Dentistry Commons^™

The Value Of Postoperative Appointments Following Full Mouth Dental Rehabilitation Under General Anesthesia, Priyanka Patel

Theses and Dissertations

Purpose: Follow-up appointments after full mouth dental rehabilitation under general anesthesia (GA) have been suggested as a method for preventing future caries and need for repeat treatment under GA. The purpose of this study is to determine current practitioner and parental perceived value of the postoperative GA appointment.

Methods: Three separate surveys were administered for this study. The pre-appointment survey asked about the guardian’s desire to have a follow-up appointment. At the follow-up appointment, the post-appointment survey ascertained the level of patient satisfaction with their follow-up appointment and postoperative experience. American Academy of Pediatric Dentistry (AAPD) members were e-mailed a …

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 …

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 = …

Patient Perspectives On Teledentistry And Face-To-Face Doctor Interaction During Orthodontic Treatment, Jackson K. Griffeth D.M.D.

Theses and Dissertations

Purpose: Orthodontic patients were surveyed to determine the perceived value of doctor-to-patient face-to-face interaction, the desire for convenience and attitudes toward specific uses of teledentistry.

Methods: Participating private practice orthodontists emailed the survey to active patients. 75 self-pay patients from VCU Orthodontic clinic were also invited to complete the survey. Patients 18 years or older were asked to complete the survey regarding their own treatment. Parents of patients under age 18 were asked to complete a separate survey regarding their child’s treatment. Questions asked patients about the importance of face-to-face interaction with their orthodontist and their preferences for the inclusion …

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 …

Ck2 Phosphorylation Of Human Papillomavirus 16 E2 On Serine 23 Promotes Interaction With Topbp1 And Is Critical For E2 Plasmid Retention Function, Apurva Tadimari Prabhakar

Theses and Dissertations

Human papillomaviruses (HPVs) are the causative agents in most cervical cancers and have been implicated in a rising number of oropharyngeal cancers. HPV positive oropharyngeal cancers have increased significantly over the last two decades with no specific anti-viral therapeutic options for the treatment of HPV diseases. During its lifecycle, HPV16 encoded E2 protein interacts with host cellular factors to regulate viral transcription, replication and genome segregation/retention. Our understanding of the cellular partner proteins that E2 uses to mediate its functions remains incomplete.

Previously, an interaction between E2 and the host protein TopBP1 was identified. In earlier studies, it was also …

Il-36g Cytokine Induction In Oral Epithelial Cells Triggered By Treponema Denticola And Their Role In Chronic Periodontitis, Christopher Blake

Theses and Dissertations

Periodontal disease is a polymicrobial disease affecting 10-15% of the population. Periodontal disease affects the quality of life by reducing mastication and potentially causing tooth loss. Periodontal disease is also linked to more severe, systemic diseases such as cardiovascular disease and rheumatoid arthritis. Development of the diseased state occurs when the plaque biofilm shifts from healthy to dysbiotic. The shift to a dysbiotic biome brings with it a shift in bacterial presence, specifically an increase in gram-negative bacteria, such as T. denticola. T. denticola is a gram-negative, anaerobic spirochete whose relationship with oral epithelial cells is poorly understood. Preliminary data …

Validation Of A Screening Tool For Pediatric Obstructive Sleep Apnea: A Pilot Study, Julia A. Giardina

Theses and Dissertations

Purpose: The purpose of this study was to evaluate the Pediatric-Modified-STOP-Bang (PM-STOP-Bang) as a screening tool to assess sleep related breathing disorders (SRBD) within a pediatric population. The specific aims of this study were: 1) compare the PM-STOP-Bang scores with those from the validated Pediatric Sleep Questionnaire (PSQ), 2) determine the ability of the PM-STOP-Bang and the PSQ screening tools to accurately detect children of high risk for SRBD from a one-night home sleep apnea test (HSAT).

Methods: Orthodontic patients were screened using the PM-STOP-Bang at VCU Graduate Clinic. Patients (n=10) who were recruited and enrolled. Five were determined to …

Radiographic Comparison Using Cbct-Pai And Volumetric Analysis Of Endodontically Treated Teeth: A Retrospective Cohort Study, Jeremy Hargrove

Theses and Dissertations

Purpose: To assess the changes in CBCT-PAI score as well as 3-D volume of periapical findings associated with endodontically treated roots and to see how these findings change over time.

Methods: Retrospective chart review with the following inclusion criteria: 1. At least one tooth was endodontically treated at the endodontic private practice; 2. Patient had a recall examination and the treated tooth was asymptomatic, functional and a CBCT was exposed; 3. CBCT interpretation found a periapical finding associated with the treated tooth; 4. A follow-up recall examination was completed and CBCT exposed. Cases that fulfilled the inclusion criteria had the …

Reproducibility And Accuracy Of The Virtual Occlusal Record, Anne M. Harper

Theses and Dissertations

Purpose: To evaluate the reproducibility and accuracy of the virtual occlusal record compared to the gold standard physical bite record

Methods: Two physical bite records of PVS and two virtual bites using an iTero Element scanner were obtained from 22 participants. Intraoral scans were exported as STL files, and virtual occlusal records were created. CBCT images were taken of physical occlusal records and converted to STL files. STL files were superimposed using Geomagic Control X™ Software. Root mean square (RMS) and percent similarity within 0.25 mm tolerance were compared at a significance level of 0.05.

Results: Average …

Virtual Reality Tool For Visualizing The Oral Microbiome, Alexus M. Harris

Theses and Dissertations

There are limited teaching tools for helping both students and patients understand the oral microbiome. It is important to understand the oral microbiome as it heavily influences the health of your oral cavity and the dysbiosis of disease. The oral microbiome influences other aspects of health and serves as an indicator for health. With a greater understanding of the oral microbiome, patients can make healthier lifestyle changes and dentists can better educate their patients. For that reason, the goal of this project was to create a virtual reality tool for visualizing the oral microbiome. The assets for the VR tool …

In Vitro Evaluation Of The Solubility Of Endosequence Bc Sealer In Acidic Solutions, Inderpal S. Sappal

Theses and Dissertations

Purpose: In recent years, bioceramic sealers (BCS), such as EndoSequence BC Sealer, have gained popularity in endodontic practices. Previous research has found BCS difficult to remove from canals during retreatments when compared with other endodontic sealers. Acidic solutions have been found to inhibit the set of BCS and increase their solubility. The purpose of this study was to evaluate the efficacy of acidic solutions in the removal of BCS as compared with a traditional retreatment solvent.

Methods: Roots of extracted human single rooted teeth (N=15) were prepared into 17 mm sections, then instrumented with ProTaper Gold (PTG) rotary files up …

The Effect Of Local Anesthesia When Used In Dental Restorative Cases Under General Anesthesia On Control Of Intraoperative Physiologic Parameters And Post-Operative Comfort, Kathryn S. Skarda

Theses and Dissertations

Purpose:

To determine the effect of local anesthesia on post-operative pain and physiologic parameters intraoperatively in patients undergoing dental care under general anesthesia.

Methods:

This study was modeled as a double-blinded randomized control trial. Patients included healthy children under the age of six scheduled for restorative dental treatment under general anesthesia. Patient behavior was evaluated pre and post-operatively using the FLACC score and post-operatively using the Parental Pain Score Measure. Intraoperatively, all participants followed a standardized general anesthesia protocol and were given either local anesthetic infiltration by the dental surgeon performing the surgery or no anesthesia was utilized. Intraoperatively physiologic …

The Effects Of Exosomes On The Regeneration Of Rat Calvaria, Jill T. Beitz

Theses and Dissertations

Periodontal disease is a bacterial induced chronic inflammatory condition that occurs in a susceptible host, affecting the teeth, gingiva, periodontal ligament, and alveolar bone. The resultant pathological bone defects often require surgical intervention, with the ultimate goal being regeneration of the periodontium through the application of grafting materials and biologics. Mesenchymal stem cells (MSCs) show great potential in regenerative medicine for their ability to enhance cell proliferation and differentiation, increase angiogenesis, and modulate the immune response. Stem cell-derived by-products, known as exosomes are a specific class of lipid-membrane-bound extracellular vesicles that are proliferative and chemotactic, are able to inhibit cytokine …

Current Trends In The Management Of Invasive Cervical Resorption, Erik J. Foisy

Theses and Dissertations

Purpose: To determine how endodontic practitioners are currently managing cases of invasive cervical resorption. Also, to analyze how invasive cervical resorption (ICR) has been managed at Virginia Commonwealth University (VCU) over the past ten years.

Methods: Both domestic and international endodontists were invited to participate in a 14-question survey developed and administered via REDCap. Survey invitations were sent via email to currently practicing endodontists. Electronic dental records were queried for patients diagnosed with ICR at VCU in the preceding ten years. Results of both were summarized using descriptive statistics (counts and percentages). Fisher’s exact test was used to compare survey …

The Role Of Manganese In Streptococcus Sanguinis, Tanya M. Puccio

Theses and Dissertations

Streptococcus sanguinis is primarily associated with oral health as a commensal bacterium. As an opportunistic pathogen, S. sanguinis is capable of colonizing heart valve vegetations, leading to the disease infective endocarditis. Previous studies from our lab have identified the high-affinity manganese transporter SsaACB as important for endocarditis virulence. The impact that manganese depletion has on S. sanguinis had never been evaluated and a secondary manganese transporter has not been identified. Thus, we employed the use of a fermentor to control large-scale growth over time and depleted manganese in an ΔssaACB mutant using a metal chelator, EDTA. The changes in …

A Comparison Of Three-Dimensional Printing Technologies On The Precision, Trueness, And Accuracy Of Printed Retainers, Owais A. Naeem

Theses and Dissertations

Purpose: The aim of this study was to evaluate the differences in the precision, trueness, and accuracy of 3D printed orthodontic clear retainers produced using printer systems with various printing technologies.

Methods: Retainers (n=15) were printed using four different 3D printers: a stereolithography (SLA) printer, two different digital light processing (DLP and cDLP) printers, and a polyjet photopolymer (PPP) printer. The 3D printed retainers were transformed into a digital file through a cone-beam computed tomography scan that was compared to the original image using a 3D superimposition analysis software. At previously chosen landmarks (R6, L6, R3, L3, R1, L1) retainers …

Non-Invasive Retrieval Of Prefabricated Zirconia Crowns With Er,Cr:Ysgg Laser From Primary And Permanent Teeth, Connor W. Mccall Dds

Theses and Dissertations

Purpose: Compromised tooth structure on permanent and deciduous teeth in the pediatric population is increasingly being restored with tooth-colored prefabricated zirconia crowns. These restorations may need to be removed or replaced with permanent crowns. The purpose of this in vitro study was to explore the use of an Er,Cr:YSGG laser for removal of prefabricated zirconia crowns cemented with RMGI as a non-invasive alternative to rotary instruments.

Methods: Thirteen permanent and 12 primary molars were prepared to dentin and prefabricated zirconia crowns were passively fitted and cemented with two resin modified glass ionomer cements. The irradiation parameters for ErCR:YSGG were 4.5 …

Selenomonas Sputigena: Growth Conditions And Projected Virulence Factors Of An Emerging Oral Pathogen, Kayla A. Keller

Theses and Dissertations

Periodontal diseases are ubiquitous diseases. They can affect people through a chronic infection that happens over a lifetime, but also as an aggressive infection that afflicts the younger population. It not only results in tooth loss and a lower quality of life, but it can also lead to fatal secondary infections like cervical cancer, heart disease, and Alzheimer’s disease. This study looks at Selenomonas sputigena, an emerging oral pathogen, that has been hypothesized to contribute to periodontal disease. It has been linked to fatal septicemia and has been found in increased abundance within the oral biofilm during peak infection. …

Exploring The Use Of Pulsed Erbium Lasers To Retrieve A Zirconia Crown From A Zirconia Implant Abutment, Ahmed Elkharashi

Theses and Dissertations

Removal of zirconia crowns, commonly used as cement-retained implant fixed restorations, can be challenging. Conventional methods of crown removal are time consuming and often leave irreparable damage to the crown, which can be costly to patients and practitioners. This research explored the use of two different types of pulsed erbium lasers, erbium-doped yttrium aluminum garnet laser (Er:YAG) and erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG), as non-invasive tools to retrieve cemented zirconia crowns from zirconia implant abutments. Times needed to remove the crowns were recorded and analyzed using ANOVA (��=0.05). No statistical differences between the debond times of each …

Comparison Of Endodontic Treatment Planning Decisions Using Cone Beam Computed Tomography Versus Periapical Radiography In Previously Endodontically Treated Molars, Sarah Alkanderi

Theses and Dissertations

Objectives: The aim of this study was to determine if treatment plans differ when evaluating previously endodontically treated molars using periapical images (PA’s) alone versus PA’s and CBCT.

Methods: A retrospective cohort chart review was conducted including 67 previously treated molars that had a CBCT taken. Two calibrated board-certified endodontists evaluated standard PA’s. A data sheet questionnaire regarding radiographic findings and treatment plan decisions was completed. Two weeks later, the same steps were repeated but the examiners evaluated both PA’s and CBCT images and again arrived at a recommended treatment plan.

Results: Agreement between raters was assessed with Cohen’s Kappa …

Characteristics Of Alveolar Bone Marrow Cells From Patients Undergoing Dental Extractions Or Dental Implant Therapy, Meng H. Lee

Theses and Dissertations

Alveolar bone marrow stromal cells (aBMSCs) play important roles in craniofacial wound healing. To establish an easy, efficient and reliable method to harvest aBMSCs, we compared three different methods: extraction socket aspiration, osteotomy aspiration and bone core digestion. Samples of aBMSC were collected from two groups of subjects. Group 1 (dental extraction): after dental extraction, 22.5-gauge needles were used to collect 0.5-1cc marrow aspirate. Group 2 (dental implant): during implant surgeries, bone core and 0.5-1cc marrow aspirate were obtained from the osteotomy. Samples were cultured in petri dishes and attached cells were expanded. The population doubling time (PDT), surface markers, …

The Effect Of Print Angulation On The Accuracy And Precision Of 3d-Printed Orthodontic Retainers, Allison Williams

Theses and Dissertations

Purpose: The aims of this study were: 1) to compare the accuracy and precision of 3-

dimensional (3D) printed retainers at various angulations, 2) to evaluate the effect of angulation

on printing time and the amount of resin consumed.

Methods: Using a stereolithography (SLA) 3D printer, a total of 60 clear retainers were printed at five angulations (n=12, each): 15, 30, 45, 60, and 90 degrees. Six retainers were printed each cycle at a random order for all print angulations as print 1 and print 2. Digital images of the original and printed retainers were superimposed. Discrepancies on eight landmarks …

Achieving Dentin Conservation Using Dynamic Navigation Technology For Locating Calcified Canals, Madison W. Saunders

Theses and Dissertations

Purpose: Pulp canal obliteration (PCO) is a common sequela of dental trauma, caries, restorations and vital pulp therapy procedures. Despite the application of high magnification and CBCT imaging, access cavity preparation for such cases is prone to procedural errors that may lead to substantial loss of dentin structure thereby reducing the long-term prognosis. This study aimed to achieve dentin conservation using a novel computer assisted dynamic navigation system (Navident) in comparison to freehand access preparation for locating calcified canals.

Methods: Forty maxillary and mandibular central incisors (tooth #9 and tooth #25) were 3-D printed to simulate PCO. They were randomly …

Amixicile As A Novel Antimicrobial Treatment For Periodontitis: A Pilot Study In The Non-Human Primate, Macaca Mulatta, Denver J. Lyons

Theses and Dissertations

Periodontitis is an inflammatory disease with a bacterial etiology in a susceptible host. Given the bacterial etiology, a selective antimicrobial agent with minimal side effects could be a useful adjunct to traditional therapy. Amixicile is a novel antimicrobial that targets the pyruvate: ferredoxin oxidoreductase (PFOR) which is an enzyme that is critical for anaerobic bacterial metabolism. It has been found to have no effect on commensal, aerobic microbes and has little to no side-effects thus far in animal models. In this study, two nonhuman primates of the Macaca mulatta species with naturally occurring mild chronic periodontitis were studied before and …

Repeat Full Mouth Dental Rehabilitation Under General Anesthesia For Medicaid Eligible Healthy Children Who Are High Caries Risk, Lajoi E. Wiggins

Theses and Dissertations

Purpose: To evaluate the treatment of healthy children who are high caries risk and of low socioeconomic status and who require repeat full mouth dental rehabilitation (FMDR) under general anesthesia (GA).

Methods: A retrospective chart review was performed on healthy Medicaid eligible patients who were initially between 18 months - 6 years of age who underwent FMDR under GA in the OR more than once at the Virginia Commonwealth University (VCU) School of Dentistry, Department of Pediatric Dentistry from January 2008 to December 2018. Biographical information for each patient was gathered into a REDCap™ Survey. Statistical analysis, chi-squared test with …

A Comparison In Pediatric Dental Website Design From A Guardian And Pediatric Dentists’ Perspective., David M. Voth

Theses and Dissertations

Purpose: This project aims to determine which aspects of pediatric dental practice websites are preferable to the guardians of pediatric dental patients and which of these aspects are currently available to guardians on the websites of pediatric dental practices across the United States. The comparison will reveal if practice websites are meeting the needs of the guardians of pediatric dental patients. Our hope is to provide meaningful guidance to pediatric dentists designing new practice websites and to provide the guardians of pediatric dental patients with an appealing online experience during their use of the aforementioned websites. Methods: A survey with …

Use Of Emoji In Pain Level Assessment In Pediatric Dental Patients, Manpreet K. Dhillon

Theses and Dissertations

USE OF EMOJI IN PAIN LEVEL ASSESSMENT IN PEDIATRIC DENTAL PATIENTS

Purpose: The purpose of this study is to determine the efficacy of a pain scale with Emoji images in comparison to the commonly used Wong-Baker FACES® pain scale. Methods: Healthy, English-speaking patients aged 4-17 presenting to the VCU Pediatric Dental clinic and the operating room and presenting to the MCV Pediatric Emergency Room were asked to rate their pain using the Wong-Baker FACES® and Emoji scales. These patients were then asked to select which pain scale they preferred. Results: A total of 151 children were enrolled in the study. …

Comparison Of Triple Combination Oral Sedation Regimens For Pediatric Dental Treatment, Brett H. Henderson

Theses and Dissertations

Purpose: Compare the efficacy of two benzodiazepines (diazepam or midazolam) in combination with meperidine and hydroxyzine for pediatric dental sedation. Methods: A randomized, double blind observation study of behaviors and outcomes related to two sedation groups. Frankl and Houpt behavior scores were recorded at three time points: injection time, initiation of treatment and at the end of treatment. Postoperative phone call surveys were conducted within eight hours of discharge to assess sleep, activity, and behavior. Results: A total of 40 sedation subjects were included in the study, of which 20 were treated with diazepam triple Combination (Di+M+H) and 20 with …