Partnering with head and neck surgeons, pathologists at Dartmouth Hitchcock Medical Center's Norris Cotton Cancer Center developed a new use for an old test to determine if a patient's cancer is recurring, or if the biopsy shows benign inflammation of mucosal tissues. In Pathology -- Research and Practice, lead author Candice C. Black, DO explained how her team confirmed the utility of ProExC, an existing antibody cocktail commonly used for pathology tests of the uterine cervix. The team's goal remained sorting out problems presented by the frequently equivocal pathology results when surgeons need to determine the difference between true pre-neoplasia and merely inflammatory/reactive biopsies.

"In reality, the biopsies we receive from head and neck patients are often tiny and poorly oriented. Particularly in smokers and other post-treatment patients, inflammation may cause reactive epithelial atypia that is difficult to distinguish from dysplasia," reported Dr. Black. "This new use of the ProExC antibody cocktail allows us to provide the head and neck surgeons with key information about which patients have post-therapy complications versus those with true tumor recurrence."

The World Health Organization (WHO) provides two systems for classifying dysplasia, and both have been criticized as being too subjective and failing to predict disease progression. A spectrum of histologic aberrations in mucosal membranes can mimic dysplasia, as well as neo-plastic cytologic and architectural changes. This is the first attempt to use ProExC as a diagnostic adjunct in the detection of head and neck mucosal biopsies.

Pathologists used 64 biopsies from the Dartmouth archives to setup groups of patients who had and had not progressed to cancer, and found statistically significant differences between the progression cases and the controls in terms of the stain scores using ProExC. "The surgeons wanted to know if the mucosa was neoplastic or just inflamed and reactive. The old-school answer of 'atypia' simply isn't sufficient to make decisions about therapeutic interventions," described Black.

Going forward, Dr. Black's Dartmouth team is gathering prospective cases and continuing to test ProExC.

Source:Norris Cotton Cancer Center Dartmouth-Hitchcock Medical Center

Rather than soothe and comfort, a hot cup of tea or cocoa can cause people with sensitive teeth a jolt of pain. But scientists are now developing a new biomaterial that can potentially rebuild worn enamel and reduce tooth sensitivity for an extended period. They describe the material, which they tested on dogs, in the journal ACS Nano.

Chun-Pin Lin and colleagues note that tooth sensitivity is one of the most common complaints among dental patients. Not only does it cause sharp pains, but it can also lead to more serious dental problems. The condition occurs when a tooth's enamel degrades, exposing tiny, porous tubes and allowing underlying nerves to become more vulnerable to hot and cold.

Current treatments, including special toothpastes, work by blocking the openings of the tubes. But the seal they create is superficial and doesn't stand up to the wear-and-tear of daily brushing and chewing. Lin's team wanted to find a more durable way to address the condition.

The researchers made a novel paste based on the elements found in teeth, namely calcium and phosphorus. They applied the mixture to dogs' teeth and found that it plugged exposed tubes more deeply than other treatments. This depth could be the key, the researchers conclude, to repairing damaged enamel and providing longer-lasting relief from tooth sensitivity.

The study, A Mesoporous Silica Biomaterial for Dental Biomimetic Crystallization, can be accessed at: https://pubs.acs.org/doi/abs/10.1021/nn5053487.

Source: Science Daily

This study was published in the November/December issue of The International Journal of Oral and Maxillofacial Implants (JOMI), the official journal of the Academy of Osseointegration (AO).

Background: Micromotion at the implant-abutment level has been identified as a major determinant of long-term implant success. Technical problems ranging from screw loosening to screw fracture may occur as a consequence of excessive micromotion. Different concepts for the design of the implant-abutment connection have been proposed in the past, which affect micromotion at the restorative interface as well as the stability of the abutments used. While initial micromotion depends predominantly on the fabrication accuracy achieved, long-term micromotion appears to be related primarily to wear phenomena at the implant-abutment interface. Despite the clinical importance of micromotion phenomena at the implant-abutment interface, no universally valid method for quantifying this phenomenon has been described.

Key Point: It cannot be predicted that a certain type of abutment will always lead to a certain level of micromotion. Relative displacement of components occurs at varying magnitudes. However, strict adherence to manufacturers’ guidelines with respect to tightening torque may help reduce implant-abutment micromotion. Because micromovement occurs during the initial phase of loading, it may be prudent to routinely retighten the abutment screws, which might have lost preload.

Authors: Dr. Matthias Karl, Department of Prosthodontics, University of Erlangen-Nuremberg, Erlangen, Germany; Dr. Thomas D. Taylor, Department of Reconstructive Sciences, University of Connecticut, Farmington, Connecticut.

Purpose: Scientists aimed to establish a biomechanical approach to directly measure relative motion at the implant-abutment interface and to quantify micromotion in a variety of implant-abutment combinations. Geometry of the implant-abutment interface; fabrication method of the abutment; engagement of antirotational features; abutment material; tightening torque and type of manufacturer (original, clone) were investigated.

Materials and Methods: Implant-abutment assemblies were fixed in a universal testing machine at a 30-degree angle. A cyclic load of 200 N (Newtons) was applied to the specimens 10 times at a cross head speed of 100N/s while relative displacement between the implant and the abutment was quantified using extensometers. For five consecutive loading cycles per specimen, micromotion was recorded as a basis for statistical analysis. Comparative analysis was based on Welch tests.

Results: Investigated implant-abutment combinations produced a broad range of micromotion values. Researchers did not find perfect implant shoulder geometry or perfect fabrication technique that would result in undetectable micromotion. The values for micromotion at the implant-abutment interface ranged from 1.52 to 94.00 µm (micrometers). Researchers found tightening torque significantly affected the level of micromotion when one specific abutment type was investigated. Implant shoulder design did not reveal a significant effect in all cases. Lack of engagement of antirotational features of the implants resulted in increased micromotion, regardless of the implant system investigated. Casting onto prefabricated gold cylinders resulted in abutments with significantly less micromotion as compared to copy-milled stock abutments. Computer aided design/computer assisted manufacture (CAD/CAM) zirconia abutments showed less micromotion than CAD/CAM titanium abutments. Inconsistent levels of micromotion were recorded for CAD/CAM abutments coupled to proprietary and competing implant systems. In most cases, the CAD/CAM abutments performed as well as stock abutments. Great variations in micromotion were found with clone abutments and clone implant systems.

More information: For a complete copy of the study and the JOMI November/December Table of Contents,” visit: https://www.osseo.org/NEWIJOMI.html. To join AO and begin receiving JOMI (bi-monthly) or obtain online access to JOMI, visit: https://www.osseo.org/NEWmembershipApply.html.

The memory and walking speeds of adults who have lost all of their teeth decline more rapidly than in those who still have some of their own teeth, finds new UCL research.

The study, published in the Journal of the American Geriatrics Society, looked at 3,166 adults aged 60 or over from the English Longitudinal Study of Ageing (ELSA) and compared their performance in tests of memory and walking speed. The results showed that the people with none of their own teeth performed approximately 10% worse in both memory and walking speed tests than the people with teeth.

The association between total tooth loss and memory was explained after the results were fully adjusted for a wide range of factors, such as sociodemographic characteristics, existing health problems, physical health, health behaviours, such as smoking and drinking, depression, relevant biomarkers, and particularly socioeconomic status. However, after adjusting for all possible factors, people without teeth still walked slightly slower than those with teeth.

These links between older adults in England losing all natural teeth and having poorer memory and worse physical function 10 years later were more evident in adults aged 60 to 74 years than in those aged 75 and older.

"Tooth loss could be used as an early marker of mental and physical decline in older age, particularly among 60-74 year-olds," says lead author Dr Georgios Tsakos (UCL Epidemiology & Public Health). "We find that common causes of tooth loss and mental and physical decline are often linked to socioeconomic status, highlighting the importance of broader social determinants such as education and wealth to improve the oral and general health of the poorest members of society.

"Regardless of what is behind the link between tooth loss and decline in function, recognising excessive tooth loss presents an opportunity for early identification of adults at higher risk of faster mental and physical decline later in their life. There are many factors likely to influence this decline, such as lifestyle and psychosocial factors, which are amenable to change."

Source: Medical News Today

The new EasySmile LifeLike Veneer System is a simple program for achieving a brighter, confident smile in one dental visit. Harvey Silverman, D.M.D., F.A.S.D.A., F.A.B.A.D., began development of EasySmile Veneers in 2008 as a cosmetic dentistry alternative to conventional porcelain. Silverman sought a same-day solution to flaws in his patient’s smiles without filing down teeth and without anesthetics.

EasySmile Veneers are a direct veneer system made using a groundbreaking foundation material that allows dentists to form the veneer to the patient’s tooth and allows a look at the new smile before any permanent bonding occurs. Once the patient has approved the size, shape and color with EasySmile’s patent pending Smile Preview Veneers, the shaped material is dried and hardened under blue light. From consultation to the final smile, the program takes between 30 minutes and one hour to be affixed, depending on the number of veneers.

Dr. Silverman’s system has solved three common problems that porcelain veneers often present. First, porcelain can be expensive, costing upwards of $1,500-3,000 per tooth. EasySmile Veneers do not incur a laboratory fee and do not require multiple appointments, therefore reducing the cost by as much as 75 percent. Second, many dentists often resort to filing down a tooth prior to installing porcelain veneers. Because EasySmile Veneers are contact lens thin and form-fitted to each patient’s tooth, there is no need to destroy nature’s own enamel because the new veneer fits perfectly over the existing tooth. Finally, many patients worry that veneers will look artificial. When cured and permanently cemented to the teeth, EasySmile Veneers combine the right mix of opacity with translucency, thus the veneered teeth appear natural looking.

Since 1984, Dr. Silverman has traveled around the world speaking at cosmetic dentistry symposiums. With the release of EasySmile Veneers, he has held on-site workshops to train dentists to use the program in cities throughout North America. Before treating a patient with EasySmile Veneers dentists must first be trained in the system.  Dr. Silverman is able to do much of the initial training via a “hands-on” training webinar format for both U.S. and international dentists.

EasySmile can straighten crooked teeth, whiten stained teeth, repair chipped teeth, close spaces, and hide silver fillings, among other problems. Visit www.EasySmileSystem.com. 

PITTSBURGH, January 5, 2015 – Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a multidisciplinary team led by scientists affiliated with the University of Pittsburgh Cancer Institute (UPCI), a partner with UPMC CancerCenter.

In an analysis published in the journal Cancer and funded by the National Institutes of Health (NIH), the team provides a rationale for a national clinical trial to assess the effectiveness of adding examination of the head and neck to lung cancer screening programs. People most at risk for lung cancer are also those most at risk for head and neck cancer.

“When caught early, the five-year survival rate for head and neck cancer is over 83 percent,” said senior author Brenda Diergaarde, Ph.D., assistant professor of epidemiology at Pitt’s Graduate School of Public Health and member of the UPCI. “However, the majority of cases are diagnosed later when survival rates generally shrink below 50 percent. There is a strong need to develop strategies that will result in identification of the cancer when it can still be successfully treated.”

Head and neck cancer is the world’s sixth-most common type of cancer. Worldwide every year, 600,000 people are diagnosed with it and about 350,000 die. Tobacco use and alcohol consumption are the major risk factors for developing the cancer.

The early symptoms are typically a lump or sore in the mouth or throat, trouble swallowing or a voice change, which are often brushed off as a cold or something that will heal. Treatment, particularly in later stages, can be disfiguring and can change the way a person talks or eats.

Dr. Diergaarde and her team analyzed the records of 3,587 people enrolled in the Pittsburgh Lung Screening Study (PLuSS), which consists of current and ex-smokers aged 50 and older, to see if they had a higher chance of developing head and neck cancer.

In the general U.S. population, fewer than 43 per 100,000 people would be expected to develop head and neck cancer annually among those 50 and older. Among the PLuSS participants, the rate was 71.4 cases annually per 100,000 people.

Recently, the U.S. Preventive Services Task Force, as well as the American Cancer Society and several other organizations, recommended annual screening for lung cancer with low-dose computed tomography in people 55 to 74 years old with a smoking history averaging at least a pack a day for a total of 30 years. The recommendation came after a national clinical trial showed that such screening reduces lung cancer mortality.

“Head and neck cancer is relatively rare, and screening the general population would be impractical,” said co-author David O. Wilson, M.D., M.P.H., associate director of UPMC’s Lung Cancer Center. “However, the patients at risk for lung cancer whom we would refer for the newly recommended annual screening are the same patients that our study shows also likely would benefit from regular head and neck cancer screenings. If such screening reduces mortality in these at-risk patients, that would be a convenient way to increase early detection and save lives.”

Dr. Diergaarde’s team is collaborating with otolaryngologists to design a national trial that would determine if regular head and neck cancer screenings for people referred for lung cancer screenings would indeed reduce mortality.

Additional researchers on this study are Ronak Dixit, Joel L. Weissfeld, M.D., M.P.H., Paula Balogh, D.N.P., F.N.P., Pamela Sufka and Jennifer R. Grandis, M.D., F.A.C.S., all of Pitt; and Jill M. Siegfried, Ph.D., of the University of Minnesota.

This research was funded by NIH grants P50 CA097190, P50 CA090440 and P30 CA047904.

INTELIHEALTH - Smoking changes the bacteria in a person's mouth, putting smokers at risk for disease, a study says.

The study was done by UK and US researchers. They collected plaque samples from under the gums of 200 people. All were between 21 and 40 years old, and healthy. Some were smokers; others had never smoked. None had gum disease.

The numbers and types of bacteria were different between the groups. On average, smokers had more types of bacteria in their mouths than nonsmokers did. Smokers had more types of disease-causing bacteria. This included a species called Fusobacterium nucleatum, which has been linked with colorectal cancer. They had fewer types of "friendly" bacteria.

Certain types of bacteria are linked with tooth decay. Smokers had more of these bacteria in their mouths than nonsmokers did. One type, Lactobacillus salivarius, was found only in smokers.

Smokers also had more of the bacteria that can cause gum disease, though no one in the study had gum disease.

The authors suggest that smoking may help to create a risky environment in the mouth. This could make smokers more vulnerable to tooth decay and gum disease, as well as other diseases.

The study appears in the January issue of The ISME Journal, the official journal of the International Society for Microbial Ecology.

Source: InteliHealth News Service

Las Vegas, NV – January 20, 2015 – Core3dcentres® and Thommen Medical are pleased to announce that Core3dcentres has been recognized as the only Authorized Milling Center for Thommen Implant System custom and hybrid abutments in North America. Core3dcentres has undergone a rigorous certification process (including machined samples, material handling and product training) to ensure their Milling Centers are delivering custom and hybrid abutments, using genuine Thommen material, meeting the high standards and quality that Thommen demands.

Both Core3dcentres and Thommen Medical are very excited by this partnership as it opens up new opportunities for the dental industry and reinforces both companies’ commitment to using the best technologies, materials and processes available in the market today.

For more information on Thommen Implant System Abutment products from Core3dcentres, or any other products, services and educational offerings, please visit www.core3dcentres.com; or contact us toll-free at 1-888-750-9204 or by email at InfoUSA@core3dcentres-na.com.

About Core3dcentres®

With production centers in Sydney, Australia; Calgary, Canada; Las Vegas, USA; Glasgow, Scotland; Maartensdijk, Netherlands; Barcelona, Spain; Osaka, Japan; Engelsbrand and Munich, Germany and growing every day, Core3dcentres offers the one of the most comprehensive suites of digital implant solutions today, allowing dental laboratories of any size to fully service every indication in dentistry’s most rapidly growing market segment with greater precision, faster turnaround and greater dentist and patient satisfaction. Using the latest in CAD/CAM technologies for a complete one-stop implant-crown solution, Core3dcentres supplies a full range of digital solutions, all supported by one of the largest ranges of dual-use lab/intraoral scan bodies (radiopaque and autoclavable) on the market today; lab analogs; digital model analogs; screws; titanium bases; hybrid abutments; titanium abutments and bars; and frameworks in PMMA, Zirconia, Titanium and Co-Cr for screw-retained bridges.

As an authorized milling partner for the Thommen Implant System, Dentsply CELTRA™ Duo, VITA Zahnfabrik, Ivoclar Vivadent™, BioHorizons® and 3M Lava™ as well as a Cadent iTero™ model milling center, Core3dcentres® offers access to all of the leading brands (CELTRA™ Duo, VITA ENAMIC®, IPS e.max® CAD, Telio CAD®, ZenoTec®, Lava™) supported by continuing education, technical assistance, validated workflows and fast turnarounds.

About Thommen Medical

Thommen Medical is a Swiss designer and manufacturer of dental implant systems with a reputation for precision, quality and functional design. We are committed to creating products that satisfy our customers' high standards for safety, aesthetics and predictability. 

The Thommen Implant System is based on more than 35 years of clinical experience. Our ongoing, intense collaborations with world-renowned clinicians and academic institutions enable us to provide easy to use and extremely precise solutions. As a result, our Thommen Implant System has become well-regarded for delivering superb clinical results and outstanding aesthetics to patients. Thommen Medical world headquarters is located in Grenchen, Switzerland. The production of the Thommen Implant System takes place at the company’s own manufacturing facility in Grenchen.

Thommen Medical has subsidiaries in Switzerland, Germany, Austria, Benelux, United States and Canada. Distribution partners represent Thommen Medical in other major markets of Europe, Asia and the Middle East.

To learn more, please contact your local Thommen representative or visit www.thommenmedical.com. 

On November 19, 2014, The Argen Corporation hosted “The Future of Digital Dentistry” seminar in San Diego, CA, featuring guest speakers Dr. Gordon Christensen, DDS, MSD, PhD, and Dr. Robert Lowe, DDS. The event focused on the emerging digital technologies and how they benefit both the dental laboratory and the dentist. Dental laboratory professionals and dentists from locations throughout the United States attended the seminar. Attendees were invited to tour the Argen Digital manufacturing facility at the Argen Corporation headquarters following the seminar.

Presentations covered a range of pertinent topics including: innovations in clinical dentistry and dental laboratory technology, intraoral scanning and split files and leading Zirconia material options. “Argen is dedicated to partnering with the dental laboratory. We offered this joint program to help our laboratory customers educate their dentist-customers about new digital technologies and the valuable role these technologies can play in their practices,” said Anton Woolf, CEO, Argen Corporation.

Dr. Gordon Christensen spoke on the importance of digital technology for both the dental laboratory and the dentist. He stressed that the dental lab and the dentist need to be reunited and work closely together to deliver the best products for their patients. “Dentists need to know about milling and printing options for restorative work, such as those available from Argen Digital,” said Dr. Christensen. He congratulated Argen on the development of digital products such as ArgenZ Transitionally shaded Zirconia and Selective laser melted substructures stating “I believe Argen is going to take the industry with this technology”.

Dr. Robert Lowe spoke on how he has embraced digital technologies within his practice and highlighted key products and tools that have helped him to be more successful from digital diagnosis, to impression making, communication with the dental laboratory and restoration fabrication.

Jeff Lowthorp, Director of Global Business Development, Argen Corp., and Logan Woomer, 3Shape Specialist, Argen Corp., presented a live demonstration of an intraoral scan using a 3Shape TRIOS scanner. They demonstrated how a lab easily accepts an intraoral scan and designs a restoration using 3Shape software for a wide range of material options including custom abutments, wax tops, gold crowns, ArgenZ Zirconia crown and more.

Chris Lowthorp, R&D Consultant for the Argen Corporation, reviewed the current full contour Zirconia material options available through the digital workflow. He further explained the benefits of transitionally shaded zirconia, such as ArgenZ Esthetic Zirconia, over monochromatic pre-shaded zirconia discs. Paul Cascone, Sr. VP of Research and Development at Argen, explained the process of developing alloys for the Selective Laser Melting process and reviewed Argen’s full line of SLM metals including SLM Non Precious, SLM Noble 25, SLM High Noble and SLM Captek.

Anton Woolf closed the afternoon with a brief history of Argen and delivered the vision of Argen’s role within the future of digital dentistry. “Our role is to deliver the highest quality products and services to support our dental laboratory partners. Making technologies available to labs of all sizes and becoming a partner in their success,” stated Anton.

About The Argen Corporation

Argen Corporation is a worldwide leader in dental alloys, digital dentistry and scrap refining services. Argen is the largest dental alloy manufacturer in the world, offering over 600 precious and non-precious alloys to more than 100 countries. Argen’s innovative digital services provide the most complete digital solution to dental laboratories of all sizes including Selective Laser Melting (SLM), Digital Precious Metals (DPM), ArgenIS Custom Abutments,Digital Captek, Milled and Printed Wax, ArgenPMMA Temporaries, ArgenZTM Transitionally Shaded Milled Zirconia, Digital Models and 3Shape Scanners.

Argen has built a reputation for consistent quality and superior customer services. Argen Corporation manufactures products under the following brand names: Jelenko, Aurium, Leach & Dillon Alloys, Wilkinson Alloys, World Alloys, Gateway Alloys, Dent-Gold, and Dental Alloy Products. To learn more about Argen, please visit www.argen.com or call (800) 255-5524.