Aylin Baysan

Reversal of primary root caries using dentifrices containing 5,000 and 1,100 ppm fluoride.

This study compared the ability of two sodium fluoride dentifrices, one containing 5,000 ppm fluoride (Prevident 5000 Plus) and the other 1,100 ppm fluoride (Winterfresh Gel), to reverse primary root caries lesions (PRCLs). A total of 201 subjects with at least one PRCL each entered the study and were randomly allocated to use one of the dentifrices. After 6 months, 186 subjects were included in statistical analyses. At baseline and after 3 and 6 months, the lesions were clinically assessed and their electrical resistance measured using an electrical caries monitor. After 3 months, 39 (38.2%) of the 102 subjects in the 5,000 ppm F– group and 9 (10.7%) of 84 subjects using the 1,100 ppm F– dentifrice, had one or more PRCLs which had hardened (p = 0.005). Between baseline and 3 months, the log10 mean ± SD resistance values of lesions for subjects in the 1,100 ppm F– group had decreased by 0.06±0.55, whereas those in the 5,000 ppm F– group had increased by 0.40±0.64 (p<0.001). After 6 months, 58 (56.9%) of the subjects in the 5,000 ppm F– group and 24 (28.6%) in the 1,100 ppm F– group had one or more PRCLs that had become hard (p = 0.002). Between baseline and 6 months, the log10 mean ± SD resistance values of lesions for subjects in the 1,100 ppm F– group decreased by 0.004±0.70, whereas in the 5,000 ppm F– group, they increased by 0.56±0.76 (p<0.001). After 3 and 6 months, the distance from the apical border of the root caries lesions to the gingival margin increased significantly in the 5,000 ppm F– group when compared with the 1,100 ppm F– group. The plaque index in the 5,000 ppm F– group was also significantly reduced when compared with the 1,100 ppm F– group. The colour of the lesions remained unchanged. It was concluded that the dentifrice containing 5,000 ppm F– was significantly better at remineralising PRCLs than the one containing 1,100 ppm F–.

The use of ozone in dentistry and medicine.

There is growing interest in the use of ozone in oral healthcare and the National Institute for Clinical Excellence (NICE) is at present reviewing the evidence for its effectiveness in the management of occlusal and plain surface caries. These are only two of the clinical problems for which ozone can, and has, been used; it has also been employed for a wide variety of other purposes in both dentistry and medicine. This pale blue-coloured gas plays an important role as a natural constituent in the higher layer of the Earths atmosphere. There is growing evidence that it can be employed as a useful therapeutic agent. This paper reviews its therapeutic uses to date and suggests its possible future clinical applications. Consumer demands for this strong oxidant may increase as the general public becomes increasingly aware of its therapeutic capacity and the non-invasive manner in which it can be administered.

Assessment of the Ozone-Mediated Killing of Bacteria in Infected Dentine Associated with Non-Cavitated Occlusal Carious Lesions

The ability of ozone to kill micro-organisms associated with non-cavitated occlusal caries was investigated. The occlusal surfaces were treated with ozone (n = 53) or air (n = 49) for 40 s, and the underlying infected dentine was exposed. There was no significant difference between the number of bacteria recovered from the ozone-treated and the control sites (p > 0.1). Treatment of the exposed dentine with ozone resulted in a just significant (p = 0.044) reduction in bacterial counts. Ozone treatment of non-cavitated occlusal lesions for 40 s failed to significantly reduce the numbers of viable bacteria in infected dentine beneath the demineralized enamel.

Reversal of Primary Root Caries Using a Dentifrice with a High Fluoride Content

Root caries is a widespread problem and can be quite serious in older populations. The restoration of root carious lesions is often difficult. Compared to enamel caries, there has been limited research into the pharmaceutical management of primary root caries lesions (PRCLs), and many of these studies have been carried out in vitro, with limited numbers of clinical trials. Fluoride is presently a cornerstone in dentifrice formulations for cost-effective and anticaries therapy. It is generally accepted that fluoride ions promote remineralization of tooth substances and reduce the rate of demineralization. The use of a dentifrice with a high fluoride content may be considered to reverse PRCLs, since more fluoride is required for the remineralization of roots than for enamel. This paper reviews the effects of dentifrices with high fluoride contents on the management of root caries.

The use of ozone in dentistry and medicine. Part 2. Ozone and root caries.

A previous paper, recently published in Primary Dental Care, gave an overview of the medical uses of ozone and outlined some of its uses in dentistry. The current paper focuses on a description of use of ozone in the management of root caries and considers recent studies in this area. There has been relatively limited research into the non-invasive (pharmaceutical) management of root caries. The best management strategy still remains to be developed. Initial studies have indicated that an application of ozone for a period of either 10 or 20 seconds is capable of clinically reversing leathery root carious lesions. It is suggested that, subject to confirmation from extensive trials, this simple and non-invasive technique may benefit many patients with root caries throughout the world since this approach to treat root caries can easily be employed in primary care clinics and in the domiciliary treatment of home-bound elderly people and immobile patients in hospices and hospitals.

Towards a pedagogy for clinical education: beyond individual learning differences

The development of teaching in higher education towards a more learner‐orientated model has been supported by the literature on individual learning differences and on learning styles in particular. This has contributed to the evolution of university pedagogy away from a medieval transmission model than runs counter to contemporary understanding of learning. However, rather than solving problems of classroom practice, recognition of student learning differences has amplified a number of tensions within the system that have not been adequately resolved in practical terms for academic staff. Such tensions complicate the professional lives of university teachers and as a consequence may lead to cycles of non‐learning as teachers retreat towards the familiar transmission of content. A reconceptualisation of university pedagogy towards an expertise model allows the variation between complementary chains of practice and networks of understanding to be exploited as a positive characteristic of the learning experience.

Association between Oral Health Impact Profile and General Health scores for patients seeking dental implants

OBJECTIVES The aim of this study was to investigate the possible association between the short form, 14-item Oral Health Impact Profile (OHIP-14) and 12-item General Health Questionnaire (GHQ-12) for patients requiring restorative dental work on Implant Assessment Clinic at Guys Dental Institute. METHODS A total of 216 patients aged 18-83 years old were recruited when attended the Implant Assessment Clinic. Restorative treatment needs were classified as hypodontia, trauma related missing teeth, edentulousness (complete denture wearers) and partially dentate (removable partial denture wearers). The OHIP-14, which assesses the adverse impact of oral conditions on quality of life and GHQ-12, a measure of global distress, were subsequently completed by the patients. RESULTS Statistical analyses showed that there is a strong correlation between OHIP-14 and GHQ-12 within all the categories of treatment needs (p<0.0001). CONCLUSION The impact of oral health on the life quality of these patients seeking dental implant treatment was strongly associated with the General Health Questionnaire status.

Effects of Ozone and ND:YAG Laser Pretreatment on Bond Strength of Self-Etch Adhesives to Coronal and Root Dentin

OBJECTIVES The aim of this study was to evaluate the effects of two different disinfection treatments--ozone and Nd:YAG laser application--on shear-bond strength (SBS) of self-etch adhesives to coronal and root dentin. MATERIALS AND METHODS Sixty extracted human canines were ground flat, exposing the coronal and root dentin surfaces, and randomly divided into three groups. The surfaces were untreated (Control) or treated with ozone (HealOzone, KaVo) or Nd:YAG laser (Fidelis III, Fotona). Coronal and root dentins of 10 teeth of each group were treated with a two-step self-etch adhesive (Clearfil SE Bond, Kuraray Medical; SE), whereas the remaining 10 teeth were treated with a one-step self-etch adhesive (Clearfil Tri-S Bond, Kuraray Medical; S3). A resin composite (Clearfil Majesty Esthetics, Kuraray Medical) was then placed, and SBS was tested with a universal testing machine. Failure modes were determined under a stereomicroscope. The mean SBS values of each group were calculated, and data were subjected to statistical analysis (p = 0.05). RESULTS For the coronal dentin, Control/SE showed significantly higher values than Control/S3, Ozone/S3, and Nd:YAG/S3. Although Ozone/SE showed significantly higher values than Nd:YAG/S3 (p < 0.05), the differences within the other groups were not significant for the root dentin (p > 0.05). Comparison of two dentin substrates in each group did not show any significant difference except for Control/SE, in which coronal dentin showed higher SBS. The failure modes of all groups were mainly adhesive. CONCLUSION Pretreatments with Ozone or Nd:YAG laser did not impair the SBS of both of the self-etch adhesives used to coronal and root dentin.

Comparison of efficacy of dental varnish containing fluoride either with CPP-ACP or bioglass on root caries: Ex vivo study

OBJECTIVES To compare the efficacy of fluoride varnishes either casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) or bioglass particles on the severity index of root caries. METHODS Visual-tactile assessments including lesion hardness was carried out to categorise the severity index of 80 extracted teeth with primary root caries. These teeth were randomly divided into four groups; CPP-ACP and fluoride, bioglass and fluoride, fluoride only, and no treatment. Standardised toothbrushing using a dentifrice containing 1450 ppm fluoride was carried out twice a day for all groups. All samples were stored in remineralising solution at 37°C for 45 days. Visual-tactile assessments were carried out at baseline, and after 45 days. Surface roughness measurements (Ra) were performed at baseline and after 7, 14, 30 and 45 days. X-ray Microtomography was performed at the baseline and after 45 days for three samples from each group to quantify the change in mineral contents in the lesion area. RESULTS The Visual-tactile assessment results showed a reduction in the severity index of root caries, being 20% in CPP-ACP and fluoride, 100% in bioglass and fluoride, 80% in fluoride only, and 60% in non-varnish (toothbrushing only). Non-significant change in surface roughness was observed in all groups. X-ray Microtomography assessment showed a highly significant increase in the mineral deposition in all cases (p > .001). CONCLUSION The combination of bioglass with fluoride has a potentially superior effect than either CPP-ACP with fluoride or fluoride only to reverse and arrest the root caries in a laboratory setting. CLINICAL SIGNIFICANCE The combination of bioglass particles and fluoride formulation is likely to have a significant impact in reversing and arresting root caries in a minimally invasive approach. However, randomised controlled double-blinded clinical trials are required to translate these results into clinical practice.