill and the control group (statistical
power = 24.38%; P= 0.206; IC = 95%); whereas, when comparing between ormocer and control group, the control group exhibited
better performance (statistical power = 81.62%; P= 0.0042; IC = 95%). (Am J
Dent 2022;35;89-96).
Clinical significance: Conventional nanofill and nanohybrid resins exhibited better clinical longevity than ormocer composites in posterior restorations, but when compared
to bulk fill, they had similar performance.
*: Dr. Robinsom Viégas Montenegro, Department of Restorative
Dentistry, Federal University of Paraíba, João
Pessoa, 8050-085, Brazil. E-*: rvmontenegro@hotmail.com
________________________________________________________________________________________________________________
Review Article
________________________________________________________________________________________________________________
Medication-related
osteonecrosis of the jaw: A multifaceted diagnostic
Roxana
Bonachea, bsc & Joseph Katz, dmd
Abstract: Medication-related
osteonecrosis of the jaw (MRONJ) may present a challenge to the dental
clinician due to the many presentations that it can have. This condition can be
caused by multiple medications including bisphosphonates, RANKL ligand
inhibitors and antiangiogenic drugs. Cases were reported in multiple sites of
both the maxilla and mandible, including the hard palate, mylohyoid area, and the
buccal plate. The risk factors for this condition include the use of a
combination of antiresorptive medications, trauma, periodontal disease, immunosuppression,
dental trauma, dental extractions, and bone manipulations. Spontaneous MRONJ
have been reported in about half of the cases. Conventional radiographs are not
conducive to a diagnosis, underscoring the importance of a three-dimensional
modality in the diagnosis of MRONJ. The multifaceted diagnostic challenges of
MRONJ are underscored in this mini review. (Am J Dent 2022;35:109-112).
Clinical
significance: MRONJ
can have diverse presentations and a lengthy multisite involvement. Therefore,
long-term follow up for patients with history of use of antiresorptive
medications is recommended.
*: Dr. Joseph Katz, Department of
Oral Medicine, University of Florida College of Dentistry, 1395 Center Drive,
Gainesville, FL 32610, USA. E-*: jkatz@dental.ufl.edu
