• Machining variability impacts on the strength of a 'chair-side' CAD-CAM ceramic.

      Addison, Owen; Cao, Xu; Sunnar, Parminder; Fleming, Garry J P; Biomaterials Unit, University of Birmingham School of Dentistry, St. Chad's Queensway, Birmingham B4 6NN, UK. addisono@adf.bham.ac.uk (2012-08)
      To develop a novel methodology to generate specimens for bi-axial flexure strength (BFS) determination from a 'chair-side' CAD-CAM feldspathic ceramic with surface defect integrals analogous to the clinical state. The hypotheses tested were: BFS and surface roughness (R(a)) are independent of machining variability introduced by the renewal or deterioration of form-grinding tools and that a post-machining annealing cycle would significantly modify BFS.
    • Maintaining dental pulp vitality

      Chong, BS; Duncan, H.F (Elsevier, 2009)
    • Management of acute dislocation of the temporomandibular joint in dental practice.

      McGoldrick, David M; Stassen, Leo F A; Dublin Dental School and Hospital, Lincoln Place, Dublin 2, Ireland. (Irish Dental Association, 2010-12)
      Acute dislocation of the temporomandibular joint is a situation that, although rare, may present to the dentist in practice at any time. A number of activities, such as removal of a tooth, may cause dislocation. The event is painful and distressing for the patient, their family and the dental team. Prompt management minimises discomfort, distress and long-term morbidity to the patient. We describe the aetiology of acute dislocation and outline a number of techniques that will aid the clinican in dealing with this event.
    • Management of dental unit waterline biofilms in the 21st century.

      O'Donnell, Mary J; Boyle, Maria A; Russell, Ronnie J; Coleman, David C; Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland. (2011-10)
      Dental chair units (DCUs) use water to cool and irrigate DCU-supplied instruments and tooth surfaces, and provide rinsewater during dental treatment. A complex network of interconnected plastic dental unit waterlines (DUWLs) supply water to these instruments. DUWLs are universally prone to microbial biofilm contamination seeded predominantly from microorganisms in supply water. Consequently, DUWL output water invariably becomes contaminated by high densities of microorganisms, principally Gram-negative environmental bacteria including Pseudomonas aeruginosa and Legionella species, but sometimes contain human-derived pathogens such as Staphylococcus aureus. Patients and staff are exposed to microorganisms from DUWL output water and to contaminated aerosols generated by DCU instruments. A wide variety of approaches, many unsuccessful, have been proposed to control DUWL biofilm. More recently, advances in biofilm science, chemical DUWL biofilm treatment agents, DCU design, supply water treatment and development of automated DUWL biofilm control systems have provided effective long-term solutions to DUWL biofilm control.
    • The management of dry socket alveolar osteitis

      Bowe, Dr Denise C (Irish Dental Association, 2011-12)
    • Management of primary molar infraocclusion in general practice.

      McGeown, Mary; O'Connell, Anne (Irish Dental Assocation (IDA), 2014-08)
      Statement of the problem: Infraoccluded primary molars can be managed in general dental practice but clinicians need to understand when intervention is necessary.
    • Management of separated instruments

      Duncan, HF (Oxford, Wiley-Blackwell, 2011)
    • Management of separated instruments

      Patel, S; Haapasalo, M; Duncan, H.F (Blackwell, 2009)
    • Mandibular implant-supported overdentures: attachment systems, and number and locations of implants – Part I

      Abdulhadi Warreth; Aslam Fadel Alkadhimi; Ahmed Sultan; Trinity College Dublin (Journal of the Irish Dental Association, 2015-04)
      The use of dental implants in replacing missing teeth is an integral part of restorative dental treatment. Use of conventional complete dentures is associated with several problems such as lack of denture stability, support and retention. However, when mandibular complete dentures were used with two or more implants, an improvement in the patients’ psychological and social well-being could be seen. There is general consensus that removable implant-supported overdentures (RISOs) with two implants should be considered as the first-choice standard of care for an edentulous mandible. This treatment option necessitates the use of attachment systems that connect the complete denture to the implant. Nevertheless, each attachment system has its inherent advantages and disadvantages, which should be considered when choosing a system. The first part of this article provides an overview on options available to restore the mandibular edentulous arch with dental implants. Different types of attachment systems, their features and drawbacks are also reviewed.
    • Mandibular implant-supported overdentures: attachment systems, and number and locations of implants – Part II

      Warreth, Abdulhadi; Byrne, Caroline; Fadel Alkadhimi, Aslam; Woods, Edel; Sultan, Ahmed (Journal of the Irish Dental Association, 2015-06)
      Factors to be considered when selecting an attachment type Selection of an attachment system that is suitable for a specific clinical situation is sometimes difficult. A good knowledge of the different systems and their mechanical properties, and the way in which they distribute load, is important. For instance, when short implants are used resilient attachments should be applied to ensure a degree of relief on the supporting implants. This allows denture movements to occur and enables the edentulous ridge to absorb the masticatory forces. Consequently, a significant amount of masticatory force is dissipated by the edentulous ridge. Some factors that should be identified and considered in order to obtain the best treatment option with the use of RISOs include the following:
    • Maxillary anterior tooth dimensions and proportions in an Irish young adult population.

      Condon, M; Bready, M; Quinn, F; O'Connell, B C; Houston, F J; O'Sullivan, M; Division of Restorative Dentistry and Periodontology, Dublin Dental School and Hospital, Trinity College, Dublin, Ireland. (2011-07)
      This study was undertaken in a young Irish population to determine the dimensions and ratios of the six maxillary anterior teeth. One hundred and nine Irish subjects (age 18-25 inclusive) had irreversible hydrocolloid impressions made of their maxillary dentition poured in type V stone. Clinical crown dimensions were measured with a digital calliper. The stone casts were digitally photographed in a standardised manner enabling calculation of various ratios between the maxillary anterior teeth. Sexual dimorphism existed for various tooth dimensions; most notably canine teeth were in the region of 0·8 mm longer and 0·6 mm wider in males. Central and lateral incisors were found to be 0·5 mm wider in males. It is, therefore, recommended that dimensional tooth guidelines should be given for each of the sexes and not on a population basis. With regard to tooth proportion ratios, no significant differences were found between genders or the left and right sides for any of the measurements or ratios measured. The digitally recorded tooth proportions were similar for both sexes, and the Golden Proportion guidelines could only be applied to the lateral incisor/central incisor widths (0·618). Identified width proportions for the canine/central incisor were 0·58 and for canine/lateral incisor 0·89.
    • Maxillary canine-first premolar transposition in the permanent dentition: treatment considerations and a case report.

      Synodinos, Philippos N; Polyzois, Ioannis; Dublin Dental School & Hospital, Lincoln Place, Dublin 2. (2010-12)
      Transposition is defined as the interchange of position between two adjacent teeth within the same quadrant of the dental arch. Permanent maxillary canine-premolar transposition is the most commonly observed transposition in the human dentition. Its prevalence is relatively low and its aetiology remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. Treatment is selected on an individual case basis after thoroughly considering the overall facial and dental characteristics, duration of treatment, cost, patient preference and the orthodontist's experience. This article provides a case report of maxillary canine transposition in the permanent dentition, successfully managed with orthodontic treatment.
    • Maxillary canine-first premolar transposition in the permanent dentition: treatment considerations and a case report.

      Synodinos, Philippos N; Polyzois, Ioannis; Dublin Dental School & Hospital, Lincoln Place, Dublin 2. (Irish Dental Association, 2010-12)
      Transposition is defined as the interchange of position between two adjacent teeth within the same quadrant of the dental arch. Permanent maxillary canine-premolar transposition is the most commonly observed transposition in the human dentition. Its prevalence is relatively low and its aetiology remains unclear, although it has been associated with genetic factors. It may also be related to a combination of localised factors such as malformation of adjacent teeth, tooth agenesis, retention of the deciduous canine and a history of local trauma. Treatment is selected on an individual case basis after thoroughly considering the overall facial and dental characteristics, duration of treatment, cost, patient preference and the orthodontist's experience. This article provides a case report of maxillary canine transposition in the permanent dentition, successfully managed with orthodontic treatment.
    • The mechanical properties of nanofilled resin-based composites: characterizing discrete filler particles and agglomerates using a micromanipulation technique.

      Curtis, Andrew R; Palin, William M; Fleming, Garry J P; Shortall, Adrian C C; Marquis, Peter M; Biomaterials Unit, School of Dentistry, University of Birmingham, St. Chads Queensway, Birmingham B4 6NN, UK. (2009-02)
      To assess the mechanical properties of discrete filler particles representative of several inorganic fillers in modern dental resin-based composites (RBCs) and to assess the validity of a novel micromanipulation technique.
    • Mechanisms of antifungal drug resistance in Candida dubliniensis.

      Coleman, David C; Moran, Gary P; McManus, Brenda A; Sullivan, Derek J; Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental School & Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland. david.coleman@dental.tcd.ie (2010-06)
      Candida dubliniensis was first described in 1995 and is the most closely related species to the predominant human fungal pathogen Candida albicans. C. dubliniensis is significantly less prevalent and less pathogenic than C. albicans and is primarily associated with infections in HIV-infected individuals and other immunocompromised cohorts. The population structure of C. dubliniensis consists of three well-defined major clades and is significantly less diverse than C. albicans. The majority of C. dubliniensis isolates are susceptible to antifungal drugs commonly used to treat Candida infections. To date only two major patterns of antifungal drug resistance have been identified and the molecular mechanisms of these are very similar to the resistance mechanisms that have been described previously in C. albicans. However, significant differences are evident in the predominant antifungal drug mechanisms employed by C. dubliniensis, differences that reflect its more clonal nature, its lower prevalence and characteristics of its genome, the complete sequence of which has only recently been determined.
    • Medical emergencies in dental practice.

      Wilson, M H; McArdle, N S; Fitzpatrick, J J; Stassen, L F A; Department of Oral & Maxillofacial Surgery, Dublin Dental School & Hospital/St James's Hospital, Dublin 2. (2009-06)
      Serious medical emergencies are fortunately a rare occurrence in the dental practice environment; however, if an emergency situation is encountered a delay in treatment may result in potentially avoidable consequences. The risk of mortality or serious morbidity can be reduced by ensuring that basic emergency equipment and medications are in place, and that the dental team is appropriately trained in basic life support measures. This article aims to provide an overview of the basic emergency medications and equipment that should be present in dental practices, and to discuss specific responses to some of the more common adverse medical events that can present while providing dental treatment.
    • Medical, nutritional, and dental considerations in children with low birth weight.

      O'Connell, Susan; O'Connell, Anne; O'Mullane, Elaine; Hoey, Hilary; Department of Pediatric Endocrinology, The National Children's Hospital, Dublin, Ireland. soconnell5@hotmail.com (2009-11)
      It is estimated that 8 to 26 percent of infants are born with low birth weight (LBW) worldwide. These children are at risk for medical problems in childhood and adulthood and often have poor oral health. The influence of fetal growth on birth weight and its relevance to childhood growth and future adult health is controversial. Evidence now indicates that the postnatal period is a critical time when nutrition may predispose the child to lifelong metabolic disturbance and obesity. Given the lack of consensus on optimum infant nutrition for LBW, premature, and small-for-gestational-age infants, many such infants may be suboptimally managed. This may result in rapid postnatal weight gain and ongoing health problems. The purpose of this review was to summarize medical terminology and issues related to fetal growth, morbidity associated with being born low birth weight, premature, or small for gestational age, and the importance of appropriate nutrition in such infants. Pediatric dentists can play an important role in supporting healthy feeding practices and improving long-term health in these children. Early integrated medical and dental care should be encouraged for all children with low birth weight.
    • Medically Compromised Patients 3

      Fleming, P; Hallett, K; Balmer, R; Sheller, B; McGovern, E (Wiley, 2012-06)
    • Microbial biofilm control within the dental clinic: reducing multiple risks

      Coleman, D. C.; O'Donnell, M. J.; Boyle, M.; Russell, R. (2010-11)
    • Microbiological screening of Irish patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy reveals persistence of Candida albicans strains, gradual reduction in susceptibility to azoles, and incidences of clinical signs of oral candidiasis without culture evidence.

      McManus, Brenda A; McGovern, Eleanor; Moran, Gary P; Healy, Claire M; Nunn, June; Fleming, Pádraig; Costigan, Colm; Sullivan, Derek J; Coleman, David C; Microbiology Research Unit, Division of Oral Biosciences, Dublin Dental University Hospital, University of Dublin, Trinity College Dublin, Dublin 2, Republic of Ireland. (2011-05)
      Patients with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) are prone to chronic mucocutaneous candidiasis, which is often treated with azoles. The purpose of this study was to characterize the oral Candida populations from 16 Irish APECED patients, who comprise approximately half the total number identified in Ireland, and to examine the effect of intermittent antifungal therapy on the azole susceptibility patterns of Candida isolates. Patients attended between one and four clinical evaluations over a 5-year period, providing oral rinses and/or oral swab samples each time. Candida was recovered from 14/16 patients, and Candida albicans was the only Candida species identified. Interestingly, clinical diagnosis of candidiasis did not correlate with microbiological evidence of Candida infection at 7/22 (32%) clinical assessments. Multilocus sequence typing analysis of C. albicans isolates recovered from the same patients on separate occasions identified the same sequence type each time. Fluconazole resistance was detected in isolates from one patient, and isolates exhibiting a progressive reduction in itraconazole and/or fluconazole susceptibility were identified in a further 3/16 patients, in each case correlating with the upregulation of CDR- and MDR-encoded efflux pumps. Mutations were also identified in the ERG11 and the TAC1 genes of isolates from these four patients; some of these mutations have previously been associated with azole resistance. The findings suggest that alternative Candida treatment options, other than azoles such as chlorhexidine, should be considered in APECED patients and that clinical diagnosis of oral candidiasis should be confirmed by culture prior to the commencement of anti-Candida therapy.