Treatment Decisions Involving Teeth With Intrapulpal Cracks: A Survey Of Endodontists, Sheldon M. Sealey

Theses and Dissertations

There is no universal protocol for diagnosing, treating and managing cracked teeth. The purpose of this survey was to investigate the use of traditional methods of crack detection and to explore how treatment decisions were made using an intrapulpal crack classification. The electronic survey was sent to 1115 active members of the American Association of Endodontists (AAE) and The Digital Office (TDO^™) community. Comparisons were assessed using logistic or repeated-measures regression. The most often used diagnostic method was probing. When the crack involved one wall, 85% of respondents would complete root canal therapy > 50% of the time or …

A Comparison Of Vitamin D Levels In Children With Early Childhood Caries, Vanessa O. Hofilena

Theses and Dissertations

Purpose: To determine if there is an association between early childhood caries (ECC) and vitamin D deficiency, as measured via a serum sample. An exploratory goal was to investigate the possibility of measuring vitamin D with a salivary assay. Methods: Serum samples of patients who were scheduled for a dental or otolaryngology procedure under general anesthesia were assessed for 25-hydroxyvitamin D (25(OH)D), parathyroid hormone and calcium. Results: Our analysis indicates that the vitamin D levels of the controls and ECC group were significantly different. There were significant inverse correlations between: 1) PTH levels and vitamin D and 2) decayed, missing, …

General Dentists' Role In Providing Care To Very Young Children:Pediatric Dentists' Perspective, Shinjni Razdan

Theses and Dissertations

To examine the pediatric dentists’ perspective on level of care to children 0-3 years old by general dentists, an electronic survey was sent out to 5185 AAPD members and 769 responded (response rate: 14.8%). Forty-six percent agreed with a general dentist providing a dental home to children 0-3 years old. Only 24% agreed that general dentists could perform complex restorative and behavior management procedures for 0-3 years old. Younger respondents, pediatric dentists who practice in rural areas or teaching pediatric dentistry, and those who perceived adequate exposure during dental school were more likely to agree on general dentists proving a …

The Effectiveness Of A Preventive Recall Strategy In Children Following Dental Rehabilitation Under General Anesthesia, Katherine A. Nordeen

Theses and Dissertations

Purpose: This was a pilot study to assess the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) under general anesthesia in children with early childhood dental caries.

Methods: Sixty-six patients completed FMDR and were included in the analysis. At the consultation visit, caries risk assessment (CRA) and dental exam information were recorded, and caregivers completed an oral health knowledge (OHK) questionnaire. Patients returned for a post-surgery and recall visit. Caregivers received oral hygiene instructions in a motivational-interviewing style.

Results:At the consultation visit all patients were high risk. At the post-surgery visit, only 47% remained high risk …

In-Vitro Assessment Of A Novel Bracket's Effect On Resistance To Sliding, James Blackburn

Theses and Dissertations

Friction, binding and notching are the factors that contribute to resistance to sliding during orthodontic tooth movement. However, most attempts at reducing resistance aim only to reduce the archwire/ligature friction. In this study, a novel bracket with a unique design aimed to reduce all three components of resistance to sliding. Four types of brackets (passive and active self-ligating, traditionally ligated and the novel bracket, (n=5, each) were tested at 0, 2, 4, 6, and 8ᵒ of tip on a 0.019 x 0.025”archwire. The resistance to sliding values were recorded. At 0ᵒ, the passive self-ligating and novel bracket showed reduced resistance …

Restoring Lateral Incisors And Orthodontic Treatment: Perceptions Among General Dentists And Othodontists, Matthew A. Sandretti, Bhavna Shroff, Steven J. Lindauer, Al M. Best

Theses and Dissertations

The purpose of this study was to identify and compare preferences and perceptions of orthodontists and general dentists when restoring peg-shaped lateral incisors. The investigation sought to summarize these preferences with regard to treatment planning, tooth preparation and interdisciplinary communication. A pair of mailed and electronic surveys was distributed to 1,500 general dentists and orthodontists, respectively. The results indicated that general dentists perceived that general dentists held the primary decision-making responsibility, while orthodontists disagreed (P<0.0001). Orthodontists prioritized the treatment goals of Class I canine relationship and overbite/overjet more significantly than general dentists, whom valued tooth proportions more highly (P<0.0001). General dentists reported receiving significantly less input than orthodontists report seeking (P<0.0001).The consensus of both groups showed that the tooth should be positioned centered mesiodistally and guided by the gingival margins incisogingivally. Both groups agree that orthodontists must improve communication to improve treatment results.

Lowering The Number Of False Positive Responses To Electric Pulp Tests By Qualifying Patient Response, Katherine Js Lee

Theses and Dissertations

The electric pulp test (EPT) has been shown to be a valuable tool in assessing pulp vitality. One of its drawbacks, however, is its high number of false positives. The purpose of this study was to determine if qualifying the type of sensation elicited by the test could lower the percentage of false positive responses. A retrospective chart review of an eleven-month period was conducted, examining all patients with necrotic teeth tested with the EPT. Of 189 teeth, when the patient responded to EPT at first sensation 23.3% of teeth were incorrectly identified as vital. When the patient was asked …

Restorative Characteristics Of Intrapulpally Cracked Teeth, Charles M. Beavers

Theses and Dissertations

Cracked teeth have long presented a diagnostic challenge. Previous investigators have considered possible predictive factors, many of which revolve around the tooth’s restorative characteristics. Few have investigated the restorative status of teeth with cracks extending into the pulp chamber. The purpose of this investigation was to determine the prevalence of the different types of restorations present in intrapulpally cracked teeth and determine any other restorative factors that may aid in predicting the presence or extent of an intrapulpal crack. Intrapulpally cracked molars requiring endodontic therapy at the VCU Graduate Endodontic Practice were included in this study. For each tooth, the …

Motivational Factors For Treating Patients With Special Health Care Needs, Arpi Patel

Theses and Dissertations

Purpose: The purpose of this study is to assess what training and motivational factors dental providers report in providing dental care to PSHCN (patients with special healthcare needs. Materials and Methods: An electronic questionnaire was sent to n=104 fourth year dental students, n=147 general dentists with a specific continuing education course pertaining to PSCHN, and n=140 pediatric dentists in Virginia. The questionnaire consisted of four sections including Demographics, Professional Attitudes, Special Needs Patients and Motivational Factors, and PSCHN Cases. Results: The overall response rate for our study was 21%. The response rates of dental students, general dentists, …

Esthetic Preferences Of Maxillary Incisor Labiolingual Inclination Across Races, Elvi M. Barcoma

Theses and Dissertations

Abstract

ESTHETIC PREFERENCES FOR MAXILLARY INCISOR LABIOLINGUAL INCLINATION ACROSS RACES

by Elvi Marie Barcoma, D.D.S.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University

Virginia Commonwealth University, 2015

Major Director: Bhavna Shroff, D.M.D., M.Dent.Sc, Program Director, Orthodontics

Objective: To determine if people of different racial backgrounds prefer different amounts of

maxillary incisor labiolingual inclination from a smiling profile view.

Materials and Methods: An electronic survey was created with smiling profile images of an African-American female and a White female with varying degrees of maxillary incisor labiolingual inclination. …

Crown Size Comparisons In Patients With Unilateral Palatally Displaced Canines, Joseph Eliason, Steven J. Lindauer

Theses and Dissertations

Abstract

CROWN SIZE COMPARISONS IN PATIENTS WITH PALATALLY DISPLACED CANINES

By Joseph L. Eliason, D.D.S.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University.

Virginia Commonwealth University, 2015

Thesis Director: Steven J. Lindauer, D.M.D., M.Dent.Sc.

Professor and Chair, Department of Orthodontics

There has been significant debate over the past decades regarding the etiology of palatally displaced canines. Theorized risk factors include agenesis or malformation of the lateral incisors, incisor retroclination, transverse deficiency, or genetic predisposition. The purpose of this study is to compare the linear and volumetric …

Peracetic Acid: A Practical Agent For Sterilizing Heat-Labile Polymeric Tissue-Engineering Scaffolds, William R. Trahan

Theses and Dissertations

Advanced biomaterials and sophisticated processing technologies aim to fabricate tissue-engineering scaffolds that can predictably interact within a biological environment at a cellular level. Sterilization of such scaffolds is at the core of patient safety and is an important regulatory issue that needs to be addressed prior to clinical translation. In addition, it is crucial that meticulously engineered micro- and nano- structures are preserved after sterilization. Conventional sterilization methods involving heat, steam and radiation are not compatible with engineered polymeric systems because of scaffold degradation and loss of architecture. Using electrospun scaffolds made from polycaprolactone (PCL), a low melting polymer, and …

The Role Of Leukocyte-Platelet Rich Fibrin In Human Alveolar Ridge Preservation: A Randomized Clinical Trial, Thomas F. Glazier, Thomas C. Waldrop, John C. Gunsolley, Robert Sabatini

Theses and Dissertations

PURPOSE: The aim of this study is to examine the healing of intact extraction sockets grafted with leukocyte-platelet rich fibrin (L-PRF) as compared to sockets grafted with freeze-dried bone allograft (FDBA) and a resorbable collagen barrier membrane (RCM).

METHODS: This prospective randomized, examiner blinded pilot study included 17 subjects randomized to two treatment groups. Serum total cholesterol, low density lipoprotein (LDL), 25-hydroxyvitamin-D₃, and platelet counts were determined preoperatively in all subjects. The experimental arm consisted of 8 posterior tooth-bounded intact extraction sites receiving L-PRF plugs. The control group consisted of 9 posterior tooth-bounded intact extraction sites receiving FDBA …

Characterization Of Leukocyte-Platelet Rich Fibrin, A Novel Biomaterial, Fadi K. Hasan

Theses and Dissertations

Autologous platelet concentrates represent promising innovative tools in the field of regenerative medicine and are successfully used in oral surgery. Several commercial systems exist that generate various forms of platelet concentrates including Platelet-rich plasma (PRP) and Platelet-rich fibrin (PRF). The alpha- granules of entrapped platelets release a variety of peptide growth factors that promotes healing. Usually PRP is a suspension that can be injected into the site of injury or used as a gel with the addition of thrombin (PRP-gel). In contrast Choukroun’s L-PRF is a dense fibrin based biomaterial enriched with platelets and growth factors. The physical state of …

A Justification For The Trend Towards Indirect Pulp Therapy, Marissa Kuhnen

Theses and Dissertations

Purpose: The purpose of this retrospective chart review was to determine how primary molars needing vital pulp therapy have been treated in the past four years at Virginia Commonwealth University (VCU) and to determine which treatments: indirect pulp therapy (IPT), formocresol pulpotomy, and ferric sulfate pulpotomy have been successful. Methods: AxiUm records that contained the procedure codes D3120 (Pulp Cap – Indirect) or D3220 (Therapeutic Pulpotomy) were totaled by year. Visit records were queried again to identify treatment failures i.e. extractions or pulpectomy. Results: In 2010, 52% of vital pulp therapies were ferric sulfate pulpotomies and in …

The Prevalence, Predictive Factors, And Classification Of Intrapulpal Cracks In Maxillary Premolars Requiring Endodontic Treatment, Sarah Krygowski

Theses and Dissertations

Cracked teeth may be difficult to diagnose. Craze lines rarely become symptomatic or require treatment. Cracks in the enamel and dentin alone may or may not become symptomatic and require restorative treatment. However, cracks extending into the enamel, dentin, and pulp chamber provide an avenue for bacteria to establish infection and this commonly results in symptoms and the need for endodontic and restorative treatment. The published endodontic literature has limited information regarding the prevalence or predictive factors for cracks extending into the pulp chamber of teeth. The purpose of this study was to determine the prevalence and classification of intrapulpal …