Sleep-disordered breathing in children seeking orthodontic care-an Australian perspective.

BACKGROUND: The prevalence of sleep-disordered breathing in children is underestimated due to impediments in detection and diagnosis. Consequently, delayed management may affect the quality of life and the growth and development of a child. Due to their patient demographic, orthodontists are optimally positioned to identify those at risk of sleep-disordered breathing and make referrals for investigation and management. This study aims to determine the prevalence of children at risk of sleep-disordered breathing in an Australian orthodontic population. METHODS: A 1-year retrospective study was conducted in an urban Western Australian private orthodontic practice with two branches in similar socioeconomic demographics. The responses of new patients to a modified paediatric sleep questionnaire and standard medical history form were recorded. RESULTS: In 1209 patients (4-18 years), 7.3% were at risk of sleep-disordered breathing. An association between sex and the potential risk of sleep-disordered breathing was found with 11% of males at risk of sleep-disordered breathing compared to 7% of females (P = 0.012). CONCLUSIONS: The relatively high prevalence of children at risk of sleep-disordered breathing presenting for orthodontic care presents an opportunity to identify at-risk individuals through routine use of the paediatric sleep questionnaire. This would facilitate early referral for diagnosis and management of sleep-disordered breathing.

Oral health education and prevention strategies among remote Aboriginal communities: a qualitative study.

BACKGROUND: The delivery of effective oral health promotion strategies is essential to improving oral health outcomes among remote Aboriginal communities. This study aimed to explore the perceptions and attitudes of Aboriginal Australians living in remote Kimberley communities towards oral health education and disease prevention. METHODS: Semi-structured interviews and yarning circles were carried out following purposive sampling of Aboriginal adults living in the East Kimberley region of Western Australia. RESULTS: A total of 80 community members participated in the yarning process. School-based oral health promotion and community-driven restrictions on the sale of sugary food and drink were seen as positive strategies in improving oral health. Lifestyle changes brought about by modernity, internet availability and fixed community stores were perceived to create new challenges and shift the priorities for those living in remote communities. CONCLUSIONS: Community-based yarning may better inform future oral health strategies in the Kimberley. A neoliberal approach of shifting responsibility onto the individual ignores the complex social inequities faced by Aboriginal people living in remote communities where macro-level determinants such as remoteness, food security and education significantly influence decisions around diet and oral health.

Accuracy of mandibular proximal segment position using virtual surgical planning and custom osteosynthesis plates.

The purpose of this study was to determine whether the use of custom osteosynthesis plates increased the accuracy of proximal segment position following bilateral sagittal split osteotomy in a cohort of 30 patients when compared to a control group of 25 patients who had surgery with conventional plates. Surgery was performed by a single surgeon between October 2015 and December 2017. Post-surgical cone beam computed tomography scans were segmented using Mimics Innovation Suite (Materialise NV), and surface-based superimposition was achieved using ProPlan CMF (Materialise NV). However, there was a tendency for the rotational error to be smaller in the custom group than in the control group. The root mean square error in both groups and for all variables fell within clinical parameters of 2 mm and 4°. In conclusion, the results of this study indicate that customized mandibular fixation plates do not necessarily improve the accuracy of the proximal segments post-surgically; however they may be of benefit in individual patients.

Fluoride release, recharge and mechanical property stability of various fluoride-containing resin composites.

AIM: To determine the fluoride release and recharge of three fluoride-containing resin composites when aged in deionized water (pH 6.5) and lactic acid (pH 4.0) and to assess mechanical properties of these composites following aging. METHODS: Three fluoride-containing resin composites were analyzed in this study; a new giomer material named Beautifil II, Gradia Direct X, and Tetric EvoCeram. A glass ionomer cement, Fuji IX Extra, was also analyzed for comparison. Specimens were fabricated for two test groups: group 1 included 10 disc specimens initially aged 43 days in deionized water (five specimens) and lactic acid (five specimens). The fluoride release from these specimens was measured using a fluoride-specific electrode on nine specific test days during the aging period. Following 49 days of aging, each specimen was recharged in 5000 ppm neutral sodium fluoride solution for 5 minutes. Specimen recharge was then repeated on a weekly basis for 3 weeks. The subsequent fluoride rerelease was measured at 1, 3, and 7 days after each recharge episode. Group 2 included six disc specimens aged for 3 months in deionized water (three specimens) and lactic acid (three specimens). The hardness and elastic modulus of each specimen was measured using nano-indentation at intervals of 24 hours, 1 month, and 3 months after fabrication. Two-way factorial analysis of variance (ANOVA) and post-hoc (Tukey) testing was used to assess the influence of storage media (two levels) and composite type (three levels) on the fluoride release, fluoride rerelease, hardness, and elastic modulus of the assessed materials. The level of significance was set at p=0.05. RESULTS: All three composites demonstrated fluoride release and recharge when aged in both deionized water and lactic acid. The cumulative fluoride released from Beautifil II into both media was substantially greater than the fluoride released from Gradia Direct X and Tetric EvoCeram after 43 days aging and was significantly (p<0.05, ANOVA, Tukey test) greater during several analysis periods. Beautifil II demonstrated the greatest recharge ability of the three composites over the 3-week recharge period in both media. Fuji IX Extra demonstrated a significantly (p<0.05) greater fluoride release and recharge compared with the three resin composites. The elastic modulus and hardness of the three composites did not decrease significantly (p<0.05) with fluoride release or fluid uptake over the 3-month aging period, in either media. CONCLUSION: The three composites in the present study demonstrated fluoride release (Beautiful II > Gradia Direct X > Tetric EvoCeram) and fluoride recharge (Beautiful II > Gradia Direct X > Tetric EvoCeram). This capability raises the possibility of fluoride-containing composites exhibiting a lower incidence of recurrent caries than non fluoride­containing composites. The mechanical properties of each composite did not diminish with aging and fluoride release over the testing period.

[Optic disc drusen in children: Advantages of various imaging modalities]. / Druses de la papille de l'enfant : intérêt des différents examens d'imagerie.

In children, optic disc drusen pose a diagnostic problem with papilledema when they are buried. The goal of our study is to retrospectively compare the results of examinations performed in 34 children with optic disc drusen. In children who underwent ultrasonography and autofluorescence imaging, the results were conclusive in both examinations in 44.7% of cases, and in neither of the two examinations in 27.6% of cases. Ultrasonography alone demonstrated superiority in diagnosing 27.6% of eyes, whereas autofluorescence imaging was inconclusive. Since diagnostic confusion with papilledema persisted in seven children, angiography was performed. B-mode ultrasonography constitutes a relevant examination in the diagnosis of buried optic disc drusen in children and shows superiority in our study compared to autofluorescence imaging.

Reducing composite restoration polymerization shrinkage stress through resin modified glass-ionomer based adhesives.

BACKGROUND: The aim of this study was to determine whether employing resin modified glass-ionomer based adhesives can reduce polymerization contraction stress generated at the interface of restorative composite adhesive systems. METHODS: Five resin based adhesives (G Bond, Optibond-All-in-One, Optibond-Solo, Optibond-XTR and Scotchbond-Universal) and two resin modified glass-ionomer based adhesives (Riva Bond-LC, Fuji Bond-LC) were analysed. Each adhesive was applied to bond restorative composite Filtek-Z250 to opposing acrylic rods secured within a universal testing machine. Stress developed at the interface of each adhesive-restorative composite system (n = 5) was calculated at 5-minute intervals over 6 hours. RESULTS: The resin based adhesive-restorative composite systems (RBA-RCS) demonstrated similar interface stress profiles over 6 hours; initial rapid contraction stress development (0-300 seconds) followed by continued contraction stress development ≤0.02MPa/s (300 seconds - 6 hours). The interface stress profile of the resin modified glass-ionomer based adhesive-restorative composite systems (RMGIBA-RCS) differed substantially to the RBA-RCS in several ways. Firstly, during 0-300 seconds the rate of contraction stress development at the interface of the RMGIBA-RCS was significantly (p < 0.05) lower than at the interface of the RBA-RCS. Secondly, at 300 seconds and 6 hours the interface contraction stress magnitude of the RMGIBA-RCS was significantly (p < 0.05) lower than the stress of all assessed RBA-RCS. Thirdly, from 300 seconds to 6 hours both the magnitude and rate of interface stress of the RMGIBA-RCS continued to decline over the 6 hours from the 300 seconds peak. CONCLUSIONS: The use of resin modified glass-ionomer based adhesives can significantly reduce the magnitude and rate of polymerization contraction stress developed at the interface of adhesive-restorative composite systems.

Fluoride release, recharge and flexural properties of polymethylmethacrylate containing fluoridated glass fillers.

BACKGROUND: The purpose of this study was to investigate the effect of fluoridated glass fillers on fluoride release, recharge and the flexural properties of modified polymethylmethacrylate (PMMA). METHODS: Specimens of PMMA denture base material with various loading of fluoridated glass fillers (0%, 1%, 2.5%, 5% and 10% by weight) were prepared. Flexural properties were evaluated on rectangular specimens (n = 10) aged in deionized water after 24 hours, 1 and 3 months. Disc specimens (n = 10) were aged for 43 days in deionized water and lactic acid (pH 4.0) and fluoride release was measured at numerous intervals. After ageing, specimens were recharged and fluoride re-release was recorded at 1, 3 and 7 days after recharge. RESULTS: Samples containing 2.5%, 5% and 10% glass fillers showed significantly (p < 0.05) greater levels of fluoride release compared with the control and 1% glass fillers specimens. All experimental specimens exhibited fluoride release in both media. The flexural strength of specimens decreased in proportion to the percentage filler inclusion with the modulus of elasticity values remaining within ISO Standard 1567. CONCLUSIONS: The modified PMMA with fluoridated glass fillers has the ability to release and re-release fluoride ion. Flexural strength decreased as glass filler uploading increased.

The effect of repeated fluoride recharge and storage media on bond durability of fluoride rechargeable Giomer bonding agent.

BACKGROUND: For a restorative material or adhesive to exhibit caries inhibitive potential through fluoride release, it must be capable of fluoride recharge. The aim of this study was to evaluate the effect of repeated fluoride recharge and different storage media on dentine bond strength durability. METHODS: Two self-etch adhesive systems (two-step) were evaluated: fluoride-rechargeable Giomer FL-Bond II and non-fluoride-containing UniFil Bond. For each adhesive 32 human dentine specimens were prepared for shear bond strength testing. The specimens were randomly allocated to one of four storage groups: Group 1 - 24-hour water ageing; Group 2 - four-month water ageing; Group 3 - four-month water ageing with weekly fluoride recharge (5000 ppm for 10 minutes); and Group 4 - four-month acid ageing with weekly fluoride recharge. RESULTS: Weekly fluoride recharge over four months ageing did not significantly (p > 0.05) reduce the dentine shear bond strength of FL-Bond II or UniFil Bond. Storage media did not significantly (p > 0.05) affect bond durability. CONCLUSIONS: The adhesion between fluoride rechargeable FL-Bond II and dentine maintained durability despite regular fluoride recharge over the four months ageing. Clinicians prescribing the fluoride recharge regime used in the present study to reduce recurrent caries incidence associated with Giomer FL-Bond II restorations can do so without compromising dentine bond strengths.