Melbourne Dental School - Research Publications
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ItemStatus and progress of treatment methods for root caries in the last decade: a literature review(WILEY, 2018-03-01)The aim of this literature review is to explore the treatment methods for root caries in laboratory and clinical research in the last decade. A systematic search of publications in PubMed and Web of Science databases was performed. The timespan was limited to the last 10 years and English language. Further retrieval was conducted using the search terms of specific therapies or treatments. Eighty-two articles were included in this systematic review and full texts were retrieved. Types of studies included laboratory studies and clinical trials. Therapeutic approaches for root caries without risk of pulp exposure can be categorized into non-invasive and restorative treatment. Non-invasive treatments which targeted different causative factors of root caries have been developed in the last decade. Accordingly, several artificial caries model systems have been proposed for the study of root caries in the laboratory. Carious tissue excavation techniques and restorative materials and procedures have been modified to improve the prognosis of invasive treatment. It is of importance to determine the most appropriate therapy for root caries and further clinical trials are needed to draw firm conclusions concerning the efficacy and consistency of the various treatment methods proposed.
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ItemSimulation and curriculum design: a global survey in dental education(WILEY, 2017-12-01)BACKGROUND: Curriculum reforms are being driven by globalization and international standardization. Although new information technologies such as dental haptic virtual reality (VR) simulation systems have provided potential new possibilities for clinical learning in dental curricula, infusion into curricula requires careful planning. METHODS: This study aimed to identify current patterns in the role and integration of simulation in dental degree curricula internationally. An original internet survey was distributed by invitation to clinical curriculum leaders in dental schools in Asia, Europe, North America, and Oceania (Australia and New Zealand). RESULTS: The results (N = 62) showed Asia, Europe and Oceania tended towards integrated curriculum designs with North America having a higher proportion of traditional curricula. North America had limited implementation of haptic VR simulation technology but reported the highest number of scheduled simulation hours. Australia and New Zealand were the most likely regions to incorporate haptic VR simulation technology. CONCLUSIONS: This survey indicated considerable variation in curriculum structure with regionally-specific preferences being evident in terms of curriculum structure, teaching philosophies and motivation for incorporation of VR haptic simulation into curricula. This study illustrates the need for an improved evidence base on dental simulations to inform curriculum designs and psychomotor skill learning in dentistry.
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ItemComparison between published clinical success of direct resin composite restorations in vital posterior teeth in 1995-2005 and 2006-2016 periods(WILEY, 2017-06-01)Composites are increasing in popularity as restorative materials. This growing role indicates the necessity of studies on their clinical outcome. In this study, clinical studies published on the performance of posterior composite restorations were included except those of less than a 24-month assessment period. Results of non-vital, anterior or primary teeth and cervical single-surface restorations were also excluded. Records about composite type, number of final recall restorations, failure/survival rate, assessment period and failure reasons were analysed for each decade. Overall survival/failure rates for studies in 1995-2005 were 89.41%/10.59% and for 2006-2016 were 86.87%/13.13%, respectively. In 1995-2005, the reasons for failure were secondary caries (29.47%) and composite fracture (28.84%) with low tooth fracture (3.45%) compared with reasons of failure in 2006-2016, which were secondary caries (25.68%), composite fracture (39.07%), and tooth fracture (23.76%). An increase in incidence of composite fracture, tooth fracture and need for endodontic treatment as failure reasons was noted in the latter decade in addition to a decrease in secondary caries, postoperative sensitivity, unsatisfactory marginal adaptation and wear. The overall rates of failure showed little difference, but the causes showed a notable change. This is believed to be a reflection of increased use of composites for larger restorations and possibly changes of material characteristics.
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ItemAn investigation into the effect of a resin infiltrant on the micromechanical properties of hypomineralised enamel(WILEY, 2017-09-01)BACKGROUND: Resin infiltration may alter the mechanical properties of enamel hypomineralised lesions (HL); however, variable surface layer (SL) thickness may affect resin penetration. AIMS: To determine the thickness of the SL of HL and to investigate the effect of resin infiltration on the mechanical properties of HL. DESIGN: The thickness of the SL over HL was determined using polarised light microscopy. Etching time using 15% HCl gel to remove the SL of 52 samples was determined. Selected HL and control areas of 21 teeth were infiltrated with Icon® resin infiltrant, and cross-sectional Knoop microhardness (KHN) measurements were recorded before and after resin infiltration. RESULTS: Ninety-six point five per cent of HL had a detectable SL with mean thickness of 58 ± 29 μm. Application of HCl for 120 s produced a mean MIH erosion depth of 58 ± 12 μm. Eleven of 21 samples had evidence of infiltration using visual examination. The infiltrant penetrated some of the HL leading to an increase in KHN (111 ± 75 KHN) which, when compared to adjacent non-infiltrated HL (96 ± 52 KHN), was not statistically significantly different (P = 0.56). CONCLUSIONS: There was marked variation in the SL thickness of HL. Resin infiltration of HL did not increase microhardness significantly.
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ItemThirty-six month clinical evaluation of a highly filled flowable composite for direct posterior restorations(WILEY, 2016-09-01)BACKGROUND: The aim of this randomized controlled study was to evaluate the clinical performance of a highly filled flowable composite compared to a conventional paste-type composite in direct posterior restorations after 36 months. METHODS: A total of 58 mid-size to extensive posterior composite restorations were randomly placed in 32 patients, mean age of 43.9 years (range 25-76), using either a conventional composite Estelite Sigma Quick (Conventional) or a highly filled flowable composite G-aenial Universal Flo with a two-step self-etch adhesive. The restorations were evaluated after placement (baseline) and at 6, 12, 24 and 36 months according to the FDI criteria. RESULTS: At the 36-month follow-up, 42 restorations were evaluated in 21 patients. After 36 months, the difference between highly filled flowable and conventional restorations was not statistically significant with respect to all evaluation parameters (p < 0.05). No secondary caries was observed. CONCLUSIONS: The highly filled flowable composite showed a comparable clinical effectiveness as the conventional paste composite in posterior restorations over 36 months.
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ItemEffect of flavonoids on remineralization of artificial root caries(WILEY-BLACKWELL, 2016-06-01)BACKGROUND: This study compared the effects of three flavonoids, including proanthocyanidin, naringin and quercetin on remineralization of artificial root caries. METHODS: Demineralized root fragments (n = 75) were randomly divided into five groups for treatment with the remineralizing agents for 10 minutes: (1) 6.5% proanthocyanidin; (2) 6.5% naringin; (3) 6.5% quercetin; (4) 1000 ppm fluoride; and (5) deionized water (control). The demineralized samples were pH-cycled through treatment solutions, acidic buffer and neutral buffer for eight days at six cycles per day. The remineralization effects were evaluated using Knoop microhardness, transverse microradiography (lesion depth and mineral loss) and confocal laser scanning microscopy. Microhardness at different lesion depths was analysed with two-way ANOVA and Tukey's test, while lesion depths and mineral loss were analysed with one-way ANOVA and Tukey's test. RESULTS: Artificial caries lesions treated with fluoride and flavonoids showed significantly greater hardness than the control group (p < 0.05). Both lesion depths and mineral loss of the flavonoid treated groups were significantly lower than the control group (p < 0.05), but significantly higher than the fluoride treated group. No significant difference in lesion depth and mineral loss was found among the three flavonoids (p > 0.05). CONCLUSIONS: All three flavonoids showed positive effects on artificial root caries remineralization, which are significantly lower than that of 1000 ppm fluoride.
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ItemCarious lesion management in children and adolescents by Australian dentists(WILEY, 2019-08-08)BACKGROUND: The management of carious lesions in children and adolescents can have lifelong implications for the patient. The aim of this study was to assess the decision-making process of dentists when managing carious lesions in children and adolescents. METHODS: Approximately, 11 000 dentists listed as members of the Australian Dental Association Inc. (ADA) and Australian and New Zealand Society of Paediatric Dentistry (ANZSPD) were emailed a link in April 2017 to a 19-question survey delivered by SurveyMonkey™. RESULTS: In this study, 887 responses were received. In 'enamel-limited' carious lesions, dentists intervened most frequently in primary tooth approximal (365, 41.1%), followed by permanent tooth occlusal (295, 33.3%) and approximal (244, 27.5%), and primary tooth occlusal (203, 22.9%) surface carious lesions. Age, university of graduation, practicing state, decade of graduation and frequency of treatment of children between 6 and 15 years were significant demographic factors influencing the restorative threshold. CONCLUSIONS: Australian dentists reported significant variation in their management of approximal and occlusal carious lesions in both primary and permanent teeth. A substantial proportion of respondents would intervene surgically on non-cavitated enamel-limited lesions.
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ItemEffect on the mechanical properties of human and bovine dentine of intracanal medicaments and irrigants(WILEY, 2019-03-01)BACKGROUND: Evidence is lacking concerning the suitability of using bovine dentine in endodontic research. This study compared the mechanical properties of human and bovine root dentine using endodontic medicaments and irrigants. METHODS: Standardized human and bovine dentine bars were allocated to six experimental groups (n = 15): calcium hydroxide paste (Calasept® Plus); Odontopaste® ; 0.5% and 1% NaOCl gels; 1% and 4% NaOCl solutions. The bars were exposed to the materials for 7 days and then immediately subjected to a three-point bend test and Vickers microhardness test. Data were analysed using analysis of variance with Fisher's pairwise comparisons, with P < 0.05. RESULTS: Human dentine displayed a significantly higher modulus of elasticity (P = 0.001), higher microhardness (P < 0.001), and lower flexural strength (P = 0.004) compared with bovine dentine. Calcium hydroxide and Odontopaste® did not result in a significant change to the mechanical properties of human dentine. In human dentine, 0.5% NaOCl gel caused a significant decrease in flexural strength (P < 0.001) and microhardness (P = 0.02). CONCLUSIONS: Bovine dentine was a suitable substrate relative to human dentine. The use of a 0.5% or 1% NaOCl gel as an intracanal medicament is not supported by this study.
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ItemA survey of Australian prosthodontists: the use of posts in endodontically treated teeth(WILEY, 2018-09-01)BACKGROUND: This study aimed to gain insight into common practises of Australian prosthodontists when placing a post in an endodontically treated tooth (ETT). METHODS: A 17-question open- and closed-format questionnaire was sent to registered Australian prosthodontists. The response rate was 55% (N = 95). RESULTS: The majority of respondents indicated the purpose of a post was to retain a core (N = 94, 99%). The decision to place a post is affected by the quantity of remaining tooth structure (N = 91, 96%) and the definitive restoration (N = 68, 72%). The ideal post length is neither a short nor long post with the most frequent response (N = 52, 34%) being 'as long as possible without disturbing the apical seal'. The apical seal requirements were defined as 4-5 mm of gutta-percha for 77% of respondents. The most preferred post type was a custom cast metal post (N = 85, 49%). The most popular luting cement was resin composite (N = 84, 39%). CONCLUSIONS: The results from this survey do not provide a definitive guide for restoring an ETT. However, it illustrates how Australian prosthodontists address this clinical challenge. The multiple responses received for a number of questions suggest that the material and technique employed in the Australian context is influenced by the individual clinical case.
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ItemEffect of Silver Diamine Fluoride and Potassium Iodide Treatment on Secondary Caries Prevention and Tooth Discolouration in Cervical Glass Ionomer Cement Restoration(MDPI, 2017-02-01)This study investigated the effect of silver diamine fluoride (SDF) and potassium iodide (KI) treatment on secondary caries prevention and tooth discolouration in glass ionomer cement (GIC) restoration. Cervical GIC restorations were done on 30 premolars with: Group 1, SDF + KI; Group 2, SDF (positive control); Group 3, no treatment (negative control). After cariogenic biofilm challenge, the demineralisation of dentine adjacent to the restoration was evaluated using micro-computed tomography (micro-CT) and Fourier transform infrared (FTIR) spectroscopy. The colour of dentine adjacent to the restoration was assessed using CIELAB system at different time points. Total colour change (∆E) was calculated and was visible if ∆E > 3.7. Micro-CT showed the outer lesion depths for Groups 1, 2 and 3 were 91 ± 7 µm, 80 ± 7 µm and 119 ± 8 µm, respectively (p < 0.001; Group 2 < Group 1 < Group 3). FTIR found that there was a significant difference in amide I-to-hydrogen phosphate ratio among the three groups (p < 0.001; Group 2 < Group 1 < Group 3). ∆E of Groups 1, 2 and 3 after biofilm challenge were 22.5 ± 4.9, 70.2 ± 8.3 and 2.9 ± 0.9, respectively (p < 0.001; Group 3 < Group 1 < Group 2). SDF + KI treatment reduced secondary caries formation on GIC restoration, but it was not as effective as SDF treatment alone. Moreover, a perceptible staining on the restoration margin was observed, but the intensity of discolouration was less than that with solely SDF treatment.