Effectiveness of Home Bleaching Treatment after Resin Infiltrant Application

Oral Health Prev Dent 18 (2020), No. 3  (08.06.2020)

Open Access ORAL MEDICINE, Page 549-554, doi:10.3290/j.ohpd.a44691

Purpose: Resin infiltration may be a barrier for bleaching gels. The aim of this study was to compare dental bleaching effectiveness using low-concentration gels on heavily or mildly stained teeth that were or were not treated with resin infiltration agents.
Materials and Methods: Forty bovine enamel surfaces were submitted to demineralisation, after which two staining protocols were performed. Twenty specimens were immersed in a staining broth for 24 h (Lab 1) or 7 days (Lab 2). Ten specimens of each group received resin infiltrant application following the manufacturer’s recommendation. All specimens were bleached using 15% carbamide peroxide gel for 14 days (8 h daily). Colour measurement was performed using a reflectance spectrophotometer at three time points: baseline, after staining, and after bleaching. Data (CIEDE00) were analysed using Student’s t-test (p < 0.05).
Results: No statistically significant differences were observed in Lab 1 (p = 0.560). For Lab 2, statistically significant differences were detected (p = 0.031). Once bleaching was achieved to some degree (Lab 2), the resin infiltrant may have behaved as a semipermeable barrier to the carbamide peroxide gels.

Conclusion: Bleaching treatment was effective on mildly pigmented tooth surfaces. On the other hand, in comparison to the control group, the heavily pigmented surfaces bleached less in the presence of the resin infiltrant, possibly due to the lack of free radicals penetrating into the substrate.

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Effect of digital enhancement on the radiographic assessment of vertical root fractures in the presence of different intracanal materials: an in vitro study

Abstract

Objectives

To evaluate the effect of enhancement tools of intraoral digital radiographs on the assessment of vertical root fracture (VRF) and to quantify the resultant image noise.

Materials and methods

Thirty single-rooted human teeth (15 control and 15 fractured) were each radiographed in four intracanal conditions: no filling, gutta-percha, metal post, and fiberglass post, totaling 120 original images. Two filters were applied to the original images—Sharpen filter (SF) and Edge Enhancement filter (EE), and brightness and contrast were adjusted in four combinations (B&C1 to 4), resulting in 840 images. Five oral radiologists analyzed the images for VRF detection. Pixel intensity was obtained in two regions from the radiographs. Diagnostic values were calculated and compared by two-way ANOVA, and the SD values of pixel intensity values were compared by one-way ANOVA (α = 0.05).

Results

There were no significant differences in accuracy for VRF detection between the experimental groups (p > 0.05). Teeth with metal post presented the lowest sensitivity (p < 0.05) for all experimental conditions, except for SF and EE (p > 0.05). B&C2, B&C3, and B&C4 had higher specificity than SF (p ≤ 0.05) for all intracanal conditions. Analysis of pixel intensity showed that all enhanced images presented statistically significant higher noise compared to those of the original images (p ≤ 0.05).

Conclusion

Digital enhancement tools in digital radiography increase image noise; however, they can be used without compromising VRF detection.

Clinical relevance

The use of digital enhancement does not impair the detection of VRF and, therefore, can be applied for this purpose according to the observer preference.

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App determines COVID-19 disease severity using artificial intelligence, biomarkers

COVID-19 severity score, built with data from china and new york city, can help clinicians identify the most at-risk patients

New York University

A new mobile app can help clinicians determine which patients with the novel coronavirus (COVID-19) are likely to have severe cases. Created by researchers at NYU College of Dentistry, the app uses artificial intelligence (AI) to assess risk factors and key biomarkers from blood tests, producing a COVID-19 "severity score."

Current diagnostic tests for COVID-19 detect viral RNA to determine whether someone does or does not have the virus–but they do not provide clues as to how sick a COVID-positive patient may become.

"Identifying and monitoring those at risk for severe cases could help hospitals prioritize care and allocate resources like ICU beds and ventilators. Likewise, knowing who is at low risk for complications could help reduce hospital admissions while these patients are safely managed at home," said John T. McDevitt, PhD, professor of biomaterials at NYU College of Dentistry, who led the research.

"We want doctors to have both the information they need and the infrastructure required to save lives. COVID-19 has challenged both of these key areas."

Creating a Severity Score

Using data from 160 hospitalized COVID-19 patients in Wuhan, China, the researchers identified four biomarkers measured in blood tests that were significantly elevated in patients who died versus those who recovered: C-reactive protein (CRP), myoglobin (MYO), procalcitonin (PCT), and cardiac troponin I (cTnI). These biomarkers can signal complications that are relevant to COVID-19, including acute inflammation, lower respiratory tract infection, and poor cardiovascular health.

The researchers then built a model using the biomarkers as well as age and sex, two established risk factors. They trained the model using a machine learning algorithm, a type of AI, to define the patterns of COVID-19 disease and predict its severity. When a patient’s biomarkers and risk factors are entered into the model, it produces a numerical COVID-19 severity score ranging from 0 (mild or moderate) to 100 (critical).

The model was validated using data from 12 hospitalized COVID-19 patients from Shenzhen, China, which confirmed that the model’s severity scores were significantly higher for the patients that died versus those who were discharged. These findings are published in Lab on a Chip, a journal of the Royal Society of Chemistry.

As New York City emerged as the epicenter of the pandemic, the researchers further validated the model using data from more than 1,000 New York City COVID-19 patients. To make the tool available and convenient for clinicians, they developed a mobile app that can be used at point-of-care to quickly calculate a patient’s severity score.

A Clinical Decision Support Tool

The app has been retrospectively evaluated in the Family Health Centers at NYU Langone in Brooklyn, which serve more than 102,000 patients each year as one of the nation’s largest Federally Qualified Health Center networks.

"Real time clinical decision support tools for COVID-19 can be extremely helpful, particularly in the outpatient setting, to help guide monitoring and treatment plans for those at greatest risk," said Isaac P. Dapkins, MD, chief medical officer for the Family Health Centers at NYU Langone and a co-author on the Lab on a Chip study.

After optimizing the clinical utility of the app at the Family Health Centers at NYU Langone in May, the researchers aim to roll it out nationwide in the coming weeks. It is possible that the COVID-19 severity score could be integrated with electronic health records, thereby providing clinicians with actionable information at an early stage for those diagnosed with COVID-19.

"We hope this tool can help identify those at high risk for adverse outcomes and reduce the health disparities present with COVID-19," said Larry K. McReynolds, executive director for the Family Health Centers at NYU Langone.

Building on Innovations in Testing

The COVID-19 severity score leverages a model McDevitt previously developed to predict outcomes for patients with cardiac disease. Cardiac health is one of several priorities of McDevitt’s lab, which creates point-of-care diagnostic systems that can be programmed to test for oral cancer, cardiac disease, and now COVID-19 biomarkers.

The diagnostic system uses small, non-invasive samples–such as swabs of saliva or drops of blood from a fingertip–which are added to credit card-sized cartridges armed with bio-nano-chips pioneered by McDevitt. The cartridge is inserted into a portable analyzer that simultaneously tests for a range of biomarkers, with results available in less than half an hour.

Because this technology is currently used for research and informational purposes only, the COVID-19 app can be used with existing laboratory tests and requires oversight by an authorized clinician. However, over the next few months, McDevitt’s laboratory, in partnership with SensoDx, a company spun out of his lab, plans to develop and scale the ability to test a drop of blood for COVID-19 severity biomarkers–similar to how a person with diabetes tests their blood sugar–and produce a severity score on the spot.

"With COVID-19, point-of-care testing, coupled with a decision support system, could improve how clinicians triage patients–and potentially improve their outcomes, particularly for those who need more immediate and aggressive care," said McDevitt.

In addition to McDevitt’s research group at NYU College of Dentistry, the study involved collaborators from NYU Grossman School of Medicine, NYU Tandon School of Engineering, Zhongnan Hospital of Wuhan University, and Latham BioPharm Group. The app was developed by McDevitt’s laboratory and OraLiva, a company founded by McDevitt, and is available for both Apple and Android devices. The app is designated for use by authorized clinicians and is not intended for general use by patients.

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Funding for the research was provided by the National Institute of Dental and Craniofacial Research (3U01DE017793-02S1 and 5U01DE017793-2).

About NYU College of Dentistry

Founded in 1865, New York University College of Dentistry (NYU Dentistry) is the third oldest and the largest dental school in the US, educating nearly 10 percent of all dentists. NYU Dentistry has a significant global reach with a highly diverse student body. Visit http://dental.nyu.edu for more.

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Sensitivity of Conventional Radiographs and Cone-Beam Computed Tomography in Detecting the Remaining Root-Canal Filling Material

. 2020 Jun 4.

doi: 10.2334/josnusd.19-0100. Online ahead of print.

Abstract

This study aimed to compare the sensitivity of radiographs and flat-panel volume-computed tomography (fpVCT) in detecting the remaining root-canal filling material. Thirty-two root canals in extracted human mandibular molars were prepared and obturated with gutta-percha and sealer. The filling material was removed, and the teeth were split longitudinally. Radiographs and fpVCT scans were obtained and digitized. Virtual images were developed using reconstruction software and then superimposed, and the remaining filling material was outlined. Direct observation of the split root halves using flatbed scans served as a control. The presence and extension of the remaining filling material were evaluated. Statistical analysis was conducted using chi-squared test (P < 0.05). A total of 116 remnants were detected in the flatbed scans, 81 in the fpVCT scans, and 90 in the radiographs, with no significant difference between the radiograph (78%) and fpVCT (70%) results (P = 0.18). In the fpVCT scans, 42% of the remnants exhibited the same dimensions as the control, whereas 27% appeared larger and 30% appeared smaller. In the radiographs, the dimensions of the remnants were identical to the control in 64% of cases, smaller in 29%, and larger in 7%. FpVCT did not exhibit better performance than dental radiographs in detecting the remaining root-canal-filling material: the extension of remnants was indicated correctly in the fpVCT in fewer than 50% of the samples.

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DentaQuest Selects MouthWatch Platform to Expand Teledentistry Capabilities in Alabama, Massachusetts, Oregon and Washington

TeleDent will enable more effective and convenient dental care for patients

Boston, MA, June 15, 2020 – DentaQuest, the nation’s leading oral health organization, is working with MouthWatch, a leader in innovative patient-friendly, clinician-focused teledentistry solutions, to provide the TeleDent teledentistry platform to more than 70 DentaQuest managed or affiliated dental practices in Alabama, Massachusetts, Oregon and Washington. 
The TeleDent platform will enable DentaQuest-affiliated dentists to conduct both synchronous (live) and asynchronous (store and forward) teledentistry encounters with patients, including video and messaging interactions and sharing of files and photos.

“Teledentistry has been essential for dentists during the COVID-19 pandemic. It enables them to connect with patients for emergency triage and consulting encounters, greatly reducing strain on hospital emergency rooms and dental practices,” said Todd Cruse, President, DentaQuest Care Group. “We also believe teledentistry will be an increasingly important part of oral health in the future, facilitating improved access for those in underserved communities and accelerating medical-dental integration.”

According to MouthWatch founder and CEO Brant Herman, “MouthWatch and DentaQuest are dedicated to providing dentists and patients with improved access to dental care by delivering user-friendly technology that will become an integral part of oral health both during and after the pandemic. Working together, we will deliver more effective and convenient dental care to a greater number of patients.”

About DentaQuest       
DentaQuest is a purpose-driven oral health care company dedicated to improving the oral health of all. We do this through Preventistry® – our all-in approach to better care, expanded access, value-based financing, and innovative solutions. We manage dental and vision benefits for 27+ million Americans and provide direct patient care through our network of more than 80 oral health centers in 6 states. We provide outcomes-based, cost-effective dental solutions for Medicaid and CHIP, Medicare Advantage, small and large businesses, and individuals nationwide. And, we’ve invested more than $200 million in grants and programs to achieve measurably healthier communities across the country. By advancing prevention-focused oral health, we will achieve better overall health for everyone. Learn more at www.DentaQuest.com  and follow us on Twitter @DentaQuest, Facebook www.facebook.com/DentaQuest, Instagram @Inside_DentaQuest, and LinkedIn www.linkedin.com/company/DentaQuest.

About MouthWatch

MouthWatch, LLC is a leader in innovative patient-friendly, clinician-focused teledentistry solutions, digital case presentation tools and intraoral imaging devices. The company is dedicated to finding new ways to constantly improve the dental health experience for both patient and provider. For more information, visit www.MouthWatch.com. Follow MouthWatch on Facebook www.facebook.com/MouthWatch, Twitter @MouthWatchPro, Instagram @MouthWatch and Linkedin www.linkedin.com/company/mouthwatch-llc. 
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LaunchPad by Carestream Dental Takes Digital Learning to New Heights

 

ATLANTAAs a company dedicated to delivering digital dentistry solutions, developing content to promote all-digital learning only makes sense. Today, Carestream Dental is excited to announce the introduction of “LaunchPad by Carestream Dental,” a program that offers a carefully curated digital learning experience to dental professionals seeking personal and professional development.

 

LaunchPad accelerates access to premier educational content from leaders in dentistry. Oral healthcare professionals can choose from live webinars, pre-recorded courses, white papers and interactive resources on the industry’s latest insights, tools and software to advance their performance.

 

Open to users across the globe—including doctors, practice staff, business partners, dealers and more—LaunchPad offers clinical and operational education for free so users can click, learn and takeoff.

 

“During these difficult times, we want to respond to customers’ needs and provide tools and resources to keep teams primed and ready to go when business returns to normal,” Ed Shellard, D.M.D., chief dental officer, Carestream Dental, said. “Our online webinars and resources offer actionable advice and information that oral healthcare professionals can immediately put into practice.”

 

Each month, LaunchPad will provide a variety of content related to a specific theme. June’s theme focuses on the Digital Reboot, a new program designed to provide practitioners with resources and solutions that will drive a safer, more efficient recovery. The following are just some of the topics that will be explored as practices consider ways to safely reopen their offices:

 

 

For more information on LaunchPad—and to sign up for upcoming webinars—please visit carestreamdental.com/launchpad.

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About Carestream Dental

Carestream Dental is committed to transforming dentistry, simplifying technology and changing lives. In this pursuit, we focus on providing the latest in high-quality scanning technology, the smartest chairside systems, the most intuitive practice management software, incredibly accurate imaging software and the data intelligence that helps continually refine patient outcomes. And we offer these solutions for the full range of dental and oral health professionals. For more information please visit carestreamdental.com.

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