Orthodontic patients have an increased risk of white-spot lesion formation. A clinical trial was conducted to test whether, in a post-orthodontic population using fluoride toothpastes and receiving supervised fluoride mouthrinses, more lesions would regress in participants using a remineralizing cream containing casein phosphopeptide- amorphous calcium phosphate compared with a placebo. Forty-five participants (aged 12-18 yrs) with 408 white-spot lesions were recruited, with 23 participants randomized to the remineralizing cream and 22 to the placebo. Product was applied twice daily after fluoride toothpaste use for 12 weeks. Clinical assessments were performed according to ICDAS II criteria. Transitions between examinations were coded as progressing, regressing, or stable. Ninety-two percent of lesions were assessed as code 2 or 3. For these lesions, 31% more had regressed with the remineralizing cream than with the placebo (OR = 2.3, P = 0.04) at 12 weeks. Significantly more post-orthodontic white-spot lesions regressed with the remineralizing cream compared with a placebo over 12 weeks.
Monitoring the proportions of P. gingivalis and T. denticola in subgingival plaque has the potential to help identify sites at significant risk for progression of periodontitis, which would assist in the targeted treatment of disease.
We found an excess risk of leukemia associated with cumulative benzene exposures and benzene exposure intensities that were considerably lower than reported in previous studies. No evidence was found of a threshold cumulative exposure below which there was no risk.
The efficacy of combinations of membranes and autogenous bone grafts at immediate implants were compared in a prospective study. Sixty-two consecutively treated patients each received an immediate implant for a single tooth replacement at a maxillary anterior or premolar site. Dimensions of the peri-implant defect at the implant collar were measured as follows: vertical defect height (VDH), horizontal defect depth (HDD) and horizontal defect width (HDW). Each implant randomly received one of five augmentation treatments and were submerged with connective tissue grafts: Group 1 (n=12)--expanded polytetrafluoroethylene membrane only, Group 2 (n=11)--resorbable polylactide/polyglycolide copolymer membrane only, Group 3 (n=13)--resorbable membrane and autogenous bone graft; Group 4 (n=14)--autogenous bone graft only, and Group 5 (n=12)--no membrane and no bone graft control. At re-entry, all groups showed significant reduction in VDH, HDD and HDW. Comparisons between groups showed no significant differences for VDH (mean 75.4%) and HDD (mean 77%) reduction. Significant differences were observed between groups for HDW reduction (range, 34.1-67.3%), with membrane-treated Groups 1, 2 and 3 showing the greatest reduction. In the presence of dehiscence defects of the labial plate, HDW reduction of 66.6% was achieved with membrane use compared with 37.7% without membranes. Over 50% more labial plate resorption occurred in the presence of a dehiscence defect irrespective of the augmentation treatment used. The results indicate that VDH and HDD reduction at defects adjacent to immediate implants may be achieved without the use of membranes and/or bone grafts.
This study investigated, using digital bitewing radiography, the progression and regression of approximal caries in adolescent subjects chewing a sugar-free gum containing 54 mg CPP-ACP relative to the identical gum without CPP-ACP. 2,720 subjects from 29 schools were randomly assigned to one of the two gums and were instructed to chew their assigned gum for 3 × 10 min/day, with one session supervised on school days, over the 24-month study period. Standardized digital bitewing radiographs were taken at the baseline and 24-month clinical examinations for each subject. The radiographs, scored by a single examiner, were assessed for approximal surface dental caries at both the enamel and dentine level. Surface level transitions were scored using a transition matrix. Caries progression or regression was analysed using proportional-odds ordered logistic regression modelling of the transition scores at the tooth surface level. There was a statistically significant difference in the frequency distributions of the transition scores between the two gum groups (OR = 0.82, p = 0.03). For subjects chewing the CPP-ACP gum the odds of a surface experiencing caries progression were 18% less than those of a surface experiencing caries progression for subjects chewing the control gum. In conclusion, the 54 mg CPP-ACP sugar-free gum significantly slowed progression and enhanced regression of approximal caries relative to a control sugar-free gum in a 24-month clinical trial.
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