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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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Chua SKX, Sim YF, Wang WC, Mok BYY, Yu VSH. One-year outcome of selective caries removal versus pulpotomy treatment of deep caries: A pilot randomized controlled trial. Int Endod J 2023; 56:1459-1474. [PMID: 37795835 DOI: 10.1111/iej.13978] [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: 10/19/2022] [Revised: 07/20/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
AIM This study aimed to compare the outcome of SCR and Pulpotomy in teeth with deep caries extending at least 75% into dentine. METHODOLOGY This two-armed, parallel-group, randomized, superiority trial included vital mature permanent teeth with deep primary or secondary caries diagnosed radiographically as being at least 75% into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were blindly allocated to receive either SCR or Pulpotomy using computer-generated randomized patient codes concealed in opaque envelopes. All teeth were reviewed clinically and radiographically at 6 months and 1 year post-treatment. Using a significance level of p < .05, the log rank test and Cox proportional hazards regression were used to compare the outcome of SCR and Pulpotomy and to identify potential prognostic factors, respectively. RESULTS In all, 58 teeth in the SCR group and 55 teeth in the pulpotomy group completed treatment, after excluding 6 teeth because they did not complete the allocated treatment and another due to severe periodontal disease. At one year, 57/58 (98.3%) teeth from the SCR group and 48/55 (87.3%) teeth from the Pulpotomy group were available for analysis. One tooth in the Pulpotomy group (2.1%) and eight teeth in the SCR group (14.0%) required the further intervention of root canal treatment (p < .05). There were no other significant prognostic factors for survival. Overall, 91.4% of teeth treated with either SCR or Pulpotomy survived without requiring further intervention over a period of one year. No other adverse events occurred over the review period. CONCLUSION Within the limitations of this study, Pulpotomy fares better than SCR in preserving the remaining pulp and periapical health. As a treatment modality, Pulpotomy carries greater cost outlay to patient and takes a longer time to complete treatment than SCR. Long-term follow-up is needed to study the pulpal and restorative outcomes of Pulpotomy and SCR.
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Affiliation(s)
- S K X Chua
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - Y F Sim
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - W C Wang
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - B Y Y Mok
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - V S H Yu
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
- Oral Care Health Innovation and Designs Singapore (ORCHIDS), National University of Singapore, Singapore City, Singapore
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Schwendicke F, Badakhsh P, Marques MG, Demarchi KM, Brant ARR, Moreira CL, Ribeiro APD, Leal SC, Hilgert LA. Subjective versus objective, polymer bur-based selective carious tissue removal: 2-year randomized clinical trial. J Dent 2023; 138:104728. [PMID: 37783372 DOI: 10.1016/j.jdent.2023.104728] [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: 08/17/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVES We aimed to compare subjective (S) selective carious tissue removal using hand instruments versus objective (O) removal using a self-limiting polymer bur in a single-blind cluster-randomized controlled superiority trial. METHODS 115 children (aged 7-8 years) with ≥1 vital primary molar with a deep dentin lesion (>1/2 dentin depth) were included and randomized (60 S/55 O); all eligible molars in a child were treated identically (91 S/86 O). Cavities were prepared and carious tissue on pulpal walls selectively removed using hand instruments (S) or a self-limiting polymer bur (Polybur P1, Komet), followed by restoration using a glass hybrid material (Equia Forte, GC). Treatment time and satisfaction data have been reported in a 1-year-interim report. We here report on 2 year survival (tooth retained with or without further retreatments being needed, or tooth exfoliated), analyzed using multi-level Cox-regression analysis, as well as success (ART criteria 0/1, no pulpal complications, no re-intervention needed, or tooth extraction). RESULTS 71 restorations in S and 65 in O were examined after a mean (SD, range) of 22 (11; 3-31) months, of which 50 S and 48 O restorations were successful and 70 S and 65 O survived. The majority of failures were restorative, not pulpal, and distribution of ART codes was not significant different between groups. Risk of failure was not significantly associated with the removal protocol (HR; 95 % CI: 0.95; 0.51-1.78), and also not age, sex or dental arch, while single surfaced restorations showed significantly lower hazard (0.14; 0.06-0.37). CONCLUSION There was no significant difference in success or survival between objective and subjective carious tissue removal. CLINICAL SIGNIFICANCE In primary teeth, subjective selective excavation had no disadvantage compared with objective excavation, which required a separate instrument (polymer-based bur) for carious tissue removal. Polymer-based burs may be particularly useful when standardized excavation is needed.
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Affiliation(s)
- Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité- Universitätsmedizin, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - Puya Badakhsh
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité- Universitätsmedizin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Marta Gomes Marques
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
| | | | | | - Cláudia Lúcia Moreira
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
| | - Ana Paula Dias Ribeiro
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil; Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, United States
| | - Soraya Coelho Leal
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
| | - Leandro Augusto Hilgert
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
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Elkady DM, Khater AGA. Knowledge and attitudes toward evidence-based cariology and restorative dentistry among Egyptian dental practitioners: a cross-sectional survey. BMC Oral Health 2023; 23:622. [PMID: 37658399 PMCID: PMC10474780 DOI: 10.1186/s12903-023-03333-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: 06/13/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND This is the first study to assess Egyptian dental practitioners' knowledge about conservative caries management approaches and investigate whether this knowledge transfers into clinical practice and the barriers to translating research into evidence-based practice. METHODS A sample of dental practitioners was surveyed using an online questionnaire. Convenience and snowball sampling were used to collect data from February to June 2022. We included graduated dentists from Egyptian universities who practiced in Egypt. Data were analyzed with descriptive statistics, and the associations between variables were checked using Kruskal Wallis and Chi-Square tests. RESULTS This study included 396 participants from throughout Egypt. There were significant correlations between specialty and participants' knowledge and behaviors toward evidence-based caries management (p = 0.002) and between specialization and tools used to detect carious lesions (p < 0.001). Most participants (59.1%) used G.V Black's classification, and (80.8%) removed caries based on the feature of dentin hardness and color, whereas (67%) removed caries until hard dentine remained. The participants' primary hurdle to staying up-to-date was their belief that the newly gained information would not be clinically applicable due to a lack of equipment or working in low-economic areas. Patient-related barriers were the major obstacles for participants in implementing evidence-based practice. CONCLUSION Egyptian dentists did not fully embrace minimal invasive approaches for caries management, and practitioners' experiences continue to shape decision-making. It emphasizes the imperative to practically educate dentists using effective knowledge translation dissemination to promote evidence adoption in daily practice and advocate value-based dental care to address the economic crisis's impact on Egypt's healthcare.
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Affiliation(s)
- Dina M Elkady
- Conservative Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Ahmad G A Khater
- Health Affairs Directorate, Egyptian Ministry of Health and Population, Banisuif, 62511, Egypt.
- Faculty of Oral and Dental Medicine, Ahram Canadian University, Giza, Egypt.
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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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Hatipoğlu Ö, Pertek Hatipoğlu F, Javed MQ, Nijakowski K, Taha N, El-Saaidi C, Sugumaran S, Elhamouly Y, Drobac M, Machado R, Abdullah T, Kobayashi H, Alfirjani S, Abidin IZ, Martín B, Maira K, Lim WY, Palma PJ, Martins JFB. Factors Affecting the Decision-Making of Direct Pulp Capping Procedures Amongst Dental Practitioners: A Multinational Survey from 16 Countries with Meta-Analysis. J Endod 2023:S0099-2399(23)00215-7. [PMID: 37094712 DOI: 10.1016/j.joen.2023.04.005] [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: 02/28/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had three purposes: i) to investigate the factors that affect clinicians' decisions in DPC cases, ii) to determine which method of caries removal is preferred, and iii) to evaluate the preferred capping material for DPC. METHODS The questionnaire comprised three sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure and patients' age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. RESULTS A tendency towards more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR=2.86, 95% CI:2.46,2.32; p<0.001) as opposed to the clinical scenario with two pulp exposures (RR=1.38, 95% CI:1.24,1.53; p<0.001). Complete caries removal was significantly preferred to selective caries removal (RR=4.59, 95% CI: 3.70, 5.69; p<0.001). Among the capping materials, calcium silicate-based materials (CS) were preferred over calcium hydroxide-based materials (CH) (RR=0.58, 95% CI: 0.44,0.76; p<0.05). CONCLUSION While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of CS appears to have replaced CH.
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Affiliation(s)
- Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Turkey.
| | | | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Saudi Arabia.
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poland.
| | - Nessrin Taha
- Department of Conservative Dentistry, Jordan University of science and Technology Irbid, Jordan.
| | | | - Surendar Sugumaran
- Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamilnadu, India.
| | - Yasmine Elhamouly
- Pediatric Dentistry Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Egypt.
| | - Milan Drobac
- Department of Conservative Dentistry and Endodontics, Faculty of Medicine, University of Novi Sad, Serbia.
| | - Ricardo Machado
- Clinical practice limited to Endodontics, Navegantes, Santa Catarina, Brazil.
| | - Thiyezen Abdullah
- Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Qassim University, Saudi Arabia.
| | - Hiro Kobayashi
- Department of Removable Partial Prosthodontics, Tokyo Dental College, Japan.
| | - Suha Alfirjani
- Department of Conservative Dentistry and Endodontics, Dental school/university of Benghazi, Libya.
| | | | - Benjamín Martín
- Department of Conservative Dentistry, Universidade de Santiago de Compostela (USC), Spain.
| | - Kopbayeva Maira
- Department of Conservative Dentistry and Endodontics, Kazakh National Medical University Asfendiyarov, Kazakhstan.
| | - Wen Yi Lim
- Restorative Department, National Dental Centre Singapore, Singapore.
| | - Paulo J Palma
- Endodontic Institute, Faculty of Medicine, University of Coimbra, Portugal.
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Al-Ali M, Camilleri J. The scientific management of deep carious lesions in vital teeth using contemporary materials—A narrative review. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.1048137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
AimThe aim of this article is to review the scientific evidence for deep caries removal in permanent vital teeth and the choice of dentine replacement material and restoration of the teeth to maintain long term tooth vitality and function.MethodThe two position statements namely the European Society of Endodontology and the American Association of Endodontists position statements on vital pulp therapy will be scrutinized and compared with regards to the deep caries removal strategy and assessed for evidence of best practice. The properties of materials used to manage vital pulps and the best way to restore the teeth will be reviewed and guidance on the full management of vital teeth will be suggested.ConclusionsPromoting new treatment modalities for reversible and irreversible pulpitis allowing for pulp preservation should be considered. Although debatable, cases with deep caries should be managed by complete non-selective caries removal which will allow for pulpal management if needed and a more predictable outcome can be expected when using the new materials and treatment modalities of vital pulp therapy.
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Influence of the chemomechanical and mechanical carious tissue removal on the risk of restorative failure: a systematic review and meta-analysis. Clin Oral Investig 2022; 26:6457-6467. [DOI: 10.1007/s00784-022-04695-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/18/2022] [Indexed: 12/01/2022]
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Bratu DC, Nikolajevic-Stoican N, Popa G, Pop SI, Dragoș B, Luca MM. A Bibliometric Analysis (2010-2020) of the Dental Scientific Literature on Chemo-Mechanical Methods of Caries Removal Using Carisolv and BRIX3000. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060788. [PMID: 35744051 PMCID: PMC9231379 DOI: 10.3390/medicina58060788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/31/2022] [Accepted: 06/08/2022] [Indexed: 11/30/2022]
Abstract
Reports in the literature have proposed and analyzed several minimally invasive techniques for caries removal in recent decades. In light of recent events surrounding the ongoing epidemiological context, concerns have been raised regarding the generation of aerosols during dental procedures. The aim of our research was to provide an overview of the scientific literature on the topic of chemo-mechanical caries removal (CMCR) methods, focusing on two products (Carisolv, BRIX3000), commercially available in Europe. A bibliometric analysis was used to investigate the scientific articles included in Web of Science (WoS) Core Collection database, published from January 2010 to December 2020. We analyzed the co-occurrence of all keywords (Author Keywords and the KeyWords Plus section), co-authorship and co-citation, using the free software VOSviewer. Our bibliometric analysis revealed a worldwide interest in the subject of chemo-mechanical methods of caries removal, which has transcended the area of pediatric dentistry. The analyzed studies have been conducted mainly in high-income countries that have developed sanitary policies regarding prevention and early treatment of carious lesions as a health priority.
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Affiliation(s)
- Dana Cristina Bratu
- Department of Orthodontics and Dento-Facial Orthopedics, Orthodontic Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
| | - Nicoleta Nikolajevic-Stoican
- Department of Pediatric Dentistry, Pediatric Dentistry Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (N.N.-S.); (M.-M.L.)
| | - George Popa
- Department of Orthodontics and Dento-Facial Orthopedics, Orthodontic Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
- Correspondence: (G.P.); (S.I.P.)
| | - Silvia Izabella Pop
- Department of Orthodontics, Faculty of Dental Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania
- Correspondence: (G.P.); (S.I.P.)
| | - Bianca Dragoș
- Research Center in Dental Medicine Using Conventional and Alternative Technologies, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 9 Revolutiei 1989 Avenue, 300070 Timisoara, Romania;
| | - Magda-Mihaela Luca
- Department of Pediatric Dentistry, Pediatric Dentistry Research Center, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (N.N.-S.); (M.-M.L.)
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Chu H, Kang B, Youn BY, Kim KI, Park J, Leem J. Comprehensive traditional East Asian medicine treatment strategy for obesity considering the therapeutic effects and adverse events: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2022; 101:e28673. [PMID: 35147089 PMCID: PMC8830816 DOI: 10.1097/md.0000000000028673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Obesity has become a serious global health problem due to its increasing prevalence. Because of several limitations or adverse events associated with conventional western medicine therapies, there has been an increase in demand for alternative therapies such as traditional East Asian medicine (TEAM). This study aims to provide comprehensive evidence-based information assessing the clinical efficacy and safety of TEAM treatment for obesity as the basis for reliable clinical strategies for patients with obesity. METHODS Electronic searches of the PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, OASIS, and Korea Citation Index will be performed. Methodological quality will be assessed using the "risk of bias" tool. The primary outcome for efficacy will be weight loss. The secondary outcomes will be response rate, body mass index, waist circumference, and blood pressure. We will also evaluate the rates of adverse events and mortality for safety assessment. First, we will conduct a conventional pairwise meta-analysis. Next, we will conduct network meta-analysis using the frequentist approach. We shall verify the assumption of network meta-analysis and provide network geometry, P-score, net league table, and intervention-based forest plot. A subgroup analysis will be conducted to ascertain the factors that affect treatment, such as dosage, treatment duration, and severity of obesity. RESULTS The results of this study will provide high-quality systematic reviews that can assist decision making in obesity management. Our network meta-analysis results can provide direct and indirect comparison evidence on comparative efficacy and safety. CONCLUSION This study will provide fundamental data for prospective research on the application of TEAM in patients with obesity. PROTOCOL REGISTRY NUMBER OF ONLINE REGISTRY This study protocol was registered in open Science framework (OSF) (Registration DOI: 10.17605/OSF.IO/ETWDS). URL OF THE ONLINE REGISTRY https://osf.io/etwds.
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Affiliation(s)
- Hongmin Chu
- Daecheong Public Health Subcenter, 3, Daecheong-ro, Daecheong-myeon, Ongjin-gun, Incheon, Republic of Korea
| | - Byungsoo Kang
- College of Korean Medicine, Dongshin University, 67, Dongsindae-gil, Naju-si, Jeollanamdo, Republic of Korea
| | - Bo-Young Youn
- Department of Preventive Medicine, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Seoul, Republic of Korea
| | - Kwan-il Kim
- Division of Allergy, Immune Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jinbong Park
- Department of Pharmacology, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Jungtae Leem
- Research Center of Traditional Korean Medicine, Wonkwang University, 460, Iksan-daero, Sin-dong, Iksan, Jeollabuk-do, Republic of Korea
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Souza TF, Martins ML, Magno MB, Vicente-Gomila JM, Fonseca-Gonçalves A, Maia LC. Worldwide research trends on the use of chemical-mechanical caries removal products over the years: a critical review. Eur Arch Paediatr Dent 2022; 23:869-883. [PMID: 35831699 PMCID: PMC9281217 DOI: 10.1007/s40368-022-00726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 06/08/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Chemical-mechanical caries removal (CMCR) products are in constant evolution and were recommended during the COVID-19 pandemic as substitutes for conventional caries removal. AIM Characterize the worldwide scientific literature about CMCR products, over the years, by means of a critical review. DESIGN Electronic search was performed on Medline/PubMed, Scopus, Web of Science, Cochrane Library, Lilacs, and Embase up to November 2020. Year, journal, country of authors, and type of study were the data extracted from the retrieved studies. Additional data of the clinical studies and systematic reviews were investigated. RESULTS 2221 records were identified, 397 selected. 2011-2020 period concentrates higher number of publications (n = 169), in the Journal of Dental Research (n = 51), developed in Brazil (n = 45) and India (n = 44). Most studies were in vitro (n = 211) and clinical trials (n = 101). Carisolv™ (n = 48) and Papacarie Duo Gel™ (n = 33) were the most used products, prescript in isolated usage (n = 101), and compared with drills (n = 77). CMCR were more studied in primary teeth (n = 78), receiving glass ionomer cement (GIC) (n = 51) as restorative material. The most evaluated outcomes were time spent (n = 48) and pain (n = 41). Clinical application of CMCR takes more time than other techniques, but can also reduce patient anxiety, pain, and need for anesthesia. CONCLUSION In vitro and clinical studies with CMCR products have been increasing, mostly carried out in developing countries, evaluating Carisolv™ and Papacarie Duo Gel™. Clinical studies tend to evaluate the time spent and pain compared to drills for removing caries in primary teeth, posteriorly restored with GIC. CMCR clinical application reduces anxiety, pain, and need for anesthesia, despite increase treatments' time.
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Affiliation(s)
- T. F. Souza
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - M. L. Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - M. B. Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - J. M. Vicente-Gomila
- Department of Corporate Management, ESIC Business and Marketing School, Pozuelo, Madrid, Spain
| | - A. Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
| | - L. C. Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro, Rua Professor Rodolpho Paulo Rocco, 325-Cidade Universitária, Rio de Janeiro, RJ CEP 21941-971 Brazil
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Moran BM, Ziegelmann PK, Berger SB, Burey A, de Paris Matos T, Fernández E, Loguercio AD, Reis A. Evaluation of Tooth Sensitivity of In-office Bleaching with Different Light Activation Sources: A Systematic Review and a Network Meta-analysis. Oper Dent 2021; 46:E199-E223. [PMID: 35486507 DOI: 10.2341/20-127-l] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVES A systematic review and network meta-analysis were performed to answer the following research question: Are there differences in the risk and the intensity of tooth sensitivity (TS) among eight light activation systems for in-office bleaching in adults? METHODS Randomized controlled trials (RCTs) that compared at least two different in-office bleaching light activations were included. The risk of bias (RoB) was evaluated with the RoB tool version 1.0 from the Cochrane Collaboration tool. A random-effects Bayesian mixed treatment comparison (MTC) model was used independently for high- and low-concentration hydrogen peroxide. The certainty of the evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. A comprehensive search was performed in PubMed, Bridge Base Online (BBO), Latin American and Caribbean Health Sciences Literature database (LILACS), Cochrane Library, Scopus, Web of Science, and grey literature without date and language restrictions on April 23, 2017 (updated on September 26, 2019). Dissertations and theses, unpublished and ongoing trials registries, and IADR (International Association for Dental Research) abstracts (2001-2019) were also searched. RESULTS After title and abstract screening and the removal of duplicates, 32 studies remained. Six were considered to be at low RoB, three had high RoB, and the remaining had an unclear RoB. The MTC analysis showed no significant differences among the treatments in each network. In general, the certainty of the evidence was graded as low due to unclear RoB and imprecision. CONCLUSION There is no evidence that the risk and intensity of TS are affected by light activation during in-office bleaching.
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Affiliation(s)
- B M Moran
- *Bianca M Maran, DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, State University of Western Paraná, Cascavel, Paraná, Brazil; Postgraduate Program in Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná, Brazil
| | - P K Ziegelmann
- Patrícia K Ziegelmann, DDS, MS, PhD, associate professor, Statistics Department and Post-Graduation Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - S B Berger
- Sandrine Bittencourt Berger DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, University of North Paraná, Londrina, Paraná
| | - A Burey
- Adrieli Burey, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - T de Paris Matos
- Thalita de Paris Matos, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - E Fernández
- Eduardo Fernández, DDS, MS, PhD, professor, Department Restorative Dentistry, University of Chile, Santiago de Chile, Chile; Professor, Universidad Autónoma de Chile, Instituto de Investigaciones Biomédicas, Santiago de Chile Chile
| | - A D Loguercio
- Alessandro D Loguercio, DDS, MS, PhD, adjunct professor, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
| | - A Reis
- Alessandra Reis, DDS, MS, PhD, adjunctive professor, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, PR, Brazil
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Dong SL, Jiao Y, Yang HL. Effectiveness of bisphosphonates on bone mineral density in osteopenic postmenopausal women: A systematic review and network meta-analysis of randomized controlled trials. Medicine (Baltimore) 2021; 100:e26715. [PMID: 34397808 PMCID: PMC8341242 DOI: 10.1097/md.0000000000026715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 07/01/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Various bisphosphonate agents have been proven to be effective in preventing bone loss and fracture in osteopenic postmenopausal women. This study was designed to compare the effectiveness of various BPs on preventing the loss of bone mineral density (BMD) for postmenopausal women with osteopenia. METHODS PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were screened up to identify randomized controlled trails comparing effectiveness of BPs or placebo on the BMD of postmenopausal women with osteopenia. Network meta-analysis and standard pair-wise meta-analyses were performed. The main outcomes include the percentage changes of 6-, 12-, 24-, and 36-month BMD at lumbar, total hip and femoral neck, and frequencies of new fractures and severe adverse events. RESULTS Fourteen randomized controlled trials were eligible, involving 11,540 participants. No significant difference was presented among the available interventions for the 6-month BMD at 3 different sites, but the magnitudes of differences among the treatment regimens became gradually increased along with the extending of follow-up periods. Daily aledronate of more than 5 mg provided the maximal percentage increase on BMD of femoral neck and lumbar spine, while zoledronate provided maximal change on BMD of total hip, at different follow-up periods. This network meta-analysis also demonstrated similar frequencies of new clinical fractures and severe adverse events among different interventions. CONCLUSIONS A ranking spectrum depicting the effectiveness on BMD percentage change following interventions with different bisphosphonate regimens was provided. Generally, regimens with zoledronate and aledronate were found to be the most effective interventions in the 3 sites at different end points.
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BRIX3000® Papain Gel for Cavity Treatment in the Adult Patient. Case Rep Dent 2021; 2021:6624825. [PMID: 34194848 PMCID: PMC8214488 DOI: 10.1155/2021/6624825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 05/25/2021] [Indexed: 11/17/2022] Open
Abstract
Tooth decay is a multifactorial disease. Fermentable sugar, host factors, and cariogenic microbial flora are several agents that influence dental structure. In literature, alternative protocols for treating cavities are always of interest in terms of reducing pain and preserving tissue. In this case report, the use of a new gel-based on papain, which has a chemical effect on bacteria and allows the consistency of the altered tissue to be modified, leads to a less traumatic removal of the infected tissue. In this case report, BRIX3000, a gel with papain as its main ingredient, was used to treat an interproximal cavity on an upper premolar of a 35-year-old man frightened of the turbine. After a clinical check of all the systematic conditions and a first view of the oral cavity, the protocol was explained to the patient, and informed consent was obtained. The protocol involved applying the papain gel directly to the cavity, and after 2.5–3 minutes, it was removed. The complete removal of the infected tissue was achieved in three steps. The patient reported no discomfort, and the cavity was completely treated and ready to be restored. In conclusion, BRIX3000 seems to be a good alternative to the turbine in cavity treatment, particularly in patients who have discomfort during traditional treatments and are frightened of the turbine.
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Phonghanyudh A, Thana-olarn C, Teanchai C, Jirarattanasopha V. Microhardness of sub-restoration dentine in primary molars after carious tissue removal to soft and firm dentine. PEDIATRIC DENTAL JOURNAL 2021. [DOI: 10.1016/j.pdj.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Schmidt J, Krohn S, Kallies R, Schneider H, Zeller K, Ziebolz D, Berg T, Haak R. Antibacterial effect of a brominated self-etch adhesive on carious dentin - An in vivo study. J Dent 2020; 105:103555. [PMID: 33346060 DOI: 10.1016/j.jdent.2020.103555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/28/2020] [Accepted: 12/08/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This in vivo study compared the antibacterial effect of a self-etch adhesive with and without the brominated monomer 12-methacryloyloxydodecyl-pyridinium bromide (MDPB) on carious dentin after selective caries removal. METHODS 10 patients showing deep primary carious lesions at two posterior teeth without pulpal symptoms were included. At visit I, carious tissue was selectively removed and carious dentin was sampled with a sterile roundbur (Komet No. 18). One cavity was restored with composite (SDR, Ceram X; DENTSPLY DeTrey) using an MDPB-containing self-etch adhesive (Clearfil Protect Bond, Kuraray Noritake; PB). The other restoration served as a control (Clearfil SE Bond II, Kuraray Noritake; SE). At visit II after 8 weeks, carious dentin was sampled again. Bacterial growth in carious dentin was differentiated using microbial cultivation. Bacterial DNA from intact cells and cell-free DNA were quantified using 16S rRNA gene-based real-time PCR and the microbial community composition was analyzed by amplicon deep-sequencing. Wilcoxon test was applied for statistical analysis. RESULTS Both treatments showed a decrease of intact bacterial cells in carious dentin at visit II compared to visit I (PB: visit I: 1.1*106, visit II: 1.7*105 (p = 0.03); SE: visit I: 1.1*107, visit II = 2.4*105 (p = 0.002)). No statistically significant reduction of cell-free bacterial DNA was detected (PB: visit I: 6.1*105, visit II: 1.6*105 (p = 0.08); SE: visit I: 5.3*105, visit II: 2.9*105 (p = 0.10)). The decrease of intact cell-derived (p = 0.371) and cell-free DNA (p = 0.455) did not differ significantly between PB and SE. Lactobacillus was most abundant within the microbial community at both visits. Alpha-diversity was not affected by treatment and samples showed high intra- and interindividual diversity. CONCLUSION AND CLINICAL SIGNIFICANCE Both self-etch adhesives have an antibacterial effect due to a decrease of bacterial DNA after selective caries removal. However, the results do not reveal any additional antibacterial effect by MDPB. The study is registered with the German Clinical Trials Register (DRKS00011532).
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Affiliation(s)
- Jana Schmidt
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| | - Sandra Krohn
- Medical Department II Gastroenterology, Hepatology, Infectious Diseases, Pneumology, Section Hepatology, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, Germany
| | - René Kallies
- Department of Environmental Microbiology, Helmholtz Centre for Environmental Research - UFZ, Permoserstr. 15, 04318 Leipzig, Germany
| | - Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - Katharina Zeller
- Medical Department II Gastroenterology, Hepatology, Infectious Diseases, Pneumology, Section Hepatology, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
| | - Thomas Berg
- Medical Department II Gastroenterology, Hepatology, Infectious Diseases, Pneumology, Section Hepatology, University Hospital Leipzig, Liebigstr. 20, 04103 Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany
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Mazur M, Jedlinski M, Vozza I, Pasqualotto D, Nardi GM, Ottolenghi L, Guerra F. Correlation between Vista Cam, ICDAS-II, X-ray bitewings and cavity extent after lesion excavation: an in-vivo pilot study. MINERVA STOMATOLOGICA 2020; 69:343-348. [PMID: 32278341 DOI: 10.23736/s0026-4970.20.04341-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND To correlate fluorescence-based camera (FC), visual inspection (ICDAS-II) and radiographic examination X-rays bitewings (BW) to the extent of caries after excavation. METHODS The occlusal sites of 20 permanent first and second molars in 14 young adolescents (12±2 years old) were examined at 1st Observation Unit of Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome. All the enrolled patients were asked to provide with X-rays bitewing of the studied teeth. The assessment of ICDAS-II and FC was performed by a trained operator. Then a second blind operator removed the carious lesion and evaluated the cavity extent (depth, width, length) after caries removal with a calibrated probe. To correlate FC measurements with bitewing sensitivity, 10 dentists evaluated the presence/absence of caries on the X-rays. RESULTS All the occlusal sites assessed by fluorescence camera, ranged from 1.7 to 2, indicating in all cases deep enamel lesions with possible extent to dentine with a mean of 1.7±0. In accordance, visual inspection by ICDAS-II showed scores of 3 and 4. By contrast, the radiographic documentation, i.e. bitewing X-rays, was evaluated in only 6 cases as presence of caries. The extent of the cavities was determined by three consecutive measurements: depth, width and length, with a mean of 3.5+1.73, 2.8+1.07 and 3.2+1.64 mm respectively. These results confirmed the agreement between FC and ICDAS-II for diagnosis of cavities with extent to enamel and dentine, while showed the low sensitivity of bitewings X-rays, in accordance with the existing evidence in Literature. Moreover, the results of this study for the first time provide information about the cavity extent after caries removal for the occlusal sites with ICDAS-II 3 and 4 scores and FC≥1.7. CONCLUSIONS X-rays evaluation showed diagnostic accuracy in 6% of the sample. VistaCam measurement of 1.7 was correlated to a cavity with 3.5, 2.8 and 3.2 mm of depth, width and length.
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Affiliation(s)
- Marta Mazur
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy -
| | - Maciej Jedlinski
- Department of Interdisciplinary Dentistry, Pomeranian Medical University, Szczecin, Poland
| | - Iole Vozza
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Debora Pasqualotto
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Gianna M Nardi
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Livia Ottolenghi
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
| | - Fabrizio Guerra
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
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Shashirekha G, Jena A, Mohanty N, Kamilla SK. Novel bioactive caries-detecting dye solution: Cytotoxicity, antimicrobial activity, scanning electron microscope, and stereomicroscopic analysis in diagnosis of dental caries. J Conserv Dent 2020; 23:79-85. [PMID: 33223647 PMCID: PMC7657426 DOI: 10.4103/jcd.jcd_154_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/25/2020] [Accepted: 07/03/2020] [Indexed: 12/01/2022] Open
Abstract
Aim The aim was (1) to study the cytotoxicity of novel Bioactive Caries-detecting Dye solution (BCD) and its antimicrobial activity against Streptococcus mutans, Lactobacillus acidophilus, Actinomyces naeslundii, and Candida albicans and (2) comparative assessment of BCD and Carie-Care for efficient removal of caries (stereomicroscope) and dentin tubule occlusion (scanning electron microscope [SEM]). Materials and Methods For BCD cytotoxic study (direct contact method), colorimetric MTT assay, and cell line study(L929 mouse fibroblast NCTC clone 929 strain L) was performed. Xenetix 350, chitosan, nanohydroxyapatite (nHA), BCD, and Carie-Care solutions were subjected to the antimicrobial activity through blood agar well diffusion method, and the minimum inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were determined. On 20 extracted human carious teeth a comparative pilot study was done for BCD (Group A, n = 10) and Carie-Care (Group B, n = 10), and evaluated visually and radiographically. After mechanical excavation of caries with a spoon excavator, teeth sectioned longitudinally and stereomicroscopically were evaluated (8x–40x) by two observers. The percentage of dentinal tubule occlusion was evaluated with SEM for both solutions. Statistical kappa analysis of agreement was 0.7–0.8 (P < 0.01). Mann–Whitney test ranks and Wilcoxon signed-rank test (P = 0.01) were applied. Results Cytotoxicity test revealed BCD to be nontoxic and biocompatible. Antimicrobial tests (zone of inhibition) showed BCD > chitosan > chlorhexidine > Carie-Care > Xenetix 350 > nHA. MIC and MBC values suggested chlorhexidine > BCD > Carie-Care. Stereomicroscopic analysis showed effective mechanical removal of caries in BCD without residual dye in the dentinal tubules as compared to Carie-Care. Dentinal tubule occlusion (SEM analysis) was 80%–85% for BCD and 10% for Carie-Care. Conclusions Profound synergistic effect for BCD was observed with advantage of radiographic assessment.
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Affiliation(s)
- Govind Shashirekha
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, India
| | - Amit Jena
- Department of Conservative Dentistry and Endodontics, Sriram Chandra Bhanja Dental College and Hospital, Cuttack, Odisha, India
| | - Neeta Mohanty
- Department of Oral Pathology and Microbiolgy, Institute of Dental Sciences, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, India
| | - Sushanta Kumar Kamilla
- Department of Physics, Institute of Technical Education and Research, Siksha 'O' Anusandhan (Deemed to be University), Bhubaneswar, India
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Scholz KJ, Hinderberger M, Widbiller M, Federlin M, Hiller KA, Buchalla W. Influence of selective caries excavation on marginal penetration of class II composite restorations in vitro. Eur J Oral Sci 2020; 128:405-414. [PMID: 32749026 DOI: 10.1111/eos.12726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Abstract
Selective caries excavation may support pulp preservation. This in vitro study investigated the influence of selective removal of demineralized dentin on marginal integrity of composite restorations as determined by dye penetration. Dentinal caries-like lesions were produced in the approximal surfaces of 40 extracted human molars (ethylenediaminetetraacetate, 0.5 M, 96 h). The following test procedures were established: complete excavation, selective excavation, and caries-free control. Two class II cavities with enamel at the cervical margins were prepared per tooth and demineralization volume was determined by micro-computed tomography for the purpose of a stratified distribution to receive complete excavation or selective excavation. After complete or selective excavation (30 cavities each), adhesive composite restorations were placed. Cavities without demineralized dentin (20 cavities) served as control. The marginal integrity of restorations was evaluated by dye penetration with and without thermocycling or mechanical loading. Results were analyzed by non-parametrical statistical tests (Mann-Whitney U Test) with an α = 0.05 level of significance. Dye penetration did not differ significantly among completely excavated, selectively excavated, or undemineralized teeth, but was increased by thermocycling and mechanical loading in all experimental groups. Selective caries removal did not increase marginal penetration in class II restorations. The presence of remaining demineralized dentin surrounded by sound dentin did not impair marginal integrity of restorations with margins placed in sound enamel.
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Affiliation(s)
- Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Michael Hinderberger
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Marianne Federlin
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
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Subjective versus objective, polymer bur-based selective carious tissue removal: 1-year interim analysis of a randomized clinical trial. Sci Rep 2020; 10:9130. [PMID: 32499552 PMCID: PMC7272648 DOI: 10.1038/s41598-020-66074-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 05/08/2020] [Indexed: 11/08/2022] Open
Abstract
We aimed to compare subjective (S) vs. objective (O) selective carious tissue removal using hand-excavation versus a self-limiting polymer bur, respectively. A community-based single-blind cluster-randomized controlled superiority trial was performed. This is a 1-year-interim analysis. 115 children (age 7-8 years) with ≥1 vital primary molar with a deep dentin lesion (>1/2 dentin depth) were included (60 S/55 O). The cluster was the child, with eligible molars being treated identically (91 S/86 O). Cavities were prepared and carious tissue on pulpo-proximal walls selectively removed using hand instruments (S), or a self-limiting polymer bur (Polybur P1, Komet). Cavities were restored using glass-hybrid material (Equia Forte, GC). Treatment times and children's satisfaction were recorded. Generalized-linear models (GLM) and multi-level Cox-regression analysis were applied. Initial treatment times were not significantly different between protocols (mean; 95%CI S: 433; 404-462 sec; O: 412; 382-441 sec; p = 0.378/GLM). There was no significant difference in patients' satisfaction (p = 0.164). No pulpal exposures occurred. 113 children were re-examined. Failures occurred in 22/84 O-molars (26.2%) and 26/90 S-molars (28.9%). Pulpal complications occurred in 5(6%) O and 2(2.2%) S molars, respectively. Risk of failure was not significantly associated with the removal protocol, age, sex, dental arch or tooth type (p > 0.05/Cox), but was nearly 5-times higher in multi-surface than single-surface restorations (HR: 4.60; 95% CI: 1.70-12.4). Within the limitations of this interim analysis, there was no significant difference in treatment time, satisfaction and risk of failure between O and S.
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MİTOVA N, RASHKOVA M, LAZAROVA Z, GATEVA N. Using a dental operating microscope in the treatment of reversible pulpitis in primary teeth. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.643952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Lainović T, Margueritat J, Martinet Q, Dagany X, Blažić L, Pantelić D, Rabasović MD, Krmpot AJ, Dehoux T. Micromechanical imaging of dentin with Brillouin microscopy. Acta Biomater 2020; 105:214-222. [PMID: 31988041 DOI: 10.1016/j.actbio.2020.01.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 01/10/2023]
Abstract
The structure of teeth can be altered by diet, age or diseases such as caries and sclerosis. It is very important to characterize their mechanical properties to predict and understand tooth decay, design restorative dental procedures, and investigate their tribological behavior. However, existing imaging techniques are not well suited to investigating the micromechanics of teeth, in particular at tissue interfaces. Here, we describe a microscope based on Brillouin light scattering (BLS) developed to probe the spectrum of the light scattered from tooth tissues, from which the mechanical properties (sound velocity, viscosity) can be inferred with a priori knowledge of the refractive index. BLS is an inelastic process that uses the scattering of light by acoustic waves in the GHz range. Our microscope thus reveals the mechanical properties at the micrometer scale without contact with the sample. BLS signals show significant differences between sound tissues and pathological lesions, and can be used to precisely delineate carious dentin. We also show maps of the sagittal and transversal planes of sound tubular dentin that reveal its anisotropic microstructure at 1 µm resolution. Our observations indicate that the collagen-based matrix of dentine is the main load-bearing structure, which can be considered as a fiber-reinforced composite. In the vicinity of polymeric tooth-filling materials, we observed the infiltration of the adhesive complex into the opened tubules of sound dentine. The ability to probe the quality of this interfacial layer could lead to innovative designs of biomaterials used for dental restorations in contemporary adhesive dentistry, with possible direct repercussions on decision-making during clinical work. STATEMENT OF SIGNIFICANCE: Mechanical properties of teeth can be altered by diet, age or diseases. Yet existing imaging modalities cannot reveal the micromechanics of the tooth. Here we developed a new type of microscope that uses the scattering of a laser light by naturally-occurring acoustic waves to probe mechanical changes in tooth tissues at a sub-micrometer scale without contact to the sample. We observe significant mechanical differences between healthy tissues and pathological lesions. The contrast in mechanical properties also reveals the microstructure of the polymer-dentin interfaces. We believe that this new development of laser spectroscopy is very important because it should lead to innovative designs of biomaterials used for dental restoration, and allow delineating precisely destructed dentin for minimally-invasive strategies.
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Verdugo-Paiva F, Zambrano-Achig P, Simancas-Racines D, Viteri-García A. Selective removal compared to complete removal for deep carious lesions. Medwave 2020; 20:e7758. [PMID: 31999678 DOI: 10.5867/medwave.2020.01.7758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/28/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Dental caries have been conventionally managed by non-selective removal of carious tissue (total complete removal); however, the adverse effects of this procedure have promoted the use of conservative caries removal techniques (selective removal), but there is still controversy regarding its effectiveness. METHODS We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified seven systematic reviews including seven studies overall, of which all were randomized trials. We concluded that selective caries removal may decrease the need for root canal treatment and the risk of pulp exposure in teeth with deep caries, but the certainty of the evidence is low. It is not clear whether the selective removal of caries reduces the risk of appearance of signs and symptoms of pulp disease and the risk of restorations failure, as the certainty of the evidence is very low.
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Affiliation(s)
- Francisca Verdugo-Paiva
- Centro Evidencia UC, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile. ORCID: 0000-0003-0199-9744
| | - Paula Zambrano-Achig
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos, Santiago, Chile. ORCID: 0000-0003-3632-4296
| | - Daniel Simancas-Racines
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos, Santiago, Chile. ORCID: 0000-0002-3641-1501
| | - Andrés Viteri-García
- Universidad UTE, Facultad de Ciencias de la Salud Eugenio Espejo, Centro de Investigación de Salud Pública y Epidemiología Clínica (CISPEC); Proyecto Epistemonikos, Santiago, Chile. Address: Centro Evidencia UC, Pontificia Universidad Católica de Chile, Diagonal Paraguay 476, Santiago, Chile. . ORCID: 0000-0003-0393-2404
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Chai B, Tay B, Chow C, Fuss J, Krishnan U. Treatment preferences for deep caries lesions among Australian dentists. Aust Dent J 2020; 65:83-89. [PMID: 31773749 DOI: 10.1111/adj.12740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND There is a global disparity in managing deep caries lesions and evidence-based strategies are not always followed. The aim of this study was to gain insight into current practices of Australian dentists for deep caries management and to determine their procedural and materials choices. METHODS An online questionnaire was sent to 1988 randomly selected practitioners across Australia asking their choice of treatment in a tooth showing symptoms of reversible pulpitis and deep caries. A total of 255 (12.6%) practitioners responded. RESULTS About 85% of respondents chose selective caries removal to selective removal (SR) while 15% chose non-selective removal to hard dentine. Respondents whose preferred approach was SR had greater odds in believing that incomplete caries removal alone would not have any effect on pulp vitality (OR = 5.20) and had greater odds of thinking that peripheral seal was more important than other factors (OR = 3.50). They also had lesser odds of believing that placing a liner would reduce postoperative sensitivity (OR = 0.269) and lesser odds of thinking that removal of all bacteria or carious dentine was important when placing a restoration (OR = 0.196). CONCLUSION Most Australian dentists reported practising evidence-based carious tissue removal strategies and accepted the concept of selectively leaving carious dentine under a sealed restoration.
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Affiliation(s)
- Byy Chai
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Byx Tay
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Cyt Chow
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - J Fuss
- Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - U Krishnan
- School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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AlHumaid J. Efficacy and Efficiency of Papacarie versus Conventional Method in Caries Removal in Primary Teeth: An SEM Study. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2020; 8:41-45. [PMID: 31929777 PMCID: PMC6945313 DOI: 10.4103/sjmms.sjmms_104_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 08/14/2018] [Accepted: 03/05/2019] [Indexed: 11/04/2022]
Abstract
Background Chemomechanical methods such as Papacarie were developed as alternate dental caries removal methods to overcome major disadvantages of the conventional drilling technique. However, few studies have demonstrated the efficacy of Papacarie for caries removal using scanning electron microscope (SEM). Objectives The purpose of this study was to compare the efficacy and efficiency of Papacarie and the conventional bur method in caries removal from primary teeth. Materials and Methods In this in vitro study, 30 freshly extracted, human primary molars with dentinal caries were obtained from the outpatient clinics at the Dental Hospital of Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia. Each tooth was sectioned mesiodistally into two halves through the center of the lesion, and each half was randomly subjected to caries removal by Papacarie (Group I) and excavation using the conventional bur method (Group II). Time taken (efficiency) for removal of caries was noted using a stopwatch. Samples were then examined under SEM for presence of bacterial colonies (efficacy). For efficiency, data were analyzed using chi-square, and for efficacy, using t-test. Results There was no significant difference in the presence of bacteria in both groups under SEM (Papacarie = 23.3%; conventional method = 16.7%; P = 0.52). However, significantly more time was taken for caries removal with Papacarie (mean = 351.56 s) than with the conventional bur method (mean = 158.41 s) (P < 0.0001). Conclusion Papacarie is as effective in removing dentinal bacteria as the conventional caries removal method but is less efficient, as the time taken for excavation was longer.
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Affiliation(s)
- Jehan AlHumaid
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
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Abstract
BACKGROUND Numerous treatment modalities have been attempted for masticatory muscle pain in patients with temporomandibular disorders (TMD). To compare the treatment efficacy of more than 2 competing treatments, a network meta-analysis (NMA) was conducted. METHODS This study was reported with reference to the extended Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for reporting of systematic reviews incorporating network meta-analyses. Medline via Pubmed, Embase via OVID, and Cochrane Library Central were searched (up to February 11, 2019). Axis I protocol of Diagnostic Criteria or Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD, RDC/TMD) were chosen as diagnostic standards. The PICOS (Problem/patient, Intervention, Comparison, Outcome, Study design) method was used to screen trials under eligibility criteria. And the NMA was performed with mvmeta commands in Stata (StataCorp, Tex). RESULTS Of 766 studies searched, 12 randomized clinical trials (RCTs) were finally included. Nineteen different therapies were found and further categorized into 9 treatment modalities. The general heterogeneity was not found among included trials. But predictive intervals (PrIs) were conspicuously wider than confidential intervals (CIs) of all pairwise comparisons, indicating that heterogeneity may exist between studies. Complementary therapy showed the greatest probability (42.7%) to be the best intervention. It also had the highest mean rank (2.3) in the rankogram and the biggest value of surface under the cumulative ranking (SUCRA, 84.1%). CONCLUSIONS Based on the limited evidence of available trials, complementary therapy seemed to be slightly more effective than remaining treatment modalities for pain reduction in TMD patients with masticatory muscle pain. High-quality randomized controlled trials are expected to validate the findings.
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Zhang K, Arora P, Sati N, Béliveau A, Troke N, Veroniki AA, Rodrigues M, Rios P, Zarin W, Tricco AC. Characteristics and methods of incorporating randomized and nonrandomized evidence in network meta-analyses: a scoping review. J Clin Epidemiol 2019; 113:1-10. [DOI: 10.1016/j.jclinepi.2019.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 03/04/2019] [Accepted: 04/04/2019] [Indexed: 12/19/2022]
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Loganathan S, Santhanakrishnan S, Bathe R, Arunachalam M. Surface Processing: An Elegant Way to Enhance the Femtosecond Laser Ablation Rate and Ablation Efficiency on Human Teeth. Lasers Surg Med 2019; 51:797-807. [DOI: 10.1002/lsm.23105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2019] [Indexed: 01/22/2023]
Affiliation(s)
- Sarathkumar Loganathan
- Department of Mechanical Engineering, Manufacturing Engineering SectionIndian Institute of Technology MadrasChennai 600036 Tamil Nadu India
| | - Soundarapandian Santhanakrishnan
- Department of Mechanical Engineering, Manufacturing Engineering SectionIndian Institute of Technology MadrasChennai 600036 Tamil Nadu India
| | - Ravi Bathe
- International Advanced Research Centre for Powder Metallurgy and New Materials (ARCI)Centre for Laser Processing of MaterialsHyderabad 500005 Telangana India
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Schmidt J, Krohn S, Buenger L, Zeller K, Schneider H, Treuheit M, Kaiser T, Ziebolz D, Berg T, Haak R. Molecular characterization of intact cell-derived and cell-free bacterial DNA from carious dentine samples. J Microbiol Methods 2019; 158:33-43. [DOI: 10.1016/j.mimet.2019.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 01/22/2023]
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Schwendicke F, Leal S, Schlattmann P, Paris S, Dias Ribeiro AP, Gomes Marques M, Hilgert LA. Selective carious tissue removal using subjective criteria or polymer bur: study protocol for a randomised controlled trial (SelecCT). BMJ Open 2018; 8:e022952. [PMID: 30552261 PMCID: PMC6303626 DOI: 10.1136/bmjopen-2018-022952] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Selective (incomplete/partial) carious tissue removal is suitable for treating deep carious lesions in teeth with vital, asymptomatic pulps. In the periphery of a cavity, removal to hard dentin is performed, while in pulpo-proximal areas, leathery or soft dentin is left to avoid pulp exposure. As the decision of what contains 'soft' or 'leathery' dentin is subjective, using self-limiting burs which help to standardise the hardness of the remaining dentin, has been suggested to increase the reliability of carious tissue removal. The trial compares subjectively measured selective carious tissue removal in deep lesions in primary teeth with objectively measured selective removal with a self-limiting bur (Polybur, Komet). METHODS AND ANALYSIS A community-based single-blind clustered randomised controlled superiority trial nested into a larger evaluation is performed. Recruitment for this trial has been concluded. We have recruited 115 children aged 6-8 years with ≥1 vital primary molar with a deep dentin lesion. The unit of randomisation was the child, with all eligible molars per child treated identically. Treatment was performed in a mobile dental unit. Subjective and objective carious tissue removal was performed at random. Teeth were restored using glass ionomer cement (Equia Forte, GC). Our primary outcome will be the time until complications occur, evaluated via multilevel survival analysis. Secondary outcomes will be the time until extraction is needed, subjective satisfaction of the child with the treatment (measured using a Likert scale) and cost-effectiveness. Re-examination will be performed after 12, 24 and 36 months (the final examination is expected in 2020). ETHICS AND DISSEMINATION This trial has been approved by the Ethics Committee of the Health Sciences of the University of Brasília (CAAE 51310415.0.0000.0030). Trial results will be published in peer-reviewed journals and presented on conferences. TRIAL REGISTRATION NUMBER NCT02754466.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - Soraya Leal
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Peter Schlattmann
- Department of Medical Statistics, Informatics and Documentation, Jena University Hospital, Jena, Germany
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - Ana Paula Dias Ribeiro
- Department of Restorative Dental Sciences, University of Florida College of Dentistry, Gainesville, Florida, USA
| | - Marta Gomes Marques
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Leandro Augusto Hilgert
- Department of Dentistry, School of Health Sciences, University of Brasília, Brasilia, Brazil
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Pagano S, Chieruzzi M, Balloni S, Lombardo G, Torre L, Bodo M, Cianetti S, Marinucci L. Biological, thermal and mechanical characterization of modified glass ionomer cements: The role of nanohydroxyapatite, ciprofloxacin and zinc l-carnosine. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2018; 94:76-85. [PMID: 30423762 DOI: 10.1016/j.msec.2018.09.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 08/01/2018] [Accepted: 09/06/2018] [Indexed: 11/19/2022]
Abstract
The study evaluated the effects of 4 wt% nanohydroxyapatite (HA), 6 wt% zinc l-carnosine (MDA) and 1.5 wt% Ciprofloxacin (AB) on the mechanical, thermal and biological properties of glass ionomer cements (GIC). Filler and additive concentrations were selected after a previous study had tested single components and different percentages. Specimens included five silicon molds of each GIC cement for all tests. They were stored at room temperature for 24 h from specimen collection to analysis. Mechanical tests, calorimetric analysis, morphological investigation, antibacterial and cell viability assays were conducted. One-way analysis of variance (ANOVA) was used for data analysis with significance set at p < 0.05. Adding HA, MDA and AB to GICs modified their thermal, mechanical and microbiological properties. Polymerization increased. A slight decrease in the compressive strength of modified GICs was observed in dry condition (p < 0.05). Cement extracts affected cell viability in relation to extract dilution. Mechanical behavior improved in modified glass ionomer cements, especially with the powder formulated antibiotic. Overall cytotoxicity was reduced. Therefore adding nanohydroxyapatite, antibiotic and a mucosal defensive agent to conventional glass ionomer cement in special need patients could improve the clinical, preventive and therapeutic performance of the cements, without altering their mechanical properties.
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Affiliation(s)
- Stefano Pagano
- School of Medicine, Department of Biomedical and Surgical Sciences, Odontostomatological University Centre: Chair Prof. Stefano Cianetti, University of Perugia, S. Andrea delle Fratte, 06156 Perugia, Italy.
| | - Manila Chieruzzi
- University of Perugia, Civil and Environmental Engineering Department, UdR INSTM, Strada di Pentima, 4, 05100 Terni, Italy.
| | - Stefania Balloni
- University of Perugia, Department of Experimental Medicine Section of Biosciences and Medical Embriology, S. Andrea delle Fratte, 06156 Perugia, Italy
| | - Guido Lombardo
- School of Medicine, Department of Biomedical and Surgical Sciences, Odontostomatological University Centre: Chair Prof. Stefano Cianetti, University of Perugia, S. Andrea delle Fratte, 06156 Perugia, Italy.
| | - Luigi Torre
- University of Perugia, Civil and Environmental Engineering Department, UdR INSTM, Strada di Pentima, 4, 05100 Terni, Italy.
| | - Maria Bodo
- University of Perugia, Department of Experimental Medicine Section of Biosciences and Medical Embriology, S. Andrea delle Fratte, 06156 Perugia, Italy.
| | - Stefano Cianetti
- School of Medicine, Department of Biomedical and Surgical Sciences, Odontostomatological University Centre: Chair Prof. Stefano Cianetti, University of Perugia, S. Andrea delle Fratte, 06156 Perugia, Italy.
| | - Lorella Marinucci
- University of Perugia, Department of Experimental Medicine Section of Biosciences and Medical Embriology, S. Andrea delle Fratte, 06156 Perugia, Italy.
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Lee DW, Shin IS. Critical quality evaluation of network meta-analyses in dental care. J Dent 2018; 75:7-11. [DOI: 10.1016/j.jdent.2018.05.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/27/2018] [Accepted: 05/17/2018] [Indexed: 02/04/2023] Open
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Crespo-Gallardo I, Hay-Levytska O, Martín-González J, Jiménez-Sánchez MC, Sánchez-Domínguez B, Segura-Egea JJ. Criteria and treatment decisions in the management of deep caries lesions: Is there endodontic overtreatment? J Clin Exp Dent 2018; 10:e751-e760. [PMID: 30305872 PMCID: PMC6174009 DOI: 10.4317/jced.55050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 06/08/2018] [Indexed: 12/03/2022] Open
Abstract
Background The aim of this study was to investigate the diagnostic criteria and treatment decisions in the management of deep caries lesions (DCLs). The null hypothesis tested was that DCLs are managed according to the current scientific evidence. Material and Methods A total of 288 dentists were contacted directly or by mail, and 125 (43%) were included in the study. Dentists were requested to answer a questionnaire about the routine approach to the diagnosis and treatment of DCLs. Logistic regression analyses were carried out to calculate odds ratios (OR). Results Pulp sensitivity tests were used by 65% of dentists when assessing pulpal health in cases of DCLs, particularly those who had followed courses in cariology (OR = 3.8; p = 0.005). Dentine hardness was the most frequent criterion used during DCLs excavation (98%). Two thirds of the respondents (65%) removed carious tissue until they felt hard dentine, and feeling hard dentine correlated with caries removal even at the risk of pulpal exposure (OR = 15.8; p = 0.0000). Acute transient pain or sensitivity to cold or heat (reversible pulpitis) were considered by 58% of respondents as a reason to provide endodontic therapy. Conclusions The null hypothesis tested is rejected. The evidence-based more conservative approach on the management of DCLs is not being translated to clinical dentistry. Root canal treatment is being indicated in cases of DCLs in which the diagnosis is reversible pulpitis. Likewise, it can be concluded that non-conservative management of DCLs, with endodontic overtreatment, could be occurring. Key words:Deep caries lesions, dental pulp capping, dental pulp health, dentists, endodontic therapy, pulpal diagnosis, reversible pulpitis, treatment decisions.
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Affiliation(s)
- Isabel Crespo-Gallardo
- DDS, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain
| | - Olesia Hay-Levytska
- DDS, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain
| | - Jenifer Martín-González
- DDS, PhD, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain
| | - Mari-Carmen Jiménez-Sánchez
- DDS, MSc, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain
| | - Benito Sánchez-Domínguez
- DDS, PhD, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain
| | - Juan J Segura-Egea
- MD, DDS, PhD, Department of Stomatology - Endodontic Section, School of Dentistry, University of Sevilla, C/ Avicena S/N, 41009 Sevilla, Spain
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Abstract
A single-blind randomized controlled clinical trial in patients with deep caries and symptoms of reversible pulpitis compared outcomes from a self-limiting excavation protocol using chemomechanical Carisolv gel/operating microscope (self-limiting) versus selective removal to leathery dentin using rotary burs (control). This was followed by pulp protection with mineral trioxide aggregate (MTA) and restoration with glass ionomer cement and resin composite, all in a single visit. The pulp sensibility and periapical health of teeth were assessed after 12 mo, in addition to the differences in bacterial tissue concentration postexcavation. Apical radiolucencies were assessed using cone beam computed tomography/periapical radiographs (CBCT/PAs) taken at baseline 0 mo (M0) and 12 mo (M12). In total, 101 restorations in 86 patients were placed and paired subsurface, and deep (postexcavation) dentin samples were obtained. DNA was extracted and bacteria-specific 16S ribosomal RNA gene quantitative polymerase chain reaction was performed. No significant difference was found in bacterial copy numbers normalized to mass of dentin (“bacterial tissue concentration”) between the self-limiting (96.3% reduction) and control protocols (97.1%, P = 0.33). The probability of 12-mo success was 4 times (odds ratio [OR] = 4.33; confidence interval [CI], 1.2–15.6; P = 0.025) higher in the self-limiting protocol compared to the control (conventional excavation technique), with pulp survival rates of 73.3% and 90%, respectively ( P = 0.049). Molars had a 4 times higher probability of success compared to premolars (OR, 4.17; CI, 1.17–14.9; P = 0.028), and symptom severity did not statistically predict outcome (OR, 0.41; CI, 0.12–13.9, P = 0.153). CBCT detected significantly more periapical (PA) lesions than PA radiographs at the baseline visit ( P < 0.001). In conclusion, the self-limiting caries excavation protocol under magnification increased pulp survival rate compared to rotary bur excavation ( ClinicalTrials.gov NCT03071588).
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Bitello-Firmino L, Soares VK, Damé-Teixeira N, Parolo CCF, Maltz M. Microbial Load After Selective and Complete Caries Removal in Permanent Molars: a Randomized Clinical Trial. Braz Dent J 2018; 29:290-295. [DOI: 10.1590/0103-6440201801816] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/16/2018] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this randomized clinical trial was to compare the remaining microbial load after treatments based on complete and selective caries removal and sealing. Patients with active carious lesions in a permanent molar were randomly allocated into 2 groups: a test group (selective caries removal-SCR; n=18) and a control group (complete caries removal - CCR; n=18). Dentin samples were collected following the excavation and three months after sealing. Streptococcus species, Streptococcus mutans, Lactobacillus species, and total viable microorganisms were cultured to count the viable cells and frequency of species isolation. CCR resulted in significant lower total viable microorganisms counts (p≤0.001), Streptococcus species (p≤0.001) and Lactobacillus species (p≤0.001) initially. However, after sealing, a decrease in total viable microorganisms, Streptococcus species, and Lactobacillus species in the SCR resulted in no difference between the groups after 3 months. In conclusion, selective caries removal is as effective as complete caries removal in reducing dentin bacterial load 3 months after sealing.
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Affiliation(s)
| | | | | | | | - Marisa Maltz
- Universidade Federal do Rio Grande do Sul, Brazil
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AlHumaid J, Al-Harbi F, El Tantawi M, Elembaby A. X-ray microtomography assessment of Carisolv and Papacarie effect on dentin mineral density and amount of removed tissue. Acta Odontol Scand 2018; 76:236-240. [PMID: 29161950 DOI: 10.1080/00016357.2017.1406614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of the present study was to directly compare Carisolv and Papacarie regarding the volume of removed tissue (RT) and dentin mineral density (DMD) after excavation. MATERIALS AND METHODS Twenty permanent molars were randomized into two groups where caries was excavated using Carisolv or Papacarie followed by removal of softened tissue by a blunt instrument. X-ray microtomography was used to scan teeth before and after excavation generating two- and three-dimensional images that were used to calculate the percentage of RT relative to baseline tooth tissue volume and DMD that was categorized into sound dentin (>1.11 g/cm3) and residual caries (≤1.11 g/cm3). The two groups were compared using t-test Fisher exact test. RESULTS DMD was higher after Papacarie than Carisolv (mean = 1.70 and 1.14, p = .14) with higher percentage of cases with sound dentin (70 and 60%, p = 1.00). The percentage of RT was lower after Papacarie than Carisolv (7.40 and 8.95%, p = .31) with 22.95% less RT in cases that ended with sound dentin after excavation. CONCLUSIONS There was higher DMD, more sound dentin and less RT when Papacarie was used compared to Carisolv.
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Affiliation(s)
- Jehan AlHumaid
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahad Al-Harbi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Maha El Tantawi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abeer Elembaby
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Ntovas P, Loubrinis N, Maniatakos P, Rahiotis C. Evaluation of dental explorer and visual inspection for the detection of residual caries among Greek dentists. J Conserv Dent 2018; 21:311-318. [PMID: 29899636 PMCID: PMC5977782 DOI: 10.4103/jcd.jcd_67_17] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objectives The objective of this study was to assess the effect of the operator's degree of clinical experience on the residual caries diagnosis through visual inspection and tactile sensation. Materials and Methods The participants were asked about the years of their clinical practice, any further training concerning cariology, their familiarity with the minimal invasive philosophy, and the techniques that they use to remove dental caries and detect when to stop the removal of carious tissues. In addition, an in vitro diagnostic test was conducted. Carious teeth were excavated to a level selected in random. Teeth were examined by each participant individually. Initial examination was performed by visual inspection. Subsequently, a dental explorer was used concerning the potential need for further removal of dental tissues. A sample of 380 dentists and dental school students were selected for the purposes of this study. Results Dental students presented statistically significant better sensitivity, than dentists from both age groups, during both visual inspection and tactile sensation of residual caries. Participants' ability to diagnose residual caries during cavity preparation was independent of their years of experience. Conclusions During the removal of carious lesions, with the goal of limiting the sacrifice of healthy structures and the leftover of residual caries, clinicians should combine a selective removal technique and the attentive visual inspection, with at least one further diagnostic method, aside from the dental explorer. Tactile examination of residual caries solely with the dental explorer must be used with attention.
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Affiliation(s)
- Panagiotis Ntovas
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | - Nikolaos Loubrinis
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | - Panagiotis Maniatakos
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | - Christos Rahiotis
- Department of Operative Dentistry, School of Dentistry, University of Athens, Athens, Greece
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López-López JA, Humphriss RL, Beswick AD, Thom HHZ, Hunt LP, Burston A, Fawsitt CG, Hollingworth W, Higgins JPT, Welton NJ, Blom AW, Marques EMR. Choice of implant combinations in total hip replacement: systematic review and network meta-analysis. BMJ 2017; 359:j4651. [PMID: 29097396 PMCID: PMC5683044 DOI: 10.1136/bmj.j4651] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 01/29/2023]
Abstract
Objective To compare the survival of different implant combinations for primary total hip replacement (THR). Design Systematic review and network meta-analysis. Data sources Medline, Embase, The Cochrane Library, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and the EU Clinical Trials Register.Review methods Published randomised controlled trials comparing different implant combinations. Implant combinations were defined by bearing surface materials (metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, or metal-on-metal), head size (large ≥36 mm or small <36 mm), and fixation technique (cemented, uncemented, hybrid, or reverse hybrid). Our reference implant combination was metal-on-polyethylene (not highly cross linked), small head, and cemented. The primary outcome was revision surgery at 0-2 years and 2-10 years after primary THR. The secondary outcome was the Harris hip score reported by clinicians.Results 77 studies were included in the systematic review, and 15 studies (3177 hips) in the network meta-analysis for revision. There was no evidence that the risk of revision surgery was reduced by other implant combinations compared with the reference implant combination. Although estimates are imprecise, metal-on-metal, small head, cemented implants (hazard ratio 4.4, 95% credible interval 1.6 to 16.6) and resurfacing (12.1, 2.1 to 120.3) increase the risk of revision at 0-2 years after primary THR compared with the reference implant combination. Similar results were observed for the 2-10 years period. 31 studies (2888 patients) were included in the analysis of Harris hip score. No implant combination had a better score than the reference implant combination.Conclusions Newer implant combinations were not found to be better than the reference implant combination (metal-on-polyethylene (not highly cross linked), small head, cemented) in terms of risk of revision surgery or Harris hip score. Metal-on-metal, small head, cemented implants and resurfacing increased the risk of revision surgery compared with the reference implant combination. The results were consistent with observational evidence and were replicated in sensitivity analysis but were limited by poor reporting across studies.Systematic review registration PROSPERO CRD42015019435.
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Affiliation(s)
- José A López-López
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Rachel L Humphriss
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew D Beswick
- Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Learning and Research Building (Level 1), Bristol BS10 5NB, UK
| | - Howard H Z Thom
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Linda P Hunt
- Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Learning and Research Building (Level 1), Bristol BS10 5NB, UK
| | - Amanda Burston
- Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Learning and Research Building (Level 1), Bristol BS10 5NB, UK
| | - Christopher G Fawsitt
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - William Hollingworth
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Julian P T Higgins
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nicky J Welton
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ashley W Blom
- Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Learning and Research Building (Level 1), Bristol BS10 5NB, UK
| | - Elsa M R Marques
- Musculoskeletal Research Unit, University of Bristol, Southmead Hospital, Learning and Research Building (Level 1), Bristol BS10 5NB, UK
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Walsh LJ. Minimal intervention management of the older patient. Br Dent J 2017; 223:151-161. [DOI: 10.1038/sj.bdj.2017.660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 01/08/2023]
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Banerjee A, Frencken JE, Schwendicke F, Innes NPT. Contemporary operative caries management: consensus recommendations on minimally invasive caries removal. Br Dent J 2017; 223:215-222. [DOI: 10.1038/sj.bdj.2017.672] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2017] [Indexed: 11/09/2022]
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Curylofo-Zotti FA, Tanta GS, Zucoloto ML, Souza-Gabriel AE, Corona SAM. Selective removal of carious lesion with Er:YAG laser followed by dentin biomodification with chitosan. Lasers Med Sci 2017; 32:1595-1603. [PMID: 28762194 DOI: 10.1007/s10103-017-2287-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/12/2017] [Indexed: 10/19/2022]
Abstract
The aim of this study was to evaluate the effect of Er:YAG laser for selective removal of carious lesion, followed by biomodification with chitosan gel where the subsurface microhardness, chemical composition, and morphological changes of the residual caries-affected dentin were examined. Artificial dentinal lesions were created by pH-cycling method (14 days) in 104 bovine specimens (5 × 5 mm). Specimens were randomly divided according to the carious removal method: bur (low-speed handpiece) or Er:YAG laser (250 mJ/4 Hz). Specimens were treated with 35% phosphoric acid and were subdivided into two groups according to dentin biomodification: without chitosan (control) and 2.5% chitosan. Forty specimens were restored with an adhesive system and composite resin. Subsurface microhardness tests were performed in sound dentin, caries-affected dentin, residual caries-affected dentin, and after the restoration. The other 64 specimens were subjected to SEM-EDS atomic analysis. Data were statistically analyzed (p < 0.05). After the Er:YAG laser excavation, the microhardness value of residual caries-affected dentin was higher (p < 0.05) than bur-treated dentin. A significant decrease in the amount of Ca, P, and Ca/P ratio was found after the removal of carious lesions with Er:YAG laser (p < 0.05). The biomodification with chitosan did not influence the microhardness and atomic percentage of Ca, P, and Ca/P ratio of residual caries-affected dentin (p > 0.05). SEM analysis showed morphological changes on residual caries-affected dentin (p > 0.05). The selective removal of carious dentin with Er:YAG laser increased microhardness of residual caries-affected dentin, changing its surface morphology and chemical composition. The biomodification with chitosan did not influence the structural and chemical composition of residual caries-affected dentin.
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Affiliation(s)
- Fabiana A Curylofo-Zotti
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-904, Brazil.
| | - Gabriela Solano Tanta
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-904, Brazil
| | - Miriane Lucindo Zucoloto
- Department of Social Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14049-900, Brazil
| | - Aline E Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-904, Brazil
| | - Silmara A M Corona
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-904, Brazil
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Nascimento MM, Behar-Horenstein LS, Feng X, Guzmán-Armstrong S, Fontana M. Exploring How U.S. Dental Schools Teach Removal of Carious Tissues During Cavity Preparations. J Dent Educ 2017. [DOI: 10.1002/j.0022-0337.2017.81.1.tb06241.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Marcelle M. Nascimento
- Department of Restorative Dental Sciences; Division of Operative Dentistry; College of Dentistry; University of Florida
| | - Linda S. Behar-Horenstein
- Colleges of Dentistry, Education, Veterinary Medicine, and Pharmacy; CTSI Educational Development and Evaluation; HRSA Faculty Development in Dentistry; University of Florida
| | - Xiaoying Feng
- School of Human Development and Organizational Studies in Education; College of Education; University of Florida
| | | | - Margherita Fontana
- Department of Cariology; Restorative Sciences, and Endodontics; School of Dentistry; University of Michigan
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Efficacy of using Carisolv in the removal of decayed tooth structure in primary teeth. Evid Based Dent 2016; 17:44-5. [PMID: 27339236 DOI: 10.1038/sj.ebd.6401167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Data sourcesMedline, Web of Science and Scopus were searched using a unique search strategy.Study selectionTwo authors independently reviewed and selected Clinical Trials, Randomised Clinical trials and Controlled Trials assessing the efficacy on primary dentition of Carisolv compared to traditional caries removal with drilling instruments. Only studies where total caries removal in each group was completed using Carisolv systems or rotary instruments used without any time limit were considered suitable. Studies assessing the complete caries removal by different methods from the clinical criteria selected (ie using a sharp probe) were excluded.Data extraction and synthesisThe outcomes considered for the review were: the caries removal rate (binary yes/no), the time required to complete the tissue removal (continuous) and the pain threshold during the procedure, assessed through the need for local anaesthesia by the patients (binary yes/no).For dichotomous data Odds Ratio (OR) was calculated along with 95% Confidence intervals (CIs) and for continuous data, the Mean Difference (MD) with 99% Confidence Intervals (CIs) was calculated. Meta-analysis was performed with studies analysing the same outcomes.ResultsFrom 195 studies identified, 28 were analysed. Ten met eligibility criteria. The trials included involved a total of 348 patients for 532 treated teeth. Three studies evaluated clinical efficacy in caries removal. When the data were collected in a meta-analysis no statistically significant difference was observed in regard of the clinical efficacy between Carisolv and the rotary instruments (p= 0.50, OR= 0.33 95% CI 0.01-8.22).In seven studies the length of time to perform the procedures was evaluated and data analysis demonstrated a statistically significant difference (p < 0.01, MD 310.92, 99 % CI 234.57- 387.27) with the Carisolv system, which required a greater amount of time than the conventional drill technique. With regard to pain threshold, a near statistically significant difference was found (p=0.06, OR=0.09 95% CI 0.01-1.07) with less anaesthesia required by patients treated using the Carisolv system technique.ConclusionsThe systematic review indicates that the clinical efficacy of chemo-mechanical removal with Carisolv seems as reliable as with rotary instruments. However, the results should be interpreted cautiously due to the hetero-geneity among study designs and to the shortage of available data. Further large-scale, well-designed randomised controlled trials are needed.
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Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP. Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2016; 116:663-740. [PMID: 28236412 DOI: 10.1016/j.prosdent.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM It is clear the contemporary dentist is confronted with a blizzard of information regarding materials and techniques from journal articles, advertisements, newsletters, the internet, and continuing education events. While some of that information is sound and helpful, much of it is misleading at best. PURPOSE This review identifies and discusses the most important scientific findings regarding outcomes of dental treatment to assist the practitioner in making evidence-based choices. This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry. MATERIAL AND METHODS Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature published in 2015 in their discipline and review the articles for important information that may have an impact on treatment decisions. Comments on experimental methodology, statistical evaluation, and overall validity of the conclusions are included in many of the reviews. RESULTS The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source if they wish more detail. CONCLUSIONS Analysis of the scientific literature published in 2015 is divided into 7 sections, dental materials, periodontics, prosthodontics, occlusion and temporomandibular disorders, sleep-disordered breathing, cariology, and implant dentistry.
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Affiliation(s)
- Terence E Donovan
- Professor, Biomaterials, University of North Carolina School of Dentistry, Chapel Hill, N.C.
| | | | | | - David R Cagna
- Professor, Advanced Prosthodontics University of Tennessee Health Sciences Center, Memphis, Tenn
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Schwendicke F, Göstemeyer G. Understanding dentists' management of deep carious lesions in permanent teeth: a systematic review and meta-analysis. Implement Sci 2016; 11:142. [PMID: 27760551 PMCID: PMC5069935 DOI: 10.1186/s13012-016-0505-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/07/2016] [Indexed: 02/01/2023] Open
Abstract
Background Increasing evidence supports selective/incomplete (SE) or stepwise (SW) instead of non-selective/complete tissue removal for deep carious lesions in vital teeth, mainly as pulpal risks are significantly reduced. Our aims were to analyze the proportion of dentists who utilize SE/SW for deep lesions in permanent teeth and to identify barriers and facilitators of utilizing SE/SW. Methods We included studies that were original, and reported on the proportion of dentists utilizing SE/SW (quantitative studies), or reported on barriers or facilitators of such utilization (qualitative studies). Electronic databases (PubMed, CENTRAL, Embase, PsycINFO) were searched and screening and data extraction performed by two reviewers. Random-effects meta-analysis and meta-regression were used for quantitative synthesis of the proportion of dentists utilizing SE/SW. Thematic analysis was performed to assess barriers and facilitators on SE/SW utilization. Identified themes were translated into the constructs of the theoretical domains framework. Results From 1728 articles, nine studies were included, all using quantitative methods. Four thousand one hundred ninety-nine dentists had been surveyed. The mean (95% CI) proportion of dentists using SE/SW for deep lesions was 53 % (44/62 %). More recent studies reported significantly higher proportions (p < 0.05). Reported estimates and thematic analysis found dentists’ age and an understanding of the disease caries and the scientific rationale behind different removal strategies to affect dentists’ behavior. Guidelines, peers, and the social and professional identity were further associated with the motivation of utilizing SE/SW. Environmental incentives, sanctions, or restrictions, mainly of financial but also regulatory character, impacted on decision-making, as did the specific indication (the patient, the tooth) and the beliefs on how well different treatments perform. Conclusions Around half of all dentists rejected evidence-based carious tissue removal strategies. A range of factors can be addressed for improving implementation. Future studies should use mixed qualitative-quantitative methods to yield a deeper understanding of dentists’ decision-making. Trial registration PROSPERO CRD42016038047 Electronic supplementary material The online version of this article (doi:10.1186/s13012-016-0505-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Falk Schwendicke
- Department for Operative and Preventive Dentistry, Charité Centre for Dental Medicine, Aßmannshauser Str 4-6, 14197, Berlin, Germany.
| | - Gerd Göstemeyer
- Department for Operative and Preventive Dentistry, Charité Centre for Dental Medicine, Aßmannshauser Str 4-6, 14197, Berlin, Germany
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Innes NPT, Frencken JE, Schwendicke F. Don't Know, Can't Do, Won't Change: Barriers to Moving Knowledge to Action in Managing the Carious Lesion. J Dent Res 2016; 95:485-6. [PMID: 27099269 DOI: 10.1177/0022034516638512] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- N P T Innes
- Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - J E Frencken
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - F Schwendicke
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Germany
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Schwendicke F, Frencken J, Bjørndal L, Maltz M, Manton D, Ricketts D, Van Landuyt K, Banerjee A, Campus G, Doméjean S, Fontana M, Leal S, Lo E, Machiulskiene V, Schulte A, Splieth C, Zandona A, Innes N. Managing Carious Lesions. Adv Dent Res 2016; 28:58-67. [DOI: 10.1177/0022034516639271] [Citation(s) in RCA: 372] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according to selective removal to firm dentine. In deep cavitated lesions in primary or permanent teeth, selective removal to soft dentine should be performed, although in permanent teeth, stepwise removal is an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.
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Affiliation(s)
- F. Schwendicke
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin Berlin, Berlin, Germany
| | - J.E. Frencken
- Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L. Bjørndal
- Department of Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - M. Maltz
- Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - D.J. Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - D. Ricketts
- Section of Operative Dentistry, Fixed Prosthodontics and Endodontology, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - K. Van Landuyt
- KULeuven BIOMAT, Department of Oral Health Sciences, University of Leuven and Dentistry University Hospitals Leuven, Leuven, Belgium
| | - A. Banerjee
- Conservative and MI Dentistry, King’s College London Dental Institute, London, UK
| | - G. Campus
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Italy; WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy
| | - S. Doméjean
- CHU Clermont-Ferrand, Service d’Odontologie, Hôtel-Dieu, Clermont-Ferrand, France; Univ Clermont1, UFR d’Odontologie, Clermont-Ferrand, France; Centre de Recherche en Odontologie Clinique EA 4847, F-63000 Clermont-Ferrand, France
| | - M. Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - S. Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - E. Lo
- Faculty of Dentistry, University of Hong Kong, Hong Kong, China
| | - V. Machiulskiene
- Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - A. Schulte
- Department of Special Care Dentistry, Faculty of Health, University of Witten/Herdecke, Witten, Germany
| | - C. Splieth
- Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - A.F. Zandona
- Department of Operative Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA
| | - N.P.T. Innes
- Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
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Schwendicke F, Stangvaltaite L, Holmgren C, Maltz M, Finet M, Elhennawy K, Eriksen I, Kuzmiszyn TC, Kerosuo E, Doméjean S. Dentists’ attitudes and behaviour regarding deep carious lesion management: a multi-national survey. Clin Oral Investig 2016; 21:191-198. [DOI: 10.1007/s00784-016-1776-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/29/2016] [Indexed: 10/22/2022]
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Lai G, Lara Capi C, Cocco F, Cagetti MG, Lingström P, Almhöjd U, Campus G. Comparison of Carisolv system vs traditional rotating instruments for caries removal in the primary dentition: A systematic review and meta-analysis. Acta Odontol Scand 2015; 73:569-80. [PMID: 25772193 DOI: 10.3109/00016357.2015.1023353] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The purpose of this systematic review and meta-analysis was to evaluate the reliability of the Carisolv system with respect to drilling regarding the full removal of decayed hard tissues in primary dentition. A systematic review of the literature was conducted to identify controlled trails, randomized controlled trials and clinical trials that compared the Carisolv system to the traditional mechanical caries removal in the primary dentition. MATERIALS AND METHODS The main relevant databases were searched: MEDLINE via PUBMED, Web of Science and SCOPUS. Complete caries removal, length of working time and need of local anesthesia were the outcomes evaluated. RESULTS A total of 195 studies were identified and complete analysis of 28 studies was performed; finally, 10 papers were included. The trials included involved a total of 348 patients for 532 treated teeth. There was no significant difference in terms of clinical efficacy between the Carisolv and the rotary instrument (z = 0.68, p = 0.50), whereas the treatment with Carisolv was significantly longer in terms of time with respect to the rotary instruments (z = 10.49, p < 0.01). The chemo mechanical technique reduces the need for local anesthesia, with a difference between two types of treatment near to statistical significance (z = 1.91 p = 0.06). CONCLUSIONS This systematic review indicates that the clinical efficacy of chemo-mechanical removal with Carisolv seems as reliable as the rotary instruments. However, the results should be interpreted cautiously due to the heterogeneity among study designs and to the shortage of available data. Further large-scale, well-designed randomized controlled trials are needed.
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Affiliation(s)
- Gianfranco Lai
- Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari , Sassari , Italy
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