• Aesthetic improvement of a smile using minimal intervention procedures. A case report

      Cowan, Marcus; Babb, C; Romero, M; Pruett, M; Coleman, J; Department of Restorative Sciences (Augusta University, 2019)
      Tooth discoloration, particularly affecting the maxillary anterior teeth, is often an esthetic concern for dental patients.1 The most common cause of intrinsic tooth discoloration is dental fluorosis (DF),1 which is enamel hypomineralization due to long-term ingestion of high levels of fluoride during tooth mineralization.2 DF results in white opaque areas or discolorations ranging from yellow to dark brown, with porosities on the enamel surface.3 A widely-used scale for classifying the severity of DF is the Tooth Surface Index of Fluorosis (TSIF), developed by Horowitz, by which the examiner determines the extent of affected enamel by estimating the amount of DF as a fraction of the total visible enamel surface.4 Microabrasion, introduced by Croll and Cavanaugh in 1986,5 is a technique used to correct surface enamel irregularities and remove intrinsic enamel stains through the application of hydrochloric acid combined with pumice in a paste.6 When performed correctly and conservatively, the amount of enamel loss from microabrasion is clincally insignificant.7 The success of microabrasion depends upon the extent and severity of the discoloration, and occasionally a slightly yellowish appearance will result from the yellow dentin shade showing through the translucent enamel.8 The final appearance can be improved by dental bleaching, with long-lasting results.7 The following article is a clinical report of the use of microabrasion combined with nightguard bleaching with 10% carbamide peroxide to improve the appearance of teeth affected by fluorosis.
    • Case Selection Criteria for use with Resin-Infiltrative Treatment of Enamel Decalcification

      Raley, N; Clayton, Ashley; Fortson, WM; Deleon, E; Rueggeberg, FA; Department of Orthodontics, Department of Restorative Sciences (Augusta University, 2019)
      Although one of the primary aims for many orthodontic patients is to achieve improvement in their dental esthetic condition, a high percentage of these patients develop unesthetic, white spot lesions (WSL) during the course of treatment. These lesions develop due to enamel decalcification resulting from bacterial plaque accumulation around difficult to clean brackets and overlying wires and ligation devices. Acids produced locally in this retained plaque will decalcify enamel along the peripheral border of the bonded bracket. Quite often, despite repeated admonishment by the clinician to the patient to take extra care in cleansing these susceptible locations, patients return with large plaque deposits around the brackets, and evidence of the early stages of enamel decalcification: the so-called “white spot lesion” (WSL). The problem becomes obvious at the time of bracket removal, when, although the teeth may now be arranged in near-to-perfect alignment and occlusion, large, white areas of enamel decalcification are prominently displayed, denoting the exact location of where the bonded bracket used to be.

      Fantaski, Lincoln; Mettenburg, D; Brenes, C; Rueggeberg, FA; Department of Restorative Sciences, Department of General Dentistry (Augusta University, 2019)
      Recent advances in the application of digital imaging of oral tissues and three-dimensional, additive fabrication techniques have led to a burgeoning industry in dentistry. Over a very short period of time, this technology has greatly improved in terms of level of surface detail reproducibility and dimensional accuracy of printed forms. Initially, thermoplastic extrusion of warmed filaments of various plastic material was used. However, the layer thickness was quite large, and surface feature reproduction was low. With advances in use of photocurable monomer resins and controlled application of photo-activating light wavelengths to provide polymerization of very thin slices of the form image, the reality of providing stoneless models of a patient’s dentition became a physical, and financial reality in private dental practices.
    • Does Time to the Operating Room Affect Outcomes in Odontogenic Infection Patients?

      Brown, Kiara; James, Jeffery; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      Diagnosis and treatments of odontogenic infections is arguably one of the most important responsibilities of the Oral and Maxillofacial Surgeon. With a command of the complex anatomy of the head and neck region and armed with knowledge of the dentition that feeds into the physiopathology of the infection, oral and maxillofacial surgeons find themselves one of the only head and neck specialists able to treat this disease. Several decades ago, odontogenic infections were a significant source of morbidity at rates greater than 50% in some reports. The current trend in an increase in unsponsored patients seeking treatment. This trend has cost hospital centers upwards of millions of dollars per year. While some factors, such as patient medical complexity and increasing antibiotic resistance are known factors in increasing costs, a surgeon and facility dependent factor- time to the operating room- has not been studied. Understanding the effect of delayed surgical intervention is critical to fully understanding ways to mitigate costs associated with odontogenic infection patients.
    • Phosphorylation of EPS8 Mediates Its Downstream Signaling and Biological Functions

      Shahoumi, Linah; Yeudall, W. Andrew; Department of Oral Biology & Diagnostic Sciences, Georgia Cancer Center (Augusta University, 2019)
      The purpose of this study was to investigate the role of EPS8 phosphorylation in modulating biochemical signaling, cell proliferation and motility in HNSCC.
    • Time To Open Repair Of Mandible Fractures And Associated Complications

      James, Jeffrey; Farrell, Thomas; Faigen, Alex; Anderson, Jessica; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      The aim of this study is to determine whether a correlation exists between the time from injury to repair of mandible fractures and the development of post operative complications.

      Faigen, A; James, J; Stevens, M; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      Lifetime implant success, in both esthetic and functional categories is a multifactorial process. Connective tissues, hard and soft, play a major role in the health of an implant platform and its associated restoration. While bone loss around the crestal portion of the implant up to 2.0mm within the first year of use is expected. We desire to determine factors which predict bone loss and overall implant success.. Many of the factors which can be used to account for such bone loss are inappropriate stresses and force distribution, trauma during surgery, micromechanical movement, infection, and multiple other patient factors. Bone loss has not been linked to a single implant type, placement procedure, or specialty, but remains a significant challenge in the long-term success of implants.
    • Proliferative Verrucous Leukoplakia (PVL) Expresses High Levels of Toll-Like Receptor 2 (TLR2)

      Koh, Joon; Kurago, Zoya; Georgia Cancer Center (Augusta University, 2019)
      In the current study, we analyzed samples of human oral mucosal PVL and other epithelial disorders to test the possibility that, if TLR2 is involved in early stages of carcinogenesis, then keratinocytes in early-intermediate stages of PVL may express more TLR2 than keratinocytes in non-dysplastic epithelium.
    • Clinical Guide for Intraosseous Pathology

      Malik, M; Kalathingal, S; Cullum, A; Buchanan, A; Abdelsayed, A; Kurago, Z; Department of Oral Biology & Diagnostic Sciences, Center for Instructional Innovation (Augusta University, 2019)
      To provide a reference database for dental students to describe and analyze intra osseous pathology that aid to develop a list of differential diagnoses for various diseases affecting the maxillofacial region on patients treated in student clinics. The online database will serve as a resource for descriptive terminology and samples to demonstrate the origin of the lesion, radiographic appearance, borders, contents, effects on adjacent structures, etc. which are the fundamental elements that guide a clinician in developing an impression and formulate the differential diagnosis. Histopathologic evaluation that provides the final diagnosis of each disease process will also be included to demonstrate that radiographic presentation of various disease categories may be similar, however, clinical management is ultimately decided by the tissue sample from the biopsy specimen. The interactive database will have various features that enable the user to access a comprehensive glossary list, word- defined searches, a brief overview of the most common diseases affecting dento-alveolar regions and learn about the management strategies.

      Patel, Mohit; Mettenburg, D; Rueggeberg, FA; Cellular and Molecular Biology, Department of Restorative Sciences (Augusta University, 2019)
      To measure and compare composite top and bottom surface microhardness values when using a multi-wave LED curing light emitting simultaneous blue and violet light, or when the sequence of wavelength applications was provided as separate exposures, of similar duration.

      Klein, Laura; Rueggeberg, FA; Department of Restorative Sciences (Augusta University, 2019)
      Purpose of this research: To measure and compare (1) tip-to-target distance irradiance profiles (2) tip-to-target distance at which irradiance has dropped to 50% of 0-mm value (3) irradiance value at the 50% distance.
    • A multidisciplinary approach to the management of a maxillary midline diastema: A clinical report

      Romero, Mario F.; Babb, C; Department of Restorative Sciences, Department of General Dentistry (Augusta University, 2019)
      Anterior maxillary spacing has been shown to be one of the most negative influences on self-perceived dental appearance, and a maxillary midline diastema (MMD) is commonly cited by patients as a primary concern during dental consultations. MMD has been defined as a space greater than 0.5 mm between the mesial surfaces of the 2 maxillary central incisors. An MMD greater than 2 mm in the mixed dentition is unlikely to spontaneously close. African Americans are more than twice as likely to have an MMD than whites or Hispanics. In esthetic situations, without a comprehensive smile analysis and proper planning, overtreatment and undesirable effects can occur. Tooth size especially has been emphasized as the primary element of an esthetic smile design. One method of establishing tooth size is tooth biometry as described by Chu. He reported that maxillary anterior tooth widths average 8.5 mm for central incisors, 6.5 mm for lateral incisors, and 7.5 mm for canines and that 80% of the patient population falls within ±0.5 mm of these values. Other important elements of smile analysis include the dental midline, tooth morphology, axial inclinations, and the soft tissue components of gingival health, levels, and harmony. The direct bonding technique is a straightforward, conservative method for diastema closure. However, artistic skills, a knowledge of tooth morphology, and the appropriate selection and use of composite resin materials are essential for success. According to Spear and Kokich, “some existing dentitions simply cannot be restored to a more pleasing appearance without the assistance of several different dental disciplines.” Therefore, complex esthetic dilemmas may require more than one dental discipline, for example, operative dentistry and orthodontics, to establish a functional, maintainable, and pleasant smile. This article illustrates a clinical situation in which an MMD was addressed by first completing a comprehensive smile analysis, followed by closure using limited orthodontics and direct composite resin restorations.
    • Conservative Porcelain Veneer: Step by step protocol for ideal preparation

      Wooten, Rebekah; Coleman, J; Pruett, M; Romeo, M (Augusta University, 2019)
      Since the 1930s laminate veneers have been commonly used to improve appearance of teeth, but they did not become popular until enamel etching and porcelain surface treatments made them more clinically predictable in the 1980s.1 Over the years, they have been indicated to modify the color, shape, length and alignment of teeth to improve their esthetic appearance. Contraindications include severely discolored teeth and lack of enamel remaining to support the restoration.3 Treatment planning is the first step to ideal veneer preparation, which involves determining the incisal edge position, shape and proportions of the teeth being restored. This information is obtained form the diagnostic wax-up and subsequent esthetic mock-up. Veneer preparations often follow one of two common reduction patterns: conservative or standard. The difference between the two being the amount of tooth structure removed. The conservative approach involves reduction of 0.3 mm gingival third, 0.5 mm middle third, and 0.7 mm incisal third; or no reduction may be required. The standard preparation typically follows a reduction pattern of 0.8 mm gingival, 1.0 mm middle, and 1.2 mm incisal. Incisal reduction can be characteristic of either technique to allow room for the addition of incisal effects such as halo and translucency. In order to ensure porcelain veneers have the maximum lifetime expectancy, it is imperative to have preparations entirely in enamel. Bonding porcelain veneers to enamel increases their fracture strength. 2 Based on the best available evidence the ten year survival rate for porcelain veneers is at around 95% if bonded to enamel.1 Maxillary midline diastemas (MMD) are present in 28% of the population, and 87.5% of females with a midline diastema are dissatisfied and seek treatment.3 This clinical report focuses on the clinical management of a maxillary midline diastema (MMD) with porcelain veneers through a conservative preparation and incisal reduction.
    • Injection of Tumescent Solution into Maxillary Sinuses During LeFort I Osteotomies for Reduction of Intra-operative Blood Loss

      Zastrow, Stephanie; James, Jeffrey; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      Orthognathic surgery is a treatment option for many dentofacial deformities that cannot be treated with orthodontics or minor surgeries alone. Repositioning of the maxilla, mandible, chin, or a combination of the three can have a significant effect on a patient’s occlusal function, facial appearance, and self-esteem. Successful, comprehensive treatment usually requires a collaborative approach between an orthodontist and oral and maxillofacial surgeon.

      Walker, Dylan; Villalobos, V; Rueggeberg, FA; Brenes, C; Department of Restorative Sciences, Department of General Dentistry (Augusta University, 2019)
      The purposes of this research were to apply an infrared spectroscopic analytical method to differentiate among a variety of commercial, 3D dental printable resins for their acrylate or methacrylate content, and to relate that knowledge to the intended use of the printed item: extraorally or intraorally.
    • DNA Sequencing of Extensive Odontogenic Keratocysts with Possible Therapeutic Implications

      Abdelsayed, Macarius; Kolhe, Ravindra; Abdelsayed, Rafik; Department of Oral and Maxillofacial Pathology (Augusta University, 2019)
      Purpose of this research is: to perform DNA sequencing on a group of previously diagnosed OKC of the jaws which demonstrated clinical aggressive behavior; Compare the genetic profile of the aggressive OKC cases with the genetic profile of a similar number of OKC cases which did not demonstrate aggressive clinical behavior; Evaluate the possibility of therapeutic implications of genetic mutations noted in OKCs
    • Investigation of the Clinical Feasibility of Incorporating Dexmedetomidine into the Outpatient Anesthesia Regimen of Oral & Maxillofacial Surgery

      Taylor, D. Craig; Ferguson, Henry W.; Department of Oral and Maxillofacial Surgery (Augusta University, 2019)
      The purpose of this investigation is to evaluate incorporating a Dexmedetomidine infusion into an established IV Sedation regimen in terms of clinical efficiency (Anesthesia time), Patient subjective experience, and physiologic response to the infusion in comparison to a control appointment without the infusion.
    • The Role of Oral Microbiota in Bisphosphonate-Induced Osteonecrosis of the Jaw: Rat Tibial Defect Model

      Jernigan, Joshua; Awad, Mohamed E.; Elsayed, Ranya; Elsalanty, Mohammed (Augusta University, 2019)
      This study aims to develop a rat model for post-traumatic osteonecrosis at an extra-oral bone site that simulates the oral micro-environment, specifically the proximal tibia.
    • Innate Lymphoid Cells in Periodontitis: A Novel Therapeutic Modality

      Ghaly, Mira; Emami, Golnaz; Khodadadi, Hesam; Mozaffari, Mahmood; Baban, Babak; Department of Periodontics, Department of Oral Biology and Diagnostic Sciences (Augusta University, 2019)
      To determine the presence of ILCs in human periodontium which are emerging immune cells with the potential to be targeted, via novel therapies, in the treatment of peridontitis.
    • Adjunct Post-Operative Analgesia Following Uncomplicated 3rd Molar Removal

      Benton, Bryan; James, J; Department of Oral and Maxillofacial Surgery (Augusta University Libraries, 2019)
      Extraction of 3rd molars is a routine procedure performed in Oral and Maxillofacial Surgery practices. Postoperative analgesia and recovery is a primary concern for patients undergoing removal of 3rd molars. Uncontrolled postoperative pain has been shown to interfere with quality of life, delay recovery, and even contribute to long term unfavorable sequelae of surgery such as chronic pain. Extraction of 3rd molars is widely performed on an outpatient basis and thus postoperative analgesia is patient directed, often with assistance from narcotic analgesics, NSAIDs, or a combination of these. Prescription drug abuse is a public health crisis in the United States. In 2016, 42,249 persons died of an opioid related drug overdose. Narcotic use following surgical procedures can lead to dependency and addiction. In 2016, new persistent opioid use after surgical procedures was 5.9% - 6.5%, this was similar for both minor and major surgical procedures.