Caries risk after interproximal enamel reduction.

INTRODUCTION: Air-rotor stripping (ARS) is a commonly used method to alleviate crowding in the permanent dentition. Its widespread acceptance, however, has been limited by the potential increase in caries risk of the abraded enamel surface. The aim of this study was to compare the susceptibility of ARS-treated enamel surfaces with intact surfaces in patients undergoing fixed orthodontic therapy. METHODS: Forty patients treated with ARS were examined clinically and radiographically for caries 1 to 6 years after interproximal enamel reduction. All patients were seen by their dentists for prophylaxis at 6-month intervals during active orthodontic treatment and were exposed to fluoridated water and toothpaste. Topical fluoride agents or sealants were not applied on the abraded surface after any ARS session. Caries incidence was compared between ARS-treated and unaltered surfaces within subjects. The decayed, missing, filled tooth (DMFT) and surface (DMFS) scores were used to evaluate the subjects' overall caries risk. RESULTS: Totals of 376 test and 376 control surfaces were examined. The number of interproximal lesions detected was found to be low with no statistically significant difference detected between the groups (test = 3; control = 6; P = .33]. The DMFT and DMFS scores increased significantly during the study period, indicating that these patients were clearly at risk of tooth decay (P <.001). CONCLUSIONS: The findings indicate that the risk of caries is not affected by ARS. Furthermore, our data show that the application of topical fluoride on the enamel surfaces immediately after ARS in patients exposed to fluoridated water and fluoride-containing toothpaste may not provide any additional benefit.

Accuracy of digital and analogue cephalometric measurements assessed with the sandwich technique.

INTRODUCTION: The purpose of the study was to evaluate the accuracy of cephalometric measurements obtained with digital tracing software compared with equivalent hand-traced measurements. In the sandwich technique, a storage phosphor plate and a conventional radiographic film are placed in the same cassette and exposed simultaneously. The method eliminates positioning errors and potential differences associated with multiple radiographic exposures that affected previous studies. It was used to ensure the equivalence of the digital images to the hard copy radiographs. Cephalometric measurements instead of landmarks were the focus of this investigation in order to acquire data with direct clinical applications. METHODS: The sample consisted of digital and analog radiographic images from 47 patients after orthodontic treatment. Nine cephalometric landmarks were identified and 13 measurements calculated by 1 operator, both manually and with digital tracing software. Measurement error was assessed for each method by duplicating measurements of 25 randomly selected radiographs and by using Pearson's correlation coefficient. A paired t test was used to detect differences between the manual and digital methods. RESULTS: An overall greater variability in the digital cephalometric measurements was found. Differences between the 2 methods for SNA, ANB, S-Go:N-Me, U1/L1, L1-GoGn, and N-ANS:ANS-Me were statistically significant (P < .05). However, only the U1/L1 and S-Go:N-Me measurements showed differences greater than 2 SE (P < .0001). CONCLUSIONS: The 2 tracing methods provide similar clinical results; therefore, efficient digital cephalometric software can be reliably chosen as a routine diagnostic tool. The user-friendly sandwich technique was effective as an option for interoffice communications.

Maxillary canine impactions: orthodontic and surgical management.

With the exception of the maxillary and mandibular third molars, the maxillary canine is the most commonly encountered impaction. In North America, palatally located impactions appear to predominate over labially impacted canines and occur more frequently in women. Because of the common nature of this phenomenon, the general dentist should know how to properly diagnose and manage potential disturbances in the eruption of the maxillary canine. If diagnosed early, and when clinically and radiographically indicated, extraction of the deciduous canine may help correct the eruption path of the permanent tooth and prevent impaction. This article reviews the etiology, prevention, and surgical and orthodontic management of impacted cuspids. Because the general dentist is often the first dental care provider to come in contact with patients with impacted canines, knowledge about this common dental anomaly is essential to provide proper comprehensive therapy.

Markers of periodontal infection and preterm birth.

OBJECTIVE: This study was undertaken to explore the relationship between clinical, microbiologic, and serologic markers of periodontitis and preterm birth (PTB). STUDY DESIGN: We compared women with a singleton gestation giving birth before the 37th week (cases, n = 83) with term delivery controls (n = 120). Periodontal examination and collection of dental plaque and blood samples were performed within 48 hours after delivery. Microbial levels and maternal immunoglobulin G titers to oral bacteria were analyzed. Multivariate regression models were fitted controlling for common covariates. RESULTS: Cases showed greater mean attachment loss (1.7 vs 1.5 mm, P = .003) and higher prevalence of periodontitis (30.1% vs 17.5%, P = .027). No differences in microbial or serum antibody levels were detected between the groups. Logistic regression revealed that PTB was associated with attachment loss (adjusted odds ratio: 2.75, 95% CI: 1.01-7.54). Linear regression indicated a significant ( P = .04) association between attachment loss and low birth weight (LBW). CONCLUSION: The data support the notion that periodontitis is independently associated with PTB and LBW.