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PubMed2000

Clinical evaluation of EBS dentine bonding agent: one year results.

There are numerous dentine bonding agents currently on the market, the majority of which adhere by means of infiltration of a hydrophilic polymerizable diacrylate into dentinal collagen exposed by acid treatment. The purpose of the present study was to evaluate the clinical performance of one such product, EBS dentine bonding, in non-undercut caries-free cervical lesions. Forty cavities were restored in eight patients of mean age 53 years. The manufacturer's instructions were followed, which involved essentially etching the enamel and dentine for 20 seconds with 32 per cent phosphoric acid, application and evaporation of EBS Primer, followed by placement and curing of EBS Bond, and restoring the cavity with Pertac II (ESPE) hybrid resin composite. Restorations were photographed at base line and one year for evaluation of marginal discolouration on a continuous linear rating scale. At six months, one patient with four restorations was not available; the remaining 36 restorations were all present. At one year, one restoration was missing, giving a cumulative retention rate of over 97 per cent. One of the 36 restorations exhibited very mild marginal discolouration.

Acid Etching, Dental↗
PubMed2004

Morphological analysis of subgingival biofilm formation on synthetic carbonate apatite inserted into human periodontal pockets.

BACKGROUND: Details of the development of human subgingival biofilm are unknown due to the difficulties in conducting experiments and especially in obtaining undisturbed materials. METHODS: This study was performed using deposits on carbonate apatite that had been inserted into human periodontal pockets for up to three weeks. Scanning electron microscopy using the vertically sectioned method and transmission electron microscopy using the freeze-substitution method were adopted. RESULTS: The development of subgingival biofilm occurred in five sequential phases: pellicle formation, microbial adherence, initial colonization, microbial organization, and establishment. Certain species in each of the initial, secondary and tertiary colonizers were considered to have a predilection for biofilm formation. Gram-positive, bacillary initial colonizers and gram-negative, filamentous secondary colonizers organized one stable structure that served as the framework for biofilm formation, and gram-negative, rod-shaped tertiary colonizers with cell-surface vesicles showed multigeneric coaggregation. The microbiota in the tertiary colonizers underwent repeated microflora alteration. CONCLUSIONS: Subgingival biofilm is constituted by initial, secondary and tertiary colonizers. Microflora alteration which is suggested to be related to periodontal disease, frequently occurred in the tertiary colonizers.

Adult↗
PubMed2003

Non-carious cervical lesions in a Nigerian population: abrasion or abfraction?

OBJECTIVES: To determine the proportion of non-carious cervical lesions (NCCL) that were either abrasion or abfraction like and to test the validity of the assumption that right-handed patients cause more abrasion on the cervical surfaces of teeth on the left side of the mouth. SETTING: Ile-lfe, Southwestern Nigeria. PARTICIPANTS: 106 first time patients diagnosed as having any form of NCCL. DESIGN: Patients were subjected to intra-oral examination followed by the administration of a questionnaire. The cervical lesions were examined and scored using the tooth wear index designed by Smith & Knight 1984. NCCL was diagnosed as abrasion or abfraction like based on established clinical features plus positive history of possible associated aetiological factors. OUTCOME MEASURES: Abrasion and abfraction like lesions. RESULTS: Abrasion was the diagnosis in 630 (62.3%) of the 1,012 tooth sites with NCCL that had no associated occlusal surface wear facet. This constituted about two-thirds of the NCCL. Three hundred and eighty two (37.7%) of the NCCL occurred in association with an occlusal surface wear facet and presented the typical wedge shaped defects with sharp margins characteristic of abfraction. These abfraction like lesions constituted about one-third of the NCCL. 50.8% of abrasive NCCL in right-handed brushers were located on the left side of the mouth. CONCLUSIONS: About one-third of NCCL in the present study presents an abfraction component, and two-thirds abrasion. Although, right-handed brushers had more severe lesions on the opposite side of the mouth, the difference was not statistically significant.

Adult↗
PubMed2006

An in vitro study of affected dentin as a risk factor for the development of secondary caries.

The objective of the study was to investigate the association between the presence of residual caries (inner affected dentin) on the cavity walls of cavity preparations and the further development of secondary caries lesions. Two 2 x 5 x 2 mm cavities, one in the apical portion (A) and one in the cervical portion (C) of the root, were prepared on both the lingual (L) and buccal (B) surfaces of 18 extracted human roots. The apical cavities (AB and AL) were artificially demineralized for 30 min using a decalcifying solution, followed by staining with a caries detector dye and then excavation of irreversibly demineralized dentin, leaving behind a layer of inner carious dentin. The cervical cavities (CB and CL) remained intact with sound dentin on the cavity walls. All cavities were then restored with composite resin. Following restoration, lingual specimens (AL and CL) were completely covered by an acid-resistant varnish to prevent further demineralization. All specimens were then incubated in an in vitro microbial artificial mouth model for 3 days in order to develop secondary carious lesions. At the end of the study all specimens were processed for energy-dispersive X-ray analysis of Ca concentration adjacent to the border between dentin and restoration. Statistical analysis of Ca concentrations revealed that the presence of affected inner dentin does not increase the susceptibility to secondary caries. Therefore, it was concluded that conservative cavity preparations leaving behind affected dentin do not increase the risk of secondary caries development.

Analysis of Variance↗
PubMed2004

The Papilla Presence Index (PPI): a new system to assess interproximal papillary levels.

The present article describes a classification system used to assess the interdental papillary height on natural teeth; the index can also be used in cases of lack of contact points and presence of diastemata. This system is particularly useful to define the loss of the interdental papilla because of periodontal disease and papilla reconstruction after periodontal treatment, particularly if tooth repositioning is involved. The index, based on esthetic evaluations, measures interproximal soft tissue height in relation to the CEJ, adjacent teeth, and the point corresponding to the ideal contact point. The four index scores are useful for an easy clinical assessment with respect to patient esthetics.

Diastema↗
PubMed2001

Cell-surface proteoglycan expression by lymphocytes from peripheral blood and gingiva in health and periodontal disease.

Cell-surface proteoglycans are involved in lymphocyte migration and activation. This study investigated the expression of syndecan-1, syndecan-4, and glypican in peripheral blood lymphocytes and by lymphocytes in variously inflamed periodontal tissues. Gingival specimens from healthy, gingivitis, or chronic periodontitis sites were stained by means of antibodies against B- and T-lymphocytes and also syndecan-1, syndecan-4, and glypican. Syndecan-1 expression by peripheral blood mononuclear cells (PBMC) from healthy, gingivitis, and chronic periodontitis subjects was assessed by flow cytometry. Syndecan-1 was expressed by B-cells/plasma cells but not T-cells in both gingivitis and chronic periodontitis lesions. Both B-cells/plasma cells and T-cells in gingivitis and chronic periodontitis expressed syndecan-4. Glypican was expressed only by macrophages. Stimulation of PBMC with mitogens and growth factors modulated syndecan-1 expression in both the T- and B-cells. Thus, cell-surface proteoglycan expression by lymphocytes in periodontal inflammation is cell-type-specific and may be modulated by inflammation.

Adult↗
PubMed2003

Does layering minimize shrinkage stresses in composite restorations?

Polymerization shrinkage of resin composites may impair restoration longevity. It is hypothesized that layering, rather than bulk, techniques result in less stress in the tooth-restoration complex. The aim of this study was to compare shrinkage stresses for different restorative techniques used for cusp-replacing restorations with direct resin composite. In a 3-D FE model, the dynamic process of shrinkage during polymerization was simulated. Time-dependent parameters (shrinkage, apparent viscosity, Young's modulus, Poisson ratio, and resulting creep), which change during the polymerization process, were implemented. Six different restorative procedures were simulated: a chemically cured bulk technique, a light-cured bulk technique, and 4 light-cured layering techniques. When polymerization shrinkage is considered, a chemically cured composite shows the least resulting stress. The differences seen among various layering build-up techniques were smaller than expected. The results indicate that the stress-bearing locations are the interface and the cervical part of the remaining cusp.

Chemical Phenomena↗
PubMed2003

Multiple idiopathic cervical root resorption: systematic review and report of four cases.

OBJECTIVES: The objectives of this study were to report four cases of multiple idiopathic cervical root resorption and to systematically review the literature on this condition. METHODS: The clinical and radiographic findings and the medical/dental histories of four patients who presented with multiple idiopathic cervical root resorption were recorded. Additionally, 10 references from the literature that reported on 14 patients were reviewed. RESULTS: Multiple idiopathic cervical root resorption was an incidental finding on routine clinical and radiographic examination. There appeared to be no correlation between this type of resorption and any medical/dental finding. Radiographically, multiple idiopathic cervical root resorption was found to begin at the cemento-enamel junction and then either progress to involve the entire cervical region or, at some point, spontaneously arrest. Those cases that progressed to involve the entire cervical region required extraction. The number of teeth that demonstrated this condition ranged from 5 to 24 per patient. More teeth became involved as the condition was followed in time. There was no detectable frequency of occurrence for any particular dental region or tooth among the involved teeth. Of a total of 18 patients, 13 were females whose ages ranged from 7 years to 68 years. Ten of the 18 patients were Caucasian. CONCLUSIONS: Multiple idiopathic cervical root resorption was found most frequently associated with younger females. This condition appeared to be of unknown aetiology and uncertain natural history.

Adult↗
PubMed2005

Comparison of observer reliability in assessing alveolar bone height on direct digital and conventional radiographs.

OBJECTIVES: Radiographs are an important adjunct in the assessment of periodontal disease in clinical practice and research. The purpose of this study is to compare intraexaminer and interexaminer reproducibility in assessing alveolar bone height on direct digital and conventional radiographs. MATERIALS AND METHODS: Matched sets of conventional radiographs and digital radiographs were taken on 23 subjects. Bone levels were measured on radiographs as the distance from the cementoenamel junction to the alveolar crest in millimetres at the mesial and distal surfaces of all available teeth excluding third molars. Two examiners measured bone levels twice on each type of imaging system independent of one another. Correlations and paired t-test values were computed. RESULTS: Intraexaminer relative agreement (r-value) on both digital and conventional radiographs ranged from 0.73 to 0.98, P<0.05; however, differences between measurements (absolute agreement) for each examiner were non-significant, P>0.05. Interexaminer relative agreement on both digital and conventional radiographs ranged from 0.70 to 0.95, P<0.05, and measurement differences between the two examiners were also significant, P<0.05. One examiner tended to score higher measurements than the other, P<0.05. CONCLUSIONS: Alveolar bone measurements are reproducible on both digital and conventional radiographs. Intraexaminer reproducibility is superior to interexaminer reproducibility. Direct digital radiographs did not enhance examiner agreement over conventional radiographs.

Adolescent↗
PubMedDate not supplied

Tooth surface floss loss: unusual interproximal and lingual cervical lesions as a result of bizarre dental flossing.

There are many reported cases of cervical abrasion/erosion cavities in the literature with various theories offered in support of their pathogenesis. The vast majority of these cases involve the labial cervical regions of the affected teeth. This case report describes an unusual dental presentation of severe lingual cervical and interproximal lesions predominantly affecting the upper and lower anterior and premolar teeth. The differential diagnosis is presented, along with the likely cause of the lesions: in this case, a bizarre oral hygiene technique. The proposed treatment plan is outlined and the problems associated with restoring such cavities are highlighted.

Dental Devices, Home Care↗
PubMed1997

Immunodetection of enamel- and cementum-related (bone) proteins at the enamel-free area and cervical portion of the tooth in rat molars.

Enamel and dentin at the cervical portion of the tooth are frequently covered by a collagen-free matrix referred to as acellular afibrillar cementum (AAC). It is believed that AAC deposition occurs when the enamel organ is displaced or disrupted, and mesenchymal cells from the dental follicle gain access to the tooth surface, differentiate into cementoblasts, and secrete noncollagenous proteins typically found in collagen-based mineralized tissues. A similar thin layer of mineralized matrix is found at the enamel-free area (EFA) of rodent molars, but in this case the matrix is covered by inner enamel epithelium (IEE) throughout development. We have, therefore, used this site as a paradigm to test the hypothesis that typical mesenchymal matrix proteins can also be found in association with epithelial cells. To this end, we have analyzed the presence and distribution of enamel- and cementum-related matrix proteins at the EFA and at the cervical portion of the tooth. Rat mandibular molars were processed for colloidal gold immunolabeling with antibodies to amelogenins, bone sialoprotein (BSP), osteopontin (OPN), osteocalcin (OC), and dentin sialoprotein (DSP), and the plasma proteins alpha 2 HS-glycoprotein and albumin. The EFA matrix was immunoreactive for amelogenins as well as for BSP, OPN, OC, and alpha 2 HS-glycoprotein, but not for albumin and DSP. The AAC was, similar to the EFA matrix, labeled for BSP, OPN, OC, and alpha 2 HS-glycoprotein. These data show for the first time that the EFA matrix is comprised of a mixture of enamel- and cementum-related proteins, a situation that parallels the distribution of matrix constituents at the cervical portion of the tooth. Since the EFA matrix is deposited on top of the mineralized dentin, and since the enamel organ seals off the forming matrix, it is concluded that EFA cells are responsible for the production of these proteins. Consistent with previous reports showing that epithelial cells can produce both BSP and OPN in some circumstances, the data also suggest that AAC may be deposited by cells of epithelial origin. Furthermore, they lend support to the possibility that cells derived from Hertwig's epithelial root sheath may likewise be capable of producing cementum matrix proteins.

Animals↗
PubMed1997

Cervical root resorption.

This article describes cervical root resorption, an external inflammatory root resorption arising immediately below the attachment level of the root. The pathogenesis is not fully understood, although many theories have been presented. Clinically, cervical root resorption is usually asymptomatic. The radiographic appearance is variable and is easily mistaken for that of internal root resorption. Histologically, the presentation is identical to that of other inflammatory root resorptions.

Humans↗
PubMed1998

Occlusal factors.

Explore the source record for details and available documents.

Dental Occlusion, Traumatic↗
PubMed2003

Comparison of direct digital and conventional intraoral radiographs in detecting alveolar bone loss.

BACKGROUND: Intraoral radiographs are important diagnostic aids in periodontics. The authors conducted a study to compare estimates of bone levels from direct digital and conventional radiographic under normal clinical use. METHODS: A full-mouth series of conventional radiographs was taken for each of 25 subjects who had periodontitis. A long cone paralleling technique was used for periapical, or PA, images, and a paper sleeve with biting tab was employed for bitewing, or BW, images. A set of direct digital radiographs matching the conventional radiographs was taken for each subject under the same conditions. The distance from the cementoenamel junction to the interproximal alveolar crest on all readable surfaces was measured. RESULTS: Examiners measured 857 PA image sites and 315 BW image sites matched on both radiographic systems. Paired t test showed significant differences in bone levels between the two systems. Measurements from conventional PA images were higher in all maxillary sextants (P < or = .02), and measurements from digital PA images were higher in mandibular anterior sextants (P = .007). Measurements in digital BW images were higher in mandibular posterior sextants (P = .002). A chi2 analysis of categorical bone levels (normal, early-to-moderate loss or advanced loss) showed significant differences between the imaging systems in revealing bone levels in both PA (P < .04) and BW (P < .001) images. Digital radiographs showed a higher number of sites with bone loss than did conventional radiographs. CONCLUSIONS: Under normal clinical use, alveolar bone levels revealed on intraoral direct digital radiographs differ from those revealed on conventional radiographs. CLINICAL IMPLICATIONS: Intraoral direct digital radiographs are not an equivalent substitute for conventional radiographs in evaluating alveolar bone levels.

Adolescent↗
PubMed2003

Noncarious cervical lesions and abfractions: a re-evaluation.

BACKGROUND: The concept of abfraction is controversial. The authors present the fundamental basis of abfraction and review studies that describe the condition. TYPES OF STUDIES REVIEWED: The authors used data on masticatory forces, enamel and dentin properties, as well as stress studies related to abfraction, for background information. They also analyzed the genesis of the abfraction theory, experimental evidence, case presentations, clinical investigations and restorative studies. RESULTS: The theory of abfraction is based primarily on engineering analyses that demonstrate theoretical stress concentration at the cervical areas of teeth. While some recent stress studies support earlier findings, others have provided significant deviating information. Few controlled studies exist that demonstrate the relationship between occlusal loading and abfraction lesions. The role of occlusal loading in noncarious cervical lesions (as shown by clinical data) appears to be part of a multifactorial event that may not necessarily follow the proposed classic abfraction mechanism, and other mechanisms or factors may explain cervical restoration failure just as well. CLINICAL IMPLICATIONS: There is little direct evidence supporting the theory of abfraction as the primary factor in the formation of noncarious cervical lesions. Controlled clinical trials are necessary to elucidate more fully the etiology of those lesions.

Bite Force↗
PubMed2005

The clinical performance of one- and two-step self-etching adhesive systems at one year.

BACKGROUND: The author compared the clinical performance of a two-step self-etching adhesive system and a one-step self-etching adhesive system over one year. METHODS: Thirty-five patients with noncarious cervical lesions were enrolled in the study. The author restored 163 lesions using a two-step (Clearfil Protect Bond, Kuraray, Osaka, Japan) or a one-step (Xeno III, Dentsply/DeTrey, Konstanz, Germany) self-etching adhesive system. Enamel margins were not beveled, and no mechanical retentions were placed. The author evaluted the restorations at baseline and at three, six, nine and 12 months after placement using modified Ryge criteria for color-matching ability, marginal discoloration, marginal adaptation, initial caries formation, anatomical form, postoperative sensitivity and retention loss. RESULTS: The author assessed the changes in the parameters using the Cochran Q test and the McNemar test at a significance level of .05. At one year, the retention rates for the restorations in the two-step group were 100 percent; they were 96 percent for the restorations in the one-step group. Of the retained 75 restorations from the one-step group, two had marginal discoloration and slight anatomical form problems. In both groups, color-matching ability and postoperative sensitivity remained excellent. CONCLUSION: The performance of both self-etching adhesive systems was excellent during this one-year clinical trial. However, the two-step system exhibited slightly better retention than the one-step system. CLINICAL IMPLICATIONS: The one- and two-step self-etching adhesive systems evaluated in this study provided excellent clinical retention in noncarious lesions without mechanical retention.

Acid Etching, Dental↗
PubMed2006

Treating cervical dentin hypersensitivity with fluoride varnish: a randomized clinical study.

BACKGROUND: This subject-blind randomized clinical trial tested the efficacy of a new 5 percent sodium fluoride varnish (AllSolutions Fluoride Varnish, Dentsply Professional, York, Pa.) for treatment of cervical dentin hypersensitivity. The authors also compared the test varnish with a control fluoride varnish (Duraphat, Colgate Oral Pharmaceuticals, New York City). METHODS: The study involved application of the test or control varnish to 19 subjects (59 teeth) with tooth sensitivity. The authors applied each product once to each tooth, following manufacturers' instructions. They used a visual analog scale (VAS) to assess subjects' responses to compressed air and ice stimuli at six weeks before baseline, at baseline and at two, eight and 24 weeks after treatment. RESULTS: Mean VAS scores for teeth receiving the test varnish dropped from 34.9 (air) and 68.0 (ice) at baseline to 26.3 (air) and 54.7 (ice) at two weeks after treatment. Mean scores at 24 weeks were 20.6 (air) and 34.8 (ice), representing statistically significant differences from baseline values. For the control varnish, mean VAS scores dropped from 36.9 (air) and 64.2 (ice) at baseline to 32.9 (air) and 47.2 (ice) at two weeks, and to 20.8 (air) and 40.3 (ice) at 24 weeks. The authors analyzed the data for statistical significance, accounting for clustering of teeth within subjects. CONCLUSION AND CLINICAL IMPLICATIONS: The test varnish was effective in reducing cervical dentin hypersensitivity. However, the efficacy was not significantly different from that of the control varnish.

Adolescent↗