Anesthesia is vital when treating patients with significant dental anxiety. The challenge often lies in deciding which anesthesia to use. Researchers at the Tokyo Dental College compared the use of propofol and sevoflurane in 20 patients who had severe anxiety about their dental surgery, as well as their recovery and satisfaction, to find which is better. All of the patients were healthy, and none had been given general anesthesia for prior dental treatment.
At 2 different appointments, each patient was anesthetized with either propofol or sevoflurane alone. Patients were given the same drug to eliminate any movement, and a breathing tube was used. The single-drug anesthetic had never been studied. Patients were always given opioids or nitrous oxide to keep them anesthetized throughout the procedure, making it difficult to pinpoint the effects of the primary painkilling drugs themselves.
The researchers found no differences between the drugs in terms of recovery. Although patients came out of anesthesia more quickly with sevoflurane than with propofol, all patients were discharged at a similar time. A few had nausea while recovering from sevoflurane, but none reported complications 24 hours later. All patients were able to eat their first meal and drink fluids at a similar time, and none experienced nausea or vomiting once leaving the dentist’s office.
However, patients revealed a clear preference for propofol after being anesthetized with each drug. They said they had more discomfort and fatigue after taking sevoflurane. Some also said they disliked the smell of sevoflurane. Even though some patients reported more pain during the injection of the propofol, 80% of the patients in the study said they would choose propofol for future surgeries.
The researchers concluded that propofol is the anesthetic of choice for dental patients with severe anxiety about surgery, but these patients may continue to need general anesthesia in future surgeries. When patient satisfaction is the highest priority, the researchers suggest that dentists may want to give propofol during in-office surgery.
It’s almost time to pack your bags if you’re heading to the Yankee Dental Congress, scheduled for January 25 through January 29 at the Boston Convention and Exhibition Center. Nearly 28,000 dental professionals are expected to take part in more than 300 continuing education courses and interact with the more than 450 exhibitors that will be on hand. And since all work and no play makes for a dull show, the Massachusetts Dental Society has entertainment lined up too.
Across the nation, dentists are struggling with the tragic consequences of the opioid epidemic. Fortunately, the Yankee Dental Congress is offering guidance via the “Interprofessional Symposium: CLT-ALT-DELETE: Rebooting the Approach to Pain Management.” Plus, the show’s Fast Track program will include a series of 6 hour-long lectures covering pain management and prescription monitoring, according to current best practices and regulations.
Clinicians also are growing more aware of the dangers of sleep apnea and the role they can play in treating it. Professionals who want to learn more can visit the Sleep Apnea Pavilion, which will showcase the latest technologies that can help patients regain peaceful and restful nights. For example, attendees can learn about oral appliance therapy and laser procedures, as well as pediatric dental sleep medicine, all for complementary continuing education credits.
The focus on technology will continue with 3-D Printing in Dentistry: The Present and the (Very Near) Future. Sponsored by Formlabs, the exhibit will showcase 3-D printers and biocompatible materials, which combine for streamlined workflows, improved outcomes, and lower costs. Meanwhile, Pete Gardell, DDS, and Rich Rosenblatt, DDS, will bring tech to the floor with “CAD/CAM for All,” which will include both lectures and hands-on programs.
Other coursework will cover a range of clinical topics, including aesthetics, anesthesia, composites, endodontics, implants, infection control, restorations, and more. Speakers also will discuss practice management issues, such as coding and reimbursement, the front desk, social media, and the work/life balance. Plus, Dentistry Today’s editor in chief Damon Adams will have a pair of lectures on innovations, controversies, and clinical tips on Thursday, January 26.
On Thursday, January 26, the show will host “A Conversation with Dr. Lisa Genova.” Genova is a neuroscientist and the author of the bestseller Still Alice, a novel about a woman struggling with Alzheimer’s disease that also was turned into a movie, featuring Julianne Moore in an Oscar-winning performance. And on Friday, January 27, Nancy Frates of the ALS Ice Bucket Challenge will speak. Her son Peter was diagnosed with ALS in 2012 and inspired the viral sensation that raised $115 million for research into the disease and other support.
The Yankee Dental Congress also is an opportunity to recognize leading clinicians for their service to the profession and to the community. Among the accolades that will be bestowed on Wednesday, January 25, Steven J. Tonelli, DMD, will receive the 2017 Etherington Award for his extensive work on behalf of organized dentistry. James Cinamon, DMD, will be named the 2017 Clinician of the Year. And, Jacklyn Ventura will be named the 2017 Hygienist of the Year.
Finally, attendees get head to the Wild West with the Yankee Roundup on Thursday, January 26 from 5:30 to 7:30 pm. Cowboys and cowgirls alike can enjoy grub, music, and prizes, along with a best costume contest. And for a few chuckles, attendees can head to Laugh Boston for premier standup comedy on Friday, January 27. Doors will open at 7:00 pm.
With all that and more to navigate, attendees will have their hands full. That’s why the show’s organizers are offering the Yankee 2017 Mobile App. Compatible with iPhones, Androids, and even Blackberries, the free software maps out courses and exhibitors, manages continuing education credits, provides real-time updates and show specials, and offers access to all information about the show via a single icon.
Numerous studies have shown that problems with oral health are strong co-indicators of other serious diseases such as diabetes, cancer, and cardiovascular disease. Now, a research team will explore innovative treatment options for periodontal diseases, specifically exploring ways to use combinatory antimicrobial approaches to disrupt biofilm such as plaque to increase the effectiveness of treating harmful oral bacteria.
Titled “Novel Strategies for Treatment of Periodontal Disease and Remediation of Oral Dysbosis,” the project comprises researchers from Wilfrid Laurier University, McMaster University, and the University of Toronto, as well as Mirexus Biotechnologies, funded by a GlycoNet Collaborative Team Grant. Also known as the Canadian Glycomics Network, GlycoNet is a pan-Canadian, multidisciplinary research network funded by the Canadian government aimed at delivering solutions to important health issues via the study of glycomes.
Mirexus Biotechnologies produces PhytoSpherix, an edible, water soluble, and biodegradable nanomaterial that’s chemically identical to glycogen and extracted from non-genetically modified corn. The human body stores glycogen, which is a natural polysaccharide, as a source of energy. Mirexus is currently investigating how PhytoSpherix can be leveraged across a variety of personal care applications.
The researchers aim to characterize biofilms formed during the establishment of a normal microflora compared to co-cultures of periodontal pathogenic organisms. Also, they will evaluate the changes to perio-pathogenic biofilms versus normal oral biofilms when challenged with combinations of various therapeutic and biofilm-disruptive additives to suggest novel treatment options that can be evaluated.
According to GlycoNet, Canadians spent approximately $12.8 billion on dental care and treatment costs in 2009, which was second in the nation only to cardiovascular disorders. Considering this financial burden as well as the increased risk of mortality associated with periodontal diseases and their connection with other systemic illnesses, the researchers believe that identifying innovative periodontal treatment options is a major health priority.
“GlycoNet’s support has brought together a unique team to tackle an important problem, and we will be excited to focus on this new opportunity in the commercialization of our unique, natural nanomaterial,” said Phil Whiting, president and CEO of Mirexus.
The 2017 KOL Access Webinar Series from OraVital Inc. will kick off with a pair of free sessions from pioneers in the oral-systemic health movement, Bradley Bale, MD, and Amy Doneen, DNP, ARNP, who are the authors of the bestselling book Beat the Heart Attack Gene. They also are coauthors of “High-Risk Periodontal Pathogens Contribute to the Pathogenesis of Atherosclerosis,” published by the British Medical Journal (BMJ) and the Postgraduate Medical Journal (PGMJ).
“This is a groundbreaking report that further validates the oral-systemic health link in general and, more specifically, the perio-cardio link,” said Dr. Jim Hyland, CEO of OraVital. “The PGMJ/BMJ manuscript clearly states, ‘periodontal disease due to high-risk pathogens is a cause of arterial disease.’ Now more than ever, dental clinicians can and should strengthen their commitment identifying and managing this form of periodontal disease.”
Bale will present the first webinar, “High-Risk Periodontal Pathogens Contribute to the Pathogenesis of Atherosclerosis,” on Thursday, February 9, at 8:30 pm est. He will discuss why periodontal disease due to high-risk pathogens must be considered a contributory cause of arterial disease and how the dental community has a significant opportunity to favorably impact the nation’s number one cause of death and disability—heart disease—by managing this type of periodontal disease.
Doneen then will present “Integrating the Science of Oral/Systemic Health into Clinical Practice” on Thursday, March 9 at 8:30 pm est. She will describe why it is necessary to respect the clinical context for which the information in the BMJ/PGMJ study can be applied to the clinical dental arena as well as why lines of communication must be created between medicine and dentistry that can clearly articulate the importance of understanding the oral pathogen burden as it relates to the vascular health of the individual patient.
Bale is an adjunct professor at the Texas Tech University Health Science Center, medical director of the Heart Health Program at Grace Clinic in Lubbock, Tex, and co-founder of the Bale/Doneen Method, which has been shown to halt, stabilize, and regress arterial disease. Doneen, also a co-founder of the Bale/Doneen Method, is medical director of the Heart Attack & Stroke Prevention Center and an adjunct professor at Texas Tech University Health Sciences.
- Calcium release stimulates1* hydroxyapatite and secondary dentin bridge formation2,3
- Alkaline pH promotes healing and apatite formation2,4
- Significant calcium release1 leads to protective seal5,7,8
- Protects and insulates the pulp5,6
- Moisture tolerant1 and radiopaque – can be placed under restorative materials and cements
- A protective liner for use under restorative materials, cements, or other base materials.
- Pulp capping agent: TheraCal LC may be placed directly on the pulpal exposures after hemostasis is obtained. It is indicated for any pulpal exposures, including caries exposures, mechanical exposures or exposures due to trauma.
- Radiopaque properties allow for easy detection on x-rays
- Gandolfi MG, Siboni F, Prati C. Chemical-physical properties of TheraCal, a novel light-curable MTA-like material for pulp capping. Int Endod J. 2012 Jun;45(6):571-9.
- ADA definitions for direct and indirect pulp capping at: http://www.ada.org/en/publications/cdt/glossary-of-dental-clinical-and-administrative-ter.
- Gandolfi MG, Siboni F, Taddei P, Modena E, and Prati C. Apatite-forming ability of TheraCal pulp-capping material, J Dent Res 90 (Spec Iss A):abstract number 2520, 2011 (www.dentalresearch.org).
- Okabe T, Sakamoto M, Takeuchi H, Matsushima K. (2006) Effects of pH on mineralization ability of human dental pulp cells. J Endod 32, 198-201.
- Sangwan P, Sangwan A, Duhan J, Rohilla A. Tertiary dentinogenesis with calcium hydroxide: a review of proposed mechanisms. Int Endod J. 2013; 46(1):3-19
- Savas S, Botsali MS, Kucukyilmaz E, Sari T. Evaluation of temperature changes in the pulp chamber during polymerization of light-cured pulp-capping materials by using a VALO LED light curing unit at different curing distances. Dent Mater J. 2014;33(6):764-9.
- Cantekin K. Bond strength of different restorative materials to light-curable mineral trioxide aggregate. J Clin Pediatr Dent. 2015 Winter;39(2):143-8.
- Nielsen M, Vanderweele R, Casey J, and Vandewalle K, USAF, JBSA-Lackland, TX. Mechanical properties of new dental pulp-capping materials over time. J Dent Res 93(Spec Iss A): 495, 2014 (www.dentalresearch.org).
The global dental consumables market will grow from its 2016 total of $25.45 billion at a compound annual growth rate of 6.8% to reach $35.35 billion by 2021, according to ResearchandMarkets. The company included dental restoration, orthodontics, periodontics, endodontics, infection control products, finishing and polishing products, and whitening products among other items in defining the market for evaluation.
The analyst firm attributes this growth to the rapid rise in the world’s geriatric population, growing dental tourism in emerging markets, rising rates of dental caries and other periodontal diseases, growing disposable incomes, greater demand for cosmetic dentistry, and increased dental care expenditures. But the company also expects high costs and limited reimbursements for dental care and a shortage of dental professionals will restrain some of the market’s growth.
The dental restoration segment accounted for the largest share of the global dental consumables market in 2015 due to its wide utilization by dental professionals in teeth regeneration and restoration procedures. Based on the type of end-users, ResearchandMarkets segmented the market into dental hospitals and clinics, dental academic and research institutes, and forensic laboratories.
In 2015, Europe commanded a major share of the dental consumables market due to its aging population, government expenditures, and high reimbursement rates. Also, implant dentistry got its start in Europe, so the penetration rate of dental implants there is very high. However, ResearchandMarkets expects the Asia-Pacific region to see the fastest growth through 2021 because of its growing geriatric population, increases in dental diseases, larger dental expenditures, and an increasing number of dental hospitals and clinics.
Augmented reality isn’t just for gamers anymore. A cross-disciplinary team of researchers at the University of Western Australia (UWA) is developing software that will enable dentists wearing augmented reality glasses to use hand gestures to access information that then will be displayed in their peripheral vision.
“A big problem at the moment is the amount of interruptions dentists face when performing procedures, with an estimated 20% of their day carrying out nonclinical tasks and a significant amount of time away from patients during a procedure to review critical information,” said lead developer Marcus Pham, an electrical engineering and computer science student.
“The technology we are developing will change this by providing dentists with all the information they need without them needing to interrupt a procedure, so they can focus entirely on the patient,” Pham said. “This means the time taken to carry out procedures will be drastically reduced, and the quality of dental work will also improve.”
Aside from providing these patient benefits, the technology also is designed to decrease costs in dentistry and help train dental school students. For example, it could provide students with accurate and fast feedback as they learn intricate manual tasks such as tooth preparation, instead of students seeking feedback from a teacher’s interpretation of their work.
The researchers have been selected as one of 10 teams in Australia to be included in the Commonwealth Scientific and Industrial Research Organization ON Accelerate3 program, a 12-week collaboration that connects experienced and aspiring researchers to develop business models, find funding, and improve marketing before commercialization.
The team also includes Paul Ichim, DMD, of UWA Dentistry, Thomas Braunl, PhD, of UWA Engineering, and Rob Shannon, project manager of the UWA Innovation Quarter. After developing and testing the technology with students at UWA Dentistry, the researchers hope it will be available for commercialization as early as next year.
The bacterial and fungal pathogens that form biofilm on traditional dental implants pose a significant risk for infections, since biofilm resists antimicrobial drugs like antibiotics. Now, researchers at the University of Leuven in Belgium have developed a titanium-silica dental implant that reduces these infection risks by fending off pathogens before biofilm forms.
“Our implant has a built-in reservoir underneath the crown of the tooth,” said Kaat De Cremer, PhD, lead author of the study. “A cover screw makes it easy to fill this reservoir with antimicrobial drugs. The implant is made of a porous composite material, so that the drugs gradually diffuse from the reservoir to the outside of the implant, which is in direct contact with the bone cells. As a result, the bacteria can no longer form a biofilm.”
The researchers subjected the implant to various tests for use with chlorhexidine mouthwash. According to the results, Streptococcus mutans can’t form biofilms on the outside of the implant when the reservoir is filled with chlorhexidine. Biofilms that were grown beforehand on the implant were eliminated in the same way, meaning the implant is effective in both preventing and curing infections.
The study, “Controlled Release of Chlorohexidine from a Mesoporous Silica-Containing Macroporous Titanium Dental Implant Prevents Microbial Biofilm Formation,” was published by European Cells and Materials.