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Barbosa CDB, Monici Silva I, Dame-Teixeira N. The action of microbial collagenases in dentinal matrix degradation in root caries and potential strategies for its management: a comprehensive state-of-the-art review. J Appl Oral Sci 2024; 32:e20240013. [PMID: 38775556 PMCID: PMC11182643 DOI: 10.1590/1678-7757-2024-0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/21/2024] [Accepted: 04/04/2024] [Indexed: 05/25/2024] Open
Abstract
Conventional views associate microbial biofilm with demineralization in root caries (RC) onset, while research on their collagenases role in the breakdown of collagen matrix has been sporadically developed, primarily in vitro. Recent discoveries, however, reveal proteolytic bacteria enrichment, specially Porphyromonas and other periodontitis-associated bacteria in subgingivally extended lesions, suggesting a potential role in RC by the catabolism of dentin organic matrix. Moreover, genes encoding proteases and bacterial collagenases, including the U32 family collagenases, were found to be overexpressed in both coronal and root dentinal caries. Despite these advancements, to prove microbial collagenolytic proteases' definitive role in RC remains a significant challenge. A more thorough investigation is warranted to explore the potential of anti-collagenolytic agents in modulating biofilm metabolic processes or inhibiting/reducing the size of RC lesions. Prospective treatments targeting collagenases and promoting biomodification through collagen fibril cross-linking show promise for RC prevention and management. However, these studies are currently in the in vitro phase, necessitating additional research to translate findings into clinical applications. This is a comprehensive state-of-the-art review aimed to explore contributing factors to the formation of RC lesions, particularly focusing on collagen degradation in root tissues by microbial collagenases.
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Affiliation(s)
- Cecília de Brito Barbosa
- Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Odontologia, Brasília, Brasil
| | - Isabela Monici Silva
- Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Odontologia, Brasília, Brasil
| | - Naile Dame-Teixeira
- Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Odontologia, Brasília, Brasil
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2
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Nandhini G, Sasidharan Nair R, Mano Christiane Angelo JB, Sreeram R, V N, Swathi VS. Comparative Analysis of the Effectiveness of Four Distinct Remineralizing Agents in Artificial White Spot Lesions Following Chitosan Nanoparticle Pretreatment: An In Vitro Study. Cureus 2024; 16:e59924. [PMID: 38854359 PMCID: PMC11161667 DOI: 10.7759/cureus.59924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 06/11/2024] Open
Abstract
Aim The aim of the study was to compare the effectiveness of chitosan nanoparticle pretreatment with four different remineralizing agents in artificial white spot lesions. Methods A total of 100 human maxillary first premolars were selected and divided into five groups of 20 samples in each group. Artificial white spot lesions were created by immersing the samples in the demineralizing solution for 96 hours. Chitosan pretreatment was done for all samples followed by subjecting Group I samples to artificial saliva (control), Group II samples to 3M Clinpro, Group III samples to GC Tooth Mousse, Group IV samples to SHY-NM, and Group V samples with Aclaim using a cotton applicator tip. Each group was divided into two subgroups of 10 samples, which were subjected to hardness testing and mineral content analysis. Surface microhardness and the calcium phosphorous ratio were recorded using a Vickers microhardness tester and energy-dispersive X-ray (EDAX) analysis at three levels i.e., baseline, after demineralization, and after remineralization and tabulated. Statistical analysis was conducted by analyzing data using ANOVA and post hoc followed by Dunnett's t-test using IBM SPSS Statistics for Windows, Version 16 (Released 2007; IBM Corp., Armonk, New York, United States). Results Vickers surface hardness testing and EDAX analysis showed statistically significant values for all the groups. Among them, maximum remineralization potential was seen in samples treated with Chitosan and 3M Clinpro combination, and minimum remineralization potential was seen in Chitosan and artificial saliva combination. Conclusion The addition of chitosan nanoparticles with various remineralizing agents showed a significant synergistic effect on remineralization activity. Also, chitosan and Clinpro combination showed the maximum surface hardness and EDAX analysis values when compared to other groups.
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Affiliation(s)
- G Nandhini
- Conservative Dentistry and Endodontics, Chettinad Dental College & Research Institute, Chennai, IND
| | - Rajesh Sasidharan Nair
- Conservative Dentistry and Endodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, IND
| | | | - Rayar Sreeram
- Conservative Dentistry and Endodontics, Chettinad Dental College & Research Institute, Chennai, IND
| | - Nyklesh V
- Conservative Dentistry and Endodontics, Chettinad Dental College & Research Institute, Chennai, IND
| | - V S Swathi
- Conservative Dentistry and Endodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, IND
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3
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Chen H, Zhang J, Hill R, Baysan A. Evaluation of toothpastes for treating root carious lesions - a laboratory-based pilot study. BMC Oral Health 2024; 24:484. [PMID: 38649931 PMCID: PMC11036671 DOI: 10.1186/s12903-024-04061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 02/22/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Root caries is preventable and can be arrested at any stage of disease development. The aim of this study was to investigate the potential mineral exchange and fluorapatite formation within artificial root carious lesions (ARCLs) using different toothpastes containing 5,000 ppm F, 1,450 ppm F or bioactive glass (BG) with 540 ppm F. MATERIALS AND METHODS The crowns of each extracted sound tooth were removed. The remaining roots were divided into four parts (n = 12). Each sample was randomly allocated into one of four groups: Group 1 (Deionised water); Group 2 (BG with 540 ppm F); Group 3 (1,450 ppm F) and Group 4 (5,000 ppm F). ARCLs were developed using demineralisation solution (pH 4.8). The samples were then pH-cycled in 13 days using demineralisation solution (6 h) and remineralisation solution (pH 7) (16 h). Standard tooth brushing was carried out twice a day with the assigned toothpaste. X-ray Microtomography (XMT) was performed for each sample at baseline, following ARCL formation and after 13-day pH-cycling. Scanning Electron Microscope (SEM) and 19F Magic angle spinning nuclear magnetic resonance (19F-MAS-NMR) were also performed. RESULTS XMT results showed that the highest mineral content increase (mean ± SD) was Group 4 (0.09 ± 0.05), whilst the mineral content decreased in Group 1 (-0.08 ± 0.06) after 13-day pH-cycling, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4 (p < 0.05). SEM scans showed that mineral contents within the surface of dentine tubules were high in comparison to the subsurface in all toothpaste groups. There was evidence of dentine tubules being either partially or completely occluded in toothpaste groups. 19F-MAS-NMR showed peaks between - 103 and - 104ppm corresponding to fluorapatite formation in Groups 3 and 4. CONCLUSION Within the limitation of this laboratory-based study, all toothpastes were potentially effective to increase the mineral density of artificial root caries on the surface, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4.
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Affiliation(s)
- Haoran Chen
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Jiaxin Zhang
- Biochemical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Robert Hill
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aylin Baysan
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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4
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Tassery H, Miletic I, Turkun LS, Sauro S, Gurgan S, Banerjee A, Basso M, Khelafia S, Terrer E, Pilliol V, Slimani A. Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions. Br Dent J 2024; 236:603-610. [PMID: 38671111 DOI: 10.1038/s41415-024-7292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 04/28/2024]
Abstract
Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.
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Affiliation(s)
- Hervé Tassery
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France; LBN, Université de Montpellier, UR-UM104, Montpellier, France.
| | - Ivana Miletic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva ul. 5, 10000 Zagreb, Croatia
| | - Lezize Sebnem Turkun
- Department of Restorative Dentistry, Ege University School of Dentistry, Izmir 35040, Turkey
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, CEU Cardenal Herrera University, CEU Universities, 46115 Valencia, Spain; Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Avijit Banerjee
- Conservative and Minimally Invasive Dentistry, Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, SE1 9RT, UK
| | - Matteo Basso
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Saber Khelafia
- Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Elodie Terrer
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Virginie Pilliol
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Amel Slimani
- LBN, Université de Montpellier, UR-UM104, Montpellier, France; Faculté d'Odontologie, Université de Montpellier, 34193 Montpellier, France
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Mankar N, Kumbhare S, Nikhade P, Mahapatra J, Agrawal P. Role of Fluoride in Dentistry: A Narrative Review. Cureus 2023; 15:e50884. [PMID: 38249196 PMCID: PMC10799546 DOI: 10.7759/cureus.50884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024] Open
Abstract
Fluoride has performed a central role in the growth over the last fifty years. This report examines the present state of knowledge about fluoride's involvement in preventing dental caries. In recent years, our knowledge of the development of dental caries and the manner of operation of fluoride has been shifted. Dental caries is a constant procedure for enamel demineralization and remineralization, and fluoride plays an important part in this action by acting at the plaque-enamel contact. Fluoride's major method of action is now recognized as posteruptive. Fluoride's post-eruptive activity has led to the development of novel fluoride delivery systems. The importance of various fluoride delivery techniques on a population and societal level is discussed, along with suggestions.
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Affiliation(s)
- Nikhil Mankar
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Saloni Kumbhare
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Pradnya Nikhade
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Joyeeta Mahapatra
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Paridhi Agrawal
- Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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6
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Limacher S, Angst L, Srinivasan M. Amount of toothpaste used by dental students. J Oral Sci 2023; 65:214-218. [PMID: 37612066 DOI: 10.2334/josnusd.23-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE This study analyzed associations of cumulative learning, demographic characteristics, fluoride content, and toothbrush head size with the amount of toothpaste used by dental students. METHODS Students in the third and fifth year of dental school were recruited. Each participant was asked to dispense three toothpastes (pediatric, regular fluoride, and high fluoride) on five toothbrushes (rotation-oscillation, sonic, manual pediatric, and two manual adult toothbrushes). The length and weight of the toothpaste dispensed were recorded. The data were evaluated by nonparametric correlation analysis (P < 0.05). RESULTS Eighty-one students (third year = 42; fifth year = 39; mean age: 26.2 ± 5.3 years) participated in the study. More toothpaste was dispensed by third-year students than by fifth-year students (weight: P = 0.014; length: P = 0.037). Men dispensed more toothpaste than did women (weight: P < 0.001; length: P = 0.042). Participants with higher educational attainment dispensed less toothpaste (weight: P < 0.001; length: P < 0.001). The type of toothbrush was associated with the weight of toothpaste dispensed (P < 0.001). Toothbrush head size was inversely associated with the length of toothpaste dispensed (P < 0.001). CONCLUSION The amount of toothpaste used by dental students was associated with cumulative learning, educational attainment, sex, and toothbrush head size but not with the fluoride content of the toothpaste.
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Affiliation(s)
- Shekev Limacher
- Clinic for General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich
| | - Lea Angst
- Clinic for General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich
| | - Murali Srinivasan
- Clinic for General-, Special Care- and Geriatric Dentistry, Center of Dental Medicine, University of Zurich
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Staun Larsen L, Nyvad B, Baelum V. Salivary fluoride levels after daily brushing with 5000 ppm fluoride toothpaste: A randomised, controlled clinical trial. Eur J Oral Sci 2023; 131:e12934. [PMID: 37127433 DOI: 10.1111/eos.12934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
This study explored salivary fluoride levels following toothbrushing with 5000 and 1450 ppm fluoride toothpaste and determined the decline in salivary fluoride levels following the return from 5000 to 1450 ppm fluoride toothpaste. The study was a randomised, controlled double-blind parallel clinical trial (n = 24/group) measuring salivary fluoride five times during a 3-week trial phase involving 2×/day use of 5000 or 1450 ppm fluoride toothpaste, and five times during an ensuing 2-week wash-out phase where all participants used 1450 ppm toothpaste. Salivary fluoride was measured using a fluoride electrode and data were analysed using multilevel mixed-effects linear regression. Baseline salivary fluoride geometric means were 0.014 and 0.016 ppm for the 1450 and 5000 ppm groups, while the values at the end of the trial phase were 0.023 and 0.044 ppm, respectively. During the trial phase, except at baseline, differences between groups were statistically significant. The salivary fluoride levels for the 5000 ppm group remained statistically significantly higher than for the 1450 ppm group only at the first measurement in the wash-out phase (≈30 h after the last 5000 ppm brushing), indicating that higher salivary fluoride levels resulting from use of 5000 ppm are sustained only as long as the brushing habit continues.
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Affiliation(s)
- L Staun Larsen
- Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - B Nyvad
- Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - V Baelum
- Section for Oral Epidemiology and Public Health, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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8
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Chen H, Hill R, Baysan A. The effect of different concentrations of fluoride in toothpastes with or without bioactive glass on artificial root caries. J Dent 2023; 133:104499. [PMID: 36965858 DOI: 10.1016/j.jdent.2023.104499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/10/2023] [Accepted: 03/22/2023] [Indexed: 03/27/2023] Open
Abstract
OBJECTIVE To investigate the effect of different toothpastes either containing 5,000ppm-F, 1,450ppm-F or bioactive glass (BG) with 540ppm-F on artificial root carious lesions (ARCLs). METHOD The crowns of 23 extracted sound teeth were removed leaving their roots only. Subsequently, each root was divided into four parts. A total of 15 sound root dentine (SRD) was left untreated as baseline. The ARCLs were developed for the remaining roots using demineralisation solution (pH-4.8). 15-ARCLs samples were then left untreated. The rest of samples were divided into four groups (n=15 each) and treated with Group-1(BG with 540ppm-F); Group-2(5,000ppm-F); Group-3(1,450ppm-F) and Group-4(deionised water). 13-day pH-cycling included using demineralisation solution for 6hrs, then placing samples into remineralisation solution (pH-7) for 16hrs. Each sample was brushed with the assigned toothpaste twice a day during pH-cycling. Fluoride concentrations at each time point were measured using F-ISE, whilst calcium (Ca2+) and phosphorus (P) ion release was determined using ICP-OES, KHN, XRD, 19F-MAS-NMR analyses. RESULTS KHN showed significant surface changes for each group (p<0.001). The uptake of Ca2+ occurred at days 1-2, phosphorus ion loss was high when compared to the uptake in all groups. XRD showed presence of sharp diffraction lines evidencing apatite formation for Groups 1-3. 19F-MAS-NMR confirmed fluorapatite presence in Groups 1-3. CONCLUSION All toothpastes were promising in fluorapatite formation. BG with 540ppm-F toothpaste released more ions (Ca2+and P) and reharden the artificial root carious lesions when compared to other groups. However, 1,450ppm-F toothpaste showed more fluoride-substituted apatite formation whilst 5,000ppm-F toothpaste had more fluorapatite formation. CLINICAL SIGNIFICANCE Toothpaste containing BG with 540ppm-F, 5,000ppm-F and 1,450ppm-F toothpastes are likely to have a significant impact in reversing and arresting root caries. However, randomised controlled double-blinded clinical trials are required to translate these results into clinical practice.
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Affiliation(s)
- Haoran Chen
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Robert Hill
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Aylin Baysan
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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9
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Gibson G, Jones JA, Wehler CJ, Cabral HJ, Orner MB, Jurasic MM. Addressing the discrepancy between efficacy and effectiveness of 1.1% sodium fluoride toothpaste or gel in adults as part of a caries prevention program. J Am Dent Assoc 2023. [PMID: 36863992 DOI: 10.1016/j.adaj.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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10
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Hartshorn JE, Nair RU. Dental innovations which will influence the oral health care of baby boomers. SPECIAL CARE IN DENTISTRY 2023; 43:359-369. [PMID: 36782274 DOI: 10.1111/scd.12835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/13/2023] [Accepted: 01/27/2023] [Indexed: 02/15/2023]
Abstract
From the widespread use of smartphones and tablets to the multitude of applications available, older adults are showing an interest in utilizing technology to maintain their independence and to improve their quality of life. As technology continues to advance and be incorporated into many day-to-day activities, the baby boom generation will see these changes affecting the way they access and utilize dental services. Innovative toothbrushes and chemotherapeutics are continuing to be developed and utilized by many older adults. Within the dental office, older adults are seeing greater application of technology in every day dental procedures. These include the use of teledentistry, artificial intelligence (AI), innovative restorative materials, digitization of fixed and removable prosthodontics, cone beam computed tomography (CBCT) scans to guide dental implant placement and endodontic procedures. There is also new technology to aid in cancer detection and shielding during cancer treatment. Improved communication between the medical and dental fields has become increasingly necessary to facilitate effective patient care and a few innovative healthcare systems have begun to consolidate these services. Overall, the baby boom generation will continue to see dental innovations that will change the way they experience everyday life and dental services.
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Affiliation(s)
- Jennifer E Hartshorn
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
| | - Rohit U Nair
- Department of Preventive and Community Dentistry, The University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa, USA
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Pakdaman A, Gholizadeh N, Kharazifard MJ, Eshrati M. Clinical practice guideline adaptation for risk-based caries management in 18-55 year-old Iranian adults. BMC Oral Health 2023; 23:7. [PMID: 36609271 PMCID: PMC9824988 DOI: 10.1186/s12903-022-02699-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To adapt an evidence-based clinical practice guideline (CPG) for risk-based management of caries in 18-55 year-old Iranian adults. METHODS A multidisciplinary adaptation team reviewed evidence-based guidelines such as the NICE, SIGN, and ADA according to the defined clinical questions. In addition, databases such as the PubMed and Google Scholar were searched and CPGs were screened and appraised using the AGREE II (Appraisal of Guidelines for Research and Evaluation II) tool. Clinical scenarios were developed and their level of evidence, clinical advantage and adaptability were assessed. Following a two-round ranking by experts, the final recommendations were selected using the RAND-UCLA appropriateness method. RESULTS Of 17 CPGs, 5 were selected as the source guidelines for adaptation. To assess the risk of caries in the adult population, reduced Cariogram (without saliva tests) and CAMBRA were suggested as diagnostic tools. In addition, 53 risk-based recommendations on the preventive care (including the use of fluoride toothpaste, fluoride, and chlorhexidine mouthwash, at home and in-office fluoride gel, fluoride varnish, mouth buffering, and sealant), operative intervention threshold, and follow-up interval were adapted for Iranian adults. CONCLUSIONS A guideline was adapted for risk-based management of dental caries in Iranian adults. This helps local dentists in decision making and promoting oral health of adults. Further research is needed to assess the external validity and feasibility of the adapted guideline in the Iranian population.
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Affiliation(s)
- A. Pakdaman
- grid.411705.60000 0001 0166 0922Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - N. Gholizadeh
- grid.411705.60000 0001 0166 0922Oral and Maxillofacial Medicine Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M. J. Kharazifard
- grid.411705.60000 0001 0166 0922Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Eshrati
- grid.411705.60000 0001 0166 0922Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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12
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Larpbunphol N, Chanamuangkon T, Thamrongananskul N. The fluoride release, abrasion resistance, and cytotoxicity to hGFs of a novel cyanoacrylate-based fluoride varnish compared with conventional fluoride varnish. Dent Mater J 2022; 41:757-766. [PMID: 35793940 DOI: 10.4012/dmj.2022-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The important factors contributing to the effectiveness of fluoride varnish are the amount of fluoride ion release and the retention time of the varnish on the tooth surface. Commercial fluoride varnishes are susceptible to mechanical removal; therefore, patients are informed to avoid eating or performing oral hygiene for at least 12-24 h, which results in patient inconvenience. However, cyanoacrylate-based fluoride varnish would not have these disadvantages. This study compared the daily fluoride ion release, abrasion resistance to brushing, and toxicity to human gingival fibroblasts (hGFs) between a newly-developed cyanoacrylate-based fluoride varnish and conventional fluoride varnish (Duraphat varnish). The results demonstrated that the cyanoacrylate varnish had a significantly higher fluoride release for 9 days after application, higher abrasion resistance to brushing, and slightly less toxicity to hGFs compared with Duraphat varnish. This novel cyanoacrylate varnish could be an alternative fluoride varnish for preventing dental caries.
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13
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Leal J, Ferreira R, Santana G, Silva-Fialho P, Oliveira-Lima L, Vale G. Effect of high-fluoride dentifrice on root dentine de-remineralization exposed to erosion challenge in vitro. J Clin Exp Dent 2022; 14:e546-e549. [PMID: 35912031 PMCID: PMC9328482 DOI: 10.4317/jced.59091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/16/2022] [Indexed: 12/02/2022] Open
Abstract
Background High-fluoride dentifrice can be used to manage dental erosion; however, little is known about it effect on root dentine previously demineralized. This study evaluated the effect of high-fluoride treatment on dentin de/remineralization exposed to an erosion challenge in vitro.
Material and Methods Sound and demineralized dentine blocks were submitted to a 5-days-erosive challenge in soft drink (4/day during 90 s) and treated with fluoride solutions (0, 1,100, or 5,000 µg F/mL). After this, the percentage of surface hardness loss (%SHL) or recovery (%SHR) was calculated. Data were analyzed by one-way ANOVA and Tukey post hoc test with p fixed at 5%.
Results High-fluoride treatment was able to reduce dentine remineralization and increase mineral recovery of previously demineralized dentine compared to other treatments tested (p<0.05).
Conclusions High-fluoride treatment was able to increase the remineralization and reduce the demineralization of root dentine submitted to an erosive challenge in vitro, being an option for the erosion prevention/treatment. Key words:Fluorides, root caries, tooth erosion, toothpastes.
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Affiliation(s)
- José Leal
- Restorative Dentistry Department, Federal University of Piauí, Teresina, Brazil
| | - Robson Ferreira
- Restorative Dentistry Department, Federal University of Piauí, Teresina, Brazil
| | - Guilherme Santana
- Restorative Dentistry Department, Federal University of Piauí, Teresina, Brazil
| | - Paulo Silva-Fialho
- Restorative Dentistry Department, Federal University of Piauí, Teresina, Brazil
| | | | - Gláuber Vale
- Restorative Dentistry Department, Federal University of Piauí, Teresina, Brazil
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Kreher D, Korn V, Meißner T, Haak R, Schmalz G, Ziebolz D. How do carious root lesions develop after the end of professional preventive measures?—Preliminary findings of a randomized clinical trial. Odontology 2022; 110:805-813. [PMID: 35410411 PMCID: PMC9463297 DOI: 10.1007/s10266-022-00706-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/21/2022] [Indexed: 12/04/2022]
Abstract
Aim of this randomized clinical trial was to assess the development of root caries lesions with and without (adjuvant) professional prevention treatment over 24 months. 20 participants with two or three non-cavitated root carious lesions were included (n = 52), whereby lesions were randomly assigned to one out of three groups depending on varnish application (CF: Cervitec F [n = 20], P: placebo [n = 20], DP: Duraphate [n = 12]). All lesions were assessed by quantitative light-induced fluorescence (QLF; QRayCam); following outcome parameters were analyzed: fluorescence loss (ΔF %), lesion volume (ΔQ %µm2) and bacterial activity (ΔR %). Professional tooth cleaning and adjuvant varnish application were performed at baseline, after 3, 6, and 9 months. A follow-up examination was performed 1 year after preventive care with varnish application 24 months after baseline. ∆F showed a significant time effect in CF (p = 0.03), which was not confirmed in post hoc analysis (p > 0.05). For P and DP, no time effect was detected (p > 0.05). ∆Q was significantly higher 12 months after baseline in CF (p = 0.02). In P, a significant time effect occurred (p = 0.01), without significant results in post hoc testing. ∆R showed higher values at baseline vs. 12 months in CF (p = 0.03) and 24 months compared to 12 months in DP (p = 0.02). Professional preventive treatment inhibited the progression of root caries lesions beyond their termination for 12 months, irrespective of an adjunctive varnish application. Preventive measures have a long-term effect on root carious lesions, even 1 year after their termination.
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Affiliation(s)
- Deborah Kreher
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Viktoria Korn
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Thomas Meißner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103, Leipzig, Germany.
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Vale GC, Carvalho GAO, Hoogenkamp M, Exterkate R, Crielaard W, Ten Cate J. Effect of high-fluoride dentifrice on root dentine and bacterial composition in a multispecies biofilm model. BIOFOULING 2022; 38:348-354. [PMID: 35418275 DOI: 10.1080/08927014.2022.2065199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
The present study evaluated the effect of high-fluoride dentifrice on dentine demineralization and bacterial composition in a multispecies biofilm model in vitro. A seven-organism bacterial consortium was grown on bovine dentine discs in a high-throughput active attachment model. The biofilms were submitted twice per day to the following dentifrices treatments: 5,000 ppm F, 1,100 ppm F, with placebo as a negative control. After 5 days of biofilm growth, dentine samples were assessed by transversal microradiography, the biofilm was collected for bacterial counts and the pH of the media was determined. Lower integrated mineral loss values were observed when 5,000 ppm F-treatment was used compared to the other treatments. Overall microbiological counts decreased with increasing F-concentration as well the pH of the media throughout the experiment. The 5,000 ppm F-treatment caused a shift in microbial composition and reduced dentine demineralization in the in-vitro experimental model.
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Affiliation(s)
- Glauber Campos Vale
- Department of Restorative Dentistry, Federal University of Piaui, Teresina, Piauí, Brazil
| | | | - Michel Hoogenkamp
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Rob Exterkate
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Wim Crielaard
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
| | - Jacob Ten Cate
- Department of Preventive Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, The Netherlands
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A novel method quantifying caries following orthodontic treatment. Sci Rep 2021; 11:21347. [PMID: 34725354 PMCID: PMC8560919 DOI: 10.1038/s41598-021-00561-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/05/2021] [Indexed: 11/17/2022] Open
Abstract
This retrospective pilot study used a newly developed evaluation tool to assess the prevalence and incidence of White Spot Lesions (WSL) before and after multibracket appliance (MB) therapy. Digital photographs of 121 adolescent patients (63 ♂, 58 ♀) with metal brackets were analyzed retrospectively before and after MB therapy. The labial surfaces of anterior teeth, canine teeth, and premolars in the upper (UJ) and lower jaws (LJ) were evaluated using the Enamel Decalcification Index (EDI) by Banks and Richmond (Eur J Orthod, 16(1):19-25, 1994, levels 0-3) and a specially developed digitally scaled graticule with concentric circles to quantify the extent of WSL (in %). The statistical data analysis was based on crosstabulations and logistic regression. Before MB, 69.4% of the patients presented at least one WSL and 97.5% after, an increase of 28.1%. Before MB, 18.4% of the tooth surfaces (TS) showed an EDI level of 1-3. After MB, 51.8% of the TS featured WSL. 18.2% of the TS showed a WSL to the extent of ≥ 20-100% before and 52.3% after MB. The incidence in the UJ (71-79%) as well as the LJ (64-76%) was highest for the first and second premolars and lowest for LJ incisors (22-35%). The probability for developing a new distal WSL is higher than developing gingival, mesial or occlusal WSL. Labial MB therapy drastically increases the risk of developing WSL. We verified a concise quantification of the extent of labial WSL with the evaluation index.
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Sleibi A, Tappuni AR, Baysan A. Reversal of Root Caries with Casein Phosphopeptide-Amorphous Calcium Phosphate and Fluoride Varnish in Xerostomia. Caries Res 2021; 55:475-484. [PMID: 34352792 DOI: 10.1159/000516176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/28/2021] [Indexed: 11/19/2022] Open
Abstract
Different formulas of topical fluoride have been used to manage root carious lesions. This clinical trial aimed to investigate the efficacy of a dental varnish containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and fluoride compared with fluoride alone in reversing/arresting root caries in xerostomic patients over 1 year. A total of 80 patients (age range 45-92 years) with primary root caries (n = 184 root carious lesions) and unstimulated salivary flow rate of <0.2 mL/min were randomly allocated to receive either dental varnish containing CPP-ACP and 5% fluoride (group 1: MI varnish; GC, Japan) (n = 41, 83 lesions), or dental varnish with 5% fluoride alone (group 2: NUPRO White; Dentsply, USA) (n = 39, 101 lesions). Clinical assessments with Severity Index (SI) for root caries, DIAGNOdent measurements, and varnish application were carried out at baseline, 3, 6, and 12 months. Standard oral hygiene instructions with 1,450 ppm fluoride toothpastes were provided for both groups. After 3 months, 63.9% (n = 46) of root caries in group 1 became hard (SI: 0) compared with 39.3% (n = 35) in group 2 (p < 0.01). After 6 and 12 months, the differences in SI were insignificant (group 1, n = 60, 83.3%) (group 2, n = 66, 74.2%) (p = 0.36), and (group 1, n = 60, 89.6%) (group 2, n = 67, 81.7%, n = 1 soft, 1.2%) (p = 0.29), respectively. In both groups, noncavitated leathery lesions were more likely to become hard when compared to the cavitated root caries. A significant decrease in plaque index, surface roughness, lesion dimension, and DIAGNOdent readings with a significant increase in lesion distance from the gingival margin was reported in both groups (p < 0.05). This study has provided evidence that fluoride dental varnish either with or without calcium and phosphate has the potential to arrest/reverse root caries, especially noncavitated lesions for patients with xerostomia.
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Affiliation(s)
- Ahmed Sleibi
- Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, UK,
| | - Anwar R Tappuni
- Centre for Oral Immunobiology and Regenerative Medicine, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Aylin Baysan
- Oral Bioengineering, Institute of Dentistry, Queen Mary University of London, London, UK
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Amaechi BT, Phillips TS, Evans V, Ugwokaegbe CP, Luong MN, Okoye LO, Meyer F, Enax J. The Potential of Hydroxyapatite Toothpaste to Prevent Root Caries: A pH-Cycling Study. Clin Cosmet Investig Dent 2021; 13:315-324. [PMID: 34321930 PMCID: PMC8312331 DOI: 10.2147/ccide.s319631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 07/08/2021] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The effectiveness of a hydroxyapatite (HAP) toothpaste and a fluoride toothpaste in preventing root tissue demineralization (root caries) was compared using an established pH-cycling caries model. MATERIALS AND METHODS Sixty dentin blocks were produced from the root tissue of extracted human teeth and were assigned to 3 test groups (n=20/group): 10% hydroxyapatite toothpaste (HAP), 1450 ppm fluoride toothpaste (fluoride), and artificial saliva (artsaliva). Early root caries lesions were developed in each sample by 7-day demineralization using a pH-cycling caries model. The daily cyclic treatment regimen consists of two 2-minute toothpaste-slurry treatment periods, one 6-hour acid challenge using acidified gel (pH 4.5), and then storage in remineralizing solution (artsaliva) for the rest of the time. Demineralization was assessed as the amount of mineral loss (∆z) using transverse microradiography (TMR). Pairwise comparisons (between treatments) were performed using analysis of variance (ANOVA), and then Tukey's HSD for multiple comparisons. All p-values are considered significant if p<0.05. RESULTS Both ANOVA and Tukey's HSD indicated no significant (ANOVA; n=20) difference in mean ∆z among the groups, with least ∆z (±Sd) in the HAP (1117±366) compared to fluoride (1392±334) and artsaliva (1406±223). Relative to control, HAP and fluoride inhibited root demineralization by 21% and 6%, respectively. CONCLUSION Within the limit of the present study, the tested toothpaste containing 10% HAP is an effective root caries control toothpaste. Toothpaste containing 10% HAP was slightly more effective in preventing tooth demineralization than 1450 ppm fluoride provided as sodium fluoride. Thus, this study shows that HAP toothpastes can serve as an effective alternative to fluoride toothpastes for root caries management.
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Affiliation(s)
- Bennett Tochukwu Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | - Thais Santiago Phillips
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | - Veronica Evans
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | | | - Minh Nguyet Luong
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, 78229-3900, USA
| | - Linda Oge Okoye
- Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
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AlQranei MS, Balhaddad AA, Melo MAS. The burden of root caries: Updated perspectives and advances on management strategies. Gerodontology 2020; 38:136-153. [PMID: 33236462 DOI: 10.1111/ger.12511] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/26/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Root caries has gained much attention in the last few years. As the world's population is ageing and people currently tend to retain more teeth compared with older generations, there is an increased prevalence of periodontal disease and gingival recession, which may accelerate the onset of root caries. OBJECTIVE This review aims to summarise recent findings related to the diagnosis, prevention and treatment of root caries. MATERIALS AND METHODS MEDLINE (OVID) and Scopus (Elsevier) searches were performed to identify and discuss articles that address the pathogenicity and clinical management of root caries. RESULTS Root caries is a multifactorial disease. Cariogenic species involved in root caries are less dependent on carbohydrates since collagen degradation inside the dentinal tubules can provide nutrients and microcavities for the invading microorganisms. Furthermore, the root surface has fewer minerals in comparison with enamel, which may accelerate the onset of demineralisation. Root caries could be prevented by patient education, modification of risk factors, and the use of in-office and home remineralisation tools. The use of non-invasive approaches to control root caries is recommended, as the survival rate of root caries restorations is poor. When plaque control is impossible and a deep/large cavity is present, glass ionomer or resin-based restorations can be placed. CONCLUSION The assessment of root carious lesions is critical to determine the lesion activity and the required intervention. Dental practitioners should also be aware of different prevention and treatment approaches to design optimum oral health care for root caries-affected patients.
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Affiliation(s)
- Mohammed S AlQranei
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdulrahman A Balhaddad
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mary A S Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland Dental School, Baltimore, MD, USA
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20
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Shiiya T, Kataoka A, Tomiyama K, Fujino F, Mukai Y. Anti-demineralization characteristics of surface pre-reacted glass-ionomer (S-PRG) filler-containing varnishes. Dent Mater J 2020; 40:416-421. [PMID: 33177310 DOI: 10.4012/dmj.2019-396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study investigated the anti-demineralization effects of surface pre-reacted glass-ionomer (S-PRG) filler-containing varnishes. Thirty-five bovine root specimens were divided into five treatment groups, with seven specimens each coated with 1) MI varnish (MIV), 2) F varnish (FV), 3) PRG varnish I (PV), 4) PRG varnish II (with sodium fluoride added, PVF), and 5) acid-resistant nail varnish (Control). A 3×1 mm area of the dentin surface adjacent to each varnish was demineralized for one week at 37°C. Integrated mineral loss (IML) of these lesions was determined by transverse microradiography, as was the amount of fluoride released by each material. IML was significantly lower in the PV and PVF groups than in the Control group, and was significantly lower in the PVF than in the MIV and FV groups. These findings indicated that S-PRG filler-containing varnishes, especially varnish containing sodium fluoride, had superior anti-demineralization effects on root dentin.
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Affiliation(s)
- Toru Shiiya
- Division of Restorative Dentistry, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University
| | - Aiko Kataoka
- Department of Dental Hygiene, Junior College, Kanagawa Dental University
| | - Kiyoshi Tomiyama
- Division of Restorative Dentistry, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University
| | - Fukue Fujino
- Department of Dental Hygiene, Junior College, Kanagawa Dental University
| | - Yoshiharu Mukai
- Division of Restorative Dentistry, Department of Oral Interdisciplinary Medicine, Graduate School of Dentistry, Kanagawa Dental University
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Abstract
Objectives To define an expert Delphi consensus on when to intervene in the caries process and existing carious lesions.Methods Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference.Results Lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations may be placed for form, function, aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated lesions which are cleansable. Cavitated lesions which are not cleansable usually require minimally invasive management. In specific circumstances, mixed interventions may be applicable. Occlusally, cavitated lesions confined to enamel/non-cavitated lesions extending radiographically into deep dentine may be exceptions. Proximally, cavitation is hard to assess tactile-visually. Most lesions extending radiographically into the middle/inner third of dentine are assumed to be cavitated. Those restricted to the enamel are not cavitated. For lesions extending radiographically into the outer third of dentine, cavitation is unlikely. These lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds.Conclusions Comprehensive diagnosis is the basis for systematic decision-making on when to intervene in the caries process and existing lesions.
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Miyaji H, Kato A, Tanaka S. Suppression of root caries progression by application of Nanoseal ®: A single-blind randomized clinical trial. Dent Mater J 2020; 39:444-448. [PMID: 31969547 DOI: 10.4012/dmj.2019-038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this single-blind, parallel and randomized controlled trial was to evaluate the effect of Nanoseal® application on root caries progression. Adult patients (n=129, mean age: 66.4±10.1 years) with root caries were randomly allocated into three groups: high-frequency (HF, n=43; intervention: Nanoseal application at baseline and 1-5 months), low-frequency (LF, n=43; intervention: Nanoseal application at baseline and 3 months), and control (n=43; intervention: no application of Nanoseal) groups. Measurements of fluorescence laser values of carious lesions using a DIAGNOdent™ Pen (D-value) were performed for each subject before intervention (baseline) and at 3 and 6 months. Significantly lower D-values for the HF (p=0.017) and LF (p=0.034) groups were observed compared with the control group at 6 months. Nanoseal application would be an effective procedure to suppress root caries progression.
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Affiliation(s)
- Hirofumi Miyaji
- Clinic of Endodontics and Periodontics, Hokkaido University Hospital
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University
| | - Akihito Kato
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University
| | - Saori Tanaka
- Department of Periodontology and Endodontology, Faculty of Dental Medicine, Hokkaido University
- Division of General Dentistry Center for Dental Clinics, Hokkaido University Hospital
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Kim JH, Kim DH, Baik SY, Lee YP. Pain control and early wound healing effect using sitz bath with ozonised water after haemorrhoidectomy. J Wound Care 2020; 29:289-294. [PMID: 32421480 DOI: 10.12968/jowc.2020.29.5.289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Studies have shown that ozone in an aqueous state on a scar, because of its antibacterial effect, aids wound-healing. This study aimed to compare the pain control effect, based on the time to wound healing, of using a sitz bath with ozonised water with that of using a sitz bath with ordinary tap water in patients who have had a haemorrhoidectomy. METHOD Patients were divided into two equal-sized groups: Group O used a sitz bath with ozonised water after haemorrhoidectomy and patients in Group T used a sitz bath with ordinary tap water. Different concentrations (1ppm, 2ppm and 4ppm) of ozonized water were tested to determine their bactericidal activities. Pain levels were measured using the Visual Analogue Scale (ranging from 0-10 where 0 is 'no pain' and 10 is 'unbearable pain'), on days two, three and seven. Cohort analysis was retrospectively performed on the prospectively randomised collected data for this study. RESULTS A total of 80 patients participated in the study. No case showed any signs of bacterial growth. On postoperative day seven, patients in Group O showed a significantly lower pain level than those in Group T (1.35±0.48 versus 2.40±0.9; p<0.001). The time needed for anus scars to be completely healed was significantly shorter for Group O than that for Group T (2.75±0.63 weeks versus 3.85±0.80 weeks; p<0.001). CONCLUSION The results of this study showed that using a sitz bath with ozonised water reduced pain and accelerated healing in patients who have had a haemorrhoidectomy.
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Affiliation(s)
- Joo Hyung Kim
- Department of Surgery, Ajou University School of Medicine, 164 World cup-ro, Yeongtong-gu, Suwon, Gyeonggi-do 16499, Republic of Korea
| | - Dae Hyun Kim
- Department of Health Services Administration, University of Alabama at Birmingham 1720, 2nd Ave S, Birmingham, AL, 35294, US
| | - Sae Yun Baik
- Department of Laboratory Medicine, Seoul Clinical Laboratories, A-dong, Heungdok IT valley 13, Heungdeok 1-ro, Giheung-gu, Yongin, 16954, Republic of Korea
| | - Yong Pyo Lee
- Department of Surgery, Hanvit Hospital, 1017 Gyeongsu-daero, Jangan-gu, Suwon, Gyeonggi-do 16300, Republic of Korea
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Lo Giudice R, Lipari F, Puleio F, Alibrandi A, Lo Giudice F, Tamà C, Sazonova E, Lo Giudice G. Spectrophotometric Evaluation of Enamel Color Variation Using Infiltration Resin Treatment of White Spot Lesions at One Year Follow-Up. Dent J (Basel) 2020; 8:E35. [PMID: 32290119 PMCID: PMC7344573 DOI: 10.3390/dj8020035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 11/29/2022] Open
Abstract
The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.
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Affiliation(s)
- Roberto Lo Giudice
- Department of Clinical and Experimental Medicine, Messina University, 98100 Messina, Italy
| | - Frank Lipari
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Francesco Puleio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Angela Alibrandi
- Department of Economics, Section of Statistical and Mathematical Sciences, Messina University, 98100 Messina, Italy;
| | - Fabrizio Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Cristina Tamà
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Evgenia Sazonova
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
| | - Giuseppe Lo Giudice
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Messina University, 98100 Messina, Italy; (F.L.); (F.P.); (F.L.G.); (C.T.); (E.S.); (G.L.G.)
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Ding L, Han S, Wang K, Zheng S, Zheng W, Peng X, Niu Y, Li W, Zhang L. Remineralization of enamel caries by an amelogenin-derived peptide and fluoride in vitro. Regen Biomater 2020; 7:283-292. [PMID: 32523730 PMCID: PMC7266664 DOI: 10.1093/rb/rbaa003] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 12/29/2019] [Accepted: 01/17/2020] [Indexed: 02/06/2023] Open
Abstract
Dental caries is one of the most common oral diseases in the world. This study was tantamount to investigate the combinatory effects of an amelogenin-derived peptide (called QP5) and fluoride on the remineralization of artificial enamel caries. The peptide QP5 was synthesized and characterized, and the binding capability of the peptide on hydroxyapatite (HA) and demineralized tooth enamel surface was analysed. Then, the mineralization function of the peptide and fluoride was studied through the spontaneous mineralization testing and remineralization on enamel caries in vitro. First, the novel peptide QP5 could bind on the hydroxyapatite and demineralized tooth enamel surfaces. Second, QP5 can transitorily stabilize the formation of amorphous calcium phosphate and direct the transformation into hydroxyapatite crystals alone and in combination with fluoride. In addition, compared to blocks treated by peptide QP5 alone or fluoride, the sample blocks showed significantly higher surface microhardness, lower mineral loss and shallower lesion depth after treatment with a combination of QP5 and fluoride at high or low concentrations. The peptide QP5 could control the crystallization of hydroxyapatite, and combinatory application of peptide QP5 and fluoride had a potential synergistic effect on the remineralization of enamel caries.
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Affiliation(s)
- Longjiang Ding
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sili Han
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Kun Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Sainan Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenyue Zheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiu Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yumei Niu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Linglin Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Dental caries following radiotherapy for head and neck cancer: A systematic review. Oral Oncol 2020; 100:104484. [DOI: 10.1016/j.oraloncology.2019.104484] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 02/07/2023]
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de Amoêdo Campos Velo MM, Agulhari MAS, Rios D, Magalhães AC, Honório HM, Wang L. Root caries lesions inhibition and repair using commercial high-fluoride toothpastes with or without tri-calcium phosphate and conventional toothpastes containing or not 1.5% arginine CaCO3: an in situ investigation. Clin Oral Investig 2019; 24:2295-2304. [DOI: 10.1007/s00784-019-03084-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 09/22/2019] [Indexed: 01/23/2023]
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Slayton RL, Urquhart O, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, Nový BB, Tinanoff N, Weyant RJ, Wolff MS, Young DA, Zero DT, Tampi MP, Pilcher L, Banfield L, Carrasco-Labra A. Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. J Am Dent Assoc 2019; 149:837-849.e19. [PMID: 30261951 DOI: 10.1016/j.adaj.2018.07.002] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 06/22/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults. TYPES OF STUDIES REVIEWED The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane database of systematic reviews to identify randomized controlled trials reporting on nonrestorative treatments for noncavitated and cavitated carious lesions. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions. RESULTS The expert panel formulated 11 clinical recommendations, each specific to lesion type, tooth surface, and dentition. Of the most effective interventions, the panel provided recommendations for the use of 38% silver diamine fluoride, sealants, 5% sodium fluoride varnish, 1.23% acidulated phosphate fluoride gel, and 5,000 parts per million fluoride (1.1% sodium fluoride) toothpaste or gel, among others. The panel also provided a recommendation against the use of 10% casein phosphopeptide-amorphous calcium phosphate. CONCLUSIONS AND PRACTICAL IMPLICATIONS Although the recommended interventions are often used for caries prevention, or in conjunction with restorative treatment options, these approaches have shown to be effective in arresting or reversing carious lesions. Clinicians are encouraged to prioritize use of these interventions based on effectiveness, safety, and feasibility.
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Talwar M, Borzabadi-Farahani A, Lynch E, Borsboom P, Ruben J. Remineralization of Demineralized Enamel and Dentine Using 3 Dentifrices-An InVitro Study. Dent J (Basel) 2019; 7:E91. [PMID: 31480726 PMCID: PMC6784461 DOI: 10.3390/dj7030091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/05/2019] [Accepted: 07/19/2019] [Indexed: 11/16/2022] Open
Abstract
Objectives: To monitor the electrical resistance of artificially demineralized enamel and root dentine after exposure to different fluoridated dentifrices and, using transversal microradiography, to quantify remineralization. Materials and methods: This in-vitro blind investigation used 20 extracted teeth (four groups of five each). Each group was exposed to one test dentifrice [Colgate PreviDent (5000 ppm F), Colgate Winterfresh gel (1100 ppm F), Fluocaril Bi-Fluoré (2500 ppm F) and placebo (without fluoride)] three times daily for three minutes for 4 weeks. In between exposure to the test dentifrices, teeth were stored in a saliva storage solution. An Electrical Caries Monitor measured the electrical resistance at baseline and during the four-week test period at weekly intervals. The measurements were log transformed and Duncan's multiple range test applied. Remineralization was quantified using transversal microradiography. Results: Log mean (SD) electronic carries monitor (ECM) measurements in enamel at baseline and after 4 weeks of exposure to the test dentifrices were 4.07(1.53) and 3.87(0.90) (Placebo-Fluocaril), 4.11(1.86) and 4.64(1.43) (Colgate Winterfresh gel), 4.81(0.9) and 4.21(1.20) (Fluocaril Bi-Fluoré), and 4.60(0.88) and 3.76(0.9) (Colgate PreviDent). Corresponding measurements in dentine were 2.13(0.89) and 3.06(0.87) (Placebo-Fluocaril), 1.87(0.63) and 2.88(1.32) (Colgate Winterfresh gel), 2.47(1.20) and 1.65(0.60) (Fluocaril), and 2.16(0.00), and 2.34(1.07) for Colgate PreviDent. Lesion depth (µm) after microradiography in enamel was 100.1 (Placebo), 50.6 (Colgate Winterfresh gel), and 110.2 (Fluocaril, and 97.1 (Colgate PreviDent), and corresponding values in dentine were 169.7, 154.8, 183.7, and 153.5. The correlation of ECM and microradiographic parameters was negative (p < 0.05). Conclusion: Exposure of artificially demineralized enamel and root dentine to fluoridated dentifrices and saliva storage solution resulted in remineralization as follows: Colgate Winterfresh > Colgate PreviDent > Placebo-Fluocaril > Fluocaril Bi-Fluoré. Remineralization in teeth of the Placebo dentifrice group may be attributed to the presence of calcium and phosphate ions in the saliva storage solution.
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Affiliation(s)
- Manjit Talwar
- Oral Health Centre Government Medical College & Hospital, Sector 32, Chandigarh 160047, India
| | - Ali Borzabadi-Farahani
- Orthodontics, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00183 Rome, Italy.
- Finchley Orthodontics, North Finchley, London N12 9EN, UK.
| | - Edward Lynch
- Biomedical and Clinical Research, School of Dental Medicine, University of Nevada (UNLV), 1001 Shadow Lane, Las Vegas, NV 89106-4124, USA
| | - Peter Borsboom
- Department of Oral and Maxillofacial Surgery, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands
| | - Jan Ruben
- Department of Dentistry, Preventive and Restorative Dentistry, Radboud University Medical Center, Philips van Leijdenlaan 25, 6525 EX Nijmegen, The Netherlands
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Schwendicke F, Splieth C, Breschi L, Banerjee A, Fontana M, Paris S, Burrow MF, Crombie F, Page LF, Gatón-Hernández P, Giacaman R, Gugnani N, Hickel R, Jordan RA, Leal S, Lo E, Tassery H, Thomson WM, Manton DJ. When to intervene in the caries process? An expert Delphi consensus statement. Clin Oral Investig 2019; 23:3691-3703. [PMID: 31444695 DOI: 10.1007/s00784-019-03058-w] [Citation(s) in RCA: 91] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 08/08/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. METHODS Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. RESULTS Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds. CONCLUSIONS Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions. CLINICAL RELEVANCE Carious lesion activity, cavitation and cleansability determine intervention thresholds. Invasive treatments should be applied restrictively and with these factors in mind.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Christian Splieth
- Preventive & Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna-Alma Mater Studiorum, Bologna, Italy
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's Health Partners, King's College London, London, UK
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Michael F Burrow
- Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Felicity Crombie
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Lyndie Foster Page
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Patricia Gatón-Hernández
- Department of Dentistry, University of Barcelona, Barcelona, Spain
- Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Giacaman
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Talca, Chile
| | - Neeraj Gugnani
- Department of Pediatric and Preventive Dentistry, DAV (C) Dental College, Yamunanagar, Haryana, India
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | | | - Soraya Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Edward Lo
- Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Hervé Tassery
- Faculty of Dentistry, AMU University, Marseille, France
| | - William Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - David J Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
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Meyer-Lueckel H, Machiulskiene V, Giacaman RA. How to Intervene in the Root Caries Process? Systematic Review and Meta-Analyses. Caries Res 2019; 53:599-608. [PMID: 31412343 DOI: 10.1159/000501588] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 06/12/2019] [Indexed: 11/19/2022] Open
Abstract
The aim of this review as part of the preparation for a workshop organized by the European Federation of Conservative Dentistry (EFCD) in conjunction with the European Organisation for Caries Research (ORCA) was to systematically analyze available evidence of non-, micro- as well as invasive interventions for root caries lesions (RCLs). For each treatment strategy, a separate systematic review was either performed (micro-invasive and choice of restorative material) or updated (non-invasive and excavation technique) each of them following PRISMA guidelines, and if possible meta-analyses were performed. Besides the general advice to improve tooth brushing with fluoride toothpaste main findings for non-invasive interventions in RCLs, the use of dentifrices containing 5,000 ppm F- as well as professionally applied chlorhexidine varnish or silver diamine fluoride seemed to be more efficacious to arrest root caries compared to conventional fluoride toothpaste or placebo respectively. However, this conclusion is based only on a few randomized clinical trials. For micro-invasive treatments, only 2 studies focusing on sealants were available without clear conclusions. A recent review on the comparison of atraumatic restorative treatment compared with conventional treatment concluded that there is insufficient data to clearly rule out if any difference with regard to restoration longevity between both techniques exists. When restoring coventionally, composites performed better than resin-modified and glass ionomer cements. However, all materials showed rather high annual failure rates in the majority of the studies and evidence is based on a low number of prospective studies with a rather high risk of bias.
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Affiliation(s)
- Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland,
| | - Vita Machiulskiene
- Clinic of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rodrigo A Giacaman
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Talca, Chile
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32
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High fluoride dentifrice for preventing and arresting root caries in community-dwelling older adults: A randomized controlled clinical trial. J Dent 2019; 86:110-117. [DOI: 10.1016/j.jdent.2019.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 01/14/2023] Open
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Vale G, Simões N, Santana G, Mota B, Moura M. Gastrointestinal Absorption and Renal Excretion of Fluoride After Ingestion of a High-Fluoride Dentifrice. Biol Trace Elem Res 2019; 190:24-29. [PMID: 30203224 DOI: 10.1007/s12011-018-1511-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
Abstract
This study aimed to evaluate the gastrointestinal absorption and renal excretion of fluoride after the ingestion of high-fluoride dentifrice. Twelve volunteers participated in this in vivo, crossover, and blinded study. In three experimental phases, the volunteers were randomly assigned to one of three treatment groups, who ingested either the following: distilled and deionized water (control), conventional dentifrice (1100 μg/g), or high-fluoride dentifrice (5000 μg/g). Both dentifrices contained fluoride in the form of NaF/SiO2. To determine the rate of fluoride absorption, non-stimulated saliva was collected for up to 120 min after ingestion and the area under the curve of the salivary fluoride concentration was plotted as a function of time and the maximum concentration determined. All urine produced during the 24 h before and after ingestion was collected, and urinary excretion was calculated from the difference between the urinary fluoride concentrations in the two periods. A specific ion electrode coupled to an ion analyzer was used to measure fluoride concentrations. Statistical analysis was performed by ANOVA followed by Tukey's test with p set at 5%. All measured parameters were highest after the ingestion of the dentifrice with 5000 μg/g (p < 0.001), confirming that this has an increased level of bioavailable fluoride compared with the conventional dentifrice. The high-fluoride dentifrice increases the concentration of salivary fluoride, which may explain its greater anticaries effect. However, it poses a potential risk of causing dental fluorosis and so should not be used by children.
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Affiliation(s)
- Glauber Vale
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil.
| | - Nícolas Simões
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil
| | - Guilherme Santana
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil
| | - Brenda Mota
- Department of Restorative Dentistry, Federal University of Piaui, Campus Universitário Ministro Petrônio Portella - SG 10, Bairro Ininga, Teresina, Piauí, 64049-550, Brazil
| | - Marcoeli Moura
- Department of Pathology and Dental Clinic, University of Piauí, Teresina, Piauí, Brazil
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Tickle M, Ricketts DJN, Duncan A, O’Malley L, Donaldson PM, Clarkson JE, Black M, Boyers D, Donaldson M, Floate R, Forrest MM, Fraser A, Glenny AM, Goulao B, McDonald A, Ramsay CR, Ross C, Walsh T, Worthington HV, Young L, Bonetti DL, Gouick J, Mitchell FE, Macpherson LE, Lin YL, Pretty IA, Birch S. Protocol for a Randomised controlled trial to Evaluate the effectiveness and cost benefit of prescribing high dose FLuoride toothpaste in preventing and treating dEntal Caries in high-risk older adulTs (reflect trial). BMC Oral Health 2019; 19:88. [PMID: 31126270 PMCID: PMC6534863 DOI: 10.1186/s12903-019-0749-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental caries in the expanding elderly, predominantly-dentate population is an emerging public health concern. Elderly individuals with heavily restored dentitions represent a clinical challenge and significant financial burden for healthcare systems, especially when their physical and cognitive abilities are in decline. Prescription of higher concentration fluoride toothpaste to prevent caries in older populations is expanding in the UK, significantly increasing costs for the National Health Services (NHS) but the effectiveness and cost benefit of this intervention are uncertain. The Reflect trial will evaluate the effectiveness and cost benefit of General Dental Practitioner (GDP) prescribing of 5000 ppm fluoride toothpaste and usual care compared to usual care alone in individuals 50 years and over with high-risk of caries. METHODS/DESIGN A pragmatic, open-label, randomised controlled trial involving adults aged 50 years and above attending NHS dental practices identified by their dentist as having high risk of dental caries. Participants will be randomised to prescription of 5000 ppm fluoride toothpaste (frequency, amount and duration decided by GDP) and usual care only. 1200 participants will be recruited from approximately 60 dental practices in England, Scotland and Northern Ireland and followed up for 3 years. The primary outcome will be the proportion of participants receiving any dental treatment due to caries. Secondary outcomes will include coronal and root caries increments measured by independent, blinded examiners, patient reported quality of life measures, and economic outcomes; NHS and patient perspective costs, willingness to pay, net benefit (analysed over the trial follow-up period and modelled lifetime horizon). A parallel qualitative study will investigate GDPs' practises of and beliefs about prescribing the toothpaste and patients' beliefs and experiences of the toothpaste and perceived impacts on their oral health-related behaviours. DISCUSSION The Reflect trial will provide valuable information to patients, policy makers and clinicians on the costs and benefits of an expensive, but evidence-deficient caries prevention intervention delivered to older adults in general dental practice. TRIAL REGISTRATION ISRCTN: 2017-002402-13 registered 02/06/2017, first participant recruited 03/05/2018. Ethics Reference No: 17/NE/0329/233335. Funding Body: Health Technology Assessment funding stream of National Institute for Health Research. Funder number: HTA project 16/23/01. Trial Sponsor: Manchester University NHS Foundation Trust, Oxford Road, Manchester, M13 9WL. The Trial was prospectively registered.
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Affiliation(s)
- M. Tickle
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
| | | | - A. Duncan
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, Scotland, UK
| | - L. O’Malley
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
| | - P. M. Donaldson
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - J. E. Clarkson
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - M. Black
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - D. Boyers
- Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
| | - M. Donaldson
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
- Northern Ireland Health & Social Care Board, Belfast, Northern Ireland
| | - R. Floate
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - M. M. Forrest
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, Scotland, UK
| | - A. Fraser
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, Scotland, UK
| | - A. M. Glenny
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
| | - B. Goulao
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, Scotland, UK
| | - A. McDonald
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, Scotland, UK
| | - C. R. Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - C. Ross
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - T. Walsh
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
| | - H. V. Worthington
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
| | - L. Young
- NHS Education for Scotland, Edinburgh, Scotland, UK
| | - D. L. Bonetti
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - J. Gouick
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - F. E. Mitchell
- School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | | | - Y. L. Lin
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
| | - I. A. Pretty
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
| | - S. Birch
- Division of Dentistry, University of Manchester, Coupland 3 Building, Oxford Road,M13 9PL, Manchester, UK
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
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Walsh T, Worthington HV, Glenny A, Marinho VCC, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 2019; 3:CD007868. [PMID: 30829399 PMCID: PMC6398117 DOI: 10.1002/14651858.cd007868.pub3] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Caries (dental decay) is a disease of the hard tissues of the teeth caused by an imbalance, over time, in the interactions between cariogenic bacteria in dental plaque and fermentable carbohydrates (mainly sugars). Regular toothbrushing with fluoride toothpaste is the principal non-professional intervention to prevent caries, but the caries-preventive effect varies according to different concentrations of fluoride in toothpaste, with higher concentrations associated with increased caries control. Toothpastes with higher fluoride concentration increases the risk of fluorosis (enamel defects) in developing teeth. This is an update of the Cochrane Review first published in 2010. OBJECTIVES To determine and compare the effects of toothpastes of different fluoride concentrations (parts per million (ppm)) in preventing dental caries in children, adolescents, and adults. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 August 2018); the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 7) in the Cochrane Library (searched 15 August 2018); MEDLINE Ovid (1946 to 15 August 2018); and Embase Ovid (1980 to 15 August 2018). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials (15 August 2018). No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised controlled trials that compared toothbrushing with fluoride toothpaste with toothbrushing with a non-fluoride toothpaste or toothpaste of a different fluoride concentration, with a follow-up period of at least 1 year. The primary outcome was caries increment measured by the change from baseline in the decayed, (missing), and filled surfaces or teeth index in all permanent or primary teeth (D(M)FS/T or d(m)fs/t). DATA COLLECTION AND ANALYSIS Two members of the review team, independently and in duplicate, undertook the selection of studies, data extraction, and risk of bias assessment. We graded the certainty of the evidence through discussion and consensus. The primary effect measure was the mean difference (MD) or standardised mean difference (SMD) caries increment. Where it was appropriate to pool data, we used random-effects pairwise or network meta-analysis. MAIN RESULTS We included 96 studies published between 1955 and 2014 in this updated review. Seven studies with 11,356 randomised participants (7047 evaluated) reported the effects of fluoride toothpaste up to 1500 ppm on the primary dentition; one study with 2500 randomised participants (2008 evaluated) reported the effects of 1450 ppm fluoride toothpaste on the primary and permanent dentition; 85 studies with 48,804 randomised participants (40,066 evaluated) reported the effects of toothpaste up to 2400 ppm on the immature permanent dentition; and three studies with 2675 randomised participants (2162 evaluated) reported the effects of up to 1100 ppm fluoride toothpaste on the mature permanent dentition. Follow-up in most studies was 36 months.In the primary dentition of young children, 1500 ppm fluoride toothpaste reduces caries increment when compared with non-fluoride toothpaste (MD -1.86 dfs, 95% confidence interval (CI) -2.51 to -1.21; 998 participants, one study, moderate-certainty evidence); the caries-preventive effects for the head-to-head comparison of 1055 ppm versus 550 ppm fluoride toothpaste are similar (MD -0.05, dmfs, 95% CI -0.38 to 0.28; 1958 participants, two studies, moderate-certainty evidence), but toothbrushing with 1450 ppm fluoride toothpaste slightly reduces decayed, missing, filled teeth (dmft) increment when compared with 440 ppm fluoride toothpaste (MD -0.34, dmft, 95%CI -0.59 to -0.09; 2362 participants, one study, moderate-certainty evidence). The certainty of the remaining evidence for this comparison was judged to be low.We included 81 studies in the network meta-analysis of D(M)FS increment in the permanent dentition of children and adolescents. The network included 21 different comparisons of seven fluoride concentrations. The certainty of the evidence was judged to be low with the following exceptions: there was high- and moderate-certainty evidence that 1000 to 1250 ppm or 1450 to 1500 ppm fluoride toothpaste reduces caries increments when compared with non-fluoride toothpaste (SMD -0.28, 95% CI -0.32 to -0.25, 55 studies; and SMD -0.36, 95% CI -0.43 to -0.29, four studies); there was moderate-certainty evidence that 1450 to 1500 ppm fluoride toothpaste slightly reduces caries increments when compared to 1000 to 1250 ppm (SMD -0.08, 95% CI -0.14 to -0.01, 10 studies); and moderate-certainty evidence that the caries increments are similar for 1700 to 2200 ppm and 2400 to 2800 ppm fluoride toothpaste when compared to 1450 to 1500 ppm (SMD 0.04, 95% CI -0.07 to 0.15, indirect evidence only; SMD -0.05, 95% CI -0.14 to 0.05, two studies).In the adult permanent dentition, 1000 or 1100 ppm fluoride toothpaste reduces DMFS increment when compared with non-fluoride toothpaste in adults of all ages (MD -0.53, 95% CI -1.02 to -0.04; 2162 participants, three studies, moderate-certainty evidence). The evidence for DMFT was low certainty.Only a minority of studies assessed adverse effects of toothpaste. When reported, effects such as soft tissue damage and tooth staining were minimal. AUTHORS' CONCLUSIONS This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non-fluoride toothpaste. Evidence for the effects of different fluoride concentrations is more limited, but a dose-response effect was observed for D(M)FS in children and adolescents. For many comparisons of different concentrations the caries-preventive effects and our confidence in these effect estimates are uncertain and could be challenged by further research. The choice of fluoride toothpaste concentration for young children should be balanced against the risk of fluorosis.
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Affiliation(s)
- Tanya Walsh
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Anne‐Marie Glenny
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthCoupland Building 3Oxford RoadManchesterUKM13 9PL
| | - Valeria CC Marinho
- Queen Mary University of LondonClinical and Diagnostic Oral Sciences, Barts and The London School of Medicine and DentistryTurner StreetWhitechapelLondonUKE1 2AD
| | - Ana Jeroncic
- University of Split School of MedicineDepartment of Research in Biomedicine and HealthSoltanska 2SplitCroatia21000
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Cornejo Ulloa P, van der Veen MH, Krom BP. Review: modulation of the oral microbiome by the host to promote ecological balance. Odontology 2019; 107:437-448. [PMID: 30719639 PMCID: PMC6732124 DOI: 10.1007/s10266-019-00413-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 01/23/2019] [Indexed: 01/05/2023]
Abstract
The indivisible relationship between the human host and its oral microbiome has been shaped throughout the millennia, by facing various changes that have forced the adaptation of oral microorganisms to new environmental conditions. In this constant crosstalk between the human host and its microbiome, a bidirectional relationship has been established. The microorganisms provide the host with functions it cannot perform on its own and at the same time the host provides its microbes with a suitable environment for their growth and development. These host factors can positively affect the microbiome, promoting diversity and balance between different species, resulting in a state of symbiosis and absence of pathology. In contrast, other host factors can negatively influence the composition of the oral microbiome and drive the interaction towards a dysbiotic state, where the balance tilts towards a harmful relationship between the host and its microbiome. The aim of this review is to describe the role host factors play in cultivating and maintaining a healthy oral ecology and discuss mechanisms that can prevent its drift towards dysbiosis.
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Affiliation(s)
- Pilar Cornejo Ulloa
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands
| | - Monique H van der Veen
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
| | - Bastiaan P Krom
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, G. Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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Fontana M, Gonzalez-Cabezas C. Evidence-Based Dentistry Caries Risk Assessment and Disease Management. Dent Clin North Am 2018; 63:119-128. [PMID: 30447787 DOI: 10.1016/j.cden.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The objective of this article was to provide a summary of evidence-based recommendations for the assessment of caries risk and management of dental caries. The goal is to help clinicians manage the caries disease process using personalized interventions supported by the best available evidence, taking into account the clinician's expertise and the patient's needs and preferences, to maintain health and preserve tooth structure.
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Affiliation(s)
- Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Ann Arbor, MI 48109, USA.
| | - Carlos Gonzalez-Cabezas
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Ann Arbor, MI 48109, USA
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Urquhart O, Tampi MP, Pilcher L, Slayton RL, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, Nový BB, Tinanoff N, Weyant RJ, Wolff MS, Young DA, Zero DT, Brignardello-Petersen R, Banfield L, Parikh A, Joshi G, Carrasco-Labra A. Nonrestorative Treatments for Caries: Systematic Review and Network Meta-analysis. J Dent Res 2018; 98:14-26. [PMID: 30290130 PMCID: PMC6304695 DOI: 10.1177/0022034518800014] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The goal of nonrestorative or non- and microinvasive caries treatment (fluoride-
and nonfluoride-based interventions) is to manage the caries disease process at
a lesion level and minimize the loss of sound tooth structure. The purpose of
this systematic review and network meta-analysis was to summarize the available
evidence on nonrestorative treatments for the outcomes of 1) arrest or reversal
of noncavitated and cavitated carious lesions on primary and permanent teeth and
2) adverse events. We included parallel and split-mouth randomized controlled
trials where patients were followed for any length of time. Studies were
identified with MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane
Database of Systematic Reviews. Pairs of reviewers independently conducted the
selection of studies, data extraction, risk-of-bias assessments, and assessment
of the certainty in the evidence with the Grading of Recommendations Assessment,
Development, and Evaluation (GRADE) approach. Data were synthesized with a
random effects model and a frequentist approach. Forty-four trials (48 reports)
were eligible, which included 7,378 participants and assessed the effect of 22
interventions in arresting or reversing noncavitated or cavitated carious
lesions. Four network meta-analyses suggested that sealants + 5% sodium fluoride
(NaF) varnish, resin infiltration + 5% NaF varnish, and 5,000-ppm F (1.1% NaF)
toothpaste or gel were the most effective for arresting or reversing
noncavitated occlusal, approximal, and noncavitated and cavitated root carious
lesions on primary and/or permanent teeth, respectively (low- to
moderate-certainty evidence). Study-level data indicated that 5% NaF varnish was
the most effective for arresting or reversing noncavitated facial/lingual
carious lesions (low certainty) and that 38% silver diamine fluoride solution
applied biannually was the most effective for arresting advanced cavitated
carious lesions on any coronal surface (moderate to high certainty). Preventing
the onset of caries is the ultimate goal of a caries management plan. However,
if the disease is present, there is a variety of effective interventions to
treat carious lesions nonrestoratively.
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Affiliation(s)
- O Urquhart
- 1 Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA
| | - M P Tampi
- 1 Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA
| | - L Pilcher
- 1 Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA
| | - R L Slayton
- 2 Department of Pediatric Dentistry, School of Dentistry, University of Washington, Seattle, WA, USA
| | - M W B Araujo
- 3 Science Institute, American Dental Association, Chicago, IL, USA
| | - M Fontana
- 4 Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - S Guzmán-Armstrong
- 5 Advance Education Program in Operative Dentistry, University of Iowa, Iowa City, IA, USA
| | - M M Nascimento
- 6 Division of Operative Dentistry, Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - B B Nový
- 7 DentaQuest Institute and DentaQuest Oral Health Center, Westborough, MA, USA
| | - N Tinanoff
- 8 Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Maryland, College Park, MD, USA
| | - R J Weyant
- 9 Department of Dental Public Health and Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - M S Wolff
- 10 University of Pennsylvania, Philadelphia, PA, USA
| | - D A Young
- 11 Department of Diagnostic Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific, Stockton, CA, USA
| | - D T Zero
- 12 Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, School of Dentistry Indiana University, Indianapolis, IN, USA
| | - R Brignardello-Petersen
- 13 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - L Banfield
- 14 Health Sciences Library, McMaster University, Hamilton, ON, Canada
| | - A Parikh
- 15 College of Dental Medicine, Midwestern University, Downers Grove, IL, USA
| | - G Joshi
- 16 GC America, Alsip, IL, USA
| | - A Carrasco-Labra
- 1 Center for Evidence-Based Dentistry, Science Institute, American Dental Association, Chicago, IL, USA.,17 Evidence-Based Dentistry Unit and Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Santiago, Chile
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Ni J, Li Y, Zhang W, Shu R, Zhong Z. Sodium fluoride causes oxidative stress and apoptosis in cementoblasts. Chem Biol Interact 2018; 294:34-39. [DOI: 10.1016/j.cbi.2018.08.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 07/11/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
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A Novel Fluoride Containing Bioactive Glass Paste is Capable of Re-Mineralizing Early Caries Lesions. MATERIALS 2018; 11:ma11091636. [PMID: 30200640 PMCID: PMC6163288 DOI: 10.3390/ma11091636] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Revised: 08/11/2018] [Accepted: 08/23/2018] [Indexed: 11/17/2022]
Abstract
White-spot-lesions (WSL) are a common complication associated with orthodontic treatment. In the current study, the remineralization efficacy of a BiominF® paste was compared to the efficacy of a fluoride gel. Methods: Orthodontic brackets were bonded to 60 human premolars buccal surfaces, which were covered with varnish, except a small treatment area (3 mm2). All specimens were challenged by a demineralization solution for 4 days. Specimens were assigned into 4 groups: BiominF® paste, Fluoride (4-min application), fluoride (twenty four hours application), and the control (n = 15). After cross-sectioning, enamel slabs having a thickness of approximately 100–120 μm were obtained. A TMR (Transverse Micro Radiography) technique was used to observe the sub-surface enamel lesions’ depth and mineral density, and their response to the remineralization protocols. One way ANOVA was used to analyze the results (α = 0.05). The top and the cross-sectional surfaces were observed using SEM/EDS. Results: Specimens treated with BiominF® paste showed significant decrease in delta z values, however lesion depth showed no significant difference when compared to the other three groups (p < 0.05). SEM/EDS observation showed the formation of crystal like structures on top of enamel demineralized surfaces, when treated with BiominF® paste. In conclusion BiominF® paste can be considered an effective remineralizing agent for white spot Lesions.
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Amaechi BT. Remineralisation - the buzzword for early MI caries management. Br Dent J 2018; 223:173-182. [PMID: 28798421 DOI: 10.1038/sj.bdj.2017.663] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2017] [Indexed: 11/09/2022]
Abstract
Minimal intervention (MI) dentistry aims to preserve dental tissues first and restore only when indicated, thus remineralisation of initial (non-cavitated) caries lesions, an integral part of caries management, is an essential treatment strategy in MI. With this understanding, dental practitioners are increasingly embracing the principle of non-operative treatment of initial caries lesions. The purpose of this review was to summarise the most recent literature published in non-operative management of dental caries. Three electronic databases (MEDLINE, EMBASE, Cochrane CENTRAL) were searched, and clinical studies, systematic reviews and meta-analysis were included. This report outlines the strategies and numerous therapeutic materials available to aid in arrestment/remineralisation of initial caries lesions on root and coronal surfaces. However, the level of evidence of effect is variable, as well as the availability in different parts of the world. Options available to practitioners will vary when placing emphasis on the level of evidence supporting them. Strong clinical evidence support the effectiveness of pits/fissure sealants for therapeutic management of active initial caries on occlusal surfaces, and fluoride varnishes for remineralisation of caries lesions on root and coronal smooth surfaces, including proximal surfaces. Other materials formulated to enhance the effectiveness of any chosen remineralisation strategy were discussed. However, it is absolutely necessary that all caries remineralisation treatment be complemented with general behavioural modification in oral health through motivational interviewing directed towards change in oral hygiene to control plaque, dietary attitude modification to reduce the frequency of intake of fermentable sugars, and establishment of risk-based recall visits.
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Affiliation(s)
- B T Amaechi
- Professor and Director of Cariology Department of Comprehensive Dentistry University of Texas Health Science Centre at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas
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Comparison of efficacy of dental varnish containing fluoride either with CPP-ACP or bioglass on root caries: Ex vivo study. J Dent 2018; 73:91-96. [DOI: 10.1016/j.jdent.2018.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Accepted: 04/12/2018] [Indexed: 01/05/2023] Open
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Nordström A, Birkhed D. Attitudes and behavioural factors relating to toothbrushing and the use of fluoride toothpaste among caries-active Swedish adolescents - a questionnaire study. Acta Odontol Scand 2017; 75:483-487. [PMID: 28701058 DOI: 10.1080/00016357.2017.1344876] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to identify attitudes and behaviour relating to fluoride toothpaste and toothbrushing habits among caries-active Swedish adolescents. MATERIALS AND METHODS This cross-sectional study is based on an earlier clinical, two-year toothpaste intervention study. At the last appointment, 206 adolescents (of 211) answered a questionnaire comprising nine semi-closed questions. RESULTS The majority (93%) brushed their teeth every day, while 7% did so only occasionally. Most participants (77%) brushed twice a day, while 12% brushed just once a day. About half of those brushing just once a day forgot to brush in the evening. Similarly, more than half of the adolescents (53%) used 1 cm of toothpaste or less on their toothbrush. Moreover, 49% brushed for less than 2 min, 41% brushed for 2 min and 10% for more than 2 min. The majority (73%) rinsed with water after toothbrushing. A difference between boys and girls was also observed; 87% of the girls brushed twice a day, whereas only 67% of the boys did so and boys more frequently forgot in the evening. CONCLUSIONS Attitudes and behaviour relating to fluoride toothpaste and toothbrushing habits among caries-active Swedish adolescents are still inadequate after two years of toothpaste intervention. There are several areas where improvements can be made, such as frequency of brushing, brushing time, amount of toothpaste and post-brushing procedures. The majority (81%) included 'fresh breath' as a reason for performing oral hygiene and this aspect can be used by dental staff in health promotion.
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Affiliation(s)
- Anna Nordström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Dowen Birkhed
- Emeritus Professor at the University of Gothenburg, Gothenburg, Sweden
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Walsh LJ. Minimal intervention management of the older patient. Br Dent J 2017; 223:151-161. [DOI: 10.1038/sj.bdj.2017.660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 01/08/2023]
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Heasman PA, Ritchie M, Asuni A, Gavillet E, Simonsen JL, Nyvad B. Gingival recession and root caries in the ageing population: a critical evaluation of treatments. J Clin Periodontol 2017; 44 Suppl 18:S178-S193. [DOI: 10.1111/jcpe.12676] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2016] [Indexed: 12/19/2022]
Affiliation(s)
- Peter A. Heasman
- School of Dental Sciences; Newcastle University; Newcastle upon Tyne UK
| | | | | | - Erika Gavillet
- Faculty of Medical Sciences; Newcastle University; Newcastle upon Tyne UK
| | | | - Bente Nyvad
- Department of Dentistry and Oral Health; Aarhus University; Aarhus C Denmark
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Ximenes M, Cardoso M, Astorga F, Arnold R, Pimenta LA, Viera RDS. Antimicrobial activity of ozone and NaF-chlorhexidine on early childhood caries. Braz Oral Res 2017; 31:e2. [PMID: 28076495 DOI: 10.1590/1807-3107bor-2017.vol31.0002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 11/14/2016] [Indexed: 11/22/2022] Open
Abstract
An early childhood carie (ECC) is an extremely destructive form of tooth decay. The aim of this study was to investigate the action of ozone (O3), and the association of sodium fluoride (NaF) with chlorhexidine (CHX) on bacteria related to ECC. Overnight culture of the bacteria was performed. On exponential phase the suspension was adjusted (101-108 CFU/mL). A drop (10μL) of each concentration of bacteria was applied on sheep blood agar plates and treated with O3 (2, 20, 200, and 2,000 ppm); after 18 hours, recovery analysis of CFU verified the reduction of bacterial activity. For NaF-CHX, sterile 96-well plates were prepared and divided into groups: G1 (150 µL TSB); G2 (20 µL of bacteria + 25 µL CHX + 25 µL NaF); and G3 (150 µL TSB + 20 µL of bacteria + 50 µL water). The plates were verified by analysis of the optical density (0, 12, 14, 16, and 18 hours). The data from O3 test were submitted to ANOVA and Tukey's test (p < 0.05). For the data from NaF-CHX, the ANOVA 2-way and Bonferroni's test (p < 0.05) were used. The number of CFU/mL showed death > 3log10 (99.9%) for all bacteria (ozone ≥ 20ppm), while the combination of NaF-CHX was more effective (p < 0.001) compared to each substance tested alone and the control group. The antimicrobial agents tested were able to inhibit all bacteria tested; O3 seemed to be a good alternative for controlling progression of carious lesions, while the association of NaF-CHX showed to be a good antimicrobial with easy and inexpensive application.
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Affiliation(s)
- Marcos Ximenes
- Universidade Federal de Santa Catarina - UFSC, Dental School, Department of Pediatric Dentistry, Florianópolis, SC, Brazil
| | - Mariane Cardoso
- Universidade Federal de Santa Catarina - UFSC, Dental School, Department of Pediatric Dentistry, Florianópolis, SC, Brazil
| | - Fernando Astorga
- University of Colorado - UC, Dental School of Dental Medicine, Department of Restorative Dentistry, Denver, CO, USA
| | - Roland Arnold
- University of North Carolina - UNC, School of Dentistry, Deparment of Dental Research, Chapel Hill, NC, USA
| | - Luiz André Pimenta
- University of North Carolina - UNC, School of Dentistry, Deparment of Dental Ecology, Chapel Hill, NC, USA
| | - Ricardo de Sousa Viera
- Universidade Federal de Santa Catarina - UFSC, Dental School, Department of Pediatric Dentistry, Florianópolis, SC, Brazil
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Abstract
Oral disease can have a significant impact on the health and wellbeing of the housebound patient. The aetiology of oral conditions such as dental caries and periodontal disease have been well investigated and there is a solid evidence base in how to best prevent their progress. The Department of Health document Delivering better oral health: an evidence-based toolkit for prevention is a valuable resource that outlines the current best preventative evidence in the form of practical advice for clinicians and patients. This article aims to distil and present this advice for the benefit of community nurses. It will identify areas of particular importance for people with additional needs, particularly the elderly and infirm. Outlining how to best tailor preventative advice and treatment for this patient group.
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Affiliation(s)
- Diana Critchlow
- Senior Dental Officer, Northeast London NHS Foundation Trust, Dental Department, Grays Health Centre
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Longbottom C, Huysmans MCDNJM. Electrical Measurements for Use in Caries Clinical Trials. J Dent Res 2016; 83 Spec No C:C76-9. [PMID: 15286127 DOI: 10.1177/154405910408301s15] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This paper reviews the use of electrical measurements of caries, particularly in relation to caries clinical trials. Electrical measurements change as tooth tissue porosity alters in the caries process, but several other variables also have a significant effect on these electrical measurements and hence upon their diagnostic validity. Available electrical-method data, in the context of clinical trials, relate to the use of the Electronic Caries Monitor (ECM), which measures “bulk” resistance. The device is presently limited in scope to occlusal surfaces, and only limited ECM data from clinical trials are available. In the context of clinical trials, more work is needed to determine the potential role of electrical measurements. Such research will need to focus both on an understanding of those electrical parameters which are most valuable in identifying changes and stages in the caries process in individual teeth and also on identifying the extent of the effects of the variables affecting these measurements.
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Affiliation(s)
- C Longbottom
- Dental School and Dental Health Services Research Unit, Dental School, University of Dundee, Park Place, Dundee, DD1 4HR, Scotland, UK.
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Nóbrega DF, Fernández CE, Del Bel Cury AA, Tenuta LMA, Cury JA. Frequency of Fluoride Dentifrice Use and Caries Lesions Inhibition and Repair. Caries Res 2016; 50:133-40. [PMID: 26992247 DOI: 10.1159/000444223] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 01/21/2016] [Indexed: 11/19/2022] Open
Abstract
The clinical relevance of the frequency of fluoride dentifrice (FD) use on enamel caries is based on evidence. However, the relative effect of FD on reduction of demineralization or enhancement of remineralization is unknown and the effect of frequency on root dentine caries has not been explored. The aim of this double-blind, crossover, in situ study, which was conducted in 4 phases of 14 days each, was to evaluate the relationship between the frequency of FD use and enamel and root dentine de- and remineralization. Eighteen volunteers wore palatal appliances containing enamel and root dentine slabs, either sound or carious. Biofilm accumulation on the slab surface was allowed, and 20% sucrose solution was dripped 3 or 8 times per day on the carious and sound slabs, respectively. Volunteers used FD (1,100 μg F/g) in the frequencies 0 (fluoride-placebo dentifrice), 1, 2 and 3 times per day. The demineralization and remineralization that occurred in sound or carious slabs was estimated by the percentage of surface hardness loss (%SHL) or recovery (%SHR). Loosely (CaF2) and firmly (FAp) bound fluoride concentrations were also determined. The relationship between the variables was analyzed by linear regression. The %SHL, CaF2 and FAp concentrations were a function of the frequency of FD use for enamel and dentine, but the %SHR was a function of the frequency of FD use only for enamel (p < 0.05). The results suggest that demineralization in enamel and root dentine is reduced in proportion to the frequency of FD use, but for remineralization the effect of the frequency of FD use was relevant only to enamel.
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