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Browsing by Subject "endodontic"

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    The Effect of Blood Contamination on the Retrograde Sealing Ability of Biodentine: A Micro-CT Analysis
    (2019-08) Dimond, Colby
    AIMS To evaluate the sealing ability of Biodentine in its use as a root end filling material. To evaluate how the sealing ability of Biodentine would be affected by contamination with blood. To evaluate the use of micro-CT and silver nitrate as a method to examine sealing ability and the microleakage of different dental materials. MATERIALS AND METHODS: Thirty single rooted teeth were selected as sample teeth. Sample teeth were prepared and obturated using gutta-percha and Ah Plus sealer. The samples were coated with nail polish, resected 3mm apically with a 0 degree bevel angle. Samples were labeled, each was apically prepared 3mm using an ultrasonic tip. Samples were assigned at random to either the uncontaminated sample group or the blood contaminated sample group. All the samples were filled using Biodentine following manufacturer’s instructions. For the blood contaminated sample, one drop of blood was placed into each root end preparation. The blood was left in place for 1 minute and then air dried, leaving blood on walls of the retropreparation. The blood contaminated samples were filled with Biodentine. All of the prepared sample groups, were placed in PBS for one week to allow for proper setting of the Biodentine material. A 25% w/w solution of silver nitrate solution was used to soak the samples overnight and allow penetration into the samples. Samples were scanned using a micro-CT unit. For each component (silver nitrate, Biodentine, voids), an object volume was calculated using the CT-Analyzer software. An overall volume of the root end preparation was calculated to compare each component in order to get a percentage. The depth of the root end preparation and depth of silver nitrate penetration were calculated according to the voxel size and the number of slices included for each sample. The data were entered into an Excel spreadsheet and statistical analysis was completed using GraphPad Prism Version 8.1.2 statistical software. RESULTS: A significant difference was found between the two sample groups in the percentage of silver nitrate volume compared to the overall retropreparation volume, with the blood contaminated group showing less penetration of silver nitrate. A significant difference was found in the void percentage of the total volume between the two groups, with the blood contamination group showing more voids in the root end filling material. No statistical difference was noted between the depth of silver nitrate penetration between the two groups. CONCLUSIONS: Blood contamination does not affect the sealing ability of Biodentine, when it is used as a root end filling material. The presence of blood in the root end preparation significantly increases the volume of voids present in the root end filling material. The combination of silver nitrate as a tracer and micro-CT to evaluate microleakage is a promising study design for future applications
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    Infection and Cardiovascular Disease: The Atherosclerosis Risk in Communities Study
    (2017-07) Cowan, Logan
    Infection has been identified as both a chronic and acute risk factor of cardiovascular disease (CVD). Despite the growing body of evidence, additional research elucidating the relationship between infection and CVD is needed. This dissertation employs longitudinal data from the Atherosclerosis Risk in Communities (ARIC) study, the Longitudinal Investigation of Thromboembolism Etiology (LITE) ancillary study, the Dental-ARIC (D-ARIC) ancillary study, and the corresponding ARIC study participant Centers for Medicare and Medicaid Services (CMS) data to examine the relationship between infection and CVD. In the first manuscript we assessed the longitudinal relationship between self-reported periodontal disease and clinical periodontal disease and incident venous thromboembolism (VTE). Self-reported periodontal disease was associated with 30% higher VTE risk that remained significant or borderline significant after adjustment. Crude associations between clinical periodontal disease classifications were attenuated with adjustment and were no longer significant. In the second manuscript we assessed the longitudinal relationship between history of endodontic therapy (ET) and incident coronary heart disease (CHD), ischemic stroke, heart failure, and VTE. We found no significant associations between self-reported history of ET and any of our outcomes of interest that remained after adjustment. In the final manuscript we used a case-crossover study design to evaluate infection as a potential trigger of CHD, ischemic stroke, and VTE. Infection was associated with higher odds of CHD, stroke, and VTE up to 90 days following the infection. The association between infection and CVD/VTE was graded such that the infection-CVD/VTE association was highest immediately following the infection and decreased as the time since the infection increased. Generally, outpatient infection was a weaker CVD/VTE trigger compared to all infections. Further research is needed to pinpoint if periodontal disease is independently associated with VTE risk and if periodontal prevention and treatment could reduce VTE risk. Our results do not support an independent association between endodontic therapy and CVD or VTE. The results of the third manuscript provide evidence in support of our hypothesis that infection is a CVD/VTE trigger. Patients with an infection who are at elevated risk of CVD should be considered potential candidates for CVD prophylaxis during and immediately after infection to reduce the otherwise elevated CVD/VTE risk.