Oral health findings in athletes with intellectual disabilities at the NYC Special Olympics

This study collected data to describe the oral health in Special Olympics athletes with intellectual disabilities from New York City, using the standardized Special Olympics, Special Smiles protocol. A total of 664 self‐selected athletes with intellectual disabilities were screened between 2005 and 2008. A standardized form was used for data collection. Screenings were performed using available light or flashlight, tongue depressor, and disposable mirror. Oral hygiene, reports of oral pain, untreated caries, missing and filled teeth were recorded. The majority of the athletes were 20 years of age or older (52%). Of the examined athletes, 9% reported oral pain, 8% needed urgent care, 28% had untreated caries, 60% had filled teeth, and 32% had signs of gingival disease. Mouthguards were recommended for 26% of athletes. Our findings offer an initial evaluation of the oral health of Special Olympics athletes with intellectual disabilities in New York City. Results showed high preventive and restorative oral health needs in the Special Olympics population.     

Comparing the In Vivo Diagnostic Accuracy of Digital Periapical Radiography with Cone-beam Computed Tomography for the Detection of Vertical Root Fracture

Introduction

The purpose of this study was to determine whether there is a difference in the in vivo diagnostic accuracy of digital radiography (DR) and cone-beam computed tomography (CBCT) imaging in the detection of vertical root fracture (VRF). The presence/absence of VRF was confirmed by visual inspection of the extracted root surface and was the reference standard against which both imaging modalities were compared.

Methods

Twenty-one unsalvageable teeth from 20 patients that had been radiographed and scanned with CBCT imaging were included in the study. The teeth were atraumatically extracted and visually inspected under a microscope to confirm the presence/absence of fracture. The widest point of each fracture was recorded using an optical coherence tomography scanner in order to quantify the size of fractures. Images were viewed under standardized conditions by 13 examiners and repeated 2 weeks later to assess their consistency.

Results

DR and CBCT imaging showed similarly poor sensitivity of 0.16 and 0.27, respectively. Both imaging modalities had similarly high specificity of 0.92 and 0.83, respectively. There was no statistical difference between the diagnostic accuracy of either imaging modality. Fracture width did not affect the detection rate of either imaging modality. Receiver operating characteristic analysis revealed mean A_z values of 0.535 and 0.552 for DR and CBCT imaging, respectively.

Conclusions

Both DR and CBCT imaging have significant limitations when detecting vertical root fractures.     

Influence of access cavity design,sodium hypochlorite formulation and XP-endo Shaper usage on apical debris extrusion – A laboratory investigation

This study assessed the amount of apically extruded debris during root canal preparation using XP-endo shaper and the supplemental use of XP-endo finisher comparing the use of traditional endodontic access or conservative endodontic access cavities and liquid or gel-based formulations of 5.25% sodium hypochlorite or distilled water as supplemental agents. Maxillary first premolar teeth (N = 148) were randomly divided based on their access cavity design and sub-grouped according to the supplemental agent used. The amount of extruded debris was analysed based on the dry weight of the debris collected using a previously established laboratory methodology. Debris extrusion occurred in all groups. Overall, the traditional endodontic access cavity design was associated with more debris extrusion compared to the conservative type. The use of sodium hypochlorite solution showed higher debris extrusion than the gel, whilst distilled water had intermediate values.     

Antimicrobial properties of calcium hydroxide dressing when used for long‐term application: A systematic review

This review aims to evaluate the antimicrobial efficacy of calcium hydroxide against endodontic pathogens when used for 7 days or longer. A systematic electronic literature search was performed in the PubMed, Embase and EBSCO Dentistry & Oral Sciences Source databases using appropriate key words to identify investigations written in the English language that examined the association between the contact time of intracanal calcium hydroxide dressing and its antimicrobial properties. There were no exclusions based on study design. The search yielded 6993 publications. After duplicate removal, 5913 publications were identified and 11 studies met the inclusion criteria. Results showed that the antimicrobial effect of calcium hydroxide for contact times ranging between seven and 45 days is comparable. Two studies demonstrated contradictory findings when exposure was extended to more than 45 days. Future studies are warranted to investigate and optimise calcium hydroxide application for longer periods and identify the potential benefits of its use in clinical settings.     

Hardness,Flexural Strength,and Flexural Modulus Comparisons of Three Differently Cured Denture Base Systems

Purpose: This study compared the surface hardness, flexural strength, and flexural modulus of a light‐ and heat‐cured urethane dimethacrylate (UDMA) to two conventional polymethyl methacrylate (PMMA) denture base resins. The effect of less‐than‐optimal processing condition on the hardness of internal and external surfaces of UDMA specimens was also investigated. Materials and Methods: The materials tested were Eclipse (light‐ and heat‐cured UDMA), Meliodent (heat‐cured PMMA), and Probase Cold (auto‐cured PMMA). Eclipse specimens were prepared by adapting the material onto the master cast and light curing in the processing unit for 10 minutes. Meliodent and Probase Cold specimens were prepared according to the manufacturers' instructions. Twenty rectangular specimens measuring 65 × 10 × 2.5 mm³ were prepared for each material. They were stored in water at 37°C for 30 days before testing. The surface hardness was measured using Vickers Hardness (VHN) test, and flexural strength and flexural modulus were measured using a 3‐point bending test. Twenty‐five additional Eclipse specimens were similarly prepared and were processed at various times of less than 20 minutes of curing. Vickers Hardness was determined on both the external and internal surfaces of specimens. Data were analyzed using a one‐way ANOVA for comparisons of hardness, flexural strength, and flexural modulus between the three denture base materials and for hardness values of both the internal and external surface of Eclipse specimens with curing times. Post hoc analyses (Scheffé test) determined the difference between the groups. Student t‐test was used for comparison of hardness between the external and internal surfaces of Eclipse specimens. Results: The hardness (VHN) values were 19.4 ± 0.7, 17.0 ± 0.4, and 16.0 ± 0.4; the flexural strengths (MPa) were 103 ± 4, 78 ± 3, and 63 ± 4; and the flexural moduli (MPa) were 2498 ± 143, 1969 ± 55, and 1832 ± 89 for Eclipse, Meliodent, and Probase Cold materials, respectively. A comparison among the three polymers showed there were significant differences in surface hardness, flexural strength, and flexural modulus (p < 0.05). No significant difference in surface hardness (VHN) between the internal (19.1 ± 0.6 to 19.4 ± 0.7) and external surfaces (18.9 ± 0.4 to 19.2 ± 0.6) of irradiated Eclipse specimens was observed at 10‐, 12‐, and 14‐minute polymerization times. Conclusion: The surface hardness, flexural strength, and flexural modulus of light‐ and heat‐cured UDMA (Eclipse) were significantly higher than the values obtained for heat‐only cured (Meliodent) and auto‐cured (Probase Cold) PMMA denture base systems.     

Rehabilitation of a Completely Edentulous Patient with Nonreducible Bilateral Anterior Dislocation of the Temporomandibular Joint: A Prosthodontic Challenge—Clinical Report

Nonreduced bilateral anterior dislocation of the temporomandibular joint (TMJ) is an extremely rare condition, and its prosthodontic rehabilitation is a clinical challenge, especially in patients who refuse to or cannot undergo surgery. There are no previous clinical reports of successful or standardized prosthetic rehabilitation approaches for patients with this condition. This clinical report describes the successful prosthodontic management of an edentulous patient with nonreduced bilateral anterior dislocation of the TMJ.     

Ocular Defect Rehabilitation Using Photography and Digital Imaging: A Clinical Report

Ocular disorders occasionally necessitate surgical intervention that may lead to eye defects. The primary objective in restoring and rehabilitating such defects with an ocular prosthesis is to enable patients to cope better with associated psychological stress and to return to their accustomed lifestyle. A series of detailed steps for custom‐made ocular prosthesis fabrication using the advantages of digital photography to replace the conventional oil paint and monopoly iris painting technique are presented in this article. In the present case, a digital photograph of the patient's iris was captured using a digital camera and manipulated on a computer using graphic software to produce a replica of the natural iris. The described technique reduces treatment time, increases simplicity, and permits the patient's natural iris to be replicated without the need for iris painting and special artistic skills.