Chemochemical caries removal: a review of the techniques and latest developments

Chemomechanical caries removal involves the chemical softening of carious dentine followed by its removal by gentle excavation. The reagent involved is generated by mixing amino acids with sodium hypochlorite; N-monochloroamino acids are formed which selectively degrade demineralised collagen in carious dentine. The procedure requires 5-15 minutes but avoids the painful removal of sound dentine thereby reducing the need for local anaesthesia. It is well suited to the treatment of deciduous teeth, dental phobics and medically compromised patients. The dentine surface formed is highly irregular and well suited to bonding with composite resin or glass ionomer. When complete caries removal is achieved, the dentine remaining is sound and properly mineralised. The system was originally marketed in the USA in the 1980's as Caridex. Large volumes of solution and a special applicator system were required. A new system, Carisolv, has recently been launched on to the market. This comes as a gel, requires volumes of 0.2-1.0 ml and is accompanied by specially designed instruments

Human salivary glucose analysis by high-performance ion-exchange chromatography and pulsed amperometric detection

The aim of this project was to develop an analytical procedure with the required level of sensitivity for the determination of glucose concentrations in small volumes of unstimulated fasting whole saliva. The technique involves high-performance ion-exchange chromatography at high pH and pulsed amperometric detection. It has a high level of reproducibility, a sensitivity as low as 0.1 μmol/l and requires only 50 μl samples (sensitivity = 0.002 pmol). Inhibition of glucose metabolism, by procedures such as collection into 0.1% (w/v) sodium fluoride, was shown to be essential if accurate results are to be obtained. Collection on to ice followed by storage at −20°C was shown to be unsuitable and resulted in glucose loss by degradation. There were inter- and intraindividual variations in the glucose concentration in unstimulated mixed saliva (range; 0.02–0.4 mmol/l). The procedure can be used for the analysis of other salivary carbohydrates and for monitoring the clearance of dietary carbohydrates from the mouth

Framework for e-learning assessment in dental education: a global model for the future

The framework presented in this article demonstrates strategies for a global approach to e-curricula in dental education by considering a collection of outcome assessment tools. By combining the outcomes for overall assessment, a global model for a pilot project that applies e-assessment tools to virtual learning environments (VLE), including haptics, is presented. Assessment strategies from two projects, HapTEL (Haptics in Technology Enhanced Learning) and UDENTE (Universal Dental E-learning), act as case-user studies that have helped develop the proposed global framework. They incorporate additional assessment tools and include evaluations from questionnaires and stakeholders' focus groups. These measure each of the factors affecting the classical teaching/learning theory framework as defined by Entwistle in a standardized manner. A mathematical combinatorial approach is proposed to join these results together as a global assessment. With the use of haptic-based simulation learning, exercises for tooth preparation assessing enamel and dentine were compared to plastic teeth in manikins. Equivalence for student performance for haptic versus traditional preparation methods was established, thus establishing the validity of the haptic solution for performing these exercises. Further data collected from HapTEL are still being analyzed, and pilots are being conducted to validate the proposed test measures. Initial results have been encouraging, but clearly the need persists to develop additional e-assessment methods for new learning domains