Scanning Electron Microscopy and Macroscopic Examination of Prematurely Erupted Teeth in Preterm Infants.

Prematurely erupted teeth are rare in fullterm neonates and extremely rare in prematurely delivered infants. The aim of this study was to present macroscopic and scanning electron microscopy (SEM) investigations of prematurely erupted primary teeth of preterm very low birthweight (VLBW) and extremely low birthweight (ELBW) infants. Three preterm VLBW and ELBW infants with prematurely erupted lower incisors were examined. The dental examination assessed the type, location, clinical appearance, and degree of mobility of the prematurely erupted teeth. The structural appearance of enamel and dentin of three extracted and longitudinally sectioned prematurely erupted teeth was investigated with scanning electron microscopy (SEM). Lower incisors were rootless with hypermobility. The surface of enamel of the prematurely erupted primary teeth was hypoplastic and hypomineralized and had a typical "honeycomb" appearance in SEM. The aprismatic type of enamel was visible in some regions. The neonatal line separating the layer of prenatal enamel from postnatal enamel was observed. The enamel prisms were interconnected by interprismatic substances, and cross-striations of prisms were visible. Dentin presented a typical tubular character. The dentinal layer near the enamel dentin junction had Y-shaped branching of dentinal tubules. On the pulpal side, dentin had a globular character. The macroscopic and SEM investigations particularly revealed alterations in enamel, while the dentin of neonatal teeth had a nearly normal appearance.

Precision of marginal adaptation of the incisor and molar Procera allceram crown copings.

The primary objective of this in vitro study was to compare the absolute marginal discrepancy (AMD) of CAD/CAM produced Procera AllCeram crown copings, fabricated on die stone master models of two different tooth groups, incisor and molar. Two maxillary central incisors and two first molars typodont teeth were prepared with 0.8 mm of circumferential chamfer, duplicated 9 times to obtain 36 die stone models and allotted into three groups of 12 models (incisors = 6 & molars = 6). Procera AllCeram 0.6 mm copings were fixed with zinc phosphate (AZ), glass ionomer (AG) and resin (AR) cement accordingly under 50 N static finger force. The AMDs were measured using the scanning electron microscope (SEM) on four axial walls with 4 measurements on each wall to obtain 16 readings for one tooth. Statistical analysis of the data was performed using the non-parametric test of Kruskal-Wallis and Mann-Whitney test. The analysis did not find any significant differences in the mean AMD of incisor and molar crown copings, and in different axial surfaces too (p < or = 0.05). Recorded mean AMD of incisor copings were AZ group 59 microm, AG 37.9 microm, and AR 44.4 microm and molar copings were AZ 48.8 microm, AG 27 microm, and AR 50.2 microm. It can be concluded that AMD of Procera AllCeram copings were within accepted level of 100 microm. Incisors showed higher AMD than molars. Molars demonstrated the higher AMD on mid-distal and mid-lingual surfaces whereas for incisor it was mid-buccal and mid-lingual surface.

Evidence-based care and the curriculum.

An evidence-based (EB) approach has been a significant driver in reforming healthcare over the past two decades. This change has extended across a broad range of health professions, including oral healthcare. A key element in achieving an EB approach to oral healthcare is educating our practitioners, both current and future. This involves providing opportunities integrated within simulated and actual clinical settings for practitioners to learn and apply the principles and processes of evidence-based oral healthcare (EBOHC). Therefore, the focus of this discussion will be on ways in which EBOHC and associated research activities can be implemented into curricula, with the aim of improving patient care. This paper will initially define the scope of EBOHC and research, what these involve, why they are important, and issues that we need to manage when implementing EBOHC. This will be followed by a discussion of factors that enable successful implementation of EBOHC and research into curricula. The paper concludes with suggestions on the future of EBOHC and research in curricula. Key recommendations related to curricula include strengthening of the culture of a scientific approach to education and oral healthcare provision; complete integration of EBOHC into the curriculum at all levels; and faculty development to implement EBOHC based on their needs and evidence of effective approaches. Key recommendations to support implementation and maintenance of EBOHC include recognition and funding for high-quality systematic reviews and development of associated methodologies relevant for global environments; building global capacity of EBOHC researchers; research into improving translation of effective interventions into education and healthcare practice, including patient-reported outcomes, safety and harms, understanding and incorporation of patient values into EB decision-making, economic evaluation research specific to oral healthcare and effective methods for changing practitioner (faculty) behaviours; and extend access to synthesized research in 'user friendly' formats and languages tailored to meet users' needs. Realizing these recommendations may help to improve access to effective healthcare as a basic human right.

Mutans streptococci and the development of dental plaque.

A study of dental plaque was first documented in the literature of the 17th century. It has been described as a biofilm composed of bacterial populations living in a plaque matrix. The plaque development starts short time after a tooth surface is cleaned and covered by salivary proteins and glycoproteins conditioning film. Mutans streptococci was described as the most important bacteria related to the etiology of dental caries. This bacteria has the basic properties of cariogenicity required in the dental caries process. Current studies have suggested that the behaviour of the oral microflora, with all its components, should be the aim of future understanding of the process of dental caries. The aim of this paper is to review literature about initiation and development of dental plaque and the influence of mutans streptococci in the dental caries.

Effect of fluoridated milk on progression of root surface lesions in vitro under pH cycling conditions.

The aim of this study was to assess the effect of milk with 0, 2.5 or 5 ppm F on progression and remineralization of caries-like root surface lesions using a pH cycling model. The root surface lesions were created utilizing a partially saturated lactic acid buffer at pH 4.6. Longitudinal sections were cut through the lesion and analyzed using polarized light microscopy (PLM) and microradiography (MRG). The sections were then coated with an acid resistant varnish, except the outer natural surface that would be exposed to water, milk or fluoridated milk and cycled in a de- and remineralizing system for 2 weeks. The lesions were characterized again by PLM and MRG after treatment. A significant reduction in lesion progression was found by PLM and MRG after treatment with either non-fluoridated or fluoridated milk when compared to the control group. Using quantitative MRG, mineral change and distribution in the lesions were recorded. A possible protective effect of fluoridated milk on root surface caries was supported by a reduction in the progression of the lesions and an increase in the mineral within the lesion.