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Manchanda S, Liu P, Sardana D, Peng S, Lo EC, Yiu CK. Randomized clinical trial to compare three fluoride varnishes in preventing early childhood caries. J Dent 2024; 147:105141. [PMID: 38901821 DOI: 10.1016/j.jdent.2024.105141] [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: 05/18/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 06/22/2024] Open
Abstract
OBJECTIVES To compare the effectiveness of two 5% sodium fluoride (NaF) varnishes containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP) (MI VarnishTM) or tricalcium phosphate (TCP) (ClinproTM White) to the conventional 5% NaF varnish (Duraphat®) in preventing early childhood caries (ECC) in high-risk preschool children. METHODS A double-blinded, randomized controlled trial recruited healthy 3-4-year-old children (N = 582) having at least one carious lesion (pre-cavitated or cavitated) after obtaining written informed consent from parents. Using a computer-generated random-number table, children were assigned to one of the 3 groups: Control group (n = 196): 5% NaF varnish (Duraphat®) or two test groups: 5% NaF with TCP (Clinpro™ White) (n = 193) and 5% NaF varnish with CPP-ACP (MI Varnish™) (n = 193) to receive quarterly (every 3 months) application over 24 months. RESULTS Incidence of new caries over 2 years was 59.2% in MI Varnish™ group (n = 125), 65.1% in the Clinpro™ White group (n = 129) and 66.1% in the Duraphat® group (n = 127) (p = 0.466). The mean cavitated lesions increment was not significant among the 3 groups (p = 0.714), as was the mean increment in non-cavitated carious lesions (p = 0.223). There was no significant difference (p = 0.630) in the distribution of total fluoride varnish applications among the three groups. Also, no significant difference was found in comparison of outcomes among the different number of fluoride varnish applications received by children in each group. CONCLUSIONS Both calcium- and phosphate-containing NaF varnishes showed similar efficacy against cavitated and non-cavitated carious lesions as compared to conventional NaF varnish in high-risk preschool children. CLINICAL SIGNIFICANCE Randomized trial provided a crucial opportunity to advance the understanding of the clinical effectiveness of different fluoride varnishes in preventing early childhood caries. Varnishes containing tricalcium phosphate or casein phosphopeptide amorphous calcium phosphate when compared to sodium fluoride varnish, demonstrated a similar efficacy against early childhood caries in high caries-risk preschool children.
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Affiliation(s)
- Sheetal Manchanda
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China
| | - Pei Liu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China
| | - Divesh Sardana
- Pediatric Dentistry, The University of Oklahoma College of Dentistry, Oklahoma, USA
| | - Simin Peng
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China
| | - Edward Cm Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Cynthia Ky Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 2nd Floor, 34 Hospital Road Sai Ying Pun, Hong Kong SAR, China.
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Jiang HF, Shi AT, Li J, Zhang YH, Yang J. Effectiveness of risk-based caries management among Chinese preschool children: a randomized controlled single-blind trial. BMC Oral Health 2024; 24:673. [PMID: 38851679 PMCID: PMC11162041 DOI: 10.1186/s12903-024-04442-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: 02/21/2024] [Accepted: 06/04/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Early childhood caries (ECC) remain a serious oral health problem on a global scale. Risk-based caries management (RBCM) implemented in some parts of the world has been effective in preventing ECC. However, there is a lack of prospective research on the application of RBCM among Chinese children, and little is known about its effectiveness. The purpose of this study was to evaluate the effectiveness of RBCM in preventing caries among children aged 3-5 years in Wanzhou District, Chongqing Municipality, China. METHODS Three- to five-year-old children from four kindergartens in Wanzhou were randomly selected for baseline dental examination and caries risk assessment (CRA) and randomly assigned to the experimental group (EG) or the control group (CG) according to the kindergarten. The EG received caries prevention measures of different intensities based on the child's caries risk level. The CG received full-mouth fluoride twice a year according to standard prevention, regardless of their caries risk. One year later, another dental examination and CRA were conducted, to observe changes in the decayed, missing, and filled teeth (dmft) index and caries risk, and to analyze potential factors that may affect the incidence of new caries. RESULTS Complete data were collected from 291 children (EG, N = 140, 84.8%; CG, N = 181, 83.4%). A total of 25.7% of the EG and 50.3% of the CG children developed new caries, with newly added dmft scores of 0.54 ± 1.12 and 1.32 ± 1.72, respectively (P < 0.05). Multivariate logistic regression indicated that children living in rural areas, assigned to the CG, and rated as high-risk at baseline were more likely to develop new caries (P < 0.05). The proportion of children with an increased caries risk in the EG was significantly lower than that in the CG (P < 0.05). CONCLUSIONS RBCM effectively prevented new caries in 3- to 5-year-old Wanzhou children and reduced the proportion of children at increased risk of caries. It is an effective approach for preventing ECC. CLINICAL TRIAL REGISTRATION This trial was registered in the Chinese Clinical Trials Register. The registration number was ChiCTR230067551 (11/01/2023).
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Affiliation(s)
- Hao-Feng Jiang
- College of Clinical Medicine, Chongqing Three Gorges Medical College, Chongqing, China
| | - An-Tian Shi
- College of Clinical Medicine, Chongqing Three Gorges Medical College, Chongqing, China.
- Department of Stomatology, Affiliated People's Hospital of Chongqing Three Gorges Medical College, Chongqing, China.
| | - Jing Li
- College of Clinical Medicine, Chongqing Three Gorges Medical College, Chongqing, China
- Department of Stomatology, Affiliated People's Hospital of Chongqing Three Gorges Medical College, Chongqing, China
| | - Yu-Han Zhang
- College of Clinical Medicine, Chongqing Three Gorges Medical College, Chongqing, China
| | - Jing Yang
- College of Clinical Medicine, Chongqing Three Gorges Medical College, Chongqing, China
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Gruba AS, Nunes GP, Danelon M, Gonçalves FMC, de Toledo PTA, Ferreira MF, Poli MCF, Delbem ACB. The use of mouthwash containing trimetaphosphate as an adjunct therapy to fluoridated toothpaste reduces enamel demineralization. J Dent 2024; 145:104966. [PMID: 38554802 DOI: 10.1016/j.jdent.2024.104966] [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: 03/03/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION The decline in dental caries has been attributed to the widespread use of fluoride (F). Two forms of presentation are fluoridated toothpaste (FT) and mouthwash (MW), widely used by the population. MATERIALS AND METHODS This study aimed to evaluate in vitro the effects of combining FT and MW, whether supplemented with sodium trimetaphosphate (TMP) or not, on dental enamel demineralization. Bovine enamel blocks (n = 60) were selected based on initial surface hardness (SHi) and divided into 5 experimental groups (n = 12 each): I) Placebo Toothpaste (without F/TMP); II) 1100 ppm F Toothpaste (FT); III) 1100F associated with a MW at 100 ppm F (FT + MW 100F); IV) 1100F associated with a MW at 225 ppm F (FT + MW 250F); and V) 1100F associated with a MW at 100 ppm F supplemented with 0.4 % TMP (FT + MW 100F-TMP). The blocks were treated twice a day, undergoing 5 pH cycles over 7 days. Thus, the percentage change in surface hardness (%SH), integrated subsurface hardness loss (ΔKHN), and the concentration of F, phosphorus (P), and calcium (Ca) in the enamel were determined. The data were submitted to ANOVA and Student-Newman-Keuls test (p < 0.001). RESULTS The 1100F group was statistically inferior to the groups associated with MW for %SH, ΔKHN, and the concentration of P and Ca in the enamel (p < 0.001). Blocks treated with FT + MW 225F and FT + MW 100F-TMP showed significantly lower %SH compared to the other groups (p < 0.001). The FT + MW 100F - TMP group exhibited the lowest depth mineral loss (ΔKHN), and higher concentration de P in enamel (p < 0.001). CONCLUSION The adjunct use of MW with FT produces a greater protective effect in inhibiting enamel demineralization, and the supplementation of TMP to the MW with 100F provides a superior effect compared to MW with 225F. CLINICAL SIGNIFICANCE This combination of treatments could be regarded as one of several alternative fluoride supplements for subjects at elevated risk of caries.
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Affiliation(s)
- Amanda Scarpin Gruba
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Marcelle Danelon
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Francyenne Maira Castro Gonçalves
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Priscila Toninatto Alves de Toledo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Mayra Fernanda Ferreira
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Maria Clara Faria Poli
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
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Tang L, Nong S, Chen K, Liu Q, Yu X, Zeng X. Cost-effectiveness and cost-benefit analyses of fluoride varnish for caries prevention in Guangxi, China. BMC Oral Health 2024; 24:534. [PMID: 38724990 PMCID: PMC11080295 DOI: 10.1186/s12903-024-04220-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/02/2024] [Indexed: 05/13/2024] Open
Abstract
OBJECTIVES The objectives of this study were to evaluate the cost-effectiveness and cost-benefit of fluoride varnish (FV) interventions for preventing caries in the first permanent molars (FPMs) among children in rural areas in Guangxi, China. METHODS This study constituted a secondary analysis of data from a randomised controlled trial, analysed from a social perspective. A total of 1,335 children aged 6-8 years in remote rural areas of Guangxi were enrolled in this three-year follow-up controlled study. Children in the experimental group (EG) and the control group (CG) received oral health education and were provided with a toothbrush and toothpaste once every six months. Additionally, FV was applied in the EG. A decision tree model was developed, and single-factor and probabilistic sensitivity analyses were conducted. RESULTS After three years of intervention, the prevalence of caries in the EG was 50.85%, with an average decayed, missing, and filled teeth (DMFT) index score of 1.12, and that in the CG was 59.04%, with a DMFT index score of 1.36. The total cost of caries intervention and postcaries treatment was 42,719.55 USD for the EG and 46,622.13 USD for the CG. The incremental cost-effectiveness ratio (ICER) of the EG was 25.36 USD per caries prevented, and the cost-benefit ratio (CBR) was 1.74 USD benefits per 1 USD cost. The results of the sensitivity analyses showed that the increase in the average DMFT index score was the largest variable affecting the ICER and CBR. CONCLUSIONS Compared to oral health education alone, a comprehensive intervention combining FV application with oral health education is more cost-effective and beneficial for preventing caries in the FPMs of children living in economically disadvantaged rural areas. These findings could provide a basis for policy-making and clinical choices to improve children's oral health.
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Affiliation(s)
- Liying Tang
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - Shengjie Nong
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China
| | - Kun Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
| | - Qiulin Liu
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China
| | - Xueting Yu
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China
| | - Xiaojuan Zeng
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, Guangxi, China.
- Department of Oral Health Policy Research, Guangxi Medical University, Nanning, Guangxi, China.
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Sorazabal AL, Salgado P, Ferrarini S, Lazzati R, Squassi AF, Campus G, Klemonskis G. An Alternative Technique for Topical Application of Acidulated Phosphate Fluoride (APF) Gel: A Two-Years Double-Blind Randomization Clinical Trial (RCT). MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2118. [PMID: 38138221 PMCID: PMC10744600 DOI: 10.3390/medicina59122118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Dental caries is still a dramatic public health problem. The effectiveness of an alternative technique using acidulated phosphate fluoride (APF) gel pH 3.5 was evaluated and compared with conventional treatments in reducing dental caries incidence. Materials and Methods: A double-blind randomized controlled trial was conducted, involving 180 children aged 4-11 years. Three groups were formed: NaF varnish (NaFV), APF in tray (APFt), and APF in toothbrush (APFtbru). Clinical examinations were performed using standardized criteria and the ICDAS Index was assessed. The Caries Treatment Needs Index (CTNI) was calculated. Dental examinations were conducted at baseline, 12 months, and 24 months. Results: At baseline, 16,719 dental surfaces were included, with 15,434 surfaces being sound. After 24 months, the Kaplan-Meier analysis showed significant differences between the APFtbru group and the other two groups (p = 0.03). Cox regression analysis revealed that the surfaces treated with NaF varnish had the lowest survival rates (HR = 0.51 95%CI = 0.33/0.81). Occlusal surfaces had the lowest cumulative survival, while other tooth surfaces showed similar performance. Conclusions: The alternative technique of APF gel application with a toothbrush resulted in maintaining dental health over 24 months. This technique can be cost-effective and may offer advantages over traditional fluoride varnish application.
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Affiliation(s)
- Ana Laura Sorazabal
- Cátedra de Odontología Preventiva y Comunitaria, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina; (A.L.S.); (P.S.); (S.F.); (R.L.); (A.F.S.); (G.K.)
- Instituto de Investigaciones en Salud Pública, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina
| | - Pablo Salgado
- Cátedra de Odontología Preventiva y Comunitaria, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina; (A.L.S.); (P.S.); (S.F.); (R.L.); (A.F.S.); (G.K.)
- Instituto de Investigaciones en Salud Pública, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina
| | - Silvana Ferrarini
- Cátedra de Odontología Preventiva y Comunitaria, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina; (A.L.S.); (P.S.); (S.F.); (R.L.); (A.F.S.); (G.K.)
- Instituto de Investigaciones en Salud Pública, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina
| | - Rocio Lazzati
- Cátedra de Odontología Preventiva y Comunitaria, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina; (A.L.S.); (P.S.); (S.F.); (R.L.); (A.F.S.); (G.K.)
- Instituto de Investigaciones en Salud Pública, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina
| | - Aldo Fabian Squassi
- Cátedra de Odontología Preventiva y Comunitaria, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina; (A.L.S.); (P.S.); (S.F.); (R.L.); (A.F.S.); (G.K.)
- Instituto de Investigaciones en Salud Pública, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Freiburgstrasse 7, 3012 Bern, Switzerland
- Department of Cariology, Saveetha Dental College and Hospitals, SIMATS, Poonamallee High Road, Chennai 600077, India
| | - Graciela Klemonskis
- Cátedra de Odontología Preventiva y Comunitaria, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina; (A.L.S.); (P.S.); (S.F.); (R.L.); (A.F.S.); (G.K.)
- Instituto de Investigaciones en Salud Pública, Facultad de Odontología, Universidad de Buenos Aires, Buenos Aires C1122AAH, Argentina
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He S, Choong EKM, Duangthip D, Chu CH, Lo ECM. Clinical interventions with various agents to prevent early childhood caries: A systematic review with network meta-analysis. Int J Paediatr Dent 2023; 33:507-520. [PMID: 36718540 DOI: 10.1111/ipd.13055] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Dental caries is one of the most prevalent chronic diseases among preschool children globally. Different preventive agents and combinations have been studied. However, the rank of the effectiveness of clinical interventions is equivocal. AIM To summarize and rank the effectiveness of clinical interventions using different agents for primary prevention of early childhood caries (ECC). DESIGN Two reviewers independently searched PubMed, Embase, and Cochrane Library to identify randomized controlled trials with at least 12-month follow-up. The network meta-analysis (NMA) on different agents was based on a random-effects model and frequentist approach. Standardized mean differences (SMD) with 95% CI of the caries increment were calculated in terms of either dmft or dmfs and used in the NMA. Caries incidences at the child level were compared using odds ratios (ORs) with 95% CI. The effectiveness of the agents was ranked using the surface under the cumulative ranking curve (SUCRA). RESULTS After screening 3807 publications and selection, the NMA finally included 33 trials. These trials used either a single or combination of agents such as fluorides, chlorhexidine, casein phosphopeptide-amorphous calcium phosphate, probiotics, xylitol, and triclosan. Compared with control, fluoride foam (FF; SMD -0.69, 95% CI: -1.06, -0.32) and fluoride salt (F salt; SMD -0.66, 95% CI: -1.20, -0.13) were effective in preventing caries increment. Probiotic milk plus low fluoride toothpaste (PMLFTP; OR 0.34, 95% CI: 0.15, 0.77), FF (OR 0.48, 95% CI: 0.37, 0.63), fluoride varnish (FV; OR 0.63, 95% CI: 0.48, 0.81), and fluoride varnish plus high fluoride toothpaste (FVHFTP; OR 0.73, 95% CI: 0.57, 0.93) were effectively preventing caries incidence. According to the SUCRA, FF ranked first in preventing caries increment, whereas PMLFTP ranked first in preventing caries incidence. CONCLUSION Fluoride foam, F salt, PMLFTP, FV, and FVHFTP all effectively reduce caries increment or caries incidence in preschool children, but the evidence indicates low degree of certainty. Considering the relatively small number of studies, confidence in the findings, and limitations in the study, clinical practitioners and readers should exercise caution when interpreting the NMA results.
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Affiliation(s)
- Shuyang He
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Elaine Kar Man Choong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
- Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
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Montagner AF, Angst PDM, Raggio DP, VAN DE Sande FH, Tedesco TK. Methodological quality of network meta-analysis in dentistry: a meta-research. Braz Oral Res 2023; 37:e062. [PMID: 37436290 DOI: 10.1590/1807-3107bor-2023.vol37.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 01/27/2023] [Indexed: 07/13/2023] Open
Abstract
This meta-research aimed to provide an overview of the methodological quality and risk of bias of network meta-analyses (NMA) in dentistry. Searches for NMA of randomized clinical trials with clinical outcomes in dentistry were performed in databases up to January 2022. Two reviewers independently screened titles/abstracts, selected full texts, and extracted the data. The adherence to PRISMA-NMA reporting guideline, the AMSTAR-2 methodological quality tool, and the ROBIS risk of bias tool were assessed in the studies. Correlation between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results was also investigated. Sixty-two NMA studies were included and presented varied methodological quality. According to AMSTAR-2, half of the NMA presented moderate quality (n = 32; 51.6%). The adherence to PRISMA-NMA also varied. Only 36 studies (58.1%) prospectively registered the protocol. Other issues lacking of reporting were data related were data related to the NMA geometry and the assessment of results consistency, and the evaluation of risk of bias across the studies. ROBIS assessment showed a high risk of bias mainly for domains 1 (study eligibility criteria) and 2 (identification and selection of studies). Correlation coefficients between the PRISMA-NMA adherence and the AMSTAR-2 and ROBIS results showed moderate correlation (rho < 0.6). Overall, NMA studies in dentistry were of moderate quality and at high risk of bias in several domains, especially study selection. Future reviews should be better planned and conducted and have higher compliance with reporting and quality assessment tools.
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Affiliation(s)
| | | | | | | | - Tamara Kerber Tedesco
- Univesidade Cruzeiro do Sul - Unicsul, Graduate Program in Dentistry, São Paulo, SP, Brazil
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Conti G, Veneri F, Amadori F, Garzoni A, Majorana A, Bardellini E. Evaluation of Antibacterial Activity of a Bioactive Restorative Material Versus a Glass-Ionomer Cement on Streptococcus Mutans: In-Vitro Study. Dent J (Basel) 2023; 11:149. [PMID: 37366672 DOI: 10.3390/dj11060149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/29/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Dental caries management consists of both preventive and restorative approaches. Pediatric dentists can rely on many techniques and materials to restore decayed teeth, but a high failure rate is still observed, mainly due to secondary caries. New restorative bioactive materials combine the mechanical and aesthetic characteristics of resinous materials with the capability to remineralize and the antimicrobial properties of glass ionomers, thus counteracting the occurrence of secondary caries. The aim of this study was to assess the antimicrobial activity against Streptococcus mutans of a bioactive restorative material (ACTIVA™ BioActive-Restorative™-Pulpdent©) and a glass ionomer cement with silver particles added (Ketac™ Silver-3M©), using agar diffusion assay. METHODS Each material was formed into disks of 4 mm in diameter, and four discs of each material were placed on nine agar plates. The analysis was repeated seven times. RESULTS Both materials showed statistically significant growth inhibition properties against S. mutans (p < 0.05). The difference in the effectiveness of the two materials was not statistically significant. CONCLUSION Both ACTIVA™ and Ketac™ Silver can be recommended since both are similarly effective against S. mutans. However ACTIVA™, given its bioactivity and better aesthetics and mechanical properties compared to GICs, may provide better clinical performance.
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Affiliation(s)
- Giulio Conti
- Department of Medicine and Surgery, School of Dentistry, University of Insubria, Via Ravasi 2, 21100 Varese, Italy
| | - Federica Veneri
- Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, Unit of Dentistry & Oral-Maxillo-Facial Surgery, University of Modena and Reggio Emilia, Via del Pozzo, 41124 Modena, Italy
| | - Francesca Amadori
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Alba Garzoni
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Alessandra Majorana
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
| | - Elena Bardellini
- Department of Medical and Surgical Sciences and Public Health, School of Pediatric Dentistry, University of Brescia, Pl. Spedali Civili 1, 25123 Brescia, Italy
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Zhang OL, Niu JY, Yin IX, Yu OY, Mei ML, Chu CH. Bioactive Materials for Caries Management: A Literature Review. Dent J (Basel) 2023; 11:dj11030059. [PMID: 36975556 PMCID: PMC10047026 DOI: 10.3390/dj11030059] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Researchers have developed novel bioactive materials for caries management. Many clinicians also favour these materials, which fit their contemporary practice philosophy of using the medical model of caries management and minimally invasive dentistry. Although there is no consensus on the definition of bioactive materials, bioactive materials in cariology are generally considered to be those that can form hydroxyapatite crystals on the tooth surface. Common bioactive materials include fluoride-based materials, calcium- and phosphate-based materials, graphene-based materials, metal and metal-oxide nanomaterials and peptide-based materials. Silver diamine fluoride (SDF) is a fluoride-based material containing silver; silver is antibacterial and fluoride promotes remineralisation. Casein phosphopeptide-amorphous calcium phosphate is a calcium- and phosphate-based material that can be added to toothpaste and chewing gum for caries prevention. Researchers use graphene-based materials and metal or metal-oxide nanomaterials as anticaries agents. Graphene-based materials, such as graphene oxide-silver, have antibacterial and mineralising properties. Metal and metal-oxide nanomaterials, such as silver and copper oxide, are antimicrobial. Incorporating mineralising materials could introduce remineralising properties to metallic nanoparticles. Researchers have also developed antimicrobial peptides with mineralising properties for caries prevention. The purpose of this literature review is to provide an overview of current bioactive materials for caries management.
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Affiliation(s)
| | - John Yun Niu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Iris Xiaoxue Yin
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - May Lei Mei
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Faculty of Dentistry, The University of Otago, Dunedin 9054, New Zealand
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
- Correspondence:
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Adel SM, El-Harouni N, Vaid NR. White Spot Lesions: State of the Art Biomaterials and Workflows used in Prevention, Progression and Treatment. Semin Orthod 2023. [DOI: 10.1053/j.sodo.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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11
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Optimal Surface Pre-Reacted Glass Filler Ratio in a Dental Varnish Effective for Inhibition of Biofilm-Induced Root Dentin Demineralization. Polymers (Basel) 2022; 14:polym14225015. [PMID: 36433140 PMCID: PMC9695696 DOI: 10.3390/polym14225015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022] Open
Abstract
A unique type of dental varnish (DV) containing surface pre-reacted glass (S-PRG) fillers of different concentrations was evaluated to determine the unpresented optimal ratio for inhibiting root dentin bio-demineralization. S-PRG DVs (10% to 40%)—10%-S, 20%-S, 30%-S, and 40%-S—were applied to bovine root dentin blocks and compared with controls—0%-f (no S-PRG) and 5%-NaF (5%-NaF). The Streptococcus mutans biofilm challenge was executed inside and outside an oral biofilm reactor for 7 days. The specimens were examined using a confocal laser scanning microscope and swept-source optical coherence tomography. Furthermore, they were observed using a scanning electron microscope and analyzed using energy-dispersive X-ray spectroscopy. The roughness (SzJIS) due to leaching of DV materials and demineralization depth were significantly less in the S-PRG groups than the control groups (p < 0.05). Complete or partially plugged dentinal tubules (DTs) were observed in 20%-S, 30%-S, and 40%-S, while wide-open DTs were observed more in controls. Cylindrical tags were present in groups containing more than 20% S-PRG. F, Na, Al, and Sr were detected in a higher percentile ratio in the 20%-S, 30%-S, and 40%-S groups compared to 0%-f and 10%-S. Nonetheless, it is suggested that incorporating 20% to 30% S-PRG fillers in DVs would be effective enough as an anti-demineralization coating, together with supplementing minerals; further evaluation is required to validate these findings.
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Review of Professionally Applied Fluorides for Preventing Dental Caries in Children and Adolescents. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031054] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This review aims to evaluate the effectiveness of professional topical fluoride application on the prevention of dental caries in primary and permanent dentition. A web search was conducted for English papers published from 2000 to 2020, using various digital resources (Pubmed, Google Scholar, Cochrane Library, and ResearchGate). The keywords were “professionally applied fluoride”, “fluoride gel”, “fluoride varnish”, “fluoride foam”, “fluoride mouthrinses”, and “non-cavitated caries lesions”. Inclusion criteria: (a) participants: children and adolescents, treated in a dental care setting; (b) intervention: professionally applied fluorides (gel, varnish, foam, mouthrinse); (c) comparator: no professional treatment or other preventive treatments; (d) outcomes: clinical effectiveness (e.g., caries reduction, tooth remineralization); (e) study design: randomized controlled trials, systematic reviews, meta-analyses; (f) publication period: 1 January 2000–31 December 2021. Clinical studies about home-use fluoride products, discussion papers, in-vitro studies, case reports, non-English articles, and studies with unclear methodology were excluded. Topical fluoride applications are indicated for patients with active smooth surface caries and for patients in high caries risk groups. Both APF gel and fluoride varnish are effective and can be recommended for caries prevention in primary and permanent teeth. For children under the age of 6, only 2.26% fluoride varnish is recommended.
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Wang X, Tewari N, Sato F, Tanimoto K, Thangavelu L, Makishima M, Bhawal UK. Biphasic Functions of Sodium Fluoride (NaF) in Soft and in Hard Periodontal Tissues. Int J Mol Sci 2022; 23:ijms23020962. [PMID: 35055148 PMCID: PMC8780524 DOI: 10.3390/ijms23020962] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/04/2023] Open
Abstract
Sodium fluoride (NaF) is widely used in clinical dentistry. However, the administration of high or low concentrations of NaF has various functions in different tissues. Understanding the mechanisms of the different effects of NaF will help to optimize its use in clinical applications. Studies of NaF and epithelial cells, osteoblasts, osteoclasts, and periodontal cells have suggested the significant roles of fluoride treatment. In this review, we summarize recent studies on the biphasic functions of NaF that are related to both soft and hard periodontal tissues, multiple diseases, and clinical dentistry.
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Affiliation(s)
- Xingzhi Wang
- Department of Biochemistry, Nihon University School of Medicine, Tokyo 173-8610, Japan;
| | - Nitesh Tewari
- Centre for Dental Education and Research, Division of Pedodontics and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi 110029, India;
| | - Fuyuki Sato
- Shizuoka Cancer Center, Pathology Division, Shizuoka 411-8777, Japan;
| | - Keiji Tanimoto
- Department of Translational Cancer Research, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-8553, Japan;
| | - Lakshmi Thangavelu
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India;
| | - Makoto Makishima
- Department of Biochemistry, Nihon University School of Medicine, Tokyo 173-8610, Japan;
- Correspondence: (M.M.); (U.K.B.)
| | - Ujjal K. Bhawal
- Center for Transdisciplinary Research, Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai 600077, India;
- Department of Biochemistry and Molecular Biology, Nihon University School of Dentistry at Matsudo, Chiba 271-8587, Japan
- Correspondence: (M.M.); (U.K.B.)
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