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Kumar S, Chhabra V, Mehra M, K S, Kumar B H, Shenoy S, Swamy RS, Murti K, Pai KSR, Kumar N. The fluorosis conundrum: bridging the gap between science and public health. Toxicol Mech Methods 2024; 34:214-235. [PMID: 37921264 DOI: 10.1080/15376516.2023.2268722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
Fluorosis, a chronic condition brought on by excessive fluoride ingestion which, has drawn much scientific attention and public health concern. It is a complex and multifaceted issue that affects millions of people worldwide. Despite decades of scientific research elucidating the causes, mechanisms, and prevention strategies for fluorosis, there remains a significant gap between scientific understanding and public health implementation. While the scientific community has made significant strides in understanding the etiology and prevention of fluorosis, effectively translating this knowledge into public health policies and practices remains challenging. This review explores the gap between scientific research on fluorosis and its practical implementation in public health initiatives. It suggests developing evidence-based guidelines for fluoride exposure and recommends comprehensive educational campaigns targeting the public and healthcare providers. Furthermore, it emphasizes the need for further research to fill the existing knowledge gaps and promote evidence-based decision-making. By fostering collaboration, communication, and evidence-based practices, policymakers, healthcare professionals, and the public can work together to implement preventive measures and mitigate the burden of fluorosis on affected communities. This review highlighted several vital strategies to bridge the gap between science and public health in the context of fluorosis. It emphasizes the importance of translating scientific evidence into actionable guidelines, raising public awareness about fluoride consumption, and promoting preventive measures at individual and community levels.
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Affiliation(s)
- Sachindra Kumar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Vishal Chhabra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Manmeet Mehra
- Department of Pharmacology, Guru Nanak Dev University, Amritsar, India
| | - Saranya K
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Harish Kumar B
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Smita Shenoy
- Department of Pharmacology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ravindra Shantakumar Swamy
- Division of Anatomy, Department of Basic Medical Sciences (DBMS), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - K Sreedhara Ranganath Pai
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
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Brum VDS, Borges MLV, Santos NMD, Kaufmann C, Rodrigues JDA. The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial. Braz Oral Res 2024; 38:e009. [PMID: 38198308 DOI: 10.1590/1807-3107bor-2024.vol38.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/09/2023] [Indexed: 01/12/2024] Open
Abstract
This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.
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Affiliation(s)
- Vanessa Dos Santos Brum
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Maria Luiza Vieira Borges
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Nicole Marchioro Dos Santos
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Camila Kaufmann
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Jonas de Almeida Rodrigues
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
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Ramburrun P, Pringle NA, Dube A, Adam RZ, D'Souza S, Aucamp M. Recent Advances in the Development of Antimicrobial and Antifouling Biocompatible Materials for Dental Applications. MATERIALS (BASEL, SWITZERLAND) 2021; 14:3167. [PMID: 34207552 PMCID: PMC8229368 DOI: 10.3390/ma14123167] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/18/2022]
Abstract
The risk of secondary bacterial infections resulting from dental procedures has driven the design of antimicrobial and antifouling dental materials to curb pathogenic microbial growth, biofilm formation and subsequent oral and dental diseases. Studies have investigated approaches based primarily on contact-killing or release-killing materials. These materials are designed for addition into dental resins, adhesives and fillings or as immobilized coatings on tooth surfaces, titanium implants and dental prosthetics. This review discusses the recent developments in the different classes of biomaterials for antimicrobial and antifouling dental applications: polymeric drug-releasing materials, polymeric and metallic nanoparticles, polymeric biocides and antimicrobial peptides. With modifications to improve cytotoxicity and mechanical properties, contact-killing and anti-adhesion materials show potential for incorporation into dental materials for long-term clinical use as opposed to short-lived antimicrobial release-based coatings. However, extended durations of biocompatibility testing, and adjustment of essential biomaterial features to enhance material longevity in the oral cavity require further investigations to confirm suitability and safety of these materials in the clinical setting. The continuous exposure of dental restorative and regenerative materials to pathogenic microbes necessitates the implementation of antimicrobial and antifouling materials to either replace antibiotics or improve its rational use, especially in the day and age of the ever-increasing problem of antimicrobial resistance.
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Affiliation(s)
- Poornima Ramburrun
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Nadine A Pringle
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Admire Dube
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Razia Z Adam
- Department of Restorative Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town 7505, South Africa
| | - Sarah D'Souza
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
| | - Marique Aucamp
- School of Pharmacy, Faculty of Natural Sciences, University of the Western Cape, Cape Town 7535, South Africa
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Vanella V, Castagnola R, Marigo L, Grande NM, Plotino G. A comparison of near-infrared imaging with other diagnostic tools for dental caries. Minerva Dent Oral Sci 2021; 70:214-222. [PMID: 33988331 DOI: 10.23736/s2724-6329.21.04527-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Dental caries is one of the most common diseases in the world, and global incidence rates are increasing. The early detection of dental lesions enables a conservative approach to be employed and represents a priority in modern dentistry. Recent studies have suggested that conventional diagnostic methods, such as visual tactile inspection and X-ray examination, exhibit low sensitivity and are not very effective in early diagnoses. Consequently, late detection of decay is associated with an increased loss of tooth structure. New diagnostic systems based on optical properties have been developed to facilitate early detection. Several studies have evaluated the performance of near-infrared imaging (NIRI) as an early diagnostic tool. NIRI using light ranging from 700 to 1700 nm has demonstrated better optical properties compared to conventional optical systems using light in the visible spectra. NIRI enables deeper penetration of the light in the tooth tissue, weak scattering with lower background noise and strong photon absorption with detailed images. Several in vivo studies have demonstrated that NIRI technology has the potential to improve performance compared with current diagnostic methods. NIRI exhibits increased sensitivity compared to radiographs and is more suitable to identify approximal enamel lesions. This paper aims to review these recent advances and their potential applications in daily clinical practice.
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Affiliation(s)
- Valeria Vanella
- Dipartimento di Conservativa ed Endodonzia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Odontoiatria e Chirurgia Maxillo-facciale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Raffaella Castagnola
- Dipartimento di Conservativa ed Endodonzia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy - .,Istituto di Odontoiatria e Chirurgia Maxillo-facciale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Marigo
- Dipartimento di Conservativa ed Endodonzia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Odontoiatria e Chirurgia Maxillo-facciale, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola M Grande
- Dipartimento di Conservativa ed Endodonzia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Istituto di Odontoiatria e Chirurgia Maxillo-facciale, Università Cattolica del Sacro Cuore, Rome, Italy
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Urzúa I, Cabello R, Marín P, Ruiz B, Jazanovich D, Mautz C, Lira M, Sánchez J, Rodríguez G, Osorio S, Ortiz ME. Detection of Approximal Caries Lesions in Adults: A Cross-sectional Study. Oper Dent 2019; 44:589-594. [PMID: 31502921 DOI: 10.2341/17-314-c] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Detection and management of posterior approximal caries lesions are still problematic. Inspection of approximal surfaces is challenging, and bitewing radiographs are used when direct vision is not possible. Unfortunately, there is no definite radiographic appearance to identify lesion cavitation with absolute certainty. Many lesions detected radiographically within the outer half of dentin are not cavitated, often resulting in unnecessary restorative treatment. Our study compared radiographic depth of approximal caries lesions with presence of cavitation in adults using visual inspection following temporary tooth separation (TTS). We conducted this observational descriptive cross-sectional study at two dental schools in two cities in Chile. Clinicians were unaware of radiographic depths of lesions and examined 147 participants (57.3% female and 42.7% male) following TTS. Using the common classification system that consists of E0 (no lesion), E1 (lesion within the outer half of enamel), E2 (lesion within the inner half of enamel), D1 (lesion within the outer third of dentin), D2 (lesion within the middle third of dentin), and D3 (lesion within the inner third of dentin), a trained dentist evaluated all the processed films. Cavitation was detected in only three sites (0.22%) within the E0 category, seven sites (3.41%) in E1, five sites (14.8%) in E2, four sites (14.8%) in D1, six sites (50%) in D2, and eight sites (61.5%) in D3. Considering that restorative treatment should be indicated strictly for cavitated lesions, our findings support indication for restorative treatment for D3 lesions and the rationale for TTS for D1-D2 caries lesions to allow direct visual inspection to determine whether there is surface cavitation.
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Lee HE, Han MS, Nam SH. Anticariogenic activity of Nelumbo nucifera leaf extract in oral healthcare. Technol Health Care 2019; 27:487-497. [PMID: 31127738 DOI: 10.3233/thc-191732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We aimed to evaluate the antimicrobial effect of the Nelumbo nucifera leaf extract. There have been no studies related to dental caries inducing bacteria up to now. OBJECTIVE This study reviewed the inhibitory effect of glucose transferase (GTase) activation and acid production to confirm the anticariogenic activity of Nelumbo nucifera leaf extract. METHODS This study used 100 g Nelumbo nucifera leaves cultivated in Yeongcheon-si, Gyeongbuk, after adding 70% methanol tenfold. The leaves were then concentrated (Gotary vacuum evaporator; N-Nseries, EYELA Co., Japan) and were placed under an aspirator (A-3S, EYELA Co., Japan) and a freeze dryer (Ilshin Lab Co., Korea). The anticariogenic effect of Nelumbo nucifera leaves extract was investigated using the growth inhibitory effect, as well as GTase activation. RESULTS Among the nine kinds of oral-disease-causing bacteria, the Nelumbo nucifera leaf extract most effectively inhibited the growth of Streptococcus anginosus (S. anginosus), but it was difficult to inhibit the growth of Streptococcus oralis (S. oralis). For the anticariogenic effect of Nelumbo nucifera leaf extract, GTase activation was inhibited by at least 50% in all the nine types of bacteria, including Streptococcus mutans (S. mutans). It was shown that Nelumbo nucifera leaf extract had the strongest GTase activation inhibitory effect (85%) in S. anginosus. In addition, Nelumbo nucifera leaf extract showed an acid production inhibitory effect in the nine types of strains by maintaining almost pH 6.2 even after being cultured for 24 hours in the Nelumbo-nucifera-leaf-extract-added culture, while the control culture without Nelumbo nucifera leaf extract showed only about pH 5.0 after 4 hours. CONCLUSIONS In conclusion, Nelumbo nucifera leaf extract showed the strongest GTase activation inhibitory effect in S. anginosus. Based on this, it was confirmed that Nelumbo nucifera leaf extract showed anticariogenic activity against oral cavity disease microorganisms.
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Affiliation(s)
- Haeng-Eun Lee
- Department of Dental Hygiene, Masan University, Changwon 51217, Korea
| | - Man-Seok Han
- Department of Radiological Science, College of Health Science, Kangwon National University, Samcheok 25949, Korea.,Department of Dental Hygiene, Masan University, Changwon 51217, Korea
| | - Seoul-Hee Nam
- Department of Dental Hygiene, College of Health Science, Kangwon National University, Samcheok 25949, Korea.,Department of Dental Hygiene, Masan University, Changwon 51217, Korea
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8
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Achilleos E, Rahiotis C, Kavvadia K, Vougiouklakis G. Clinical Evaluation of Two Different Prevention Programs in Adults Depending on Their Caries Risk Profile: One-year Results. Oper Dent 2018; 44:127-137. [PMID: 30517071 DOI: 10.2341/17-164-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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 investigate the management of incipient caries lesions in adults with two preventive protocols. A total of 44 adult patients with high, moderate and low caries risk with 516 incipient caries took part in the study. These patients were assessed for caries with International Caries Detection and Assessment System (ICDAS) criteria and were then divided into three groups depending on their caries risk profile: a high-risk group (group A), a moderate-risk group (group B), and a low-risk group (group C). Participants in each group were further divided randomly into two subgroups. In subgroups A1, B1, and C1, an intensive preventive protocol was applied, while in subgroups A2, B2, and C2, the protocol consisted only of instructions in oral hygiene. The invasive-intensive protocol included the topical application of fluoride, brushing with 5000-ppm fluoride toothpaste, use of amorphous calcium phosphate-casein phosphopeptide, applications of sealants for occlusal lesions (ICDAS code 2), and minimal resin restorations for occlusal lesions (ICDAS code 3). There was no statistically significant difference in the number of lesions (baseline and after one year) in the high-risk and moderate-risk groups that received the intensive protocol (groups A1 and B1), while the control groups were statistically significant different (groups A2 and B2). In the low-risk group, there was no statistically significant difference in the number of lesions (groups C1 and C2). The two different preventive protocols in the high- and moderate-risk groups presented differences in effectiveness, while in the low-risk group, no significant difference was demonstrated.
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Lacruz RS, Habelitz S, Wright JT, Paine ML. DENTAL ENAMEL FORMATION AND IMPLICATIONS FOR ORAL HEALTH AND DISEASE. Physiol Rev 2017; 97:939-993. [PMID: 28468833 DOI: 10.1152/physrev.00030.2016] [Citation(s) in RCA: 223] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 01/10/2017] [Accepted: 01/10/2017] [Indexed: 12/16/2022] Open
Abstract
Dental enamel is the hardest and most mineralized tissue in extinct and extant vertebrate species and provides maximum durability that allows teeth to function as weapons and/or tools as well as for food processing. Enamel development and mineralization is an intricate process tightly regulated by cells of the enamel organ called ameloblasts. These heavily polarized cells form a monolayer around the developing enamel tissue and move as a single forming front in specified directions as they lay down a proteinaceous matrix that serves as a template for crystal growth. Ameloblasts maintain intercellular connections creating a semi-permeable barrier that at one end (basal/proximal) receives nutrients and ions from blood vessels, and at the opposite end (secretory/apical/distal) forms extracellular crystals within specified pH conditions. In this unique environment, ameloblasts orchestrate crystal growth via multiple cellular activities including modulating the transport of minerals and ions, pH regulation, proteolysis, and endocytosis. In many vertebrates, the bulk of the enamel tissue volume is first formed and subsequently mineralized by these same cells as they retransform their morphology and function. Cell death by apoptosis and regression are the fates of many ameloblasts following enamel maturation, and what cells remain of the enamel organ are shed during tooth eruption, or are incorporated into the tooth's epithelial attachment to the oral gingiva. In this review, we examine key aspects of dental enamel formation, from its developmental genesis to the ever-increasing wealth of data on the mechanisms mediating ionic transport, as well as the clinical outcomes resulting from abnormal ameloblast function.
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Affiliation(s)
- Rodrigo S Lacruz
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, New York; Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California; Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina; Herman Ostrow School of Dentistry, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, California
| | - Stefan Habelitz
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, New York; Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California; Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina; Herman Ostrow School of Dentistry, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, California
| | - J Timothy Wright
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, New York; Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California; Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina; Herman Ostrow School of Dentistry, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, California
| | - Michael L Paine
- Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, New York; Department of Preventive and Restorative Dental Sciences, University of California, San Francisco, San Francisco, California; Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina; Herman Ostrow School of Dentistry, Center for Craniofacial Molecular Biology, University of Southern California, Los Angeles, California
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Mitchell ST, Funkhouser E, Gordan VV, Riley JL, Makhija SK, Litaker MS, Gilbert GH. Satisfaction with dental care among patients who receive invasive or non-invasive treatment for non-cavitated early dental caries: findings from one region of the National Dental PBRN. BMC Oral Health 2017; 17:70. [PMID: 28347303 PMCID: PMC5368933 DOI: 10.1186/s12903-017-0363-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 03/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objectives were to: (1) quantify patient satisfaction with treatment for early dental caries overall, and according to whether or not (2a) the patient received invasive treatment; (2b) was high-risk for dental caries, and had dental insurance; and (3) encourage practitioners to begin using non-invasive approaches to early caries management. METHODS Ten practitioners recorded patient, lesion, and treatment information about non-cavitated early caries lesions. Information on 276 consecutive patients with complete data was included, who received either non-invasive (no dental restoration) or invasive (dental restoration) treatment. Patients completed a patient satisfaction questionnaire and were classified as dissatisfied if they did not "agree" or "strongly agree" with any of 14 satisfaction items. RESULTS Patients had a mean (± SD) age of 41.8 (±15.8) years, 64% were female and 88% were white. Twenty-five percent (n = 68) were dissatisfied in at least one of the 14 satisfaction items. Satisfaction levels did not significantly vary by patient's gender, race, caries risk category, or affected tooth surface location. Overall, 11% (28 of 276) received invasive treatment; satisfaction did not differ between patients who had invasive or non-invasive treatment. Seven patients received invasive treatment at their request even though that was not what their practitioner recommended; 5 out of 6 were satisfied with their treatment nonetheless. CONCLUSIONS About one-fourth of patients treated for non-cavitated early caries were dissatisfied with at least some aspect of their dental care experience. Satisfaction of patients who received invasive treatment did not differ from those who received non-invasive treatment.
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Affiliation(s)
- Sonya T Mitchell
- University of Alabama at Birmingham, SDB Room 609; Box 48, 1720 Second Avenue South, Birmingham, AL, 35294-0007, USA.
| | - Ellen Funkhouser
- Department of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Valeria V Gordan
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Joseph L Riley
- Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Sonia K Makhija
- University of Alabama at Birmingham, SDB Room 609; Box 48, 1720 Second Avenue South, Birmingham, AL, 35294-0007, USA
| | - Mark S Litaker
- University of Alabama at Birmingham, SDB Room 609; Box 48, 1720 Second Avenue South, Birmingham, AL, 35294-0007, USA
| | - Gregg H Gilbert
- University of Alabama at Birmingham, SDB Room 609; Box 48, 1720 Second Avenue South, Birmingham, AL, 35294-0007, USA
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Jablonski-Momeni A, Heinzel-Gutenbrunner M, Haak R, Krause F. Use of AC impedance spectroscopy for monitoring sound teeth and incipient carious lesions. Clin Oral Investig 2016; 21:2421-2427. [DOI: 10.1007/s00784-016-2038-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 12/14/2016] [Indexed: 11/30/2022]
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Antibacterial Peptides: Opportunities for the Prevention and Treatment of Dental Caries. Probiotics Antimicrob Proteins 2016; 3:68. [PMID: 26781572 DOI: 10.1007/s12602-011-9076-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Dental caries is a multifactorial disease that is a growing and costly global health concern. The onset of disease is a consequence of an ecological imbalance within the dental plaque biofilm that favors specific acidogenic and aciduric caries pathogens, namely Streptococcus mutans and Streptococcus sobrinus. It is now recognized by the scientific and medical community that it is neither possible nor desirable to totally eliminate dental plaque. Conversely, the chemical biocides most commonly used for caries prevention and treatment indiscriminately attack all plaque microorganisms. These treatments also suffer from other drawbacks such as bad taste, irritability, and staining. Furthermore, the public demand for safe and natural personal hygiene products continues to rise. Therefore, there are opportunities that exist to develop new strategies for the treatment of this disease. As an alternative to conventional antibiotics, antibacterial peptides have been explored greatly over the last three decades for many different therapeutic uses. There are currently tens of hundreds of antibacterial peptides characterized across the evolutionary spectrum, and among these, many demonstrate physical and/or biological properties that may be suitable for a more targeted approach to the selective control or elimination of putative caries pathogens. Additionally, many peptides, such as nisin, are odorless, colorless, and tasteless and do not cause irritation or staining. This review focuses on antibacterial peptides for their potential role in the treatment and prevention of dental caries and suggests candidates that need to be explored further. Practical considerations for the development of antibacterial peptides as oral treatments are also discussed.
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Chlorhexidine versus topical fluoride treatment for the prevention and management of dental caries in children and adolescents. Hippokratia 2016. [DOI: 10.1002/14651858.cd009962.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Evans RW, Clark P, Jia N. The Caries Management System: are preventive effects sustained postclinical trial? Community Dent Oral Epidemiol 2015; 44:188-97. [PMID: 26639787 PMCID: PMC5324629 DOI: 10.1111/cdoe.12204] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
Objectives To report, at two and 4 years post‐trial, on the potential legacy of a 3‐year randomized controlled clinical trial (RCT) of the Caries Management System (CMS) at private general dental practices. The CMS was designed to reduce caries risk and need for restorative care. Methods Nineteen dental practices located in city, urban, and rural locations in both fluoridated and nonfluoridated communities participated in the RCT. Eight practices were lost to follow‐up post‐trial; however, baseline mean DMFT balance between CMS and control practices was maintained. At the control practices, caries management following usual practice continued to be delivered. The patient outcome measure was the cumulative increment in the DMFT index score, and the practice outcome measures included the practice‐mean and practice‐median increments of patient DMFT index scores. In covariable analysis (patient‐level unit of analysis), as the patients were clustered by practices, mean DMFT increments were determined through multilevel modeling analysis. Practice‐mean DMFT increments (practice‐level unit of analysis) and practice‐median DMFT increments (also practice level) were determined through general linear modeling analysis of covariance. In addition, a multiple variable logistic regression analysis of caries risk status was conducted. Results The overall 4‐year post‐trial result (years 4–7) for CMS patients was a DMFT increment of 2.44 compared with 3.39 for control patients (P < 0.01), a difference equivalent to 28%. From the clinical trial baseline to the end of the post‐trial follow‐up period, the CMS and control increments were 6.13 and 8.66, respectively, a difference of 29% (P < 0.0001). Over the post‐trial period, the CMS and control practice‐mean DMFT increments were 2.16 and 3.10 (P = 0.055) and the respective increments from baseline to year 7 were 4.38 and 6.55 (P = 0.029), difference of 33%. The practice‐median DMFT increments during the 4‐year post‐trial period for CMS and control practices were 1.25 and 2.36 (P = 0.039), and the respective increments during the period from baseline to year 7 were 2.87 and 5.36 (P < 0.01), difference of 47%. Minimally elevated odds of being high risk were associated with baseline DMFT (OR = 1.17). Patients attending the CMS practices had lower odds of being high risk than those attending control practices (OR = 0.23, 95% CI = 0.06, 0.88). Conclusion In practices where adherence to the CMS protocols was maintained during the 4‐year post‐trial follow‐up period, patients continued to benefit from a reduced risk of caries and, therefore, experienced lower needs for restorative treatment.
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Affiliation(s)
- R Wendell Evans
- Population Oral Health, Sydney Dental School, University of Sydney, Sydney, NSW, Australia
| | - Paula Clark
- Population Oral Health, Sydney Dental School, University of Sydney, Sydney, NSW, Australia
| | - Nan Jia
- Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
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15
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Sakuma A, Makino Y, Saitoh H, Chiba F, Ishii N, Iwase H. Evaluation of a personal identification method using the fusion function of CT images and dental radiographs. Dentomaxillofac Radiol 2014; 44:20140137. [PMID: 25270062 DOI: 10.1259/dmfr.20140137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES We applied the fusion function of dental analysis software to examine whether the anatomical relationships of tooth roots when compared between reconstructed post-mortem CT (PMCT) and dental radiographs can aid dental identification. METHODS One PMCT image taken from a cadaver (43-year-old male; Cadaver 1) was compared with 64 digital dental radiographs of the left and right upper and lower molars from Cadaver 1 and 30 other cadavers. Five corresponding anatomical reference points were marked on each image. After adjusting the angle and magnification using the fusion function, the automatically calculated error in pixels was determined five times for each of four sites on the images. RESULTS Comparison of the PMCT image with the dental radiographs from the other cadavers revealed obvious discrepancies in the anatomical positioning of the teeth. When t-tests were applied to the data from any of the four sites, the error in pixels was found to be significantly smaller (p < 0.001) between Cadaver 1 and the other cadaver images. The average error in pixels between the PMCT and dental radiographs was smaller in the lower jaw than in the upper jaw. CONCLUSIONS This method uses corresponding reference points on two images to calculate the error between the regions that contain all points. This feature also makes it possible to compare images taken with different modalities. The demand for a dental identification method involving PMCT is likely to increase, and we expect that the accuracy of dental identification will improve by using radiological images.
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Affiliation(s)
- A Sakuma
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
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16
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Influence of Pastes Containing Casein Phosphopeptide-amorphous Calcium Phosphate on Surface of Demineralized Enamel. J Appl Biomater Funct Mater 2014; 12:234-9. [DOI: 10.5301/jabfm.5000194] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2013] [Indexed: 11/20/2022] Open
Abstract
Purpose The purpose of the study was to evaluate the surface characteristics of demineralized enamel after treatment with pastes containing casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) or casein phosphopeptide–amorphous calcium fluoride phosphate (CPP-ACFP) and to compare their efficacy with that of 0.05% NaF. Methods Following formation of the artificial carious lesion, enamel slabs were divided into 4 groups (CPP-ACP, CPP-ACFP, 0.05% NaF and control) and submitted to a chemical caries model. Remineralization potential was examined using scanning electron microscope, energy-dispersive spectroscopy (EDS) and microhardness test. Scanning electron microphotographs were analyzed for area, minimal, maximal and mean diameter, perimeter, roundness and number of enamel defects and percentage of tooth surface affected by defects. Results Treatment with 0.05% NaF partly reduced the appearance of enamel defects when compared with irregular demineralized enamel. Treatment with CPP-ACP or CPP-ACFP resulted in occlusion of defects which produced more flattened enamel surface. Image analysis revealed reduction of the dimensions of the defects in the 3 experimental groups. Treatment with CPP-ACFP decreased the number of enamel defects when compared with demineralized enamel. The EDS analysis did not show differences in Ca/O, P/O and Ca/P ratios between the groups (P>0.05). Microhardness test revealed significant effects of CPP-ACP and CPP-ACFP (P<0.05). Conclusions Pastes containing CPP-ACP or CPP-ACFP showed potential to remineralize enamel surface lesions.
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17
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Zhao A, Blackburn C, Chin J, Srinivasan M. Soluble toll like receptor 2 (TLR-2) is increased in saliva of children with dental caries. BMC Oral Health 2014; 14:108. [PMID: 25174416 PMCID: PMC4236648 DOI: 10.1186/1472-6831-14-108] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 08/18/2014] [Indexed: 11/19/2022] Open
Abstract
Background Dental caries is the most common microbial disease affecting mankind. Caries risk assessment methods, identification of biomarkers and vaccine development strategies are being emphasized to control the incidence of the largely preventable disease. Pattern recognition receptors such as the toll like receptors (TLR) have been implicated as modulators of host-microbial interactions. Soluble TLR-2 and its co-receptor, CD14 identified in saliva can bind the cell wall components of cariogenic bacteria and modulate the disease process. The objective of this study is to determine the potential of salivary sTLR-2 and sCD14 as biomarkers of caries activity and indirect measures of the cariogenic bacterial burden. Methods Unstimulated whole saliva was collected from twenty caries free and twenty caries active children between the ages of 5 and 13 years. The concentration of sCD14 and sTLR-2 together with that of the cytokine IL-8 reported to be increased in dental caries was assessed by the enzyme linked immunosorbent assay. Results While the level of sCD14 and that of IL-8 was equivocal between the two groups, the sTLR-2 concentration in caries active saliva was significantly higher than that in caries free saliva. Conclusions The sTLR-2 in saliva could serve as a potential biomarker for caries activity.
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Affiliation(s)
| | | | | | - Mythily Srinivasan
- Department of Oral Pathology, Medicine and Radiology, Indianapolis, IN 46202, USA.
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18
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Marovic D, Tarle Z, Hiller KA, Müller R, Rosentritt M, Skrtic D, Schmalz G. Reinforcement of experimental composite materials based on amorphous calcium phosphate with inert fillers. Dent Mater 2014; 30:1052-60. [PMID: 25015877 DOI: 10.1016/j.dental.2014.06.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2013] [Revised: 11/08/2013] [Accepted: 06/05/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to examine the influence of the addition of glass fillers with different sizes and degrees of silanization percentages to remineralizing composite materials based on amorphous calcium phosphate (ACP). METHODS Four different materials were tested in this study. Three ACP based materials: 0-ACP (40 wt% ACP, 60 wt% resin), Ba-ACP (40 wt% ACP, 50 wt% resin, 10 wt% barium-glass) and Sr-ACP (40 wt% ACP, 50 wt% resin, 10 wt% strontium-glass) were compared to the control material, resin modified glass ionomer (Fuji II LC capsule, GC, Japan). The fillers and composites were characterized using scanning electron microscopy. Flexural strength and modulus were determined using a three-point bending test. Calcium and phosphate ion release from ACP based composites was measured using inductively coupled plasma atomic emission spectroscopy. RESULTS The addition of barium-glass fillers (35.4 (29.1-42.1) MPa) (median (25-75%)) had improved the flexural strength in comparison to the 0-ACP (24.8 (20.8-36.9) MPa) and glass ionomer control (33.1 (29.7-36.2) MPa). The admixture of strontium-glass (20.3 (19.5-22.2) MPa) did not have any effect on flexural strength, but significantly improved its flexural modulus (6.4 (4.8-6.9) GPa) in comparison to 0-ACP (3.9 (3.4-4.1) GPa) and Ba-ACP (4.6 (4.2-6.9) GPa). Ion release kinetics was not affected by the addition of inert fillers to the ACP composites. SIGNIFICANCE Incorporation of barium-glass fillers to the composition of ACP composites contributed to the improvement of flexural strength and modulus, with no adverse influence on ion release profiles.
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Affiliation(s)
- Danijela Marovic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia.
| | - Zrinka Tarle
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Croatia
| | - Karl-Anton Hiller
- Department of Operative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Germany
| | - Rainer Müller
- Institute of Physical and Theoretical Chemistry, University of Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthodontics, University Hospital Regensburg, University of Regensburg, Germany
| | - Drago Skrtic
- Dr. Anthony Volpe Research Center, ADA Foundation, Gaithersburg, MD, USA
| | - Gottfried Schmalz
- Department of Operative Dentistry and Periodontology, University Hospital Regensburg, University of Regensburg, Germany
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19
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Teich ST, Demko C, Al-Rawi W, Gutberg T. Assessment of Implementation of a CAMBRA-Based Program in a Dental School Environment. J Dent Educ 2012. [DOI: 10.1002/j.0022-0337.2013.77.4.tb05489.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Rindal DB, Gordan VV, Fellows JL, Spurlock NL, Bauer MR, Litaker MS, Gilbert GH. Differences between reported and actual restored caries lesion depths: results from The Dental PBRN. J Dent 2012; 40:248-54. [PMID: 22245444 PMCID: PMC3279178 DOI: 10.1016/j.jdent.2011.12.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 12/16/2011] [Accepted: 12/19/2011] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The objectives of this research were to (1) quantify the discordance between the caries lesion depth at which dentists restored initial lesions during a clinical study ("actual depth") and the lesion depth that they reported during a hypothetical clinical scenario ("reported depth"); (2) test the hypothesis that certain practitioner, practice, patient, and caries lesion characteristics are significantly associated with this discordance. METHODS Practitioner-investigators who perform restorative dentistry in their practices completed an enrollment questionnaire and participated in two consecutive studies on caries diagnosis and treatment. The first study was a survey asking about caries treatment. The second study collected data on restorations placed in routine clinical practice due to caries in patients over 19 years of age on occlusal surfaces only or proximal surfaces only. We report results on 2691 restorations placed by 205 dentists in 1930 patients with complete data. RESULTS Discordance between actual depth and reported depth occurred in only about 2% of the restorations done due to proximal caries, but about 49% of the restorations done due to occlusal caries. Practice type, restorative material used and the diagnostic methods used were significantly associated with discordance. CONCLUSION Dentists frequently restored occlusal caries at a shallower depth as compared to their reported depth, but the discordance was very small for proximal lesions. Discordance for occlusal caries was more common when radiographs were not taken or if a resin restoration was placed.
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Affiliation(s)
- D B Rindal
- HealthPartners Research Foundation, Minneapolis, MN 55425, USA.
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21
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Parisotto TM, Steiner-Oliveira C, De Souza-E-Silva CM, Peres RCR, Rodrigues LKA, Nobre-Dos-Santos M. Assessment of cavitated and active non-cavitated caries lesions in 3- to 4-year-old preschool children: a field study. Int J Paediatr Dent 2012; 22:92-9. [PMID: 21815955 DOI: 10.1111/j.1365-263x.2011.01171.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The prevalence of early childhood caries (ECC) is high in developing countries; thus, sensitive methods for the early diagnosis of ECC are of prime importance to implement the appropriate preventive measures. AIM To investigate the effects of the addition of early caries lesions (ECL) into WHO threshold caries detection methods on the prevalence of caries in primary teeth and the epidemiological profile of the studied population. DESIGN In total, 351 3- to 4-year-old preschoolers participated in this cross-sectional study. Clinical exams were conducted by one calibrated examiner using WHO and WHO + ECL criteria. During the exams, a mirror, a ball-ended probe, gauze, and an artificial light were used. The data were analysed by Wilcoxon and Mc-Nemar's tests (α=0.05). RESULTS Good intra-examiner Kappa values at tooth/surface levels were obtained for WHO and WHO+ECL criteria (0.93/0.87 and 0.75/0.78, respectively). The dmfs scores were significantly higher (P<0.05) when WHO+ECL criteria were used. ECLs were the predominant caries lesions in the majority of teeth. CONCLUSIONS The results strongly suggest that the WHO+ECL diagnosis method could be used to identify ECL in young children under field conditions, increasing the prevalence and classification of caries activity and providing valuable information for the early establishment of preventive measures.
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Affiliation(s)
- Thaís M Parisotto
- Department of Pediatric Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba-SP, Brazil
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22
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Anti–cell-associated glucosyltransferase immunoglobulin Y suppression of salivary mutans streptococci in healthy young adults. J Am Dent Assoc 2011; 142:943-9. [DOI: 10.14219/jada.archive.2011.0301] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Lenčová E, Broukal Z, Spížek J. Point-of-care salivary microbial tests for detection of cariogenic species--clinical relevance thereof--review. Folia Microbiol (Praha) 2011; 55:559-68. [PMID: 21253899 DOI: 10.1007/s12223-010-0090-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Revised: 04/16/2010] [Indexed: 10/18/2022]
Abstract
Dental caries is a highly prevalent multifactorial disease that can result in serious health impairment. It was shown that oral bacteria play a significant role in caries development. Point-of-care (POC) salivary microbial tests for detection of cariogenic species have been investigated as a potential tool for caries risk assessment. This review aims to evaluate clinical relevance of these tests in the light of recent scientific evidence. Methodology involved PubMed search using key words salivary microbial tests, cariogenic bacteria and caries risk prediction. Articles obtained by the search were cross-referenced to obtain further sources. Specificity and negative-predictive value of these tests are higher than their sensitivity and positive value. Predictive power of the POC salivary microbial tests as a single predictor is generally weak, although it increases when included in multifactorial models for caries prediction. Literature findings support the use of these tests for screening of at-risk individuals in a population of young preschool children without visible caries and for motivation of subjects on individual level. POC salivary microbial tests are simple and inexpensive and, therefore, may be advantageous from public health perspective.
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Affiliation(s)
- E Lenčová
- Institute of Dental Research, 1st Faculty of Medicine, Charles University, and General Teaching Hospital in Prague, 12111 Prague, Czech Republic.
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24
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Yorty JS, Walls AT, Wearden S. Caries Risk Assessment/Treatment Programs in U.S. Dental Schools: An Eleven-Year Follow-Up. J Dent Educ 2011. [DOI: 10.1002/j.0022-0337.2011.75.1.tb05023.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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General practitioners' use of caries-preventive agents in adult patients versus pediatric patients: findings from the dental practice-based research network. J Am Dent Assoc 2010; 141:679-87. [PMID: 20516100 DOI: 10.14219/jada.archive.2010.0258] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND In this study, the authors tested the frequency of dentists' recommendations for and use of caries-preventive agents for children as compared with adults. METHODS The authors surveyed 467 general dentists in the Dental Practice-Based Research Network who practice within the United States and treat both pediatric and adult patients. They asked dentists to identify the percentage of their patients for whom they had administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse and xylitol gum. RESULTS Dentists were less likely to provide adult patients than pediatric patients with in-office caries-preventive agents. However, the rate at which they recommended at-home preventive regimens for the two groups of patients was similar. Dentists with a conservative approach to caries treatment were the most likely to use and recommend the use of caries-preventive agents at similar rates in adults as in children. In addition, dentists in practices with a greater number of patients who had dental insurance were significantly more likely to provide in-office fluoride or sealants to adult patients than to pediatric patients. CONCLUSION General dentists use in-office caries-preventive agents more commonly with their pediatric patients than with their adult patients. PRACTICE IMPLICATIONS General dentists should consider providing additional in-office caries-preventive agents for their adult patients who are at increased risk of experiencing dental caries.
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Gupta S, Marwah N. 'Use a Thorn to Draw Thorn' Replacement Therapy for Prevention of Dental Caries. Int J Clin Pediatr Dent 2010; 3:125-37. [PMID: 27616834 PMCID: PMC4993818 DOI: 10.5005/jp-journals-10005-1068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2010] [Accepted: 06/07/2010] [Indexed: 11/23/2022] Open
Abstract
Despite the use of conventional physical and chemotherapeutic agents for caries management, dental caries still continues to be the most prevalent oral infectious disease. Thus, there is a need of additional caries prevention approaches. Strain replacement therapy is one such novel approach. In this, relatively avirulent strains of Streptococcus mutans produced by recombinant DNA technology are implanted into the oral cavity. These may either interfere with the colonization of, or compete with the indigenous cariogenic mutans streptococci. This technique might provide a cost-effective, long-term means of achieving tailor made protection for the host against dental caries.
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Affiliation(s)
- Seema Gupta
- Senior Resident, Department of Pedodontics and Preventive Dentistry, Maulana Azad Institute of Dental Sciences, New Delhi, India
| | - Nikhil Marwah
- Reader, Department of Pediatric Dentistry, Mahatma Gandhi Dental College, Jaipur, Rajasthan, India
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27
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Riley JL, Gordan VV, Rindal DB, Fellows JL, Ajmo CT, Amundson C, Anderson GA, Gilbert GH. Preferences for caries prevention agents in adult patients: findings from the dental practice-based research network. Community Dent Oral Epidemiol 2010; 38:360-70. [PMID: 20560997 PMCID: PMC2933181 DOI: 10.1111/j.1600-0528.2010.00547.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To identify factors that are significantly associated with dentists' use of specific caries preventive agents in adult patients, and whether dentists who use one preventive agent are also more likely to use certain others. METHODS Data were collected from 564 practitioners in The Dental Practice-Based Research Network, a multi-region consortium of participating practices and dental organizations. RESULTS In-office topical fluoride was the method most frequently used. Regarding at-home preventive agents, there was little difference in preference between nonprescription fluoride, prescription fluoride, or chlorhexidine rinse. Dentists who most frequently used caries prevention were also those who regularly perform caries risk assessment and individualize caries prevention at the patient level. Higher percentages of patients with dental insurance were significantly associated with more use of in-office prevention modalities. Female dentists and dentists with more-recent training were more likely to recommend preventive agents that are applied by the patient. Dentists who reported more-conservative decisions in clinical treatment scenarios were also more likely to use caries preventive agents. Groups of dentist who shared a common preference for certain preventive agents were identified. One group used preventive agents selectively, whereas the other groups predominately used either in-office or at-home fluorides. CONCLUSIONS Caries prevention is commonly used with adult patients. However, these results suggest that only a subset of dentists base preventive treatments on caries risk at the individual patient level.
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Affiliation(s)
- Joseph L. Riley
- Associate Professor, Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - Valeria V. Gordan
- Professor, Department of Operative Dentistry, College of Dentistry, University of Florida, Gainesville, Florida, USA
| | - D. Brad Rindal
- Investigator and Dental Health Provider, HealthPartners, Minneapolis, Minnesota, USA
| | - Jeffrey L. Fellows
- Investigator, Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | | | - Craig Amundson
- HealthPartners Central Minnesota Clinics, St. Cloud, Minnesota, USA
| | | | - Gregg H. Gilbert
- Professor and Chair, Department of General Dental Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Zakian CM, Taylor AM, Ellwood RP, Pretty IA. Occlusal caries detection by using thermal imaging. J Dent 2010; 38:788-95. [PMID: 20599464 DOI: 10.1016/j.jdent.2010.06.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Revised: 06/21/2010] [Accepted: 06/23/2010] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To explore the applicability of thermal changes associated with dehydration for the detection and quantification of early tooth decay on occlusal surfaces using infrared imaging. METHODS A total of 72 sites on 25 human teeth with various degrees of natural demineralisation have been used. Continuous evaporation of water inside the pores by pressurised air-drying is used to produce a thermodynamic response on the tooth surface. The temporal profile of the temperature will depend on the amount of water at each position and this is studied in relation to the degree of porosity and the lesion severity. The area enclosed by the time-temperature curve, DeltaQ, was then used for quantification of the lesion. RESULTS Maps of DeltaQ were obtained and histological examinations were performed for all teeth. A detection sensitivity of 77% and specificity of 87% for areas that are either sound or have a histological E1 lesion, 87% and 72% for areas that have either an E2 or EDJ lesion, and 58% and 83% for areas that have a lesion reaching the dentin was found using this method. CONCLUSIONS Thermal imaging shows the ability to discriminate, in vitro, between (a) either areas that are sound or with a lesion on the outer half of the enamel and (b) areas with a lesion extending to the middle of the enamel or deeper. However, variations of the temperature in an open mouth and humidity due to respiration can potentially challenge the ability of using this technique in vivo and this requires further investigation.
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Affiliation(s)
- C M Zakian
- The University of Manchester, Dental Health Unit, 3A Skelton House, Lloyd Street North, Manchester Science Park, Manchester, M15 6SH, UK
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Shen C, Zhang NZ, Anusavice KJ. Fluoride and chlorhexidine release from filled resins. J Dent Res 2010; 89:1002-6. [PMID: 20581354 DOI: 10.1177/0022034510374055] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Resin-based materials that release either fluoride or chlorhexidine have been formulated for inhibiting caries activity. It is not known if the two agents, when incorporated into one material, would interact and affect their release potential. We hypothesized that the ratio of fluoride to chlorhexidine incorporated into a resin, and the pH of the storage medium, will affect their releases from the material. The material investigated contained 23 wt% of filler, and the ratios of calcium fluoride to chlorhexidine diacetate were 8/2, 5/5, and 2/8. The release was conducted in pH 4, 5, and 6 acetate buffers. The results showed that release of either agent increased as the pH of the medium decreased. The presence of fluoride salt substantially reduced the chlorhexidine release, while the presence of a specific quantity of chlorhexidine significantly increased fluoride release. This interaction can be utilized to optimize the release of either agent for therapeutic purposes.
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Affiliation(s)
- C Shen
- Department of Prosthodontics, College of Dentistry, University of Florida, PO Box 100435, 1600 SW Archer Rd., Gainesville, FL 32610-0435, USA.
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Reasons for placement of restorations on previously unrestored tooth surfaces by dentists in The Dental Practice-Based Research Network. J Am Dent Assoc 2010; 141:441-8. [PMID: 20354094 DOI: 10.14219/jada.archive.2010.0197] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The authors conducted a study to identify and quantify the reasons used by dentists in The Dental Practice-Based Research Network (DPBRN) for placing restorations on unrestored permanent tooth surfaces and the dental materials they used in doing so. METHODS A total of 229 DPBRN practitioner-investigators provided data from their practices regarding 9,890 consecutive restorations in 5,810 patients. Information the practitioner-investigators provided included their reasons for restoring the teeth, the specific teeth and surfaces they restored and the restorative materials they used. RESULTS Primary caries (85 percent of teeth, 8,351 of 9,890) and noncarious defects (15 percent, 1,479 of 9,890) were the main reasons participants gave for placing restorations. Participants placed restorations necessitated by caries most frequently on occlusal surfaces (49 percent, 4,091 of 8,351). They used amalgam for 47 percent of the molar restorations and 45 percent of the premolar restorations. They used directly placed resin-based composite (RBC) for 48 percent of the molar restorations, 50 percent of the premolar restorations and 93 percent of the anterior restorations. CONCLUSION DPBRN practitioner-investigators cited dental caries on occlusal and proximal surfaces of molar teeth as the main reasons for placing restorations on previously unrestored tooth surfaces. RBC was the material they used most commonly for occlusal and anterior restorations. Amalgam remains the material of choice to restore posterior teeth with proximal caries, although the authors noted significant differences in the use of amalgam and RBC by dentists in various regions of the DPBRN.
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Zakian C, Pretty I, Ellwood R. Near-infrared hyperspectral imaging of teeth for dental caries detection. JOURNAL OF BIOMEDICAL OPTICS 2009; 14:064047. [PMID: 20059285 DOI: 10.1117/1.3275480] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Near-infrared (NIR) is preferred for caries detection compared to visible light imaging because it exhibits low absorption by stain and deeper penetration into teeth. Hyperspectral images from 1000 to 2500 nm have been obtained for a total of 12 extracted teeth (premolars and molars) with different degrees of natural lesion. Analysis of the reflectance spectra suggests that light scattering by porous enamel and absorption by water in dentin can be used to quantify the lesion severity and generate a NIR caries score. Teeth were ground for histological examination after the measurements. The NIR caries score obtained correlates significantly (Spearman's correlation of 0.89, p<0.01) with the corresponding histological score. Results yield a sensitivity of >99% and a specificity of 87.5% for enamel lesions and a sensitivity of 80% and a specificity >99% for dentine lesions. The nature of the technique offers significant advantages, including the ability to map the lesion distribution rather than obtaining single-point measurements, it is also noninvasive, noncontact, and stain insensitive. These results suggest that NIR spectral imaging is a potential clinical technique for quantitative caries diagnosis and can determine the presence of occlusal enamel and dentin lesions.
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Affiliation(s)
- Christian Zakian
- The University of Manchester, Dental Health Unit, School of Dentistry, Oxford Road, Manchester, M13 9PL, United Kingdom.
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Sakai VT, Oliveira TM, Silva TC, Moretti ABS, Geller-Palti D, Biella VA, Machado MAAM. Knowledge and attitude of parents or caretakers regarding transmissibility of caries disease. J Appl Oral Sci 2009; 16:150-4. [PMID: 19089208 PMCID: PMC4327636 DOI: 10.1590/s1678-77572008000200013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Accepted: 09/28/2007] [Indexed: 12/11/2022] Open
Abstract
Dental caries is a transmissible infectious disease in which mutans streptococci are generally considered to be the main etiological agents. Although the transmissibility of dental caries is relatively well established in the literature, little is known whether information regarding this issue is correctly provided to the population. The present study aimed at evaluating, by means of a questionnaire, the knowledge and usual attitude of 640 parents and caretakers regarding the transmissibility of caries disease. Most interviewed adults did not know the concept of dental caries being an infectious and transmissible disease, and reported the habit of blowing and tasting food, sharing utensils and kissing the children on their mouth. 372 (58.1%) adults reported that their children had already been seen by a dentist, 264 (41.3%) answered that their children had never gone to a dentist, and 4 (0.6%) did not know. When the adults were asked whether their children had already had dental caries, 107 (16.7%) answered yes, 489 (76.4%) answered no, and 44 (6.9%) did not know. Taken together, these data reinforce the need to provide the population with some important information regarding the transmission of dental caries in order to facilitate a more comprehensive approach towards the prevention of the disease.
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Affiliation(s)
- Vivien T Sakai
- Department of Pediatric Dentistry, Orthodontics and Public Health, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
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Tokudome Y, Otsuka M, Ito A, LeGeros RZ. Long-term therapeutic effect of novel calcium phosphate-based compounds injected in ovariectomized rats. J Biomed Mater Res B Appl Biomater 2009; 90:229-37. [DOI: 10.1002/jbm.b.31277] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Bader JD, Shugars DA. The evidence supporting alternative management strategies for early occlusal caries and suspected occlusal dentinal caries. J Evid Based Dent Pract 2006; 6:91-100. [PMID: 17138407 DOI: 10.1016/j.jebdp.2005.12.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To assess the strength of the evidence describing the effectiveness of alternative strategies to the detection and management of early occlusal caries and suspected occlusal dentinal caries. METHODS Nine detection and intervention decision points were identified as being central to the management of early occlusal caries and suspected occlusal dentinal caries, or suspicious areas. For each decision point, the evidence for effectiveness was assessed, using existing systematic reviews when available, and nonsystematic review methods when necessary. RESULTS For the 2 detection decisions (early occlusal caries and suspicious areas) the strength of the evidence was weak. Accuracy in detecting early occlusal caries was extremely variable within and across detection methods. Approximately 50% of suspicious areas identified had dentinal caries. The strength of the evidence for effectiveness of nonsurgical approaches for the management of early occlusal caries was weak for all 3 management strategies examined (doing nothing, sealants, remineralization). This evidence suggested that sealants were highly effective, with remineralization reflecting moderate effectiveness. For the management of suspicious areas, the strength of the evidence was still weaker and reflected the same relative effectiveness. For the surgical management strategy for suspicious areas, operative treatment, the evidence was strong and reflected high effectiveness for preventive resin restorations, but no evidence was available for minimally invasive techniques. CONCLUSION Identification methods for early occlusal caries are not accurate. The strength of the evidence for effectiveness of nonsurgical management strategies for early occlusal caries is at best, weak. The available evidence suggests that sealing both enamel caries and suspected occlusal dentinal caries is the most effective management approach if subsequent maintenance of the sealed surfaces can be assured.
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Affiliation(s)
- James D Bader
- Operative Dentistry, University of North Carolina, Chapel Hill, NC, USA
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