Clinical evaluation of the Carisolv chemomechanical caries removal technique according to the site/stage concept,a revised caries classification system

The objective of the present study was to assess the efficiency and benefit of a chemomechanical system for carious dentin removal, Carisolv, in general practice. A revised caries classification, the site/stage concept, was used to describe the clinical situations of all carious lesions treated. The study was performed by 12 investigators, and 120 carious lesions were treated with Carisolv. Sixty percent of the cases were treated without anaesthesia, and we found a significant correlation between chemomechanical treatment without anaesthesia and absence of pain ( P=0.01). In 78.3% of the cases, carious dentin was totally removed with Carisolv, and in 21.7%, the dentin treatment was completed by drilling. In cases performed with Carisolv alone, the time required to remove carious dentin was 11.1+/-9.51 min (mean+/-SD). Treatment time was equivalent for all sites and increased significantly with each successive stage of lesion progression ( P<0.001). In 82.5% of cases, the clinicians were satisfied with Carisolv, and in 99.2%, so were the patients. We conclude that, using clinical examination methods, Carisolv seems to remove carious dentin at all sites and stages of carious lesions but must be made more efficient for use in general practice.     

The prevalence of periodontal-related changes in adolescents with asthma: results of the Third Annual National Health and Nutrition Examination Survey

PURPOSE: The purpose of this study was to explore the association between asthma and periodontal disease in adolescents using oral examination and health interview data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994. METHODS: The study population comprised 1,596 adolescents 13 to 17 years of age: 253 (16%) asthmatics and 1,358 (84%) nonasthmatic controls who were examined for bleeding on probing (BOP), subgingival calculus (SBC), supragingival calculus (SPC), probing depth greater than or equal to 3 mm (PD), and loss of periodontal attachment greater than or equal to 2 mm (LPA). The authors fitted separate multivariate GEE Poisson regression models adjusting for parents' income, gender, race, exposure to potentially xerogenic drugs (antihistamines, corticosteroids, and inhalers), tobacco exposure, and dental examination within the past year. RESULTS: None of the periodontal measures was associated with asthma severity or with the use of antiasthmatic drugs. However, several covariates had statistically significant odds ratios (P < .05). CONCLUSIONS: There was no evidence to support the association between asthma and periodontal health in the adolescent population. Since the findings may be due to the inherent limitations of cross-sectional studies, the lack of knowledge about the daily dose of antiasthmatic medication, and the level of-compliance with the therapeutic regimen, future studies should be longitudinal and monitor medication use.     

Endpoint quantitative PCR assays for Bacteroides forsythus,Porphyromonas gingivalis,and Actinobacillus actinomycetemcomitans

BACKGROUND: Conventional polymerase chain reaction (PCR) assays for periodontal pathogens are so sensitive that they detect infections of no clinical significance. Quantitative PCR (qPCR) may provide a solution to this problem. However, most qPCR systems require expensive real-time thermal cyclers. OBJECTIVE: Our goal was to develop qPCR assays which would allow endpoint quantification. MATERIALS AND METHODS: 16S rRNA primers for Bacteroides forsythus, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans were adapted to the Amplifluor qPCR system, which incorporates fluorescein into the PCR product so that endpoint fluorescence is proportional to the original amount of template. DNA dilutions representing known numbers of cells were used as standard curves. Pooled subgingival plaques from the four deepest pockets of 21 severe adult periodontitis patients were assayed. Buccal molar supragingival plaque from 35 dental students provided healthy controls. Endpoint fluorescence was measured with a microplate reader. RESULTS: Optimized standard curves were linear in log-log or semilog fits over a range of 100-10(6) cells. Countable B. forsythus was present in all patients, with counts (as logs) from 2.4 to 7.3 (mean = 5.0), and 11 controls with counts from 2.1 to 4.5 (mean = 3.0). P. gingivalis was present in 11 patients and no controls, with counts from 2.2 to 4.7 (mean = 3.2). A. actinomycetemcomitans was present in two patients, with counts of 1.5 and 3.5. CONCLUSIONS: Amplifluor qPCR assays discriminated between plaque samples differing by one log or more, allowing major infections to be distinguished from minor ones. This approach allows high-throughput qPCR of plaque samples, using equipment available to many laboratories.     

An optimized synthetic substrate for orthodontic bond strength testing

OBJECTIVE: The purpose of this study was to investigate the suitability of different synthetic calcium phosphate based substrates as a biomimetic enamel surface model for orthodontic bond strength testing. METHODS: Carbonated apatite, amorphous calcium phosphate and commercial hydroxyapatite specimens were prepared as substrates for orthodontic bond strength testing. Carbonated apatite specimens were prepared by pressing, sintering and treatment with NaF. The shear bond strength was measured with a universal testing machine. RESULTS: Hydroxyapatite, amorphous and cold pressed carbonated hydroxyapatite exhibited fractures within the substrate after debonding. Mean bond strength values for carbonated hydroxyapatite were 7.38 (1.75) MPa for specimens pressed at 300 degrees C and 9.55 (2.23) MPa for specimens pressed at 300 degrees C and then sintered at 600 degrees C. An additional NaF treatment after sintering resulted in lower bond strength measurements of on average 6.52 (1.03) MPa. SIGNIFICANCE: Hot pressed and sintered carbonated hydroxyapatite showed acceptable shear bond strength values and may represent a suitable biomimetic model for orthodontic bond strength testing.