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Meyer F, Schulze Zur Wiesche E, Amaechi BT, Limeback H, Enax J. Caries Etiology and Preventive Measures. Eur J Dent 2024. [PMID: 38555649 DOI: 10.1055/s-0043-1777051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024] Open
Abstract
Caries is a widespread disease in both children and adults. Caries is caused by the conversion of fermentable carbohydrates by plaque bacteria into acids on the tooth surface. Thus, it is important to focus on sugar reduction and plaque control. For efficient plaque removal/control, state-of-the-art toothpastes contain various active ingredients such as antimicrobial agents (e.g., chlorhexidine, stannous salts, and zinc salts), abrasives (e.g., calcium carbonate, calcium phosphates, and hydrated silica), surfactants (e.g., sodium lauryl sulfate and sodium methyl cocoyl taurate), and natural compounds (e.g., polyphenols and xylitol). Agents with pH-buffering and calcium-releasing properties (e.g., calcium carbonate and calcium phosphates) and biomimetic actives (e.g., hydroxyapatite) reverse the effects of the acids. Additionally, modern toothbrushes (i.e., electric toothbrushes) as well as dental floss and interdental brushes significantly help remove plaque from dental surfaces including interproximal surfaces. In conclusion, modern concepts in caries prevention should focus not only on tooth remineralization alone but also on the control of all the key factors involved in caries development.
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Affiliation(s)
- Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | | | - Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, Texas, United States
| | - Hardy Limeback
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
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Unterbrink P, Schulze Zur Wiesche E, Meyer F, Fandrich P, Amaechi BT, Enax J. Prevention of Dental Caries: A Review on the Improvements of Toothpaste Formulations from 1900 to 2023. Dent J (Basel) 2024; 12:64. [PMID: 38534288 DOI: 10.3390/dj12030064] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/28/2024] Open
Abstract
Modern toothpastes are complex formulations with various ingredients. The aim of this study was to analyze the improvement of toothpaste formulations from 1900 to 2023 focusing on active ingredients with remineralizing, antibacterial, or plaque-removing effects, and to discuss their influence on caries prevention. For this, worldwide patent applications were searched using the international database Espacenet from the European Patent Office. Additionally, toothpaste products were searched using the Mintel product database from 1996 to 2023. The searched ingredients were (in alphabetical order): calcium carbonate, calcium phosphates, hydrated silica, sodium fluoride, sodium lauryl sulfate, triclosan, xylitol, and zinc salts as they are known from the scientific literature to be remineralizing or antibacterial/antiplaque agents. It was shown that the number of patent applications containing these ingredients significantly increased since the 1970s. As these ingredients have remineralizing, antibacterial, or plaque-removing effects, they all can contribute to caries prevention. In conclusion, and within the limitations of this approach, this study shows that toothpaste formulations have greatly improved over the past decades by using various active anticaries ingredients.
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Affiliation(s)
- Patrick Unterbrink
- Research Department, Dr. August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstr. 56, 33611 Bielefeld, Germany
| | - Erik Schulze Zur Wiesche
- Research Department, Dr. August Wolff GmbH & Co. KG Arzneimittel, Sudbrackstr. 56, 33611 Bielefeld, Germany
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Pascal Fandrich
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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Amaechi BT, Mohseni S, Dillow AM, Abdul Azees PA, Movaghari Pour F, Kataoka Y, Restrepo MC. Investigation of the effects of Bipolar Radiofrequency Energy on the Structural Morphology of Dental Plaque. Eur J Dent 2024; 18:243-252. [PMID: 37172943 PMCID: PMC10959635 DOI: 10.1055/s-0043-1764427] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established. MATERIALS AND METHODS Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively. STATISTICAL ANALYSIS Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests. RESULTS At each time, RF treatment significantly (p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques. CONCLUSION The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste.
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Affiliation(s)
- Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Sahar Mohseni
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Andrew M. Dillow
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Parveez Ahamed Abdul Azees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Fatemeh Movaghari Pour
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | - Yuko Kataoka
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
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Farokhi MR, English DK, Boone SL, Amaechi BT. Health professions learners' evaluation of e-learning scenario-based case study design: Reinvigorating flipped classroom modalities. J Dent Educ 2023; 87:1754-1765. [PMID: 37753866 DOI: 10.1002/jdd.13379] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/24/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
OBJECTIVES Interactive scenario-based learning (SBL) cases were developed using the SoftChalk platform to deliver content about patients' barriers to accessing healthcare and patient management strategies connecting oral to systemic health. The interactive cases were designed to engage the digital-savvy learners, meet them where they are by leveling up, and seek their feedback to determine flipped (FC) or modified flipped classroom (MFC) content delivery approaches. METHODS Health professions students completed interactive SBL cases (Phase-I) using either FC as assigning content outside of class time preparation or MFC as allocating time at the beginning of the class deliveries, and a 12-item post-completion survey. The senior dental student cohort (Phase-II) completed an anonymous Qualtrics survey that assessed their confidence leading to clinical competence two years after the interactive SBL case deliveries. The final survey (Phase-III) of first-year dental students evaluated the improved interactive scenario-based cases post modifications. [Corrections added on 03 October 2023: After first online publication the first sentence of methods section has been updated.] RESULTS: No significant differences existed between the FC and MFC content delivery scores; however, learners preferred the structured time allotted in the MFC approach as a learning style for participants (N=989). The overall means percent score was 93.2% (n = 398) for FC and 96.5% (n = 591) for MFC. Thematic analysis of written responses indicated that learners felt the vignettes were relevant, thought-provoking, incorporated decision-making, and provided feedback. Four themes about strengths emerged as engaging, interactive, relevant, and critical. Design and technological challenges emerged as interactive SBL improvements. A follow-up report (74/103, 2021) revealed that 48% of senior dental students surveyed recollected the SBL cases when they delivered preventive, patient-centered dental services as juniors and seniors. They also recalled that the interactive cases prepared them for clinical success. The Final comments (2022) did not commend any significant improvements. CONCLUSION Interactive scenario-based approaches nurture active learning and critical thinking. The educator can engage learners by incorporating teaching modalities as SBL cases to enhance their knowledge and create educational environments by meeting learners where they are. Learners can be valuable partners as educators define their instructional strategies to be equitable and student-centered. [Correction added on 04 October 2023: after first online publication, abstract section has been revised.].
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Affiliation(s)
- Moshtagh R Farokhi
- Department of Comprehensive Dentistry, School of Dentistry, UT Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Dana Kiefer English
- Office of the Dental Dean, Assistant Dean for Faculty Development, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | - Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, UT Health Science Center at San Antonio, San Antonio, Texas, USA
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Paszynska E, Hernik A, Rangé H, Amaechi BT, Gross GS, Pawinska M. Diet Traps during Eating Disorders among Dentate Patients at an Oral Health Glance. Nutrients 2023; 15:4414. [PMID: 37892489 PMCID: PMC10610111 DOI: 10.3390/nu15204414] [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: 09/08/2023] [Revised: 10/04/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
Persons suffering from eating disorders (ED) may often experience a recurrence/persistence symptoms despite the completion of psychiatric therapy. In most cases, their general health status is linked to current nutritional behaviors. Medical professionals, general practitioners (GPs), dieticians, and dentists may see those patients in their practices. At the same time, due to low sense of illness, some patients may delay or never seek professional medical care. The aim of this article is to analyze the main ED types according to dietary behaviors causing oral health problems and discuss oral health complications in affected dentate patients. The second objective is to update oral preventive measures and technological innovations together with active agents for oral hygiene care that might effectively support oral health maintenance during the presence of long-term symptoms. The research method involved a review of clinical reports as a synthesis of the electronic research in the Pubmed, Web of Science, and Google Scholar databases. Based on the research, ED patients were found to present related incidences of oral complications. Studies have reported that the possible course of an ED and comorbidities may be an imbalance in the oral environment. The results showed an association between biological (malnutrition, etc.), behavioral (binge eating episodes, vomiting, acidic diet, poor oral hygiene), and pharmacotherapeutic (addiction, hyposalivation) factors that may threaten oral health. Early diagnosis of the past and present symptoms is essential to eliminate and take control of destructive behaviors. Oral changes need to be tackled with medical insight, and additionally, the perception of dietary interactions is recommended.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), 60-812 Poznan, Poland
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences (PUMS), 60-812 Poznan, Poland
| | - Hélène Rangé
- Department of Periodontology, Faculty of Odontology, University of Rennes, CHU de Rennes, F-35000 Rennes, France
- Institut NUMECAN (Nutrition Metabolism and Cancer), INSERM, INRAE, University of Rennes, F-35000 Rennes, France
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Georgiana S. Gross
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX 78229, USA
| | - Malgorzata Pawinska
- Department of Integrated Dentistry, Medical University in Bialystok, 15-276 Bialystok, Poland
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Enax J, Ganss B, Amaechi BT, Schulze zur Wiesche E, Meyer F. The composition of the dental pellicle: an updated literature review. Front Oral Health 2023; 4:1260442. [PMID: 37899941 PMCID: PMC10600522 DOI: 10.3389/froh.2023.1260442] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/26/2023] [Indexed: 10/31/2023] Open
Abstract
Background The dental pellicle is a thin layer of up to several hundred nm in thickness, covering the tooth surface. It is known to protect the teeth from acid attacks through its selective permeability and it is involved in the remineralization process of the teeth. It functions also as binding site and source of nutrients for bacteria and conditioning biofilm (foundation) for dental plaque formation. Methods For this updated literature review, the PubMed database was searched for the dental pellicle and its composition. Results The dental pellicle has been analyzed in the past years with various state-of-the art analytic techniques such as high-resolution microscopic techniques (e.g., scanning electron microscopy, atomic force microscopy), spectrophotometry, mass spectrometry, affinity chromatography, enzyme-linked immunosorbent assays (ELISA), and blotting-techniques (e.g., western blot). It consists of several different amino acids, proteins, and proteolytic protein fragments. Some studies also investigated other compounds of the pellicle, mainly fatty acids, and carbohydrates. Conclusions The dental pellicle is composed mainly of different proteins, but also fatty acids, and carbohydrates. Analysis with state-of-the-art analytical techniques have uncovered mainly acidic proline-rich proteins, amylase, cystatin, immunoglobulins, lysozyme, and mucins as main proteins of the dental pellicle. The pellicle has protective properties for the teeth. Further research is necessary to gain more knowledge about the role of the pellicle in the tooth remineralization process.
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Affiliation(s)
- Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - Bernhard Ganss
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, United States
| | | | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
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Paszynska E, Pawinska M, Enax J, Meyer F, Schulze zur Wiesche E, May TW, Amaechi BT, Limeback H, Hernik A, Otulakowska-Skrzynska J, Krahel A, Kaminska I, Lapinska-Antonczuk J, Stokowska E, Gawriolek M. Caries-preventing effect of a hydroxyapatite-toothpaste in adults: a 18-month double-blinded randomized clinical trial. Front Public Health 2023; 11:1199728. [PMID: 37533523 PMCID: PMC10393266 DOI: 10.3389/fpubh.2023.1199728] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/05/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dental caries is a worldwide challenge for public health. The aim of this 18-month double-blinded, randomized, clinical trial was to compare the caries-preventing effect of a fluoride-free, hydroxyapatite toothpaste (test) and a toothpaste with sodium fluoride (1450 ppm fluoride; positive control) in adults. Methods The primary endpoint was the percentage of subjects showing no increase in overall Decayed Missing Filled Surfaces (DMFS) index. The study was designed as non-inferiority trial. Non-inferiority was claimed if the upper limit of the exact one-sided 95% confidence interval for the difference of the primary endpoint DMFS between test and control toothpaste was less than the predefined margin of non-inferiority (Δ ≤ 20%). Results In total, 189 adults were included in the intention-to-treat (ITT) analysis; 171 subjects finished the study per protocol (PP). According to the PP analysis, no increase in DMFS index was observed in 89.3% of subjects of the hydroxyapatite group and 87.4% of the subjects of the fluoride group. The hydroxyapatite toothpaste was not statistically inferior to a fluoride toothpaste with regard to the primary endpoint. Conclusion Hydroxyapatite was proven to be a safe and efficient anticaries agent in oral care. Clinical trial registration NCT04756557.
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Malgorzata Pawinska
- Department of Integrated Dentistry, Medical University of Bialystok, Bialystok, Poland
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Bielefeld, Germany
| | | | - Theodor W. May
- Society for Biometrics and Psychometrics, Bielefeld, Germany
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, United States
| | - Hardy Limeback
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Amadeusz Hernik
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Anna Krahel
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Inga Kaminska
- Department of Integrated Dentistry, Medical University of Bialystok, Bialystok, Poland
| | | | - Ewa Stokowska
- Department of Gerostomatology, Medical University of Bialystok, Bialystok, Poland
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
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Alawadi A, AbdulAzees PA, Lin CY, Haney SJ, Hanlon JP, Angelara K, Taft RM, Amaechi BT. Application of Organoselenium in inhibiting Candida albicans biofilm adhesion on 3D printed denture base material. J Prosthodont 2023. [PMID: 37422719 DOI: 10.1111/jopr.13733] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 07/06/2023] [Indexed: 07/10/2023] Open
Abstract
PURPOSE Denture Stomatitis, a chronic mucosal inflammation associated with Candida albicans, is common among denture wearers. Several health conditions have been linked to chronic Candida infections. The complex, multifactorial nature of denture stomatitis requires the continuous pursuit of effective long-term solutions. The present in vitro study investigated the effect of incorporating organoselenium into 3D-printed denture base resin on Candida albicans adhesion and biofilm formation. MATERIALS AND METHODS Thirty disks were fabricated using 3D-printed denture base resin and assigned to 3 experimental groups (10/group): disks without organoselenium (control), disks with 0.5% organoselenium (0.5%SE), and disks with 1% organoselenium (1%SE). Each disk was incubated with approximately 1 × 106 cells/mL of Candida albicans for 48 hours. Microbial viability (CFU/mL) was quantified by the spread plate method, while Confocal laser scanning microscopy and scanning electron microscope were performed for quantifying the biofilm thickness and examining biofilm morphology, respectively. Data were analyzed using One-way ANOVA with Tukey's multiple comparisons test. RESULTS CFU/mL was significantly (P<0.05) higher in Control when compared with 0.5%SE and 1%SE, but no significant difference between 0.5%SE and 1%SE. A similar trend was observed with biofilm thickness except that there was no significant difference between the Control and 0.5%SE. There was C. albicans biofilm adhesion on the Control disks, with yeast cells and hyphae formation, whereas on 0.5%SE and 1%SE, there was inhibition of yeast cells transition to hyphae formation. CONCLUSIONS Incorporation of organoselenium into 3D-printed denture base resin was effective in reducing Candida albicans biofilm formation and growth on denture base material. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ahmad Alawadi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
| | - Parveez Ahmed AbdulAzees
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
| | - Chun-Yen Lin
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
- Department of Family Dentistry and Oral Diagnosis, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan
| | - Stephan J Haney
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
| | - John P Hanlon
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
| | - Konstantina Angelara
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
| | - Robert M Taft
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, School of Dentistry, San Antonio, Texas, USA
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Keeper JH, Kibbe LJ, Thakkar-Samtani M, Heaton LJ, Desrosiers C, Vela K, Amaechi BT, Jablonski-Momeni A, Young DA, MacLean J, Weyant RJ, Zandona AF, Sohn W, Pitts N, Frantsve-Hawley J. Systematic review and meta-analysis on the effect of self-assembling peptide P 11-4 on arrest, cavitation, and progression of initial caries lesions. J Am Dent Assoc 2023:S0002-8177(23)00189-7. [PMID: 37245138 DOI: 10.1016/j.adaj.2023.03.014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/14/2023] [Accepted: 03/10/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Simple noninvasive evidence-based interventions for caries are needed to overcome limitations in the restorative paradigm. The self-assembling peptide P11-4 is a noninvasive intervention that regenerates enamel in initial caries lesions. STUDIES REVIEWED The authors conducted a systematic review and meta-analysis on the effectiveness of the P11-4 products Curodont Repair (Credentis; now manufactured by vVARDIS) (CR) and Curodont Repair Fluoride Plus (Credentis; now manufactured by vVARDIS) on initial caries lesions. Primary outcomes were lesion progression after 24 months, caries arrest, and cavitation. Secondary outcomes were changes in merged International Caries Detection and Assessment System score categories, quantitative light-induced fluorescence (QLF; Inspektor Research System), esthetic appearance, and lesion size. RESULTS Six clinical trials met the inclusion criteria. Results of this review represent 2 primary and 2 secondary outcomes. When compared with parallel groups, use of CR likely results in a large increase in caries arrest (relative risk [RR], 1.82 [95% CI, 1.32 to 2.50]; 45% attributable risk [95% CI, 24% to 60%]; number needed to treat [NNT], 2.8) and likely decreases lesion size by a mean (SD) of 32% (28%). The evidence also suggests that use of CR results in a large reduction in cavitation (RR, 0.32 [95% CI, 0.10 to 1.06]; NNT, 6.9) and is uncertain about lowering merged International Caries Detection and Assessment System score (RR, 3.68 [95% CI, 0.42 to 32.3]; NNT, 19). No studies used Curodont Repair Fluoride Plus. No studies reported adverse esthetic changes. PRACTICAL IMPLICATIONS CR likely has clinically important effects on caries arrest and decreased lesion size. Two trials had nonmasked assessors, and all trials had elevated risks of bias. The authors recommend conducting longer trials. CR is a promising treatment for initial caries lesions. The protocol for this systematic review was registered a priori with PROSPERO (304794).
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Enax J, Amaechi BT, Farah R, Liu JA, Schulze zur Wiesche E, Meyer F. Remineralization Strategies for Teeth with Molar Incisor Hypomineralization (MIH): A Literature Review. Dent J (Basel) 2023; 11:dj11030080. [PMID: 36975577 PMCID: PMC10047667 DOI: 10.3390/dj11030080] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/16/2023] Open
Abstract
Molar incisor hypomineralization (MIH) is a highly prevalent dental developmental disorder with a significant health burden for patients and high treatment needs, yet no comprehensive review article on all remineralization systems as a non-invasive treatment approach for MIH has been published. Typical characteristics of MIH-affected teeth are a lower mineral density and lower hardness compared to healthy teeth leading to sensitivity and loss of function. Thus, the use of formulations with calcium phosphates to remineralize MIH-affected teeth is reasonable. This review presents an up-to-date overview of remineralization studies focusing on active ingredients investigated for remineralization of MIH, i.e., casein phosphopeptide amorphous calcium phosphate (CPP-ACP), casein phosphopeptide amorphous calcium fluoride phosphate (CPP-ACFP), hydroxyapatite, calcium glycerophosphate, self-assembling peptide, and fluoride. Overall, 19 studies (in vitro, in situ, and in vivo) were found. Furthermore, an additional search for studies focusing on using toothpaste/dentifrices for MIH management resulted in six studies, where three studies were on remineralization and three on reduction of sensitivity. Overall, the studies analyzed in this review showed that MIH-affected teeth could be remineralized using calcium phosphate-based approaches. In conclusion, calcium phosphates like CPP-ACP, calcium glycerophosphate, and hydroxyapatite can be used to remineralize MIH-affected teeth. In addition to MIH-remineralization, CPP-ACP and hydroxyapatite also offer relief from MIH-associated tooth sensitivity.
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Affiliation(s)
- Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (B.T.A.); (F.M.)
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
- Correspondence: (J.E.); (B.T.A.); (F.M.)
| | - Rayane Farah
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Jungyi Alexis Liu
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Erik Schulze zur Wiesche
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (B.T.A.); (F.M.)
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AlMojel N, AbdulAzees PA, Lamb EM, Amaechi BT. Determining growth inhibition of Candida albicans biofilm on denture materials after application of an organoselenium-containing dental sealant. J Prosthet Dent 2023; 129:205-212. [PMID: 34078547 DOI: 10.1016/j.prosdent.2021.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 01/18/2023]
Abstract
STATEMENT OF PROBLEM Denture stomatitis is a chronic inflammatory condition caused by the formation of Candida albicans biofilm on denture bases. It is associated with aggravating intraoral pain, itching, and burning sensations. It can also potentiate cardiovascular diseases and aspiration pneumonia. The problem has thus far eluded efficient, toxic-free, and cost-effective solutions. PURPOSE The purpose of this in vitro study was to investigate the effectiveness of organoselenium to inhibit the formation of C. albicans biofilm on the surface of acrylic resin denture base materials when it is either incorporated into the acrylic resin material or coated on the denture surface as a light-polymerized surface sealant. MATERIAL AND METHODS Sixty heat-polymerized polymethyl methacrylate disks were fabricated and assigned to 4 groups (n=15): disks coated with a light-polymerized organoselenium-containing enamel surface sealant (DenteShield), disks impregnated with 0.5% organoselenium (0.5% selenium), disks impregnated with 1% organoselenium (1% selenium), and disks without organoselenium (control). C. albicans biofilm was grown on each disk which had been placed in a well of the microtiter plate containing 1-mL brain heart infusion broth inoculated with C. albicans. The plates were incubated aerobically at 37 °C for 48 hours. A confocal laser scanning microscope was used to determine the biofilm thickness, biomass, and live/dead cell ratio. Biofilm morphology was examined with scanning electron microscopy, whereas microbial viability was quantified by the spread plate method. The data were analyzed by using ANOVA and Tukey-Kramer multiple comparisons (α=.05). RESULTS The microbial viability, biofilm thickness, biofilm biomass, and live/dead cell ratio were lower (P<.001) on disks in the test groups (DenteShield, 0.5% selenium, 1% selenium) when compared with the control group, with these variables being lowest in the 0.5% selenium and 1% selenium groups. The 0.5% selenium and 1% selenium groups did not differ significantly from each other in any of the variables (P>.05). Scanning electron microscope images showed inhibition of both biofilm growth and yeast to hyphae transition in the DenteShield, 0.5% selenium, and 1% selenium groups, with visible disruption of the biofilm morphology. CONCLUSIONS The present study demonstrated that organoselenium, whether incorporated into or coated on the surface of an acrylic resin denture base material, has the potential to inhibit Candida albicans biofilm growth on denture surfaces and as such can be clinically useful for the prevention of denture stomatitis.
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Affiliation(s)
- Neda AlMojel
- Former Resident, Postgraduate Prosthodontics, Department of Comprehensive Dentistry, UT Health School of Dentistry, San Antonio, Texas
| | - Parveez Ahmed AbdulAzees
- Post-doctoral fellow, Department of Comprehensive Dentistry, UT Health School of Dentistry, San Antonio, Texas
| | - E Mathew Lamb
- Assistance Professor and program director prosthodontic residency, Department of Comprehensive dentistry, UT Health School of Dentistry, San Antonio, Texas
| | - Bennett T Amaechi
- Professor and Director of Cariology, Department of Comprehensive Dentistry, UT Health School of Dentistry, San Antonio, Texas.
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Rahul B, Anand Sherwood I, Amaechi BT, Swathipriyadharshini S, Gokuapiriyan K, Farooq M, Savadamoorthi Subramani K. Survival and success of composite resin restorations in endodontically treated maxillary incisors with minimal structure loss. Gen Dent 2023; 71:44-49. [PMID: 36592358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The primary aim of this study was to evaluate the clinical performance of nanofilled composite resin restorations in traumatized, endodontically treated maxillary incisors with structural loss of 40% or less. The performance of the restorations was assessed in terms of longevity (survival) and esthetics (success) over a 20-month period. The secondary objective was to employ a novel digital method to quantify preoperative tooth structure loss. Sixty-one fractured maxillary incisors in 55 patients were included in the study. The teeth were photographed with a digital single-lens reflex camera equipped with a macro ring flash. The amount of lost tooth structure was calculated with digital photography software. The teeth were restored with a nanohybrid composite resin and self-etching adhesive system bonding agent. To assess esthetics, color change in the blue-yellow axis (Δb*) of the composite resin restoration was evaluated digitally with the Commission Internationale de l'Eclairage (CIE) L*a*b color system. The Wilcoxon signed-rank test was used to assess Δb*, and a Kaplan-Meier survival analysis was used to assess the longevity of the restorations. The study findings showed a statistically significant difference between pretreatment and posttreatment b* values (P < 0.05), but the difference was too small to be clinically perceptible to the human eye. A total of 5 restorations (9.8%) failed. The remaining restorations survived for a mean (SD) period of 18.6 (4.4) months. The log-rank test did not show any significant association between the amount of residual tooth structure and success of the restoration. The results of this study showed that use of direct composite resin restorations in endodontically treated maxillary incisors resulted in acceptable survival and success rates. Trial registration: Clinical Trial Registry of India No. CTRI/2020/01/023019.
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Enax J, Amaechi BT, Schulze zur Wiesche E, Meyer F. Overview on Adjunct Ingredients Used in Hydroxyapatite-Based Oral Care Products. Biomimetics (Basel) 2022; 7:biomimetics7040250. [PMID: 36546950 PMCID: PMC9775056 DOI: 10.3390/biomimetics7040250] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/14/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022] Open
Abstract
Hydroxyapatite, Ca5(PO4)3(OH), is a biomimetic active ingredient, which is used in commercial oral care products such as toothpastes and mouthwashes worldwide. Clinical studies (in vivo) as well as in situ and in vitro studies have shown the preventive effects of hydroxyapatite in various field of oral care. In some products, hydroxyapatite is combined with other active ingredients, to achieve an additional antibacterial effect or to promote gum health. This review analyzes the efficacy of six selected natural and nature-inspired ingredients that are commonly used together with hydroxyapatite. These additional actives are either antibacterial (lactoferrin, xylitol, and zinc) or promote gum health (allantoin, bisabolol, and hyaluronic acid). A systematic literature search was performed, and all studies found on each ingredient were analyzed. In summary, all analyzed ingredients mentioned in this review are well described in scientific studies on their beneficial effect for oral health and can be used to expand the preventive effect of hydroxyapatite in oral care products.
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Affiliation(s)
- Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34 36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (F.M.)
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Erik Schulze zur Wiesche
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34 36, 33611 Bielefeld, Germany
| | - Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34 36, 33611 Bielefeld, Germany
- Correspondence: (J.E.); (F.M.)
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Gudkina J, Amaechi BT, Abrams SH, Brinkmane A, Petrosina E. The Effect of MI Varnish™ on Caries Increment and Dietary Habits among 6- and 12-Year-Old Children in Riga, Latvia: A 3-Year Randomized Controlled Trial. Dent J (Basel) 2022; 10:dj10060096. [PMID: 35735638 PMCID: PMC9221846 DOI: 10.3390/dj10060096] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/05/2022] [Accepted: 05/20/2022] [Indexed: 12/04/2022] Open
Abstract
Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-year-old children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia.
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Affiliation(s)
- Jekaterina Gudkina
- Conservative Dentistry and Oral Health Department, Riga Stradins University, LV-1007 Riga, Latvia;
- Correspondence:
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, TX 78229, USA;
| | - Stephen H. Abrams
- Quantum Dental Technologies and Cliffcrest Dental Office, 2995 Kingston Road Scarborough, Scarborough, ON M1M 1P1, Canada;
| | - Anda Brinkmane
- Conservative Dentistry and Oral Health Department, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Eva Petrosina
- Statistical Laboratory, Riga Stradins University, LV-1007 Riga, Latvia;
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Azees PAA, Natarajan S, Amaechi BT, Thajuddin N, Raghavendra VB, Brindhadevi K, Pugazhendhi A. An empirical review on the risk factors, therapeutic strategies and materials at nanoscale for the treatment of oral malignancies. Process Biochem 2022. [DOI: 10.1016/j.procbio.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Durbin A, Amaechi BT, Abrams S, Mandelis A, Werb S, Roebuck B, Durbin J, Wang R, Daneshvarfard M, Sivagurunathan K, Bozec L. Protocol for a Case Control Study to Evaluate Oral Health as a Biomarker of Child Exposure to Adverse Psychosocial Experiences. Int J Environ Res Public Health 2022; 19:ijerph19063403. [PMID: 35329091 PMCID: PMC8948931 DOI: 10.3390/ijerph19063403] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
Background: The early identification of children who have experienced adversity is critical for the timely delivery of interventions to improve coping and reduce negative consequences. Self-report is the usual practice for identifying children with exposure to adversity. However, physiological characteristics that signal the presence of disease or other exposures may provide a more objective identification strategy. This protocol describes a case–control study that assesses whether exposure to adversity is more common in children with tooth enamel anomalies compared to children without such anomalies. Methods: For 150 mother–child pairs from a pediatric dental clinic in Toronto, Canada, maternal interviews will assess the child’s adverse and resilience-building experiences. Per child, one (exfoliated or extracted) tooth will be assessed for suspected enamel anomalies. If anomalies are present, the child is a case, and if absent, the child is a control. Tooth assessment modalities will include usual practice for dental exams (visual assessment) and modalities with greater sensitivity to identify anomalies. Conclusion: If structural changes in children’s teeth are associated with exposure to adversity, routine dental exams could provide an opportunity to screen children for experiences of adversity. Affected children could be referred for follow-up.
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Affiliation(s)
- Anna Durbin
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (R.W.); (M.D.)
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Correspondence: ; Tel.: +1-416-824-1078
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA;
| | - Stephen Abrams
- Cliffcrest Dental Office, Four Cell Consulting, Quantum Dental Technologies, Toronto, ON M6B 1L3, Canada;
| | - Andreas Mandelis
- Center for Diffusion-Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Toronto, ON M5T 1R8, Canada; (A.M.); (K.S.)
| | - Sara Werb
- Toronto Children’s Dentistry, Toronto, ON M5T 1R8, Canada;
| | - Benjamin Roebuck
- Victimology Research Centre, Algonquin College, Ottawa, ON K2G 1V8, Canada;
| | - Janet Durbin
- Provincial System Support Program (PSSP), Centre for Addiction and Mental Health (CAMH), Toronto, ON M5S 2S1, Canada;
| | - Ri Wang
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (R.W.); (M.D.)
| | - Maryam Daneshvarfard
- MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON M5B 1W8, Canada; (R.W.); (M.D.)
| | - Konesh Sivagurunathan
- Center for Diffusion-Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Toronto, ON M5T 1R8, Canada; (A.M.); (K.S.)
| | - Laurent Bozec
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada;
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Gudkina J, Amaechi BT, Abrams SH, Brinkmane A, Jelisejeva I. Inadequacy of self-Implemented preventive measures to control caries increment due to poor dietary habits in 6 and 12 years old children in Riga, Latvia. Stomatologija 2022; 24:13-20. [PMID: 36321705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
AIM This study investigated whether the self-implemented preventive measures practiced among the 6 and 12 years olds in Riga, Latvia can control the caries increment due to poor dietary habits among this age groups. MATERIAL AND METHODS Caries examination was performed on Thirty-eight 6 and thirty-nine 12 years olds by visual and bitewing radiographic examination at baseline and after 3 years. All participants and/or their parents completed dietary habits questionnaires. The data was analyzed using t-test, chi-square test, ANOVA and frequency tables, Wilcoxon and Fisher's tests (α=0.05). RESULTS The mean (SD) values of caries experience at baseline/3-year period in 6- vs.12-year olds were as follows. DMFS: 0.72 (1.02)/3.13 (3.13) (p=0.0000) vs. 6.79 (5.14)/14.79 (9.86) (p=0.0000); dmfs: 11.26(8.71)/7.74 (4.86) (p=0.078) vs. 3.57 (2.03)/1.5 (0.71) (p=0.317). The statistical significance was reported only for the consumption of soft drinks (p=0.032) and sugared tea (p=0.018) for the 6 years olds, and for sugared tea (p=0.017) and number of teaspoons of sugar added to tea (p=0.0095) for the 12-years olds. There was positive caries increment in all the 6 and 12 years olds that reported significant increase in consumption of soft drinks and sugared tea, and increase daily number of teaspoons of sugar used in tea. CONCLUSIONS The present study demonstrated high cariogenic diet among the children in Riga, which is associated with increased caries experience that the currently practiced self-implemented oral hygiene measures was not capable of controlling.
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Amaechi BT, Levi L, Silman Z, Evans V, Shehata MAS, Alonso-Ryan JR, Phillips TS, Ugwokaegbe PC, Farokhi MR. Clinical efficacy of a novel radiofrequency toothbrush for tooth stain reduction and tooth whitening: A randomized controlled trial. J Am Dent Assoc 2021; 153:342-353. [PMID: 34973707 DOI: 10.1016/j.adaj.2021.09.006] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/25/2021] [Accepted: 09/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The authors aimed to evaluate the effect of a novel radiofrequency (RF) toothbrush on tooth stains and shades compared with a sonic vibrating toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. METHODS The authors conducted a single-blind prospective study over 6 weeks. Participants were randomized to 1 of 2 study groups to receive either an RF toothbrush (ToothWave, Home Skinovations [test]) or a sonic vibrating toothbrush (SmileSonic powered toothbrush, Ranir [control]) and performed twice-daily toothbrushing with fluoridated toothpaste (Crest Cavity Protection, Procter & Gamble) for 6 weeks. Tooth stains and shades were assessed using the Lobene Stain Index and VITA Bleachedguide 3D-MASTER shade guide (VITA North America) at baseline and after 4 and 6 weeks of toothbrushing. In addition, the VITA Easyshade Advance 4.0 spectrophotometer (VITA North America) was used for shade evaluation. Safety was evaluated by means of oral soft-tissue examinations at each visit. Percentage reduction from baseline was compared between the groups. Statistical analyses were conducted using Mann-Whitney nonparametric model. RESULTS Eighty-six participants (43 in each group) completed the study with fully evaluable data. At baseline, the groups did not differ significantly in mean measurement scores. Percentage reductions of the measured scores were significantly greater (more extrinsic stain removal and whitening) in the test group than in the control group (P < .001). Both toothbrushes were well-tolerated, and no device-related adverse events were reported during the study. CONCLUSIONS The RF toothbrush produced substantial benefits in the reduction of tooth stains and whitening of tooth shade compared with a powered toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. PRACTICAL IMPLICATIONS The novel RF toothbrush is a safe and effective tool for stain removal and tooth whitening and can serve as an alternative to other whitening agents. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT03885609.
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Amaechi BT, Alshareif DO, Azees PAA, Shehata MA, Lima PP, Abdollahi A, Kalkhorani PS, Evans V, Bagheri A, Okoye LO. Anti-caries evaluation of a nano-hydroxyapatite dental lotion for use after toothbrushing: An in situ study. J Dent 2021; 115:103863. [PMID: 34743963 DOI: 10.1016/j.jdent.2021.103863] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 09/20/2021] [Accepted: 10/22/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES The aim of this randomized, double-blind, two-arm crossover in situ study was to investigate whether nano-hydroxyapatite (nanoHAP) dental lotion (Apagard Deep Care) applied immediately after tooth-brushing with nanoHAP toothpaste (Apagard M-plus) enhances the remineralization promotion and the demineralization inhibition efficacies of nanoHAP toothpastes. METHODS 64 sound enamel blocks and 64 blocks bearing artificially-produced initial caries were produced from human permanent molar teeth. During each treatment period, lasting 14 days per arm, two blocks, one sound and one lesion-bearing, were exposed to either 5% nanoHAP-containing or placebo dental lotion after tooth-brushing with 5% nanoHAP toothpaste, via an intra-oral appliance worn by 30 adults in each of the study groups. Baseline and post-test mineral loss were quantified using transverse microradiography (TMR). One-sided t-test of one group mean was used for intragroup comparison, while two-sided t-test of two independent means was used to compare the two dental lotions. RESULTS Pairwise comparison (baseline vs. post-test) indicated significant (p<.001) remineralization by nanoHAP toothpaste in both groups. However, when compared against each other, there was a significantly (p<.001) greater percentage of remineralization with nanoHAP lotion [58.4(±1.8)%] than with placebo lotion [37.7(±2.2)%]. TMR examination showed absolute demineralization inhibition in sound enamel blocks exposed to either lotions. CONCLUSIONS Toothpaste containing 5% nanoHAP effectively remineralized initial caries and inhibited demineralization of healthy enamel; however, the application of a dental lotion containing 5% nanoHAP after brushing resulted in superior remineralization compared to a placebo lotion. CLINICAL SIGNIFICANCE Dental lotion containing 5% nanohydroxyapatite used immediately after toothbrushing with 5% nanohydroxyapatite toothpaste can serve as an adjunct to enhance the clinical benefits of the toothpaste.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States.
| | - Dina O Alshareif
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Parveez A Abdul Azees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Marina A Shehata
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Patricia P Lima
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Azadeh Abdollahi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Parisa S Kalkhorani
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Veronica Evans
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, United States
| | - Ariana Bagheri
- Department of Biology, University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX 78249, United States
| | - Linda O Okoye
- Faculty of Dentistry, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
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Meyer F, Enax J, Epple M, Amaechi BT, Simader B. Cariogenic Biofilms: Development, Properties, and Biomimetic Preventive Agents. Dent J (Basel) 2021; 9:dj9080088. [PMID: 34436000 PMCID: PMC8394942 DOI: 10.3390/dj9080088] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 12/12/2022] Open
Abstract
Oral biofilms will build up within minutes after cleaning of the dental hard tissues. While the application of remineralizing agents is a well-known approach to prevent dental caries, modern oral care products offer also additional active agents to maintain oral health. Human saliva contains many different organic and inorganic compounds that help to buffer organic acids produced by cariogenic microorganisms. However, most oral care products only contain remineralizing agents. To improve the benefit of those products, further active ingredients are needed. Books, review articles, and original research papers were included in this narrative review. Putting all these data together, we give an overview of oral biofilms and active compounds used in modern oral care products to interact with them. The special focus is on inorganic compounds and their interaction with oral biofilms. While organic compounds have several limitations (e.g., cell toxicity), inorganic compounds based on calcium and/or phosphate (e.g., sodium bicarbonate, hydroxyapatite, calcium carbonate) offer several advantages when used in oral care products. Calcium release can inhibit demineralization, and the release of hydroxide and phosphate ions might help in the buffering of acids. Therefore, the focus of this review is to summarize the scientific background of further active ingredients that can be used for oral care formulations.
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Affiliation(s)
- Frederic Meyer
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany; (J.E.); (B.S.)
- Correspondence: ; Tel.: +49-521-8808-6061
| | - Joachim Enax
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany; (J.E.); (B.S.)
| | - Matthias Epple
- Inorganic Chemistry and Center for Nanointegration Duisburg-Essen (CeNIDE), University of Duisburg-Essen, Universitaetsstr. 5-7, 45117 Essen, Germany;
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA;
| | - Barbara Simader
- Research Department, Dr. Kurt Wolff GmbH & Co. KG, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany; (J.E.); (B.S.)
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Barma MD, Muthupandiyan I, Samuel SR, Amaechi BT. Inhibition of Streptococcus mutans, antioxidant property and cytotoxicity of novel nano-zinc oxide varnish. Arch Oral Biol 2021; 126:105132. [PMID: 33895543 DOI: 10.1016/j.archoralbio.2021.105132] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/10/2020] [Revised: 04/09/2021] [Accepted: 04/15/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Zinc is a potent antimicrobial against cariogenic bacteria and effective anti-plaque agent. The present study investigated the efficacy of zinc oxide nanoparticles (ZnO-NP) varnish to inhibit S. mutans growth, biofilm, acid production, and its antioxidant potential and cytotoxicity. DESIGN Green synthesized ZnO-NP were characterized using ultraviolet-visible spectroscopy, x-ray diffraction spectroscopy, and transmission electron microscopy. Secondary metabolites were assessed using fourier transform infrared spectroscopy. Anti-oxidant potential was ascertained using 2,2-diphenyl-2-picrylhydrazyl hydrate (DDPH) assay and cytotoxicity of synthesized nanoparticles was evaluated on human liver cancer (Hep G2) and human embryonic kidney 293 (HEK-293T) cell lines. RESULTS Synthesized ZnO-NP showed excellent antimicrobial properties against S. mutans, as the minimum inhibitory and bactericidal concentrations were 0.53 μg/mL, and 1.3 μg/mL respectively. ZnO-NP at 0.1 mg/μl concentration had the greatest zone of inhibition (24 mm), followed by 0.05 mg/μl ZnO-NP (23 mm) and 0.05 mg/μl ampicillin (21 mm). Further, 0.1 mg/μl ZnO-NP varnish inhibited 90 % of S. mutans biofilms and reduced 24 h acid production closest to that of baseline and it also exhibited antioxidant capacity in a dose dependent manner (94 % inhibition-100 μg/mL). Biocompatibility of ZnO-NP varnish was evaluated on Hep G2 and HEK-293T cell lines; and the highest concentration of 0.1 mg/μl ZnO-NP used caused very low cytotoxicity to Hep G2 cells and was non-cytotoxic to HEK-293T cells. CONCLUSIONS Within the limits of this study, ZnO-NP varnish was effective in inhibiting S. mutans and holds great potential as an effective anticaries agent.
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Affiliation(s)
- Manali Deb Barma
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Indumathy Muthupandiyan
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Srinivasan Raj Samuel
- Department of Public Health Dentistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India.
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, USA
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22
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Paszynska E, Pawinska M, Gawriolek M, Kaminska I, Otulakowska-Skrzynska J, Marczuk-Kolada G, Rzatowski S, Sokolowska K, Olszewska A, Schlagenhauf U, May TW, Amaechi BT, Luczaj-Cepowicz E. Impact of a toothpaste with microcrystalline hydroxyapatite on the occurrence of early childhood caries: a 1-year randomized clinical trial. Sci Rep 2021; 11:2650. [PMID: 33514787 PMCID: PMC7846568 DOI: 10.1038/s41598-021-81112-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 01/01/2021] [Indexed: 12/30/2022] Open
Abstract
The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite is not inferior to a fluoride toothpaste in prevention of caries in children. This double-blinded randomized control trial compared two toothpastes regarding the occurrence of caries lesions using International Caries Detection and Assessment System (ICDAS) ≥ code 1 on the primary dentition within 336 days. The test group used a fluoride-free hydroxyapatite toothpaste three times daily while control group used a toothpaste with fluoride. 207 children were included in the intention-to-treat analysis; 177 of them finished the study per protocol. An increase in caries ICDAS ≥ code 1 per tooth was observed in 72.7% of the hydroxyapatite-group (n = 88), compared with 74.2% of the fluoride-group (n = 89). The exact one-sided upper 95% confidence limit for the difference in proportion of participants with ICDAS increase ≥ 1 (-1.4%) was 9.8%, which is below the non-inferiority margin of 20% demonstrating non-inferiority of hydroxyapatite compared to the fluoride control toothpaste. This RCT showed for the first time, that in children, the impact of the daily use of a toothpaste with microcrystalline hydroxyapatite on enamel caries progression in the primary dentition is not inferior to a fluoride control toothpaste (Clinical Trials NCT03553966).
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Affiliation(s)
- Elzbieta Paszynska
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland.
| | - Malgorzata Pawinska
- Department of Integrated Dentistry, Medical University of Bialystok, Białystok, Poland
| | - Maria Gawriolek
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | - Inga Kaminska
- Department of Integrated Dentistry, Medical University of Bialystok, Białystok, Poland
| | | | | | - Szymon Rzatowski
- Department of Integrated Dentistry, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Aneta Olszewska
- Department of Facial Malformation, Pediatric Dentistry Clinic, Poznan University of Medical Sciences, Poznan, Poland
| | - Ulrich Schlagenhauf
- Department of Conservative Dentistry and Periodontology, University Hospital Wuerzburg, Wuerzburg, Germany
| | - Theodor W May
- Society for Biometrics and Psychometrics, Bielefeld, Germany
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, San Antonio, TX, USA
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23
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Abstract
Objective The present study compared the ability of bleaching, resin infiltration and microabrasion to restore the appearance of existing white spot lesions (WSL) on tooth surfaces as close as possible to that of the original healthy enamel. Materials and Methods Sixty extracted human teeth with WSL were randomly assigned to three treatment groups (20/group). Prior to treatment, the colour of the surrounding healthy enamel and the WSL were measured as the baseline and pre-treatment (PreRX) colours respectively using spectrophotometer based on CIE L*A*B. The L-value was used for the statistical comparison. WSLs in each group were treated respectively by bleaching, infiltration or microabrasion following the manufacturer's instructions. Colour measurement was repeated after treatment. Both intragroup and intergroup comparisons were performed using ANOVA followed by Tukey's multiple comparison test (α=0.05). Result In all groups the mean L-values were significantly higher in PreRX WSL (P < 0.01; Tukey) compared to baseline (sound enamel). After treatment the difference in mean L-value between baseline and WSL increased significantly (P < 0.01, Tukey) in Bleaching and Microabrasion groups by 1.4% and 1% respectively, but decreased in Infiltration group by 3.4%. Thus resin infiltration decreased the L-value of the WSL, bringing it closer to the L-value of the sound enamel while bleaching and microabrasion increased the L-value. Conclusions Among the three treatment modalities investigated in this study, resin infiltration was the most effective in masking the WSLs.
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Affiliation(s)
- J Lee
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
| | - L O Okoye
- Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - P P Lima
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
| | - P T Gakunga
- Department of Developmental Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
| | - B T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, Texas, USA
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24
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Amaechi BT, AbdulAzees PA, Okoye LO, Meyer F, Enax J. Comparison of hydroxyapatite and fluoride oral care gels for remineralization of initial caries: a pH-cycling study. BDJ Open 2020; 6:9. [PMID: 32714565 PMCID: PMC7376056 DOI: 10.1038/s41405-020-0037-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 06/01/2020] [Accepted: 06/07/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The present in vitro study investigated if simulated daily use of hydroxyapatite-based gel (15% HAP) remineralizes early caries lesions as effective as weekly use of high fluoride (12,500 ppm) concentration gel, comparing them with artificial saliva alone. MATERIALS AND METHODS Three tooth blocks were produced from each of 20 bovine teeth. Caries-like lesion was created on each block by 4-day demineralization in acidified gel. The blocks were randomized into three remineralization groups (20 blocks/group); Hydroxyapatite-based gel (Karex gelée, 15% HAP, fluoride-free), fluoride-based gel (Elmex gelée, 12,500 ppm F-), and artificial saliva (AS). Remineralization was conducted using pH-cycling model for 28 days with storage in AS. The pH cycling model consisted of 2 h demineralization once daily for all groups, and 3 min HAP gel application once daily, 3 min fluoride gel application once weekly, or remain in AS only respectively. Baseline and post-test mineral loss were quantified using microradiography. RESULTS Paired t-tests (baseline vs. post-Test) indicated significant (p < 0.0001) remineralization in all groups. When compared against each other using Games-Howell's multiple comparison test, no significant difference in remineralization was observed between the two gels, but both gels exhibited significantly (p < 0.001) higher percentage mineral gain (HAP:39 ± 7%; fluoride:41 ± 11%) than AS alone (6 ± 2%). CONCLUSION Hydroxyapatite-based gel (15% HAP) was as effective as fluoride-based gel (12,500 ppm F-) in remineralizing initial caries lesion.
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Affiliation(s)
- Bennett T. Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Parveez Ahamed AbdulAzees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Linda O. Okoye
- Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Frederic Meyer
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Joachim Enax
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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25
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Joe Asir JJ, Sherwood IA, Amaechi BT, Vaanjay M, Swathipriyadarshini S, Prince PE. Influence of desensitizing agents in management of noncarious cervical lesion and bonded restorations: A preliminary 12-week report. J Conserv Dent 2020; 23:341-347. [PMID: 33623233 PMCID: PMC7883786 DOI: 10.4103/jcd.jcd_389_20] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/28/2020] [Accepted: 09/21/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The primary objective of this study was to investigate the effectiveness in reducing dentin hypersensitivity in noncarious cervical lesions (NCCLs) by home-based desensitizing toothpaste (TP), in-office Gluma desensitizer application, and resin-modified glass-ionomer cement (RMGIC) restoration. The secondary objective was to evaluate the long-term outcome of the glass-ionomer cement restoration following the application of bioactive glass-containing desensitizer TP. MATERIALS AND METHODS A total of 73 patients or 151 teeth were included in the study and randomly allotted to one of the four different treatment groups. Pre- and postoperative symptom and air-blast/tactile sensitivity scores were recorded for statistical analysis. Postoperative sensitivity was analyzed at 1, 4, and 12 weeks after treatment. Nonparametric statistical tests were employed. RESULTS Kruskal-Wallis test noted a significant reduction in postoperative sensitivity at all time periods with the RMGIC group compared to other treatment options. Significantly higher patient dropout was observed in desensitizing TP regimen. CONCLUSIONS This interim 12-week report on dentin hypersensitivity management of NCCLs concludes that resin-modified glass-ionomer restoration was able to achieve a significant instant reduction in sensitivity and patient satisfaction compared to other noninvasive at-home and in-office procedures. CLINICAL RELEVANCE This interim 12-week report on dentin hypersensitivity management of noncarious cervical lesions concludes that resin-modified glass-ionomer restoration was able to achieve a significant reduction in sensitivity, and patient satisfaction was higher compared to other noninvasive at-home and in-office procedures.
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Affiliation(s)
- J. Joyson Joe Asir
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - I. Anand Sherwood
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health, San Antonio, USA
| | - M. Vaanjay
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - S. Swathipriyadarshini
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
| | - P. Ernest Prince
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences, Madurai, Tamil Nadu, India
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26
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Liporoni PCS, Wan Bakar WZ, Zanatta RF, Ambrosano GM, Aguiar FHB, Amaechi BT. Influence of Erosion/Abrasion and the Dentifrice Abrasiveness Concomitant with Bleaching Procedures. Clin Cosmet Investig Dent 2020; 12:101-109. [PMID: 32280280 PMCID: PMC7132029 DOI: 10.2147/ccide.s234716] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 02/04/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose The aim of this study was to evaluate the effect of erosive/abrasive cycles and two different levels of abrasiveness of dentifrices over enamel and dentin subjected to bleaching. Methods Enamel and dentin bovine specimens were prepared and submitted to an at-home bleaching treatment using 9.5% hydrogen peroxide gel, which was applied daily (30 min/14 days). Concomitant with bleaching, an erosive cycle was performed using citric acid (0.3%, pH 3.8, 5 mins, 3×/day), followed by immersions in artificial saliva for remineralization (30 mins). Abrasion was done with two (high and low abrasiveness) dentifrices (2×/day, 120 seconds) after the first and third erosive immersion each day. Enamel and dentin softening were assessed by microhardness and erosive tooth wear by optical profilometry. Data were submitted to repeated measures ANOVA, followed by the Tukey’s test with a significance level of 5%. Results For the enamel and considering the erosive-abrasive cycle, significant differences were found between the groups tested, the bleaching, and the abrasiveness of the dentifrice tested; however, the final microhardness values were significantly lower than the initial ones. For dentin, differences were found between the eroded/abrasion and the non-eroded/abrasion groups, with the former presenting lower microhardness values compared with the latter. In addition, bleaching decreased the microhardness values only for the highly abrasive dentifrice, and the final values were lower than for the initial ones for all tested groups. Conclusion The use of high and low abrasiveness dentifrices during bleaching and concomitant with erosion/abrasion cycles is more harmful to dentin than to enamel. Clinical Relevance Although bleaching is considered a conservative treatment, it can cause deleterious effects to dental hard tissue. The association of an at-home bleaching technique with erosion and high- or low- abrasive dentifrices harms dentin more than enamel.
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Affiliation(s)
- Priscila Christiane Suzy Liporoni
- Department of Restorative Dentistry, University of Taubaté, Taubaté, SP, Brazil.,Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Wan Zaripah Wan Bakar
- School of Dental Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | | | - Glaucia Maria Ambrosano
- Department of Community Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | | | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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27
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Dayo AF, Amaechi BT, Noujeim M, Deahl ST, Gakunga P, Katkar R. Comparison of photothermal radiometry and modulated luminescence, intraoral radiography, and cone beam computed tomography for detection of natural caries under restorations. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:539-548. [PMID: 31956069 DOI: 10.1016/j.oooo.2019.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 08/31/2019] [Accepted: 09/13/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of this ex vivo study was to measure the sensitivity, specificity, and receiver operating characteristic (ROC) area under the curve (AUC) of a caries diagnostic system based on photothermal radiometry and modulated luminescence (PTR/LUM) and compare them with the values for digital intraoral radiography (IR) and cone beam computed tomography (CBCT) in detecting recurrent decay. STUDY DESIGN Class 2 composite restorations were prepared on 70 proximal surfaces: 35 with caries and 35 without caries. The gingival floor of the restored surfaces was assessed for caries under the restorations using each of the 3 modalities. Statistical calculations and analysis were performed using the R statistical computing environment. RESULTS The average scores for sensitivity among the 6 observers were 0.89 for PTR/LUM, 0.38 for IR, and 0.40 for CBCT. Sensitivity for PTR/LUM was significantly greater than sensitivity for IR and CBCT. Average scores for specificity were 0.83, 0.80, and 0.70 for PTR/LUM, IR, and CBCT, respectively. CBCT had significantly lower specificity. The AUC was 0.65 for IR and 0.59 for CBCT, which were significantly different. PTR/LUM had moderate intraobserver agreement. CONCLUSIONS PTR/LUM, which involves non-ionizing radiation, can serve as a sensitive adjunct in early caries detection and monitoring.
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Affiliation(s)
- Adeyinka F Dayo
- Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology, University of Texas Health, San Antonio, TX, USA.
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology, University of Texas Health, San Antonio, TX, USA
| | - Marcel Noujeim
- Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology, University of Texas Health, San Antonio, TX, USA
| | - S Thomas Deahl
- Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology, University of Texas Health, San Antonio, TX, USA
| | - Peter Gakunga
- Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology, University of Texas Health, San Antonio, TX, USA
| | - Rujuta Katkar
- Department of Comprehensive Dentistry, Oral and Maxillofacial Radiology, University of Texas Health, San Antonio, TX, USA
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28
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Amaechi BT, AbdulAzees PA, Alshareif DO, Shehata MA, Lima PPDCS, Abdollahi A, Kalkhorani PS, Evans V. Comparative efficacy of a hydroxyapatite and a fluoride toothpaste for prevention and remineralization of dental caries in children. BDJ Open 2019; 5:18. [PMID: 31839988 PMCID: PMC6901576 DOI: 10.1038/s41405-019-0026-8] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/12/2019] [Accepted: 10/21/2019] [Indexed: 12/18/2022] Open
Abstract
Objective This in situ study compared the effectiveness of two toothpastes containing hydroxyapatite or 500 ppm fluoride in promoting remineralization and inhibiting caries development. Materials and methods Two enamel blocks (human primary teeth), one sound and one with artificially-produced caries lesion, were exposed to toothpaste containing either 10% hydroxyapatite or 500 ppm F− (amine fluoride) via intra-oral appliance worn by 30 adults in two-arm double blind randomized crossover study lasting 14 days per arm (ClinicalTrials.gov: NCT03681340). Baseline and post-test mineral loss and lesion depth (LD) were quantified using microradiography. One-sided t-test of one group mean was used for intragroup comparison (baseline vs. post-test), while two-sided t-test of two independent means was used to compare the two toothpaste groups. Results Pairwise comparison (baseline vs. test) indicated significant (p < 0.0001) remineralization and LD reduction by either toothpaste; however, when compared against each other, there was no statistically significant difference in remineralization or LD reduction between the two toothpastes. No demineralization could be observed in sound enamel blocks exposed to either toothpaste. While F− induced lesion surface lamination, HAP produced a more homogenous lesion remineralization. Conclusions 10% hydroxyapatite achieved comparable efficacy with 500 ppm F− in remineralizing initial caries and preventing demineralization. Thus the HAP toothpaste is confirmed to be equal to the fluoride toothpaste in this study.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Parveez Ahamed AbdulAzees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Dina Ossama Alshareif
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Marina Adel Shehata
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | | | - Azadeh Abdollahi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Parisa Samadi Kalkhorani
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - Veronica Evans
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
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29
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Gudkina J, Amaechi BT, Abrams SH, Brinkmane A, Jelisejeva I. Caries Increment and Oral Hygiene Changes in 6- and 12-Year-Old Children in Riga, Latvia: A 3-Year Follow-Up Report Using ICDAS II and RADKE Criteria. Eur J Dent 2019; 13:413-419. [PMID: 31795005 PMCID: PMC6890505 DOI: 10.1055/s-0039-1700250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives
The purpose of this study was to investigate the caries increment and oral hygiene changes over a 3-year period and also compare the sensitivity and specificity of Radke’s caries assessment method to ICDAS II among 6- and 12-year-old children in Riga, Latvia.
Materials and Methods
Thirty-eight 6 and thirty-nine 12-year-old children were examined visually and with bitewing (BW) radiographs for dental caries at baseline and after a 3-year period. Decayed, missing, and filled surfaces (dmfs/DMFS) in all teeth were scored by one calibrated examiner using the Radke’s caries scoring criteria. Oral hygiene level was determined using Green-Vermillion index (G-V ind.) at baseline and after 3 years. ICDAS II was used to assess all children only at the 3rd-year time point. The parents of the 6- and 12-year-old children responded to a questionnaire on oral hygiene at baseline and at the 3-year mark.
Statistical Analysis
The data were analyzed using
t
-test, Chi-square test, Wilcoxon test (α= 0.05), and sensitivity and specificity tests.
Results
The mean (SD) values of G–V ind. and caries experience at baseline/3-year period in 6- versus 12-year-old children were as follows. G-V ind.: 1.14(0.80) /1.48(0.89) [
p
= 0.4768] versus 0.99(0.45)/1.45(1.22) [
p
= 0.0337]. DMFS: 0.72(1.02)/ 3.13(3.13) [
p
= 0.0000] versus 6.79(5.14)/14.79(9.86)[
p
= 0.0000]; dmfs: 11.26(8.71)/7.74 (4.86) [
p
= 0.0780] versus 3.57 (2.03)/1.5(0.71)[
p
= 0.3173].The sensitivity and specificity of Radke to ICDAS II of caries-affected surfaces was: in proximal surfaces–0.57 and 0.98, on occlusal surfaces–0.83 and 0.98, on buccal/lingual surfaces–0.43 and 0.99.
Conclusions
The result of the present study suggests that the increased caries experience over a 3-year period among the 6- and 12-year-old children in Riga may be due to the concurrent decreased level of oral hygiene, suggesting that ICDAS II instead of Radke’s criteria should be used to detect and monitor dental caries.
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Affiliation(s)
- Jekaterina Gudkina
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, United States
| | | | - Anda Brinkmane
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - Ieva Jelisejeva
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
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30
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Amaechi BT, Abdul Azees PA, Menon S, Kasundra H. In vitro evaluation of the effects of Ultrasound Tongue Scraper on bacteria and biofilm formation. ACTA ACUST UNITED AC 2019; 10:e12471. [PMID: 31541515 DOI: 10.1111/jicd.12471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/08/2019] [Accepted: 08/20/2019] [Indexed: 11/26/2022]
Abstract
AIM Oral malodor is a common condition caused by some Gram-negative oral bacteria, among which are the 3 red complex bacteria (RCB). The present study investigated the effectiveness of the Ultrasound Tongue Scraper (UTS) to disrupt the structural morphology of the bacteria and their biofilm. METHODS While developing over 72 hours, multispecies biofilms of RCB (Porphromonas gingivalis, Tryponema denticola, Tannerella forsythia) were treated every 24 hours with 1.6-MHz ultrasound waves generated with UTS. An untreated group served as controls. Confocal laser scanning microscopy was used to determine the biofilm thickness, biomass and live : dead cell ratio at each time point (24, 48 and 72 hours). Biofilm morphology and bacteria ultrastructure were viewed using scanning/transmission electron microscopy, respectively. Data were analyzed using ANOVA and Tukey tests. RESULTS At each time point, the 3 variables were significantly lower in treated samples than the untreated. Significant biofilm disruption was observed in treated samples at each time period while the untreated had intact biofilm morphology. Cells in treated samples showed disrupted cell wall, cytoplasmic material, huge vacuoles and heterogeneity in electron density, while these cell organelles remained intact in untreated samples. CONCLUSION The UTS has an inhibitory effect on RCB and could be useful for oral malodor management.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
| | - Parveez Ahamed Abdul Azees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
| | - Suchitra Menon
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
| | - Hariyali Kasundra
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
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Enax J, Fabritius HO, Fabritius-Vilpoux K, Amaechi BT, Meyer F. Modes of Action and Clinical Efficacy of Particulate Hydroxyapatite in Preventive Oral Health Care − State of the Art. Open Dent J 2019. [DOI: 10.2174/1874210601913010274] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background:Particulate Hydroxyapatite (HAP; Ca5(PO4)3(OH)) is being increasingly used as multifunctional active ingredient in oral care. Due to its high similarity to human enamel crystallites, it is considered as a biomimetic agent.Objective:The aim of this narrative review is to identify the modes of action of HAP in preventive oral health care based on published studies. The outcomes are expected to improve the understanding of the effects of HAP in the oral cavity and to provide a knowledge base for future research in the field of biomimetic oral care.Methods:The data analyzed and discussed are primarily based on selected published scientific studies and reviews fromin vivo,in situ, andin vitrostudies on HAP in the field of preventive oral health care. The databases Cochrane Library, EBSCO, PubMed and SciFinder were used for literature search.Results:We identified different modes of action of HAP in the oral cavity. They are mainly based on (I) Physical principles (e.g. attachment of HAP-particles to the tooth surface and cleaning properties), (II) Bio-chemical principles (e.g. source of calcium and phosphate ions under acidic conditions and formation of an interface between HAP-particles and the enamel), and (III) Biological principles (e.g. HAP-particles interacting with microorganisms).Conclusion:Although more mechanistic studies are needed, published data show that HAP has multiple modes of action in the oral cavity. Since the effects address a wide range of oral health problems, HAP is a biomimetic agent with a broad range of applications in preventive oral health care.
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Kalanzi D, Mayanja-Kizza H, Nakanjako D, Mwesigwa CL, Ssenyonga R, Amaechi BT. Prevalence and factors associated with dental caries in patients attending an HIV care clinic in Uganda: a cross sectional study. BMC Oral Health 2019; 19:159. [PMID: 31324242 PMCID: PMC6642521 DOI: 10.1186/s12903-019-0847-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/03/2019] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Chronic Human Immunodeficiency Virus (HIV) infection is associated with reduced saliva flow rate due to infiltration of HIV and proliferation of CD8 lymphocytes in salivary glands. It is unclear whether HIV infection and antiretroviral therapy (ART) increase caries risk. This study aimed to determine the prevalence and factors associated with dental caries in HIV infected adults attending the Mulago Immune Suppression Syndrome (ISS) clinic in Uganda. METHODS A cross-sectional study was conducted among HIV infected persons. Dental examinations were performed by two calibrated dentists using the WHO Radke's caries classification criteria and reported using the decayed (D), missing (M), filled (F), teeth (DMFT) index. The prevalence and factors associated with dental caries was examined through linear regression analyses. RESULTS Overall, 748 participants (females = 491, 65.6%) with a mean age of 39 ± 9.4 years were included in the final analysis; of whom 83.7% had caries (DMFT> 0), with a significantly (p < 0.05) higher prevalence among females 86.6% than males 78.2%. The mean DMFT was 5.9 ± 5.5, with statistically significant differences based on gender (males 4.9 ± 4.8 and females 6.3 ± 5.9, p < 0.05) and duration on ART (< 2 years 4.8 ± 4.4, > 2 years but < 5 years 5.7 ± 5.5, > 5 years 6.6 ± 6.0 p < 0.05). The majority (67.2%) of participants reported brushing their teeth twice or more a day, and sugar intake was not associated with dental caries. CONCLUSION Caries prevalence is high among HIV infected adults under care. Duration of ART was associated with increased risk and severity of caries. Therefore, we recommend integration of dental care in HIV treatment programs.
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Affiliation(s)
- Dunstan Kalanzi
- Department of Dentistry School of Health Sciences, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda.
| | - Harriet Mayanja-Kizza
- Department of Medicine School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Damalie Nakanjako
- Department of Medicine School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Catherine Lutalo Mwesigwa
- Department of Dentistry School of Health Sciences, Makerere University College of Health Sciences, P.O.Box 7072, Kampala, Uganda
| | - Ronald Ssenyonga
- Department of Epidemiology and Biostatistics School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health San Antonio School of Dentistry, San Antonio, TX, USA
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Amaechi BT, Kasundra H, Okoye LO, Tran PL, Reid TW. Comparative Efficacy in Preventing Plaque Formation around Pit and Fissure Sealants: A Clinical Trial. J Contemp Dent Pract 2019; 20:531-536. [PMID: 31316012] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM The purpose of this study is to compare the clinical performance of an organo-selenium-containing pit and fissure sealant with that of a selenium-free sealant for clinical retention and prevention of plaque and caries development around the sealants. MATERIALS AND METHODS Following an in vitro study confirming the antimicrobial effect of an organo-selenium-containing pit/fissure sealant [DenteShield™ (DS)], 120 adolescents (7-20 years old) at varying caries risk status had DS sealant applied to a single tooth on the left or the right side of the dentition and UltraSeal™ XT Plus (UXT) on a corresponding tooth on the opposite side. Sealants' assessment was performed quarterly for 1 year for clinical retention, plaque, and caries formation around the sealant. Each sealant lost was replaced but considered as a failure in further analysis. McNemar's test was used to statistically analyze the outcome variables at each assessment time point. RESULTS While 7% and 12% plaque growth was observed around the UXT sealant at 9th and 12th months, respectively, DS exhibited 100% prevention of plaque growth. Both sealants exhibited 100% caries prevention. Clinical retention did not significantly differ between DS and UXT at all assessment time points except at 12 months when DS showed statistically significantly (p < 0.001) better retention (96%) than UXT (81%). CONCLUSION In this study, while both sealants are equally effective in caries prevention, DS completely prevented plaque growth around it with better clinical retention than UXT that offered only limited protection against plaque growth. CLINICAL SIGNIFICANCE Being antimicrobial, DS pit and fissure sealant may be the best sealant option for patients whose caries risk status is due to poor oral hygiene.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Hariyali Kasundra
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Linda O Okoye
- Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria, Phone: +234 8068424848, e-mail:
| | - Phat L Tran
- Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Ted W Reid
- Department of Ophthalmology and Visual Sciences, Texas Tech University Health Sciences Center, Lubbock, Texas, USA Department of Medical Microbiology and Immunology, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Abstract
Optical coherence tomography (OCT) is a noninvasive diagnostic technique providing cross-sectional images of biologic structures based on the differences in tissue optical properties. OCT has been widely used in numerous clinical applications and is becoming popular as a promising technology in dentistry. Today, dental hard (tooth) and soft (hard palate mucosa and gingiva mucosa) tissues are visualized with OCT. With new developments in technology, the applications of OCT are being investigated in various fields in dentistry, such as to detect microleakage around restoration, tooth cracks/fractures, examination of periodontal tissues/pockets, early detection of oral cancerous tissues, and in endodontics for location of pulp canal.
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Affiliation(s)
- Rujuta A Katkar
- Department of Comprehensive Dentistry, UT Health, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | | | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science San Antonio, School of Dentistry, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Daniel Fried
- Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, 707 Parnassus Avenue, San Francisco, CA 94143-0758, USA
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Abstract
As laboratory models are bridges to in vivo caries studies, they must mirror clinical conditions, where demineralization and remineralization alternate constantly (i.e., pH cycling) and are only interrupted during the very short period of application of investigational products, such as toothpaste or mouth rinse. In view of this, models have been developed, based on pH cycling, to study the anticaries or caries remineralizing effects of substances. The pH cycling models have long been accepted and utilized by the scientific community and the toothpaste industry as an appropriate alternative to animal caries testing, particularly for ionic fluoride-based dentifrices. Several pH cycling models have been developed and described in the literature over the years. However, in this chapter, we crudely categorize them into two types: according to what the investigational product is tailored to achieve, i.e., prevention of caries development (net demineralization) or remineralization of early caries (net remineralization). Thus the models are termed "demineralization" or "remineralization" models and are described in details here together with their disadvantages and applications.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
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Abstract
Caries lesions result from the interaction between dental biofilm and sugars. Since the biofilm is an important component in the etiology of the disease, biofilm models have been developed to study the cariogenicity of dietary sugars, as well as the anticaries effect of substances. Two of such models, termed as "static" or "continuous flow," are described in details here together with their advantages, limitations, and applications.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Livia M A Tenuta
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Antonio P Ricomini Filho
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Jaime A Cury
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Amaechi BT, Najibfard K, Chedjieu IP, Kasundra H, Okoye LO. Do Products Preventing Demineralization Around Orthodontic Brackets Affect Adhesive Bond Strength? Open Dent J 2018. [DOI: 10.2174/1874210601812011029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective:
This study investigated the effects, on the shear bond strength of orthodontic brackets, of using an antimicrobial selenium-containing sealant (DenteShieldTM) to serve dual functions of priming enamel prior to bonding and as a protective barrier against whitespot lesion formation.
Materials and Methods:
A total of 150 extracted human premolars were randomly assigned into 10 groups (n=15/group). Stainless steel brackets were bonded with two adhesive systems (DenteShieldTM or Transbond XT) after the enamel was conditioned with a primer (DenteShieldTM or Assure Universal) or a filled resin sealant (DenteShieldTM, Pro SealTM or Opal SealTM). The specimens were stored in deionized water at 37 °C for 24 hours and debonded with a universal testing machine.
Results:
The use of DenteShieldTM adhesive to bond orthodontic brackets to the enamel surface resulted in a significantly lower (P<0.05), but clinically acceptable, shear bond strength (mean & SD: 14.5±1.6 MPa) as compared with Transbond XT group (mean & SD: 19.3±1.7 MPa). DenteShieldTM sealant used as primer resulted in shear bond strength values comparable to those of Pro SealTM and Opal SealTM. All adhesive-sealant and primer-sealant combinations tested in this study exhibited shear bond strength values greater than 9.6 MPa, sufficient for clinical orthodontic needs.
Conclusion:
DenteShieldTM sealant can serve as primer as well as anti-demineralization sealant during orthodontic treatment without adversely affecting the shear bond strength of the bracket.
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Ramalingam K, Amaechi BT. Antimicrobial effect of herbal extract of Acacia arabica with triphala on the biofilm forming cariogenic microorganisms. J Ayurveda Integr Med 2018; 11:322-328. [PMID: 30389224 PMCID: PMC7527819 DOI: 10.1016/j.jaim.2018.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/04/2017] [Accepted: 01/16/2018] [Indexed: 11/18/2022] Open
Abstract
Background Dental caries is a biofilm-related infectious disease with a multifactorial etiology, over five billion inhabitants have affected worldwide due to this disease. Objective Antimicrobial efficacy of a mixed herbal powder extract (MHPE) against cariogenic microorganisms was investigated. Materials and methods MIC, MBC, kinetics of killing, biofilm disruption and anticaries effect of MHPE were determined. For biofilm disruption, biofilms of Streptococcus mutans, Lactobacillus casei, Actinomyces viscosus and Candida albicans were treated with MHPE for 30 min and attached cells were quantified after staining. For live/dead staining biofilm assay, S. mutans biofilm treated with MHPE for 1min, 5min and 1 h was examined with confocal laser scanning system after live/dead staining. Efficacy was experimented by structural quality using Scanning Electron Microscope (SEM). Anticaries effect was determined by formation of caries-like lesion in continuous flow biofilm model. Results MHPE exhibited inhibition zones ranging from 12.5 to 24.0 mm. The highest inhibition zone was recorded at concentration of 50 μg/ml. MIC for S. mutans was between 12.23 and 36.7 μg/ml, while the MBC values ranged from 36.7 to 110.65 μg/ml. Inhibitory concentration of MHPE was three fold higher than CHLX. Significant reduction of cell count (49–95%) was observed with increasing time and higher concentration. Percentage biofilm reduction compare with negative control was 96.9% (A. viscosus), 94% (C. albicans), 99.8% (L. casei) and 91.7% (S. mutans). For MHPE-treated biofilm, live/dead staining demonstrated significant (p < 0.05) higher in deceased red fluorescence areas in all kinetics points from 53.6% (1min) to 85% (1h). SEM confirmed the damage in the outer layers of S. mutans. MHPE has components with effective antibacterial activity against caries-inducing microorganisms. Conclusion The anti-adherence and anti-biofilm effect as well as the faster killing activity suggests that MHPE formula has effective antibacterial activity and could be a useful source of anti-cariogenic agents in near future.
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Affiliation(s)
- Karthikeyan Ramalingam
- School of Life Sciences, B.S. Abdur Rahman Institute of Science and Technology, GST Road, Vandalur, Chennai, 600 048, India.
| | - Bennett T Amaechi
- Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7914, San Antonio, TX, 78229-3900, USA
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Amaechi BT, Kasundra H, Joshi D, Abdollahi A, Azees PAA, Okoye LO. Effectiveness of S-PRG Filler-Containing Toothpaste in Inhibiting Demineralization of Human Tooth Surface. Open Dent J 2018; 12:811-819. [PMID: 30505361 PMCID: PMC6210529 DOI: 10.2174/1874210601812010811] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 08/23/2018] [Accepted: 10/02/2018] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES Using an established pH-cycling caries model, the authors evaluated the effectiveness of toothpastes containing Surface Pre-reacted Glass-ionomer filler (S-PRG) in preventing tooth surface demineralization. MATERIALS AND METHODS 210 tooth blocks were randomly assigned to seven experimental groups (30 blocks/group): no treatment (A), and toothpaste containing either NaF (B), 0 wt% S-PRG (C), 1 wt% S-PRG (D), 5 wt% S-PRG (E), 20 wt% S-PRG (F) or 30 wt% S-PRG (G). Groups were subjected to 14-day demineralization for development of early caries lesions using a pH-cycling caries model. Demineralization was assessed using Quantitative Light-induced Fluorescence (QLF) and Transverse Microradiography (TMR). All pairwise contrasts (between treatments) were tested using Analysis of Variance (ANOVA), and then Tukey's HSD for multiple comparisons. All p-values are considered significant if <0.05. RESULTS With QLF, there was a significant (ANOVA; p<0.001) difference in mean percent fluorescence loss (∆F) observed among the groups. Relative to control, all S-PRG-containing toothpastes significantly (Tukey's; p<0.0001) inhibited demineralization at varying percentages (48.6%, 61.3%, 67.4% and 69.8% reduction with S-PRG 1%, 5%, 20% and 30% respectively). Demineralization reduction was not significant with either NaF (15.6% reduction) or 0% S-PRG (-2.5% reduction i.e. 2.5% more demineralization than the Control) when compared to control group. Mineral loss assessed using TMR followed a similar trend as fluorescence loss. CONCLUSION Toothpaste containing S-PRG filler can serve as an effective caries control tool. S-PRG filler-containing dentifrice to be more effective in preventing tooth demineralization than 1100 ppm fluoride provided as sodium fluoride.
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Affiliation(s)
- Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Hariyali Kasundra
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Deepika Joshi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Azadeh Abdollahi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Parveez A. A. Azees
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Linda O. Okoye
- Department of Restorative Dentistry, Faculty of Dentistry’ College of Medicine, University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu State, Nigeria
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Amaechi BT, Lemke KC, Saha S, Gelfond J. Clinical Efficacy in Relieving Dentin Hypersensitivity of Nanohydroxyapatite-containing Cream: A Randomized Controlled Trial. Open Dent J 2018; 12:572-585. [PMID: 30288181 PMCID: PMC6142669 DOI: 10.2174/1874210601812010572] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/11/2018] [Accepted: 08/10/2018] [Indexed: 12/22/2022] Open
Abstract
Objective:
The study aimed to investigate the effectiveness of Apadent Pro (Sangi) Nanohydroxyapatite (nHAP) dental cream to relieve Dentin Hypersensitivity (DHS), compared with a positive control cream containing 20% pure silica (Silica). Methods: In this double-blind, randomized, parallel-group clinical trial, patients diagnosed with DHS and qualified to participate were randomized into two groups, nHAP (n=25) and Silica (n=26). Subjects’ baseline and posttreatment sensitivity were assessed using two pain scales, a four-point Dental Pain Scale (DPS) followed by a linear Visual Analog Scale (VAS), after the application of ice-cold and air stimuli. Subjects used custom-fabricated trays to apply their respective cream for 5 minutes once daily following brushing with standard fluoride toothpaste. Posttreatment sensitivity (efficacy) was assessed every 2 weeks for 8 weeks. Mean treatment outcomes (percentage change from baseline) at each time point were compared using the Tukey HSD test for multiplicity (P<0.05). Results: With either air or cold stimulus, VAS and DPS indicated a significant (P<0.001) reduction in DHS at each time point with either nHAP or Silica. Comparing pain scales, VAS showed no significant difference in DHS reduction between the products with either air or cold. However, with DPS, DHS reduction was significantly (P<0.05) better with Silica than with nHAP at all time points with cold, and at 2, 4, and 8 weeks with air. Conclusion: Both Apadent Pro nHAP and Silica dental creams are effective at promoting the relief of DHS symptoms. When comparing the efficacy of the two compounds to relieve DHS, results of the two pain scales were conflicting.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Kelly C Lemke
- Department of Developmental Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Shyamali Saha
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Jonathan Gelfond
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, Texas, USA
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Abstract
Minimal intervention (MI) dentistry aims to preserve dental tissues first and restore only when indicated, thus remineralisation of initial (non-cavitated) caries lesions, an integral part of caries management, is an essential treatment strategy in MI. With this understanding, dental practitioners are increasingly embracing the principle of non-operative treatment of initial caries lesions. The purpose of this review was to summarise the most recent literature published in non-operative management of dental caries. Three electronic databases (MEDLINE, EMBASE, Cochrane CENTRAL) were searched, and clinical studies, systematic reviews and meta-analysis were included. This report outlines the strategies and numerous therapeutic materials available to aid in arrestment/remineralisation of initial caries lesions on root and coronal surfaces. However, the level of evidence of effect is variable, as well as the availability in different parts of the world. Options available to practitioners will vary when placing emphasis on the level of evidence supporting them. Strong clinical evidence support the effectiveness of pits/fissure sealants for therapeutic management of active initial caries on occlusal surfaces, and fluoride varnishes for remineralisation of caries lesions on root and coronal smooth surfaces, including proximal surfaces. Other materials formulated to enhance the effectiveness of any chosen remineralisation strategy were discussed. However, it is absolutely necessary that all caries remineralisation treatment be complemented with general behavioural modification in oral health through motivational interviewing directed towards change in oral hygiene to control plaque, dietary attitude modification to reduce the frequency of intake of fermentable sugars, and establishment of risk-based recall visits.
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Affiliation(s)
- B T Amaechi
- Professor and Director of Cariology Department of Comprehensive Dentistry University of Texas Health Science Centre at San Antonio, 7703 Floyd Curl Drive, San Antonio, Texas
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Meyer F, Amaechi BT, Fabritius HO, Enax J. Overview of Calcium Phosphates used in Biomimetic Oral Care. Open Dent J 2018; 12:406-423. [PMID: 29988215 PMCID: PMC5997847 DOI: 10.2174/1874210601812010406] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/23/2018] [Accepted: 05/14/2018] [Indexed: 11/24/2022] Open
Abstract
Background: The use of biomimetic agents is an emerging field in modern oral care. Promising biomimetic substances for such applications are calcium phosphates, because their chemical composition is very similar to that of the mineral phase in human teeth, especially of natural enamel. Examples for their application include the remineralization of early caries lesions and repair of small enamel defects. Objective: This review provides an interdisciplinary view on calcium phosphates and their applications in biomimetic oral care. The aim of this work is to give an overview of in vivo and in situ studies comparing several calcium phosphates in preventive dentistry that can be used as a knowledge base for the development of innovative alternative oral care concepts. Methods: Books, reviews, and original research papers with a focus on in vivo and in situ studies were included. The databases PubMed® and SciFinder® were used for literature search. Calcium phosphates that are frequently utilized in oral care products are covered in this review and were used as search terms alone and together with the following key words: in vivo, in situ, caries, clinical study, and remineralization. From 13,470 studies found, 35 studies complied with the inclusion criteria and were used for this review. Results: Published in vivo and in situ studies demonstrate calcium phosphates’ potential in enamel remineralization. However, more studies are needed to further substantiate existing results and to extend and refine the application of calcium phosphates in modern oral care. Conclusion: Calcium phosphates represent an innovative biomimetic approach for daily oral care because of their high similarity to natural enamel that will broaden the range of future treatments in preventive dentistry.
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Affiliation(s)
- Frederic Meyer
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
| | - Bennett T Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, 703 Floyd Curl Drive, San Antonio, Texas 78229-3900, USA
| | - Helge-Otto Fabritius
- Max-Planck-Institut für Eisenforschung GmbH, Microstructure Physics and Alloy Design, Max-Planck-Straße 1, 40237 Duesseldorf, Germany
| | - Joachim Enax
- Dr. Kurt Wolff GmbH & Co. KG, Research Department, Johanneswerkstr. 34-36, 33611 Bielefeld, Germany
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Abrams TE, Abrams SH, Sivagurunathan KS, Silvertown JD, Hellen WMP, Elman GI, Amaechi BT. In Vitro Detection of Caries Around Amalgam Restorations Using Four Different Modalities. Open Dent J 2018; 11:609-620. [PMID: 29290839 PMCID: PMC5738745 DOI: 10.2174/1874210601711010609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/20/2017] [Accepted: 11/06/2017] [Indexed: 11/25/2022] Open
Abstract
Objective: The aim of this study was to evaluate the ability of PTR-LUM (The Canary System, CS), laser fluorescence (DIAGNOdent, DD), LED fluorescence (Spectra), and visual inspection (ICDAS II) to detect natural decay around bonded amalgam restorations in vitro. Methods: Seventeen extracted human molars and premolars, consisting of visually healthy (n=5) and natural cavitated (n=12) teeth were selected. For the carious teeth, caries was removed leaving some decayed tissue on the floor and or wall of the preparation. For sound teeth, 3 mm. deep cavity preparations were made and teeth were restored with bonded-amalgam restorations. Thirty-six sites (13 sound sites; 23 carious sites) were selected. CS and DD scans were performed in triplicate at 2, 1.5, 0.5, and 0 mm away from the margin of the restoration (MOR). Spectra images were captured for the entire surface, and dentists blinded to the samples provided ICDAS II scoring. Results: Canary Numbers (Mean±SE) for healthy and carious sites at 2, 1.5, 0.5, and 0 mm from the MOR ranged from 12.9±0.9 to 15.4±0.9 and 56.1±4.0 to 56.3±2.0, respectively. DD peak values for healthy and carious sites ranged from 4.7±0.5 to 13.5±2.99, and 16.7±3.7 to 24.5±4.4, respectively. For CS and DD, sensitivity/specificity for sites at 2.0, 1.5, 0.5, 0 mm ranged from 0.95-1.0/0.85-1.0, and 0.45-0.74/0.54-1.0, respectively. For ICDAS II, sensitivity and specificity were 1.0 and 0.17, respectively. For Spectra, data and images were inconclusive due to signal intereference from the amalgam restoration. Conclusions: Using this in-vitro model, CS and DD were able to differentiate between sound and carious tissue at the MOR, but larger variation, less reliability, and poorer accuracy was observed for DD. Therefore, CS has the potential to detect secondary caries around amalgam restorations more accurately than the other investigated modalities.
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Affiliation(s)
| | - Stephen H Abrams
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada.,Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | | | | | | | - Gary I Elman
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
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Chee HT, Wan Bakar WZ, Ghani ZA, Amaechi BT. Comparison of composite resin and porcelain inlays for restoration of noncarious cervical lesions: An In vitro study. Dent Res J (Isfahan) 2018; 15:215-219. [PMID: 29922341 PMCID: PMC5958539] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Composite resin (CR) currently is one of the most commonly used material in restoring noncarious cervical lesions (NCCL) due to its strength and esthetics color but has microleakage problem. The aim of this study is to compare in vitro the microleakage depth between CR and porcelain in restoring NCCL. MATERIALS AND METHODS This an in vitro study was done by preparing cavities on the buccocervical surface of 62 extracted premolar teeth which randomly assigned to two groups (n = 31) where Group 1 was restored with nanocomposite and Group 2 was cemented with porcelain cervical inlays. They were then subjected to thermocycling before immersion in 2% methylene blue dye for 24 h. Dye penetration depths were measured using Leica imaging system For statistical analysis, independent t-test was used to analyze the results (P < 0.05). RESULTS Porcelain cervical inlay restorations demonstrated statistically lesser microleakage depth for the cervical margins (P = 0.018) when compared to CR. Deeper microleakage depth at the cervical compared to coronal margins of CR (P = 0.006) but no significant difference of both margins for porcelain cervical inlays (P = 0.600). CONCLUSION Porcelain cervical inlays show lesser microleakage than CR which could be alternative treatment option in restoring NCCL with better marginal seal and esthetics.
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Affiliation(s)
- Hui Theng Chee
- Dental Officer, Taman Selasih Dental Clinic, 09000 Kulim, Kedah, Malaysia
| | - Wan Zaripah Wan Bakar
- Conservative Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia,Address for correspondence: Dr. Wan Zaripah Wan Bakar, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia. E-mail:
| | - Zuryati Ab Ghani
- Conservative Unit, School of Dental Sciences, Universiti Sains Malaysia, Kubang Kerian, 16150, Kelantan, Malaysia
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry, University of Texas Health Science Center, San Antonio, Texas, USA
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Abrams SH, Sivagurunathan KS, Silvertown JD, Wong B, Hellen A, Mandelis A, Hellen WMP, Elman GI, Mathew SM, Mensinkai PK, Amaechi BT. Correlation with Caries Lesion Depth of The Canary System, DIAGNOdent and ICDAS II. Open Dent J 2017; 11:679-689. [PMID: 29387284 PMCID: PMC5750685 DOI: 10.2174/1874210601711010679] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/17/2017] [Accepted: 11/06/2017] [Indexed: 12/04/2022] Open
Abstract
Introduction: The aim of this study was to correlate lesion depth of natural caries, measured with Polarized Light Microscopy (PLM), to Canary Numbers (CN) derived from The Canary System™ (CS), numerical readings from DIAGNOdent (DD), and lesion scores from ICDAS II. Methods: A total of 20 examination sites on extracted human molars and premolars were selected. The selected examination sites consisted of healthy and enamel caries on smooth and occlusal surfaces of each tooth. Two blinded dentists ranked each examination site using ICDAS II and the consensus score for each examined site was recorded. The same examination sites were scanned with CS and DD, and the CN and DD readings were recorded. After all the measurements were completed, the readings of the three caries detection methods were validated with a histological method, Polarized Light Microscopy (PLM). PLM performed by blinded examiners was used as the ‘gold standard’ to confirm the presence or absence of a caries lesion within each examined site and to determine caries lesion depth. Results: Pearson’s coefficients of correlation with caries lesion depth of CNs, DD readings and ICDAS scores were 0.84, 0.21 and 0.77, respectively. Mean ± SD CN for sound sites (n=3), caries lesion depths <800 µm (n=11), and caries lesion depths >800 µm (n=6) were 11±1, 55±15, and 75±22, respectively. Mean ± SD DD readings for sound sites, caries lesion depths <800 µm, and caries lesion depths >800 µm were 1±1, 7±11, and 8±9, respectively. Mean ± SD ICDAS II scores for sound sites, caries lesion depths <800 µm, and caries lesion depths >800 µm were 0±0, 2±1, and 2±1, respectively. The intra-operator repeatability for the Canary System was .953 (0.913, 0.978). Conclusion: This study demonstrated that the CS exhibits much higher correlation with caries lesion depth compared to ICDAS II and DD. CS may provide the clinician with more information about the size and position of the lesion which might help in monitoring or treating the lesion. The present extracted tooth study found that The Canary System correlates with caries lesion depth more accurately that ICDAS II and DIAGNOdent.
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Affiliation(s)
- Stephen H Abrams
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada.,Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | | | | | - Bonny Wong
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Adam Hellen
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Andreas Mandelis
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada.,Center for Advanced Diffusion Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Ontario, Canadas
| | | | - Gary I Elman
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | - S M Mathew
- University of Texas Health Science Center, San Antonio, Texas, USA
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Silvertown JD, Abrams SH, Sivagurunathan KS, Kennedy J, Jeon J, Mandelis A, Hellen A, Hellen W, Elman G, Ehrlich R, Chouljian R, Finer Y, Amaechi BT. Multi-Centre Clinical Evaluation of Photothermal Radiometry and Luminescence Correlated with International Benchmarks for Caries Detection. Open Dent J 2017; 11:636-647. [PMID: 29290842 PMCID: PMC5738748 DOI: 10.2174/1874210601711010636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/25/2017] [Accepted: 11/12/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION A clinical study was initiated to investigate a caries detection device (The Canary System (CS)), based on photothermal radiometry and modulated luminescence (PTR-LUM). The primary objective of this study was to determine if PTR-LUM values (in the form of Canary Numbers; CN) correlate with International Caries Diagnostic and Assessment System (ICDAS II) scores and clinical situations. The secondary objectives of this study were to monitor the safety of PTR-LUM, and collect data to determine how CN values could be used to differentiate healthy from decayed tooth surfaces on a normalized scale. METHODS The trial was a four site, non-blinded study. Data was collected from 92 patients, resulting in 842 scanned tooth surfaces over multiple appointments. Surfaces were assessed according to ICDAS II, and further stratified into five clinical situation categories: 1) healthy surface, 2) non-cavitated white and/or brown spots; 3) caries lesions; 4) cavitation and 5) teeth undergoing remineralization therapy.CN data was analyzed separately for smooth and occlusal surfaces. Using a semi-logarithmic graph to plot raw CN (rCN) and normalized (CN) values, rCN data was normalized into a scale of 0-100. RESULTS Linear correlations (R2) between CN and ICDAS II groupings for smooth and occlusal surfaces were calculated as 0.9759 and 0.9267, respectively. The mean CN values derived from smooth (20.2±0.6) and occlusal (19±1.0) surfaces identified as healthy had significantly lower CN values (P<0.05) compared with the values from the other clinical situation categories. No adverse events were reported. CONCLUSION The present study demonstrated the safety of PTR-LUM for clinical application and its ability to distinguish sound from carious tooth surfaces. A clear shift from the baseline in both PTR and LUM in carious enamel was observed depending on the type and nature of the lesion, and correlated to ICDAS II classification codes, which enabled the preliminary development of a Canary Scale.
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Affiliation(s)
| | - Stephen H. Abrams
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | | | - Julia Kennedy
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Jinseok Jeon
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Andreas Mandelis
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
- Center for Advanced Diffusion Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Ontario, Canada
| | - Adam Hellen
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | - Warren Hellen
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | - Gary Elman
- Downsview Plaza Dental Office, Toronto Ontario, Canada
| | | | | | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
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Silvertown JD, Wong BPY, Sivagurunathan KS, Abrams SH, Kirkham J, Amaechi BT. Remineralization of natural early caries lesions in vitro by P11-4 monitored with photothermal radiometry and luminescence. ACTA ACUST UNITED AC 2017; 8. [DOI: 10.1111/jicd.12257] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 10/14/2016] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | | | - Jennifer Kirkham
- Department of Oral Biology; University of Leeds; St. James's University Hospital; Leeds UK
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry; University of Texas Health Science Center at San Antonio; San Antonio TX USA
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Silvertown JD, Wong BPY, Abrams SH, Sivagurunathan KS, Mathews SM, Amaechi BT. Comparison of The Canary System and DIAGNOdent for the in vitro detection of caries under opaque dental sealants. ACTA ACUST UNITED AC 2016; 8. [DOI: 10.1111/jicd.12239] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 08/07/2016] [Indexed: 11/24/2022]
Affiliation(s)
| | | | - Stephen H. Abrams
- Quantum Dental Technologies; Toronto ON Canada
- Cliffcrest Dental Office; Scarborough ON Canada
| | | | - Sapna M. Mathews
- Department of Comprehensive Dentistry; University of Texas Health Science Center at San Antonio; San Antonio TX USA
| | - Bennett T. Amaechi
- Department of Comprehensive Dentistry; University of Texas Health Science Center at San Antonio; San Antonio TX USA
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Gudkina J, Brinkmane A, Abrams SH, Amaechi BT. Factors influencing the caries experience of 6 and 12 year old children in Riga, Latvia. Stomatologija 2016; 18:14-20. [PMID: 27649612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM Authors assessed the influence of drinking tea with sugar, level of cariogenic microflora and use of fluoride toothpaste and tablets on caries experience of 6 and 12 year old children in Riga, Latvia. METHODS 141 six and 164 twelve year old children were examined clinically and with bitewing radiographs to determine their dmft/DMFT and dmfs/DMFS. Children or their parents responded to questionnaire on number teaspoons of sugar (TS) used per cup of tea, number of cups of tea consumed daily, using fluoride or non-fluoride toothpaste (TP), frequency of toothbrushing, using fluoride tablets or not (ft). Salivary mutans streptococci (MS) and lactobacilli (LB) levels were measured in children with dmft/DMFT>4.0 for age of 6 (73% (n=103)), and for age of 12 (54% (n=88)). Impact of variables in caries status was determined using frequency tables and ANOVA, while proportion differences were tested using chi-square test. RESULTS In 6 year olds, statistically significant associations were observed between the salivary microflora (MS, LB) and dt/DT (p=0.032; dt=3.71, DT=0.42), use of F-toothpaste (p=0.020), and TS (p<0.001). In 12 year olds, statistically significant (p<0.01) associations were observed between salivary microflora and dt/DT, ds/DS and dmft/DMFT. In both age groups, significant (p<0.001) association was demonstrated between dmfs/DMFS and salivary microflora, F-toothpaste and TS. CONCLUSIONS The present study indicated that the caries development in Latvian children was associated with consumption of sugary tea and use of non-fluoride toothpaste.
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Brown JP, Amaechi BT, Bader JD, Shugars D, Vollmer WM, Chen C, Gilbert GH, Esterberg EJ. The dynamic behavior of the early dental caries lesion in caries-active adults and implications. Community Dent Oral Epidemiol 2015; 43:208-16. [PMID: 25656426 PMCID: PMC4418491 DOI: 10.1111/cdoe.12143] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 03/09/2014] [Accepted: 12/13/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the full range of behavior of the visible, noncavitated, early caries lesion in caries-active adults with substantial fluoride exposure, and to consider implications. METHODS The data were from the Xylitol for Adult Caries Trial (X-ACT) collected annually for 33 months using condensed ICDAS caries threshold criteria. Individual tooth surfaces having a noncavitated caries lesion were included, and the patterns of transition to each subsequent annual clinical examination to sound, noncavitated or cavitated, filled or crowned were determined. The resulting sets of patterns for an individual tooth surface, looking forward from its first appearance as a noncavitated lesion, were combined into one of four behavior profiles classified as reversing, stable, oscillating, or continuously progressing, or were excluded if not part of the caries continuum. The distributions of profile types were assessed using the Rao-Scott chi-square test, which adjusts for clustering of tooth surfaces within teeth. RESULTS Inter- and intra-examiner kappa scores demonstrated acceptable calibration at baseline and annually. 8084 tooth surfaces from 543 subjects were included. The distribution of profile types differed significantly between coronal and root surfaces. Overall, two-thirds of all coronal noncavitated lesions were first seen at baseline, half reversed, over a fifth were stable, 15% oscillated, and only 8.3% progressed to cavitation, filled, or crowned in 33 months or less (6.3% consistently Progressed plus 2.0% inconsistently, a subset of oscillating, which oscillated before progressing to cavitation). Approximal, smooth, and occlusal coronal surfaces each were significantly different in their individual distributions of profile types. Xylitol showed no significant and consistent effect on this distribution by tooth surface type. This was in keeping with the X-ACT's lack of effect of xylitol at the noncavitated plus cavitated lesion thresholds combined. CONCLUSIONS This study demonstrated the full dynamic range of early caries lesion behavior. The great majority were not progressive, and few (8.3%) became cavitated over 33 months in caries-active adults using fluorides. Important caries management implications favoring recorded longitudinal monitoring, prevention of active risks, and minimal restoration only after direct visual determination of cavitation are discussed.
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Affiliation(s)
- John P Brown
- Dental School, University of Texas Health Science Center, San Antonio, TX, 78229, USA
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