1-year Recall Research Articles

Responsiveness of a 1-Year Recall Modified DASH Work Module in Active Workers with Upper Extremity Musculoskeletal Symptoms.

To evaluate the responsiveness to change of a modified version of the Work module of the Disabilities of the Arm, Shoulder, and Hand (DASH-W) in a prospective, longitudinal cohort study of active workers. We compared change on a 1-year recall modified DASH-W to change on work ability, work productivity, and symptom severity, according to predetermined hypotheses following the Consensus-based standards for the selection of health measurement instruments (COSMIN). We evaluated concordance in the direction of change, and magnitude of change using Spearman rank correlations, effect sizes (ES), standardized response means (SRM), and area under the receiver operating characteristic curves (AUC). In a sample of 551 workers, change in 1-year recall modified DASH-W scores showed moderate correlations with changes in work ability, work productivity, and symptom severity (r = 0.47, 0.44, and 0.36, respectively). ES and SRM were moderate for 1-year recall modified DASH-W scores in workers whose work ability (ES = -0.58, SRM = -0.52) and work productivity improved (ES = -0.59, SRM = -0.56), and larger for workers whose work ability (ES = 1.24, SRM = 0.68) and work productivity worsened (ES = 1.02, SRM = 0.61). ES and SRM were small for 1-year recall modified DASH-W scores of workers whose symptom severity improved (-0.32 and -0.29, respectively). Responsiveness of the 1-year recall modified DASH-W was moderate for those whose symptom severity worsened (ES = 0.77, SRM = 0.50). AUC met responsiveness criteria for work ability and work productivity. The 1-year recall modified DASH-W is responsive to changes in work ability and work productivity in active workers with upper extremity symptoms.

A case report on fluorosed teeth whitening without microabrasion - Is it possible?

Whitening of fluorosis stains ranging from yellow to dark brown presents a great challenge to the dentists. The aim of this study was to report the clinical case of a 32-year-old female patient with moderate fluorosis, who was treated using the combination of light-assisted in-office and at-home whitening system. The in-office whitening was performed using 25% hydrogen peroxide (Zoom DayWhite, Discus Dental, Stamford, USA) for four 15-min sessions with supplemental light (Philips Zoom, Stamford, USA) immediately followed by home whitening with a take-home custom tray using 22% carbamide peroxide (Zoom NiteWhite, Discus Dental, Stamford, USA) worn for 6 h a day for 1 week. Color measurements using a dental spectrophotometer (Spectroshade, MHT Optic Research AG, Niederhasli, Switzerland) after the first week showed that the suggested combination technique provided a fast whitening result with a high degree of patient satisfaction. The in-office whitening with light exhibited to be an efficient method for removing yellow and brown fluorosis stains, while the at-home whitening was useful for obtaining a uniform tooth shade. At the 6-month and 1-year recall, the teeth shade and appearance were evaluated. The results of this case report clearly show an effective esthetic result in the long term; however, the question of whether appropriate color stability would be provided by the technique still remains to be answered.

Two-year clinical performance of dimethacrylatebased composite restorations repaired with a silorane-based composite.

To investigate the clinical performance of a silorane-based composite resin used for repairing dimethacrylate- based composite restorations. One operator repaired defective dimethacrylate-based resin restorations that were randomly assigned to one of two treatment groups: control (n=50), repaired with Adper SE Plus and Filtek P60 Posterior Restorative (3M ESPE); or test (n=50), repaired with P90 System Adhesive Self-Etch Primer and Bond and Filtek P90 Low Shrink Posterior Restorative (3M ESPE). After 1 week, restorations were finished and polished. Two calibrated examiners (weighted Kappa≥0.78) evaluated the repaired restorations, blindly and independently, at baseline, after 6 months, 1 and 2 years. The parameters examined were marginal adaptation, anatomic form, surface roughness, marginal discoloration, postoperative sensitivity, and secondary caries. The restorations were classified as Alfa, Bravo, or Charlie, according to modified US Public Health Service criteria. Variation in the levels of clinical parameters over time was evaluated by Friedman's ANOVA (α=0.05). The Mann-Whitney test assessed the differences between the materials for all clinical criteria at baseline, 6-month, 1- and 2-year recalls (α=0.05). The Wilcoxon test compared each composite resin for all clinical criteria at the same recalls (α=0.05). After two years, 79 repaired restorations were re-examined. No statistically significant differences were found between the materials at baseline or at the 2-year recall (p>0.05). Comparing baseline and 2-year recall, there was a statistically significant difference for marginal discoloration (p=0.029) in silorane-based composite restorations. After two years, the clinical performance of the silorane-based composite was similar to that of the dimethacrylate-based composite when used to make repairs.

Patient-reported frequency, awareness and patient-physician communication of hypoglycaemia in Belgium

Objectives:Limited data exist on the frequency of non-severe hypoglycaemic events in patients with insulin-treated diabetes outside of clinical trial settings. Our study investigated the rates of self-reported non-severe events in a sample of Belgian patients. We also investigated self-reported awareness of the symptoms of hypoglycaemia and communication about hypoglycaemia between patients and their physicians.Methods:Patients aged >15 years with Type 1 (T1DM) and insulin-treated Type 2 (T2DM) diabetes were recruited via existing panels in Belgium to complete four questionnaires at weekly intervals. In addition to demographics, data on frequency of non-severe hypoglycaemic events (7-day recall), severe hypoglycaemic events (1-year recall), awareness of hypoglycaemia and reporting of hypoglycaemia to physicians were recorded.Results:In total, 412 patients (44% T1DM, 56% T2DM) completed 1148 patient-week records. Mean insulin-treatment duration was 11 years, mean HbA1c 7·7%. Mean reported non-severe hypoglycaemic events per patient-week were 2·3 in T1DM patients, 0·3 in T2DM patients receiving basal-only therapy, 0·7 in T2DM patients receiving basal-bolus therapy and 0·8 in T2DM patients receiving another form of insulin. Mean reported annual frequencies of severe hypoglycaemic events were 0·9 in T1DM and 0·4 in T2DM. Impaired awareness or unawareness of hypoglycaemia was reported by 70% of T1DM patients, 55% of T2DM patients receiving basal-only therapy, 61% of T2DM patients receiving basal-bolus therapy and 73% of T2DM patients receiving another form of insulin. Overall, 60% of T1DM patients and 46% of T2DM patients rarely/never discuss hypoglycaemia with their GP/specialist. In addition, 10% of T1DM patients and 13% of T2DM patients stated that GPs/specialists did not ask them about their hypoglycaemia in routine appointments.Conclusion:Hypoglycaemic events and unawareness of these events are common in Belgian insulin-treated diabetes patients. Patients often fail to report hypoglycaemic events to their physician and many physicians do not inquire about hypoglycaemia, meaning the current burden of hypoglycaemic events may be underestimated.

Evaluation of a Variable‐Thread Tapered Implant in Extraction Sites With Immediate Temporization: A 3‐Year Multicenter Clinical Study

The purpose of this clinical study is to evaluate the radiographic bone remodeling, survival rate, and soft tissue health surrounding a variable-thread tapered implant immediately placed in extraction sites. Sixty implants were placed in 55 patients at six centers according to a predetermined protocol. All implants were placed in extraction sockets and were subjected to immediate temporization and function. Definitive prostheses (58 single crowns and one two-unit fixed bridge) were placed within the first year. Clinical and radiographic examinations were performed at implant placement and after 3, 6, 12, 24, and 36 months. Measurements of implant stability, papilla index, plaque, peri-implant mucosa, and marginal bone levels were recorded at each visit. Thirty-five implants were evaluated at both implant insertion and 3-year follow-up. Bone levels were observed at 6 months after surgery and yearly intervals thereafter and remained stable throughout the study. There was a slight decrease in mean bone level from -0.68 mm at implant insertion to -0.93 mm at the 6-month recall and then an increase of bone to -0.53 mm from the reference point at the 2-year follow-up (an average increase of 0.15 mm from implant insertion). Bone levels remained steady between the 2-year recall and the 3-year recall. Papilla scores increased significantly (P <0.001; Wilcoxon signed-rank test) from insertion to the 3-year follow-up, with most of the increase occurring during the first year. Patient assessments of function, esthetics, feel of implant, speech, and self-esteem also showed significant improvement over the course of the study. The results, over 36 months, indicate that the variable-thread tapered implant can be used safely and effectively under demanding conditions as an immediate postextraction tooth replacement. Bone remodeling remained stable with a slight increase, and patients expressed high levels of satisfaction with the restorative results over the course of the study.

Evaluation of 3 retention protocols using the American Board of Orthodontics cast and radiograph evaluation

The purpose of this study was to quantify tooth movement among different retention protocols after the orthodontic appliances were removed. A total of 90 patients were evaluated using the American Board of Orthodontics discrepancy index and the cast and radiograph evaluation at debond and the 1-year recall. These patients were equally divided into 3 retention protocols: upper Hawley/lower Hawley, upper Hawley/lower bonded, and upper Essix/lower bonded. The patients were then equally grouped by extraction or nonextraction treatment and case complexity. Paired t tests were used to compare the paired sample means. Analysis of variance tests were used to compare the means for more than 2 groups. A 2-sided 0.05 alpha level was used to define statistical significance. The upper Hawley/lower bonded showed the greatest amount of settling, and the upper Essix/lower bonded had the least settling, but these differences were statistically insignificant. The differences between the extraction and nonextraction treatments were not significant. The group with low discrepancy index scores showed significantly more settling than did the group with high discrepancy index scores. The cast and radiograph evaluation variables that improved overall were marginal ridges, overjet, occlusal contacts, interproximal contacts, root angulation, and total cast and radiograph score. The cast and radiograph evaluation variables that worsened were alignment/rotation, buccolingual inclination, and occlusal relationship. Extraction or nonextraction treatment led to no real difference in settling. The discrepancy index, or initial case complexity, was the greatest factor in determining the improvement of occlusion or settling during the retention phase.

Wear of two denture teeth materials in vivo—2-year results

Objective(1) To quantify wear of two different denture tooth materials in vivo with two study designs, (2) to relate tooth variables to vertical loss. MethodsTwo different denture tooth materials had been used (experimental material=test; DCL=control). In study 1 (split-mouth, 6 test centers) 60 subjects received complete dentures, in study 2 (two-arm, 1 test center) 29 subjects. In study 1 the mandibular dentures were supported by implants in 33% of the subjects, in study 2 only in 3% of the subjects. Impressions of the dentures were taken and poured with improved stone at baseline and after 6, 12, 18 and 24 months. Each operator evaluated the wear subjectively. Wear analysis was carried out with a laser scanning device. Maximal vertical loss of the attrition zones was calculated for each tooth cusp and tooth. A mixed linear model was used to statistically analyse the logarithmically transformed wear data. ResultsDue to drop-outs and unmatchable casts, only 47 subjects of study 1 and 14 of study 2 completed the 2-year recall. Overall, 75% of all teeth present could be analysed. There was no statistically difference in the overall wear between the test and control material for either study 1 or study 2. The relative increase in wear over time was similar in both study designs. However, a strong subject effect and center effect were observed. The fixed factors included in the model (time, tooth, center, etc.) accounted for 43% of the variability, whereas the random subject effect accounted for another 30% of the variability, leaving about 28% of unexplained variability. More wear was consistently recorded in the maxillary teeth compared to the mandibular teeth and in the first molar teeth compared to the premolar teeth and the second molars. Likewise, the supporting cusps showed more wear than the non-supporting cusps. The amount of wear did not depend on whether or not the lower dentures were supported by implants. The subjective wear was correct in about 67% of the cases if it is postulated that a wear difference of 100μm should be subjectively detectable. SignificanceThe clinical wear of denture teeth is highly variable with a strong patient effect. More wear can be expected in maxillary denture teeth compared to mandibular teeth, first molars compared to premolars and supported cusps compared to non-supported cusps.Laboratory data on the wear of denture tooth materials may not be confirmed in well-structured clinical trials probably due to the large inter-individual variability.

Differences in Dietary Supplement Use and Secular and Seasonal Trends Assessed Using Three Different Instruments in the EPIC-Norfolk Population Study

ABSTRACTObjective: Supplement use has increased over time and measurements of supplement use are dependent on instruments chosen. Therefore, we investigated three different questionnaires to measure supplement use and whether these results were associated with age, year of recruitment (secular trend, 1993–1998), and seasonal trends. Design: The questionnaires were self-administered within a median time interval of 54 days and included a Health and Lifestyle Questionnaire (1-year recall), a Food Frequency Questionnaire (1-year recall), and a 7-day diet diary. Setting: Men and women, aged 40–79 years from the general population living in Norfolk (East Anglia, UK), recruited between 1993 and 1998 in the European Prospective Investigation into Cancer Study (EPIC-Norfolk). Results: The prevalence of supplement use estimated with different instruments ranged from 31.7% to 39.0% for men and 45.0% to 54.3% for women. Agreement was substantial with kappa-statistics between 0.72 and 0.81. Participants’ age (men only) and recruitment year were independently associated with supplement use; season showed inconsistent results. Conclusions: The diary provides a good agreement as measured by the kappa-statistic, compared to more long-term measures of supplement use classification. The secular and seasonal trends in supplement use and type of assessment instrument need to be taken into account in studies on health and supplement use.

Effects of in vitro cyclic dislodging on retentive force and removal torque of three overdenture attachment systems

Mandibular two-implant-retained overdentures were suggested as first choice of treatment for edentulous mandibles. However, wear of the attachments may reduce their retention and compromise long-term clinical success. The aim of this in vitro study was to compare the change in the retentive force and removal torque of three attachment systems during simulation of insertion-removal cycles. Thirty custom-manufactured polyvinyl chloride blocks mimicking an implant-retained overdenture using Locator(®) -, spherical Dalbo(®) -PLUS - and SFI(®) -Bar-attachments on Straumann(®) RN Implants were fabricated. The samples were distributed equally into three groups which were subdivided into two sets of five blocks, one set with implants parallel to one another and the other with angulated implants (12°). All attachments were tightened to 35Ncm, while the fixation screws of the SFI(®) -Bar were tightened to 15Ncm. Testing was carried out with an Instron(®) universal testing machine for a total of 14,600 insertion-removal cycles in 0.9% sodium chloride solution. Retentive forces from cycles 10, 100, 1000, 5000, 10,000 and 14,600 were used for the analysis. The removal torque of the attachments was measured before and at the end of the study. Statistical analysis comprised three-way ANOVA and multiple linear regression models. Initially, all three attachment systems demonstrated increasing retentive forces. From cycle 5000 on, Locator(®) -attachments showed lower mean retentive forces than the Dalbo(®) -PLUS and SFI(®) -Bar-groups. The Dalbo(®) -PLUS and SFI(®) -Bar-attachments showed a steady yet not significant increase during the whole observation period. Implant-angulation had no significant influence on the retention forces. The final mean removal torques were significantly reduced. No complete failure was observed. Within the limits of this in vitro study, it can be concluded that the investigated overdenture attachment systems are sufficiently resistant to wear. However, the Dalbo(®) -Plus- and SFI(®) -Bar- exhibit higher retentive capacities than the Locator(®) -attachment over time. The fixation screw of the SFI(®) -Bar may loosen during long-term use, but these observations might be less important if 1-year recall intervals are respected. An angulation of up to 12° between implants does not seem to have a significant effect on attachment wear.

Two‐year clinical study on postoperative pulpal complications arising from the absence of a glass‐ionomer lining in deep occlusal resin‐composite restorations

To observe the effects of glass-ionomer cement (GIC) lining on the risk of pulpal complications in deep occlusal cavities with resin-based restorations. Fifty-three patients, aged 18-30years, who had one or two deep occlusal carious lesions (≥3mm in depth) in molars, were recruited. Dental caries were removed, and the prepared cavity was restored with resin composite using one of two restorative procedures: (a) without GIC lining; and (b) with (resin-modified) GIC lining. Restored teeth were evaluated for any pulpal complications (subjective symptoms, objective signs or loss of tooth vitality) at 1month (baseline), 1year, and 2years after restoration. After excluding shallow cavities, 31 restorations without GIC lining, and 31 restorations with GIC lining, were placed and recalled at baseline without any pulpal complications. At the 1- and 2-year recalls, six patients who had restorations in group 1, and 13 in group 2, had dropped out. None of the remaining teeth in the two groups exhibited pulpal complications at either recall period, regardless of GIC lining placement. The absence of GIC lining does not increase the risk of pulpal complications in deep occlusal cavities restored with resin-based restorations in either the short or long term.

Cognitive decline and cardiometabolic risk among Hispanic and non-Hispanic white adults in the San Luis Valley Health and Aging Study

Cardiometabolic risk factors, including hypertension, dyslipidemia, central obesity, insulin resistance and diabetes are linked to cognitive impairment. The Hispanic population appears to be differentially affected by both cardiometabolic risk factors and cognitive impairment. We sought to determine whether ethnic differences in cognitive impairment in long-resident southwestern US elders was explained by the presence of cardiometabolic risk factors, and to explore patterns of cognitive decline over time. We performed a secondary analysis of data collected on 378 Hispanic and 409 non-Hispanic white adult participants in a longitudinal study of community-dwelling elderly in southern Colorado. Measures of cardiometabolic risk included waist circumference, blood pressure, diagnosis of diabetes, and random blood glucose. Cognitive measures included the Mini-Mental State Exam (MMSE) and the behavioral dyscontrol scale (a measure of executive cognitive function), at baseline and after an average of 22months. Subjects were also administered the Center for Epidemiologic Studies Depression Scale, and the Coronary Artery Risk Development in Young Adults 1-Year Activity Recall. At baseline, Hispanic elders had a greater number of cardiometabolic risk factors and lower MMSE and behavioral dyscontrol scale scores than non-Hispanic whites. Hispanic ethnicity was associated with a greater likelihood of decline in general cognitive function, but not executive cognitive function, after adjusting for age and education. This differential decline was not explained by either individual or total number of baseline cardiometabolic risk factors, depression, or physical activity. A borderline increased risk of decline in general cognitive function was seen in sedentary individuals (P=0.05).

Clinical evaluation of the performance and safety of a new dentine substitute, Biodentine, in the restoration of posterior teeth — a prospective study

ObjectivesA multicentric randomized, 3-year prospective study was conducted to determine for how long Biodentine, a new biocompatible dentine substitute, can remain as a posterior restoration.Materials and methodsFirst, Biodentine was compared to the composite Z100®, to evaluate whether and for how long it could be used as a posterior restoration according to selected United States Public Health Service (USPHS)’ criteria (mean ± SD). Second, when abrasion occurred, Biodentine was evaluated as a dentine substitute combined with Z100®.ResultsA total of 397 cases were included. This interim analysis was conducted on 212 cases that were seen for the 1-year recall. On the day of restoration placement, both materials obtained good scores for material handling, anatomic form (0.12 ± 0.33), marginal adaptation (0.01 ± 0.10) and interproximal contact (0.11 ± 0.39). During the follow-up, both materials scored well in surface roughness (≤1) without secondary decay and post-operative pain. Biodentine kept acceptable surface properties regarding anatomic form score (≤1), marginal adaptation score (≤2) and interproximal contact score (≤1) for up to 6 months after placement. Resistance to marginal discoloration was superior with Biodentine compared to Z100®. When Biodentine was retained as a dentine substitute after pulp vitality control, it was covered systematically with the composite Z100®. This procedure yielded restorations that were clinically sound and symptom free.ConclusionsBiodentine is able to restore posterior teeth for up to 6 months. When subsequently covered with Z100®, it is a convenient, efficient and well tolerated dentine substitute.Clinical relevanceBiodentine as a dentine substitute can be used under a composite for posterior restorations.

Validation of the Reflux, Airway and Sleep Questionnaire (RASQ)

Background.Airway symptoms and sleeplessness in patients with gastroesophageal reflux disease (GERD) may be of importance. This study validates a new questionnaire dealing with such symptoms. Material and methods. The Reflux, Airway and Sleep Questionnaire (RASQ) is self-administered, asks about 18 symptoms or diagnoses possibly related to GERD answered on a seven-point Likert scale and with a 1-year recall period. There are questions about heartburn/regurgitation, sleeplessness, snoring, pneumonia, and upper airway infections, as well as various bronchial and laryngeal symptoms. The study included 305 patients diagnosed with GERD (n = 65), laryngitis (n = 32), asthma (n = 30), chronic obstructive pulmonary disease (n = 45), acute bronchitis (n = 39), pneumonia (n = 42), or upper airway infection (n = 52) during the last year, and 708 matched healthy controls. Concurrent validity was based on comparisons between patients and controls. Convergent validity for sleeplessness and snoring were tested by comparing the RASQ with the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Test–retest reliability was examined in patients with GERD with stable symptoms (n = 29). Results. Response rates were 64% for patients and 55% for controls. Scores for RASQ as a total and all subscales were significantly higher in patients than in controls. Sleeplessness scores correlated significantly to the global PSQI score. Snoring correlated significantly with both the ESS and relevant aspects of the PSQI. Test–retest reliability and Cronbach's alpha were satisfactory, with coefficients ranging between 0.65–0.95 and 0.88–0.92, respectively. Conclusion.The RASQ appears to be well suited for measuring typical reflux symptoms as well as airway symptoms and sleep disturbances.

Atypical facial pain related to apical fenestration and overfilling

To report a case of apical fenestration and overfilling in which unusual pain characteristics made differential diagnosis challenging. A 32-year-old woman with diffuse, spontaneous, moderate pain in the maxillary left posterior sector, exacerbated by masticatory and facial muscle movement, with intense sporadic electric-shooting pain, underwent clinical examination and 3D cone beam computed tomography (CBCT). Apical fenestration with protrusion of the mesial root of tooth 26 beyond the buccal cortical plate, extrusion of canal filling material into the soft tissues and a periosteal reaction were detected. Surgery was performed under the operating microscope. The filling material and surrounding fibrous tissue were located, dissected from healthy soft tissues and removed. The mesiobuccal root apex was resected with a bur to within the bony crypt. A root end was prepared and filled with Tech Biosealer RootEnd™ (Isasan, Como, Italy). At the 2-week recall, the patient had complete resolution of the symptoms and good soft-tissue healing. The 1-year recall examination and intra-oral radiography confirmed complete resolution of the symptoms and health of periradicular tissues. Apical fenestration may occur in 9% of cases and may be considered an anatomic predisposing factor for persistent pain after root canal treatment. This complication provides a considerable differential diagnostic challenge and is often misdiagnosed and mistreated. When correctly diagnosed through an accurate, multidisciplinary approach, it may be managed with a simple surgical procedure in which the endodontist should play a key role. Misdiagnosis and over treatment of apical fenestration, through the surgical management of chronic facial pain conditions, could lead to severe exacerbation of chronic pain, which may potentially become persistent or, indeed, intractable.

Lifestyle Factors and 5‐Year Abdominal Fat Accumulation in a Minority Cohort: The IRAS Family Study

The objective of this study was to examine whether lifestyle factors were associated with 5-year change in abdominal fat measured by computed tomography (CT) in the Insulin Resistance and Atherosclerosis (IRAS) Family Study. We obtained abdominal CT scans at baseline and at 5 years, from African Americans (AA) (N = 339) and Hispanic Americans (N = 775), aged 18-81 years. Visceral (VAT) and subcutaneous (SAT) adipose tissue was measured at the L4/L5 vertebral level. Physical activity was documented by self-report of vigorous activity and a 1-year recall instrument. Dietary intake was assessed at follow-up using a semi-quantitative food frequency questionnaire referencing the previous year. Generalized linear models, accounting for family structure, were used to assess the associations between percent change in fat accumulation and smoking, physical activity, total calories, polyunsaturated, monounsaturated, protein, and saturated fat intake, percent of calories from sweets, and soluble and insoluble fiber. Soluble fiber intake and participation in vigorous activity were inversely related to change in VAT, independent of change in BMI. For each 10g increase in soluble fiber, rate of VAT accumulation decreased by 3.7% (P = 0.01). Soluble fiber was not associated with change in SAT (0.2%, P = 0.82). Moderately active participants had a 7.4% decrease in rate of VAT accumulation and a 3.6% decrease in rate of SAT accumulation versus less active participants (P = 0.003 and P = 0.01, respectively). Total energy expenditure was also inversely associated with accumulation of VAT. Soluble fiber intake and increased physical activity were related to decreased VAT accumulation over 5 years.

Evaluation of 2 self-report measures of physical activity with accelerometry in young adults.

The purpose of this paper is to evaluate self-reported physical activity of young adults using 1-week and 1-year recall measures with an accelerometer as the criterion measure. Participants were a subsample (N = 121, 24 ± 1.7 yrs) from a large longitudinal cohort study. Participants completed a detailed 1-year physical activity recall, wore an accelerometer for 1 week and then completed a brief 1-week physical activity recall when they returned the accelerometer. Mean values for moderate-to-vigorous physical activity (MVPA) from the 3 instruments were 3.2, 2.2, and 13.7 hours/wk for the accelerometer, 1-week recall, and 1-year recall, respectively (all different from each other, P < .001). Spearman correlations for moderate, vigorous, and MVPA between the accelerometer and the 1-week recall (0.30, 0.50, and 0.40, respectively) and the 1-year recall (0.31, 0.42, and 0.44, respectively) demonstrated adequate validity. Both recall instruments may be used for ranking physical activity at the group level. At the individual level, the 1-week recall performed much better in terms of absolute value of physical activity. The 1-year recall overestimated total physical activity but additional research is needed to fully test its validity.

A Conservative Bioadhesive Approach to the Reattachment of Complicated Crown Fractures in Permanent First Molars: A Case Report with a 2-Year Followup

This paper presents a clinical report demonstrating combined restorative bioadhesive treatment and prosthetic rehabilitation of uncommon type of dental injury in an eighteen-year-old female involving crown fracture of all the permanent first molars and left upper premolars due to a bicycle riding accident. To restore the coronal fracture with invasion of biologic width, flap surgery with osteotomy and osteoplasty localized on the fractured teeth was performed, and the tooth remnant was reattached to the crown with a self-etch adhesive system. Frank pulp exposure was treated by self-etch dentin adhesive after surface disinfection prior to sealing of the wound site. At 2-year recall, the teeth continue to be aesthetically and functionally stable with a favourable pulpal and periapical environment.

Occupational Exposure to Sharp Instrument Injuries among Dental, Medical and Nursing Students in Mahatma Gandhi Mission's Campus, Navi Mumbai, India

ABSTRACTBackgroundSharp instrument injuries among health care students significantly increase the risk of transmission of different blood-borne pathogens which can lead to serious consequences including death.ObjectivesThe study was carried out to determine the prevalence and factors associated with sharp instrument injuries among the health care students in the Mahatma Gandhi Mission's Campus, Navi Mumbai and to make recommendations to the institutional authorities about measures to be undertaken to prevent such injuries among the students.Materials and MethodsA cross-sectional questionnaire study was conducted among 700 health care students which included dental, medical and nursing students during their clinical training at Mahatma Gandhi Mission's Campus, Navi Mumbai from May 2012 to July 2012. It was a self-administered questionnaire with a 1-year recall period for sharp instrument injury. The data was analyzed using descriptive statistics and Chi-square test.ResultsThe questionnaire was completed by 627 students of which 76.4% of nursing, 75.4% of dental and 48.7% of the medical students had experienced sharp instrument injuries in the past 1 year with hollow-bore needle being the most common instrument causing such injuries. Overall, 77.4% of the students had not reported the incident of the injury and only 34.4% of the students had taken postexposure prophylaxis.ConclusionEducational interventions with effective training on proper handling and disposal of sharp instruments and postexposure prophylaxis along with the formation of a reporting center are some of the recommendations which can reduce the occupational exposure to sharp instrument injuries among the health care students.How to cite this articleHussain JSA, Ram SM, Galinde J, Jingade RRK. Occupational Exposure to Sharp Instrument Injuries among Dental, Medical and Nursing Students in Mahatma Gandhi Mission's Campus, Navi Mumbai, India. J Contemp Dent 2012;2(2):1-10.

Prospective Observation of a New Bioactive Luting Cement: 2‐Year Follow‐Up

A pilot study was conducted to determine the 2-year clinical performance of a new bioactive dental cement (Ceramir C&B, formerly XeraCem) for permanent cementation. The cement used in this study is a new formulation class, a hybrid material comprising calcium aluminate and glass ionomer. Thirty-eight crowns and fixed partial denture (FPD) abutments were cemented in 17 patients. Thirty-one of the abutment teeth were vital, 7 nonvital. Six reconstructions were FPDs comprising 14 abutment teeth (12 vital/2 nonvital). A two-unit fixed splint was also included. Preparation parameters and cement characteristics (dispensing, working time, seating characteristics, ease of cement removal) were recorded. Baseline and postcementation data were recorded for marginal integrity, marginal discoloration, secondary caries, retention, and gingival inflammation. Tooth sensitivity was assessed at pre- and postcementation time points using categorical and visual analogue scale (VAS) assessment measures. Mixing of the cement was reported as "easy." Clinical working time for this cement was deemed acceptable. Assessment of seating characteristics indicated all restorations were seated completely after cementation. Cement removal was determined to be "easy." Fifteen of 17 subjects were available for 1-year recall examination; 13 patients were available for the 2-year recall examination. Restorations at 2-year recall examination included 17 single-unit, full-coverage crown restorations, four 3-unit FPDs comprising 8 abutments, and one 2-unit splint. No retentive failures or sensitivity were recorded at 2-year recall. Marginal integrities of all restorations/abutments at 2 years were rated in the "alpha" category. Average VAS score for tooth sensitivity decreased from 7.63 mm at baseline to 0.44 mm at 6-month recall, 0.20 mm at 1-year recall, and 0.00 mm at 2-year recall. The average gingival index score for gingival inflammation decreased from 0.56 at baseline to 0.11 at 6-month recall, then 0.16 at 1-year recall, and 0.21 at 2-year recall. Two-year recall data yielded no loss of retention, no secondary caries, no marginal discolorations, and no subjective sensitivity. All restorations rated "alpha" for marginal integrity at the 2-year recall. After periodic recalls up to 2 years, the new bioactive cement tested thus far has performed favorably as a luting agent for permanent cementation.

Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years

A 2-year randomized, controlled prospective study evaluated the clinical effectiveness of a one-step self-etch adhesive and a "gold-standard" three-step etch-and-rinse adhesive in non-carious Class-V lesions. The null hypothesis tested was that the one-step self-etch adhesive does perform clinically equally well as the three-step etch-and-rinse adhesive. A total of 161 lesions in 26 patients were restored with Clearfil AP-X (Kuraray). The restorations were bonded either with the "all-in-one" adhesive Clearfil S3 Bond (Kuraray) or with the three-step etch-and-rinse adhesive Optibond FL (Kerr). The restorations were evaluated at baseline and after 6 months, 1 and 2 years, regarding their retention, marginal adapation, marginal discoloration, caries occurrence, preservation of tooth vitality and post-operative sensivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. The recall rate at 2 years was 93.8%. Only one Clearfil S3 Bond restoration was lost at the 2-year recall. All other restorations were clinically acceptable. The number of restorations with defect-free margins decreased severely during the 2-year study period (to 6.7% and 25.3% for Clearfil S3 Bond and Optibond FL, respectively). The Clearfil S3 Bond restorations presented significantly more small marginal defects at the enamel side than the Optibond FL restorations (Clearfil S3 Bond: 93.3%; Optibond FL: 73.3%; p = 0.000). Superficial marginal discoloration increased in both groups (to 53.3% and 36% for Clearfil S3 Bond and Optibond FL, respectively) and was also more pronounced in the Clearfil S3 Bond group (p = 0.007). After 2 years, the simplified one-step self-etch adhesive Clearfil S3 Bond and the three-step etch-and-rinse adhesive Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation in marginal integrity. Clearfil S3 Bond exhibited more small enamel marginal defects and superficial marginal discolorations.