Long-term effect of simulated five years professional mechanical biofilm removal on the luting gap of ceramic restorations.

BACKGROUND: Achieving sufficient professional mechanical biofilm removal (PMPR) can be challenging in supportive periodontal therapy (SPT), particularly in patients with prosthetic restorations. This experimental study aimed to simulate five years of SPT with periodic PMPR near the luting gap of ceramic restorations using a rubber cup with polishing paste (RCP), air polishing with two different low-abrasive powders (LAPA-1: glycine powder, LAPA-2: erythritol powder), and non-professional mechanical cleaning (control group) to measure the extent of volume loss in the luting gap after baseline (∆V = Vbaseline-V1-5; in µm3). METHODS: Two operators randomly performed PMPR ten times for thirty seconds on one of four sides of 30 crown replicas fixed with glass-ionomer cement (CGIZ: n = 15) or adhesive bonding (CAB: n = 15). The replicas were separated in a template during PMPR, and afterward, cleaned for five seconds per side with a sonic brush under flowing water. The artificial aging process between two PMPRs simulated a 5-year SPT with two PMPRs per year. Profilometric measurements were performed at baseline and after each second PMPR to obtain the mean change of ∆V. The statistical evaluation of the data was carried out using nonparametric tests with Bonferroni correction applied for multiple tests. RESULTS: Ninety-six out of 120 sides could be included in the analysis. PMPR methods showed a loss of substance in the luting gap with a ∆V (mean(standard deviation)) of -4.35 × 106(4.8 × 106)µm3 versus 8.79 × 104(1.05 × 106)µm3 for control at V5 (p ≤ 0.001). No significant differences of ∆V1-5 values could be identified in the control (p > 0.05), whereat all PMPRs showed a significant increasing loss of substance per simulated year (p ≤ 0.001). Intergroup comparison identified LAPA-1 as having the highest significant loss of substance determined on CAB (∆V: -1.05 × 107 (7,2 × 106) µm3), followed by LAPA-2 on CAB (∆V: -6.29 × 106 (4,24 × 106) µm3), LAPA-1 on CGIZ (∆V: -4.15 × 106 (3,25 × 106) µm3), LAPA-2 on CGIZ (∆V: -3.0 × 106 (2,23 × 106) µm3), RCP on CAB (∆V: -1.86 × 106 (2,23 × 106) µm3) and CGIZ (∆V: -1.2 × 106 (1,31 × 106) µm3; p ≤ 0.001)). CONCLUSIONS: Within study limitations, all PMPRs caused a significantly higher loss of substance in the luting gap versus control without professional intervention, with the highest values in the CAB group for LAPA-1, LAPA-2 and RCP. Similar findings were observed for CGIZ, although the loss values were lower.

Attitude of Midwives towards Fluoride Recommendations and Oral Prevention in Infants and Young Children.

Early childhood caries is a challenge. Early dental screening flanked by multidisciplinary preventions by pediatricians, dentists, and midwives (MWs) may be helpful. New recommendations for dental screening in children (FUs) and fluoride have been introduced in Germany. The aim of this study was to investigate whether midwives consider FUs useful and implement early childhood caries prevention, as well as fluoride recommendations. The survey was conducted using an online questionnaire. Demographic data, including 11 items on early childhood dental prophylaxis and fluoride, were requested. Agreement was recorded using Likert scales. The data were analyzed descriptively. Two hundred and seventeen female MWs participated (age: 44.1 (11.04) years). One hundred and four (47.9%) participants knew about the FUs. Of the MWs, 30.7% found a referral from the first tooth to be very important (important/neutral/unimportant: 27%/27.9%/14.4%), compared with 84.8% for the entire primary dentition (11.8%/2.8%/0.5%). Of the MWs, 41.7% always recommended fluoride toothpaste from the first tooth (often/occasionally/rarely/never: 22.7%/12.4%/7.9%/15.3%) and 48.1% completely rejected fluoride-free toothpaste (always/often/occasionally/rarely: 9.8%/8.9%/17.3%/15.9%). In addition, 54.8% never recommended the use of fluoride tablets (always/often/occasionally/rarely: 9.2%/7.4%/10.2%/18.4%). The FUs are not yet well-known among MWs, and only less than one-third recommended dental check-ups, starting with the first tooth. This contrasts with the high uptake of fluoridated toothpaste. More educational work should be carried out to convince more MWs of the benefits of the FUs.

Are the Dental Guidelines for Early Dental Visits and Fluoridation Measures Supported by Pediatricians, and What Are Their Caries Prevention Efforts?

(1) Background: In Germany, new recommendations for dental examinations of children and the use of fluorides have been introduced. The pediatrician (PA) should refer the patient to the dentist for dental examinations and check-ups (DEs) from the sixth month of age. Therefore, our aim was to determine with a questionnaire the extent to which PAs find DE useful, make referrals for DE and recommend fluoride. (2) Methods: The nationwide empirical survey was conducted with a self-developed and validated standardized online questionnaire. In addition to personal information, 16 items were collected. Agreement with the items was recorded using Likert scales. The data were primarily analysed descriptively. (3) Results: 696 PAs participated in the survey (age: 51.7 (8.4) years, women/men: 428/286 (61.5/38.5%). A total of 11% of PAs found referral by eruption of first tooth very important (important/neutral/unimportant: 13.8/32/43.2%), compared to 70% for complete deciduous teeth (21.3/7.3/1.4%). A total of 48.8% of PAs always recommended fluoridated toothpaste from the first tooth (often/occasionally/rarely/never: 18.3/7.8/8/17.1%) and 50.6% completely refused to recommend fluoride-free toothpaste (always/often/occasionally/rarely: 9.8/9/14.7/15.9%). A total of 44.8% never recommended the use of fluoridated toothpaste if the child cannot yet spit (always/often/occasionally/rarely: 19.2/13.9/7.8/14.3%). (4) Conclusions: Among PAs, referral to DEs was increasingly implemented as children grew older. Specific fluoride recommendations were accepted.