Denture stomatitis-An interdisciplinary clinical review.

PURPOSE: An interdisciplinary clinical review on denture stomatitis formulated by experts from prosthodontics, oral medicine, and oral microbiology is presented. The review outlines the etiopathogenesis, clinical features, and management strategies of denture stomatitis from an interdisciplinary perspective. MATERIALS AND METHODS: English-language articles relating to the definition, incidence, gender distribution, geographical distribution, etiology, pathogenesis, symptoms, signs, treatment, and prognosis of denture stomatitis were retrieved via electronic literature search. Relevant articles were summarized for this manuscript with a view toward providing pragmatic information. RESULTS: Denture stomatitis represents a very common, multifactorial infectious, inflammatory, and hyperplastic condition which is primarily caused by poor oral hygiene, poor denture hygiene, and full-time; mainly night-time denture wear, bringing about the emergence of advanced Candida-containing polymicrobial biofilms in close proximity to the host's mucosal tissues. Denture stomatitis shares clinically relevant associations with dental caries, periodontitis, median rhomboid glossitis, angular cheilitis, aspirational pneumonia, and associated mortality. CONCLUSIONS: Effective, long-term treatment of denture stomatitis relies upon sustained patient-driven behavioral change which should focus on daily prosthesis-level cleaning and disinfection, removal of dentures at night, every night, engagement with professional denture maintenance, and when required, denture replacement. Antifungal medications offer limited benefits outside of short-term use due to the emergence of antifungal resistance. For frail, older, medically compromised, and nursing home populations, treatment of denture stomatitis lowers the risk of aspirational pneumonia and associated mortality.

Minimally invasive selective caries removal: a clinical guide.

An evolving understanding of the carious process, along with new research in adhesive restorative materials, has led to a more conservative, minimally invasive and biologically-based approach to managing dental carious lesions. The growing volume of literature has also demonstrated prognostic success in the selective caries excavation technique, subsequently preventing excessive tooth structure removal and injury to the dentine-pulp complex, which maintains pulp vitality and improves the long-term prognosis of the tooth. However, at present, there remains a limited volume of high-quality evidence to support selective caries removal, which subsequently could partly explain some resistance to its use in clinical practice. This clinical technique guide aims to demonstrate the management of carious lesions of moderate-to-deep depth in permanent teeth based on current minimally invasive dental literature.

An in vitro evaluation of 2 methods for retrieving fractured abutment screw fragments from the intaglio of 4 different implant systems.

STATEMENT OF PROBLEM: When an abutment screw fractures, there is no standardized technique for retrieving it from the intaglio of the dental implant. PURPOSE: The purpose of this in vitro study was to assess the relative efficacy of a commercially available screw fragment retrieval kit with a range of standard dental instruments in regard to success and retrieval time. In addition, the effects of other variables on the success rate of screw fragment retrieval and the retrieval time required were also investigated. Finally, the integrity of the intaglio screw channel of the dental implant was also assessed following retrieval. MATERIAL AND METHODS: The abutment screws from 4 dental implant systems: Osseotite Certain, Ø4.1 mm (Zimmer Biomet); Osseotite External hexagonal connection micromini, Ø3.25 mm (Zimmer Biomet); Standard Plus Tissue Level, Ø4.8 mm (Institut Straumann AG); and Brånemark Mark III TiUnite, Ø4.1 mm (Nobel Biocare) had notches placed between the first and second coronal threads before being placed in their respective abutments, positioned in the dental implants (n=128), and tightened until the screws fractured. The dental implant specimens were placed in maxillary and mandibular casts at the lateral incisor and first molar sites on both sides. The casts were placed in mannequin heads on a dental chair and assigned to 2 experienced and 2 inexperienced operators who used 2 different retrieval kits to retrieve the screw fragments. Chisquared tests were used to determine the association between the success rate of screw fragment retrieval and the other factors recorded (α=.05), and a binary logistic regression was used to determine the association between the retrieval event and all of the independent variables. Regression models were developed to determine the factors effecting retrieval time. RESULTS: An overall success rate of 88.3% was achieved for screw fragment retrieval. No statistically significant difference (P=1) was found in the relative efficacy of the retrieval kits. Univariate analysis identified a statistically significant association (P<.01) in the success of abutment screw fragment retrieval between the Osseotite Certain and the Osseotite External hexagonal connection micromini implant systems. Gamma regression analysis identified significant differences between the time taken to retrieve the screw fragments and the type of dental implant (P<.001), (P<.01). The time taken to retrieve screw fragments in the maxillary arch was significantly longer than for the mandibular arch (P<.05). CONCLUSIONS: The commercially available screw fragment retrieval kit and the standard dental instruments were equally effective in retrieving the screw fragments. Less time was required to retrieve screw fragments in the mandibular arch than the maxillary arch. The level of experience of the operator had no effect on the ability to successfully retrieve fractured abutment screws.

The occurrence of paraesthesia of the maxillary division of the trigeminal nerve after dental local anaesthetic use: a case report.

Paraesthesia can be a complication of surgical intervention. Its occurrence after dental local anaesthetic use is a rare event in general dental practice. Reported cases have mainly described its presentation for the mandibular division of the trigeminal nerve with very few reports for the maxillary division of this nerve. This report describes a case of paraesthesia in the maxillary region following local anaesthetic use prior to removal of an upper molar tooth.

The adhesive potential of dentin bonding systems assessed using cuspal deflection measurements and cervical microleakage scores.

OBJECTIVES: To assess the cuspal deflection and cervical microleakage of standardized mesio-occluso-distal (MOD) cavities restored with a dimethacrylate resin-based-composite (RBC) placed with one 3-step, one 2-step and three 1-step bonding systems and compared with the unbound condition. METHODS: Forty-eight sound maxillary premolar teeth with standardized MOD cavities were randomly allocated to six groups. Restoration was performed in eight oblique increments using a quartz-tungsten-halogen (QTH) light curing unit (LCU) with the bonding condition as the dependent variable. Buccal and palatal cuspal deflections were recorded post-irradiation using a twin channel deflection measuring gauge at 0, 30, 60 and 180s. Following restoration, the teeth were thermocycled, immersed in a 0.2% basic fuchsin dye for 24h, sectioned and examined for cervical microleakage assessment. RESULTS: The mean total cuspal deflection measurements with the one 3-step, one 2-step and three 1-step bonding systems were 11.26 (2.56), 10.95 (2.16), 10.03 (2.05) (Futurabond(®) DC SingleDose), 6.37 (1.37) (Adper™ Prompt™ L-Pop™), 8.98 (1.34) µm (All-Bond SE(®)), respectively when compared with the unbound condition (6.46 (1.88) µm) The one-way ANOVA of the total cuspal deflection measurements identified statistical differences (p<0.001) between groups. Cervical microleakage scores significantly increased (p<0.001) for the negative control (unbound condition) when compared with teeth restored with a bonding system although differences between the bonding systems were evident (p<0.001). SIGNIFICANCE: The cuspal deflection and cervical microleakage protocol reported offers an opportunity to test the bonding technologies available to practitioners for RBCs. Poorly performing adhesives can be identified which indicated the technique may be useful as a screening tool for assessing existing and new bonding technologies which offers the potential to limit complications routinely encountered with Class II RBC restorations.