bluuebunny/crossref_metadata_2025 huggingface dataset:
The Microtensile Strength of Bonding Resins
Authors: Hogan Lucinda C. , Burrow Michael F.
Published: March 2008

Background: The purpose of this study was to determine the effect of water on the tensile strength of three bonding resins (All Bond 2, Scotchbond Multi‐Purpose Adhesive, Clearfil LB Bond) and a low viscosity resin composite (Protect Liner F) after 1, 7, 28, 84 and 168 days of storage.

Methods: Cylinders of bonding resin 2.4±0.2mm diameter and 9.5mm long were made and stored at 37d̀C for 24 hours. The specimens were milled into dumb‐bell shapes and stored in either air or water at 37d̀C. Five specimens of each material were stressed in tension after the specified storage times at a crosshead speed of 1mm/min in a testing jig attached to a universal testing machine. The mean tensile strengths of bonding resins were calculated and analysed statistically using one‐way analysis of variance, lower standard deviation and student t‐tests.

Results: Comparison of the air and water samples at all test periods showed the tensile strengths of specimens stored in water were significantly less than those stored in air (P<0.001).

Conclusion: The effect of water on the tensile strength of bonding resins indicated a slight decrease in strength of each material over the 168 day test period, whereas the air samples showed little change over the test period.
Studies on Dental Erosion: An in Vitro Model of Root Surface Erosion
Authors: White I. , McIntyre J. , Logan R.
Published: March 2008

Most research on dental erosion has focused on erosion in enamel. However, the increasing retention of teeth into old age has increased the potential for root surface erosion. The nature and kinetics of root surface erosion have not yet been adequately explored.

The objective of this project was to develop an in vitro model of root surface erosion in order to investigate the polarised light microscopy of controlled erosion and the histology and rate of demineralisation of this process in root cementum/dentine.

The results demonstrate a process quite different in outcome from that in enamel erosion. Erosion results in loss of volume of enamel. However, it leaves a root surface softened though with little volume loss so long as the demineralised collagen remains hydrated. The polarised light histology was similar to that seen in root surface caries. The rate of erosive demineralisation of tooth roots by selected acids was investigated, with differing rates of demineralisation similar to that seen in enamel erosion observed. The process of erosion showed evidence of significant diffusion control.
Oral Health Among Vietnamese Using a Community Health Centre in Richmond, Victoria
Authors: Mariño R. , Wright FAC , Minas IH
Published: March 2008

Background: The purpose of this study was to assess the prevalence of specific oral diseases in a Vietnamese background population living in Melbourne, Australia, and to compare these findings to existing oral health data.

Methods: One hundred and fifty‐eight subjects of Vietnamese background, 18 and older, participated in the study. Results: Subjects were clinically examined, in a cross‐sectional study, using standard World Health Organization criteria. The mean decayed, missing and filled surfaces scores were 27.8 (26.1). With the exception of one person, all subjects displayed clinical signs of gingivitis and 39 per cent had shallow pockets. Complex periodontal therapy was required by about 5 per cent of the sample. Comparing these findings to existing data on oral health in Melbourne, subjects in the study had lower DMFS scores, a higher number of untreated decayed surfaces and higher prevalence of gingivitis but less need for advanced periodontal treatment.

Conclusions: These findings, in terms of dental caries and periodontal disease, represent a more encouraging oral health situation than that previously described in this immigrant population. Inequalities within the present sample were not reflected in the overall caries experience but were reflected in the proportion of unmet restorative needs. Further research is needed to get a clearer picture of the factors that shape the oral health of migrant Vietnamese populations and expansion of this research into other migrant groups is also necessary.
Dental Erosion: In Vitro Model of Wine Assessor's Erosion
Authors: Mok Tong Bee , McIntyre J. , Hunt D.
Published: March 2008

Background: Wine makers and assessors frequently experience severe dental erosion. The objectives of this study were to develop an in vitro model of dental erosion caused by frequent wine contact with teeth, and to use this model to assess the effectiveness of a variety of methods which might protect against this form of erosion.

Methods: An initial pilot study found that riesling style wine was more erosive than champagne style, and both more than claret. Wine tasting was simulated by subjecting exposed windows of enamel and root surfaces on 50 intact, extracted human teeth to 1400 one minute exposures to white wine (pH 3.2). A variety of dental materials were applied to the exposed windows on groups of teeth prior to erosive challenge, to assess their protective ability.

Results: Protective resin coatings and fluoride varnishes protected both enamel and roots against wine induced erosion. A high degree of protection was provided by APF gel, with less by NaF gel.

Conclusions: It was concluded that dentists may be able to help minimise erosion resulting from frequent wine‐tasting in their patients by the clinical application of one or a combination of these agents at times prior to prolonged assessment periods.
Intra‐Muscular Ketorolac Administered as a Supplemental Analgesic for Removal of Impacted Third Molar Teeth: A Prospective Study
Authors: Wright G. , Smith A.
Published: March 2008

Background: Post‐operative pain follows dentalveolar oral surgery. Ketorolac is a potent nonsteroidal analgesic with moderate anti‐inflammatory effects. The purpose of this study was to test whether a single supplementary dose of ketorolac reduced post‐operative pain experienced by patients having third molar teeth removed.

Methods: A prospective double‐blind trial utilizing 30mg of ketorolac and a standard anaesthetic and surgical technique was performed on 65 female patients having impacted third molar teeth removed. Assessment was made by means of a patient questionnaire and visual analogue pain scales and subjected to statistical analysis.

Results: There was a statistically significant difference confirming improved pain relief for patients receiving ketorolac 30mg at the early postoperative stage (two hours) but at later time intervals (four and six hours) there was no significant difference. Seventy two per cent of patients found ketorolac to be a satisfactory analgesic for postoperative pain. There were minimal side effects.

Conclusion: A single supplemental dose of ketorolac 30mg provides improved pain relief in the immediate post‐operative phase following the removal of third molar teeth. Oral ketorolac can be recommended as a oral analgesic for post‐operative pain, with minimal side effects.
Cast post and core foundation for the badly broken down molar tooth
Authors: Bass EV
Published: March 2008

Background: This article addresses the difficult clinical problem of restoration of endodontically treated posterior teeth, where there is nothing left of the clinical crown.

Methods: A step by step procedure, including instrumentation and materials and a new impression technique, is described in detail, with clinical photographs.

Results: This technique results in the fabrication of a robust and extremely retentive post and core on which to place fixed prosthodontic restorations.

Conclusions: The author has placed over 600 restorations of this type over a five year period, without any reported failures. With the |Dsgreying|DS of the population there are increased demands on dentists to restore structurally compromised teeth, and increasing expectations of the performance of these restorations. This technique is offered as a superior alternative to conventional post and core constructions methods.
A Case Report of Acute Heart Failure Caused by a Patient Delaying Taking his Diuretic Medication
Authors: Chapman PJ
Published: March 2008

Acute heart failure is a life‐threatening medical emergency, most commonly occurring as an immediate or delayed complication of acute myocardial infarction (AMI), or resulting from severe hypertension or valvular defects (stenosis or incompetence). Occasionally it is caused by patients' non‐compliance with medication orders.

In this case the patient had a history of three previous AMIs, controlled hypertension, and controlled congestive heart failure (CHF) for which he took two 40mg frusemide tablets (a very potent oral diuretic) each morning. Because he had experienced bladder discomfort during the latter stages of previous appointments he decided to delay taking the diuretic until after his appointment and acute heart failure ensued.
Impact of Opioid Use on Dentistry
Authors: Titsas A. , Ferguson MM
Published: March 2008

The oral consequences of opioid drug use are commonly attributed to personal neglect of general health and financial constraint. These factors are compounded by the increasingly recognized range of physical effects exerted by opioid drugs. The dental management of opioid drug dependents is further complicated by a variety of infections and behavioural modifications commonly associated with opioid use. Adequate strategies for the oral care of opioid users need to take cognisance of the broad medical issues for these people along with an appropriate personal approach.
Dental Erosion Patterns from Intrinsic Acid Regurgitation and Vomiting
Authors: Valena V. , Young WG
Published: March 2008

Background: The distribution of lesions from dental erosion due to intrinsic acid regurgitation and vomiting may be different from patterns of dental erosion due to extrinsic acids. To date studies have failed to validate this assumption. This study described the sites and nature of lesions from dental erosion in cases of intrinsic acid regurgitation, and compared them with the distribution of lesions occurring in age and sex matched controls, whose lesions are due to extrinsic acids.

Methods: The University of Queensland tooth wear clinic patients were screened to select 30 cases, 21 self‐identified bulimics and nine medically diagnosed chronic gastric acid regurgitators, and 30 controls. Epoxy resin models of the subjects' dentition were examined under stereoscopic light microscope at magnification 16 to 40. The patterns and sites of tooth wear were recorded for teeth representative of 20 tooth sites in every subject.

Results: While the incisal edges of maxillary and mandibular anterior teeth of acid regurgitators were more frequently affected by erosion, incisal attrition was more common on controls' teeth. Cervical lesions were more commonly found in association with incisal attrition in the controls, and in association with incisal erosion in the cases. In 10 per cent of sites in case subjects, cervical lesions associated with incisal erosion were found on the lingual aspects of their mandibular incisors, canines and premolars. These lesions were almost exclusive to the case subjects.

Conclusions: These results validate that lingual cervical lesions associated with incisal erosion on the mandibular anterior teeth are strong discriminators between tooth wear in patients with bulimia nervosa or chronic gastro‐oesophageal reflux and those whose dental erosion is due to extrinsic acids.
Maintenance of Mouth Hygiene in Patients with Oral Cancer in the Immediate Post‐Operative Period
Authors: Chandu A. , Stulner C. , Bridgeman AM , Smith ACH
Published: March 2008

Background: Little has been written about mouth hygiene measures during the immediate postoperative phase in patients with oral cancer. Mouth hygiene not only involves the care and maintenance of the dentition and its related structures, but also the maintenance of surgical sites, reconstructive techniques such as free flaps and generally keeping the mouth clean, which may optimize healing potential and patient comfort. Ward conditions and novel methods of reconstruction require innovation and improvisation of routine methods of mouth and oral hygiene.

Methods: A review of techniques of mouth hygiene used during the immediate post‐operative phase by our unit over the last nine years and a review of the literature.

Results: Various methods gained from our experience in treating patients with oral cancer at the Austin and Repatriation Medical Centre are documented. Most methods involve a combination of either chlorhexidine or normal saline mouth rinses and mechanical cleaning.

Conclusions: There are many different methods of mouth care in patients who have had resection for oral tumours. It is important for dental practitioners, hygienists and allied health professionals, who may be involved with care of such patients to have an understanding of the methods that are available and appropriate for such patients.
Successful Defibrillation of a Dental Patient in Cardiac Arrest
Authors: Chapman PJ , Penkeyman HW
Published: March 2008

Cardiac arrest is a very rare event in a dental patient. However, practitioners have a duty of care to their patients if ever such an event occurs. The cardiac arrest discussed in this case report occurred in an elderly person with an implanted pacemaker whilst undergoing restorative dental treatment. Cardiac arrest was diagnosed and cardiopulmonary resuscitation instituted immediately, followed within three minutes by successful defibrillation using the School's semi‐automatic defibrillator.
Tooth Development Standards for South Australia
Authors: McKenna CJ , James H. , Taylor JA , Townsend GC
Published: March 2008

Background: Chronological age, as recorded by registration of birth date, is referred to throughout an individual's life. This information is relevant in medical and dental practice for evaluating developmental progress, for educational purposes, and in legal matters, particularly in the application of criminal law. The absence of birth date information raises particular concerns, and estimates of chronological age are often required. Standards of dental maturation may be used to estimate age, but they have been shown to be gender and population sensitive.

Methods: The revised Demirjian1 system of dental age estimation was applied to a sample of 615 South Australian children in order to assess its accuracy.

Results: The results of our study have shown that the Demirjian system is of limited accuracy when used to estimate the age of South Australian children.

Conclusions: Generation of new standard curves, specific to the Australian population, is indicated.
Undergraduate Student Experience in Dental Service Delivery in Rural South Australia: An Analysis of Costs and Benefits
Authors: Richards L. , Symon B. , Burrow D. , Chartier A. , Misan G. , Wilkinson D.
Published: March 2008

Background: Rural experience for dental students can provide valuable clinical education, change attitudes to rural practice, and make a valuable contribution to clinical service provision. The aim of this paper is to assess the costs and benefits of service delivery by students through rural training programmes.

Methods: Groups of two students worked in the public dental clinics in adjacent rural centres where there had been long‐term difficulties in recruiting staff. The costs and benefits of the programme were assessed by the impact on waiting lists, the total cost per patient of a course of care and by the marginal cost of adding service provision by students to existing arrangements.

Results: The total costs of emergency and complete treatment provided by students were greater than the costs of treatment provided by public‐sector dentists but less than the costs of private providers treating public patients. However, the value of services were greater when care was provided by students or private providers and the marginal cost of students providing services was 50–70 per cent of the cost of care provided by public dentists.

Conclusion: This assessment suggests that the service benefits achieved compliment the primary objective of influencing the attitude of students to rural practice.
Chest Pain in the Dental Surgery: A Brief Review and Practical Points in Diagnosis and Management
Authors: Chapman PJ
Published: March 2008

If a dental patient develops chest pain it must always be managed promptly and properly, i.e., the practitioner immediately stops the procedure and, being aware of the patient's medical history, questions the patient regarding the nature of the pain to help determine the likely diagnosis. It will most likely be a manifestation of coronary artery disease (synonymous with ischaemic heart disease), i.e., angina pectoris or acute myocardial infarction, most usually the former. Angina will usually resolve with proper intervention whereas up to about onehalf of myocardial infarction cases will develop cardiac arrest, mostly in the first few hours, and this will be fatal in up to two‐thirds of cases. As health care professionals, dental practitioners have an inherent duty of care to be able to initiate appropriate care if such a medical emergency occurs.
Patterns of referral of patients undergoing surgical management for oral cancer
Authors: Chandu A. , Smith ACH
Published: March 2008

Background: Oral cancer is most often diagnosed by dentists or dental specialists. We were interested in analyzing demographic and referral data for a cohort of patients referred for the management of oral cancer to our unit.

Methods: A consecutive review of all patients treated by oral and maxillofacial surgery at the Austin and Repatriation Medical Centre over the last 10 years. Inclusion criteria included those patients with malignant oral and perioral disease that underwent surgical management. Exclusion criteria included those patients who did not have malignant oral disease, who did not have surgical management and those patients who were not treated by our unit as the primary surgeon.

Results: A total of 113 patients were identified. The mean age for presentation for the group was 61.6 years and the male to female ratio was 1.2:1. Approximately 70 per cent of patients were smokers or had smoked in the past. Over the last 10 years there has been a steady increase in referrals to our unit. Over half of all patients referred were from the Royal Dental Hospital of Melbourne while the majority of the remainder of the referrals were from private oral and maxillofacial surgeons. A significantly increased number of referrals from other sources were identified. Surveillance techniques that can be used in general dental practice are also described.

Conclusions: A high proportion of referrals from dental sources highlights the importance of the dentist and dental specialist in the diagnosis and referral of patients with suspected oral cancer. Patients can either be referred to a dental hospital, private oral and maxillofacial surgeons or directly to a public hospital oral and maxillofacial surgery unit treating oral cancer, such as the one at the Austin and Repatriation Medical Centre.
Dental caries experience of preschool children from the north brisbane region
Authors: Hallett KB , O'Rourke PK
Published: March 2008

Background: To report the dental caries experience of preschool children within the north Brisbane region and to investigate the association between selected social and demographic variables and disease presence.

Methods: A cross‐sectional sample of 2515 children aged four to six years was examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) and percentage caries free indices. A self‐administered questionnaire obtained information regarding selected social and demographic variables. The data were analysed using the chi‐square and one way analysis of variance procedures at the 5 per cent level of significance.

Results: Overall, 1668 (66.3 per cent) children were disease free at the examination and mean dmft was 1.4±77 and dmfs was 2.28±6.00. Dental caries occurred more frequently and severely in children from non‐Caucasian background (p<0.000), family language other than English (p=0.001) and lower socio‐economic status (p<0.000).

Conclusions: Significant associations between child ethnicity, language spoken at home, socio‐economic status and caries presence have been identified. Epidemiological data can be used for improved public oral health service planning and resource allocation within the region.
Oral health promotion for our ageing Australian population
Authors: Chalmers JM
Published: March 2008

The ageing Australian population living in the new millennium has dental needs that are very different and more complex than those experienced by previous older adult cohorts during the twentieth century. A summary of the oral health status of older Australians is presented, together with a review of the important relationships between general health and oral health. The key to maintaining and improving older adults' oral health status is the use of oral health promotion strategies that focus not only on dental characteristics, but also on the life characteristics of older adults, and on their quality of life issues. Traditionally, there has been very limited geriatric oral health promotion, with several myths contributing to this situation. Contemporary geriatric oral health promotion in the new millenium has an evidence‐based and planned approach. It encompasses not only the treatment of oral diseases and conditions, but has an increased focus on the prevention of oral diseases and conditions to enhance oral health status and older adults' quality of life. Using the Ottawa Charter and a functional dependence classification, a geriatric oral health promotion matrix is presented, using a specific example of Australian residential care.
New standards for permanent tooth emergence in Australian children
Authors: Diamanti J. , Townsend GC
Published: March 2008

Background: Published standards for permanent tooth emergence in Australian children are 40 years old. The aim of this study was to present new data on the timing and sequence of permanent tooth emergence in a large sample of Australian children and to compare the findings with those of earlier studies.

Methods: Records of a randomly selected sample of 8676 children, aged between 4 to 16 years, who had attended the clinics of the South Australian Dental Service were scanned optically and coded to provide the data for this study. A logistic regression analysis enabled median times of emergence, together with percentile ranges, to be calculated for each tooth, except third molars, in boys and girls. Comparisons were made between the sexes and with previously published values. The frequencies of occurrence of emergence polymorphisms for different tooth pairs were also computed.

Results: The earliest teeth to emerge in both boys and girls were the central incisors and first molars, whereas the second premolars and molars and maxillary canines tended to be last to emerge. The mandibular teeth tended to precede the corresponding maxillary teeth in emergence in both sexes. Tooth emergence was advanced in girls compared with boys, averaging 4.5 months in the maxilla and 5.3 months in the mandible. In general, emergence times of children in the present sample were later than those reported previously for Australian children. The most common emergence polymorphism in the maxilla involved the canine and second premolar, whereas common polymorphisms in the mandible were noted for the central incisor and first molar, canine and first premolar, and the second premolar and second molar.

Conclusions: Given that they have been collected relatively recently from a large sample of children, the new data reported in this paper can now be used as standards when assessing permanent tooth emergence of Australian children.
Diagnostic and preventive service trends in private general practice: 1983–1984 to 1998–1999
Authors: Brennan DS , Spencer AJ
Published: March 2008

Background: Aggregate trends have indicated increases in the provision of diagnostic and preventive services but there have been few reports based on their component sub‐categories. The aims of this study were to investigate time trends in the provision of sub‐categories of diagnostic and preventive services across a 15‐year period.

Methods: A random sample of Australian dentists was surveyed by mailed questionnaire in 1983–1984, 1988–1989, 1993–1994 and 1998–1999 (response rates 71–75 per cent). Data were weighted to provide representative estimates for the age by sex distribution of private general practitioners in 1983, 1988, 1993 and 1998.

Results: Rates per visit were higher, Poisson regression, P<0.05, in 1998–1999 compared to baseline for examinations, radiographs, prophylaxis and topical fluoride. Diagnostic and preventive service rates varied by age of patient: compared to patients aged 65+ years, examinations were higher among children aged <5 years to adults aged 25–44 years, radiographs were lower among children <5 years and 5–11 years but higher among adults aged from 18–24 years to 45–64 years, prophylaxis services were lower among children <5 years but higher among adolescents 12–17 years to adults aged 45–64 years, while topical fluoride was higher among children 5–11 years and adolescents 12–17 years.

Conclusions: Examination, radiograph, prophylaxis, and topical fluoride rates increased over the study period. While examination rates increased for both children and adults, and prophylaxis rates increased for adolescents and adults, rates for radiographs and topical fluoride only increased for adults. Age‐specific changes in service rates over time indicate the effect of changing oral health status and population demographics on service provision.
Dental caries experience in a young adult military population
Authors: Hopcraft M. , Morgan M.
Published: March 2008

Background: The purpose of this study was to investigate a group of young Australian adults to determine their caries experience and compare these current levels with similar aged cohorts over the past 30 years. Caries experience was also related to lifetime exposure of fluoridated water consumption.

Methods: This was achieved through a cross‐sectional study involving Australian Army recruits seen for their initial dental examination at 1st Recruit Training Battalion, Kapooka. A total of 499 recruits had a clinical examination with the aid of bitewing radiographs and an orthopantogram. Sociodemographic and fluoride history data were elicited via a questionnaire.

Results: Mean DMFT scores for age cohorts were: 17–20 years of age — DMFT 3.59; 21–25 years of age — DMFT 4.63; 26–30 years of age — DMFT 7.07; 31–35 years of age — DMFT 9.04. Subjects with a lifetime exposure to fluoridated water had significantly lower dental caries experience (DMFT 3.80) than subjects with no exposure to fluoridated water (DMFT 5.15).

Conclusions: It was found that there has been a decline in the level of caries experience in young Australian adults when the data from this study were compared to other ad hoc studies.
Pits and fissures: Relative space contribution in fissures from sealants, prophylaxis pastes and organic remnants
Authors: Burrow JF , Burrow MF , Makinson OF
Published: March 2008

Background: Previous studies by the authors have looked at the nature of the fissure system of human permanent molars and premolars, and has provided evidence for the presence of a prismless layer of enamel. It was noted during these studies that the fissure spaces were often occupied by material other than the fissure sealant. The aim of this study was to define these materials and to look at the percentage contribution of each to the sealed fissure space.

Methods: A sample of teeth, both molars and premolars, were sealed with an unfilled fissure sealant after prophylaxis with a coloured prophylaxis paste. In one group, the crown of the tooth was removed by dissolution in hydrochloric acid following placement of the sealant. This revealed a negative image of the fissure system and its contents. The second group of teeth was sectioned following sealing, and the contents of the fissure space were analyzed.

Results: The negative image of the fissure system displayed the fissure contents by colour and the sectioned teeth were able to be computer analyzed to establish the relative contribution of sealant, prophylaxis paste and organic material to the fissure space.

Conclusions: Sealant contribution was in the range of 14–96 per cent, prophylaxis paste from 0–50 per cent and organic remnants 0–55 per cent. The presence of these last two components could contribute to sealant loss.
Precision ablation of dental enamel using a subpicosecond pulsed laser
Authors: Rode AV , Gamaly EG , Luther‐Davies B , Taylor BT , Graessel M. , Dawes JM , Chan A. , Lowe RM , Hannaford P.
Published: March 2008

In this study we report the use of ultra‐short‐pulsed near‐infrared lasers for precision laser ablation of freshly extracted human teeth. The laser wavelength was ˜800nm, with pulsewidths of 95 and 150fs, and pulse repetition rates of 1kHz. The laser beam was focused to an approximate diameter of 50μm and was scanned over the tooth surface. The rise in the intrapulpal temperature was monitored by embedded thermocouples, and was shown to remain below 5C when the tooth was air‐cooled during laser treatment. The surface preparation of the ablated teeth, observed by optical and electron microscopy, showed no apparent cracking or heat effects, and the hardness and Raman spectra of the laser‐treated enamel were not distinguishable from those of native enamel. This study indicates the potential for ultra‐short‐pulsed lasers to effect precision ablation of dental enamel.
Remineralization of enamel subsurface lesions in situ by sugar‐free lozenges containing casein phosphopeptideamorphous calcium phosphate
Authors: Cai F. , Shen P. , Morgan MV , Reynolds EC
Published: March 2008

Background: The anticariogenic potential of casein phosphopeptide‐amorphous calcium phosphate nanocomplexes (CPP‐ACP) has been demonstrated using laboratory, animal and human in situ caries models. The aim of this study was to determine the effect of CPP‐ACP incorporation into a sugar‐free lozenge (pressed mint tablet) on enamel remineralization in a human in situ model.

Methods: The study utilized a double‐blind, randomized, cross‐over design with four treatments: (i) a lozenge containing 56.4mg (3 per cent w/w) CPP‐ACP; (ii) a lozenge containing 18.8mg (1 per cent w/w) CPP‐ACP; (iii) a lozenge not containing CPP‐ACP; and (iv) a no lozenge nil‐treatment control. Ten subjects wore removable palatal appliances with four, human‐enamel, half‐slab insets containing subsurface lesions. Lozenges were consumed, without chewing, four times per day for 14 days duration. After each treatment period the enamel slabs were removed, paired with their respective demineralized control, embedded, sectioned and subjected to microradiography and computer‐assisted densitometric image analysis to determine the level of remineralization.

Results: The incorporation of CPP‐ACP into the lozenge significantly increased enamel subsurface lesion remineralization with 18.8 and 56.4mg of CPP‐ACP increasing remineralization by 78 and 176 per cent respectively, relative to the control sugarfree lozenge.

Conclusion: This study demonstrates that lozenges are a suitable vehicle for the delivery of CPP‐ACP to promote enamel remineralization.
Efficacy of cardiopulmonary resuscitation performed in a dental chair
Authors: Lepere AJ , Finn J. , Jacobs I.
Published: March 2008

Background: Within the dental setting, historically there has been some concern as to whether cardiopulmonary resuscitation (CPR) can be performed effectively in the dental chair. This study tested the hypothesis that there is no difference in the efficacy of CPR performed in the dental chair or on the floor.

Methods: Four cycles of two‐person CPR were performed by three health professionals on a manikin positioned alternately on the floor and in a dental chair. Ventilation was performed using a Laerdal pocket mask, without oxygen supplementation. Compression and ventilation performance was recorded using a computerized manikin skill meter.

Results: Each of the participants was able to achieve a mean cardiac compression depth of between 41 and 50cm, irrespective of the CPR surface. The only statistically significant difference found in expired air resuscitation (EAR) and external cardiac compression performance was that 37 per cent of ventilations performed on the floor were deemed to be too shallow, compared to only 15 per cent in the dental chair (p=0.001).

Conclusions: It is possible for those trained in basic life support to perform CPR effectively in the dental chair. Each of the participants agreed that CPR, in particular EAR, was easier to perform when the manikin was in the dental chair compared with the floor. Dentists are encourage to regularly update their CPR knowledge and skills, including the practice of CPR in the dental chair.
Microscopic investigation of artificially demineralized surface enamel exposed to controlled intra‐oral periods
Authors: Neves AA , Primo LG , Ramos PR
Published: March 2008

Background: Arrest and regression of enamel caries is generally followed by clinical surface changes in enamel. The aim of this study was to evaluate microscopic surface changes in demineralized enamel submitted to toothbrushing with a fluoridated dentifrice or to a fluoridated gel in situ.

Methods: Enamel blocks demineralized by an acidic gel, were built in plates of five volunteers during three periods of 14 days each: exposure to the oral cavity (C+); brushing with a fluoridated dentifrice three times a days (B); application of a 2 per cent sodium fluoride gel and exposure to the oral cavity (F). Eight blocks were kept in 100 per cent humidity under refrigeration as negative controls (C‐).

Results: Stereomicroscopic examination revealed that 15, 47.4 and 30 per cent of samples from C+, B and F presented enamel cavitation after the experimental period. The demineralized enamel area in these groups decreased considerably compared to C‐, both in cavitated and non‐cavitated samples, although it was statistically significant only in cavitated samples from B (p=0.003; t test). Scanning electron microscopy revealed that C+ and F retained irregularities caused by the acid challenge, while B presented a more leveled profile of the enamel surface.

Conclusions: Exposure of demineralized enamel to intra‐oral periods reduced the demineralized enamel area. Tooth brushing enhanced this reduction, because of surface abrasion.
Treatment delays in paediatric dento‐alveolar trauma at a tertiary referral hospital
Authors: Batstone MD , Waters C. , Porter SAT , Monsour FNT
Published: March 2008

Background: Paediatric dento‐alveolar trauma is a common event. Delays in treatment can have adverse effects on long term outcomes and the aim of this study was to quantify the treatment delays in paediatric dento‐alveolar trauma in a tertiary referral hospital.

Methods: All cases of paediatric dento‐alveolar trauma over a two year period from July 2000 to June 2002 were identified and the charts were reviewed retrospectively. All children presenting to the emergency department with dento‐alveolar trauma within 48 hours of injury during the time period were included.

Results: Forty‐three patients were identified. The average age was 5.51 years, though there was a bias towards one and two year olds. Males were injured 1.5 times more frequently than females. There was an average delay of 9.6 hours between injury and treatment for all patients. Transit time from outside practitioners to hospital and waiting times in hospital made up the greatest delays. Children injured an average of 2.37 teeth and only 14 per cent were uncomplicated crown fractures.

Conclusions: Children who present to children's hospitals for treatment of dento‐alveolar trauma have more severe injuries than those treated elsewhere. They have large but potentially reducible delays between injury and treatment.
Assessing restored teeth with pulp and periapical diseases for the presence of cracks, caries and marginal breakdown
Authors: Abbott PV
Published: March 2008

Background: To determine whether clinical examinations and periapical radiographs provide sufficient information to assess the cause of pulp and periapical diseases, the status of teeth when restored and their further treatment needs. Other aims were to determine whether restorations should be removed prior to commencing endodontic treatment, and whether the type and longevity of restorations were related to the presence of disease.

Methods: Information was collected regarding 245 restored teeth from 220 consecutive patients referred for endodontic treatment. Teeth were examined before and after the restorations were removed and the findings were compared.

Results: Pre‐operative examination revealed 47 (19.2 per cent) teeth had caries, 57 (23.3 per cent) had cracks and 96 (39.2 per cent) had marginal breakdown. After restoration removal, the figures were 211 (86.1 per cent), 147 (60 per cent), and 244 (99.6 per cent) respectively. Almost all teeth (93 per cent) had more than one of these factors and periapical radiographs were unreliable indicators of their presence. There was only a 56.1 per cent chance (with 95 per cent Confidence Interval) of finding caries, cracks or marginal breakdown prior to restoration removal. Composite resins were more often associated with early onset and rapid progression of pulp diseases.

Conclusions: All restorations should be removed prior to endodontic treatment in order to remove the common factors that may have caused the pulp and periapical disease, and to assess the tooth's prognosis and future treatment needs.
Ceramic inlays for restoring posterior teeth*
Authors: Hayashi M.
Published: March 2008

Citation: Hayashi M, Yeung CA. Ceramic inlays for restoring posterior teeth (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.

Background: In recent decades ceramic inlays have been used with the increasing requirements from patients for tooth‐coloured restorations in posterior teeth. Ceramic inlays can offer an excellent appearance. However, their long‐term prognosis is uncertain, as only a few studies have reported the long‐term clinical performance of these restorations.

Objectives:T o compare the effectiveness of ceramic inlays in posterior teeth with other posterior restorations.

Search strategy: We conducted an electronic search of the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 1, 2002), MEDLINE, and EMBASE from 1990 to 2001. Handsearching included relevant journals and bibliographies of all relevant papers and review articles from 1990 up to 2001. In addition, we contacted experts and companies conducting clinical research on ceramic restorations to find other trials or unpublished materials or to clarify ambiguous or missing data.

Selection criteria: Randomized controlled trials, in which the longevity of ceramic inlays is compared with those of other posterior restorations.

Data collection and analysis: Screening of possible studies and data extraction were independently conducted by two reviewers (MH and AY) using a specially designed chart. Authors of studies were contacted for additional information. The methodological quality of studies was assessed in duplicate using individual components. The Cochrane Oral Health Group statistical guidelines were followed and the results expressed as Odds Ratio (OR) and 95 per cent confidence interval for dichotomous outcomes.

Main results: Tw o studies fulfilled the criteria to be included in the review. However, one of them was later excluded from the review, as the study design was not clearly described. The remaining, included study, evaluated the clinical performance of 60 ceramic inlays and 20 gold inlays for five years. Seven of the 60 ceramic inlays and two of the 20 gold inlays failed at five‐year review. No ceramic inlays resulted in postoperative pain/discomfort after the treatment. However, one gold inlay did. The power of the included study was not great enough to detect an important difference in longevity and post‐operative pain/discomfort between ceramic and gold inlays.

Reviewers' conclusions: There is no strong evidence available to support any differences in the clinical performance of ceramic inlays and other posterior restorations. There is a limited number of well‐designed clinical trials within this research area. Greater attention to the design and reporting of studies should be given to improve the study quality of ceramic restoration trials.
An historical perspective on early progress of Queensland water fluoridation 1945–1954: Sheep, climate and sugar
Authors: Akers HF , Porter SAT
Published: March 2008

Background: Queensland's virtual rejection of artificial water fluoridation sets it apart from other Australian states, yet the early fluoride environs has been scantily recorded.

Methods: This paper used archives, literature review, personal interview and the traditional historic method.

Results: The connection between Queensland artesian bore water and caries resistance was postulated as early as 1912. Four decades later, two Queensland‐specific factors influenced the planning to fluoridate community water supplies. The first (1945–1950) was confusion between the high levels of fluoride in artesian water supplying the pastoral industry and the scientific concept of artificial water fluoridation of communal supplies. The second (1952–1954) involved further scientific investigation involving water consumption patterns, occupational dehydration and fluid homeostasis within a sub‐tropical climate. The role of the Australian Dental Association Queensland Branch (ADAQ) in early fluoride politics was minimal. Four early protagonists are identified—two dentists, an engineer and the sugar industry.

Conclusions: Queensland had its advocates for artificial water fluoridation of communal supply as a means of caries prevention. Interest came from the dental, medical and engineering professions, and from the sugar industry. However, these efforts met with indifference based on confused extrapolation of the artesian experience (1945–1952) and hesitancy (1952–1954) due to contemporaneous concerns about human fluid homeostasis in Queensland's sub‐tropical climate.
A rare presentation of dens invaginatus in a mandibular lateral incisor occurring concurrently with bilateral maxillary dens invaginatus: Case report and review of literature
Authors: Mupparapu M. , Singer SR
Published: March 2008

Background: Dens Invaginatus (DI), commonly known as dens in dente, is a developmental malformation of tooth that most commonly affects permanent maxillary lateral incisor teeth. Deciduous teeth are infrequently affected. Presence of DI in mandibular permanent teeth is extremely rare. Further, the presence of DI bilaterally in the maxillary lateral incisors of the same patient is even more unusual.

Methods: In this article, an unusual case of DI affecting a mandibular lateral incisor tooth is described. This malformation was uncovered after a full mouth radiographic examination when the patient presented for dental treatment unrelated to this finding. In addition, the various radiographic appearances of DI as they present within the maxillary and mandibular teeth are described. Essential clinical considerations and treatment options are presented. A review of the pertinent literature is undertaken and a table summarizing previous published findings of mandibular DI is presented.

Results: A review of the literature indicates that DI in mandibular teeth is extremely rare with only 10 other cases involving 13 teeth reported previously.

Conclusions: Although this is an extremely rare case, DI is an anomaly that should be familiar to all practising dentists due to the clinical implications of potential sequelae of pulpal involvement.
Histoplasmosis in Australia: A report of a case with a review of the literature
Authors: O'Sullivan MVN , Whitby M. , Chahoud C. , Miller SM
Published: March 2008

Histoplasmosis is a rare but serious fungal infection commonly presenting as mucosal ulceration of the oral cavity. It is increasingly recognized in Australia but the source of infection remains obscure and it is likely to be under‐diagnosed. We report a case of chronic mucosal ulceration which failed to fully respond to periodontal therapy. Histology and culture of a gingival biopsy was consistent with histoplasmosis, and the patient responded favourably to treatment with oral itraconazole. Histoplasmosis may present to general dental practitioners as chronic mucosal ulceration and should be considered in the differential diagnosis of such lesions. Diagnosis is best made by culture and histology of biopsy specimens.
Prevalence of systemic diseases in Brisbane general and periodontal practice patients
Authors: Georgiou TO , Marshall RI , Bartold PM
Published: March 2008

Background Periodontitis has been associated with a number of systemic diseases such as atherosclerosis, coronary heart diseases, and respiratory diseases. This study aimed to determine whether there is a significant difference in the prevalence of systemic diseases (a) in patients referred for periodontal care compared to the general practice population, (b) in patients attending a public hospital and private practices, (c) in patients attending public and private periodontal practices, and (d) among patients with periodontitis of varying severity.

Methods Charts of 1000 adult patients were selected from four clinics (University of Queensland (UQ) School of Dentistry Admissions Clinic, UQ School of Dentistry Periodontics Clinic, Private Periodontal Practice, and Private General Dental Practice). The prevalence of medical conditions was evaluated using validated self‐reported health questionnaires. The periodontal condition was assessed from the most recent relevant radiographs in the files.

Results Periodontal patients had a higher prevalence of systemic diseases compared to the general practice population. Public patients had a greater prevalence of systemic diseases compared to patients in private practice for both general practice and periodontal patients. In patients with advanced periodontitis, bronchitis, hepatitis and rheumatoid arthritis were most prevalent. Patients with periodontitis also took more medications and were more likely to suffer from multiple conditions compared to the general dental population.

Conclusions Patients attending public dental facilities have an increased prevalence of systemic disease compared to those attending private practices. Furthermore periodontal patients have a greater prevalence of diseases compared to general practice patients. Patients with moderate or advanced periodontitis show an increase in the prevalence of some systemic diseases previously reported to be risk factors for periodontal disease.