Current Issue : January - March Volume : 2017 Issue Number : 1 Articles : 6 Articles
Background: Gingivitis can develop as a reaction to dental plaque. It can be limited by curtailing plaque build-up\nthrough actions including tooth brushing and the use of medicinal mouthwashes, such as those containing\nchlorhexidine digluconate (CHX), that can reach parts of the mouth that may be missed when brushing. This study\naimed to compare dental stain control of twice-daily brushing with a sodium fluoride (NaF) dentifrice containing\n67 % sodium bicarbonate (NaHCO3) or a commercially available NaF silica dentifrice without NaHCO3, while using a\nmouthwash containing 0.2 % CHX.\nMethods: This was a 6-week, randomised, two-site, examiner-blind, parallel-group study in healthy subjects with at\nleast ââ?¬Ë?mildââ?¬â?¢ stain levels on the facial surfaces of ââ?°Â¥4 teeth and ââ?°Â¥15 bleeding sites. Assessment was via modified\nLobene Stain Index (MLSI), the score being the mean of stain intensity multiplied by area (MLSI [IxA]).\nResults: One hundred and fifty of 160 randomised subjects completed the study. There were no significant differences\nin Overall (facial and lingual) MLSI (IxA) scores between dentifrices. The Facial MLSI (IxA) was statistically significant\nat 6 weeks, favouring the 67 % NaHCO3 dentifrice (p = 0.0404). Post-hoc analysis, conducted due to a significant site\ninteraction, found significant differences for all MLSI scores in favour of the 67 % NaHCO3 dentifrice at Site 1 (both\nweeks) but not Site 2.\nConclusions: No overall significant differences were found between a 67 and 0 % NaHCO3 dentifrice in controlling\nCHX stain; a significant difference on facial surfaces suggests advantage of the former on more accessible surfaces....
Abstract: Dental anxiety (DA) negatively affects patients� oral and overall health. This study explored\nattitudes and clinical practices of licensed Ohio general dentists who treat patients with DA. Methods:\nAn anonymous self-administered mail survey was sent to 500 general dentists licensed and practicing\nin Ohio. Responses to 21 pre-coded questions were analyzed. Frequencies were examined; cross-tabs,\nChi-Square, and Fischer�s Exact Test were calculated for statements according to dentists� gender.\nAlpha was set at p = 0.05. Results: Nearly all respondents treated anxious patients; males were more\nlikely to find it challenging than females. Dentists were most familiar with distraction, although\nhalf found nitrous oxide to be an effective tool. Female dentists were more likely than males to be\nfamiliar with anxiolytics and find them effective. Conclusion: Overall, Ohio general dentists are\nmost familiar with using distraction and nitrous oxide during appointments for anxious patients.\nGender differences exist in attitudes towards anxiolytic use for patients with DA. Practice Implications:\nBy identifying techniques that are comfortable for patient and practitioner, oral health disparities\nassociated with DA may be reduced....
Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication in patients receiving antiresorptive therapies for\nbone neoplastic localizations and osteoporosis. The aim of this study was to evaluate the clinicopathological features of MRONJ\nin a cohort of patients treated by new antiresorptive drugs (denosumab) and the corresponding outcome after 13-year maximum\nfollow-up.Overall, 244 patients affected byMRONJ were treated from2003 to 2015. After clinical and radiological examinations, all\nlesions were staged according to a dimensional staging system and then surgically treated. All the denosumab-related lesions were\nclassified as stage II or III, thus requiring a more or less invasive surgical approach, despite the results of many recent studies, which\nsuggested a conservative medical approach with early resolution forMRONJ in patients on denosumab. In the current series, 86.9%\nof treated lesions showed complete clinical and radiological healing, while 13.1% recurred; all recurrences were detected in patients\nwho could not interrupt chemotherapy, steroids, and/or antiresorptive drugs administration due to their general conditions. In\nconclusion, all oral specialists should be aware of the MRONJ risk among patients taking new antiresorptive drugs; moreover, our\nprotocol based on surgical treatment guided by dimensional staging could be considered effective in view of the low recurrence\nrate....
Background: The aim of this study was to determine the success of psychotherapeutic treatment for dental phobia\nby measurement of anxiety using the dental anxiety score (DAS), the state trait anxiety score (STAI state), salivary\ncortisol and protein concentrations and the salivary secretion rate. Primary endpoint of the study was the\ncomparison of the data before and after psychotherapeutic treatment.\nMethods: Forty patients were included into the study. Twenty-four were allocated to the phobic group, 16 to the\ncontrol group. Saliva was collected upon entering the dental clinic and again after three weeks of psychotherapy.\nThe results were compared with those of a control group. The DAS and STAI questionnaires were completed at\neach visit.\nResults: A reduction in DAS values was found after psychotherapy. However, the values remained significantly\nhigher in the phobic group than in the controls. Similar results were found for STAI scores. A slightly higher salivary\ncortisol level was found in the phobic group. No changes occurred in cortisol or protein concentrations. The\nsalivary secretion rate increased in the phobic patients after psychotherapy.\nConclusions: It could be concluded that psychotherapy is effective in the treatment of dental phobic patients...
Background: Mature teeth with chronic apical abscesses characterized by intermittent discharge of pus through an\nassociated sinus tract. This communication between oral mucosa and periapical inflammation is challenging for the\nsealing ability of root canal obturation material. Therefore, the study aim was to compare the outcomes of\nendodontic treatment using mineral trioxide aggregate (MTA) cement to the conventional gutta-percha cone and\nroot canal sealer as an obturation material in mature teeth with chronic apical abscesses.\nMethods: Mature teeth with chronic apical abscesses referred to our clinic for root canal treatment between 2010\nand 2012 were treated in a single visit and distributed among treatment (T) and control (C) groups using a\npredetermined randomization block (TCTC). After chemo-mechanical preparation, teeth in group T received MTA\ncement mixed in a 0.26 water to powder ratio, and teeth group C received gutta-percha and root canal sealer\nusing the warm vertical technique. The treatment outcomes were defined as obturation length, periapical healing,\nresorption of extruded material, and survival rate at least 2.5 years after treatment. Three endodontists blinded to\nthe type of obturation material documented treatment outcomes. Statistical analysis at P < 0.05 was conducted to\nmeasure difference between the groups.\nResults: Thirty-six teeth were treated between 2010 and 2012, and 32 teeth were evaluated in 2015. Complete\nperiapical healing was observed in 87.5 % of MTA-treated teeth and 75.0 % of gutta-percha-treated teeth. Adequate\nobturation length was reported in 50.0 % of MTA-treated and 37.5 % of gutta-percha-treated teeth. Complete\nresorption of extruded material was evident in 83.3 % MTA-treated teeth and 100.0 % gutta-percha-treated teeth.\nThe survival rate of MTA-treated teeth was 100 % at 3, and 5 years, while the survival rate of gutta-percha-treated\nteeth was 83.3 % at 3, and 5 years. There was no significant difference between the groups in term of periapical\nhealing, survival rate, obturation length, or resorption of extruded material.\nConclusions: The outcomes of single-visit endodontic treatment of mature teeth with chronic apical abscesses\nusing MTA cement were better, but not statistically significant, compared to conventional treatme...
Background: Studies investigating the use of plateletââ?¬â??rich plasma (PRP) in the treatment of intrabony defects have\nyielded mixed results. The aim of our study was to evaluate the efficacy of PRP by comparing clinical attachment\nlevel (CAL) and pocket depth (PD) for patients who received PRP as an adjunct to periodontal intrabony defect\ntherapy with those for patients who did not. We also analyzed the influence of guided tissue regeneration (GTR)\nand different study designs (parallel and splitââ?¬â??mouth studies) on the clinical outcomes of intrabony defects.\nMethods: We performed a systematic review of articles published in any language up to June 7, 2015 by searching\nPubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials. We included only\nrandomized controlled clinical trials (RCTs) that compared clinical outcomes between patients who received\nPRP as an adjunct to periodontal intrabony defect therapy and patients who did not. We combined data\nfrom randomized trials to assess clinical outcomes using a randomââ?¬â??effects model.\nResults: Of the 307 abstracts that were initially identified, 12 RCTs related to the treatment of periodontal\nintrabony defects were included in the final analysis. Clinically and significantly greater CAL gains and PD\nreductions were observed in subjects who received PRP as an adjunct to periodontal intrabony defect\ntherapy than in subjects who did not (CAL: WMD 0.76 mm, 95 % CI = 0.34 to 1.18 mm, P = 0.0004; PD: WMD\n0.53 mm, 95 % CI = 0.21 to 0.85 mm, P = 0.001). Subgroup meta-analyses of patients who underwent GTR\ndemonstrated that this approach did not significantly affect treatment outcomes (CAL: WMD 0.08 mm, 95 % CI = âË?â??0.30\nto 0.46 mm, P = 0.67), as indicated by a comparison with patients who did not undergo GTR (CAL: WMD 1.\n22 mm, 95 % CI = 0.88 to 1.57 mm, P < 0.00001). Univariate meta-regression analyses revealed that the use of\nGTR explained the heterogeneity among the included studies (P < 0.05).\nConclusions: Within its limitations, this review suggests that PRP may be beneficial as an adjunct to graft\nmaterials for the treatment of periodontal intrabony defects, except in cases involving the use of GT...
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