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Brenes-Alvarado A, Farias-da-Silva FF, Soto-Montero JR, Benine-Warlet J, Groppo FC, Steiner-Oliveira C. Reduction of microorganisms in carious dentin by photodynamic therapy mediated by potassium iodide added to methylene blue and red laser. Arch Oral Biol 2024; 164:105978. [PMID: 38718465 DOI: 10.1016/j.archoralbio.2024.105978] [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: 10/10/2023] [Revised: 04/16/2024] [Accepted: 04/19/2024] [Indexed: 06/06/2024]
Abstract
OBJECTIVE To evaluate the effect of the association of potassium iodide to antimicrobial photodynamic therapy on human carious dentin produced with a microcosm biofilm model. METHODS A microcosm biofilm model was used to generate a caries lesion on human dentin. Pooled human saliva diluted with glycerol was used as an inoculum on specimens immersed on McBain artificial saliva enriched with 1 % sucrose (24 h at 37 °C in 5 % CO2). After refreshing culture media for 7 days, the dentin specimens were divided in 5 groups (3 specimens per group, in triplicate; n = 9): C (NaCl 0.9 %), CX (2 % chlorhexidine), PKI (0.01 % methylene blue photosensitizer+50 mM KI), L (laser at 15 J, 180 s, 22.7 J/cm2), and PKIL (methylene blue + KI + Laser). After the treatments, dentin was collected, and a 10-fold serial dilution was performed. The number of total microorganisms, total lactobacilli, total streptococci, and Streptococcus mutans was analyzed by microbial counts (CFU/mL). After normality and homoscedasticity analysis, the Welch's ANOVA and Dunnett's tests were used for CFU. All tests used a 5 % significance level. RESULTS CX and PKIL groups showed significant bacterial decontamination of dentin, compared to group C (p < 0.05) reaching reductions up to 3.8 log10 for CX for all microorganisms' groups and PKIL showed 0.93, 1.30, 1.45, and 1.22 log10 for total microorganisms, total lactobacilli, total streptococci, and S. mutans, respectively. CONCLUSION aPDT mediated by the association of KI and methylene blue with red laser reduced the viability of microorganisms from carious dentin and could be a promising option for cavity decontamination.
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Affiliation(s)
- Alejandra Brenes-Alvarado
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidad de Costa Rica, Montes de Oca, SJ, Costa Rica
| | - Felipe Fabrício Farias-da-Silva
- Department of Health Sciences and Pediatric Dentistry, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Jorge Rodrigo Soto-Montero
- Department of Restorative Dentistry, School of Dentistry, Universidad de Costa Rica, Montes de Oca, SJ, Costa Rica
| | - Juliana Benine-Warlet
- Department of Health Sciences and Pediatric Dentistry, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Francisco Carlos Groppo
- Department of Biosciences, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Carolina Steiner-Oliveira
- Department of Health Sciences and Pediatric Dentistry, Faculdade de Odontologia de Piracicaba (FOP), Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil.
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R R, Wani W, Sharma S, Kumar V, Chawla A, Kalaivani M, Logani A. Selective Removal to Soft Dentine versus Full Pulpotomy for Management of Proximal Deep Carious Lesions: A Randomized Controlled Non-Inferiority Trial. Caries Res 2023; 57:536-545. [PMID: 37552970 DOI: 10.1159/000530895] [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: 03/29/2022] [Accepted: 04/25/2023] [Indexed: 08/10/2023] Open
Abstract
The management of the deep carious lesion with reversible pulpitis is a dilemma for the dentist. The current study compared selective removal to soft dentine (SRSD) and full pulpotomy (FP) for treating proximal deep carious lesions in teeth with reversible pulpitis. Visual-tactile examination and bitewing radiographs were used to determine the depth of carious lesion, and American Association of Endodontists recommendations were used to formulate pulp diagnosis. Sixty mandibular molar teeth from healthy patients between the ages of 16-35 years and a diagnosis of proximal deep carious lesion with reversible pulpitis were included. Teeth were randomly allocated to two study groups. SRSD group (n = 30): soft dentine was preserved over the pulpal aspect. A hard-setting calcium hydroxide cement liner and resin-modified glass ionomer cement base were applied over the remaining soft carious dentine. FP group (n = 30): complete caries removal followed by mineral trioxide aggregate FP was performed. The teeth in both groups were restored with composite resin restoration. The established criteria for outcome assessment of SRSD and pulpotomy were used. Accordingly, only asymptomatic teeth with no radiological evidence of periapical rarefaction were considered successful at the 12-month follow-up. Two-sample t test, Pearson χ2 test/Fisher's exact test, and percentage agreement were used for statistical evaluation. According to the per-protocol analysis, the success rate of both SRSD and FP treatment was 95.45% and 95.65%, respectively, and the actual difference between the two treatments was 1% (95% CI: [-10, 9]). The data suggests that both treatments (SRSD and FP) appear to have a good success rate (>95%) when used to manage permanent mandibular molar teeth with proximal deep carious lesion and reversible pulpitis. As SRSD is a noninvasive procedure, it should be favored over FP in these instances.
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Affiliation(s)
- Rechithra R
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Wasim Wani
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sidhartha Sharma
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Philip N, Suneja B. The revolutionary evolution in carious lesion management. J Conserv Dent 2023; 26:249-257. [PMID: 37398856 PMCID: PMC10309123 DOI: 10.4103/jcd.jcd_54_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/23/2023] [Accepted: 04/19/2023] [Indexed: 07/04/2023] Open
Abstract
Contemporary paradigms of dental caries management focus on the biological approaches to treating the disease and its principal symptom, the carious lesion. This narrative review traces the evolution of carious lesion management from the operative and invasive approaches of G. V. Black's era to the current period of minimally invasive biological approaches. The paper explains the rationale for adopting biological approaches to dental caries management and lists the five core principles of this management approach. The paper also details the aims, features, and the most recent evidence base for the different biological carious lesion management approaches. Based on current practice guidelines, collated clinical pathways for lesion management are also presented in the paper to aid clinicians in their decision-making. It is hoped that the biological rationale and evidence summarized in this paper will bolster the shift to modern biological carious lesion management approaches among dental practitioners.
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Affiliation(s)
- Nebu Philip
- Paediatric Dentistry, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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4
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Shang W, Zhang Z, Zhao X, Dong Q, Schmalz G, Hu S. The Understanding of Vital Pulp Therapy in Permanent Teeth: A New Perspective. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8788358. [PMID: 36132084 PMCID: PMC9484899 DOI: 10.1155/2022/8788358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 08/29/2022] [Indexed: 11/18/2022]
Abstract
The indications of vital pulp therapy (VPT) are expanding, which cases are suitable for VPT, and how to improve the success rate of VPT is a problem that often bothers us. The main purpose of VPT is to eliminate pulpitis by promoting the formation of reparative dentin or calcium bridge, so that it can continue to perform various physiological functions, and finally achieve the purpose of preserving pulp vitality and long-term preservation of affected teeth. Pulp capping and pulpotomy are the most common methods for VPT. The research field of VPT has attracted the attention of many scholars, who have studied it from many aspects (such as indications, material selection, operation requirements, and long-term prognosis). This article reviews the recent advances in the techniques of VPT in permanent teeth.
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Affiliation(s)
- Wei Shang
- Department of Stomatology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, 046000 Shanxi, China
| | - Zeliang Zhang
- Department of Stomatology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, 046000 Shanxi, China
| | - Xicong Zhao
- Department of Stomatology, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, 046000 Shanxi, China
| | - Qingquan Dong
- Department of Stomatology, Changzhi Medical College, Changzhi, 046000 Shanxi, China
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr 12, 04103 Leipzig, Germany
| | - Shaonan Hu
- Department of Stomatology, Changzhi Medical College, Changzhi, 046000 Shanxi, China
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Melo L, Blum IR, Foxton RM. Should new operating procedures arising from COVID-19 make us re-think our management of deep caries? Prim Dent J 2022; 11:72-74. [PMID: 35383500 DOI: 10.1177/20501684221085872] [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: 11/15/2022]
Abstract
COVID-19 has impacted heavily on the delivery of dental services within the UK, particularly in regards to aerosol generating procedures (AGPs). However, it has created an opportunity to reflect on how operative dental procedures, such as the management of dental caries, are undertaken. In light of recent evidence in favour of speed increasing contra-angle handpieces in combination with an electric micromotor to eliminate the generation of aerosols at certain speeds while still allowing the cutting of hard tooth tissue, albeit at a slower rate than the traditional air-turbine, this article explores the evidence for partial caries removal using the electric micromotor system. Aspects of maintaing the health of the pulpal tissue using this system and adopting a logical approach to placing adhesive direct resin composites to faciliate an optimum outcome for the patient are also explored.
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Affiliation(s)
- Luciana Melo
- Senior Specialist Clinical Teacher, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Igor R Blum
- Clinical Professor of Primary Care Dentistry & Advanced General Dental Practice, Lead for Dental Outreach, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.,Clinical Lead, Consultant & Specialist in Restorative Dentistry, Head, Restorative Dentistry & Primary Dental Care, King's College Hospital Dental Institute, London, UK
| | - Richard M Foxton
- Senior Clinical Lecturer in Dental Education/Honorary Consultant in Restorative Dentistry, Lead for Simulation, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Shetty AA, Acharya A, R. M. Is Non-Restorative Cavity Treatment a Practical Choice in Primary Teeth? JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1743530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractFor years, “extension for prevention” was considered as the standard protocol for the restoration of caries. With advances in the field of cariology regarding the biofilm and improvement in materials, this perspective is being challenged. This is being challenged by more biological and less-invasive approaches, where the emphasis is on biofilm alteration to arrest carious lesions. This minimally invasive intervention is based on the concept that biofilm overlying the carious lesion is a driving force for the carious process and not the bacteria present in the infected dentin. Hence, daily removal or disruption of this biofilm will slow down the carious process or bring it to halt.One such approach is non-restorative cavity treatment, where no caries is removed but lesions are made self-cleansable that allows it to be brushed by the parent or the child. This wholesome approach targets the disease at a causal level.This review of literature describes the various advantages and limitations of this technique and the practicability of its use in pediatric patients during the pandemic COVID-19.
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Affiliation(s)
- Amarshree A. Shetty
- Department of Paediatric and Preventive Dentistry, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
| | - Aditi Acharya
- Department of Paediatric and Preventive Dentistry, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
| | - Manju R.
- Department of Pediatric Dentistry, AB Shetty Memorial Institute of Dental Sciences, Deralakatte, Mangalore, Karnataka, India
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In Vitro Analysis of Organic Ester Functional Groups in Carious Dentine. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: With the implementation of minimally invasive selective caries removal protocols to treat cavitated, deep carious dentine lesions, there is a need to investigate specific biochemical moiety distributions to help characterise and distinguish between infected (contaminated) and affected (demineralised) zones within the dentine lesion. The present in vitro investigation aimed to compare the distribution of ester functional groups (1740 cm−1) within carious dentine tissue (infected and affected dentine). The null hypothesis stipulated that there are no differences in ester function intensity/distribution within carious dentine lesions. Materials and Methods: From a total of five extracted human molar teeth with carious dentine lesions, 246 points from 10 sections of carious dentine were examined using high-resolution Raman spectroscopy and characterised into infected, affected and sound dentine. The peak intensity of the characteristic vibration mode of the ester function was calculated from sample scans. Results: Analyses indicated a statistically significant difference in the spectroscopic vibration bands of esters between the infected and affected dentine zones. Conclusion: The ester functional group is higher in intensity in the caries-infected dentine zone compared to the affected tissue. This finding could be used to develop an objective indicator for the selective operative management of carious dentine.
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Carraro RLC, Fontanella V, Carvalho JC, Alves LS, Maltz M. Loss of dental tissue after restoration or sealing of occlusal carious lesions: 3-4-year results of randomized clinical trials. J Conserv Dent 2022; 25:521-525. [PMID: 36506636 PMCID: PMC9733557 DOI: 10.4103/jcd.jcd_194_22] [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: 04/06/2022] [Revised: 05/18/2022] [Accepted: 05/25/2022] [Indexed: 12/15/2022] Open
Abstract
Context Although preservation of the tooth structure is quoted as the main advantage of sealing of carious lesions, there are no long-term studies comparing the maintenance of dental tissue after restoration or after caries sealing. Aim To measure the radiographically visible loss of dental tissue after conventional restoration and sealing of carious lesions. Subjects and Methods This study was a secondary analysis of two randomized controlled clinical trials, one conducted in Brazil and another in Belgium, which evaluated two different therapies for the treatment of occlusal carious lesions in permanent teeth: sealant (SE) without previous carious tissue removal or restoration (RE) with total removal of carious dentin. The greater depth and width of sealed carious lesions and restorations were compared. Statistical Analysis The independent t-test was used to compare therapies at different time points, while the paired t-test was used to compare the same therapy over time. Results Carious lesions in the RE and SE groups showed similar measurements at baseline (P > 0.05). Over time, significantly greater loss of tooth structure was observed in the RE group than in the SE group. No increase in lesion depth or width was observed in the SE group, suggesting no progression of sealed lesions. Conclusion Sealing of carious lesions resulted in greater preservation of dental tissue.
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Affiliation(s)
- Rafaela L. C. Carraro
- Department of Social and Preventive Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Vânia Fontanella
- Department of Surgery and Orthopedics, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Luana Severo Alves
- Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil,Address for correspondence: Dr. Luana Severo Alves, Department of Restorative Dentistry, School of Dentistry - UFSM, AV. Roraima, 1000 Camobi, 97105-900, Santa Maria, Rio Grande Do Sul, Brazil. E-mail:
| | - Marisa Maltz
- Department of Social and Preventive Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Rodrigues MDP, Cunha LSD, Vilela ABF, Schettini ACT, Bragança GFD, França R, Soares CJ. Selective carious tissue removal and glass ionomer liner reduction of pulp stress in bulk fill resin composite restorations. Braz Oral Res 2021; 35:e119. [PMID: 34878074 DOI: 10.1590/1807-3107bor-2021.vol35.0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 02/10/2021] [Indexed: 11/21/2022] Open
Abstract
To evaluate the effect of selective or nonselective carious tissue removal and the use of a resin-modified glass ionomer (RMGIC) liner under bulk fill resin composite restoration on the stress at the pulp chamber, the elastic moduli of hard, firm, soft and intact dentin were calculated using nanoindentation. Post-gel shrinkage of the bulk fill resin composite and RMGIC were determined using the strain-gauge method. Six finite element models were created by using digital radiography with the combination of two study factors: a) carious tissue removal: selective removal or nonselective removal of carious tissue, and b) use of RMGIC liner: with or without 1.0 mm of RMGIC liner. The modified von Mises stresses (mvm) (MPa) were extracted on the nodes of the internal wall of the pulp ceiling chamber at 100 N occlusal loading. Data were analyzed descriptively and recorded quantitively. Both study factors influenced the stress distribution. The mvm stress during the restorative procedure was higher for nonselective carious tissue removal without RMGIC (25.9 MPa) and lower for selective carious tissue removal associated with RMGIC (13.5 MPa). The dentin elastic modulus increased from soft carious (3.6 ± 0.3 MPa) to firm carious (5.2 ± 1.0 MPa) to hard carious (10.9 ± 1.2 MPa) to intact dentin (22.7 ± 3.0 MPa). Molars with carious lesions showed high mvm stress at the pulp ceiling (89.6 MPa) and at fragilized coronal structure remaining. Selective carious tissue removal followed by restoration using a Vitrebond liner and Tetric N-Ceram Bulk fill reduced the stress at the pulp chamber ceiling.
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Affiliation(s)
- Monise de Paula Rodrigues
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Laryssa Silva da Cunha
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Andomar Bruno Fernandes Vilela
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Ana Cecília Teodoro Schettini
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Gabriel Felipe de Bragança
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Rodrigo França
- University of Manitoba, Faculty of Health Science, College of Dentistry, Department of Restorative Dentistry, Winnipeg, Canada
| | - Carlos José Soares
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Operative Dentistry and Dental Materials, Uberlândia, MG, Brazil
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Moradi S, Sabbagh S, Timms L, Ravaghi V. Teaching Minimally Invasive Interventions in Paediatric Dentistry: A Cross-Sectional Survey of Dental Schools in Iran. BMC Oral Health 2021; 21:368. [PMID: 34301216 PMCID: PMC8298961 DOI: 10.1186/s12903-021-01735-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental caries is a significant public health problem in Iran. Teaching minimally invasive interventions in paediatric dentistry may facilitate the provision of treatment for untreated dental caries in children. We evaluated the teaching of such interventions in both undergraduate dental curriculum and Paediatric Dentistry Specialty Training Programme (PDSTP) in Iran. METHODS This was a cross-sectional questionnaire-based survey. Participants in this study were the directors of 40 undergraduate programmes and 15 PDSTPs in all Iranian dental schools (response rate = 100%). Descriptive statistics were reported. RESULTS The most commonly taught methods were preventive fissure sealant and preventive resin restoration (PRR), which were taught 'both didactically and clinically' in all undergraduate dental programmes. The least commonly taught methods were silver diamine fluoride (SDF), the Hall technique and resin infiltration, which were taught 'both didactically and clinically' in less than 5% of dental schools. The same three methods were the least commonly approaches taught in PDSTP, further, they were less often perceived to be 'essential'. CONCLUSIONS There was a notable variation in the teaching of the management of dental caries in Iran's dental education. Some minimally invasive approaches including SDF, the Hall technique and resin infiltration are not being commonly taught in Iranian dental schools despite the evidence base for these techniques.
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Affiliation(s)
- S Moradi
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - S Sabbagh
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - L Timms
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - V Ravaghi
- School of Dentistry, University of Birmingham, Birmingham, UK
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Stafuzza TC, Vitor LLR, Lourenço Neto N, Rios D, Cruvinel T, Sakai VT, Moretti ABS, Machado MAAM, Oliveira TM. Pulp liner materials in selective caries removal: study protocol for a randomised controlled trial. BMJ Open 2021; 11:e029612. [PMID: 33419899 PMCID: PMC7798680 DOI: 10.1136/bmjopen-2019-029612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The literature shows that selective carious tissue removal (SCTR) decreases the number and diversity of bacteria, stops the caries process and reduces the risk of pulp exposure. However, no consensus exists on which pulp liner would be suitable for teeth undergoing SCTR. So, this study will verify the in vivo response of dentine-pulp complex after SCTR in primary teeth with or without pulp liner material. METHODS AND ANALYSIS A randomised clinical trial, double-blinded, parallel-group and allocation concealment will be conducted with the enrolment of 384 patients from 5 to 9 years, with one maxillary/mandibular first/second primary molars with deep occlusal/occlusoproximal cavities. The remaining dentine will be lined with calcium hydroxide cement-group 1; mineral trioxide aggregate-group 2 and without liner-group 3. The primary outcome will be success of the of dentine-pulp complex evaluated clinically and radiographically at 6, 12 and 24 months, while the secondary outcomes will be the measurement of the dentine barrier on periapical radiographs. During all study, two trained and calibrated examiners will evaluate the treated teeth clinically and radiographically. Interexaminer and intraexaminer reliability will be verified by casual and systematic error. The Kolmogorov-Smirnov test will be adopted to test the normality of continuous variables. Comparisons among groups will be performed by using the χ2 test and anaylsis of variance, followed by Tukey test (p<0.05). The logistic regression will be applied, and the degrees of this association will be measured using the OR and 95% CI. ETHICS AND DISSEMINATION The present protocol was submitted and approved by the Ethical Committee of the University of São Paulo, Bauru, São Paulo, Brazil (CAAE: 79123517.0.0000.5417). Consent for publication will be obtained from all parents or legal guardians. Results of this study will be reported in full through peer-reviewed journals. TRIAL REGISTRATION NUMBER RBR-9fsxnn.
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Affiliation(s)
- Tássia Carina Stafuzza
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Dentistry of Bauru, University of São Paulo, São Paulo, Brazil
| | - Luciana Lourenço Ribeiro Vitor
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Dentistry of Bauru, University of São Paulo, São Paulo, Brazil
| | - Natalino Lourenço Neto
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Dentistry of Bauru, University of São Paulo, São Paulo, Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Dentistry of Bauru, University of São Paulo, São Paulo, Brazil
| | - Thiago Cruvinel
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Dentistry of Bauru, University of São Paulo, São Paulo, Brazil
| | - Vivien Thiemy Sakai
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas, Alfenas, Brazil
| | | | | | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Public Health, School of Dentistry of Bauru, University of São Paulo, São Paulo, Brazil
- Department of Pediatric Dentistry, Hospital for the Rehabilitation of Craniofacial Anomalies, University of São Paulo, São Paulo, Brazil
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12
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Alturki M, Koller G, Warburton F, Almhöjd U, Banerjee A. Biochemical characterisation of carious dentine zones using Raman spectroscopy. J Dent 2020; 105:103558. [PMID: 33309806 DOI: 10.1016/j.jdent.2020.103558] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Carious tissue discrimination in clinical operative caries management relies traditionally on the subjective hardness of carious dentine. Biochemical alterations within the lesion have the potential to discriminate the lesion zones objectively. This study aimed to determine the correlation between the biochemical proportions of amide I and phosphate moieties as these are the most prominent peaks found in dentine with the Knoop microhardness of carious dentine zones, using non-contact Raman spectroscopy. The null hypothesis investigated was that there was no correlation between Raman peak ratios, amide I: phosphateν1, and the Knoop microhardness within specific zones of a carious lesion. METHODS 423 scan points from 20 carious dentine lesion samples examined using high-resolution Raman spectroscopy. The peak ratio of the characteristic vibration mode of amide I (1650 cm-1) and phosphate (960 cm-1) bands were calculated, following a straight line path through the lesion to the pulp and correlated to corresponding Knoop microhardness measurements. RESULTS Using logistic regression analysis, clear correlations were found between the Knoop microhardness and Raman peak ratio cut-off values between caries-infected and caries-affected dentine (81.5 % sensitivity / 92.7 % specificity), with a lower specificity (2.7 %) found between caries-affected and sound dentine. CONCLUSION This study concluded that non-contact Raman spectroscopy can be used in vitro to discriminate objectively between the different zones of a carious dentine lesion at high resolution, using the Raman peak ratios, amide I : phosphate ν1. CLINICAL SIGNIFICANCE Specific biochemical alterations have the potential to be used in-vitro and in-vivo to identify the end-point of selective carious lesion excavation.
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Affiliation(s)
- M Alturki
- Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom; Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - G Koller
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom; LCN - London Centre for Nanotechnology, 19 Gordon St, Bloomsbury, London, WC1H 0AH, United Kingdom
| | - F Warburton
- Oral Clinical Research Unit, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - U Almhöjd
- Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom; Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, SE-405 30, Gothenburg, Sweden
| | - A Banerjee
- Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom.
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13
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Alkhalaf R, Neves ADA, Banerjee A, Hosey MT. Minimally invasive judgement calls: managing compromised first permanent molars in children. Br Dent J 2020; 229:459-465. [PMID: 33037366 DOI: 10.1038/s41415-020-2154-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/11/2020] [Indexed: 12/23/2022]
Abstract
This paper aims to update the reader on how minimally invasive (MI) techniques may be used to improve the longevity of carious or defective/compromised first permanent molars (cFPMs) in young children. Clinical and radiographic diagnosis and the prognostic factors will be discussed in view of recent studies showing that these teeth can be kept in function and have an improved prognosis as the child gets older. Clinical protocols for their care, based on the latest evidence and techniques for MI restorations, together with longevity information of possible restorative options, are described. This paper also explores the rationale behind enforced extractions and related morbidity, in order to help oral healthcare practitioners to determine the optimal management of these key elements in the dentition for the benefit of the patients.
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Affiliation(s)
- Reem Alkhalaf
- Centre of Oral, Clinical & Translational Science, Faculty of Dentistry, Oral and Craniofacial Research, King's College London, London, UK
| | - Aline de Almeida Neves
- Clinical Lecturer in Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK; Adjunct Professor in Paediatric Dentistry, Federal University of Rio de Janeiro, Brazil.
| | - Avijit Banerjee
- Professor of Cariology & Operative Dentistry, Honorary Consultant/Clinical Lead, Restorative Dentistry, Conservative & MI Dentistry/Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Marie Therese Hosey
- Professor of Paediatric Dentistry, Honorary Consultant, Chair of Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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14
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Alturki M, Koller G, Almhöjd U, Banerjee A. Chemo-mechanical characterization of carious dentine using Raman microscopy and Knoop microhardness. ROYAL SOCIETY OPEN SCIENCE 2020; 7:200404. [PMID: 32537229 PMCID: PMC7277260 DOI: 10.1098/rsos.200404] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
One of the aims in the clinical operative management of dental carious lesions is to remove selectively the highly infected and structurally denatured dentine tissue, while retaining the deeper, repairable affected and intact, healthy tissues for long-term mechanical strength. The present study examined the correlation of chemical functional groups and the microhardness through the different depths of a carious lesion using Raman spectroscopy and Knoop microhardness testing. The null hypothesis investigated was that there was no correlation between Raman peak ratios (amide I : phosphate ν1 ) and equivalent Knoop microhardness measurements. Ten freshly extracted human permanent teeth with carious dentine lesions were sectioned and examined using high-resolution Raman microscopy. The ratio of absorbency at the amide I and phosphate bands were calculated from 139 scan points through the depth of the lesions and correlated with 139 juxtaposed Knoop microhardness indentations. The results indicated a high correlation (p < 0.01) between the peak ratio and the equivalent Knoop hardness within carious dentine lesions. This study concluded that Raman spectroscopy can be used as a non-invasive analytical technology for in vitro studies to discriminate the hardness of carious dentine layers using the peak ratio as an alternative to the invasive, mechanical Knoop hardness test.
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Affiliation(s)
- M. Alturki
- Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - G. Koller
- Centre for Host Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- LCN – London Centre for Nanotechnology, 19 Gordon St, Bloomsbury, London WC1H 0AH, UK
| | - U. Almhöjd
- Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
- Department of Cariology, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Box 450, SE-405 30 Gothenburg, Sweden
| | - A. Banerjee
- Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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15
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Midani R, Splieth CH, Mustafa Ali M, Schmoeckel J, Mourad SM, Santamaria RM. Success rates of preformed metal crowns placed with the modified and standard hall technique in a paediatric dentistry setting. Int J Paediatr Dent 2019; 29:550-556. [PMID: 30888708 DOI: 10.1111/ipd.12495] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 03/01/2019] [Accepted: 03/10/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND The Hall Technique is a less invasive caries management technique for treating carious primary molars. It has become a routine treatment at specialists' practices. AIM To retrospectively evaluate the clinical success and survival rates of preformed metal crowns placed on primary molars using the Hall Technique in a Paediatric Dentistry Setting. DESIGN Patient records of children receiving Hall crowns (with or without proximal slicing) between 2011 and 2017 were reviewed. Teeth with no clinical or radiographic evidence of pulp involvement at baseline and at least six months' follow-up were included. Kaplan-Meier survival analyses and Mantel-Cox statistics were carried out. RESULTS In total, 181 Hall crowns performed in 2- to 10-year-olds with a mean follow-up period of 22 months were included for analysis. Mean d3 mft/D3 MFT was 6.55 ± 3.48/0.18 ± 0.66. The majority of crowns were successful (92.3%; n = 167), four presented at least one minor failure (2.2%; reversible pulpitis, crown lost, or secondary caries) and ten were major failures (5.5%; irreversible pulpitis or abscess). When comparing crowns performed with no tooth preparation to crowns performed with proximal slicing, no differences were observed (P = 0.70, CI = 0.68-0.83). CONCLUSION The survival rate and clinical efficacy of Hall crowns were high in a secondary care-based setting. The HT is an effective and less invasive management option for asymptomatic carious primary molars.
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Affiliation(s)
- Rama Midani
- Department of Preventive and Pediatric Dentistry, Greifswald University, Greifswald, Germany
| | - Christian H Splieth
- Department of Preventive and Pediatric Dentistry, Greifswald University, Greifswald, Germany
| | - Mahmoud Mustafa Ali
- Department of Preventive and Pediatric Dentistry, Greifswald University, Greifswald, Germany
| | - Julian Schmoeckel
- Department of Preventive and Pediatric Dentistry, Greifswald University, Greifswald, Germany
| | - Said M Mourad
- Department of Preventive and Pediatric Dentistry, Greifswald University, Greifswald, Germany
| | - Ruth M Santamaria
- Department of Preventive and Pediatric Dentistry, Greifswald University, Greifswald, Germany
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Jeggle LM, Baker S, Schwendicke F. Changing dentists’ carious tissue removal behavior: Qualitative study and behavioral change simulation experiment. J Dent 2019; 81:43-51. [DOI: 10.1016/j.jdent.2018.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 11/01/2018] [Accepted: 12/17/2018] [Indexed: 11/28/2022] Open
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