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Biomedical subjects

A J Moule

Publications and source records attributed to A J Moule.

At least 19 recordsLinked to original sources

Dissolution of porcine incisor pulps in sodium hypochlorite solutions of varying compositions and concentrations.

BACKGROUND: The solubility of dental pulp tissue in sodium hypochlorite has been extensively investigated but results have been inconsistent; due most likely to variations in experimental design, the volume and/or rate of replenishment of the solutions used and the nature of the tissues assessed. Traditionally, the sodium hypochlorite solutions used for endodontic irrigation in Australia have been either Milton or commercial bleach, with Milton being the most common. Recently, a range of Therapeutic Goods Administration (TGA) approved proprietary sodium hypochlorite solutions, which contain surfactant, has become available. Some domestic chlorine bleaches now also contain surfactants. The purpose of this study was to perform new solubility assessments, comparing Milton with new TGA approved products, Hypochlor 1% and Hypochlor 4% forte, and with a domestic bleach containing surfactant (White King). METHODS: Ten randomly assigned pulp samples of porcine dental pulp of approximately equal dimensions were immersed in the above solutions, as well as representative concentrations of sodium hydroxide. Time to complete dissolution was measured and assessed statistically. RESULTS: White King 4% showed the shortest dissolution time, closely followed by Hypochlor 4% forte. White King 1% and Hypochlor 1% each took around three times as long to completely dissolve the samples of pulp as their respective 4% concentrations, while Milton took nearly 10 times as long. The sodium hydroxide solutions showed no noticeable dissolution of the pulp samples. CONCLUSIONS: The composition and content of sodium hypochlorite solutions had a profound effect on the ability of these solutions to dissolve pulp tissue in vitro. Greater concentrations provided more rapid dissolution of tissue. One per cent solutions with added surfactant and which contained higher concentrations of sodium hydroxide were significantly more effective in dissolution of pulp tissue than Milton.

Animals↗

A survey of sodium hypochlorite use by general dental practitioners and endodontists in Australia.

BACKGROUND: Sodium hypochlorite is used commonly as an endodontic irrigant, but there are no published reports that provide details of its use. This survey sought to determine the percentage of Australian dentists who practiced endodontics, whether they used sodium hypochlorite for irrigation, and the manner of dilution, storage and dispensing sodium hypochlorite used by both dentists and endodontists. METHODS: All Australian endodontists and a stratified random sample of 200 general dentists in Australia were surveyed to address the issues identified above. RESULTS: Almost 98 per cent of dentists surveyed performed endodontic treatment. Among endodontists, nearly 94 per cent used sodium hypochlorite for irrigation compared with just under 75 per cent of general dentists. Sodium hypochlorite use by general dentists was more common in Victoria and South Australia than in other States. An infant sanitizer (Milton or Johnson's Antibacterial Solution) was used by just over 92 per cent of general practitioners and by more than 67 per cent of endodontists. All other respondents used domestic bleach. One hundred and sixty four of the respondents (80 per cent of endodontists and over 90 per cent of general dentists) used a 1 per cent w/v solution. Ten practitioners used a 4 per cent w/v solution, five used a 2 per cent w/v solution and four used a 1.5 per cent w/v solution. Eighty per cent of the practitioners who diluted their sodium hypochlorite before use, used demineralized water for this purpose. The remainder used tap water. Only four practitioners stored sodium hypochlorite in a manner which risked light exposure and loss of available chlorine content. CONCLUSIONS: Sodium hypochlorite is commonly used as an endodontic irrigant and Australian dentists generally stored the material correctly.

Australia↗

A comparison of Kodak Ultraspeed and Ektaspeed plus dental X-ray films for the detection of dental caries.

BACKGROUND: Using the fastest dental X-ray film available is an easy way of reducing exposure to ionizing radiation. However, the diagnostic ability of fast films for the detection of proximal surface caries must be demonstrated before these films will become universally accepted. METHODS: Extracted premolar and molar teeth were arranged to simulate a bitewing examination and radiographed using Ultraspeed and Ektaspeed Plus dental X-ray films. Three different exposure times were used for each film type. Six general dentists were used to determine the presence and depth of the decay in the proximal surfaces of the teeth radiographed. The actual extent of the decay in the teeth was determined by sectioning the teeth and examining them under a microscope. RESULTS: There was no significant difference between the two films for the mean correct diagnosis. However, there was a significant difference between the means for the three exposure times used for Ultraspeed film. The practitioners used were not consistent in their ability to make a correct diagnosis, or for the film for which they got the highest correct diagnosis. CONCLUSIONS: Ektaspeed Plus dental X-ray film is just as reliable as Ultraspeed dental X-ray film for the detection of proximal surface decay. The effect of underexposure was significant for Ultraspeed, but not for Ektaspeed Plus. Patient exposure can be reduced significantly with no loss of diagnostic ability by changing from Ultraspeed X-ray film to Ektaspeed Plus X-ray film.

Dental Caries↗

Approach to high-resolution ex situ NMR spectroscopy.

Nuclear magnetic resonance (NMR) experiments are typically performed with samples immersed in a magnet shimmed to high homogeneity. However, there are many circumstances in which it is impractical or undesirable to insert objects or subjects into the bore of a high-field magnet. Here we present a methodology based on an adaptation of nutation echoes that provides resolved spectra in the presence of matched inhomogeneous static and radiofrequency fields, thereby opening the way to high-resolution ex situ NMR. The observation of chemical shifts is regained through the use of multiple-pulse sequences of correlated, composite z-rotation pulses, producing resolved NMR spectra of liquid samples.

Magnetic Resonance Spectroscopy↗

The shelf-life of sodium hypochlorite irrigating solutions.

BACKGROUND: Sodium hypochlorite (bleach) solutions are widely used as irrigants in endodontics. Their tendency to deteriorate is worsened by environmental influences which could cause loss of available chlorine content. METHODS: This study measured the loss of available chlorine concentration in a range of sodium hypochlorite solutions under conditions which mimic clinical usage and storage. Domestic bleach, both undiluted and diluted with demineralised water or hard water, was tested, along with Milton, for initial concentration of available chlorine, and then retested after varying periods and modes of storage to measure loss of chlorine concentration. The types of storage were: (1) in closed plastic bottles which were opened daily and agitated; (2) in open plastic bottles; (3) in syringes exposed to sunlight; (4) in syringes kept in the dark; (5) in open stainless steel bowls; (6) in closed stainless steel bowls; and (7) when heated to 50 degrees C. Not all solutions were tested under all storage conditions. RESULTS: Of the solutions opened daily, undiluted domestic bleach was the most stable and Milton was the least stable. Initially, diluted bleach left open deteriorated rapidly but deterioration slowed with time. Solutions in syringes exposed to sunlight showed the most rapid loss of chlorine content. Heated bleach lost nearly 5 per cent of its strength in six hours. Diluted bleach surprisingly, increased its chlorine concentration in open bowls probably due to evaporation of water. Dilution of bleach with hard tap water did not significantly affect shelf-life. Preloading of diluted bleach into syringes appears to be a sound technique if the syringes are stored away from light. CONCLUSIONS: This study reinforces the need for sodium hypochlorite to be stored in closed opaque containers. Constant opening of containers appears to cause greater loss in chlorine concentration of diluted bleach solutions, perhaps because a lower concentration of sodium hydroxide allows the pH to drop more rapidly.

Air↗

A comparison of Kodak Ultraspeed and Ektaspeed Plus dental X-ray films for use in endodontics.

BACKGROUND: The advantage of using a faster film for length determination in endodontic therapy is obvious. However, for such a film to be generally accepted, it must demonstrate comparable diagnostic quality to traditionally used films. METHODS: The comparative accuracy of canal length determination of Ultraspeed and Ektaspeed Plus dental X-ray films was assessed in maxillary first and second molars; for different canals, for different teeth, for different exposures, and for different examiners (five general dentists and three endodontic specialists). RESULTS: In general, there were no significant differences between films, among examiners, or any interaction between films and exposures. That is, an assessor's ability to estimate lengths was not significantly influenced by the film type or by exposure used. There was a wide divergence in the individual assessor's ability to estimate lengths. Specialists estimated lengths more accurately than general practitioners and estimated lengths more accurately with Ektaspeed Plus film. Length determination in distobuccal and mesiobuccal canals was more accurate than in palatal canals. Most palatal canals were underestimated in length by more than 1mm. The use of file sizes larger in number than size 15 is recommended in these canals. CONCLUSION: For length determination, Ektaspeed Plus dental X-ray film is as effective as Ultraspeed film. Given the acceptable quality and accuracy of Ektaspeed Plus film, there seems to be no clinical reason to subject patients to greater radiation by using a slower film during endodontic therapy.

Dental Pulp Cavity↗

A comparison in vitro of fibroblast attachment to resected root-ends.

AIM: The aim of this study was to investigate the effect of surface morphology of root ends resected with various bur configurations on fibroblast attachment. METHODOLOGY: Seventy-two human single-rooted teeth were collected and decoronated. The root canals were instrumented, and then obturated with thermoplasticized gutta-percha using AH-26 as the sealer. The roots were randomly divided into eight different groups, and apical root-end resections were performed using eight different instruments, which included high and low speed burs and a scalpel blade. After each root was resected, the surface area of the root end was measured. Cultured human periodontal ligament fibroblasts were radiolabelled and then allowed to attach, in vitro, to the root-ends. Cell attachment to the resected root-ends was determined by counting in a liquid scintillation system and expressed as the number of decays per min/mm2 (DPM/mm2) of root surface. RESULTS: There was no significant difference in fibroblast attachment to the root-ends prepared with various instruments. CONCLUSIONS: These findings indicate that the choice of instrument for root-end resection has little influence on the initial attachment of fibroblasts, and thus may have little effect on healing following root-end resection.

Analysis of Variance↗

A scanning electron microscopic evaluation of root surfaces and the gutta-percha interface following root-end resection in vitro.

AIM: The aim of this study was to evaluate the effects that various commonly used instruments have on root surface morphology, the obturating material, and the interface between the obturation and the root canal walls following root-end resection in vitro. METHODOLOGY: Sixty human single-rooted teeth with fully formed apices were collected and decoronated. The root canals were instrumented, and then obturated with thermoplasticized gutta-percha using AH-26 as the sealer. The roots were randomly divided into 12 different groups, and apical root-end resections were performed using eight different instrument configurations, and two different directions in which the bur moved across the root face in relation to its direction of rotation. Epoxy resin replicas of the resected root ends were examined using scanning electron microscopy. RESULTS: Each instrument produced a characteristic surface finish on the resected root end that mirrored its cutting profile. Irrespective of the design of the bur used, smearing and shredding of the gutta-percha across the root face occurred only when the handpiece was moved across the root face in reverse direction in relation to the direction of rotation of the bur. CONCLUSIONS: To ensure minimal disruption and distortion of the root filling and to prevent shredding of the gutta-percha interface, care should be taken to ensure that the final pass of the bur across the root canal is in the correct direction in relation to its direction of rotation.

Bismuth↗

Diagnosis and management of teeth with vertical root fractures.

Vertical fractures in teeth can present difficulties in diagnosis. There are, however, many specific clinical and radiographical signs which, when present, can alert clinicians to the existence of a fracture. In this review, the diagnosis of vertical root fractures is discussed in detail, and examples are presented of clinical and radiographic signs associated with these fractured teeth. Treatment alternatives are discussed for both posterior and anterior teeth.

Alveolar Bone Loss↗

Changes in root canal morphology in simulated curved canals over-instrumented with a variety of stainless steel and nickel titanium files.

The purpose of this project was to observe the amount of apical and mid-curve transportation produced by a range of nickel titanium (NiTi), titanium alloy and stainless steel (SS) files. Tests were carried out in simulated curved root canals produced in epoxy resin blocks. Seven commercially available file types were tested using sizes 15 to 40. Instrumentation was carried out to 1 mm beyond the apex. Changes in canal dimensions were measured at 10x magnification under a shadowgraph. There were substantial differences in the amount and the pattern of apical and mid-curve transportation produced. The amount of transportation increased with each subsequent size of file. Under the same conditions, nickel titanium files produced significantly less transportation than stainless steel files. The least apical transportation was obtained with the NiTi Mity Turbo and the most by the SS K file and SS Hedstrom file. The least mid-curve transportation was produced by the NiTi Mity Turbo and the most by the SS Hedstrom file.

Alloys↗

The behaviour and proliferation of human dental pulp cell strains in vitro, and their response to the application of platelet-derived growth factor-BB and insulin-like growth factor-1.

Human dental pulp fibroblast strains were established from explants of dental pulps using identical culture techniques. To determine proliferative activity, a 3H-thymidine uptake and a crystal violet dye-binding assay were performed at passage numbers seven and eight. Assays were performed in the presence of either 0% fetal calf serum (FCS), 0.2% FCS or 10% FCS. Considerable variation in the overall proliferative activity of the different pulp cell strains (when averaged over all other variables) was noted. All dental pulp cell strains demonstrated significantly different proliferative activity from each other. In addition, the level of proliferative response and 3H-thymidine incorporation decreased as the passage number of the cells increased. This was in accordance with the findings of Tardieu-Moreau et al. (1992). It is proposed that the differences in proliferative activity are most likely attributable to inherent variability within the established pulp cell strains. Platelet derived growth factor-BB (PDGF-BB) and insulin-like growth factor-1 (IGF-1) were added to the human pulp cells both separately and in combination. All of the pulp cells exhibited increased proliferative activity in the presence of the growth factors with the combination of PDGF-BB/IGF-1 having the greatest mitogenic effect. There was also significant variability in the level of response of all pulp cell strains to the different growth factors. This study identified significant variability in the responsiveness to the growth factors between the pulp cell strains when the results of the 3H-thymidine and dye binding assays were compared. These findings reinforce the thesis that different assay procedures may also influence the findings of biological investigations involving the human dental pulp. The results of this study confirm that when comparing the findings of different in vitro studies involving human pulp cells, variations in experimental data can be strongly influenced by the pulp cell strain used and the culture technique employed. Indeed, studies of human pulp cell proliferation using pulp cells which are not of the same transfer number may not be relevant.

Adult↗

Sodium hypochlorite and its use as an endodontic irrigant.

Sodium hypochlorite has been used as an endodontic irrigant for more than 70 years, and is now one of the most common solutions for this purpose. The chemical properties and production of commercial sodium hypochlorite are reviewed. Domestic bleaches and an infant sanitizer are compared from the point of view of cost and ease of use--Milton being recommended where a 1% solution is required. The cost of syringes and needles for endodontic irrigation is many times greater than the hypochlorite they contain, and total annual practice costs for hypochlorite are low. Brief guidelines for clinical use, storage, handling and disposal are included.

Costs and Cost Analysis↗

Resumed tooth development following avulsion of a permanent central incisor.

A case is presented in which an upper right central incisor was avulsed because of trauma at age six. At the time of trauma it was suspected that the pulp had remained in the socket although the tooth had been lost. No attempt was made to treat the socket, remove the pulp, or replant the tooth. Follow-up radiography showed that, despite initial apparent complete loss of the calcified portion of the tooth, root development proceeded to completion.

Child↗

Isolation and characterization of the proteoglycans synthesized by adult human pulp fibroblasts in vitro.

The proteoglycans synthesized by fibroblasts derived from healthy human adult dental pulps have been isolated and characterized on the basis of their glycosaminoglycan content, molecular size and charge. The proteoglycans were identified by their labelling with [35S] sulphate and susceptibility to digestion by papain. The sulphated glycosaminoglycans associated with the proteoglycans were identified following specific enzymatic and chemical degradations as chondroitin sulphate, dermatan sulphate and heparan sulphate. Dermatan sulphate and chondroitin sulphate and heparan sulphate were the principal glycosaminoglycans associated with the cell layers. The proteoglycans could be fractionated on the basis of their charge and size into a number of heterogeneous pools. The principal proteoglycans isolated were small and contained either chondroitin sulphate or dermatan sulphate and most likely correspond to decorin and biglycan. Other molecules with features similar to versican and syndecan were also identified.

Adult↗

Donor variability in the proliferation of human dental pulp fibroblasts.

Fibroblasts were isolated from human dental pulps of healthy third molars from 49 donors of ages ranging from 17 to 68. Significant variability was noted in the success of obtaining primary cultures from these pulps. Variability between the various cultures was also observed in the reliability of maintaining subcultures of the primary cultures as well as recovery from frozen stocks of established cell lines. Of the original 49 explant cultures studied, only three survived long-term passage and freezing. In addition to difficulties and variability in establishing cell lines, the human pulp fibroblasts also showed great variability in proliferative activity which could not be accounted for by donor age, source, or passage number. These findings highlight significant difficulties in establishing reliable human pulp fibroblast cultures and the need for great care in interpreting any in vitro data.

Adolescent↗

A morphometric analysis of the cross-sectional area of dentine occupied by dentinal tubules in human third molar teeth.

The number and the mean percentage tubular cross-sectional area of dentinal tubules per square millimetre were calculated in specimens of coronal dentine of 13 intact human third molar teeth from patients 18 to 28 years of age. The dentine was fractured at various known distances from the dentino-enamel junction. Near the dentino-enamel junction the number of tubules per square millimetre was 22,000 and the mean tubular cross-sectional area was 3.6%. Midway between the pulpal wall and the dentino-enamel junction the number of tubules was 37,000 mm-2 and the mean tubular cross-sectional area was 6.2%. Close to the pulp the number of dentinal tubules was 48,000 mm-2 and the mean cross sectional area of tubules was 10.2 percent. The number of tubules per square millimetre more than doubled and the area occupied by tubules increased threefold from the dentine close to the dentine-enamel junction, to that close to the pulp. These differences in tubular patterns at different depths in dentine are clinically significant in dentine permeability, the treatment of traumatized teeth, and pain transmission in dentine.

Dentin↗

Root canal morphology of maxillary permanent first molar teeth at various ages.

The root canal anatomy and pulp chamber morphology of 216 maxillary permanent first molar teeth of known age was examined using a radiographic technique after infusion of the root canal system with a radiopaque sodium iothalomate gel. This technique proved to be a rapid and effective method for the examination of root canal morphology and is recommended when root canal anatomy needs to be examined before further investigations are carried out. Over 95% of palatal and disto-buccal roots contained a single root canal. The mesio-buccal root was more complex. All types of configurations were seen. Only 26% of mesio-buccal roots showed a single canal. The pulp canal in all roots appeared to narrow at an early age. In the mesio-buccal root, a definite two-directional calcification pattern was apparent in most teeth by the age of 10. The rate of progress of root formation was very variable. There was no apparent relationship between the type of canal system in the mesio-buccal root and the type of canal orifice present. The transverse cross-sectional shape of the pulp chamber was trapezoidal in 81% of teeth.

Adolescent↗