Oral Hard Tissues Research Articles

Efficacy of a Commercial Dentifrice Containing 2% Strontium Chloride and 5% Potassium Nitrate for Dentin Hypersensitivity: A 3-Day Clinical Study in Adults in China

BackgroundStudies of dentifrices containing strontium chloride or potassium nitrate have documented the clinical efficacy of these formulations for dentin hypersensitivity (DH), but few studies have evaluated dentifrices containing both active ingredients. ObjectiveThe objective of this study was to compare the effects on DH of a dentifrice containing 2% strontium chloride and 5% potassium nitrate in a silica base (experimental dentifrice) with those of a dentifrice containing the same silica base without any active ingredient (control dentifrice). MethodsMale and female patients aged 20 to 65 years with DH were eligible to participate in this randomized, double-blind, placebo-controlled study in China. Patients were assigned to receive the experimental or control dentifrice. At baseline, immediately after topical dentifrice use, and after 3 days, patients received an oral examination of their hard and soft tissues, followed by an evaluation of DH that used the Yeaple Probe to measure tactile hypersensitivity and the Schiff Cold Air Scale to measure the perception of pain from an air blast stimulus. Adverse events (in particular, discomfort while brushing or alteration in taste) in the oral hard or soft tissues were monitored throughout the study. ResultsA total of 81 patients were enrolled (40 in the experimental group; 41 in the control group), of whom 79 (55 women; 24 men) completed the study. After topical use, the experimental group had a significantly higher mean (SD) tactile hypersensitivity score (19.47 [14.69] vs 14.27 [5.76]; P = 0.047) and a significantly lower mean air blast hypersensitivity score (1.93 [0.51] vs 2.22 [0.60]; P = 0.026) than did the control group. After 3 days, the experimental group had a significantly higher mean tactile hypersensitivity score (19.87 [14.95] vs 14.51 [6.00]; P = 0.045) and a significantly lower air blast hypersensitivity score (1.80 [0.56] and 2.13 [0.60]; P = 0.014) than the control group. After topical use and after 3 days, the experimental group had increases from baseline in tactile scores of 54.04% and 56.67%, respectively (both, P = 0.001) and reductions from baseline in air blast scores of 18.51% and 24.21% (both, P < 0.001); the control group had increases in tactile scores of 21.14% and 21.54% (P = 0.022 and P = 0.007) and reductions in air blast scores of 10.24% and 13.41% (P = 0.001 and P < 0.001). No adverse events were reported throughout the study. ConclusionIn these patients with DH in China, the dentifrice containing 2% strontium chloride and 5% potassium nitrate was efficacious in reducing DH when used instantly after topical dentifrice use and after 3 days of use. Clinicaltrials.gov identifier: NCT01426360.

Stability of voxel values from cone‐beam computed tomography for dental use in evaluating bone mineral content

The objective of this study was to investigate the stability of voxel values from cone-beam CT (CBCT) using a flat panel detector in changing surrounding circumstances mimicking clinical situations. Seven hydroxyapatite (HA) rods (0, 40, 80, 120, 160, 199, and 239mgCa/cm(3) ) were set in a 16cm diameter water phantom and scanned with CBCT (FineCube) and also with multislice CT (MSCT) used as reference. The voxel values from CBCT were measured by the obtained images with OsiriX software (http://www.osirix-viewer.com), and compared with the CT numbers from MSCT. We examined the correlation between the voxel values and the HA contents, the variance of voxel values, and the influence of changing surrounding circumstances on the voxel values. The voxel values from CBCT were different from the CT numbers from MSCT, but there was a linear Pearson correlation between the voxel values and the HA contents. The voxel values were greatly influenced when the samples were scanned surrounded in air. However, the voxel values were not affected significantly in the existence of materials simulating oral hard tissues and/or a metal core post. There was a linear correlation between the voxel values of CBCT and the contents of HA rod samples. Our study indicated that it might be possible to evaluate bone mineral content(BMC) from the voxel values of CBCT for dental implant treatment.

Flapless implant surgery in mandibular molar region: Case report

The use of dental implants in the treatment of partially or fully edentulous patients has become an important addition in oral and dental rehabilitation. The fact that these implants penetrate the oral mucosa can lead to the assumption that peri-implant tissues, similar to the periodontal tissues, have an important function as a barrier in protecting the bone tissue underneath mucosa. The success of dental implants depends on the integration of the implant surface in the oral hard and soft tissue. Some initial loss of marginal bone around dental implants is generally accepted. Flapless implant surgery has numerous advantages, including the preservation of circulation, soft tissue architecture, and hard tissue volume, decreased surgical time, improved patient comfort, and accelerated recuperation. The size of the soft tissue punch plays an important role in achieving optimal healing and is determined by the implant diameter. After the flapless implant surgery, the peri-implant mucosa heals with minimal scar. The postoperative course is shortened and painless.

Bisphosphonates and Osteonecrosis of the Jaws: A Review of Clinical Features and the Drug Effect on Oral Soft Tissues

The beneficial effects of the nitrogen-containing bisphosphonate drugs have been clearly defined, especially for the treatment for osteoporosis, metastatic or primary bone malignancies, and some rare bone diseases. The adverse effects of these drugs on oral hard and soft tissues are significant and recognized with increasing frequency. The clinical, radiographic, and histopathologic features of osteonecrosis of the jaws (ONJ) are well characterized; the effects of bisphosphonates on oral soft tissues are an emerging area of study. This review will provide an overview of ONJ from a clinical perspective and also discuss recent findings related to bisphosphonate-induced soft tissue pathology.

Cone-Beam Computed Tomography: A useful tool for dental age estimation?

Assessment of oral hard tissues can be of great help in determining the age of an individual. The development and physiological aging of teeth provide many clues for estimating age, in methods that are mainly based on conventional radiography. Although these conventional techniques reveal information on the anatomical and pathological characteristics, they only show two-dimensional images of a system that originally exists in three dimensions. With the growth and development of three-dimensional imaging, it has become possible to include measurements such as volumetric data, which give a better grasp of the continuous process of tooth mineralization. Up to now, these measurements have been obtained in vitro using micro-computed tomography (micro-CT) but three-dimensional imaging has recently been enriched by a new technique: Cone-Beam Computed Tomography (CBCT), which is devoted to the maxillo-facial sphere. These acquisitions may offer real potential for exploiting and analyzing volumetric measurements of teeth. We hypothesize that, using CBCT acquisitions, multiple regression analysis including quantitative volumetric measurement of various parts of each tooth can be useful to determine significant variables for dental age estimation in living subjects. Currently, CBCT examinations are being performed and contain important information for the quantitative study of dental tissue. Although CBCT examinations are conducted in the first intention of making a clinical diagnosis or prognostic evaluation, they could be used as an initial database for the measurement of dental volumes and their ratios, thus furnishing preliminary evaluations and information. Multiple regression analysis requires the constitution of a larger sample sizes which may demonstrate that CBCT data can be helpful to study other aspects of dental morphology in greater depth, especially dental growth. In this hypothesis, integration with a larger network system would be necessary. CBCT data could be helpful in defining new parameters for the rating of dental development, for a quantitative description of the fractions of crown and root and could offer new research oriented towards various aspects of teeth and jaws, thanks to its broad sampling possibilities.

Age-Related Oral Changes

Age-related oral changes are seen in the oral hard and soft tissues as well as in bone, the temporomandibular joints and the oral mucosa. As older patients retain their natural teeth for longer, the clinical picture consists of normal physiological age changes in combination with pathological and iatrogenic effects. With an ageing population retaining more of its natural teeth for longer, dental professionals should expect to observe oral age changes more frequently.

Immediate Loading in Mandible Full-Arch: Pilot Study in Patients With Osteoporosis in Bisphosphonate Therapy

Immediate Loading in Mandible Full-Arch: Pilot Study in Patients With Osteoporosis in Bisphosphonate Therapy

Implant‐Supported Electrostimulating Device to Treat Xerostomia: A Preliminary Study

The full accomplishment of salivary function depends on proper salivary flow rate and composition. Salivary secretion is highly essential in the maintenance of health and integrity of oral hard and soft tissue. Xerostomia is a common symptom affecting between one-fifth and one-third of the adult population, more commonly women than men. Induction of salivary secretion exists in several pharmacological formulations per os. Electrostimulation to enhance salivary secretion has been used frequently as a research tool but only in limited extent as a clinical method to treat patients with xerostomia. The aims of this preliminary study were to observe and evaluate the therapeutic effect on xerostomia of the Saliwell Crown (Saliwell Ltd., Harutzim, Israel), an innovative saliva electrostimulation device fixed on an implant, placed in the lower third molar area. A Saliwell Crown was placed in the lower third molar area of an 81-year-old female patient with complaints of dry and burning mouth. Salivary secretion was measured, and the patient was asked to fill in written satisfaction questionnaires. The patient was monitored for a year, comparing her salivary secretion rates and the written questionnaires. The results showed a constant slight but significant increase in the salivary secretion and in the patient's personal feelings as presented in the questionnaires. The saliva stimulation device Saliwell Crown, placed on an implant in an 81-year-old patient with dry and burning mouth complaints, presented promising results when both the salivary secretion tests and the self-assessment questionnaires were examined and compared.

Investigation of the color of anterior teeth, vermilion and attachment gingiva of 151 Uygur youth

To analyze the characteristics of color of Uygur's oral soft and hard tissue. One hundred and fifty-one Uygur medical students (18 to 22 years) were included in this study. The Lab*, Cab*, Hab0, values of subjects' anterior teeth, upper and lower vermilion, attachment gingiva were measured. The mean and distribution of Lab*, Cab*, Hab0, values of Uygur youth' anterior teeth were obtained. The Lab* values of attachment gingiva, upper and lower vermilion in male were 50.50 +/- 3.59, 41.92 +/- 4.10, 45.02 +/- 3.06, and Cab* were 29.94 +/- 3.21, 27.00 +/- 2.47, 30.35 +/- 2.67, and Hab0 were 30.00 +/- 3.27, 31.71 +/- 3.69, 27.73 +/- 3.27, respectively. The Lab* values of attachment gingiva, upper and lower vermilion in female were 54.28 +/- 5.06, 41.73 +/- 3.70, 47.27 +/- 2.97, and Cab* were 27.98 +/- 3.93, 27.23 +/- 2.42, 31.22 +/- 2.59, and Hab0 were 33.39 +/- 3.67, 32.28 +/- 3.68, 27.57 +/- 2.65. There was a specific color space distribution pattern in oral soft and hard tissue in Uygur youth. There was a trend of decreasing lightness, increasing saturation, and red hue shifting from the center to both distal directions. There was statistical significant gender difference in color of tooth and attachment gingiva. What's more, there was extremely significant difference between upper and lower vermilion.

Concentration and fate of histatins and acidic proline-rich proteins in the oral environment

Saliva plays a critical role in the protection of oral hard and soft tissues and contains a multitude of constituents with well-characterized biological activities in vitro. Among these are histatins and acidic proline-rich proteins (PRPs). Nevertheless, few functional studies have recognized the structural instability of these proteins in the proteolytic environment of whole saliva. The aim of this investigation was to determine histatin and acidic PRP levels in parotid secretion (PS) and in whole saliva (WS) as well as to establish their susceptibility to proteolysis in these salivary fluids. Using cationic polyacrylamide gel electrophoresis and densitometric analysis the average total histatin concentration (histatin 1 + 3 + 5) in WS was determined to be 33.3 ± 16.7 μg/ml ( n = 22) and the average total acidic PRP concentration (PRP1/PIF-s + PRP3/PIF-f) was 427.9 ± 123.3 μg/ml ( n = 22). Histatin and acidic PRP concentrations in PS were 6 and 1.5 times higher than in WS ( n = 7), respectively. WS histatin and acidic PRP levels each correlated significantly with WS total protein concentrations ( P < 0.01 and P < 0.05, respectively), as well as with each other ( P < 0.01). Stability studies of histatin 3 and PRP1/Pif-s in PS revealed t 1/2 times of 7.2 ± 5.5 and 50.3 ± 24.8 h, respectively ( n = 7). Histatin 3 (40 μg/ml) and PRP1 (400 μg/ml), added to WS in concentrations equivalent to their concentrations in PS, disappeared at a much faster rate, with t 1/2 values of 1.7 ± 1.6 min and 29.3 ± 15.3 min, respectively ( n = 7). The data indicate that proteolysis in WS is an important factor in explaining the substantially lower concentrations of histatins and acidic PRPs in WS as compared to in glandular secretions.

Optical approach to the salivary pellicle

The salivary pellicle plays an important role in oral physiology, yet noninvasive in situ characterization and mapping of this layer remains elusive. The goal of this study is to develop an optical approach for the real-time, noninvasive mapping and characterization of salivary pellicles using optical coherence tomography (OCT) and optical coherence microscopy (OCM). The long-term goals are to improve diagnostic capabilities in the oral cavity, gain a better understanding of physiological and pathological processes related to the oral hard tissues, and monitor treatment responses. A salivary pellicle is incubated on small enamel cubes using human whole saliva. OCT and OCM imaging occurs at 0, 10, 30, 60 min, and 24 h. For some imaging, spherical gold nanoparticles (15 nm) are added to determine whether this would increase the optical signal from the pellicle. Multiphoton microscopy (MPM) provides the baseline information. In the saliva-incubated samples, a surface signal from the developing pellicle is visible in OCT images. Pellicle "islands" form, which increase in complexity over time until they merge to form a continuous layer over the enamel surface. Noninvasive, in situ time-based pellicle formation on the enamel surface is visualized and characterized using optical imaging.

Panmasala Chewing Induces Deterioration in Oral Health and Its Implications in Carcinogenesis

ABSTRACTPanmasala containing tobacco was introduced in the Indian market during the 1970s. Panmasala consists of areca nut (betel nut), catechu, lime, cardamom, spices, and unspecified flavoring agents, etc., with tobacco locally known as gutkha or without tobacco (Plain or sada), and consumed abundantly in India and also other parts of the world, predominantly in South East Asian countries. Available studies demonstrate that the habits of chewing panmasala gutkha or plain by students and adolesescents are on the increase, which may lead to deterioration of oral health and other organ systems. Based on the experimental as well as clinical studies available on panmasala as well as on different components of panmasala, this review suggests that it has the potential in causation of various oral diseases such as Oral Sub Mucosis Fibrosis (OSMF) and leucoplakia which may lead to oral cancer. Studies reviewed on these chewing mixtures also reveal that it is likely to be carcinogenic, as tobacco and areca nut have carcinogenic potential and both have encompassing addictive potential leading to dependence on chewing mixture containing areca nut and tobacco. These mixtures might not only lead to cancer but may also affect other organs of the body, including oral hard tissues in the form of dental attrition and sensitivity. There is a need to consider the potential health hazards associated with the habits of these products, especially oral cancer. More research is needed to find out early changes which could be reversible and also intervention measures through education to desist people in indulging in such habits.

Eating Disorders Part II: Clinical Strategies for Dental Treatment

To present the strategies of treatment for dental implications of eating disorders. A comprehensive review of the literature was conducted with special emphasis on the treatment of the oral implications of anorexia nervosa and bulimia nervosa, dividing the treatment into different parts. Oral manifestations of eating disorders represent a challenge to the dental practitioner. Dental erosion, caries, xerostomia, enlargement of parotide glands, traumatized oral mucosa, and other oral manifestations may present in anorexic and bulimic patients. Often the dentist is the first healthcare provider to observe the clinical symptoms of an eating disorder. Dental treatment should be carried out simultaneously with the medical treatment. However, dentists are not aware of the fundamental importance of the dentist's participation in the multidisciplinary treatment and no training is provided with regard to the strategies involved in the dental treatment. Oral complications of eating disorders are a major concern. The difficulties of recognizing the oral manifestations, and the failure to do so, may lead to serious systemic problems in addition to progressive and irreversible damage to the oral hard tissues. Considering the increasing incidence and prevalence rates of eating disorders, the dentist's participation and dental treatment should be discussed.

Tensile bond strength and SEM analysis of enamel etched with Er:YAG laser and phosphoric acid: a comparative study In vitro

Er:YAG laser has been studied as a potential tool for restorative dentistry due to its ability to selectively remove oral hard tissue with minimal or no thermal damage to the surrounding tissues. The purpose of this study was to evaluate in vitro the tensile bond strength (TBS) of an adhesive/composite resin system to human enamel surfaces treated with 37% phosphoric acid, Er:YAG laser (lambda=2.94 microm) with a total energy of 16 J (80 mJ/pulse, 2Hz, 200 pulses, 250 ms pulse width), and Er:YAG laser followed by phosphoric acid etching. Analysis of the treated surfaces was performed by scanning electron microscopy (SEM) to assess morphological differences among the groups. TBS means (in MPa) were as follows: Er:YAG laser + acid (11.7 MPa) > acid (8.2 MPa) > Er:YAG laser (6.1 MPa), with the group treated with laser+acid being significantly from the other groups (p=0.0006 and p= 0.00019, respectively). The groups treated with acid alone and laser alone were significantly different from each other (p=0.0003). The SEM analysis revealed morphological changes that corroborate the TBS results, suggesting that the differences in TBS means among the groups are related to the different etching patterns produced by each type of surface treatment. The findings of this study indicate that the association between Er:YAG laser and phosphoric acid can be used as a valuable resource to increase bond strength to laser-prepared enamel.

Lasers in dentistry: use for hard oral tissue

In the second article of a series, Steven Parker explains the use of lasers in dentistry for the dental nurse. His article covers undertaking clinical procedures on hard tissue with lasers in comparison to using rotary instruments.

Prevalence of oral diseases in Shwachman‐Diamond syndrome

The aim of this study was to determine the prevalence and severity of oral diseases in patients with ShwachmanDiamond syndrome (SDS). Thirty-five persons with SDS were compared to 20 healthy controls. A cross-sectional survey was carried out using self-reporting questionnaires and dental radiographs collected from the subjects and their dentists. Overall, oral diseases were more prevalent among subjects with SDS when compared to controls (p < 0.001). Persons with SDS also had more caries in both primary (p < 0.03) and permanent dentitions (p < 0.01), and also had delayed dental development (p < 0.04). Oral soft tissue pathoses, such as recurrent oral ulcerations (p < 0.00) and gingival bleeding upon brushing (p < 0.00), were significantly more prevalent in subjects with SDS. Pain on eating was also more frequent amongst persons with SDS (p < 0.008) and was often associated with oral ulcerations (p < 0.002). In conclusion, based on self-completed subject and dentist questionnaires, diseases of oral hard and soft tissues were more prevalent and severe in persons with SDS when compared with healthy controls.

P158 Consequences of Chewing Habits in Gujarat, India

Objective: To investigate the effect of chewing areca and/or betel quid with pan masala (tobacco) on oral hard tissue, oral submucous fibrosis (OSMF), and associated molecular impairment underlying the causation of oral precancerous disorders.

Quantitative and qualitative influence on oral hard tissues of neonatal rats born to mothers given methamphetamine during pregnancy

We conducted research as part of a series of studies on the influence on various oral tissues of the offspring of mothers that were given methamphetamine (MA) during pregnancy. The mandibular strength during the growth process of newborn rats from mothers that had received MA was compared with normal newborns. Methamphetamine hydrochloride was continually administered to mother rats (MA group) every day from conception to the day before delivery. Observations of the newborn were made at birth, two, three, four and five weeks. Newborn rats from mothers who had been administered the same amount of physiological saline solution were used as controls. Peripheral quantitative computed tomography (pQCT) was used to measure bone strength to determine bone mineral density and bone structures. A complete determination was made after soft X-ray photography of the mandible. No significant difference was observed in mandibular growth from the menton to the gonion between the MA and the control groups throughout the experimental period. Although no difference was noted in trabecular bone, a significant difference was seen in cortical bone, which tended to become thinner in the MA group. In addition, the cortical bones in the MA group showed lower values for bone mineral density and bone mineral content compared with those in the control group. We concluded that the mandibular strength of neonatal rats of mothers that had received MA was weak, and could break easily compared with normal infants. These results indicate that the problems of female methamphetamine drug users extend to influence on the oral hard tissue formations of their offspring.

Quantitative and qualitative influence on oral hard tissues of neonatal rats born to mothers given methamphetamine during pregnancy

Quantitative and qualitative influence on oral hard tissues of neonatal rats born to mothers given methamphetamine during pregnancy

Effect of Cyclosporin A on the Mineral Apposition Rate of Cementum and Dentin in Growing Rats

Since there is no direct information to verify whether cyclosporin A (CsA) can affect the mineralization of dental hard tissue, the formation of dentin and cementum in growing rats was recorded by labeling the mineral phase of these tissues with fluorochrome marker in this study. After the extraction of the right maxillary molars, 30 male 3-week-old Sprague-Dawley rats were assigned to two groups. Following a 2-week healing period, the experimental rats received 30 mg/kg CsA daily for 7 weeks, while the control rats received only mineral oil. The fluorescent markers, calcein and alizarin red, were given on alternate weeks for 7 weeks. At the end of study, the mandibles were obtained and undemineralized sections were processed. Serial sections, 8 microm thick, were cut for the entire distal roots of the first molars. Five central sections were selected to determine the mineral apposition of cellular cementum and dentin at the apex and middle of root, respectively. The apposition rates of apical cellular cementum were significantly influenced by CsA therapy, occlusal function, and observation duration. However, the dentin apposition rates were significantly influenced by the observation intervals only. In this study, CsA therapy and occlusal function significantly influenced the apposition rates of apical cementum, but not the rates of mid-root dentin. Our hypothesis that CsA can induce oral hard tissue alterations, as well as gingival overgrowth, is demonstrated.