Important oral care needs of older French people: A cross-sectional study.

BACKGROUND: Older persons comprise a growing proportion of the European population and may have a distinct epidemiological oral profile requiring specific preventive and curative care poorly documented. The objectives of this study were to assess the oral health status of people ≥90 years of age in France, to compare their perceived and observed oral care needs and to investigate the oral problems associated with a low oral health-related quality-of-life (OHRQoL). METHODS: An oral cross-sectional study was performed during the 25th follow-up of a cohort of older persons being followed up prospectively for screening of dementia over a 15-year period in Gironde and Dordogne, France. Clinical oral indices were determined by oral examinations conducted at the participants' place of living. Cohen's Kappa coefficient was used to assess the agreement between perceived and observed oral care needs. Oral problems associated with a low OHRQoL, measured with the Geriatric Oral Health Assessment Index (GOHAI<50) were investigated with logistic regression. Odds ratios (OR) were estimated with their 95% confidence intervals (CI). RESULTS: Data from 90 persons were analysed (76% female; median age=93 years; 20% living in an institution). Plaque and calculus were present in 93% and 58% respectively, of the 74 dentate participants. The mean number of decayed, missing, and filled teeth was 26.5 (±5.3); 66% of the participants had at least one untreated decayed tooth. Among the 85 participants with tooth loss not replaced by a fixed denture, two thirds had a removable dental prosthesis; 84% of these prostheses were considered to be maladapted. Among the 39 participants who felt unable to consult a dentist (43%), lack of transportation was the most frequently cited reason. Although 88% of the participants needed oral care, only 26% perceived that they had such a need (Kappa=0.06). Oral problems associated with a GOHAI<50 were the absence of posterior occluding teeth (OR=7.15; 95%CI=1.53-33.35; P=0.012), feeling of dry mouth (OR=11.94; 95%CI=3.21-44.39; P=0.0002) and oral pain (OR=9.06; 95%CI=1.91-69.00; P=0.033). CONCLUSIONS: Persons ≥90 years of age have considerable preventive and curative dental care needs that impact their quality-of-life but they are rarely aware and lack transportation. NCT04065828.

Depth microhardness of glass ionomer cements.

The purpose of this study was to observe the effect of different conditions of storage on the surface and in the depth of luting glass ionomer cement by measuring microhardness. The hardness of a glass ionomer cement was measured after storage in wet and dry conditions and in an atmosphere of 80% relative humidity, for times up to 1000 h. Storage in distilled water produced a softening effect, but the depth hardness increased progressively. The penetration of the water is a surface phenomenon and does not affect the depth of the cement. However, the cement is vulnerable to moisture to a depth of 600 microns and marginal gaps evolve in the range of 40 to 80 microns when the luting cement at the tooth crown margin is always destroyed.

Solubility and disintegration of zinc phosphate cement.

The mechanism of erosion of a zinc phosphate cement was studied using two experimental procedures: discs of dental cement were immersed in distilled water under unrenewed conditions as defined by ISO standard; or discs were immersed under continuously running distilled water to simulate the oral environment. Both experiments revealed no physical disintegration mechanism, and suggest that erosion is only controlled by dissolution.

Compomers: between glass-ionomer cements and composites.

The term 'compomer' was crafted by the producers of the first commercial material of this kind: a polyacid-modified composite resin, sold as a filling material for some specific applications. This term should recall the composite resins and glass-ionomer cements, since some features of these two generic materials are found in the compomers. Compomers contain a bifunctional monomer, which should be able to react with the pendant methacrylate groups of other monomers, as well as with the cations liberated by the glass particles. Several products of this kind are now available, and the purpose of this paper is to describe some of their specificities and to compare their influence on the mechanical properties, water uptake and fluoride release.

Comparative study of the physical properties of a polyacid-modified composite resin and a resin-modified glass ionomer cement.

OBJECTIVES: The physical properties of the resin-modified composite resin Dyract (Detrey Dentsply) and the resin-modified glass ionomer cement Fuji II LC (GC) were compared, and the effect of water sorption on these properties was studied. METHODS: Compressive, diametral compressive and flexural strengths were measured using specimens aged up to three months. The Vickers hardness and the water erosion were also determined. The specimens were stored at 37 degrees C under five different conditions, chosen to vary the water sorption of the samples. The results were analyzed using a multi-factor analysis of variance. RESULTS: Dry specimens of Dyract and Fuji II LC showed similar properties. However, the two materials behaved differently when stored in presence of water. In contrast to Fuji II LC, Dyract showed very little expansion for the first 24 h (1.5 +/- 0.3 and 0.03 +/- 0.01%, respectively), leached small quantities of ions and retained its mechanical strength. Those differences are related to their chemical composition. Fuji II LC is hydrophilic, as it contains polyHEMA. In the presence of water, Fuji II LC behaves like a hydrogel, but the network resulting from the copolymerization of acidic and UDMA monomers is less hydrophilic, and the effect of water on Dyract is retarded. SIGNIFICANCE: The significant properties of Dyract are determined by its composite character. This certainly represents some advantages, for instance, a higher mechanical strength, a better protection against initial dehydration and subsequent water effects. However, Dyract shows some disadvantages over Fuji II LC, like a lower amount of fluoride release or the interference of oxygen during polymerization.

Effect of water on the physical properties of resin-modified glass ionomer cements.

OBJECTIVES: Resin-modified glass ionomer cements (GIC) are available for clinical use as restorative materials or as liners and bases. This work was conducted to study the effect of water sorption on the physical properties of several resin-modified GIC, by changing the samples' storage conditions. METHODS: The water sorption, the flexural strength, the flexural elastic modulus, the Vickers hardness and the dimensional changes of five resin-modified GICs were measured using specimens aged for 24 h to 3 mon. The specimens were stored at 37 degrees C, either in a dry environment (A), immersed in water (B), stored in a humid environment (C), stored in a humid environment for 1 h and then immersed in water (D), or immersed in water and subsequently dried (B + A). An analysis of variance was used to compare the results. RESULTS: The resin-modified GIC absorb during the first 24 h large amounts of water (114-172 mg/cm3) compared to the conventional GIC (30-63 mg/cm3). Water alters the physical properties of resin-modified GICs: With regard to dry specimens, a decrease in the flexural strength of 20 to 80% was observed for samples immersed in water. Decreases in their flexural elastic modulus (50 to 80%) and in their hardness (approximately 50%) were also observed. Water sorption also provoked an expansion in volume of the immersed specimens, ranging from 3.4 to 11.3% after 24 h. SIGNIFICANCE: The flexural strength and Vickers hardness of the resin-modified GICs are sensitive to the water contained in the tested specimens. A correlation was established between the decrease in their physical properties and the water uptake. However, it should not be concluded that these materials are not adequate for use in applications in direct contact with oral fluids. Probably, resin-modified GIC placed in oral cavities would not be affected to the same extent as in in vitro tests. In an oral environment, the constituents of saliva will certainly decrease the rate of water sorption and will hence delay its effects.

Optimization of operator and physical parameters for laser welding of dental materials.

OBJECTIVE: Interactions between lasers and materials are very complex phenomena. The success of laser welding procedures in dental metals depends on the operator's control of many parameters. The aims of this study were to evaluate factors relating to the operator's dexterity and the choice of the welding parameters (power, pulse duration and therefore energy), which are recognized determinants of weld quality. DESIGN: In vitro laboratory study. MATERIALS AND METHODS: FeNiCr dental drawn wires were chosen for these experiments because their properties are well known. Different diameters of wires were laser welded, then tested in tension and compared to the control material as extruded, in order to evaluate the quality of the welding. Scanning electron microscopy of the fractured zone and micrograph observations perpendicular and parallel to the wire axis were also conducted in order to analyse the depth penetration and the quality of the microstructure. Additionally, the micro-hardness (Vickers type) was measured both in the welded and the heat-affected zones and then compared to the non-welded alloy. RESULTS: Adequate combination of energy and pulse duration with the power set in the range between 0.8 to 1 kW appears to improve penetration depth of the laser beam and success of the welding procedure. Operator skill is also an important variable. CONCLUSION: The variation in laser weld quality in dental FeNiCr wires attributable to operator skill can be minimized by optimization of the physical welding parameters.

The laser welding technique applied to the non precious dental alloys procedure and results.

AIM: The laser welding technique was chosen for its versatility in the repair of dental metal prosthesis. The aim of this research is to assess the accuracy, quality and reproducibility of this technique as applied to Ni-Cr-Mo and Cr-Co-Mo alloys often used to make prosthesis METHOD: The alloy's ability to weld was evaluated with a pulsed Nd-Yag Laser equipment. In order to evaluate the joining, various cast wires with different diameters were used. The efficiency of the joining was measured with tensile tests. In order to understand this difference, metallographic examinations and X-Ray microprobe analysis were performed through the welded area and compared with the cast part. RESULTS: It was found that a very slight change in the chemistry of the Ni-Cr alloys had a strong influence on the quality of the joining. The Co-Cr alloy presented an excellent weldability. A very important change in the microstructure due to the effect of the laser was pointed out in the welding zone, increasing its micro-hardness. CONCLUSION: The higher level of carbon and boron in one of the two Ni-Cr was found to be responsible for its poor welding ability. However for the others, the maximum depth of welding was found to be around 2mm which is one of the usual thicknesses of the components which have to be repaired.

Microleakage and penetration depth of three types of materials in fissure sealant: self-etching primer vs etching: an in vitro study.

Clinical preventive procedures must be done after a risk assessment. One of the risk factors is the occlusal morphology of the posterior teeth. These caries-free fissures must be sealed. This first in vitro experimentation of the study evaluated the microleakage and the penetration depth of three types of materials by Vivadent: Helioseal F, Tetric, Tetric Flow. The teeth were etched with phosphoric acid and bonded using a one bottle bonding in order to determine the best material for the sealing of the fissure. The depth of penetration of fuschine dye as well as that of the tested material was measured with a grid. The results, compared to the depth of the fissures, are expressed in percentage of penetration. The results were as follows: penetration of fuschine dye: 0% for the 2 composites, 100% for Helioseal F; penetration of the materials: 96.90% for Helioseal F, 70.82 for Tetric and 86.10 for Tetric Flow (significant difference, Wilcoxon test = 0.0105). In this first in vitro study, Tetric Flow shows no microleakage and is more efficient when compared to Helioseal F and Tetric in obturating deep fissures of non carious bicuspids. The second experiment of the study evaluated the microleakage and the penetration depth of Tetric Flow when it is bonded by two different methods: Group 1: total etch (phosphoric acid) and Scotch-bond 1 (3M), and Group 2: self-etching primer with Prompt (Espe). There was no significant difference (p > 0.03) between classical bonding vs self-etching primer. The self-etching primer Prompt is very efficient vs phosphoric acid in obturating the fissures of non carious bicuspids with Tetric Flow. It is concluded that for prevention by sealing, using a flowable ceromer (Tetric Flow) with the self-etching (Prompt), is a really good technique.

[Water absorption of five dental resins used in bonded restorations]. / Absorption d'eau de cinq matériaux à base de résine utilisés en Dentisterie restauratrice collée.

The actual restorative dentistry need to bond material which are under the constraint of saliva likely, as all liquid, to enter inside the product with time and to modify its characteristics. In this study, we compare the behaviour of five materials opposite water absorption, in vitro, until one year: two composite resins (Tetric et Pertac II), two ceromer (ceromer (Tetric ceram et Tetric flow) and one compomer (Hytac(r)). Each pastille weight is expressed in percentage of initial weight. All materials loose weight in the first hours except Tetric ceram which stay stable. At 48 h, all materials except Pertac II get back their initial weight. At long-term, all the materials are stable with a profit of 1% for Hytac, 0.5% for Tetric, Tetric ceram et Tetric flow and a loss of à 0.3% for Pertac II. As a result of this study, we understand why the clinical used of Hytac must be done following strict conditions.