The annual 3M Oral Care Graduate Student Research Presentations and Awards are a result of the partnership formed between 3M Oral Care and CAPD/ACDP.
3M Oral Care generously sponsors the attendance of Canadian pediatric dentistry graduate students presenting original research at the CAPD/ACDP Annual Conference. All presenters will receive 3M Oral Care product samples and, through a formal judging process, the top graduate student presenter will also receive $1000.00.
Full details at http://capd-acdp.org/Grads-and-Undergrads
The 2019 Presenters, in alphabetical order
Dr. Ashley Gill, University of Washington
Comparison of Three Esthetic Full-coverage Restorations in Primary Maxillary Incisors
Ashley Gill DMD, Mariella Garcia DDS, Se Won An BSc, JoAnna Scott PhD, Ana L. Seminario DDS, PhD, MPH (University of Washington, Seattle, Washington)
Objective: To compare the 12-month clinical outcomes of primary maxillary incisors restored with composite strip crowns (CSCs), NuSmile Preveneered Stainless Steel Crowns (PVSSCs), and NuSmile Zirconia Crowns (ZCs).
Methods: The University of Washington (UW) Human Subjects Review Board (STUDY00003980) approved this single-center, single-blinded, randomized controlled clinical trial. There was financial support from NuSmile (Houston, Texas, USA). The terms of this arrangement have been reviewed and approved by the UW Human Subjects Review Board in accordance with its policy on objectivity in research. One hundred and thirty-five (N=135) teeth in 47 children aged two to four years with ECC were randomly assigned to one of the three crown groups and were available at follow-up. Demographic and tooth-related variables at baseline and at 12 months were assessed by calibrated examiners. Fisher’s exact or Chi-square tests were used to test associations (P<.05).
Results: Children were on average 3.4 years, female (55%), and had a mean dmft of 10.6. At 12 months, crown retention was significantly lower for CSCs than PVSSCs or ZCs (79% vs 100% and 95%, P=.002). Partial and complete loss of esthetic facing was significantly higher in CSCs than PVSSCs or ZCs (29% vs 11% and 0%, P<.001). Teeth restored with composite presented with an increased rate of marginal discrepancies and color change (P<.001). Parental dissatisfaction of the crowns was most often related to color (83%), whereby 63% were dissatisfied with CSCs, and 37% with PVSSCs, while no parents were concerned with the color of ZCs (P=0.005). The remainder of parental esthetic dissatisfaction regarded shape and alignment of ZCs (P=0.007).
Conclusions: Clinical outcomes were significantly different among CSCs, PVSSCs, and ZCs at 12 months. CSCs showed significantly reduced clinical success in regard to retention, facing integrity, marginal adaptation, and color compared to PVSSCs or ZCs. Overall parental esthetic satisfaction was highest for ZCs.
Dr. Pauline Lee, University of British Columbia
University of British Columbia Children’s Dental Program – A Retrospective Study, Lee PSJ, Aleksejuniene J (University of British Columbia, Vancouver, BC)
Objective: Many dental schools contribute to public health through free or reduced-fee treatment for underserved pediatric populations. The University of British Columbia (UBC) Faculty of Dentistry’s students provide dental care to pediatric patients through a bussing program known as the Children’s Dental Program (CDP), which transports children from areas outside of Vancouver city limits to UBC for free care. The purpose of this study was to quantify the scope of the CDP by reviewing the populations serviced and dental treatment provided over the past 21 years.
Methods: De-identified data was retrieved from UBC’s axiUm Dental Software database, including demographic information and treatment procedures performed. The first three digits of the patients’ postal codes were used to create choropleth maps using QGIS Software. The treatment procedures were organized into ten categories, including preventive and restorative. The 21-year period was split into 4 periods (Period 1 to Period 4), and one-way ANOVA testing was done using SPSS Software.
Results: A total of 5,203 patients were treated between April 1997 and March 2018. A majority were from the suburbs of Surrey, Abbotsford, and Burnaby. Over each successive period, the number of patients increased (1,279 in Period 1 to 1,641 in Period 4), but the mean number of total procedures decreased (13.1 procedures per patient in Period 1 to 8.4 in Period 4, p<0.001). The mean number of restorative procedures was found to have decreased over the periods (4.4 per patient in Period 1 to 2.3 in Period 4, p<0.001). The mean number of preventive procedures also decreased over the four periods (4.3 per patient in Period 1 to 2.5 in Period 4, p<0.001).
Conclusions: The CDP has been providing dental care to children from many disadvantaged communities located in the Vancouver suburbs. Since its inception, the number of patients seen had increased, but the number of treatment procedures had decreased. Based on the interesting inverse trend of patients seen to procedures performed, the next step in this study will be to further investigate changes in the treatment needs of the population. The preventive component in patient care appeared to have decreased over the periods; further analyses will be done to determine the reasons. This will allow us to suggest valuable and timely improvements for the CDP. Last but not least, the method of using procedure codes to calculate treatment provision may be useful in epidemiology for indirectly quantifying a population’s treatment needs.
Dr. Kimberly Ngai, University of Toronto
Ex vivo evaluation of novel antimicrobial-containing adhesive systems for bacterial inhibition and secondary caries reduction
Kimberly Ngai1, Cameron Stewart1,2, Dennis Cvitkovitch1,2, Andreas Mandelis2,3, Benjamin Hatton2,4, Yoav Finer1,2
1Faculty of Dentistry, University of Toronto, Toronto, ON
2Institute of Biomaterials and Biomedical Engineering, University of Toronto, Ontario
3Department of Mechanical and Industrial Engineering, University of Toronto, Ontario
4Department of Materials Science and Engineering, University of Toronto, Ontario
Objectives: Resin composite restorations fail prematurely within 5-7 years from placement, primarily due to bacterial attack and subsequent secondary caries formation. We previously developed drug-silica co-assembled particles (DSPs) utilizing the antimicrobial agent octenidine dihydrochloride as a template for long-term antimicrobial effect. The aim of this ex vivo study was to examine the efficacy of experimental total-etch and self-etch dental adhesives containing DSPs in 1) inhibiting interfacial bacterial biodegradation markers (biofilm formation, viability, and penetration), and 2) reducing the development of secondary caries.
Methods: Standardized specimens were prepared from commercial resin composite (Z250, 3M) bonded to human dentin using either modified commercial total-etch (DTE) (Scotchbond, 3M) or self-etch (DSE) (EasyBond, 3M) adhesives (experimental) loaded with 10% wt. DSPs, or control DSP-free commercial total-etch (TE) or self-etch (SE) adhesives.
Two experiments were conducted: 1) Specimens were incubated in simulated human salivary esterase media mimicking physiological oral conditions (37°C, pH=7) for 0, 90 and 180 days to induce interfacial biodegradation. Specimens were then suspended in a continuous flow biofilm fermenter inoculated with Streptococcus mutans UA159 and Lactobacillus rhamnosus ATCC 11981 mimicking pathogenic oral conditions for 3 days. Biofilm formation, viability and penetration were measured using confocal laser scanning microscopy (CLSM) (Imaris, Bitplane). 2) Specimens were incubated for 7 days in sucrose-supplemented media and bacterial species as above. Volume of demineralization and cavitation were evaluated using micro-computed tomography (µCT). Two-way ANOVA and Tukey’s test were used for statistical analyses (p<0.05).
Results: DTE specimens had a reduction in all bacterial biodegradation markers compared to controls at all time points (average reduction of 19.2 ±4.9%, 23.1 ±4.3%, and 15.5 ±5.6% in biomass, viability and penetration, respectively) (p<0.05). DSE specimens reduced bacterial biomass and viability (average 15 ±5.8% and 44.1 ±4.7%, respectively) at all time points (p<0.05), and reduced bacterial penetration at 6 months only (23 ±8.3%) (p<0.05). Initial µCT results show reduced cavitation/secondary caries formation in drug-containing specimens compared to controls.
Conclusions: Dental adhesives containing DSPs show reduced bacterial biofilm formation, viability and/or penetration versus controls. The reduction in these markers is expected to significantly impact the rate of secondary caries formation, as indicated by the preliminary µCT results. Completion of the µCT analyses will allow validation of CLSM as a predictive quantitative method for secondary caries formation. With increasing demands for aesthetic restorations in children, incorporation of antimicrobial activity into dental adhesives may be a promising strategy to improve the longevity of resin composite restorations.
Dr. Michael Rullo, University of Toledo Medical Center
Visits to the Emergency Department for Paediatric Dental Treatment
Introduction: Many patients with dental emergencies are seen in the hospital emergency department after regular dental service hours. It is not fully understood why these patients are seeking care at the hospital emergency department rather than calling their local dentist or other after-hours dental services. Previous studies investigated mostly adult populations and were retrospective from hospital records. This results in correlation-based conclusions rather than direct responses from the parents.
Dental related hospital emergency department visits burden the healthcare system costing 1.6 billion per year while the majority of these could be managed in community dental practices.1 Data from the ADA demonstrated a decline in adult utilization of the emergency department since 2000 however usage from the paediatric population has been left unchanged.2 When patients have a dental home this significantly reduces the usage of emergency services.2
Objective: The purpose of this current study was to determine why patients are utilizing hospital emergency departments for dental related emergencies when there is limited or no dental coverage available. It is hypothesized that patients from the Toledo and surrounding area are utilizing after hours hospital emergency services for dental emergencies because they do not know where to seek dental treatment after regular business hours.
Methods: This study is an observational cohort study. Data was collected utilizing a survey pertaining to the dental emergency. Inclusion criteria consisted of children under the age of 15 who presented to the University of Toledo Medical Center Hospital Emergency Department after hours for emergency dental treatment.
Results: Preliminary results show most emergencies are related to dental trauma (84.2%) compared to infection. Most patients are insured through government funded programs (94.7%) and 47.3% have a dental home. Most parents perceived the severity of the emergency to be high and came to the hospital emergency department to get an assessment less than 6hrs after the time of incident. 42.1% of respondents phoned a dentist before coming to the hospital emergency department. 52.6% presented to the hospital emergency department because they had no other option or could not get a hold of any dental care provider.
Conclusions: Parents do not have adequate access to after-hours dental emergency services even if they have a dental home. Parents with and without a dental home lack adequate knowledge regarding what to do when their child experiences a dental emergency. Most paediatric patient traumatic injuries tend to be perceived as serious by their parents.
1. Management of After-Hours Pediatric Dental Emergencies Among Pediatric and General Dentists.
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2. Effect of Treatment Delay Upon Pulp and Periodontal Healing of Traumatic Dental Injuries –
A Review Article. J.O. Andreasen, F.M. Andreasen, A. Skeie, E. Hjorting-Hannsen, O.
Schwartz. Dental Traumatology 2002; 18: 116-118
3. Utilization of a Hospital for Treatment of Pediatric Dental Emergencies. Scott T. Rowley,
Barbara Sheller, Bryan J. Williams, Lloyd Mancl. Pediatric Dentistry – 28:1, 2006
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center in Taiwan. Chia-Pei Jung, Aileen I. Tsai, Ching-Ming Chen. Biomedical Journal 2006;
5. Visiting the emergency department for dental problems: Trends in utilization, 2001 to 2008.
Helen H. Lee, Charlotte W. Lewis, Babette Saltzman, Helene Starks. American Journal of
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6. Low income and minority patient satisfaction with visits to emergency departments and
physician offices for dental problems. Leonard A. Cohen et al. J Am Coll Dent 2009; 76(3):
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offices for dental problems and injuries. Leonard A. Cohen et al. Journal of Public Health
Dentistry 2011; 71:13-22
8. Epidemiology of dental emergency visits to an urban children’s hospital. Yang Zeng, Barbara
Sheller, Peter Milgrom. Pediatric Dentistry Nov/Dec 1994; 16(6)
9. Increasing prevalence of emergency department visits for pediatric dental care, 1997-2001.
Teresita E. Ladrillo, Martin H. Hobdell, Chantal Caviness. J Am Dent Assoc. March 2006;
10. Who attends a children’s hospital emergency department for dental reasons? A two stage
cluster analysis approach. Z. Marshman, T. Broomhead, H.D. Rodd, K. Jones, D. Burke, S.R.
Baker. Community Dentistry and Oral Epidemiology 2017; 45: 49-58
11. Medical emergency department attendance of under 16-year-olds with dental problems.
Nicola J. Parten, Greig D. Taylor, Charlotte C. Currie, Justin Durham, Christopher R.
Vernazza. J Oral Rehabilitation 2019; 46; 46: 433-440
12. Social factors associated with pediatric emergency department visits for caries-related
dental pain. Douglas Von Kaenel, Dominic Vitangeli, Paul S. Casamassimo, Stephen Wilson,
James Preisch. Pediatric Dentistry 2001; 23:1
13. Reducing the burden of dental patients on the busy hospital emergency department.
McCormick AP, Abutbaker AO, Laskin DM, Gonzales MS, Garland S. J Oral Maxilofacial
Surgery march 2013; 71(3): 475-478
14. Hospital-based emergency department visits involving dental conditions: Profile and
predictors of poor outcomes and resource utilization. Allareddy V, Rampa S, Lee MK,
Allareddy V, Nalliah RP. J American Dental Association April 2014; 145(4): 331-337
15. Emergency department visits for nontraumatic dental problems: A mixed –methods study.
Benjamin C. Sun et al. American Journal of Public Health May 2015; 105(5)
16. Ethical Moment. Rickland G. Asai. JADA October 2006; Vol 137