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Janusz CB, Doan T, Gebremariam A, Rose A, Keels MA, Quinonez RB, Eckert G, Yanca E, Fontana M, Prosser LA. A Cost-Effectiveness Analysis of Population-Level Dental Caries Prevention Strategies in US Children. Acad Pediatr 2024; 24:765-775. [PMID: 38548263 PMCID: PMC11193632 DOI: 10.1016/j.acap.2024.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVE To improve oral health disparities and outcomes among US children impacted by dental caries, there is a need to understand the cost-effectiveness of a targeted, risk-based versus universal-based approach for caries prevention. METHODS Health and economic outcomes were simulated in a cohort of 50,000 US children aged 1-18 years, comparing current practice (CP) to risk-based-prevention (RBP) and prevention-for-all (PFA) strategies using health care sector and limited societal perspectives. Prevention included biannual oral health exams and fluoride varnish application, and one-time dental sealant placement. The primary outcome is the cost-effectiveness ratio (ICER), defined as the additional cost per quality-adjusted life year (QALY) gained when comparing each strategy to the next least costly one. RESULTS For RBP compared to CP, the ICER was US$83,000/QALY from the health care sector perspective; for PFA compared to RBP the ICER was US$154,000/QALY. Using a limited societal perspective that includes caregiver time spent attending dental or medical setting visits, RBP compared to CP yielded a ratio of $119,000/QALY and PFA compared to RBP was $235,000/QALY. Results were most sensitive to changes in the probability of pain from an episode of dental caries, costs for prevention and restoration, and the loss in health-related quality of life due to dental caries pain. Scenario analyses evaluating a reduced intensity of prevention services yielded lower ICERs. CONCLUSION Using a risk-based approach that identifies and targets children at increased risk for dental caries to guide the delivery of prevention services represents an economic value similar to other pediatric prevention programs.
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Affiliation(s)
- Cara B. Janusz
- Susan B. Meister Child Health and Evaluation Research (CHEAR) Center, Department of Pediatrics, University of Michigan, Ann Arbor MI
| | - Tran Doan
- Susan B. Meister Child Health and Evaluation Research (CHEAR) Center, Department of Pediatrics, University of Michigan, Ann Arbor MI
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor MI
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh PA (current)
| | - Acham Gebremariam
- Susan B. Meister Child Health and Evaluation Research (CHEAR) Center, Department of Pediatrics, University of Michigan, Ann Arbor MI
| | - Angela Rose
- Susan B. Meister Child Health and Evaluation Research (CHEAR) Center, Department of Pediatrics, University of Michigan, Ann Arbor MI
| | - Martha Ann Keels
- Department of Pediatrics, Duke University, Durham NC
- Division of Pediatric Dentistry and Public Health, University of North Carolina Adams School of Dentistry, Chapel Hill NC
| | - Rocio B. Quinonez
- Division of Pediatric Dentistry and Public Health, University of North Carolina Adams School of Dentistry, Chapel Hill NC
| | - George Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Bloomington IN
| | - Emily Yanca
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine and Richard M. Fairbanks School of Public Health, Bloomington IN
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences & Endodontics, School of Dentistry, University of Michigan, Ann Arbor MI
| | - Lisa A. Prosser
- Susan B. Meister Child Health and Evaluation Research (CHEAR) Center, Department of Pediatrics, University of Michigan, Ann Arbor MI
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor MI
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Diniz ACS, Silva TBD, Araujo MR, Bauer J, Firoozmand LM. Sealing moderate caries lesions with bioactive glass-ionomer: A split-mouth clinical trial. Dent Mater J 2024:2023-261. [PMID: 38945864 DOI: 10.4012/dmj.2023-261] [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: 07/02/2024]
Abstract
Laboratory evidence has shown that 45S5 bioglass can help in dental remineralization, so its incorporation into resin-modified glass ionomer cement (RMGIC) has been studied. This randomized clinical trial aimed to determine the efficacy of RMGIC enriched with 10% 45S5 bioglass (RMGIC/45S5) in preventing the progression of moderate caries lesions. Sixty-six permanent molars with moderate caries lesions, were randomly sealed with RMGIC or RMGIC/45S5. After 1, 3-6 months, patients' oral health, material behavior, and caries evolution were evaluated. Chi-square and Fisher's exact test was employed. After one month, the RMGIC showed higher total retention and better clinical performance compared to RMGIC/45S5, both showed a predominance of sealed teeth or without caries progression. After 6 months, no materials retention, quality and caries progression difference was observed for both materials. Short-term clinical follow-up reveals worse retention and quality of RMGIC/45S5, only after 6 months no clinical/microscopic differences are observed between the materials.
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Affiliation(s)
| | | | - Mayenne Rabelo Araujo
- Department of Dentistry I and Dental Post-Graduation Program, Federal University of Maranhão
| | - José Bauer
- Department of Dentistry I and Dental Post-Graduation Program, Federal University of Maranhão
| | - Leily Macedo Firoozmand
- Department of Dentistry I and Dental Post-Graduation Program, Federal University of Maranhão
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Choi JW, Han AR, Yang SY. Ion Release and Apatite Formation of Resin Based Pit and Fissure Sealants Containing 45S5 Bioactive Glass. Polymers (Basel) 2024; 16:1855. [PMID: 39000710 PMCID: PMC11243898 DOI: 10.3390/polym16131855] [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: 05/29/2024] [Revised: 06/20/2024] [Accepted: 06/26/2024] [Indexed: 07/17/2024] Open
Abstract
The purpose of this study was to evaluate a resin based pit and fissure sealant containing 45S5 bioactive glass (BAG) by examining its ion release, pH variation, and apatite-forming properties. To prepare the experimental materials, 45S5 BAG, used as a filler, was incorporated into the light curable resin matrix at concentrations of 0 (control), 12.5, 37.5, and 50.0 wt.%. Ion release, pH variation, and apatite formation (Raman spectrometer and scanning electron microscopy-energy-dispersive X-ray spectrometry measurements) were performed. While no ions were released from the control group, the experimental groups containing 45S5 BAG showed an increased release of Ca and P ions with increasing amounts of 45S5 BAG (p < 0.05). The pH of the experimental group remained high and was significantly different from the control group (p < 0.05). Unlike the control group, it was confirmed that the apatite peak was formed in the 50.0 wt.% BAG group for 90 days, and the apatite layer consisting of Ca and P was deposited on the surface. Thus, a resin based pit and fissure sealant containing 45S5 BAG is a promising material for preventing secondary caries by releasing ions and forming apatite.
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Affiliation(s)
- Ji-Won Choi
- Department of Dental Hygiene, Kyungdong University, Wonju-si 26495, Republic of Korea
| | - A Ruem Han
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul 03722, Republic of Korea
| | - Song-Yi Yang
- Department of Dental Hygiene, Konyang University, Daejeon 35365, Republic of Korea
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Fei X, Li Y, Zhang Q, Tian C, Li Y, Dong Q, Weir MD, Homayounfar N, Oates TW, Imazato S, Dai Q, Xu HHK, Ruan J. Novel pit and fissure sealant with nano-CaF 2 and antibacterial monomer: Fluoride recharge, microleakage, sealing ability and cytotoxicity. Dent Mater J 2024; 43:346-358. [PMID: 38583998 DOI: 10.4012/dmj.2023-166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Conventional resin-based sealants release minimal fluoride ions (F) and lack antibacterial activity. The objectives of this study were to: (1) develop a novel bioactive sealant containing calcium fluoride nanoparticles (nCaF2) and antibacterial dimethylaminohexadecyl methacrylate (DMAHDM), and (2) investigate mechanical performance, F recharge and re-release, microleakage, sealing ability and cytotoxicity. Helioseal F served as commercial control. The initial F release from sealant containing 20% nCaF2 was 25-fold that of Helioseal F. After ion exhaustion and recharge, the F re-release from bioactive sealant did not decrease with increasing number of recharge and re-release cycles. Elastic modulus of new bioactive sealant was 44% higher than Helioseal F. The new sealant had excellent sealing, minimal microleakage, and good cytocompatibility. Hence, the nanostructured sealant had substantial and sustained F release and antibacterial activity, good sealing ability and biocompatibility. The novel bioactive nCaF2 sealant is promising to provide long-term F ions for caries prevention.
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Affiliation(s)
- Xiuzhi Fei
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
- Center of Oral Public Health, College of Stomatology, Xi'an Jiaotong University
| | - Yuncong Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
- Department of Prosthodontics, College of Stomatology, Xi'an Jiaotong University
| | - Qian Zhang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
- Center of Oral Public Health, College of Stomatology, Xi'an Jiaotong University
| | - Chunli Tian
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
- Center of Oral Public Health, College of Stomatology, Xi'an Jiaotong University
| | - Yue Li
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
- Center of Oral Public Health, College of Stomatology, Xi'an Jiaotong University
| | - Qiannan Dong
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
- Center of Oral Public Health, College of Stomatology, Xi'an Jiaotong University
| | - Michael D Weir
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry
| | - Negar Homayounfar
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry
| | - Thomas W Oates
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry
| | - Satoshi Imazato
- Department of Dental Biomaterials, Osaka University Graduate School of Dentistry
| | - Quan Dai
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
| | - Hockin H K Xu
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry
- Center for Stem Cell Biology and Regenerative Medicine, University of Maryland School of Medicine
- Marlene and Stewart Greenebaum Cancer Center, University of Maryland School of Medicine
| | - Jianping Ruan
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University
- Center of Oral Public Health, College of Stomatology, Xi'an Jiaotong University
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Xiong Y, Zhang H, Zhou S, Lu M, Huang J, Huang Q, Huang B, Ding J. Simultaneous detection of dental caries and fissure sealant in intraoral photos by deep learning: a pilot study. BMC Oral Health 2024; 24:553. [PMID: 38735954 PMCID: PMC11089789 DOI: 10.1186/s12903-024-04254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 04/11/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Deep learning, as an artificial intelligence method has been proved to be powerful in analyzing images. The purpose of this study is to construct a deep learning-based model (ToothNet) for the simultaneous detection of dental caries and fissure sealants in intraoral photos. METHODS A total of 1020 intraoral photos were collected from 762 volunteers. Teeth, caries and sealants were annotated by two endodontists using the LabelMe tool. ToothNet was developed by modifying the YOLOX framework for simultaneous detection of caries and fissure sealants. The area under curve (AUC) in the receiver operating characteristic curve (ROC) and free-response ROC (FROC) curves were used to evaluate model performance in the following aspects: (i) classification accuracy of detecting dental caries and fissure sealants from a photograph (image-level); and (ii) localization accuracy of the locations of predicted dental caries and fissure sealants (tooth-level). The performance of ToothNet and dentist with 1year of experience (1-year dentist) were compared at tooth-level and image-level using Wilcoxon test and DeLong test. RESULTS At the image level, ToothNet achieved an AUC of 0.925 (95% CI, 0.880-0.958) for caries detection and 0.902 (95% CI, 0.853-0.940) for sealant detection. At the tooth level, with a confidence threshold of 0.5, the sensitivity, precision, and F1-score for caries detection were 0.807, 0.814, and 0.810, respectively. For fissure sealant detection, the values were 0.714, 0.750, and 0.731. Compared with ToothNet, the 1-year dentist had a lower F1 value (0.599, p < 0.0001) and AUC (0.749, p < 0.0001) in caries detection, and a lower F1 value (0.727, p = 0.023) and similar AUC (0.829, p = 0.154) in sealant detection. CONCLUSIONS The proposed deep learning model achieved multi-task simultaneous detection in intraoral photos and showed good performance in the detection of dental caries and fissure sealants. Compared with 1-year dentist, the model has advantages in caries detection and is equivalent in fissure sealants detection.
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Affiliation(s)
- Yanshan Xiong
- Department of Endodontics, Shenzhen Stomatology Hospital, Shenzhen, Guangdong, China
| | - Hongyuan Zhang
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, Guangdong, China
| | - Shiyong Zhou
- Department of Endodontics, Shenzhen Stomatology Hospital, Shenzhen, Guangdong, China
| | - Minhua Lu
- Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, Guangdong, China
| | - Jiahui Huang
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, Guangdong, China
| | - Qiangtai Huang
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, Guangdong, China
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, Shenzhen, Guangdong, China.
| | - Jiangfeng Ding
- Department of Endodontics, Shenzhen Stomatology Hospital, Shenzhen, Guangdong, China.
- Department of Pediatric Stomatology, Shenzhen Stomatology Hospital, Shenzhen, Guangdong, China.
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Lin M, Griffin SO, Li CH, Wei L, Espinoza L, Wang CY, Thornton-Evans G. Exploring Recent Decreases in First Molar Sealants among US Children. J Dent Res 2024; 103:509-515. [PMID: 38410889 PMCID: PMC11145301 DOI: 10.1177/00220345241231774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods (P < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.
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Affiliation(s)
- M. Lin
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - S. O. Griffin
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - C. H. Li
- CyberData Technologies, Inc., Herndon, VA, USA
| | - L. Wei
- DB Consulting Group, Inc., Atlanta, GA, USA
| | - L. Espinoza
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
| | - C. Y. Wang
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, CDC, Hyattsville, MD, USA
| | - G. Thornton-Evans
- Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA
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Campbell F, Rogers H, Goldsmith R, Rowles K, Raggio DP, Innes N. A scoping review of guidelines on caries management for children and young people to inform UK undergraduate core curriculum development. BMC Oral Health 2024; 24:494. [PMID: 38671432 PMCID: PMC11055302 DOI: 10.1186/s12903-024-04278-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Current evidence in cariology teaching is not consistently reflected in paediatric dentistry in the United Kingdom (UK). Many dental schools are not consistently teaching biological approaches to caries management, with outdated or complex methods being taught outwith the purview of general dental practitioners. This scoping review aimed to map current guidelines on the management of caries in children and young people. This is part of a work package to inform the consensus and development of a UK-wide caries management curriculum for paediatric dentistry. METHODS A search of electronic databases for peer reviewed literature was performed using Cochrane Library, MEDLINE via PubMed, TRIP Medical Database and Web of Science. Hand searching was undertaken for grey literature (citations of sources of evidence, websites of global organisations and Google Web Search™ (Google LLC, California, USA). Results from databases were screened independently, concurrently by two reviewers. Full texts were obtained, and reviewers met to discuss any disagreement for both database and hand searching. RESULTS This review identified 16 guidelines suitable for inclusion. After quality appraisal, eight were selected for synthesis and interpretation. Key themes included the shift towards selective caries removal and avoidance of complete caries removal unless in specific circumstances in anterior teeth. For "early lesions" in primary and permanent teeth with and without cavitation, several guidelines recommend biological management including site specific prevention and fissure sealants. CONCLUSIONS This review mapping current cariology guidelines for children and young people found gaps in the literature including classification of early carious lesions and management of early cavitated lesions. Areas identified for further exploration include integration of biological caries management into treatment planning, selective caries removal and whether pulpotomy is specialist-level treatment, requiring referral. These results will inform consensus recommendations in the UK, using Delphi methods.
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Affiliation(s)
| | - Helen Rogers
- Clinical Lecturer in Paediatric Dentistry, School of Dental Sciences, Newcastle University, Newcastle, UK
| | - Rachel Goldsmith
- Specialty Registrar in Paediatric Dentistry, Newcastle Dental Hospital, Newcastle, UK
| | - Kathryn Rowles
- Clinical Lecturer in Paediatric Dentistry, Cardiff University, Cardiff, UK
| | - Daniela Prócida Raggio
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Nicola Innes
- Paediatric Dentistry, Honorary Consultant and Head of Cardiff Dental School, Cardiff University, Cardiff, UK
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Rahul S, Saikiran KV, Elicherla NR, Anchala K, Singaraju A, Nuvvula S. Evaluation of child's behavior during the pit and fissure sealant administration using the rubber dam and MiniDam: A randomized clinical trial. J Indian Soc Pedod Prev Dent 2024; 42:119-125. [PMID: 38957909 DOI: 10.4103/jisppd.jisppd_127_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Accepted: 05/24/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive treatment for addressing teeth with deep pits and fissures in children. The purpose of the present study was to evaluate the behavior of the child when administering the pit and fissure sealant using the rubber dam and MiniDam. METHODOLOGY Fifty-two children in the age range of 9-12 years were randomly allocated into two groups: Group I, rubber dam and Group II, MiniDam. The children were randomly assigned into two groups with 26 members in Group 1 (rubber dam isolation) and 26 members in Group 2 (MiniDam isolation). Children's anxiety was assessed using the modified Venham scale and heart rate. The children's pain intensity was assessed using Memojis Pain Scale. The data collected were tabulated and statistically analyzed using SPSS software. The level of significance was established at 0.05. RESULTS Intergroup comparison of heart rates showed a statistically significant difference for both the groups at various intervals (P value 0.05), that is, before placing the dam, with the dam, and during treatment. Pain and anxiety scores showed a statistically significant difference in both the groups before and after the procedure (P < 0.05). CONCLUSIONS The use of MiniDam can offer a better option for the pit/fissure sealant procedure due to its unique qualities, including simplicity of placement, improved behavior management, and less chair time in children.
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Affiliation(s)
- Shaik Rahul
- Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Tassery H, Miletic I, Turkun LS, Sauro S, Gurgan S, Banerjee A, Basso M, Khelafia S, Terrer E, Pilliol V, Slimani A. Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions. Br Dent J 2024; 236:603-610. [PMID: 38671111 DOI: 10.1038/s41415-024-7292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 04/28/2024]
Abstract
Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.
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Affiliation(s)
- Hervé Tassery
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France; LBN, Université de Montpellier, UR-UM104, Montpellier, France.
| | - Ivana Miletic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva ul. 5, 10000 Zagreb, Croatia
| | - Lezize Sebnem Turkun
- Department of Restorative Dentistry, Ege University School of Dentistry, Izmir 35040, Turkey
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, CEU Cardenal Herrera University, CEU Universities, 46115 Valencia, Spain; Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Avijit Banerjee
- Conservative and Minimally Invasive Dentistry, Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, SE1 9RT, UK
| | - Matteo Basso
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Saber Khelafia
- Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Elodie Terrer
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Virginie Pilliol
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Amel Slimani
- LBN, Université de Montpellier, UR-UM104, Montpellier, France; Faculté d'Odontologie, Université de Montpellier, 34193 Montpellier, France
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Wang Y, Wen J, Pan T, Cao Y, Lin H, Zhou Y. Comparing the effectiveness of caries arrest by micro-operative treatment to operative treatment: A 2-year randomized controlled clinical trial. Clin Oral Investig 2024; 28:222. [PMID: 38499947 DOI: 10.1007/s00784-024-05567-9] [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: 12/22/2023] [Accepted: 02/17/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To compare the effectiveness of caries arrest by micro-operative treatment (sealing) to operative treatment (flowable resin composite restoration) through a 2-year randomized controlled clinical trial. MATERIALS AND METHODS A prospective randomized controlled trial was conducted among 7-9-year-old children. At baseline, 630 subjects were screened and 92 children who had at least one carious lesion classified as ICDAS 3 on the pit and fissure of first permanent molar were included. Then they were randomly assigned to the sealant group (73 lesions) and the flowable resin composite group (76 lesions) to receive the corresponding intervention. Lesions status in each group was evaluated every 6 months up to 24 months. Clinical progression of dental caries and materials retention were the outcomes used for group comparisons at p-value < 0.05. RESULTS After 24 months, three lesions (4.1%) in the sealant group clinically progressed to dentin caries. No lesion in the flowable composite group was observed a progression. The results of Life-table survival analysis show that the cumulative caries arrest rate had no statistically significant difference between the two groups (p = 0.075). However, the cumulative retention rate was 57.5% in the sealant group and 92.1% in the flowable composite group, with significant differences (p < 0.001). The multilevel mixed model showed the sealant had higher risk of retention failure than the flowable composite (OR = 8.66, p < 0.001), while tooth position did not influence material retention (p = 0.083). In addition, the results of Fisher Exact test show that dentin lesions had more retention failure than enamel lesions in the sealant group (p = 0.026). CONCLUSION Although sealing microcavitated carious lesions of the first permanent molar achieved lower retention rate than resin composite restoration, both sealing and restoration effectively arrested caries progression for two years. CLINICAL RELEVANCE To preserving dental structure and delaying or eliminating the need for operative procedures, microcavitated carious lesion can be arrested by sealing. TRIAL REGISTRATION Registered at http://www.chictr.org.cn ; Feb 15th, 2020; No. ChiCTR2000029862.
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Affiliation(s)
- Yinuo Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Jie Wen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Ting Pan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yina Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Huancai Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China.
| | - Yan Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China.
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Kumar S, Chhabra V, Mehra M, K S, Kumar B H, Shenoy S, Swamy RS, Murti K, Pai KSR, Kumar N. The fluorosis conundrum: bridging the gap between science and public health. Toxicol Mech Methods 2024; 34:214-235. [PMID: 37921264 DOI: 10.1080/15376516.2023.2268722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/04/2023] [Indexed: 11/04/2023]
Abstract
Fluorosis, a chronic condition brought on by excessive fluoride ingestion which, has drawn much scientific attention and public health concern. It is a complex and multifaceted issue that affects millions of people worldwide. Despite decades of scientific research elucidating the causes, mechanisms, and prevention strategies for fluorosis, there remains a significant gap between scientific understanding and public health implementation. While the scientific community has made significant strides in understanding the etiology and prevention of fluorosis, effectively translating this knowledge into public health policies and practices remains challenging. This review explores the gap between scientific research on fluorosis and its practical implementation in public health initiatives. It suggests developing evidence-based guidelines for fluoride exposure and recommends comprehensive educational campaigns targeting the public and healthcare providers. Furthermore, it emphasizes the need for further research to fill the existing knowledge gaps and promote evidence-based decision-making. By fostering collaboration, communication, and evidence-based practices, policymakers, healthcare professionals, and the public can work together to implement preventive measures and mitigate the burden of fluorosis on affected communities. This review highlighted several vital strategies to bridge the gap between science and public health in the context of fluorosis. It emphasizes the importance of translating scientific evidence into actionable guidelines, raising public awareness about fluoride consumption, and promoting preventive measures at individual and community levels.
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Affiliation(s)
- Sachindra Kumar
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Vishal Chhabra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Manmeet Mehra
- Department of Pharmacology, Guru Nanak Dev University, Amritsar, India
| | - Saranya K
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - Harish Kumar B
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Smita Shenoy
- Department of Pharmacology, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Ravindra Shantakumar Swamy
- Division of Anatomy, Department of Basic Medical Sciences (DBMS), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Krishna Murti
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research, Hajipur, India
| | - K Sreedhara Ranganath Pai
- Department of Pharmacology, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Nitesh Kumar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research, Hajipur, India
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Souza TF, Leonel Martins M, Jural LA, Maciel IP, Magno MB, da Silva Coqueiro R, Pithon MM, Leal SC, Fonseca-Gonçalves A, Maia LC. Brazilian dentist's knowledge of minimum intervention dentistry for caries management: application of a developed knowledge scale (MIDDeC-KS) and evaluation of its psychometric properties. Eur Arch Paediatr Dent 2024; 25:27-38. [PMID: 37770814 DOI: 10.1007/s40368-023-00844-9] [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: 04/02/2023] [Accepted: 09/02/2023] [Indexed: 09/30/2023]
Abstract
AIM To assess the knowledge of Brazilian dentists about Minimum Intervention (MI) using a Minimum Intervention Dentistry to Dental Caries-Knowledge Scale (MIDDeC-KS) and evaluate its psychometric properties. MATERIALS AND METHODS An online scale was developed to evaluate dentists' knowledge about MI. The higher the score, the greater the knowledge and vice versa. A preliminary study was carried out with 143 dentists to validate the MIDDeC-KS. For psychometric properties analysis, convergent and discriminant validity, test-retest reliability, and internal consistency of the instrument were assessed. After validation, MIDDeC-KS was applied to a representative sample of Brazilian dentists. T test for independent samples, Chi-square, and/or ANOVA one-way tests were applied. RESULTS The MIDDeC-KS convergent (Spearman's = 0.48) and discriminant (P = 0.001) validity and reliability (ICC = 0.85, α = 0.72 and ω = 0.74) were proved. The participants (n = 637) obtained an overall mean score of 7.4 ± 2.5. The sample was mainly composed of females (P < 0.01), who graduated over 10 years prior (P = 0.02), from public colleges (P < 0.01), and most were pediatric dentists (38.2%). The highest and lowest scores were reached by pediatric dentists (9.2 ± 1.6) and bucomaxillofacial professionals (3.1 ± 2.1), respectively. Brazilian dentists demonstrated more knowledge about diet, biofilm, and topical fluoride control (84.3%), while the Hall technique (31.9%), resin infiltrant (47.6%), and chemical mechanical caries removal (48.4%) were the least known MI techniques. CONCLUSION Brazilian dentists demonstrated more knowledge about preventive measures and less about more recent protocols, such as the Hall technique, resin infiltrant, and chemical mechanical caries tissue removal. Sufficient psychometric evidence of the MIDDeC-KS was found. CLINICAL RELEVANCE Identify dentist's knowledge about MI.
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Affiliation(s)
- T F Souza
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - M Leonel Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - L A Jural
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - I P Maciel
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - M B Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - R da Silva Coqueiro
- Department of Health I, Universidade Estadual Do Sudoeste da Bahia (UESB), Jequié, Bahia, Brazil
| | - M M Pithon
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil
| | - S C Leal
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, DF, Brazil
| | - A Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal Do Rio de Janeiro (UFRJ), 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 (UFRJ), Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ, CEP 21941-971, Brazil.
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13
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Sartori CHM, Mazzetti T, Júnior FAV, Daneris ÂP, Cenci MS, van de Sande FH, Montagner AF. Methodological quality of evidence-based clinical practice guidelines in cariology. Clin Oral Investig 2023; 28:66. [PMID: 38159154 DOI: 10.1007/s00784-023-05429-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The present study aimed to appraise the methodological quality of evidence-based Clinical Practice Guidelines (CPGs) in the cariology field. MATERIALS AND METHODS A systematic search on electronic databases (MEDLINE/Pubmed, EMBASE, DARE and Epistemonikos), websites, and guideline organizations were undertaken. Evidence-based CPGs including at least one recommendation for clinical prevention and/or management of dental caries, developed for any clinical setting, were included. The quality of each guideline was evaluated using the AGREE II tool. Descriptive analysis was performed and the average overall score for each domain was calculated. RESULTS Thirty-two guidelines were included. Most of the CPGs achieved higher scores for the domains of clarity of presentation (66.7%, 95% IC 37.3-52.2) and scope and purpose (59.6%, 95% IC 53.7-65.5) domains; and lower scores for editorial independence (46.1%, 95% IC 37.8-55.7) and applicability domain (44.7%, 95% IC 37-55.3). The reviewers assessed 12 CPGs (37.5%) as recommended for use, 15 (46.9%) recommended with modifications, and 5 (15.6%) as not recommended. CONCLUSION The overall methodological quality of evidence-based CPGs in the cariology field is moderate, and there is a need for improvements in reporting related to most domains. The poorest reporting was found in the description of the domains' applicability of its recommendations and editorial independence. CLINICAL RELEVANCE Clinical Practice Guidelines provide guidance to patients, healthcare professionals, and stakeholders. The quality of these documents is essential for establishing trust in their recommendations.
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Affiliation(s)
| | - Thais Mazzetti
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | | | | | - Maximiliano Sérgio Cenci
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Françoise Hélène van de Sande
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
| | - Anelise Fernandes Montagner
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil.
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Bangash M, Humayun M, Anser M, Chaudhary FA, Arjumand B, Alharkan HM. Microleakage Assessment of Different Preparation Techniques and Pit and Fissure Sealants in Permanent Molars. Cureus 2023; 15:e50382. [PMID: 38213342 PMCID: PMC10782185 DOI: 10.7759/cureus.50382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND This study aimed to evaluate the predisposition of microleakage in permanent molar teeth following different preparation techniques for pits and fissure sealants. METHODS In this cross-sectional analytical study, a dye penetration method was employed to evaluate microleakage in dental restorations. A total of 104 extracted molars were randomly assigned into two groups and further subdivided into two subgroups based on a class of sealant (filled/unfilled resin) containing 26 teeth each. Teeth in one group were prepared by a conventional method using pumice and acid etching with 37% phosphoric acid, and teeth in the other group were prepared with a 1/4-round carbide bur in a low-speed handpiece and then acid etched. In each group, 26 teeth were sealed with a filled sealant, and 26 teeth with an unfilled sealant. The chi-square test was used for the comparison of microleakage between the groups. RESULTS Unfilled sealants prepared with bur preparation showed the lowest degree of microleakage. The greater number of teeth (17) showed no microleakage in the group of teeth prepared using the bur preparation technique. Furthermore, in dye penetration analysis, the subgroup of teeth that were filled with unfilled sealants showed a greater number of teeth (57.6%), with zero penetration, and the dye penetration scores were statistically significant among the groups with different preparation techniques (p=0.002). CONCLUSION Teeth whose pits and fissures were prepared through 1/4 carbide bur and filled with unfilled pits and fissure sealants show less microleakage than those prepared with the conventional method and filled with filled sealants. Therefore, the choice of surface preparation technique for pit and fissure sealants can influence the effectiveness of the sealant in preventing microleakage.
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Affiliation(s)
- Madeeha Bangash
- Department of Paediatric Dentistry, Rehman College of Dentistry, Peshawar, PAK
| | - Mashal Humayun
- Department of Paediatric Dentistry, Rehman College of Dentistry, Peshawar, PAK
| | - Miraat Anser
- School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, PAK
| | | | - Bilal Arjumand
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, SAU
| | - Hamad Mohammad Alharkan
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Buraydah, SAU
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Tran NC, Wells CR, Atchison KA, Bhoopathi V. A national sample of developmentally disabled adolescents with obesity and their utilization of preventive dental care services. FRONTIERS IN ORAL HEALTH 2023; 4:1285416. [PMID: 38024150 PMCID: PMC10665891 DOI: 10.3389/froh.2023.1285416] [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: 08/29/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Background Previous literature indicates that adolescents with developmental disabilities and obesity may have more oral health complications than healthy adolescents. However, dental care utilization among adolescents with developmental disabilities (DDs) and obesity is unclear. We investigated the differences in the utilization of preventive dental services between this high-risk group of adolescents and those with no DDs or obesity. Methods Parent-reported data of adolescents 10-17 years (n = 68,942) from the 2016 to 2019 National Survey of Children's Health was used. In addition to descriptive and bivariate statistics, we ran three multiple logistic regression models guided by Andersen's Behavioral Model of Health Services Use, predicting the use of dental cleanings, fluoride treatments, and dental sealants. Results Among adolescents with DDs and obesity, dental cleanings, fluoride treatments, and dental sealant utilization prevalence were 76%, 48%, and 21%, respectively. In comparison, adolescents with no DDs or obesity had a prevalence of 83%, 50%, and 19%, respectively. Multiple logistic regression analysis showed that adolescents with DDs and obesity did not significantly differ in their receipt of dental cleanings (p = .07), fluoride treatments (p = .55), and dental sealants (p = .23) compared to those with neither DDs nor obesity. Adolescents with DDs but no obesity were 22% and 30% more likely to receive fluoride treatments (p < .0001) and dental sealants (p < .0001), respectively. Conclusions Fewer than half of adolescents with DDs and obesity utilized fluoride treatments, and less than one quarter utilized dental sealants but used all three preventive services at the same rate as those with no DDs or obesity. Implications This study identified no differences in preventive dental care services utilization in adolescents with developmental disabilities (DDs) and obesity compared to those without DDs and obesity. However, the utilization of preventive dental services in this population is influenced by the federal poverty level and family background.
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Affiliation(s)
- Nini C. Tran
- Section of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Christine R. Wells
- Statistical Methods and Data Analytics, Office of Advanced Research Computing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Kathryn A. Atchison
- Section of Public & Population Health, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Vinodh Bhoopathi
- Section of Public & Population Health, School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
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16
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Yaşa B, Erçin Ö, Hatırlı H. Evaluation of the marginal integrity of various pit and fissure sealants. J Oral Sci 2023; 65:209-213. [PMID: 37518766 DOI: 10.2334/josnusd.23-0126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE To evaluate the marginal integrity of various pit and fissure sealants subjected to different application methods. METHODS A total of 253 non-carious human third molars extracted and randomly divided into two groups according to the preparation method employed: invasive or non-invasive. Eight fissure sealant materials were tested: nano-filled flowable composite (Filtek Ultimate Flow), nanohybrid flowable composite (GrandioSo Flow), micro-hybrid flowable composite (Majesty Flow), resin-based unfilled fissure sealant (ClinPro Sealant), resin-based filled fissure sealant (Fissurit FX), resin-based highly filled fissure sealant (GrandioSeal), giomer-based fissure sealant (BeautiSealant), and glass ionomer-based fissure sealant (Fuji Triage). Samples were subjected to two-year cyclic thermo-mechanical and brushing simulations. Two observers quantitatively evaluated the restoration margins and classified them as either "permanent restoration edge", or if a gap larger than 250 μm was evident, "gapping at the restoration edge". The extent of the gap was recorded as a percentage relative to the total length of the restoration edge. RESULTS The baseline marginal adaptation had no significant effect on the marginal adaptation (P > 0.05). However, the preparation method and type of fissure sealant material had a significant impact on the marginal adaptation (P < 0.05). CONCLUSION On the basis of quantitative analysis, the highest marginal integrity was observed for flowable composites, whereas the lowest was observed for glass ionomer-based fissure sealant.
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Affiliation(s)
- Bilal Yaşa
- Deparment of Restorative Dentistry, Faculty of Dentistry, Istanbul Kent University
| | - Özlem Erçin
- Deparment of Restorative Dentistry, Faculty of Dentistry, Istanbul Kent University
| | - Hüseyin Hatırlı
- Deparment of Restorative Dentistry, Faculty of Dentistry, Gaziosmanpasa University
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McKernan S, Momany E, Sukalski J, Jones M, Damiano P, Kuthy R. Variation in General Dentists' Patterns of Sealant Use in Children with Elevated Caries Risk. JDR Clin Trans Res 2023; 8:367-373. [PMID: 35708460 PMCID: PMC10504877 DOI: 10.1177/23800844221102836] [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] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Strong evidence supports use of dental sealants to prevent tooth decay, and professional guidelines recommend use in children with elevated caries risk. However, not all children indicated for sealants receive this preventive intervention, even when they use routine dental care. OBJECTIVE The aim of this study was to explore the extent to which dentists' use of sealants varied in pediatric patients with elevated caries risk. METHODS Claims and enrollment data from a private dental program were used to identify a cohort of 6- to 17-y-olds with elevated caries risk (N = 27,677) and general dentists (N = 818) who provided services to the children. Children were identified as having elevated caries risk based on history of restorative treatment over a 5-y period (2010-2014). The 2 outcomes of interest were whether a dentist provided any sealants to children with elevated risk and, if so, the extent to which these were used during a 2-y observation period (2013-2014). A 2-stage hurdle model was used for multivariable analysis to identify dentist characteristics associated with sealant use. RESULTS Over the observation period, 13.3% (n = 109) of dentists did not provide any sealants to their elevated risk patients from the study cohort. Logistic regression found that female dentists were significantly more likely to have used sealants (odds ratio = 2.27); dentist age and practice in an isolated small rural town were negatively associated with any sealant use. However, among dentists who did place sealants (n = 709), female dentists, older dentists, dentists in solo practice, and those working full-time were significantly more likely to provide sealants to a child. Overall, substantial variation in practitioners' use of sealants was observed. CONCLUSION This is the first study to explore provider-level variation in sealant use, representing a critical step in future efforts to increase routine use of sealants by dentists and eliminate oral health disparities. KNOWLEDGE TRANSFER STATEMENT Findings from this study can be used to design targeted policy and behavioral interventions to increase sealant use by general dentists. This study provides foundational evidence for future research that explores motivation and barriers to routine use of preventive dental interventions by clinicians.
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Affiliation(s)
- S.C. McKernan
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, IA, USA
| | - E.T. Momany
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, IA, USA
| | - J.M.C. Sukalski
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
| | - M.P. Jones
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - P.C. Damiano
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, IA, USA
| | - R.A. Kuthy
- Department of Preventive and Community Dentistry, University of Iowa College of Dentistry and Dental Clinics, Iowa City, IA, USA
- Health Policy Research Program, University of Iowa Public Policy Center, Iowa City, IA, USA
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Piszko A, Piszko PJ, Lubojański A, Grzebieluch W, Szymonowicz M, Dobrzyński M. Brief Narrative Review on Commercial Dental Sealants-Comparison with Respect to Their Composition and Potential Modifications. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6453. [PMID: 37834590 PMCID: PMC10573513 DOI: 10.3390/ma16196453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
The scope of this paper is to compare different dental sealants and flow materials indicated for sealing pits and fissures considering their chemical formula. The narrative review aims to address the following questions: What is the essence of different dental sealants' activity, how does their chemical formula affect their mechanisms of caries prevention, and what makes a dental sealant efficient mean of caries prevention? Another vital issue is whether the sealants that contain fluoride, or any other additions, have potentially increased antimicrobial properties. An electronic search of the PubMed, Cochrane, Web of Science, and Scopus databases was performed. The following keywords were used: (dental sealants) AND (chemical composition). Additionally, information about composition and indications for clinical use provided by manufacturers were utilized. All of the considered materials are indicated for use both in permanent and primary dentition for sealing fissures, pits, and foramina caeca. The selection of suitable material should be made individually and adjusted to conditions of the sealing procedure and patient's needs. Cariostatic mechanisms increasing sealants' effectiveness such as fluoride release are desired in modern dentistry appreciating preventive approach. The review aims are to find crucial elements of sealants' composition which affect their cariostatic mechanisms.
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Affiliation(s)
- Aleksandra Piszko
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wrocław, Poland; (A.L.); (M.D.)
| | - Paweł J. Piszko
- Department of Polymer Engineering and Technology, Faculty of Chemistry, Wrocław University of Science and Technology (WUST), wyb. Wyspiańskiego 27, 50-370 Wrocław, Poland
| | - Adam Lubojański
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wrocław, Poland; (A.L.); (M.D.)
| | - Wojciech Grzebieluch
- Laboratory for Digital Dentistry, Department of Conservative Dentistry with Endodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland
| | - Maria Szymonowicz
- Pre-Clinical Research Centre, Wroclaw Medical University, wyb. Ludwika Pasteura 1, 50-367 Wrocław, Poland;
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wrocław, Poland; (A.L.); (M.D.)
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Prabakar J, Jeevanandan G, Kengadaran S. In Vitro Evaluation of Viscosity, Depth of Penetration, Microleakage, and Shear Bond Strength of Conventional and Hydrophilic Sealants. Int J Clin Pediatr Dent 2023; 16:745-750. [PMID: 38162245 PMCID: PMC10753099 DOI: 10.5005/jp-journals-10005-2684] [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] [Indexed: 01/03/2024] Open
Abstract
Background Sealants are effective in preventing and arresting pit and fissure caries. Newer brands of sealants continue to be developed despite the lack of scientifically based information addressing the caries-preventive properties of these materials. Hence, laboratory in vitro tests play a vital role in providing the necessary information regarding the efficacy of new products in a short period of time. Objectives To compare and evaluate the viscosity, resin tag length, microleakage, and shear bond strength between conventional and hydrophilic sealants. Materials and methods A total of 40 extracted third molars were selected. Only 20 were evaluated for microleakage and resin tag length and another 20 for shear bond strength evaluation between group I-ClinPro and group II-UltraSeal XT hydro. After sealant placement, specimens were immersed in 0.1% rhodamine dye, followed by thermocycling. Microleakage testing was done using a confocal laser scanning microscope and resin tag length evaluation using a scanning electron microscope (SEM) and shear bond strength using an Universal Instron machine. Viscosity was assessed using an Anton Paar viscometer. Results were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) software version 20. Results Viscosity and mean microleakage scores for group I (0.92 MPa and 1.50) were found to be higher than for group II (0.72 MPa and 0.60). Mean resin tag length and mean shear bond strength for group I (7.46 ± 0.95 μm and 13.71 ± 0.94 MPa) were found to be less compared to group II (10.03 ± 1.00 μm and 20.39 ± 0.98 MPa). The results were found to be statistically significant (p < 0.05). Conclusion Group II was found to be less viscous, which resulted in the formation of resin tags of sufficient length and showed less microleakage and higher shear bond strength than group I. How to cite this article Prabakar J, Jeevanandan G, Kengadaran S. In Vitro Evaluation of Viscosity, Depth of Penetration, Microleakage, and Shear Bond Strength of Conventional and Hydrophilic Sealants. Int J Clin Pediatr Dent 2023;16(5):745-750.
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Affiliation(s)
- Jayashri Prabakar
- Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pedodontics and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, Tamil Nadu, India
| | - Shivashankar Kengadaran
- Department of Public Health Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University (Deemed to be University), Puducherry, India
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He S, Choong EKM, Duangthip D, Chu CH, Lo ECM. Clinical interventions with various agents to prevent early childhood caries: A systematic review with network meta-analysis. Int J Paediatr Dent 2023; 33:507-520. [PMID: 36718540 DOI: 10.1111/ipd.13055] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Dental caries is one of the most prevalent chronic diseases among preschool children globally. Different preventive agents and combinations have been studied. However, the rank of the effectiveness of clinical interventions is equivocal. AIM To summarize and rank the effectiveness of clinical interventions using different agents for primary prevention of early childhood caries (ECC). DESIGN Two reviewers independently searched PubMed, Embase, and Cochrane Library to identify randomized controlled trials with at least 12-month follow-up. The network meta-analysis (NMA) on different agents was based on a random-effects model and frequentist approach. Standardized mean differences (SMD) with 95% CI of the caries increment were calculated in terms of either dmft or dmfs and used in the NMA. Caries incidences at the child level were compared using odds ratios (ORs) with 95% CI. The effectiveness of the agents was ranked using the surface under the cumulative ranking curve (SUCRA). RESULTS After screening 3807 publications and selection, the NMA finally included 33 trials. These trials used either a single or combination of agents such as fluorides, chlorhexidine, casein phosphopeptide-amorphous calcium phosphate, probiotics, xylitol, and triclosan. Compared with control, fluoride foam (FF; SMD -0.69, 95% CI: -1.06, -0.32) and fluoride salt (F salt; SMD -0.66, 95% CI: -1.20, -0.13) were effective in preventing caries increment. Probiotic milk plus low fluoride toothpaste (PMLFTP; OR 0.34, 95% CI: 0.15, 0.77), FF (OR 0.48, 95% CI: 0.37, 0.63), fluoride varnish (FV; OR 0.63, 95% CI: 0.48, 0.81), and fluoride varnish plus high fluoride toothpaste (FVHFTP; OR 0.73, 95% CI: 0.57, 0.93) were effectively preventing caries incidence. According to the SUCRA, FF ranked first in preventing caries increment, whereas PMLFTP ranked first in preventing caries incidence. CONCLUSION Fluoride foam, F salt, PMLFTP, FV, and FVHFTP all effectively reduce caries increment or caries incidence in preschool children, but the evidence indicates low degree of certainty. Considering the relatively small number of studies, confidence in the findings, and limitations in the study, clinical practitioners and readers should exercise caution when interpreting the NMA results.
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Affiliation(s)
- Shuyang He
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Elaine Kar Man Choong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
- Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
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Yassin SM, Mohamad D, Togoo RA, Sanusi SY, Johari Y. Do nanofillers provide better physicomechanical properties to resin-based pit and fissure sealants? A systematic review. J Mech Behav Biomed Mater 2023; 145:106037. [PMID: 37499522 DOI: 10.1016/j.jmbbm.2023.106037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023]
Abstract
The purpose of this study was to systematically review the impact of nanofillers on the physicomechanical properties of resin-based pit and fissure sealants (RBS). This review included in vitro studies with full-length English-language articles reporting on the physicomechanical properties of nanofilled RBS until February 2023. PubMed, Web of Sciences, Scopus, and LILACS databases were accessed for literature searches. The review was formulated based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and used the Consolidated Standards of Reporting Trials (CONSORT) guidelines and risk of bias Cochrane tool for quality assessment. The search resulted in 539 papers, of which 22 were eligible to be included in the review. Inorganic, polymeric, core-shell, and composite nanomaterials were used to reinforce the studied RBS. The inherent nature of the nanomaterial used, its morphology, concentration, and volume used were the primary parameters that determined the nanomaterial's success as a filler in RBS. These parameters also influenced their interaction with the resin matrix, which influenced the final physicomechanical properties of RBS. The use of nanofillers that were non-agglomerated and well dispersed in the resin matrix enhanced the physicomechanical properties of RBS.
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Affiliation(s)
- Syed M Yassin
- Biomaterials and Craniofacial Aesthetics Research Cluster, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia; Department of Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, 62529, Kingdom of Saudi Arabia.
| | - Dasmawati Mohamad
- Biomaterials and Craniofacial Aesthetics Research Cluster, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Rafi Ahmad Togoo
- Department of Pediatric Dentistry and Orthodontic Sciences, College of Dentistry, King Khalid University, Abha, 62529, Kingdom of Saudi Arabia.
| | - Sarliza Yasmin Sanusi
- Biomaterials and Craniofacial Aesthetics Research Cluster, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Yanti Johari
- Biomaterials and Craniofacial Aesthetics Research Cluster, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
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Bhoopathi V, Wells C, Atchison KA. Dental care utilization among developmentally disabled adolescents experiencing difficulty with decayed teeth: A population-level study. SPECIAL CARE IN DENTISTRY 2023; 43:619-627. [PMID: 36575154 DOI: 10.1111/scd.12817] [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: 09/01/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022]
Abstract
AIMS To determine if adolescents with developmental disabilities (DDs) who experienced difficulty with dental caries differed by dental visits in the past 12 months and receipt of preventive services (fluoride treatment and dental sealants) during those visits compared to adolescents with no DDs or difficulty with dental caries. METHODS AND RESULTS A cross-sectional study was conducted using data of 91 196 adolescents aged 10-17 years from the 2016-2020 National Survey of Children's Health. Descriptive and bivariate statistics and multivariable regression models were conducted. We derived the odds ratio for visiting a dental office (OR: 0.76, 95% CI: 0.57-1.03, p = .07), receiving fluoride treatments (OR: 1.20, 95% CI: 1.01-1.43, p = .04), and dental sealants (OR: 1.44, 95% CI: 1.19-1.75, p < .001) for DD adolescents who experienced difficulty with dental caries compared to adolescents with no DDs or difficulty with dental caries. CONCLUSIONS DD adolescents who experienced difficulty with dental caries were more likely to receive fluoride treatments and sealants during dental visits but were equally likely to have a dental visit in the past 12 months than adolescents with no DDs or difficulty with dental caries.
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Affiliation(s)
- Vinodh Bhoopathi
- Section of Public and Population Health, University of California at Los Angeles School of Dentistry, Los Angeles, California, USA
| | - Christine Wells
- Statistical Methods and Data Analytics, University of California at Los Angeles Office of Advanced Research Computing, Los Angeles, California, USA
| | - Kathryn Ann Atchison
- Section of Public and Population Health, University of California at Los Angeles School of Dentistry, Los Angeles, California, USA
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23
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Shtereva L, Kondeva V. Twelve-month clinical evaluation of retention of resin-based sealant on first permanent molars. Folia Med (Plovdiv) 2023; 65:651-658. [PMID: 37655386 DOI: 10.3897/folmed.65.e90408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 11/07/2022] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION The majority of researchers agree that sealants need to be monitored and kept in good condition because even a small amount of sealant loss raises the possibility of developing caries lesions. The first year after application is when sealant loss is reported to be at its highest. This motivated us to monitor silanized patients who received resin-based sealant for a full year.
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Lin GSS, Chin YJ, Chong RS, Baharin F, Syed Saadun Tarek Wafa SWW, Dziaruddin N. Expert consensus on relevant topics for undergraduate paediatric dental curriculum using the fuzzy Delphi method: a new direction for Malaysian dental education. BMC Oral Health 2023; 23:452. [PMID: 37407955 DOI: 10.1186/s12903-023-03130-8] [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: 03/06/2023] [Accepted: 06/13/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Paediatric dentistry is a branch of dental specialty that focuses on dental care for children from infancy through adolescence. However, there is no standardised national undergraduate paediatric dental curriculum in Malaysia. The present study aimed to identify relevant topics for undergraduate paediatric dental curricula and to determine the appropriate cognitive and psychomotor levels for each topic based on the consensus among paediatric dental experts. METHODS Potential relevant undergraduate paediatric dentistry topics were initially drafted and revised according to the revised national competency statement. The final draft included 65 topics clustered under 18 domains. A fuzzy Delphi method was used and experts who fulfilled the inclusion criteria were invited to anonymously ranked the importance of relevant topics using a five-point Likert scale and proposed suitable cognitive and psychomotor levels for each topic. Fuzzy evaluation was then performed, and experts were considered to have reached a consensus if the following three conditions were achieved: (a). the difference between the average and expert rating data was ≤ 0.2; (b). the average expert consensus was ˃70%; and (c). the average fuzzy number was ≥ 0.5. Subsequently, the mean ratings were used to determine the cognitive and psychomotor levels. RESULTS 20 experts participated in the survey. 64 out of 65 paediatric dentistry topics were deemed acceptable. The average fuzzy number ranged from 0.36 to 0.85, while the average Likert score ranged from 3.05 to 5.00. The topic "Dental amalgam" was rejected based on expert consensus since the average fuzzy number was 0.36. The most significant topic was "Pit and fissure sealant", followed by "Preventive advice", "Early childhood caries", "Dental caries in children & adolescent", "Management of dental caries in paediatric patients", and "Consent" which were equally ranked as the second most important topics. According to Bloom's and Simpson's taxonomies, most of the paediatric dentistry topics were rated adequate for undergraduate students at the cognitive level of "Apply" (C3) and a psychomotor level of "Guided response" (P3). CONCLUSION The current study successfully identified relevant undergraduate paediatric dentistry topics using the fuzzy Delphi method, which can facilitate future educators to improve existing Malaysian undergraduate paediatric dental curricula.
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Affiliation(s)
- Galvin Sim Siang Lin
- Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, 08100, Kedah, Malaysia.
| | - Yu Jie Chin
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Rob Son Chong
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Fadzlinda Baharin
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kelantan, Malaysia
| | | | - Nabihah Dziaruddin
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
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Gruß I, Dawson T, Kaplan CD, Pihlstrom DJ, Reich S, Fellows JL, Polk DE. Sharing voice during deliberative engagement to improve guideline adherence in dental clinics: findings from a qualitative evaluation of an online deliberative forum discussion. BMJ Open 2023; 13:e072727. [PMID: 37407045 DOI: 10.1136/bmjopen-2023-072727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Selecting effective implementation strategies to support guideline-concordant dental care is a complex process. For this research project, an online deliberative forum brought together staff from dental clinics to discuss the strengths and weaknesses of implementation strategies and barriers to implementation of a component of a dental (pit-and-fissure) guideline. The goal was to determine whether deliberative engagement enabled participants' sharing of promotive and prohibitive voice about implementation strategies to promote guideline-concordant care. DESIGN Qualitative analysis of online chat transcripts of facilitated deliberations from 31 small group sessions. SETTING Kaiser Permanente Dental (KP Dental) in the USA. PARTICIPANTS All staff from 16 dental offices. RESULTS The directed content analysis revealed that participants shared prohibitive and promotive voice when offering critique of the barriers and the implementation strategies suggested by the researchers. The analysis also revealed that the focus of the deliberations often was not on the aspect of the pit-and-fissure guideline intended by the research team for deliberation. CONCLUSIONS The deliberative forum discussions were a productive venue to ask staff in dental clinics to share their perspectives on strategies to promote guideline-concordant care as well as barriers. Participants demonstrated prohibitive voice and engaged critically with the materials the research team had put together. An important limitation of the deliberation was that the discussion often centred around an aspect of the pit-and-fissure guideline that already was implemented well. To ensure a deliberation oriented towards resolving challenging aspects of the pit-and-fissure guideline, greater familiarity with the guideline would have been important, as well as more intimate knowledge of the current discrepancies in guideline-concordant care. TRIAL REGISTRATION NUMBER This project is registered at ClinicalTrials.gov with ID NCT04682730. The trial was first registered on 18 December 2020. https://clinicaltrials.gov/ct2/show/NCT04682730.
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Affiliation(s)
- Inga Gruß
- Kaiser Permanente Center for Health Research Northwest Region, Portland, Oregon, USA
| | - Tim Dawson
- The Art of Democracy, LLC, Pittsburgh, Pennsylvania, USA
| | - Charles D Kaplan
- Sunrise Community Counseling Center, Los Angeles, California, USA
| | | | - Sacha Reich
- Kaiser Permanente Center for Health Research Northwest Region, Portland, Oregon, USA
| | - Jeffrey L Fellows
- Kaiser Permanente Center for Health Research Northwest Region, Portland, Oregon, USA
| | - Deborah E Polk
- School of Dental Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Tianviwat S, Pokawattana K, Thitasomakul S. Safety and effectiveness of an innosvative SS-suction device to control moisture in dental procedures. Heliyon 2023; 9:e18129. [PMID: 37496924 PMCID: PMC10366434 DOI: 10.1016/j.heliyon.2023.e18129] [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: 07/10/2022] [Revised: 07/06/2023] [Accepted: 07/07/2023] [Indexed: 07/28/2023] Open
Abstract
Control of moisture is critical for retention of sealants, which can reduce the incidence of caries in high-risk groups. OBJECTIVES We investigated the safety and efficacy of the novel SS-suction device in the laboratory and a small clinical trial in children aged 6 to 8-years-old. METHODS First, a laboratory test of 52 SS-suction devices was conducted to determine the pressure generated by the chin plate to maintain suction at different intervals and to determine the pressure resistance of the spring to maintain suction in a child's mouth. Second, 12 healthy children with sound lower molars participated in a clinical trial of the use of SS-suction during sealant application. RESULTS The laboratory test showed that when pressed to the maximum distance of 25 mm, the chin plate produced a pressure of 247.5 ± 116.6 mmHg. At this pressure, the SS-suction could be used safely for up to 120 min without damaging the soft tissues. In the clinical study, the dentists inserted and removed the SS-suction in 7.80 ± 2.48 s. The range by which the chin plate was pressed down varied between 0 and 13 mm. The highest pressure on the skin was 120 mmHg (at 13 mm) and the device effectively maintained suction and effectively removed water and saliva. The time required to apply sealant was 7.01 ± 2.26 min. CONCLUSIONS The SS-suction is a safe, effective device for two-handed application of sealants in children, with no negative side effects. CLINICAL SIGNIFICANCE We demonstrate the unique SS-suction device can quickly drain water and saliva to help dentists treat young patients using a two-handed approach; this device provides good control of moisture during sealant application. The device prevents the tongue and cheeks from interfering with the operation area, reduces tension, and does not require a dental assistant.
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Affiliation(s)
- Sukanya Tianviwat
- Evidence-Based Dentistry for Oral Health Care and Promotion Phase II Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand
| | - Kan Pokawattana
- Residency Training Program in Dental Public Health, Faculty of Dentistry, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Songchai Thitasomakul
- Evidence-Based Dentistry for Oral Health Care and Promotion Phase II Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, 90110, Thailand
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Lamloum D, Arghittu A, Ferrara P, Castiglia P, Dettori M, Gaeta M, Odone A, Campus G. A Systematic Review of Clinical Practice Guidelines for Caries Prevention following the AGREE II Checklist. Healthcare (Basel) 2023; 11:1895. [PMID: 37444729 DOI: 10.3390/healthcare11131895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/07/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Untreated oral diseases are detrimental to overall well-being and quality of life and are in close relationship with social and economic consequences. The presence of strong evidence for caries primary and secondary prevention is a compulsory tool for the development of clinical practice guidelines (CPGs). This paper was aimed to assess systematically the importance of clinical practice guidelines in caries prevention management considering both the adult and pediatric populations and evaluate them using the Appraisal of Guidelines for Research and Evaluation (AGREE II) Checklist. Records were extracted from EMBASE, SCOPUS, PubMed/Medline and seven other relevant guideline databases between 6 January and 14 February 2023. Two reviewers independently conducted the appraisal using the web-based platform My AGREE PLUS. Twenty-one guidelines/papers met the inclusion criteria and were reviewed. Eight CPGs included both primary and secondary prevention interventions, whereas thirteen presented a single preventive model. Overall, 12 guidelines were published in the USA. The mean AGREE II scores ranged from 35.4% to 84.3%. Of the total twenty-one included guidelines, twelve were classified as "Recommended", ranging from 56.3% to 84.3%, the others were described as "Recommended with modification", ranging from 35.4% to 68.9%. From the AGREE II analysis carried out, the CPGs included in this survey adopted a punctual methodological rigor but lacked applicative power. The present survey showed that the public, as the primary beneficiary, played a limited role in the development of the twenty-one CPGs. Hence, methodological improvement can better support high-quality CPG development in the future.
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Affiliation(s)
- Demetrio Lamloum
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Antonella Arghittu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20126 Monza, Italy
- IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Marco Dettori
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Guglielmo Campus
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai 600077, India
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Brewster J, Roberts HW. 12-Month flexural mechanical properties of conventional and self-adhesive flowable resin composite materials. Dent Mater J 2023:2023-011. [PMID: 37302821 DOI: 10.4012/dmj.2023-011] [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: 06/13/2023]
Abstract
The aim of this study was to investigate the 12-month flexural mechanical properties of 23 flowable resin-based composites (FRBC) that included 5 self-adhesive FRBC materials. Specimens were evaluated following ISO 4049:2019 guidelines, but additionally stored in physiologic 0.2M phosphate buffered saline solution being tested at 24 h, 1 week, 1 month, and at 3-, 6-, 9-, and 12-months. While some deviation and degradation were noted at testing intervals, conventional FRBC materials overall demonstrated greater flexural strength than the self-adhesive and compomer materials. Three self-adhesive materials and the compomer were below recommended ISO 4049:2019 flexural strength values at 24 h with another after 6 months storage. Conventional FRBC materials, except at 1 month, overall demonstrated increased flexural modulus than the self-adhesive FRBC materials. Although results were material dependent, conventional FRBC materials demonstrated overall greater flexural mechanical properties as compared to the self-adhesive FRBC materials and the compomer evaluated.
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Veiga N, Figueiredo R, Correia P, Lopes P, Couto P, Fernandes GVO. Methods of Primary Clinical Prevention of Dental Caries in the Adult Patient: An Integrative Review. Healthcare (Basel) 2023; 11:healthcare11111635. [PMID: 37297776 DOI: 10.3390/healthcare11111635] [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: 04/20/2023] [Revised: 05/29/2023] [Accepted: 06/01/2023] [Indexed: 06/12/2023] Open
Abstract
AIM Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels. METHODS This review followed the PICO strategy with the research question: "What are the methods of primary prevention of dental caries, in adults, for improving and maintaining oral health integrating clinical and community-based strategies?" Electronic screening was carried out by two independent reviewers in five databases (MedLine/PubMed, SciELO, Web of Science, Cochrane Library, and LILACS) to find relevant publications between 2015-2022. We applied eligibility criteria for selection of the articles. The following MeSH terms were used: "Primary Prevention"; "Adult"; "Oral Health"; "Dental Caries"; "Fluorides, Topical"; "Fluoride Varnishes"; "Pit and Fissure Sealants"; "Preventive Dentistry". Although the term "Prevention strategy" is not a MeSH descriptor, several correlated terms appeared and were used in the search engines: "Preventative Care", "Disease Prevention, Primary", and "Prevention, Primary". The tool provided by the JBI organization (Joanna Briggs Institute) was used to assess the quality of the included studies. RESULTS Nine studies were included. Overall, it was found that the main primary prevention methods applied in dentistry in adults are the application of pit and fissure sealants, topical application of fluoride performed in the dental clinic, use of fluoridated toothpaste, mouthwash with chlorhexidine at home, use of xylitol, the recommendation for regular appointments with the dentist, and the need to inform patients about the saliva buffer capacity and adoption of a non-cariogenic diet. For that purpose, preventive policies should be taken to prevent dental caries. These include three major challenges: providing the adult population with more knowledge regarding their oral health, empowering patients through adopting healthy lifestyles, and developing new preventive strategies and awareness campaigns aimed at the adult population to promote proper oral health habits. CONCLUSIONS A small number of studies were found whose participants were adult patients. There was some consistency regarding primary prevention methods in our studies. However, good quality randomized control studies are still required to define the best intervention strategies for adult caries prevention.
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Affiliation(s)
- Nélio Veiga
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Ricardo Figueiredo
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Patrícia Correia
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Pedro Lopes
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Patrícia Couto
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Gustavo Vicentis Oliveira Fernandes
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
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Emmanuelli B, Knorst JK, Menegazzo GR, Mendes FM, Ardenghi TM. Dental caries prediction and the indication of pit and fissure sealant in children first permanent molars: a prospective study. J Dent 2023:104557. [PMID: 37230242 DOI: 10.1016/j.jdent.2023.104557] [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: 02/11/2023] [Revised: 05/15/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES To evaluate predictors for caries incidence on first permanent molars and to assess the accuracy and efficiency of these predictors for the indication of pit and fissure sealants. METHODS This 7-y cohort study started in 2010 with a sample of 639 children (1-5 years) from Southern Brazil. Dental caries was assessed using the ICDAS. Maternal education, family income, parental perception on child oral health and severe dental caries experience were collected at baseline and used to test the prediction of dental caries. Predictive values, accuracy and efficiency were estimated for each possible predictor. RESULTS About 449 children were re-assessed at follow-up (70.3% retention rate). The baseline characteristics showed similar risks for dental caries incidence in first permanent molars. Low family income and poor parental perception of child oral health were moderately accurate in correctly identifying sound children who would not need to receive pit and fissure sealant. However, all the adopted criteria have lower accuracy incorrectly identifying children who later developed dental caries in first permanent molars. CONCLUSIONS Distal and intermediate factors were relatively accurate in determining caries risk incidence on children's first permanent molars. The criteria adopted were more accurate in identifying sound children than those who need to receive pit and fissure sealant. CLINICAL RELEVANCE Our findings reinforce the idea that investing in strategies that take into account common risk factors still represents the best option for dental caries prevention. However, adopting only these parameters is not enough to indicate pit and fissure sealants.
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Affiliation(s)
- Bruno Emmanuelli
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil
| | | | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, Faculty of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
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Zhou Y, Huang X, Wu L, Liang Y, Huang Y, Huang S. Microleakage, microgap, and shear bond strength of an infiltrant for pit and fissure sealing. Heliyon 2023; 9:e16248. [PMID: 37229157 PMCID: PMC10205491 DOI: 10.1016/j.heliyon.2023.e16248] [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: 09/19/2022] [Revised: 05/05/2023] [Accepted: 05/10/2023] [Indexed: 05/27/2023] Open
Abstract
Objectives This study aimed to evaluate the potential clinical application of an infiltrant with different etchants as pit and fissure sealants and to compare them with a conventional resin-based sealant. Materials and methods Seventy-five molars were randomly divided into three groups (n = 25): phosphoric acid etchant + conventional resin-based sealant (Group A); 15% hydrochloric acid etchant + infiltrant (Group B); phosphoric acid etchant + infiltrant (Group C). Fifteen teeth in each group were subjected to pit and fissure sealing procedures. After 500 thermocycling and methylene blue dye penetration, ten specimens were sectioned and the pencentages of dye penetration were measured under a stereomicroscope. Another five teeth in each group were sectioned and the microgaps between materials and enamel surface were measured using electron microscope scanning. Ten teeth in each group were used to measure shear bond strength and the failure mode was analyzed. Results The results showed that infiltrant exhibited significantly less microleakage and microgap than resin-based sealant, no matter which echant was used. Although there was no significant difference betweern the three groups, infiltrant applied with 15% hydrochloric acid etching showed higher shear bond strength than resin-based sealant etching with 35% phosphoric acid. Conclusions The infiltrant has significant advantages in reducing the degree of microleakage and microgap. Moreover, the infiltrant could achieve the same bonding strength as conventional resin-based sealant. Although, manufacturers do not currently recommend the infiltrant for fissure sealing, the potential clinical application would be an off-label use.Clinical relevance This report provides a theoretical basis for the potential clinical application of the infiltrant as a pit and fissure sealant, and provides a new perspective for selecting pit and fissure sealants.
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Philip N, Suneja B. The revolutionary evolution in carious lesion management. J Conserv Dent 2023; 26:249-257. [PMID: 37398856 PMCID: PMC10309123 DOI: 10.4103/jcd.jcd_54_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/23/2023] [Accepted: 04/19/2023] [Indexed: 07/04/2023] Open
Abstract
Contemporary paradigms of dental caries management focus on the biological approaches to treating the disease and its principal symptom, the carious lesion. This narrative review traces the evolution of carious lesion management from the operative and invasive approaches of G. V. Black's era to the current period of minimally invasive biological approaches. The paper explains the rationale for adopting biological approaches to dental caries management and lists the five core principles of this management approach. The paper also details the aims, features, and the most recent evidence base for the different biological carious lesion management approaches. Based on current practice guidelines, collated clinical pathways for lesion management are also presented in the paper to aid clinicians in their decision-making. It is hoped that the biological rationale and evidence summarized in this paper will bolster the shift to modern biological carious lesion management approaches among dental practitioners.
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Affiliation(s)
- Nebu Philip
- Paediatric Dentistry, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Li J, Zhang K, Cha C, Lu Z, Liu L. Oral health status of students with visual or hearing impairments in Northeast China. BMC Oral Health 2023; 23:242. [PMID: 37101257 PMCID: PMC10130807 DOI: 10.1186/s12903-023-02923-1] [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: 01/10/2023] [Accepted: 03/29/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Visual or hearing impairments in students seriously affect their quality of life. The aim of this study was to identify oral hygiene status and its influencing factors on visual or hearing impairments in students in Northeast China. METHODS This study was conducted in May 2022. A total of 118 visually impaired students and 56 hearing impaired students from Northeast China were included in this study via census. Oral examinations and questionnaire-based surveys of students and their teachers were conducted. The oral examinations included caries experience, prevalence of gingival bleeding and dental calculus. The questionnaires included three parts: Social demographics (residence, sex and race) and parents' educational level; Oral hygiene habits and medical treatment behaviors; Knowledge and attitudes towards oral health care. This questionnaire was selected from the Fourth China National Oral Health Survey and the reliability and validity of the questionnaire were previously tested. T tests, one-way ANOVA, χ2 tests and multivariate logistic analyses were conducted to evaluate the differences and dependent variables of dental caries. RESULTS The prevalence of dental caries in visually impaired and hearing impaired students were 66.10% and 66.07%. The mean number of DMFT, prevalence of gingival bleeding and dental calculus in visually impaired students were 2.71 ± 3.06, 52.08% and 59.38%, respectively. The mean number of DMFT, prevalence of gingival bleeding and dental calculus in hearing impaired students were 2.57 ± 2.83, 17.86% and 42.86%, respectively. The results of the multivariate logistic analysis showed that fluoride use and parents' educational background had an impact on the caries experience of visually impaired students. The daily toothbrushing frequency and parents' educational background had an impact on the caries experience of hearing impaired students. CONCLUSIONS The oral health situation of students with visual or hearing impairments remains severe. It is still necessary to promote oral and general health in this population.
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Affiliation(s)
- Jian Li
- Department of Preventive Dentistry, School and Hospital of Stomatology, Liaoning Provincial Key laboratory of Oral Diseases, China Medical University, Nanjing North Street, No.117, 110101, Shenyang, China
| | - Kaiqiang Zhang
- Department of Preventive Dentistry, School and Hospital of Stomatology, Liaoning Provincial Key laboratory of Oral Diseases, China Medical University, Nanjing North Street, No.117, 110101, Shenyang, China
| | - Chang Cha
- Department of Preventive Dentistry, School and Hospital of Stomatology, Liaoning Provincial Key laboratory of Oral Diseases, China Medical University, Nanjing North Street, No.117, 110101, Shenyang, China
| | - Zhenfu Lu
- Department of Preventive Dentistry, School and Hospital of Stomatology, Liaoning Provincial Key laboratory of Oral Diseases, China Medical University, Nanjing North Street, No.117, 110101, Shenyang, China
| | - Lu Liu
- Department of Preventive Dentistry, School and Hospital of Stomatology, Liaoning Provincial Key laboratory of Oral Diseases, China Medical University, Nanjing North Street, No.117, 110101, Shenyang, China.
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London SD, Chamut S, Fontelo P, Iafolla T, Dye BA. Assessment of the Quality of Current American Dental Association Clinical Practice Guidelines. JDR Clin Trans Res 2023; 8:178-187. [PMID: 35369790 PMCID: PMC10029135 DOI: 10.1177/23800844221083563] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The American Dental Association (ADA) defines evidence-based dentistry (EBD) as "an approach to oral healthcare that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences." Clinical practice guidelines (CPGs) are statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options. Therefore, ADA CPGs are the most rigorous examples of EBD to inform clinical practice. CPGs should be of the highest level of quality to ensure the appropriateness and timeliness of clinical recommendations. OBJECTIVES The aim of this study was to measure the methodological rigor and transparency of the ADA CPGs. METHODS Each ADA CPG was appraised by 4 independent assessors using the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument. Quantitative quality scores were obtained for 6 domains and overall quality. In addition, assessors provided a qualitative analysis by providing comments for each item and an appraisal of the full recommendation. RESULTS A quality score of 75% was used as the threshold for high-quality guidelines. Using this metric, 6 of the current 10 current ADA CPGs were considered to be of high quality, 1 was slightly below the quality threshold, and 3 were considered marginal. Even among those evaluated to be high quality in overall assessment, certain domains did not reach the quality threshold of 75%. CONCLUSION Overall, the ADA CPGs collectively provide high-quality guidance for the clinician. While the AGREE appraisal guidelines have been used in CPG development since 2016, there is still room for improvement in certain domains (i.e., stakeholder involvement, rigor of development, applicability, and editorial independence). KNOWLEDGE TRANSFER STATEMENT The results of this study summarize the methodological rigor and transparency of the 10 current ADA clinical practice guidelines. Since adoption of AGREE standards (2016), CPGs have been uniformly of high quality. The quality of older CPGs was somewhat lower but overall deemed acceptable. Thus, ADA CPGs may be used with confidence to inform practitioners of treatment options supported by rigorous evidence-based dentistry standards. However, there is still room for improvement in methodological quality.
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Affiliation(s)
- S D London
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
- Applied Clinical Informatics Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
- Department of Oral Biology and Pathology, Stony Brook University School of Dental Medicine, Stony Brook, NY, USA
| | - S Chamut
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
| | - P Fontelo
- Applied Clinical Informatics Branch, Lister Hill National Center for Biomedical Communications, National Library of Medicine, National Institutes of Health, Bethesda, MD, USA
| | - T Iafolla
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - B A Dye
- Office of Science Policy and Analysis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
- Department of Community Dentistry and Population Health, University of Colorado School of Dental Medicine, Aurora, CO, USA
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Gyati O, Jain M, Sogi S, Shahi P, Sharma P, Ramesh A. Clinical Evaluation of Retention of Hydrophilic and Hydrophobic Pit and Fissure Sealants in Permanent First Molars: An 18 Months Follow-up: Randomized Controlled Trial. Int J Clin Pediatr Dent 2023; 16:350-356. [PMID: 37519987 PMCID: PMC10373778 DOI: 10.5005/jp-journals-10005-2578] [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] [Indexed: 08/01/2023] Open
Abstract
Introduction Deep pits and fissures are more prone to caries development due to their complex morphological anatomy. Preventive measures, such as pit and fissure sealants, can help in the reduction of dental caries. Conventional sealants being hydrophobic in nature, require isolation. Sealants which are hydrophilic have been introduced as an alternative where isolation is difficult to achieve. Aim To compare and evaluate the retention and marginal integrity of hydrophilic pit and fissure sealant (Embrace WetBond) with hydrophobic pit and fissure sealant (Clinpro) in permanent first molars. Materials and methods Sealants were applied randomly using the split-mouth design technique on 80 permanent first molars in children aged between 6 and 9 years and evaluation was done at 3, 6, 9, and 18 months. Results The difference in retention rates between the groups was not significant using the Chi-squared test, though the WetBond group exhibited better results with 40% complete retention at the end of 18 months while in the Clinpro group, it was 37.50%. The marginal integrity in both the sealant groups was also found to be statistically insignificant. Caries incidence was found to be slightly higher in the Clinpro group. Conclusion The clinical performance of Embrace WetBond was better when compared to Clinpro because of its moisture-tolerance capacity. Embrace Wetbond pit and fissure sealant can be the choice of material in cases where moisture control is a challenging issue. How to cite this article Gyati O, Jain M, Sogi S, et al. Clinical Evaluation of Retention of Hydrophilic and Hydrophobic Pit and Fissure Sealants in Permanent First Molars: An 18 Months follow-up: Randomized Controlled Trial. Int J Clin Pediatr Dent 2023;16(2):350-356.
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Affiliation(s)
- Oma Gyati
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Ambala, Haryana, India
| | - Mansi Jain
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Ambala, Haryana, India
| | - Suma Sogi
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Ambala, Haryana, India
| | - Prinka Shahi
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Ambala, Haryana, India
| | - Priyanka Sharma
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Ambala, Haryana, India
| | - Archana Ramesh
- Department of Pediatric and Preventive Dentistry, Maharishi Markandeshwar College of Dental Sciences and Research, Ambala, Haryana, India
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Kharouba J, Gonoratsky AA, Brosh T, Masri M, Iraqi R, Blumer S. Effect of Different Etching Times on Pit-and-Fissure Sealant Micro-Shear Bond Strength to the Enamel of Primary Teeth. CHILDREN 2023; 10:children10030461. [PMID: 36980019 PMCID: PMC10047212 DOI: 10.3390/children10030461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 02/15/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
Successful clinical use of pit-and-fissure sealants relies on the sufficient etching of the enamel, field isolation and sealant retention. The etching time changes the physical and mechanical surface properties of the etched tooth tissues; therefore, it impacts both etching depth and the bond strength of sealants to the enamel. We examined if reducing the recommended 15 s etching time of primary teeth enamel affects the micro-shear bond strength (µSBS) of pit-and-fissure sealants. The cusps of forty non-carious, extracted human primary molars were separately etched for 8, 15 or 30 s. Then, a pit-and-fissure sealant was placed and light-cured. The µSBS values were evaluated and compared among the three groups. The mean µSBS values ± standard deviations were 34.68 ± 16.93, 34.19 ± 17.35 and 36.56 ± 16.57 MPa in the cusps etched for 8, 15 and 30 s, respectively. No statistically significant differences in µSBS were observed among the three test groups. In this study, we showed for the first time that the recommended etching time of primary teeth enamel may be reduced from 15 to 8 s without compromising the µSBS of the sealant. Further evaluations in a clinical setting are warranted.
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Affiliation(s)
- Johnny Kharouba
- Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Anna Annael Gonoratsky
- Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Tamar Brosh
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Mahmoud Masri
- Department of Oral Rehabilitation, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Rabea Iraqi
- Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
| | - Sigalit Blumer
- Department of Pediatric Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 69978, Israel
- Correspondence: ; Tel.: +972-3-6409254
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Hamza B, Sekularac M, Attin T, Wegehaupt FJ. In vitro evaluation of fissure sealants' wear under erosive, abrasive and erosive/abrasive conditions. Eur Arch Paediatr Dent 2023; 24:55-61. [PMID: 36171525 PMCID: PMC9992041 DOI: 10.1007/s40368-022-00757-z] [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: 04/25/2022] [Accepted: 09/22/2022] [Indexed: 10/14/2022]
Abstract
PURPOSE To evaluate and compare the wear of selected resin-based fissure sealants with different compositions properties under erosive, abrasive, and erosive/abrasive conditions. METHODS Forty-five samples of the following resin-based fissure sealants were prepared: Fissurit (fluoride free), Fissurit F (with fluoride), Fissurit FX (55 wt.% filler content), Grandio Seal (70 wt.% nano-filler content) and bovine enamel. Fifteen samples from each material were randomly allocated into three groups according to the wear condition they would be subjected to as follows: erosive condition (citric acid, 1 min, pH 2.3), abrasive condition (120 brushing strokes at 2 N, toothpaste slurry RDA value = 69), and erosive/abrasive condition (combination of both). The wear challenges were repeated six times each day for 10 days. The material wear was measured using a stylus profilometer. Kruskal-Wallis and Conover's test was applied to compare the resulting material wear between the groups. RESULTS Under erosive conditions, Grandio Seal and Fissurit FX showed statistically significantly the least material wear. Under abrasive and erosive/abrasive conditions, Grandio Seal showed statistically significantly the least material wear. Fissurit F showed statistically significantly the highest material wear under abrasive and erosive/abrasive conditions, after dental enamel (p < 0.05). CONCLUSION Higher filler content in sealants leads to better wear resistance. Incorporating fluoride into sealants seems to reduce their wear resistance at similar filler contents.
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Affiliation(s)
- B Hamza
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - M Sekularac
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - T Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - F J Wegehaupt
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
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Pakdaman A, Gholizadeh N, Kharazifard MJ, Eshrati M. Clinical practice guideline adaptation for risk-based caries management in 18-55 year-old Iranian adults. BMC Oral Health 2023; 23:7. [PMID: 36609271 PMCID: PMC9824988 DOI: 10.1186/s12903-022-02699-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/27/2022] [Indexed: 01/09/2023] Open
Abstract
PURPOSE To adapt an evidence-based clinical practice guideline (CPG) for risk-based management of caries in 18-55 year-old Iranian adults. METHODS A multidisciplinary adaptation team reviewed evidence-based guidelines such as the NICE, SIGN, and ADA according to the defined clinical questions. In addition, databases such as the PubMed and Google Scholar were searched and CPGs were screened and appraised using the AGREE II (Appraisal of Guidelines for Research and Evaluation II) tool. Clinical scenarios were developed and their level of evidence, clinical advantage and adaptability were assessed. Following a two-round ranking by experts, the final recommendations were selected using the RAND-UCLA appropriateness method. RESULTS Of 17 CPGs, 5 were selected as the source guidelines for adaptation. To assess the risk of caries in the adult population, reduced Cariogram (without saliva tests) and CAMBRA were suggested as diagnostic tools. In addition, 53 risk-based recommendations on the preventive care (including the use of fluoride toothpaste, fluoride, and chlorhexidine mouthwash, at home and in-office fluoride gel, fluoride varnish, mouth buffering, and sealant), operative intervention threshold, and follow-up interval were adapted for Iranian adults. CONCLUSIONS A guideline was adapted for risk-based management of dental caries in Iranian adults. This helps local dentists in decision making and promoting oral health of adults. Further research is needed to assess the external validity and feasibility of the adapted guideline in the Iranian population.
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Affiliation(s)
- A. Pakdaman
- grid.411705.60000 0001 0166 0922Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - N. Gholizadeh
- grid.411705.60000 0001 0166 0922Oral and Maxillofacial Medicine Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - M. J. Kharazifard
- grid.411705.60000 0001 0166 0922Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M. Eshrati
- grid.411705.60000 0001 0166 0922Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Adel SM, El-Harouni N, Vaid NR. White Spot Lesions: State of the Art Biomaterials and Workflows used in Prevention, Progression and Treatment. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Treeratweerapong Y, Nakornchai S, Jirarattanasopha V. Effectiveness of applying proximal enamel caries with fluoride-releasing sealant and fluoride varnish on caries progression in permanent teeth: A 12-month split-mouth randomized clinical trial. Int J Paediatr Dent 2023; 33:30-39. [PMID: 35579583 DOI: 10.1111/ipd.13011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 05/07/2022] [Accepted: 05/15/2022] [Indexed: 12/16/2022]
Abstract
BACKGROUND Few studies report on managing initial proximal caries with sealants, and no reports focus on fluoride-releasing sealants. AIM To compare the effectiveness between applications of a fluoride-releasing sealant and fluoride varnish on proximal enamel caries to control caries progression in permanent teeth. DESIGN This was a split-mouth randomized controlled trial in forty-four 11- to 16-year-old children with radiographic caries in at least one contralateral pair of teeth with proximal enamel caries. The lesions were evaluated using DIAGNOdent and were also assessed visually after tooth separation. The lesions in each subject were randomly sealed with a fluoride-releasing sealant (Helioseal® F) or applied with fluoride varnish (Duraphat®). The fluoride varnish-treated lesion was reapplied at 3 and 6 months. Clinical examination, bitewing radiograph evaluation, and DIAGNOdent assessment were performed at 6 and 12 months. The caries progression outcome variables were regression, no change, and progression. The data were analyzed with the McNemar-Bowker test. RESULTS Radiographic examination and DIAGNOdent assessment demonstrated no significant differences in the percentages of regression, no change, or progression at the 12-month follow-up (p > .05). CONCLUSION Applications of a fluoride-releasing sealant and of fluoride varnish three times resulted in a nonsignificant difference in caries progression of initial proximal caries at the 12-month follow-up.
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Affiliation(s)
| | - Siriruk Nakornchai
- Department of Pediatric Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Salma RS, AbdElfatah OM. Effect of a bioactive pit and fissure sealant on demineralized human enamel: in vitro study. BMC Oral Health 2022; 22:569. [PMID: 36463155 PMCID: PMC9719630 DOI: 10.1186/s12903-022-02617-0] [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: 05/17/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Incorporation of bioactive agent into pit and fissure sealant would halt demineralization and promote further remineralization. The aim was to assess the effect of bioactive and fluoride fissure sealants on calcium and phosphate content and surface topography of artificially demineralized enamel in young permanent teeth. METHODS 30 sound extracted premolars free from cracks or any developmental anomalies were used. They were divided into group I bioactive fissure sealant, group II fluoride fissure sealant and group III no material applied. Each tooth was divided into halves in a buccolingual direction and evaluated by energy dispersive X-ray spectrometer (EDX) at baseline, demineralization and after applying the material. Another set of 7 sound extracted premolars was evaluated by scanning electron microscopy (SEM) at the same phases. RESULTS EDX showed that regaining calcium to demineralized enamel was significantly higher with bioactive sealant than either fluoride or the control group. SEM revealed minerals deposits with formation of distinct white zone at tooth/sealant interface for both pit and fissure sealant groups. Whereas no white zone formation was detected in control group. CONCLUSIONS Incorporating bioactive material into pit and fissure sealant through microcapsules provided better results than incorporating fluoride by enhancing the biological process of remineralization. CLINICAL RELEVANCE The more use of bioactive pit and fissure sealant would maintain the occlusal surfaces as sound structures and decrease the need for operative procedures to restore teeth cavitation.
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Affiliation(s)
- Rehab Samir Salma
- grid.442603.70000 0004 0377 4159Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - Omnia M. AbdElfatah
- grid.442603.70000 0004 0377 4159Oral Biology Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
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Kaverikana K, Vojjala B, Subramaniam P. Comparison of Clinical Efficacy of Glass Ionomer-based Sealant using ART Protocol and Resin-based Sealant on Primary Molars in Children. Int J Clin Pediatr Dent 2022; 15:724-728. [PMID: 36866139 PMCID: PMC9973092 DOI: 10.5005/jp-journals-10005-2450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
Aim The present in vivo study aims to evaluate and compare the clinical efficacy and survival rate of resin-based composite sealant (Clinpro Sealant, 3M ESPE, Irvine, California, United States of America) with high viscosity glass ionomer (GI) (Equia Forte, GC India, Patancheru, Telangana, India) using atraumatic restorative treatment (ART) sealant protocol in primary molars. Materials and methods The design of the study was a clinical, prospective split-mouth study. A total of 100 contralateral primary molars were selected and divided into two groups. In group I, children received Equia Forte, and in group II, children received Clinpro Sealant. The follow-up examinations were performed in the 1st and 6th months. Simonsen's criteria were used to check for retention. International Caries Assessment and Detection System II (ICDAS II) criteria were used to check for dental caries. The data obtained were subjected to statistical analysis. Results At 6 months, there was no statistically significant difference between the groups with regard to retention and caries preventive effect. Conclusions High-viscosity GI sealants can be applied using the ART protocol and provide an alternative to resin-based sealants. Clinical significance There is a limited number of studies on the performance of ART sealants in primary molars. Thus, the clinical efficacy and survival rate of resin-based composite sealant (Clinpro Sealant, 3M ESPE, Irvine, California, United States of America) with high viscosity GI (Equia Forte, GC India, Patancheru, Telangana, India) using ART sealant protocol in primary molars were evaluated. The research concluded that high-viscosity GI sealants using ART protocol are effective sealants in primary molars. How to cite this article Kaverikana K, Vojjala B, Subramaniam P. Comparison of Clinical Efficacy of Glass Ionomer-based Sealant using ART Protocol and Resin-based Sealant on Primary Molars in Children. Int J Clin Pediatr Dent 2022;15(6):724-728.
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Affiliation(s)
- Kiran Kaverikana
- Department of Pedodontics and Preventive Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Bhargavi Vojjala
- Department of Pedodontics and Preventive Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
| | - Priya Subramaniam
- Department of Pedodontics and Preventive Dentistry, The Oxford Dental College, Bengaluru, Karnataka, India
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Marques JFDL, Ferraz LN, Lopes BKB, Vasconcelos TAB, Teixeira TR, Lima DANL, Aguiar FHB, Miranda DDA. Assessment of influence of LED curing units used on microhardness of resin-modified glass ionomer sealants. BRAZILIAN JOURNAL OF ORAL SCIENCES 2022. [DOI: 10.20396/bjos.v21i00.8666202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Aim: Resin modified glass ionomer (RMGI) is class of material that can be used as sealant for preventing and arresting the progression of caries in pits and fissures. As these are hybrid materials, their properties can be affected by factors related to the polymerization process. Therefore, this study aimed to evaluate the influence of different generations of LED curing units (Elipar DeepCure-L and VALO Grand) on Knoop microhardness values (KHN) of RMGI sealants (Clinpro XT and Vitremer). Methods: Forty cylindrical specimens (6mm ø x 1 mm high) were prepared according to the manufacturer’s instructions and divided into four groups (n=10) according to the type of RMGI and LED used. The KHN of the top surface of each sample was calculated 7 days after light-curing. Data were submitted to two-way ANOVA (α = 0.05). Results: Vitremer had higher KHN values than Clinpro XT after using both LEDs (p<0.0001), but especially when light-cured with the use of VALO Grand (p<0.0001). Whereas the KHN value of Clinpro was not influenced by the LED device (p>0.05). Conclusions: Top surface microhardness values of RGMI sealants were affected by both material composition and generations of LED curing units used. Third generation LED curing units seemed to be more efficient for the polymerization of RMGI-based sealants.
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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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Caries-Preventive Effect and Retention of Glass-Ionomer and Resin-Based Sealants: A Randomized Clinical Comparative Evaluation. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7205692. [PMID: 35769675 PMCID: PMC9236800 DOI: 10.1155/2022/7205692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/21/2022] [Accepted: 06/04/2022] [Indexed: 11/17/2022]
Abstract
Background. Deep fissures are highly unprotected from the development of caries. Resin-based materials and glass-ionomer cements for sealing fissures are useful in caries control through physical barrier formation, which prohibits metabolic exchange between fissure microorganisms. Retention is one of the most critical properties of fissure sealants. This in vivo study is aimed at comparing and evaluating the clinical efficacy of resin and glass ionomer-based fissure sealants on first permanent molars with follow-ups at 6-, 12-, and 18-month intervals. Methods. A randomized split-mouth design clinical study was conducted after obtaining the ethical committee approval. A total of 50 patients, aged between 7 and 12 years, were randomized and enrolled in the study to perform a total of 200 sealant placements on all four caries-free and hypoplasia-free first permanent molars having deep fissures, which are susceptible to caries, were included in this study. The four permanent molars were divided into the following four groups: group A (control), B (Grandioseal, Voco, Germany), C (Smartseal & Loc, Detax Gmbh & Co, Germany), and D (Fuji triage capsule, GC, Belgium). The sealed molars were clinically evaluated at intervals of 6, 12, and 18 months to assess sealant retention, surface roughness, marginal coloration, and caries status through visual evaluation of the sealant by two evaluators. Results. Concerning retention, there were statistically significant differences between the sealants in terms of the survival of partial and fully retained sealants as well as in the survival of caries-free teeth. Two resin-based (Smartseal & Loc) and glass-ionomer cement (Fuji triage) sealants showed significantly similar performances in permanent molars for up to 18 months. In terms of retention, one of the resin-based (Grandioseal) sealants performed better as compared to the others and showed better caries prevention in deep fissures. Conclusion. It is concluded that both the sealants had comparable retention and caries-preventive effects in 7 to 12-year-old children and can be considered as suitable sealants for a period of at least 18 months in moderate caries risk patients.
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Comparison of a resin-based sealant with a nano-filled flowable resin composite on sealing performance of marginal defects in resin composites restorations: a 36-months clinical evaluation. Clin Oral Investig 2022; 26:6087-6095. [PMID: 35608683 DOI: 10.1007/s00784-022-04557-z] [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: 10/20/2021] [Accepted: 05/17/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Our goal was to evaluate the clinical behavior of resin-based composite (RBC) restorations with sealed marginal defects using nano-filled flowable RBCs (FRS) compared with resin-based sealant (RBS); this work used marginal adaptation, marginal staining, and secondary caries according to the World Dental Federation (FDI) criteria. MATERIALS AND METHODS This was a prospective, randomized, double-blind, controlled trial. Fifty-four patients who met the inclusion criteria (older than 18 years old; with high cariogenic risk determined by Cariogram software; and restorations with marginal defects, 3 and 4 according to FDI criteria) were randomly divided into three groups. There were three defective RBC restorations per patient and were repaired (n = 162). The groups were RBS-marginal sealing using a resin-based sealant (Clinpro Sealant, 3 M ESPE, MN, USA) plus adhesive (Single Bond Universal, 3 M ESPE, MN, USA); FRS-sealing using flowable resin (Filtek Flow Z350XT, 3 M ESPE, MN, USA) plus adhesive (Single Bond Universal, 3 M ESPE, MN, USA); and control-no repair treatment. All procedures were performed under complete isolation. Evaluations were evaluated at 1-week post treatment (baseline) as well as at 18 and 36 months after treatment regarding marginal adaptation, marginal staining, and secondary caries according to FDI criteria. The data were analyzed using the Wilcoxon test (α = 0.05) to compare the differences in each treatment group at different evaluation times. RESULTS Marginal adaptation of micro-repaired RBC restorations were seen in patients with a high risk of caries using flowable resin composite or resin-based sealants. There were differences (P < 0.001) when baseline was compared at 18 and 36 months. Marginal staining showed differences when baseline was compared to 18 months (P < 0.001) and 36 months (P = 0.001) for both treatments. Secondary caries parameters for RBS treatment showed differences when baseline was compared to 36 months (P = 0.025) and when 18 months was compared to 36 months (P = 0.046). CONCLUSIONS Micro-repair of RBC restorations resulted in clinical deterioration of marginal adaptation and marginal staining. Nano-filled flowable resin composites were sealed on defective restorations; 3 and 4 FDI marginal defects have better clinical performance to prevent secondary caries than resin-based sealants after 36 months. CLINICAL RELEVANCE Micro-repair with RBS does not seem to be an effective treatment to prevent secondary caries.
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Penetration and Adaptation of the Highly Viscous Zinc-Reinforced Glass Ionomer Cement on Contaminated Fissures: An In Vitro Study with SEM Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106291. [PMID: 35627829 PMCID: PMC9141603 DOI: 10.3390/ijerph19106291] [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: 03/24/2022] [Revised: 05/11/2022] [Accepted: 05/20/2022] [Indexed: 11/17/2022]
Abstract
Objective: To evaluate the penetration and adaptation of highly viscous zinc-reinforced glass ionomer cement (ZRGIC), using a scanning electron microscope (SEM), when applied under various contaminated conditions on grooves and fissures of primary second molars. Materials and Methods: A total of 40 extracted human primary second molars were randomly assigned into five groups (8 teeth each), with different surface conditions (conditioned with 40% polyacrylic acid, dry condition, water contamination, saliva contamination, or saliva contamination and air-drying) on the occlusal surface before placement of zinc-reinforced highly viscous glass ionomer cement with the finger-press technique. After sectioning the teeth, they were subjected to SEM analysis, where four in each group underwent aging by thermocycling and the other four were without aging. ANOVA tests, post hoc analysis, and unpaired t-tests were used for statistical analyses. Results: There was a significant statistical difference in the sealant penetration in the non-aging group, but in the aging group, there was no significant statistical difference in the sealant penetration. On other hand, a significant statistical difference was found in the adaptation between all the groups (p < 0.05). Highly viscous zinc-reinforced glass ionomer fissure sealants have better fissure penetration and more intimate adaptation under fissures conditioned with 40% polyacrylic acid and dry surface fissures with no contamination. However, the best penetration and retention after aging were under contaminated fissures with a shiny layer of saliva. Conclusions: The ZRGIC is a highly viscous fluoride-releasing cement, effectively seals fissures by interfering with food lodgment and protecting teeth from caries. It is advisable to restore the fissures with the minimal technique of sensitive fluoride-releasing GIC, particularly in young, uncooperative children, rather than leaving a caries-prone environment.
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Caries Experience and Increment in Children Attending Kindergartens with an Early Childhood Caries Preventive Program Compared to Basic Prophylaxis Measures-A Retrospective Cohort Study. J Clin Med 2022; 11:jcm11102864. [PMID: 35628990 PMCID: PMC9146011 DOI: 10.3390/jcm11102864] [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: 04/06/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
Dental caries constitutes a public health challenge. As preventive strategies are desirable, this retrospective cohort study aimed to assess the caries experience and increment in children attending kindergartens with an early childhood caries (ECC) preventive program (intervention group, IG) compared to basic prophylaxis measures (control group, CG) located in areas of different socioeconomic status (SES) within Marburg (Germany). The long-term caries experience (2009−2019) of these 3−5-year-old kindergarten children was evaluated. For the caries increment, dental records of 2019 were screened for the availability of a minimum of two dental examinations at least 8 months apart. Caries was scored according to the WHO criteria (dmf−t). The data were split by observation period (300−550 and >550 days). Overall, 135 children (Ø 3.7 years) attended IG, and 132 children (Ø 3.6 years) attended CG. After 300−550 days, no significant differences were found between both groups regarding mean caries increment and experience (p > 0.05). After >550 days, IG with low SES exhibited a high caries experience. Fluoride varnish applications could not reduce the caries increment compared to CG in the short-term but slightly decreased the long-term caries experience. Comprehensive ECC prevention measures actively involving parents are needed to overcome the caries burden.
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Gupta D, Rao A, Shenoy R, Suprabha BS. Comparison of clinical effectiveness of conventional and self-etch sealant: a split mouth randomized controlled trial. F1000Res 2022; 11:261. [PMID: 35529283 PMCID: PMC9044499 DOI: 10.12688/f1000research.109584.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Self-etching has been shown to be beneficial compared to the other resin sealants especially in pediatric practice. The present
in-vivo study was designed to clinically evaluate the sealing ability and retention of the self-etching sealant compared to the conventional resin sealant. The aim was to evaluate and compare the retention and marginal integrity of the self-etch and acid etch sealant materials at three, six and twelve-month follow up. Methods: The study was designed as a double blinded, split mouth randomized controlled trial, . In total, 35 children (70 teeth) between 7 and 10 years of age formed part of the study. Group 1 received acid-etch sealant and Group 2 received self-etch sealants. The study participants and the investigator who performed the statistical analysis were blinded to the treatment allocation. All the samples were evaluated at 3, 6, and 12 months. The inter-group and intragroup comparison were carried out using the Chi-Square test and Friedman test with level of significance set at 5% and the P value less than 0.05. Results: Complete retention of sealants was observed in 34.5% of conventional acid etch (group 1) and 22.9% of self-etch samples (group 2) whereas complete loss of sealants were seen in 11.4% of group 1 and 20% of the group 2 samples and intergroup comparison of retention failure was non-significant (p=0.135). In total, 85.7% of the group 1 and 82.9% of the group 2 samples exhibited good marginal integrity with no clinical changes in the enamel around the margins but this was not statistically significant (p=0.5). Conclusions: Sealants with fewer procedural steps and those which provide adequate retention would be ideal for use in children. Thus, self-etch sealants have been found to be effective and efficient as a sealant in the present
in-vivo study. Clinical Trials Registry, India registration: CTRI/2019/03/018343 (29/03/2019).
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Affiliation(s)
- Deveshi Gupta
- Pediatric & Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Arathi Rao
- Pediatric & Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Ramya Shenoy
- Public Health Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
| | - Baranya Srikrishna Suprabha
- Pediatric & Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India
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Alkheraif AA, AlMufareh NA, AlQhtani FA, Asiri W, Abuhadi RI, Hamoud M, Khan AA. Minocycline incorporated cobalt oxide nanoparticles in dental sealants: An in vitro study. Microsc Res Tech 2022; 85:2558-2566. [PMID: 35421274 DOI: 10.1002/jemt.24109] [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: 10/28/2021] [Revised: 02/27/2022] [Accepted: 03/14/2022] [Indexed: 11/07/2022]
Abstract
The purpose of this study was to introduce antibacterial property to pits and fissure sealant (PFS) in order to mitigate the major clinical problems associated with PFS, such as microleakage and secondary caries. We prepared a pH reliant cobalt oxide nanoparticle incorporated with minocycline (MNC@CO) and characterized to investigate its antibacterial potential against Streptococcus sobrinus. The physiochemical, morphological, and drug release kinetics at different pH (7.4, 5.0, and 3.5) from nanoparticles were investigated. The MNC@CO were added at 2.5% and 5.0% into experimental PFS and characterized for their antibiofilm capacity, biocompatibility, and mechanical properties including compressive and flexural strength. The groups 2.5% and 5.0% has shown statistically significant antimicrobial capacity against S. sobrinus compared to control (p < .05). The highest percentage of MNC release at different pH (especially at pH 5.0 and 3.5) was observed from 5.0% MNC@CO doped PFS. The PFS doped with 2.5% MNC@CO showed a highest compressive strength (110 MPa) over a period of 70 days as compared to 5.0% MNC@CO (75 MPa) and control (80 MPa). The flexural strength of both experimental groups was lower for both time points (24 h and 30 days) than control. In conclusion, the present study found that 2.5% MNC@CO doped PFS showed considerable anti-biofilm potential without compromising mechanical properties.
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Affiliation(s)
- Abdulaziz Abdullah Alkheraif
- Dental Biomaterial Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nawaf Abdulrahman AlMufareh
- Department of Pediatric Dentistry and Special Health Care Needs, Abha Specialist Dental Center, Ministry of Health, Abha, Saudi Arabia
| | - Faisal A AlQhtani
- Department of Pediatric Dentistry and Special Health Care Needs, Abha Maternity and Children Hospital, Ministry of Health, Abha, Saudi Arabia
| | - Waleed Asiri
- Department of Restorative Dentistry, Najran University, Najran, Saudi Arabia
| | | | - Majed Hamoud
- Department of Restorative Dentistry, King Faisal Medical City, Abha, Saudi Arabia
| | - Aftab Ahmed Khan
- Dental Biomaterial Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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