Browsing by Subject "Dental"
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Item Beam profile characterization of light-emitting-diode curing units and its effect on polymerization of a resin-matrix composite(2017) AlZain, Afnan Omar; Platt, Jeffrey A.; Chu, Tien-Min G.; Bottino, Marco C.; Hara, Anderson T.; Goodpaster, John V.; Roulet, Jean-FrancoisThe general aim of this study was to investigate the influence of the localized irradiance beam profiles from multiple light-emitting-diode (LED) light-curing units (LCUs) on the polymerization pattern within a resin-matrix composite (RMC). Irradiance beam profiles were generated from one quartz-tungsten-halogen and various single and multiple emission peak LED LCUs using a camera-based beam profiler system combined with LCU power measurements obtained using an integrating sphere/spectrometer assembly. The influence of distance on irradiance, radiant exposure (RE) and degree of conversion (DC) on the top and bottom surfaces of a RMC increment, using various LCUs, at two clinically relevant distances was investigated. Molar absorptivity of the photoinitiators present in the nano-hybrid RMC (Tetric EvoCeram bleaching shade-XL) assessed was using UV-spectrophotometry. The correlation among irradiance, RE and DC was explored. A mapping approach was used to investigate DC, microhardness and cross-link density (CLD) within 5×5×2 mm specimens at various depths; top, 0.5, 0.7, 0.9, 1.1, 1.3,1.5 mm and bottom. The localized irradiance correlation with its corresponding DC, microhardness and CLD was explored, and localized DC correlation with microhardness was assessed. The DC was measured using micro-Raman spectroscopy, and CLD was assessed by an ethanol-softening method (%KHN reduction) using an automated microhardness tester. Molar absorptivity of diphenyl (2,4,6-trimethylbenzoyl) phosphine oxide was 20-fold higher than camphorquinone. Non-uniform LCU beam profiles caused localized polymerization discrepancies that were significant at specific depths and points within the specimens with respect to DC, microhardness and CLD, which did not follow a specific pattern regardless of the LCU or curing distance assessed. A moderate correlation was displayed among irradiance, RE and DC. The localized irradiance from the LCUs was weakly correlated with the corresponding DC, microhardness and CLD on the top surface of a RMC at both curing distances. The localized microhardness was moderately correlated with DC. In conclusion, polymerization within the RMC investigated was non-uniform and did not reflect the LCU irradiance pattern at the area assessed. Also, a mapping approach within the specimens provided a detailed polymerization pattern assessment occurring within a RMC increment. Therefore, the LCUs explored may potentially increase the risk of RMC fracture.Item Dentists’ Information Needs and Opinions on Accessing Patient Information via Health Information Exchange: Survey Study(JMIR, 2024-01-11) Li, Shuning; Gomez, Grace Felix; Xu, Huiping; Rajapuri, Anushri Singh; Dixon, Brian E.; Thyvalikakath, Thankam; Biostatistics and Health Data Science, Richard M. Fairbanks School of Public HealthBackground: The integration of medical and dental records is gaining significance over the past 2 decades. However, few studies have evaluated the opinions of practicing dentists on patient medical histories. Questions remain on dentists' information needs; their perception of the reliability of patient-reported medical history; satisfaction with the available information and the methods to gather this information; and their attitudes to other options, such as a health information exchange (HIE) network, to collect patient medical history. Objective: This study aims to determine Indiana dentists' information needs regarding patients' medical information and their opinions about accessing it via an HIE. Methods: We administered a web-based survey to Indiana Dental Association members to assess their current medical information-retrieval approaches, the information critical for dental care, and their willingness to access or share information via an HIE. We used descriptive statistics to summarize survey results and multivariable regression to examine the associations between survey respondents' characteristics and responses. Results: Of the 161 respondents (161/2148, 7.5% response rate), 99.5% (n=160) respondents considered patients' medical histories essential to confirm no contraindications, including allergies or the need for antibiotic prophylaxis during dental care and other adverse drug events. The critical information required were medical conditions or diagnosis, current medications, and allergies, which were gathered from patient reports. Furthermore, 88.2% (n=142) of respondents considered patient-reported histories reliable; however, they experienced challenges obtaining information from patients and physicians. Additionally, 70.2% (n=113) of respondents, especially those who currently access an HIE or electronic health record, were willing to use an HIE to access or share their patient's information, and 91.3% (n=147) shared varying interests in such a service. However, usability, data accuracy, data safety, and cost are the driving factors in adopting an HIE. Conclusions: Patients' medical histories are essential for dentists to optimize dental care, especially for those with chronic conditions. In addition, most dentists are interested in using an HIE to access patient medical histories. The findings from this study can provide an alternative option for improving communications between dental and medical professionals and help the health information technology system or tool developers identify critical requirements for more user-friendly designs.Item Evaluation of multiple and single emission peak light emitting diode light curing units effect on the degree of conversion and microhardness of resin-based pit and fissure sealant(2017) Alqahtani, Saleh Ali M.; Soto, Armando E.; Platt, Jeffrey A.; Cook, Norman BlaineObjective: The objective was to assess a multiple emission peak light-emitting-diode (LED) light-curing unit (LCU) by measuring the polymerization efficiency through the degree of conversion (DC) and Knoop microhardness (KHN) of a resin-based pit and fissure sealant at various light curing times and two distances compared to a single emission peak LED LCU. Method: Sixty disks of resin-based pit and fissure sealant (Delton, DENTSPLY, York, PA) samples (6x1mm) were fabricated (n=5/LCU/group). Prepared samples were polymerized using 10, 20 and 40 second curing time at 2 or 4 mm curing distances. The irradiance and radiant exposure received on the top/bottom surfaces of the samples were measured using the Managing Accurate Resin Curing-Resin Calibrator (MARC-RC) system. The samples were stored at 37°C for one hour. Then, the DC (n=3/surface) and KHN (n=5/surface) measurements were collected on the top and bottom surfaces using Attenuated Total Reflection-Fourier Transform Infrared Spectroscopy (ATR-FTIR) and a microhardness tester (Instron) utilizing 25-gm at 10 seconds dwell time, respectively. Multiple-way ANOVA was performed followed by Tukey test (α=0.05). Result: The irradiance from the multiple emission peak LED LCU was significantly higher than the single emission peak LED LCU (1312.6 and 768.3 mW/cm2) respectively. Moreover, the multiple emission peak LED LCU displayed significantly higher DC (82.5%) and microhardness (26.2 KHN) compared to the single emission peak LED LCU (75.5% DC and 21.2 KHN) when curing samples at 2 and 4 mm curing distances assessed using 10, 20 and 40-second curing times. The 10 second cure at 4 mm showed significantly lower DC and KHN values compared to the other groups. Conclusion: The multiple emission peak LED LCU demonstrated significantly higher irradiance, DC and KHN compared to the single emission peak LED LCU on a resin-based pit and fissure sealant at 2 and 4 mm curing distances and 10, 20 and 40 second curing times. Therefore, the multiple emission peak LED LCU performed higher than the single emission peak LED LCU.Item Influence of curing-light beam profile non-uniformity on degree of conversion and micro-flexural strength of resin-matrix composite(2016-10-05) Eshmawi, Yousef Tariq; Platt, Jeffrey A.; Hara, Anderson T.; Diefenderfer, Kim E.; Cook, Norman B.Background. Beam profile non-uniformity of light-curing units (LCUs) may result in suboptimal properties of resin-matrix composite (RMC) restorations. Objectives: The objective of this study was to evaluate the effect of curing-light beam profile of multiple light curing units (LCUs) on the degree of conversion (DC) and micro-flexural strength (μ-flexural strength) of RMC. Methods: Forty-five nano-filled hybrid RMC (Tetric EvoCeram, Ivoclar Vivadent, Amherst, NY) specimens were fabricated. Quartz tungsten halogen (QTH) (Optilux 401) (O), multiple emission peak (VALO Cordless) (V) and single emission peak (Demi Ultra) (DU) light-emitting-diode (LED) LCUs were investigated at different light-curing locations (LCLs): 1) the center of the LCU tip; 2) 1.5 mm to the left of the center of the LCU tip; and 3) 1.5 mm to the right of the center of the LCU tip. Specimens were stored wet in deionized water at 37C for 24 hours. The DC was measured on top and bottom surfaces using Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy. Micro-flexural strength testing was performed using a universal mechanical testing machine at crosshead speed of 1 mm/min. Multi-factorial ANOVAs were used to analyze the data (α = 0.05). Results: All LCUs exhibited significant differences in DC between top and bottom surfaces at the different LCLs. Micro-flexural strength varied with LCL for DU. Conclusions: The non-uniform curing-light beam profile could have a significant effect on μ-flexural strength and DC on top and bottom surfaces of RMC specimens cured at different LCLs.Item Mucosal Perfusion Preservation by a Novel Shapeable Tissue Expander for Oral Reconstruction(Wolters Kluwer, 2017-08-28) Barwinska, Daria; Garner, John; Davidson, Darrell D.; Cook, Todd G.; Eckert, George J.; Tholpady, Sunil S.; March, Keith L.; Park, Kinam; Barco, Clark T.; Cellular and Integrative Physiology, School of MedicineBackground: There are few methods for expanding oral mucosa, and these often cause complications such as tissue necrosis and expander eruption. This study examines mucosal blood perfusion following insertion of a novel shapeable hydrogel tissue expander (HTE). The canine model used subgingival insertion of HTE following tooth extraction and alveolar bone reduction. The primary goal of this study was to gain understanding of epithelial perfusion and reparative responses of gingival mucosa during HTE expansion. Methods: Nine Beagle dogs underwent bilateral premolar maxillary and mandibular tooth extraction. Three to four months later, HTE-contoured inserts were implanted submucosally under the buccal surface of the alveolar ridge. After removal and following a 6- to 7-month period of healing, new HTE implants were inserted at the same sites. The area was assessed weekly for tissue perfusion and volume of expansion. Biopsies for histological analysis were performed at the time of expander removal. Results: Within 2 weeks following the second insertion, blood flow returned to baseline (defined as the values of perfusion measurements at the presurgery assessment) and remained normal until hydrogel full expansion and removal. Volume expansion analysis revealed that the hydrogel doubled in volume. Histological assessment showed no macrophage or inflammatory infiltration of the mucosa. No superficial fibrosis, decreased vascularity, or mucosal change was seen. Conclusion: Maintenance of adequate tissue perfusion is a clinically important aspect of tissue expander performance to reduce risk of device loss or injury to the patient, particularly for areas with a history of previous surgeries.Item Primary Caregiver Retention and Perceptions of Retention Strategies in a 36-Month Prospective Childhood Caries Study(Sage, 2022) Daly, Jeanette M.; Xu, Yinghui; Yanca, Emily; Levy, Steven M.; Levy, Barcey T.; Talbert, Jennifer; Tran, Jennifer L.; Keels, Martha Ann; Fontana, Margherita; Biomedical and Applied Sciences, School of DentistryIntroduction/objectives: This paper reports on participant retention from an ongoing prospective, multi-site cohort caries risk study involving parent/infant pairs. The objectives were to: (1) compare the retention rates at each intermediate contact (every 4 months) and dental visit (every 18 months) across the 3 clinical sites, (2) assess primary caregivers' perceptions at the end of the study about the retention efforts used in this longitudinal study, and (3) determine whether primary caregiver baseline demographic characteristics and child's baseline caries experience were associated with retention. Methods: 1325 primary caregiver-child pairs recruited at the child's first birthday were followed for 36 months at 3 sites. Dental visits occurred at children's ages of approximately 12, 30, and 48 months. Telephone/email intermediate contacts with the primary caregiver occurred 6 times between dental visits. The outcome variable was the retention rates at each dental visit and each intermediate contact. Primary caregivers' perceptions of intermediate contacts were evaluated. Retention rates were compared by maternal age, race, ethnicity, Medicaid status, yearly household income, baseline caries experience (defined as decayed, missing due to caries, or filled tooth surfaces) at 12 months, and the number of teeth erupted. Results: 1325 primary caregiver/infant pairs were enrolled and completed the first in-person dental visit, 1062 pairs (80%) completed the second visit and 985 (74%) completed the third. Most primary caregivers were female (94%), with a mean age of 29 years and 667 (50%) self-identified as White, 544 (41%) as Black, and 146 (11%) as Hispanic. The percentages of successful intermediate contacts were 95% at 4 months decreasing to 82% at 34 months. Almost all 964 (98%) of 985 primary caregivers reported at the last visit that they were comfortable/very comfortable with 4-month intermediate contacts. The multivariable analysis showed that primary caregivers who were older (OR = 1.07; 95% CI, 1.04-1.09) and White (OR = 1.52; 95% CI, 1.12-2.06) were more likely to complete the study. Conclusions: Retention strategies were focused on frequent routine contact and increasing monetary incentives. Those strategies may have resulted in retention exceeding the proposed goals. At the end of the study, primary caregivers were comfortable with the 4-month intermediate contacts.Item The status of climate studies in the United States and Canadian dental schools: Deans' perspectives(Wiley, 2021) Ester, Todd V.; Tucker-Lively, Felicia L.; Smith, Carlos; Taylor, George W.; Ware, Tawana K.; Inglehart, Marita R.; Pediatric Dentistry, School of DentistryObjectives: Institutions with a positive cultural climate make community members from all backgrounds valued and included, and treated equitably. Such an environment is optimally suited to prepare future dentists well for leading a diverse team of staff members and addressing the oral health care needs of increasingly more diverse patient populations. The objectives were to assess how many United States and Canadian dental schools had participated in a climate study at their parent institution and/or had conducted their own climate study, which topics these studies had addressed, how they collected their data, from whom they collected data, and how the findings affected these academic units. Methods: In January 2020, 54 of the 78 dental school deans in the United States and Canada responded to a web-based survey (response rate: 69%). Results: Forty-six parent institutions (85%) and 27 dental schools (50%) had conducted climate studies. Eighty-seven percent of parent institutions assessed the climate overall and the climate for specific groups (70%), such as for persons from underrepresented minority backgrounds (67%) or different religious backgrounds (59%). Most parent institution and dental school studies utilized surveys to collect data from faculty (parent institutions: 76%/dental schools: 96%), staff (74%/93%), administrators (72%/93%), and students (72%/89%). Overall, climate study results positively affected parent institutions' and dental schools' humanistic environment (61%/63%) and the recruitment of faculty (46%/50%), students (46%/46%), and staff (41%/43%). Conclusions: Climate studies are a widely accepted practice at dental schools and their parent institutions. Their results can play a vital role in shaping the climate of these academic units by fostering efforts to increase diversity, equity, and inclusion.Item Validation of an artificial tooth-periodontal ligament-bone complex for in-vitro orthodontic research(2015-08) Favor, Trevor E.; Chen, Jie; El-Mounayri, Hazim A.; Katona, Thomas R.Orthodontics research investigates the methods in which tooth displacement may be directed in the tooth-periodontal ligament-bone-complex. In the biological environment, the periodontal ligament is the soft tissue responsible for the absorption of forces on teeth and has a direct connection to tooth mobility. Current research is limited in that it must be conducted in an in-vivo capacity. A major advancement in orthodontics research would be a testing method that allows for the development and analysis of orthodontic devices without a patient present. This study outlines the development and testing methods for the validation of an artificial periodontal ligament to be used in conjunction with an artificial-tooth-periodontal ligament-bone-complex. The study focused on finding the criteria in which consistent results were produced, the mixture that best simulated the human periodontal ligament’s mechanical behavior, and the robustness of the artificial-periodontal ligament-bone-complex. This study utilized a geometrically accurate denture mold filled with varying compositions of an artificial periodontal ligament for testing. Experiments focused on findings of viscoelasticity, curing times, and instantaneous responses of the teeth under direct orthodontic loading, as well as the changes in response from different teeth within the denture mold. Tests confirmed that a mixture composed of 50\% Gasket Sealant No. 2 and 50\% RTV 587 Silicone produced a substance that could adequately serve as an artificial periodontal ligament.