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Vázquez-Ortíz MF, Borges-Yáñez SA, Lussi A, González-Aragón Pineda ÁE. Risk indicators for the severity of erosive wear in deciduous dentition of Mexican schoolchildren aged 5 to 7 years. J Clin Pediatr Dent 2024; 48:146-155. [PMID: 38755993 DOI: 10.22514/jocpd.2024.068] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 10/10/2023] [Indexed: 05/18/2024] Open
Abstract
The objective of this work was to estimate the prevalence and severity of erosive tooth wear (ETW), and to identify risk indicators of deciduous dentition of a group of schoolchildren from public schools in Tlalnepantla de Baz, State of Mexico. A cross-sectional study was carried out in 352 schoolchildren from 5 to 7 years old. The severity of the ETW was evaluated using the Basic Erosive Wear Examination (BEWE). Risk indicators were evaluated through a survey which included food and beverage consumption, consumption habits, vitamin C consumption, gastroesophageal reflux, heartburn, belching, xerostomia, vomiting and teeth grinding. Multinomial logistic regression models were fitted. The prevalence of ETW was 99.7% (n = 351). Regarding severity, 46.6% were at a null/mild level, 27.3% moderate, and 26.1% severe. Males were more likely to present severe ETW (odds ratio (OR) = 2.23, 95% confidence interval (CI), 1.27-3.93; p = 0.005). The risk indicators for the severity of ETW were the frequent consumption of citrus fruits (OR = 2.09, 95% CI, 1.12-3.89; p = 0.021), fruit juice (OR = 1.99, 95% CI, 1.06-3.75; p = 0.033), processed beverages (OR = 2.15, 95% CI, 1.23-3.78; p = 0.008) and hot sauce (OR = 1.82, 95% CI, 1.03-3.20; p = 0.036). The prevalence of ETW in the deciduous dentition was very high (99.7%) and ~1/3 for severe ETW. The dietary factors associated with severe ETW are part of the regular consumption of Mexican school-age children, which impact their oral health condition. It is important to establish intervention strategies from the infant stage, focused on both children and their caregivers.
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Affiliation(s)
- María Fernanda Vázquez-Ortíz
- Master and Doctoral Program in Medical, Dental and Health Sciences at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - Socorro Aída Borges-Yáñez
- Dental Public Health Department, Graduate and Research Division at the School of Dentistry, National Autonomous University of México, 04510 Mexico City, Mexico
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, University Medical Centre, 79106 Freiburg, BW, Germany
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Neuhaus KW, Kühnisch J, Banerjee A, Martignon S, Ricketts D, Schwendicke F, van der Veen MH, Doméjean S, Fontana M, Lussi A, Jablonski-Momeni A, Mendes FM, Douglas G, Schmalz G, Campus G, Aps J, Horner K, Opdam N, Huysmans MC, Splieth CH. ORCA-EFCD consensus report on clinical recommendations for caries diagnosis. Paper II: caries lesion activity and progression assessment. Caries Res 2024:000538619. [PMID: 38684147 DOI: 10.1159/000538619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/27/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION This consensus paper provides recommendations for oral health professionals on why and how to assess caries activity and progression with special respect to the site of a lesion. METHODS An expert panel was nominated by the executive councils of the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD). The steering committee built three working groups that were asked to provide recommendations on 1) caries detection and diagnostic methods, 2) caries activity and progression assessment and 3) obtain individualized caries diagnoses. The experts of work group 2 phrased and agreed on provisional general and specific recommendations on caries lesion activity and progression, based on a review of the current literature. These recommendations were then discussed and refined in a consensus workshop followed by an anonymous Delphi survey to determine the agreement on each recommendation. RESULTS The expert panel agreed on general (n=7) and specific recommendations (n=6). The specific recommendations cover coronal caries on pits and fissures, smooth surfaces, proximal surfaces, as well as root caries and secondary caries/ caries adjacent to restorations and sealants (CARS). 3/13 recommendations yielded perfect agreement. CONCLUSION The most suitable method for lesion activity assessment is the visual-tactile method. No single clinical characteristic is indicative of lesion activity; instead, lesion activity assessment is based on assessing and weighing several clinical signs. The recall intervals for visual and radiographic examination need to be adjusted to the presence of active caries lesions and recent caries progression rates. Modifications should be based on individual patient characteristics.
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Fernández C, Silva-Acevedo CA, Padilla-Orellana F, Zero D, Carvalho TS, Lussi A. Should We Wait to Brush Our Teeth?: A Scoping Review Regarding Dental Caries and Erosive Tooth Wear. Caries Res 2024:000538862. [PMID: 38621371 DOI: 10.1159/000538862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 04/05/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Tooth brushing is a universal recommendation. However, the recommendations related to the time of its execution are conflicting, especially when dealing with patients at risk of erosive tooth wear (ETW) or dental caries. SUMMARY Our objective was to summarize the evidence on the timing of brushing with fluoridated toothpaste in relation to ETW and cariogenic dietary challenges. We conducted a scoping review following the PRISMA-ScR checklist, using three databases searching for in-vivo, in-situ, or in-vitro studies involving human teeth exposed to either a cariogenic or an erosive challenge. Only models including human saliva and fluoride were assessed. Data selection, extraction, and risk of bias analysis were done in duplicate and independently. From 1,545 identified studies, 17 (16 related to ETW and 1 to dental caries) were included. Most evidence (n=10) supported that brushing with a fluoride-containing product does not increase ETW, independent of the moment of brushing. Delaying tooth brushing up to 1 hour (n=4) or individualized recommendations based on the patient's problem (n=2) were less frequent. Only one study reported that brushing pre- or post-meal does not affect Streptococcus mutans counts. Most data was in-situ (n=13), and the overall study quality was judged as sufficient/low risk of bias. KEY MESSAGES Although the available evidence lacked robust clinical studies, tooth brushing using fluoridated products immediately after an erosive challenge does not increase the risk of ETW and can be recommended, which is in line with recommendations for dental caries prevention. Furthermore, we suggest updating the international guidelines to promote individualized recommendations based on risk factors to prevent either ETW or dental caries.
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Kühnisch J, Aps JK, Splieth C, Lussi A, Jablonski-Momeni A, Mendes FM, Schmalz G, Fontana M, Banerjee A, Ricketts D, Schwendicke F, Douglas G, Campus G, van der Veen M, Opdam N, Doméjean S, Martignon S, Neuhaus KW, Horner K, Huysmans MCD. ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment. Clin Oral Investig 2024; 28:227. [PMID: 38514502 PMCID: PMC10957694 DOI: 10.1007/s00784-024-05597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection. MATERIALS AND METHODS The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity assessment and (3) forming individualised caries diagnoses. The experts responsible for "caries detection and diagnostic methods" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous Delphi survey. RESULTS Recommendations (N = 8) were approved and agreed upon by the whole expert panel: visual examination (N = 3), dental radiography (N = 3) and additional diagnostic methods (N = 2). While the quality of evidence was found to be heterogeneous, all recommendations were agreed upon by the expert panel. CONCLUSION Visual examination is recommended as the first-choice method for the detection and assessment of caries lesions on accessible surfaces. Intraoral radiography, preferably bitewing, is recommended as an additional method. Adjunct, non-ionising radiation methods might also be useful in certain clinical situations. CLINICAL RELEVANCE The expert panel merged evidence from the scientific literature with practical considerations and provided recommendations for their use in daily dental practice.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany.
| | | | - Christian Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Adrian Lussi
- University Hospital for Conservative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - David Ricketts
- Unit of Restorative Dentistry, University of Dundee, Dundee, UK
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany
| | - Gail Douglas
- Department of Dental Public Health, University of Leeds Dental School, Leeds, UK
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Monique van der Veen
- Departments of Preventive Dentistry and Paediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
- Oral Hygiene School, Inholland University of applied sciences, Amsterdam, The Netherlands
| | - Niek Opdam
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia
| | - Klaus W Neuhaus
- Department of Pediatric Oral Health, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Marcondes APM, Campos PHD, Ribeiro CS, Novaes TFD, Lussi A, Diniz MB. Performance of near-infrared light transillumination in the detection of occlusal caries lesions in deciduous teeth. Photodiagnosis Photodyn Ther 2023; 44:103744. [PMID: 37567332 DOI: 10.1016/j.pdpdt.2023.103744] [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: 01/04/2023] [Revised: 07/11/2023] [Accepted: 08/08/2023] [Indexed: 08/13/2023]
Abstract
BACKGROUND This study compared the performance of near-infrared light transillumination (NILT; DIAGNOcam [DC]) in detecting occlusal caries lesions in deciduous molars with the performance of the International Caries Detection and Assessment System (ICDAS), digital radiographic method (RX) and laser fluorescence (DIAGNOdent pen [LFpen]). METHODS Fifty-seven extracted deciduous molars with no frank cavitation caries lesions were selected. One site per tooth was evaluated twice each by two examiners using all methods. Then, a histological examination was performed using a stereomicroscope. The performance of the methods was assessed with respect to two thresholds: D1 (all visible caries lesions affecting enamel) and D3 (caries lesions extended into dentin). RESULTS A weighted kappa and intraclass correlation coefficients were calculated for intra- and inter-observer reproducibilities, varying from 0.31 (RX) to 0.89 (LFpen). The intra-observer reproducibility at D1 and D3 thresholds varied from 0.51 (ICDAS) to 0.85 (DC) and from 0.30 (ICDAS) to 1.00 (RX), respectively. The inter-observer reproducibility varied from 0.28 (RX) to 0.47 (DC) and from 0.22 (LFpen) to 0.75 (DC), respectively. At the D1 threshold, higher sensitivity and accuracy were found for LFpen (0.76/0.71) and ICDAS (0.65/0.66); and higher specificities were found for RX (0.94), DC (0.79), and ICDAS (0.71). At the D3 threshold, all methods exhibited lower sensitivities (0.13-0.35) and higher specificity, accuracy, and area under the ROC curve values (0.70-1.00). All methods showed a correlation with histological results, especially for ICDAS and DC. CONCLUSIONS NILT technology (DC) and LFpen exhibited similar performance for the detection of occlusal caries lesions in deciduous molars when compared with ICDAS criteria.
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Affiliation(s)
- Ana Paula Marçal Marcondes
- Graduate Program in Dentistry, Cruzeiro do Sul University, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil
| | - Priscila Hernández de Campos
- Graduate Program in Dentistry, Cruzeiro do Sul University, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil
| | - Caroline Santos Ribeiro
- Graduate Program in Dentistry, Cruzeiro do Sul University, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil
| | - Tatiane Fernandes de Novaes
- Graduate Program in Dentistry, Cruzeiro do Sul University, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Freiburg, Hugstetter Strasse 55, Freiburg DE-79106, Germany
| | - Michele Baffi Diniz
- Graduate Program in Dentistry, Cruzeiro do Sul University, Rua Galvão Bueno, 868, Liberdade, São Paulo, SP 01506-000, Brazil.
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Martini T, Câmara JVF, Dionizio A, Ventura TMO, Cassiano LDPS, de Souza E Silva CM, Taira EA, Araujo TT, Santos LA, Ferrari CR, Magalhães AC, Carvalho TS, Baumann T, Lussi A, Rios D, de Oliveira RB, Palma-Dibb RG, Buzalaf MAR. Proteomic analysis of stimulated saliva in gastroesophageal reflux disease patients with and without erosive tooth wear: Observational study. J Dent 2023; 139:104724. [PMID: 37797812 DOI: 10.1016/j.jdent.2023.104724] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/27/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE To evaluate the difference in the proteomic profile of stimulated saliva in patients with gastroesophageal reflux disease (GERD) with (GE) and without (GNE) erosive tooth wear (ETW), regarding both human and bacterial proteins. METHODS Stimulated saliva (SS) was collected from 16 patients (8/group). Samples were centrifuged at 4.500 g for 15 min under refrigeration to remove all debris. The supernatant from each saliva sample was taken and frozen at -80 °C. After extracting the proteins, they were submitted to reverse phase liquid chromatography and mass spectrometry (nLC-ESI-MS/MS). Label-free proteomic quantification was performed using Protein Lynx Global Service (PLGS) software (p < 0.05) for human and bacterial proteins. RESULTS In total, 67 human proteins were common for GNE and GE groups. GNE group presented, compared to GE group, increase in proteins that confer antimicrobial and acid resistant properties, such as cystatins, histatin and immunoglobulins. However, GNE group had a marked decrease in subunits of hemoglobin (α, β and delta). Regarding bacterial proteins, for SS, 7 and 10 unique proteins were identified in the GE and GNE groups, respectively. They are related to protein synthesis and energy metabolism and interact with human proteins typically found in saliva and supramolecular complexes of the acquired pellicle. CONCLUSIONS Our data indicate that the stimulation of the salivary flow increases acid resistant and antimicrobial proteins in saliva, which might protect against ETW. CLINICAL SIGNIFICANCE This pioneer study showed important differences in the human and bacterial proteome of SS in patients with GERD with or without ETW.
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Affiliation(s)
- Tatiana Martini
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil.
| | - João Victor Frazão Câmara
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Aline Dionizio
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Talita Mendes Oliveira Ventura
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Luiza de Paula Silva Cassiano
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Cíntia Maria de Souza E Silva
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Even Akemi Taira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Tamara Teodoro Araujo
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Lethycia Almeida Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Carolina Ruis Ferrari
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Thiago Saads Carvalho
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Hochschulstrasse 6, Bern 3012, Switzerland
| | - Tommy Baumann
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Hochschulstrasse 6, Bern 3012, Switzerland
| | - Adrian Lussi
- Department of Preventive, Restorative and Pediatric Dentistry, University of Bern, Hochschulstrasse 6, Bern 3012, Switzerland
| | - Daniela Rios
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
| | - Ricardo Brandt de Oliveira
- Ribeirão Preto School of Medicine, University of São Paulo, Av. Bandeirantes, 3900, Ribeirão Preto, SP 14049-900, Brazil
| | - Regina Guenka Palma-Dibb
- Ribeirão Preto School of Dentistry, University of São Paulo, Av. do Café - Subsetor Oeste - 11 (N-11), Ribeirão Preto, SP 14040-904, Brazil
| | - Marília Afonso Rabelo Buzalaf
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Vila Regina, Bauru, SP 17011-220, Brazil
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Perez MM, Lus ACM, Campos PH, Amaral SFD, Lussi A, Diniz MB, Guaré RO. Association of salivary parameters and erosive tooth wear in preschool children. Braz Oral Res 2023; 37:e093. [PMID: 37820251 DOI: 10.1590/1807-3107bor-2023.vol37.0093] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/01/2023] [Indexed: 10/13/2023] Open
Abstract
The aims of this study were to 1) assess the association between erosive tooth wear (ETW) according to the BEWE (Basic Erosive Wear Examination) scoring system and salivary parameters and 2) compare salivary parameters according to ETW severity in the subgroup of children with ETW. This cross-sectional study included 52 preschool children aged 5 years paired by sex. A calibrated examiner assessed ETW using BEWE criteria, and stimulated saliva was collected to determine salivary flow, osmolality, pH, and buffering capacity. The children were divided into two groups: without ETW (n=26; BEWE score 0) and with ETW (n=26; BEWE scores 1 and 2). Logistic regression analysis was used to determine the magnitude of the association between ETW and salivary parameters and estimates of odds ratios (OR). In the unadjusted analysis, the ETW group was more likely to have lower salivary flow (OR = 0.079; 95%CI = 0.013-0.469; p = 0.005) and lower osmolality (OR = 0.993; 95%CI = 0.985-1.000; p = 0.049). In the adjusted analysis, salivary flow remained significantly associated with ETW (OR = 0.087; 95%CI = 0.014-0.533; p = 0.008). Lower salivary osmolality values were observed in ETW, especially in preschool children with more severe ETW (BEWE score 2). Receiver operating characteristic (ROC) determined a salivary osmolality cutoff point of < 201 for the presence of ETW. In conclusion, salivary flow rate was significantly associated with ETW prevalence. Lower values of salivary osmolality were observed in preschool children with distinct erosive lesions with significant loss of tooth structure (BEWE 2).
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Affiliation(s)
| | | | | | | | - Adrian Lussi
- University of Freiburg, Department of Operative Dentistry & Periodontology, Freiburg, DE
| | - Michele Baffi Diniz
- Universidade Cruzeiro do Sul, Department of Dentistry, São Paulo, SP, Brazil
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Martini T, Rios D, Dionizio A, Cassiano LDPS, Silva CMDSE, Taira EA, Ventura TMO, Câmara JVF, Araujo TT, Magalhães AC, Carvalho TS, Baumann T, Lussi A, Oliveira RBD, Palma-Dibb RG, Buzalaf MAR. Acquired enamel pellicle protects gastroesophageal reflux disease patients against erosive tooth wear. Braz Oral Res 2023; 37:e085. [PMID: 37729290 DOI: 10.1590/1807-3107bor-2023.vol37.0085] [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: 09/16/2022] [Accepted: 12/20/2022] [Indexed: 09/22/2023] Open
Abstract
The objective of this study was to compare the protein profile of the acquired enamel pellicle (AEP) formed in vivo in patients with or without gastroesophageal reflux disease (GERD), and with or without erosive tooth wear (ETW). Twenty-four volunteers were divided into 3 groups: 1) GERD and ETW; 2) GERD without ETW; and 3) control (without GERD). The AEP formed 120 min after prophylaxis was collected from the lingual/palatal surfaces. The samples were subjected to mass spectrometry (nLC-ESI-MS/MS) and label-free quantification by Protein Lynx Global Service software. A total of 213 proteins were identified, or 119, 92 and 106 from each group, respectively. Group 2 showed a high number of phosphorylated and calcium-binding proteins. Twenty-three proteins were found in all the groups, including 14-3-3 protein zeta/delta and 1-phosphatidylinositol. Several intracellular proteins that join saliva after the exfoliation of oral mucosa cells might have the potential to bind hydroxyapatite, or participate in forming supramolecular aggregates that bind to precursor proteins in the AEP. Proteins might play a central role in protecting the dental surface against acid dissolution.
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Affiliation(s)
- Tatiana Martini
- Universidade de São Paulo - USP, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Daniela Rios
- Universidade de São Paulo - USP, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Aline Dionizio
- Universidade de São Paulo - USP, Bauru School of Dentistry, Bauru, SP, Brazil
| | | | | | - Even Akemi Taira
- Universidade de São Paulo - USP, Bauru School of Dentistry, Bauru, SP, Brazil
| | | | | | | | | | - Thiago Saads Carvalho
- University of Bern, Department of Preventive, Restorative and Pediatric Dentistry, Bern, Switzerland
| | - Tommy Baumann
- University of Bern, Department of Preventive, Restorative and Pediatric Dentistry, Bern, Switzerland
| | - Adrian Lussi
- University of Bern, Department of Preventive, Restorative and Pediatric Dentistry, Bern, Switzerland
| | - Ricardo Brandt de Oliveira
- Universidade de São Paulo - USP, Ribeirão Preto School of Medicine, Department of General Medicine, Ribeirão Preto, SP, Brazil
| | - Regina Guenka Palma-Dibb
- Universidade de São Paulo - USP, Ribeirão Preto School of Medicine, Department of Restorative Dentistry, Ribeirão Preto, SP, Brazil
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Baumann T, Niemeyer SH, Lussi A, Scaramucci T, Carvalho TS. Rinsing solutions containing natural extracts and fluoride prevent enamel erosion in vitro. J Appl Oral Sci 2023; 31:e20230108. [PMID: 37493702 PMCID: PMC10382078 DOI: 10.1590/1678-7757-2023-0108] [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] [Received: 03/24/2023] [Accepted: 06/08/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND Polyphenols interact with salivary proteins and thus can improve the pellicle's erosion protective properties. This effect could be exploited to create rinsing solutions with polyphenols as active ingredients for erosion prevention. Different from the current gold standard for erosion protective rinsing solutions, these rinses would not rely on stannous ions. This would offer alternatives for patients with concerns regarding the composition of rinsing solutions and preferring bio-products. OBJECTIVE To develop an erosion-preventive rinsing solution containing natural polyphenol-rich extracts. METHODOLOGY Solutions were prepared with polyphenols from either grapeseed extract or cranberry extract, 500 ppm fluoride added, and additionally flavors and sweeteners. Controls were deionized water, 500 ppm fluoride solution, and the gold standard rinse in the field (Sn2+/F-). In total, 135 enamel specimens (n=15/group) were subjected to five cycles of salivary pellicle formation (30 min, 37°C), modification with the solutions (2 min, 25°C), further salivary pellicle formation (60 min, 37°C), and erosive challenge (1 min, 1% citric acid, pH 3.6). Relative surface microhardness (rSMH), surface reflection intensity (rSRI), and amount of calcium release (CaR) were investigated. Data were analyzed with Kruskal-Wallis and Wilcoxon rank sum tests (α=0.05). RESULTS The polyphenol solutions containing fluoride, as well as additional flavors, protected enamel better than fluoride alone, and similar to the Sn2+/F- solution, when investigating both rSMH and CaR. When measuring rSRI, Sn2+/F- showed the best protection, while the polyphenol solutions were similar to fluoride. CONCLUSION For two of the three assessed parameters (rSMH and CaR), both developed polyphenol-rich rinsing solutions were able to protect enamel from erosion, improving/potentializing the effect of fluoride and matching the protection offered by the current gold standard rinsing solution.
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Affiliation(s)
- Tommy Baumann
- University of Bern, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, Bern, Switzerland
| | - Samira Helena Niemeyer
- University of Bern, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, Bern, Switzerland
| | - Adrian Lussi
- University of Bern, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, Bern, Switzerland
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center, University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Taís Scaramucci
- Universidade de São Paulo, Faculdade de Odontologia, Departmento de Odontologia Restauradora, São Paulo, SP, Brasil
| | - Thiago Saads Carvalho
- University of Bern, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, Bern, Switzerland
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10
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Kühnisch J, Anttonen V, Lussi J, Lussi A. Chapter 7: Technological Aids and Coronal Caries. Monogr Oral Sci 2023; 31:105-114. [PMID: 37364554 DOI: 10.1159/000530561] [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] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 01/12/2023] [Indexed: 06/28/2023]
Abstract
In recent decades, dentistry has developed significantly in all areas. While in the past, caries was mainly treated operatively, the today's management has shifted toward noninvasive, minimal invasive, and, only if needed, invasive treatment options. Aiming at enabling the most noninvasive or conservative treatment option requires early caries detection, which, however, remains challenging. The progression of early or noncavitated caries lesions can nowadays be successfully controlled, as well as lesions arrested by oral hygiene procedures combined with the use of fluorides, sealants, or resin infiltration. Methods such as near-infrared light transillumination, fibre-optic transillumination, digital fibre-optic transillumination, laser fluorescence, or quantitative light fluorescence measurements were introduced in the dental market to provide X-ray-free caries detection, assessment, and monitoring. For approximal surfaces that are not directly visible, bitewing radiography is still the standard in detecting caries lesions. The use of artificial intelligence has become the most recent technological aid for the detection of caries lesions on bitewing radiographs and clinical images and has to be understood as an emerging technology, which requires extensive research in the future. The aim of this chapter is to give an overview of different possibilities to detect coronal caries lesions and suggestions of how to improve this process.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Vuokko Anttonen
- Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Population Health, University of Oulu, Oulu, Finland
| | - Jonas Lussi
- Multi-Scale Robotics Lab, ETH Zürich, Zürich, Switzerland
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany
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11
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Niemeyer SH, Baumann T, Lussi A, Scaramucci T, Carvalho TS. Plant extracts have dual mechanism on the protection against dentine erosion: action on the dentine substrate and modification of the salivary pellicle. Sci Rep 2023; 13:7089. [PMID: 37130893 PMCID: PMC10154312 DOI: 10.1038/s41598-023-34256-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/26/2023] [Indexed: 05/04/2023] Open
Abstract
To investigate the effect of some polyphenol-rich plant extracts on the protection of dentine against demineralization, both acting on the dentine and on the salivary pellicle. Dentine specimens (n = 180) were randomly distributed into 6 experimental groups (n = 30/group): Control (deionized water), Açaí extract, Blueberry extract, Green tea extract, Grape seed extract, and Sn2+/F- (mouthrinse containing stannous and fluoride). Each group was further divided into two subgroups (n = 15), according to the site of action of the substance: on the dentine surface (D) or on the salivary pellicle (P). The specimens were submitted to 10 cycles: 30 min incubation in human saliva (P) or only in humid chamber (D), 2 min immersion in experimental substances, 60 min of incubation in saliva (P) or not (D), and 1 min erosive challenge. Dentine surface loss (DSL), amount of degraded collagen (dColl) and total calcium release were analyzed. Green tea, Grape seed and Sn2+/F- showed significant protection, with least DSL and dColl. The Sn2+/F- showed better protection on D than on P, whereas Green tea and Grape seed showed a dual mode of action, with good results on D, and even better on P. Sn2+/F- showed the lowest values of calcium release, not differing only from Grape seed. Sn2+/F- is more effective when acting directly on the dentine surface, while Green tea and Grape seed have a dual mode of action: with a positive effect on the dentine surface itself, but an improved efficacy in the presence of the salivary pellicle. We further elucidate the mechanism of action of different active ingredients on dentine erosion, where Sn2+/F- acts better on the dentine surface, but plant extracts have a dual mode of action, acting on the dentine itself as well as on the salivary pellicle, improving the protection against acid demineralization.
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Affiliation(s)
- Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Adrian Lussi
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Tais Scaramucci
- Department of Restorative Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes 2227, Cidade Universitária, São Paulo, SP, 05508-000, Brazil
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
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12
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Pelá VT, Ventura TMO, Taira EA, Thomassian LTG, Brito L, Matuhara YE, Henrique-Silva F, Groisman S, Carvalho TS, Lussi A, Buzalaf MAR. Use of Reflectometer Optipen to assess the preventive effect of a sugarcane cystatin on initial dental erosion in vivo. J Mech Behav Biomed Mater 2023; 141:105782. [PMID: 36934688 DOI: 10.1016/j.jmbbm.2023.105782] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 03/16/2023]
Abstract
The sugarcane cystatin 5 (CaneCPI-5) showed protection against erosion and erosive tooth wear (ETW) under several protocols. However, evaluating these conditions in vivo is hard due to the lack of a suitable device. The aim of this study was to use clinically the relative surface reflection intensity (%SRI) by the Reflectometer Optipen to assess the acquired pellicle engineering with CaneCPI-5 rinse for the prevention of initial erosion in vivo. Nine volunteers were distributed in three cross-over phases, according to the rinse used, as follows: 1) Deionized water (negative control); 2) Elmex® (800 ppm Sn2+, 500 ppm F-; positive control); 3) 0.1 mg/mL CaneCPI-5. The following experimental steps were performed: Initially, the volunteers received prophylaxis and the initial %SRI was performed. Subsequently, they rinsed with the solutions (10 mL; 1min), followed by the formation of the acquired enamel pellicle (AEP; 120min). After, the erosive challenge with citric acid 1%, pH 2.5 (10 μL; 10s) was performed (in isolation) on the buccal surface of the maxillary central incisors (right and left). The calcium present in the acid was analyzed by Arsenazo III method. Finally, the final %SRI was performed. Data were analyzed by Kruskal-Wallis/Dunn's tests and Spearman's correlation were used (p < 0.05). For both variables, the negative control led to significantly less protection (lower reflectivity and higher calcium release) in comparison with the other groups. The best protection (higher reflectivity and lower calcium release) was observed for the Elmex® and the CaneCPI-5 groups, with no significant differences between them (p < 0.05). There was a significant correlation between both analyzes. The Reflectometer Optipen demonstrated to be a good device to assess clinically. Moreover, CaneCPI-5 rinse proved effective through acquired pellicle engineering against initial erosion in vivo.
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Affiliation(s)
- Vinícius Taioqui Pelá
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, SP, Brazil.
| | | | - Even Akemi Taira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | | | - Leonardo Brito
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
| | - Yan Eiji Matuhara
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Flávio Henrique-Silva
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Sonia Groisman
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, BE, Switzerland.
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany, School of Dental Medicine, University of Bern, Switzerland.
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13
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Lussi A, Megert B, Shellis P. The erosive effect of various drinks, foods, stimulants, medications and mouthwashes on human tooth enamel. Swiss Dent J 2023; 133:sdj-2023-07-08-02. [PMID: 36861647] [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] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Two forms of non-carious dental disorder - erosive tooth hard tissue loss and dental erosion - have been increasingly observed in recent years. Dental erosion is the chemical loss of dental hard substances caused by exposure to acids not derived from oral bacteria. Mechanical forces from, for example, the tongue, the cheeks or toothbrushing, increase loss of partly-demineralized tooth surfaces and the cumulative loss of dental hard tissue is defined as erosive tooth wear (ETW). Dental hard tissue losses which occur because of very frequent acid exposure, such as through increased vomiting, but without mechanical stress, are also assigned to tooth erosion. Without prior softening, practically no loss of enamel takes place due to abrasion with the modern Western diet. The present work is a continuation of earlier work. A total of 226 beverages, food, stimulants as well as medicines and mouthwashes were tested for their erosive potential on premolars and deciduous molars covered with a human pellicle. The influence of temperature, phosphate and calcium was also investigated in additional experiments. The change in hardness before and after immersion in the respective test substance was measured and the erosive potential was classified. For each test product, we determined pH and other properties which were possibly related to erosive potential. There were considerable and sometimes surprising differences between the tested products. The addition of phosphate did not influence the erosive potential of the liquids, but calcium did. A modified erosion scheme is presented, which incorporates these and other new findings.
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Affiliation(s)
- Adrian Lussi
- Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany and School of Dental Medicine, University of Bern, Switzerland.,Department of Preventive, Restorative and Pediatric Dentistry University of Bern, CH-3010 Bern
| | - Brigitte Megert
- Department of Preventive, Restorative and Pediatric Dentistry University of Bern, CH-3010 Bern
| | - Peter Shellis
- Bristol Dental School, University of Bristol, Bristol, U.K
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14
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Shellis RP, Barbour ME, Parker DM, Addy M, Lussi A. Effects of Calcium and Phosphate on Dissolution of Enamel, Dentin and Hydroxyapatite in Citric Acid. Swiss Dent J 2023; 133:sdj-2023-07-08-01. [PMID: 36861646] [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] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
The aim was to evaluate the effect of dissolved calcium and phosphate on dissolution rate of enamel, dentin and compressed hydroxyapatite (HA) in citric acid solution as a function of pH. At pH 2.5, dissolution rate of enamel increased significantly by 6% in 20 mmol/L added calcium but, otherwise, dissolution rates of neither enamel, dentin nor HA were significantly affected by 10 or 20 mmol/L calcium. However, enamel dissolution rate was reduced by > 50 mmol/L calcium. At pH 3.25 and 4.0, 10-20 mmol/L calcium inhibited dissolution of enamel by 29-100% and HA by 65-75% but did not affect dentin dissolution. Phosphate (10 or 20 mmol/L) did not inhibit dissolution of enamel, dentin or HA at any pH, but there were increases in dissolution rate of all three substrates at pH 2.5 and, in one test with dentine (at 20 mmol/L phosphate), at pH 3.25. The results suggest that calcium addition to soft drinks and other acidic products such as medications may reduce erosivity against enamel, provided that pH is not too low; that phosphate would not reduce erosivity against enamel; and that neither calcium nor phosphate at these concentrations would reduce erosivity against dentin.
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Affiliation(s)
| | | | | | - Martin Addy
- Bristol Dental School, University of Bristol, Bristol, U.K
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, Switzerland and Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany
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15
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Coluccia A, Matti F, Zhu X, Lussi A, Stähli A, Sculean A, Eick S. In Vitro Study on Green Propolis as a Potential Ingredient of Oral Health Care Products. Antibiotics (Basel) 2022; 11:antibiotics11121764. [PMID: 36551420 PMCID: PMC9774696 DOI: 10.3390/antibiotics11121764] [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: 11/10/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Propolis is increasingly being discussed as an alternative to commonly used antiseptics. This in vitro study focused on the ethanolic extract of green Brazilian propolis (EEPg) as an additive in an oral health care product. We investigated (i) a potential inflammation-modulation activity of EEPg when a periodontal or Candida biofilm was exposed to monocytic (MONO-MAC-6) cells, (ii) the adhesion of oral pathogens to gingival keratinocytes and (iii) the antimicrobial and antibiofilm effect of different toothpaste formulations. EEPg decreased the levels of interleukin (IL)-1β and increased IL-10 in MONO-MAC cells challenged with a periodontal biofilm. In contact with TIGK cells, EEPg reduced the numbers of adherent Porphyromonas gingivalis to 0.5% but did not affect the adhesion of Candida albicans. The frequent brushing of a cariogenic biofilm with a toothpaste supplemented with EEPg reduced the surface microhardness loss of enamel specimens. Mixing an experimental erythritol toothpaste with 25 and 50 mg/mL of EEPg confirmed the antibacterial activity of EEPg against oral bacteria and particularly inhibited periodontal biofilm formation. The suggested toothpaste formulations seem to have potential in the prevention of caries, gingivitis and periodontitis and should be evaluated in further in vitro research and in clinical trials.
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Affiliation(s)
- Achille Coluccia
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Fabienne Matti
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Xilei Zhu
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Adrian Lussi
- Preventive and Paediatric Dentistry, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, 3010 Bern, Switzerland
- Correspondence:
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16
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Pelá VT, Brito L, Taira EA, Henrique-Silva F, Pieretti JC, Seabra AB, de Almeida Baldini Cardoso C, de Souza EP, Groisman S, Rodrigues MC, Lussi A, Carvalho TS, Buzalaf MAR. Preventive effect of chitosan gel containing CaneCPI-5 against enamel erosive wear in situ. Clin Oral Investig 2022; 26:6511-6519. [PMID: 35829772 DOI: 10.1007/s00784-022-04600-z] [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: 12/23/2021] [Accepted: 06/20/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study evaluated the preventive effect of a chitosan gel containing CaneCPI-5 against enamel erosion and erosion + abrasion in situ. METHODS Sixteen volunteers participated in a crossover, double-blind protocol, comprising 4 phases: (1) no treatment (Nt); (2) chitosan gel (Cg); (3) chitosan gel + 12,300 ppm NaF (Cg + NaF); and (4) chitosan gel + 0.1 mg/mL CaneCPI-5 (Cg + Cane). Volunteers wore an appliance containing 4 specimens. Once/day, they applied the gel (except for Nt) (4 min/specimen). Erosive challenges were performed extra-orally (0.1% citric acid, 90 s, 4 × /day; ERO). Specimens were also abraded (toothbrush, 15 s/specimen, 2 × /day; ERO + ABR). Enamel wear was assessed by profilometry and relative surface reflection intensity (%SRI). Two-way RM-ANOVA/Sidak's tests and Spearman's correlation were used (p < 0.05). RESULTS For profilometry, ERO + ABR promoted significantly greater wear when compared with ERO. There was a significant difference among all treatments. The lowest enamel loss occurred for Cg + Cane, followed by Cg + NaF, Cg, and Nt (p < 0.05). The %SRI was significantly lower for ERO + ABR when compared to ERO, only for the Nt group. The greatest %SRI was found for the Cg + NaF and Cg + Cane groups, which did not differ significantly, regardless of the conditions. The lowest %SRI was found for the Nt and Cg groups, which did not differ from each other, regardless of the conditions. The Nt group did not differ significantly from the Cg + NaF (ERO). There was a significant correlation between both analyses. CONCLUSION The incorporation of CaneCPI-5 in the chitosan gel prevented erosive wear in situ. CLINICAL RELEVANCE These results open a new perspective for the use of CaneCPI-5 in other application vehicles, such as chitosan gel.
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Affiliation(s)
- Vinícius Taioqui Pelá
- Department of Genetics and Evolution, São Carlos Federal University, São Carlos, São Paulo, Brazil
| | - Leonardo Brito
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Even Akemi Taira
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil
| | - Flávio Henrique-Silva
- Department of Genetics and Evolution, São Carlos Federal University, São Carlos, São Paulo, Brazil
| | - Joana Claudio Pieretti
- Center for Natural and Human Sciences, Federal University of ABC, Santo André, São Paulo, Brazil
| | - Amedea Barozzi Seabra
- Center for Natural and Human Sciences, Federal University of ABC, Santo André, São Paulo, Brazil
| | | | - Eduardo Pereira de Souza
- Department of Genetics and Evolution, São Carlos Federal University, São Carlos, São Paulo, Brazil
| | - Sonia Groisman
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
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17
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Schmidlin PR, Schmidlin AD, Gubler A, Attin T, Lussi A. [Not Available]. Swiss Dent J 2022; 132:354-355. [PMID: 35546138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
- Patrick R Schmidlin
- Klinik für Zahnerhaltung und Präventivzahnmedizin, Zentrum für Zahnmedizin der Universität Zürich, Schweiz
| | - Andrin D Schmidlin
- Klinik für Zahnerhaltung und Präventivzahnmedizin, Zentrum für Zahnmedizin der Universität Zürich, Schweiz
| | - Andrea Gubler
- Klinik für Zahnerhaltung und Präventivzahnmedizin, Zentrum für Zahnmedizin der Universität Zürich, Schweiz
| | - Thomas Attin
- Klinik für Zahnerhaltung und Präventivzahnmedizin, Zentrum für Zahnmedizin der Universität Zürich, Schweiz
| | - Adrian Lussi
- Klinik für Zahnerhaltungskunde und Parodontologie, Universitätsklinikum Freiburg, Deutschland
- Zahnmedizinische Kliniken der Universität Bern, Schweiz
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18
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Sezer B, Giritlioğlu B, Sıddıkoğlu D, Lussi A, Kargül B. Relationship between erosive tooth wear and possible etiological factors among dental students. Clin Oral Investig 2022; 26:4229-4238. [PMID: 35199194 DOI: 10.1007/s00784-022-04425-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 11/09/2021] [Accepted: 02/19/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to assess the relationship between erosive tooth wear (ETW) and possible etiological factors in a group of dental students. MATERIALS AND METHODS A total of 126 dental students from a public dental school were included in this study. A questionnaire was used to investigate the possible etiological factors related to ETW. The Basic Erosive Wear Examination (BEWE) criteria were used to examine the status of ETW. A univariable and multivariable logistic regression models were used to assess the relationship between the presence of ETW and explanatory variables. RESULTS Univariable analysis revealed that taking acidic foods and alcohol more than 4-5 times per week increases the odds of ETW by 6.043 and 2.532 times, respectively, and taking dairy products, fruit juice, and milk more than 4-5 times per week decreases the likelihood of ETW by 61%, 66%, and 80%, respectively. The results of multivariable regression analysis showed that the frequency of consumption of especially acidic foods significantly increased the risk of ETW (OR = 9.981, 95% CI 3.577-27.849, p < 0.001). CONCLUSIONS Although the ETW status of dental students, who are the future dentists, varies depending on different possible etiological factors, especially the consumption of acidic foods has increased the risk of ETW approximately 10 times. CLINICAL RELEVANCE The findings highlight the high relevance of ETW, especially with acidic food consumption, and the importance of controlling potential etiological factors in dental students.
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Affiliation(s)
- Berkant Sezer
- Department of Pediatric Dentistry, School of Dentistry, Çanakkale Onsekiz Mart University, Çanakkale, Turkey.
| | - Begüm Giritlioğlu
- Department of Prosthodontics, School of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Duygu Sıddıkoğlu
- Department of Biostatistics, School of Medicine, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, School of Dentistry, University Medical Centre, Freiburg, Germany
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Betül Kargül
- Department of Pediatric Dentistry, School of Dentistry, Marmara University, Istanbul, Turkey
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19
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Taioqui Pelá V, Niemeyer SH, Baumann T, Levy FM, Henrique-Silva F, Lussi A, Carvalho TS, Buzalaf MAR. Acquired pellicle engineering using a combination of organic (sugarcane cystatin) and inorganic (sodium fluoride) components against dental erosion. Caries Res 2022; 56:138-145. [DOI: 10.1159/000522490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/06/2022] [Indexed: 11/19/2022] Open
Abstract
This study evaluated the combination of a sugarcane cystatin (CaneCPI-5) and sodium fluoride (NaF) in acquired pellicle engineering for the prevention of dental erosion in vitro. 75 human enamel specimens were prepared and divided into 5 treatment groups (n = 15/group): Deionized water (Control); Elmex™ (SnCl2/NaF/AmF); 0.1 mg/ml CaneCPI-5; 500 ppm NaF; and CaneCPI-5+NaF (Combination). The specimens were individually treated (200 μl; 2 min; 37 °C), then incubated in human saliva (200 μl; 1 h, at 37 °C) for acquired pellicle formation. Afterwards, the specimens were submitted to an erosive challenge (1% citric acid, pH 3.6, 10 ml, 2 min, 25 °C). This sequence was conducted 5 times. Percentage of surface microhardness change (%SMC), relative surface reflection intensity (rSRI) and calcium released to the citric acid (CR) were measured and analyzed by One-way ANOVA followed by Tukey's test (p<0.05). In general, all the treatments (SnCl2/NaF/AmF, CaneCPI-5, NaF and Combination) significantly protected the enamel when compared the control group. Regarding %SMC and rSRI, the Combination was the most effective treatment, reducing the %SMC significantly (p<0.01) when compared to all the other treatments, although this difference was not significant in the CR analysis. All treatments demonstrated a protective effect on enamel against dental erosion; however the combination of CaneCPI-5 with NaF showed a greater protection.
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Campos PH, Gimenez T, Rocha RS, Caneppele TMF, Guaré RO, Lussi A, Bresciani E, Diniz MB. Prevalence of White Spot Caries Lesions in Primary Teeth in Preschool Children: Systematic Review and Meta-analysis. Curr Pediatr Rev 2022; 18:33-46. [PMID: 34856910 DOI: 10.2174/1573396317666211202090657] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The first clinically detectable stage of caries lesion is a non-cavitated white spot lesion (WSL). The detection of early stages of caries lesions allows non-invasive management by fluoride usage, oral hygiene and diet control. There is a lack of information in the literature regarding the prevalence of these caries lesions in preschool children, which is important especially for public health strategies. OBJECTIVE The aim of this study was to conduct a systematic review with meta-analysis to verify the WSLs prevalence in primary teeth of preschool children. METHODS A literature search with MEDLINE/PubMed, Scopus, Web of Science, and Open Gray databases was conducted. Included studies fulfilled the eligibility criteria. Meta-analyses were performed using random effects model, for prevalence of pooled WSLs and subgroups analyses. RESULTS The search strategy identified 4922 potentially relevant articles, with final inclusion of 16 studies. The pooled prevalence of WSLs in primary teeth was 14.0% (95% CI: 8.0-24.0), without publication bias (p=0.2668). For subgroup analyses, an increase in WSLs prevalence for children of low-income economy (24.0%; 95% CI: 20.0-28.0), for age >31 months (22.0%; 95% CI: 12.0-37.0), for validated visual criteria assessment (20.0%; 95% CI: 11.0-33.0), and for tactile assessment with ball-ended probe (26.0%; 95% CI: 11-50.0) were detected. CONCLUSION It is suggested that the prevalence of WSLs in primary teeth of preschool children increases in countries with low income economy, with age greater than 31 months or texture assessment with visual validated criteria or ball-ended probe. PROSPERO Registration: Protocol number #CDR42017078434.
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Affiliation(s)
- Priscila H Campos
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
| | - Thais Gimenez
- Post-graduate Program in Dentistry, Ibirapuera University, São Paulo, Brazil
| | - Rafael S Rocha
- GAPEC, Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology of São José dos Campos, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Taciana M F Caneppele
- GAPEC, Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology of São José dos Campos, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Renata O Guaré
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Center of Dental Medicine, University of Freiburg, Freiburg, Germany.,School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Eduardo Bresciani
- GAPEC, Academic Group of Clinical Research, Department of Restorative Dentistry, Institute of Science and Technology of São José dos Campos, São Paulo State University (UNESP), São José dos Campos, São Paulo, Brazil
| | - Michele B Diniz
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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Janjic Rankovic M, Kapor S, Khazaei Y, Crispin A, Schüler I, Krause F, Ekstrand K, Michou S, Eggmann F, Lussi A, Huysmans MC, Neuhaus K, Kühnisch J. Systematic review and meta-analysis of diagnostic studies of proximal surface caries. Clin Oral Investig 2021; 25:6069-6079. [PMID: 34480645 PMCID: PMC8531083 DOI: 10.1007/s00784-021-04113-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 09/07/2020] [Accepted: 07/29/2021] [Indexed: 12/26/2022]
Abstract
AIM This systematic review and meta-analysis aimed to assess the diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries diagnostics. Visual examination (VE), bitewing radiography (BWR), laser fluorescence (LF), and fibre-optic transillumination (FOTI) were considered in detail. MATERIAL AND METHODS PRISMA guidelines for the reporting of systematic reviews and meta-analyses were applied. The mnemonic PIRDS (problem, index test, reference test, diagnostic and study type) concept was used to guide the literature search. Next, studies that met the inclusion criteria were stepwise selected and evaluated for their quality with a risk of bias (RoB) assessment tool. Studies with low/moderate bias and sufficient reporting were considered for meta-analysis. The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR), and area under the ROC curve (AUC) were calculated. RESULTS From 129 studies meeting the selection criteria, 31 in vitro studies and five clinical studies were finally included in the meta-analysis. The AUC values for in vitro VE amounted to 0.84 (caries detection) and 0.85 (dentin caries detection). BWR ranged in vitro from 0.55 to 0.82 (caries detection) and 0.81-0.92 (dentin caries detection). LF showed higher AUC values for overall caries detection (0.91) and dentin caries detection (0.83) than did other methods. Clinical data are limited. CONCLUSION The number of diagnostic studies with low/moderate RoB was found to be low and indicates a need for high-quality, well-designed caries diagnostic studies. CLINICAL RELEVANCE BWR and LF showed good diagnostic performance on proximal surfaces. However, because of the low number of includable clinical studies, these data should be interpreted with caution.
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Affiliation(s)
- Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Yegane Khazaei
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Alexander Crispin
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, Jena, Germany
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Aachen, Germany
| | - Kim Ekstrand
- Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Stavroula Michou
- Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Florin Eggmann
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Klaus Neuhaus
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital - Bern University Hospital, Bern, Switzerland
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.
- Poliklinik für Zahnerhaltung und Parodontologie, Klinikum der Universität München, LMU München, Goethestraße 70, 80336, Munich, Germany.
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22
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Wolgin M, Frankenhauser A, Shakavets N, Bastendorf KD, Lussi A, Kielbassa AM. A randomized controlled trial on the plaque-removing efficacy of a low-abrasive air-polishing system to improve oral health care. Quintessence Int 2021; 52:752-762. [PMID: 34269042 DOI: 10.3290/j.qi.b1763661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES While air polishing with abrasive powders has been proved efficient for sub- and supragingival application, only few studies concerning the quality of supragingival biofilm removal using the low-abrasive erythritol powder (EP) exist. The aim of the present randomized controlled trial was to clinically compare the efficacy of supragingival air polishing using EP in comparison with the rubber cup method, and to juxtapose the corresponding biofilm regrowth rates. METHOD AND MATERIALS Thirty-two young adults, suspending oral hygiene for 48 hours, were enrolled in the present double-blind short-term investigation. Using a split-mouth design, tooth polishing was conducted by means of either air polishing or rubber cups with prophylaxis paste (control). While 16 participants received air polishing in the second and fourth quadrants (and rubber cup prophylaxis in the first and third ones), the reverse sequence was applied with the remaining 16 subjects. Biofilms were assessed using the modified Quigley-Hein index (QHI), and QHI sum scores achieved both prior to and immediately after the polishing procedure, as well as 24 hours later, were assessed using a two-way analysis of variance (ANOVA), followed by Tukey's HSD to test multiple pairwise comparisons. RESULTS Both methods revealed a significant reduction of QHI scores (P < .001). Compared to the rubber cup method, air polishing resulted in significantly lower scores, both after tooth cleaning and after 24 hours (P < .001). CONCLUSIONS Supragingival biofilm removal by means of air polishing combined with low-abrasive erythritol seems to be more efficacious than the traditional polishing method, and should improve oral health care.
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Stähli A, Liakhova I, Cvikl B, Lussi A, Sculean A, Eick S. Activity of chlorhexidine formulations on oral microorganisms and periodontal ligament fibroblasts. Swiss Dent J 2021; 131:705-712. [PMID: 33512793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Affiliation(s)
- Alexandra Stähli
- Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Irina Liakhova
- Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Barbara Cvikl
- Department of Conservative Dentistry, Sigmund Freud University, Vienna, Austria
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany and School of Dental Medicine, University of Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Switzerland
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24
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Schaffner M, Stich H, Lussi A. [Not Available]. Swiss Dent J 2021; 131:726-727. [PMID: 34472765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Markus Schaffner
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern
| | - Herrmann Stich
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern
| | - Adrian Lussi
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern
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25
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Kapor S, Rankovic MJ, Khazaei Y, Crispin A, Schüler I, Krause F, Lussi A, Neuhaus K, Eggmann F, Michou S, Ekstrand K, Huysmans MC, Kühnisch J. Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. Clin Oral Investig 2021; 25:4801-4815. [PMID: 34128130 PMCID: PMC8342337 DOI: 10.1007/s00784-021-04024-1] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/01/2021] [Indexed: 02/01/2023]
Abstract
AIM This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. MATERIALS AND METHODS A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. RESULTS SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. CONCLUSION The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. CLINICAL RELEVANCE VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.
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Affiliation(s)
- Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, Ludwig-Maximilian Universität München, Munich, Germany
| | - Yegane Khazaei
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Alexander Crispin
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, Jena, Germany
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Aachen, Germany
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Klaus Neuhaus
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital-Bern University Hospital, Bern, Switzerland
| | - Florin Eggmann
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Stavroula Michou
- Department of Odontology, University Copenhagen, Copenhagen, Denmark
| | - Kim Ekstrand
- Department of Odontology, University Copenhagen, Copenhagen, Denmark
| | | | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany.
- Poliklinik Für Zahnerhaltung Und Parodontologie, Klinikum Der Universität München, LMU München, Goethestraße 70, 80336, München, Germany.
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26
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Kühnisch J, Janjic Rankovic M, Kapor S, Schüler I, Krause F, Michou S, Ekstrand K, Eggmann F, Neuhaus KW, Lussi A, Huysmans MC. Identifying and Avoiding Risk of Bias in Caries Diagnostic Studies. J Clin Med 2021; 10:3223. [PMID: 34362007 PMCID: PMC8347423 DOI: 10.3390/jcm10153223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Caries diagnostic studies differ with respect to their design, included patients/tooth samples, use of diagnostic and reference methods, calibration, blinding and data reporting. Such heterogeneity makes comparisons between studies difficult and could represent a substantial risk of bias (RoB) when it is not identified. Therefore, the present report aims to describe the development and background of a RoB assessment tool for caries diagnostic studies. The expert group developed and agreed to use a RoB assessment tool during three workshops. Here, existing instruments (e.g., QUADAS 2 and the Joanna Briggs Institute Reviewers' Manual) influenced the hierarchy and phrasing of the signalling questions that were adapted to the specific dental purpose. The tailored RoB assessment tool that was created consists of 16 signalling questions that are organized in four domains. This tool considers the selection/spectrum bias (1), the bias of the index (2) and reference tests (3), and the bias of the study flow and data analysis (4) and can be downloaded from the journal website. This paper explores possible sources of heterogeneity and bias in caries diagnostic studies and summarizes the relevant methodological aspects.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopaedics, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, 07743 Jena, Germany;
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, 52074 Aachen, Germany;
| | - Stavroula Michou
- Department of Odontology, University Copenhagen, 2200 Copenhagen, Denmark; (S.M.); (K.E.)
| | - Kim Ekstrand
- Department of Odontology, University Copenhagen, 2200 Copenhagen, Denmark; (S.M.); (K.E.)
| | - Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland; (F.E.); (K.W.N.)
| | - Klaus W. Neuhaus
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland; (F.E.); (K.W.N.)
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, 3012 Bern, Switzerland;
- Department of Operative Dentistry and Periodontology, University Medical Centre, 79098 Freiburg, Germany
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Castelo Branco CMC, Cabral GMP, Castro AMGS, Ferreira ACFM, Bonacina CF, Lussi A, Santos MTBR, Diniz MB. Caries prevalence using ICDAS visual criteria and risk assessment in children and adolescents with cerebral palsy: A comparative study. Spec Care Dentist 2021; 41:688-699. [PMID: 34171134 DOI: 10.1111/scd.12621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
AIMS To compare the dental caries prevalence using the International Caries Detection and Assessment System (ICDAS) and the caries risk by Caries Management by Risk Assessment (CAMBRA) in individuals with cerebral palsy (CP) and normoactives (NAs). METHODS AND RESULTS Sixty children and adolescents aged 6-12 years (30 CP/30 NA) were clinically evaluated by one calibrated examiner using two-digit ICDAS criteria and converted into components of dmf/DMF indices: d2mf2/D2MF2 (enamel and dentin lesions) and d3mf3/D3MF3 (dentin lesions). An adapted CAMBRA was used for risk classification. The mean d2mf2s/d2mf2t and D2MF2S/D2MF2T for CP were 17.0 ± 16.8/7.5 ± 4.3 and 10.7 ± 17.6/5.3 ± 5.8, respectively, and for NA were 17.2 ± 16.9 /6.9 ± 4.8 and 11.1 ± 11.7/5.5 ± 4.7, respectively. The mean d3mf3s/d3mf3t and D3MF3S/D3MF3T for CP were 10.1 ± 16.7/3.0 ± 4.1 and 4.9 ± 15.6/0.2 ± 0.4, respectively, while for NA the mean values were 9.8 ± 13.0/3.5 ± 3.8 and 2.1 ± 5.7/0.9 ± 2.0, respectively. There were no statistically differences for caries prevalence and risk in both groups (p > 0.05). CONCLUSIONS Dental caries was highly prevalent in CP and NA children and adolescents. Enamel and dentin lesions and high caries risk were the most common condition.
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Affiliation(s)
| | | | | | | | | | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany.,School of Dental Medicine, University of Bern, Switzerland
| | | | - Michele Baffi Diniz
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
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Diniz M, Campos P, Souza M, Guaré R, Cardoso C, Lussi A, Bresciani E. The Evaluation of Different Treatments of Incipient Caries Lesions: An in Situ Study of Progression Using Fluorescence-based Methods. Oper Dent 2021; 46:87-99. [PMID: 33882139 DOI: 10.2341/19-268-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2020] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE Effective methods to control incipient caries lesions are needed. In this investigation, several methods provide encouraging results. SUMMARY This study aimed to evaluate in situ the inhibition of incipient caries lesion progression using different treatment protocols and to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent, DIAGNOdent pen, and VistaProof fluorescence camera [FC]) in monitoring this process. The research was conducted in four phases: (1) at baseline, (2) after a first cariogenic challenge, (3) after treatment modalities, and (4) after a second cariogenic challenge. Sixteen volunteers used intraoral acrylic palatal appliances, each containing six enamel blocks (n=96). The cariogenic challenge was performed using a 20% sucrose solution over a 14-day period. The appliances were removed eight times a day and, upon removal, two drops of the solution were placed onto each enamel block. The enamel blocks were randomly assigned to three treatment groups: fluoride varnish ([FV] Duraphat; n=32), resin infiltrant ([RI] Icon; n=32), and adhesive system ([AS] Scotchbond; n=32). At the end of each phase, the surface microhardness (SMH) was measured, and two trained examiners evaluated the specimens using fluorescence-based methods. In addition, integrated mineral loss (ΔΔZ; vol%.min x μm) and lesion depth (ΔLD; μm) were evaluated using transverse microradiography. A two-way analysis of variance and a Tukey post hoc test were calculated (α=5%). Significant differences in SMH were observed according to the treatment, phases, and interaction of factors (p<0.001). Treatment with FV resulted in significantly higher SMH values in phases 3 and 4 compared to RI and AS, with the last two treatments resulting in similar values (p>0.05). The ΔΔZ value was similar for FV and AS but significantly higher for RI (p=0.016). ΔLD was not significantly different among the groups (p=0.126). Significant differences in the measurement of fluorescence for each fluorescence-based method were observed between each phase of the study (p<0.05). It can be concluded that all treatments were effective in inhibiting the in situ progression of incipient lesions, although to different degrees, with minor mineral loss changes observed for the AS and FV. Besides, all fluorescence-based methods tested, except for that using the FC device, were effective in monitoring caries lesion progression.
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Pelá VT, Buzalaf MAR, Niemeyer SH, Baumann T, Henrique-Silva F, Toyama D, Crusca E, Marchetto R, Lussi A, Carvalho TS. Acquired pellicle engineering with proteins/peptides: Mechanism of action on native human enamel surface. J Dent 2021; 107:103612. [PMID: 33621617 DOI: 10.1016/j.jdent.2021.103612] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 11/16/2020] [Revised: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE This study investigated the mechanism of action of different proteins/peptides (separately or in combination), focusing on how they act directly on the native enamel surface and on modifying the salivary pellicle. METHODS A total of 170 native human enamel specimens were prepared and submitted to different treatments (2 h; 37 °C): with deionized water, CaneCPI-5, Hemoglobin, Statherin, or a combination of all three proteins/peptides. The groups were subdivided into treatment acting on the enamel surface (NoP - absence of salivary pellicle), and treatment modifying the salivary pellicle (P). Treatment was made (2 h; 37 °C) in all specimens, and later, for P, the specimens were incubated in human saliva (2 h; 37 °C). In both cases, the specimens were immersed in 1% citric acid (pH 3.6; 2 min; 25 °C). Calcium released from enamel (CaR) and its relative surface reflection intensity (%SRI) was measured after 5 cycles. Between-group differences were verified with two-way ANOVA, with "presence of pellicle" and "treatment" as factors (α = 0.05). RESULTS The presence of pellicle provided better protection regarding %SRI (p < 0.01), but not regarding CaR (p = 0.201). In relation to treatment, when compared to the control group, all proteins/peptides provided significantly better protection (p < 0.01 for %SRI and Car). The combination of all three proteins/peptides demonstrated the best protective effect (p < 0.01 for %SRI). CONCLUSION Depending on the protein or peptide, its erosion-inhibiting effect derives from their interaction with the enamel surface or from modifying the pellicle, so a combination of proteins and peptides provides the best protection. CLINICAL SIGNIFICANCE The present study opens a new direction for a possible treatment with a combination of proteins for native human enamel, which can act directly on the enamel surface as well on the modification of the salivary pellicle, for the prevention of dental erosion.
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Affiliation(s)
- Vinícius Taioqui Pelá
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, SP, Brazil; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, BE, Switzerland.
| | | | - Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, BE, Switzerland.
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, BE, Switzerland.
| | - Flávio Henrique-Silva
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Danyelle Toyama
- Department of Genetics and Evolution, Federal University of São Carlos, São Carlos, SP, Brazil.
| | - Edson Crusca
- Chemistry Institute, Paulista State University, Araraquara, SP, Brazil.
| | | | - Adrian Lussi
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, BE, Switzerland.
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, BE, Switzerland.
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Moser C, Baumann T, Lussi A, Carvalho TS. Is the Erosion-Protective Effect Still Maintained when Tin Concentrations Are Reduced in Mouth Rinse Solutions? Caries Res 2021; 55:108-113. [PMID: 33556950 DOI: 10.1159/000513059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 11/15/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE As a preventive measure, tin (Sn2+)-containing products have a great potential to prevent enamel surface loss during erosive challenges, but adverse effects of high Sn2+ concentrations, such as astringent feeling of the teeth, are reported. Therefore, the main aim of this in vitro study was to develop a solution with lower Sn2+ concentrations that can still prevent dental erosion. METHODS A total of 162 enamel specimens were prepared from human premolars, which were selected from a pool of extracted teeth. The specimens were randomly distributed to 9 groups (each group n = 18 enamel specimens) according to the different test treatments: a humid chamber (no treatment) as the negative control, the commercial Elmex® Erosion Protection mouth rinse as the positive control, and 7 solutions either with lower Sn2+ concentrations and/or containing flavoring. The experiment included 4 cycles, consisting of pellicle formation by incubating the specimens with 200 μL of human saliva at 37°C for 1 h, then placing the specimens in the treatment for 2 min (60 mL, 30°C, shaking at 70 rpm), and later submitting them to an erosive challenge for 1 min in citric acid (60 mL 1%, pH 3.6, 30°C). Surface hardness was measured with a Vickers diamond and surface reflection intensity was measured with a reflectometer. RESULTS The control group performed significantly worse than all other solutions containing Sn2+. In general, there were no significant differences among the Sn2+-containing groups, and they presented similar protective effects on the enamel even when Sn2+ concentrations were reduced and flavorings were added. CONCLUSION Sn2+ concentrations in mouth rinses may be lowered to 200 ppm without compromising the anti-erosive properties of the solution.
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Affiliation(s)
- Corina Moser
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Adrian Lussi
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland,
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Bastendorf KD, Strafela-Bastendorf N, Lussi A. Mechanical Removal of the Biofilm: Is the Curette Still the Gold Standard? Monogr Oral Sci 2021; 29:105-118. [PMID: 33427229 DOI: 10.1159/000510187] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022]
Abstract
The goal of modern periodontal therapy, both during the initial stages and during maintenance, is to create biologically acceptable tooth surfaces through sub- and supragingival cleaning, which enables binding of the connective tissue to the greatest extent possible. In past centuries, the focus of periodontal treatment was on the removal of the supposed cause of periodontal disease, the supra- and supragingival calculus and "infected" root cementum. The findings on the importance of biofilm<A51_FootRef>1</A51_FootRef> (plaque) and the endogenous responses to biofilm metabolism have shifted the therapeutic focus to elimination of the biofilm. The importance of avoiding injury to the hard and soft dental tissue is nowadays of upmost importance. For classical scaling and root planing to remove mineralized deposits and "infected" cementum, only hand instruments were available in the past. The regular, long-term use of these tools is associated with changes in the hard and soft tooth tissues, and with pain and sensitivity experienced by the patient during and after treatment. Modern root-surface debridement primarily uses ultrasound systems to remove hard mineralized deposits. For biofilm management, air polishing devices with low-abrasive powders are increasingly gaining acceptance. With this new technology, biofilm management can now be performed much more effectively and efficiently, using materials more sparingly; this also causes less pain and discomfort for patients during and after treatment, and less fatigue for practitioners. The modern systems allow gentle, optimal biofilm management, whereas the traditional hand instruments (curettes, scalers) and classic rotating instruments used for polishing do not. Current knowledge suggests that these instruments are not best suited for biofilm management.
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Affiliation(s)
| | | | - Adrian Lussi
- School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany
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Cvikl B, Lussi A. Supragingival Biofilm: Toothpaste and Toothbrushes. Monogr Oral Sci 2021; 29:65-73. [PMID: 33427212 DOI: 10.1159/000510201] [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] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/19/2022]
Abstract
The formation of a physiological biofilm cannot be avoided under normal circumstances. However, the consequences of a supragingivally located biofilm, such as caries, gingivitis and, as a further effect, periodontitis, are relatively easy to avoid. The simplest and most common method used worldwide for the elimination of biofilm is periodic mechanical removal using a toothbrush or similar tools, such as chewing sticks or woods. This method was already used in ancient Egypt, and is still being used today, albeit advanced and improved with the help of toothpastes. Here we give a summary of the most common toothbrushes, highlighting their advantages and disadvantages. Furthermore, we provide an overview of the most common toothpastes, their ingredients, and functions. In addition, the ingredients will be critically evaluated and recommendations given for the use or non-use of certain ingredients for different target groups, such as children, healthy adults, or patients with special needs.
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Affiliation(s)
- Barbara Cvikl
- Department of Conservative Dentistry, Sigmund Freud University, Vienna, Austria,
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, Bern, Switzerland.,Department of Operative Dentistry and Periodontology, University Medical Centre, Freiburg, Germany
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Schultze L, Maldonado A, Lussi A, Sculean A, Eick S. The Impact of the pH Value on Biofilm Formation. Oral Biofilms 2021; 29:19-29. [DOI: 10.1159/000510196] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/05/2022]
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Arefnia B, Koller M, Wimmer G, Lussi A, Haas M. In Vitro Study of Surface Changes Induced on Enamel and Cementum by Different Scaling and Polishing Techniques. Oral Health Prev Dent 2021; 19:85-92. [PMID: 33511822 DOI: 10.3290/j.ohpd.b927695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To determine how the currently available techniques of scaling and root planing, used either alone or with additional polishing techniques, affect the substance thickness and surface roughness of enamel and cementum. MATERIALS AND METHODS After extraction, impacted third molars were prepared and subjected to air polishing with a nonabrasive powder, ultrasonic scaling, or hand instrumentation. All three techniques were performed alone and in combinations for a total of 9 treatment groups. The control group consisted of untreated surfaces. Optical microcoordination measurements were conducted to separately assess substance loss, mean roughness depth (Rz), and roughness average (Ra) on enamel and cementum. The Rz results were analysed using a t-test for paired samples. RESULTS Air polishing alone and with additional rubber-cup polishing using a paste were the only two approaches which caused no enamel loss. Both groups also entailed less cementum loss (≤ 20 μm) than any of the other seven groups, and both yielded the most favorable Rz results on enamel. Air polishing alone was the only group to reveal no significant change in Rz from untreated cementum (p = 0.999). The other 8 approaches statistically significantly reduced the surface roughness of cementum (p ≤ 0.017). CONCLUSION Air polishing with a nonabrasive powder yielded the best hard-tissue preservation. Combining any of the scaling techniques with additional polishing was not beneficial; on the contrary, they caused even more abrasion of hard tissue on both enamel and cementum.
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Niemeyer SH, Baumann T, Lussi A, Meyer-Lueckel H, Scaramucci T, Carvalho TS. Salivary pellicle modification with polyphenol-rich teas and natural extracts to improve protection against dental erosion. J Dent 2020; 105:103567. [PMID: 33387569 DOI: 10.1016/j.jdent.2020.103567] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 08/21/2020] [Revised: 10/22/2020] [Accepted: 12/19/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To investigate the modification of the salivary pellicle with different polyphenol-rich teas and natural extracts for the protection against dental erosion. METHODS We performed two experiments: one with teas (Green tea, Black tea, Peppermint tea, Rosehip tea, negative control [NC]) and other with natural extracts (Grape seed, Grapefruit seed, Cranberry, Propolis, NC), where NC was deionized water. A total of 150 enamel specimens were used (n = 15/group). Both experiments followed the same design, consisting of 5 cycles of: salivary pellicle formation (30 min, 37 °C), modification with the solutions (30 min, 25 °C), further salivary pellicle formation (60 min, 37 °C) and erosive challenge (1 min, 1% citric acid, pH 3.6). Relative surface microhardness (rSMH), relative surface reflection intensity (rSRI) and amount of calcium release (CaR) were evaluated. Data were analysed with Kruskal-Wallis and Wilcoxon rank sum tests with Bonferroni correction (α = 0.05). RESULTS Regarding teas, Black and Green teas showed the best protection against dental erosion, presenting higher rSMH and lower CaR than NC. Peppermint tea was not different to NC and Rosehip tea caused erosion, showing the highest CaR and greatest loss of SMH and SRI. Regarding natural extracts, Grape seed and Grapefruit seed extracts presented the best protective effect, with significantly higher rSMH and lower CaR. Cranberry caused significantly more demineralization; and Propolis did not differ from NC. CONCLUSION Green tea, Black tea, Grape seed extract and Grapefruit seed extract were able to modify the salivary pellicle and improve its protective effect against enamel erosion, but Rosehip tea and Cranberry extract caused erosion. CLINICAL RELEVANCE Some some bio-products, such as teas and natural extracts, improve the protective effect of the salivary pellicle against enamel erosion. More studies should be performed in order to test the viability of their use as active ingredients for oral care products.
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Affiliation(s)
- Samira Helena Niemeyer
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | - Adrian Lussi
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | - Hendrik Meyer-Lueckel
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
| | - Taís Scaramucci
- Department of Restorative Dentistry, University of São Paulo, School of Dentistry, Av. Prof. Lineu Prestes 2227, Cidade Universitária, São Paulo, SP, Zip code: 05508-000, Brazil.
| | - Thiago Saads Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, CH-3010, Bern, Switzerland.
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Paris S, Banerjee A, Bottenberg P, Breschi L, Campus G, Doméjean S, Ekstrand K, Giacaman RA, Haak R, Hannig M, Hickel R, Juric H, Lussi A, Machiulskiene V, Manton D, Jablonski-Momeni A, Santamaria R, Schwendicke F, Splieth CH, Tassery H, Zandona A, Zero D, Zimmer S, Opdam N. How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement. Caries Res 2020; 54:1-7. [PMID: 33291110 DOI: 10.1159/000510843] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [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: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022] Open
Abstract
AIM To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. METHODS A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. RESULTS Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient's individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.
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Affiliation(s)
- Sebastian Paris
- Department of Operative and Preventive Dentistry, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany,
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Peter Bottenberg
- Oral Health Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna - Alma Mater Studiorum, Bologna, Italy
| | - Guglielmo Campus
- Department of Restorative, Preventive and Paediatric Dentistry, Zahnmedizinische Kliniken (ZMK), University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Sophie Doméjean
- Département d'Odontologie Conservatrice, Université Clermont Auvergne, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique Clermont-Ferrand, Clermont-Ferrand, France
| | - Kim Ekstrand
- Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rodrigo A Giacaman
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry and Periodontology, Saarland University, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Hrvoje Juric
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
| | - Vita Machiulskiene
- Clinic of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - David Manton
- Centrum van Tandheelkunde en Mondzorgkunde, Universitair Medisch Centrum Groningen, University of Groningen, Groningen, The Netherlands
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Ruth Santamaria
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Falk Schwendicke
- Department of Oral Diagnosis, Digital Health and Health Services Research, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Christian H Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Hervé Tassery
- Faculté d'Odontologie Marseille, Preventive and Restorative Department, Aix-Marseille-Université, Marseille, France
- EA 4203 Laboratory, Université de Montpellier, Montpellier, France
| | - Andrea Zandona
- Department of Comprehensive Care, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Domenick Zero
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, School of Dentistry, Indiana University, Indianapolis, Indiana, USA
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, Dental School, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Niek Opdam
- Radboud University Medical Centre, Department of Dentistry, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Pelá VT, Lunardelli JG, Ventura TM, Camiloti GD, Baumann T, Carvalho TS, Lussi A, Buzalaf MA. Proteomic profiles of the acquired enamel pellicle formed in vitro, in situ, or in vivo. Eur J Oral Sci 2020; 128:487-494. [DOI: 10.1111/eos.12744] [Citation(s) in RCA: 6] [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: 06/09/2020] [Revised: 10/06/2020] [Accepted: 10/13/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Vinícius T. Pelá
- Department of Genetics and Evolution Federal University of São Carlos São Carlos Brazil
| | - João G.Q. Lunardelli
- Department of Biological Sciences Bauru School of Dentistry University of São Paulo Bauru‐SP Brazil
| | - Talita M.O. Ventura
- Department of Biological Sciences Bauru School of Dentistry University of São Paulo Bauru‐SP Brazil
| | - Gabriel D. Camiloti
- Department of Biological Sciences Bauru School of Dentistry University of São Paulo Bauru‐SP Brazil
| | - Tommy Baumann
- Department of Restorative, Preventive and Pediatric Dentistry School of Dental Medicine University of Bern Bern Switzerland
| | - Thiago S. Carvalho
- Department of Restorative, Preventive and Pediatric Dentistry School of Dental Medicine University of Bern Bern Switzerland
| | - Adrian Lussi
- Department of Restorative, Preventive and Pediatric Dentistry School of Dental Medicine University of Bern Bern Switzerland
| | - Marília A.R. Buzalaf
- Department of Biological Sciences Bauru School of Dentistry University of São Paulo Bauru‐SP Brazil
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Martini T, Rios D, Dionizio A, Cassiano L, Taioqui Pelá V, e Silva C, Taira E, Ventura T, Magalhães A, Carvalho T, Baumann T, Lussi A, de Oliveira R, Palma-Dibb R, Buzalaf M. Salivary Hemoglobin Protects against Erosive Tooth Wear in Gastric Reflux Patients. Caries Res 2020; 54:466-474. [DOI: 10.1159/000507110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 03/09/2020] [Indexed: 11/19/2022] Open
Abstract
<b><i>Objective:</i></b> Saliva is the most important biological factor to protect against erosive tooth wear (ETW). Gastroesophageal reflux disease (GERD) patients have an increased risk of ETW due to the frequent presence of intrinsic acids in the oral cavity. Remarkably, not all GERD patients suffer from ETW, which might be due to differences in the composition of the saliva. <b><i>Methods:</i></b> This study compared the proteomic profile of saliva in patients (1) with GERD and ETW (basic erosive wear examination, BEWE, score ≥9; GE group) and (2) with GERD without ETW (BEWE = 0; GNE group) using shotgun label-free quantitative proteomic analysis nLC-ESI-MS/MS. The ability of hemoglobin (Hb) to protect against initial enamel erosion caused by a daily 10-s immersion of enamel specimens in 0.01 M HCl (pH 2.3) for 3 days was evaluated in vitro for proof of concept. Surface hardness change was used as response variable. <b><i>Results:</i></b> The differential expression of Hb subunits was significantly increased in the GNE group versus the GE group, in particular the Hb α-subunit that showed a >22-fold increase. Expressions of serum albumin (4.5-fold) and isoforms of cytoskeletal keratin type II (>3-fold) were also increased in the GNE group. Proteinase inhibitors, such as α<sub>1</sub>-antitrypsin and α<sub>2</sub>-macroglobulin, were only identified in the GNE group. In vitro, Hb (1.0 and 4.0 mg/mL) significantly reduced initial enamel erosion compared to a negative control after 3 days. <b><i>Conclusions:</i></b> Our results indicate that many proteins, with special emphasis on Hb, may be involved in the resistance of GERD patients to the occurrence of ETW. These proteins may be candidates for inclusion in dental products to protect against ETW.
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Lepperdinger U, Maurer E, Witsch-Baumgartner M, Stigler R, Zschocke J, Lussi A, Kapferer-Seebacher I. Correction to: Expanding the phenotype of hypomaturation amelogenesis imperfecta due to a novel SLC24A4 variant. Clin Oral Investig 2020; 24:3527-3528. [PMID: 32895769 DOI: 10.1007/s00784-020-03550-8] [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: 11/25/2022]
Abstract
In the pedigree, one of the individuals was marked as unaffected whereas it is heterozygous for the SLC24A4 mutation.
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Affiliation(s)
- Ulrike Lepperdinger
- Department of Operative and Restorative Dentistry, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Elisabeth Maurer
- Division of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Robert Stigler
- Department of Oral and Maxillofacial Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Johannes Zschocke
- Division of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
| | - Ines Kapferer-Seebacher
- Department of Operative and Restorative Dentistry, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria.
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González-Aragón Pineda ÁE, Borges-Yáñez SA, Lussi A, Aguirre-Hernandez R, García-Pérez Á. Prevalence, Incidence, and Progression of Erosive Tooth Wear and Their Respective Risk Factors Among Schoolchildren in Mexico City. Pediatr Dent 2020; 42:300-307. [PMID: 32847670] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose: To evaluate the cumulative incidence and progression of erosive tooth wear (ETW) and identify risk factors over 18 months in a cohort of 11- to 14-year-old schoolchildren in Mexico. Methods: The study was conducted in public schools located in northern Mexico City. Permanent teeth of 424 schoolchildren were examined using the basic erosive wear examination. The possible risk factors were included in the logistic models: the consumption of acidic food and beverages; habits related to the consumption of beverages; medication; gastroesophageal reflux; frequent vomiting; and characteristics of the saliva. Results: The prevalence of ETW was 62.5 percent (265 out of 424). The cumulative incidence was 35.2 percent (56 out of 159) and the progression was 72.8 percent (193 out of 265). The consumption of acidic beverages increased the relative risk (RR) of both the cumulative incidence (RR equals 1.09; 95 percent confidence interval [95% CI] 1.02 to 1.18; P=0.005) and the progression (RR equals 1.16; 95% CI 1.01 to 1.34; P=0.003). Conclusions: This population has a high risk of the development and progression of ETW, found in approximately one-third and approximately two-thirds of the schoolchildren, respectively. The most important risk factor was the consumption of acidic beverages.
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Affiliation(s)
- Álvaro Edgar González-Aragón Pineda
- González-Aragón Pineda, Associate professors, Dentistry Department, School of Higher Education-Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Socorro Aída Borges-Yáñez
- Dr. Borges-Yáñez is a coordinator, Dental Public Health Department, Graduate Division, School of Dentistry, Universidad Nacional Autónoma de México, Mexico City, Mexico;,
| | - Adrian Lussi
- Dr. Lussi is a guest professor, Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Baden-Württemberg, Germany
| | - Rebeca Aguirre-Hernandez
- Dr. Aguirre- Hernandez is an associate professor, Pharmacology Department, School of Medicine; Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Álvaro García-Pérez
- García-Pérez, Associate professors, Dentistry Department, School of Higher Education-Iztacala, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Schwendicke F, Splieth CH, Bottenberg P, Breschi L, Campus G, Doméjean S, Ekstrand K, Giacaman RA, Haak R, Hannig M, Hickel R, Juric H, Lussi A, Machiulskiene V, Manton D, Jablonski-Momeni A, Opdam N, Paris S, Santamaria R, Tassery H, Zandona A, Zero D, Zimmer S, Banerjee A. How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement. Clin Oral Investig 2020; 24:3315-3321. [PMID: 32643090 DOI: 10.1007/s00784-020-03431-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [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: 03/23/2020] [Accepted: 06/23/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. METHODS Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. RESULTS Managing an individual's caries risk using non-invasive means (oral hygiene measures including flossing/interdental brushes, fluoride application) is recommended, as both proximal and secondary carious lesions may be prevented or their activity reduced. For proximal lesions, only cavitated lesions (confirmed by visual-tactile, or radiographically extending into the middle/inner dentine third) should be treated invasively/restoratively. Non-cavitated lesions may be successfully arrested using non-invasive measures in low-risk individuals or if radiographically confined to the enamel. In high-risk individuals or if radiographically extended into dentine, for these lesions, additional micro-invasive (lesion sealing and infiltration) treatment should be considered. For restoring proximal lesions, adhesive direct restorations allow minimally invasive, tooth-preserving preparations. Amalgams come with a lower risk of secondary lesions and may be preferable in more clinically complex scenarios, dependent on specific national guidelines. In structurally compromised (especially endodontically treated) teeth, indirect cuspal coverage restorations may be indicated. Detection methods for secondary lesions should be tailored according to the individual's caries risk. Avoiding false positive detection and over-treatment is a priority. Bitewing radiographs should be combined with visual-tactile assessment to confirm secondary caries detections. Review/refurbishing/resealing/repairing instead of replacing partially defective restorations should be considered for managing secondary caries, if possible. CONCLUSIONS An individualized and lesion-specific approach is recommended for intervening in the caries process in adults. CLINICAL SIGNIFICANCE Dental clinicians have an increasing number of interventions available for the management of dental caries. Many of them are grounded in the growing understanding of the disease. The best evidence, patients' expectations, clinicians' expertise, and the individual clinical scenario all need to be considered during the decision-making process.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative Dentistry, Charité - Universitätsmedizin, Berlin, Germany.
| | - Christian H Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Peter Bottenberg
- Oral Health Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna - Alma Mater Studiorum, Bologna, Italy
| | - Guglielmo Campus
- Department of Restorative, Preventive and Paediatric Dentistry, Zahnmedizinische Kliniken (ZMK), University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Sophie Doméjean
- Département d'Odontologie Conservatrice, Univ Clermont Auvergne, UFR d'Odontologie; Centre de Recherche en Odontologie Clinique EA 4847, F-63100, Clermont-Ferrand, France
- CHU Estaing Clermont-Ferrand, Service d'Odontologie, F-63001, Clermont-Ferrand, France
| | - Kim Ekstrand
- Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rodrigo A Giacaman
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry and Periodontology, Saarland University, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Hrvoje Juric
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, Bern, Switzerland and Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
| | - Vita Machiulskiene
- Clinic of Dental and Oral Pathology, Faculty of odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - David Manton
- Centrum van Tandheelkunde en Mondzorgkunde, UMCG, Groningen, Netherlands
| | | | - Niek Opdam
- Radboud University Medical Centre, Department of Dentistry, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Sebastian Paris
- Department of Operative Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ruth Santamaria
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Hervé Tassery
- Faculté d'Odontologie Marseille, Preventive and Restorative Department, Marseille cedex, Aix-Marseille-Université, Marseille, France
- EA 4203 Laboratory, Université de Montpellier, Montpellier, France
| | - Andrea Zandona
- Department of Comprehensive Care, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Domenick Zero
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, School of Dentistry Indiana University, Indianapolis, IN, USA
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, Faculty of Health, Dental School, Witten/Herdecke University, Witten, Germany
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Carvalho TS, Halter JE, Muçolli D, Lussi A, Eick S, Baumann T. Pellicle Modification with Casein and Mucin Does Not Promote In Vitro Bacterial Biofilm Formation. Oral Health Prev Dent 2020; 18:475-483. [PMID: 32515418 DOI: 10.3290/j.ohpd.a43351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE During biofilm formation, bacterial species do not attach directly onto the enamel surface, but rather onto the salivary pellicle. Salivary pellicle modification with casein and mucin can hinder erosive demineralisation of the enamel, but it should also not promote bacterial adhesion. The aim of our study was to assess whether salivary pellicle modification with casein, or mucin, or a mixture of both proteins (casein and mucin) influence bacterial adhesion, biofilm diversity, metabolism and composition, or enamel demineralisation, after incubation in: (a) a single bacterial model; (b) a five-species biofilm model; or (c) biofilm reformation using the five-species biofilm model after removal of initial biofilm with toothbrushing. MATERIALS AND METHODS Enamel specimens were prepared from human molars. Whole-mouth stimulated human saliva was used for pellicle formation. Four pellicle modification groups were established: control (non-modified pellicle); casein - modified with 0.5% casein; mucin - modified with 0.5% mucin; casein and mucin - modified with 0.5% casein and 0.5% mucin. Bacterial adhesion, biofilm diversity, metabolic activity, biofilm mass, and demineralisation (surface hardness) of enamel were assessed after incubation in bacterial broths after 6 h or 24 h. RESULTS After 24 h incubation in the five-species biofilm model, the mucin group presented significantly lower biofilm mass than the control (p = 0.028) and the casein and mucin (p = 0.030) groups. No other differences between the groups were observed in any of the other experimental procedures. CONCLUSION Pellicle modification with casein and mucin does not promote in vitro bacterial biofilm formation.
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Splieth CH, Banerjee A, Bottenberg P, Breschi L, Campus G, Ekstrand KR, Giacaman RA, Haak R, Hannig M, Hickel R, Juric H, Lussi A, Machiulskiene V, Manton DJ, Jablonski-Momeni A, Opdam NJM, Paris S, Santamaría RM, Schwendicke F, Tassery H, Ferreira Zandona A, Zero DT, Zimmer S, Doméjean S. How to Intervene in the Caries Process in Children: A Joint ORCA and EFCD Expert Delphi Consensus Statement. Caries Res 2020; 54:297-305. [PMID: 32610317 DOI: 10.1159/000507692] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [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: 03/02/2020] [Accepted: 03/29/2020] [Indexed: 11/19/2022] Open
Abstract
This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the individual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia.
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Affiliation(s)
- Christian H Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany,
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Peter Bottenberg
- Oral Health Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna - Alma Mater Studiorum, Bologna, Italy
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, Zahnmedizinische Kliniken (ZMK), University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Kim Rud Ekstrand
- Department of Odontology, University of Copenhagen, Copenhagen, Denmark
| | - Rodrigo A Giacaman
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Homburg, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Hrvoje Juric
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre Freiburg, Freiburg, Germany
| | - Vita Machiulskiene
- Clinic of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - David J Manton
- Centrum voor Tandheelkunde en Mondzorgkunde, Universitair Medisch Centrum Groningen, University of Groningen, Groningen, The Netherlands
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | | | - Niek J M Opdam
- Department of Dentistry, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ruth M Santamaría
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Falk Schwendicke
- Department of Oral Diagnosis, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Herve Tassery
- EA 4203 Laboratory, Faculté d'Odontologie, Université de Montpellier, Montpellier, France
- Faculté d'Odontologie Marseille, Preventive and Restorative Department, Aix-Marseille-Université, Marseille, France
| | - Andrea Ferreira Zandona
- Department of Comprehensive Care, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Domenick T Zero
- Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Stefan Zimmer
- Faculty of Health, School of Dentistry, Department of Operative and Preventive Dentistry, Witten/Herdecke University, Witten, Germany
| | - Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France
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Wilde S, Campos PH, Marcondes APM, Moura-Netto C, Novaes TF, Lussi A, Diniz MB. Optical magnification has no benefits on the detection of occlusal caries lesions in permanent molars using different visual scoring systems: An in vitro study. J Clin Exp Dent 2020; 12:e479-e487. [PMID: 32509231 PMCID: PMC7263771 DOI: 10.4317/jced.56445] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/27/2020] [Indexed: 01/22/2023] Open
Abstract
Background Some studies have addressed the influence of optical magnification on the detection of caries lesions using a visual scoring system. However, there is a lack of research related to the use of the CAST and ADA-CCS visual scoring systems. In addition, the reliability and accuracy of ADA-CCS index in permanent teeth were not studied yet. So, the aim of this study was to evaluate, in vitro, the influence of different levels of optical magnification on the detection of occlusal caries lesions in permanent molars using three visual scoring systems. Material and Methods One occlusal site per tooth was analyzed in 120 extracted permanent molars. Two trained examiners inspected the teeth using ICDAS (International Caries Detection and Assessment System), CAST (Caries Assessment Spectrum and Treatment), and ADA-CCS (American Dental Association-Caries Classification System) visual criteria, twice with each scoring system, with a one-week interval between examinations. The study was conducted in three phases: (A) without optical magnification, (B) using a binocular lens (3.5× magnification), and (C) using an operating microscope (16× magnification). Then, the teeth were sectioned longitudinally through the center of the selected site and the section with the more severe lesion was histological evaluated considering the D1 (lesions in enamel and dentin) and D3 (dentin lesions) thresholds. Results Kappa values for intra- and inter-examiner reproducibility were good to excellent for all systems. At the D1 threshold, sensitivity, accuracy, and area under the ROC curve were high for ICDAS and CAST in all phases. However, this was not the case for the ADA-CCS in phase C (<0.05). At the D3 diagnostic threshold, there was no significant difference between the visual scoring systems during the study phases (>0.05). Conclusions The magnification does not improve the accuracy of the visual scoring systems in the detection of occlusal caries lesions in permanent molars. Key words:Dental caries, caries detection, permanent teeth, visual examination, magnification.
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Affiliation(s)
- Sabrina Wilde
- School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | | | - Cacio Moura-Netto
- Faculty of Dental Medicine, Center for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, Viseu, Portugal
| | | | - Adrian Lussi
- Center for Dental Medicine, Medical Center, University of Freiburg - Freiburg, Germany
| | - Michele-Baffi Diniz
- Post-graduate Program in Dentistry, Cruzeiro do Sul University - São Paulo, SP, Brazil
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45
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Mazur M, Bietolini S, Bellardini D, Lussi A, Corridore D, Maruotti A, Ottolenghi L, Vozza I, Guerra F. Oral health in a cohort of individuals on a plant-based diet: a pilot study. Clin Ter 2020; 171:e142-e148. [PMID: 32141486 DOI: 10.7417/ct.2020.2204] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Plant-based diets are associated with a lower: (i) body mass index, (ii) rates of death from ischemic heart disease, (iii) serum cholesterol, (iv) incidence of high blood pressure, (v) type II diabetes mellitus and cancer, with an overall longer life expectancy. However, little data concerning the oral health in individuals on a plant-based diet are available. AIM The aim of the present study was to investigate the general and clinical oral health status in a cohort of adults who had been following a plant-based diet for a minimum of 24 months. MATERIAL AND METHODS For this purpose, individuals were administered two questionnaires (a.Questionnaire investigating risk areas for oral diseases; b. Italian version of the Oral Health Impact Profile -14 (IOHIP-14)) by a dental hygienist and clinical examination of the oral cavity was carried out. RESULTS Seventy-seven adult individuals were enrolled. On average, they followed a plant-based diet for the last four years, had four meals a day and brushed their teeth twice a day. Fruit was the most frequently consumed food at breakfast by 48 of the participants. Thirty-four responders did not drink beer or wine, 65 did not drink spirits, 57 avoided carbonated beverages and 62 (80.5%) did not consume any highly-sugared beverages. Different dental therapies in the previous three years were reported in 36 of the responders. Overall, answers "never and almost never" to the IOHIP-14 questionnaire were observed in 87% to 100% of the individuals. Multiple logistic regression analysis revealed that fresh fruit consumption at lunch had a protective effect against caries (p<0.05). CONCLUSIONS In conclusion, this study showed that individuals on a plant-based diet have good overall oral health conditions. These features are in agreement with the behavior of these subjects towards an overall healthy life style.
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Affiliation(s)
- M Mazur
- Sapienza University of Rome, Department of Oral and Maxillo-Facial Sciences, Rome (Italy)
| | | | - D Bellardini
- Sapienza University of Rome, Department of Oral and Maxillo-Facial Sciences, Rome (Italy)
| | - A Lussi
- University of Bern, School of Dental Medicine, Bern (Switzerland)
| | - D Corridore
- Sapienza University of Rome, Department of Oral and Maxillo-Facial Sciences, Rome (Italy)
| | - A Maruotti
- Department of Mathematics, University of Bergen (Norway
| | - L Ottolenghi
- Sapienza University of Rome, Department of Oral and Maxillo-Facial Sciences, Rome (Italy)
| | - I Vozza
- Sapienza University of Rome, Department of Oral and Maxillo-Facial Sciences, Rome (Italy)
| | - F Guerra
- Sapienza University of Rome, Department of Oral and Maxillo-Facial Sciences, Rome (Italy)
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Pinheiro SADA, Rodrigues HB, Santos JTL, Granja GL, Lussi A, Leal SC, Diniz MB. Association of dental caries morbidity stages with oral health-related quality of life in children and adolescents. Int J Paediatr Dent 2020; 30:293-302. [PMID: 31834963 DOI: 10.1111/ipd.12605] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/28/2019] [Accepted: 12/09/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Dental caries morbidity stages and their impact on oral health-related quality of life (OHRQoL) have not yet been established. AIM To compare the association of dental caries morbidity stages with OHRQoL in children and adolescents from public schools of Patos-PB, Brazil. DESIGN A cross-sectional study was performed on 461 students at 8-10 years and 454 at 11-14 years. Caries was evaluated by Caries Assessment Spectrum and Treatment (CAST) instrument. The maximum CAST code per individual was registered. OHRQoL was assessed using the Child Perceptions Questionnaires for children (CPQ8-10 ) and adolescents (CPQ11-14 ). RESULTS Morbidity stage was the most prevalent caries condition in children (40.8%) and adolescents (38.1%). Factors associated with higher CPQ8-10 scores in the multivariate regression analysis after adjustments were age [9 years, prevalence ratio (PR): 1.24; 95% confidence interval (CI): 1.06-1.45; and 10 years, PR: 1.32, CI: 1.13-1.55] and dental caries status [morbidity, PR: 1.23, CI: 1.03-1.48; and severe morbidity, PR: 1.30, CI: 1.04-1.61]. The factor associated with higher CPQ11-14 scores was dental caries status [morbidity, PR: 1.20, CI: 1.00-1.44]. CONCLUSIONS The OHRQoL of children was negatively associated with morbidity and severe morbidity stages of dental caries, while for adolescents, only morbidity had a negative association with their OHRQoL.
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Affiliation(s)
- Sammia Anacleto de Albuquerque Pinheiro
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo-SP, Brazil.,School of Dentistry, Integrated Faculty of Patos - FIP, Patos-PB, Brazil
| | - Hermanda Barbosa Rodrigues
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo-SP, Brazil.,School of Dentistry, Integrated Faculty of Patos - FIP, Patos-PB, Brazil
| | | | - Gélica Lima Granja
- School of Dentistry, Integrated Faculty of Patos - FIP, Patos-PB, Brazil
| | - Adrian Lussi
- Department of Operative Dentistry & Periodontology, Center for Dental Medicine, University of Freiburg, Freiburg, Germany
| | - Soraya Coelho Leal
- Department of Pediatric Dentistry, School of Health Sciences, University of Brasília - UnB, Brasília-DF, Brazil
| | - Michele Baffi Diniz
- Post-graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo-SP, Brazil
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Flury S, Lussi A. [Not Available]. Swiss Dent J 2020; 130:244-225. [PMID: 32162857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Simon Flury
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern
| | - Adrian Lussi
- Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin, Zahnmedizinische Kliniken der Universität Bern
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Lepperdinger U, Maurer E, Witsch-Baumgartner M, Stigler R, Zschocke J, Lussi A, Kapferer-Seebacher I. Expanding the phenotype of hypomaturation amelogenesis imperfecta due to a novel SLC24A4 variant. Clin Oral Investig 2020; 24:3519-3525. [PMID: 32034543 DOI: 10.1007/s00784-020-03222-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/11/2019] [Accepted: 01/23/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Biallelic variants in solute carrier family 24 member 4 (SLC24A4) have been previously reported to cause non-syndromic autosomal recessive amelogenesis imperfecta (AI) of the pigmented hypomaturation type (MIM #615887). We here describe a novel variant in SLC24A4 causing mild enamel hypomaturation defects also in heterozygous individuals. MATERIALS AND METHODS In the present pedigree analysis, a large consanguineous Syrian family with AI of the hypomaturation type was investigated by clinical and dental evaluation, and exome and Sanger sequencing. Dental histological investigations of seven primary and two permanent teeth were performed. RESULTS Homozygous variants in SLC24A4 (c.1604G>A; p.Gly535Asp) were identified in five individuals with brown discolorations and irregular pits and grooves of the teeth. Severe attritions, occlusal abfractions, and the radiological lack of contrast between enamel and dentin point out a mineralization defect. Histological dental investigations confirmed the clinical diagnosis of AI of the hypomaturation type. In two heterozygous individuals, a mild hypomaturation defect was present with white and light brown enamel discolorations. CONCLUSIONS This is the first report of heterozygous SLC24A4 variants causing mild hypomaturation defects, providing confirmatory evidence that the function of SLC24A4 in calcium transport has a crucial role in the maturation stage of amelogenesis. CLINICAL RELEVANCE The present report is expanding the clinical phenotype of SLC24A4 variants to more severe forms of amelogenesis imperfecta. An autosomal-dominant inheritance pattern with mild clinical phenotypes in heterozygotes has to be considered.
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Affiliation(s)
- Ulrike Lepperdinger
- Department of Operative and Restorative Dentistry, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria
| | - Elisabeth Maurer
- Division of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | | | - Robert Stigler
- Department of Oral and Maxillofacial Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - Johannes Zschocke
- Division of Human Genetics, Medical University Innsbruck, Innsbruck, Austria
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
| | - Ines Kapferer-Seebacher
- Department of Operative and Restorative Dentistry, Medical University of Innsbruck, Anichstraße 35, A-6020, Innsbruck, Austria.
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Abstract
Are there feline odontoclastic resorptive lesions (FORL) in large cats? Macroscopic and radiological investigations of teeth of a zoo leopard, two wild lions and a wild leopard revealed that there are lesions identical to those found in teeth of domestic cats. Because of the radiological and clinical similarity between resorptive lesions and caries, additional examinations were carried out in order to differentiate between those two conditions. Based on the results of investigations such as Rhodamin B dye test, fuchsin/acetic light green staining, hardness measurements by the Knoop-diamond (KHN), and electron-microscopy, we conclude that FORL also occur in captive and wild large cats.
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Affiliation(s)
- Marianne Berger
- From the Department of Surgery, Orthopaedics and Stomatology of the Clinic for Small Domestic Animals, University of Bern, Längass-Strasse, 124/128, CH-3012 Bern, Switzerland (Berger, Schawalder), and the Clinic for Dental Preservation, University of Bern, Switzerland (Stich, Lussi)
| | - Peter Schawalder
- From the Department of Surgery, Orthopaedics and Stomatology of the Clinic for Small Domestic Animals, University of Bern, Längass-Strasse, 124/128, CH-3012 Bern, Switzerland (Berger, Schawalder), and the Clinic for Dental Preservation, University of Bern, Switzerland (Stich, Lussi)
| | - Hermann Stich
- From the Department of Surgery, Orthopaedics and Stomatology of the Clinic for Small Domestic Animals, University of Bern, Längass-Strasse, 124/128, CH-3012 Bern, Switzerland (Berger, Schawalder), and the Clinic for Dental Preservation, University of Bern, Switzerland (Stich, Lussi)
| | - Adrian Lussi
- From the Department of Surgery, Orthopaedics and Stomatology of the Clinic for Small Domestic Animals, University of Bern, Längass-Strasse, 124/128, CH-3012 Bern, Switzerland (Berger, Schawalder), and the Clinic for Dental Preservation, University of Bern, Switzerland (Stich, Lussi)
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Saads Carvalho T, Lussi A. Chapter 9: Acidic Beverages and Foods Associated with Dental Erosion and Erosive Tooth Wear. Monographs in Oral Science 2020; 28:91-98. [DOI: 10.1159/000455376] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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