The Effects Of Amixicile On Sub-Gingival Biofilm Cultured From Humans, Kian Azarnoush

Theses and Dissertations

Periodontitis is an inflammatory disease of the oral cavity induced by anaerobic bacteria, that remains to be the primary cause of tooth loss in adults worldwide. Finding an anti-microbial therapeutic to selectively target periodontal pathogens has proven to be difficult, and current treatment modalities only provide a transient benefit. Amixicile is a non-toxic, readily bioavailable novel antimicrobial that targets strict anaerobes through inhibition of the activity of Pyruvate Ferredoxin Oxidoreductase (PFOR), a major enzyme mediating oxidative decarboxylation of pyruvate, a critical step in metabolism. Our study aimed to evaluate the efficacy of amixicile in inhibiting the growth of bacteria harvested …

Observations Of Trends And Successes Of Revascularization Therapy At Virginia Commonwealth University: A Retrospective Study, Richard W. Sedwick

Theses and Dissertations

The aim of this study was to determine the trends in protocol, success rates, and consistency in follow up of revascularization procedures in a controlled environment. Patients of the Virginia Commonwealth University School of Dentistry were identified who were offered revascularization therapy as a treatment option on immature permanent teeth from January 1, 2010 to May 31, 2017. A total of 77 patients and 78 teeth were evaluated for revascularization therapy. For patients accepting treatment, records were reviewed for outcome assessment and consistency of follow up. A total of 30 patients (31 teeth) were treated following revascularization protocols, with only …

Prevalence And Clinical Characteristics Of Teeth Extracted With A Diagnosis Of Cracked Tooth: A Retrospective Study, Riley B. Sturgill

Theses and Dissertations

The body of knowledge that exists regarding cracked teeth is limited. The purpose of this study was to determine the prevalence of cracks among extracted teeth. This retrospective longitudinal cohort study included patients of the Virginia Commonwealth University School of Dentistry that underwent extraction procedures over a 6 year period. The sample consisted of 20,408 patients and 40,870 teeth. Statistical analysis software was used to identify diagnoses of a crack, fracture, or split tooth prior to extraction of the tooth by analyzing the Electronic Health Record (EHR) (axiUm™, Version 6.03.03.1035, Exan Corporation, Vancouver, BC, Canada). There were 3,228 teeth …

Evaluation Of Volumetric Change Of Periapical Lesions After Apicoectomy As A Measure Of Postsurgical Healing Utilizing Cone Beam Computed Tomography, Eshwar Arasu

Theses and Dissertations

The aim of this study was to evaluate whether volumetric changes in persistent periapical lesions can be detected in follow-ups six months to five years after apicoectomy using cone-beam computed tomography. Patients with a previous treatment history of apicoectomy and for whom a pre-surgical CBCT scan was taken between November 2010 and December 2015 were invited to participate in the study. A post-surgical CBCT image of the treated tooth was obtained at the recall visit. Volumetric and linear measurements of periapical lesions on initial and postoperative CBCT images were performed using DiThreshGUI software and two calibrated examiners—a board-certified endodontist and …

Orthodontists' And Parents' Perspective Of Occlusion In Varying Anterior-Posterior Positions: A Comparative Study, David H. Lindsey

Theses and Dissertations

Objective: The purpose was to compare orthodontists’ and parents’ perception of orthodontic treatment outcomes in the anterior-posterior (AP) dimension. Assessment of treatment time and compliance were also investigated.

Material and Methods: Parallel surveys for orthodontists (n=1000) and parents (n=750) displayed occlusions from 3 mm Class III (Cl III:3) to 3 mm Class II. Participants rated occlusal relationships on a 100 mm VAS from least to most acceptable (0-100).

Results: 233 orthodontists (23%) and 243 parents (32%) responded. Orthodontists (mean=93.9, 25.9) and parents (mean=80.7, 40.9) rated Class I (Cl I) occlusion most and Cl III:3 least acceptable. No significant difference was …

A Comparison Of Moderate Oral Sedation Drug Regimens For Pediatric Dental Treatment: A Pilot Study, Ojas A. Parikh

Theses and Dissertations

Purpose: Compare moderate oral sedation of pediatric patients using Hydroxyzine and Meperidine with either Diazepam or Midazolam in management of pediatric dental patients.

Methods: Randomized, double-blind, crossover pilot study of patients 3 to 7 years of age requiring two sedation visits. Frankl and Houpt behavior scores recorded at injection time, initiation of treatment and 100% oxygen at end of treatment. Postoperative phone call surveys conducted within eight hours and within 24 hours of discharge. Wilcoxon Signed-Rank tests, Fisher’s Exact Chi-squared test and 0.10 significance level.

Results: 25 subjects completed 35 sedations. Eight participants completed both treatments and demonstrated significantly higher …

Nitrosative Stress Sensing In Porphyromonas Gingivalis: Structure And Function Of The Heme Binding Transcriptional Regulator Hcpr, Benjamin R. Belvin

Theses and Dissertations

Porphyromonas gingivalis, a Gram negative anaerobe implicated in the progression of periodontal disease, is capable of surviving and causing infection despite high levels of reactive nitrogen species found in the oral cavity due to its efficient nitrosative stress response. HcpR is an important sensor-regulator that plays a vital step in the initiation of the nitrosative stress response in many Gram negative anaerobic bacteria. We employ a combination of X-ray crystallography, SAXS, resonance Raman spectroscopy, UV-Vis spectroscopy, and molecular biology techniques to better understand this key regulator. Knockout of the hcpR gene in W83 P. gingivalis results in the inability of …

Silver Diamine Fluoride And Oral Health-Related Quality Of Life, Nazafarin Javdan

Theses and Dissertations

Purpose: The purpose of this study was to study the association between Silver Diamine Fluoride (SDF) and Oral Health-Related Quality of Life as assessed by “The Early Childhood Oral Health Impact Scale” questionnaire. Methods: Parents of healthy children (ASA I and II) ages 1-5 with early childhood caries with reversible pulpitis who had application of SDF filled out a questionnaire at baseline and again after one month. The questionnaire was designed to evaluate the child’s behavior, physical abilities, pain, temperament, and how well the child gets along with others. Results: Wilcoxon Signed Rank Test was used to …

Amixicile Inhibits Anaerobic Bacteria Within An Oral Microbiome Derived From Patients With Chronic Periodontitis, Kane Ramsey

Theses and Dissertations

Periodontitis is a chronic inflammatory disease caused by pathogenic bacteria residing in a complex biofilm within a susceptible host. Amixicile is a non-toxic, readily bioavailable novel antimicrobial that targets strict anaerobes through inhibition of the activity of Pyruvate Ferredoxin Oxidoreductase (PFOR), a major enzyme mediating oxidative decarboxylation of pyruvate. Our study aimed to evaluate the efficacy of amixicile, when compared to metronidazole, in inhibiting the growth of bacteria present in a microbiome harvested from patients with chronic periodontitis.

Plaque samples were harvested from patients with severe chronic periodontitis and cultured under anaerobic conditions. The microbiomes were grown in the presence …

The Role Of Human Msc Derived Exosomes In The Treatment Of Periodontal Diseases, Sonia S. Talegaonkar

Theses and Dissertations

Periodontal disease affects 47% of Americans over 30. Characterized by microbial dysbiosis and unregulated inflammation, severe periodontitis causes degradation of bone and soft tissue around teeth. Current treatments have limited regenerative outcomes and frequent reinfection by harmful bacteria. Human mesenchymal stem cells (hMSCs) have been shown to promote wound healing and tissue regeneration. Many therapeutic benefits of hMSCs are due to their secretome products, like exosomes. Our long-term goal is to develop periodontal therapies with hMSC exosomes. The objectives of this study were to determine the effect of hMSC-derived exosomes on cellular activity of hMSCs and investigate whether hMSC exosome …

Provider Appearance: A Survey Of Guardian And Patient Preference, Joshua Westphal

Theses and Dissertations

Purpose: To understand guardian and child preferences for the appearance of their pediatric dentist. This was a cross-sectional descriptive study using survey methodology with patients and parents that attended the VCU Pediatric Dental clinic.

Methods: A total sample of 100 guardians and 97 pediatric patient participants completed the computer-based questionnaire. Four subjects were asked to pose for photographs wearing various combinations of attire (professional, casual, white coat, scrubs).

Results: Among guardians, 56% reported preferring a provider in scrubs, with white coat the second most preferred attire (39%) for their children. For pediatric patients, scrubs were still most often selected, …

Role Of The Pediatric Dental Provider In Human Papillomavirus (Hpv) Education, Meredith L. Dugoni

Theses and Dissertations

Purpose: This study investigates knowledge about HPV and examines if pediatric dental providers should include HPV education for guardians of patients 10-18 years.

Methods: Legal guardians of 10-18 year-old patients of the Virginia Commonwealth University Pediatric Dental Clinic were enrolled in this prospective cohort study. Participants completed a baseline survey, were provided HPV education, completed an initial follow-up survey, and then completed a 6-month follow-up survey.

Results: A total of 54 participants completed the baseline and initial follow-up surveys and 17 completed the 6-month follow-up survey. The average number of correct responses was 3.4 of 6 knowledge questions, which significantly …

A Comparative Study Of Intraradicular Enterococcus Faecalis Biofilm Removal With Three Root Canal Treatment Systems: A Scanning Electron Microscopy Evaluation, Cyrous Ardalan

Theses and Dissertations

The objective of this study was to evaluate the biofilm removal efficacy of three root canal treatment systems: ProUltra® PiezoFlow™, traditional needle irrigation, and the GentleWave® system in an ex-vivo benchtop study. Twenty-four extracted maxillary and mandibular molars were selected. Teeth were all instrumented to a master apical file size #25 with 4% taper. Teeth were then randomly divided into four experimental groups and two control groups. The root canals were inoculated with a culture of Enterococcus faecalis and incubated for five weeks to form a biofilm. Each group was then treated with one of the different root canal treatment …

A Comparison Of Treatment Planning Modalities For The Pediatric Dental Patient, Martha M. Holland

Theses and Dissertations

Purpose: To assess the treatment modalities of pediatric dentists for restoring Class II lesions in primary molars.

Methods: A survey of eight cases was emailed to AAPD members, who were asked to choose a stainless steel crown (SSC) or composite resin. Treatment choice was associated with provider type, years in practice, behavior management, lesion detection, and patient age.

Results: Clinically detectable caries restored under general anesthesia were treated more often with a SSC. Faculty and residents chose a SSC at a greater rate. Providers with 10 or more years experience chose a SSC more often.

Conclusions: The scope of treatment …

The Prevalence, Predictive Factors, And Classification Of Intrapulpal Cracks In Maxillary Molars Requiring Endodontic Treatment, Husain Karashi

Theses and Dissertations

Diagnosis and treatment of teeth with longitudinal fractures is challenging. Cracks are usually not visible radiographically; they require a thorough evaluation to aid in diagnosis. Patients may be asymptomatic, demanding the dentist rely on clinical findings to make a diagnosis. Early diagnosis of the presence and extent of a crack is essential for the successful management of a cracked tooth. There is limited information in the literature regarding the prevalence or predictive factors of cracks extending into the pulp chamber of teeth. The purpose of this study was to determine the prevalence of intrapulpal cracks in maxillary molars and to …

Profiling Precursor Lipids For Specialized Pro-Resolution Molecules In Platelet-Rich Fibrin Following Fish Oil And Aspirin Intake, Danielle M. Mccormack

Theses and Dissertations

Background: Current research has demonstrated that aspirin and fish oil (EFA) increase plasma levels of specialized pro-resolution molecules (SPMs). This study investigates their effects on SPM precursor pools in platelet rich fibrin (PRF). Methods: Twenty healthy volunteers were randomly assigned to take aspirin; EFA or aspirin and EFA. Four hours later, SPM precursor levels were quantified using combined Liquid Chromatography tandem mass spectrometry. The differences between the groups: Aspirin (yes or no), EFA (yes or no), were analyzed by ANCOVA, testing for group differences after covarying out the baseline value. Results: There were 4 significant interactions, 1 with an aspirin …

Profiling Precursor Lipids For Specialized Pro-Resolution Molecules In Platelet-Rich Plasma Following Fish Oil And Aspirin Intake, Lisa A. Turner

Theses and Dissertations

Background: Unfavorable outcomes following periodontal surgeries can be attributed to impaired resolution mechanisms likely due to decreased levels of specialized pro-resolution molecules (SPM). The current study investigates if SPM substrate pools in platelet-rich plasma preparations (PRP) can be increased by essential fatty acid (EFA) and / or aspirin supplementation. Methods: Nineteen healthy volunteers were randomly assigned to take i) aspirin; ii) EFA; iii) aspirin and EFA. Four hours after intake, the lipid precursor pools in PRP were quantified using combined Liquid Chromatography tandem mass spectrometry (LC-MS/MS) and the data statistically analyzed using ANCOVA. Results: Of the 77 metabolites screened, only …

An Investigation Of Surface Characteristics Of Enamel Treated With Infiltrative Resin: A Scanning Electron Microscopy Study, Danielle E. Easterly

Theses and Dissertations

AN INVESTIGATION OF SURFACE CHARACTERISTICS OF ENAMEL TREATED WITH INFILTRATIVE RESIN: A SCANNING ELECTRON MICROSCOPY STUDY

Danielle E. Easterly, Doctorate of Dental Surgery.

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. 2017.

Director: Dr. Eser Tüfekçi

D.D.S., M.S., Ph.D., M.S.H.A.

Objective: To evaluate the microstructural changes of a resin infiltrant (ICON®, DMG America LLC, Englewood, NJ) after six months of simulated toothbrushing.

Materials and Methods: Ten extracted third molars (n=10) were collected. Artificial white spot lesions were created and resin applied. Environmental SEM …

Work-Related Musculoskeletal Disorders Among Dentists And Orthodontists, Natalie R. La Rochelle

Theses and Dissertations

WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG DENTISTS AND ORTHODONTISTS

A thesis submitted in partial fulfillment of the requirements for the degree of

Master of Science in Dentistry at Virginia Commonwealth University.

by

Natalie R. La Rochelle

Thesis Director: Dr. Eser Tüfekçi, D.D.S., M.S., Ph.D., M.S.H.A.

Professor, Department of Orthodontics

Virginia Commonwealth University

Richmond, Virginia

May 2017

The practice of dentistry is physically demanding due to static and dynamic postures sustained daily throughout careers. Previous literature suggests that work-related musculoskeletal disorders (WMSD) are not solely the result of work habits, but also due to the individual, his or her physical makeup, genetics, and …

Comparison Of Intraoral And Extraoral Scanners On The Accuracy Of Digital Model Articulation, Jason L. Porter

Theses and Dissertations

Introduction: Orthodontists increasingly rely on digital models in clinical practice. The ability of modern scanners to articulate digital models must be scientifically evaluated. Methods:Twenty five digital articulated models were produced from four digital scanners in five experimental groups. The resulting inter-arch measurements were compared to the gold standard. An acceptable range of 0.5mm more or less than the gold standard was used for evaluation. Results: iTero® and iTero® Element yielded all acceptable inter-arch measurements. The 3M™ True Definition and Ortho Insight 3D® with Regisil® bite registration produced four of six acceptable inter-arch measurements. The Ortho Insight 3D® with Coprwax ™ …

The Effects Of Amixicile, A Pyruvate Ferredoxin Oxidoreductase Inhibitor, On Oral Treponemes, Lucas A. Reed

Theses and Dissertations

Periodontal disease (PD) is a polymicrobial infection characterized by inflammation of the gingiva, alveolar bone resorption, and tooth loss (edentulism). Treponema denticola along with Porphyromonas gingivalis and Tannerella forsythia are among the “Red Complex” and are main etiological agents in PD. Treponemes are a member of the Spirochaeta phylum and are obligate anaerobes, that express pyruvate ferredoxin oxidoreductase (PFOR). The enzyme catalyzes the oxidation of pyruvate to acetyl-CoA and reduced ferredoxin. Amixicile is a novel bacteriostatic derivative of nitazoxanide and an inhibitor of PFOR. In light of the fact that Treponemes express PFOR, this study was conducted to investigate the …

Trabecular Bone Microarchitecture In Association With Systemic And Local Factors As Potential Predictors Of Implant Failure, Diego A. Camacho Dmd

Theses and Dissertations

Clinicians have described the success rates of dental implants. The use of implants is projected to increase in the future. With a 5-10% failure rate, it is unclear the exact factors that are associated with implant failures. To improve upon these success rates, it is critical to understand parameters associated with implant failure including: periodontitis, peri-implantitis, systemic diseases, site preparation, dental history of the implant site, bone quality, materials, occlusion, and treatment timelines. While bone quality is associated with failure, objective measures to assess bone quality and characteristics are scarce. Therefore, the aim of this study is to determine whether …

Comparison Of Treatment Planning Decisions When Combining Cbct And Digital Radiography Verses Digital Radiography Alone, Mckay Barlow Packer

Theses and Dissertations

Cone beam computed tomography (CBCT) is the recommended imaging modality of choice for evaluating previous endodontic treatment (1). The aim of this study was to compare treatment planning decisions made when evaluating previous endodontic treatment to determine if treatment planned and projected prognosis differs when digital radiography is used alone or in combination with CBCT. A retrospective chart review was conducted. Patients for whom a CBCT was taken were included in the study. Twenty-eight patients qualified. Patient’s periapical digital radiographs (Dexis©) were evaluated by 2 calibrated endodontists, a treatment plan was identified and a prognosis was projected. Later the same …

The Incidence Of Root Dentinal Micro-Cracks Caused By Reciprocating And Continuous Rotary Instrumentation, Stephen N. Schroeder

Theses and Dissertations

The aim of this study was to compare the incidence of root canal dentinal micro-cracks after canal instrumentation using reciprocating files (WaveOne Gold® and Twisted Adaptive®) and continuous rotation files (Edge Evolve® and EndoSequence®) in an ex-vivo benchtop study. This project used a novel methodology of finding dentinal defects using the “K-cube”, which allows evaluators to visualize sectioned root surfaces before instrumentation and after instrumentation. Mesial roots from 40 human mandibular first molars were divided into 4 groups of 10 for each file type. Root section pictures were taken with a Zeiss Discovery V20 stereomicroscope before and after canal instrumentation. …

Involvement Of Signal Peptidase I In Streptococcus Sanguinis Biofilm Formation, Jessica Aynapudi

Theses and Dissertations

Biofilm accounts for 65%-80% of microbial infections in humans. Considerable evidence links biofilm formation to oral disease and consequently systemic infections. Eradication of biofilm-associated infections is important. Streptococcus sanguinis, a Gram-positive bacterium, is one of the most abundant species in oral biofilm. It contributes to biofilm development in oral cavities and is one of the recognized causes of infective endocarditis. To study and identify biofilm genes in S. sanguinis, biofilm formation of 51 mutants was compared with the wild type SK36 strain using crystal violet (CV) staining in a microtiter plate. Confocal laser scanning microscopy (CLSM) and image analysis was …

Vital Pulp Therapy Survivability Based On Radiographic Depth Of Caries, Aaron T. Schmick

Theses and Dissertations

Purpose: The purpose of this retrospective chart review was to determine if the survival of two methods of vital pulp therapy (VPT) were influenced by the pre-operative radiographic depth and location of caries. Methods: Electronic patient records (axiUm®) that contained the procedure codes D3120, Indirect Pulp Therapy (IPT), or D3220, Therapeutic Pulpotomy (TP), were queried. Qualifying charts’ pre-operative and post-operative radiographs were viewed in MiPACS® by two raters. Visit records were queried again to identify any other treatment failures. Results: A total of 568 primary molars met the eligibility criteria. There was a difference in survival depending upon the treatment …

The Effectiveness Of A Preventive Recall Strategy In Children Following Dental Rehabilitation Under General Anesthesia, Amanda Kerns Dr.

Theses and Dissertations

Abstract

THE EFFECTIVENESS OF A PREVENTIVE RECALL STRATEGY IN CHILDREN FOLLOWING DENTAL REHABILITATION UNDER GENERAL ANESTHESIA

By Amanda Kerns, DDS

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, 2016

Thesis Advisor: Elizabeth Berry, DDS, MPH, MSD

Vice Chair, Assistant Professor, Department of Pediatric Dentistry

Purpose: This was a prospective randomized controlled trial assessing the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) in children with early childhood dental caries.

Methods: 130 patients completed FMDR and were included in the analysis. …

Serum Vitamin D, Pth, And Calcium Levels In Patients With And Without Early Childhood Caries, Susan A. Meinerz, Harmeet Chiang, Peter C. Moon, Lorin M. Bachmann, Tegwyn Brickhouse, Al M. Best, Tiffany Williams

Theses and Dissertations

Purpose: The purpose was to determine differences in serum vitamin D, parathyroid hormone (PTH), and calcium levels between patients with early childhood caries (ECC) and patients without dental decay.

Materials and Methods: Serum vitamin D, PTH, and calcium levels were obtained from 30 children without dental decay who acted as controls and 60 children with ECC. A questionnaire was filled out by the parent/guardian of each participant consisting of questions regarding medical and dental history, exposure to sources of vitamin D and demographic information.

Results: The difference in the vitamin D levels of the participants was most …

Social Determinants Of Participation In A Home Visitation Fluoride Varnish Program, James E. Puryear, Tegwyn Brickhouse, Caroline Carrico

Theses and Dissertations

Purpose: The purpose of this study is to examine the social determinants of CHIP (Child Health Investment Partnership) of Roanoke Valley children who participated in the preventive oral health program compared to those who did not.

Methods: This is a retrospective cohort study of children (n=2,425) enrolled in CHIP of Roanoke Valley from September 2008-September 2014. Bivariate analysis and multivariable logistic regression models were used to compare age, gender, race, locality, parents’ education level, age at enrollment, and length of enrollment for oral health program participants versus those who did not participate.

Results: Children who were Hispanic …

Parental Perceptions Of Oral Health Related Quality Of Life For Children That Receive Care On Give Kids A Smile Day, Andrew Gibson

Theses and Dissertations

Purpose: The purpose of this study is to evaluate the oral health-related quality of life for patients treated at Give Kids a Smile. Methods: Participants were asked to complete a 25-question survey regarding their child’s oral health-related quality of life (OHRQoL), with answers ranked on a 0 to 4 point scale. Results: A total of 78 questionnaires were completed, with the mean score of 5.19. Conclusions: Give Kids a Smile was created to treat children with unmet oral healthcare needs, therefore it was hypothesized that the OHRQoL for the children treated would be negatively impacted and thus this score high. …