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At least 163 records · Page 9Linked to original sources
PubMed2006

Aesthetic changes with four anterior units.

Cosmetic dentistry has evolved with the advent of more robust porcelain materials and ever-stronger bonding agents. This series of three articles aims to provide a practical overview of what is now possible both functionally and cosmetically from the preparation of a small number of teeth, through a whole smile, to full mouth rehabilitation. A complete diagnosis is the starting point to planning any cosmetic or functional changes. Guidance is given on the techniques used but adequate training must be considered essential before embarking upon modification in occlusal schemes or even minor adjustments in smile design. Conservative use of porcelain laminate veneers can result in significant aesthetic improvements to a patient's smile and it is not always necessary to prepare all the teeth visible in a smile.

Cementation↗
PubMed2002

Real-time monitoring of stain formation and removal on calcium hydroxyapatite surfaces using quartz crystal sensor technology.

Stain formation, stain inhibition and stain removal may be monitored in real-time using a novel method employing a quartz crystal resonance sensor (QCR), based upon quartz crystal microbalance (QCM) technologies. Crystalline hydroxyapatite (HA) surfaces were prepared on phosphate-terminated, polymer-modified gold surfaces of quartz crystal transducers. The resulting sensors were placed in a specially constructed flow cell, and the interaction of adsorbates from the tea stain solution monitored as a function of time. The ability of sodium tripolyphosphate (STP) to remove extrinsic stain and also to inhibit its formation was examined. The adsorption of material from the staining solution passed over the sensor was clearly observable, and once bound, the crystal based real-time data suggest that tea adsorbates were not removed in the absence of an active under conditions of continuous flow. STP was shown to rapidly remove existing stain, and exhibited a clear inhibitory action on stain formation irrespective of whether the HA had been previously exposed to tea chromogens. The continuous data generated by the QCR technique were in good agreement with the results obtained using a discontinuous spectrophotometric method. The presently described quartz crystal model for extrinsic dental stain should provide a valuable tool to aid understanding of the interactions of staining agents with a crystalline HA surface as a model tooth surface, and to evaluate the efficacy and mode of action of STP and putative stain removal agents.

Coloring Agents↗
PubMed2006

Dental aesthetics and the aging patient.

Those over the age of 65 years old and the "baby boomers" regard oral health, including oral/dental/facial aesthetics, as part of their overall health and wellness. Over 65% of discretionary wealth in the United States belongs to those over the age of 50. In many instances, they have had to deny their own needs for those of their families and are now at a point where their dental issues can finally be addressed. Aesthetic dentistry offers the opportunity to reverse the signs of aging and restore a youthful appearance. A smile can be the most eye-catching feature of a face and therefore should blend in or harmonize with facial appearance. Advances in aesthetic dentistry, such as porcelain veneers, bonding, periodontal surgery, and dental implants, have shown great efficacy and reliability when used properly. Aesthetic dentistry offers the opportunity for the aged population to have a more youthful, harmonious smile with improved function and optimum oral health.

Aged↗
PubMed2000

Cementoenamel junction: microscopic analysis and external cervical resorption.

There is a lack of data regarding the shapes and distribution of the mineralized tissue that composes the cementoenamel junction. A sample of 198 permanent human teeth was analyzed by optical microscopy and scanning electron microscopy. Scanning electron microscopy showed three types of tissue interrelations: enamel overlapped by cementum; enamel and cementum edge-to-edge; and a gap, revealing a strip of exposed dentin. Using optical microscopy, a fourth type of cementoenamel junction was observed: cementum overlapped by enamel. The distribution of the hard tissues found at the cementoenamel junction is unpredictable and irregular both for any tooth type (e.g. on cuspids) and on any one individual tooth. Based on these results and on analysis of the mechanisms involved in cervical root resorption, it is possible to consider the cervical region as prone to external resorption.

Dental Cementum↗
PubMed2004

Development of methods to enhance extrinsic tooth discoloration for comparison of toothpastes. 2. Two-product clinical study.

BACKGROUND: Extrinsic staining of teeth is considered to be unsightly and a number of 'whitening' toothpastes have been formulated to inhibit or remove such tooth discoloration. The aim of this study was to compare the stain prevention of two toothpastes. METHOD: The study was a single-blind, randomised, placebo-controlled, crossover design, balanced for residual effects involving 24 healthy dentate volunteers. The treatments were as follows: (1) a whitening toothpaste product, (2) an experimental toothpaste formulation and (3) water. For each 4-day rinse period, subjects were rendered stain free on the teeth and tongue. Approximately on the hour from 09:00 to 16:00 hours, subjects rinsed with chlorhexidine mouth rinse for 1 min followed by warm black tea for 1 min. The treatment interventions were at 09:00 and 16:00 hours and before the chlorhexidine rinse. The toothpastes were rinsed as 3 g/10 ml water slurries and water as a 10 ml rinse each for 2 min. On day 5, subjects were scored for tooth and tongue stain intensity and area, and the product of these was calculated. The washout period was at least 9 days. RESULTS: Treatment differences for the teeth were highly significant but not for the tongue. Paired contrasts for tooth stain intensity, area and product were mostly all significantly in favour of reduced staining by the experimental formulation compared with water and the whitening product. There were no significant differences between water and the whitening product. CONCLUSIONS: Using a forced dietary staining method, the data support a tooth stain-inhibitory/-removal action for the experimental formulation, but not the whitening product.

Adult↗
PubMed2004

Development of methods to enhance extrinsic tooth discoloration for comparison of toothpastes. 1. Studies in vitro.

BACKGROUND: The interaction of chlorhexidine with dietary chromogens to cause extrinsic dental staining has been exploited in vitro and in vivo to study tooth discoloration and its control. These studies in vitro investigated factors that might enhance stain formation, and evaluated formulations to inhibit the stain with the primary aim of devising a protocol for use in vivo. METHOD: The standard method cycled acrylic specimens through saliva, 0.2% chlorhexidine and tea on the hour 8 times per day and stain was measured using a spectrophotometer. Test interventions were 3 "whitening" toothpastes (A, P, R), a fluoride toothpaste (C) and water. In studies 1 and 3 interventions were at 09:00 and 16:00, and in studies 2 and 4 at 09:00 and 13:00. Between cycles, specimens remained dry in studies 1 and 2 and were maintained in water day and night in studies 3 and 4. Studies 5-7 determined the influence of tea temperature, exposure time and concentration, and chlorhexidine temperature and exposure time on stain development. Studies 8-10 modified the standard procedure using tea at triple strength and 50 degrees C, and assessed stain inhibition by toothpastes and water using optical density, colorimetric and visual assessment recordings. RESULTS: In studies 1-4, there were highly significant differences between interventions. Overall, the experimental whitening paste (P) produced the most stain inhibition, and water or the proprietary whitening paste (R), produced the least stain inhibition. More stain inhibition was seen with interventions at 09:00 and 16:00. Both tea concentration and temperature significantly influenced staining. Chlorhexidine temperature did not influence staining. Exposure time to tea and chlorhexidine had a small effect on staining. In studies 8 and 9, interventions at 09:00 and 16:00 were more effective; the most stain inhibition was with paste P and the least with water, paste R being intermediate. In study 10, P was the most effective and R the least effective interventions. CONCLUSIONS: These studies in vitro suggest that the chlorhexidine tea stain model can be manipulated to enhance stain and thereby should improve discrimination between stain inhibition formulations. The timing of interventions in the model appears to be important. These studies in vitro were used to plan a clinical protocol.

Acrylic Resins↗
PubMed1997

Benign mucous membrane pemphigoid presenting as desquamative gingivitis in a 14-year-old child.

A 14-year-old girl presented with painful, erythematous gingivae, which occasionally developed blisters. There were no other mucosal or skin lesions. Clinical, histopathological and immunofluorescence studies suggested a diagnosis of benign mucous membrane (cicatricial) pemphigoid, presenting as desquamative gingivitis. Benign mucous membrane pemphigoid in childhood is rare and only a few cases with exclusive oral mucosal involvement have been reported in the literature. The desquamative gingivitis responded well to a topical steroid regimen.

Adolescent↗
PubMed2004

Clinical study to compare the effectiveness of a test whitening toothpaste with a commercial whitening toothpaste at inhibiting dental stain.

AIMS: A single centre, randomised single-blind, three-way crossover study was performed, to compare the effect of an experimental test toothpaste with a commercially available whitening toothpaste and water control at inhibiting extrinsic stain promoted by repeated chlorhexidine/tea rinses. METHODS: This study used 23 subjects. During the week before the study the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the Monday of the following week subjects returned to the clinic to receive their rinses and to check their dentition was stain free. Under direct supervision at both 09:00 and 13:00 hours they rinsed with either a toothpaste slurry or water control that was repeated daily up to and including the following Thursday. Additionally from the Monday to the Thursday each subject rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. Throughout this period volunteers omitted all other forms of oral hygiene except rinsing with the chlorhexidine mouthwash. On the Friday the level of stain on the teeth and dorsum of tongue was assessed using the Lobene stain index for both stain area and intensity. At the end of each trial period each subject received a thorough prophylaxis to remove all plaque, calculus and staining before starting the second and third period of the study. RESULTS: As expected appreciable amounts of extrinsic stain accumulated on the teeth over each study period. The amount of stain following use of the toothpastes and water control was least with the experimental toothpaste, followed by water control and lastly the commercial whitening paste. For all sites combined there was evidence that the experimental paste was significantly superior to both the commercial paste and water control at reducing stain area (p<0.001), a product of stain area and intensity (p<0.001 and 0.05, respectively) but not stain intensity (p>0.05). CONCLUSIONS: In this stain-prevention model the use of an experimental paste showed a significant reduction in stain accumulation on the teeth compared with a (placebo) negative water control and a commercially available whitening paste. As such the experimental paste would be expected to be of benefit in controlling extrinsic dental staining.

Adult↗
PubMed2005

Clinical studies to determine the effectiveness of a whitening toothpaste at reducing stain (using a forced stain model).

AIMS: Two single centre, randomized single-blind, crossover studies were performed, to compare the effect of a test toothpaste with a conventional fluoride paste in the inhibition and removal of extrinsic dental stain promoted by repeated chlorhexidine/tea rinses. METHODS: These studies used 24 subjects in each of two separate clinical trials. On the Friday before each trial period, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the following Monday, subjects were checked whether they were stain free and then under direct supervision they rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. In addition subjects also received daily a single toothpaste slurry rinse or control water rinse in the morning and lunchtime. No other form of oral hygiene was permitted during this period. On the Friday, both stain area and intensity was assessed using the Lobene Stain Index. For the stain removal study, stain was promoted again using chlorhexidine and tea rinses. After 4 days, stain was measured both prior to and immediately after brushing with the allocated toothpaste for 2 min. Subjects were then instructed to use the toothbrush at home according to their normal oral hygiene practices. On the following Wednesday, the amount of stain present was re-assessed. Each subject subsequently received a thorough prophylaxis to remove all plaque calculus and staining before starting the following periods of the study. RESULTS: The study showed no difference in the ability of the test whitening toothpaste, control toothpaste and water control at inhibiting stain. There was also only a small difference (3.5% for product of area and intensity) between the ability of the two toothpastes to help remove stain after a single brushing. The difference was however in favour of the test product which approached a conventional level of significance (P = 0.089). There was no evidence of superiority for either of the pastes after normal home usage. CONCLUSIONS: This study has suggested that the test product may have some advantage over the conventional paste at removing stain but the magnitude of difference would appear to be small and of little clinical relevance.

Adult↗
PubMedDate not supplied

Evaluation of effects of application of a citroxain-containing dentifrice.

The benefits to the patient of the removal of tooth deposits is well documented. Should such removal provide the additional effect of "whitening" the tooth surface, an additional cosmetic benefit would be provided. This study documents that a Citroxain-containing dentifrice provides all of these benefits.

Adult↗