Silver Diammine Fluoride Usage in General Dentistry Offices in Louisiana.

Purpose: To evaluate the current knowledge and usage of silver diammine fluoride (SDF) by general dentists in Louisiana and to identify primary barriers to the imple- mentation of SDF. Methods: A 16-item survey was emailed to 1719 Louisiana Dental Association members to identify factors influencing general dentists' usage of SDF. Results: Eighty-two surveys were completed with a response rate of 4.8 percent, with 69 identified as general dentists. Over half of the respondents were male (53.6%) and their practice experience ranged from less than one year to 48 years. The majority were solo owners (43.5%) while 7.3 percent had jobs in the corporate setting. Most agreed/strongly agreed that their knowledge of SDF was from either dental journals or online resources, while fewer stated they were taught about SDF (25%) or used SDF (8%) in dental school. The majority knew the advantages and off-label usage of SDF. However, only 40 percent recognized that SDF was officially approved for tooth hypersensitivity only. The most reported perceived barrier to SDF implementation was not learning about SDF in dental school (36%). Conclusion: There is a lack of understanding of SDF usage among Louisiana general dentists. The main reason for not incorporating SDF into their practice is the lack of training in their dental education.

Potassium Iodide's Effect on Silver Diammine Fluoride Staining Properties as Measured Through Objective Color Analysis Using CIELAB.

Purpose: To determine the effect of potassium iodide (KI) on the black/gray staining caused by silver diammine fluoride (SDF) when applied to carious lesions. Methods: Extracted caries-free molar surfaces had caries induced to examine the use of SDF and SDF followed by KI (SDF+KI) on extracted permanent molars that had caries induced on their surfaces and were monitored for a period after application. To monitor the color changes, CIELAB color space readings???a color space defined by the International Commission on Illumination???were used. The system is composed of three values, of which the L* measures black to white across a span of zero (black) to 100 (white). Measurements were taken at eight intervals between days zero to 72. Results: L* values were found to be significantly different between SDF and SDF+KI groups and from baseline. On average, the SDF+KI group versus the SDF group was 9.47 units lighter. Conclusion: The findings indicate the application of silver diammine fluoride followed by potassium iodide can reduce the black staining SDF alone causes, potentially making it a viable esthetic option for patients with anterior tooth caries.

Direct Comparison Between Intraoral Scanning and Alginate Impressions for Pediatric Patients: An In Vitro Study.

Purpose: To compare the accuracy and efficiency of both alginate and digital impression techniques in a method representative of a clinical setting. By evaluating the difference in fabrication time and accuracy for these techniques, it can be determined if using digital scanning is a viable alternative to alginate impressions to fabricate pediatric dental appliances.
Methods: Both the alginate and digital impressions were taken from the same pediatric typodont study model. The alginate impressions were handled and poured up, per product instructions, and digital impressions were 3D printed. A digital caliper was used to measure different landmarks on both the stone models and 3D printed models, and these measurements were compared to the pediatric typodont to determine accuracy. All steps in the process, including obtaining the impression, fabrication of the model and total time, were recorded to determine the efficiency of both methods.
Results: The alginate models had a significantly higher intercanine distance than the control. Measurements of anterior-posterior (AP) left, AP right, left central, and right central were larger than the control but did not show a significant difference in measurement. The alginate group had a significantly shorter impression time. Model fabrication time between the two groups was similar.
Conclusion: Alginate impressions require less chairside time and the digital technique was shown to be accurate in all measurements. Digital scanning may be a good alternative to alginate impressions for pediatric patients.

The prevalence of developmental dental and eruption anomalies assessed using panoramic radiographs: a retrospective study.

Developmental dental anomalies are a common finding in adolescent populations. The objective of this study was to utilize panoramic radiographs to determine the prevalence of dental anomalies and developmental disturbances in a heterogenous adolescent orthodontic patient population seeking care at a North American orthodontic residency program. A total of 1042 panoramic radiographs of 457 male and 585 female orthodontic patients aged 10 to 18 years were evaluated. Developmental and eruption anomalies were recorded and categorized, and chi-square and Fisher exact tests were used for statistical analysis. The evaluation revealed that 40.88% of patients had at least 1 anomalous finding. The most common finding overall was agenesis (12.00%), followed by deviations in eruption path (9.12%), delayed eruption (7.39%), and impaction (7.29%). There was no difference in the prevalence of having any anomalous finding or the prevalence of any specific category of anomalies based on the sex or Angle classification of the patients. Comparison of developmental dental anomalies in 3 age groups (10 to 12, 13 to 15, or 16 to 18 years) revealed no statistically significant difference in the overall prevalence of anomalous findings. Statistically significant differences for some specific categories of anomalies were explainable by correlating dental development with chronologic age, such as a greater frequency of blocked out teeth and eruption path deviation among patients aged 10 to 12 years. Black patients were found to have a significantly greater prevalence of impactions (P = 0.030), and Asian patients had a significantly greater prevalence of anomalies categorized as "other pathology," which could not be definitively diagnosed by panoramic radiograph alone (P = 0.007).

Recall Attendance After General Anesthesia Versus Oral Conscious Sedation.

Purpose: The purpose of this study was to compare recall attendance after dental rehabilitation with general anesthesia versus recall attendance after treatment performed with oral conscious sedation. Methods: This was a retrospective chart review of 733 patients who underwent general anesthesia or oral conscious sedation to complete dental treatment from January 2015 to February 2018. Six hundred patients received general anesthesia (GA), and 133 received oral conscious sedation (OCS). Demographic data, procedural dates, recall attendance, insurance reimbursement, and behavior scores were recorded. Results: A total of 31.8 versus 52.6 percent of the GA versus OCS group attended a periodic examination within one year of their restorative appointment. Conclusions: Oral conscious sedation patients attended periodic examinations within one year more often than general anesthesia patients. Increased mileage distance for both groups decreased the odds that patients would attend a periodic examination.

The Effect of Silver Diamine Fluoride on Bond Strength of Three Types of Bulk-Fill Restorative Materials to Dentin.

Purpose: The purpose of this study was to evaluate the effect of 38 percent silver diamine fluoride (SDF) application on the shear bond strength (SBS) of three types of bulk-fill restorative materials to dentin. Methods: Eighty recently extracted deidentified, sound, human premolar teeth were sectioned to expose the mid-coronal dentin. A composite restorative material (ACTIVA™), a giomer (Beautifil®), and a high-viscosity glass ionomer (HVGI) cement (Equia Forte®) were used. The specimens were randomly assigned into eight groups (N equals 10 per group) according to the type of restorative material (ACTIVA™, Beautifil ®, Equia Forte ® with and without the conditioner) and pretreatment with one drop of 38 percent SDF. Both ACTIVA™ and Beautifil ® were bonded to dentin with a universal adhesive (Scotchbond™ Universal). The SBS was measured in a universal testing machine with a 0.5 mm per minute crosshead speed. One-way analysis of variance, Tukey's, and adjusted pairwise comparison tests were used for statistical analysis of data (α equals 0.05). Results: Pretreatment of dentin with SDF did not affect the SBS of the tested bulk-fill materials (P>0.05). The SBS of the ACTIVA™ and Beautifil® groups was similar (P>0.05) and significantly higher than all Equia Forte® groups (P<0.001). Application of conditioner had no significant effect on the SBS values of Equia Forte® (adjusted P>0.01). Conclusions: The application of silver diamine fluoride did not influence the shear bond strength of tested bulk-fill materials to dentin. Prior conditioning did not affect the SBS of the high-viscosity glass ionomer to dentin. The giomer and composite restorative materials showed significantly higher SBS than high-viscosity glass ionomer.

Prevalence of Molar-Incisor Hypomineralization Within an Orthodontic Department in the United States.

Purpose: The purpose of this study was to determine the prevalence and severity of molar-incisor hypomineralization (MIH) by examining standard orthodontic intraoral photographs. Methods: A total of 690 patients were evaluated retrospectively for the presence or absence and extent of MIH using standardized assessment criteria. Results: Fourteen percent of all patients examined presented with MIH on at least one tooth. There was no significant difference in the presence of MIH when compared to age, race, or gender. MIH is most commonly presented on maxillary molars and maxillary central incisors as demarcated opacities with less than one-third of the tooth affected. More severe clinical status groups were associated with higher average age and were more commonly seen in molars than incisors. Conclusions: At 14 percent, the prevalence is reflective of the worldwide prevalence previously determined from other studies. MIH most commonly presents in its mildest form; however, older individuals tend to present with more severe forms, indicating that it continues to cause problems as patients age. Future studies should extend to further areas to continue to ascertain the extent and severity of this condition.

Custom-molded foot-orthosis intervention and multisegment medial foot kinematics during walking.

CONTEXT: Foot-orthosis (FO) intervention to prevent and treat numerous lower extremity injuries is widely accepted clinically. However, the results of quantitative gait analyses have been equivocal. The foot models used, participants receiving intervention, and orthoses used might contribute to the variability. OBJECTIVE: To investigate the effect of a custom-molded FO intervention on multisegment medial foot kinematics during walking in participants with low-mobile foot posture. DESIGN: Crossover study. SETTING: University biomechanics and ergonomics laboratory. PATIENTS OR OTHER PARTICIPANTS: Sixteen participants with low-mobile foot posture (7 men, 9 women) were assigned randomly to 1 of 2 FO groups. INTERVENTION(S): After a 2-week period to break in the FOs, individuals participated in a gait analysis that consisted of 5 successful walking trials (1.3 to 1.4 m/s) during no-FO and FO conditions. MAIN OUTCOME MEASURE(S): Three-dimensional displacements during 4 subphases of stance (loading response, midstance, terminal stance, preswing) were computed for each multisegment foot model articulation. RESULTS: Repeated-measures analyses of variance (ANOVAs) revealed that rearfoot complex dorsiflexion displacement during midstance was greater in the FO than the no-FO condition (F(1,14) = 5.24, P = .04, partial η(2) = 0.27). Terminal stance repeated-measures ANOVA results revealed insert-by-insert condition interactions for the first metatarsophalangeal joint complex (F(1,14) = 7.87, P = .01, partial η(2) = 0.36). However, additional follow-up analysis did not reveal differences between the no-FO and FO conditions for the balanced traditional orthosis (F(1,14) = 4.32, P = .08, partial η(2) = 0.38) or full-contact orthosis (F(1,14) = 4.10, P = .08, partial η(2) = 0.37). CONCLUSIONS: Greater rearfoot complex dorsiflexion during midstance associated with FO intervention may represent improved foot kinematics in people with low-mobile foot postures. Furthermore, FO intervention might partially correct dysfunctional kinematic patterns associated with low-mobile foot postures.

The effect of low-mobile foot posture on multi-segment medial foot model gait kinematics.

A number of in vitro, invasive in vivo, and non-invasive marker based multi-segment foot models (MSFMs) have reported significant motion in the articulations distal to the calcaneus during gait. Few studies, however, have applied a MSFM to the investigation of the effect of foot posture on gait kinematics. Differences in stance phase kinematics between participants with low-mobile (LMF) (n=11) versus "typical" (TYPF) (n=11) foot postures were investigated using a multi-segment medial foot model. Three-dimensional position and stance phase excursions of four functional articulations (rearfoot complex [RC], calcaneonavicular complex [CNC], medial forefoot, first metatarsophalangeal complex) were quantified using an eight optical camera motion analysis system (Vicon Motus, Vicon Motions Systems, Centennial, CO) and a custom written software program (Matlab 7.0.1, The MathWorks, Natick, MA), respectively. Excursions during four subphases of stance phase (loading response, midstance, terminal stance, pre-swing) at each of the functional articulations were compared using multivariate analyses of variance (alpha

The effect of 6 weeks of custom-molded foot orthosis intervention on postural stability in participants with >or=7 degrees of forefoot varus.

OBJECTIVE: Postural stability (PS) was assessed in a group of participants with >or=7 degrees of forefoot varus (FV) after 6 weeks of custom-molded functional foot orthosis (FO) intervention to investigate the effect of FO intervention in a population that may have decreased PS due to their foot structure. DESIGN: A force platform was used to assess right and left single-limb stance position and eyes open and eyes closed condition PS. SETTING: PS was assessed in a biomechanics research laboratory. PARTICIPANTS: Twelve participants with >or=7 degrees of FV (MFV) and 5 participants with <7 degrees of FV (LFV) participated in the study. INTERVENTIONS: PS of the MFV group was assessed initially when FOs were received and after 6 weeks of FO intervention. The LFV group PS was assessed during initial and 6-week testing sessions. MAIN OUTCOME MEASURES: The root mean square of the center of pressure velocity was used to quantify single-limb stance PS during no FO and FO conditions. RESULTS: LFV group PS did not change significantly (P=0.829) over the 6-week time period. Significant improvement was, however, reported in the MFV group anteroposterior (P=0.003) and mediolateral (P=0.032) PS at the 6-week assessment versus the initial assessment during both the noFO and FO conditions. CONCLUSIONS: Six weeks of FO intervention may significantly improve PS in participants with >or=7 degrees of FV both when wearing FOs and when not wearing FOs.

Factors associated with comprehensive dental care following an initial emergency dental visit.

PURPOSE: The purpose of this study was to characterize the patient population utilization of a dental home as grouped by: (1) age; (2) sex; and (3) payment method. METHODS: A retrospective chart review of 1,020 patients, who initially presented for an emergency visit, was performed. From the original data pool, 2 groups were delineated: (1) those patients who returned for comprehensive dental care; and (2) those who did not return for comprehensive dental care. RESULTS: Patients with private dental insurance or Medicaid dental benefits were statistically more likely to return for comprehensive oral health care than those with no form of dental insurance. Younger patients (< or =3 years of age) were least likely to return for comprehensive dental care. CONCLUSIONS: Socioeconomic factors play a crucial role in care-seeking behaviors. These obstacles are often a barrier to preventive and comprehensive oral health care.

Creating learner-centered classrooms: use of an audience response system in pediatric dentistry education.

Research suggests that the exclusive use of lecture in the classroom hinders student learning. The advent of compact electronic wireless audience response systems has allowed for increased student participation in the classroom. Such technology is utilized in medical education. This article describes the use of an audience response system in a "quiz bowl" format to facilitate and improve the comprehension of student dentists in core concepts in pulp therapy for the pediatric patient.

Acrylic artificial fingernail embedded in the palate of an 11-month-old: a case report.

Foreign bodies found embedded in the oral cavity have been reported in the literature. The purpose of this case report was to document embedding of an acrylic artificial fingernail in the palate of an 11-month-old. As the use of artificial acrylic nails increases, this case report is also meant to alert oral health professionals as to what may become a more common occurrence.

Oral health care for the internationally adopted child: a case report.

While the health considerations of the internationally adopted child have been widely discussed in the medical scientific literature, there has not been substantial discourse on the oral health needs of international adoptees. The purpose of this case report is to review some of the medical implications associated with international adoption and, more importantly, highlight some of the potential oral health complications present in this at-risk group of children.