Quintessence International, 10/2008

Hypodontia is often found during orthodontic screening and occurs with a prevalence of between 5% and 10%. One or more congenitally missing permanent teeth is a clinical finding that affects both male and female patients. Although maintaining deciduous teeth is an option in a few cases, the majority of patients with agenesis of teeth require extraction and orthodontic space closure or restorative treatment. Depending on the number and location of missing teeth, implant-supported fixed single-tooth restorations provide excellent long-term results. Choosing appropriate treatment techniques and materials will result in long-term clinical function, stability, and esthetic success. Keywords: all ceramic, biocompatibility, hypodontia, shaded zirconia, soft tissue stability

Objectives: To measure expectations of satisfaction with implant and conventional denture treatment in 2 groups of edentulous people and compare them with their resultant ratings of satisfaction to determine if either treatment meets the pretreatment expectation. Method and Materials: One hundred sixty-two edentulous middleaged (MA, n = 102) and senior (S, n = 60) patients were enrolled in 2 trials and, after randomization, received either a mandibular 2-implant overdenture (IOD) or a new conventional denture (CD). Before randomization, each subject rated their satisfaction with their current denture and expectations of satisfaction with both IOD and CD treatment on 100-mm visual analog scales (VAS). Six months posttreatment, all rated their satisfaction with their new prostheses on similar VAS. Expectations and satisfaction with treatment were compared. Results: Posttreatment satisfaction with CD treatment was significantly lower than pretreatment expected satisfaction in both study populations (MA, P .0001; S, P = .036). There was no (or only borderline) significant difference between pretreatment expectation and posttreatment satisfaction for patients receiving IODs in both study populations (MA, P = .078; S, P = .057). Conclusion: Posttreatment CD satisfaction failed to meet patients' pretreatment expectations of satisfaction; this was not the case for IODs, for which expectations were largely met. Keywords: dental implants, expectations, mandibular prostheses, overdentures, satisfaction

Objectives: To evaluate and compare the effect of nonsurgical periodontal therapy in conjunction with 2 different antibacterial agents on clinical and immunological parameters in aggressive periodontitis (AgP) patients. Method and Materials: Thirty-one AgP patients underwent clinical examination that included plaque index (PI), gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). GCF (gingival crevicular fluid) samples were collected and assayed for PGE2, IL-1ß, and TNFα. Nonsurgical periodontal therapy was performed. The patients received doxycycline (doxy group) or metronidazole plus amoxicillin (am-met group). After completion of the mechanical phase of therapy, patients were seen biweekly for oral hygiene reinforcement. After 12 weeks, clinical measurements and GCF sampling were repeated. Results: The combined mechanical and antimicrobial therapy resulted in overall improvement in all clinical parameters; mean PPD reduction of 0.74 ± 0.1 mm and mean CAL gain 0.86 ± 0.1 mm were both statistically significant (P = .0001). Marked reduction was observed for PGE2 and IL-1ß, but not TNFα. There was no significant difference between the 2 groups at baseline or final examination, except for PGE2 at final examination: It was significantly lower for the doxy group (83.61 ± 5.8 ng) than for the am-met group (124.08 ± 15.8 ng), P = .0202. Conclusion: Both treatment protocols resulted in significant improvements in the clinical and immunological parameters. When combined mechanical and antimicrobial protocol is desired and microbial cultures are not available, the use of both antibiotic regimens is recommended; the treatment of choice should be based on compliance, allergies, and potential side effects. Keywords: aggressive periodontitis, antibiotic regimen, clinical attachment level, cytokines, gingival crevicular fluid, treatment

Oculofaciocardiodental syndrome is a very rare multiple congenital anomaly syndrome characterized by congenital cataracts, multiple minor facial dysmorphic features, congenital heart defects, and dental anomalies including canine radiculomegaly and oligodontia. It is unrecognized by many medical and dental professionals. Oculofaciocardiodental syndrome is inherited as an X-linked dominant condition and is lethal in males. Only 20 cases have been documented to date. The present case is that of an affected female who had congenital cataracts, microphthalmia, characteristic dental anomalies, and typical facial dysmorphism. Keywords: canine radiculomegaly, congenital cataracts, dental anomalies, Marashi Gorlin, microphthalmia, septal heart defects

Objective: To evaluate, in vitro, the antimicrobial effect of ozone gas on strains of reference mutans streptococci and strains isolated from children at a high risk of developing caries. Method and Materials: A series of dilutions was obtained from a total of 41 strains, and the effect of ozone was determined for applications of 10, 20, and 40 seconds, as well as a control, in terms of the reduction of viable bacteria. Results: Ozone application for 10 and 20 seconds produced a significant reduction in the number of bacteria, inversely proportional to the bacterial concentration. When exposure lasted 40 seconds, no viable bacteria were obtained. Conclusions: Both time of application and initial bacterial concentration bear an influence on the antimicrobial effect of ozone on mutans streptococci. Keywords: antimicrobial agents, caries, caries therapy, in vitro study, mutans streptococci, ozone

Objectives: To evaluate the effect of microwave disinfection on the flexural strength and Vickers hardness of 4 autopolymerized resins (Kooliner [K], Tokuso Rebase Fast [T], Ufi Gel Hard [U], and New Truliner [N]) and 1 denture base resin (Lucitone 550 [L]). Method and Materials: For each material, 48 specimens (64 x 10 x 3.3 mm) were made and divided into 6 equal groups (n = 8). In the control group, specimens were untreated. Before testing, specimens were immersed in 200 mL of distilled water and submitted to disinfection for 1 of the following irradiation times: 1, 2, 3, 4, or 5 minutes. The irradiation procedure was performed twice. The flexural strength was determined using a testing machine MTS-810 and measurements of Vickers hardness were made on Micromet 2100. The values were submitted to ANOVA and Tukey's test (P = .05). Results: The K material showed a significant increase (P = .0010) in flexural strength following 5 minutes of disinfection compared to control specimens. The flexural strength mean values of materials T, U, and N were not significantly affected (P > .05) by disinfection. Compared to the control group, the K material showed a significant increase in hardness (P .001) following disinfection for 3, 4, and 5 minutes. For material U, disinfection for 4 and 5 minutes produced specimens with significantly increased hardness values (P .001) compared to the control group. For material N, disinfection for 5 minutes resulted in significantly higher hardness values (P .001) than the control group. Conclusion: Regardless of the irradiation time, the flexural strength and hardness of the materials evaluated were not detrimentally affected by microwave disinfection. Keywords: acrylic resins, cross infection, disinfection, flexural strength, hardness, microwave

Objectives: To evaluate the use of the center of the incisive papilla as a guide for the selection of the proper width of maxillary dentures in 4 racial groups. Method and Materials: One hundred sixty stone casts were obtained from impressions of the maxillary arch of white, black, mixed, and Asian subjects. The occlusal surfaces of the casts were photocopied and the images placed on a digitizer. The most anterior and posterior points of the papilla and cusp tips of the canines were digitized. Dentofacial Planner Plus software was used to calculate the distance from a line passing through the cusp tips of the canines to the center of the papilla, defined as the midpoint of the anterior and posterior points of the papilla. The selection error (in millimeters) due to the clinical application of the method of the incisive papilla was calculated and analyzed. Results: In all studied racial groups, there was no coincidence between the center of the incisive papilla and the canine line. The utilization of the center of the papilla would lead to the selection of wider artificial teeth. In 24.9% of the white, 19.3% of the mixed, 32.9% of the black, and 15.5% of the Asian populations, errors greater than 4 mm would be present with the utilization of the papilla. Conclusion: The method of the center of the incisive papilla is not accurate, but may aid in initial artificial teeth selection for the racial groups studied. Keywords: artificial teeth, complete denture, dental esthetics, race

Objective: It has been reported that caries prevalence in patients with aggressive periodontitis (ie, juvenile periodontitis) might be higher than that in matched controls. However, the available results are inconclusive. The aim of this study was to assess this relationship by comparing caries experience among subjects with generalized aggressive periodontitis (AgP) and those with chronic periodontitis (CP) and to identify reasons for tooth loss in both groups. Method and Materials: A convenient sample of subjects with AgP (210) and CP (332) was evaluated for decayed, missing, and filled teeth (DMFT) by both clinical and radiographic methods. Statistical analysis was performed by t test and ANOVA. Results: The AgP subjects have significantly less caries experience than the CP subjects older than 20 (P .001). Tooth loss was mainly due to periodontal disease in AgP subjects and caries in CP subjects. Conclusion: Subjects with AgP have significantly less caries experience than subjects with CP over 20 years of age (P .001). Keywords: aggressive periodontitis, chronic periodontitis, dental caries

Objectives: To evaluate the effects of a 6% hydrogen peroxide tooth whitener, Xtra White, on sound human enamel microhardness in vitro after an extended and exaggerated simulated 8 weeks of product use. Method and Materials: Polished human enamel specimens were prepared and baseline microhardness and color measurements determined. The enamel specimens were exposed to a fluoride-containing toothpaste for 30 seconds and then exposed to water, Xtra White, a control carbopol gel containing no hydrogen peroxide, or a carbonated beverage (each group, n = 8) for 20 minutes. Specimens were exposed to whole saliva at all other times. In order to simulate 8 weeks of extended product use, quadruple the length of the manufacturer's instructions, 112 treatments, were conducted. Microhardness measurements were taken after 2, 4, 6, and 8 weeks of simulated treatments, and color was measured after 2 and 8 weeks. Results: The Xtra White-treated specimens showed a statistically significant (P .0001) increase in L* and decrease in b* compared to the water-treated specimens after 2 weeks simulated use, indicating bleaching had occurred. The carbonated beverage-treated specimens were significantly softened (P = .0009) compared to baseline after only 1 treatment. The carbopol gel-treated specimens were significantly softened (P = .0028) after 2 weeks of simulated treatments compared to baseline. There were no statistically significant differences in enamel microhardness between baseline and all treatment times for XW and water groups. Conclusion: Xtra White does not have any deleterious effects on sound human enamel microhardness after an extended and exaggerated simulated 8 weeks of product use. Keywords: color measurement, colorimeter, esthetics, peroxide, tooth bleaching, tooth color, tooth whitening