Department of Comprehensive Care and Allied Professions Works
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Item Influence of inorganic composition and filler particle morphology on the mechanical properties of self-adhesive resin cements(Korean Academy of Conservative Dentistry, 2022-07-14) Santi, Marina Rodrigues; Lins, Rodrigo Barros Esteves; Sahadi, Beatriz Ometto; Denucci, Giovanna Corrêa; Soffner, Gabriela; Martins, Luís Roberto Marcondes; Comprehensive Care and Allied Professions Works, School of DentistryObjectives: This study aimed to evaluate the influence of inorganic composition and filler particle morphology on the mechanical properties of different self-adhesive resin cements (SARCs). Materials and methods: Three SARCs including RelyX Unicem-2 (RUN), Maxcem Elite (MAX), and Calibra Universal (CAL) were tested. Rectangular bar-shaped specimens were prepared for flexural strength (FS) and flexural modulus (FM) and determined by a 3-point bending test. The Knoop microhardness (KHN) and top/bottom microhardness ratio (%KHN) were conducted on the top and bottom faces of disc-shaped samples. Sorption (Wsp) and solubility (Wsl) were evaluated after 24 hours of water immersion. Filler morphology was analyzed by scanning electron microscopy and X-ray energy dispersive spectroscopy (EDS). FS, FM, %KHN, Wsp, Wsl, and EDS results were submitted to 1-way analysis of variance and Tukey's post-hoc test, and KHN also to paired t-test (α = 0.05). Results: SARC-CAL presented the highest FS value, and SARC-RUN presented the highest FM. SARC-MAX and RUN showed the lowest Wsp and Wsl values. KHN values decreased from top to bottom and the SARCs did not differ statistically. Also, all resin cements presented carbon, aluminum, and silica in their composition. SARC-MAX and RUN showed irregular and splintered particles while CAL presented small and regular size particles. Conclusions: A higher mechanical strength can be achieved by a reduced spread in grit size and the filler morphology can influence the KHN, as well as photoinitiators in the composition. Wsp and Wsl can be correlated with ions diffusion of inorganic particles.Item Aesthetic and functional enhancement using anterior implant supported Cantilever Partial Fixed Dental Prostheses: A 5-year case report(Discovery, 2023-11) Alqudaihi, Fatema; Al Qudaihi, Walla; Cook, Norman Blaine; Comprehensive Care and Allied Professions Works, School of DentistryRestoring two adjacent maxillary anterior teeth with implants remains challenging, especially with limited mesiodistal space. It can result in implants being positioned relatively close which may affect the final appearance of the surrounding soft tissues. Our clinical case study describes a treatment approach to restore bilateral congenitally missing maxillary canines and lateral incisors utilizing implant-supported cantilever prostheses to achieve good aesthetic and functional outcomes. After 5-year follow-up the case showed favorable results.Item Implementing a dental and pharmacy interprofessional telehealth simulation between two universities(Wiley, 2023-12) Zahl, David A.; Zeitlin, Deborah; Devine, Trish; Romito, Laura M.; Comprehensive Care and Allied Professions, School of DentistryItem Effect of Rapid High-Intensity Light-Curing on Increasing Transdentinal Temperature and Cell Viability: An In Vitro Study(MDPI, 2024-05-22) Miranda, Samille Biasi; Lins, Rodrigo Barros Esteves; Santi, Marina Rodrigues; Denucci, Giovanna Corrêa; Silva, Cleyton Cézar Souto; da Silva, Silvana de Fátima Ferreira; Marques, Daniela de Araújo Viana; Montes, Marcos Antônio Japiassú Resende; Comprehensive Care and Allied Professions, School of DentistryBackground: This study investigated effects of rapid high-intensity light-curing (3 s) on increasing transdentinal temperature and cell viability. Methods: A total of 40 dentin discs (0.5 mm) obtained from human molars were prepared, included in artificial pulp chambers (4.5 × 5 mm), and subjected to four light-curing protocols (n = 5), with a Valo Grand light curing unit: (i) 10 s protocol with a moderate intensity of 1000 mW/cm2 (Valo-10 s); (ii) 3 s protocol with a high intensity of 3200 mW/cm2 (Valo-3 s); (iii) adhesive system + Filtek Bulk-Fill Flow bulk-fill composite resin in 10 s (FBF-10 s); (iv) adhesive system + Tetric PowerFlow bulk-fill composite resin in 3 s (TPF-3 s). Transdentinal temperature changes were recorded with a type K thermocouple. Cell viability was assessed using the MTT assay. Data were analyzed using one-way ANOVA and Tukey tests for comparison between experimental groups (p < 0.05). Results: The 3 s high-intensity light-curing protocol generated a higher temperature than the 10 s moderate-intensity standard (p < 0.001). The Valo-10 s and Valo-3 s groups demonstrated greater cell viability than the FBF-10s and TPF-3 s groups and statistical differences were observed between the Valo-3 s and FBF-10 s groups (p = 0.023) and Valo-3 s and TPF-3 s (p = 0.025), with a potential cytotoxic effect for the FBF-10 s and TPF-3 s groups. Conclusions: The 3 s rapid high-intensity light-curing protocol of bulk-fill composite resins caused a temperature increase greater than 10 s and showed cell viability similar to and comparable to the standard protocol.Item Non-Carious Cervical Lesions: A Bibliometric Analysis and Future Research Trends(Elsevier, 2024-07-11) Denucci, Giovanna; Stone, Sean; Hara, AndersonObjective: The present bibliometric review analyzed the literature on non-carious cervical lesions (NCCLs) to explore the current state and propose future research topics. Data: An electronic search was performed, only full scientific papers published in English were included. Sources: A search was conducted of all databases in the Web of Science (WOS) platform for available publications on the topic of NCCLs. Study Selection: 959 publications were retrieved, and the following data were extracted and analyzed: number of publications, study topics, keywords, study type, authors, affiliations, countries, funding agencies, journals and citations. Articles on NCCLs have been increasing in count, ever since they were first mentioned in the literature. Therapy alternatives account for 628 with few on prevention, and the majority were clinical. Brazil has published the most on NCCLs as well as has the highest number of authors and the most funded articles. The three journals that published the most on the topic were Operative Dentistry, Journal of Dentistry and Clinical Oral Investigations. Conclusion: The findings of this study provide a full picture of the current literature on NCCLs, research trends, knowledge gaps, and areas requiring further investigation. Clinical Significance: By highlighting evolving treatment strategies and potential gaps in prevention, researchers can contribute to the advancement of clinical practice. This can improve patient care and outcomes in the management of NCCLs, while also providing valuable insights for policymakers to prioritize research funding and policy initiatives.Item Inclusive Lab Space for International Dentist and Allied Dental Students(2023-10-25) Cho, Sopanis; Priest, Michelle; Stone, SeanStudents in the International Dentist Program (IDP) and Allied Dental Programs [Dental Assisting (DA) and Dental Hygiene (DH)] lack a space in the Dental School building to call “home”. Scheduling of laboratory, and didactic spaces for both DA and IDP specific courses is often challenging as the room scheduling for the traditional DDS courses takes priority. Because of this, DA and IDP students experience a diminished sense of belonging. The repurposing of an existing shared preclinical laboratory space to address unique needs of DA, DH, and IDP students will not only enhance their learning experiences, but also foster inclusivity and promote their sense of belonging at the schoolItem Caries risk assessment using different Cariogram models. A comparative study about concordance in different populations—Adults and children(Public Library of Science, 2022-06-24) Cagetti, Maria Grazia; Bontà, Giuliana; Lara, Juan Sebastian; Campus, Guglielmo; Comprehensive Care and Allied Professions, School of DentistryThis methodological survey aimed to verify whether there is concordance among several Cariogram different risk models at different thresholds, comparing both children and adult populations and how each risk/protective factor weight on the overall caries risk profile. Three groups' data (two in children and one in adults) were obtained from previous studies, while a fourth, in young adults, was ad hoc enrolled. Different caries risk levels were assessed: a) three risk categories with two different thresholds as: "low risk" = 61-100% or 81-100% chance to avoid caries, "moderate risk" = 41-60% or 21-80% and "high risk" = 0-40% or 0-20%, named model 1 and 2; b) four risk categories with two different thresholds as: "low risk" = 61-100% or 76-100%, "moderate/low risk" = 41-60% or 51-75%; "moderate/high risk" = 21-40% or 26-50% and "high risk" = 0-20% or 0-25%, model 3 and 4; c) five risk categories as: "very low risk" = 81-100%; "low risk" = 61-80% "moderate risk" = 41-60%; "high risk" = 21-40% and "very high risk" = 0-20%, model 5. Concordance of the different Cariogram risk categories among the four groups was calculated using Cohen's kappa. The weight of the association between all Cariogram models toward the Cariogram risk variables was evaluated by ordinal logistic regression models. Considering Cariogram model 1 and 2, Cohen's Kappa values ranged from 0.40 (SE = 0.07) for the young adult group to 0.71 (SE = 0.05) for the adult one. Cohen's Kappa values ranged from 0.14 (SE = 0.03 p<0.01) for the adult group to 0.62 (SE = 0.02) for the two groups of children in models 3 and 4. Statistically significant associations were found for all Cariogram risk variables excepting Fluoride program in models 4 and 5 and the overall risk on children's samples. Caries experience showed a quite variable weight in the different models in both adult groups. In the regression analyses, adult groups' convergence was not always achievable since variations in associations between caries risk and different risk variables were narrower compared to other samples. Significant differences in caries risk stratification using different thresholds stands out from data analysis; consequently, risk assessments need to be carefully considered due to the risk of misleadingly choosing preventive and research actions.Item Urinary fluoride levels and metal co-exposures among pregnant women in Los Angeles, California(BMC, 2023-10-26) Malin, Ashley J.; Hu, Howard; Martínez‑Mier, E. Angeles; Eckel, Sandrah P.; Farzan, Shohreh F.; Howe, Caitlin G.; Funk, William; Meeker, John D.; Habre, Rima; Bastain, Theresa M.; Breton, Carrie V.; Cariology, Operative Dentistry and Dental Public Health, School of DentistryBackground: Fluoride is ubiquitous in the United States (US); however, data on biomarkers and patterns of fluoride exposure among US pregnant women are scarce. We examined specific gravity adjusted maternal urinary fluoride (MUFsg) in relation to sociodemographic variables and metal co-exposures among pregnant women in Los Angeles, California. Methods: Participants were from the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. There were 293 and 490 women with MUFsg measured during first and third trimesters, respectively. An intra-class correlation coefficient examined consistency of MUFsg between trimesters. Kruskal-Wallis and Mann-Whitney U tests examined associations of MUFsg with sociodemographic variables. Covariate adjusted linear regression examined associations of MUFsg with blood metals and specific gravity adjusted urine metals among a subsample of participants within and between trimesters. A False Discovery Rate (FDR) correction accounted for multiple comparisons. Results: Median (IQR) MUFsg was 0.65 (0.5) mg/L and 0.8 (0.59) mg/L, during trimesters one and three respectively. During both trimesters, MUFsg was higher among older participants, those with higher income, and White, non-Hispanic participants than Hispanic participants. MUFsg was also higher for White, non-Hispanic participants than for Black, non-Hispanic participants in trimester three, and for those with graduate training in trimester one. MUFsg was negatively associated with blood mercury in trimester one and positively associated with blood lead in trimester three. MUFsg was positively associated with various urinary metals, including antimony, barium, cadmium, cobalt, copper, lead, nickel, tin, and zinc in trimesters one and/or three. Conclusions: MUFsg levels observed were comparable to those found in pregnant women in Mexico and Canada that have been associated with poorer neurodevelopmental outcomes. Lower urinary fluoride levels among Hispanic and non-Hispanic Black participants in MADRES compared to non-Hispanic White participants may reflect lower tap water consumption or lower fluoride exposure from other sources. Additional research is needed to examine whether MUFsg levels observed among pregnant women in the US are associated with neurodevelopmental outcomes.Item Pulp vitality of primary molars with deep caries treated with ART restorations: 2-year RCT(Pediatric Dentistry, 2022) da Silva, Gabriela Seabra; Raggio, Daniela Prócida; Mello-Moura, Anna Carolina Volpi; Gimenez, Thais; Montagner, Anelise Fernandes; Floriano, Isabela; Lara, Juan Sebastian; Calvo, Ana Flávia Bissoto; Pascareli-Carlos, Aline Maquiné; Tedesco, Tamara Kerber; Cariology, Operative Dentistry and Dental Public Health, School of DentistryThe aim of this study was to compare the pulp vitality of primary teeth with deep caries treated with two restorative techniques. The restoration survival rate was also evaluated as a secondary outcome. Children aged from 4 to 8 years with at least one deep carious lesion in molars were selected at the Ibirapuera University dental clinic. One hundred and eight deciduous molars were allocated into two groups: (1) restoration with calcium hydroxide cement lining followed by filling with high-viscosity glass ionomer cement (CHC+HVGIC) or (2) restoration with HVGIC. Pulp vitality and restoration survival were evaluated at 6, 12, and 24 months. Intent-to-treat analysis was used for pulp vitality, and survival analysis was performed with the Kaplan-Meier method (α=5%). Results: At 24 months, 86 restorations were evaluated, and 91 were evaluated at least once during the study. There was no significant difference between the restorative treatments regarding pulp vitality (CHC +HVGIC=70% and HVGIC=68.5%) (OR=1.091; CI95%=0.481-2.475). However, HVGIC (73%) restorations showed a higher survival rate than CHC+HVGIC (50%) (p=0.021). Thus, it can conclude that deep caries in primary molars should be restored with HVGIC, since the technique results in similar pulp vitality to the CHC +HVGIC, but with a higher restoration survival rate.Item Dietary Fluoride Intake during Pregnancy and Neurodevelopment in Toddlers: A Prospective Study in the PROGRESS Cohort(Elsevier, 2021) Cantoral, Alejandra; Téllez-Rojo, Martha M.; Malin, Ashley J.; Schnaas, Lourdes; Osorio-Valencia, Erika; Mercado, Adriana; Martínez-Mier, E. Ángeles; Wright, Robert O.; Till, Christine; Cariology, Operative Dentistry and Dental Public Health, School of DentistryFoods and beverages provide a source of fluoride exposure in Mexico. While high fluoride concentrations are neurotoxic, recent research suggests that exposures within the optimal range may also pose a risk to the developing brain. This prospective study examined whether dietary fluoride intake during pregnancy is associated with toddlers' neurodevelopment in 103 mother-child pairs from the PROGRESS cohort in Mexico City. Food and beverage fluoride intake was assessed in trimesters 2 and 3 using a food frequency questionnaire and Mexican tables of fluoride content. We used the Bayley-III to evaluate cognitive, motor, and language outcomes at 12 and 24 months of age. Adjusted linear regression models were generated for each neurodevelopment assessment time point (12 and 24 months). Mixed-effects models were used to consider a repeated measurement approach. Interactions between maternal fluoride intake and child sex on neurodevelopmental outcomes were tested. Median (IQR) dietary fluoride intake during pregnancy was 1.01 mg/d (0.73, 1.32). Maternal fluoride intake was not associated with cognitive, language, or motor outcomes collapsing across boys and girls. However, child sex modified the association between maternal fluoride intake and cognitive outcome (p interaction term = 0.06). A 0.5 mg/day increase in overall dietary fluoride intake was associated with a 3.50-point lower cognitive outcome in 24-month old boys (95 % CI: -6.58, -0.42); there was no statistical association with girls (β = 0.07, 95 % CI: -2.37, 2.51), nor on the cognitive outcome at 12-months of age. Averaging across the 12- and 24-month cognitive outcomes using mixed-effects models revealed a similar association: a 0.5 mg/day increase in overall dietary fluoride intake was associated with a 3.46-point lower cognitive outcome in boys (95 % CI: -6.23, -0.70). These findings suggest that the development of nonverbal abilities in males may be more vulnerable to prenatal fluoride exposure than language or motor abilities, even at levels within the recommended intake range.