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Biomedical subjects

J D Strahan

Publications and source records attributed to J D Strahan.

At least 19 recordsLinked to original sources

'The great debate'.

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Dental Hygienists

Effect of a desensitizing dentifrice on dentinal hypersensitivity.

The objective of this study was to assess the effectiveness of a dentifrice with 2% dibasic sodium citrate in poloxamer 407 in decreasing dentinal hypersensitivity. The test toothpaste was compared with a control toothpaste containing 0.76% sodium monofluorophosphate in a 6-week double-blind clinical trial. A total of 75 hypersensitive teeth were examined in the test group, while 100 hypersensitive teeth were in the control group. Changes in hypersensitivity levels were monitored after 6 weeks, using thermal, chemical and mechanical stimuli. At the end of 6 weeks, the test dentifrice was not significantly more effective than the control in decreasing dentinal hypersensitivity. Of the stimuli used, cold was the most effective in eliciting a hypersensitive response, followed by chemical stimulation and air. Heat and toothbrushing caused the least discomfort.

Adult

Loss of attachment adjacent to class II carious lesions.

The present study was designed to investigate the relationship between large open class II carious lesions and loss of periodontal attachment in 224 extracted teeth. Each tooth had a carious and a sound approximal surface. The teeth were divided into 4 groups: upper premolars, upper molars, lower premolars and lower molars each consisting of 56 teeth. Within each group, the carious lesions were divided equally between the mesial and distal surfaces. The teeth were stained and loss of attachment was measured under a stereomicroscope fitted with an ocularmicrometer. The difference in loss of attachment between carious (0.79 +/- 0.05 mm) and sound (0.76 +/- 0.04 mm) surfaces was not statistically significant. Loss of attachment was greater on the carious surface of 98 teeth, equal to in 40 teeth and less in 86 teeth than the sound surface. Mesial and distal surfaces with and without carious lesions exhibited essentially the same degree of loss of periodontal support. Upper molars and lower premolars tended towards more loss of attachment when compared with upper premolars and lower molars. The results indicate that large open class II carious lesions cannot be regarded as an important factor in the progression of attachment loss.

Bicuspid

Amalgam restorations, plaque removal and periodontal health.

A total of 156 approximal subgingival amalgam overhanging margins were assessed in the buccal segments of 13 patients for plaque accumulation, gingival inflammation, pocket depth and gingival shrinkage. Recordings were made immediately before and 2, 4 and 8 weeks following scaling, removal of overhangs, and oral hygiene instruction. Surfaces with overhangs were compared with control surfaces, which were either intact or contained supragingival amalgams. Initially it was found that gingival inflammation and pocket depth were more extensive adjacent to subgingival amalgam overhangs than to sound teeth or those with supragingivally located amalgams. This appeared to be due to preferential plaque accumulation in relation to subgingival overhangs. For all parameters compared, differences apparent at the baseline had disappeared by the end of the 8-week study period. Contouring of defective subgingival restorations, followed by effective scaling and oral hygiene instruction produced approximately 1 mn of gingival shrinkage, sufficient in most cases to produce clinical gingival health. Of the 156 subgingival fillings 83 (53%) became supragingival and 43 (28%) reached the gingival crest by the end of the 8-week study period.

Dental Amalgam

The effect of a 1% chlorhexidine gel in the initial therapy of chronic periodontal disease.

Thirty patients took part in a 4 week 'double-blind' clinical trial. Following initial oral hygiene instruction and scaling, half the patients were instructed to brush with a 1% Chlorhexidine gel in the evenings, the other half to use placebo. A standard dentifrice was used in the morning. In both groups there was a marked improvement in all parameters recorded, and although final plaque scores showed a statistically significant difference in favor of the test group, there was virtually no difference in rate or degree of resolution of gingivitis. The use of standard dentifrice was only partially successful in preventing staining.

Adolescent

Control of plaque by non-chemical means.

Bacterial plaque at the dento-gingival margin is always associated with gingivitis. Measures which keep the area free from plaque will maintain health or encourage healing of existing gingivitis. Scaling and polishing at 6-month intervals may be sufficient for those patients who practice near-perfect oral hygiene but it is not an effective way of promoting the resolution of established gingivitis. A change to effective oral hygiene measures by the patient is the major factor in resolving gingivitis, but the association with scaling and polishing provides the ideal combination. Toothbrushing may only clean the oral and facial aspects of the teeth so interdental cleaning is necessary where gingivitis is established. There is no clear evidence that any particular oral hygiene routine is better than any other for all patients. It is generally agreed that thoroughness is extremely important. There is a variety of ways of motivating patients to practice effective oral hygiene but all reports indicate that it is most likely to be effective on a person-to-person basis. Motivation itself is not enough and must be associated with education and instruction. Long-term failure is likely unless the message is reinforced at regular intervals.

Dental Plaque

[Plaque control].

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Dental Plaque