Wear of composite resin restorations in primary versus permanent molar teeth

The purpose of this investigation was to compare the wear rates of posterior composite resin restorations in primary versus permanent teeth. Based on theories of composite wear in primary molars, as well as on empirical observations, we hypothesized that wear would be greater in permanent tooth restorations. In Part I of the study, quantitative wear data from four different clinical trials (three permanent tooth studies and one primary tooth study) were compared. The same posterior composite restorative material was investigated in each of the four studies. In Part II of the study, quantitative wear data were drawn from a single clinical trial wherein the same experimental posterior composite material was placed in primary and permanent molars in the same children. In Part II, the baseline sample size included posterior composite restorations placed in 92 primary and 95 permanent molars in all children (ages 7-10). Quantitative wear data were obtained by the cast assessment method at baseline, six, 12, and 24 months. The 24-month sample size was based on 48 available primary molar restorations and 89 permanent molar restorations. The loss of primary restorations was due almost exclusively to natural exfoliations. Findings in Part I revealed no significant difference in the wear of primary versus permanent molar restorations. In Part II, wear findings for primary molar versus permanent teeth, respectively, were as follows (in micrometers): 47 versus 49 at six months; 86 versus 80 at 12 months; and 133 versus 131 at 24 months. With a Wilcoxon two-sample test and an alpha level of 0.05, there were no significant differences at any recall for the wear rate of primary versus permanent restorations. These results differ sharply from findings reported by others.     

Clinical effects of electromagnetic stimulation as an adjunct to periodontal therapy

The clinical effects of electromagnetic stimulation (EMS) on periodontal soft tissues and alveolar bone level were studied among 23 patients. The sides of the arch to receive EMS were randomly selected and exposed for a period of eight weeks following periodontal surgery. The contralateral control sides received surgery only. The electromagnetic signal was a multiple pulse signal with 21 asymmetrical quasirectangular pulses per burst and a burst frequency of 16.9 Hz. The peak magnetic field strength reached 0.46 Gauss. Changes from baseline in clinical attachment level, probing depth, and radiographic alveolar bone level were assessed at six, 12, and 18 months postsurgically. A greater gain of clinical attachment level following EMS was observed only for pockets with initial depth of 1 to 3 mm. There were no consistent differences between test (EMS) and control sides in the change of clinical attachment level or probing depth for pockets deeper than 4 mm. Radiographically, the test sides demonstrated statistically significant gain of alveolar bone level compared with the control sides at six months following surgery. Hereafter, the rates of change were similar in the stimulated and unstimulated sides, and the total gain of alveolar bone level remained greater in the test side throughout the observation period. Within the limitations of this study, it was concluded that electromagnetic stimulation does not promote gains in clinical attachment or alveolar bone level to the extent that it can be recommended as an adjunct to conventional periodontal therapy.     

Radiobiologic risk estimation from dental radiology. Part I. Absorbed doses to critical organs

The aim of the present study was to generate one consistent set of data for evaluating and comparing radiobiologic risks from different dental radiographic techniques. To accomplish this goal, absorbed doses were measured in fourteen anatomic sites from (1) five different panoramic machines with the use of rare-earth screens, (2) a twenty-film complete-mouth survey with E-speed film, long round cone, (3) a twenty-film complete-mouth survey with E-speed film, long rectangular cone, (4) a four-film interproximal survey with E-speed film, long round cone, and (5) a four-film interproximal survey with E-speed film, long rectangular cone. The dose to the thyroid gland, the active bone marrow, the brain, and the salivary glands was evaluated by means of exposure of a tissue-equivalent phantom, fitted with lithium fluoride thermoluminescent dosimeters (TLDs) at the relevant locations.     

No evidence of hypersensitivity to dental restorative metals in oral lichen planus

Twelve patients with oral lichen planus (OLP) suspected of dental restorative metal allergy were examined. All patients were patch tested with several metals including six different mercury compounds. One (8%) patient showed a positive patch test to two mercury compounds whereas no mercury allergy was found in a reference group of 17 patients suspected of dental restorative material allergy but without OLP lesions. The mercury allergic OLP patient was further tested on palatal mucosa but no reactions developed. Moreover, the energy dispersive X-ray microanalysis failed to show any contaminating metals in his OLP lesion. Mucosal biopsies were taken in close contact with amalgam fillings from nine OLP patients but these disclosed no evidence of lichenoid or dysplastic alterations. In OLP lesions, the immunofluorescence findings showed fibrinogen deposition, altered basement membrane and elastic fiber staining and intense Ulex europeaus I lectin fluorescence through all epithelial cell layers. Therefore, the present patch tests did not reveal increased frequency of mercury or other metal allergy in OLP patients and the mucosal biopsies failed to show any histologic or immunofluorescence alterations deviating from idiopathic OLP lesions.     

An evaluation of a glass ionomer luting agent: pulpal histological response

Pulpal histological response after crown cementation with a glass ionomer luting agent was evaluated and compared with the response to a polycarboxylate cement or a varnish plus zinc phosphate cement. Pulpal histological response was evaluated on teeth that had full crowns cemented with the test luting agents 3, 10, and 56 days after cementation. No statistically significant differences were found in pulpal histological response between the materials tested during all periods. These findings suggest that factors other than pulpal inflammation are contributing to the reported hypersensitivity after cementation associated with glass ionomer luting agents.     

In vivo effects of a SnF2 gel on acid-softened enamel

The purpose of this investigation was to study the intra-oral rehardening of acid-softened enamel and fluoride uptake from SnF2 gel. Bovine enamel slabs were softened with 0.1 mol/L lactate buffer at pH 4.0 for 14 hrs and then mounted in a mandibular removable Hawley appliance. Control slabs were worn for 96 hrs by seven adult males whose teeth were brushed daily with a fluoride-free dentifrice. Test slabs were exposed once/day to 0.4% SnF2 gel. The gel was swabbed onto the slabs for one minute before being replaced in the mouth unrinsed. The natural dentition was brushed 4 X /day with a fluoride-free dentifrice. Microhardness testing was performed after intra-oral exposure (IOE) and after acid-resistance-testing (ART) following immersion in 0.01 mol/L lactate buffer for 24 hrs at pH of 4.0. Fluoride uptake was measured on separate controls, test slabs, and test slabs after ART, with 0.5 mol/L HClO4 etches of from 15 to 60 sec. The F content was measured with a F-ion-specific electrode and the phosphate content by spectrophotometry. Following IOE, microhardness recovery was 35.6% for control and 37.9% for test slabs, and control slabs retained 1.4% resistance to acid, as compared with 18.6% for the test slabs. The F content of control slabs was significantly less than that of SnF2-treated slabs from 5 to 60 micron in depth, and the F content of SnF2-treated slabs after ART was significantly less at depths of from 5 to 35 micron than that of SnF2-treated slabs not exposed to ART. Both control and SnF2 enamel slabs demonstrated rehardening after IOE, but only SnF2-treated enamel retained a significant fraction of that rehardening after ART.     

The use of panoramic radiography in the evaluation of asymptomatic adult dental patients

This article examines the efficacy of panoramic radiography alone and in combination with intraoral films as part of the "full-mouth" radiographic evaluation of asymptomatic dental patients in the diagnosis of dental caries and periodontal disease. Three full-mouth radiographic surveys--the panoramic alone, the panoramic plus posterior bitewing, and the periapical plus posterior bitewing--are compared. Two forms of measurement--comparative and incremental--were used to identify the radiographic survey with the highest single diagnostic yield when measured against the consensus standard. The findings show that the panoramic radiograph alone exhibits very low sensitivities to dental caries, ranging from 0.6% on anterior teeth to 25.6% on premolars. Even when posterior bitewing radiographs are added to the panoramic films, the sensitivities are significantly below those of the full-mouth periapical and bitewing survey. In contrast, the sensitivities of all three radiographic surveys in the diagnosis of periodontal disease are quite high, ranging from 87% to 96%, so that differences are not clinically significant. However, specificities tended to be low for periodontal disease and high for caries. Thus, for dental caries and (to a lesser extent) periodontal disease, the panoramic radiograph was inferior to the full-mouth intraoral series in its ability to correctly detect evidence of the disease.