Antimicrobial effects of ozonated water on the sanitization of dental instruments contaminated with E. coli, S. aureus, C. albicans, or the spores of B. atrophaeus

Objectives: Ozone has been used as an alternative method for the decontamination of water, food, equipment and instruments. The objective of this study was to evaluate the antimicrobial effects of ozonated water on the sanitization of dental instruments that were contaminated by Escherichia coli, Staphylococcus aureus, Candida albicans and the spores of Bacillus atrophaeus. Methods: A total of one hundred and twenty standardized samples of diamond dental burs were experimentally contaminated with E. coli (ATCC 25922), S. aureus (ATCC 6538) and C. albicans (ATCC 18804) and the spores of B. atrophaeus (ATCC 6633) for 30min. After the contamination, the samples were exposed to ozonated water (10mg/L O3) for 10 or 30min. The control group was composed of samples that were exposed to distilled water for 30min. After the exposure to the ozonated water, 0.1mL aliquots were seeded onto BHI agar to count the colony-forming units per milliliter (CFU/mL) of E. coli, S. aureus, and B. atrophaeus. Sabouraud dextrose agar was used to count the CFU/mL of C. albicans. The results were subjected to an analysis of variance and the Tukey test. Results: For all of the microorganisms studied, the ozonated water reduced the number of CFU/mL after 10 and 30. min of sanitization, and this microbial reduction was dependent on the duration of the exposure to the ozonated water. E. coli exhibited the greatest reduction in CFU/mL (2.72-3.78. log) followed by S. aureus (2.14-3.19. log), C. albicans (1.44-2.14. log) and the spores of B. atrophaeus (1.01-1.98. log). Conclusion: The ozonated water was effective in reducing the CFU of E. coli, S. aureus, C. albicans and B. atrophaeus spores, suggesting that ozonated water can be used for the sanitization of dental instruments. © 2012 King Saud Bin Abdulaziz University for Health Sciences.

Prevalence and reasons for tooth loss in a sample from a dental clinic in Brazil

Purpose. To evaluate the prevalence and reasons for teeth extractions in a sample from a dental clinic in Brazil. Methods. The prevalence of teeth mortality was analyzed by gender, age, tooth type and reasons for extraction on 800 teeth of 439 subjects, whose data was collected in clinical records in a convenience sample. Results. The groups with range from 35 to 44 years, 45 to 54 years and 55 to 64 years revealed significantly greater number of teeth extractions than other age groups (P < 0.0001). The anterior teeth loss increased significantly with aging, while the tooth mortality of premolar and molar were higher in younger people. The caries was the more prevalent reason for tooth mortality among young and adults up to 44 years old, while the periodontal disease was the main reason for extractions from 45 years old until range of 81 years (P < 0.0001). Conclusions. It can be suggested that some reasons for tooth loss were age-dependent, but the caries and the periodontal diseases were the main reasons for tooth mortality in this Brazilian sample. Copyright © 2012 Andréia Montandon et al.

Semiautomatic dental recognition using a graph-based segmentation algorithm and teeth shapes features

Dental recognition is very important for forensic human identification, mainly regarding the mass disasters, which have frequently happened due to tsunamis, airplanes crashes, etc. Algorithms for automatic, precise, and robust teeth segmentation from radiograph images are crucial for dental recognition. In this work we propose the use of a graph-based algorithm to extract the teeth contours from panoramic dental radiographs that are used as dental features. In order to assess our proposal, we have carried out experiments using a database of 1126 tooth images, obtained from 40 panoramic dental radiograph images from 20 individuals. The results of the graph-based algorithm was qualitatively assessed by a human expert who reported excellent scores. For dental recognition we propose the use of the teeth shapes as biometric features, by the means of BAS (Bean Angle Statistics) and Shape Context descriptors. The BAS descriptors showed, on the same database, a better performance (EER 14%) than the Shape Context (EER 20%). © 2012 IEEE.

Multiple brain abscess from dental origin: Case report and literature review

Background: Brain abscess of dental origin is a rare situation and deserves attention due to its high mortality rate even when adequate treatment is done. Few reports are available when dental origin is the main cause of this infection. Case report: We present the case of a 70-year-old man diagnosed with cerebral abscess caused by apical lesions located at superior and inferior teeth. The three lesions containing pus were drained from anterior and posterior brain region and the laboratory evaluation revealed the presence of Streptococcus viridians and Bacteroides. Postoperative period was uneventful with excellent recovery after 1 year of surgery. Final diagnosis was able to be done due to excellent image exams availability like computer tomography and magnetic resonance using diffusion and perfusion techniques. Discussion: The early detection of this pathology with the correct diagnosis essential to give the patient the best treatment including antimicrobial drugs and drainage is of extreme importance. © 2011 Springer-Verlag.

New approaches to dental occlusion: A literature update

Because the study of occlusion is a basic area in dentistry, its components, physiology and integration with the stomatognathic system (SS) have been the subject of interest in the scientific literature. However, the focus given to this issue has changed substantially. Currently, new approaches have been proposed in order to update concepts and to demonstrate the full integration and functionality of this system within the human body. With this approach, the authors proposed the following literature review aimed at gathering recent papers (published from 2000 to 2010) with innovative study design, methodology and/or results. The authors' intention is to show the main trends in the study of occlusion and the SS. The literature review was conducted in the PubMed database, using initially the term dental occlusion as a key-word. As items of interest were found, papers were grouped by categories according to their main subject matter. Forty-seven articles were selected and the main categories obtained were: 1. functional magnetic resonance imaging (fMRI); 2. brain activation; 3. masticatory/occlusal function; 4. body function and physical performance; 5. osseoperception; 6. finite element models; and 7. occlusion and pain. Observing the current literature, the authors found that recent studies present different methodologies for the study of occlusion. These studies have allowed scientists to obtain detailed information about the physiology of occlusion and the SS, as well as about its integration in the body. Research in this area should be continued in order to clarify, in detail, the role of each component of the SS and its interaction with human physiology. © 2012 by CHROMA, Inc.

Bleaching gels containing calcium and fluoride: Effect on enamel erosion susceptibility

This in vitro study evaluated the effect of 35 hydrogen peroxide (HP) bleaching gel modified or not by the addition of calcium and fluoride on enamel susceptibility to erosion. Bovine enamel samples (3 mm in diameter) were divided into four groups (n = 15) according to the bleaching agent: control-without bleaching (C); 35 hydrogen peroxide (HP); 35 HP with the addition of 2 calcium gluconate (HP + Ca); 35 HP with the addition of 0.6 sodium fluoride (HP + F). The bleaching gels were applied on the enamel surface for 40 min, and the specimens were subjected to erosive challenge with Sprite Zero and remineralization with artificial saliva for 5 days. Enamel wear was assessed using profilometry. The data were analyzed by ANOVA/ Tukey's test (P 0.05). There were significant differences among the groups (P = 0.009). The most enamel wear was seen for C (3.37 ± 0.80 μm), followed by HP (2.89 ± 0.98 μm) and HP + F (2.72 ± 0.64 μm). HP + Ca (2.31 ± 0.92 μm) was the only group able to significantly reduce enamel erosion compared to C. The application of HP bleaching agent did not increase the enamel susceptibility to erosion. However, the addition of calcium gluconate to the HP gel resulted in reduced susceptibility of the enamel to erosion. © 2012 Alessandra B. Borges et al.

Osseointegration assessment of chairside argon-based nonthermal plasma-treated Ca-P coated dental implants

This study investigated the effect of an Argon-based nonthermal plasma (NTP) surface treatment-operated chairside at atmospheric pressure conditions applied immediately prior to dental implant placement in a canine model. Surfaces investigated comprised: Calcium-Phosphate (CaP) and CaP + NTP (CaP-Plasma). Surface energy was characterized by the Owens-Wendt-Rabel-Kaelble method and chemistry by X-ray photoelectron spectroscopy (XPS). Six adult beagles dogs received 2 plateau-root form implants (n = 1 each surface) in each radii, providing implants that remained 1 and 3 weeks in vivo. Histometric parameters assessed were bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO). Statistical analysis was performed by Kruskall-Wallis (95% level of significance) and Dunn's post-hoc test. The XPS analysis showed peaks of Ca, C, O, and P for the CaP and CaP-Plasma surfaces. Both surfaces presented carbon primarily as hydro-carbon (CAC, CAH) with lower levels of oxidized carbon forms. The CaP surface presented atomic percent values of 38, 42, 11, and 7 for C, O, Ca, and P, respectively, and the CaPPlasma presented increases in O, Ca, and P atomic percent levels at 53, 12, and 13, respectively, in addition to a decrease in C content at 18 atomic percent. At 1 week no difference was found in histometric parameters between groups. At 3 weeks significantly higher BIC and BAFO were observed for CaPPlasma treated surfaces. Surface elemental chemistry was modified by the Ar-based NTP. Ar-based NTP improved bone formation around plateau-root form implants at 3 weeks compared with CaP treatment alone. © 2012 Wiley Periodicals, Inc.

A hydrogel scaffold that maintains viability and supports differentiation of dental pulp stem cells

Objectives: The clinical translation of stem cell-based Regenerative Endodontics demands further development of suitable injectable scaffolds. Puramatrix™ is a defined, self-assembling peptide hydrogel which instantaneously polymerizes under normal physiological conditions. Here, we assessed the compatibility of Puramatrix™ with dental pulp stem cell (DPSC) growth and differentiation. Methods: DPSC cells were grown in 0.05-0.25% Puramatrix™. Cell viability was measured colorimetrically using the WST-1 assay. Cell morphology was observed in 3D modeling using confocal microscopy. In addition, we used the human tooth slice model with Puramatrix™ to verify DPSC differentiation into odontoblast-like cells, as measured by expression of DSPP and DMP-1. Results: DPSC survived and proliferated in Puramatrix™ for at least three weeks in culture. Confocal microscopy revealed that cells seeded in Puramatrix™ presented morphological features of healthy cells, and some cells exhibited cytoplasmic elongations. Notably, after 21 days in tooth slices containing Puramatrix™, DPSC cells expressed DMP-1 and DSPP, putative markers of odontoblastic differentiation. Significance: Collectively, these data suggest that self-assembling peptide hydrogels might be useful injectable scaffolds for stem cell-based Regenerative Endodontics. © 2012 Academy of Dental Materials.

Oral health-related quality of life and satisfaction before and after treatment with complete dentures in a Dental School in Brazil

Purpose: The aim of this study was to evaluate the impact of treatment with new complete dentures on oral health-related quality of life and satisfaction of edentulous patients attending the Prosthodontic Department in a Dental School in Brazil. Methods: A total of 70 edentulous subjects (37-86 years) treated by undergradute students at the Araçatuba Dental School, University of State of São Paulo, were accessed. A specific questionnaire for edentulous patients (EDENT) based on the Oral Health Impact Profile (OHIP-EDENT) was applied to collect information on patient oral health-related quality of life. Questions related to the personal satisfaction of the edentulous patients with their complete dentures were also included. The patients were accessed before the treatment, and 3 months after receiving the new dentures. Results: After rehabilitation with new complete dentures, all domains of OHIP-EDENT showed significant improvements. There was also a significant improvement in patient satisfaction after placement of new complete dentures. Furthermore, it was possible to observe association between upper denture satisfaction and age. Conclusion: Conventional complete dentures may have a positive impact on oral health-related quality of life and satisfaction of edentulous patients. © 2012 Japan Prosthodontic Society.

Efficacy of mouth rinses and toothpaste on tooth whitening.

People increasingly desire tooth whitening. Considering the wide range of whitening products on the market, this study evaluated the efficacy of whitening toothpastes and mouth rinses compared with the 10% carbamide peroxide (CP) whitening gel. We obtained 120 cylindrical specimens from bovine teeth, which were darkened for 24 hours in a coffee solution. The color measurement was performed by a spectrophotometer using the CIE L*a*b* system, and specimens were divided into six groups according to the use of the following agents: group 1, conventional fluoridated toothpaste; group 2, Close Up White Now; group 3, Listerine Whitening; group 4, Colgate Plax Whitening; group 5, experimental mouth rinse with Plasdone; and group 6, 10% CP Whiteness Perfect. After the simulation of 12 weeks of treatment for groups 1 to 5 and 14 days of treatment for group 6, the specimens were subjected to a new color reading. Data were subjected to one-way analysis of variance (α=0.05), which showed significant differences among groups after 12 weeks for ΔE (p=0.001). Results of the Tukey test revealed that groups 3, 4, and 6 presented significantly higher color alteration than groups 1, 2, and 5. The whitening toothpaste Close Up White Now and the experimental mouth rinse with Plasdone showed similar color alteration as conventional toothpaste after a 12-week treatment simulation. These groups presented significantly lower color alteration compared with whitening mouth rinses Listerine and Colgate Plax Whitening, which showed similar results to those observed after 14 days of bleaching with 10% CP treatment.

Influence of polishing procedures on the surface roughness of dental ceramics made by different techniques

The aim of this study was to evaluate the influence of 2 different surface polishing procedures - glazing (GZ) and manual polishing (MP) - on the roughness of ceramics processed by computer-aided design/computer-aided manufacturing (CAD/CAM) and conventional systems (stratification technique). Eighty ceramic discs (diameter: 8 mm, thickness: 1 mm) were prepared and divided among 8 groups (n = 10) according to the type of ceramic disc and polishing method: 4 GZ and 4 MP. Specimens were glazed according to each manufacturer's recommendations. Two silicone polishing points were used on the ceramic surface for manual polishing. Roughness was measured using a surface roughness tester. The roughness measurements were made along a distance of 2 mm on the sample surface and the speed of reading was 0.1 mm/s. Three measurements were taken for each sample. The data (μm) were statistically analyzed using analysis of variance (ANOVA) and Tukey's test (α = 0.05). Qualitative analysis was performed using scanning electron microscopy (SEM). The mean (± SD) roughness values obtained for GZ were: 1.1 ± 0.40 μm; 1.0 ± 0.31 μm; 1.6 ± 0.31 μm; and 2.2 ± 0.73 μm. For MP, the mean values were: 0.66 ± 0.13 μm; 0.43 ± 0.14 μm; 1.6 ± 0.55 μm; and 2.0 ± 0.63 μm. The mean roughness values were significantly affected by the ceramic type (P = 0.0001) and polishing technique (P = 0.0047). The SEM images confirmed the roughness data. The manually polished glass CAD/CAM ceramics promoted lower surface roughness than did the glazed feldspathic dental ceramics.

Brazilian dental students' intentions and motivations towards their professional career

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Dental students' familiarity with the medical management of dental patients at Brazilian dental schools

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effect of microthread presence and restoration design (screw versus cemented) in dental implant reliability and failure modes

Objectives: This study evaluated the reliability and failure modes of implants with a microthreaded or smooth design at the crestal region, restored with screwed or cemented crowns. The postulated null hypothesis was that the presence of microthreads in the implant cervical region would not result in different reliability and strength to failure than smooth design, regardless of fixation method, when subjected to step-stress accelerated life-testing (SSALT) in water. Materials and methods: Eighty four dental implants (3.3 × 10 mm) were divided into four groups (n = 21) according to implant macrogeometric design at the crestal region and crown fixation method: Microthreads Screwed (MS); Smooth Screwed (SS); Microthreads Cemented (MC), and Smooth Cemented (SC). The abutments were torqued to the implants and standardized maxillary central incisor metallic crowns were cemented (MC, SC) or screwed (MS, SS) and subjected to SSALT in water. The probability of failure versus cycles (90% two-sided confidence intervals) was calculated and plotted using a power law relationship for damage accumulation. Reliability for a mission of 50,000 cycles at 150 N (90% 2-sided confidence intervals) was calculated. Differences between final failure loads during fatigue for each group were assessed by Kruskal-Wallis along with Benferroni's post hoc tests. Polarized-light and scanning electron microscopes were used for failure analyses. Results: The Beta (β) value (confidence interval range) derived from use level probability Weibull calculation of 1.30 (0.76-2.22), 1.17 (0.70-1.96), 1.12 (0.71-1.76), and 0.52 (0.30-0.89) for groups MC, SC, MS, and SS respectively, indicated that fatigue was an accelerating factor for all groups, except for SS. The calculated reliability was higher for SC (99%) compared to MC (87%). No difference was observed between screwed restorations (MS - 29%, SS - 43%). Failure involved abutment screw fracture for all groups. The cemented groups (MC, SC) presented more abutment and implant fractures. Significantly higher load to fracture values were observed for SC and MC relative to MS and SS (P < 0.001). Conclusion: Since reliability and strength to failure was higher for SC than for MC, our postulated null hypothesis was rejected. © 2012 John Wiley & Sons A/S.