IU Indianapolis ScholarWorks :: Browsing by Author "Tomlin, Angela"

Browsing by Author "Tomlin, Angela"

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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.
A comparison of hardness and abrasion resistance of two sealant materials after polymerization from different distances by different light sources
(2008) Ritchie, Craig D.; Dean, Jeffrey A.; Avery, David R.; Sanders, Brian J.; Weddell, James A. (James Arthur), 1949-; Platt, Jeffrey A., 1958-; Tomlin, Angela; Moore, B. Keith
BACKGROUND The efficacy of sealants to aid in the prevention of pit and fissure caries is well documented. In order for the sealants to be effective, they must be placed properly and retained for as long as possible. Clinicians must be aware that the proper placement of sealants is technique-sensitive and must be well controlled in order to achieve the best results. This study aims to determine if certain variables have an effect on curing of the sealant material to a degree that would compromise its integrity, strength, and longevity. METHODS AND MATERIALS Two commonly used sealant materials Ultraseal XT (Ultradent Products Inc., South Jordan, UT) and Delton (Dentsply International, Woodbridge, Ontario, Canada) were chosen and tested for microhardness and abrasion resistance after they were polymerized. This study did not focus on the materials themselves, but rather the technique by which they were polymerized and what effect this had on the materials. Three separate light sources, a traditional halogen light (QHL 75, Dentsply International, Woodbridge, Ontario, Canada), and two newer LED lights (Ultralume LED, Ultradent Products Inc., South Jordan, UT; and 3M Freelight LED, 3M Corp, St Paul, MN) were used in this study. The materials were then cured with each light at each of three different distances: contact (0.5 mm), 2 mm, and 10 mm. The effects of light source variation and distance from the material at the time of polymerization was then evaluated for any significance to sealant placement technique. Specimens were tested for each variable combination of sealant material, light source, and distance between the two while curing. Six samples were tested for each variable grouping for abrasion resistance, and four separate san1ples were tested fron1 the san1e grouping for Knoop hardness. The results were analyzed for significance to determine if certain techniques are or could be beneficial or damaging to the quality of care provided by today's practitioners. RESULTS It was found that materials and light sources varied in combination and with different techniques (e.g., distance). In general, the top surface polymerized best when cured at a distance of 2 mm to 10 mm, while the bottom surface polymerized best at a distance of 0.5 mm. The halogen light consistently outperformed the two LED lights, with the 3M LED consistently producing the worst results. CONCLUSIONS The halogen curing light used in this study outperformed the LED lights in almost every category, despite the LED light manufacturer's claims of equality. For more reliable polymerization, the halogen light should be used. SIGNIFICANCE The practitioner must be aware of the material that he/she is using and how the chosen light source polymerizes that material. Manufacturers' claims and recommendations cannot be trusted to accurately produce the best results with every product on the market today, sometimes not even with the manufacturers' own products. It is crucial for practitioners to be well versed and knowledgeable about the products that they use, based on current research and not manufacturers' claims.
Conscious Sedation of the pediatric dental patient: a comparison of meperidine versus butorphanol
(2001) Guthrie, Andrew C. (Andrew Cleveland), 1969-; Sanders, Brian J.; Majcher, Thomas; Tomlin, Angela; Weddell, James A. (James Arthur), 1949-; Avery, David R.
Treating pediatric dental patients four years old and younger can be difficult at times due to patient behavior. Conscious sedation has been employed as a means to control pediatric dental patients for several years. Butorphanol tartrate has been used safely for pain control in pediatric patients for several years, but has never been used for sedating pediatric dental patients. The purpose of this study is to compare the behavioral and physiologic effects of conscious sedation on pediatric dental patients using intramuscular meperidine and an equipotent dosage of intramuscular butorphanol. Forty conscious sedations of ASA I pediatric dental patients between the ages of 13 and 60 months were accomplished using either 2.0 mg/kg of intramuscular meperidine or 0.03 mg/kg of intramuscular butorphanol. Each sedation was videotaped and three viewers viewed the videotapes rating them with a computer program (ACS) involving a four-code behavior rating scale. The tlrree viewers rated patient behavior for each sedation also with a form with global rating, categorical, and dichotomous scales. Physiologic signs of oxygen saturation, blood pressure, heart rate, and respiration rate were monitored at baseline and every 5 minutes during treatment. The operator also rated the sedation patient behavior with a form that had pre-treatment Frankl, post-treatment Frankl, global rating categorical, dichotomous, and sedation success rating scales. The two groups demographic data, physiologic data, ACS data, the three viewer's behavior rating form, and the operator's behavior rating form were analyzed for any statistically significant differences between the groups. The statistical analysis of the demographic data revealed a statistically significant trend in the butorphanol group toward extractions. The meperidine group had a statistically significant higher mean oxygen saturation during treatment (99.63 percent) than the butorphanol group (99.20 percent). The butorphanol group spent significantly more time in the annoyed ACS behavior rating code and showed a trend toward less time spent in the quiet ACS behavior rating code. There were no statistically significant differences in the three viewers ratings of global rating, categorical, and dichotomous scales. The operators' ratings showed the meperidine group had a statistically significant better global rating than the butorphanol group. Overall butorphanol appears to be equal clinically to meperidine in physiologic effects and patient behavior effects. No adverse effects occurred with either medication. Butorphanol may be offered as an alternative sedative agent to other narcotic sedative agents with more side effects.
Correlation between caries prevalence and socioeconomic status in children ages 6 to 36 months
(2000) Ching, Brent Bing Yee; Weddell, James A. (James Arthur), 1949-; Sanders, Brian J.; Tomlin, Angela; Dean, Jeffrey A.; Klein, Arthur Irving, 1922-2004
The purpose of this study was to evaluate the status of a sample of children ages 6 to 36 months with regard to prevalence of tooth decay in a community with an optimum fluoridated water supply. It was determined whether a relation existed between these data and the socioeconomic level of the family. One hundred and fifty children ages 6 to 36 months born and reared in Marion County, Indiana were examined with a dental mirror, explorer and a portable light. Parents/legal guardians of these children were given a questionnaire to obtain family history. Caries prevalence for children ages 6 to 12, 13 to 18, 19 to 24, 25 to 30, and 31 to 36 months were 4%, 0%, 22%, 23%, and 26%, respectively. Age, mother's educational attainment, and Medicaid experience remained significant predictors of caries experience: the odds of caries were 1.1 times for each monthly increase in age. Gender, father's educational attainment, family household income, and single parent status remained marginally significant predictors of caries experience. Results for similar correlation studies between caries prevalence and socioeconomic status for children ages 6 to 36 months are inconsistent. Further research is needed for children ages 6 to 36 months. Caries experience begins before age one. Patients, parents, and health care professionals need to be aware that the caries process begins at an early age, and prevention should begin as early as 6 months of age.
COVID-19 Pandemic Highlights Access Barriers for Children with Autism Spectrum Disorder
(Wolters Kluwer, 2021-09) McNally Keehn, Rebecca; Tomlin, Angela; Ciccarelli, Mary R.; Pediatrics, School of Medicine
Engagement in early intensive behavioral intervention has been shown to improve outcomes and lower lifetime care costs for children with autism spectrum disorder (ASD). However, in most regions of the United States, a medical diagnosis of ASD is necessary to access these interventions. A shortage of expert diagnosticians, inefficient evaluation models, and long evaluation wait times result in substantial delays in ASD diagnosis and markedly later entry into services. These delays are increased for children from diverse racial and socioeconomic backgrounds and underresourced regions. Although systemic barriers require ongoing attention, we highlight here the critical role that insurers play in limiting intervention access through application of inappropriate medical review criteria for ASD diagnostic evaluations. Specifically, to consider a medical diagnosis as valid and authorize specialized interventions, many insurers mandate the use of a specific assessment tool(s) instead of allowing qualified clinicians to use a flexible evidence-informed evaluation protocol. This has become especially problematic during COVID-19, when evaluation practices have rapidly shifted to meet demands for remote and/or socially distanced procedures through implementation of telehealth and use of novel diagnostic tools that are not yet accepted by insurers. When insurers erroneously deem ASD diagnoses as invalid, children are unable to benefit from needed interventions, resulting in a cascade of deleterious consequences.
Exploring Early Care and Education Policy for Young Children of Incarcerated Parents
(Zero To Three Journal, 2020) Dichter, Harriet; Ruprecht, Karen; Tomlin, Angela; Pediatrics, School of Medicine
Children of incarcerated parents who participate in the early care and education system may face an increased risk for developmental and behavioral problems, however, these children are largely hidden when it comes to formal early care and education policy and program initiatives. This article will focus on the impacts of parental incarceration on young children, consider trends and opportunities in early care and education policy that can help address the needs of children of incarcerated parents, and provide suggestions for future policy strategies.
Fissure Penetration and Microleakage of a Conventional Pit and Fissure Sealant and a Flowable Composite: A Comparative Study Using Three Different Bonding Systems
(2002) Chan, Terence; Moore, B. Keith; Dean, Jeffrey A.; Platt, Jeffrey A.; Sanders, Brian J.; Tomlin, Angela; Weddell, James A.
The concepts of using a pit and fissure sealant material to prevent dental caries have been well established in dental research. Effectiveness of a pit and fissure sealant material is limited to its ability to remain bonded to the occlusal surfaces . Adding a dentin-bonding agent between the etched enamel and the sealant material has been demonstrated as a way of optimizing bond strength in the face of moisture and salivary contamination. The purpose of this study was to examine if there was a difference in fissure penetration or microleakage between a conventional pit and fissure sealant or a flowable composite when used as a pit and fissure sealant, while using three different adhesive systems. Delton Direct Delivery System (Dentsply), an opaque, light cured pit and fissure sealant and the commercially available flowable composite, Revolution Formula 2 (Kerr) was selected for this study. Three clinically used adhesive systems selected for this study were: conventional phosphoric acid etching; Opti-bond Solo Plus(Kerr), a single bottle system; and Prompt L-Pop (3M ESPE), an all-in-one primer adhesive. One hundred fifty extracted caries-free third molars, selected for well-defined occlusal pits, were randomly divided into six treatment groups. Fissure penetration and microleakage was examined after immersion of the treated teeth in 5.0-percent methylene blue solution for 18 hours; the teeth were removed and thoroughly cleaned. Mesial and distal flat-ground sections were obtained and examined at X20; micro leakage was recorded as either present or absent, and penetration was recorded as either complete or incomplete. The interaction between the material and the adhesive system was non-significant based on the logistic regression model for the penetration and the microleakage, so that only the main effects of material and adhesive system were included in the final model. Enamel conditioning with the total-etch and single-bottle adhesive system provided consistently microleakage resistance when compared with the use of the all-in-one bonding system. The all-in-one adhesive system demonstrated the most microleakage regardless of the material used for the pit and fissure sealant. The hypothesis of this thesis was that there would be no significant difference in fissure penetration or microleakage between the conventional pit and fissure sealant or the flowable composite, regardless of the adhesive system used. The results of this study support the hypothesis that there was no significant difference in fissure penetration between the materials. The result did demonstrate that there was significant difference in microleakage between the three different adhesive systems used.
Fissure penetration and microleakage of a conventional pit and fissure sealant and a flowable composite: a comparative study using three different bonding systems
(2002) Chan, Terence; Moore, B. Keith; Platt, Jeffrey A., 1958-; Sanders, Brian J.; Tomlin, Angela; Weddell, James A. (James Arthur), 1949-; Dean, Jeffrey A.
The concepts of using a pit and fissure sealant material to prevent dental caries have been well established in dental research. Effectiveness of a pit and fissure sealant material is limited to its ability to remain bonded to the occlusal surfaces. Adding a dentin-bonding agent between the etched enamel and the sealant material has been demonstrated as a way of optimizing bond strength in the face of moisture and salivary contamination. The purpose of this study was to examine if there was a difference in fissure penetration or microleakage between a conventional pit and fissure sealant or a flowable composite when used as a pit and fissure sealant, while using three different adhesive systems. Delton Direct Delivery System (Dentsply), an opaque, light cured pit and fissure sealant and the commercially available flowable composite, Revolution Formula 2 (Kerr) was selected for this study. Three clinically used adhesive systems selected for this study were: conventional phosphoric acid etching; Opti-bond Solo Plus(Kerr), a single bottle system; and Prompt L-Pop (3M ESPE), an all-in-one primer adhesive. One hundred fifty extracted caries-free third molars, selected for well-defined occlusal pits, were randomly divided into six treatment groups. Fissure penetration and microleakage was examined after immersion of the treated teeth in 5.0-percent methylene blue solution for 18 hours; the teeth were removed and thoroughly cleaned. Mesial and distal flat-ground sections were obtained and examined at X20; microleakage was recorded as either present or absent, and penetration was recorded as either complete or incomplete. The interaction between the material and the adhesive system was non-significant based on the logistic regression model for the penetration and the microleakage, so that only the main effects of material and adhesive system were included in the final model. Enamel conditioning with the total-etch and single-bottle adhesive system provided consistently microleakage resistance when compared with the use of the all-in-one bonding system. The all-in-one adhesive system demonstrated the most microleakage regardless of the material used for the pit and fissure sealant. The hypothesis of this thesis was that there would be no significant difference in fissure penetration or microleakage between the conventional pit and fissure sealant or the flowable composite, regardless of the adhesive system used. The results of this study support the hypothesis that there was no significant difference in fissure penetration between the materials. The result did demonstrate that there was significant difference in microleakage between the three different adhesive systems used.
Promoting Resilience with Children Impacted by Parental Incarceration
(Zero To Three, 2020) Tomlin, Angela; Ruprecht, Karen; Arditti, Joyce; Pediatrics, School of Medicine
In prison, jails, and detention centers, the United States incarcerates more people than any other country, and most of these individuals are parents. As a result, early care and intervention professionals are likely to encounter infants and young children affected by parental incarceration. This article will review the scope of the problem, the effects on children, and discuss how providers can best help young children by being aware of their own bias, recognizing and supporting resilience, responding sensitively, knowing and sharing resources, and advocating as appropriate.
Rapid deployment of neurodevelopmental telehealth evaluation services in response to COVID-19: Lessons learned and implications for future clinical innovation
(2021-12) McNally Keehn, Rebecca; Curtin, Michelle; Enneking, Brett; Rouse, Maura; Hines, Elesia; Raches, Christine; James, Cristina; Tang, Qing; Paxton, Angela; Ramaker, Margo; Fitterling, Caroline; Jones, Alyssa; Blewitt, Audra; Etling, Allison; Tomlin, Angela
Children with autism spectrum disorder frequently experience unmet needs. This presentation will describe a model of care navigation delivered to families of children receiving virtual ASD evaluation. Outcomes regarding caregiver engagement and satisfaction with care navigation, as well as enrollment in recommended services and supports and barriers encountered, will be reported.

Browsing by Author "Tomlin, Angela"

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