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Chewing and bacteremia
teeth had higher load capabilities than specimens without ferrule preparation but with unaffected residual dentin wall thickness. The highest values were achieved with specimens having posts inserted with conventional resin cement; these values were nearly twice the mean values of group 3 and about 13 times those of group 1. All of the group 1 and 4 of the group 2 specimens fractured in a way that permitted repeat restorations to be made. Specimens combining the ferrule and unaffected remaining dentin wall suffered most of the catastrophic failures. Loss of retention was the cause of failure in 7 of the specimens from group 1 (Fig 3). Vertical root fracture occurred in 1 specimen in group 2. Discussion.—The load capacity of flared unferruled teeth restored with FRP luted with self-adhesive cement and covered with all-ceramic crowns was not sufficient for clinical use. The fracture capability of endodontically
treated teeth is significantly influenced by the type of luting resin cement used for the endodontic posts.
Clinical Significance.—Demonstrated here is the necessity of a ferrule in post-retained anterior crowns on endodontically treated teeth. While utilizing a ferrule reduced the incidence of failures, those that occurred tended to be catastrophic. Everything is a trade-off.
Naumann M, Preuss A, Frankenberger R: Load capability of excessively flared teeth restored with fiber-reinforced composite posts and all-ceramic crowns. Oper Dent 31:699-704, 2006 Reprints available from M Naumann, Augustenburger Platz 1, D-13353 Berlin, Germany; e-mail: [email protected]
Oral Medicine Chewing and bacteremia Background.—Viridans streptococci cause 20% to 30% of cases of native valve and late prosthetic valve endocarditis. Bacteremia with organisms such as streptococci from the oral cavity is considered a contributing factor in endocarditis, leading to the recommendation for antibiotic prophylaxis when undergoing dental procedures. Chewing also has been postulated to be a source of bacteremia of oral origin. Studies have not consistently produced evidence of bacteremia on chewing. An investigation was undertaken to determine whether chewing in patients with plaque-induced gingivitis or chronic periodontitis causes bacteremia, to identify clinical factors significantly linked to such bacteremia, and to pinpoint the microorganisms present in positive blood cultures. Methods.—The participants included 21 with untreated chronic periodontitis and 20 with plaque-induced gingivitis. All chewed a standard wax medium for 4 minutes. Blood samples were drawn before chewing, during chewing, and 5 minutes after chewing. Cultures were obtained for 21 days using the aerobic and anaerobic Bactec system. Subcultures were obtained for positive cultures, with isolates identified to genus level. All patients underwent periodontal examinations, including probing depth, recession, attachment levels, bleeding on probing, mobility plaque index, and gingival index. Severity of alveolar bone loss was estimated from radiographs. Results.—Two of the patients with chronic periodontitis and 1 with plaque-induced gingivitis had bacteremia at
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Dental Abstracts
baseline measurement. Bacteremia during chewing was found in the tw2o periodontitis patients only. None of the blood samples contained bacteria of oral origin. The bacterial species found were considered skin contaminants from the blood sampling procedure, consisting of Propionibacterium spp and Streptococcus epidermidis. Discussion.—Chewing did not produce bacteremia of oral origin in these patients with chronic periodontitis or plaque-induced gingivitis. The bacteria detected were skin contaminants from the blood sample procedure.
Clinical Significance.—Interest in connections between oral events and systemic health has suggested the possibility of chewing, in subjects with periodontal pathology, inducing bacteremia and the resultant risk of infective endocarditis. In this study of subjects with plaque-induced gingivitis and untreated chronic periodontitis no such link was shown.
Murphy AM, Daly CG, Mitchell DH, et al: Chewing fails to induce oral bacteraemia in patients with periodontal disease. J Clin Periodontol 33:730-736, 2006 Reprints available from CG Daly, Faculty of Dentistry, Univ of Sydney, 2 Chalmers St, Surry Hills, NSW 2010, Australia; e-mail: cdaly@ dentistry-usyd.edu.au
treated teeth is significantly influenced by the type of luting resin cement used for the endodontic posts.
Clinical Significance.—Demonstrated here is the necessity of a ferrule in post-retained anterior crowns on endodontically treated teeth. While utilizing a ferrule reduced the incidence of failures, those that occurred tended to be catastrophic. Everything is a trade-off.
Naumann M, Preuss A, Frankenberger R: Load capability of excessively flared teeth restored with fiber-reinforced composite posts and all-ceramic crowns. Oper Dent 31:699-704, 2006 Reprints available from M Naumann, Augustenburger Platz 1, D-13353 Berlin, Germany; e-mail: [email protected]
Oral Medicine Chewing and bacteremia Background.—Viridans streptococci cause 20% to 30% of cases of native valve and late prosthetic valve endocarditis. Bacteremia with organisms such as streptococci from the oral cavity is considered a contributing factor in endocarditis, leading to the recommendation for antibiotic prophylaxis when undergoing dental procedures. Chewing also has been postulated to be a source of bacteremia of oral origin. Studies have not consistently produced evidence of bacteremia on chewing. An investigation was undertaken to determine whether chewing in patients with plaque-induced gingivitis or chronic periodontitis causes bacteremia, to identify clinical factors significantly linked to such bacteremia, and to pinpoint the microorganisms present in positive blood cultures. Methods.—The participants included 21 with untreated chronic periodontitis and 20 with plaque-induced gingivitis. All chewed a standard wax medium for 4 minutes. Blood samples were drawn before chewing, during chewing, and 5 minutes after chewing. Cultures were obtained for 21 days using the aerobic and anaerobic Bactec system. Subcultures were obtained for positive cultures, with isolates identified to genus level. All patients underwent periodontal examinations, including probing depth, recession, attachment levels, bleeding on probing, mobility plaque index, and gingival index. Severity of alveolar bone loss was estimated from radiographs. Results.—Two of the patients with chronic periodontitis and 1 with plaque-induced gingivitis had bacteremia at
240
Dental Abstracts
baseline measurement. Bacteremia during chewing was found in the tw2o periodontitis patients only. None of the blood samples contained bacteria of oral origin. The bacterial species found were considered skin contaminants from the blood sampling procedure, consisting of Propionibacterium spp and Streptococcus epidermidis. Discussion.—Chewing did not produce bacteremia of oral origin in these patients with chronic periodontitis or plaque-induced gingivitis. The bacteria detected were skin contaminants from the blood sample procedure.
Clinical Significance.—Interest in connections between oral events and systemic health has suggested the possibility of chewing, in subjects with periodontal pathology, inducing bacteremia and the resultant risk of infective endocarditis. In this study of subjects with plaque-induced gingivitis and untreated chronic periodontitis no such link was shown.
Murphy AM, Daly CG, Mitchell DH, et al: Chewing fails to induce oral bacteraemia in patients with periodontal disease. J Clin Periodontol 33:730-736, 2006 Reprints available from CG Daly, Faculty of Dentistry, Univ of Sydney, 2 Chalmers St, Surry Hills, NSW 2010, Australia; e-mail: cdaly@ dentistry-usyd.edu.au