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PubMedDate not supplied

Prevalence of hidden caries.

Clinical evaluations of the first and second permanent molars were compared with radiographic evaluations of the same teeth, for 359 patients (between six and eighteen years old) of the pediatric department of the Academic Centre for Dentistry Amsterdam (ACTA). The teeth were professionally cleaned and dried before the clinical evaluation. Despite the thorough examination, taking into account the fact that all discolorations and/or decalcifications were noted, 15 percent of the teeth that did not show signs of enamel caries clinically, showed a dentine lesion on the bitewing radiograph. These 15 percent of teeth with hidden caries were found in 7.5 percent of the population studied. The absence of clinical signs of occlusal enamel caries or dentine caries does not guarantee a sound dentition. Sealant treatment of teeth that are sound (both clinically and radiographically) is justified, therefore, soon after tooth eruption.

Adolescent↗

PubMed2006

An in vitro comparison between two methods of electrical resistance measurement for occlusal caries detection.

Because of different measurement techniques and the easier design of the CRM prototype, this in vitro study aimed to compare the diagnostic performance and reproducibility of two electrical methods (Electronic Caries Monitor III, ECM and Cariometer 800, CRM) for occlusal caries detection, and to evaluate the effect of staining/discoloration of fissures on diagnostic performance. Hundred and seventeen third molars with no apparent occlusal cavitation were selected. Six examiners inspected all specimens independently, using the CRM, and a subgroup of 4 using the ECM. Histological validation using a stereomicroscope was performed after hemisectioning. Intra- and interexaminer reproducibility was assessed by Lin's concordance correlation coefficient (CCC) and Bland and Altman analysis. Diagnostic performance parameters included sensitivity (SE), specificity (SP) and area under the ROC curve (Az). The CCC yielded an intra- and interexaminer reproducibility of 0.69/0.62 (ECM) and of 0.79/0.74 (CRM). The mean intra- and interexaminer 95% range of measurements (range between Bland and Altman limits of agreement) given in percentages of the instrument reading were 67%/65% for the ECM and 28%/33% for the CRM. Az at the D3-4 level was 0.74 (ECM) and 0.78 (CRM). The CRM showed at least equivalent diagnostic performance to the ECM. However, improvement is still desirable. Diagnostic performance appeared to be enhanced in discolored lesions; however, this may be related to sample lesion distribution characteristics.

Dental Caries↗

PubMedDate not supplied

Comparison of 10% carbamide peroxide and sodium perborate for intracoronal bleaching.

The purpose of this study was to compare 10% carbamide peroxide to the combination of sodium perborate and water as intracoronal bleaching agents. Forty-four extracted teeth were discolored in vitro. Bleaching agents were placed intracoronally to the level of the cemento-enamel junction for 12 days; solutions were replaced after four and eight days. Standardized slides were used to rank color changes; a colorimeter was used to quantify color change. After 12 days, 65% of the discolored teeth in the 10% carbamide peroxide group and 67% of the discolored teeth in the sodium perborate group had lightened to their original shade or lighter. While there was no statistical difference between the two treatments, sodium perborate was easier to use.

Borates↗

PubMed1982

Corrosion of resin-bonded orthodontic brackets.

The objective was to identify the nature and origin of indelible black and green stains found in enamel after the removal of bonded orthodontic brackets. Several brackets were examined by scanning electron microscopy and energy-dispersive x-ray analysis. Irrespective of the type of bracket or resin, morphologic evidence of corrosion activity was found. Brackets were pitted, and in some cases large amounts of metal were missing. Cracks were found in the resin which led to sites of destruction in which structures resembling microorganisms were also found. X-ray analysis showed the presence of chromium, nickel, iron, and chlorine in significant amounts in the bonding, discolored resin. It was concluded that the cracks were favoring crevice corrosion. In the presence of organisms and a lowered pH, together with a chloride environment and an oxygen gradient, conditions conducive to corrosion are established.

Chemical Phenomena↗

PubMed1977

Discoloration of dental pellicle by tannic acid.

The ability of tannic acid to discolor pellicle was studied in vitro and in vivo. Freshly extracted teeth were submerget in solutions of tannic acid, and in the clinical study individuals rinsed three times daily with 0.1% or 0.2% tannic acid. It was fount that 0.2% tannic acid caused brownish discolorations within 10-12 days both in vitro and in vivo. Discolored pellicle material collected from the in vivo test group was shown to contain furaldehyde after hydrolysis. The origin of the furaldehyde is not ascertained, but could be due to the presence of dietary deposits, transformation of pellicle pentoses, or from reactions between reducing sugars and amino compounds.

Dental Enamel↗

PubMed1980

Criteria for diagnosis of pulp necrosis in traumatized permanent incisors.

Records and radiographs of 108 patients (6-18 years) with 134 root canal treated incisors were examined. Subluxation was the most common type of injury, followed by intrusive, extrusive or lingual luxation, exarticulation and uncomplicated crown fracture. Negative response to electric stimulation was noted in 107 teeth from the first examination. In 23 teeth an initial positive response changed to negative within 3 weeks to 9 months, whereas persistent positive reactions were recorded in four teeth. The diagnosis of necrosis was based on the following observations: negative vitality and radiographic changes (76 teeth), negative vitality and discoloration (45 teeth), negative vitality only (nine teeth), positive vitality and radiographic changes (four teeth). External inflammatory root resorption confirmed the diagnosis of necrosis in all replanted teeth and in 13 of 16 intruded teeth. Discoloration and periapical lesions were the most important diagnostic factors following subluxation, extrusive and lingual luxation. Necrosis was disclosed within 4 months in 117 teeth (87%). Diagnoses based on negative vitality and discoloration were made within 6 days to 3 months in all but one case. All external root resorptions and 37 of the 49 periapical lesions were observed within 3 weeks to 4 months of the injury.

Adolescent↗

PubMed1998

Effect of smear layer removal on bleaching of human teeth in vitro.

The purpose of this study was to evaluate objectively in vitro the effectiveness of bleaching artificially discolored teeth with or without the smear layer present using sodium perborate mixed with sterile water or 35% hydrogen peroxide (H2O2). Seventy fully developed maxillary anterior teeth were artificially stained with human hemoglobin and separated into one control and four experimental groups. After the smear layer was removed on half the experimental teeth and left intact on the other half, all of the teeth were bleached intracoronally with sodium perborate and 35% H2O2 or sodium perborate plus water. The bleaching agents were applied twice over a 6-day period. The changes in tooth shade were objectively analyzed using a SP78 sphere spectrophotometer at 1, 30, and 60 days postbleaching. The presence or absence of the smear layer did not significantly influence the outcome of bleaching (p > 0.05). The teeth bleached with sodium perborate and 35% H2O2 were significantly lighter than the teeth bleached with sodium perborate and sterile water (p < 0.0001) at each experimental period. Based on the findings of this study, it is not advantageous to remove the smear layer before intracoronal bleaching.

Borates↗

PubMed1995

[Preventive effect of 10% (NH4)2MoO2F4 solution on artificial root-surface caries in vitro].

The aim of this study is to determine the preventive effect of F-Mo preparation on artificial root-surface caries. 60 premolar teeth extraced for orthodontic purpose were divided into five groups. A window was prepared on every tooth. They were treated by 10% (NH4)2MoO2F4, 38%Ag (NH4)2F, 2% NaF, 7.3% (NH4)2MoO4 and deionized water for 2 minutes and three times. They were then put in the fluid contained cariogenic bacteria for 96 hours to produce root caries. The root surface lesion of every tooth was examined and analysed by micro-radiography, SEM and spectrum. The result showed that the lesion depth of the groups treated by 10% (NH4)2MoO2F4 and 38%Ag (NH4)2F were significantly smaller than the other groups, and the surface of windows are more integrate and smooth, and mean mineral concentration is more higher than those of the other groups. It can be concluded that 10% (NH4)2MoO2F4 solution has greater inhibit effect to the development of root caries, so as the 38% Ag(NH4)2F solution. But the former discolored the tooth much less than the latter.

Administration, Topical↗

PubMedDate not supplied

Creating the appearance of white enamel dysmineralization with bonded resins.

In special cases, white enamel discoloration can be stimulated using bonded resin materials. This paper describes a method of using bright white visible light-polymerized resin sealant material as an enamel bonding agent, which is overlayed with composite resin to enhance wear resistance of the restoration.

Child↗

PubMed1986

Developmental defects of enamel: a study of 12-year-olds in Hong Kong.

The prevalence of enamel defects in Hong Kong was determined using a randomly selected group of 12-year-olds (N = 1,069). The most common defects were enamel opacities, which occurred in 99.6% of the Chinese children, with 63.4% of them having more than 20 teeth affected. Almost 17% of the Chinese children had disfiguring enamel discoloration, but only one of the non-Chinese children had this defect. The high prevalence of enamel defects may be related to the high frequency of use of tetracycline, metabolic disturbances, and a greater-than-optimal intake of dietary fluoride.

Child↗

PubMedDate not supplied

Oral and systemic effects of prolonged minocycline therapy.

The following case report shows the unfortunate side effects of minocycline therapy used in the management of facial acne. All three features of discoloration affecting the skin, bone and dentition were found. A 46-year-old patient presented with adult onset discoloration of the dentition following prolonged minocycline therapy. In addition, oral and cutaneous pigmentation were noted. Unfortunately, the undesirable cosmetic appearance of facial acne was exchanged for permanent discoloration of the dentition. When considering prolonged minocycline therapy, patients would benefit from dialogue between the medical and dental practitioners, so that the risk of this potential side effect can be assessed in a more informed way.

Acne Vulgaris↗

PubMed1999

An evaluation of the changes in maxillary pulpal blood flow associated with orthognathic surgery.

The objective of this study was to evaluate the use of the Laser Döppler Flowmeter (LDF) in the measurement of pulpal blood flow following orthognathic surgery and to conduct an initial study of the effects of a Le Fort I osteotomy on the pulpal blood flow of the maxillary central incisors. The design consisted of a preliminary prospective controlled consecutive clinical trial undertaken at the Orthodontic Clinic, University Dental Hospital NHS Trust, Wales, 1994. The study group consisted of 15 consecutive patients who were to receive a standard advancement Le Fort I osteotomy. Seven patients who were to undergo a mandibular advancement only acted as a control. A further 20 separate patients participated in a study for the assessment of measurement error. The blood flow in relative perfusion unit v. time, was measured using a Laser Döppler Flowmeter. Measurement error for flowmeter recordings with hand-held application and custom-made splint support showed no consistent difference or significant random variation between the two methods for holding the probe against the teeth (pooled S.D. of reproducibility 1/1 = 1.91/1.39 for custom splint location as opposed to 0.96/1.07 for hand-held/fixed bracket location). For the surgical patients under investigation no significant differences for maxillary pulpal blood flow were found in the control group (mandibular osteotomy) over time. However, in the maxillary osteotomy patients there was a tendency for an initial rise in the maxillary perfusion post-surgery as measured at the central incisor pulps, followed by an overall reduction at 6 months. As an example, the mean value for the upper right central showed a significant increase in blood flow during the immediate post-operative period (P < 0.05), but at 6 months after surgery demonstrated a statistically significant overall reduction in comparison with the presurgical reading (P < 0.001). The laser Döppler flowmeter is not an easy instrument to use in the clinical assessment of pulpal blood flow. However, it would appear from these longitudinal series of readings, taken over a 6-month period on 15 patients, that the maxillary perfusion recorded at the central incisor pulps may be permanently affected in many Le Fort I osteotomy patients. For patients that already have a prejudiced blood supply this could lead to devitalization and discoloration of incisors. It is not known if this affect on the perfusion of the pulp continues beyond 6 months post-surgery.

Blood Flow Velocity↗

PubMed2003

[Treatment of dental fluorosis].

Fluorotic stains present a variety of clinical surface alteration with the modification of the enamel colour, we have a structural modification of hard tissues resulting in their hypo-mineralisation. A knowledge of the kind of surface, nature, and deepness of the discoloration is necessary in order to make the right diagnosis and so, to adapt the specific treatment which can varies from a simple general treatment based on VIT C drugs, to aesthetic veneers and includes micro-abrasion technique, and chemical bleaching methods.

Ascorbic Acid↗

PubMed1993

[A study on the clinical application of thinner porcelain laminates for upper anterior teeth].

Porcelain laminates can be used to treat the stained or discolored teeth effectively. In this paper, 18 cases were selected, 102 porcelain laminates (in thickness of 0.5 mm) were fabricated and bonded to the upper anterior teeth through the light curing composite. Following more than three years tracing observation, the results expressed satisfactorily. The questions including the fabrication of porcelain laminate and its clinical application were discussed.

Adolescent↗

PubMed2001

Nanomechanical properties of hydrated carious human dentin.

Most restorative materials are bonded to caries-affected dentin that has altered structure. We tested the hypothesis that hydrated dentin of the transparent zone did not have increased hardness or elastic modulus. Nanoindentation by modified AFM was used to determine site-specific elastic modulus and hardness for components of hydrated dentin from 8 carious and non-carious human teeth. Indentations in intertubular dentin were made at intervals from pulp through the affected layers (subtransparent, transparent, and discolored zones). The values of intertubular dentin increased slightly from near the pulp into the transparent zone, then remained constant or decreased slightly through transparent dentin (E, 18.3 GPa; H, 0.8 GPa; confirming the hypothesis), and decreased markedly through the discolored region. Peritubular dentin values were unaltered in transparent dentin, and intratubular mineral had values between those of normal peritubular and intertubular dentin. Superficial areas contained distorted tubules without peritubular dentin or intratubular mineral.

Analysis of Variance↗

PubMed2002

Three-year clinical evaluation of One-Step in non-carious cervical lesions.

PURPOSE: To clinically evaluate the 3-year performance of a one-bottle dentin adhesive in the restoration of non-carious cervical lesions (NCCLs) with resin composite. MATERIALS AND METHODS: 105 NCCLs were restored with either AElite Flow, Bisco Glaze (both flowable resin-based composites) or Silux (a microfilled resin-based composite), using One-Step dentin adhesive. The cavities were cleaned with pumice and water slurry, the dentin lightly roughened with a fine diamond bur, and the restorations placed according to the manufacturer's instructions. Patients were recalled at 6 months, 1 year, 2 years and 3 years, and restoration integrity and marginal discoloration assessed. RESULTS: The overall retention rates were: 6 months, 100%; 1 year, 95%; 2 years, 87%; 3 years, 75%. Marginal discoloration was negligible, and there was no significant difference among the materials, although there was a trend for it to be greater around the Bisco Glaze restorations.

Adult↗

PubMed1989

Developmental defects of enamel in Chinese girls and boys in Hong Kong.

The FDI (DDE) Index--with some modifications and a re-designed recording sheet--was used to determine the prevalence of the different types of developmental defects of enamel. The public water supply contained 1.0 ppm when the children were bron and 0.7 ppm at the time of the examinations. All surfaces of the teeth of 460 female and 484 male, 12-year-old, Chinese children were examined after the teeth had been cleaned and dried. Mouth prevalences for all types of opacities, hypoplasia, and discoloration were 99.6%, 82.8%, and 16.6%, respectively. There was no apparent statistically significant difference between girls and boys. However, a statistically significant difference was seen between the sexes for white patches (p less than 0.05), missing enamel (p less than 0.05), and horizontal grooves (p less than 0.01). There were 811 (85.7%) children with more than 13 teeth affected by opacities, and 417 (44.2%) children had more than four teeth affected by hypoplasia. The most common defect was the diffuse white patch, and the least common was the vertical groove. There were 189 (39.0%) boys with between four and 12 teeth affected by more than two types of defect per tooth. White lines were the most difficult defect to diagnose reproducibly. Intra-examiner reproducibility for all other defects achieved levels of "almost perfect" and "substantial" by calculation of the Kappa coefficient.

Child↗

PubMed1973

Prevalence of tetracyclines in children's teeth. II. A resurvey after five years.

The capacity of the tetracyclines to discolour teeth has been widely recognized for over 10 years. This survey examined recent trends in tetracycline usage as shown by deposits of the antibiotic in primary molars extracted from 505 children aged from 3 to 5 years.It was found that 70% of the children had been given the antibiotic during their first three years of life, each having received on average 2.4 courses. This represented an increase of 12% in tetracycline usage in children of this age as compared with a similar series five years ago. There was no evidence of increasing preference by prescribers for oxytetracycline (the analogue least likely to cause dental discoloration). Staining of the permanent incisor teeth frequently occurs if tetracyclines are given to children under 6 years of age and it is predicted that some degree of staining will occur in about 23% of the children in this series.All things considered, there appears to be a strong case for stopping the manufacture of paediatric preparations of tetracycline except for those comprised of oxytetracycline for use in exceptional cases.

Age Factors↗