Medicine and Health Sciences Commons^™

Association Of Inflammatory Markers And Growth Factors With Radiographically Assessed Wound Healing Of Extraction Sockets, Sasha Mohammadi

Theses & Dissertations

The purpose of this prospective cohort pilot study was to investigate the association of the periodontal status and inflammatory markers from the gingival crevicular and wound fluid with the healing outcomes following tooth extraction. The central research hypothesis is that extraction sites and the adjacent teeth that exhibit increased markers of inflammation, or decreased growth factors, at baseline or 2 weeks will be associated with reduced healing outcomes observed radiographically 3 months following surgery. Nine patients at the UNMC College of Dentistry who were seeking care to extract a posterior tooth due to advanced periodontal bone loss, non-restorable caries or …

A Cell Culture Model To Study Tobacco Associated Oral Cancer Progression And Treatment Resistance, Amanda Busch

Theses & Dissertations

Head and Neck Squamous cell carcinoma is the 6^th most common cancer in the world. Risk factors for HNSCC include alcohol and tobacco consumption, infection with Human Papilloma Virus, and exposure to environmental toxins. Unlike many other cancers, the incidence of HNSCC is growing, yet the treatment options and outcomes have not been significantly improved for decades. An increased understanding of the molecular mechanisms of these cancers is needed for improvement in early diagnosis, enhanced treatment effectiveness, and cancer prevention. 4-nitroquinoline 1-oxide (4NQO) is a well-tested, tobacco mimicking, carcinogen. 4NQO produces similar histological and chemical changes found in human …

The Effect Of Interproximal Home Regimens Of Inflammatory Biomarkers In Periodontal Maintenance Patients, Grace Moore

Theses & Dissertations

A survey of dental hygienists in general practice (DHGP; n = 74) and periodontal practice (DHPP; n = 62) indicated a difference (p £ 0.04) in preference for interproximal cleaning with oral irrigators (DHGP) and interproximal brushes (DHPP) during periodontal maintenance therapy (PMT). The purpose of the subsequent blinded, randomized controlled clinical trial was to compare the effect of interproximal cleaning aids on reducing inflammation in posterior pockets during PMT. Seventy-six patients on PMT with a 5-7 mm interproximal probing depth were randomly allocated to one of three groups: 1) interproximal brush with tracking device (IB + TD; n=23), 2) …

The Effect Of Orthodontic Treatment With Extraction On The Upper Airway Dimensions And Three-Dimensional Morphology: A Retrospective Study Using Cone-Beam Computed Tomography Technique, Ehsan Mostaghni

Theses & Dissertations

The purpose of this study was to evaluate the effect of orthodontic treatment with and without extractions of teeth on the upper airway dimension and morphology. Records of 40 consecutively treated patients who received orthodontic treatment with or without dental extractions were evaluated. Pre-and post-treatment volumes, minimum cross-sectional areas, and linear dimensions of oropharyngeal airways were quantified using InVivo Dental 6.0 (Anatomage, San Jose, CA). Additionally, pre and post CBCT images of the upper airways were superimposed on each other using voxel-based registration and fixed coordinate system using 3D Slicer 4.1.1 (www.Slicer.org) and ITK-SNAP (http://www.itksnap.org). While the …

Alignment Of Cervical Vertebrae And Reliability Of Cephalometric Measurements, Ece Agirgol

Theses & Dissertations

Cervical vertebrae are in close relationship with dentofacial structures due to their anatomical position. In previous studies, the inclination of cervical vertebrae was measured by mostly Nasion-Sella line as the reference plane to evaluate the relationship with dentofacial structures.

The aim of this study is to observe the correlation between cervical vertebrae inclination and lateral cephalometric measurements. 124 lateral cephalograms taken in Natural Head Position of subjects over 18 years of age were traced with Dolphin Imaging Software 11.95 Premium. Cervical vertebrae inclination was measured by using the lines passing from landmarks on second, third and forth cervical vertebrae. Correlation …

The Effect Of Locally Applied Simvastatin On Clinical Attachment Level And Alveolar Bone In Periodontal Maintenance Patients, Lauren Krell

Theses & Dissertations

The purpose of this double-blinded, randomized, controlled trial was to determine if the local application of simvastatin (SIM), combined with minimally invasive papilla reflection and root preparation (PR/RP), is effective in improving clinical attachment level (CAL), primary outcome measure; probing depth (PD) reduction; increasing interproximal bone height (IBH); and reducing bleeding on probing (BOP) in persistent 6-9 mm periodontal pockets in patients receiving periodontal maintenance therapy (PMT). Fifty patients with Stage III, Grade B periodontitis (AAP, 2018) presenting with a 6-9 mm interproximal PD with a history of bleeding on probing (BOP) were included in the study. Experimental 2.2 mg …

The Effect Of Simvastatin On Periodontonal Inflammation In Periodontal Maintenance Patients, Devin L. Christiansen

Theses & Dissertations

The purpose of this analysis of inflammation markers from a double blinded, randomized, controlled clinical trial was to determine if local application of simvastatin, combined with minimally invasive papilla reflection/root preparation (PR/RP) is effective in reducing markers of inflammation: 1) bleeding upon probing (BOP), 2) tissue inflammatory / anti-inflammatory gene activation (rt-PCR) and 3) corresponding gingival crevicular fluid (GCF) protein production in non-resolving 6-9 mm periodontal pockets in patients on periodontal maintenance therapy (PMT). Fifty periodontal maintenance patients diagnosed with advanced chronic adult periodontitis presenting with a 6-9 mm interproximal PD were included in study. Experimental (PR/RP+SIM; n=27) and control …

Stress Relaxation In Orthodontic Aligner Plastics; An In Vitro Comparison Study, Kristopher J. Keller

Theses & Dissertations

The purpose of this study was to ascertain if repeated stresses from extension cycling would result in accumulated damage in aligner materials and affect force delivery. A secondary goal was to identify potential differences in mechanical behavior present among orthodontic aligner polymers. Four thermoplastic polymers (Essix ACE, Taglus, Zendura, and Zendura FLX) were thermoformed, cut into strips, and extension cycled to 0.4 millimeters in a 37C water bath. Force decay, maximum and minimum force, and elastic modulus were measured during cycling. Additional samples were subjected to controlled tension until failure, allowing the measurement of yield strength, ultimate strength, and elastic …

Inflammatory Cytokine Expression Of Immune Cells On Exposure To Invisalign® Material: An In Vitro Pilot Study, Alaina M. Allen

Theses & Dissertations

The purpose of this study is to characterize the inflammatory cytokines that are expressed in peripheral blood mononuclear cells (PBMCs) and THP-1 monocytes exposed to Invisalign^® aligner material in vitro. Invisalign^® material was ground into particles, soaked in artificial saliva, and the eluate was collected. Commercially available cryopreserved pooled and individual human PBMCs and THP-1 monocytes were cultured with Invisalign^® material eluate and positive (lipopolysaccharide) and negative controls. The supernatants were collected and used with a BioLegend LEGENDplex^™ multi-analyte flow assay, a sandwich enzyme-linked immunosorbent assay (ELISA), to identify the expression of TNF-α, IL-6, IL-8, IL-10, …

Outcomes Of Unilateral Alveolar Clefts Grafted Using Recombinant Human Bone Morphogenetic Protein-2: A Retrospective Volumetric Analysis Using Cbct, Landon Robert Peterson

Theses & Dissertations

Purpose of this study is to evaluate the success rates of secondary alveolar grafts using recombinant human bone morphogenetic protein with CBCT and to evaluate the effects of several variables on these outcomes. After our inclusion/exclusion criteria, records of 24 patients receiving secondary alveolar grafts at the University of Nebraska Medical Center were evaluated. Pre-graft and 6-month post-graft cleft volumes were measured using ITK-SNAP 3.8.0 software to determine a percent residual defect following surgery. Of the 24 patients, one was excluded as the graft surgery was deemed a failure. The patients’ gender, age, side of cleft, cleft side canine root …

Effect Of Nanofiller Coating And Loading On Facial Elastomer Physical Properties, Rahmi K. Aulia

Theses & Dissertations

Current materials used for facial prostheses are far from being desirable, and improved properties with “skin-like” feel are needed. This study evaluates property changes induced by sequential additions of uncoated and hydrophobic-coated nano-SiO₂ to polydimethylsiloxane (PDMS) and compares them with those measured for conventional submicron SiO₂-filled materials. Each filler type was sequentially added to vinyl-terminated PDMS at 0%, 0.5%, 5%, 10%, and 15% by weight. Tensile, tear, Durometer hardness, translucency and viscoelastic properties were evaluated, with hardness and translucency also evaluated following 3000 hours of outdoor weathering. Results demonstrated that 15% coated nano-SiO₂-filled PDMS materials …

Orthodontically Induced External Root Resorption In Extraction Versus Non-Extraction Treatment Modalities – A Retrospective Cone-Beam Computed Tomography (Cbct) Study, Jaykishan Patel

Theses & Dissertations

Purpose of this study was to evaluate orthodontically induced external apical root resorption using cone beam computed tomography in patients receiving orthodontic treatment with or without extractions. Records of 188 consecutively treated patients who received orthodontic treatment with or without extractions were evaluated. Pre-and post-treatment root lengths of maxillary incisors, volumes of maxillary central incisors, and apex displacement of either right or left maxillary central incisors were measured using Invivo 5.4 or ITK-SNAP 3.8.0 software. After adjusting for initial length, treatment duration, tooth, sex, race, bracket type, and malocclusion, maxillary incisor reduction of root length in extraction group was 0.37 …

The Effectiveness Of Resin-Modified Glass Ionomer Varnish In Preventing White Spot Lesions During Fixed Appliance Orthodontic Therapy: An In Vitro Study, Bradley Herman

Theses & Dissertations

The purpose of this investigation was to evaluate the efficacy of a glass ionomer varnish in preventing demineralization of enamel adjacent to and some distance away from an orthodontic bracket. Forty extracted human molars were divided into four different treatment groups (varnish in distilled water, varnish in acetic acid, enamel in acetic acid, and enamel in distilled water). Two 3 x 3 mm graphite windows were drawn on the tooth, one adjacent to the bracket and one 3 mm away from the first window, indicating the scanning area. Varnish was applied to the teeth in the varnish groups and all …

Perception Of Bone Mineral Loss On Cone-Beam Computed Tomography (Cbct) & Digital Periapical (Pa) Film: An Ex-Vivo Comparison, David P. Hamm

Theses & Dissertations

Using micro computed tomography (micro-CT) as a reference standard, the purpose of this investigation was to evaluate the influences of bone mineral loss and radiographic contrast in digital periapical (PA) film and cone-beam computed tomography (CBCT). Seven dog and human mandibles were sectioned, followed by modification via cortical bone drilling to create 248 lesions and/or trabecular bone acid demineralization to create 96 coronal slice pairs. Pretreatment and post-treatment radiographs (PA, CBCT, and/or micro-CT) were taken for lesion rating/perception in addition to two-dimensional (area) and three-dimensional (volumetric) measurements of 50 drilling lesions and 20 coronal slice pairs. 4-7% bone mineral loss …

The Effect Of Enamel Matrix Derivative/Papilla Reflection Surgery On The Clinical And Alveolar Bone Outcomes In Periodontal Maintenance Patients, Erica E. Jasa

Theses & Dissertations

The purpose of this study was to determine if local application of enamel matrix derivative (Emdogain; EMD), combined with minimally invasive papilla reflection/root preparation (PR/RP), is effective in improving probe depth (PD), clinical attachment level (CAL), and interproximal bone height (IBH) in persistent 6-9 mm periodontal pockets in patients on periodontal maintenance therapy (PMT). Fifty periodontal maintenance patients with advanced chronic periodontitis presenting with a 6-9 mm interproximal PD were included in study. Experimental (PR/RP+EMD; n=24) and control (PR/RP+S; n=26) therapies were randomly allocated. Roots were treated with reflection of interproximal papillae, root planing assisted with endoscope evaluation, and acid …

The Effect Of Emdogain Periodontal Regenerative Material On Inflammation In Periodontal Maintenance Patients, Jessica M. Gradoville

Theses & Dissertations

The purpose of this double-blinded, randomized, controlled clinical trial was to determine if local application of enamel matrix protein derivative (Emdogain:EMD), combined with minimally-invasive papilla reflection is effective in reducing inflammation in periodontal pockets in patients on periodontal maintenance therapy (PMT).Fifty patients diagnosed with advanced chronic periodontitis presenting with a 6-9mm interproximal probing depth were included in the trial. Experimental (EMD; n=24) and control (saline, n=26) therapies were randomly allocated. Roots were treated with mini-flaps and root planing assisted with endoscope evaluation before EMD or saline application. Inflammation was assessed by bleeding on probing (BOP) at baseline, 6-, and 12-months …

Effects Of Class Ii Correctors And Functional Appliances On The Periodontal Health Of The Mandibular Incisors – A Prospective Cone-Beam Computed Tomography (Cbct) Study, David C. Duevel

Theses & Dissertations

The purpose of this investigation was to evaluate the effects of Class II correctors and functional appliances on the dentoalveolar support of the mandibular incisors during orthodontic treatment. Twenty six patients who were treated with a Forsus^TM, Herbst, or MARA participated this study. Lateral cephalometric radiographs, limited field-of-view CBCTs, and periodontal measurements were collected both the day of appliance activation and day of appliance deactivation. Ten hard tissue measurements on all four mandibular incisors were collected at each time point on CBCT images. Bone thickness increased at 6 and 9 mm apical from the cementoenamel junction (CEJ) on …

Changes In The Transverse Dimension Of The Nasomaxillary Complex Following Rapid Palatal Expansion – A Post-Retention, Cbct Evaluation, Allison Schubert

Theses & Dissertations

Purpose: The purpose of this investigation was to evaluate the immediate and long-term effects of palatal expansion on the transverse dimension of the nasomaxillary complex.

Materials and Methods: Twenty-eight patients’ CBCTs were obtained at four time points: pre-expansion (T₁), post-expansion (T₂), pre-treatment (T₃), and middle or end of orthodontic treatment (T₄). The patients’ age, sex, cervical vertebral maturation stage, and the number of instructed expander turns were recorded. Measurements of the nasal floor, nasal passage, maxillary sinus, maxillary first molar mesiolingual cusp, maxillary first molar palatal cusp, maxillary first molar buccal cortical …

Cpap-Mad Combination Therapy For Cpap Intolerant Patients With Moderate To Severe Osa, Jacob Stadiem

Theses & Dissertations

The treatment of obstructive sleep apnea (OSA) allows for a multidisciplinary approach between dentistry and medicine. Continuous positive airway pressure (CPAP) is the gold standard for OSA treatment, but the non-adherence rates are high. The mandibular advancement device (MAD) has a higher acceptance rate than the CPAP, however the efficacy is much lower in cases of moderate to severe OSA. This thesis attempted to evaluate if there was a change in compliance when a MAD was added as a combination therapy to moderate to severe OSA subjects that were currently non-compliant with their CPAP. In addition, the change in air …

The Effect Of Mechanical Vibration On Pain And Rate Of Tooth Movement During Initial Orthodontic Alignment, Leslie Ellingson

Theses & Dissertations

Purpose: The purpose of this investigation was to evaluate the effect of mechanical vibration on pain experienced and rate of tooth movement (OTM) during the initial alignment phase of orthodontic treatment.

Materials and Methods: Participants were randomly allocated to control, low frequency or high frequency. An electric toothbrush was modified to provide high frequency vibration. A low frequency vibration device was acquired from a commercial vendor. Experimental groups applied vibration to the dentition for 20 minutes daily. All participants completed questionnaires using visual analog scales at five time points. Pain experience was measured in millimeters (mm) with the scale measuring …

Hospital Based Emergency Department Visits With Dental Conditions: Outcomes And Policy Implications In The States Of California, Nebraska And New York, Sankeerth Rampa

Theses & Dissertations

The purpose of this dissertation was to present state-level estimates of hospital-based emergency department (ED) visits with dental conditions across all ages in the states of California, Nebraska, and New York. Also, this dissertation examined the outcomes and impact of changes in Medicaid policies on the utilization of ED with dental problems. State Emergency Department Databases (California, Nebraska, and New York), a component of the Healthcare Cost and Utilization Project (HCUP) was used for this dissertation. Dental conditions were identified by using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. High-risk groups visiting EDs with dental conditions were …

Bone Loss Quantification Following Extraction In Rats: A Foundation For Grafting And Regenerative Studies, Emily Willett

Theses & Dissertations

Background: Loss of the alveolar ridge width and height following extraction is well-documented and several techniques, including grafting, have been proposed to reduce bone loss. Purpose: To characterize the pattern of bone turnover and inflammation after extraction and to initiate a study of the effect of grafting and local administration of simvastatin (SIM). Methods: Thirty-two retired-breeder rats underwent extraction of the right maxillary first molar and standard surgical defect creation under inhalation anesthesia. The left side of each animal served as the unmanipulated control. Comparison of groups (n=8, ANOVA) was done at days 0, 7, 14, and …

Effects Of Flash-Free Technique On Plaque Retention, White Spot Lesions, And Bracket Failure: A Randomized Clinical Trial, Payam Ishani Afousi

Theses & Dissertations

A side effect of orthodontic treatment is the development of white spot lesions (WSLs). This thesis attempted to evaluate the effects of the use of APC™ Flash-Free (FF) and conventional adhesives in bonding of orthodontic brackets on plaque formation and retention, WSL development, and bracket failure in-vivo. This was accomplished by collecting plaque samples from around orthodontic appliances and analyzing them using ATP-driven bioluminescence; scanning enamel surfaces using the Canary System™ to evaluate WSL development, and counting the number of spontaneous debonding of brackets of the 4 maxillary incisors in the first 6 months of treatment. It was found …

Local Minocycline To Reduce Future Inflammation And Bone Loss In Periodontal Maintenance Patients, Jeffery S. Jensen

Theses & Dissertations

The objectives of this study were to compare the effect of SRP+MM versus SRP alone on inflammatory cytokines, interleukin (IL)-1β and IL-1 receptor antagonist (ra), found in gingival crevicular fluid (GCF) and saliva, and correlate IL-1 values with clinical outcomes over a 2-year period of PMT. Fifty-five patients with an initial posterior pocket ≥5 mm and history of bleeding on probing (BOP) were randomized to test (SRP+MM, n=27) and control (SRP, n=28) groups. Clinical measurements and GCF samples were done at baseline and 24 months. SRP+MM or SRP were provided at 6-month intervals. IL-1β and IL-1ra were measured in GCF …

Color Stability, Physical Properties And Antifungal Effects Of Zro2 And Tio2 Nanoparticle Additions To Pigmented Polydimethylsiloxanes, Mazen Alkahtany

Theses & Dissertations

Introduction: Color changes, physical degradation and fungal infections are potential challenges to the longevity of polydimethylsiloxane (PDMS) elastomers. The purpose of this study was to evaluate potential improvements in color change, physical properties and anti fungal properties of PDMS loaded with TiO2 and ZrO2 nanoparticles.

Methods: 1% weight of 40 nm or 200 nm diameter TiO2 or ZrO2 nanoparticles were mixed into PDMS with 2% functional intrinsic yellow pigment and polymerized. Control materials contained 13% weight 200 nm silica. Samples were exposed to either 3000 hours of UVB radiation (200 μW/cm2) or darkness. Color parameters L*a*b* and ΔE*, ultimate tensile …

Squamous Cell Carcinoma Response To Cisplatin Exposure, Khanh V. Luong

Theses & Dissertations

Purpose: This thesis attempted to quantitatively analyze the individual cell fate choice in resistant head and neck UM-SCC38 cells exposed to cisplatin using the most current techniques available.

Methods: UM-SCC-38 cells were grown in Dulbecco’s modified Eagle’s medium (DMEM) supplemented with 10% fetal bovine serum (FBS). They were treated with cisplatin and ATM/ATR inhibitors of known dosages. Using live cell imaging, one hundred cells were tracked in each experiment and their behaviors were analyzed and entered into Microsoft Excel Spreadsheet to generate cell profile graphs. HaCaT cells, non-tumorigenic keratinocyte cell line, were also analyzed using live cell imaging and their …

Prevention Of Experimental Periodontitis In Rats With A Simvastatin Prodrug, Aaron Bradley

Theses & Dissertations

Introduction: Simvastatin (SIM) is a hypolipidemic drug that has been shown to have anti-inflammatory and bone anabolic properties. The aim of this study was to examine the effects of novel locally-applied SIM conjugated with methoxypolyethylene glycol to form micelles (SIM/SIM-mPEG) in an experimental periodontitis model in rats using micro-computed tomography (µ-CT) and histologic evaluation.

Methods: Experimental periodontitis was induced using silk ligatures around the maxillary right second molar (M2) in 40 Sprague-Dawley rats. Rats were divided into five groups using SIM/SIM-mPEG at 0.5, 1.0, or 1.5 mg SIM doses, mPEG-alone or no drug (ligature-alone) injected into the palatal M1-M2 gingiva …

Effect Of Chemical Pocket Disinfection As An Adjunct To Non-Surgical Maintenance Therapy Of Inflamed Periodontal Pockets, Chad Riggs

Theses & Dissertations

Purpose: Scaling and root planing with adjunctive chemical pocket disinfection (SRP+C) utilizing sodium hypochlorite solution has been used to treat inflamed pockets of periodontal maintenance patients for many years, without evidence of its benefits. The primary objective was to determine if SRP+C is more effective than scaling and root planing alone (SRP) in improving clinical outcomes. The secondary objective was to compare the effect of SRP+C and SRP on pro-inflammatory IL-1β, anti-inflammatory IL-1ra, and anti-inflammatory index (IL-1ra/IL-1β ratio) found in gingival crevicular fluid (GCF).

Materials and Methods: Pockets (≥ 5 mm and BOP) of 31 maintenance patients were included. Test …