Dentistry Commons^™

Factors Associated With Tooth Loss In Periodontal Maintenance Patients: A Retrospective Study, Nicholas D. Stolze, Randin A. Rawlings, W. Edward Hardy, Kaeli K. Samson, Laura E. Ruiz, Bobbie J. Fowler, Kavya Shankar Muttanahally, Jeffrey B. Payne

Graduate Medical Education Research Journal

Background. Tooth retention is related to overall health and quality of life. Thus, it is important to understand factors associated with tooth loss. The objective of this cross-sectional study was to evaluate associations between systemic and oral factors with tooth loss in a retrospective study of periodontal maintenance patients.

Methods. Periodontal maintenance patients seen in both 2013 and 2019 at the University of Nebraska Medical Center College of Dentistry were included. Demographic data, smoking status, diabetes status, periodontitis stage and extent, medication use, alveolar bone height, probing depths, and tooth mobility were recorded from the electronic dental record. Adjusted odds …

Investigate The Role Of Tgfβ3 In Regulating Irf6 And Δnp63 In Periderm Desquamation, Nam Ha

Theses & Dissertations

Introduction: Failure in palatal fusion during palate development results in cleft palate, one of the most common birth defects in the US. During the final phases of palatogenesis, the palatal periderm (a protective cell layer that prevents premature fusion and adhesion with oral epithelium) must be removed, also known as desquamation. This process is a prerequisite for establishing the midline seam in the fused palate. Previous studies have shown that transforming growth factor-β3 (TGFβ3) plays an irreplaceable role in palate development in mice. Our previously published mechanistic models outline the role of TGFβ3 and its downstream signaling cascade involving proteins …

Posterior Anatomic Limit For Mandibular Molar Distalization In Subjects With Different Growth Patterns, Genders, And Growth Status, Rehana Bashir

Theses & Dissertations

The objective of this study is to identify the anatomical limits for mandibular molar distalization, a technique frequently employed in orthodontics to address various malocclusions. Mandibular molar distalization plays a critical role in the management of crowding, and correction of the molar relationship.

It is imperative to assess the posterior anatomical space (PAS) in the mandibular retromolar area prior to distalization or uprighting the mandibular molars to avoid periodontal issues (dehiscence, orthodontically induced root resorption, and tooth mobility) and achieve successful treatment outcomes.

A clinical question that, however, isn't well understood is whether the amount of mandibular molar distalization is …

Improving Oral Hygiene Practices In A Long-Term Care Setting For Individuals With Advanced Dementia: A Quality Improvement Initiative, Rachel L. Mcinerney

Capstone Experience: Master of Public Health

This quality improvement project utilized the Plan-Do-Study-Act framework to enhance oral hygiene practices in a long-term care setting for individuals with advanced dementia. Advanced dementia often leads to significant oral health challenges due to the individuals’ inability to communicate needs or independently manage oral care. Poor oral hygiene results in pain, systemic infections, and reduced quality of life. The project aimed to identify and address barriers to effective oral care delivery by focusing on organizational factors such as leadership, training, and caregiver support. This capstone paper provides insights into the quality improvement initiative’s aims, background, and methodology, while emphasizing its …

The Use Of Platelet-Rich Fibrin In Maintaining Vascularity For Intentionally Replanted Teeth: A Randomized Clinical Trial, Elizabeth L. Easley-Perez, Joseph B. Bavitz, Lynette M. Smith, Peter J. Giannini

Journal Articles: College of Dentistry

Background: A primary goal for a mature tooth autotransplant is preserving tooth vitality. Platelet-rich fibrin (PRF) has characteristics that may improve the success of autotransplanted mature teeth by decreasing harmful inflammation and boosting vascular growth. This prospective human trial aimed to evaluate the effectiveness of PRF on vitality in a mature tooth replantation model. Methods: This double-blind, randomized controlled trial included 18 participants with 70 single-rooted vital teeth planned for prosthetic extraction. Experimental teeth were extracted and apicoectomized to increase vascular growth. PRF was condensed into the canals before teeth were replanted in their respective sockets. In the same patient, …

Development Of A Streptococcus Mutans Biofilm Model On A Typodont Platform To Investigate Its Dynamics In Orthodontics, Hibah Chughtai

Theses & Dissertations

Introduction: Biofilm formation plays a significant role in dental health, resulting in plaque accumulation, which can lead to caries and oral diseases. Streptococcus mutans (S. mutans) is a key bacterium involved in this process. The goal of this study was to establish a protocol for the development of an S. mutans biofilm on dental typodont teeth to analyze the effects of orthodontic brackets on biofilm formation. Understanding these dynamics is critical for developing strategies to mitigate biofilm accumulation during orthodontic treatment. Methods: S. mutans biofilms were cultivated under three conditions: 96-well tissue culture plates, S. mutans inoculated non-bracketed …

The Impact Of Aging On Fibroblast Gene Expression In Post-Extraction Wound Healing: A Single-Cell Rna Sequencing Study, Paula Christina Cohen Schlemmer

Theses & Dissertations

Wound healing is slower in aged patients. Immediately after tooth extraction, fibroblasts are activated to rebuild the ECM, which is later remodeled through the expression of MMPs. Gene expression may be altered in fibroblasts of aged patients leading to deficiencies in ECM deposition and the recruitment and proliferation of immune cells, resulting in a slow-healing fibrotic wound.

Using scRNA-seq, soft tissue was profiled from two healthy patients: one young and one aged at the time of tooth extraction. Two weeks post-extraction, a second soft tissue sample was harvested. Differentially expressed genes were used to identify enriched pathways for each …

Serum Antibodies To Periodontal Pathogens And Anti-Malondialdehyde-Acetaldehyde: Potential Role In The Interrelationship Between The Periodontium And Rheumatoid Arthritis, Joyce Lee

Theses & Dissertations

Objectives: Study 1 – To quantify associations between anti-Porphyromonas gingivalis, anti-Prevotella intermedia, and anti-Fusobacterium nucleatum serum antibody concentrations and risk of developing rheumatoid arthritis (RA). Study 2 – To test if periodontal clinical measures, alveolar bone loss (ABL), and the aforementioned serum anti-bacterial antibody concentrations are associated with anti-malondialdehyde-acetaldehyde (MAA) serum antibody concentrations.

Methods: Study 1 – Serum samples pre- and post- RA diagnosis (n=214 cases, 210 matched controls) from the U.S. Department of Defense Serum Repository were utilized to compare timing of elevations of anti-bacterial antibody concentrations relative to RA diagnosis and associations …

Breaking The Bamboo Ceiling And De-Bunking The Model Minority Myth, Yun Saksena

Journal Articles: College of Dentistry

Leadership roles must incorporate representation from all involved individuals for the resulting decision-making process to reflect the interests and expertise of a diverse organization. Many resources have rightly focused on developing historically underrepresented racial and ethnic (HURE) leaders. Though numbers of Black and Hispanic dental school deans have increased, more work is needed for these and other HURE groups such as American Indians. Asians are not classified as HURE. As an aggregated group they have robust presence in the dental workforce in North America, the United Kingdom and Australia. The assumption is they are fine, so the group is ignored. …

Machine Learning For Automated Cervical Vertebral Maturation Assessment On Lateral Cephalograms, Nuo Dong

Theses & Dissertations

Introduction: Skeletal maturation age is an important guide in growing adolescent patients to determine the proper time to start orthodontic treatment. The most practical and commonly used method to determine skeletal age in today’s clinical practice is the Cervical Vertebral Maturation (CVM) method [2]. Based on the morphology of the cervical vertebrae, six maturational stages can be determined – designated CS 1 to CS 6. The main drawback of this technique is the time required to determine CS number. Objective: In this research a machine learning (ML) algorithm to automatically determine CVM staging from the lateral cephalometric radiograph was developed. …

Biomechanics Of The Tip-Back Bend: An Analysis Of The Force System Via Translational Research, Lyndzie Brace

Theses & Dissertations

Purpose: The purpose of this study was to 1. experimentally (in vitro) quantify the force system acting on the molar and the incisor when a tip-back bend is placed on an auxiliary spring mounted on a base archwire and create a prediction model 2. to compare the type of tooth movement obtained from the prediction model (in-vitro) and the clinical outcome (in-vivo) data obtained from a previously conducted clinical trial. Methods: A computerized 3-dimensional (3D) orthodontic force tester (OFT) was used to quantify and compare the force systems generated from different combinations of tip-back bend archwires and base …

Three-Dimensional Analysis Of Condylar Displacement After Orthognathic Surgery In Patients With Facial Asymmetry, Teresa Bae

Theses & Dissertations

Facial asymmetry is apparent when there is a clinically significant variation between the two halves of the face. There can be varying degrees of facial asymmetry and mild asymmetry can be treated by orthodontics alone. For severe facial asymmetry a combination of orthodontics and orthognathic surgery may be necessary. The condyle must be in a stable position following surgery to have functional and structural stability and prevent relapse. This research proposal is to perform a retrospective CBCT study on the displacement of the condyle following orthognathic surgery in patients with facial asymmetry. The CBCTs were obtained from Taipei Veterans General …

Strategies To Encourage Recall And Prevent Relapse After Full Mouth Rehabilitation Under General Anesthesia In Children, Claire Koukol

Capstone Experience: Master of Public Health

Background: Dental caries are preventable. Dentists utilize many prevention strategies in the office and provide at-home education to families. However, once a child develops Early Childhood Caries (ECC), especially in more severe cases, they may need general anesthesia (GA) to complete treatment. While this is an effective way to achieve full mouth dental rehabilitation (FMDR), this burdens the healthcare systems and families and does not come without risk to the patient. Patients with high caries experience remain at high risk of caries relapse after FMDR under GA, sometimes necessitating additional FMDR under GA. While there has been a significant amount …

Nutrition Needs Assessment For A Produce Prescription Program In The Pediatric Dental Setting, Zachary Houser

Capstone Experience: Master of Public Health

More than half of young people in the U.S. aged 2-19 have a poor-quality diet, including low fruit and vegetable (FV) intake (Liu et al., 2020). Poor nutrition increases health risks, including chronic diseases such as dental caries and obesity, low-income households experience higher rates of poor nutrition and subsequent health burdens (AAPD, 2022b). Produce prescriptions (PPR) are a type of financial incentive program that can improve FV intake among low-income populations (Ridberg et al., 2019). PPR programs are often conducted in a primary medical setting (Little et al., 2022); however, no literature describes PPR programs conducted in a dental …

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 …

Reducing Oral Health Disparities: Effectiveness Of Preventive Dental Care On Treatment Use, Expenditures And Determinants Of Service Utilization, Rashmi Lamsal

Theses & Dissertations

Given the importance of oral health in maintaining the general health and well-being of an individual, this dissertation includes three independent studies examining dental care utilization and expenditures among adults in the U.S. The first study examines the effectiveness of preventive dental visits on treatment utilization and expenditures among adults aged 18 and above. The second study focuses on the impact of paid sick leave on different types of dental services utilization among working adults aged 18-64. Finally, the last paper compares the differences in dental care utilization and related expenditure between foreign-born and US-born adults with diabetes. The paper …

Accuracy Of Interproximal Reduction In Commonly Used Operator Positions Using An Intraoral Scanner, Behnoush Bakhtiari

Theses & Dissertations

Introduction: The aim of this study was to determine operator’s best position when doing interproximal reduction. Also, to determine if these positions are ergonomically recommended.

Materials and methods: 54 sets of upper and lower models were scanned and 3D-printed. Air-rotor stripping was performed at different provider positions. Vertical and horizontal deviations were measured, and errors were recorded.

Results: In LA, there was no statistically significant difference between vertical deviations in P7 and 11, however, they were both superior to P9. In LL, P11 leads to significantly lower vertical deviation than P7 and 9. In LR, P9 and 11 were superior …

Assessing The Agreement Of Light Microscopic Evaluation Of Oral Lichen Planus Lesions With Associated Direct Immunofluorescence Evaluation, Blake T. Hansen, Jeffrey B. Payne, Kaeli Samson, Peter J. Giannini

Journal Articles: College of Dentistry

AIM/OBJECTIVE: Assess agreement between light microscopy and direct immunofluorescence (DIF) for histopathologic evaluation of oral lichen planus (OLP).

METHODS: Records evaluated included 60 OLP, 16 lichenoid mucositis (LM), and 56 non-OLP/non-LM cases. Cases had both light microscopic and DIF evaluations. Histopathologic parameters of OLP included: (1) hydropic degeneration of the basal cell layer, (2) band-like lymphocytic infiltrate immediately subjacent to the epithelium, and (3) presence of Civatte bodies. Two calibrated examiners independently assessed light microscopic features. Examiners reviewed cases with discordant diagnoses to determine a consensus diagnosis. Intra-rater reliability (IRR), sensitivity, specificity, positive, and negative predictive values (PPV and NPV) …

Aerosols In Orthodontics: Characterization Of Particle Size And Travel Distance, Donte Jochum-Nesbitt

Theses & Dissertations

Introduction: Aerosol production is a key contributor to occupational risk and disease transmission in the dental clinic. These aerosols can host harmful pathogens, such as SARS-CoV-2. Considering the 2020 pandemic, researchers endeavored to bolster the existing body of literature related to disease transmission via aerosols and droplets to provide better recommendations for infection control. This investigation aims to support that mission by characterizing the risk to orthodontic professionals and patients based on aerosolized particle size and travel distance. Methods: The experimental protocol used in this study was validated through a smaller scale pilot study in 2021. High- and Low-risk orthodontic …

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 State Of Oral Health In People With Disabilities And The Impact Of Family-Centered Care On The Oral Health Of Children With Special Health Care Needs, Bedant Chakraborty

Theses & Dissertations

Oral diseases are one of the most prevalent non-communicable, chronic diseases of the 21st century. Yet, dental diseases are generally neglected and are a top concern for policymakers globally. The burden of oral diseases disrupts routine activities that affect the overall quality of life, especially for those with special healthcare needs. Dental diseases have also been marked as the “silent epidemic” and are the leading secondary health condition that affects individuals with disabilities. Disabled people are less likely to receive timely and adequate dental care, which could be tied to poor oral health outcomes among them. This group of studies …

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 …

Characterization Of Aerosols Produced By Common Orthodontic Procedures, Anna R. Schoettger

Theses & Dissertations

Introduction: Aerosols can harbor active viruses, including SARS-CoV-2, making it vital that clinical protocols implemented in the orthodontic office be based on which procedures produce aerosols. Research shows that various procedures in the field of orthodontics generate aerosols, however, there is a lack of consensus as to which procedures should be deemed aerosol-generating procedures (AGPs). The current study aimed to better understand aerosol production of various orthodontic procedures. Methods: Orthodontic procedures were performed in a closed-room dental operatory on acrylic teeth mounted onto a dental manikin. Procedures performed included: debonding, bonding, and repositioning of one bracket. Variations introduced included: high-speed …

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 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 …

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 …

Re-Imagining Machine Learning In Dental Research: A Lesson Learned From The Covid-19 Pandemic, Jafar Kolahi, Mohammad Seyedhamzeh, David G. Dunning, Nader Kalbasi

Journal Articles: College of Dentistry

At this time, humankind is experiencing on a global scale a frightening infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of September 25, 2020, more than 32.3 million cases have been reported in 188 countries, resulting in more than 984,000 official reported deaths.^[1],[2] During the course of human history, there have been several pandemics, for example, plague and smallpox. However, one of the main differences between COVID-19 and previous pandemics is the availability of computer-based technologies. Paralleling the global growth of COVID-19, studies using computer-based technologies have emerged (e.g., machine learning) to fight against …

Prerequisites In Behavioral Sciences And Business Revisited A Decade Later: Ongoing Opportunities For Dental Education, Rebecca M. Beckler, Natalie A. Nuckolls, David G. Dunning

Journal Articles: College of Dentistry

Introduction: Ten years ago a study reported on the lack of prerequisites in behavioral sciences and business management for entry into dental college. The primary objective of this follow-up study was to assess the current status of similar prerequisite courses in both U.S. and Canadian dental schools. Materials and Methods: Required and recommended courses in behavioral sciences and in business in each North American dental school's official online publication were analyzed in December 2019. Admissions requirements were readily available in sixty-five of the sixty-eight U.S. dental schools and in all ten schools in Canada; three U.S. schools were contacted by …

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, …