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Biomedical subjects

B R Nattress

Publications and source records attributed to B R Nattress.

11 recordsLinked to original sources

Penetration of fluoride into natural plaque biofilms.

Caries occurs at inaccessible stagnation sites where plaque removal is difficult. Here, the penetration through plaque of protective components, such as fluoride, is likely to be crucial in caries inhibition. We hypothesized that topically applied fluoride would readily penetrate such plaque deposits. In this study, plaque biofilms generated in vivo on natural enamel surfaces were exposed to NaF (1000 ppm F-) for 30 or 120 sec (equivalent to toothbrushing) or for 30 min. Biofilms were then sectioned throughout their depth, and the fluoride content of each section was determined with the use of a fluoride electrode. Exposure to NaF for 30 or 120 sec increased plaque fluoride concentrations near the saliva interface, while concentrations near the enamel surface remained low. Fluoride penetration increased with duration of NaF exposure. Removal of exogenous fluoride resulted in fluoride loss and redistribution. Penetration of fluoride into plaque biofilms during brief topical exposure is restricted, which may limit anti-caries efficacy.

Biofilms↗

Minimizing prion risk without compromising the microbial composition of biofilms grown in vivo in a human plaque model.

AIMS: To determine whether the stringency of sterilization procedures for biological components of in vivo dental plaque-generating devices based on enamel can be increased to minimize prion risk without compromising natural biofilm composition. METHODS AND RESULTS: The composition of in vitro biofilms, grown on hypochlorite-treated and untreated autoclaved enamel surfaces, was determined using culture-based methods and checkerboard DNA: DNA hybridization analysis. No differences were found between biofilms recovered from either substrate. SIGNIFICANCE: Several in situ models allow generation of plaque in the oral cavity, followed by recovery of intact biofilms for experimentation. Approaches allowing plaque formation on natural tooth surfaces are most valuable, but present a possible infection risk to volunteers wearing plaque-collecting devices, particularly with respect to prions. Hypochlorite treatment of biological material, as an adjunct to autoclaving, reduces infection risk without compromising biofilm composition and should be adopted in all future studies using plaque-generating devices incorporating enamel, where there is a potential prion threat, and further investigated in other biological hard tissues.

Bacteria↗

Improving student learning in root canal treatment using self-assessment.

AIM: This paper reports the first attempts to implement a new course in endodontology for undergraduate dental students based upon independent, reflective learning and self-assessment. METHODOLOGY: The responses were analysed of two successive cohorts of third-year students to laboratory courses in (i) the restoration of teeth with crowns and (ii) endodontology and root canal treatment. The major changes introduced to the endodontology course were a substantial reduction in the number of formal lectures, the introduction of a series of structured tutorials, time for private study and the use of self-assessment in practical classes. RESULTS: The evidence indicates that the new approach increased student confidence in practical skills, although the time available for operative practice was actually reduced; there was a perceived increase in problem-solving ability; and that students felt encouraged to pursue greater understanding. Reports from tutors suggested that students' self-assessments became more accurate as the courses proceeded. Seven experimental learning points were derived from the study. These included the importance of careful planning, well-designed assessment procedures and the creation of a climate of trust and openness. CONCLUSIONS: The task of developing fully the students' skills of accurate self-assessment remains a challenge.

Attitude of Health Personnel↗

A model for the teaching of clinical techniques in root canal treatment.

A practical model to aid the understanding and practice of endodontic techniques is described. The model uses extracted teeth mounted in light-cured acrylic resin and set in a preformed model tray. Before mounting, the root surfaces of teeth are dipped in wax to simulate the periodontal ligament space. This model allows endodontic techniques to be practised in the operative technique classroom in a way that simulates the clinical situation and enables radiographs of good diagnostic quality to be taken during treatment. Subsequently, teeth can be reset to allow restoration of the root-filled tooth.

Audiovisual Aids↗

Evaluation of X-ray beam angulation for successful twin canal identification in mandibular incisors.

This study was undertaken to determine the most effective horizontal beam angulation for the diagnosis of twin canals in mandibular incisors. Two hundred extracted mandibular incisor teeth, in groups of four, were aligned in the form of a lower dental arch and radiographed using a beam alignment device at 10 degrees intervals between 0 degree and 50 degrees from both right and left sides. Five observers with varying degrees of experience were asked to assess the number of canals in each of the four teeth from these radiographs. A further radiograph of each individual tooth was taken at 90 degrees through the mesio-distal plane to identify the number of twin canals present. A random sample of 10% of the radiographs were viewed for a second time 3 months later to assess intra-observer variation. The 20 degrees right and 30 degrees left horizontal beam angulations showed significantly more accurate diagnosis of twin canals than the ortho-radial view (0 degree) by all five observers. Analysis of the inter-observer results suggests that the experienced viewers were no better but more consistent at identifying twin canals in mandibular incisors.

Dental Pulp Cavity↗

An in vitro assessment of tooth preparation for porcelain veneer restorations.

OBJECTIVES: This in vitro study aimed to examine the depth of preparation and incidence of dentine exposure resulting from the use of a 'freehand' technique to prepare maxillary central incisors for porcelain veneers. METHODS: Twenty-two maxillary central incisors were selected. Prior to preparation an index of the labial surface of each tooth was recorded and the tooth secured in a jig to permit accurate relocation. Two operators each prepared 11 teeth aiming to reduce the labial thickness evenly by 0.5 mm. Low viscosity silicone impression material was then placed on the index and the teeth relocated into the jig. Upon removal, this material was sectioned in the cervical, middle and incisal thirds of the tooth and its thickness measured using a toolmaker's microscope. The teeth were acid etched and also stained with a dentine dye to identify any area of dentine exposed during preparation. RESULTS: Significant differences (P < 0.001) in the depth of preparation at different sites, with least reduction in the mid-incisal region, were found. Greater reduction was found at the cervical and proximal margins with areas of dentine exposed at those sites in the majority of teeth. CONCLUSIONS: In view of the incidence and position of dentine exposure found in this study, the use of a dentine bonding system during the placement of porcelain veneers would appear essential when employing a 'freehand' preparation technique.

Dental Cavity Preparation↗

In vitro radiographic representation of the extent of voids within obturated root canals.

The aim of this study was to determine whether radiographs provide an accurate representation of the degree of root canal obturation following a cold lateral condensation technique. A total of 40 extracted single-rooted lower premolar teeth were prepared using either a standardized step-back technique or an ultrasonic device by one of two operators. The four groups each of 10 teeth were obturated using lateral condensation by a third operator. To assess apical leakage the obturated teeth were coated with nail varnish to within 2 mm of the apex and immersed in methylene blue for 48 h. The teeth were then radiographed in bucco-lingual and mesio-distal planes prior to subsequent sectioning in a bucco-lingual plane. Sections and radiographs were analysed using an image analysis apparatus to determine the proportion of root canal occupied by gutta-percha, void and/or sealer. Mean percentages of void calculated from the bucco-lingual radiographs, mesiodistal radiographs and tooth sections were 4.14%, 5.98% and 4.98%, respectively. Statistical analysis showed no significant differences between the radiographic views and the tooth sections (P > 0.05). Both planes of radiograph accurately represented the proportion of void when compared with the tooth section.

Analysis of Variance↗

Comparison of the quality of obturation following endosonic versus hand instrumentation.

This study was undertaken to compare the quality of root canal obturation following preparation by endosonic or hand instrumentation. Forty single-canal, extracted lower premolar teeth were selected. One group of 20 teeth was prepared using a standard step-back technique, the other 20 teeth were prepared with an ultrasonic machine. The groups were subdivided, with two operators preparing 10 teeth of each group. The teeth were obturated by a third operator using cold laterally condensed gutta percha. The root apices were then immersed in methylene blue dye for 48 h and the teeth sectioned longitudinally. Image analysis recorded the amount of sealer and void within the obturated canal. The linear distance of dye penetration was measured to provide an indication of apical seal. Examination of the root canal shape resulting from the different preparation techniques used was also undertaken. No significant difference was noted in the percentage of sealer and void present in the root canals obturated after endosonic or hand instrumentation. There was a slightly greater although not significant increase in the degree of linear penetration of dye in canals prepared endosonically. The endosonic technique used in this study appeared to produce a canal preparation of slightly less continuous taper than that obtained with hand preparation.

Analysis of Variance↗

Determination of volumes of fluid in the mouth by fluoride dilution.

A dilution technique, with fluoride as a marker, has been developed to measure the volume of saliva and other fluids in the mouth. Immediately after swallowing, a small amount of fluoride solution is placed in the mouth, mixed with the oral fluids, and expelled from the mouth. The fluoride concentration of the expelled oral fluid is measured and the volume of fluid in the mouth at the time of spitting calculated from the fluoride dilution. Mean values of 0.75 +/- (SD) 0.28 ml for males and 0.72 +/- (SD) 0.16 ml for females were recorded. The accuracy of the volume determination is about +/- 0.10 ml in vivo. This technique has provided a convenient and rapid means of determining saliva volumes. It could also be used to determine rates of secretion and may prove useful in the clinic for assessing a patient's salivary competence.

Adult↗

Predictability of radiographic diagnosis of variations in root canal anatomy in mandibular incisor and premolar teeth.

Four hundred and fifty-five extracted mandibular incisor and 340 extracted mandibular premolar teeth were radiographed to assess the incidence of twin canals as visualized on radiographs taken in the mesio-distal direction. The ability to detect the presence of these twin canals by viewing radiographs taken in the standard bucco-lingual direction was then assessed. Using the guideline that 'disappearance or narrowing infers division' when viewing these radiographs resulted in a failure to diagnose one-third of the twin canals.

Bicuspid↗

Site-specific variations in the concentrations of substances in the mouth.

Estimates of the concentration of soluble substances in the oral fluids have generally been obtained by the analysis of whole saliva, either mixed in the mouth or obtained directly from the salivary duct. Such values may give little indication of concentrations at any particular site in the mouth. This is partly because substances do not always move easily about the mouth and also because there are large regional differences between the rates of oral clearance or retention of substances dissolved in saliva. Differential patterns therefore develop and are related, via the patterns of salivary flow, to the anatomy and physiology of the mouth. There are general features in these patterns common to all mouths and variations, which relate to characteristics of the individual, which may influence the rates of reactions occurring at different sites. The patterns may be associated with the site-specific patterns of dental disease, and they may have implications with regard to the best use of pharmaceutical agents. This paper describes some of the more recent data, problems and future possibilities in this hitherto unexplored area of oral physiology.

Fluorides↗