1
|
Hamed S, Abd El Latief MH, El-Wassefy NA, Montasser MA. Fluoride-amorphous calcium phosphate and biomimetic nano-hydroxyapatite for enamel remineralization: An in-vitro study of surface microhardness and composition. Int Orthod 2024; 22:100865. [PMID: 38457899 DOI: 10.1016/j.ortho.2024.100865] [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: 01/17/2024] [Revised: 02/09/2024] [Accepted: 02/12/2024] [Indexed: 03/10/2024]
Abstract
AIM Fluoride-Amorphous Calcium Phosphate and Biomimetic Nano-Hydroxyapatite for Enamel Remineralization; An In-Vitro Study of Surface Microhardness and Composition. MATERIAL AND METHODS Ninety-six extracted human premolars with sound buccal surface were divided using a randomization computer-generating software into four groups; Group I (control) sound untreated enamel, Group II (demineralized) demineralized to create white spot lesions, Group III (biom-n-HA) demineralized and then treated with biomimetic nanohydroxyapatite cream, and Group IV (F-ACP) demineralized and then treated using Fluoride-Amorphous Calcium Phosphate varnish. Each group was divided into two subgroups; subgroup "A" evaluated for mineral content using energy dispersive x-ray spectroscopy (EDX) and for surface microhardness using the Vickers microhardness test and Subgroup "B" evaluated for white spot lesion depth using a polarized light microscope (PLM). RESULTS The highest microhardness (VHN) was found in the (F-ACP) group (mean=428.61±54.43) and then in the (Biom-n-HA) group (mean=408.11±70.16) followed by the (Control) group (mean=402.13±53.40) with no significant difference between them and finally in the significantly different (Demineralized) group (mean=256.99±45.83). The weight percentage of Ca (30.29±1.04 and 33.44±1.07) and Ca/P ratio (1.87±0.06 and 2.03±0.05) were significantly different between Group III and Group IV respectively. PLM measurements in Group II (198.83μm), Group III (60.17μm), and Group IV (26.33μm) were significantly different. CONCLUSIONS Both the (Biom-n-HA) cream and the (F-ACP) varnish showed promising results for enamel remineralization. The increased enamel surface microhardness was consistent with the mineral content and the changes in the birefringence.
Collapse
Affiliation(s)
- Sameh Hamed
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt
| | | | - Noha A El-Wassefy
- Department of Dental Biomaterials, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt
| | - Mona A Montasser
- Department of Orthodontics, Faculty of Dentistry, Mansoura University, 35516 Mansoura, Egypt.
| |
Collapse
|
2
|
Tang L, Nong S, Chen K, Liu Q, Yu X, Zeng X. Cost-effectiveness and cost-benefit analyses of fluoride varnish for caries prevention in Guangxi, China. BMC Oral Health 2024; 24:534. [PMID: 38724990 PMCID: PMC11080295 DOI: 10.1186/s12903-024-04220-x] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/02/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVES The objectives of this study were to evaluate the cost-effectiveness and cost-benefit of fluoride varnish (FV) interventions for preventing caries in the first permanent molars (FPMs) among children in rural areas in Guangxi, China. METHODS This study constituted a secondary analysis of data from a randomised controlled trial, analysed from a social perspective. A total of 1,335 children aged 6-8 years in remote rural areas of Guangxi were enrolled in this three-year follow-up controlled study. Children in the experimental group (EG) and the control group (CG) received oral health education and were provided with a toothbrush and toothpaste once every six months. Additionally, FV was applied in the EG. A decision tree model was developed, and single-factor and probabilistic sensitivity analyses were conducted. RESULTS After three years of intervention, the prevalence of caries in the EG was 50.85%, with an average decayed, missing, and filled teeth (DMFT) index score of 1.12, and that in the CG was 59.04%, with a DMFT index score of 1.36. The total cost of caries intervention and postcaries treatment was 42,719.55 USD for the EG and 46,622.13 USD for the CG. The incremental cost-effectiveness ratio (ICER) of the EG was 25.36 USD per caries prevented, and the cost-benefit ratio (CBR) was 1.74 USD benefits per 1 USD cost. The results of the sensitivity analyses showed that the increase in the average DMFT index score was the largest variable affecting the ICER and CBR. CONCLUSIONS Compared to oral health education alone, a comprehensive intervention combining FV application with oral health education is more cost-effective and beneficial for preventing caries in the FPMs of children living in economically disadvantaged rural areas. These findings could provide a basis for policy-making and clinical choices to improve children's oral health.
Collapse
Affiliation(s)
- Liying Tang
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - Shengjie Nong
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China
| | - Kun Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - Qiulin Liu
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China
| | - Xueting Yu
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaojuan Zeng
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China.
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China.
| |
Collapse
|
3
|
Park SA, Son J, Kim AJ, Oh S, Bae JM. Effect of adhesive components in experimental fluoride varnish on fluoride release within 30 days in vitro study. Dent Mater J 2024; 43:320-327. [PMID: 38382939 DOI: 10.4012/dmj.2023-299] [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] [Indexed: 02/23/2024]
Abstract
We aimed to determine whether adhesive components could increase the release time of effective fluoride concentration from an experimental fluoride varnish applied to bovine teeth. An experimental fluoride varnish containing 5% sodium fluoride (EX1) was prepared and combined with 35% hydroxyethyl methacrylate (HEMA) (EX2), 5% glutaraldehyde (EX3), or 35% HEMA/5% glutaraldehyde mixture (EX4). Two commercially available fluoride varnishes were used for comparison. Each group was applied to bovine incisors, and the fluoride release and pH were monitored for 30 days. Cell viability analysis, scanning electron microscopy, and energy-dispersive spectroscopy were performed. EX4 released the highest and most effective concentration of fluoride for the longest period and reached neutral pH at the earliest; the release was maintained for up to 30 days without cytotoxicity. In conclusion, EX4 is considered to be the most effective varnish to prevent dental caries.
Collapse
Affiliation(s)
- Soo-Auk Park
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University
| | - Julee Son
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University
| | - Ah-Jin Kim
- Department of Dental Hygienist, Singyeongju University
| | - Seunghan Oh
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University
- Institute of Biomaterials•Implant, College of Dentistry, Wonkwang University
| | - Ji-Myung Bae
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University
- Institute of Biomaterials•Implant, College of Dentistry, Wonkwang University
- Musculoskeletal and Immune Disease Research Institute, Wonkwang University
| |
Collapse
|
4
|
Wang Q, Zhou Y, Cui T, Li J, Lo ECM, Hao G, Zhi Q. Comparative evaluation of four treatments for postorthodontic white spot lesions: a randomized controlled trial. Clin Oral Investig 2023; 27:5957-5968. [PMID: 37603170 DOI: 10.1007/s00784-023-05209-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 08/13/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVES To evaluate the treatment efficacy of fluoride toothpaste alone and those of adjunctive use of resin infiltration, sodium fluoride varnish, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on white spot lesions (WSLs). MATERIALS AND METHODS Seventy-nine patients (356 teeth) with WSLs after orthodontic treatment were randomly allocated into four groups. The WSLs of the participants received resin infiltration only at baseline, and the other groups received fluoride varnish, CPP-ACP mousse, and placebo treatment every 6 months, respectively. A toothpaste containing 1400 ppm fluoride and toothbrushes were distributed to all participants, and oral hygiene instructions were provided. Photos of the teeth with WSL were taken to compare the change between groups which was measured by ImageJ software. RESULTS Twelve months later, different degrees of reduction in the area of WSLs were observed in all groups. The percentage of lesion area reduction in WSLs in the resin infiltration group was 46.6%, which was significantly higher than that in fluoride varnish group (26.6%), CPP-ACP group (28.6%), and control group (29.8%), and the differences were statistically significant (p < 0.001). CONCLUSIONS This study shows that after 1-year follow-up, the use of fluoride toothpaste, with or without the use of fluoride varnish or CPP-ACP, can reduce the area of WSLs. While resin infiltration can immediately improve dental aesthetics and continuously improved in 12 months, resin infiltration group showed much better results than other groups. TRIAL REGISTRATION Clinical Trials Registration Number: ChiCTR2000032516. CLINICAL SIGNIFICANCE The use of fluoride toothpaste, with or without adjunctive use of fluoride varnish and CPP-ACP, can reduce the area of WSLs, while resin infiltration treatment has additional effect and can immediately improve dental aesthetics.
Collapse
Affiliation(s)
- Qiqiu Wang
- Hospital of Stomatology, Sun Yat-Sen University, No. 56, Lingyuan Xi Road, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Yang Zhou
- Hospital of Stomatology, Sun Yat-Sen University, No. 56, Lingyuan Xi Road, Guangzhou, 510055, China
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Tianqiang Cui
- Foshan Stomatological Hospital & School of Medicine, Foshan University, Foshan, China
| | - Jianbo Li
- School of Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - E C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Gaofeng Hao
- Oral Disease Prevention Center of Shenzhen Maternity and Child Healthcare Hospital, Shenzhen, China.
| | - Qinghui Zhi
- Hospital of Stomatology, Sun Yat-Sen University, No. 56, Lingyuan Xi Road, Guangzhou, 510055, China.
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.
| |
Collapse
|
5
|
Matar MA, Darwish SS, Salma RS, Lotfy WA. Evaluation of the antibacterial activity of Enamelast® and Fluor defender® fluoride varnishes against Streptococcus mutans biofilm: an in vitro study in primary teeth. Eur Arch Paediatr Dent 2023; 24:549-558. [PMID: 37525011 PMCID: PMC10600041 DOI: 10.1007/s40368-023-00811-4] [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: 11/13/2022] [Accepted: 06/02/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE The aim of the current work was to compare the antibacterial activity of Enamelast® and Fluor defender® fluoride varnish on biofilm generation by Streptococcus mutans on extracted primary teeth. METHODS Thirty-six primary molars were collected and sliced into seventy-two test model disks. All specimens were examined, and the cracked or broken ones were discarded. A total number of specimens (n = 54) were divided into two experimental analyses viz; biofilm formation (n = 27) and microscopic examination (n = 27). Specimens of each analysis were tested under different experimental conditions: a negative control group (n = 9), Fluor defender group (n = 9), and Enamelast group (n = 9). Following treatment, biofilms were generated by adherent Streptococcus mutans on the test model disks on three time intervals: 24 h (n = 3), 48 h (n = 3), and 72 h (n = 3) for each analysis. Then, for biofilm formation analysis, the biofilm was detected spectrophotometrically at 620 nm after being stained by crystal violet. For microscopical analysis, the surfaces of the test model disks were visualized by scanning electron microscopy (SEM), and each image was processed and analyzed using ImageJ software. RESULTS At 48 and 72 h, Enamelast® and Fluor defender®-treated group showed significantly (p < 0.001) slight adhered bacterial cells when compared with the negative control group as revealed by the absorbance and SEM. Compared with the Fluor defender®-treated group, the absorbance of the Enamelast®-treated group showed a significant (p < 0.001) increase by approximately 7- and 16.5-fold at 48 and 72 h, respectively. Similarly, SEM showed that the number of bacterial cells adhered to enamel surfaces in the Fluor defender®-treated group was significantly (p < 0.001) fewer than the Enamelast®-treated group by approximately 36.55% and 20.62% at 48 and 72 h after exposure, respectively. CONCLUSION We conclude that the anti-biofilm activity of Fluor defender® against Streptococcus mutans was significantly (p < 0.001) greater than Enamelast® fluoride varnish. The use of Fluor defender® is encouraged as a preventive measure in children with the high risk of developing dental caries.
Collapse
Affiliation(s)
- M A Matar
- Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - S S Darwish
- Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - R S Salma
- Pediatric Dentistry Department, College of Dentistry El Alamein, Arab Academy for Science, Technology and Maritime Transport (AAST), Alamein, Egypt.
| | - W A Lotfy
- Microbiology Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| |
Collapse
|
6
|
Zendron MP, Rocha ADO, Simões MSDS, Santana CM, Bolan M, Cardoso M. Fluoride Varnish in Dentistry: A Bibliometric Analysis of the 100 Most-Cited Papers. Caries Res 2023; 57:189-196. [PMID: 37751726 DOI: 10.1159/000534200] [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: 02/15/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
A highly cited paper is a milestone and might impact research and clinical practice. The present study analyzed the 100 most-cited papers on fluoride varnishes in dentistry. A search was performed on July 20, 2022, on the Web of Science Core Collection. Two independent researchers extracted the following data: number and citation density; year and journal of publication; study design; main topic; authors; institutions; keywords; countries and continents. Scopus and Google Scholar were consulted to compare the number of citations. Bibliometric networks were generated in the VOSviewer. The number of citations ranged from 36 to 351, and thirteen papers were cited more than 100 times. The papers were published between 1977 and 2018, most of which were published after 2008 (48%). The most prevalent journal was Caries Research (17%). Intervention studies were the most common design (41%). The most discussed topics were dental caries prevention (48%) and dental remineralization (31%). Europe was the continent with the highest number of publications (46%), mainly from Sweden (14%), and Umea University had the most substantial number of studies (8%). Petersson L.G. was the author with more papers in the top 100 (6%). The most used keywords were "dental caries" (34%) and "fluoride varnish" (31%). It can be concluded that the top 100 cited papers on fluoride varnish primarily originated from Europe, with the majority consisting of intervention studies focusing on the utilization of fluoride varnish for the prevention of dental caries.
Collapse
Affiliation(s)
- Mariana Perini Zendron
- Department of Dentistry, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil,
| | | | | | - Carla Miranda Santana
- Department of Dentistry, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Michele Bolan
- Department of Dentistry, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Brazil
| |
Collapse
|
7
|
Helal N, Azzahrani GS, Azzouz LZ, Sabbagh HJ. Effectiveness of MI Varnish™ and PreviDent ® Varnish in Noncavitated Interproximal Lesions: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023; 16:751-757. [PMID: 38162230 PMCID: PMC10753103 DOI: 10.5005/jp-journals-10005-2689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Aim Evaluating the remineralization efficacy of noncavitated proximal incipient lesions with Colgate® PreviDent® and MI™ varnishes in comparison to the industry standard (1.23%) acidulated phosphate fluoride (APF) gel. Study design Parallel randomized controlled, multicenter, single-blinded trial. Materials and methods By flipping a coin, 18 patients with 91 lesions were divided into three groups. The Colgate® PreviDent (n = 33), MI varnish (n = 30), and control (APF gel) groups (n = 28) were identified as the three arms. We conducted an initial assessment and therapy as well as follow-ups at 3 and 6 months to evaluate the course of the caries lesion. Results and statistics Caries progression was significantly reduced on treated surfaces across both groups. Nine surfaces in the Colgate® PreviDent® group with white spots and dryness did not change, one surface turned into a white patch without dryness, and another surface changed to a sound surface; only two surfaces were discontinued from treatment (restored) due to a misdiagnosis by the operator (n = 2). Nine of the surfaces in the MI™ group maintained their white patches with dryness, whereas one developed a new white patch that was not dry. Only MI varnish™-treated teeth exhibited dramatic radiographic improvement. Caries on the outside enamel were either unchanged or restored to healthy levels. Caries on the inner surface of the enamel also did not change. Conclusion Remineralizing noncavitated early-stage lesions may be done with both MI™ and Colgate® PreviDent® varnishes. Despite this, radiographic results did not vary significantly across the three groups. In situations of rather advanced incipient caries seen on radiographs, the MI varnish™ might be recommended. How to cite this article Helal N, Azzahrani GS, Azzouz LZ. Effectiveness of MI VarnishTM and PreviDent® Varnish in Noncavitated Interproximal Lesions: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(5):751-757.
Collapse
Affiliation(s)
- Narmin Helal
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ghadi S Azzahrani
- Department of Pediatric Dentistry, Ministry of Health, Yanbu, Saudi Arabia
| | - Lujain Z Azzouz
- Department of Pediatric Dentistry, King Abdulaziz University, Saudi Arabia
| | - Heba J Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
8
|
Oo TH, Tianviwat S, Sontamino P, Thitasomakul S. Long-term Effectiveness of Integrated Caries Preventive Programs in Thailand Among Preschool Children Using a System Dynamics Model. Community Dent Health 2023; 40:176-181. [PMID: 37555540 DOI: 10.1922/cdh_00078oo06] [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] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/07/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE To compare the effect of three caries preventive interventions provided by Thailand's Ministry of Public Health (MOPH): supervised toothbrushing (STB), fluoride varnish (FV), and combined STB+FV from 0 to 5 years old to the base case using the System Dynamics Model (SDM). METHODS The SDM was developed to compare the intervention scenarios: STB, FV, and combined STB+FV with the base case scenario. Meta-analyses determined the effective rates of the interventions included in the model. RESULTS The model indicated that the population with no caries in deciduous teeth increased by 7.5%, 5.7%, and 4.2% at three years of age, and 12.8%, 9.9%, and 5.9% at five years of age, under STB+FV, STB, and FV respectively when compared to the base case. At three years old, the population with untreated caries in deciduous teeth decreased by 12.9% in STB+FV, 9.8% in STB, and 7.3% in FV, and by 10.9% in STB+FV, 8.5% in STB, and 4.9% in FV, at five years old. The increase in the population without caries is considered clinically significant compared to baseline. CONCLUSION The model determined that an effective combination of STB and FV should be administered between 0 and 5 years of age to reduce caries in the primary dentition. The SDM could be applied as a "what-if" analysis in order to determine the most beneficial intervention or policy by comparing them.
Collapse
Affiliation(s)
- T H Oo
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Thailand
| | - S Tianviwat
- Evidence-Based Dentistry for Oral Health Care and Promotion Phase II Research Unit, Department of Preventive Dentistry, Prince of Songkla University, Faculty of Dentistry, Thailand
| | - P Sontamino
- Department of Mining and Materials Engineering, Faculty of Engineering, Prince of Songkla University, Thailand
| | - S Thitasomakul
- Evidence-Based Dentistry for Oral Health Care and Promotion Phase II Research Unit, Department of Preventive Dentistry, Prince of Songkla University, Faculty of Dentistry, Thailand
| |
Collapse
|
9
|
Zamperini CA, Bedran-Russo AK. Immediate and Sustained Root Caries Prevention of Fluoride Varnish Combined with Toothpastes. Caries Res 2023; 57:592-601. [PMID: 37549651 DOI: 10.1159/000533279] [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: 10/14/2022] [Accepted: 07/16/2023] [Indexed: 08/09/2023] Open
Abstract
The aim of this study was to determine the immediate and sustained effect of a fluoride varnish and its combinations with toothpastes in preventing root caries development using a salivary microcosm in vitro model. Human root dentin specimens (n = 150) were randomly divided into 5 experimental protocols (n = 30): (1) Fluoride Varnish (V); (2) V followed by Paste One (V + PO); (3) V followed by Paste Plus (V + PP); (4) V followed by PO and PP (V + PO + PP); and (5) No treatment (control). One varnish layer was applied on the specimens (except for the control group) and kept for 18 h. Then, the varnish was removed and toothpaste treatments were initiated according to experimental groups. For the short-term incubation model (n = 15), the specimens were also immediately subjected to 7-day cariogenic challenge. For that, human saliva was used as bacterial inoculum and McBain artificial saliva containing 2% sucrose as growth medium. The other half of the specimens (n = 15) were used to study the varnish's sustained effect by long-term incubation (8 weeks) before cariogenic challenge. The protocols' anti-caries properties were evaluated by dentin porosity (rhodamine intensity; RI) and mineral density, while their anti-biofilm effects were evaluated using biofilm's biomass and viability assays. For short- and long-term incubation models, all experimental regimens resulted in statistically significant decreases (p < 0.05) in the RI (up to 180 μm and 120 μm, respectively) as well as higher mineral density compared to No treatment (p < 0.001). V + PO + PP and/or V + PO resulted in statistically lower RI compared to V for some depths (p < 0.05) in both models. There were changes in RI and mineral density within groups over time. All experimental treatments exhibited anti-biofilm effects. All prevention protocols exhibited immediate and sustained anti-caries effect against root caries development. The combination of a fluoride varnish with PO resulted in superior additional anti-caries effects.
Collapse
Affiliation(s)
- Camila A Zamperini
- Department of Restorative Dentistry, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Ana K Bedran-Russo
- Department of Oral Biology, College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| |
Collapse
|
10
|
Kaur S, Bhola M, Bajaj N, Brar GS. Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023; 16:S91-S96. [PMID: 37663209 PMCID: PMC10474381 DOI: 10.5005/jp-journals-10005-2622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Introduction With the paradigm shift in the management of dental caries, the focus is now laid on remineralization therapies that can arrest the progression of the disease and remineralize the subsurface lesions. Objectives The purpose of this study was to determine and compare the remineralizing potential of silver diamine fluoride (SDF), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and fluoride varnish (FV) on enamel surfaces in primary and permanent teeth. Materials and methods A total of 120 primary anterior teeth and 120 premolars were used to prepare enamel blocks in acrylic resin. The mean baseline surface microhardness (SMH) for each sample was determined using a microvickers hardness testing machine. Thereafter, the samples were randomly and equally distributed into groups and subgroups based on the materials used, that is, SDF, CPP-ACP, FV, and distilled water (control). After subjecting the samples to a pH cycling regime, SMH was determined again and the percentage change in SMH was calculated. Results The data were tabulated and subjected to statistical analysis using an independent t-test and one-way analysis of variance (ANOVA). In primary teeth, the least mean percentage reduction in SMH was observed after the application of FV followed by SDF, CPP-ACP, and control. In permanent teeth, both SDF and FV showed the least percentage reduction of enamel SMH followed by CPP-ACP and control. Conclusion Silver diamine fluoride (SDF), FV, and CPP-ACP showed remineralizing potential in both primary and permanent teeth. How to cite this article Kaur S, Bhola M, Bajaj N, et al. Comparative Evaluation of the Remineralizing Potential of Silver Diamine Fluoride, Casein Phosphopeptide-amorphous Calcium Phosphate, and Fluoride Varnish on the Enamel Surface of Primary and Permanent Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(S-1):S91-S96.
Collapse
Affiliation(s)
- Samarpreet Kaur
- Department of Pedodontics and Preventive Dentistry, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Meenu Bhola
- Department of Pedodontics and Preventive Dentistry, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Nitika Bajaj
- Department of Pedodontics and Preventive Dentistry, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| | - Gurlal S Brar
- Department of Pedodontics and Preventive Dentistry, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
| |
Collapse
|
11
|
Golriz N, Barekatain M, Mirzakocheki Broujeni P. Penetration and durability of CPP-ACP paste and sodium fluoride varnish as desensitizing agents: An in vitro comparison. J Dent Res Dent Clin Dent Prospects 2023; 17:119-127. [PMID: 37649823 PMCID: PMC10462472 DOI: 10.34172/joddd.2023.28050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/23/2023] [Indexed: 09/01/2023] Open
Abstract
Background This study aimed to investigate and compare the penetration and durability of two dentin desensitizers, sodium fluoride varnish and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste, using electron microscopy. Methods The study was performed on 60 dentin specimens prepared from extracted human premolars. After applying 17% EDTA to remove the smear layer, the specimens were divided into two groups. MI Paste and Bi-fluoride varnish were applied to the specimens. Microscopic images of 20 samples were obtained immediately. Twenty other samples were accessed after 15 days, and the other 20 were accessed after 30 days of toothbrushing and thermal cycling. Both surface and longitudinal cross-sectional images (after sample fracture) were studied. Data were analyzed with two-way ANOVA and Mann-Whitney U test at a significance level of P<0.05. Results The mean depth of material penetration was significantly time-dependent and fluctuated in both groups. There was a significant difference between the mean level of plugs between 0, 15, and 30 days (P<0.001). Penetration increased with time for the MI Paste group, while in the Bi-fluoride group, the increase was significant at 15 and 30 days than immediately after application. The mean thickness of the plugs was significantly different at the three time periods, and MI Paste showed a sudden decrease in plug thickness after 15 days. Conclusion Immediately after application, Bi-fluoride occluded dentinal tubules more effectively, and its durability after abrasion and thermal fatigue were higher than MI Paste.
Collapse
Affiliation(s)
| | - Mehrdad Barekatain
- Department of Operative Dentistry, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
| | | |
Collapse
|
12
|
Sirivichayakul P, Jirarattanasopha V, Phonghanyudh A, Tunlayadechanont P, Khumsub P, Duangthip D. The effectiveness of topical fluoride agents on preventing development of approximal caries in primary teeth: a randomized clinical trial. BMC Oral Health 2023; 23:349. [PMID: 37268914 DOI: 10.1186/s12903-023-03045-4] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/14/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND This 18-month randomized clinical trial aimed to compare the effectiveness of two topical fluoride applications versus placebo control on preventing development of approximal caries in primary teeth. METHODS Preschool children were recruited if they had at least one initial approximal carious lesion at the distal surface of the canines, both approximal surfaces of the first molars, or the mesial surface of the second molars assessed from bitewing radiographs. The participants were randomly allocated into 3 intervention groups: Group 1 (placebo control), Group 2 (5% sodium fluoride [NaF] varnish), and Group 3 (38% silver diamine fluoride [SDF]). All agents were applied semiannually. Two calibrated examiners evaluated the caries development from bitewing radiographs. Caries development was recorded when the baseline sound surface or initial approximal carious lesion surface developed dentin caries (beyond the outer one-third of dentine) at the follow-up examination. The intention-to-treat approach was adopted. The Chi-square test was used to analyze the effectiveness of topical fluoride agents in preventing approximal caries development and the effect of other variables. The multi-level logistic regression analysis was performed to assess the relative effectiveness of topical fluoride agents in preventing approximal caries development at the 18-month follow-up. RESULTS At baseline, 190 participants with 2,685 sound or initial carries at the approximal surfaces were recruited. No differences in participant demographic backgrounds, oral health related habits, or caries experience were observed among the 3 groups (P > 0.05). After 18 months, 155 (82%) participants remained in the study. The rates of developing approximal caries in Groups 1, 2, and 3 were 24.1%, 17.1%, and 27.2%, respectively (P < 0.001, χ2 test). After adjusting for confounding factors and clustering effect, the multilevel logistic regression analysis showed no differences in caries development rates between the 3 groups (P > 0.05). Tooth type and the extent of a carious lesion at baseline were the significant factors for caries development. CONCLUSION At 18-month follow-up, after adjusting for confounding factors and clustering effect, there were no statistically significant differences in preventing of approximal caries development between the semiannual application of 5%NaF, 38%SDF, or placebo. TRIAL REGISTRATION The study was registered in the Thai Clinical Trials Registry under the number TCTR20190315003 on 15/03/2019.
Collapse
Affiliation(s)
- Parach Sirivichayakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Varangkanar Jirarattanasopha
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand.
| | - Araya Phonghanyudh
- School of Dentistry, King Mongkut's Institute of Technology Ladkrabang, 1 Chalongkrung St, Ladkrabang, Bangkok, 10520, Thailand
| | - Pitchaya Tunlayadechanont
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, No. 6, Yothi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Ploychompoo Khumsub
- Dental department, Pakkred hospital, 33 Moo 5 Saphan Nonthaburi - Bang Bua Thong Rd., Pakkret district, Nonthaburi, 11120, Thailand
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Prince Phillip Dental Hospital, 34 Hospital Rd., Sai Ying Pun, Hong Kong SAR, China
| |
Collapse
|
13
|
Xie Z, Yu L, Li S, Li J, Liu Y. Comparison of therapies of white spot lesions: a systematic review and network meta-analysis. BMC Oral Health 2023; 23:346. [PMID: 37264364 DOI: 10.1186/s12903-023-03076-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVE White spot lesions (WSLs), the earliest evidence of enamel demineralization, are considered amenable to intervention to achieve a remineralized or arrested state of caries. The management of WSLs is quite challenging, and there is no definitive cure as yet. We performed a network meta-analysis to assess the efficacy of seven therapies for WSLs and gave a hierarchy of them. MATERIALS AND METHODS We systematically searched the PubMed, EMBASE, Cochrane, and Web of Science databases (last search: July 2022) to identify all relevant studies. We limited our search to studies published in English. Randomized controlled designed in vitro/clinical trials related to the efficacy of the seven therapies for WSLs were included. Data extraction was performed independently by two reviewers. The risk of bias (ROB) 2.0 tool from Cochrane and a previous in vitro methodological tool will be used for the quality assessment. Variations in quantitative light-induced fluorescence (QLF), laser fluorescence (LF), and lesions area were the primary outcome measures. Standard mean difference (SMD) was used as the effect size for the Network meta-analysis (NMA). Consistency and inconsistency tests were conducted. The hierarchy of 7 treatment effects was evaluated using surface probabilities under cumulative ranking (SUCRA). Publication bias was evaluated using a bias plot. RESULTS Forty-two articles were included in the systematic review. Thirty-one of them, with a total of 1906 participants, were included in the network meta-analysis. The studies owned a low and moderate risk of bias. This analysis does not suffer from significant inconsistency. The difference between 4 groups 'self-assembled peptide (SAP) P11-4', 'P11-4 + Fluoride Varnish (FV)', 'Resin Infiltration (RI)', 'casein phosphor peptides-amorphous calcium fluoride phosphate (CPP-ACFP)' and the 'Control' group was found to be statistically significant. Compared to the 'FV' and 'casein phosphor peptides-amorphous calcium phosphate (CPP-ACP)' groups, the 'P11-4 + FV" group and 'RI" group made a significant difference. The hierarchy was evident in the SUCRA values of 7 therapies. P11-4 + FV and RI were considered effective therapies compared to the control group or the FV group (gold standard group). CONCLUSIONS The available evidence suggests that resin infiltration and P11-4 in combination with fluoride varnish had advantages over gold standard (FV). The effect of tricalcium phosphate-based drugs and fluoride is not very noticeable. Overall, drugs based on P11-4 and resin infiltration will be better therapies. Using more than two drugs in combination also would increase efficacy.
Collapse
Affiliation(s)
- Zunxuan Xie
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Lei Yu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Sining Li
- Department of Prosthodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Jianing Li
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China
| | - Yuyan Liu
- Department of Endodontics, Hospital of Stomatology, Jilin University, Jilin, China.
| |
Collapse
|
14
|
Ghaly YS, El-Wassefy NA, Shamaa MS, Tawfik MA. Effect of self-assembling peptide and other remineralizing agents on preventing initial enamel lesions around orthodontic brackets: An in vitro comparative study. Int Orthod 2023; 21:100751. [PMID: 37003059 DOI: 10.1016/j.ortho.2023.100751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/14/2023] [Accepted: 03/21/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To investigate and compare the effect of self-assembling peptide SAP (P11-4), casein phosphopeptide-amorphous calcium phosphate fluoride paste (CPP-ACPF), and fluoride varnish (FV) on preventing enamel demineralization around orthodontic brackets. MATERIAL AND METHODS Orthodontic brackets were bonded to the buccal surfaces of 80 freshly extracted human maxillary premolars. Teeth were randomly assigned to four groups (n=20) according to the remineralizing agent used as follows: SAP (P11-4) group (Curodont™ Protect/Credentis), CPP-ACPF group (MI Paste Plus®/Recaldent™), fluoride varnish group (Profluoride varnish®/VOCO), and control group. All products were applied according to the manufacturer's instructions. Specimens were cycled in daily refreshed demineralizing and remineralizing solutions for 8h and 16h, respectively, for 28 days. The calcium/phosphorus ratio (Ca/P) and surface microhardness (SMH) were evaluated at baseline and at two and four weeks. Two-way ANOVA (analysis of variance), one-way ANOVA and repeated measures ANOVA were used for statistical analysis. RESULTS Two-way ANOVA demonstrated significant differences between remineralizing agents and time points. After 4 weeks, the SAP (P11-4) group had had significantly higher Ca/P ratio and SMH (1.68±0.11 and 346.47±55.38) compared to other groups, followed by CPP-ACPF (1.52±0.19 and 283.53±64.75), FV (1.37±0.14 and 262.80±82.98), and the control group (1.31±0.10 and 213.00±41.95). Significantly higher Ca/P ratio and SMH were observed at 2 weeks in the control group (1.44±0.10 and 269.63±57.37) and FV group (1.52±0.09 and 321.17±55.24) compared to 4 weeks. No significant differences were found regarding Ca/P ratio and SMH at 2 weeks in the CPP-ACPF (1.55±0.15 and 295.14±53.88) and SAP P11-4 groups (1.64±0.10 and 320.18±58.04) compared to 4 weeks. CONCLUSION SAP (P11-4) had the greatest remineralizing efficacy compared to FV and CPP-ACPF. Moreover, extended period of time improved the preventive efficacy of SAP (P11-4) compared to the other regimens.
Collapse
Affiliation(s)
- Yasmin Samir Ghaly
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt.
| | - Noha A El-Wassefy
- Department of Dental Biomaterials, Mansoura University, Faculty of Dentistry, Mansoura, Egypt
| | - Marwa Sameh Shamaa
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt
| | - Marwa Ali Tawfik
- Department of Orthodontics, Mansoura University, Faculty of Dentistry, Algomhoria Street, Aldakhlia, 35516 Mansoura, Egypt
| |
Collapse
|
15
|
Shetty SS, Nekkanti S. Remineralization Potential of a Novel Biomimetic Material (Self-assembling Peptide P 11-4) on Early Enamel Caries: An In Vitro Study. J Contemp Dent Pract 2023; 24:181-187. [PMID: 37272130 DOI: 10.5005/jp-journals-10024-3490] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
AIM To assess the remineralizing potential of self-assembling peptide P11-4 and compare it to the remineralizing potential of fluoride varnish using DIAGNOdentTM, as well as the amount of mineral gain after application of fluoride varnish and self-assembling peptide P11-4. MATERIALS AND METHODS This study included 20 premolars extracted during orthodontic therapy with all surfaces intact and free of hypoplastic regions, white spot lesions (WSL) and dental caries. The teeth sample for Curodont RepairTM (self-assembling P11-4) and Bifluorid 10® (fluoride varnish) was equally divided. On each tooth surface, a 2 × 2 mm window was created. The samples were immersed in a demineralizing solution for 96 hours before being subjected to DIAGNOdentTM pen reading, ICDAS-II scoring, and scanning electron microscopy-energy-dispersive X-ray (SEM-EDX) analysis on one half of the sample. The remineralizing agents were applied to the second half of the sample according to the manufacturer's instructions and placed in artificial saliva for 21 days, with the artificial salvia being replaced every 24 hours. After 21 days, the second half of the sample was subjected to DIAGNOdentTM pen reading, ICDAS-II score, and SEM-EDX analysis. RESULTS Following remineralization, the DIAGNOdentTM pen and ICDAS-II score values differed statistically between the two groups, with the Bifluorid 10® group reporting higher mean values (p > 0.05) using t-test analysis. Energy-dispersive X-ray analysis using the t-test revealed a statistically significant result for remineralization (p < 0.05), with CurodontTM Repair group (55.150.84) reporting better mean values than Bifluorid 10® for phosphorus and calcium, but Bifluorid 10® reporting a higher result in remineralization (p < 0.05) than CurodontTM Repair for fluoride. CONCLUSION CurodontTM Repair showed better remineralizing potential compared with Bifluorid 10® varnish. In terms of the mineral gain, CurodontTM Repair showed better results for calcium and phosphorus post-remineralization. Whereas Bifluorid 10® showed a higher gain in terms of fluoride. Self-assembling peptide P11-4 can be used as an alternative to fluoride varnish for remineralizing WSL. CLINICAL SIGNIFICANCE Self-assembling polypeptide P11-4 is a novel remineralizing agent for initial enamel lesions, which is the least-invasive method of enamel remineralization.
Collapse
Affiliation(s)
- Shruti Satish Shetty
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sridhar Nekkanti
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India, Phone: +91 9886932642, e-mail:
| |
Collapse
|
16
|
Hardikar AS, Gaonkar NN, Devendrappa SN, Machindra TS, Hadkar S. Qualitative and Quantitative Profiling of Enamel Remineralizing Potential of Fluoride Varnishes Incorporating Bioactive Glass, Dicalcium Phosphate Dihydrate, and Modified MTA: A Raman Spectroscopic Study. Int J Clin Pediatr Dent 2023; 16:363-370. [PMID: 37519984 PMCID: PMC10373779 DOI: 10.5005/jp-journals-10005-2535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Aim To evaluate and compare for remineralization potential of enamel at three different time intervals using commercially available MI Varnish and Duraflor Halo varnish [5% sodium fluoride (NaF) varnish] incorporating bioactive glass, dicalcium phosphate dihydrate (DCPD), and biomimetically modified mineral trioxide aggregate (MTA). Materials and methods For the study, a buccolingual division into equal halves was done for 64 decoronated premolar crowns. Among these 64 crowns, we mounted 32 in acrylic discs to be used for microhardness and induced white spot lesions (WSLs) measuring 5 × 5 mm on the exposed enamel surface. These samples were divided into four groups of 24 each depending upon the varnish used. Varnish application was done, followed by immersion of these samples for 24 hours in artificial saliva, followed by peeling off of varnish. A pH cycling of 28 days was done after the varnish application before assessing the remineralization of the samples. Evaluation of all these samples was done at three different time intervals, baseline, after demineralization, and post remineralization for microhardness on the enamel surface. Raman spectroscopy was utilized for the measurement of phosphate (P) ion release. Sectioning of these samples to a thickness of 100 µm approximately was done to be viewed under a polarized light microscope. Results Bioactive glass incorporated varnish showed the highest microhardness values, mineral content levels, and least depth of lesion posttreatment. Conclusion All the experimental varnish showed significant remineralizing potential with the best potency seen with bioactive glass incorporated varnish. Clinical significance The nonfluoride agents can be appropriately used in 2 wt% amount to augment the benefits of fluoride. How to cite this article Hardikar AS, Gaonkar NN, Devendrappa SN, et al. Qualitative and Quantitative Profiling of Enamel Remineralizing Potential of Fluoride Varnishes incorporating Bioactive Glass, Dicalcium Phosphate Dihydrate, and modified MTA: A Raman Spectroscopic Study. Int J Clin Pediatr Dent 2023;16(2):363-370.
Collapse
Affiliation(s)
- Anushka S Hardikar
- Department of Pedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Maharashtra, India
| | - Namrata N Gaonkar
- Department of Pedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Maharashtra, India
| | - Shashikiran Nandhihally Devendrappa
- Department of Pedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Maharashtra, India
| | - Taur S Machindra
- Department of Pedodontics and Preventive Dentistry, Bapuji Dental College & Hospital (BDCH), Davanagere, Karnataka, India
| | - Savita Hadkar
- Department of Pedodontics and Preventive Dentistry, School of Dental Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, Maharashtra, India
| |
Collapse
|
17
|
Mashhour A, Allam G, Wassel M. Comparative evaluation of prevention of demineralization of artificial enamel caries treated with two fluoride varnishes and 38% SDF in primary teeth: an in vitro study. BMC Oral Health 2023; 23:110. [PMID: 36803462 PMCID: PMC9938617 DOI: 10.1186/s12903-023-02799-1] [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: 09/10/2022] [Accepted: 02/09/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND This study aimed to compare the effect of Clinpro™ White varnish containing 5% sodium fluoride (NaF) and functionalized tricalcium phosphate, MI varnish containing 5% NaF and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and 38% Silver diamine fluoride (SDF) in preventing demineralization of treated white spot lesions (WSLs) in enamel of primary teeth. METHODS Forty-eight primary molars with artificial WSLs were allocated into four groups as follows: Group 1: Clinpro white varnish, Group 2: MI varnish, Group 3: SDF, and Group 4: control (no treatment). The three surface treatments were applied for 24 h and then enamel specimens were subjected to pH cycling. Thereafter, the mineral content of specimens was evaluated by Energy Dispersive X-ray Spectrometer and the lesion depth was assessed via Polarized Light Microscope. One-way ANOVA followed by Tukey's post hoc test were used at p ≤ 0.05 to identify significant differences. RESULTS Insignificant difference in mineral content was observed among treatment groups. Treatment groups exhibited significantly higher mineral content compared to control except for Fluoride (F). MI varnish showed the highest mean calcium (Ca) ion content (66.57 ± 0.63), and Ca/P (2.19 ± 0.11), followed by Clinpro white varnish, and SDF. MI varnish also displayed the highest phosphate (P) ion content (31.46 ± 0.56), followed by SDF (30.93 ± 1.02), and Clinpro white varnish (30.53 ± 2.19). Fluoride content was highest in SDF (0.93 ± 1.18), followed by MI (0.89 ± 0.34) and Clinpro (0.66 ± 0.68) varnishes. Significant difference in lesion depth was observed among all groups (p < 0.001). The lowest mean lesion depth (µm) was found in MI varnish (226.23 ± 44.25) which was significantly lower than Clinpro white varnish (285.43 ± 44.70), SDF (293.32 ± 46.82), and control (576.69 ± 42.66). Insignificant difference in lesion depth was found between SDF and Clinpro varnish. CONCLUSIONS In primary teeth, WSLs treated with MI varnish displayed better resistance to demineralization compared to WSLs treated with Clinpro white varnish and SDF.
Collapse
Affiliation(s)
- Alshaimaa Mashhour
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566, Egypt.
| | - Gehan Allam
- grid.7269.a0000 0004 0621 1570Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566 Egypt
| | - Mariem Wassel
- grid.7269.a0000 0004 0621 1570Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Organization of African Unity St.-Abbasia, Cairo, 11566 Egypt
| |
Collapse
|
18
|
Chauhan C, Mangla R, Gandhi G, Bhatnagar D, Singh K, Baijal R. Evaluation of the Effects of Topical Fluoride Varnish and Fluoride Releasing Adhesive on Shear Bond Strength of Orthodontic Brackets: An In Vitro Study. Int J Clin Pediatr Dent 2023; 16:37-41. [PMID: 37020761 PMCID: PMC10067978 DOI: 10.5005/jp-journals-10005-2501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Aim The aim of this study was to evaluate the in vitro effects of topical fluoride varnish and fluoride-releasing adhesive on the shear bond strength (SBS) of orthodontic brackets. Materials and methods A total of 60 extracted premolars were bonded to 0.022, stainless steel brackets and equally divided into three groups (n = 20) based on the adhesive used-Group I- Transbond XT Plus color change (3M Unitek), Group II- Transbond XT followed by application of fluoride varnish, and Group III- Transbond XT (3M Unitek) adhesive and their bond strengths were compared. Brackets were debonded with a universal testing machine. The modified adhesive remnant index (ARI) was also recorded. Data were analyzed by using an analysis of variance, and a post hoc test was performed for multiple comparisons among the groups. Results There were no significant differences between the SBSs (p = 0.91) between the groups. Also, no significant difference was found in the modified ARI (p = 0.093). Conclusion The orthodontic adhesives used in our study, with or without the application of topical fluoride varnish, did not have a significant effect on the bond strengths of brackets. Clinical significance Adhesives evaluated in this study can be successfully used for bonding brackets. How to cite this article Chauhan C, Mangla R, Gandhi G, et al. Evaluation of the Effects of Topical Fluoride Varnish and Fluoride Releasing Adhesive on Shear Bond Strength of Orthodontic Brackets: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(1):37-41.
Collapse
Affiliation(s)
- Charu Chauhan
- Department of Orthodontics & Dentofacial Orthopaedics, Maharishi Markandeshwar College of Dental Sciences and Research (MMCDSR), Mullana, Ambala, Haryana, India
| | - Rajat Mangla
- Department of Orthodontics & Dentofacial Orthopaedics, Maharishi Markandeshwar College of Dental Sciences and Research (MMCDSR), Mullana, Ambala, Haryana, India
| | - Geetanjali Gandhi
- Department of Orthodontics & Dentofacial Orthopaedics, Maharishi Markandeshwar College of Dental Sciences and Research (MMCDSR), Mullana, Ambala, Haryana, India
| | - Deepankar Bhatnagar
- Department of Orthodontics & Dentofacial Orthopaedics, Maharishi Markandeshwar College of Dental Sciences and Research (MMCDSR), Mullana, Ambala, Haryana, India
| | - Kanika Singh
- Department of Orthodontics & Dentofacial Orthopaedics, Maharishi Markandeshwar College of Dental Sciences and Research (MMCDSR), Mullana, Ambala, Haryana, India
| | - Rheia Baijal
- Department of Orthodontics & Dentofacial Orthopaedics, Maharishi Markandeshwar College of Dental Sciences and Research (MMCDSR), Mullana, Ambala, Haryana, India
| |
Collapse
|
19
|
Lohfeld S, Kawamoto B, Wang Y, Walker MP. Effect of fluoride varnish in combination with simulated oral environment on enamel-bracket shear bond strength. Odontology 2023; 111:85-92. [PMID: 35771340 DOI: 10.1007/s10266-022-00724-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/07/2022] [Indexed: 01/06/2023]
Abstract
To determine the effect of fluoride varnish application combined with a simulated oral environment prior to bracket bonding on the shear bond strength (SBS) between brackets and tooth enamel. Sixty de-identified, extracted teeth were grouped to either receive or not receive fluoride varnish and then stored for 7 days at 37 °C in phosphate-buffered saline (PBS) solution or PBS combined with three 15-min cycles/day in a demineralizing solution to simulate pH variation following meals. Subsequently, brackets were bonded and after 24-h dark cure at 37 °C, debonded using shear forces in a simulated oral environment. The maximum shear force was used to calculate SBS, and the adhesive remnant index (ARI) was determined by image analysis of photos of the bracket mesh pad after debonding. A statistically higher SBS (10.16 MPa) was observed when fluoride varnish was applied prior to storage in PBS + demineralizing solution compared to SBS (6.38 MPa) following storage in the same solution without varnish application. Based on 37% effect size, this difference is also clinically relevant. In contrast, no significant differences in SBS were observed with varnish application combined with PBS with no demineralizing solution or between storage solution alone. Moreover, there was no significant difference in ARI due to varnish combined with either storage method or storage solution only. Results suggest varnish application prior to bracket bonding in combination with simulated oral environment that included acid exposure is beneficial in maintaining higher SBS between bracket and enamel. Despite higher SBS, adhesive remaining on enamel did not increase.
Collapse
|
20
|
Jain A, Deshpande AN, Shah YS, Jaiswal V, Tailor B. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023; 16:1-8. [PMID: 37020768 PMCID: PMC10067996 DOI: 10.5005/jp-journals-10005-2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Introduction Dental caries is a site-specific, multifactorial chronic disease affected globally. The prevalence of dental caries is strongly associated with social and economic disadvantage, and also the susceptibility of children to dental caries. Dental caries prevention can be achieved with topical fluoride agents. Topical fluoride promotes the remineralization of early carious lesions and reduces the demineralization of healthy enamel. Aim The aim of this randomized clinical trial was to compare the effectiveness of silver diamine fluoride (SDF) and sodium fluoride varnish (FV) in preventing new carious lesions in preschoolers. Materials and methods This randomized clinical trial was conducted on 285 children aged 3-6 years. Children were randomly allocated into three groups namely, group I-deionized distilled water (DIW), group II-sodium FV, and group III-SDF. The biannual application was performed at an interval of 6 months. New carious lesions were recorded using defs and International Caries Detection and Assessment System (ICDAS II) under LED magnifying loupes. Descriptive and inferential statistics were applied and tabulated using Statistical Package for the Social Sciences (SPSS) 23.0 software. Result There was a significant difference seen in the mean values of group III (SDF) when compared with group II (FV) and also between group III (SDF) and group I (DIW) when defs index was used. The mean score of ICDAS II after 12 months in group I (DIW) was -1.171, group II (FV) was -0.690, and group III (SDF) was -0.374. Conclusion silver diamine fluoride (SDF) was found to be most effective in preventing dental caries and also it appears to be the most cost-saving fluoride therapy. How to cite this article Jain A, Deshpande AN, Shah YS, et al. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(1):1-8.
Collapse
Affiliation(s)
- Aishwarya Jain
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Anshula N Deshpande
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Yash S Shah
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Vidhi Jaiswal
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Brijesh Tailor
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| |
Collapse
|
21
|
Vishwakarma AP, Bondarde P, Vishwakarma P, Dodamani AS, Mujawar S, Bansal S. Evaluation of Fluoride Uptake of Two Fluoride Varnishes into and onto the Enamel Surface at Different Temperatures: An In Vitro Study. Int J Clin Pediatr Dent 2022; 15:672-679. [PMID: 36866124 PMCID: PMC9973086 DOI: 10.5005/jp-journals-10005-2449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Background Fluoride (F) is an effective anticaries agent and can be delivered through various mediums at different concentrations. The ability to increase the enamel resistance to acid by decreasing solubility through the incorporation of F into the enamel apatite structure is the primary function of these agents. The efficacy of topical F can be determined by measuring the amount of F incorporated in and on human enamel. Aim To compare the F uptake into and onto the enamel surface of two different F varnishes at different temperatures. Materials and methods In this study, 96 teeth were divided equally and randomly (n = 48) into two experimental groups (group I and group II). Each group was further divided into four equal subgroups (n = 12); depending on the temperature (25°, 37°, 50°, and 60°C) they were subjected to Fluor-Protector® 0.7% and Embrace® 5% F varnishes were allocated to experimental groups I and II, respectively, and every sample was individually treated with the assigned F varnish. After the varnish application, two specimens from each subgroup, the group I and group II (n = 16), were mounted for hard tissue microtome sectioning for scanning electron microscope (SEM) analysis. The remaining 80 teeth underwent potassium hydroxide (KOH) soluble and KOH-insoluble F estimation. Results Group I and group II, both, showed maximum F uptake of 2817.07 ppm and 1626.8 ppm at 37°C temperature and the lowest of 1168.9 ppm and 1068.93 ppm at 50°C, respectively. The intergroup comparison was carried out using an unpaired t-test and the intragroup comparison was done using one-way analysis of variance (ANOVA) univariate analysis.Post hoc Tukey test was performed for pairwise comparison between different temperature groups. In group I (Fluor-Protector®), the difference in F uptake was statistically significant when the temperature was increased from 25° to 37° C (mean difference = -9.90, p = 0.016). In group II (Embrace®), a statistically significant difference in F uptake was observed when the temperature was increased from 25° to 50°C (mean difference = 10.00, p = 0.003) and 25° to 60°C (mean difference = 13.38, p = 0.001), respectively. Conclusion Fluor-Protector® varnish proved to have better F uptake in comparison to Embrace® varnish on human enamel. Topical F varnishes were most effective at 37°C, which is close to the standard human body temperature. Thus, the application of warm F varnish ensures more uptake of F in and onto the enamel surface for greater protection against dental caries. How to cite this article Vishwakarma AP, Bondarde P, Vishwakarma P, et al. Evaluation of Fluoride Uptake of Two Fluoride Varnishes Into and onto the Enamel Surface at Different Temperatures: An In Vitro Study. Int J Clin Pediatr Dent 2022;15(6):672-679.
Collapse
Affiliation(s)
- Aruna P Vishwakarma
- Department of Pedodontics and Preventive Dentistry, ACPM Dental College and Hospital, Dhule, Maharashtra, India
| | - Prashant Bondarde
- Department of Pedodontics and Preventive Dentistry, ACPM Dental College and Hospital, Dhule, Maharashtra, India
| | | | - Arun S Dodamani
- Department of Public Health Dentistry, ACPM Dental College and Hospital, Dhule, Maharashtra, India
| | - Shoeb Mujawar
- Department of Pedodontics and Preventive Dentistry, ACPM Dental College and Hospital, Dhule, Maharashtra, India
| | - Sandesh Bansal
- Department of Pedodontics and Preventive Dentistry, ACPM Dental College and Hospital, Dhule, Maharashtra, India
| |
Collapse
|
22
|
Larpbunphol N, Chanamuangkon T, Thamrongananskul N. The fluoride release, abrasion resistance, and cytotoxicity to hGFs of a novel cyanoacrylate-based fluoride varnish compared with conventional fluoride varnish. Dent Mater J 2022; 41:757-766. [PMID: 35793940 DOI: 10.4012/dmj.2022-005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The important factors contributing to the effectiveness of fluoride varnish are the amount of fluoride ion release and the retention time of the varnish on the tooth surface. Commercial fluoride varnishes are susceptible to mechanical removal; therefore, patients are informed to avoid eating or performing oral hygiene for at least 12-24 h, which results in patient inconvenience. However, cyanoacrylate-based fluoride varnish would not have these disadvantages. This study compared the daily fluoride ion release, abrasion resistance to brushing, and toxicity to human gingival fibroblasts (hGFs) between a newly-developed cyanoacrylate-based fluoride varnish and conventional fluoride varnish (Duraphat varnish). The results demonstrated that the cyanoacrylate varnish had a significantly higher fluoride release for 9 days after application, higher abrasion resistance to brushing, and slightly less toxicity to hGFs compared with Duraphat varnish. This novel cyanoacrylate varnish could be an alternative fluoride varnish for preventing dental caries.
Collapse
|
23
|
El-Desouky DI, Hanno A, Elhamouly Y, Hamza SA, El-Desouky LM, Dowidar KML. Preventive potential of nano silver fluoride versus sodium fluoride varnish on enamel caries like lesions in primary teeth: in vitro study. BMC Oral Health 2022; 22:244. [PMID: 35725433 PMCID: PMC9208095 DOI: 10.1186/s12903-022-02271-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 06/09/2022] [Indexed: 11/14/2022] Open
Abstract
Background Professionally applied topical fluoride preparations have been commonly used and have proven to prevent dental decay. Alternative preparations that provide further benefits may be of interest to investigate. This study aimed to investigate the effect of experimental nano silver fluoride (NSF) formulation compared to commercial sodium fluoride varnish (FV) on prevention of in vitro demineralization of initially sound enamel in primary teeth. Methods Forty-eight extracted/exfoliated sound molars were sectioned buccolingually into 96 specimens then assigned randomly into two equal groups. Each group was further subdivided into two equal subgroups (Ia: NSF, IIa: FV, Ib and IIb as negative controls). The test materials were applied, then all the specimens were subjected to a demineralization pH cycling model for 7 days. Specimens were examined for surface microhardness using Vickers microhardness device and lesion depth was evaluated by polarized light microscope using image J 1.46r software. Data were analyzed using paired t-test, independent t-test, and Mann Whitney U test. Results The test materials were significantly superior to their negative controls, (P < 0.001) and comparable to each other, (P > 0.05) regarding microhardness and lesion depth. In comparison to FV, NSF showed lower yet statistically insignificant percent increase in microhardness and decrease in lesion depth, (P = 0.81, 0.86, respectively). Qualitative evaluation revealed that both agents reduced the lesion depth formation. Conclusion NSF showed similar effect to that of FV in limiting in vitro enamel demineralization caused by acidic challenge. Hence, it could be regarded as a promising alternative preventive agent in primary teeth. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02271-6.
Collapse
Affiliation(s)
- Dina I El-Desouky
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Azza Hanno
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Yasmine Elhamouly
- Department of Pediatric and Community Dentistry, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt.
| | - Sara A Hamza
- Department of Oral Biology, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Lubna M El-Desouky
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt
| | - Karin M L Dowidar
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
24
|
Agarwal D, Purohit B, Ravi P, Priya H, Kumar V. Effectiveness of topical fluorides in prevention of radiation caries in adults: A systematic review and meta- analysis. Oral Oncol 2022; 129:105869. [PMID: 35483157 DOI: 10.1016/j.oraloncology.2022.105869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 01/18/2022] [Revised: 03/21/2022] [Accepted: 04/12/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Topical fluoride is used for prevention of dental caries. However, its effectiveness and more specifically its formulation and frequency of application in patients undergoing head and neck radiotherapy are still debatable. The aim of this systematic review was to pool the evidence of effectiveness of various topical fluorides in preventing radiation caries or change in bacterial growth in adult patients of head and neck cancer. METHODS Three databases (PubMed and Google Scholar and Cochrane) were searched for randomized controlled or uncontrolled trials or quasi randomised trials published till February 2021. Two independent reviewers screened 346 abstracts finally 14 articles were included in the current systematic review. Primary outcome evaluated was the prevention of radiation caries or change in bacterial growth in saliva. Meta-analysis was performed for the sub groups formed on the basis of fluoride formulations and adjuncts used with it. RESULTS Studies included were highly heterogeneous. Majority of studies found different fluoride formulations to be effective in controlling radiation caries to a variable extent up to 70% depending upon the intervention, patient compliance, rate of attrition and follow up period. Sodium fluoride was the most commonly used caries preventive agent. Meta-analysis showed no significant difference between sodium fluoride formulations and other fluoride agents. Fluoride treatment when incorporated with re-mineralising agent had no significant effect on caries prevention CONCLUSION: Fluoride prevents radiation caries. However, to delineate its exact formulation, dosage or frequency, there is need for more well conducted randomised controlled trials.
Collapse
Affiliation(s)
- Deepali Agarwal
- Division of Public Health Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Bharathi Purohit
- Division of Public Health Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Priyanka Ravi
- Division of Public Health Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Harsh Priya
- Division of Public Health Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Vijay Kumar
- Department of Oral and Maxillofacial Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
25
|
Skudutyte-Rysstad R, Mdala I, Uhlen MM. Fissure sealants or fluoride varnish? Factors associated with choice of management method for occlusal caries in Public Dental Service in Norway. Eur Arch Paediatr Dent 2022. [PMID: 35416617 DOI: 10.1007/s40368-022-00708-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 03/23/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of this practice-based study was to identify factors associated with choice of caries management method in first permanent molars in high-risk children treated in Public Dental Service in Norway. METHODS The present study was based on practice-based observational data from 366 high-risk children (6-9 years). Caries management of occlusal surface of first permanent molars was used as outcome variable and categorized into "no treatment", "fluoride varnish" or "fissure sealant". Patient-related variables (age, gender, oral hygiene, caries experience at age 5, sugar snacking and dental anxiety), tooth-related variables (upper or lower jaw and diagnosis of occlusal surface) and county were used as independent variables. Data were analysed by descriptive analyses followed by generalized structural equation models (GSEM) and presented as relative risk ratios (RRR) with 95% confidence intervals (CIs). RESULTS In 319 of the 366 children, both first permanent molars in the same jaw were available for analyses, 276 (87%) had the same diagnosis for both teeth and received the same treatment. Multivariable analysis at patient level showed that age (RRR = 2.42, CI 1.38, 4.23) and caries experience (RRR = 1.39, CI 1.09, 1.77) were associated with higher probability of fissure sealant, while the county variable was significantly associated with lower probability for fluoride varnish use (RRR = 0.03 (0.004, 0.31). CONCLUSION The majority of high-risk children in PDS received fluoride varnish or fissure sealants on newly erupted occlusal surfaces of first permanent molars. In addition to age and caries experience of the child, county appeared to substantially influence occlusal caries management method.
Collapse
|
26
|
Agarwal D, Kumar A, Ghanghas M, Bc M, Yadav V. Effectiveness of Fluoride Varnish in Prevention of Early Childhood Caries in 3-4 Years Old Children - A 36 Month Prospective Community Based Randomized Controlled Trial. J Clin Pediatr Dent 2022; 46:125-31. [PMID: 35533225 DOI: 10.17796/1053-4625-46.2.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Evidence for the benefit of applying Fluoride Varnish FV to permanent teeth is generally very positive. However, the caries-inhibiting effect of FVs on primary teeth is still debatable. AIM To assess the effectiveness of fluoride varnish in prevention of early childhood caries in children over the period of 3 years in high fluoride areas. STUDY DESIGN A double-blind cluster-randomized controlled trial was undertaken amongst 3-4 years old children. The varnish application was done at three points in the intervention group. RESULTS Experimental group showed significantly lesser increment in mean ICDAS score than control group at both 12 month and 36 months. Preventive fraction was 72.4% at 12 months and 18.2% at 36 months. Multiple linear regression showed that at 12 months, intervention was the significant predictor with varnish group having 0.140 (95% CI 0.175-0.230) lower net caries increment. At 36 months, baseline ICDAS score and intervention were the significant predictors. CONCLUSION This study suggests that fluoride varnish is an effective and a safe mode of prevention of early childhood caries in children residing in high fluoride zone. However, the overall effect is influenced by the baseline caries status.
Collapse
|
27
|
Lin PY, Wang J, Chuang TY, Chang YM, Chang HJ, Chi LY. Association between population-based fluoride varnish application services and dental caries experience among schoolchildren in Taiwan. J Formos Med Assoc 2021; 121:986-994. [PMID: 34353718 DOI: 10.1016/j.jfma.2021.07.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND/PURPOSE Taiwan government has provided population-based fluoride varnish application services for all preschool children since July 2004. This study investigated the association providing such services on dental caries experiences among schoolchildren. METHODS A cross-sectional study was conducted on schoolchildren aged 8-9 years. A questionnaire collected information on sociodemographic background, parents' oral health status, children's oral health-related behavior, and dietary habits. Dental caries was recorded through standardized oral examinations. The number of services was retrieved from the Taiwan National Health Insurance Research Database. Univariate, multivariable linear, and logistic regression analyses were performed. RESULTS The study involved 1246 children. The mean dental caries indices were 3.97 for decayed, extracted, and filled teeth (deft) and 0.94 for decayed, missing and filled teeth (DMFT). After adjustments for confounding factors, it was revealed that children receiving services were not associated with significantly lower deft and DMFT indices (P > 0.05). The adjusted odds ratio (OR) for untreated primary teeth of children receiving 3 or more services was 0.64 (95% CI = 0.44-0.95) compared with those who received no services (P = 0.025). However, subgroup analyses demonstrated that children in the low-risk group were mainly affected (adjusted OR = 0.36-0.89, P = 0.013). CONCLUSION This study revealed that children receiving 3 or more services were associated with a 36% decreased risk of having untreated caries in primary dentition, but these children were mainly in the low-risk group. These results illustrate real data that provides dentists and policymakers with valuable information.
Collapse
Affiliation(s)
- Po-Yen Lin
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jui Wang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tsai-Yi Chuang
- Department of Dentistry, En Chu Kong Hospital, New Taipei City, Taiwan
| | - Yung-Ming Chang
- Department of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan; Ministry of Health and Welfare, Taipei, Taiwan
| | - Hong-Ji Chang
- Department of Dentistry, Cheng Hsin General Hospital, Taipei, Taiwan.
| | - Lin-Yang Chi
- Department of Dentistry, School of Dentistry, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Education and Research, Taipei City Hospital, Taipei, Taiwan.
| |
Collapse
|
28
|
Bourouni S, Dritsas K, Kloukos D, Wierichs RJ. Efficacy of resin infiltration to mask post-orthodontic or non-post-orthodontic white spot lesions or fluorosis - a systematic review and meta-analysis. Clin Oral Investig 2021; 25:4711-4719. [PMID: 34106348 PMCID: PMC8342329 DOI: 10.1007/s00784-021-03931-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/11/2021] [Accepted: 03/30/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present review systematically analyzed clinical studies investigating the efficacy of resin infiltration on post-orthodontic or non-post-orthodontic, white spot lesions (WSL), or fluorosis. MATERIALS Five electronic databases (Central, PubMed, Ovid MEDLINE, Ovid EMBASE, LILACS) were screened. Article selection and data abstraction were done in duplicate. No language or time restrictions were applied. Outcomes were visual-tactile or DIAGNOdent measurements. RESULTS Eleven studies with 1834 teeth being affected in 413 patients were included. Nine studies were randomized control trials, one a prospective cohort study, and one had an unclear study design. Meta-analysis could be performed for "resin infiltration vs. untreated control," "resin infiltration vs. fluoride varnish," and "resin infiltration without bleaching vs. resin infiltration with bleaching." WSL being treated with resin infiltration showed a significantly higher optical improvement than WSL without any treatment (standard mean difference (SMD) [95% CI] = 1.24 [0.59, 1.88], moderate level of evidence [visual-tactile assessment]) and with fluoride varnish application (mean difference (MD) [95% CI] = 4.76 [0.74, 8.78], moderate level of evidence [DIAGNOdent reading]). In patients with fluorosis, bleaching prior to resin infiltration showed no difference in the masking effect compared to infiltration alone (MD [95% CI] = - 0.30 [- 0.98, 0.39], moderate level of evidence). CONCLUSION Resin infiltration has a significantly higher masking effect than natural remineralization or regular application of fluoride varnishes. However, although the evidence was graded as moderate, this conclusion is based on only very few well-conducted RCTs. CLINICAL RELEVANCE Resin infiltration seems to be a viable option to esthetically mask enamel white spot lesions and fluorosis.
Collapse
Affiliation(s)
- S Bourouni
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| | - K Dritsas
- Department of Orthodontics and Dentofacial Orthopedics, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - D Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, zmk bern, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| |
Collapse
|
29
|
Ying Lam PP, Sardana D, Luo W, Ekambaram M, Man Lee GH, Man Lo EC, Yung Yiu CK. Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A Randomized Controlled Trial. Caries Res 2021; 55:322-332. [PMID: 34284374 DOI: 10.1159/000517390] [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: 12/03/2020] [Accepted: 05/15/2021] [Indexed: 11/19/2022] Open
Abstract
Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3-4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0-1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group - application of 5% NaFV at 3-monthly intervals or GIS group - 1 single placement of GIS. A parental questionnaire was used to collect information on the children's sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (p = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.
Collapse
Affiliation(s)
- Phoebe Pui Ying Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China,
| | - Divesh Sardana
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Weijia Luo
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Gillian Hiu Man Lee
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong, China
| |
Collapse
|
30
|
Abufarwa M, Noureldin A, Campbell PM, Buschang PH. How different time intervals between repeated applications of CPP-ACP fluoride varnish effect smooth surface enamel demineralization? J Dent 2021; 112:103742. [PMID: 34224791 DOI: 10.1016/j.jdent.2021.103742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the preventive effects of different time intervals between repeated applications of the CPP-ACP fluoride varnish on enamel demineralization. METHODS Human teeth were sectioned and randomly allocated to three groups: 4-week, 6-week, and 12-week (N = 22/group). Baseline images of the enamel surfaces were obtained using the FluoreCam recording the area, intensity, and impact of baseline enamel demineralization. All groups received fluoride varnish applications at the beginning of the experiment. The varnish was reapplied every 4 or 6 weeks in the 4-week and 6-week groups, respectively. Following each application, the groups underwent thermo-cycling, tooth brushing and pH cycling to simulate the time effect. After 12 weeks, the enamel surfaces were reimaged using the FluoreCam. Within and between-group differences in the area, intensity and impact of demineralization were evaluated. RESULTS At baseline, there were no significant between-group differences for area, intensity, or impact. Statistically significant (p<0.001) enamel demineralization occurred over time within each group. There were significant between-group differences in the changes that occurred in area (P = 0.004), impact (P = 0.022), but not intensity. The 12-week had significantly larger areas of demineralization than the 6-week (P = 0.041) and 4-week (P = 0.001) groups. Changes in impact was significantly (P = 0.007) greater in the 12-week group than 4-week group, but not greater than the 6-week group. There were no statistically significant differences between 4- and 6-week groups in the changes of area, intensity, or impact. CONCLUSION Reapplication of the CPP-ACP fluoride varnish every 4-6 weeks, is more effective in reducing enamel demineralization compared to every 12 weeks.
Collapse
|
31
|
Moeintaghavi A, Ahrari F, Nasrabadi N, Fallahrastegar A, Sarabadani J, Rajabian F. Low level laser therapy, Er,Cr:YSGG laser and fluoride varnish for treatment of dentin hypersensitivity after periodontal surgery: A randomized clinical trial. Lasers Med Sci 2021; 36:1949-1956. [PMID: 33881673 DOI: 10.1007/s10103-021-03310-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/29/2021] [Indexed: 11/26/2022]
Abstract
This clinical trial aimed to compare the effects of low-level laser therapy (LLLT), Er,Cr;YSGG laser, and fluoride varnish, as compared to the placebo laser on decreasing dentin hypersensitivity (DH). This randomized, double-blinded clinical trial included 60 jaw quadrants in 24 patients who underwent periodontal surgery. The quadrants were randomly assigned to 4 groups and received treatments as follows. Group 1: LLLT with a combination of red and infrared wavelengths, group 2: Er,Cr:YSGG laser (0.25 W and 0.5 W), group 3: fluoride varnish, and group 4: placebo laser. The sensitivity response to the cold spray was recorded using visual analogue scale (VAS) at baseline, immediately, and 1 week post-treatment. The data were analyzed by repeated measures analysis at the significance level of P<0.05. There was a significant reduction in DH after treatment by low-level lasers, Er,Cr:YSGG laser, or fluoride varnish compared to the baseline data (P<0.05), but the placebo group displayed no significant alteration in DH (P=0.069). At 1 week, the VAS score in the Er,Cr:YSGG laser group was significantly lower than that of the LLLT (P= 0.043) and placebo (P<0.001) groups. Furthermore, the subjects who received fluoride varnish exhibited significantly lower DH compared with the placebo group (P = 0.023). Er,Cr:YSGG laser was the most effective strategy in dealing with DH, as it caused the greatest pain reduction over the study period and showed a significant superiority over LLLT and placebo groups. Alternatively, the application of fluoride varnish could be recommended for attenuating DH following periodontal surgery.
Collapse
Affiliation(s)
- Amir Moeintaghavi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Farzaneh Ahrari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran.
| | - Nahid Nasrabadi
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Amir Fallahrastegar
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad Blvd, Mashhad, Iran
| | - Javad Sarabadani
- Oral and Maxillofacial Disease Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Fatemeh Rajabian
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
32
|
Silva VM, Massaro C, Buzalaf MAR, Janson G, Garib D. Prevention of non-cavitated lesions with fluoride and xylitol varnishes during orthodontic treatment: a randomized clinical trial. Clin Oral Investig 2021; 25:3421-30. [PMID: 33835256 DOI: 10.1007/s00784-021-03930-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Fixed orthodontic appliances impair oral hygiene increasing the risk of non-cavitated lesions (NCLs) and tooth decay. The aim of this study was to compare the outcomes of fluoride and xylitol varnishes in preventing NCLs during comprehensive orthodontic treatment. MATERIALS AND METHODS The sample comprised 55 volunteers from 15 to 20 years of age under orthodontic treatment that were randomly divided into three groups: Fluoride Group (FG; n=17), Xylitol Group (XG; n=19), and Placebo Group (PG; n=19). The patients in each group received two applications of the following varnishes: DuraphatTM (5% NaF), 20% xylitol, and placebo (no F/Xylitol) in the three groups, respectively. The varnishes were applied in the first appointment (T0) and 3 months later (T1). Clinical examinations were carried out at T0 and 6 months after (T2) using the ICDAS index and the QLF system (fluorescence difference). The intergroup comparisons were performed by ANOVA/Tukey's or Kruskal-Wallis/Dunn's tests (P<0.05). RESULTS There was no significant intergroup difference regarding ICDAS index changes from T0 to T2. Fluoride varnish produced significantly greater increase in fluorescence of NCLs (mean change of -0.65 +0.78 and -0.56 +0.83, for maxilla and mandible, respectively) in comparison to the other groups. The majority of non-cavitated lesions improved in the fluoride and xylitol varnish groups. CONCLUSIONS Fluoride varnish produced significantly greater increase in enamel fluorescence compared to xylitol and placebo varnishes. In short term, both fluoride and xylitol varnishes produced remineralization of NCLs in orthodontic patients. CLINICAL RELEVANCE Non-cavitated lesions can be effectively controlled in high-risk orthodontic patients by means of fluoride varnishes. CLINICAL TRIAL REGISTRATION ReBEC Identifier: RBR-6mdxfq; Date of Register: March 19th, 2020. Retrospectively Registered.
Collapse
|
33
|
Yu L, Yu X, Li Y, Yang F, Hong J, Qin D, Song G, Hua F. The additional benefit of professional fluoride application for children as an adjunct to regular fluoride toothpaste: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:3409-3419. [PMID: 33782769 DOI: 10.1007/s00784-021-03909-5] [Citation(s) in RCA: 3] [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: 01/06/2021] [Accepted: 03/23/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess whether professional fluoride application (PFA) used in addition to regular fluoride toothpaste (RFT, ≥ 1,000 ppm) is more effective than RFT alone in children. MATERIALS AND METHODS A systematic search was conducted using the PubMed, Embase, Google Scholar and CENTRAL databases. Randomized controlled trials (RCTs) comparing the effectiveness of RFT + PFA and RFT alone were included. Meta-analyses with random-effects models were performed. The certainty of evidence was assessed using the GRADE approach. RESULTS A total of 2,729 records were identified from electronic and manual searches, which were screened by two reviewers independently and in duplicate. Six RCTs (5,034 participants) were included, of which four had high risk of bias and two had unclear risk of bias. The PFA used in all these trials was fluoride varnish (FV). In meta-analyses, no significant difference was observed between participants receiving FV + RFT and RFT alone of d(m/e)fs increment (mean difference (MD) - 0.17, 95% confidence interval (CI) - 0.60 to 0.26, P = 0.43, I2 = 38%; 6 trials, 5,034 participants, moderate certainty evidence), incidence of caries (risk ratio (RR) 0.91, 95% CI 0.80 to 1.05, P = 0.21, I2 = 41%; 4 trials, 4,487 participants, moderate certainty evidence) or changes in prevalence of caries (RR 0.89, 95% CI 0.78 to 1.01, P = 0.07, I2 = 0%, 4 trials, 4,189 participants, low certainty evidence). CONCLUSIONS Low to moderate certainty evidence suggests that FV does not have significant additional caries-preventive benefit for children (under 8 years old) when provided as an adjunct to daily tooth brushing with RFT (≥ 1,000 ppm). There is insufficient evidence regarding the additional benefit of other PFA interventions. CLINICAL RELEVANCE The decision to apply FV to children needs to be made in light of their actual usage of RFT. TRIAL REGISTRATION PROSPERO (CRD42020165270).
Collapse
Affiliation(s)
- Lintong Yu
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China
| | - Xueqian Yu
- Library, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yueyang Li
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Fengjiao Yang
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China
| | - Jialan Hong
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Danchen Qin
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Guangtai Song
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China.
| | - Fang Hua
- Centre for Evidence-Based Stomatology, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China.
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
| |
Collapse
|
34
|
Mascarenhas AK. Is fluoride varnish safe?: Validating the safety of fluoride varnish. J Am Dent Assoc 2021; 152:364-368. [PMID: 33766405 DOI: 10.1016/j.adaj.2021.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Fluoride varnish is widely used in dentistry as a caries preventive measure with recommendations for its use even in infants. In addition, nondental providers are also applying varnish on children's teeth in various settings. However, there are questions from these nondental providers as to the safety of fluoride varnish. METHODS To evaluate and describe the adverse events (AEs) related to fluoride varnish, the US Food and Drug Administration's Manufacturer and User Facility Device Experience database was used. AEs reported for the dental product code for "varnish, cavity," "varnish," and "fluoride" were evaluated. The identified AEs were then reviewed and categorized using appropriate key words for the various signs and symptoms, outcomes, and treatment. RESULTS Over the 10-year period, only 65 AEs were reported for fluoride varnish products. Swelling (33.8%); burning, itching, or soreness (23.1%); and rash (16.9%) were the most common signs and symptoms reported. The most common site reported was the lips (27.7%). The most common outcome was that the patient was taken to the hospital (18.5%) or emergency department (15.4%). No deaths were reported. The patients were treated primarily using diphenhydramine (Benadryl, Johnson & Johnson Consumer) (26.1%), followed by an epinephrine autoinjector (EpiPen, Mylan) and other forms of epinephrine (15.4%), and prednisolone (9.2%). In 16.9% of the cases with AEs there was a history of allergies. The rate of AEs is estimated to be between 0.099 and 0.105 per million for fluoride varnish. A concern is the likelihood of underreporting AEs in the Manufacturer and User Facility Device Experience database. CONCLUSIONS Given the widespread use of fluoride varnish in the United States, the number of AEs reported to the US Food and Drug Administration were few. Thus fluoride varnish can be considered a safe dental product. PRACTICAL IMPLICATIONS Provides data on the safety of fluoride varnish that can be used by the dental profession to allay concerns by nondental providers and patients on this important caries preventive measure.
Collapse
|
35
|
Timms L, Hume C, Wilson V, McClean L, Marshman Z, Zaitoun H. A service evaluation of an intervention to increase application of topical fluoride varnish in general dental practice in South Yorkshire. Eur Arch Paediatr Dent 2021; 22:93-7. [PMID: 32418054 DOI: 10.1007/s40368-020-00539-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 05/03/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Dental caries is still common in children in the UK despite many available preventative interventions. Application of topical fluoride varnish can reduce caries experience. National and international guidance recommends at least twice-yearly application of topical fluoride varnish, however guidance is not always followed. This project aimed to first identify the proportion of patients receiving fluoride varnish by their primary care dental practitioner prior to their referral to a secondary care service and subsequently increase this rate by introducing an intervention. METHODS The intervention required the referring practitioner to document the date of which topical fluoride was applied prior to referral. Referrals without this information were rejected. Data were collected pre and post this change in policy to ascertain fluoride application rates. Parents and children were questioned about the frequency of application, and referral forms were reviewed for practitioner-reported application. RESULTS Topical fluoride application rates improved by 19% points for patient-reported application, and 31% points for practitioner-reported application. The biggest increase in application rate was in the cohort of patients receiving 6-monthly fluoride application. CONCLUSION This study demonstrated that a simple intervention, mandating that primary care dental practitioners record the most recent application of topical fluoride before referring a patient to secondary care, can improve the rates of topical fluoride varnish application in the UK.
Collapse
|
36
|
Lena Sezici Y, Yetkiner E, Aykut Yetkiner A, Eden E, Attin R. Comparative evaluation of fluoride varnishes, self-assembling peptide-based remineralization agent, and enamel matrix protein derivative on artificial enamel remineralization in vitro. Prog Orthod 2021; 22:4. [PMID: 33491110 PMCID: PMC7829296 DOI: 10.1186/s40510-020-00345-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 12/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background One of the most unfavorable side effects of fixed orthodontic treatment is white spot lesions (WSLs). Although the most important approach is prevention of WSLs, it is also essential to evaluate the efficacy of the remineralization agents. However, there is no concurrence in the literature with respect to the remineralization process of these agents. The objective of the present study was to evaluate the effects of different fluoride varnishes, enamel matrix protein, and self-assembling peptide derivatives with varying chemical compositions on remineralization of artificially created WSLs in vitro using quantitative light-induced fluorescence (QLF). Methods Artificial WSLs were created on bovine enamel samples using acidic buffer solution (pH 5, 10 days). Specimens were randomly allocated to six groups (n = 10/group): (1) Emdogain (Straumann, Basel, Switzerland), (2) Curodont Repair (Credentis AG, Switzerland), (3) Duraphat (Colgate-Palmolive, New York, NY), (4) Clinpro XT (3 M ESPE, Pymble, New South Wales, Australia), (5) Enamel Pro Varnish (Premier Dental Products, PA, USA), and (6) control (untreated). The agents were applied to the WSLs according to the manufacturers’ instructions. Fluorescence loss (ΔF), lesion area (area), and impact (ΔQ) values of enamel surfaces were quantified by QLF-D BiluminatorTM (Inspektor-Pro, Amsterdam, The Netherlands) at baseline and after 7, 14, and 21 days of application of the respective materials. Results ΔF value presented a significantly decreasing trend throughout the 21 days for all groups except the Duraphat and Enamel Pro varnishes. The changes between 14th and 21st days of the Clinpro XT varnish application were significantly higher than Emdogain, Curodont, and Enamel Pro. The Curodont group showed higher lesion area changes between the first and second week in comparison to the Emdogain, Clinpro XT, and Enamel Pro groups, whereas Clinpro XT assured the highest reduction from the second to the third week of the observation period. Conclusions The fluorescence loss was significantly reduced with enamel matrix protein, self-assembling peptide, and light-curable fluoride varnishes in the analysis for 21 days. Curodont and Clinpro XT were effective in diminishing the fluorescence loss and lesion area compared to the Duraphat, Enamel Pro fluoride varnishes, and Emdogain in different time points.
Collapse
Affiliation(s)
| | - Enver Yetkiner
- Department of Orthodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Arzu Aykut Yetkiner
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey.
| | - Ece Eden
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Rengin Attin
- Clinic for Orthodontics and Pediatric Dentistry, University of Zurich, Zurich, Switzerland
| |
Collapse
|
37
|
Vertuan M, Souza BM, Mosquim V, Silva CV, Freitas PM, Borges AFS, Rios D, Magalhães AC, Honório HM. Effect of TiF 4 varnish after pre-treatment with proanthocyanidin or chlorhexidine on the progression of erosive dentin loss in the presence or absence of the demineralized organic matrix. J Mech Behav Biomed Mater 2021; 115:104287. [PMID: 33352427 DOI: 10.1016/j.jmbbm.2020.104287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/09/2020] [Accepted: 12/13/2020] [Indexed: 11/23/2022]
Abstract
This study evaluated the protective effect of TiF4 varnish, after pre-treatment with proantocyanidin or chlorhexidine, on the progression of erosive dentin loss (EDL), under the presence or absence of the demineralized organic matrix (DOM). Bovine root dentin samples were eroded for 30 min (0.1% citric acid, pH 2.5) and the loss was measured by profilometry. Half of them were subjected to the DOM removal using collagenase for 4 days, while the other half remained immersed in water. The removal of DOM was checked by profilometry. Samples were divided into 24 groups (n = 15) according to the factors: 1- With or without DOM; 2- Pre-treatment with 0.012% chlorhexidine gel, 10% proanthocyanidin gel or untreated for 1 min; 3-Final Treatment with TiF4 varnish, NaF varnish, placebo varnish or untreated for 6 h. The samples were submitted to a pH cycling for 5 days: 0.1% citric acid (4 × 90s/day) and artificial saliva between the challenges. The final profile was obtained for the calculation of EDL (μm, three-way ANOVA/Tukey test). When DOM was preserved, the EDL was lower compared to the condition without DOM (7.08 ± 4.03 μm and 9.80 ± 3.79 μm, p < 0.001, respectively), regardless of the treatments. The pre-treatment had no influence on the progression of EDL (p = 0.637), while the final treatment (TiF4 varnish only, 6.77 ± 4.08 μm) was effective in reducing the progression of EDL (NaF varnish: 9.52 ± 4.02 μm; Placebo varnish: 8.64 ± 4.06 μm and no treatment: 8.80 ± 3.95 μm). It can be concluded that DOM has important protective effect on the progression of EDL. TiF4 was the unique treatment capable of reducing EDL progression, regardless of the pre-treatment of DOM.
Collapse
|
38
|
Bakhurji E. Fluoride Varnish Application in Preschoolers Have a Modest Effectiveness in Reducing the Incidence of Dentinal Caries. J Evid Based Dent Pract 2020; 20:101489. [PMID: 33303097 DOI: 10.1016/j.jebdp.2020.101489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Fluoride Varnish and Dental Caries in Preschoolers: A Systematic Review and Meta-Analysis. de Sousa FSO, Dos Santos APP, Nadanovsky P, Hujoel P, Cunha-Cruz J, de Oliveira BH. Caries Res. 2019;53(5):502-513. SOURCE OF FUNDING Government. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data.
Collapse
|
39
|
Alhamed M, Almalki F, Alselami A, Alotaibi T, Elkwatehy W. Effect of different remineralizing agents on the initial carious lesions - A comparative study. Saudi Dent J 2020; 32:390-395. [PMID: 33304082 PMCID: PMC7714979 DOI: 10.1016/j.sdentj.2019.11.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/03/2019] [Accepted: 11/05/2019] [Indexed: 11/18/2022] Open
Abstract
Objectives This study aimed to assess and compare the effectiveness of three different remineralizing agents (Tricalcium phosphate paste, Fluoride varnish, and Nano-hydroxyapatite gel) using the DIAGNOdent device. Material and Methods The present clinical study was carried out on 90 initial carious lesions detected by ICDAS caries diagnostic criteria and then take the baseline record by DIAGNOdent device. The selected initial carious lesions were randomly classified into three groups according to treatment modalities (30 lesions in each group) according to remineralizing agents: group A (TCP), group B (fluoride varnish) and group C (nano-hydroxyapatite gel). The remineralizing agents were applied for four minutes once weekly for four weeks. At the fifth week, the DIAGNOdent scores of initial carious lesions were recorded to evaluate the effect of remineralizing agents. A paired t-test was used to compare between baseline date and follow up of DIAGNOdent scores. A one-way ANOVA test was used to compare DIAGNOdent scores among the three groups. Post- Hoc Tukey test was used to determine the significant difference between every two groups. Results There were statistically significant differences among the three groups at follow up (p = 0.001). Within each group, there was a significant difference between baseline and follow up scores (p = 0.000 for the three groups). Multiple comparisons between every two groups showed a highly statistically significant difference at follow up records between nano-hydroxyapatite versus TCP and fluoride varnish on pit and fissure caries (p = 0.039 and p = 0.007 respectively) and the nano-hydroxyapatite was the best of them. Conclusion The present study concluded that the three remineralizing agents were effective in the treatment of initial carious lesion and the most effective remineralizing agent was nano-hydroxyapatite.
Collapse
Affiliation(s)
- Mohammed Alhamed
- Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
- Corresponding author at: College of Dentistry, Umm Al-Qura University, P.O. Box 2653, Makkah 24351, Saudi Arabia.
| | - Faisal Almalki
- Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Ahmad Alselami
- Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Tariq Alotaibi
- Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
| | - Wahdan Elkwatehy
- Faculty of Dentistry, Umm Al-Qura University, Saudi Arabia
- Department of Pediatric, Dental Public Health and Preventive Dentistry, Faculty of Dentistry, Mansoura University, Egypt
| |
Collapse
|
40
|
Skinner J, Dimitropoulos Y, Rambaldini B, Calma T, Raymond K, Ummer-Christian R, Orr N, Gwynne K. Costing the Scale-Up of a National Primary School-Based Fluoride Varnish Program for Aboriginal Children Using Dental Assistants in Australia. Int J Environ Res Public Health 2020; 17:E8774. [PMID: 33255962 DOI: 10.3390/ijerph17238774] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 12/13/2022]
Abstract
There is good evidence that fluoride varnish programs are effective in preventing dental caries in children. This study aims to provide a costing for the scale-up of a child fluoride varnish program in New South Wales (NSW), Australia. Most child fluoride varnish programs are school-based, and a number of studies have examined the acceptability and cost effectiveness of using non-dental providers to apply the fluoride varnish. This paper describes the number of primary schools in Australia that could be targeted using a standard population-based risk criteria based on published data. A costing method was developed for various scenarios of school enrolment and provider types, along with potential revenue from the Child Dental Benefits Schedule (CDBS). Most of the costs of a school-based fluoride varnish program can be covered by the CDBS with assumptions of 80% child consent and 75% CDBS eligibility. While the scale-up of child fluoride varnish programs to prevent dental caries has been recommended by numerous strategic plans and reports, particularly for Aboriginal and Torres Strait Islander children, limited progress has been made. This paper concludes that using a standardized criteria for targeting schools using a combination of ICSEA and Aboriginal enrolments, and aiming at four applications a year, is feasible, and that the main costs of the program could be covered by using the CDBS.
Collapse
|
41
|
Luksamijarulkul N, Pongpanich S, Panza A. Protective factors for caries of a school-based oral health program in Bangkok, Thailand: a retrospective cohort study. Public Health 2020; 187:53-8. [PMID: 32898761 DOI: 10.1016/j.puhe.2020.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/01/2020] [Accepted: 07/03/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of the study was to assess protective factors of a school-based oral health preventive program on caries in permanent teeth in students and to identify other risk and protective factors associated with caries in this group. STUDY DESIGN This is a retrospective cohort study. METHODS A total of 433 students were examined in the 1st grade and followed up until the 6th grade. Each student was annually assessed for caries as per the World Health Organization index. Binary simple and multiple logistic regressions were performed to assess risk or protective factors with a P-value ≤0.05. RESULTS In 1st graders, the caries prevalence in deciduous teeth was 87.2%, and the mean decayed, missing and filled teeth (dmft) index was 6.44 (±4.4); in 6th graders, the caries prevalence in permanent teeth was 51.7%, and the mean DMFT was 1.37 (±1.84). Protective factors for caries in permanent teeth were complete participation in the program, receiving fluoride varnish >4 times, and sealant applications on all first molars. Risk factors were female sex and caries prevalence in deciduous teeth. After multiple logistic regression, sealant application only remained significant, with an odds ratio (OR) of 0.19 (95% confidence interval [CI] = 0.06-0.63, P = 0.007), and for risk factor, caries prevalence in deciduous teeth only remained significant, with an OR of 5.44 (95% CI = 2.23-13.27, P < 0.001). CONCLUSIONS There is an association between deciduous dentition caries and permanent dentition caries. Early prevention in school settings by applying fluoride varnish and dental sealants onto molars is protective and feasible. The study suggests that regular fluoride varnish and sealant applications should be extended to similar low-income area schools.
Collapse
|
42
|
Konagala RK, Mandava J, Anwarullah A, Uppalapati LV, Karumuri S, Angadala PL. Synergistic Effect of Arginine on Remineralization Potential of Fluoride Varnish and Nanohydroxyapatite on Artificial Caries Lesions: An In Vitro Study. J Contemp Dent Pract 2020; 21:1048-1053. [PMID: 33568594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
AIM AND OBJECTIVE To evaluate the synergistic effect of arginine on the remineralizing potential of fluoride varnish and nanohydroxyapatite. MATERIALS AND METHODS A total of 100 teeth were taken; of them, 50 teeth were allotted for microhardness test and 50 teeth for scanning-electron microscopy (SEM) with energy-dispersive X-ray spectroscopy (EDX) analysis. Fifty teeth used for hardness testing were sectioned to obtain 100 samples, and the baseline hardness values were measured. Samples were allotted into five groups (n = 20): group I: arginine; group II: fluoride varnish; group III: nanohydroxyapatite; group IV: arginine + fluoride varnish; group V: arginine + nanohydroxyapatite. Microhardness values were measured after 96 hours of demineralization and then again after application of remineralizing agents (pH cycling) for 10 days to check for gain in microhardness. The other 50 samples were subjected to SEM-EDX analysis for evaluating gain in the mineral content after demineralization and after application of the remineralizing agents. The collected data were subjected to statistical analysis using SPSS software version 22.0. RESULTS The maximum mean microhardness values were observed in group IV and group V. There was no statistical significance between them. Similarly, maximum mineral gain was seen in groups IV and V. A significant increase in fluoride gain was seen in group IV. CONCLUSION Arginine has a synergistic effect on remineralization potential of fluoride varnish and nanohydroxyapatite. CLINICAL SIGNIFICANCE The incorporation of arginine into fluoride varnishes and nanohydroxyapatite significantly increased their remineralization potential.
Collapse
Affiliation(s)
- Ravi K Konagala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India, Phone: +91 9493415354, e-mail:
| | - Jyothi Mandava
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Anupreeta Anwarullah
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Lakshman V Uppalapati
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Srujana Karumuri
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| | - Priyanka L Angadala
- Department of Conservative Dentistry and Endodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India
| |
Collapse
|
43
|
Rechmann P, Kubitz M, Chaffee BW, Rechmann BMT. Fissure caries inhibition with a CO 2 9.3-μm short-pulsed laser-a randomized, single-blind, split-mouth controlled, 1-year clinical trial. Clin Oral Investig 2021; 25:2055-68. [PMID: 32803438 DOI: 10.1007/s00784-020-03515-x] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The objective of this randomized, single-blind, split-mouth controlled, clinical trial was to evaluate whether the use of a short-pulsed 9.3-μm CO2 laser increases the caries resistance of occlusal pit and fissures in addition to fluoride therapy over 12 months. MATERIALS AND METHODS A total of 60 participants, average age 13.1 years, were enrolled. At baseline, second molars were randomized into test and control, and assessed by ICDAS, SOPROLIFE, and DIAGNOdent. An independent investigator irradiated test molars with a CO2 laser (wavelength 9.3 μm, pulse duration 4 μs, pulse repetition rate 43 Hz, beam diameter 250 μm, average fluence 3.9 J/cm2, 20 laser pulses per spot). Test molars received laser and fluoride treatment, control teeth fluoride alone. Fluoride varnish was applied at baseline and at 6 months. After 6 and 12 months, teeth were again assessed. RESULTS A total of 57 participants completed the 6-month and 51 the 12-month recall. Laser-treated surfaces showed very slight ICDAS improvements over time with ICDAS change - 1 in 11% and 8%, no changes (ICDAS change 0) in 68% and 67%, and slightly worsened (ICDAS change 1) in 19% and 24% at 6- and 12-month recalls, respectively, and worsened by two scores in 2% at both recall time points. Control teeth showed significantly higher ICDAS increases, with 47% and 25% showing ICDAS change 0, ICDAS change 1 in 49% and 55%, and ICDAS change 2 in 4% and 20% at 6- and 12-month recalls, respectively. Differences in ICDAS changes between the groups were statistically significant (P = 0.0002 and P < 0.0001; Wilcoxon's signed-rank test, exact). A total of 22% of the participants developed ICDAS 3 scores on the control teeth. CONCLUSIONS Microsecond short-pulsed 9.3-μm CO2 laser irradiation markedly inhibits caries progression in pits and fissures in comparison with fluoride varnish alone. CLINICAL RELEVANCE The 9.3-μm CO2 laser irradiation of pits and fissures enhances caries resistance. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02357979.
Collapse
|
44
|
Son JL, Kim AJ, Oh S, Bae JM. Inhibitory effects on Streptococcus mutans of antibacterial agents mixed with experimental fluoride varnish. Dent Mater J 2020; 39:690-695. [PMID: 32522914 DOI: 10.4012/dmj.2020-016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We investigated the inhibitory effect of antibacterial agents mixed with experimental fluoride varnish (EFV) on Streptococcus mutans. The antibacterial agents used were (1 and 10) mM of xanthorrhizol, bakuchiol, bavachalcone, isobavachromene, and bavachromene. Agar diffusion tests were performed on S. mutans (1.1×1010 CFU/mL), using antibacterial agents without and with EFV. Bavachalcone showed the highest inhibition zone without and with EFV at both (1 and 10) mM (p<0.05). All EFV with antibacterial agents showed greater inhibition and semi-inhibition zones than EFV alone (p<0.05). The cell viability of each antibacterial agent was not significantly different from the vehicle controls (p>0.05), except xanthorrhizol and bakuchiol at 1 mM. All antibacterial agents were effective, while antibacterial agents with EFV co-formulations were more effective than EFV alone. Bavachalcone was the most effective agent against S. mutans, indicating its potential usefulness with fluoride varnish in preventing dental caries.
Collapse
Affiliation(s)
- Ju-Lee Son
- Department of Dental Biomaterials, College of Dentistry, Wonkwang University
| | - Ah-Jin Kim
- Department of Dental Hygiene, Sorabol College
| | - Seunghan Oh
- Dental Biomaterials and Institute of Biomaterials · Implant, College of Dentistry, Wonkwang University
| | - Ji-Myung Bae
- Dental Biomaterials and Institute of Biomaterials · Implant, College of Dentistry, Wonkwang University
| |
Collapse
|
45
|
Mabangkhru S, Duangthip D, Chu CH, Phonghanyudh A, Jirarattanasopha V. A randomized clinical trial to arrest dentin caries in young children using silver diamine fluoride. J Dent 2020; 99:103375. [PMID: 32428523 DOI: 10.1016/j.jdent.2020.103375] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES The study aimed to compare the effectiveness of 38% silver diamine fluoride (SDF) solution, and 5% sodium fluoride (NaF) varnish applied semiannually in arresting dentin caries in young children with high caries risk. METHODS Children aged 1-3 years who had at least one active dentin carious lesion were randomly allocated into 2 groups as follows: Group 1 = 38% SDF (Topamine), and Group 2 = 5% NaF varnish (Duraphat). Both agents were applied every 6 months onto the carious surface. Lesion activity was assessed by the visual-tactile examination. Baseline and follow-up examinations were conducted by the same examiner. The children's demographic background, oral health-related habits, and oral hygiene practices, as well as parental satisfaction with children's dental appearance were collected at baseline and the 12-month follow-up. RESULTS At baseline, 153 and 149 children were recruited in Group 1 and Group 2, respectively. The mean dmfs scores in Groups 1 and 2 were 8.89 and 9.79, respectively. After 12 months, 87.1% remained in the study. The caries arrest rate of Group 1 (35.7%) was significantly higher than that of Group 2 (20.9%) (p < 0.001). The results of the multilevel logistic regression analysis confirmed that the treatment in Group 1 was more effective in arresting dentin carious lesions than that of Group 2 (OR = 2.04; 95% CI, 1.41-2.96). The presence of plaque on caries lesions, tooth type, tooth surface type, frequency of milk feeding, snack taking, and family income influenced on caries activity. Regardless of the intervention groups, there were no differences in parental satisfaction with on the child's dental appearance before and after receiving the intervention. CONCLUSION Based on the 12-month results, 38% SDF is more effective than 5% NaF varnish in arresting dentin carious lesions in young children. SDF has no negative impact on parental satisfaction with the child's dental appearance. CLINICAL SIGNIFICANCE To control dentin carious lesions in young children with high caries risk, 38% SDF is more effective than 5% NaF varnish.
Collapse
|
46
|
Wu S, Zhang T, Liu Q, Yu X, Zeng X. Effectiveness of fluoride varnish on caries in the first molars of primary schoolchildren: a 3-year longitudinal study in Guangxi Province, China. Int Dent J 2019; 70:108-115. [PMID: 31705529 DOI: 10.1111/idj.12528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
AIMS To evaluate the effectiveness of 5% sodium fluoride varnish on caries in first permanent molars and to assess the suitability of using this method to control caries among children in rural areas of Guangxi province, China. METHODS A total of nine schools with 32 classes were selected by simple random sampling. There were 999 students in the experimental group and 1,004 in the control group. The experimental group received oral health education and topical application of 5% sodium fluoride varnish, while the control group received oral health education only. Dental examinations were performed in November 2014 and November 2017, and the modified International Caries Detection and Assessment System (ICDAS-II) was used to record the caries status of the first permanent molars. The data were entered into SPSS 22 for statistical analysis. RESULTS A total of 1,748 students (853 in the experimental group and 895 in the control group) completed the study. After 3 years of intervention, the experimental group had a lower prevalence of caries, a lower caries increment, a lower decayed, missing and filled teeth (DMFT) index and a lower decayed, missing and filled surfaces (DMFS) index compared with the control group (respectively: 58.9% vs 65.5%, 34.8% vs 42.1%, 1.38 vs 1.59 and 2.06 vs 2.38). All the differences were statistically significant (P < 0.05). CONCLUSION In this study population, twice-yearly application of 5% sodium fluoride varnish and oral health education were more effective for preventing caries in first permanent molars than oral health education alone. The implementation of fluoride varnish application as a public health measure in schools in rural areas is recommended.
Collapse
Affiliation(s)
- Shanshan Wu
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Tingting Zhang
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Qiulin Liu
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Xueting Yu
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| | - Xiaojuan Zeng
- Department of Dental Public Health, College of Stomatology, Guangxi Medical University, Nanning, China
| |
Collapse
|
47
|
Dahlberg D, Hiott DB, Wilson CC. Implementing Pediatric Fluoride Varnish Application in a Rural Primary Care Medical Office: A Feasibility Study. J Pediatr Health Care 2019; 33:702-710. [PMID: 31477489 DOI: 10.1016/j.pedhc.2019.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 05/24/2019] [Accepted: 06/02/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The objective of this study was to determine if the application of fluoride varnish (FV) to children 5 years and under was acceptable and practical for health care providers in a rural primary care office. METHODS We employed a quasi-experimental study design comprised of providers who received education and training in FV application. Pre- and post-study surveys regarding barriers and facilitators were administered. Data was collected on the number of FV applications, time spent on procedure, perceived barriers, and overall cost. RESULTS The total direct variable cost of providing FV was $4.35 per procedure, resulting in an $11.85 profit. FV application increased 9.57%. Potential barriers were lack of proper supplies, lack of adequate support staff, and lack of additional financial compensation for providers. DISCUSSION FV application is a service that can be delivered in a rural practice with existing resources, but the initiative needs support from practice management.
Collapse
|
48
|
Pichaiaukrit W, Thamrongananskul N, Siralertmukul K, Swasdison S. Fluoride varnish containing chitosan demonstrated sustained fluoride release. Dent Mater J 2019; 38:1036-1042. [PMID: 31611494 DOI: 10.4012/dmj.2018-112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Fluoride varnish is a professionally applied product that prevents dental caries. However, fluoride varnishes do not provide sustained fluoride release. The objective of this study was to prepare fluoride varnish formulations containing various amounts of chitosan that would generate sustained fluoride release. We evaluated their chemical structure, viscosity, and in vitro fluoride release. Furthermore, the 3-(4, 5-dimethylthiazolyl-2)-2,5diphenyltetrazolium bromide (MTT) assay and direct contact test were used to determine varnish cytotoxicity. We found that all fluoride varnish formulations had the same chemical structure. Their viscosity demonstrated a chitosan concentration-dependent increase. In vitro fluoride release showed a sustained fluoride release. The chitosan fluoride varnishes were cytotoxic to human gingival fibroblasts. We propose the new fluoride varnish formulation as a potential material to be used as a sustained release fluoride varnish.
Collapse
Affiliation(s)
- Woradej Pichaiaukrit
- Dental Biomaterials Science, Graduate School-Interdisciplinary Program, Chulalongkorn University
| | | | | | - Somporn Swasdison
- Department of Oral Medicine, College of Dental Medicine, Rangsit University
| |
Collapse
|
49
|
Abstract
INTRODUCTION Interproximal enamel reduction (IPR) is a clinical procedure that has been in use since the advent of non-extraction orthodontic techniques. However, such a procedure affects the surface condition of the enamel and may predispose patients to cavities and hypersensitivity. The use of a remineralizing agent is recommended to prevent these side effects. The objective of our study was to evaluate the evolution of stripped proximal dental surfaces after exposure to the oral environment for 4 months with and without fluoride protection. MATERIALS AND METHODS Our sample consisted of 14 premolars (PM) from 6 patients of the Dentofacial Orthopaedics Department of the Consultation and Dental Treatment Centre of Rabat (CDTC) who required orthodontic treatment with PM extraction and had given their informed consent. The teeth were divided into 5 groups: group 1: intact enamel; group 2: intact enamel+fluoride varnish+4-month oral exposure; group 3: IPR (manual and mechanized)+extraction; group 4: IPR (manual and mechanized) without varnish+4-month oral exposure; group 5: IPR (manual and mechanized)+fluoride varnish+4-month oral exposure. Proximal surfaces were subjected to qualitative analysis by scanning electron microscopy and quantitative analysis by Dispersive Energy Spectroscopy (DES) to quantify the percentage of mineral elements. RESULTS Exposure of stripped dental surfaces to the oral environment for 4 months with or without fluoride protection showed the persistence of surface irregularities caused by stripping. We noted an improvement in the percentage of mineral elements for both groups with and without fluoride protection. However, the percentages of calcium (Ca) and phosphorus (P) were close to that of intact enamel in the fluoride varnish group. CONCLUSION Protecting stripped surfaces with fluoride varnish could help preserve the integrity of the enamel surface by restoring some of the mineral elements lost during stripping.
Collapse
Affiliation(s)
- Hajar Ben Mohimd
- Institut, université Mohammed V à Rabat, centre de consultation et de traitement dentaire, faculté de médecine dentaire, département d'orthopédie dentofaciale, avenue Allal El Fassi, Mohammed Jazouli street, Al Irfane, BP 6212, Rabat, Morocco.
| | - Yassine Kaaouara
- Institut, université Mohammed V à Rabat, centre de consultation et de traitement dentaire, faculté de médecine dentaire, département d'orthopédie dentofaciale, avenue Allal El Fassi, Mohammed Jazouli street, Al Irfane, BP 6212, Rabat, Morocco
| | - Faouzi Azaroual
- Institut, université Mohammed V à Rabat, centre de consultation et de traitement dentaire, faculté de médecine dentaire, département d'orthopédie dentofaciale, avenue Allal El Fassi, Mohammed Jazouli street, Al Irfane, BP 6212, Rabat, Morocco
| | - Fatima Zaoui
- Institut, université Mohammed V à Rabat, centre de consultation et de traitement dentaire, faculté de médecine dentaire, département d'orthopédie dentofaciale, avenue Allal El Fassi, Mohammed Jazouli street, Al Irfane, BP 6212, Rabat, Morocco
| | - Loubna Bahije
- Institut, université Mohammed V à Rabat, centre de consultation et de traitement dentaire, faculté de médecine dentaire, département d'orthopédie dentofaciale, avenue Allal El Fassi, Mohammed Jazouli street, Al Irfane, BP 6212, Rabat, Morocco
| | - Hicham Benyahia
- Institut, université Mohammed V à Rabat, centre de consultation et de traitement dentaire, faculté de médecine dentaire, département d'orthopédie dentofaciale, avenue Allal El Fassi, Mohammed Jazouli street, Al Irfane, BP 6212, Rabat, Morocco
| |
Collapse
|
50
|
Uhlen MM, Wang NJ, Skudutyte-Rysstad R. Fissure sealants or fluoride varnish? Routines and attitudes among dental health personnel in Norway. Eur Arch Paediatr Dent 2019; 20:577-583. [PMID: 30980252 DOI: 10.1007/s40368-019-00440-w] [Citation(s) in RCA: 4] [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: 11/09/2018] [Accepted: 04/08/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate routines and attitudes among dentists and dental hygienists concerning use of fissure sealants and fluoride varnish for non-operative management of occlusal caries. METHODS All dentists and dental hygienists working in child dental care in three counties in Norway were invited to answer a questionnaire on routines for use of fissure sealants and fluoride varnish. Nine statements regarding attitudes towards use of sealants were scored using a five-point Likert scale. Multivariable logistic regression analyses were performed to assess indicators associated with reported routines for use of sealants and varnish. The study was approved by the Norwegian Centre for Research Data. RESULTS In total 142 of 189 (75%) dentists and dental hygienists answered the questionnaire. The majority of the respondents, n = 83 (59%), reported to prefer fissure sealants while fluoride varnish was preferred by 57 (41%) of the respondents. Frequent use of fissure sealants was reported by 58 (41%) and frequent use of varnish by 104 (74%) of the respondents. Most (n = 104, 74%), used sealants on specific indications, and 89 (64%) opened fissures only when suspecting dentine caries. Preferred method and routines for occlusal caries management differed between counties (p < 0.05). Almost all clinicians agreed with the statement that sealants are protective against caries, while statements regarding costs, technique sensitivity and children's cooperation revealed some concerns regarding fissure sealing. CONCLUSIONS Fissure sealants were the preferred method for occlusal caries management despite reported concerns related to technical aspects and patient cooperation. County-level variation in frequency of sealant use was observed.
Collapse
Affiliation(s)
- M-M Uhlen
- Oral Health Centre of Expertise in Eastern Norway, Sørkedalsveien 10A, 0369, Oslo, Norway
| | - N J Wang
- Oral Health Centre of Expertise in Eastern Norway, Sørkedalsveien 10A, 0369, Oslo, Norway
| | - R Skudutyte-Rysstad
- Oral Health Centre of Expertise in Eastern Norway, Sørkedalsveien 10A, 0369, Oslo, Norway.
| |
Collapse
|