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Biomedical subjects

Michael J Wahl

Publications and source records attributed to Michael J Wahl.

10 recordsLinked to original sources
PubMed2006

Osteoradionecrosis prevention myths.

PURPOSE: To critically analyze controversial osteoradionecrosis (ORN) prevention techniques, including preradiation extractions of healthy or restorable teeth and the use of prophylactic antibiotics or hyperbaric oxygen (HBO) treatments for preradiation and postradiation extractions. METHODS: The author reviewed ORN studies found on PubMed and in other article references, including studies on overall ORN incidence and pre- and postradiation incidence, with and without prophylactic HBO or antibiotics. RESULTS: Owing in part to more efficient radiation techniques, the incidence of ORN has been declining in radiation patients over the last 2 decades, but the prevention of ORN remains controversial. A review of the available literature does not support the preradiation extraction of restorable or healthy teeth. There is also insufficient evidence to support the use of prophylactic HBO treatments or prophylactic antibiotics before extractions or other oral surgical procedures in radiation patients. CONCLUSIONS: To prevent ORN, irradiated dental patients should maintain a high level of oral health. A preradiation referral for a dental evaluation and close collaboration by a multidisciplinary team can be invaluable for radiation patients. As with most other dental patients, restorable and healthy teeth should be retained in irradiated patients. The use of prophylactic HBO or antibiotics should be reconsidered for preradiation and postradiation extractions.

Antibiotic Prophylaxis↗
PubMed2005

Dentistry and Endocarditis.

Bacterial endocarditis (BE), a rare heart infection caused by a bacteremia, has frequently been blamed on but rarely caused by dental procedures. Viridans group streptococci are found abundantly in the mouth and the gingival sulcus but have been surpassed by staphylococci as the leading cause of BE. Antibiotic prophylaxis has been recommended before dental procedures in patients at risk for BE, but it remains controversial because studies have failed to show that antibiotic prophylaxis is an effective preventive for BE or that dental procedures are an important cause of BE. The risks and costs of antibiotic prophylaxis, including antibiotic resistance, cross-reactions with other drugs, allergy, anaphylaxis, and even death, may exceed the benefits in preventing BE. The rationale for the use of antibiotic prophylaxis to prevent BE allegedly caused by dental procedure bacteremias must be seriously reexamined based on recent evidence, particularly the absolute risk rates for endocarditis after a given dental procedure.

Journal Article↗
PubMed2005

Relationship between hockey skating speed and selected performance measures.

The objective of this study was to determine the relationship between specific performance measures and hockey skating speed. Thirty competitive secondary school and junior hockey players were timed for skating speed. Off-ice measures included a 40-yd (36.9-m) sprint, concentric squat jump, drop jump, 1 repetition maximum leg press, flexibility, and balance ratio (wobble board test). Pearson product moment correlations were used to quantify the relationships between the variables. Electromyographic (EMG) activity of the dominant vastus lateralis and biceps femoris was monitored in 12 of the players while skating, stopping, turning, and performing a change-of-direction drill. Significant correlations (p < 0.005) were found between skating performance and the sprint and balance tests. Further analysis demonstrated significant correlations between balance and players under the age of 19 years (r = -0.65) but not those over 19 years old (r = -0.28). The significant correlations with balance suggested that stability may be associated with skating speed in younger players. The low correlations with drop jumps suggested that short contact time stretch-shortening activities (i.e., low amplitude plyometrics) may not be an important factor. Electromyographic activities illustrated the very high activation levels associated with maximum skating speed.

Adolescent↗
PubMed2004

Prevalence of cusp fractures in teeth restored with amalgam and with resin-based composite.

BACKGROUND: Complete cusp fracture in restored teeth is a common problem observed in general dental practice. Many dentists believe that teeth restored with amalgam are more likely to be associated with cusp fractures than are those restored with resin-based composite. METHODS. The authors noted the condition of 10,869 posterior teeth with amalgam or resin-based composite restorations with at least one cusp present, unrestored or missing in 1,902 consecutively seen adult patients in a private general dental practice. For each patient, the authors recorded age, type of restorations, number of surfaces of each restoration, and presence or absence of a complete cusp fracture and of caries. RESULTS: There was a lower percentage of cusp fractures in younger subjects than in older subjects and in teeth with a single restored surface than in those with more than one restored surface. There was no significant difference in the prevalence of cusp fracture rates in amalgam-restored teeth versus composite-restored teeth in subjects aged 18 through 54 years. In subjects aged 55 through 96 years, there was a marginally significantly greater cusp fracture rate in composite-restored teeth than in those restored with amalgam. Overall, there was no significant difference in the prevalence of cusp fracture in teeth restored with amalgam (1.88 percent) versus composite-restored teeth (2.29 percent). CONCLUSIONS: The prevalence of cusp fractures in amalgam-restored teeth and resin-based composite-restored teeth is not significantly different. Teeth with more than one surface restored with either resin-based composite or amalgam and teeth in older subjects were more likely to suffer a cusp fracture. CLINICAL IMPLICATIONS: Teeth restored with amalgam and with resin-based composite exhibited equally low cusp fracture prevalence. When choosing between amalgam and resin-based composite in consideration of the likelihood of a future cusp fracture, either restorative material is acceptable.

Adolescent↗
PubMed2004

Are there acceptable alternatives to amalgam?

Amalgam has been the material of choice for restoring posterior teeth for more than 100 years. The past 25 years have witnessed significant advances in restorative materials themselves and in the bonding systems for retaining a restoration in the prepared tooth. As a result, there has been a shift toward resin composite materials during this same period because of concerns about the esthetics and biocompatibility of dental amalgam. In addition, other materials such as glass ionomer cements, ceramic inlays and onlays, and gold alloys have been used as alternatives to amalgam. This article will review recent studies on the longevity and biocompatibility of these alternatives to dental amalgam.

Biocompatible Materials↗
PubMed2003

A resin alternative for posterior teeth: questions and answers on dental amalgam.

Amalgam has been used to restore cavities in posterior teeth for over 100 years, but formulations used today are different from those used a century ago. Amalgam restorations have been blamed for a number of problems, such as cusp fracture and higher rates of secondary caries. This article discusses these issues, along with possible toxic effects, in the light of current literature.

Composite Resins↗
PubMed2002

Injection pain of bupivacaine with epinephrine vs. prilocaine plain.

BACKGROUND: Prilocaine plain has been described in the literature as causing less pain on injection than bupivacaine with epinephrine, possibly because of the higher pH of the prilocaine anesthetic solution. METHODS: In a double-blind study design, 681 consecutive patients in a general dental practice received maxillary buccal infiltration, posterior palatal infiltration or inferior alveolar block injections, administered under clinical conditions by one of two dentists. Immediately after injection, patients rated the pain from each injection on a six-point scale. The pain response was analyzed according to treating dentist, location of injection, patient's sex and anesthetic administered. RESULTS: The reported pain on injection of bupivacaine with epinephrine was significantly greater than that of prilocaine plain. Patients reported no significant difference in pain at different injection locations, except that palatal injections caused significantly more reported pain than did anterior maxillary infiltration, posterior maxillary infiltration or inferior alveolar block injections. CONCLUSIONS: Under clinical conditions, the injection of bupivacaine with epinephrine causes significantly more perceived pain than does the injection of prilocaine plain. Clinical Implications. Bupivacaine with epinephrine and prilocaine plain have certain advantages and disadvantages that should be considered before choosing an anesthetic for a dental procedure. A disadvantage of bupivacaine with epinephrine is that it produces more perceived pain than does prilocaine plain.

Adolescent↗
PubMed2002

Amalgam revisited.

Explore the source record for details and available documents.

Dental Amalgam↗
PubMedDate not supplied

Injection pain of prilocaine plain, mepivacaine plain, articaine with epinephrine, and lidocaine with epinephrine.

In a double-blind study design, 1,391 consecutive patients in a general dental practice received one of four different local anesthetics (articaine with epinephrine, lidocaine with epinephrine, mepivacaine plain, or prilocaine plain) via a maxillary buccal infiltration, palatal infiltration, or inferior alveolar block injection. The anesthetics were administered under clinical conditions by one of two dentists. Immediately after receiving the injection, patients rated the pain from each injection on a ten-point scale. The pain response was analyzed according to the dentist administering the injection, the location of injection, the patient's gender, and the type of anesthetic administered. Injection of prilocaine plain produced significantly lower pain scores than lidocaine with epinephrine, mepivacaine plain, or articaine with epinephrine.

Anesthetics, Local↗