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Yu OY, Ge KX, Lung CYK, Chu CH. Developing a novel glass ionomer cement with enhanced mechanical and chemical properties. Dent Mater 2024; 40:e1-e13. [PMID: 38782634 DOI: 10.1016/j.dental.2024.05.019] [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: 08/07/2023] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To develop a novel glass ionomer cement (NGIC) with enhanced mechanical and chemical properties and assess its biocompatibility, mechanical strength, and ion release. METHODS Nanosilver doped bioactive glass (NanoAg BAG) was synthesized by sol-gel method and characterized by scanning electron microscopy with energy-dispersive X-ray spectroscopy and transmission electron microscopy. The NanoAg BAG, together with poly(vinylphosphonic acid) (PVPA), alumino-fluorosilicate glass and poly-acrylic acid were used to synthesize NGIC. The optimal PVPA concentration for NGIC was determined by PVPA modified GIC's biocompatibility and mechanical properties and used to prepare NGIC specimens. NGIC specimens with NanoAg BAG at 0%, 1%, 2%, and 5% were allocated into Groups NGIC0, NGIC1, NGIC2, and NGIC5, respectively. The biocompatibility, surface morphology, elemental composition, surface topography, chemical properties, compressive strength, diametral tensile strength, and ion release of the NGIC were assessed. A conventional glass ionomer cement (GIC) was used as a control. RESULTS A granular BAG with nano silver particles attached on its surface were found, indicating the successful synthesis of NanoAg BAG. PVPA at 10% presented the best effect in enhancing the biocompatibility and mechanical properties of PVPA modified GIC and was used to prepare NGIC specimens. NGIC1 showed similar biocompatibility, surface morphology and topography to GIC. Chemical properties results showed that NGICs showed the same adsorption peaks to GIC. The compressive strength (mean±SD in MPa) was 168.1 ± 29.7, 205.5 ± 29.5, 221.8 ± 46.8, 216.6 ± 59.3 and 167.7 ± 36.4, and the diametral tensile strength (mean±SD in MPa) was 14.1 ± 1.7, 18.3 ± 4.9, 21.2 ± 2.2, 17.2 ± 3.8 and 13.3 ± 3.3 for GIC, NGIC0, NGIC1, NGIC2 and NGIC5 respectively. NIGC0, NGIC1 and NGIC2 showed higher compressive and diametral tensile strength than GIC (p < 0.01). NGIC2 and NGIC5 showed higher release of fluoride, calcium, phosphate and silver ion than GIC and NGIC0 (p < 0.05). CONCLUSION A biocompatible NGIC with enhanced mechanical properties were developed. It presented enhanced fluoride, calcium, phosphate and silver ion release compared to conventional GIC.
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Affiliation(s)
- Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region.
| | - Kelsey Xingyun Ge
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Christie Ying-Kei Lung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong Special Administrative Region
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Kuru E, Eronat N, Türkün M, Çoğulu D. Comparison of remineralization ability of tricalcium silicate and of glass ionomer cement on residual dentin: an in vitro study. BMC Oral Health 2024; 24:732. [PMID: 38926776 PMCID: PMC11202387 DOI: 10.1186/s12903-024-04475-4] [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: 03/05/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE This study aimed to compare the remineralization effects of a calcium silicate-based cement (Biodentine) and of a glass ionomer cement (GIC: Fuji IX) on artificially demineralized dentin. METHODS Four standard cavities were prepared in dentin discs prepared from 34 extracted sound human third molars. In each disc, one cavity was covered with an acid-resistant varnish before demineralization (Group 1). The specimens were soaked in a chemical demineralization solution for 96 h to induce artificial carious lesions. Thereafter, one cavity each was filled with Biodentine (Group 2) and GIC (Group 3), respectively, and one carious lesion was left unrestored as a negative control (Group 4). Next, specimens were immersed in simulated body fluid (SBF) for 21 days. After cross-sectioning the specimens, the Ca/P ratio was calculated in each specimen by using scanning electron microscopy-energy-dispersive X-ray spectroscopy (SEM-EDX). Finally, data were analyzed using repeated-measures ANOVA with post-hoc Bonferroni correction. RESULTS Both cement types induced dentin remineralization as compared to Group 4. The Ca/P ratio was significantly higher in Group 2 than in Group 3 (p < 0.05). CONCLUSION The dentin lesion remineralization capability of Biodentine is higher than that of GIC, suggesting the usefulness of the former as a bioactive dentin replacement material. CLINICAL RELEVANCE Biodentine has a higher remineralization ability than that of GIC for carious dentin, and its interfacial properties make it a promising bioactive dentin restorative material.
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Affiliation(s)
- Elif Kuru
- Department of Pediatric Dentistry, Usak University School of Dentistry, Cumhuriyet, Merkez/Usak, 64200, Turkey.
| | - Nesrin Eronat
- Department of Pediatric Dentistry, Ege University School of Dentistry, Erzene, Bornova/İzmir, 35040, Turkey
| | - Murat Türkün
- Department of Restorative Dentistry, Ege University School of Dentistry, Erzene, Bornova / İzmir, 35040, Turkey
| | - Dilşah Çoğulu
- Department of Pediatric Dentistry, Ege University School of Dentistry, Erzene, Bornova/İzmir, 35040, Turkey
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Timms L, Choi S, Marshman Z, Rodd H, Wilson AR, Tiwari T. Parental acceptability of silver diamine fluoride: The UK and US experiences. Int J Paediatr Dent 2024. [PMID: 38676286 DOI: 10.1111/ipd.13195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 02/29/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND International data suggest that parents may have reservations about the use of silver diamine fluoride (SDF). AIM The aims of this study were to: (1) examine the acceptance of parents/carers towards the use of SDF for the management of caries in children's primary teeth in secondary care dental settings in the UK and the United States and (2) determine which factors may affect the acceptance of the use of SDF. DESIGN This was a cross-sectional questionnaire of SDF acceptability, completed by parents of young children. It was validated and adapted to local populations. Data were analysed with descriptive and inferential statistics. RESULTS Of the 113 Sheffield parents, 73% reported that they would accept SDF treatment of children's posterior teeth, with 58% reporting this for anterior teeth. Parents having less concern about posterior aesthetics had a statistically significant effect on reported acceptance of SDF (p = .013). In the Colorado sample (n = 104), 72% reported that they would accept SDF on posterior teeth, and 58% reported that they would accept SDF on anterior teeth. Concerns about aesthetics had an effect on decreasing SDF acceptance overall (p = .0065) in anterior (p = .023) and posterior teeth (p = .108). CONCLUSION The majority of parents in the two study populations accepted the treatment using SDF. However, concern about aesthetics had an influence on acceptability.
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Affiliation(s)
- Laura Timms
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Sooji Choi
- Children's Hospital Colorado, Aurora, Colorado, USA
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Helen Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Anne R Wilson
- Children's Hospital Colorado, Aurora, Colorado, USA
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Tamanna Tiwari
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Alambiaga-Caravaca AM, Chou YF, Moreno D, Aparicio C, López-Castellano A, Feitosa VP, Tezvergil-Mutluay A, Sauro S. Characterisation of experimental flowable composites containing fluoride-doped calcium phosphates as promising remineralising materials. J Dent 2024; 143:104906. [PMID: 38428715 DOI: 10.1016/j.jdent.2024.104906] [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: 02/04/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVE Remineralising composites with antibacterial properties may seal the cavity and prevent secondary caries. This study aimed at developing experimental flowable composites containing different concentrations of fluoride-doped calcium phosphate fillers and evaluating their remineralising and antibacterial properties. METHODS Experimental resin-based composites containing different concentrations (0-20 %) of fluoride-doped calcium phosphate fillers (VS10/VS20) were formulated. The release of calcium (Ca), phosphate (PO) and fluoride (F) ions was assessed for 30 days. Remineralisation properties were evaluated through ATR-FTIR and SEM/EDX after storage in simulated body fluid (SBF). The metabolic activity and viability of Streptococcus gordonii was also evaluated through ATP, CFU and live/dead confocal microscopy. The evaluation of specific monomer elution from the experimental composites was conducted using high-performance liquid chromatography (HPLC). RESULTS The composites containing VS10 showed the highest release of Ca, those containing VS20 released more F over time (p < 0.05), while there was no significant difference in terms of PO ions release between the groups (p > 0.05). A quick 7-day mineral precipitation was observed in the tested composites containing VS10 or VS20 at 10 %; these materials also showed the greatest antibacterial activity (p < 0.05). Moreover, the tested composites containing VS10 presented the lowest elution of monomers (p < 0.05). CONCLUSIONS Innovative composites were developed with low monomers elution, evident antibacterial activity against S. gordonii and important remineralisation properties due to specific ions release. CLINICAL SIGNIFICANCE Novel composites containing fluoride-doped calcium phosphates may be promising to modulate bacteria growth, promote remineralisation and reduce the risk of cytotoxicity related to monomers' elution.
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Affiliation(s)
- Adrián M Alambiaga-Caravaca
- Department of Pharmacy, Faculty of Health Sciences, Institute of Biomedical Sciences, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain; Department of Anatomy & Regenerative Medicine, Tissue Engineering Research Group, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Yu Fu Chou
- Department of Dentistry (Dental Biomaterials and Minimally Invasive Dentistry), Faculty of Health Sciences, Univeristy CEU Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia 46115, Spain
| | - Daniel Moreno
- Division of Research, Faculty of Odontology, UIC Barcelona - Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | - Conrado Aparicio
- Division of Research, Faculty of Odontology, UIC Barcelona - Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain; IBEC-Institute for Bioengineering of Catalonia, Barcelona, Spain
| | - Alicia López-Castellano
- Department of Pharmacy, Faculty of Health Sciences, Institute of Biomedical Sciences, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | | | - Arzu Tezvergil-Mutluay
- Adhesive Dentistry Research Group, Institute of Dentistry, and TYKS University Hospital, University of Turku, Turku, Finland
| | - Salvatore Sauro
- Department of Dentistry (Dental Biomaterials and Minimally Invasive Dentistry), Faculty of Health Sciences, Univeristy CEU Cardenal Herrera, CEU Universities, Alfara del Patriarca, Valencia 46115, Spain.
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Sartori CHM, Mazzetti T, Júnior FAV, Daneris ÂP, Cenci MS, van de Sande FH, Montagner AF. Methodological quality of evidence-based clinical practice guidelines in cariology. Clin Oral Investig 2023; 28:66. [PMID: 38159154 DOI: 10.1007/s00784-023-05429-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/20/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The present study aimed to appraise the methodological quality of evidence-based Clinical Practice Guidelines (CPGs) in the cariology field. MATERIALS AND METHODS A systematic search on electronic databases (MEDLINE/Pubmed, EMBASE, DARE and Epistemonikos), websites, and guideline organizations were undertaken. Evidence-based CPGs including at least one recommendation for clinical prevention and/or management of dental caries, developed for any clinical setting, were included. The quality of each guideline was evaluated using the AGREE II tool. Descriptive analysis was performed and the average overall score for each domain was calculated. RESULTS Thirty-two guidelines were included. Most of the CPGs achieved higher scores for the domains of clarity of presentation (66.7%, 95% IC 37.3-52.2) and scope and purpose (59.6%, 95% IC 53.7-65.5) domains; and lower scores for editorial independence (46.1%, 95% IC 37.8-55.7) and applicability domain (44.7%, 95% IC 37-55.3). The reviewers assessed 12 CPGs (37.5%) as recommended for use, 15 (46.9%) recommended with modifications, and 5 (15.6%) as not recommended. CONCLUSION The overall methodological quality of evidence-based CPGs in the cariology field is moderate, and there is a need for improvements in reporting related to most domains. The poorest reporting was found in the description of the domains' applicability of its recommendations and editorial independence. CLINICAL RELEVANCE Clinical Practice Guidelines provide guidance to patients, healthcare professionals, and stakeholders. The quality of these documents is essential for establishing trust in their recommendations.
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Affiliation(s)
| | - Thais Mazzetti
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
- Centre for Implementation Research, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Ottawa, Canada
| | | | | | - Maximiliano Sérgio Cenci
- Department of Dentistry, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Françoise Hélène van de Sande
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil
| | - Anelise Fernandes Montagner
- Graduate Program in Dentistry, Federal University of Pelotas, 457 Gonçalves Chaves Street, Pelotas, Rio Grande do Sul, Brazil.
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Valentim FB, Moreira KMS, Carneiro VC, do Nascimento LJ, Colares V, Imparato JCP. Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023; 24:1016-1025. [PMID: 38317401 DOI: 10.5005/jp-journals-10024-3607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIMS The purpose of this systematic review was to evaluate the cost-effectiveness and acceptance of children and their parents of the Hall technique (HT) for dental rehabilitation in pediatric dentistry. BACKGROUND The approach of the HT is that of minimally invasive treatment of the dental element and is used exclusively on primary molars. Various studies in the literature point to HT as a restorative option well accepted by children and parents and quite predictable, with low retreatment rates and good cost-effectiveness for the management of primary molars with carious lesions. However, no systematic review in the literature has approached randomized clinical trials on these topics to produce a high level of evidence and help establish clinical HT protocols. REVIEW RESULTS Eight articles were selected for the systematic review. The HT was more cost-effective than procedures using other restorative materials. Regarding acceptance, in terms of esthetics, high percentages of satisfaction were reported for parents and children, with a divergence between studies in the comparison of esthetic preference with atraumatic restorative treatment. However, when considering crown cementation pain, comfort, anxiety, preference, and satisfaction, the HT was generally better evaluated when compared to other restorative materials. CONCLUSION The HT is an excellent restorative option when considering cost-effectiveness and acceptance and is recommended for use in daily clinical practice. CLINICAL SIGNIFICANCE Results indicate that HT is superior to other restorative materials regarding its acceptance by children and parents in terms of pain, comfort, anxiety, and crown preference and satisfaction. There were also high percentages of satisfaction with esthetics. Hall technique may initially appear expensive for dentists, but its effectiveness over time and the lesser need for consultations and reinventions ensure better cost-benefit than other restorative materials. How to cite this article: Valentim FB, Moreira KMS, Carneiro VC, et al. Cost-effectiveness and Acceptance in Children and Parents of the Hall Technique: Systematic Review of Clinical Trials. J Contemp Dent Pract 2023;24(12):1016-1025.
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Affiliation(s)
- Flavia Bridi Valentim
- Department of Dentistry, São Leopoldo Mandic College, Campinas, São Paulo, Brazil, Orcid: https://orcid.org/0000-0003-1927-1591
| | - Kelly Maria Silva Moreira
- Department of Dentistry, São Leopoldo Mandic College, Campinas, São Paulo, Brazil, Orcid: https://orcid.org/0000-0002-1137-3908
| | - Vinícius Cavalcanti Carneiro
- Department of Dental Clinic, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil, Orcid: https://orcid.org/0000-0001-7567-0365
| | - Lidiane Jacinto do Nascimento
- Department of Dentistry, Dental School of Pernambuco, University of Pernambuco (UPE), Recife, Pernambuco, Brazil, Phone: +55 81 99690-8042, e-mail: , Orcid: https://orcid.org/0009-0009-6840-5227
| | - Viviane Colares
- Department of Dentistry, Dental School of Pernambuco, University of Pernambuco (UPE), Recife, Pernambuco, Brazil, Orcid: https://orcid.org/0000-0003-2912-2100
| | - José Carlos Pettorossi Imparato
- Department of Dentistry, São Leopoldo Mandic College, Campinas, São Paulo, Brazil, Orcid: https://orcid.org/0000-0002-1990-2851
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Hiltch G, Steier L, de Figueiredo JAP. Enhanced Clinical Decision-Making and Delivery of Minimally Invasive Care Using the ICCMS4D Integrated with Hands-Free Fluorescence-Based Loupes and a Chemomechanical Caries Removal Agent. Eur J Dent 2023; 17:1356-1362. [PMID: 37105220 PMCID: PMC10756833 DOI: 10.1055/s-0043-1764423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
The purpose of this case report was to evaluate an approach for enhanced clinical decision-making while providing minimally invasive treatment, using the combined International Caries Classification and Management System (ICCMS 4D) with hands-free fluorescence-enhanced loupes (Reveal, Designs for Vision Inc., New York City, NY, United States) and a chemo-mechanical caries removal agent (Papacárie Duo Gel, Formula & Acao, Sao Paulo, Brazil). In recent decades, a shift towards a conservative approach to caries management has developed. The use of adequate operative techniques and correct decision-making are of paramount importance for early caries detection and tooth-preserving operative care. The use of noninvasive fluorescence-based adjuncts for enhanced diagnostic accuracy has gained popularity. Fluorescence describes the absorption of photons by a molecule, followed by its partial emission at a longer wavelength. Fluorescence detection of bacterial activity is largely based on the red/orange fluorescence emanating from bacterial metabolism, and has been shown to be found particularly in active caries and mature anaerobic plaque. The combined approach of using the standardized visual International Caries Detection and Assessment System (ICDAS) with fluorescence as an operative adjunct was shown to enhance the advantages of both systems. The approach may potentially increase detection sensitivity without compromising the specificity of the visual tactile method. A recent hands-free device is aimed to combine simultaneous diagnosis and therapy (theragnosis) using fluorescence, while overcoming possible obstacles to workflow continuity. The "Reveal" fluorescence-enhanced loupes are fitted with a dual white light/fluorescence light, and are said to allow the clinician to conduct any operational procedure with optional fluorescence guidance, from detection to caries removal, to treatment completion. Using the described method, a comprehensive pathway that emphasizes evidence-based information, correct clinical decision-making, and a minimally invasive therapeutic approach was proposed. The approach may represent a potential advancement in providing minimally invasive caries care.
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Affiliation(s)
- Gal Hiltch
- Department of Dentistry, Federal University of Rio Grande do Sul—UFRGS, Porto Alegre, Brazil
| | - Liviu Steier
- Department of Preventive and Restorative Sciences, Dental School, University of Pennsylvania- UPENN, Philadelphia, Pennsylvania, United States
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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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Figundio N, Lopes P, Tedesco TK, Fernandes JCH, Fernandes GVO, Mello-Moura ACV. Deep Carious Lesions Management with Stepwise, Selective, or Non-Selective Removal in Permanent Dentition: A Systematic Review of Randomized Clinical Trials. Healthcare (Basel) 2023; 11:2338. [PMID: 37628535 PMCID: PMC10454894 DOI: 10.3390/healthcare11162338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 07/29/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE The goal of this systematic study was to investigate the effectiveness of selective, stepwise, and non-selective removal techniques for caries removal in permanent teeth with deep carious lesions. The primary focus was the results found comparing techniques for caries removal to check whether there was pulp exposition; the secondary was the materials used for pulp protection and clinical findings reported within the included studies. METHODS The search was performed in two databases (PubMed/MEDLINE and Web Of Science). The studies included in this systematic review were selected based on eligibility criteria. The inclusion criteria were: (1) randomized controlled trials (RCTs), (2) that compared the total removal of carious tissue with selective removal in permanent teeth with deep carious lesions, (3) with a follow-up period of at least 6 months, and (4) publications in English. Regarding the exclusion criteria, the following were not considered: (1) articles published in other languages, (2) articles that did not compare the different types of total/selective decay removal, and (3) articles published before January 2008. The risk of bias and the quality of the included studies were independently assessed by two reviewers using the RoB 2 tool. RESULTS 5 out of 105 potentially eligible studies were included. Regarding the teeth included in the study, three articles performed management only on permanent molars, while other studies also performed management on incisors/canines/premolars/molars. Management protocols were divided into nonselective caries removal and partial caries removal (selective/stepwise). The theory of non-selective caries removal was considered an excessive, unnecessarily invasive option and a form of outdated management, and selective removal was preferred. CONCLUSION The selective removal technique presented a higher success rate and fewer incidences of pulpal exposure than total removal, after up to 18 months of follow up. Moreover, only one session seemed to be a better management choice compared to two sessions because the cavity re-opening procedure is more prone to pulp exposure and highly depends on patient commitment. Otherwise, at 5 years of follow up, there was no difference between selective removal and total removal in management longevity. In addition, there were also no differences between the success of the materials used for definitive restorations in teeth subjected to any of the techniques evaluated.
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Affiliation(s)
- Nicola Figundio
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
| | - Pedro Lopes
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal;
| | - Tamara Kerber Tedesco
- Orthodontics and Pediatric Dentistry, Dental School, University of Sao Paulo, São Paulo 05508-000, SP, Brazil
| | | | - Gustavo Vicentis Oliveira Fernandes
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal;
- Periodontics and Oral Medicine Department, University of Michigan School of Dentistry, Ann Arbor, MI 48109, USA
| | - Anna Carolina Volpi Mello-Moura
- Faculty of Dental Medicine, Universidade Católica Portuguesa, 3504-505 Viseu, Portugal
- Centre for Interdisciplinary Research in Health (CIIS), Universidade Católica Portuguesa, 3504-505 Viseu, Portugal;
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Lamloum D, Arghittu A, Ferrara P, Castiglia P, Dettori M, Gaeta M, Odone A, Campus G. A Systematic Review of Clinical Practice Guidelines for Caries Prevention following the AGREE II Checklist. Healthcare (Basel) 2023; 11:1895. [PMID: 37444729 DOI: 10.3390/healthcare11131895] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/07/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Untreated oral diseases are detrimental to overall well-being and quality of life and are in close relationship with social and economic consequences. The presence of strong evidence for caries primary and secondary prevention is a compulsory tool for the development of clinical practice guidelines (CPGs). This paper was aimed to assess systematically the importance of clinical practice guidelines in caries prevention management considering both the adult and pediatric populations and evaluate them using the Appraisal of Guidelines for Research and Evaluation (AGREE II) Checklist. Records were extracted from EMBASE, SCOPUS, PubMed/Medline and seven other relevant guideline databases between 6 January and 14 February 2023. Two reviewers independently conducted the appraisal using the web-based platform My AGREE PLUS. Twenty-one guidelines/papers met the inclusion criteria and were reviewed. Eight CPGs included both primary and secondary prevention interventions, whereas thirteen presented a single preventive model. Overall, 12 guidelines were published in the USA. The mean AGREE II scores ranged from 35.4% to 84.3%. Of the total twenty-one included guidelines, twelve were classified as "Recommended", ranging from 56.3% to 84.3%, the others were described as "Recommended with modification", ranging from 35.4% to 68.9%. From the AGREE II analysis carried out, the CPGs included in this survey adopted a punctual methodological rigor but lacked applicative power. The present survey showed that the public, as the primary beneficiary, played a limited role in the development of the twenty-one CPGs. Hence, methodological improvement can better support high-quality CPG development in the future.
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Affiliation(s)
- Demetrio Lamloum
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Antonella Arghittu
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Pietro Ferrara
- Center for Public Health Research, University of Milan-Bicocca, 20126 Monza, Italy
- IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Paolo Castiglia
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Marco Dettori
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Maddalena Gaeta
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Anna Odone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy
| | - Guglielmo Campus
- Department of Restorative, Pediatric and Preventive Dentistry, University of Bern, 3012 Bern, Switzerland
- Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Department of Cariology, Saveetha Dental College and Hospitals, Chennai 600077, India
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11
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He Y, Vasilev K, Zilm P. pH-Responsive Biomaterials for the Treatment of Dental Caries-A Focussed and Critical Review. Pharmaceutics 2023; 15:1837. [PMID: 37514024 PMCID: PMC10385394 DOI: 10.3390/pharmaceutics15071837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Dental caries is a common and costly multifactorial biofilm disease caused by cariogenic bacteria that ferment carbohydrates to lactic acid, demineralizing the inorganic component of teeth. Therefore, low pH (pH 4.5) is a characteristic signal of the localised carious environment, compared to a healthy oral pH range (6.8 to 7.4). The development of pH-responsive delivery systems that release antibacterial agents in response to low pH has gained attention as a targeted therapy for dental caries. Release is triggered by high levels of acidogenic species and their reduction may select for the establishment of health-associated biofilm communities. Moreover, drug efficacy can be amplified by the modification of the delivery system to target adhesion to the plaque biofilm to extend the retention time of antimicrobial agents in the oral cavity. In this review, recent developments of different pH-responsive nanocarriers and their biofilm targeting mechanisms are discussed. This review critically discusses the current state of the art and innovations in the development and use of smart delivery materials for dental caries treatment. The authors' views for the future of the field are also presented.
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Affiliation(s)
- Yanping He
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia
| | - Krasimir Vasilev
- College of Medicine and Public Health, Flinders University, Bedford Park, Adelaide, SA 5042, Australia
| | - Peter Zilm
- Adelaide Dental School, University of Adelaide, Adelaide, SA 5000, Australia
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12
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Pires PM, Rosa TDC, Ribeiro-Lages MB, Duarte ML, Cople Maia L, Neves ADA, Sauro S. Bioactive Restorative Materials Applied over Coronal Dentine-A Bibliometric and Critical Review. Bioengineering (Basel) 2023; 10:731. [PMID: 37370661 DOI: 10.3390/bioengineering10060731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
The objective of the research was to examine the scientific literature concerning restorative materials with bioactive properties for the purpose of covering dentin. Searches were performed in various databases including MEDLINE, Scopus, Web of Science, Cochrane Library, Lilacs/BBO, and Embase. Inclusion criteria involved studies that utilized the terms "dentin" and "bioactive", along with "ion-releasing", "smart materials", "biomimetic materials" and "smart replacement for dentin". The information extracted included the title, authors, publication year, journal and the country of affiliation of the corresponding author. The studies were categorized based on their study design, type of material, substrate, analytical method, and bioactivity. A total of 7161 records were recovered and 159 were included for data extraction. Most of the publications were in vitro studies (n = 149), testing different types of materials in sound dentine (n = 115). Most studies were published in Dental Materials (n = 29), and an increase in publications could be observed after the year 2000. Most of the articles were from the USA (n = 34), followed by Brazil (n = 28). Interfacial analysis was the most investigated (n = 105), followed by bond strength (n = 86). Bioactivity potential was demonstrated for most tested materials (n = 148). This review presents insights into the current trends of bioactive materials development, clearly showing a severe lack of clinical studies.
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Affiliation(s)
- Paula Maciel Pires
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
- Dental Biomaterials & Minimally Invasive Dentistry, Departamento de Odontologia, CEU Cardenal Herrera University, 46115 Valencia, Spain
| | - Thamirys da Costa Rosa
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Mariana Batista Ribeiro-Lages
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Maysa Lannes Duarte
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-853, Brazil
| | - Salvatore Sauro
- Dental Biomaterials & Minimally Invasive Dentistry, Departamento de Odontologia, CEU Cardenal Herrera University, 46115 Valencia, Spain
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13
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de Moura RC, Santos PS, dosSantos Matias PM, Vitali FC, Hilgert LA, Cardoso M, Massignan C. Knowledge, attitudes, and practice of dentists on Minimal Intervention Dentistry: a systematic review and meta-analysis. J Dent 2023; 132:104484. [PMID: 36958696 DOI: 10.1016/j.jdent.2023.104484] [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: 11/13/2022] [Revised: 03/09/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVES To evaluate the knowledge, attitudes, and practice (KAP) of dentists on Minimal Intervention Dentistry (MID). DATA Cross-sectional studies that analyzed KAP outcomes on MID principles were included. SOURCES Eight databases (Cochrane, DOSS, Embase, LILACS, PsycINFO, PubMed, Scopus, and Web of Science) and the grey literature were searched on January 2022. STUDY SELECTION Two independent reviewers selected the included studies, initially by screening titles and abstracts and, finally, by full-text reading. The methodological quality of studies was assessed by using the Joanna Briggs Institute Critical Assessment Checklist for Prevalence Studies. Proportion meta-analysis was conducted using a random effect model for data analysis. Cochran's Q test was used to assess the heterogeneity and the I² statistic for evaluation of true variation due to heterogeneity. RESULTS Of 2,079 studies initially identified, twelve were included in the systematic review. Twenty-four statements about MID were included in the meta-analysis, based on data from ten studies (n=1728 participants). The pooled proportion of knowledge on MID was 75.66% (95%CI: 69.33 - 81.48; p<0.01; I²: 97%; Tau2: 0.0456) and of attitudes and practice was 47.95% (95%CI: 38.55 - 57.43; p<0.01; I²: 98%; Tau2: 0.0743). The higher prevalences rates were in the "knowledge" field, and the lowest was in "attitudes and practice". CONCLUSIONS The findings suggest that the knowledge of dentists on MID topics is acceptable, and the attitudes and practices need improvements. The studies lacked uniformity in methods and there is still a need for more studies to elucidate the KAP of dentists worldwide. CLINICAL SIGNIFICANCE Understanding the cognizance and the way oral healthcare professionals are treating dental caries is the first step to expanding the minimal intervention evidence into a dental practice. The final goal is to change the practice and make Minimal Intervention Dentistry the standard of care for dental caries worldwide. REGISTRATION PROSPERO CRD42021257518.
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Affiliation(s)
| | | | | | | | | | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina, Brazil
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14
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Sauro S, Spagnuolo G, Del Giudice C, Neto DMA, Fechine PBA, Chen X, Rengo S, Chen X, Feitosa VP. Chemical, structural and cytotoxicity characterisation of experimental fluoride-doped calcium phosphates as promising remineralising materials for dental applications. Dent Mater 2023; 39:391-401. [PMID: 36907820 DOI: 10.1016/j.dental.2023.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 02/14/2023] [Accepted: 03/03/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES This study aimed at evaluating the cytotoxicity, chemical and structural properties of experimental fluoride-doped calcium-phosphates as potential remineralising materials for dental applications. METHODS Experimental calcium phosphates were formulated using β-tricalcium phosphate, monocalcium phosphate monohydrate, calcium hydroxide, and different concentrations of calcium/sodium fluoride salts [(5 wt%: VSG5F), (10 wt%: VSG10F), (20 wt%: VSG20F)]. A fluoride-free calcium phosphate (VSG) was used as control. Each tested material was immersed in simulated body fluid (SBF), (24 h, 15 and 30 days) to assess their ability to crystallise into apatite-like. Cumulative fluoride release was assayed up to 45 days. Moreover, each powder was placed into a medium containing human dental pulp stem cells (200 mg/mL) and their cytotoxicity was analysed using the 3-(4,5-dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide (MTT) assay (24 h, 48 h and 72 h incubation). These latter results were statistically analysed by ANOVA and Tukey's test (α = 0.05). RESULTS All the experimental VSG-F materials produced fluoride-containing apatite-like crystals after SBF immersion. VSG20F presented prolonged release of fluoride ions into the storage media (45d). VSG, VSG10F and VSG20F showed a significant cytotoxicity at dilution of 1:1, while at 1:5, only VSG and VSG20F demonstrated a reduction in cell viability. At lower dilutions (1:10, 1:50 and 1:100) all specimens showed no significant toxicity to hDPSCs, but an increase in cell proliferation. SIGNIFICANCE The experimental fluoride-doped calcium-phosphates are biocompatible and possess a clear ability to evoke fluoride-containing apatite-like crystallisation. Hence, they may be promising remineralising materials for dental applications.
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Affiliation(s)
- Salvatore Sauro
- Dental Biomaterials & Minimally Invasive Dentistry, Departamento de Odontologia, CEU Cardenal Herrera University, Alfara del Patriarca, Valencia, Spain.
| | - Gianrico Spagnuolo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Carmela Del Giudice
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Davino M Andrade Neto
- Federal Institute of Education, Science, and Technology of Ceará, Campus Camocim, 62400-000 Camocim, CE, Brazil
| | - Pierre B A Fechine
- Grupo de Química de Materiais Avançados (GQMat) - Departamento de Química Analítica e Físico-Química, Universidade Federal do Ceará (UFC), Campus do Pici, CP 12100, Fortaleza CE 60451-970, Brazil
| | - Xiaohui Chen
- Division of Dentistry, School of Medical Sciences, The University of Manchester, Manchester, UK
| | - Sandro Rengo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131 Naples, Italy
| | - Xiaojing Chen
- Xiangya School of Stomatology and Hospital, Central South University, Changsha 410008, Hunan, China; Hunan Key Laboratory of Oral Health Research, Central South University, Changsha, 410008, Hunan, China; Institute of Dentistry, Dental Physical Sciences Unit, Queen Mary University of London, London, United Kingdom
| | - Victor P Feitosa
- Research Division, Paulo Picanço School of Dentistry, 900 Joaquim Sá St., Fortaleza 60135-218, Ceará, Brazil
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15
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Curylofo-Zotti FA, Oliveira VDC, Marchesin AR, Borges HS, Tedesco AC, Corona SAM. In vitro antibacterial activity of green tea-loaded chitosan nanoparticles on caries-related microorganisms and dentin after Er:YAG laser caries removal. Lasers Med Sci 2023; 38:50. [PMID: 36689037 DOI: 10.1007/s10103-023-03707-3] [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: 05/30/2022] [Accepted: 01/11/2023] [Indexed: 01/24/2023]
Abstract
This study aimed to determine the inhibitory effects of green tea (Gt), EGCG, and nanoformulations containing chitosan (Nchi) and chitosan+green tea (Nchi+Gt) against Streptococcus mutans and Lactobacillus casei. In addition, the antibacterial effect of nanoformulations was evaluated directly on dentin after the selective removal of carious lesion. At first, the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against S. mutans and L. casei isolates were investigated. In parallel, dentin specimens were exposed to S. mutans to induce carious lesions. Soft dentin was selectively removed by Er:YAG laser (n=33) or bur (n=33). Remaining dentin was biomodified with Nchi (n=11) or Gt+Nchi (n=11). Control group (n=11) did not receive any treatment. Dentin scraps were collected at three time points. Microbiological analyses were conducted and evaluated by agar plate counts. Gt at 1:32 dilution inhibited S. mutans growth while 1:16 was efficient against L. casei. EGCG at 1:4 dilution completely inhibited S. mutans and L. casei growth. Independently of the association with Gt, Nchi completely inhibited S. mutans at 1:4 dilution. For L. casei, different concentrations of Nchi (1:32) and Nchi+Gt (1:8) were required to inhibit cell growth. After selective carious removal, viability of S. mutans decreased (p<0.001), without difference between bur and Er:YAG laser (p>0.05). Treatment with Nchi and Nchi+Gt did not influence the microbial load of S. mutans on dentin (p>0.05). Although variations in concentrations were noticed, all compounds showed antibacterial activity against S. mutans and L. casei. Both bur and Er:YAG laser have effectively removed soft dentin and reduced S. mutans counts. Nanoformulations did not promote any additional antibacterial effect in the remaining dentin.
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Affiliation(s)
- Fabiana Almeida Curylofo-Zotti
- Department of Restorative Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Cafe Avenue, s/n 14040-904, Sao Paulo, Ribeirao Preto, Brazil.
| | - Viviane De Cássia Oliveira
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirao Preto, Sao Paulo, SP, Brazil
| | - Analu Rodriguez Marchesin
- Department of Restorative Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Cafe Avenue, s/n 14040-904, Sao Paulo, Ribeirao Preto, Brazil
| | - Hiago Salge Borges
- Department of Chemistry, Center of Nanotechnology and Tissue Engineering - Photobiology and Photomedicine Research Group, Faculty of Philosophy, Sciences and Letters of Ribeirao Preto, University of Sao Paulo (USP), São Paulo, Brazil
| | - Antonio Claudio Tedesco
- Department of Chemistry, Center of Nanotechnology and Tissue Engineering - Photobiology and Photomedicine Research Group, Faculty of Philosophy, Sciences and Letters of Ribeirao Preto, University of Sao Paulo (USP), São Paulo, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Cafe Avenue, s/n 14040-904, Sao Paulo, Ribeirao Preto, Brazil
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16
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Lim ZE, Duncan HF, Moorthy A, McReynolds D. Minimally invasive selective caries removal: a clinical guide. Br Dent J 2023; 234:233-240. [PMID: 36829011 PMCID: PMC9957719 DOI: 10.1038/s41415-023-5515-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/23/2022] [Accepted: 11/07/2022] [Indexed: 02/26/2023]
Abstract
An evolving understanding of the carious process, along with new research in adhesive restorative materials, has led to a more conservative, minimally invasive and biologically-based approach to managing dental carious lesions. The growing volume of literature has also demonstrated prognostic success in the selective caries excavation technique, subsequently preventing excessive tooth structure removal and injury to the dentine-pulp complex, which maintains pulp vitality and improves the long-term prognosis of the tooth. However, at present, there remains a limited volume of high-quality evidence to support selective caries removal, which subsequently could partly explain some resistance to its use in clinical practice. This clinical technique guide aims to demonstrate the management of carious lesions of moderate-to-deep depth in permanent teeth based on current minimally invasive dental literature.
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Affiliation(s)
- Zi En Lim
- General Dental Practitioner, Dublin, Ireland
| | - Henry F. Duncan
- grid.8217.c0000 0004 1936 9705Professor/Consultant in Endodontics, Trinity College Dublin, Ireland
| | | | - David McReynolds
- Academic Prosthodontist and Assistant Professor in Restorative Dentistry, Dublin Dental University Hospital, Ireland.
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17
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Turkay EY, Kargul B, Aydinoglu AK, Yoruc ABH. Evaluation of different remineralization agents in the treatment of natural caries-affected dentin in permanent teeth. Biomed Mater Eng 2023; 34:133-142. [PMID: 36120758 DOI: 10.3233/bme-221396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In the preventive treatment protocol, providing remineralization of the tissue in demineralized dentin caries is an important step. OBJECTIVE In this in vitro study, the effectiveness of remineralization agents in natural caries-affected dentin (NCAD) were investigated. METHODS Forty caries slices were prepared from permanent molar dentin with International Caries Detection and Assessment System (ICDAS 2) (Code 3). The interventions with 8 days pH cycling were as follows: Deionized water (DW); 5% Sodium Fluoride (5% NaF) Varnish; Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate (CPP-ACFP); Calcium Glyserophosphate (CaGP) + Magnesium (Mg) + Xylitol. DIAGNOdent (Laser Fluorescence, LF), Surface Microhardness (SMH), and X-ray Fluorescence (XRF) Spectroscopy measurements were calculated before and after pH cycling. RESULTS LF values decreased between 5% NaF, CCP-ACFP and CaGP. NCAD treated with 5% NaF, CaGP and CCP-ACFP exhibited statistically higher hardness compared to the control group. After 5% NaF application, SMH values were significantly higher than the others. There was no statistically significant difference between baseline and after pH cycling hardness of the control group. After cycling, XRF showed that Ca and P concentrations were increased in all groups. CONCLUSION The application of agents used in the study could be recommended and promoted as a treatment option of caries dentin for conventional management of caries.
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Affiliation(s)
| | - Betul Kargul
- Department of Pediatric Dentistry, Faculty of Dentistry, Marmara University, Istanbul, Turkey
| | - Aysu Karakas Aydinoglu
- Metallurgical and Materials Engineering Department, Chemistry and Metallurgy Faculty, Yildiz Technical University, Istanbul, Turkey
| | - Afife Binnaz Hazar Yoruc
- Metallurgical and Materials Engineering Department, Chemistry and Metallurgy Faculty, Yildiz Technical University, Istanbul, Turkey
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18
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Biochemical and Mechanical Analysis of Occlusal and Proximal Carious Lesions. Diagnostics (Basel) 2022; 12:diagnostics12122944. [PMID: 36552951 PMCID: PMC9777497 DOI: 10.3390/diagnostics12122944] [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: 09/28/2022] [Revised: 10/29/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022] Open
Abstract
A precise evaluation of caries excavation endpoint is essential in clinical and laboratory investigations. Caries invasion differentiates dentin into structurally altered layers. This study assessed these changes using Raman spectroscopy and Vickers microhardness. Ten permanent molars with occlusal and proximal carious lesions were assessed and compared at 130 points utilizing four Raman spectroscopic peaks: phosphate v1 at 960 cm-1, amide I (1650 cm-1), amide III (1235 cm-1) and the C-H bond of the pyrrolidine ring (1450 cm-1). The phosphate-to-amide I peak ratio and collagen integrity peak ratio (amide III: C-H bond) of carious zones were calculated and compared in both lesions. The former ratio was correlated to 130 Vickers microhardness indentations through lesions. The caries-infected dentin (CID) exhibited low phosphate peak, but higher amide I, III and C-H bond peaks than other zones in both lesions. The peaks in amide regions (I and III) varied in occlusal versus proximal lesions. A high correlation was found between mineral: matrix peak ratio and equivalent microhardness number within carious lesions, while the collagen integrity peak ratio was applied in proximal lesions only. Raman spectroscopy detected changes in the mineral and matrix contents within different carious zones and regions.
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19
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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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20
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Fierascu RC. Incorporation of Nanomaterials in Glass Ionomer Cements-Recent Developments and Future Perspectives: A Narrative Review. NANOMATERIALS (BASEL, SWITZERLAND) 2022; 12:nano12213827. [PMID: 36364603 PMCID: PMC9658828 DOI: 10.3390/nano12213827] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 05/29/2023]
Abstract
Glass ionomer cements (GICs), restorative materials with commercial availability spanning over five decades, are widely applied due to their advantages (including bio-compatibility, fluoride release, or excellent bonding properties). However, GICs have shortcomings. Among the disadvantages limiting the application of GICs, the poor mechanical properties are the most significant. In order to enhance the mechanical or antimicrobial properties of these materials, the addition of nanomaterials represents a viable approach. The present paper aims to review the literature on the application of different types of nanomaterials for the enhancement of GICs' mechanical and antimicrobial properties, which could lead to several clinical benefits, including better physical properties and the prevention of tooth decay. After applying the described methodology, representative articles published in the time period 2011-present were selected and included in the final review, covering the modification of GICs with metallic nanoparticles (Cu, Ag), metallic and metalloid oxide nanoparticles (TiO2, ZnO, MgO, Al2O3, ZrO2, SiO2), apatitic nanomaterials, and other nanomaterials or multi-component nanocomposites.
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Affiliation(s)
- Radu Claudiu Fierascu
- National Institute for Research & Development in Chemistry and Petrochemistry—ICECHIM Bucharest, 202 Spl. Independentei, 060021 Bucharest, Romania;
- Faculty of Chemical Engineering and Biotechnologies, University “Politehnica” of Bucharest, Bucharest, 313 Splaiul Independentei Str., 060042 Bucharest, Romania
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21
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Gomide RT, Frencken JE, Faber J, Kuijpers-Jagtman AM. Does treating proximal cavities in primary molars non-restoratively affect intra-arch space and alignment of successor teeth negatively? A 4-year longitudinal study. PeerJ 2022; 10:e14008. [PMID: 36213499 PMCID: PMC9536320 DOI: 10.7717/peerj.14008] [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: 05/11/2022] [Accepted: 08/14/2022] [Indexed: 01/19/2023] Open
Abstract
Background Removing plaque with toothbrush and toothpaste from proximal cavities in primary molars without restoring them follows sound cariological principles. But does this treatment affect space for and alignment of their permanent successors negatively? Hypothesis There is no difference in impaction and displacement of the premolars, as well as in the D+E space in quadrants with three different statuses of the proximal surface of primary molars over a 4-year period. Methods A total of 936 quadrants (466 maxillary and 470 mandibular quadrants) in 233 children were assessed. Treatment of cavities in the proximal surfaces of the primary molars consisted of amalgam and ART restorations using high-viscosity glass-ionomer cement, and cleaning of open large- and medium-sized cavities with toothbrush and toothpaste (UCT) under supervision for 220 days per year over 3 years. Dental casts were made at baseline, and after two, three, and 4 years. The D+E spaces were measured digitally. Status of the proximal surface of the primary molars was assessed by two calibrated examiners, and quadrants were grouped into normal anatomy, defective restoration, and proximal cavity. ANCOVA, ANOVA and LSD tests were applied. Results There was a statistically significant difference between groups (p <= 0.001) and between evaluation times (p < 0.001), for the D+E space in both the maxilla and mandible. A sex difference related to the D+E space in the maxilla was found (p = 0.007). For boys, quadrants in the maxilla of the group 'proximal cavity' showed a significant shorter D+E space when compared to quadrants of the group 'normal anatomy' at the 3- and 4-year evaluation time. For girls the difference between the two groups was only present at the 3-year evaluation time. There was no significant difference between the D+E space in quadrants with defective restorations and those with normal anatomy in the mandible and in the maxilla. Displacement and impaction of the premolars showed no significant difference between groups. Conclusion Primary molars with open proximal cavities that are cleaned with toothbrush and toothpaste do not result in displacement and impaction of the successor teeth, neither do primary molars with defective restorations in proximal tooth surfaces.
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Affiliation(s)
- Rafael T. Gomide
- Department of Pediatric Dentistry, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Jo E. Frencken
- Department of Dentistry – Oral function and Prosthetic Dentistry, Radboud University Nijmegen, Nijmegen, Netherlands
| | | | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, Netherlands,Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Berne, Berne, Switzerland,Faculty of Dentistry, Universitas of Indonesia, Jakarta, Indonesia
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22
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Maciel Pires P, Ionescu AC, Pérez-Gracia MT, Vezzoli E, Soares IPM, Brambilla E, de Almeida Neves A, Sauro S. Assessment of the remineralisation induced by contemporary ion-releasing materials in mineral-depleted dentine. Clin Oral Investig 2022; 26:6195-6207. [PMID: 35670863 DOI: 10.1007/s00784-022-04569-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/29/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Evaluate the ability of current ion-releasing materials to remineralise bacteria-driven artificial caries lesions. MATERIALS AND METHODS Standardised class I cavities were obtained in 60 extracted human molars. Specimens underwent a microbiological cariogenic protocol (28 days) to generate artificial caries lesions and then were randomly divided into four restorative groups: adhesive + composite (negative control); glass ionomer cement (GIC); calcium silicate cement (MTA); and resin-modified calcium silicate cement (RMTA). Microhardness analysis (ΔKHN) was performed on 40 specimens (10/group, t = 30 days, 45 days, 60 days in artificial saliva, AS). Micro-CT scans were acquired (3/group, t = 0 days, 30 days, and 90 days in AS). Confocal microscopy was employed for interfacial ultra-morphology analysis (2/group, t = 0 days and 60 days in AS). Additional specimens were prepared and processed for scanning electron microscopy (SEM) and FTIR (n = 3/group + control) to analyse the ability of the tested materials to induce apatite formation on totally demineralised dentine discs (60 days in AS). Statistical analyses were performed with a significance level of 5%. RESULTS Adhesive + composite specimens showed the lowest ΔKHN values and the presence of gaps at the interface when assessed through micro-CT even after storage in AS. Conversely, all the tested ion-releasing materials presented an increase in ΔKHN after storage (p < 0.05), while MTA best reduced the demineralised artificial carious lesions gap at the interface. MTA and RMTA also showed apatite deposition on totally demineralised dentine surfaces (SEM and FTIR). CONCLUSIONS All tested ion-releasing materials expressed mineral precipitation in demineralised dentine. Additionally, calcium silicate-based materials induced apatite precipitation and hardness recovery of artificial carious dentine lesions over time. CLINICAL RELEVANCE Current ion-releasing materials can induce remineralisation of carious dentine. MTA shows enhanced ability of nucleation/precipitation of hydroxyapatite compared to RMTA and GIC, which may be more appropriate to recover severe mineral-depleted dentine.
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Affiliation(s)
- Paula Maciel Pires
- Department of Pediatric Dentistry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil.,Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Andrei Cristian Ionescu
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Maria Teresa Pérez-Gracia
- Microbiology, Departamento de Farmacia, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain
| | - Elena Vezzoli
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy
| | - Igor Paulino Mendes Soares
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University UNESP, Araraquara, Brazil
| | - Eugenio Brambilla
- Oral Microbiology and Biomaterials Laboratory, Department of Biomedical, Surgical and Dental Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, Valencia, Spain.
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Sajini S, Atmeh AR, Banerjee A, Festy F, Cook RJ, Andiappan M, Watson TF. Glass-ionomer and calcium silicate-based cements interactions with human dentine in health and disease: Two-photon fluorescence microscopy and Raman spectroscopy analysis. Dent Mater 2022; 38:1710-1720. [PMID: 36123189 DOI: 10.1016/j.dental.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/31/2022] [Accepted: 09/08/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To investigate the potential mineralising effects of calcium silicate-based dentine replacement material (Biodentine™) in comparison with glass-ionomer cement (GIC) (Fuji IX™) on different human dentine substrates using a multimodal non-invasive optical assessment. METHODS Cements were applied on artificially demineralised or naturally carious dentine and stored for 4 weeks in phosphate-rich media +/- tetracycline used for mineralisation labelling. Interfacial dentine was examined from the same sample and location before and after aging using two-photon fluorescence microscopy, fluorescence lifetime imaging (FLIM) and second harmonic generation (SHG) imaging. Additionally, Raman spectroscopy was used to detect changes in the mineral content of dentine. RESULTS Significant changes in the fluorescence intensity and lifetime were detected in partially demineralised dentine and caries-affected dentine underneath both tested cements, after storage (p < 0.001). This was associated with a significant increase in the mineral content as indicated by the increased intensity of the phosphate Raman peak located at 959 cm-1 (p < 0.0001). Caries-infected dentine showed significant fluorescence changes under Biodentine™ after storage (p < 0.001), but not under GIC (p = 0.44). Tetracycline binding induced a reduction in the fluorescence lifetime with comparable increase in the fluorescence intensity in both cements' groups within the affected dentine (p < 0.001). Significance Two-photon fluorescence microscopy can be used efficiently for non-destructive in-vitro dentine caries characterisation providing a technique for studying the same dentine-cement interface over time and detect changes. Biodentine™ demonstrated comparable remineralising potential to GIC, in addition to inducing remineralisation of caries-infected dentine. This may suggest using Biodentine™ as part of minimally invasive operative dentistry (MID) in caries management.
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Affiliation(s)
- Shara Sajini
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK; Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amre R Atmeh
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK; Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates.
| | - Avijit Banerjee
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | | | - Richard J Cook
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Manoharan Andiappan
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Timothy F Watson
- Centre for Oral, Clinical and Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Color changes and shear bond strength to simulated caries lesions treated with a novel solution of 20% silver nanoclusters in polymethacrylic acid. Sci Rep 2022; 12:15418. [PMID: 36104473 PMCID: PMC9474811 DOI: 10.1038/s41598-022-19757-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 09/05/2022] [Indexed: 11/17/2022] Open
Abstract
The aims of the study were: (1) To compare the staining effect on demineralized dentin simulating caries between silver nanoclusters (AgNCls) synthesized using polymethacrylic acid (PMAA) and silver diammine fluoride (SDF), and (2) to measure the shear bond strength (SBS) of a glass ionomer cement (GIC) to simulated caries lesions with and without the application of AgNCls/PMAA or SDF. Dentine blocks 4 mm thick from twenty-four non-carious third molars were sectioned and coated with nail varnish (Revlon, New York, USA). Simulated caries lesions on occlusal dentin surfaces were created (66 h in 0.05 M acetate buffer 2.2 mM calcium/phosphate pH 5.0). Specimens were divided into groups and treated with (n = 8): (A) 20% AgNCls/PMAA; (B) SDF 38% (Fagamin, Tedequim, Córdoba, Argentina); or (C) without treatment. AgNCls/PMAA or SDF were applied on the exposed surfaces with a microbrush for 10 s. Samples were incubated for 24 h at 37 °C at 100% relative humidity. Surface color was measured according to the CIE-L*a*b* system before and after demineralization (R0 and R1), 24 h and one week after treatment (R2 and R3), using a spectrophotometer (CM-600D Konica Minolta Sesing Inc., Japan). Groups A and B received an extra application of AgNCls/PMAA or SDF before a conventional GIC (Fuji IX-Gold Label, GC Corp, Tokyo, Japan) was bonded using a mold, 4 mm diameter × 3 mm high. For SBS, a Universal Testing Machine (Digimess RS-8000-5, China)—crosshead speed of 1 mm/min—was used. Statistical analysis was performed using ANOVA, Student-t and Scheffe-test at a significance of p < 0.05. Group A presented a stable color p = 0.24 between R1-R2 and R1-R3 in contrast to significant color changes in Group B (p = 0.02). SBS was higher (p < 0.01) in Group A (10.4 ± 2.7 MPa) compared to Groups B (3.3 ± 1.3 MPa) and C (4.0 ± 0.4 MPa), where no differences between the latter groups were observed (p = 0.77). Results of this preliminary study demonstrated that 20% AgNCls/PMAA did not stain simulated carious dentin and improved SBS of the GIC. The relevance of this study relies on the development of a therapeutic system to potentially arrest caries lesions without staining.
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AlKhalaf R, Neves ADA, Warburton F, Banerjee A, Hosey MT. Management of compromised first permanent molars in a cohort of UK paediatric patients referred to hospital-based services. Int J Paediatr Dent 2022; 32:724-736. [PMID: 34967478 PMCID: PMC9540387 DOI: 10.1111/ipd.12951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/30/2021] [Accepted: 12/17/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND There are diverse opinions among dentists about managing compromised first permanent molars (cFPMs) in children and a perceived lack of guidance to help them evaluate prognosis. AIM To evaluate the current management of cFPM in children referred to a UK hospital centre and to report the severity of the affected teeth. DESIGN A service evaluation was undertaken, based on case records of medically fit children (6-11 years) referred to for the management of cFPMs. The presence of hypomineralisation, post-eruptive breakdown and the proposed care plans were recorded. Radiographic signs of severity were scored using the ICDAS index (intra/inter-rater kappa 0.96/0.82). RESULTS From 349 records screened over a 4-month period, 249 met the selection criteria. Almost 81% were planned to have extraction of at least one cFPM, whereas 19.3% were managed without extraction. More than half of the extraction cases (n = 105) had radiographic radiolucencies not exceeding the middle third of dentine in the worst-affected FPM. At the time of extraction, the mean age of the patients was 9.8 years (±0.9). GA was used in 196 (97.5%) cases, and 40.8% had not received previous treatment in any of their cFPMs. CONCLUSION Potentially restorable cFPMs in children is, most of the time, in a cohort of UK patients referred for tier 3 services, being managed by timed extractions under general anasethesia.
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Affiliation(s)
- Reem AlKhalaf
- Centre of OralClinical & Transitional ScienceFaculty of Dentistry, Oral and Craniofacial SciencesKing's College LondonLondonUK
- Department of clinical dental sciencesCollege of DentistryPrincess Nourah Bint Abdul Rahman UniversityRiyadhSaudi Arabia
| | - Aline de Almeida Neves
- Clinical Lecturer in Paediatric DentistryCentre of Oral, Clinical and Translational SciencesFaculty of Dentistry, Oral and Craniofacial ScienceKing's College LondonLondonUK
- Federal University of Rio de JaneiroRio de JaneiroBrazil
| | - Fiona Warburton
- Oral Clinical Research UnitFaculty of Dentistry, Oral & Craniofacial SciencesKing's College LondonLondonUK
| | - Avijit Banerjee
- Restorative DentistryCentre of Oral, Clinical and Translational SciencesFaculty of Dentistry, Oral and Craniofacial ScienceKing's College LondonLondonUK
| | - Marie Therese Hosey
- Centre of Oral, Clinical and Translational SciencesFaculty of Dentistry, Oral and Craniofacial ScienceKing's College LondonLondonUK
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Cabalén MB, Molina GF, Bono A, Burrow MF. Nonrestorative Caries Treatment: A Systematic Review Update. Int Dent J 2022; 72:746-764. [PMID: 35879115 PMCID: PMC9676527 DOI: 10.1016/j.identj.2022.06.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/16/2022] [Accepted: 06/26/2022] [Indexed: 11/29/2022] Open
Abstract
Caries is the most prevalent chronic noncommunicable disease. Strategies to prevent its onset and early interventions to arrest the progression of early lesions have been emphasised throughout recent decades to avoid or delay the restorative spiral of the tooth. More individuals are retaining their natural teeth into old age, thereby necessitating ongoing restorative dentistry intervention for their maintenance. The aim of this systematic review was to update the state of the art regarding clinical studies reporting the effectiveness of different nonrestorative caries treatment options in the 5-year period from 2017 to 2022. Relevant articles were retrieved from 2 electronic databases, including randomised clinical trials (RCTs) published from January 2017 until April 2022, assessing effectiveness and secondary effects of at least one nonrestorative caries treatment option, carried out with adults and/or children with noncavitated or cavitated carious lesions on either primary or permanent teeth and diagnosed by radiographs or visual/tactile assessment. All 35 included articles presented the results of RCTs with a follow-up period ranging from 6 to 84 months. Most of these studies were considered high-quality articles with a low risk of bias. Sealants and fluoride gels and varnishes were mentioned in 12 studies as effective strategies to prevent the onset of caries lesions and to arrest them in the early stages. Resin infiltration reported high caries arresting rates in noncavitated proximal lesions in 10 publications. Silver diammine fluoride presented high caries-arresting rates in open dentin lesions, both in primary and permanent dentitions as well as in root caries lesions that were accessible for cleansing. New evidence has been published between 2017 and 2022 as the result of numerous clinical studies providing further evidence of the effectiveness of nonrestorative caries treatment options.
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Affiliation(s)
- María Belén Cabalén
- Cátedra de Materiales Dentales, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina
| | - Gustavo Fabián Molina
- Cátedra de Materiales Dentales, Facultad de Ciencias de la Salud, Universidad Católica de Córdoba, Argentina; Division of Restorative Dental Sciences, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR China.
| | - Alejandra Bono
- Cátedra de Periodoncia, Faculty of Dentistry, Universidad Nacional de Córdoba, Argentina
| | - Michael F Burrow
- Division of Restorative Dental Sciences, Faculty of Dentistry, University of Hong Kong, Hong Kong SAR China
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Silva GSD, Raggio DP, Mello-Moura ACV, Gimenez T, Montagner AF, Floriano I, Lara JS, Calvo AFB, Pascareli-Carlos AM, Tedesco TK. Pulp vitality of primary molars with deep caries treated with ART restorations: 2-year RCT. Braz Oral Res 2022; 36:e061. [PMID: 36507748 DOI: 10.1590/1807-3107bor-2022.vol36.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/01/2021] [Indexed: 12/15/2022] Open
Abstract
The aim of this study was to compare the pulp vitality of primary teeth with deep caries treated with two restorative techniques. The restoration survival rate was also evaluated as a secondary outcome. Children aged from 4 to 8 years with at least one deep carious lesion in molars were selected at the Ibirapuera University dental clinic. One hundred and eight deciduous molars were allocated into two groups: (1) restoration with calcium hydroxide cement lining followed by filling with high-viscosity glass ionomer cement (CHC+HVGIC) or (2) restoration with HVGIC. Pulp vitality and restoration survival were evaluated at 6, 12, and 24 months. Intent-to-treat analysis was used for pulp vitality, and survival analysis was performed with the Kaplan-Meier method (α=5%). Results: At 24 months, 86 restorations were evaluated, and 91 were evaluated at least once during the study. There was no significant difference between the restorative treatments regarding pulp vitality (CHC +HVGIC=70% and HVGIC=68.5%) (OR=1.091; CI95%=0.481-2.475). However, HVGIC (73%) restorations showed a higher survival rate than CHC+HVGIC (50%) (p=0.021). Thus, it can conclude that deep caries in primary molars should be restored with HVGIC, since the technique results in similar pulp vitality to the CHC +HVGIC, but with a higher restoration survival rate.
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Affiliation(s)
- Gabriela Seabra da Silva
- Universidade de São Paulo - USP, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, São Paulo, SP, Brazil
| | - Daniela Prócida Raggio
- Universidade de São Paulo - USP, School of Dentistry, Department of Orthodontics and Pediatric Dentistry, São Paulo, SP, Brazil
| | - Anna Carolina Volpi Mello-Moura
- Universidade Católica Portuguesa, Faculty of Dental Medicine, Center for Interdisciplinary Research in Health - SalivaTec Lab, Viseu, Portugal
| | - Thais Gimenez
- Universidade Ibirapuera - UNIB, Graduate Program in Dentistry, São Paulo, SP, Brazil
| | | | - Isabela Floriano
- Centro Universitário Uninovafapi, School of Dentistry, Teresina, PI, Brazil
| | - Juan Sebastian Lara
- Indiana University, School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, Indianapolis, IN, USA
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da Cunha CMBDL, Wambier LM, Matos TDP, Malaquias P, Reis A, Loguercio AD, Wambier DS, Chibinski ACR. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022; 15:38-46. [PMID: 35528486 PMCID: PMC9016904 DOI: 10.5005/jp-journals-10005-2173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The clinical performance of new restorative materials must be evaluated before recommending its use in primary teeth. Aim This randomized clinical trial evaluated the survival rates of restorations in single and occluso-proximal cavities of primary teeth performed with a new dual-cure resin-based material in comparison with a resin-modified glass ionomer cement after 12 months of follow-up. Materials and methods A total of 107 restorations were placed in 27 children by one experienced pediatric dentist. Two materials were tested: Vitremer and a dual-cure resin-based material with (CentionN+Adh) and without (Cention N-Adh) adhesive system application. Two calibrated and blinded examiners evaluated the restorations at 3, 6, and 12-month. The longevity of the restorations was analyzed using Kaplan-Meier survival curves and Log-rank test (α = 5%). Results The overall survival rates after 12-month were 81.9% for Vitremer, 70.4% for Cention N+Adh, and 66.7% for Cention N-Adh, which had the poorer performance (HR = 0.54; 95% CI= 0.31-0.95; p = 0.031). When considering the type of the cavities, the difference was significant only for occluso-proximal cavities when Cention N-Adh was used (HR = 0.46; CI = 0.26-0.81; p = 0.008). Conclusion All evaluated materials are suitable for restoring occlusal cavities after selective caries removal. However, Cention N needs to be used with adhesive in occluso-proximal cavities. Clinical significance Cention-N can be used for deciduous teeth restorations, with similar longevity rates as resin modified glass ionomer cements. Trial registration number RBR-9nqszr How to cite this article da Cunha CM, Wambier LM, Paris Matos TD, et al. New Dual-cure Resin-based Material in Occlusal and Occluso-proximal Restorations of Primary Teeth: Results of a Randomized Clinical Trial. Int J Clin Pediatr Dent 2022;15(1):38-46.
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Affiliation(s)
| | - Letícia Maíra Wambier
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | - Pamela Malaquias
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Alessandra Reis
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | | | | | - Ana Cláudia Rodrigues Chibinski
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
- Ana Cláudia Rodrigues Chibinski, Department of Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil, Phone: +55 42 999171983, e-mail:
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García-Bernal D, Pecci-Lloret MP, López-García S. The Cytocompatibility of Silver Diamine Fluoride on Mesenchymal Stromal Cells from Human Exfoliated Deciduous Teeth: An In Vitro Study. MATERIALS 2022; 15:ma15062104. [PMID: 35329556 PMCID: PMC8954535 DOI: 10.3390/ma15062104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022]
Abstract
Silver diamine fluoride (SDF) has been used for many years for the treatment of caries, and minimally invasive dentistry concepts have made it popular again. The fact that its application does not require the administration of anesthesia makes its use in children more desirable. The aim of this study was to determine the cytotoxicity of two new commercial SDF products: Riva Star (SDI Dental Limited) and e-SDF (Kids-e-Dental) on mesenchymal stromal cells from human exfoliated deciduous teeth (SHEDs). SHEDs were exposed to SDF products at different concentrations (0.1%, 0.01% and 0.005%). Then different assays were performed to evaluate their cytocompatibility on SHEDs: IC50, MTT, cell migration (wound healing), cell cytoskeleton staining, cell apoptosis, generation of intracellular reactive oxygen species (ROS), and ion chromatography. Statistical analyses were performed using one-way ANOVA and Tukey’s post hoc test (p < 0.05). Riva Star Step 2 showed the same cell metabolic activity when compared to the control condition at any time and concentration. Meanwhile, e-SDF displayed high cytotoxicity at any time and any concentration (*** p < 0.001), whereas Riva Star Step 1 displayed high cytotoxicity at any time at 0.1% and 0.01% (*** p < 0.001). Only e-SDF showed a statistically significant decreased cell migration rate (*** p < 0.001) at all times and in all concentrations. At 0.1%, e-SDF and Riva Star Step 1 only showed 4.37% and 4.47% of viable cells, respectively. These results suggest that Riva Star has better in vitro cytocompatibility on SHEDs than does e-SDF. Riva Star Step 1 was found to be as cytotoxic as e-SDF, but it had better biological properties when mixed with Riva Star Step 2. Our findings suggest that Riva Star is more suitable when used in deciduous teeth due to its lower cytotoxicity compared to e-SDF.
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Affiliation(s)
- David García-Bernal
- Biochemistry, Molecular Biology and Immunology Department, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain;
| | - Maria Pilar Pecci-Lloret
- Gerodontology and Special Care Dentistry Unit, Morales Meseguer Hospital, Faculty of Medicine, University of Murcia, 30100 Murcia, Spain
- Correspondence: ; Tel.: +34-8688-8575
| | - Sergio López-García
- Department of Stomatology, Faculty of Medicine and Dentistry, Universitat de Valencia, 46003 Valencia, Spain;
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Sajini SI, Alshawi BA, Alharbi LM. Assessment of remineralisation potentials of bioactive dental composite using an in-vitro demineralised dentine model. J Taibah Univ Med Sci 2022; 17:640-647. [PMID: 35983447 PMCID: PMC9356364 DOI: 10.1016/j.jtumed.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/20/2021] [Accepted: 12/01/2021] [Indexed: 11/22/2022] Open
Abstract
Objective Minimally invasive dentistry encourages conservative caries excavation and remineralisation of the remaining dental tissues. However, dentine remineralisation is more difficult than enamel remineralisation due to the differences in their composition. This study aims to assess the remineralisation potential of Activa BioActive-Restorative and Beautifil II restoration on demineralised dentine samples, and compares it with glass-ionomer (GIC) restoration using energy dispersive X-ray (EDX) and Knoop hardness number (KHN). Methods Non-carious extracted molar teeth were used, a total number of ten teeth were sectioned into halves and partially demineralised using 37.0% phosphoric acid for 60 s. All samples are assessed using EDX and KHN prior to restorations. The samples are then subdivided into four groups (n = 5). Group 1 was restored with Activa BioActive-Restorative, Group 2 received Beautifil II, Group 3 was restored with GIC, and the last group was used as a negative control. After storage, the samples were analysed using EDX and KHN. Results The demineralisation protocol with 37.0% phosphoric acid significantly decreased the calcium:phosphate (Ca:P) ratio and KHN. Remineralisation occurred in all groups, but the highest percentage change in Ca:P ratio and KHN was observed in the Activa BioActive-Restorative group (20.7%, 82.0%, respectively), followed by the Beautifil II group, glass ionomer group, and the control group, in that order. Conclusion Activa BioActive-Restorative restoration presents superior remineralisation compared to Beautifil II and glass-ionomer dental restorations.
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Affiliation(s)
- Shara I. Sajini
- Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, KSA
- Corresponding address: Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, P.O.Box 80209, Jeddah, 21589, KSA.
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Cascales ÁF, Moscardó AP, Toledano M, Banerjee A, Sauro S. An in-vitro investigation of the bond strength of experimental ion-releasing dental adhesives to caries-affected dentine after 1 year of water storage. J Dent 2022; 119:104075. [DOI: 10.1016/j.jdent.2022.104075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 02/12/2022] [Accepted: 02/22/2022] [Indexed: 11/15/2022] Open
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Effect of silver diamine fluoride on vital dental pulp: A systematic review. J Dent 2022; 119:104066. [DOI: 10.1016/j.jdent.2022.104066] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 01/21/2022] [Accepted: 02/05/2022] [Indexed: 12/14/2022] Open
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Besegato JF, Melo PBGD, Bernardi ACDA, Bagnato VS, Rastelli ANDS. Ultrasound device as a minimally invasive approach for caries dentin removal. Braz Dent J 2022; 33:57-67. [DOI: 10.1590/0103-6440202203878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/08/2021] [Indexed: 11/21/2022] Open
Abstract
Abstract The aim of this study was to evaluate the efficacy of an ultrasound device and the dentin surface morphology after removal of the caries dentin lesions by removal rate and scanning electron microscopy (SEM). The Knoop hardness test on the bovine dentin blocks (n = 20, 4x4x2mm) was performed to standardize the samples and only those with 38 ± 2 KHN were included. The dentin blocks were submitted to induction of artificial caries lesions, using the bacterial model. Strains of Streptococcus mutans and Lactobacillus acidophilus were used for 7 days. The caries dentin lesion was removed for 1 min, according to two methods: G1 - carbide bur under low-speed rotation (control group) and G2 - ultrasound device under refrigeration. For the removal rate, the samples were weighed 3 times: T0 (before induction), T1 (after induction) and T2 (after removal). Morphology evaluation of the residual dentin surface was performed by SEM. Data normality was verified by Shapiro-Wilk test (p ≥ 0.240). T-test for independent samples was applied to evaluate the removal rate. A significance level of 5% was adopted. G2 provided lower removal rate than G1 (G1: 3.68 mg and G2 = 2.26 mg). SEM images showed different morphological characteristics between the groups. G2 showed absent of smear layer, while G1 showed a visible smear layer over the surface. We concluded that ultrasound device provides minimally invasive removal with residual dentin exhibiting open dentin tubules and no smear layer formation and no bacteria, which infer the removal of the infected tissue.
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Agel M, Scambler S, Hosey MT. Parental Views on Minimally Invasive Dentistry versus General Anaesthesia Extractions of Children's Compromised First Permanent Molars: An Exploratory Qualitative Study. Prim Dent J 2022; 10:27-32. [PMID: 35088636 DOI: 10.1177/20501684211066230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The current standard of care for first permanent molars (FPMs) requiring extraction is removal of these teeth between the chronological ages of eight to ten years, as per UK guidelines.1 This often involves a general anaesthetic (GA) with surgical admission to hospital. This study explores parental views on minimally invasive (MI) techniques as an alternative to the UK current standard of care for extractions of FPMs deemed to require removal between the chronological ages of eight to ten years. METHODS A qualitative investigation, using semi-structured interviews was conducted with parents/carers of children attending a teaching hospital for extraction of compromised FPMs under GA. Thematic framework analysis was used to present the findings. The consolidated criteria for reporting qualitative research (COREQ) were used as a guide to ensure quality. RESULTS The main themes emerging were: participants' surprise at how poor the prognosis was for their child's FPMs; acceptance that care was beyond the scope of primary care; willingness by some to undergo GA again; requests for information about the guarantee of success of MI treatment; concerns about the residual black staining from silver diamine fluoride (SDF); and acceptance of extraction spaces because of potential future failure of MI. CONCLUSION This exploratory qualitative study has shown that, while extraction of compromised FPMs under GA is accepted by most parents/carers, there appears to be a growing acceptance of MI approaches to restore FPMs instead of extraction of these teeth.
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Affiliation(s)
- Mona Agel
- Specialty Registrar in Paediatric Dentistry, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - Sasha Scambler
- Reader in Medical Sociology, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
| | - Marie Therese Hosey
- Head of Paediatric Dentistry, Programme Coordinator MSc Paediatric Dentistry, Centre for Oral Clinical and Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, UK
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Patel S, Fine P, Shukla M, Blizard R, Leung A. An investigation into the management of the deep carious lesion by general dental practitioners in the UK. Br Dent J 2022:10.1038/s41415-022-3880-z. [PMID: 35091690 DOI: 10.1038/s41415-022-3880-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 04/03/2021] [Indexed: 11/09/2022]
Abstract
Objectives As techniques and dental materials have evolved, the management of deep carious lesions has also changed. This study investigated how UK-based general dental practitioners (GDPs) managed deep carious lesions in permanent, vital teeth and factors that influence their choices.Methods This mixed-method study employed an online questionnaire as its primary source of quantitative data collection. The questionnaire enquired about GDPs': a) demographics; b) working environment; and c) whether they had postgraduate training that covered caries management/minimally invasive dentistry (MID). Respondents were presented with a clinical case to elicit qualitative data. Relevant questions were asked in order to examine current practice and explore treatment among the respondents.Results In total, 239 responses were received. Overall, 168 (70% [95% CI 64%, 76%]) of the respondents chose a partial caries removal technique, 155 (69.3% [95% CI 60%, 72%]) used an adhesive restorative material and 205 (85.8% [95% CI 81%, 89%]) advised fluoride adjuncts. However, rubber dam (75; 31.4% [95% CI 26%, 38%]) and saliva testing (17; 7.1% [95% CI 4%, 11%]) were not routinely used. A significant relationship between those who had postgraduate training and those who chose partial caries removal as their treatment choice (χ2 = 6.27; p = 0.01) was noted. Respondents working in an NHS-based practice were significantly (χ2 = 34.98; p <0.001) more likely to restore teeth with amalgam.Conclusions There is an inconsistent management protocol when presented with a deep carious lesion, but partial caries removal is more widely adopted than previously reported. Rubber dam isolation was not routinely used when choosing to restore a deep carious lesion. Those who have had postgraduate training felt more confident in offering MID, so there is a clear need for further education to ensure its engagement.
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Affiliation(s)
- Sheena Patel
- University College London, Eastman Dental Institute, London, UK
| | - Peter Fine
- University College London, Eastman Dental Institute, London, UK.
| | - Mandeep Shukla
- University College London, Eastman Dental Institute, London, UK
| | - Robert Blizard
- University College London, Eastman Dental Institute, London, UK
| | - Albert Leung
- University College London, Eastman Dental Institute, London, UK
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da Mata C, McKenna G, Hayes M. Knowledge transfer on the use of Atraumatic Restorative Treatment: A mixed-methods study: Knowledge transfer on the use of ART. J Dent 2022; 118:103944. [PMID: 34999141 DOI: 10.1016/j.jdent.2022.103944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/02/2022] [Accepted: 01/05/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Cristiane da Mata
- Cork University Dental School and Hospital, University College Cork, Ireland.
| | - Gerry McKenna
- Centre for Public Health, Queens University Belfast, Northern Ireland.
| | - Martina Hayes
- Cork University Dental School and Hospital, University College Cork, Ireland.
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Penetration of Silver Diamine Fluoride in Deep Carious Lesions of Human Permanent Teeth: An In Vitro Study. Int J Dent 2022; 2021:3059129. [PMID: 34976061 PMCID: PMC8716243 DOI: 10.1155/2021/3059129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/08/2021] [Indexed: 11/17/2022] Open
Abstract
Background When silver diamine fluoride (SDF) is used in conjunction with conservative caries removal in deep carious lesions, the distribution depth of silver is critical for safety and effectiveness. Objective The purpose of this study is to determine the effect of selected caries removal on silver penetration when 38% SDF is applied to deep carious lesions in permanent teeth. Methods Extracted permanent teeth with caries extending to the inner third of the dentin were used (N = 18). The periphery of the carious lesion was completely removed to the dentinoenamel junction (DEJ). In group A (n = 9), no further removal of carious tissue was performed, leaving necrotic dentin inner to the DEJ, whereas in group B (n = 9) superficial necrotic dentin was completely removed until leathery, slightly moist, reasonably soft dentin remained. SDF was applied for 3 minutes in both groups. Microcomputer tomography (micro-CT) and field emission scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (FESEM-EDS) were used to measure mineral density and silver distribution. The silver penetration depth/lesion depth (PD/LD) ratio was calculated for each sample. The Mann–Whitney U test was used to compare differences between the two groups. Results The micro-CT analysis showed that the PD/LD ratios of group B (1.07–2.29) were marginally greater than those of group A (1.00–1.31). However, a statistically significant difference was not observed (pvalue = 0.5078). When stratified by remaining dentin thickness (RDT), the PD/LD ratios of group B were still greater than those of group A only when RDT was >500 µm. The FESEM-EDS analysis indicated that silver particles precipitated throughout the entire thickness of the carious lesions. Conclusion Applying SDF on a deep carious lesion and leaving the necrotic dentin pulpally did not affect silver penetration. However, the extent to which silver penetrates the remaining dentin beneath the lesions is dependent on the amount and characteristics of that dentin.
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LEAL SC, DAME-TEIXEIRA N, BARBOSA CDB, KOMINAMI PAA, RAPOSO F, NAKAGAWA EMT, BANERJEE A. Minimum intervention oral care: defining the future of caries management. Braz Oral Res 2022; 36:e135. [DOI: 10.1590/1807-3107bor-2022.vol36.0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 07/04/2022] [Indexed: 11/13/2022] Open
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Wambier LM, Gonçalves ADR, Wambier DS, Reis A, Chibinski ACR. Adherence to the CONSORT statement of randomized clinical trials on ART restorations in children: current status and reporting characteristics. Braz Oral Res 2022; 36:e017. [DOI: 10.1590/1807-3107bor-2022.vol36.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/03/2021] [Indexed: 11/22/2022] Open
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Vernazza CR, Pitts NB, Mayne C, Mazevet ME. Dental Policy Lab 1 - towards a cavity-free future. Br Dent J 2021; 231:754-758. [PMID: 34921272 PMCID: PMC8683374 DOI: 10.1038/s41415-021-3723-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/20/2021] [Indexed: 01/10/2023]
Abstract
Although many dental professionals argue that prevention of oral diseases, including dental caries, will benefit both the patient and public finances, a paradigm shift has yet to happen in most countries. The literature has demonstrated that caries prevention and control is possible, but authorities have yet to implement health systems that allow patients to stay in a good health state. 'Policy Labs' are an innovative policy-making initiative that allow a positive collaboration between the many stakeholders around a given policy issue. In July 2017, 24 international experts, including representatives of both international and European Chief Dental Officers associations, were gathered for the first Alliance for a Cavity-Free Future/King's College London Dental Policy Lab to identify the main barriers for a change, and concrete actions to facilitate a policy shift towards increased resource allocation in prevention. A comprehensive report and well-received infographic summarising the key recommendations (explored in this paper) were produced to explain the situation and highlight the value of a cavity-free world to policymakers, demonstrating where change is needed. The first Dental Policy Lab proved to be an efficient way to generate new ideas and concrete ways to implement them, and has led to several subsequent initiatives worldwide.
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Affiliation(s)
- Christopher R Vernazza
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK; Newcastle upon Tyne Hospital NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - Nigel B Pitts
- Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, Tower Wing, Guy´s Hospital, London, SE1 9RT, UK
| | - Catherine Mayne
- Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, Tower Wing, Guy´s Hospital, London, SE1 9RT, UK
| | - Marco E Mazevet
- Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, Tower Wing, Guy´s Hospital, London, SE1 9RT, UK
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Restorative treatment decisions for carious lesions: Do Russian dentists and dental students apply minimal intervention dentistry? BMC Oral Health 2021; 21:638. [PMID: 34911518 PMCID: PMC8672640 DOI: 10.1186/s12903-021-01978-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions. METHODS We included 171 general dental practitioners and dental therapists (collectively referred to here as "dentists") from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis. RESULTS For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13-15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33-6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite. CONCLUSIONS The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results.
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Besegato JF, de Melo PBG, Tamae PE, Alves APAR, Rondón LF, Leanse LG, Dos Anjos C, Casarin HH, Chinelatti MA, Faria G, Dai T, Bagnato VS, Rastelli ANDS. How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2? Photodiagnosis Photodyn Ther 2021; 37:102682. [PMID: 34910994 PMCID: PMC8666148 DOI: 10.1016/j.pdpdt.2021.102682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022]
Abstract
Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Priscila Borges Gobbo de Melo
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Patrícia Eriko Tamae
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Ana Paula Aparecida Raimundo Alves
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Luis Felipe Rondón
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Carolina Dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Heitor Hussni Casarin
- Dentistry School, Central Paulista University Center - UNICEP, São Carlos 13563-470, SP, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
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Maia TS, Lima TD, Vieira WDA, Blumenberg C, Agostini BA, Nascimento GG, Paranhos LR, Menezes MDS. Survival of atraumatic restorative treatment restorations in the elderly patients: a systematic review. Braz Oral Res 2021; 35:e130. [PMID: 34878085 DOI: 10.1590/1807-3107bor-2021.vol35.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 06/02/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients.
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Affiliation(s)
- Thaís Souza Maia
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Postgraduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Thamires Diogo Lima
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Postgraduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Walbert de Andrade Vieira
- Universidade Estadual de Campinas - Unicamp, School of Dentistry of Piracicaba, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | - Cauane Blumenberg
- Universidade Federal de Pelotas - UFPel, Postgraduate Program in Epidemiology, Pelotas, RS, Brazil
| | | | | | - Luiz Renato Paranhos
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Preventive and Community Dentistry, Uberlândia, MG, Brazil
| | - Murilo de Sousa Menezes
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Restorative Dentistry and Dental Materials, Uberlândia, MG, Brazil
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Desai H, Stewart CA, Finer Y. Minimally Invasive Therapies for the Management of Dental Caries—A Literature Review. Dent J (Basel) 2021; 9:dj9120147. [PMID: 34940044 PMCID: PMC8700643 DOI: 10.3390/dj9120147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 11/28/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In recent years, due to a better understanding of the caries pathology and advances in dental materials, the utilization of non-invasive and minimally invasive techniques that delay/obviate the need for traditional restorations has started gaining momentum. This literature review focuses on some of these approaches, including fluoride varnish, silver diamine fluoride, resin sealants, resin infiltration, chemomechanical caries removal and atraumatic restorative treatment, in the context of their chemistries, indications for use, clinical efficacy, factors determining efficacy and limitations. Additionally, we discuss strategies currently being explored to enhance the antimicrobial properties of these treatment modalities to expand the scope of their application.
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Affiliation(s)
- Hetal Desai
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
| | - Cameron A. Stewart
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
| | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, ON M5G 1G6, Canada; (H.D.); (C.A.S.)
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Correspondence:
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Slimani A, Sauro S, Gatón Hernández P, Gurgan S, Turkun LS, Miletic I, Banerjee A, Tassery H. Commercially Available Ion-Releasing Dental Materials and Cavitated Carious Lesions: Clinical Treatment Options. MATERIALS 2021; 14:ma14216272. [PMID: 34771800 PMCID: PMC8585007 DOI: 10.3390/ma14216272] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 02/06/2023]
Abstract
The contemporary approach for operative caries management emphasizes personalized interventions for each patient, dependent upon the individual's caries susceptibility/risk, the stage of the carious lesion and its activity. The clinician's challenge is to optimize the extent of cavity preparation and the choice of dental restorative biomaterials, appreciating the benefits offered by ion-releasing restorative materials. There is a growing application of bioactive/bio-interactive materials in minimally invasive operative dentistry, as they may help with tissue recovery by ion release. In case of moderate or extensive occlusal cavitation, the clinical criteria include the individual caries susceptibility and carious lesion activity. In high caries risk cases, ion-releasing biomaterials (IRB) can be used, as well as for active carious lesions. In proximal lesions, the clinical criteria include the individual caries susceptibility, the lesion activity and presence of cavities with little or no enamel at the gingival margin. This article aims to discuss the restorative ion-releasing options, according to different clinical situations, and the caries susceptibility to manage cavitated carious lesions in permanent adult teeth.
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Affiliation(s)
- Amel Slimani
- LBN/Faculté d’Odontologie, Université de Montpellier, 34193 Montpellier, France;
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, Cardenal Herrera-CEU University, CEU Universities, 46115 Valencia, Spain;
- Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow 119146, Russia
| | | | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey;
| | | | - Ivana Miletic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva ul. 5, 10000 Zagreb, Croatia;
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 9RT, UK;
| | - Hervé Tassery
- LBN/Faculté d’Odontologie, Université de Montpellier, 34193 Montpellier, France;
- Ecole de Médecine Dentaire de Marseille, Université d’Aix-Marseille, 13385 Marseille, France
- Correspondence:
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Current Novel Caries Diagnostic Technologies: Restorative Dentists' Attitude and Use Preferences. Healthcare (Basel) 2021; 9:healthcare9101387. [PMID: 34683068 PMCID: PMC8535563 DOI: 10.3390/healthcare9101387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/02/2021] [Accepted: 10/14/2021] [Indexed: 11/17/2022] Open
Abstract
Early detection of caries lesions is key to a successful restorative dental treatment plan. The aim of this study was to investigate the preferences and attitude of graduate restorative dentistry residents (RDRs) regarding novel caries diagnostic technologies (NCDT) and to provide a brief overview of available technologies for both specialized and general dental practice. This cross-sectional study used an online questionnaire (17 questions) concerning RDRs’ attitude, preferences, and insights regarding five available NCDTs. It was distributed among twenty RDRs at a local government dental school following a review session about NCDTs. Collected responses were analyzed statistically using one-way analysis of variance (ANOVA), chi-squared with Bonferroni correction, and Kruskal-Wallis tests at a 0.05 significance level. Sixty-five percent of RDRs reported an interest in NCDTs as a discussion topic and almost half of them were positive towards their use, however, sixty percent of respondents were hesitant to diagnose caries solely using NCDTs. Fiber-optic-transillumination (FOTI) systems were ranked the best overall and with regard to all the investigated criteria (p < 0.05). Chosen reasons for FOTI included price followed by ease of use. In general, high price rated as the most perceived reason for not choosing a given NCDT followed by low practical applicability. Meanwhile, ease of use followed by relevant application ranked as the main reported reasons to choose an NCDTs.
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ToF-SIMS Analysis of Demineralized Dentin Biomodified with Calcium Phosphate and Collagen Crosslinking: Effect on Marginal Adaptation of Class V Adhesive Restorations. MATERIALS 2021; 14:ma14164535. [PMID: 34443059 PMCID: PMC8398264 DOI: 10.3390/ma14164535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/06/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022]
Abstract
This study aimed to assess the effect of biomodification before adhesive procedures on the tooth-restoration interface of class V restorations located in caries-simulated vs. sound dentin, and the quality of dentin surface by time-of-flight secondary ion mass spectrometry (ToF-SIMS). Class V cavities located on cervical dentin were prepared on the buccal surfaces of extracted human molars under the simulation of intratubular fluid flow. Two dentin types, i.e., sound and demineralized by formic-acid, were biomodified with 1% riboflavin and calcium phosphate (CaP) prior to the application of a universal adhesive (Clearfil Universal Bond) in etch and rinse or self-etch mode, and a conventional micro hybrid composite (Clearfil APX). Restorations were subjected to thermo mechanical fatigue test and percentages of continuous margins (% CM) before/after fatigue were compared. Bio modification of dentin surfaces at the molecular level was analyzed by Time-of-Flight Secondary Mass Spectometry (ToF-SIMS). % CM were still significantly higher in tooth-restoration interfaces on sound dentin. Meanwhile, biomodification with riboflavin and CaP had no detrimental effect on adhesion and in carious dentin, it improved the % CM both before and after loading. Etching carious dentin with phosphoric acid provided with the lowest results, leading even to restoration loss. The presence of molecule fragments of riboflavin and CaP were detected by ToF-SIMS, evidencing dentin biomodification. The adhesive interface involving carious dentin could be improved by the use of a collagen crosslinker and CaP prior to adhesive procedures.
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Dentists' Perception and Clinical Use of Preformed Metal Crowns to Restore Primary Molar Defects in Chengdu City, China: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6200083. [PMID: 34395620 PMCID: PMC8355980 DOI: 10.1155/2021/6200083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 02/05/2023]
Abstract
Background Preformed metal crowns (PMCs), as an effective technique recommended for the enduring restoration of primary molar defects, have not been widely implemented in China as well as that in Western countries. This study is aimed at assessing the knowledge on the clinical use of the PMC technique and its effective factors among dentists in Chengdu, China. Thus, the present study is aimed at providing the best available evidence on clinical decision-making to manage dental caries in children and the overall benefits. Methods The self-designed questionnaire in this study consisted of two main sections, including the sociodemographic characteristics of the respondents and their perception and use of PMCs. The anonymous questionnaire was distributed among 1000 dentists practicing in Chengdu via SO JUMP. Results The response rate was 45%. Most respondents (69.6%) did not use PMCs. Academic qualification, working specialty, and professional experience were associated with dentists' use of PMCs. The lack of knowledge about the PMC technique was the main obstacle to the dental practitioners' use of PMCs (41.7%). The lack of understanding of the rationale behind PMCs was the main reason for parents' acceptance of PMC restorations (43.6%). Attending continuing education programs was the main approach to learning the PMC restorative technique (59.1%). Conclusions The clinical use of PMCs was not very popular in Chengdu city. To promote this restorative technique, knowledge and practical training should be incorporated into routine courses of undergraduate dental education.
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Clinical Evaluation of Flowable Composite Materials in Permanent Molars Small Class I Restorations: 3-Year Double Blind Clinical Study. MATERIALS 2021; 14:ma14154283. [PMID: 34361477 PMCID: PMC8347401 DOI: 10.3390/ma14154283] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 11/24/2022]
Abstract
This study evaluated the 3-year clinical performance of four different flowable composite materials used in Small Class I restorations in permanent molars. This double-blinded, clinical study analyzed 229 Small Class I restorations/103 children at baseline, 12, 24, and 36 months with modified United States Public Health Services (USPHS) criteria. The tested flowable materials were Voco Grandio Flow + Voco Solobond M, Vivadent Tetric EvoFlow + Vivadent Excite, Dentsply X-Flow + Dentsply Prime&Bond NT, and 3M ESPE Filtek Supreme XT Flow + 3M ESPE Scotchbond Universal. The retention and marginal adaptation rates were highest for Grandio Flow and X Flow materials after 36 months, resulting in the highest score of clinical acceptability at 95.3% and 97.6%, respectively. The Tetric EvoFlow and Filtek Supreme XT Flow had the same retention rate after 36 months at 88.1%. Statistical significance was found in Grandio flow material in postoperative sensitivity criteria (p = 0.021). Tetric EvoFlow showed statistical differences in retention (p = 0.01), color match (p = 0.004), and marginal adaptation (p = 0.042). Filtek Supreme showed statistical differences in retention (p = 0.01) and marginal adaptation (p < 0.001). The flowable composite materials showed excellent clinical efficacy after 36 months of their clinical usage. There was no difference among the tested flowable composite materials quality in Small Class I restorations over time.
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Rheological Properties, Surface Microhardness, and Dentin Shear Bond Strength of Resin-Modified Glass Ionomer Cements Containing Methacrylate-Functionalized Polyacids and Spherical Pre-Reacted Glass Fillers. J Funct Biomater 2021; 12:jfb12030042. [PMID: 34287317 PMCID: PMC8293056 DOI: 10.3390/jfb12030042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/03/2021] [Accepted: 07/08/2021] [Indexed: 01/08/2023] Open
Abstract
The aim of this study was to prepare experimental resin-modified glass ionomer cements (RMGICs) containing low levels of hydroxyethyl methacrylate (HEMA) for pulp protection. Liquid and powder phases of the experimental RMGICs were polyacid functionalized with methacrylate groups and spherical pre-reacted glass fillers (SPG). Two types of liquid phase containing 0 wt. % HEMA (CM liquid) or 5 wt. % HEMA (CMH liquid) were formulated. The experimental RMGICs were prepared by mixing SPG fillers with CM liquid (F1) or CMH liquid (F2). Rheological properties were examined using a strain-controlled rheometer (n = 5). The Vickers microhardness (n = 5) and dentin shear bond strength (SBS) (n = 10) of the materials were tested. Commercial pulp protection materials (Vitrebond and TheraCal LC) were used as comparisons. The viscosity and surface microhardness of F1 (22 m Pa·s, 18 VHN) and F2 (18 m Pa·s, 16 VHN) were significantly higher than those of Vitrebond (6 mPa·s, 6 VHN) and TheraCal (0.1 mPa·s, 7 VHN). The SBS of F1 (10.7 MPa) and F2 (11.9 MPa) was comparable to that of Vitrebond (15.4 MPa) but higher than that of TheraCal LC (5.6 MPa). The addition of 5 wt. % HEMA showed no significant effect on viscosity, surface microhardness, or SBS of the experimental RMGICs. The experimental materials showed higher viscosity and microhardness but similar SBS when compared with the commercial RMGIC.
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