Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: a matched case-control study.

BACKGROUND: Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM. METHODS: This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire as well as the Oral Health Impact Profile short form (OHIP-14), which measures OHRQoL. Clinical examinations were conducted to assess participants' dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3 mm and CAL ≥3 mm. Linear regression models were used to identify the association among OHIP domains, clinical attachment loss, DMFT scores, and diabetes status. RESULTS: The mean age of participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥3 mm than non-diabetic patients (10%). No significant differences in OHIP scores were observed between diabetic and non-diabetic patients. The results of the linear regression suggested that irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetic patients, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetic patients, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetic patients. CONCLUSIONS: Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both diabetic and non-diabetic patients.

The effect of immediate dentin sealing and optical powder removal method on the fracture resistance of CAD/CAM-fabricated endocrowns.

OBJECTIVES: To evaluate the effect of immediate dentin sealing and optical powder removal method on the fracture resistance of CAD/CAM-fabricated ceramic endocrowns. MATERIALS AND METHODS: Seventy-eight extracted premolars were endodontically treated. Standardized endocrown preparations were done in 60 teeth. Teeth were divided equally (n = 10) depending on the treatment of dentin (delayed sealing [DS] or immediate sealing [IS]), and the methods of optical powder removal (air-water spray washing [AW]; microabrasion [MA]; or aqueous suspension of pumice [PB], followed by air-water spray washing). After cementation, specimens were thermocycled (5,000 cycles, 5°C/50°C) and stored in distilled water for 1 week. Specimens were loaded in compression using a universal testing machine until failure. Failure load was recorded, and modes of failure were examined under a stereomicroscope. Micromorphological evaluation of different dentin treatments was done under SEM (n = 3). Results were analyzed using two-way ANOVA and Bonferroni post hoc multiple comparison tests (α = 0.05). RESULTS: Fracture resistance of all IS groups was significantly lower than DS groups, except for AW. There was no statistically significant difference between powder removal methods. CONCLUSION: Immediate dentin sealing does not improve the fracture resistance of endocrown restorations. Air-water spray washing is adequate to remove the optical powder after optical scanning impression taking.

Mechanical properties of orthodontic wires derived by instrumented indentation testing (IIT) according to ISO 14577.

BACKGROUND: The aim of this study was the characterization of mechanical properties of representative types of orthodontic wires employing instrumented indentation testing (IIT) according to ISO 14577. METHODS: Segments were cut from ten wires. The first six are made of stainless steel (SS), two are made of Ni-Ti, and the last two are made of titanium molybdenum alloys (TMA). Then, the Martens hardness (HM), the Vickers hardness (HVIT) based on indentation hardness (H IT), the indentation modulus (E IT), the ratio of elastic to total work (η IT), and the traditional Vickers hardness (HV1) were measured by IIT. The results were statistically analyzed by one-way ANOVA followed by Student-Newman-Keuls (SNK) test at a = 0.05. The HVIT and HV1 data were analyzed by paired t test (a = 0.05). RESULTS: SS wires showed the highest hardness followed by TMA and Ni-Ti alloys. However, all wires showed significantly lower HVIT compared to corresponding HV1, a finding probably appended to elastic recovery around the indentation. E IT for all wires tested was determined much lower than the nominal values of the corresponding alloys due to the implication of residual stress field at the slope of unloading curve. Elastic to total work ratio was ranged from 45.8 to 64.4 % which is higher than that expected for ductile alloys (<30 %). CONCLUSIONS: The products tested illustrated significant differences in their mechanical properties. Although IIT provides reliable data for hardness and elastic index of materials tested, the intense residual stress field developed during the manufacturing process significantly affects the determination of modulus of elasticity.

Micro-Raman spectroscopic analysis of TiO2 phases on the root surfaces of commercial dental implants.

OBJECTIVES: To identify the TiO2 phases of the root surface of commercially available titanium dental implants, subjected to various surface treatments. METHODS: The titanium implants studied were: Allfit (ALF), Ice (ICE), IMZ TPS (TPS), Laser Lok (LLK), Prima Connex (PRC), Ospol (OSP), Osseospeed TX (OSS), Osseotite Full (OTF), Replace Select (RPS), SLA (SLA) and Trilobe (TRB). The root parts of the implants (n:2) were analyzed by Raman microspectroscopy employing argon ion laser excitation (514.5nm wavelength) and a 100 µm × 100 µm sampling area at two randomly selected sites. RESULTS: The spectra of OSP and RPS showed the characteristic peaks of anatase, with traces of rutile (RPS). Complex phases composed of anatase, rutile and amorphous TiO2 were identified in ALF, ICE and LLK. Rutile and amorphous TiO2 were found in PRC, OSS, OTF, TPS and TRB, whereas rutile and possibly brookite were traced in SLA. In all implants, except OSP and RPS, peaks assigned to organic impurities (CH2, CH3) and carbonates were recorded. Ti2O3 was identified in OTF, PRC and Al2O3 in TRB. SIGNIFICANCE: Great variations in the TiO2 polymorphs were registered among the implant root surfaces tested. Considering the important differences in the biological activity of these polymorphs, it can be concluded that provision of information regarding the TiO2 state on implant surfaces should be a mandatory task for implant manufacturers.

Clinical effectiveness of a desensitizing system on dentin hypersensitivity in periodontitis patients.

PURPOSE: To evaluate the efficacy of the DenShield desensitizing system, based on calcium sodium phosphosilicate, in the hypersensitivity reduction for a 6-month period in periodontitis patients previously subjected to periodontal treatment and to compare the combination of the in-office paste and at-home dentifrice use to the at-home dentifrice use alone. METHODS: A total of 248 teeth (eight teeth in each subject) in 31 periodontitis patients (mean age 48 +/- 8 years) previously subjected to periodontal treatment were studied. 193 (77.8%) teeth had been treated with phase I periodontal treatment alone (non-surgical treatment) and 55 (22.2%) had been additionally subjected to periodontal surgery. Periodontal clinical parameters were recorded for each subject. Hypersensitivity was assessed by tactile and air-blast stimuli. The hypersensitive teeth of each of two quadrants in each subject were randomly assigned with split-mouth design to in-office application of DenShield Starter paste (four teeth) or placebo (distilled water) (four teeth). After the in-office application each patient used the DenShield dentifrices (Builder and Saver) for 6 months. The final evaluation was at 6 months. RESULTS: The prevalence and the degree of baseline hypersensitivity was significantly higher for the surgically than the non-surgically-treated teeth (83.6% versus 68.4%) and it was greater in teeth with attachment loss. The dentin hypersensitivity observed after periodontal treatment was significantly reduced in periodontitis patients who used the DenShield system for 6 months. There was no difference in hypersensitivity reduction between the additional in-office application of the DenShield and the at-home use of the DenShield dentifrices alone.

A study on colour stability of self-etching and etch-and-rinse adhesives.

OBJECTIVES: The purpose of this study was to investigate the color change in two "self-etch" and one "etch and rinse" adhesive under dark/water and photoaging conditions and to evaluate the influence of these changes on the color stability of resin composite restorative systems. METHODS: The adhesives were: One-Up Bond F (OB/Tokuyama), Adper Prompt L-Pop (PL/3M Espe) and Optibond Solo Plus (OS/Kerr). 10 sample disks of each material were prepared (OB(1), LP(1), OS(1)). Additionally, 30 sample discs of TPH Spectrum (Caulk/Dentsply) resin composite were prepared and bonded with the three adhesives tested (OB(2), LP(2), OS(2) groups) to freshly cut dentin discs. 30 days of storage in deionised water (37+/-1 degrees C) in dark conditions was followed by exposure of all samples to UV light photoaging. A colorimetric evaluation (CIEL*a*b* system) was performed immediate after sample photopolymization (baseline), at 7 and 30 days of dark/water storage and after the 360h of UV aging. Color changes (DeltaE*) were calculated between baseline and subsequent measurements. The results were analyzed by independent two-way Anova and Sheffe's statistical tests (a=0.05). RESULTS: All the adhesives evaluated exhibited significant color changes even after early aging time into water. One-Up Bond F presented the highest color alterations under both experimental conditions and Optibond Solo Plus the lowest. The adhesives were proved able to influence the color stability of a resin composite, which is bonded to a dentin substrate. One-Up Bond F induced the strongest effect on color change of the resin composite while no differences were clarified between Adper Prompt L-Pop and Optibond Solo Plus. CONCLUSION: Significant color changes were determined under water and photoaging conditions for the "self-etch" and "etch and rinse" adhesives evaluated and the resin composite combined with these agents.

Molecular characterization of one-step self-etching adhesives placed on dentin and inert substrate.

PURPOSE: To evaluate the phase separation, extent of dentin demineralization, and curing efficiency of one-step self-etching adhesives placed on dentin and on inert substrate. MATERIALS AND METHODS: The adhesives tested were G-Bond (GB), iBond (IB) and Clearfil S3 Bond (SB). Two groups (2 x 3) of dentin and inert (gold) specimens were prepared for each product. The films formed on inert surfaces were subjected to mild (1st group) or strong air drying (2nd group) and examined with near- and mid-FTIR microspectroscopy. On dentin (1st group), the extent of demineralization (% DM) was evaluated before and after adhesive treatment plus rinsing with water and acetone by mid-FTIR microspectroscopy. The films formed after strong air drying (2nd group) and 20 s of light curing were rinsed with acetone, and the degree of cure (% DC) was measured by micro-multiple internal reflection FTIR spectroscopy. ANOVA was used to assess the statistically significant differences in % DM and % DC (alpha = 0.05). RESULTS: In GB and IB, mild air drying produced more water droplets and monomer separation than strong air drying. SB demonstrated the least separation. IB induced the highest % DM. All the adhesives demonstrated the greatest % DC on dentin. On both substrates SB showed the highest % DC values. CONCLUSION: Phase separation including water and/or monomers was found in all the adhesives. The extent of dentin demineralization and degree of cure varied among the products tested. The degree of cure was higher on dentin than on the inert substrate.

Colour stability of tooth-coloured restorative materials.

The colour stability of the surface and in-depth (2 mm) layer of two resin composites, a laboratory second-generation resin composite and a compomer were evaluated after 24 and 360 hours of water aging under dark and UV light conditions. The influence of various polymerization techniques on color changes was also evaluated. Color differences (deltaE*) showed higher color changes under UV light exposure than under dark storage, both at 24- and 360-hour evaluations. Color changes were statistically higher at the 360-hour assessment, in both conditions of maintenance. Compomer was the least color stable of the materials tested. Additional polymerization significantly decreased the colour change of both composite resins.