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Influence of bioactive particles on the chemical-mechanical properties of experimental enamel resin infiltrants. Clin Oral Investig 2016; 21:2143-2151. [DOI: 10.1007/s00784-016-2005-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 11/01/2016] [Indexed: 10/20/2022]
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Inagaki LT, Alonso RCB, Araújo GAS, de Souza-Junior EJC, Anibal PC, Höfling JF, Pascon FM, Puppin-Rontani RM. Effect of monomer blend and chlorhexidine-adding on physical, mechanical and biological properties of experimental infiltrants. Dent Mater 2016; 32:e307-e313. [PMID: 28327302 DOI: 10.1016/j.dental.2016.09.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 08/23/2016] [Accepted: 09/03/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aim of the study was to evaluate antimicrobial inhibition zone, degree of conversion (DC) and Knoop hardness (KH) of experimental infiltrants. Experimental low viscosity monomer blends were prepared and chlorhexidine diacetate salt (CHX) (0.1% or 0.2%) was added comprising the groups: G1) TEGDMA; G2) TEGDMA/0.1CHX; G3) TEGDMA/0.2CHX; G4) TEGDMA/UDMA; G5) TEGDMA/UDMA/0.1CHX; G6) TEGDMA/UDMA/0.2CHX; G7) TEGDMA/BISEMA; G8) TEGDMA/BISEMA/0.1CHX; G9) TEGDMA/BISEMA/0.2CHX. Icon® was used as control group. METHODS Specimens of resin blends were made (n=9) to accomplished DC and KH. Pour plate was accomplished to evaluate antimicrobial groups' activity against Streptococcus mutans (SM) and Lactobacillus acidophilus (LA). Data obtained were submitted to two-way ANOVA and Tukey tests for blends comparisons and Dunnett's test for comparisons between experimental infiltrants and Icon® (p<0.05). RESULTS In relation to antimicrobial effect, uncured blends showed higher antibacterial activity than cured ones for the most of blends. After polymerization, G5 showed the highest inhibition zone against SM and, G3 and G6 against LA. Concerning KH, TEGDMA/UDMA-based blends showed the highest values of KH number and it was influenced by monomeric base, regardless CHX concentration. DC was not affected by monomer blend composition, neither for CHX concentration. The antimicrobial activity was affected by monomeric base, CHX concentration and polymerization. Experimental infiltrants presented similar or higher performance than Icon® for the properties evaluated. SIGNIFICANCE White spot lesion infiltration with low viscosity monomer blends (infiltrants) is an alternative to stop initial caries lesions progression. The incorporation of an antimicrobial agent as chlorhexidine diacetate salt in infiltrants composition could enhance the performance of these materials.
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Affiliation(s)
- Luciana Tiemi Inagaki
- Piracicaba Dental School, Department of Pediatric Dentistry, P.O. BOX 52, Piracicaba 13414-903, SP, Brazil.
| | - Roberta Caroline Bruschi Alonso
- Anhanguera University of São Paulo, Biomaterials Department, Rua Maria Cândida, 1813, Bloco G - 6° andar, São Paulo 02071-013, SP, Brazil.
| | - Giovana Albamonte Spagnolo Araújo
- Piracicaba Dental School, Department of Restorative Dentistry, Dental Materials Division, P.O. BOX 52, Piracicaba 13414-903, SP, Brazil.
| | - Eduardo José Carvalho de Souza-Junior
- University Center of Várzea Grande, Prosthodontic and Dental Materials Department, Várzea Grande, Mato Grosso, Brazil Av Dom Orlando Chaves, 2655, Bairro Cristo Rei - Varzea Grande, 78118-900, MT, Brazil.
| | - Paula Cristina Anibal
- Piracicaba Dental School, Department of Oral Diagnostic, Laboratory of Microbiology and Immunology, P.O. BOX 52, Piracicaba 13414-903, SP, Brazil.
| | - José Francisco Höfling
- Piracicaba Dental School, Department of Oral Diagnostic, Laboratory of Microbiology and Immunology, P.O. BOX 52, Piracicaba 13414-903, SP, Brazil.
| | - Fernanda Miori Pascon
- Piracicaba Dental School, Department of Pediatric Dentistry, P.O. BOX 52, Piracicaba 13414-903, SP, Brazil.
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Zhao X, Ren YF. Surface Properties and Color Stability of Resin-Infiltrated Enamel Lesions. Oper Dent 2016; 41:617-626. [PMID: 27589273 DOI: 10.2341/15-319-l] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To examine the surface topographies, microhardness, and color stability of resin-infiltrated enamel lesions before and after aging challenges in vitro using three-dimensional laser scanning profilometry, surface microhardness testing, spectrophotometry, and scanning electron microscopy. METHODS Forty human third molars were embedded in epoxy resin, and each tooth was prepared to have two white spot lesions and one sound enamel area. One white spot lesion received resin infiltration and the other was untreated. Ten specimens were subjected to thermocycling for 10,000 cycles, 10 specimens were immersed in coffee solutions, and 10 specimens were placed in water storage. Surface area roughness (Sa), Vickers microhardness (VHN), and CIE L*a*b* color values were measured on sound enamel, resin-infiltrated lesions, and untreated lesions before and after aging. The surface morphology of resin-infiltrated lesions was observed after aging under scanning electron microscopy and compared with 10 specimens that were not subjected to aging challenge. RESULTS Resin infiltration increased the surface microhardness of the enamel lesions from 89.3 to 212.0 VHN. The surface microhardness of resin-infiltrated enamel lesions was not significantly affected by aging. The surface roughness of resin-infiltrated lesions (0.32-0.37 μm) was greater than that of sound enamel (0.05-0.06 μm) and untreated lesions (0.12-0.13 μm). Thermocycling and water storage further increased surface roughness of resin-infiltrated surfaces. Resin-infiltrated enamel lesions showed greater discoloration than sound enamel surfaces. Surface microfissures and microcracks were observed on resin-infiltrated enamel lesions after thermocycling. CONCLUSIONS Surface hardness of enamel lesions increased significantly after resin infiltration and remained stable following thermocycling. Surface roughness and color stability of resin-infiltrated enamel lesions were less than ideal and might further deteriorate after aging in the oral environment.
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Cocco AR, Lund RG, Torre E, Martos J. Treatment of Fluorosis Spots Using a Resin Infiltration Technique: 14-month Follow-up. Oper Dent 2016; 41:357-62. [PMID: 27455116 DOI: 10.2341/14-335-s] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to report a clinical case of moderate fluorosis spots treated with infiltration of low-viscosity resin. A commercial resin was applied to the facial surfaces on the anterior teeth in both the maxillary and mandibular arches. The white spots of fluorosis lost their whitish appearance and appeared similar to sound enamel. This technique, which might constitute an alternative to white-masking of fluorosis spots, showed optimal esthetic results.
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Ritwik P, Jones CM, Fan Y, Sarkar NK. Hydrolytic and Color Stability of Resin Infiltration: A Preliminary in vitro Trial. J Contemp Dent Pract 2016; 17:377-81. [PMID: 27443363 DOI: 10.5005/jp-journals-10024-1858] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Resin infiltration is an emerging technique for management of noncavitated lesions. This study evaluated the in vitro hydrolytic and color stability of the ICON® resin infiltration system (IC) in 42 extracted human teeth. MATERIALS AND METHODS ICON® resin infiltration system was compared with dental adhesive (DA) and dental sealant (DS). The products were applied according to manufacturer's instructions. The baseline weight and color of the samples were recorded. Color was recorded by spectoral colorimeter. The samples were subjected to four experimental conditions: (1) group 1: Stored in lactic acid solution (pH 4.9) for 24 hours; (2) group 2: Thermocycled for 100 cycles (temperatures: 5°C, 55°C, and dwell time of 15 seconds); (3) group 3: Stored in 0.1 N sodium hydroxide solution (pH 12.48) for 14 days at 60°C; (4) group 4: Stored in phosphate-buffered saline solution (pH 7.2) at 37°C for 4 months. The weight and color were recorded again after removal of the samples from the experimental conditions. Two-factor analysis of variance models and Tukey's Honestly Significant Difference were performed to assess statistical differences among the groups. Scanning electron microscopy imaging was performed for samples from groups 1, 3, and 4. RESULTS All the samples showed loss of material and change in color. In the demineralizing solution, IC showed significantly greater weight loss (p = 0.032) and color change (p = 0.038) compared with DA. Dental Sealant showed significantly greater weight loss than IC (p = 0.027) after thermocycling. Teeth in group 3 exhibited the greatest weight loss (p < 0.001). Teeth in group 2 exhibited the greatest color change (p < 0.001). CONCLUSION All tested materials showed loss of retention and color change in the experimental conditions. Infiltration system exhibited greatest weight loss and color change in demineralizing solution. Dental sealant exhibited greatest weight loss upon thermocycling. CLINICAL SIGNIFICANCE Clinicians should be cautious about the limitations of retention and color stability when considering resin infiltration for incipient lesions.
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Affiliation(s)
- Priyanshi Ritwik
- Associate Pofessor, Department of Pediatric Dentistry, LSUHSC School of Dentistry, New Orleans, Los Angeles, USA, Phone: +5043528038, e-mail: ,
| | - Christopher M Jones
- Department of Pediatric Dentistry, LSUHSC School of Dentistry, New Orleans, Los Angeles, USA
| | - Yuwei Fan
- Department of Comprehensive Dentistry, LSUHSC School of Dentistry, New Orleans, Los Angeles, USA
| | - Nikhil K Sarkar
- Department of Comprehensive Dentistry, LSUHSC School of Dentistry, New Orleans, Los Angeles, USA
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Evaluation of sorption/solubility, softening, flexural strength and elastic modulus of experimental resin blends with chlorhexidine. J Dent 2016; 49:40-5. [PMID: 27101768 DOI: 10.1016/j.jdent.2016.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 04/09/2016] [Accepted: 04/16/2016] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To evaluate physical-chemical properties of experimental diacetate chlorhexidine (CHX)-added resin blends. METHODS Blends were formulated: G1)TEGDMA; G2)TEGDMA/0.1%CHX; G3)TEGDMA/0.2%CHX; G4)TEGDMA/UDMA; G5)TEGDMA/UDMA/0.1%CHX; G6)TEGDMA/UDMA/0.2%CHX; G7)TEGDMA/BisEMA, G8)TEGDMA/BisEMA/0.1%CHX; G9)TEGDMA/BisEMA/0.2%CHX. Icon(®) was the control group. For sorption/solubility (SS), cylindrical specimens (n=5) were prepared and their weight obtained. The specimens were immersed in deionized water for 7days at 37°C and their weight was verified again. SS were calculated using accepted formulas. For softening, cylindrical specimens (n=10) were prepared and initial Knoop hardness number (KHN) obtained. The specimens were immersed in absolute ethanol for 24h at 37°C and final KHN accomplished. Softening values were calculated by KHN reduction percentage. For elastic modulus (EM) and flexural strength (FS) bar specimens were prepared (n=10) and values obtained with a universal device (three point, 5mm distance, 0.5mm/min, load of 50N). The data was analyzed using one-way ANOVA and Tukey test (α=5%). RESULTS TEGDMA/BisEMA blends and Icon(®) showed the lowest sorption from blends (p>0.05), and Icon(®) was the most soluble material (p<0.01). TEGDMA/UDMA/0.1%CHX showed the highest softening, similar to Icon(®) (p>0.05). For EM, all blends were different than Icon(®) (p<0.01). For FS, TEGDMA blends were similar to Icon(®), showing the lowest averages (p>0.05). CONCLUSIONS Monomers chemical characteristics influenced the physical-chemical properties of experimental blends more than CHX. Between the blends tested, UDMA blends presented satisfactory results for assays evaluated. CLINICAL SIGNIFICANCE Infiltrants CHX-added could arrest and reinforce initial caries lesions, and the antimicrobial effect could prevent new lesions in sound enamel adjacent to the infiltrated area.
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Zhao X, Pan J, Zhang S, Malmstrom HS, Ren YF. Effectiveness of resin-based materials against erosive and abrasive enamel wear. Clin Oral Investig 2016; 21:463-468. [PMID: 27059993 DOI: 10.1007/s00784-016-1814-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 03/28/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to test the effectiveness of resin-based materials against erosive enamel wear under erosive and abrasive challenges by orange juice and tooth brushing. METHODS Fifty enamel specimens from third molars were assigned to five groups: ICON resin infiltration with no etching (ICON-NE), ICON resin infiltration with 15 % HCl etching (ICON-AE), Seal & Protect sealant (S&P), Tetric EvoFlow (TEF), and control. Erosive lesions were first created on enamel, then treated with resin-based materials. Erosive and abrasive challenges by orange juice and tooth brushing were repeated after treatments. Erosive wear of the treated areas was measured with 3D scanning microscopy, and data were analyzed using ANOVA and paired t tests. RESULTS Treatments with ICON, S&P, and TEF created a protective material coating of 4.5 ± 1.9 μm, 44.3 ± 8.1 μm, and 84.6 ± 15.7 μm in thickness on the lesion surfaces, respectively. After 15 cycles of erosive and abrasive challenges, enamel or material losses were 21.9 ± 2.3 μm for control, 24.5 ± 4.0 μm for ICON-NE, 24.6 ± 7.4 μm for ICON-AE, 11.2 ± 4.1 μm for S&P, and 3.9 ± 1.9 μm for TEF, respectively. The protective coatings were completely lost in the ICON infiltration groups but remained intact in both the S&P and TEF groups after erosive and abrasive challenges. CONCLUSION In contrast to a resin sealant and a flowable composite, ICON infiltration resin was not effective in protecting enamel surfaces from erosive and abrasive wear. CLINICAL RELEVANCE Sealant and flowable composite resin may create protective coatings on eroded enamel surfaces and prevent further tissue loss.
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Affiliation(s)
- Xiaoyi Zhao
- University of Rochester Eastman Institute for Oral Health, 625 Elmwood Avenue, Rochester, 14625, NY, USA
- Department of General Dentistry, Peking University School of Stomatology, Beijing, China
| | - Jie Pan
- Department of General Dentistry, Peking University School of Stomatology, Beijing, China
| | - Songmei Zhang
- University of Rochester Eastman Institute for Oral Health, 625 Elmwood Avenue, Rochester, 14625, NY, USA
| | - Hans S Malmstrom
- University of Rochester Eastman Institute for Oral Health, 625 Elmwood Avenue, Rochester, 14625, NY, USA
| | - Yan-Fang Ren
- University of Rochester Eastman Institute for Oral Health, 625 Elmwood Avenue, Rochester, 14625, NY, USA.
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van Loveren C, van Palenstein Helderman W. EAPD interim seminar and workshop in Brussels May 9 2015 : Non-invasive caries treatment. Eur Arch Paediatr Dent 2016; 17:33-44. [PMID: 26860292 PMCID: PMC4766220 DOI: 10.1007/s40368-015-0219-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 12/08/2015] [Indexed: 01/08/2023]
Abstract
Aim This was to collect information for the 9th European Academy of Paediatric Dentistry Interim Seminar and Workshops to discuss the state of art on non-invasive caries therapy to be used if possible to formulate clinical guidelines by European experts in paediatric dentistry Methods Based on systematic reviews and additional papers were assessed for methods to prevent caries initiation and caries progression both in the state of pre-cavitation and cavitation without invasive technologies. Results The use of fluoridated water, careful diligent daily use of fluoride toothpaste, fluoride varnishes, pit and fissure sealants and leak-proof restorative materials without excavation of caries are evidence based for caries prevention and for non-invasive treatment of pre-cavitated and cavitated caries. Other technologies are far less evidenced based and would not logically fit in guidelines for the non-invasive treatment of caries. Recent studies on cavitated lesions in the primary dentition demonstrate that thorough oral hygiene practices may arrest progression. This strategy depends heavily on the strategies in the dental surgery to change behaviour of children. An important aspect is for advice to be tailored at recall intervals to ensure compliance and to timely detect unnecessary and unwanted progression of the lesions. Conclusion Non-invasive therapies have been proven to be effective for caries prevention and the management of pre-cavitated caries lesions. Non-invasive therapies can also be effective to arrest cavitated lesions but the success depends greatly on behavioural changes of patients to brush the lesions.
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Affiliation(s)
- C van Loveren
- Department of Preventive Dentistry, Academic Centre for Dentistry, University of Amsterdam and VU University Amsterdam, ACTA, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands.
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Meyer-Lueckel H, Balbach A, Schikowsky C, Bitter K, Paris S. Pragmatic RCT on the Efficacy of Proximal Caries Infiltration. J Dent Res 2016; 95:531-6. [DOI: 10.1177/0022034516629116] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Proximal caries infiltration has been shown to be efficacious in hampering caries lesion progression when performed by dentists working in a university setting. The aim of this randomized split-mouth, placebo-controlled clinical trial was to assess the efficacy of resin infiltration of proximal caries lesions being performed by several dentists in private practices, in combination with individualized oral hygiene plus noninvasive measures compared with these alone. In this study, 87 children and young adults (with 238 pairs of proximal caries lesions radiographically extending into the inner half of the enamel [E2] or the outer third of the dentin [D1]) were randomly allocated to either 1 of 2 treatments. Test lesions were infiltrated, and a mock treatment was performed in control lesions by 5 German private practitioners. All patients received instructions for a noncariogenic diet, flossing and fluoridation, and individualized noninvasive interventions. The primary outcome was radiographic lesion progression (pairwise comparison) evaluated independently by 2 evaluators who were blinded to treatment allocation. After approximately 10 mo (mean ± SD 307 ± 43 d), 92 of 148 lesion pairs in 24 of 38 treated patients who were at high caries risk could be re-evaluated clinically as well as radiographically using individualized bitewing holders, as at baseline; 186 of 204 lesion pairs in 70 of 77 patients (35 of 38 high-risk patients) could be evaluated after 18 mo (mean 542 ± 110 d). No unwanted effects were observed. After 10 mo, progression was recorded in 2 of 92 test lesions (2%) and in 22 of 92 control lesions (24%) ( P = 0.001, McNemar/Obuchowski test; relative risk reduction, 91; 95% confidence interval, 62%–98%). After 18 mo, lesion progression was recorded in all included patients in 10 of 186 test lesions (5%) and in 58 of 186 control lesions (31%) ( P < 0.001; relative risk reduction, 83; 95% confidence interval, 67%–91%). Thus, resin infiltration seems to be more efficacious in reducing lesion progression compared with individualized noninvasive measures alone over a period of 18 mo when performed in a private practice setting by various practitioners (German Clinical Trials Register / Deutsches Register Klinischer Studien DRKS00009963).
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Affiliation(s)
- H. Meyer-Lueckel
- Department of Operative Dentistry, Periodontology, and Preventive Dentistry, RWTH Aachen University, Aachen, Germany
| | - A. Balbach
- Department of Operative Dentistry, Periodontology, and Preventive Dentistry, RWTH Aachen University, Aachen, Germany
| | - C. Schikowsky
- Institute of Occupational Medicine, RWTH Aachen University, Aachen, Germany
| | - K. Bitter
- Department of Operative Dentistry and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S. Paris
- Department of Operative Dentistry and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Lara JS, Braga MM, Shitsuka C, Wen CL, Haddad AE. Dental students' and lecturers' perception of the degree of difficulty of caries detection associated learning topics in Brazil. JOURNAL OF EDUCATIONAL EVALUATION FOR HEALTH PROFESSIONS 2015; 12:56. [PMID: 26708573 PMCID: PMC4722168 DOI: 10.3352/jeehp.2015.12.56] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 12/24/2015] [Indexed: 06/02/2023]
Abstract
PURPOSE It aimed to explore the degree of difficulty of caries-detection-associated-topics perceived by dental students and lecturers as pedagogical step in the development of learning objects for e-learning. METHODS A convenience sample comprising ninety-eight subjects from different academic levels (undergraduate/graduate students and pediatric dentistry lecturers) participated. Two spreadsheets (isolated/relative) were created considering key topics in the caries detection process. The isolated evaluation intended to explore each topic in an isolated way, while the relative intended to classify, comparatively, the participants' perceived difficulty per topic. Afterwards, data were analyzed. All values on spreadsheets were combined obtaining the subject's final perception. Associations between the subjects' degree of the perceived difficulty and academic level were estimated. ANOVA was used to determine differences regarding the perception among evaluated topics in distinct groups. RESULTS Caries histopathology and detection of proximal carious lesions were the topics perceived as the most difficult in the process of caries detection by both students and lecturers. Differentiation between an extrinsic pigmentation and a brown-spot (caries lesion) as well as differential diagnosis between caries and enamel developmental defects or non-carious lesions were considered as more difficult by undergraduates in comparison to graduates/lecturers (regression-coefficient=14.54; Standard Error=3.34; P<0.001 and 8.40, 3.31, and 0.01 respectively). CONCLUSION Topics as histopathology and detection of proximal caries lesions were identified as the most difficult despite the academic level. However, some topics are differently perceived according to the group. These results are useful for developing pedagogical material, based on the students real learning needs/expectations.
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Affiliation(s)
- Juan Sebastian Lara
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Caleb Shitsuka
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Chao Lung Wen
- Telemedicine Discipline, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Ana Estela Haddad
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
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Ionta FQ, Boteon AP, Moretto MJ, Júnior OB, Honório HM, Silva TC, Wang L, Rios D. Penetration of resin-based materials into initial erosion lesion: A confocal microscopic study. Microsc Res Tech 2015; 79:72-80. [DOI: 10.1002/jemt.22607] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 10/28/2015] [Accepted: 11/11/2015] [Indexed: 11/12/2022]
Affiliation(s)
- Franciny Querobim Ionta
- Department of Pediatric Dentistry Orthodontics and Public Health, Bauru School of Dentistry; University of São Paulo (FOB-USP); Alameda Dr. Octávio Pinheiro Brisolla 9-75 Bauru São Paulo 17012-101 Brazil
| | - Ana Paula Boteon
- Department of Dentistry Endodontics and Dental Materials, Bauru School of Dentistry; University of São Paulo (FOB-USP); Alameda Dr. Octávio Pinheiro Brisolla 9-75 Bauru São Paulo 17012-101 Brazil
| | - Marcelo Juliano Moretto
- Department of Pediatric Dentistry, Mineiros School of Dentistry; Center of Higher Education Rezende & Potrich (FAMA), Jau; São Paulo Brazil
| | - Odair Bim Júnior
- Department of Operative Dentistry Endodontics and Dental Materials, Bauru School of Dentistry; University of São Paulo (FOB-USP); Alameda Dr. Octávio Pinheiro Brisolla 9-75 Bauru São Paulo 17012-101 Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry Orthodontics and Public Health, Bauru School of Dentistry; University of São Paulo (FOB-USP); Alameda Dr. Octávio Pinheiro Brisolla 9-75 Bauru São Paulo 17012-101 Brazil
| | - Thiago Cruvinel Silva
- Department of Pediatric Dentistry Orthodontics and Public Health, Bauru School of Dentistry; University of São Paulo (FOB-USP); Alameda Dr. Octávio Pinheiro Brisolla 9-75 Bauru São Paulo 17012-101 Brazil
| | - Linda Wang
- Department of Operative Dentistry Endodontics and Dental Materials, Bauru School of Dentistry; University of São Paulo (FOB-USP); Alameda Dr. Octávio Pinheiro Brisolla 9-75 Bauru São Paulo 17012-101 Brazil
| | - Daniela Rios
- Department of Pediatric Dentistry Orthodontics and Public Health, Bauru School of Dentistry; University of São Paulo (FOB-USP); Alameda Dr. Octávio Pinheiro Brisolla 9-75 Bauru São Paulo 17012-101 Brazil
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Dorri M, Dunne SM, Walsh T, Schwendicke F. Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth. Cochrane Database Syst Rev 2015; 2015:CD010431. [PMID: 26545080 PMCID: PMC8504982 DOI: 10.1002/14651858.cd010431.pub2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Proximal dental lesions, limited to dentine, are traditionally treated by invasive (drill and fill) means. Non-invasive alternatives (e.g. fluoride varnish, flossing) might avoid substance loss but their effectiveness depends on patients' adherence. Recently, micro-invasive approaches for treating proximal caries lesions have been tried. These interventions install a barrier either on top (sealing) or within (infiltrating) the lesion. Different methods and materials are currently available for micro-invasive treatments, such as sealing via resin sealants, (polyurethane) patches/tapes, glass ionomer cements (GIC) or resin infiltration. OBJECTIVES To evaluate the effects of micro-invasive treatments for managing proximal caries lesions in primary and permanent dentition in children and adults. SEARCH METHODS We searched the following databases to 31 December 2014: the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID, EMBASE via OVID, LILACs via BIREME Virtual Health Library, Web of Science Conference Proceedings, ZETOC Conference Proceedings, Proquest Dissertations and Theses, ClinicalTrials.gov, OpenGrey and the World Health Organization (WHO) International Clinical Trials Registry Platform. We searched the metaRegister of Controlled Trials to 1 October 2014. There were no language or date restrictions in the searches of the electronic databases. SELECTION CRITERIA We included randomised controlled trials of at least six months' duration that compared micro-invasive treatments for managing non-cavitated proximal dental decay in primary teeth, permanent teeth or both, versus non-invasive measures, invasive means, no intervention or placebo. We also included studies that compared different types of micro-invasive treatments. DATA COLLECTION AND ANALYSIS Two review authors independently screened search results, extracted data and assessed the risk of bias. We used standard methodological procedures expected by Cochrane to evaluate risk of bias and synthesise data. We conducted meta-analyses with the random-effects model, using the Becker-Balagtas method to calculate the odds ratio (OR) for lesion progression. We assessed the quality of the evidence using GRADE methods. MAIN RESULTS We included eight trials, which randomised 365 participants. The trials all used a split-mouth design, some with more than one pair of lesions treated within the same participant. Studies took place in university or dental public health clinics in Brazil, Colombia, Denmark, Germany, Thailand, Greenland and Chile. Six studies evaluated the effects of micro-invasive treatments in the permanent dentition and two studies on the primary dentition, with caries risk ranging from low to high. Investigators measured caries risk in different studies either by caries experience alone or by using the Cariogram programme, which combines eight contributing factors, including caries experience, diet, saliva and other factors related to caries. The follow-up period in the trials ranged from one to three years. All studies used lesion progression as the primary outcome, evaluating it by different methods of reading radiographs. Four studies received industry support to carry out the research, with one of them being carried out by inventors of the intervention.We judged seven studies to be at high overall risk of bias, primarily due to lack of blinding of participants and personnel. We evaluated intervention effects for all micro-invasive therapies and analysed subgroups according to the different treatment methods reported in the included studies.Our meta-analysis, which pooled the most sensitive set of data (in terms of measurement method) from studies presenting data in a format suitable for meta-analysis, showed that micro-invasive treatment significantly reduced the odds of lesion progression compared with non-invasive treatment (e.g fluoride varnish) or oral hygiene advice (e.g to floss) (OR 0.24, 95% CI 0.14 to 0.41; 602 lesions; seven studies; I(2) = 32%). There was no evidence of subgroup differences (P = 0.36).The four studies that measured adverse events reported no adverse events after micro-invasive treatment. Most studies did not report on any further outcomes.We assessed the quality of evidence for micro-invasive treatments as moderate. It remains unclear which micro-invasive treatment is more advantageous, or if certain clinical conditions or patient characteristics are better suited for micro-invasive treatments than others. AUTHORS' CONCLUSIONS The available evidence shows that micro-invasive treatment of proximal caries lesions arrests non-cavitated enamel and initial dentinal lesions (limited to outer third of dentine, based on radiograph) and is significantly more effective than non-invasive professional treatment (e.g. fluoride varnish) or advice (e.g. to floss). We can be moderately confident that further research is unlikely to substantially change the estimate of effect. Due to the small number of studies, it does remain unclear which micro-invasive technique offers the greatest benefit, or whether the effects of micro-invasive treatment confer greater or lesser benefit according to different clinical or patient considerations.
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Affiliation(s)
- Mojtaba Dorri
- Bristol Oral and Dental SchoolDepartment of Restorative DentistryLower Maudlin StreetBristolUKBS1 2LY
| | - Stephen M Dunne
- Kings College London Dental InstitutePrimary Dental CareDenmark Hill CampusCaldecot RoadLondonUKSE5 9RW
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Falk Schwendicke
- Charité ‐ Universitätsmedizin BerlinDepartment of Operative and Preventive DentistryCampus Benjamin FranklinAßmannshauser Str 4‐6BerlinGermany14197
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Wright MN, Ziegler A. Multiple censored data in dentistry: A new statistical model for analyzing lesion size in randomized controlled trials. Biom J 2015; 57:384-94. [DOI: 10.1002/bimj.201400118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 12/17/2014] [Accepted: 01/12/2015] [Indexed: 11/09/2022]
Affiliation(s)
- Marvin N. Wright
- Institut für Medizinische Biometrie und Statistik; Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein; Campus Lübeck, Ratzeburger Allee 160 23562 Lübeck Germany
| | - Andreas Ziegler
- Institut für Medizinische Biometrie und Statistik; Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein; Campus Lübeck, Ratzeburger Allee 160 23562 Lübeck Germany
- Zentrum für Klinische Studien; Universität zu Lübeck, Universitätsklinikum Schleswig-Holstein; Campus Lübeck Lübeck Germany
- School of Mathematics; Statistics and Computer Science, University of KwaZulu-Natal; Pietermaritzburg South Africa
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Ismail AI, Tellez M, Pitts NB, Ekstrand KR, Ricketts D, Longbottom C, Eggertsson H, Deery C, Fisher J, Young DA, Featherstone JDB, Evans W, Zeller GG, Zero D, Martignon S, Fontana M, Zandona A. Caries management pathways preserve dental tissues and promote oral health. Community Dent Oral Epidemiol 2015; 41:e12-40. [PMID: 24916676 DOI: 10.1111/cdoe.12024] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
In May 2012, cariologists, dentists, representatives of dental organizations, manufacturers, and third party payers from several countries, met in Philadelphia, Pennsylvania, to define a common mission; goals and strategic approaches for caries management in the 21th century. The workshop started with an address by Mr. Stanley Bergman, CEO of Henry Schein Inc. which focused on the imperative for change in academia, clinical practice, and public health. For decades, new scientific evidence on caries and how it should be managed have been discussed among experts in the field. However, there has been some limited change, except in some Scandinavian countries, in the models of caries management and reimbursement which have been heavily skewed toward 'drilling and filling'. There is no overall agreement on a caries' case definition or on when to surgically intervene. The participants in the workshop defined a new mission for all caries management approaches, both conventional and new. The mission of each system should be to preserve the tooth structure, and restore only when necessary. This mission marks a pivotal line for judging when to surgically intervene and when to arrest or remineralize early noncavitated lesions. Even when restorative care is necessary, the removal of hard tissues should be lesion-focused and aim to preserve, as much as possible, sound tooth structure. Continuing management of the etiological factors of caries and the use of science-based preventive regimens also will be required to prevent recurrence and re-restoration. These changes have been debated for over a decade. The Caries Management Pathways includes all systems and philosophies, conventional and new, of caries management that can be used or modified to achieve the new mission. The choice of which system to use to achieve the mission of caries management is left to the users and should be based on the science supporting each approach or philosophy, experience, utility, and ease of use. This document also presents a new 'Caries Management Cycle' that should be followed regardless of which approach is adopted for caries prevention, detection, diagnosis, and treatment. To aid success in the adoption of the new mission, a new reimbursement system that third party payers may utilize is proposed (for use by countries other than Scandinavian countries or other countries where such systems already exist). The new reimbursement/incentive model focuses on the mission of preservation of tooth structure and outcomes of caries management. Also described, is a research agenda to revitalize research on the most important and prevalent world-wide human disease. The alliance of major dental organizations and experts that started in Philadelphia will hopefully propel over the next months and years, a change in how caries is managed by dentists all over the world. A new mission has been defined and it is time for all oral health professionals to focus on the promotion of oral health and preservation of sound teeth rather than counting the number of surgical restorative procedures provided.
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Affiliation(s)
- Amid I Ismail
- Korenberg School of Dentistry, Temple University, Philadelphia, PA, USA
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Arslan S, Zorba YO, Atalay MA, Özcan S, Demirbuga S, Pala K, Percin D, Ozer F. Effect of resin infiltration on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Dent Mater J 2015; 34:25-30. [PMID: 25748455 DOI: 10.4012/dmj.2014-078] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to evaluate and compare the effects of resin infiltration and sealant type on enamel surface properties and Streptococcus mutans adhesion to artificial enamel lesions. Artificial enamel lesions were produced on the surfaces of 120 enamel specimens, which were divided into two groups: Group A and Group B (n=60 per group). Each group was further divided into four subgroups (n=15 per subgroup) according to sealant type: Group I-Demineralized enamel (control); Group II-Enamel Pro Varnish; Group III-ExciTE F; and Group IV-Icon. In Group A, hardness and surface roughness were evaluated; in Group B, bacterial adhesion was evaluated. Icon application resulted in significantly lower surface roughness and higher hardness than the other subgroups in Group A. In Group B, Enamel Pro Varnish resulted in lowest bacterial adhesion, followed by Icon. This study showed that resin infiltration of enamel lesions could arrest lesion progress.
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Affiliation(s)
- Soley Arslan
- Department of Restorative Dentistry, Faculty of Dentistry, University of Erciyes
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66
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Tostes MA, Santos E, Camargo SA. Effect of resin infiltration on the nanomechanical properties of demineralized bovine enamel. Indian J Dent 2015; 5:116-22. [PMID: 25565739 PMCID: PMC4213871 DOI: 10.4103/0975-962x.140819] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: The aim of the present study was to evaluate the efficacy of resin infiltration in preventing in vitro lesion progression. Materials and Methods: Buccal surfaces of bovine incisors were divided into mesial and distal regions and, at the center, nail varnish was applied (1.0 mm width) to protect the enamel surface against any further treatment. In order to create artificial enamel lesions in the unprotected areas, each specimen was soaked in a demineralizing solution. After that, specimens had two enamel lesions. One lesion in each sample was etched with 15% HCl for 120 s and infiltrated with a commercial infiltrating resin for 3 min, while the other lesion was not treated (control). Each specimen was cross-sectionally halved and randomly allocated to two groups: Group 1 was immediately processed and Group 2 was submitted to a new demineralization process. The samples were analyzed by means of cross-sectional hardness measurements using a nanoindenter equipment. Hardness data were statistically analyzed by non-parametric Kruskal-Wallis and MannWhitney tests (α = 0.05). Results: The findings showed statistical difference between treatments at the same analyzed distance range from the outer surface of the enamel (P < 0.05). Conclusion: The untreated lesion showed lower hardness values for distances near the outer surface of the enamel. The resin infiltration was efficient in preventing further in vitro demineralization of bovine enamel lesions.
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Affiliation(s)
- Mônica Almeida Tostes
- Department of Pediatric Dentistry, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
| | - Emanuel Santos
- Department of Metallurgical and Materials Engineering, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Sérgio Alvaro Camargo
- Department of Metallurgical and Materials Engineering, COPPE, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Doméjean S, Ducamp R, Léger S, Holmgren C. Resin infiltration of non-cavitated caries lesions: a systematic review. Med Princ Pract 2015; 24:216-21. [PMID: 25661012 PMCID: PMC5588225 DOI: 10.1159/000371709] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 12/21/2014] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE The aim of this systematic review was to evaluate the in vivo scientific evidence of the ability of resin infiltration (RI) to arrest non-cavitated caries lesions. MATERIALS AND METHODS The PubMed database was searched for randomized controlled trials that evaluated the in vivo effect of RI versus placebo or other preventive treatment on the progression of caries lesions. The keywords used were 'resin infiltration, dental caries', 'resin infiltration, carious lesions', 'resin infiltration, caries lesions', 'caries infiltration' and 'Icon DMG' with the 'clinical trial' filter activated. Among the 14 articles originally identified with these keywords, only 4 (related to 3 different in vivo studies) were included for this review. RESULTS All 4 articles reported on proximal caries lesions. One study had been conducted on 48 high-caries-risk children while the other 3 (n = 22, 22 and 39, respectively) concerned moderate- and low-caries-risk adolescents and adults. The quality of the studies was assessed to be high with respect to randomization, split-mouth design and blinding. All the included studies showed significant differences in caries progression between test and control/placebo groups, indicating that RI may inhibit the carious process. CONCLUSION This systematic review revealed that RI appeared to be an effective method to arrest the progression of non-cavitated caries lesions. Additional, long-term studies are required.
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Affiliation(s)
- Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, Montrouge, France
- Service d'Odontologie, CHU Clermont-Ferrand, Montrouge, France
- UFR d'Odontologie, Université de Clermont 1, Clermont-Ferrand, Montrouge, France
- *Prof. Sophie Doméjean, UFR d'Odontologie, Université de Clermont 1, 2 rue de Braga, FR-63100 Clermont-Ferrand (France), E-Mail
| | - Raphaël Ducamp
- Centre de Recherche en Odontologie Clinique EA 4847, Montrouge, France
- Service d'Odontologie, CHU Clermont-Ferrand, Montrouge, France
- UFR d'Odontologie, Université de Clermont 1, Clermont-Ferrand, Montrouge, France
| | - Stéphanie Léger
- Département de Mathématiques, University Blaise Pascal, Aubière, France
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ALSAYED EZ, HARIRI I, SADR A, NAKASHIMA S, BAKHSH TA, SHIMADA Y, SUMI Y, TAGAMI J. Optical coherence tomography for evaluation of enamel and protective coatings. Dent Mater J 2015; 34:98-107. [DOI: 10.4012/dmj.2014-215] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Ehab Z. ALSAYED
- Yanbu Dental Center, Saudi Ministry of Health, Al-Madina Health Region
- Tokyo Medical and Dental University, Cariology and Operative Dentistry Department and Global Center of Excellence (GCOE) Program
| | - Ilnaz HARIRI
- Tokyo Medical and Dental University, Cariology and Operative Dentistry Department
| | - Alireza SADR
- University of Washington, School of Dentistry, Department of Restorative Dentistry
- Tokyo Medical and Dental University, International Exchange Center and Cariology and Operative Dentistry Department
| | - Syozi NAKASHIMA
- Tokyo Medical and Dental University, Cariology and Operative Dentistry Department
| | | | - Yasushi SHIMADA
- Tokyo Medical and Dental University, Cariology and Operative Dentistry Department
| | - Yasunori SUMI
- National Center for Geriatrics and Gerontology, Department for Advanced Dental Research, Center of Advanced Medicine for Dental and Oral Diseases
| | - Junji TAGAMI
- Tokyo Medical and Dental University, Cariology and Operative Dentistry Department
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Tridimensional surface roughness analysis after resin infiltration of (deproteinized) natural subsurface carious lesions. Clin Oral Investig 2014; 19:1473-83. [PMID: 25483122 DOI: 10.1007/s00784-014-1372-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2014] [Accepted: 11/12/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The objectives of this study were to evaluate ex vivo the effects of resin infiltration on the areal surface roughness of natural non-cavitated proximal subsurface lesions with or without previous deproteinization and to determine differences between E2 and D1 lesions or between premolars and molars. MATERIALS AND METHODS Forty premolars and 40 molars with proximal carious lesions and macroscopically intact surfaces (International Caries Detection and Assessment System (ICDAS) II; code 2) were radiologically assessed and randomly allocated to four groups (with 20 E2 and 20 D1 lesions, respectively). In each group, 10 lesions were deproteinized (NaOCl; 1%) before etching (HCl; 15%) and resin infiltration (Icon). Areal surface roughness (Sa) at the most demineralized lesion part (DIAGNOdent) was evaluated topometrically before and after deproteinization, after etching, and after infiltration using focus variation 3D scanning microscopy. RESULTS Pretreatment with NaOCl (n = 40) had no significant effects on Sa (p = 0.208), but resulted in significantly differing Sa values between premolars and molars after etching (p = 0.011). Regarding the effects between etching and baseline, significantly differing Sa values (p = 0.0498) were found for premolars and molars (n = 40/40); Sa after resin infiltration (compared to etching) differed significantly between premolars and molars (p = 0.009). No treatment regimen lead to differences among the radiological grades (E2 vs. D1; p > 0.106). CONCLUSIONS Resin infiltration showed only minor effects on Sa values of etched subsurface lesions (p < 0.170) and did neither equal nor improve baseline surface roughness (p > 0.401) of the different tooth types. CLINICAL RELEVANCE Deproteinization should be recommended before etching and infiltration, even if surface roughness of infiltrated advanced (pre-)molar lesions will not be improved.
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Mattos-Silveira J, Floriano I, Ferreira FR, Viganó MEF, Frizzo MA, Reyes A, Novaes TF, Moriyama CM, Raggio DP, Imparato JCP, Mendes FM, Braga MM. New proposal of silver diamine fluoride use in arresting approximal caries: study protocol for a randomized controlled trial. Trials 2014; 15:448. [PMID: 25409545 PMCID: PMC4255679 DOI: 10.1186/1745-6215-15-448] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 11/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approximal surfaces are a challenge to caries lesions control. Silver diamine fluoride (SDF) is a simple,low-cost and promisor intervention for arresting caries lesions, but it has never been tested on approximal surfaces. Our aim is to evaluate the efficacy and cost-efficacy of SDF in arresting initial lesions compared to resin infiltration and exclusively flossing (control group). Our second aim is to assess discomfort and satisfaction regarding interventions. METHODS/DESIGN This is a randomized clinical trial, double-blinded, placebo-controlled study. Children/adolescents presenting at least one approximal initial caries lesion in primary molars/permanent premolars and molars will be included. Surfaces with advanced dentine lesions identified by radiography and participants who refuse to participate or present negative behaviors will be excluded. A minimum sample size of 504 surfaces will be required for each subgroup. Individuals will be randomly allocated in three groups of interventions: SDF, resin infiltration, and control group. Depending on the allocation, the patients will receive the active treatment and respective placebo therapies. All patients will be oriented to daily flossing the included surfaces. Our primary outcome will be caries progression by clinical and radiographic examinations. Appointments will be timed and costs of materials will be considered to calculate cost-efficacy. Patient discomfort will be assessed after interventions. Parent and patient satisfaction with the treatment will be collected after treatment and in the last follow-up visit. Individuals will be assessed at 1 and 3 months after treatment to evaluate dental biofilm and at 6, 12, and 24 months to assess caries progression by visual examination and/or radiography. Multilevel analyses will be used to verify if the type of treatment influenced on the tested outcomes. Costs will be compared and analyses of cost-efficacy will be performed. Poisson analysis will test the association between intervention and reported discomfort and satisfaction. DISCUSSION Our hypothesis is that SDF is the most cost-efficacious option from all tested interventions. If our hypothesis is confirmed, the use of SDF in private and public contexts could represent an easier and effective option in the treatment of enamel approximal caries in children/adolescents. TRIAL REGISTRATION ClinicalTrials.gov (NCT01477385), Initial release: 11/16/2011: last update: 06/02/2014.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av, Lineu Prestes, 2227, São Paulo, SP 05508-000, Brazil.
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Tulunoglu O, Tulunoglu IF, Antonson SA, Campillo-Funollet M, Antonson D, Munoz-Viveros C. Effectiveness of an infiltrant on sealing of composite restoration margins with/without artificial caries. J Contemp Dent Pract 2014; 15:717-25. [PMID: 25825096 DOI: 10.5005/jp-journals-10024-1605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this in vitro study was to evaluate the effectiveness of a resin infiltrant (ICON) on marginal sealing ability of class II resin restorations with/without-caries. MATERIALS AND METHODS Forty-eight noncarious human pre-molar teeth were embedded and MO and DO preparations of standard dimensions were prepared. The left side of dentin margins of the cavities were left nonbonded (UB) while the right side were bonded using total etch-bonding agent and all restored with a Nanohybrid composite. The teeth were thermocycled and half of the specimens in the UB and B groups were subjected to an artificial caries process. ICON was applied to caries and noncaries subgroups following the manufacturer's directions. Impressions were made at each step: after the restorations were completed, thermocycling, artificial caries procedures, and infiltrant application and the silicone tag lengths were measured with a stereomicroscope. The specimens were immersed in 0.5% basic fuchsine at 37° C for 24 hours, sectioned and microleakage was evaluated with a stereomicroscope. Selected samples and their replicas were assessed for marginal quality under a stereomicroscope and SEM. Statistical evaluation of the data were made using Kruskal-Wallis, Mann-Whitney U and Wilcoxon Sign Rank tests. RESULTS While bonding application did not create a meaningful difference, the thermocycling and artificial caries significantly increased the gap length and microleakage (p < 0.05). ICON application was decreased the microleakage, created gap-free margins and closed the gaps which were previously occurred at the same cavities (p < 0.05). CONCLUSION A resin infiltrant (ICON) application decreased the microleakage, created gap-free margins and closed the gaps, which previously occurred at the same cavities. CLINICAL SIGNIFICANCE Approximal application of resin infiltrant may increase the success of the class II composite restorations also reduced the risk of needing more complex restoration therapy.
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Affiliation(s)
- Ozlem Tulunoglu
- Clinical Instructor, Department of Pediatric Dentistry, Case Western Reserve University, School of Dental Medicine, Cleveland, Ohio, USA Phone: 2167445884, e-mail:
| | - Ibrahim Fevzi Tulunoglu
- Associate Professor, Department of Comprehensive Care, Case Western Reserve University School of Dental Medicine, Ohio, USA
| | - Sibel A Antonson
- Associate Professor, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, State University of New York New York, USA
| | - Marc Campillo-Funollet
- Researcher, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, State University of New York New York, USA
| | - Donald Antonson
- Professor, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, State University of New York New York, USA
| | - Carlos Munoz-Viveros
- Professor, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, State University of New York New York, USA
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Hayes M, Allen E, da Mata C, McKenna G, Burke F. Minimal intervention dentistry and older patients part 2: minimally invasive operative interventions. ACTA ACUST UNITED AC 2014; 41:500-2, 504-5. [PMID: 25195481 DOI: 10.12968/denu.2014.41.6.500] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED As described in the first paper of this two part series, the expansion of our older population and the concomitant reduction in levels of edentulism will result in an increase in the number of patients presenting in general practice with complex restorative challenges. The application of the concepts of minimal intervention dentistry and minimally invasive operative techniques may offer a powerful armamentarium to the general dentist to provide ethical and conservative treatment to older patients. CLINICAL RELEVANCE When it is unavoidable, operative intervention should be as minimally invasive as practicable in older patients to preserve the longevity of their natural dentition.
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Mews L, Kern M, Ciesielski R, Fischer-Brandies H, Koos B. Shear bond strength of orthodontic brackets to enamel after application of a caries infiltrant. Angle Orthod 2014; 85:645-50. [PMID: 25157972 DOI: 10.2319/013014-82.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To examine differences in the shear bond strength of orthodontic brackets on differently mineralized enamel surfaces after applying a caries infiltrant or conventional adhesive. MATERIALS AND METHODS A total of 320 bovine incisors were assigned to eight pretreated groups, and the shear force required for debonding was recorded. Residual adhesive was evaluated by light microscopy using the adhesive remnant index. Statistical analysis included Kolmogorov-Smirnov, analysis of variance (ANOVA), and Scheffé tests. RESULTS The highest bond strength (18.8 ± 4.4 MPa) was obtained after use of the caries infiltrant. More residual adhesive and fewer enamel defects were observed on infiltrated enamel surfaces. Brackets on demineralized enamel produced multiple enamel defects. CONCLUSIONS Acceptable bond strengths were obtained with all material combinations. A caries-infiltrant applied before bracket fixation has a protective effect, especially on demineralized enamel.
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Affiliation(s)
- Laura Mews
- a Postdoctoral student, Department of Orthodontics, Christian-Albrechts University, Kiel, Germany
| | - Matthias Kern
- b Professor and Chair, Department of Prosthodontics, Propaedeutics and Dental Materials, Christian-Albrechts University, Kiel, Germany
| | - Robert Ciesielski
- c Research Assistant, Department of Orthodontics, Christian-Albrechts University, Kiel, Germany
| | - Helge Fischer-Brandies
- d Professor and Chair, Department of Orthodontics, Christian-Albrechts University, Kiel, Germany
| | - Bernd Koos
- e Assistant Professor, Department of Orthodontics, Christian-Albrechts University, Kiel, Germany
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Ammari MM, Soviero VM, da Silva Fidalgo TK, Lenzi M, Ferreira DMTP, Mattos CT, de Souza IPR, Maia LC. Is non-cavitated proximal lesion sealing an effective method for caries control in primary and permanent teeth? A systematic review and meta-analysis. J Dent 2014; 42:1217-27. [PMID: 25066832 DOI: 10.1016/j.jdent.2014.07.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Revised: 07/16/2014] [Accepted: 07/18/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to perform a systematic review and meta-analysis on the effectiveness of sealing non-cavitated proximal caries lesions in primary and permanent teeth. DATA Only controlled clinical trials and randomized controlled clinical trials that evaluated the effectiveness of sealing on non-cavitated proximal caries with a minimum follow-up of 12 months were included in the study. The primary outcome should be arrestment/progression of proximal caries evaluated by bitewing radiographs. A risk of bias evaluation based on the Cochrane Collaboration common scheme for bias was carried out for each study. The meta-analysis was performed on the studies considered low risk of bias and with pair-wise visual reading results through RevMan software. SOURCES A comprehensive search was performed in the Systematic Electronic Databases: Pubmed, Cochrane Library, Scopus, IBI Web of Science, Lilacs, SIGLE, and on website Clinical trials.gov, through until June 2013. STUDY SELECTION From 967 studies identified, 10 articles and 3 studies with partial results were assessed for eligibility. However three articles were excluded and our final sample included 10 studies. According to the risk of bias evaluation, six studies were considered "high" risk of bias, and four "low" risk of bias. The forest plot of the meta-analysis showed low heterogeneity (I(2)=29%) and a favourable outcome for the Infiltrant. The chance of caries progression when this technique was used was significantly lower (p=0.002) compared with Placebo. CONCLUSION Our results suggest that the technique of sealing non-cavitated proximal caries seems to be effective in controlling proximal caries in the short and medium term. Further long-term randomized clinical trials are still necessary to increase this evidence. CLINICAL SIGNIFICANCE Contemporary dentistry is focused in minimally invasive approaches that prevent the destruction of sound dental tissues next to carious lesions. This paper searches for evidence of the efficacy of sealing/infiltrating non-cavitated proximal caries in arresting caries progression both in permanent and primary teeth.
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Affiliation(s)
- Michelle Mikhael Ammari
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Department of Specific Training, School of Dentistry, Universidade Federal Fluminense, Nova Friburgo, Brazil
| | - Vera Mendes Soviero
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Brazil
| | - Tatiana Kelly da Silva Fidalgo
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michele Lenzi
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Cláudia Trindade Mattos
- Department of Dental Clinics, School of Dentistry, Universidade Federal Fluminense, Niterói, Brazil
| | - Ivete Pomarico Ribeiro de Souza
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
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Abstract
Zusammenfassung
Hintergrund
Karies hat bis heute eine hohe Prävalenz, auch in westlichen Ländern mit präventiven zahnmedizinischen Angeboten. Bei mechanischer Therapie werden die behandelten Zähne geschwächt. Dies führt über die Jahre oder Jahrzehnte häufig zum Verlust mit erheblichen Folgekosten. In den letzten Jahren eingeführte remineralisierende Substanzen sollen die etablierten remineralisationsfördernden Fluoride ergänzen. Daneben stehen die nicht oder minimal-invasiven Konzepte approximale Versiegelung und Kunststoffinfiltration zur Verfügung.
Methode
In diesem Beitrag wird mit der biomimetischen Mineralisation eine neue Methode vorstellt, die auf sich selbst organisierenden Peptiden (SAP) beruht. Die SAP werden in wässriger Lösung auf die gereinigte und geätzte Schmelzoberfläche aufgetragen und dringen in den Läsionskörper ein. Dort bauen sie eine organische Matrix auf, die sekundär mit Kalzium- und Phosphationen aus dem Speichel mineralisiert wird.
Ergebnis
Die Zwischenauswertung einer klinischen Studie bei Approximalläsionen zeigt, dass mit der neuen Methode drei von vier Läsionen stabilisiert oder remineralisiert werden konnten. Damit könnte es erstmals gelingen, demineralisierten Schmelz bis zum angrenzenden Dentin naturanalog wieder herzustellen.
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76
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Jablonski-Momeni A, Heinzel-Gutenbrunner M. Efficacy of the self-assembling peptide P11-4 in constructing a remineralization scaffold on artificially-induced enamel lesions on smooth surfaces. J Orofac Orthop 2014; 75:175-90. [DOI: 10.1007/s00056-014-0211-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 10/08/2013] [Indexed: 11/25/2022]
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77
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Subramaniam P, Girish Babu KL, Lakhotia D. Evaluation of penetration depth of a commercially available resin infiltrate into artificially created enamel lesions: An in vitro study. J Conserv Dent 2014; 17:146-9. [PMID: 24778511 PMCID: PMC4001271 DOI: 10.4103/0972-0707.128054] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/10/2014] [Accepted: 01/15/2014] [Indexed: 11/17/2022] Open
Abstract
Background: Early enamel lesions have a potential to re-mineralize and prevent caries progress. Aim: The aim of the following study is to determine the depth of penetration of low viscosity resin into artificially created enamel lesions. Materials and Methods: A sample of 20 sound premolars, indicated for orthodontic extraction, formed the study group. The teeth were coated with a nail varnish, leaving a window of 4 mm × 4 mm, on buccal surfaces of sound, intact enamel. Each tooth was subsequently immersed in demineralizing solution for 4 days to produce artificial enamel lesions. The demineralized area was then infiltrated with low viscosity resin (Icon Infiltrant, DMG, Hamburg, Germany) as per the manufacturer's instructions. All the restored teeth were then immersed in methylene blue dye for 24 h at 37°C. Teeth were then sectioned longitudinally through the lesion into two halves. The sections were observed under stereomicroscope at ×80 magnification and depth of penetration of the material was measured quantitatively using Motic software. Results: The maximum depth of penetration of the resin material was 6.06 ± 3.31 μm. Conclusions: Resin infiltration technique appears to be effective in sealing enamel lesions and has great potential for arresting white spot lesions.
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Affiliation(s)
- Priya Subramaniam
- Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bengaluru, Karnataka, India
| | - K L Girish Babu
- Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bengaluru, Karnataka, India
| | - Disha Lakhotia
- Department of Pedodontics and Preventive Dentistry, The Oxford Dental College and Hospital, Bengaluru, Karnataka, India
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78
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Taches blanches de l’émail : protocole de traitement par infiltration superficielle ou en profondeur (partie 2). Int Orthod 2014. [DOI: 10.1016/j.ortho.2013.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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79
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Attal JP, Atlan A, Denis M, Vennat E, Tirlet G. White spots on enamel: treatment protocol by superficial or deep infiltration (part 2). Int Orthod 2014; 12:1-31. [PMID: 24503373 DOI: 10.1016/j.ortho.2013.12.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures.
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Affiliation(s)
- Jean-Pierre Attal
- Unité de recherches biomatériaux innovation et interfaces (URB2i), faculté de chirurgie dentaire, Paris Descartes, 1, rue Maurice-Arnoux, 92120 Montrouge, France; Faculté de chirurgie dentaire, 1, rue Maurice-Arnoux, 92120 Montrouge, France; Hôpital Charles-Foix, 7, avenue de la République, 94205 Ivry-sur-Seine, France.
| | - Anthony Atlan
- Unité de recherches biomatériaux innovation et interfaces (URB2i), faculté de chirurgie dentaire, Paris Descartes, 1, rue Maurice-Arnoux, 92120 Montrouge, France; Faculté de chirurgie dentaire, 1, rue Maurice-Arnoux, 92120 Montrouge, France; Hôpital Charles-Foix, 7, avenue de la République, 94205 Ivry-sur-Seine, France
| | - Maud Denis
- Unité de recherches biomatériaux innovation et interfaces (URB2i), faculté de chirurgie dentaire, Paris Descartes, 1, rue Maurice-Arnoux, 92120 Montrouge, France; Faculté de chirurgie dentaire, 1, rue Maurice-Arnoux, 92120 Montrouge, France; Hôpital Charles-Foix, 7, avenue de la République, 94205 Ivry-sur-Seine, France
| | - Elsa Vennat
- École centrale Paris, laboratoire MSSMat, grande voie des Vignes, 92295 Châtenay-Malabry, France
| | - Gilles Tirlet
- Faculté de chirurgie dentaire, 1, rue Maurice-Arnoux, 92120 Montrouge, France; Hôpital Charles-Foix, 7, avenue de la République, 94205 Ivry-sur-Seine, France
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80
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Schwendicke F, Meyer-Lueckel H, Stolpe M, Dörfer CE, Paris S. Costs and effectiveness of treatment alternatives for proximal caries lesions. PLoS One 2014; 9:e86992. [PMID: 24475208 PMCID: PMC3903601 DOI: 10.1371/journal.pone.0086992] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2013] [Accepted: 10/17/2013] [Indexed: 11/18/2022] Open
Abstract
Objectives Invasive therapy of proximal caries lesions initiates a cascade of re-treatment cycles with increasing loss of dental hard tissue. Non- and micro-invasive treatment aim at delaying this cascade and may thus reduce both the health and economic burden of such lesions. This study compared the costs and effectiveness of alternative treatments of proximal caries lesions. Methods A Markov-process model was used to simulate the events following the treatment of a proximal posterior lesion (E2/D1) in a 20-year-old patient in Germany. We compared three interventions (non-invasive; micro-invasive using resin infiltration; invasive using composite restoration). We calculated the risk of complications of initial and possible follow-up treatments and modelled time-dependent non-linear transition probabilities. Costs were calculated based on item-fee catalogues in Germany. Monte-Carlo-microsimulations were performed to compare cost-effectiveness of non- versus micro-invasive treatment and to analyse lifetime costs of all three treatments. Results Micro-invasive treatment was both more costly and more effective than non-invasive therapy, with ceiling-value-thresholds for willingness-to-pay between 16.73 € for E2 and 1.57 € for D1 lesions. Invasive treatment was the most costly strategy. Calculated costs and effectiveness were sensitive to lesion stage, patient’s age, discounting rate and assumed initial treatment costs. Conclusions Non- and micro-invasive treatments have lower long-term costs than invasive therapy of proximal lesions. Micro-invasive therapy had the highest cost-effectiveness for treating D1 lesions in young patients. Decision makers with a willingness-to-pay over 16.73 € and 1.57 € for E2 and D1 lesions, respectively, will find micro-invasive treatment more cost-effective than non-invasive therapy.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
- * E-mail:
| | - Hendrik Meyer-Lueckel
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, Aachen, Germany
| | | | - Christof Edmund Dörfer
- Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University, Kiel, Germany
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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81
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REY N, BENBACHIR N, BORTOLOTTO T, KREJCI I. Evaluation of the staining potential of a caries infiltrant in comparison to other products. Dent Mater J 2014; 33:86-91. [PMID: 24492117 DOI: 10.4012/dmj.2013-241] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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82
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How the introduction of the acid-etch technique revolutionized dental practice. J Am Dent Assoc 2013; 144 Spec No:47S-51S. [DOI: 10.14219/jada.archive.2013.0249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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83
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Araújo GSA, Sfalcin RA, Araújo TGF, Alonso RCB, Puppin-Rontani RM. Evaluation of polymerization characteristics and penetration into enamel caries lesions of experimental infiltrants. J Dent 2013; 41:1014-9. [PMID: 24004967 DOI: 10.1016/j.jdent.2013.08.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2013] [Revised: 08/20/2013] [Accepted: 08/22/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVES To evaluate the properties of experimental infiltrant blends by comparing them with the commercial infiltrant Icon(®) and penetration homogeneity into enamel caries lesions. METHODS Groups were set up as follows: G1 (TEGDMA 100%); G2 (TEGDMA 80%, Ethanol 20%); G3 (TEGDMA 80%, HEMA 20%); G4 (TEGDMA 75%, BisEMA 25%); G5 (TEGDMA 60%, BisEMA 20%, Ethanol 20%); G6 (TEGDMA 60%, BisEMA 20%, HEMA 20%); G7 (TEGDMA 75%, UDMA 25%); G8 (TEGDMA 60%, UDMA 20%, Ethanol 20%); G9 (TEGDMA 60%, UDMA 20%, HEMA 20%) and Icon(®). Ten specimens were comprised by each group for the following tests (n=10): degree of conversion (DC), elastic modulus (EM), Knoop hardness (KH), and softening ratio (SR). Infiltrant penetration was evaluated using confocal microscopy (CLSM). Data were subjected to two-way ANOVA and a Tukey's test (5%). Data comparing experimental materials and Icon(®) were analysed using ANOVA and Dunnett's test (5%). RESULTS The highest DC values were found in G1, G7, G8, and G9. The lowest DC values were found in G2, G4, G5, and G6. EM and KHN were significantly lower in HEMA and with ethanol addition for all blends, except for G9. There was no significant difference among the groups regarding SR, and it was not possible to take KHN readings of G2, G5, and G8 after storage. There was no significant difference among groups for infiltrant penetration into enamel lesions. CONCLUSIONS The addition of hydrophobic monomers and solvents into TEGDMA blends affected DC, EM, and KHN. UDMA added to TEGDMA resulted in an increase in DC, EM, and KHN. Overall, solvents added to monomer blends resulted in decreased properties. The addition of hydrophobic monomers and solvents into TEGDMA blends does not improve the penetration depth of the infiltrants.
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84
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Donovan TE, Anderson M, Becker W, Cagna DR, Carr GB, Albouy JP, Metz J, Eichmiller F, McKee JR. Annual Review of selected dental literature: Report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2013; 110:161-210. [DOI: 10.1016/s0022-3913(13)60358-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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85
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86
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Banerjee A, Doméjean S. The contemporary approach to tooth preservation: minimum intervention (MI) caries management in general practice. Prim Dent J 2013; 2:30-37. [PMID: 24340496 DOI: 10.1308/205016813807440119] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The minimum intervention (MI) approach summarises a clinical, evidence-based rationale for the preventive and cause-related approach to oral diseases in general and to caries in particular. MI oral care with respect to the management of patients suffering from dental caries is a concept based on an updated understanding of the histopathological carious process as well as the development of diagnostic technologies and adhesive, bioactive restorative materials. A patient-centred MI care plan for use in general dental practice is described, detailing the four phases of identifying disease, controlling/preventing disease, refurbishing/repairing tooth surfaces/restorations and recall consultations.
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Affiliation(s)
- Avijit Banerjee
- King's College Dental Institute at Guy's Hospital, King's Health Partners, London
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87
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Paris S, Schwendicke F, Seddig S, Müller WD, Dörfer C, Meyer-Lueckel H. Micro-hardness and mineral loss of enamel lesions after infiltration with various resins: influence of infiltrant composition and application frequency in vitro. J Dent 2013; 41:543-8. [PMID: 23571098 DOI: 10.1016/j.jdent.2013.03.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 03/14/2013] [Accepted: 03/28/2013] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES The aim of this in vitro study was to evaluate the influence of infiltrant composition and application frequency on micro-hardness and lesion progression after resin infiltration of artificial enamel lesions. METHODS In each of 100 bovine enamel samples, three artificial caries lesions were created (pH=4.95, 50 days). After etching two of the lesions (37% phosphoric acid) specimens were randomly allocated to five infiltrants (four experimental infiltrants with different monomer and solvent compositions and penetration coefficients, and one commercial infiltrant [Icon, DMG]). Lesions were then infiltrated and light-cured, and infiltration repeated afterwards for one of the lesions. Infiltrated samples were cut into halves, with one half being demineralised for further 50 days. Micro-hardness (VHN) and integrated mineral loss (ΔZ) were evaluated at baseline and after second demineralisation. Repeated measures ANOVA and paired t-tests were used to analyse influence of material composition and application frequency on micro-hardness and lesion progression (integrated mineral loss difference ΔΔZ). RESULTS Resin infiltration significantly increased micro-hardness and reduced lesion progression compared to untreated artificial lesions (p<0.05, t-test). Neither micro-hardness nor lesion progression were significantly influenced by material composition (p>0.05, ANOVA). In contrast, twice application resulted in significantly increased micro-hardness and demineralisation resistance of infiltrated lesions (p<0.05, ANOVA). CONCLUSION Resin infiltration significantly improves micro-hardness and demineralisation resistance of enamel lesions; these effects are significantly enhanced if resins are applied twice. Experimental resins did not outperform the commercial infiltrant. CLINICAL SIGNIFICANCE This in vitro study demonstrated that resin infiltration significantly increases both micro-hardness and demineralisation resistance of enamel caries lesions. Twice application of the infiltrant seems to increase these effects. In contrast, the composition of the infiltrant had no significant influence on investigated parameters.
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Affiliation(s)
- S Paris
- Department for Conservative Dentistry and Periodontology, Christian-Albrechts-Universität, Kiel, Germany
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88
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Ekstrand K, Martignon S, Bakhshandeh A, Ricketts DNJ. The non-operative resin treatment of proximal caries lesions. ACTA ACUST UNITED AC 2013; 39:614-6, 618-20, 622. [PMID: 23479850 DOI: 10.12968/denu.2012.39.9.614] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
UNLABELLED Epidemiological data show that the prevalence of caries on proximal surfaces in need of operative treatment is very high around the world, both in the primary and the permanent dentition. This article presents two new treatment methods: proximal sealing and proximal infiltration. The indications are progressing proximal caries lesions, radiographically with a depth around the enamel-dentine junction. A small number of studies regarding the effect of sealing and infiltration on proximal caries versus the use of fluoride varnish, placebo treatment and flossing instructions have been carried out. About half of the studies disclose a not significant difference between test and control treatment. In the other half, the therapeutic effect is significant and corresponds to about 30% reduction in lesion progression. However, longitudinal studies of longer duration are lacking. CLINICAL RELEVANCE Proximal sealing and proximal infiltration may have a place in the treatment of non-cavitated proximal lesions. Proximal caries is a problem in both primary and permanent dentitions. Proximal sealants or lesion infiltration are possible treatments.
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Affiliation(s)
- Kim Ekstrand
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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89
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Naidu E, Stawarczyk B, Tawakoli PN, Attin R, Attin T, Wiegand A. Shear bond strength of orthodontic resins after caries infiltrant preconditioning. Angle Orthod 2013; 83:306-312. [PMID: 22908947 PMCID: PMC8793655 DOI: 10.2319/052112-409.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 07/01/2012] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVE To investigate the influence of caries infiltrant preconditioning on the shear bond strength of orthodontic resin cements on sound and demineralized enamel. MATERIALS AND METHODS Stainless-steel brackets were bonded to sound or artificially demineralized (14 d, acidic buffer, pH 5.0) bovine enamel specimens using a resin cement or a combination of caries infiltrant preconditioning (Icon, DMG) and the respective resin cement (light-curing composite: Heliosit Orthodontic, Transbond XT, using either Transbond XT Primer or Transbond Plus Self Etching Primer; light-curing resin-modified glass ionomer cement: Fuji Ortho; or self-curing composite: Concise Orthodontic Bonding System). Each group consisted of 15 specimens. Shear bond strength was evaluated after thermo-cycling (10,000×, 5°C to 55°C) at a crosshead speed of 1 mm/min, and data were statistically analyzed by analysis of variance, Mann-Whitney test, and Weibull statistics. Adhesive Remnant Index (ARI) scores and enamel fractures were determined at 25× magnification and were statistically analyzed by regression analyses (P < .05). RESULTS The caries infiltrant system significantly increased the shear bond strength of Transbond XT Primer, Transbond Plus Self Etching Primer, and Fuji Ortho in sound specimens, and of all resin cements except for the Concise Orthodontic Bonding System in demineralized enamel. Overall, caries infiltrant preconditioning decreased significantly the number of enamel fractures, but it did not affect ARI scores. CONCLUSION Preconditioning of sound and demineralized enamel with the caries infiltrant system did not impair but rather increased the shear bond strength of most orthodontic resin cements while decreasing the risk of enamel fracture at debonding.
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Affiliation(s)
- Ewelina Naidu
- Assistant, Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland
| | - Bogna Stawarczyk
- Dental Technician, Department of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Switzerland, and Department of Prosthodontics, Ludwig-Maximillians University, Munich, Germany
| | - Pune Nina Tawakoli
- Assistant, Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland
| | | | - Thomas Attin
- Professor and Department Chair, Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland
| | - Annette Wiegand
- Senior Lecturer, Department of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Switzerland
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90
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Souza-Junior EJ, Borges BCD, Montes MAJR, Alonso RCB, Ambrosano GMB, Sinhoreti MAC. Influence of etching time and bonding strategies on the microshear bond strength of self- and light-cured pit-and-fissure sealants. Braz Dent J 2013; 23:477-83. [PMID: 23306221 DOI: 10.1590/s0103-64402012000500002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Accepted: 04/13/2012] [Indexed: 11/22/2022] Open
Abstract
This study evaluated the impact of extended etching and bonding strategies on the microshear bond strength of three sealant materials. Two pit-and-fissure sealants [FluroShield, Dentsply (light-cured) and AlphaSeal, DFL (self-cured)] and one light-cured flowable composite resin (Permaflo, Ultradent) were evaluated according to different enamel etching times (15 s or 30 s) and bonding procedures (no adhesive application, application of primer/hydrophobic resin or hydrophobic resin only). Intact enamel blocks were obtained from bovine teeth and sealed via the tested protocols. After 24 h, the microshear bond strength test was performed in a universal testing machine at a crosshead speed of 0.5 mm/min. Failure modes were classified by stereomicroscopy. Data were submitted to a three-way ANOVA and to Tukey's test (α=0.05). There was no statistically significant difference (p>0.05) among the materials. Permaflo showed higher bond strength when etched for 30 s alone. Enamel overetching decreased the bond strength of the light-cured sealant. Primer/bond previous treatment improved bond performance for AlphaSeal. In conclusion, from the tested conditions, all sealant materials presented similar bond strength values in relation to bonding protocol and etching time. The flowable composite can be used as a pit-and-fissure sealant. The use of a three-step adhesive system was essential for the self-cured sealant application.
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91
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Neuhaus K, Schlafer S, Lussi A, Nyvad B. Infiltration of Natural Caries Lesions in Relation to Their Activity Status and Acid Pretreatment in vitro. Caries Res 2013; 47:203-10. [DOI: 10.1159/000345654] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 11/07/2012] [Indexed: 11/19/2022] Open
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92
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Tellez M, Gomez J, Kaur S, Pretty IA, Ellwood R, Ismail AI. Non-surgical management methods of noncavitated carious lesions. Community Dent Oral Epidemiol 2012; 41:79-96. [DOI: 10.1111/cdoe.12028] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 11/02/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Marisol Tellez
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
| | - Juliana Gomez
- Colgate Palmolive Dental Health Unit; School of Dentistry; University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - Sundeep Kaur
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
| | - Iain A. Pretty
- Colgate Palmolive Dental Health Unit; School of Dentistry; University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - Roger Ellwood
- Colgate Palmolive Dental Health Unit; School of Dentistry; University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - Amid I. Ismail
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
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93
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Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group. Int Dent J 2012; 62:223-43. [PMID: 23106836 DOI: 10.1111/idj.12007] [Citation(s) in RCA: 248] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
This publication describes the history of minimal intervention dentistry (MID) for managing dental caries and presents evidence for various carious lesion detection devices, for preventive measures, for restorative and non-restorative therapies as well as for repairing rather than replacing defective restorations. It is a follow-up to the FDI World Dental Federation publication on MID, of 2000. The dental profession currently is faced with an enormous task of how to manage the high burden of consequences of the caries process amongst the world population. If it is to manage carious lesion development and its progression, it should move away from the 'surgical' care approach and fully embrace the MID approach. The chance for MID to be successful is thought to be increased tremendously if dental caries is not considered an infectious but instead a behavioural disease with a bacterial component. Controlling the two main carious lesion development related behaviours, i.e. intake and frequency of fermentable sugars, to not more than five times daily and removing/disturbing dental plaque from all tooth surfaces using an effective fluoridated toothpaste twice daily, are the ingredients for reducing the burden of dental caries in many communities in the world. FDI's policy of reducing the need for restorative therapy by placing an even greater emphasis on caries prevention than is currently done, is therefore, worth pursuing.
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Affiliation(s)
- Jo E Frencken
- Department of Global Oral Health, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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94
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Soviero VM, Paris S, Leal SC, Azevedo RB, Meyer-Lueckel H. Ex vivo evaluation of caries infiltration after different application times in primary molars. Caries Res 2012. [PMID: 23207512 DOI: 10.1159/000345065] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Low viscosity resins (infiltrants) have been shown to penetrate the lesion body of natural caries lesions almost completely in vitro. However, penetration depths (PD) have not been evaluated in vivo. Therefore, the aim of the present study was to evaluate the penetration of an infiltrant into proximal caries lesions in primary molars after different application times using an ex vivo model. 59 proximal lesions from 34 children were randomly allocated to one of the application times and were infiltrated under clinical conditions for 1, 3, or 5 min. After extraction or exfoliation (n = 48), teeth were sectioned perpendicular to their surfaces and lesion depths (LD) as well as lesion areas (LA) were evaluated using polarized light microscopy. PD and penetration areas (PA) were measured on scanning electron microscopic images. Percentage penetration depth (PPD) and percentage penetration area (PPA) were calculated. The mean (±SD) LD and LA were 596 ± 203 µm and 4.03 ± 2.75 × 10(5) µm(2), respectively. PPD ranged from 70 to 80% and PPA from 54 to 60%. Longer application times did not result in significantly deeper or more complete penetration (p > 0.05; ANOVA). In conclusion, proximal caries lesions in primary molars can be infiltrated in vivo to a similar extent as observed previously in vitro. Moreover, 1-min application of the infiltrant led to PD and homogeneity similar to those observed with longer application times up to 5 min.
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Affiliation(s)
- V M Soviero
- Department of Preventive and Community Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
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Infiltrating/sealing proximal caries lesions: a 3-year randomized clinical trial. Br Dent J 2012. [DOI: 10.1038/sj.bdj.2012.910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Meyer-Lueckel H, Bitter K, Paris S. Randomized Controlled Clinical Trial on Proximal Caries Infiltration: Three-Year Follow-Up. Caries Res 2012; 46:544-8. [DOI: 10.1159/000341807] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 07/04/2012] [Indexed: 11/19/2022] Open
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MORE ABOUT SEALANTS: Author's response. J Am Dent Assoc 2012. [DOI: 10.14219/jada.archive.2012.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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