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Garbim JR, Saihara CS, Olegário IC, Hesse D, Araujo MP, Bonifácio CC, Braga MM, Raggio DP. 2-year survival and cost analysis of occlusoproximal ART restorations using encapsulated glass ionomer cement in primary molars: a randomized controlled trial. BMC Oral Health 2024; 24:647. [PMID: 38824540 PMCID: PMC11143694 DOI: 10.1186/s12903-024-04357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 05/09/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND The survival of ART restorations can be influenced by the choice of the restorative material. The aim of this randomized non-inferiority controlled trial was to compare the 2-year survival rate and cost analysis of two encapsulated glass ionomer cements (GIC) as occlusoproximal restorative materials in primary molars. METHODS Children from public schools in Tietê (Brazil), aged 4-8 years with occlusoproximal dentine carious lesions in primary molars were selected and randomly assigned to receive either Equia Forte (EF) or Riva Self Cure (RSC) as restorative materials. Treatment was carried out by two trained final-year dental students in schools following ART premises. Restorations were assessed by a trained and calibrated examiner after 2, 6, 12, 18, and 24 months. The primary outcome was restoration survival after 2 years, analyzed using Kaplan-Meier survival and Cox regression analysis (α = 5%). Professional and materials costs for each group were collected in Brazilian Reais (R$) and converted into US dollars (US$) and analyzed using Monte-Carlo simulation. RESULTS A total of 152 children (76 per group) were included in the study, and 121 (79%) were evaluated after 2 years. The overall 2-year restoration survival rate was 39% (EF = 45%; RSC = 32%) with no difference between the groups. The baseline and 2-year total cost of restorations using RSC was lower when compared to EF (incremental cost: US$ 6.18). CONCLUSION After two years of follow-up, Riva Self Cure shows comparable restoration survival rates to Equia Forte, being more cost-effective in the Brazilian perspective. TRIAL REGISTRATION This randomized clinical trial was registered on ClinicalTrials.Gov - NCT02730000.
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Affiliation(s)
- Jonathan Rafael Garbim
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, Brazil
| | - Cintia Saori Saihara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, Brazil
| | - Isabel Cristina Olegário
- Department of Public & Child Dental Health, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Daniela Hesse
- Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | | | | | - Mariana Minatel Braga
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, Brazil
| | - Daniela Prócida Raggio
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, Brazil.
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Rangel-Coelho JP, Gogolla PV, Meyer MD, Simão LC, Costa BC, Casarin RCV, Santamaria MP, Teixeira LN, Peruzzo DC, Lisboa-Filho PN, Nociti-Jr FH, Kantovitz KR. Titanium dioxide nanotubes applied to conventional glass ionomer cement influence the expression of immunoinflammatory markers: An in vitro study. Heliyon 2024; 10:e30834. [PMID: 38784540 PMCID: PMC11112319 DOI: 10.1016/j.heliyon.2024.e30834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/03/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Objectives To assess the impact of different concentrations TiO2-nt incorporated into a glass ionomer cement on the proliferation, mitochondrial metabolism, morphology, and pro- and anti-inflammatory cytokine production of cultured fibroblasts (NIH/3T3), whether or not stimulated by lipopolysaccharides (LPS-2 μg/mL, 24 h). Methods TiO2-nt was added to KM (Ketac Molar EasyMix™, 3 %, 5 %, 7 % in weight); unblended KM was used as the control. The analyses included: Cell proliferation assay (n = 6; 24/48/72h); Mitochondrial metabolism assay (n = 6; 24/48/72h); Confocal laser microscopy (n = 3; 24/48/72h); Determination of biomarkers (IL-1β/IL-6/IL-10/VEGF/TNF) by using both multiplex technology (n = 6; 12/18 h) and the quantitative real-time PCR assay (q-PCR) (n = 3, 24/72/120 h). The data underwent analysis using both the Shapiro-Wilk and Levene tests, and by generalized linear models (α = 0.05). Results It demonstrated that cell proliferation increased over time, regardless of the presence of TiO2-nt or LPS, and displayed a significant increase at 72 h; mitochondrial metabolism increased (p < 0.05), irrespective of exposure to LPS (p = 0.937); no cell morphology changes were observed; TiO2-nt reverted the impact of KM on the secreted levels of the evaluated proteins and the gene expressions in the presence of LPS (p < 0.0001). Conclusions TiO2-nt did not adversely affect the biological behavior of fibroblastic cells cultured on GIC discs.
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Affiliation(s)
- João Pedro Rangel-Coelho
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
| | - Pedro Viel Gogolla
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
| | - Maria Davoli Meyer
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
| | - Lucas Carvalho Simão
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
| | - Bruna Carolina Costa
- Department of Physics, School of Science, State University Júlio de Mesquita (UNESP), Av. Engenheiro Luís Edmundo Carrijo Coube 2085, Bauru, SP, 17033-360, Brazil
| | - Renato Côrrea Viana Casarin
- Department of Prosthodontics and Periodontics, Division of Periodontics, Piracicaba Dental School, State University of Campinas (FOP-UNICAMP), Av. Limeira 901, Areião, Piracicaba, SP, 13414-903, Brazil
| | | | - Lucas Novaes Teixeira
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
| | - Daiane Cristina Peruzzo
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
| | - Paulo Noronha Lisboa-Filho
- Department of Physics, School of Science, State University Júlio de Mesquita (UNESP), Av. Engenheiro Luís Edmundo Carrijo Coube 2085, Bauru, SP, 17033-360, Brazil
| | - Francisco Humberto Nociti-Jr
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
- American Dental Association Science and Research Institute - ADASRI, Cellular and Molecular Biology Research Group, Innovation and Technology Research, 100 Bureau Dr, Gaithersburg, MD, 20899, USA
| | - Kamila Rosamilia Kantovitz
- Faculdade São Leopoldo Mandic (SLMANDIC), Rua José Rocha Junqueira 13, Swift, Campinas, SP, 13045-755, Brazil
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Panetta A, Lopes P, Novaes TF, Rio R, Fernandes GVO, Mello-Moura ACV. Evaluating Glass Ionomer Cement Longevity in the Primary and Permanent Teeth-An Umbrella Review. J Funct Biomater 2024; 15:48. [PMID: 38391901 PMCID: PMC10890125 DOI: 10.3390/jfb15020048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024] Open
Abstract
The aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the literature was conducted in three databases (MedLine/PubMed, Web of Science, and Scopus). The inclusion criteria were: (1) to be a systematic review of clinical trials that (2) evaluated the clinical longevity of GICs as a restorative material in primary and/or permanent teeth; the exclusion criteria were: (1) not being a systematic review of clinical trials; (2) not evaluating longevity/clinical performance of GICs as a restorative material; and (3) studies of dental restorative materials in teeth with enamel alterations, root caries, and non-carious cervical lesions. Twenty-four eligible articles were identified, and 13 were included. The follow-up periods ranged from 6 months to 6 years. Different types of GICs were evaluated in the included studies: resin-modified glass ionomer cement (RMGIC), compomers, and low- and high-viscosity glass ionomer cement. Some studies compared amalgam and composite resins to GICs regarding longevity/clinical performance. Analyzing the AMSTAR-2 results, none of the articles had positive criteria in all the evaluated requisites, and none of the articles had an a priori design. The criteria considered for the analysis of the risk of bias of the included studies were evaluated through the ROBIS tool, and the results of this analysis showed that seven studies had a low risk of bias; three studies had positive results in all criteria except for one criterion of unclear risk; and two studies showed a high risk of bias. GRADE tool was used to determine the quality of evidence; for the degree of recommendations, all studies were classified as Class II, meaning there was still conflicting evidence on the clinical performance/longevity of GICs and their recommendations compared to other materials. The level of evidence was classified as Level B, meaning that the data were obtained from less robust meta-analyses and single randomized clinical trials. To the best of our knowledge, this is the first umbrella review approaching GIC in permanent teeth. GICs are a good choice in both dentitions, but primary dentition presents more evidence, especially regarding the atraumatic restorative treatment (ART) technique. Within the limitation of this study, it is still questionable if GIC is a good restorative material in the medium/long term for permanent and primary dentition. Many of the included studies presented a high risk of bias and low quality. The techniques, type of GIC, type of cavity, and operator experience highly influence clinical performance. Thus, clinical decision-making should be based on the dental practitioner's ability, each case analysis, and the patient's wishes. More evidence is needed to determine which is the best material for definitive restorations in permanent and primary dentition.
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Affiliation(s)
- Alessandro Panetta
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Pedro Lopes
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | | | - Rute Rio
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Gustavo Vicentis Oliveira Fernandes
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- A. T. Still University-Missouri School of Dentistry & Oral Health, St. Louis, MO 63104, USA
| | - Anna Carolina Volpi Mello-Moura
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Center for Interdisciplinary Research in Health, Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
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Boachie MK, Molete M, Hofman K, Thsehla E. Cost-effectiveness of dental caries prevention strategies in South African schools. BMC Oral Health 2023; 23:814. [PMID: 37898738 PMCID: PMC10613394 DOI: 10.1186/s12903-023-03474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/29/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND In South Africa, an estimated 85% of the population relies on the public sector for oral health services. With poor infrastructure and inadequate personnel, over 80% of children with dental caries remain untreated. To reduce this burden of disease, one key goal is to promote good oral health and address oral diseases through prevention, screening, and treatment among children. While all policies have been proven to be effective in the control and prevention of dental caries, it is unclear which of those strategies provide value for money. This study evaluated five caries preventative strategies in terms of the cost and benefits among South African school children. METHODS The study uses a hypothetical South African population of school aged learners aged 5-15. The context and insights of the strategies utilized at the schools were informed by data from both grey and published literature. Using Markov modeling techniques, we conducted a cost-effectiveness analysis of Acidulated Phosphate Fluoride (APF) application, atraumatic restorative treatment (ART), sugar-reduction and fissure sealants. Markov model was used to depict the movement of a hypothetical patient cohort between different health states over time. We assessed both health outcomes and costs of various interventions. The health outcome metric was measured as the number of Decayed, Missing, Filled Tooth (DMFT). The net monetary benefit was then used to determine which intervention was most cost-effective. RESULTS The results showed that school-based caries prevention strategies are cost-effective compared to the status quo of doing nothing. The average cost per learner over the 10-year period ranged from ZAR4380 to approx. ZAR7300 for the interventions considered. The total costs (including screening) associated with the interventions and health outcome (DMFT averted) were: sugar reduction (ZAR91,380, DFMT: 63,762), APF-Gel (ZAR54 million, DMFT: 42,010), tooth brushing (ZAR72.8 million, DMFT: 74,018), fissure sealant (ZAR44.63 million, DMFT: 100,024), and ART (ZAR45 million, DMFT: 144,035). The net monetary benefits achieved for APF-Gel, sugar reduction, tooth brushing, fissure sealant and ART programs were ZAR1.56, ZAR2.45, ZAR2.78, ZAR3.81, and ZAR5.55 billion, respectively. CONCLUSION Based on the net monetary benefit, ART, fissure sealant and sugar-reduction appear to be the most cost-effective strategies for preventing caries in South Africa. In a resource-scarce setting such as South Africa, where there is no fluoridation of drinking water, this analysis can inform decisions about service packages for oral health.
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Affiliation(s)
- Micheal Kofi Boachie
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, 4041, Durban, South Africa.
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa.
| | - Mpho Molete
- Department of Oral Biological Sciences, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Evelyn Thsehla
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
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Kantovitz KR, Carlos NR, Silva IAPS, Braido C, Costa BC, Kitagawa IL, Nociti-Jr FH, Basting RT, de Figueiredo FKP, Lisboa-Filho PN. TiO 2 nanotube-based nanotechnology applied to high-viscosity conventional glass-ionomer cement: ultrastructural analyses and physicochemical characterization. Odontology 2023; 111:916-928. [PMID: 36917400 DOI: 10.1007/s10266-023-00799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
This study characterized TiO2 nanotube (TiO2-nt) ultrastructure and morphology, and the physicochemical impact on high-viscosity conventional glass-ionomer cement (GIC). TiO2-nt was synthesized by the alkaline method (n = 3), assessed by scanning (SEM) and transmission electron microscope (TEM), and was added (3%, 5%, 7%-in weight) to KM (Ketac Molar EasyMix™). Analyses included: SEM; Energy-dispersive spectroscopy (EDS); Raman spectroscopy (RAMAN); Setting time with Gillmore needles (ST); Color (Co); Radiopacity (XR); Water sorption (WS); and solubility (SO). Quantitative data were submitted to ANOVA and Tukey's tests (chr = 0.05). External and internal TiO2-nt diameters were 11 ± 2 nm and 6 ± 0 nm, respectively. Data analyses showed: (i) TiO2-nt present into KM matrix, with a concentration-dependent increase of Ti levels into KM, (ii) physical interaction between KM and TiO2-nt, (iii) longer initial ST for the 7% group compared to KM and 3% groups (p ≤ 0.01), (iv) decreased luminosity and yellowness for the 5% and 7% groups, (v) 36% greater radiopacity for the 5% group compared to enamel, dentin, and KM, and (vi) lower SO values for the 5% group, with no significant differences on WS across the groups. TiO2-nt displayed physical interaction with KM matrix, and also modified SO, XR and Co, without affecting ST. This study provides information on the potential impact of TiO2-nt on GIC performance. TiO2-nt may be proposed to boost confidence among dental surgeons in terms of GIC's handling characteristics, success rate and differential diagnostic.
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Affiliation(s)
| | - Natália Russo Carlos
- Faculdade São Leopoldo, SLMANDIC, Rua José Rocha Junqueira, 13, Campinas, SP, 13045-755, Brazil
| | | | - Caroline Braido
- Pediatric Division, Department of Health Sciences, Orthodontics and Pediatric Dentistry, Piracicaba Dental School, University of Campinas, UNICAMP, Piracicaba, SP, Brazil
| | - Bruna Carolina Costa
- Department of Physics, School of Science, São Paulo State University, UNESP, Bauru, SP, Brazil
| | - Igor Lebedenco Kitagawa
- Federal Institute of Education, Science and Technology of São Paulo, IFSP, Birigui, SP, Brazil
| | - Francisco Humberto Nociti-Jr
- Faculdade São Leopoldo, SLMANDIC, Rua José Rocha Junqueira, 13, Campinas, SP, 13045-755, Brazil
- Division of Periodontics, Department of Prosthodontics and Periodontics, Piracicaba Dental School, University of Campinas, UNICAMP, Piracicaba, SP, Brazil
| | - Roberta Tarkany Basting
- Faculdade São Leopoldo, SLMANDIC, Rua José Rocha Junqueira, 13, Campinas, SP, 13045-755, Brazil
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Prokshi R, Gjorgievska E, Prokshi B, Sopi M, Sejdiu M. Survival Rate of Atraumatic Restorative Treatment Restorations in Primary Posterior Teeth in Children with High Risk of Caries in the Republic of Kosovo-1-Year Follow-up. Eur J Dent 2023; 17:902-909. [PMID: 36513339 PMCID: PMC10569845 DOI: 10.1055/s-0042-1757907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE Atraumatic restorative treatment (ART) may be beneficial for disadvantaged populations with no or limited access to dental services. This study aimed to evaluate the survival rate of single-surface ART restorations in primary posterior teeth in children with high caries risk. MATERIALS AND METHODS This study was conducted in six rural areas of the Republic of Kosovo, and 100 children aged 3 to 8 years participated in the study. Information was obtained from each parent/guardian regarding their children, such as sociodemographic characteristics, general health, dental history, dietary habits, oral hygiene, and fluoride exposure. The reduced Cariogram was used to estimate the risk of caries in the participants based on the seven factors specified in the program, and all the provided information were collected and entered in a computer program of the Cariogram. A pediatric dentist, accompanied by two assistants, performed 100 ART restorations in school settings using high-viscosity glass-ionomer cement (Fuji IX) following the nine steps of the ART procedure. The restorations were evaluated at 3, 6, 9, and 12 months using the ART restoration criteria. STATISTICAL ANALYSIS Percentages, mean value, standard deviation, mean interquartile range, and difference test between arithmetic mean values were used to analyze the research results. RESULTS Review of the average of reduced Cariogram showed that the majority of children, 72%, were at high risk of developing caries, with only 28% having a good chance of avoiding caries in the future. A total of 77% of the children in the study had never visited dentists before due to poor economic conditions and the lack of dentists in the area. The success rates of ART restorations performed in single-surface cavities in primary teeth were very encouraging, with more than 97% success rates after a 1-year follow-up period. CONCLUSION Our results demonstrate that ART is efficient, affordable, and practical for the treatment of single-surface cavities in primary posterior teeth. Owing to its low price and atraumatic nature, ART can potentially help disadvantaged children in Kosovo access dental care.
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Affiliation(s)
- Rina Prokshi
- Department of Pediatric and Preventive Dentistry, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Elizabeta Gjorgievska
- Department of Pediatric and Preventive Dentistry, Faculty of Dentistry, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | - Brikena Prokshi
- Department of Pharmacy, Faculty of Medicine, University of Pristina, Pristina, Kosovo
| | - Mirlinda Sopi
- Department of Periodontology and Oral Medicine, Dentistry School, University of Pristina, Pristina, Kosovo
| | - Miranda Sejdiu
- Department of Dentistry, Faculty of Medicine, University of Pristina, Pristina, Kosovo
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Oz E, Kırzıoglu Z, Kale C. The clinical success of ART restorations and Hall technique in primary molars: a randomized 18-month follow-up study. Restor Dent Endod 2023; 48:e19. [PMID: 37284348 PMCID: PMC10240095 DOI: 10.5395/rde.2023.48.e19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 03/06/2023] [Accepted: 03/16/2023] [Indexed: 06/08/2023] Open
Abstract
Objectives The aim of the study was to evaluate the clinical and radiographic success of the Hall technique (HT) and atraumatic restorative treatment (ART) restorations using high-viscosity glass-ionomer cement for the management of occlusal carious lesions in primary molars. Materials and Methods This randomized clinical study observed 40 children (aged 5-6 years). For each child, one tooth was treated with HT and one with ART. The primary outcome measures for HT restorations were successful, minor, and major failure rates. Clinical evaluations of ART restorations were performed according to the modified United States Public Health Service criteria during 18-month follow-up. McNemar test was used for statistical analysis. Results Thirty of 40 (75%) participants returned for 18 months of follow-up. In the clinical evaluations of teeth that were treated with HT, the patients did not have complaints of pain or other symptoms, all crowns remained in the oral cavity, the gums were healthy, and the teeth were functional in all evaluations. At the end of the 18-month follow-up, the surface texture and marginal integrity criteria of ART restorations were recorded as 26.7% and 33.3%, respectively. In the radiographic evaluation of 30 patients treated with ART and HT, all restorations were considered successful. Conclusions The 18-month clinical and radiographic results after treatments applied to single-surface cavities in anxious children showed that both treatment methods were successful.
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Affiliation(s)
- Esra Oz
- Department of Pediatric Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Zuhal Kırzıoglu
- Department of Pediatric Dentistry, Faculty of Dentistry, Suleyman Demirel University, Isparta, Turkey
| | - Canan Kale
- Papatya Oral and Dental Health Clinic, Antalya, Turkey
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Survival Analysis and Cost Effectiveness of Silver Modified Atraumatic Restorative Treatment (SMART) and ART Occlusal Restorations in Primary Molars: a randomized controlled trial. J Dent 2023; 128:104379. [PMID: 36460236 DOI: 10.1016/j.jdent.2022.104379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 11/03/2022] [Accepted: 11/23/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate and compare the clinical performance and cost effectiveness of Silver Modified Atraumatic Restorative Treatment (SMART) and Atraumatic Restorative Treatment (ART) restorations in primary molars over 12 months follow up period. MATERIALS AND METHODS Sixty-seven children, aged 5-9 years old having at least one asymptomatic primary molar with active caries, were randomly assigned to either the test arm (SMART) or the control arm (ART). Clinical performance was assessed after 6 and 12-months using the modified United States Public Health Services criteria. The trial was registered at Clinical Trial.gov with a registration number (NCT03881020). Treatment time for each restoration was recorded, Kaplan-Meier survival analysis and the log-rank test were performed (p<0.05) and cost effectiveness was measured at the end of the study. RESULTS Both techniques showed comparable clinical performance and the mean survival time was 11.8 and 11.6 months for SMART and ART restorations respectively with no detected significant differences (p=0.416). Mean treatment time for SMART restorations (7.8 min.), however, was significantly lower than ART (15 min.) (p < 0.001). SMART technique, also, showed statistically significant lower mean total cost per restoration (p <0.001). CONCLUSIONS Though SMART and ART have comparable clinical performance and survival in single-surface occlusal restorations in primary molars, SMART is less time consuming and more cost effective. CLINICAL SIGNIFICANCE Using SMART technique could change paradigms in caries management. Being a patient friendly and cost-effective approach, it could be adopted as a superior treatment option when dealing with young children, those with behavioral and medical challenges and for promoting access to oral care among the underprivileged.
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BaniHani A, Hamid A, Van Eeckhoven J, Gizani S, Albadri S. Minimal Intervention Dentistry (MID) mainstream or unconventional option? Study exploring the impact of COVID-19 on paediatric dentists' views and practices of MID for managing carious primary teeth in children across the United Kingdom and European Union. Eur Arch Paediatr Dent 2022; 23:835-844. [PMID: 36315343 PMCID: PMC9619005 DOI: 10.1007/s40368-022-00746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/13/2022] [Indexed: 11/06/2022]
Abstract
Purpose To explore the techniques used to manage carious primary teeth during the COVID-19 pandemic by paediatric dentists and dentists with a special interest in paediatric dentistry (DwSI) who are members of the British Society of Paediatric Dentistry (BSPD) and the European Academy of Paediatric Dentistry (EAPD), and their views on the use of minimal intervention dentistry (MID) in children prior to, during and post the COVID era. Methods A total of 212 paediatric dentists and DwSI completed an online questionnaire. Six MID techniques were explored: fissure sealants, resin infiltration, Hall Technique (HT), 38% silver diamine fluoride (SDF), atraumatic restorative treatment (ART), stepwise removal and selective caries removal. Results The majority were specialists (26%) followed by clinical academics (23.1%) working mainly in university teaching hospitals (46.2%). Routine dental treatment for children with carious primary teeth was provided by the majority (92.5%) during the pandemic. HT (96%) and 38% SDF (65.7%) were the most commonly used techniques among the BSPD members whereas conventional restoration of non-selective caries removal and pulp therapy remained the most widely used technique among the EAPD members (66.2%). Most of the MID techniques were used as a treatment option (48.1%) rather than a choice (43.4%), with most of these choices having been affected by the patient’s behaviour (82.5%). More than one thirds (39.2%) of the participants were reluctant to adopt MID after the pandemic. Several barriers such as lack of teaching and confidence as well as perceived lack of evidence were identified. Conclusion A range of MID techniques is practiced broadly by a sample of paediatric dentists and DwSI across the United Kingdom (U.K) and European Union (E.U). The majority of clinicians are willing to continue using these techniques going forward after COVID restrictions are lifted. The pandemic served as an opportunity for many dentists to become familiar with various MID practices, such as SDF, which has been already established some time ago.
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Affiliation(s)
- A. BaniHani
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Worsley Building, The Clarendon Way, Leeds, LS2 9LU UK
| | - A. Hamid
- Bristol Dental Hospital, Bristol, UK
| | | | - S. Gizani
- Department of Paediatric Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - S. Albadri
- School of Dentistry, University of Liverpool, Liverpool, UK
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10
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Zou J, Du Q, Ge L, Wang J, Wang X, Li Y, Song G, Zhao W, Chen X, Jiang B, Mei Y, Huang Y, Deng S, Zhang H, Li Y, Zhou X. Expert consensus on early childhood caries management. Int J Oral Sci 2022; 14:35. [PMID: 35835750 PMCID: PMC9283525 DOI: 10.1038/s41368-022-00186-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023] Open
Abstract
Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.
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Affiliation(s)
- Jing Zou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qin Du
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Lihong Ge
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jun Wang
- Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Department of Pediatric Dentistry, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xiaojing Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Military Stomatology, Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Guangtai Song
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhao
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat‑Sen University, Guangzhou, China
| | - Xu Chen
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Beizhan Jiang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yufeng Mei
- Department of Pediatric Dentistry, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Yang Huang
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, China
| | - Shuli Deng
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Hongmei Zhang
- Department of Pediatric Dentistry, The Affiliated Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Yanhong Li
- Department of Pediatric and Preventive Dentistry, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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11
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Silva GSD, Raggio DP, Mello-Moura ACV, Gimenez T, Montagner AF, Floriano I, Lara JS, Calvo AFB, Pascareli-Carlos AM, Tedesco TK. Pulp vitality of primary molars with deep caries treated with ART restorations: 2-year RCT. Braz Oral Res 2022; 36:e061. [PMID: 36507748 DOI: 10.1590/1807-3107bor-2022.vol36.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to compare the pulp vitality of primary teeth with deep caries treated with two restorative techniques. The restoration survival rate was also evaluated as a secondary outcome. Children aged from 4 to 8 years with at least one deep carious lesion in molars were selected at the Ibirapuera University dental clinic. One hundred and eight deciduous molars were allocated into two groups: (1) restoration with calcium hydroxide cement lining followed by filling with high-viscosity glass ionomer cement (CHC+HVGIC) or (2) restoration with HVGIC. Pulp vitality and restoration survival were evaluated at 6, 12, and 24 months. Intent-to-treat analysis was used for pulp vitality, and survival analysis was performed with the Kaplan-Meier method (α=5%). Results: At 24 months, 86 restorations were evaluated, and 91 were evaluated at least once during the study. There was no significant difference between the restorative treatments regarding pulp vitality (CHC +HVGIC=70% and HVGIC=68.5%) (OR=1.091; CI95%=0.481-2.475). However, HVGIC (73%) restorations showed a higher survival rate than CHC+HVGIC (50%) (p=0.021). Thus, it can conclude that deep caries in primary molars should be restored with HVGIC, since the technique results in similar pulp vitality to the CHC +HVGIC, but with a higher restoration survival rate.
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Affiliation(s)
- Gabriela Seabra da Silva
- Universidade de São Paulo - USP, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, São Paulo, SP, Brazil
| | - Daniela Prócida Raggio
- Universidade de São Paulo - USP, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, São Paulo, SP, Brazil
| | - Anna Carolina Volpi Mello-Moura
- Universidade Católica Portuguesa, Faculty of Dental Medicine, Center for Interdisciplinary Research in Health - SalivaTec Lab, Viseu, Portugal
| | - Thais Gimenez
- Universidade Ibirapuera - UNIB, Graduate Program in Dentistry, São Paulo, SP, Brazil
| | | | - Isabela Floriano
- Centro Universitário Uninovafapi, School of Dentistry, Teresina, PI, Brazil
| | - Juan Sebastian Lara
- Indiana University, School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, Indianapolis, IN, USA
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12
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da Cunha CMBDL, Wambier LM, Matos TDP, Malaquias P, Reis A, Loguercio AD, Wambier DS, Chibinski ACR. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022; 15:38-46. [PMID: 35528486 PMCID: PMC9016904 DOI: 10.5005/jp-journals-10005-2173] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth. Aim This randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up. Materials and methods A total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N-Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%). Results The overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N-Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31-0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N-Adh was used (HR = 0.46; CI = 0.26-0.81; p = 0.008). Conclusion All evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities. Clinical significance Cention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements. Trial registration number RBR-9nqszr How to cite this article da Cunha CM, Wambier LM, Paris Matos TD, et al. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(1):38-46.
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Affiliation(s)
| | - Letícia Maíra Wambier
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | - Pamela Malaquias
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | | | - Ana Cláudia Rodrigues Chibinski
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
- Ana Cláudia Rodrigues Chibinski, Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil, Phone: +55 42 999171983, e-mail:
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Borompiyasawat P, Putraphan B, Luangworakhun S, Sukarawan W, Techatharatip O. Chlorhexidine gluconate enhances the remineralization effect of high viscosity glass ionomer cement on dentin carious lesions in vitro. BMC Oral Health 2022; 22:60. [PMID: 35248048 PMCID: PMC8898514 DOI: 10.1186/s12903-022-02098-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
To compare the mean mineral density (MMD) and examine the remineralization of carious dentin after cavity disinfection with chlorhexidine gluconate (CHX) and restoration with high viscosity glass ionomer cement (H-GIC) in vitro.
Methods
Selective caries removal to leathery dentin was performed in 40 extracted primary molars. The samples were scanned using micro-computed tomography (micro-CT) to determine the MMD baseline and randomly divided into 4 groups (n = 10): Equia™ group, applied dentin conditioner and restored with H-GIC (Equia Forte™), CHX-Equia™ group, disinfected the cavity with 2% CHX before applying dentin conditioner and restored with H-GIC (Equia Forte™), Ketac™ group, restored with H-GIC (Ketac Universal™) and CHX-Ketac™ group, disinfected the cavity with 2% CHX before restored with H-GIC (Ketac Universal™). The samples underwent micro-CT scanning post-restoration and post-pH-cycling to determine their respective MMDs. One sample from each group was randomly selected to analyze by scanning electron microscopy (SEM).
Results
The MMD gain in the 4 groups post-restoration was significantly different between the Equia™ and CHX-Ketac™ groups (oneway ANOVA with Post hoc (Tukey) test, P = 0.045). There was a significant difference in MMD gain post-restoration between the Equia™ and CHX-Equia™ groups (Independent t-test, P = 0.046). However, the Ketac™ and CHX-Ketac™ group’s MMD were similar. The SEM images revealed that the CHX-Ketac™ group had the smallest dentinal tubule orifices and the thickest intertubular dentin among the groups. However, the CHX-Equia™ group had thicker intertubular dentin than the Equia™ group.
Conclusion
Applying 2% CHX on demineralized dentin enhances the remineralization of the dentin beneath the restoration.
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Roberts H, Berzins D, Nicholson J. Long-Term Water Balance Evaluation in Glass Ionomer Restorative Materials. MATERIALS 2022; 15:ma15030807. [PMID: 35160751 PMCID: PMC8836498 DOI: 10.3390/ma15030807] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/13/2022] [Accepted: 01/14/2022] [Indexed: 02/01/2023]
Abstract
The complex role of water in glass ionomer cement (polyalkenoate) dental restorative materials has been studied, but much of the present understanding concerning water balance within these materials is based on very early studies and short-term experiments. This study evaluated the nature of the water species of six conventional and four resin modified glass ionomer restorative materials over 3 years using thermogravimetric analysis techniques. Materials were prepared, placed in crucibles, and stored in physiologic phosphate buffered saline and evaluated at 24 h, 1 week, and then at 1, 3, 6, 9, 12, 18, 24, 30 and 36 months. All materials demonstrated a significant increase in unbound water percentage content but except for the resin modified materials, the enthalpy required to remove the unbound water species did not significantly change over 36 months. Also, bound water content percentage and removal enthalpy was established at 24 h, as no significant increase was noted in both bound water content and removal enthalpy over the course of this evaluation. This study suggests that unbound water species may increase with time and is loosely held except for the resin modified materials. Protective coatings placement and re-evaluation are prudent to prevent unbound water loss.
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Affiliation(s)
- Howard Roberts
- Dental Biomaterials Research, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA
- Correspondence: ; Tel.: +1-(847)-910-4255
| | - David Berzins
- Graduate Dental Biomaterials, School of Dentistry, Marquette University, Milwaukee, WI 53233, USA;
| | - John Nicholson
- Bluefield Centre for Biomaterials, UK and Dental Physical Sciences, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK;
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15
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OLEGÁRIO IC, FURLAN ALDBP, LAUX CM, HESSE D, BONIFÁCIO CC, IMPARATO JCP, RAGGIO DP. ART restorations for occluso-proximal cavities in primary molars: a two-year survival and cost analysis of an RCT comparing two GIC brands. J Appl Oral Sci 2022. [DOI: 10.1590/1678-7757-2022-0148] [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] Open
Affiliation(s)
| | | | | | - Daniela HESSE
- Academic Centre for Dentistry Amsterdam, Netherlands
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16
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Souza TF, Martins ML, Magno MB, Vicente-Gomila JM, Fonseca-Gonçalves A, Maia LC. Worldwide research trends on the use of chemical-mechanical caries removal products over the years: a critical review. Eur Arch Paediatr Dent 2022; 23:869-883. [PMID: 35831699 PMCID: PMC9281217 DOI: 10.1007/s40368-022-00726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chemical-mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries removal. AIM Characterize the worldwide scientific literature about CMCR products, over the years, by means of a critical review. DESIGN Electronic search was performed on Medline/PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, and Embase up to November 2020. Year, journal, country of authors, and type of study were the data extracted from the retrieved studies. Additional data of the clinical studies and systematic reviews were investigated. RESULTS 2221 records were identified, 397 selected. 2011-2020 period concentrates higher number of publications (n = 169), in the Journal of Dental Research (n = 51), developed in Brazil (n = 45) and India (n = 44). Most studies were in vitro (n = 211) and clinical trials (n = 101). Carisolv™ (n = 48) and Papacarie Duo Gel™ (n = 33) were the most used products, prescript in isolated usage (n = 101), and compared with drills (n = 77). CMCR were more studied in primary teeth (n = 78), receiving glass ionomer cement (GIC) (n = 51) as restorative material. The most evaluated outcomes were time spent (n = 48) and pain (n = 41). Clinical application of CMCR takes more time than other techniques, but can also reduce patient anxiety, pain, and need for anesthesia. CONCLUSION In vitro and clinical studies with CMCR products have been increasing, mostly carried out in developing countries, evaluating Carisolv™ and Papacarie Duo Gel™. Clinical studies tend to evaluate the time spent and pain compared to drills for removing caries in primary teeth, posteriorly restored with GIC. CMCR clinical application reduces anxiety, pain, and need for anesthesia, despite increase treatments' time.
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Affiliation(s)
- T. F. Souza
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - M. L. Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - M. B. Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - J. M. Vicente-Gomila
- Department of Corporate Management, ESIC Business and Marketing School, Pozuelo, Madrid, Spain
| | - A. Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - L. C. Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
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17
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Wambier LM, Gonçalves ADR, Wambier DS, Reis A, Chibinski ACR. Adherence to the CONSORT statement of randomized clinical trials on ART restorations in children: current status and reporting characteristics. Braz Oral Res 2022; 36:e017. [DOI: 10.1590/1807-3107bor-2022.vol36.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022] Open
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18
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Neves AB, Lopes LIG, Bergstrom TG, da Silva ASS, Lopes RT, Neves ADA. Porosity and pore size distribution in high-viscosity and conventional glass ionomer cements: a micro-computed tomography study. Restor Dent Endod 2021; 46:e57. [PMID: 34909421 PMCID: PMC8636077 DOI: 10.5395/rde.2021.46.e57] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/08/2021] [Accepted: 03/10/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives This study aimed to compare and evaluate the porosity and pore size distribution of high-viscosity glass ionomer cements (HVGICs) and conventional glass ionomer cements (GICs) using micro-computed tomography (micro-CT). Materials and Methods Forty cylindrical specimens (n = 10) were produced in standardized molds using HVGICs and conventional GICs (Ketac Molar Easymix, Vitro Molar, MaxxionR, and Riva Self-Cure). The specimens were prepared according to ISO 9917-1 standards, scanned in a high-energy micro-CT device, and reconstructed using specific parameters. After reconstruction, segmentation procedures, and image analysis, total porosity and pore size distribution were obtained for specimens in each group. After checking the normality of the data distribution, the Kruskal-Wallis test followed by the Student-Newman-Keuls test was used to detect differences in porosity among the experimental groups with a 5% significance level. Results Ketac Molar Easymix showed statistically significantly lower total porosity (0.15%) than MaxxionR (0.62%), Riva (0.42%), and Vitro Molar (0.57%). The pore size in all experimental cements was within the small-size range (< 0.01 mm3), but Vitro Molar showed statistically significantly more pores/defects with a larger size (> 0.01 mm3). Conclusions Major differences in porosity and pore size were identified among the evaluated GICs. Among these, the Ketac Molar Easymix HVGIC showed the lowest porosity and void size.
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Affiliation(s)
- Aline Borburema Neves
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Laísa Inara Gracindo Lopes
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Tamiris Gomes Bergstrom
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
| | - Aline Saddock Sá da Silva
- Laboratory of Nuclear Instrumentation, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
| | - Ricardo Tadeu Lopes
- Laboratory of Nuclear Instrumentation, Universidade Federal do Rio de Janeiro - UFRJ, Rio de Janeiro, RJ, Brazil
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro - UFRJ, School of Dentistry, Rio de Janeiro, RJ, Brazil
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19
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Pássaro AL, Olegário IC, Laux CM, Oliveira RC, Tedesco TK, Raggio DP. Giomer composite compared to glass ionomer in occlusoproximal ART restorations of primary molars: 24-month RCT. Aust Dent J 2021; 67:148-158. [PMID: 34904247 DOI: 10.1111/adj.12894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Occlusoproximal restorations of primary molars usually fail, so it is necessary to investigate new materials that may overcome this challenge. Thus, this trial aimed to evaluate the longevity of occlusoproximal ART restorations in primary molars using a glass ionomer cement - GIC (Equia Forte® - GC Corp) and a Giomer resin composite - GCR (Beautifil Bulk Restorative® - Shofu Inc) after 24 months. METHODS One hundred and eighty-two (182) children aged from 4 to 8 years were selected and randomly assigned to GIC or GCR. A paediatric dentist treated them in the school setting in Cerquilho, Brazil, and the restorations were assessed after 3, 6, 12, 18 and 24 months. The primary outcome was the restoration survival, evaluated using the Kaplan-Meier and superiority Cox regression analyses. Intention to treat (ITT) was performed as a sensitivity analysis using superiority test P value and confidence interval (CI = 95%). Independent variables included gender, age, molar, jaw, cavity volume and caries experience. RESULTS The restoration survival after 24 months was GIC = 58.1% and GCR = 49.1% (HR = 1.24; CI = 0.97-1.59). ITT analysis showed a success of GIC = 61.1% and GCR = 52.2% (RR = 1.17; CI = 0.91-1.52). The superiority hypothesis was not proved in both analyses (P > 0.05). CONCLUSION GCR does not have superior longevity than GIC in occlusoproximal ART restorations of primary molars.
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Affiliation(s)
- A L Pássaro
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - I C Olegário
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - C M Laux
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - R C Oliveira
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - T K Tedesco
- Graduate Program in Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
| | - D P Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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20
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Maia TS, Lima TD, Vieira WDA, Blumenberg C, Agostini BA, Nascimento GG, Paranhos LR, Menezes MDS. Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review. Braz Oral Res 2021; 35:e130. [PMID: 34878085 DOI: 10.1590/1807-3107bor-2021.vol35.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.
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Affiliation(s)
- Thaís Souza Maia
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Postgraduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Thamires Diogo Lima
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Postgraduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Walbert de Andrade Vieira
- Universidade Estadual de Campinas - Unicamp, School of Dentistry of Piracicaba, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Cauane Blumenberg
- Universidade Federal de Pelotas - UFPel, Postgraduate Program in Epidemiology, Pelotas, RS, Brazil
| | | | | | - Luiz Renato Paranhos
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Preventive and Community Dentistry, Uberlândia, MG, Brazil
| | - Murilo de Sousa Menezes
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Restorative Dentistry and Dental Materials, Uberlândia, MG, Brazil
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Desai H, Stewart CA, Finer Y. Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review. Dent J (Basel) 2021; 9:dj9120147. [PMID: 34940044 PMCID: PMC8700643 DOI: 10.3390/dj9120147] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
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Affiliation(s)
- Hetal Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Correspondence:
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22
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BaniHani A, Santamaría RM, Hu S, Maden M, Albadri S. Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review. Eur Arch Paediatr Dent 2021; 23:667-693. [PMID: 34784027 DOI: 10.1007/s40368-021-00675-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 10/08/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE This umbrella review systematically appraised published systematic reviews on Minimal Intervention Dentistry interventions carried out to manage dentine carious primary teeth to determine how best to translate the available evidence into practice, and to provide recommendations for what requires further research. METHOD An experienced information specialist searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, and the NIHR Journals Library. In addition, the PROSPERO database was searched to identify forthcoming systematic reviews. Searches were built around the following four concepts: primary teeth AND caries/carious lesion AND Minimal Intervention Dentistry AND systematic review/meta-analysis. Searches were restricted to English language, systematic reviews with/without meta-analyses published between January 2000 and August 2020. Two reviewers independently screened all titles and abstracts. Interventions included involved no dentine carious tissue removal (fissure sealants, resin infiltration, topical application of 38% Silver Diamine Fluoride, and Hall Technique), non-restorative caries control, and selective removal of carious tissue involving both stepwise excavation and atraumatic restorative treatment. Systematic reviews were selected, data extracted, and risk of bias assessed using ROBIS by two independent reviewers. Studies overlap was calculated using corrected covered area. RESULTS Eighteen systematic reviews were included in total; 8 assessed the caries arresting effects of 38% Silver Demine Fluoride (SDF), 1 on the Hall Technique (HT), 1 on selective removal of carious tissue, and eight investigated interventions using atraumatic restorative treatment (ART). Included systematic reviews were published between 2006 and 2020, covering a defined time frame of included randomised controlled trials ranging from 1969 to 2018. Systematic reviews assessed the sealing efficacy of fissure sealants and resin infiltration in carious primary teeth were excluded due to pooled data reporting on caries arrest in both enamel and outer third of dentine with the majority of these carious lesions being limited to enamel. Therefore, fissure sealants and resin infiltration are not recommended for the management of dentinal caries lesions in primary teeth. Topical application of 38% SDF showed a significant caries arrest effect in primary teeth (p < 0.05), and its success rate in arresting dental caries increased when it was applied twice (range between 53 and 91%) rather than once a year (range between 31 and 79%). Data on HT were limited and revealed that preformed metal crowns placed using the HT were likely to reduce discomfort at time of treatment, the risk of major failure (pulp treatment or extraction needed) and pain compared to conventional restorations. Selective removal of carious tissue particularly in deep carious lesions has significantly reduced the risk of pulp exposure (77% and 69% risk reduction with one-step selective caries removal and stepwise excavation, respectively). ART showed higher success rate when placed in single surface compared to multi-surface cavities (86% and 48.7-88%, respectively, over 3 years follow-up). CONCLUSION Minimal Intervention Dentistry techniques, namely 38% SDF, HT, selective removal of carious tissue, and ART for single surface cavity, appear to be effective in arresting the progress of dentinal caries in primary teeth when compared to no treatment, or conventional restorations. There is clear need to increase the emphasis on considering these techniques for managing carious primary teeth as a mainstream option rather than a compromise option in circumstances where the conventional approach is not possible due to cooperation or cost.
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Affiliation(s)
- A BaniHani
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - R M Santamaría
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - S Hu
- Faculty of Dentistry, National University of Singapore, Singapore, Singapore
| | - M Maden
- Liverpool Reviews & Implementation Group, University of Liverpool, Liverpool, UK
| | - S Albadri
- School of Dentistry, University of Liverpool, Pembroke place, Liverpool, L3 5PS, UK.
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Management of initial carious lesions of hypomineralized molars (MIH) with silver diamine fluoride or silver-modified atraumatic restorative treatment (SMART): 1-year results of a prospective, randomized clinical trial. Clin Oral Investig 2021; 26:2197-2205. [PMID: 34743243 PMCID: PMC8572062 DOI: 10.1007/s00784-021-04236-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 10/15/2021] [Indexed: 11/27/2022]
Abstract
Objectives This study evaluated and compared the effect of silver diamine fluoride (SDF) and silver-modified atraumatic restorative treatment (SMART) sealants for the treatment of initial carious lesions of permanent molars affected by molar incisor hypomineralization (MIH). Methods One hundred and twelve hypomineralized permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF and SMART sealant groups (n = 56 teeth/group) in a split-mouth fashion. Hypersensitivity, formation of caries, and enamel breakdown were evaluated in both groups. Hypersensitivity was assessed by Schiff Cold Air Sensitivity Scale (SCASS), and clinical assessments of SMART sealants were performed according to modified USPHS criteria at 1, 6, and 12 months. The data were analyzed statistically using Fisher’s exact test, Kaplan–Meier analysis, Mann–Whitney U test, and Friedman test. Results Twenty-six hypomineralized molars with marked baseline hypersensitivity showed significantly lower SCASS scores at all evaluation periods (p < 0.001). There was no significant difference in hypersensitivity scores between the groups at the repeated applications of SDF at 1, 6, and 12 months. The cumulative survival rates of SMART sealants on occlusal and palatal surfaces were 88.7% and 58.8%, respectively. Conclusions In hypomineralized molars, both SDF and SMART sealants showed favorable short-term prevention against dental caries while providing effective desensitization. Marginal discoloration was the most common side effect of the SMART sealants as a result of SDF application. Clinical Significance Both SDF and SMART sealants showed similar short-term effectiveness as non-aerosol procedures in arresting enamel caries and reducing hypersensitivity in hypomineralized molars. Trial registration Clinical Trials Registration Number: NCT03862014.
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Lam PP, Sardana D, Lo EC, Yiu CK. FISSURE SEALANT IN A NUTSHELL. EVIDENCE-BASED META-EVALUATION OF SEALANTS' EFFECTIVENESS IN CARIES PREVENTION AND ARREST. J Evid Based Dent Pract 2021; 21:101587. [PMID: 34479663 DOI: 10.1016/j.jebdp.2021.101587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 03/31/2021] [Accepted: 05/03/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE This meta-evaluation aimed to summarize all available evidence regarding different fissure sealants on occlusal caries prevention, arrest, retention rate, adverse effect, and cost-effectiveness; when compared with no intervention, other preventive or minimally-invasive procedures. MATERIALS AND METHODS The systematic reviews and meta-analyses were identified via four electronic databases and manual searching. Two independent reviewers performed study selection, data extraction, quality assessment with AMSTAR-2. RESULTS Among the 366 records yielded, 38 systematic reviews were identified as eligible 24 of them included meta-analyses. Moderate evidence has supported the efficacies of resin-based sealants (RBS) in occlusal caries prevention, arrest and cost-effectiveness compared to no interventions. Low to very low certainty of evidence suggested similar effectiveness of glass-ionomer cements in caries prevention with RBS and more superior performance of resin infiltration in arresting non-cavitated occlusal lesions. CONCLUSION This meta-evaluation supports the use of RBS on permanent molars to reduce occlusal caries occurrence, arrest lesion progression and alleviate oral health inequalities between individuals of different socioeconomic status. This meta-evaluation also advocates further research on glass-ionomer cements and resin infiltration with respect to their efficacies in caries prevention and arrest.
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Affiliation(s)
- Phoebe Py Lam
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong
| | - Divesh Sardana
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong
| | - Edward Cm Lo
- Community Dental Care, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong
| | - Cynthia Ky Yiu
- Paediatric Dentistry, Faculty of Dentistry, the University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong.
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25
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Oliveira RDC, Camargo LB, Novaes TF, Pontes LRA, Olegário IC, Gimenez T, Pássaro AL, Tedesco TK, Braga MM, Mendes FM, Raggio DP. Survival rate of primary molar restorations is not influenced by hand mixed or encapsulated GIC: 24 months RCT. BMC Oral Health 2021; 21:371. [PMID: 34301217 PMCID: PMC8305516 DOI: 10.1186/s12903-021-01710-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Glass ionomer cements (GIC) have been considered the top option to restore primary teeth by dentists. The most common supply forms are hand mixed and encapsulated GIC. There is a lack of information about the impact of different GIC supply forms on restoration survival. METHODS This randomized clinical trial compared the survival rate of occlusal and occlusoproximal restorations in primary molars using two glass ionomer cements versions: hand-mixed (H/M) and encapsulated (ENC) after 24 months. Children aged 3-10 years who presented dentin caries lesions in primary molars were selected at School of Dentistry, University of São Paulo, Brazil. They were randomly assigned to groups: H /M (Fuji IX®, GC Europe) or ENC (Equia Fill®, GC Europe). The occurrence of restoration failure was evaluated by two blinded and calibrated examiners. The analyses were performed in Stata 13 (StataCorp, USA). To evaluate the primary outcome (restoration survival), we performed a survival analysis. Additionally an intention to treat (ITT) analysis were done at 24 months of follow-up. Cox Regression with shared frailty was performed to assess association between restoration failure and independent variables (α = 5%). RESULTS A total of 324 restorations were performed in 145 children. The survival for H/M group was 58.2% and 60.1% for ENC, with no difference (p = 0.738). Occlusoproximal restorations had lower survival rate when compared to occlusal ones (HR = 3.83; p < 0.001). CONCLUSIONS The survival rate in primary molars is not influenced by the different supply forms of GIC. Also, occlusoproximal restorations present reduced performances when compared to occlusal cavities. TRIAL REGISTRATION This randomized clinical trial was registered on ClinicalTrials.Gov on 10/15/2014 under protocol (NCT02274142).
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Affiliation(s)
| | | | | | | | - Isabel Cristina Olegário
- Department of Public & Child Dental Health, Dublin Dental University Hospital, Trinitty College Dublin, Dublin, Ireland
| | - Thais Gimenez
- Department of Dentistry, Ibirapuera University, São Paulo, Brazil
| | - Ana Laura Pássaro
- Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Mariana Minatel Braga
- Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil
| | - Daniela Prócida Raggio
- Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, Brazil. .,School of Dentistry, University of Sao Paulo, Av. Professor Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
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Maru V. The 'new normal' in post-COVID-19 pediatric dental practice. Int J Paediatr Dent 2021; 31:528-538. [PMID: 34148269 PMCID: PMC8447441 DOI: 10.1111/ipd.12764] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/15/2020] [Accepted: 11/23/2020] [Indexed: 01/20/2023]
Abstract
The COVID-19 pandemic has posed an extraordinary challenge to the world. Dental healthcare personnel are considered to be at high risk as they work in close proximity to the oral cavity of patients. New procedures of approach and management should be incorporated in different aspects of routine dental practice. In addition, pediatric dentists are posed with unique and extraordinary challenges of parental anxiety and behavioral guidance of pediatric patients and parents/guardians. The aim of this study was to highlight the changing perceptions of pediatric dental practice as the 'new normal' in the post-COVID era.
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Affiliation(s)
- Viral Maru
- Department of Pediatric DentistryGovernment Dental College and HospitalMumbaiIndia
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27
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Kohli R, Clemens J, Mann L, Newton M, Glassman P, Schwarz E. Training dental hygienists to place interim therapeutic restorations in a school-based teledentistry program: Oregon's virtual dental home. J Public Health Dent 2021; 82:229-238. [PMID: 34142372 DOI: 10.1111/jphd.12465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/13/2021] [Accepted: 06/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objectives of this study on Oregon's virtual dental home were to: 1) demonstrate the feasibility of pilot project training of existing Expanded Practice Dental Hygienists (EPDHs) to perform interim therapeutic restorations (ITRs) in the community settings after diagnosis by the supervising dentist via teledentistry and 2) evaluate satisfaction of parents/guardians of children participating in a pilot program that provides school-based/on-site preventive dental care services utilizing expanded scope EPDHs to conduct dental screenings and place ITRs. METHODS This demonstration project was a 4-years longitudinal cohort study (2016-2019) in the school/community-based settings focusing on children in kindergarten to 3rd grade. EPDHs and dentists from a Dental Care Organization were trained to utilize teledentistry and EPDHs were trained to place ITRs, the latter provided onsite dental care. Data was collected regarding child's demographics and oral health status; and parents reported level of satisfaction from services received by their children. Data analysis included descriptive statistics and logistic regression analysis to assess the relative importance of demographic and clinical factors on caries status. RESULTS Onsite dental care was provided to 759 children. Of repeat patients (n = 377), 201 (53.3%) children had untreated decay at their first visit. Of these, 13% saw improvements in oral health status at their most recent visit (MRV). There were 162 ITRs planned out of which 50 patients received 99 ITRs. No adverse events were experienced. Of the repeat children receiving ITRs (n = 43), 28% saw improvement in their caries status at their MRV. Parents reported very high levels of satisfaction with the dental care program. CONCLUSION Oregon's virtual dental home project was successful in training EPDHs to perform ITRs safely in school settings after caries diagnosis by the supervising dentist via teledentistry and in integrating this component into a regular school-based preventive dental program.
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Affiliation(s)
- Richie Kohli
- Department of Community Dentistry, School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA
| | | | | | | | - Paul Glassman
- California Northstate University, Elk Grove, California, USA
| | - Eli Schwarz
- Department of Community Dentistry, School of Dentistry, Oregon Health & Science University, Portland, Oregon, USA
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Schraverus MS, Olegário IC, Bonifácio CC, González APR, Pedroza M, Hesse D. Glass Ionomer Sealants Can Prevent Dental Caries but Cannot Prevent Posteruptive Breakdown on Molars Affected by Molar Incisor Hypomineralization: One-Year Results of a Randomized Clinical Trial. Caries Res 2021; 55:301-309. [PMID: 34107492 DOI: 10.1159/000516266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/21/2021] [Indexed: 11/19/2022] Open
Abstract
To evaluate the preventive effect of glass ionomer cement (GIC) against dental caries and posteruptive breakdown (PEB) on molars affected by molar incisor hypomineralization (MIH). In this randomized clinical trial, 77 children aged 5-9 years with at least 1 MIH-affected molar and without PEB or dentin caries lesions (n = 228) were included and randomly allocated to one of the following groups: (1) MIH-affected molars that remained unsealed and (2) MIH-affected molars that received GIC sealants. Dental caries and PEB were clinically evaluated after 6 and 12 months. Associations between dental caries and PEB with independent variables were evaluated using logistic regression analysis (p < 0.05). The MIH-affected molars allocated to the GIC sealant group were less likely to develop dental caries compared to those allocated to the unsealed group (OR = 0.23; 95% CI 0.06-0.95). Conversely, application of a GIC sealant was not associated with prevention of PEB (p = 0.313). Furthermore, MIH-affected molars presenting yellow-brown opacities were almost 5 times more likely to develop dental caries (p = 0.013) and PEB (p = 0.001) compared to those presenting white-creamy opacities. We can conclude that GIC sealants can prevent dental caries on MIH-affected molars; however, the same protective effect was not observed for PEB.
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Affiliation(s)
- Milou S Schraverus
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Isabel C Olegário
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland
| | - Clarissa C Bonifácio
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Ana Paola R González
- Programme of Specialization in Paediatric Dentistry, Dental School, Los Altos Campus, University of Guadalajara, Guadalajara, Mexico
| | - Murisi Pedroza
- Programme of Specialization in Paediatric Dentistry, Dental School, Los Altos Campus, University of Guadalajara, Guadalajara, Mexico
| | - Daniela Hesse
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
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Araújo IJDS, Ricardo MG, Gomes OP, Giovani PA, Puppin-Rontani J, Pecorari VA, Martinez EF, Napimoga MH, Nociti Junior FH, Puppin-Rontani RM, Lisboa-Filho PN, Kantovitz KR. Titanium dioxide nanotubes added to glass ionomer cements affect S. mutans viability and mechanisms of virulence. Braz Oral Res 2021; 35:e062. [PMID: 34133579 DOI: 10.1590/1807-3107bor-2021.vol35.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 11/11/2020] [Indexed: 11/22/2022] Open
Abstract
This in vitro study evaluated the impact of TiO2 nanotubes (n-TiO2) incorporated into glass ionomer cement (GIC) on Streptococcus mutans (S. mutans) characteristics at cellular and molecular levels. n-TiO2, synthesized by the alkaline method (20 nm in size), was added to Ketac Molar EasyMix® at 0%, 3%, 5%, and 7% by weight. S. mutans strains were cultured on GIC disks with addition or not of n-TiO2 for 1, 3, and 7 days and the following parameters were assessed: inhibition halo (mm) (n=3/group); cell viability (live/dead) (n=5/group); cell morphology (SEM) (n=3/group); and gene expression by real-time PCR (vicR, covR, gtfB, gtfC, and gtfD) (n=6/group). The data were analyzed by the Kruskal-Wallis test, repeated-measures ANOVA or two-way ANOVA, and Tukey's and Dunn's post-hoc tests (α=0.05). The agar diffusion test showed a higher antibacterial property for 5% n-TiO2 compared with 3% and 7% (p<0.05) with no effect of time (1, 3, and 7 days). The cell number was significantly affected by all n-TiO2 groups, while viability was mostly affected by 3% and 5% n-TiO2, which also affected cell morphology and organization. Real-time PCR demonstrated that n-TiO2 reduced the expression of covR when compared with GIC with no n-TiO2 (p<0.05), with no effect of time, except for 3% n-TiO2 on vicR expression. Within-group and between-group analyses revealed n-TiO2 did not affect mRNA levels of gtfB, gtfC, and gtfD (p>0.05). Incorporation of n-TiO2 at 3% and 5% potentially affected S. mutans viability and the expression of key genes for bacterial survival and growth, improving the anticariogenic properties of GIC.
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Affiliation(s)
- Isaac Jordão de Souza Araújo
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | | | - Orisson Ponce Gomes
- Universidade Estadual Paulista Júlio Mesquita Filho - UNESP, School of Sciences, Department of Physics, Bauru, SP, Brazil
| | - Priscila Alves Giovani
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Pediatric Dentistry, Piracicaba, SP, Brazil
| | - Júlia Puppin-Rontani
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Vanessa Arias Pecorari
- Universidade Paulista - UNIP, School of Dentistry, Department of Bioestatistics, São Paulo, São Paulo, Brazil
| | | | | | - Francisco Humberto Nociti Junior
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Prosthodontics and Periodontology, Piracicaba, SP, Brazil
| | - Regina Maria Puppin-Rontani
- Universidade Estadual de Campinas - Unicamp, Piracicaba Dental School, Department of Pediatric Dentistry, Piracicaba, SP, Brazil
| | - Paulo Noronha Lisboa-Filho
- Universidade Estadual Paulista Júlio Mesquita Filho - UNESP, School of Sciences, Department of Physics, Bauru, SP, Brazil
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Pozos-Guillén A, Molina G, Soviero V, Arthur RA, Chavarria-Bolaños D, Acevedo AM. Management of dental caries lesions in Latin American and Caribbean countries. Braz Oral Res 2021; 35:e055. [PMID: 34076079 DOI: 10.1590/1807-3107bor-2021.vol35.0055] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/09/2021] [Indexed: 11/22/2022] Open
Abstract
Caries management at the lesion level is dependent on the lesion activity, the presence of a cavitation (either cleanable or non-cleanable), and lesion depth as evaluated via radiographic examination. A variety of non-invasive, micro-invasive, and minimally invasive treatment (with or without restoration) options are available for primary and permanent teeth. Non-invasive strategies include oral hygiene instructions, dietary counseling, and personal as well as professional use of fluoridated products that reduce demineralization and increase re-mineralization. Micro-invasive procedures include the use of occlusal resin sealants and resin infiltrants, while minimally invasive strategies comprise those related to selective removal of caries tissues and placement of restorations. Deep caries management includes indirect pulp capping, while exposed pulp may be treated using direct pulp capping and partial or complete pulpotomy. The aim of the present study was to review available evidence on recommended preventive and restorative strategies for caries lesions in Latin American/Caribbean countries, and subsequently develop evidence-based recommendations for treatment options that take into consideration material availability, emphasize ways to adapt available treatments to the local context, and suggest ways in which dentists and health systems can adopt these treatments.
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Affiliation(s)
- Amaury Pozos-Guillén
- Universidad Autónoma de San Luis Potosí, Faculty of Dentistry, Basic Sciences Laboratory, San Luis Potosí, México
| | - Gustavo Molina
- Universidad Nacional de Córdoba, The Dental Faculty, Department of Dental Materials, Córdoba, Argentina
| | - Vera Soviero
- Universidade Estadual do Rio de Janeiro - UERJ, School of Dentistry, Department of Preventive and Community Dentistry, Rio de Janeiro, RJ, Brazil.,Centro Universitário Arthur Sá Earp Neto - Unifase, School of Dentistry, Petrópolis, RJ, Brazil
| | - Rodrigo Alex Arthur
- Universidade Federal do Rio Grande do Sul - UFRGS, Dental School, Department of Preventive and Community Dentistry, Porto Alegre, RS, Brazil
| | - Daniel Chavarria-Bolaños
- Universidad de Costa Rica, Faculty of Dentistry, Department of Diagnostic and Surgical Sciences, San José, Costa Rica
| | - Ana María Acevedo
- Universidad Central de Venezuela, Faculty of Dentistry, Institute of Dental Research "Raul Vincentelli", Caracas, Venezuela
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Tekbas Atay M, Koray F. Microbiological and SEM assessment of atraumatic restorative treatment in adult dentition. Clin Oral Investig 2021; 25:6871-6880. [PMID: 33982167 DOI: 10.1007/s00784-021-03976-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 05/03/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To investigate the practicability of atraumatic restorative treatment (ART) in adults in terms of marginal adaptation of restorations and microbiological changes in residual carious dentin. MATERIALS AND METHODS The occlusal dentin caries of 25 permanent molar teeth were removed with hand instruments. The total counts of bacteria (TCB) and the facultative anaerobic bacteria (FAB), mutans streptococci (MS), and Lactobacillus spp. (LB) counts in the affected dentin were evaluated quantitatively. The weights of the samples were measured with an electronic balance (Shimadzu, Type AX200, Japan). The cavities were restored with glass ionomer cement (KetacTM Molar Easymix, ESPE Dental AG, Seefeld, Germany). Twenty replicas of randomly selected ART restorations were prepared and marginal adaptation was evaluated by scanning electron microscopy (SEM). After 6 months, the same protocols were repeated. Data were analyzed with paired sample t-tests, Wilcoxon t-tests, Pearson and Spearman correlations, and chi-square tests (p<0.05). RESULTS In the sixth month, restoration loss and pulpitis were not observed. The mean weight of samples removed from the cavity floor was less than the baseline (0.014±0.009 and 0.023±0.013 g, respectively) (p<0.01), and the counts of total bacteria, FAB, MS, and LB significantly decreased compared to baseline (p<0.01). The frequency of marginal gaps was increased (p< 0.01). CONCLUSIONS ART showed that the counts of microorganisms decreased after 6 months although the marginal gap rates of restorations increased. CLINICAL RELEVANCE ART can be a reliable treatment approach in adults for 6 months due to the decrease in microorganism counts, although gaps exist.
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Affiliation(s)
- Meltem Tekbas Atay
- Department of Restorative Dentistry, Faculty of Dentistry, Trakya University, Edirne, Turkey.
| | - Fatma Koray
- Department of Restorative Dentistry, Faculty of Dentistry, Yeniyüzyıl University, Istanbul, Turkey
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Liu B, Wang W. A cost minimisation analysis of two dental sealing methods in an outreach dental program. J Dent 2021; 110:103687. [PMID: 33961937 DOI: 10.1016/j.jdent.2021.103687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/27/2021] [Accepted: 05/01/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To conduct economic evaluation of two sealing methods (placement of resin sealant or glass ionomer ART sealant) in preventing pit and fissure caries in permanent first molars (PFMs) in schoolchildren. MATERIALS AND METHODS An outreach dental program was conducted in two randomly selected primary schools, one was covered by the national government-funded dental sealing service (group 1) and the other was not (group 2). Resin or ART sealant (sealant using glass ionomer material with the aid of the finger-press technique) was applied to all of the eligible PFMs in group 1 and group 2 students (grade 1 or 2), respectively. All the applications was provided at school. The cost for sealant application was recorded for each method. After 18 months, a cost minimisation analysis was performed based on the efficacy results of the two methods. RESULTS AND CONCLUSION In total, 445 sealants were applied to 126 children in group 1, and 668 sealants were applied to 203 children in group 2. Dental caries incidence was 29.4 % in group 1 and 28.6 % in group 2 after 18 months. Logistic regression analysis showed no statistically significant difference (p = 0.552) between the two groups. Cost minimisation analysis was used to evaluate the economic performance. The analytical model showed that the ART sealant was economically better than resin sealant. Sensitivity analysis showed that the life expectancy of the equipment/instrument used in sealant applications was the major parameter affecting the cost. The cost of using ART sealant over the study period was lower than that of using resin sealant. Overall, ART sealant is a less costly alternative for pit and fissure caries prevention in outreach dental services. CLINICAL SIGNIFICANCE While pit and fissure sealing using ART sealant was as effective as using resin sealant in dental caries prevention, the cost of using ART sealant was lower than that of using resin sealant. Therefore, ART sealant could be a good alternative to resin sealant for pit and fissure caries prevention in outreach dental services for rural populations who have the greatest need.
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Affiliation(s)
- Baoying Liu
- The First Affiliated Hospital, School and Hospital of Stomatology of Zhengzhou University, No. 40 Daxue Road, Erqi District, Zhengzhou, Henan, 450052, China.
| | - Wenke Wang
- The First Affiliated Hospital, School and Hospital of Stomatology of Zhengzhou University, No. 40 Daxue Road, Erqi District, Zhengzhou, Henan, 450052, China.
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Frencken JE, Liang S, Zhang Q. Survival estimates of atraumatic restorative treatment versus traditional restorative treatment: a systematic review with meta-analyses. Br Dent J 2021:10.1038/s41415-021-2701-0. [PMID: 33883705 DOI: 10.1038/s41415-021-2701-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 06/25/2020] [Indexed: 11/09/2022]
Abstract
Objectives The hypothesis tested was that there is no significant difference between the survival estimates of atraumatic restorative treatment/high-viscosity glass-ionomer cement (ART/HVGIC) restorations, in posterior primary and permanent teeth, and traditional amalgam and resin composite restorations.Data sources The databases PubMed, DOAJ, LILACS, IndMed, Google Scholar and CNKI were searched.Data selection Using inclusion and exclusion criteria led to 14 eligible randomised trials. A low risk of bias was observed for two reports. Homogeneity was obtained for single-surface ART restorations after one and two years in the primary dentition.Data synthesis No statistically significant difference was found between the weighted mean survival percentages of ART/HVGIC and traditional treatments in both single- and multiple-surface restorations in primary molars and in single-surface restorations in posterior permanent teeth at years 1, 2, 3 and 5. At years 4.3 and 6.3, the difference between the two treatments was statistically significant, favouring the ART/HVGIC restorations. No statistically significant difference was found between the weighted mean survival percentages of ART/HVGIC and traditional treatments in multiple-surface restorations in posterior permanent teeth.Conclusion The ART method using HVGICs can be considered as a replacement for traditional restorations in single- and multiple-surface cavities in primary molars, and in single-surface cavities in posterior permanent teeth, particularly for amalgam.
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Affiliation(s)
- Jo E Frencken
- Department of Dentistry, Section of Function and Prosthetic Dentistry, Radboud University Medical Centre, Nijmegen, The Netherlands.
| | - Shanshan Liang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Qian Zhang
- Department of Dentistry, Section of Function and Prosthetic Dentistry, Radboud University Medical Centre, Nijmegen, The Netherlands
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Menezes-Silva R, Velasco SRM, BRESCIANi E, Bastos RDS, Navarro MFDL. A prospective and randomized clinical trial evaluating the effectiveness of ART restorations with high-viscosity glass-ionomer cement versus conventional restorations with resin composite in Class II cavities of permanent teeth: two-year follow-up. J Appl Oral Sci 2021; 29:e20200609. [PMID: 33656064 PMCID: PMC7934279 DOI: 10.1590/1678-7757-2020-0609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/19/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the effectiveness of ART restorations using High Viscosity Glass-ionomer cement (HVGIC) with conventional restorations using resin composite in Class II cavities of permanent teeth, in a 2-year follow-up. METHODOLOGY Seventy-seven restorations were made with each restorative material, Equia Fil-GC Corporation (ART restorations) and Z350-3M (conventional restoration), in 54 participants in this parallel and randomized clinical trial. Restorations were evaluated at 6 months, 1 and 2 years using the ART and the modified United States Public Health Service (USPHS) criteria. Chi-square test and Survival Analysis (p<0.05) were used for statistical analysis. RESULTS The success rates for ART restorations were 98.7% (6 months) and 95.8% (1 year) for both criteria. At 2 years, success rate was 92% and 90.3% when scored by the modified USPHS and ART criteria (p=0.466), respectively. The success rates for conventional restorations were 100% (6 months), 98.7% (1 year) and 91.5% (2 years) for both assessment criteria. ART restorations presented a lower survival rate by the criterion of ART (83.7%) when compared to the modified USPHS criterion of (87.8%), after 2 years (p=0.051). The survival of conventional restorations was 90.7% for both evaluation criteria. CONCLUSION At the 2-years follow-up evaluation, no statistically significant difference was observed between the success rate of ART restorations with HVGIC compared to conventional restorations with resin composite in Class II cavities of permanent teeth.
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Affiliation(s)
- Rafael Menezes-Silva
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Materiais Dentários, Endodontia e Dentística, Bauru, SP, Brasil
| | | | - Eduardo BRESCIANi
- Universidade Estadual Paulista (UNESP), Instituto de Ciências e Tecnologia, São José dos Campos, SP, Brasil
| | - Roosevelt da Silva Bastos
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Materiais Dentários, Endodontia e Dentística, Bauru, SP, Brasil
| | - Maria Fidela de Lima Navarro
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Materiais Dentários, Endodontia e Dentística, Bauru, SP, Brasil
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de Lima Navarro MF, Pascotto RC, Borges AFS, Soares CJ, Raggio DP, Rios D, Bresciani E, Molina GF, Ngo HC, Miletić I, Frencken J, Wang L, Menezes-Silva R, Puppin-Rontani RM, de Carvalho RM, Gurgan S, Leal SC, Tüzüner T, Fagundes TC, Nicholson JW, Sidhu SK. Consensus on glass-ionomer cement thresholds for restorative indications. J Dent 2021; 107:103609. [PMID: 33610589 DOI: 10.1016/j.jdent.2021.103609] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE The aim of this paper is to present the results of a consensus meeting on the threshold property requirements for the clinical use of conventional glass-ionomer cements (GICs) for restorative indications. METHODS Twenty-one experts on GICs evaluated the results of tests on mechanical and optical properties of 18 different brands of restorative GICs: Bioglass R [B], Chemfil Rock [CR], Equia Forte [EF], Gold Label 2 [GL2], Gold Label 9 [GL9], Glass Ionomer Cement II [GI], Ionglass [IG], Ion Z [IZ], Ionomaster [IM], Ionofil Plus [IP], Ionostar Plus [IS], Ketac Molar Easymix [KM], Magic Glass [MG], Maxxion R [MA], Riva Self Cure [R], Vidrion R [V], Vitro Fil [VF] and Vitro Molar [VM]. All experiments were carried out by a team of researchers from Brazil and England following strict protocols, under the same laboratory conditions throughout, and maintaining data integrity. RESULTS There was consensus on: determining as primary properties of the material: compressive strength, microhardness, acid erosion and fluoride release, and as secondary properties: contrast ratio and translucency parameter, in order to rank the materials. Seven brands were below the thresholds for restorative indications: IZ, IM, IG, MA, VF, B and MG. CONCLUSIONS Based on the primary properties adopted as being essential for restorative indications, the conventional restorative GICs that met the thresholds and could be considered suitable as long-term restorative materials were: EF, GI, GL9, KM, IP, GL2, IS, CR, V, VM and R. A decision-making process to select the best GIC must also include results from clinical trials. CLINICAL SIGNIFICANCE This study provides a ranking of GICs that could be considered suitable as long-term restorative materials based on their main properties.
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Affiliation(s)
- Maria Fidela de Lima Navarro
- Department of Restorative Dentistry, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, 17012-901, Bauru, Brazil.
| | - Renata Corrêa Pascotto
- Department of Restorative Dentistry, State University of Maringá, Av. Colombo, 5790 - Jd. Universitário, 87020-900, Maringá, Brazil
| | - Ana Flávia Sanches Borges
- Department of Restorative Dentistry, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, 17012-901, Bauru, Brazil
| | - Carlos José Soares
- Department of Restorative Dentistry, Federal University of Uberlândia, Av. João Naves de Ávila, 2121 - Santa Mônica, 38408-100, Uberlândia, Brazil
| | - Daniela Prócida Raggio
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Butantã, 05508-000, São Paulo, Brazil
| | - Daniela Rios
- Department of Restorative Dentistry, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, 17012-901, Bauru, Brazil
| | - Eduardo Bresciani
- Institute of Science and Technology, State University of São Paulo, Av. Eng. Francisco José Longo, 777 - Jardim São Dimas, 12245-00, São José dos Campos, Brazil
| | | | - Hien Chi Ngo
- Dean and Head of School/Director of OHCWA, The University of Western Australia, 512, 17 Monash Avenue, Nedlands, WA 6009, Australia
| | - Ivana Miletić
- School of Dental Medicine, University of Zagreb, Gundulićeva ul. 5, 10000, Zagreb, Croatia
| | - Jo Frencken
- Department of Dentistry, Radboud University Medical Centre, Philips van Leydenlaan 25, 6525 EX, Nijmegen, the Netherlands
| | - Linda Wang
- Department of Restorative Dentistry, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, 17012-901, Bauru, Brazil
| | - Rafael Menezes-Silva
- Department of Restorative Dentistry, Bauru School of Dentistry, University of São Paulo, Alameda Dr. Octávio Pinheiro Brisolla, 9-75 - Jardim Brasil, 17012-901, Bauru, Brazil
| | | | | | - Sevil Gurgan
- Department of Restorative Dentistry, Hacettepe University, 06800, Ankara, Turkey
| | | | | | - Ticiane Cestari Fagundes
- Araçatuba School of Dentistry, State University of São Paulo, Rua José Bonifácio, 1193, 16015-050, Araçatuba, Brazil
| | - John William Nicholson
- Bluefield Centre for Biomaterials, Unit 34, 67-68 Hatton Garden, Holborn, London EC1N 8JY, England, United Kingdom
| | - Sharanbir Kaur Sidhu
- Queen Mary University of London, Mile End Rd, Bethnal Green, London E1 4NS, England, United Kingdom
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Reopening Dental Offices for Routine Care Amid the COVID-19 Pandemic: Report From Palestine. Int Dent J 2021; 72:83-92. [PMID: 33632475 PMCID: PMC7881762 DOI: 10.1016/j.identj.2021.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/28/2021] [Indexed: 12/31/2022] Open
Abstract
Objectives This study reports on the readiness of Palestinian dentists to reopen their practices for routine care during the current coronavirus disease 2019 (COVID-19) pandemic. Methods A cross-sectional study targeted dentists in the West Bank area of Palestine using an online survey during the first 2 weeks of May 2020. Questions mainly asked about dentists’ perception of the risks of COVID-19, readiness to reopen their clinics for routine care, and the level of confidence in dealing with patients suspected of having COVID-19. Results A total of 488 dentists completed the survey. Almost 60% believed that they were not ready to reopen their practices. Almost 13% had “no confidence” in dealing with patients with COVID-19, while 64% had “little to moderate” confidence. Confidence was correlated negatively with increased fear of becoming infected (ρ = -0.317, P < .0001) and positively with years of practice (ρ = 1.7, P < .0001). Dentists who received updated training on infection control or on COVID-19 reported higher levels of confidence (χ2 = 53.8, P < .0001, χ2 = 26.8, P < .0001, respectively). Although 88% preferred not to treat patients with COVID-19, 40% were willing to provide care to them. Almost 75% reported that they were already facing financial hardships and could not survive financially until the end of the current month. Conclusions Ethical and financial reasons were the main drivers for dentists in this sample to reopen their practices for routine care. Data from this study highlights the fragility of private dental practice in emergency situations. Ethical, health, and financial challenges that emerged during COVID-19 require dentists to adapt and be better prepared to face future crises.
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Gupta A, Shah SG, Kaul B, Mahajan N, Gupta RK. The Epiphany of Post-COVID: A Watershed for Pediatric Dentistry. Int J Clin Pediatr Dent 2021; 14:802-811. [PMID: 35110875 PMCID: PMC8783216 DOI: 10.5005/jp-journals-10005-2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Aishwaraya Gupta
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu Tawi, Jammu and Kashmir, India
| | - Syed G Shah
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu Tawi, Jammu and Kashmir, India
| | - Bhavna Kaul
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu Tawi, Jammu and Kashmir, India
| | - Nanika Mahajan
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu Tawi, Jammu and Kashmir, India
- Nanika Mahajan, Department of Pedodontics and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu Tawi, Jammu and Kashmir, India, Phone: +91 9419260565, e-mail:
| | - Rakesh K Gupta
- Department of Pedodontics and Preventive Dentistry, Indira Gandhi Government Dental College and Hospital, Jammu Tawi, Jammu and Kashmir, India
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Cagetti MG, Angelino E. Could SARS-CoV-2 burst the use of Non-Invasive and Minimally Invasive treatments in paediatric dentistry? Int J Paediatr Dent 2021; 31:27-30. [PMID: 32748562 PMCID: PMC7436454 DOI: 10.1111/ipd.12679] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/09/2020] [Accepted: 05/20/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Maria Grazia Cagetti
- Department of BiomedicalSurgical and Dental SciencesUniversity of MilanMilanItaly
| | - Eleonora Angelino
- Department of BiomedicalSurgical and Dental SciencesUniversity of MilanMilanItaly
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Fiehn R, Okunev I, Bayham M, Barefoot S, Tranby EP. Emergency and urgent dental visits among Medicaid enrollees from 2013 to 2017. BMC Oral Health 2020; 20:355. [PMID: 33276770 PMCID: PMC7716286 DOI: 10.1186/s12903-020-01345-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/22/2020] [Indexed: 11/11/2022] Open
Abstract
Background Better understanding of the frequency of dental emergencies and the procedures performed during those emergency visits can help providers, insurers, and policymakers understand workforce and care provision needs. Methods Procedures performed at an emergency dental encounter and in the encounter following that encounter are assessed. Emergency dental encounters are those with a CDT code of D0140, D0160, or D0170. Data was analyzed from the IBM Watson Medicaid Marketscan data from 2013 to 2017, a nationally representative dental and medical claims database from 13 deidentified states in the United States. Result Consistently over time, about 10% of all dental encounters are due to a dental emergency. 28% of emergency dental encounters had no other procedure performed during those encounters. When other procedures were performed during the encounter, the majority were diagnostic in nature, primarily radiographs. Among patients who returned to the dentists following an emergency visit, 43% returned for more definitive dental treatment, most within 30 days. Conclusions The majority of dental emergency encounters do not result in definitive treatment, rather patients often return to the dentist at a later date for that treatment. Where possible, dental providers could utilize teledental services to triage patients to appropriate care.
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Affiliation(s)
- Rebekah Fiehn
- DentaQuest Partnership for Oral Health Advancement, 465 Medford Street, Boston, MA, 02129, USA
| | - Ilya Okunev
- DentaQuest Partnership for Oral Health Advancement, 465 Medford Street, Boston, MA, 02129, USA
| | - Mary Bayham
- DentaQuest Partnership for Oral Health Advancement, 465 Medford Street, Boston, MA, 02129, USA
| | - Steven Barefoot
- DentaQuest, 11100 West Liberty Drive, Milwaukee, WI, 53224, USA
| | - Eric P Tranby
- DentaQuest Partnership for Oral Health Advancement, 465 Medford Street, Boston, MA, 02129, USA.
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Araujo MP, Innes NP, Bonifácio CC, Hesse D, Olegário IC, Mendes FM, Raggio DP. Atraumatic restorative treatment compared to the Hall Technique for occluso-proximal carious lesions in primary molars; 36-month follow-up of a randomised control trial in a school setting. BMC Oral Health 2020; 20:318. [PMID: 33176756 PMCID: PMC7656501 DOI: 10.1186/s12903-020-01298-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Atraumatic Restorative Treatment (ART) and the Hall Technique (HT) are both minimally invasive, non-aerosol generating procedures (non-AGPs). They seem to have never been directly compared, nor has the HT been studied in a non-clinical setting. This study compared the HT and ART restorations placed in a school setting after 36 months. METHODS Children (5-10 yo) who had a primary molar with a dentinal occluso-proximal, cavitated carious lesion were allocated to the ART (selective removal) or HT arms. PRIMARY OUTCOME restoration survival over 36-months (using Kaplan-Meier survival analysis, log rank test, and Cox regression). SECONDARY OUTCOMES (1) occlusal vertical dimension (OVD) (1, 2, 3, 4 weeks) and (2) child self-reported discomfort; (3) treatment acceptability (immediately following interventions); (4) Child Oral Health Related Quality of Life (OHRQoL), before treatment and after 6 months and (5) a post hoc analysis of time to tooth exfoliation (1, 6, 12, 18, 24, 30, 36 months). RESULTS One-hundred and thirty-one children (ART = 65; HT = 66) were included (mean age = 8.1 ± 1.2). At 36 months, 112 (85.5%) children were followed-up. PRIMARY OUTCOME restoration survival rates ART = 32.7% (SE = 0.08; 95% CI 0.17-0.47); HT = 93.4% (0.05; 0.72-0.99), p < 0.001; Secondary outcomes: (1) OVD returned to pre-treatment state within 4 weeks; (2) treatment discomfort was higher for the HT (p = 0.018); (3) over 70% of children and parents showed a high acceptability for treatments, with crown aesthetics being a concern for around 23% of parents; (4) Child OHRQoL improved after 6 months; and (5) teeth treated with the HT exfoliated earlier than those in the ART group (p = 0.007). CONCLUSIONS Both ART and the HT were acceptable to child participants and their parents and all parents thought both restorations protected their child's tooth. However, the crown appearance concerned almost a quarter of parents in the HT arm. Children experienced less discomfort in the ART group. Although both treatments can be performed in a non-clinical setting and have the advantage of being non-aerosol generating procedures (non-AGPs), the HT had almost three times higher survival rates (93.4%) for restoring primary molar occluso-proximal cavities compared to ART (32.7%). TRIAL REGISTRATION This trial was registered in ClinicalTrials.gov (NCT02569047), 5th October 2015. https://clinicaltrials.gov/ct2/show/study/NCT02569047?cond=Hall+Technique+Atraumatic+Rest orative+Treatment&draw=2&rank=2.
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Affiliation(s)
- Mariana Pinheiro Araujo
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, University of Dundee, Dundee, Scotland, UK
| | - Nicola Patricia Innes
- School of Dentistry, University of Dundee, Dundee, Scotland, UK. .,School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK.
| | - Clarissa Calil Bonifácio
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Daniela Hesse
- Department of Paediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands
| | - Isabel Cristina Olegário
- Department of Public and Child Dental Health, Dublin Dental University Hospital, Trinity College, Dublin, Ireland, UK
| | - Fausto Medeiros Mendes
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Daniela Prócida Raggio
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Jiang M, Fan Y, Li KY, Lo ECM, Chu CH, Wong MCM. Factors affecting success rate of atraumatic restorative treatment (ART) restorations in children: A systematic review and meta-analysis. J Dent 2020; 104:103526. [PMID: 33188846 DOI: 10.1016/j.jdent.2020.103526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Aim of this systematic review was to summarize the factors that affect the success rate of atraumatic restorative treatment (ART) restorations in children. DATA/SOURCES Two independent reviewers conducted a literature search in the databases PubMed, Medline and Web of Science until October 2019 with no initial time limit. Articles reporting on clinical outcomes of ART restorations placed in children were included. STUDY SELECTION A total of 67 articles were included in this review reporting on clinical outcomes of ART restorations placed in children in 47 studies. The overall estimated success rate and 95 % confidence interval (CI) of ART restorations were 0.71 (0.65-0.77) and 0.67 (0.56-0.78) at the 12-month and the 24-month follow-up, respectively. Operator was one of the significant factors associated with the success rate of ART restorations. ART restorations placed by dental students/therapists had a significantly lower success rate compared with those placed by dentists. Besides, type of restoration (single-surface vs. multiple-surface restoration) was also associated with the success rate of ART restorations. Other factors including dentition, restorative material, clinical setting, and moisture control method had no significant influence on the success rate of ART restorations in children. CONCLUSION It is concluded that ART approach can be used to manage cavitated caries lesions in children. Operator and type of restoration are significant factors influencing the success rate of ART restorations. CLINICAL SIGNIFICANCE This study provides valuable information on the factors that affect success rate of ART restorations in children, which helps clinicians to make informed decisions on provision of ART restorations in children.
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Affiliation(s)
- Meng Jiang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Yanpin Fan
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Kar Yan Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - May Chun Mei Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Chlorhexidine to improve the survival of ART restorations: A systematic review and meta-analysis. J Dent 2020; 103:103491. [PMID: 33010387 DOI: 10.1016/j.jdent.2020.103491] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Our aim was to systematically assess the efficacy of chlorhexidine (CHX) as a cavity pre-treatment or restoration mix-in on the survival of ART restorations. DATA We included randomized controlled trials that assessed the effect of cavity pretreatment with CHX or the restoration mix-in of CHX on the survival of ART restorations (test group) versus a similar restorative approach without CHX. Risk of bias was assessed using Cochrane's randomized trial quality assessment Tool (RoB 2.0). Random-effects meta-analysis was conducted, with mean Odds Ratios and 95 % confidence intervals (OR, 95 % CI) as effect estimates. The certainty of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. SOURCES Medline, Web of Science, Cochrane Central were searched. Eligible studies were in- or excluded and data extracted for included studies by two reviewers independently. STUDY SELECTION Four studies with 261 patients (mean age 3.8-14.6 years) and 467 ART restorations were included. All studies showed some concerns about the risk of bias. Three studies involving a total of 167 restorations in the CHX group and 188 restorations in the control group, followed up for one year, were submitted to meta-analysis. There were no significant differences between CHX vs. control (OR = 0.79, 95 % CI [0.26, 2.40], P = 0.68, I2 = 3%, P = 0.35). The strength of the evidence was estimated as low. CONCLUSIONS Based on very limited data, CHX pre-treatment or restoration mix-in did not have any significant benefit for survival of ART restorations. CLINICAL SIGNIFICANCE There is a lack of evidence regarding the influence of chlorhexidine on the survival of ART restorations. Our results revealed that there was no significant difference in the survival of ART restorations when CHX was used as a cavity pre-treatment or mix-in.
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Eden E, Frencken J, Gao S, Horst JA, Innes N. Managing dental caries against the backdrop of COVID-19: approaches to reduce aerosol generation. Br Dent J 2020; 229:411-416. [PMID: 33037360 PMCID: PMC7546139 DOI: 10.1038/s41415-020-2153-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 08/10/2020] [Indexed: 11/08/2022]
Abstract
The COVID-19 pandemic resulted in severe limitation and closure of dental practices in many countries. Outside of the acute (peak) phases of the disease, dentistry has begun to be practised again. However, there is emerging evidence that SARS-CoV-2 can be transmitted via airborne routes, carrying implications for dental procedures that produce aerosol. At the time of writing, additional precautions are required when a procedure considered to generate aerosol is undertaken.This paper aims to present evidence-based treatments that remove or reduce the generation of aerosols during the management of carious lesions. It maps aerosol generating procedures (AGPs), where possible, to alternative non-AGPs or low AGPs. This risk reduction approach overcomes the less favourable outcomes associated with temporary solutions or extraction-only approaches. Even if this risk reduction approach for aerosol generation becomes unnecessary in the future, these procedures are not only suitable but desirable for use as part of general dental care post-COVID-19.
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Affiliation(s)
- Ece Eden
- Ege University, School of Dentistry, Department of Paediatric Dentistry, Bornova, Izmir, 35100, Turkey.
| | - Jo Frencken
- Radboud University, Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, 6525 GA, The Netherlands
| | - Sherry Gao
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong
| | - Jeremy A Horst
- Director of Clinical Innovation, DentaQuest, Boston, MA 02129 USA; University of Washington, Department of Oral Health Sciences, Seattle, 98195, USA
| | - Nicola Innes
- Professor and Honorary Consultant, Paediatric Dentistry, School of Dentistry, College of Biomedical & Life Sciences, Cardiff University, Heath Park, Cardiff, CF14 4XY, UK
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Jiang M, Mei ML, Wong M, Chu CH, Lo E. Influence of Silver Diamine Fluoride Treatment on the Microtensile Bond Strength of Glass Ionomer Cement to Sound and Carious Dentin. Oper Dent 2020; 45:E271-E279. [PMID: 32502257 DOI: 10.2341/19-237-l] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2020] [Indexed: 11/23/2022]
Abstract
CLINICAL RELEVANCE This study provides valuable information about the influence of silver diamine fluoride (SDF) treatment on the microtensile bond strength of glass ionomer cement (GIC) to dentin. SUMMARY Objectives: To investigate the influence of silver diamine fluoride (SDF) treatment on the microtensile bond strength (mTBS) of glass ionomer cement (GIC) to sound and artificial carious dentin.Methods: Thirty dentin blocks prepared from 30 noncarious human molars were randomly allocated into either the sound (Gp1) or artificial carious dentin (Gp2) groups. A microbiological method was adopted to create artificial dentin caries lesions in Gp2 specimens. Each dentin block was sectioned into two halves perpendicularly, and each pair of block halves was randomly assigned to two subgroups to receive topical application of SDF (Gp1-SDF, Gp2-SDF) or water as control (Gp1-water, Gp2-water). An encapsulated GIC was bonded to the exposed dentin surfaces 14 days after the SDF/water application. After immersion for 7 days in artificial saliva, the GIC-dentin specimens were sectioned into beams for mTBS testing. Failure mode was examined after the mTBS test.Results: There was no significant difference in the mean mTBS values between the SDF and control subgroups (Gp1-SDF vs Gp1-water, 10.57±1.6 MPa vs 10.20±1.8 MPa; Gp2-SDF vs Gp2-water, 6.14±2.2 MPa vs 5.97±2.3 MPa; paired t-test, p>0.05). However, the mean mTBS value of the sound dentin group was significantly higher than that of the carious dentin group, irrespective of whether SDF was applied prior to GIC bonding (independent t-test, p<0.001). Proportionally more cohesive failures occurred in the sound dentin groups (Gp1-SDF, 48.4%; Gp1-water, 42.9%) compared with the carious dentin groups (Gp2-SDF, 15.6%; Gp2-water, 9.8%; p<0.05).Conclusions: SDF treatment had no significant influence on the mTBS of GIC to dentin. Compared with sound dentin, dentin with caries had lower mTBS to GIC.
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BaniHani A, Gardener C, Raggio DP, Santamaría RM, Albadri S. Could COVID-19 change the way we manage caries in primary teeth? Current implications on Paediatric Dentistry. Int J Paediatr Dent 2020; 30:523-525. [PMID: 32722881 DOI: 10.1111/ipd.12690] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Alaa BaniHani
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Collette Gardener
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Daniela Prócida Raggio
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ruth M Santamaría
- Department of Preventive and Paediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Sondos Albadri
- School of Dentistry, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
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Santamaría RM, Abudrya MH, Gül G, Mourad MS, Gomez GF, Zandona AGF. How to Intervene in the Caries Process: Dentin Caries in Primary Teeth. Caries Res 2020; 54:306-323. [PMID: 32854105 DOI: 10.1159/000508899] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 05/03/2020] [Indexed: 11/19/2022] Open
Abstract
For an ORCA/EFCD consensus, this review systematically assessed available evidence regarding interventions performed and materials used to manage dentin carious lesions in primary teeth. A search for systematic reviews (SRs) and randomized clinical trials (RCTs) with a follow-up of at least 12 months after intervention was performed in PubMed, LILACS, BBO, and the Cochrane Library. The risk of bias tool from the Cochrane Collaboration and the PRISMA Statement were used for assessment of the included studies. From 101 screened articles, 2 SRs and 5 RCTs, which assessed the effectiveness of interventions in terms of pulp vitality and success of restoration, and 10 SRs and 1 RCT assessing the success of restorative materials were included. For treatments involving no carious tissue removal, the Hall technique showed lower treatment failure for approximal carious lesions compared to complete caries removal (CCR) and filling. For the treatment of deep carious lesions, techniques involving selective caries removal (SCR) showed a reduction in the incidence of pulp exposure. However, the benefit of SCR over CCR in terms of pulp symptoms or restoration success/failure was not confirmed. Regarding restorative materials, preformed metal crowns (PMCs) used to restore multisurface lesions showed the highest success rates compared to other restorative materials (amalgam, composite resin, glass ionomer cement, and compomer), and in the long term (12-48 months) these were also less likely to fail. There is limited evidence supporting the use of PMCs to restore carious lesions with single cavities. Among nonrestorative options, silver diammine fluoride was significantly more effective in arresting caries than other treatments for treating active carious lesions of different depths. Considerable heterogeneity and bias risk were observed in the included studies. Although heterogeneity observed among the studies was substantial, the trends were similar. In conclusion, less invasive caries approaches involving selective or no caries removal seem advantageous in comparison to CCR for patients presenting with vital, symptomless, carious dentin lesions in primary teeth. There is evidence in favor of PMCs for restoring multisurface carious lesions in primary molars.
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Affiliation(s)
- Ruth M Santamaría
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany,
| | - Mohamed Hassan Abudrya
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Gülsün Gül
- Department of Comprehensive Care, Tufts University, Boston, Massachusetts, USA
| | - Mhd Said Mourad
- Department of Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Grace Felix Gomez
- Department of Community Dentistry, Case Western Reserve University, Cleveland, Ohio, USA
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Alawia R, Riad A, Kateeb E. Risk perception and readiness of dental students to treat patients amid COVID-19: Implication for dental education. Oral Dis 2020; 28 Suppl 1:975-976. [PMID: 32767714 PMCID: PMC7436224 DOI: 10.1111/odi.13593] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Ruwaa Alawia
- Oral Health Research and Promotion Unit, Faculty of Dentistry, Al-Quds University, Jerusalem, Palestine
| | - Abanoub Riad
- Faculty of Medicine, Czech National Centre for Evidence-Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Center of Excellence, Masaryk University GRADE Center), Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Elham Kateeb
- Oral Health Research and Promotion Unit, Faculty of Dentistry, Al-Quds University, Jerusalem, Palestine
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A 24-month randomized controlled trial on the success rates of restoring untreated and SDF-treated dentine caries lesions in primary teeth with the ART approach. J Dent 2020; 100:103435. [PMID: 32712307 DOI: 10.1016/j.jdent.2020.103435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/10/2020] [Accepted: 07/18/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the success rates of restoring untreated and SDF-treated dentine caries lesions in primary teeth with atraumatic restorative treatment (ART) approach. METHOD Cavitated dentine caries lesions in preschool children were randomly allocated to two groups to be applied with either 38% silver diamine fluoride (SDF) solution or tonic water (control) ten weeks before being restored with the ART approach. Status of the restorations were assessed every six months by a blinded independent examiner. Multilevel logistic regression and multilevel survival analyses were conducted to assess the restoration success rates. RESULTS A total of 194 children (SDF group, 101; control group, 93) were included, with 260 and 249 ART restorations placed in the SDF and the control groups, respectively. At 24-month follow-up, 88 (87 %) and 84 (90 %) children remained in the SDF and the control groups, respectively. There was no significant difference between the ART restoration success rates of the two study groups (p > 0.05). The success rate of ART restorations was associated with the class of restorations. Class I restorations had the highest success rate (∼50 %), followed by Class V (∼35 %), Class II (∼15 %) and Class III (<10 %). Besides, the mean time used to place an ART restoration in a SDF-treated caries lesion was shorter than that in untreated lesion (4.8 vs. 5.1 min, p = 0.006). CONCLUSION Prior SDF application does not significantly affect the success rate of ART restorations placed in primary teeth. Besides, it is faster to place ART restorations in caries lesions that have been previously treated with SDF. CLINICAL SIGNIFICANCE Prior application of silver diamine fluoride solution on cavitated dentine caries lesions in primary teeth can shorten the average time required to place an ART restoration while not jeopardizing the success rate of the restorations.
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Efficacy of GC Gold Label 9 and GC Miracle Mix ® Restorations using Atraumatic Restorative Treatment (ART) in Rural Settings: A Randomized Controlled Trial. J Clin Pediatr Dent 2020; 44:148-153. [PMID: 32644894 DOI: 10.17796/1053-4625-44.3.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: This study compared the longevity of high strength posterior glass ionomer and metal-reinforced glass ionomer using ART in rural settings within an 18-month observation period. Study Design: A nonblinded parallel design randomized controlled trial was conducted among children who attended dental outreach programs in a rural area of Southern India. Atraumatic Restorative Treatment (ART) was performed in 92 permanent posterior teeth with either high strength posterior glass ionomer or metal-reinforced glass ionomer restorations. The allocation ratio was 1:1. Restorations were evaluated at 1, 6, 12 and 18 months after placement. Results: The success rate of metal-reinforced glass ionomer restorations was 100%, 95.4%, 90.4% and 87.2% as compared to high strength posterior glass ionomer whose success rates were 100%, 93%, 85% and 61.8% at the four follow ups respectively. There was a statistically significant difference between the success rate of the two materials at the end of 18 months with the metal-reinforced glass ionomer restorations having a higher success rate (p=0.015). Conclusions : Although the clinical performance of both materials were largely similar, the metal-reinforced glass ionomer restorations had a higher success rate than the conventional GIC at the end of 18 months of follow-up.
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Assessment of paediatric dental guidelines and caries management alternatives in the post COVID-19 period. A critical review and clinical recommendations. Eur Arch Paediatr Dent 2020; 21:543-556. [PMID: 32557183 PMCID: PMC7298449 DOI: 10.1007/s40368-020-00547-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/07/2020] [Indexed: 01/24/2023]
Abstract
Purpose The first aim of this paper is to provide dental professionals caring for children and adolescents during and after the COVID-19 pandemic with a reference to international dental guidelines. The second aim is to suggest minimally invasive treatment alternatives for caries management, minimising the risk of viral cross-infection and offering a safer clinical environment. Methods An evidence-based pertinent literature search of different electronic databases was performed in addition to leading global dental authorities, royal colleges, and programmes. Results All guidelines released in response to COVID-19 centred around minimising Aerosol Generating Procedures (AGP) impacting the provision of regular dental treatment of paediatric patients. There was an emphasis on triaging and only treating emergency and urgent cases. Special attention was given to medically compromised children in the guidelines. Detailed guidelines for the dental environment and equipment were given. This paper also summarised the relevant evidence-based guidelines for the use of non-invasive and minimally invasive caries management techniques. Conclusion Specific recommendations for dental management of paediatric patients during and in the post-COVID-19 era are suggested. Minimisation of AGP procedures, and case-based selection of biological, non-invasive or minimally invasive methods are recommended.
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