Publications (20) View all
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Article: An In Vitro Comparison of the Accuracy of Measurements Obtained from High- and Low-resolution Cone-beam Computed Tomography Scans.
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ABSTRACT: This study aimed to investigate in an ex vivo model the reduction in patient radiation dose while maintaining accurate linear measurements by comparing cone-beam computed tomography (CBCT) scans taken at 360° versus 180° rotation, with porcine jaw specimens as a reference standard. CBCT scans of 12 sectioned porcine hemimandibles at 360° and 180° rotations were taken with standardized clinical exposure parameters. To assess interobserver variability, 6 assessors who were blinded to the degree of rotation took linear measurements of anatomic structures on each scan. The measurements were repeated after 2 weeks to assess intraobserver variability. Accuracy of measurement was judged against the corresponding measurements taken from the porcine jaw specimens. Intraclass correlations signaled good-to-excellent intraobserver and interobserver agreement (0.65-0.98 and 0.79-0.98), respectively. Mixed regression analysis found no significant difference between the measurements from 180° or 360° rotations and no difference between the 2 rotations and porcine jaw specimens. A CBCT image sufficient to make accurate clinical measurements with a reduced radiation exposure may be obtained by using 180° rotation of the CBCT tube head.Journal of endodontics 03/2013; 39(3):394-7. · 2.95 Impact Factor -
Article: Retention of orthodontic brackets bonded with resin-modified GIC versus composite resin adhesives--a quantitative systematic review of clinical trials.
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ABSTRACT: The aim of this systematic review was to establish whether the clinical debonding (failure) rates of orthodontic brackets bonded either with resin-modified glass ionomer (RM-GIC) or with composite resin adhesive are the same. Five databases were searched for articles up to 18 November 2010. Inclusion criteria were titles/abstracts relevant to the review question and two or more arm clinical trial. Exclusion criteria were the following: no computable data recorded and subjects of both groups not followed up in the same way. From the accepted trials, datasets were analysed concerning clinical precision and internal validity. Eleven trials were accepted. From these, 15 dichotomous datasets were extracted. Relative risk with 95% confidence interval of nine datasets showed no statistically significant differences in outcome between the treatment and control group after 6 months-1.32 years. Five showed a statistically significant difference (p < 0.05), favouring resin composite bonding after 12 and 18 months. One favoured RM-GIC after 10 months. Meta-analysis found no difference in the failure rate between the two treatment groups after 12 months (RR, 1.11; 95% CI, 0.87-1.42; p = 0.40) and found in favour of composite resin adhesive after >14 months (RR, 2.25; 95% CI, 1.60-3.17; p < 0.00001). All trials had poor internal validity due to selection and detection/performance bias risk. The current evidence suggests no difference between the types of materials after 12 months but favours composite resin adhesives after a >14-month period. However, its risk of selection and detection/performance bias are high, and all results need to be regarded with caution. Further high quality randomised control trials addressing this topic are needed. The clinical relevance of this study is that RM-GIC may have the same clinical debonding (failure) rate as composite resin adhesives after 1 year when used for bonding of orthodontic brackets.Clinical Oral Investigations 02/2012; 16(1):1-14. · 2.36 Impact Factor -
Article: Contemporary adhesive bonding: bridging the gap between research and clinical practice.
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ABSTRACT: The dawn of minimally invasive dentistry has led to the development of materials which rely on the use of effective adhesion to bond to remaining tooth tissue. Successful adhesive bonding is dependent upon appreciating the quality of the dental substrate, appropriate clinical handling of the material and patient, together with an appreciation of the chemistry of the adhesive. This paper outlines the current status of contemporary bonding, with particular emphasis on translating laboratory-based evidence into clinical practice. Using laboratory-based evidence, the ability of a bond to achieve a seal to enamel appears to be the best predictor of clinical performance. CLINICAL RELEVANCE: This article discusses the issues raised when translating research data about adhesive bonding from the laboratory to clinical dental practice.Dental update 09/2011; 38(7):439-40, 443-6, 449-50. -
Article: An in vitro evaluation of selective demineralised enamel removal using bio-active glass air abrasion.
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ABSTRACT: Unnecessary over-preparation of carious enamel often occurs clinically during operative caries management. The working hypothesis to be investigated in this study is the potential for bio-active glass air abrasion to remove selectively only demineralised enamel in artificial enamel lesions when compared to equivalent alumina air abrasion, so potentially minimising cavity over-preparation. Bisected artificial, paired smooth surface enamel lesions on ethics-approved, extracted sound human molars were created and subsequently air abraded with 27 μm alumina (n = 19) and bio-active glass (n = 19). The difference between pre-operative lesion boundary and post-operative cavity margin was calculated following optical confocal fluorescent assessment of the lesion boundary. Data indicated mean% over-preparation (sound enamel removal) of 176% with alumina and 15.2% for bio-active glass (p = 0.005). Bio-active glass abrasion removed completely the demineralised enamel from artificial lesions with clinically insignificant over-preparation of sound tissue, indicating technique selectivity towards grossly demineralised enamel. Alumina air abrasion resulted in substantial enamel removal in both sound and demineralised tissues indicating the operator selectivity required to use the techniques effectively in clinical practice.Clinical Oral Investigations 10/2010; 15(6):895-900. · 2.36 Impact Factor -
Article: Pulp response to resin-modified glass ionomer and calcium hydroxide cements in deep cavities: A quantitative systematic review.
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ABSTRACT: To quantitatively determine whether the pulp response to resin-modified glass ionomer cements placed in deep cavities differs from that generated by calcium hydroxide cement. Five databases were searched for articles up to 31 May 2009. Inclusion criteria: titles/abstracts relevant to topic; published in English; two-arm longitudinal in vivo trial; containing computable dichotomous datasets for test and control group. Exclusion criteria: not all entered subjects accounted for at the end of the trial; subjects of both groups not followed up in the same way; trial on animal tissue. One randomized and five non-randomized control trials, reporting on 1 and 17 datasets, respectively, were accepted. From non-randomized trials, the Relative Risk with 95% Confidence Interval of 13 datasets showed no statistically significant differences (p>0.05) and 4 showed a statistically significant difference between both materials. Meta-analysis of datasets from these trials found no difference between the inflammatory cell response after 30 days (0.87; 95%CI 0.59-1.26; p=0.46); 38% less inflammatory cell response with calcium hydroxide after 60 days (0.62; 95%CI 0.50-0.76; p<0.00001); higher number of intact odontoblasts beneath restored cavities after 381 days (0.56; 95%CI 0.38-0.82; p=0.0008). The results from the randomized control trial (1.40; 95%CI 0.92-2.14; p=0.11) indicated no difference in clinically identifiable pulp symptoms after two years. All trials showed limited internal validity due to selection bias. No conclusive statement about the superiority of either type of material can yet be made. Further high-quality randomized control trials are needed.Dental materials: official publication of the Academy of Dental Materials 05/2010; 26(8):761-70. · 2.88 Impact Factor
