The Journal Of The Tennessee Dental Association[JOURNAL]
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200 papers
Admissions at the University of Tennessee College of Dentistry Part 1: Trend in Applications 1977-2015.
Covington JSI
J Tenn Dent Assoc · 2016 Fall · PMID 30290098
This is the first in a series of commentaries related to admission to The University of Tennessee College of Dentistry. Admission to dental school in the current climate is exceedingly competitive-much more so than at an...
This is the first in a series of commentaries related to admission to The University of Tennessee College of Dentistry. Admission to dental school in the current climate is exceedingly competitive-much more so than at any time in history. The purpose of the paper is to examine over thirty-five years of class size and total applications to the University of Tennessee College of Dentistry to gauge competition for admission today versus any time in the past thirty-five years.
A Novel Protocol to Evaluate Hard and Soft Tissue Relationships in Three Dimensions without the Use of Additional Radiographic Studies.
Maness H, Hottel SA, Trojan T … +1 more , Hottel TL
J Tenn Dent Assoc · 2016 Fall · PMID 30290097
OBJECTIVE: The evaluation of hard and soft tissue relationships is an important part of the study of facial morphology, craniofacial development and orthodontic treatment and outcomes. Historically, this evaluation has o...
OBJECTIVE: The evaluation of hard and soft tissue relationships is an important part of the study of facial morphology, craniofacial development and orthodontic treatment and outcomes. Historically, this evaluation has occurred in two dimensions. The purpose of this study was to develop a protocol to study the relationships of hard and soft tissues in three dimensions without the use of additional radiation. MATERIALS AND METHODS: Stereo photogrammetric images created by the 3dMDTM Face system and models digitized using the Motion View scanner were utilized. Using a previous lateral cephalometric image from the orthodontic records appointment, these hard tissue and soft tissue images were integrated. RESULTS: The integration of all data sets was accomplished with an average error rate of less than .05mm. A method was developed, thus allowing measurement of soft tissue thicknesses and changes over treatment time in relation to the underlying dentition. CONCLUSIONS: Evaluation of hard and soft tissue relationship in three dimensions can be accomplished without the use of additional radiographic studies.
Tennessee Dental Establishments: 2007-2012 Economic Survey.
Waldman HB, Garey M, Rader R
J Tenn Dent Assoc · 2016 Fall · PMID 30290096
OBJECTIVE: To document the evolving economies of dental establishments in the State of Tennessee during a period of significant growth of the number of establishments before and after the "Great Recession." METHOD: Publi...
OBJECTIVE: To document the evolving economies of dental establishments in the State of Tennessee during a period of significant growth of the number of establishments before and after the "Great Recession." METHOD: Published results from the five-year economic surveys by the U.S. Census Bureau on business receipts and salaries of employees (including dentists) for the State of Tennessee and its counties were used to construct a review of these developments. RESULTS: Between 2007 and 2012, there were continued increases in average current dollar business receipts and employee salaries. However, in terms of standard dollars, removing the effects of inflation: 1) business receipts increased in 19 counties but decreased in 37 counties; 2) employee salaries increased in 13 counties but decreased in 30 counties. CONCLUSIONS: Results are in line with the reports by the ADA Health Policy Institute, which indicate that nationally the percentage of dentists who report they are not busy enough has increased and dentists' earnings are stagnating. The need is to expand the delivery of care to underserved populations, including the poor, individuals with disabilities, minorities and new immigrant populations, for whom oral health services may not be a priority commodity.
Provisional Replacement of Anterior Teeth: A Review of Clinical Techniques and Case Report in a Dental School Training Experience.
Mallard WA, Deuring WN, Owens BM … +2 more , Phebus JG, Umsted DE
J Tenn Dent Assoc · 2016 Fall · PMID 30290095
Upon the premature loss of permanent anterior teeth from unanticipated trauma or by ongoing patient neglect requiring surgery, patient requisites of functional and esthetic considerations must be addressed. Interim manag...
Upon the premature loss of permanent anterior teeth from unanticipated trauma or by ongoing patient neglect requiring surgery, patient requisites of functional and esthetic considerations must be addressed. Interim management can be achieved through the use of several diverse fixed and/or removable treatment modalities. The purposes of this report are to provide a review of traditional and unconventional techniques for interim replacement of missing anterior teeth and to present a clinical report demonstrating the fabrication of a removable, thermoplastic (vacuum-formed) EssixTM prosthesis, utilizing composite resin as the surrogate material of choice for the absent teeth. This measure proved to be an immediate, esthetic, and transitional treatment solution prior to a permanent resolution for the patient's long-term dental requirements.
We May Have Done Something Right: Composite Restorations at the College of Dentistry, University of Tennessee Health Science Center.
Versluis-Tantbirojn D, Simon JS, Harrison J
J Tenn Dent Assoc · 2016 Fall · PMID 30290094
The success of composite restorations requires meticulous clinical technique in addition to reliable restorative materials and armamentarium. Early failure of restorations is undesirable and are usually replaced at no co...
The success of composite restorations requires meticulous clinical technique in addition to reliable restorative materials and armamentarium. Early failure of restorations is undesirable and are usually replaced at no cost to patients. A metaanalysis study reported a mean annual failure rate of 1.46% for posterior composite restorations. At the University of Tennessee Health Science Center College of Dentistry (UTHSC CoD) predoctoral clinic the percentage of posterior composite restorations replaced within 12 months, retrieved from 2007-2014 electronic chart 'redo' records, was on average 0.58%. Several factors may have contributed to the quality of composite restorations placed by novice clinicians with modest experience. Student doctors are educated about composite placement in preclinical courses and then work under close supervision during their clinical training. This article describes restorative techniques for composites and the rationales taught at the UTHSC CoD Department of Restorative Dentistry. The objective is to share the information, which can be adopted or modified by general practitioners in daily practice.
Comparison of Laser Versus Rotary Instrumentation- A Case Study.
Gregory P, Lea J, Walinski C … +4 more , Terese-Koch D, Hottel T, Fields D, Rodriguez C
J Tenn Dent Assoc · 2016 Fall · PMID 30290093
The use of an erbium laser to treat carious teeth has proven to have several advantages when compared to rotary instruments. The clinician is able to remove a minimal amount of tooth structure, thus minimizing the risk o...
The use of an erbium laser to treat carious teeth has proven to have several advantages when compared to rotary instruments. The clinician is able to remove a minimal amount of tooth structure, thus minimizing the risk of pulpal exposure. The extremely short pulses of erbium lasers combined with an aerosolized water spray have been shown to cool the pulp as opposed to rotary instruments which may create heat that could lead to a pulpitis. Bonding to the lased surfaces is improved because the smear layer is removed, bleeding is controlled, and the lased tooth surface appears etched with open dentinal tubules. The laser also provides a bactericidal effect and the need for local anesthetics is eliminated or reduced. The use of the erbium laser to prepare cavity preparations can be done as quickly, or oftentimes more quickly, than using a rotary instruments. In addition, patients appreciate the absence of the high speed drill noise and vibration.
Antibiotic Therapy in the Treatment of Odontogenic Infections-An Evolving Landscape.
Weeda L, Backer MJ
J Tenn Dent Assoc · 2016 Fall · PMID 30290092
Odontogenic infections continue to be the most common reason for people to seek dental care. Antibiotic therapy, combined with appropriate surgical intervention has been the mainstay in treating dental infections for man...
Odontogenic infections continue to be the most common reason for people to seek dental care. Antibiotic therapy, combined with appropriate surgical intervention has been the mainstay in treating dental infections for many years. Availability of new antimicrobial agents and reports of decreased efficacy in commonly used antibiotics warrant continued study to assure that the most effective agents are utilized. This paper presents a brief summary of the bacterial populations associated with odontogenic infection and their antibiotic resistance mechanisms. Information from a number of studies, including our own data, concerning antibiotic resistance and efficacy are presented. This paper may provide the practitioner with additional information as a guide for appropriate antibiotic use in odontogenic infections.
What is Missing for Stem Cell-Based Therapies in Dentistry.
Huang GTJ, Garcia-Godoy F
J Tenn Dent Assoc · 2016 Fall · PMID 30290091
There have been significant advancements in regenerative dentistry demonstrated in large animal studies, particularly in the areas of endodontics and periodontics. By using dental stem cells, pulp tissues can be regenera...
There have been significant advancements in regenerative dentistry demonstrated in large animal studies, particularly in the areas of endodontics and periodontics. By using dental stem cells, pulp tissues can be regenerated in empty root canal space, and periodontal pockets can be regenerated to its normal state. To further test its clinical applications and perhaps to provide such patient care service if proven safe and successful, a facility called good manufacturing practice where stem cells are processed is needed. However, such facilities are rare.
Step-by-Step Resin Bonding of Ceramic Veneers in the Anterior Maxilla: A Case Report.
Ferreira CF, Oderich E, Boff LL … +1 more , Volpato CAM
J Tenn Dent Assoc · 2016 Spring · PMID 30281966
Applying the biomimetic principles, maximum preservation of the sound tooth structure may be achieved by means of adhesive restorations. Due to bonding, it is possible to conduct minimally invasive esthetic procedures wi...
Applying the biomimetic principles, maximum preservation of the sound tooth structure may be achieved by means of adhesive restorations. Due to bonding, it is possible to conduct minimally invasive esthetic procedures with laminate veneers assuring a high mechanical resistance of the tooth/restoration bond. A clinical case of adhesive restorations is presented using the bonding protocol respecting the diversity of each product's commercial brands and manufacturer's recommendations.
Introduction to Clinical Practice in Dentistry: Transitioning from Pre-clinical to Clinical Student Doctors at The University of Tennessee Health Science Center College of Dentistry.
Braxton A, Versluis-Tantbirojn D, Wasson W … +3 more , Harrison J, Levy L, Stewart C
J Tenn Dent Assoc · 2016 Spring · PMID 30281965
Matriculation from the pre-clinical setting to the clinical environment is a tremendous accomplishment and exemplifies the student's perseverance in learning the fundamental concepts necessary for success in the clinical...
Matriculation from the pre-clinical setting to the clinical environment is a tremendous accomplishment and exemplifies the student's perseverance in learning the fundamental concepts necessary for success in the clinical application of dentistry. In an effort to maximize its educational philosophy for the teaching program, the University of Tennessee's College of Dentistry has implemented Introduction to Clinical Practice I and II within the dental curriculum. Introduction to Clinical Practice I and II are designed to help the dental students effectively and smoothly transition to the clinical setting from the classroom and pre-clinical setting. This article describes the university's efforts and continuous improvements within the pre-clinical dental curriculum for advancing students to the clinics. The purpose of this article is to provide helpful information to other dental educational institutions on how to assist their pre-clinical dental students in transitioning to clinical student-doctors.
Teaching of Fixed Prosthodontics: A Paradigm Shift.
Korioth T, Lea JD, Simon J … +1 more , McBride M
J Tenn Dent Assoc · 2016 Spring · PMID 30281964
Restorative dentistry is experiencing a significant shift towards a rising usage of tougher all-ceramic materials. This trend must be incorporated into existing fixed prosthodontics academic curricula through the integra...
Restorative dentistry is experiencing a significant shift towards a rising usage of tougher all-ceramic materials. This trend must be incorporated into existing fixed prosthodontics academic curricula through the integration of lithium disilicate and zirconium oxide crown preparation guidelines. In addition, crown fabrication techniques have also evolved for these newer materials through digitization of preparations and impressions and their computer-assisted manufacturing. This article reviews current crown preparation and cementation guidelines while describing the teaching program in fixed prosthodontics at the University of Tennessee Health Sciences College of Dentistry.
Concurrence of Gemination and Fusion in Maxillary Central Incisors: A Case Report.
Worthy CE, Wilson OL, Hudson JW
J Tenn Dent Assoc · 2016 Spring · PMID 30281963
This case reports the concurrence of gemination and fusion affecting the maxillary central incisors of a twelve-year-old patient and the collaboration of the pediatric dentist, endodontist, orthodontist and oral and maxi...
This case reports the concurrence of gemination and fusion affecting the maxillary central incisors of a twelve-year-old patient and the collaboration of the pediatric dentist, endodontist, orthodontist and oral and maxillofacial surgeon. Developmental dental anomalies can occur in both primary and permanent dentitions as a result of conjoining defects. Double teeth, or cases of gemination or fusion, are not exceedingly rare, but the presence of both anomalies in a single patient is a rarity. Gemination is the division of a single tooth bud, resulting in a large single tooth with a bifid crown and common root and root canal. Fusion is the union of two separate tooth buds, resulting in a joined tooth with confluence of dentin and separate root canals. Labial apexogenesis with MTA, composite resin placement, re-contouring and orthodontic care allowed proper alignment with long-term monitoring of growth and development for possible incisor replacement.
Treatment for Recurrent Odontogenic Keratocysts.
Goddard AC, Brooks JH, Lewis RH … +1 more , Lewis PS
J Tenn Dent Assoc · 2016 Spring · PMID 30281962
Controversy remains in understanding both the development and treatment for the odontogenic keratocyst (OKC). With recent changes in nomenclature recognizing the odontogenic keratocyst as a benign tumor, the debate over...
Controversy remains in understanding both the development and treatment for the odontogenic keratocyst (OKC). With recent changes in nomenclature recognizing the odontogenic keratocyst as a benign tumor, the debate over the proper course of treatment to limit recurrence and morbidity will continue. This study presents two cases where conservative treatment failed to prevent recurrence and each patient underwent resection of aggressive, multicystic OKCs to provide the best chance for definitive care without recurrence and limited morbidity.
Determination and Correlation of Depth of Cure of a New Composite Resin Delivery System.
Owens BM, Slaven, Phebus JG … +1 more , Ragain JC
J Tenn Dent Assoc · 2015 · PMID 27024889
OBJECTIVES: To quantify the depth of cure (DOC) of a composite resin system using two different testing criteria. METHOD AND MATERIALS: The DOC testing employed two different experimental protocol: 1) Forty-eight previou...
OBJECTIVES: To quantify the depth of cure (DOC) of a composite resin system using two different testing criteria. METHOD AND MATERIALS: The DOC testing employed two different experimental protocol: 1) Forty-eight previously extracted human molars were randomly assigned to four groups of twelve each (n = 12): Group 1 SonicFill composite resin system, shade A1; Group 2 SonicFill, shade A3; Group 3 Herculite Ultra composite resin, shade A1; Group 4 Herculite Ultra, shade A3. Cylindrical cavities (4.0 mm diameter and 10 mm depth) were prepared at the tooth CEJ, in a mesiodistal direction. The preparations were filled with each composite resin material in one bulk increment and polymerized with a LED light for 20 seconds. After 5 minutes, the occlusal surfaces of the teeth (specimens) were ground flat until the composite was exposed in a transverse plane. The uncured (soft) composite was scraped away, using a "modified" ISO 4049 DOC specification, and the remaining cured (hard) material was measured. Three measurements, at different positions of the specimen, were performed, for a total of thirty-six measurements per specimen group. The measurements were averaged and divided by fifty percent, arriving at the final DOC for each specimen. 2) A DOC testing protocol was performed using a two-piece (4.0 mm x 10.0 mm) custom-made Teflon device (mold). The groupings duplicated the previous experimental protocol. The mold was filled with each composite resin material in one bulk increment to a 10 mm length (depth). Excess composite material was removed, followed by placement of a Mylar strip over the external orifice. The composite resin specimen was light-polymerized for 20 seconds. Again, the uncured (soft) composite was scraped away, with the same measurement protocol followed as in method 1. Statistical analyses were conducted using ANOVA tests at a p < .05 level of significance. RESULTS: Statistical differences were exhibited between the two different DOC methodologies, extracted teeth versus the Teflon device. Considering each method, the SonicFilTM composite revealed significantly greater DOC compared to the Herculite Ultra composite resin. Also, significant differences were displayed between the Al compared to the A3 shades, with the A1 (lighter) shades exhibiting greater DOC. CONCLUSION: The prepped teeth seemed a more realistic DOC testing approach due to the variables of light interaction of the composite resin to either tooth substance (enamel/dentin) versus using the Tefion mold, although greater DOCs were recorded using the manufactured device. The SonicFill composite system did reveal greater DOC compared to the Herculite Ultra composite regardless of experimental method or material shade.
Non-Orthodontic, Non-Restorative Closure of Acquired Diastemata.
Livada R, Shiloah J, Hottel TL
J Tenn Dent Assoc · 2015 · PMID 27008768
AIM: To illustrate the reversibility of "pathologic tooth migration" in several patients that were managed by periodontal therapy alone, along with a review of the relevant literature. BACKGROUND: Pathologic tooth migrat...
AIM: To illustrate the reversibility of "pathologic tooth migration" in several patients that were managed by periodontal therapy alone, along with a review of the relevant literature. BACKGROUND: Pathologic tooth migration (PTM) is a common phenomenon among patients seeking dental care. Different etiologic factors have been implicated in PTM: loss of periodontal support, occlusal interferences, posterior bite collapse, and various oral habits such as: lip biting, tongue thrusting, and playing wind instruments. Identification of all the causative factors involved in PTM is crucial for a successful treatment outcome. Managing severe cases of acquired diastemata may necessitate a complex and a sequential intervention involving periodontic, orthodontic and prosthodontic measures. However, "spontaneous regression" of teeth to their original position may occur in certain cases after elimination of the offending factors. CONCLUSION: "Spontaneous" closure of acquired diastemata could occur following surgical and/or non-surgical periodontal therapy or removal of occlusal interferences. Correction of pathologically migrated teeth without orthodontic or restorative treatment is feasible, but unpredictable.
Technological Innovations in the Restorative Department at the University of Tennessee College of Dentistry.
Harrison JL, Simon JF, Dehghan M
J Tenn Dent Assoc · 2015 · PMID 27008767
The UT College of Dentistry has been one of the leaders in the introduction of the CAD/CAM delivery of dentistry to the dental students. The integration of technology into a dental school curriculum requires a change in...
The UT College of Dentistry has been one of the leaders in the introduction of the CAD/CAM delivery of dentistry to the dental students. The integration of technology into a dental school curriculum requires a change in thinking and a modification of the curriculum in order to introduce it to the present day students This article updates the integration of the CEREC system into the UT Dental School curriculum, discussing the changes in equipment and teaching techniques since the last article in 2012.
Pediatricians and the Oral Health Needs of Children: One Potential Means for Reducing Oral Healthcare Inequities.
Roberts RZ, Erwin PC
J Tenn Dent Assoc · 2015 · PMID 27008766
OBJECTIVES: Children in poverty have limited access to oral healthcare. One approach to reduce such health inequities is to expand the involvement of primary care physicians in the provision of oral healthcare. The purpo...
OBJECTIVES: Children in poverty have limited access to oral healthcare. One approach to reduce such health inequities is to expand the involvement of primary care physicians in the provision of oral healthcare. The purpose of this study was to assess pediatricians' knowledge, attitudes, and professional experiences regarding oral health in children, and to determine their willingness to incorporate preventive dental education and procedures into their practices. METHODS: We conducted a survey of pediatricians in Tennessee to assess their knowledge, attitudes, and professional experiences regarding oral health, and to determine their willingness to incorporate preventive dental education and procedures into their practices. RESULTS: Of the 450 providers randomly selected for survey distribution, 107 returned completed surveys (response rate, 23.8%). The majority of respondents reported that they are likely to examine children's teeth during well-child care visits, but only a minority use preventive techniques such as application of fluoride varnish. Pediatricians receive very little education on oral health during medical school and residency programs. CONCLUSIONS: Expanding oral healthcare access through primary care physicians will require adequate training in medical school, residency, and in continuing education courses.
Surgical Prosthodontics--A Shift in Patient Treatment at the University of Tennessee Graduate Prosthodontic Program (Case Report].
Karunagaran S, Egbert J, Johnson A … +1 more , Markose SC
J Tenn Dent Assoc · 2015 · PMID 27008765
Over recent years Dentistry has evolved, and as such, we have been able to make strides in restoring edentulous patients with dental implants. Recently, the specialty of Prosthodontics, in addition to the prosthetic reha...
Over recent years Dentistry has evolved, and as such, we have been able to make strides in restoring edentulous patients with dental implants. Recently, the specialty of Prosthodontics, in addition to the prosthetic rehabilitation of complex dental patients with fixed, removable, implant, and cosmetic dental needs, has begun to shift into the surgical realm of patient treatment. This report outlines a minimally invasive technique for sinus floor elevation, on the controlled use of drills and osteotomes, while simultaneously placing implants through a guided protocol. The rational for such a technique is that it provides a predictable and repeatable method of attaining vertical ridge augmentation as well as correct implant placement in order to obtain ideal restorative reconstructions. In addition it provides the dentist with the autonomy to treat patients requiring implants from start to completion with a great deal of control. Postoperative radiographs reveal the amount of vertical height gained and concomitant implant placements.
Regression of Calcium Channel Blocker--Induced Gingival Enlargement in the Absence of Periodontal Therapy.
Livada R, Shelton W, Bland PS … +1 more , Shiloal J
J Tenn Dent Assoc · 2015 · PMID 27008764
AIM: To illustrate the negative effect of calcium channel blocker (CCB) drugs on the gingival tissues and the reversibility of these lesions. CASE DESCRIPTION: The authors examined a forty-eight year-old male patient wit...
AIM: To illustrate the negative effect of calcium channel blocker (CCB) drugs on the gingival tissues and the reversibility of these lesions. CASE DESCRIPTION: The authors examined a forty-eight year-old male patient with drug-induced gingival enlargement associated with diltiazem, a CCB drug. Prior to initiating the proposed periodontal treatment, the patient was advised to consult his physician, for a possible switch to a different anti-hypertensive drug. The patient returned to the clinic three months later with a significant regression of the gingival overgrowth, which was induced by the patient ceasing the prescribed regimen without medical consultation or periodontal intervention. CONCLUSION: Although CCBs are effective cardiovascular drugs, they can negatively impact the oral health by promoting gingival overgrowth in some patients. Substitution of these drugs is strongly recommended prior to any periodontal intervention in order to improve prognosis and prevent recurrence, and should be done only by the medical providers.
Changes in the Clinical Training of Dental Students at the University of Tennessee College of Dentistry.
Lea J, McBride M, Hottel TL
J Tenn Dent Assoc · 2015 · PMID 26434003
Dental education is an ever evolving process due to continual advancements in patient treatment. This article provides the reader with a look into an educational process that affords the student with better clinical expe...
Dental education is an ever evolving process due to continual advancements in patient treatment. This article provides the reader with a look into an educational process that affords the student with better clinical experience without an increase in clinical training hours. When a comprehensive care model of education is introduced into a traditional care setting, the comparison of procedures completed with the previous 5 years results indicate an increase in the number of amalgam and composite restorations placed of 26% and an increase in crowns placed of 32.9%. Integration of the dental hygiene program and additional remote sites afford new populations of patients where clinical skills can be developed which will result in a graduate more able to go directly into private practice.
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