Hydrolytic Stability of Self-etch Adhesives Bonded to Dentin
S. Inoue1,2, K. Koshiro3, Y. Yoshida4, J. De Munck2, K. Nagakane5, K. Suzuki4, H. Sano3, and B. Van Meerbeek2,*
1 Division for General Dentistry, Center for Dental Clinics, Hokkaido University Hospital, Kita 13 Nishi 7, Kita-ku,Sapporo 060-8586, Japan;
2 Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo
-facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium;
3 Department of Conservative Dentistry, Hokkaido University Graduate School of Dental Medicine, Kita 13 Nishi 7, Kita-ku,Sapporo 060-8586, Japan;
4 Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, and
Research Center for Biomedical Engineering, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8525, Japan; and
5 Department of Biomaterials Science, Hiroshima University Graduate School of Dentistry, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan;
* corresponding author, bart.vanmeerbeek@med.kuleuven.ac.be
Functional monomers chemically interact with hydroxyapatite that remains within submicron hybrid layers produced by mild
self-etch adhesives. The functional monomer 10-MDP interacts most intensively with hydroxyapatite, and its calcium salt
appeared most hydrolytically stable, as compared with 4-MET and phenyl-P. We investigated the hypothesis that additional
chemical interaction of self-etch adhesives improves bond stability. The micro-tensile bond strength (µTBS) of the 10-MDP
-based adhesive did not decrease significantly after 100,000 cycles, but did after 50,000 and 30,000 cycles, respectively,
for the 4-MET-based and the phenyl-P-based adhesives. Likewise, the interfacial ultrastructure was unchanged after 100,000
thermocycles for the 10-MDP-based adhesive, while that of both the 4-MET- and phenyl-P-based adhesives contained voids and
less-defined collagen. The findings of this study support the concept that long-term durability of adhesive-dentin bonds
depends on the chemical bonding potential of the functional monomer.
KEY WORDS: hydrolytic stability • self-etch adhesive • durability • functional monomer • dentin
RESEARCH REPORT
Clinical
Does Periodontal Treatment Improve Glycemic Control in Diabetic Patients? A Meta-analysis of Intervention Studies
S.-J. Janket1,2,*, A. Wightman3, A.E. Baird4, T.E. Van Dyke5, and J.A. Jones1,6
1 Department of General Dentistry, Boston University, Goldman School of Dental Medicine, 100 East Newton Street, Boston, MA 02118, USA;
2 Harvard School of Public Health, Department of Nutrition, Boston, MA, USA;
3 US Air Force 59th Dental Squadron, San Antonio, TX, USA;
4 Stroke Neuroscience Unit, NINDS, National Institutes of Health, Bethesda, MD, USA;
5 Clinical Research Center/Periodontology and Oral Biology, Boston University Goldman School of Dental Medicine, Boston, MA, USA; and
6 VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
* corresponding author, sjanket@post.harvard.edu
Previous analyses regarding effects of periodontal treatment on glycemic control included studies where causal association
might not be assumed, or the results were reported non-quantitatively. We initiated this meta-analysis of 10 intervention
studies to quantify the effects of periodontal treatment on HbA1c level among diabetic patients, to explore possible
causes for the discrepant reports, and to make recommendations for future studies. Data sources were MEDLINE (January,
1980, to January, 2005), the EBMR, Cochrane Register, and bibliographies of the published articles. Three investigators
extracted data regarding intervention, outcomes, and effect size. A total of 456 patients was included in this analysis,
with periodontal treatment as predictor and the actual change in hemoglobin A1c level as the outcome. The weighted average
decrease in actual HbA1c level was 0.38% for all studies, 0.66% when restricted to type 2 diabetic patients, and 0.71% if
antibiotics were given to them. However, none was statistically significant.
KEY WORDS: meta-analysis • inflammatory mediators • hemoglobin A1c • non-surgical periodontal treatment • antibiotics treatment
American Academy of Implant Dentistry Journal 31:234–241 (2005)
DOI: 10.1563/1548-1336(2005)31[234:AOTXIR]2.0.CO;2
Journal of Oral Implantology: Vol. 31, No. 5, pp. 234–241.
ASSESSMENT OF THREE-DIMENSIONAL X-RAY IMAGES: RECONSTRUCTION FROM CONVENTIONAL TOMOGRAMS,
COMPACT COMPUTERIZED TOMOGRAPHY IMAGES, AND MULTISLICE HELICAL COMPUTERIZED TOMOGRAPHY IMAGES
Munetaka Naitoh, DDS, PhD
Akitoshi Katsumata, DDS, PhD
Yukinobu Kubota, DDS
Eiichiro Ariji, DDS, PhD
Tomography
Compact computerized tomography
Multislice helical computerized tomography
Three-dimensional image
Dental implant
Three-dimensional X-ray images (3D images) were used for imaging diagnosis in the oral and maxillofacial region.
These images could be fundamentally reconstructed from various tomograms, though clinical 3D images were mainly
reconstructed from computerized tomography (CT) images. In this investigation, 3D images were reconstructed from
conventional tomograms with a panoramic unit, compact CT images, and multislice helical CT images, and the usefulness
of each system was subjectively assessed for dental implant treatment. Three hemilateral dried human mandibles were
used and were examined by linear tomography with a panoramic unit, compact CT, and multislice helical CT, and 3D images
were reconstructed by using the rendering software for each system. The 3D images were visually evaluated on a 5-point
scale covering the alveolar ridge, buccal and lingual bone surface, mental foramen, and tooth sockets. As a result,
3D images reconstructed from conventional tomograms with the panoramic unit were assessed as fair to unsure, compact
CT 3D images were assessed as unsure to good, and multislice helical CT 3D images were assessed as good to excellent.
It was concluded that compact CT 3D images and multislice helical CT 3D images were useful in dental implant treatment.
The minimum clinically significant difference in patient-assigned numeric scores for pain
This paper was presented at the American College of Emergency Physicians Research Forum, San Francisco, Calif, October 2004.
Dawn B. Kendrick MD and Tania D. Strout RN, BSN,
Department of Emergency Medicine, Maine Medical Center, Portland, ME 04102, USA
Study Group Authorship: DBK and TDS conceived the study and designed the trial. DBK and TDS supervised the conduct of the
trial and data collection. DBK and TDS both participated in subject identification and enrollment. TDS undertook data
management. DBK and TDS performed data analysis. DBK and TDS drafted the manuscript and both authors contributed substantially
to its revision. TDS takes responsibility for the paper as a whole.. Available online 13 November 2005.
Abstract
Objective
To determine the minimum clinically significant difference (MCSD) in patient-assigned, 11-point numeric rating scale
(NRS-11) scores for pain and to determine if the MCSD varied with demographic characteristics.
Methods
Eligible emergency department patients presenting with pain were asked to rate their pain on the NRS-11 every 20 minutes.
Subjects compared pain intensity by choosing from the following verbal descriptor responses: “a lot more,” “a little more,
” “about the same,” “a little less,” or “a lot less” pain. The MCSD was defined as the difference between scores rated
“a little more” or “a little less” severe.
Results
Three hundred fifty-four subjects were enrolled. The MCSD was 1.39 ± 1.05 (95% confidence interval, 1.27-1.51).
No statistically significant difference based on sex or pain etiology was noted.
Conclusions
Findings suggest that a change of 1.39 ± 1.05 (95% confidence interval, 1.27-1.51) on the NRS-11 is clinically significant
when measuring pain.
Journal of Periodontal Research
Online Early
doi:10.1111/j.1600-0765.2005.00835.x
Volume 0 Issue 0
Porphyromonas gingivalis affects host collagen degradation by affecting expression, activation,
and inhibition of matrix metalloproteinases
A Comparison of Three Techniques to Obtain Root Coverage on Mandibular Incisors
Randall J. Harris,* Laura Harris Miller, Christopher R. Harris, and Richard J. Miller
*Currently, retired; previously, private practice, Reno, NV.
†Currently, resident, Periodontology, University of Nebraska, Lincoln, NE; previously, Marquette Dental School, Marquette University, Milwaukee, WI.
‡Currently, resident, Oral and Maxillofacial Surgery, Baylor University, Dallas, TX; previously, Oral Surgery Internship, University of Nebraska.
Correspondence to: Correspondence: Dr. Laura H. Miller, 6591 Breckenridge Court, Reno, NV 89523. E-mail: rjmandlhm@yahoo.com.
Background: Multiple variations on the subepithelial connective tissue graft have been shown to produce good clinical results.
The goal of this study was to compare three variations in the treatment of recession on mandibular incisors.
Methods: An a priori analysis was done to determine the sample size. Three groups of patients received root coverage procedures on mandibular incisors.
Each group was treated with a different variation of a subepithelial graft. The first group received a connective tissue (CT) graft with a coronally
positioned flap (CPF) (CPF + CT). The second group received a connective tissue graft with a double pedicle (DP) graft (DP + CT). The third group received
a connective tissue graft with a tunneling (TUN) procedure and a laterally positioned (LAT) pedicle (TUN-LAT + CT). The clinical results of these procedures
were compared to determine if one procedure offered an advantage over the other procedures.
Results: All of the procedures produced a statistically significant improvement in the clinical parameters. The groups treated with the DP + CT and
TUN-LAT + CT had greater mean root coverage (95.5% and 90.5%, respectively) than the CPF + CT group (80.2%). Additionally, DP + CT produced a greater
increase in keratinized tissue (3 mm) than CPF + CT (1.4 mm) or TUN-LAT + CT (1.9 mm). There was no statistically significant difference in the mean
root coverage of any technique treating defects <3 mm deep (CPF + CT, 90.9%; DP + CT, 96.4%; and TUN-LAT + CT, 92.1%) or the defects >3 mm deep treated
with DP + CT (95.4%) or TUN-LAT + CT (88.3%). However, the CPF + CT produced less mean root coverage (68.4%) when treating defects =3 mm deep. When defects
treated as isolated defects were compared to cases where multiple defects were treated, the cases with multiple defects treated with the CPF + CT had less
mean root coverage (77%) than cases where single defects were treated with the CPF + CT (90.3%), DP + CT (isolated, 96.7% and multiple, 95.6%), and
TUN-LAT + CT (isolated, 97.2% and multiple, 87.8%).
Conclusions: All three of the procedures were effective in obtaining root coverage and improved clinical parameters on mandibular incisors. Overall,
the DP + CT and TUN-LAT + CT procedures had greater mean root coverage than the CPF + CT technique. Based on this study, when treating defects =3 mm deep,
one should consider using the DP + CT or TUN-LAT + CT rather than the CPF + CT. Additionally, when treating multiple defects at a time, one should consider
using the DP + CT or TUN-LAT + CT rather than the CPF + CT. In cases where an increased amount of keratinized tissue is desired, based on this study,
the DP + CT may be the best procedure to use.
KEYWORDS: Connective tissue/surgery, gingival recession/surgery, surgical flaps, tooth root/surgery
Publication: Quintessence International
November 2005 Volume 36 , Issue 10
Long-term evolution of a case of direct pulp capping by adhesion to dentin
Santiago Gonzalez-Lopez MD, PhD/Victoria Bolaños-Carmona MD, PhD
This article presents the long-term follow-up of a female patient who suffered pulp exposure during removal of a large caries lesion from the mandibular
right first molar. The clinical decision to perform direct pulp capping was made. The tooth was treated with 5% chlorhexidine, etched with 37% phosphoric acid,
and then restored with Heliomolar composite after application of Gluma dentin adhesive. The patient was followed for more than 8 years.
(Quintessence Int 2005;36:797–803)
Key words: clinical follow-up, clinical report, compound resins, conservative treatment, dentin adhesion, direct pulp capping, pulp exposure, pulp vitality
Abstract
Journal of Periodontology 2005, Vol. 76, No. 10, Pages 1798-1804
(doi:10.1902/jop.2005.76.10.1798)
Squamous Cell Carcinoma Presenting as an Endodontic-Periodontic Lesion
Paul A. Levi Jr.,* David M. Kim, Scott L. Harsfield,§ and Erica R. Jacobson
*Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA.
†Private practice, Burlington, VT.
‡Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA.
§Private practice, Sharon, MA.
Department of Pathology, University of Vermont College of Medicine, Burlington, VT.
Correspondence to: Correspondence: Dr. Paul A. Levi Jr., Department of Periodontology, Tufts School of Dental Medicine,
One Kneeland St., Boston, MA 02111. Fax: 617/636-0911; e-mail: levishuman@aol.com.
Background: Regardless of advances in diagnosis and treatment during the past 40 years, the overall 5-year survival rates
oral and oropharyngeal squamous cancers have only slightly improved and remain around 50%. Thus, the early diagnosis and
treatment of carcinoma by health care providers are essential in achieving a good prognosis. We report a case of invasive
squamous cell carcinoma that presented as a benign endodontic-periodontic lesion with a 7-mm periodontal pocket on
tooth #15 in a 40-year-old, non-smoking woman. The subsequent management of the case is also discussed. The study was
conducted in accordance with the Helsinki Declaration of 1975, as revised in 2000.
Methods: Our patient was seen for a comprehensive periodontal examination including a periodontal charting, occlusal
analysis, study casts, electronic pulp test for tooth #15, and complete mouth periapical radiographs. As there was a
periapical radiolucency, an endodontic consultation was obtained. A periodontal flap surgical procedure was performed on
teeth #13 to #15, and as there was bone erosion into the maxillary sinus, a biopsy of the soft tissue was submitted to the
local hospital for histological analysis.
Results: The biopsied lesion was diagnosed as invasive, moderately differentiated squamous cell carcinoma with focal
spindle and clear cell differentiation (grade II to III of IV). Bone invasion was also identified. The treatment of the
carcinoma involved a hemimaxillectomy with the removal of the maxillary left posterior teeth. The patient remained free of
tumor for 5 years after the initial presentation.
Conclusions: Patient education and periodic oral cancer examinations by dental professionals are necessary to reduce
diagnostic delay and improve prognosis. This case report emphasizes the important role of dental professionals, especially
periodontists and endodontists, of being aware that squamous cell carcinoma may manifest itself clinically and/or
radiographically as a common periodontal or endodontic lesion.
KEYWORDS: Diagnosis, maxillary sinus, periodontitis, squamous cell carcinoma
Abstracts 11