Biomedical subjects

R G Chadwick

Publications and source records attributed to R G Chadwick.

At least 37 records · Page 2Linked to original sources

PubMed1997

Development of a novel system for assessing tooth and restoration wear.

OBJECTIVES: This investigation sought to develop a mapping apparatus for use in the assessment of both tooth and restoration wear. METHODS: A computer controlled mapping device, capable of scanning a suitably prepared electroconductive tooth replica by means of an electrical feedback mechanism, was constructed and its accuracy assessed by measuring the thicknesses of four engineers' slip gauges 12 times each. The reproducibility of three potential methods of rendering a die stone replica electroconductive was also investigated. Finally, tooth replicas were surface profiled and compared empirically with the originals using a commercial surface mapping program. RESULTS: The overall mean accuracy of the mean thicknesses of the slip gauges was 4.4 (2.8) microns. Surface deposition of either nickel spray or gold leaf, upon a ready formed replica, did not give a reproducible thickness. Precoating silicone impressions with nickel spray prior to replica production overcame this problem. On an empirical basis the instrument yielded accurate digital terrain models of tooth replicas. CONCLUSIONS: A surface mapping device has been developed which is both accurate and reproducible. A satisfactory electroconductive surface may be produced upon a tooth replica by precoating a silicone impression with nickel spray before casting the replica. The technique should prove invaluable for monitoring both tooth and restoration wear but further work is necessary to examine how such an approach will perform clinically.

Dental Impression Materials↗

PubMed1997

The permeability of dental gloves following exposure to certain dental materials.

OBJECTIVES: This investigation sought to study the permeability of three commonly used clinical gloves when exposed to chemical agents. METHODS: A total of 35 gloves of each type were selected at random and were assigned to one of seven equally sized treatment groups. The effective barrier properties were investigated following treatment for 15 min with one of: acid etchant, Trim, cavity varnish, Hibiscrub, Hydrex and Vitremer using a dye permeability test. Following the chemical insult a 0.02% solution of erythrosine dye was introduced into each glove and the outer glove surface was washed with 10 ml of distilled water at intervals of 30, 60, 90 and 120 min. The percentage absorption of the collected washings, at 530 nm, was determined using a spectrophotometer. The results were compared with those values obtained from untreated gloves. RESULTS: Acid etchant and Hydrex had little effect on any of the gloves. Trim caused an increase in permeability of the vinyl gloves but had little or no effect upon those made of latex. Cavity varnish increased the permeability of both Biogel D and Tru-Touch but had no effect on Featherlite. The integrity of the latex gloves was diminished by Hibiscrub but little effect was observed in the case of the vinyl based glove. The permeability of all three gloves was increased by exposure to Vitremer liquid. CONCLUSIONS: Manufacturers should provide details of potential glove chemical interactions to assist dentists in glove selection.

Analysis of Variance↗

PubMed1997

Development, application and effectiveness of a novel logbook checklist assessment scheme in conservative dentistry.

In response to a lack of staff consistency in assessing clinical work, as identified by a student questionnaire, a checklist scheme of assessment was devised. This consisted of a series of questions covering the key stages of the majority of procedures in conservative dentistry to which a demonstrator indicates whether each aspect has been completed satisfactorily or not (yes/no) giving written comment to enhance the level of immediate feedback. Some 12 months following the introduction of the new logbook, a questionnaire was distributed to all 42 students who had experienced both this system and a previous ABC grading scale for completed work. This consisted of a series of 14 statements and sought to compare, for both systems, the clarity of assessment criteria, the relative level of staff consistency in applying these, effectiveness of feedback and overall meaningfulness of the grades awarded. In addition, in relation to self appraisal of performance, both the relevance of this to the practice of dentistry together with the degree the logbook facilitated this were assessed. The questionnaire return rate was 100%. Compared to the former grading system, the new logbook gave a significantly (P < 0.001) more meaningful measure of performance, indicated better what was being assessed (P < 0.001) and gave better feedback of those points requiring attention to improve performance. In addition, the consistency of staff applying the checklist had improved significantly (P < 0.05) since the introduction of the logbook. It was thus concluded that the logbook was a versatile tool in assessment of the clinical skills in conservative dentistry.

Education, Dental↗

PubMed1996

Dental injuries during general anaesthesia.

Although most anaesthetic textbooks cite dental injury as a complication of endotracheal intubation few studies have examined the extent and nature of the problem. Such damage however, formed the basis for one-third of all confirmed or potential anaesthetic claims notified to the Medical Protection Society between 1977 and 1986. This article seeks to explore the extent of the problem, outline predisposing factors, summarise current prophylactic measures and make recommendations to reduce the overall incidence. Increased awareness of the problem, by both anaesthetists and dental surgeons, coupled with appropriate prophylactic measures may result in a reduced incidence of dental injury arising from general anaesthesia. Given the high incidence of dental damage we recommend that all patients undergoing a surgical operation under endotracheal intubation should have a pre-operative dental check wherever possible. Clearly, the first dental examination would be conducted by an anaesthetist familiar with the predisposing factors. Where he/she considers there to be a higher than average risk of dental damage occurring during intubation a more specialised examination should be conducted by a dental surgeon. It may, where appropriate, be possible for remedial dental treatment to be carried out and customised mouth guards to be constructed prior to the operation. Obviously such recommendations have certain financial implications and would have to be subject to controlled cost-benefit analysis before their widespread application.

Anesthesia, General↗

PubMed1995

Effects of a commercial orthodontic debonding agent upon the surface microhardness of two orthodontic bonding resins.

The bonding techniques employed in orthodontic practice differ from those used in restorative dentistry for, upon the completion of treatment, the appliance is removed. This necessitates breaking the resin/enamel bond. Ideally a smooth, undamaged enamel surface free from all traces of bonding agent should result. Regrettably, however, this ideal is rarely achieved. This investigation assessed the effects of a commercial debonding agent (P-de-A, Oradent Ltd, Eton, Berks, UK), derived from peppermint oil, upon the surface microhardness of two orthodontic resins (Orthodontic Concise and Transbond, both 3M, St Paul, MN, USA). Twenty discs (10 mm diameter x 1.25 mm deep) of each resin were fabricated and, following 1 week's storage in distilled water at 37 degrees C, were allocated to application groups composed of four specimens. The mean initial surface hardness of each group was then determined prior to the application of P-de-A for one of: 30, 60, 90, 120 and 180 s. The hardness was then remeasured. One-way analyses of variance were performed upon the mean initial and final hardness data and revealed only a significant (P < 0.05) reduction in surface hardness following the 180 s application of P-de-A to Orthodontic Concise. We were therefore unable to find little evidence to suggest that the agent facilitates debonding by a softening mechanism and further work is required to elucidate the means whereby orthodontic debonding and 'clean-up' of residual composite, as reported by others, is facilitated.

Acrylic Resins↗

PubMed1994

Blue light curing units--a dermatological hazard?

The setting reactions of a large number of dental materials are activated upon exposure to visible blue light emitted from a curing unit. Although the wavelength (lambda) from such devices is principally in the visible spectrum (lambda > 400 nm) a small amount of ultraviolet radiation (UV) is also present. Little attention has been paid to the consequences of such exposure upon the skin of dental surgeons' fingers. This investigation studied the level of UVA I (lambda = 340-400 nm) emitted by three commonly used polymerisation sources and assessed the level of protection afforded by six brands of surgical glove. The integrated irradiances of the Translux, Topaz T100 and Heliomat units in the UVA I range were 15861, 3611 and 305 mW/m2 respectively. For all gloves the mean % transmission, at lambda = 400 nm, was less than 4% with the exception of one brand where, in the stretched state, the level of transmission was 7%. It is concluded that the risk of initiating adverse dermatological consequences as a result of exposure to UVA I, emitted by light polymerisation units, is minimal in normal usage. The combined effects of exposure to radiation of this type and contamination of the fingers with quantities of irritant chemicals, such as found in many dental materials, are unknown. Due to the ability of the gloves to shield the skin from both chemicals and UVA I it is recommended that gloves are routinely worn for all light curing procedures.

Dental Equipment↗

PubMed1994

Strength-probability-time (SPT) diagram--an adjunct to the assessment of dental materials?

This investigation sought to construct and compare strength-probability-time (S-P-T) diagrams for four dental materials. Three of these were resin composites and one was dental plaster. In the case of dental plaster a total of 90 compressive specimens as fabricated whereas for each of the other materials a total of 75 specimens was prepared. The compressive strength of equal sized groups of each material was then determined at the crosshead (XHD) speeds of 1, 5 and 10 mm min-1 respectively. The data was subjected to Weibull analysis to relate the probability of failure to the applied stress. Where strong correlations were found between the (i) mean compressive strength and crosshead speed, (ii) individual compressive strengths and failure times, the data was used to determine the crack velocity exponent (n) and produce a S-P-T diagram. Although only one of the materials (P-50) evaluated fulfilled all the necessary criteria and yielded a value of n = 16.13 (7.22), it is suggested that this method may enable comparisons to be made amongst other materials satisfying the required conditions. As such diagrams are based upon a crack growth law they may be of value in assessing the likely clinical wear resistance of new formulations. Consideration, however, should always be given to what levels are deemed acceptable for the intended clinical application of the material. Thus, before this technique can be employed fully, to the evaluation of new restorative materials, further work is necessary to determine appropriate design criteria.

Composite Resins↗

PubMed1994

Thermocycling--the effects upon the compressive strength and abrasion resistance of three composite resins.

The purpose of this investigation was to examine the effects of thermocycling upon the compressive strength and abrasive wear resistance of three commercial composites Fulfil, P-50 and Herculite-XR. Specimens of each material were divided into five treatment groups comprising a control, and four different cycling and storage regimes. Tests for compressive strength and wear resistance were carried out. Prior to testing all specimens were stored in distilled water for 1 week. Three groups were stored at a temperature of 37 degrees C and the remaining two at 60 degrees C. Thereafter all groups that were thermocycled were subjected to 750 cycles of a thermocycling regime consisting of the cycle ACAB where A and B represent the fixed temperatures of 37 degrees C and 5 degrees C, and C, depending upon the treatment group, either 50 degrees C or 60 degrees C. One-way analyses of variance upon the compressive strength and wear factor data following the treatments highlighted significant differences in the mean compressive strength for all materials (Fulfil (P < 0.05), P-50 and Herculite-XR (P < 0.01)) and in the wear factor values for only Fulfil and P-50 (P < 0.001). Surprisingly, thermocycling P-50 with an upper temperature limit of 50 degrees C had catastrophic consequences upon the measured properties. It is concluded that some of the observed behaviour may have potentially detrimental consequences upon the long-term clinical durability of the materials tested.

Analysis of Variance↗

PubMed1993

A comparison of the shear bond strengths to a resin composite of two conventional and two resin-modified glass polyalkenoate (ionomer) cements.

The inability of resin composite to bond directly to dentine has compromised the clinical success of this restorative material. This problem may be overcome by the so-called laminate technique in which glass polyalkenoate cement is placed upon dentine and then covered with a resin composite. The cement both adheres to dentine and affords micromechanical attachment to the composite. The introduction of the resin-modified glass polyalkenoate cements (RMCs) offers the potential for chemical union between cement and composite. This investigation examined the shear bond strengths of P-50 resin composite to four glass polyalkenoate lining materials, with and without the application of an intermediate bonding agent (Scotchbond 2). Two of the cements were RMCs (Vitrebond, XR-Ionomer) and the others were conventional base materials (Baseline, Ketac-Bond). The bond between P-50 and Vitrebond with or without Scotchbond 2 was significantly (P < 0.01) stronger and more consistent (P < 0.05) than that observed for all other materials. The treatment of the conventional materials and XR-Ionomer with Scotchbond 2 significantly (P < 0.01) improved the bond strengths to P-50. It is concluded that Vitrebond formed the most favourable cement-resin composite bond and that the other materials studied should be used in conjunction with an effective intermediate bonding agent, such as Scotchbond 2.

Bisphenol A-Glycidyl Methacrylate↗

PubMed1992

Surface pH of resin-modified glass polyalkenoate (ionomer) cements.

The recently developed group of materials known as light-activated, or resin-modified, glass polyalkenoate (ionomer) cements have been produced in response to clinical demands for a command set cavity base material. This study monitored the surface pH of three commercially available resin-modified glass ionomer cements over a 60-min period following either mixing alone or mixing followed by a 30-s exposure to a curing lamp. The results indicate that each material behaves in a unique manner. For all materials and conditions the pH reached after a 60-min period was significantly (P < 0.001) higher than the initial value. Light curing the materials significantly increased (P < 0.01) the surface pH of two of the materials (Baseline VLC and Vitrebond) as compared to the same materials in the uncured state. In the case of XR-Ionomer, however, no significant (P > 0.05) effect of light curing upon the surface pH was apparent. The precise clinical consequences of a low surface pH are unclear but may be an aetiological factor in postoperative pulpal sensitivity. It is therefore recommended that a sublining of a proprietary calcium hydroxide lining material should be placed routinely beneath these materials and every effort made to ensure effective light curing.

Glass Ionomer Cements↗

PubMed1992

Close range photogrammetry--a clinical dental research tool.

Photogrammetry is the art, science and technology of obtaining reliable information about physical objects through processes of recording and interpreting photographic images. This review outlines the principles of the technique and summarizes the various methodologies and applications in clinical dental research.

Dentistry↗

PubMed1991

Comparison of a novel photogrammetric technique and modified USPHS criteria to monitor the wear of restorations.

This paper describes monitoring the wear of restorations borne by partial dentures over a 12 months period using a novel photogrammetric technique and modified United States Public Health Service (USPHS) criteria. The performance of Class II restorations of Dispersalloy was compared with that of similar restorations of either KetacFil or Occlusin. The photogrammetric technique highlighted differences in performance not detected by the modified USPHS criteria. It is concluded that the photogrammetric technique should prove valuable in the in vivo assessment of the performance of restorative materials but that further refinement of the method is required particularly with regard to the orientation of replicas for sequential measurements.

Composite Resins↗

PubMed1990

Alternative approaches to evaluating the fatigue characteristics of materials.

Two models of fatigue failure (designated type 1 and type 2) have been investigated by use of a total of seven materials. For type 1 behavior, there is a clear relationship between fatigue life and fatigue stress, whereas for type 2 behavior no such relationship exists. For materials exhibiting type 2 behavior, failure occurs at a level of stress below the ultimate strength of the material, but the values of fatigue life appear to be distributed randomly when several specimens of the same material are tested. A value of fatigue limit can be calculated for these materials which is independent of fatigue life. It is likely that, for these materials, resistance to fatigue is primarily dependent upon the presence or absence of flaws such as porosities. For the dental materials investigated in this study, it appears that brittle materials such as dental plaster and heavily filled composites are likely to exhibit type 2 behavior, whereas less brittle materials, such as more likely filled composites, are more likely to exhibit type 1 behavior.

Calcium Sulfate↗

PubMed1990

The effect of storage media upon the surface microhardness and abrasion resistance of three composites.

The effects of various storage media [distilled water, lactate (pH 4.0), and citrate (pH 6.0) buffers] upon the hardness and wear factor values of three composites [Occlusin (O), P-30 (P), and Fulfil (F)] were studied. Over the one-year storage period, the hardness of all three materials stored in citrate buffer was unchanged. In the case of P in water and all materials stored in lactate buffer, a reduction was observed. There was no significant difference (P greater than 0.05) between the wear factors of specimens after one year or one week of water storage. Specimens of F stored in citrate buffer had a wear factor (P less than 0.01) higher than that of those stored in water. The other materials were not affected by storage in the lactate or citrate buffers. A reduction in surface hardness for some materials did not result in an increase in wear rate. This indicates that the softening effect was limited to a thin surface layer. Although not significant in vitro, this effect would probably increase the rate of in vivo wear, since the softened material would be lost, exposing a fresh surface to further attack. This would adversely prejudice the material's long-term clinical durability by impairing its resistance to abrasion.

Buffers↗

PubMed1989

The effect of placement technique upon the compressive strength and porosity of a composite resin.

This paper examines the effect of two placement techniques upon the compressive strength and level of porosity of specimens of a composite resin. Those specimens prepared by a condensation technique had a significantly lower mean compressive strength (P less than 0.05) and value of Weibull modulus (P less than 0.05) than specimens prepared using a smearing technique. No significant differences in the overall mean percentage area occupied by porosity and mean number of pores were demonstrated (P greater than 0.05) between the two placement techniques. Specimens prepared using the smearing technique, however, had significantly smaller mean maximum pore diameters (P less than 0.05) than those prepared using the condensation technique. It is therefore desirable when placing composite resins to reduce to a minimum handling procedures that are likely to influence the levels of porosity within the material.

Composite Resins↗

PubMed1982

Hepatitis B among Indochinese refugees in Great Britain.

Six hundred and thirty-two blood samples from 879 consecutive admissions to one resettlement camp for Indochinese refugees in Great Britain were screened for markers of hepatitis B (HB) virus infection. The overall prevalence of HB surface antigen (HBsAg) was 15%, being 16% in those aged 40 years or less, and falling to 8% in those older than 40 (P less than 0.05). No significant difference in prevalence was found between males and females. HBe antigen was detected in 56% of those with HBsAg and was demonstrable in 55-76% of those under 30 years of age. HBe antibody was found in 21% of HBsAg-positive refugees. In those under 40 years old, HB core (HBc) antibody was commoner in males (P less than 0.01). HBc antibody prevalence increased significantly with age in females (P less than 0.01) but not in males. There was no definite evidence that vertical transmission of hepatitis B was present in the group studied.

Adolescent↗

PubMed1981

Adenine arabinoside therapy in HBsAg-positive chronic liver disease: a controlled study.

A controlled trial has been undertaken to evaluate adenine arabinoside in the treatment of hepatitis B surface antigen-positive chronic liver disease. Thirteen patients (7 hepatitis B virus DNA polymerase and hepatitis B e antigen-positive, 6 DNA polymerase negative and hepatitis B e antibody-positive) were treated with adenine arabinoside. Eleven comparable patients served as controls, and follow-up was for 6 mo. In the 7 hepatitis B e antigen-positive patients, adenine arabinoside produced a fall in DNA polymerase activity during treatment. When this effect was sustained, it was followed by a loss of e antigen (3 patients). Hepatitis B surface antigen concentrations and aspartate transaminase levels fell significantly at 6 mo (p less than 0.05) in the treated group compared with controls. In the hepatitis B e antibody-positive patients, adenine arabinoside treatment produced no significant change in hepatitis B surface antigen concentrations or aspartate transaminase levels at 6 mo as compared with controls. Adenine arabinoside would appear to reduce either transiently or permanently, hepatitis B virus replication, and it may therefore be useful in reducing the infectivity of some carriers of this virus. In the dose used, adenine arabinoside was ineffective in clearing hepatitis B surface antigen from the serum and eradicating hepatitis B virus from the liver, but combination with other antiviral or immunostimulant agents may enhance its therapeutic effectiveness.

Adult↗

PubMed1980

Levamisole therapy for HBsAg-positive chronic liver disease.

Eight subjects with HBsAg-positive chronic liver disease received levamisole therapy continuously for 6 to 8 weeks. Depressed T-lymphocyte concentrations, found in all patients before therapy, transiently returned towards normal. All of the three patients who had normal delayed hypersensitivity responses before treatment showed an acute hepatitic reaction manifested by elevation of serum aspartate transaminase (AsT) and HBsAg levels, with transient cell-mediated immunity to HBsAg. This was interpreted as indicating increased lysis of infected hepatocytes. All of the five anergic patients showed no change in AsT or HBsAg levels. The clinical features and hepatic histology were unchanged. In patients with the capacity to mount normal delayed hypersensitivity responses, levamisole enhanced the cell-mediated response to HBsAg, and there was increased lysis of infected cells. Nevertheless, this treatment failed to eradicate the virus, as all patients remained HBsAg-positive.

Adult↗