Prevalence of Nontraditional Dental Hygiene Practice

There is little knowledge of the number or the work characteristics of dental hygienists outside the private-practice setting. This survey was conducted to determine the percentage of hygienists practicing in nontraditional (nonprivate-practice) settings and the types of settings in which they are employed. Mail questionnaires were returned from a total of 21,847 (56.9%) of the hygienists in the survey sample. The percentage of active hygienists practicing in nontraditional settings was 11.8. Dental or dental hygiene schools, and government and nongovernment-supported clinics were the most frequent nontraditional practice settings. State supervision requirements were found to be associated significantly with the prevalence of nontraditional hygiene practice.     

Effects of preservation on the osteoinductive capacity of demineralized bone powder allografts

Demineralized bone powder (DBP) has repeatedly been shown to serve as an osteoinductive material. The aim of this study was to investigate the effects of different methods of storage of DBP on its osteoinductive property. Forty-five Long Evan rats were used in this study. Twenty rats were used as donors; the diaphyses of their femoral bones were used for the preparation of DBP. The DBP was divided into four portions that were either lyophilized or frozen at -70 degrees C, -4 degrees C, or kept at room temperature (25 degrees C). All samples were stored under the specified condition for six months. At the time of implantation, fresh DBP was prepared and used as a control. Twenty-five rats were divided equally into five groups. Each group received an implant of either one of the differently preserved and stored samples of DBP or fresh DBP. The animals were killed 60 days following implantation. The implants were excised and processed to obtain 5 micron thick decalcified sections and 3 micron thick undecalcified sections. Semicomputerized histomorphometry was used for the quantification of the newly-formed bone in each implant. Newly-formed bone was detected in all experimental and control groups and there were no statistically significant differences between the various groups. It was concluded that DBP retains its osteoinductivity after lyophilization or preservation at -70 degrees C, -4 degrees C, and 25 degrees C for a period of up to six months, and that the different methods of preservation did not significantly affect the amount of the induced newly-formed bone.(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of recombinant human bone morphogenetic protein-2 in mandibular distraction osteogenesis in rabbits: Effect of dosage and number of doses on formation of bone

We evaluated the dose- and time-dependent response of recombinant human bone morphogenetic protein-2 (rhBMP-2) to the formation of bone in mandibular distraction osteogenesis. Twenty-one adult white New Zealand rabbits (3.0-3.8 kg) were used to establish the mandibular distraction model, 18 of which completed the experiment. Eight rabbits were given rhBMP-2 360 microg and eight 1080 microg; two were given no rhBMP-2. The fluids were injected into the regenerating bone at three different time sequences (days 5, 8, and 11 of active distraction; days 5 and 11 of active distraction; and day 11 of active distraction alone). After four weeks of consolidation, the specimens were harvested and examined radiographically by micro-computed tomography (micro-CT), and histologically. The formation and remodelling of bone in distraction osteogenesis was significantly increased by the addition of rhBMP-2, and the increase was dose-dependent. There was no significant difference between different dosage regimens. A single injection of rhBMP-2 at the end of the distraction phase was as effective as multiple injections.     

Effect of opacifiers on color stability of pigmented maxillofacial silicone A-2186 subjected to artificial aging

PURPOSE: This study was designed to determine the effect of opacifiers used at different ratios on the color stability of pigmented A-2186 silicone maxillofacial elastomers and to evaluate the color spectrophotometrically before and after artificial aging. MATERIALS AND METHODS: Sixty experimental groups of elastomers were made using various concentrations (5%, 10%, and 15%) of 4 opacifiers (Georgia kaolin powder neutral, kaolin powder calcined, Artskin white, and dry pigment titanium white) with 1 of 5 dry earth cosmetic pigment groups (no pigment [control], red, yellow ochre, burnt sienna, and a mixture of all pigments). Five specimens of each elastomer were tested, for a total of 300 specimens. All specimens were placed in an aging chamber and artificially aged by exposure to light, water spray, fluctuating temperatures, and humidity. CIE L*a*b* values were measured by spectrophotometer. The color differences (Delta E*) at various exposure energies (150, 300, and 450 kJ/m(2)) were subjected to 4-way analysis of variance with repeated measures (super ANOVA). Mean values were compared with Tukey-Kramer intervals calculated at the 0.05 significance level. RESULTS: The trained human eye can detect color changes (Delta E*) greater than 1.0. Adding all pigments to any of the kaolin groups did not protect silicone A-2186 from color degradation over time. Mixing red pigment in all groups at all times drastically increased DeltaE* values ranging from 0.1 to 1.3 up to 16.6 to 49.6. Yellow ochre had an effect only with 10% and 15% concentrations of kaolin powder calcined, increasing the value of Delta E* to greater than 1.0. Burnt sienna had an effect only with a 15% concentration of kaolin powder calcined, increasing the value of Delta E* at 300 and 450 kJ/m(2) to greater than 11.0. At the 5% concentration, kaolin powder calcined had the smallest color changes, followed by, in order, dry pigment titanium white, Artskin white, and Georgia kaolin. At the 10% concentration, Artskin white had the smallest color changes, followed by, in order, dry pigment titanium white, kaolin powder calcined, and Georgia kaolin. At the 15% concentration, Artskin white again had the smallest color changes, followed by, in order, dry pigment titanium white, Georgia kaolin, and the kaolin powder calcined. The smallest color changes in each kaolin group were at the 10% concentration for Artskin white, dry pigment titanium white, and kaolin powder calcined and at the 5% concentration for Georgia kaolin. CONCLUSIONS: Mixing dry earth cosmetic pigments with opacifiers did not protect silicone A-2186 from color degradation over time, especially in the case of red pigment. The group in which pigments were mixed with 10% Artskin white had the smallest color changes over time, followed by, in order, the groups in which pigments were mixed with 10% dry pigment titanium white, 10% kaolin powder calcined, and 5% Georgia kaolin. Red pigment had a significant effect on all opacifiers, especially Georgia kaolin and kaolin powder calcined. Yellow ochre and burnt sienna had an effect only on 15% kaolin powder calcined. Among all the pigment groups tested, yellow ochre remained the most color stable over time.     

Application of neural networks to the prediction of lymph node metastasis in oral cancer

Neural networks are a new type of computing algorithm. They are especially useful in pattern recognition. In this study we applied neural networks to the prediction of lymph node metastasis of patients with oral cancer. A data set of 1,116 lymph nodes verified histopathologically was used to train and evaluate the neural networks. Various three-layer feed-forward networks with a back-propagation algorithm were employed in this study. Performance of the neural networks was compared with that of radiologists and discriminant analysis (Quantification theory type II). Neural networks had a sensitivity of 80.6% and a specificity of 94.6%. Diagnostic accuracy of the neural networks was 93.6%, which was comparable to those of discriminant analysis and clinical radiologists.     

Pulp response in primary teeth with deep residual caries treated with silver fluoride and glass ionomer cement ('atraumatic' technique)

A bstract — Histological assessment of the dental pulps of 55 carious primary teeth was carried out 3 to 56 months after treatment by the 'atraumatic' technique involving application of 40 per cent silver fluoride to residual caries followed by restoration with glass ionomer cement. Fifty of the 55 teeth examined showed a favourable pulpal response, including presence of abundant reparative dentine and a wide odontoblast layer. Histological comparisons were made between these teeth and others not treated with silver fluoride but restored with glass ionomer cement, amalgam or zinc oxide and eugenol.
Possible mechanisms of the action of silver fluoride in arresting residual caries are discussed. The question of whether or not treatment of carious dentine with silver fluoride represents a biologically acceptable clinical procedure cannot be answered on the basis of pulpal histology alone. The very high concentration of fluoride in commercial preparations of silver fluoride raises several questions concerning its clinical safety.     

A Survey of U.S. Prosthodontists and Dental Schools on the Current Materials and Methods for Final Impressions for Complete Denture Prosthodontics

PURPOSE: The purpose of this study was to survey members of The American College of Prosthodontists (ACP) to evaluate current materials and methods for final impressions for complete denture prosthodontics in the United States. In addition, those methods were compared with methods and materials taught in U.S. dental schools via a second survey sent to the chairpersons of prosthodontic/restorative departments. MATERIALS AND METHODS: An anonymous questionnaire was mailed to all 1762 active ACP members in the United States in 2003. A slightly modified questionnaire was also distributed to chairpersons of prosthodontic/restorative departments in the 54 U.S. dental schools. Data analysis was performed via frequency distribution and chi-square statistics. RESULTS: Nine hundred and forty-five questionnaires were returned by members of the ACP (54% return rate) and 42 questionnaires were returned by the U.S. dental schools (78% return rate). The majority of the reporting prosthodontists (88%) and dental schools (98%) use a border-molded custom tray for final impressions for complete denture prosthodontics. The most popular material for border molding was plastic modeling compound (67% of reporting ACP members, and 95% of the responding dental schools). Variability of the materials used for final impressions was observed, with the most popular materials being polyvinylsiloxane for the ACP members (36%) and polysulfide for the dental schools (64%). Statistically significant differences were found in the materials used for border molding by prosthodontists based on the time elapsed since completion of prosthodontic training. No differences were found in the materials used for impression of edentulous arches based on years of experience. Geographic location did not influence the materials and methods used by prosthodontists for complete denture final impressions. CONCLUSIONS: There was variability of the materials and techniques used for final impressions by ACP members and dental schools; however, overall there was an agreement on the materials and techniques used by prosthodontists and dental schools. Distinct trends for increasing use of polyvinylsiloxane and polyether for border molding procedures and impressions of edentulous arches were observed both in members of the ACP and in the U.S. dental schools.     

University of North Carolina Caries Risk Assessment Study. III. Multiple Factors in Caries Prevalence

The baseline caries experienced of approximately 5,000 children in South Carolina and Maine was used as the dependent variable in caries risk assessment analyses. Clinical, microbiologic, and demographic factors served as independent variables in a multivariate relationship to caries through regression and discriminant function analyses. Four factors--number of dental visits by the child in the past year, presence of white spot lesions, and both the urgency of need for restorative care and the future caries increment predicted by the examiner--associated significantly and consistently with caries prevalence in primary and permanent teeth of first and fifth graders at both study sites. Several factors associated significantly with caries prevalence at only one site or grade within a site, suggesting that wide applicability of a specific caries risk assessment model may be limited. In these analyses, sensitivity ranged from .60 to .72 and specificity varied from .86 to .91 in the four grade-site groups. The ultimate goal of this longitudinal study is to identify highly caries-prone children in time to prevent the occurrence of a future caries increment. Although the lack of consistent association of many variables, including microbiologic factors, with baseline caries prevalence was unexpected, it is expected that some of these variables will contribute predictive power in the prospective study.     

Effect of Heat Treatment on Joint Properties of Laser-Welded Ag-Au-Cu-Pd and Co-Cr Alloys

PURPOSE: This study investigated the effect of heat treatment on the strengths of laser-welded cast Ag-Au-Cu-Pd and Co-Cr alloys. MATERIALS AND METHODS: Cast plates of Ag-Au-Cu-Pd (Ag) and Co-Cr (Co) alloys were prepared. After polishing the surfaces to be welded, the plates were matched and butted Ag to Ag (Ag/Ag), Co to Co (Co/Co), and Ag to Co (Ag/Co) and welded using Nd:YAG laser at a pulse duration of 10 ms, spot diameter of 1 mm, and voltage of 200 V. Five specimens were prepared for each experimental condition by bilaterally welding them with five spots. The Ag/Ag, Ag/Co, and control Ag underwent two heat treatments-softening (ST) and hardening (AH). A group of as-cast specimens serving as controls was not given either heat treatment. The failure load and percent elongation were measured at a crosshead speed of 1.0 mm/min. RESULTS: The fracture resistance of Co/Co was similar to that of the control Co, while the fracture resistance of Co/Ag was significantly lower than that of both like alloy pairings for all heat-treating conditions. The control Ag had greater fracture resistance after AH and lower fracture resistance after ST. The AH treatment increased the fracture resistance, and the ST treatment decreased the fracture resistance of both Ag/Ag and Co/Ag, although not significantly. The percentage of elongation appeared to positively correlate with the fracture resistance results. CONCLUSIONS: The results obtained in this study indicated that the age-hardening heat treatment increased the weld strength between the paired Au-Ag-Cu-Pd alloys and between the Au-Ag-Cu-Pd and Co-Cr alloys.