A European perspective on fluoride use in seven countries

Abstract -  Objectives: The aim of this study was to collate data on national policies for the use of fluoride in the seven European countries participating in the FLINT project. Methods: Policies on the use of fluoride were obtained for each of the study areas. Data collected included the presence of water fluoridation and regulations governing fluoride toothpaste and fluoride supplements. Results: In Ireland 74% of the population had a fluoridated water supply but in all the other countries fluoride toothpaste was the principal form of delivering fluoride, usually recommended as a dose of a pea-sized amount. Fluoride supplement use varied considerably between countries. The Netherlands had the clearest regulations covering the use of fluoride supplements and definition of at-risk individuals. Most countries, even if they recognized particular caries-risk did not define the term clearly. In Iceland all children were regarded as being at high risk of developing caries. Conclusion: Considerable variation exists between European countries in their policies for fluoride use and no clear definitions of high-caries-risk individuals were found. The results show that there is even a lack of coherent thought and planning within the different countries, let alone between them.     

Preformed acrylic cranial implants using fused deposition modeling: a clinical report

Fabrication of acrylic cranial implants by conventional methods of moulage and mold formation may be difficult when the margin of the defect cannot be accurately detected. Three-dimensional anatomic models built by fused deposition modeling can serve as templates for the fabrication of custom acrylic implants for large or complicated cranial defects. Virtual mirror imaging of the contralateral nondefect side can facilitate the restoration of symmetry in appearance-sensitive areas. This clinical report presents a method for the fabrication of cranial implants for 2 patients using anatomic modeling technology.     

Soft tissue management in endodontic surgery

Modern endodontic surgery involves both root-end preparation and proper sealing of all apical portals of exit. Both components are requirements for mechanical and biological success, but the management of soft tissues becomes increasingly important for an esthetically successful treatment. A healthy appearance of soft tissues plays an important role in the esthetic outcome of periradicular surgery. This is true considering maintenance of attachment levels and regarding the amount of possible recession after surgical procedures. Complete, recession-free and predictable healing of gingival tissue is one important goal of endodontic surgical treatment. A critical review of currently used techniques based on clinical and scientific data reveals great potential for improvements. Possible reasons for scar formation and recession specifically in healthy periodontal conditions requiring surgical endodontic intervention are highlighted. Based on anatomical considerations various incision types are evaluated and recommendations made. Clear understanding of wound closure and tissue-healing patterns call for the use of atraumatic procedures, nonirritating suture materials and adequate suturing techniques. This article gives an overview and guidance for integrating current and new successful flap designs and wound closure methods. The methods described have the intention of maintaining the attachment level and avoiding postoperative recession after surgical endodontic therapy.     

Density of dentinal tubules affects the tensile strength of root dentin.

OBJECTIVES: The aim of this study is to count the dentinal tubules in the coronal and middle-apical third of root dentin of teeth extracted due to the progression of periodontal disease, and to compare the Ultimate Tensile Strength (UTS) of the same areas. The research hypothesis was that root dentin areas with different densities of dentinal tubules would also show different UTS values. METHODS: From 10 caries free maxillary central, lateral incisors and canines, extracted for periodontal reasons from three patients, cylindrical specimens approximately 10 mm long were prepared parallel to the long axis of the root and then divided into two parts using a low speed diamond saw one from the coronal third of the root, (Group 1) and one from the middle-apical third of the root (Group 2). The density of the dentinal tubules of the specimens of the two groups was measured by means of a scanning electron microscope and the UTS of the specimens was measured by a microtensile test. One way ANOVA was used to assess the effect of specimen location (coronal specimens vs. middle-apical specimens) on UTS. The differences in the density of dentinal tubules between coronal and middle-apical specimens were also subjected to statistical analysis using one-way ANOVA. RESULTS: UTS values of middle-apical specimens were found to be significantly (p < 0.05) higher than those of coronal specimens. The results of the one-way analysis of variance showed that the number of dentinal tubules of the samples from the coronal part of the root groups was significantly higher than that of samples from the middle-apical part (p < 0.05). SIGNIFICANCE: These results suggest that high values of tensile strength of the dentin are associated with low densities of dentinal tubules and that apical areas of root dentin are more resistant to tension than coronal ones.     

A scanning electron microscope study of dentinal tubule continuity in monkey tooth sections

Abstract The American Dental Association (ADA) and Federation Dentaire Internationale (FDI) specifications for the biological evaluation of dental materials in experimental Cavities in dentine require that sections permit dentinal tubules to be followed from cavity floor to pulp lumen. The aim of this study was to investigate this requirement in the specification. Twenty hematoxylin and eosin stained sections of vervet monkey incisor teeth satisfying the ADA and FDI specifications were selected. Adjacent unstained sections of the same specimens were prepared for scanning electron microscopy, and a low power photomicrograph was taken of the dentine between the cavity floor and pulp for each specimen. Two areas on each photomicrograph were selected using a superimposed grid and random number table and this area was re-photographed at higher magnification on the specimen. A histometric analysis of the 40 SEM photomicrographs thus prepared showed that the dentinal tubules in 14 specimens were cut in cross-section, 14 were tangential and only 12 were longitudinal sections. None of die tubules examined in the high power photomicrographs was continuous. It is concluded that serial section evaluation of the area encompassing die entire cavity as well as a few sections before and beyond the cavity zone should be considered for inclusion in die specifications.     

Effect of root curvature on post length in the restoration of endodontically treated premolars

Abstract Two hundred and eighteen bi-rooted maxillary premolars were examined radio graphically to determine the length from the apex at which root curvature occurred. The information may serve as a guide in determining post preparation length. The results of the study indicated that the lingual root was slightly straighter than the buccal root. The curvature of the root was on the average 6.47 mm from the apex on the buccal root and 5.18 mm from the apex on the lingual root.     

Changes in matrix phosphorylation during bovine dentin development

Phosphorylation of the organic matrix proteins of dentin is important for the initiation of mineralization, but its relevance in later mineralization stages is controversial. The objective of this study was to analyze changes in the total matrix phosphate content during dentin development and to identify their origin. Amino acid and total matrix phosphate analyses of microdissected developing mantle and circumpulpal fetal bovine dentin specimens were performed. The amino acid composition showed few changes during mantle and circumpulpal dentin maturation. However, the total matrix phosphate content showed a significant, positive correlation with tissue maturation in both mantle and circumpulpal dentin, with a two- and a three-fold increase, respectively, being observed. The data indicate that changes occur in the pattern of phosphorylation of matrix proteins during dentin maturation, which we suggest may play a functional role in later stages of tooth mineralization.     

Teeth with large amalgam restorations and crowns: factors affecting the receipt of subsequent treatment after 10 years

BACKGROUND: The authors evaluated the factors associated with the receipt of subsequent treatment by teeth restored with a large amalgam restoration or a large amalgam restoration and crown restoration after 10 years. METHODS: The authors used retrospective data from the University of Iowa College of Dentistry (Iowa City, Iowa) administrative database and patient records to evaluate patient and tooth factors for their association with the two primary outcomes: receipt of any subsequent treatment and receipt of catastrophic treatment (extraction, endodontic therapy). RESULTS: The authors followed 518 teeth over a 10-year period (49 percent with large amalgam restorations and 51 percent with crowns). Sixty-four percent of the large amalgam restorations and 32 percent of the crowns received subsequent treatment during the 10 years. In addition to restoration type, the patient's sex, history of grinding teeth and having a broken tooth were related to the tooth's receiving subsequent treatment. Twenty-two percent of large amalgam restorations and 12 percent of crowns received catastrophic treatment with the odds of teeth with large amalgam restorations receiving a catastrophic treatment being 2.1 times the odds of teeth with crowns receiving catastrophic treatment. CONCLUSIONS: Teeth with crowns were less likely to receive any treatment or catastrophic treatment over 10 years than were teeth with large amalgam restorations. Patient and tooth factors also were related to a tooth experiencing subsequent treatment. CLINICAL IMPLICATIONS: Teeth with crowns received less subsequent treatment than teeth with large amalgam restorations. This could be related to both the difference in longevity between the two restorations, as well as how appropriately treatment was planned for each procedure. Cost differences between the two restorations need to be factored into the decision-making process.     

Prevalence of dental disease amongst 5-6 and 12-13 year old school children of Puttur municipality, Karnataka State-India

A survey was conducted among 5-6 and 12-13 years old school children of Puttur municipality, Karnataka State, India, to assess the prevalence of dental caries, malocclusion and dental calculus. A sample size of 200 subjects was taken for each age group and cluster-sampling method was used to select those schools which were to be included in the sample frame. Data collection was done using the Basic Oral Health Survey (WHO) form. The deciduous dentition alone was considered for 5-6 year old subjects while the permanent dentition alone was considered for those aged 12-13 years. A total of 427 subjects from 7 schools were studied. Results indicated that 81.25% of 5-6 year old subjects had dental caries (mean dmft = 4.86 +/- 4.16 S.D.) as compared to 59.6% of 12-13 year old (mean DMFT = 1.87 +/- 2.01 S.D.). The prevalence of malocclusion was 1.79% and 36.95% among those aged 5-6 year and 12-13 year, respectively. None of the 5-6 years old subjects had calculus on their teeth while 47.78% of 12-13 year old subjects exhibited the presence of dental calculus. Overall the prevalence of dental caries was found to be significantly higher among 5-6 year old subjects compared to 12-13 year old subjects. The prevalence of malocclusion and dental calculus was significantly higher among 12-13 year old subjects compared to 5-6 year old subjects.     

A survey of deans: trends, challenges, and mentoring in prosthodontics. Part 2.

PURPOSE: This study consists of two parts. Part 1, a survey of program directors, was conducted to examine current trends in advanced education in prosthodontics in the United States. Part 2 reports on the findings of a survey distributed to the deans of US dental schools to evaluate their observations of trends in prosthodontic education. MATERIALS AND METHODS: A national, electronic survey of 55 dental school deans was distributed by e-mail to evaluate an interest in specialty training, an interest in specialization in prosthodontics, faculty shortages, programs to address faculty shortages, predoctoral curriculum in prosthodontics, opinions regarding dental specialties, and the administrative position of prosthodontics within the schools. RESULTS: Of the 55 deans, 44 deans responded, an 80% response rate. Only five deans reported a decrease in the number of students seeking specialty training after dental school. The remaining 39 deans reported a large increase, slight increase, or no change in those seeking specialty training. In 29.6% of the deans' responses, an increased interest in prosthodontics was reported, whereas 16 deans reported no change in the level of interest. One or more open faculty positions in prosthodontics existed at 29 dental schools, and 28 schools offered at least one incentive or a variety of incentives to recruit faculty. The respondents to the deans' survey revealed predoctoral student exposure to prosthodontists was high, and exposure to postgraduate prosthodontics students was low. A survey of internal school programs that might have an impact on an increased interest in prosthodontics revealed the presence of a predoctoral mentoring program for prosthodontics in 80% of the institutions. The clinical curriculum included treatment of a variety of cases, including complex cases as defined by a diagnostic classification system. The response to whether dental specialties should be combined or remain individual provided some interesting data. Only 40.9% of the deans responded that prosthodontics was a separate department. CONCLUSION: Dental school deans reported an increased interest in specialty training. Predoctoral student exposure to prosthodontics was high due to the nature of their clinical experience and due to the exposure to full-time prosthodontics faculty. Many dental schools have programs, such as mentoring and new technology, which might have an impact on predoctoral students' increased interest in prosthodontics.