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Free Full Text ArticleInterdisciplinary approach to endodontic therapy for uncooperative children i...
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Interdisciplinary approach to endodontic therapy for uncooperative children in a dental school environment.

J Dent Educ. 2006 Dec;70(12):1362-5

Authors: Soares F, Britto LR, Vertucci FJ, Guelmann M

The aim of this study was to describe an interdisciplinary approach for endodontic therapy of behavior-challenging children and to report the efficacy of sedation techniques for these procedures. Sedation records of thirty-two patients who received root canal treatment were reviewed. Age at treatment in months, gender, year of treatment, tooth type, status of root maturation (open or closed apex), etiological factor(s), sedation protocol, and outcome were the variables analyzed. The collected information was entered into a computerized flowchart and the data analyzed using descriptive statistics. Midazolam in combination with meperidine or hydroxyzine were the most common protocols used (46 percent and 40 percent of the cases, respectively). Only two (6 percent) treatments were aborted due to uncontrolled behavior during sedation. We conclude that cooperation between pediatric dentists and endodontists is fundamental to achieving success when providing root canal treatment for uncooperative child patients.

PMID: 17170328 [PubMed - indexed for MEDLINE]

Free Full Text ArticleThe role of Carisolv and different auxiliary chemical substances in the remov...
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The role of Carisolv and different auxiliary chemical substances in the removal of bovine root canal smear layer.

J Oral Sci. 2006 Sep;48(3):99-103

Authors: Antonio AG, Maia LC, Primo LG, Moraes RS, Cunha CB

To evaluate the effectiveness of Carisolv and different auxiliary chemical substances in root canal smear layer (SL) removal. SL was produced in the centre of 40 hemi-disks of bovine root dentine. The samples were divided into four irrigation groups (G): GI (control) - 0.9% NaCl; GII - 1% NaOCl + 0.9% NaCl; GIII - Carisolv + 0.9% NaCl; GIV - 1% NaOCl + 10% citric acid solution + 0.9% NaCl. The photomicrographs (SEM analysis) were coded (0 - absence of SL; 1 - moderate SL; 2 - dense SL with visible tubules; 3 - dense SL with no visible tubules). GIV was more effective in SL removal (P < 0.01). It should be noted that GI and GIII obtained score 3 in 100% of the samples (P > 0.01). Conclusion: NaOHCl, citric acid and NaCl solutions, when used together, presented a better performance in the removal of SL when compared to the other solutions.

PMID: 17023740 [PubMed - indexed for MEDLINE]

Free Full Text ArticleEffect of the sodium hypochlorite and citric acid association on smear layer ...
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Effect of the sodium hypochlorite and citric acid association on smear layer removal of primary molars.

Braz Oral Res. 2005 Oct-Dec;19(4):261-6

Authors: G&#xF6;tze Gda R, Cunha CB, Primo LS, Maia LC

This study aimed to assess the capacity of a sodium hypochlorite and citric acid (CA) association (the latter at different concentrations) in removing coronal smear layer (SL) of primary teeth. For this purpose, the pulp chamber roof and floor of 28 primary molars were removed to obtain enamel and dentine disks. SL was produced on the internal walls of the disks using high-speed drills. The disks were irrigated with 1% sodium hypochlorite and citric acid at different concentrations (CA-4%, CA-6%, CA-8% and CA-10%), and with 0.9% sodium chloride. The samples were split and observed under SEM. Scores were attributed to the obtained photomicrographs, according to the amount of SL present. It was noted that all the tested concentrations of citric acid used after the sodium hypochlorite were capable of removing SL. The results were analyzed by the Kruskal-Wallis test, and there was no significant statistical difference among the scores of the groups tested. However, it was observed that CA-8% and CA-10% caused peritubular dentine destruction, and that CA-4% presented a larger number of samples with dense SL. Based on these results, 6.0% citric acid in association with 1% sodium hypochlorite is suggested as auxiliary chemical substances for primary teeth irrigation.

PMID: 16491253 [PubMed - indexed for MEDLINE]

Free Full Text ArticleEffectiveness of computerized delivery of intrasulcular anesthetic in primary...
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Effectiveness of computerized delivery of intrasulcular anesthetic in primary molars.

J Am Dent Assoc. 2005 Oct;136(10):1418-25

Authors: Ashkenazi M, Blumer S, Eli I

BACKGROUND: Pain measures associated with computerized delivery of intrasulcular anesthestic have not been reported. The authors evaluated a computerized delivery system for intrasulcular (CDS-IS) anesthesia in primary molars. METHODS; The study population consisted of children aged 2 to 13 years who received CDS-IS injections, 159 in mandibular molars and 48 in maxillary molars. Children were treated by one of three modes of behavioral management: behavior modification (BM) only, inhalation of nitrous oxide (N2O) in addition to BM or intrarectal sedation. Variables evaluated included the subjective perception of the child's well-being before and after administration of the anesthetic, the child's pain behavior during anesthetic administration, effectiveness of the anesthetic during dental treatment, incidence of reported postoperative dental pain (PDP) and analgesic use after the CDS-IS injections. RESULTS: The effectiveness of CDS-IS anesthesia in mandibular molars was 97 percent, 92 percent, 63 percent and 71 percent for restorations, preformed stainless steel crowns, extractions and pulpal therapies, respectively (mean effectiveness, 89 percent). The effectiveness of CDS-IS anesthesia in maxillary molars was 96 percent, 50 percent, 92 percent and 78 percent, respectively (mean effectiveness, 90 percent). CDS-IS was less effective in children aged 2 to 4 years who received sedation than it was in older children. The authors found no differences between children's subjective self-reports of well-being before and after anesthetic administration, between the sexes and/or between modes of behavioral management (that is, BM or N2O). Most children exhibited low pain-related behavior during anesthetic administration, with no differences between boys and girls. The overall incidence of PDP was 31.4 percent; 64.9 percent of these patients received pain-relieving medications as a result, with no correlation to age, tooth treated, effectiveness of anesthesia or type of treatment. CONCLUSIONS: CDS-IS is effective for anesthetizing primary molars, mainly for amalgam, resin-based composite and stainless steel crown restorations.

PMID: 16255467 [PubMed - indexed for MEDLINE]

Free Full Text ArticleSpecialty and sex as predictors of depression in dentists.
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Specialty and sex as predictors of depression in dentists.

J Am Dent Assoc. 2005 Oct;136(10):1388-95

Authors: Mathias S, Koerber A, Fadavi S, Punwani I

BACKGROUND: Stress, burnout, substance abuse and suicide among dentists have been studied, yet no study in the United States has specifically addressed depression in e dentists. The objective of the authors' study was to determine if sex and dental specialty were correlated with depression in dentists. METHODS: The authors conducted a survey of a sample of dentists chosen randomly from the American Dental Association's mailing list of member dentists. The survey, stratified by sex and specialty, resulted in 560 responses, for a 53 percent response rate. The authors used the Zung Self-Rating Depression Scale to measure depression. The authors examined the respondents' sex, age, number of children, marital status, specialty, practice type, location of practice, years in practice and hours worked per week. RESULTS: The rate of depression in the overall sample was 9 percent. Sex was associated with depression (P < .001), but specialty was not. However, multiple regression analysis found that sex was significantly related to depression in only two specialties: periodontics and pediatric dentistry. Overall, the regression model explained an unimpressive 6 percent of the variance in depression scores. The most important finding of the study was that only 15 percent of depressed dentists were receiving treatment. CONCLUSIONS: The survey results showed that only female pediatric dentists and periodontists were more depressed than their male counterparts. None of the other variables studied contributed significantly to the understanding of depression in dentists. Depressed dentists, like other depressed people, tend not to seek treatment. CLINICAL IMPLICATIONS: Depression and serious depression occur among dentists, and much of it is untreated. Because depression is harmful to dentists and raises quality-of-care issues, they should be educated to help them recognize depression and encouraged to seek treatment.

PMID: 16255463 [PubMed - indexed for MEDLINE]

Free Full Text ArticleHistomorphological response of dogs' dental pulp capped with white mineral tr...
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Histomorphological response of dogs' dental pulp capped with white mineral trioxide aggregate.

Braz Dent J. 2004;15(2):104-8

Authors: Faraco Junior IM, Holland R

This study was conducted to observe the response of dogs' dental pulp to white mineral trioxide aggregate (MTA) when used as pulp capping material. The pulp of 15 dogs' teeth was experimentally exposed and capped with white MTA. The animals were sacrificed two months later and the specimens were prepared for histomorphological study. The pulp capped with white MTA showed a healing process with complete dentin bridge formation in all samples. In some cases, there was not a tubular dentin shape, but only a structure with an interesting morphological aspect sealing the exposure site. Only 2 specimens exhibited pulp inflammation. In conclusion, the data obtained in this study showed that white MTA has the necessary properties of a pulp capping material.

PMID: 15776191 [PubMed - indexed for MEDLINE]

Free Full Text ArticleA randomized controlled trial comparing mandibular local anesthesia technique...
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A randomized controlled trial comparing mandibular local anesthesia techniques in children receiving nitrous oxide-oxygen sedation.

Anesth Prog. 2004;51(1):19-23

Authors: Naidu S, Loughlin P, Coldwell SE, Noonan CJ, Milgrom P

The aim of this study was to test the hypothesis that dental pain control using infiltration/intrapapillary injection was less effective than inferior alveolar block/long buccal infiltration anesthesia in children. A total of 101 healthy children, aged 5-8 years, who had no contraindication for local anesthetic and who needed a pulpotomy treatment and stainless steel crown placement in a lower primary molar were studied. A 2-group randomized blinded controlled design was employed comparing the 2 local anesthesia techniques using 2% lidocaine, 1:100,000 epinephrine. All children were given 40% nitrous oxide. Children self-reported pain using the Color Analogue Scale. The study was conducted in a private pediatric dental practice in Mount Vernon, Wash. Overall pain levels reported by the children were low, and there were no differences between conditions at any point in the procedure. Pain reports for clamp placement were block/long buccal 2.8 and infiltration/intrapapillary 1.9 (P = .1). Pain reports for drilling were block/long buccal 2.0 and infiltration/intrapapillary 1.8 (P = .7). Nine percent of children required supplementary local anesthetic: 4 of 52 (7.7%) in the block/long buccal group and 5 of 49 (10.2%) in the infiltration/intrapapillary group (P = .07). The hypothesis that block/long buccal would be more effective than infiltration/intrapapillary was not supported. There was no difference in pain control effectiveness between infiltration/intrapapillary injection and inferior alveolar block/long buccal infiltration using 2% lidocaine with 1:100,000 epinephrine when mandibular primary molars received pulpotomy treatment and stainless steel crowns.

PMID: 15106686 [PubMed - indexed for MEDLINE]

Free Full Text ArticlePatterns of oral care in dental school and general dental practice.
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Patterns of oral care in dental school and general dental practice.

J Dent Educ. 2002 Apr;66(4):541-7

Authors: Leggott PJ, Robertson PB, del Aguila M, Swift JJ, Porterfield D, Phillips S, Anderson MH

This study compared patterns of oral care provided by predoctoral dental students for patients seeking treatment at the University of Washington (UW) with patterns reported for general dental offices by the Washington Dental Service (WDS). Dental care included about 5 million services provided to 880,317 patients by 2,803 WDS general dentists and about 45,600 dental services provided to 9,488 patients by 155 UW dental students during 1999. There was high fidelity between databases and randomly surveyed patient records for treatment provided in both UW (95 percent) and WDS (97 percent) populations. While patient age patterns were generally similar, UW students completed more procedures for young children and for adults older than seventy-four years but completed fewer procedures for age groups of from thirteen to eighteen and from forty-five to fifty-four than general dental offices. The relative mix of all services completed by UW and WDS providers was similar (ANOVA, P=0.82). Within categories of service, the percentage of total services completed by students compared to those submitted by community dentists to WDS was about the same for examinations, radiographs, fluoride and sealants, amalgams, composites, single crowns, and endodontics. The percentage of total procedures completed showed a greater emphasis by UW students on inlays/onlays, dentures, extractions, and periodontal maintenance, and lesser experience with implants, orthodontics, sedation, and emergency procedures than general dental offices. We conclude that the relative distribution of clinical services provided by UW dental students is comparable to those procedures reported to WDS by dental offices in the adjacent community.

PMID: 12014570 [PubMed - indexed for MEDLINE]

Free Full Text ArticleMedline search validity for randomised controlled trials in different areas o...
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Medline search validity for randomised controlled trials in different areas of dental research.

Br Dent J. 2002 Jan 26;192(2):97-9

Authors: Sj&#xF6;gren P, Halling A

OBJECTIVE: To determine the validity of Medline searches for randomised controlled trials in dental research (RCT-Ds), using the medical subject headings (MeSH-terms). DESIGN: The Medline database was searched for randomised controlled trials in dental research (RCT-Ds) published in 1999 and with MeSH-terms corresponding to different areas of dental research. All RCT-Ds were manually examined for relevance to the different areas of dental research and cross-tabulated against the Medline search results. The sensitivity, specificity, positive (precision) and negative predictive values, as well as the accuracy of the search results were calculated. RESULTS: The highest validity in the Medline searches for RCT-Ds was seen for endodontics, followed by orthodontics, whereas the lowest validity was seen for pediatric dentistry and public health dentistry. For pediatric dentistry the MeSH-term searches had too low a sensitivity for adequate location of RCT-Ds. CONCLUSIONS: MeSH-term searches on Medline are a useful tool for rapid location of RCT-Ds in most areas of dental research. However, there is a vast variation in the search validity. More refined search strategies are required to locate RCT-Ds in areas of dental research with low search validity.

PMID: 11838013 [PubMed - indexed for MEDLINE]

Free Full Text ArticleThe reinforced composite post and core.
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The reinforced composite post and core.

J Am Dent Assoc. 2000 May;131(5):667

Authors: Kroll RG

PMID: 10832260 [PubMed - indexed for MEDLINE]

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