Publications by authors named "A M Kielbassa"

165 Publications

A randomized controlled trial on the plaque-removing efficacy of a low-abrasive air-polishing system to improve oral health care.

Quintessence Int 2021 Jul 16;0(0). Epub 2021 Jul 16.

Objectives: While air polishing with abrasive powders has been proved efficient for sub- and supragingival application, only few studies concerning the quality of supragingival biofilm removal using the low-abrasive erythritol powder (EP) exist. The aim of the present randomized controlled trial was to clinically compare the efficacy of supragingival air polishing using EP in comparison with the rubber cup method, and to juxtapose the corresponding biofilm regrowth rates.

Method And Materials: Thirty-two young adults, suspending oral hygiene for 48 hours, were enrolled in the present double-blind short-term investigation. Using a split-mouth design, tooth polishing was conducted by means of either air polishing or rubber cups with prophylaxis paste (control). While 16 participants received air polishing in the second and fourth quadrants (and rubber cup prophylaxis in the first and third ones), the reverse sequence was applied with the remaining 16 subjects. Biofilms were assessed using the modified Quigley-Hein index (QHI), and QHI sum scores achieved both prior to and immediately after the polishing procedure, as well as 24 hours later, were assessed using a two-way analysis of variance (ANOVA), followed by Tukey's HSD to test multiple pairwise comparisons.

Results: Both methods revealed a significant reduction of QHI scores (P < .001). Compared to the rubber cup method, air polishing resulted in significantly lower scores, both after tooth cleaning and after 24 hours (P < .001).

Conclusions: Supragingival biofilm removal by means of air polishing combined with low-abrasive erythritol seems to be more efficacious than the traditional polishing method, and should improve oral health care.
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July 2021

In vitro wear of (resin-coated) high-viscosity glass ionomer cements and glass hybrid restorative systems.

J Dent 2021 02 9;105:103554. Epub 2020 Dec 9.

Department of Operative Dentistry, Periodontology, and Endodontology, University School of Dental Medicine and Oral Health, Danube Private University (DPU), Steiner Landstraße 124, 3500, Krems, Austria.

Objectives: The aim of the present study was to investigate the volumetric abrasive wear of a high-viscosity glass ionomer cement (hvGIC; Equia Fil) and a glass hybrid restorative system (ghRS; Equia Forte), each being recommended as amalgam alternatives. Both materials were applied with or without their respective resinous coating, and were compared with a conventional GIC (Ketac Fil) and a hybrid composite resin (CR; G-ænial Posterior).

Methods: 78 standardized occlusal Class I cavities were restored with the various materials (n = 13 per group). Before and after chewing simulation (30,000 cycles at 40 N), each sample underwent optical scanning procedures (Omnicam). A comparison of the total wear using a fluorescence-aided identification technique (OraCheck) followed, and differences (α = 5%) between groups were compared by means of MANOVA.

Results: Regarding the wear rates of hvGIC and ghRS, no differences could be observed (p > .050), and this was not affected by the resinous coating. All hvGIC and ghRS restorations showed significantly higher abrasive wear than CR (p < .001), while the conventional GIC displayed a significant underperformance compared with any other material (p < .001).

Conclusions: Resinous coating of hvGIC or ghRS does not appear to exert an effective long-term protection against advanced abrasive wear. Compared to the conventional GIC showing a considerable substance loss, both hvGIC and ghRS materials revealed an improved abrasion resistance, but clearly failed to meet the excellent values of the CR.

Clinical Significance: Occlusal loading should be carefully considered when using hvGIC or ghRS as amalgam (or composite resin) alternatives for the restoration of posterior teeth.
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February 2021

Improving oral health: a short-term split-mouth randomized clinical trial revealing the superiority of resin infiltration over remineralization of white spot lesions.

Quintessence Int 2020 ;51(9):696-709

Objectives: To evaluate masking effects of resin infiltration on labial white spot lesions (WSL), by comparing the latter with a remineralization approach (using hydroxyapatite and fluorides) and conventional oral care (using fluoride-free toothpaste).

Method And Materials: Fifteen patients with at least three WSL were enrolled for a within-person randomized controlled trial, thus allowing for intrapersonal comparisons. Each WSL per tooth in every patient was randomly assigned to one of the following groups. Group 1: lesions were resin-infiltrated with Icon (RI; DMG); Group 2: Remin Pro (RP; VOCO) was used as remineralizing agent; and Group 3 (control): affected teeth were brushed with Complete Care toothpaste (CC; Himalaya). RP and CC were applied by means of a polishing brush, using a low-speed handpiece (5 min), and these procedures were repeated chairside thrice daily for 7 consecutive days. Digital photographs were captured before and after lesion treatment under standardized conditions. The CIE L*a*b* color system was used to analyze the optical outcome, and intrapersonal color differences were statistically evaluated.

Results: Compared to RP and CC, RI showed prompt and subjectively satisfactory color improvements, and this was primarily driven by L* and b* shifts. Statistical analysis of the objective color differences (ΔE*) between the three groups revealed significant differences for RI vs RP (P = .029), RI vs CC (P < .001), and RP vs CC (P = .001).

Conclusion: Resin infiltration is considered a time-effective treatment option for esthetically camouflaging WSL, while RP and CC failed to improve lesion appearance and oral health in the current short-term trial.
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September 2020

Knowledge, attitude, and practice of institutional dental professionals regarding management of patients taking oral antithrombotic medications.

Quintessence Int 2020 ;51(8):650-658

Objectives: Nowadays, there is an increasing number of patients prescribed regular antithrombotics. With these long-term medications, complications like postoperative bleeding are extremely important. Despite available guidelines on this issue, disparities in approach have been noticed. The current study aimed to explore the knowledge, attitude, and practice of dental professionals associated with a dental school in Saudi Arabia regarding the management of patients with oral antithrombotic medications.

Method And Materials: A cross-sectional study was conducted on institutional-based dental professionals in Saudi Arabia. Fifty-six subjects, including 12 interns, 20 demonstrators, and 24 faculty members were included in the study. A modified semistructured questionnaire comprising 20 questions was used to gather respondents' knowledge, attitude, and practice related to oral antithrombotic medications. The chi-square test was applied for computing inferential statistics. Spearman correlation coefficient was performed for significant variables.

Results: The faculty members had comparable knowledge (P = .010) as well as practice (P = .001) levels, and significantly outscored the other two groups. The interns displayed a significantly higher knowledge score over the demonstrators, whereas the reverse scenario was seen for practice scores. Interestingly, participants were frequently found to be significantly overestimating the bleeding risk for procedures falling into the "no risk" category. A significantly positive correlation regarding the professional level could be shown in all domains.

Conclusion: Professionals need to regularly update about novel anticoagulants, and should strictly comply with the established practice guidelines, thus improving the quality, safety, and value of dental health care.
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August 2020