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Browsing by Subject "Xerostomia"
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Item Artificial biofilm thickness and salivary flow effects on fluoride efficacy – A model development study(2017-10-26) Lippert, Frank; Hara, Anderson T.; Churchley, David; Lynch, Richard J. M.This laboratory model development study investigated the interaction between artificial biofilm thickness and salivary flow rate on fluoride-mediated prevention of enamel caries lesion formation. This 5-day pH cycling study on sound bovine enamel specimens utilized a continuous flow model and followed a 4 (agarose biofilm thickness-‘no biofilm’/1/2/3mm)×2 (remineralizing solution flow rate-0.05/0.5ml/min)×2 (fluoride-0/383ppm as sodium fluoride) factorial design. Vickers surface microhardness change was the outcome measure. Data were analyzed with three-way ANOVA. The three-way interaction gel thickness×flow rate×fluoride concentration was significant (p=0.0006). 383ppm fluoride caused less softening than 0ppm regardless of gel thickness or flow rate. 0.5ml/min flow rate caused less softening than 0.05ml/min for ‘no biofilm’ and 1mm biofilm thickness regardless of fluoride concentration, for 2 and 3mm with 0ppm F but not for 383ppm F. For 0.05ml/min, softening was reduced as gel thickness increased from ‘no biofilm’-1-2mm, but not from 2-3mm. For 0.5ml/min, ‘no biofilm’ caused more softening than 1, 2, and 3mm, but 1, 2, and 3mm were not different from each other for both 0 and 383ppm F. The present findings suggest that the efficacy of fluoride in preventing enamel demineralization is affected by both biofilm thickness and salivary flow rate, with both thicker biofilms and higher flow rate resulting in less demineralization.Item Longevity of dental restorations in Sjogren's disease patients using electronic dental and health record data(Springer Nature, 2024-02-07) Gomez, Grace Gomez Felix; Wang, Mei; Siddiqui, Zasim A.; Gonzalez, Theresa; Capin, Oriana R.; Willis, Lisa; Boyd, LaKeisha; Eckert, George J.; Zero, Domenick T.; Thyvalikakath, Thankam Paul; Biomedical Sciences and Comprehensive Care, School of DentistryBackground: Decreased salivary secretion is not only a risk factor for carious lesions in Sjögren's disease (SD) but also an indicator of deterioration of teeth with every restorative replacement. This study determined the longevity of direct dental restorations placed in patients with SD using matched electronic dental record (EDR) and electronic health record (EHR) data. Methods: We conducted a retrospective cohort study using EDR and EHR data of Indiana University School of Dentistry patients who have a SD diagnosis in their EHR. Treatment history of patients during 15 years with SD (cases) and their matched controls with at least one direct dental restoration were retrieved from the EDR. Descriptive statistics summarized the study population characteristics. Cox regression models with random effects analyzed differences between cases and controls for time to direct restoration failure. Further the model explored the effect of covariates such as age, sex, race, dental insurance, medical insurance, medical diagnosis, medication use, preventive dental visits per year, and the number of tooth surfaces on time to restoration failure. Results: At least one completed direct restoration was present for 102 cases and 42 controls resulting in a cohort of 144 patients' EDR and EHR data. The cases were distributed as 21 positives, 57 negatives, and 24 uncertain cases based on clinical findings. The average age was 56, about 93% were females, 54% were White, 74% had no dental insurance, 61% had public medical insurance, < 1 preventive dental visit per year, 94% used medications and 93% had a medical diagnosis that potentially causes dry mouth within the overall study cohort. About 529 direct dental restorations were present in cases with SD and 140 restorations in corresponding controls. Hazard ratios of 2.99 (1.48-6.03; p = 0.002) and 3.30 (1.49-7.31, p-value: 0.003) showed significantly decreased time to restoration failure among cases and positive for SD cases compared to controls, respectively. Except for the number of tooth surfaces, no other covariates had a significant influence on the survival time. Conclusion: Considering the rapid failure of dental restorations, appropriate post-treatment assessment, management, and evaluation should be implemented while planning restorative dental procedures among cases with SD. Since survival time is decreased with an increase in the number of surfaces, guidelines for restorative procedures should be formulated specifically for patients with SD.