Gingival crevicular blood as a source to screen for diabetes control
in a dental office setting
Jung-Wan M. Kim, dds,
ms, Ryan E. Wolff, dds, ms, Philippe
Gaillard, phd & Larry F. Wolff, ms, phd, dds
Abstract: Purpose: To determine if gingival crevicular blood (GCB) could potentially be used as a
reliable source to screen for diabetes control, this study compared glycosylated hemoglobin (HbA1c) levels found in GCB and
serum. Methods: Patients diagnosed (n=
29), with diabetes received a venipuncture on the
finger and serum blood (control) obtained was tested for HbA1c status
chair-side. GCB (test) was collected at site(s) with evidence of bleeding after
probing and the HbA1c value was determined in the same manner as with the serum
blood. Results: There was a
significant correlation between serum blood and GCB using the HbA1c test. The
Pearson correlation was 0.98 (P< 0.0001). The Altman-Bland bias was -0.21 (P=
0.0095), indicating that on average, the GCB method slightly underestimated the venipuncture serum (control) method for determining
HbA1c values. The Altman-Bland 95% agreement interval ranged from -1.02 to 0.6.
Furthermore, the HbA1c values were independent of the gingival sites used for
collection with intra-patient GCB values exhibiting a correlation value between
sites of 0.91 (P< 0.0001). (Am J Dent 2015;28:63-67).
Clinical significance: This study demonstrated that HbA1c levels can be reliably
screened in patients during routine dental visits, as a conservative,
noninvasive alternative to conventional venipuncture serum sampling procedures.
Mail:
Dr. Larry F. Wolff, Division of Periodontics, Department
of Developmental and Surgical Sciences University of Minnesota School of
Dentistry, 515 Delaware St, SE Minneapolis, MN 55455, USA. E-mail: wolff001@umn.edu
Comparing three toothpastes in
controlling plaque and gingivitis:
A 6-month clinical study
Terdphong Triratana, dds, Petcharat Kraivaphan, dds, Cholticha Amornchat, dds, Luis R. Mateo,
ma,
Abstract: Purpose: To
investigate the clinical efficacy of three toothpastes in controlling
established gingivitis and plaque over 6 months. Methods: 135 subjects were enrolled in a single-center,
double-blind, parallel group, randomized clinical study. Subjects were randomly
assigned to one of three treatments: triclosan/copolymer/fluoride
dentifrice containing 0.3% triclosan, 2.0% copolymer
and 1,450 ppm F as sodium fluoride in a silica base; herbal/bicarbonate
dentifrice containing herbal extract and 1,400 ppm F
as sodium fluoride in a sodium bicarbonate base; or fluoride dentifrice
containing 450 ppm F as sodium fluoride, and 1,000 ppm F as sodium monofluorophosphate.
Subjects were instructed to brush their teeth twice daily for 1 minute for 6
months. Results: After 6 months,
subjects assigned to the triclosan/copolymer/fluoride
group exhibited statistically significant reductions in gingival index scores
and plaque index scores as compared to subjects assigned to the herbal/bicarbonate
group by 35.4% and 48.9%, respectively. There were no statistically significant
differences in gingival index and plaque index between subjects in the herbal/
bicarbonate group and those in the fluoride group. The triclosan/copolymer/fluoride
dentifrice was statistically significantly more effective in reducing
gingivitis and dental plaque than the herbal/bicarbonate dentifrice, and this
difference in efficacy was clinically meaningful. (Am J Dent 2015;28:68-74).
Clinical
significance: The results of this double blind
clinical study supported the conclusion that brushing twice daily with a triclosan/copolymer/fluoride dentifrice can help promote
oral health by reducing plaque and gingivitis, whereas the herbal/bicarbonate dentifrice
was no more effective than the fluoride dentifrice.
Mail: Dr. Yun-Po Zhang, Colgate-Palmolive, 909 River
Road, Piscataway, NJ 08854, USA. E-mail:
yun_po_zhang@colpal.com
Laser-induced fluorescence in the diagnosis of pulp
exposure
Camilo Abalos, dds, md, phd, Manuela Herrera, dds, md, phd, Victoria Bonilla, dds, phd,
Laura San Martin, dds, md, phd, mdphc & Asuncion Mendoza, dds, md, phd
Abstract: Purpose: To clinically (a) determine
whether laser-induced fluorescence (LIF) was able to assess pulp tissue health
or disease in situations of pulp exposure; (b) evaluate the influence of
different pulp tissue conditions upon LIF through dentin thicknesses of ≤
Clinical significance: This clinical study showed
quantitative and qualitative laser-induced fluorescence to be useful in
assessing pulp tissue health or disease. The technique may be useful to determine
the prognosis and treatment of pulp tissue lesions.
Mail: Dr. Camilo Abalos, Faculty of Dentistry, University of Seville,
C/ Avicena s/n, 41009 – Seville, Spain. E-mail:
cabalos@us.es
Efficacy of a solar-powered TiO2 semiconductor electric toothbrush
Takenori Sato, dds, phd, Naoki Hirai, dds, Yasuhiro Oishi, dds, phd, Gerry Uswak, dmd, mph,
Kunio Komiyama, dds, phd & Nobushiro Hamada, dds, phd
Abstract: Purpose: To determine the efficacy of a
solar-powered TiO2 semiconductor electric toothbrush on Porphyromonas gingivalis biofilm. Methods: P. gingivalis cells were cultivated on sterilized coverslips under
anaerobic conditions and were used as a biofilm. To
evaluate the efficacy of the solar-powered TiO2 electric toothbrush
on the P. gingivalis biofilm, the bacterial cell biofilm coverslips were placed into sterilized phosphate
buffered saline (PBS) and brushed for 1 minute. Following mechanical brushing,
the coverslips were stained with 1% crystal violet
(CV) for 10 seconds at room temperature. The efficacy of P. gingivalis biofilm removal by the solar-powered TiO2 electric toothbrush was measured
through the absorbance of the CV-stained solution containing the removed biofilm at 595 nm. The antimicrobial effect of the
solar-powered TiO2 semiconductor was evaluated by the P. gingivalis bacterial count in PBS by blacklight irradiation for
0 to 60 minutes at a distance of 7 cm. The electrical current though the
solar-powered TiO2 semiconductor was measured by a digital multimeter. The biofilm removal
by the solar-powered TiO2 semiconductor was also evaluated by
scanning electron microscopy (SEM). Results: The biofilm removal rate of the solar-powered TiO2 electric toothbrush was 90.1 ± 1.4%, which was 1.3-fold greater than that of
non-solar-powered electric toothbrushes. The solar-powered TiO2 semiconductor
significantly decreased P. gingivalis cells and biofilm microbial activity in a time-dependent manner (P< 0.01). The electrical
current passing through the solar-powered TiO2 semiconductor was
70.5 ± 0.1 µA, which was a 27-fold higher intensity than the non-solar-powered
brush. SEM analysis revealed that the solar-powered TiO2 semiconductor
caused a biofilm disruption and that cytoplasmic contents were released from the microbial
cells. (Am J Dent 2015;28:81-84).
Clinical significance: P. gingivalis biofilm removal by the solar-powered electric toothbrush was significantly greater than
that by the non-solar-powered electric toothbrush and the electric control
brush. TiO2 semiconductors within the solar-powered electric
toothbrush can enhance the antimicrobial activity against an oral biofilm and contribute to the elimination of periodontal
pathogens.
Mail: Dr. Nobushiro Hamada, Department of Microbiology, Kanagawa Dental University, 82 Inaoka-cho, Yokosuka 238-8580, Japan. E-mail:
hamada@kdu.ac.jp
Effect of different prosthetic abutments on peri-implant soft tissue.
A randomized controlled clinical trial
Marco Ferrari, md, dmd, phd, Maria Crysanti Cagidiaco, md, dmd, phd, Franklin Garcia-Godoy, dds, ms, phd, phd,
Abstract: Purpose: This randomized clinical trial assessed the effect of
three different prosthetic abutments (titanium, gold-hue titanium and zirconia) on peri-implant soft
tissue 2 years after treatment in partially edentulous subjects. Methods: Baseline data concerning (1)
thickness of the buccal peri-implant
soft tissue, (2) soft tissue thickness above the bone crest, (3) depth/length
of transmucosal pathway, and (4) periodontal biotype
at adjacent teeth were collected. The final sample consisted of 47 subjects (21
males, 26 females) with a total of 97 implants. A two-level (patient, implant)
statistical model was applied. Results: At the 2-year clinical observation, recession of the gingival margin was
observed only at 13% of implants irrespective of the type of abutment. No
significant correlation between periodontal biotype at adjacent teeth and peri-implant biotype was observed. Furthermore, none of the
investigated variables at patient level (age, gender, implant type, periodontal
biotype) or at implant level (keratinized tissue thickness, probing depth, soft
tissue thickness) was identified as a significant predictor of recession. In
conclusion, this study pointed out that (1) abutment type was not able to
influence peri-implant variables after 2 years, and
(2) caution should be used in considering periodontal biotype at patient level
as a possible indicator of the future peri-implant
biotype. (Am J Dent 2015;28:85-89).
Clinical significance: Peri-implant
soft tissues are not influenced by different types of abutments (titanium,
titanium nitrade and zirconia)
after 2 years of clinical service and caution should be used in considering
periodontal biotype at patient level as a possible indicator of the future peri-implant biotype.
Mail: Prof. Dr. Marco Ferrari, Department of Medical
Biotechnology, University of Siena, Viale Bracci 1, Siena 53100, Italy. E-mail: ferrarm@gmail.com
Dentin tubule occluding ability of dentin
desensitizers
Linlin Han, dds, phd & Takashi Okiji, dds, phd
Abstract: Purpose: To compare the dentin tubule-occluding ability of fluoroaluminocalciumsilicate-based (Nanoseal),
calcium phosphate-based (Teethmate Desensitizer),
resin-containing oxalate (MS Coat ONE) and diamine silver fluoride (Saforide) dentin desensitizers using
artificially demineralized bovine dentin. Methods: Simulated hypersensitive
dentin was created using cervical dentin sections derived from bovine incisors
using phosphoric acid etching followed by polishing with a paste containing hydroxyapatite. The test desensitizers were applied in one,
two, or three cycles, where each cycle involved desensitizer application,
brushing, and immersion in artificial saliva (n= 5 each). The dentin surfaces
were examined with scanning electron microscopy, and the dentin tubule
occlusion rate was calculated. The elemental composition of the deposits was
analyzed with electron probe microanalysis. Data were analyzed by one-way ANOVA
and the Tukey honestly significant different test. Results: Marked deposit formation was
observed on the specimens treated with Nanoseal or Teethmate Desensitizer, and tags were detected in the specimens’
dentin tubules. These findings became more prominent as the number of
application cycles increased. The major elemental components of the tags were
Ca, F, and Al (Nanoseal) and Ca and P (Teethmate Desensitizer). The tubule occlusion rates of MS
Coat ONE and Saforide were significantly lower than
those of Nanoseal and Teethmate Desensitizer (P< 0.05). (Am J Dent 2015;28:90-94).
Clinical significance: The fluoroaluminocalciumsilicate-based
desensitizer Nanoseal and the calcium phosphate-based
desensitizer Teethmate Desensitizer demonstrated
significantly higher dentin tubule occlusion rates than the resin-containing
oxalate-based desensitizer MS Coat One and diamine silver fluoride-based solution (Saforide). The higher
dentin tubule occluding abilities of the fluoroaluminocalciumsilicate-based
and calcium phosphate-based products may contribute to their
dentin-desensitizing effects.
Mail: Dr. Linlin Han, Division of Cariology, Operative Dentistry and Endodontics, Department of Oral Health Science, Niigata
University Graduate School of Medical and Dental Sciences, 5274 Gakkocho-dori 2-bancho, Chuo-ku,
Influence of CAD-CAM diamond bur deterioration on
surface roughness and maximum failure load of Y-TZP-based restorations
Pedro Henrique Corazza, dds, ms, phd, Humberto Lago de Castro, dds, msc, phd,
Abstract: Purpose: To investigate the influence of
CAD-CAM diamond bur deterioration on surface roughness (Ra) and maximum failure
load (Lf) of Y-TZP-based ceramic (YZ) substructures (SB) veneered with a feldspathic porcelain. Methods: Two sets of burs (B1 and B2) were used to fabricate 30 YZ SB each in a CAD/CAM
system (Cerec InLab). The
SB were identified (1-30) according to the milling sequence (MS). SEM images of
the burs were recorded before milling, and after milling 15 and 30 SB. The SB
Ra was measured. All SB were veneered, cemented onto a fiber reinforced epoxy
resin die, and loaded to failure. Specimens from B1 group were cyclic fatigued
(106 cycles) before loading to failure. Fractographic analysis was performed. Data were statistically analyzed using Student’s
t-test, Weibull analysis, Pearson’s correlation and
ANOVA (α= 0.05). Results: The
mean Ra value of B1 specimens was statistically greater than B2. Weibull modulus of B1 and B2 were statistically similar.
The correlation between MS and Lf was not statistically significant for the
groups. MS and Ra had significant correlation for both groups (B1: r= -0.514, P=
0.015; B2: r= -0.462, P= 0.03). Although the visual aspect (SEM) of the burs
was similar after 30 millings, the mean Ra values were significantly different
after 27 millings for B1 and 24 millings for B2. (Am J Dent 2015;28:95-99).
Clinical significance: Milling 30 substructures using
the same set of burs did not affect the failure load. Different sets of burs
produced different mean surface roughness values. This difference did not
affect the reliability of the YZ-based restorations.
Mail: Dr. Alvaro Della Bona,
Post-graduate Program in Dentistry, Dental School, University of Passo Fundo, Campus I, BR 285, Passo Fundo, 99001-970 Brazil. E-mail: dbona@upf.br
The effect of antacid on salivary pH in patients
with and without
Sarah Dhuhair, bds, ms, Joseph B. Dennison, dds, ms, ms, Peter Yaman, dds, ms & Gisele F. Neiva, dds,
ms, ms
Abstract: Purpose: To evaluate
the effect of antacid swish in the salivary pH values and to monitor the pH
changes in subjects with and without dental erosion after multiple acid
challenge tests. Methods: 20
subjects with tooth erosion were matched in age and gender with 20 healthy
controls according to specific inclusion/exclusion criteria. Baseline measures
were taken of salivary pH, buffering capacity and salivary flow rate using the
Saliva Check System. Subjects swished with Diet Pepsi three times at 10-minute
intervals. Changes in pH were monitored using a digital pH meter at 0-, 5-, and
10-minute intervals and at every 5 minutes after the third swish until pH
resumed baseline value or 45 minutes relapse. Swishing regimen was repeated on
a second visit, followed by swishing with sugar-free liquid antacid (Mylanta
Supreme). Recovery times were also recorded. Data was analyzed using
independent t-tests, repeated measures ANOVA, and Fisher’s exact test (α=
0.05). Results: Baseline buffering
capacity and flow rate were not significantly different between groups (P=
0.542; P= 0.2831, respectively). Baseline salivary pH values were similar
between groups (P= 0.721). No significant differences in salivary pH values
were found between erosion and non-erosion groups in response to multiple acid
challenges (P= 0.695) or antacid neutralization (P= 0.861). Analysis of
salivary pH recovery time revealed no significant differences between groups
after acid challenges (P= 0.091) or after the use of antacid (P= 0.118). There
was a highly significant difference in the survival curves of the two groups on
Day 2, with the non-erosion group resolving significantly faster than the
erosion group (P= 0.0086). (Am J Dent 2015;28:100-104).
Clinical
significance: After
antacid use, the erosion group took a significantly longer time to resume
baseline pH values, therefore maintaining a more basic pH longer. Swishing with
antacid after acidic exposure may slow down the progression of mineral tooth
loss for people with high risk for tooth erosion.
Mail: Dr.
Gisele F. Neiva, Department of Cariology, Restorative
Sciences and Endodontics, University of Michigan,
1011 N. University, Ann Arbor, MI 48109-1078, USA. E-mail: gisele@umich.edu
Influence of heat and ultrasonic treatments on the
setting and maturation
of a glass-ionomer cement
Marion Dehurtevent, dds, Etienne Deveaux, dds, phd, Jean Christophe Hornez, phd, Lieven Robberecht, dds,
Abstract: Purpose: To compare the effect of different treatments (heat
capsule, ultrasound, and dual treatments) on the setting kinetics and
maturation properties of a conventional GIC (EQUIA, GC) to that of standard
setting. Methods: The optimal
durations of the heat and ultrasonic treatments were determined by monitoring
changes in the COO-/COOH ratio,
surface hardness, and temperature within the samples. The influence of optimal
treatments on the maturation properties of the GIC (microhardness,
and 3-point flexural strength) were assessed using GIC samples incubated in
artificial saliva for 24 hours, 1 month, and 3 months. Results: The optimal durations of the heat and ultrasonic
treatments for accelerating setting were 5 minutes and 35 seconds,
respectively. The dual treatment using the optimal conditions of the individual
treatments further enhanced the setting kinetics. A temperature peak (49°C)
within the GIC was detected during setting. Only the dual treatment increased
the mechanical properties of the GIC after 24 hours compared to the control,
while no significant difference was observed after 1 and 3 months. (Am J Dent 2015;28:105-110).
Clinical significance: Heat and/or ultrasonic treatments
slightly accelerated the setting kinetics and short-term (24 hours) mechanical
properties of the GIC. Such limited benefits raise doubts about the clinical
value of using these chair-side applications.
Mail: Dr. Marion Dehurtevent; Dr. Feng Chai, INSERM U1008, Groupe
Recherche Biomatériaux, 1 Place de Verdun, Université Lille 2, 59045 Lille, France. E-mail: marion.dehurtevent@ univ-lille2.fr,
fchai@univ-lille2.fr
Sol-gel-derived bioactive glasses
demonstrate antimicrobial effects
on common oral bacteria
Satin Salehi, phd, Harry B. Davis, phd, Jack L. Ferracane, phd & John C. Mitchell, phd
Abstract: Purpose: To
determine the antibacterial effect of nano-structured,
sol-gel processed bioactive glasses that may be used for implants, coatings,
and as adjuncts to dental restorative materials. Methods: Six bioactive glasses (BAG), three made with differing
amounts of silica (65, 75 and 85 mole%), and three with different amounts of
silica (61, 71, and 81 mole%) and 3 mole% fluoride were prepared by a sol-gel
synthesis method and tested against clinically important bacteria species, Streptococcus sobrinus (ATCC33478), Streptococcus mutans (ATCC25175) and Enterococcus faecalis(ATCC19433). Bacterial
suspensions were independently incubated with bioactive glass in particulate
form (< 3 µm) for 4 and 24 hours. Viability was determined by colony-forming
units. Results: At 4 hours, all BAG
produced an order of magnitude reduction in all three bacteria. After 24 hours,
all BAG produced a significant reduction in S. sobrinus colonies, but no further reduction in S. mutans; all
BAG, except BAG 61-F, significantly reduced E. faecalis compared to the control. At 4 hours, an
increase in the pH of the BAG groups (to pH 9) could also have contributed to
the bactericidal effect. In further experiments it was found that the viability
of S. sobrinus was significantly reduced following exposure to an extract of BAG in media
adjusted to a pH of 7.4. Additionally media with pH adjusted to 9 exerted a
significant antibacterial effect against S. sobrinusafter 4 hours. To determine the
influence of the calcium ions released from the BAG in the absence of the pH effect,
a typical dose response was demonstrated after 4 hours of exposure of S. sobrinus to
media containing various levels of calcium. The results of this study clearly
suggest that the effect of BAG extract on bacteria is not only related to a pH
effect, but is also linked to an effect of liberated ions, such as calcium,
extracted from the surface of the bioactive glasses. (Am J Dent 2015;28:111-115).
Clinical
significance: Sol-gel processed bioactive glass has been shown to be capable of reducing the
number of Streptococcus sobrinus, Streptococcus mutans and Enterococcus faecalis bacteria in culture.
Consequently, these materials may be useful as potential antibacterial
ingredients in dental restorative materials and other oral care products.
Mail:
Dr. Satin Salehi, CLSB 6N099.A2, 2730 S.W. Moody
Avenue, Portland, OR 97201, USA. E-mail:
salehi@ohsu.edu
Modifying the biomechanical response of mouthguards with hard inserts:
A finite element study
Crisnicaw Verissimo, dds,ms,phd, Paulo César Freitas Santos-Filho, dds,ms,phd, Daranee Tantbirojn, dds,ms,phd, Antheunis
Versluis, phd & Carlos JosÉ Soares, dds,
ms, phd
Abstract: Purpose: To investigate the influence of
a high elastic modulus material insert on the stress, shock absorption and
displacement of mouthguards. Methods: Finite element models of a human maxillary central incisor
with and without mouthguard were created based on
cross-sectional CT-tomography. The mouthguard models
had four designs: without insert, and middle, external, or palatal hard insert.
The hard inserts had a relatively high elastic modulus when compared to the
elastic modulus of ethylene vinyl acetate (EVA): 15 GPa versus 18 MPa. A non-linear dynamic impact analysis
was performed in which a heavy rigid object hit the model at 1 m/s. Strain and
stress (von Mises and critical modified von Mises) distributions and shock absorption during impact
were calculated as well as the mouthguard displacement. Results: The model
without mouthguard had the highest stress values at
the enamel and dentin structures in the tooth crown during the impact. It was
concluded that the use of a mouthguard promoted lower
stress and strain values in the teeth during impact. Hard insertion in the
middle and palatal side of the mouthguard improved
biomechanical response by lowering stress and strain on the teeth and lowering mouthguard displacement. (Am J Dent 2015;28:116-120).
Clinical significance: Mouthguards are protective devices that can
be used to decrease the likelihood of dental trauma from impact. Dental
practitioners should recommend mouthguards for their
patients for use during contact sports practice. Mouthguards with middle hard insertions combine lower stress and strain values with lower
displacements and thus better retention during impact.
Mail: Dr. Carlos José Soares, Federal University of Uberlândia. School of Dentistry, Avenida Pará, 1720, Bloco 4L, Anexo A, Sala 42, Campus Umuarama, Uberlândia-Minas Gerais 38400-902 Brazil. E-mail: carlosjsoares@umuarama.ufu.br