Environmentally friendly behavior in dentistry.

Background and aims: Sustainability is the sensitive and responsible way of using the natural resources, its goal being to prevent their depletion and preserving the ecological balance. An essential requirement to achieve this is to practice environmentally conscious behavior. The main objective of the present study was to carry out a survey among dentists about the importance of sustainability, feasibility of an environmentally friendly dental practice and the steps in favor of it. Methods: An online survey with 6 question groups, including a total of 50 questions, was performed. The survey was available online for dentists on different platforms. In total 98 responses were recorded during September - November 2020. Results: Out of the responding dentists, 74.49% liked the idea of an environmentally friendly dental practice and 98.97% would take some steps toward environmental awareness in their practice. A statistically significant (p<0.05) difference between those who prefer an environmentally conscious practice and those who had not yet thought about it was only in the questions related to environmentally conscious lifestyle in their household, the use of environmentally friendly cleaning products, the creation of a 'green wall' and selective waste collection in their practice. Conclusions: Most of the respondents were open to the idea of forming an environmentally conscious dental practice and they would act to achieve it. In order to reach this, it is necessary to provide dentists with feasible solutions for better practice. Some of the guidance issues, which would be easy to implement, are listed at the end of the present study. We intend to provide a guidance regarding sustainable dental practice.

Quantitative and Qualitative Assessment of Fluorescence in Aesthetic Direct Restorations.

Currently available direct restoration materials have been developed to have improved optical properties to interact with light in the same manner as the natural tooth. The objective of this study was to investigate the fluorescence of different enamel resin composites. In the present study, nine brands of enamel composites were tested in vitro, some of which are cited by manufacturers as having color adjustment potential. Fluorescence spectra of the composite specimens and the human natural enamel were measured with a fluorescence spectrophotometer immediately after preparation and after 6 months. Qualitative data of the specimens were also collected. Statistical analyses were conducted by Kruskal−Wallis and Mann−Whitney U nonparametric tests (p < 0.05). Almost all tested resin composites presented a significant decrease in the fluorescence values after a period of 6 months. There was no significant decrease in fluorescence in the case of Harmonize™ resin composite samples, which presented the lowest initial fluorescence values. The highest value in the reduction of the initial fluorescence intensity after 6 months (22.95%) was observed for the Charisma® specimens. Composites with a color adjustment did not perform significantly better than other composites in terms of reduction in fluorescence intensity.

Multicenter study to develop and validate a risk assessment tool as part of composite scoring system for erosive tooth wear.

OBJECTIVES: (i) To develop, validate, and apply in practice a new risk assessment tool for erosive tooth wear (ETW) including a risk factors questionnaire and a saliva secretion evaluation, which combined with a clinical index, can be part of an ETW composite scoring system; (ii) to assess ETW lesions and current and past erosive challenges in younger age groups. METHODS: The Tooth Surface Loss/Erosion Working Group of the European Association of Dental Public Health consisted of an international panel of experts designed the survey component of the new tool (Erosive Wear Assessment of Risk-EWAR) and confirmed its construct and content validity. After receiving ethical approvals and informed consents, the EWAR tool (questionnaire + saliva secretion evaluation) was applied in a multicenter cross-sectional study with 207 participants aged 15-21 years old from four countries (Finland, Greece, Romania, the USA). BEWE score was used for the clinical assessment of ETW. RESULTS: A total of 58.5% of participants had ETW. 10.9% and 20.3% of participants had low secretion of stimulated (< 1 ml/min) and unstimulated saliva (< 0.25 ml/min), respectively. The following factors were bivariately significantly associated with ETW: energy drink consumption, low secretion of stimulated saliva, juices consumption, erosive drink consumption for quenching thirst between meals, erosive drink kept in the mouth, feeling pain/icing after consuming something acidic or cold, and co-existence of other type of tooth wear. In regression analysis, only energy drink consumption (OR = 3.5, 95% CI: 1.39, 8.9), low secretion of stimulated saliva (OR = 36.3, 95% CI: 4.71, 78.94), and feeling pain/icing (OR = 8.8, 95% CI: 1.92, 40.04) remained significant. CONCLUSIONS: The examiners of the study reported that the EWAR tool appeared to be an affordable and easy-to-use instrument. Some challenges occurred during the saliva collection process. Inferential analysis revealed that the risk factors/indicators of low stimulated salivary flow, energy drink consumption, and pain/icing with ETW were considered the most important in ETW occurrence. CLINICAL RELEVANCE: EWAR tool combined with the BEWE clinical index can be used for ETW risk assessment for epidemiological studies and chairside use.

Jaw relationship assessment for removable complete dentures using the t-scan computerised system - a case report.

OBJECTIVE: For obtaining the perfect balance of a removable complete denture, we have a few clinical procedures to complete, but only the analysis of the occlusal load distribution at various vertical dimensions of occlusion can give us the precise data. METHOD: The patient selected for this case report was a 35 years old edentulous female who requested prosthetic treatment with complete removable dentures. We followed the usual clinical steps of obtaining an acrylic denture, as well as the T-Scan III analysis during the jaw registration, in different conditions: with the occlusal wax rims, and with the trial denture in the next step, registering three different occlusal vertical dimension - understated, overstated and ideal height. Using these dimensions, we realized four mock-ups, two at the proper vertical dimensions, with various types of tooth color and shape. We analyzed the mock-ups using the T-scan III system. After the dental prosthesis was manufactured, we made another measurement with the T-scan III system. RESULTS: After analyzing all the data from the T-scan III system, we distinguished that the most suitable solution for the patient was the proper dimension mock-up with D2 shade. CONCLUSIONS: Although the registered situations were satisfactory, the aesthetic issues are essential, and the functional aspects are fundamental, the most suitable solution in this case, was the mock-up with proper dimensions.

Mild hypodontia is associated with smaller tooth dimensions and cusp numbers than in controls.

OBJECTIVE: The associations seen clinically between variations in tooth number, size and shape reflect the repetitive genetic interactions occurring between the epithelium and mesenchyme during the initiation and morphogenetic stages of the Complex Adaptive System that is dental development. The aim of this study was to investigate the clinical relationship further by comparing multiple crown parameters, including cusp numbers, between patients with mild hypodontia and controls in a Romanian sample. DESIGN: Digital images of dental casts of the permanent dentition from 28 patients with mild hypodontia and 28 controls were used. Measurements from the vestibular and occlusal surfaces were performed using a 2D image analysis method and cusps, including the Carabelli trait, were counted. Two-way analysis of variance was performed. RESULTS: The dimensions of the mild hypodontia group had smaller values than the controls, with many measurements being significantly different (significance values varied from p=0.049 to p=0.001). The most affected regions were the upper and lower anterior region in both sexes. Mesio-distal, bucco-lingual and occlusal area and perimeter dimensions were affected. Females from the hypodontia group had significantly less tricuspidated lower premolars when compared with the control group. Carabelli cusps were present in the hypodontia group less frequently, the difference being highly significant (p=0.0002) in women. CONCLUSIONS: The hypodontia patients presented with reduced crown dimensions and shape compared with controls. This is the first published study to demonstrate smaller cusp numbers in patients with hypodontia than in controls. The findings are compatible with a model of dental development as a Complex Adaptive System incorporating associations between tooth number, size and shape.

Intraoral fluoride levels after use of conventional and high-fluoride dentifrices.

OBJECTIVES: This study aimed to evaluate saliva and plaque as indicators of intraoral fluoride (F) levels after the use of conventional and high-fluoride dentifrices. MATERIALS AND METHODS: Subjects were randomly assigned to brush their teeth with conventional (1000 ppm F), high-fluoride (5000 ppm F), and placebo dentifrices (fluoride free) for 10 days, following a double-blind, crossover protocol. Saliva and plaque samples were collected on the morning of the 5(th) and 10th days, respectively at 1 and 12 h after brushing, and analyzed with an ion-selective electrode after HMDS-facilitated diffusion. Data were analyzed by two-way repeated measures ANOVA, Tukey's test and Spearman's correlation coefficient (p < 0.05). RESULTS: Plaque and salivary F levels were significantly increased after the use of conventional and high-fluoride dentifrices when compared to values obtained for placebo, except plaque 12 h after the use of conventional dentifrice. A positive and significant correlation was found between fluoride concentrations in plaque and saliva for both times of sample collection. CONCLUSION: Both indicators assessed were able to detect significant differences among treatments and between times after brushing. The use of a high-fluoride dentifrice is able to significantly increase intraoral fluoride levels throughout the day, being therefore a useful therapy for patients at high caries risk. CLINICAL RELEVANCE: A dentifrice with high fluoride concentration could be regarded as a useful therapy of F delivery for high caries-risk patients, since intraoral F levels were sustained throughout most of the day after using this formulation.