Janet G. Bauer

Development and evaluation of a safe and effective sugar-free herbal lollipop that kills cavity-causing bacteria.

Dental caries (tooth decay) is caused by a specific group of cariogenic bacteria, like Streptococcus mutans, which convert dietary sugars into acids that dissolve the mineral in tooth structure. Killing cariogenic bacteria is an effective way to control or prevent tooth decay. In a previous study, we discovered a novel compound (Glycyrrhizol A), from the extraction of licorice roots, with strong antimicrobial activity against cariogenic bacteria. In the current study, we developed a method to produce these specific herbal extracts in large quantities, and then used these extracts to develop a sugar‐free lollipop that effectively kills cariogenic bacteria like Streptococcus mutans. Further studies showed that these sugar‐free lollipops are safe and their antimicrobial activity is stable. Two pilot human studies indicate that a brief application of these lollipops (twice a day for ten days) led to a marked reduction of cariogenic bacteria in oral cavity among most human subjects tested. This herbal lollipop could be a novel tool to promote oral health through functional foods.

A clinical comparison of xeroradiography and film radiography for the detection of proximal caries

Xeroradiographs and conventional film radiographs (D- and E-speed) were compared in a clinical study with the use of 1 complete-mouth radiographs for (1) the presence of interproximal caries and (2) the determination of the depth of interproximal caries with the use of 200 tooth surfaces. In addition, an analysis of correct classification rates making a comparison of the same techniques was conducted. The results with the use of ROC analysis indicated that when a comparison was made of xeroradiography and D- and E-speed film, all techniques were equally useful. A broad range of observer ROC area values was found, indicating that diagnostic performance varies greatly with observer. The results of the diagnostic decisions made on carious surfaces versus noncarious surfaces indicated that all techniques tested were similar: 90% correct for noncarious surfaces and 77% correct for carious surfaces.

The surface of composite resin finished with instruments and matrices

I t is difficult to obtain a smooth surface on composite resin restorations.‘-” The problem is inherent in the composite resin. Some investigators have suggested that the difference in hardness between the filler particles and matrix contributes to a roughened surface.‘, *, I37 I4 Still others suggest that a rough surface is to be expected and results from wear factors. These include wear of the resin matrix, exposure of air bubbles and loss of the filler particles by shearing forces, bond failure, and cracking of the resin matrix.2* 3, 6, “3 “* I6 Various finishing and polishing procedures have been studied to produce a smooth composite resin surface. ‘, 6, ‘3 “v 13, ‘X ” Nonsmooth or irregular and rough surfaces can be irritating to the periodontal ligament and lead to increased adhesion of dental plaque, inviting recurrent caries.‘-+ ‘3 *, I3 With complex lesions and defects occurring in the gingival third of teeth, restorations with rough surface texture, adhesion of dental plaque, and irritation of the periodontal ligament induce pathoses. In the cervical area, access for finishing and polishing with abrasive instruments is limited. To minimize these problems, care in the insertion of the composite resin and proper matrix technique have been suggested.‘3s’8 In this manner it is possible that with minimal finishing, a smooth surface, recreating the natural contours of the tooth, is produced and decreases the potential for dental plaque to injure the periodontal ligament and also induce recurrent caries. The purpose of this study was to compare the surface finish ptoduced by various insertion and matrix techniques.

Psychoneuroimmunology in Oral Biology and Medicine

Abstract: Rheumatoid arthritis involves psychoneuroendocrine‐immunopathological comorbidities. In the stoma, patients with rheumatoid arthritis frequently show signs of periondontal disease consequent to elevated levels of crevicular proinflammatory cytokines. It is not clear whether rheumatoid arthritis may manifest in association with immunopathological manifestations of the oral soft mucosa. Oral lichen planus (OLP), first described by E. Wilson in 1859, is a T‐cell‐mediated inflammatory disease whose lesions characteristically lack B cells, plasma cells, immunoglobulin. or complement. It is increasingly well characterized and recognized as a model for psychoneuroimmunology research in oral biology and medicine. To date, we have shown an association between changes in hypothalamic‐pituitary‐adrenal (HPA) regulation, systemic markers of cellular immunity and mood states, with clinical stages of OLP (i.e., atrophic vs. erosive vs. bullous lesions). We report significant associations (p < 0.05) between the stage of OLP, HPA deregulation, and altered distribution and functional responses of naïve CD4+ cells. We emphasize the need to study in greater details the psychoneuroendocrine‐immune inter‐relationships in OLP, and we propose a novel neuroimmune hypothesis for OLP.

Silver-plated dies. Part I: Platability of impression materials

The purpose of this study were to determine the acceptability of silver-plated dies made from representative brands of impression material from each of the four groups of elastomers and to determine the time required for initial plating of dies. Permlastic and Impregum , each previously shown to produce consistent silver-plated dies, were used for comparison. Representatives from the condensation-reaction and addition-reaction ( polyvinylsiloxanes ) silicones groups were tested until satisfactory materials were selected. Citricon and Xantopren - Optosil were tested in the former group and President and Reprosil in the latter. Conclusions include the following: All materials were flash-plated in 10 minutes or less. Acceptable silver-plated dies were obtained from Permlastic and Impregum . Acceptable silver-plated dies were obtained from condensation-reaction silicones with Xantopren - Optosil . From the polyvinylsiloxane group, Reprosil plated more consistently than President. Both produce acceptable dies. The technique modification studied was not effective for Citricon and President. The surface quality of silver-plated dies and the consistency of plating varies with materials. Individual impression materials should be tested prior to their routine clinical use with silver-plating procedures.

A clinical comparison between xeroradiography and film radiography for the detection of recurrent caries

Xeroradiographs and conventional film radiographs (D- and E-speed) were compared in a clinical study with the use of one-half complete-mouth radiographs for the detection of recurrent dental caries in 200 teeth. The results indicated that film was the most useful in identification of noncarious restored teeth (91% correct versus 79% correct for xeroradiography); however, xeroradiography was better than film for detection of recurrent caries (67% versus 53%). With ROC analysis, both film and xeroradiography were equally useful, having the same ROC value of 0.78. At rates of 67% and 53% for detection of the presence of recurrent caries, neither imaging system can overcome basic geometric limitations of superimposition of metallic restorations. Thus, there is the continued need for careful clinical assessesment of existing restorations for the presence of recurrent caries.

The Translation Evidence Mechanism. The Compact between Researcher and Clinician.

Currently, best evidence is a concentrated effort by researchers. Researchers produce information and expect that clinicians will implement their advances in improving patient care. However, difficulties exist in maximizing cooperation and coordination between the producers, facilitators, and users (patients) of best evidence outcomes. The Translational Evidence Mechanism is introduced to overcome these difficulties by forming a compact between researcher, clinician and patient. With this compact, best evidence may become an integral part of private practice when uncertainties arise in patient health status, treatments, and therapies. The mechanism is composed of an organization, central database, and decision algorithm. Communication between the translational evidence organization, clinicians and patients is through the electronic chart. Through the chart, clinical inquiries are made, patient data from provider assessments and practice cost schedules are collected and encrypted (HIPAA standards), then inputted into the central database. Outputs are made within a timeframe suitable to private practice and patient flow. The output consists of a clinical practice guideline that responds to the clinical inquiry with decision, utility and cost data (based on the “average patient”) for shared decision-making within informed consent. This shared decision-making allows for patients to “game” treatment scenarios using personal choice inputs. Accompanying the clinical practice guideline is a decision analysis that explains the optimized clinical decision. The resultant clinical decision is returned to the central database using the clinical practice guideline. The result is subsequently used to update current best evidence, indicate the need for new evidence, and analyze the changes made in best evidence implementation. When updates in knowledge occur, these are transmitted to the provider as alerts or flags through patient charts and other communication modalities.

A study of procedures for burnishing amalgam restorations.

0 f the studies and clinical notations reported, numerous burnishing techniques have been suggested; there is no standardized procedure. Since the 196Os, these techniques have consisted of a one-, two-, or three-step procedure. The time suggested to begin the one-step procedure has ranged from just after overfill, or after completion of the condensation procedure, to 12 minutes after carving.‘-I3 The average time to begin burnishing is just after the carving procedure when the amalgam is hard enough to resist deformation. For the two-step method, burnishing is done at 7 minutes and again at 12 minutes after trituration.14 The three-step procedure is done after overfill, after carving, and again after recarving.15 Other aspects of the procedure have also varied. The burnishing force has ranged from light pressure to 2 kg, the average a light pressure. The duration has ranged from the attainment of a dull luster (satin, velvety shine) to a shiny, highly reflective surface. The purpose of this study was to investigate the various procedures of burnishing. A technique comprised of these procedures would provide for more consistency in testing the efficacy of burnishing.

Can a Licorice Lollipop Decrease Cariogenic Bacteria in Nursing Home Residents

The purpose of this pilot study was to examine whether an herbal lollipop containing licorice root decreases Streptococcus mutans (S. mutans) bacteria that cause dental caries in nursing home residents. A total of 8 residents (5 women, 3 men; mean age = 85) consented to participate in this study. Participants were offered two lollipops per day for 21 days. Saliva samples were collected at baseline and Days 1, 3, 7, 14, and 21, then analyzed for numbers of S. mutans. Using linear mixed-models analysis with difference in numbers of S. mutans from baseline to any time point as the dependent variable, and number of lollipops consumed with effect of time controlled as the predictor variable, participants who consumed more lollipops during the 21-day time period were more likely to have fewer numbers of S. mutans (β = -8.703, p = 0.067). There was a trend toward reduction of S. mutans with consumption of more lollipops during the 21-day period. Recruiting a larger sample for future research may demonstrate a significant reduction.

Simplified class V matrix for resin restorations

A matrix technique and its modifications to assist in the restoration of Class V lesions occurring in the gingival third of the teeth are described. This technique is applicable for filled and unfilled restorative resins.