Need for integration of hepatitis C (HCV) services in community-based settings for people who inject drugs: results from a global values and preferences survey.

BACKGROUND: To inform the development of updated World Health Organization (WHO) guidelines on simplified service delivery for HCV infection, a global survey was undertaken among people affected or infected by HCV. The objective of this analysis is to identify specific needs and preferences among people who inject drugs. METHODS: A multi-country, anonymous, self-administered online survey conducted in 2021 was developed by Coalition PLUS and the World Hepatitis Alliance in partnership with the WHO. Preferences for test and treat locations and simplifying HCV care were collected among people affected or infected by HCV. Chi-square tests were used to compare respondents who identified with current or former injection drug users through identification with key population to other respondents who did not identify with this key population. RESULTS: Among 202 respondents, 62 (30.7%) identified with current/former injection drug users. Compared to other respondents, they were: older [median (IQR): 48 (36-57) vs. 39 (31-51) years, p = 0.003]; more likely to have been tested for HCV (90.2% vs. 64.3%, p = 0.001); more likely to prefer testing in a community-based centre (CBC) (55.4% vs. 33.3%, p = 0.005); or in a support centres for people who use drugs (SCPUD)(50.0% vs. 9.8%, p < 0.001). The most important considerations regarding testing locations among people identified with current/former injection drug users (compared to the other respondents) were: non-judgemental atmosphere (p < 0.001), anonymity (p = 0.018) and community worker (CW) presence (p < 0.001). People identified with current/former injection drug users were more likely to prefer to receive HCV treatment in a CBC (63.0% vs. 44.8%, p = 0.028) or in a SCPUD (46.3% vs. 9.5%, p < 0.001), compared to the other respondents. The most important considerations regarding treatment locations among people identified with current/former injection drug users were the non-stigmatising/non-judgemental approach at the site (p < 0.001) and the presence of community-friendly medical personnel or CW (p = 0.016 and 0.002), compared to the other respondents. CONCLUSION: The preferences of people identified with current/former injection drug users indicated specific needs concerning HCV services. Integration of HCV services in community-based risk reduction centres may be an important element in the development of adapted services to increase uptake and retention in HCV care among this population.

Two in-office bleaching systems: a scanning electron microscope study.

The purpose of this investigation was to analyze by scanning electron microscopy the effects of heated and light-absorbing bleaching agents on enamel surface morphology. Twelve freshly extracted human anterior teeth were selected for this study. The teeth were randomly divided into four equal groups: Group I (control), Group II (teeth treated with Opalescence Quick, a heated bleaching agent), Group III (teeth treated with Opalescence Xtra, a light-absorbing bleaching agent), Group IV (teeth treated with Ultra-Etch 35% phosphoric acid etchant). After receiving a prophylaxis with a slurry of pumice, the bleaching materials were applied to the facial enamel surfaces following the manufacturer's specifications. The teeth in Group IV were etched for 15 to 20 seconds, washed, and air-dried. All specimens were prepared for scanning electron microscope evaluations. Scanning electron microscope micrographs indicated that only those specimens etched with phosphoric acid (Group IV) exhibited an etching pattern on the enamel surface. No differences in enamel surface morphology were observed between the untreated control specimens and the specimens treated with the bleaching materials.

Antimicrobial activity of cavity disinfectants.

The purpose of this study was to determine the antimicrobial activity of four commercially available cavity disinfectants and one prescription mouthwash as they came into contact with bacteria commonly found in the oral cavity. Streptococcus mutans, salivarius, and Actinomyces viscosus were used in the study. Zones of microbial inhibition were measured in millimeters after 48 hours. The results of this study indicate that all of the antimicrobial agents demonstrated activity against the bacteria tested. Consepsis Solution produced the largest zones of inhibition against all three of the bacteria used.

Treating enamel surfaces with a prepared pumice prophy paste prior to bonding.

The use of pumice to remove the salivary pellicle, plaque, and/or surface debris is a well-known procedure. However, pumice can act as a contaminant. Therefore, a slurry of pumice without additives is recommended for use prior to bonding procedures. This article presents a review of the shear bond strengths obtained by bonding composite resin to enamel after the enamel had been cleansed with a slurry of pumice and a premixed caplet of pumice.

Removal of surface stains from enamel surfaces with at-home vital bleaching: a case report.

Stone model casts of a patient's maxillary and mandibular arches were used to fabricate a clear, soft, vacuum-formed custom mouth guard that was scalloped to end 1.0 mm supragingivally. The patient was given prophylaxis and oral hygiene home care instruction, and instructions regarding the placement of an at-home bleaching gel into the mouth guard and the mouth guard into the mouth. The patient was asked to wear the mouth guard for two hours daily before bedtime for one week and to return to the clinic for evaluation. This protocol was followed for three weeks for each arch. At the end of the three weeks, the stains on the most affected teeth were reduced dramatically.

Enhanced visualization during dental practice using magnification systems.

The practice of dentistry involves viewing and evaluating small details of teeth, soft tissues, restorations, casts, and instruments. Although normal vision often is adequate to view details to make treatment decisions, the use of magnification loupes provides the clinician with an increased image size for improved visual acuity and improved posture while practicing. There are many choices when selecting a magnifying system. This article recommends the use of a binocular surgical telescope, either a flip-up type or a fixed-lens system, because it affords the clinician more choices in power of magnification, working distance, field of view, depth of field, and working angulation for improved posture.

Clinical efficacy of an herbal toothpaste.

The purpose of this three-month, double-blind, parallel-design clinical study was to compare the efficacy of two commercially available dentifrices, Herbal Toothpaste and Gum Therapy and Colgate Total, in controlling gingivitis, gingival bleeding, plaque and stain. Forty healthy adult volunteers from the Junior Comprehensive Care Clinics at New York University College of Dentistry were accepted as subjects for this clinical trial. To be eligible for a baseline clinical examination, subjects had to first indicate that during the previous six months they habitually brushed their teeth two or more times per day, and had noticed "bleeding gums" or "blood in the toothpaste" after brushing or flossing their teeth. At the baseline examination, subjects were enrolled in the study if they had at least five Löe-Silness gingival bleeding sites and 20 natural teeth, including all anterior teeth and four molars. An independent t-test before treatment indicated that there were no significant differences between the two groups at baseline. A one-way Analysis of Variance indicated that both dentifrices had a significant effect on gingivitis, gingival bleeding, plaque, and dental stain (p < 0.05). No significant statistical differences were observed between Herbal Toothpaste and Gum Therapy and Colgate Total for gingivitis or gingival bleeding. Herbal Toothpaste and Gum Therapy produced statistically significant differences in reducing plaque and stain relative to Colgate Total (p < 0.05). The results obtained in this study support the clinical efficacy of both products in reducing gingivitis and plaque, and demonstrate the efficacy of Herbal Toothpaste and Gum Therapy in maintaining reductions of plaque and stain.

An in vivo comparison of the antimicrobial activities of three mouthrinses.

The purpose of this in vivo study was to determine and compare the antimicrobial effectiveness of three commercial mouthrinses and a water control. The antimicrobial efficacy of the products was determined against aerobic, micro-aerophilic, and anaerobic bacteria. Twenty human subjects participated in this study. At each experimental session for a given subject, a pre-test saliva sample was taken. This sample was divided and used to grow three bacteria cultures under the different incubation environments. After giving the pre-test sample, the subject rinsed with one of the mouthrinses or the water control for 30 seconds, then waited one hour, at which time a post-test saliva sample was collected. Again, the sample was divided and used to culture the different types of bacteria. Following a 48-hour incubation period, the numbers of microbial colonies on each plate were counted and compared. The results indicated that all of the mouthrinses tested performed significantly better than the water control. Herbal Mouth and Gum Therapy and Peridex did not demonstrate a statistically significant difference in inhibiting aerobic, microaerophilic, and anaerobic bacteria. Both Herbal Mouth and Gum Therapy and Peridex were significantly more effective than Listerine in inhibiting the three different types of bacteria.

An in vitro investigation of the antimicrobial activity of an herbal mouthrinse.

The purpose of this study was to determine the antimicrobial activity of one prescription and two commercially available over-the-counter mouthrinses and positive and negative controls against bacteria commonly found in the oral cavity. The bacteria used in this study were Streptococcus mutans, Streptococcus sanguis and Actinomyces viscosus. Sterile discs which were treated with the mouthrinses were placed on agar plates along with the controls. Zones of microbial inhibition were measured in millimeters after 48 hours. The results indicated that all of the mouthrinses demonstrated antimicrobial activity against the bacteria tested. Herbal Mouth and Gum Therapy mouthrinse, containing natural ingredients, produced the largest zones of microbial inhibition when compared to Listerine against all three of the bacteria tested. Herbal Mouth and Gum Therapy mouthrinse produced larger zones of microbial inhibition when compared to Peridex against two of the three bacteria tested, and produced similar zones of inhibition against the third bacteria.

The ability of an herbal mouthrinse to reduce gingival bleeding.

Forty healthy adult volunteers from the Junior Comprehensive Care Clinics at New York University College of Dentistry were accepted as subjects for this three-month, examiner-blinded, parallel-group clinical trial. To be eligible for a baseline clinical examination, subjects had to first indicate that during the previous six months they habitually brushed their teeth two or more times per day and had noticed "bleeding gums" or "blood in the toothpaste" after brushing or after flossing their teeth. At the baseline examination, subjects were enrolled in the study if they were found to have at least five Löe-Silness gingival bleeding sites and 20 natural teeth, including four molars. Subjects were assigned to one of the two following treatment groups: 1) Herbal Mouth and Gum Therapy; or 2) Control (distilled water and dye). Subjects were instructed to clean their teeth in their usual manner, not to use any other mouthrinses or oral irrigation products for the duration of the study. Subjects were to return for clinical examinations after three months of product use. At these examinations, gingivitis and gingival bleeding scores were recorded. An independent t-test before treatment indicated that there were no significant differences between the baseline evaluations of the two groups in the study. A one-way analysis of variance (ANOVA), comparing gingivitis and bleeding scores from baseline and three months with the baseline scores as a covariate, indicated that Herbal Mouth and Gum Therapy produced a statistically significant effect (p < 0.01) on both parameters relative to the control mouthrinse. The results of this study support the clinical efficacy of Herbal Mouth and Gum Therapy in reducing gingivitis and gingival bleeding.

A single-component bonding system microleakage study.

The microleakage of a one-component bonding system is compared to a two-component system and a control. Class V cavity preparations were prepared in extracted teeth under high speed and water coolant so that incisal/occlusal margins were in enamel, and gingival margins were in dentin. Group I was restored with composite and no bonding agent; Group II was restored with Prime and Bond and composite, and Group III was restored with ProBond and composite. All specimens were thermocycled in fuchsin dye to evaluate the degree of microleakage. Significant differences were observed between the no bonding agent group and the Prime and Bond and ProBond groups. The results indicate that the one-step dentin bonding system has the ability to prevent microleakage effectively at both composite-enamel and composite-dentin tooth surface interfaces.

Oral HIV-I recovery in the presence of periodontal disease.

OBJECTIVE: To determine whether a significant association occurs between the presence of various periodontal diseases and recoverable infectious HIV-I in the saliva of injecting drug users. DESIGN: Five hundred and fifty-one injecting drug users were recruited from various programs associated with the Beth Israel Medical Center. Examiners were 'blinded' to the subject's HIV-I serostatus. A socio-economic and risk factors' survey was conducted and a complete oral examination, including periodontal disease indices was performed. Whole saliva and blood were collected for virus culture. MAIN OUTCOME MEASUREMENTS: Recovery of infectious HIV-I in saliva related to presence of periodontal diseases. RESULTS: Those HIV-I seropositive subjects with periodontal diseases did not differ from those HIV-I seropositive subjects without periodontal disease in mean age and immune status. Less than 1% of the HIV-I seropositive subjects had cultivable HIV-I in their saliva while it was present in 78% of PBMCs and 35% of the sera. There was no significant association between infectious HIV-I in saliva, serum, or PBMCs and any of the various periodontal diseases. CONCLUSIONS: The presence of periodontal disease in HIV-I seropositive injecting drug users does not appear to be a potential risk factor for infectious HIV-I in saliva, probably due to the various anti-viral components of saliva.

Sensitivity study in vivo: glass-ionomer versus zinc-phosphate bases beneath amalgam restorations.

This study in vivo evaluated the sensitivity of class 1 and 2 amalgam restorations which had bases of either zinc phosphate or an admix, silver-reinforced glass ionomer. The evaluation of sensitivity was done by providing the patient with five postcard questionnaires to be mailed to the clinic over a period of time from one to 28 days. Teeth restored with amalgam and silver-reinforced glass ionomer were significantly less sensitive to cold than those restored with amalgam and zinc phosphate.

Third generation dentin bonding agents: a microleakage study.

This article examines and compares the extent of microleakage after 24 hours in freshly extracted teeth using three newer or "third generation" dentin bonding agents. Gluma/Pekalux and Scotchbond 2/Silux were more effective in preventing microleakage in cementum/dentin margins than was Universal Bond/Prisma Micro-fine.

Antimicrobial properties of VLC liners.

The antimicrobial activity of several visible light cured glass ionomer and liner materials against three bacteria commonly found in the oral cavity is discussed. Vitrabond light cure glass ionomer produced zones of inhibition against all the bacteria tested in this study. It appeared to resemble a true glass ionomer cement in regard to its antimicrobial properties whereas the other materials used in this study appeared to possess no antimicrobial activity.