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.
    • 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.
    • 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.

      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.

      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.
    • 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.
    • 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.
    • In Vivo Pilot Study: Effect of Dehydration/Rehydration on Upper Anterior Tooth Color Change

      Britton, Eduardo; Nappi, A; Cao, T; Shepherd, K; Department of General Dentistry, Dental Hygiene, Department of Restorative Sciences (Augusta University Libraries, 2019)
      Isolation of tooth structure during fabrication of a bonded, direct, resin-based restoration is essential to optimizing its potential for long-term clinical success. Failure to protect etched enamel and bonding agents from contamination by saliva results in inadequate and unpredictable interfacial bonding of the restorative composite, potentially leading to marginal discoloration, open margins, recurrent decay, or ultimately to restoration loss or failure. A consequence of tooth isolation during placement of direct, esthetic restorative resins is the dehydration of enamel surfaces that will not be coated with saliva, and will, over time, lose water that has penetrated into the outer enamel layers (will dehydrate). The longer the tooth isolation time, the greater will be the subsequent loss of water from enamel. Presence of this water in enamel helps to provide for a stable tooth color. In teeth, the observed tooth color is the result of internal light penetration and interaction with tissues below the surface. Enamel is a translucent material, passing a great majority of transmitted light to fall on the more opaque and yellow-colored tissue underneath of it: dentin. In the hydrated state, enamel is more translucent than in its dehydrated state. The white opaque appearance of dehydrated enamel can be of great clinical concern, once a rubber dam has been removed, and the treated teeth with newly placed restorations are observed. Usually, because of the opaque, white nature of recently dehydrated enamel, there is an initial mismatch between an esthetic restoration just placed and its surrounding, remaining enamel. Patients are normally forwarded of this consequence, and are advised that a period of time needs to pass before the surrounding enamel becomes rehydrated, and more translucent (less opaque), before its pre-isolated color returns to a natural state. It is hoped that, at that time, the new restoration will perfectly match the color characteristics of the remaining enamel, and the recent replacement will not be visible at all, but will instead optically blend in without notice. However, prior to that time, there are definitely distinct color differences between a recently placed resin restoration and its surrounding tooth structure. To date, little-to-no information is available on the rate at which a clinician or patient can expect isolated enamel to return to its pre-isolated color, and when to expect this esthetic blending to occur.

      Bowerman, Brielle; Rueggeberg, FA; Brenes, C; Department of Restorative Sciences, Department of General Dentistry (Augusta University Libraries, 2019)
      A variety of manufacturing techniques have been used throughout the history of dentistry, in order to fabricate indirect restorations. Formative processes (pouring or pressing items into molds) are used when making conventional dentures, or when pressing ceramics. Recently, subtractive fabrication methods have enabled clinicians to mill a wide variety of ceramic and resin-based blanks directly into final forms, fitting the oral structures with high degrees of precision. Examples of older additive techniques include wax buildups to establish missing tooth structure for fabrication of subsequent cast restorations and the manual layering of powdered porcelains for development of ceramic facings on metallic substrates, or for ceramic veneers themselves. Tremendous advancements have been made in the field of 3D digital printing for many industrially based applications. Advances in research and development have resulted in tabletop 3D printers that produce rapid prototype specimens having very high accuracy and surface feature details. Recently, these advances have resulted in the manufacture and availability of a wide variety of 3D digital printers that dental offices now use to directly fabricate a wide range of restorative appliances (denture bases and teeth, temporary restorations, splints) as well as ancillary devices (impression trays, surgical implant guides, casts, try-in set-ups, and stents). Contemporary dental 3D printing typically involves use of near or true ultraviolet radiation (405 nm & 385 nm, respectively) in order to fabricate the basic desired form from a vat of photo-polymerizable monomers. Subsequent to initial form fabrication, the specimen is alcohol-washed of excess surface monomer, and is then subjected to an additional exposure of strong near/UV light, in order to maximize the polymerization process and provide optimal physical properties, as well as to minimize cytotoxicity resulting from leaching of unreacted, residual monomer within the bulk of the as-printed item.
    • Maxillary growth in patients with complete unilateral cleft lip and palate treated with Nasoalveolar molding

      Manente, M; Levy-Bercowski, D; Abreu, A; Fortson, W; Deleon, E; Yu, J; Looney, S; Department of Orthodontics; Department of Plastic Surgery; Department of Biostatistics and Data Science (Augusta University Libraries, 2019)
      In patients with cleft lip and/or palate (CLP), the nasolabial defect has a significant esthetic impact on the face and may impair psychosocial development. Nasoalveolar molding (NAM) is a pre-surgical orthopedic technique aimed to improve the alveolar and nasolabial morphology of patients with cleft lip and palate. This technique is used to facilitate and improve the future surgical correction in cleft lip and palate patients. Influences such as differences in patient age and gingivoperiosteoplasty procedures are among many that have made it difficult for conclusive results to be found and published on the impact of the NAM technique on maxillary growth in patients with complete unilateral cleft lip and palate (CUCLP).
    • 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.

      Baxter, John; Brenes, C; Rueggeberg, FA; Departments of General Dentistry; Department of Restorative Sciences (Augusta University, 2019)
      Direct, tissue-borne, full denture restoration of edentulous arches has become a well accepted restoration modality for millions of people. In this methodology, the tissue-bearing surface of a polymeric material replacing the form and structure of lost alveolar bond and overlying mucosa rests directly on the residual ridge tissue. Retention of the denture is attained through capillary adhesion forces acting to wet (cover) both the oral mucosa and the polymeric denture bases that rests upon it. Good wetting by saliva is thus one of the many critical features affecting adhesion of the denture base to the oral mucosa. Measurement of the ability of a fluid to wet a surface is performed using the shape of a fluid droplet on that surface. If the fluid wets that surface, then the droplet will spread out. If the fluid does not wet that surface, it will bead up. Quantitative measurement of fluid flow on a surface is performed using measurement of the “contact angle.” In this method, a controlled volume is dispensed onto a surface, and while viewing the interaction of that fluid in silhouette, the angle formed at the tangent of that drop and the flat surface is determined. The lower the contact angle, the more a fluid wets a surface, and the higher its value, the less wetting is that fluid on a specific surface.
    • Biocompatibility and mechanical/physical properties of 3D printed, milled, and conventionally processed denture base materials

      Ulmer, Mallory; Biomedical Sciences (Augusta University, 2019-12)
      According to the American College of Prosthodontists, over 36 million people in the USA are edentulous with a 2:1 predilection for geriatric patients1. Each year, an estimated 15% of edentulous Americans will seek denture treatment1. Conventional dentures require multiple visits and lab processing time. 3D printing technology offers the potential to reduce the number of appointments and speed up the time until patient rehabilitation. However, the newly FDA-certified 3D printer denture resins, featuring secretive and proprietary formulae, lack studies concerning their biocompatibility/safety and mechanical strength. This study aims to investigate the biocompatibility and physical properties of one such 3D printer resin, NextDent® Base (Vertex, Soesterberg, The Netherlands), and compare it to pre-existing conventional polymethyl methacrylate (PMMA) denture base (Lucitone 199, Dentsply Sirona, York, Pennsylvania) and milled PMMA denture base (IvoBase CAD®, Ivoclar Vivadent AG, Schaan, Liechtenstein). The cytotoxicity was examined using of 12 discs: conventional PMMA, milled PMMA, as-printed 3D printer resin, post-cured 3D printer resin, and Teflon controls. An MTT assay using human periodontal ligament (900L) cells was employed, and specimens were aged for 1, 3, 7, 10, and 14 days. After day 7, there were no statistically significant differences among the groups, excluding the Teflon control, which showed significantly less cell viability on day 14. Bars of conventional PMMA, milled PMMA, as-printed 3D printer resin, and post-cured 3D printer resin were subjected to a 3-point bend test to examine flexural strength and moduli differences. The mean flexural strength was 63.8 ± 3.06, 82.6 ± 1.9, 5.1 ± 0.4, and 22.1 ± 6.4 MPa, respectively, while the flexural moduli were 1757.3 ± 109.5, 2226.7 ± 76.3, 110.3 ± 20.3, and 537.0 ± 210.6 MPa, respectively. The flexural strength and modulus were significantly different among all groups. Weibull analyses for conventional PMMA, milled PMMA, as-printed 3D printer resin, and post-cured 3D printer resin revealed a Weibull modulus of 23.5, 42.8, 16.6, and 3.7, respectively, and a characteristic strength of 65.2, 83.5, 5.3, and 24.5 MPa, respectively. The characteristic strength was significantly different among all groups as well. The Weibull modulus was significantly different between all groups, except for conventional vs. as-printed, which were not significantly different. In summary, milled PMMA featured significantly greater mechanical properties. Both 3D printed groups proved to be very weak, with the as-printed group being the weakest of all. The differences between the as-printed and post-cured groups highlight the importance of properly post-curing the resin. While the biocompatibility results showed promise, the mechanical testing results were disappointing. Unfortunately, the findings suggest that 3D-printed denture base resin is not yet ready for clinical use.
    • The Effect of Nrf2 on Inflammatory Responses of Human Monocytic Cells After Blue Light Exposure

      Trotter, Leigh Ann; Trotter, Leigh Ann; Department of Oral Biology (12-Apr)
      Blue light treatment alters cellular signaling and affects intracellular biochemical processes in tissues. PURPOSE: This study determined the ability of blue light to modulate Nrf2 and decrease LPS-induced secretion of pro-inflammatory cytokines from cultured, human monocytic cells. METHODS: Cultured THP-1 human monocytic cells were exposed to LPS and blue light treatment. Western Blot analyses, EMSA, and ELISA were used to evaluate NF?B, Nrf2, HO-1, TNF-?, IL-6 and IL-8 production. RESULTS: Light treatment increased nuclear Nrf2 and increased HO-1. Cells pretreated with light had no detectable NF?B-DNA binding. LPS treatment increased nuclear NF?B, and had little effect on Nrf2. Light pre-treatment significantly decreased the amount of TNF-? by 63% and IL-8 by 55%. CONCLUSIONS: Blue light increases the production of Nrf2 and HO-1, decreases the ability of Nf?B to bind in the nucleus, and leads to a decrease in the secretion of pro-inflammatory proteins in human monocytic cells.