Optical Coherence Tomography for Patients with Developmental Disabilities: A Preliminary Study.

Dental radiographs are essential for diagnosis and treatment planning, but are sometimes difficult to acquire for patients with developmental disabilities (PDD). Optical Coherence Tomography (OCT) is a non-ionizing imaging modality that has the potential application as an alternative to dental radiographs for PDD. This study aimed to determine the feasibility of intraoral OCT imaging for PDD. Ten participants were recruited in the Dental Education in the Care of Persons with Disabilities (DECOD) Clinic to explore the utility of dental OCT. The prototype system (Yoshida Dental) creates in-depth and three-dimensional images of teeth. The participants indicated their degree of pain during imaging on the Wong-Baker FACES Pain Rating Scale, and the degree of discomfort after imaging on a visual analog scale. OCT can be used for patients with developmental disabilities with minimal levels of pain and discomfort, without ionizing radiation.

Period1 gene expression in the olfactory bulb and liver of freely moving streptozotocin-treated diabetic mouse.

Clock genes express circadian rhythms in most organs. These rhythms are organized throughout the whole body, regulated by the suprachiasmatic nucleus (SCN) in the brain. Disturbance of these clock gene expression rhythms is a risk factor for diseases such as obesity. In the present study, to explore the role of clock genes in developing diabetes, we examined the effect of streptozotocin (STZ)-induced high glucose on Period1 (Per1) gene expression rhythm in the liver and the olfactory bub (OB) in the brain. We found a drastic increase of Per1 expression in both tissues after STZ injection while blood glucose content was low. After a rapid expression peak, Per1 expression showed no rhythm. Associated with an increase of glucose content, behavior became arrhythmic. Finally, we succeeded in detecting an increase of Per1 expression in mice hair follicles on day 1 after STZ administration, before the onset of symptoms. These results show that elevated Per1 expression by STZ plays an important role in the aggravation of diabetes.

New bulk-fill composite system with high irradiance light polymerization: Integrity and degree of conversion.

OBJECTIVE: The study used optical coherence tomography (OCT) and micro Raman microscopy (mRM) to investigate internal defect (ID) and degree of conversion (DC) of two bulk-fill composite systems with high-irradiance or conventional light polymerization settings. METHODS: The ID and DC of the new bulk-fill composites; Tetric PowerFill (PwrPst) and Tetric PowerFlow (PwrFlw) were compared with the predecessor bulk-fill composites; Tetric EvoCeram Bulkfill (EvoPst) and Tetric EvoFlow Bulkfill (EvoFlw), using LED light curing unit in two settings; normal (LED-Nrm: 1000 mW/cm2, 10-s) or PowerCure (LED-Pwr: 3000 mW/cm2, 3-s). ID formation was observed in bonded cylindrical composite cavities (4-mm depth, 3-mm diameter) using Yoshida Dental OCT. From the vertically projected 2D image, ID area percentage (ID-A%) was calculated. DC at the top and bottom and bottom/top DC ratio (DC-R%) of 4-mm thick discs was calculated using mRM. All data were statistically analyzed at significance level of α = 0.05. RESULTS: Flowable composites in LED-Pwr showed smaller ID frequencies than other groups (PwrFlw: 0/8, EvoFlw: 2/8) (p < 0.05). Composite type significantly affected ID-A%, DC and DC-R% (p < 0.001), while light settings significantly affected ID-A% but not DC and DC-R% (p > 0.05). In both light settings, EvoPst showed the lowest DC-R% (<80%). SIGNIFICANCE: Internal defect and degree of conversion of bulk-fill composites were affected by their composition and light settings. There was a tendency for less defects and better polymerization for the flowable bulk-fills. The new flowable bulk-fill composite with 3-seconds high irradiance light curing showed no defect formation.

Accuracy of CAD/CAM Digital Impressions with Different Intraoral Scanner Parameters.

The advancement of intraoral scanners has allowed for more efficient workflow in the dental clinical setting. However, limited data exist regarding the accuracy of the digital impressions produced with various scanner settings and scanning approaches. The purpose of this in vitro study was to compare the accuracy of digital impressions at the crown preparation margin using different scanning resolutions of a specific intraoral scanner system. An all-ceramic crown preparation of a mandibular first molar was constructed in a typodont, and a scan (n = 3) was created with an industrial-grade laboratory scanner (3Shape D2000) as the control. Digital impressions were obtained with an intraoral scanner (3Shape TRIOS 3) under three settings-high resolution (HR), standard resolution (SR), and combined resolution (SHR). Comparative 3D analysis of scans was performed with Geomagic Control X software to measure the discrepancy between intraoral scans and the control scan along the preparation finish line. The scan time and number of images captured per scan were recorded. Statistical analysis was performed by one-way ANOVA, two-way repeated measures ANOVA, Pearson's correlation, and Dunnett's T3 test (α = 0.05). Significant differences were observed for scan time and for number of images captured among scan resolution settings (α < 0.05). The scan time for the SR group was, on average, 34.2 s less than the SHR group and 46.5 s less than the HR group. For discrepancy on the finish line, no significant differences were observed among scanning resolutions (HR: 31.5 ± 5.5 µm, SHR: 33.2 ± 3.7 µm, SR: 33.6 ± 3.1 µm). Significant differences in discrepancy were observed among tooth surfaces, with the distal surface showing the highest discrepancies. In conclusion, the resolution of the intra-oral scanner is primarily defined by the system hardware and optimized for default scans. A software high-resolution mode that obtains more data over a longer time may not necessarily benefit the scan accuracy, while the tooth preparation and surface parameters do affect the accuracy.

Effects of fiber reinforcement on adaptation and bond strength of a bulk-fill composite in deep preparations.

OBJECTIVE: This study investigated the effect of plasma-treated leno weaved ultra-high-molecular-weight polyethylene fiber placement on gap formation and microtensile bond strength (MTBS) of a bulk-fill composite in deep cavity. METHODS: Resin composite molds (3 mm width, 4 mm depth) were treated with Clearfil SE Bond 2 and restored with 3 techniques : (1) Surefil SDR flow (SDR) placed in bulk (BLK), (2) SDR placed in two unequal increments (INC) and (3) SDR placed after an increment of SDR placed with wetted polyethylene fiber (Ribbond Ultra) at the cavity floor (FRC). As a control, the cavities were bulk-filled with SDR and no bonding agent (n = 12). All the specimens were subjected to real-time and 3D imaging by SS-OCT (1330 nm) to calculate the total volume of gap formed (mm3) at the cavity floor and between the composite increments. For MTBS, the occlusal cavities of the similar dimensions (3 × 3 × 4 mm3) were prepared on extracted molars with similar composite placement techniques (BLK, INC and FRC). After 24 h 37 °C water storage, the specimens were sectioned using a diamond saw to create 0.7 × 0.7 mm2 beams for MTBS, and subjected to bond testing at a crosshead speed of 1 mm/min. Data for both tests was analyzed by one-way ANOVA and multiple-comparisons with Bonferroni correction (α = 0.05). RESULTS: The gap volumes were different among the groups (p < 0.05). The largest cavity floor gaps (mm3) were observed in the control group (2.00 ± 0.08); followed by BLK (0.74 ± 0.20) and INC (0.02 ± 0.01). In FRC, the cavity floor was gap-free in all specimens but some separation was observed between the two increments. MTBS values (MPa) were 13.8 ± 7.6, 31.7 ± 12.5 and 28.3 ± 8.5 for BLK, INC and FRC groups. There was no significant difference between FRC and INC and both were different from BLK (p < 0.05). SIGNIFICANCE: Gap formation of the bulk-fill composite at cavity floor was significantly reduced with the placement of a fiber-reinforced increment at the base of the deep preparation. The fiber-reinforced increment acts as a shrinkage stress breaker and protects the bonded interface at deep dentin.

Effect of silver diamine fluoride and potassium iodide on bonding to demineralized dentin.

PURPOSE: To evaluate the microtensile bond strength (MTBS) of resin composite to demineralized dentin treated with SDF or SDF-KI. METHODS: Occlusal enamel of 30 caries-free extracted human molars was removed to expose flat dentin surfaces. Specimens were immersed in demineralizing solution (pH 4.5) for 7 days. A standard smear layer was created using 600-grit silicon carbide paper. Specimens were distributed into three groups (n=10). Control: Dentin rinsed with deionized water; SDF: Dentin treated with 38% SDF; and SDF-KI: Dentin treated with SDF and KI. Specimens were bonded with composite using Scotchbond Universal in etch-and-rinse mode. MTBS beams were prepared from each specimen after 24 hours and tested. Data was analyzed by one-way ANOVA with Tukey HSD post-hoc test. RESULTS: MTBS test results ranged from 0 to 40 MPa. The highest values were obtained in the Control and lowest in SDF-KI, where pre-test failures were frequently observed. One-way ANOVA showed a significant difference among groups (P< 0.005); post-hoc analysis suggested no statistical difference between Control and SDF, but both groups showed higher MTBS compared with SDF-KI. CLINICAL SIGNIFICANCE: Silver diamine fluoride can be applied precisely and regionally on demineralized dentin before bonding without compromising the bond strength of a universal adhesive used with phosphoric acid etching. Addition of potassium iodide to reduce discoloration will dramatically weaken the bond.

Effect of light-curing time on light-cure/post-cure volumetric polymerization shrinkage and regional ultimate tensile strength at different depths of bulk-fill resin composites.

The aim of this study was to investigate volumetric polymerization shrinkage (VS), using swept-source optical coherence tomography (SS-OCT), of bulk-fill composites with different light-curing strategies; immediately after light-irradiation and after 24 h, and to evaluate their regional ultimate tensile strength (UTS) at different curing depths. The immediate VS after photo-polymerization decreased when the curing light-curing time was reduced from 20 to 10 to 5 s. On the other hand, their VS values after 24 h significantly increased due to the post-cure polymerization, resulting in similar VS values at all the light-curing times. Five seconds light-curing decreased the regional UTS of resin composites after the 24 h period compared with the 10 and 20 s light-curing regimes; therefore, the remarkable progress of post-cure polymerization after light-curing for a short time would not lead to an improvement in the mechanical properties of resin composites. The influence of the light-curing time on the curing depth was dependent upon the bulk-fill composite material.

Real-time in-depth imaging of gap formation in bulk-fill resin composites.

OBJECTIVES: This study visualized in real-time the gap forming of bulk-fill resin composites during polymerization using optical coherence tomography (OCT). METHODS: Light-cured bulk-fill resin composites; Tetric N-ceram Bulk Fill (TNB), SonicFill (SNF), Surefil SDR (SDR), dual-cured bulk-fill resin composite Bulk EZ (BEZ), and light-cured core resin composite Clearfil Photo Core (CPC) were investigated. Swept-source OCT real-time cross-sectional monitoring was obtained during resin composite placement and curing procedure. Gap formation was observed in bonded cylindrical resin composite molds (4-mm depth, 3-mm diameter) and free shrinkage volume was observed at the top and bottom of a tube with similar dimensions (n=10). OCT 3D data were analyzed to calculate sealing floor area percentage (SFA%) and volumetric shrinkage in bonded tube (VS%). Data were analyzed by ANOVA at significance level of 0.05. The bottom-top degree of conversion ratio (DC%-R) through 4-mm depth was measured using the XploRA Plus micro-Raman spectroscopy. RESULTS: BEZ showed no gap formation at the cavity floor in any specimens while SNF showed the highest gap formation; the statistical order in terms of SFA% was BEZ (100±0)>TNB (84.97±2.98)>CPC (52.13±8.23)=SDR (45.97±9.21)>SNF (16.23±6.00) (p<0.05). On the other hand, total VS% was statistically ordered as BEZ (3.40±0.14)>SDR (3.22±0.09)>TNB (1.82±0.11)>SNF (1.65±0.04)=CPC (1.56±0.04) (p<0.05). Unlike BEZ, the light-cured resin composites showed larger shrinkage at specimen bottom than top. TNB showed the lowest DC%-R followed by SNF (p<0.05). SIGNIFICANCE: Light-cured bulk-fill resin composites showed various degrees of gap formation and shrinkage at 4-mm deep cavity. The dual-cured bulk-filled resin composite showed no decrease of degree of conversion through the depth and the highest cavity adaptation despite its tendency for higher volumetric shrinkage.

Enamel margins resealing by low-viscosity resin infiltration.

This study evaluated low-viscosity resin potential as enamel marginal gap sealant for existing composite restoration. Standard restorations with marginal gaps were created in bovine teeth; gaps were resealed using G-Bond Plus (GB, GC, Tokyo, Japan) or Icon (ICN, DMG, Hamburg, Germany) with or without HCl pretreatment (n=8). Swept-source optical coherence tomography (SS-OCT) images were taken before and after resealing of the margin and thermal cycling to calculate enamel marginal gap extent. Cross-sectional microscopy was performed to confirm SS-OCT findings. SS-OCT showed remarkable reduction of backscatter signal at enamel margins after application of the low-viscosity resin. Enamel margin resealing significantly decreased gap and there was a significant difference between ICN (regardless of HCl pretreatment) and GB, while thermal cycling increased gaps (p<0.05). The low-viscosity resin could effectively infiltrate micro-gaps at enamel margins and improve sealing of an existing composite restoration. Resin infiltration is a viable option for resealing intact restorations with open margins.

Suppression of NF-kappaB increases bone formation and ameliorates osteopenia in ovariectomized mice.

Bone degenerative diseases, including osteoporosis, impair the fine balance between osteoclast bone resorption and osteoblast bone formation. Single-agent therapy for anabolic and anticatabolic effects is attractive as a drug target to ameliorate such conditions. Inhibition of nuclear factor (NF)-κB reduces the osteoclast bone resorption. The role of NF-κB inhibitors on osteoblasts and bone formation, however, is minimal and not well investigated. Using an established NF-κB inhibitor named S1627, we demonstrated that inhibition of NF-κB increases osteoblast differentiation and bone formation in vitro by up-regulating the mRNAs of osteoblast-specific genes like type I collagen, alkaline phosphatase, and osteopontin. In addition, S1627 was able to increase bone formation and repair bone defect in a murine calvarial defect model. To determine the effect of NF-κB on a model of osteoporosis, we injected two doses of inhibitor (25 and 50 mg/kg·d) twice a day in sham-operated or ovariectomized 12-wk-old mice and killed them after 4 wk. The anabolic effect of S1627 on trabecular bone was determined by micro focal computed tomography and histomorphometry. Bone mineral density of inhibitor-treated ovariectomized animals was significantly increased compared with sham-operated mice. Osteoblast-related indices like osteoblast surface, mineral apposition rate, and bone formation rate were increased in S1627-treated animals in a dose-dependent manner. NF-κB inhibition by S1627 increased the trabecular bone volume in ovariectomized mice. Furthermore, S1627 could inhibit the osteoclast number, and osteoclast surface to bone surface. In vitro osteoclastogenesis and bone resorbing activity were dose-dependently reduced by NF-κB inhibitor S1627. Taken collectively, our results suggest that NF-κB inhibitors are effective in treating bone-related diseases due to their dual anabolic and antiresorptive activities.