Dent. J., Volume 4, Issue 3 (September 2016) – 10 articles

The aim of this study was to qualitatively evaluate the marginal vertical fit along two different implant-abutment interfaces: (1) a standard abutment on an implant and (2) a computer-aided-design/computer-aided-machine (CAD/CAM) customized screw-retained crown on an implant. Four groups were compared: three customized screw-retained crowns with three different “tolerance” values (CAD-CAM 0, CAD-CAM +1, CAD-CAM −1) and a standard titanium abutment. Qualitative analysis was carried out using an optical microscope. Results showed a vertical gap significantly different from both CAD-CAM 0 and CAD-CAM −1, while no difference was found between standard abutment and CAD-CAM +1. The set tolerance in producing CAD/CAM screw-retained crowns plays a key role in the final fit. Full article

Negative pressure wound therapy has greatly advanced the field of wound healing for nearly two decades, by providing a robust surgical adjunct technique for accelerating wound closure in acute and chronic wounds. However, the application of negative pressure wound therapy in maxillofacial applications has been relatively under utilized as a result of the physical articulations and contours of the head and neck that make it challenging to obtain an airtight seal for different negative pressure wound therapy systems. Adapting negative pressure wound therapies for maxillofacial applications could yield significant enhancement of wound closure in maxillofacial applications. The current review summarizes the basic science underlying negative pressure wound therapy, as well as specific maxillofacial procedures that could benefit from negative pressure wound therapy. Full article

Background: Bisphosphonate-associated osteonecrosis of the jaws (MRONJ/BP-ONJ/BRONJ) is a commonly seen disease. During recent decades, major advances in diagnostics have occurred. Once the clinical picture shows typical MRONJ features, imaging is necessary to determine the size of the lesion. Exposed bone is not always painful, therefore a thorough clinical examination and radiological imaging are essential when MRONJ is suspected. Methods: In this paper we will present the latest clinical update on the imaging options in regard to MRONJ: X-ray/Panoramic Radiograph, Cone Beam Computed Tomography (CBCT) and Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Nuclear Imaging, Fluorescence-Guided Bone Resection. Conclusion: Which image modality is chosen depends not only on the surgeon’s/practitioner’s preference but also on the available imaging modalities. A three-dimensional imaging modality is desirable, and in severe cases necessary, for extended resections and planning of reconstruction. Full article

Nine out of ten metastatic prostate cancer (PCa) patients will develop osseous metastases. Of these, every second will suffer from skeletal-related events (SRE). SRE are associated with an increased risk for death, which is markedly increased in the presence of pathological fracture. Moreover, health insurance costs nearly double in the presence of SRE. Zoledronic acid and denosumab are both approved drugs for the prevention or delay of SRE in castration-resistant prostate cancer (CRPC) patients with osseous metastases. However, long-term treatment with one of these two drugs is associated with the development of medication-related osteonecrosis of the jaw (MRONJ). Routine inspections of the oral cavity before and during treatment are mandatory in these patients. Regarding imaging techniques, bone scintigraphy seems to be a promising tool to detect early stage MRONJ. Zoledronic acid does not reduce the incidence of SRE in hormone-sensitive PCa. First data shows 3-monthly application of zoledronic acid to be equi-effective to monthly application. Full article

The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA) or office-based general anesthesia (OBGA) in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029). Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office. Full article

The aim of this study was to explore the attitudes towards postgraduate specialisation of final-year students at one UK dental school and to identify any possible influencing factors. A cross-sectional survey of all 73 final-year students using an anonymous self-report questionnaire was carried out. The response rate was 79%, of which nearly two-thirds were female. Age, ethnicity and parental occupation did not have an effect on the intention to specialise, although student gender did, with more females not wishing to specialise (p = 0.006). Having a ‘talent in the field’ had the largest positive influence on pursuing a specialist career (37.9% of responses), whilst the length of time needed to obtain a specialist qualification was seen as the largest negative influence (41.1% of responses). The two most popular subjects were Restorative Dentistry and Orthodontics with 24.1% and 20.7% of students listing them as their first choices, respectively. Further research could be carried out to determine if the intentions of UK undergraduates to specialise will meet the increasing specialist oral health needs of the population and which could ultimately influence future dental workforce planning. Full article

To develop an in vitro model to mimic the effects of meals equivalent to a day’s diet on tooth tissue loss (TTL). To identify how diet effects tooth wear and to test the efficacy of dental products designed to reduce tooth wear in a more realistic environment. A typical Friday diet was devised comprising: Breakfast then brushing, lunch, dinner then brushing. Groups of enamel samples were exposed to one meal, or all three in series, a control group was exposed to water and brushed. The daily cycle was repeated to represent two days’ consumption; TTL was quantified by non-contact profilometry. This pilot study highlighted adaptions that could be made to the model such as human enamel and saliva to further replicate natural eating habits. The sum of the TTL measured after Breakfast, lunch and dinner (bovine enamel specimens exposed to single meals) was less than that exhibited by the group of samples exposed to the series of meals but this difference was not significant (p = 0.09).In the absence and presence of brushing, TTL caused by breakfast and dinner was similar, but significantly greater than that caused by lunch (p < 0.05). While brushing increased TTL, this increase was not significant. It is possible to model a daily diet in vitro, and the data obtained confirms that the combination of food and drink affects the degree of TTL. This supports the further development of an in vitro model that includes alternative foodstuffs. This would aid understanding of the effects different diets have on TTL and could test new products designed to prevent TTL. Full article

Accidental ingestion or inhalation of foreign bodies has been widely documented, including incidents which occur whilst undertaking dental treatment. Most ingested objects pass through the gastrointestinal tract (GIT) spontaneously, but approximately 10%–20% need to be removed endoscopically and 1% require surgery. This case reports a complication arising from the accidental loss of an archwire fragment during maxillary archwire placement. It describes the immediate and subsequent management, including the use of radiographs to track the passage of the fragment through the gastro-intestinal tract. This case stresses the vigilance that dentists must take to prevent inhalation or ingestion of foreign bodies and the consequences of time-delays when management decisions are needed. Full article

This case report describes a 33-year-old female currently undergoing breast cancer treatment following the AC-T-T (doxorubicin hydrochloride (Adriamycin) and cyclophosphamide followed by paclitaxel (Taxol) and trastuzumab (Herceptin)) treatment regimen. Her chief complaint at the time of the emergency visit at the dental office was that she had an episode of profuse spontaneous bleeding located at the palatal gingiva in the maxilla between the left central and lateral incisor. To our knowledge, this is a novel finding related to the medications she is utilizing and should be further investigated. Full article