The early erosive lesion in polished enamel could be characterised quantitatively surface roughness and microhardness and qualitatively using OCT and TSM; whilst in natural enamel only surface roughness could be utilised. Further investigation of early erosion in natural enamel is required to develop new more clinically relevant models.
Dentures are an excellent treatment modality for partial and edentate patients; however, improper denture care and hygiene can result in both decreased longevity of the prosthesis and increased risk of developing dental caries, periodontal disease and oral candidosis. Previously, it has been shown that patients and dental professionals are unaware of the different materials and methods available for optimum denture care and hygiene. This article provides an overview of the key legislation and main commercially available methods for denture cleanliness and hygiene, and serves as a basis for providing tailored denture hygiene for denture wearers.
The aims of the study were to develop a method of quantifying denture cleanliness and evaluate the quality of clinical record keeping; record baseline denture cleanliness for 30 patients; introduce denture hygiene instruction (DHI); and then re-assess the patients for improvement and enhanced record keeping. A retrospective analysis of denture hygiene instruction record keeping was undertaken (n = 30). A bespoke denture cleanliness index (DCI) was developed for assessing denture cleanliness (best score 0, worst score 4). Baseline DCI scores were taken and individual DHI was delivered. Patients were reviewed and scored after 1 month, together with a further analysis of record keeping. At baseline, 16% (n = 5) of patients had DCI scores of ≤2, improving to 90% (n = 27) after 1 month, demonstrating short term improvement in denture cleanliness. Only 20% (n = 6) of patients had evidence of a record of DHI within their notes at baseline, improving to 100% at recall. The bespoke denture cleanliness index (DCI) worked well as a simple objective clinical measurement and patient education tool. Provision of tailored DHI resulted in the general improvement of denture cleanliness after 1 month. The authors recommend that where denture hygiene has been issued, this should be recorded in the records as 'DHI' within the clinical notes, in a manner analogous to the recording of oral hygiene.
Oral submucous fibrosis (OSF) is a chronic progressive condition affecting the oral cavity, oropharynx and upper third of the oesophagus. It is a potentially malignant disorder. The authors collated and analysed the existing literature to establish the overall malignant transformation rate (MTR). A retrospective analysis of medical and dental scientific literature using online indexed databases was conducted for the period 1956 to 2021. The quality of the enrolled studies was assessed by the Newcastle-Ottawa Scale (NOS). A meta-analysis using a random effects model of a single proportion was performed along with statistical tests for heterogeneity. The overall proportion of malignancy across all studies was 0.06 (95% CI, 0.02–0.10), indicating an overall 6% risk of malignant transformation across all studies and cohorts. Sub-group analyses revealed strong differences in proportion of malignancy according to ethnicity/cohort; Chinese = 0.02 (95% CI 0.01–0.02), Taiwanese = 0.06 (95% CI, 0.03–0.10), Indian = 0.08 (95% CI, 0.03–0.14) and Pakistani = 0.27 (95% CI 0.25–0.29). Overall, the MTR was 6%; however, wide heterogeneity of the included studies was noted. Geographic variations in MTR were noted but were not statistically significant. Further studies are required to analyse the difference between cohort groups.
This study demonstrates a method for precise surface texture measurement of natural human enamel. Measurement precision was superior for polished flat enamel in contrast to natural enamel however, natural enamel responds very differently to polished enamel when exposed to erosion challenges. Therefore, thus future studies characterising enamel surface changes following erosion on natural enamel may provide more clinically relevant responses in comparison to polished enamel.
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