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Bekes K, Steffen R, Krämer N. Hypomineralised second primary molars: the Würzburg concept. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00913-7. [PMID: 38805129 DOI: 10.1007/s40368-024-00913-7] [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: 03/16/2024] [Accepted: 05/01/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE In addition to molar incisor hypomineralisation, the occurrence of enamel hypomineralisation in the primary dentition has become increasingly important in recent years. Hypomineralised second primary molar (HSPM) is defined as hypomineralisation of systemic origin affecting from one to all four second primary molars. Some years ago, the "Würzburg concept" was introduced, which proposed a grading of MIH findings (MIH treatment need index) in combination with an appropriate treatment plan depending on the severity of the affected tooth. Recently, this concept was updated and new treatment approaches have been added. However, currently, the concept solely addresses the treatment plan for permanent teeth. As there is a need to expand its scope to encompass primary teeth and, consequently, HSPM, this paper seeks to develop the second component of the Würzburg concept, the treatment plan, for the primary dentition in response to the increased focus on the disease in recent years. Although the evidence base for the different treatment options is still weak, there is a need for guidance for clinicians in their day-to-day practice. METHODS The authors conducted a comprehensive review of the literature, encompassing clinical and laboratory studies along with published guidelines. RESULTS The treatment plan of the HSPM Würzburg concept contains prophylactic and regenerative aspects, non-invasive interventions, temporary and permanent restorative techniques, and extraction. CONCLUSIONS The intention is to provide practical guidance to practitioners, acknowledging the necessity for further validation through clinical trials.
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Affiliation(s)
- K Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University of Vienna, 1090, Vienna, Austria.
| | - R Steffen
- Private Practice, Weinfelden, Switzerland
| | - N Krämer
- Department of Pediatric Dentistry, Justus Liebig University, Giessen, Germany
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Muntean A, Mzoughi SM, Pacurar M, Candrea S, Inchingolo AD, Inchingolo AM, Ferrante L, Dipalma G, Inchingolo F, Palermo A, Bordea IR. Silver Diamine Fluoride in Pediatric Dentistry: Effectiveness in Preventing and Arresting Dental Caries-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:499. [PMID: 38671716 PMCID: PMC11049537 DOI: 10.3390/children11040499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/04/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Tooth decay is considered a global scourge by the World Health Organization (WHO) starting at an early age. In recent years, silver diamine fluoride (SDF) has regained interest, particularly in pediatric dentistry, used to prevent the development of carious lesions or arrest their progression. OBJECTIVE The aim of this study was to assess, through a systematic review of the literature, the effectiveness of SDF, used in pedodontics, in temporary teeth, in preventing or arresting dental caries. MATERIAL AND METHODS An electronic search was conducted on PubMed, Web of Science and Scopus. The effect of SDF on both temporary and permanent teeth has been considered. RESULTS The inclusion criteria identified 16 randomized controlled trials involving patients aged 18 months to 13 years and followed over a period of 12-30 months. CONCLUSIONS SDF is a practical, accessible and effective non-invasive way to prevent and arrest caries in temporary and permanent teeth. Its application requires regular monitoring. The resulting black spot is diminished by immediate application of potassium iodide but this may affect its effectiveness.
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Affiliation(s)
- Alexandrina Muntean
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Soundouss Myriam Mzoughi
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Mariana Pacurar
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine, Pharmacy Science and Technology “G. E. Palade” Targu Mures Romania, Gheorghe Marinescu Street, nr. 38, 540139 Târgu Mureș, Romania;
| | - Sebastian Candrea
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Ioana Roxana Bordea
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 15 V. Babes Street, 400012 Cluj-Napoca, Romania;
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Abdulrahim R, Splieth CH, Mourad MS, Vielhauer A, Khole MR, Santamaría RM. Silver Diamine Fluoride Renaissance in Paediatric Dentistry: A 24-Month Retrospective and Cross-Sectional Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:16. [PMID: 38276050 PMCID: PMC10820628 DOI: 10.3390/medicina60010016] [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: 10/19/2023] [Revised: 12/08/2023] [Accepted: 12/19/2023] [Indexed: 01/27/2024]
Abstract
Background and Objectives: Silver diamine fluoride (SDF) has been incorporated into the treatment of dental caries in children, mainly in countries with high caries prevalence. In Europe, however, SDF started to gain popularity during the COVID-19 pandemic. This study aimed to investigate the efficacy of SDF and to evaluate dentists'/parents' acceptance of SDF use in paediatric patients treated in a German university setting. Materials and Methods: A retrospective analysis of all patients treated with SDF between 2017 and 2020 was carried out. Only teeth with no reported clinical/radiographic evidence of irreversible pulpal inflammation were included. The outcome measures were success, minor failures (caries progression, reversible pulpitis) and major failures (irreversible pulpitis, abscess). The treatment acceptance by dentists and the parents of SDF-treated children was cross-sectionally evaluated using questionnaires. Descriptive statistics and Kaplan-Meier survival analysis were performed. Results: A total of 93 patients (mean age 5.3 ± 2.9 years) with 455 treated teeth (418 primary/91.9%; 37 permanent/8.1%) were included and followed up for up to 24 months (19.9 ± 10.5 months). SDF was used for dental caries (98.2%) and hypersensitivity relief on MIH teeth (1.8%). Most teeth did not show any failure (total success 84.2%). A total of 5 teeth (1.1%) showed minor failures, and 67 teeth (14.7%) showed major failures (p = 0.001). Success/failure rates were not affected by patient compliance, gender, dentition, or operator (p > 0.05). In total, 30 questionnaires were collected from parents (mean age 36.8 ± 6.4 years). SDF was applied on anterior (n = 2/6.7%), posterior (n = 15/50%) and anterior/posterior teeth (n = 13/43.3%). At the 1-week follow-up, 80% of parents noticed black teeth discoloration. Treatment satisfaction was higher for posterior (95.2%) than for anterior teeth (36.4%; p < 0.001). In the 27 responses from clinicians, SDF was generally considered a viable option in paediatric dentistry (n = 23; 85%). Conclusions: SDF was found to be effective and well-accepted by parents and dentists for caries inactivation in a paediatric dentistry German university setting.
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Affiliation(s)
- Ruba Abdulrahim
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany; (R.A.); (C.H.S.); (M.S.M.); (A.V.); (M.R.K.)
| | - Christian H. Splieth
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany; (R.A.); (C.H.S.); (M.S.M.); (A.V.); (M.R.K.)
| | - Mhd Said Mourad
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany; (R.A.); (C.H.S.); (M.S.M.); (A.V.); (M.R.K.)
- Department of Orthodontics, University of Greifswald, 17475 Greifswald, Germany
| | - Annina Vielhauer
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany; (R.A.); (C.H.S.); (M.S.M.); (A.V.); (M.R.K.)
| | - Manasi R. Khole
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany; (R.A.); (C.H.S.); (M.S.M.); (A.V.); (M.R.K.)
| | - Ruth M. Santamaría
- Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany; (R.A.); (C.H.S.); (M.S.M.); (A.V.); (M.R.K.)
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2023; 130:453-532. [PMID: 37453884 DOI: 10.1016/j.prosdent.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/18/2023]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | - Frederick Eichmiller
- Vice President and Science Officer (Emeritus), Delta Dental of Wisconsin, Stevens Point, Wis
| | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md
| | - Matthias Troeltzsch
- Private practice, Oral, Maxillofacial, and Facial Plastic Surgery, Ansbach, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilian University of Munich (LMU), Munich, Germany
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Conti G, Veneri F, Amadori F, Garzoni A, Majorana A, Bardellini E. Evaluation of Antibacterial Activity of a Bioactive Restorative Material Versus a Glass-Ionomer Cement on Streptococcus Mutans: In-Vitro Study. Dent J (Basel) 2023; 11:149. [PMID: 37366672 DOI: 10.3390/dj11060149] [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: 03/23/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Dental caries management consists of both preventive and restorative approaches. Pediatric dentists can rely on many techniques and materials to restore decayed teeth, but a high failure rate is still observed, mainly due to secondary caries. New restorative bioactive materials combine the mechanical and aesthetic characteristics of resinous materials with the capability to remineralize and the antimicrobial properties of glass ionomers, thus counteracting the occurrence of secondary caries. The aim of this study was to assess the antimicrobial activity against Streptococcus mutans of a bioactive restorative material (ACTIVA™ BioActive-Restorative™-Pulpdent©) and a glass ionomer cement with silver particles added (Ketac™ Silver-3M©), using agar diffusion assay. METHODS Each material was formed into disks of 4 mm in diameter, and four discs of each material were placed on nine agar plates. The analysis was repeated seven times. RESULTS Both materials showed statistically significant growth inhibition properties against S. mutans (p < 0.05). The difference in the effectiveness of the two materials was not statistically significant. CONCLUSION Both ACTIVA™ and Ketac™ Silver can be recommended since both are similarly effective against S. mutans. However ACTIVA™, given its bioactivity and better aesthetics and mechanical properties compared to GICs, may provide better clinical performance.
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Affiliation(s)
- Giulio Conti
- Department of Medicine and Surgery, School of Dentistry, University of Insubria, Via Ravasi 2, 21100 Varese, Italy
| | - Federica Veneri
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, Unit of Dentistry & Oral-Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Via del Pozzo, 41124 Modena, Italy
| | - Francesca Amadori
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Alba Garzoni
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Alessandra Majorana
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Elena Bardellini
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
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