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. A randomised clinical trial to determine the abrasive effect of the tongue on human enamel loss with and without a prior erosive challenge. Journal of Dentistry, 58, 48-53. DOI: 10.1016/j.jdent.2017 University of Bristol -Explore Bristol Research General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms 1 A Randomised clinical trial to determine the abrasive effect of the tongue on human enamel loss with and without a prior erosive challenge ABSTRACT Objectives: To investigate the abrasive effect of the tongue on human enamel loss with and without a prior dietary acid challenge in an in situ model. Methods:A single centre, single blind, randomly allocated, split mouth, four treatment regimen, in situ study in healthy adult volunteers was undertaken. Twenty four subjects wore two lower intra-oral appliances each fitted with 4 human enamel samples 6 hours/day for 15 days. The samples were treated with either 50ml orange juice or water for 5 minutes ex vivo 4x /day; prior to being licked or not licked with the subject's tongue for 60 seconds. There were 2 samples per group per subject. Surface loss was measured by contact profilometry. Results:23 subjects completed the study with no adverse events. The mean loss of enamel at 15 days was: 0.08 μm for water without licking, 0.10 μm with water and licking; 1.55 μm with orange juice alone, 3.65 μm with orange juice and licking. In the absence of erosive challenge, licking had no detectable effect on enamel loss p=0.28. Without licking, orange juice had a highly significant effect on loss compared to water, p<0.001. Erosive challenge followed by licking more than doubled the loss of enamel p<0.001. Conclusions:When enamel was exposed to orange juice prior to licking, tissue loss as a result of tongue abrasion of the eroded surface was increased, and double that of the erosive challenge alone. Licking enamel with the tongue had no perceptible effect on enamel loss in the absence of the erosive challenge. Clinical Significance:Enamel wear resulting from tongue abrasion on tooth surfaces softened by acid challenge, can be an unavoidable consequence of oral function. This may account for the pattern of erosive toothwear on palatal and occlusal tooth surfaces, reinforcing the importance of restricting the frequency of dietary acid challenge in susceptible individuals.

Chlorhexidine hexametaphosphate nanoparticles increased both the local dose and duration of soluble CHX delivery when applied to hydroxyapatite surfaces. This may provide a means to deliver a sustained dose of CHX with less frequent interventions.

Radiotherapy to the head and neck region has oral side effects and can lead to catastrophic dental deterioration, but this is largely preventable. This article describes the case of a patient whose dentition was irreparably compromised after radical radiotherapy for a soft palate cancer. The patient had a fairly well maintained dentition at the pre-radiotherapy dental screen, but the side effects of radiotherapy -notably dry mouth and reduced access to the mouth for cleaning -coupled with a highsugar diet intended to aid recovery, led to the rapid progression of dental caries and tooth wear. Additionally, service restrictions due to the coronavirus disease 2019 pandemic meant that his dental care was delayed. Eight months after completion of radiotherapy, all his teeth were deemed unrestorable. The authors discuss the importance of frequent and regular dental reviews to prevent rapid dental deterioration in patients undergoing radiotherapy for head and neck cancer.

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Background : Oral cancer has the highest incidence of head and neck cancer and it is reported that the number of cases are rising every year. Many patients face the struggle with speech, chewing, swallowing which can largely affect their nutrition as well psychosocial health, possibly due to the altered anatomy of their oral cavity as well as facial disfigurement. Patient expectations and outcomes following their cancer treatment and dental rehabilitation is under reported in the UK. Aim/Hypothesis : The aim of this study was to report on the patient reported outcomes measures (PROMS) on their oral rehabilitation with dental implants following their oral cancer treatment.

Dental implants are an increasingly popular way to replace missing teeth. Whilst implant survival rates are high, a small number fail soon after placement, with various factors, including bacterial contamination, capable of disrupting osseointegration. This work describes the development of chlorhexidine-hexametaphosphate coatings for titanium that hydrolyse to release the antiseptic agent chlorhexidine. The aim was to develop a coating for titanium that released sufficient chlorhexidine to prevent biofilm formation, whilst simultaneously maintaining cytocompatibility with cells involved in osseointegration. The coatings were characterised with respect to physical properties, after which antibiofilm efficacy was investigated using a multispecies biofilm model, and cytocompatibility determined using human mesenchymal stem cells. The coatings exhibited similar physicochemical properties to some implant surfaces in clinical use, and significantly reduced formation of multispecies biofilm biomass up to 72 h. One coating had superior cytocompatibility, with mesenchymal stem cells able to perform normal functions and commence osteoblastic differentiation, although at a slower rate than those grown on uncoated titanium. With further refinement, these coatings may have application in the prevention of bacterial contamination of dental implants at the time of surgery. This could aid a reduction in rates of early implant failure.