bluuebunny/crossref_metadata_2025 huggingface dataset:
Edentulism and associated factors in people 60 years and over from urban, rural and remote Western Australia
Authors: Adams C. , Slack‐Smith LM , Larson A. , O'Grady MJ
Published: March 2008

Background: Edentulism is declining in the aged, in turn increasing demand on dental services. The aim of this study was to describe the pattern of edentulism and associated factors for people 60 years or over in urban, rural and remote Western Australia.

Methods: A cross‐sectional telephone interview survey was conducted of 2100 people aged 60 years or over (urban n=800, rural n=800, remote n=500), identified through the State Electoral Roll, who were living in non‐institutionalized accommodation in Western Australia and who were able to speak English sufficiently well to be interviewed in English.

Results: The main outcome measure was edentulism. The prevalence of edentulism was 25 per cent for people in urban areas, 34 per cent for people in rural areas and 32 per cent for people in remote areas. Respondents aged 60–69 years had less than half the edentulism than respondents aged 80 years or over. Multivariable logistic regression models showed geographic location, age, gender, education and occupation were significantly associated with edentulism.

Conclusions: The percentage of edentulism was highest in rural areas with some clear demographic trends. These future aged cohorts are likely to follow the same patterns of social and geographic disadvantage as found for the current edentate cohort. The results were consistent with other studies while providing state level multivariate results to assist service planning.
Oral health status of prison inmates — New South Wales, Australia
Authors: Osborn M. , Butler T. , Barnard PD
Published: March 2008

Background: This paper assesses the oral health status in a prison population and identifies risk factors associated with oral health.

Methods: Cross‐sectional stratified random sample of 789 prisoners (657 males and 132 females) from 27 correctional centres across New South Wales, stratified by sex, age and aboriginality. A face to face interview was used to collect information on health status and behavioural risk factors. A subset of participants (312 males and 22 females) received an oral examination which enabled the decayed, missing or filled permanent teeth (DMFT) score to be calculated.

Results: In the last 12 months 391 (50 per cent) inmates had visited a dentist. Reports on treatment received at this last visit were mainly for dental examinations, (62 per cent), dental fillings, (38 per cent), and dental extractions (28 per cent). Self‐reported dental needs indicated that 42 per cent perceived the need for a check‐up; the perceived need for dental fillings was highest in females compared with males. The mean DMFT for the population was 20.4 and 3.4 for decayed teeth.

Conclusions: This survey demonstrates that the standard of past oral health care for prison inmates is low. There is a need to be more attentive to oral health promotion as eventually respondents will be returning to the community.
Canine eruption into grafted alveolar clefts: A retrospective study
Authors: Hogan L. , Shand JM , Heggie AA , Kilpatrick N.
Published: March 2008

Background: The contemporary treatment of cleft lip and palate involves a sequence of surgical procedures and orthodontic management. Alveolar bone grafting (ABG) is usually undertaken after orthodontic expansion of the maxillary segments between the ages of eight and 12 years. Two of the important goals of alveolar bone grafting are the provision of bony support for the eruption of the canine and the closure of residual oro‐nasal fistulae. The purpose of this study was to retrospectively evaluate the root development and eruption of the canine following ABG.

Methods: Group 1: radiographic and clinical records of a sample of 19 cleft patients who underwent alveolar bone grafting procedures, performed between 1996 and 1999 were reviewed. Group 2: a random sample of 15 cleft patients attending for routine dental review were clinically examined. The age of patient, degree of root development and eruption status of the canine, and presence of oronasal fistulae pre and post alveolar bone grafting were evaluated.

Results: Most cleft canines had continued root development and descended in the alveolus towards eruption following ABG. Four canine teeth (8 per cent) were impacted and required surgical exposure and orthodontic treatment following failure of eruption. Closure of anterior oro‐nasal fistulae at the time of grafting was maintained post‐operatively.

Conclusions: This study demonstrated that canine root development and eruption continued satisfactorily through grafted alveolar clefts in most cases and closure of anterior oro‐nasal fistulae was achieved in all cases.
Crohn's disease with oral presenting signs masquerading as chronic osteomyelitis
Authors: Aquilina P. , Savage NW , Lynham A.
Published: March 2008

Background: A case of Crohn's disease (CD) was diagnosed following recognition of oral and systemic signs and symptoms in a 19‐year‐old male patient.

Methods: Clinical investigation utilized included blood tests (full blood count, electrolytes, urea, creatinine, liver function tests), computed tomogrphy scans, magnetic resonance imaging scans, oral biopsies, colonoscopy and biopsies of the terminal ileum and colon.

Results: A diagnosis of CD was made which then allowed appropriate medical treatment to be initiated.

Conclusion: The importance of a thorough medical history and full physical examination with appropriate investigations as dictated by clinical findings is demonstrated.
The current status of laser applications in dentistry
Authors: Walsh LJ
Published: March 2008

A range of lasers is now available for use in dentistry. This paper summarizes key current and emerging applications for lasers in clinical practice. A major diagnostic application of low power lasers is the detection of caries, using fluorescence elicited from hydroxyapatite or from bacterial by‐products. Laser fluorescence is an effective method for detecting and quantifying incipient occlusal and cervical carious lesions, and with further refinement could be used in the same manner for proximal lesions. Photoactivated dye techniques have been developed which use low power lasers to elicit a photochemical reaction. Photoactivated dye techniques can be used to disinfect root canals, periodontal pockets, cavity preparations and sites of peri‐implantitis. Using similar principles, more powerful lasers can be used for photodynamic therapy in the treatment of malignancies of the oral mucosa. Laser‐driven photochemical reactions can also be used for tooth whitening. In combination with fluoride, laser irradiation can improve the resistance of tooth structure to demineralization, and this application is of particular benefit for susceptible sites in high caries risk patients. Laser technology for caries removal, cavity preparation and soft tissue surgery is at a high state of refinement, having had several decades of development up to the present time. Used in conjunction with or as a replacement for traditional methods, it is expected that specific laser technologies will become an essential component of contemporary dental practice over the next decade.
Diagnosis and management of unusual dental abscesses in children
Authors: Seow WK
Published: March 2008

Although the majority of dental abscesses in children originate from dental caries or trauma, a few are associated with unusual conditions which challenge diagnosis and management. Recent research findings have shed light on these unusual entities and greatly improved understanding of their clinical implications. These conditions include developmental abnormalities such as dens invaginatus in which there is an invagination of dental tissues into the pulp chamber and dens evaginatus in which a tubercle containing pulp is found on the external surface of a tooth crown. In addition, inherited conditions which show abnormal dentine such as dentine dysplasia, dentinogenesis imperfecta, and osteogenesis imperfecta predispose the dentition to abscess formation. Furthermore, ‘spontaneous’ dental abscesses are frequently encountered in familial hypophosphataemia, also known as vitamin D‐resistant rickets, in which there is hypomineralization of dentine and enlargement of the pulp. In addition to developmental conditions, there are also acquired conditions which may cause unusual dental abscesses. These include pre‐eruptive intracoronal resorption which was previously known as ‘pre‐eruptive caries’ or the ‘fluoride bomb’. In addition, some undiagnosed infections associated with developing teeth are now thought to be the mandibular infected buccal cysts which originate from infection of the developing dental follicles. In the present paper, these relatively unknown entities which cause unusual abscesses in children are reviewed with the aim of updating the general practitioner in their diagnosis and management.
Desquamative gingivitis: A sign of mucocutaneous disorders‐a review
Authors: Robinson NA , Wray D.
Published: March 2008

Desquamative gingivitis is a clinical term to describe red, painful, glazed and friable gingivae which may be a manifestation of some mucocutaneous conditions such as lichen planus or the vesiculobullous disorders. It is important to be aware of this rare clinical entity so as to distinguish desquamative gingivitis from plaque induced gingivitis which is an extremely common condition, easily recognized and treated daily by the dental practitioner. This article gives an overview of desquamative gingivitis, its presentation, the possible causes, diagnosis and treatment. Early recognition of these lesions may prevent delayed diagnosis and inappropriate treatment of potentially serious dermatological diseases.
The diagnosis and surgical management of major salivary gland pathology
Authors: Lawler B. , Pierce A. , Sambrook PJ , Jones RHB , Goss AN
Published: March 2008

Background: Major salivary gland pathology is an uncommon but important finding which may initially present to general dental and medical practitioners. The consequences of misdiagnosis are important, as acute obstruction and neoplasia are the main pathological lesions diagnosed. The purpose of this study was to analyze a consecutive series of major gland pathologies treated surgically to determine diagnostic and treatment problems.

Methods: A retrospective analysis of all cases of the major salivary glands treated on an inpatient surgical basis over a five‐year period by the Oral and Maxillofacial Surgery Unit of the Royal Adelaide Hospital was performed. Particular emphasis was placed on the referring diagnosis as compared to the final diagnosis.

Results: Fifty‐four patients had surgical management of 62 major salivary glands over the five‐year period. By gland, 18 (33.3 per cent) were parotid, 35 (51.1 per cent) submandibular and nine (16.6 per cent) were sublingual. Fifty‐one (82 per cent) of all lesions were inflammatory and 11 (18 per cent) neoplastic. The most common presentations were swelling (72 per cent) and pain (33 per cent). Most patients were referred by general dentists (37 per cent), followed by general medical practitioners (32 per cent) and specialists (28 per cent). The referring diagnosis was correct for only 45 per cent of the dentists but 76 per cent for the general medical practitioners and 87 per cent for the specialists. Only two of the 11 gland neoplasms were correctly identified as neoplasms, both by specialists. The morbidity of the surgical treatment was low.

Conclusion: The general dental practitioner is often the first health professional with the opportunity to assess salivary gland pathology, and therefore needs to be aware of the presenting signs and symptoms of major salivary gland lesions.
Morphological analysis of subgingival biofilm formation on synthetic carbonate apatite inserted into human periodontal pockets
Authors: Takeuchi H. , Yamanaka Y. , Yamamoto K.
Published: March 2008

Background: Details of the development of human subgingival biofilm are unknown due to the difficulties in conducting experiments and especially in obtaining undisturbed materials.

Methods: This study was performed using deposits on carbonate apatite that had been inserted into human periodontal pockets for up to three weeks. Scanning electron microscopy using the vertically sectioned method and transmission electron microscopy using the freeze‐substitution method were adopted.

Results: The development of subgingival biofilm occurred in five sequential phases: pellicle formation, microbial adherence, initial colonization, microbial organization, and establishment. Certain species in each of the initial, secondary and tertiary colonizers were considered to have a predilection for biofilm formation. Gram‐positive, bacillary initial colonizers and Gram‐negative, filamentous secondary colonizers organized one stable structure that served as the framework for biofilm formation, and Gram‐negative, rod‐shaped tertiary colonizers with cell‐surface vesicles showed multigeneric coaggregation. The microbiota in the tertiary colonizers underwent repeated microflora alteration.

Conclusions: Subgingival biofilm is constituted by initial, secondary and tertiary colonizers. Microflora alteration which is suggested to be related to periodontal disease, frequently occurred in the tertiary colonizers.
The effects of a tea tree oil‐containing gel on plaque and chronic gingivitis
Authors: Soukoulis S. , Hirsch R.
Published: March 2008

Background: This clinical study assessed the effects of topically applied tea tree oil (TTO)‐containing gel on dental plaque and chronic gingivitis.

Methods: This was a double‐blind, longitudinal, non‐crossover study in 49 medically fit non‐smokers (24 males and 25 females) aged 18–60 years with severe chronic gingivitis. Subjects were randomly assigned to three groups and given either TTO‐gel (2.5 per cent), chlorhexidine (CHX) gel (0.2 per cent), or a placebo gel to apply with a toothbrush twice daily. Treatment effects were assessed using the Gingival Index (GI), Papillary Bleeding Index (PBI) and plaque staining score (PSS) at four and eight weeks.

Results: No adverse reactions to any of the gels were reported. The data were separated into subsets by tooth (anterior and posterior) and tooth surface (buccal and lingual). The TTO group had significant reduction in PBI and GI scores. However, TTO did not reduce plaque scores, which tended to increase over the latter weeks of the study period.

Conclusion: Although further studies are required, the anti‐inflammatory properties of TTO‐containing gel applied topically to inflamed gingival tissues may prove to be a useful non‐toxic adjunct to chemotherapeutic periodontal therapy.
Microbiological evaluation of endodontic files after cleaning and steam sterilization procedures
Authors: Eldik DA Van , Zilm PS , Rogers AH , Marin PD
Published: March 2008

Background: Infection control procedures are essential for modern dental practice and they are continually evolving to meet the dental profession's high standards. The present study evaluated the efficacy of two cleaning procedures to reduce bacterial numbers on endodontic files, and evaluated the effect of biological debris on the subsequent sterilization of files.

Methods: Stainless steel and nickel‐titanium (NiTi) files were examined upon removal from the manufacturer's packaging, after instrumentation in root canals of human teeth inoculated with a broth containing two anaerobic species and one facultative anaerobic species of bacteria, and after instrumentation and cleaning with either an ultrasonic bath or a thermal disinfector. For each file, the bacterial numbers were quantified using routine microbiological techniques in an anaerobic chamber.

Results: No bacteria were detected from files direct from their packets. The size, taper and type of file did not affect the ability of either of the cleaning procedures to reduce bacterial numbers. However, an absence of bacteria was more likely when files were cleaned in the thermal disinfector. No bacteria were detected from files that were subjected to steam sterilization irrespective of the type of prior cleaning procedure.

Conclusions: Steam sterilization eliminated all bacteria from the endodontic files irrespective of the presence of biological debris. The majority of bacteria were eliminated from endodontic files after either ultrasonic cleaning or using a thermal disinfector.
A SEM evaluation of debris removal from endodontic files after cleaning and steam sterilization procedures
Authors: Eldik DA Van , Zilm PS , Rogers AH , Marin PD
Published: March 2008

Background: In recent times, it has been proposed to classify endodontic files as single‐use items due to a perceived inability to adequately clean the instruments. The purpose of the present study was to quantify the surface debris on files removed from the manufacturer's packaging, and after cleaning using an ultrasonic bath or a thermal disinfector.

Methods: Stainless steel and rotary nickel‐titanium files were examined after removal from the manufacturer's packaging, after instrumentation in broth‐contaminated human teeth, and after various cleaning procedures. The cleaning procedures consisted of either a thermal disinfector cycle, ultrasonication with the files placed in a perforated container or ultrasonication with the files loosely placed in a beaker. The presence of manufacturing debris and biological debris was evaluated using scanning electron microscopy and quantified using image analysis software.

Results: The effectiveness of cleaning was not affected by variation in the size or taper of the files when an effective cleaning procedure was used. Cleaning the files in a thermal disinfector or by ultrasonication within a container did not consistently achieve complete removal of biological debris. Placing the files loosely in the ultrasonic bath achieved the most effective cleaning, an average of 98.33 per cent of the file surface area was freed of any biological debris.

Conclusions: A conventional cleaning method is capable of effectively removing biological debris from endodontic files. The efficacy of ultrasonic cleaning was impaired when the files were placed within a perforated container.
Occlusal adjustment for treating and preventing temporomandibular joint disorders
Authors: Koh H. , Robinson PG
Published: March 2008

The Cochrane Collaboration is an international organization that aims to help people make well‐informed decisions about healthcare by preparing, maintaining and promoting the accessibility of systematic reviews on the effects of healthcare interventions. The Cochrane Oral Health Group aims to produce systematic reviews which primarily include all randomized control trials (RCTs) of oral health, including prevention, treatment and rehabilitation of oral, dental and craniofacial diseases and disorders. The abstracts of these reviews can be accessd electronically at http:www.cochrane‐oral.man.ac.uk. Full copies of the review papers can also be purchased via this website.

TheAustralian Dental Journal publishes selected abstracts in each issue for our readers' interest. A detailed description of the activities of the Cochrane Oral Health Group, written by the Review Group Co‐ordinator, Dr Emma Tavender, was published in the June 2004 issue of the Journal (Aust Dent J 2004;49:58–59). Also, for explanations of abbreviations and terminology please see Appendix 1 on page 59 of the aforementioned article.

EDITOR
Doxycycline‐induced staining of permanent adult dentition
Authors: Ayaslioglu E. , Erkek E. , Oba AA , Cebecioglu E.
Published: March 2008

Background: Doxycycline is the most effective antibiotic for managing brucellosis. Although it is relatively free from side effects, complications involving the skin, nails and teeth may rarely be encountered.

Methods: Four patients with brucellosis developed yellow‐brown discolouration of teeth following a 30–45 day course of doxycycline therapy during summer at a dose of 200mg/day. Results: All four patients were diagnosed as having doxycycline‐induced staining of the permanent dentition. In all cases, the staining completely resolved and the teeth recovered their original colour following abrasive dental cleaning.

Conclusions: These observations indicate that the incidence of staining of the permanent dentition, as a complication of doxycycline, may be much higher than the literature indicates, especially if treatment is administered during summer months. Fortunately, this complication is reversible and does not require termination of doxycycline therapy. Complete resolution following abrasive cleaning may suggest that an extrinsic mechanism within the dental milieu may be involved in its pathogenesis. Strict avoidance of sunlight exposure during high‐dose, long‐term doxycycline therapy might prevent the development of this complication.
Fluoridated milk for preventing dental caries
Authors: Yeung CA , Hitchings JL , Macfarlane TV , Threlfall AG , Tickle M. , Glenny AM , AO ERIC C REYNOLDS
Published: March 2008

The Cochrane Collaboration is an international organization that aims to help people make well‐informed decisions about healthcare by preparing, maintaining and promoting the accessibility of systematic reviews on the effects of healthcare interventions. The Cochrane Oral Health Group aims to produce systematic reviews which primarily include all randomized control trials (RCTs) of oral health, including prevention, treatment and rehabilitation of oral, dental and craniofacial diseases and disorders. Full copies of the review papers can be accessed electronically at http:www.cochrane.orgreviewsindex.htm, clicking on ‘Login to the Cochrane Library’, followed by clicking on ‘Cochrane Reviews’, and selecting the appropriate review. This is a free service provided by the Australian Government.

The Australian Dental Journal publishes selected Abstracts in each issue for our readers' interest. A detailed description of the activities of the Cochrane Oral Health Group, written by the Review Group Co‐ordinator, Dr Emma Tavender, was published in the June 2004 issue of the Journal (Aust Dent J 2004;49:58–59). Also, for explanations of abbreviations and terminology please see Appendix 1 on page 59 of the aforementioned article.

Editor
Oral viral infections and the therapeutic use of antiviral agents in dentistry
Authors: McCullough MJ , Savage NW
Published: March 2008

This paper reviews the current concepts of viral classification, infection and replication. The clinical presentation of common oral viral infections encountered in the dental practice are discussed, including: herpes simplex virus types 1 and 2; Epstein‐Barr virus; varicella‐zoster virus; Coxsackie virus; human papilloma virus; and human immunodeficiency virus. The diagnosis, principles of management and pharmacological agents available for the treatment of oral viral infections are also discussed.
Accessing government subsidized specialist orthodontic services in Western Australia
Authors: Kruger E. , Tennant M.
Published: March 2008

Background: In Australia there is growing demand for dental services. This leads to more pressure on the oral health service providers, and in particular government subsidized dental care. Against this backdrop it is important that government dental services (rationed to health care cardholders) are provided equitably on a basis of need, not access. The primary hypothesis investigated in this study was that there would be an even distribution of patients referred for government subsidized orthodontic care across Western Australia when regionally adjusted for socio‐economic status.

Methods: Data were obtained as a de‐identified waiting list for orthodontic treatment at The University of Western Australia. The data included all patients on the orthodontic waiting list as at December 2003.

Results: Significant differences between ARIA categories were detected when all waiting list entries were distributed. However, the trend was towards more entries (adjusted for population) in highly accessible areas. It was found that people from relatively wealthy areas tended to be more likely to be on the waiting list than those from more disadvantaged regions.

Conclusion: In summary, the results of this study indicate that there is an uneven distribution of demand for orthodontics waiting list positions across Western Australian postcode areas by remoteness (ARIA) and by socio‐economic disadvantage (IRSD). The results suggest that demand for subsidized orthodontic care may be influenced by the general demand for treatment of that region and not on what would be expected to be an even need for treatment across all health care cardholders.
Factors influencing recent dental graduates' location and sector of employment in Victoria
Authors: Silva M. , Phung K. , Huynh W. , Wong H. , Lu J. , Aijaz A. , Hopcraft M.
Published: March 2008

Background: Recruitment and retention of dentists in the public sector and rural areas in Victoria has become increasingly difficult in recent years. There are little available data on the factors that influence the sector and location of practice of new dental graduates. The objective of this study was to investigate the factors considered by new graduates in determining the location and sector of employment after graduation, and influencing any early changes in career path.

Methods: Questionnaires were sent to dentists who graduated from The University of Melbourne from 2000–2003 who were currently practising in Victoria. There were 154 subjects to whom questionnaires were sent and 109 useable questionnaires were returned, a response rate of 74 per cent.

Results: Upon graduation, 53 per cent of the new graduates chose to work in the private sector only, compared to 15 per cent in public sector only and 33 per cent in both. At present, 71 per cent work in the private sector only, 17 per cent in the public sector only and 12 per cent in both. The most important factors for choosing to work in the private sector were receiving broad range of clinical experience, opportunities to familiarize with practice management and providing a continuity of care. The principal factors for practising in the public sector were clinical mentoring and advice, consolidating clinical skills and work environment. Initially, 48 per cent of the sample chose to work in metropolitan areas only, 39 per cent in rural areas only and 13 per cent in both. Factors that influenced the decision to work in rural areas were the broad range of clinical experience and remuneration, while the main factors for choosing to work in metropolitan areas were lifestyle and proximity to family and friends.

Conclusions: This study found that a large proportion of new dental graduates initially chose to work in the public sector and rural areas on graduation primarily as a means of consolidating their clinical skills. However, retention of dentists in both these areas appears to be a problem, with less than 10 per cent of 2000–2001 graduates still working in the public sector and only 20 per cent of 2000–2001 graduates still working in rural areas.
Caries experience in preschool children referred for specialist dental care in hospital
Authors: Hallett KB , O'Rourke PK
Published: March 2008

Background
: Increasing numbers of preschool children are being referred for specialist dental management in a paediatric hospital. Most cases have severe early childhood caries and require comprehensive management under general anaesthesia. The present study investigated risk factors for disease presence at initial consultation.

Methods
: A convenience sample of 125 children under four years of age from the north Brisbane region were examined and caries experience recorded using dmft and dmfs indices. A self‐administered questionnaire obtained information regarding social, demographic, birth, neonatal, infant feeding and dental health behaviour variables. The data were analysed using the chi‐square and one‐way analysis of variance procedures.

Results
: Ninety‐four per cent of referred children had severe ECC with mean dmft of 10.5 ± 3.8 and mean dmfs of 27.1 ± 15.1. Prevalence of severe ECC was significantly higher in children allowed a sweetened liquid in the infant feeding bottle (99 per cent) and allowed to sip from an infant feeding bottle during the day (100 per cent). Mean dmfs was significantly higher in children allowed to sleep with a bottle (28.7) and sip from a bottle during the day (29.9), children from a non‐Caucasian background (31.8), those children that commenced regular toothbrushing between 6 to 12 months of age (28.1), had no current parental supervision of daily tooth‐brushing (34.2) and had not taken daily fluoride supplements (27.8), vitamin supplements (27.8) or prescription medicine previously (27.6).

Conclusions
: The behavioural determinants for severe early childhood caries presence in hospital‐referred children were similar to those identified in the regional preschool population.
Dental health in rural Victoria: the Crossroads Household Survey
Authors: Simmons D. , Culliney K. , Joshy G. , McKenzies A. , Morgan M.
Published: March 2008

Background
: The aims of this study were to describe dental health and perceived barriers to dental care in a regional centre and surrounding smaller towns in rural Victoria.

Methods
: A stratified, randomized, face‐to‐face household survey was undertaken to assess levels of edentulism and access to oral health services. A study response rate of 70.3 per cent (6316/9260) was achieved.

Results
: When compared with those in the regional centre, people living in the shire capitals were more likely to travel greater distances to see a dentist and were less likely to have seen a dentist within the past 12 months. While there was little difference in the edentulous proportion living in shire capitals compared with the regional centre, the level of edentulousness over the entire region was greater than overall Australian estimates. Differences in perceived barriers to care within the region were less than expected. Existing perceived barriers were lack of need, time until available appointments, attitudes of dentists and lack of public dental facilities. Differences in these barriers existed between socioeconomic groups.

Conclusions
: This study shows that the prevalence of edentulism was higher in the areas studied relative to the Australian population. Significant patient perceived barriers to care exist which may contribute to the problem.
Resin adhesion to caries‐affected dentine after different removal methods
Authors: Sattabanasuk V. , Burrow MF , Shimada Y. , Tagami J.
Published: March 2008

Background
: Caries‐affected dentine is the common bonding substrate when treating a patient. At present, there are many methods used for caries removal. The aim of this study was to evaluate the microtensile bond strength of two adhesives (Clearfil Protect Bond and OptiBond Solo Plus Total‐Etch) to caries‐affected dentine after three different caries removal methods.

Methods
: Extracted carious human third molars were used and caries‐affected dentine surfaces were obtained from one of the three removal methods: (i) round steel bur in a slow‐speed handpiece; (ii) Er:YAG laser; or (iii) 600‐grit silicon carbide abrasive paper. Each of the adhesives was used to bond resin composite to the caries‐affected dentine according to the manufacturers' instructions. Hourglass‐shaped specimens were prepared and stressed in tension at 1mm/min. Data were analysed using two‐way analysis of variance and least significant difference test.

Results
: Clearfil Protect Bond showed significantly lower bond strength than OptiBond Solo Plus Total‐Etch after caries removal with round steel bur, but the opposite was found for specimens treated with silicon carbide abrasive paper. For laser‐treated dentine, no significant differences between the adhesives were revealed.

Conclusions
: Besides the differences in adhesives, different caries removal methods seem to influence resin adhesion to caries‐affected dentine.
Dentinal hypersensitivity: a review
Authors: Bartold PM
Published: March 2008

Tooth sensitivity is a very common clinical presentation which can cause considerable concern for patients. This condition is frequently encountered by periodontists, dentists, hygienists and dental therapists. The management of this condition requires a good understanding of the complexity of the problem, as well as the variety of treatments available. This review considers the aetiology, incidence and management of dentinal hypersensitivity.
Dissolution of porcine incisor pulps in sodium hypochlorite solutions of varying compositions and concentrations
Authors: Clarkson RM , Moule AJ , Podlich H. , Kellaway R. , Macfarlane R. , Lewis D. , Rowell J.
Published: March 2008

Background: The solubility of dental pulp tissue in sodium hypochlorite has been extensively investigated but results have been inconsistent; due most likely to variations in experimental design, the volume and/or rate of replenishment of the solutions used and the nature of the tissues assessed. Traditionally, the sodium hypochlorite solutions used for endodontic irrigation in Australia have been either Milton or commercial bleach, with Milton being the most common. Recently, a range of Therapeutic Goods Administration (TGA) approved proprietary sodium hypochlorite solutions, which contain surfactant, has become available. Some domestic chlorine bleaches now also contain surfactants. The purpose of this study was to perform new solubility assessments, comparing Milton with new TGA approved products, Hypochlor 1% and Hypochlor 4% forte, and with a domestic bleach containing surfactant (White King).

Methods: Ten randomly assigned pulp samples of porcine dental pulp of approximately equal dimensions were immersed in the above solutions, as well as representative concentrations of sodium hydroxide. Time to complete dissolution was measured and assessed statistically.

Results: White King 4% showed the shortest dissolution time, closely followed by Hypochlor 4% forte. White King 1% and Hypochlor 1% each took around three times as long to completely dissolve the samples of pulp as their respective 4% concentrations, while Milton took nearly 10 times as long. The sodium hydroxide solutions showed no noticeable dissolution of the pulp samples.

Conclusions: The composition and content of sodium hypochlorite solutions had a profound effect on the ability of these solutions to dissolve pulp tissuein vitro.Greater concentrations provided more rapid dissolution of tissue. One per cent solutions with added surfactant and which contained higher concentrations of sodium hydroxide were significantly more effective in dissolution of pulp tissue than Milton.
The use of a dental implant as an abutment in three unit implant‐tooth supported fixed partial denture: a case report and 32 month follow‐up
Authors: Clarke DF , Chen ST , Dickinson AJG
Published: March 2008

The combined use of dental implants and teeth as abutments in fixed partial dentures may offer advantages to both patients and practitioners in certain clinical situations. An implant‐tooth retained prosthesis may reduce surgical intervention and cost to the patient. It may also mean that anatomical restrictions to the provision of an implant‐retained fixed prosthesis may be overcome. In this case report, the steps in provision of a three unit implant‐ to‐tooth fixed partial denture are described and the treatment planning and prognosis of a restoration of this type are discussed.
Prevention of white spot lesions in orthodontic practice: a contemporary review
Authors: Sudjalim TR , Woods MG , Manton DJ
Published: March 2008

The development of white spot demineralization associated with fixed appliance orthodontic treatment is a significant clinical problem. Both established and experimental methods for prevention of such lesions in day‐to‐day clinical practice are presented and discussed.
Holes a plenty: oral health status a major issue for newly arrived refugees in Australia
Authors: Davidson N. , Skull S. , Calache H. , Murray S. , Chalmers J.
Published: March 2008

Background: Dental health needs of newly arrived refugees are much greater than for the wider Australian community. This paper identifies the disparities and highlights major dental health issues for Australia's growing and constantly changing refugee population.

Methods: Using available data and the decayed, missing and filled teeth (DMFT) index as a measure of oral health, the reported oral health status of refugee groups in Australia was compared with that of the general population, Indigenous Australians, recipients of public dental services, special needs groups in Australia and other refugee groups outside Australia.

Results: The reported oral health status of Australian refugees compared poorly with the comparison groups. Of particular concern was the number of reported untreated decayed teeth (D). This ranged from a mean of 2.0 to 5.2 compared with 0.6 to 1.4 for the general Australian population. Refugee groups also reported fewer filled teeth (1.0 to 5.8) compared with the general population (4.1 to 9.3). Similar results were found when reported D, M and F teeth for refugees were compared to Indigenous Australians, public dental service recipients, immigrants and special needs groups in Australia.

Conclusions: Dental health of refugees, particularly untreated decay, compared poorly to that of Indigenous Australians, and special needs populations in Australia who all have known worse dental health than the general population. There is an urgent need for the inclusion of this at risk population among targeted dental services. In addition, sources of health related data must clearly identify refugees to enable appropriate comparisons with other population groups. Recommendations for refugees are made regarding on‐arrival dental assessment and treatment, and community based oral health programmes.
Enhancement of fluoride release from glass ionomer cement following a coating of silver fluoride
Authors: Ariffin Z. , Ngo H. , McIntyre J.
Published: March 2008

Background: This study investigated the extent to which a coating of 10% silver fluoride (AgF) on discs of glass ionomer cements (GICs) would enhance the release of fluoride ion into eluting solutions at varying pH.

Materials and methods: Forty discs each of Fuji IX, Fuji VII and of Vitrebond were prepared in a plastic mould. Twenty discs of each material were coated for 30 seconds with a 10% solution of AgF. Five discs each of coated and uncoated material were placed individually in 4ml of differing eluant solutions. The eluant solutions comprised deionized distilled water (DDW) and three separate acetate buffered solutions at pH 7, pH 5 and pH 3. After 30 minutes the discs were removed and placed in five vials containing 4ml of the various solutions for a further 30 minutes. This was repeated for further intervals of time up to 216 hours, and all eluant solutions were stored. Fluoride concentrations in the eluant solutions were estimated using a fluoride specific electrode, with TISAB IV as a metal ion complexing and ionic concentration adjustment agent. Cumulative fluoride release patterns were determined from the incremental data.

Results: The coating of AgF greatly enhanced the level of fluoride ion release from all materials tested. Of the uncoated samples, Vitrebond released the greater concentrations of fluoride ion, followed by Fuji VII. However, cumulative levels of fluoride released from coated samples of the GICs almost matched those from coated Vitrebond.

Conclusions: It was concluded that a coating of 10% AgF on GICs and a resin modified GIC greatly enhanced the concentration of fluoride released from these materials. This finding might be applied to improving protection against recurrent caries, particularly in high caries risk patients, and in the atraumatic restorative technique (ART) of restoration placement.
Recurrent aphthous ulcerative disease: presentation and management
Authors: Boras V Vucicevic , Savage NW
Published: March 2008

Recurrent aphthous ulceration (RAU) is the second most common type of ulceration seen in the oral cavity. Notwithstanding an extensive literature and numerous proposed aetiologies, the cause of the disease remains obscure. In addition to the current conservative management of RAU lesions with corticosteroids, new treatment options are available and some have proven successful in open trials. This paper reviews patient work‐up and management.
A longitudinal study of 0.2% chlorhexidine gel for removal of mutans streptococci infection in preschool children
Authors: Law V. , Seow WK
Published: March 2008

Background: The purpose of the present longitudinal study was to determine the effectiveness of 0.2% chlorhexidine (CHX) in removing mutans streptococci (MS) in a treatment cohort of caries‐free, preschool children.

Methods: Thirty‐six children with mean age 38.6 ± 15.9 months who had MS infection brushed once daily with 0.2% chlorhexidine (CHX) gel for a period of 6–12 months. The children were examined every three months to assess their oral hygiene and dietary habits and MS status using a commercial microbiological kit.

Results: The percentages of children who eliminated MS from their mouths increased from 28 per cent after three months to 48 per cent after six months and over 70 per cent after 12 months of gel use (p=0.039). Compliance of brushing with CHX gel was significantly associated with MS removal after six months gel use (p < 0.02). At the three and six month recalls, sugar snacks and increased sugar frequency were associated with continued presence of MS (p=0.03 and p=0.007). After three months cessation of CHX use, 13 (45 per cent) remained MS free (p=0.003).

Conclusions: This pilot study involving caries‐free preschoolers with MS shows the potential of chlorhexidine gel to remove MS for the limited duration of study.
Periodontal disease among 45–54 year olds in Adelaide, South Australia
Authors: Brennan DS , Spencer AJ , Roberts‐Thomson KF
Published: March 2008

Background: The aims of this study were to describe the prevalence, extent and severity of periodontal disease among middle‐aged adults, and to examine periodontitis by dental visit pattern, dental and health behaviour, socio‐demographics and socio‐economic status.

Methods: A random sample of 45–54 year olds from metropolitan Adelaide, South Australia was surveyed by mailed self‐complete questionnaire during 2004–2005 with up to four follow‐up mailings of the questionnaire to non‐respondents (n=879 responded, response rate=43.8 per cent). Oral examinations were performed on 709 people who responded to the questionnaire (completion rate=80.7 per cent), providing an assessment of periodontal status.

Results: Prevalence of loss of attachment (LOA) of 6+ mm was 19.2 per cent, extent of sites with LOA of 6+ mm was 1.3 per cent, and severity of LOA of sites with LOA of 2+ mm was 2.4mm. Using a case definition for periodontitis of two or more sites with LOA of 5+ mm and one or more sites with PD of 4+ mm in a multivariate logistic regression showed higher odds of periodontitis for people who last visited for relief of pain (OR=1.93) and who smoked daily/occasionally (OR=3.84), while lower odds were observed for people who were born in Australia (OR=0.51) and spoke English as the main language at home (OR=0.34).

Conclusions: While periodontal disease was related to visit pattern and health‐related behaviours, the relationship with place of birth and main language spoken at home indicated socio‐cultural variation in disease not explained by behaviour among this cohort of 45–54 year olds.
The implications and management of acute odontogenic infection in association with Down and Eisenmenger syndromes and schizophrenia in a rural setting
Authors: Butler DR , Chilvers CR , Cane RJ
Published: March 2008

Background: This report describes the case management of a 32 year old special needs patient with life‐threatening odontogenic infection. The combination of schizophrenia, Down and Eisenmenger syndromes presented significant challenges to managing his oral health, particularly within the rural context. In this case, dental treatment was limited to a full dental clearance during a high risk general anaesthesia session.

Method: A comprehensive work‐up prior to general anaesthesia was an essential aspect of care. This included a full medical history and examination, communication between medical specialists, the dentist and family consultation. The anaesthetic procedure was undertaken using a careful regimen of drugs and monitoring to minimize the impact on his cardiovascular system. Techniques to minimize bleeding from extraction sites were also important.

Results: Three weeks postsurgically the patient was reviewed and his family reported that he was interacting positively with them after years of surliness and conflict. This was attributed to a managed psychotropic medication regimen and improved dental condition, which has led to a sustained improvement in quality of life.

Conclusions: The management of acute odontogenic infection for special needs patients in the rural setting requires a local interdisciplinary team approach, careful consideration of related pathophysiology and its potential impact on general anaesthesia, and close consultation with family and carers.
Recruitment and standardization of a group of Australian dentists for a multipractice study on dental caries prevention
Authors: Curtis B. , Evans RW , Sbaraini A. , Schwarz E.
Published: March 2008

Background
: This introductory paper details the recruitment and standardization of a group of dentists participating in a clinical trial. The trial is being undertaken to determine the cost‐effectiveness of a structured preventive programme compared to standard care within private dental practices. We recruited private dental practitioners from a variety of locations in New South Wales (NSW) and the Australian Capital Territory (ACT). We sought to quantify the diagnostic reliability of dentists involved, and to define, quantify, and analyse standard care.

Methods
: This is a multi‐centre, clustered randomized controlled trial, where dentists are allocated to an intervention preventive or control group. Recruitment was facilitated with the support of key stakeholders and included oral presentations at divisional meetings of the Australian Dental Association, NSW Branch (ADA). A detailed time‐in‐motion study of 426 dental procedures was undertaken in order to define the parameters of standard care. The reliability study involved each dentist reading a set of 12 pairs of bitewing radiographs that had been produced and reviewed under standardized conditions. The reliability analysis was undertaken blind to allocation status of the dentist.

Results
: Recruitment ceased three months into the planned six‐month recruitment period, 31 practices having approached the researchers. Eight suburban, five Central Business District (CBD), five rural (in fluoridated communities), and four rural (in non‐fluoridated communities) practices have been recruited. Standard care did not differ significantly between intervention and control practices (Mann‐Whitney U: z =‐0.50; P = 0.6). Diagnostic reliability was substantial (Kappa = 0.79 [range 0.73–0.81] and 0.78 [range 0.72–0.82]) in relation to the intervention and control practices, respectively; P = 0.6.

Conclusion
: The involvement of private dental practices in research is feasible and well supported by the profession. Standard care does not differ significantly between intervention and control practices. Inter‐and intra‐observer reliability was substantial, and not statistically different between the two arms of the trial.