Digital Commons Network^™

The Effect Of Er:Yag, Nd:Yag And Co2 Laser Combined With Hydrogen Peroxide, Sodium Hypochlorite, Chlorohexidine Or Fluoride On Reducing Oral Bacterial Count Implicated In Root Caries, Nitya Reddy

Theses and Dissertations

Purpose: Lasers have been used for treatment of dentinal hypersensitivity and for various bacterial reduction indications in periodontology. Their effectiveness in killing oral bacteria is not well known. The compounding effect of the combination of a laser treatment and adjunct antimicrobial agent use on bacterial viability is still evolving. The purpose of this in vitro study was to evaluate the effect of three lasers commonly used in dentistry in conjunction with chlorhexidine (CHX), hydrogen peroxide (H₂O₂), sodium hypochlorite (NaOCl), or sodium fluoride (NaF) on viability of oral bacteria associated with root caries.

Methods: Three …

The Value Of Educating Teachers, Coaches, And Athletic Trainers On The Management Of Dental Trauma., Laura Satoski

Theses and Dissertations

Purpose: The aim of this study is to investigate the baseline knowledge and assess the benefit of educating teachers, coaches, and athletic trainers about the management of sports-related dental injuries.

Methods: Teachers, coaches, and athletic trainers working in youth sports activities across the city of Richmond and the Greater Richmond Region were recruited via email. Participants answered a pre-seminar survey to evaluate their baseline knowledge and determine whether they experienced dental trauma with their athletes previously. The survey also indicated whether they participated in a public or private sports facility. The participants watched a pre-recorded virtual seminar educating them on …

Exploring Dynamic Navigation For Palatally Impacted Canine Uncovery Surgery., Daniel Joseph Hall

Theses and Dissertations

Purpose: The objective of this study was to compare the exposure/uncovery of palatally impacted canines via the use of dynamic navigation guidance to the traditional freehand approach. Outcomes evaluated include the time to plan and perform exposure, area/size of initial access to locate the impacted tooth and the final size of the osteotomy to completely uncover the impacted tooth.

Methods: In order to simulate various frequently encountered clinical scenarios, three different model types were used. Six plastic models of each model type were fabricated from epoxy resin. Each model contained 2 bilaterally, palatally impacted canines, that were randomly embedded in …

Characteristics Of Posterior Permanent Teeth With A Periradicular Diagnosis Of Symptomatic Apical Periodontitis: A Retrospective Study, Christina A. Martin

Theses and Dissertations

The diagnosis of apical periodontitis is based on radiographic manifestations and the results of the various clinical tests that can be performed as part of a routine dental examination. Apical periodontitis producing clinical symptoms involving a painful response to biting and/or percussion or palpation is given the diagnosis of symptomatic apical periodontitis (SAP). This study aimed to determine associations of SAP with gender, age, radiographic findings, diagnostic testing, pulpal diagnosis, and location of the tooth in the arch. Data for this study were obtained from patients of record treated at Virginia Commonwealth University School of Dentistry in the Department of …

Academic Health Science Centers And Health Disparities: A Qualitative Review Of The Intervening Role Of The Electronic Health Record And Social Determinants Of Health, Wies Rafi

Theses and Dissertations

Literature on the magnitude of negative health outcomes from health disparities is voluminous. Defined as the health effects of racism, environmental injustice, forms of discrimination, biases in science, and sociological or socioeconomic predictors across populations, health disparities are part of an ongoing and complicated national problem that health equity programs are specifically designed to address. Academic Health Science Centers (AHC) institutions are a complex and unique educational-healthcare ecosystem that often serves as a safety net for patients in vulnerable and lower-income communities. These institutions are often viewed as one of the most uniquely positioned entities in the U.S. with an …

Viral Overexpression Of Rprd2 In Mouse Nucleus Accumbens Induces Anxiety-Like Behavior And Regulates Genes Associated With Microtubule Transport, Claire Nuhad Atiyeh

Theses and Dissertations

Anxiety disorders are the most prevalent mental illness in the United States with many individuals underdiagnosed and undertreated (Anxiety & Depression Association of America, 2021; Bandelow et al., 2017). While stress is a known risk factor for developing anxiety disorders, there is emerging evidence that biological variability in the expression of key proteins in the brain may contribute to regulating an organism’s stress-related behaviors. Earlier work from our laboratory identified a protein, called Regulation of Nuclear Pre-mRNA Domain Containing 2 (RPRD2), that was differentially expressed in the brain of mice stratified in terms of their phenotypic response to chronic stress …

Effect Of Moderate Sedation Regimen (Diazepam, Meperidine, And Hydroxyzine) Dosages On Patient Behavior And Outcome Of Sedation In Pediatric Dentistry: A Retrospective Study, Taibah M A M J Albaker

Theses and Dissertations

Purpose: To determine if behavior at consult visit and sedation medication dosages are associated with the success of sedation visits and patient’s behavior using the diazepam, meperidine, and hydroxyzine (DMH) regimen.

Methods: A retrospective chart review was conducted of 324 VCU Pediatric Dentistry Department patients who underwent 404 moderate conscious sedation visits with DMH regimen from April 2017 to June 2022. Sedation visits were graded as “Successful” or “Unsuccessful” and “Good” or “Poor behavior.” The primary variables of interest included Frankl behavior at consult visit and the sedation medication dosages. Logistic regression models were used to determine if these factors …

Virginia Dental Journal (Vol. 99, No. 1, 2022)

Virginia Dental Journal

No abstract provided.

Covid-19 Pandemic Impact On Us Childhood Caries And Potential Mitigation, Christina Scherrer, Shillpa Naavaal, Susan O. Griffin, Mei Lin

Dental Public Health and Policy Publications

Non-Hispanic Black (NHB) and Hispanic and low-income US children have a higher prevalence of untreated caries than their higher-income and non-Hispanic White (NHW) counterparts. Due to the COVID-19 pandemic, many dental offices and school sealant programs closed beginning March 2020. We examine the effect of reduced access to restorative care and sealants on the oral health of children from low-income households overall and by race/ethnicity and how increased sealant delivery in September 2022 could mitigate these effects. We used Markov chain Monte Carlo simulation to model COVID-19’s impact on first permanent molar (1M) caries incidence and loss in quality of …

Peri-Implantitis Incidence And Effect Of Supportive Periodontal Therapy On Outcomes: Retrospective Cohort Study, Michael Ha

Theses and Dissertations

Purpose: Management of peri-implantitis is becoming an increasing component of dental practice. Dental implants can develop peri-implantitis lesions which occur in a non‐linear and accelerating pattern compared to a gradual periodontitis lesion. It is crucial to diagnose and treat this disease early, or ideally prevent it. Contemporary implants have a rough surface texture which is difficult to properly decontaminate as a crucial component for treatment prognosis. Evidence on the long-term effects of Periodontal implant maintenance therapy (PIMT) on implants is limited. This study aims to investigate the effect of periodontal maintenance on peri-implant tissue health.

Methods: A retrospective chart review …

Virginia Dental Journal (Vol. 99, No. 4, 2022)

Virginia Dental Journal

No abstract provided.

Association Between Periodontal Disease And Oral Cancer Screening Among Us Adults: Nhanes 2011-2014, Shillpa Naavaal, Dina T. Garcia, Xiaoyan Deng, Dipankar Bandyopadhya

Dental Public Health and Policy Publications

Objectives:

To examine oral cancer screening rates and associated factors among adults with periodontal disease (PD). We hypothesized that adults with severe PD will be less likely to report receipt of any type of oral cancer screening than adults with no PD.

Materials and Methods:

We used 2011-2014 National Health and Nutrition Examination Survey (NHANES) data on adults ≥ 30 years. PD status was classified as no PD, mild/moderate PD, and severe PD. Survey-adjusted logistic regression analysis was used to examine the model adjusted risk ratio (RR) and 95% confidence intervals (CI) for the outcome of not receiving intraoral, extraoral …

Comprehensive Pregnancy Dental Benefits Improved Dental Coverage And Increased Dental Care Utilization Among Medicaid-Enrolled Pregnant Women In Virginia, Shillpa Naavaal, David W. Harless

Dental Public Health and Policy Publications

Objectives: To evaluate the changes in dental insurance and utilization among pregnant women before and after the pregnancy Medicaid dental benefit policy implementation in 2015 in Virginia.

Methods: We used pooled cross-sectional data from six cycles of the Virginia Pregnancy Risk Assessment Monitoring System on women aged ≥21 years. Using logistic regression models and a difference-in-difference design, we compared the effects of policy implementation on dental insurance and utilization between pre-policy (2013-2014) and post-policy period (2016-2019) among women enrolled in Medicaid (treatment, N = 1,105) vs. those with private insurance (control, N = 2,575). A p-value of 0.05 was …

Clear Aligner Therapy In The Mixed Dentition: Indications And Practitioner Perspectives, Nicholas M. Lynch

Theses and Dissertations

Introduction: This study evaluated current trends and perspectives among orthodontists regarding clear aligner therapy in the mixed dentition (CAMD), including insights into perceived indications, compliance, oral hygiene, and other factors.

Methods: An original, 22-item survey was mailed to both a randomized, nationally representative sample of practicing orthodontic specialists (n = 800) and to a specific, randomized sub-sample of high-aligner-prescribing orthodontists (n = 200). Questions assessed respondents’ demographic information, experience with clear aligner therapy, and perceived advantages/disadvantages of CAMD compared to fixed appliance therapy (FA). Responses were compared using McNemar’s chi-squared and paired t-tests to assess CAMD versus FA. …

The Effect Of Crowding On The Accuracy Of 3d Printed Aligners, Tonya Spangler

Theses and Dissertations

Purpose: To evaluate the accuracy of three-dimensionally (3D) printed aligners compared to conventional vacuum-formed thermoplastic aligners with varying levels of dental crowding.

Methods: Digital intraoral scans of 10 different cases were assigned to their respective groups (n=10, each, 30 total) as follows: no crowding (control), moderate crowding, and severe crowding. Using 3Shape software, digital aligner samples were created in standard tessellation language (STL) file format and randomly 3D printed. The same STL files of each case were also sent to a dental laboratory for the fabrication of vacuum-formed samples, which is the current technology used for manufacturing aligners. The intaglio …

A Method For Predicting Dose Changes For Hn Treatment Using Surface Imaging, Sarah E. Holler

Theses and Dissertations

Head and neck cancer is commonly treated with a six- to seven-week course of radiotherapy, during which a patient’s anatomy may change substantially, due to target reduction or weight loss. Anatomical changes lead to reduction in treatment quality due to decreased setup reproducibility and altered dose deposition compared to the original plan. Few clinics have developed a standard method for triggering resimulation and replan due to anatomic changes. This work investigates a new method for determining when to resimulate and replan HNC patients by utilizing their topographic anatomical changes to predict differences in planned versus delivered dose distributions. The first …

Feeling The Squeeze: The Association Between Multigeneration Caregiving And Informal Caregivers’ Health, Christine L. Patterson

Theses and Dissertations

While U.S. public policy and research has focused on the health needs of the aging population, less attention has been given to the consequences informal caregivers face caring for this generation. With the segment of the population aged 65 years or older growing rapidly, it is important to understand the factors that place informal caregivers at risk for poor health outcomes and health behaviors. Since multigeneration caregivers balance more personal, work, and caregiving demands than single-generation informal caregivers of older adults, they may be at higher risk for poor health outcomes. The aim of this study was to examine the …

Comparing The Sensitivity And Specificity Of Cbct And Mri In Detecting Osteoarthritis Of The Tmj: A Systematic Review, Gabriel R. Saavedra

Theses and Dissertations

The aim of this systematic review was to compare the sensitivity and specificity of cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) in detecting osteoarthritis (OA) of the temporomandibular joint (TMJ). This was done by using computed tomography (CT) and the research diagnostic criteria for temporomandibular disorders (RDC/TMD) as reference methods and using CBCT and MRI as index methods. A specific search strategy was developed and applied to these electronic databases: PubMed, Embase, DOSS, and Cochrane. The search results returned 802 articles, which were then narrowed down using the inclusion/exclusion criteria, to four final articles that were included in …

Amixicile, A Novel Antimicrobial Agent, And Its Effect On The Salivary And Subgingival Microbiome In Rhesus Macaque Monkeys, Erin E. Block

Theses and Dissertations

Background/Purpose: Periodontitis is an inflammatory disease with a bacterial etiology in a susceptible host. A selective antibiotic with minimal systemic side effects could be a useful adjunct to traditional periodontal therapy. Amixicile is a novel antimicrobial agent that targets pyruvate: ferredoxin oxidoreductase (PFOR), an enzyme that is critical for anaerobic bacterial metabolism and has been found to have little-to-no side-effects in animal models. The aim of this study was to prospectively evaluate the effect of amixicile on clinical periodontal parameters and the composition of the oral microbiome in rhesus macaque monkeys. It was hypothesized that the amixicile would reduce growth …

Antibiotic-Loaded Dendrimer Hydrogels In Periodontal Bone Regeneration: A Feasibility Study, Nicholas G. Yesbeck

Theses and Dissertations

Purpose: Prescription of a complete course of oral antibiotics following bone grafting procedures is a common clinical practice in surgical periodontics. Prophylactic administration of antibiotics reduces the risk of surgical site infection and systemic administration is preferred over local delivery because of short duration of action in the latter circumstance. The goal of this study is to demonstrate the ability of dendrimer hydrogels (DH) to prolong the release kinetics of antibiotics in-vitro. A secondary goal will be to analyze the effect of different particulate bone allografts on the release kinetics of the antibiotic.

Methods: Dendrimer hydrogels (DH) were synthesized …

A Scoping Review Of The Roles, Training, And Impact Of Community Health Workers In Oral Health Supplemental Tables, Dina T. Garcia, Jaime Lawson, Erica R. Brody, Susan C. Mckernan, Sarah E. Raskin, Nixon Arauz, Maghboeba Mosavel, Tegwyn Brickhouse

Health Behavior and Policy Publications

Objective: To synthesize English or Spanish-language literature on community health workers’ (CHWs’) roles, training, and impact in oral health. Basic research design: A scoping review conducted in accordance with the Arksey and O’Malley (2005) methodological framework. Method: Electronic literature searches were conducted in Medline (Ovid), Embase (Ovid), DOSS, CINAHL, Web of Science, and Global Health CAB from inception of the databases to April 2020. Three reviewers independently conducted the title and abstract and full-text reviews. This was followed by data charting by three reviewers and data summarizing by two reviewers. Results: Out of the 36 articles that met the inclusion …

Xylitol In Preventing Dental Caries, Nicholas Fields, Tu Bui

Dental Hygiene Student Scholarship

Abstract

Problem: Dental caries is a common form of tooth infection among adults and children. The disease is easily transmissible, and therefore a great focus should be put on prevention to ensure healthy and proper oral hygiene for the population. Xylitol use has been proposed as one of the most effective preventive interventions against dental caries.

Methods: The literature review engaged different electronic databases such as PubMed, MEDLINE, Google Scholar, and Cochrane Library in evaluating the effectiveness of xylitol use in preventing dental caries in both children and adults. Articles used in the review were published between 2016 …

Can Botox Be The Cure For Tmj Associated Pain And Dysfunction?, Haley Headley, Bella Pollard

Dental Hygiene Student Scholarship

Problem: Over 10 million Americans suffer from pain, headaches, and jaw dysfunction associated with temporomandibular joint disorders. Traditionally, when diagnosed, patients are given conservative treatment option recommendations such as an occlusal bite guard, stabilization splint, and over-the-counter pain medication, such as Ibuprofen. These conservative treatment options are meant for short term use. What is the long term answer to temporomandibular joint pain and dysfunction? Surgical replacement of jaw joints with artificial implants has been considered; however, the effectiveness of this irreversible procedure is inconclusive and highly controversial. Botulinum toxin type A injections, or botox, offers an alternative treatment that …

The Effects Of Covid-19-Related Stressors On Bruxism And Temporomandibular Disorders, Hagir A. Saleh, Samantha Smith

Dental Hygiene Student Scholarship

Problem: COVID-19 has proven to be a major public health emergency, with an array of physical and emotional complications. While COVID-19 has its own effects on the human body, anxiety induced by the pandemic has shown to take a toll on the human oral cavity by means of causing individuals to grind and clench their teeth due to anxiety/stress, potentially leading to temporomandibular disorders and orofacial pain.

Methods: A thorough review of literature was conducted by consulting credible studies published on online databases such as PubMed, Dentistry & Oral Sciences Source, Google Scholar, and Academic Search Complete. The studies examined …

Lucy Corr Dental Clinic: Addressing Dental Needs Of Uninsured Older Adults, Patricia B. Bonwell

Case Studies from Age in Action

Educational Objectives

1. Discuss the critical importance of oral health and the oral-systemic relationship in older adults.

2. Describe how dental insurance determines receipt of dental treatment in older adults.

3. Share how the Lucy Corr Dental Clinic (LCDC) increases access to dental care for uninsured older adults.

4. Describe valuable collaborations with community foundations, the Virginia Dental Association, and Virginia Commonwealth University that enable the success of the LCDC.

Improving Guardianship Practices Through Collaborative Stakeholder Action, Erica Wood, Shasta Douglass

Case Studies from Age in Action

Educational Objectives

1. Describe the purpose of adult guardianship and its effect on fundamental rights.

2. Explain the need for guardianship reform, the obstacles to reform, and what issues need attention in Virginia.

3. Discuss the purpose of state Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS) and the creation and accomplishments of Virginia WINGS.

4. Review cases in which a WINGS pilot project supported the needs and rights of adults with guardians.

Virginia Dental Journal (Vol. 98, No. 4, 2021)

Virginia Dental Journal

No abstract provided.

Influence Of Metal Sleeves In The Accuracy Of Dental Implant Placement Using Guided Implant Surgery, Coleman Adams

Theses and Dissertations

The fabrication of implant surgical guides through stereolithographic 3D printing has become a staple in dental implant guided surgery over the last couple decades. These surgical guides have typically utilized metal sleeves to assist in guidance of the drills during osteotome preparation. The metal sleeves can be costly and potentially cause deviations if improperly placed during post-processing of the guide. This research explored a novel method for the utilization of sleeve-free surgical guides by comparing the dimensional and angulational deviations between the implant guides with and without a metal sleeve. To achieve this goal, two separate aims were pursued. Our …

Perceived Efficacy Of Extrusion Of Maxillary Lateral Incisors With Aligners, Mason T. Bates

Theses and Dissertations

Purpose: To assess the perceived efficacy of aligners (Invisalign, Align Technology Inc) at performing extrusive movements of maxillary lateral incisors, determine a general threshold of when a maxillary lateral incisor is not extruding as predicted and requiring intervention, evaluate the frequency and methods of intervention to achieve the predicted extrusion, and to evaluate any related differences between orthodontists and general dentists, and between clinicians having treated various numbers of patients with Invisalign in the past 12 months.

Methods: An original 18-question survey was sent by mail to a randomized and geographically proportionate selection of orthodontic specialists (N = …

Knowledge, Perception, And Clinical Management Strategies Of Us Pediatric Dentists On Molar Incisor Hypomineralization, Courtney T. Brashier

Theses and Dissertations

Purpose: The purpose of this cross-sectional, survey-based study is to determine current US pediatric dentists’ knowledge, perceptions, and clinical management strategies for patients with molar incisor hypomineralization (MIH).

Methods: Following appropriate protocol and authorizations, all active pediatric dentists, general dentists, and post-doctoral student members identified by the 2020 American Academy of Pediatric Dentistry’s membership list were invited to partake in an anonymous email survey. Data regarding participants sociodemographic, education, and clinical backgrounds were collected in addition to information obtained from MIH-focused questions. Descriptive statistics and chi-square tests were used to compare and analyze data. A significance level was set at …