Baseline characteristics as 3-year predictors of tooth fracture and crack progression: Findings from The National Dental Practice-Based Research Network

BackgroundThe authors of this practice-based study estimated the risk of experiencing tooth fractures and crack progression over 3 years and correlated baseline patient-, tooth-, and crack-level characteristics with these outcomes.MethodsTwo-hundred-and-nine National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2,601 participants with a cracked vital posterior tooth that had been examined for at least 1 recall visit over 3 years. Data were collected at the patient, tooth, and crack levels at baseline, annual follow-up visits, and any interim visits. Associations between these characteristics and the subsequent same-tooth fractures and crack progression were quantified.ResultsOf the 2,601 teeth with a crack or cracks at baseline, 78 (3.0%; 95% confidence interval, 2.4% to 3.7%) subsequently developed a fracture. Of the 1,889 patients untreated before year 1, 232 (12.3%; 95% confidence interval, 10.9% to 13.8%) had some type of crack progression. Baseline tooth-level characteristics associated with tooth fracture were the tooth was maxillary and had a wear facet through enamel and a crack was detectable with an explorer, on the facial surface, and in a horizontal direction. Crack progression was associated with males and teeth with multiple cracks at baseline; teeth with a baseline facial crack were less likely to show crack progression. There was no commonality between characteristics associated with tooth fracture and those associated with crack progression.ConclusionsDevelopment of tooth fractures and crack progression over 3 years were rare occurrences. Specific characteristics were associated with the development of tooth fracture and crack progression, although none were common to both.Practical ImplicationsThis information can aid dentists in assessing factors that place posterior cracked teeth at risk of experiencing adverse outcomes.     

Longitudinal dental arch changes in the mixed dentition

The purpose of this study was to investigate dental arch changes that occurred during the mixed dentition in 30 normal occlusion children. Two analyses were done. The first one was at the age of early mixed dentition and the second at the age of late mixed dentition. Most width variables were greater in the males, and depth variables greater in the female subjects. A directionally larger left side of the maxilla and right side of the mandible were observed. Our findings indicate that most arch width dimensions are established in the early mixed dentition. We conclude that the period between the early and late mixed dentition is suitable for environmental factors to disrupt the ideal symmetrical developmental pattern because more growth and developmental changes occur after a relatively stabile period of deciduous dentition.     

Dental practitioners’ use of health risk assessments for a variety of health conditions: Results from the South Atlantic region of The National Dental Practice-Based Research Network

BackgroundAn important step in integrating dental and medical care is improving understanding of the frequency and characteristics of dental practitioners who conduct health risk assessments (HRAs).MethodsFrom September 2017 through July 2018, active dentist and hygienist members of the South Atlantic region of The National Dental Practice-Based Research Network (N = 870) were invited to participate in a survey evaluating their HRA practices (screening, measuring, discussing, referring patients) for 6 health conditions (obesity, hypertension, sexual activities, diabetes, alcohol use, tobacco use). For each health condition, the authors used ordinal logistic regression to measure the associations among the practitioner’s HRA practices and the practitioner’s characteristics, barriers, and practice characteristics.ResultsMost of the 475 responding practitioners (≥ 72%) reported they at least occasionally complete 1 or more HRA steps for the health conditions except sexual activities. Most practitioners screened (that is, asked about) and gave referral information to affected patients for diabetes (56%) and hypertension (63%). Factors associated with each increased HRA practice for 2 or more outcomes were non-Hispanic white compared with Hispanic practitioner (cumulative odds ratio [COR] obesity, 0.4; 95% confidence interval [CI], 0.2 to 0.8; and COR diabetes, 0.3; 95% CI 0.2 to 0.8), male compared with female practitioner (COR tobacco, 0.3; 95% CI, 0.2 to 0.7; and COR hypertension, 0.4; 95% CI 0.2 to 0.8), and practitioner discomfort (COR, obesity and alcohol use, 0.7; 95% CI, 0.6 to 0.9; and COR, sexual activities 0.6; 95% CI 0.5 to 0.8).Conclusions and Practical ImplicationsDental practitioners are conducting HRA practices for multiple conditions. Interventions should focus on reducing practitioner discomfort and target non-Hispanic white, male practitioners.     

Outcomes of treatment and monitoring of posterior teeth with cracks: three-year results from the National Dental Practice-Based Research Network

Clinical Oral Investigations - To describe treatment and monitoring outcomes of posterior teeth with cracks at baseline followed in the National Dental Practice-Based Research Network for up to...     

Growth inhibition of MXT mammary carcinoma by enhancing programmed cell death (apoptosis) with analogs of LH-RH and somatostatin

BDF female mice inoculated with MXT mammary adenocarcinoma were treated for 30 days with microcapsules of the luteinizing hormone-releasing hormone (LH-RH) agonist D-Trp-6-LH-RH (releasing 25µg/day for 30 days), microcapsules of the somatostatin agonist RC-160 (liberating 25µg/day for one month), or the combination of these peptides. Bilateral surgical ovariectomy was performed in one group which served as an additional control. Tumor volume was measured weekly during the treatment period of 30 days. When tumor volume changes in the treated groups were compared to the corresponding changes in controls, the combination of D-Trp-6-LH-RH and RC-160 was the most effective in inhibiting tumor growth and approached the effect of surgical ovariectomy. At the conclusion of the experiment, tumor weights were also measured. All peptide analogs inhibited tumor weight by 42 to 63%. In the D-Trp-6-LH-RH treated group, ovarian weights and uterine weights decreased by 48% and 52%, respectively, as compared to controls. Histologically, the regressive changes in tumors caused by the treatment with RC-160, D-Trp-6-LH-RH and their combination were characterized by the coexistence of apoptosis (programmed cell death) and coagulation necrosis. The transition of apoptosis into coagulation necrosis was a common finding. The term apoptotic index is proposed for the ratio of tumorous glands containing apoptotic cells. The apoptotic index was higher in the treated groups than in the control.     

Quantitative computed tomography for spinal mineral assessment: current status

Quantitative CT (QCT) is an established method for the noninvasive assessment of bone mineral content in the vertebral spongiosum and other anatomic locations. The potential strengths of QCT relative to dual photon absorptiometry (DPA) are its capability for precise three-dimensional anatomic localization providing a direct density measurement and its capability for spatial separation of highly responsive cancellous bone from less responsive cortical bone. The extraction of this quantitative information from the CT image, however, requires sophisticated calibration and positioning techniques and careful technical monitoring.