The effect of phosphate functionality and dentin surface state on adhesion to dentin was investigated in a series of experiments. In all cases, variable effects were evaluated by measuring the strength of adhesion promoted by either of two priming agents, (PENTA, or DIPENTA), or their combination, to different surface conditions of dentin. The main difference between primers is the presence of a phosphate functionality in PENTA. These experiments demonstrated that the phosphate-containing primer promotes significantly greater adhesion compared to the non-phosphate containing primer for all surface states studied. They further showed that on demineralized dentin, strong adhesion for PENTA may be due to phosphate interaction with collagen and the mineral aptatite of unaltered dentin. Finally, phosphate bonds to either intact or demineralized dentin were relatively stable in the presence of water. We conclude that for the adhesion promoter studied, the interaction of a phosphate functionality with organic and inorganic components of dentin promotes a strong and durable adhesive joint.

A rodent model was developed to assess the osteogenic potential of continuous capacitive electrical stimulation on bone healing around titanium (Ti) implants. Adult male rats were fitted subcutaneously with electrical leads, that were placed around Ti implants inserted in the tibia. One electrical lead was attached directly to the extraosseous component of the implant, and the other was anchored to the adjacent subcutaneous tissues. Bone healing around the Ti implant was assessed histologically after 2, 3, 4, 5, 6, 7, 14 and 21 days of continuous capacitive electrical stimulation as compared to controls and sacrificed immediately. Other groups of animals were given 7 days of continuous capacitive electrical stimulation but sacrificed at day 14 or 21 post-implantation. Histomorphometric analysis of the bone-Ti interface revealed that animals given 5--7 days of continuous capacitive electrical stimulation demonstrated more bone at the surface of the Ti implant than in controls. Radioautographic analyses of bone formation was carried out in rats injected with tritiated (3H)-proline 4 days prior to sacrifice at days 7, 14 and 21. These results showed increased 3H-proline deposition at day 7, corresponding to increased bone formation as shown by morphometric findings. Biomechanical 'pull-out' tests demonstrated that the force required to remove the Ti implants from the tibiae was significantly greater in electrically stimulated animals compared to controls at day 7. Bone densitometric measurements revealed a statistically significant increase in bone density in the electrically-stimulated animals by days 5--7 compared to controls. In summary, an animal model was developed to evaluate the effects of continuous capacitive electrical stimulation on bone healing around Ti implants placed in tibiae of rats. Significant bone growth was demonstrated by days 5--7 postimplantation as in all parameters tested. These findings suggest that continuous capacitive electrical stimula

<p>The aim of the study was to analyze oral health status(dental caries, periodontal conditions, fluorosis and malocclusion) of institutionalised children at Amani and Mkombozi street children homes in Moshi town, Tanzania. 100 street children participated. A cross sectional survey of street children between 12-18 years was carried out based on WHO guidelines. Self administered questionnaires were used to collect information from the caregivers.The findings indicate clear need to improve oral hygiene among these children.</p>

Since 1983, the WHO has recommended the use of the INR for measuring the level of anticoagulation for patients receiving warfarin therapy. However, no scientifically-derived guidelines, using the INR, for the surgical management of this group of patients exists. In the first part of this study, the protocols followed by oral surgeons, when treating patients receiving warfarin, and who require dental extractions were established by performing a mail survey. The results of the survey illustrated that although the majority of oral surgeons use the INR, most of them use the INR along with the PT and only one fifth of them use this measure alone. In the second part of this study, dental extractions were performed on rabbits which were anticoagulated to various INR levels. The results of this study strongly suggest that dental extractions may be safely performed on subjects receiving oral anticoagulants using routine measures for local hemostasis.

Introduction: Manufactured Colas are consumed universally as soft drinks. Evidence about the acid contents of Cola-beverages and its effects on teeth is rare. Aim: To assess: (i) cola acidity and buffering capacity in vitro, (ii) tooth erosion after swishing with colas in vivo (iii) scanning electron microscopic effects on teeth of colas, and tooth-brush abrasion, and (iv) report a clinical case of erosion from cola consumption. Materials and Methods: (i) We measured six commercially available pop ‘Cola-beverages', pH and buffering capacities using a pH-Mettler Automatic Titrator, with weak solution of Sodium Hydroxide. (ii) Two cohorts, one with teeth, the second without teeth rinsed with aliquots of Cola for 60 seconds. Swished cola samples tested for calcium and phosphorus contents using standardized chemical analytical methods. (iii) Enamel, dentine and the enamel-cemental junction from unerupted extracted wisdom teeth were examined with a scanning electron microscope after exposure to colas, and tested for tooth-brush abrasion and (iv) a clinical case of pop-cola erosion presentation, are all described. Results: Comparisons among pop-colas tested in vitro reveal high acidity with very low pH. Buffering capacities in milliliters of 0.5M NaOH needed to increase one pH unit, to pH 5.5 and pH 7 are reported. Rinsing in vivo with pop-cola causes leaching of calcium from teeth; SEM shows dental erosion, and pop-cola consumption induces advanced dental erosion and facilitates abrasion. Conclusions: (i) Pop-Cola acid activity is below the critical pH 5.5 for tooth dissolution, with high buffering capacities countering neutralization effects of saliva; (ii) calcium is leached out of teeth after rinsing with pop-colas; (iii) SEM evidence explains why chronic exposure to acid pop-colas causes dental damages; and (iv) a clinical case of pop-cola erosion confirms this. Key Words: Acid, Attrition, Abrasion, Beverages, Buffering, Calcium, Cola, Coca-Cola, Diet-Coke, Diet-Pepsi, Diet-Selection, Erosion, Frangibles, Pepsi, Selection-Cola, Teeth. / Introduction : Il se consomme des boissons gazeuses de type cola partout dans le monde. Les éléments de preuve concernant la teneur en acide des boissons de type cola et ses effets sur les dents sont rares. Objectif : (i) Mesurer l'acidité et le pouvoir tampon du cola in vitro, (ii) mesurer l'érosion dentaire à la suite d'un rinçage in vivo avec des colas, (iii) mesurer les effets du cola sur les dents au moyen d'un microscope électronique à balayage, ainsi que l'abrasion découlant du brossage, et (iv) présenter un cas clinique d'érosion issue de la consommation de cola. Matériel et méthodes : (i) Nous avons mesuré le pH et les pouvoirs tampons de six boissons gazeuses commerciales de type cola au moyen d'un pH-mètre et d'un titrimètre automatique de Mettler, avec une solution faible d'hydroxyde de sodium. (ii) Deux groupes, l'un dont les membres avaient des dents et l'autre non, se sont soumis à un rinçage de 60 secondes avec une aliquote de cola. La teneur en calcium et en phosphore des échantillons se rapportant au rinçage avec du cola a été mesurée au moyen de méthodes normalisées de chimie analytique. (iii) L'émail, la dentine et la jonction émail-cément des troisièmes molaires extraites n'ayant pas fait leur éruption ont été examinés au microscope électronique à balayage après l'exposition au cola, et ont été soumis à un test d'abrasion par brosse à dents, et (iv) un cas clinique d'érosion attribuable au cola est présenté. Résultats : Les comparaisons entre les colas testés in vitro révèlent une acidité élevée avec un pH très bas. Les pouvoirs tampons en millilitres de NaOH 0.5 M devaient augmenter d'une unité de pH, et les mesures de pH 5.5 et pH 7 sont rapportées. Le rinçage in vivo avec du cola entraîne la décalcification des dents. En effet, les examens réalisés au microscope électronique à balayage montrent une érosion dentaire. Par conséquent, la consommation de colas provoque une érosion dentaire avancée et contribue à l'abrasion. Conclusions : (i) L'activité acidifiante du cola se situe sous le seuil critique de pH 5.5 pour la dissolution dentaire, et présente un pouvoir tampon élevé qui annule les effets neutralisants de la salive; (ii) le calcium est éliminé des dents après le rinçage avec les colas; (iii) les analyses réalisées au microscope électronique à balayage expliquent pourquoi l'exposition chronique à l'acidité des colas entraîne une fragilité dentaire ; et (iv) un cas clinique d'érosion due au cola vient confirmer les résultats obtenus. Mots clés : Acide, Attrition, Abrasion, Boissons, Tamponnage, Calcium, Cola, Coca-Cola, Coke diète, Pepsi diète, Sélection diète, Érosion, Fragile, Pepsi, Sélection cola, Dents.

Objectives. This study was undertaken to evaluate whether the effects of hyperbaric oxygen (HBO) therapy could alter the critical size for spontaneous healing of a bone defect in the rabbit calvarial model. / Study design. An animal trial of 12 weeks duration was conducted using 20 New Zealand White rabbits, which were randomly divided into 2 groups of 10 animals each. Calvarial defects were created in the parietal bone of each animal bilaterally. Defects were critical sized, 15mm on one side and supra critical sized, 18mm on the contralateral side. Group 1 received 90 minutes HBO treatment sessions at 2.4 ATA per day for 20 consecutive days. Group 2 served as a control without any HBO treatment sessions. Five animals in each group were sacrificed at 6 and 12 weeks. Data analysis included qualitative assessment of the calvarial specimens, post sacrifice radiographs as well as histomorphometric analysis to compute the amount of regenerated bone within the defects. Two way ANOVA was used for statistical analysis. / Results. Both radiographic analysis and histomorphometric analysis demonstrated that HBO treated animals had significantly more new bone within defects compared with the control group. There was no statistically significant difference between the percentage of new bone forming in the 15mm and 18mm HBO treated defects. There was no difference between the 6 week and the 12 week HBO treated groups. / Conclusion. HBO is effective in enhancing the bone healing of full thickness critical sized as well as supra-critical sized defects in the rabbit calvarial model. Bone regeneration was significantly greater in the HBO treated animals regardless the defect size. HBO may have increased the diameter of the rabbit critical sized calvarial defect to more than 18mm.

INTRODUCTION: Deciduous and permanent teeth differ in shape and calcium content. Deciduous enamel and dentin are thinner and softer than permanent teeth. Chronic, frequent imbibing of acidulated pop-drinks imbibing is erosive, and dentinal pain occurs after rinsing with acidulated pop-drinks. Since calcium and phosphorous leach from teeth with acid drinks, we investigated pop-colas and pop-guaraná for pain sensitivity and erosion in adults and children. AIM: This research assessed (i) in vitro, the pH buffering, calcium, phosphorous and fluoride content of pop-guaraná and pop-colas. This research compares (ii) in situ scanning surface electron microscopy (ESEM) of granular hydroxyapatite crystals (HAP), enamel, dentin and enamel-dentin junctions (AMCJx) after exposure to pop-colas and pop-guaraná. This research reports (iii) in vivo calcium and phosphorous, leached from children and adults derived from erosion after swishing with pop-colas and pop-guaraná. This research assesses (iv) in vivo pain in children and adults after swishing with pop-colas and pop-guaraná. METHODS: Six pop-colas (3 regular; 3 diet) and six pop-guaraná drinks (4 regular; 2 diet) were tested pH, buffering capacity, calcium, phosphorus and fluoride concentrations using standard chemical analytical methods: ICP-OES for calcium and phosphorous, and a Single Orion Electrode for fluoride, coupled to an automated electronic digital recorder. Scanning surface electron microscopy (ESEM), without metal coating, was used to examine calcified samples. The same precise microscopic locations were used for visual comparisons. Three cohort volunteers (adult dentate, adult edentulous and children dentate) swished aliquots of drinks for 30s. Each drink had readings recorded 72 times. Six colas and six guaraná drinks from source and mouth rinse were tested for calcium and phosphorous. VAS scales were used for comparisons of pain for each drink. RESULTS: Data showed significant (p < .0001) increases of calcium and phosphorous after rinsing with colas and significantly less (p < .0001) leaching after rinsing with guaraná. Guaraná induced less pain than colas. Children show more erosion with rinsing colas than guaraná, but less pain after cola rinsing than adults. Little pain with guaraná rinses was recorded in children. All guaraná pop-drinks have fluoride content, with a range from concentration at 0.8 ppm F- to 1.6ppm F. CONCLUSION: While both colas and guaraná are erosive to teeth and cause pain in adults and children, pop-colas are more erosive than guaraná in children, and colas induce more dentinal pain in adults than in children. Fluoride in the drink may modulate the erosion. ESEM evidence shows guaraná pop drinks demonstrate marked visual increases in mordant changes of HAP and the hard tissues of teeth. Some pop-guaraná drinks are less erosive than others are. KEYWORDS: Acid, attrition, abrasion, beverages, buffering, calcium, phosphorus, guaraná, erosion, teeth. / RésuméINTRODUCTION : Les dents décidues et les dents permanentes diffèrent par leur forme et teneur en calcium. L'émail et la dentine de dents décidues sont plus minces et moins dure que les dents permanentes. Si utilisée de façon chronique, souvent l'ingestion de boissons gazeuses acidulées est érosive, et la douleur dentinaire se produit après rinçage à boisson gazeuse acidulée. Étant donné la perte de calcium et de phosphore découlant de L'ingestion des boissons acides, nous avons étudié des boissons gazeuses colas et guaraná pour La sensibilité à la douleur et l'érosion. OBJECTIF: Cette recherche a évaluée: (i) in vitro le pH, le pouvoir tampon, le calcium, le phosphore et la quantité de fluorure des boissons gazeuses guaraná et colas, (ii) la comparaison des données in situ: - Surface de microscopie électronique à balayage: cristaux d'hydrox apatite granulaire, émail, dentine, l'émail -dentine jonction (AMCJx) (iii) in vivo la perte de calcium et de phosphore chez enfants et chez adultes pour l'érosion avec des boissons gazeuses colas et de guaraná, et (iv) la douleur après le rinçage. MÉTHODES: Six boissons gazeuses colas (3 régulières; 3 diètes) et six boissons gazeuses guaraná (4 régulières, 2 diètes), ont été testées le pH, le pouvoir tampon, le calcium, phosphures et le fluorure ont été mesurées dans le guaranás. En utilisant des méthodes chimiques classiques d'analyse; ICP-OES pour le calcium et le phosphore et un unique Orion électrode pour le fluorure, couplé à un enregistreur numérique automatisé électronique. Trois cohortes de bénévoles, (la première des adultes dentées, la deuxième des adultes édentés, et la troisième des enfants dentées); rinçage des aliquotes de boissons pendant 30s. Chaque échantillon a été analysé, des mesures ainsi que des moyennes ont été enregistrées (α ÷ 6 = β où α a été la lecture et β la moyenne); 12 échantillons de chaque boisson ont été enregistrés (β X 12 mesures pour toutes les boissons) pour chaque boisson appréciée. En conséquence, chaque boisson a eue des lectures enregistrées pour un total de 72 fois, toutes avec des méthodes standards préétablies. Colas de la source et pos rinçage ont été testés pour le calcium et le phosphore. Des échelles EVA ont été utilisées pour les comparaisons de la douleur, (notes initiales et pos rinçage pour chaque boisson). Chaque analyse a été vérifiée comme décrite pour les six guaraná évaluées. RÉSULTAT: Les données ont montré une augmentation significative du calcium et du phosphore après rinçage avec les colas et beaucoup moins après rinçage avec le guaraná. Le Guaraná cause moins de douleur que les colas. Les enfants montrent une plus grande érosion lors du rinçage avec l'utilisation de cola par rapport le guaraná, mais moins de douleur. Cependant les enfants accusent moins de douleur après rinçage avec cola que les adultes. Chez les enfants, le rinçage avec le guaranás a produit peu de douleur. Toutes les boissons gazeuses à base de guaraná ont une quantité en fluorure. La boisson gazeuse Kuat montrant la plus faible concentration à 0,8ppm F- tandis que l'Antarctica et la régulière Mineiro sont a plus de 1,6ppm F-. CONCLUSION: Bien que les deux colas et le guaraná sont érosifs sur les dents et causent de la douleur chez les adultes et chez les enfants, les boissons gazeuses colas sont plus érosives que le guaraná chez les enfants, et les colas provoquent plus des douleurs dentinaires chez les adultes que chez les enfants. Le fluorure dans la boisson peut moduler l'érosion. La preuve ESEM démontre que les boissons gazeuses au guaranás. Dénotent une augmentation marquée de changements visuels concernant le occlusal/bord incisif de HAP et de tissus durs des dents. Guaraná Mineiro cause moins de dommages par rapport à toutes les boissons gazeuses guaraná testées. MOTS-CLÉS: acides, de l'attrition, l'abrasion, des boissons, le pouvoir tampon, le calcium, le phosphore, le guaranás. , l'érosion, dents.

The use of endosseous titanium implants, for the replacement of missing teeth, has become a predictable treatment alternative in restorative dentistry. Success of dental implants appears to be related to the quality of bone. Bone of high quality will ensure better implant stability and, consequently, better conditions for osseointegration. This thesis reviews both and human data related to bone quality in association with endosseous titanium implant placement. / Biomechanical pull out testing is one among several methods used to quantitatively assess the forces required to remove an implant from bone. Pull out testing has the advantage of assessing the biomechanical stress between two materials of different physical and chemical properties, in this case bone and a titanium, implant surface. The variability of our results in the animal model led us to review our laboratory notes. Interesting correlations between the initial implant stability and the eventual pull out values were identified. Clinical data involving many variables were available from previous clinical trials and an attempt was made to retrospectively evaluate this information. The goal of this process was to determine, clinically, if a similar correlation could be identified between initial impressions at the time of implant placement and ultimate implant success. / Clinical data revealed that the following variables were important for the final prognosis of an implant: dental arch, implant length, method of insertion, bone graft, the surgeon, jaw bone quality and jaw bone quantity. Using a sophisticated statistical analysis, generalized estimating equation, most of these factors were found only to indirectly influence the success or failure of an implant. Our clinical findings suggested that jaw bone quality and quantity were the primary determining factors for implant success. This supports our observations from the animal study.

Bone is constantly undergoing remodeling of its bony matrix in response to various stimuli impinged upon the tissue. Bony remodeling occurs in both the dentate and edentulous states, but the edentulous lose more bone over time. This study analyzed sex, age and years edentulous for their influence on the height, width and shape of the anterior residual alveolar ridge of the jaws. Significantly greater amounts of mandibular residual alveolar bone height were found in males (p < 0.0001) and in those with more edentulous years in the maxilla (p = 0.003). The maxilla showed significantly greater amounts of residual alveolar bone height in the group with fewer edentulous years (p = 0.004). No significant associations were detected when sex, age and years edentulous were compared with anterior maxillary bone width. Statistical analysis of this study population also revealed no significant associations between sex, age, and years edentulous and anterior maxillary bone shape.

<p> Primary care providers have not customarily provided oral assessments or offered anticipatory guidance about oral health care; dentists manage that task. Myths and access-to-care issues often result in limited or no dental care during pregnancy. Improving the oral health of pregnant women has a positive correlation with fewer dental caries in their children. Currently, evidence-based practice (EBP) oral health guidelines exist for pregnant women and children. While health care providers (HCPs) want to implement best practices, they find practice change challenging.</p><p> This project utilizes a planned change theory to guide the implementation of oral health guidelines with a methodical approach. Retrospective and prospective chart audits evaluate HCP behavior change. The chart audits reveal HCPs change behaviors after a practice intervention with a Primary Care Oral Assessment Tool (PCOAT), and again after introduction of EBP guidelines. Some changes in provider behavior were statistically and clinically significant.</p><p> <i>Keywords:</i> pregnancy, pregnant, prenatal, antenatal, dental care, oral health, and practice guidelines</p>