-
[show abstract]
[hide abstract]
ABSTRACT: Proximal carious lesions comprise a constant clinical problem. The aim of this investigation was to test the safety and clinical effect of a new treatment for proximal caries.
In 50 patients with two proximal initial lesions (D1-3 without cavitation, bitewing radiograph), orthodontic rubber rings were applied to gain access to the interproximal space. One of the lesions was sealed with a thin polyurethane-dimethacrylate foil using a bonding agent; the other lesion received oral home care with dental floss and fluoridated toothpaste, and was left as control.
In clinical follow-ups after 6 and 12 months and radiographic evaluation after two years, clinical retention of proximal tape and the underlying sealant, marginal adaptation, discoloration, tooth vitality, proximal plaque, and gingivitis were checked. In addition, carious lesions were assessed clinically and radiographically. The sealants showed good retention, marginal adaptation, and color. After two years, vitality of all teeth was still positive and no relevant differences in plaque accumulation or gingival status were found between sealed and control teeth. Nine sealed lesions showed caries regression and 2 progression. In contrast, only 4 control lesions regressed and also 2 showed progression. The loss of tape had no significant influence on the lesion progression, indicating the effect of the underlying bond. All other sealants and control lesions were stable, indicating an arrest of the lesion.
Sealing initial proximal lesions showed no clinical problems and mostly arrest of initial carious lesions on bitewing radiographs.
The journal of adhesive dentistry 05/2009; 11(2):91-4. · 1.11 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Endodontic treatment of a maxillary lateral incisor with dens invaginatus in association with sinus tract and lateroradicular lesion is reported. Invaginated teeth present technical difficulties with respect to their management because of complicated canal morphology. This case was treated by conventional root canal treatment. At follow up examination after one year the tooth was asymptomatic and radiographically showed repair of the lesion.
Journal of Endodontics 03/2005; 31(2):130-3. · 2.88 Impact Factor
-
GMS Zeitschrift für Medizinische Ausbildung. 01/2005;
-
Cynthia M Pine,
Pauline M Adair,
Girvan Burnside,
Alison D Nicoll,
Angela Gillett,
S Aida Borges-Yáñez,
Zdenek Broukal,
John Brown,
Dominique Declerck,
Feng Xi Ping, [......],
Jaranya Hunsrisakhun,
Edward C M Lo,
Sudeshni Naidoo,
Ursuline Nyandindi,
Vibeke Juul Poulsen,
Noëline Razanamihaja, Christian Splieth,
Betty King Sutton,
Teo Choo Soo,
Helen Whelton
[show abstract]
[hide abstract]
ABSTRACT: To explore whether dentists' beliefs and attitudes to providing preventive and restorative dental care for young children can form a barrier to the provision of care.
The Barriers to Childhood Caries Treatment (BaCCT) Questionnaire, a standardised international measure was developed and applied.
Through a research consortium, each site was asked to recruit 100 dentists. The sample participating was not intended to be nationally representative. Dentists were mainly randomly selected and contacted by mail with one or more mailings depending on site.
2,333 dentists in 14 countries and 17 sites participated. Factor analysis identified four factors as potential barriers. Two factors were found to be barriers in many sites. First, in most countries, dentists agreed that young children's coping skills limit their ability to accept dental care. Secondly, dentists with negative personal feelings, for example, that providing care can be stressful and troublesome and that they feel time constrained. Differences in dentists' beliefs can be partly explained by their work profile, with those treating children often, and those working under systems where they feel they can provide quality care being least likely to identify barriers to providing care for children.
The BaCCT Questionnaire was determined to be a valid psychometric measure. Separately, it was found that health systems do impact on dentists' ability to deliver preventive and restorative care for children but that these effects vary across countries and further work is needed to determine how best these should be examined.
Community dental health 04/2004; 21(1 Suppl):112-20. · 0.75 Impact Factor
-
Cynthia M Pine,
Pauline M Adair,
Alison D Nicoll,
Girvan Burnside,
Poul Erik Petersen,
David Beighton,
Angela Gillett,
Ruth Anderson,
Shahid Anwar,
Susan Brailsford, [......],
Mohamed Hanif Moola,
Sudeshni Naidoo,
Francisco Ramos-Gomez,
Lakshman P Samaranayake,
Swarngit Shahid,
Marit Slåttelid Skeie, Christian Splieth,
Betty King Sutton,
Teo Choo Soo,
Helen Whelton
[show abstract]
[hide abstract]
ABSTRACT: To undertake formative studies investigating how the experience of dental caries in young children living in diverse settings relates to familial and cultural perceptions and beliefs, oral health-related behaviour and oral microflora.
The scientific consortium came from 27 sites in 17 countries, each site followed a common protocol. Each aimed to recruit 100 families with children aged 3 or 4 years, half from deprived backgrounds, and within deprived and non-deprived groups, half to be "caries-free" and half to have at least 3 decayed teeth.
Parents completed a questionnaire, developed using psychological models, on their beliefs, attitudes and behaviours related to their child's oral health. 10% of children had plaque sampled.
2,822 children and families were recruited. In multivariate analyses, reported toothbrushing behaviours that doubled the odds of being caries-free were a combination of brushing before age 1, brushing twice a day and adult involvement in brushing. Analyses combining beliefs, attitudes and behaviours found that parents' perceived ability to implement regular toothbrushing into their child's daily routine was the most important predictor of whether children had caries and this factor persisted in children from disadvantaged communities. 90% of children with lactobacillus had caries.
Parental beliefs and attitudes play a key role in moderating oral health related behaviour in young children and in determining whether they develop caries. Further research is indicated to determine whether supporting the development of parenting skills would reduce dental caries in children from disadvantaged communities independent of ethnic origin.
Community dental health 04/2004; 21(1 Suppl):121-30. · 0.75 Impact Factor
-
Pauline M Adair,
Cynthia M Pine,
Girvan Burnside,
Alison D Nicoll,
Angela Gillett,
Shahid Anwar,
Zdenek Broukal,
Ivor G Chestnutt,
Dominique Declerck,
Feng Xi Ping, [......],
Vibeke Juul Poulsen,
Francisco Ramos-Gomez,
Noëline Razanamihaja,
Swarngit Shahid,
Marit Slåttelid Skeie,
O Patricia Skur, Christian Splieth,
Teo Choo Soo,
Helen Whelton,
David W Young
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE; The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries.
Nurseries, health centres and dental clinics in 17 countries.
2822 children aged 3 to 4 years and their parents.
Dental examination of children and questionnaire to parents.
Factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictor of whether or not favourable habits were reported. Some differences were found by site and ethnic group.
This study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.
Community dental health 04/2004; 21(1 Suppl):102-11. · 0.75 Impact Factor
-
Florian Mack,
Philippe Mojon,
Ejvind Budtz-Jørgensen,
Thomas Kocher, Christian Splieth,
Christian Schwahn,
Olaf Bernhardt,
Dietmar Gesch,
Bernd Kordass,
Ulrich John,
Reiner Biffar
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to describe the oral health status of older adults living in northeastern Germany.
Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross-sectional, population-based study. Data on 1446 subjects aged 60-79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss.
The prevalence of edentulousness varied from 16% in the 60-65-year-old group to 30% in the 75-79-year-old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60-65 years) to one in the oldest (75-79 years). Among subjects aged 60-69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70-79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70-79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60-69 years: 85% vs. 71% in 70-79-year-old men; women aged 60-69 years: 71% vs. 62% in 70-79-year-olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern.
It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.
Gerodontology 04/2004; 21(1):27-36. · 1.03 Impact Factor
-
Florian Mack,
Philippe Mojon,
Ejvind Budtz-Jørgensen,
Thomas Kocher, Christian Splieth,
Christian Schwahn,
Olaf Bernhardt,
Dietmar Gesch,
Bernd Kordaß,
Ulrich John,
Reiner Biffar
[show abstract]
[hide abstract]
ABSTRACT: Objective: The aim of this study was to describe the oral health status of older adults living in north-eastern Germany.Materials and Methods: Representative samples of adults aged 60 years or older were examined as part of Study of the Health in Pomerania, a cross-sectional, population-based study. Data on 1446 subjects aged 60–79 years were evaluated for coronal caries using the decayed/missing/filled teeth (DMFT) index, root caries using the root caries index (RCI), calculus, plaque, bleeding on probing, pocket depth and attachment loss.Results: The prevalence of edentulousness varied from 16% in the 60–65-year-old group to 30% in the 75–79-year-old group, whereas the median number of remaining natural teeth per subject varied from 14 in the youngest age group (60–65 years) to one in the oldest (75–79 years). Among subjects aged 60–69 years, a quarter (26%) of the teeth examined had coronal restoration against 17% in the oldest age group (70–79 years). Coronal caries was found in 2% of the teeth in both age groups. Among teeth with gingival recession, 6% had fillings on root surfaces and 2% had root caries, irrespective of age. In all, 11% of the subjects had at least one untreated coronal lesion and 27% had at least one untreated root caries lesion. Plaque score, calculus score and bleeding on probing were higher in the oldest age group (70–79 years). The prevalence of periodontal disease expressed as the presence of at least one periodontal pocket of 4 mm and more, was higher in men and among the younger subjects (men aged 60–69 years: 85% vs. 71% in 70–79-year-old men; women aged 60–69 years: 71% vs. 62% in 70–79-year-olds). The prevalence of attachment loss of 3 mm or more followed a similar pattern.Conclusions: It seems therefore that in this population, the major oral health concern is related to caries and the small number of teeth retained among the dentate subjects.
Gerodontology 03/2004; 21(1):27 - 36. · 1.03 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The goal of the Study of Health in Pomerania (SHIP) was to estimate the prevalence of diseases, identify potential risk factors in a defined region in northeast Germany, and examine the particular living situation of this population after the reunification of East and West Germany. One of the main concerns of the SHIP design is the analysis of the relationships between dental, medical, social, and environmentally and behaviorally determined health factors. SHIP is a cross-sectional study (clinical findings and sociologic interviews). The sample was drawn in two steps: Thirty-two communities in the region were selected, and within these communities, a simple random sample was drawn from residence registries, stratified by gender and age. The final sample included 4,310 males and females, aged 20 to 79 years. This is equivalent to a participation rate of 68.8%. Data collection was completed in May 2001. The data collection and items comprised four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination included the teeth, periodontium, oral mucosa, morphology and function of the craniomandibular system, and prosthodontics. The medical examination included blood pressure measurements; electrocardiography; echocardiography; carotid, thyroid, and liver ultrasound examinations; neurologic screening; and blood and urine sampling. The computer-assisted interview consisted of questions on symptoms of disease, utilization of medical and dental services, self-assessment of general and oral health, health behavior and knowledge, and socioeconomic variables. The self-administered questionnaire comprised housing conditions, social network, work conditions, subjective well-being, and individual consequences of the German reunification.
Quintessence international 06/2003; 34(5):370-8. · 0.76 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The determination of a tooth-size to arch-length discrepancy in the mixed dentition requires an accurate prediction of the mesiodistal widths of the unerupted permanent teeth. This is an essential factor in treatment planning. The aim of this study was to validate Tanaka and Johnston's analysis on 600 Syrian patients aged 14-22 years. Tanaka and Johnston's tables, equations, and approximations were modified in order to improve the accuracy of the prediction. The correlation coefficients found between the size of the permanent mandibular central incisors and maxillary first molars (31, 41, 16, and 26) and the maxillary and mandibular canines and premolars were high (r = .72 and .74, respectively). New, more accurate prediction tables applicable at earlier ages, and new regression equations were constructed. In addition, new easier approximations were developed to allow the prediction of the size of the unerupted maxillary canines and premolars by adding 6 mm to the half-widths of teeth 31, 41, 16, and 26. The analogous prediction of the size of the unerupted mandibular canines and premolars was obtained by adding 5.5 mm to the half-widths of same teeth, 31, 41, 16, and 26.
The Angle Orthodontist 07/2002; 72(3):216-21. · 1.21 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The aim of this study was to analyse the residual periodontal attachment in teeth extracted by East German dentists in order to determine a possible 'forceps level'.
Out of about 8000 extracted teeth collected from a dental waste disposal company, 500 teeth were randomly selected. After exclusion of wisdom teeth and premolars extracted for orthodontic reasons (intact teeth with attachment > 90%), coronal and root caries, fillings, pulp exposure and incomplete root fillings (based on X-rays) were registered. The periodontal ligament was stained with 1% Fuchsin Red and measured with a light microscope.
For intact teeth (DF = 0, periodontal disease definition I), the mean periodontal attachment (50.5% +/- 16.0) was significantly lower than for teeth with carious defects or fillings (64.7% +/- 18.8. unpaired t-test: p < 0. 00 1). There was a marked increase in frequency of extractions in intact teeth below 70% periodontal attachment and 37% were extracted at attachment levels between 50 and 69%. Teeth with pulpal involvement showed significantly different frequency distributions and mean attachment values (77.9% +/- 17.8) than the remaining teeth (periodontal disease definition II; 55,2% +/- 15.5).
A considerable number of teeth with no or minor coronal destruction were extracted at an attachment level of 50-70%, regardless of the tooth type. The threshold for 'periodontal' extractions seem to be too low and undifferentiated, which calls for an improvement in knowledge of periodontal diagnosis and treatment.
Journal Of Clinical Periodontology 06/2002; 29(6):514-8. · 3.00 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To determine the degree of psychological distress, the experience of emotional exhaustion, and the extent of stress associated with course work in dental students and to compare these measurements among seven European dental schools.
Multi-centred survey.
Dental Schools at Amsterdam, Belfast, Cork, Greifswald, Helsinki, Liverpool and Manchester.
333 undergraduate first-year dental students.
General Health Questionnaire (GHQ12), Maslach Burnout Inventory (MBI), Dental Environment Stress Questionnaire (DES), demographic variables.
Questionnaire administered to all students attending first year course. Completed questionnaires sent to central office for processing.
Seventy-nine percent of the sampled students responded. Over a third of the students (36%) reported significant psychological distress (morbidity) at the recommended cut-off point (>3 on GHQ). These scores were similar to those reported for medical undergraduates. Twenty-two percent recorded comparatively high scores on emotional exhaustion. A wide variation in these 2 measurements was found across schools (p's<0.001). Stress levels indicated by the DES were less variable (p>0.5). Some evidence showed that contact with patients and the level of support afforded by living at home may be protective.
Higher than expected levels of emotional exhaustion were found in a large sample of first-year undergraduate dental students in Europe.
European Journal Of Dental Education 03/2002; 6(1):22-9. · 1.18 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Using a population-based sample of the cross-sectional epidemiologic "Study of Health in Pomerania" (SHIP), this study evaluated whether certain occlusal and sociodemographic factors besides age and gender are risk factors for high dental wear.
Medical history and dental and sociodemographic parameters of 2,529 dentate subjects selected representatively and according to age distribution were checked for correlations with the occurrence of high occlusal wear symptoms using a multivariate logistic regression model. Occlusal wear was recorded using the attrition index by Ekfeldt et al and was age adjusted by determining high occlusal wear for every 10-year age group as index values > or = 90th percentile.
The following independent variables were found to be correlated with high occlusal wear: male gender, odds ratio 2.2; frequent bruxism, odds ratio 2.5; loss of molar occlusal contact (Eichner classification), odds ratio from 1.5 to 3.1; edge-to-edge relation of incisors, odds ratio 1.7; unilateral buccolingual cusp-to-cusp relation, odds ratio 1.8; and unemployment, odds ratio 1.6. In contrast, anterior cross-bite, unilateral posterior cross-bite, and anterior crowding were protective for high occlusal wear levels, as shown by significantly reduced odds ratios. Gender-separated analysis showed that self-reported bruxism was a risk factor only for men.
In addition to some occlusal factors, the main factors associated with occlusal wear were bruxism and gender.
The International journal of prosthodontics 17(3):333-9. · 1.38 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The microflora around and beneath restorations is an important factor of restoration failure. The aim of this pilot study was to determine and compare the microbial spectrum under composite and amalgam restorations with special attention to the anaerobic flora.
Ten composite and five amalgam restorations scheduled for replacement were clinically evaluated for marginal gaps, fractures, and secondary caries. After their removal and caries diagnosis, a dentin sample just below the restoration was taken under sterile conditions, stored in a prereduced transport medium for anaerobic bacteria, and immediately transferred to a laboratory for microbial diagnosis.
The clinical parameters showing mostly moderate marginal imperfections and the ratios of aerobic to anaerobic flora were comparable for composite and amalgam restorations (11.4%:88.6% and 15.4%:84.5%, respectively). The microbial variety under composite restorations was much greater compared to amalgam, and it was similar to that of infected root canals including anaerobic gram-negative rods, such as Fusobacterium species or Porphyromonas species. Beneath amalgam, the microbial flora was similar to the one found in carious dentin and plaque, with anaerobic and facultatively anaerobic gram-positive rods dominating. Quantitatively, there were up to eight times more microorganisms under composite restorations. The number of bacterial strains correlated with the caries activity and the filling material, the number of anaerobic rods correlated highly with caries activity and localization. In a linear regression, caries activity and the filling material had statistically significant influence on the bacterial load.
Although caries activity and location had the greatest influence on the microbial flora under the restorations, the kind of restoration material seemed to have an additional effect on the composition of the microflora. This pilot study indicates that inadequate composite restorations may promote the growth of cariogenic, as well as obligate anaerobic and potentially pulpopathogenic bacteria, which should be confirmed by further studies.
Quintessence international 34(7):497-503. · 0.76 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: To compare the effectiveness of polymer burs (SmartPrep, SS White) and conventional carbide burs in removing dentin caries.
Thirty extracted permanent teeth were assigned to 2 groups according to the caries removal technique. One experienced clinician performed all excavation procedures, monitoring the caries removal by checking the hardness of the dentin with a dental explorer. The excavation working time was documented and stopped in each group when a leather-hard texture was reached. After the teeth were embedded and sectioned (400 Microm), the caries in the remaining dentin was assessed using a caries detector. On microscope images of the samples, the mean stain depth of the remaining carious tissue per tooth was measured by AnalySIS computer software.
Mean carious surface areas differed minimally but not statistically significantly after use of polymer burs (31.5 mm2 +/- 0.18) and carbide burs (38.1 mm2 +/- 0.15). Mean carious surface staining depth was slightly smaller with carbide burs (0.26 mm +/- 1.38) than with polymer burs (0.40 mm +/- 1.15). The mean-quartile test for the total carious surface (P = .363) and the carious margin (P = .681) showed no statistically significant differences. Of the carbide bur-treated samples, 84.5% were caries free as opposed to 93.0% in the polymer bur group. The results also showed no significant difference between the mean working time of the polymer burs (5.11 minutes) and the carbide burs (4.99 minutes).
Under these experimental conditions, polymer burs and tungsten carbide burs were similarly effective for caries removal.
Quintessence international (Berlin, Germany: 1985) 38(7):565-9. · 0.64 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Eine gute Mundgesundheit ist eine wichtige Voraussetzung dafür, sich gesund und wohl zu fühlen. Sie ermöglicht es, problemlos zu essen, selbstbewusst zu lächeln und zu kommunizieren. Die orale Gesundheit hat vielfältige Auswirkungen auf den gesamten Organismus und wird durch ihn beeinflusst. Erkrankungen des Mundes und der Zähne sind in Deutschland weit verbreitet: Weniger als 1% aller Erwachsenen haben ein kariesfreies Gebiss. Die Prävalenz von Erkrankungen des Zahnhalteapparates (Parodontalerkrankungen) stagnierte in den letzten Jahren auf hohem Niveau. Über 7% der gesamten Leistungsausgaben der Gesetzlichen Krankenversicherung, insgesamt mehr als 10 Mrd. Euro, wurden im Jahr 2007 für zahnärztliche Behandlung und Zahnersatz ausgegeben. Die hohe Prävalenz von Mund- und Zahnerkrankungen ist eng mit der Lebensweise verbunden, insbesondere mit dem Konsum von Zucker, Alkohol und Tabak. Gleichwohl besteht bei diesen Krankheiten ein hohes Präventionspotenzial und es gibt zahlreiche wirkungsvolle und kostengünstige Vorsorgemaßnahmen. Bei Kindern und Jugendlichen konnten in den letzten Jahren unter anderem durch den breiten Einsatz von Fluoriden in der Gruppen- und Individualprophylaxe deutliche Verbesserungen der Zahngesundheit erreicht werden. Allerdings ist eine Polarisation der Kariesbetroffenheit bei Kindern und Jugendlichen in Deutschland zu erkennen, d.h. eine kleine Teilgruppe der Erkrankten vereinigt den Großteil der kariösen Zähne auf sich. Bei den Erwachsenen und Seniorinnen/Senioren wurde im Jahr 2005 erstmals ein Rückgang der Karieserfahrung und der Zahnverluste registriert. Aktuelle Studien belegen, dass drei Viertel aller Deutschen ein gutes Mundpflegeverhalten haben und regelmäßig eine zahnärztliche Praxis zu Kontrolluntersuchungen aufsuchen. Das vorliegende Themenheft der Gesundheitsberichterstattung gibt auf der Basis aktueller und repräsentativer Daten eine Übersicht über die verschiedenen Erkrankungen und Störungen der Mundgesundheit und deren Verbreitung. Risikofaktoren und Krankheitsursachen werden diskutiert und die Folgen der Erkrankungen dargestellt. Ausführungen zu präventiven und therapeutischen Maßnahmen sowie deren Inanspruchnahme und Kosten vervollständigen den Überblick über die Mundgesundheit der Bevölkerung in Deutschland.
