Browsing by Author "Pagni, Sarah"

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Shear Bond Strength of Glass Ionomer Cement after Silver Diamine Fluoride Application to Primary Molars: In-Vitro Study.
(Tufts University, 2024-06-01) Alabdulmohsen, Amjad; Loo, Cheen; Pagni, Sarah; Swee, Gerald; Uzel, Guzin
Aim: The aim of this in vitro study was to investigate and compare shear bond strength of Glass Ionomer cement to carious dentin of primary molars after the application of three different types of Silver Diamine Fluoride therapy: Silver Diamine Fluoride 38% (SDF), Silver Diamine Fluoride 38% with Potassium Iodide (SDF/KI), and Silver Fluoride Aqua with Iodide (AgF/KI). Materials and Methods: Extracted carious teeth were collected from Tufts University School of dental medicine. Sample size calculation was based on the pilot study results, total of 40 teeth were included and randomized into four groups (N= 10). Teeth were mounted and cut using Isomat saw, carious part of the tooth was exposed for the experiment. Control group: teeth received glass ionomer restoration. First test group received Silver Diamine Fluoride 38% (SDF), second test group received Silver Diamine Fluoride 38% with Potassium Iodide (SDF/KI), third test group received Silver Fluoride Aqua with Iodide (AgF/KI). Three test groups then received glass ionomer restoration and all four groups were tested for shear bond strength using Instron Machine. Mean and standard deviation were calculated, Welch’s ANOVA and the Games-Howell test for pairwise comparisons were used. Results: Comparison between control group of glass ionomer restoration used directly on dentin and all test groups of SDF therapy shows that shear bond strength is decreased when caries arresting medicaments used, regardless of the type. This reduction is statically significant. Conclusion: Within the limitation of this laboratory study, it can be concluded that SDF application in all three forms reduced shear bond strength of glass ionomer cements to extracted primary molars with natural caries.
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The Efficacy and Adverse Effects of Pilocarpine and Cevimeline in Patients with Hyposalivation: A Retrospective Cohort Study
(Saudi Digital Library, 2025) Alyousef, Sarah; Papas, Athena; Farag, Arwa; Uzel, Nciye; Zoukhri, Driss; Pagni, Sarah; Papas, Athena
Objective: The efficacy and side effects vary among cholinergic receptor agonist medications that stimulate salivary flow. This retrospective cohort investigation primarily aimed to compare the efficacy of pilocarpine (Pilo) and cevimeline (Cev) in stimulating salivary flow among patients with hyposalivation. The secondary aim was to compare the medications' side effects,discontinuation rates, and reasons for discontinuations, along with subjective changes in xerostomia, subjective perception, fungal recurrence, and the frequent usage of over-the-counter (OTC) oral lubricant products among the two drugs. Patients were further categorized into subgroups based on the underlying causes of hyposalivation, including Sjögren’s disease/Sicca Syndrome, polypharmacy, and radiotherapy. Method: A retrospective chart review was conducted for all patients seen at the Oral Medicine Clinic at Tufts University School of Dental Medicine (TUSDM) from January 1990 to January 2025 and prescribed Pilo or Cev. Patient demographics, medical history, and medications were collected. Changes in xerostomia perception over time (at 3, 6, 12, and 24 months) were evaluated using mixed linear regression. VAS scores were compared between medication groups at each time point using independent sample t-tests, while the Mann-Whitney U test was applied for non-normally distributed data. Categorical variables such as medication dosage/frequency changes, reported side effects, and drug discontinuation rates were analyzed using Fisher’s exact test. Descriptive statistics were used to summarize patient demographics, baseline characteristics, and polypharmacy profiles. Significance was set at P<0.05. Result: This retrospective cohort study evaluated 326 patients with hyposalivation treated with Pilo or Cev at Tufts University School of Dental Medicine from 1990 to 2025. Both medications significantly improved unstimulated whole saliva (USW) and reduced subjective oral dryness measured by visual analogue scale (VAS) scores at 3 and 6 months. Cev demonstrated more sustained benefits. USW stimulated whole saliva (SWS) showed modest, time-variable improvements with both agents. There is no statistically significant difference between Cev and Pilo regarding USW, SWS, and VAS through 24 months. Adherence rates favored Cev at baseline significantly, with higher continuation rates and fewer discontinuations observed across all follow-up periods. Although overall fungal infection recurrence was low, a statistically significant association was identified between Cev use and a higher recurrence rate. No significant difference in OTC oral lubricant use was observed between the two groups. Baseline adverse effects were infrequent and mild, and both medications exhibited a strong long-term safety profile. A statistically significant association between female gender prevalence and four etiologies of hyposalivation was observed, with Sjögren’s disease being predominantly female. Conclusion: Both Pilo and Cev are effective and well-tolerated treatments for hyposalivation. However, Cev may offer superior long-term adherence, more consistent improvements in salivary flow, and greater relief of subjective dryness. Pilo showed a lower fungal recurrence rate.
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