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February 2020 Abstracts
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Bisphosphonate-related osteonecrosis of
the jaw:
Jaewon Kim, dds, msd, phd, Du-Hyeong Lee, dds, msd, phd, Rosemary Dziak,
ms, phd & Sebastian Ciancio, dds
Abstract: Purpose: This review paper is intended to
provide updated information about the significance of bisphosphonate-related osteonecrosis of the jaw (BRONJ) related to dental
departments and also to provide treatment information. However, it does not
review anti-resorptive related osteonecrosis of the jaw (ARONJ). Methods: PubMED was searched for published articles on BRONJ that
have particular relevance to clinical aspects in orthodontics, endodontics, periodontics, prosthodontics, oral and maxillofacial surgery, implants
and treatment planning. In vitro and
animal studies were excluded. Results: Bisphosphonate therapy has a significant level of
importance within all dental departments, and the treatments for BRONJ are
diverse without any documented superiority of one over another. (Am J Dent 2020;33:115-128).
Clinical significance: Each dental specialty must be
aware of the risk of BRONJ in their patients, especially elderly ones with
history of bone-related therapy or tumor. No definite consensus is made for
some departments due to lack of evidence and rare cases.
Mail: Dr. Sebastian Ciancio, School of Dental Medicine, University at Buffalo,
250 Squire Hall Buffalo, NY 14214, USA. E-mail: ciancio@buffalo.edu
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Transmission routes of SARS-CoV-2 and protective
measures
Yingxiao Pan, md, Hengyi Liu, md, Chen Chu, md, Xin Li, md, Siyu Liu, md & Shulai Lu, phd
Abstract: The
outbreak of coronavirus disease 2019 (COVID-19) has
become a primary challenging public health issue for not only China but also
the world. On March 11, 2020, the World Health Organization declared that the
pandemic of COVID-19 had become a public health emergency of global concern. As
of May 12, 2020 COVID-19 has been reported in over 180 countries/regions, with
a total of 4,178,156 confirmed cases and over 280,000 deaths. The risk of
cross-infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be elevated between dental specialists and patients due to
the peculiarity of dental practice. Therefore, detailed and effective infection
control measures are imminently needed to prevent nosocomial coronavirus infection. This paper, based on proven
effective experience, relevant guidelines, and research, not only presents the
fundamental knowledge about the name, etiologic characteristics, epidemiologic
characteristics and clinical manifestations of COVID-19, transmission routes
and risk points of SARS-CoV-2 in dental clinics but also provides recommended
protective measures for dental professionals to interdict the transmission of
SARS-CoV-2 in dental clinics. Classification schemes as well as color identification
according to the results of the questionnaire survey and temperature
measurement in precheck and triages are innovations proposed
in this paper. (Am J Dent 2020;33:129-134).
Clinical significance: This paper,
based on proven effective experience, relevant guidelines, and research, not
only presents the fundamental knowledge about the name, etiologic
characteristics, epidemiologic characteristics and clinical manifestations of
COVID-19, transmission routes and risk points of SARS-CoV-2 in dental clinics
but also provides recommended protective measures for dental professionals to
interdict the transmission of SARS-CoV-2 in dental clinics.
Mail: Dr. Shulai Lu, Oral Medical Center of Qingdao Municipal Hospital (Group), Jiaozhou Road 1, Qingdao, Shandong Province 266003, China.
E-mail: lshl97@163.com
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Review Article
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Taste and smell as chemosensory dysfunctions in
COVID-19 infection
Pier Carmine Passarelli, dds, Michele Antonio
Lopez, dds, Giuseppe Niccolò Mastandrea Bonaviri, md,
Abstract: Purpose: To review the literature on the
presence of two clinical manifestations in patients presenting COVID-19 (SARS-CoV-2)
infection: loss of taste (ageusia) and loss of smell
(anosmia). Methods: PubMed and EMBASE were searched and studies were selected
starting from November, 2019 until April 2020; also, the references of the selected
articles were evaluated for methodological quality. Results: Of the 19 studies analyzed, five were included to evaluate
the presence of ageusia and/or anosmia as symptoms in patients who were tested and resulted positive for the SARS-CoV-2
virus. In a total of 10,818 patients, 8,823 presented ageusia (81.6%; range 5.6%-88%) and 8,088 presented anosmia (74.8%; range 5.1-85.6%). Only one study recorded both symptoms with a
percentage of 18.6%. (Am J Dent 2020;33:135-137).
Clinical significance: This
systematic review demonstrated significant presence of ageusia and anosmia in the patients with COVID-19 infection.
These symptoms may be considered as the first manifestation of the infection.
Mail: Dr. Pier Carmine Passarelli, Department of Head and Neck, Division of Oral
Surgery and Implantology, Institute of Clinical
Dentistry, Catholic University of the Sacred Heart, Gemelli University Policlinic Foundation, Rome, Italy. E-mail: piercarmine.passarelli@unicatt.it
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Effect of nanohydroxyapatite associated with photobiomodulation
Cristiane de Melo Alencar, dds, msc, Mariangela Ivette Guanipa Ortiz, dds, msc, Fabio
Alves Silva, dds,
Abstract: Purpose: To evaluate the effect of nanohydroxyapatite (nHAP) associated with photobiomodulation (PBM) in the control of dentin hypersensitivity (DH). Methods: 32 subjects with 83 hypersensitive teeth were randomized
into four groups (N =8): GPlacebo - simulated PBM
(without light emission) followed by the application of nHAP-free
toothpaste; GLaser - PBM followed by the application
of nHAP-free toothpaste; GnHAP - simulated PBM followed by the application of nHAP; GLasernHAP - PBM followed by the application of nHAP. A visual analogue scale (VAS) was used to measure DH
after a tactile and evaporative stimulus. DH evaluations were performed at four
times: baseline, 1st, and 2nd treatment sessions, and 1 month. A questionnaire
was used to evaluate the risk factors associated with DH intensity.
Mixed-design ANOVA followed by Tukey test and
logistic regression were used. Results: The mechanical stimulus showed a significant reduction in DH in all
experimental groups (P< 0.05) at the 2nd treatment session. For the
evaporative stimulus, the GLasernHAP group presented
a significant reduction in DH at the 1st treatment session (P< 0.05). Intragroup analysis showed that only the GnHAP group showed regression of DH at 1 month for the two
applied stimuli. The variables of parafunctional habits, diets rich in acidic drinks and anxiety had significant relationships
with the intensity of DH (P< 0.05). (Am
J Dent 2020;33:138-144).
Clinical significance: The use of nHAP and application of PBM to laser are effective in the control of dentin
hypersensitivity. However, their association did not enhance the desensitizing
effect.
Mail: Dr. Cecy Martins Silva,
Federal University of Para, School of Dentistry, Augusto Correa Avenue, no 1, Guamá, Belém, PA, Brazil,
66075-110. E-mail: cecymsilva@gmail.com
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Marginal adaptation and internal indentation
resistance of a Class II
Mohamed A. El Naga, bds,
ms, cags, Fang Qian,
ma, mphil, phd, Gerald
E. Denehy, dds, ms, Ryan L.
Quock, dds
Abstract: Purpose: To compare the dentin bonded external marginal integrity
and the internal surface indentation hardness of bulk-fill and conventional
resin-based composite (RBC) placed in both bulk and increments. Methods: 120 MO and DO cavities were prepared
in 60 extracted human third molars. The teeth were randomly divided into four
groups of 15 teeth per group to be restored as follows: BB (bulk-fill RBC,
placed in a 4 mm bulk increment), BL (bulk-fill RBC, placed in 2 mm incremental
layers), CB (conventional RBC, placed in a 4 mm bulk increment), and CL
(conventional RBC, placed in 2 mm incremental layers). Marginal gaps were
measured at mesial and distal dentin gingival cavosurfaces of each tooth using scanning electron microscopy of epoxy resin replicas and Knoop hardness (KHN) was measured at three different RBC
depths (1.8, 2.8 and 3.8 mm). Statistical analyses included one-way ANOVA with
post-hoc Tukey’s HSD, and paired-sample t-test or a
nonparametric Wilcoxon signed-rank test, as
appropriate. Results: There was no
significant effect of RBC restoration type on external marginal gap at the
distal surface or at the mesial surface among the four groups tested (P>
0.05 in each instance), while no significant difference in external marginal
gap was found between the mesial and distal surfaces within groups (P> 0.05
in each instance). The mean RBC internal surface KHN at 1.8 mm depth was
significantly greater than at 2.8 mm and 3.8 mm depths in all tested groups
(P< 0.05 for all instances), with a similar mean
internal hardness between all groups. The bulk-fill RBC restorations
demonstrated similar marginal gap formation and Knoop hardness to conventional universal RBC restorations under the conditions of
this study. (Am J Dent 2020;33:145-150).
Clinical significance: Bulk-fill resin-based composite
(RBC), from the perspective of marginal adaptation and internal hardness, may
be a suitable alternative to conventional RBC.
Mail: Dr. Ryan Quock, Department
of Restorative Dentistry & Prosthodontics, University
of Texas School of Dentistry, 7500 Cambridge, Houston, TX 77054, USA. E-mail: Ryan.Quock@uth.tmc.edu
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Research Article
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Safety and efficacy of a novel toothbrush utilizing RF
energy
Kimberly R. Milleman, rdh, bsed,
ms, Liora Levi, phd, Tori L. Grahovac, bsdh & Jeffery L. Milleman, dds, mpa
Abstract: Purpose: To evaluate the safety and efficacy of the ToothWave radiofrequency (RF) toothbrush in the reduction
of plaque, calculus and gingival inflammation, as compared to a standard
powered toothbrush accepted by the American Dental Association (ADA). Methods: This was a single-blind,
double arm, prospective study. Subjects were randomized to one of two treatment
groups, receiving either the RF powered toothbrush or a control powered
toothbrush, and performing twice daily brushing for a test period of 6 weeks.
Plaque (RMNPI), calculus (V-MI), gingival inflammation (MGI) and bleeding (GBI)
were assessed at baseline, after 4 and 6 weeks. Comparisons were completed both
within and between each treatment group. Statistical analyses were conducted
using the Mann Whitney non-parametric model. Results: 85 subjects completed the study and had fully evaluable
data. No significant differences between the groups were found in the baseline
scores (P≥ 0.165). Following 6 weeks, the RF test group demonstrated
statistically significant reductions in plaque, gingivitis and calculus
compared to the control powered toothbrush (P≤ 0.001). Both toothbrushes
were well-tolerated and no device-related adverse events were reported. The
RF-utilizing powered toothbrush produced statistically significant reductions
in dental plaque, calculus deposition, gingival inflammation and gingival
bleeding as compared to a control powered toothbrush. (Am J Dent 2020;33:151-156).
Clinical significance: The RF powered toothbrush used twice daily resulted in an
overall improvement in oral health.
Mail: Dr. Liora Levi, Director of Clinical Affairs, Home Skinovations Ltd., Tavor Building, Shaar Yokneam, POB 533, Yokneam 2069206, Israel. E-mail: lioral@silkn.com
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Influence of mechanical and chemical degradation on
surface gloss
Stefano Ardu, dds, phd, René Daher, dds, dr med dent, Enrico
Di Bella, phd, Isaline Rossier
Abstract: Purpose: To compare the gloss retention of four resin based
materials, two direct resin composites (Tetric EvoCeram and Filtek Supreme) and
two indirect resin composite CAD-CAM blocks (Tetric CAD and Lava Ultimate). Methods: 36
samples of 1 mm thickness were readied of each test material and manually
polished with polishing discs (Sof-Lex) up to the
finest grit size. Three gloss measurements per sample were taken (one every 120
degrees of sample rotation) by means of a glossmeter (Novo-Curve) for a total of 60 values obtained per tested material. Samples of
each material were then randomly divided into three equal groups and aged with
75% alcohol (Group 1), amine fluoride gel (Elmex gelée) (Group 2) or mechanical brushing (Group 3). Another
set of gloss measurements was performed on all samples after 1 hour of aging.
Gloss values were statistically evaluated by means of repeated measures ANOVA
and Fisher’s LSD post-hoc tests. Results: Gloss retention values ranged from 59.0 (Tetric EvoCeram) to 70.9 (Lava Ultimate) for alcohol, from 59.3 (Filtek Supreme) to 67.5 (Lava Ultimate) for Elmex gelée and from 33.3 (Tetric EvoCeram) to 53.4 (Lava
Ultimate) for mechanical brushing. Statistical analysis revealed: (1)
significant difference between intial and final gloss
values for all materials and groups; (2) significant difference between final
gloss values of all the materials in the alcohol group; (3) significant
difference between final gloss values of Lava Ultimate and all the other
materials in the Elmex gelée group; (4) significant difference between final gloss values of Lava Ultimate
and Tetric CAD with the other tested materials in the
brushing group. (Am J Dent 2020;33:157-160).
Clinical significance: Direct resin composites in
general are widely used, and CAD-CAM resin composite materials are becoming
progressively more accessible. Making the choice between direct and indirect
techniques is still a challenge, and understanding the advantages of CAD-CAM
resin composites in the form of higher gloss retention, which translates into
higher durability of esthetics, may be one the parameters facilitating the
decision.
Mail: Dr. Stefano Ardu, Division of Cariology & Endodontology, University Clinics of Dental Medicine,
University of Geneva, Geneva, Switzerland. E-mail: stefano.ardu@unige.ch
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Laboratory screening evaluation of the safety of low
pH
Joel Moore, bs, Donald
J. White, phd, Eva Schneiderman, phd, Haijing Chen, phd, Ross Strand, phd
Abstract: Purpose: To assess the hard tissue safety
of a variety of low pH oral care rinses to dental enamel in a newly developed
screening method. Methods: Bovine
enamel specimens were subjected to a cycling model that consisted of commercial mouthrinse product exposures and artificial saliva
soaks based on a previously published screening method. The effect of test
products on the surface of treated specimens was measured using surface microhardness (SMH). Results are presented as the change in
SMH (between sound enamel baseline and cycling final). An assortment of rinse
products were assessed relative to distilled water (positive control) and 1%
citric acid (negative control). A priori, a product was considered safe if the
change in measured SMH values over the course of six treatment cycles was both
significantly greater than the negative control and was not significantly
different from the positive control. A non-inferiority statistical test was
applied to create a quantitative rule defining product safety. Results: Products tested included two
rinses with a pH in excess of 5.5, and eight with a pH less than 5.5. Four of
the rinses included fluoride, while six did not. Analyses showed that all of
the rinse products tested passed the non-inferiority acceptance criteria. One
of the 10 marketed oral care rinses failed to meet the a priori criteria needed
to be considered safe as the product was significantly better than the negative
control but also significantly lower than the positive control treatment. This
product had the lowest pH of all products tested and did not contain fluoride.
Application of the non-inferiority statistical test showed the questionable
product passing safety criteria. As a proposed method for a screening tool,
further testing would be recommended based on these results. (Am J Dent 2020;33:161-164).
Clinical significance: An in vitro enamel safety
screening method was applied as an assessment of the enamel demineralization
safety to a number of oral care rinse products. Surface microhardness,
coupled with a non-inferiority statistical evaluation, provided a reasonable
approach for detecting potential product issues. Products failing this
screening laboratory method may require additional testing to verify their
safety on hard tissues.
Mail: Dr. Eva Schneiderman, The Procter & Gamble Company, 8700
Mason-Montgomery Road, Mason, OH, USA. E-mail: schneiderman.e@pg.com
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Prospective randomized clinical trial of
primary molar crowns:
Kevin J. Donly, dds,
ms, Maria
José Cervantes Méndez, dds, ms, Claudia
Isabel Contreras, dds
Abstract: Purpose: To clinically evaluate the clinical success of a primary zirconia molar crown, compared with stainless steel crowns (SSCs). Methods: This randomized, controlled clinical trial was designed as
a split-mouth study. 50 subjects ranging in age from 3-7 years were recruited
to provide a total of 50 paired teeth requiring primary molar crowns, each
participant receiving a SSC and zirconia crown.
Restorations were evaluated at 6-, 12-, 24-, and 36-month recall appointments
examining the following criteria: gingival health, estimate of the degree crown
was high in occlusion, surface roughness, staining on crown surface, wear of
opposing arch tooth, color match, anatomic form, marginal integrity, marginal
discoloration, proximal contact area, secondary caries at crown margin and
parent/guardian satisfaction with crown appearance. Results: The 36-month follow up included 23 subjects (46%). 35
crowns (35%) were evaluated; of the 18 zirconia crowns and 17 SSCs, there were no failures at the 36-month evaluation. The only
significant differences in the parameters evaluated were parent satisfaction,
with the zirconia crown preference (P< 0.05) and
gingival health, with the zirconia crowns having
healthy adjacent gingiva (P< 0.01). The 36-month
results indicated that zirconia primary molar crowns
performed similarly to an established SSC for restoration of primary molars. (Am J Dent 2020;33:165-168).
Clinical significance: The findings from this study
indicated that at 36 months, NuSmile ZR zirconia crowns clinically performed as well as stainless
steel crowns.
Mail: Dr. Kevin J. Donly,
Department of Developmental Dentistry, School of Dentistry, University of Texas
Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX
78229-3900, USA. E-mail:
donly@uthscsa.edu
