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PubMed1997

Caries prevalence and periodontal treatment needs in public and private school pupils in Jordan.

A total of 886 pupils aged 15-16 years selected from 20 public and 10 private schools in northern Jordan were investigated for frequency of toothbrushing and sweet consumption, dental caries and periodontal treatment needs. A questionnaire and clinical examination were used utilising decayed-missing-filled teeth (DMFT) code and the Community Periodontal Index of Treatment Needs (CPITN), respectively. Results revealed that 35.5 per cent of public and 57.1 per cent of private school pupils reported to brush their teeth regularly while the majority of them frequently consumed sweets. There were slight differences in caries experience amongst public and private school pupils, as measured by DMFT (4.74: 4.95). While bleeding and calculus scores were prevalent in pupils of both types of schools, they were slightly higher in pupils of public schools than those in private schools. Both shallow and deep pathological pockets were found in fewer numbers (6.09 per cent) in pupils in public schools only. Oral hygiene instruction and scaling were the predominant periodontal treatment needs in both types of schools. However, the treatment needed by pupils in public schools was higher than those in private schools. Complex treatment was rarely needed by public school pupils only.

Adolescent↗
PubMed1997

Environmental issues in dentistry--mercury. FDI Commission.

One of the consequences of placing amalgam restorations is that mercury is required for the trituration process. In turn, this raises the issue of the possible environmental impact of mercury. This report considers ways in which any impact can be modified and reduced by careful attention to mercury usage and hygiene in the dental practice, the use of filters and separators in waste water pipes and the appropriate disposal of waste contaminated with amalgam. The total amount of mercury discharged into the environment varies considerably in different parts of the world due to both natural and human activities. The extent to which dentistry adds to this total also varies according to local circumstances and requirements. Recommendations are given for further development of ways to reduce mercury discharge and for further research into the environmental impact of the metal.

Dental Amalgam↗
PubMed1999

Dental anxiety among patients prior to different dental treatments.

The purpose of the present study was to evaluate dental anxiety among patients anticipating various dental treatments. One hundred and eighty patients who were scheduled for specific dental treatments at the School of Dental Medicine, the Hebrew University--Hadassah, Jerusalem, Israel participated in the study. Patients were anticipating one of the following dental procedures: scaling, filling, root canal therapy, preparation for crown, periodontal surgery or extraction. For each of the six dental treatments, 30 patients were selected at random. Dental Anxiety Scale (DAS) questionnaires were completed by the patients while waiting for their treatments. The results indicated that extraction caused the highest score, followed by scaling (though not significantly). Patients in the 35 to 49 year age group showed the highest total DAS scores. Women demonstrated higher total DAS scores than men. The relative influence of gender, type of treatment and age on the anxiety scores is demonstrated by using logistic regression, which revealed gender to have the strongest impact on the DAS scores, followed by the type of treatment and age.

Adult↗
PubMed2005

Conservative restoration with resin composites of a case of amelogenesis imperfecta.

Amelogenesis imperfecta (AI) is an inherited enamel dysplasia involving both dentitions with no other systemic effects. The hereditary pattern is autosomal or X-related dominant or recessive. Its prevalence is approximately 1:14,000-1:16,000. It can be classified as hypocalcified, hypoplastic and hypomaturated according to clinical, radiological, histological and hereditary findings. This study presents a case of hypomaturated type AI in a 16-year-old young man that was successfully treated with different types of resin composites. The patient was regularly recalled during the one-year postoperative period. Radiographic and clinical examinations at recall revealed no evidence of complications associated with the restored teeth or their supporting structures.

Adolescent↗
PubMed1983

The teeth and infective endocarditis.

During 1981 and 1982 544 cases of infective endocarditis were investigated retrospectively by means of a questionnaire. Only 13.7% had undergone any dental procedure within three months of the onset of the illness, and in 42.5% there was no known cardiac abnormality before the onset of the disease. Furthermore, the number of cases occurring annually was about the same as or more than it was before the introduction of penicillin. The mouth and nasopharynx were the most likely sources of the commonest organism, Streptococcus viridans, and it is suggested that it is not dental extractions themselves which are of importance but good dental hygiene. In most patients with infective endocarditis the portal of entry of the organism whatever its nature cannot be identified. If this is so antibiotics are being given to only a small proportion of those at risk, and this would explain why the number of cases is much the same as it was before the introduction of penicillin. Furthermore, the large proportion of patients with no known previous cardiac abnormality adds to the difficulty of providing effective prophylaxis. The evidence suggests that antibiotic prophylaxis should still be given before dental procedures, and a schedule is appended. Much more importance should be given, however, to encouraging people to seek better routine dental care. We also believe that doctors and dentists should appreciate that the pattern of the disease has changed considerably in the past 50 years and that the information given here warrants a revised approach to the problem.

Adolescent↗
PubMed2003

Preventive (evidence-based) approach to quality general dental care.

Restorative and scaling treatments have not generally provided an effective method for managing dental caries and periodontal diseases. Rather, restorative treatment has often covered up the disease processes in the short term and created a new problem: that of maintenance and re-restoration of restored teeth. Thus, standard invasive dental treatments that are commonly provided fail to address the fundamental bacterial nature of the diseases. Indeed, these treatments rather readily generate and perpetuate a totally unacceptable chain of events. This chain embraces many shortcomings, which themselves nurture what may be described as the repeat restorative cycle. The time has come to correct this iniquity. Dental caries and periodontal diseases are dynamic conditions which need 'managing' with a focused cocktail of preventive and refined restoration care. Much more emphasis should be placed upon the assessment of each and every caries or periodontal lesion, with a view to implementing specific preventive measures and allowing the natural arrest of disease processes to occur. The universal adoption of a preventive (evidence-based) approach to making dental treatment decisions could be by far the most powerful factor in reducing the restorative burden of dental services. It is clear that dental education and practice need to rise proactively to the challenge, or changes will be forced upon them while they are in a defensive position. There is a need to move wholeheartedly and contentedly into the preventive era.

Algorithms↗
PubMed2006

Restorative therapy of erosion.

When substance loss caused by erosive tooth wear reaches a certain degree, oral rehabilitation becomes necessary. Prior to the most recent decade, the severely eroded dentition could only be rehabilitated by the provision of extensive crown and bridge work or removable overdentures. As a result of the improvements in composite restorative materials, and in adhesive techniques, it has become possible to rehabilitate eroded dentitions in a less invasive manner. However, even today advanced erosive destruction requires the placement of more extensive restorations such as ceramic veneers or overlays and crowns. It has to be kept in mind that the etiology of the erosive lesions needs to be determined in order to halt the disease, otherwise the erosive process will continue to destroy tooth substance. This overview presents aspects concerning the restorative materials as well as the treatment options available to rehabilitate patients with erosion, from minimally invasive direct composite reconstructions to adhesively retained all-ceramic restorations. Restorative treatment is dependent on individual circumstances and the perceived needs and concerns of the patient. Long-term success is only possible when the cause is eliminated. In all situations, the restorative preparations have to follow the principles of minimally invasive treatment.

Ceramics↗
PubMed1993

An in vitro study into the effect of a bacterial artificial caries system on the enamel adjacent to composite and amalgam restorations.

A microbial artificial caries system was used to produce caries-like lesions adjacent to amalgam and composite restorations. Polarised microscopy allowed measurement of outer and wall lesions depths. Comparison was made of the depths found in relation to the restorative materials, margin finishing procedures (composite group), varnish application (amalgam group) and thermal stressing. It was found that differences were detectable between the different restorative materials and the type of margin finishing procedure used in the composite group. Varnish application and thermal stressing had little effect. Some comparison is made between this microbial technique, other artificial caries techniques, and other methods of assessing marginal leakage.

Adolescent↗
PubMedDate not supplied

Effects of cement bases on the stresses in amalgam restorations.

A computerized dental model was used to study the stress induced in a Class 1 amalgam restoration when supported by bases of varying materials and thickness. Under the same load, the maximum tensile stresses and deflections in the amalgam restoration increased at least threefold with a zinc oxide-eugenol base as compared with a ZnPO4 cement base.

Dental Amalgam↗
PubMedDate not supplied

Effects of cement bases on the stresses and deflections in composite restorations.

A model was used to investigate stresses and deflections in cement bases and in a composite restorative material induced in a posterior Class I restoration. Deflections in the composite were highest when it was supported by a base with a low modulus; however, the maximum tensile stress (12 MN/meter2) occurring in the composite restoration at the interface with the base was well below the maximum tensile strength of most composite materials (30 to 40 MN/ meter2). Tensile and shear stresses occurring in the cement bases were of sufficient magnitude to exceed the strength of the cement when a 1.5-mm layer of zinc phosphate cement (base consistency) was supported by a 0.5-mm layer of ZOE lining material. Lowest values of stress were observed when a 2-mm layer of a zinc polyacrylate base was used to support the composite restoration. An ideal situation would be to have a cement base with a modulus of elasticity equal to that of the composite material. Finally, the maximum stress and deflection values obtained here can be easily exceeded in a clinical situation when wider variations can be easily introduced, making the choice of a cement with the proper modulus even more critical.

Composite Resins↗
PubMedDate not supplied

Surface failure of commercial and experimental restorative resins.

A single-pass test was used to study the surface failure of commercial and experimental restorative resins and composites. The surface failure observed for unfilled diacrylate resins was more severe than that seen for an unfilled acrylic resin. Addition of nonsilanated filler to the diacrylate resins increased the resistance to penetration but did not dramatically change the mode of surface failure. The surface failure of the commercial composite resins, which contain silanated filler, was ductile in mode and the resistance to penetration of the diamond slider was the highest of the materials studied. The wear of restorative resins and composites is determined, therefore, by resistance to penetration as well as mode of deformation during sliding.

Acrylic Resins↗
PubMedDate not supplied

Finite element stress analysis of the crowns of normal and restored teeth.

Stress distributions are presented for a normal and a restored mandibular second premolar under masticatory-type forces. These were obtained using the finite element method of stress analysis applied to two-dimensional models. The effect of the relative stiffness of the materials is examined in each instance.

Bicuspid↗
PubMed1977

Marginal failure of amalgam class II restoration.

Analysis of stresses in a bicuspid with an amalgam Class II restoration was carried out with the finite element method. When stresses were known, creep in the margin of the restoration was calculated. If the buccal cusp was loaded, the maximum compressive stresses were found in the buccal part of the restoration.

Dental Amalgam↗
PubMed1977

Loading rate and temperature as variables in amalgam bending.

Three commercial dental amalgams of known dissimilar clinical properties were evaluated in pure blending at widely different loading rates and temperatures. Comparative data of fracture stress at 140 F rank these alloys according to their clinical fracture resistance; the phenomenon of creep may account for early marginal fracture prior to corrosion-induced fracture.

Dental Amalgam↗