JDR clinical and translational research, Jun 21, 2021
Background: The South Australian Dental Service’s Special Needs Network was established to suppor... more Background: The South Australian Dental Service’s Special Needs Network was established to support oral health professionals working within their statewide government-funded dental service to treat patients with special needs. This study aimed to investigate how a structured network relationship with specialists in special needs dentistry influenced the willingness of dentists to treat this group of patients. Methods: Semi-structured interviews were used to explore the views of specialists and dentists involved in the South Australian Dental Service’s Special Needs Network. Inductive thematic analysis identified emerging themes enabling completion of a SWOT (strengths, weaknesses, opportunities, threats) analysis. Results: Dentists felt that a strength of the Network was a greater sense of collegiality, particularly for those working in rural areas. Although the inability to get immediate advice was seen as a weakness, dentists felt a more structured relationship with specialists improved communication pathways and resulted in more timely care. The aging workforce, systemic barriers in the public dental system, such as productivity pressures and infrastructure, and the lack of support from other health professionals were seen as ongoing barriers and threats. Regardless, dentists identified the use of telehealth and visiting specialists as future opportunities. Specialists felt that the Network was a valuable resource but were skeptical about its effectiveness, feeling that a limitation was the ability of dentists to recognize the complexity of cases. Conclusions: Ongoing support from and communication with specialists in special needs dentistry through a structured network improved the perceived ability and willingness of dentists to treat patients with special needs. Knowledge Transfer Statement: This research suggests that providing support to dentists through a hub-and-spoke network that facilitates additional training, professional interaction, and improved communication with specialists in special needs dentistry may help overcome some of the current barriers to access to care experienced by individuals with special needs, particularly those associated with the willingness and capability of clinicians treat them.
The aim of this study was to test a casein peptide in its glycosylated form (kappa-casein glycope... more The aim of this study was to test a casein peptide in its glycosylated form (kappa-casein glycopeptide, KCGP) and its non-glycosylated form (kappa-casein peptide, KCP) for antibacterial efficacy against Enterococcus faecalis in planktonic and biofilm cultures. E. faecalis strain JKD 15036 was exposed to different concentrations of KCGP and KCP in a 96-well culture plate. The effect of the peptides on the growth of E. faecalis in planktonic culture was monitored by measuring optical density over 7 hours. Biofilm formation was measured after 24 hours using a crystal violet assay. All experiments were performed in triplicate. KCGP and KCP inhibited growth of E. faecalis in planktonic culture with no significant difference in activity between the peptides. KCGP at 0.16% w/v was significantly better at inhibiting E. faecalis biofilm formation than KCP at the same concentration and significantly better than NaOCl at 1.0% w/v. KCGP effectively inhibited E. faecalis biofilm formation and may have potential to augment the efficacy of traditional antiseptic agents.
To determine whether the following can be sterilized by autoclaving - endodontic sponges, rotary ... more To determine whether the following can be sterilized by autoclaving - endodontic sponges, rotary nickel-titanium (NiTi) instruments within endodontic sponges, and rotary NiTi instruments with rubber stoppers. Sixty-four samples of eight different endodontic sponges (n = 512) were placed into brain heart infusion broth (BHI) for 72 h. An aliquot of this was then spread onto horse blood agar and cultured aerobically and anaerobically to test sterility at purchase. Bacterial suspensions of Enterococcus faecalis, Porphyromonas gingivalis and Geobacillus stearothermophilus in BHI were used to contaminate sterile sponges and rotary NiTi instruments (with and without rubber stoppers) inserted into sponges. The various samples were autoclaved and then cultured aerobically and anaerobically. Success of sterilization was measured qualitatively as no growth. The experiment was repeated with clinically used rotary NiTi instruments (n = 512). All experiments were conducted in quadruplicate. No sponges on purchase had microbial growth when anaerobically cultured but some did when aerobically cultured. All autoclaved sponges and instruments (within or without sponges, and with or without rubber stoppers) were associated with no microbial growth. All nonautoclaved positive control samples showed microbial growth. Autoclaving was effective in the sterilization of sponges and endodontic instruments. Endodontic sponges should be autoclaved before clinical use. For clinical efficiency and cost-effectiveness, rotary NiTi instruments can be sterilized in endodontic sponges without removal of rubber stoppers.
BackgroundThere are no cone‐beam computed tomography (CBCT)‐based data on the anatomy of mandibul... more BackgroundThere are no cone‐beam computed tomography (CBCT)‐based data on the anatomy of mandibular second molars in an Australian population. This study investigated the prevalence and descending morphology of mandibular second molars with and without C‐shaped canals using retrospective analysis of CBCT scans.MethodsScans from 715 patients were screened for the presence of C‐shaped canals and assessed for cross‐sectional configuration at five axial levels. Non‐C‐shaped molars were assessed for other morphological characteristics. Data were modelled against patient, tooth and CBCT scan characteristics.ResultsA total of 1278 teeth from 657 patients were evaluated. The overall prevalence of C‐shaped canals was 13%. Cross‐sectional configuration of C‐shaped canals was variable, with an average of 2.8 unique cross‐sections per tooth. Non‐C‐shaped teeth were predominantly Vertucci Type II (60%) and Type IV (29%) configurations in mesial roots, and Type I (91%) in distal roots. Additional roots occurred in 4.3% of teeth and there was a significant association between radix paramolaris and distal root bifurcation (P < 0.001).ConclusionsCross‐sectional analysis confirmed the complexity and variability of C‐shaped canals. Clinicians should be cognizant of the prevalence and variability of C‐shaped root canal morphology and how this may affect endodontic treatment.
Journal of The Mechanical Behavior of Biomedical Materials, Sep 1, 2021
The objectives of this study were to evaluate 4 aspects of ion-leaching restorative materials (IL... more The objectives of this study were to evaluate 4 aspects of ion-leaching restorative materials (ILMs): 4-point bending flexural strength (4 PB-FS) and relative mechanical properties; biaxial flexural strength (B-FS) in relation to 4 PB-FS; porosity; and surface morphology. Eleven ILMs were used for the 4-point bending test. Bar-shaped (n = 15) samples were fabricated, stored in distilled water for 7 days. Then 4 PB-FS and the other mechanical properties were determined. Five ILMs were selected for the B-FS test using disk specimens (n = 15). The correlation between 4 PB-FS and B-FS was addressed. After the 4 PB test, 5 randomised fragments from each material were used to make 0.5 mm-thick sections for light microscopy to investigate the degree of porosity using reflected and transmitted lights. Eight ILMs were selected for quantitative analysis of the fractional % pore volume (PV%) due to their relative pore prominence using ImageJ software. One-way ANOVA/Dunnett's T3 was used to test for significance. Resin-based ILMs (RB-ILMs) were ranked first (p < 0.05) for 4 PB-FS values (53.3-110.2 MPa) followed by resin-modified glass-ionomer cements (RMGICs; 30.9-44.3 MPa) and high-viscosity glass-ionomer cements (HVGICs; 12.9-19.6 MPa), respectively. 'Flexural modulus' (4 PB-E) and 'flexural toughness' (4 PB-T) of ILMs varied even though similar 4 PB-FS values were observed. There was a positive correlation (p < 0.001) between 4PB-FS and B-FS (R2 = 0.992) with B-FS>4 PB-FS. There was no correlation between PV% and 4 PB-FS. In summary, material type played a major role in 4 PB-FS outcomes, whereas PV% seemed to have a minor effect when evaluating each material group of ILMs. Brittleness/ductility of ILMs was observed when determining 4 PB-E and 4 PB-T relative to 4 PB-FS. When selecting materials for posterior load-bearing dental restorations in high-caries risk patients, RB-ILMs or RMGICs would be more appropriate due to their superior flexural properties compared with recently introduced HVGICs. The decision for each situation will also be dependent on further evidence of the ion-leaching capacity.
JDR clinical and translational research, Jun 21, 2021
Background: The South Australian Dental Service’s Special Needs Network was established to suppor... more Background: The South Australian Dental Service’s Special Needs Network was established to support oral health professionals working within their statewide government-funded dental service to treat patients with special needs. This study aimed to investigate how a structured network relationship with specialists in special needs dentistry influenced the willingness of dentists to treat this group of patients. Methods: Semi-structured interviews were used to explore the views of specialists and dentists involved in the South Australian Dental Service’s Special Needs Network. Inductive thematic analysis identified emerging themes enabling completion of a SWOT (strengths, weaknesses, opportunities, threats) analysis. Results: Dentists felt that a strength of the Network was a greater sense of collegiality, particularly for those working in rural areas. Although the inability to get immediate advice was seen as a weakness, dentists felt a more structured relationship with specialists improved communication pathways and resulted in more timely care. The aging workforce, systemic barriers in the public dental system, such as productivity pressures and infrastructure, and the lack of support from other health professionals were seen as ongoing barriers and threats. Regardless, dentists identified the use of telehealth and visiting specialists as future opportunities. Specialists felt that the Network was a valuable resource but were skeptical about its effectiveness, feeling that a limitation was the ability of dentists to recognize the complexity of cases. Conclusions: Ongoing support from and communication with specialists in special needs dentistry through a structured network improved the perceived ability and willingness of dentists to treat patients with special needs. Knowledge Transfer Statement: This research suggests that providing support to dentists through a hub-and-spoke network that facilitates additional training, professional interaction, and improved communication with specialists in special needs dentistry may help overcome some of the current barriers to access to care experienced by individuals with special needs, particularly those associated with the willingness and capability of clinicians treat them.
The aim of this study was to test a casein peptide in its glycosylated form (kappa-casein glycope... more The aim of this study was to test a casein peptide in its glycosylated form (kappa-casein glycopeptide, KCGP) and its non-glycosylated form (kappa-casein peptide, KCP) for antibacterial efficacy against Enterococcus faecalis in planktonic and biofilm cultures. E. faecalis strain JKD 15036 was exposed to different concentrations of KCGP and KCP in a 96-well culture plate. The effect of the peptides on the growth of E. faecalis in planktonic culture was monitored by measuring optical density over 7 hours. Biofilm formation was measured after 24 hours using a crystal violet assay. All experiments were performed in triplicate. KCGP and KCP inhibited growth of E. faecalis in planktonic culture with no significant difference in activity between the peptides. KCGP at 0.16% w/v was significantly better at inhibiting E. faecalis biofilm formation than KCP at the same concentration and significantly better than NaOCl at 1.0% w/v. KCGP effectively inhibited E. faecalis biofilm formation and may have potential to augment the efficacy of traditional antiseptic agents.
To determine whether the following can be sterilized by autoclaving - endodontic sponges, rotary ... more To determine whether the following can be sterilized by autoclaving - endodontic sponges, rotary nickel-titanium (NiTi) instruments within endodontic sponges, and rotary NiTi instruments with rubber stoppers. Sixty-four samples of eight different endodontic sponges (n = 512) were placed into brain heart infusion broth (BHI) for 72 h. An aliquot of this was then spread onto horse blood agar and cultured aerobically and anaerobically to test sterility at purchase. Bacterial suspensions of Enterococcus faecalis, Porphyromonas gingivalis and Geobacillus stearothermophilus in BHI were used to contaminate sterile sponges and rotary NiTi instruments (with and without rubber stoppers) inserted into sponges. The various samples were autoclaved and then cultured aerobically and anaerobically. Success of sterilization was measured qualitatively as no growth. The experiment was repeated with clinically used rotary NiTi instruments (n = 512). All experiments were conducted in quadruplicate. No sponges on purchase had microbial growth when anaerobically cultured but some did when aerobically cultured. All autoclaved sponges and instruments (within or without sponges, and with or without rubber stoppers) were associated with no microbial growth. All nonautoclaved positive control samples showed microbial growth. Autoclaving was effective in the sterilization of sponges and endodontic instruments. Endodontic sponges should be autoclaved before clinical use. For clinical efficiency and cost-effectiveness, rotary NiTi instruments can be sterilized in endodontic sponges without removal of rubber stoppers.
BackgroundThere are no cone‐beam computed tomography (CBCT)‐based data on the anatomy of mandibul... more BackgroundThere are no cone‐beam computed tomography (CBCT)‐based data on the anatomy of mandibular second molars in an Australian population. This study investigated the prevalence and descending morphology of mandibular second molars with and without C‐shaped canals using retrospective analysis of CBCT scans.MethodsScans from 715 patients were screened for the presence of C‐shaped canals and assessed for cross‐sectional configuration at five axial levels. Non‐C‐shaped molars were assessed for other morphological characteristics. Data were modelled against patient, tooth and CBCT scan characteristics.ResultsA total of 1278 teeth from 657 patients were evaluated. The overall prevalence of C‐shaped canals was 13%. Cross‐sectional configuration of C‐shaped canals was variable, with an average of 2.8 unique cross‐sections per tooth. Non‐C‐shaped teeth were predominantly Vertucci Type II (60%) and Type IV (29%) configurations in mesial roots, and Type I (91%) in distal roots. Additional roots occurred in 4.3% of teeth and there was a significant association between radix paramolaris and distal root bifurcation (P &lt; 0.001).ConclusionsCross‐sectional analysis confirmed the complexity and variability of C‐shaped canals. Clinicians should be cognizant of the prevalence and variability of C‐shaped root canal morphology and how this may affect endodontic treatment.
Journal of The Mechanical Behavior of Biomedical Materials, Sep 1, 2021
The objectives of this study were to evaluate 4 aspects of ion-leaching restorative materials (IL... more The objectives of this study were to evaluate 4 aspects of ion-leaching restorative materials (ILMs): 4-point bending flexural strength (4 PB-FS) and relative mechanical properties; biaxial flexural strength (B-FS) in relation to 4 PB-FS; porosity; and surface morphology. Eleven ILMs were used for the 4-point bending test. Bar-shaped (n = 15) samples were fabricated, stored in distilled water for 7 days. Then 4 PB-FS and the other mechanical properties were determined. Five ILMs were selected for the B-FS test using disk specimens (n = 15). The correlation between 4 PB-FS and B-FS was addressed. After the 4 PB test, 5 randomised fragments from each material were used to make 0.5 mm-thick sections for light microscopy to investigate the degree of porosity using reflected and transmitted lights. Eight ILMs were selected for quantitative analysis of the fractional % pore volume (PV%) due to their relative pore prominence using ImageJ software. One-way ANOVA/Dunnett's T3 was used to test for significance. Resin-based ILMs (RB-ILMs) were ranked first (p < 0.05) for 4 PB-FS values (53.3-110.2 MPa) followed by resin-modified glass-ionomer cements (RMGICs; 30.9-44.3 MPa) and high-viscosity glass-ionomer cements (HVGICs; 12.9-19.6 MPa), respectively. 'Flexural modulus' (4 PB-E) and 'flexural toughness' (4 PB-T) of ILMs varied even though similar 4 PB-FS values were observed. There was a positive correlation (p < 0.001) between 4PB-FS and B-FS (R2 = 0.992) with B-FS>4 PB-FS. There was no correlation between PV% and 4 PB-FS. In summary, material type played a major role in 4 PB-FS outcomes, whereas PV% seemed to have a minor effect when evaluating each material group of ILMs. Brittleness/ductility of ILMs was observed when determining 4 PB-E and 4 PB-T relative to 4 PB-FS. When selecting materials for posterior load-bearing dental restorations in high-caries risk patients, RB-ILMs or RMGICs would be more appropriate due to their superior flexural properties compared with recently introduced HVGICs. The decision for each situation will also be dependent on further evidence of the ion-leaching capacity.
Uploads
Papers by Peter Parashos