Though dentin hypersensitivity (DHS) is one of the most common complaints from patients in dental clinics, there are no universally accepted guidelines for differential diagnosis as well as selection of reliable treatment modalities for this condition. The neurosensory mechanisms underlying DHS remain unclear, but fluid movements within exposed dentinal tubules, i.e., the hydrodynamic theory, has been a widely accepted explanation for DHS pain. As several dental conditions have symptoms that mimic DHS at different stages of their progression, diagnosis and treatment of DHS are often confusing, especially for inexperienced dental practitioners. In this paper we provide an up-to-date review on risk factors that play a role in the development and chronicity of DHS and summarize the current principles and strategies for differential diagnosis and management of DHS in dental practices. We will outline the etiology, predisposing factors and the underlying putative mechanisms of DHS, and provide principles and indications for its diagnosis and management. Though desensitization remains to be the first choice for DHS for many dental practitioners and most of desensitizing agents reduce the symptoms of DHS by occluding patent dentinal tubules, the long-term outcome of such treatment is uncertain. With improved understanding of the underlying nociceptive mechanisms of DHS, it is expected that promising novel therapies will emerge and provide more effective relief for patients with DHS.
The aim of this in vitro study was to investigate the effect of the cariostatic and preventive agent silver diamine fluoride (SDF) on the microtensile bond strength of resin composite to dentin. Forty-two caries-free, extracted molars were flattened occlusally and apically using a diamond saw, and the exposed occlusal dentin was polished with a series of silicon carbide papers, all under water irrigation. The teeth were then randomly divided into six groups of seven teeth each that were treated as follows: 1) Peak SE self-etch bonding agent; 2) 12% SDF + Peak SE; 3) 38% SDF + Peak SE; 4) Peak LC etch-and-rinse bonding agent; 5) 12% SDF + Peak LC; and 6) 38% SDF + Peak LC. Four-millimeter buildups of Amelogen Plus were incrementally placed on all teeth; after a 24-hour storage period in distilled water, the specimens were sectioned perpendicular to the adhesive interface to produce beams of cross-sectional surface area measuring approximately 1 mm(2). The beams were placed on a microtensile testing machine, which utilized a single-speed pump motor and force gauge at 20 kgf × 0.01 second to record maximum tensile force before failure occurred. Two-way analysis of variance and post hoc Tukey tests were performed to compare the effects of the SDF on microtensile bond strength, with statistical significance set at α = 0.05. None of the experimental groups treated with different concentrations of SDF showed a significant difference in bond strength compared to the control groups, and there was no significant difference in bond strength between self-etch and etch-and-rinse groups. However, the effect of SDF on self-etch bonded teeth compared to etch-and-rinse bonded teeth was statistically significant (p=0.0363), specifically at the 12% concentration. SDF does not adversely affect the bond strength of resin composite to noncarious dentin.
Objectives: The goal of endodontic therapy is to prevent apical periodontitis. This is achieved by biomechanical preparation, microbial control using endodontic irrigants, and complete obturation of the canal space. In order to prevent possible postobturation complications and for an added antimicrobial effect, substantivity is a desired characteristic of endodontic irrigants. Currently the most commonly used endodontic irrigant that produces an antibacterial substantivity effect is chlorohexidine (CHX). Silver diamine fluoride (SDF) is a topically applied agent for managing dental caries and has shown to stop caries lesion progression. The objective of this study was to compare the antimicrobial substantivity effect of 3.8% SDF against other commonly used endodontic irrigants such as 2% CHX and 6.25% Sodium hypochlorite (NaOCl).Material and methods: Using a diffusion disc assay we determined the antimicrobial activities of 38%, 3.8%, 0.38%, and 0.038% of SDF against the bacterium Enterococcus faecalis OG1RF. Subsequently, we compared the levels of colonization of E. faecalis by scanning electron microscopy (SEM) at 1.5-and 3-week time intervals on dentin pretreated with 3.8% SDF, 6.25% NaOCl, 2% CHX or sterile phosphate buffered saline (PBS). Results:The diffusion disc assay demonstrated that 38% and 3.8% of SDF inhibited the growth of E. faecalis. Moreover, the substantivity of 3.8% SDF (p < 0.01) was comparable to 2% CHX (p < 0.01) and it is significantly greater than 6.25% of NaOCl compared to the PBS treated samples after 1.5 and 3 weeks of incubation.Conclusions: In this study, we demonstrate that SDF possesses antimicrobial properties against the opportunistic pathogen E. faecalis. Moreover, using a dentin model we show the substantivity of 3.8% SDF is significantly greater than 6.25% NaOCl, but is comparable to 2% CHX.
Background: One challenge in dental education is new faculty members can be hired with limited teaching experience or understanding of pedagogy. Recent publications document increasing initiatives of faculty development in US and Canadian dental schools. This study evaluates full-time faculty perspectives of their develop and academic environment.Methods: A 33-item questionnaire distributed to senior administrators and forwarded to faculty, collected data on demographics and satisfaction, utilizing a 5-item Likert scale, multiple choice, and binary yes/no questions. Responses were descriptively and statistically analyzed utilizing an analysis of variance, chisquare, and two-sample t-test. Results: There were 183 faculty respondents (37.7% male/62.3% female), age ranges were 20-29 (2.2%), 30-39 (53.5%), and 41-49(44.3). Respondents reported race/ethnicity: Caucasian (60.7%), Asian (19.1%), Hispanic (12.6%), Black/African American (5.5%), two or more races (2.2%), and Native American 0%. Length of employment was significantly associated with primary responsibility (p = 0.0023), recent publications (p < 0.0011), and short-term intent to remain in academia (p = 0.046). There was a statistically significant difference between age and satisfaction with professional development (p = 0.0411),career objectives (p = 0.0151), well-being (p = 0.0492), access to resources for scholarly interests (p = 0.0114), communication (p = 0.0058), and assessment training (p = 0.0249). Non-Caucasian faculty reported greater dissatisfaction with being treated respectfully (p = 0.0302), departmental commitment to diversity and inclusion (p = 0.0075), and departmental cooperation/teamwork (p = 0.0323). Conclusions: A significant number of junior faculty have interest in academic dental careers. Institutions should invest in improving onboarding and professional development. Improve the early experiences of faculty, and foster diversity and inclusion and faculty well-being.
Although dental education has traditionally been organized into basic sciences education (first and second years) and clinical education (third and fourth years), there has been growing interest in ways to better integrate the two to more effectively educate students and prepare them for practice. Since 2012, The University of Texas School of Dentistry at Houston (UTSD) has made it a priority to improve integration of basic and clinical sciences, with a focus to this point on integrating the basic sciences. The aim of this study was to determine the perspectives of basic and clinical science faculty members regarding basic and clinical sciences integration and the degree of integration currently occurring. In October 2016, all 227 faculty members (15 basic scientists and 212 clinicians) were invited to participate in an online survey. Of the 212 clinicians, 84 completed the clinician educator survey (response rate 40%). All 15 basic scientists completed the basic science educator survey (response rate 100%). The majority of basic and clinical respondents affirmed the value of integration (93.3%, 97.6%, respectively) and reported regular integration in their teaching (80%, 86.9%). There were no significant differences between basic scientists and clinicians on perceived importance (p=0.457) and comfort with integration (p=0.240), but the basic scientists were more likely to integrate (p=0.039) and collaborate (p=0.021) than the clinicians. There were no significant differences between generalist and specialist clinicians on importance (p=0.474) and degree (p=0.972) of integration in teaching and intent to collaborate (p=0.864), but the specialists reported feeling more comfortable presenting basic science information (p=0.033). Protected faculty time for collaborative efforts and a repository of integrated basic science and clinical examples for use in teaching and faculty development were recommended to improve integration. Although questions might be raised about the respondents' definition of "integration," this study provides a baseline assessment of perceptions at a dental school that is placing a priority on integration.
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