A clinical comparison of the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients.
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This study compared the efficacy and efficiency of two professional prophylaxis procedures in orthodontic patients performing different oral hygiene regimens: the air powder polishing system (APP), and the rubber cup and pumice (RCP) technique. Sixty-two patients were divided into two groups: group I included 40 subjects who did not use any chlorhexidine mouthwash and group II comprised 22 subjects who regularly rinsed with a chlorhexidine mouthwash (at a 0.12 per cent concentration) and showed increased tooth staining. Using a split-mouth experimental design, the buccal and lingual tooth surfaces were cleaned in half of the mouth by the APP and in the opposite half by the RCP technique. Tooth surfaces were scored before (PRE) and after (POST) the experimental procedures for the plaque index (PI), and for the presence of tooth staining. In addition, the treatment time required by each procedure was recorded. In test group I, significant reductions in the PI after APP and RCP were observed. Likewise, in test group II, both procedures significantly reduced the baseline PI values. In both experimental groups, the percentage of stained sites significantly decreased after APP and RCP, but in test group II, APP seemed to be more effective than RCP. In addition, APP required significantly less time than RCP to remove dental plaque and staining. These data show that both professional prophylaxis procedures are effective in orthodontic patients, with APP being the most time-efficient technique and the most effective method for removal of tooth staining. (+info)
Tooth loss in periodontal patients.
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OBJECTIVE: To compare tooth loss between patients who received surgical therapy for chronic periodontitis and those who received nonsurgical therapy alone. METHODS: A retrospective chart study was conducted at Dalhousie University. All patients who had periodontal treatment and were active cases for at least 10 years were included (n = 335). The sample consisted of 120 males (35.8%) and 215 females (64.2%). Ages ranged from 16 to 77 (mean = 46.1 +/- 12.0 years). All patients received nonsurgical therapy; 44.8% received periodontal surgery as well. Variables recorded were demographics, initial attachment loss, treatment type, recall frequency, patient compliance and history of extracted teeth. Independent t-tests or chi-squared tests were used to compare these for surgical and nonsurgical patients. ANOVA was used to test for interactions between initial attachment loss, age, gender, compliance and type of therapy a patient received as reasons for tooth loss. RESULTS: 521 teeth were lost in 69 patients (20.6% of sample). Of teeth lost, 61.8% were due to periodontal disease; 24.8% to caries; 13.2% to other reasons. Patients initially diagnosed with early attachment loss lost an average of 0.37 (+/- 1.33) teeth. Patients diagnosed with moderate attachment loss lost an average of 1.50 (+/- 2.54) teeth and those diagnosed with advanced attachment loss lost an average of 3.11 (+/- 3.01) teeth. Those who received surgical therapy lost more teeth (mean = 1.31 +/- 2.36) than those who received nonsurgical treatment (mean = 0.68 +/- 1.87; p = 0.001). However, initial attachment loss was the only factor that could predict tooth loss. The type of therapy (surgical or nonsurgical) was not statistically significant. CONCLUSIONS: Most periodontal patients (79.4%) who received treatment at this dental school clinic did not lose any teeth due to periodontal disease over at least 10 years. Although patients who had surgical therapy lost more teeth than those who had nonsurgical therapy alone, this was not an important predictor of tooth loss. (+info)
Decision-making on the use of antimicrobial prophylaxis for dental procedures: a survey of infectious disease consultants and review.
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There is debate concerning use of antibiotic prophylaxis before invasive dental procedures for patients at risk of acquiring distant site infection (DSI). We determined the opinions and practices of infectious disease consultants (IDCs) regarding antimicrobial prophylaxis to prevent DSIs that result from invasive dental procedures by conducting a survey of the 797 members of the Infectious Diseases Society of America Emerging Infections Network (477 members [60%] responded). Ninety percent of respondents closely follow the American Heart Association guidelines for antibiotic prophylaxis for patients with valvular heart disease who undergo invasive dental procedures. In contrast, few IDCs recommend prophylaxis for patients with lupus erythematosus, poorly controlled diabetes mellitus, dialysis catheters or shunts, cardiac pacemakers, or ventriculoperitoneal shunts. Twenty-five percent to forty percent of respondents recommended prophylaxis for prosthetic vascular grafts, orthopedic implants, or chemotherapy-induced neutropenia. We conclude that IDCs differ considerably in their assessment of the need for prophylaxis for patients who have noncardiac risk factors for DSI. These differences underscore the need for definitive studies to delineate appropriate candidates for antimicrobial prophylaxis in dental practice. (+info)
Assessment of evidence-based dental prophylaxis education in postdoctoral pediatric dentistry programs.
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The objective of the study was to investigate various aspects of evidence-based dental prophylaxis education in postdoctoral pediatric dentistry training programs in the United States. An anonymous nationwide postal survey of fifty-two postdoctoral pediatric dentistry program directors was conducted in September 2001. The survey had a response rate of 75 percent with all geographic regions of the nation represented and with a preponderance of university-based programs (62 percent). Most of the training programs (74 percent) routinely recommended dental prophylaxis for all recall patients. The proportion of programs that recommended dental prophylaxis for the following indications were: plaque, stain and/or calculus removal--97 percent; caries prevention--59 percent; prior to topical fluoride application--67 percent; prior to sealant application--62 percent; and for behavioral modification--77 percent. Most training programs (77 percent) defined dental prophylaxis as both rubber cup pumice prophylaxis and toothbrush prophylaxis. However, only one-half of the training programs (51 percent) had modified their teaching to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. In conclusion, only one half of postdoctoral pediatric dentistry training programs in the United States teach evidence-based practice of dental prophylaxis for recall patients. (+info)
Effect of prophylactic treatments on the superficial roughness of dental tissues and of two esthetic restorative materials.
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Dental prophylaxis is a common way to remove dental plaque and stain, both undesirable factors in most dentistry procedures. However, besides cleaning the tooth surface, prophylactic techniques may increase the surface roughness of restorations and dental tissues, which, in turn, may result in plaque accumulation, superficial staining and superficial degradation. This study evaluated the effect of three prophylactic techniques--sodium bicarbonate jet, pumice paste and whiting paste--on the superficial roughness of two restorative materials--a composite resin and a compomer--and on the superficial roughness of two dental surfaces--enamel and cementum/dentin--through rugosimetric and scanning electron microscopy (SEM) analysis. Statistical analysis of the rugosimetric data showed that the use of pumice paste on enamel produced a significantly smoother surface than the natural surface. However, comparing the effect of the three techniques, prophylaxis with the pumice paste produced a rougher surface than did the other techniques as regards enamel and cementum/dentin probably due to its abrasiveness. On composite resin, the pumice paste only produced a rougher surface than did the whiting paste. On compomer, all of the applied treatments produced similar results. Based on rugosimetric and SEM analysis, we could conclude that the prophylactic treatments employed did not improve roughness of the studied surfaces. As to the effects of the techniques, they were different depending on the surfaces on which the prophylactic treatments were applied. (+info)
Effects of a non-rinse conditioner on the enamel of primary teeth.
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The aim of this in vitro study was to evaluate by scanning electron microscopy the morphological aspects of the enamel of primary teeth after etching with 36% phosphoric acid or a non-rinse conditioner. Ten naturally exfoliated anterior primary teeth were selected. The samples were subjected to prophylaxis with pumice paste and water using a low-speed hand piece. Etching was done on the buccal surface. Specimens were divided into 2 groups: G1 (n=10): etching with 36% phosphoric acid gel - Conditioner 36 (Dentsply) for 20 s, followed by water rinse for 15 s; G2 (n=10): etching with NRC - Non Rinse Conditioner (Dentsply) for 20 s, followed by air drying for 15 s. The samples were dehydrated, mounted on metal stubs, coated with gold and observed with Jeol JSM-6100 scanning electron microscope. Electron-micrographic analysis showed that both etching agents were effective for etching the enamel of primary teeth causing the formation of microporosities on the enamel surface, although the etching pattern was more effective with the use of 36% phosphoric acid gel. (+info)
Control of gingival inflammation in a teenager population using ultrasonic prophylaxis.
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Gingival inflammation is clinically characterized by gingival redness, swelling and increased tendency of bleeding of the soft tissue. Bacterial biofilm is the etiological agent. If, at this stage, the bacterial biofilm is removed and appropriate control methods are applied, remission of gingival inflammation occurs. This study evaluated the effectiveness of a single session of ultrasonic prophylaxis for the reduction of gingivitis in an adolescent population using the Plaque Index (PI) and Gingival Index (GI). The study sample consisted of 15 male adolescent students selected at a dentist's office of a public high school. Prior to treatment (baseline), plaque index (PI) and bleeding on probing (BOP) were recorded. The patients then received oral hygiene instructions and ultrasonic prophylaxis. Follow-up exams were made 15 and 30 days after the ultrasonic prophylaxis, again recording PI and BOP. The data were analyzed by the Student's t-test for dependent samples. Correlation analysis between presence of biofilm and bleeding on probing was also made using the Pearson correlation test. There was a statistically significant decrease in the plaque index and bleeding on probing between baseline and examinations at both 15 days and 30 days (p<0.05). However, the difference between the means at 15 and 30 days was statistically similar. The correlation analysis showed correlation between both parameters (p<0.05). The results indicate that a single session of ultrasonic prophylaxis associated to oral hygiene instructions is efficient to reverse gingivitis in adolescents. (+info)
Medical dental prophylaxis of endocarditis.
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Antibiotics have long been the main reason for the increase in man's longevity. Since their discovery, man has tried to reduce the level of infection by treating with antibiotics. At the same time, prophylactic use has been suggested, although this is controversial. Their routine use is not recommended, and empirical treatments at non-therapeutic doses, and indiscriminately, should be avoided, because they may become dangerous and harmful, causing among other things, the prevalence of resistant microorganisms and the eventual potentiation of an increase in morbid states. Infectious endocarditis is a systemic pathology that can start with a bacteremia, which comes either from dental procedures or/and chronic processes that already existed. Its etiopathogeny consists of a combination of bacteremia and two other factors: Cardiac injury, which can be congenital or/and acquired, and a debilitated immunological system (patients who have transplanted organs, or those who have auto-immune diseases, such as pemphigus vulgaris, systemic lupus erythematosus). The main goal is to prevent or to fight against the transient bacteremia, reducing its intensity and duration, and also to kill the bacteria in at-risk patients. In this way, infectious endocarditis can be prevented; the dental surgeon plays an important role in the prevention of this condition, which joins medical and dental aspects. This can be done by antibiotic prophylaxis. The dentist needs to be acquainted with the medical protocols of the heart health societies. (+info)