Practice-based clinical evaluation of ceramic single crowns after at least five years.

STATEMENT OF PROBLEM: Long-term practice-based clinical evaluations of various contemporary ceramic crown restorations from multiple practitioners are limited. PURPOSE: The aims of this study were to evaluate the clinical performance of ceramic single crowns and to identify factors that influence their clinical performance. MATERIAL AND METHODS: Ceramic single crowns that had been placed at the Mayo Clinic and in function since 2005 were identified and included in the study. The restorations were examined clinically, radiographically, and with photographs. Modified United States Public Health Services criteria were used for the clinical evaluation. The ceramic systems evaluated were bilayer and monolayer. RESULTS: Fifty-nine patients (41 women, 18 men) with 226 single teeth and implants restored with single ceramic crowns were identified. The mean duration from insertion date to study examination date was 6.1 years. Thirteen restorations (6%) were replaced at a mean 3.3 years after insertion date (range, 0.1-6.1 years). Estimated replacement-free survival rates (95% confidence interval [CI]; number of teeth/implants still at risk) at 5 years after insertion date were 95.1% (95% CI, 92.2-98.1; 153) and at 10 years were 92.8% (95% CI, 89.1-96.8; 8). The most common reason for replacement was fracture to the core of posterior layered ceramic crowns. The most commonly used luting agent was resin-modified ionomer cement. Most restorations exhibited clinically acceptable marginal integrity, shade, no caries recurrence, and no periapical pathology. CONCLUSIONS: The clinical performance of ceramic single crowns at 5 and 10 years supports their application in all areas of the mouth. With the majority of fractures to the core occurring early in the lifetime of layered ceramic posterior crowns, consideration of other monolithic ceramic systems for posterior crowns is advised.

Salivary parameters and caries indices in children with black tooth stains.

OBJECTIVE: Black tooth stain in children has been associated commonly with a low caries experience. The present study aimed to to compare salivary factors and caries indices in children with and without black tooth stain and to investigate the relationship between caries and caries associated salivary factors in these children. STUDY DESIGN: Salivary flow rate, pH, buffering capacity, total calcium and phosphorus were determined. Calcium and phosphorus levels were assayed by Inductive Coupled Plasma with Atomic Emission Spectrometry. DMFT and dft indices were evaluated according to WHO criteria. RESULTS: Significantly higher levels of salivary buffering capacity and calcium, and lower flow rate were found in children with black tooth stain compared with those of without black tooth stain (p < 0.01, p = 0.044 and p = 0.037, respectively). The differences in phosphorus and pH were not significant between the groups. The dft index was found to be significantly lower in children with black tooth stain than children without black tooth stain (p = 0.030). However, DMFT did not change between the groups. There is no relationship between salivary parameters and caries indices in children with black tooth stain. CONCLUSION: It is suggested that low caries tendency seen in children with black tooth stain may be associated with high salivary calcium and buffering capacity.

Effect of consuming different dairy products on calcium, phosphorus and pH levels of human dental plaque: a comparative study.

AIM: To determine the calcium, phosphorus and pH levels of human dental plaque after consuming different dairy products. METHODS: 68 students (34 with caries and 34 caries-free) aged 17-20 years from a private dental college, Moradabad city, who agreed to refrain from oral hygiene procedures for 48 hours were selected for the study. Calcium and phosphorus levels of harvested dental plaque were measured using an electrolyte analyser while plaque pH was measured using a digital pH meter after consuming different dairy products (cheese, milk, yogurt) and compared with the control (paraffin) group. RESULTS: Cheese and yogurt groups showed a statistically significant rise in mean plaque concentrations of calcium and phosphorus, whereas milk and control groups showed the least rise in plaque concentrations for both caries-active and caries-free subjects. Plaque pH showed a stronger correlation with plaque calcium and phosphorus concentrations in both caries-active and caries-free subjects. CONCLUSION: Cheese and yogurt without any added sugar (sucrose) are non-cariogenic and to some extent cariostatic as they increase calcium and phosphorus concentration in dental plaque. Dairy products without added sugar can be recommended as after meal desserts, especially to school children, which would help to reduce the incidence of dental caries.

Management of carious primary molar teeth by UK postgraduates in paediatric dentistry.

AIM: To assess the treatment preferences amongst UK postgraduates (PG) in Paediatric Dentistry for a symbolic child with sample case history of differing caries severity in a primary molar tooth. METHODS: All Paediatric Dentistry PG were contacted by e-mail and asked to participate in an on-line structured questionnaire. The survey described four different case scenarios of a 5-year-old child, presenting with a mesio-occlusal cavity in tooth 85 with varying symptoms and signs. Treatment options were listed and participants asked to select the single most preferred treatment for each case. The same scenarios were also presented for both non-anxious and dentally-anxious children and differences were analysed by Chi2 analysis. RESULTS: Responses were received from 38/59 (F: 31; M: 7) PGs. The preformed metal crown (PMC) with Hall technique was selected as the option for patients with no indication of pulpal involvement by 4/38 and 20/38 for non-anxious and dentally-anxious patients respectively (Chi2=27.56, P=0.001, 1 dof). For a tooth with signs of pulpal involvement or symptoms the options selected were (non-anxious, dentally-anxious): zinc-oxide eugenol pulpecotomy and PMC 8/38, 2/38 (Chi2=9.85, P=0.002, 1 dof); local analgesia extraction 15/38, 2/38 (Chi2=27.22, P=0.001, 1 dof) and extraction under a general anaesthetic 0/38, 16/38 (Chi2=42.00, P=0.001, 1dof). CONCLUSION: There was no consistency of response by PGs in Paediatric Dentistry within the UK. The Hall technique appeared to be a favoured option for treatment of an asymptomatic carious primary molar tooth in dentally-anxious child patients. Extraction was preferred for those with pulpal involvement for both non-anxious and dentally-anxious patients, although the suggested mode of extraction differed.

The correlation of DIFOTI to clinical and radiographic images in Class II carious lesions.

BACKGROUND: The authors conducted a study to evaluate the correlation between digital imaging fiber-optic transillumination (DIFOTI) (KaVo Dental, Lake Zurich, Ill.) and clinical and radiographic images in estimating the true clinical axial extension of Class II carious lesions. METHODS: The authors examined 51 Class II carious lesions visually, imaged them by means of DIFOTI and radiographed them with D-speed film and a complementary metal oxide silicon (CMOS)-based digital radiographic sensor. They validated axial extension of the lesions clinically. They compared the clinical and radiographic depths of the carious lesion with the size of the lesion on the DIFOTI images. RESULTS: The authors detected 84 percent of the lesions with DIFOTI, and 82 percent showed a visible dark shadow under the marginal ridge when examined clinically. DIFOTI correlated significantly with the clinical depth of decay (Pearson r = 0.43189). The combination of a CMOS digital sensor and DIFOTI (R2 = 0.7210) provided readings closer to the clinical measures than did the combination of D-speed film and DIFOTI (R2 = 0.6215). CONCLUSIONS: DIFOTI images correlated with clinical depth, especially in smaller lesions, and improved the estimation of lesion size when used in conjunction with the CMOS digital sensor and D-speed images. CLINICAL IMPLICATIONS: Using radiographs in combination with DIFOTI images could help clinicians determine the presence and, to some extent, the size of proximal caries, especially in smaller lesions.

The relationship between sweetness preference and dental caries in mother/child pairs from Maringá-Pr, Brazil.

AIM: Children's patterns of sugar consumption and dental health status have been associated to their mothers' patterns. As a liking for sweetness has been related to caries levels, this study was carried out to analyse the relationship between sweetness preference and caries experience in mother/child pairs. PARTICIPANTS AND METHODS: A cross-sectional survey was conducted on a sample of low socio-economic mothers and their 4-5-year-olds from Maringá-Pr, Brazil. Mothers' and children's preference for sugar was measured using the Sweet Preference Inventory. Their caries experience was assessed according to World Health Organization (WHO) guidelines. RESULTS: High levels of sweetness preference and caries experience were found in the sample studied. Although not strong, a significant correlation in patterns of sweetness preference (r=0.12, P<0.05) and caries experience (r=0.14, P<0.05) between mother/child pairs was identified. Among the social-demographic variables, only family income was statistically associated with the children's preference for sweetness (P<0.05). No significant association between sweetness preference and caries experience could be established. CONCLUSION: The findings of this study suggest that mothers may play an important role on the establishment of their children dietary preferences and patterns of dental health. Also, that the socio-economic status may influence children's preference for sugar.

Access to dental care for Head Start enrollees.

OBJECTIVES: The objectives of this review are to characterize the oral health and dental access of Head Start children, describe barriers to their care, advance strategies to address those barriers, and consider how Head Start Performance Standards can be utilized to maximize oral health and access to dental care. METHODS: Published, programmatic, and solicited data describing oral health status and dental service utilization are reviewed together with reports of conferences exploring access barriers. Head Start performance measures for child health and development services, child health and safety, family partnerships, and community partnerships are individually evaluated for their potential to improve oral health. RESULTS: Head Start children, like all low-income children, enjoy the highest rates of dental coverage (because of Medicaid and the State Child Health Insurance Program), yet these children also experience the highest rates of tooth decay, the most unmet dental care needs, the highest rates of dental pain, and the fewest dental visits. Getting children the dental care they need is problematic because of: multiple barriers associated with public and private dental delivery systems, Medicaid program funding and administration, dental workforce sufficiency and distribution, and issues of culture and communication that stand between parents, children, and caregivers. CONCLUSIONS: To move beyond screening and to access necessary dental care requires integration between medical and dental care, recognition and elimination of barriers to care, an understanding of dental provider types and their capacities, a formally structured referral process, and regular monitoring to ensure that complete care is obtained. Action steps are suggested that can maximize the effectiveness of Head Start Performance Standards. Head Start holds tremendous potential to actively develop and implement policies that can markedly improve both access to needed dental services and the oral health status of young disadvantaged children.

Evaluación clínica radiográfica de caries en estudiantes de odontología 1993 / Clinical and radiographic evaluation of caries in odontology students 1993

El análisi epidemiológico realizado, índice COP-D, en estudiantes de 1er año de odontología 1993. Universidad de Chile muestra las diferencias observadas al diagnosticar caries, y compararlas con un estudio radiográfico (técnica de aleta de mordida). Los valores promedios de caries clínica en 97 alumnos corresponden a 2,64 (2,7), de un COP-D 8,66 (3,8). Al examinar a 62 de ellos mediante la técnica de aleta de mordida, los valores por caries ascendieron a un promedio de 6,1 (3,3) de un COP-D 11,05 (3,3), valor que connstituye el 55 por ciento del COP-D total. De acuerdo a la clasificación realizada la presencia de lesiones de caries muy incipientes e incipientes constituyen un valor equivalente al 63,5 por ciento del total de las caries. El promedio de edad del grupo era de 18,7 años, constituida por un 54,6 por ciento de hombres y 45,3 por ciento de mujeres