Reisha Rafeek

The prevalence and severity of non-carious cervical lesions in a group of patients attending a university hospital in Trinidad

Non-carious cervical lesions (NCCLs) are often encountered in clinical practice and their aetiology attributed to toothbrush abrasion, erosion and tooth flexure. This paper aims to determine the prevalence and severity of NCCLs in a sample of patients attending a university clinic in Trinidad and to investigate the relationship with medical and dental histories, oral hygiene practices, dietary habits and occlusion. Data were collected via a questionnaire and clinical examination. Odds ratios were used to determine the association of the presence of lesions and the factors examined. One hundred and fifty-six patients with a mean age of 40.6 years were examined of whom 62.2% had one or more NCCLs. Forty five per cent of the lesions were sensitive to compressed air. Younger age groups had a significantly lower correlation with the presence of NCCLs than older age groups. Other significant factors included patients who reported heartburn, gastric reflux, headaches, bruxism, sensitive teeth and swimming or had a history of broken restorations in the last year. There was also significant correlation of NCCLs in patients who brushed more than once a day or used a medium or hard toothbrush. Patients with vegetarian diets and those who reported consuming citrus fruits, soft drinks, alcohol, yoghurt and vitamin C drinks were associated with the presence of lesions. Significant associations were also found in patients with group function, faceting, clicking joints or those who wore occlusal splints.

Taper of Full-Veneer Crown Preparations by Dental Students at the University of the West Indies

PURPOSE The ideal taper recommended for a full-veneer crown is 4° to 14°, but this is very difficult to achieve clinically, and studies on taper achieved by dental students have found mean taper measurements ranging from 11° to 27°. The objective of this study was to examine and compare the taper of teeth prepared for full-veneer crowns by dental students on typodonts in the laboratory and on patients, and also to compare the results with those of other dental schools. MATERIALS AND METHODS Preparations were scanned by specialized metrology equipment that gave the taper of the preparation in a buccolingual (BL) and mesiodistal (MD) plane. RESULTS No undercut was detected on any of the laboratory specimens; however, 12.5% of clinical specimens were undercut. The mean taper of the laboratory anterior specimens were 26.7° BL and 14.9° MD, and the laboratory posterior specimens were 18.2° BL and 14.2° MD. The mean taper of the clinical anteriors were 31.6° BL and 16.8° MD, and the clinical posteriors were 16.8° BL and 22.4° MD. CONCLUSIONS This study shows that although the taper achieved by dental students in the University of the West Indies when preparing teeth for full-veneer crowns was outside the ideal range of 4° to 14°, it is comparable to those achieved by dental students in other schools.

Radiographic evaluation of the technical quality of root canal fillings performed by dental students

The objective of this study was to evaluate radiographically the technical quality of root canal fillings performed by dental students at the School of Dentistry, University of the West Indies. The schools database between 2000 and 2004 was investigated for patients with completed root canal treatment. The final sample consisted of 198 patients with 288 root-filled teeth and 460 canals. The length, presence of voids, taper, curvature of canal and fractured instruments were recorded and scored. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings and tooth type. Sixty-three per cent, 27.6% and 72.2% of root-filled canals had adequate length, density and taper respectively. The overall acceptability of root fillings having adequate length and taper, absence of voids and no fractured instruments was found in 10.9% of canals. Changes in teaching methods may be required to improve the technical quality of root canal treatment done by dental students.

Cusp Fracture Resistance of Maxillary Premolars Restored with the Bonded Amalgam Technique Using Various Luting Agents

Objective. This in vitro study uses measurements of fracture resistance to compare maxillary premolars restored with the bonded amalgam technique using a new resin luting cement, glass ionomer, and resin-modified glass ionomer as the bonding agents. Materials. Eighty-five sound maxillary premolars were selected and randomly assigned to one of five test groups of 17 teeth each. One group of intact teeth served as the control. The remaining groups were prepared to a standard cavity form relative to the dimensions of the overall tooth and restored with amalgam alone or a bonded amalgam using one of three luting agents: RelyX Arc (a new resin luting cement), RelyX luting (a resin-modified glass ionomer), or Ketac-Cem μ (a glass ionomer) as the bonding agents. Each tooth was then subjected to compressive testing until catastrophic failure occurred. The mean loads at failure of each group were statistically compared using ANOVA with a post hoc Bonferroni test. Results. It was found that regardless of the luting cement used for the amalgam bonding technique, there was little effect on the fracture resistance of teeth. Conclusion. Cusp fracture resistance of premolars prepared with conservative MOD cavity preparations is not improved by using an amalgam-bonding technique compared to similar cavities restored with amalgam alone.

Exploring the versatility of gingiva-colored composite

Gingival recession has a diverse etiology. The consequences may include gingivitis, periodontitis, and hypersensitivity. Whereas the management can include surgical treatment options, sometimes a more conservative, yet still esthetic approach may be required. The use of gingiva-colored composites provides one such alternative and can be applied to varying presentations of the problem. While surgical treatment can be successful in re-creating favorable esthetic anatomy as well as achieving accurate tissue contour in cases when minor amounts of tissue are reconstructed, long-term results vary because of the vascularity and complexity of the interdental space. Factors such as cost, healing time, discomfort, and variable long-term results make surgery an unpopular choice. If tooth-colored restorative materials are utilized to restore cervical tooth exposure as a result of severe recession, the disproportionate appearance of the visible crown may give a dissatisfying result. Gingiva-colored composite provides dental practitioners with a versatile material that can be used to directly restore cervical defects caused by gingival recession, thus correcting the appearance of the gingival anatomy. It offers a treatment option that may increase patient satisfaction through the provision of a cost-effective, minimally invasive solution with highly esthetic results.

Dimensional Measurement for Dentistry

Dentistry requires development in hand skills throughout the undergraduate and postgraduate programs both in the pre-clinical and clinical settings (Allred, 1977). The level of expertise achieved depends on the level of training, the natural ability of the dentist and also experience. Tooth preparation for a crown is a common procedure in general dental practice and it is essential that dental students are able to perform this procedure competently before they graduate. The skill training of these techniques is in itself subjective, as there is use of “eyeballing” of the preparation rather than a definite measure. There is clearly a need to obtain more formal dimensional assessment of crown preparations. This will assist in the feedback to and the training of dentists and also in the practise of dentistry.

Xylitol and sorbitol effects on the microbiome of saliva and plaque

ABSTRACT Chewing gum containing xylitol may help prevent caries by reducing levels of mutans streptococci (MS) and lactobacilli in saliva and plaque. Very little is known about other species which are possibly beneficial to oral health. In this study, we employed high-throughput sequencing of the 16S rRNA gene to profile microbial communities of saliva and plaque following short-term consumption of xylitol and sorbitol containing chewing gum. Participants (n = 30) underwent a washout period and were randomly assigned to one of two groups. Each group chewed either xylitol or sorbitol gum for three weeks, before undergoing a second four-week washout period after which they switched to the alternate gum for three weeks. Analysis of samples collected before and after each intervention identified distinct plaque and saliva microbial communities that altered dependent on the order in which gum treatments were given. Neither the xylitol nor sorbitol treatments significantly affected the bacterial composition of plaque. Lactobacilli were undetected and the number of Streptococcus mutans sequence reads was very low and unaffected by either xylitol or sorbitol. However, sorbitol affected several other streptococcal species in saliva including increasing the abundance of S. cristatus, an oral commensal shown to inhibit bacteria associated with chronic periodontitis. Trial registration: ClinicalTrials.gov identifier: NCT03668015.

Colored Gingiva Composite Used for the Rehabilitation of Gingiva Recessions and Non-Carious Cervical Lesions

In this case of extensive gingival recession (Miller’s Class II) and mild physiologic pigmentation, an alternative method for the placement of Amaris Gingiva-Colored Composite was used to produce a non-invasive, aesthetic result acceptable to the patient. In restoring the defects in the entire maxilla of this patient, the opaquers were not mixed, but applied individually, directly to various areas of the teeth. Multiple opaquers were placed in a pattern mimicking the coloring of the patient’s gingiva. These were then covered with the base shade for a more aesthetic result to the patient’s satisfaction. The restorations resulting from the alternative method were highly aesthetic and at an eleven (11) month review showed no signs of failure giving rise to the conclusion that this method proposed for application of Amaris Gingiva-Colored Composite is viable for producing highly-aesthetic restorations in cases of gingival recession.