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Wang Y, Wen J, Pan T, Cao Y, Lin H, Zhou Y. Comparing the effectiveness of caries arrest by micro-operative treatment to operative treatment: A 2-year randomized controlled clinical trial. Clin Oral Investig 2024; 28:222. [PMID: 38499947 DOI: 10.1007/s00784-024-05567-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/17/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To compare the effectiveness of caries arrest by micro-operative treatment (sealing) to operative treatment (flowable resin composite restoration) through a 2-year randomized controlled clinical trial. MATERIALS AND METHODS A prospective randomized controlled trial was conducted among 7-9-year-old children. At baseline, 630 subjects were screened and 92 children who had at least one carious lesion classified as ICDAS 3 on the pit and fissure of first permanent molar were included. Then they were randomly assigned to the sealant group (73 lesions) and the flowable resin composite group (76 lesions) to receive the corresponding intervention. Lesions status in each group was evaluated every 6 months up to 24 months. Clinical progression of dental caries and materials retention were the outcomes used for group comparisons at p-value < 0.05. RESULTS After 24 months, three lesions (4.1%) in the sealant group clinically progressed to dentin caries. No lesion in the flowable composite group was observed a progression. The results of Life-table survival analysis show that the cumulative caries arrest rate had no statistically significant difference between the two groups (p = 0.075). However, the cumulative retention rate was 57.5% in the sealant group and 92.1% in the flowable composite group, with significant differences (p < 0.001). The multilevel mixed model showed the sealant had higher risk of retention failure than the flowable composite (OR = 8.66, p < 0.001), while tooth position did not influence material retention (p = 0.083). In addition, the results of Fisher Exact test show that dentin lesions had more retention failure than enamel lesions in the sealant group (p = 0.026). CONCLUSION Although sealing microcavitated carious lesions of the first permanent molar achieved lower retention rate than resin composite restoration, both sealing and restoration effectively arrested caries progression for two years. CLINICAL RELEVANCE To preserving dental structure and delaying or eliminating the need for operative procedures, microcavitated carious lesion can be arrested by sealing. TRIAL REGISTRATION Registered at http://www.chictr.org.cn ; Feb 15th, 2020; No. ChiCTR2000029862.
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Affiliation(s)
- Yinuo Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Jie Wen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Ting Pan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yina Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Huancai Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China.
| | - Yan Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China.
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Beresescu L, Păcurar M, Bica CI, Vlasa A, Stoica OE, Dako T, Petcu B, Esian D. The Assessment of Sealants' Effectiveness in Arresting Non-Cavitated Caries Lesion-A 24-Month Follow-Up. Healthcare (Basel) 2022; 10. [PMID: 36141263 DOI: 10.3390/healthcare10091651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/27/2022] [Accepted: 08/27/2022] [Indexed: 11/16/2022] Open
Abstract
Dental sealants are excellent means to prevent pits and fissure caries. Nowadays, the application of sealants is extended to therapeutic use in arresting non-cavitated carious lesions. This relatively new concept still lacks evidence to support its routine use. The aim of this study was to evaluate the effectiveness of a resin-based sealant applied on first permanent molars with carious lesions (ICDAS 1−3), in comparison with its effectiveness when applied on sound surfaces (ICDAS 0). Included in the study were 114 children aged between six and eight years old, with a high caries risk (according to the CAMBRA system), with all four permanent molars erupted and with deep pits and fissures. A total number of 407 molars were sealed and assessed. A total of 49 were excluded (they had caries, which according to the ICDAS II classification were classified with code 4−6 or had older sealants or fillings). Out of these 407 molars, 213 were sound (code 0) and 194 had caries lesions as follows: 56 teeth classified as code 1, 79 teeth classified as code 2, and 59 teeth classified as code 3 according to the ICDAS II classification. The retention of the sealant and carious lesions were assessed clinically at 6, 12, 18, and 24 months. Regarding sealant retention, a statistically significant difference (p < 0.05) among the two types of sealed teeth, sound (ICDAS 0) and decayed (ICDAS 3), showed at 18- and 24-month follow-up intervals. Regarding caries lesions, a statistically significant difference (p < 0.05) showed between sound (ICDAS 0) and decayed (ICDAS 3) molars at 24-month follow-up. Our study results supported the resin-based sealant effectiveness in arresting incipient carious lesions, which according to the ICDAS II classification have received codes 1 and 2 but did not support sealant effectiveness in arresting caries lesions classified according to the same classification with code 3.
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Desai H, Stewart CA, Finer Y. Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review. Dent J (Basel) 2021; 9:dj9120147. [PMID: 34940044 PMCID: PMC8700643 DOI: 10.3390/dj9120147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
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Affiliation(s)
- Hetal Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Correspondence:
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Kasemkhun P, Nakornchai S, Phonghanyudh A, Srimaneekarn N. The efficacy of dental sealant used with bonding agent on occlusal caries (ICDAS 2-4): A 24-month randomized clinical trial. Int J Paediatr Dent 2021; 31:760-766. [PMID: 33220141 DOI: 10.1111/ipd.12758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bonding before sealant application enhances retention on saliva-contaminated sound teeth; however, there are few studies of bonding's efficacy on sealant retention on occlusal caries. AIM To evaluate a bonding agent's efficacy on sealant retention on occlusal caries and caries transition. DESIGN One hundred twenty pairs of first permanent molars with occlusal caries (ICDAS 2-4) from 98 children aged 7.3-9.9 years were included. One molar was randomly selected to use bonding (Adper™ Single Bond 2, 3M ESPE) applied before sealant application (Helioseal® clear, Ivoclar Vivadent). Bonding was not used on the contralateral tooth. Retention was determined using Simonsen's criteria; caries transition was evaluated using ICDAS scores, DIAGNOdent values, and bitewings at baseline, 6, 12, and 24 months. Data were analyzed with McNemar's and Fisher's exact tests. RESULTS Bonding agent use significantly increased sealant retention rates (P < .001). Bonded (B) sealants had a higher retention rate (83.3%) than non-bonded (NB) sealants (53.7%). The difference in the caries-transition rate was not significant between the groups (P > .05). Three teeth (1.4%; NB:B = 2:1) were restored due to radiographic dentin-caries progression. CONCLUSIONS Using a bonding agent before applying sealant on permanent molar occlusal caries (ICDAS 2-4) significantly enhanced sealant retention. Caries progression was rarely detected at the 24-month follow-up.
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Affiliation(s)
| | - Siriruk Nakornchai
- Department of Pediatric Dentistry, Mahidol University, Bangkok, Thailand
| | - Araya Phonghanyudh
- Department of Pediatric Dentistry, Mahidol University, Bangkok, Thailand
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Silva VBD, Carvalho RND, Bergstrom TG, Santos TMPD, Lopes RT, Neves ADA. Sealing Carious Fissures with Resin Infiltrant in Association with a Flowable Composite Reduces Immediate Microleakage? Pesqui Bras Odontopediatria Clín Integr 2020. [DOI: 10.1590/pboci.2020.067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Abstract
Aim The hypothesis was tested that dentine carious lesion progression is higher in sealed micro-cavitated pits and fissures than in sealed pits and fissures having no or enamel carious lesions at baseline over a period of four years.Results Epidemiological survey identified no enamel carious lesions (code 0), enamel carious lesions (code 1), and micro-cavitated dentine carious lesions (code 2), in pits/fissures of occlusal surfaces of first permanent molars at baseline. Using block randomisation, 405 children (mean age of eight years) were allocated to high-viscosity glass-ionomer, atraumatic restorative treatment method (HVGIC/ART), thermo-cured HVGIC/ART, glass-carbomer, and resin composite groups, receiving 1,344 sealants. Evaluation was performed after six months and annually. Carious lesion progression for baseline code 0 (n = 784) and code 1 (n = 481) was determined by scoring code 2, and that for baseline code 2 (n = 79) by scoring code 3 or 4 (frank cavitation). Tests were performed using a proportional hazard model with frailty correction.Discussion and conclusion There was neither an effect for sealant group nor between baseline codes 0 and 1. A total of 19 baseline code 0, and 20 code 1 developed a cavitated dentine carious lesion; while 5% of the sealed over micro-cavitated dentine carious lesions developed frank cavitation. The progression of carious lesions in the group baseline code (0 + 1) was not statistically significantly different from the group of baseline code 2 (p = 0.29). Progression of micro-cavities sealed over with HVGIC according to the ART method, a glass-carbomer or a resin composite over a period of four years is low. Dentine lesions with a small orifice (Ø <0.5 mm) in pits/fissures of occlusal surfaces in permanent molars have a high chance of surviving four years if they are sealed over.
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Affiliation(s)
- WeiWei Zhang
- Preventive Department, Key Laboratory for Oral Biomedical Engineering, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, China
| | - Jan Mulder
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Jo E Frencken
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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Muñoz-Sandoval C, Gambetta-Tessini K, Giacaman RA. Microcavitated (ICDAS 3) carious lesion arrest with resin or glass ionomer sealants in first permanent molars: A randomized controlled trial. J Dent 2019; 88:103163. [PMID: 31276747 DOI: 10.1016/j.jdent.2019.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 06/28/2019] [Accepted: 07/01/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Although there is some consensus that carious lesions in early stages (non-cavitated) could be treated using sealants, neither the type of materials nor their use in lesions with localized enamel breakdown (microcavitated) has been reported To compare the efficacy of resin or glass ionomer (GI) sealants in arresting microcavitated carious lesions (ICDAS 3) in first permanent molars. MATERIALS AND METHODS A double-blinded randomized controlled clinical trial was conducted in 41 healthy 6 to 11-year-old children. At the baseline examination, each subject had at least one carious lesion classified as ICDAS 3 on the first permanent molar. One hundred fifty-one lesions were randomized into: Group 1: resin sealants (76 lesions) and Group 2: GI sealant (75 lesions). Carious lesion progression was assessed clinically and radiographically. Progression and retention failure were the outcomes used for group comparisons at p-value<0.05. RESULTS After a two-year follow-up, only one lesion progressed to ICDAS 5, without statistically significant differences between the groups (χ2(1) = 0.90, p = 0.53). Radiographically, 100 lesions (98%) were arrested and 2 (2%) showed radiographic progression, without differences between groups (χ2(1) = 0.93, p = 0.93). At 2 years, complete retention was observed in 77% of the resin-based and in 83% of the GI sealants, without statistical differences between type of sealant (χ2(1) = 0.71, p = 0.48). The multilevel mixed model demonstrated that location and type of sealant did not affect retention rates (χ2(1) = 24,98, p < 0.001). CONCLUSION Sealing ICDAS 3 carious lesions in permanent molars appears to be effective in arresting lesions after a two-year follow-up. Clinicaltrials.gov: RCTICDAS3/2015. CLINICAL SIGNIFICANCE Minimally invasive approaches for carious lesion management have been promoted. Using sealants for the treatment of microcavitated lesions (ICDAS 3) appears predictable in the routine practice, without predilection for resin or glass ionomer materials. In addition to preserving tooth structure, this strategy reduces chair-time, dental fear and costs, and increases coverage to dental care.
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Affiliation(s)
| | | | - Rodrigo A Giacaman
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Chile.
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Lausch J, Askar H, Paris S, Meyer-Lueckel H. Micro-filled resin infiltration of fissure caries lesions in vitro. J Dent 2017; 57:73-76. [DOI: 10.1016/j.jdent.2016.12.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 12/22/2016] [Accepted: 12/30/2016] [Indexed: 11/29/2022] Open
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Schwendicke F, Diederich C, Paris S. Restoration gaps needed to exceed a threshold size to impede sealed lesion arrest in vitro. J Dent 2016; 48:77-80. [PMID: 27026078 DOI: 10.1016/j.jdent.2016.03.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 03/19/2016] [Accepted: 03/25/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES After selective excavation, bacteria are sealed beneath restorations. Leaking restorations could maintain carbohydrate-supply, leading to lesion progression and pulp damage. It is unclear if fluid (and thereby carbohydrate) exchange occurs through any interfacial gaps, or if such exchange only occurs in case gaps exceed a certain threshold size. We investigated how different restoration gap sizes impact on survival of sealed bacterial in vitro. METHODS Bacterially contaminated artificial residual lesions were induced on the pulpo-axial walls of standardized dentin micro-cavities using acetic-acid demineralization and a continuous-culture Lactobacillus rhamnosus biofilm-model. Adhesive restorations with different gap sizes (0/100/200/400 μm) were placed (n=24/group). Restorations were submitted to cyclic loading (42 g/0.2 Hz) under highly cariogenic conditions in a mastication-simulating artificial mouth. After 25 days, the number of sealed viable bacteria was determined as colony-forming units. RESULTS After 25 days, CFU were significantly reduced in all groups (-99.99%, p<0.001/Mann-Whitney). Significantly more viable bacteria remained in restorations with gaps ≥ 200 μm (p<0.001). CONCLUSIONS Restoration gaps needed to exceed a threshold size to impede lesion arrest in vitro. There is great need to better understand why such threshold exists and which factors (mastication forces, restoration material, lesion location) could moderate the observed association. CLINICAL SIGNIFICANCE A certain gap sizes was necessary to allow sufficient fluid exchange for bacterial survival in vitro. It is not possible to deduct clinical recommendations at present.
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Kerr JE, Arndt GD, Byerly DL, Rubinovitz R, Theriot CA, Stangel I. FT-Raman Spectroscopy Study of the Remineralization of Microwave-Exposed Artificial Caries. J Dent Res 2015; 95:342-8. [PMID: 26647390 DOI: 10.1177/0022034515619370] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dental caries is a microbially mediated disease that can result in significant tooth structure degradation. Although the preponderance of lesions is treated by surgical intervention, various strategies have been developed for its noninvasive management. Here, we use a novel approach for noninvasive treatment based on killing Streptococcus mutans with high-frequency microwave energy (ME). The rationale for this approach is based on modulating the pH of caries to a physiological state to enable spontaneous tooth remineralization from exogenous sources. In the present study, after demonstrating that ME kills >99% of S. mutans in planktonic cultures, 8 enamel slabs were harvested from a single tooth. Baseline mineral concentration at each of 12 points per slab was obtained using Fourier transform (FT)-Raman spectroscopy. Surface demineralization was subsequently promoted by subjecting all samples to an S. mutans acidic biofilm for 6 d. Half of the samples were then exposed to high-frequency ME, and the other half were used as controls. All samples were next subjected to a remineralization protocol consisting of two 45-min exposures per 24-h period in tryptic soy broth followed by immersion in a remineralizing solution for the remaining period. After 10 d, samples were removed and cleaned. FT-Raman spectra were again obtained at the same 12 points per sample, and the mineral concentration was determined. The effect of the remineralization protocol on the demineralized slabs was expressed as a percentage of mineral loss or gain relative to baseline. The mineral concentration of the microwave-exposed group collectively approached 100% of baseline values, while that of the control group was in the order of 40%. Differences between groups were significant (P = 0.001, Mann-Whitney U test). We concluded that killing of S. mutans by ME promotes effective remineralization of S. mutans-demineralized enamel compared with controls.
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Affiliation(s)
- J E Kerr
- Department of Biology, Notre Dame of Maryland University, Baltimore, MD, USA
| | - G D Arndt
- Biomedical Engineering for Exploration Space Technology Laboratory, Engineering Laboratory, Lyndon B. Johnson Space Center, National Aeronautics and Space Administration (NASA), Houston, TX, USA
| | - D L Byerly
- Biomedical Engineering for Exploration Space Technology Laboratory, Engineering Laboratory, Lyndon B. Johnson Space Center, National Aeronautics and Space Administration (NASA), Houston, TX, USA
| | | | - C A Theriot
- Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA
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Kakuda S, Sidhu SK, Sano H. Buffering or non-buffering; an action of pit-and-fissure sealants. J Dent 2015; 43:1285-9. [PMID: 26163162 DOI: 10.1016/j.jdent.2015.06.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the buffering capacity of glass-ionomer material in vitro. The null hypothesis tested was that there is no effect of cured glass-ionomer pit-and-fissure sealant (PFS) pastes on the environmental acidity as well as the tooth substrate. METHOD For each material, a cured PFS disk and a section of human enamel were simultaneously soaked in lactic acid solution in a conical tube, and the pH of the solution was measured daily for one week. Subsequently, the total amount of calcium leached out in solution was also measured with ICP-AES. RESULTS The results showed that the acidity of the solutions changed over time. Significant differences of calcium ion concentration in solution were observed as a result of decalcification. As the PFS products tested did not include calcium, the concentration of calcium ion released indicated acidic erosion of the tooth enamel. CONCLUSIONS The glass-ionomer countered the acid of the solution rapidly and preserved the structure of human tooth enamel.
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Affiliation(s)
- Shinichi Kakuda
- Department of Restorative Dentistry, Division of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan.
| | - Sharanbir K Sidhu
- Institute of Dentistry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Hidehiko Sano
- Department of Restorative Dentistry, Division of Oral Health Science, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
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Abstract
BACKGROUND Dental caries is one of the most prevalent chronic oral diseases across the globe that can be both treated and prevented. Preventive management strategies can effectively arrest and even completely reverse the caries process. This article aimed to review the literature on different approaches explored towards arresting caries progression. MATERIALS AND METHODS Literature search of publications in Pubmed/Medline was carried out. Total 73 articles including clinical trials, invitro studies, case reports and review articles were reviewed. RESULTS Twenty-two clinical trials and invitro studies were selected for review. Most studies suggested use of Silver Diamine Fluoride (SDF) as simple and effective caries arresting approach. Fluoride varnish treatment effectively arrests caries by inhibiting demineralization, resulting in highly significant caries reductions. Arginine with an insoluble calcium compound enhances arresting and reversing buccal, coronal and root caries. A few clinical studies have shown that sealants placed in caries fissures can arrest the caries process. CONCLUSION Various fluoride containing agents are clinically effective in arresting progression of carious lesion. However, these materials should be used appropriately understanding their scope and limitations to arrest dental caries.
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Affiliation(s)
- Gaurav Sharma
- Post-Graduate student, Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
| | - Manjunath P. Puranik
- Professor and Head, Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
| | - Sowmya K.R.
- Assistant Professor, Department of Public Health Dentistry, Government Dental College and Research Institute, Bangalore, India
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Hesse D, Bonifácio CC, Mendes FM, Braga MM, Imparato JCP, Raggio DP. Sealing versus partial caries removal in primary molars: a randomized clinical trial. BMC Oral Health 2014; 14:58. [PMID: 24884684 PMCID: PMC4045925 DOI: 10.1186/1472-6831-14-58] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 05/22/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The resin-based pit and fissure sealant is considered a successful tool in caries prevention, however there is a growing evidence of its use in controlling already established caries in posterior teeth. The aim of this clinical trial is to verify the efficacy of pit and fissure sealants in arresting dentinal caries lesions compared to partial excavation and restorative treatment in primary molar teeth. METHODS Thirty six patients with occlusal cavitated primary molar reaching outer half of dentin were selected. The patients were randomly allocated into two groups: sealant application (experimental group - n = 17) and restoration with composite resin (control group - n = 19). Clinical and radiograph evaluation were performed after 6, 12 and 18 months. The chi-square test was used to verify the distribution of characteristics variables of the sample among the groups. The survival rate of treatments was evaluated using Kaplan-Meier survival and log-rank test. Fisher's Exact and logistic regression tests were calculated in each evaluation period (α = 5%). RESULTS The control group showed significantly better clinical survival after 18 months (p = 0.0025). In both groups, no caries progression was registered on the radiographic evaluations. CONCLUSIONS Sealing had similar efficacy in the arrestment of caries progression of cavitated occlusal lesions compared to partial excavation of the lesions, even though the frequency of re-treatments was significantly higher in sealed lesions. TRIAL REGISTRATION Registro Brasileiro de Ensaios Clínicos (ReBEC): RBR-9kkv53.
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Affiliation(s)
- Daniela Hesse
- Orthodontics and Pediatric Dentistry Department, Dental School, University of São Paulo - USP, Av, Lineu Prestes, São Paulo, SP 2227, Brazil.
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Kaga M, Kakuda S, Ida Y, Toshima H, Hashimoto M, Endo K, Sano H. Inhibition of enamel demineralization by buffering effect of S-PRG filler-containing dental sealant. Eur J Oral Sci 2013; 122:78-83. [DOI: 10.1111/eos.12107] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Masayuki Kaga
- Division of Biomaterials and Bioengineering Department of Oral Rehabilitation; School of Dentistry; Health Sciences University of Hokkaido; Ishikari-Tobetsu, Hokkaido Japan
| | - Shinichi Kakuda
- Department of Restorative Dentistry; Division of Oral Health Science; Graduate School of Dental Medicine; Hokkaido University; Sapporo Hokkaido, Japan
| | - Yusuke Ida
- Division of Biomaterials and Bioengineering Department of Oral Rehabilitation; School of Dentistry; Health Sciences University of Hokkaido; Ishikari-Tobetsu, Hokkaido Japan
| | - Hirokazu Toshima
- Division of Biomaterials and Bioengineering Department of Oral Rehabilitation; School of Dentistry; Health Sciences University of Hokkaido; Ishikari-Tobetsu, Hokkaido Japan
| | - Masanori Hashimoto
- Division of Biomaterials and Bioengineering Department of Oral Rehabilitation; School of Dentistry; Health Sciences University of Hokkaido; Ishikari-Tobetsu, Hokkaido Japan
| | - Kazuhiko Endo
- Division of Biomaterials and Bioengineering Department of Oral Rehabilitation; School of Dentistry; Health Sciences University of Hokkaido; Ishikari-Tobetsu, Hokkaido Japan
| | - Hidehiko Sano
- Department of Restorative Dentistry; Division of Oral Health Science; Graduate School of Dental Medicine; Hokkaido University; Sapporo Hokkaido, Japan
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Schwendicke F, Meyer-lueckel H, Dörfer C, Paris S. Failure of incompletely excavated teeth—A systematic review. J Dent 2013; 41:569-80. [DOI: 10.1016/j.jdent.2013.05.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 05/04/2013] [Accepted: 05/04/2013] [Indexed: 11/22/2022] Open
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Markowitz K, Rosenfeld D, Peikes D, Guzy G, Rosivack G. Effect of pit and fissure sealants on caries detection by a fluorescent camera system. J Dent 2013; 41:590-9. [PMID: 23684780 DOI: 10.1016/j.jdent.2013.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 05/06/2013] [Accepted: 05/07/2013] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of sealant placement on the detection of caries by a fluorescent camera (FC), the Spectra caries detector. MATERIALS AND METHODS In a laboratory study, FC images and readings were obtained from 31 extracted teeth, before and following application of clear sealants (Shofu Clear or Delton unfilled), or opaque sealants (3M Clinpro or Delton FS). Teeth were then sectioned and examined for enamel or dentine caries. Using each tooth's true caries diagnosis, the sensitivity and specificity of the FC measurements in detecting dentine caries was calculated. In the clinical study, FC readings were obtained from 41 molars in children prior to and following application of clear sealants. RESULTS Following application of Shofu or Delton unfilled there were reductions in the mean FC readings of 10% (p=0.5) and 8.2% (p=0.009), respectively. Application of two opaque sealants, 3M or Delton FS significantly reduced mean FC readings 16.2% and 20.8% (p<0.5), respectively. Although the carious lesions could still be observed in FC images from teeth with opaque sealants there was a significant loss of sensitivity in detecting dentinal caries. Clear sealant application caused an insignificant loss of detection sensitivity. Following application of clear sealants to children's molars there was a small (4.01%) but significant (p<0.01) reduction in FC readings recorded from these teeth. CONCLUSIONS The FC can detect caries under clear sealants with little loss of sensitivity. Although lesions can be seen through opaque sealants, loss of sensitivity precludes accurate lesion assessment.
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Affiliation(s)
- Kenneth Markowitz
- Department of Oral Biology, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, 185 South Orange Avenue, Newark, NJ 07103, USA.
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Bakhshandeh A, Qvist V, Ekstrand KR. Sealing occlusal caries lesions in adults referred for restorative treatment: 2-3 years of follow-up. Clin Oral Investig 2011; 16:521-9. [PMID: 21479565 DOI: 10.1007/s00784-011-0549-4] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 03/14/2011] [Indexed: 12/23/2022]
Abstract
The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25-38 months (mean = 33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2-3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression (p > 0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations (p > 0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health.
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Affiliation(s)
- Azam Bakhshandeh
- Department of Cariology and Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen N, Denmark.
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Holtzman JS, Osann K, Pharar J, Lee K, Ahn YC, Tucker T, Sabet S, Chen Z, Gukasyan R, Wilder-Smith P. Ability of optical coherence tomography to detect caries beneath commonly used dental sealants. Lasers Surg Med 2010; 42:752-9. [PMID: 20848554 PMCID: PMC3369270 DOI: 10.1002/lsm.20963] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVE The onset and progression of early tooth decay is often preventable with dental sealants. However, occasionally decay progresses underneath the sealant. Current technology does not permit monitoring of potential lesion progression or arrest. Dental sealants themselves mask the visual cues that identify early tooth decay, and radiographs are not sufficiently sensitive. Therefore, clinicians can be reluctant to use dental sealant. The objective of this ex vivo study was to evaluate the ability of dentists to detect decay beneath commonly used dental sealants using optical coherence tomography (OCT) imaging. STUDY DESIGNS/MATERIALS/METHODS: Forty extracted teeth were divided into equal groups of carious and non-carious teeth, as determined by visual inspection. After radiographs and OCT imaging, teeth were randomly assigned for sealant placement with one of four commonly purchased dental sealants: Clinpro™, Fuji Triage™, Embrace Wet Bond™, and Delton™.Following sealant placement, teeth were radiographed, imaged with OCT, sectioned, examined histologically, and scored as healthy/not healthy. OCT and radiographic images were scored separately. The gold standard was histopathological diagnosis from the serial sections.Cohen's kappa, sensitivity, negative predictive value, and positive predictive value were computed for all measures. RESULTS After 90 minutes training, pre-standardized dentists were able to detect tooth decay more accurately using OCT than with visual or radiographic examination. Detection using OCT was somewhat better prior to sealant placement than afterwards. This effect varied in size depending on the type of sealant used. Radiographic diagnosis was also less accurate after sealant placement. Of the four dental sealants, Delton provided excellent positive predictive value and the best post-sealant negative predictive values. CONCLUSION In this ex vivo study, dentists were able to detect tooth decay beneath four commonly used dental sealants based on OCT images. Clinical investigations are now underway to determine the usefulness of this approach in vivo.
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Affiliation(s)
- Jennifer S Holtzman
- The Herman Ostrow School of Dentistry, University of Southern California, 3305B South Hoover Street, Bldg A, Room 120, Los Angeles, California 90089-71001, USA.
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Chen X, Cuijpers V, Fan M, Frencken J. Marginal leakage of two newer glass-ionomer-based sealant materials assessed using micro-CT. J Dent 2010; 38:731-5. [DOI: 10.1016/j.jdent.2010.05.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2010] [Revised: 05/10/2010] [Accepted: 05/15/2010] [Indexed: 11/21/2022] Open
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Affiliation(s)
- Jolanta Aleksejūnienė
- Department of Oral Health Sciences; Faculty of Dentistry; University of British Columbia
| | - Mario A. Brondani
- Department of Oral Health Sciences; Faculty of Dentistry; University of British Columbia
| | - Komkham Pattanaporn
- Department of Oral Health Sciences; Faculty of Dentistry; University of British Columbia
| | - Vilma Brukiene
- Institute of Odontology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
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