Zinc-modified nanopolymers improve the quality of resin–dentin bonded interfaces

Introduction

Demineralized collagen fibers at the hybrid layer are susceptible to degradation. Remineralization may aid to improve bond longevity.

Objectives

The aim of the present study was to infiltrate zinc and calcium-loaded polymeric nanoparticles into demineralized dentin to facilitate hybrid layer remineralization.

Materials and methods

Zinc or calcium-loaded polymeric nanoparticles were infiltrated into etched dentin, and Single Bond Adhesive was applied. Bond strength was tested after 24 h and 6 months storage. Nanomechanical properties, dye-assisted confocal laser microscopy, and Masson’s trichrome staining evaluation were performed to assess for the hybrid layer morphology, permeability, and remineralization ability after 24 h and 3 months. Data were analyzed by ANOVA and Student–Newman–Keuls multiple comparisons tests (p < 0.05).

Results

Immediate bond strength was not affected by nanoparticles infiltration (25 to 30 MPa), while after 6 months, bond strengths were maintained (22 to 24 MPa). After 3 months, permeability occurred only in specimens in which nanoparticles were not infiltrated. Dentin remineralization, at the bottom of the hybrid layer, was observed in all groups. After microscopy analysis, zinc-loaded nanoparticles were shown to facilitate calcium deposition throughout the entire hybrid layer. Young’s modulus at the hybrid layer increased from 2.09 to 3.25 GPa after 3 months, in specimens with zinc nanoparticles; meanwhile, these values were reduced from 1.66 to 0.49 GPa, in the control group.

Conclusion

Infiltration of polymeric nanoparticles into demineralized dentin increased long-term bond strengths. Zinc-loaded nanoparticles facilitate dentin remineralization within the complete resin–dentin interface.

Clinical relevance

Resin–dentin bond longevity and dentin remineralization at the hybrid layer were facilitated by zinc-loaded nanoparticles.

     

To what extent do oral disorders compromise the quality of life?

Locker D, Quiñonez C. To what extent do oral disorders compromise the quality of life? Community Dent Oral Epidemiol 2011; 39: 3–11. © 2010 John Wiley & Sons A/S Abstract – Objective: Most measures of ‘oral health‐related quality of life’ assess the presence and frequency of functional and psychosocial impacts rather than explicitly documenting their impact on the quality of life. The aim of this study was to evaluate Prutkin and Feinstein’s suggestion for addressing the issue of quality of life in health outcome research by the use of global ratings. Methods: Data were collected from a national sample of Canadian adults by means of a telephone interview survey based on random digit dialing. Participants completed the OHIP‐14. Those reporting one or more impacts in the previous year were asked three questions concerning the extent to which these impacts bothered them, affected their life as a whole, and affected their quality of life. These items were scored on a scale ranging from ‘Not at all’ to ‘A great deal’. All participants were asked to rate the quality of their life using a six‐point scale ranging from ‘Very poor’ to ‘Excellent’. Results: Interviews were completed with 2027 participants, and 2019 were included in the analysis. Overall, 19.5% reported one or more impacts ‘fairly often’ or ‘very often’. Of these, 48.3% reported being bothered by these impacts, 40.3% that their life overall was affected, and 36.0% that their quality of life was affected. These individuals represent 9.4%, 7.8%, and 6.9% of the sample as a whole. Among those reporting impacts, there was a significant association between OHIP‐14 extent and severity scores and the three ratings. Those with impacts that bothered them, that affected their life overall or affected their quality of life, rated their overall quality of life less favorably than those with impacts that did not. Analysis by household income indicated that low‐income participants were more likely to be OHIP‐14 ‘cases’. Moreover, among the ‘cases’, low‐income participants were more likely to report an impact on the quality of life. Conclusions: The addition of global ratings of oral health‐related quality of life and quality of life provides information of use in understanding the negative consequences of oral disorders.     

Patients’ quality of life improves after surgical intervention of stage III medication-related osteonecrosis of the jaw

Oral and Maxillofacial Surgery - The treatment of advanced stages of medication-related osteonecrosis of the jaw (MRONJ) remains challenging. In order to improve decision making concerning the...     

Exploring the relation between patients’ resilience and quality of life after treatment for cancer of the head and neck

Resilience, which is a measure of a patient's ability to recover from a traumatic event, varies among the general population, and previous studies have suggested that it has an important influence on a patient's quality of life. We conducted a study of patients treated for cancer of the head and neck to investigate the relation between scores for resilience and quality of life (QoL). A total of 98 patients, who had been treated with curative intent, completed the University of Washington quality of life questionnaire (UW-QoL) and the Connor-Davidson resilience scale (CD-RISC). Retrospective analysis of patients’ records identified demographic data, stage of disease, and treatment. The Mann-Whitney U-test, Kruskal-Wallis test, and Spearman’s rank correlation were used to assess the significance of differences between the groups. The mean (SE) QoL score after treatment was 61 (2.081), and the mean CD-RISC score 0.427 for QoL in the last seven days. There was a significant correlation between overall scores for QoL and resilience (Spearman's Rho = 0.427, p < 0.005). As higher resilience scores had a significant correlation with a better QoL, strengthening a patient’s resilience might in turn help to improve their quality of life.     

How strong is the evidence for the need to restore posterior bounded edentulous spaces in adults? Grading the quality of evidence and the strength of recommendations

Background

It is unclear whether or not untreated bounded edentulous spaces (BES) can cause patients problems because of migration of unopposed and adjacent teeth.

Objectives

To quantitatively assess BES-related occlusal changes and the level of evidence available.

Material and methods

A systematic search of the literature was conducted in triplicate in the PubMed and Cochrane Register of Controlled Trials (CENTRAL) databases up to and including February 2010 to assess studies related to the topic. The LILACS database also was searched by one of the authors (CMF). Quantitative mesio-distal changes and overeruption were the outcome measures. Manual searching of the reference lists of studies retrieved from the electronic databases was also conducted. Google Scholar in English, French, German, Greek, Italian, Portuguese, and Spanish was also searched to retrieve potential studies. Grey literature was searched in OpenSIGLE (System for Information on Grey Literature in Europe) for more potential papers. The quality of the retrieved literature and the strength of recommendations were assessed by use of the GRADE system. A decision-tree-like scheme was produced to depict treatment options.

Results

The available evidence demonstrated that for most cases occlusal changes in BES after tooth loss might be limited (on average up to 2 mm). The quality of evidence was regarded as very low, however.

Conclusions

Tooth replacement should not necessarily be regarded as the mainstay of therapy for posterior BES, although more robust studies are necessary to clarify the long-term effects of non-treatment. The GRADE approach may be useful for enhancing the transparency of the decision-making process in dentistry, especially when evidence of only limited quality is available.     

Do socioeconomic determinants affect the quality of posterior dental restorations? A multilevel approach

Objectives

This study aimed to evaluate posterior restorations placed in young adults, investigating the association between social determinants experienced during the life course and the quality of tooth fillings.

Methods

A representative sample (n = 720) of all 5914 individuals who were born in Pelotas in 1982 was prospectively investigated, and posterior restorations were assessed at 24 years of age. Exploratory variables included demographic and socioeconomic, oral health and dental service payment mode during the life course. Tooth-related variables (type of tooth, material and size of cavity) were also analysed.

Results

Multilevel logistic regression models showed that individuals who were always poor from birth to age 23 [odds ratio (OR) 2.35 (1.38–4.00)] and whose mothers had less years of education at their birth (OR 2.60 (1.44–4.68)) were with unsatisfactory restorations in posterior teeth more often. In addition, caries presence at age 15 (high decayed, missing, filled teeth (DMFT) tertile) (OR 1.95 (1.25–3.03)) and cavities with four or more surfaces (OR 18.67 (9.25–37.68)) were associated with the outcome.

Conclusions

These results show that socioeconomic characteristics of the individuals play an important role in restoration failures, reinforcing the need for preventive dental strategies and public policies to reduce inequalities as a major topic of oral health. In addition, the size of cavity appears as the most important determinant for restoration failure.

Clinical significance

Individual socioeconomic characteristics were associated with failure in posterior restorations in detriment of other clinical variables such as restorative material and type of tooth.     

Does outpatient dental treatment have impact on the quality of life of children with early childhood caries?

Clinical Oral Investigations - To assess the impact of outpatient dental treatment on oral health-related quality of life (OHRQoL) of children and their families. This prospective observational...     

Who knows more about the impact of malocclusion on children's quality of life, mothers or fathers?

Shared decision making between children and parents is required in orthodontics. This study compared agreement among mothers, fathers, and children regarding the oral health-related quality of life (OHRQoL) of children. A sample of 71 child patients (41 girls and 30 boys) aged 12.6 years with an orthodontic treatment need, together with both their parents completed components of the child OHRQoL measure. Agreement among children, mothers, and fathers was derived from the 31 analogous questions and assessed using comparison and correlation analyses. Comparison analyses identified significant differences between mother's and children's reports and between father's and children's reports. The magnitude of the difference between mother's and children's reports, and between father's and children's reports could best be described as moderate (standard difference >0.2). In addition, absolute differences in scores constituted between 12 and 18 per cent of domain and overall scores for both mother's and children's, and father's and children's reports. Correlation analysis, at the individual family unit level, showed that agreement between mothers and children, and between fathers and children was fair [intraclass correlation coefficient (ICC) < 0.04]. Neither mothers nor fathers know their child's oral health status very well, as there was significant disagreement between mothers', fathers', and children's perceptions. The disagreement between mothers and children, and fathers and children was similar. While at the group level, mothers and fathers tended to agree on perception of their children's oral health status, at an individual family unit level they did not.     

Impact of oral health on quality of life among the elderly population of Joaçaba, Santa Catarina, Brazil

The objective of this study was to investigate the impact of oral health conditions on the quality of life of elderly people in Joa?aba - SC, in Southern Brazil. A survey based on systematic sampling of clusters was carried out with 183 elderly people that belong to old age groups. The survey was conducted in order to assess the oral conditions of the participants (use of and need for prosthesis) based on the criteria from the World Health Organization publication "Oral Health Surveys, Basic Methods", 4th edition. The oral health impact profile (OHIP) was used to evaluate the impact of oral condition in the quality of life. ABIPEME (Brazilian Association of Market Research Institutes) criterion was used, together with the level of education and the number of people in the household to determine social inequalities. The participants were mostly women (82%) and the OHIP mean was 10.35. No correlation was observed between the OHIP level and formal education or between OHIP and number of residents per household. There was a correlation of 0.240 (p = 0.001) between ABIPEME and OHIP. The OHIP mean for those not using maxillary prosthesis was 12.48 and the mean for those using it was 9.81 (p = 0.399). The mean OHIP for those in need of maxillary prosthesis for those who did not need it was 13.00 and 8.88, respectively (p = 0.014). The same trend was found for the use and need for mandibular prosthesis. The conclusion was that the need for maxillary and mandibular prosthesis impacted the quality of life among the elderly population of Joa?aba.     

Does self‐weighting of items enhance the performance of an oral health‐related quality of life questionnaire?

OBJECTIVES: To determine if self-weighting of the items in an oral health-related quality of life questionnaire improves its psychometric properties. METHODS: The Surgical Orthodontic Outcome Questionnaire (SOOQ) was designed to assess the oral health-related quality of life of individuals before and after corrective surgery. Each of its 33 'items' consists of two questions: a question concerning the frequency with which a given functional or psychosocial problem had been experienced and a 'weighting' question which asked about how much the individual was bothered by that problem. The questionnaire was completed by three groups of individuals: (i) pretreatment; (ii) immediate (i.e. 2-6 months) postsurgery and (iii) postsurgery (i.e. more than 2 years after surgery). Unweighted scale scores were obtained by summing the response codes to the frequency question and weighted scores by summing the products of the frequency and bother questions. These scores were calculated for the full questionnaire and a short form consisting of 15 items. The discriminative and correlational construct validity of these scores was compared along with internal consistency reliability. The sensitivity to change and longitudinal construct validity of unweighted and weighted scores was assessed in a simulated evaluative study in which pretreatment and postsurgery subjects were paired. RESULTS: For both the long and short forms of the questionnaire, unweighted and weighted scores discriminated between the groups enrolled in the study. Correlations with a general health rating were similar, as were Cronbach's alpha values and test-retest reliabilities. The simulated evaluative study suggested no differences in sensitivity to change or longitudinal construct validity. When subscale scores were examined, there was a suggestion that weighting improved their reliability. CONCLUSIONS: Self-weighting of items did not substantially improve the performance of the SOOQ. Domain weights should be developed and tested to determine if they have an effect on its properties.