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1.
Melissa Drum Al Reader John Nusstein Sara Fowler 《Journal of the American Dental Association (1939)》2017,148(4):267-271
Background and Overview
Profound pulpal anesthesia after a successful inferior alveolar nerve block can be difficult to achieve when the clinical condition is a pulpal diagnosis of symptomatic irreversible pulpitis. The authors reviewed the literature as it relates to the anesthesia necessary for endodontic therapy of patients with painful, vital, mandibular teeth diagnosed with symptomatic irreversible pulpitis.Conclusions
Supplemental anesthetic techniques and medications are available that can be used to improve pulpal anesthesia for patients with the clinical condition of symptomatic irreversible pulpitis.Practical Implications
The authors identified treatment recommendations for anesthesia in the case of symptomatic irreversible pulpitis based on a review of the available evidence. 相似文献2.
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Gary Goldstein Mark Andrawis Mijin Choi Jonathan Wiens Malvin N. Janal 《The Journal of prosthetic dentistry》2017,117(3):426-429
Statement of problem
The definition of centric relation (CR) has been both controversial and divisive, with little consensus.Purpose
The purpose of this study was to determine whether agreement can be reached on a definition for CR among the Fellows of the Academy of Prosthodontics, the organization that writes the Glossary of Prosthodontic Terms.Material and methods
A survey of the Fellows of the Academy of Prosthodontics was conducted at the organization’s annual business meeting.Results
Of the 83 eligible Fellows in attendance, 72 responded to the survey, a response rate of 86%. Of those, the 5 responders who did not indicate a preferred definition and the 2 that chose 2 definitions were censored, yielding an analyzable sample of 65 for the definitions. The most common definition received 19 votes, the next 16, and the third 13, with the other 6 definitions receiving from 2 to 5 votes. Some of the variability in definition depended on the era of training.Conclusions
Disagreement and confusion continues regarding the definition of centric relation. Some of this disagreement can be explained by training era. 相似文献5.
Jun Tian Yuanhe Zhang Zhihui Lai Mengjie Li Yu Huang Hongwei Jiang Xi Wei 《Journal of endodontics》2017,43(1):163-168
Introduction
This study evaluated how exposing the novel calcium silicate nanoparticulate bioceramic iRoot BP Plus (Innovative Bioceramix, Vancouver, Canada) to an acidic environment affects ion release from this material and alters MC3T3-E1 preosteoblast viability on and attachment to this material. These factors were compared against those of ProRoot MTA under similar conditions.Methods
Each material was exposed to phosphate-buffered saline (pH = 7.4) or butyric acid (pH = 5.4) for 5 days. Trace metal elements within the 2 materials and released ions were identified using inductively coupled plasma optical emission spectroscopy. The microstructures and elemental compositions of MTA and iRoot BP Plus after treatment with butyric acid were determined using scanning electron microscopy with an energy-dispersive X-ray spectrometer. Furthermore, the viability of MC3T3-E1 cells on and their levels of attachment to the materials after the butyric acid treatment were compared.Results
iRoot BP Plus contained fewer toxic metal elements than MTA. Under acidic conditions, both materials displayed similar ion release abilities, with increased release of Si and Ca ions. Substantial changes in microstructure, including reduced apatite formation, were observed for both materials after exposure to acidic pH. Furthermore, exposing iRoot BP Plus and MTA to an acidic environment increased and decreased MC3T3-E1 cell viability on these materials, respectively. MC3T3-E1 cell attachment to both materials was not significantly affected by acidic pH.Conclusions
iRoot BP Plus seems more biologically appropriate for application in an inflamed acidic environment than ProRoot MTA. 相似文献6.
Ronald E. Goldstein Wendy Auclair Clark 《Journal of the American Dental Association (1939)》2017,148(6):387-391
Background
Awake bruxism is a common clinical condition that often goes undetected, often leading to pain or damaged teeth and restorations.Methods
The authors searched electronic databases regarding the treatment and effects of awake bruxism compared with those of sleep bruxism. The authors used the search terms diurnal bruxism and oral parafunction. The authors combined information from relevant literature with clinical experience to establish a recommended protocol for diagnosis and treatment.Results
The authors found articles regarding the diagnosis and treatment of bruxism. The authors combined information from the articles with a review of clinical cases to establish a treatment protocol for awake bruxism.Conclusions
Literature and clinical experience indicate a lack of patient awareness and, thus, underreporting of awake bruxism. As a result, myriad dental consequences can occur from bruxism. The authors propose a need for increased awareness, for both patients and professionals, particularly of the number of conditions related to awake bruxism.Practical Implications
Clinicians should look for clinical signs and symptoms of awake bruxism and use minimally invasive treatment modalities. 相似文献7.
8.
Thanh An Nguyen Le Anthony T. Lo Sasso Marko Vujicic 《Journal of the American Dental Association (1939)》2017,148(4):257-262.e2
Background
The authors examined the factors associated with sex differences in earnings for 3 professional occupations.Methods
The authors used a multivariate Blinder-Oaxaca method to decompose the differences in mean earnings across sex.Results
Although mean differences in earnings between men and women narrowed over time, there remained large, unaccountable earnings differences between men and women among all professions after multivariate adjustments. For dentists, the unexplained difference in earnings for women was approximately constant at 62% to 66%. For physicians, the unexplained difference in earnings for women ranged from 52% to 57%. For lawyers, the unexplained difference in earnings for women was the smallest of the 3 professions but also exhibited the most growth, increasing from 34% in 1990 to 45% in 2010.Conclusions
The reduction in the earnings gap is driven largely by a general convergence between men and women in some, but not all, observable characteristics over time. Nevertheless, large unexplained gender gaps in earnings remain for all 3 professions.Practical Implications
Policy makers must use care in efforts to alleviate earnings differences for men and women because measures could make matters worse without a clear understanding of the nature of the factors driving the differences. 相似文献9.
Gerardo Maupomé Juan F. Yepes Madison Galloway Qing Tang George J. Eckert Timothy Downey LaQuia Vinson 《Journal of the American Dental Association (1939)》2017,148(10):760-766
Background
The effectiveness of stainless steel crowns (SSCs) versus direct restorations when placed in primary mandibular molars (teeth nos. L and S) is uncertain. The authors evaluated effectiveness by gauging longevity of treatment.Methods
The authors obtained private dental insurance claims (2004-2016) from a national dental data warehouse. Paid insurance claims records (n = 1,323,489) included type of treating dentist, treatment placed, and patient age.Results
Dentist specialty, type of treatment, and patient age were significant in predicting failure after the first restoration. The authors found high survival rates for all treatments (> 90%) after 5 years; however, as soon as within 3 years after treatment, SCCs had approximately 6% better survival.Conclusions
Teeth nos. L and S first treated with SSCs lasted longer without new treatment compared with teeth first treated with direct restorations; the difference was small. Teeth treated by pediatric dentists had better survival rates.Practical Implications
Primary mandibular first molars initially treated with SSCs lasted longer without new treatment compared with direct restorations. Overall dental care costs of the former were considerably higher. 相似文献10.
Statement of problem
Reports on computer-engineered complete dentures (CECDs) continue to increase. Systematic reviews on clinical outcomes and applications associated with CECDs are lacking in the literature.Purpose
The purpose of this systematic review was to determine the clinical outcomes and applications of CECDs.Material and methods
Electronic searches of the English literature from January 1984 to May 2016 were performed in MEDLINE and Cochrane databases, with the results enriched by hand searches and citation mining to address 2 relevant population intervention comparison outcome (PICO) questions: What are the clinical outcomes associated with CECDs? Are there specific applications and significant advantages for CECDs?Results
A review of the selected articles on CECDs revealed significantly better retention and reduced clinical time for the milled CECDs compared with conventional complete dentures. An advantage associated with CECDs is the possibility of electronically archiving data using digital technology for rapid fabrication. Applications reported in the literature with CECDs were also identified.Conclusions
A positive trend was seen in the outcomes with CECDs, although patient selection might have also contributed to favorable outcomes. Significantly reduced clinical time, improved retention, and digital archiving were the main advantages associated with CECDs. 相似文献11.
Mahshid Majlessi Koopaeei Marita R. Inglehart Neville McDonald Margherita Fontana 《Journal of the American Dental Association (1939)》2017,148(2):64-74
Background
There is a large variation among clinicians when managing deep carious lesions (DCLs). The purpose of this study was to assess general dentists’ (GDs), pediatric dentists’ (PDs), and endodontists’ (EDs) diagnostic methods, clinical decision-making considerations, treatment strategies, and knowledge, behavior, and attitudes related to the diagnosis and treatment of DCLs.Methods
A total of 175 GDs, 511 PDs, and 377 EDs responded to a nationwide Web-based survey.Results
Most EDs (68%) and GDs (47%) practiced complete caries removal. PDs (31%) were more likely than GDs (12%) and EDs (4%) to remove carious tissues partially. Dentin hardness was the most important diagnostic criterion used during caries excavation (GDs, 90%; PDs, 72%; EDs, 88%). Only 30% of GDs, 17% of PDs, and 90% of EDs used diagnostic tests (for example, a cold test) when assessing pupal health. A substantial percentage of respondents considered endodontic treatment as a choice for treating DCLs in asymptomatic teeth in young patients (GDs, 40%; PDs, 30%; EDs, 40%). GDs rarely used a rubber dam when treating these lesions.Conclusions
Most respondents practiced complete caries removal until hard dentin was felt, using hardness as the primary excavation criterion, and did not use pulp diagnostic tests routinely before making decisions about treatment of teeth with DCLs.Practical Implications
Efforts should be made to translate the growing body of evidence supporting the use of conservative caries removal criteria to preserve pulpal health and tooth structure integrity when managing DCLs. 相似文献12.
Jason R. Garner Michael N. Wajdowicz Nicholas B. DuVall Howard W. Roberts 《The Journal of prosthetic dentistry》2017,117(2):277-282
Statement of problem
Two resin-modified glass ionomer (RMGI)-based luting agents have been recently marketed without independent reports of their physical properties.Purpose
The purpose of this in vitro study was to evaluate selected physical properties of 2 newly marketed RMGI luting agents and compare the findings with traditional materials.Material and methods
Specimens (N=12) of Nexus RMGI, UltraCem, GC Fuji Cem 2, and RelyX Luting Plus were fabricated using standardized molds for flexural strength and fracture toughness according to manufacturer recommendations and stored in physiologic phosphate-buffered saline solution at 37°C until testing. Specimens were tested at 1 and 24 hours, 1 week, and 1 month. Mean values for flexural strength, flexural modulus, flexural toughness, and fracture toughness were determined. Additionally, film thickness (N=12) for each material was determined following Amerian National Standards Association/American Dental Association (ANSI/ADA) specifications. Mean results were analyzed with Kruskal-Wallis and Mann-Whitney U tests (α=.05).Results
All luting agents exhibited a similar film thickness that met ANSI/ADA requirements for aqueous-based luting agents. Nexus RMGI surprisingly demonstrated significantly greater flexural strength and fracture toughness at 1 hour, which decreased significantly at 24 hours, making it similar to the other materials evaluated. All materials had similar flexural strength values at 7 days.Conclusions
Physical property performance was material dependent. Nexus RMGI demonstrated greater early physical properties that were significantly less at 24 hours. UltraCem, GC Fuji Cem 2, and RelyX Luting Plus demonstrated the increasing physical property development that is normally associated with polyalkenoate-based systems. 相似文献13.
Junxin Zhu Qiguo Rong Xiaoyan Wang Xuejun Gao 《The Journal of prosthetic dentistry》2017,117(5):646-655
Statement of problem
How tooth preparation and material type affect the stress distribution of endodontically treated teeth restored with endocrowns remains unclear.Purpose
The purpose of this finite element (FE) study was to determine the influence of the quantity of remaining dental tissues and material type on stress distribution in endodontically treated maxillary premolars using 3-dimensional FE analysis.Material and methods
Five 3-dimensional FE models were constructed on the basis of the restorative methods used and the quantity of preserved tooth tissues: a sound maxillary premolar, an endodontically treated maxillary premolar restored with composite resin, and endodontically treated maxillary premolars restored with endocrowns with thicknesses of 1.0 mm, 2.0 mm, and 3.0 mm. The following endocrown materials were used: Paradigm MZ100, IPS Empress, IPS e.max CAD, and In-Ceram Zirconia. Stress distributions were analyzed under vertical and oblique loads.Results
As the quantity of preserved dental tissues increased, the von Mises stress in dentin decreased, and the peak von Mises strain value of the cement layer increased. When the elastic modulus of the endocrown material increased, the von Mises stress in endocrown and dentin increased, and the peak von Mises strain value of the cement layer decreased.Conclusions
Although the conservative preparation of teeth for endocrowns is likely to protect the residual tooth structure, it may cause future cohesive bonding failure. An increase in the elastic modulus of the material may benefit the durability of bonding between the endocrown and the abutment tooth; however, it may cause fracture of the residual tooth structure. 相似文献14.
Po-Yen Lin Yu-Chih Chiang Yu-Ju Chou Hong-Ji Chang Lin-Yang Chi 《Journal of endodontics》2017,43(1):29-35
Introduction
The objective of root canal treatments (RCTs) is to control pulpal diseases and salvage infected teeth by eradicating microorganisms within the root canal system. However, an unfinished RCT can leave a space for bacterial accumulation, which can leak into the oral cavity and then aspirate into the lower respiratory tract and the lungs, causing infection. This study investigated the association of unfinished RCTs with the possible risk of pneumonia hospitalization using a nationwide population-based database.Methods
After a matching process, we recruited 116,490 subjects who received an initiated RCT and had no history of pneumonia before 2005 and observed until the end of 2011. An unfinished RCT was operationally defined as an endodontic session that was started on a tooth but had no subsequent completion records. Cox proportional hazards models and subgroup analyses were used to estimate the association of unfinished RCTs on the risk of pneumonia hospitalization.Results
In total, 1285 subjects were hospitalized for pneumonia during 2005 to 2011 with an overall pneumonia hospitalization incidence rate of 0.22% per person year. After adjusting for confounding factors, the adjusted pneumonia hospitalization hazard ratio for subjects who had unfinished RCTs was 1.40 (95% confidence interval, 1.24–1.59) compared with subjects without unfinished RCTs (P < .0001). For middle-aged patients, the hazard ratio was 1.81 (95% confidence interval, 1.45–2.24).Conclusions
Patients with unfinished RCTs had a higher risk of pneumonia hospitalization. Thus, dentists are advised to complete endodontic treatments once started. 相似文献15.
Dental plan premiums in the Affordable Care Act marketplaces trended downward from 2014 through 2016
Background
Pediatric dental benefits must be offered in the health insurance marketplaces created under the Affordable Care Act. The authors analyzed trends over time in premiums and the number of dental insurers participating in the marketplaces.Methods
The authors collected dental benefit plan data from 35 states participating in the federally facilitated marketplaces in 2014, 2015, and 2016. For each county, they counted the number of issuers offering stand-alone dental plans (SADPs) and medical plans with embedded pediatric dental benefits. They also analyzed trends in premiums.Results
From 2014 through 2016, the number of issuers of stand-alone dental plans and medical plans with embedded pediatric dental benefits either did not change or increased in most counties. Average premiums for low–actuarial-value SADPs declined from 2014 through 2016.Conclusions
The increase in the number of issuers of stand-alone dental plans and medical plans with embedded dental benefits may be associated with lower premiums. However, more research is needed to determine if this is the case.Practical Implications
Affordable dental plans in the marketplaces could induce people with lower incomes to sign up for dental benefits. Newly insured people could have significant oral health needs and pent-up demand for dental care. 相似文献16.
Suman Arya Jigyasa Duhan Sanjay Tewari Pankaj Sangwan Veena Ghalaut Sameer Aggarwal 《Journal of endodontics》2017,43(10):1623-1627
Introduction
The purpose of this prospective study was to compare the success of primary root canal treatment between type 2 diabetic and nondiabetic patients and to investigate the effect of periapical healing on glycated hemoglobin (HbA1c) in type 2 diabetic patients with apical periodontitis.Methods
Sixty mandibular molars with necrotic pulps and apical radiolucency (size ≥ 2 mm × 2 mm) were included in the study. Based on the HbA1c levels, patients were divided into 2 groups: type 2 diabetic (HbA1c ≥6.5%) and nondiabetic (HbA1c <6.5%). Forty-six teeth were evaluated at the 12-month follow-up time period. The primary outcome measure was the change in apical bone density as determined by the periapical index.Results
Both the diabetic and nondiabetic group depicted a significant reduction in the periapical score after endodontic treatment at the 12-month follow-up (P < .05). Significantly less periapical healing was observed in the diabetic group (43%) compared with the nondiabetic group (80%) at the 12-month follow-up (P < .05). HbA1c levels in the diabetic group increased at each follow-up after endodontic treatment.Conclusions
Diabetes mellitus may have a negative impact on the outcome of endodontic treatment in terms of periapical healing. Nonsurgical endodontic treatment did not improve HbA1c levels in patients with type 2 diabetes. 相似文献17.
Jason Clague Thomas R. Belin Vivek Shetty 《Journal of the American Dental Association (1939)》2017,148(6):377-386
Background
The authors clarified the causal mechanisms underlying the high prevalence of dental disease encountered in people who habitually use methamphetamine (meth).Methods
Using a stratified sampling approach, the authors conducted comprehensive oral examinations and psychosocial assessments for 571 study participants who used meth. Three calibrated dentists, who used National Health and Nutrition Examination Survey (NHANES) protocols, characterized the study participants’ dental disease. The authors also collected data related to study participants’ history of meth use and other attributes linked to dental disease.Results
Study participants who used meth manifested higher rates of xerostomia and caries experience compared with NHANES control participants. Participants who used meth had a higher level of daily consumption of sugary beverages compared with NHANES control participants. Smoking meth did not increase caries experience over other modes of intake. Dental hygiene was a significant determinant of dental health outcomes.Conclusions
Mode of intake and frequency of meth use have a minimal impact on dental health outcomes. Behaviors, such as sugary beverage consumption and poor oral hygiene, better explain dental health outcomes.Practical Implications
Having a better understanding of the causal mechanisms of “meth mouth” sets the stage for clinicians to provide more personalized interventions and management of dental disease in people who use meth. 相似文献18.
Jamie Moeller Rebecca Starkel Carlos Quiñonez Marko Vujicic 《Journal of the American Dental Association (1939)》2017,148(6):361-368
Background
The authors explored the relationship between income inequality and self-reported oral health and oral health–related quality of life.Methods
The authors used an online survey to gather data about US adults’ perceptions of their overall oral health and how oral health affected their quality of life. The authors categorized respondents as coming from areas of low, medium, or high income inequality on the basis of a county-level Gini coefficient.Results
Results of χ2 tests and an analysis of variance indicated that there was a significant association between income inequality and oral health as measured by using the overall condition of the mouth and teeth, life satisfaction, and frequency of experiencing functional and social problems related to oral health. Generally, adults from areas of lower income inequality reported better oral health and oral health–related quality of life.Conclusions
Income inequality has the potential to affect both functional and social dimensions of oral health, possibly through a psychosocial pathway. Future research is necessary to determine whether any causal link exists.Practical Implications
Our findings may inform oral health policy. Long-term policies designed to improve the oral health of Americans could work best when supported by policies designed to reduce levels of income inequality, and thereby, may reduce oral health inequalities. Further research is needed to examine the effectiveness of such policies. 相似文献19.
Introduction
Mandibular premolars that have rare and complex anatomies may have the highest failure rate in nonsurgical endodontic treatment. Awareness of rare and complex anatomies of mandibular second premolars would aid in better outcomes of the treatment. This study aimed to evaluate the success of nonsurgical root canal treatment of mandibular second premolar teeth with complex apical branching.Methods
Twenty-six mandibular second premolar teeth with complex apical branching treated with multiple-visit nonsurgical root canal treatment or nonsurgical retreatment were retrospectively evaluated.Results
For the clinical outcomes, 9 subjects had complete healing, 1 subject had functional healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had functional healing, and 2 subjects had no healing scores out of 16 retreatment subjects. For the radiographic outcomes, 7 subjects had complete healing, 3 subjects had incomplete healing, and no subject had no healing scores out of 10 root canal treatment subjects. Six subjects had complete healing, 8 subjects had incomplete healing, and 2 subjects had no healing scores out of 16 retreatment subjects. The clinical outcome of root canal treatment subjects was significantly different than retreatment subjects (P < .05). Similarly, the radiographic outcome of root canal treatment subjects was also significantly different than retreatment cases (P < .05).Conclusions
The outcome of endodontic treatment of mandibular second premolars may be influenced by treatment type. 相似文献20.