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Pinzon LM, Velazquez A, Rutkoski H, Tay DL, Martel L, Drury C, Ayres S, Dixon B, Winkler JR, Kepka D. Cross-cultural adaptation of a Spanish version of a previously validated HPV survey that evaluates dental students' knowledge, perception and clinical practices in Latin America. BMC Oral Health 2022; 22:72. [PMID: 35287664 PMCID: PMC8922929 DOI: 10.1186/s12903-022-02108-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 02/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background The global incidence of oropharyngeal cancer (OPC) is increasing. Dental professionals play a key role in the detection of oral lesions that could lead to cancer. However, scientific-based HPV-OPC visual inspection guidelines are underdeveloped and HPV knowledge and awareness has been reported to be low among dental students and professionals. The present study adapted and performed pretesting of a multi-scale survey evaluating knowledge, perceptions, and clinical practices regarding HPV and HPV-OPC for Latin American Spanish-speaking populations. Methods A previously developed questionnaire for English-speaking dental students was translated to Spanish. The questionnaire was administered to first year dental students at two Latin American universities with dental programs. Internal consistencies were measured using Cronbach Alpha. Analyses were conducted in SAS Version 9.4. Results Data from a total of 114 students, a majority of the which were female (61%), and Hispanic/Latino(a)/Spanish (91%). The HPV, HPV-OPC, and HPV vaccine knowledge subscales demonstrated good internal consistency, the Cronbach’s alpha was 0.83, 0.75, and 0.86 respectively. The Barriers subscale had a Cronbach’s alpha of 0.93, showing excellent internal consistency. The Clinical Procedures subscale, focused on factors surrounding dental students’ hypothetical clinical practice procedures, had a Cronbach’s alpha of 0.86. The Scope of Practice scale had a Cronbach’s alpha of 0.93. Conclusions Ultimately, this survey demonstrated reliability and applicability for the assessment of dental students’ knowledge, perceptions, and clinical practices regarding HPV and HPV-OPC in Latin America. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02108-2.
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Affiliation(s)
- Lilliam M Pinzon
- College of Nursing, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Alan Velazquez
- Universidad Autonoma de Baja California, Tijuana, Mexico
| | | | - Djin L Tay
- College of Nursing, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Lara Martel
- College of Nursing, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Carmen Drury
- Utah Department of Health, Salt Lake City, UT, USA
| | - Shauna Ayres
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Barbara Dixon
- College of Nursing, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - James R Winkler
- College of Nursing, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Deanna Kepka
- College of Nursing, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA.
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Rutkoski H, Tay DL, Dixon BL, Pinzon LM, Mooney R, Winkler JR, Kepka D. A Multi-state Evaluation of Oral Health Students' Knowledge of Human Papillomavirus-Related Oropharyngeal Cancer and HPV Vaccination. J Cancer Educ 2020; 35:1017-1025. [PMID: 31222578 PMCID: PMC6923618 DOI: 10.1007/s13187-019-01561-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Human papillomavirus-related oropharyngeal cancers (HPV-OPCs) are on the rise, yet HPV knowledge among dental professionals remains low. The purpose of this multi-state study was to examine sociodemographic factors associated with final year dental hygiene (DH), third year dental (DS3), and fourth year dental (DS4) students' knowledge regarding HPV, HPV-OPC, and HPV vaccination. Twenty dental programs in the USA were approached in the implementation phase to complete an online, 153-item, self-administered questionnaire that was developed and tested in a previous study. Descriptive statistics and chi-square analyses were conducted in SAS version 9.4 to examine the relationship between sociodemographic variables with HPV, HPV-OPC, and HPV vaccination knowledge levels. This study included the participation of students from 15 dental programs (n = 380) with an overall response rate of 28%. Although the results cannot be generalized to the entire population of dental students in the USA, most students had inadequate overall HPV knowledge (65%), HPV-OPC knowledge (80%), and HPV vaccination knowledge (55%). While all student groups displayed adequate general HPV knowledge levels (≥ 70% correct responses), gender, racial, religious, age, and regional differences were observed. Future dental professionals need to have adequate levels of HPV knowledge to aid in reducing the HPV-OPC burden. This study identified sociodemographic factors related to lower knowledge of HPV, HPV-OPC, and HPV vaccination, and highlights groups of students with greater needs for HPV education. This study provides a foundation for future research and interventions to be developed. Dental institutions can use findings to strengthen curricula development.
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Affiliation(s)
- Holdunn Rutkoski
- University of Nevada, Las Vegas: School of Dental Medicine, Las Vegas, NV, USA
| | - Djin L Tay
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Barbara L Dixon
- School of Dentistry, College of Nursing; Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, 2000 Circle of Hope, Room 4707, Salt Lake City, UT, 84112, USA
| | - Lilliam M Pinzon
- School of Dentistry, College of Nursing; Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, 2000 Circle of Hope, Room 4707, Salt Lake City, UT, 84112, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - James R Winkler
- School of Dentistry, College of Nursing; Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, 2000 Circle of Hope, Room 4707, Salt Lake City, UT, 84112, USA
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
- College of Nursing, University of Utah, Salt Lake City, UT, USA.
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Harris KL, Tay D, Kaiser D, Praag A, Rutkoski H, Dixon BL, Pinzon LM, Winkler JR, Kepka D. The perspectives, barriers, and willingness of Utah dentists to engage in human papillomavirus (HPV) vaccine practices. Hum Vaccin Immunother 2019; 16:436-444. [PMID: 31361179 DOI: 10.1080/21645515.2019.1649550] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Including dental health providers in human papillomavirus (HPV) vaccination could reduce rising rates in HPV-associated oropharyngeal cancer (HPV-OPC). This study assessed Utah dentists' perspectives on providing HPV vaccination education and services in the dental setting. A cross-sectional, 70-item self-administered survey was conducted among a convenience sample of N = 203 practicing Utah dentists. Statistical analyses included Chi Square tests of independence, scaled scores and Cronbach's alpha coefficients. Majority of Utah dentists surveyed perceived that discussing the link between HPV and OPC and recommending the HPV vaccine is within their scope of practice, but not administration of the HPV vaccine. Dentists with >10 minutes of patient education per week were less likely to be concerned about the cultural, social norms or religious ideology of discussing HPV with their patients (p = .024). Rural dentists were more concerned about the safety and liability of the HPV vaccine (p = .011). Good internal consistency was observed survey items regarding barriers and willing to engage in HPV vaccination practices. Dental providers were interested in HPV training and patient education brochures as strategies, but less interested in administering the HPV vaccine. Dental associations support dentists' engagement in HPV education and HPV-OPC prevention. This is the first study in Utah to examine dentists' perspectives on HPV vaccination. Findings have implications for program planning, intervention development, and future research.
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Affiliation(s)
- Katherine L Harris
- Gyneocologic Oncology, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - D Tay
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - D Kaiser
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - A Praag
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - H Rutkoski
- School of Dental Medicine, University of Nevada, Las Vegas, NV, USA
| | - B L Dixon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - L M Pinzon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - J R Winkler
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - D Kepka
- College of Nursing, University of Utah, Salt Lake City, UT, USA.,Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
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Kepka D, Rutkoski H, Pappas L, Tay DL, Winkler JR, Dixon B, Velazquez A, Pinzon LM. US oral health students' willingness to train and administer the HPV vaccine in dental practices. Prev Med Rep 2019. [PMID: 31372330 DOI: 10.1016/j.pmedr.2019.100957)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023] Open
Abstract
HPV oropharyngeal cancers have now surpassed cervical cancer rates in the US. Dental providers' engagement in HPV education and vaccination efforts may help reduce the burden of HPV oropharyngeal cancers. We examined factors associated with oral health students' willingness to train and administer the human papillomavirus (HPV) vaccine in dental settings. US students in 15 oral health programs participated in an online survey in 2016. Unadjusted and adjusted multivariable logistic regression were conducted and odds ratios (OR) and 95% confidence intervals (CI) were reported. Analyses were conducted in SAS Version 9.4. Data from a total of N = 306 students were analyzed to examine sociodemographic, educational, practice, and attitudinal factors associated with willingness to train and administer the HPV vaccine. Majority of the participants were female (70.3%), non-Hispanic/Latino (90.8%), and White (62.1%). Perceiving that HPV vaccination recommendation (OR = 1.95, 95% CI = 1.14-3.35) and administration (OR = 3.79, 95% CI = 1.63-8.81) was in the dental professional's scope was positively associated with outcome measures when other factors were held constant. Students with greater patient contact time (OR = 4.47, 95% CI = 1.14-17.58) and lower role conflict (agreed that HPV vaccine administration was in the dental professional's scope) had higher odds of willingness to administer the HPV vaccine when other factors were held constant (OR = 5.9, 95% CI = 2.27-15.3). The major barrier to engaging oral health students in HPV vaccination efforts was role conflict. Professional organizations and oral health programs should strongly support the role of oral health professionals in HPV oropharyngeal prevention.
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Affiliation(s)
- Deanna Kepka
- Huntsman Cancer Institute, USA
- College of Nursing, University of Utah, USA
| | | | | | - Djin L Tay
- Huntsman Cancer Institute, USA
- College of Nursing, University of Utah, USA
| | | | | | - Alan Velazquez
- Facultad de Odontología, Universidad Autónoma de Baja , Baja California, Mexico
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5
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Kepka D, Rutkoski H, Pappas L, Tay DL, Winkler JR, Dixon B, Velazquez A, Pinzon LM. US oral health students' willingness to train and administer the HPV vaccine in dental practices. Prev Med Rep 2019; 15:100957. [PMID: 31372330 PMCID: PMC6661379 DOI: 10.1016/j.pmedr.2019.100957] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 06/14/2019] [Accepted: 07/16/2019] [Indexed: 12/25/2022] Open
Abstract
HPV oropharyngeal cancers have now surpassed cervical cancer rates in the US. Dental providers' engagement in HPV education and vaccination efforts may help reduce the burden of HPV oropharyngeal cancers. We examined factors associated with oral health students' willingness to train and administer the human papillomavirus (HPV) vaccine in dental settings. US students in 15 oral health programs participated in an online survey in 2016. Unadjusted and adjusted multivariable logistic regression were conducted and odds ratios (OR) and 95% confidence intervals (CI) were reported. Analyses were conducted in SAS Version 9.4. Data from a total of N = 306 students were analyzed to examine sociodemographic, educational, practice, and attitudinal factors associated with willingness to train and administer the HPV vaccine. Majority of the participants were female (70.3%), non-Hispanic/Latino (90.8%), and White (62.1%). Perceiving that HPV vaccination recommendation (OR = 1.95, 95% CI = 1.14-3.35) and administration (OR = 3.79, 95% CI = 1.63-8.81) was in the dental professional's scope was positively associated with outcome measures when other factors were held constant. Students with greater patient contact time (OR = 4.47, 95% CI = 1.14-17.58) and lower role conflict (agreed that HPV vaccine administration was in the dental professional's scope) had higher odds of willingness to administer the HPV vaccine when other factors were held constant (OR = 5.9, 95% CI = 2.27-15.3). The major barrier to engaging oral health students in HPV vaccination efforts was role conflict. Professional organizations and oral health programs should strongly support the role of oral health professionals in HPV oropharyngeal prevention.
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Affiliation(s)
- Deanna Kepka
- Huntsman Cancer Institute, USA.,College of Nursing, University of Utah, USA
| | | | | | - Djin L Tay
- Huntsman Cancer Institute, USA.,College of Nursing, University of Utah, USA
| | | | | | - Alan Velazquez
- Facultad de Odontología, Universidad Autónoma de Baja , Baja California, Mexico
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Ahn Y, Lamy R, Darling CL, Stewart JM, Pinzon LM. Photochemical crosslinking of caries-affected dentin combined with total- or self-etch systems. Am J Transl Res 2018; 10:2990-2995. [PMID: 30323885 PMCID: PMC6176226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/06/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To evaluate the effects of collagen crosslinking with riboflavin 0.1% and ultraviolet-A (UVA) 5.4 J on bond strength of total-etch or self-etch adhesives on caries-affected dentin. METHODS Sixty human caries-affected molars were randomly divided into three groups: control (C), riboflavin (R), and riboflavin + 3 minutes of UVA (R+UVA). After each treatment, either total-etch or self-etch adhesives were applied following the manufacturer's instructions, and composite stubs were built up on the treated surfaces. They were de-bonded in tension to measure bond strength. Twelve extra molars were used for scanning electron microscope (SEM) analysis. RESULTS We observed that R+UVA-treated group yielded significantly higher bond strengths for carious dentin when the total-etch adhesive was applied. For the self-etch adhesive, no statistical differences were observed between the three pretreated-groups. CONCLUSION Our results, for the first time, are suggesting that etching with phosphoric acid potentialized the benefits of R+UVA crosslinking on carious dentin. R+UVA dentinal collagen crosslinking improves bond strength for caries-affected dentin when using a total-etch adhesive, but did not affect it when using a self-etch adhesive.
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Affiliation(s)
- Yoomin Ahn
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California-San FranciscoUSA
| | - Ricardo Lamy
- Department of Ophthalmology, School of Medicine, University of California-San FranciscoUSA
| | - Cynthia L Darling
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California-San FranciscoUSA
| | - Jay M Stewart
- Department of Ophthalmology, School of Medicine, University of California-San FranciscoUSA
| | - Lilliam M Pinzon
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California-San FranciscoUSA
- School of Dentistry, University of UtahUSA
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Rutkoski H, Fowler B, Mooney R, Pappas L, Dixon BL, Pinzon LM, Winkler J, Kepka D. Pilot Test of Survey to Assess Dental and Dental Hygiene Student Human Papillomavirus-Related Oropharyngeal Cancer Knowledge, Perceptions, and Clinical Practices. J Cancer Educ 2018; 33:907-914. [PMID: 28091963 DOI: 10.1007/s13187-017-1165-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This was the first study to develop and pilot test an assessment tool for the examination of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) knowledge, perceptions, and clinical practices of oral health students. An interdisciplinary team developed the tool using surveys that examined this topic in other populations. The tool was then pilot tested at two different dental programs. Results from the pilot informed revisions to the final version of the tool. Of the 46 student participants, 18 were first-year dental hygiene and 28 were first-year dental students. The majority of participants were female (N = 29, 63%) and ages 18 to 29 years old (N = 41, 89%). Four scales used in the questionnaire were analyzed for reliability. Of these, the HPV and HPV-OPC knowledge and the HPV vaccination knowledge scales had Cronbach alphas of 0.71 and 0.79, respectively. Questions assessing HPV and the role of dental professionals had a correlation coefficient of 0.71. Questions assessing willingness to administer vaccines in the dental office had a correlation coefficient of 0.85. Assessing oral health students' HPV-OPC knowledge, perceptions, and clinical practices are important for future assessment of possible HPV-OPC cases. Dental professionals may be optimally positioned to provide HPV patient education. The tool developed and pilot tested in this study can help schools assess their students' knowledge and guide their dental curriculum to address deficiencies. Since this topic has not been effectively examined with dental health students, the results could help improve dental education and dental care.
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Affiliation(s)
- Holdunn Rutkoski
- School of Dental Medicine, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Brynn Fowler
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Ryan Mooney
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Lisa Pappas
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Barbara L Dixon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Lilliam M Pinzon
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - James Winkler
- School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - Deanna Kepka
- Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
- College of Nursing, Cancer Control and Population Science, University of Utah, Huntsman Cancer Institute, 2000 Circle of Hope, Room 4144, Salt Lake City, UT, 84112, USA.
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Arrive E, Meless D, Anaya-Saavedra G, Gallottini M, Pinzon LM, Ramirez-Amador V. The global burden of oral diseases in pediatric HIV-infected populations: a workshop report. Oral Dis 2016; 22 Suppl 1:149-57. [PMID: 26882532 DOI: 10.1111/odi.12417] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 07/22/2015] [Accepted: 11/02/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To achieve a comprehensive understanding about the global burden of oral diseases in HIV-infected children and to identify research needs. MATERIALS AND METHODS A literature search was conducted in PubMed (2009-2014) to address five questions: (i) prevalence of oral diseases in HIV-infected compared with uninfected children, (ii) impact of oral diseases on quality of life, (iii) effect of antiretroviral exposure in utero on craniofacial and dental development, (iv) important co-infections and antiretroviral complications, and (v) value of atraumatic restorative treatment. RESULTS Studies showed a high prevalence of dental caries in HIV-infected children but the relationship between HIV infection and dental caries remains unclear. Also quality of life needs further investigation supported by better study designs and improvement of the instruments used. Up-to-date evidence suggested long-term harms associated with in utero antiretroviral exposure were minor but would require long-term follow-up through National Registries. The reviews also revealed the wide spectrum of metabolic disease due to antiretroviral therapy and co-infections such as tuberculosis. Finally, atraumatic restorative technique appears to be a simple and safe technique to treat dental caries but outcomes need further evaluation. CONCLUSIONS The impact of antiretroviral therapy in HIV-infected children has raised novel challenging questions in the field of oral health warranting future research.
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Affiliation(s)
- E Arrive
- UFR d'Odontologie, University of Bordeaux, Bordeaux, France.,Equipe VIH et Santé Globale, INSERM U897, Bordeaux, France
| | - D Meless
- UFR d'Odontostomatologie, Félix Houphouët Boigny University of Abidjan, Abidjan, Côte d'Ivoire
| | - G Anaya-Saavedra
- Department of Health Care, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
| | - M Gallottini
- Department of Stomatology, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - L M Pinzon
- School of Dentistry, University of California, San Francisco, CA, USA.,School of Dentistry, University of Utah, Salt Lake City, UT, USA
| | - V Ramirez-Amador
- Department of Health Care, Universidad Autónoma Metropolitana-Xochimilco, México City, Mexico
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Pinzon LM, Watanabe LG, Reis AF, Powers JM, Marshall SJ, Marshall GW. Analysis of interfacial structure and bond strength of self-etch adhesives. Am J Dent 2013; 26:335-40. [PMID: 24640438 PMCID: PMC3962957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To determine the bond strength, nanoleakage and interfacial morphology of four self-etch adhesives bonded to superficial dentin. METHODS Microtensile (MT) (n= 15) and single plane shear (SP) (n= 8) bond tests were performed using human dentin polished through 320-grit SiC paper. Clearfil Protect Bond (PB), Clearfil S3 Bond (S3), Prompt L-Pop (PLP) and G-Bond (GB) were used according to their manufacturers' instructions. Composite was applied as cylinders with a thickness of 4 mm with a 1 mm diameter and stored in water at 370C for 24 hours. Specimens were debonded with a testing machine at a cross-head speed of 1 mm/minute. Means and standard deviations of bond strength were calculated. Data were analyzed using ANOVA. Fisher's PLSD intervals were calculated at the 0.05 level of significance. Failure modes were determined at x100. The hybrid layer was revealed by treatment with 5N HC1/5% NaOCl or fractured perpendicular to the interface and sputter coated with gold. Specimens were viewed at x1,000, x2,500, and x5,000 in a field emission SEM at 15 kV. Teeth (n=2) sectioned into 0.9 mm-thick slabs were immersed in ammoniacal silver nitrate solution for 24 hours, rinsed and immersed in photo-developing solution for 8 hours. Specimens were sectioned (90 nm-thick) and observed under TEM. RESULTS Means ranged from 25.0 to 73.1 MPa for MT and from 15.5 to 56.4 MPa for SP. MT values were greater than SP, but were highly correlated (R2 = 0.99, P= 0.003) and provided the same order for the systems studied. Fisher's PLSD intervals (P< 0.05) for bond strength techniques and adhesives results were 1.7 and 2.3 MPa, respectively. Failures sites were mixed. TEM showed that hybrid layers were -0.5 pm for PB, GB and S3 and approximately 5 microm for PLP. SEM showed morphologic differences among adhesives. Silver nitrate deposits were observed within the interfaces for all adhesive systems.
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Hsu KW, Marshall SJ, Pinzon LM, Watanabe L, Saiz E, Marshall GW. SEM evaluation of resin-carious dentin interfaces formed by two dentin adhesive systems. Dent Mater 2007; 24:880-7. [PMID: 18155289 DOI: 10.1016/j.dental.2007.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2007] [Revised: 10/26/2007] [Accepted: 11/04/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We investigated the influence of dentin tubule direction and identifiable zone of carious dentin on the microstructure and the thickness of the hybrid-like layer (HL) formed by self-etch and etch-rinse adhesive systems. METHODS An etch-rinse and a self-etching adhesive were bonded to dentin carious zones divided into groups with parallel or perpendicular orientation relative to the dentin tubules at the resin-carious dentin interface (N=5/variable). Bonds were prepared to each of the four zones of carious dentin apparent after staining with Caries Detector: pink, light pink, transparent and apparently normal; six non-carious third molars were controls. The microstructure and thickness of the HL were determined by SEM and compared using three-way ANOVA and Tukey's multiple comparisons (p<0.05). RESULTS Etch-rinse controls gave thicker HLs than self-etching systems; orientation did not affect thickness for the self-etch system. Perpendicular orientations gave thicker HLs than parallel for the pink zone bonded with the etch-rinse system. For both adhesives, HL thickness in the pink zone was significantly greater than in light pink for the perpendicular group, but no significant differences were found among other variables. HL microstructure was more granular and rougher for the etch-rinse than for the self-etching system. Pores and cracks were obvious in the more demineralized zones. Resin tags were shorter and irregular in the transparent zone and often were completely absent in the outer demineralized zones (pink, light pink). SIGNIFICANCE Microstructure of bonded interfaces varies markedly depending on adhesive system, tubule orientation and carious zone.
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Affiliation(s)
- Kuang-Wei Hsu
- Division of Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, 707 Parnassus Avenue, San Francisco, CA 94143-0758, USA
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11
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Lee YK, Pinzon LM, O'Keefe KL, Powers JM. Effect of filler addition on the bonding parameters of dentin bonding adhesives bonded to human dentin. Am J Dent 2006; 19:23-7. [PMID: 16555653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
PURPOSE To determine the effect of filler addition on two total-etch, single component bonding systems on the bond strength, displacement at debonding, stiffness of debonding and energy absorbed to debonding of resin composites to human dentin. METHODS Two dentin bonding systems with no-filler (OS and SB) and filler-added (OSP and SBP) versions were studied. The dentin surfaces of human teeth were exposed with 600-grit SiC. TPH Spectrum A2 was used to bond to the dentin surfaces in the form of a truncated cone, 3 mm in diameter at the bonding surfaces and 5 mm in diameter at the base. Bonded specimens were stored in distilled water at 37 degrees C for 24 hours. They were then debonded in tension with a universal testing machine at a cross-head speed of 0.5 mm/minute. Displacement at debonding, stiffness and energy to debonding were calculated based on the stress-displacement curve. RESULTS Bond strength, displacement at debonding and energy to debonding (measured and elastic) were influenced by the brand of the adhesive (OS/OSP vs. SB/SBP), but were not influenced by the filler addition based on two-way analysis of variance. Bond strength was in the range of 24.4-30.1 MPa, and there were significant differences between the bond strengths of OS and SB. Displacement and energy to debonding (measured and elastic) were different between the adhesives. Bond strength, bond stiffness and energy to debonding (measured) showed significant correlations.
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Affiliation(s)
- Yong-Keun Lee
- Department of Dental Biomaterials Science, Dental Research Institute, College of Dentistry, Seoul National University, 28 Yeongeon-dong, Jongro-gu, Seoul, Korea.
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O'Keefe KL, Pinzon LM. Management of the prepared tooth for placement of direct posterior composite restorations. Dent Today 2005; 24:70, 72, 74-7; quiz 77. [PMID: 16229294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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O'Keefe KL, Pinzon LM, Rivera B, Powers JM. Bond strength of composite to astringent-contaminated dentin using self-etching adhesives. Am J Dent 2005; 18:168-72. [PMID: 16158807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE To determine the effects of contamination by ferric sulfate and aluminum chloride astringents on the bond strength of composite bonded to superficial dentin using self-etching adhesives. METHODS Freshly extracted human teeth were ground to expose superficial dentin and polished to 600 grit. One of three self-etching adhesive systems and restorative composites were bonded to the specimens, with contamination by one of three astringents and five surface conditions (no contamination, moist dentin control; contaminant, air, adhesive; contaminant, water rinse, air, adhesive; contaminant, water rinse, glycolic acid scrub, rinse, adhesive; contaminant, water rinse, chlorhexadine scrub, rinse, adhesive). Composite was bonded to the surfaces in the shape of an inverted, truncated cone (n = 5, 180 specimens total). Specimens were stored in water at 37 degrees C for 24 hours, then de-bonded in tension with a testing machine at a crosshead speed of 0.5 mm/minute. Tensile bond strengths (MPa) were calculated. RESULTS Means (SD) were compared using analysis of variance. Significant differences (Fisher's PLSD) were found among all variables. SE and ABF had the highest control values, but were affected most by astringent contamination. Ferric sulfate reduced bond strengths the greatest in most cases, and aluminum chloride putty reduced bond strengths the least. Chlorhexadine rinse was most effective in restoring bond strength values.
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Affiliation(s)
- Kathy L O'Keefe
- Department of Restorative Dentistry and Biomaterials, The University of Texas Dental Branch at Houston, 6516 M. D. Anderson Blvd., Houston, Texas 77030, USA.
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Abstract
Four generations of total-etch (fourth, fifth) and self-etching (sixth, seventh) bonding agents for use with resin composites are commercially available in the United States. Innovations in bonding agents include: filled systems, release of fluoride and other agents, unit dose, self-cured catalyst, option of etching with either phosphoric acid or self-etching primer, and pH indicators. Factors that can affect in vitro bond strength to human dentin include substrate (superficial dentin, deep dentin; permanent versus primary teeth; artificial carious dentin), phosphoric acid versus acidic primers, preparation by air abrasion and laser, moisture, contaminants, desensitizing agents, astringents, and self-cured restorative materials. This article reviews studies conducted at the Houston Biomaterials Research Center from 1993 to 2003. Results show that in vitro bond strengths can be reduced by more than 50% when bonding conditions are not ideal.
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Affiliation(s)
- John M Powers
- Department of Restorative Dentistry and Biomaterials, Houston Biomaterials Research Center, University of Texas Health Science Center at Houston Dental Branch, 6516 M.D. Anderson Blvd., Houston, Texas 77030-3402, USA.
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