Antibiotics And Antimicrobial Resistance: An Evaluation Of The Knowledge, Attitude And Perception Among Dental Students And Academic Deans And Department Chairs Within U.S. Dental Schools, Magdalena S. Holz

Theses and Dissertations

Purpose: This study aimed to survey current 3^rd and 4^th year dental students, academic deans, and department chairs within U.S. dental schools to analyze the level of understanding; education; guidelines; and overall awareness regarding antibiotic use within dentistry and antimicrobial resistance.

Methods: A 25-question survey intended for 3^rd and 4^th year dental students and a 20-question survey intended for academic deans and various department chairs of U.S dental schools were each developed utilizing REDCap. The survey invitations were sent via e-mail to the current academic dean of each U.S. dental school for distribution.

Results: There were …

Designing Biomimetic Implant Surfaces To Promote Osseointegration Under Osteoporotic Conditions By Revitalizing Mechanisms Coupling Bone Resorption To Formation, Ethan M. Lotz

Theses and Dissertations

In cases of compromised bone remodeling like osteoporosis, insufficient osseointegration occurs and results in implant failure. Implant retention relies on proper secondary fixation, which is developed during bone remodeling. This process is disrupted in metastatic bone diseases like osteoporosis. Osteoporosis is characterized low bone mass and bone strength resulting from either accelerated osteoclast-mediated bone resorption or impaired osteoblast-mediated bone formation. These two processes are not independent phenomena. In fact, osteoporosis can be viewed as a breakdown of the cellular communication connecting bone resorption to bone formation. Because bone remodeling occurs at temporally generated specific anatomical sites and at different times, …

Management Of The Open Apex Using A Bioceramic Apical Barrier: Success And Survival Rates At Virginia Commonwealth University, Adam Sarnowski

Theses and Dissertations

Purpose: The aim of this study was to assess the outcome of treatment of teeth with open apices managed by the orthograde placement of a bioceramic apical barrier as well as to identify potential outcome factors for this type of treatment. Methods: Patient records were pooled from graduate resident cases completed at Virginia Commonwealth University between January 1, 2010 and May 31, 2018. A total of 515 patients were identified using relevant ADA codes and a key word search within the patient record database. A total of 104 patients (119 teeth) had an open apex that had NSRCT utilizing a …

Perception Of Patient Cooperation Among Dentist, Guardian, And Child, Cole A. Staines Dds

Theses and Dissertations

Purpose: Evaluate behavior assessment and agreement among dentist, guardian, and child. Evaluate child behavior by appointment type.

Methods: Patients recruited from the pediatric dental department at Virginia Commonwealth University for this convenience sample. Inclusion criteria: patients presenting for clinical exams and/or restorative treatment without the use of advanced behavior guidance between August 29, 2018, and March 7, 2019; ages 4-12-years-old; and scheduled with a single clinician. Appointments were stratified by difficulty. Behavior was assessed by dentist and caregiver using the Frankl Scale. Patient self-assessed cooperation using an age-appropriate modified Frankl Scale, developed for this study. Agreement assessed among the 3 …

Examination Of Strain-Dependent Differences In S. Sanguinis Virulence And Growth, Shannon Baker

Theses and Dissertations

Streptococcus sanguinis, an abundant and benign inhabitant of the oral cavity, is an important etiologic agent of infective endocarditis, particularly in people with pre-disposing cardiac valvular damage. Although commonly isolated from patients with IE, little is known about the factors that make any particular S. sanguinis isolate more virulent than another or, indeed, whether significant differences in virulence exist among isolates. To investigate the virulence of multiple isolates, a variation of the Bar-seq (barcode sequencing) method was employed. A conserved chromosomal site was identified for subsequent insertion of a barcode identifier, unique for each strain. Barcode insertion did not …

Impact On Bacterial Micro-Leakage In Exposed Root Canal Obturation Material In Teeth Irrigated With Different Solutions, Khalifa W. Alhaddad

Theses and Dissertations

Purpose: Determine the timeframe of bacterial penetration that occurs to the apex when obturation material (gutta percha) is exposed to bacteria for a set period of time (45 days) and to determine if bacterial penetration of the obturated root is influenced by the type of irrigant used during the final rinse (17% EDTA vs 2% Chlorhexidine vs full strength 5.25% NaOCl). Methods: Thirty-six extracted teeth, including six controls, were instrumented and irrigated with 5.25% NaOCl followed by a final rinse of either: 17% EDTA, 2% Chlorhexidine, or 5.25% NaOCl, and then obturated. Each root was suspended between two chambers: the …

Comparison Of Patient Factors Influencing The Selection Of An Orthodontist, General Dentist, Or Direct-To-Consumer Aligners For Orthodontic Treatment, Jeffrey C. Olson

Theses and Dissertations

Purpose: To evaluate the factors that influence potential orthodontic patients choosing between an orthodontist, general dentist, and direct-to-consumer (DTC) aligners for their treatment, and to determine the demand for each provider type.

Methods: An electronic survey was administered to 250 individuals among the general population of adults in the United States. Questions were designed to determine the respondent’s level of interest in pursuing orthodontic treatment with each provider type, evaluate their current level of knowledge concerning provider options, and identify factors influencing their selection. Pearson’s chi-squared test and ANOVA were used to evaluate the factors influencing patients in …

Evaluation And Comparison Of Periapical Healing Using Periapical Films And Cone Beam Computed Tomography: Post-Treatment Follow Up, Adam S. Polinsky

Theses and Dissertations

Purpose: The purpose of this study was to assess the radiographic changes in periapical status and analysis of healing determined using periapical radiographs (PA) versus cone beam computed tomography (CBCT) pre-operatively and at 3-64 months following endodontic treatment.

Methods: Pre/post treatment radiograph and CBCT scans of patients who had NSRCT, NSReTx, or SRCT from July 2011-December 2018 at VCU Graduate Endodontic clinic were included in this study. Volumetric and linear measurements of periapical lesions on initial and recall PA and CBCT images were performed using three calibrated examiners. Changes and differences in the estimated area from PA to CBCT were …

Frictional Properties Of Novel Bracket Systems: An In-Vitro Study, Stephen M. Haverkos

Theses and Dissertations

Orthodontic brackets undergo resistance during sliding that includes classical friction, binding, and notching. Current bracket systems are hampered by these challenging forces. As a result, the clinician usually needs to apply additional forces to overcome the resistance which increases the risk of root resorption and discomfort for the patient. This study evaluated frictional properties of a novel bracket that had polytetrafluoroethylene (Teflon™) coated rollers in its design. Five types of brackets (n = 10, each), including a passive self-ligating bracket, a traditional ligated bracket, a three-dimensionally printed direct metal laser sintering (DMLS) bracket with and without Teflon™ rollers, and computer …

Let’S Face It: The Effect Of Orthognathic Surgery On Facial Recognition Algorithm Analysis, Carolyn Bradford Dragon

Theses and Dissertations

Aim: To evaluate the ability of a publicly available facial recognition application program interface (API) to calculate similarity scores for pre- and post-surgical photographs of patients undergoing orthognathic surgeries. Our primary objective was to identify which surgical procedure(s) had the greatest effect(s) on similarity score.

Methods: Standard treatment progress photographs for 25 retrospectively identified, orthodontic-orthognathic patients were analyzed using the API to calculate similarity scores between the pre- and post-surgical photographs. Photographs from two pre-surgical timepoints were compared as controls. Both relaxed and smiling photographs were included in the study to assess for the added impact of facial pose on …

The Efficacy Of A Fluoride-Containing Orthodontic Primer In Preventing Demineralization, Alyssa G. Ricci

Theses and Dissertations

Purpose: To evaluate the efficacy of a fluoride-containing orthodontic primer in preventing demineralization adjacent to brackets and compare the quality of enamel on tooth surfaces that received interproximal reduction (IPR).

Methods: Patients at the VCU Orthodontic clinic who consented to orthodontic treatment involving extraction of at least 2 premolars were recruited to this pilot clinical study. Brackets were bonded to premolars using one of two primers, fluoride-containing experimental or control. IPR was also performed, and the experimental primer was applied to randomly selected teeth. Extracted teeth were analyzed visually for the presence of white spot lesions (WSLs). Micro-CT analyses were …

The Effect Of Change In Medi-Cal Dental Coverage On Dental Care Utilization Among Medi-Cal Beneficiaries, Min H. Zhang

Theses and Dissertations

One of the most important factors in accessing dental care is having dental insurance. For people with low incomes, Medicaid is the main source of health insurance. Medi-Cal is California’s Medicaid program. Adult dental services were mostly eliminated in Medi-Cal in 2009 due to the economic downturn and partially restored in 2014. The objective of this study is to evaluate the effect of change in Medi-Cal dental coverage, specifically the partial restoration of adult dental coverage in 2014, on dental care utilization among Medi-Cal beneficiaries. The partial restoration significantly increased the utilization rates in dental clinics from 2014 to 2017 …

The Effect Of Quercetin In Periodontal Inflammation, Sara Holden

Theses and Dissertations

Purpose: To determine the effect of Quercetin, a plant based over the counter flavonoid, on periodontal inflammation in a murine model of periodontitis.

Methods: Periodontitis was induced in age and gender matched mice (C57BL/6) using ligatures on the left side of the maxilla and right side was left un-ligated as baseline control. The animals received daily Quercetin gavage or Phosphate Buffered Saline (PBS) starting 5 days prior to ligation which continued throughout the experimental protocol. Micro-computed tomography (micro CT) imaging was used to determine alveolar bone loss. Real Time quantitative (qRT) PCR was used to determine level of gingival tissue …

Diversity In Parenting: A Qualitative Study On The Socialization Goals Of Palestinian Mothers From Different Socio-Economic Backgrounds, Layali Ba Hamayel

Theses and Dissertations

This study examined diversity in the socialization goals (SGs) of Palestinian mothers from different educational and socioeconomic backgrounds. It specifically looked at their cultural model using the Family Change model to analyze elements of collectivism and individualism in their attitudes and goals for the future. Purposeful-convenience sampling was used to recruit twelve urban Arab mothers of first grade children from two types of socio-economic backgrounds (SES). Each mother was interviewed about her goals and asked to describe her child. The interviews were analyzed thematically, and coding was guided by that used by other studies on SGs. One main finding was …

Impact Of Sensory Adapted Dental Environment On Children With Developmental Disabilities, Gail Kim

Theses and Dissertations

Purpose: This was a pilot study assessing the impact of a sensory adapted dental environment (SADE) on children with developmental disabilities (DD) receiving routine dental care.

Methods: A crossover study of 22 children with DD, aged 6 through 21, was conducted at Virginia Commonwealth University Pediatric Dental clinic. Each participant was randomized to a sequence of two dental cleanings, one regular dental environment (RDE) and one SADE with a 3-4-month recall. Outcomes included physiological measures (heart rate and oxygen saturation) and cooperation (Frankl scores).

Results: Study subjects completed a total of 36 visits. None of the physiological measures differed at …

Directing Mesenchymal Stem Cells For Periodontal Regeneration, Charles Stoianovici

Theses and Dissertations

Background: Directing autogenous Mesenchymal Stem Cell (MSC) to defect sites has a great promise in bone regeneration. We designed a MSC specific, bone affinity peptide (E7HA7) by conjugating E7 with a polyglutamate hydroxyapatite (HA) binding motif. We sought to characterize the in-vivo releasing pattern and bioactivity of E7HA7. Methods: HA discs were coated with fluorescent labeled peptides E7HA7, E7HA2 or E7 were subcutaneously implanted in Sprague Dawley rats. In an ectopic bone formation model was used to test the in-vivo bioactivity of E7HA7 conjugated to DBM. Results: E7HA7 showed slower peptide release from scaffolds in comparison to other groups, being …

The Effect Of Instrumentation Taper On Dentin Conservation, Megan E. Green

Theses and Dissertations

Introduction: The aim of this in vitro study was two part. The first being to assess and compare the amount of dentin removed by an instrument with a taper of 0.04 versus an instrument with a taper of 0.06 using the Edge Evolve® file system at different increments within the canal system. Secondly, this study evaluated whether instrumentation with either taper resulted in a remaining dentin thickness (RDT) of less than 0.3mm. If this RDT was imposed upon, fracture resistance was compromised. Both pre and post instrumentation measurements were taken of samples instrumented with the 0.04 and 0.06 tapered files. …

Accuracy Of A Smartphone-Based Orthodontic Treatment Monitoring Application, Heather Moylan

Theses and Dissertations

Objectives: Dental Monitoring® (“DM,” Dental Monitoring, Paris, France), is a cloud-based software that allows orthodontists to track patients’ treatment remotely. The purpose of this study was to investigate the accuracy of the software in making linear measurements.

Methods: Patients took intraoral photographs using the DM application, immediately followed by impressions for plaster models. Intercanine and intermolar width and arch depth measurements were made by DM and compared to measurements made on the plaster models. Data was analyzed using two one-sided t-tests for equivalence with equivalence bounds of

+/-0.5mm. Significance level was set at 0.05.

Results: Thirty sets of measurements were …

A Comparison Of The Antimicrobial Efficacy Of Silver Diamine Fluoride And Silver Nitrate: An Ex Vivo Study, Reham M. Alnajjar

Theses and Dissertations

A comparison of the antimicrobial efficacy of silver diamine fluoride and silver nitrate on various cariogenic bacteria: an ex vivo study By: Reham AlNajjar, D.D.S.

A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2019

Thesis Advisor: William Dahlke, D.M.D., Associate Professor and Chair of Pediatric Dentistry, School of Dentistry

Purpose: The use of silver-based antimicrobials is an emerging method for the treatment of dental caries. In this study, the authors compare the efficacy of the two most prominent silver- based therapeutics, silver diamine …

Trna Profiling Of Mesenchymal Stem Cell Exosome, Khin Mimi San

Theses and Dissertations

Background: Exosomes have great potential in regenerative medicine through the

transfer of their bioactive cargos, such as RNA. tRF RNA and tiRNA are tRNAderived

non-coding RNA. Here, we sought to identify the tRF/tiRNA profile in human

mesenchymal stem cell (hMSC) exosomes. Methods: Bone marrow hMSCs were

cultured with/without osteogenic differentiation medium and exosomes were

harvested. RNA was extracted from: 1) control cells (Cell-NT); 2) control exosomes

(EXO-NT); 3) differentiated cells (Cell-OM); 4) exosomes produced by differentiated

cells (EXO-OM). RNA was sequenced to profile the small RNA with a focus on

tRF/tiRNA. Results: tRF/tiRNA was highly enriched in hMSC exosomes. Less …

The Effect Of Biologic Materials And Oral Steroids On Radiographic And Clinical Outcomes Of Horizontal Alveolar Ridge Augmentation., Amy Reichert

Theses and Dissertations

The purpose of this study was to investigate if the addition of biologic materials and/or oral steroids would affect horizontal bone gain, or the bone density of the grafted bone in horizontal alveolar ridge augmentations. A retrospective chart review was completed to assess the clinical and radiographic outcomes of 53 ridge augmentation patients. An average bone gain of 3.6mm of width was found in our study based on radiographic analysis. There were no statistically significant differences found in the linear bone gain with the addition of biologic materials and steroids. A marginally statistically significant difference was found in the bone …

The Periodontal Specialty: A Survey Regarding Our Future, John H. White

Theses and Dissertations

Purpose: To determine the characteristics influencing periodontal practices in Virginia and report on the anticipated changes in practice.

Methods: A REDCap survey was emailed to Virginia based American Academy of Periodontology (AAP) members assessing personal and practice demographics, trends in dental treatment and practice models, and how periodontists will adjust to account for these trends.

Results: The response rate was 31% (n=46). Respondents report greater referrals from more experienced general practitioners (GPs). Student debt was associated with age. Respondents ranked biologic advances, treatment of peri-implantitis, digital dentistry, development of corporate and group practice models, and GPs incorporating more periodontal …

A Comparison Of The Antimicrobial Efficacy Of Silver Diamine Fluoride And Silver Nitrate: An In Vitro Study, Nicholas L. Luke

Theses and Dissertations

A COMPARISON OF THE ANTIMICROBIAL EFFICACY OF SILVER DIAMINE FLUORIDE AND SILVER NITRATE: AN IN VITRO STUDY

By: Nicholas L Luke, D.D.S.

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

Virginia Commonwealth University, May 2018

Thesis Advisor: William O. Dahlke Jr., D.M.D.

Pediatric Dentistry, Department Chair

Purpose: To determine the antimicrobial efficacy of SDF and SN/NaF.

Methods: Three bacterial species were combined to create an in vitro biofilm. Treatment was completed with SN, SN/NaF, SDF, SDF½ or untreated (control).

Results: The untreated group demonstrated significantly higher …

Prevalence And Factors Of Sibling-Recurrent Dental Treatment Under General Anesthesia, Brandy N. Edmonds

Theses and Dissertations

Objective/Aims: Assess the prevalence of sibling recurrent dental general anesthesia (DGA) at VCU Pediatric Dentistry. Assess factors that contribute to sibling recurrent dental general anesthesia. Methods: The guardian of patients with siblings were provided a questionnaire to assess the prevalence and factors associated with recurrent DGA. Results: A total of 40 families with a child presenting for GA and at least one sibling were included in the study. Of these, 45% had sibling-recurrent GA treatment (20% in one sibling; 25% in 2 or more siblings). Additionally, 13% of the children currently presenting for GA had already been treated under GA, …

Assessment Of Pediatric-Focused Brief Motivational Interviewing Training Of Dental Students And Pediatric Dental Residents, Victoria M. Onesty

Theses and Dissertations

Purpose: To assess dental students and pediatric dental residents’ knowledge and attitudes towards motivational interviewing and evaluate the efficacy of a pediatric-focused brief motivational interviewing training program.

Methods: A total of 66 participants were enrolled; 35% were third year dental students, 46% were fourth year dental students and 18% were pediatric dental residents. Participants completed three questionnaires: the first before the training, the second immediately after the training and the third approximately 3.5 months after the training.

Results: A significant increase in correct responses was found for 4 of the 5 questions assessing participants’ knowledge. Participants were satisfied with the …

Comparison Of Hiring Strategies Of Orthodontic Private Practitioners, Steven C. Petritz

Theses and Dissertations

COMPARISON OF HIRING STRATEGIES OF ORTHODONTIC PRIVATE PRACTITIONERS

By Steven C. Petritz, D.D.S.

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

Virginia Commonwealth University, 2018

Thesis Director: Bhavna Shroff, D.D.S., M.Dent.Sc., M.P.A.

Virginia Commonwealth University Department of Orthodontics Program Director

Purpose: Evaluate factors that influence hiring outcomes of clinical and non-clinical staff in orthodontic private practices.

Methods: Orthodontists (n=1968) were surveyed regarding their hiring methods and outcomes. Responses were summarized using descriptive statistics. Chi-square tests were used to compare between hiring strategies and outcomes. …

Evaluation Of Fit For 3d Printed Retainers As Compared To Thermoform Retainers, David J. Cole

Theses and Dissertations

ABSTRACT

EVALUATION OF FIT FOR 3D PRINTED RETAINERS AS COMPARED TO THERMOFORM RETAINERS

By David Cole, D.M.D.

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

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

Professor, Department of Orthodontics

Sompop Bencharit, D.D.S., M.S., Ph.D.

Associate Professor and Director of Digital Dentistry, Department of General Practice

Introduction: Despite recent advances in three-dimensional (3D) printing, little information is available on 3D printed retainers

Methods: Three reference models were used to fabricate traditional vacuum formed, commercially-available vacuum formed, and 3D printed …

Potential Antimicrobial Methods For Provisionalizing Teeth After Endodontic Treatment, Laura T. Garden

Theses and Dissertations

POTENTIAL ANTIMICROBIAL METHODS FOR PROVISIONALIZING TEETH AFTER ENDODONTIC TREATMENT

By Laura T. Garden, 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, 2018

Thesis Advisor: Garry Myers, DDS

Department of Endodontics

Objective:To evaluate the effectiveness of a Chlorhexidine soaked cotton pellet on bacterial leakage.

Methods: Fifty-one extracted teeth, including six controls, were instrumented, obturated, and sealed with either a cotton pellet (CP), 2% Chlorhexidine soaked cotton pellet (CHX), or a Permaflo orifice barrier (OB). Each root was suspended between two chambers: the …

Orthodontists’ And Patients’ Preferences In Website Design In The Selection Of An Orthodontic Practice: A Comparative Study, Taylor R. Brown

Theses and Dissertations

Objective: To determine which website characteristics are preferred by orthodontists, adult patients, and parents of patients.

Materials and Methods: 1,000 active members of the American Association of Orthodontists and 750 active orthodontic patients/parents were sampled. Participants rated the importance of website characteristics, indicated presence of those characteristics on the current website, and ranked sample website images. Preferences were compared between orthodontist and the patient/parent group using t-tests and sample websites were compared using ANOVA models and Tukey’s adjusted post-hoc tests. Significance level was set at 0.05.

Results: 11 of the 16 website features showed significant differences between patients/parents and orthodontists. …

Change In Working Length At Different Stages Of Instrumentation As A Function Of Canal Curvature, Mei Tang

Theses and Dissertations

The aim of this study was to determine the change in working length (∆WL) before and after coronal flaring and after complete rotary instrumentation as a function of canal curvature. One mesiobuccal or mesiolingual canal from each of 43 extracted molars had coronal standardization and access performed. Once the access was completed, canal preparation was accomplished using Gates Glidden drills for coronal flaring and EndoSequence files for rotary instrumentation. WLs were obtained at 3 time points: pre-instrumentation (unflared), mid-instrumentation (flared) and post-instrumentation (concluded). Measurements were made via direct visualization (DV) and the CanalPro apex locator (EM) in triplicate by a …