Browsing by Author "Stookey, George K."
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Item A comparison of a 2.26% fluoride varnish versus a 1.23% APF foam using polarized light microscopy, confocal microscopy and quantitative light fluorescence(2000) Quackenbush, Brett Michael; Dean, Jeffrey A.; Fontana, Margherita Ruth, 1966-; Stookey, George K.; Tomlin, Angela; Donly, Kevin J.Secondary caries and the replacement of existing restorations account for 50 to 70 percent of operative dentistry today. Quantitative Light Fluorescence (QLF) has been shown to be effective at diagnosing very early tooth demineralization on smooth surfaces (less than 50 μ in depth); however, QLF has never been utilized to evaluate secondary caries in dentin. The objective of this study was to validate the accuracy of QLF in diagnosing early secondary caries and then verify the results using confocal microscopy and polarized light microscopy. Seventy-five mandibular molar teeth were prepared with Class V amalgam preparations on the mesial surface. A fluoridated varnish and 1.23- percent acidulated phosphate fluoride (APF) were introduced to this evaluation system, two agents known to effectively inhibit tooth demineralization. The artificial caries system utilized was adjusted to ensure that secondary caries would occur at restoration/tooth surface interfaces. The teeth were exposed to this artificial caries challenge for five days and following lesion formation, QLF was used to determine if incipient demineralization could be detected. The results of the QLF analysis were then compared with the data gathered using confocal microscopy and polarized light microscopy. Our results demonstrate that QLF detected 100 percent of the lesions seen with confocal microscopy and polarized light microscopy; however, no sound specimens were analyzed with any of the three techniques. There were no consistent significant differences between the fluoridated varnish and APF (p < 0.05) with any of the three methods utilized. We conclude that QLF can be used in early caries diagnosis and that emphasis should now be focused on treatment of the early lesion.Item Early Detection of Dietary-Induced Periodontal Bone Loss and the Effect of Flurbiprofen Administration in the Syrian Hamster(1991) Child, Michael E.; Roberts, W. Eugene; Shanks, James C.; Stookey, George K.; Hancock, E. Brady; Garetto, Lawrence P.Root surface caries is an increasing problem in the United States as more of the population are retaining their teeth to an older age. The disease requires the recession of gingival tissue and resorption of alveolar bone prior to exposure of the root surface. Animal models for root surface caries provide a means to investigate the etiology and treatment of the disease. The Golden Syrian hamster has been used as a model, and alveolar bone loss and root exposure are induced by feeding the animals a high glucose diet. Significant bone loss, when compared to control groups, is usually detected within five weeks. At present, the use of non-steroidal anti-inflammatory drugs in the treatment of periodontal disease is an area of great interest. As there is a role of host response in the alveolar bone destruction seen in periodontitis, inhibition of this prostaglandin-mediated process may provide a means of treatment. Flurbiprofen (Ansaid™, Upjohn Co., Kalamazoo, Ml) has been widely studied and appears to inhibit this bone loss in a variety of animals, including man. The purposes of the study were to determine if the early alveolar bone loss occurring after three, four and five weeks' exposure to the high carbohydrate diet could be quantitated with fluorescent bone labels, and if this bone loss could be inhibited by daily administration of flurbiprofen. The animals received a series of four intraperitoneally-injected fluorochrome labels over a one-month period, then were fed ground lab chow, the high carbohydrate MIT-200GI diet or the MIT-200GI diet plus flurbiprofen. At the end of three, four and five weeks, animals were euthanized, and the mandibles were prepared for analysis. Statistical analysis of gross and histomorphometric measurements detected no significant differences between the experimental groups. It is suspected that the diets failed to produce periodontal disease in this experiment, possibly due to changes in the oral microflora caused by administration of tetracycline as the final bone label. There was much variation in the presence of bone labels, but they were able to provide the growth velocity of the alveolar complex. Flurbiprofen administration produced no measurable effects, but the animals did tolerate the dosage given. Future studies should consider variation of the labels and a different route of administration.Item The effects of apical modification on the vitality of replanted permanent monkey teeth(1977) Walsh, John Senan, 1951-; Roche, James R., 1924-; El-Kafrawy, Abdel Hady, 1935-; Koerber, Leonard G.; Starkey, Paul E.; Stookey, George K.A study was conducted on the effects in a rhesus monkey of increasing the surface area of pulpal tissue available for revascularisation and regeneration of nerves after replantation of permanent teeth. Four teeth were replanted and used for controls, including two with incomplete apical development. Twelve teeth with completed apical development were replanted immediately after apical modification to increase the surface area of exposed pulp. The technique consisted of creating a facial and lingual groove in the apical region and exposing additional pulpal tissue. Radiographs were taken periodically and the replanted teeth were stable during the study period. The monkey was sacrificed after 93 days. The first hypothesis, that the apically modified teeth would sustain a healthy periodontium clinically for a period of ninety days, was disproved. Histological sections of the teeth and their supporting tissues showed varying amounts of root resorption and ankylosis. All of the apically modified teeth showed pulp necrosis, while three of the four control teeth had reestablished blood and vascular supplies and appeared vital. Ingrowth of granulation tissue was seen in the replanted teeth with pulp necrosis including one control tooth which had failed to revascularize. The second hypothesis, that the apically modified teeth would demonstrate significantly more apical revascularisation and nerve regeneration than the control teeth, was also disproved. In conclusion, the apical modification technique as performed to increase the area available for regeneration of nerves and vessels was not a success. As expected, however, immediate replantation of avulsed teeth resulted in reestablishment of periodontal membrane attachments.Item Fluoride varnish concentration gradient effects measured by quantitative light fluorescence(2001) Hazelrigg, Chad Owen; Dean, Jeffrey A.; Stookey, George K.; Hazelrigg, Charles O.; Zunt, Susan L., 1951-; Fontana, Margherita Ruth, 1966-Two of the three fluoride varnishes sold on the American market today are sold in 10-ml tubes of 5.0-percent NaF varnish (Duraphat and Duraflor). Pilot studies have shown that a separation of contents within these tubes exists. The purpose of the current study was four-fold: 1) to measure the fluoride concentration gradient in 10-ml tubes of fluoride varnish, based on the resting position of the tube prior to use; 2 ) to compare a varnish 's concentration gradient to its ability to inhibit caries in an artificial caries environment; 3) to compare and contrast fluoride concentration gradients of Duraphat and Duraflor; and finally, 4) to determine if Quantitative Light Fluorescence(QLF) can detect differences in lesions developed when exposed to an artificial caries environment and fluoride varnish. Human teeth specimens were subjected to a caries challenge and treated with a sample of fluoride varnish from one of five categories: Duraphat stored horizontally and vertically for one week; Duraflor stored horizontally and vertically for one week; or a CavityShield 0.4 ml unit-dose. Results show that no significant fluoride/ppm differences exist between groups (p = 0.29). It was shown that the order in which Duraflor varnish was dispensed from the tubes significantly affected the fluoride concentration (p < 0.05). The order effect was not significant for Duraphat (p = 0.99). QLF data analysis shows there is no significant difference (p > 0.05) in the amount of remineralization obtained by using any varnish stored in any position. This was confirmed using confocal microscopy. These results indicate that all three brands of fluoride varnish are able to remineralize incipient in vitro carious lesions, regardless of from which part of the 10-ml tube the varnish is taken. However, a fluoride concentration gradient exists in tubes of Duraflor. Also, QLF is able to detect denmineralized and remineralized incipient lesions.Item The genetic susceptibility/resistance to fluorosis among different inbred mouse strains(2003) McHenry, Melissa A.K., 1971-; Everett, Eric T.; Dean, Jeffrey A.; Gonzalez-Cabezas, Carlos, 1966-; Jackson, Richard D.; Sanders, Brian J.; Stookey, George K.Fluoridation of community water supplies for the purpose of preventing dental caries remains one of the top 10 public health interventions of the last century. However, exposure (ingestion) of greater than optimal amounts of fluoride from a variety of sources has led to an increase in the prevalence of dental fluorosis. We propose that dental fluorosis represents a complex condition caused by environmental and genetic factors. Purpose: To assess the role of genetics in the pathogenesis of dental fluorosis using genetically separate inbred strains of mice. Methods: Twelve genealogically disparate strains of mice were treated with 0 ppm, 25 ppm, and 50 ppm of fluoride in their drinking water. Each mouse was given weekly dental fluorosis evaluations. After 60 days of treatment, femurs were collected for fluoride analysis. Mandibular incisors were isolated for quantitative light induced fluorescence (QLF) studies and fluoride analysis. Digital and 35 mm images were taken of all mouse incisors in order to apply and compare the Dean's Index and the modified Thylstrup and Fejerskov Index (TFI), both indices of dental fluorosis. Skeletal radiographs were taken on the euthanized mice and later examined for extra skeletal calcifications and other gross bony deformities. Results: Differences in dental fluorosis susceptibility/resistance were identified between the strains, ranging from mild, moderate, to severe dental fluorosis. Furthermore, we found clustering of strains into distinct phenotypic groups. The A/J mouse strain was highly susceptible, with a rapid onset and severe development of dental fluorosis compared with the other strains tested. The 129P3/J mouse strain was least affected with negligible dental fluorosis. From the skeletal radiographs, no gross skeletal lesions or evidence of bone dysplasia were noted. Similar body burden of fluoride, as judged from analysis of mineralized tissues, was seen in all strains despite differences in their predispositions to develop dental fluorosis. Both the Dean's and TF indices are useful for classifying the stage or severity of fluorosis in mice, and there are advantages to the use of digital images over conventional 35 mm slide images. Both indices correlate well with the amount of fluoride exposure during amelogenesis; however, these indices are not promising indicators of fluoride burden during amelogenesis. Conclusions: QLF proved to be an innovative and useful tool for the quantification of dental fluorosis. Furthermore, these observations support the role of a genetic component in the pathogenesis of fluorosis.Item Pilot clinical study to assess caries lesion activity using quantitative light-induced fluorescence during dehydration(SPIE, 2017-03) Ando, Masatoshi; Ferreira-Zandoná, Andrea G.; Eckert, George J.; Zero, Domenick T.; Stookey, George K.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryThis study aimed to evaluate the ability of quantitative light-induced fluorescence (QLF) to assess caries lesion activity using visual examination (VE) as the gold standard. Twenty-four visible white spot lesions on buccal surfaces were examined from 23 children, ages 9 to 14 years. At baseline, the surface was hydrated with water, and thereafter, it was dehydrated with continuous compressed air during image acquisition. QLF images were acquired at 0 (baseline), 5, and 15 s. QLF variables [ QLF V : fluorescence loss ( Δ F ), lesion size (S), Δ Q : Δ F × S ] was recorded. Changes-in- QLF V per second ( Δ QLF V ) were determined: Δ QLF V = ( QLF VN − QLF V Baseline ) / N , where N indicates dehydration time. One experienced dentist conducted VE independently using a dental unit’s light, compressed air, and explorer.