Dental Hypotheses
Volume:3 Issue: 4, Oct-Dec 2012

Dental caries still remains one of the most prevalent diseases worldwide.Unlike enamel caries which can be restored mainly by modulating mineral balance, the dentine caries are characterized with irreversible proteolytic disintegration of organic matrices, highlighting an urgent need to seek novel management strategies. Bio modification of dentine matrix has been proposed as a novel and alternative approach to enhancing its biochemical and biomechanical properties. The resultant chemical stability and mechanic durability are specifically desirable for prevention and restoration of dentine caries. However, conventional cross linking agents, e.g. glutaraldehyde, formaldehyde,are unsuitable for clinical use due to marked cytotoxicity or instability over time. The Hypothesis: Previous studies revealed that Galla chinesis extract (GCE) could inhibit cariogenic microbes and positively modulate enamel de/remineralization balance, and the mechanism was directed to the polyphenols-organic matrix interaction involving hydrogen, covalent, ionic bonding and hydrophobic processes. Microbial transglutaminase (mTGase) could inducecrosslinks between peptide chains and improve functional properties of food proteins by catalyzing an acyl transfer reaction through ε - (γ-glutamyl) lysine (GL bonds). Given the high organic content in dentine and universal reaction nature of GCE and mTGase, we put forward a hypothesis that these two natural products may serve as novel biocompatible bio-modifiers to improve biochemical and biomechanical properties of dentine matrices. Evaluation of the Hypothesis: The validation of our hypothesis will provide profound insights updating current therapeutic strategies against dentine caries, and pioneer novel approaches for biocompatible bio-modification of dentine matrices. Specifically, GCE and mTGase can be integrated into the root canal irrigating and dentine boding procedures, where they may generate beneficial effects on preservation of integrity of dentine as well as dentine-sealer interface.

The success rate of dental implant is closely related to three aspects including supporting bone before implantation, osseointegration process, and prevention of peri-implantitis after implantation. Icariin isone of the traditional Chinese herbal medicines to treat impotence, improve sexual function, and enhance immune function. Recently,there are abundant evidences showing that icariin can strengthen bones, enhance bone healing, inhibit osteopenia, and inhibit inflammation. The Hypothesis: We hypothesize that Icariin may be applied clinically to strengthen and accelerate osseointegration of dental implants, inhibit the peri-implantitis, and shorten the rehabilitation time. Evaluation of the Hypothesis: Limited success has been achieved to help implant surgery in spite of much effort. The application of icariin might be a potential method to improve the success rate of dental implant, contributing greatly to implant dentistry.

Nanobacteria (calcifying nanoparticles, nanobes) are one of the most controversial issues in contemporary biology.Studies show accumulating evidence on association of nanobacteria with oral pathologic calcifications such as calculus, pulp stone, and salivary gland stones. The Hypothesis: Experiments have shown that nanobacteria are excreted from the body in urine and saliva, lifted from the ground by winds into the cloud, and transit between the high humidity region of the clouds and the relatively dry intercloud regions. Remnants of a sticky protein coating that nanobacteria make it act as an extremely efficient cloud condensation nuclei. Following condensation of cloud, nanobacteria return to the earth via rain and snow. Evaluation of the Hypothesis: Transmission of nanobacteria via clouds is not surprising when compared with cosmic transmission of nanobacteria. The apatite mineral layer around the organism serves as a primary defence shield against various seriously life threatening conditions. A double defence with the apatite layer and an impermeable membrane combined with a very slow metabolism is a likely explanation for the resistance of nanobacteria.

The purpose of this study was to introduce a nanosilver particle based endodontic irrigation solution and to evaluate its antimicrobial efficacy in comparison to 5.25% NaOCl. In an in vitro experiment the effect of the new irrigant against Enterococcus faecalis (ATCC: 29212) and Staphylococcus aureus (ATCC 25923), two most commonly isolated species of root canal space, was studied in different time intervals of 3, 5 and 15 minutes. No growth of E. faecalis and S. aureus was observed in any of irrigant groups and any of different time intervals. These results indicate that the new irrigant is as effective as NaOCl in preventing the bacterial growth of common root canal bacteria.

Radiographic examination forms an integral part of clinical dentistry, with some form of radiographs necessary on the majority of patients. Intra-oral periapical (IOPA) radiographs form the backbone of imaging for diagnosis and follow-up of various dento-facial pathologies. However, certain patient populations are unable to tolerate intra-oral films/sensors due to various reasons. A not-so recent development called extra-oral periapical (EOPA) radiography may be a useful adjuvant to such a situation, at least in the near future. It is essentially a technique where the film is placed extra-orally overlying the tooth of interest. The following manuscript is an attempt to throw light on this technique and the impact it may have on various disciplines of dental practices. The advantages and disadvantages of EOPA radiography and it’s comparison to IOPA radiography has been discussed.

Reduction of the visits for fabricating complete dentures are welcomed by both dentists and patients and this might be an aspect of the new changes in prosthodontic treatment according to the suggested new methods. Clinical Innovation: Complete dentures fabricated by the technique described in this report reduce processing time, cost and efforts since the technique does not require the use of gypsum materials, metal flasks or other related materials to obtain a mold for packing the heat cured acrylic resin as might be needed with the conventional method. This method requires only an appropriate volume of silicone impression material to provide the required mold and a heat pressure machine for processing and polymerization of the heat-cured acrylic resin. Although this technique might be difficult to be applicable by all dentist but it could be consider an advisable method. Becausethe record base in this technique is made of heat cured resin, it provides a reliable denture base with better retention and stability and it overcomes the shortcomings that may be faced during registration of vertical dimension. This technique meets the basic requirements for a successful complete denture which is well tolerated by the patient’s mouth.

There are many luting cements coming to market which claim to be adhesive, but there is no clinical protocol currently for testing these claims. There is a standardized protocol for testing direct restorations bonded to dentin and it is used extensively. Case Report: We describe a clinical procedure for restoring a non-carious cervical lesion (NCCL) with a ceramic inlay using Computer-Aided Design and Computer-Aided Manufacturing (CAD-CAM) technology and an adhesive resin cement. The procedure was straightforward and the result was good at one month. NCCL’s can be restored with CAD-CAM technology in one appointment. This technique can be used to clinically test adhesion of luting cements to dentin, similarly to the current standard for direct restorations.

The management، treatment and long-term retention of mandibular molar teeth with furcation involvement havealways been a challenge in periodontal therapy. Hemisection has been used successfully to retain teeth with furcation involvement. The term hemisection refers to the sectioning of a molar tooth، with the removal of an unrestorable root which may be affected by periodontal، endodontic، structural (cracked roots)، or caries. Case Report: This case report describes a simple procedure of hemisection in a mandibular molar with socket preservation with help of an alloplastic bone graft and subsequent restoration of the tooth with fixed prothesis. Hemisection represents a form of conservative procedure، which aims at retaining as much of the original tooth structure as possible. It may be a suitable alternative to extraction. Hemisection of the affected tooth allows the preservation of tooth structure، alveolar bone and cost savings (time and money) over other treatment options. The preservation of posterior abutment teeth permits oral rehabilitation with fixed bridges instead of removable prosthesis. The keys to long term success appear to be thorough diagnosis followed by interdisciplinary approach with endodontic، surgical and prosthetic procedures. Preservation of a hopeless tooth is possible by selecting patients with good oral hygiene، and careful surgical and restorative management.

This article summarizes relevant scientific data on the alleged high suicide rate among dentists as compared to other health care professions. Potential contributing risk factors for the dental profession are identified. In addition, a brief review is provided for major depressive disorder, a contributor to increased suicide, along with its symptoms, underlying theory, drug treatment and coping skills to combat this disorder.