Fun facts: What you didn’t know about food and oral health relationship
It’s obvious that high daily intake of sugar may increase the risk of tooth decay and diabetes. But did you know that not all sugars affect our enamel in the same way? Is it possible to prevent decay by making small changes in our diet? Let’s see if you know the answers.
Intrinsic sugars
These are naturally occurring sugars. Easily found in fruits and vegetables, which are the staples of a healthy diet. It’s mainly glucose and fructose packed in the cells of veggies. Whereas processed sugars, or sugars that are added to food, are considered extrinsic (sacharose, maltose, dextrose and free glucose and fructose as well). It’s easier for saliva to cleanse mouth from intrinsic sugars. This is why we should avoid eating too many sweets, cakes, drinking sodas and sweetened juices. That’s the best way to cut on extrinsic sugars.
Orange juice has a higher erosive potential than a soda
There is no doubt that fruit juices are more harmful for enamel than fresh fruits. We also know that it’s better to eat more sugary and acid food in one sitting, than in couple portions. Read about it here. But did you know that it is easier for saliva to neutralise cola than orange juice? Yes, that’s right. Orange, apple and grapefruit juices are highly erosive. It’s better for our teeth to eats fruits and drink some water instead.
Black tea is more likely to satin your teeth than coffee
That’s because black tea contains more of a natural class of compounds called tannins. Tannins stick to your teeth because they’re attracted to the protein in enamel. Coffee stains teeth too, but it contains less tannins.
Eat the foods you love, just know the risk. And don’t forget to wait extra 30 minutes after every meal with brushing. It will help with natural remineralisation of your teeth.
Tertiary dentine also known as reactive, reparative, irritation, replacement, adventitious and defense dentine. It’s laid down in response to an irritation or damage to the overlaying dentine or enamel and it provides protection to underlying pulp by decresing dentin permeability. It is characterized by variable and atypical structure. The quality of newly formed tissue depends on intensity of damage and pulp vitality.
It forms between pulp and dentine in localized way and it’s determined by the site of stimulus. It varies from the primary or secondary dentine because of the differences of the structure.
If the stimulus is a carious lesion, there is extensive destruction of dentine and damage to the pulp, due to the differentiation of bacterial metabolites and toxins. Thus, tertiary dentine is deposited rapidly by new odontoblas-like cells, with a sparse and irregular tubular pattern and some cellular inclusions; in this case it is referred to as “osteodentine”-the reparative dentine.
If the stimulus is mild and the pulp is vital with pre-existing odontoblasts the tetriary dentine is called the reactionary. It has a similar structure to primary dentine, with a more regular tubular pattern and hardly any cellular inclusions.
With aging or severe damage, tetriary dentine can totally obliterate the pulp cavity.
Is it possible for tertiary dentine to fill the cavity?
Unfortunately it’s impossible. Enamel tissue is formed only during odontogenesis. Thus, cavities in enamel can’t be filled up with tertiary dentine.
If tertiary dentine protects the pulp, why is it stil necessary to fill cavities?
Tertiary dentine has a ability to decrease dentine permability, but it can’t stop the differentiation of bacterial metabolites thus, acids. The process of demineralisation and dentine disintegration is relentless without previous removal of decayed tissues.
-All tongue muscles except palatoglossus are innvervated by CN XII
-Blood supply is via the lingual artery. Veins drain to the internal jugular vein
-Lymph: anterior -> submental
- Middle: lateral -> submandibular; medial -> inferior deep cervical nodes
- Posterior -> superior deep cervical nodes
Musculature:
Intrinsic muscles of the tongue:
Longitudinals (sup and inf) - shorten tongue, bending
Transversus - Narrows and elongates tongue
Verticalis - flattens and broadens tongue
Extrinsic muscles:
Genioglossus - protrudes tongue
Hyoglossus - depresses tongue
Styloglossus - pulls tongue up and back
Palatoglossus - pulls tongue up and back, INNERVATED BY CN X (pharyngeal plexus)
Phonetics:
CNXII: L’s - moves tongue against the roof of the mouth
Mo Lit - All-ceramic or Metal-ceramic Multiple Unit FDPs: Part II
ARTICLE INFORMATION:
Title: All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs
Authors: Pjetursson, Bjarni Elvar, Sailer, Makarov, Zwahlen, and Thoma
Citation: Pjetursson, Bjarni Elvar, et al. "All-ceramic or metal-ceramic tooth-supported fixed dental prostheses (FDPs)? A systematic review of the survival and complication rates. Part II: Multiple-unit FDPs." Dental materials 31.6 (2015): 624-639.
Summary and review below the break~~
SUMMARY:
INTRO
Wanted to assess the 5-year survival rate of metal ceramic and all ceramic tooth supported fixed dental prostheses and to describe possible complications.
Higher rate of caries in abutment teeth found in zirconia, and not in other materials
Also zinc had issues with ceramic fractures and loss of retention
Higher rate of framework fractures found in reinforced glass ceramics and glass infiltrated alumina
OG: gold based with feldspathic
Veneered has moved toward monolithic
Zirconia framework is strong but riddled with issues...
SCIENCE TIME
Started at 71 studies and narrowed it down to 40
Studies must have a study period of at least 3 years
Minimum of 10 patients with FDP
Didn’t include reports based on questionnaires, interviews and charts (??)
Previous review was only 15 publications.. which seems low..
Stats included parameters such as number of vital abutment teeth, location in the mouth, number of teeth lost, etc.
This seems like they accounted for patient’s caries index which makes me very happy ^.^
Failure and complication rates were found by dividing the number of events (bad events that is) by the FDP total exposure time in years
“Total number of events was considered to be Poisson distributed for a given sum of FDP exposure years and Poisson regression with a logarithmic link-function and total exposure time per study as an offset variable were used”... Sure. Why not.
A friend sent me some information about Poisson distributions and these are some key assumptions:
Cont:
I would think that if a patient has demonstrated poor oral care in the past, it is a strong indicator of future outcomes. This makes me question if this stats model was best, especially when used to extrapolate the remaining two years in many of these studies.
7 studies were eliminated so as not to re-use the same patient cohort, which I also really like
28 had a prospective design. Does this mean extrapolation??
FINDINGS:
This is where things get hairy for me...
29 studies used ceramic which included 1225 patients, but this number dropped 1110 due to 10% of the studies being excluded for lack of patient follow up.
For metal-ceramic FDPs, 15 studies provided data on 1796 FDP’s. Elsewhere in the study, it is 1669 FDPs... Where did they go??
Success rate at 94.4% (91.2-96.5% success rate)
All ceramic ones were further divided into their specific materials
Glass ceramic: 7 studies at 89.1% (80.4-94.0%)
Glass infiltrated alumina: 6 studies at 86.2% (69.3-94.2% RANGE)
Densely sintered alumina: 16 studies at 90.4% (84.8-94.0%)
Overall findings: All ceramics showed a higher failure rate
DATA:
This is where I go in with the tables. May want to skip this portion....
Metal Ceramic: Numbers seem reasonable with nothing jumping out at me
Glass ceramic: Any study with a 100% success rate should be looked at, ESPECIALLY when it’s one of the first studies. Little suspicious
Glass infiltrated alumina: This is the one with the CRAZY range... One study had an estimated 5 year survival at 45.1%... Are outliers not a thing? Should we seriously examine this? It was the last study included in the set. Shouldn’t success with materials increase the longer we have experience using them? So many questions...
Densley sintered Zirconia: All 3 of the studies from the earliest publication year record a 100% survival rate. Is that not suspicious. I’m sure the world in filled with totally ethical people but... If i made dental materials, I would want the research to show great success, especially as it’s first entering the market. Just saying...
Also to note: all of these are based on “robust Poisson regression”. Is that a statistical measure or just an adjective of how hard they worked??
The only material to show a statistical signficant difference was the glass infiltrated alumina but that one was the one with the HUGE range.
Second part they looked at were the complications:
Secondary caries: So they included 3351 FDPs... but... 1796 and 1225, the numbers given earlier in the paper before studies were tossed adds up to 3021. Where did these extra FDPs come from??? Did they use different parameters for which of the sample cohort to include? Despite the fact this should totally be contained within the initial sample set? Hold me.
Anyway
They found reinforced glass ceramic FDP’s at 0.11% complication rate
Highest was densely sintered zirconia FDPs at 0.65%
Lowest annual FAILURE rates are given next, which leaves me with teh question.... If you have abutment caries... does that not count as a failure? Guess not.
Failure rates ranged from 0.09% for reinforced glass to 0.54% for metal ceramic? this apparently was not found to be statistically significantly different from zircona at 0.39%
Loss of pulp vitality happened at a rate of 0.44% annually which seems high... Unless loss of pulp vitality is happening irrespective of caries.. Sure, why not.
There was no stat significant difference in fracture rate among materials.
Repairs were needed the most for zirconia, at an annual rate of 3.14%
other materials were at 1.03-1.36%
No sig difference in chipping among the materials however.
Final Thoughts:
I really liked part 1... but now part 2 has me doubting... I don’t know how I feel about the stats, but if i had to pick from these materials I would pick:
- Metal Ceramic or
- Reinforced glass ceramic.
Tbh, I didn’t finish the discussion or conclusions because I was emotionally done with this paper.
-Nucleus of solitary tract
-Superior salivatory nucleus (parasympathic to submandibular, sunglingual glands)
-Chorda typami nerve arises from the geniculate ganglion
-Emerges from petrotympanic fissure
-Crosses the medial surface of tympanic membrane.
-Joins the lingual nerve of V3 in the infratemporal fossa.
Components:
Taste
Anterior 2/3 of tastebuds
Chorda tympani (travels with lingual nerve)
Cell bodies are located in the geniculate ganglion (within facial canal or petrous temporal).
Preganglionic Sympathetic
Synapses in the submandibular ganglion
1-15-17
For oral histology. I used faber castell watercolor pencils, derwent waterbrush fine tip pen and artline pigment ink .6 Can’t wait for summer break! 😞
