IADR Irish Division Annual Scientific Meeting 2013 · The International Association for Dental...

IADR Irish Division Annual Scientific Meeting 2013

IADR Irish Division Annual Scientific

Meeting 2013 Devere Hall, University College Cork, Cork, Ireland

Thursday 14th & Friday 15th November 2013

Irish Division of the International Association of Dental Research

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Irish Division of IADR Annual Scientific Meeting

Devere Hall, University College Cork, Cork, Ireland

Hosted by

Cork University Dental School and Hospital

www.ucc.ie/dentalschool/

Local Organizing Committee

Paul Brady Frank Burke

Christiane da Mata Hurley Eimear

Mairead Harding Martina Hayes Gerry McKenna

Antonis Theocharopoulos

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The International Association for Dental Research (IADR)

The International Association for Dental Research (IADR, www.iadr.org),

headquartered in Alexandria, VA, USA, is a non-profit organization with more than

11,000 members worldwide.

Its mission is: (1) to advance research and increase knowledge for the improvement

of oral health worldwide; (2) to support and represent the oral health research

community; and (3) to facilitate the communication and application of research

findings.

The Irish Division of the IADR (www.iadr.ie)

President

President Elect

Mairead Harding

Brian O’Connell

[email protected]

brian.o’[email protected]

Secretary Garry James Patrick

Fleming

[email protected]

Treasurer Gerald John

McKenna

[email protected]

Councillors Finbarr Allen [email protected]

Wilson Alexander

Coulter

[email protected]

Chris Irwin [email protected]

Jeff O’Sullivan

Hal Duncan

Anne O’Connell

[email protected]

[email protected]

anne.o’[email protected]

Immediate Past

President

Fionnuala T Lundy [email protected]

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We would like to thank our sponsors for their kind support:

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Table of Contents

Meeting Schedule ................................................................. 8

Keynote Speakers ............................................................... 10

Scientific Programme .......................................................... 13

Irish Division Undergraduate Award Abstracts ................... 17

Irish Division Postgraduate Award Abstracts ...................... 25

RCSI Award Abstracts .......................................................... 34

DHF Award Abstracts .......................................................... 41

Poster Abstracts .................................................................. 48

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Meeting Schedule

Thursday 14th November

12.30 Registration

13.00 Opening Address: Dr Mairead Harding, IADR Irish Division President:

Chair Session 1: M Harding

13.15 The Seamus O’Hickey Inaugural Lecture

Speaker: Dr Seamus O’Hickey

13.45 IADR Irish Division Undergraduate Award (Oral Presentations)

IADR Irish Division Postgraduate Award (Oral Presentations)

Chair Session 2: G McKenna

15.30 Break and Poster Viewing

16.00 Keynote Address: Professor Mark Ferguson, CEO Science Foundation Ireland “Science Foundation Ireland: Strategy, Programmes and Opportunity”

17.00 Poster Viewing

17.30 Annual General Meeting (IADR Irish Division Members)

19.30 Conference Dinner: The River Lee Hotel After Dinner Speaker: Dr Chris Fox, CEO IADR

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Friday 15th November

Chair Session 1: A Theocharopoulos

09.00 IADR Irish Division / Royal College of Surgeons Ireland

Postgraduate Clinical Award (Oral Presentations)

10.30 Key note address: Professor Helen Whelton, IADR President –

“Advocacy in Dental Research”

11.30 Break and Poster Viewing

Chair Session 2: F Allen

12.00 IADR Irish Division Public Dental Health and Health Promotion

Prize (Oral Presentations)

13.30 Close and Prize Presentations

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Keynote Speakers

Prof Mark Ferguson

Director General, Science Foundation Ireland

Chief Scientific Adviser, Government of Ireland

Professor Mark W.J. Ferguson commenced as Director

General of Science Foundation Ireland in January 2012 and

as Chief Scientific Adviser to the Government of Ireland in

October 2012. Previously he was Professor in Life Sciences

at the University of Manchester (since 1984) and co-

founder, CEO and Chairman of Renovo Group plc. (1998-

2011).

He is the recipient of numerous international research awards including the 2002

European Science Prize (jointly), and is the author of 327 research papers and book

chapters, 60 patent families and author / editor of 8 books.

Mark graduated from the Queens University of Belfast with degrees in Dentistry (BDS

1st class honours), Anatomy and Embryology (BSc 1st class honours, PhD) and

Medical Sciences (DMedSc), holds Fellowships from the Royal Colleges of Surgeons in

Ireland (FFD), and Edinburgh (FDS) and is a Founding Fellow of the UK Academy of

Medical Sciences (FMedSci). He is a member or Fellow of a number of learned

Societies, and was made a “Commander of the British Empire” (CBE) by the Queen in

1999 for services to Health and Life Sciences.

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Prof Helen Whelton

President, IADR 2013-2014,

Dean of Leeds Dental Institute, Leeds University, UK

Helen Whelton recently took up the position of Dean of

Leeds Dental Institute, Leeds University, UK following on

from a distinguished career at UCC where she was Vice Head

of the College of Medicine and Health and also Dean of the

College’s Graduate School. She also held the position of a

Professor of Dental Public Health at the Dental School and

Director of the Oral Health Services Research Centre which is a designated World

Health Organisation Collaborating Centre. She is currently the President of the

International Association for Dental Research, a global research organisation with

almost 13,000 members worldwide.

Since gaining a PhD in Oral Epidemiology she has led multiple regional and six

national oral health surveys in Ireland, she has also been involved in helping others in

both developing and developed countries to monitor oral health among their

populations. She has been PI on an extensive range of RCTs for industry.

Her work in Ireland has also involved research to inform the development of dental

services and she has also expanded her research contribution to the areas of

overweight and obesity and to women’s general health issues. Internationally her

research focus has been on health services research incorporating fluoride

research. She has contributed to the development of the agenda for dental research

internationally through her leadership of research organisations..

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Dr Seamus O’Hickey

former Chief Dental Officer at the Department of Health

& Senior Lecturer in Dental Public Health at Dublin Dental Hospital, Trinity College

Chairman of the Expert Body on Fluorides and Health and Consultant to the

Department of Health.

Dr Seamus O’Hickey is a former Chief Dental Officer at the

Department of Health and senior lecturer in Dental Public

Health at Dublin Dental Hospital, Trinity College, University

of Dublin. He is the current Chairman of the Expert Body on

Fluorides and Health and Consultant to the Department of

Health.

Through a long and distinguished career, he has always

been actively involved in supporting dental research and the profession. He is a past

editor of the Journal of the Irish Dental Association, former president of the EU

advisory committee on training dentists, member of the Irish Postgraduate Medical

& Dental Board, Dental Council of Ireland, Specialist Advisory Committee of the Royal

Colleges and Joint Committee of the Royal Colleges on Higher Training in Dentistry.

He is the author of over 30 scientific published papers.

This year Dr O’ Hickey is honoured by the Pan European Region of the IADR for his

contributions through the introduction of the Seamus O’Hickey lecture.

Dr O’Hickey was one of the original founding members of the Irish Division of IADR,

along with Professor John Clarkson and Emeritus Professor Denis O’Mullane. This

lecture will in future be delivered by a distinguished researcher at the IADR (PER)

meeting, which takes place every two years.

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Scientific Programme THURSDAY 14 NOVEMBER 2013

Seq#: 1, Thursday, November 14 2013, 13.45 – 15.30

Irish Division Undergraduate Award

Sponsored by: Ivoclar Vivadent

Oral Session Location: Devere Hall meeting room, UCC

0001 13.45 PM Treatment of Candida albicans biofilms with fluconazole and

LL-37, CODY C., LUO Y. and LUNDY F. (Queen's University Belfast, UK)

0002 14.00 PM In-vitro acidic wear of dental cements in Class V cavities,

IYER A. and HAYES M. (Cork Dental School, Ireland)

0003 14.15 PM The role of myofibroblasts in head and neck cancer, EVES R.,

PICKARD A., MORAN M. and MCCANCE D. (Queen's University Belfast,

UK)

0004 14.30 PM Adhesive potential of dentine bonding systems (total versus

self-etch), KEARNS J. and FLEMING G.J.P. (Dublin Dental University

Hospital, Ireland)

0005 14.45 PM Analysis of critical errors during simulated dental office

medical emergencies MCDONOUGH P. and YARASCAVITCH C.

(University of Toronto School of Dentistry, Canada)

0006 15.00 PM A retrospective evaluation of cast versus fibre post placements

2008-2012, LAMBA K.and BURKE F. (Cork Dental School, Ireland)

0007 15.15 PM Characterisation of lithium disilicate dental ceramics with

varying translucencies, FITZGERALD R. and THEOCHAROPOULOS A.

(Cork Dental School, Ireland)

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Seq#: 2, Thursday, November 14 2013, 13.45 – 15.30

Irish Division Postgraduate Award


Oral Session Location: Devere Hall, UCC

Chairperson: M Harding

0008 13.45 PM An in vitro model of nociceptors in human trigeminal nerves

CLARKE R., MONAGHAN K., ABOUT I., CURTIS T.A., COSBY LS.,

MCGARVEY L.P. and LUNDY F.T. (Queen's University Belfast, UK)

0009 14.00 PM The potential therapeutic value of BAMLET in OSCC,

SINEVICI N., HARTE N., HUN MOK K. and O'SULLIVAN J. (Dublin

Dental University Hospital, Ireland)

0010 14.15 PM Ethanol modulation of hypoxia response proteins in oral

epithelial cells, O'CALLAGHAN K. and O’SULLIVAN J. (Dublin Dental

University Hospital, Ireland)

0011 14.30 PM Strength determination of curved brittle dental materials,

HOOI P., ADDISON O and FLEMING G.J.P. (Dublin Dental University

Hospital, Ireland)

0012 14.45 PM Accuracy comparison of two dental CAD/CAM fabrication

routes.NASRUDDIN M.F., BURKE F., RAY N. and THEOCHAROPOULOS

A. (Cork Dental School, Ireland)

0013 15.00 PM The use of atraumatic restorative treatment in elderly patients

DA MATA C., ALLEN F.,

O'MAHONY D., CRONIN M. and WOODS N

(Cork Dental School, Ireland)

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FRIDAY 15 NOVEMBER 2013

Seq# 3, Friday, November 13 2013, 09.00 – 10.30

IADR / RCSI Postgraduate Clinical Award


Chairperson: A Theocharopoulos

0014 09.00 AM Longitudinal analysis of peri-implant health using resonance

frequency analysis, ALKARADSHEH O., POLYZOIS I.,

O'SULLIVAN J

and CLAFFEY N. (Trinity College Dublin, Ireland)

0015 09.15 AM Comparison of two different techniques used to maintain peri-

implant health, AL GHAZAL and POLYZOIS I1. (Dublin Dental University

Hospital, Ireland)

0016 09.30 AM Odontogenic infections and their management: A four year

retrospective study BOWE C., GARGAN M.L., KEARNS G. and STASSEN

L. (St James Hospital, Dublin, Ireland )

0017 09.45 AM Comparison of anaesthetic regime in patients undergoing

third molar extraction, WARREN E. and SLEEMAN D. (Cork Dental School,

Ireland)

0018 10.00 AM Improving intra-examiner variability of Little’s Irregularity

using 3D digital models. BURNS A., GARVEY T., DOWLING A. and

FLEMMING G.J.P. (Dublin Dental University Hospital, Ireland)

0019 10.15 AM An ex vivo molar model to assess irrigation regimens

QUILLIGAN G., NG Y-L. and GULABIVALA K. (Eastman Dental Institute,

University College London, UK)

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Seq# 4, Friday, November 13 2013, 12.00 – 13.00

IADR Public Dental Health and Health Promotion Prize

Sponsored by: Dental Health Foundation


Chairperson: F Allen

0020 12.00 PM “Are you talking to me?”: Exploring triadic communication in

dentistry, KELLY A., NUNN J. and WALSH I.

(Trinity College Dublin,

Ireland)

0021 12.15 PM Retrospective study of dental general anaesthesia and financial

considerations, MCAULIFFE U., KINIRONS M., WOODS N. and

HARDING M. (Cork Dental School, Ireland)

0022 12.30 PM Quality of life and treatment satisfaction in cleft lip/palate

patients WHITAKER A. O'MAHONY A. and MCKIERNAN E. (Cork Dental

School, Ireland)

0023 12.45 PM Toothpaste use in preschool children. Facebook - A valid

research methodology? MC LOUGHLIN M. and WHELTON H (Cork Dental

School, Ireland)

0024 13.00 PM Subjective outcomes of edentulous patients treated by Clinical

Dental Technology students, AHMED S., LALLY U. and O’CONNELL B.

(Dublin Dental University Hospital, Ireland)

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Irish Division Undergraduate Award Abstracts


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Treatment of Candida albicans biofilms with fluconazole and LL-37

Cody C*,1 Luo Y1 Lundy F1

1 Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast

* Corresponding author: Ms Caitriona Cody, [email protected] Introduction: Candida albicans is a commensal organism of the oral flora commonly implicated in the pathogenesis of oral candidiasis. The clinical presentation of candidiasis is associated with the formation of Candida biofilms, making the treatment of oral candidiasis complex. Fluconazole is an ‘azole’ systemic anti-fungal therapy which is currently used in the treatment of Candidal infections. Objectives: The study was designed to assess the anti-biofilm activity of the conventional treatment fluconazole in combination with the naturally occurring antimicrobial peptide LL-37. Method: C. albicans was grown overnight in yeast-extract peptone dextrose broth and seeded out onto 96 well plates in Roswell Park Memorial Institute medium, commonly referred to as RPMI broth. Plates were incubated for 4 hours at 37°C to allow initial biofilm formation. Bioflms were then treated with fluconazole and/or LL-37 for a further 24 hours to determine treatment effectiveness on biofilm maturation. Biofilms were quantified using the XTT assay which measures metabolic activity. Results: Fluconazole and LL37 were found to have significant anti-biofilm effects at concentrations of 16ug/ml and 32ug/ml respectively when used independently. A combination of fluconazole and LL-37 showed significant efficacy against C. albicans biofilms at fluconazole concentrations as low as 4ug/ml. Conclusion: LL-37 may be a potential adjunct to traditional ‘azole’ treatment, allowing for a potential decrease in fluconazole concentration used in therapy.

I D U A

Keywords: Antimicrobial peptide

mailto:[email protected]

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In-vitro acidic wear of dental cements in Class V cavities

Iyer A*,1 Hayes M1

1 Cork University Dental School and Hospital, Wilton, Cork, Ireland

* Corresponding author: Mr. Anand Iyer, [email protected] Objectives: The aim of this study is to evaluate the erosive wear of three dental cements: a high- viscosity glass ionomer cement (GIC) (Fuji IX Extra, GC Corp), resin-modified glass ionomer cement (RMGIC) (Fuji II LC, GC Corp) and tricalcium-silicate cement (Biodentine, Septodont). Methods: Thirty caries-free extracted teeth were collected and cavities prepared along the CEJ measuring approximately 2x1x2mm deep. The dental cements were randomly allocated to each tooth utilising a randomisation tool (www.random.org), 10 teeth per material. The teeth were digitised using the Renishaw dental scanner and Incise CAD software. The teeth were then subjected to acid exposure of pH 2.48 (Coca-Cola®), for 15-minute cycles, 6 times a day, for 15 days. In between cycles, the teeth were rinsed with Milli-Q (Merck Millipore) purified water and stored in artificial saliva (Oral Balance Gel, Biotene®). At the completion of acid cycling, the teeth were rescanned. The digital scans were superimposed using Cloud software, which utilises an iterative closest point algorithm. The regions encompassing the dental cements were marked and mean difference values in millimetres were measured. Results: There was a statistically significant difference between the materials as determined by one-way ANOVA, F2,27 = 46.42, p < 0.001. Bonferroni Post Hoc comparisons revealed that RMGIC exhibited a slight expansion, which was significant compared to both the tricalcium-silicate cement and GIC, +0.009±0.003mm, p < .001. While no significant difference was found between tricalcium-silicate cement and GIC, -0.045±0.004mm and -0.054±0.007mm respectively, ns, both materials

demonstrated similar levels of wear relative to baseline, p < 0.001.

Conclusion: Within the parameters of this study, the tricalcium-silicate cement and GIC demonstrated similar levels of acid wear while RMGIC exhibited minor expansion. 1 Dental Student Cork University Dental School and Hospital (CUDSH) 2 Clinical Fellow in Restorative Dentistry (CUDSH)

I D U A

Keywords: Dental cements, erosion, contact-Profilometry


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The role of myofibroblasts in head and neck cancer.

Eves R*,1 Pickard A1 Moran M1 McCance D1

1 Centre for Cancer Research and Cell Biology, Queen's University Belfast.

* Corresponding author: Rebekah Eves, [email protected] Objectives: Myofibroblasts are sub-epithelial, stromal cells derived from fibroblasts and bone marrow precursors. The differentiation from fibroblasts to myofibroblasts is induced by paracrine signals such as transforming growth factor beta (TGFβ) and this plays an important role in wound healing due to the contractility of myofibroblasts. Cancer is often regarded as an inappropriately healed wound and it has been suggested that the interactions between epithelial cancer cells and surrounding myofibroblasts promotes invasive growth. Methods: Real-time Polymerase Chain Reaction (PCR), tissue microarrays and immunohistochemistry were used. Results: We have shown that depletion of the retinoblastoma protein (Rb) in stromal fibroblasts promotes epithelial invasion and so we have investigated whether Rb-depleted fibroblasts behave like myofibroblasts. Firstly, differentiation markers such as various cytoskeletal actins and extracellular matrix proteins were identified in primary human fibroblasts treated with TGFβ. We observed that Rb-depletion enhanced expression of actins and fibronectins suggesting Rb regulates the differentiation process. Secondly, we investigated the consequences of myofibroblast differentiation in Head and Neck cancer. 120 oropharyngeal tumour cores in tissue microarrays were stained for smooth muscle actin (SMA), as a marker of myofibroblasts, and we show a strong correlation between high expression of SMA (myofibroblasts) and recurrent disease. Currently, patients with recurrent Head and Neck cancer show a good response to EGFR inhibitors so investigations are under way to determine if SMA levels could be used to identify patients at risk of recurrence and perhaps use EGFR treatment at an earlier stage. Conclusions: Rb is involved in myofibroblast differentiation and these cells show a strong association with recurrent disease.

I D U A

Keywords: Myofibroblasts, oropharyngeal cancer, Rb


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Adhesive potential of dentine bonding systems (total versus self-etch).

Kearns J*,1 Fleming GJP1

1 Dublin Dental University Hospital

* Corresponding author: Ms Jennifer Kearns, [email protected] Objectives: No in-vitro bond strength test provides a reliable prediction of clinical performance in a clinically meaningful context The current study provides for a measurement of bond integrity at the tooth/RBC interface during and immediately after light irradiation. The study aims to assess the cuspal deflection and cervical microleakage of standardised mesio-occlusal-buccal (MOD) cavities when restored with dimethacrylate resin-based-composites (RBCs) and their appropriate bonding systems in total- or self-etch conditions. Materials and Methods: Sound maxillary premolar teeth with standardised MOD cavities were randomly allocated to eight groups. Restoration was performed in eight oblique increments where the dependent variable for each RBC used was the bonding condition (total-etch or self-etch). Buccal and palatal cuspal deflections were recorded post-irradiation using a twin channel deflection measuring gauge at 0, 30, 60 and 180s. Following restoration, the teeth were thermocycled, immersed in a 0.2% basic fuchsin dye for 24h, sectioned and examined for cervical microleakage. Results: The one-way ANOVA of the total cuspal deflection measurements identified significant differences (p<0.001) between groups and bonding condition (total-etch or self-etch) had a significant impact on total cuspal deflection. The Kruskal-Wallis non-parametric test of the cervical microleakage scores also revealed a significant difference between groups. The cervical microleakage scores significantly increased (p<0.001) for the negative control (no bonding system) when compared with restoration using a bonding system. Differences between the bonding condition (total- or self-etch) and the individual RBC bonding systems employed were evident (p<0.001). Significance: The cuspal deflection and cervical microleakage protocol reported offers an opportunity to test the different bonding technologies and systems available to practitioners for RBCs. Poorly performing adhesives could be identified which in time could save the potential complications routinely encountered with Class II RBC restorations.

I D U A

Keywords: RBC, cuspal deflection, cervical microleakage


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Analysis of critical errors during simulated dental office medical emergencies

McDonough P*,1 Yarascavitch C1

1 Faculty of Dentistry, University of Toronto School of Dentistry

* Corresponding author: Patrick McDonough [email protected] Objective: To systematically quantify and describe the errors occurring during the management of simulated dental office patient medical emergencies Methods: Digitally recorded performances of twenty-two dental teams of one dentist and assistant managing four different simulated medical emergencies (angina, anaphylaxis, bronchospasm, and hypoglycaemia) were reviewed (N=88). Scoring tools previously developed through a Delphi method were used to develop a coding structure for frequency counts of key interventions within scenarios (rescue drugs) and common interventions across all scenarios (oxygen administration (OA), emergency response system activation (EMS), vital sign monitoring (VS)). Errors of omission and commission were considered. Comission errors included both action errors and timing errors. Task interruptions, an error of commission, were also noted and categorized into 1) intrusions (non-task-related) and 2) interferences (task-related) which resulted in delay (D) of a task being completed or failure to follow through with said task (F). Results: Omission errors for rescue drugs were: 59.1% morphine and 18.2% aspirin during angina; 36.4% diphenhydramine during anaphylaxis; 45.5% midazolam during hypoglycemic seizure. Commission errors for rescue drugs were: 22.2% aspirin, 33.3% morphine and 95.5% nitroglycerin during angina; 46.2% diphenhydramine and 36.4% epinephrine during anaphylaxis; 28.6% ventolin and 23.1% epinephrine during bronchospasm; 18.2% oral carbohydrate and 11.1% midazolam during hypoglycemia. For tasks common to all scenarios, omission errors were rare (OA=3.4%, EMS=1.1%, VS=9.1%), but commission errors were more likely (interferences and intrusions for OA 29.4%, 12.9%; EMS 12.6%, 3.4%, and VS 12.5%, 5%, respectively). Interruptions resulted in both delay and failure to complete tasks (OA D=25.9%, F=7.1%; EMS D=16.1%, F=2.3% and VS D=18.8%, F=1.3%). Conclusions: Errors of omission and commission occur during the management of dental office medical emergencies and teams appear vulnerable to interruptions that are both task and non-task related, which resulted in delays of care or failure to complete care.

I D U A

Keywords: Dental Office, medical emergencies, simulation


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Characterisation of lithium disilicate dental ceramics with varying translucencies. 

Fitzgerald R *,1 Theocharopoulos A 1


* Corresponding author: Fitzgerald R, [email protected] Objectives: To test the equibiaxial flexural strength of a lithium disilicate heat pressed dental glass-ceramic with varying translucencies.   Methods:  Ingots of the five available translucency levels [High Opacity (HO), Medium Opacity (MO), Low Translucency (LT), High Translucency (HT) and Impulse Opal (IO)] of IPS e.max Press (Ivoclar, Schaan, Liectenstein) were processed into disc specimens (n=30, 1.5mm x 15mm). IPS Empress Esthetic (Ivoclar, Liechtenstein) served as a control group. Wax disc patterns were invested and the ingots from the control and the test groups were heat-pressed according to manufacturer’s recommendations. All specimens were tested using a ring-on-ring equibiaxial flexural strength test (ASTM C1499-05) at a 1mm/min crosshead speed until failure. Results were analysed using Gaussian (ANOVA, Tuckey’s Tests) and Weibull statistics. Results:  Mean [MPa (SD)] flexural strengths of the lithium disilicate groups were recorded as HO: 240 (32), LT: 242 (28), HT: 306 (54), IO: 337 (73) and MO: 409 (52) with significant (p<0.05) differences between translucency groups apart from the pairs LT-HO and HT-Imp (p>0.05). There were also significant differences between all the characteristic strength values with the exception of the LT and HO groups based on comparisons of overlap between double sided 95% confidence intervals. All the mean flexural strengths and characteristic strengths of the lithium disilicate groups were significantly (p<0.05) higher than the leucite-based control. A range of Weibull moduli from 5 to 10.4 were recorded for the lithium disilicate groups and were not significantly different (p>0.05) to the control group. Conclusion: Lithium disilicate test groups of 5 different translucency levels where found to be significantly stronger and of similar reliability to a commercial leucite glass-ceramic. Significant differences found amongst the different lithium disilicate translucency groups need to be further investigated.

I D U A

Keywords: Lithium Disilicate, flexural Strength, translucency


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A retrospective evaluation of cast versus fibre post placements 2008-2012

Lamba K*,1 , Burke F1


* Corresponding author: Komal Lamba, [email protected] Objective: The objective of this study was to investigate the distribution of direct fibre posts and, custom–fabricated, cast post and cores placed at Cork University Dental School and Hospital from 2008-2012. Method: This retrospective study was conducted using data from a five-year period (2008-2012) at Cork University Dental School and Hospital. Patients that were fitted with fibre or cast post and cores during this timespan were identified using the hospital’s computerized record system. The files of 350 patients who had been fitted with a total 437 posts were further analyzed by consulting patient records. The following parameters were used in the evaluation: type of restoration, year of treatment completion, location (maxilla, mandible), and tooth type (anterior, posterior). The results were tabulated using SPSS and statistical significance was determined at a level of p<0.05. Results: Among the 437 posts placed, 191 were fibre posts and 246 were cast post and cores. Results showed that over the five-year period, the proportion of fibre posts placed has increased from 2.90% to 81.30%, while a proportionate reduction from 97.10% to 18.80% of cast post and cores placed has been seen. A chi-square tests was performed and a significant relationship was found between year and the type of restoration, x

2 (4, N= 437) =121.979, p<0.001. The majority of fibre and cast

post and cores were placed on upper incisor or canine teeth (fibre posts: 46.6%, cast post and cores: 56.1%) while the least common placement were lower incisor or canine teeth (fibre posts: 4.2%, cast post and cores: 5.3%). No significant difference was found between tooth identity and restoration type. Conclusion: From the results of this investigation, direct fibre posts have become more commonly placed over cast post and cores at Cork University Dental School and Hospital. This information can be used for educational planning and resource allocation.

I D U A

Keywords: Fibre posts, cast post and core ,tooth identity


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Irish Division Postgraduate Award Abstracts


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The potential therapeutic value of BAMLET in OSCC

Sinevici N*,1 Harte N2 Hun Mok K2 O'Sullivan J1 1 School of Dental Science, TCD

School of Biochemistry and Immunology, TCD

2 * Corresponding author: Nicoleta Sinevici, [email protected]

Oral cancer (OC) is the 6th most common cancer worldwide posing an ever more increasing problem to society. Late stage diagnosis is characteristic for OC and surgery remains the standard treatment. OC occurs due to the accumulation of cell defects with ~50% of OCs displaying a p53 mutation. Objectives: The aims of this study were to determine if BAMLET, a complex of bovine alpha-lactalbumin made lethal to tumor cells, has the potential to disrupt dysplastic/cancerous oral cells and determine the mechanism through which BAMLET mediates cell death. Methods: BAMLET’s cytotoxic activity was examined using two oral cancer cell line models (+/- p53 mutation). Alamar blue was used to determine cell viability. Cells (1.5 X 105) were seeded in 96-well plates before treatment with BAMLET and maintained under standard conditions in FBS free medium for the duration of the exposure. Fluorescence of the alamar blue product was measured using a microplate spectrophotometer. The cell-killing mechanism of BAMLET was examined by propidium iodide (PI) using flow cytometry, this enabled examination of apoptosis- and necrosis- inducing activity. Cells were seeded at 7 X 106 cells/T25 flask and incubated overnight in 1% FBS. Cells were treated with BAMLET for 24 hours in FBS free medium and analysed using the BD FACS CANTO II flow cytometer. Results: BAMLET proved cytotoxic to both cell lines though cell viability experiments indicate a significant dose-dependent cytotoxicity and IC50 levels were determined. Cells displaying the p53 wildtype gene were more sensitive to treatment compared to the mutated p53 cancer cell line. Conclusion: BAMLET is cytotoxic to OC cell lines in a dose and p53 status dependant manner. Deciphering the mechanism of cytotoxicity will provide valuable information regarding treatment modalities for OC and also highlighting the significance of personalised treatment whereby the geno/phenotype of each cancer should be treated accordingly.

IDPA

Keywords: OSCC, therapeutics, BAMLET


29

Accuracy comparison of two dental CAD/CAM fabrication routes

Nasruddin MF*,1,2 Burke F 1 RayN1 Theocharopoulos A1 1 Cork University Dental School and Hospital, Wilton, Cork, Ireland

Universiti Teknologi MARA, Malaysia

2 * Corresponding author: Dr Mohd Faiz Nasruddin, [email protected]

Introduction: Computer-Aided-Design (CAD) and Computer-Aided-Manufacturing (CAM) of dental prostheses can save time and effort for dental technicians thus reducing cost of manufacture. Laser-Sintering (LS) and Milling (M) CAD/CAM fabrication routes are currently available for alloy frameworks. However, inaccuracies arising from the transition of virtual model to actual fabricated component may partly negate the benefits that these methods offer. Objectives: - To introduce a novel method utilising micro-computed tomography (micro-CT) that examines the CAD to CAM transition introduced inaccuracies. - To compare volume between LS and M fabricated copings. - To compare accuracy of LS and M copings to the original CAD design. Methods: An aluminium model of a prepared lower premolar tooth for a metal-ceramic crown was made. A virtual cobalt chrome coping was then designed (InciseCAD, Renishaw, UK) and saved as stereolithography (STL) format. Two groups of five copings were then fabricated via LS (AM125, Renishaw, UK) and M (Cybaman Replicator, Cybaman-Tech, UK) methods of CAD/CAM. All copings were then scanned and saved as STL format with micro-CT (Nanotom-X) to produce three-dimensional digital models. Actual/Nominal comparisons were then performed utilising multiple modelling/inspection software. Coloured deviation maps and volume differences were computed and statistically analysed. Results: Volume of LS copings differentiated significantly (p<0.01) to M copings with mean of 52.99(1.93) mm3 and 62.62(0.75) mm3 respectively. Volume of CAD design (56.96 mm3) was significantly different (p<0.01) to volume of LS and M copings. Mean deviations of LS and M copings were different significantly (p<0.05) to CAD design. Coloured distance mapping show contrast in surface roughness of LS and M copings. Conclusion: The CAD design differentiated statistically from the actual fabricated component. Results may negate time, labour and cost saving benefits of CAD/CAM, however the findings may facilitate improvements. Presented method also holds promise as a non-destructive method for manufacture accuracy testing.

IDPA

Keywords: CAD/CAM, FPD, accuracy


30

Ethanol modulation of hypoxia response proteins in oral epithelial cells

O'Callaghan K*,1 O’Sullivan J1 1 Division of Restorative Dentistry & Periodontology, Dublin Dental

University Hospital, Trinity College, Dublin, Ireland

2 * Corresponding author: Ms Kate O'Callaghan, [email protected]

Objectives:Oral squamous cell carcinoma (OSCC) is a destructive disease with an extremely aggressive nature and poor survival rate. The role alcohol, a known risk factor, has to play in the progression of the disease is yet to be fully investigated. This study aims to further understand the role of ethanol in the carcinogenic transformation of oral tissue with specific interest in the role of p53 and subsequent effects on redox controlling genes and proteins. Methods: We examined the effect of ethanol on primary human epithelial cells recovered from mucoperiosteal tissue of patients in the Dublin Dental Hospital. Variations in the effect of ethanol exposure between patients was studied and compared to data obtained from two cell lines; Ca9.22 a gingival cell line and TR146 a buccal mucosal cell line. Cells were cultured in the presence or absence of a range of ethanol concentrations over 6, 24 and 48h time points. Extracellular production of H2O2 was monitored using Amplex Red and intracellular levels were monitored using 2',7'--‐dichlorfluoresceindiacetate using flow cytometry and confocal microscopy. Protein expression levels of targets of interest within the cell were determined through quantitative real time polymerase chain reaction (qRT--‐PCR). Results: Ethanol concentrations from 0.1--‐3% showed no detrimental effect on cell survival over the given time course. The presence of ethanol was found to reduce the release of H2O2 in a dose dependent manner (p< 0.5--‐ 0.001, n=3). However variation in the expression levels of redox enzymes was observed in both human primary cells and cell lines. Differential expression of MnSOD occurred between cells containing mutations in the tumor suppressor protein p53. Conclusion: These results identify a possible novel mechanism of ethanol and p53 mediated redox response through an imbalance of antioxidant enzymes and oxidative stress, which may promote tumor cell survival.

IDPA

Keywords: Cancer, ethanol, hypoxia, p53


31

Strength determination of curved brittle dental materials

Hooi P*,1 Addison O2 Fleming GJP1 1 Dublin Dental University Hospital

University of Birmingham

2 * Corresponding author: Dr Paul Hooi, [email protected]

Introduction: We investigated the influence of non-planar geometries on the maximum-principal-stress of curved-discs tested in biaxial flexure. Radii-of-curvature analogous to elements of complex dental geometries and a finite-element-analysis (FEA) method were integrated with experimental testing as a surrogate solution to calculate the maximum-principal-stress at failure. Methods: We employed soda-lime-glass discs, a flat control (n=20) as Group A with curvature applied to the remaining discs by slump forming to different radii-of-curvature (30, 20, 15 and 10 mm) as Groups B-E. The mean deflection (Group A) and radii-of-curvature obtained on slumping (Groups B-E) were determined by profilometry before and after annealing and surface treatment protocols. FEA used the biaxial flexure load-to-failure data to determine the maximum-principal-stress at failure. Mean maximum-principal-stresses and load-to-failure were analysed using one-way ANOVAs and Post-hoc all-paired Tukeys tests (P<0.05). Results: The measured radii-of-curvature differed significantly between groups and the radii-of-curvature was not influenced by annealing. Significant increases in the mean load-to-failure were observed as the radius-of-curvature was reduced. The maximum principal stress did not demonstrate sensitivity to radius-of-curvature. Conclusions: The findings highlighted the sensitivity of load-to-failure data to specimen shape demonstrating that comparisons between load-to-failure data in isolation is problematic and highlights the potential complications associated with complex specimen geometries.

IDPA

Keywords: Maximum-principal-stress, radius-of-curvature


32

An in vitro model of nociceptors in human trigeminal nerves

Clarke R*,1 Monaghan K1 About I 1 Curtis TA1 Cosby LS1 McGarvey LP1 Lundy FT 1

1 School of Medicine, Dentistry and Biomedical Sciences, Queens University, Belfast.

* Corresponding author: Ms Rebecca Clarke, [email protected] Background: The oro-facial region is densely innervated by the trigeminal nerve, which when stimulated can induce noxious pain sensation and contribute to neurogenic inflammation in local tissues. Recent research on the expression of specialised ion channels on the trigeminal nerve has highlighted the need to undertake more extensive studies on ion channel expression/functionality with the aim of elucidating their role in pain sensations. A major family of such ion channels is the transient receptor potential (TRP) channels which are activated by a wide variety of thermal, mechanical or chemical stimuli and merit investigation as possible druggable targets for future analgesics. Objectives: Study of TRP channel expression and regulation in oro-facial tissues is hindered by the fact that the cell bodies of neurons innervating these tissues are located in the trigeminal ganglion. Using dental pulp stem cells differentiated towards peripheral neuronal equivalents (PNEs) we sought to study TRP channels on human neuronal cells and determine whether their expression is regulated by inflammatory cytokines. Methods: Dental pulp stem cells (DPSCs) were grown on substrate-coated tissue culture plates and differentiated towards a neuronal phenotype using neuronal induction media. RNA was extracted from PNEs +/-cytokine treatment. The RNA was then reverse transcribed into cDNA and quantified by the quantitative polymerase chain reaction (qPCR). Results: qPCR analysis showed that PNEs expressed the TRP channels TRPA1, TRPV1, TRPV4 and TRPM8. TRPA1 was the most abundantly expressed TRP channel of those studied whereas TRPM8 was lowly expressed. TRP channel expression was shown to be regulated by treatment with inflammatory cytokines. Conclusion: PNEs differentiated from DPSCs provide a suitable model for TRP channel expression and regulation in oro-facial tissues. This human neuronal model has potential for use in pre-clinical studies of novel analgesics. This study was funded by National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs).

IDPA

Keywords: Pain, inflammation, TRP channels, trigeminal


33

The use of atraumatic restorative treatment in elderly patients

Da Mata C*,1 Allen F1 O'Mahony D1 Cronin M1 Woods N1 1 School of Dentistry, University College Cork

School of Medicine, University College Cork School of Mathematical Sciences, University College Cork School of Policy Studies, University College Cork

2

3

4

* Corresponding author: Dr Cristiane da Mata, [email protected]

Objectives: to compare the survival rate, impact on patients’ quality of life and, cost-effectiveness of Atraumatic Restorative Treatment (ART) and a conventional treatment (CT) to restore carious lesions in an elderly population. Methods: In this randomised clinical trial, 99 independently living adults (65-90 yrs) with coronal and root carious lesions were randomly allocated to receive either ART or CT. Details of restored, missing and carious teeth were recorded and patients answered questions about their oral hygiene and dental attendance habits. Direct and indirect costs were measured based on treatment time, materials and labour. Effectiveness was measured using restoration survival percentage after one year. The survival of restorations placed using standardised clinical protocols was assessed by an independent examiner 6 months and one year after restoration placement. Oral-health related quality of life (OHRQoL) was assessed using the OHIP-14 at baseline and 2 months after treatment together with a global transition statement used to measure satisfaction with oral health status. Results: The patient sample comprised 46 male and 53 female participants at baseline, with a mean age of 73.18 (SD=6.76). The mean DMFT of the entire sample was 27.10. Ninety patients and 268 restorations could be assessed using modified ART criteria after one year, with 127 ART (46 patients) and 141 conventional restorations (44 patients). 93.7% and 97.2% of the restorations placed were considered successful in the ART and CT groups, respectively. The OHIP scores did not change signficantly 2 months after treatment in either group. The global transition scale showed an improvement in overall oral health after treatment for the majority of patients in both groups. The ART were more cost-effective compared to the CT restorations. Conclusions: ART presented survival rates similar to CT after 1 year and was a more cost-effective alternative to treat caries in the elderly. Patients in both groups reported similar OHRQoL outcomes.

IDPA

Keywords: Gerodontology, caries, public health


34

RCSI Award Abstracts

Sponsored by: Royal College of Surgeons in Ireland

35

Longitudinal analysis of peri-implant health using resonance frequency analysis

Alkaradsheh O*,1 Polyzois I1 O'Sullivan J1 Claffey N1 1 Dublin Dental University Hospital-Trinity College Dublin

* Corresponding author: Dr. Omar Alkaradsheh, [email protected] Objectives: To evaluate the diagnostic potential of a resonance frequency analysis device (RFA) in monitoring peri-implant health and investigate how clinical and inflammatory changes in peri-implant tissues relate to changes in RFA values. Finally, to test if the orientation of the transducer can affect the RFA values. Methods: 15 patients (38 implants) with implant-supported over-dentures were recruited. Clinical examination, Peri-implant Crevicular Fluid (PICF) samples and RFA values (measured using an Osstell ISQ™ device) were obtained at baseline, 1-2 weeks, 3 months and 1 year. Implants were diagnosed as healthy, with peri-mucositis or peri-implantitis according to their baseline examination. The PICF samples were analysed using the Human Inflammatory Cytokines kit and flow cytometry to quantitatively measure the levels of IL-1β, IL-6, IL-8, IL-10, IL-12 P70 and TNF-α. Non-surgical therapy was provided at the end of each visit. Descriptive statistics and multilevel analysis were used for data analyses. Results: in 14 patients (34 implants), Bleeding on Probing (BoP) and Plaque Scores (PS) improved over the study period while such an improvement was not seen in the probing depths (PPDs). RFA values showed a tendency to increase over time particularly in implants diagnosed with peri-implantitis at baseline; a positive correlation (Pearson, r=0.65, P<0.0001) was observed between RFA values measured at two perpendicular directions (Bucco-lingually & Mesio-distally). The multilevel analysis indicated that changes in the ISQ values over time were positively related to changes in BoP, IL12 p70 and treatment while it was negatively related by changes in PPD, IL-10 and TNF-α. Conclusion: Taking into consideration the limitations of this study, RFA appear to be sensitive to certain changes in clinical and inflammatory parameters. Further studies are needed to confirm that the ISQ device is a useful tool in monitoring peri-implant health. Finally, RFA values did not seem to be affected by the orientation of the transducer.

RCSI

Keywords: Diagnosis, peri-implantitis, clinical, RFA, cytokines


36

Comparison of two different techniques used to maintain peri-implant health

Al Ghazal L*,1 Polyzois I1 1 Dublin Dental School and Hospital, Trinity College Dublin, Dublin, Ireland

* Corresponding author: Logien Al Ghazal, [email protected] Aim: The aim of this study was to compare the effectiveness of two different methods of debridement for the prevention of peri-implant mucositis over a period of 12 months. Materials and Methods: Twenty adult patients were enrolled in a randomized, single blinded, parallel group clinical trial. All implants included showed no signs of bone loss. Patients were scheduled to be reviewed every three months over a 12 months period.Ten patients were randomly allocated to a test group and treated with alow abrasive air polishing powder (Air-Flow® Perio, EMS) and another ten to a control group and treated with titanium curettes.A number of clinical parameters were measured and peri-implant crevicular fluid (PICF) samples were collected prior to treatment at each follow up visit. PICF samples were analyzed to quantitatively measure the concentration of six interleukins (IL-6, IL-8, IL-1β, TNF, IL-10 and IL-12). A random effect multilevel analysis was used to test the comparison between the two treatments. The same analysis was used to study the relationship between clinical parameters and cytokines while controlling for confounding factors. Results: There was no significant difference between both treatment methods (P=0.35). Both debridement techniques resulted in a mean reduction of BOP (40.04% and 39.93%). A mean probing depth(PD) reduction of 0.8mm and 0.9mm for control and test groups was also observed. IL-6 was the only cytokine of the six investigated that demonstrated a correlation with a clinical parameter (BOP) (P=0.05). Conclusion: Both treatment methods were proven to be effective in reducing peri-implant inflammation and preventing further disease progression. One could suggest that some cytokines may act as markers for peri-implant disease as the present study showed a significant relationship between IL-6 and BOP.

RCSI

Keywords: Peri-implant mucositis, maintenance, air flow


37

Odontogenic infections and their management: A four year retrospective study

Bowe C*,1 Gargan ML1 Kearns G1 Stassen L1 1 St James Hospital, Dublin, Ireland

* Corresponding author: Dr Conor Bowe, [email protected] . Aim: To review the treatment and management of odontogenic infections in a large urban teaching hospital. Objectives: a) To assess the change in presentation since the changes were made to the dental treatment services scheme (DTSS) and the dental treatment benefits scheme (DTBS). b) To evaluate the management required to treat these infections. Method: Data was collated by a combination of a comprehensive chart review and electronic patient record analysis based on the primary discharge diagnosis as recorded in the hospital inpatient enquiry (HIPE) system. Results: Fifty patients were admitted to the National Maxillofacial Unit, St James Hospital under the oral and maxillofacial team from 2008 – 2011 inclusive, with an odontogenic infection as the primary diagnosis. A total of 34 males (68%) and 16 females (32%) was recorded. The age range was 15-91 with a mean of 38.5, and median of 33. Tertiary referrals from other acute hospitals were the most common referral source (n=26, 52%). Other referrals came from general dental practitioners / private medical clinics (n=10, 20%), Dublin Dental Hospital (n=8, 16%) and self-presentations to the emergency department (n=6, 12%). The primary cause of the odontogenic infection was dental caries in all patients. In this study 58% (n=29) of the carious teeth involving the mandibular molar teeth. The mandibular second molar was the tooth most frequently involved (24%, n=12). The most frequent single space infection was the submandibular (42%, n=21) followed by the buccal (16%, n=8), infraorbital (12%, n=60) and parapharngeal (8%, n=4). Ninety per cent (n =45) of patients required surgical intervention from the oral and maxillofacial team. The length of stay (LOS) ranged from 2-37 days, with a median of 5.5 days. Conclusions: The number of patients requiring secondary and tertiary care for the treatment of odontogenic infections has increased since the introduction of the changes to the medical card and pay related social insurance (PRSI) entitlements, namely the DTSS and DTBS in 2010. The mean length of stay is increasing with most patients having an in-patient hospital stay of more than 5 days.There is increased use of valuable resources at a secondary level for a preventable and treatable disease which ideally would be treated in the primary care setting. Increased resources should be made available to reduce barriers to access and thereby lessen the potential for morbidity and mortality associated with serious odontogenic infections

RCSI

Keywords: Peri-implant mucositis, maintenance, air flow


38

Comparison of anaesthetic regime in patients undergoing third molar extraction.

Warren E*,1 Sleeman D1 1 Cork University Dental School and Hospital, Wilton, Cork, Ireland

* Corresponding author: Emma Warren, [email protected] . Objectives: To compare current practiced anaesthetic regimes in third molar extraction. To determine whether intra-operative local anaesthetic improves patient satisfaction following third molar extraction, and the effect if any; this has on the magnitude of acute pain experienced. Materials and Methods: A prospective observational clinical trial. 52 patients for surgical removal of bilateral third molars under general anaesthesia were recruited. Local anaesthetic in the form of 2% lidocaine with 1:80,000 epinepherine was administered on one randomly allocated side. Data was recorded with respect to; patient demographics, psychometric analysis, third molar assessment, surgical technique, and post operative pain levels including a one week pain diary. Data was analysed using SPSS 18.0 (SPSS, Chicago, Illinois, USA). Normally distributed data was analysed using a student’s paired t-test; non- parametric data using the Wilcoxon signed-rank test and the Kruskal- Wallis test. For categorical variables Chi-squared test was applied. Results: The average age was 24.1 with a standard deviation 6.9. The distribution by sex was 21% men and 79% women. Psychometric analysis had no effect on overall outcomes. All 52 cases had bilaterally symmetrical third molar impactions. Data assessment with regards to control and experimental sites showed no difference in the frequency of surgical technique employed and no significant difference between the mean surgical times of either side (P>0.1). Pain assessment showed a significant difference between mean and experimental sides in the post-operative period until discharge (P<0.001). High levels of patient satisfaction were reported. Conclusion:This split-mouth, randomised study has minimised the variables of age, sex, race, anxiety and personality in the exploration of pain experience and satisfaction following third molar surgery. We have conclusively shown a significant difference in pain experience during the immediate post operative period with the use of local anaesthesia in third molar day case surgery. The high levels of satisfaction suggest that this is an acceptable treatment modality.

RCSI

Keywords: Third molar extractions


39

Improving intra-examiner variability of Little’s Irregularity using 3D digital models.

Burns A*,1 Garvey T1 Dowling A1 Flemming GJP1 1 Dublin Dental University Hospital

* Corresponding author: Dr Angus Burns, [email protected] . Objectives: To compare contact point displacement measurements, used to determine the Little’s Irregularity Index (LII) score on study casts and digital models of the study casts by an independent examiner. Methods: The contact point displacement measurements of the six maxillary labial teeth were measured on ten study casts using digital callipers and their associated digital models using Creo Parametric software on five occasions following scanning using a LAVA Chairside Oral Scanner (LCOS) three-dimensional (3D) intra oral scanner. Means, standard deviations and coefficients of variation (CoV) were determined, data analyses (Pearson's correlation coefficients (PCCs) and Intraclass correlation coefficients (ICCs)) and statistical analyses (three and two-way analyses of variance (ANOVAs) and Independent Sample Student's t-tests) were carried out (p<0.05). Results: Significant positive correlations for the contact point displacement measurements were evident between all measurement time points for the study casts (r>0.978; p<0.0001 and ICC>0.910; p<0.0001) and the digital models (r>0.963; p<0.0001 and ICC>0.986; p<0.0001). The CoV results showed that 41% of the study casts had a CoV of >0.20 (20%) while 22% of the digital models had a CoV of >0.20 (20%). Independent Sample Student’s t-tests (33 of 50) showed significant differences (p<0.042) between the individual contact point displacement measurements from the study casts and the digital models. Conclusion: The use of 3D digital models can improve the reliability of LII measurements by reducing the subjectivity associated with choosing the anatomic tooth contact points and the clumsiness of measuring the contact point displacements on study casts using a cumbersome calliper technique. Intra-examiner variability in the measurement of LII is still evident with digital models suggesting either improved software specifically aimed at the orthodontic community be identified or a new method for measuring anterior incisor crowding should be sought.

RCSI

Keywords: Littles irregularity index, intra oral scanner


40

An ex vivo molar model to assess irrigation regimens

Quilligan G*,1 Ng Y-L1 Gulabivala K1 1 Eastman Dental Institute, University College London

* Corresponding author: Dr. Graham Quilligan, [email protected] . Objectives: To develop an ex vivo molar model to simultaneously investigate NaOCl extrusion and irrigation efficacy of three final rinse regimens. Methods: Extracted human molars (n=60) were randomly assigned to three experimental groups. Stained collagen was applied to accessed, unprepared root canal walls, a simulated periapical lesion was attached and teeth mounted in plastic boxes filled with yellow dyed mounting plaster. Each tooth was prepared to 35/0.06 using ProFile® rotary instrumentation. The final rinse irrigation regimens of 8 mL NaOCl (2.5%) per canal were: Group A – passive syringe irrigation (PSI); Group B- manual dynamic irrigation (MDI); and Group C – EndoVac® irrigation system. The model was then disassembled into two halves and photographed to assess the area of “bleached” plaster. Each tooth was removed from the model, demineralised in nitric acid (5%), each root amputated and divided longitudinally into two equal halves with a scalpel blade. The proportion of residual stained collagen was assessed using Image Pro-plus software. Data were subjected to regression analyses. Results: The EndoVac® system resulted in significantly less extrusion of NaOCl than PSI (P = 0.02) and MDI (P = 0.03), while there was no obvious difference (P = 0.1) between the latter experimental groups. Potential confounding factors did not have a significant influence. There was no obvious difference (P = 0.7) between EndoVac® and MDI at removing the stained collagen film, while both were better than PSI alone (P = 0.001 and P= 0.007 respectively). Only apical foramen size had a significant influence (P= 0.04) with 36% more residual stained collagen per 1 mm increase in foramen size. Conclusion: The EndoVac® irrigation system resulted in less extrusion than the other two regimens. MDI was comparable to EndoVac® in removing stained collagen. The advantage of the EndoVac® system is reduced irrigant extrusion.

RCSI

Keywords: Molar, model, assess, irrigation regimens


41

DHF Award Abstracts

Sponsored by: Dental Health Foundation of Ireland

42

“Are you talking to me?”: Exploring triadic communication in dentistry

Kelly A*,1 Nunn J2 Walsh I1 1

2 Trinity College Dublin Dublin Dental Hospital

* Corresponding author: Dr Aengus Kelly, [email protected] . Objectives: Understand the dynamic, triadic nature of interaction between dentist, nurse and patient; Explore the role of the dental nurse in promoting and maintaining engaged communication. Methods: Twenty-nine audio-recordings were made of clinical interactions in Irish primary care dental settings. A Discourse Analysis of the transcribed data (comprising more than 11 hours) highlighted instances where interactional engagement became salient. This paper focuses on Goffman’s notion of ‘participation framework’ (Goffman, 1981:31), which distinguishes roles such as Speaker and Listener, introduces the idea of an interactional ‘pivot’, and considers the involvement of each participant in a given framework. Results: Four communication pathways were observed: Direct: the nurse communicates directly with the patient to establish or maintain rapport, or to explain treatment; Conduit: the dentist, in dictating clinical notes or otherwise engaging in clinical conversation with the nurse, addresses the patient indirectly with an explanation or a plan embedded in this conversation; Pivot 1: the dentist and nurse establish an informal or personal interaction, indirectly inviting (and resulting in) the patient’s participation; Pivot 2: the nurse causes a suspension of the dentist’s normal interactional power by interrupting the usual dentist-patient interactional dynamic. Conclusion: In the triangular interaction pivoting between dentist, nurse and patient, what is said (or not said) by an interactant influences, and is influenced by, the others. The communicative role of the dental nurse deserves greater scrutiny. Rather than assessing the interactional ‘performance’ of the dentist in isolation, an analysis of the triad may improve our understanding of the development of rapport, interactional engagement and effective communication. The results of such analysis might influence the communicative training of the dental team, and enhance the development of patient-centred care and theories of health promotion.

DHF

Keywords: Communication, engagement, triadic, nurse, team


43

Retrospective study of dental general anaesthesia and financial considerations

McAuliffe U*,1 Kinirons M,1, Woods N,1, Harding M,1,2,3 1

2

3

University College Cork OHSRC, Cork University Dental School and Hospital HSE-South (Cork ISA), Dental Clinic, Ballincollig, Co Cork

* Corresponding author: Dr Una McAuliffe, [email protected] Objectives: To investigate a cohort of pre-school children referred to HSE South for dental extractions under general anaesthesia (DGA) considering indication for referral, treatment completed and associated risk factors. To examine subsequent dental experience and average cost of care relative to a preventive program for the same cohort. Methods: A retrospective review of records of children aged 5 and under referred for DGA to HSE South between the year 2000 and 2002 was completed. Demographic and clinical data was collated and analysed using SPSS. Costs were examined at a micro-economic level and provided by Cork University Hospital and HSE. Costs of a preventive program for this cohort were obtained from the Irish Oral Health Services Guideline Initiative. Results: 347 children were included. A higher proportion of children of low socio-economic status were attending for treatment under DGA than was representative of the population. The majority of patients were living in a fluoridated area (73%) and had no relevant medical history (91%). For 88% of children examined their first dental visit was an emergency appointment. The primary indication for DGA was treatment of dental caries with 59% of children suffering from early childhood caries. One fifth of patients had an extraction of a permanent tooth. Eighty percent of patients included in this research did not receive a recall appointment post DGA. Ten percent of children were referred for their second DGA while 15% of patients required either antibiotic or an extraction in the immediate visit post DGA. The average cost of DGA per child was €818.97. Conclusions: Pre-school children are not routinely screened by public services in Ireland and consequently a large proportion of this population require referral for extractions of primary and permanent teeth under DGA. Results have shown that such children progress to adolescence with poor oral health as evidenced by the need for further restorations, extractions and repeat treatment under DGA. The average cost of the service examined is over €8,000 per day. This figure has been shown to be as much as eight times the cost of a preventive/oral health promotion program operating within the same cohort. A nationally structured preventive program

DHF


44

targeting pre-school aged children is vital from an economic and oral health perspective in attempting to defeat the high levels of dental caries within this group.

Keywords: Dental, general anaesthesia, public healthcare costs

45

Quality of life and treatment satisfaction in cleft lip/palate patients

Whitaker A*,1 O'Mahony A2 McKiernan E2 1

2 Cork University Dental School and Hospital, Wilton, Cork, Ireland Cleft Orthodontic/Prosthodontic Department, National Maxillofacial Unit, St. James’s Hospital, Dublin

* Corresponding author: Dr T Aisling Whitaker, [email protected] Objectives: Over their lifetime, Cleft Lip and Palate (CLP) patients undergo a myriad of treatments including cranio-facial surgeries, speech and language therapy and substantial dental procedures. While the physical changes that occur over the course of treatment are apparent, the effect on the social and emotional aspect of their life is less understood. This study aims to investigate the impact that being born with CLP has on Quality of Life (QOL). Further, the experience and satisfaction of patients undergoing treatment was evaluated. Methods: Participants (aged 20-56 years) were recruited from the Cleft Orthodontic/Prosthodontic Department, National Maxillofacial Unit, St. James’s Hospital. Semi-structured interviews (n=2) and focus groups (n=12) were conducted. These were recorded, transcribed and subsequently analysed using thematic analysis. Results: Overall, participants reported that while growing up with CLP was difficult in terms of peer comparison and bullying, it did not define who they were as a person. Some described a dichotomy in terms of how they presented themselves as strong in public, despite struggling with identity in private. Difficult time-points arose from the data, with realisation of peer-difference around 8 years, and social difficulties during the teenage years. All patients reported strong parental support in their role as advocate, informer, protector and empowerer. Undergoing treatment was sometimes painful, often time-consuming and burdened family and work commitments. However, the physical and emotional outcomes achieved outweighed these negative experiences for patients. Conclusion: Being born with CLP has an impact on the social and emotional wellbeing, thus QOL, of a person. This effect is particularly apparent in childhood. In the presence of strong support systems and with age, there is identity resolution. Elective dental and surgical procedures can benefit CLP patients not only in a physical sense but also bring confidence, raise self-esteem and improve QOL.

DHF

Keywords: CLP, QOL, Treatment Satisfaction


46

Toothpaste use in preschool children. Facebook - A valid research methodology?

Mc Loughlin M*,1 Whelton H1 1 Cork University Dental School and Hospital, Wilton, Cork, Ireland * Corresponding author: Ms. Mairead Mc Loughlin, [email protected] Objectives: To determine the pattern of use (age of introduction, amount and frequency of use) of fluoridated toothpaste for children in Ireland. Generate report on patterns of toothpaste use as reported by the three samples and report on the experience of using Facebook as a research tool with recommendations for future use to inform the Fluorosis and Caries in Children’s Teeth (CARG 2012) project at the OHSRC. Methodology: There were 3 samples of interest in this project 1: The sample of parents whom have already completed the Happy Teeth questionnaire (Disadvantaged). 2. Sample recruited though Facebook (mixed SES). 3. Sample recruited from preschools in Cork area(mixed SES). Seven questions were used pertaining to the pattern of use of toothpaste by the child, one relating to the SES of the child and two relating to Facebook use(sample 3). An advertisement campaign was set up on Facebook targeted at parents 18-40yrs of preschoolers, allowing users to fill out questionnaire via survey monkey (sample 2). Results: Of 545 paper questionnaires distributed 115 were returned for a response rate of 21%. Online questionnaires generated 328 responses over a 2 week campaign length. An overwhelming percentage of parents had never received advise on toothbrushing . Of parents who were beginning tooth brushing at correct time, majority were introducing toothpaste at this stage also not in keeping with current guidelines of beginning toothpaste use at age 2 . Conclusions: Facebook has shown to be a valid research methodology with regard to responses however control over participants is rather limited with age ranges of children being far wider in this sample group. Via all surveys it is clear to see a lack of knowledge amongst parents in Ireland in relation to adopting correct toothbrushing habits.

DHF

Keywords: Toothpaste, toothbrushing, preschool, Facebook


47

Subjective outcomes of edentulous patients treated by Clinical Dental Technology students.

Ahmed S*,1 Lally U 1 O’Connell B1 1 Dublin Dental University Hospital, Dublin, Ireland * Corresponding author: Sittana Ahmed, [email protected]

Introduction: Clinical Dental Technology (CDT) was recognised in Ireland as a way to increase patient access to dental care. A CDT training programme was established in the Dublin Dental University Hospital (DDUH) and students were recruited from among qualified dental technicians. There is little data available to document the experience of patients treated by CDT students. Objective: The objective of this project was to evaluate the impact of complete denture treatment provided by CDT students in the DDUH. Methods: A cohort of 15 edentulous patients was provided with complete denture by CDT students. The patients were surveyed before treatment and 3 months after treatment was completed. Structured interviews and a clinical examination were conducted to collect objective data (Prosthodontic Diagnostic Index of edentulism - PDI) and subjective data (Denture Satisfaction Questionnaire and OHIP-EDENT). Results: One male and 14 females completed the study; the median age was 74 years and the time edentulous 31.5 years. Most participants were considered complex (PDI class III or IV). The complete dentures provided by the CDT students yielded a significant increase in overall denture satisfaction (2.33 vs 3.27 p=0.02). There were also significant improvements in chewing function, choice of foods and enjoyment of meals. There was no reported change in speech, comfort or stability of dentures, or broader indicators such as socialisation, self-confidence and general health. In all seven domains of OHIP-EDENT, there was a reduction in values post-treatment, though the only significant improvement was in physical pain. Conclusion: Patients reported an increase in satisfaction and eating following denture treatment by CDT students. These results are consistent with care provided by dentists and dental students. From a patient perspective, CDT students in the DDUH achieve proficiency in complete denture treatment. This project was supported by HRB grant HRA_HSR/2011/2

DHF

Keywords: Edentulism, dentures, education


48

Poster Abstracts

Poster award sponsored by: Pamex, Kin

49

Dentine tubule occlusion of an experimental anti-sensitivity toothpaste in-situ Parkinson C*,1, Hughes N1, Targett D1, Ferrier A1, Jones SB2, Seong J2, Davies M2, Macdonald EL2, West NX2

1 GlaxoSmithKline Consumer Healthcare, Weybridge, UK Applied Clinical and Materials Science Group, Bristol Dental School, Bristol 2

* Corresponding author: Dr Charles Parkinson, [email protected]

Objectives: To compare the dentine occluding properties of an experimental antisensitivity toothpaste containing 0.454% w/w stannous fluoride (SnF2), a marketed 0.454% SnF2 containing toothpaste (Crest® ProHealth), a control toothpaste (Colgate® Cavity Protection) and water, after 4 days of twice daily treatment using an in situ model. Methods: This was a single centre, single-blind, randomised, split-mouth, four treatment, two period crossover design, in-situ, study in 28 healthy subjects. Subjects wore (for ~5 hours) lower right and left buccal intra-oral appliances fitted with four dentine samples each. One study product was applied (with brushing) to each appliance, twice a day (morning/afternoon), per 4 day treatment period. At the end of each treatment day one dentine sample was removed from each appliance for analysis by scanning electron microscopy (SEM). On Days 3 and 4, two in vivo acid challenges occurred (25ml/minute orange juice for 10min). The extent of tubule occlusion was determined by visual scoring of the SEM images. Results: The experimental SnF2 toothpaste demonstrated greater dentine occlusion than the water and control toothpaste, on Days 2, 3, and 4. The differences observed on Days 3 and 4, under acid challenge conditions was statistically significant (p<0.05). The marketed SnF2 reference toothpaste demonstrated statistically significantly greater (p<0.0001) tubule occlusion, at all time points compared to all other treatments. Conclusion: Both SnF2 containing toothpastes demonstrated statistically significantly greater dentine occlusion than the control toothpaste (Colgate Cavity Protection) and water, under acidic challenge conditions on Days 3 and 4. This observation is in agreement with the purported mode of action of SnF2 - the formation of an occluding layer composed of stannous salts, insoluble under weak acidic conditions. The relative differences in the level of occlusion observed for the two SnF2 containing toothpastes are attributed to the different active dispersion characteristics of the formulations, under the conditions of this in-situ model.

Keywords: Dentine tubule occlusion, anti-sensitivity, toothpaste


50

Impact of prosthodontic rehabilitation on the chewing efficiency of partially dentate older patients McKenna G1, Schimmel M2

1 Cork University Dental School and Hospital, University College Cork, Ireland Division of Gerodontology and Removable Prosthodontics, Dental School, University of Geneva, Switzerland

2

* Corresponding author: Dr Gerry McKenna: [email protected]

Objectives: This study compared two tooth replacement strategies for partially dentate older patients namely; removable partial dentures (RPDs) and functionally orientated treatment based on the shortened dental arch (SDA) concept. Patients were compared in terms of chewing efficiency after prosthodontic rehabilitation. Methods: Chewing efficiency was assessed electronically by a two-colour gum-mixing test. Specimens were assembled from two different colours of chewing gums with a size of 30 x 18 x 3 mm. After participants chewed for 20 cycles, the gum was retrieved, flattened to a 1-mm-thick wafer, and digitized with a flatbed image scanner. The pixels of unmixed colour in the specimen were counted by means of Adobe Photoshop 2.0R software (Adobe Systems, San Jose, CA, USA), and the ratio to the pixels of the entire frame was computed. This ratio is called the Unmixed Fraction (UF). The more efficiently the specimen is chewed, the less unmixed colour remains, and the smaller the gum becomes. Consequently, a low unmixed fraction corresponds to good chewing efficiency. Results: 32 patients completed the chewing efficiency test (17 RPDs and 15 SDA). The mean UF recorded for the SDA group was not significantly different to that recorded for the RPD group (p>0.05, unpaired t-test). Conclusion: These results indicate that prosthodontic rehabilitation according to the principles of the SDA is equivalent to RPDs in terms of restoration of chewing ability for partially dentate older patients.

Keywords: Elderly, Prosthodontics, Function


51

Nutritional Status of older patients attending Cork University Dental School and Hospital Ong KR *,1, Goh SY1, McKenna G1, Hayes M1 1 Cork University Dental School and Hospital, University College Cork,

Ireland

* Corresponding author: Kay Rin Ong, [email protected]

Objectives: This study aimed to gather data on the nutritional status of older patients attending Cork University Dental School and Hospital for treatment in the Restorative Department. Information was also collected about the medical status of the patients including the prevalence of self-reported xerostomia. Methods: Data was collected by a self-completion questionnaire followed by a brief clinical examination. Nutritional Status was measured using the short version of the Mini Nutritional Assessment (MNA) which recorded patients’ Body Mass Index (BMI). The MNA consists of 6 parameters (including questions relating to patients’ history and anthropometric data) with a maximum total of 14 points. Scores of 12-14 indicate “normal nutritional status” whilst those between 8 and 11 indicate a patient “at risk of malnutrition”. Scores lower than 8 are an indication a patient who is “malnourished”. All patients attending Cork University Dental School and Hospital aged 65 years and older were invited to participate in the study. Results: A total of 22 subjects participated in this study. Twelve patients were partially dentate with 10 edentulous. The results from the MNA indicate that 11 patients were of “normal nutritional status” with 11 patients identified as being “at risk of malnutrition”. None of the subjects were “malnourished”. Edentate patients generally recorded lower MNA scores than partially dentate patients. In total, 9 patients reported experiencing xerostomia with 8 indicating that they needed to sip liquids to aid swallowing but only 3 had difficulty swallowing food. Conclusion: This small study indicates that a number of the older patients attending Cork University Dental School and Hospital for dental care may be “at risk of malnutrition”. These findings suggest that nutritional advice and dental care should both be included in an overall package of care for older patients.

Keywords: Elderly patients, Nutrition, Dry mouth/xerostomia


52

Forensic Odontology in Cork: A 3 year review Brady P*,1 Hayes M 1


* Corresponding author: Paul Brady, [email protected]

Objectives: To describe the use of forensic dentistry to identify human remains in Cork over a three year period. Methods: The ante mortem and post-mortem dental records of deceased persons examined over a three year period in Cork University Hospital were reviewed and data extracted by two independent reviewers. Results: Forensic odontology was requested for 23 (21 M, 2 F) deceased persons over a two year period. 19 of these were successfully identified using ante-mortem dental records, 1 was subsequently identified using DNA testing and three are unidentified to date. The mean age of those identified was 45.6 years (range 33-75). Dental records were available for 19 cases, 17 of these were in English and two were in Polish. Dental radiographs were available in 11 cases. The time elapsed between the ante-mortem dental records available and the post-mortem examination was on average 4.4 years (range 1 to 17 years). 11 of the 19 sets of dental records were assessed as good, four were fair and four were poor. Conclusion: Forensic odontology is a useful method of identifying otherwise unidentifiable human remains and is less expensive and faster than DNA identification. It does however rely heavily on good ante-mortem dental records.

Keywords: Forensic odontology, record-keeping


53

Zinc releasing multicomponent bioactive glasses for toothpastes Lynch E*,1 Hill R1 Gillam D2 Mneimne M1 Brauer D1 1 Dental Physical Sciences, Barts and the London School of Medicine and

Dentistry, Queen Mary University London Adult Oral Health, Barts and the London School of Medicine and Dentistry, Queen Mary University London, United Kingdom.

2

* Corresponding author: Lynch, [email protected]

Objective: Bioactive glasses (BG) have been incorporated into toothpastes to treat dentine hypersensitivity (DH) and promote tooth mineralisation. The existing BG used

is called Novamin and is a simple four component glass. Zinc salts have been added to toothpastes to inhibit gingivitis and prevent halitosis. Zinc ions have been shown to inhibit enamel demineralisation under acidic caries forming conditions. However zinc ions also suppress remineralisation and apatite formation at higher pHs. The purpose of the present in vitro study is to evaluate the release of zinc from novel multi-component BGs at neutral and low pH with a view to developing glasses that release zinc under acidic pHs but not at neutral pHs, where zinc release could inhibit remineralisation. Method: A series of multicomponent bioactive glasses based on: SiO2(44)P2O5(5)CaO(15)SrO(15)Na2O(10)K2O(10)ZnO(1)XMF2 where M is a 50/50 mixture of Ca and Sr, were made. The final total mole percentages of MF2 were 0, 4.76, 9.28, 13.62, 17.76, 25.54 and 32.72. The glasses were synthesised by a melt quench route and ground and sieved to give a powder with a particle size <38 microns. 75mg of each glass was placed in 50ml of both Tris buffer at pH 7.25 and acetic acid buffer at pH 4.5. The dissolution of the glasses in the two solutions was followed by inductively coupled plasma emission spectroscopy as a function of time and zinc release measured. Result: The glasses released negligible quantities of zinc at pH 7.25 in Tris buffer even after 1 week of immersion. The percentage of the zinc released from the glass was less than 1% of the total zinc content. However under acidic conditions in acetic acid all the glasses released significant amounts of zinc in less than 15 minutes with the lower fluoride content glasses giving > 5ppm Zn which is sufficient to inhibit enamel demineralisation in vitro. The percentage of zinc released from the glasses was >40% for all the glasses at 15 minutes. Conclusion: The results of this in vitro study indicate that bioactive glasses do not release significant quantities of zinc at neutral pH but do release zinc rapidly at acidic pHs and have the potential to form the basis of pH sensitive “smart” toothpastes.

Keywords: Bioactive glass, toothpaste


54

Dental nursing students’ learning experience using video conferencing Harrington M*,1 1


* Corresponding author: Ms. Mary Harrington, [email protected],

This thesis will explore and analyse how Dental Nursing students in geographically remote sites to the Cork University Dental School and Hospital (CUDSH) experience learning through the medium of video conferencing technology. The National Dental Nurse Training Programme of Ireland (NDNTP) was developed as a joint initiative between Cork University Dental School and Hospital and the Dublin Dental School and Hospital in order to standardise Dental Nursing education in Ireland. Dental Nursing students have the opportunity of attending on a part-time basis the Cork or Dublin Dental Schools or alternatively one of the outreach centres located in: Galway, Limerick or Waterford. These students also work in a general dental practice in order to fulfil the clinical component of this programme. Didactic teaching methods are supported by various technologies to provide a flexible, collaborative learning environment. Videoconferencing technology is utilised to create an online environment that opens up geographical barriers thus creating wider access to Dental Nursing education. The primary focus thus far has been on the analysis of the video conferencing performance during lectures with little analysis of the student Dental Nurses learning experience through this distance learning format. Questionnaires were utilised to gather data from 100 Dental Nursing students located in 5 centres across Ireland. Data was analysed to determine the respondent’s level of confidence with technology prior to commencing this programme and again after 4 months of learning via video conferencing. Recommendations were offered that will enhance the student Dental Nurses learning experience via video conferencing and provide a more comprehensive picture of video conferencing and its potential in third level education.

Keywords: Video conferencing, teaching, online learning,


55

The relationship between clinically significant tooth-size discrepancies and dental archform McSwiney T*,1 Millett D1


* Corresponding author: Mr Timothy McSwiney, [email protected]

Objectives: To determine the relationship between the presence of clinically significant tooth-size discrepancies (TSDs) and dental archform type. Design and Setting: Retrospective study carried out at Cork Dental School. Methods and Materials: Sixty sets of pre-treatment study models, comprising 30 cases with clinically significant (>2 standard deviations beyond Bolton’s means) overall TSDs and 30 cases with ideal Bolton ratios were randomly selected from a pre-treatment cohort of 1380 cases. Each group consisted of 15 Class II division 1 and 15 Class III malocclusions and each set of study models had ≤2mm of crowding. Archforms were generated on digital images and classified as square, ovoid or tapered, according to the 3M Unitek archform templates. Distribution of archform type between those cases classified with or without clinically significant TSDs was determined using a Fishers Exact test. Separate analyses were performed for the upper and lower arches. Results: The most common archform in the upper arch was ovoid for the clinically significant overall TSD group and tapered for the ideal Bolton group. For the lower arch, the tapered and ovoid archforms were most common and showed a similar distribution in both groups. Archform type did not differ significantly between cases with clinically significant overall TSDs and ideal Bolton ratios in either the upper (p=0.62) or lower arch (p=0.88). Conclusion: Action plan: In the cohort assessed, there was no significant difference in the type of archform between groups with clinically significant overall TSDs and those with ideal Bolton ratios.

Keywords: Tooth-size discrepancies, dental archform


56

Proportioning variability in the dispensation of hand-mixed dental cements Ray N*,1 Burke F1 McKenna G1 1 Cork University Dental School and Hospital, Wilton, Cork, Ireland

* Corresponding author: Dr Noel Ray, [email protected]

Objectives: The purpose of this investigation was to determine for dispensed multiples (1 through 4) of powder (P) and liquid (L) in hand-mixed dental cement whether: (1) the mean (P/L) ratio (m/m) and (2) the maximum difference in (P/L) ratio is dependent on the number of multiples dispensed. The Null hypotheses were: (a) mean (P/L) ratio is independent of the number of multiples dispensed and (b) maximum difference in (P/L) ratio is independent of the number of multiples dispensed. Methods: The materials investigated are listed in the Table. The masses of dispensed aliquots of powder and liquid were measured by a single operator (n=10, for multiples 1 through 4) on a 4-place analytical balance. All measurements were made independently and all possible (P/L) ratios calculated for each sample. The effect of multiple dispensations on (P/L) ratios and maximum (P/L) differences was by one-way ANOVA and linear regression, respectively, with the Tukey post-hoc correction for multiple comparisons.

Results: Mean (SD) (P/L) ratios are presented in the Table. Null hypothesis (a) is rejected: either (x1) or (x2) dispensation yields a different (P/L) ratio to (x3) or (x4) (p < 0.05). Null hypothesis (b) is rejected: a negative correlation is observed in max (P/L) ratio difference with dispensed multiple for Ketac Cem (p = 0.029).

MULTIPLE DISPENSED DISPENSED MU

(x1) (x2) (x3) (x4)

Zinc phosphate Heraeus 12.271 (0.691)a

13.051 (1.269)b

13.215 (0.824)b

13.118 (1.149)b

Fuji IX GC 4.209 (0.373)a

4.085 (0.275)b

4.095 (0.226)b

4.095 (0.217)b

IRM Dentsply 7.933 (0.767)a

7.430 (0.451)b

7.977 (0.729)a

8.186 (0.929)a

Ketac-Cem 3M Espe 9.6206 (0.613)a

9.714 (0.523)a

9.298 (0.314)b

9.321 (0.292)b

Mean (SD) powder/liquid ratio (m/m). Superscript letters represent significances (α = 0.05) within each material


57

Conclusion: For hand-mixed dental cements: (1) more consistent (P/L) ratios may be observed with multiple dispensations of powder & liquid; (2) maximum differences in (P/L) ratio may be negatively correlated with dispensation multiple in some materials.

Keywords: Dental cement, hand-mixed, proportioning

58

Hardness of a light cured and dual cured resin cement Abbas M*,1 Ray N1 1 Cork University Dental School and Hospital, Wilton, Cork, Ireland

* Corresponding author: Ms Meriem Abbas, [email protected]

Objectives: The purpose of this investigation was to compare the Vickers microhardness numbers (VHN) of a light cured and dual cured resin cement stored under wet and dry conditions, respectively. The hypothesis to be tested was that no difference would be observed in VHN between materials after storage conditions (wet, dry) for 30 days. Methods: 80 disc specimens (n= 20 x 2 x 2; 8mm x 1.5mm) were prepared from 2 generic resin cements, Variolink Veneer LC (VVLC) and Variolink II DC (VIIDC) [Ivoclar]. Each disc was light cured by exposure to an Elipar S10 LCU [3M Espe] for 30 secs on one surface only (top). Dry specimens were stored @ 23±2

oC and wet specimens

stored in deionized water @ 37±1oC for 30 days. All microhardness measurements

(top & bottom surfaces) were performed using a Vickers indenter MVK-H1 [Mitutoyo, 1-20-1 Sakato, Takatsu-Ku, Kawasaki-Shi 213, Japan] using a load of 300g and a dwell time of 10 seconds. The underlying assumptions of normality and constant variability were established by appropriate tests. A one-way ANOVA (α = 0.05) was carried out to identify significances with VHN as the variable and storage conditions and position, respectively, as factors. Results: Mean (SD) VHN data were as follows:

Mean VHN (SD)

Stored dry (30 days) Stored wet (30 days)

Material top bottom top bottom

VVLC 39.00 (1.79)aA

37.75 (1.44)aA

38.92 (2.08)aA

39.20 (2.18)aA

VIIDC 58.36 (1.45)aB

56.66 (2.44)abB

54.96 (1.53)bB

55.13 (2.88)bB

Superscripts indicate significances (α=0.05); lowercase across rows, uppercase down columns

Material and material*storage were significant factors in determining VHN (p < 0.001) but position (top, bottom) was not (p = 0.066). Conclusion: Choice of resin cement & subsequent environmental conditions may be the most important determining factors with regard to VHN after 30 days.

Keywords: Hardness, light, dual, wet, dry


59

A novel technique for clinical screening of treatments for dentin hypersensitivity Mason S*,1 1 Maggio B1 Sufi F1

1 GlaxoSmithKline Consumer Healthcare, St Georges Avenue, Weybridge, Surrey, KT13 0DE, UK

* Corresponding author: Dr Stephen Mason, [email protected]

Objective: Creation of a novel clinical methodology for screening agents for dentin hypersensitivity. Methods: Two clinical studies were performed at University Park Research Centre, Indiana following ethical approval. In the initial study, fabrication of a custom stent was developed (Phase I). The requirement was to hold a reservoir of ~ 300ul of solution in contact with the exposed dentin at the cervical margin. Stents were then fabricated for 21 subjects, each with 3 non-adjacent hypersensitive teeth. Test teeth were randomly assigned to either 250ul of sterile water, 2.5% potassium nitrate (KNO3) or 5.0% KNO3 solution, for 2, 5 or 10 mins (Phase II). Self reported dentin hypersensitivity was evaluated using a Visual Analogue Scale after air-blast stimulation before and after application and at various time points post application. The second study tested the reliability of the stent in repeated application to the cervical margin. Stents were fabricated for 32 subjects with 3 non-adjacent hypersensitive teeth. Test teeth were randomly assigned to 250ul of sterile water, 2.5% KNO3 or 5.0% KNO3 solution, applied twice daily for 5 days. Self reported dentin hypersensitivity was evaluated in the same manner as the first study. Results: Fabrication of a suitable stent was achieved. It could be reproducibly located at the cervical margin, and was able to maintain a solution in contact with the experimental area on reapplication, enabling twice daily applications of solutions for 5 days. No differences in treatment efficacy were observed following single applications of sterile water, 2.5% or 5.0% KNO3 solutions, or after 5 days of twice daily application. Conclusions: The stent may be an appropriate way to clinically evaluate agents for dentin hypersensitivity. However strong placebo effects were observed, even though the subjects had no knowledge as to which solution had been randomly applied to the tooth. www.clinicaltrials.gov NCT01587950: NCT01115452

Keywords: Dentin hypersensitivity, potassium, clinical


60

Amine derived H2O2 can modulate OSSC apoptotic mechanisms Naughton D*,1 Sinevici N1 O’Callaghan1 O’Sullivan J1

1 School of Dental Science, Trinity College Dublin

* Corresponding author: David Naughton, [email protected]

Objectives: The aim of this project was to establish if primary amine oxidase (PrAO) activity can modulate cellular functions including apoptosis and autophagy through the H2O2 product produced during the oxidation of exogenous and endogenous amine substrates in two cell line models of OSCC. Methods: Ca9.22 and Tr146 cells were maintained in MEM and DMEM respectively supplemented with 10% FBS, 2mM glutamine, and 1% pen/strep. Cell viability was determined using the alamar blue assay. Analysis of the cell cycle and autophagy was achieved by measuring propidium iodide and acridine orange fluorescence respectively in a FACSCalibur flow cytometer. Results: No significant reduction in cell viability was observed in the presence of histamine and methylamine while a significant disruption of cell viability was noted in the presence of benzylamine in both cell lines. This reduction was abrogated in the presence of semicarbazide, a potent inhibitor of PrAO. No apoptosis was noted in the Ca9.22 cells in the presence of benzylamine however the Tr146 cells did undergo apoptosis. The presence of benzylamine did not induce any observable increase in autophagy in either cell line. Conclusion: Benzylamine derived H2O2 was the only amine product to elicit a response in the level of apoptosis undertaken by the OSSC cell lines. Tr146 cells, which have no known p53 mutation showed a significant increase in apoptosis, which was not observed in the Ca9-22 cells, which have a p53 mutation. This observation may be a result of the functioning p53 and confirms a role for H2O2 in the apoptotic pathway while suggesting that p53 mediated apoptosis does not function properly in patients presenting with p53 mutation. It appears that amine derived H2O2 does not have a role to play in OSCC autophagy.

Keywords: OSCC, apoptosis, H2O2, amine


61

Evaluating the antifungal activity of a novel truncated antimicrobial peptide Lunkes L*,1,2 Luo Y3 Yu Y3 Walker B4 Irwin C3 Lundy F3 1 School of Biological Sciences, Queen’s University Belfast

School of Dentistry, Federal University of Rio Grande do Sul School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast School of Pharmacy, Queen’s University Belfast

2

3

4

* Corresponding author: Ms Leticia Lunkes, [email protected]

Background: Candida albicans is an opportunistic pathogen that is prevalent in the oral cavity. C. albicans can grow in planktonic or biofilm forms, with the biofilm form displaying increased resistant to antimicrobial treatment. New approaches for treatment of candidal infections are needed and our recent work has focused on the effectiveness of naturally occurring antimicrobial peptides. LL-37 is a human antimicrobial peptide and several truncated mimetics of this peptide have been studied for their antimicrobial effects. One such novel peptide is a-KE-18 which is modeled on the mid-region of LL-37 and contains a C-terminal amide group to protect against carboxypeptidase degradation. Objectives: The present study was designed to determine the minimum inhibitory concentration (MIC) of an amidated form of KE-18 (a-KE-18) against C. albicans and to verify the effectiveness of a-KE-18 against C. albicans in a biofilm assay. Methods: The MIC of a-KE-18 against planktonic C.albicans was determined by microbroth dilution assay. In addition a 96 well microtitre plate biofilm model was used to study the ability of a-KE-18 to disrupt the maturation of early biofilms (up to 24 hours). Biofilm quantification was determined by both XTT and crystal violet assay. Results: The MIC of a-KE-18 against planktonic C.albicans was 128 ug/ml. At this concentration a-KE-18 significantly inhibited biofilm formation as determined by crystal violet assay. Using the XTT assay we showed significant effects on the metabolic activity of C. albicans at and below a concentration of 128 ug/ml. Conclusions: a-KE-18 is a novel truncated from of LL-37 which was shown to be effective against C. albicans in both planktonic and biofilm form. Amidation of KE-18 at the C-terminus should protect the peptide from exopeptidases and improve its therapeutic potential. More extensive studies on this peptide are warranted. Funded by the Brazilian National Council for Scientific and Technological Development (CNPq) Keywords: Antimicrobial peptide, biofilm, Candida albicans


62

Economic Evaluation and it's place in Dentistry Bhorania N*,1 McKenna G1


* Corresponding author: Ms Nisha Bhorania, [email protected],

Objective: This review intends to examine current research surrounding economic assessment in the delivery of dental care. Economic evaluation is an acknowledged method of analysing dental care systems by means of efficiency, effectiveness, efficacy and availability. Though this is a widely used method in medicine, it is underappreciated in dentistry. As the delivery of health care changes there has been recent demand by the public, the profession, and those funding dental treatment to investigate current practices regarding programs themselves and resource allocation. Methods: A meta-analysis was conducted regarding health economics. The initial search was carried out using Pubmed, Google Scholar, Science Direct, and The Cochrane Library with search terms “health AND economics AND dentistry”. A secondary search was conducted with the terms “heath care AND dentistry AND”. The third part of the entry was changed to address the aims and included the following terms: “cost benefit analysis”, “efficiency criteria”, “supply & demand”, “cost-effectiveness”, “cost minimisation”, “cost utility”, “resource allocation”, “QALY”, and “delivery and economics”. Limits were applied to all searches to only include papers published in English within the last eight years. Results: Preliminary results demonstrated a limited number of economic evaluations conducted in dentistry. Those that were carried out were mainly confined to the United Kingdom. Furthermore analysis was mainly restricted to restorative dentistry, followed by orthodontics, and maxillofacial surgery, thereby demonstrating a need for investigation in all fields of dentistry. Conclusion: Health economics has been overlooked in the past regarding delivery of dental care and resource allocation. Economic appraisal is a crucial part of generating an effective and efficient dental care system. It is becoming increasingly evident that there is a need for economic evaluation in all dental fields.

Keywords: Efficiency, effectiveness, efficacy, availability


63

Design and efficacy of peptide mimetics of LL-37 Irwin C*,1 Yu Y1 Walker B1 Lundy FT1

1 School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast

* Corresponding author: Dr Chris Irwin, [email protected]

Background: Host defence peptides, including the cathelicidin LL-37, express both antimicrobial and immunomodulatory activity, and have been considered as potential therapeutics in the treatment of inflammatory conditions such as periodontitis. The bioactivity of any peptide placed at a site of inflammation is dependent on its ability to withstand proteolytic degradation by proteases released during the inflammatory process. We have synthesised the shorter peptide, KE-18, from the mid-region of LL-37 where the biological activity of the parent molecule resides. Objectives: The aim of this study was to determine the stability of KE-18 in gingival crevicular fluid (GCF) derived from periodontitis sites and to modify the peptide sequence in an attempt to protect against proteolytic degradation. Methods: KE-18 and its peptide mimetics were synthesised using Fmoc chemistry. GCF was collected from advanced periodontitis sites defined as sites with probing pocket depths >6mm. The detection and quantification of P gingivalis in plaque samples collected from the same sites was undertaken using QPCR. A MALDI-MS assay was used to monitor KE-18 degradation in GCF and the cleavage sites confirmed by mass profiling. The α-helical structure of peptides, which confers their antimicrobial activity, was determined by circular dichroism. Results: KE-18 was almost completely degraded after a 30 minute incubation in GCF derived from P gingivalis-positive periodontitis sites. Analysis of cleavage sites revealed carboxypeptidase activity to play a significant role in the degradation. Amidation of the carboxyl terminal of KE-18 significantly enhanced stability of the peptide in GCF. Amidation also improved the α-helical structure of the peptide. Conclusion: Amidated KE-18 showed increased stability in GCF and an improved α-helical structure, suggesting the amidated form is a more stable and more potent peptide for potential use in periodontal therapy. This study was supported by an IADR/GSK Innovation in Oral Care Award.

Keywords: LL-37, defence peptides, periodontitis


64

Strong endorsement of publishing guidelines by high impact dental journals. Fitzgerald RC*,1

1 University of Liverpool

* Corresponding author: Dr Rhian C Fitzgerald, [email protected], University of

Liverpool

Objectives: Assess the extent to which high citation impact factor dental journals incorporate, into their guidance to authors: the EQUATOR (Enhancing the QUAlity and Transparity Of health Research) guidelines, Declaration of Helsinki (DoH) and ICJME (International Committee of Medical Journal Editors) recommendations and recommend the use of a Clinical Trials Registry (CTR). Methods: Journal Selection: The top forty dental journals, as judged by 2012 citation impact factor, were assessed. The extent to which EQUATOR, DoH, ICJME and a CTR were incorporated into instructions to authors was assessed. Data Extraction: The online version of “Instructions to Authors” was investigated. The components of EQUATOR were assessed individually, or whether EQUATOR in its entirety was included. Whether the DoH or whether the journal required ethical approval and informed consent was noted. If the journal subscribed to the ICJME code of conduct was recorded, as was whether it discussed the use of a Clinical Trial Registry and whether this was “encouraged” or “required”. Intra-examiner reliability was assessed. Results: 10% of journals referred to EQUATOR in its entirety. Of these 1 also referred DoH, ICJME and a CTR and 1 DoH and ICJME. The DoH was the most commonly referred to guidance at 80% with 60% referring to ICJME and ethical treatment of experimental animals. CONSORT was the EQUATOR guideline most commonly subscribed to at 57.5%. ICJME guidance was subscribed to by 60% of cases. Clinical Trial Registration was “encouraged” by 17.5% of journals and a “must” for 12.5% of journals. Intra-examiner reliability was 100%. Conclusions: There is relatively good uptake of guidelines aimed at improving the quality of published research, however there is still scope for improvement particularly in clinical trials registration and full implementation of EQUATOR.

Keywords: EQUATOR, CONSORT, Clinical trials registry


65

Relationship between periodontal health and survival of denture abutment teeth Tada S*,1 Allen F1 Ikebe K1


* Corresponding author: Postdoctoral fellow Sayaka Tada, [email protected]

Objectives: In determining the prognosis of teeth which may serve as abutments for removable partial dentures (RPD), we don’t have definitive criteria to guide the clinician. In particular, periodontal health is thought to be one of the most influential factors on abutment tooth longevity. However, even though there are some measurements of its condition, because of a deficiency of longitudinal clinical data, the prognosis tends to still be based on the heuristic information and clinical experience, rather than evidence. The aim of this longitudinal study is to show the impact of periodontal status on abutment tooth survival. Methods: Data were collected from 147 patients provided with RPDs in Osaka University Dental Hospital, Japan. 236 cobalt-chromium clasp-retained removable partial dentures (RPDs), and 856 abutments of RPDs were analyzed. Longevity of abutment teeth was assessed using Kaplan-Meier methods and Cox's proportional hazard modeling. Cox's proportional hazard modeling was used to calculate the hazard ratio (HR) after controlling simultaneously for other variables. Explanatory variables for multivariate analysis were Age, Gender, Life-Style-Disease, Occlusal support area, Abutment type, Root Canal Treatment, Crown/Root ratio (CR ratio) and Pocket Depth (PD). Results: Survival curves of abutment teeth divided into 4 groups according to the CR ratio and PD were constructed. Compared with the reference group (CR ratio = 1.0 and less), “1.01-1.25 group” was 0.94 (p=0.872), “1.26-1.50 group” was 2.93 (p=0.004) and “over 1.51 group” was 3.16 (p<0.001). Compared with PD under 4mm, “4mm group” is 0.94 (p=0.860), “5mm group” is 1.95 (p=0.049) and “over 6mm group” was 2.78 (p<0.001). Conclusion: These results display the relationship between periodontal condition and tooth longevity. Also it would assist clinicians to determine the evidence-based prognosis of abutment teeth for RPDs.

Keywords: Evidence Based Dentistry


66

Optimal simulated skin sample thickness for Spectrophotometer skin colour measurements Nacher-Garcia C1 Bamber MA*,1 Douiri A2 Knibb3 1 Cranio-Maxillofacial Prosthetics Unit, King’s College Hospital, UK

Department Of Primary Care And Public Health Sciences, King's College London, UK School of Health and Social Care, University of Surrey, UK

2

3

* Corresponding author: Dr M A Bamber, [email protected], King’s College

Hospital NHS Foundation Trust, London, UK Objectives: To establish the optimal silicone sample thickness for colour measurements, using a spectrophotometer, in four ethnic groups, for digital colouring of facial prostheses. Methods: 8 subjects; two White (male and female), two Black, two Chinese, two Indians, were consented. A facial skin colour scan, (Konica Minolta 2300D, Spectromatch Ltd. UK) was taken for each subject and a silicone colour formula for each subject computed with Spectromatch Software. For each subject 2.5 cm X 6 cm silicone samples (medical grade silicone M511, Technovent Ltd. UK) in the following thickness; 2, 4, 6, 8, 10, 12 and 14 mm; in total 56 samples, were manufactured. These silicone samples (n=56), were scanned for colour reproducibility against white and black backgrounds. Using the Spectromatch Software L* a* b* values were obtained and the ∆E for each sample computed. The sample with lowest ∆E value was considered optimal thickness silicone test sample. Results: ∆E means; White subjects, 2mm:2.8, 4mm:0.8, 6mm:0.5, 8mm:0.5, 10mm:0.6, 12mm: 0.6, and 14mm:0.6. Chinese, 2mm:2, 4mm:0.6, 6mm:0.5, 8mm:0.6, 10mm:0.7, 12mm:0.7, and 14mm:0.7. Indian, 2mm: 2.2, 4mm:1.7, 6mm:1.6, 8mm:1.7, 10mm:1.9, 12mm:1.8, and 14mm:2. Black, 2mm:2.3, 4mm:2.1, 6mm:1.8, 8mm:1.3, 10mm:1.3, 12mm:1.5, and 14mm:1.5. After pooling the data, mean ∆E were; 2mm: 2.3, 4mm: 1.3, 6mm: 1.1, 8mm: 1.0, 10mm: 1.1, 12mm: 1.2 and 14mm: 1.2. Statistical analysis (t test), showed that ∆E, 2mm V 4mm, 4mm V 6mm, 8mm V 10mm (p<0.05). 4mm V 6mm: p=0.01. 8mm V 12mm: p=0.01 Conclusion: This study showed that optimal thickness for simulated skin colour measurements for Whites, Chinese and Indians was 6mm, whereas for Blacks 8mm. After pooling the data overall results showed that the optimal thickness would be 8mm for digital colour scan measurements.

Keywords: Simulated Skin, Thickness, Spectrophotometer


67

Le Fort I osteotomy in cleft lip and palate patients McGoldrick D*,1 McKiernan E 1 Takla G1 Kearns GJ 1

1 National Maxillofacial Unit, St. James’s Hospital, Dublin 2, Ireland.

* Corresponding author: Dr David McGoldrick, [email protected]

Objectives: Cleft Lip and Palate (CLP) affects approximately 1 in 800 live births. Many patients with CLP develop maxillary retrognathism which is thought to be associated with previous palate and lip surgery. The management of maxillary retrognathism requires a collaborative Orthodontic and Surgical approach using a Le Fort I Osteotomy (LeF) to correct the mid-face deficiency and normalise the occlusion. Assessment of skeletal stability following LeF is of particular interest to surgeons and orthodontists involved in the care of these patients. This is a retrospective review of patients with CLP who underwent LeF to correct maxillary retrognathism at St James’s Hospital between December 2009 and March 2012. Methods: Patients with CLP who underwent LeF between December 2009 and March 2012 were selected for analysis. Patients were excluded if the radiographic or clinical records did not permit detailed review. Data was collected from patient charts using a pro-forma. One operator performed cephalometric analysis digitally on pre-operative, immediate post-operative and review lateral cephalograms. Skeletal stability was assessed using SNA and SNB values. Results: The study population comprised six patients. The following demographic data was recorded : Gender- Male 4, Female 2, mean age at surgery 23.3 (17.25- 33.33) years. Two patients had unilateral CLP, four had bilateral CLP. The mean post-operative hospital stay was 3.5 (2-5) days. All patients were treated with LeF and iliac crest bone grafting. The average SNA and SNB prior to surgery was 74.78° (68.5-80.3) and 75.23° (67.2-80.3). The average values postoperatively were 79.23° (72-86.3) and 75.22° (66-83.1). The mean follow-up cephalometric analysis was at 17.33 (6-43) months. The SNA and SNB values at follow up were 78.43° (69.8-85.1) and 75.5° (66.8-82.1). This shows a mean surgical change in SNA of 4.45° initially and of 3.65° at follow up displaying a relapse of 0.8 degrees. This represents a relapse rate of 18%. Conclusion: Our study demonstrates the effectiveness of osteotomy in correcting maxillary retrognathism in this cohort. Although our sample size is small, our rate of relapse of 18%, compares favourably with other studies.

Keywords: LeFort I, cleft lip, palate


68

An evaluation of dental anxiety in paediatric patients: a comparative study Horgan TJ*,1Hurley E1 Curtin S1 1 Cork University Dental School and Hospital, Wilton, Cork, Ireland

* Corresponding author: Mr T.J Horgan, [email protected]

Background: Assessment of dental anxiety in children and adolescence is often based on the clinician’s experience and judgement. Accurate and reproducible assessment methods can enable a clinician to identify an anxious patient and tailor their treatment plan accordingly. This will help build rapport with the patient and lead to improvements in oral health while reducing dental avoidance. Aims: The aim of this study is to compare dental students’ behavioural based judgements of perceived dental anxiety with the self-report indices of the paediatric patient using the Facial Image Scale (Buchanan & Niven, 2002). Method: Paediatric patients (6-13yrs), attending the undergraduate Paediatric Clinic in the Cork University Dental School & Hospital, took part in the study. After completing a full medical history on the patient, students rated the patients’ anxiety level based on their own observational judgements. The patient was then asked to identify their current level of anxiety using the Facial Image Scale. Results: A small number of students ranked the patients anxiety level correctly while the majority of students overestimated the patients’ anxiety. Factors such as patient responsiveness, smiling, inquisitiveness and previous dental experience led students to believe the patient was calm. While behaviours such as, being unresponsive to conversation, restlessness and a reluctance to make eye contact was interpreted to indicate a higher anxiety level. Conclusion: The introduction of the Facial Image Scale provides a clear and accurate measurement of dental anxiety in paediatric patients, which can inform the patient-clinician interaction.

Keywords: Anxiety, Children


69

The difference in microtensile-bond strength jigs influences the test outcome El-Deeb H *,1 El-Samman M#,2 Mobarak E 1 1 Faculty of Oral and Dental Medicine, Cairo Universiy, Egypt

Faculty of Dentistry, El-Azhar University, Egypt 2

* Corresponding author: El-Deeb H, [email protected] # Presenting author

Objective: This study was performed to evaluate the influence of four different designs of microtensile-bond strength (µTBS) jigs on tensile strength values. Method: Twenty-four cylinder-shaped (5mm diameter and 8mm height) resin composite (Esthet·X, Dentsply, USA) specimens were made. Each specimen was serially sectioned to obtain six sticks with 0.8±0.01 mm2 cross-sectional area. Sticks (n=144) were then equally distributed over the four differently designed µTBS jigs (n=36/jig); split acrylic jig, Ciucchi’s jig, Bisco µTBS testing jig and ACTA µTBS testing jig. Each stick was glued to the proposed jig using cyanoacrylate adhesive (Rocket, dental Venture of America, USA) and tested using Universal Testing Machine at a crosshead speed of 0.5mm/min until fracture. Data were analyzed using one way ANOVA followed by Newman-Keils post hoc test. Result: There was a statistical significant difference among µTBS values obtained with the different µTBS jigs. Split acrylic jig recorded the significantly lowest µTBS values. Conclusion: Difference in the design of µTBS jigs influenced the microtensile strength results. Keywords: Microtensile strength test, jig design


70

CAD evaluation of student first molar preparations Ow C*,1 Phuah D1 Theocharopoulos A1 1 Cork University Dental School and Hospital, Wilton, Cork, Ireland

* Corresponding authors: Christopher Ow, [email protected], & Disen Phuah,

[email protected]

Objectives: To provide a protocol for evaluating the accuracy of first molar preparations amongst 4

th year dental students in Cork University Dental School and

Hospital (CUDSH). Experimental Methods: Student preparations of 20 Lower Left (LL6) and 21 Lower Right First Molars (LR6) (KaVo Model Teeth) were scanned with a dental 3D contact scanner (InciseCAD, Renishaw, UK) and exported to an inspection software (GOMInspect, Version 1.21) for analysis. The samples were superimposed on unprepared LL6 and LR6s respectively and digital planes fabricated to intersect the superimposed molars in mesiodistal, buccolingual and the 2 intermediate directions. Measurements for interocclusal reduction, convergence angle(s) and functional cusp bevel were then carried out using fixed points along these planes. The results were statistically analysed using Student’s t-tests (interocclusal reduction) and the Mann-Whitney U test (convergence angle) (SPSS Version 22.0, IBM, USA). Results and Statistics: Preparation of the functional cusp bevel showed no significant difference from the proposed value of 1.5mm. 67%, 72% and 76% removed ≥2.0mm from the distobuccal, mesiobuccal and mesiolingual LR6 cusps respectively. All cusp preparations proved to be significantly different (p<0.05) compared to the 1.0mm recommendation. Prepared tapers ranged from 2.46° to 47.14° with an overall mean(SD) of 19.89°(10.48°). The mesiodistal and buccolingual convergence angles of both LL6 and LR6 were significantly greater (p<0.05) than the ideal recommended values (12-15°) with the exception of the buccolingual convergence angles of LL6 lying within the ideal values. There was no significant difference (p>0.05) between mesiodistal and buccolingual measurements. At least 38% of students prepared a taper greater than 20°. Conclusion: CUDSH 4

th year students were found to overprepare first molars

occlusally and significantly exceed convergence angle(s) at first attempt. The devised protocol may prove useful as a teaching and learning tool in fixed prosthodontics for crown preparation feedback and analysis.

Keywords: Contact scanner, interocclusal, angle, taper



71

A molecular analysis approach for biofilm quantification Luo Y*,1 McAuley DF1 McMullan R1 Lundy F1 1 Centre for Infection and Immunity, School of Medicine, Dentistry and

Biomedical Sciences, Queen's University Belfast

* Corresponding author: Mr Yu Luo, [email protected]

Background: Biofilm formation on medical devices such as endotracheal (ET) tubes can contribute to the development of ventilator associated pneumonia (VAP). Further study of the potential of oral micro-organisms to form mixed species biofilms with respiratory pathogens will aid our understanding of the complexity of biofilm formation in ET tubes and could inform the development of specific therapies to prevent biofilm formation and hence VAP in critically ill mechanically ventilated patients. Objectives: There is a growing body of evidence to suggest that staphylococci can be isolated frequently from the oral cavity of particular patient groups such as the elderly and the terminally ill. This study was designed to develop a molecular method suitable for quantifying Staphylococcus aureus biofilms in vitro. Initial studies were focused on molecular detection of S. aureus following a simple heat treatment however the method is suitable for application to studies addressing the effectiveness of novel antimicrobials. Methods: S.aureus biofilms were prepared in 96 well plates for 24 hrs. Biofilms were heat treated for 10 minutes prior to DNA extraction and quantified using propidium monoazide (PMA)-modified quantitative polymerase chain reaction (qPCR). Results: PMA-qPCR did not quantify dead S.aureus cells within the biofilm, a limitation which is associated with conventional qPCR. In mature biofilms containing approximately 1000,000 cells less than 10 cells were detected by PMA-qPCR following heat treatment. Conclusions: We have developed a molecular method to quantify living organisms within a biofilm following a simple heat treatment protocol. The method has the potential to be utilised to study the effectiveness of novel antimicrobials on complex biofilms. It will be of interest to compare the effectiveness of novel antimicrobial peptides on biofilms consisting of oral and respiratory pathogens and determine whether these treatments are effective in reducing biofilm load. Supported by an International QUB PhD Scholarship and the HSC R&D office (Critical Care TRG).

Keywords: Biofilm, qPCR


72

ORALMET: The oral microbiota of Irish children in health and disease Hurley E*,1 Kinirons M1 Ryan T3 Stanton C4 Ross P4 Whelton H1 O’Toole PW2 1 Cork Dental School & Hospital, University College Cork

APC, Microbiology Department, University College Cork Neonatal Unit, Cork University Maternity Hospital Teagasc, Moorepark, Fermoy, Cork.

2

3

4

* Corresponding author: Dr Eimear Hurley, [email protected]

Background: The oral cavity is a complex niche, reflected by its complex microbial community. The microorganisms found in the oral cavity are referred to as the oral microbiota and the collection of genes that these bacteria carry is the oral microbiome. This oral microbiome is intimately related to health and disease. In disease, there is a shift in oral microbiota composition, although few studies have demonstrated this clearly, or explained its importance for future disease risk. With the development of metagenomic techniques and next generation sequencing, it is now possible to study complete bacterial communities, which was not previously possible using culture-dependent methods. Aims: The aim of the ORALMET project is to identify oral microbiota changes that occur from birth to pre-school age in a longitudinally-studied cohort, and to compare this data with baseline microbiota analyses of caries-affected and caries-free children. The first objective of this study is to characterise the developing oral microbiota from birth to 36 months using microbiota profiling technology. The second overlapping objective is to investigate the oral microbiota in a cohort of children from 12-71 months, to generate insight into the microbiological risk factors for disease progression (Early Childhood Caries) and which may lead to possible interventions. Methods: Mothers were recruited antenatal at Cork University Maternity Hospital (N=100). We first compared and validated DNA extraction methods for saliva samples from mothers and babies, and for vaginal/skin swabs from mothers. DNA extraction methods were validated and adjustment to the protocol had to be taken to ensure breakdown of the ‘hard-to-lyse’ species. PCR of the 16s rRNA V4 region was completed. Results: DNA yield was quantified and quality was assessed using both Methods (see Gel Image) using Nanodrop (ng/ul). PCR performed on respective 16S rRNA gene (V 4 Region). PCR Purification was then completed prior to sequencing.


73

Conclusion: On validation of DNA extraction methods, Genomic DNA is now being extracted with all samples using the MO Bio kit, used by the Human Microbiome Project. Difficulty still lies, with Minimal Bacterial Load on saliva samples from neonates, before they cut teeth etc., as salivary flow is low.

Keywords: Microbiome, caries, saliva, neonates, delivery

74

The reproducibility of Spectrophotometer skin scans for facial prosthetic reconstruction Nacher-Garcia C*,1 Bamber A1 Douiri A2 Knibb W1

1 Cranio-Maxillofacial Prosthetics Unit, King’s College Hospital, London, UK Department of Primary Care and Public Health Sciences, King's College, London, UK

School of Health and Social Care, University of Surrey, UK

2

3

* Corresponding author: Cristina Nacher-Garcia, [email protected]

Objectives: The aim of this study was to establish the reproducibility of digital skin colour scans for facial prostheses using a spectrophotometer and Spectromatch colour matching system software. Methods: Eight volunteers; two White (Caucasian, male and female), two Chinese, two Indian, and two Black, were recruited. Their facial skin at the forehead (glabella) was scanned to obtain the skin colour spectral data using a spectrophotometer scanner (Konica Minolta 2300D, Spectromatch Ltd. UK). For each of the eight volunteer subjects, a total of 6 scans were taken, at intervals of 5 minutes. The individual scan spectral data, from 400 to 700 nm of the 48 scans were recorded and digitally stored in MS Excel spread sheet, and analysed. A custom designed computer programme (Colour-Cal 2300, Spectromatch Ltd.) was used to compare the raw spectral data of each scan against the spectral data of a mean scan of the relevant subject and their respective ∆E values obtained to assess the reproducibility of skin-scans within the subject. Results: The mean ∆E ± SD were: subject 1; 1.43 ± 0.63, subject 2; 0.47 ± 0.21, subject 3; 0.75 ± 0.40, subject 4; 0.75 ± 0.31, subject 5; 1.01 ± 0.61, subject 6; 0.75 ± 0.53, subject 7; 0.68 ± 0.54, subject 8; 0.90 ± 0.44. The spectral raw data was also statistically analysed using one-way analysis of variance, which showed no significance difference between the scans within each subject (p>0.05). All six scans of each subject also showed high correlation (r > 0.98) Conclusion: This study reported that the mean ∆E for the most scans was ≤ 1.00 showing that scans were reproducible. Statistical analysis showed that there was a high correlation between scans in each subject. High correlation showed that the scans were reproducible within each subject in all four ethnic groups.

Keywords: Spectrophotometer, skin, colour, facial prostheses


75

The efficacy of selected desensitising OTC products: A systematic review Talioti E*,1 Hill R2 Gillam DG1 1 Adult Oral Health, Barts and the London School of Medicine and Dentistry

QMUL, London, United Kingdom. Dental Physical Sciences Unit, Barts and the London School of Medicine and Dentistry QMUL, London, United Kingdom.

2

* Corresponding author: Dr Elena Talioti, [email protected]

Objectives: The aim of the present study was to critically review the available published literature in order to identify all relevant studies for inclusion and to determine whether there was any evidence on the effectiveness of selected Over-The-Counter (OTC) toothpastes ,Calcium Sodium Phosphosilicate (CSPS [Novamin®]), Amorphous Calcium Phosphate (ACP), Nano-hydroxyapatite (HAP) and Tooth Mousse™ dentifrices on reducing Dentine Hypersensitivity (DH). Methods: The search methodology used was a modified version of the Cochrane systematic review by Poulsen et al. (2006) and Karim & Gillam (2013). Following a review of 593 papers identified from searching both electronic databases (PUBMED) and hand searching of relevant written journals only 5 papers were accepted for inclusion. The extraction of data for inclusion was conducted by two reviewers (ET & DGG). The main measurement outcome was a statistically significant reduction in DH between the control and comparison groups which was measured by comparing baseline and post-treatment DH levels. Results: Analysis of the 5 included studies (3 CSPS and 2 ACP) would suggest that there may be some benefit for patients using these two products for reducing pain associated with DH. There were however, no comparative studies available to assess all selected products under the same conditions; neither were there any comparative randomised controlled studies (RCT) that compared at least two of these products in determining their effectiveness in treating DH. No conclusions can therefore be made on any direct comparison of CSPS, ACP, (nano)-HAP or ACP and their efficacy in reducing DH. Conclusion(s): The present study would therefore suggest that due to the small number of included studies there are limited clinical data to support any claims of clinical efficacy of these OTC products. Further studies are required to determine the efficacy of these products in well controlled RCT studies with a larger sample size.

Keywords: Dentifrices, human, pain, Periodontics and systema


76

Audit of H&N cancer patients comparing referral patterns and dental extractions MacCarthy D *,1 Carty O 2 1 Dublin Dental University Hospital, Trinity College

* Corresponding author: Dr Denise MacCarthy, [email protected]

Aim of study was to audit referral patterns and dental extractions completed pre-radiation in patients with head and neck cancer. Radiotherapy to the head and neck can cause dry mouth often resulting in severe dental caries. Dental extractions following radiation therapy are associated with an increased risk of osteo-radionecrosis (ORN). Methods: Dental records of patients seen on the Dental Oncology assessment clinic, DDUH in 2007 and 2012 were reviewed and compared. Results:

2007 2012 2007 2012

Number of subjects 93 202 Patients needing extraction

59% 70%

Gender 58m/ 35f

144m/ 58f

Most common number of extractions per subject

4 4

Age 58 61 Extractions on date of assessment

40% 19%

Referral to appointment within 14 days

91% 96% Extractions in DDUH 70% 87%

Discussion: Due to the nature of H&N cancer, necessary extractions must be completed without delay. The risk of ORN in this patient group is minimised by adhering to RCSE Guidelines, to ensure that dental extractions are carried out a minimum of 3 weeks prior to commencing radiotherapy and ideally review following extractions to ensure healing. Numbers increased between 2007/12 and assessment time improved. The same average number of extractions were planned in 2007/12 but the number of patients requiring extractions increased. More extractions were completed in DDUH in 2012, but fewer extractions were completed on the day of assessment in 2012. Conclusion: There are increased numbers of patients in DDUH in 2012. The scheduling of pre radiotherapy extractions is delayed in 2012.

Keywords: Cancer, preradiation, assessment, extractions, ORN


77

FACCT (Fluoride And Caring for Children’s Teeth) Whelton H*,1 Beecher T2 Harding M2,3,4 James P2 Parnell C2,5

1 Leeds Dental Institute, Leeds University OHSRC, Cork University Dental School and Hospital HSE-South (Cork ISA), Dental Clinic, Ballincollig, Co Cork Cork University Dental School and Hospital HSE- Meath, Dental Clinic, Navan Co Meath

2

3

4

5

* Corresponding author: Professor Helen Whelton, [email protected] Introduction: FACCT is a collaborative project between the Oral Health Services Research Centre, UCC and the HSE dental service, with funding from the Health Research Board (HRBCARG\2012\34) Objective: Evaluate the impact and outcome of the change in policy on water fluoridation and the use of fluoride toothpaste on dental caries and enamel fluorosis in Irish children with and without lifetime exposure to water fluoridation. Methods: A cross-sectional study with nested cohort study will be conducted by standardised trained examiners in primary schools in Dublin, Cork and Kerry for children born either prior to (age 12, born 2001) or post (age 5, born 2008) policy changes. For a target sample size of 5,245; equal numbers of male and female participants; 8,000 participants must be contacted. Outcome measures: dental caries, enamel fluorosis, Oral-Health-related Quality of Life (COHRQoL), oral health protective and risk behaviours and height and weight. The 5-year-olds (born 2008) will be followed-up and examined for caries and fluorosis when they are 8-years-old (2016). Results: Ethical approval for the study was obtained from the CREC of the CTH. Ten HSE examining teams were trained in the nominated indices: dmft, DMFT (decayed, missing and filled primary or permanent teeth), Developmental Defects of Enamel (DDE) and Dean’s Index for dental fluorosis. An electronic direct data entry version of the Oral-Health-related Quality of Life (COHRQoL) and oral health behaviours questionnaire was developed and piloted. The dental recorders were trained in electronic direct data entry of clinical data. Innovative software was developed and tested to ensure that sensitive personal data is managed in compliance with the Data Protection Acts. Conclusion: Prior to the commencement of data collection in a large epidemiological study, considerable resources are expended in determining sample size, training, development and piloting. Keywords: Caries, fluorides, QoL, policy


78

Inability to access dental care places a burden on other health care services McGrath C *,1 Nunn J 2

1 University of Hong Kong, Hong Kong Trinity College Dublin, Ireland 2

* Corresponding author: Prof Colman McGrath, [email protected]

Background: There have been considerable cutbacks to oral health services in Ireland in the current financial climate. Aim: To determine the dental attendance patterns of 9-year-old children in Ireland, and their inability to access oral health care service when dental care is needed (as perceived by their primary caregivers). In addition, to identify associations between ‘inability to access dental care when needed’ and the use of other health services in Ireland. Methods: This study was based on the Growing Up in Ireland (GUI) child cohort study involving a random sample of 8,557 9-year-old children. Their dental attendance pattern and inability to access dental service when need (as perceived by primary caregivers) were determined. Associations between inability to access dental care when needed and use of other health service (time spent in hospital, number of times they contacted a General Medical Practitioner (GMP), number of times they contacted a hospital doctor, number of times they contacted other health care professionals) were determined. Results: More than a third of the children (35.8%, 3076/8557) had not visited a dentist in the previous year and almost one-in-twenty (4.8%, 414/8565) had been unable to access dental care when needed (according to child's primary caregivers). In comparison 2% (170/8585) were unable to access medical care when needed. Inability to access dental care when needed was associated with the number of nights children were hospitalized (P<0.001), the number of times they contacted their GMP (P<0.01), the number of times they contacted a medical doctor (P<0.01), and number of times they contacted other health care professionals (P<0.05). Conclusion: More than a third of the children were not accessing dental care regularly, and one-in-twenty were unable to access care when needed (according to their primary caregivers). Inability to access dental service when needed was associated with use of other health services. These findings have implications to inform the debate of how cutbacks to oral health services place additional burdens on other health services in Ireland.

Keywords: Epidemiology, children, access, Health Services


79

Mechanical properties of preheated silorane-based resin composite Abd El-Aziz H *,1 El-Deeb H1 Mobarak E2

1 Faculty of Oral and Dental medicine, Cairo University, Egypt

* Corresponding author: Dr Enas Mobarak, [email protected]

Objective: This study evaluated the effect of preheating on the mechanical properties of a low-shrinking silorane-based resin composite. Method: Two resin composites were tested; a nanofilled methacrylate-based resin composite [Filtek™ Z350 XT (3MESPE)] and a low-shrinking silorane-based resin composite [Filtek™ P90 (3MESPE)]. Specimens of each resin composite were divided into three groups according to their temperature during placement, either at room temperature (23±1

oC), or preheated to 54

oC or 68

oC in a commercial device [Calset™

(AdDent Inc., Danbury, CT, USA)]. Diametral tensile strength (DTS) and fracture toughness test (FT) were measured. For DTS, 30 disc specimens (10/each temperature) were prepared from each resin composite using a split Teflon mold. Specimens were compressed diametrically and mean DTS values were calculated in MPa. For the FT test, from each resin composite specimens (10/each temperature) were prepared using the single-edge notched design. Each specimen was loaded up to failure in a three point bending test. Both tests were done using a Universal Testing Machine at crosshead speed of 0.5mm/min until fracture. Data were statistically analyzed using two-way ANOVA followed by Bonferroni post hoc test. Results: The DTS and the FT of the tested resin composites were not statistically different fom those prepared at room temprature. Conclusion: Preheating had no effect on the DTS and FT of the low-shrinking silorane-based resin composite.

Keywords: Silorane-based composite, preheating technique, Diametral

tensile strength, Fracture toughness


80

Intrapulpal-temperature changes and dentin bond strength of preheated silorane-based composite Abd El-Aziz S *,1 El-Deeb H1 Mobarak E2 1 Faculty of Oral and Dental medicine, Cairo University, Egypt

* Corresponding author: Dr Enas Mobarak, [email protected]

Objective: To evaluate the effect of preheating of the silorane-based resin composite on the intrapulpal-temperature changes (IPT) and dentin microtensile bond strength (µTBS). Method: For the IPT, teeth (n=15) were sectioned to obtain discs of 0.5mm thickness (2discs/tooth). The discs were divided into three groups (n=10/group) according to the temperature of the silorane-based resin composite (Filtek LS, 3MESPE) during its placement, either at room temperature (23±1

oC) or preheated to 54˚C or 68˚C using a

commercial CalsetTM

device (AdDent Inc./USA). Discs were subjected to a simulated intrapulpal pressure (IPP) and placed inside a specially constructed incubator adjusted at 37

oC. IPT changes were measured using K-type thermocouple touching

the pulpal side of the dentin disc before, during and after the placement and the curing of the resin composite. For µTBS testing, standardized flat occlusal mid dentin surfaces (n=24) were obtained. P90 System Adhesive was applied according to manufacturer’s instructions then Filtek LS was placed either at room temperature or preheated to 54˚C or 68˚C (n=6). Restorative procedures were done while the specimens were connected to IPP simulation. The IPP was maintained and the specimens were immersed in artificial saliva at 37

oC for 24-hour before testing. Each

specimen was sectioned into sticks (24/group) of 0.9±0.01mm² and subjected to µTBS test. Modes of failure were determined using scanning electron microscope (SEM). Result: For both preheated groups, IPT equally increased by 1.5

oC upon application of

the composite. After light curing, IPT increased by 4-5oC in all tested groups.

Nevertheless, in the preheated groups, the IPT required a longer time to regain normal temperature. One-way ANOVA revealed no significant difference between the µTBS values of all groups. SEM revealed predominately mixed mode of failure. Conclusion: Preheating of silorane-based resin composite increased the IPT but not to the critical level and had no effect on dentin µTBS.

Keywords: Microtensile bond strength, dentin bonding, intrapulpal pressure, intrapulpal tempeature, preheating, silorane-based resin composite


81

Developing a tooth wear training App O’Regan A *,1 Harding M1 Whelton H2 Tabirca S3

1

2

3

Dental School and Hospital, UCC, Oral Health Services Research Centre, UCC, HSE-South Leeds Dental Institute Department of Computer Science, UCC

* Corresponding author: Arthur O'Regan, [email protected]

Introduction: Prior to the last decades of the 20

th century less emphasis was placed

on tooth wear it being of less importance due to a high prevalence of dental caries, and tooth loss. Consequently methods in education, recognition and quantification of tooth wear are still evolving. The term tooth wear describes the loss of tooth surface through a combination of attrition, abrasion and erosion; each expressed to varying degrees as a consequence of the gradual loss of tooth substance. Objective: Develop Application software (App) to support oral health professionals in e-learning, and the use of a tooth wear index for epidemiological purposes. Develop the App for future additions to enhance e-learning and data gathering opportunities. Methods: Through focussed discussion determine the requirements of oral health professionals for e-learning in toothwear. Through dental and computer science collaboration transfer traditional epidemiological training to digital interactive media, using javascript and HTML5 mark-up language. Results: An App was developed for deployment across multiple devices to suit the array of laptops, desktop monitors, tablets and smartphones the oral health professional may access. The use of HTML5 and Javascript ensured the App was delivered without the limitations of the various proprietary operating system specifications. The content developed for the App permitted the learner to sequentially view the tooth score assigned for conditions from no toothwear to severe toothwear, to proceed through examples of toothwear and to self-assess and receive feedback. Conclusion: A successful means of e-learning through the use of an App has assisted oral health professionals from diverse locations to develop their skills in recognising and recording tooth wear. Further evaluation and development of the App are ongoing

Keywords: e-learning, toothwear, digital media, App


82

Endodontic case difficulty assessment. A study among Irish General Dental Practitioners. Mulcare G *,1 Brunton P1

1

University of Leeds

* Corresponding author: Dr. Gráinne Mulcare, [email protected]

Objectives: In order to improve the success rate of endodontics in general dental practice, practitioners should be able to recognize the appropriate level of difficulty in endodontic cases, and should refer those which exceed his/her comfort level. The objectives of this study were:

To compare endodontic case difficulty assessments carried out by Irish general dental practitioners with that of a recognised standard.

To determine if general dental practitioners would intervene appropriately in referring cases of high difficulty.

To test inter-rater agreement.

To test associations between sample groups.

To determine the current awareness and use of endodontic case difficulty assessment systems among general dental practitioners.

Methods: An electronic survey was issued to all 169 members of The Irish Faculty of Primary Dental Care (IFPDC). Five classification questions were asked. Participants were shown a series of 21 radiographs, asked to rate the difficulty of each, and state whether they would treat or refer the case. Outcomes of the assessment were compared with the assessment of each case by an endodontic specialist using the American Association of Endodontists (AAE) Endodontic Case Difficulty Assessment system. Results: The response rate was 48%. The average overall agreement in difficulty rating was 56%. The average overall agreement in difficulty rating or rated as more difficult than the AAE rating was 96%. The average overall agreement in high difficulty cases was 95%. The average overall agreement in intervention was 96%. Conclusion: Using radiographic assessment, general dental practitioners were able to recognize the appropriate level of difficulty in high difficulty endodontic cases. In cases of minimal and moderate difficulty, they had a tendency to rate cases as more difficult than the AAE classification. They would have intervened appropriately in referring cases of high difficulty.

Keywords: Endodontic case difficulty assessment


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Cork University Dental School and Hospital Dental Satisfaction Questionnaire McCreary C *,1 Curtin S *,1 Ni Riordan R2 Trace A3

1

2

3

Cork University Dental School, Wilton, Cork, Ireland Eastman Institute, UK School of Psychology, UCC, Ireland

* Corresponding authors: Dr. Sharon Curtin, [email protected]

Background: An evaluation of the interpersonal skills and clinical competencies of dental clinicians is vital because it provides an indication of the level of care and service provided by dental hospitals. In addition to examining interpersonal and clinical skills, it is also critical to survey patient’s attitudes, beliefs and level of satisfaction with the service provided. The aim of this study is to evaluate patient satisfaction in the Cork University Dental School and Hospital (CUDSH). Method: Patients (N=113) attending the dental hospital completed three questionnaires: the Dental Satisfaction Questionnaire designed to measure patients opinions and attitudes about dentistry, e.g. access to service, pain management, and quality of care; The Dental Beliefs Survey designed to measure the dentist’s behaviour, and how the care is delivered as perceived by the patient; and the Communication Assessment Tool used to assess the dentists’ interpersonal and communication skills. Results: In relation to general satisfaction about quality of care, patients revealed that they had confidence in the clinician’s dental skills, with the dentist demonstrating respect, care and concern for the patient. Patients believed that the dentists acted professionally, and that the patients were given time, and that their views were taken seriously. Conclusion: Patients’ perception of the CUDSH has been rated highly, especially in the areas of patient-dentist interpersonal communication, evaluation of professional competencies, and service satisfaction ratings. In regards to improving the service, some key recommendations were that more information about dental procedures should be provided and, generally, that dentists should do more to reduce patients’ pain.

Keywords: Dentistry, Patient Satisfaction, Beliefs, Attitude


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SPIKES Model: its applicability in delivering bad news to dental patients Curtin S *,1 Trace A2

1

2 Cork University Dental School, Wilton, Cork, Ireland School of Applied Psychology, UCC, Ireland

* Corresponding author: Dr. Sharon Curtin, [email protected]

Background: Delivering bad news is an emotive and stressful task for professionals, and highlights the need for good communication practice based upon a ‘patient–centred’ approach. The S-P-I-K-E-S model, an innovative approach, provides a systematic and structured way for dentists to deliver bad news in an effective and empathetic manner. A pilot project was undertaken to assess dental students’ experiential knowledge and understanding of the process of delivering bad news. Methods: A qualitative content analysis of the 3

rd BDS students’ responses was

undertaken and then mapped against the S-P-I-K-E-S model. Results: 33% students had delivered bad news; yet the majority indicated that doing so was perceived as difficult or stressful. Key findings showed that students jumped too quickly to solution-focused remedies but need to spend more time setting the scene and understanding the collaborative process in delivering bad news. Conclusion: It is crucial that the SPIKES model be integrated into the professional education.

Keywords: SPIKES, delivering bad news, Dentistry


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Developing an Online OSCE for Dental Nursing Examination. Shakeshaft S *,1 1 Cork University Dental School, Wilton, Cork, Ireland

* Corresponding author: Ms Siobhán Shakeshaft, [email protected]

Objectives: This thesis aims to investigate the possibility of introducing an online OSCE as a form of student assessment in Dental Nursing (DN) education in Ireland. The research was carried out in an attempt to break down geographical barriers faced by DN students enrolled on the National Dental Nurse Training Programme of Ireland. The issues investigated included advantages and disadvantages of online assessment, cheating and plagiarism in online assessment and concerns in relation to a students’ technological ability. Methods: An OSCE was created and undertaken by 48 Dental Nursing students in an online environment. Questionnaires were distributed among these students across three centres, namely Cork, Waterford and Limerick. Data was gathered prior to and following completion of this pilot online OSCE. Data was collated to ascertain the students’ experience and how they would feel with regards to undertaking a legitimate online OSCE. Outcome: Findings indicated that some participants were apprehensive prior to completing the online OSCE; however, they were more willing to undertake this type of examination following their participation in this research. While the research revealed potential benefits associated with the introduction of an online OSCE format, it highlighted several technological issues which would need to be addressed to ensure a comprehensive and fair experience for all students. Opportunities for cheating and plagiarism in an online environment would also need to be addressed. Recommendations were offered in relation to increasing the confidence of the student with regards to an online examination environment. This research suggests that students would be faced with fewer disadvantages which could arise in a classroom environment. This highlights the potential for further development of online OSCE’s in third level education.

Keywords: E assessment, online assessment, dental online OSCE


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Outpatient orthognathic surgery for bilateral sagittal split osteotomies McCarthy C *,1 Sleeman D1

1 Cork University Dental School, Wilton, Cork, Ireland

* Corresponding author: Ms Caroline McCarthy, [email protected]

Objective: This retrospective study evaluated the experience of one centre in the transition from in-patient to out-patient care for Bilateral Saggital Split Osteotomies (BSSO). Methods: Dental charts from 200 consecutive patients undergoing day surgery for mandibular osteotomies over an 84 month period were examined. The medical charts of those patients requiring hospital admission on the day of surgery were also studied. Results: One Hundred and ninety one (95.5%) patients were discharged on the day of surgery. Nine (4.5%) patients required admission post-surgery; eight requiring admission on the day of surgery. One patient was admitted for care 1 day post-op due to persistent nausea and vomiting. Post-operative nausea +/- vomiting accounted for 8/9 of the cases. The remaining patient was admitted due to increased intra-operative blood loss. Conclusion: Outpatient orthognathic care is a feasible and safe option, particularly where hospital bed shortages exist. Success relies on the experience and confidence of the operating surgeon, anaesthetist, theatre and recovery nursing staff.

Keywords: Orthognathic, Osteotomy, Outpatient, Day Surgery


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Repair bond strength of dual-cured resin composite core buildup materials Ghalab R*,1 El-Deeb H1 Mobarak E1

1 Faculty of Oral and Dental Medicine, Cairo University, Egypt

* Corresponding author: Dr Ghalab R, [email protected],

Objective: To compare the repairing ability of dual-cured with that of light-cured resin composite core buildup materials. Method: In this study, one light-cured nanofilled resin composite; Filtek™ Z350 XT (3MESPE) and two different dual-cured resin composites; Cosmecore™ DC automix (Cosmedent America) and Clearfil™ DC automix (Kuraray) core buildup materials were used. Substrate specimens (3mm diameter x 4mm thickness) were prepared from each material (n=12). Specimens were stored in artificial saliva at 37°C either for 1 week or for 3 months. Then, all the specimens were ground flat, etched using Scotchbond

™ phosphoric acid etchant (3M ESPE) and received Single Bond Universal

adhesive system (3MESPE) according to the manufacturer's instructions. Filtek™ Z350 XT light-cured resin composite was used as a repair material buildup. To determine the cohesive strength of each substrate material, additional specimens (4mm diameter x 7mm height) (n=6) were prepared and stored for the same periods. From

each specimen, five sticks (0.8±0.01mm2) were obtained for microtensile bond

strength (µTBS) testing. Modes of failure of the repaired sticks were determined using scanning electron microscope. Result: Two-way ANOVA revealed a significant effect for the substrate material and not for the stoage periods, however, their interaction was significant. Cosmecore™ DC and Clearfil™ DC revealed significantly higher repair µTBS than Filtek™ Z350 XT. All repair strength values were significantly lower than the cohesive strength of tested materials. In all tested group, the predominant mode of failure was the mixed type. Conclusion: Dual-cured resin composite core buildup materials had better repairing ability compared to light-cured resin composite even after 3-month storage in artificial saliva.

Keywords: Repair, Core Build-up, Dual-cure resin composite


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IADR Irish Division Annual Scientific Meeting 2013 · The International Association for Dental...

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Transcript of IADR Irish Division Annual Scientific Meeting 2013 · The International Association for Dental...