Dental erosion as an indicator of gastroesophageal reflux disease.

While evidence shows that dental erosion (DE) is often caused by gastroesophageal reflux disease (GERD), the relationship of DE severity to a patient's symptoms and receipt of appropriate medical treatment for GERD is not clearly understood. The purpose of this study was to evaluate the association between DE and GERD. Eighty participants underwent a Basic Erosive Wear Examination for DE and completed the Patient-Reported Outcomes Measurement Information System (PROMIS) survey on symptoms of gastrointestinal reflux (PROMIS Scale v1.0, Gastrointestinal Gastroesophageal Reflux 13a) in English. Patients with observed erosive patterns were referred for gastroenterologic evaluation. The association between DE and GERD was assessed using multiple regression. The results showed that the extent of DE was positively associated with GERD symptoms (B = 0.585; 95% CI, 0.21-0.96), as measured by the PROMIS survey, in participants without a current diagnosis of GERD. Of the 80 patients in the study, 28 with more severe DE were evaluated in the gastroenterology department. A diagnosis of GERD was established for 27 of the 28, 9 of whom denied a past history of the disease. Twenty patients with GERD underwent upper endoscopy, and esophageal lesions were found in 6 patients (erosive esophagitis in 5 and Barrett esophagus in 1). Patients with clinically identified DE may benefit from medical evaluation and, if necessary, management of GERD. For a subset of patients, DE may be the only clinical indication of untreated or undertreated GERD, which could lead to serious esophageal changes. Dentists should consider referring patients with DE to primary care providers or gastrointestinal specialists to ensure that systemic conditions are identified and managed appropriately.

A Survey of US Air Force General Dentists Regarding Computer-aided Design/Computer-aided Manufacturing Usage.

AIM: The purpose of this study was to survey all United States Air Force (USAF) general dentists regarding their experience with computer-aided design/computer-aided manufacturing (CAD/CAM) while in a dental school. Dental school graduation year and location was compared to the type and amount of CAD/CAM training and clinical experience during dental school to better understand the differences and influence of this technology. MATERIALS AND METHODS: A survey consisting of six questions was sent through e-mail to 546 general dentists in the AF Dental Corps in 2018 of which 306 replied (56% response rate). RESULTS: Dentists who graduated in 2005 or earlier and between 2006 and 2009 stated they did not receive CAD/CAM training in dental school, while more respondents in the group of graduation years 2014-2017 stated that they did receive training. About 11% of the respondents who graduated in 2014-2017 completed 6-10 restorations and 9% completed 11 or more restorations compared to the other year groups. More respondents who graduated from a dental school in the southwest and southeast regions of the United States reported completing more restorations compared to other school regions. CONCLUSION: Computer-aided design/computer-aided manufacturing is now becoming a prevalent curriculum in US dental schools, both as a core requirement and an elective. Its training platforms varied from lectures and literature reviews to preclinical laboratory. CLINICAL SIGNIFICANCE: More respondents in the groups of graduation years 2014-2017 had completed more CAD/CAM restorations compared to other year groups; however, most of the respondents did not feel their training was sufficient enough to use CAD/CAM technology independently.

Bond strength of dual-cured resin cement used with dual-cured adhesives.

The reported advantage of new dual-cured adhesive agents is that they do not require light curing, resulting in a reduced film thickness and improved seating of bonded all-ceramic restorations. The purpose of this study was to determine the effect of dual-cured adhesives on the bond strength of dual-cured resin cement to dentin under different polymerization conditions: with or without light curing of the dual-cured adhesive as well as with or without light curing of the dual-cured resin cement through a lithium disilicate ceramic material. Human molars were sectioned to remove the coronal tooth structure and randomly divided into 3 adhesive groups: Clearfil SE Bond 2, ExciTE F DSC, and Universal Primer. The adhesive agents were applied to the dentin surface with or without light activation. A dual-cured resin cement was applied, and discs of lithium disilicate were cemented to the dentin surface. Half of the discs were light cured from the top surface, and the other half were allowed to self-cure. Shear bond strength was tested after storage in distilled water for 24 hours. The effect of light curing of the adhesive or cement on the shear bond strength of the lithium disilicate discs to dentin was product dependent. Clearfil SE Bond 2 performed significantly better with light curing of both the adhesive and cement. Less significant effects of the various light-curing and self-curing combinations were observed with ExciTE F DSC or Universal Primer. When neither the adhesive nor the cement was light cured, all 3 adhesives performed poorly and had a significant loss in bond strength.

A comparison of a refrigerant and a topical anesthetic gel as preinjection anesthetics: a clinical evaluation.

BACKGROUND: The authors used a split-mouth design to determine the effectiveness of a refrigerant compared with that of a topical anesthetic gel in reducing the pain experienced during a posterior palatal anesthetic injection. METHODS: Sixteen participants received a five-second application of a refrigerant (1,1,1,3,3-pentafluoropropane/1,1,1,2-tetrafluoroethane) and a two-minute application of a topical anesthetic gel (20 percent benzocaine gel) in the posterior palatal area before an injection of a local anesthetic solution was administered with a 30-gauge needle. Participants rated the pain they experienced after each injection by using a 100-millimeter visual analog scale (VAS) with endpoints of "no pain" and "worst possible pain." The authors calculated VAS scores by measuring the distance in millimeters from the no pain end of the scale. They analyzed data with a paired t test (alpha = .05). RESULTS: The group receiving the refrigerant had a mean VAS score of 17.7 +/- 15.3 mm, and the group receiving the topical anesthetic gel had a VAS score of 26.2 +/- 18.0 mm. The use of the refrigerant compared with the use of topical anesthetic gel significantly reduced the pain experienced during administration of local anesthetic injections (P = .02). CONCLUSIONS: The use of a refrigerant as a preinjection anesthetic was more effective compared with the use of a topical anesthetic gel in reducing the pain experienced by participants who received a posterior palatal injection. CLINICAL IMPLICATIONS: The potential benefits of using a refrigerant rather than a topical anesthetic gel are pain reduction, decreased application time, ease of application and avoidance of displeasing taste.