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Sample records for proximal carious lesions

  1. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique

    NARCIS (Netherlands)

    Kemoli, A.M.; van Amerongen, W.E.

    2011-01-01

    OBJECTIVE: To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. BASIC RESEARCH DESIGN: Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from

  2. The dilemma of selecting suitable proximal carious lesions in primary molars for restoration using ART technique.

    Science.gov (United States)

    Kemoli, A M; van Amerongen, W E

    2011-03-01

    To determine the examiner's accuracy in selecting proximal carious lesions in primary molars for restoration using the atraumatic restorative treatment (ART) approach. Intervention study. CLINICAL SETTING AND PARTICIPANTS: A total of 804 six to eight year-olds from 30 rural schools in Kenya participated in the study. Three examiners selected a total of 1,280 suitable proximal carious lesions in primary molars after examining 6,002 children from 30 schools randomly selected out of 142 schools in two divisions. Seven operators randomly paired on a daily basis with eight assistants restored the lesions. An explanation was provided for any cavity that was not restored. Pre-and post-operative radiographs of the cavities were also taken for evaluation. The examiner's choice of suitable proximal cavities restorable using the ART approach was related to the decision made to either restore or not during the operative stage. The radiographic findings of the selected cavities were also compared to the decision made by the operator. The results obtained were used to determine the examiner's accuracy in selecting suitable proximal cavities for restoration using the ART approach. The majority of the children recruited in the study were excluded due to absenteeism, pulpal-exposure or anxiety during the operative stage. Only 804 children received one restoration in their primary molars. The examiner's accuracy in selecting suitable ART-restorable cavities clinically was 94.9% and based on radiographic analysis was 91.7%. A trained and diligent examiner has a very good chance of selecting proximal carious lesions restorable with the use of ART approach, without the threat of dental pulpal-involvement during the excavation of caries.

  3. In Vitro Evaluation of Proximal Carious Lesions Using Digital Radiographic Systems

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    Mayana Soares Vieira

    2015-01-01

    Full Text Available The study aimed to compare the sensitivity and specificity of digital radiographic systems for the diagnosis of proximal carious lesions. Extracted human teeth (3 canines, 3 premolars, and 3 molars were submitted to one of three types of proximal lesions (demineralized area, cavity affecting the enamel alone, and cavity affecting enamel and dentin. Bitewing radiographs were obtained from each system (Sirona, Kodak, and Schick and evaluated by 12 raters (4 dental students, 4 radiology specialists, and 4 dentists. The chi-squared test was used to determine the frequency of correct diagnoses among the different systems, raters, teeth, and types of lesion. Sensitivity and specificity regarding demineralized areas were calculated for each system. The frequencies of correct diagnoses were found: Schick (70.8%, Kodak (63.9%, Sirona (59.0%, specialists (69.4%, students (62.5%, dentists (61.8%, premolars (70.1%, canines (65.3%, and molars (58.3%. No significant differences were found among the different systems, raters, or teeth (P>0.05. Sensitivity and specificity were 0.64 and 0.47 (Schick, 0.56 and 0.50 (Sirona, and 0.48 and 0.58 (Kodak. The most correct diagnoses were achieved using the Schick digital system on premolars and evaluated by specialists in radiology. The systems demonstrated low sensitivity and specificity for the diagnosis of demineralized areas.

  4. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Innes, N P T; Frencken, J E; Bjørndal, L

    2016-01-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current...... manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm...

  5. Radiographic detection of initial carious lesions on the proximal surfaces of teeth. Part I. The influence of exposure conditions

    Energy Technology Data Exchange (ETDEWEB)

    Arnold, L.V.

    1987-08-01

    The relationship between a number of technical exposure conditions and the diagnostic value of bitewing radiographs in the interpretation of initial proximal carious lesions was evaluated. The most important exposure factors for radiographs are tube voltage, filtration, and exposure time. Tube voltage and filtration were found to have an insignificant influence on the diagnostic quality. Exposure time proved to be the most critical factor in influencing diagnostic quality. The greatest difference in diagnostic quality, however, was caused by differences between observers.

  6. Managing Carious Lesions

    DEFF Research Database (Denmark)

    Schwendicke, F; Frencken, J E; Bjørndal, L

    2016-01-01

    or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth...

  7. Randomized Clinical Trials on Deep Carious Lesions

    DEFF Research Database (Denmark)

    Bjørndal, Lars; Fransson, Helena; Bruun, Gitte

    2017-01-01

    nonselective carious removal to hard dentin with or without pulp exposure. The aim of this article was to report the 5-y outcome on these previously treated patients having radiographically well-defined carious lesions extending into the pulpal quarter of the dentin but with a well-defined radiodense zone...... between the carious lesion and the pulp. In this long-term study, 239 of 314 (76.2%) patients were analyzed. The stepwise removal group had a significantly higher proportion of success (60.2%) at 5-y follow-up compared with the nonselective carious removal to hard dentin group (46.3%) (P = 0.031) when......) in deep carious lesions in adults. In conclusion, the stepwise carious removal group had a significantly higher proportion of pulps with sustained vitality without apical radiolucency versus nonselective carious removal of deep carious lesions in adult teeth at 5-y follow-up (ClinicalTrials.gov NCT...

  8. Distribution and Characteristics of Non Carious Cervical lesions in ...

    African Journals Online (AJOL)

    Background: Controversies rages in the literature as to the characteristics of non carious cervical lesions (NCCLs) in terms of the location and its severity. Objective: The study is to investigate the characteristics of NCCLs in adult patients who had a high incidence in them and to see if there are any association with the ...

  9. Tooth brushing frequency and risk of new carious lesions.

    Science.gov (United States)

    Holmes, Richard D

    2016-12-01

    Data sourcesMedline, Embase, CINHAL and the Cochrane databases.Study selectionTwo reviewers selected studies, and case-control, prospective cohort, retrospective cohort and experimental trials evaluating the effect of toothbrushing frequency on the incidence or increment of new carious lesions were considered.Data extraction and synthesisTwo reviewers undertook data abstraction independently using pre-piloted forms. Study quality was assessed using a quality assessment tool for quantitative studies developed by the Effective Public Health Practice Project (EPHPP). Meta-analysis of caries outcomes was carried out using RefMan and meta-regressions undertaken to assess the influence of sample size, follow-up period, caries diagnosis level and study methodological quality.ResultsThirty-three studies were included of which 13 were considered to be methodologically strong, 14 moderate and six weak. Twenty-five studies contributed to the quantitative analysis. Compared with frequent brushers, self-reported infrequent brushers demonstrated a higher incidence of carious lesions, OR=1.50 (95%CI: 1.34 -1.69). The odds of having carious lesions differed little when subgroup analysis was conducted to compare the incidence between ≥2 times/d vs Brushing brushing, standardised mean difference [SMD] =0.34; (95%CI; 0.18 - 0.49). Overall, infrequent brushing was associated with an increment of carious lesions, SMD= 0.28; (95%CI; 0.13 - 0.44). Meta-analysis conducted with the type of dentition as subgroups found the effect of infrequent brushing on incidence and increment of carious lesions was higher in deciduous, OR=1.75; (95%CI; 1.49 - 2.06) than permanent dentition OR=1.39; (95% CI: 1.29 -1.49). Meta-regression indicated that none of the included variables influenced the effect estimate.ConclusionsIndividuals who state that they brush their teeth infrequently are at greater risk for the incidence or increment of new carious lesions than those brushing more frequently. The

  10. Characteristics, Detection Methods and Treatment of Questionable Occlusal Carious Lesions

    DEFF Research Database (Denmark)

    Makhija, S.K.; Gilbert, G.H.; Funkhouser, E.

    2014-01-01

    . The objective of this report has been to quantify the characteristics of these common lesions, the diagnostic aids used and the treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the USA and Denmark in the National Dental Practice-Based Research Network participated. When......Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities or staining. An earlier analysis of data from this study indicates 1/3 of patients have a QOC...

  11. Radiographic display of carious lesions and cavitation in approximal surfaces

    DEFF Research Database (Denmark)

    Wenzel, Ann

    2014-01-01

    Abstract Background. Treatment strategies have changed with efforts on arresting carious lesions suspected to have an intact surface sparing operative treatment for cavitated lesions. Radiography is still the most recommended adjunct method in the diagnosis of clinically inaccessible approximal...... surfaces. Bitewing radiography. The major drawback of bitewing radiography for caries diagnosis is that the clinical state of the surface cannot be determined; i.e. if cavitation has developed or the demineralized surface is still intact. Based on studies of the relationship between radiographic lesion...... depth and clinical cavitation in approximal surfaces, a threshold for operative treatment decision has been suggested when a lesion is observed radiographically more than one-third into dentine. However, the results from previous studies are contradictory and the majority of studies are ∼25 years old...

  12. Odontoblast layer structure alteration as a response to carious lesions

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    Tetiana Haniastuti

    2011-09-01

    Full Text Available Background: Dental caries is a bacterial disease affecting the hard tissue of the teeth as well as the pulp. The human dental pulp consists of odontoblast which are organized as a densely packed cell layer. Odontoblasts is located at the periphery of the pulp; therefore, they are the first cells encountered by cariogenic bacteria and their products that are represented in the carious lesion. Purpose: This study aimed to elucidate the effect of cariogenic bacteria to odontoblasts of human teeth. Methods: Five intact third molars and 15 third molars with occlusal caries at various stages of decay were extracted because of orthodontic or therapeutic reasons. The tooth specimens were fixed, decalcified with 10% EDTA solution (pH 7.4, and embedded in paraffin. Serial sections of 5 μm thickness were cut and stained with haematoxylin eosin and Gram’s, in addition to nestin immunohistochemistry. The specimens were then examined under light microscopy. Results: In normal teeth, odontoblast layer were aligned along the pulp chamber showing normal morphology of the cells. Slight disorganization of odontoblast layer was seen in the cases of carious lesions confined to enamel. In the cases of carious lesions confined to dentin, odontoblast layer was not observed in the areas subjacent to the lesions, only single cells showing flattened cell morphology were found. Odontoblasts beneath the lesion suffered severe damage and diminished nestin immunoreaction were observed in all cases of carious lesions with pulp exposure. Conclusion: Cariogenic bacteria invasion may damage the odontoblasts by affecting the morphology and vitality of the cells. The severity of the damage of the odontoblasts may increase as the bacterial invasion progresses toward the pulp.Latar belakang: Karies merupakan penyakit yang disebabkan oleh bakteri, yang dapat memengaruhi jaringan keras gigi maupun pulpa. Pada pulpa gigi manusia terdapat sel odontoblas yang tersusun atas lapisan sel

  13. A randomized clinical trial on the sealing of occlusal carious lesions

    DEFF Research Database (Denmark)

    Alves, Luana Severo; Giongo, Fernanda Cristina Mendes de Santa; Mua, Bruna

    2017-01-01

    This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8-43 years (median: 19 years). The inclusion criteria comprised the presenc...

  14. AN IN-VITRO EVALUATION OF FLUORESCEIN PENETRATION INTO NATURAL ROOT SURFACE CARIOUS LESIONS

    NARCIS (Netherlands)

    VANDERVEEN, MH; TENBOSCH, JJ

    1993-01-01

    In order to develop a method for detection and quantification of initial root surface carious lesions, the use of fluorescein sodium as a fluorescent dye is evaluated. The penetration depth of fluorescein sodium into human roots containing natural carious lesions was measured on approximately

  15. Restorative Thresholds for Carious Lesions: Systematic Review and Meta-analysis.

    Science.gov (United States)

    Innes, N P T; Schwendicke, F

    2017-05-01

    Current evidence supports noninvasive/nonrestorative treatment of "early" carious lesions: those confined to enamel or reaching the enamel-dentin junction. The extent that dentists' thresholds for intervening restoratively have changed with this evidence is unknown. This systematic review aimed to determine dentists' and therapists' current lesion threshold for carrying our restorative interventions in adults/children and primary/permanent teeth. Embase, Medline via PubMed, and Web of Science were searched for observational studies, without language, time, or quality restrictions. Screening and data extraction were independent and in duplicate. Random-effects meta-analyses with subgroup and meta-regression analysis were performed. Thirty studies, mainly involving dentists, met the inclusion criteria. There was heterogeneity in sampling frames, methods, and scales used to investigate thresholds. The studies spanned 30 y (1983-2014), and sample representativeness and response bias issues were likely to have affected the results. Studies measured what dentists said they would do rather than actually did. Studies represented 17 countries, focusing mainly on adults ( n = 17) and permanent teeth ( n = 24). For proximal carious lesions confined to enamel (not reaching the enamel-dentin junction), 21% (95% confidence interval [CI], 15%-28%) of dentists/therapists would intervene invasively. The likelihood of a restorative intervention almost doubled (risk ratio, 1.98; 95% CI, 1.68-2.33) in high caries risk patients. For proximal lesions extending up to the enamel-dentin junction, 48% (95% CI, 40%-56%) of dentists/therapists would intervene restoratively. For occlusal lesions with enamel discoloration/cavitation but no clinical/radiographic dentin involvement, 12% (95% CI, 6%-22%) of dentists/therapists stated they would intervene, increasing to 74% (95% CI, 56%-86%) with dentin involvement. There was variance between countries but no significant temporal trend. A

  16. The presence of non-carious lesions in children

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    Demko-Rihter Ivana

    2015-01-01

    Full Text Available Introduction. A non-carious lesion (NCL is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment. Objective. The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH, as well as their possible risk factors in children, in the population of the city of Novi Sad. Methods. A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing. Results. The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (χ2=3.86, df=1, p=0.04. The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65% and canine permanent teeth (51%. BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36% did not respond to air stimulus, while most patients with permanent teeth (74.29% did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs. Conclusion. Research

  17. Non-cavitated carious lesions detection methods: a systematic review.

    Science.gov (United States)

    Gomez, Juliana; Tellez, M; Pretty, I A; Ellwood, R P; Ismail, A I

    2013-02-01

    The aim of this study was to critically appraise the performance of detection methods for non-cavitated carious lesions (NCCLs). A detailed search of Medline (via OVID), the Cochrane Collaboration, Scielo and EMBASE identified 2054 publications. After title and abstract review by three investigators (JG, MT, AI), 124 publications were selected for further review. The final publications evaluated the following methods: Visual (V), Caries Lesion Activity Assessment (CLAA), Laser Fluorescence (LF), Radiographic (R), Fibre-optic Transillumination (FOTI), Electrical Conductance (EC) and Quantitative Light-induced Fluorescence (QLF). All included studies used histological assessment as a gold standard for in vitro studies or clinical/visual validation for the in vivo designs. They reported outcomes measures such as sensitivity (SE), specificity (SP), area under the receiver operating characteristic curve (AUROC) and reliability. Data were extracted from the selected studies independently by two reviewers and checked for errors. The quality of the studies was evaluated as described by Bader et al. (2002). Of the 124 articles, 42 were included that described 85 clinical assessments. Overall, the quality of evidence on detection methods was rated ‘poor’, except for EC that was rated ‘fair’. The SE rates were as follows: V (0.17–0.96), LF or DIAGNOdent (DD) (0.16–0.96), R (0.12–0.84), FOTI (0.21–0.96), EC (0.61–0.92) and QLF (0.82). The SP rates were as follows: V (0.46–1.0), LF (0.25–1.00), R (0.55–0.99), FOTI (0.74-0.88), EC (0.73–1.0) and QLF (0.92). There is a large variation in SE and SP values for methods and a lack of consistency in definition of disease and analytical methods. EC and QLF seem to be promising for detection of early lesions. For both cost and practicality considerations, visual methods should remain the standard for clinical assessment in dental practice.

  18. Non-surgical management methods of noncavitated carious lesions.

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    Tellez, Marisol; Gomez, Juliana; Kaur, Sundeep; Pretty, Iain A; Ellwood, Roger; Ismail, Amid I

    2013-02-01

    To critically appraise all evidence related to the efficacy of nonsurgical caries preventive methods to arrest or reverse the progression of noncavitated carious lesions (NCCls). A detailed search of Medline (via OVID), Cochrane Collaboration, Scielo, and EMBASE identified 625 publications. After title and abstract review, 103 publications were selected for further review, and 29 were finally included. The final publications evaluated the following therapies: fluorides (F) in varying vehicles (toothpaste, gel, varnish, mouthrinse, and combination), chlorhexidine (CHX) alone or in combination with F, resin infiltration (I), sealants (S), xylitol (X) in varying vehicles (lozenges, gum, or in combination with F and/or xylitol), casein phosphopeptide amorphous calcium phosphate (CPP-ACP) or in combination with calcium fluoride phosphate. All included studies were randomized clinical trials, were conducted with human subjects and natural NCCls, and reported findings that can yield outcomes measures such as caries incidence/increments, percentage of progression and/or arrest, odds ratio progression test to control, fluorescence loss/mean values, changes in lesion area/volume and lesion depth. Data were extracted from the selected studies and checked for errors. The quality of the studies was evaluated by three different methods (ADA, Cochrane, author's consensus). Sample size for these trials ranged between 15 and 3903 subjects, with a duration between 2 weeks and 4.02 years. More than half of the trials assessed had moderate to high risk of bias or may be categorized as 'poor'. The great majority (65.5%) did not use intention to treat analysis, 21% did not use any blinding techniques, and 41% reported concealment allocation procedures. Slightly more than half of the trials (55%) factored in background exposure to other fluoride sources, and only 41% properly adjusted for potential confounders. Fluoride interventions (varnishes, gels, and toothpaste) seem to have the

  19. Relationship between the color of carious dentin with varying lesion activity, and bacterial detection.

    Science.gov (United States)

    Iwami, Yukiteru; Hayashi, Norifumi; Takeshige, Fumio; Ebisu, Shigeyuki

    2008-02-01

    To investigate the relationship between the color of carious dentin with varying lesion activity, and bacterial detection in the lesions. In 26 extracted human molars with coronal dentin caries and four extracted sound human molars, dentin was removed by a round bur every 150 microm from the dentin surface, in the direction of the pulp chamber. Before and after removal, images of nine-color samples and the dentin surface stained with a caries detector dye (1% acid red in propylene glycol) were taken simultaneously by a charge-coupled device (CCD), and dentinal tissue samples were taken with a new round bur. From the images, corrected L*, a* and b* values (CIE 1976 L*a*b* color system) of the dentin surfaces were calculated from the color changes of the nine-color samples. Bacterial DNA in the dentinal tissues was detected by polymerase chain reaction. Before removal of dentin, the L* of sound molars (L*>50) was significantly larger than that of carious molars (L*type I (a*>20, characteristics of active caries) and type II (a*types, the area under the receiver operating characteristic curve of L* was significantly larger than that of a* or b* (univariate Z score test, Pdentinal tissue increased, and bacterial DNA was not detected when L* was >60. Sound and types I and II carious dentin were discriminated by the combination of L* and a* values of dentinal tissue stained with the caries detector dye before removal of dentin. In carious lesions, the a* values of carious dentin stained with the dye were related to the carious lesion activity before removal of carious tissue, and the L* values were related to the degree of caries progression.

  20. Glass ionomer cements and their role in the restoration of non-carious cervical lesions

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    Luciana Fávaro Francisconi

    2009-10-01

    Full Text Available Glass ionomer based materials are clinically popular in several areas of restorative dentistry, but restoration of cervical lesions has proven particularly successful. Various etiologies, conformations, locations and structural characteristics make non-carious cervical lesions more challenging to adhesive restorative procedures and marginal seal in the long run. Due to their characteristics, glass ionomer cements (GICs have precise indication for these cases. Moreover, the use of a GIC base underneath composite resin, the so-called "sandwich" or mixed technique, allows associating the good characteristics of composite resins and GICs, and has been considered quite useful in the restoration of non-carious cervical defects. The aim of this paper is to critically review the literature and discuss peculiar features of GICs regarding their role in the restoration of non-carious cervical lesions.

  1. Stepwise Excavation Allows Apexogenesis in Permanent Molars with Deep Carious Lesions and Incomplete Root Formation.

    Science.gov (United States)

    Hernandéz-Gatón, Patrícia; Serrano, César Ruiz; Nelson Filho, Paulo; De Castañeda, Esther Ruiz; Lucisano, Marília P; Silva, Raquel A B da; Silva, Léa A B da

    2015-01-01

    This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis. © 2015 S. Karger AG, Basel.

  2. 5-year clinical performance of resin composite versus resin modified glass ionomer restorative system in non-carious cervical lesions

    DEFF Research Database (Denmark)

    Franco, Eduardo Batista; Benetti, Ana Raquel; Ishikiriama, Sérgio Kiyoshi

    2006-01-01

    To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions.......To comparatively assess the 5-year clinical performance of a 1-bottle adhesive and resin composite system with a resin-modified glass ionomer restorative in non-carious cervical lesions....

  3. A randomized clinical trial on the sealing of occlusal carious lesions: 3–4-year results

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    Luana Severo ALVES

    2017-06-01

    Full Text Available Abstract This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8–43 years (median: 19 years. The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28 or restorative treatment (n = 26. Clinical and radiographic examinations were performed after 1 year and after 3–4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair. The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05. The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3–4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

  4. NON - OPERATIVE TREATMENT OF NON - CAVITATED APPROXIMAL CARIOUS LESIONS OF PERMANENT CHIDREN’S TEETH.

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    Rossiza I. Kabakchieva

    2014-10-01

    Full Text Available Aim: To apply and follow up in clinical conditions the success rate of microinvasive technique of infiltration with low viscosity resin ICON® (DMG of non cavitated approximal caries lesions of permanent children's teeth for a period of one year. Material and methods: The study included 18 children aged 7-16 years. They were divided into two groups - children with medium and high caries risk. The survey include 20 teeth with approximal non-cavitated enamel lesions up to the outer third of dentin (E1, E2, D1 – according to the manufacturer’s instructions of ICON®. The size of the lesions was determined using bitewing radiographs and the activity - by Papilla Bleeding Index. The clinical application of the infiltr+ant (ICON® Caries Infiltrant Proximal, DMG was conducted according to the manufacturer's instructions. Bitewing radiographs were made at 6 and 12 months after infiltration in order to evaluate the success of the method. A test of the difference between two relative proportions and alternative test for analysis of the results were used. Results: Our study confirm the hypothesis that this method of infiltration is equally successful for permanent teeth in patients with moderate caries risk as well as those at high caries risk. Conclusion: This study is the first survey regarding the success of the application of ICON® for treatment of non-cavitated approximal carious lesions in permanent dentition of children in the country. Research in this direction should continue in order to increase the conviction that caries can be controlled and arrested in its earliest stages.

  5. The effect of fluoride gel on incipient carious lesions in a low-caries child population.

    NARCIS (Netherlands)

    Truin, G.J.; Hof, M.A. van 't

    2007-01-01

    OBJECTIVES: Secondary analyses were performed to study the cariostatic efficacy of semi-annual professional fluoride gel application on incipient carious lesions in low-caries children initially aged 9.5-11.5 years. METHODS: Double-blind randomized controlled clinical trial. RESULTS: The mean

  6. Periodontal and Restorative Treatment of Gingival Recession Associated with Non-Carious Cervical Lesions: Case Study.

    Science.gov (United States)

    Pereira, Analice Giovani; Teixeira, Daniela Navarro Ribeiro; Soares, Michelle Pereira Costa Mundim; Gonzaga, Ramon Corrêa de Queiroz; Fernandes-Neto, Alfredo Júlio; Soares, Paulo Vinícius

    2016-01-14

    The association between the presence of gingival recession and non-carious cervical lesions is a common finding in dentistry. These diseases have multifactorial etiology and the treatment should be multidisciplinary. Although traditionally the majority of professionals treat non-carious cervical lesions only with conventional restorative procedures, in most cases a combination of periodontal and restorative treatments provides the best functional and esthetic results. Thus, the objective of this case report was to present a new option for treatment, which consists of a subepithelial connective tissue graft associated with a coronally advanced flap placed on dentin and non-carious cervical lesions restored with lithium disilicate partial veneers. A patient complaining about the esthetic aspects of her teeth and cervical dentin hypersensitivity was submitted to occlusal adjustments and daily diet analysis in order to manage etiologic factors. Experienced operators then performed restorative and surgical treatments. Periodontal clinical attachment level (probing depth + gingival margin), bleeding on probing, plaque index, and the integrity of the restorations were observed. During the monitoring period, the treatment was effective, with good functional and esthetic results. The hypersensitivity disappeared, and neither inflammatory characteristics in gingival tissue nor failures in restorations were noted. It might be concluded that treatment with a combination of techniques can be effective and predictable for patients with gingival recession and non-carious cervical lesions that may or may not require restorative procedures under controlled conditions. Copyright© by the International Academy of Periodontology.

  7. High-resolution 3D magnetic resonance imaging and quantification of carious lesions and dental pulp in vivo.

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    Tymofiyeva, Olga; Boldt, Julian; Rottner, Kurt; Schmid, Florian; Richter, Ernst-Juergen; Jakob, Peter M

    2009-12-01

    The purpose of the study was to assess the feasibility of MRI of three-dimensional visualization and quantification of carious lesions, as well as measurement of the distance between the lesion and dental pulp in vivo. High-resolution 3D MRI was performed to measure seven carious lesions in vivo using gelatinous gadolinium-based oral contrast medium in combination with an intraoral radio frequency receiver coil on a clinical 1.5 T MRI scanner. Extension of the carious lesion in three spatial dimensions and the minimum distance between the lesion and dental pulp were quantified. When possible, the result was compared to an X-ray projection and an impression of the lesion taken using a plastic impression material before and after dental treatment. Carious lesions, including pit and fissure, approximal lesions, and occult dentin caries, could be visualized due to the MRI signal rise in the porous affected dentin. The minimum distance between the carious lesion and dental pulp could be determined in all cases. The results presented demonstrate the feasibility of high-resolution dental MRI to three-dimensionally visualize and quantify carious lesions, including approximal and occult caries lesions, and measure the minimum distance to the dental pulp.

  8. Identification of the microbiota in carious dentin lesions using 16S rRNA gene sequencing.

    Directory of Open Access Journals (Sweden)

    Junko Obata

    Full Text Available While mutans streptococci have long been assumed to be the specific pathogen responsible for human dental caries, the concept of a complex dental caries-associated microbiota has received significant attention in recent years. Molecular analyses revealed the complexity of the microbiota with the predominance of Lactobacillus and Prevotella in carious dentine lesions. However, characterization of the dentin caries-associated microbiota has not been extensively explored in different ethnicities and races. In the present study, the bacterial communities in the carious dentin of Japanese subjects were analyzed comprehensively with molecular approaches using the16S rRNA gene. Carious dentin lesion samples were collected from 32 subjects aged 4-76 years, and the 16S rRNA genes, amplified from the extracted DNA with universal primers, were sequenced with a pyrosequencer. The bacterial composition was classified into clusters I, II, and III according to the relative abundance (high, middle, low of Lactobacillus. The bacterial composition in cluster II was composed of relatively high proportions of Olsenella and Propionibacterium or subdominated by heterogeneous genera. The bacterial communities in cluster III were characterized by the predominance of Atopobium, Prevotella, or Propionibacterium with Streptococcus or Actinomyces. Some samples in clusters II and III, mainly related to Atopobium and Propionibacterium, were novel combinations of microbiota in carious dentin lesions and may be characteristic of the Japanese population. Clone library analysis revealed that Atopobium sp. HOT-416 and P. acidifaciens were specific species associated with dentinal caries among these genera in a Japanese population. We summarized the bacterial composition of dentinal carious lesions in a Japanese population using next-generation sequencing and found typical Japanese types with Atopobium or Propionibacterium predominating.

  9. Carious lesions of permanent molars and oral health practices of parents and peers in Saudi male adolescents.

    Science.gov (United States)

    Bakhurji, Eman; El Tantawi, Maha M; Gaffar, Balgis O; Al-Khalifa, Khalifa S; Al-Ansari, Asim A

    2017-07-01

    To assess the association between carious lesions in first and second permanent molars in adolescents and their parents' and peers' oral health practices. Methods: This cross-sectional study of 12-15 year-old male adolescents was conducted in  Dammam, Kingdom of Saudi Arabia, on February 2016. Data collection included dental examination to measure carious lesions and plaque. There was a questionnaire to assess oral health practices such as brushing with fluoridated toothpaste, current daily tobacco use, and daily consumption of sugary food and drinks. Logistic regression models assessed the association between first and second molars carious lesions with adolescents', parents', and peers' oral health practices. Results: Of 302 students, 294 participated. The mother's brushing was significantly associated with a lower odds of carious lesions in the first molar (odds ratio [OR] = 0.17, 95% confidence interval [CI]: 0.04 - 0.77). The mothers' sugary food intake and students' own brushing were significantly associated with carious lesions in the second molar (OR = 1.95 and 0.36, 95% CI: 1.01-9.89 and 0.12-0.89). Friends' intake of sugary drinks had a strong, but non-significant, association with second molar's carious lesions (OR=3.61, 95% CI: 0.35 - 7.44). Conclusion: In Saudi society, mothers have a major influence on their adolescent sons' carious lesions. Adolescents' oral health strategies should involve parents to reduce their risk of caries.

  10. Are Carious Lesions in Previously Sealed Occlusal Surfaces Detected as well on Colour Photographs as by Visual Clinical Examination?

    Science.gov (United States)

    Hu, Xuan; Fan, Mingwen; Mulder, Jan; Frencken, Jo E

    2016-01-01

    To compare the level of agreement between carious lesion assessments according to the visual clinical examination and the colour photograph methods. Data on the presence of enamel/dentin carious lesions in previously sealed occlusal surfaces in first molars were obtained by two trained and calibrated examiners through visual clinical examination and from colour photographs 4 years after sealing. Kappa statistics were applied to calculate agreement between assessment methods. Data analysis was performed using sign, Bowker symmetry and McNemar's tests. The prevalence of dentin carious lesions was very low. The kappa coefficients for detecting enamel/dentin carious lesions using the two assessment methods were 0.65 (CI: 0.56-0.74) for examiner 1 and 0.70 (CI: 0.62-0.78) for examiner 2. Examiner 2 observed more enamel/dentin carious lesions on colour photographs than did examiner 1 (p = 0.008). Sensitivity analyses did not confirm this outcome. There was no difference in the detection of enamel/dentin carious lesions in previously sealed occlusal surfaces using colour photographs vs visual clinical examination. The colour photograph method is therefore equivalent to the visual clinical examination in detecting enamel/dentin carious lesions. More studies are required.

  11. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    Science.gov (United States)

    Deana, A. M.; Jesus, S. H. C.; Koshoji, N. H.; Bussadori, S. K.; Oliveira, M. T.

    2013-07-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture.

  12. A randomized clinical trial on the sealing of occlusal carious lesions

    DEFF Research Database (Denmark)

    Alves, Luana Severo; Giongo, Fernanda Cristina Mendes de Santa; Mua, Bruna

    2017-01-01

    of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were......This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8-43 years (median: 19 years). The inclusion criteria comprised the presence...... performed after 1 year and after 3-4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1...

  13. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions

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    Kenneth Gilbert

    2014-10-01

    Full Text Available Background and objectives: Mutans streptococci (MS are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC, and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Design: Dental plaque from children (N=20; aged 3–6 with S-ECC was collected from carious lesions (CLs, white spot lesions (WSLs and non-carious enamel surfaces. Streptococcal isolates (N=10–20 from each site were subjected to polymerase chain reaction (PCR to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Results: Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1–6 strains. In many patients (N=11, single primary MS strains were identified throughout the dentition. In other patients (N=4, primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Conclusions: Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and

  14. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions.

    Science.gov (United States)

    Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A

    2014-01-01

    Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Dental plaque from children (N=20; aged 3-6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10-20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1-6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric potential of these strains may influence susceptibility in the

  15. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions

    Science.gov (United States)

    Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A.; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A.

    2014-01-01

    Background and objectives Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Design Dental plaque from children (N=20; aged 3–6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10–20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Results Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1–6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Conclusions Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric

  16. Are topical fluorides effective for treating incipient carious lesions?: A systematic review and meta-analysis.

    Science.gov (United States)

    Lenzi, Tathiane Larissa; Montagner, Anelise Fernandes; Soares, Fabio Zovico Maxnuck; de Oliveira Rocha, Rachel

    2016-02-01

    This systematic review and meta-analysis evaluated the effectiveness of professional topical fluoride application (gels or varnishes) on the reversal treatment of incipient enamel carious lesions in primary or permanent dentition. Literature searching was carried out by the authors in PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, Turning Research Into Practice, and ClinicalTrials.gov to verify the clinical trials available about the outcome. From 754 potentially eligible studies, 21 were selected for full-text analysis, 5 were included for review, and 3 for meta-analysis. The statistical analysis was performed only for studies assessing fluoride varnish; there were insufficient data to perform it for fluoride gel studies. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Pooled-effect estimates were expressed as the weighted mean difference between groups. The therapeutic methods ranged considerably regarding the fluoride application protocols. There was a significant trend of effectiveness of fluoride varnish on the reversal of incipient enamel carious lesions (P Fluoride varnish seems to be an effective treatment for the reversal of incipient carious lesions in primary and permanent dentition; however, further clinical trials concerning efficacy of topical fluorides for treating those lesions are still required, mainly regarding the fluoride gel. Considering the scientific evidence on topical fluorides, pediatric dentists can use fluoride varnishes as an adjuvant for the treatment of active white-spot lesions in primary or permanent dentition. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  17. Assessment of chemomechanical removal of carious lesions using Papacarie Duo ™: Randomized longitudinal clinical trial

    Directory of Open Access Journals (Sweden)

    Simone Ferreira Borges Matsumoto

    2013-01-01

    Full Text Available Background: Chemomechanical removal of carious lesions consists of the dissolution of carious tissue by the application of a natural or synthetic agent, followed by atraumatic mechanical removal. Aim: The aim of the present study was to assess the effectiveness of Papacarie Duo ® gel in the chemomechanical removal of carious lesions in primary teeth in comparison to the traditional method (low-speed bur. Settings and Design: A randomized clinical trial was conducted with 20 children between 5 and 8 years of age. Materials and Methods: Two teeth were treated in each child (split-mouth design, with the randomization of two methods: Group 1 - chemomechanical caries removal with Papacarie Duo™; and Group 2 - removal of carious dentin tissue using a low-speed bur. Both methods involved restoration with glass ionomer cement and follow up. The following aspects were evaluated: time required for the procedure; pain (face evaluation scale; rtention of the restorative material in the cavity; and the presence of secondary caries after 30 days. Statistical Analysis Used: Chi-squared test, Student′s t-test, and Wilcoxon test. Results: No statistically significant differences between methods were found regarding time required for the procedure (P = 0.13, the occurrence of pain (P = 0.585, or restoration status at the 30-day clinical evaluation (P = 0.713. Conclusion: The findings of the present study demonstrate that the two methods achieve similar results. The advantages of minimally invasive treatment, such as chemomechanical caries removal with Papacarie Duo™, are its ease of use, patient comfort, and the fact that it causes less damage to dental tissue.

  18. Diversity of Lactobacillus species in deep carious lesions of primary molars.

    Science.gov (United States)

    Kneist, S; Schmidt, F; Callaway, A; Willershausen, B; Rupf, S; Wicht, M; Thiede, B

    2010-08-01

    This was to determine the prevalence of Lactobacilli (LB) species in different stages of caries progression and are considered as secondary invaders of existing carious lesions and specialists for caries progression. Carious dentine samples were collected from 70 primary molars (M) during step-wise (S1, S2: n = 35 M) or one-step (O1: n = 35 M) caries treatment and after 11 months of temporary restorations (S3, O2). LB were identified by selected physiological and biochemical characteristics, ratio of lactic acid isomers, electrophoretic mobilities of lactic acid dehydrogenases, and shotgun mass mapping by MALDI mass spectrometry. LB were isolated from 46% of soft dentine samples (S1). The prevalence of LB from hard dentine collected during caries excavation (O1) reached 34%, after 8 weeks of temporary filling (S2) 11%, and 9% each after 11 months of temporary restoration (S3, O2). The mean total bacterial counts (cfu) of soft dentine (S1) were 3.6 x 10⁵. From hard dentine during caries excavation (O1) 4.4x10⁴ cfu were calculated, at S2 3.7 x 10³ cfu, at S3 0.1 x 10³ cfu, and at O2 1.8 x 10³ cfu. The percentages of LB in the cfu for LB positive dentine samples were for S1 / S2 / S3 / O1 / O2: 60% (16 M)/34% (4 M)/54% (3 M)/57% (9 M), and 64% (3 M). Five LB species were identified from carious dentine: L. paracasei subsp. paracasei, L. paracasei subsp. tolerans, L. rhamnosus, L. gasseri, and L. alimentarius. While L. rhamnosus and L. paracasei subsp. paracasei occurred in all caries progression stages, the other species were found only sporadically. L. paracasei subsp. paracasei and L. rhamnosus might be the specialists of the LB in carious progression.

  19. Remineralization efficiency of bioactive glass on artificially induced carious lesion an in-vitro study

    Directory of Open Access Journals (Sweden)

    Sai Sathya Narayana

    2014-01-01

    Full Text Available Objectives: The objective of this study is to investigate the efficacy of bioactive glass containing product on remineralization of artificial induced carious enamel lesion and to compare its efficiency with other remineralization products using an in-vitro pH cycling method. The null hypothesis tested was bioactive glass has no effect on enamel remineralization. Materials and Methods: A total of 20 enamel samples of human molar teeth were subjected to artificial caries lesion formation using pH cycling method and was verified using high resolution scanning electron microscope (HRSEM. Each demineralized sample was then divided into five test groups each containing twenty. Group A - Bioactive glass (SHY-NM, Group B - Fluoride tooth paste (Amflor, Group C - CPP-ACP (Tooth mousse, Group D - CPP-ACPF (Tooth mousse plus, Group E - control. All the test groups were exposed to the pH cycling regime, the remineralizing agents were applied for 10 min except control. After 10 days period, the entire test groups were evaluated with HRSEM and quantitative assessment by energy dispersive X-ray spectroscopy. The obtained data was analyzed statistically using one-way ANOVA, Student′s t-test and Tukey′s multiple comparison tests. P ≤ 0.05 was considered to be significant. Results: Rejection of the null hypothesis and highlights the concept of biomimetic bioactive glass as an effective remineralizing agent. Clinical Relevance: To focus on the importance of minimal invasive treatment on incipient carious lesion by remineralization.

  20. Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

    Energy Technology Data Exchange (ETDEWEB)

    Morais, A. P. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Salgado de Oliveira University, Marechal Deodoro Street, 217 – Centro, Niterói, Rio de Janeiro (Brazil); Pino, A. V. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Souza, M. N. [Biomedical Engineering Program, COPPE, Rio de Janeiro (Brazil); Electronics Department at Polytechnic School, Federal University of Rio de Janeiro, Centro de Tecnologia Bloco H sala 217, Ilha do Fundão, Rio de Janeiro (Brazil)

    2016-08-15

    This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

  1. Nd:YAG Lasers Treating of Carious Lesion and Root Canal In Vitro

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    Danqing Xia

    2012-01-01

    Full Text Available Dental caries is a transmissible bacterial disease process, with cavities at the end, and caused by acids from bacterial metabolism. The essence of dental treatment is to clean and disinfect bacterial contamination from the tooth. In this work, we tried to demonstrate the cleaning and disinfecting effects of Nd:YAG laser irradiation on dental carious lesion and root canal in vitro. Acousto-optic Q-switched quasicontinuous and Cr3+:YAG crystal Q-switched pulse Nd:YAG lasers were employed to treat caries lesion and the root canal, respectively. Results showed that acousto-optic Q-switched quasicontinuous Nd:YAG laser irradiation and Cr3+:YAG crystal Q-switched pulse Nd:YAG laser irradiation could rapidly clean decayed material and bacterial contamination from dental carious lesion and the narrow tail end of root canal with minimally invasive in vitro, respectively. It was concluded that acousto-optic Q-switched quasicontinuous laser irradiation may be a rapid and effective alternative caries treatment, and Cr3+:YAG crystal Q-switched pulse Nd:YAG laser irradiation may be an effective method for canal cleaning and disinfecting during root canal therapy.

  2. A triclosan-containing compomer reduces Lactobacillus spp. predominant in advanced carious lesions.

    Science.gov (United States)

    Wicht, Michael J; Haak, Rainer; Kneist, Susanne; Noack, Michael J

    2005-09-01

    To assess the antimicrobial effect of acid etching or a triclosan-containing compomer on the cultivable microflora of incompletely excavated dentinal carious lesions. Thirty detinal lesions were opened with a diamond burr. Subsequent to removal of the softened biomass a sample of dentin was taken from the cavity floor with a round bur. Ten cavities each were treated with 36% phosphoric acid (PH) for 15s, covered with a triclosan-containing compomer (TC) or received no treatment as control (CO). All lesions were restored with a compomer composite. Sampling was performed directly after etching in the PH group and at re-entry after 6 weeks in all groups. Aliquots were plated on blood agar and selective media for Lactobacilli (Rogosa) and mutans Streptococci (MSB). Cultures were incubated anaerobically for 7 days at 37 degrees C prior to quantitative assessment and biotyping of the isolates. Application of phosphoric acid resulted in initial reduction of the totally cultivable microflora (p=0.006). Evaluation of the total number of cultivable microflora after 6 weeks revealed no differences between the groups (p>0.05). Lactobacilli counts were significantly lower in the TC group compared to the PH and CO groups (p<0.05). No difference was detected between the PH and CO groups after 6 weeks. Phosphoric acid initially reduces the number of microorganisms in carious dentin but not in the longer term. The experimental triclosan composite suppresses Lactobacilli species over a period of 6 weeks.

  3. Insights into the Virulence Traits of Streptococcus mutans in Dentine Carious Lesions of Children with Early Childhood Caries.

    Science.gov (United States)

    Bezerra, Daniela S; Stipp, Rafael N; Neves, Beatriz G; Guedes, Sarah F F; Nascimento, Marcelle M; Rodrigues, Lidiany K A

    2016-01-01

    Streptococcus mutans is an oral bacterium considered to play a major role in the development of dental caries. This study aimed to investigate the prevalence of S. mutans in active and arrested dentine carious lesions of children with early childhood caries and to examine the expression profile of selected S. mutans genes associated with survival and virulence, within the same carious lesions. Dentine samples were collected from 29 active and 16 arrested carious lesions that were diagnosed in preschool children aged 2-5 years. Total RNA was extracted from the dentine samples, and reverse transcription quantitative real-time PCR analyses were performed for the quantification of S. mutans and for analyses of the expression of S. mutans genes associated with bacterial survival (atpD, nox, pdhA) and virulence (fabM and aguD). There was no statistically significant difference in the prevalence of S. mutans between active and arrested carious lesions. Expression of the tested genes was detected in both types of carious dentine. The pdhA (p = 0.04) and aguD (p = 0.05) genes were expressed at higher levels in arrested as compared to active lesions. Our findings revealed that S. mutans is part of the viable microbial community in active and arrested dentine carious lesions. The increase in expression of the pdhA and aguD genes in arrested lesions is likely due to the unfavourable environmental conditions for microbial growth, inherent to this type of lesions. © 2016 S. Karger AG, Basel.

  4. Infiltrating/sealing proximal caries lesions

    DEFF Research Database (Denmark)

    Martignon, S; Ekstrand, K R; Gomez, J

    2012-01-01

    This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3...... differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference...... proximal lesions identified radiographically around the enamel-dentin junction to the outer third of the dentin, were included. Lesions were randomly allocated for treatment to test-A (Infiltration: ICON-pre-product; DMG), test-B (Sealing: Prime-Bond-NT; Dentsply), or control-C (Placebo). Primary outcome...

  5. Selective removal of carious lesion with Er:YAG laser followed by dentin biomodification with chitosan.

    Science.gov (United States)

    Curylofo-Zotti, Fabiana A; Tanta, Gabriela Solano; Zucoloto, Miriane Lucindo; Souza-Gabriel, Aline E; Corona, Silmara A M

    2017-09-01

    The aim of this study was to evaluate the effect of Er:YAG laser for selective removal of carious lesion, followed by biomodification with chitosan gel where the subsurface microhardness, chemical composition, and morphological changes of the residual caries-affected dentin were examined. Artificial dentinal lesions were created by pH-cycling method (14 days) in 104 bovine specimens (5 × 5 mm). Specimens were randomly divided according to the carious removal method: bur (low-speed handpiece) or Er:YAG laser (250 mJ/4 Hz). Specimens were treated with 35% phosphoric acid and were subdivided into two groups according to dentin biomodification: without chitosan (control) and 2.5% chitosan. Forty specimens were restored with an adhesive system and composite resin. Subsurface microhardness tests were performed in sound dentin, caries-affected dentin, residual caries-affected dentin, and after the restoration. The other 64 specimens were subjected to SEM-EDS atomic analysis. Data were statistically analyzed (p laser excavation, the microhardness value of residual caries-affected dentin was higher (p laser (p caries-affected dentin (p > 0.05). SEM analysis showed morphological changes on residual caries-affected dentin (p > 0.05). The selective removal of carious dentin with Er:YAG laser increased microhardness of residual caries-affected dentin, changing its surface morphology and chemical composition. The biomodification with chitosan did not influence the structural and chemical composition of residual caries-affected dentin.

  6. Clinical use of photodynamic antimicrobial chemotherapy for the treatment of deep carious lesions

    Science.gov (United States)

    Guglielmi, Camila De Almeida B.; Simionato, Maria Regina L.; Ramalho, Karen Müller; Imparato, José Carlos P.; Pinheiro, Sérgio Luiz; Luz, Maria A. A. C.

    2011-08-01

    The purpose of this study was to assess photodynamic antimicrobial chemotherapy (PACT) via irradiation, using a low power laser associated with a photosensitization dye, as an alternative to remove cariogenic microorganisms by drilling. Remaining dentinal samples in deep carious lesions on permanent molars (n = 26) were treated with 0.01% methylene blue dye and irradiated with a low power laser (InGaAIP - indium gallium aluminum phosphide; λ = 660 nm; 100 mW; 320 Jcm-2 90 s; 9J). Samples of dentin from the pulpal wall region were collected with a micropunch before and immediately after PACT and kept in a transport medium for microbiological analysis. Samples were cultured in plates of Brucella blood agar, Mitis Salivarius Bacitracin agar and Rogosa SL agar to determine the total viable bacteria, mutans streptococci and Lactobacillus spp. counts, respectively. After incubation, colony-forming units were counted and microbial reduction was calculated for each group of bacteria. PACT led to statistically significant reductions in mutans streptococci (1.38 log), Lactobacillus spp. (0.93 log), and total viable bacteria (0.91 log). This therapy may be an appropriate approach for the treatment of deep carious lesions using minimally invasive procedures.

  7. Do occlusal carious lesions spread laterally at the enamel-dentin junction? A histolopathological study.

    Science.gov (United States)

    Ekstrand, K R; Ricketts, D N; Kidd, E A

    1998-03-01

    It is conventionally taught that the carious lesion in dentin undermines the enamel due to lateral spread of the lesion at the enamel-dentin junction (EDJ). The aim of the present study was to challenge this hypothesis by testing an alternative hypothesis, that lateral spread is related to advanced lesions where the dentin is infected. Selected points in the groove-fossa system of 100 unrestored occlusal surfaces were examined and the teeth divided into five groups (scores 0-4) depending on the clinical appearance of the lesion. Teeth were sectioned through these sites and texture of the dentin was assessed by probing. Colour slides of the section face with the more extensive changes in the dentin were projected and the dimensions of the lesions at the EDJ were assessed by three examiners on two separate occasions. Inter- and intra-examiner reproducibility was assessed and found acceptable. Results showed that in 47 teeth demineralisation had not reached the EDJ. In the remaining teeth the presence or absence of lateral spread of the lesion at the EDJ was related to the clinical features of the lesion. Lateral spread was rarely found in lesions with an apparently intact enamel surface (scores 0-2). However, 32% of sites with microcavitation (score 3) and 63% of sites with obvious cavitation (score 4) showed lateral spread. Of those 31 sections which were judged to have soft dentin, 80% had lateral spread. In conclusion, the phenomenon of lateral spread of caries at the FDJ is related to advanced lesions with cavity formation where the dentin is soft and infected.

  8. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions

    National Research Council Canada - National Science Library

    Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A

    2014-01-01

    .... The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC...

  9. Antimicrobial photodynamic therapy as an adjunct for treatment of deep carious lesions-A systematic review.

    Science.gov (United States)

    Cieplik, Fabian; Buchalla, Wolfgang; Hellwig, Elmar; Al-Ahmad, Ali; Hiller, Karl-Anton; Maisch, Tim; Karygianni, Lamprini

    2017-06-01

    For deep carious lesions, a more conservative treatment modality ("selective caries removal") has been proposed, where only the heavily contaminated dentine is removed. In this regard, effective adjuncts for cavity disinfection such as the antimicrobial photodynamic therapy (aPDT) can be valuable clinically prior to definitive restoration. Therefore, the aim of this study was to systematically assess clinical studies on the effectiveness of aPDT as a supplementary tool in the treatment of deep caries lesions. Searches were performed in four databases (PubMed, EMBASE, ISI Web of Science, ClinicalTrials.gov) from 1st January, 2011 until 21st June, 2016 for search terms relevant to the observed parameters, pathological condition, intervention and anatomic entity. The pooled information was evaluated according to PRISMA guidelines. At first, 1651 articles were recovered, of which 1249 full-text articles were evaluated, 270 articles thereof were reviewed for eligibility and finally 6 articles met all inclusion criteria. The aPDT protocols involved Methylene Blue, Toluidine Blue and aluminium-chloride-phthalocyanine as photosensitizers and diode lasers, light-emitting diodes and halogen light-sources. The data from five reports, utilizing both culture-dependent and -independent methods, disclosed significant reduction of cariogenic bacterial load after mechanical caries removal with adjunct aPDT. As these studies exhibit some methodological limitations, e.g. lack of positive controls, this systematic review can support the application of aPDT to a limited extent only in terms of reducing the microbial load in deep carious lesions before restorative treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Distribution of class ii major histocompatibility complex antigenexpressing cells in human dental pulp with carious lesions

    Directory of Open Access Journals (Sweden)

    Tetiana Haniastuti

    2012-09-01

    Full Text Available Background: Dental caries is a bacterial infection which causes destruction of the hard tissues of the tooth. Exposure of the dentin to the oral environment as a result of caries inevitably results in a cellular response in the pulp. The major histocompatibility complex (MHC is a group of genes that code for cell-surface histocompatibility antigens. Cells expressing class II MHC molecules participate in the initial recognition and the processing of antigenic substances to serve as antigen-presenting cells. Purpose: The aim of the study was to elucidate the alteration in the distribution of class II MHC antigen-expressing cells in human dental pulp as carious lesions progressed toward the pulp. Methods: Fifteen third molars with caries at the occlusal site at various stages of decay and 5 intact third molars were extracted and used in this study. Before decalcifying with 10% EDTA solution (pH 7.4, all the samples were observed by micro-computed tomography to confirm the lesion condition three-dimensionally. The specimens were then processed for cryosection and immunohistochemistry using an anti-MHC class II monoclonal antibody. Results: Class II MHC antigen-expressing cells were found both in normal and carious specimens. In normal tooth, the class II MHC-immunopositive cells were observed mainly at the periphery of the pulp tissue. In teeth with caries, class II MHC-immunopositive cells were located predominantly subjacent to the carious lesions. As the caries progressed, the number of class II MHC antigen-expressing cells was increased. Conclusion: The depth of carious lesions affects the distribution of class II MHC antigen-expressing cells in the dental pulp.Latar belakang: Karies merupakan penyakit infeksi bakteri yang mengakibatkan destruksi jaringan keras gigi. Dentin yang terbuka akibat karies akan menginduksi respon imun seluler pada pulpa. Kompleks histokompatibilitas utama (MHC merupakan sekumpulan gen yang mengkode histokompatibilitas

  11. Effectiveness of sealing active proximal caries lesions with an adhesive system: 1-year clinical evaluation

    Directory of Open Access Journals (Sweden)

    Clarisse Abuchaim

    2010-09-01

    Full Text Available The objective of this study was to evaluate the effectiveness of a therapeutic sealant to arrest non-cavitated proximal carious lesion progression. The study population comprised 44 adolescents who had bitewing radiographs taken for caries diagnosis. Non-cavitated lesions extending up to half of dentin thickness were included in the sample. In the experimental group (n = 33, the proximal caries-lesion surfaces were sealed with an adhesive (OptiBond Solo, Kerr after tooth separation. The control group (n = 11 received no treatment, except for oral hygiene instructions including use of dental floss. Follow-up radiographs were taken after one year and were analyzed in comparison with baseline radiographs. In a blind study setting, visual readings were performed by two examiners, blinded to whether the examined radiograph was baseline or follow-up, and whether it concerned a test or control lesion. The efficacy of sealing treatment was evaluated by the McNemar test (0.05. About 22% of the sealed lesions showed reduction, 61% showed no change and 16% showed progression. For the control lesions, the corresponding values were 27%, 36% and 36% respectively. The number of lesions that showed reduction and no changes were merged and therefore 83.3% of the sealed lesions and 63.6% of the control lesions were considered clinically successful. No statistical significance was detected (p > 0.05. In the course of 1 year, sealing proximal caries lesions was not shown to be superior to lesion monitoring.

  12. Association between untreated carious lesions and asthma in adults at Rabat University Hospital, Morocco: a cross sectional study.

    Science.gov (United States)

    Chala, Sanaa; Rouiffi, Saloua; Soualhi, Mouna; Bourkadi, Jamal Eddine; Abouqal, Redouane; Abdallaoui, Faïza

    2017-06-26

    Depending on risk factors, cumulative risk of developing more dental caries by age has been reported. However, the association between dental caries and asthma is less studied among adults. The aims of this study were to evaluate the severity of untreated carious lesions in a population of asthmatic adults and to evaluate the mediation of socio-economic and oral health behaviour variables. The study involved participants with diagnosed asthma (N = 100) and control (N = 100) subjects attending a tertiary hospital. Groups were matched by age and gender. Asthma was the exposure of interest. The outcome measure was the rate of carious lesions. Recorded variables included demographics, socio-economic status, tooth brushing habits and oral health status using WHO criteria. Poisson regression analysis examined the association between asthma and untreated dental caries. The adjusted model, after the inclusion of individuals' behaviours regarding oral health, social determinants and asthma, revealed a significant association between the number of untreated carious lesions and asthma (PR = 1.23; 95% CI 1.23-1.58; p asthma showed a greater number of untreated carious lesions. Looking forward, better understanding of the association between asthma and oral health may require exploiting the interactions of behavioural, social determinant and biological factors.

  13. Effect of nano-hydroxyapatite toothpaste on microhardness ofartificial carious lesions created on extracted teeth

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    Asghar Ebadifar

    2017-03-01

    Full Text Available Background. Many types of toothpastes contain substances that can remineralize initial enamel caries. This study aimed to assess the effect of nano-hydroxyapatite (NHA on microhardness of artificially created carious lesions. Methods. In this in vitro study, NHA was prepared using sol-gel technique and added to the toothpaste with 7% concentration. A total of 80 extracted sound teeth were collected. The crowns were polished using 500-grit abrasive paper. The specimens were randomly coded from 1 to 80. Number 1 to 40 were assigned to group A and numbers 41 to 80 to group B. The microhardness was measured using HVS-1000 Vickers microhardness tester. The specimens were demineralized using 37% phosphoric acid for 3 minutes in order to create artificial carious lesions and then were rinsed with water, air-sprayed for 3 minutes and dried. Microhardness was measured again. Next, the specimens were brushed for 15 days, twice daily, for 15 seconds. After 15 days, microhardness was measured again. Toothpaste A contained NHA and fluoride and toothpaste B contained fluoride alone. Data were analyzed using SPSS 16, with one-sample Kolmogorov-Smirnov test and ANOVA at a significance level of P<0.05. Results. The microhardness of specimens significantly decreased following acid exposure (P<0.01 but increased again in both groups after exposure to toothpastes. The increase in microhardness was significantly greater in group A (P<0.01. Conclusion. The toothpaste containing NHA was more effective than the toothpaste without NHA for the purpose of remineralization.

  14. Adhesives for the restoration of non-carious cervical lesions: a systematic review.

    Science.gov (United States)

    Chee, Brian; Rickman, Luke J; Satterthwaite, Julian D

    2012-06-01

    To establish whether simplified adhesives (self-etch) are as clinically effective as conventional adhesives (etch-and-rinse) with multiple application steps for treatment of non-carious cervical lesions (NCCLs). there is no difference in the clinical effectiveness of the four different bonding strategies: Three-step etch-and-rinse; Two-step etch-and-rinse; Two-step self-etch; One-step self-etch for treatment of NCCLs. Electronic databases were searched including: Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. In addition, studies were identified by handsearching of selected journals. Randomised controlled trials (RCTs) comparing at least two adhesives in non-carious cervical lesions (NCCLs), with at least 18 months follow-up were selected. The primary outcome was loss of retention/restoration loss, with marginal adaptation and marginal discolouration as secondary outcomes. Criteria for quality assessment included: random sequence generation; allocation concealment; blinding of outcome assessment; and information on withdrawals. Twenty six studies were identified that met the inclusion criteria. In general, studies were not of sufficient quality to fully address the objectives of this review. There is not enough evidence to support one adhesive or bonding strategy over another for treatment of NCCLs. Consequently, the null hypothesis of no difference cannot be supported or rejected with the data currently available. There is a need for better standardisation and reporting of randomised controlled trials investigating adhesive performance. Studies with low overall risk of bias demonstrated good clinical performance for adhesives with all four bonding strategies. However, included studies showed wide variation between adhesives of the same category. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Laboratory model to evaluate the influence of stress and corrosion in the formation of non-carious cervical lesions

    OpenAIRE

    Leal, Noélia Maria de Sousa; Benigno, Maria Ivone Mendes; Silva, Juscelino Lopes; Pedrosa,Simone Soares; ALVES, Eliane Bemerguy; Ballester,Rafael Yagüe

    2014-01-01

    Objective: To conceive and test a laboratory model that simulates the multifactorial etiology of non-carious cervical lesions. The model enables researchers to assess the pathological process with increasing levels of complexity, focusing on tension and corrosion. The model is aimed at clarifying the mechanisms that lead to the development of these lesions. Methods: Specimens were manufactured from bovine incisors cut into 18 × 3 × 3 mm sticks, with a notch in the cervical region facing the p...

  16. Selective Laser Ablation of Carious Lesions using Simultaneous Scanned Near-IR Diode and CO2 Lasers.

    Science.gov (United States)

    Chan, Kenneth H; Fried, Daniel

    2017-01-28

    Previous studies have established that carious lesions can be imaged with high contrast using near-IR wavelengths coincident with high water absorption, namely 1450-nm, without the interference of stains. It has been demonstrated that computer-controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, a point-to-point scanning system was developed integrating a 1450-nm diode laser with the CO2 ablation laser. This approach is advantageous since it does not require an expensive near-IR camera. In this pilot study, we demonstrate the feasibility of a combined NIR and IR laser system for the selective removal of carious lesions.

  17. Effectiveness of fluoride sealant in the prevention of carious lesions around orthodontic brackets: an OCT evaluation

    Directory of Open Access Journals (Sweden)

    Matheus Melo Pithon

    2015-12-01

    Full Text Available Abstract Objective: This article aimed to evaluate in vitro the efficiency of Pro Seal fluoride sealant application in the prevention of white spot lesions around orthodontic brackets. Material and Methods: Brackets were bonded to the buccal surface of bovine incisors, and five groups were formed (n = 15 according to the exposure of teeth to oral hygiene substances and the application of enamel sealant: G1 (control, only brushing was performed with 1.450 ppm fluoride; G2 (control brushing associated with the use of mouthwash with 225 ppm fluoride; G3, only Pro Seal sealant application was performed with 1.000 ppm fluoride; G4 Pro Seal associated with brushing; G5 Pro Seal associated with brushing and mouthwash. Experimental groups alternated between pH cycling and the procedures described. All specimens were kept at a temperature of 37 °C throughout the entire experiment. Both brushing and immersion in solutions were performed within a time interval of one minute, followed by washing in deionized water three times a day for 28 days. Afterwards, an evaluation by Optical Coherence Tomography (OCT of the spectral type was performed. In each group, a scanning exam of the white spot lesion area (around the sites where brackets were bonded and depth measurement of carious lesions were performed. Analysis of variance (ANOVA was applied to determine whether there were significant differences among groups. For post hoc analysis, Tukey test was used. Results: There was statistically significant difference between groups 1 and 2 (p = 0.003, 1 and 3 (p = 0.008, 1 and 4 (p = 0.000 and 1 and 5 (p = 0.000. The group in which only brushing was performed (Group 1 showed deeper enamel lesion. Conclusion: Pro Seal sealant alone or combined with brushing and/or brushing and the use of a mouthwash with fluoride was more effective in protecting enamel, in comparison to brushing alone.

  18. Pilot Study of the Canary System Use in the Diagnosis of Approximal Carious Lesions in Primary Molars.

    Science.gov (United States)

    Herzog, Karin; D'Elia, Mindi; Kim, Amy; Slayton, Rebecca L

    2015-01-01

    This study assessed the feasibility and ease of use of the Canary System in approximal carious lesion detection in primary molars. Forty healthy five- to 12-year-olds, who presented to the Center for Pediatric Dentistry in Seattle, Wash., U.S.A., for initial or recall exams, were enrolled. Participants had one to two primary molars, with or without approximal radiographic radiolucencies. Four Canary System scans were performed at the approximal area of each study tooth. The maximum Canary number of the four scans was compared to bitewing radiographs. Seventy-five teeth were included in the final analysis. All study patients easily tolerated being scanned with the Canary System. The overall sensitivity and specificity of the Canary System, when compared to bitewing radiographs, was 81 percent and 35 percent, respectively. Among teeth without radiographic radiolucencies, the Canary System identified 65 percent (31 of 48) of study teeth as having carious lesions. The Canary System is a safe approximal caries detection device in five- to 12-year-olds. When compared to bitewing radiographs, the specificity of the Canary System for approximal carious lesion detection in primary molars was low. However, this could indicate that the Canary System is detecting lesions earlier than radiographs.

  19. In vitro evaluation of fluoride products in the development of carious lesions in deciduous teeth

    Directory of Open Access Journals (Sweden)

    Lucineide de Melo Santos

    2009-09-01

    Full Text Available The purpose of this study was to evaluate the effect of the application of fluoride products on the development of enamel caries in deciduous teeth. A total of 108 deciduous teeth were chosen for the study. Acid-resistant varnish was applied on the teeth, leaving only one area of 5 mm x 1 mm of dental enamel exposed. The teeth were allocated randomly to one of the following groups: 1 control - toothpaste without fluoride; 2 1.23% fluoride gel; 3 Duraflur fluoride varnish; 4 Duraphat fluoride varnish; 5 Fluorniz fluoride varnish; 6 Fluorphat fluoride varnish; 7 varnish with Duofluorid; 8 12% silver fluoride diamine (Cariestop; 9 children's fluoride toothpaste (500 ppm. The tested products were applied on the teeth according to the manufacturer's recommendations and the teeth were stored in a moist environment for 24 hours. Each group of teeth was then subjected to a pH cycling model for 14 days, after which the teeth were cut through the center for an analysis of the depth of the carious lesion by polarized light microscopy. Comparisons were made between the treatments and the control group. The mean lesion depth values were 318 μm ± 39 (control, 213 μm ± 27 (fluoride gel, 203 μm ± 34 (Duraflur, 133 μm ± 25 (Duraphat, 207 μm ± 27 (Fluor-niz, 212 μm ± 27 (Fluorphat, 210 ± 28 (Duofluorid, 146 ± 31 (Cariestop and 228 ± 24 (fluoride toothpaste. None of the products used here was able to completely prevent the formation of lesions. The highest cariostatic effect was achieved by fluoride varnish Duraphat and the lowest by the fluoride toothpaste.

  20. In vitro evaluation of fluoride products in the development of carious lesions in deciduous teeth.

    Science.gov (United States)

    Santos, Lucineide de Melo; Reis, José Ivo Limeira dos; Medeiros, Maria Perolina de; Ramos, Sheyla Moreira; Araújo, Juliane Mendes de

    2009-01-01

    The purpose of this study was to evaluate the effect of the application of fluoride products on the development of enamel caries in deciduous teeth. A total of 108 deciduous teeth were chosen for the study. Acid-resistant varnish was applied on the teeth, leaving only one area of 5 mm x 1 mm of dental enamel exposed. The teeth were allocated randomly to one of the following groups: 1) control - toothpaste without fluoride; 2) 1.23% fluoride gel; 3) Duraflur fluoride varnish; 4) Duraphat fluoride varnish; 5) Fluorniz fluoride varnish; 6) Fluorphat fluoride varnish; 7) varnish with Duofluorid; 8) 12% silver fluoride diamine (Cariestop); 9) children's fluoride toothpaste (500 ppm). The tested products were applied on the teeth according to the manufacturer's recommendations and the teeth were stored in a moist environment for 24 hours. Each group of teeth was then subjected to a pH cycling model for 14 days, after which the teeth were cut through the center for an analysis of the depth of the carious lesion by polarized light microscopy. Comparisons were made between the treatments and the control group. The mean lesion depth values were 318 microm +/- 39 (control), 213 microm +/- 27 (fluoride gel), 203 microm +/- 34 (Duraflur), 133 microm +/- 25 (Duraphat), 207 microm +/- 27 (Fluor-niz), 212 microm +/- 27 (Fluorphat), 210 +/- 28 (Duofluorid), 146 +/- 31 (Cariestop) and 228 +/- 24 (fluoride toothpaste). None of the products used here was able to completely prevent the formation of lesions. The highest cariostatic effect was achieved by fluoride varnish Duraphat and the lowest by the fluoride toothpaste.

  1. Antimicrobial effect of photodynamic therapy in carious lesions in vivo, using culture and real-time PCR methods.

    Science.gov (United States)

    Araújo, Patricia Valente; Correia-Silva, Jeane de Fátima; Gomez, Ricardo Santiago; Massara, Maria de Lourdes de Andrade; Cortes, Maria Esperanza; Poletto, Luiz Thadeu de Abreu

    2015-09-01

    The aim of this study was to evaluate the antimicrobial effect of photodynamic therapy (PDT) in carious lesions in vivo by culture and real-time PCR methods. Ten teeth with deep active carious lesions were selected and five portions of carious dentin were removed for each tooth. Two increments were used as control, to represent the superficial and deep dentin, respectively. Methylene blue at 100mg/L was placed in contact with the cavity for 5min, before being irradiated with a halogen light source for 1min. Then, after PDT, other three portions were removed. The samples were processed in laboratory and the number of viable cfu was obtained. The real-time PCR analyses were performed in two increments of carious dentin, removed before and after PDT. The Streptococcus mutans DNA was isolated from carious dentin samples and amplification and detection of DNA were performed with real-time PCR. The cavities were then restored with glass-ionomer cement. Using conventional culture methods, the results demonstrated that viable bacteria were significantly reduced in all of the agar plates following photosensitization. No difference was found between both groups regarding S. mutans DNA quantification by real-time PCR. Although PDT may not affect the number of S. mutans DNA copies immediately after the treatment, clear reduction of the number of cfu was found. Despite its promising use for eliminating bacteria in dental caries treatment, further studies are necessary to establish an effective clinical protocol for the PDT. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Conduction of reparative dentin: A pulp protecting approach by indirect pulp capping in deep carious lesion with biodentine

    Directory of Open Access Journals (Sweden)

    Rafeza Sultana

    2016-12-01

    Full Text Available This case report represents, the treatment of deep carious lesion in a male was done by using indirect pulp capping with biodentine. The clinical and radiological outcomes were evaluated. The patient was presented with mild to moderate sensitivity on thermal (cold stimulation and discomfort associated with eating in the left mandibular first molar. The clinico–radiographical examination revealed a disto–occlusal carious lesion, very close to the pulp, absence of radiolucencies in the periapical region and no periodontal space widening. Pulp sensitivity was confirmed by thermal pulp vitality test. Indirect pulp capping treatment was performed with biodentine. Following 6 months of the treatment, the clinical symptoms were resolved and a calcific bridge was found at the dentin over the pulp and biodentine interface that was indicative the evidence of reparative dentin formation.

  3. Clinical evaluation of a self-etch adhesive system in non-carious cervical lesions.

    Science.gov (United States)

    Ashaye, A R; Shaba, O P; Umesi-Koleoso, D C

    2009-01-01

    All-in one adhesive systems reduce the number of steps and thus possible soures of error that may occur in clinical wage of adhesives, it is hoped that they also have good clinical performance. To evaluate the clinical performance of a self-etch adhesive system--Adper's Prompt L-Pop in non-carious cervical lesions over a six months period. One hundred and eighty-one (181) restorations were placed by one operator for 35 patients. The self-etch adhesive was applied to the cavity and composite was used to restore the teeth. The restorations were evaluated at baseline, 3 months and 6 months according to the modified Ryge's criteria. Restorations were monitored for postoperative sensitivity, retention rates and marginal adaptation. At six months, 160 restorations were available for evaluation in 32 patients. The retention rate was 96.3%, postoperative sensitivity was scored Alpha for all restorations (no sensitivity), and 3.7% restorations had marginal adaptation failure at six months. The adhesive system tested exhibited very good clinical performance at the end of six months.

  4. Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD.

    Science.gov (United States)

    Bozejac, Branislava Velicki; Stojšin, Ivana; Ðuric, Mirna; Zvezdin, Biljana; Brkanić, Tatjana; Budišin, Evica; Vukoje, Karolina; Sečen, Nevena

    2017-01-01

    The aim of this study was to investigate the incidence of carious lesions, the amount of salivary flow rate and pH value in patients with asthma and chronic obstructive pulmonary diseases (COPD), using inhalation therapy. The obtained results were compared with the results of adult healthy subjects, forming a control group. The study included 80 participants aging between 18 and 65 years. The experimental group (EG) was comprised of 40 participants, previously diagnosed with asthma or COPD undergoing inhalation therapy for more than five years. The control group (CG), comprised of 40 participants, mirrored the same age and gender status of the EG. Dental status was determined by decayed, missing, and filled teeth (DMFT index). Quantity and pH value of saliva were determined in the laboratory. In the EG, the mean value of the salivary flow rate and pH value were statistically significantly lower than in the CG (pdental caries due to the lower salivary flow rate and pH value along with the inhalation therapy. They should receive intensive preventive care, including oral hygiene instruction and dietary advice.

  5. Salivary peptidome profiling analysis for occurrence of new carious lesions in patients with severe early childhood caries.

    Science.gov (United States)

    Tian, Chang; Sun, Xiangyu; Liu, Xiaochen; Huang, Xin; Chen, Feng; Zheng, Shuguo

    2017-01-01

    This study aimed to identify differences of peptide profiles in stimulated whole saliva among children with and without occurrence of new carious lesions, and to provide a simple way for early diagnosis and prevention of the relapse of severe early childhood caries (s-ECC). Overall, 26 children aged 3-4 years were selected out from all the children in the kindergarten to be involved in the present study, among them 13 were diagnosed as s-ECC and underwent dental treatment, whilst the other 13 were matched by age and sex as control. Stimulated whole saliva samples were collected before treatment, and at 10 days and 4 months after treatment. During follow-up, 7 of the 13 children with s-ECC showed a relapse, and the new carious lesions were then treated. Salivary peptides were detected using the technique of magnetic beads combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Fifteen peptides showed significant differences in the group without occurrence of new carious lesions (CH group). On comparing the CH group and the other group with occurrence of new carious lesions (CR group), no significant differences were observed before treatment, whereas certain peptides showed significant differences at both 10 days and 4 months after treatment. Two peptides (experimental m/z values: 3162.0 Da and 3290.4 Da) exhibited a consistent tendency in cross-sectional and longitudinal comparisons among these groups; these may be associated with recurrence of s-ECC. Based on our findings, it is concluded that different saliva peptide peaks can be detected in s-ECC using MALDI-TOF MS combined with magnetic beads. Moreover, 2 specific peptides with m/z values 3162.0 Da and 3290.4 Da could be promising salivary protein biomarkers for diagnosis of recurrence of s-ECC.

  6. Association between untreated carious lesions and asthma in adults at Rabat University Hospital, Morocco: a cross sectional study

    OpenAIRE

    Chala, Sanaa; Rouiffi, Saloua; Soualhi, Mouna; Bourkadi, Jamal Eddine; Abouqal, Redouane; Abdallaoui, Fa?za

    2017-01-01

    Background Depending on risk factors, cumulative risk of developing more dental caries by age has been reported. However, the association between dental caries and asthma is less studied among adults. The aims of this study were to evaluate the severity of untreated carious lesions in a population of asthmatic adults and to evaluate the mediation of socio-economic and oral health behaviour variables. Methods The study involved participants with diagnosed asthma (N?=?100) and control (N?=?100)...

  7. Indirect pulp capping versus pulpotomy for treating deep carious lesions approaching the pulp in primary teeth: a systematic review.

    Science.gov (United States)

    Smaïl-Faugeron, V; Porot, A; Muller-Bolla, M; Courson, F

    2016-06-01

    To assess dental practice regarding the use of indirect pulp capping or pulpotomy in children with deep carious lesions approaching the pulp in primary teeth and to compare the efficacy of the two pulp treatments. Systematic review. We searched the Cochrane Library, PubMed via MEDLINE, and EMBASE as well as the reference lists of included reports and ClinicalTrials.gov (for ongoing trials). Eligible studies were surveys of dental practice sent to dentists regarding the use of indirect pulp capping and pulpotomy in children with deep carious lesions approaching the pulp in primary teeth and any type of clinical study. Two review authors independently extracted data and assessed risk of bias in duplicate. Of the 481 potentially eligible articles, 11 were included in the review: 8 described surveys of dental practice, 1 a non-randomised study, and 2 ongoing randomised trials. The surveys of dental practice showed an overall increase in the teaching and practice of indirect pulp capping in primary teeth. The non- randomised study found a statistically significant difference in favour of indirect pulp capping for clinical and radiological success at 3 years but with high overall risk of bias. Despite the success rate of indirect pulp capping for treating deep carious lesions approaching the pulp in primary teeth, practitioners still hesitate to practice this technique because of lack of evidence and studies on this topic. Thus, for strong evidence, investigators are encouraged to conduct randomised trials comparing the efficacy of indirect pulp capping and pulpotomy for treating deep carious lesions approaching the pulp in primary teeth.

  8. Two-year clinical evaluation of three adhesive systems in non-carious cervical lesions

    Directory of Open Access Journals (Sweden)

    Evrim Eliguzeloglu Dalkilic

    2012-04-01

    Full Text Available OBJECTIVES: Adhesive systems are continuously being introduced to Dentistry, unfortunately often without sufficient clinical validation. The aim of this study was to evaluate the clinical performance of cervical restorations done with three different adhesive systems. MATERIAL AND METHODS: 158 non-carious cervical lesions of 23 patients were restored with a nanofilled composite resin (Filtek Supreme, 3M/ESPE combined with Single Bond (3M/ESPE, group SI, Clearfil SE (Kuraray Medical Inc., group CL and Xeno III (De Trey Dentsply, group XE. In groups SI-B, CL-B and XE-B, the outer surface of the sclerotic dentin was removed by roughening with a diamond bur before application of the respective adhesive systems. In groups CL-BP and XE-BP, after removal of the outer surface of the sclerotic dentin with the bur, the remaining dentin was etched with 37% phosphoric acid and the self-etch adhesive systems Clearfil SE and Xeno III were applied, respectively. Lesions were evaluated at baseline, and restorations after 3 months, 1 year and 2 years using modified USPHS criteria. RESULTS: After 2 years, no significant difference was found between the retention rates of the groups (p >0.05. Although groups CL and SI showed significantly better marginal adaptation than group XE (p0.05. After 2 years no significant difference was observed among the marginal staining results of all groups (p>0.05. CONCLUSION: Although all adhesive systems showed similar retention rates, Clearfil SE and Single Bond showed better marginal adaptation than Xeno III after 2 years of follow-up.

  9. Factors associated with Non-Carious Cervical Lesions (NCCLs) in teeth.

    Science.gov (United States)

    Ahmed, Hina; Durr-E-Sadaf; Rahman, Munawar

    2009-05-01

    To determine factors associated with Non-Carious Cervical Lesions (NCCLs) and the teeth most commonly involved in such lesions. Cross-sectional study. Department of Operative Dentistry, Section of Dentistry at Aga Khan University Hospital, Karachi, Pakistan, from December 2005 to January 2006. A total number of 95 patients with 671 teeth were evaluated using a pre-coded questionnaire. Subject of evaluation was teeth. Patients with symptomatic or asymptomatic NCCLs and permanent dentition were included. Patients exhibiting active, untreatable periodontal disease, rampant uncontrolled caries, xerostomia, primary dentition, patients undergoing orthodontic treatment or bleaching procedure were excluded from the study. Data analysis was done using Spearman's correlation, Mann Whitney test and Kruskal-Wallis test. Mean age of patients was 50.3 years (r=0.22, p=0.028); males (73%) had more NCCLs than females (23%). Majority (45.3%) of them brushed their teeth twice a day, with medium type of brush (48.4%) and horizontal (73.7%) brushing technique. Most of the patients were non-bruxists (90.5%), with Angles Class 1 occlusion (48.4%) and canine guidance (50.5%). Majority (74.7%) of the patients did not have sensitivity. First premolars in all the quadrants were the most frequently involved teeth in NCCLs. More males had NCCLs. Middle aged patients were more involved. A weak positive correlation was found between age and NCCLs. No association was observed between hand used and site of NCCLs, between wear facets and NCCL, Excursive guidance and NCCL, Angles classification and NCCL.

  10. Impact of inhalation therapy on the incidence of carious lesions in patients with asthma and COPD

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    Branislava Velicki Bozejac

    Full Text Available Abstract Objective: The aim of this study was to investigate the incidence of carious lesions, the amount of salivary flow rate and pH value in patients with asthma and chronic obstructive pulmonary diseases (COPD, using inhalation therapy. The obtained results were compared with the results of adult healthy subjects, forming a control group. Material and Methods: The study included 80 participants aging between 18 and 65 years. The experimental group (EG was comprised of 40 participants, previously diagnosed with asthma or COPD undergoing inhalation therapy for more than five years. The control group (CG, comprised of 40 participants, mirrored the same age and gender status of the EG. Dental status was determined by decayed, missing, and filled teeth (DMFT index. Quantity and pH value of saliva were determined in the laboratory. Results: In the EG, the mean value of the salivary flow rate and pH value were statistically significantly lower than in the CG (p<0.001. Patients in the EG had a higher value of DMFT index when compared with the CG, although the difference was not statistically significant (p=0.199. Mean number of decayed teeth, as well as missing teeth, in the EG was statistically significantly higher than in the CG (p<0.001. Mean number of filled teeth in the EG was statistically significantly lower than in the CG (p<0.001. Conclusion: It was found that patients undergoing inhalation therapy face increasing risk of dental caries due to the lower salivary flow rate and pH value along with the inhalation therapy. They should receive intensive preventive care, including oral hygiene instruction and dietary advice.

  11. Practitioner, patient and carious lesion characteristics associated with type of restorative material: findings from The Dental Practice-Based Research Network.

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    Makhija, Sonia K; Gordan, Valeria V; Gilbert, Gregg H; Litaker, Mark S; Rindal, D Brad; Pihlstrom, Daniel J; Qvist, Vibeke

    2011-06-01

    The authors conducted a study to identify factors associated with the materials that dentists in The Dental Practice-Based Research Network (DPBRN) use when placing the first restoration on permanent posterior tooth surfaces. A total of 182 DPBRN practitioner-investigators provided data regarding 5,599 posterior teeth with caries. Practitioner-investigators completed an enrollment questionnaire that included the dentist's age, sex, practice workload, practice type and number of years since graduation. When patients who had provided informed consent to participate in the investigation sought treatment for a previously unrestored carious surface, the practitioner-investigator recorded patient and tooth characteristics. Practitioner-investigators used amalgam more often than they used direct resin-based composite (RBC) for posterior carious lesions. Practitioner and practice characteristics (years since graduation and type of practice); patient characteristics (sex, race, age and dental insurance status); and lesion characteristics (tooth location and surface, preoperative and postoperative lesion depth) were associated with the type of restorative material used. Several practitioner and practice, patient and lesion characteristics were associated significantly with use of amalgam and RBC: geographical region, years since dentist's graduation, patient's dental insurance status, tooth location and surface, and preoperative and postoperative lesion depth. Despite advances in esthetic dentistry, U.S. dentists still are placing amalgam on posterior teeth with carious lesions. Amalgam was used more often than RBC in older patients, who may have had deeper carious lesions.

  12. Prevalence and risk factors for non-carious cervical lesions in children attending special needs schools in India.

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    Kumar, Sandeep; Kumar, Arunoday; Debnath, Nitai; Kumar, Amit; K Badiyani, Bhumika; Basak, Debashish; S A Ali, Mohamed; B Ismail, Mohammed

    2015-03-01

    We assessed the prevalence and risk factors for development of non-carious cervical lesions (NCCLs) in children attending special needs schools in India. The participants were 395 children aged 12-15 years with disabilities in learning, communication, physical function, and/or development. A questionnaire was designed in order to collect information on sociodemographic characteristics, oral hygiene practices, dietary habits, and risk factors for NCCLs. The chi-square test, bivariate analysis, and logistic regression analysis were used to analyze the data. Presence of NCCLs was associated with use of toothpowder or other materials for teeth cleaning, use of harder toothbrushes, use of a horizontal scrub technique for toothbrushing, consumption of a vegetarian diet, and greater consumption of lemon. The overall prevalence of NCCLs was 22.7%. Most lesions involved minimal loss of contour or defects children attending special needs schools.

  13. Efficacy of 1.23% APF gel applications on incipient carious lesions: a double-blind randomized clinical trial

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    Maria Laura Menezes Bonow

    2013-06-01

    Full Text Available The aim of this double-blind randomized clinical trial was to evaluate the efficacy of 1.23% APF gel application on the arrest of active incipient carious lesions in children. Sixty 7- to 12-year-old children, with active incipient lesions were included in the study. Children were divided randomly into 2 groups: 1.23% APF gel and placebo gel applications. Each group received 8 weekly applications of treatment. The lesions were re-evaluated at the 4th and 8th appointments. Poisson regression analysis was used to estimate relative risks of the presence of active white spot lesions. Groups showed similar results (PR = 1.67; CI 95% 0.69–3.98. The persistence of at least 1 active lesion was associated with a higher number of lesions in the baseline (PR = 2.67; CI 95% 1.19–6.03, but not with sugar intake (PR = 1.06; CI 95% 0.56–2.86 and previous exposure to fluoride dentifrice (PR = 1.26; CI 95% 0.49–2.29. The trial demonstrates the equivalence of the treatments. The use of the APF gel showed no additional benefits in this sample of children exposed to fluoridated water and dentifrice. The professional dental plaque removal in both groups may also account for the resulting equivalence of the treatments.

  14. The non-operative resin treatment of proximal caries lesions.

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    Ekstrand, Kim; Martignon, Stefania; Bakhshandeh, Azam; Ricketts, David N J

    2012-11-01

    Epidemiological data show that the prevalence of caries on proximal surfaces in need of operative treatment is very high around the world, both in the primary and the permanent dentition. This article presents two new treatment methods: proximal sealing and proximal infiltration. The indications are progressing proximal caries lesions, radiographically with a depth around the enamel-dentine junction. A small number of studies regarding the effect of sealing and infiltration on proximal caries versus the use of fluoride varnish, placebo treatment and flossing instructions have been carried out. About half of the studies disclose a not significant difference between test and control treatment. In the other half, the therapeutic effect is significant and corresponds to about 30% reduction in lesion progression. However, longitudinal studies of longer duration are lacking. Proximal sealing and proximal infiltration may have a place in the treatment of non-cavitated proximal lesions. Proximal caries is a problem in both primary and permanent dentitions. Proximal sealants or lesion infiltration are possible treatments.

  15. Characteristics, detection methods, and treatment of questionable occlusal carious lesions: findings from The National Dental Practice-Based Research Network

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    Makhija, Sonia K; Gilbert, Gregg H.; Funkhouser, Ellen; Bader, James D; Gordan, Valeria V.; Rindal, D. Brad; Pihlstrom, Daniel J.; Qvist, Vibeke

    2014-01-01

    Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities, or staining. An earlier analysis of data from this study indicates ⅓ of patients have a QOC. The objective of this report is to quantify the characteristics of these common lesions, diagnostic aids used, and treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the United States and Denmark in The National Dental Practice-Based Research Network participated. When consented patients presented with a QOC, information was recorded about the patient, tooth, lesion, and treatments. 2,603 QOC from 1,732 patients were analyzed. Lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky luster and had a rough surface when examined with an explorer. There was an association between color and luster, 10% were chalky-light, 47% were shiny-dark, and 42% were mixtures. A higher proportion of chalky than shiny lesions were light (22% vs. 9%; p < 0.001). Lesions light in color were less common in adults than pediatric patients (9% vs. 32%; p < 0.001). Lesions that were chalky and light were more common among pediatric than adult patients (22% vs. 6%, p < 0.001). This is the first study to investigate characteristics of QOC in routine clinical practice. Clinicians commonly face this diagnostic uncertainty. Determining the characteristics of these lesions are relevant when making diagnostic and treatment decisions. PMID:24480989

  16. Restoration of non-carious cervical lesions with ceramic inlays: A possible model for clinical testing of adhesive cements

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    Michal Staninec

    2012-01-01

    Full Text Available Introduction: There are many luting cements coming to market which claim to be adhesive, but there is no clinical protocol currently for testing these claims. There is a standardized protocol for testing direct restorations bonded to dentin and it is used extensively. Case Report: We describe a clinical procedure for restoring a non-carious cervical lesion (NCCL with a ceramic inlay using Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM technology and an adhesive resin cement.The procedure was straightforward and the result was good at one month. Discussion: NCCL′s can be restored with CAD-CAM technology in one appointment. This technique can be used to clinically test adhesion of luting cements to dentin, similarly to the current standard for direct restorations.

  17. Carious lesions and maize consumption among the Prehispanic Maya: an analysis of a coastal community in northern Yucatan.

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    Cucina, Andrea; Cantillo, Cristina Perera; Sosa, Thelma Sierra; Tiesler, Vera

    2011-08-01

    Patterns of carious lesions were analyzed in the Classic period coastal Maya population of Xcambó, a salt production and administration center in northern Yucatan. To this end, the study investigated caries in the permanent dentitions of 163 adult skeletons, 23 from the Early Classic (AD 250-550) and 140 from the Late Classic period (AD 550-750), equally distributed between sexes. The archaeological and bioarchaeological evidence indicates a wealthy and socially homogeneous population dedicated to salt production and administration in the Early Classic that switched to pure administrative functions in the Late Classic. The results indicate an increase in caries from 7.4% and 21.2% (males and females respectively) from the Early Classic to 14.0% in males and 27.4% in females from the Late Classic period. The rate of caries in the Early and in the Late Classic phases of continuous occupation is not consistent with a simple interpretation of a heavier reliance on maize during the latter phase, characterized by a sedentary lifestyle, particularly for the male segment of the society now dedicated completely to the administration of the salt mines. Rather, the increase in caries rates in both sexes is best explained within a broader context of overall food habits, new cariogenic foods for both sexes, and the changes in lifestyle imposed by the increased socioeconomic role of the site. Our conclusions stress the limitations imposed by interpreting carious lesions solely in terms of single dietary components, such as maize consumption, without taking into account broader aspects of cultural and socioeconomic relevance. Copyright © 2011 Wiley-Liss, Inc.

  18. Diagnostic yield of ink-jet prints from digital radiographs for the assessment of approximal carious lesions: ROC-analysis

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    Schulze, Ralf K.W., E-mail: rschulze@mail.uni-mainz.de [Poliklinik fuer Zahnaerztliche Chirurgie, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, D-55131 Mainz (Germany); Grimm, Stefanie, E-mail: StefanieGrimm@gmx.de [Poliklinik fuer Zahnaerztliche Chirurgie, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, D-55131 Mainz (Germany); Schulze, Dirk, E-mail: dirk.schulze@uniklinik-freiburg.de [Klinik fuer Mund,- Kiefer- und Gesichtschirurgie, Sektion Roentgen, Universitaetsklinikum Freiburg, Hugstetterstr. 55, D-79106 Freiburg (Germany); Voss, Kai, E-mail: zahnarzt@drvoss.eu [Zahnaerztekammer Schleswig-Holstein, Vorstand fuer Praxisfuehrung, Westring 496, D- 24106 Kiel (Germany); Keller, Hans-Peter, E-mail: hans-peter.keller@din.de [NA Dental (NADENT) im DIN, Alexander-Wellendorff-Str. 2, D-75172 Pforzheim (Germany); Wedel, Matthias, E-mail: matthias.wedel@siemens.com [Siemens AG, Medical Solutions, Postfach 32 60, D-91050 Erlangen (Germany)

    2011-08-15

    Aims: To investigate the diagnostic quality of different quality, individually calibrated ink-jet printers for the very challenging dental radiographic task of approximal carious lesion detection. Materials and methods: A test-pattern evaluating resolution, contrast and homogeneity of the ink-jet prints was developed. 50 standardized dental radiographs each showing two neighbouring teeth in natural contact were printed on glossy paper with calibrated, randomly selected ink-jet printers (Canon S520 and iP4500, Epson Stylus Photo R2400). Printing size equalled the viewing size on a 17'' cathode-ray-tube monitor daily quality-tested according to German regulations. The true caries status was determined from serial sectioning and microscopic evaluation. 16 experienced observers evaluated the radiographs on a five-point confidence scale on all prints plus the viewing monitor with respect to the visibility of a carious lesion. A non-parametric Receiver-Operating Characteristics (ROC-) analysis was performed explicitly designed for the evaluation of readings stemming from identical samples but different modality. Significant differences are expressed by a critical ratio z exceeding {+-}2. Diagnostic accuracy was determined by the area (Az) underneath the ROC-curves. Results: Average Az-values ranged between 0.62 (S520 and R2400) and 0.64 (monitor, iP4500), with no significant difference between modalities (P = 0.172). Neither significant (range mean z: -0.40 (S520) and -0.11 (iP4500)) nor clinically relevant differences were found between printers and viewing monitor. Conclusions: Our results for a challenging task in dental radiography indicate that calibrated, off-the-shelf ink-jet printers are able to reproduce (dental) radiographs at quality levels sufficient for radiographic diagnosis in a typical dental working environment.

  19. Surface characteristics and lesion depth and activity of suspicious occlusal carious lesions: Findings from The National Dental Practice-Based Research Network.

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    Makhija, Sonia K; Shugars, Daniel A; Gilbert, Gregg H; Litaker, Mark S; Bader, James D; Schaffer, Rebecca; Gordan, Valeria V; Rindal, D Brad; Pihlstrom, Daniel J; Mungia, Rahma; Meyerowitz, Cyril

    2017-12-01

    A lesion on an occlusal tooth surface with no cavitation and no radiographic radiolucency but in which caries is suspected owing to surface roughness, opacities, or staining can be defined as a suspicious occlusal carious lesion (SOCL). The authors' objective was to quantify the characteristics of SOCLs and their relationship to lesion depth and activity after these lesions were opened surgically. Ninety-three dentists participated in the study. When a consenting patient had an SOCL, information was recorded about the tooth, lesion, treatment provided, and, if the SOCL was opened surgically, its lesion depth. The Rao-Scott cluster-adjusted χ 2 test was used to evaluate associations between lesion depth and color, roughness, patient risk, and luster. The authors analyzed 1,593 SOCLs. Lesion color varied from yellow/light brown (40%) to dark brown/black (47%), with 13% other colors. Most (69%) of SOCLs had a rough surface when examined with an explorer. Over one-third of the SOCLs (39%) were treated surgically. Of the 585 surgically treated SOCLs, 61% had dentinal caries. There were statistically significant associations between lesion depth and color (P = .03), luster (P = .04), and roughness (P = .01). The authors classified 52% of the patients as being at elevated caries risk. The authors found no significant associations between lesion depth and patient risk (P = .07). Although statistically significant, the clinical characteristics studied do not provide accurate guidance for making definitive treatment decisions and result in high rates of false positives. Given that 39% of the opened lesions did not have dentinal caries or were inactive, evidence-based preventive management is an appropriate alternative to surgical intervention. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  20. Resin infiltration of proximal caries lesions differing in ICDAS codes.

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    Paris, Sebastian; Bitter, Kerstin; Naumann, Michael; Dörfer, Christof E; Meyer-Lueckel, Hendrik

    2011-04-01

    Resin infiltration of non-cavitated proximal caries lesions has been shown to inhibit further demineralization. However, the effect of resin infiltration in cavitated lesions is unknown. Therefore, the aim of this in vitro study was to evaluate infiltration patterns of proximal caries lesions differing in International Caries Detection and Assessment System (ICDAS) codes. Extracted human molars and premolars showing proximal caries lesions with and without cavitations (ICDAS codes 2-5) were etched with 15% hydrochloric acid gel and resin infiltrated according to the manufacturer's instructions. Three sections from each lesion were prepared and analyzed using a dual-fluorescence staining technique and confocal microscopy. The dimensions of the demineralized and cavitated lesions areas, as well as the resin-infiltrated parts within these lesions, were measured. The demineralized parts were infiltrated from 73% to 100% (median values) but the cavities were filled only negligibly (0-5%). Teeth that had an ICDAS code of 5 showed a significantly lower percentage infiltration/filling of lesions compared to teeth with ICDAS codes of 2 and 3. It was concluded that under in vitro conditions the tested infiltrant penetrates most parts of the demineralized enamel but is not capable of filling up cavities and therefore the efficacy of caries infiltration, particularly in lesions with larger cavitations, might be impaired. © 2011 Eur J Oral Sci.

  1. Different protocols to produce artificial dentine carious lesions in vitro and in situ: hardness and mineral content correlation.

    Science.gov (United States)

    Moron, B M; Comar, L P; Wiegand, A; Buchalla, W; Yu, H; Buzalaf, M A R; Magalhães, A C

    2013-01-01

    This study compared dentine demineralization induced by in vitro and in situ models, and correlated dentine surface hardness (SH), cross-sectional hardness (CSH) and mineral content by transverse microradiography (TMR). Bovine dentine specimens (n = 15/group) were demineralized in vitro with the following: MC gel (6% carboxymethylcellulose gel and 0.1 M lactic acid, pH 5.0, 14 days); buffer I (0.05 M acetic acid solution with calcium, phosphate and fluoride, pH 4.5, 7 days); buffer II (0.05 M acetic acid solution with calcium and phosphate, pH 5.0, 7 days), and TEMDP (0.05 M lactic acid with calcium, phosphate and tetraethyl methyl diphosphonate, pH 5.0, 7 days). In an in situ study, 11 volunteers wore palatal appliances containing 2 bovine dentine specimens, protected with a plastic mesh to allow biofilm development. The volunteers dripped a 20% sucrose solution on each specimen 4 times a day for 14 days. In vitro and in situ lesions were analyzed using TMR and statistically compared by ANOVA. TMR and CSH/SH were submitted to regression and correlation analysis (p < 0.05). The in situ model produced a deep lesion with a high R value, but with a thin surface layer. Regarding the in vitro models, MC gel produced only a shallow lesion, while buffers I and II as well as TEMDP induced a pronounced subsurface lesion with deep demineralization. The relationship between CSH and TMR was weak and not linear. The artificial dentine carious lesions induced by the different models differed significantly, which in turn might influence further de- and remineralization processes. Hardness analysis should not be interpreted with respect to dentine mineral loss. Copyright © 2012 S. Karger AG, Basel.

  2. Comparison of visual, impedance spectroscopy and laser fluorescence methods in detecting early carious lesions on occlusal surfaces

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    Chalas Renata

    2014-06-01

    Full Text Available The diagnostic management is a very important and integral part of the entire treatment process and has a direct influence on the decision-taking on the choice of the most appropriate form of therapy consistent with current knowledge. Knowledge of the morphology of hard dental tissues lesions has led to the development of quantitative methods for diagnosis and monitoring of dental caries, which enabled the implementation of appropriate treatments aimed at repairing than replacing damaged tissue. The aim of the study was to compare selected diagnostic methods: visual (ICDAS, impedance spectroscopy (CarieScan PRO and laser fluorescence (Diagnodent Pen in detecting caries in grooves on the chewing surfaces of molars and premolars. The obtained results indicated a high concordance of measurements performed with the Diagnodent Pen with the results of visual examination and a lower compliance of visual examination with the results obtained using the CarieScan PRO. A combination of visual and tactile method with tests using advanced technology provides greater opportunity to confirm the diagnosis of carious lesions requiring medical intervention.

  3. Costs and effectiveness of treatment alternatives for proximal caries lesions.

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    Falk Schwendicke

    Full Text Available OBJECTIVES: Invasive therapy of proximal caries lesions initiates a cascade of re-treatment cycles with increasing loss of dental hard tissue. Non- and micro-invasive treatment aim at delaying this cascade and may thus reduce both the health and economic burden of such lesions. This study compared the costs and effectiveness of alternative treatments of proximal caries lesions. METHODS: A Markov-process model was used to simulate the events following the treatment of a proximal posterior lesion (E2/D1 in a 20-year-old patient in Germany. We compared three interventions (non-invasive; micro-invasive using resin infiltration; invasive using composite restoration. We calculated the risk of complications of initial and possible follow-up treatments and modelled time-dependent non-linear transition probabilities. Costs were calculated based on item-fee catalogues in Germany. Monte-Carlo-microsimulations were performed to compare cost-effectiveness of non- versus micro-invasive treatment and to analyse lifetime costs of all three treatments. RESULTS: Micro-invasive treatment was both more costly and more effective than non-invasive therapy, with ceiling-value-thresholds for willingness-to-pay between 16.73 € for E2 and 1.57 € for D1 lesions. Invasive treatment was the most costly strategy. Calculated costs and effectiveness were sensitive to lesion stage, patient's age, discounting rate and assumed initial treatment costs. CONCLUSIONS: Non- and micro-invasive treatments have lower long-term costs than invasive therapy of proximal lesions. Micro-invasive therapy had the highest cost-effectiveness for treating D1 lesions in young patients. Decision makers with a willingness-to-pay over 16.73 € and 1.57 € for E2 and D1 lesions, respectively, will find micro-invasive treatment more cost-effective than non-invasive therapy.

  4. Costs and effectiveness of treatment alternatives for proximal caries lesions.

    Science.gov (United States)

    Schwendicke, Falk; Meyer-Lueckel, Hendrik; Stolpe, Michael; Dörfer, Christof Edmund; Paris, Sebastian

    2014-01-01

    Invasive therapy of proximal caries lesions initiates a cascade of re-treatment cycles with increasing loss of dental hard tissue. Non- and micro-invasive treatment aim at delaying this cascade and may thus reduce both the health and economic burden of such lesions. This study compared the costs and effectiveness of alternative treatments of proximal caries lesions. A Markov-process model was used to simulate the events following the treatment of a proximal posterior lesion (E2/D1) in a 20-year-old patient in Germany. We compared three interventions (non-invasive; micro-invasive using resin infiltration; invasive using composite restoration). We calculated the risk of complications of initial and possible follow-up treatments and modelled time-dependent non-linear transition probabilities. Costs were calculated based on item-fee catalogues in Germany. Monte-Carlo-microsimulations were performed to compare cost-effectiveness of non- versus micro-invasive treatment and to analyse lifetime costs of all three treatments. Micro-invasive treatment was both more costly and more effective than non-invasive therapy, with ceiling-value-thresholds for willingness-to-pay between 16.73 € for E2 and 1.57 € for D1 lesions. Invasive treatment was the most costly strategy. Calculated costs and effectiveness were sensitive to lesion stage, patient's age, discounting rate and assumed initial treatment costs. Non- and micro-invasive treatments have lower long-term costs than invasive therapy of proximal lesions. Micro-invasive therapy had the highest cost-effectiveness for treating D1 lesions in young patients. Decision makers with a willingness-to-pay over 16.73 € and 1.57 € for E2 and D1 lesions, respectively, will find micro-invasive treatment more cost-effective than non-invasive therapy.

  5. Task-specific enhancement filters in storage phosphor images from the Vistascan system for detection of proximal caries lesions of known size.

    Science.gov (United States)

    Haiter-Neto, Francisco; Casanova, Marcia Spinelli; Frydenberg, Morten; Wenzel, Ann

    2009-01-01

    The aim was to compare original 8-bit images from the Vistascan storage phosphor plate system with images enhanced with specific filters for detection of proximal caries lesions and, further, to analyze the mutual sensitivity of the filtered images for different lesion sizes. One hundred sixty approximal noncavitated surfaces were radiographed using the Vistascan storage phosphor plate system. Original and enhanced (Fine, Caries1, and Caries2 filters) images were assessed by 6 observers who recorded the presence/absence of proximal carious lesions. Microscopy served to detect and measure true lesion size. One hundred one surfaces were sound, and 59 had lesions. The sensitivity of the Fine filter images was significantly higher than the Caries1 and Caries2 filter modalities (P Caries1 and Caries2 modalities. Both the Fine filter and the original images had a significantly higher specificity than the Caries2 modality (P Caries2 modality (P Caries1 modality (P detection of shallow carious lesion, because it showed less observer variability. The task-specific enhancement filters, Caries1 and Caries2, were less accurate than the original and Fine filter images and cannot be recommended for detection of the lesion sizes included in this study.

  6. Evidence for the occurrence of gingival recession and non-carious cervical lesions as a consequence of traumatic toothbrushing.

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    Heasman, Peter A; Holliday, Richard; Bryant, Andrew; Preshaw, Philip M

    2015-04-01

    To identify the best available evidence for the effect of toothbrushing on the initiation and progression of gingival recession and non-carious cervical lesions (NCCLs). A protocol was developed for the questions: Does traumatic toothbrushing, compared to normal toothbrushing, lead to an increased prevalence of non-inflammatory gingival recession? [FQ1] and NCCLs? [FQ2]. The search covered four electronic databases. Bibliographies of review articles, relevant texts, World and European Workshops were screened. Hand searches were performed of the Journals of Clinical Periodontology, Periodontology, Periodontal Research and IADR abstracts. A meta-analysis included 159 subjects and showed that subjects who used MTBs (manual toothbrush) had greater gingival recession after 12 months when compared with those using PTBs (powered toothbrush). Thirteen cross-sectional studies identified the most frequent toothbrushing factors associated with gingival recession as being toothbrushing frequency, a horizontal or scrub toothbrushing method, bristle hardness, toothbrushing duration and the frequency of changing a toothbrush. The principal toothbrushing factors associated with NCCLs were toothbrushing method and frequency. The data to support or refute the association between toothbrushing and gingival recession and NCCLs remain largely inconclusive. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Clinical evaluation of non-carious cervical lesion restorations using a HEMA-free adhesive: three-year results.

    Science.gov (United States)

    Burrow, M F

    2011-12-01

    The use of all-in-one resin-based adhesives in clinical practice has continued to increase. The aim of this study was to evaluate retention and marginal staining of a HEMA-free all-in-one adhesive Go! (SDI, Australia) and Ice resin composite in non-carious cervical lesions (NCCLs). Forty-one restorations were placed in 13 patients (age range 44-72 years). Human Ethics Committee approval from the University of Melbourne and Dental Health Services Victoria was obtained. Restorations were bonded and placed according to the manufacturer's instructions. Enamel etching was performed on NCCL margins after cleaning with pumice and water. Patients were recalled at six months and one, two and three years. Restorations were evaluated for retention and marginal staining, and photographic records of restorations were obtained. At three years, six patients were available for recall with 23 restoration sites reviewed. At the six-month recall, three restorations had been lost, with a further two lost at two years. At three years, an overall cumulative retention rate of 85% was calculated using survival analysis. Fifteen of the 23 restorations showed slight marginal staining. At three years, the overall retention rate of 85% indicates a satisfactory result for this new adhesive. Marginal staining was regarded as minimal. © 2011 Australian Dental Association.

  8. OCT assessment of non-cavitated occlusal carious lesions by variation of incidence angle of probe light and refractive index matching.

    Science.gov (United States)

    Park, Kyung-Jin; Haak, Rainer; Ziebolz, Dirk; Krause, Felix; Schneider, Hartmut

    2017-07-01

    This study evaluated (1) the detection and assessment of non-cavitated occlusal carious lesions by spectral domain optical coherence tomography (SD-OCT) and (2) the impact of varying angle of incidence (AI) of probe light and refractive index matching (RIM). Nine extracted human molars with 18 occlusal lesions (ICDAS code 2) were visually selected. 18 regions of interest (ROI) were imaged with SD-OCT under varying AI (0°, ±5°, ±10°, ±15°) and with/without application of glycerine at 0°. X-ray micro computed tomography (μCT) was used as a validation standard. μCT and OCT signals were categorized according to the lesion extent: 1-sound, 2-lesion limited to half of enamel, 3-lesion limited to enamel, 4-lesion into dentin. Agreement between both methods was assessed. Intra- and inter-examiner reproducibility analyses were conducted. Cohen's kappa coefficient (κ), Spearman's rho correlation (rs) and Wilcoxon test (α=0.05). Slight to moderate agreement (κ=0.153) between μCT and OCT was obtained at an AI of 0° (Wilcoxon: p=0.02). With variation of Al a substantial agreement (κ=0.607) was observed (p=0.74). Spearman's correlation between both methods was 0.428 at 0°, 0.75 with varying AI and 0.573 with glycerine. Kappa values for intra-and inter-examiner analysis ranged between 0.81 and 0.88 and between 0.25 and 0.73, respectively. Variation of AI improves the detectability of non-cavitated occlusal carious lesions. RIM can enhance signal-to-noise ratio. OCT could provide additional diagnostic information in single and longitudinal assessments of occlusal carious lesions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Remineralizing efficacy of Calcarea Fluorica tablets on the artificial carious enamel lesions using scanning electron microscope and surface microhardness testing: In vivostudy

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    Kalpana Bansal

    2014-01-01

    Conclusions: (1 Remineralization occurred in both the groups as indicated by SEM and the increase in surface hardness values in both the groups. (2 Remineralization of enamel samples in the control group as indicated by SEM and also by increase in VHN values indicated that the saliva has a tendency of remineralizing the early carious lesions. Conclusions drawn from the study are that the calc-f tablets can be used as safe and cost effective remineralizing agent.

  10. Diagnostic accuracy of Digital Bite Wing radiography in interproximal carious lesion detection of posterior teeth

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    Tahereh Shakeri

    2016-11-01

    Full Text Available Background and purpose: Dental decay is the most prevalent infectious disease. One of the dentists’ major disturbances is accurate diagnosis of small proximal decay in posterior teeth. Different diagnostic methods have been offered to detect decay since before. One of them is radiography that consists of different methods and machines. The purpose of this study was to evaluate the diagnostic accuracy of intra-oral digital radiography in detection of interproximal decay of posterior teeth. Materials and methods: This cross-sectional In vitro study was conducted with the 140 interproximal surfaces of patients’ molar as sample size. In half of them, decay was simulated by drilling and were mounted on the cast and then digital bite wing radiography was taken using PSP diagora optime sensor. Results: Diagnostic specifity was 71% and 69% for mesial and distal surfaces respectively. No significant relationships between detecting interproximal decays in mesial and distal surfaces of teeth were observed after statistical analysis using digital BW radiography. Conclusion: Results of this study concluded that there are no meaningful statistical differences in diagnosis of interproximal decays between mesial and distal surfaces of teeth while using BW radiography. Sensitivity and specialty of BW technique in diagnosing interproximal decays is lower than diagnosing decays larger than 0.5mm, however considering the positive and negative predictive value, this technique can still be used to for periodic examinations and patients` follow-ups in society due to its high sensitivity

  11. Absence of carious lesions at margins of glass-ionomer cement and amalgam restorations: An update of systematic review evidence

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    Yengopal Veerasamy

    2011-03-01

    Full Text Available Abstract Background This article aims to update the existing systematic review evidence elicited by Mickenautsch et al. up to 18 January 2008 (published in the European Journal of Paediatric Dentistry in 2009 and addressing the review question of whether, in the same dentition and same cavity class, glass-ionomer cement (GIC restored cavities show less recurrent carious lesions on cavity margins than cavities restored with amalgam. Methods The systematic literature search was extended beyond the original search date and a further hand-search and reference check was done. The quality of accepted trials was assessed, using updated quality criteria, and the risk of bias was investigated in more depth than previously reported. In addition, the focus of quantitative synthesis was shifted to single datasets extracted from the accepted trials. Results The database search (up to 10 August 2010 identified 1 new trial, in addition to the 9 included in the original systematic review, and 11 further trials were included after a hand-search and reference check. Of these 21 trials, 11 were excluded and 10 were accepted for data extraction and quality assessment. Thirteen dichotomous datasets of primary outcomes and 4 datasets with secondary outcomes were extracted. Meta-analysis and cumulative meta-analysis were used in combining clinically homogenous datasets. The overall results of the computed datasets suggest that GIC has a higher caries-preventive effect than amalgam for restorations in permanent teeth. No difference was found for restorations in the primary dentition. Conclusion This outcome is in agreement with the conclusions of the original systematic review. Although the findings of the trials identified in this update may be considered to be less affected by attrition- and publication bias, their risk of selection- and detection/performance bias is high. Thus, verification of the currently available results requires further high-quality randomised

  12. Stress Analysis of Occlusal Forces in Canine Teeth and Their Role in the Development of Non-Carious Cervical Lesions: Abfraction

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    Shihab A. Romeed

    2012-01-01

    Full Text Available Non-carious cervical tooth lesions for many decades were attributed to the effects of abrasion and erosion mainly through toothbrush trauma, abrasive toothpaste, and erosive acids. However, though the above may be involved, more recently a biomechanical theory for the formation of these lesions has arisen, and the term abfraction was coined. The aim of this study was to investigate the biomechanics of abfraction lesions in upper canine teeth under axial and lateral loading conditions using a three-dimensional finite element analysis. An extracted human upper canine tooth was scanned by μCT machine (Skyscan, Belgium. These μCT scans were segmented, reconstructed, and meshed using ScanIP (Simpleware, Exeter, UK to create a three-dimensional finite element model. A 100 N load was applied axially at the incisal edge and laterally at 45° midpalatally to the long axis of the canine tooth. Separately, 200 N axial and non-axial loads were applied simultaneously to the tooth. It was found that stresses were concentrated at the CEJ in all scenarios. Lateral loading produced maximum stresses greater than axial loading, and pulp tissues, however, experienced minimum levels of stresses. This study has contributed towards the understanding of the aetiology of non-carious cervical lesions which is a key in their clinical management.

  13. Detecting Proximal Secondary Caries Lesions: A Cost-effectiveness Analysis.

    Science.gov (United States)

    Schwendicke, F; Brouwer, F; Paris, S; Stolpe, M

    2016-02-01

    When choosing detection methods for secondary caries lesions, dentists need to weigh sensitivity, allowing early initiation of retreatments to avoid lesion progression, against specificity, aiming to reduce risks of false-positive diagnoses and invasive overtreatments. We assessed the cost-effectiveness of different detection methods for proximal secondary lesions using Monte Carlo microsimulations. A vital permanent molar with an occlusal-proximal restoration was simulated over the lifetime of an initially 20-y-old. Three methods were compared: biannual tactile detection, radiographic detection every 2 y, and biannual laser fluorescence detection. Methods were employed either on their own or in pairwise combinations at sensitive and specific thresholds estimated with systematically collected data. A mixed public-private payer perspective in the context of German health care was applied. Effectiveness was calculated as years of tooth retention. Net-benefit analyses were used to evaluate cost-effectiveness acceptability at different willingness-to-pay thresholds. Radiographic detection verified by tactile assessment (both at specific thresholds) was least costly (mean, 1,060 euros) but had limited effectiveness (mean retention time, 50 y). The most effective but also more costly combination was laser fluorescence detection verified by radiography, again at specific thresholds (1157 euros, 53 y, acceptable if willingness to pay >32 euro/y). In the majority of simulations, not combining detection methods or applying them at sensitive thresholds was less effective and more costly. Net benefits were not greatly altered by applying different discounting rates or using different baseline prevalence of secondary lesions. Current detection methods for secondary lesions should best be used in combination, not on their own, at specific thresholds to avoid false-positive diagnoses leading to costly and invasive overtreatment. The relevant characteristics, such as predictive

  14. Functional remineralization of carious dentin

    Science.gov (United States)

    Pugach, Megan Kardon

    A primary goal of dental tissue engineering is the biological reconstruction of tooth substrate destroyed by caries or other diseases affecting tooth mineralization. Traditionally, dentists treat caries by using invasive techniques to remove the diseased dental tissue and restore the lesion, ideally preventing further progression of decay. Success in strategies associated with remineralization of enamel and root caries have contributed to the less invasive prospect of remineralization of dentinal carious lesions. The central hypothesis of this dissertation is that carious dentin lesions can be remineralized if the lesions contain residual mineral. Caries Detector (CD) stained zones (pink, light pink, transparent and normal) of arrested carious dentin lesions were characterized according to microstructure by atomic force microscopy (AFM) imaging, mineral content by digital transverse microradiography, and nanomechanical properties by AFM-based nanoindentation. CD-stained and unstained zones had significantly different microstructure, mineral content and nanomechanical properties. Furthermore, the most demineralized carious zone contained residual mineral. To obtain reproducible, standardized dentin caries lesions, we characterized the lesions from an artificial carious dentin lesion model using a 0.05M acetate demineralization buffer. The artificial caries-like lesions produced by the buffer had similar mineral content and nanomechanical properties in the stained and unstained zones as natural dentin lesions. Both natural and artificial lesions had significant correlations between mineral content and nanomechanical properties. Mineral crystallite size and shape was examined by small angle x-ray scattering. Both natural and artificial carious dentin had different mineral sizes than normal dentin. Collagen in natural and artificial carious dentin lesions was examined by trichrome stain, AFM high-resolution imaging, and UV resonance Raman spectroscopy, to determine if

  15. Evaluation of clinical and radiological outcomes of mineral trioxide aggregate and calcium hydroxide as indirect pulp capping agents in the treatment of deep carious lesion of permanent teeth

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    Rafeza Sultana

    2016-09-01

    Full Text Available The maintenance of pulp vitality and conduction of reparative dentin can be possible by indirect pulp capping with mineral trioxide aggregate (MTA and calcium hydroxide as pulp capping agents. The objective of the study is to assess the clinical and radiological outcomes of MTA and calcium hydroxide as indirect pulp capping agents in deep carious lesions of permanent teeth. The present study included 50 permanent teeth having deep carious lesions with reversible pulp status were selected and then randomly divided into two groups of 25 teeth in a group. Standard indirect pulp capping procedures were followed. Patients were recalled at 3, 6 and 12 months interval to assess postoperative pain, the vitality of the pulp and formation of reparative dentin. In all observation periods, MTA showed more capable of reducing pain and maintain pulp vitality which was statistically significant than that of calcium hydroxide. At 12 months observation period, 24 teeth (96% of MTA and 19 teeth (76% of calcium hydroxide showed reparative dentin formation. It can be concluded that MTA is more effective than that of calcium hydroxide. 

  16. Assessing consequences of untreated carious lesions using pufa index among 5-6 years old school children in an urban Indian population

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    Abhishek Mehta

    2014-01-01

    Full Text Available Background: Dental caries is a major chronic noncommunicable disease affecting whole of mankind. Nontreatment of caries can have severe consequences such as pain, abscess formation, space infection, etc., which leads to loss of function, working hours or absence from school in children. These consequences are equally important, while planning dental care program for a community. Aim: The aim of this study is to assess the prevalence and severity of consequences of untreated carious lesions using pufa index that is, pulpal involvement, and ulcer due to root fragments, fistula, and abscess index among 5-6 year old school children in an urban Indian population. Materials and Methods: A cross-sectional survey was conducted on 603 school going children of 5-6 year age group in mainly an urban Indian population. Children from 12 randomly selected schools were examined for pufa and decayed extracted filled indices. Results and Conclusions: Overall mean pufa value was 0.9 ± 1.93 and prevalence was 38.6% with major contribution from P component of index. Untreated caries ratio was 35%, suggesting that more than one-third of the developed carious lesions cause adverse events in a population. This study emphasis the need for treating dental caries at its earliest possible stage to avoid severe consequences. The pufa index can be used as tool to highlight these adverse consequences to dental professionals and health authorities.

  17. Correlation of Streptococcus mutans and Streptococcus sanguinis colonization and ex vivo hydrogen peroxide production in carious lesion-free and high caries adults.

    Science.gov (United States)

    Giacaman, Rodrigo A; Torres, Sebastián; Gómez, Yenifer; Muñoz-Sandoval, Cecilia; Kreth, Jens

    2015-01-01

    This study was conducted to estimate oral colonization by Streptococcus mutans and Streptococcus sanguinis in adults with high and without any caries experience. Furthermore, differences in the amount of hydrogen peroxide (H2O2) produced by S. sanguinis isolated from both groups were assessed. Forty adults were divided into: (i) carious lesion-free, without any carious lesion, assessed by the International Caries Detection and Assessment System (ICDAS), or restoration, (CF) and (ii) high caries experience (HC). Saliva samples were collected and seeded on respective agar-plates for enumeration of total streptococci, S. mutans and S. sanguinis (CFU/mL) and compared between groups. Additionally, S. sanguinis colonies obtained from both groups were inoculated on Prussian blue agar for H2O2 detection. Production of H2O2 was quantified and compared between the two groups. S. sanguinis counts were significantly higher in CF than HC individuals (pmutans showed significantly higher levels in HC than CF subjects (pmutans in saliva of adults without caries experience. In those people, S. sanguinis produces more H2O2ex vivo. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Effect of enamel organic matrix on the potential of Galla chinensis to promote the remineralization of initial enamel carious lesions in vitro

    Energy Technology Data Exchange (ETDEWEB)

    Zhang Linglin; Zou Ling; Li Jiyao; Hao Yuqing; Xiao Liying; Zhou Xuedong; Li Wei, E-mail: leewei2000@sina.co, E-mail: zhll_sc@yahoo.c [State Key Laboratory of Oral Diseases, West China College of Stomatology, West China Hospital of Stomatology, Sichuan University, Chengdu (China)

    2009-06-15

    Galla chinensis, a natural traditional Chinese medicine with main composition of tannic acid and gallic acid, is formed when the Chinese sumac aphid Baker (Melaphis chinensis bell) parasitizes the levels of Rhus chinensis Mill. Galla chinensis has shown the potential to enhance the remineralization of initial enamel carious lesion, but the mechanism is still unknown. This study was to investigate whether the enamel organic matrix plays a significant role in the potential of Galla chinensis to promote the remineralization of initial enamel caries. Bovine sound enamel blocks and non-organic enamel blocks were demineralized and exposed to a 12 day pH cycling. During the pH cycling, 30 specimens with the enamel organic matrix were randomly divided into three groups, and treated with 1 g L{sup -1} NaF (group A), 4 g L{sup -1} Galla chinensis extract (group B1) or double deionized water (group C1). Twenty specimens without the enamel organic matrix were randomly divided into two groups, and treated with 4 g L{sup -1} Galla chinensis extract (group B2) or double deionized water (group C2). The integrated mineral loss and lesion depth of all the specimens were analysed by transverse microradiography. The integrated mineral loss and lesion depth of group B1 were less than those of groups B2, C1 and C2, and there were no statistical differences among groups B2, C1 and C2. In conclusion, Galla chinensis can enhance the remineralization of initial enamel carious lesion, and the enamel organic matrix plays a significant role in this potential of Galla chinensis.

  19. Clinical cavitation and radiographic lesion depth in proximal surfaces in an Indian population

    DEFF Research Database (Denmark)

    Sansare, Kaustubh; Raghav, Mamta; Sontakke, Subodeh

    2014-01-01

    Abstract Objectives. To assess the relationship between clinical cavitation and radiographic caries lesion depth in proximal surfaces of permanent posterior teeth in an Indian population. This study also assessed the clinical feasibility of applying 'western guidelines' to this population from...... the developing world. Materials and methods. Relationship between clinical cavitation and radiographic caries lesion depth in proximal surfaces in an Indian population was assessed. Proximal surfaces (n = 126) without restorations were examined on bitewing radiographs in patients with suspected caries and lesion...

  20. Resin infiltration of natural proximal caries lesions regarding different stages of disease in vitro

    OpenAIRE

    Büchting, Andrea

    2013-01-01

    INTRODUCTION: Resin infiltration provides a treatment option for non-cavitated proximal caries lesions. Although further demineralisation of early non-cavitated lesions can be hampered by this treatment, it is uncertain; weather caries infiltration of cavitated lesions is possible. Thus, this in vitro study aimed to evaluate the performance of resin infiltration regarding proximal caries lesions (n=72) differing in International Caries Detection and Assessment System (ICDAS) codes. METHOD...

  1. Resin composite plus connective tissue graft to treat single maxillary gingival recession associated with non-carious cervical lesion: randomized clinical trial.

    Science.gov (United States)

    Santamaria, Mauro Pedrine; Queiroz, Lucas Araújo; Mathias, Ingrid Fernandes; Neves, Felipe Lucas da Silva; Silveira, Camila Augusto; Bresciani, Eduardo; Jardini, Maria Aparecida Neves; Sallum, Enilson Antônio

    2016-05-01

    To evaluate clinically, the aesthetics and the patient-centred parameters after the treatment of gingival recession associated with non-carious cervical lesion by connective tissue graft alone or combined with a nanofilled resin composite restoration. Thirty-six patients presenting one Miller Class I or II gingival recessions and B+ tooth cervical defect were included. The defects were treated by either connective tissue graft (CTG: control group; n = 18) or connective tissue graft plus resin composite restoration (CTG+RC: test group; n = 18). The mean percentage of defect coverage was 82.16 ± 16.1% for CTG and 73.84 ± 19.2% for CTG+RC after 1 year (p > 0.05). Both groups presented statistically significant improvements in two aesthetics evaluations. The professional evaluation (MRES) was 7.44 ± 2.3 for the CTG group and 7.52 ± 2.27 for CTG+RC after 1 year, with no significant difference between the groups. The two groups presented significant reduction of dentin sensitivity (DS), it decreased from 94.4% of the sites to 44.4% in the CTG group and from 88.8% to 5.5% in the CTG+RC group. CTG or CTG+RC can successfully treat gingival recession associated with B+ non-carious cervical lesion, but less sensitivity may be expected with the combined approach (NCT02423473). © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Bacteriology of deep carious lesions underneath amalgam restorations with different pulp-capping materials - an in vivo analysis

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    Prasanna Neelakantan

    2012-04-01

    Full Text Available Microorganisms remaining in dentin following cavity preparation may induce pulp damage, requiring the use of pulp-capping agents with antimicrobial activity underneath permanent restorations. OBJECTIVE: The aims of this study were to analyze the bacteriological status of carious dentin and to assess the efficacy of different base underneath silver amalgam restorations. MATERIAL AND METHODS: This study was conducted on 50 patients aged 13 to 30 years. Sterile swabs were used to take samples after cavity preparation, which was assessed by microbiological culture to identify the microorganisms present. Following this, cavities were restored with silver amalgam, using one of the materials being investigated, as the base: calcium hydroxide (Group II, polyantibiotic paste (Group III, a novel light-cured fluoride-releasing hydroxyapatite-based liner (Group IV and mineral trioxide aggregate - MTA (Group V. In Group I, the cavities were restored with silver amalgam, without any base. After 3 months, the amalgam was removed and samples taken again and analyzed for the microbial flora. RESULTS: Lactobacilli were the most commonly isolated microorganisms in the samples of carious dentin. Groups IV and V showed negative culture in the 3-month samples. There was no statistically significant difference between Groups I, II and III. There was no significant difference between Groups IV and V (p>0.05. Both Groups IV and V showed significantly better results when compared to Groups I, II and III (p<0.05. CONCLUSIONS: The hydroxyapatite-based liner and MTA performed significantly better in terms of antibacterial activity than the other materials.

  3. Comparison between one-step self-etch adhesive and along with additional hydrophobic layer in the retention of giomer at non-carious cervical lesion

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    Sultana Parveen

    2017-09-01

    Full Text Available The purpose of the present study was to assess the giomer retention following application of one step self etch adhesive and one-step self-etch adhesive plus an extra hydrophobic adhesive layer in non-carious cervical lesion. Twenty four participants having bilateral cervical lesion at the maxillary premolars teeth were selected. Following cleaning of the cervical lesions, 24 left premolar teeth were restored with giomer by using the one-step self-etch system (Group A and 24 right premolar teeth were restored with giomer by using one-step self-etching plus extra hydrophobic adhesive layer (Group B. Participants were recalled at 6 and 15 months for evaluating the clinical outcome. The results showed that at 15 months, 18 giomer restorations in Group A and 21 in Group B were intact inside the cavity and no significant difference was found between the two groups. It can be concluded that giomer restoration used with one-step self- etching plus additional adhesive layer slightly improved the retention of the material.

  4. Identification of Lactobacilli from deep carious lesions by means of species-specific PCR and MALDI-TOF mass spectrometry.

    Science.gov (United States)

    Callaway, Angelika; Kostrzewa, Markus; Willershausen, Brita; Schmidt, Frank; Thiede, Bernd; Küpper, Harald; Kneist, Susanne

    2013-01-01

    The aim of the present study was to compare MALDI-TOF results for the identification of 87 lactobacilli, isolated from soft or hard carious dentin from 70 first molars of 7- to 8-year-old children with those obtained by species-specific PCR. The 87 isolates were analyzed by MALDI-TOF MS (Microflex LT, MALDI Biotyper 3.0, Bruker Daltonik, Bremen, Germany), using a reference data base of 4110 strains including > 90 lactobacillus species. For the identification with species-specific PCR, oligonucleotide primers (16S rRNA) specific for L. casei, L. paracasei, L. rhamnosus, L. gasseri, L. plantarum, and L. acidophilus were used; type strains served as controls. The PCR-products were separated electrophoretically on a 1.5% agarose gel and identified by their position on the gel. For 93% of the strains both methods produced concordant results: 40 strains were identified as L. rhamnosus, 16 as L. paracasei subsp. paracasei, 15 as L. paracasei subsp. tolerans, 4 as L. paracasei, 3 as L. gasseri, 2 as L. plantarum, and 1 as L. casei. In 4.5% of the cases the results were discordant. Of the 3 strains, not identified by species-specific PCR, 1 strain was identified by MALDI-TOF MS as L. spec. and 1 as L. parabuchneri. One strain could not be identified by either method. Both methods are highly sensitive. Limitations can be the precision of the primers (PCR) or the scarcity of strains from a certain habitat in the data base. Additional information is necessary for the strains without or with discordant identification.

  5. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study

    Science.gov (United States)

    Sawant, Ajinkya; Chunawalla, Yusuf; Morawala, Abdul; Jain, Kapil; Talathi, Rohan

    2017-01-01

    Background Early childhood caries discloses a distinct clinical pattern, and the teeth most often involved are the maxillary central incisors, lateral incisors, and the maxillary and man-dibular first molars. The maxillary incisors are most severely affected, with deep carious lesions usually involving the pulp. Teeth that have been endodontically treated often have little coronal tooth tissue remaining and as such require a post to retain the core and restoration .This study evaluated and compared the efficacy of EverStick glass fiber-reinforced composite post with ParaPost Taper Lux in primary maxillary anterior teeth. Aim An in vivo study was conducted to evaluate and compare the longevity and failures of two fiber post systems in primary maxillary anterior teeth. Materials and methods A total of 60 severely mutilated primary maxillary anterior teeth from children aged 3 to 5 years were selected according to the inclusion criteria. These teeth were treated endodontically and were randomly assigned into two groups with 30 samples in each group, group I: EverStick glass fiber-reinforced composite post, group II: ParaPost Taper Lux post. The evaluation of dislodgment of posts, secondary caries, root fracture, and post fracture was carried out clinically and radiographically during every follow-up at 3, 6, 9, and 12 months interval. Results Statistical tests (Chi-square test, Fisher’s exact probability test) suggested that dislodgment of the posts was significant between the two groups at 6, 9, and 12 months follow-ups. But within the group during subsequent follow-up intervals, dislodgment of posts as a mode of failure was not statistically significant. However, clinically failures were seen in both the study groups. Conclusion Fiber post system has proved to be successful clinically in both primary and permanent teeth due to the mono-block effect with luting agent, post system, core material, and bonding to dentin. Thus, today the EverStick glass fiber post

  6. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study.

    Science.gov (United States)

    Sawant, Ajinkya; Chunawalla, Yusuf; Morawala, Abdul; S Kanchan, Nupur; Jain, Kapil; Talathi, Rohan

    2017-01-01

    Early childhood caries discloses a distinct clinical pattern, and the teeth most often involved are the maxillary central incisors, lateral incisors, and the maxillary and man-dibular first molars. The maxillary incisors are most severely affected, with deep carious lesions usually involving the pulp. Teeth that have been endodontically treated often have little coronal tooth tissue remaining and as such require a post to retain the core and restoration .This study evaluated and compared the efficacy of EverStick glass fiber-reinforced composite post with ParaPost Taper Lux in primary maxillary anterior teeth. An in vivo study was conducted to evaluate and compare the longevity and failures of two fiber post systems in primary maxillary anterior teeth. A total of 60 severely mutilated primary maxillary anterior teeth from children aged 3 to 5 years were selected according to the inclusion criteria. These teeth were treated endodontically and were randomly assigned into two groups with 30 samples in each group, group I: EverStick glass fiber-reinforced composite post, group II: ParaPost Taper Lux post. The evaluation of dislodgment of posts, secondary caries, root fracture, and post fracture was carried out clinically and radiographically during every follow-up at 3, 6, 9, and 12 months interval. Statistical tests (Chi-square test, Fisher's exact probability test) suggested that dislodgment of the posts was significant between the two groups at 6, 9, and 12 months follow-ups. But within the group during subsequent follow-up intervals, dislodgment of posts as a mode of failure was not statistically significant. However, clinically failures were seen in both the study groups. Fiber post system has proved to be successful clinically in both primary and permanent teeth due to the mono-block effect with luting agent, post system, core material, and bonding to dentin. Thus, today the EverStick glass fiber post system provides a novel way of fabricating cost-effective and

  7. Diagnostic accuracy of cone beam computed tomography compared with intraoral radiography for the detection of noncavitated occlusal carious lesions.

    Science.gov (United States)

    Krzyżostaniak, Joanna; Surdacka, Anna; Kulczyk, Tomasz; Dyszkiewicz-Konwińska, Marta; Owecka, Magdalena

    2014-01-01

    The aim of this study was to evaluate the accuracy of cone beam computed tomography (CBCT) in the detection of noncavitated occlusal caries lesions and to compare this accuracy with that observed with conventional radiographs. 135 human teeth, 67 premolars and 68 molars with macroscopically intact occlusal surfaces, were examined by two independent observers using the CBCT system: NewTom 3G (Quantitative Radiology) and intraoral conventional film (Kodak Insight). The true lesion diagnosis was established by histological examination. The detection methods were compared by means of sensitivity, specificity, predictive values and accuracy. To assess intra- and interobserver agreement, weighted kappa coefficients were computed. Analyses were performed separately for caries reaching into dentin and for all noncavitated lesions. For the detection of occlusal lesions extending into dentin, sensitivity values were lower for film (0.45) when compared with CBCT (0.51), but the differences were not statistically significant (p > 0.19). For all occlusal lesions sensitivity values were 0.32 and 0.22, respectively, for CBCT and film. The specificity scores were high for both modalities. Interobserver agreement amounted to 0.93 for the CBCT system and to 0.87 for film. It was concluded that the use of the 9-inch field of view NewTom CBCT unit for the diagnosis of noncavitated occlusal caries cannot be recommended. © 2014 S. Karger AG, Basel.

  8. Comparing natural and artificial carious lesions in human crowns by means of conventional hard x-ray micro-tomography and two-dimensional x-ray scattering with synchrotron radiation

    Science.gov (United States)

    Botta, Lea Maria; White, Shane N.; Deyhle, Hans; Dziadowiec, Iwona; Schulz, Georg; Thalmann, Peter; Müller, Bert

    2016-10-01

    Dental caries, one of the most prevalent infectious bacterial diseases in the world, is caused by specific types of acid-producing bacteria. Caries is a disease continuum resulting from the earliest loss of ions from apatite crystals through gross cavitation. Enamel dissolution starts when the pH-value drops below 5.5. Neutralizing the pH-value in the oral cavity opposes the process of demineralization, and so caries lesions occur in a dynamic cyclic de-mineralizing/remineralizing environment. Unfortunately, biomimetic regeneration of cavitated enamel is not yet possible, although remineralization of small carious lesions occurs under optimal conditions. Therefore, the development of methods that can regenerate carious lesions, and subsequently recover and retain teeth, is highly desirable. For the present proceedings we analyzed one naturally occurring sub-surface and one artificially produced lesion. For the characterization of artificial and natural lesions micro computed tomography is the method of choice when looking to determine three-dimensional mineral distribution and to quantify the degree of mineralization. In this pilot study we elucidate that the de-mineralized enamel in natural and artificially induced lesions shows comparable X-ray attenuation behavior, thereby implying that the study protocol employed herein seems to be appropriate. Once we know that the lesions are comparable, a series of well-reproducible in vitro experiments on enamel regeneration could be performed. In order to quantify further lesion morphology, the anisotropy of the enamel's nanostructure can be characterized by using spatially resolved, small-angle X-ray scattering. We wanted to demonstrate that the artificially induced defect fittingly resembles the natural carious lesion.

  9. A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and restorative material

    DEFF Research Database (Denmark)

    van Dijken, Jan W V; Pallesen, Ulla

    2012-01-01

    Objective: The aim of this study was to evaluate the clinical retention of a one-step self-etching adhesive system (Xeno III) in Class V non-carious cervical lesions and the effect of restorative material and curing techniques on longevity of the restorations. Material and methods: A total of 139...... be evaluated. No post-operative sensitivity was reported by the participants. Overall relative cumulative loss rate frequencies for the adhesive system at 6, 18 and 7 years, independent of curing technique and restorative material, were 0.8%, 6.9% and 23.0%, respectively. The self-etching adhesive fulfilled...... Class V restorations were placed with the self-etching primer Xeno III and a resin composite (Tetric Ceram) or a poly-acid modified resin composite (Dyract AP) in non-carious cervical lesions without intentional enamel involvement. The materials were cured with a conventional continuous light, a soft...

  10. Should cavitation in proximal surfaces be reported in cone beam computed tomography examination?

    DEFF Research Database (Denmark)

    Sansare, K; Singh, D; Sontakke, S

    2014-01-01

    Aim: A clinical study was done to assess the clinical diagnostic accuracy of cone beam computed tomography (CBCT) in detecting proximal cavitated carious lesions in order to determine whether cavitation should be reported when a CBCT examination is available. Materials and Methods: 79 adjacent...... proximal surfaces without restorations in permanent teeth were examined. Patients suspected to have carious lesions after a visual clinical and a bitewing examination participated in a CBCT examination (Kodak 9000 3D, 5 × 3.7 cm field of view, voxel size 0.07 mm). Ethical approval and informed consent were...... higher for CBCT than for bitewings (average difference 33%, p proximal surfaces...

  11. Depth and activity of carious lesions as indicators for the regenerative potential of dental pulp after intervention.

    Science.gov (United States)

    Bjørndal, Lars; Demant, Sune; Dabelsteen, Sally

    2014-04-01

    Studies on dental regeneration involving interventions for pulp therapy such as regeneration and revascularization procedures are promising for the injured tooth; however, a complete replication of the original pulp tissue does not seem to take place. In cases in which we wish to preserve or maintain parts of the pulp during treatment, it is apparent that the effectiveness of healing or biological regeneration is dependent on the degree of inflammation of the pulp tissue. Thus, the control or prevention of a pulp infection is still a major issue for the clinicians. Data indicate that the typical reason for performing endodontic treatment is deep caries. The biological concept of vital pulp therapy associated with deep caries takes the treatment and evaluation of the unexposed as well as the exposed pulp into account. Interestingly, the clinical diagnosis is typically the same. Deep caries with reversible pulpitis may receive differing treatments such as excavation procedures aiming to avoid pulp exposure or more pulp invasive treatments such as pulp capping or pulpotomy. This should not be the case. Consequently, huge treatment variation is noted among clinicians based on the same caries diagnosis. Which treatment should be selected? High-quality trials are needed, and it is important to obtain information on the actual lesion depth and an estimate of the lesion activity before treatment. These may be basic indicators for the regenerative potential of dental pulp. Recent clinical trials dealing with the treatment of deep caries lesion are discussed, including pulp invasive and noninvasive concepts, to attempt to solve the task of getting the best clinical outcome for adult patients. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  12. Characterization of a human tooth with carious lesions using conventional and synchrotron radiation-based micro computed tomography

    Science.gov (United States)

    Dziadowiec, Iwona; Beckmann, Felix; Schulz, Georg; Deyhle, Hans; Müller, Bert

    2014-09-01

    In a dental office, every day X rays of teeth within the oral cavity are obtained. Caries induces a mineral loss and, therefore, becomes visible by reduced X-ray absorption. The detailed spatial distribution of the mineral loss, however, is inaccessible in conventional dental radiology, since the dose for such studies is intolerable. As a consequence, such measurements can only be performed after tooth extraction. We have taken advantage of synchrotron radiation-based micro computed tomography to characterize a human tooth with a rather small, natural caries lesion and an artificially induced lesion provoked by acidic etching. Both halves of the tooth were separately visualized from 2400 radiographs recorded at the beam line P07 / PETRA III (HASYLAB at DESY, Hamburg, Germany) with an asymmetric rotation axis at photon energy of 45 keV. Because of the setup, one finds an energy shift in the horizontal plane, to be corrected. After the appropriate three-dimensional registration of the data with the ones of the same crown using the better accessible phoenix nanotom® m of General Electric, Wunstorf, Germany, one can determine the joint histogram, which enable to calibrate the system with the conventional X-ray source.

  13. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions.

    Science.gov (United States)

    Lawson, Nathaniel C; Robles, Augusto; Fu, Chin-Chuan; Lin, Chee Paul; Sawlani, Kanchan; Burgess, John O

    2015-10-01

    To compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs). 37 adults were recruited with 3 or 6 NCCLs (>1.5mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan-Meier method was used to compare the retention between adhesive materials. Clinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (pself-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively. Scotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively. 24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. [Clinical evaluation of a two-step etch-and-rinse adhesive and a one-step self-etch adhesive in non-carious cervical lesion].

    Science.gov (United States)

    Tian, Fu-cong; Wang, Xiao-yan; Gao, Xue-jun

    2014-02-18

    To compare the clinical effectiveness of the two-step etch-and-rinse with the one-step self-etch adhesive in non-carious cervical lesions. Fifty patients were selected, each with at least two wedge-shaped defects in the mouth. The paired defects were randomly bonded either with the two-step etch-and-rinse adhesive α or the one-step self-etch adhesive β and then restored with resin composite. The treatment was carried out by one practitioner according to standard procedures. The evaluation was performed by another practitioner according to modified United States Public Health Service (USPHS) criteria at one week, six months and eighteen months after treatment. Chi-square test was used for statistical analysis. Fifty restorations were placed for each group. Forty-eight patients attended the six months recall, with two restorations loss for each group. Forty-four patients attended the eighteen months recall, with accumulative four restorations loss for adhesive α and six restorations loss for adhesive β. The retention rate was 90.0% for group α and 86.4% for group β. Marginal adaptation of three restorations in group α and five restorations in group β were scored Bravo; while for marginal discoloration, two restorations in group α and three restorations in group β were scored Bravo respectively. No secondary caries and post-operative sensitivity occurred for any of the restorations after eighteen months. No significant difference was detected between the groups for any evaluation criteria (P > 0.05). Within the observation period of this study, the two-step etch-and-rinse adhesive and the one-step self-etch adhesive showed similar clinical performance. The long term follow-up is still warranted.

  15. 2-year Clinical evaluation of sodium hypochlorite treatment in the restoration of non-carious cervical lesions: a pilot study.

    Science.gov (United States)

    Saboia, Vicente de Paulo Aragão; Almeida, Paulo César; Rittet, André V; Swift, Edward J; Pimenta, Luiz André Freire

    2006-01-01

    This pilot study evaluated the effect of removing acid-etch-exposed dentin collagen on the clinical performance of composite restorations of noncarious cervical lesions placed using 2 different adhesive systems. Fifty-six restorations were placed in 14 subjects, each subject receiving at least 4 restorations. No cavity preparation or mechanical retention form was used. The variables tested were: 1) dentin treatment prior to application of the adhesive (acid-etch only vs acid-etch and collagen removal) and 2) type of adhesive (acetone- vs ethanol-based). For the acid-etch only groups, enamel and dentin were etched with 37% phosphoric acid for 15 seconds, rinsed and blot dried. Prime & Bond 2.1 (Dentsply Caulk) or Single Bond (3M ESPE) was applied and light-cured according to the manufacturer's instructions. For the acid-etch and collagen removal groups, the enamel and dentin were etched and rinsed in the same manner and a 10% sodium hypochlorite (NaOCl) solution was applied for 60 seconds and rinsed before adhesive application. Filtek Z-250 (3M ESPE) was applied to all specimens and light-cured according to the manufacturer's instructions, and the restorations were finished and polished immediately. The restorations were evaluated for pre- and post-operative sensitivity, retention, marginal staining and secondary caries at baseline, 12 and 24 months after placement, using modified USPHS criteria. Data were analyzed using the Kruskal-Wallis and Wilcoxon statistical tests (p=0.05). At 24 months, the retention rates for Prime & Bond 2.1 with and without NaOCl pretreatment were 80% and 63%, respectively. The corresponding retention rates for Single Bond were 70% and 90%. Marginal staining was minimal. Statistical analyses revealed no significant differences at any time interval between groups for retention or marginal staining. No post-operative sensitivity or secondary caries was detected during the study.

  16. Restoring proximal caries lesions conservatively with tunnel restorations

    Directory of Open Access Journals (Sweden)

    Chu CH

    2013-07-01

    Full Text Available Chun-Hung Chu1, May L Mei,1 Chloe Cheung,1 Romesh P Nalliah2 1Faculty of Dentistry, The University of Hong Kong, Hong Kong, People's Republic of China; 2Department of Restorative Dentistry and Biomaterials Sciences, Harvard School of Dental Medicine, Boston, MA, USA Abstract: The tunnel restoration has been suggested as a conservative alternative to the conventional box preparation for treating proximal caries. The main advantage of tunnel restoration over the conventional box or slot preparation includes being more conservative and increasing tooth integrity and strength by preserving the marginal ridge. However, tunnel restoration is technique-sensitive and can be particularly challenging for inexperienced restorative dentists. Recent advances in technology, such as the contemporary design of dental handpieces with advanced light-emitting diode (LED and handheld comfort, offer operative dentists better vision, illumination, and maneuverability. The use of magnifying loupes also enhances the visibility of the preparation. The advent of digital radiographic imaging has improved dental imaging and reduced radiation. The new generation of restorative materials has improved mechanical properties. Tunnel restoration can be an option to restore proximal caries if the dentist performs proper case selection and pays attention to the details of the restorative procedures. This paper describes the clinical technique of tunnel restoration and reviews the studies of tunnel restorations. Keywords: operative, practice, tunnel preparation, composite, amalgam, glass ionomer

  17. The reliability and accuracy of two methods for proximal caries detection and depth on directly visible proximal surfaces: an in vitro study

    DEFF Research Database (Denmark)

    Ekstrand, K R; Alloza, Alvaro Luna; Promisiero, L

    2011-01-01

    This study aimed to determine the reliability and accuracy of the ICDAS and radiographs in detecting and estimating the depth of proximal lesions on extracted teeth. The lesions were visible to the naked eye. Three trained examiners scored a total of 132 sound/carious proximal surfaces from 106...... primary teeth and 160 sound/carious proximal surfaces from 140 permanent teeth. The selected surfaces were first scored visually, using the 7 classes in the ICDAS. They were then assessed on radiographs using a 5-point classification system. Reexaminations were conducted with both scoring systems. Teeth...... and the radiographs. The associations between the 2 detection methods were measured to be moderate. In particular, the ICDAS was accurate in predicting lesion depth (histologically) confined to the enamel/outer third of the dentine versus deeper lesions. This study shows that when proximal lesions are open...

  18. A 13-year clinical evaluation of two three-step etch-and-rinse adhesives in non-carious class-V lesions.

    Science.gov (United States)

    Peumans, Marleen; De Munck, Jan; Van Landuyt, Kirsten L; Poitevin, Andre; Lambrechts, Paul; Van Meerbeek, Bart

    2012-02-01

    This 13-year randomized clinical trial compared the clinical effectiveness of two three-step etch-and-rinse adhesives in combination with a hybrid, stiffer composite versus a micro-filled, more flexible composite. The influence of composite stiffness on the clinical performance of one of the adhesives was assessed as well. One hundred and forty-two non-carious cervical lesions were restored with composites with contrasting stiffness. Seventy-one patients randomly received two cervical restorations placed following two out of three adhesive procedures: (1) the three-step etch-and-rinse adhesive Permaquick applied with the stiff micro-hybrid composite Amelogen Hybrid (PMQ-H, Ultradent), (2) Permaquick applied with the more flexible micro-filled Amelogen Microfill (PMQ-M, Ultradent), or (3) the "gold-standard" three-step etch-and-rinse adhesive Optibond FL applied with the micro-hybrid composite Prodigy (OFL-P, Kerr). The restorations were evaluated after 6 months, 1, 2, 3, 5, 7, and 13 years of clinical service regarding their retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality, and post-operative sensitivity. Retention loss, severe marginal defects, and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. The recall rate at 13 years was 77%. Bond degradation after 13 years was mainly characterized by a further increase in the presence of small but clinically acceptable marginal defects and superficial marginal discoloration. Twelve percent of the OFL-P restorations were clinically unacceptable. In the PMQ group, 22% of the PMQ-M restorations and 26% of the PMQ-H restorations needed repair or replacement. Regarding the clinical failure rate, Optibond FL scored significantly better than Permaquick (McNemar; p = 0.015). No statistically significant differences were found between the micro-filled and the hybrid composite for each of the

  19. Sealing distal proximal caries lesions in first primary molars: efficacy after 2.5 years.

    Science.gov (United States)

    Martignon, S; Tellez, M; Santamaría, R M; Gomez, J; Ekstrand, K R

    2010-01-01

    The prevalence of proximal caries in primary molar teeth is high in many countries. (1) To study by means of a split-mouth design the 1- and 2.5-year efficacy of sealing proximal lesions vs. flossing instructions (control) on primary molar teeth. (2) To assess children's behaviour and pain perception during the procedure. Ninety-one 4- to 6-year-old children from Bogotá, Colombia participated. Participants had to have at least two proximal lesions scored according to the following radiographic classification system: radiolucency (1) in enamel outer half, (2) restricted to enamel-dentine junction, or (3) restricted to dentine outer third. Baseline, 1- and 2.5-year follow-up bitewing radiographs were taken. Test and control lesions were randomly selected. After temporary separation test lesions were sealed (adhesive). Parents/caregivers received a flossing leaflet for their children. Progression of the lesions was assessed by means of independent reading of conventional bitewing radiographs. One-year (n = 73) test vs. control lesion progression was 27.4 vs. 50.7%, respectively (p caries baseline data. More than 88% of the participants presented positive to definitively positive behaviour and very low or low pain intensity at both first and second appointments. The sealing technique was superior to flossing instructions both after 1 and 2.5 years of follow-up and the majority of the participants had no anxiety or pain during the treatment. Copyright © 2010 S. Karger AG, Basel.

  20. Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars

    NARCIS (Netherlands)

    Kemoli, A.M.; van Amerongen, W.E.

    2009-01-01

    Aim.  To evaluate the influence of the size of proximal cavities on the survival rate of the atraumatic restorative treatment (ART) restorations. Design.  A total of 804 children, aged 6-8 years, from a low socio-economic community, with an ART restorable proximal carious lesion in their primary

  1. Rehabilitation of children with lesions of the proximal humeral metaepiphysis using transosseous distraction osteosynthesis technique

    Directory of Open Access Journals (Sweden)

    Юрий Евгеньевич Гаркавенко

    2015-09-01

    Full Text Available We present an analysis of the treatment of 39 children with a shortening of the humerus after sustained osteomyelitis. Variants of lesions of the proximal humerus metaepiphysis are highlighted, and the differentiated approach to therapeutic measures depending on the identified changes resulted in a positive outcome.

  2. A randomized controlled 5-year prospective study of two HEMA-free adhesives, a 1-step self etching and a 3-step etch-and-rinse, in non-carious cervical lesions.

    Science.gov (United States)

    van Dijken, Jan W V

    2013-11-01

    The aim of this study was to evaluate the 5 year clinical dentin bonding effectiveness of two HEMA-free adhesives in Class V non-carious cervical lesions. A total of 169 Class V restorations were placed in 67 patients with a self-etching adhesive (G-Bond; 67), a 3-step HEMA and TEGDMA free etch-and-rinse (cfm; 51) and a control HEMA-containing etch-and-rinse adhesive (XP Bond; 51) in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline and yearly during a 5 year follow-up with modified USPHS criteria. Dentin bonding efficiency was determined by the percentage of lost restorations. During the 5 years, 159 restorations could be evaluated. Good short time dentin retention was observed for the three adhesives, there all adhesives fulfilled at 18 months the full acceptance ADA criteria. At 5 years a cumulative number of 22 lost restorations (13.8%) was observed. The HEMA-free adhesives showed significantly higher dentin retention compared to the HEMA-containing one. Loss of retention was observed for 5 G-Bond (7.9%), 4 cfm (8.3%) and 13 XP Bond (27.1%) restorations (padhesives was successful after 5 years. Despite concerns which have been raised, showed the 1-step SEA one of the best reported clinical dentin bonding effectiveness. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  3. Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis.

    Science.gov (United States)

    Ammari, Michelle Mikhael; Soviero, Vera Mendes; da Silva Fidalgo, Tatiana Kelly; Lenzi, Michele; Ferreira, Daniele Masterson T P; Mattos, Cláudia Trindade; de Souza, Ivete Pomarico Ribeiro; Maia, Lucianne Cople

    2014-10-01

    The aim of this study was to perform a systematic review and meta-analysis on the effectiveness of sealing non-cavitated proximal caries lesions in primary and permanent teeth. Only controlled clinical trials and randomized controlled clinical trials that evaluated the effectiveness of sealing on non-cavitated proximal caries with a minimum follow-up of 12 months were included in the study. The primary outcome should be arrestment/progression of proximal caries evaluated by bitewing radiographs. A risk of bias evaluation based on the Cochrane Collaboration common scheme for bias was carried out for each study. The meta-analysis was performed on the studies considered low risk of bias and with pair-wise visual reading results through RevMan software. A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs, SIGLE, and on website Clinical trials.gov, through until June 2013. From 967 studies identified, 10 articles and 3 studies with partial results were assessed for eligibility. However three articles were excluded and our final sample included 10 studies. According to the risk of bias evaluation, six studies were considered "high" risk of bias, and four "low" risk of bias. The forest plot of the meta-analysis showed low heterogeneity (I(2)=29%) and a favourable outcome for the Infiltrant. The chance of caries progression when this technique was used was significantly lower (p=0.002) compared with Placebo. Our results suggest that the technique of sealing non-cavitated proximal caries seems to be effective in controlling proximal caries in the short and medium term. Further long-term randomized clinical trials are still necessary to increase this evidence. Contemporary dentistry is focused in minimally invasive approaches that prevent the destruction of sound dental tissues next to carious lesions. This paper searches for evidence of the efficacy of sealing/infiltrating non

  4. Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year

    DEFF Research Database (Denmark)

    Ekstrand, K R; Bakhshandeh, A; Martignon, S

    2010-01-01

    This split-mouth study aimed to assess the efficacy of resin-infiltrated lesions covered by fluoride varnish (FV) versus FV treatment only of proximal lesions on deciduous molar teeth. The study lasted for 1 year. Children with 2 or more superficial proximal lesions on deciduous molar teeth...... for controlling proximal lesion progression on deciduous molar teeth....

  5. Radiographic diagnosis of incipient proximal caries: an ex-vivo study.

    Science.gov (United States)

    da Silva Neto, José Moreira; dos Santos, Rosenês Lima; Sampaio, Maria Carmeli Correia; Sampaio, Fábio Correia; Passos, Isabela Albuquerque

    2008-01-01

    The aim of this ex vivo study was to compare visual clinical and radiographic examinations to the histological analysis for proximal caries diagnosis in extracted permanent molars and premolars. The relationship between clinical aspects and carious lesions was also evaluated. Eighty-eight proximal surfaces (44 freshly extracted teeth) were longitudinally sectioned with a 370-microm diamond disk, thinned with wet silicon carbide paper and observed with a stereomicroscope at x40 magnification. Sensitivity and specificity were 65.6% and 83.3% for clinical examination and 29.7% and 95.8% for radiographic examination, respectively. Kappa values ranged from 0.64 to 0.91. The white spots corresponded to lesions restricted to enamel, while the dark spots corresponded to lesions that reached the dentinoenamel junction. In most cases, cavitation corresponded to dentin lesions. It may be concluded that interproximal radiographic examination is not a reliable method for detection of incipient proximal carious lesions.

  6. The influence of interdental spacing on the detection of proximal caries lesions in primary teeth

    Directory of Open Access Journals (Sweden)

    Tatiane Fernandes Novaes

    2012-08-01

    Full Text Available The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344 of 76 children (4-12 years old were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen. Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm. The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

  7. Proximal caries lesion detection using the Canary Caries Detection System: an in vitro study.

    Science.gov (United States)

    Jan, Janja; Wan Bakar, Wan Zaripah; Mathews, Sapna M; Okoye, Linda O; Ehler, Benjamin R; Louden, Christopher; Amaechi, Bennett T

    2016-11-01

    This study investigated the accuracy of the Canary System (CS) to detect proximal caries lesions in vitro, and compared it with conventional methods: International Caries Detection and Assessment System (ICDAS) II and bitewing radiography (BW). Visible proximal surfaces of extracted human teeth were assessed by ICDAS-II before setting them in five manikin mouth models. Then contacting proximal surfaces in mouth models were assessed by BW and CS. Histological validation with polarized-light microscopy served as a gold standard. Pairwise comparisons were performed on area under the curve (AUC), sensitivity, and specificity of the three methods, and corrected using Bonferroni's method. Sensitivities and specificities were compared using a test of proportions and AUC values were compared using DeLong's method. The CS presented significantly higher sensitivity (0.933) than ICDAS-II (0.733, P = 0.01) and BW (0.267, P proximal lesions than ICDAS-II and BW, although without significantly higher specificity. © 2015 Wiley Publishing Asia Pty Ltd.

  8. The influence of interdental spacing on the detection of proximal caries lesions in primary teeth.

    Science.gov (United States)

    Novaes, Tatiane Fernandes; Matos, Ronilza; Celiberti, Paula; Braga, Mariana Minatel; Mendes, Fausto Medeiros

    2012-01-01

    The aim of this study was to investigate the influence of interdental spacing on the performance of proximal caries detection methods in primary molars. In addition, aspects related to temporary tooth separation with orthodontic separators were evaluated. The proximal spaces between the posterior primary teeth (n = 344) of 76 children (4-12 years old) were evaluated before and after temporary separation. Stainless steel strips with different standardized thicknesses were used to measure the presence of biological spacing and the spacing obtained after temporary separation with orthodontic rubber rings. First, the presence of proximal caries lesions was assessed by visual inspection, bitewing radiographs and a pen-type laser fluorescence device (DIAGNOdent pen). Visual inspection after temporary separation with separators was the reference standard method in checking the actual presence of caries. Multilevel analyses were performed considering different outcomes: the performance of the methods in detecting caries lesions and the spacing after temporary separation. The spacing did not influence the performance of the caries detection methods. The maximum spacing obtained with temporary tooth separation was 0.80 mm (mean ± standard deviation = 0.46 ± 0.13 mm). The temporary separation was more effective in the upper arch and less effective when an initial biological interdental spacing was present. The biological interdental spacing does not influence the performance of proximal caries detection methods in primary molars, and temporary tooth separation provides spacing narrower than 1.0 mm.

  9. Caries status and proximal lesion behaviour during a 6-year period in young adult Danes: an epidemiological investigation

    DEFF Research Database (Denmark)

    Martignon, Stefania; Chavarría, Nathaly; Ekstrand, Kim

    2009-01-01

    Studies have indicated that many initial proximal caries lesions progress and are eventually restored even if the patients have been under comprehensive preventive programmes. The objectives of the study were (1) to describe the 1996-year baseline caries status of male Danish conscripts and (2......-surface caries and restoration patterns. After 6 years, the behaviour of proximal lesions was studied in 73 of these subjects, and oral health habits were assessed through a questionnaire. Mean number of filled surfaces was 7.5, of which 23% were posterior proximal. Radiographically, the mean number of proximal......) to assess their early proximal lesions 6-year behaviour. In 1996, all 20-year-old conscripts at Central Barrack Birkerød (n = 115) went through an oral examination, including visual surface-level fillings' recording and a radiographic examination with bitewing radiographs that assessed the proximal...

  10. Do the levels of selected metals differ significantly between the roots of carious and non-carious teeth?

    Science.gov (United States)

    Malara, Piotr; Kwapulinski, Jerzy; Malara, Beata

    2006-10-01

    Since the metals deposited in teeth during formation and mineralization processes are to a large extent retained, human teeth receive a considerable attention as the indicators of the heavy metal exposure. The use of permanent teeth is limited because the extraction of healthy permanent teeth just for this purpose is hardly acceptable. As the issue of the loss of elements from a carious lesion in the coronal part of a tooth remains controversial, the valuable material could only be the root of carious and fractured permanent teeth. However, to ensure the validity of the results, it should be ascertained that the levels of certain toxic and essential elements do not differ significantly between the roots of non-carious and carious teeth, and therefore this is the aim of this project. The levels of cadmium, chromium, copper, iron, manganese, lead, zinc, potassium, sodium, calcium and magnesium were determined in the roots of 344 permanent teeth (189 carious and 155 caries-free teeth) from the residents of Ruda Slaska, Poland, aged 18 to 34. No statistically significant difference between the concentration of these metals in the roots of non-carious and carious teeth was found. This finding applies to both the general population and after the grouping by donor's gender and tooth type. The concentration of lead, iron, calcium and manganese in the roots of non-carious and carious teeth exhibited dependence upon tooth type, as well as the concentration of potassium in the roots of carious teeth. Since the mineral composition of the roots of permanent teeth is similar for the non-carious, as well as the carious teeth, they can be indiscriminately selected for the tests required by a research project, as they will produce the comparable results. However, in the case of lead, iron, calcium, potassium and manganese, the comparison should be made after grouping by tooth type.

  11. Do the levels of selected metals differ significantly between the roots of carious and non-carious teeth?

    Energy Technology Data Exchange (ETDEWEB)

    Malara, Piotr [Silesian Medical University, Department of Maxillofacial Surgery 20/24 Francuska Street, 40-027 Katowice (Poland)]. E-mail: malara@netinfo.pl; Kwapulinski, Jerzy [Silesian Medical University, Department of Toxicology 4 Jagiellonska Street, 41-200 Sosnowiec (Poland); Malara, Beata [Silesian Medical University, Department of Environmental Medicine and Epidemiology 19 Jordana Street, 41-808 Zabrze (Poland)

    2006-10-01

    Since the metals deposited in teeth during formation and mineralization processes are to a large extent retained, human teeth receive a considerable attention as the indicators of the heavy metal exposure. The use of permanent teeth is limited because the extraction of healthy permanent teeth just for this purpose is hardly acceptable. As the issue of the loss of elements from a carious lesion in the coronal part of a tooth remains controversial, the valuable material could only be the root of carious and fractured permanent teeth. However, to ensure the validity of the results, it should be ascertained that the levels of certain toxic and essential elements do not differ significantly between the roots of non-carious and carious teeth, and therefore this is the aim of this project. The levels of cadmium, chromium, copper, iron, manganese, lead, zinc, potassium, sodium, calcium and magnesium were determined in the roots of 344 permanent teeth (189 carious and 155 caries-free teeth) from the residents of Ruda Slaska, Poland, aged 18 to 34. No statistically significant difference between the concentration of these metals in the roots of non-carious and carious teeth was found. This finding applies to both the general population and after the grouping by donor's gender and tooth type. The concentration of lead, iron, calcium and manganese in the roots of non-carious and carious teeth exhibited dependence upon tooth type, as well as the concentration of potassium in the roots of carious teeth. Since the mineral composition of the roots of permanent teeth is similar for the non-carious, as well as the carious teeth, they can be indiscriminately selected for the tests required by a research project, as they will produce the comparable results. However, in the case of lead, iron, calcium, potassium and manganese, the comparison should be made after grouping by tooth type.

  12. A three-year clinical evaluation of a one-step self-etch and a two-step etch-and-rinse adhesive in non-carious cervical lesions.

    Science.gov (United States)

    Häfer, Matthias; Jentsch, Holger; Haak, Rainer; Schneider, Hartmut

    2015-03-01

    The aim of the study was to assess a one-step self-etch adhesive (Futurabond M, 1-SE) and a two-step etch-and-rinse adhesive (Solobond M, 2-ER) used in combination with the nano-hybrid composite (Amaris) in a prospective clinical study on non-carious cervical lesions. 110 restorations were placed in 40 patients and graded over 36 months according to aesthetical, functional and biological criteria (Clinical Oral Investigations 2007;11:5). The four-step etch-and-rinse adhesive Syntac classic (4-ER) combined with the nano-hybrid composite Tetric EvoCeram was used as a control. Cumulative failure rates (CFR), retention rates and Kaplan-Meier survival curves were calculated for each observation period. After 3 years, the CFR of 33.3% in the 2-ER group was significantly higher compared to those of the 1-SE group (9.1%, p = 0.019) and of the 4-ER group (8.3%, p = 0.035). Additionally, retention rates in the 1-SE and the 4-ER groups were higher compared to 2-ER (p = 0.012 each) after 36 months. Annual failure rates ranged between 2.8% for 4-ER, 3.0% for 1-SE and 11.1% for 2-ER. During the study, restorations in all groups showed progressive marginal deterioration within the limits of clinical acceptance. After 3 years, restorations in the 2-ER and the 4-ER group showed more small defects at dentin than at enamel margins. The 1-SE group was clinically as successful as the 4-ER, with both performing better than the 2-ER group. Futurabond M/Amaris can be recommended for the restoration of sclerotic non-carious cervical lesions. Number protocol 192/2008. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Comparison of Proximal Caries Detection in Primary Teeth between Laser Fluorescence and Bitewing Radiography: An in vivo Study

    OpenAIRE

    Mepparambath, Ratheesh; S Bhat, Sham; K Hegde, Sundeep; Anjana, G; Sunil, M; Mathew, Sherryl

    2015-01-01

    ABSTRACT% Background and objective: Proximal caries detection is of great importance because of the rapid rate of caries progression and the difficulty in determining the absence or presence of a lesion in primary dentition. Although, various methods for caries diagnosis offer good diagnostic performances, they provide varying sensitivities for detecting proximal carious lesions. The objective of this study was to compare, in vivo, the accuracy of DIAGNOdent and bitewing radiography at detect...

  14. Proximal caries lesion detection in primary teeth: does this justify the association of diagnostic methods?

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    Bussaneli, D G; Restrepo, M; Boldieri, T; Albertoni, T H; Santos-Pinto, L; Cordeiro, R C L

    2015-12-01

    The aim of this clinical study was to evaluate and compare the performance of visual exam with use of the Nyvad criteria (visual examination - (VE)), interproximal radiography (BW), laser fluorescence device (DIAGNOdent Pen-DDPen), and their association in the diagnosis of proximal lesions in primary teeth. For this purpose, 45 children (n = 59 surfaces) of both sexes, aged between 5 and 9 years were selected, who presented healthy primary molars or primary molars with signs suggestive of the presence of caries lesions. The surfaces were clinically evaluated and coded according to the Nyvad criteria and immediately afterwards with the DDPen. Radiographic exam was performed only on the surfaces coded with Nyvad scores 2, 3, 5, or 6. Active caries lesions and/or those with discontinuous surfaces were restored, considering the depth of lesion as reference standard. Sensitivity, specificity, accuracy, and area under ROC curve were calculated for each technique and its associations. Visual exam with Nyvad criteria presented the highest specificity, accuracy, and area under ROC curve values. The DDPen presented the highest sensitivity values. Association with one or more methods resulted in an increase in specificity. The performance of visual, radiographic, and DDpen exams and their associations were good; however, the clinical examination with the Nyvad criteria was sufficient for the diagnosis of interproximal lesions in primary teeth.

  15. Axillary artery lesion secondary to fracturing of the proximal third of the humerus: case report

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    Alberto Naoki Miyazaki

    2015-02-01

    Full Text Available Lesions of the axillary artery are rare in patients with fracturing of the proximal third of the humerus and may have greatly varying clinical manifestations. They are responsible for 15% and 20% of upper-limb artery injuries and the commonest mechanism is a fall to the ground, which accounts for 79% of such injuries. In some cases, the signs only appear later on. It is important to bear this association in mind, so as to make an early diagnosis and avoid serious complications. We report on a case of traumatic injury of the axillary artery secondary to fracturing of the proximal third of the humerus in an 84-year-old patient, with late evolution of clinical signs of ischemia in the limb affected. The aim here was to discuss the diagnostic difficulties and treatment.

  16. Caries status and proximal lesion behaviour during a 6-year period in young adult Danes: an epidemiological investigation.

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    Martignon, Stefania; Chavarría, Nathaly; Ekstrand, Kim Rud

    2010-08-01

    Studies have indicated that many initial proximal caries lesions progress and are eventually restored even if the patients have been under comprehensive preventive programmes. The objectives of the study were (1) to describe the 1996-year baseline caries status of male Danish conscripts and (2) to assess their early proximal lesions 6-year behaviour. In 1996, all 20-year-old conscripts at Central Barrack Birkerød (n = 115) went through an oral examination, including visual surface-level fillings' recording and a radiographic examination with bitewing radiographs that assessed the proximal-surface caries and restoration patterns. After 6 years, the behaviour of proximal lesions was studied in 73 of these subjects, and oral health habits were assessed through a questionnaire. Mean number of filled surfaces was 7.5, of which 23% were posterior proximal. Radiographically, the mean number of proximal lesions was 5.5. Over the 6-year period, there was progression of lesions into deeper radiolucencies or fillings in 57% of cases. The questionnaire showed a poor compliance with regular flossing/tooth-stick use (18%). Based on these results, more efficacious preventive measures seem to be needed for proximal surfaces.

  17. Sarcomeric lesions and remodeling proximal to intercalated disks in overload-induced cardiac hypertrophy.

    Science.gov (United States)

    Kebir, Sied; Orfanos, Zacharias; Schuld, Julia; Linhart, Markus; Lamberz, Christian; van der Ven, Peter F M; Schrickel, Jan; Kirfel, Gregor; Fürst, Dieter O; Meyer, Rainer

    2016-10-15

    Pressure overload induces cardiac remodeling involving both the contractile machinery and intercalated disks (IDs). Filamin C (FlnC) and Xin actin-binding repeat-containing proteins (XIRPs) are multi-adapters localizing in IDs of higher vertebrates. Knockout of the gene encoding Xin (Xirp1) in mice leads to a mild cardiac phenotype with ID mislocalization. In order to amplify this phenotype, we performed transverse aortic constriction (TAC) on control and Xirp1-deficient mice. TAC induced similar left ventricular hypertrophy in both genotypes, suggesting that the lack of Xin does not lead to higher susceptibility to cardiac overload. However, in both genotypes, FlnC appeared in "streaming" localizations across multiple sarcomeres proximal to the IDs, suggesting a remodeling response. Furthermore, FlnC-positive areas of remodeling, reminiscent of sarcomeric lesions previously described for skeletal muscles (but so far unreported in the heart), were also observed. These adaptations reflect a similarly strong effect of the pressure induced by TAC in both genotypes. However, 2 weeks post-operation TAC-treated knockout hearts had reduced levels of connexin43 and slightly increased incidents of ventricular tachycardia compared to their wild-type (WT) counterparts. Our findings highlight the FlnC-positive sarcomeric lesions and ID-proximal streaming as general remodeling responses in cardiac overload-induced hypertrophy. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Detection and treatment of proximal caries lesions: Milieu-specific cost-effectiveness analysis.

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    Schwendicke, Falk; Paris, Sebastian; Stolpe, Michael

    2015-06-01

    Dental caries lesions are highly prevalent, concentrated in high-risk groups, and often affect proximal tooth surfaces. Choosing a caries detection method determines the available treatment options: radiographically detected early lesion stages might receive non-, micro-, or invasive treatments, whilst visually tactile detected lesions are often advanced and mostly require invasive treatment. Thus, the choice of detection method impacts on patients via the applied treatment. We compared the cost-effectiveness of combinations of detections and treatments of proximal lesions in different populations which did or did not receive prevention during adolescence. These cost-effectiveness comparisons of different detection-treatment combinations should aid clinical decision making and improve resource allocation. A Markov-model was constructed to follow a proximal posterior surface in a 12-year-old German over his lifetime. Prevalence, validity and transition probabilities were extracted from the literature. Microsimulations were performed to evaluate costs (Euro) per tooth-retention-time (years). For populations with low risk, radiographic detection plus non-invasive treatment without (270 Euro, 61.5 years) and with prevention (312 Euro, 63.0 years), as well as radiographic detection plus micro-invasive treatment and prevention (373 Euro, 64.0 years) were cost-effective. For populations with high risk, radiographic detection plus micro-invasive treatment without (427 Euro, 58.5 years) and with prevention (436 Euro, 61.0 years) were cost-effective. Combinations involving invasive treatments had limited cost-effectiveness. Caries detection methods should be evaluated regarding the cost-effectiveness resulting from their use in different populations. Caries detection methods are usually evaluated regarding their validity compared to a gold standard. We demonstrate that the cost-effectiveness stemming from using different detection methods additionally depends on the

  19. Specifics of proximal caries and their diagnostics in posterior teeth

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    Wojcik-Checinska Ilona

    2015-06-01

    Full Text Available Proximal surfaces are the second in turn after the occlusal surfaces, as being the most exposed places to the carious process. The specificity of changes and location makes the diagnostic of approximal cavities difficult. The aim of the study was to collect information on possibilities of detection, monitoring and assessment of carious lesions located on proximal surfaces, starting from the early stage. On the base of current literature, chosen methods of diagnosis, from conventional, to advanced technologies were presented. Current literature also suggests that none of the diagnostic methods exclude the possibility of misdiagnosis of proximal caries. Therefore, during the diagnosing of doubtful cases, it is advisable to employ several methods of assessment, with simultaneous individual appraisal of caries risk factors, such as oral hygiene, frequency of eating sweets or the number of active caries foci.

  20. Two-Year Clinical Evaluation of a Nanofilled Etch-and-Rinse and a Self-Etch Adhesive System Containing MDPB and Fluoride in Non-carious Cervical Lesions.

    Science.gov (United States)

    de Oliveira, Fernanda Garcia; Machado, Lucas Silveira; Sundfeld-Neto, Daniel; Giannini, Marcelo; Briso, André Luiz Fraga; Dos Santos, Paulo Henrique; Sundefeld, Maria Lúcia Marçal Mazza; Sundfeld, Renato Herman

    2017-03-01

    The aim of this clinical study was to evaluate the performance of restorations for non-carious cervical lesions performed with a two-step etch-and-rinse or with a two-step self-etch adhesive. The teeth to be restored (15 patients, N = 90 restorations) were randomly assigned into 3 groups (n = 30), according to the adhesive system: group 1 (G1): Peak LC Bond; group 2 (G2): Clearfil Protect Bond; and group 3 (G3): prior selective acid etching of the enamel margins before bonding with Clearfil Protect Bond. The NCCLs were restored with Amelogen Plus composite resin. Two calibrated examiners evaluated the restorations using modified US Public Health Service criteria. The data of retention, marginal integrity, and marginal discoloration were analyzed using the Kruskal-Wallis and Wilcoxon tests. There were no significant differences in clinical performance among the groups for the variables: retention, marginal integrity, and marginal discoloration after 1 year and 2 years. The alpha rates after 2 years were: 93.3% for G1 and 96.7% for G2 and G3 for retention; 93.3%, 100%, and 90% for G1, G2, and G3 for marginal discoloration; 86.7%, 96.7%, and 90% for G1, G2, and G3 for marginal integrity, respectively. The adhesives presented similar clinical performance at the end of 2 years. Also, the prior etching with phosphoric acid did not significantly improve the clinical performance of self-etch adhesive.

  1. Influence of multi-step etch-and-rinse versus self-etch adhesive systems on the post-operative sensitivity in medium-depth carious lesions: An in vivo study.

    Science.gov (United States)

    Scotti, Nicola; Bergantin, Emanuele; Giovannini, Roberta; Delbosco, Laura; Breschi, Lorenzo; Migliaretti, Giuseppe; Pasqualini, Damiano; Berutti, Elio

    2015-08-01

    To evaluate the influence of a three-step etch-and-rinse versus a two-step self-etch adhesive system on immediate post-operative sensitivity. In total, 204 subjects with one posterior tooth affected by a primary carious lesion were recruited. The subjects were randomly divided into two groups, based on the two multi-step adhesive systems used: Group A (All Bond 3) and Group B (Clearfil Protect Bond). The same skilled operator carried out the restorations using a nano-hybrid composite (Venus Diamond) in oblique stratification. Each increment was light-cured for 20 seconds with a LED lamp (Translux Power Blue). Subjects received a three-level thermal sensitivity questionnaire for post-operative sensitivity ratings. The evaluations were recorded daily for 7 days. Scores were analyzed using the McNemar test and postoperative trends were analyzed with the Friedman test (P adhesives, etch-and-rinse or self-etch, provided effective dentin sealing, preventing subjects from experiencing post-operative sensitivity in the treatment of medium-depth cavities.

  2. Digital contrast subtraction radiography for proximal caries diagnosis

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    Kang, Byung Cheol; Yoon, Suk Ja [Department of Dental Radiology, Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2002-06-15

    To determine whether subtraction images utilizing contrast media can improve the diagnostic performance of proximal caries diagnosis compared to conventional periapical radiographic images. Thirty-six teeth with 57 proximal surfaces were radiographied using a size no.2 RVG-ui sensor (Trophy Radiology, Marne-la-Vallee, France). The teeth immersed in water-soluble contrast media and subtraction images were taken. Each tooth was then sectioned for histologic examination. The digital radiographic images and subtraction images were examined and interpreted by three dentists for proximal caries. The results of the proximal caries diagnosis were then verified with the results of the histologic examination. The proximal caries sensitivity using digital subtraction radiography was significantly higher than simply examining a single digital radiograph. The sensitivity of the proximal dentinal carious lesion when analyzed with the subtraction radiograph and the radiograph together was higher than with the subtraction radiograph or the radiograph alone. The use of subtraction radiography with contrast media may be useful for detecting proximal dentinal carious lesions.

  3. The Comparison of Dentine Thickness Under Proximal Caries Between Bitewing Radiographs and Tooth Structure

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    Khosravi K

    2001-05-01

    Full Text Available Carious lesions are usually found by dentists, using bitewing radiographs, and according to the depth of the lesions, the treatment plan is designed. At the present, this technique is the most accepted one and is used generally. But it is not a perfect technique and there are some errors in determining of depth of proximal carious lesions. These errors are mainly related to the use of new high-speed films with broad density and lower voltages. In this study, dentin thickness under proximal caries in bitewing radiography was compared with its real thickness, in tooth structure. Twenty-four teeth samples with proximal caries were used. Before and after removal of carious lesions bitewing radiographs were taken and then each tooth was sectioned occlusogingivally and the thickness of dentine under proximal caries and on bitewing radiographs were measured under microscope with 0.01 mm accuracy. Mean value of dentine thickness in tooth structure was 41% of its mean thickness in bitewing radiographs, showing 59% difference (reduction. Therefore, more care should be taken in using standard technique and interpreting of bitewing radiographs by clinicians. Clinical examinations also should be performed in ideal conditions, and patients should be clinically and radiographically examined every six months.

  4. [Accuracy of computer aided measurement for detecting dental proximal caries lesions in images of cone-beam computed tomography].

    Science.gov (United States)

    Zhang, Z L; Li, J P; Li, G; Ma, X C

    2017-02-09

    Objective: To establish and validate a computer program used to aid the detection of dental proximal caries in the images cone beam computed tomography (CBCT) images. Methods: According to the characteristics of caries lesions in X-ray images, a computer aided detection program for proximal caries was established with Matlab and Visual C++. The whole process for caries lesion detection included image import and preprocessing, measuring average gray value of air area, choosing region of interest and calculating gray value, defining the caries areas. The program was used to examine 90 proximal surfaces from 45 extracted human teeth collected from Peking University School and Hospital of Stomatology. The teeth were then scanned with a CBCT scanner (Promax 3D). The proximal surfaces of the teeth were respectively detected by caries detection program and scored by human observer for the extent of lesions with 6-level-scale. With histologic examination serving as the reference standard, the caries detection program and the human observer performances were assessed with receiver operating characteristic (ROC) curves. Student t -test was used to analyze the areas under the ROC curves (AUC) for the differences between caries detection program and human observer. Spearman correlation coefficient was used to analyze the detection accuracy of caries depth. Results: For the diagnosis of proximal caries in CBCT images, the AUC values of human observers and caries detection program were 0.632 and 0.703, respectively. There was a statistically significant difference between the AUC values ( P= 0.023). The correlation between program performance and gold standard (correlation coefficient r (s)=0.525) was higher than that of observer performance and gold standard ( r (s)=0.457) and there was a statistically significant difference between the correlation coefficients ( P= 0.000). Conclusions: The program that automatically detects dental proximal caries lesions could improve the

  5. Comparison of pattern of failure of resin composite restorations in non-carious cervical lesions with and without occlusal wear facets.

    Science.gov (United States)

    Oginni, Adeleke Oke; Adeleke, Adeyinka Adedayo

    2014-07-01

    Many studies have reported the clinical problems associated with resin composite restorations in NCCLs. None has compared these clinical problems in NCCLs with and without occlusal wear facets. The present study sets out to determine the proportion of NCCLs that presents occlusal wear facets, and to compare the failure pattern of resin composite restorations in NCCLs with and without occlusal wear facets. Teeth with NCCLs were classified into two groups, those with and without occlusal wear facets. Both groups were restored using micro hybrid resin composite. The restorations were evaluated at the end of 2 years concerning post-operative sensitivity, retention, marginal integrity, marginal discolouration, wear, and secondary caries, using the USPHS criteria. Statistical analysis compared the ratings of each criterion between the two groups using Pearson's χ(2) or Fisher's exact test. About one-third (33.8%) of teeth with NCCLs presented with occlusal wear facets, more NCCLs with occlusal wear facets in mandibular teeth (44.7%) than maxillary teeth (24.5%). Retention rate of composite resin restorations in NCCLs with and without occlusal wear facets was 63.9% and 74.4% respectively at the end of 2 years. More marginal discolouration and defects were observed in restorations in NCCLs with occlusal wear facets, the differences were not statistically significant (p>0.05). The decline in ratings of marginal discolouration and defects, and the lower retention rate of restorations in NCCLs with occlusal wear facets may support the role of occlusal stress and tooth flexure as a cause of failure of restorations in NCCLs. The ability to distinguish between stress induced lesions (with occlusal wear facets) and other cervical lesions will have important ramifications for the success of their restorations because they are not subjected to the same physical forces that are responsible for the deterioration of the restoration. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Evaluation of cavitated and non-cavitated carious lesions using the WHO basic methods, ICDAS-II and laser fluorescence measurements

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    Mridula Goswami

    2015-01-01

    Full Text Available Aim: This study was aimed to compare the diagnostic outcome of the WHO criteria, ICDAS-II criteria and laser fluorescence measurements in measuring the caries ratings of children. Settings and Design: Cross-sectional study. Materials and Methods: The study involved 31 children between 3 and 14 years of age, attending the Department of Pedodontics at Maulana Azad College of Dental Sciences, New Delhi. The surface-related caries status was registered according to the WHO basic method criteria (1997. Additionally, the ICDAS-II visual criteria and the DIAGNOdent readings were documented. Statistical analysis used: The data were analysed with ezANOVA and Excel 2000 (Microsoft Corporation, Redmond, WA, USA. Results: The mean ICDAS-II values amounted to 8.76 ± 0.72. The mean values for DMFS/def were 7.67 ± 0.91, whereas for DIAGNOdent it amounted to 4.00 ± 0.62. Conclusions: In conclusion, this study showed the diagnostic potential of the ICDAS-II criteria in comparison to the traditional WHO criteria by means of the non-cavitated caries lesions additionally detected. The DIAGNOdent use in field studies that already apply detailed visual criteria seems to bring limited additional information.

  7. In vitro study of the effect of a pulsed 10.6μm CO2 laser and fluoride on the reduction of carious lesions progression in bovine root dentin

    Science.gov (United States)

    Parisotto, Thaís M.; Sacramento, Patrícia A.; Alves, Marcelo C.; Puppin-Rontani, Regina M.; Gavião, Maria Beatriz D.; Nobre-dos-Santos, Marin"s.

    2010-02-01

    The aim of the present study was to evaluate the combined in vitro effects a pulsed 10.6 μm CO2 laser and fluoride on the reduction of carious lesion progression in root dentin. Sixty five slabs of previously demineralized bovine root dentin were assigned into five groups (n=13): control (no treatment), acidulated phosphate fluoride gel 1.23% (FFA), CO2 Laser (L), FFA+L, L+FFA. The lasered groups were irradiated with 4.0J/cm2. After a 7 day pH cycling regime, the knoop hardness number (KHN) was determined by cross-sectional microhardness testing (5g, 5s, 10-60 μm, 10 μm interval). The data was analyzed by ANOVA and Student's t-test (α= 0.05). A significant interaction between KHN and the indentation depths was found (pcaries progression when compared to control group (KHN:8.76+/-0.95/9.50+/-1.03) (p0.05). At 30 μm, the KHN was significantly higher than the control only in the FFA group (KHN:15.35+/-1.16). At 40 μm, the groups FFA (KHN: 15.87+/-3.76), L (KHN: 15.57+/-5.71) and L+FFA (KHN:15.50+/-5.08) were capable of significantly inhibiting caries progression, however they did not differ each other (p>0.05). At depths of 50-60 μm, only group L (KHN:17.05+/-1.29/18.26+/-1.30) differed statistically from the control (KHN:13.43+/-1.24/13.81+/-1.25), but not from the other groups. In conclusion, CO2 laser alone was able to inhibit caries progression in the deepest layers. However, no synergistic effect was obtained when CO2 laser irradiation and FFA application and were combined.

  8. [An experimental study on the penetration abilities of resin infiltration into proximal caries lesions in primary molars].

    Science.gov (United States)

    Liu, Yong-Hong; Ge, Li-Hong; Zhang, Zhi-Yong; Chi, Xue-Qian; Hou, Feng-Chun; Chen, Hui-Zhen

    2012-11-01

    To compare the penetration abilities of resin infiltration into proximal lesions in primary molars with those of adhesive in vitro. Thirty-two extracted or exfoliated primary molars showing proximal white spot lesions were selected. Roots of the teeth were removed, and the crowns were cut across the white spot lesions perpendicular to the surface. Cut surfaces were examined (by stereo microscopy) and classified with respect to histological lesion extension (C1-C4): lesions confined to the outer half on enamel (C1), lesions confined to the inner half on enamel (C2), lesions confined to the outer half on dentin (C3), lesions extending into the inner half of dentin (C4). Corresponding lesion halves were etched for 120 s with 15% hydrochloric acid gel and were subsequently treated with either adhesive or resin infiltration. Specimens were observed with laser scanning confocal microscope (LSCM) in dual fluorescence mode. In confocal microscopic images, lesion depth and penetration depth of the resin infiltration or the adhesive in corresponding halves were measured, and penetration percentages were calculated respectively. Differences of the data between two groups were analyzed by Wilcoxon signed rank test. Variations of histological caries extensions were detected with Kruskal-Wallis H test. At the same grading level (C1-C3) in histological caries extension, penetration depths of the resin infiltration group and the adhesive group were 240 (230, 260) µm vs 190 (150, 210) µm, 405 (300, 523) µm vs 180 (160, 200) µm, and 590 (430, 640) µm vs 180 (160, 200) µm respectively. There was significant statistical difference in the data between two groups (P caries extension, percentage penetrations of the resin infiltration group and the adhesive group were [100.0% (96.2%, 100.0%)], [99.1% (95.7%, 100.0%)], [82.0% (81.1%, 92.2%)] and [79.2% (68.4%, 87.5%)], [41.8% (29.1%, 74.5%)], [30.2% (29.2%, 39.6%)], respectively. The difference between the above data was also

  9. Morel-Lavallée lesion of the proximal tibia in an obese patient after low-energy trauma.

    Science.gov (United States)

    Hogerzeil, Dirk Pieter; Jansen, Joris

    2017-06-13

    Morel-Lavallée lesions (MLL) are usually localised in the hip or gluteal region, but have rarely been reported at the proximal tibia. We present a case of an overweight patient, aged 59, with a MLLof the left proximal tibia after a low-energy fall in his backyard. MLL pathogenesis, history, radiographic imaging, applied treatment and relevant literature to this specific case and MLL in general are discussed. Initially the patient's MLL was managed conservatively until he presented with persisting pain and swelling. The lesion was subsequently treated by needle aspiration and stabilising knee brace. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Assessment of cavitation in artificial approximal dental lesions with near-IR imaging

    Science.gov (United States)

    Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2017-02-01

    Bitewing radiography is still considered state-of-the-art diagnostic technology for assessing cavitation within approximal carious dental lesions, even though radiographs cannot resolve cavitated surfaces but instead are used to measure lesion depth in order to predict cavitation. Clinicians need new technologies capable of determining whether approximal carious lesions have become cavitated because not all lesions progress to cavitation. Assessing lesion cavitation from near-infrared (NIR) imaging methods holds great potential due to the high transparency of enamel in the NIR region from λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. The objective of this study was to measure the change in lesion appearance between non-cavitated and cavitated lesions in artificially generated lesions using NIR imaging modalities (two-dimensional) at λ=1300-nm and λ=1450-nm and cross-polarization optical coherence tomography (CP-OCT) (thee-dimensional) λ=1300-nm. Extracted human posterior teeth with sound proximal surfaces were chosen for this study and imaged before and after artificial lesions were made. A high speed dental hand piece was used to create artificial cavitated proximal lesions in sound samples and imaged. The cavitated artificial lesions were then filled with hydroxyapatite powder to simulate non-cavitated proximal lesions.

  11. The different pathogeneses of sporadic adenoma and adenocarcinoma in non-ampullary lesions of the proximal and distal duodenum.

    Science.gov (United States)

    Niwa, Ayumi; Kuwano, Seiya; Tomita, Hiroyuki; Kimura, Keita; Orihara, Yukiya; Kanayama, Tomohiro; Noguchi, Kei; Hisamatsu, Kenji; Nakashima, Takayuki; Hatano, Yuichiro; Hirata, Akihiro; Miyazaki, Tatsuhiko; Kaneko, Kazuhiro; Tanaka, Takuji; Hara, Akira

    2017-06-20

    Non-ampullary duodenal adenoma with activation of Wnt/β-catenin signalling is common in familial adenomatous polyposis (FAP) patients, whereas sporadic non-ampullary adenoma is uncommon. The adenoma-carcinoma sequence similar to colon cancer is associated with duodenal tumors in FAP, but not always in sporadic tumors. We obtained 37 non-ampullary duodenal tumors, including 25 adenomas and 12 adenocarcinomas, were obtained from biopsies and endoscopic resections. We performed immunohistochemistry for β-catenin, the hallmark of Wnt activation, and aldehyde dehydrogenase 1 (ALDH1), a putative cancer stem cell marker. In non-ampullary lesions, abnormal nuclear localization of β-catenin was observed in 21 (84.0%) of 25 adenomas and 4 (33.3%) of 12 adenocarcinomas. In the proximal duodenum, nuclear β-catenin was less frequent in both adenomas and adenocarcinomas. Gastric duodenal metaplasia (GDM) was observed only in the proximal duodenum. All adenomas with GDM were the gastric foveolar and pyloric gland types, and showed only membranous β-catenin. The intestinal-type adenomas had nuclear β-catenin in the proximal and distal duodenum. ALDH1-positive cells were more frequent in adenocarcinomas than adenomas. Nuclear β-catenin accumulation frequently occurred in ALDH1-positive cells in adenoma, but not in adenocarcinoma. In the non-ampullary proximal duodenum, Wnt/β-catenin pathway activation was more closely associated with adenomas than adenocarcinomas, and while it might cooperate with ALDH1 in adenoma, it does not in adenocarcinoma. The pathogenesis thus may differ between sporadic adenoma and adenocarcinoma of non-ampullary duodenal lesions, especially in the proximal and distal duodenum.

  12. One-year clinical evaluation of tooth-colored materials in non-carious cervical lesions Avaliação clínica de restaurações de lesões cervicais não cariosas

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    Sérgio Lima Santiago

    2003-09-01

    Full Text Available The purpose of this study was to assess the clinical performance of bonded composite (Excite/Tetric Ceram - Vivadent versus a resin-modified glass ionomer cement (Vitremer - 3M for restoring non-carious cervical lesions. A total of 70 restorations (thirty-five per material were placed in 30 patients, 18-50 aged, by one operator. Rubber dam was employed in all cases, lesions were pumiced, enamel margins were not beveled, and no mechanical retention was placed. The restorations were directly assessed by two independent evaluators using modified-USPHS criteria for six clinical categories. The ratings for clinical acceptability restorations (alfa plus bravo were as follows (Tetric Ceram/Vitremer: retention (86%/100%, marginal integrity (100%/100%, marginal discoloration (100%/100%, wear (97%/100%, postoperative sensitivity (100%/100% and recurrent caries (100%/100%. Statistical analysis was completed with Fisher's exact or Pearson Chi-square tests at a significance level of 5% (PAvaliou-se o desempenho clínico de um sistema restaurador adesivo (Excite - Tetric Ceram/ Vivadent e do cimento de ionômero de vidro modificado por resina (Vitremer/ 3M na restauração de lesões cervicais não cariosas por meio do sistema de avaliação do USPHS modificado. Um total de setenta restaurações, trinta e cinco por material, foi realizado por um único operador em trinta pacientes voluntários com idades de 18 a 50 anos. Previamente à execução das restaurações, foi realizada uma profilaxia com pedra-pomes e água a fim de remover quaisquer resíduos. As lesões cervicais não foram submetidas a qualquer tipo de preparo cavitário, sendo restauradas sob isolamento absoluto e de acordo com as instruções do fabricante. Todas as restaurações foram avaliadas pelo método direto por dois examinadores usando os critérios de retenção (R, integridade marginal (IM, descoloração marginal (DM, desgaste (D, sensibilidade pós-operatória (S e incidência de

  13. [EFFECTIVENESS OF COMBINED TENODESIS FOR PROXIMAL LESIONS OF BICEPS TENDON WITH MASSIVE ROTATOR CUFF TEAR BY ARTHROSCOPY].

    Science.gov (United States)

    Chen, Xianwu; Ye, Ruqing; Xu, Haiping; Lu, Jianmeng

    2015-06-01

    To evaluate the effectiveness of the combined tenodesis for proximal lesions of biceps tendon with massive rotator cuff tear by arthroscopy. Between January 2011 and June 2013, 48 patients with massive rotator cuff tear and proximal lesions of biceps tendon underwent combined tenodesis under arthroscopy, and the clinical data were retrospectively analyzed. Of 48 cases, 22 were male and 26 were female with an average age of 46 years (range, 35-59 years); 12 cases had clear history of trauma. The disease duration ranged from 1 to 57 months (mean, 4.6 months). All cases suffered from moderate to severe shoulder pain, the strength and the range of motion (ROM) declined when compared with those of the other side. According to Goutallier classification standard, 3 cases were rated as grade 0, 18 cases as grade 1, and 27 cases as grade 2. The operation time and complication were recorded. The visual analogue scale (VAS) score, ROM, the strength of flexed elevation and elbow flexion, Constant-Murley score, University of California Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, Mayo elbow performance score (MEPS) were used to evaluate the effectiveness. The operations were performed successfully, and incisions healed primarily. The operation time was 120-160 minutes (mean, 135 minutes). One case had shoulder joint swelling with wound bleeding, which was cured after proper treatment. All 48 patients were followed up 12-18 months (mean, 13.9 months). The results of MRI showed good healing of tendon at 6 months after operation. When compared with preoperative values, VAS score was significantly decreased (P 0.05). The technique of combined tenodesis under arthroscopy can obtain satisfactory clinical outcomes in treating proximal lesions of biceps tendon with massive rotator cuff tear.

  14. PENETRACIÓN DE TRES ADHESIVOS EN LESIONES INTERPROXIMALES DE CARIES DE MANCHA BLANCA: ESTUDIO IN VITRO/PENETRATION OF THREE ADHESIVES IN PROXIMAL WHITE-SPOT CARIES LESIONS: AN IN VITRO STUDY

    National Research Council Canada - National Science Library

    Olga Lucía Zarta; Alba Lucía Zuluaga Valencia; María Cristina Huertas Díaz; Juan Sebastián Lara; Ingrid Katherine Quintero; Marisol Téllez; Margarita Úsuga; Stefania Martignon

    2012-01-01

    .... One hundred seventeen extracted human premolars with ICDAS 2 white-spot non-cavitated proximal lesions mounted on plaster, to simulate oral cavity conditions, were randomly sorted out in each of the three groups...

  15. Development and Evaluation of a Percutaneous Technique for Repairing Proximal Femora With Metastatic Lesions

    National Research Council Canada - National Science Library

    Keyak, Joyce H

    2006-01-01

    .... These lesions can be painful and can lead to pathological fracture. Prophylactic surgical fixation is advised in patients thought to be at high risk of fracture and typically involves placement of a prosthetic implant or compression hip screw...

  16. Development and Evaluation of a Percutaneous Technique for Repairing Proximal Femora With Metastatic Lesions

    National Research Council Canada - National Science Library

    Keyak, Joyce

    2003-01-01

    .... These lesions can be painful and can lead to pathological fracture. Prophylactic surgical fixation is advised in patients thought to be at high risk of fracture and typically involves placement of a prosthetic implant or compression hip screw...

  17. Development and Evaluation of a Percutaneous Technique for Repairing Proximal Femora With Metastatic Lesions

    National Research Council Canada - National Science Library

    Keyak, Joyce

    2004-01-01

    .... These lesions can be painful and can lead to pathological fracture. Prophylactic surgical fixation is advised in patients thought to be at high risk of fracture and typically involves placement of a prosthetic implant or compression hip screw...

  18. Tratamiento de lesiones de caries interproximales mediante el uso de infiltrantes Treatment of approximal caries lesions using infiltrants

    Directory of Open Access Journals (Sweden)

    ML Marró Freitte

    2011-12-01

    Full Text Available Basados en el respeto por la estructura dentaria junto a un adecuado tratamiento y detención de las lesiones de caries, se ha desarrollado ICON®, un sistema que penetra los tejidos afectados con una resina de baja viscosidad fotopolimerizable (infiltrante sin necesidad de la apertura mecánica de una cavidad. De este modo se introducen los “infiltrantes” como herramientas para el tratamiento de las lesiones proximales. El “infiltrante” actúa bloqueando la progresión de la lesión de caries y estabilizando la estructura dentaria. En este reporte se muestra la técnica de infiltración con el uso del kit ICON®, mediante la presentación de un caso clínico de lesión proximal extendida al tercio externo de la dentina.Based on the respect for the tooth structure with adequate treatment and arrest of carious lesions, ICON ® has been developed. This system enters the affected tissue with a low-viscosity light-curing resin (infiltrant with no need for mechanical opening of a cavity. This will introduce the infiltrants as tools for the treatment of proximal lesions. The “infiltrant” works by blocking the progression of caries lesion and stabilizing tooth structure. This report shows the technique with the use of the ICON ® kit, by presenting a case of proximal carious lesion extended to the outer third of dentin.

  19. Posterior tibial tendoscopy: Description of an accessory proximal portal and assessment of tendon vascularization lesion according to portal.

    Science.gov (United States)

    Roussignol, X; Lagrave, B; Berthiaux, S; Duparc, F; Dujardin, F

    2013-03-01

    Posterior tibial tendoscopy was codified in 1997 by Van Dijck, who described a portal between 1.5 and 2cm proximally and distally to the tip of the medial malleolus. However, this approach does not allow proximal exploration of the posterior tibial tendon (PTT). We here describe an accessory portal 7cm proximal to the medial malleolus, enabling complete PTT exploration. Posterior tibial tendoscopy was performed on 12 cadaver specimens, mapping PTT exploration and vascularization. The accessory portal enabled the whole PTT to be explored, from the myotendinous junction to the entry into the retromalleolar groove. PTT observation quality was improved compared to using a submalleolar portal. Dissection confirmed systematic presence of a vincula on the posterior side of the tendon, connected to the flexor digitorum longus (FDL) tendon, containing collateral vessels of the posterior tibial artery. None of these elements were damaged by the tendoscopy as long and the scope and motorized instruments were not rotated on the posterior side of the supramalleolar part of the PTT. This accessory entry portal provides complete PTT exploration without the risk of neurovascular bundle lesion. Copyright © 2012 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

  20. Reverse shoulder endoprosthesis for pathologic lesions of the proximal humerus: a minimum 3-year follow-up.

    Science.gov (United States)

    Maclean, Simon; Malik, Shahbaz S; Evans, Scott; Gregory, Jonathan; Jeys, Lee

    2017-11-01

    The Bayley Walker (Stanmore Implants, Elstree, UK) reversed polarity, linked shoulder replacement is designed to provide stable function in the treatment of a painful shoulder with poor soft tissue coverage. We reviewed the results of the prosthesis in destructive pathologic lesions of the proximal humerus at a United Kingdom tumor center. We identified 8 patients (2 men, 6 women) in our database. Clinical information and functional outcome scores were collected, including range of movement, Toronto Extremity Salvage Score, the Musculoskeletal Tumor Score. Radiographs from the last clinic follow-up were analyzed. Of the 8 patients, 2 were revisions for aseptic loosening around proximal humeral endoprosthetic replacements. Indications for surgery included chondrosarcoma in 4, metastatic disease in 2, Ewing sarcoma in 1, and osteomyelitis in 1. Patients were a mean age at diagnosis of 49 years (range, 16-78 years). One patient died of metastatic disease during follow-up. Mean follow-up was 49 months (range, 36-90 months). At the latest follow-up, there was 100% survivorship using revision as the end point. There were no local recurrences. Three of 5 patients returned to their previous occupation. Neuropathic pain developed in 1 patient postoperatively, but no other postoperative complications were noted. Radiographs showed no progressive lucencies or scapula notching. Mean range of movement at final follow-up was abduction, 62°; forward flexion, 71°; and external and internal rotation, 50°. The Bayley Walker prosthesis gives excellent medium-term survivorship and pain relief in patients with pathologic lesions of the proximal humerus requiring wide local excision. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  1. Staining of non-carious human coronal dentin by caries dyes.

    Science.gov (United States)

    Boston, Daniel W; Liao, Janice

    2004-01-01

    This study tested the hypothesis that commercially available caries dyes stain non-carious human coronal dentin in freshly extracted teeth. Multiple sections were cut from 10 non-carious and two control carious teeth using a water-cooled saw. Each section was stained with one of five caries dyes. The location of staining, if any, was noted and the staining intensity was scored on a four-point scale. One of the sections from each tooth was subsequently decalcified and processed for observation under a light microscope using four histologic staining techniques to evaluate morphology, collagen distribution and bacterial content. The association between the stain intensity scores on the undecalcified sections and the five dyes was evaluated using the Kruskal-Wallis One-Way ANOVA by Ranks test. Outer carious dentin in the control specimens stained intensely with each of the five dyes. In the undecalcified, non-carious sections, all had at least one area of staining. However, this staining could be differentiated from the intensity of dye staining in the carious controls, except in two instances. The association between stain intensity scores and the five dyes was not statistically significant. In the histologic sections, numerous bacteria were seen within the dentinal tubules of carious lesions of the two control specimens; however, no bacteria were found in any of the sections from non-carious specimens. Histologically, no differences were observed in the morphology or staining pattern within mantle or circumpulpal dentin in areas stained with caries dye, and in only one unique instance within the main body of the dentin. These results suggest that the five dyes evaluated in this study can stain non-carious dentin, however, this stain can be differentiated from the staining of outer carious dentin in vitro.

  2. Macroscopic and radiographic examination of proximal root surface caries

    Energy Technology Data Exchange (ETDEWEB)

    Nordenram, G.; Bergvist, A.; Johnson, G.; Henriksen, C.O.; Anneroth, G.

    1988-01-01

    The purpose of the study was to compare macroscopic and radiographic examination of proximal root surface caries of extracted teeth from patients aged 65-95 years. Although the study conditions for macroscopic and radiographic diagnosis favored more sensitive evaluations than routine clinical conditions, there was a 24% disagreement in diagnosis. This finding indicates that under routine clinical conditions it is difficult to register with certainty all superficial root carious lesions. Even in the absence of clinically detectable root surface caries, preventive measures should be considered for elderly people with exposed root surfaces.

  3. The reliability and accuracy of two methods for proximal caries detection and depth on directly visible proximal surfaces: an in vitro study.

    Science.gov (United States)

    Ekstrand, K R; Luna, L E; Promisiero, L; Cortes, A; Cuevas, S; Reyes, J F; Torres, C E; Martignon, S

    2011-01-01

    This study aimed to determine the reliability and accuracy of the ICDAS and radiographs in detecting and estimating the depth of proximal lesions on extracted teeth. The lesions were visible to the naked eye. Three trained examiners scored a total of 132 sound/carious proximal surfaces from 106 primary teeth and 160 sound/carious proximal surfaces from 140 permanent teeth. The selected surfaces were first scored visually, using the 7 classes in the ICDAS. They were then assessed on radiographs using a 5-point classification system. Reexaminations were conducted with both scoring systems. Teeth were then sectioned and the selected surfaces histologically classified using a stereomicroscope (×5). Intrareproducibility values (weighted kappa statistics) for the ICDAS for both primary and permanent teeth were >0.9, and for the radiographs between 0.6 and 0.8. Interreproducibility values for the ICDAS were >0.85, for the radiographs >0.6. For both primary and permanent teeth, the accuracy of each examiner (Spearman's correlation coefficient) for the ICDAS was ≥0.85, and for the radiographs ≥0.45. Corresponding data were achieved when using pooled data from the 3 examiners for both the ICDAS and the radiographs. The associations between the 2 detection methods were measured to be moderate. In particular, the ICDAS was accurate in predicting lesion depth (histologically) confined to the enamel/outer third of the dentine versus deeper lesions. This study shows that when proximal lesions are open for inspection, the ICDAS is a more reliable and accurate method than the radiograph for detecting and estimating the depth of the lesion in both primary and permanent teeth. Copyright © 2011 S. Karger AG, Basel.

  4. Photodynamic antimicrobial therapy of curcumin in biofilms and carious dentine.

    Science.gov (United States)

    Araújo, N C; Fontana, C R; Bagnato, V S; Gerbi, M E M

    2014-03-01

    Photodynamic therapy (PDT) is a technique that involves the activation of photosensitizers by light in the presence of oxygen, resulting in the production of reactive radicals that are capable of inducing cell death. The present study evaluated the susceptibility of Streptococcus mutans and Lactobacillus acidophilus to PDT grown as multi-species in the biofilm phase versus in dentine carious lesions. A brain-heart infusion culture medium supplemented with 1% glucose, 2% sucrose, and 1% young primary culture of L. acidophilus 10(8) CFU/mL and S. mutans 10(8) CFU/mL was used to develop multi-species biofilms and to induce caries on human dentine slabs. Five different concentrations of curcumin (0.75, 1.5, 3.0, 4.0, and 5.0 g/L) were used associated with 5.7 J/cm(2) light emission diode. Four different groups were analyzed L-D- (control group), L-D+ (drug group), L+D- (light group), and L+D+ (PDT group). ANOVA/Tukey's tests were conducted to compare groups. A significant reduction (p <0.05) in cell viability was observed in the biofilm phase following photosensitization with all curcumin concentrations tested. To achieve significant bacterial reduction (p <0.05) in carious dentine, it was necessary to utilize 5.0 g/L of curcumin in association with blue light. No significant reduction was found for L-D+, supporting the absence of the drug's dark toxicity. S. mutans and L. acidophilus were susceptible to curcumin in the presence of blue light. However, due to light penetration and drug diffusion difficulties, these microorganisms within dentine carious lesions were less affected than they were in the biofilm phase.

  5. Safety of hydrophilic guidewires used for side-branch protection during stenting and proximal optimization technique in coronary bifurcation lesions

    Energy Technology Data Exchange (ETDEWEB)

    Chatterjee, Arka [Division of Cardiology, University of Alabama-Birmingham (United States); Brott, Brigitta C. [Division of Cardiology, University of Alabama-Birmingham (United States); Department of Biomedical Engineering, University of Alabama-Birmingham (United States); Foley, Robin [Department of Material Science and Engineering, University of Alabama-Birmingham (United States); Alli, Oluseun; Sasse, Mark; Ahmed, Mustafa; Al Solaiman, Firas; Reddy, Gautam; Ather, Sameer [Division of Cardiology, University of Alabama-Birmingham (United States); Leesar, Massoud A., E-mail: mleesar@uab.edu [Division of Cardiology, University of Alabama-Birmingham (United States)

    2016-10-15

    Background and propose: In coronary bifurcation lesions (CBL), hydrophilic guidewires used for side-branch (SB) protection can be withdrawn from underneath the stent easier than other wires. However, the safety of which has not been investigated. Methods/materials: We performed scanning electron microscopic (SEM) examination of hydrophilic wires – the Whisper and Runthrough wires – used for SB protection during stenting and proximal optimization technique (POT) in 30 patients with CBL. The distal 15 cm of the wire was examined every 1 mm by SEM and 4500 segments were analyzed to investigate for wire fracture, polymer shearing (PS), and its correlations with post-stenting creatine kinase (CK)-MB release. Results: SEM examination showed no evidence for wire fracture. The total area of PS and the largest defect on the wire were significantly larger with the Whisper wire versus the Runthrough wire (0.15 ± 0.04 mm{sup 2} vs. 0.026 ± 0.01 mm{sup 2} and 0.04 ± 0.05 mm{sup 2} vs. 0.01 ± 0.01 mm{sup 2}; P < 0.05, respectively). The total length of PS and the longest defect on the wire were significantly longer with the Whisper wire vs. the Runthrough wire (12.1 ± 14.5 mm vs. 2.7 ± 3.0 mm and 2.9 ± 4.2 mm vs. 1.0 ± 1.2 mm; P < 0.05, respectively), but there were weak correlations between the extents of PS with CK-MB release. Conclusions: Hydrophilic guidewires may be safely used for SB protection during stenting and POT in CBLs. The extent of PS was significantly greater with the Whisper wire than with the Runthrough wire, but its correlation with post-stenting CK-MB release was weak. - Highlights: • There was no wire fracture by jailing hydrophilic wires. • There was no wire entrapment by jailing hydrophilic wires. • There were weak correlations between polymer shearing and creatine kinase-MB levels. • The impact of polymer shearing on myocardial infraction warrants future studies.

  6. Endoscopic mucosal resection for proximal superficial lesions: efficacy and safety study in 59 consecutive resections Resección endoscópica mucosa de lesiones superficiales altas: estudio de su eficacia y seguridad en 59 resecciones consecutivas

    Directory of Open Access Journals (Sweden)

    Eduardo Albéniz-Arbizu

    2012-09-01

    Full Text Available Introduction: endoscopic mucosal resection is an accepted technique for the treatment of proximal gastrointestinal tract superficial lesions. Objectives: to evaluate the efficacy and safety of this procedure in the proximal gastrointestinal tract. Material and methods: forty one consecutive patients (23 males and 18 females, mean age of 61 ± 11.5 years were included in our study. Fifty nine resections were performed in these patients in 69 sessions. Lesions treated consisted of elevated lesions with high grade dysplasia in the context of Barrett's esophagus (group A, high grade dysplasia appearing in random biopsies taken during the follow-up of Barrett's esophagus (group B and superficial gastroduodenal lesions (group C. Snare resection after submucosal injection, band ligator-assisted or cap-assisted mucosal resection were the chosen techniques. Results: we resected 7 elevated lesions with high grade dysplasia in the context of Barrett's esophagus, 6 complete Barrett's esophagus with high grade dysplasia in 16 sequential sessions and 46 gastroduodenal superficial lesions (10 adenomas, 9 gastric superficial carcinomas, 18 carcinoid tumours and 9 lesions of different histological nature. Resections in the two first groups were complete in 100% of the cases, and in 97.9% of the cases in group C. Complications included 2 cases of limited deferred bleeding (groups A and B and another two cases of stenosis with little clinical relevance in Group B. Conclusions: a endoscopic mucosal resection is an efficient technique for the treatment of proximal gastrointestinal tract superficial lesions; b it is a safe procedure with a low percentage of complications, which can generally be managed endoscopically; and c in contrast with other ablative techniques, endoscopic mucosal resection offers the possibility of a pathologic analysis of the samples.Introducción: la resección endoscópica mucosa es una técnica aceptada en el tratamiento de lesiones

  7. Histological comparison of pulpal inflammation in primary teeth with occlusal or proximal caries.

    Science.gov (United States)

    Kassa, Despoina; Day, Peter; High, Alex; Duggal, Monty

    2009-01-01

    A number of clinical and histological studies have investigated caries-related changes in the primary tooth pulp, but the effect of caries site, as a clinical variable, has not been previously considered. This study sought to compare inflammatory changes within the pulp of primary molars according to the location of the caries lesion (occlusal or proximal). Eighty-three primary molars were extracted under general anaesthesia for caries and/or orthodontic reasons, and were split immediately after removal and fixed in 10% formalin. Teeth were then decalcified, sectioned, and stained with haematoxylin and eosin for histological examination using light microscopy. Caries depth was measured using a graticle, and the site of the caries lesion noted as occlusal or proximal. Samples were further classified into one of five subgroups according to the observed degree of pulpal inflammation. Key findings were that where caries depth was less than 50% of the total dentine thickness, there were no significant differences in inflammatory status according to caries site. In contrast, marked inflammatory changes were significantly more likely throughout the coronal pulp of teeth with proximal caries compared to teeth with occlusal caries where caries depth was equal to, or greater than, 50% of the total dentine thickness (P = 0.017, Fisher's exact test). Primary teeth with proximal carious lesions extending more than 50% through the dentine thickness appear to have more extensive inflammatory pulpal changes than teeth with occlusal caries of a similar depth. This finding has clinical implications and may help inform treatment decisions in the management of primary teeth with deep carious lesions.

  8. Resin adhesion to carious dentin.

    Science.gov (United States)

    Yoshiyama, Masahiro; Tay, Franklin R; Torii, Yasuhiro; Nishitani, Yoshihiro; Doi, Junichi; Itou, Kousuke; Ciucchi, Bernard; Pashley, David H

    2003-02-01

    To investigate the microtensile bond strength (microTBS) of a self-etching priming adhesive system to normal, caries-affected and caries-infected dentin, and to observe the ultrastructure of the resin-dentin interface by transmission electron microscopy (TEM). Twelve extracted human molar teeth with deep occlusal caries were stained with caries detector solution and ground flat occlusally. The red-stained soft dentin was classified as caries-infected. The surrounding discolored dentin was classified as caries-affected dentin. The surrounding normal dentin served as a control. The entire flat surface was bonded with Clearfil Liner Bond 2V (CV) and covered with resin composite to form a composite crown 5 mm high. One day later the specimens were serially sectioned vertically into multiple slabs 0.8 mm thick. Under microscopic observation, the specimens were divided into normal or caries-infected or caries-affected dentin. These regions were isolated by cutting away the remaining dentin to form hour-glass shapes with the smallest surface area at the test site. After measuring the areas, the specimens were fixed to a microtensile tester and pulled under tension to failure. Additional slabs that were not used for bond strength tests were processed for TEM. Bond strength data were analyzed by Kruskal-Wallis one-way ANOVA and Student-Newman-Keuls multiple comparisons. The microTBS of CV to normal, caries-affected and caries-infected dentin were 45 +/- 10 MPa, 30 +/- 10 MPa, 10 +/- 5 MPa, respectively. TEM images showed that CV formed thin hybrid layers that were less than 1 microm thick in normal dentin, but that were between 6-8 microm thick in caries-affected dentin. Bacteria were only sparsely observed in the dentin tubules of bonded caries-affected dentin. However, in caries-infected dentin, an unusual interface was seen in which carious bacteria within disorganized non-banded collagen fibrils could be seen embedded by the adhesive. The hybrid layer in caries

  9. A Novel Antegrade Approach for Simultaneous Carotid Endarterectomy and Angioplasty of Proximal Lesions in Patients with Tandem Stenosis of Supraaortic Arch Vessels.

    Science.gov (United States)

    Radak, Djordje; Tanaskovic, Slobodan; Sagic, Dragan; Antonic, Zelimir; Gajin, Predrag; Babic, Srdjan; Neskovic, Mihailo; Matic, Predrag; Kovacevic, Vladimir; Nenezic, Dragoslav; Ilijevski, Nenad

    2017-10-01

    To date, all published studies analyzing simultaneous treatment of carotid and proximal atherosclerotic lesions are describing retrograde approach and several technical variations. In the presented study, for the first time, antegrade approach is described for simultaneous carotid endarterectomy (CEA) and associated brachiocephalic trunk (BCT) or common carotid artery (CCA) angioplasty in the hybrid operating room. From January 2012 till January 2016, antegrade hybrid procedures were performed in 18 patients. All patients were admitted to our institute for elective supraaortic arch multidetector computed tomography angiography when significant simultaneous proximal and distal supraaortic arch lesions were revealed. After surgical exposure of carotid arteries, proximal lesions were crossed by antegrade approach. Prior to stent placement, internal carotid artery (ICA) is clamped at its origin with the guidewire placed in the external carotid artery (ECA). After primary stenting and control arteriography, CCA and ECA are clamped and the ICA clamp moved more distally. An arteriotomy is performed in the CCA, with flushing of possible debris and thrombus before performance of the eversion CEA, once again flushing before completion of the anastomosis. Follow-up ranged from 6 to 36 months with average follow-up of 22.15 ± 11.31 months. All procedures went uneventfully. Out of 18 patients, 11 were males and 7 females, mean age 66.6 ± 3.82 years. In 10 patients (55.5%), simultaneous CEA and CCA angioplasty was performed, in 7 patients (38.9%) CEA and BCT angioplasty, and in 1 patient (5.5%) tubular graft interposition between the CCA and the ICA and CCA angioplasty. In 6 patients (33.3%), CCA/BCT balloon angioplasty alone was performed simultaneously with CEA. None of the patient had postoperative transient ischemic attack, stroke, hematoma, dissection, myocardial infarction, or ischemia in the early postoperative period and during the follow-up. There were no

  10. Estimation of Remnant Dentin Thickness under Proximal Caries Using Digital Bitewing Radiography: An In-Vitro Study

    Directory of Open Access Journals (Sweden)

    Masoomeh Afsa

    2016-03-01

    Full Text Available Objectives: In restorative dentistry, it is essential to estimate the amount of remnant tooth structure after caries removal to make the best treatment plan. The present study was aimed to determine whether there is a correlation between the real thickness of remnant dentin under carious lesion and the radiographical measurement from photostimulable phosphor plates (PSPs. Methods: a whole number of 68 unrestored permanent human molar and premolar teeth with 82 proximal carious surfaces were mounted in an artificial arch. Digital bitewing radiographs with PSPs were taken, carious lesions were removed and radiographic imaging was repeated. Teeth were sectioned mesiodistally in two parts and thickness of remnant tooth structure to pulp was measured. Measurements of remnant dentin under caries from radiographic images and teeth structures were compared. Result: The mean measurements of remnant dentin on primary radiographs were statistically different from the measurements on teeth structures. The mean thickness of remnant dentin on tooth structure was around 30% less than what measured on radiographic image. Conclusion: The real thickness of remnant dentin under caries is about 70% of its thickness measured on digital bitewing radiographs prepared by PSPs as image receptor.

  11. Estimation of Remnant Dentin Thickness under Proximal Caries Using Digital Bitewing Radiography: An In-Vitro Study

    Directory of Open Access Journals (Sweden)

    Masoomeh Afsa

    2015-12-01

    Full Text Available Objectives: In restorative dentistry, it is essential to estimate the amount of remnant tooth structure after caries removal to make the best treatment plan. The present study was aimed to determine whether there is a correlation between the real thickness of remnant dentin under carious lesion and the radiographical measurement from photostimulable phosphor plates (PSPs. Methods: a whole number of 68 unrestored permanent human molar and premolar teeth with 82 proximal carious surfaces were mounted in an artificial arch. Digital bitewing radiographs with PSPs were taken, carious lesions were removed and radiographic imaging was repeated. Teeth were sectioned mesiodistally in two parts and thickness of remnant tooth structure to pulp was measured. Measurements of remnant dentin under caries from radiographic images and teeth structures were compared. Result: The mean measurements of remnant dentin on primary radiographs were statistically different from the measurements on teeth structures. The mean thickness of remnant dentin on tooth structure was around 30% less than what measured on radiographic image. Conclusion: The real thickness of remnant dentin under caries is about 70% of its thickness measured on digital bitewing radiographs prepared by PSPs as image receptor.

  12. First-time isolation of Candida dubliniensis from plaque and carious dentine of primary teeth.

    Science.gov (United States)

    Kneist, S; Borutta, A; Sigusch, B W; Nietzsche, S; Küpper, H; Kostrzewa, M; Callaway, A

    2015-08-01

    To determine those organisms of the genus Candida associated with dental caries by investigating samples from active carious lesions. Within the genus Candida, the species Candida albicans and Candida dubliniensis are capable of forming chlamydospores and germ tubes. Until it became possible in 1995 to differentiate between the two species taxonomically, C. dubliniensis was falsely identified as C. albicans. Whilst the importance of C. albicans for rapidly progressing early childhood caries (ECC) has been recognised, so far there have been only reports about C. dubliniensis in connection with children/mothers who have been infected with HIV or already developed AIDS. In the present study, C. dubliniensis was for the first time isolated from plaque and carious dentine of a healthy five-year-old boy. As part of the investigation, a number of samples were collected from individual children affected by active dental caries. Amongst the samples, one in particular indicated that Candida species might be involved. The patient was a five-year-old boy with ECC of the primary dentition, scheduled for restorative treatment under general anaesthesia. Before treatment, a salivary, plaque (region of 54/55) and soft carious dentine sample from the tooth 51 was taken before extraction. The counts of yeasts, lactobacilli (LB) and mutans streptococci were determined in the samples. The boy's dmft was 11, which was dominated by the d component. In the saliva of the boy, LB and mutans streptococci (MS) were detected. In plaque and carious dentine, MS and most interestingly C. dubliniensis were present. The yeasts were visualised in carious dentine by means of scanning electron micrographs. Plaque and carious dentine may be a further habitat of C. dubliniensis.

  13. Evaluation of Cone Beam Computed Tomography (CBCT System: Comparison with Intraoral Periapical Radiography in Proximal Caries Detection

    Directory of Open Access Journals (Sweden)

    Solmaz Valizadeh

    2012-02-01

    Full Text Available Background and aims. With the introduction of Cone Beam Computed Tomography (CBCT in dentistry, a question has been raised whether the technique significantly increases the diagnostic accuracy in comparison with other techniques or not. Therefore, the present study was undertaken to assess the accuracy of CBCT modality in detecting proximal carious lesions as compared to conventional periapical radiographs. Materials and methods. This diagnostic study was carried out on 84 human extracted molars and premolars. The teeth were mounted and divided in 28 blocks of 3 teeth. Periapical and CBCT images of teeth were obtained. Five observers scored the images for the detection of proximal carious lesions using a 2-point scale (caries, present; caries, absent. The gold standard was determined by histopathologic sections. Sensitivity, specificity, PPV, NPV and receiver operating characteristics (ROC curves were traced for observers in both systems. The results were analyzed by paired t-test. Results. The area under the ROC curve, sensitivity, specificity, accuracy, positive and negative predictive values of CBCT images were 0.568, 0.835, 0.637, 0.714, 0.598 and 0.856, respectively. These parameters were 0.432, 0.837, 0.722, 0.77, 0.687 and 0.858 for the periapical conventional technique, respectively. Conclusion. The CBCT images did not enhance detection of proximal caries in comparison with periapical images.

  14. Noninvasive cross-sectional imaging of proximal caries using swept-source optical coherence tomography (SS-OCT) in vivo.

    Science.gov (United States)

    Shimada, Yasushi; Nakagawa, Hisaichi; Sadr, Alireza; Wada, Ikumi; Nakajima, Masatoshi; Nikaido, Toru; Otsuki, Masayuki; Tagami, Junji; Sumi, Yasunori

    2014-07-01

    The aim of this study was to determine the diagnostic accuracy of swept-source optical coherent tomography (SS-OCT) in detecting and estimating the depth of proximal caries in posterior teeth in vivo. SS-OCT images and bitewing radiographs were obtained from 86 proximal surfaces of 53 patients. Six examiners scored the locations according to a caries lesion depth scale (0-4) using SS-OCT and the radiographs. The results were compared with clinical observations obtained after the treatment. SS-OCT could detect the presence of proximal caries in tomograms that were synthesized based on the backscatter signal obtained from the proximal carious lesion through occlusal enamel. SS-OCT showed significantly higher sensitivity and larger area under the receiver operating characteristic curve than radiographs for the detection of cavitated enamel lesions and dentin caries (Student's t -test, p proximal lesions in the clinical environment. Copyright © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Resin infiltration of non-cavitated caries lesions: a systematic review.

    Science.gov (United States)

    Doméjean, Sophie; Ducamp, Raphaël; Léger, Stéphanie; Holmgren, Christopher

    2015-01-01

    The aim of this systematic review was to evaluate the in vivo scientific evidence of the ability of resin infiltration (RI) to arrest non-cavitated caries lesions. The PubMed database was searched for randomized controlled trials that evaluated the in vivo effect of RI versus placebo or other preventive treatment on the progression of caries lesions. The keywords used were 'resin infiltration, dental caries', 'resin infiltration, carious lesions', 'resin infiltration, caries lesions', 'caries infiltration' and 'Icon DMG' with the 'clinical trial' filter activated. Among the 14 articles originally identified with these keywords, only 4 (related to 3 different in vivo studies) were included for this review. All 4 articles reported on proximal caries lesions. One study had been conducted on 48 high-caries-risk children while the other 3 (n = 22, 22 and 39, respectively) concerned moderate- and low-caries-risk adolescents and adults. The quality of the studies was assessed to be high with respect to randomization, split-mouth design and blinding. All the included studies showed significant differences in caries progression between test and control/placebo groups, indicating that RI may inhibit the carious process. This systematic review revealed that RI appeared to be an effective method to arrest the progression of non-cavitated caries lesions. Additional, long-term studies are required.

  16. Neutrophil to lymphocyte ratio is associated with proximal/middle segment of the LAD lesions in patients with ST segment elevation infarction

    Directory of Open Access Journals (Sweden)

    Ozlem Arican Ozluk

    2017-01-01

    Full Text Available Introduction: Neutrophil to lymphocyte ratio (NLR was revaled to have a close relation with atherosclerotic cardiovascular disease. The relationship between NLR and culprit plaque localization has never been studied. Aim of the study : To evaluate the association between NLR and unstable plaque localization of left anterior descending artery (LAD in anterior miyocardial infarction patients. Material and methods : Patients admitted to our hospital with acute anterior STEMI were included. Fifhy-eight patients who have single-vessel disease at LAD and their hematological parameters were analyzed retrospectively. Proximal segment of LAD lesions were groupped as Group I and mid segment of the LAD lesion groupped as Group II. The groups were compared according to their NLR and other parameters. Results : Between group I (n = 41, mean age 52.5 ±12.7 and group II (n = 17, mean ages 52.0 ±10.8; NLR, were significantly higher in group I compared to the group II (6.9 ±5.6 vs. 3.3 ±2.0, p = 0.01. In group I, left ventricular ejection fraction (LVEF was significantly lower (p = 0.02. In correlation analyzes, NLR was positively correlated with CK MB (r = 0.32, p = 0.01 and negatively correlated with LVEF (r = –0.28, p = 0.03. Conclusions : The present study demonstrated that anterior myocardial infarction patients with high NLR had a greater possibility having proximal culprit lesion on the LAD. Therefore NLR can be used as a useful tool to culprit plaque localization in patients with acute miyocardial infarction patients.

  17. Closing the gap between oral hygiene and minimally invasive dentistry: a review on the resin infiltration technique of incipient (proximal) enamel lesions.

    Science.gov (United States)

    Kielbassa, Andrej M; Muller, Jan; Gernhardt, Christian R

    2009-09-01

    Dental caries on (proximal) tooth surfaces is still a problem in many industrialized countries. The objectives of this review were to present the scientific basis and the principles of the resin infiltration concept, to discuss the inherent clinical applications, and to describe how these backgrounds can be integrated into the concept of minimal intervention dentistry. Data were identified by searches of the Cochrane Registers, Medline, and Scopus. Articles published in English and German through December 2008 were selected, and most up-to-date or relevant references were chosen. Cross-referencing of significant articles identified additionally relevant articles written in other languages and those of historical value. A total of 23 in vitro studies (focusing on penetration depths or demineralization prevention) were found, and 3 clinical studies (involving 122 subjects) could be retrieved; these studies were not comparable. With an increased understanding of the caries process, it is now recognized that demineralized but noncavitated enamel lesions can be arrested or remineralized in many situations. The clinical research evidence on the resin infiltration technique currently is of moderate extent to reach any decisive conclusions; however, based on available laboratory and clinical studies, it seems convincing that resin infiltration of enamel lesions should reduce (or even stop) the progress of white spot lesions. Combining this ultraconservative restorative approach (which is considered microinvasive) with a substantial caries remineralization program may provide therapeutic benefits and significantly reduce both long-term restorative needs and costs, thus complementing the concept of minimal intervention dentistry.

  18. Sanation of carious and periapical foci in young athletes with impairment of cardiovascular adaptation

    Directory of Open Access Journals (Sweden)

    I. I. Belyaev

    2014-01-01

    Full Text Available The aim of this study was to evaluate the impact of sanation of oral cavity in young athletes on the course of adaptation of the cardiovascular system to the condition of sports activities. According to the research results, it was revealed that the optimal period for sanation of periapical odontogenic foci in athletes with clinical signs of impairment (dysfunction of cardiovascular system adaptation to exercise stress was a preparatory training period, while carious lesion sanation required preparatory or postcompetition periods.

  19. The Evaluation of the Vector System in Removal of Carious Tissue

    Directory of Open Access Journals (Sweden)

    Mine Yildirim

    2010-01-01

    Full Text Available The aim of this study was to evaluate the Vector system in comparison to the conventional technique in cavity preparation. Four extracted primary teeth with no restorations and similar fissure carious lesions and four permanent teeth extracted for orthodontic reasons were used. Class I preparations were made provided that the caries depth remained within the dentin limits. Two teeth were treated with an aerator, the other two had carious tissue removed with the Vector system. Prepared cavities were evaluated with scanning electron microscopy for the surface roughness of the dentine and enamel and for the carious tissue removal efficiency. This pilot study determined that it is possible to remove carious tissue and perform cavity preparation with the Vector system. According to this preliminary evaluation of surface quality, a cavity prepared with the Vector treatment system, allows for a slicker floor, and a more regular enamel-dentine line than that prepared with an aerator. However, the Vector system requires a longer treatment time which we believe may be a negative point, especially for young patients.

  20. Preventing Advanced Carious Lesions with Caries Atraumatic Restorative Technique.

    Science.gov (United States)

    Byrd, Tammi O

    2016-06-01

    An alternative approach to controlling dental caries and preventing the associated pain, called atraumatic restorative technique (ART), is described for populations in need, where dental hygienists restore decayed teeth with glass ionomer restorations without prior removal of all decayed tooth structure. There are populations whose decay needs are not adequately being met within the current oral health care delivery system. These include those in poverty conditions, vulnerable children, and the elderly who are often in long-term care facilities without adequate resources or opportunities for traditional dentistry. ART provides a viable option for controlling caries and relieving the pain of untreated decay. The purpose of this article is to suggest that the evidence surrounding ART be viewed objectively and that dental hygienists, with additional education in this approach, can contribute to relieving the pain of untreated dental decay. Evidence suggests that teeth can be effectively restored with ART. Dental hygienists represent an appropriate workforce to provide ART with their current background and education combined plus a brief training program; it is suggested that dental hygiene educational programs include ART within the curriculum. Along with dental sealants and fluoride varnish application, ART can be an important component of a comprehensive preventive program to address the unmet needs of vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Achilles Tendon Vascularization of Proximal, Medial, and Distal Portion Before and After Partial Lesion in Rats Treated with Phototherapy.

    Science.gov (United States)

    Ferreira, Rafaela; Silva, Rosangela; Folha, Roberta A C; Polacow, Maria Luiza O; Teodori, Rosana Macher; Pinfildi, Carlos Eduardo

    2015-12-01

    The Achilles tendon is one of the tendons most commonly injured by microtraumas and overuse during sports practice. This tendon is especially fragile because of the low blood supply in its central part. Nevertheless, the literature does not offer enough scientific support to explain the composition and vascular dynamic of animal tendons, despite the relevance of being able to observe if the animal tendon undergoes the same processes of vascularization in different regions, as occurs in humans. We used 28 rats weighing 280 ± 20 g, which were divided into four groups with seven animals each (control, sham, 830 nm, 660 nm). The laser parameters were: power output 60 mW for both lasers, 40 J/cm(2) of energy density, total energy 1.1 J, power density 2.14 W/cm(2), and application time 18.6 sec. This study evaluated the vascular constitution of healthy and injured calcaneous tendons. The tendons of each animal were processed to be embedded in Paraplast and, after that, they were divided into three parts: proximal, medial, and distal. Afterwards, they were cut in slices of 6 μm were made, then they were stained with hematoxylin and eosin. Using an ocular lens reticulated with magnification × 400, we analyzed the number and the area density of the blood vessels using morphometric methods. Data were analyzed with the Shapiro-Wilk test, followed by Tukey, considering p as <0.05. The area density and the number of blood vessels in the proximal part were 36% and 42%, respectively, of the values found in the medial part. The distal part had 64% more vessels and 52.8% more area density (p < 0.05) than the medial part. Low-level laser therapy (LLLT) had no effect on the studied parameters. The vascularization of rat tendon is similar to that of humans, which contributes to the studies of therapies that have been applied in humans.

  2. Quantitative analysis of the mineral content of sound and carious primary dentine using BSE imaging.

    Science.gov (United States)

    Angker, Linny; Nockolds, Clive; Swain, Michael V; Kilpatrick, Nicky

    2004-02-01

    Backscattered electron-scanning electron microscope (BSE-SEM) imaging has been recommended as a reliable tool to quantify the mineralisation state of calcified tissues and is commonly used in bone studies. The aim of this study is to investigate the use of BSE imaging to quantitatively analyse the mineral content of sound and carious dentine. Eight primary molars with untreated carious dentine were embedded in resin, axially sectioned and fine polished for this study. The BSE images were from a solid-state detector in an SEM operating at 1.5Torr gas pressure. BSE images of a number of different elements and compounds with atomic number ranged from 4 to 26 were analysed prior to the test to calibrate the experimental conditions and an enamel-carbon block. The mineral analysis was based on the change in BSE intensity (measured in graylevels). The results showed that variation in graylevels accurately represented difference in the atomic number and BSE coefficient of the test materials. The mineral content of sound primary dentine in the most regions was 59.3+/-5.5 wt.%, but it decreased gradually to be just 41.82+/-6.74 wt.% adjacent to the pulp. The carious dentine showed a marked reduction in mineral content which proceeded progressively toward the cavity floor, in which the minimum value of less than 10 wt.% was normally found in the outer layer of the lesion. The results show that BSE imaging is a simple and reliable technique that can be used to quantify the mineral content of sound and carious dentine. More importantly the variable pressure SEM offers an approach to minimize the impact of dehydration on carious dentine specimens.

  3. Efficacy of removal of cariogenic bacteria and carious dentin by ablation using different modes of Er:YAG lasers

    Directory of Open Access Journals (Sweden)

    A. Baraba

    2018-01-01

    Full Text Available The primary objective of this in vitro study was to evaluate the efficiency of removal of cariogenic bacteria and carious dentin by ablation using two lasers: fluorescence-feedback controlled (FFC Er:YAG laser and different pulses of Er:YAG laser based on variable square pulse technology (VSPt. The secondary objective was to measure the temperature during laser ablation of carious tissue. Seventy-two extracted human molars were used in this study. Sixty teeth with carious dentin were randomly divided into four experimental groups according to the treatment for caries removal: group 1: 400 µs (FFC group; group 2: super short pulse (SSP group, 50 µs pulse; group 3: medium short pulse (MSP group, 100 µs pulse; group 4: short pulse (SP group, 300 µs pulse and one positive control group with no treatment. Twelve teeth without carious lesion were used as a negative control group. After caries removal, swabs were taken with cotton pellets and real-time PCR analysis was performed. During caries ablation, a thermal infrared camera was used to measure the temperature changes. In all experimental groups, specimens were free of bacterial contamination after the treatment. In the SSP, MSP and SP groups, temperatures measured during caries ablation were significantly higher compared to temperatures in the FFC group (P<0.001. In this in vitro study, laser treatment for removal of carious dentin and cariogenic bacteria was an efficient treatment modality without causing excessive temperatures that might adversely affect pulp vitality.

  4. Detection accuracy of proximal caries by phosphor plate and cone-beam computerized tomography images scanned with different resolutions.

    Science.gov (United States)

    Cheng, Jun-Ge; Zhang, Zhi-Ling; Wang, Xiao-Yan; Zhang, Zu-Yan; Ma, Xu-Chen; Li, Gang

    2012-08-01

    This study was carried out to assess whether the spatial resolution has an impact on the detection accuracy of proximal caries in flat panel CBCT (cone beam computerized tomography) images and if the detection accuracy can be improved by flat panel CBCT images scanned with high spatial resolution when compared to digital intraoral images. The CBCT test images of 45 non-restored human permanent teeth were respectively scanned with the ProMax 3D and the DCT Pro scanners at different resolutions. Digital images were obtained with a phosphor plate imaging system Digora Optime. Eight observers evaluated all the test images for carious lesion within the 90 proximal surfaces. With the histological examination serving as the reference standard, observer performances were evaluated by receiver operating characteristic (ROC) curves. The areas under the ROC curves were analyzed with two-way analysis of variance. No significant differences were found among the CBCT images and between CBCT and digital images when only proximal enamel caries was detected (p = 0.989). With respect to the detection of proximal dentinal caries, significant difference was found between CBCT and digital images (p proximal caries in flat panel CBCT images. The flat panel CBCT images scanned with high spatial resolution did not improve the detection accuracy of proximal enamel caries compared to digital intraoral images. CBCT images scanned with high spatial resolutions could not be used for proximal caries detection.

  5. In Vitro Comparison of Diagnostic Accuracy of DIAGNOdent and Digital Radiography for Detection of Secondary Proximal Caries Adjacent to Composite Restorations.

    Science.gov (United States)

    Ghoncheh, Zahra; Zonouzy, Zahra; Kiomarsi, Nazanin; Kharazifar, Mohammad Javad; Chiniforush, Nasim

    2017-01-01

    Introduction: Early detection of secondary proximal caries is critical for the preservation of tooth vitality. This study sought to assess and compare the diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations. Methods: Sixty extracted molars including 30 teeth with carious lesions and 30 sound teeth were randomly selected. Class II cavities were prepared in all teeth and carious dentin was intentionally left in the gingival floor of cavities in 30 carious teeth. All cavities were restored with composite resin. The teeth were mounted in wax blocks (three teeth per block) and examined for caries using (DIAGNOdent kaVo Dental, Biberach, Germany). Digital radiographs using DIGORA photostimulable phosphor (PSP) plates (Soredex Corporation, Helsinki, Finland) were obtained from all teeth using the parallel technique and were evaluated by 4 observers. Repeated measure analysis of variance (ANOVA) was applied to calculate sensitivity and specificity values of the two diagnostic techniques. Receiver operating characteristic (ROC) curve was plotted for DIAGNOdent results and based on that, the cutoff points were determined. Results: The sensitivity and specificity values at the cut-off point of 10.5 were 0.622±0.038 and 0.822±0.077 for DIAGNOdent and 0.591±0.093 and 0.891±0.083 for digital radiography, respectively. The area under the ROC curve was 0.7 for DIAGNOdent. Weighted kappa revealed moderate to almost perfect intra-observer agreement (0.46-0.99). Intraclass correlation coefficient (ICC) for DIAGNOdent was calculated to be 0.88. Conclusion: No statistically significant difference was noted in diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations. Thus, DIAGNOdent may be used as an adjunct diagnostic tool for detection of secondary proximal caries beneath composite restorations.

  6. Microleakage and sealant penetration in contaminated carious fissures.

    NARCIS (Netherlands)

    Hevinga, M.; Opdam, N.J.M.; Frencken, J.E.F.M.; Bronkhorst, E.M.; Truin, G.J.

    2007-01-01

    OBJECTIVES: The aim of the present in vitro study was to evaluate the effect of an adhesive system on microleakage and sealant penetration depth in carious fissures after different surface contamination circumstances. METHODS: Extracted third molars (n=128) with small occlusal cavitated carious

  7. Comparison of Proximal Caries Detection in Primary Teeth between Laser Fluorescence and Bitewing Radiography: An in vivo Study.

    Science.gov (United States)

    Mepparambath, Ratheesh; S Bhat, Sham; K Hegde, Sundeep; Anjana, G; Sunil, M; Mathew, Sherryl

    2014-01-01

    Proximal caries detection is of great importance because of the rapid rate of caries progression and the difficulty in determining the absence or presence of a lesion in primary dentition. Although, various methods for caries diagnosis offer good diagnostic performances, they provide varying sensitivities for detecting proximal carious lesions. The objective of this study was to compare, in vivo, the accuracy of DIAGNOdent and bitewing radiography at detecting proximal caries in primary teeth. One Hundred and one primary maxillary and mandibular molars without obvious cavities of children between the age group of 3 and 10 years were included. The teeth were first subjected to DIAGNOdent examination followed by bitewing radiography. The specificity and sensitivity of the systems were calculated. At the dentin caries (D3) level, the sensitivity of DIAGNOdent and bitewing radiography was 78.5%; at the enamel caries (D1 and D2) level it was 39.12% and for the sound teeth (D0) it was found to be 76.52%. A strong association was observed between the DIAGNOdent and the bitewing radiograph (p proximal caries in primary teeth. But when seen at the each caries level, the DIAGNOdent is more accurate at the D0 and D3 threshold. How to cite this article: Mepparambath R, Bhat SS, Hegde SK, Anjana G, Sunil M, Mathew S. Comparison of Proximal Caries Detection in Primary Teeth between Laser Fluorescence and Bitewing Radiography: An in vivo Study. Int J Clin Pediatr Dent 2014;7(3):163-167.

  8. Guided fluorescence diagnosis of childhood caries: preliminary measures correlate with depth of carious decay

    Science.gov (United States)

    Timoshchuk, Mari-Alina; Zhang, Liang; Dickinson, Brian A.; Ridge, Jeremy S.; Kim, Amy S.; Baltuck, Camille T.; Nelson, Leonard Y.; Berg, Joel H.; Seibel, Eric J.

    2014-02-01

    The current rise in childhood caries worldwide has increased the demand for portable technologies that can quickly and accurately detect and diagnose early stage carious lesions. These lesions, if identified at an early stage, can be reversed with remineralization treatments, education, and improvements in home care. A multi-modal optical prototype for detecting and diagnosing occlusal caries demineralization in vivo has been developed and pilot tested. The device uses a 405-nm laser as a scanned illumination source to obtain high resolution and high surface contrast reflectance images, which allows the user to quickly image and screen for any signs of demineralized enamel. When a suspicious region is located, the device can be switched to perform dual laser fluorescence spectroscopy using 405-nm and 532-nm laser excitations. These spectra are used to compute an auto-fluorescence (AF) ratio of the suspicious region and the percent difference of AF ratios from a healthy region of the same tooth. The device was tested on 7 children's teeth in vivo with clinically diagnosed carious lesions. Lesion depth was then visually estimated from the video image using the 405-nm scanned light source, and within a month the maximum drill depth was assessed by a clinician. The researcher and clinicians were masked from previous measurements in a blinded study protocol. Preliminary results show that the ratiometric percent difference measurement of the AF spectrum of the tooth correlates with the severity of the demineralization as assessed by the clinician after drilling.

  9. Randomized in vivo evaluation of photodynamic antimicrobial chemotherapy on deciduous carious dentin

    Science.gov (United States)

    Steiner-Oliveira, Carolina; Longo, Priscila Larcher; Aranha, Ana Cecília Corrêa; Ramalho, Karen Müller; Mayer, Marcia Pinto Alves; de Paula Eduardo, Carlos

    2015-10-01

    The aim of this randomized in vivo study was to compare antimicrobial chemotherapies in primary carious dentin. Thirty-two participants ages 5 to 7 years underwent partial caries removal from deep carious dentin lesions in primary molars and were subsequently divided into three groups: control [chlorhexidine and resin-modified glass ionomer cement (RMGIC)], LEDTB [photodynamic antimicrobial chemotherapy (PACT) with light-emitting diode associated with toluidine blue solution and RMGIC], and LMB [PACT with laser associated with methylene blue solution and RMGIC]. The participants were submitted to initial clinical and radiographic examinations. Demographic features and biofilm, gingival, and DMFT/DMFS indexes were evaluated, in addition to clinical and radiographic followups at 6 and 12 months after treatments. Carious dentin was collected before and after each treatment, and the number of Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Fusobacterium nucleatum, Atopobium rimae, and total bacteria was established by quantitative polymerase chain reaction. No signs of pain or restoration failure were observed. All therapies were effective in reducing the number of microorganisms, except for S. sobrinus. No statistical differences were observed among the protocols used. All therapies may be considered as effective modern approaches to minimal intervention for the management of deep primary caries treatment.

  10. Randomized in vivo evaluation of photodynamic antimicrobial chemotherapy on deciduous carious dentin.

    Science.gov (United States)

    Steiner-Oliveira, Carolina; Longo, Priscila Larcher; Aranha, Ana Cecília Corrêa; Ramalho, Karen Müller; Mayer, Marcia Pinto Alves; de Paula Eduardo, Carlos

    2015-10-01

    The aim of this randomized in vivo study was to compare antimicrobial chemotherapies in primary carious dentin. Thirty-two participants ages 5 to 7 years underwent partial caries removal from deep carious dentin lesions in primary molars and were subsequently divided into three groups: control [chlorhexidine and resin-modified glass ionomer cement (RMGIC)], LEDTB [photodynamic antimicrobial chemotherapy (PACT) with light-emitting diode associated with toluidine blue solution and RMGIC], and LMB [PACT with laser associated with methylene blue solution and RMGIC]. The participants were submitted to initial clinical and radiographic examinations. Demographic features and biofilm, gingival, and DMFT/DMFS indexes were evaluated, in addition to clinical and radiographic followups at 6 and 12 months after treatments. Carious dentin was collected before and after each treatment, and the number of Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Fusobacterium nucleatum, Atopobium rimae, and total bacteria was established by quantitative polymerase chain reaction. No signs of pain or restoration failure were observed. All therapies were effective in reducing the number of microorganisms, except for S. sobrinus. No statistical differences were observed among the protocols used. All therapies may be considered as effective modern approaches to minimal intervention for the management of deep primary caries treatment.

  11. Mineral element analysis of carious and sound rat dentin by electron probe microanalyzer combined with back-scattered electron image.

    Science.gov (United States)

    Tjäderhane, L; Hietala, E L; Larmas, M

    1995-11-01

    We recently demonstrated the advantages of back-scattered electron images (COMPO) in the visualization of dentinal caries, and the relationship of the change in the dentin fluorescence pattern in caries lesions. However, the exact nature of these changes is not known. In this paper, the nature of the changes in the areas with reduced mineral content in COMPO images was investigated. We examined the relation of changes in mineral elements and the appearance of soft carious and sound dentin in COMPO images using a scanning electron microscope (SEM) equipped with an electron probe microanalyzer (EPMA). Rat molars with small dentinal caries lesions just under the DEJ were chosen for the study. The Ca, P, Na, Mg, Zn, F, and total contents were determined by EPMA from five different dentin sites, and the Ca/P and Mg/Ca ratios were calculated. Generally, the lowest contents were found in caries lesions and highest in mantle dentin, with the exceptions of Mg and Zn. The Ca/P ratio was lowest in mantle dentin and highest in carious dentin. The results confirm that the change in fluorescence in the dentinal caries lesion is correlated with the very initial changes in mineral content, and that EPMA used in combination with COMPO images is a useful tool for determining small changes in mineral elements in the carious and adjacent areas of dentin.

  12. Apoptosis Activation in Human Carious Dentin. An Immunohistochemical Study

    Science.gov (United States)

    Loreto, C.; Psaila, A.; Musumeci, G.; Castorina, S.; Leonardi, R.

    2015-01-01

    The exact mechanisms and enzymes involved in caries progression are largely unclear. Apoptosis plays a key role in dentin remodelling related to damage repair; however, it is unclear whether apoptosis in decayed teeth is activated through the extrinsic or the intrinsic pathway. This ex vivo immunohistochemical study explored the localization of TRAIL, DR5, Bcl-2 and Bax, the main proteins involved in apoptosis, in teeth with advanced caries. To evaluate TRAIL, DR5, Bcl-2 and Bax immunoexpressions twelve permanent carious premolars were embedded in paraffin and processed for immunohistochemistry. The results showed that TRAIL and DR5 were overexpressed in dentin and in pulp vessels and mononuclear cells; strong Bax immunostaining was detected in dilated dentinal tubules close to the lesion, and Bcl-2 staining was weak in some dentin areas under the cavity or altogether absent. These findings suggest that both apoptosis pathways are activated in dental caries. Further studies are required to gain insights into its biomolecular mechanisms. PMID:26428882

  13. Clinical comparative study between the use of lasers and conventional methods of diagnosis and treatment in deciduous teeth with presence of carious lesion; Estudo clinico comparativo entre o uso de lasers e metodos convencionais de diagnostico e tratamento em dentes deciduos da presenca de lesao cariosa

    Energy Technology Data Exchange (ETDEWEB)

    Pulga, Fabiane Galvao

    2001-07-01

    The aim of this work was to evaluate the efficiency of deciduous tooth cavity preparation by the Er:YAG laser in comparison with the conventional burr rotary instrument. Besides, we have used the laser fluorescence technique (DIAGNOdent equipment) for diagnosis and compared it to the usual tactile and visual examination as well as X-ray diagnosis. For this purpose, 20 chronic occlusal carious deciduous molar teeth from children with the ages between 5 to 10 years old were selected. Selection was ma de according to visual inspection, X-ray periapical image and measures of the DIAGNOdent. For treatment the teeth were divided in two groups, 10 to be treated by the Er:YAG laser and 10 with conventional burr. For enamel, the laser energy used was in the interval from 200 to 300 mJ; for the dentine the range was from 100 mJ to 200 mJ. In both cases, the laser frequency was in the range from 2 to 4 Hz. The results have shown that the laser treatment was more accepted by the children than the conventional burro Clinical evaluation of the cavity preparation indicates that the Er:YAG laser treatment is recommend. The DIAGNOdent evaluation method was very effective for diagnosis of carious tissue for initial detection. After successful removal of the carious tissue, confirmed by visual inspection, the DIAGNOdent evaluation method was only effective for the treatment with conventional burro For evaluation of the tooth after cavity preparation with the Er:YAG laser, the measurements oscillate covering the full range of the equipment. Therefore, the use of the DIAGNOdent equipment is indicated only for initial caries diagnosis. (author)

  14. Detection and monitoring of early caries lesions

    DEFF Research Database (Denmark)

    Pretty, I A; Ekstrand, K R

    2016-01-01

    AIM: To review the current evidence base of detecting and monitoring early carious lesions in children and adolescents and a rationale proposed to ensure that such lesions are identified and appropriately managed. METHODS: The systematic literature search identified initially a review by Gomez an...

  15. Proximal surface caries detection with direct-exposure and rare earth screen/film imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lundeen, R.C.; McDavid, W.D.; Barnwell, G.M.

    1988-12-01

    This laboratory study compared five imaging systems for their diagnostic accuracy in detection of proximal surface dental caries. Ten viewers provided data on radiographic detectability of carious lesions. The diagnostic accuracy of each system was determined with receiver operating characteristic (ROC) curves by comparing viewer data with the true state of the teeth as determined microscopically. D-speed film marginally outperformed the other four systems, but the three screen/film systems matched the diagnostic accuracy of E-speed film. Radiation reductions between 62% and 92% were achieved with the screen/film systems when compared to the two conventional dental films. The feasibility of designing a screen/film bite-wing cassette was shown, but the poor diagnostic accuracy of the present bite-wing system indicated a need for a new technology in caries detection.

  16. Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine: a case report

    Directory of Open Access Journals (Sweden)

    Cyril Villat

    2013-11-01

    Full Text Available The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont and a glass ionomer cement (Fuji IX extra, GC Corp. restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

  17. Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine): a case report.

    Science.gov (United States)

    Villat, Cyril; Grosgogeat, Brigitte; Seux, Dominique; Farge, Pierre

    2013-11-01

    The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

  18. Microbiochemical analysis of carious dentine using Raman and fluorescence spectroscopy

    National Research Council Canada - National Science Library

    Almahdy, A; Downey, F C; Sauro, S; Cook, R J; Sherriff, M; Richards, D; Watson, T F; Banerjee, A; Festy, F

    2012-01-01

    The aim of this study was to evaluate and correlate objectively the microspectroscopically derived biochemical components of sound, infected and affected carious dentine with their microhardness and autofluorescence (AF) characteristics...

  19. Accuracy of extraoral bite-wing radiography in detecting proximal caries and crestal bone loss.

    Science.gov (United States)

    Chan, Micah; Dadul, Tenzin; Langlais, Robert; Russell, David; Ahmad, Mansur

    2018-01-01

    Extraoral bite-wing (EB) radiography is an imaging technology used in dentistry. The authors conducted an in vivo study comparing the accuracy of intraoral bitewing (IB) radiographs and EB radiographs for proximal caries and bone loss diagnosis. The authors recruited 116 patients who received IB radiographs to receive EB radiographs. The 5 calibrated authors made a consensus radiographic diagnosis of proximal caries and crestal bone loss. For this study, they assumed IB radiographs as the criterion standard. Next, they obtained EB radiographs for the 116 patients and calculated sensitivity, specificity, and false-positive rates against each patient's IB radiograph. The patients' EB radiographs revealed a significantly greater number of caries and crestal bone loss findings compared with their IB radiographs. The EB radiographs had a high to excellent sensitivity and moderate to low specificity of caries and crestal bone loss findings, respectively. Considering IB radiographs to be the criterion standard, the false-positive rate for EB radiographs was moderate for caries and high for bone loss diagnosis. The EB radiographs, which generate fewer images of overlapping proximal surfaces, have the advantage of detecting more carious lesions and bone loss findings than the IB radiographs do, but with the disadvantage of more false-positive diagnoses. Further research is needed to evaluate if the false-positive findings represent true carious lesions and bone loss. EB radiography is a promising technology, which has several advantages over traditional IB radiography. Clinicians should be aware of false-positive diagnosis of caries and bone loss with EB radiography. Copyright © 2018 American Dental Association. Published by Elsevier Inc. All rights reserved.

  20. Effects of occlusal adjustment on clinical success of non carious cervical restoration’s

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    Ghavam Nasiri M.

    2004-07-01

    Full Text Available Statement of Problem: Parafunctional habits are the most important factor in the creation of non-carious cervical lesions and correcting of these habits may affect cervical lesions. Purpose: The goal of this study was to survey the effects of one-year occlusal adjustment on clinical success of non- carious cervical restorations. Materials and Methods: In this clinical study, sixty tooth-colored cervical restorations on canines and premolars in patients with parafunctional habits (bruxism and clenching were studied. The teeth, according to the type of restorative material, were randomly divided into two groups: One group with a composite resin (Tetric Flow; Group A: n=30 and the other group with a compomer (Compoglass Flow; Group B: n=30. After restoration, each group was divided into two subgroups: (A1, B1 with occlusal adjustment (case group, (A2, B2 without occlusal adjustment (control group. The evaluation was perfumed single blind at 6 and 12 months after restorative operations according to Us Public Health Service (USPHS classification. Assessment criteria included: marginal integrity, marginal discoloration, recurrent caries, postoperative sensitivity and loss of filling. Statistical analysis was completed using Fisher’s exact test. Results: In 12 month period between two groups of compoglass Flow restorations, group B1 showed superior results than group B2, however, no significant difference was found between both groups of tetric flow restorations (A1 and A2. There was also no difference in clinical conditions between A2 and B2 groups. Conclusion: Considering the results of this study, it can be concluded that occlusal adjustment puts a considerable effect on clinical success of compoglass non- carious cervical restorations. However, it should be mentioned that such and effect was not found among Tetric flow restoration.

  1. Distribution of the amelogenin protein in developing, injured and carious human teeth

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    Thimios eMitsiadis

    2014-12-01

    Full Text Available Amelogenin is the major enamel matrix protein with key roles in amelogenesis. Although for many decades amelogenin was considered to be exclusively expressed by ameloblasts, more recent studies have shown that amelogenin is also expressed in other dental and no-dental cells. However, amelogenin expression in human tissues remains unclear. Here, we show that amelogenin protein is not only expressed during human embryonic development but also in pathological conditions such as carious lesions and injuries after dental cavity preparation. In developing embryonic teeth, amelogenin stage-specific expression is found in all dental epithelia cell populations but with different instensities. In the different layers of enamel matrix, waves of positive versus negative immunostaining for amelogenin are detected suggesting that the secretion of amelogenin protein is orchestreted by a biological clock. Amelogenin is also expressed transiently in differentiating odontoblasts during predentin formation, but was absent in mature functional odontoblasts. In intact adult teeth, amelogenin was not present in dental pulp, odontoblasts, and dentin. However, in injured and carious adult human teeth amelogenin is strongly re-expressed in newly differentiated odontoblasts and is distributed in the dentinal tubuli under the lesion site. In an in vitro culture system, amelogenin is expressed preferentially in human dental pulp cells that start differentiating into odontoblast-like cells and form mineralization nodules. These data suggest that amelogenin plays important roles not only during cytodifferentiation, but also during tooth repair processes in humans.

  2. Radiographic assessment of proximal caries: A comparison between film-based and dexis digital imaging systems

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    Anupama N Kalappanavar

    2011-01-01

    Full Text Available This study compared Kodak Ektaspeed film and Dexis digital imaging systems for their diagnostic accuracy in detection of proximal canes in 210 proximal surfaces from 105 extracted human teeth (20 premolars and 85 molars, 129 of which were carious. Ground teeth were evaluated histologically. The images were assessed by an observer. ANOVA revealed that groups differ in scoring patterns with f-value of 26.72 and p < 0.01. The mean caries score by histologic assessment was significantly (p < 0.01 more when compared with the scores obtained by conventional and Dexis digital radiographic methods. The mean score for conventional radiographic method was slightly more than Dexis digital radiographic method, but the difference was statistically insignificant (p < 0.05. Both the radiographic methods were less accurate in detecting proximal canes confined to enamel, but as the lesion depth was increased to dentin, the rate of caries detection increased dramatically. It was concluded that both conventional and Dexis digital radiographic methods under estimated canes depth when compared with histologic method. Lastly, conventional film radiographs and Dexis digital radiographs did not perform significantly different from each other in the detection of canes.

  3. Dentin matrix protein 1 and dentin sialophosphoprotein in human sound and carious teeth: an immunohistochemical and colorimetric assay

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    D. Martini

    2013-10-01

    Full Text Available Dentin matrix protein 1 (DMP1 and dentin sialophosphoprotein (DSPP are extracellular matrix proteins produced by odontoblasts involved in the dentin mineralization. The aim this study was to compare the distribution of DMP1 and DSPP in human sound dentin vs human sclerotic dentin. Sixteen sound and sixteen carious human molars were selected, fixed in paraformaldehyde and processed for immunohistochemical detection of DMP1 and DSPP by means of light microscopy, transmission electron microscopy (TEM and high-resolution field emission in-lens scanning electron microscopy (FEI-SEM. Specimens were submitted to a pre-embedding or a post-embedding immunolabeling technique using primary antibodies anti DMP1 and anti-DSPP and gold-conjugated secondary antibodies. Other samples were processed for the detection of DMP1 and DSPP levels. Dentin from these samples was mechanically fractured to powder, then a protein extraction and a protein level detection assay were performed. DMP1 and DSPP were more abundant in carious than in sound samples. Immunohistochemical analyses in sclerotic dentin disclosed a high expression of DMP1 and DSPP inside the tubules, suggesting an active biomineralization of dentin by odontoblasts. Furthermore, the detection of small amounts of these proteins inside the tubules far from the carious lesion, as shown in the present study, is consistent with the hypothesis of a preventive defense of all dentin after a noxious stimulus has undermined the tooth.

  4. Bonding longevity of flowable GIC layer in artificially carious dentin

    NARCIS (Netherlands)

    Tedesco, T.K.; Bonifácio, C.C.; Hesse, D.; Kleverlaan, C.J.; Lenzi, T.L.; Raggio, D.P.

    2014-01-01

    Purpose To evaluate the bond longevity of glass ionomer cement (GIC) to sound and artificially carious dentin, using a high viscosity material with regular consistency and using a flowable GIC, after one year water storage. Material and methods Sixty bovine incisors were polished to obtain flat

  5. Accuracy of digital subtraction radiography in combination with a contrast media in assessment of proximal caries depth

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    Farzad Esmaeili

    2008-07-01

    Full Text Available Background and aims. Radiography is used to diagnose the demineralization process and carious lesions; however, conventional radiography and direct digital images do not show these lesions when the amount of demineralization is less than 40%. Digital subtraction radiography has recently been used to improve the diagnostic quality of these lesions. The purpose of this study was to compare the caries depth estimated by digital subtraction radiography in combination with barium sulfate in diagnosing proximal dental caries with histopathologic evaluation. Materials and methods. In this study 30 molars and premolars (24 demineralized lesions with cavity, 8 without cavity were studied. Direct digital images were taken (kVp: 68, mA: 8; t: 0.12 for premolars and t: 0.16 for molars whereas the position of X-ray tube and CCD receptor and teeth was fixed. To prepare the second images 135 gr/L barium sulfate was used. The images obtained with the same exposure and geometry and then subtracted. The depth of the lesions in direct digital and subtracted images were assessed and compared with the depth measured in histopathologic assessments. Results. The mean depths (± SD of the lesions were 1.80 ± 0.77 mm in direct digital radiography, 2.32 ± 0.76 mm in subtracted images after barium sulfate treatment, and 2.51 ± 0.43 mm in histopathologic sections. The statistical difference between direct digital radiography and the other methods was significant (P < 0.05. However, the differences were not statistically significant between subtracted images and histopathologic sections. The average intra-class correlation coefficient was 0.7241 (CI: 95%. Conclusion. The present study has demonstrated that digital subtraction radiography images have the potential to measure the depth of proximal caries with no significant difference with histopathologic evaluation.

  6. Painful ultrasound detected lesion in the proximal part of the corpus cavernosum: A case of so called “partial priapism”?

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    Andrea Fabiani

    2016-03-01

    Full Text Available Partial priapism is a rare disorder generally described in literature as related to an idiopathic etiology leading to the thrombosis of the corpus cavernosum. Despite his rarity, this condition has been described in the last years with an increased frequency. It is characterized by thrombosis of the proximal segment of one corpus cavernosum with perineal pain as the more frequent clinical manifestation. Few cases were associated with perineal trauma. Instrumental appearance suggests for an hematoma in the interstitium of the proximal part of corpus cavernosum. Therapy is still controversial. We report a case of a 52-years old man referred to our Section of Urology suffering from a perineal pain occurred without trauma, sexual arousal or sexual intercourse, during the working office time. Laboratory revealed a slightly elevated white blood cells count. The full blood count, protein C reactive, electrolytes, international normalized ratio, activated partial thromboplastin time and urinalysis were within normal range. Tunica albuginea was normal. The partial thrombosis of the right corpus cavernosum was hypothesized. Treatment was conservative with non steroidal anti-inflammatory drug. Only the clinical presentation of symptoms and perineal ultrasound scan performed with color sonography leaded to the diagnosis. Eleven days later, at the clinical and ultrasonographic follow-up visit, the patient was asymptomatic with a total clinical and instrumental disappearance of signs of the corpus cavernosum involvement previously described. Considering the rarity of the condition, we performed a literature review.

  7. Ablation of human carious dentin with a nanosecond pulsed laser at a wavelength of 5.85 μm: relationship between hardness and ablation depth

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    Ishii, Katsunori; Kita, Tetsuya; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2014-02-01

    Less invasive treatment and preservation of teeth, referred to as minimal intervention, are strong requirements in dentistry. In our previous study, the fundamental ablation properties of human dentin at wavelengths around 5.8 μm were investigated, and the results indicated that the wavelength of 5.85 μm was optimal for selective removal of carious dentin with less damage to normal dentin. The purpose of this study was to investigate the relationship between the ablation depth and hardness of human dentin including carious lesion. A nanosecond pulsed laser produced by difference-frequency generation was used for irradiations to human carious dentin. It was observed that correlation between ablation depth and Vickers hardness after 2 s laser irradiation at the wavelength of 5.85 μm and the average power density of 30 W/cm2. On the other hand, ablations did not depend on Vickers hardness at the wavelength of 6.00 μm. A nanosecond pulsed laser with the wavelength at 5.85 μm is useful for selective ablation of human carious dentin in accordance with the hardness.

  8. Influence of the cavity-size on the survival rate of proximal ART restorations in primary molars.

    Science.gov (United States)

    Kemoli, Arthur Musakulu; van Amerongen, Willem Evert

    2009-11-01

    To evaluate the influence of the size of proximal cavities on the survival rate of the atraumatic restorative treatment (ART) restorations. A total of 804 children, aged 6-8 years, from a low socio-economic community, with an ART restorable proximal carious lesion in their primary molars, participated. Over a 3-week period, three 'experienced' and four 'inexperienced' operators randomly paired with four 'experienced' and four 'inexperienced' assistants, made the restorations at site using hand instruments. They randomly used Fuji IX, Ketac Molar Easymix and Ketac Molar Aplicap glass ionomer cements to restore the cavities, under randomly selected rubber dam and cotton roll isolation methods. The fillings were independently evaluated by nine trained and calibrated evaluators. After 1 year, the survival rate of the fillings evaluated in the study was 44.8%. Irrespective of the other factors involved, restorations with the highest survival rate were of size between 2 and 3 mm (mesio-distal, bucco-lingual, and depth) or volumes 10.0-19.9 mm(3) (Chi-square, P = 0.002, KM mean survival of 345 days). While the survival rates for class II ART restorations were still low, the choice of medium-sized proximal cavities gave better survival rates for this technique.

  9. CARIOUS EXPERIENCE IN CHILDREN SUFFERING FROM BRONCHIAL ASTHMA

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    Mona Olar

    2012-03-01

    Full Text Available Bronchial asthma is one of the most common pathologies of the chronic diseases of childhood, recording an ever-increasing frequency. The paper develops a control-type case study on the carious experience of 25 children suffering from bronchial asthma, comparatively with 25 healthy children. In both groups, the dmf-t/DMFT indices were calculated and the presence of Streptococcus mutans (SM and Lactobacillus acidophillus (LA in stimulated saliva, in concentrations with high cariogeneity risk, was determined. Carious experience and the SM level in concentrations with cariogenic risk were statistically significant in children with bronchic asthma (p=0.02. The presence of LA in concentrations with cariogenic risk was also higher in these children, yet statistically insignificant, comparatively with the reference (p>0.05.

  10. A prospective cohort study of digital cushion and corium thickness. Part 1: Associations with body condition, lesion incidence, and proximity to calving.

    Science.gov (United States)

    Newsome, R F; Green, M J; Bell, N J; Bollard, N J; Mason, C S; Whay, H R; Huxley, J N

    2017-06-01

    Claw horn disruption lesions (CHDL) are a major cause of lameness in dairy cattle and are likely a result of excessive forces being applied to the germinal epithelium that produces the claw horn. The digital cushion is a connective tissue structure, containing depots of adipose tissue, that sits beneath the distal phalanx and has been shown to be thicker in fatter cows. Body condition score (BCS) loss is a risk factor for CHDL, and one possible explanation is that fat is mobilized from the digital cushion during negative energy balance, causing the digital cushion to thin and lose force-dissipating capacity, leading to disruption of claw horn growth. This prospective cohort study investigated the association between measures of body fat and sole soft tissue (SST) thickness (a combined measure of the corium and digital cushion beneath the distal phalanx) in a longitudinal manner. The SST of 179 cows in 2 high-yielding dairy herds were measured at 5 assessment points between 8 wk before and 35 wk postcalving. The BCS, back fat thickness (BFT), and lesion incidence were recorded. Data were analyzed in a 4-level mixed effects regression model, with the outcome being SST thickness beneath the flexor tuberosity of the distal phalanx. Data from 827 assessment points were available for analysis. The overall mean of SST was 4.99 mm (standard deviation: 0.95). The SST was thickest 8 wk before calving (5.22 mm, standard deviation: 0.91) and thinnest 1 wk postcalving (4.68 mm, standard deviation: 0.87), suggesting an effect of calving on SST. The BFT was positively correlated with SST in the model with a small effect size (a 10 mm decrease in BFT corresponded with a 0.13 mm decrease in SST), yet the nadir of BFT was 11.0 mm at 9 to 17 wk postcalving (when SST was ∼4.95 mm), rather than occurring with the nadir of SST immediately after calving. The SST also varied with other variables [e.g., cows that developed a sole ulcer or severe sole hemorrhage during the study had

  11. The effects of necrotic lesion size and orientation of the femoral component on stress alterations in the proximal femur in hip resurfacing - a finite element simulation.

    Science.gov (United States)

    Tai, Ching-Lung; Chen, Yung-Chou; Hsieh, Pang-Hsin

    2014-08-05

    Due to the advantages of its bone-conserving nature, hip resurface arthroplasty (HRA) has recently gained the interest of orthopedic surgeons for the treatment of young and active patients who have osteonerosis of the femoral head. However, in long-term follow-up studies after HRA, narrowing of the femoral neck has often been found, which may lead to fracture. This phenomenon has been attributed to the stress alteration (stress shielding). Studies addressing the effects of necrotic size and the orientation of the implant on stress alterations are lacking. Computed tomography images of a standard composite femur were used to create a three-dimensional finite-element (FE) intact femur model. Based on the intact model, FE models simulating four different levels of necrotic regions (0°, 60°, 100°, 115°) and three different implant insertion angles (varus 10°, neutral, valgus 10°) were created. The von Mises stress distributions and the displacement of the stem tip of each model were analyzed and compared for loading conditions that simulated a single-legged stance. Stress shielding occurred at the femoral neck after HRA. More severe stress shielding and an increased displacement of the stem tip were found for femoral heads that had a wider necrotic lesion. From a biomechanics perspective, the results were consistent with clinical evidence of femoral neck narrowing after HRA. In addition, a varus orientation of the implant resulted in a larger displacement of the stem tip, which could lead to an increased risk of implant loosening. A femoral head with a wide necrotic lesion combined with a varus orientation of the prosthesis increases the risk of femoral neck narrowing and implant loosening following HRA.

  12. A Study on the Diagnostic Detection Ability of the Artificial Proximal Caries by Digora

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    Oh, Kyung Ran; Choi, Eui Hwan; Kim, Jae Duck [Dept. of Oral and Maxillofacial Radiology, College of Dentistry, Chosun University, Kwangju (Korea, Republic of)

    1998-08-15

    Digora system is an intraoral indirect digital radiography system utilizing storage phosphor image plate. It has wide dynamic range which allows it to decrease the patient's exposure time and may increase diagnostic ability through image processing (such as edge enhancement, grey scale conversion, brightness change, and contrast enhancement). And also, it can transmit and storage image information. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries between Conventional radiograph and Digora images (unenhanced image, brightness and contrast controlled image, and edge enhanced image). ROC (Receiver Operating Characteristic) analysis, paired t-tests, and F-tests were done for the statistical evaluation of detectability. The following results were acquired: 1. In Grade I lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.953, 0.933, 0.965, 0.978 (p>0.05). 2. In Grade II lesions, the mean ROC areas of Conventional radiograph, Digora unenhanced image, Digora controlled image, and Digora edge enhanced image were 0.969, 0.964, 0.988, 0.994. Among theses areas, there was just statistical significance between Diagnostic abilities of Digora edge enhanced image and Conventional radiograph (p<0.05). 3. In the Interobserver variability, the ROC curve areas of Digora edge enhanced image was lowerest in these areas, regardless of the Carious lesion depths. In conclusion, intraoral indirect digital system, Digora system, has the potential possibility as an alternative of Conventional radiograph in the diagnosis of proximal caries.

  13. Proximal Hypospadias

    Science.gov (United States)

    Kraft, Kate H.; Shukla, Aseem R.; Canning, Douglas A.

    2011-01-01

    Hypospadias results from abnormal development of the penis that leaves the urethral meatus proximal to its normal glanular position. Meatal position may be located anywhere along the penile shaft, but more severe forms of hypospadias may have a urethral meatus located at the scrotum or perineum. The spectrum of abnormalities may also include ventral curvature of the penis, a dorsally redundant prepuce, and atrophic corpus spongiosum. Due to the severity of these abnormalities, proximal hypospadias often requires more extensive reconstruction in order to achieve an anatomically and functionally successful result. We review the spectrum of proximal hypospadias etiology, presentation, correction, and possible associated complications. PMID:21516286

  14. Quantitative Microbiological Study of Human Carious Dentine by Culture and Real-Time PCR: Association of Anaerobes with Histopathological Changes in Chronic Pulpitis

    Science.gov (United States)

    Martin, F. Elizabeth; Nadkarni, Mangala A.; Jacques, Nicholas A.; Hunter, Neil

    2002-01-01

    The bacteria found in carious dentine were correlated with the tissue response of the dental pulps of 65 teeth extracted from patients with advanced caries and pulpitis. Standardized homogenates of carious dentine were plated onto selective and nonselective media under anaerobic and microaerophilic conditions. In addition, real-time PCR was used to quantify the recovery of anaerobic bacteria. Primers and fluorogenic probes were designed to detect the total anaerobic microbial load, the genera Prevotella and Fusobacterium, and the species Prevotella melaninogenica, Porphyromonas endodontalis, Porphyromonas gingivalis, and Micromonas (formerly Peptostreptococcus) micros. The pulpal pathology was categorized according to the cellular response and degenerative changes. Analysis of cultured bacteria showed a predominance of gram-positive microorganisms, particularly lactobacilli. Gram-negative bacteria were also present in significant numbers with Prevotella spp., the most numerous anaerobic group cultured. Real-time PCR analysis indicated a greater microbial load than that determined by colony counting. The total number of anaerobes detected was 41-fold greater by real-time PCR than by colony counting, while the numbers of Prevotella and Fusobacterium spp. detected were 82- and 2.4-fold greater by real-time PCR than by colony counting, respectively. Real-time PCR also identified M. micros, P. endodontalis, and P. gingivalis in 71, 60, and 52% of carious samples, respectively. Correlation matrices of the real-time PCR data revealed significant positive associations between M. micros and P. endodontalis detection and inflammatory degeneration of pulpal tissues. These anaerobes have been strongly implicated in endodontic infections that occur as sequelae to carious pulpitis. Accordingly, the data suggest that the presence of high levels of these bacteria in carious lesions may be indicative of irreversible pulpal pathology. PMID:11980945

  15. Detection of intaoral lesions using a fluorescence camera

    Science.gov (United States)

    Thoms, Michael

    2006-02-01

    Optical methods for the detection of carious lesions, calculus and plaque have the advantage of being minimally invasive. The use of endogeneous fluorescence markers like porphyrins could simplify the application of fluorescence techniques in the dental practice. It is known that porphyrins are produced by some of the bacterial species that are present in the oral cavity. Since porphyrins have an excitation band at about 400nm they have the potential to be used as fluorescent markers of locations in the oral cavity where the production of bacteria is out of the limits of healthy regions. Further, modern and efficient GaN-based semiconductor diodes emit light in this spectral range and thus make the implementation of fluorescence sensors with excitation at this wavelength easy. Carious lesions, calculus and plaque have been measured using a self build fluorescence camera using GaN-diodes for illumination at 405nm. Further, emission spectra under this excitation were recorded. For the latter purpose freshly extracted teeth were used. It has been found that already in the case of an initial carious lesion red porphyrin-fluorescence is emitted whereas it is absent in healthy enamel. In already brown coloured carious lesions the emission bands of porphyrin are present but the observed overall fluorescence intensity is lower, probably due to the absorption of the fluorescence by the carious defect itself. In dental calculus, dental plaque and subgingival concrements porphyrin originated luminescence was found as well. Since in these cases the emission spectra differ slightly it can be concluded that they originate from different types of porphyrins and thus also from different bacteria. These results show that this fluorescence technique can be a promising method to diagnose carious lesions, calculus and plaque.

  16. Conventional treatment, Hall Technique or immediate pulpotomy for carious primary molars: a cost-effectiveness analysis.

    Science.gov (United States)

    Schwendicke, F; Stolpe, M; Innes, N

    2015-09-01

    To compare the cost-effectiveness of three strategies for treating primary molars with cavitated carious lesions and sensible (vital), asymptomatic pulps. Conventional excavation and restoration, Hall Technique (caries sealing using a preformed crown), and pulpotomy were compared. As the latter would not be applied to all teeth in clinical reality, decision-making under perfect information was modelled, with teeth at-risk for pulpal complications receiving immediate pulpotomy, whilst all others were treated conventionally. A Markov model was constructed and transition probabilities derived from randomized trials and systematic reviews. A carious molar in a 5-year-old child was followed until exfoliation. Cost-effectiveness was assessed within the German healthcare system using a public-payer perspective. Monte Carlo microsimulations were performed to evaluate the primary outcome, costs (in Euros) per year of tooth retention. Conventional treatment was least effective and more expensive than the Hall Technique. Risk-based pulpotomy was more costly, but also more effective than alternatives. Overall, the Hall Technique was most cost-effective (9.77 Euros year(-1) ), followed by pulpotomy (11.75 Euros year(-1) ) and conventional treatment (13.31 Euros year(-1) ). For payers willing to invest >59 Euros per additional year of tooth retention, risk-based pulpotomy was most cost-effective. Providing pulpotomy to all teeth was not cost-effective. The Hall Technique was most cost-effective, whilst conventional treatment was least effective and more costly. Performing pulpotomy for molars at-risk of pulpal complications might be effective, but was more expensive than alternatives. Moreover, accurately predicting such pulpal complications is currently not possible. Risk-based decision-making does not necessarily reduce costs. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  17. Evaluation of the Shear Bond Strength of Nanocomposite on Carious and Sound Deciduous Dentin

    OpenAIRE

    Deshmukh, Seema; Nandlal, B.

    2012-01-01

    ABSTRACT Aim: The aim of the study was to evaluate and compare the shear bond strength of conventional composites with nanocomposites in carious and sound deciduous dentin with the use of self-etching adhesive. Methodology: Human primary molars were ground to obtain flat dentin surfaces and divided into two groups: Carious dentin and sound dentin group. The carious teeth specimens were prepared by removing infected dentin and area with affected dentin was used for bonding composite. Teeth wit...

  18. The Efficiency of Operating Microscope Compared with Unaided Visual Examination, Conventional and Digital Intraoral Radiography for Proximal Caries Detection

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    Ilkay Peker

    2009-01-01

    Full Text Available Objective. The purpose of this study was to evaluate the efficiency of operating microscope compared with unaided visual examination, conventional and digital intraoral radiography for proximal caries detection. Materials and Methods. The study was based on 48 extracted human posterior permanent teeth. The teeth were examined with unaided visual examination, operating microscope, conventional bitewing and digital intraoral radiographs. Then, true caries depth was determined by histological examination. The extent of the carious lesions was assessed by three examiners independently. One way variance of analysis (ANOVA and Scheffe test were performed for comparison of observers, and the diagnostic accuracies of all systems were assessed from the area under the ROC curve (Az. Results. Statistically significant difference was found between observers (P<.01. There was a statistically significant difference between operating microscope-film radiography, operating microscope-RVG, unaided visual examination-film radiography, and unaided visual examination-RVG according to pairwise comparison (P<.05. Conclusion. The efficiency of operating microscope was found statistically equal with unaided visual examination and lower than radiographic systems for proximal caries detection.

  19. Quantitative diagnosis of small approximal caries lesions utilizing wavelength-dependent fiber-optic transillumination

    NARCIS (Netherlands)

    Vaarkamp, J; TenBosch, JJ; Verdonschot, EH; Tranaeus, S

    The instruments clinically available for the diagnosis of approximal caries lesions are inadequate to detect lesions early and quantitatively. The aim of this study was to investigate whether wavelength-dependent light scattering and absorption of carious tissues may be utilized for the quantitative

  20. Atraumatic Restorative Treatment compared to the Hall Technique for occluso-proximal cavities in primary molars: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Hesse, Daniela; de Araujo, Mariana Pinheiro; Olegário, Isabel Cristina; Innes, Nicola; Raggio, Daniela Prócida; Bonifácio, Clarissa Calil

    2016-03-31

    In many parts of the world, school-age children have high dental treatment needs; however, there is often low, or no, dental care provision. Although Atraumatic Restorative Treatment (ART) was developed to address this, its survival rate in occluso-proximal lesions is low. An alternative, the Hall Technique (HT) has shown better relative outcomes for occluso-proximal lesions, but has not been directly compared to ART or tested in field settings. This trial will compare ART and the HT for the most clinically- and cost-effective strategy for managing occluso-proximal lesions in primary molars, in a school setting, using low-technology and child-friendly dental techniques. This two-arm, parallel group, patient-randomized controlled, superiority trial will have treatment provided in schools. Schoolchildren (n = 124, age 6-8) with at least one occluso-proximal carious primary molar lesion will have random allocation to treatment with ART or HT. Baseline measures and outcome data will be assessed through participant report, clinical examination and parent report/questionnaires. The primary outcome is survival rate, a composite measure of absence of Minor Failures (a defect in the restoration/crown, but not interfering with tooth health) and Major Failures (signs or symptoms of irreversible pulp damage, such as dental fistula/abscess, tooth fracture or failures that cannot be repaired). Secondary outcomes are: (1) child-reported discomfort, (2) childrens' and (3) parents' concerns around dental appearance and (4) acceptability of treatments, (5) occlusal-vertical dimensions (OVD) changes, (6) plaque index, (7) gingival health, (8) decayed, missing, filled teeth in permanent teeth (DMFT)/decayed, missing, filled teeth in primary teeth (dmft), (9) oral health-related-quality of life, reported by children and parents/caregivers, (10) the incremental cost-effectiveness, and (11) operator effect. A trained and calibrated examiner will evaluate the treated teeth after 1

  1. The Hall Technique for managing carious primary molars.

    Science.gov (United States)

    Innes, Nicola; Evans, Dafydd; Hall, Norna

    2009-10-01

    The Hall Technique, a method of managing carious primary molars effectively with preformed metal crowns, without the use of local anaesthesia, caries removal or tooth preparation of any kind, is described.The technique is illustrated with a case report.The evidence underpinning the technique is discussed, along with indications and contra-indications for its use, and details of where clinicians can obtain further information on the technique if they are considering using it. Research evidence has indicated that the Hall Technique is effective in managing dental caries in primary molar teeth when used by General Dental Practitioners, and is preferred by them, their child patients and the children's parents to conventional restorative methods for these teeth.

  2. Evaluation of proximal caries in images resulting from different modes of radiographic digitalization.

    Science.gov (United States)

    Xavier, C R G; Araujo-Pires, Ana Claudia; Poleti, M L; Rubira-Bullen, I R F; Ferreira, O; Capelozza, A L A

    2011-09-01

    The aim of this study was to evaluate the performances of observers in diagnosing proximal caries in digital images obtained from digital bitewing radiographs using two scanners and four digital cameras in Joint Photographic Experts Group (JPEG) and tagged image file format (TIFF) files, and comparing them with the original conventional radiographs. In total, 56 extracted teeth were radiographed with Kodak Insight film (Eastman Kodak, Rochester, NY) in a Kaycor Yoshida X-ray device (Kaycor X-707; Yoshida Dental Manufacturing Co., Tokyo, Japan) operating at 70 kV and 7 mA with an exposure time of 0.40 s. The radiographs were obtained and scanned by CanonScan D646U (Canon USA Inc., Newport News, VA) and Genius ColorPage HR7X (KYE Systems Corp. America, Doral, FL) scanners, and by Canon Powershot G2 (Canon USA Inc.), Canon RebelXT (Canon USA Inc.), Nikon Coolpix 8700 (Nikon Inc., Melville, NY), and Nikon D70s (Nikon Inc.) digital cameras in JPEG and TIFF formats. Three observers evaluated the images. The teeth were then observed under the microscope in polarized light for the verification of the presence and depth of the carious lesions. The probability of no diagnosis ranged from 1.34% (Insight film) to 52.83% (CanonScan/JPEG). The sensitivity ranged from 0.24 (Canon RebelXT/JPEG) to 0.53 (Insight film), the specificity ranged from 0.93 (Nikon Coolpix/JPEG, Canon Powershot/TIFF, Canon RebelXT/JPEG and TIFF) to 0.97 (CanonScan/TIFF and JPEG) and the accuracy ranged from 0.82 (Canon RebelXT/JPEG) to 0.91 (CanonScan/JPEG). The carious lesion diagnosis did not change in either of the file formats (JPEG and TIFF) in which the images were saved for any of the equipment used. Only the CanonScan scanner did not have adequate performance in radiography digitalization for caries diagnosis and it is not recommended for this purpose.

  3. Clinical Performance of Indirect Composite Onlays as Esthetic Alternative to Stainless Steel Crowns for Rehabilitation of a Large Carious Primary Molar.

    Science.gov (United States)

    Mittal, Hitesh Chander; Goyal, Ashima; Gauba, Krishan; Kapur, Aditi

    The aim of the present study was to evaluate the clinical performance of indirect resin composite onlays (IRC onlay) compared to stainless steel crowns (SSCs), as an esthetic alternative for rehabilitation of extensively carious primary molars. Fifty pediatric patients each received either IRC onlay or SSC randomly on extensively carious endodontically treated primary molars. All the restorations were evaluated at baseline and then every 6 months till 36 months using 'modified FDI criteria' for retention, marginal integrity, occlusion, proximal contact, secondary caries and gingival health. The dental chair side treatment time and post-operative acceptability were also evaluated for both the groups. The cumulative survival rate of IRC onlays was 82.9% compared to 90.7% for SSCs over a time period of 36 months. The difference between the two study groups at various time intervals in terms of retention, marginal integrity, secondary caries, proximal contact, occlusion and gingival health was not statistically significant (p>0.05). The IRC onlays required significantly less mean chair side treatment time and were preferred the most by parents and children as per VAS scores compared to SSCs. IRC onlays are an acceptable esthetic alternative to SSCs and may be considered for use in aesthetically conscious children/parents as per their preference.

  4. Characterization of dentin, enamel, and carious lesions by a polarization-sensitive optical coherence tomography system

    Science.gov (United States)

    Chen, Yueli; Otis, Linda; Piao, Daqing; Zhu, Quing

    2005-04-01

    Enamel and dentin are the primary components of human teeth. Both of them have a strong polarization effect. We designed a polarization-sensitive optical coherence tomography (PSOCT) system to study the spatially resolved scattering and polarization phenomena of teeth. The system is constructed in free space to avoid the complexity of polarization control in fiber-based PSOCT. The structural features of enamel were evaluated in five human teeth that had no visible evidence of caries. The teeth were subsequently sectioned in mesial distal orientation and coronal orientation. Then the structural aspects of dentin were evaluated. OCT images were made of the mantel dentin near the dentin-enamel junction. Five teeth with interproximal and occlusal caries were also studied. With two channel and phase-retardation images, PSOCT provided better functional contrast and more detailed structural information than conventional OCT. For a better description of the measured PSOCT data, we classify these features by two types, i.e., the local textural features and the global structural features. This study indicates that PSOCT has the potential to be a powerful tool for research of dental formation and caries diagnosis.

  5. Practitioner, patient and carious lesion characteristics associated with type of restorative material

    DEFF Research Database (Denmark)

    Makhija, Sonia K; Gordan, Valeria V; Gilbert, Gregg H

    2011-01-01

    The authors conducted a study to identify factors associated with the materials that dentists in The Dental Practice-Based Research Network (DPBRN) use when placing the first restoration on permanent posterior tooth surfaces.......The authors conducted a study to identify factors associated with the materials that dentists in The Dental Practice-Based Research Network (DPBRN) use when placing the first restoration on permanent posterior tooth surfaces....

  6. The effect of different fluoride application methods on the remineralization of initial carious lesions.

    Science.gov (United States)

    Byeon, Seon Mi; Lee, Min Ho; Bae, Tae Sung

    2016-05-01

    The purpose of this study was to assess the effect of single and combined applications of fluoride on the amount of fluoride release, and the remineralization and physical properties of enamel. Each of four fluoride varnish and gel products (Fluor Protector, FP, Ivoclar Vivadent; Tooth Mousse Plus, TM, GC; 60 Second Gel, A, Germiphene; CavityShield, CS, 3M ESPE) and two fluoride solutions (2% sodium fluoride, N; 8% tin(ii) fluoride, S) were applied on bovine teeth using single and combined methods (10 per group), and then the amount of fluoride release was measured for 4 wk. The electron probe microanalysis and the Vickers microhardness measurements were conducted to assess the effect of fluoride application on the surface properties of bovine teeth. The amount of fluoride release was higher in combined applications than in single application (p < 0.05). Microhardness values were higher after combined applications of N with FP, TM, and CS than single application of them, and these values were also higher after combined applications of S than single application of A (p < 0.05). Ca and P values were higher in combined applications of N with TM and CS than single application of them (p < 0.05). They were also increased after combined applications of the S with A than after single application (p < 0.05). Combined applications of fluoride could be used as a basis to design more effective methods of fluoride application to provide enhanced remineralization.

  7. Individuals Who Brush Their Teeth Infrequently May Be at Greater Risk for New Carious Lesions.

    Science.gov (United States)

    Tinanoff, Norman

    2017-03-01

    Effect of Toothbrushing Frequency on Incidence and Increment of Dental Caries: A Systematic Review and Meta-Analysis. Kumar S, Tadadamadla J, Johnson NW. J Dent Res 2016;95(11):1230-6. Information not available TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Parental attitudes to the care of the carious primary dentition.

    Science.gov (United States)

    Tickle, M; Milsom, K M; Humphris, G M; Blinkhorn, A S

    2003-10-25

    To examine parents' attitudes to the dental care of their children, taking into account the family's socio-economic background, dentally-related behaviour including the child's level of dental anxiety and dental treatment history. A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined; dmft and its components were recorded. A postal questionnaire was sent to the children's parents to measure their preferences for dental care with reference to two scenarios, (1) if their child had a carious but asymptomatic primary tooth, or (2) if their child had a carious primary tooth which was causing toothache. Parents were also asked to provide information on the dental attendance pattern of their child and an assessment of their child's dental anxiety. Family socio-economic status was recorded using the Townsend material deprivation index of the electoral ward in which they resided. Questionnaires were distributed to the home addresses of the 1,745 children who were clinically examined, and 1,437 were returned, giving a response rate of 82%. In both scenarios the majority of parents were happy to leave the decision on treatment to the dentist. In the asymptomatic tooth scenario, approximately one third of parents wanted the tooth to remain untreated but periodically monitored, only 6% expressed a desire to have their child's tooth restored. Multivariate analysis showed that parents of children who had a filling (OR 4.32 95%CI 2.21-8.43) or extraction (OR 2.24 95%CI 1.11-4.53) in the past were significantly more likely to want restorative care for their children. In the scenario where the child had toothache, multivariate analysis confirmed that parents had a preference for an intervention (extraction or filling) if they lived in a deprived area (Townsend score OR 1.10, 95% CI 1.04, 1.16) or if their child had had an extraction (OR 4.35, 95% CI 1.59, 11.88) or filling (OR 2.39, 95% CI 1.05, 5.45) in the

  9. SEM evaluation of resin-carious dentin interfaces formed by two dentin adhesive systems.

    Science.gov (United States)

    Hsu, Kuang-Wei; Marshall, Sally J; Pinzon, Lilliam M; Watanabe, Larry; Saiz, Eduardo; Marshall, Grayson W

    2008-07-01

    We investigated the influence of dentin tubule direction and identifiable zone of carious dentin on the microstructure and the thickness of the hybrid-like layer (HL) formed by self-etch and etch-rinse adhesive systems. An etch-rinse and a self-etching adhesive were bonded to dentin carious zones divided into groups with parallel or perpendicular orientation relative to the dentin tubules at the resin-carious dentin interface (N=5/variable). Bonds were prepared to each of the four zones of carious dentin apparent after staining with Caries Detector: pink, light pink, transparent and apparently normal; six non-carious third molars were controls. The microstructure and thickness of the HL were determined by SEM and compared using three-way ANOVA and Tukey's multiple comparisons (pbonded with the etch-rinse system. For both adhesives, HL thickness in the pink zone was significantly greater than in light pink for the perpendicular group, but no significant differences were found among other variables. HL microstructure was more granular and rougher for the etch-rinse than for the self-etching system. Pores and cracks were obvious in the more demineralized zones. Resin tags were shorter and irregular in the transparent zone and often were completely absent in the outer demineralized zones (pink, light pink). Microstructure of bonded interfaces varies markedly depending on adhesive system, tubule orientation and carious zone.

  10. Carious Exposure versus Mechanical Exposure for MTA Pulpotomy in Primary Teeth

    Directory of Open Access Journals (Sweden)

    Burcu Nihan Çelik

    2016-01-01

    Full Text Available Introduction. The etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposure. This study clinically and radiographically evaluated the success of MTA pulpotomies conducted to treat carious and mechanical pulp exposure. Materials and Methods. This study was conducted with 50 mandibular primary molar teeth. Teeth were divided into 2 groups according to status of the exposure site, with teeth surrounded by carious dentin placed in a carious exposure group and those surrounded by sound dentin in a mechanical exposure group. MTA pulpotomies were performed for both groups. Treatment was followed up clinically and radiographically for 18 months. Results. Clinical and radiographic success rates at 18 months were 100% for both groups. Success rates did not vary significantly between the groups (p=1.000. Pulp canal obliteration was only seen in the carious exposure group, observed in 2 teeth (8.3%. Conclusion. The long term success rates achieved in this study indicate that MTA can be used as a vital pulpotomy material for the long term success in primary teeth with either mechanical or carious exposure. The findings of the present study highlight the fact that treatment prognosis is dependent upon diagnosis and selection of the appropriate materials for treatment.

  11. Carious Exposure versus Mechanical Exposure for MTA Pulpotomy in Primary Teeth.

    Science.gov (United States)

    Çelik, Burcu Nihan; Sarı, Şaziye

    2016-01-01

    Introduction. The etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposure. This study clinically and radiographically evaluated the success of MTA pulpotomies conducted to treat carious and mechanical pulp exposure. Materials and Methods. This study was conducted with 50 mandibular primary molar teeth. Teeth were divided into 2 groups according to status of the exposure site, with teeth surrounded by carious dentin placed in a carious exposure group and those surrounded by sound dentin in a mechanical exposure group. MTA pulpotomies were performed for both groups. Treatment was followed up clinically and radiographically for 18 months. Results. Clinical and radiographic success rates at 18 months were 100% for both groups. Success rates did not vary significantly between the groups (p = 1.000). Pulp canal obliteration was only seen in the carious exposure group, observed in 2 teeth (8.3%). Conclusion. The long term success rates achieved in this study indicate that MTA can be used as a vital pulpotomy material for the long term success in primary teeth with either mechanical or carious exposure. The findings of the present study highlight the fact that treatment prognosis is dependent upon diagnosis and selection of the appropriate materials for treatment.

  12. Pulp nerve fibers distribution of human carious teeth: An immunohistochemical study

    Directory of Open Access Journals (Sweden)

    Tetiana Haniastuti

    2010-12-01

    Full Text Available Background: Human dental pulp is richly innervated by trigeminal afferent axons that subserve nociceptive function. Accordingly, they respond to stimuli that induce injury to the pulp tissue. An injury to the nerve terminals and other tissue components in the pulp stimulate metabolic activation of the neurons in the trigeminal ganglion which result in morphological changes in the peripheral nerve terminals. Purpose: The aim of the study was to observe caries-related changes in the distribution of human pulpal nerve. Methods: Under informed consents, 15 third molars with caries at various stages of decay and 5 intact third molars were extracted because of orthodontic or therapeutic reasons. All samples were observed by micro-computed tomography to confirm the lesion condition 3-dimensionally, before decalcifying with 10% EDTA solution (pH 7.4. The specimens were then processed for immunohistochemistry using anti-protein gene products (PGP 9.5, a specific marker for the nerve fiber. Results: In normal intact teeth, PGP 9.5 immunoreactive nerve fibers were seen concentrated beneath the odontoblast cell layer. Nerve fibers exhibited an increased density along the pulp-dentin border corresponding to the carious lesions. Conclusion: Neural density increases throughout the pulp chamber with the progression of caries. The activity and pathogenicity of the lesion as well as caries depth, might influence the degree of neural sprouting.Latar belakang: Pulpa gigi manusia diinervasi oleh serabut saraf trigeminal yang berespon terhadap stimuli penyebab perlukaan dengan menimbulkan rasa sakit. Perlukaan pada akhiran saraf dan komponen lain dari pulpa akan menstimulasi aktivasi metabolik dari neuron pada ganglion trigeminal sehingga mengakibatkan perubahan morfologi pada akhiran saraf perifer. Tujuan: Penelitian ini bertujuan untuk mengamati perubahan distribusi saraf pada pulpa gigi manusia yang disebabkan oleh proses karies. Metode: Penelitian ini menggunakan

  13. Minimal intervention dentistry: part 4. Detection and diagnosis of initial caries lesions.

    Science.gov (United States)

    Guerrieri, A; Gaucher, C; Bonte, E; Lasfargues, J J

    2012-12-01

    The detection of carious lesions is focused on the identification of early mineral changes to allow the demineralisation process to be managed by non-invasive interventions. The methods recommended for clinical diagnosis of initial carious lesions are discussed and illustrated. These include the early detection of lesions, evaluation of the extent of the lesion and its state of activity and the establishment of appropriate monitoring. The place of modern tools, including those based on fluorescence, is discussed. These can help inform patients. They are also potentially useful in regular control visits to monitor the progression or regression of early lesions. A rigorous and systematic approach to caries diagnosis is essential to establish a care plan for the disease and to identify preventive measures based on more precise diagnosis and to reduce reliance on restorative measures.

  14. Proximal renal tubular acidosis

    Science.gov (United States)

    Renal tubular acidosis - proximal; Type II RTA; RTA - proximal; Renal tubular acidosis type II ... by alkaline substances, mainly bicarbonate. Proximal renal tubular acidosis (Type II RTA) occurs when bicarbonate is not ...

  15. Carious deciduous teeth are a potential source for dental pulp stem cells.

    Science.gov (United States)

    Werle, Stefanie Bressan; Lindemann, Daniele; Steffens, Daniela; Demarco, Flávio Fernando; de Araujo, Fernando Borba; Pranke, Patrícia; Casagrande, Luciano

    2016-01-01

    The objectives of this study are to isolate, cultivate, and characterize stem cells from the pulp of carious deciduous teeth (SCCD) and compare them to those retrieved from sound deciduous teeth (SHED--stem cells from human exfoliated deciduous teeth). Cells were obtained of dental pulp collected from sound (n = 10) and carious (n = 10) deciduous human teeth. Rate of isolation, proliferation assay (0, 1, 3, 5, and 7 days), STRO-1, mesenchymal (CD29, CD73, and CD90) and hematopoietic surface marker expression (CD14, CD34, CD45, HLA-DR), and differentiation capacity were evaluated. Isolation success rates were 70 and 80 % from the carious and sound groups, respectively. SCCD and SHED presented similar proliferation rate. There were no statistical differences between the groups for the tested surface markers. The cells from sound and carious deciduous teeth were positive for CD29, CD73, and CD90 and negative for CD14, CD34, CD45, and HLA-DR and were capable of differentiating into osteogenic, chondrogenic, and adipogenic lineages. SCCD demonstrated a similar pattern of proliferation, immunophenotypical characteristics, and differentiation ability as those obtained from sound deciduous teeth. These SCCD represent a feasible source of stem cells. Decayed deciduous teeth have been usually discarded once the pulp tissue could be damaged and the activity of stem cells compromised. These findings show that stem cells from carious deciduous teeth can be applicable source for cell-based therapies in tissue regeneration.

  16. Suitability of ART approach for managing caries lesions in people with disability-Experts' opinion

    NARCIS (Netherlands)

    Molina, G.F.; Faulks, D.; Frencken, J.E.F.M.

    2013-01-01

    Abstract Objective. This study aimed to obtain the opinions of experts in Special Care Dentistry (SCD) regarding the suitability of the Atraumatic Restorative Treatment (ART) approach for the treatment of carious lesions in persons with disability. Material and methods. Thirty expert participants

  17. Materials for Paediatric Dentistry. Part 1: Background to the Treatment of Carious Primary Teeth.

    Science.gov (United States)

    Jenkins, Natalie

    2015-12-01

    Dental caries is a disease that affects many people, including children, and presents numerous challenges to healthcare providers. As clinicians it is important that we consider the advantages and disadvantages of treating carious primary teeth, and make an informed decision about when it is appropriate or not. This paper describes the background to the treatment of carious primary teeth, looking at the differences between primary and permanent teeth, and the relevance of this. It also suggests points to consider when looking at restoration survival studies, as the ability to appraise the literature critically is important for us all in this 'evidence-based' age. CPD/Clinical Relevance: Our early life experiences have the ability to shape our future attitudes and behaviour. Children with carious teeth require careful management so that pain and suffering is minimized, and positive attitudes towards dentistry are fostered.

  18. Clinical effects of glass ionomer restorations on residual carious dentin in primary molars.

    Science.gov (United States)

    Smales, Roger J; Ngo, Hien C; Yip, Kevin H K; Yu, Chang

    2005-06-01

    To evaluate the mineralization and morphology of residual (infected and affected) carious dentin following the restoration of vital primary molars with viscous glass-ionomer cement (GIC). Encapsulated Fuji IX GP and Ketac-Molar Aplicap GICs were placed in cavities that were prepared using the atraumatic restorative treatment (ART) approach. Four suitable exfoliated teeth with intact restorations were sectioned and then examined by electron probe microanalysis (EPMA) and scanning electron microscopy (SEM). EPMA demonstrated the presence of fluorine and strontium that had penetrated into the underlying residual carious dentin from the adjacent GIC. The concentrations of these two elements, and those of calcium and phosphorous, varied with distance from the GIC/dentin interface. SEM showed varying degrees of dentin tubule destruction and intratubular (peritubular) dentin present immediately subjacent to the GIC/dentin interface. Incomplete removal of carious dentin was observed in all specimens, and GIC remained adherent to the tissue.

  19. Prevalencia de lesiones incipientes de caries dental en niños escolares Prevalence of incipient lesions of dental caries in school children

    Directory of Open Access Journals (Sweden)

    Nayda Nasco Hidalgo

    2008-06-01

    School in Plaza de la Revolución municipality from January to December 2006, and to identify in the studied group the frequency of children according to the number of incipient lesion, as well as the frequency of incipient lesions per tooth localization in the arcade and per dental surface. METHODS: an observational descriptive cross-sectional study was undertaken. The universe consisted of all the children aged 6-11 that fulfilled the inclusion criteria for a total of 236, who were examined in the open-air and with natural light by using the soft visual-tactile method. The teeth were cleaned with cotton and were dried with air to detect the presence of incipient carious lesions, which were indicated in a dentigram model in the place corresponding to the surface affected. RESULTS: it was found that 22.5 % of the school children examined presented these lesions. Of them, 60.1 % were females, 19.5 % of the total of children presented a lesion and just 3 % had 2 incipient lesions of dental caries; 79.2 % of them were observed in the posterior tooth. The smooth surfaces were the most affected with 45.3 %. CONCLUSIONS: Approximately the fourth part of the studied children presented incipient carious lesions. Females were the most affected. Of all the children with incipient lesions, the highest figure corresponded to those having a lesion. The posterior teeth were the most affected by incipient lesions. The smooth surfaces showed more incipient lesions than the occlusal and proximal

  20. Comparison between RVG UI sensor and Kodak InSight film for detection of incipient proximal caries

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Yukiko; Hanazawa, Tomomi; Seki, Kenji; Araki, Kazuyuki; Okano, Tomohiro [Showa Univ., Tokyo (Japan). School of Dentistry

    2002-12-01

    The purpose of this study was to compare the efficacy of the four combination modes of Trophy Radio Visio Graphy (RVG) UI sensor (Trex-Trophy Radiology Inc., Marne-la-Valee, France) and Kodak InSight film (Eastman Kodak Co., Rochester, NY) for detecting proximal dental caries. Thirty extracted human upper premolars were selected. Of 60 surfaces, 25 had carious lesions in the form of small cavities, and the rest showed no evidence of caries as verified by a micro computed tomogram (micro CT; XCT Research SA+, Stratec Medizintechnik GmbH, Pforzheim, Germany). All teeth were radiographed with the paralleling technique (60 kV, 40 cm focus-to-sensor distance). Four combination modes (high-resolution caries mode-HRC; high-sensitivity caries mode-HSC; high-resolution periodontal mode-HRP; and high-resolution endo mode-HRE) were used. Exposure was set at 0.12 sec for HRC, 0.08 sec for HSC, 0.16 sec for HRP, 0.12 sec for HRE, and 0.16 sec for the Kodak InSight film. The resulting images were evaluated by three oral radiologists. The same three observers evaluated the digital images, and were allowed to use the contrast and brightness controls in doing so. Possible differences in receiver operating characteristic (ROC) curve areas among image modalities were assessed by the Friedman test. The mean ROC curve areas were 0.66{+-}0.11 for HRC, 0.78{+-}0.02 for HSC, 0.76{+-}0.04 for HRE, 0.77{+-}0.04 for HRP, and 0.71{+-}0.09 for the Kodak InSight film. There were no statistically significant differences between HRC, HSC, HRE, HRP and the Kodak InSight film in terms of proximal caries detection. The four modes of RVG UI system are each a viable alternative to intraoral film for the detection of incipient dental caries. (author)

  1. Brain Lesions

    Science.gov (United States)

    Symptoms Brain lesions By Mayo Clinic Staff A brain lesion is an abnormality seen on a brain-imaging test, such as ... tomography (CT). On CT or MRI scans, brain lesions appear as dark or light spots that don' ...

  2. Bizarre parosteal osteochondromatous proliferation of the proximal humerus: case report

    Energy Technology Data Exchange (ETDEWEB)

    Bush, J.B.; Meyer, Mark S. [Ochsner Clinic Foundation, Department of Orthopedics, New Orleans, LA (United States); Reith, John D. [University of Florida College of Medicine, Departments of Pathology, Immunology and Laboratory Medicine and Orthopaedics and Rehabilitation, Gainesville, Florida (United States)

    2007-06-15

    Bizarre parosteal osteochondromatous proliferation (BPOP), or Nora's lesion, is a rare lesion of bone occurring predominantly in the long bones of the hands and feet. It exists as a puzzling clinical entity of uncertain origins and high recurrence rates after surgical resection. To our knowledge, this clinical entity has not been reported in the proximal aspect of the humerus. An interesting report of a lesion occurring in the proximal humerus, which initially was misinterpreted as a parosteal osteosarcoma, is discussed outlining the clinical, radiographic and pathologic features of the BPOP lesion. (orig.)

  3. Multiset proximity spaces

    Directory of Open Access Journals (Sweden)

    A. Kandil

    2016-10-01

    Full Text Available A multiset is a collection of objects in which repetition of elements is essential. This paper is an attempt to explore the theoretical aspects of multiset by extending the notions of compact, proximity relation and proximal neighborhood to the multiset context. Examples of new multiset topologies, open multiset cover, compact multiset and many identities involving the concept of multiset have been introduced. Further, an integral examples of multiset proximity relations are obtained. A multiset topology induced by a multiset proximity relation on a multiset M has been presented. Also the concept of multiset δ- neighborhood in the multiset proximity space which furnishes an alternative approach to the study of multiset proximity spaces has been mentioned. Finally, some results on this new approach have been obtained and one of the most important results is: every T4- multiset space is semi-compatible with multiset proximity relation δ on M (Theorem 5.10.

  4. Imaging caries lesions and lesion progression with polarization-sensitive optical coherence tomography

    Science.gov (United States)

    Fried, Daniel; Xie, John; Shafi, Sahar; Featherstone, John D. B.; Breunig, Thomas; Le, Charles Q.

    2002-06-01

    New diagnostic tools are needed for the characterization of dental caries in the early stages of development. If carious lesions are detected early enough, they can be arrested without the need for surgical intervention. The objective of this study was to demonstrate that polarization sensitive optical coherence tomography (PS-OCT) can be used for the imaging of early caries lesions and for the monitoring of lesion progression over time. High-resolution polarization resolved images were acquired of natural caries lesions and simulated caries lesions of varying severity created over time periods of 1 to 14 days. Linearly polarized light was incident on the tooth samples and the reflected intensity in both orthogonal polarizations was measured. PS-OCT was invaluable for removing the confounding influence of surface reflections and native birefringence and for resolving the surface structure of caries lesions. This study demonstrated that PS-OCT is well suited for the resolution of interproximal and occlusal caries, early root caries, and secondary caries around composite fillings. Longitudinal measurements of lesion progression established a strong correlation (p<0.001) between the reflected light from the lesion area and the square root of time indicating that PS-OCT is well suited for monitoring changes in enamel mineralization over time.

  5. Environmental lead pollution and its possible influence on tooth loss and hard dental tissue lesions

    Directory of Open Access Journals (Sweden)

    Cenić-Milošević Desanka

    2013-01-01

    Full Text Available Bacground/Aim. Environmental lead (Pb pollution is a global problem. Hard dental tissue is capable of accumulating lead and other hard metals from the environment. The aim of this study was to investigate any correlation between the concentration of lead in teeth extracted from inhabitants of Pančevo and Belgrade, Serbia, belonging to different age groups and occurrence of tooth loss, caries and non-carious lesions. Methods. A total of 160 volunteers were chosen consecutively from Pančevo (the experimental group and Belgrade (the control group and divided into 5 age subgroups of 32 subjects each. Clinical examination consisted of caries and hard dental tissue diagnostics. The Decayed Missing Filled Teeth (DMFT Index and Significant Caries Index were calculated. Extracted teeth were freed of any organic residue by UV digestion and subjected to voltammetric analysis for the content of lead. Results. The average DMFT scores in Pančevo (20.41 were higher than in Belgrade (16.52; in the patients aged 31-40 and 41-50 years the difference was significant (p < 0.05 and highly significant in the patients aged 51-60 (23.69 vs 18.5, p < 0.01. Non-carious lesions were diagnosed in 71 (44% patients from Pančevo and 39 (24% patients from Belgrade. The concentrations of Pb in extracted teeth in all the groups from Pančevo were statistically significantly (p < 0.05 higher than in all the groups from Belgrade. In the patients from Pančevo correlations between Pb concentration in extracted teeth and the number of extracted teeth, the number of carious lesions and the number of non-carious lesions showed a statistical significance (p < 0.001, p < 0.01 and p < 0.001, respectively. Conclusion. According to correlations between lead concentration and the number of extracted teeth, number of carious lesions and non-carious lesions found in the patients living in Pančevo, one possible cause of tooth loss and hard dental tissue damage could be a long

  6. Minimal invasive treatment using 6.02 micrometer DFG laser for carious dentin

    Science.gov (United States)

    Awazu, Kunio; Ishii, Katsunori; Saiki, Masayuki; Yasuo, Kenzo; Yamamoto, Kazuyo; Yoshikawa, Kazushi

    2010-11-01

    Conventional laser light sources for the treatment of a hard tissue in dental are good for removal of caries. However these lasers cannot achieve to give a selective treatment effect for caries without a side effect for normal tissue. The objective of this study is to develop the minimal invasive treatment technique of carious dentin by selective absorption effect using the laser with a wavelength of 6.02 μm which corresponds to an absorption peak of organic matters called amide 1 band. Mid-infrared nanosecond pulsed laser by difference-frequency generation was used for the experiment of selective treatment. A tunable wavelength range, pulse width and repetition rate is from 5.5 to 10 μm, 5 ns and 10 Hz, respectively. The laser with a wavelength of 6.02 μm and predetermined energy parameters was irradiated to a carious dentin model. After laser irradiation, the surface and cross-sectional surface of samples were observed. Average power density about 15 W/cm2 realized to excavate a demineralized region selectively. In the same energy condition, serious side effect was not observed on the surface of normal dentin. A wavelength of 6.02 μm realizes a selective excavation of carious dentin. Using 6.02 μm is a novel and promising technique toward to next-generation dental treatment procedure for realizing minimal intervention.

  7. Fluorine determination in human healthy and carious teeth using the PIGE technique

    Science.gov (United States)

    Carvalho, M. L.; Karydas, A. G.; Casaca, C.; Zarkadas, Ch; Paradellis, Th; Kokkoris, M.; Nsouli, B.; Cunha, A. S.

    2001-09-01

    The purpose of this study is to determine and compare the fluorine concentration in human teeth from two different populations, living in the Portuguese quite isolated islands of Açores: S. Miguel and Terceira. Both populations have similar dietary habits, similar occupational activities, mostly rural, and the age of both populations is more or less the same, around 40 years. No chronic diseases were registered in any of the donors. The two groups are exposed to different levels of fluorine in drinking water. Terceira island has moderate fluorine concentration levels (1-2 μg g -1) while S. Miguel island is known for the high fluorine concentration levels in its water (>3 μg g -1), especially in one area known as Furnas. Thirty-three teeth, 17 healthy and 16 carious without restoration (14 incisors and canines, 7 premolars and 12 molars), were collected and analyzed for the determination of fluorine concentration in the dentine region, using the nuclear reaction 19F( p, αγ) 16O. The teeth were cross-sectioned along the vertical plane and polished, in order to obtain a smooth and plane surface of about 1 mm thickness. In this work an association between caries prevalence and fluorine content of drinking water is discussed and the variation of fluorine concentration among different types of teeth (canines and incisors, premolars, molars) and physical state (carious and non-carious) is examined.

  8. Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth.

    Science.gov (United States)

    Hegde, Swaroop; Sowmya, B; Mathew, Sylvia; Bhandi, Shilpa H; Nagaraja, Shruthi; Dinesh, K

    2017-01-01

    Root canal treatment has been a routine treatment option for carious exposure of the dental pulp. In the context of minimally invasive dentistry, direct pulp capping (DPC) procedure with a reliable biomaterial may be considered as an alternative provided the pulp status is favorable. Mineral trioxide aggregate (MTA), a bioactive cement with excellent sealing ability and biocompatibility is capable of regenerating relatively damaged pulp and formation of dentin bridge when used as DPC agent. Biodentine is comparatively a new biomaterial claimed to possess properties similar to MTA and is currently explored for vital pulp therapy procedures. The aim of the present study was to evaluate the clinical response of pulp-dentin complex after DPC with MTA and biodentine in carious teeth. Twenty-four permanent molars with carious exposure having no signs and symptoms of irreversible pulpitis were selected and assigned to one of the two groups, Group I - MTA and Group II - biodentine. Patients were recalled at 3 weeks, 3 months, and 6 months for clinical and radiographic evaluation. Fisher's exact test was used along with Chi-square test for statistical analysis. Over a period of 6 months, MTA and biodentine showed 91.7% and 83.3% success rate, respectively, based on the subjective symptoms, pulp sensibility tests, and radiographic appearance. MTA and biodentine may be used as DPC agents when the pulpal diagnosis is not more than reversible pulpitis.

  9. Shear bond strengths of glass-ionomer cements to sound and to prepared carious dentine.

    Science.gov (United States)

    Czarnecka, Beata; Deregowska-Nosowicz, Patricia; Limanowska-Shaw, Honorata; Nicholson, John W

    2007-05-01

    The aim of this study was determine whether bonding of glass-ionomer cements to non-carious dentine differed from that to carious dentine. Five commercial cements were used, namely Fuji IX GP, Fuji IX capsulated, Fuji IX Fast capsulated (all GC, Japan), Ketac-Molar and Ketac-Molar Aplicap (both 3M-ESPE, Germany). Following conditioning of the substrate with 10% poly (acrylic acid) for 10 s, sets of 10 samples of the cements were bonded to prepared teeth that had been removed for orthodontic reasons. The teeth used had either sound dentine or sclerotic dentine. Shear bond strengths were determined following 24 h storage. For the auto-mixed cements, shear bond strength to sound dentine was found not to differ statistically from shear bond strength to sclerotic dentine whereas for hand-mixed cements, shear bond to sound dentine was found to be higher than to carious dentine (to at least p < 0.05). This shows that the chemical effects arising from interactions of glass-ionomer cements with the mineral phase of the tooth are the most important in developing strong bonds, at least in the shorter term.

  10. Radiopaque Tagging Masks Caries Lesions following Incomplete Excavation in vitro.

    Science.gov (United States)

    Schwendicke, F; Meyer-Lueckel, H; Schulz, M; Dörfer, C E; Paris, S

    2014-06-01

    One-step incomplete excavation seals caries-affected dentin under a restoration and appears to be advantageous in the treatment of deep lesions. However, it is impossible to discriminate radiographically between intentionally left, arrested lesions and overlooked or active lesions. This diagnostic uncertainty decreases the acceptance of minimally invasive excavation and might lead to unnecessary re-treatment of incompletely excavated teeth. Radiopaque tagging of sealed lesions might mask arrested lesions and assist in discrimination from progressing lesions. Therefore, we microradiographically screened 4 substances (SnCl2, AgNO3, CsF, CsCH3COO) for their effect on artificial lesions. Since water-dissolved tin chloride (SnCl2×Aq) was found to stably mask artificial lesions, we then investigated its radiographic effects on progressing lesions. Natural lesions were incompletely excavated and radiopaque tagging performed. Grey-value differences (△GV) between sound and carious dentin were determined and radiographs assessed by 20 dentists. While radiographic effects of SnCl2×Aq were stable for non-progressing lesions, they significantly decreased during a second demineralization (p excavation. © International & American Associations for Dental Research.

  11. Proximal Probes Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Proximal Probes Facility consists of laboratories for microscopy, spectroscopy, and probing of nanostructured materials and their functional properties. At the...

  12. Imaging caries lesions and lesion progression with polarization sensitive optical coherence tomography.

    Science.gov (United States)

    Fried, Daniel; Xie, John; Shafi, Sahar; Featherstone, John D B; Breunig, Thomas M; Le, Charles

    2002-10-01

    New diagnostic tools are needed for the characterization of dental caries in the early stages of development. If carious lesions are detected early enough, they can be arrested without the need for surgical intervention. The objective of this study was to demonstrate that polarization sensitive optical coherence tomography (PS-OCT) can be used for the imaging of early caries lesions and for the monitoring of lesion progression over time. High-resolution polarization resolved images were acquired of natural caries lesions and simulated caries lesions of varying severity created over time periods of 1 to 14 days. Linearly polarized light was incident on the tooth samples and the reflected intensity in both orthogonal polarizations was measured. PS-OCT was invaluable for removing the confounding influence of surface reflections and native birefringence necessary for the enhanced resolution of the surface structure of caries lesions. This study demonstrated that PS-OCT is well suited for the imaging of interproximal and occlusal caries, early root caries, and for imaging decay under composite fillings. Longitudinal measurements of the reflected light intensity in the orthogonal polarization state from the area of simulated caries lesions linearly correlated with the square root of time of demineralization indicating that PS-OCT is well suited for monitoring changes in enamel mineralization over time.

  13. Dentine microhardness after different methods for detection and removal of carious dentine tissue

    Directory of Open Access Journals (Sweden)

    Fernanda Brandão Mollica

    2012-08-01

    Full Text Available There are several methods for identifying carious dentinal tissue aiming to avoid removal of healthy dentinal tissue. OBJECTIVES: The purpose of this study was to test different methods for the detection of carious dentinal tissue regarding the amount of carious tissue removed and the remaining dentin microhardness after caries removal. MATERIAL AND METHODS: The dentin surfaces of 20 bovine teeth were exposed and half of the surface was protected with nail polish. Cariogenic challenge was performed by immersion in a demineralizing solution for 14 days. After transverse cross-section of the crown, the specimens were divided into four groups (n=10, according to the method used to identify and remove the carious tissue: "Papacárie", Caries-detector dye, DIAGNOdent and Tactile method. After caries removal, the cross-sectional surface was included in acrylic resin and polished. In a microhardness tester, the removed dentin thickness and the Vickers microhardness of the following regions were evaluated: remaining dentin after caries removal and superficial and deep healthy dentin. RESULTS: ANOVA and Tukey's test (α=0.05 were performed, except for DIAGNOdent, which did not detect the presence of caries. Results for removed dentin thickness were: "Papacárie" (424.7±105.0; a, Caries-detector dye (370.5±78.3; ab, Tactile method (322.8±51.5; bc. Results for the remaining dentin microhardness were: "Papacárie" (42.2±10.5; bc, Caries-detector dye (44.6±11.8; abc, Tactile method (24.3±9.0; d. CONCLUSIONS: DIAGNOdent did not detect the presence of carious tissue; Tactile method and "Papacárie" resulted in the least and the most dentinal thickness removal, respectively; Tactile method differed significantly from "Papacárie" and Caries-detector dye in terms of the remaining dentin microhardness, and Tactile method was the one which presented the lowest microhardness values.

  14. Optical path-length spectroscopy of incipient caries lesions in relation to quantitative light-induced fluorescence and lesion characteristics.

    Science.gov (United States)

    Mujat, Claudia; van der Veen, Monique H; Ruben, Jan L; ten Bosch, Jaap J; Dogariu, Aristide

    2003-06-01

    A basic understanding of the light-scattering processes that take place inside the dental tissue (either sound or carious) is obtained both with measurements of the photon path-length distribution of light inside such media and with Monte Carlo simulations. Furthermore, the following is investigated: the correlations between different momenta of the photon path-length distribution of light inside caries lesions, the fluorescence loss determined with quantitative light-induced fluorescence, and/or the demineralization and depth of caries lesions determined with transversal microradiography. It is concluded that (i) the light paths inside both carious and sound enamel are considerably influenced by the refractive-index contrast at the tooth surface; (ii) contrary to a previous hypothesis, the fluorescence loss is larger in lesions in which the average photon path length is longer; (iii) very good correlations are obtained between the optical characteristics and the physical parameters of lesions when the optical measurements are performed such that there is high refractive contrast at the tooth surface.

  15. Extended sealing of interproximal caries lesions.

    Science.gov (United States)

    Ardu, Stefano; Perroud, Reymond; Krejci, Ivo

    2006-06-01

    In recent years the concept of minimally invasive dentistry has offered a more conservative approach to restoration of teeth with caries lesions. Several techniques have been suggested for treatment of proximal lesions, but their results have been less than ideal. The aim of this article is to present a new technique for ultraconservative restoration of small interproximal caries lesions that avoids the disadvantages of both the tunnel and the proximal slot restorative techniques. Two cases, of patients with high and low caries risk, are presented to illustrate the technique. The proposed technique can be considered the most conservative alternative to conventional Class 2 or slot-cavity treatment approaches.

  16. Molecular and Histological Association Between Candida albicans from Oral Soft Tissue and Carious Dentine of HIV-Positive Children.

    Science.gov (United States)

    Blignaut, Elaine; van Heerden, Willie F P

    2015-10-01

    Candida albicans and caries are frequently investigated among healthy and immunosuppressed individuals. The objective of this study was to demonstrate the presence of C. albicans on both oral soft and hard tissue and to investigate, at molecular level, the genetic subtype of the organism from the two oral sites. Tongue swabs and dentine scrapings from 362 HIV-positive children, referred for the extraction of carious primary teeth, were cultured on CHROMagar and identified to species level with ID32C. Histological staining of extracted carious teeth was also done. In patients with positive C. albicans cultures from both the tongue and carious dentine, DNA fingerprinting of such paired isolates was performed, using Southern blot hybridisation with the Ca3 probe. Yeasts were cultured from the tongue of 151 (41.7 %) individuals and 57 (37.7 %) simultaneously yielded positive C. albicans cultures from carious dentine. Nine different yeast spp. were identified from the tongue using the ID32C commercial system, but C. albicans was the only species recovered from carious dentine and histological investigation demonstrated fungal elements penetrated into the dentine and not limited to superficial debris on the floor of the cavity. Twelve of 13 paired isolates of C. albicans revealed identical fingerprinting patterns. The findings from this study demonstrated that in a particular individual, the same genetic subtype of C. albicans was capable of colonising both oral soft tissue and carious dentine. This renders carious teeth a constant source, or reservoir, of potentially infectious agents and, particularly among immunosuppressed individuals, should therefore not be left unattended.

  17. From Black to Contemporary Cariology: Learning to look at the same lesions with a different perspective

    OpenAIRE

    Gudiño DDS, MPH, Sylvia; Lanata DDS, PhD, Eduardo

    2015-01-01

    Since its birth as a profession and in the XIXth and XXth centuries, Dental Sciences generated overwhelming amount of new knowledge in Cariology, in such dispair areas as basic sciences, tissue engineering and regeneration, microbiology, endogenous and exogenous nutritional factors, social sciences, etc., as well as in prevention, diagnosis, classification, activity, control, monitoring, treatment and rehabilitation of carious lesions. However, according to the Centers for Disease Control, US...

  18. Selective excavation of human carious dentin using the nanosecond pulsed laser in 5.8-μm wavelength range

    Science.gov (United States)

    Kita, Tetsuya; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    Less-invasive treatment of caries has been needed in laser dentistry. Based on the absorption property of dentin substrates, 6 μm wavelength range shows specific absorptions and promising characteristics for the excavation. In our previous study, 5.8 μm wavelength range was found to be effective for selective excavation of carious dentin and restoration treatment using composite resin from the irradiation experiment with bovine sound and demineralized dentin. In this study, the availability of 5.8 μm wavelength range for selective excavation of human carious dentin was investigated for clinical application. A mid-infrared tunable nanosecond pulsed laser by difference-frequency generation was used for revealing the ablation property of human carious dentin. Irradiation experiments indicated that the wavelength of 5.85 μm and the average power density of 30 W/cm2 realized the selective excavation of human carious dentin, but ablation property was different with respect to each sample because of the different caries progression. In conclusion, 5.8 μm wavelength range was found to be effective for selective excavation of human carious dentin.

  19. Optical Spectroscopy Study of Transparent Non-Carious Human Dentin and Dentin-Enamel Junction

    Energy Technology Data Exchange (ETDEWEB)

    Marshall, G.W.; Marshall, S.J.; Gallagher, R.R.; Demos, S.

    1999-12-14

    Improving our knowledge of the morphology, composition and properties of the dentin, enamel, and the dentin-enamel junction (DEJ) is vital for the development of improved restorative materials and clinical placement techniques. Most studies of dental tissues have used light microscopy for characterization. In our investigation, the spectroscopic properties of normal and non-carious transparent human root dentin, and the dentin-enamel junction were investigated using emission imaging microscopy, and micro-spectroscopy. Experimental results reveal new information on the structural and biochemical characteristics of these dental tissues.

  20. Depth and activity of carious lesions as indicators for the regenerative potential of dental pulp after intervention

    DEFF Research Database (Denmark)

    Bjørndal, Lars; Pedersen, Sune Demant Nørgaard; Dabelsteen, Sally

    2014-01-01

    that the typical reason for performing endodontic treatment is deep caries. The biological concept of vital pulp therapy associated with deep caries takes the treatment and evaluation of the unexposed as well as the exposed pulp into account. Interestingly, the clinical diagnosis is typically the same. Deep caries...

  1. Lesiones laborales

    OpenAIRE

    Plachesi, Pierina

    2015-01-01

    Las lesiones laborales se producen por un esfuerzo repetitivo, cuando un exceso de presión se ejerce sobre una parte del cuerpo provocando lesiones óseas, articulares, musculares y daños en los tejidos. Los accidentes laborales también pueden producir una lesión en el organismo y esto sumado a diversos factores es un problema para la reinserción laboral de los trabajadores de la energía eléctrica. Objetivo: Establecer cuáles son las lesiones más frecuentes que afectan a los ...

  2. Characterization of enamel caries lesions in rat molars using synchrotron X-ray microtomography

    Energy Technology Data Exchange (ETDEWEB)

    Free, R.D.; DeRocher, K.; Stock, S.R.; Keane, D.; Scott-Anne, K.; Bowen, W.H.; Joester, D. (Rochester); (NWU)

    2017-08-18

    Dental caries is a ubiquitous infectious disease with a nearly 100% lifetime prevalence. Rodent caries models are widely used to investigate the etiology, progression and potential prevention or treatment of the disease. To explore the suitability of these models for deeper investigations of intact surface zones during enamel caries, the structures of early-stage carious lesions in rats were characterized and compared with previous reports on white spot enamel lesions in humans. Synchrotron X-ray microcomputed tomography non-destructively mapped demineralization in carious rat molar specimens across a range of caries severity, identifying 52 lesions across the 30 teeth imaged. Of these lesions, 13 were shown to have intact surface zones. Depth profiles of fractional mineral density were qualitatively similar to lesions in human teeth. However, the thickness of the surface zone in the rat model ranges from 10 to 58 µm, and is therefore significantly thinner than in human enamel. These results indicate that a fraction of lesions in rat caries possess an intact surface zone and are qualitatively similar to human lesions at the micrometer scale. This suggests that rat caries models may be a suitable analog through which to investigate the structure of surface zone enamel and its role during dental caries.

  3. Mixed periapical lesion: differential diagnosis of a case.

    Science.gov (United States)

    Krithika, C; Kota, S; Gopal, K S; Koteeswaran, D

    2011-03-01

    A radicular cyst associated with carious teeth is a very common odontogenic lesion in the oral cavity, but calcifications in residual radicular cysts are quite rare. We report one such case where a routine pre-implant radiographic assessment revealed a mixed periapical radiopaque radiolucent lesion in the right maxillary central incisor region. Histological and radiographic studies show that there is a slow increase in the mineralized deposits within the cyst lumen with time. This becomes prominent histochemically in cysts more than 8 years old and radiographically 6 years later, as seen in our case. In this paper we would like to highlight the importance of a residual radicular cyst with calcifications in the differential diagnosis of a mixed periapical radiopaque radiolucent lesion.

  4. Effect of mineral trioxide aggregate as a direct pulp capping agent in cariously exposed permanent teeth

    Directory of Open Access Journals (Sweden)

    Parul Bansal

    2014-01-01

    Full Text Available Aims and Objectives: To evaluate the effectiveness of mineral trioxide aggregate (MTA when used as a pulp capping agent in permanent teeth with carious exposure (≤1mm after root formation is completed. Materials and Methods: Clinical follow-up was performed on 32 mandibular molars with deep occlusal caries, in patients in the age group range of 18 to 42 years. Carious pulpal exposures were treated by direct pulp capping with MTA, followed by a base of light cure glass ionomer cement and restored with amalgam. Clinical and radiographic examinations were carried out periodically at 1, 3, 6, 9, 12, 18 and 24 months. Results: After 24 months clinical and radiographic follow-up, it was found that 25 (out of 32 patients had successful outcome. However, two patients failed to return for evaluation after permanent restoration, and five patients exhibited clinical failure. Conclusions: Mineral trioxide aggregate was found to be an effective material when used for direct pulp capping in permanent teeth. However, further investigations with a larger sample size are needed to support these findings.

  5. Pulpotomy versus pulpectomy for carious vital primary incisors: randomized controlled trial.

    Science.gov (United States)

    Howley, Brega; Seale, N Sue; McWhorter, Alton G; Kerins, Carolyn; Boozer, Kent B; Lindsey, Donna

    2012-01-01

    The purpose of this prospective, randomized, split-mouth investigation was to compare the success rates of formocresol pulpotomies (FC) and Vitapex(®) pulpectomies (RCT) in asymptomatic carious vital primary incisors. Matched contralateral pairs of asymptomatic, carious, vital primary incisors were randomized to receive FC or RCT by 2 standardized operators and restored with stainless steel crowns. Seventy-four incisors were followed clinically and radiographically for up to 23 months. Two standardized examiners evaluated radiographic findings using separate pulpotomy and pulpectomy scales (modified Zurn/Seale). Incisors present at each interval (5-9, 10-14, and 15-23 months) showed no clinical failures. One FC incisor was lost early and counted as a failure. Though not significantly different, there were higher numbers of successful radiographic outcomes for FC than RCT at each observation interval. Cumulative final radiographic success was 89% (n=33) for FC and 73% (n=27) for RCT. (P=.11). Anecdotal claims that pulpotomies are unsuccessful in primary incisors are unfounded. There was no significant difference in success rates of pulpotomies and pulpectomies in the pulp treatment of asymptomatic vital primary incisors. Intracanal resorption of Vitapex(®) was seen in all pulpectomy teeth and did not affect pulpectomy outcome.

  6. Image processing with the radial Hilbert transform of photo-thermal imaging for carious detection

    Science.gov (United States)

    El-Sharkawy, Yasser H.

    2014-03-01

    Knowledge of heat transfer in biological bodies has many diagnostic and therapeutic applications involving either raising or lowering of temperature, and often requires precise monitoring of the spatial distribution of thermal histories that are produced during a treatment protocol. The present paper therefore aims to design and implementation of laser therapeutic and imaging system used for carious tracking and drilling by develop a mathematical algorithm using Hilbert transform for edge detection of photo-thermal imaging. photothermal imaging has the ability to penetrate and yield information about an opaque medium well beyond the range of conventional optical imaging. Owing to this ability, Q- switching Nd:YAG laser at wavelength 1064 nm has been extensively used in human teeth to study the sub-surface deposition of laser radiation. The high absorption coefficient of the carious rather than normal region rise its temperature generating IR thermal radiation captured by high resolution thermal camera. Changing the pulse repetition frequency of the laser pulses affects the penetration depth of the laser, which can provide three-dimensional (3D) images in arbitrary planes and allow imaging deep within a solid tissue.

  7. A CHANGE IN PRACTICE PROTOCOL: PREFORMED METAL CROWNS FOR TREATING NON-INFECTED CARIOUS PRIMARY MOLARS IN A GENERAL PRACTICE SETTING--A SERVICE EVALUATION.

    Science.gov (United States)

    Taylor, Greig D

    2015-11-01

    Restoring non-infected carious primary molars can pose a challenge to the general dental practitioner. This paper aims to assess the effect on primary caries management and patient experience in a general dental practice setting, when restoring non-infected carious primary molars using a Hall preformed metal crown (PMC).

  8. Dental cervical lesions associated with occlusal erosion and attrition.

    Science.gov (United States)

    Khan, F; Young, W G; Shahabi, S; Daley, T J

    1999-09-01

    Acid demineralization of teeth causes occlusal erosion and attrition, and shallow and wedge-shaped cervical lesions putatively involving abfraction. From 250 patients with tooth wear, 122 with cervical lesions were identified. From epoxy resin replicas of their dentitions, associations of occlusal attrition or erosion or no wear with cervical lesions were recorded at 24 tooth sites (total 2928 sites). Criteria used to discriminate occlusal attrition from erosion, and shallow from grooved, wedge-shaped or restored cervical lesions were delineated by scanning electron microscopy. A 96 per cent association was found between occlusal and cervical pathology. Shallow cervical lesions were more commonly found in association with occlusal erosion. Wedge-shaped lesions were found equally commonly in association with occlusal erosion, as with attrition. Grooved and restored cervical lesions were uncommon. Differences were appreciated in the associations within incisor, canine, premolar and molar tooth sites which related more to the site-specificity of dental erosion than to attrition from occlusal forces. Non-carious lesions on teeth then have multifactorial aetiology and pathogenesis in which erosion and salivary protection play central roles. Dentists should primarily consider erosion in the diagnosis, prevention and treatment of tooth wear.

  9. Capacitive proximity sensor

    Science.gov (United States)

    Kronberg, James W.

    1994-01-01

    A proximity sensor based on a closed field circuit. The circuit comprises a ring oscillator using a symmetrical array of plates that creates an oscillating displacement current. The displacement current varies as a function of the proximity of objects to the plate array. Preferably the plates are in the form of a group of three pair of symmetric plates having a common center, arranged in a hexagonal pattern with opposing plates linked as a pair. The sensor produces logic level pulses suitable for interfacing with a computer or process controller. The proximity sensor can be incorporated into a load cell, a differential pressure gauge, or a device for measuring the consistency of a characteristic of a material where a variation in the consistency causes the dielectric constant of the material to change.

  10. Neighborhoods and manageable proximity

    Directory of Open Access Journals (Sweden)

    Stavros Stavrides

    2011-08-01

    Full Text Available The theatricality of urban encounters is above all a theatricality of distances which allow for the encounter. The absolute “strangeness” of the crowd (Simmel 1997: 74 expressed, in its purest form, in the absolute proximity of a crowded subway train, does not generally allow for any movements of approach, but only for nervous hostile reactions and submissive hypnotic gestures. Neither forced intersections in the course of pedestrians or vehicles, nor the instantaneous crossing of distances by the technology of live broadcasting and remote control give birth to places of encounter. In the forced proximity of the metropolitan crowd which haunted the city of the 19th and 20th century, as well as in the forced proximity of the tele-presence which haunts the dystopic prospect of the future “omnipolis” (Virilio 1997: 74, the necessary distance, which is the stage of an encounter between different instances of otherness, is dissipated.

  11. Laser-induced breakdown spectroscopy of dental lesions: diagnostic and therapeutic monitoring tool

    Science.gov (United States)

    Borisova, Ekaterina; Uzunov, Tzonko; Penev, Dimitar; Genova, Tsanislava; Avramov, Latchezar

    2016-01-01

    The carious decay develops a tiny area of demineralization on the enamel, which could be detected by element analytic techniques such as laser-induced breakdown spectroscopy (LIBS). That demineralization can quickly turn into a large lesion inside the tooth, it is often discovered too late to prevent the kind of decay that leads to cavities. The same optical LIBS detection approach could be used for monitoring of the caries removal using laser ablation or drilling techniques. For LIBS measurements we applied LIBS 2500Plus (Ocean Optics Inc., Dunedin, USA) system, which consists of seven spectrometric channels, covering spectral region from 200 to 980 nm, which optical resolution 0,05 nm, the spectrometers are connected with sample fiber bundle for 7-channels spectral system to the chamber for solid and liquid samples, Q-switched Nd:YAG laser, at 1 064 nm, with energy per pulse - 40 mJ, which is applied to induce plasma in the samples. LIBS spectra were obtained after single shot of the laser in the region of pathology. Samples investigated by LIBS are extracted teeth from patients, with periodontal problems on different stage of carious lesions, and their LIBS spectra are compared with the LIBS signals obtained from normal enamel and dentine tissues to receive complete picture of the carious lesion development. The major line of our investigations is related to the development of a methodology for real-time optical feedback control during selective ablation of tooth tissues using LIBS. Tooth structures, with and without pathological changes, are compared and their LIBS element analysis is used to differentiate major changes, which occur during tooth carious process and growth.

  12. Atrofia muscular proximal familiar

    Directory of Open Access Journals (Sweden)

    José Antonio Levy

    1962-09-01

    Full Text Available Os autores relatam dois casos de atrofia muscular proximal familiar, moléstia caracterizada por déficit motor e atrofias musculares de distribuição proximal, secundárias a lesão de neurônios periféricos. Assim, como em outros casos descritos na literatura, foi feito inicialmente o diagnóstico de distrofia muscular progressiva. O diagnóstico correto foi conseguido com auxílio da eletromiografia e da biopsia muscular.

  13. Quantification of carious pathogens in the interdental microbiota of young caries-free adults

    Science.gov (United States)

    Inquimbert, Camille; Tramini, Paul; Molinari, Nicolas; Carrouel, Florence

    2017-01-01

    Background The majority of caries lesions in adults occur on the proximal tooth surfaces of the posterior teeth. A comprehensive study of the composition of the oral microbiota is fundamental for a better understanding of the etiology of interdental caries. Methods Twenty-five caries-free subjects (20–35 years old) were enrolled in the study. The interdental biofilm of four interdental sites were collected. The real-time polymerase chain reaction (PCR) methodology were used to quantify (i) the following bacteria: Streptococcus spp., Streptococcus mutans, Lactobacillus spp., Enterococcus spp., and Enterococcus faecalis; (ii) the fungus Candida albicans; and (iii) total bacteria. Results Streptococcus spp. was the most abundant species, followed by Lactobacillus spp. and Enterococcus spp. Streptococcus spp. and Lactobacillus spp. were detected at all tested sites and Enterococcus spp. at 99% of sites. S. mutans was detected at only 28% of the tested sites and C. albicans was detected at 11% of sites. E. faecalis was never detected. In 54.5% of the biofilm inhabited by C. albicans, S. mutans was present. Moreover, 28% of the ID sites co-expressed S. mutans and Lactobacillus spp. The studied pathogens were organized into two correlated groups of species. Strikingly, the fungus C. albicans and the bacteria Enterococcus spp. cluster together, whereas Streptococcus spp., S. mutans and Lactobacillus spp. form one distinct cluster. Conclusion The interdental biofilm of young caries-free adults is comprised of pathogens that are able to induce interproximal caries. That several of these pathogens are implicated in heart disease or other systemic diseases is an argument for the disruption of interdental biofilms using daily oral hygiene. PMID:29016613

  14. Quantification of carious pathogens in the interdental microbiota of young caries-free adults.

    Science.gov (United States)

    Bourgeois, Denis; David, Alexandra; Inquimbert, Camille; Tramini, Paul; Molinari, Nicolas; Carrouel, Florence

    2017-01-01

    The majority of caries lesions in adults occur on the proximal tooth surfaces of the posterior teeth. A comprehensive study of the composition of the oral microbiota is fundamental for a better understanding of the etiology of interdental caries. Twenty-five caries-free subjects (20-35 years old) were enrolled in the study. The interdental biofilm of four interdental sites were collected. The real-time polymerase chain reaction (PCR) methodology were used to quantify (i) the following bacteria: Streptococcus spp., Streptococcus mutans, Lactobacillus spp., Enterococcus spp., and Enterococcus faecalis; (ii) the fungus Candida albicans; and (iii) total bacteria. Streptococcus spp. was the most abundant species, followed by Lactobacillus spp. and Enterococcus spp. Streptococcus spp. and Lactobacillus spp. were detected at all tested sites and Enterococcus spp. at 99% of sites. S. mutans was detected at only 28% of the tested sites and C. albicans was detected at 11% of sites. E. faecalis was never detected. In 54.5% of the biofilm inhabited by C. albicans, S. mutans was present. Moreover, 28% of the ID sites co-expressed S. mutans and Lactobacillus spp. The studied pathogens were organized into two correlated groups of species. Strikingly, the fungus C. albicans and the bacteria Enterococcus spp. cluster together, whereas Streptococcus spp., S. mutans and Lactobacillus spp. form one distinct cluster. The interdental biofilm of young caries-free adults is comprised of pathogens that are able to induce interproximal caries. That several of these pathogens are implicated in heart disease or other systemic diseases is an argument for the disruption of interdental biofilms using daily oral hygiene.

  15. Quantification of carious pathogens in the interdental microbiota of young caries-free adults.

    Directory of Open Access Journals (Sweden)

    Denis Bourgeois

    Full Text Available The majority of caries lesions in adults occur on the proximal tooth surfaces of the posterior teeth. A comprehensive study of the composition of the oral microbiota is fundamental for a better understanding of the etiology of interdental caries.Twenty-five caries-free subjects (20-35 years old were enrolled in the study. The interdental biofilm of four interdental sites were collected. The real-time polymerase chain reaction (PCR methodology were used to quantify (i the following bacteria: Streptococcus spp., Streptococcus mutans, Lactobacillus spp., Enterococcus spp., and Enterococcus faecalis; (ii the fungus Candida albicans; and (iii total bacteria.Streptococcus spp. was the most abundant species, followed by Lactobacillus spp. and Enterococcus spp. Streptococcus spp. and Lactobacillus spp. were detected at all tested sites and Enterococcus spp. at 99% of sites. S. mutans was detected at only 28% of the tested sites and C. albicans was detected at 11% of sites. E. faecalis was never detected. In 54.5% of the biofilm inhabited by C. albicans, S. mutans was present. Moreover, 28% of the ID sites co-expressed S. mutans and Lactobacillus spp. The studied pathogens were organized into two correlated groups of species. Strikingly, the fungus C. albicans and the bacteria Enterococcus spp. cluster together, whereas Streptococcus spp., S. mutans and Lactobacillus spp. form one distinct cluster.The interdental biofilm of young caries-free adults is comprised of pathogens that are able to induce interproximal caries. That several of these pathogens are implicated in heart disease or other systemic diseases is an argument for the disruption of interdental biofilms using daily oral hygiene.

  16. [Experimental proximal carpectomy. Biodynamics].

    Science.gov (United States)

    Kuhlmann, J N

    1992-01-01

    Proximal carpectomy was performed in 10 fresh cadavre wrists. Dynamic x-rays were taken and the forces necessary to obtain different movements before and after the operation were measured. Comparison of these parameters clearly defines the advantages and limitations of carpectomy and indicates the reasons.

  17. Proximate Analysis of Coal

    Science.gov (United States)

    Donahue, Craig J.; Rais, Elizabeth A.

    2009-01-01

    This lab experiment illustrates the use of thermogravimetric analysis (TGA) to perform proximate analysis on a series of coal samples of different rank. Peat and coke are also examined. A total of four exercises are described. These are dry exercises as students interpret previously recorded scans. The weight percent moisture, volatile matter,…

  18. Proximal Tibial Bone Graft

    Science.gov (United States)

    ... the Big Toe Ailments of the Smaller Toes Diabetic Foot Treatments Currently selected Injections and other Procedures Treatments ... from which the bone was taken if the foot/ankle surgeries done at the same time allow for it. ... problems after a PTBG include infection, fracture of the proximal tibia and pain related ...

  19. SEM-EDX analysis of brushing abrasion of chitosan and propolis based toothpastes on sound and artificial carious primary enamel surfaces.

    Science.gov (United States)

    Ozalp, Serife; Tulunoglu, Ozlem

    2014-09-01

    The objective of this study was to assess the brushing abrasion effects of toothpastes containing chitosan and propolis on sound and demineralized primary tooth enamel. Pairs of enamel specimens were prepared from human extracted primary teeth, embedded in epoxy resin and polished. An artificial subsurface lesion was created in one specimen from each pair. All samples were divided into four groups (Chitodent, Aagaard propolis, Elmex, and Control) and brushed with slurry of toothpastes and artificial saliva in a brushing machine. The brushing abrasion depths were evaluated using computer-guided optical profilometry. No significant differences existed in terms of brushing depths between artificial carious enamel and brushed sound enamel specimens (P>0.05). The abrasion values of the sound enamel samples brushed with Aagaard propolis and control samples were significantly lower than the Elmex group (Pbrushing abrasion values of demineralized enamel specimens were observed in the Chitodent group (P>0.05). The tested toothpastes exhibited similar effects in terms of brushing abrasion on both sound and artificially demineralized enamel. Based on mean values without statistical significance, the lowest brushing abrasion values in the demineralized brushed enamel samples were detected in the Chitodent group. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Dedifferentiated chondrosarcoma of right proximal femur

    Directory of Open Access Journals (Sweden)

    Sachin A Badge

    2016-01-01

    Full Text Available Dedifferentiated chondrosarcoma (DDCS comprises approximately 10% of all chondrosarcomas. The tumor generally occurs after the age of 50 years, with equal distribution among males and females. It is most often located in the bones of the pelvis, the proximal femur or humerus, the distal femur, and the ribs. Regardless of treatment, the prognosis is ominous with 90% of patients dying with distant metastases within 2 years. We report a case of DDCS of right proximal femur in a 73-year-old woman. The most important factors affecting survival are early recognition of the radiographic features, adequate histological sampling, and wide-margin resection of the lesion. So for the correct histopathological diagnosis the biopsy sample should be adequate to visualize both cartilaginous and noncartilaginous sarcomatous component which helps to increase the survival of patients before the distant metastasis occurs.

  1. [Microradiographic investigations of carious changes in the enamel in the ground sections made perpendicularly to tooth axis].

    Science.gov (United States)

    Mizuhashi, T; Suga, S

    1990-08-01

    Carious changes in the enamel in the undermineralized ground sections made perpendicularly to tooth axis were investigated using microradiography. By this way, relationship between carious invasion and the enamel lamellae and tuft, which has been not able to be examined in the longitudinal ground sections, could be clarified. 1) Direction of progress of demineralization and contour of demineralization front in the enamel are closely related to arrangement of enamel prisms. This findings strongly suggest that carious demineralization progresses along the enamel prisms. 2) Mode of carious demineralization in the enamel lamellae can be divided into two types; in the first type, demineralization progresses through the enamel lamellae more quickly than in the surrounding enamel and, in the second type, the enamel lamellae and its surrounding enamel show higher mineralization degree than the demineralized part in the rest of enamel, probably due to remineralization. The second type is observed more frequently than the first. 3) Mode of carious demineralization in the enamel tuft are also divided into two types; the first type which shows that demineralization progresses more quickly through the enamel tuft than the surrounding enamel and the second type that the enamel tuft and its surrounding narrow enamel are highly mineralized probably due to remineralization, whereas the rest of enamel is prominently demineralized. The second type is more frequently observed than the first. 4) In the ground sections made perpendicularly to tooth axis, it is more clearly observed that the interprismatic area is very highly remineralized whereas the main body of prism is easily demineralized, than in the longitudinal ground sections. 5) Striae of Retzius is composed of the band which appear to resist to demineralization and that which is easily demineralized. However, in the later case, demineralization which progresses laterally along the band can not be observed. 6) The degree and

  2. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    -displaced femoral neck fractures and prosthesis for displaced among the elderly; and sliding hip screw for stabile- and intramedullary nails for unstable- and sub-trochanteric fractures) but they are based on a variety of criteria and definitions - and often leave wide space for the individual surgeons' subjective...... guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we...... searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  3. Proximal humeral fractures

    OpenAIRE

    Mauro, Craig S.

    2011-01-01

    Proximal humeral fractures may present with many different configurations in patients with varying co-morbities and expectations. As a result, the treating physician must understand the fracture pattern, the quality of the bone, other patient-related factors, and the expanding range of reconstructive options to achieve the best functional outcome and to minimize complications. Current treatment options range from non-operative treatment with physical therapy to fracture fixation using percuta...

  4. Clinical applicability of resin infiltration for proximal caries.

    Science.gov (United States)

    Altarabulsi, Mohammad Basel; Alkilzy, Mohammad; Splieth, Christian H

    2013-02-01

    Resin infiltration is a new microinvasive treatment to arrest the progress of proximal initial caries lesions. This study evaluated the clinical applicability of proximal caries infiltration. In the study population of 50 children, adolescents, and young adults (mean age, 17.3 ± 6.4 years), 10 dentists at the University of Greifswald, Greifswald, Germany, applied the infiltration material Icon on noncavitated proximal lesions in permanent and primary teeth as described by the manufacturer. The applicability was evaluated using two questionnaires filled out by clinicians and patients assessing the comfort, complexity, time, and difficulties of the application in comparison to a filling. The results showed good patient satisfaction with the procedure. The mean time for infiltration (24.3 ± 7.4 minutes), which included rubber dam application (7.7 ± 4 minutes) and the effort were perceived to be comparable to or even easier than a composite filling by clinicians. In three patients (6%), it was not possible to gain sufficient proximal space for the application of an infiltration. The location of the infiltrated tooth, separation problems, and the routine of clinicians with the infiltration technique had an effect on the duration of the infiltration. A clear learning curve with a reduction of treatment time for subsequent treatments was observed (P proximal lesion showed good clinical applicability for clinicians and very high acceptance by patients.

  5. Observer differentiation of proximal enamel mechanical defects versus natural proximal dental caries with computed dental radiography.

    Science.gov (United States)

    Kang, B C; Farman, A G; Scarfe, W C; Goldsmith, L J

    1996-10-01

    Various models have been used to study the accuracy of imaging systems for detection of dental caries. This study compares the ability of dentists to detect mechanically created defects versus natural dental caries cavitations on the proximal surfaces of extracted teeth with Computed Dental Radiography (Schick Industries, Long Island City, N.Y.). Detection rates are investigated according to lesion depth to permit comparisons to be made between studies in the literature with other mechanical defects or natural caries models. Discrimination of natural caries versus artificial defects with Computed Dental Radiography is also compared with a previous report that used standard dental film. Fifty-two extracted molar and premolar teeth were mounted into representative sets of maxillary and mandibular posterior arches for bite-wing radiography. There were 16 proximal surfaces with natural caries and 28 proximal surfaces with mechanical defects. An optical bench was used to ensure constant beam geometry. A 1.8 cm acrylic soft tissue equivalent attenuator was placed in front of the receptor. Thirty dentists acted independently as observers to differentiate between sound proximal tooth surfaces, natural dental caries, and mechanical defects. Evaluation of intra- and interobserver variability was made with use of the kappa statistic. The Zelen test of odds ratios was used to test for homogeneity, and the Mantel-Haenszel analysis plus stratified logistic regression were used for inference about the common odds ratio. Significance was set at p detection was 74% for mechanical defects and 67% for natural caries. The odds of detecting a mechanical defect were 1.40 times the odds of finding natural dental caries cavitation of the same depth. Lesion depth did influence the probability of correctly identifying the presence of a lesion; the odds of identifying cavitation increased 1.41 times with every 0.1 mm increase in lesion depth. Correct designation of lesion type was 1.42 times

  6. Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis

    Science.gov (United States)

    Ornellas, Pâmela Oliveira; Antunes, Leonardo Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

    2016-09-01

    This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration's tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

  7. Pragmatic RCT on the Efficacy of Proximal Caries Infiltration.

    Science.gov (United States)

    Meyer-Lueckel, H; Balbach, A; Schikowsky, C; Bitter, K; Paris, S

    2016-05-01

    Proximal caries infiltration has been shown to be efficacious in hampering caries lesion progression when performed by dentists working in a university setting. The aim of this randomized split-mouth, placebo-controlled clinical trial was to assess the efficacy of resin infiltration of proximal caries lesions being performed by several dentists in private practices, in combination with individualized oral hygiene plus noninvasive measures compared with these alone. In this study, 87 children and young adults (with 238 pairs of proximal caries lesions radiographically extending into the inner half of the enamel [E2] or the outer third of the dentin [D1]) were randomly allocated to either 1 of 2 treatments. Test lesions were infiltrated, and a mock treatment was performed in control lesions by 5 German private practitioners. All patients received instructions for a noncariogenic diet, flossing and fluoridation, and individualized noninvasive interventions. The primary outcome was radiographic lesion progression (pairwise comparison) evaluated independently by 2 evaluators who were blinded to treatment allocation. After approximately 10 mo (mean ± SD 307 ± 43 d), 92 of 148 lesion pairs in 24 of 38 treated patients who were at high caries risk could be re-evaluated clinically as well as radiographically using individualized bitewing holders, as at baseline; 186 of 204 lesion pairs in 70 of 77 patients (35 of 38 high-risk patients) could be evaluated after 18 mo (mean 542 ± 110 d). No unwanted effects were observed. After 10 mo, progression was recorded in 2 of 92 test lesions (2%) and in 22 of 92 control lesions (24%) (P= 0.001, McNemar/Obuchowski test; relative risk reduction, 91; 95% confidence interval, 62%-98%). After 18 mo, lesion progression was recorded in all included patients in 10 of 186 test lesions (5%) and in 58 of 186 control lesions (31%) (P< 0.001; relative risk reduction, 83; 95% confidence interval, 67%-91%). Thus, resin infiltration seems to be

  8. Detection of in vitro proximal caries in storage phosphor plate radiographs scanned with different resolutions

    NARCIS (Netherlands)

    Li, G.; Berkhout, W.E.R.; Sanderink, G.C.H.; Martins, M.; van der Stelt, P.F.

    2008-01-01

    Objectives: To investigate the effect of the scanning resolution of storage phosphor plate (SPP) radiographs on the detection of proximal caries lesions. Methods: 10 dentists evaluated 72 proximal surfaces of premolars with respect to caries from SPP radiographs scanned with theoretical spatial

  9. Is it Ethical to Withhold Restorative Dental Care From a Child with Occlusoproximal Caries Lesions Into Dentin of Primary Molars?

    Science.gov (United States)

    Nainar, S M Hashim

    2015-01-01

    Non-restorative caries treatment (NRCT) has been mentioned as a treatment option for occluso-proximal caries lesions into dentin of primary molars. The NRCT approach for occluso-proximal caries lesions in primary molars was considered from an ethical perspective. In summary, it is not ethical to withhold restorative dental care from a child with occluso-proximal caries lesions into dentin of primary molars.

  10. Computer-aided proximal caries diagnosis: correlation with clinical examination and histology

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Cheol [Chonnam University, School of Dentistry, Gwangju (Korea, Republic of); Scheetz, James P.; Aarman, Allan G. [University of Louisville, School of Dentistry, Louisville (United States)

    2002-09-15

    To evaluate the performance of the LOGICON Caries Detector using RVG-4 and RVG-ui sensors, by comparing results of each detector to the results of clinical and histological examinations. Pairs of extracted teeth were radiographed, and a total of 57 proximal surfaces, which included both carious and non-carious situations, were analyzed. The RVG-4 produced 8-bit images, while the RVG-ui unit produced 12-bit images, which were taken in the high sensitivity mode. The images produced by the LOGICON were evaluated by a trained observer using both automated and manual caries detection software modes. Ground sections of the teeth established the actual absence or existence of caries. LOGICON-aided caries detection and depth discrimination of the RVG-4 and RVG-ui sensors were equally inconsistent irrespective of whether the LOGICON software was set to the automated or manual mode. Sensitivity ranged from 50% to 57% for caries penetration of the enamel-dentin junction. Care needs to be taken when using LOGICON in conjunction with RVG images as an adjunct for treatment planning dental caries. Even when applied by a trained observer, substantial discrepancies exist between the results of the LOGICON software-guided evalutation using RVG images and histologic examination.

  11. Comparative analysis of sclerotic dentinal changes in attrited and carious teeth around pulp chamber for age determination.

    Science.gov (United States)

    Chatterjee, S

    2011-05-01

    The aim of this study was to estimate age by comparing sclerotic dentin thickness around coronal pulp chamber in carious and attrited teeth. Inclusion criteria for teeth selection was eruption age around six to seven years (incisors and first molars). 100 teeth (50 carious + 50 attrited) were ground up to their pulp chamber, observed and photographed under an Olympus stereomicroscope. Image J 1.38 NIH software was employed to analyze dentinal thickness. Regression formula was employed for evaluating age and compared with clinical age obtained at time of extraction. No matching values were found between calculated age and actual clinical age. Sclerotic dentin thickness values cannot be used as an indicator for the purpose of age estimation. Copyright © 2011 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  12. Proximal Gastrojejunal Reconstruction after Pancreaticoduodenal Resection

    Directory of Open Access Journals (Sweden)

    M. Wayne

    2012-01-01

    Full Text Available Introduction. Reconstruction by proximal gastrojejunostomy, and distal biliary and pancreatic anastomoses is infrequently used after resection of the head of the pancreas because of fear of fistulas and cholangitis. Pancreaticoduodenectomy is being performed more frequently for cystic malignant and premalignant lesions. Because of this there is a need for endoscopic visualization and biopsy of the residual pancreatic duct, since multi-centricity is characteristic of some of these malignancies. Since endoscopic access of the bile duct and pancreatic duct is difficult and unsuccessful in 50–70% after B II or Roux Y reconstruction, we prospectively studied the merit and complications (early and late of proximal gastrojejunal (PGJ reconstruction after pancreaticoduodenal resection. Material and Methods. Thirty nine consecutive, non-radomized patients underwent pancreaticoduodenectomy and PGJ reconstruction over 14 mos. There were 21 males and 18 females. Results. 7 patients with IPMN have undergone repeat CT scanning for surveillance, with 3 requiring repeat EUS and ERCP. There were no technical difficulties accessing the pancreas or the pancreatic duct, supporting the PGJ reconstruction. Conclusion. Proximal gastrojejunal reconstruction following pancreaticoduodenal resection may be safely done with similar morbidity to traditional pancreaticojejunal reconstructions. PGJ reconstruction may be of greater value when direct visual access to the bile duct or pancreatic duct is necessary, and should be considered when doing resection for mucinous cysts or IPMN of the head of the pancreas.

  13. Selective removal of carious dentin using a nanosecond pulsed laser with a wavelength of 6.02 μm

    Science.gov (United States)

    Ishii, Katsunori; Saiki, Masayuki; Yasuo, Kenzo; Yamamoto, Kazuyo; Yoshikawa, Kazushi; Awazu, Kunio

    2010-04-01

    Conventional laser light sources for the treatment of a hard tissue in dental (Er:YAG laser, Er,Cr:YSGG laser and CO2 laser etc.) are good for removal of caries. However these lasers cannot achieve to give a selective treatment effect for caries without a side effect for normal tissue. The objective of this study is to develop the less-invasive treatment technique of carious dentin by selective absorption effect using the laser with a wavelength of 6.02 μm which corresponds to an absorption peak of organic matters called amide 1 band. Mid-infrared nanosecond pulsed laser by difference-frequency generation was used for the experiment of selective treatment. A tunable wavelength range, pulse width and repetition rate is from 5.5 to 10 μm, 5 ns and Hz, respectively. The laser with a wavelength of 6.02 μm and predetermined energy parameters was irradiated to the plate of carious dentin model which is made by soaking in lactic acid solution. After laser irradiation, the surface and cross-sectional surface of samples were observed by a scanning electron microscope (SEM). Average power density about 15 W/cm2 realized to excavate a demineralized region (carious dentin model) selectively in a SEM observation. In the same energy condition, serious side effect was not observed on the surface of normal dentin. A wavelength of 6.02 μm realizes a selective excavation of carious dentin. Using 6.02 μm is a novel and promising technique toward to next-generation dental treatment procedure for realizing MI.

  14. Coronal pulpotomy for cariously exposed permanent posterior teeth with closed apices: A systematic review and meta-analysis.

    Science.gov (United States)

    Alqaderi, Hend; Lee, Chun-Teh; Borzangy, Sary; Pagonis, Tom C

    2016-01-01

    This systematic review was performed to evaluate the clinical outcome of coronal pulpotomy treatment to manage carious vital pulp exposure in permanent posterior teeth with closed root apices. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline was used. A search of articles published between 1960 January and 2015 July was conducted in PubMed, EMBASE, and CENTRAL databases. Only studies that performed full coronal pulpotomy for carious vital pulp exposure of permanent posterior teeth and had clinical and radiographic assessments during at least one-year follow-up were qualified for data analyses. The weighted mean success rate (WSR) was the primary outcome and estimated using DerSimonian-Laird random effects model. Out of 299 articles, six studies were included for the analysis of one-year WSR, and five studies were included in the analysis of two-year WSR. The one-year and two-year WSR were 94% (95% confidence interval (CI): [90,99]) and 92% (CI: [84,100]) respectively. Differences in pulp capping and restoration materials did not significantly affect success rates (Two-year WSR in the MTA and MTA-like products group vs. the calcium hydroxide group: 92% (CI: [85,99]) vs. 88% (CI: [76,100]); the amalgam group vs. the composite group: 92% (CI: [81,100]) vs. 93% (CI: [81,100])). Generally, full coronal pulpotomy had a favorable success rate in treating carious vital pulp exposure of permanent mature teeth with closed root apices. More studies with control group of root canal treated teeth and longer follow-up periods are needed. Coronal pulpotomy treatment can be considered as an intermediate treatment option in managing carious vital pulp exposures of permanent teeth with closed root apices. This option may also serve as a substitute to extraction when root canal treatment cannot be performed for low income and uninsured patients or in underserved areas. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Treatment Outcomes of Mineral Trioxide Aggregate Pulpotomy in Vital Permanent Teeth with Carious Pulp Exposure: The Retrospective Study.

    Science.gov (United States)

    Linsuwanont, Pairoj; Wimonsutthikul, Kongthum; Pothimoke, Uht; Santiwong, Busayarat

    2017-02-01

    This study aimed to illustrate the treatment outcomes of mineral trioxide aggregate (MTA) pulpotomy in vital permanent teeth with carious pulp exposure. MTA pulpotomy was performed in 66 vital permanent teeth with carious pulp exposure including teeth with signs and symptoms of irreversible pulpitis and the presence of periapical radiolucency. Patients were assessed for clinical and radiographic outcomes by 2 examiners. The relationship between treatment outcomes and factors was analyzed by means of univariate analysis and binary logistic regression. Fifty patients (a total of 55 teeth) attended the follow-up examination. The age of the patients ranged from 7-68 years old (mean = 29 years old). For the follow-up period as far as 62 months, 48 teeth showed successful outcomes (success rate = 87.3%). Teeth with clinical signs of irreversible pulpitis and the presence of periapical radiolucency could be treated successfully by MTA pulpotomy with success rates of 84% and 76%, respectively.Three of 7 failed cases required pulpectomy after MTA pulpotomy to relieve painful pulpitis. Four other failed cases were asymptomatic, and failure was detected from radiographic examination. The relationship between treatment outcomes and treatment factors could not be detected statistically. Teeth with carious pulp exposure can be treated successfully by MTA pulpotomy. Clinical signs of irreversible pulpitis and the presence of periapical radiolucency should not be considered as a contraindication for pulpotomy. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. Pathological fractures of the proximal humerus treated with a proximal humeral locking plate and bone cement.

    Science.gov (United States)

    Siegel, H J; Lopez-Ben, R; Mann, J P; Ponce, B A

    2010-05-01

    Bone loss secondary to primary or metastatic lesions of the proximal humerus remains a challenging surgical problem. Options include preservation of the joint with stabilisation using internal fixation or resection of the tumour with prosthetic replacement. Resection of the proximal humerus often includes the greater tuberosity and adjacent diaphysis, which may result in poor function secondary to loss of the rotator cuff and/or deltoid function. Preservation of the joint with internal fixation may reduce the time in hospital and peri-operative morbidity compared with joint replacement, and result in a better functional outcome. We included 32 patients with pathological fractures of the proximal humerus in this study. Functional and radiological assessments were performed. At a mean follow-up of 17.6 months (8 to 61) there was no radiological evidence of failure of fixation. The mean revised musculoskeletal Tumour Society functional score was 94.6% (86% to 99%). There was recurrent tumour requiring further surgery in four patients (12.5%). Of the 22 patients who were employed prior to presentation all returned to work without restrictions. The use of a locking plate combined with augmentation with cement extends the indications for salvage of the proximal humerus with good function in patients with pathological and impending pathological fractures.

  17. The Hall technique is an effective treatment option for carious primary molar teeth.

    Science.gov (United States)

    Rosenblatt, Aronita

    2008-01-01

    This was a general dental practice (GDP)-based, split-mouth, randomised controlled trial (RCT). The Hall technique, where a preformed metal crown (PMC) is cemented with no local anaesthesia, caries removal or tooth preparation, was compared with restoration with the material the GDP would normally choose. The outcomes were recorded as success; minor failure (restoration failure or reversible pulpitis, which could be managed by repair or replacement); or major failure (signs or symptoms of irreversible pulpal damage, such as dental abscess, or tooth broken down and unfeasible to repair or replace the restoration). A total of 128 conventional restorations were placed on 132 control teeth, and 128 PMC on 132 intervention teeth. Eighty-nine per cent of Hall PMC were rated by dentists as causing no apparent discomfort through to merely mild discomfort: for the control restorations this was 78% (not a significant difference). The Hall PMC outperformed the control restorations in terms of the number of major and minor failures (see Table 1). Preference for the Hall technique was recorded at 77% for the children, 83% for carers and 81% for dentists who expressed a preference, which this was significant (Chi square, P<0.0001). The Hall technique was preferred to conventional restorations by the majority of children, carers and dental practitioners. After 2 years, Hall PMC showed more favourable outcomes for pulpal health and restoration longevity than conventional restorations. The Hall technique appears to offer an effective treatment option for carious primary molar teeth.

  18. Clinical effect of photodynamic therapy on primary carious dentin after partial caries removal

    Directory of Open Access Journals (Sweden)

    Pierre Adriano Moreno NEVES

    2016-01-01

    Full Text Available Abstract This study was conducted to assess the clinical effect of photodynamic therapy (PDT in the decontamination of the deep dentin of deciduous molars submitted to partial removal of carious tissue. After cavity preparation, dentin samples were taken from the pulp wall of nineteen deciduous molars before and after PDT application. Remaining dentin was treated with 0.01% methylene blue dye followed by irradiation with an InGaAlP diode laser (λ – 660 nm; 40 mW; 120 J/cm2; 120 s. Dentin samples were microbiologically assessed for the enumeration of total microorganisms, Lactobacillus spp. and mutans streptococci. There was no significant difference in the number of colony-forming units (CFU for any of the microorganisms assessed (p > 0.05. Photodynamic therapy, using 0.01% methylene blue dye at a dosimetry of 120 J/cm2 would not be a viable clinical alternative to reduce bacterial contamination in deep dentin.

  19. Proteomic analysis of mesenchymal stem cells from normal and deep carious dental pulp.

    Directory of Open Access Journals (Sweden)

    Dandan Ma

    Full Text Available Dental pulp stem cells (DPSCs, precursor cells of odontoblasts, are ideal seed cells for tooth tissue engineering and regeneration. Our previous study has demonstrated that stem cells exist in dental pulp with deep caries and are called carious dental pulp stem cells (CDPSCs. The results indicated that CDPSCs had a higher proliferative and stronger osteogenic differentiation potential than DPSCs. However, the molecular mechanisms responsible for the biological differences between DPSCs and CDPSCs are poorly understood. The aim of this study was to define the molecular features of DPSCs and CDPSCs by comparing the proteomic profiles using two-dimensional fluorescence difference gel electrophoresis (2-D DIGE in combination with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS. Our results revealed that there were 18 protein spots differentially expressed between DPSCs and CDPSCs in a narrow pH range of 4 to 7. These differently expressed proteins are mostly involved in the regulation of cell proliferation, differentiation, cell cytoskeleton and motility. In addition, our results suggested that CDPSCs had a higher expression of antioxidative proteins that might protect CDPSCs from oxidative stress. This study explores some potential proteins responsible for the biological differences between DPSCs and CDPSCs and expands our understanding on the molecular mechanisms of mineralization of DPSCs in the formation of the dentin-pulp complex.

  20. Hematoma of the proximal nail fold due to oximeter in a child

    Directory of Open Access Journals (Sweden)

    Patricia Chang

    2014-01-01

    Full Text Available Boy 4 years old, hospitalized due to hemorrhagic chickenpox and sepsis during his clinical examination besides hemorrhagic crust, vesicles and bullous he has also a cutaneous red lesion localized at the right proximal nail fold of the big toenail (Fig. 1, dermatoscopic view of the lesion (Fig. 2. The diagnosis of hematoma of the proximal nail fold due to oximeter was done. The proximal nail fold hematomas due to oximeter are uncommon dermatoses at this level that are caused for the pressure of the oximeter and it has been seeing in patient in Unit Intensive or Intermediate Unit Care since 2007.

  1. Some Properties of Fuzzy Soft Proximity Spaces

    Science.gov (United States)

    Demir, İzzettin; Özbakır, Oya Bedre

    2015-01-01

    We study the fuzzy soft proximity spaces in Katsaras's sense. First, we show how a fuzzy soft topology is derived from a fuzzy soft proximity. Also, we define the notion of fuzzy soft δ-neighborhood in the fuzzy soft proximity space which offers an alternative approach to the study of fuzzy soft proximity spaces. Later, we obtain the initial fuzzy soft proximity determined by a family of fuzzy soft proximities. Finally, we investigate relationship between fuzzy soft proximities and proximities. PMID:25793224

  2. Results of the proximal humerus endoprosthetic reconstruction after tumour resection

    Directory of Open Access Journals (Sweden)

    I. M. Mikailov

    2014-01-01

    Full Text Available The purpose of the study was to evaluate the results of surgical reconstructions of the proximal humerus after transarticular tumour resection, compare the functional results with the results of shoulder arthroplasty in patients with extensive damage of the proximal humerus of non-neoplastic origin. Material and methods. Between 2001 and 2013 38 proximal humeral reconstructions were performed in our clinic: using monopolar endoprostheses - 26 (68% and modular systems with reversible head -12 (32%. The control group included 46 patients with extensive lesions of the proximal humerus of non-neoplastic origin, operated in our clinic in the period from 2006 to 2012. Term follow-up of patients ranged from 7 months to 9 years. Assessment of functional results was carried out in a period from six months to one year. Results. The seven-year survival according the Kaplan - Meier method for patients with primary malignant tumors of the proximal humerus (25 patients was 77%. In the study group the average value of functional outcome MSTS score was 77.7%. Unipolar prosthesis showed a bad result, both in the control (61,3% MSTS, 60,7 Neer and in the main (67,7% MSTS, 61,1 Neer study groups. Conclusion. Currently the method of choice which doesn’t impair the oncologic component of treatment patients with shoulder neoplastic lesions is its replacement with modular reversible systems in combination with additional soft tissue fixation.

  3. PROXIMITY MANAGEMENT IN CRISIS CONDITIONS

    Directory of Open Access Journals (Sweden)

    Ion Dorin BUMBENECI

    2010-01-01

    Full Text Available The purpose of this study is to evaluate the level of assimilation for the terms "Proximity Management" and "Proximity Manager", both in the specialized literature and in practice. The study has two parts: the theoretical research of the two terms, and an evaluation of the use of Proximity management in 32 companies in Gorj, Romania. The object of the evaluation resides in 27 companies with less than 50 employees and 5 companies with more than 50 employees.

  4. Randomized controlled clinical trial on proximal caries infiltration: three-year follow-up.

    Science.gov (United States)

    Meyer-Lueckel, H; Bitter, K; Paris, S

    2012-01-01

    We report the 3-year efficacy of resin infiltration (Icon, pre-product; DMG, Hamburg) to arrest progression of proximal non-cavitated caries lesions as compared with placebo treatment. In 22 young adults, 29 lesion pairs with radiographic extensions into the inner half of enamel up to the outer third of dentin were included (split-mouth design). All subjects received risk-related instructions for diet, flossing and fluoridation. No unwanted effects could be observed. Radiographically 1/26 test lesions (4%) and 11/26 control lesions (42%) had progressed (p = 0.002, McNemar). After 3-year follow-up, infiltration of proximal caries lesions can be said to be efficacious to reduce lesion progression. Copyright © 2012 S. Karger AG, Basel.

  5. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions☆

    Science.gov (United States)

    Lawson, Nathaniel C.; Robles, Augusto; Fu, Chin-Chuan; Lin, Chee Paul; Sawlani, Kanchan; Burgess, John O.

    2016-01-01

    Objectives To compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs). Methods 37 adults were recruited with 3 or 6 NCCLs (>1.5 mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan–Meier method was used to compare the retention between adhesive materials. Results Clinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (p self-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively. Conclusions Scotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively. Clinical significance 24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode. PMID:26231300

  6. Giant Cell Reparative Granuloma Mimicking Aneurysmal Bone Cyst in Proximal Phalanx of Toe

    Directory of Open Access Journals (Sweden)

    Huan CM

    2016-03-01

    Full Text Available Giant Cell Reparative Granuloma (GCRG of phalanx is uncommon. It is a benign osteolytic lesion but can be locally aggressive. GCRG has certain radiology and histological features that are similar to other giant cell lesions of the bone. We present a case report of a young patient with giant cell reparative granuloma of proximal phalanx of left third toe. The bone lesion was successfully treated surgically.

  7. Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report

    OpenAIRE

    Sanjeev Kumar Salaria; Shilpa Kamra; Simrat Kaur Ghuman; Garima Sharma

    2016-01-01

    Radicular cyst (RC) is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of...

  8. Critical evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following high-pressure gas and micro-particle abrasion.

    Science.gov (United States)

    Dixon, P M; Savill, D; Horbyl, A; Reardon, R J M; Liuti, T

    2014-06-01

    Infundibular caries of the equine maxillary cheek teeth is an important disorder that can lead to dental fracture or apical infection. Treatment by removing food debris and carious dental tissue from affected infundibulae using high-pressure abrasion with aluminium hydroxide micro-particles, followed by filling the cleaned defect with endodontic restorative materials is a recommended treatment. However, although anecdotally considered a successful treatment option, there is currently no objective evidence to support this claim. Forty maxillary cheek teeth (CT) that contained 55 infundibulae with caries (mainly grade 2) were extracted post-mortem from 21 adult horses. Five of the CT were sectioned prior to treatment to facilitate visual examination of the carious infundibulae. The remaining carious infundibulae were cleaned using high-pressure abrasion with aluminium hydroxide particles and five CT were sectioned to assess the efficacy of this cleaning process. The remaining 30 CT containing 39 carious infundibulae were then filled with a composite restorative material. The efficacy of this restoration was assessed by computed tomography imaging followed by direct visual examination after sectioning the teeth. Only 46% (18/39) of restored infundibulae, all with shallow (mean 9.6 mm deep) defects, were fully cleaned of food debris and carious material, and filled with restorative material to their full depth. Of these 18, 11 had peripheral defects around the restoration, leaving just 18% (7/39) of restorations without any gross defects. The remaining 54% (21/39) of infundibulae (mean depth of infundibular caries defect, 18.3 mm) still contained food debris and/or carious material in more apical locations, with infundibulae with the deepest caries defects being the least effectively cleaned. The findings of this study indicate that high-pressure micro-particle abrasion is only effective in cleaning food debris from shallow, carious CT infundibulae and consequently

  9. Modified Van Nes rotationplasty for osteosarcoma of the proximal tibia in children.

    Science.gov (United States)

    de Bari, A; Krajbich, J I; Langer, F; Hamilton, E L; Hubbard, S

    1990-11-01

    Above-knee amputation has been the traditional treatment for osteosarcoma of the proximal tibia. Recent advances in chemotherapy have encouraged the development of limb-salvage techniques. Van Nes rotationplasty for malignant lesions of the distal femur has increased in popularity as a reconstructive technique, but no similar procedure has been described for lesions of the proximal tibia. We have developed a modified rotationplasty for this lesion and have performed it in four children. The surgical technique, postoperative management and results of the procedure are described. Two patients had delayed wound healing. No other complications have developed and our patients were disease-free at follow-up, while the appearance of the leg was well accepted by the patients and their parents. This procedure is a useful addition to the armamentarium of the tumour surgeon for the treatment of malignant lesions of the proximal tibia.

  10. Optical Assessment of Caries Lesion Structure and Activity

    Science.gov (United States)

    Lee, Robert Chulsung

    technology will be employed for the detection and monitoring of early carious lesions without the use of ionizing radiation, thereby enabling conservative non-surgical intervention and the preservation of healthy tissue structure.

  11. Management of carious primary molar teeth by UK postgraduates in paediatric dentistry.

    Science.gov (United States)

    Foley, J I

    2010-12-01

    To assess the treatment preferences amongst UK postgraduates (PG) in Paediatric Dentistry for a symbolic child with sample case history of differing caries severity in a primary molar tooth. All Paediatric Dentistry PG were contacted by e-mail and asked to participate in an on-line structured questionnaire. The survey described four different case scenarios of a 5-year-old child, presenting with a mesio-occlusal cavity in tooth 85 with varying symptoms and signs. Treatment options were listed and participants asked to select the single most preferred treatment for each case. The same scenarios were also presented for both non-anxious and dentally-anxious children and differences were analysed by Chi2 analysis. Responses were received from 38/59 (F: 31; M: 7) PGs. The preformed metal crown (PMC) with Hall technique was selected as the option for patients with no indication of pulpal involvement by 4/38 and 20/38 for non-anxious and dentally-anxious patients respectively (Chi2=27.56, P=0.001, 1 dof). For a tooth with signs of pulpal involvement or symptoms the options selected were (non-anxious, dentally-anxious): zinc-oxide eugenol pulpecotomy and PMC 8/38, 2/38 (Chi2=9.85, P=0.002, 1 dof); local analgesia extraction 15/38, 2/38 (Chi2=27.22, P=0.001, 1 dof) and extraction under a general anaesthetic 0/38, 16/38 (Chi2=42.00, P=0.001, 1dof). There was no consistency of response by PGs in Paediatric Dentistry within the UK. The Hall technique appeared to be a favoured option for treatment of an asymptomatic carious primary molar tooth in dentally-anxious child patients. Extraction was preferred for those with pulpal involvement for both non-anxious and dentally-anxious patients, although the suggested mode of extraction differed.

  12. Accuracy of Digital Bitewing Radiography versus Different Views of Digital Panoramic Radiography for Detection of Proximal Caries

    Directory of Open Access Journals (Sweden)

    Mehrdad Abdinian

    2015-10-01

    Full Text Available Objectives: Dental caries are common and have a high incidence among populations. Radiographs are essential for detecting proximal caries. The best technique should be recognized for accurate detection of caries. The aim of this study was to compare the accuracy of detection of proximal caries using intra oral bitewing, extra oral bitewing, improved interproximal panoramic, improved orthogonality panoramic and digital con- ventional panoramic radiographs.Materials and Methods: In this descriptive cross sectional study, 100 extracted human teeth with and without proximal caries were used. Intra and extra oral radiographs were taken. Images were evaluated and scored by two observers. Scores were compared with the histological gold standard. The diagnostic accuracy of radiographs was assessed by means of receiver operating characteristic (ROC curve analysis (P<0.05.Results: Microscopic evaluation of proximal surfaces revealed that 54.8% of the sur- faces were sound and 45.2% were carious (with different depths. The differences in the area under the ROC curve (Az value among the five techniques were not statisti- cally significant.Conclusion: Improved interproximal panoramic and extra oral bitewing radiographs were superior to conventional panoramic radiography for detection of proximal caries ex vivo and should be considered for patients with contraindications for intra oral radi- ographs.

  13. Selective excavation of human carious dentin using a nanosecond pulsed laser with a wavelength of 5.85 μm

    Science.gov (United States)

    Kita, Tetsuya; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2013-06-01

    Less-invasive treatment of caries has been needed in laser dentistry. Based on the absorption property of dentin substrates, 6 μm wavelength range shows specific absorptions and promising characteristics for the excavation. In our previous study, 5.8 μm wavelength range was found to be effective for selective excavation of carious dentin and restoration treatment using composite resin from the irradiation experiment with bovine sound and demineralized dentin. In this study, the availability of 5.8 μm wavelength range for selective excavation of human carious dentin was investigated for clinical application. A mid-infrared tunable nanosecond pulsed laser by difference-frequency generation was used for revealing the ablation property of human carious dentin. Irradiation experiments indicated that the wavelength of 5.85 μm and the average power density of 30 W/cm2 realized the selective excavation of human carious dentin, but ablation property was different with respect to each sample because of the different caries progression. In conclusion, the wavelength of 5.85 μm could realize the selective excavation of human carious dentin, but it was necessary to evaluate the stage of caries progression in order to control the ablation property.

  14. Talar Dome Lesion

    Science.gov (United States)

    ... Please enable Javascript in your browser. Talar Dome Lesion What Is a Talar Dome Lesion? The ankle joint is composed of the bottom ... on the specific case. Complications of Talar Dome Lesions Depending on the amount of damage to the ...

  15. A preliminary study on the screening of emerging drug resistance among the caries pathogens isolated from carious dentine

    Directory of Open Access Journals (Sweden)

    Girija AS Smiline

    2012-01-01

    Full Text Available Background: Dental caries being the commonest unmet public health problem indicates its need to urge the dentists to overcome this problem globally. Caries exhibit in different types and is found to be associated with co-aggregation property of microbial flora with other oral hygienic factors. In spite of the surgical removals, excavations and administration of antimicrobials for carious dentine, there seems to be repeated infection and chronic prevalence of caries. A complete understanding of microbial etiology and prevention of emerging drug-resistant strains will aid in the eradication of this chronic dentine problem condition from the oral cavity. Aim: This study is aimed to isolate the predominant bacterial pathogens associated with caries and to screen for the emergence of drug resistance among the isolated caries pathogens. Materials and Methods: Carious dentine specimens were collected from 75 endodontic patients and the samples were processed microbiologically to isolate the caries pathogens. Identification of the strains was done by standard biochemical characterization studies. Statistical analysis of the isolates was done by Pearson Chi-square test and Fisher′s exact test. The predominant isolates were subjected to antimicrobial sensitivity test using Kirby Bauer′s method. The results were recorded and analyzed for drug resistance. Results: Carious dentine samples yielded a high percentage of Lactobacillus sp., and Candida albicans from different type of caries. Among the study population, dentinal caries was the most predominant type affecting most males with other associated risk factors. Nearly 47.3% of the isolated Lactobacillus sp. and 55.5% of the yeast C. albicans were screened to show resistance against the antimicrobials used for the study. Conclusion: This study concludes by stating that Lactobacillus sp., and C. albicans are mostly involved in the caries etiology and show resistance to the commonest antimicrobial agent

  16. Subacute narrowing of the left main coronary artery following directional atherectomy for proximal obstructive coronary artery disease

    NARCIS (Netherlands)

    Piek, J. J.; Koch, K. T.; van der Wal, A. C.; Becker, A. E.

    1997-01-01

    Directional atherectomy is an alternative device for treatment of highly eccentric or proximal coronary lesions considered less suitable for balloon angioplasty. We report a patient with exuberant neointimal proliferation, extending into the left main coronary artery, following directional

  17. [Observation and analysis of microstructure of dentin caries lesions through 3D laser scanning microscope].

    Science.gov (United States)

    Lixia, Xu; Hongmei, Xu; Xiaoying, Zhu; Limei, Sun

    2016-10-01

    Microstructural changes in dentin carious lesions were investigated using a 3D laser scanning microscope, which has a morphological theoretical foundation in the further study of clinical caries disease prevention and treatments. Six fresh extracted caries molars were prepared into cross-section specimens. The sections were examined by 3D and laser measuring morphology. Zones were identified in the lesions on the basis of their optical appearance. Two zones were identified in the lesions on the basis of their laser appearance. The microstructure showed that the tubular was partly closed in transparent dentin; peritubular and intertubular dentin were reduced in the zone of demineralization; peritubular and intertubular dentin were damaged and fused; a beaded sample and oval lesions formed in the zone of bacterial invasion; and abnormal dentin structure was present in the zone of destruction on the basis of their laser appearance. Four zones were iden-tified in the lesions according to their colors, as determined from their 3D appearance. 3D laser scanning micros-cope may be a powerful, accessible, and non-destructive technique, as it identified the lesion and tubular zones, as well as peritubular and intertubular dentin in the four zones' lesions. The microstructure of dentin caries lesions may have significant merit in the evaluation of clinical prevention and treatment.

  18. Fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig

    2013-01-01

    . The bandages were further supported by splints made of wood or coarse grass. Healing was expected in forty days. Different fracture patterns have been discussed and classified since Ancient Greece. Current classification of proximal humeral fractures mainly relies on the classifications proposed by Charles......, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis......Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate...

  19. Digital camera resolution and proximal caries detection.

    Science.gov (United States)

    Prapayasatok, S; Janhom, A; Verochana, K; Pramojanee, S

    2006-07-01

    To evaluate the diagnostic accuracy of proximal caries detection from digitized film images captured by a digital camera at different resolution settings. Twenty-five periapical radiographs of 50 premolar and 25 molar teeth were photographed using a digital camera, Sony Cyber-shot, DSC-S75 at three different resolution settings: 640 x 480, 1280 x 960 and 1600 x 1200. Seventy-five digital images were transferred to a computer, saved and opened using ACDSee software. In addition, a PowerPoint slide was made from each digital image. Five observers scored three groups of images (the films, the displayed 1:1 digital images on the ACDSee software, and the PowerPoint slides) for the existence of proximal caries using a 5-point confidence scale, and the depth of caries on a 4-point scale. Ground sections of the teeth were used as the gold standard. Az values under the receiver operating characteristic (ROC) curve of each group of images and at different resolutions were compared using the Friedman and Wilcoxon signed rank tests. Mean different values between the lesions' depth interpreted by the observers and that of the gold standard were analysed. Films showed the highest Az values. Only the 1280 x 960 images on the ACDSee software showed no significant difference of the Az value from the films (P=0.28). The digital images from three resolution settings on the PowerPoint slides showed no significant differences, either among each other or between them and the films. For caries depth, the 1280 x 960 images showed lower values of mean difference in enamel lesions compared with the other two resolution groups. This study showed that in order to digitize conventional films, it was not necessary to use the highest camera resolution setting to achieve high diagnostic accuracy for proximal caries detection. The 1280 x 960 resolution setting of the digital camera demonstrated comparable diagnostic accuracy with film and was adequate for digitizing radiographs for caries

  20. The infrastructure of psychological proximity

    DEFF Research Database (Denmark)

    Nickelsen, Niels Christian Mossfeldt

    2015-01-01

    ). The experience of psychological proximity between patient and nurse is provided through confidence, continuity and the practical set-up. This constitutes an important enactment of skillfulness, which may render telemedicine a convincing health service in the future. Methodology: The study draws on a pilot...... (Langstrup & Winthereik 2008). This study contributes by showing the infrastructure of psychological proximity, which is provided by way of device, confidence, continuity and accountability....

  1. Imaging of rectus femoris proximal tendinopathies

    Energy Technology Data Exchange (ETDEWEB)

    Pesquer, Lionel; Poussange, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu [Clinique du Sport de Bordeaux, Centre d' Imagerie Osteo-articulaire, Merignac (France); Sonnery-Cottet, Bertrand [Groupe Ramsay Generale de Sante - Hopital Prive Jean Mermoz, Centre Orthopedique Santy, Lyon (France); Graveleau, Nicolas [Clinique du Sport de Bordeaux, Centre de Chirurgie Orthopedique et Sportive, Merignac (France)

    2016-07-15

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. (orig.)

  2. Near infrared transillumination compared with radiography to detect and monitor proximal caries: A clinical retrospective study.

    Science.gov (United States)

    Abdelaziz, Marwa; Krejci, Ivo; Perneger, Thomas; Feilzer, Albert; Vazquez, Lydia

    2018-03-01

    To compare near infrared transillumination device, DIAGNOcam (DC) and bitewing radiography (BW) for the detection of proximal caries. This retrospective analysis of DC and BW images of 18 students in dental medicine who had consented to the anonymous use of their dental record. The data included BW and DC images performed for a check-up in 2013, and corresponding follow-up images performed in 2015. Two observers rated 376 proximal surfaces on a 4-level dentin lesion scale and reached a unanimous rating for each surface. Calculated measures of agreement for each assessment method over time provided the reproducibility of the information obtained by each method. Agreement between 2013 and 2015 within each method was excellent (intraclass correlation coefficient, BW: 0.86, DC: 0.90). Agreement between DC and BW was similar for dentin lesion detection, but was low for enamel caries detection; DC detected more enamel caries than BW. Agreement between DC and BW was modest (0.33 in 2013 and 0.36 in 2015), chiefly because DC identified more enamel caries. This study shows that DC is as reliable as BW to detect proximal dentin lesions. DC detects proximal enamel lesions at an earlier stage than BW. DC enables clinicians to differentiate lesions limited to the enamel from lesions that have reached the enamel dentin junction. Regular monitoring with DC should help provide individualized preventive measures and early non-invasive caries management. The early detection of enamel lesions with near infrared transillumination can help clinicians undertake early non invasive treatments to prevent or slow down the progression of initial proximal lesions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Selective treatment of carious dentin using a mid-infrared tunable pulsed laser at 6 μm wavelength range

    Science.gov (United States)

    Saiki, Masayuki; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2011-03-01

    Optical technologies have good potential for caries detection, prevention, excavation, and the realization of minimal intervention dentistry. This study aimed to develop a selective excavation technique of carious tissue using the specific absorption in 6 μm wavelength range. Bovine dentin demineralized with lactic acid solution was used as a carious dentin model. A mid-infrared tunable pulsed laser was obtained by difference-frequency generation technique. The wavelength was tuned to 6.02 and 6.42 μm which correspond to absorption bands called amide I and amide II, respectively. The laser delivers 5 ns pulse width at a repetition rate of 10 Hz. The morphological change after irradiation was observed with a scanning electron microscope, and the measurement of ablation depth was performed with a confocal laser microscope. At λ = 6.02 μm and the average power density of 15 W/cm2, demineralized dentin was removed selectively with less-invasive effect on sound dentin. The wavelength of 6.42 μm also showed the possibility of selective removal. High ablation efficiency and low thermal side effect were observed using the nanosecond pulsed laser with λ = 6.02 μm. In the near future, development of compact laser device will open the minimal invasive laser treatment to the dental clinic.

  4. Intramedullary Nailing for Pathological Fractures of the Proximal Humerus.

    Science.gov (United States)

    Choi, Eun-Seok; Han, Ilkyu; Cho, Hwan Seong; Park, In Woong; Park, Jong Woong; Kim, Han-Soo

    2016-12-01

    Endoprosthetic reconstruction is widely applied for pathological fractures of the proximal humerus; however, functional impairment is usually unsatisfactory. The aims of the current study are to evaluate the reliability of interlocking intramedullary (IM) nailing with cement augmentation as a fixation method in proximal humeral lesions and to assess functional outcomes. We reviewed 32 patients with pathological fractures of the proximal humerus who underwent interlocking IM nailing and cement augmentation. Functional scores and pain relief were assessed as outcomes. The mean follow-up period was 14.2 months. The mean Musculoskeletal Tumor Society functional score and Karnofsky performance status scale score were 27.7 and 75.6, respectively. Improvement of pain assessed using the visual analogue scale was 6.2 on average. Thirty-one patients (97%) experienced no pain after surgery. The mean ranges of forward flexion and abduction were 115° and 112.6°, respectively. All patients achieved stability and had no local recurrence without failure of fixation until the last follow-up. Proximal interlocking IM nailing with cement augmentation appears to be a reliable treatment option for pathological or impending fractures of the proximal humerus in selected patients with metastatic tumors, even with extensive bone destruction.

  5. Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm.

    Science.gov (United States)

    Lee, Chulsung; Lee, Dustin; Darling, Cynthia L; Fried, Daniel

    2010-01-01

    The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (parray and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

  6. Accuracy of Digital Bitewing Radiography versus Different Views of Digital Panoramic Radiography for Detection of Proximal Caries.

    Science.gov (United States)

    Abdinian, Mehrdad; Razavi, Sayed Mohammad; Faghihian, Reyhaneh; Samety, Amir Abbas; Faghihian, Elham

    2015-04-01

    Dental caries are common and have a high incidence among populations. Radiographs are essential for detecting proximal caries. The best technique should be recognized for accurate detection of caries. The aim of this study was to compare the accuracy of detection of proximal caries using intraoral bitewing, extraoral bitewing, improved interproximal panoramic, improved orthogonality panoramic and conventional panoramic radiographs. In this descriptive cross sectional study, 100 extracted human teeth with and without proximal caries were used. Intra and extraoral radiographs were taken. Images were evaluated and scored by two observers. Scores were compared with the histological gold standard. The diagnostic accuracy of radiographs was assessed by means of receiver operating characteristic (ROC) curve analysis (Pproximal surfaces revealed that 54.8% of the surfaces were sound and 45.2% were carious (with different depths). The differences in the area under the ROC curve (Az value) among the five techniques were not statistically significant. Improved interproximal panoramic and extraoral bitewing radiographs were superior to conventional panoramic radiography for detection of proximal caries ex vivo and should be considered for patients with contraindications for intraoral radiographs.

  7. Validity of digital imaging of fiber-optic transillumination in caries detection on proximal tooth surfaces

    OpenAIRE

    Laitala, M.-L. (Marja-Liisa); Piipari, L. (Liina); Sämpi, N. (Noora); Korhonen, M. (Maria); Pesonen, P. (Paula); Joensuu, T. (Tiina); Anttonen, V. (Vuokko)

    2017-01-01

    Objective The aim of our study was to evaluate the validity of the digital imaging fiber-optic transillumination (DIFOTI) method in comparison with clinical visual examination (CV) and bitewing (BW) radiography on detecting caries lesions on proximal surfaces of teeth. Materials and Methods Proximal tooth surfaces of premolars and molars (n = 2,103) of 91 voluntary university students aged from 18 to 30 years were examined with CV, BW radiography, and the DIFOTI method. Results DIFOTI detecte...

  8. Clinical performance of fluorescence-based methods for detection of occlusal caries lesions in primary teeth

    Directory of Open Access Journals (Sweden)

    Laura Regina Antunes PONTES

    2017-11-01

    Full Text Available Abstract We aimed to investigate the performance of fluorescence-based methods (FBMs, compared to visual inspection after histological validation, in detecting and assessing the activity status of occlusal carious lesions in primary teeth. One examiner evaluated 50 primary molars close to exfoliation in 24 children. Teeth were assessed using quantitative light-induced fluorescence (QLF and pen-type laser fluorescence (LFpen. After exfoliation, histological validation was performed. Teeth were cut and sections were evaluated for lesion depth and activity status (after utilization of a pH indicator under a stereomicroscope. Parameters related to the performance of the methods in detecting caries lesions at two thresholds (initial and dentin lesions were calculated. Regarding the activity status, lesions were classified into sound+inactive or active, and the area under the ROC curve and the diagnostic odds ratio values of the methods were calculated and compared. Evaluation of red fluorescence using QLF presented higher sensitivity but lower specificity than visual inspection in detecting dentin caries lesions. However, QLF considering different parameters and LFpen had similar performance to that obtained with visual inspection. Regarding activity assessment, all FBMs and visual inspection also presented similar performance. In conclusion, FBMs did not prove advantageous for the detection and activity assessment of occlusal caries lesions in primary molars when compared to visual inspection.

  9. Validity of Digital Imaging of Fiber-Optic Transillumination in Caries Detection on Proximal Tooth Surfaces.

    Science.gov (United States)

    Laitala, Marja-Liisa; Piipari, Liina; Sämpi, Noora; Korhonen, Maria; Pesonen, Paula; Joensuu, Tiina; Anttonen, Vuokko

    2017-01-01

    The aim of our study was to evaluate the validity of the digital imaging fiber-optic transillumination (DIFOTI) method in comparison with clinical visual examination (CV) and bitewing (BW) radiography on detecting caries lesions on proximal surfaces of teeth. Proximal tooth surfaces of premolars and molars ( n = 2,103) of 91 voluntary university students aged from 18 to 30 years were examined with CV, BW radiography, and the DIFOTI method. DIFOTI detected more initial and manifested caries lesions compared with CV and BW. Of the analyzed tooth surfaces, 69.8% were classified as sound by DIFOTI, 80.3% by BW, and 91.6% by CV. Initial caries lesions were found in 21.2% of the surfaces by DIFOTI, in 14.1% by BW, and in 6.2% by CV, whereas the proportions for manifested dental caries lesions were 9.0%, 5.6%, and 2.2%, respectively. The interexaminer agreement regarding the DIFOTI findings between an experienced clinician and a fifth-year dental student was high: κ = 0.67 for initial and κ = 0.91 for manifested caries lesions. The noninvasive DIFOTI method seems to offer a potential tool for everyday clinical practice. In clinical use, DIFOTI finds well even initial caries lesions on proximal surfaces, thus providing an instrument for detecting lesions potential for arresting as well as for monitoring the outcome after preventive measures.

  10. Validity of Digital Imaging of Fiber-Optic Transillumination in Caries Detection on Proximal Tooth Surfaces

    Directory of Open Access Journals (Sweden)

    Marja-Liisa Laitala

    2017-01-01

    Full Text Available Objective. The aim of our study was to evaluate the validity of the digital imaging fiber-optic transillumination (DIFOTI method in comparison with clinical visual examination (CV and bitewing (BW radiography on detecting caries lesions on proximal surfaces of teeth. Materials and Methods. Proximal tooth surfaces of premolars and molars (n=2,103 of 91 voluntary university students aged from 18 to 30 years were examined with CV, BW radiography, and the DIFOTI method. Results. DIFOTI detected more initial and manifested caries lesions compared with CV and BW. Of the analyzed tooth surfaces, 69.8% were classified as sound by DIFOTI, 80.3% by BW, and 91.6% by CV. Initial caries lesions were found in 21.2% of the surfaces by DIFOTI, in 14.1% by BW, and in 6.2% by CV, whereas the proportions for manifested dental caries lesions were 9.0%, 5.6%, and 2.2%, respectively. The interexaminer agreement regarding the DIFOTI findings between an experienced clinician and a fifth-year dental student was high: κ=0.67 for initial and κ=0.91 for manifested caries lesions. Conclusions. The noninvasive DIFOTI method seems to offer a potential tool for everyday clinical practice. In clinical use, DIFOTI finds well even initial caries lesions on proximal surfaces, thus providing an instrument for detecting lesions potential for arresting as well as for monitoring the outcome after preventive measures.

  11. Microbiological Evaluation of Ozone on Dentinal Lesions in Young Permanent Molars using the Stepwise Excavation.

    Science.gov (United States)

    Safwat, Osama; Elkateb, Mona; Dowidar, Karin; Salam, Hala Abdel; El Meligy, Omar

    2017-09-22

    To assess the microbial effect of ozone gas on dentinal lesions in young permanent molars using the stepwise excavation. An experimental, controlled clinical trial was performed. The sample included 80 immature first permanent molars, showing deep occlusal carious cavities that were indicated for stepwise excavation. Following first step of dentin excavation, the sample was divided into test (ozone gas) and control (calcium hydroxide (Ca(OH)2) base material) groups. One half of the cases in each group were evaluated for microbiological changes after 6 months, and the other half after 12 months. Mutans streptococci (MS), Lactobacilli, and Candida counts were significantly reduced immediately after ozone application in the test group (P ≤0.05). At the final assessment period, MS and Lactobacilli were significantly reduced in the test group (P ≤0.05). Meanwhile, the Candida counts were significantly reduced only in the test group of the 6 and 12 month-cases (P ≤0.05). Regarding the control group, the significant reduction in microbial count was observed with MS after 6 and 12 months (P ≤0.05). No significant differences were observed between test and control groups at different evaluation periods (P >0.05). Ozone gas had a significant antimicrobial effect in deep class I carious lesions.

  12. A Review of Emerging Technologies for the Detection and Diagnosis of Dental Caries

    Science.gov (United States)

    2016-06-01

    specificity for detecting caries on visible surfaces of teeth, the detection of proximal carious lesions has been shown to be only around 0.30 meaning...radiography as an adjunct to visual examination generally allows for a more sensitive detection of proximal and occlusal caries lesions, provides a...study has shown that radiographic caries detection is best suited for detecting proximal lesions that are cavitated and lesions extending into dentin

  13. Cubesat Proximity Operations Demonstration (CPOD)

    Science.gov (United States)

    Villa, Marco; Martinez, Andres; Petro, Andrew

    2015-01-01

    The CubeSat Proximity Operations Demonstration (CPOD) project will demonstrate rendezvous, proximity operations and docking (RPOD) using two 3-unit (3U) CubeSats. Each CubeSat is a satellite with the dimensions 4 inches x 4 inches x 13 inches (10 centimeters x 10 centimeters x 33 centimeters) and weighing approximately 11 pounds (5 kilograms). This flight demonstration will validate and characterize many new miniature low-power proximity operations technologies applicable to future missions. This mission will advance the state of the art in nanosatellite attitude determination,navigation and control systems, in addition to demonstrating relative navigation capabilities.The two CPOD satellites are scheduled to be launched together to low-Earth orbit no earlier than Dec. 1, 2015.

  14. Osteoblastoma-like Osteosarcoma of the Proximal Tibia: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Soon Young; Kim, Mi Sung; Park, Noh Hyuck; Park, Chan Sub [Dept. of Radiology, Myoungji Hospital, Kwandong University College of Medicine, Goyang (Korea, Republic of); Park, Hee Jin [Dept. of Radiology, Kangbuk Samsung, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Yi, Sng Yeop [Dept. of Pathology, Myoungji Hospital, Kwandong University College of Medicine, Goyang (Korea, Republic of); Kim, Hyung Soo [Dept. of Orthpedic Surgery, Myoungji Hospital, Kwandong University College of Medicine, Goyang (Korea, Republic of)

    2011-05-15

    Osteoblastoma-like osteosarcoma is a rare, low-grade variant of osteosarcoma that may resemble osteoblastoma clinically, radiographically and histologically. We report a case of osteoblastoma-like osteosarcoma in the right proximal tibia in a 17-year-old woman. Plain radiography revealed an irregular osteolytic lesion in the metaepiphysis of the right proximal tibia and transverse fracture line of the metaphysic through an osteolytic lesion. MRI showed well-defined mass confined to the medullary space with cortical disruption and pathologic fracture. The MR signals were low on T1-weighted image and intermediate on T2-weighted image.

  15. Intraoral versus extraoral bitewing radiography in detection of enamel proximal caries: an ex vivo study.

    Science.gov (United States)

    Abu El-Ela, Walaa Hussein; Farid, Mary Medhat; Mostafa, Mostafa Saad El-Din

    2016-01-01

    To compare the diagnostic accuracy of digital intraoral and extraoral bitewing (EO BW) radiography in the detection of enamel proximal caries regardless of their ability to separate contacts. Artificial caries with different degrees of decalcification was induced in 80 human sound premolars and molars using formic acid. Intraoral radiographs were taken with photostimulable phosphor plate (PSP) and complementary metal oxide semiconductor (CMOS), using the paralleling bitewing technique. Extraoral bitewing radiographs were obtained using Sirona digital panoramic X-ray unit (Sirona Siemens, Bensheim, Germany). In total, 160 proximal surfaces were assessed by 2 observers twice. Area under the receiver operating characteristic curve (Az) values for each image type, observer and reading were compared using z-tests, with a significance level of p ≤ 0.05. Sensitivity, specificity, positive-predictive value and negative-predictive value for each observer and reading were calculated. Spearman's test showed a strong positive correlation between the duration of demineralization and histological grading of carious teeth surfaces. For the three radiographic techniques, intraobserver reliability was strong to excellent. Moreover, interobserver agreement was strong. The differences between all detection methods were not statistically significant (p > 0.05). Intraoral bitewing using CMOS sensor had the highest sensitivity while EO BW had the highest specificity in the detection of incipient proximal caries. Within the limits of the ex vivo design, the difference in diagnostic accuracy between the three radiographic techniques was not significant. EO BW could be used in the detection of enamel proximal caries with results comparable with intraoral bitewing with PSP plate and CMOS sensor.

  16. Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue

    Directory of Open Access Journals (Sweden)

    Lena Karlsson

    2010-01-01

    Full Text Available A conservative, noninvasive or minimally invasive approach to clinical management of dental caries requires diagnostic techniques capable of detecting and quantifying lesions at an early stage, when progression can be arrested or reversed. Objective evidence of initiation of the disease can be detected in the form of distinct changes in the optical properties of the affected tooth structure. Caries detection methods based on changes in a specific optical property are collectively referred to as optically based methods. This paper presents a simple overview of the feasibility of three such technologies for quantitative or semiquantitative assessment of caries lesions. Two of the techniques are well-established: quantitative light-induced fluorescence, which is used primarily in caries research, and laser-induced fluorescence, a commercially available method used in clinical dental practice. The third technique, based on near-infrared transillumination of dental enamel is in the developmental stages.

  17. A pilot study of a modified radiographic technique for detecting early proximal cavities.

    Science.gov (United States)

    Akbari, M; Zarch, H H; Movagharipour, F; Ahrari, F

    2013-01-01

    Diagnosing the necessity of cavity preparation in demineralized proximal areas has been considered as a challenge in restorative treatment planning. The purpose of this study was to investigate the clinical performance of a modified radiographic technique for the detection of proximal cavities. The sample consisted of 44 proximal surfaces in 38 dental students. The patients had radiolucent proximal lesions restricted to the inner half of enamel or the outer third of dentine in bitewing radiographs, and there was doubt regarding the presence or absence of cavities in the approximal areas. The suspected surfaces were then examined by secondary bitewing radiographs which were taken after pressing radiopaque material into the proximal areas. Finally, orthodontic elastic separators were placed in the contact areas to provide enough space for direct visual and tactile examination, thus detecting any proximal cavity (reference standard). The sensitivity, specificity and accuracy of the modified bitewing radiography were calculated against the reference standard. Overall, 7 surfaces presented caries cavities according to the reference standard. All proximal radiolucencies observed in the inner half of enamel and 46% of those extended to the outer third of dentine were not cavitated when evaluated by direct visual and tactile examination. The sensitivity, specificity and accuracy of bitewing radiography with opaque material for detecting proximal cavities (n = 7) were 86, 100 and 98%, respectively. The tested radiographic technique displayed good validity in this pilot study for detecting proximal cavities in posterior teeth and should be further investigated. © 2013 S. Karger AG, Basel.

  18. Assessing the Performance of the Laser Fluorescence Technique in Detecting Proximal Caries Cavities

    Directory of Open Access Journals (Sweden)

    Majid Akbari

    Full Text Available Introduction: Diagnosing the necessity of cavity preparation and restoration in demineralized proximal areas is always considered as a challenge in restorative treatment planning. The purpose of this study was to assess the performance of the laser fluorescence (LF technique in detection of proximal cavities.Materials & Methods: In this clinical trial, 44 proximal surfaces in 38 dental students were evaluated. The selected patients had radiolucent proximal lesions restricted to inner half of enamel or outer third of dentine in bitewing radiographs (BW. DIAGNOdent pen (LF pen device was used to determine the presence or absence of caries cavities in suspected proximal surfaces. Orthodontic elastic separators were then placed in the contact areas to provide enough space for direct visual and tactile examination. The sensitivity, specificity and accuracy of the laser fluorescence technique were calculated versus the reference standard. The ROC curve was drawn and the best cut-off to determine the presence or absence of proximal cavities was determined.Results: Using DIAGNOdent pen, the optimal cut-off for detecting proximal cavities was 18. The sensitivity, specificity and accuracy of DIAGNOdent pen for diagnosing proximal caries cavities were 100 per cent, 97.3 per cent and 97.7 per cent, respectively. Conclusion: Due to the high diagnostic accuracy of DIAGNOdent pen in detecting proximal caries cavities, it can be used as a valuable supplement in restorative treatment planning.

  19. Lesion activity assessment

    DEFF Research Database (Denmark)

    Ekstrand, K R; Zero, D T; Martignon, S

    2009-01-01

    of predictors increases the accuracy of lesion activity prediction for both primary coronal and root lesions. Three surrogate methods have been used for evaluating lesion activity (construct validity); all have disadvantages. If construct validity is accepted as a 'gold standard', it is possible to assess......This chapter focusses on the probability of a caries lesion detected during a clinical examination being active (progressing) or arrested. Visual and tactile methods to assess primary coronal lesions and primary root lesions are considered. The evidence level is rated as low (R...... in response to cariogenic plaque as well as lesion arrest. Based on this understanding, different clinical scoring systems have been developed to assess the severity/depth and activity of lesions. A recent system has been devised by the International Caries Detection and Assessment System Committee...

  20. Skin lesion removal

    Science.gov (United States)

    Shave excision - skin; Excision of skin lesions - benign; Skin lesion removal - benign; Cryosurgery - skin, benign; BCC - removal; Basal cell cancer - removal; Actinic keratosis - removal; Wart - removal; Squamous cell - removal; ...

  1. Skin lesion of blastomycosis

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/000865.htm Skin lesion of blastomycosis To use the sharing features on this page, please enable JavaScript. A skin lesion of blastomycosis is a symptom of an infection ...

  2. Skin lesion aspiration

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003451.htm Skin lesion aspiration To use the sharing features on this page, please enable JavaScript. Skin lesion aspiration is the withdrawal of fluid from a ...

  3. SHORT COMMUNICATION PROXIMATE COMPOSITION, MINERAL ...

    African Journals Online (AJOL)

    Preferred Customer

    SHORT COMMUNICATION. PROXIMATE COMPOSITION, MINERAL CONTENT AND ANTINUTRITIONAL. FACTORS OF SOME CAPSICUM (Capsicum annum) VARIETIES GROWN IN. ETHIOPIA. Esayas K.1, Shimelis A.2, Ashebir F.3, Negussie R.3, Tilahun B.4 and Gulelat D.4*. 1Hawassa University, Department of Food ...

  4. Simple bone cyst involving proximal epiphysis of the humerus : a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Bum Ha; Ryu, Kyung Nam; Park, Yong Koo; Han, Chung Soo [Kyughee Univ. Hospital, Seoul (Korea, Republic of)

    1998-08-01

    Simple or unicameral bone cysts are metaphyseal lesions of long bones. They usually move away from the physis with growth to become diaphyseal in location. Involvement of the physis and epiphysis by these cystic lesions is very rare. This paper reports a case of simple bone cyst of the proximal humerus in a 11- year -old girl which was shown by MR imaging to extend through the physis into the epiphysis.

  5. THE RENAL LESIONS OF ELECTROLYTE IMBALANCE

    Science.gov (United States)

    Oliver, Jean; MacDowell, Muriel; Welt, L. G.; Holliday, M. A.; Hollander, W.; Winters, R. W.; Williams, T. F.; Segar, W. E.

    1957-01-01

    Renal tubular lesions during the early phases of progressive potassium depletion in rats were found in nephrons isolated by microdissection in two locations, the collecting tubules and the proximal convolutions. All other portions of the nephron, in particular the "distal tubule," i.e. ascending limbs of Henle's loop and distal convolutions, showed no structural alterations except the passive effects of dilatation and cellular compression which developed as a result of primary disturbances lower in the tubular system. The alterations affected all the collecting tubules uniformly and took two forms; the more severe, a swelling and hyperplasia of the tubular epithelium and the lesser, an intracellular accumulation of granule droplets. The former was limited to the outer zone of the medulla, the latter to its inner zone. In the proximal convolution the structural alteration began in its middle third and extended downward towards the medulla; only occasional nephrons were affected. The essential nature of the more severe epithelial lesion was similar in both collecting tubule and proximal convolution, beginning as a swelling of cell bodies, increasing to protoplasmic disturbances with disintegration of the mitochondrial pattern, followed by rupture of cells and nuclear disappearance. These retrogressive alterations were followed by prolific regenerative hyperplasia. In the collecting tubules of the outer zone these epithelial alterations were present in both the clear and the intercalcated cells; in the latter the swelling of the cells was not prominent, but the hyperplastic proliferative increase in their number was the predominating feature of the lesion when the dissected tubules were viewed intact in the continuity of their topographical relations. The cellular alterations in the tubules are associated with an inability to concentrate the urine; reasons are given for considering this functional disturbance a correlate of the structural lesion in the collecting

  6. Monitoring of sound and carious surfaces under sealants over 44 months.

    Science.gov (United States)

    Fontana, M; Platt, J A; Eckert, G J; González-Cabezas, C; Yoder, K; Zero, D T; Ando, M; Soto-Rojas, A E; Peters, M C

    2014-11-01

    Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 (i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair. © International & American Associations for Dental Research.

  7. Fractures of the proximal humerus in children and adolescents

    Directory of Open Access Journals (Sweden)

    Ruban Raj Joshi, Dr

    2013-12-01

    Full Text Available Background: In most children proximal humeral fractures are treated non-operatively with generally good results. The aim of the study was to evaluate the clinical outcome of closed/open reduction in children with severely displaced proximal humeral fractures. Materials and Methods: The charts of 15 patients (8 girls and 7 boys; mean age: 9.4 years with proximal humeral fractures who were managed at our institution were reviewed from October 2011 to December 2013. Results: There were 7 metaphyseal fractures and 8 physeal injuries which were angulated according to Neer-Horowitz score as grade II (n=2, grade III(n=4 and grade IV(n=9. Associated lesions comprised open fracture with head trauma in a 2 year old female child which was operated on primarily and the 14 others by secondary intention. All patients were treated surgically with either closed (n = 5 or open (n=10 reduction and internal fixation with Kirschner wire or titanium elastic nails (TENs. They were assessed for clinical and radiological healing at a mean follow up of 1.25 years ranging from 0.5 to 2.0 years. Conclusion: Surgical option is indicated for severely displaced and unstable fractures in older children and adolescents. In addition to the periosteum , long head of the biceps, deltoid muscle, and bone fragments in combination can prevent fracture reduction. Key words: Proximal humerus fracture, Children, Open reduction, Operative.

  8. Visualizing cellular interactions with a generalized proximity reporter.

    Science.gov (United States)

    Sellmyer, Mark A; Bronsart, Laura; Imoto, Hiroshi; Contag, Christopher H; Wandless, Thomas J; Prescher, Jennifer A

    2013-05-21

    Interactions among neighboring cells underpin many physiological processes ranging from early development to immune responses. When these interactions do not function properly, numerous pathologies, including infection and cancer, can result. Molecular imaging technologies, especially optical imaging, are uniquely suited to illuminate complex cellular interactions within the context of living tissues in the body. However, no tools yet exist that allow the detection of microscopic events, such as two cells coming into close proximity, on a global, whole-animal scale. We report here a broadly applicable, longitudinal strategy for probing interactions among cells in living subjects. This approach relies on the generation of bioluminescent light when two distinct cell populations come into close proximity, with the intensity of the optical signal correlating with relative cellular location. We demonstrate the ability of this reporter strategy to gauge cell-cell proximity in culture models in vitro and then evaluate this approach for imaging tumor-immune cell interactions using a murine breast cancer model. In these studies, our imaging strategy enabled the facile visualization of features that are otherwise difficult to observe with conventional imaging techniques, including detection of micrometastatic lesions and potential sites of tumor immunosurveillance. This proximity reporter will facilitate probing of numerous types of cell-cell interactions and will stimulate the development of similar techniques to detect rare events and pathological processes in live animals.

  9. Tumefactive demyelinating lesions

    Energy Technology Data Exchange (ETDEWEB)

    Dagher, A.P. [Thomas Jefferson Univ. Hospital, Philadelphia, PA (United States). Div. of Neuroradiology; Smirniotopoulos, J. [Thomas Jefferson Univ. Hospital, Philadelphia, PA (United States). Div. of Neuroradiology]|[Armed Forces Inst. of Pathology, Washington, DC (United States). Dept. of Radiological Pathology

    1996-08-01

    We studied 21 cases of pathologically confirmed tumefactive demyelinating lesions and reviewed the spectrum of tumefactive demyelinating lesions in the literature. Radiological features and clinical data were reviewed to characterize the lesions as consistent with a known demyelinating disease, most notably multiple sclerosis. Atypical clinical or radiological features (other than tumefaction) were noted. Most lesions were part of a clinical and/or radiological picture consistent with multiple sclerosis. No case strongly suggestive of variants or related diseases, such as Schilder`s disease or Balo`s concentric sclerosis, were found. There was one case suggestive of acute disseminated encephalomyelitis. Features which help distinguish the lesions from tumour are discussed. (orig.)

  10. Photoactivated In Vivo Proximity Labeling.

    Science.gov (United States)

    Beck, David B; Bonasio, Roberto

    2017-06-19

    Identification of molecular interactions is paramount to understanding how cells function. Most available technologies rely on co-purification of a protein of interest and its binding partners. Therefore, they are limited in their ability to detect low-affinity interactions and cannot be applied to proteins that localize to difficult-to-solubilize cellular compartments. In vivo proximity labeling (IPL) overcomes these obstacles by covalently tagging proteins and RNAs based on their proximity in vivo to a protein of interest. In IPL, a heterobifunctional probe comprising a photoactivatable moiety and biotin is recruited by a monomeric streptavidin tag fused to a protein of interest. Following UV irradiation, candidate interacting proteins and RNAs are covalently biotinylated with tight spatial and temporal control and subsequently recovered using biotin as an affinity handle. Here, we describe experimental protocols to discover novel protein-protein and protein-RNA interactions using IPL. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

  11. Cerebral lesions can impair fMRI-based language lateralization.

    Science.gov (United States)

    Wellmer, Jörg; Weber, Bernd; Urbach, Horst; Reul, Jürgen; Fernandez, Guillen; Elger, Christian E

    2009-10-01

    Several small patient studies and case reports raise concerns that the reliability of functional magnetic resonance imaging (fMRI) may be impaired in the vicinity of cerebral lesions. This could affect the clinical validity of fMRI for presurgical language lateralization. The current study sets out to identify if a systematic effect of lesion type and localization on fMRI exists. We classify lesions typically occurring in epilepsy patients according to (1) their potential to disturb blood oxygenation level dependent (BOLD)-effect generation or detection or to disturb spatial brain normalization, and (2) the proximity of lesions to protocol-specific volumes of interest (VOIs). The effect of lesions is evaluated through the examination of 238 epilepsy patients and a subgroup of 37 patients with suspected unilateral left-language dominance according to the Wada test. Patients with fMRI-critical lesions such as cavernomas, gliomas, and mass defects close to VOIs, or with severe atrophy, show lower lateralization indices (LIs) and more often discordant language lateralization with the Wada test than do patients without such lesions. This study points seriously toward fMRI-language lateralization being sensitive to cerebral lesions. Some lesion types and locations are more critical than others. Our results question the noncritical application of fMRI in patients with cerebral lesions.

  12. Prox-1 Automated Proximity Operations

    Science.gov (United States)

    2016-01-13

    on demonstrating the functionality required to meet minimum mission success criteria. The minimum mission includes on- orbit spacecraft checkout of...also includes deployment of LightSail-B from the P-POD, and imaging of LightSail-B for 20 minutes as it recedes from Prox-1. small satellite ; proximity...criteria. The minimum mission includes on- orbit spacecraft checkout of all spacecraft subsystems, including flight qualification of the following new

  13. Proximal tibial epiphyseal intraosseous schwannoma: a rare entity.

    Science.gov (United States)

    Meyer, Alain; Sailhan, Frédéric; Coulomb, Aurore; Thevenin-Lemoine, Camille; Mary, Pierre; Ducou-Lepointe, Hubert; Damsin, Jean-Paul

    2008-01-01

    Schwannoma is a benign nerve sheath tumor most commonly located in the soft tissue. Occasionally, schwannomas involve osseous structures. The rarity of osseous involvement leads to omission of schwannoma from the initial differential diagnosis in the majority of cases. Intraosseous schwannomas arising in children have not been reported. We present the case of a schwannoma affecting the proximal tibial epiphysis in a growing child. Intraosseous schwannomas should be included in the differential diagnosis of lytic epiphyseal benign-appearing bone lesions in children. Its radiographic characteristics mimic those of benign chondroblastoma.

  14. Proximal caries detection using digital subtraction radiography in the artificial caries activity model

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jong Hoon; Lee, Gi Ja; Choi, Sam Jin; Park, Young Ho; Kim, Kyung Soo; Jin, Hyun Seok; Hong, Kyung Won; Oh, Berm Seok; Park, Hun Kuk [Department of Biomedical Engineering, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Choi, Yong Suk; Hwang, Eui Hwan [Department of Oral and Maxillofacial Radiology, Institute of Oral Biology, School of Dentistry, Kyung Hee University, Seoul (Korea, Republic of)

    2009-03-15

    The purpose of the experiment was to evaluating the diagnostic ability of dental caries detection using digital subtraction in the artificial caries activity model. Digital radiographs of five teeth with 8 proximal surfaces were obtained by CCD sensor (Kodak RVG 6100 using a size no.2). The digital radiographic images and subtraction images from artificial proximal caries were examined and interpreted. In this study, we proposed novel caries detection method which could diagnose the dental proximal caries from single digital radiographic image. In artificial caries activity model, the range of lesional depth was 572-1,374 {mu}m and the range of lesional area was 36.95-138.52 mm{sup 2}. The lesional depth and the area were significantly increased with demineralization time (p<0.001). Furthermore, the proximal caries detection using digital subtraction radiography showed high detection rate compared to the proximal caries examination using simple digital radiograph. The results demonstrated that the digital subtraction radiography from single radiographic image of artificial caries was highly efficient in the detection of dental caries compared to the data from simple digital radiograph.

  15. Remineralizing Efficacy of Fluorohydroxyapatite Gel on Artificial Dentinal Caries Lesion

    Directory of Open Access Journals (Sweden)

    Qianqian Wang

    2015-01-01

    Full Text Available The aim was to evaluate the remineralizing efficacy of fluorohydroxyapatite (FHA gel on artificial dentinal caries lesion in vitro. Artificial carious lesions were made on occlusal cavities of teeth by exposing the dentin surface to a demineralizing solution. Each cavity was capped with a 3 mm thick FHA gel for 4 weeks. After the FHA gel was removed, the surface morphology and structure of the dentin were characterized by scanning electron microscopy (SEM, energy-dispersive X-ray spectroscopy (EDX, X-ray diffraction (XRD, and Fourier transform infrared spectroscopy (FT-IR. The dentin mineral density (DMD was measured by micro-computed tomography (Micro-CT. A layer of dense and orderly hexagonal crystal structure, with average diameter of 1 μm and thickness of 4~5 μm, could be observed on dentin surface. These crystals exhibited elemental peaks for calcium, phosphorus, carbon, and oxygen and characteristic peaks of hydroxyapatite (HA and fluorapatite (FA via XRD and FT-IR. The DMD of dentin surface layer significantly increased after it was capped with FHA gel (P<0.05. In the present study, the FHA gel could rapidly construct apatite on the artificial dentin caries surface and significantly increase the mineral density, which suggests that FHA gel might be a proper IPT material with remineralizing function.

  16. Metatranscriptomics reveals overall active bacterial composition in caries lesions

    Directory of Open Access Journals (Sweden)

    Aurea Simón-Soro

    2014-10-01

    Full Text Available Background: Identifying the microbial species in caries lesions is instrumental to determine the etiology of dental caries. However, a significant proportion of bacteria in carious lesions have not been cultured, and the use of molecular methods has been limited to DNA-based approaches, which detect both active and inactive or dead microorganisms. Objective: To identify the RNA-based, metabolically active bacterial composition of caries lesions at different stages of disease progression in order to provide a list of potential etiological agents of tooth decay. Design: Non-cavitated enamel caries lesions (n=15 and dentin caries lesions samples (n=12 were collected from 13 individuals. RNA was extracted and cDNA was constructed, which was used to amplify the 16S rRNA gene. The resulting 780 bp polymerase chain reaction products were pyrosequenced using Titanium-plus chemistry, and the sequences obtained were used to determine the bacterial composition. Results: A mean of 4,900 sequences of the 16S rRNA gene with an average read length of 661 bp was obtained per sample, giving a comprehensive view of the active bacterial communities in caries lesions. Estimates of bacterial diversity indicate that the microbiota of cavities is highly complex, each sample containing between 70 and 400 metabolically active species. The composition of these bacterial consortia varied among individuals and between caries lesions of the same individuals. In addition, enamel and dentin lesions had a different bacterial makeup. Lactobacilli were found almost exclusively in dentin cavities. Streptococci accounted for 40% of the total active community in enamel caries, and 20% in dentin caries. However, Streptococcus mutans represented only 0.02–0.73% of the total bacterial community. Conclusions: The data indicate that the etiology of dental caries is tissue dependent and that the disease has a clear polymicrobial origin. The low proportion of mutans streptococci

  17. Detection of in vitro proximal caries in storage phosphor plate radiographs scanned with different resolutions.

    Science.gov (United States)

    Li, G; Berkhout, W E R; Sanderink, G C H; Martins, M; van der Stelt, P F

    2008-09-01

    To investigate the effect of the scanning resolution of storage phosphor plate (SPP) radiographs on the detection of proximal caries lesions. 10 dentists evaluated 72 proximal surfaces of premolars with respect to caries from SPP radiographs scanned with theoretical spatial resolutions of: (1) the Digora FMX at 7.8 lp mm(-1); (2) the Digora Optime at both 7.8 lp mm(-1) and 12.5 lp mm(-1); and (3) the Dürr VistaScan at 10 lp mm(-1) and 20 lp mm(-1), respectively. The lesions were validated by histological examination. Receiver operating characteristic (ROC) analysis was employed. The A(z) value for the radiographs scanned with the Dürr VistaScan at 10 lp mm(-1) is significantly lower than those for the other series of radiographs (P = 0.000). For SPP radiographs, an increased theoretical spatial resolution per se is not related to an improved detection of proximal caries.

  18. In vivo near-IR imaging of occlusal lesions at 1310 nm

    Science.gov (United States)

    Fried, Daniel; Staninec, Michal; Darling, Cynthia L.; Lee, Chulsung; Kang, Hobin; Chan, Kenneth H.

    2011-03-01

    Several in vitro studies have demonstrated the potential for transillumination imaging and optical coherence tomography operating at 1310-nm for imaging caries lesions on tooth proximal and occlusal surfaces. Recently, we demonstrated that lesions on proximal surfaces could be imaged in vivo using NIR transillumination and that PS-OCT can be used in vivo to measure early demineralization on tooth buccal and occlusal surfaces. In this paper we report the first in vivo measurements using OCT and NIR imaging of occlusal lesions that have been scheduled for restoration. Occlusal lesions were chosen that were scheduled for restoration based on conventional diagnosis that consists of visual and tactile examination. Occlusal lesions were visible in the NIR. OCT looks promising for confirming the lateral spread of occlusal caries under the dentinal-enamel junction adjacent to fissures. These studies suggest that both near infrared transillumination imaging at 1310-nm and OCT provide valuable information about the severity of caries lesions.

  19. PROXIMATE AND ELEMENTAL COMPOSITION OF WHITE GRUBS

    African Journals Online (AJOL)

    DR. AMINU

    PROXIMATE AND ELEMENTAL COMPOSITION OF WHITE GRUBS. 1 Alhassan, A. J. 1M .S. Sule, 1J. ... ABSTRACT. This study determined the proximate and mineral element composition of whole white grubs using standard methods of analysis. Proximate ... days, before pulverized to powder and kept in plastic container.

  20. Uterine vascular lesions.

    Science.gov (United States)

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management.

  1. Effect of caries infiltration technique and fluoride therapy on the colour masking of white spot lesions.

    Science.gov (United States)

    Rocha Gomes Torres, Carlos; Borges, Alessandra Buhler; Torres, Luciana Marcondes Sarmento; Gomes, Isabela Silva; de Oliveira, Rodrigo Simões

    2011-03-01

    A carious lesion is initiated through the subsurface demineralization of enamel, and presents clinically as a white spot, interfering with the aesthetics. This lesion should not receive restorative treatment because it is capable of remineralization. The aim of this study was to evaluate the performance of different treatments on masking white spot lesions by assessing the colour change. Artificial white spot lesions were produced in bovine enamel of 60 cylindrical-shaped samples. The samples were randomly divided into four groups: CON (control) - immersion in artificial saliva; DF - daily application of 0.05% fluoride solution; WF - weekly application of 2% fluoride gel; and IC - resin infiltration (Icon(®) - DMG). The assessment of colour was performed by a spectrophotometer in four distinct stages: baseline, after the production of artificial caries; after 4 weeks; after 8 weeks; and after a new acid challenge. The ΔL values were calculated at each stage in relation to the baseline colour. The application of RM ANOVA revealed significant differences between the factors' treatment and time (p=0.001). For the interaction between factors there were no significant differences (p=0.27). The Tukey's test (pwhite spot lesions. Also, after a new acid challenge, the group infiltrated with low viscosity resin presented the lowest means of colour change. Copyright © 2011. Published by Elsevier Ltd.

  2. Clinical safety, quality and effect of resin infiltration for proximal caries.

    Science.gov (United States)

    Altarabulsi, M B; Alkilzy, M; Petrou, M A; Splieth, C

    2014-03-01

    Resin infiltration of proximal lesions is a new approach to stop caries progression. The aim of this clinical trial was to assess its safety and quality, as well as the therapeutic effect. In 47 children, adolescents and young adults, ten dentists applied the infiltration material ICON (DMG, Germany) on initial proximal lesions according to the manufacturer's instruction. One lesion with radiographic extension into enamel or the outer third of dentin per participant was allocated for the treatment. The clinical safety and quality of resin infiltration were assessed 1 week, 6 months and 12 months after the treatment and the evaluation of the therapeutic effect was analysed by pair-wise radiographs. The clinical safety and quality of the infiltration were assessed in 45 individuals after 12 months. The test surfaces showed no relevant changes in clinical status, plaque accumulation or gingival status (p > 0.05). A high quality of infiltration was found for the marginal adaptation. In contrast to the improvement of colour at the one-week recall (p = 0.005), the infiltrated surfaces showed a statistically significant increase in the discoloration within the following year (p = 0.014). Out of the 43 lesions which could be assessed radiographically, only two lesions showed progression to a different score (4.7%). Resin infiltration can be considered a safe and effective treatment to reduce progression of initial proximal caries.

  3. Radiographic diagnosis of proximal caries-influence of experience and gender of the dental staff.

    Science.gov (United States)

    Geibel, Margrit-Ann; Carstens, S; Braisch, U; Rahman, A; Herz, M; Jablonski-Momeni, A

    2017-12-01

    The aim of this study was to examine the influence of experience and gender on the radiographic detection of proximal caries lesions and on therapeutic decisions. A survey of 220 examiners (students and employees at three universities and dentists in the field) was taken using a standardized written questionnaire concerning radiographic diagnosis and therapy planning. An expert opinion of four dentists was determined as radiographic reference. A mixed effect logistic regression model was used for statistical evaluation and the odds ratio and p values were calculated (α = 0.05). Examiners with experience had an almost four times greater chance of a correct assessment, if proximal caries lesion was present or not, than examiners with low experience (OR 3.7 (95% CI 2.4-5.8)). No gender-specific differences were discovered (OR women vs. men 0.9 (95% CI 0.6-1.4)). There was a relationship between the severity of the burnout effect on the x-ray and false positive caries diagnosis. Overall, 43% of respondents would plan invasive treatment in the enamel on a patient at low risk of caries and 78% on a high-risk patient. The results showed that the more experienced practitioners would be more likely to postpone restorative therapy on proximal caries until the lesion reached a later stage. The results of this study suggest that examiner's experience influences the radiographic diagnosis of proximal lesions. No gender-specific differences could be found. Examiner's professional experience is an important factor when radiography is included for detection and treatment planning of proximal lesions.

  4. Clinical Evaluation of Ozone on Dentinal Lesions in Young Permanent Molars using the Stepwise Excavation.

    Science.gov (United States)

    Safwat, Osama; Elkateb, Mona; Dowidar, Karin; El Meligy, Omar

    To evaluate the clinical changes in dentin of deep carious lesions in young permanent molars, following ozone application with and without the use of a remineralizing solution, using the stepwise excavation. The sample included 162 first permanent immature molars, showing deep occlusal carious cavities that were indicated for indirect pulp capping. Teeth were divided into 2 main groups according to the method of ozone treatment. Each group was further subdivided equally into test and control subgroups. Following caries excavation, color, consistency and DIAGNOdent assessments of dentin were evaluated after 6 and 12 months. Regarding dentin color and consistency, no significant differences were observed following ozone application, with and without a remineralizing solution. There were no significant differences between ozone treatment, and calcium hydroxide during the different evaluation periods, except in group I cases after 6 months, concerning the dentin color. The DIAGNOdent values were significantly reduced following ozone application, with or without a remineralizing solution, as well as between test and control cases in group I after 6 months. Ozone application through the stepwise excavation had no significant effect on dentin color and consistency in young permanent molars. DIAGNOdent was unreliable in monitoring caries activity.

  5. Effect of three different pastes on remineralization of initial enamel lesion: an in vitro study.

    Science.gov (United States)

    Vyavhare, S; Sharma, D S; Kulkarni, V K

    2015-01-01

    Dental caries in enamel is unique as enamel is both acellular and avascular. Fluoride is one of the most effective remineralizing agents in caries prevention. The purpose of the study was to assess whether nano-hydroxyapatite and CPP-ACP can be used as an alternative to fluoride for remineralization of early carious lesions. Initial artificial carious lesions were prepared in enamel with demineralization solution. The treatment materials used as remineralizing agents were Nano-hydroxyapatite (10%), CPP - ACP (10%), NaF (1000 ppm) and Deionized water (negative control). Surface microhardness (SMH) measurements were performed before/after demineralization and after 3, 6, 9 and 12 days of pH cycling and the percentage surface microhardness recovery (%SMHR) was calculated. The specimens were then examined by scanning electron microscope. Percentage surface microhardness recovery of nano-hydroxyapatite and fluoride was significantly greater than CPP - ACP and negative control. There was no significant difference of %SMHR between n-HA and fluoride at different time periods in the pH cycling. SEM analysis revealed n-HA particles were deposited on the demineralized enamel surface which formed a new surface layer. When observed under SEM CPP - ACP failed to show any significant surface remineralization while surface globular crystal depositions with multiple discrete porosities were evident with fluoride. It was concluded that nano-hydroxyapatite and fluoride had the potential to remineralize initial enamel lesions. CPP - ACP can be used as an effective adjunct to fluoride therapy but cannot be used as an alternative to fluoride.

  6. In vitro assessment of cone beam local computed tomography for proximal caries detection.

    Science.gov (United States)

    Kalathingal, Sajitha M; Mol, André; Tyndall, Donald A; Caplan, Daniel J

    2007-11-01

    To compare the accuracy of local computed tomography (LCT) and conventional radiography for proximal caries detection and depth assessment. An in vitro model was used consisting of 20 extracted posterior teeth with 18 caries lesions. Local computed tomography slices were reconstructed in axial and parasagittal planes from 100 basis projections. Conventional radiographs were also acquired. Eight observers determined the presence and depth of caries lesions. Receiver operating characteristic analysis and weighted kappa statistics were used. Local computed tomography had a mean A(z) score of 0.82 (SD = 0.07) and conventional radiography of 0.79 (SD = 0.08; analysis of variance: P > .05). Interobserver agreement was moderate. The mean kappa for depth assessment was 0.68 (SD = 0.06) for LCT and 0.47 (SD = 0.08) for conventional radiography (analysis of variance: P proximal caries detection. Local computed tomography was more accurate for assessing caries lesion depth.

  7. Finger Proximal Interphalangeal Joint Dislocation.

    Science.gov (United States)

    Ramponi, Denise; Cerepani, Mary Jo

    2015-01-01

    Finger dislocations are common injuries that are often managed by emergency nurse practitioners. A systematic physical examination following these injuries is imperative to avoid complications. Radiographic views, including the anteroposterior, lateral, and oblique views, are imperative to evaluate these finger dislocations. A dorsal dislocation of the proximal interphalangeal (PIP) joint is the most common finger dislocation type often easily reduced. A volar PIP dislocation can often be difficult to reduce and may result in finger deformity. Finger dislocations should be reduced promptly. Referral to an orthopedic hand specialist is required if the dislocation is unable to be reduced or if the finger joint is unstable following reduction attempts.

  8. Equilibrium properties of proximity effect

    Energy Technology Data Exchange (ETDEWEB)

    Esteve, D.; Pothier, H.; Gueron, S.; Birge, N.O.; Devoret, M.

    1996-12-31

    The proximity effect in diffusive normal-superconducting (NS) nano-structures is described by the Usadel equations for the electron pair correlations. We show that these equations obey a variational principle with a potential which generalizes the Ginzburg-Landau energy functional. We discuss simple examples of NS circuits using this formalism. In order to test the theoretical predictions of the Usadel equations, we have measured the density of states as a function of energy on a long N wire in contact with a S wire at one end, at different distances from the NS interface. (authors). 12 refs.

  9. Resin infiltration of caries lesions: an efficacy randomized trial.

    Science.gov (United States)

    Paris, S; Hopfenmuller, W; Meyer-Lueckel, H

    2010-08-01

    Resin infiltration is an innovative approach to arrest progression of caries lesions. The aim of this randomized split-mouth placebo-controlled clinical trial was to assess whether resin infiltration of proximal lesions is more effective than non-operative measures alone with respect to the inhibition of caries progression. In 22 young adults, 29 pairs of interproximal lesions with radiological extension into the inner half of enamel or the outer third of dentin were randomly allocated to two treatment groups. In the test group, lesions were infiltrated (Icon, pre-product; DMG). A placebo treatment was performed in the control group. All participants received instructions for diet, flossing, and fluoridation. The primary outcome after 18 months was radiographic lesion progression (assessed by digital subtraction radiography). No unwanted effects could be observed. In the effect group, 2/27 lesions (7%) and in the control group 10/27 lesions (37%) showed progression (p = 0.021; McNemar). Infiltration of interproximal caries lesions is efficacious in reducing lesion progression.

  10. Comparative analysis of bacterial decrease by Er:YAG laser radiation and by a tip mounted on a high-rotation device after remove of carious tissue in dentine: study 'in anima mobile'; Analise comparativa da reducao bacteriana com irradiacao do laser Er:YAG ou ponta montada em alta rotacao apos remocao de tecido cariado em dentina: estudo in anima nobile

    Energy Technology Data Exchange (ETDEWEB)

    Blay, Claudia Campos

    2002-07-01

    The purpose of this study was to analyze bacterial decrease after removal of carious tissue in dentine by Er:YAG laser, comparing the results with those achieved by using a tip mounted on a high-rotation device. In view of the difficulty of totally eliminating microorganisms from dentine, even after removing all the carious tissue, and since the presence of a smear layer is a proven fact, it would be extremely convenient to eliminate or to achieve better disinfecting of this notoriously contaminated dentine layer, so as to prevent failure of the restoration process in most cases. For this study, we selected 30 pre-molars and molars with caries rated as medium sized and which required restoration treatment. The teeth were divided in two groups, where 15 teeth received conventional treatment (control group - I) and 15 teeth were treated with Er:YAG laser (Kavo Key Laser) (laser group - II). Microbiologic analysis was used in order to determine presence or absence of bacteria. In group I as well as in group II a previous curettage of part of the dentine caries was performed, and the sample was seeded in an Agar culture medium and incubated at 37 deg C for 72 hours, for a quantitative analysis of bacteria colony forming units (c.f.u.) and qualitative bacterial analysis. After this procedure, carious lesions were removed in group I, using a spherical diamond drill mounted on a high rotation tip, followed by cleaning of the cavity with chlorhexidine digluconate at 2%. In group II, an Er:YAG laser emitting a wave length of 2,94 {mu}m, delivering a 250 mJ energy per pulse at a repetition rate of 2 Hz was used for carious tissue removal. Furthermore in group II (laser), the cavity was conditioned by performing a sweeping at all walls of the preparation with the 50/10 fiber (Kavo), in contact mode, using an energy of 60 mJ per pulse at a frequency of 10 Hz. After removing all caries and performing a cleaning operation in both groups, dentine shavings were collected and

  11. A new screening method to detect proximal dental caries using fluorescence imaging.

    Science.gov (United States)

    Kim, Eun-Soo; Lee, Eun-Song; Kang, Si-Mook; Jung, Eun-Ha; de Josselin de Jong, Elbert; Jung, Hoi-In; Kim, Baek-Il

    2017-12-01

    This study aimed to assess the screening performance of the quantitative light-induced fluorescence (QLF) technology to detect proximal caries using both fluorescence loss and red fluorescence in a clinical situation. Moreover, a new simplified QLF score for the proximal caries (QS-Proximal) is proposed and its validity for detecting proximal caries was evaluated as well. This clinical study included 280 proximal surfaces, which were assessed by visual-tactile and radiographic examinations and scored by each scoring system according to lesion severity. The occlusal QLF images were analysed in two different ways: (1) a quantitative analysis producing fluorescence loss (ΔF) and red fluorescence (ΔR) parameters; and (2) a new QLF scoring index. For both quantitative parameters and QS-Proximal, the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated as a function of the radiographic scoring index at the enamel and dentine caries levels. Both ΔF and ΔR showed excellent AUROC values at the dentine caries level (ΔF=0.860, ΔR=0.902) whereas a relatively lower value was observed at the enamel caries level (ΔF=0.655, ΔR=0.686). The QS-Proximal also showed excellent AUROC ranged from 0.826 to 0.864 for detecting proximal caries at the dentine level. The QS-Proximal, which represents fluorescence changes, showed excellent performance in detecting proximal caries using the radiographic score as the gold standard. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Magnetic resonance imaging findings of the proximal metacarpus in Quarter Horses used for cutting: Retrospective analysis of 32 horses 2009-2012.

    Science.gov (United States)

    Barrett, M F; Manchon, P T; Hersman, J; Kawcak, C E

    2018-03-01

    Injury to the proximal suspensory ligament is a common cause of lameness in cutting horses. Radiographic and ultrasonographic imaging of lesions responsible for lameness can provide ambiguous results. MRI provides the most comprehensive diagnostic imaging evaluation of lesions specifically affecting cutting horses. To describe the distribution and severity of bone and soft tissue lesions present in the proximal metacarpus of Quarter Horse cutting horses and to assess the impact of these lesions on return to competition. Retrospective case series. Retrospective analysis of 32 cutting horses referred for MRI of the proximal metacarpus between 2009 and 2012 with a 2-year follow-up period. MRI studies were evaluated by a board-certified veterinary radiologist; the severity of lesions was graded from 0 (absent) to 3 (severe). A total of 20 right and 24 left forelimbs (12 bilateral studies) of 32 horses were evaluated. The most common findings were: third metacarpal (McIII) sclerosis at the proximal suspensory ligament (PSL) origin (42/44), McIII resorption at the PSL origin (32/44), PSL dorsal margin fibre irregularity (30/44) and McIII bone contusion (22/39). Of the 30 horses, 22 horses successfully returned to competition, irrespective of severity of injury. Strong correlation exists between the degree of resorption in the palmar cortex of proximal McIII, degree of McIII sclerosis and severity of dorsal margin fibre irregularity. Statistical significance was limited by small study population. Further analysis of prognosis was limited by availability of comprehensive medical records. Cutting horses with proximal metacarpal pain have significant pathological change within the proximal suspensory ligament and its enthesis on the palmar cortex of McIII. Severity of lesions and degree of lameness at the time of diagnosis does not influence return to performance. Accurate diagnosis of proximal metacarpal lesions based on MRI offers clinicians the capacity to select

  13. A prospective randomized study of conservative versus surgical treatment of unstable palmar plate disruption in the proximal interphalangeal finger joint

    DEFF Research Database (Denmark)

    Werlinrud, Jens Christian; Petersen, Kirstin; Lauritsen, Jens

    2013-01-01

    The aim of this study was to assess the effect of conservative versus operative treatment for unstable palmar plate disruption in the proximal interphalangeal (PIP) joint of the fingers with respect to preservation of joint stability, mobility, and pain. The study was conducted as a prospective...... do not recommend primary surgical repair of unstable isolated palmar plate lesions in the proximal interphalangeal joints of the 4 ulnar fingers. Type of study/level of evidence Therapeutic, Level II....

  14. Intraosseous osteolytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Adler, C.P.; Wenz, W.

    1981-10-01

    Any pathological damage occurring in a bone will produce either an osteolytic or osteosclerotic lesion which can be seen in the macroscopic specimen as well as in the roentgenogram. Various bone lesions may lead to local destructions of the bone. An osteoma or osteoplastic osteosarcoma produces an osteosclerotic lesion showing a dense mass in the roentgenogram; a chondroblastoma or an osteoclastoma, on the other hand, induces an osteolytic focal lesion. This paper presents examples of different osteolytic lesions of the humerus. An osteolytic lesion seen in the roentgenogram may be either produced by an underlying non-ossifying fibroma of the bone, by fibrous dysplasia, osteomyelitis or Ewing's sarcoma. Differential diagnostic considerations based on the radiological picture include eosinophilic bone granuloma, juvenile or aneurysmal bone cyst, multiple myeloma or bone metastases. Serious differential diagnostic problems may be involved in case of osteolytic lesions occurring in the humerus. Cases of this type involving complications have been reported and include the presence of an teleangiectatic osteosarcoma as well as that of a hemangiosarcoma of the bone.

  15. Elastomeric impression as a diagnostic method of cavitation in proximal dentin caries in primary molars

    Directory of Open Access Journals (Sweden)

    Adriela Azevedo Souza Mariath

    2007-12-01

    Full Text Available The purpose of this study was to validate the elastomeric impression after temporary tooth separation as a method of cavitation detection in proximal caries lesions in primary molars with outer half dentin radiolucency. Fifty-one children (4-10 years old, presenting radiolucency in the outer half of the dentin at the proximal surfaces of primary molars and proximal anatomic contact with the adjacent tooth (without restoration/cavitated caries lesion were enrolled in the study. Temporary tooth separation was performed with an orthodontic rubber ring placed around the contact point during 2-3 days. Thereafter, impression of the proximal surfaces was made. The elastomeric impressions were classified as "non-cavitated" or "cavitated" surfaces. Visual inspection after tooth separation was considered as the gold standard. Examiner reliability of visual inspection after tooth separation was determined (kappa 0.92. Impression examination was repeated every 5 participants to evaluate the reproducibility of the method. The frequency of cavitated lesions was 65%, and 67% of those were inactive. Sensitivity, specificity, positive and negative predictive values were 0.88% (95%CI 0.73-0.95, 0.89% (95%CI 0.67-0.97, 0.94% (95%CI 0.79-0.98 and 0.80% (95%CI 0.58-0.92, respectively. Impression examination showed total agreement regarding cavitation. The evaluation of elastomeric impression after tooth separation is a useful clinical resource in cavitation detection for clinicians and researchers when visual inspection is doubtful.

  16. Complications in proximal humeral fractures.

    Science.gov (United States)

    Calori, Giorgio Maria; Colombo, Massimiliano; Bucci, Miguel Simon; Fadigati, Piero; Colombo, Alessandra Ines Maria; Mazzola, Simone; Cefalo, Vittorio; Mazza, Emilio

    2016-10-01

    Necrosis of the humeral head, infections and non-unions are among the most dangerous and difficult-to-treat complications of proximal humeral fractures. The aim of this work was to analyse in detail non-unions and post-traumatic bone defects and to suggest an algorithm of care. Treatment options are based not only on the radiological frame, but also according to a detailed analysis of the patient, who is classified using a risk factor analysis. This method enables the surgeon to choose the most suitable treatment for the patient, thereby facilitating return of function in the shortest possible time. The treatment of such serious complications requires the surgeon to be knowledgeable about the following possible solutions: increased mechanical stability; biological stimulation; and reconstructive techniques in two steps, with application of biotechnologies and prosthetic substitution. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Proximity sensor technology for manipulator end effectors

    Science.gov (United States)

    Johnston, A. R.

    1975-01-01

    Optical proximity sensing techniques which could be used to help control the critical grasping phase of a remote manipulation are described. The proximity sensors described use a triangulation geometry to detect a surface located in a pre-determined region. The design of the proximity sensors themselves is discussed, as well as their application to manipulator control with a local control loop, and possibilities for future development are discussed.

  18. Gram stain of skin lesion

    Science.gov (United States)

    Skin lesion gram stain ... skin sore. This procedure is called a skin lesion biopsy . Before the biopsy, your provider will numb ... means bacteria have been found in the skin lesion. Further tests are needed to confirm the results. ...

  19. Acute periodontal lesions

    OpenAIRE

    Herrera Gonzalez, David; Alonso Álvarez, Bettina; Arriba de la Fuente, Lorenzo; Santa- Cruz Astorqui, Isabel; Serrano, Cristina; Sanz Alonso, Mariano

    2014-01-01

    This is a review and update on acute conditions affecting the gingival tissues, including abscesses in the periodontium, necrotizing periodontal diseases, and other acute conditions that cause gingival lesions with acute presentation, such as infectious process not associated with oral bacterial biofilms, muco-cutanenous disorders, and traumatic and allergic lesions. A periodontal abscess is clinically important since it is a relatively frequent dental emergency, it can compromise the periodo...

  20. Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar Salaria

    2016-01-01

    Full Text Available Radicular cyst (RC is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue.

  1. Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report.

    Science.gov (United States)

    Salaria, Sanjeev Kumar; Kamra, Shilpa; Ghuman, Simrat Kaur; Sharma, Garima

    2016-01-01

    Radicular cyst (RC) is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue.

  2. Proximate composition and antinutrient content of pumpkin ...

    African Journals Online (AJOL)

    Proximate composition and antinutrient content of pumpkin ( Cucurbita pepo ) and sorghum ( Sorghum bicolor ) flour blends fermented with Lactobacillus plantarum , Aspergillus niger and Bacillus subtilis.

  3. Restorative Treatment Thresholds for Proximal Caries in Dental PBRN

    Science.gov (United States)

    Kakudate, N.; Sumida, F.; Matsumoto, Y.; Manabe, K.; Yokoyama, Y.; Gilbert, G.H.; Gordan, V.V.

    2012-01-01

    This study was conducted to assess caries treatment thresholds among Japanese dentists and to identify characteristics associated with their decision to intervene surgically in proximal caries lesions within the enamel. Participants (n = 189) were shown radiographic images depicting interproximal caries and asked to indicate the lesion depth at which they would surgically intervene in both high- and low-caries-risk scenarios. Differences in treatment thresholds were then assessed via chi-square tests, and associations between the decision to intervene and dentist, practice, and patient characteristics were analyzed via logistic regression. The proportion of dentists who indicated surgical intervention into enamel was significantly higher in the high-caries-risk scenario (73.8%, N = 138) than in the low-caries-risk scenario (46.5%, N = 87) (p dentist, city population, type of practice, conducting caries-risk assessment, and administering diet counseling were significant factors associated with surgical enamel intervention. However, for a low-caries-risk scenario, city population, type of practice, and use of a dental explorer were the factors significantly associated with surgical enamel intervention. These findings demonstrate that restorative treatment thresholds for interproximal primary caries differ by caries risk. Most participants would restore lesions within the enamel for high-caries-risk individuals (Clinicaltrials.gov registration number NCT01680848). PMID:23053847

  4. Restorative treatment thresholds for proximal caries in dental PBRN.

    Science.gov (United States)

    Kakudate, N; Sumida, F; Matsumoto, Y; Manabe, K; Yokoyama, Y; Gilbert, G H; Gordan, V V

    2012-12-01

    This study was conducted to assess caries treatment thresholds among Japanese dentists and to identify characteristics associated with their decision to intervene surgically in proximal caries lesions within the enamel. Participants (n = 189) were shown radiographic images depicting interproximal caries and asked to indicate the lesion depth at which they would surgically intervene in both high- and low-caries-risk scenarios. Differences in treatment thresholds were then assessed via chi-square tests, and associations between the decision to intervene and dentist, practice, and patient characteristics were analyzed via logistic regression. The proportion of dentists who indicated surgical intervention into enamel was significantly higher in the high-caries-risk scenario (73.8%, N = 138) than in the low-caries-risk scenario (46.5%, N = 87) (p caries-risk scenario, gender of dentist, city population, type of practice, conducting caries-risk assessment, and administering diet counseling were significant factors associated with surgical enamel intervention. However, for a low-caries-risk scenario, city population, type of practice, and use of a dental explorer were the factors significantly associated with surgical enamel intervention. These findings demonstrate that restorative treatment thresholds for interproximal primary caries differ by caries risk. Most participants would restore lesions within the enamel for high-caries-risk individuals.

  5. Traditional lesion detection aids.

    Science.gov (United States)

    Neuhaus, K W; Ellwood, R; Lussi, A; Pitts, N B

    2009-01-01

    Lesion detection aids ideally aim at increasing the sensitivity of visual caries detection without trading off too much in terms of specificity. The use of a dental probe (explorer), bitewing radiography and fibre-optic transillumination (FOTI) have long been recommended for this purpose. Today, probing of suspected lesions in the sense of checking the 'stickiness' is regarded as obsolete, since it achieves no gain of sensitivity and might cause irreversible tooth damage. Bitewing radiography helps to detect lesions that are otherwise hidden from visual examination, and it should therefore be applied to a new patient. The diagnostic performance of radiography at approximal and occlusal sites is different, as this relates to the 3-dimensional anatomy of the tooth at these sites. However, treatment decisions have to take more into account than just lesion extension. Bitewing radiography provides additional information for the decision-making process that mainly relies on the visual and clinical findings. FOTI is a quick and inexpensive method which can enhance visual examination of all tooth surfaces. Both radiography and FOTI can improve the sensitivity of caries detection, but require sufficient training and experience to interpret information correctly. Radiography also carries the burden of the risks and legislation associated with using ionizing radiation in a health setting and should be repeated at intervals guided by the individual patient's caries risk. Lesion detection aids can assist in the longitudinal monitoring of the behaviour of initial lesions. Copyright 2009 S. Karger AG, Basel

  6. Oral lesions in leprosy

    Directory of Open Access Journals (Sweden)

    Costa A

    2003-11-01

    Full Text Available BACKGROUND: Leprotic oral lesions are more common in the lepromatous form of leprosy, indicate a late manifestation, and have a great epidemiological importance as a source of infection. METHODS: Patients with leprosy were examined searching for oral lesions. Biopsies of the left buccal mucosa in all patients, and of oral lesions, were performed and were stained with H&E and Wade. RESULTS: Oral lesions were found in 26 patients, 11 lepromatous leprosy, 14 borderline leprosy, and one tuberculoid leprosy. Clinically 5 patients had enanthem of the anterior pillars, 3 of the uvula and 3 of the palate. Two had palatal infiltration. Viable bacilli were found in two lepromatous patients. Biopsies of the buccal mucosa showed no change or a nonspecific inflammatory infiltrate. Oral clinical alterations were present in 69% of the patients; of these 50% showed histopathological features in an area without any lesion. DISCUSSION: Our clinical and histopathological findings corroborate earlier reports that there is a reduced incidence of oral changes, which is probably due to early treatment. The maintenance of oral infection in this area can also lead to and maintain lepra reactions, while they may also act as possible infection sources. Attention should be given to oral disease in leprosy because detection and treatment of oral lesions can prevent the spread of the disease.

  7. A novel technique using preformed metal crowns for managing carious primary molars in general practice - a retrospective analysis.

    Science.gov (United States)

    Innes, N P T; Stirrups, D R; Evans, D J P; Hall, N; Leggate, M

    2006-04-22

    There is a high level of untreated dental decay in primary teeth in Scotland. Despite evidence for the efficacy of preformed metal crowns (PMCs) for the restoration of primary molars, few are placed in general practice, possibly due to the interventive nature of the clinical procedure. There is, however, a novel way of placing PMCs involving no local anaesthesia, no caries removal and no preparation of the tooth: the Hall technique. To investigate the survival of carious primary teeth treated with PMCs placed using a novel, simplified method - the Hall technique. General dental practice, in Scotland. A retrospective analysis of practice records from one general practitioner, from 1988 to 2001. The majority of the 978 PMCs fitted on 259 children, using the Hall technique, were placed when there was clinical evidence of approximal caries into dentine. The Kaplan-Meier approach was used to analyse survival times and the Mantel-Haenszel Log rank test for comparison between tooth types. For all tooth types, the probability of surviving three years without being extracted or the PMC being lost, was 73.4% (95% confidence interval 70.1% to 76.4%), and for five years was 67.6% (95% confidence interval 63.3% to 71.5%). The probability of surviving without extraction alone for three years was 86.0% (95% confidence interval 83.2% to 88.4%), and for five years was 80.5% (95% confidence interval 76.5% to 83.9%). Hall technique restorations placed on primary molars with decay clinically into dentine, by a single operator in general dental practice, have a similar success rate to some other, more conventional, restorative techniques. The technique requires further evaluation through a prospective randomised control clinical trial before its use could be generally recommended.

  8. Short communication: a pan-European comparison of the management of carious primary molar teeth by postgraduates in paediatric dentistry.

    Science.gov (United States)

    Foley, J I

    2012-02-01

    To assess the preferences amongst European postgraduates (PG) in Paediatric Dentistry for the treatment of a child with differing caries severity in a primary molar tooth. An on-line structured questionnaire. All European Paediatric Dentistry PGs were contacted by e-mail and asked to participate in an on-line questionnaire. The survey described four different case scenarios of a 5-year-old child, presenting with a mesio-occlusal cavity in tooth 85 with varying symptoms and signs. Treatment options were listed and participants asked to select the single most preferred treatment for each case. The same scenarios were presented for both non-anxious and dentally-anxious patients. Responses were received from 32/56 (F: 27; M: 5) PGs. A range of treatment options were selected for patients with no indication of pulpal involvement for non-anxious patients whilst the Hall technique was selected by 16/32 students for a dentally-anxious patient. For both a nonanxious and dentally-anxious patient, the preferred option for a tooth which produced pulpal symptoms was extraction selected by 16/32 students in both cases, although the mode of extraction differed. There was no consistency of response by PGs in Paediatric Dentistry within Europe. The Hall technique appeared to be a favoured option by half of the students for treatment of an asymptomatic carious primary molar tooth in a dentally-anxious child patient. Dental extraction was an option for a tooth demonstrating pulpal symptoms in both non-anxious and dentally-anxious patients.

  9. Functional outcome following proximal humeral interlocking system plating for displaced proximal humeral fractures

    OpenAIRE

    Thyagarajan David; Haridas Samarth; Jones Denise; Dent Colin; Evans Richard; Williams Rhys

    2009-01-01

    Aim: To assess the functional outcome following internal fixation with the PHILOS (proximal humeral interlocking system) for displaced proximal humeral fractures. Patients and Methods: We reviewed 30 consecutive patients treated surgically with the proximal humeral locking plate for a displaced proximal humeral fracture. Functional outcome was determined using the American Shoulder and Elbow Society (ASES) score and Constant Murley score. Results: Average age of the patients was 58 years...

  10. Best Proximity Points for a New Class of Generalized Proximal Mappings

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    Tayyab Kamran

    2017-03-01

    Full Text Available The best proximity points are usually used to find the optimal approximate solution of the operator equation Tx = x, when T has no fixed point. In this paper, we prove some best proximity point theorems for nonself multivalued operators, following the foot steps of Basha and Shahzad [Best proximity point theorems for generalized proximal contractions, Fixed Point Theory Appl., 2012, 2012:42].

  11. Preliminary phytochemical screening, proximate and elemental ...

    African Journals Online (AJOL)

    The seed powder of Moringa oleifera was analysed for its phytochemical, proximate and elemental composition using Folin-Denis spectrophotometric method, gravimetric method and energy dispersing X-ray fluorescence (EDXRF) transmission emission technique respectively. The seed powder had the following proximate ...

  12. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

    Colenbrander, R. J.; Struijs, P. A. A.; Ultee, J. M.

    2005-01-01

    A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. The proximal fibular

  13. Grouping by Proximity in Haptic Contour Detection

    Science.gov (United States)

    Overvliet, Krista E.; Krampe, Ralf Th.; Wagemans, Johan

    2013-01-01

    We investigated the applicability of the Gestalt principle of perceptual grouping by proximity in the haptic modality. To do so, we investigated the influence of element proximity on haptic contour detection. In the course of four sessions ten participants performed a haptic contour detection task in which they freely explored a haptic random dot display that contained a contour in 50% of the trials. A contour was defined by a higher density of elements (raised dots), relative to the background surface. Proximity of the contour elements as well as the average proximity of background elements was systematically varied. We hypothesized that if proximity of contour elements influences haptic contour detection, detection will be more likely when contour elements are in closer proximity. This should be irrespective of the ratio with the proximity of the background elements. Results showed indeed that the closer the contour elements were, the higher the detection rates. Moreover, this was the case independent of the contour/background ratio. We conclude that the Gestalt law of proximity applies to haptic contour detection. PMID:23762364

  14. Proximate analysis on four edible mushrooms ADEDAYO ...

    African Journals Online (AJOL)

    Michael Horsfall

    Vol. 15 (1) 9 - 11. Full-text Available Online at www.bioline.org.br/ja. Proximate analysis on four edible mushrooms. ADEDAYO, MAJEKODUNMI RACHEL. Nigerian Stored Product Research Institute, P.M.B.3032, Kano. ABSTRACT: Proximate study was conducted on four edible mushrooms commonly found in farmlands in.

  15. Proximate Sources of Collective Teacher Efficacy

    Science.gov (United States)

    Adams, Curt M.; Forsyth, Patrick B.

    2006-01-01

    Purpose: Recent scholarship has augmented Bandura's theory underlying efficacy formation by pointing to more proximate sources of efficacy information involved in forming collective teacher efficacy. These proximate sources of efficacy information theoretically shape a teacher's perception of the teaching context, operationalizing the difficulty…

  16. Phytochemical screening, proximate analysis and anticonvulsant ...

    African Journals Online (AJOL)

    Spigelia anthelmia is used traditionally in Southern Nigeria for the treatment of infant convulsion and epilepsy. This study investigated the phytochemical constituents, proximate analysis and anticonvulsant effect of the methanolic extract of Spigelia anthelmia. Phytochemical evaluation and proximate analysis was carried ...

  17. Detection method of proximal caries using line profile in digital intra-oral radiography

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yong Suk; Kim, Gyu Tae; Hwang, Eui Hwan; Lee, Min Ja; Choi, Sam Jin; Park, Hun Kuk [Department of Oral and Maxillofacial Radiology, School of Dentistry and Institute of Oral Biology, Kyung Hee University, Seoul (Korea, Republic of); Park, Jeong Hoon [Department of Biomedical Engineering, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2009-12-15

    The purpose of this study was to investigate how to detect proximal caries using line profile and validate linear measurements of proximal caries lesions by basic digital manipulation of radiographic images. The X-ray images of control group (15) and caries teeth (15) from patients were used. For each image, the line profile at the proximal caries-susceptible zone was calculated. To evaluate the contrast as a function of line profile to detect proximal caries, a difference coefficient (D) that indicates the relative difference between caries and sound dentin or intact enamel was measured. Mean values of D were 0.0354 {+-} 0.0155 in non-caries and 0.2632 {+-} 0.0982 in caries (p<0.001). The mean values of caries group were higher than non-caries group and there was correlation between proximal dental caries and D. It is demonstrated that the mean value of D from caries group was higher than that of control group. From the result, values of D possess great potentiality as a new detection parameter for proximal dental caries.

  18. Meniscal Ramp Lesions

    Science.gov (United States)

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  19. Monitoring pigmented skin lesions

    Science.gov (United States)

    Wallace, Vincent P.; Bamber, Jeffery C.; Ott, Robert J.; Crawford, Diane C.; Mortimer, Peter S.

    2002-06-01

    The rising incidence of skin cancer has led to an increase in the number of patients with skin lesions that require diagnosis, mostly using subjective visual examination. Successful treatment depends on early diagnosis. Unfortunately diagnostic accuracy, even by experts, can be as low as 56%; therefore, an accurate, objective diagnostic aid is greatly needed. Reflectance characteristics of pigmented skin lesions were documented to evaluate their diagnostic potential. Reflectance spectra in the wavelength range 320-1100nm were obtained from 260 lesions. Differences between spectra from benign and malignant lesions were utilized by extracting features with the best discriminating power. Discrimination was evaluated using two techniques: multivariate statistical analysis and artificial neural networks, using histology as the standard. Each technique was tested in a blind study and assessed in terms of its ability to diagnose new cases and compared to the clinical diagnosis. The artificial neural network achieved the best diagnostic performance for discriminating between malignant melanoma and benign nevi, having a sensitivity of 100% and a specificity of 65%. Utilization of visible and infrared techniques for monitoring skin lesions has lead to improvements in diagnostic accuracy. We conclude that these techniques are worthy of further development and evaluation in clinical practice as a screening tool.

  20. Intramedullary compression device for proximal ulna fracture.

    Science.gov (United States)

    Hong, Choon Chiet; Han, Fucai; Decruz, Joshua; Pannirselvam, Vinodhkumar; Murphy, Diarmuid

    2015-02-01

    Proximal ulna fractures account for 20% of all proximal forearm fractures. Many treatment options are available for such fractures, such as cast immobilisation, plate and screw fixation, tension band wiring and intramedullary screw fixation, depending on the fracture pattern. Due to the subcutaneous nature of the proximal forearm, it is vulnerable to open injuries over the dorsal aspect of the proximal ulna. This may in turn prove challenging, as it is critical to obtain adequate soft tissue coverage to reduce the risk of implant exposure and bony infections. We herein describe a patient with a Gustillo III-B open fracture of the proximal ulna, treated with minimally invasive intramedullary screw fixation using a 6.0-mm cannulated headless titanium compression screw (FusiFIX, Péronnas, France).

  1. Comparative analisys of three different diagnostic methods to evaluate carious activity in a community basis Análise comparativa de três métodos de diagnóstico de atividade cariosa em âmbito coletivo

    Directory of Open Access Journals (Sweden)

    Luciana Cardoso

    2005-06-01

    Full Text Available The present research has made a comparison between three distinct methods to evaluate carious activity in a community basis. The studied method was based in a modified DMFS/dmfs index including non-cavitated lesions. Two factors were analyzed: the possible reproduction of the inclusion of carious activity criteria and the presence of bacterial plaque. Thus, the three study groups presented with plaque, after supervised self-performed plaque removal with dental toothbrush and without plaque after professional prophylaxis, which corresponded to three diagnostic methods. The three exams took place one week apart from each other. For this analysis, a modified DMFS/dmfs index was proposed with alterations in diagnostic criteria due to the inclusion of carious activity parameters. The study was performed in a group of 30 children aged 11 years old. According to the results, the diagnostic method for carious activity in the three situations was reproducible and can be considered a proper approach to perform caries diagnosis in a community basis.Este trabalho realizou uma comparação entre três métodos distintos para avaliação da atividade cariosa em âmbito coletivo. Os métodos estudados foram baseados em um CPOS/ceos modificado, com inclusão de lesões não cavitadas. Os fatores estudados foram a possibilidade de reprodutibilidade da inclusão de critérios de atividade cariosa, bem como a presença de placa bacteriana. Portanto, os três grupos avaliados apresentavam-se com placa bacteriana; com remoção de placa bacteriana pelo próprio paciente (sob supervisão com escova dental e sem placa bacteriana, após profilaxia profissional, que correspondiam aos três métodos de diagnóstico. Os três exames foram realizados com intervalo de uma semana entre cada um. Para esta análise, propõe-se um índice CPOS/ceos modificado com alterações nos critérios de diagnóstico através da inclusão de parâmetros de atividade de doença. O estudo

  2. A proximal femur aneurysmal bone cyst resulting in amputation: a rare case report.

    Directory of Open Access Journals (Sweden)

    Khodamorad Jamshidi

    2015-02-01

    Full Text Available Aneurysmal bone cyst (ABC is blood filled expansile cystic lesion that most commonly occurs in patients during the second decade of their lives. Traditionally it has been described as a benign lesion but can be locally aggressive and result in the destruction of the involved bone. Treatment methods include surgical excision and curettage with or without bone grafting. We report a proximal femur aneurysmal bone cyst, which resulted in the amputation of the lower extremity, even though all available classic methods of treatment were applied for it.

  3. Suspected Acoustic Neuroma Demyelinating Lesions.

    Science.gov (United States)

    Zhou, Xiuming; Wang, Xiang; Zhang, Xiejun; Wu, Qiang; Huang, Guodong; Li, Weiping

    2016-11-01

    Demyelinating lesions were recognized as a kind of rare central nervous system demyelinating lesion. The diagnosis and differential diagnosis of demyelinating lesions is difficult. Once the diagnosis was delayed or incorrect, it will make a great impact on patients.Demyelinating lesions often involved in young and middle-aged, but this patient was the aged, which is rare.

  4. Antimicrobial photodynamic therapy: a promise candidate for caries lesions treatment.

    Science.gov (United States)

    Diniz, Ivana Márcia Alves; Horta, Ivay Diniz; Azevedo, Cynthia Soares; Elmadjian, Thaís Regina; Matos, Adriana Bona; Simionato, Maria Regina Lorenzetti; Marques, Márcia Martins

    2015-09-01

    Antibacterial photodynamic therapy (aPDT) is a promising adjunctive therapy to the treatment of caries lesions, mainly in the minimally invasive approach to preserve dental tissue and favor its repair. Here we analyzed both the efficacy of aPDT in reducing the bacterial load in cariogenic biofilms and the indirect effect of noxious components produced by aPDT on the viability of dental pulp cells. The aPDT protocol was established using 0.025g/mL methylene blue (MB) and 5min pre-irradiation time. A continuous-wave diode laser (660nm, 0.04cm(2) spot size, 40mW, 60s, 60J/cm(2) and 2.4J) was used in punctual and distance modes to excite the MB. The protocol was first tested against Streptococcus mutans (U159) biofilms produced in 96-well microplates, and then evaluated on caries-like affected human dentin discs of three thicknesses. The number of colony forming units (CFU) was compared between groups. Discs were then assembled in metallic inserts to produce an artificial pulp chamber and allow investigation of the indirect effects of aPDT on dental pulp cells by the 3-(4,5-dimethylthiazol-2-yl)-diphenyltetrazolium bromide (MTT) assay. Data were analyzed using Student's t test or one-way analysis of variance (ANOVA) followed by the Tukey's test at a significance level of 5%. Bacterial load reduction was observed in biofilms produced both in the microplates (pcaries-like affected dentin discs (81.01% or mean reduction of log21.010±0.1548; p=0.0029). The cell viability of aPDT and control group was similar (p>0.05). aPDT may be considered a promise adjunctive therapy for deep carious lesions. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Proximal Alternating Direction Method with Relaxed Proximal Parameters for the Least Squares Covariance Adjustment Problem

    Directory of Open Access Journals (Sweden)

    Minghua Xu

    2014-01-01

    Full Text Available We consider the problem of seeking a symmetric positive semidefinite matrix in a closed convex set to approximate a given matrix. This problem may arise in several areas of numerical linear algebra or come from finance industry or statistics and thus has many applications. For solving this class of matrix optimization problems, many methods have been proposed in the literature. The proximal alternating direction method is one of those methods which can be easily applied to solve these matrix optimization problems. Generally, the proximal parameters of the proximal alternating direction method are greater than zero. In this paper, we conclude that the restriction on the proximal parameters can be relaxed for solving this kind of matrix optimization problems. Numerical experiments also show that the proximal alternating direction method with the relaxed proximal parameters is convergent and generally has a better performance than the classical proximal alternating direction method.

  6. Transillumination and HDR Imaging for Proximal Caries Detection.

    Science.gov (United States)

    Lederer, A; Kunzelmann, K H; Hickel, R; Litzenburger, F

    2018-02-01

    The purpose was to develop an in vitro model for the validation of near-infrared transillumination (NIRT) for proximal caries detection, to enhance NIRT with high-dynamic-range imaging (HDRI), and to compare both methods, using micro-computed tomography (µCT) as a reference standard. Both proximal surfaces of 53 healthy or decayed permanent human teeth were examined using the Diagnocam (DC) (KaVo) and NIRT with HDRI (NIRT-HDRI). NIRT was combined with HDRI to improve the diagnostic performance by reducing under- and overexposed image areas. For NIRT-HDRI, an exposure series was captured and merged into a single HDR image. A classification was applied according to lesion depth. All surfaces were assessed twice by 2 trained examiners, and additionally with µCT for validation. The Kappa statistic was used to calculate inter-rater reliability and agreement between DC and NIRT-HDRI. Inter-rater reliability (weighted Kappa, wκ) showed very good agreement for the DC (0.90) and NIRT-HDRI (0.96). The overall agreement (wκ) was almost perfect (0.85). In the individual categories (0 to 4), the agreement (simple Kappa) ranged from almost perfect (category 4) to moderate (1 and 2) to substantial (categories 0 and 3). Sensitivity and specificity of sound surfaces, enamel, and dentin caries ranged from 0.57 to 0.99 and were similar for both methods in the different categories. NIRT-HDRI had a higher sensitivity for sound surfaces and enamel caries, as well as a higher specificity for dentin caries. Regarding the obtained images, HDRI allowed for the detection of caries within a greater range of luminance levels, resulting in a more detailed visualization of structures without under- or overexposure. However, HDRI this did not improve the diagnostics significantly. Distinguishing between a processed demineralized enamel and dentin lesions appears to be a problem specific to NIRT and cannot be balanced using HDRI.

  7. Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars.

    Science.gov (United States)

    Huth, K C; Neuhaus, K W; Gygax, M; Bücher, K; Crispin, A; Paschos, E; Hickel, R; Lussi, A

    2008-12-01

    To determine the clinical performance of a laser fluorescence device (DIAGNOdent pen, KaVo) to discriminate between different occlusal caries depths (D(0)-D(1-4); D(0-2)-D(3,4)) in permanent molars. In this prospective, randomized two-centre-study 120 sound/uncavitated carious sites in 120 patients were measured after visual and radiographic caries assessment. In cases of operative intervention (n=86), the lesion depths after caries removal were recorded (reference). In cases of preventive intervention (n=34), the sites were reassessed visually/radiographically after 12 months to verify the status assessed before (reference). The discrimination performance was determined statistically (Mann-Whitney test, Spearman's rho coefficient, and areas under the receiver operating characteristic curves (AUCs)). Sensitivities (SE) and specificities (SP) were plotted as a function of the measured values and cut-off values for the mentioned thresholds suggested. Sound sites (n=13) had significantly minor fluorescence values than carious sites (n=107) (Pcaries (n=63) compared to dentinal caries (n=57). The AUCs for the same discriminations were 0.92 and 0.78 (Pcaries depths was calculated (rho=+0.57, P=0.01). Within this study, the device's discrimination performance for different caries depths was moderate to very good and it may be recommended as adjunct tool in the diagnosis of occlusal caries.

  8. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides

    Directory of Open Access Journals (Sweden)

    Patrick Schmidlin

    2016-02-01

    Full Text Available ABSTRACT Objectives To assess the re-hardening potential of enamel matrix derivatives (EMD and self-assembling peptides in vitro, hypothesizing that these materials may increase the mineralization of artificial carious lesions and improve hardness profiles. Material and Methods Forty-eight enamel samples were prepared from extracted bovine lower central incisors. After embedding and polishing, nail varnish was applied, leaving a defined test area. One third of this area was covered with a flowable composite (non-demineralized control. The remaining area was demineralized in an acidic buffer solution for 18 d to simulate a carious lesion. Half the demineralized area was then covered with composite (demineralized control, while the last third was left open for three test and one control treatments: (A Application of enamel-matrix proteins (EMD - lyophilized protein fractions dissolved in acetic acid, Straumann, (B self-assembling peptides (SAP, Curodont, or (C amine fluoride solution (Am-F, GABA for 5 min each. Untreated samples (D served as control. After treatment, samples were immersed in artificial saliva for four weeks (remineralization phase and microhardness (Knoop depth profiles (25-300 µm were obtained at sections. Two-way ANOVA was calculated to determine differences between the areas (re-hardening or softening. Results Decalcification resulted in significant softening of the subsurface enamel in all groups (A-D. A significant re-hardening up to 125 µm was observed in the EMD and SAP groups. Conclusions This study showed that EMD and SAP were able to improve the hardness profiles when applied to deep demineralized artificial lesions. However, further research is needed to verify and improve this observed effect.

  9. Effect of Repeated Acid Challenges on the Color Stability of Resin-Infiltrated Enamel White Spot Lesions

    Science.gov (United States)

    2016-06-01

    Gomez J, Lara JS, Cortes A. (2012). Infiltrating/sealing proximal caries lesions: a 3-year randomized clinical trial. Journal of Dental Research, 91...infiltration in masking white spot lesions and inhibiting caries , few studies have examined the durability of resin-infiltration against acid challenges. We...infiltration in masking white spot lesions and inhibiting caries , few studies have examined the durability of resin-infiltration against acid challenges. We

  10. Interproximal contact points and proximal caries in posterior primary teeth.

    Science.gov (United States)

    Allison, Paul J; Schwartz, Stephane

    2003-01-01

    The purpose of this study was to investigate the hypothesis that the risk of proximal caries in posterior primary teeth is higher when interproximal contact points are closed than when they are open. A cross-sectional study design was used with a sample of 286 children aged 24 to 72 months (mean age 54 months +/- 16 months). Children with any permanent dentition were excluded. Caries (defined as a lesion halfway through enamel or further) was assessed radiographically by a single dentist. The open/closed nature of contact points was assessed by a different dentist through resistance to dental floss. Data concerning known risk factors and indicators for caries were also collected. Analyses were performed at the level of the contact point, comparing the same contact points in different children. Multiple logistic regression was used to asses the relationship between open/closed status and caries status for each posterior contact point. In 7 of the 8 contact points examined, the odds for caries were significantly increased when contact points were dosed. This research suggests that the risk for proximal caries in the posterior primary dentition is raised if contact points are dosed compared to those that are open.

  11. Mallory-Weiss lesions

    DEFF Research Database (Denmark)

    Lange, J.; Jensen, Lone Susanne

    2010-01-01

    Introduction: Malory-Weiss syndrome (MW) has been known since 1929. Only few studies exist which focus on the prognosis of the lesion. No Danish MW data are available. The purpose of the study was to describe the demographics of patients admitted with an MW to a Danish surgical unit during a 5-year...

  12. Common conjunctival lesions

    African Journals Online (AJOL)

    where vision is affected, if the pterygium looks suspicious or if it is cosmetically unacceptable. Limbal dermoid (Fig. 6). A limbal dermoid is a congenital tumour that usually occurs at the inferotemporal limbus or globe. ... Such lesions may be multiple and appear in the caruncle or fornix. e sessile papilloma is more frequently ...

  13. White matter lesion progression

    DEFF Research Database (Denmark)

    Hofer, Edith; Cavalieri, Margherita; Bis, Joshua C

    2015-01-01

    BACKGROUND AND PURPOSE: White matter lesion (WML) progression on magnetic resonance imaging is related to cognitive decline and stroke, but its determinants besides baseline WML burden are largely unknown. Here, we estimated heritability of WML progression, and sought common genetic variants asso...

  14. Genital lesions following bestiality

    Directory of Open Access Journals (Sweden)

    Mittal A

    2000-01-01

    Full Text Available A 48-year-old man presented with painful genital lesions with history of bestiality and abnor-mal sexual behaviour. Examination revealed multiple irregular tender ulcers and erosions, with phimosis and left sided tender inguinal adenopathy. VDRL, TPHA, HIV-ELISA were negative. He was treated with ciprofloxacin 500mg b.d. along with saline compresses with complete resolution.

  15. Subclinical ischemic events in patients undergoing carotid artery stent placement: comparison of proximal and distal protection techniques.

    Science.gov (United States)

    Aytac, Emrah; Gürkaş, Erdem; Akpinar, Cetin Kursad; Saleem, Muhammad A; Qureshi, Adnan I

    2017-10-01

    To determine the relative effectiveness of proximal and distal protection in prevention of cerebral ischemic events during carotid artery stent (CAS) placement using diffusion-weighted MRI (DW-MRI). We analyzed data from patients who had undergone DW-MRI before and within 24 hours of CAS for symptomatic internal carotid artery (ICA) stenosis (with last ischemic events within 3 months). The study was performed prospectively; patients were not randomized, and were treated either with a proximal balloon occlusion system (Mo.Ma; Invatec, Roncadelle, Italy) or filter-type distal protection device (Spider device; ev3, Plymouth, Minnesota, USA). Of the 45 patients (mean age±SD: 66.9±9.8 years; 73.3% were men) who underwent CAS, 19 had proximal protection and 26 distal protection. New ischemic lesions were detected in 26/45 patients on DW-MRI scans obtained within 24 hours after CAS. The proportion of patients with new lesions on DW-MRI at 24 hours was not different between the two groups (47.4% vs 65.4% for proximal and distal protection, respectively). The mean number of new ischemic lesions on post-CAS DW-MRI was non-significantly higher in patients who underwent CAS with distal protection (2.80±3.54 for proximal protection vs 4.96±5.11 for distal protection; p=0.12). The proportion of patients with new lesions >1 cm did not differ between the two groups (5.3% for proximal protection vs 11.5% for distal protection; p=0.62). There was no difference in the rates of ischemic stroke between patients who underwent CAS treatment using proximal and distal protection (5.3% vs 7.7%; p=1.000). We found a relatively high rate of new ischemic lesions in patients undergoing CAS with cerebral protection. There was no difference in the proportion of patients with new lesions between patients treated using distal protection and those treated using proximal protection. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

  16. A quantitative light microscopic study of the odontoblast and subodontoblastic reactions to active and arrested enamel caries without cavitation

    DEFF Research Database (Denmark)

    Bjørndal, L.; Darvann, T.A.; Thylstrup, Anders

    1998-01-01

    Carious lesions, Computerized histomorphology, Dental pulp, Dentine, Enamel, Microradiography, Odontoblast......Carious lesions, Computerized histomorphology, Dental pulp, Dentine, Enamel, Microradiography, Odontoblast...

  17. The Life Saving Effects of Hospital Proximity

    DEFF Research Database (Denmark)

    Bertoli, Paola; Grembi, Veronica

    We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from......) increases the fatality rate by 13.84% on the sample average. This is equal to a 0.92 additional death per every 100 accidents. We show that OLS estimates provide a downward biased measure of the real effect of hospital proximity because they do not fully solve spatial sorting problems. Proximity matters...

  18. Imaging of noncarious cervical lesions by means of a fast swept source optical coherence tomography system

    Science.gov (United States)

    Stoica, Eniko T.; Marcauteanu, Corina; Bradu, Adrian; Sinescu, Cosmin; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil Florin; Podoleanu, Adrian Gh.

    2014-01-01

    Non-carious cervical lesions (NCCL) are defined as the loss of tooth substance at the cemento-enamel junction and are caused by abrasion, erosion and/or occlusal overload. In this paper we proved that our fast swept source OCT system is a valuable tool to track the evolution of NCCL lesions in time. On several extracted bicuspids, four levels of NCCL were artificially created. After every level of induced lesion, OCT scanning was performed. B scans were acquired and 3D reconstructions were generated. The swept source OCT instrument used in this study has a central wavelength of 1050 nm, a sweeping range of 106 nm (measured at 10 dB), an average output power of 16 mW and a sweeping rate of 100 kHz. A depth resolution determined by the swept source of 12 μm in air was experimentally obtained. NCCL were measured on the B-scans as 2D images and 3D reconstructions (volumes). For quantitative evaluations of volumes, the Image J software was used. By calculating the areas of the amount of lost tissue corresponding to each difference of Bscans, the final volumes of NCCL were obtained. This swept source OCT method allows the dynamic diagnosis of NCCL in time.

  19. High contrast optical imaging methods for image guided laser ablation of dental caries lesions

    Science.gov (United States)

    LaMantia, Nicole R.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    Laser based methods are well suited for automation and can be used to selectively remove dental caries to minimize the loss of healthy tissues and render the underlying enamel more resistant to acid dissolution. The purpose of this study was to determine which imaging methods are best suited for image-guided ablation of natural non-cavitated carious lesions on occlusal surfaces. Multiple caries imaging methods were compared including near-IR and visible reflectance and quantitative light fluorescence (QLF). In order for image-guided laser ablation to be feasible, chemical and physical modification of tooth surfaces due to laser irradiation cannot greatly reduce the contrast between sound and demineralized dental hard tissues. Sound and demineralized surfaces of 48 extracted human molar teeth with non-cavitated lesions were examined. Images were acquired before and after laser irradiation using visible and near-IR reflectance and QLF at several wavelengths. Polarization sensitive-optical coherence tomography was used to confirm that lesions were present. The highest contrast was attained at 1460-nm and 1500-1700-nm, wavelengths coincident with higher water absorption. The reflectance did not decrease significantly after laser irradiation for those wavelengths.

  20. Morel-Lavallee lesion.

    Science.gov (United States)

    Li, Hui; Zhang, Fangjie; Lei, Guanghua

    2014-01-01

    To review current knowledge of the Morel-Lavallee lesion (MLL) to help clinicians become familiar with this entity. Familiarization may decrease missed diagnoses and misdiagnoses. It could also help steer the clinician to the proper treatment choice. A search was performed via PubMed and EMBASE from 1966 to July 2013 using the following keywords: Morel-Lavallee lesion, closed degloving injury, concealed degloving injury, Morel-Lavallee effusion, Morel-Lavallee hematoma, posttraumatic pseudocyst, posttraumatic soft tissue cyst. Chinese and English language literatures relevant to the subject were collected. Their references were also reviewed. Morel-Lavallee lesion is a relatively rare condition involving a closed degloving injury. It is characterized by a filled cystic cavity created by separation of the subcutaneous tissue from the underlying fascia. Apart from the classic location over the region of the greater trochanter, MLLs have been described in other parts of the body. The natural history of MLL has not yet been established. The lesion may decrease in volume, remain stable, enlarge progressively or show a recurrent pattern. Diagnosis of MLL was often missed or delayed. Ultrasonography, computed tomography, and magnetic resonance imaging have great value in the diagnosis of MLL. Treatment of MLL has included compression, local aspiration, open debridement, and sclerodesis. No standard treatment has been established. A diagnosis of MLL should be suspected when a soft, fluctuant area of skin or chronic recurrent fluid collection is found in a region exposed to a previous shear injury. Clinicians and radiologists should be aware of both the acute and chronic appearances to make the correct diagnosis. Treatment decisions should base on association with fractures, the condition of the lesion, symptom and desire of the patient.

  1. Comparison of the Level of Substance P and Neurokinin A in Gingival Crevicular Fluid of Sound and Symptomatic Carious Primary Teeth by ELISA

    Directory of Open Access Journals (Sweden)

    Alireza Heidari

    2017-10-01

    Full Text Available Objectives: Pulpal inflammation is often associated with odontogenic pain. Dental pulp is abundantly innervated with sensory fibers encompassing neuropeptides. Neurokinin A (NKA and substance P (SP are important neuropeptides in the dental pulp that can cause neurogenic inflammation. Since no previous study has assessed dental pulp neuropeptides in children, this study aimed to compare the level of NKA and SP in gingival crevicular fluid (GCF of sound and symptomatic carious primary teeth.Materials and Methods: Samples of GCF were obtained of 20 sound and 20 painful carious primary teeth. Enzyme-linked immunosorbent assay (ELISA was used to quantify neuropeptides in GCF. Data were analyzed using paired t-test, ANOVA, Kolmogorov-Smirnov test and correlation coefficient test.Results: A significant difference was noted in the level of NKA in GCF of painful and sound teeth (2.23 pg/ml in painful, and 1.84 pg/ml in sound teeth, P<0.05. The difference between the two groups regarding SP was not significant (2.23 pg/ml in painful, and 2.02 pg/ml in sound teeth, P>0.05.Conclusions: The results showed that the level of NKA and SP was higher in GCF of painful teeth compared to that of sound teeth. This difference was statistically significant with regard to NKA. Thus, these neuropeptides can serve as indicators for pathological activities in teeth with symptomatic irreversible pulpitis.

  2. Proximity and Collaboration in European Nanotechnology

    NARCIS (Netherlands)

    Cunningham, S.W.; Werker, C.

    2011-01-01

    Collaborations are particularly important for the development and deployment of technology. We analyze the influence of organizational, technological and geographical proximity on European nanotechnology collaborations with the help of a publication dataset and additional geographical information.

  3. Promoting proximal formative assessment with relational discourse

    Science.gov (United States)

    Scherr, Rachel E.; Close, Hunter G.; McKagan, Sarah B.

    2012-02-01

    The practice of proximal formative assessment - the continual, responsive attention to students' developing understanding as it is expressed in real time - depends on students' sharing their ideas with instructors and on teachers' attending to them. Rogerian psychology presents an account of the conditions under which proximal formative assessment may be promoted or inhibited: (1) Normal classroom conditions, characterized by evaluation and attention to learning targets, may present threats to students' sense of their own competence and value, causing them to conceal their ideas and reducing the potential for proximal formative assessment. (2) In contrast, discourse patterns characterized by positive anticipation and attention to learner ideas increase the potential for proximal formative assessment and promote self-directed learning. We present an analysis methodology based on these principles and demonstrate its utility for understanding episodes of university physics instruction.

  4. Ammonia transport in the proximal tubule.

    Science.gov (United States)

    Hamm, L L; Simon, E E

    1990-01-01

    The transport of ammonia in the proximal tubule is a complex interaction of a number of processes. Ammonia transport in the proximal tubule is clearly bidirectional; ammonia is secreted into the early proximal tubule lumen, but later in the proximal tubule, efflux out of the lumen may result in net ammonia reabsorption. Two mechanisms of ammonia transport have clearly been established: NH3 diffusion and NH4+ transport on the Na(+)-H+ exchanger. The relative contribution of these pathways to ammonia transport is still unsettled. Other pathways for ammonia transport, particularly NH4+ efflux out of the lumen, may be important as well. A variety of factors may modulate ammonia transport: plasma, cell and luminal pH, luminal flow rate, luminal potassium, and angiotensin II. Each of these factors also alters ammonia production rates and in most circumstances, ammonia transport appears to follow ammonia production rates.

  5. Proximate composition and cholesterol concentrations of ...

    African Journals Online (AJOL)

    STORAGESEVER

    2009-05-18

    DWB) for raw and fried samples, respectively, but decreased to 295.20 ... Key words: Rhynchophorus phoenicis, Oryctes monoceros, proximate composition, cholesterol, heat treatment. INTRODUCTION. Insects have played ...

  6. COMPARATIVE ANALYSIS OF PROXIMATE COMPOSITIONS OF ...

    African Journals Online (AJOL)

    Babatunde Emmanuel

    2011-10-06

    Oct 6, 2011 ... Fish allows for protein improved nutrition in that it has a high biological value in terms of high ... marine algae upon which the fish feed [11]. ... Proximate composition of catfish Clarias gariepinus and Tarpon atlanticus were.

  7. Methods dentists use to diagnose primary caries lesions prior to restorative treatment: findings from The Dental PBRN.

    Science.gov (United States)

    Rindal, D Brad; Gordan, Valeria V; Litaker, Mark S; Bader, James D; Fellows, Jeffrey L; Qvist, Vibeke; Wallace-Dawson, Martha C; Anderson, Mary L; Gilbert, Gregg H

    2010-12-01

    To (1) quantify the diagnostic techniques used by Dental Practice-Based Research Network (DPBRN) dentists before they decide to treat primary caries lesions surgically and (2) examine whether certain dentist, practice, and patient characteristics are associated with their use. A total of 228 DPBRN dentists recorded information on 5676 consecutive restorations inserted due to primary caries lesions on 3751 patients. Practitioner-investigators placed a mean of 24.9 (SD=12.4) restorations. Lesions were categorised as posterior proximal, anterior proximal, posterior occlusal, posterior smooth, or anterior smooth. Techniques used to diagnose the lesion were categorised as clinical assessment, radiographs, and/or optical. Statistical analysis utilised generalised mixed-model ANOVA to account for the hierarchical structure of the data. By lesion category, the diagnostic technique combinations used most frequently were clinical assessment plus radiographs for posterior proximal (47%), clinical assessment for anterior proximal (51%), clinical assessment for posterior occlusal (46%), clinical assessment for posterior smooth (77%), and clinical assessment for anterior smooth (80%). Diagnostic technique was significantly associated with lesion category after adjusting for clustering in dentists (p<0.0001). These results - obtained during actual clinical procedures rather than from questionnaire-based hypothetical scenarios - quantified the diagnostic techniques most commonly used during the actual delivery of routine restorative care. Diagnostic technique varied by lesion category and with certain practice and patient characteristics. Copyright © 2010 Elsevier Ltd. All rights reserved.

  8. Role of dental restoration materials in oral mucosal lichenoid lesions

    Directory of Open Access Journals (Sweden)

    Rajneesh Sharma

    2015-01-01

    Full Text Available Background: Dental restorative materials containing silver-mercury compounds have been known to induce oral lichenoid lesions. Objectives: To determine the frequency of contact allergy to dental restoration materials in patients with oral lichenoid lesions and to study the effect of removal of the materials on the lesions. Results: Forty-five patients were recruited in three groups of 15 each: Group A (lesions in close contact with dental materials, Group B (lesions extending 1 cm beyond the area of contact and Group C (no topographic relationship. Thirty controls were recruited in two groups of 15 individuals each: Group D (oral lichenoid lesions but no dental material and Group E (dental material but no oral lichenoid lesions. Patch tests were positive in 20 (44.5% patients. Mercury was the most common allergen to elicit a positive reaction in eight patients, followed by nickel (7, palladium (5, potassium dichromate (3, balsam of Peru, gold sodium thiosulphate 2 and tinuvin (2 and eugenol (1, cobalt chloride (1 and carvone (1. Seven patients elicited positive response to more than one allergen. In 13 of 20 patients who consented to removal of the dental material, complete healing was observed in 6 (30%, marked improvement in 7 (35% and no improvement in 7 (35% patients. Relief of symptoms was usually observed 3 months after removal. Limitations: Limited number of study subjects and short follow up after removal/replacement of dental restoration materials are the main limitations of this study. Conclusion: Contact allergy to amalgam is an important etiologic factor in oral lichenoid lesions and removal of restorative material should be offered to patients who have lesions in close proximity to the dental material.

  9. Phytochemical screening, proximate analysis and acute toxicity ...

    African Journals Online (AJOL)

    Phytochemical screening, proximate analysis and acute toxicity studies were carried out on the leaf extract of Cola lepidota, in accordance with established standard procedures. The proximate analysis reveals a moisture content of 27.43 ± 3.11 % w/w, total ash value 9.32 ± 0.27 % w/w, acid insoluble ash 3.12 ± 1.05 % w/w ...

  10. Proximate, Mineral and Phytochemical Composition of Dioscorea ...

    African Journals Online (AJOL)

    ADOWIE PERE

    ABSTRACT: Proximate, mineral and phytochemical composition of Dioscorea dumetorum tubers was investigated using standard procedures. Proximate analysis included in g% dry weight: crude protein (6.44 ± 0.32), crude fat (0.75 ± 0.04), crude fibre (15.00 ± 0.56), total ash. (3.45 ± 0.20) and a moisture content of 70.04 ...

  11. Painful Spastic Hip Dislocation: Proximal Femoral Resection

    OpenAIRE

    Albiñana, Javier; Gonzalez-Moran, Gaspar

    2002-01-01

    The dislocated hip in a non-ambulatory child with spastic paresis tends to be a painful interference to sleep, sitting upright, and perineal care. Proximal femoral resection-interposition arthroplasty is one method of treatment for this condition. We reviewed eight hips, two bilateral cases, with a mean follow-up of 30 months. Clinical improvement was observed in all except one case, with respect to pain relief and sitting tolerance. Some proximal migration was observed in three cases, despit...

  12. The effect of wavelet and discrete cosine transform compression of digital radiographs on the detection of subtle proximal caries. ROC analysis.

    Science.gov (United States)

    Schulze, R K W; Richter, A; d'Hoedt, B

    2008-01-01

    The study compared diagnostic performances of 2 different image compression methods: JPEG (discrete cosine transform; Joint Photographic Experts Group compression standard) versus JPEG2000 (discrete wavelet transform), both at a compression ratio of 12:1, from the original uncompressed TIFF radiograph with respect to the detection of non-cavitated carious lesions. Therefore, 100 approximal surfaces of 50 tooth pairs were evaluated on the radiographs by 10 experienced observers using a 5-point confidence scale. Observations were carried out on a standardized viewing monitor under subdued light conditions. The proportion of diseased surfaces was balanced to approximately 50% to avoid bias. True caries status was assessed by serial ground sectioning and microscopic evaluation. A non-parametric receiver operating characteristic analysis revealed non-significant differences between the 3 image modalities, as computed from the critical ratios z not exceeding +/-2 (JPEG/JPEG2000, z = -0.0339; TIFF/JPEG2000, z = 0.251;TIFF/JPEG, z = 0.914). The mean area beneath the curve was highest for TIFF (0.604) followed by JPEG2000 (0.593) and JPEG (0.591). Both intra-rater and inter-rater agreement were significantly higher for TIFF (kappa(intra) = 0.52; kappa(inter) = 0.40) and JPEG2000 images (kappa(intra) = 0.49; kappa(inter) = 0.38) than for JPEG images (kappa(intra) = 0.33; kappa(inter) = 0.35). Our results indicate that image compression with typical compression algorithms at rates yielding storage sizes of around 50 kB is sufficient even for the challenging task of radiographic detection of non-cavitated carious approximal lesions. Copyright 2008 S. Karger AG, Basel.

  13. Proximity sensor system development. CRADA final report

    Energy Technology Data Exchange (ETDEWEB)

    Haley, D.C. [Oak Ridge National Lab., TN (United States); Pigoski, T.M. [Merrit Systems, Inc. (United States)

    1998-01-01

    Lockheed Martin Energy Research Corporation (LMERC) and Merritt Systems, Inc. (MSI) entered into a Cooperative Research and Development Agreement (CRADA) for the development and demonstration of a compact, modular proximity sensing system suitable for application to a wide class of manipulator systems operated in support of environmental restoration and waste management activities. In teleoperated modes, proximity sensing provides the manipulator operator continuous information regarding the proximity of the manipulator to objects in the workspace. In teleoperated and robotic modes, proximity sensing provides added safety through the implementation of active whole arm collision avoidance capabilities. Oak Ridge National Laboratory (ORNL), managed by LMERC for the United States Department of Energy (DOE), has developed an application specific integrated circuit (ASIC) design for the electronics required to support a modular whole arm proximity sensing system based on the use of capacitive sensors developed at Sandia National Laboratories. The use of ASIC technology greatly reduces the size of the electronics required to support the selected sensor types allowing deployment of many small sensor nodes over a large area of the manipulator surface to provide maximum sensor coverage. The ASIC design also provides a communication interface to support sensor commands from and sensor data transmission to a distributed processing system which allows modular implementation and operation of the sensor system. MSI is a commercial small business specializing in proximity sensing systems based upon infrared and acoustic sensors.

  14. Transformations through Proximity Flying: A Phenomenological Investigation

    Science.gov (United States)

    Holmbom, Maria; Brymer, Eric; Schweitzer, Robert D.

    2017-01-01

    Participation in extreme sports has been linked to personal transformations in everyday life. Descriptions of lived experience resulting from transformative experiences are limited. Proximity flying, a relatively new discipline involving BASE jumping with a wingsuit where participants fly close to solid structures, is arguably one of the most extreme of extreme sports. The aim of this paper, part of a larger phenomenological study on the lived experience of proximity flying, is to explicate the ways in which participating in proximity flying influences the everyday lives of participants. Interpretative phenomenological analysis was used to explicate the lived experience of six proximity pilots. An analysis of interview transcripts revealed three significant themes describing the lived experience of participants. First, experiences of change were described as positive and skills developed through proximity flying were transferable into everyday life. Second, transformative experiences were considered fundamental to participants’ perspectives on life. Third, experience of transformation influenced their sense of personal identity and facilitated flourishing in other aspects of everyday life. Participants were clear that their experiences in proximity flying facilitated a profound process of transformation which manifest as changes in everyday capabilities and behaviors, values and sense of identity. PMID:29104552

  15. Lesion progression in post-treatment persistent endodontic lesions.

    Science.gov (United States)

    Yu, Victoria Soo Hoon; Messer, Harold Henry; Shen, Liang; Yee, Robert; Hsu, Chin-ying Stephen

    2012-10-01

    Radiographic lesions related to root-filled teeth may persist for long periods after treatment and are considered to indicate failure of initial treatment. Persistent lesions are found in a proportion of cases, but information on lesion progression is lacking. This study examined the incidence of lesion improvement, remaining unchanged, and deterioration among persistent lesions in a group of patients recruited from a university-based clinic and identified potential predictors for lesion progression. Patients of a university clinic with persistent endodontic lesions at least 4 years since treatment and with original treatment radiographs available were recruited with informed consent. Data were obtained by interview and from dental records and clinical and radiographic examinations. Univariate and multivariate statistical analyses were carried out by using SPSS (version 19). One hundred fifty-one persistent lesions were identified in 114 patients. A majority of the lesions (107, 70.9%) received treatment between 4 and 5 years prior. Eighty-six lesions (57.0%) improved, 18 (11.9%) remained unchanged, and 47 (31.1%) deteriorated since treatment. Potential predictors for lesions that did not improve included recall lesion size, pain on biting at recall examination, history of a postobturation flare-up, and a non-ideal root-filling length (P < .05). Lesions that had persisted for a longer period appeared less likely to be improving (relative risk, 1.038; 95% confidence interval, 1.000-1.077). A specific time interval alone should not be used to conclude that a lesion will not resolve without intervention. This study identified several clinical factors that are associated with deteriorating persistent lesions, which should aid in identifying lesions that require further intervention. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  16. Predicting ischemic stroke after carotid artery stenting based on proximal calcification and the jellyfish sign.

    Science.gov (United States)

    Ichinose, Nobuhiko; Hama, Seiji; Tsuji, Toshio; Soh, Zu; Hayashi, Hideaki; Kiura, Yoshihiro; Sakamoto, Shigeyuki; Okazaki, Takahito; Ishii, Daizo; Shinagawa, Katsuhiro; Kurisu, Kaoru

    2017-07-07

    OBJECTIVE Carotid artery stenting (CAS) has been considered to prevent ischemic strokes caused by stenosis of the cervical carotid artery. The most common complication of CAS is new cerebral infarction. The authors have previously reported that the jellyfish sign-the rise and fall of the mobile component of the carotid plaque surface detected by carotid ultrasonography-suggests thinning and rupture of the fibrous cap over the unstable plaque content, such as the lipid-rich necrotic core or internal plaque hemorrhage. The authors' aim in the present study was to evaluate the risk of a new ischemic lesion after CAS by using many risk factors including calcification (size and location) and the jellyfish sign. METHODS Eighty-six lesions (77 patients) were treated with CAS. The presence of ischemic stroke was determined using diffusion-weighted imaging (DWI). Risk factors included calcification of the plaque (classified into 5 groups for size and 3 groups for location) and the jellyfish sign, among others. Multiple linear regression analysis (stepwise analysis and partial least squares [PLS] analysis) was conducted, followed by a machine learning analysis using an artificial neural network (ANN) based on the log-linearized gaussian mixture network (LLGMN). The additive effects of the jellyfish sign and calcification on ischemic stroke after CAS were examined using the Kruskal-Wallis test, followed by the Steel-Dwass test. RESULTS The stepwise analysis selected the jellyfish sign, proximal calcification (proximal Ca), low-density lipoprotein (LDL) cholesterol, and patient age for the prediction model to predict new DWI lesions. The PLS analysis revealed the same top 3 variables (jellyfish sign, proximal Ca, and LDL cholesterol) according to the variable importance in projection scores. The ANN was then used, showing that these 3 variables remained. The accuracy of the ANN improved; areas under the receiver operating characteristic curves of the stepwise analysis, the PLS

  17. Meniscal Ramp Lesions

    OpenAIRE

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LAPRADE, ROBERT F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and conse...

  18. Skin lesions in sadomasochism.

    Science.gov (United States)

    Sønderbo, K; Nyfors, A

    1986-01-01

    This paper presents the case of a 35-year-old man who consulted the department of venereology because of healing problems with some wounds caused by burning his skin perianally with cigarettes as part of a sexual satisfaction ritual. Knowledge of such lesions may be useful to physicians and social workers. Sadomasochism and 'offers' in the intimate-massage clinics in Copenhagen are surveyed.

  19. COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF THREE METHODS FOR PROXIMAL CARIES DIAGNOSIS – A CLINICAL STUDY.

    Directory of Open Access Journals (Sweden)

    Mirela Marinova-Takorova

    2014-06-01

    Full Text Available Aim: The aim of the presented study is to compare the effectiveness of the diagnosis with a dental microscope, laser fluorescence (DIAGNOcam and X-ray examination in proximal caries diagnosis. Material and methods: Thirty-eight adult patients were examined. They were first examined with a dental mirror and a probe, under magnification 6.4 times. After that a diagnosis with DIAGNOcam was performed. Bitewing X-ray images were administered. The data from the three diagnostic methods was compared using SPSS 16 package of Windows. The lesions that were diagnosed as involving dentin were then excavated which served as a confirmation of the diagnosis. Results: The results of the study showed that dentinal lesions were detected with a high degree of correlation with all three diagnostic methods. The visual examination seriously underestimated lesions involving only enamel. In these cases there was a good correlation between laser fluorescence and X-ray data. Conclusions: Based on the conducted study we could conclude that the diagnosis of proximal caries with DIAGNOcam is equivalent to X-ray, both being more accurate in cases with early lesions, compared to visual diagnosis.

  20. Skin lesion removal-aftercare

    Science.gov (United States)

    Shave excision - skin aftercare; Excision of skin lesions - benign aftercare; Skin lesion removal - benign aftercare; Cryosurgery - skin aftercare; BCC - removal aftercare; Basal cell cancer - removal aftercare; Actinic keratosis - removal aftercare; Wart - ...

  1. Morphological classifications of gastrointestinal lesions

    NARCIS (Netherlands)

    Vleugels, Jasper L. A.; Hazewinkel, Yark; Dekker, Evelien

    2017-01-01

    In the era of spreading adoption of gastrointestinal endoscopy screening worldwide, endoscopists encounter an increasing number of complex lesions in the gastrointestinal tract. For decision-making on optimal treatment, precise lesion characterization is crucial. Especially the assessment of

  2. Treatment of three- and four-part proximal humeral fractures with locking proximal humerus plate.

    Science.gov (United States)

    Sun, Jing-Cheng; Li, Yu-Lin; Ning, Guang-Zhi; Wu, Qiang; Feng, Shi-Qing

    2013-08-01

    The purpose of this study was to evaluate the effectiveness and complications of the locking proximal humerus plate to treat proximal humerus fractures. A retrospective clinical trial. Department of Orthopaedics, Tianjin Medical University General Hospital. Sixty-eight consecutive patients with three- or four-part fractures of the proximal humerus were treated with locking proximal humerus plates. The deltopectoral anterolateral acromial approach was used to the proximal humerus; open reduction and locking proximal humerus plate were applied. Constant Score was used to measure the shoulder functional recovery, and Visual Analog Scale (VAS) was used to measure subjective evaluation of pain. The radiology was observed. After average 26.7 months, the average Constant Score was 72.6 ± 13.2 points and the average VAS was 1.2 ± 0.8 points. All the complications such as screw perforation into the glenohumeral joint, screws loosening, soft tissue infections, avascular necrosis and delayed union occurred in eight cases (11.8 %). The effectiveness of the locking proximal humerus plate was similar to other published literatures on treating fractures of the proximal humerus; however, a lower complications rate in short follow-up time was observed in this study. It may potentially provide a favorable option for treating three- or four-part fractures of the proximal humerus. Dealing with each particular fracture pattern, surgeons should have a decision of appropriate way to internal fixation.

  3. Acute periodontal lesions.

    Science.gov (United States)

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  4. A disappearing neonatal skin lesion.

    LENUS (Irish Health Repository)

    Hawkes, Colin Patrick

    2012-01-31

    A preterm baby girl was noted at birth to have a firm, raised, non-tender skin lesion located over her right hip. She developed three similar smaller lesions on her ear, buttock and right knee. All lesions had resolved by 2 months of age.

  5. Effect of Er,Cr:YSGG Laser at Different Output Powers on the Micromorphology and the Bond Property of Non-Carious Sclerotic Dentin to Resin Composites.

    Directory of Open Access Journals (Sweden)

    Xiang Sun

    Full Text Available The objective of this study was to investigate the influence of Er,Cr:YSGG laser irradiated at different powers on the micromorphology and the bonding property of non-carious sclerotic dentin to resin composites.Two hundred bovine incisors characterized by non-carious sclerotic dentin were selected, and the seventy-two teeth of which for surface morphological analysis were divided into nine groups according to various treatments (A: the control group, B: only treated with the adhesive Adper Easy One, C: diamond bur polishing followed by Adper Easy One, D-I: Er,Cr:YSGG laser irradiating at 1W, 2W, 3W, 4W, 5W, 6W output power, respectively, followed by Adper Easy One. The surface roughness values were measured by the non-contact three-dimensional morphology scanner, then the surface micromorphologies of surfaces in all groups were assessed by scanning electron microscopy (SEM; meanwhile, Image Pro-Plus 6.0 software was used to measure the relative percentage of open tubules on SEM images. The rest, one hundred twenty-eight teeth for bond strength test, were divided into eight groups according to the different treatments (A: only treated with the adhesive Adper Easy One, B: diamond bur polishing followed by the above adhesive, C-H: Er,Cr:YSGG laser irradiating at 1 W, 2 W, 3 W, 4 W, 5 W, 6 W output power, respectively, followed by the above adhesive, and each group was subsequently divided into two subgroups according to whether aging is performed (immediately tested and after thermocycling. Micro-shear bond strength test was used to evaluate the bond strength.The 4W laser group showed the highest roughness value (30.84±1.93μm, which was statistically higher than the control group and the diamond bur groups (p<0.05. The mean percentages ((27.8±1.8%, (28.0±2.2%, (30.0±1.9% of open tubules area in the 4W, 5W, 6W group were higher than other groups (p<0.05. The 4W laser group showed the highest micro-shear bond strength not only in immediately

  6. Role of CT Colonography in Colonic Lesions and Its Correlation with Conventional Colonoscopic Findings.

    Science.gov (United States)

    Singh, Kunwarpal; Narula, Aparna Kaur; Thukral, Chuni Lal; Singh, Neeti Rajan; Singh, Amandeep; Kaur, Harmeet

    2015-04-01

    Preoperative evaluation in patients with colorectal carcinoma is essential for a correct therapeutic plan. Conventional colonoscopy has certain limitations including its inability to detect synchronous lesions in case of distal obstructive mass and inaccurate tumour localization. CT colonography combines cross sectional imaging with virtual colonoscopic images and offers a comprehensive preoperative evaluation in patients with colorectal carcinoma including detection of synchronous lesions with accurate segmental localization and loco regional staging. The objective was to determine the role of CT colonography in various colonic lesions and to correlate the findings with conventional colonoscopy and histopathological findings. This prospective study included 50 patients with clinical symptoms suspicious of colonic pathology. All the patients underwent both CT colonography and conventional colonoscopy on the same day. CT colonography was performed in supine and prone position. Considering histopathological and/or surgical findings as gold standard, sensitivity and specificity of both the modalities were calculated. Conventional colonoscopy missed two synchronous lesions proximal to occlusive mass and one lesion proximal to the anastomotic site; all were detected with CT colonography. One carpet lesion in rectum and one case of mild ulcerative colitis were missed by CT colonography. Sensitivity and specificity for detection of colorectal cancer were 97.56% and 100%, resp. with PPV and NPV of 100% and 93.75%, for CT colonography and 92.68% and 100%, respectively with PPV and NPV of 100% and 83.3% for conventional colonoscopy. Sensitivity for correct detection of acute and chronic ulcerative colitis of CT colonography was 66.6 % and 100 %, resp. CT colonography has higher sensitivity than conventional colonoscopy for detection of colorectal carcinoma, including its ability to detect abnormalities proximal to obstructing lesion, accurate segmental localization of

  7. Locking plate fixation for proximal humerus fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

  8. Lesiones deportivas Sports injuries

    Directory of Open Access Journals (Sweden)

    Isabel Cristina Gallego Ching

    2007-04-01

    Full Text Available El estrés generado por la práctica deportiva ha originado una mayor probabilidad de que los atletas presenten lesiones agudas y crónicas. En el ámbito mundial existen diferentes investigaciones acerca de la incidencia de lesiones deportivas. La comparación de sus resultados es difícil por las diferencias en las características de la población y en la forma de reportar los datos, que varía ampliamente entre los estudios (proporciones o tasas de incidencia o tasas por cada 100 ó 1.000 participantes o tasas por horas de juego o por número de partidos jugados. Las tasas varían entre 1,7 y 53 lesiones por 1.000 horas de práctica deportiva, entre 0,8 y 90,9 por 1.000 horas de entrenamiento, entre 3,1 y 54,8 por 1.000 horas de competición y de 6,1 a 10,9 por 100 juegos. La gran variación entre las tasas de incidencia se explica por las diferencias existentes entre los deportes, los países, el nivel competitivo, las edades y la metodología empleada en los estudios. Se ha definido la lesión deportiva como la que ocurre cuando los atletas están expuestos a la práctica del deporte y se produce alteración o daño de un tejido, afectando el funcionamiento de la estructura. Los deportes de contacto generan mayor riesgo de presentar lesiones; se destacan al respecto los siguientes: fútbol, rugby, baloncesto, balonmano, artes marciales y jockey. Las lesiones ocurren con mayor probabilidad en las competencias que en el entrenamiento. Stress generated by sports practice has increased the probability that athletes suffer from acute and chronic injuries. Worldwide, there have been many different investigations concerning the incidence of sport injuries. The different ways in which results have been presented makes it difficult to compare among them. Rates of sports injuries vary between 1.7 and 53 per 1.000 hours of sports practice; 0.8 and 90.9 per 1.000 hours of training; 3.1 and 54.8 per 1.000 hours of competition, and 6.1 and 10.9 per 100

  9. Study of genital lesions

    Directory of Open Access Journals (Sweden)

    Anand Kumar B

    2003-03-01

    Full Text Available A total of one hundred patients (75 males and 25 females age ranged from 17-65 years with genital lesions attending the STD clinic of Bowring and LC Hospitals Bangalore constituted the study group. Based on clinical features, the study groups were classified as syphilis (39, chancroid (30, herpes genitolis (13, condylomato lato (9, LGV (7t condylomata acuminata (5, genital scabies (3, granuloma inguinole (2 and genital candidiasis (1. In 68% microbiological findings confirmed the clinical diagnosis. Of the 100 cases 13% and 2% were positive for HIV antibodies and HbsAg respectively.

  10. Lesiones Deportivas En Corredores

    OpenAIRE

    Martínez Cano, Juan Pablo

    2012-01-01

    Hoy escribo como médico pero también como corredor. Por eso hay que empezar diciendo que los corredores somos unos apasionados con este deporte. Se convierte en una adicción. No se corre de vez en cuando, se hace por lo menos 5 días a la semana. Y los días que no corremos, quedamos incompletos. Eso es lo que siente un corredor, una sensación que parecería que sólo la entiende quien ha corrido. Tal vez por eso las lesiones deportivas son tan sentidas en este gremio d...

  11. Comparative study on the effectiveness of corticosteroid injections between trigger fingers with and without proximal interphalangeal joint flexion contracture.

    Science.gov (United States)

    Shinomiya, R; Sunagawa, T; Nakashima, Y; Kawanishi, Y; Masuda, T; Ochi, M

    2016-02-01

    Trigger fingers with proximal interphalangeal joint flexion contracture are suggested to have a poorer response to corticosteroid injection than those without contracture, though this has not been proven scientifically. We compared the clinical response to corticosteroid injection between trigger fingers with and without proximal interphalangeal joint contracture, and investigated the influence of the injection on the A1 pulley and flexor digitorum tendons using ultrasonography. One month after injection, pain was significantly reduced in the no contracture group, and 56% of trigger fingers with proximal interphalangeal joint contracture resolved. Before injection, relative thickening of the A1 pulley and flexor digitorum tendons, and a partial hypoechoic lesion of the flexor digitorum superficialis tendon were observed in the contracture group. One month after injection, the thickening of the tendons and the A1 pulley was reduced, but the partial hypoechoic lesion was still observed in significant numbers. We have demonstrated that the presence of a proximal interphalangeal joint contracture was associated with a reduced clinical response to corticosteroid injection, and we suggest that the pathologic change in the flexor digitorum superficialis tendon, represented by the partial hypoechoic lesion, contributed to corticosteroid injection resistance. IV. © The Author(s) 2015.

  12. Poor outcome of bilateral lower extremity morel-lavallee lesions: a case report.

    Science.gov (United States)

    Stanley, Sharon S; Molmenti, Ernesto P; Siskind, Eric; Kasabian, Armen K; Huang, Su-I D

    2014-03-01

    The Morel-Lavallee lesion is a closed, internal degloving injury that results when a strong, shearing force is applied parallel to the plane of injury, as is common in vehicular trauma. It is an underdiagnosed entity that is often missed during the initial trauma workup as symptoms can be subtle. There are few reports of lesions occurring below the knee. Most cases affect the proximal thigh and trochanter, as these tend to be dependent areas in high velocity trauma. To the best of our knowledge, this is the first literature report of bilateral lower extremity Morel-Lavallee lesions.

  13. Industrial Computed Tomography using Proximal Algorithm

    KAUST Repository

    Zang, Guangming

    2016-04-14

    In this thesis, we present ProxiSART, a flexible proximal framework for robust 3D cone beam tomographic reconstruction based on the Simultaneous Algebraic Reconstruction Technique (SART). We derive the proximal operator for the SART algorithm and use it for minimizing the data term in a proximal algorithm. We show the flexibility of the framework by plugging in different powerful regularizers, and show its robustness in achieving better reconstruction results in the presence of noise and using fewer projections. We compare our framework to state-of-the-art methods and existing popular software tomography reconstruction packages, on both synthetic and real datasets, and show superior reconstruction quality, especially from noisy data and a small number of projections.

  14. Correlation between social proximity and mobility similarity.

    Science.gov (United States)

    Fan, Chao; Liu, Yiding; Huang, Junming; Rong, Zhihai; Zhou, Tao

    2017-09-20

    Human behaviors exhibit ubiquitous correlations in many aspects, such as individual and collective levels, temporal and spatial dimensions, content, social and geographical layers. With rich Internet data of online behaviors becoming available, it attracts academic interests to explore human mobility similarity from the perspective of social network proximity. Existent analysis shows a strong correlation between online social proximity and offline mobility similarity, namely, mobile records between friends are significantly more similar than between strangers, and those between friends with common neighbors are even more similar. We argue the importance of the number and diversity of common friends, with a counter intuitive finding that the number of common friends has no positive impact on mobility similarity while the diversity plays a key role, disagreeing with previous studies. Our analysis provides a novel view for better understanding the coupling between human online and offline behaviors, and will help model and predict human behaviors based on social proximity.

  15. [Disorders of sex development and proximal hypospadias].

    Science.gov (United States)

    Oswald, J

    2016-01-01

    Children with ambiguous genitalia due to different chromosome or gonadal sex are a particular challenge concerning the diagnostic and therapeutic implications. Proximal hypospadias patients with normal gonadal development should be distinguished from children with DSD (disorders of sex development) to guarantee normal gender identity and the best possible surgical therapy. This paper focuses on the terminology, embryology, and pathophysiology of the different manifestations of DSD. The state of knowledge about this disease pattern with particular emphasis on proximal hypospadias based on national and international scientific discussions is presented. The different clinical pictures as well as therapeutic options of DSD with a special focus on recent literature and giving particular attention to patients with proximal hypospadias are presented. Because of the complexity of patients suffering from disorders of sex development an interdisciplinary DSD healthcare team including a paediatric endocrinologist as well as paediatric urologist should be provided. These specialists enable an accurate diagnosis in severe hypospadias patients without reference to DSD diseases patterns.

  16. PLACEMENT OF PREFORMED METAL CROWNS ON CARIOUS PRIMARY MOLARS BY DENTAL HYGIENE/THERAPY VOCATIONAL TRAINEES IN SCOTLAND: A SERVICE EVALUATION ASSESSING PATIENT AND PARENT SATISFACTION.

    Science.gov (United States)

    Jackson, Guy

    2015-11-01

    The utility and acceptability of preformed metal crowns (PMC) for management of carious primary molars has been established in the literature and published guidance. The role of dental hygienist and therapists (DHT) in the evolving team model in primary care has been recognised as requiring further investigation. The importance of patient and parental acceptance is acknowledged in recent healthcare research. This study focuses on patient and parent acceptance of preformed metal crowns placed by DHTs. Prescription format is investigated and the availability of bitewing radiographs considered. Reflective assignments at the end of training gave an indication of DHTs views on increased professional autonomy and the issue of direct access. Patient and parent satisfaction following placement of PMCs by DHT vocational trainees (DHTVT) were evaluated. Data was collected in two audit rounds from 2013 to 2014 using a 'faces' scale for children and a Likert scale for parents following placement of PMCs on carious primary molars. 133 PMCs were placed (110 children) by 10 DHTVTs over an eight-month period. Overall, radiographs were available for 10.5% of cases. The data showed high levels of patient and parent acceptance of the use of PMCs. Low availability of radiographs may represent a missed diagnostic opportunity. PMC placement by DHTVTs resulted in high patient and parent satisfaction, comparable to other studies. Although caries has been declining over the last decade in Scotland, evidence shows that inequalities and a social gradient in experience of caries in children remain. There is a need for tools and strategies for the prevention, recognition, risk assessment, diagnosis, and management of caries in the primary dentition. These must be accessible, acceptable to children and their parents/carers, cost effective, affordable and applicable in the primary care general dental practice environment where most families are likely to be registered. The emerging theme of

  17. Selective removal of carious human dentin using a nanosecond pulsed laser operating at a wavelength of 5.85 μ m

    Science.gov (United States)

    Ishii, Katsunori; Kita, Tetsuya; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2015-05-01

    Less invasive methods for treating dental caries are strongly desired. However, conventional dental lasers do not always selectively remove caries or ensure good bonding to the composite resin. According to our previous study, demineralized dentin might be removed by a nanosecond pulsed laser operating at wavelengths of around 5.8 μm. The present study investigated the irradiation effect of the light on carious human dentin classified into "remove," "not remove," and "unclear" categories. Under 5.85-μm laser pulses, at average power densities of 30 W/cm2 and irradiation time of 2 s, the ablation depth of "remove" and "not remove," and also the ablation depth of "unclear" and "not remove," were significantly different (plaser operating at 5.85 μm proved an effective less-invasive caries treatment.

  18. Knowledge networks in the Dutch aviation industry: The proximity paradox

    NARCIS (Netherlands)

    Broekel, T.; Boschma, R.A.

    2012-01-01

    The importance of geographical proximity for interaction and knowledge sharing has been discussed extensively in recent years. There is increasing consensus that geographical proximity is just one out of many types of proximities that might be relevant. We argue that proximity may be a crucial

  19. The developmental spectrum of proximal radioulnar synostosis

    Energy Technology Data Exchange (ETDEWEB)

    Elliott, Alison M. [University of Manitoba, Winnipeg Regional Health Association Program of Genetics and Metabolism, Winnipeg, MB (Canada); University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, WRHA Program of Genetics and Metabolism, Departments of Paediatrics and Child Health, Biochemistry and Medical Genetics, Winnipeg, MB (Canada); Kibria, Lisa [University of Manitoba, Department of School of Medical Rehabilitation, Winnipeg, MB (Canada); Reed, Martin H. [University of Manitoba, Department of Paediatrics and Child Health, Winnipeg, MB (Canada); University of Manitoba, Department of Biochemistry and Medical Genetics, Winnipeg, MB (Canada); University of Manitoba, Department of Diagnostic Imaging, Winnipeg, MB (Canada)

    2010-01-15

    Proximal radioulnar synostosis is a rare upper limb malformation. The elbow is first identifiable at 35 days (after conception), at which stage the cartilaginous anlagen of the humerus, radius and ulna are continuous. Subsequently, longitudinal segmentation produces separation of the distal radius and ulna. However, temporarily, the proximal ends are united and continue to share a common perichondrium. We investigated the hypothesis that posterior congenital dislocation of the radial head and proximal radioulnar fusion are different clinical manifestations of the same primary developmental abnormality. Records were searched for ''proximal radioulnar fusion/posterior radial head dislocation'' in patients followed at the local Children's Hospital and Rehabilitation Centre for Children. Relevant radiographic, demographic and clinical data were recorded. Ethics approval was obtained through the University Research Ethics Board. In total, 28 patients met the inclusion criteria. The majority of patients (16) had bilateral involvement; eight with posterior dislocation of the radial head only; five had posterior radial head dislocation with radioulnar fusion and two had radioulnar fusion without dislocation. One patient had bilateral proximal radioulnar fusion and posterior dislocation of the left radial head. Nine patients had only left-sided involvement, and three had only right-sided involvement.The degree of proximal fusion varied, with some patients showing 'complete' proximal fusion and others showing fusion that occurred slightly distal to the radial head: 'partially separated.' Associated disorders in our cohort included Poland syndrome (two patients), Cornelia de Lange syndrome, chromosome anomalies (including tetrasomy X) and Cenani Lenz syndactyly. The suggestion of a developmental relationship between posterior dislocation of the radial head and proximal radioulnar fusion is supported by the fact that both anomalies

  20. Non-DSB clustered DNA lesions. Does theory colocalize with the experiment?

    Science.gov (United States)

    Nikitaki, Zacharenia; Nikolov, Vladimir; Mavragani, Ifigeneia V.; Plante, Ianik; Emfietzoglou, Dimitris; Iliakis, George; Georgakilas, Alexandros G.

    2016-11-01

    Ionizing radiation results in various kinds of DNA lesions such as double strand breaks (DSBs) and other non-DSB base lesions. These lesions may be formed in close proximity (i.e., within a few nanometers) resulting in clustered types of DNA lesions. These damage clusters are considered the fingerprint of ionizing radiation, notably charged particles of high linear energy transfer (LET). Accumulating theoretical and experimental evidence suggests that the induction of these clustered lesions appears under various irradiation conditions but also as a result of high levels of oxidative stress. The biological significance of these clustered DNA lesions pertains to the inability of cells to process them efficiently compared to isolated DNA lesions. The results in the case of unsuccessful or erroneous repair can vary from mutations up to chromosomal instability. In this mini review, we discuss of several Monte Carlo simulations codes and experimental evidence regarding the induction and repair of radiation-induced non-DSB complex DNA lesions. We also critically present the most widely used methodologies (i.e., gel electrophoresis and fluorescence microscopy [in situ colocalization assays]). Based on the comparison of different approaches, we provide examples and suggestions for the improved detection of these lesions in situ. Based on the current status of knowledge, we conclude that there is a great need for improvement of the detection techniques at the cellular or tissue level, which will provide valuable information for understanding the mechanisms used by the cell to process clustered DNA lesions.

  1. Impact of bistrand abasic sites and proximate orientation on DNA global structure and duplex energetics.

    Science.gov (United States)

    Minetti, Conceição A; Sun, Jeffrey Y; Jacobs, Daniel P; Kang, Inkoo; Remeta, David P; Breslauer, Kenneth J

    2018-01-11

    Bistrand lesions embedded within a single helical turn of tridecameric deoxyoligonucleotide duplexes represent a model system for exploring the impact of clustered lesions that occur in vivo and pose a significant challenge to cellular repair machineries. Such investigations are essential for understanding the forces that dictate lesion-induced mutagenesis, carcinogenesis, and cytotoxicity within a context that mimics local helical perturbations caused by an ionizing radiation event. This study characterizes the structural and energy profiles of DNA duplexes harboring synthetic abasic sites (tetrahydrofuran, F) as models of clustered bistrand abasic (AP) lesions. The standard tridecameric dGCGTACCCATGCG·dCGCATGGGTACGC duplex is employed to investigate the energetic impact of single and bistrand AP sites by strategically replacing one or two bases within the central CCC/GGG triplet. Our combined analysis of temperature-dependent UV and circular dichroism (CD) profiles reveals that the proximity and relative orientation of AP sites within bistrand-damaged duplexes imparts a significant thermodynamic impact. Specifically, 3'-staggered lesions (CCF/GFG) exert a greater destabilizing effect when compared with their 5'-counterpart (FCC/GFG). Moreover, a duplex harboring the central bistrand AP lesion (CFC/GFG) is moderately destabilized yet exhibits distinct properties relative to both the 3' and 5'-orientations. Collectively, our energetic data are consistent with structural studies on bistrand AP-duplexes of similar sequence in which a 3'-staggered lesion exerts the greatest perturbation, a finding that provides significant insight regarding the impact of orientation on lesion repair processing efficiency. © 2018 The Authors Biopolymers Published by Wiley Periodicals, Inc.

  2. Lugol staining pattern and histology of esophageal lesions.

    Science.gov (United States)

    Mori, M; Adachi, Y; Matsushima, T; Matsuda, H; Kuwano, H; Sugimachi, K

    1993-05-01

    To analyze the relationship between Lugol unstained areas and their histologic features, we applied the Lugol test to 24 specimens of resected esophagus. The staining patterns were graded into four types: grade I, hyperstaining; grade II, normal greenish brown staining; grade III, less intense staining; and grade IV, unstained. Most of the grade IV lesions were invasive carcinomas, carcinomas in situ, or severe dysplasia. The carcinomas in situ and the intraepithelial extension of the carcinomas, which were difficult to detect, were clearly shown as grade IV. On the other hand, moderate to mild dysplasia or atrophy showed grade III staining. Grade IV lesions showed well-demarcated sharp margins, whereas grade III lesions showed ill-demarcated dull margins. The grade III carcinomas, however, by the Lugol test, showed well-demarcated margins. Histologic evaluation disclosed that the staining intensity reflected well the thickness of the glycogen-containing cell layer in the lesion. The sharpness of the margin reflected the abrupt or gradual change from the glycogen-containing to non-containing cell layers. These findings suggest 1) the usefulness of the staining pattern of the Lugol test for the diagnosis of esophageal lesions such as squamous cell carcinoma and severe dysplasia, and 2) the usefulness of the Lugol test for precise delineation of the proximal resection line during surgery of esophageal carcinomas with unexpected wide extension.

  3. Laser and caries diagnosis: the state of the art and evaluation in vitro of the differences of the fluorescence between sound, carious and demineralized enamel; Laser e diagnostico de caries: estado da arte e avaliacao in vitro das diferencas de fluorescencia entre esmalte sadio, cariado e desmineralizado

    Energy Technology Data Exchange (ETDEWEB)

    Mendonca, Maria Angelica Lopes Chaves

    2001-07-01

    The aim of this study was to evaluate the methods for establishing dental caries diagnosis that make use of Laser light as source of illumination, establishing the 'state of the art'. Experimental observation of the differences among fluorescence of sound, demineralized and carious enamel by visible luminescent spectroscopy was also done. Six human teeth, extracted for clinical reasons were studied, and the results showed that the spectrum of carious enamel is different from the sound and demineralized ones. The differences are more evident relative to sond enamel and carious enamel, the same occurring between demineralized and carious enamel. The review of the literature aimed to make comparative considerations between QLF, LF and DELF; their effectiveness relative to traditional methods such as visual, visual with probe, radiography. It was verified that DELF was more sensitive, but could not discriminate between different degrees of mineral loss. QLF, compared to DIAGNOdent has the same sensitivity, but it is better for scientific purposes. The experimental part of the present study used on argon ion Laser to illuminated the teeth and signs of emission of fluorescence were captured by a PMT and then analyzed by a computer system with EG and G software. The results showed that the spectrum of carious enamel is different from the sound and demineralized. The differences are more evident in relation to sound and carious enamel, the same occurs between demineralized and carious enamel. (author)

  4. Oral lesions in lupus erythematosus: correlation with cutaneous lesions.

    Science.gov (United States)

    Nico, Marcello Menta Simonsen; Vilela, Maria Apparecida Constantino; Rivitti, Evandro Ararigbóia; Lourenço, Silvia Vanessa

    2008-01-01

    Oral lesions in the context of lupus erythematosus (LE) have long been described. However, definitive agreement on about the exact nature and correct classification of these manifestations is lacking in published studies. Controversy exists on the significance of oral LE lesions regarding patient outcome. In this article, medical and dental literature on clinical and histopathological aspects of oral LE lesions are reviewed and critically discussed. A clinico-pathological correlation of oral lesions (interface mucositis-lupus mucositis) with cutaneous lesions (interface dermatitis-lupus dermatitis) is established, for those represent the mucosal counterparts of cutaneous LE. Validity about widely used but imprecise terms such as "oral ulcers", "ulcerative plaques", and others, in the context of LE, is discussed, and the uncertain relationship of these alterations to systemic disease with a worse outcome is commented. Furthermore, insights about the nature, differential diagnosis, and prognosis of oral lesions in LE patients are presented.

  5. SHORTAND MIDDLE-TERM RESULTS OF HIP ARTHROPLASTY FOR TUMORS OF THE PROXIMAL FEMUR

    Directory of Open Access Journals (Sweden)

    R. M. Tikhilov

    2014-01-01

    Full Text Available A purpose of the study was to evaluate the immediate and medium-term outcomes of the treatment of patients with primary tumor lesions of proximal femur after the lesion resection together with total hip arthroplastyby total revision systems. Material and methods. 34 patients with primary tumors of proximal femur [chondrosarcoma - 9 (26.5%,giant cell tumor - II (32.4%,osteosarcoma - 2 (5.8%, other malignancies - 5 (14.7%,benign neoplasms - 7 (20.6%] underwent the conserving surgery at R.R. Vreden Russian Research Institute of Traumatology and Orthopedics since 2003 through 2013. The follow-up was from one to five years. The age of patients ranged from 16 to 70 years, patients younger than 40 years accounted for 61.8%. Acetabulum was replaced by standard components. To replace post-resection defects of proximal femur, in 21 (61.8% patents revision legs of cementless fixation Wagner Revision (Zimmer were used, in 10 (29.4% - “Fenix”, and in 3 (8.8% - Solution (DePuy, J&J. Results. A technique of total hip arthroplasty with the use of revision systems demonstrated excellent and positive results in 32 (94.2% cases. Complications leading to revision surgery occurred in 3 (8.8% patients. Conclusion. The method allows achievement of favorable functional outcomes and early patients’ activation without worsening the oncologic component of treatment and being not inferior to expensive modular systems.

  6. Differences between reported and actual restored caries lesion depths: results from The Dental PBRN.

    Science.gov (United States)

    Rindal, D B; Gordan, V V; Fellows, J L; Spurlock, N L; Bauer, M R; Litaker, M S; Gilbert, G H

    2014-07-01

    The objectives of this research were to: (1) quantify the discordance between the caries lesion depth at which dentists restored initial lesions during a clinical study ("actual depth") and the lesion depth that they reported during a hypothetical clinical scenario ("reported depth"); (2) test the hypothesis that certain practitioner, practice, patient, and caries lesion characteristics are significantly associated with this discordance. Practitioner-investigators who perform restorative dentistry in their practices completed an enrollment questionnaire and participated in 2 consecutive studies on caries diagnosis and treatment. The first study was a survey asking about caries treatment. The second study collected data on restorations placed in routine clinical practice due to caries in patients over 19 years of age on occlusal surfaces only or proximal surfaces only. We report results on 2,691 restorations placed by 205 dentists in 1,930 patients with complete data. Discordance between actual depth and reported depth occurred in only about 2% of the restorations done due to proximal caries, but about 49% of the restorations done due to occlusal caries. Practice type, restorative material used and the diagnostic methods used were significantly associated with discordance. Dentists frequently restored occlusal caries at a shallower depth as compared to their reported depth, but the discordance was very small for proximal lesions. Discordance for occlusal caries was more common when radiographs were not taken or if a resin restoration was placed.

  7. Can classic metaphyseal lesions follow uncomplicated caesarean section?

    Energy Technology Data Exchange (ETDEWEB)

    O' Connell, AnnaMarie [Children' s University Hospital, Radiology Department, Dublin 1 (Ireland); Donoghue, Veronica B. [Children' s University Hospital, Radiology Department, Dublin 1 (Ireland); National Maternity Hospital, Radiology Department, Dublin (Ireland)

    2007-05-15

    Classic metaphyseal lesion (CML) is the term given to a fracture that most often occurs in the posteromedial aspect of the distal femur, proximal tibia, distal tibia, and proximal humerus in infants; this finding is strongly associated with non-accidental injury. To demonstrate that the CML may occur following simple lower segment caesarean section (LSCS). A review of 22 years of an obstetric practice that delivers 8,500 babies per year. We identified three neonates born by elective LSCS, each with distal femoral metaphyseal fractures on postpartum radiographs. All caesarean sections were elective and uncomplicated. External cephalic version was not employed preoperatively. Postpartum radiographs demonstrated a fracture of the distal femoral metaphysis in each neonate, typical of a CML. We propose that a CML can occur in the setting of a simple, elective and uncomplicated LSCS where no external cephalic version is employed. (orig.)

  8. The Etiology and Arthroscopic Surgical Management of Cam Lesions.

    Science.gov (United States)

    Werner, Brian C; Gaudiani, Michael A; Ranawat, Anil S

    2016-07-01

    Cam-type deformity of the proximal femur is a relative increase in the discrepancy of the femoral head-neck offset. The etiology is unknown; several conditions have been implicated in the development of abnormal proximal femoral anatomy. Recent evidence suggests that high-impact sports place stress on the immature physis during growth and may play an important role. Imaging is essential in the initial diagnostic workup, characterization of pathology, preoperative planning, and intraoperative decision making. Short-term and mid-term outcomes for arthroscopic osteoplasty of cam lesions for both isolated cam-type deformity and mixed cam-pincer femoroacetabular impingement have been well-described and are favorable. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. preliminary phytochemical screening, proximate and elemental

    African Journals Online (AJOL)

    DR. AMINU

    ABSTRACT. The seed powder of Moringa oleifera was analysed for its phytochemical, proximate and elemental composition using Folin-Denis spectrophotometric method, gravimetric method and energy dispersing X-ray fluorescence (EDXRF) transmission emission technique respectively. The seed powder had the ...

  10. Proximate, mineral composition, antioxidant activity, and total ...

    African Journals Online (AJOL)

    Four varieties of the red pepper fruits (Capsicum species) were evaluated for chemical composition, antioxidant activity and total phenolic contents using standard analytical technique, ferric-ion reducing antioxidant potential (FRAP) assay and Folin-Colcalteau method respectively. The proximate composition values ...

  11. 9__43 - 50__Tijjani_Proximate

    African Journals Online (AJOL)

    User

    Sena et al., 1998). In Nigeria, the plant is commonly consumed by the Hausa speaking communities as a spice and a sauce (Ibrahim et al., 2012). However, during preparation the leaves and stem are not carefully separated before processing of food. Thus, the present study was aimed at evaluating the proximate, minerals ...

  12. Phytochemistry and proximate composition of ginger ( Zingiber ...

    African Journals Online (AJOL)

    ... a little crude fibre content of 0.92 %. The results indicated that ginger rhizome is an excellent natural remedy for a wide range of ailments. Keywords: Zingiber officinale, spice, rhizome, phytochemistry, proximate analysis, Zingiberaceae, zingerone, methanolic extraction. Journal of Pharmaceutical and Allied Sciences, Vol.

  13. DEPRESSIONARY EFFECT OF PROXIMITY OF RESIDENTIAL ...

    African Journals Online (AJOL)

    Osondu

    2012-10-24

    Oct 24, 2012 ... opinions are analyzed and it revealed that the site has major impacts on the residents perceived quality of life, security and ... Key words: Landfill, Property value, Health and safety, Residential property, Solous. Introduction. The location ... Proximity to landfills and hazardous waste sites can severely affect ...

  14. Renal fibrosis: Primacy of the proximal tubule.

    Science.gov (United States)

    Gewin, Leslie S

    2018-02-06

    Tubulointerstitial fibrosis (TIF) is the hallmark of chronic kidney disease and best predictor of renal survival. Many different cell types contribute to TIF progression including tubular epithelial cells, myofibroblasts, endothelia, and inflammatory cells. Previously, most of the attention has centered on myofibroblasts given their central importance in extracellular matrix production. However, emerging data focuses on how the response of the proximal tubule, a specialized epithelial segment vulnerable to injury, plays a central role in TIF progression. Several proximal tubular responses such as de-differentiation, cell cycle changes, autophagy, and metabolic changes may be adaptive initially, but can lead to maladaptive responses that promote TIF both through autocrine and paracrine effects. This review discusses the current paradigm of TIF progression and the increasingly important role of the proximal tubule in promoting TIF both in tubulointerstitial and glomerular injuries. A better understanding and appreciation of the role of the proximal tubule in TIF has important implications for therapeutic strategies to halt chronic kidney disease progression. Copyright © 2017 International Society of Matrix Biology. Published by Elsevier B.V. All rights reserved.

  15. 182 179 Comparative Study on the Proximate

    African Journals Online (AJOL)

    2008-12-02

    Dec 2, 2008 ... Key words: Annona squamosa, Fruits, Proximate, Minerals, nutrient density. INTRODUCTION. Sugar apple (Annona squamosa) also called. “Gwanda masar” in Hausa belong to the family. Annonacae. The most widely grown of all the species are A. muricata, A. cherimola, A reticulata, A. senegalensis and ...

  16. Phytochemical Screening, Proximate and Mineral Composition of ...

    African Journals Online (AJOL)

    Leaves of sweet potato (Ipomoea batatas) grown in Tepi area was studied for their class of phytochemicals, mineral and proximate composition using standard analytical methods. The phytochemical screening revealed the presence of alkaloids, flavonoid, terpenoids, saponins, quinones, phenol, tannins, amino acid and ...

  17. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    Citrus sinensis was screened for its phytochemical composition and was evaluated for the proximate and elemental analysis. The phytochemical analysis indicated the presence of reducing sugar, saponins, cardiac glycosides, tannins and flavonoids. The elemental analysis indicated the presence of the following mineral ...

  18. Phytochemical Screening and Proximate Analysis of Newbouldia ...

    African Journals Online (AJOL)

    The study was conducted to assess the phytochemical and proximate composition of Newboudia laevis leaves and Allium sativum bulb extracts. The leaves and bulbs extracts were analyzed for their chemical composition and antinutritional factors (ANFs) which include moisture, crude protein, crude fat, crude fiber, total ash ...

  19. Disability occurrence and proximity to death

    NARCIS (Netherlands)

    Klijs, Bart; Mackenbach, Johan P.; Kunst, Anton E.

    2010-01-01

    Purpose. This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age. Method. Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study.

  20. [Four family members with proximal myotonic myopathy

    NARCIS (Netherlands)

    Tieleman, A.A.; Velden, M.P. van der; Visser, M.C.; Wokke, J.H.J.; Scheffer, H.; Engelen, B.G.M. van

    2004-01-01

    A 41-year-old woman had a 15-year history of pain in her thighs and arms, which also became weaker, and a decrease in visual acuity. Her 35-year-old brother, their 38-year-old sister and their 64-year-old mother also had myalgia, myotonia and proximal muscle weakness, and the women also had

  1. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    ... was about 0.01 in concentration. Proximate analysis also shows that it has a high nutritional value such as carbohydrate, fibre, Ash, fat and protein. These results recommended the consumption of these peels of desired physiochemical properties as sources of food fibres or low-calorie bulk ingredients in food applications ...

  2. Proximate composition and consumer acceptability of African ...

    African Journals Online (AJOL)

    The aim of the study was to assess the organoleptic differences of Clarias gariepinus smoked with two different energy sources, Anogeissus leiocarpus and Tamarindus indica with the help of a hedonic scale and to determine possible proximate composition difference between the smoked products. Smoking of the fishes ...

  3. Controllable proximity effect in superconducting hybrid devices

    NARCIS (Netherlands)

    Bakurskiy, S.V.

    2015-01-01

    This thesis is devoted to the study of controllable proximity effects in superconductors, both in terms of fundamental aspects and applications. As a part of this thesis theoretical description was suggested for a number of structures with superconducting electrodes and multiple interlayers. These

  4. Proximate, chemical compositions and sulphur concentrations on ...

    African Journals Online (AJOL)

    0, 10, 20, 50, 100, 150, 200, 250 and 300 ppm) on the nutritional value and the proximate composition of six selected mango cultivars (Tommy Atkins, Peach, Saber, Sunshine, Keitt and Vhavenda) grown in South Africa. The study shows that ...

  5. Proximate composition, bread characteristics and sensory ...

    African Journals Online (AJOL)

    This study was carried out to investigate proximate composition, bread characteristics and sensory evaluation of cocoyam-wheat composite breads at different levels of cocoyam flour substitution for human consumption.A whole wheat bread (WWB) and cocoyam-composite breads (CCB1,CCB 2 and CCB 3) were prepared ...

  6. Evaluation of the Proximate, Chemical and Phytochemical ...

    African Journals Online (AJOL)

    The increased interest in the utilization of the leaves of Moringa oleifera necessitated this study which evaluated the proximate, chemical and phytochemical composition, especially the presence of anti- physiological and toxic factors in the leaves. The results of the phytochemical analyses were: alkaloid 1.24 ± 0.141%; ...

  7. comparative proximate composition and antioxidant vitamins

    African Journals Online (AJOL)

    DR. AMINU

    ABSTRACT. The proximate composition and antioxidant vitamins analysis of two varieties of honey (dark amber and light amber) were carried out using standard methods. The values for moisture, ash, crude lipid, crude protein and crude carbohydrate contents of the two honeys, (light amber and dark amber) are 9.39 ...

  8. Proximate composition and cholesterol concentrations of ...

    African Journals Online (AJOL)

    Proximate composition and cholesterol concentrations of Rhynchophorus phoenicis and Oryctes monoceros larvae subjected to different heat treatments. ... 514.63 mg/100g dry weight basis (DWB) for raw and fried samples, respectively, but decreased to 295.20 mg/100 g DWB in the smoke-dried samples. Similarly, the ...

  9. Preliminary Phytochemical Screening, Elemental and Proximate ...

    African Journals Online (AJOL)

    The study aimed at phytochemical screening, elemental and proximate composition of two varieties of Cyperus esculentus (tiger nut) big yellow and small brown nuts using standard methods. The phytochemicals tested for were alkaloid, saponin, tannin, glycoside, flavonoid, steroid and resin. All the aforementioned ...

  10. Protein biomarker validation via proximity ligation assays.

    Science.gov (United States)

    Blokzijl, A; Nong, R; Darmanis, S; Hertz, E; Landegren, U; Kamali-Moghaddam, M

    2014-05-01

    The ability to detect minute amounts of specific proteins or protein modifications in blood as biomarkers for a plethora of human pathological conditions holds great promise for future medicine. Despite a large number of plausible candidate protein biomarkers published annually, the translation to clinical use is impeded by factors such as the required size of the initial studies, and limitations of the technologies used. The proximity ligation assay (PLA) is a versatile molecular tool that has the potential to address some obstacles, both in validation of biomarkers previously discovered using other techniques, and for future routine clinical diagnostic needs. The enhanced specificity of PLA extends the opportunities for large-scale, high-performance analyses of proteins. Besides advantages in the form of minimal sample consumption and an extended dynamic range, the PLA technique allows flexible assay reconfiguration. The technology can be adapted for detecting protein complexes, proximity between proteins in extracellular vesicles or in circulating tumor cells, and to address multiple post-translational modifications in the same protein molecule. We discuss herein requirements for biomarker validation, and how PLA may play an increasing role in this regard. We describe some recent developments of the technology, including proximity extension assays, the use of recombinant affinity reagents suitable for use in proximity assays, and the potential for single cell proteomics. This article is part of a Special Issue entitled: Biomarkers: A Proteomic Challenge. © 2013.

  11. Phytochemical screening, proximate and elemental analysis of ...

    African Journals Online (AJOL)

    Michael Horsfall

    2009). The aim of this study was to analyses the extract of. Citrus sinensis peels for the phytochemical, proximate and elemental composition. MATERIALS AND METHODS. Plant materials Fresh peels of Citrus sinensis were collected from Uselu market in Benin City, Edo. State, Nigeria. It was identified and authenticated by.

  12. Keldysh proximity action for disordered superconductors

    Indian Academy of Sciences (India)

    Abstract. We review a novel approach to the superconductive proximity effect in dis- ordered normal–superconducting (N–S) structures. The method is based on the multi- charge Keldysh action and is suitable for the treatment of interaction and fluctuation effects. As an application of the formalism, we study the subgap ...

  13. Goal-Proximity Decision-Making

    Science.gov (United States)

    Veksler, Vladislav D.; Gray, Wayne D.; Schoelles, Michael J.

    2013-01-01

    Reinforcement learning (RL) models of decision-making cannot account for human decisions in the absence of prior reward or punishment. We propose a mechanism for choosing among available options based on goal-option association strengths, where association strengths between objects represent previously experienced object proximity. The proposed…

  14. Avascular necrosis in proximal humeral fractures in patients treated with operative fixation: a meta-analysis.

    Science.gov (United States)

    Xu, Jiaming; Zhang, Changqing; Wang, Tao

    2014-04-27

    Proximal humeral fractures are common lesions of the elderly, but there are no established treatment guidelines. A surgical treatment for comminuted and displaced fractures of the proximal humerus was developed and is still evolving. The aim of this study was to perform a quantitative review to evaluate the risk of avascular necrosis (AVN) in patients with proximal humeral fractures who were treated by operative fixation compared with conservative treatment. We searched the PubMed, MEDLINE, Springer, Elsevier Science Direct, Cochrane Library, Google Scholar, China National Knowledge Infrastructure (in Chinese), and Wanfang database (in Chinese) up to December 2013 to identify studies related to operative fixation and AVN in patients with proximal humeral fractures. Seven studies with a total of 291 patients (142 operative fixation cases and 149 conservative treatment cases) with proximal humeral fractures were considered in the meta-analysis. The overall meta-analysis showed no significant difference in the incidence of AVN between the two groups [odds ratio (OR) 1.42, 95% confidence interval (CI) 0.33-6.11, p = 0.64]. The subgroup meta-analysis by study design (retrospective/prospective), sample size (≤40/>40), and ethnicity (European/Asian) demonstrated similar results. However, the subgroup analysis by specific operative approach (plate fixation/tension band wiring fixation/others) indicated that plate fixation was associated with a higher rate of AVN than conservative treatment (OR 0.20, 95% CI 0.05-0.76, p = 0.019). Plate fixation was associated with a higher risk of AVN development than conservative treatment in patients with proximal humeral fractures.

  15. Lesion procedures in psychiatric neurosurgery.

    Science.gov (United States)

    Patel, Shaun R; Aronson, Joshua P; Sheth, Sameer A; Eskandar, Emad N

    2013-01-01

    Lesion procedures for psychiatric indications have a history that spans more than a century. This review provides a brief history of psychiatric surgery and addresses the most recent literature on lesion surgery for the treatment of anxiety and mood disorders. Relevant data described in publications from the early 1900 s through the modern era regarding lesion procedures for psychiatric indications, both historical and current use, are reported. The early procedures of Burkhardt, Moniz, and Freeman are reviewed, followed by descriptions of the more refined techniques of Leksell, Knight, Foltz, White, and Kelly. The application of lesion procedures to obsessive-compulsive disorder, mood disorders, and addiction are discussed. Lesioning proce