The effect of multiple uses of disposable diamond burs on restoration leakage

BACKGROUND: The authors tested the clinical longevity of disposable diamond burs. They cut a series of five preparations and assessed the leakage after restoring the tooth. METHODS: The authors prepared 10 teeth for Class V restorations, and used a new disposable diamond bur for each tooth. The burs were used to cut preparations in extra teeth before being used to prepare a second series of 10 teeth (third use). The authors then cut preparations in extra teeth before preparing a third set of 10 teeth (fifth use). They removed existing restorations in a second group of 30 teeth and extended the preparations using the same regimen of one, three and five bur uses. All preparations were etched and conditioned, and the teeth were restored with resin-based composite. Using a 20-volt direct-current power source and a stainless-steel counter electrode, the authors measured the leakage electrochemically in 1.0 percent sodium chloride for 30 days. RESULTS: Freshly prepared and restored teeth leaked less than reprepared teeth. Leakage was similar for the first and third uses of the bur, but was far greater for the fifth use (P < .01). The previously restored teeth that were cut with the first- and third-use burs behaved the same, but the third-use bur caused more leakage than the fifth-use bur (P < .01). CONCLUSIONS: Reuse of disposable burs can affect leakage behavior. With new preparations, use of a disposable bur to cut more than three preparations increased leakage. For teeth that were reprepared and restored, greater leakage occurred than it did with new preparations, although repeated use of a bur may reduce leakage. CLINICAL IMPLICATIONS: Disposable diamond burs may cut preparations in up to three teeth before adversely affecting leakage behavior. Restoration removal and repreparation of teeth results in greater leakage than that with freshly prepared teeth.     

Quantified simulation of canine retraction: evaluation of frictional resistance

The purpose of this study was to evaluate the frictional resistance of various bracket/archwire combinations. The friction testing apparatus allowed dynamic and progressive bracket tipping and uprighting concurrent with linear bracket traction which experimentally approximated canine retraction with sliding mechanics. Multiple ANOVA using general linear models procedure demonstrated significant effects (P < 0.05) for bracket type, archwire type, archwire size, and archwire shape, as well as pair-wise interactions for bracket type/archwire type, bracket type/archwire size, bracket type/archwire shape, archwire type/archwire size, archwire type/archwire shape, and archwire size/archwire shape. Duncan’s multiple range test (P < 0.05) revealed the general trends regarding frictional performance of brackets and archwires tested, while Least squares means table (P < 0.05) illustrated significant interactions of pair-wise factors that differed from the general trends. It was concluded that: (1) Ceramic brackets with and without metal slots had the greatest friction followed by metal brackets, active self-ligating brackets, variable self-ligating brackets, and passive self-ligating brackets. (2) Stainless steel and braided stainless archwires measured greater friction than nickel-titanium. (3) Smaller dimension wires had less friction than larger wires, and round wires had less friction than rectangular wires. In addition, consideration of specific bracket-archwire coupling appear to reduce the frictional resistance with sliding.     

Gene expression analysis in cells of the dentine-pulp complex in healthy and carious teeth

Knowledge of the molecular events that occur in carious disease has so far been constrained due to difficulties in obtaining sufficient quantities of the dental tissues and cells involved. Our histological findings indicate that a pulp-odontoblast cellular complex can be obtained from carious and healthy human teeth when exposed to low-temperatures prior to pulpal extirpation and from rodent teeth processed at room-temperature. In contrast, pulpal tissue extracted from room-temperature processed human teeth and low-temperature processed rodent teeth resulted in the odontoblast layer remaining attached to the pulp chamber. Semi-quantitative RT-PCR (sq-RT-PCR) analysis confirmed that markers previously shown to be preferentially expressed in odontoblasts, namely dentin sialophosphoprotein (DSPP) and Nestin, amplified more readily from the extracted pulp-odontoblast complex, as compared to pulpal tissue alone, in both human and rodent samples. Subsequent gene expression analysis of collagen-1alpha and collagen-3alpha indicated levels were significantly higher in carious pulpal tissue. In addition, analysis characterising the expression of members of the transforming growth factor and bone morphogenic protein families and their receptors indicated in general, that these genes were expressed by healthy odontoblasts and up-regulated in both pulpal cells and odontoblasts in response to carious injury. Use of this temperature-sensitive dental tissue preparation procedure allows detection of differential gene expression in odontoblasts and other pulpal cells in healthy and carious tissue.     

Evidence for charge domains on developing enamel crystal surfaces

The control of hydroxyapatite crystal initiation and growth during enamel development is thought to be mediated via the proteins of the extracellular matrix. However, the precise nature of these matrix-mineral interactions remains obscure. The aim of the present study was to use a combination of atomic and chemical force microscopy to characterize developing enamel crystal surfaces and to determine their relationship with endogenous enamel matrix protein (amelogenin). The results show regular and discrete domains of various charges or charge densities on the surfaces of hydroxyapatite crystals derived from the maturation stage of enamel development. Binding of amelogenin to individual crystals at physiological pH was seen to be coincident with positively charged surface domains. These domains may therefore provide an instructional template for matrix-mineral interactions. Alternatively, the alternating array of charge on the crystal surfaces may reflect the original relationship with, and influence of, matrix interaction with the crystal surfaces during crystal growth.     

Post-orthodontic occlusal function

The significance of orthodontic treatment in the aetiology of temporomandibular dysfunction continues to be a matter of controversy. However, the evidence of any association has been generally negative. This investigation involved the examination of a study group of 87 post-orthodontic patients, the average time out of all retention being 52 months. They were compared with an untreated control group. Signs and symptoms of temporomandibular disfunction were assessed for both groups. In only one instance, soft joint click, was there found to be a significant association between the treatment category and the occurrence of the symptom, there being a higher rate of soft clicks in the post-treatment group. While this may be ascribed to orthodontic treatment, there was also a different restorative pattern in the two groups. No other significant associations were found.     

The post-operative maxillary cyst. Experience with 23 cases

23 cases, diagnosed as post-operative maxillary cyst, from outside Japan are described. Clinical, radiographic and histopathological features are not dissimilar to those cases reported from Japan, and various parameters have been found to be helpful in diagnosis. This lesion is more common outside Japan than previously suggested, and this is probably largely due to faulty diagnosis.     

Laboratory assessment of the Sensodyne Mikro Aktiv extra soft toothbrush and the Oral-B indicator soft toothbrush

OBJECTIVE: The objective of this laboratory study was to assess the Sensodyne Mikro Aktiv extra soft toothbrush, compared with the Oral-B Indicator soft toothbrush, for interproximal access efficacy (IAE). METHODS: Six toothbrushes of each product were tested four times, for a total of twenty-four tests on each toothbrush design. In the IAE assay, the tooth brushing technique involved independent evaluations of each toothbrush in a vertical or horizontal brushing motion, tooth shapes simulating anterior and posterior teeth, and a brushing weight of 250 g. The brushing apparatus was set to brush for 15 seconds at two strokes per second with a 50 mm stroke. All readings were measured with 3x magnification by a single investigator. RESULTS: The mean IAE value on anterior tooth shapes, with vertical and horizontal brushing, was significantly (p < 0.001) higher for the Sensodyne Mikro Aktiv toothbrush than for the Oral-B Indicator toothbrush. When the IAE values were combined to give an overall brushing average, the Sensodyne Mikro Aktiv toothbrush was significantly (p < 0.001) higher compared to the Oral-B Indicator toothbrush. CONCLUSION: The Sensodyne Mikro Aktiv toothbrush has demonstrated superiority to the Oral-B Indicator toothbrush for access into interproximal areas using this laboratory methodology.     

Prions and the oral cavity

Prion diseases have recently emerged as a significant challenge to health-care workers, including those involved in dentistry. Abnormal prion proteins are resistant to complete inactivation by conventional sterilization techniques. In the last decade, a new form of prion disease emerged in the UK, termed "variant CJD", thought to be acquired by consumption of bovine spongiform encephalopathy-contaminated food products. At present, CJD is an invariably fatal disease with no immediate prospect of treatment or vaccination. Of concern with the variant form of CJD, unlike the more classic forms of the disease, is the appearance of significant levels of infectivity outside the central nervous system. This raises concerns for the potential transmission of prion proteins via surgical procedures from individuals in the asymptomatic stage of the disease. This article reviews the existing knowledge base on the nature of prions, their distribution in oral tissues, and the implications for dental treatment.