Five-to-five clear aligner therapy: predictable orthodontic movement for general dentist to achieve minimally invasive dentistry

Background

Esthetic dentistry has become a very important aspect of every dental treatment from the patient perspective, whether it is orthodontics or implant therapy. The aim of this article is to describe the advantages of a newly developed branch of five-to-five clear aligner therapy (CAT) (Invisalign Go, Align Technology, San Jose, Calif) in interdisciplinary treatments especially in terms of minimally invasive interventions.

Case presentation

Two case reports are presented together with a comprehensive analysis using the SAFE (Safety, Assessment, Function, Ethics) assessment. This paper aims to introduce a new systematic in CAT. Invisalign Go (Align Technology, Santa Clara, California, USA) allows orthodontic treatment from second premolar and second premolar in both arches. It is specially designed for general practitioners devoted to restorative dentistry for a better planning of a multidisciplinary and mini-invasive treatment plan.

Discussion and conclusion

The clinical results demonstrate how CAT is extremely useful in multidisciplinary treatment plan in order to straighten teeth especially in a pre-restorative phase to allow minimally invasive and adhesive restorations.

Laboratory evaluation of the potential masking of color changes produced by silver diamine fluoride in primary molars

BACKGROUND

The importance of Silver diamine fluoride (SDF) as a minimally invasive and nonaerosolizing management during COVID-19 pandemic has highly increased. SDF is a caries-arresting agent that causes staining of tooth structure. Managing this discoloration will increase its acceptance in treating primary teeth. The main aim of this study was to quantify the color change associated with the application of SDF on extracted carious primary molars, the potential masking of this color change by potassium iodide (KI), composite (CMP) and glass ionomer cement (GI) and the effect of aging on this color masking effect.

METHODS

An in-vitro study in which 52 carious primary molars were collected, prepared, and distributed randomly into four groups equally as follows: Group A: SDF 38%; Group B: SDF 38% + KI; Group C: SDF 38% + CMP; Group D: SDF 38% + GI. Color changes were recorded for each sample at baseline, and after application of the tested materials. Moreover, all samples had undergone Suntest aging followed by a third color reading. CIELAB values L*, a*, b*, ΔL, Δa, and Δb were measured, ΔE was calculated, and data were analyzed using multivariate analysis of variance (MANOVA) and post-Hoc Scheffé test (p < 0.05).

RESULTS

MANOVA revealed the significant influence of the factor 'material'. SDF caused an obvious color change compared to the color of carious dentin. Regarding ΔL, the color change of groups C and D was not significant directly after application of the tested materials. After aging, it was significant among all groups, including groups C and D. In Δa there was a difference between SDF and groups B and C after application of the tested materials, and aging produced the same results. The color shifts of Δb of all tested groups varied significantly from one another. After aging, there was no difference between group D and either group A or B.

CONCLUSIONS

Treatment with SDF caused obvious discoloration of carious dentin. Directly after SDF application, all tested materials could effectively mask the color change associated with the application of SDF. CMP was the only material whose color masking effect was not completely reversed by aging.

An In Vitro Evaluation of Remineralization Potential of Functionalized Tricalcium Phosphate Paste and CPP-ACPF on Artificial White Spot Lesion in Primary and Permanent Enamel

Aim

Investigation and evaluation of remineralization potential of functionalized tricalcium phosphate paste (fTCP) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACPF) paste on artificially created white spot lesion on human primary and permanent enamel through scanning electron microscopy and microhardness assessment.

Materials and methods

Sixty freshly extracted primary and permanent teeth were selected and artificial white spot lesion were created by using standardized demineralizing solution. Remineralization was carried out using the test pastes. The assessment of demineralization and remineralization was done through a scanning electron microscope and microhardness assessment.

Results

Among the three groups, fTCP shows significantly higher increase in mean microhardness (p < 0.001) through ANOVA and the LSD post hoc test when compared to CPP-ACPF and control group. Also, the unpaired t-test showed that mean change in microhardness in permanent teeth was significantly higher than primary teeth in different time intervals for both experimental groups. Surface morphology was assessed through a scanning electron microscope.

Conclusion

Based on the results of the current study, f-TCP showed comparatively more remineralization potential than CPP-ACP with fluoride.

How to cite this article

Bhadoria N, Gunwal MK, Kukreja R, et al. An In Vitro Evaluation of Remineralization Potential of Functionalized Tricalcium Phosphate Paste and CPP-ACPF on Artificial White Spot Lesion in Primary and Permanent Enamel. Int J Clin Pediatr Dent 2020;13(6):579–584.

The impact of minimally invasive restorative techniques on perception of dental pain among pregnant women: a randomized controlled clinical trial

BACKGROUND

The public dental care sector is striving to fulfill the preventive and restorative needs of Egyptians, including pregnant women, who may not receive timely care due to misconceptions about dental treatment during pregnancy. Because of this, they are likely to suffer dental pain, with higher risk of infection affecting their offsprings.

AIM OF THE STUDY

To compare the effectiveness of chemo-mechanical caries removal using Papacarie-Duo and Atraumatic Restorative Treatment (ART) in reducing dental pain among pregnant women.

MATERIALS AND METHODS

A randomized controlled clinical trial was conducted, in 2019, and included 162 pregnant women visiting family health centers in Alexandria, Egypt, with dental pain due to dental caries not extending to pulp. Patients were randomly assigned to Papacarie-Duo group (n = 82) and ART group (n = 80) after stratification by number of treated surfaces. The outcome variables were reduction in pain assessed using Visual Analogue Scale (VAS), satisfaction with treatment, and time taken for dental caries removal. T test/ Mann Whitney U test were used to compare groups and Freidman test was used to compare change across time.

RESULTS

Pain reduction was significantly greater in the Papacarie-Duo than the ART group (81.55% and 69.43%, P = 0.001). Patients in the Papacarie-Duo group were significantly more satisfied with treatment than those in the ART, immediately after treatment (mean = 9.60 and 8.00, P =  < 0.01) and after 6 months (mean = 9.63 and 8.16, P =  < 0.01). Significantly less excavation time was recorded in the Papacarie-Duo group than in the ART group (mean = 10.38 and 11.56 min, P =  < 0.01).

CONCLUSION

Chemo-mechanical caries removal using Papacarie-Duo is more effective in reducing dental pain, in pregnant women, and is associated with more satisfaction and less excavation time than ART.

TRIAL REGISTRATION

ID NCT04573608 ( https://clinicaltrials.gov/ ); 5/10/2020, retrospective registration.

Bromelain vs Papain Gel for Caries Removal in Primary Teeth

AIM

The aim of the study was to evaluate and compare bromelain with papain as the chemomechanical caries removal agent in relation to their efficacy.

MATERIALS AND METHODS

Thirty extracted primary molars with active carious lesion extending into dentin were selected. The samples were randomly divided into groups by sectioning the samples into two halves. Group I-cavity prepared using papain gel; group II-cavity prepared using bromelain gel. Time taken for caries removal in both the groups (I and II) was recorded with the help of a stopwatch. Following caries removal, the amount of remaining demineralized dentin was measured with the help of stereomicroscope and weld check (biological image analysis) software.

RESULTS

t test is used to evaluate the significance of study parameters on continuous scale between two groups on metric parameters. The mean of residual carious dentin thickness obtained from the group II (bromelain) was 36.74 μm, which was much lower than that obtained from group I (papain) with a mean of 73.84 μm. The mean time taken in the group II (bromelain) was 335.30 seconds which was nearly equal to the mean time of group I (papain) of 352.33 seconds.

CONCLUSION

The amount of remaining demineralized dentin was found to be lower in bromelain group than the papain group and time taken for the carious dentin removal was almost found similar in both bromelain and papain groups. It may be concluded that bromelain was more effective in amount of caries removal than papain.

CLINICAL SIGNIFICANCE

Chemomechanical caries removal with the organic gels pose a great benefit as they are less invasive and has low side effects and cost-effective. How to cite this article: Reddy VK, Nagar P, Reddy S, et al. Bromelain vs Papain Gel for Caries Removal in Primary Teeth. J Contemp Dent Pract 2019;20(11):1345-1349.

Effect of chicken egg shell powder solution on early enamel carious lesions: an invitro preliminary study

AIM

To evaluate the remineralization potential of enamel surface lesion using chicken eggshell powder (CESP) solution.

MATERIALS AND METHODS

Ten freshly extracted un-erupted third molars decoronated at cement-enamel junction (CEJ) used in this study. Each decoronated tooth was sectioned to get 4 samples of enamel blocks such that 40 blocks were obtained which were then subjected to demineralization protocol and grouped as: Group 1-untreated group, Group 2-subsurface demineralization, Group 3-subsurface demineralization + 7 days CESP immersion, Group 4- subsurface demineralization + clinpro application. The samples were evaluated for X-ray fluorescence spectroscopy analysis, microhardness testing and atomic analyses using energy dispersive X-ray spectroscopy. The data were statistically analysed by using one-way ANOVA and Tukey - Kramer multiple comparison test.

RESULTS

X-ray Fluorescence spectroscopy shows Calcium concentration of 98% and 0.46% of phosphate. Group 4 (Clinpro) shows the highest efficacy in enhancing the remineralization followed by Group 3 (CESP). The results of atomic analyses showed that quantitative amounts of Ca weight % and P weight % is statistically greater for all the three groups except the demineralized group.

CONCLUSION

CESP with higher calcium content can remineralise enamel surface lesion.