Dublin Dental University Hospital

Dublin, Ireland

Dublin Dental University Hospital

Dublin, Ireland
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Finan L.,Dublin Dental University Hospital | Palin W.M.,University of Birmingham | Moskwa N.,Dublin Dental University Hospital | McGinley E.L.,Dublin Dental University Hospital | Fleming G.J.P.,Dublin Dental University Hospital
Dental Materials | Year: 2013

Objective To assess the depth of cure claims of two bulk-fill flowable RBC bases (SDR and x-tra base) using Fourier transform infrared (FTIR) spectroscopy, biaxial flexure strength (BFS), and Vickers hardness number (VHN) for specimen depths of 8 mm (in 1 mm increments). Methods The degree of conversion (DC) was measured by monitoring the peak height (6164 cm-1) of specimens (11.0 ± 0.1 mm diameter, 1.0 ± 0.1 mm thickness) during light irradiation for 20 s using a quartz tungsten halogen light curing unit at 650 ± 26 mW/cm2. DC was measured up to 120 s post irradiation and repeated (n = 3) for irradiation depths up to 8 mm (in 1 mm increments). Further series (n = 20) of eight discs were prepared, stacked, light irradiated and numbered from one to eight (distance from the LCU). The specimens were stored at 37 ± 1 C for 24 h and BFS tested with the fracture fragments used to determine the VHN for each specimen. Results X-tra base can be irradiated to 8 mm without a change in DC, something the SDR material cannot claim. However, the DC results confirm both bulk-fill flowable RBC bases have a depth of cure in excess of 4 mm. One-way ANOVAs of BFS and VHN data showed significant differences between irradiation depths for x-tra base and SDR with increasing irradiation depth (4 mm) resulting in significant reductions in mean BFS and VHN. Significance The claims that the bulk-fill flowable RBC bases have a depth of cure in excess of 4 mm can be confirmed but the differing chemistry of the resin formulations and filler characteristics contribute to significant differences in DC, BFS and VHN data between the two materials tested. © 2013 Academy of Dental Materials.

Finucane D.,Dublin Dental University Hospital
European Archives of Paediatric Dentistry | Year: 2012

Background: The literature regarding dental and systemic effects of Early Childhood Caries (ECC), consequences of leaving carious primary teeth untreated, benefits of appropriate treatment, and concerns regarding dental treatment of young children and the potential for dental anxiety, is reviewed. ECC has consequences, affecting both the child's dental health and his/her general health. This paper reviews the literature regarding ECC and its consequences (pain, sepsis, space loss, disruption to quality of life, failure to thrive, effects on intellectual development, greater risk of new carious lesions in both primary and permanent dentitions, higher incidence of hospitalisation and emergency visits, and increased treatment costs and time). The effects of treatment of ECC are also reviewed; and concerns regarding purported associations between treatment of ECC and dental anxiety are addressed. Search Method: A Pub Med search was conducted of peer reviewed papers published in the English language in the years 1986-2011, using the search terms: Early Childhood Caries (ECC), Nursing Caries (NC), Consequences and ECC/NC, Treatment and ECC/NC, Treatment outcomes and ECC/NC, Dental anxiety, Dental fears, Onset of dental anxiety/fear, Dental experiences and dental fear/anxiety. More than 300 articles were studied. Reference lists of the selected articles were also studied, and frequently quoted articles were thus also located. Articles with small sample size, poor or poorly described methodology, and unclear or unsupportable conclusions were rejected. A representative sample is presented in this paper, citing the articles with greater levels of evidence, with a description of study methods, where appropriate. Conclusion: This review has demonstrated that ECC has implications for both the dental and general health of the affected child. Such problems are potentially serious, even life-threatening. Evidence has been provided of the beneficial effects on dental and general health of dental rehabilitation of children with caries. Causes of dental anxiety are multifactorial, and treatment of ECC does not invariably contribute to dental anxiety, as long as the child's experience of dentistry is not traumatic. Children with the highest levels of dental disease are primarily from disadvantaged communities. Failure to adequately treat their dental disease may further disadvantage these children. Paediatric Dental Societies, renowned experts in Paediatric Dentistry, and the Medical Protection Society (Dental Protection, Professional Insurance) do not support a policy of leaving carious primary teeth untreated.

Reidy J.T.,Dublin Dental University Hospital
Journal of the Irish Dental Association | Year: 2011

This article will review the most recent literature on the effects of alcohol on the oral mucosa, and the possible mechanisms by which alcohol is thought to act as a carcinogen. The article will also consider the possible link between alcohol-containing mouthrinses and oral cancer. The authors recommend that the use of alcohol-containing mouthrinses in high-risk populations should be restricted, pending the outcome of further research.

Margaritis V.,University of Washington | Nunn J.,Dublin Dental University Hospital
Monographs in Oral Science | Year: 2014

Indices for assessing erosive wear are expected to deliver more than is expected of an ideal index: simple with defined scoring criteria so that it is reproducible, reflective of the aetiology of the condition and accurately categorizing shape, area and depth of affect, both at a point in time (prevalence) and longitudinally (incidence/increment). In addition, the differential diagnosis of erosive wear is complex, as it usually co-exists with other types of tooth wear. Therefore, a valid recording of erosive wear at an individual as well as at a population level without a thorough history with respect to general health, diet and habits is a challenge. The aims of this chapter are to describe the potential methodological challenges in assessing erosive wear, to critique the strengths and limitations of the existing erosion indices and to propose the adoption of a validated erosion index for the purpose for which it is intended. © 2014 S. Karger AG, Basel.

McGinley E.L.,Dublin Dental University Hospital | Moran G.P.,Dublin Dental University Hospital | Fleming G.J.P.,Dublin Dental University Hospital
Acta Biomaterialia | Year: 2012

Nickel-chromium (Ni-Cr) alloys used in fixed prosthodontics have been associated with type IV Ni-induced hypersensitivity. We hypothesised that the full-thickness human-derived oral mucosa model employed for biocompatibility testing of base-metal dental alloys would provide insights into the mechanisms of Ni-induced toxicity. Primary oral keratinocytes and gingival fibroblasts were seeded onto Alloderm™ and maintained until full thickness was achieved prior to Ni-Cr and cobalt-chromium (Co-Cr) alloy disc exposure (2-72 h). Biocompatibility assessment involved histological analyses with cell viability measurements, oxidative stress responses, inflammatory cytokine expression and cellular toxicity analyses. Inductively coupled plasma mass spectrometry analysis determined elemental ion release levels. We detected adverse morphology with significant reductions in cell viability, significant increases in oxidative stress, inflammatory cytokine expression and cellular toxicity for the Ni-Cr alloy-treated oral mucosal models compared with untreated oral mucosal models, and adverse effects were increased for the Ni-Cr alloy that leached the most Ni. Co-Cr demonstrated significantly enhanced biocompatibility compared with Ni-Cr alloy-treated oral mucosal models. The human-derived full-thickness oral mucosal model discriminated between dental alloys and provided insights into the mechanisms of Ni-induced toxicity, highlighting potential clinical relevance. © 2011 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Nolan R.,Dublin Dental University Hospital | Kemmoona M.,Dublin Dental University Hospital | Polyzois I.,Dublin Dental University Hospital | Claffey N.,Dublin Dental University Hospital
Clinical Oral Implants Research | Year: 2014

Objectives: A prospective double-blind randomised controlled trial was conducted to test the effect of prophylactic antibiotics on post-operative morbidity and osseointegration of dental implants. Materials and Methods: Fifty-five subjects scheduled for implant surgery were enrolled. The patients were randomly assigned to the antibiotic (test group) and placebo (control group). Twenty-seven patients (test group) received 3 g amoxicillin one hour pre-operatively, and 28 patients (control group) received placebo capsules 1 h pre-operatively. No post-operative antibiotics were prescribed. Pain diaries and interference with daily activities diaries were kept by the patients for 1 week post-operatively. Signs of post-operative morbidity (swelling, bruising, suppuration and wound dehiscence) were recorded by the principal investigators at day 2 and day 7 following the operation. Osseointegration was assessed at 2nd stage surgery or 3-4 months post-operatively. Results: The results of this study suggest that the use of prophylactic pre-operative antibiotics may result in higher dental implant survival rates (100% vs. 82%). Five implant failures, one in each of five patients, were reported in the placebo group and none in the antibiotic group (P = 0.0515). No significant differences were found for most of the signs of post-operative morbidity 2 and 7 days post-operatively. Only bruising at 2 days following the operation appeared to be higher in the placebo group (P = 0.0511). Post-operative pain (P = 0.01) and interference with daily activities (P = 0.01) appeared to be significantly lower for the antibiotic group after 7 days. Those patients with implant failure reported higher pain (based on the VAS scores) after 2 days (P = 0.003) and after 7 days (P = 0.0005), higher pain (based on the amount of analgesics used) after 7 days (P = 0.001) and higher interference with daily activities (based on the VAS scores) after 2 days (P = 0.005). Conclusions: The use of for dental implant surgery may be justified, as it appears to improve implant survival in the short term and also results in less post-operative pain and interference with daily activities. From the results of this study, it appears that prophylactic antibiotics may also be beneficial both in terms of implant survival, especially when the surgical procedure is prolonged due to its difficulty, high number of implants placed or operator's inexperience. © 2013 John Wiley & Sons A/S.

Gallagher S.,Dublin Dental University Hospital | O'Connell B.C.,Dublin Dental University Hospital | O'Connell A.C.,Dublin Dental University Hospital
Journal of Oral Rehabilitation | Year: 2014

Many stainless steel crowns (SSCs) disrupt the occlusion in children, but stabilisation appears to occur within a short period post-placement. The extent and mechanism of these short-term occlusal changes in children are unknown. This study sought to determine whether placement of a SSC changes the maximum intercuspation position (MIP) in children, whether the MIP returns to normal within 4 weeks and whether local anaesthesia had an effect on the child's ability to achieve MIP. The T-Scan® III was used for the measurement of occlusal contacts. Reliability and reproducibility of the system was determined using a calibration exercise where MIP recordings were taken of eleven children not undergoing any dental treatment. For the main study, the percentage of total occlusal force on each tooth was recorded in 20 children preoperatively, after local anaesthesia, after SSC placement and 4 weeks postoperatively. There was no significant difference in MIP (P = 0·435) preoperatively and post-administration of local anaesthesia. There was a significant difference between the preoperative force on a tooth and the reading after crown placement (P = 0·0013, Wilcoxon test). By 4 weeks, there was no significant difference overall between post-SSC placement and the preoperative value for the tooth (P = 0·3). Administration of local anaesthesia did not affect the ability of a child to attain MIP. Maximum intercuspation position was disturbed by the placement of a SSC in seven of 20 cases. When MIP was disturbed, in most cases, it returned to preoperative status within 4 weeks of crown placement. © 2014 John Wiley & Sons Ltd.

Warreth A.,Dublin Dental University Hospital
Journal of the Irish Dental Association | Year: 2013

Replacing missing teeth using dental implants is a good treatment option with a high degree of success. As the dental implantology field develops and the number of implants placed worldwide increases, several terms and techniques have been formulated. Therefore, a basic knowledge of dental implants is necessary for every dental student and dentist. The current article sheds light on how the dental implant integrates with its surrounding bone and what factors can affect this integration. The relationship between the implant and its surrounding soft tissue, different types of the dental implants, and the restorative components and procedures, are all reviewed.

PubMed | Dublin Dental University Hospital
Type: Journal Article | Journal: Evidence-based dentistry | Year: 2016

Data sourcesMedline, Embase, PreMedline and Cochrane Central Register of Controlled Trials.Study selectionClinical trials, investigating only clinical caries outcomes on participants of any age comparing the use of Tooth Mousse() or Tooth Mousse Plus() to a routine oral care regimen for the prevention of dental caries with or without comparison to additional preventive products. Studies that used other formulations of CCP-ACP were excluded. Trials using split-mouth design were also excluded. Only English language papers were considered.Data extraction and synthesisPapers were assessed independently by both authors using the Cochrane Collaboration tool for assessing risk of bias in randomised trials.1 Meta-analysis was not possible due to study heterogeneity.ResultsTwelve studies were available for the final review; three studies on caries prevention were assessed as having low risk of bias. The remaining nine studies, with high risk of bias, reported on treatment or regression of early carious lesions. Two RCTs reported no significant benefits in the use of Tooth Mousse() over brushing with a fluoride toothpaste, a third study demonstrated a statistically significant increase in enamel microhardness for the Tooth Mousse() group compared to control group but no difference to the group who had fluoride gel treatment. Overall the authors concluded that Tooth Mousse() performs no better than fluoride in the prevention of carious lesions.Seven of nine studies evaluated caries lesion severity in orthodontic patients, with four demonstrating statistically significant white spot regression. Two trials in non-orthodontic patients showed statistically significant remineralising potential of Tooth Mousse() over fluoride mouthrinse or the regular use of fluoride toothpaste in 14-30 days.ConclusionsThe authors found no evidence to support the use of Tooth Mousse() over brushing with a fluoride toothpaste for the prevention of early caries. ToothMousse() appeared to benefit regression of white spot lesions associated with orthodontic treatment but the evidence is limited. Effectiveness of Tooth Mousse() was not significantly increased by the addition of fluoride in Tooth Mousse Plus() and evidence is still lacking to support the use of one over another. High quality randomised clinical trials are needed before these products can be recommended for the prevention and treatment of early carious lesions in the general population.Source of fundingThe publication was funded by Colgate Palmolive, Australia.

Smith C.P.,Dublin Dental University Hospital | Al-Awadhi E.A.,Dublin Dental University Hospital | Garvey M.T.,Dublin Dental University Hospital
European Archives of Paediatric Dentistry | Year: 2012

background: Failure of eruption of mandibular permanent molars occurs infrequently but is a difficult clinical problem. It can be due to local or systemic factors or failure of the eruption process. Primary failure of eruption (PFE) is a rare condition that can result in severe posterior open bite, requires complex treatment strategies and has unfavourable outcomes. Mechanical failure of eruption (MFE) is more unusual but can respond positively to treatment. Differentiating between the two is crucial in making the correct diagnosis and managing the case successfully. CASE REPORT: A 10-year-old girl presented with a partially erupted mandibular right first permanent molar, 46. She had no relevant medical or dental history and no family history of tooth eruption failure. TREATMENT: 46 was monitored for 6 months to allow spontaneous eruption. Local and systemic factors were eliminated. Progress radiographs and longitudinal clinical data were collected. Attempted eruption of 46 was completed by surgical luxation and elevation by orthodontic force. FOLLOW-UP: Surgical luxation and elevation of 46 was repeated with the removal of the mandibular right second permanent molar, 47, which was mechanically obstructing the eruption of 46. With continued orthodontic force the tooth was righted up and brought into occlusion with no complication of ankylosis. The mandibular right third molar continues to erupt and migrate mesially. The patient now exhibits a bilateral functioning posterior bite three years after the treatment was commenced. CONCLUSION: Through a combination of sequential monitoring with treatment including surgical luxation and orthodontic force, a therapeutic diagnosis of MFE was made. The appropriate treatment was carried out and the tooth erupted into occlusion.

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