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Mitrani R, Papaspyridakos P, Bedrossian EA, Goldberg J, Tsigarida A, Chochlidakis K. Treatment planning algorithm for patients with a terminal dentition. J Prosthet Dent 2024:S0022-3913(24)00351-2. [PMID: 38797577 DOI: 10.1016/j.prosdent.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 05/29/2024]
Abstract
This article discusses the variables that affect the diagnostic process in patients with a compromised dentition and addresses the clinical decision of whether to extract or maintain teeth. A decision tree algorithm is proposed to guide clinicians in planning complete arch rehabilitations.
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Affiliation(s)
- Ricardo Mitrani
- Affiliate Associate Professor, University of Washington, Seattle, Wash
| | - Panos Papaspyridakos
- Associate Professor, Department of Prosthodontics, Tufts School of Dental Medicine, Boston, Mass.; and Adjunct Associate Professor, Eastman Institute for Oral Health, Department of Prosthodontics, University of Rochester, Rochester, NY
| | | | - Jack Goldberg
- Affiliate Associate Professor, University of Washington, Seattle, Wash
| | - Alexandra Tsigarida
- Associate Professor and Program Director, Department of Periodontology and Implant Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Konstantinos Chochlidakis
- Associate Professor and Program Director, Department of Prosthodontics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
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Tassery H, Miletic I, Turkun LS, Sauro S, Gurgan S, Banerjee A, Basso M, Khelafia S, Terrer E, Pilliol V, Slimani A. Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions. Br Dent J 2024; 236:603-610. [PMID: 38671111 DOI: 10.1038/s41415-024-7292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 04/28/2024]
Abstract
Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.
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Affiliation(s)
- Hervé Tassery
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France; LBN, Université de Montpellier, UR-UM104, Montpellier, France.
| | - Ivana Miletic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva ul. 5, 10000 Zagreb, Croatia
| | - Lezize Sebnem Turkun
- Department of Restorative Dentistry, Ege University School of Dentistry, Izmir 35040, Turkey
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, CEU Cardenal Herrera University, CEU Universities, 46115 Valencia, Spain; Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Avijit Banerjee
- Conservative and Minimally Invasive Dentistry, Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, SE1 9RT, UK
| | - Matteo Basso
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Saber Khelafia
- Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Elodie Terrer
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Virginie Pilliol
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Amel Slimani
- LBN, Université de Montpellier, UR-UM104, Montpellier, France; Faculté d'Odontologie, Université de Montpellier, 34193 Montpellier, France
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Maciel IP, Basso MB, Piovesan ÉTDA, Ribeiro CDPV, Queiroz IQDD, Alves JB, Kominami PAA, Leal SC. Is there an association between family structure and the oral health of socially vulnerable children? Braz Oral Res 2023; 37:e133. [PMID: 38126476 DOI: 10.1590/1807-3107bor-2023.vol37.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/14/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this study was to evaluate the impact of the family structure on the oral health status of socially vulnerable children in the Federal District of Brazil. A total of 471 schoolchildren with a mean age of 8.12 (± 0.90) years were examined for dental caries using the CAST instrument. Dental biofilm and oral pain were also registered. Children's guardians were interviewed about socioeconomic variables and oral hygiene habits. The association between oral pain in the previous 30 days and the child's maximum CAST score were analyzed using the Pearson chi-squared test. Multivariate Poisson regression models with robust variance were used to determine the predictors of presence of biofilm, oral pain, and caries severity. The prevalence of cavitated dentin lesions was 43.74% and, both dentin and enamel lesions, 52.87%; for both dentitions. An association between pain and severe nontreated carious lesions was found (p < 0.0001). The family structure was not related to the presence of dental caries, but a significant association was found between low maternal education and severe carious lesions (PR = 1.41; p = 0.0077) and oral pain (PR = 1.47; p = 0. 0335); not owning a residence and frequency of toothbrushing were also associated with the substantial presence of biofilm (PR = 1.13, p = 0.0493 and PR = 1.18, p = 0.0470; respectively). For socially vulnerable children, variables related to the socioeconomic status of the families were more relevant than the family structure in relation to their oral health status.
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Affiliation(s)
- Isadora Passos Maciel
- Universidade de Brasília - UnB, Faculdade de Ciências da Saúde , Departamento de Odontologia , Brasília , DF , Brazil
| | | | | | | | | | - Júlia Barros Alves
- Universidade de Brasília - UnB, Faculdade de Ciências da Saúde , Departamento de Odontologia , Brasília , DF , Brazil
| | | | - Soraya Coelho Leal
- Universidade de Brasília - UnB, Faculdade de Ciências da Saúde , Departamento de Odontologia , Brasília , DF , Brazil
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Fan W, Chen Q, Zhang Y, Feng J, Zhai Y, He B. Case Report: Treatment and management of a child at high risk of caries. Front Pediatr 2023; 11:1103386. [PMID: 37936890 PMCID: PMC10626505 DOI: 10.3389/fped.2023.1103386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 09/26/2023] [Indexed: 11/09/2023] Open
Abstract
Introduction Caries are at the forefront of childhood diseases. Although childhood caries is usually not life-threatening, it can affect children's dental-maxillofacial development and mental health and place significant financial and psychological burdens on parents. As the focus of childhood dental caries shifts to early diagnosis and prevention rather than restorative dentistry alone, screening children at a high risk of dental caries is urgent. Appropriate caries prevention measures and treatment sequences can effectively reduce the occurrence and development of dental caries in children. Case We report the case of a 7-year-old boy presenting with a high risk of dental caries involving multiple primary teeth and premature eruption of the permanent teeth. We shifted the caries status of the child from high to moderate likelihood. At the 9-month post-treatment follow-up, the patient had no new dental caries, and the length and width of the dental arch were effectively maintained. Conclusion Oral health education, dental plaque removal in a regular basis, and fluoride application contribute to caries management.
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Affiliation(s)
- Wen Fan
- School of Stomatology, Henan University, Kaifeng, China
- Henan University Seth Stomatological Hospital, Zhengzhou, China
| | - Qianjing Chen
- School of Stomatology, Henan University, Kaifeng, China
- Henan University Seth Stomatological Hospital, Zhengzhou, China
| | - Yushan Zhang
- School of Stomatology, Henan University, Kaifeng, China
- Henan University Seth Stomatological Hospital, Zhengzhou, China
- Department of Stomatology, Weinan Central Hospital, Weinan, China
| | - Jixian Feng
- School of Stomatology, Henan University, Kaifeng, China
- Henan University Seth Stomatological Hospital, Zhengzhou, China
- Department of Stomatology, the Second Affiliated Hospital of Shandong First Medical University, Tai'an, China
| | - Yuankun Zhai
- School of Stomatology, Henan University, Kaifeng, China
- Henan University Seth Stomatological Hospital, Zhengzhou, China
- Kaifeng Key Laboratory of Periodontal Tissue Engineering, Kaifeng, China
| | - Baojie He
- School of Stomatology, Henan University, Kaifeng, China
- Henan University Seth Stomatological Hospital, Zhengzhou, China
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Aboubakr RM, Alkhadragy DM, Okda MMES, Rady HWM, Elnagar RM. Predictors of Caries Risk among Egyptian Children Attending Pediatric Dental Clinics at a University Hospital. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:219-228. [PMID: 37533660 PMCID: PMC10393090 DOI: 10.4103/sjmms.sjmms_128_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/24/2023] [Accepted: 06/01/2023] [Indexed: 08/04/2023]
Abstract
Background Dental caries is the most prevalent dental disease. The external validity of the available caries risk assessment (CRA) tools is not established, especially among pediatric population. Objectives To assess caries risk using the caries management by risk assessment (CAMBRA) protocol among Egyptian children aged 3-12 years and suggest variables that could potentially be used to develop a simpler CRA model. Materials and Methods For this cross-sectional study, we recruited 320 children aged 3 to <6 years (Group I) and 320 children aged 6-12 years (Group II). CAMBRA was used to collect data about disease indicators, biological and environmental factors, and protective factors among study participants. Each child was examined clinically to collect data about past caries experiences and to measure plaque scores. Results The risk of caries was high in 92.5% of Group I and 83.4% of Group II participants. The overall dmft was 5.71 ± 3.18 for Group I and 4.78 ± 2.53 for Group II. In Group I, a significant positive relation was found between the overall mean caries risk score and past caries experience (dmft; r = 0.344, P < 0.001) and mean plaque index (r = 0.463, P < 0.001). In Group II, a significant positive relation was found between the overall mean caries risk score and dmft score (r = 0.511, P < 0.001), S. mutans count (r = 234, P < 0.001), Lactobacilli count (r = 0.316, P < 0.001), and plaque index (r = 0.463, P < 0.001). Participants' age, parents' education, and parents' occupation had a negative significant effect on the overall mean caries risk score. Conclusion This study suggests predictors that can be used in the development of a new CRA model for children aged 3-12 years.
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Affiliation(s)
- Rabaa Mahmoud Aboubakr
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Doaa Mohsen Alkhadragy
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Mai Monuir El Said Okda
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Hadeer Wael Mohamed Rady
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Rasha Mokhtar Elnagar
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
- Department of Basic Medical Sciences, College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
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Iyer CR, Jawdekar AM. ECC Status, CRAFT Categorization and OHRQoL Assessment in 3-6-year-old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2023; 16:199-204. [PMID: 37519963 PMCID: PMC10373758 DOI: 10.5005/jp-journals-10005-2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Introduction Early Childhood Caries (ECC) can affect the health and quality of life of the children. Assessing a patient's risk of developing caries is an important aspect of caries management; however, can assessing the caries risk predict the impact of ECC on the OHRQoL? Few Indian studies have reported association between caries status, risk, and the impact on OHRQoL. Aim To assess the association between dental caries status, risk assessment, and OHRQoL in 3-6-year-old children. Methodology A total of 50 healthy children were recruited in a cross-sectional study. Parents filled the ECOHIS questionnaire. Caries status, risk, and OHRQoL were measured as dmft-pufa, CRAFT (Caries Risk Assessment for Treatment- an indigenous tool) and ECOHIS scores, respectively. Results Moderate correlation was seen between dmft and ECOHIS scores (r = 0.496, p < 0.01), and pufa and ECOHIS scores (r = 0.408, p < 0.05). More number of subjects with higher scores of ECOHIS were in the high-risk category of CRAFT (p < 0.05). Conclusion Caries status, risk and OHRQoL were associated in 3-6-year-old children. Thus, caries risk assessment may predict poor OHRQoL. How to cite this article Iyer CR, Jawdekar AM. ECC Status, CRAFT Categorization and OHRQoL Assessment in 3-6-year-old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2023;16(2):199-204.
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Affiliation(s)
- Chitra R Iyer
- Department of Pediatric and Preventive Dentistry, Y.M.T. Dental college and Hospital, Navi Mumbai, Maharashtra, India
| | - Ashwin M Jawdekar
- Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Giacaman RA, Fernández CE, Muñoz-Sandoval C, León S, García-Manríquez N, Echeverría C, Valdés S, Castro RJ, Gambetta-Tessini K. Understanding dental caries as a non-communicable and behavioral disease: Management implications. FRONTIERS IN ORAL HEALTH 2022; 3:764479. [PMID: 36092137 PMCID: PMC9448953 DOI: 10.3389/froh.2022.764479] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
New paradigms in caries conceptualization have emerged during the last decades, leading to intense debate and discussion on how to approach the disease, both from a preventive and a therapeutic perspective. Among many new ideas, research discoveries and technologies, one major concept can be highlighted that created a deep frontier between the old and the new paradigm in caries conceptualization; the non-communicable nature of the disease, firmly associated with behaviors and lifestyles. This article synthetizes the conceptual construction of dental caries as a non-communicable disease (NCD) based on the current evidence and discusses the appropriate management of the disease in this context. Dental caries has shifted from being considered transmissible and infectious to an ecological and non-communicable disease. Environmental factors such as frequent sugars intake, disrupt the symbiosis of the dental biofilm leading to a dysbiosis, which favors caries lesion initiation and progression. As an NCD, dental caries shares characteristics with other NCDs such as cardiovascular and chronic respiratory diseases, cancer and diabetes, including long duration and slow progression, not being transmissible from person-to-person, being strongly related to modifiable behavioral risk factors, and affecting preferentially disadvantaged populations with a strong inequality gradient. Given the high prevalence of dental caries, and its consequences on people's health and quality of life, a recognizable conceptual view of caries as a NCD is required to target an effective management. Current understanding of dental caries supports prevention through acting on the modifiable risk factors (behaviors) and involves management based on an interdisciplinary approach. Communicating these modern concepts among researchers, clinicians and policymakers is needed to decrease the global high burden of the disease.
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Affiliation(s)
- Rodrigo A. Giacaman
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
- *Correspondence: Rodrigo A. Giacaman
| | - Constanza E. Fernández
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Cecilia Muñoz-Sandoval
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Soraya León
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
| | - Natalia García-Manríquez
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Constanza Echeverría
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Sebastián Valdés
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
| | - Ramiro J. Castro
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Interuniversity Center on Healthy Aging, Punta Arenas, Chile
| | - Karla Gambetta-Tessini
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Gerodontology Research Group, Department of Oral Rehabilitation, Faculty of Dentistry, University of Talca, Talca, Chile
- Centro de Epidemiología y Vigilancia de las Enfermedades Orales, University of Chile and University of Talca, Santiago, Chile
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Ling W, Wang Y, Lu B, Shang X, Wu Z, Chen Z, Li X, Zou C, Yan J, Zhou Y, Liu J, Li H, Que K, Huang X. Continuously Quantifying Oral Chemicals Based on Flexible Hybrid Electronics for Clinical Diagnosis and Pathogenetic Study. Research (Wash D C) 2022; 2022:9810129. [PMID: 36072268 PMCID: PMC9414179 DOI: 10.34133/2022/9810129] [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: 05/22/2022] [Accepted: 07/19/2022] [Indexed: 11/06/2022] Open
Abstract
Simultaneous monitoring of diverse salivary parameters can reveal underlying mechanisms of intraoral biological processes and offer profound insights into the evolution of oral diseases. However, conventional analytical devices with bulky volumes, rigid formats, and discrete sensing mechanisms deviate from the requirements of continuous biophysiological quantification, resulting in huge difficulty in precise clinical diagnosis and pathogenetic study. Here, we present a flexible hybrid electronic system integrated with functional nanomaterials to continuously sense Ca2+, pH, and temperature for wireless real-time oral health monitoring. The miniaturized system with an island-bridge structure that is designed specifically to fit the teeth is only 0.4 g in weight and 31.5×8.5×1.35 mm3 in dimension, allowing effective integration with customized dental braces and comfort attachment on teeth. Characterization results indicate high sensitivities of 30.3 and 60.6 mV/decade for Ca2+ and pH with low potential drifts. The system has been applied in clinical studies to conduct Ca2+ and pH mappings on carious teeth, biophysiological monitoring for up to 12 h, and outcome evaluation of dental restoration, providing quantitative data to assist in the diagnosis and understanding of oral diseases. Notably, caries risk assessment of 10 human subjects using the flexible system validates the important role of saliva buffering capacity in caries pathogenesis. The proposed flexible system may offer an open platform to carry diverse components to support both clinical diagnosis and treatment as well as fundamental research for oral diseases and induced systemic diseases.
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Affiliation(s)
- Wei Ling
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
- Center of Flexible Wearable Technology, Institute of Flexible Electronic Technology of Tsinghua, Jiaxing 314006, China
| | - Yinghui Wang
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Bingyu Lu
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Xue Shang
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Ziyue Wu
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
- Center of Flexible Wearable Technology, Institute of Flexible Electronic Technology of Tsinghua, Jiaxing 314006, China
| | - Zhaorun Chen
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Xueting Li
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
| | - Chenchen Zou
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Jinjie Yan
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Yunjie Zhou
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Jie Liu
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Hongjie Li
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Kehua Que
- School of Stomatology, Hospital of Stomatology, Tianjin Medical University, 12 Observatory Road, Tianjin 300070, China
| | - Xian Huang
- Department of Biomedical Engineering, Tianjin University, 92 Weijin Road, Tianjin 300072, China
- Center of Flexible Wearable Technology, Institute of Flexible Electronic Technology of Tsinghua, Jiaxing 314006, China
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Coelho A, Amaro I, Iunes T, Paula A, Marto CM, Saraiva J, Ferreira MM, Carrilho E. CAMBRA Protocol Efficacy: A Systematic Review and Critical Appraisal. Dent J (Basel) 2022; 10:97. [PMID: 35735639 PMCID: PMC9221725 DOI: 10.3390/dj10060097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 02/01/2023] Open
Abstract
The Caries Management by Risk Assessment (CAMBRA) protocol consists of analyzing the patient's profile by assessing the risk and protective factors and assigning a risk level to the patient to allow an individualized treatment plan, which combines restorative treatments with a preventive chemical therapy. This systematic review and critical appraisal aim to evaluate the effectiveness of the CAMBRA protocol in reducing the incidence of caries lesions and oral bacterial load. An electronic search was carried out in the Cochrane Library, PubMed, Web of Science, Scopus, and Embase databases. Clinical studies evaluating the incidence of dental caries lesions and/or the reduction of cariogenic bacterial load (Streptococcus mutans and/or Lactobacilli spp.), with at least an intervention group that follows the CAMBRA protocol and a control group published up until January 2022, were included. The methodological quality assessment of the included clinical studies was assessed through the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2). The quality of the case-control study was evaluated according to the Methodological Index for Non-Randomized Studies (ROBINS-I). There is currently no scientific evidence to recommend the integration of the CAMBRA protocol into clinical practice. The results reported by the studies included in the systematic review do not suggest a decrease in the incidence of dental caries lesions and/or bacterial load. There is a clear need for the development of new clinical studies with an adequate methodology and follow-up, both for the CAMBRA protocol and for its components individually.
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Affiliation(s)
- Ana Coelho
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (I.A.); (T.I.); (A.P.); (J.S.); (E.C.)
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.M.F.)
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Inês Amaro
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (I.A.); (T.I.); (A.P.); (J.S.); (E.C.)
| | - Tainá Iunes
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (I.A.); (T.I.); (A.P.); (J.S.); (E.C.)
| | - Anabela Paula
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (I.A.); (T.I.); (A.P.); (J.S.); (E.C.)
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.M.F.)
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
| | - Carlos Miguel Marto
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.M.F.)
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Biophysics, Faculty of Medicine, University of Coimbra, 3004-548 Coimbra, Portugal
- Institute of Experimental Pathology, Faculty of Medicine, University of Coimbra, 3004-548 Coimbra, Portugal
| | - José Saraiva
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (I.A.); (T.I.); (A.P.); (J.S.); (E.C.)
| | - Manuel Marques Ferreira
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.M.F.)
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal
| | - Eunice Carrilho
- Institute of Integrated Clinical Practice, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal; (I.A.); (T.I.); (A.P.); (J.S.); (E.C.)
- Area of Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3000-548 Coimbra, Portugal; (C.M.M.); (M.M.F.)
- Clinical Academic Center of Coimbra (CACC), 3004-561 Coimbra, Portugal
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10
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Cheng L, Zhang L, Yue L, Ling J, Fan M, Yang D, Huang Z, Niu Y, Liu J, Zhao J, Li Y, Guo B, Chen Z, Zhou X. Expert consensus on dental caries management. Int J Oral Sci 2022; 14:17. [PMID: 35361749 PMCID: PMC8971510 DOI: 10.1038/s41368-022-00167-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/20/2022] [Indexed: 02/05/2023] Open
Abstract
Dental Caries is a kind of chronic oral disease that greatly threaten human being's health. Though dentists and researchers struggled for decades to combat this oral disease, the incidence and prevalence of dental caries remain quite high. Therefore, improving the disease management is a key issue for the whole population and life cycle management of dental caries. So clinical difficulty assessment system of caries prevention and management is established based on dental caries diagnosis and classification. Dentists should perform oral examination and establish dental records at each visit. When treatment plan is made on the base of caries risk assessment and carious lesion activity, we need to work out patient‑centered and personalized treatment planning to regain oral microecological balance, to control caries progression and to restore the structure and function of the carious teeth. And the follow-up visits are made based on personalized caries management. This expert consensus mainly discusses caries risk assessment, caries treatment difficulty assessment and dental caries treatment plan, which are the most important parts of caries management in the whole life cycle.
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Affiliation(s)
- Lei Cheng
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China
| | - Lu Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Peking University, Beijing, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University and Guangdong Provincial Key Laboratory of Stomatology, Sun Yat‑Sen University, Guangzhou, Guangdong, China
| | - Mingwen Fan
- School of Medicine, Jianghan University, Wuhan, China
| | - Deqin Yang
- College of Stomathology, Chongqing Medical University, Chongqing, China
| | - Zhengwei Huang
- Department of Endodontics, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University, Shanghai, China
| | - Yumei Niu
- Department of Endodontics, The First Affiliated Hospital of Harbin Medical University & Department of Endodontics, School of Stomatology, Harbin Medical University, Harbin, China
| | - Jianguo Liu
- Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Yanhong Li
- Affiliated Stomatological Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Bin Guo
- Department of Stomatology, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, National Clinical Research Centre for Oral Diseases, Sichuan University, Chengdu, China.
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11
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Holguin-Loya B, Soto-Barreras U, Martinez-Martinez R, Martinez-Mata G, Sanin L, Nevarez-Rascon M, Dominguez-Perez R. Relationship between fluoride exposure and count of Streptococcus mutans in supragingival biofilm of mexican scholar children. J Dent Sci 2022; 17:211-216. [PMID: 35028040 PMCID: PMC8739274 DOI: 10.1016/j.jds.2021.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 11/19/2022] Open
Abstract
Background/purpose The use of fluoride is known to reduce the risk of dental caries. There is limited information on the relationship between Streptococcus mutans (S. mutans) and fluoride exposure. This study investigated the association between the count of S. mutans on supragingival biofilm and fluoride exposure of scholar children. Materials and methods In this cross-sectional study, 56 children from 9 to 11 years of age were selected. Fluoride concentration in drinking water, urine and saliva of each participant were assessed. The count of S. mutans was estimated by calculating the DNA copy number through a quantitative real time polymerase chain reaction (qPCR) assay. Also, sociodemographic data, oral and general health information and variables related to caries risk were evaluated. A stepwise multiple linear regression was performed in all caries related predictor variables with the count of S. mutans as the dependent variable. Results The multiple linear regression analysis showed that the concentration of fluoride in saliva (β = −3.029, p < 0.001) and urine (β = −2.057, p = 0.017), time of last visit to the dentist (β = 1.968, p = 0.001), plaque index (β = 1.637, p = 0.006) and number of surfaces with codes 3–6 (D3-6MFS) of ICDAS II criteria (β = 0.283, p = 0.076) were significantly associated with the count of S. mutans (Adjusted R square = 0.427, p < 0.001). Conclusion Fluoride levels in urine and saliva were negatively associated with the count of S. mutans in supragingival biofilm. Plaque index, D3-6MFS and time of last visit to the dentist showed a positive association.
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Affiliation(s)
- B Holguin-Loya
- Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - U Soto-Barreras
- Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - R Martinez-Martinez
- Maestría en Ciencias Odontológicas, Universidad Autónoma de San Luis Potosí, SLP, México
| | - G Martinez-Mata
- Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - L Sanin
- Facultad de Medicina, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - M Nevarez-Rascon
- Facultad de Odontología, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - R Dominguez-Perez
- Facultad de Medicina, Universidad Autónoma de Querétaro, Santiago de Querétaro, México
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12
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Yu OY, Lam WYH, Wong AWY, Duangthip D, Chu CH. Nonrestorative Management of Dental Caries. Dent J (Basel) 2021; 9:121. [PMID: 34677183 PMCID: PMC8534976 DOI: 10.3390/dj9100121] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/10/2021] [Accepted: 10/12/2021] [Indexed: 11/30/2022] Open
Abstract
The World Dental Federation (FDI) policy statement in 2016 advocated evidence-based caries-control measures for managing dental caries. The caries management philosophy has shifted from the traditional surgical manners to minimal intervention dentistry. Minimal intervention dentistry aims to extend the longevity of natural teeth. It places the nonrestorative approaches as a priority. The nonrestorative approaches for caries management aim to tackle the etiological factors of dental caries. Caries can be prevented or reversed by restricting the sugar intake and its frequency in the diet, improving oral hygiene practices, and using fluoride toothpaste. This article aims to present strategies for the nonrestorative management of dental caries, which are divided into four components to address the different etiological factors of dental caries. The first component is controlling dental plaque. Strategies for plaque control include oral hygiene instruction, motivational interviewing, mechanical plaque control, and chemical plaque control. The second component for nonrestorative management is reducing the risk of caries by identifying caries risk factors and protective factors, assessing personal caries risk, and customizing a treatment plan. Evidence-based measures for caries prevention include using fluoride, and dental sealants should be provided. The third component includes topical treatment to remineralise early carious lesions. The last component is long-term follow-up. Appropriate strategy adoption for the nonrestorative management of dental caries prolongs the life span of the teeth and sustains the good oral health of patients.
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Affiliation(s)
- Ollie Yiru Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong; (W.Y.-H.L.); (A.W.-Y.W.); (D.D.); (C.-H.C.)
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13
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Duan S, Li M, Zhao J, Yang H, He J, Lei L, Cheng R, Hu T. A predictive nomogram: a cross-sectional study on a simple-to-use model for screening 12-year-old children for severe caries in middle schools. BMC Oral Health 2021; 21:457. [PMID: 34544417 PMCID: PMC8451146 DOI: 10.1186/s12903-021-01819-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/10/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A nomogram is a tool that transforms complex regression equations into simple and visual graphs and enables clinicians and patients to conveniently compute output probabilities without needing medical knowledge and complex formulas. The aim of this study was to develop and validate a predictive nomogram to screen for severe caries among 12-year-old children based on risk factors in Sichuan Province, China. METHODS A cross-sectional study of 4573 12-year-olds was conducted up to May 2016 in middle schools from three districts and three counties in Sichuan Province, China. All the children underwent oral examinations and completed questionnaires to assess general information, oral impacts on daily performance, dietary habits, subjective health conditions, history of dental trauma, frequency of toothache, dental visits, and knowledge, attitudes, and behaviours toward oral hygiene. Univariate analysis and multivariate logistic regression analysis were used to determine which variables were significantly associated with severe caries (operationalized as DMFT ≥ 3). A nomogram was developed and validated by using the 'rms' package and two cross-validation methods. RESULTS Severe caries was found in 537 of the 4573 children (11.74%). Multivariate logistic regression analysis revealed that the following variables predicted a higher risk of severe caries: 'female' [odds ratio (OR) = 1.985, 95% confidence interval (95% CI): 1.63-2.411], 'urban' (OR = 2.389, 95% CI: 1.96-2.91), 'non-only child' (OR = 1.317, 95% CI: 1.07-1.625), 'very poor self-assessment of oral health status' (OR = 2.157, 95% CI: 1.34-3.467) and 'visited a dentist less than 6 months' (OR = 1.861, 95% CI: 1.38-2.505). Multivariate logistic regression analysis also indicated that the following variables predicted a lower risk of severe caries: 'middle level of urbanization' (OR = 0.395, 95% CI: 0.32-0.495) and 'high level of urbanization' (OR = 0.466, 95% CI: 0.37-0.596). Both the fivefold and leave-one-out cross-validation methods indicated that the nomogram model built by these 6 variables displayed good disease recognition ability. CONCLUSIONS The nomogram was a simple-to-use model to screen children for severe caries. This model was found to facilitate non-dental professionals in assessing risk values without oral examinations and making referrals to dental professionals.
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Affiliation(s)
- Shaoying Duan
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Meng Li
- Orange Dental Technology Co., Ltd., Shanghai, China
| | - Jialiang Zhao
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Huiyu Yang
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jinfeng He
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Lei Lei
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ran Cheng
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
| | - Tao Hu
- Department of Preventive Dentistry, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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14
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Heck K, Litzenburger F, Geitl T, Kunzelmann KH. Near-infrared reflection at 780 nm for detection of early proximal caries in posterior permanent teeth in vitro. Dentomaxillofac Radiol 2021; 50:20210005. [PMID: 33956491 PMCID: PMC8404521 DOI: 10.1259/dmfr.20210005] [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] [Indexed: 11/10/2022] Open
Abstract
Objectives: The aim of this in vitro study was to evaluate the diagnostic potential of near-infrared reflection at 780 nm (NIRR780nm) for early proximal caries detection on the occlusal, buccal and oral surfaces of molars and premolars under simulated, clinically relevant conditions. The findings were validated by micro-computed tomography (µCT). Methods: Bitewing radiography (BWR) was used as a comparative diagnostic method. 250 sound or decayed permanent teeth were examined using NIRR780nm and BWR. The NIRR780nm findings were evaluated using yes/no decisions depending on the presence of caries lesions, as the enamel-dentin junction was not detectable in the majority of samples. All NIRR780nm, BWR and µCT findings were obtained twice by two trained examiners. NIRR780nm images were evaluated both occlusally alone and combined occlusally, lingually and buccally. All findings were presented in a cross-table. Sensitivity, specificity and area under the curve (AUC) values were calculated. Reliability assessment was performed using κ statistics. Results: Underestimation of caries was observed for NIRR780nm in 26.0% of all surfaces and for BWR in 32.8% of all surfaces. Overestimation was 10.0% for NIRR780nm and 0.4% for BWR. Trilateral NIRR780nm assessment exhibited an overall accuracy of 67.2 %, an underestimation of 13.6% and an overestimation of 19.2%. Trilateral NIRR780nm exhibited 63.0% sensitivity and 69.6% specificity, while BWR exhibited 26.7% sensitivity but 100% specificity for proximal caries detection. Conclusion: NIRR780nm is not suitable for reliable detection of early proximal caries, even with the application of an ideal setup and optimized in vitro conditions.
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Affiliation(s)
- Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Friederike Litzenburger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Thomas Geitl
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Karl-Heinz Kunzelmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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AlShaya MS, Sabbagh HJ, El-Housseiny AA. Diagnosis and Management Approaches for Non-cavitated Carious Dental Lesions- A Narrative Review. Open Dent J 2021. [DOI: 10.2174/1874210602115010337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Dental caries is one of the most prevalent diseases. Its detection and management should start with a comprehensive treatment plan, with the goals of the elimination of cariogenic bacteria, the reduction of plaque acidogenicity, the encouragement of tooth remineralization, and the repair of damaged teeth.
Objectives:
The aim of this paper was to review the literature regarding the latest updates on the diagnosis and management approaches of non-cavitated carious dental lesions.
Methods:
Studies regarding the diagnosis and management of non-cavitated carious dental lesions were included.
Results: The subclinical non-cavitated carious lesion might progress to an early enamel lesion, develop into an established dentin lesion, or sometimes end up with a lesion reaching the pulp. The detection and management of caries should be patient-centered, risk-based, and evidence-supported, and should consider the dentists’ expertise and the patients’ needs and preferences. The visual-tactile and radiographic detection of non-cavitated carious lesions are greatly helped by the advances of non-invasive detection tools such as DIAGNOdent, fiber-optic transillumination, quantitative light-induced fluorescence, and DIAGNOcam.
Conclusion:
Accordingly, non-cavitated carious lesions can be arrested by several non-invasive techniques, which are preferred over the invasive options. The clinicians can use sealants plus fluoride varnish on occlusal surfaces, fluoride varnish or resin infiltration on proximal surfaces, and resin infiltration,fluoride gel, or varnish alone on facial or lingual surfaces to manage non-cavitated carious lesions.
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16
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Angarita-Díaz MP, Simon-Soro A, Forero D, Balcázar F, Sarmiento L, Romero E, Mira A. Evaluation of possible biomarkers for caries risk in children 6 to 12 years of age. J Oral Microbiol 2021; 13:1956219. [PMID: 34434531 PMCID: PMC8381948 DOI: 10.1080/20002297.2021.1956219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Electrolytes, proteins, and other salivary molecules play an important role in tooth integrity and can serve as biomarkers associated with caries. Objective: To determine the concentration of potential biomarkers in children without caries (CF) and children with caries (CA). Methods: Unstimulated saliva was collected, and the biomarkers quantified in duplicate, using commercial Enzyme Linked Immunosorbent Assay (ELISA) kits to determine IgA, fibronectin, cathelicidin LL-37, and statherin levels, as well as colorimetric tests to detect formate and phosphate. Results: Significantly higher concentrations of statherin was detected in the CF group (Median: 94,734.6; IQR: 92,934.6-95,113.7) compared to the CA2 group (90,875.0; IQR: 83,580.2-94,633.4) (p = 0.03). Slightly higher median IgA (48,250.0; IQR: 31,461.9-67,418.8) and LL-37 levels (56.1; IQR 43.6-116.2) and a lower concentration of formate were detected in the CF group (0.02; IQR 0.0034-0.15) compared to the group with caries (IgA: 37,776.42; IQR: 33,383.9-44,128.5; LL-37: 46.3; IQR: 40.1011-67.7; formate: 0.10; IQR: 0.01-0.18), but these differences were not statistically significant. Conclusion: The fact that these compounds have been identified as good markers for caries among European adults highlights the difficulty of identifying universal biomarkers that are applicable to all ages or to different populations.
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Affiliation(s)
- María P Angarita-Díaz
- Department of Health Sciences, School of Dentistry, Universidad Cooperativa De Colombia, Villavicencio Campus, Colombia
| | - Aurea Simon-Soro
- Department of Health and Genomics, Foundation for the Promotion of Health and Biomedical Research, Valencia, Spain
| | - Diana Forero
- Department of Health Sciences, School of Dentistry, Universidad Cooperativa De Colombia, Villavicencio Campus, Colombia
| | - Felipe Balcázar
- Department of Health Sciences, School of Dentistry, Universidad Cooperativa De Colombia, Villavicencio Campus, Colombia
| | - Luisa Sarmiento
- Department of Health Sciences, School of Dentistry, Universidad Cooperativa De Colombia, Villavicencio Campus, Colombia
| | - Erika Romero
- Department of Health Sciences, School of Dentistry, Universidad Cooperativa De Colombia, Villavicencio Campus, Colombia
| | - Alex Mira
- Department of Health and Genomics, Foundation for the Promotion of Health and Biomedical Research, Valencia, Spain
- Centre for Oral Health, School of Health and Welfare, Jönköping University, Sweden
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17
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Reis ACM, Bezerra DDS, Hart-Chú ENS, Stipp RN, Guedes SFDF, Neves BG, Rodrigues LKA. Quantification and gene expression of Lactobacillus casei group species associated with dentinal lesions in early childhood caries. Saudi Dent J 2021; 33:69-77. [PMID: 33551619 PMCID: PMC7848803 DOI: 10.1016/j.sdentj.2020.01.006] [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: 06/03/2019] [Revised: 01/15/2020] [Accepted: 01/19/2020] [Indexed: 11/22/2022] Open
Abstract
Background Considering that the Lactobacillus casei group is strongly associated with caries progression, the use of lactobacilli as probiotics must be balanced due to their possible involvement in dental caries. Objective This study aimed to detect and quantify L. paracasei, L. rhamnosus, and L. casei group species in the active and arrested dentinal lesions of preschoolers. It also aimed to determine the expression profiles of lactobacilli genes related to adhesion, extracellular polymeric substance regulation, and pyruvate oxidation. Methods Total ribonucleic acid (RNA) was extracted from dentinal lesion samples (25 active, 13 arrested) of children between 2 and 5 years of age. The samples were converted to complementary deoxyribonucleic acid (cDNA), and quantitative polymerase chain reaction (qPCR) analyses were performed to quantify and determine the relative abundance (measured by percentage of total bacteria) of L. paracasei, L. rhamnosus, and L. casei group species. The expression profiles of L. paracasei/casei genes (spaC and spxB) and L. rhamnosus genes (spaE and wzb) were assessed. The Student t-test and the Mann-Whitney U test were used for comparisons. Results The L. casei group species were found to be part of the viable microbial community in dentinal caries. L. paracasei (p = 0.001), L. rhamnosus (p = 0.022), and L. casei (p = 0.004) group species were abundant in the active dentinal lesions compared to the arrested dentinal lesions. Only the wzb gene (p = 0.006) exhibited a statistically significant difference between the active and arrested lesions in terms of its expression profile; it was expressed to a higher extent in the active dentinal lesions. Conclusions The L. casei group species presented in large numbers in the active dentinal caries lesions, indicating that these microorganisms are related to caries activity, and the wzb gene may play an important role in caries progression.
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Affiliation(s)
- Ana Catarina Martins Reis
- Postgraduate Program in Medical Microbiology, Federal University of Ceará, R. Coronel Nunes de Melo 1315, 60430-270 Fortaleza, CE, Brazil
| | - Daniela da Silva Bezerra
- Unichristus Campus Ecological Park, Dental College, R. João Adolfo Gurgel, 133, 60190-180, Fortaleza, CE, Brazil
| | - Erika Nikitza Shiauha Hart-Chú
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, 13414-903 Piracicaba, SP, Brazil
| | - Rafael Nóbrega Stipp
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, 13414-903 Piracicaba, SP, Brazil
| | | | - Beatriz Gonçalves Neves
- School of Dentistry, Federal University of Ceará, Rua Conselheiro José Júlio, S/N, 62010-080 Sobral, CE, Brazil
| | - Lidiany Karla Azevedo Rodrigues
- Postgraduate Program in Medical Microbiology, Federal University of Ceará, R. Coronel Nunes de Melo 1315, 60430-270 Fortaleza, CE, Brazil.,Postgraduate Program in Dentistry, Federal University of Ceará, R. Alexandre Baraúna, 949, 60430-160 Fortaleza, CE, Brazil
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18
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Tong H, Yu X, Shi Z, Liu F, Yu Y, Deng F, He J. Physicochemical properties, bond strength and dual-species biofilm inhibition effect of dental resin composites with branched silicone methacrylate. J Mech Behav Biomed Mater 2021; 116:104368. [PMID: 33545416 DOI: 10.1016/j.jmbbm.2021.104368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
Dental resin composites (DRCs) with 15 wt% (EC-15%) and 20 wt% (EC-20%) synthesized branched silicone methacrylate (BSM) in resin matrix have showed anti-adhesion effect against Streptococcus mutans. With the aim to evaluate the BSM containing DRCs further, water sorption (WS), solubility (SL), mechanical properties before and after water immersion, anti-adhesion effect against dual-species, bonding strength to adhesive treated dentin, and cytotoxicity of BSM containing DRCs were investigated. DRC without BSM was used as control. The WS and SL were obtained until the mass variation of composite in distilled water kept stable. Three-point bending test was used to evaluate flexural strength (FS) and modulus (FM) of composite before and after water immersion. Mixture of Streptococcus mutans and Lactobacillus acidophilus was used to study the anti-adhesion effect against dual-species. Bonding strength of composite to adhesive treated dentin was measured through macro-shear test. Extract of composite was used to evaluate its cytotoxicity effect on L-929 mouse fibroblasts, and cell viability was obtained by MTT assay. The results showed that EC-15% and EC-20% had similar WS and SL as control (p < 0.05); After water immersion, FS and FM of all composites decreased (p < 0.05), but there was no significant difference in value of FS and FM between different groups (p > 0.05); More bacteria were recovered from the surface of control than those from the surface of EC-15% and EC-20% (p < 0.05); Extract of EC-15% was less cytotoxic (higher cell viability) than those EC-20% and control (p < 0.05). All of results revealed that incorporation of 15 wt% or 20 wt% BSM in resin matrix could endow DRC with inhibition effect on dual-species biofilm formation without impairing physiochemical properties, bonding strength to adhesive treated dentin, and cytotoxicity of DRC.
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Affiliation(s)
- Hui Tong
- College of Materials Science and Engineering, South China University of Technology, Guangzhou, PR China
| | - Xiaolin Yu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Zhifeng Shi
- College of Materials Science and Engineering, South China University of Technology, Guangzhou, PR China; National Engineering Research Center for Tissue Restoration and Reconstruction, South China University of Technology, Guangzhou, PR China
| | - Fang Liu
- College of Materials Science and Engineering, South China University of Technology, Guangzhou, PR China
| | - Yi Yu
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China
| | - Feilong Deng
- Department of Oral Implantology, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, PR China.
| | - Jingwei He
- College of Materials Science and Engineering, South China University of Technology, Guangzhou, PR China.
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19
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Chen Y, Chen D, Lin H. Infiltration and sealing for managing non-cavitated proximal lesions: a systematic review and meta-analysis. BMC Oral Health 2021; 21:13. [PMID: 33413327 PMCID: PMC7791990 DOI: 10.1186/s12903-020-01364-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/10/2020] [Indexed: 11/25/2022] Open
Abstract
Background Infiltration and sealing are micro-invasive treatments for arresting proximal non-cavitated caries lesions; however, their efficacies under different conditions remain unknown. This systematic review and meta-analysis aimed to evaluate the caries-arresting effectiveness of infiltration and sealing and to further analyse their efficacies across different dentition types and caries risk levels. Methods Six electronic databases were searched for published literature, and references were manually searched. Split-mouth randomised controlled trials (RCTs) to compare the effectiveness between infiltration/sealing and non-invasive treatments in proximal lesions were included. The primary outcome was obtained from radiographical readings. Results In total, 1033 citations were identified, and 17 RCTs (22 articles) were included. Infiltration and sealing reduced the odds of lesion progression (infiltration vs. non-invasive: OR = 0.21, 95% CI 0.15–0.30; sealing vs. placebo: OR = 0.27, 95% CI 0.18–0.42). For both the primary and permanent dentitions, infiltration and sealing were more effective than non-invasive treatments (primary dentition: OR = 0.30, 95% CI 0.20–0.45; permanent dentition: OR = 0.20, 95% CI 0.14–0.28). The overall effects of infiltration and sealing were significantly different from the control effects based on different caries risk levels (OR = 0.20, 95% CI 0.14–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), there were significant differences between micro-invasive and non-invasive treatments (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.17, 95% CI 0.10–0.29; and high risk: OR = 0.14, 95% CI 0.07–0.28). Except for caries risk at moderate levels (moderate risk: OR = 0.32, 95% CI 0.01–8.27), infiltration was superior (low risk: OR = 0.24, 95% CI 0.08–0.72; low to moderate risk: OR = 0.38, 95% CI 0.18–0.81; moderate to high risk: OR = 0.20, 95% CI 0.10–0.39; and high risk: OR = 0.14, 95% CI 0.05–0.37). Conclusion Infiltration and sealing were more efficacious than non-invasive treatments for halting non-cavitated proximal lesions.
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Affiliation(s)
- Yuanyuan Chen
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China
| | - Dongru Chen
- Department of Orthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China
| | - Huancai Lin
- Hospital of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China. .,Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China. .,Guangdong Key Laboratory for Dental Disease Prevention and Control, Sun Yat-Sen University, Guangzhou, China.
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Effects of melatonin in wound healing of dental pulp and periodontium: Evidence from in vitro, in vivo and clinical studies. Arch Oral Biol 2021; 123:105037. [PMID: 33440268 DOI: 10.1016/j.archoralbio.2020.105037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 12/15/2020] [Accepted: 12/24/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Database research has revealed that melatonin has beneficial effects in pulpal and periodontal regeneration. Several studies reported protective effects of melatonin against inflammation in several organs including the heart, brain, and teeth. In addition to inflammation reduction, melatonin has been involved in tissue regeneration and wound healing. The aim of this review is to summarize the evidence from in vitro, in vivo and clinical studies on the effects of melatonin in wound healing of dental pulp and periodontium. This review gives a thorough summary of the possible role of melatonin in wound healing of dental pulp and periodontium in connection with anti-inflammatory and antioxidant effects, cell proliferation, and cell differentiation. Any contradictory evidence is also assessed. METHODS The PubMed database was searched for all research articles published before April 2020 with the search terms "melatonin" and "dental pulp". Articles with the search terms "melatonin", "periodontal disease" and "bone" published before October 2019 were also included. Non-English articles were excluded. RESULTS Melatonin has been shown to reduce inflammation, inhibit cell proliferation and regulate differentiation of pulp cells. Melatonin increased odontoblast activities, resulting in the differentiation in the dental pulp. However, melatonin did not initiate differentiation in undifferentiated pulp cells but seemed to have beneficial effects in periodontitis by promoting periodontium's wound healing. CONCLUSION Those findings suggest that melatonin could have beneficial effects on pulpal and periodontal cells under inflammatory conditions. However, discrepancies remain between in vitro and in vivo findings regarding the effect of melatonin on dental pulp and periodontium.
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Abstract
Despite evidence strongly supporting use of non-invasive or minimally invasive procedures in caries management, there is still a large gap between evidence-based recommendations and application of these concepts in practice, with the practice of dentistry still largely dominated by invasive procedures in the US. This paper describes efforts in education and clinical practice in the US in the last decade to promote evidence-based cariology strategies, which support a minimum intervention dentistry (MID) philosophy. These include, for example: a competency-based core cariology curriculum framework which has been developed and disseminated. National education accreditation standards supporting caries management are likely to soon be changed to support assessment of best evidence in cariology. There are several ongoing efforts by organised dentistry and other groups involving dental educators, researchers and clinical practitioners to promote cariology concepts in practice, such as the development of evidence-based clinical practice guidelines for caries management by the American Dental Association. Within each of these strategies there are challenges, but also opportunities to expand the implementation of MID in the US, which create optimism for future improvements over time.
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Li B, Pan T, Lin H, Zhou Y. The enhancing antibiofilm activity of curcumin on Streptococcus mutans strains from severe early childhood caries. BMC Microbiol 2020; 20:286. [PMID: 32938379 PMCID: PMC7493841 DOI: 10.1186/s12866-020-01975-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Streptococcus mutans (S. mutans) is one of the main cariogenic bacteria for caries. It was found that the clinical strains of S. mutans isolated from caries active population have stronger cariogenic ability than the isolates from caries-free (CF) people. Previous studies have found that curcumin can inhibit biofilm formation of S. mutans UA159. The objective of this study is to explore the antibiofilm effect of curcumin on the clinical isolates of S. mutans from severe early childhood caries(SECC). RESULTS The isolates from SECC group had more biomass than CF group (t = 4.296, P < 0.001). The acidogenicity and aciduricity of the strains from two groups showed no significant difference. After treatment with curcumin, the viability of biofilm was reduced to 61.865% ± 7.108% in SECC and to 84.059% ± 10.227% in CF group at 24 h (P < 0.05). The net reduction of live bacteria and total bacteria in the SECC group was significantly higher than that of the CF group (live bacteria t = 3.305, P = 0.016; total bacteria t = 2.378, P = 0.045) at 5 min. For 24 h, the net reduction of live bacteria and total bacteria in the SECC group was significantly higher than that of the CF group (live bacteria t = 3.305, P = 0.016; total bacteria t = 2.378, P = 0.045). The reduction of biofilm thickness reduced significantly in 5 min (t = 4.110, P = 0.015) and in 24 h (t = 3.453, P = 0.014). Long-term (24 h) curcumin treatment inhibited the amount of EPS in SECC group from (25.980 ± 1.156) μm3/μm2 to (20.136 ± 1.042) μm3/μm2, the difference was statistically significant (t = 7.510, P < 0.001). The gene of gtfC, gtfD, ftf, gbpB, fruA and srtA in the CF group and the gtfB, gtfC, gtfD, ftf, gbpB, srtA in SECC group were respectively reduced after 5 min curcumin treatment. After 24 h treatment, the gtfB, gtfC, gtfD, ftf, gbpB, fruA and srtA in both two groups were downregulation, all the differences were statistically significant. CONCLUSIONS Curcumin has antibiofilm activity on clinical strains of S. mutans, especially for those isolated from SECC.
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Affiliation(s)
- Bingchun Li
- Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Ting Pan
- Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, Guangzhou, 510055, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Huancai Lin
- Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, Guangzhou, 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.
| | - Yan Zhou
- Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, Guangzhou, 510055, China. .,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.
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23
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Song Y, Luzzi L, Brennan DS. Trust in dentist‐patient relationships: mapping the relevant concepts. Eur J Oral Sci 2020; 128:110-119. [DOI: 10.1111/eos.12686] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2020] [Indexed: 01/26/2023]
Affiliation(s)
- YoungHa Song
- Australian Research Centre for Population Oral Health Adelaide Dental School The University of Adelaide Adelaide SA Australia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health Adelaide Dental School The University of Adelaide Adelaide SA Australia
| | - David S. Brennan
- Australian Research Centre for Population Oral Health Adelaide Dental School The University of Adelaide Adelaide SA Australia
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Thorn AK, Lin WS, Levon JA, Morton D, Eckert GJ, Lippert F. The effect of theobromine on the in vitro de- and remineralization of enamel carious lesions. J Dent 2020; 103S:100013. [PMID: 34059300 DOI: 10.1016/j.jjodo.2020.100013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/11/2020] [Accepted: 02/14/2020] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES This in vitro study investigated the effect of theobromine on the de- and remineralization of enamel carious lesions under plaque fluid-like conditions. METHODS Early carious lesions were created in 272 bovine enamel specimens and assigned to sixteen groups (n=17) based on Knoop surface microhardness (SMH). Lesions were demineralized again under plaque fluid-like conditions in the presence of fluoride (0.2 or 1ppm) and theobromine (0; 10; 100 or 200ppm) at different pH values (5.5 or 7.0) in a factorial design. SMH was determined again and percent SMH recovery (%SMHr) calculated. Three-way ANOVA was used for the fixed effects of fluoride, theobromine and pH levels to compare the differences between each level. RESULTS The three-way interaction was not significant (p=0.712). The two-way interaction between fluoride and pH was significant (p=0.030), whereas those between fluoride and theobromine as well as that for pH and theobromine were not (p=0.478 and p=0.998, respectively). Theobromine did not affect %SMHr at any of the tested concentrations. There were trends for the higher fluoride concentration and the higher pH resulting in more rehardening with the lesions exposed to 0.2ppm fluoride at pH 5.5 displaying significantly less rehardening than those exposed to 0.2ppm fluoride at pH of 7.0 and lesions exposed to 1ppm fluoride at pH of 5.5. CONCLUSION Theobromine, when continuously present in a plaque fluid-like medium at various concentrations and at different pH values, does not affect de- or remineralization of enamel carious lesions under the presently studied conditions. CLINICAL SIGNIFICANCE Based on the presently available evidence, theobromine cannot be recommended as an anticaries agent.
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Affiliation(s)
- Anna K Thorn
- Indiana University School of Dentistry, Department of Prosthodontics, 1121 W Michigan St., Indianapolis, IN, 46202, USA
| | - Wei-Shao Lin
- Indiana University School of Dentistry, Department of Prosthodontics, 1121 W Michigan St., Indianapolis, IN, 46202, USA
| | - John A Levon
- Indiana University School of Dentistry, Department of Prosthodontics, 1121 W Michigan St., Indianapolis, IN, 46202, USA
| | - Dean Morton
- Indiana University School of Dentistry, Department of Prosthodontics, 1121 W Michigan St., Indianapolis, IN, 46202, USA
| | - George J Eckert
- Indiana University School of Medicine, Department of Biostatistics, 410 W. Tenth St., Suite 3000, Indianapolis, IN, 46202, USA
| | - Frank Lippert
- Indiana University School of Dentistry, Department of Cariology, Operative Dentistry and Dental Public Health, 1121 W Michigan St., Indianapolis, IN, 46202, USA.
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25
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Inquimbert C, Bourgeois D, Giraudeau N, Tramini P, Viennot S, Dussart C, Carrouel F. Microbiota of interdental space of adolescents according to Risk of Caries: A cross-sectional study protocol. Contemp Clin Trials Commun 2019; 16:100444. [PMID: 31709310 PMCID: PMC6833308 DOI: 10.1016/j.conctc.2019.100444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/21/2019] [Accepted: 08/21/2019] [Indexed: 11/21/2022] Open
Abstract
Dental caries is a major oral disease resulting from a complex interaction between the commensal microbiota, host susceptibility (heredity, immunity, diseases, etc.) and environmental factors (diet, dental hygiene, etc.). To predict the patient's risk of new carious lesions or progression of existing lesions, the Caries Risk Assessment (CRA) takes account of clinical, biological and behavioural factors. Thus, the CRA can predict whether the patient is at high or low risk of developing caries. The practitioner can thus set up a follow-up adapted to the risk of the patient. However, although bacteria are the main etiological factor of carious lesions, the CRA does not consider bacterial quantification or just focus on the level of S. mutans in the saliva. As the majority of cavities are interproximal in adolescence, the aim of this trial is to identify and quantify the interdental microbiota of adolescents aged from 15 to 17 years with low or high carious risk. So, the quantification of new biomarkers associated with carious lesion could be added to the CRA to improve it.
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Affiliation(s)
- Camille Inquimbert
- Systemic Healthcare Laboratory EA4129, Faculty of Medicine Laennec, University Lyon 1, University of Lyon, Lyon, France
- Department of Public Health, Faculty of Oral Medicine, University of Montpellier, Montpellier, France
| | - Denis Bourgeois
- Systemic Healthcare Laboratory EA4129, Faculty of Medicine Laennec, University Lyon 1, University of Lyon, Lyon, France
| | - Nicolas Giraudeau
- Department of Public Health, Faculty of Oral Medicine, University of Montpellier, Montpellier, France
| | - Paul Tramini
- Department of Public Health, Faculty of Oral Medicine, University of Montpellier, Montpellier, France
| | - Stéphane Viennot
- Systemic Healthcare Laboratory EA4129, Faculty of Medicine Laennec, University Lyon 1, University of Lyon, Lyon, France
| | - Claude Dussart
- Systemic Healthcare Laboratory EA4129, Faculty of Medicine Laennec, University Lyon 1, University of Lyon, Lyon, France
| | - Florence Carrouel
- Systemic Healthcare Laboratory EA4129, Faculty of Medicine Laennec, University Lyon 1, University of Lyon, Lyon, France
- Department of Fundamental and Clinical Biological Sciences, Faculty of Oral Medicine, University Lyon 1, University of Lyon, Lyon, France
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3D Dental Subsurface Imaging Using Enhanced Truncated Correlation-Photothermal Coherence Tomography. Sci Rep 2019; 9:16788. [PMID: 31727979 PMCID: PMC6856164 DOI: 10.1038/s41598-019-53170-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 10/29/2019] [Indexed: 12/14/2022] Open
Abstract
Development of accurate and sensitive dental imaging technologies is a top priority in the pursuit of high-quality dental care. However, while early dental caries detection and routine monitoring of treatment progress are crucial for effective long-term results, current radiographic technologies fall short of this objective due to low sensitivity for small lesions and use of ionizing radiation which is unsuitable for frequent monitoring. Here we demonstrate the first application of enhanced Truncated Correlation-Photothermal Coherence Tomography (eTC-PCT) to dental imaging. eTC-PCT is non-invasive and non-ionizing, operates well below the maximum permissible exposure (MPE) limit, and features 3D subsurface imaging capability with operator controlled axial resolution. We explore the potential of this method for dental applications and demonstrate its capability for depth-resolved tomographic 3D reconstructions of the details and subsurface extent of a variety of dental defects. To this end, in this proof-of-concept study, dental eTC-PCT imaging results, and its sensitivity to dental caries, are discussed in comparison with visual examination, x-rays and micro-CT imaging.
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27
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Allen PF, Da Mata C, Hayes M. Minimal intervention dentistry for partially dentate older adults. Gerodontology 2019; 36:92-98. [DOI: 10.1111/ger.12389] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 12/04/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Martina Hayes
- Cork University Dental School & Hospital, Wilton Cork Ireland
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28
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Chávez EM, Wong LM, Subar P, Young DA, Wong A. Dental Care for Geriatric and Special Needs Populations. Dent Clin North Am 2019; 62:245-267. [PMID: 29478456 DOI: 10.1016/j.cden.2017.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This article reviews considerations for oral health care associated with the most common causes of mortality and morbidity in older adults. Many of these diseases result in functional or cognitive impairments that must be considered in treatment planning to ensure appropriate, safe, and effective care for patients. Many of these considerations parallel those of adults who have lived with developmental disabilities over a lifetime and similar principles can be applied. Systemic diseases, conditions, and their treatments can pose significant risks to oral health, which requires prevention, treatment, and advocacy for oral health care as integral to chronic disease management.
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Affiliation(s)
- Elisa M Chávez
- Department of Diagnostic Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA.
| | - Lynne M Wong
- Department of Diagnostic Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
| | - Paul Subar
- Special Care Clinic, Hospital Dentistry Program, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA; Department of Family and Community Medicine, UCSF School of Medicine, San Francisco, CA, USA
| | - Douglas A Young
- Department of Diagnostic Sciences, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
| | - Allen Wong
- AEGD Program, Hospital Dentistry Program, University of the Pacific, Arthur A. Dugoni School of Dentistry, 155 5th Street, San Francisco, CA 94103, USA
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Fatimah Rahamat S, Nor Hayati Wan Abd Manan W, Azura Shahdan I, Azura Jalaludin A, Abllah Z. Plant-based milk in arresting caries. MATERIALS TODAY: PROCEEDINGS 2019; 16:2231-2237. [DOI: 10.1016/j.matpr.2019.06.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Abstract
Dental caries is a disease that results from microbiome dysbiosis with the involvement of multiple cariogenic species, including mutans streptococci (MS), lactobacilli, Scardovia wiggsiae, and several Actinomyces species that have the cariogenic traits of acid production and acid tolerance. Sugar consumption also plays an important role interacting with microbiome dysbiosis, determining the fate of caries development. In addition, the MS transmission that encompasses multiple sources can have long-term impacts on the oral microbiome and caries development in children. Intervention in MS transmission in early childhood may promote effective long-term caries prevention. Anticaries regimens aimed against the above mechanisms will be important for successful caries management. Xylitol and erythritol may serve as good components of anticaries regimens as oral microbiome modifiers, sugar substitutes, and agents to prevent MS transmission in early childhood with both oral and systemic benefits. Further studies are needed to elucidate the mechanism of the anticaries effects of xylitol and erythritol with consideration of their impacts on the microbiome and bacterial virulence, in addition to cariogenic bacteria levels as well as their benefits for overall health. On the other hand, the anticaries agent C16G2, specifically targeting Streptococcus mutans, the most common cariogenic bacterial species, has shown good safety for short-term oral topical use and promising effects in reducing S. mutans in vitro and in vivo with the promotion of oral commensal bacteria. Future study on its anticaries effect will need to include its long-term impact on the oral microbiome and effects on other important cariogenic bacteria.
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Affiliation(s)
- L Zhan
- 1 Division of Pediatric Dentistry, Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco, San Francisco, CA, USA
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31
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Maske TT, Hollanders ACC, Kuper NK, Bronkhorst EM, Cenci MS, Huysmans MCDNJM. A threshold gap size for in situ secondary caries lesion development. J Dent 2018; 80:36-40. [PMID: 30395875 DOI: 10.1016/j.jdent.2018.10.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES This study investigated the influence of very small gaps in secondary caries (SC) development and additionally linked the threshold gap size with the caries activity level from volunteers. METHODS For 21 days, 15 volunteers wore a modified occlusal splint loaded with dentin-composite samples restored with different interfaces: bonded (B = samples restored with complete adhesive procedure), no-bonded (NB = restored with composite resin without adhesive procedure), and 30, 60 and 90 μm (no adhesive procedure and with intentional gap). The splint was dipped in a 20% sucrose solution (10 min) 8 x per day. Samples were imaged with transversal wavelength independent microradiography (T-WIM) and lesion depth and mineral loss were calculated. Average wall lesion depth from each volunteer was determined and according to the values the volunteers were grouped as high, mid and low caries activity levels. RESULTS No wall lesion formation was observed in B and NB groups. In general, intentional gaps led to SC lesion depth progression independent of caries activity level of volunteers. No substantial wall lesions were found for two volunteers. A trend for deeper lesion in larger gaps was observed for the high activity group. CONCLUSION Very small gaps around or wider than 30 μm develop SC independent of the caries activity level of the patient and SC wall lesion progression seemed to be related to individual factors even in this standardized in situ model. SIGNIFICANCE Independently of caries activity level of the patient, the threshold gap size for secondary caries wall lesion seems to be 30 μm at most.
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Affiliation(s)
- T T Maske
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands.
| | - A C C Hollanders
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - N K Kuper
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - E M Bronkhorst
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
| | - M S Cenci
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - M C D N J M Huysmans
- Radboud University Medical Center, Department of Dentistry, Nijmegen, The Netherlands
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Sharma A, Agarwal N, Anand A, Jabin Z. To compare the effectiveness of different mouthrinses on Streptococcus mutans count in caries active children. J Oral Biol Craniofac Res 2018; 8:113-117. [PMID: 29892532 PMCID: PMC5993469 DOI: 10.1016/j.jobcr.2018.05.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 05/01/2018] [Indexed: 10/17/2022] Open
Abstract
INTRODUCTION Streptococcus mutans is the prime microbe responsible for caries. Mouthwashes represent an effective means for decreasing their count. To ascertain this, three commercially available mouthrinses were evaluated for their antimicrobial activity. MATERIALS AND METHOD Chlorhexidine, Sodium fluoride and Herbal mouth rinse were evaluated for their efficacy against S. mutans in 60 children aged 6-12 years old. Plain water acted as the control group. RESULTS The values obtained were subjected to statistical analysis. ANOVA test, student-t test and paired t-test were used for evaluation. Chlorhexidine and fluoride showed statistically significant reduction in S. mutans count as compared to herbal rinse. CONCLUSION All the mouthrinses used in the present study have shown a definite decline in S. mutans count.
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Affiliation(s)
| | - Nidhi Agarwal
- Department of Pedodontics and Preventive Dentistry, Institute of Dental Studies and Technologies, Kadrabad, Modinagar, Ghaziabad, 201201, India
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Mitchell JK, Furness AR, Sword RJ, Looney SW, Brackett WW, Brackett MG. Diagnosis of Pit-and-fissure Caries Using Three-dimensional Scanned Images. Oper Dent 2018; 43:E152-E157. [PMID: 29676978 DOI: 10.2341/17-076-l] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Diagnosis of the extent of pit-and-fissure caries has been subjective and thus difficult to teach and categorize for treatment planning. This in vitro study compares occlusal caries diagnosis of extracted posterior teeth (n=49) using three-dimensional (3D) scanned images vs visual examination, according to the International Caries Detection and Assessment System (ICDAS). The surfaces chosen for study represent all ICDAS classifications. Five experienced restorative faculty members examined scanned images for 60 seconds from a standardized series of views of each surface and scored them independently. One month later, the same teeth were examined visually by the same five raters with magnification and LED headlamps, with compressed air available. Intrarater and interrater agreement and validity were assessed using intraclass correlation coefficients (ICCs). The ICCs, ranging from 0.90 to 0.93, indicated excellent agreement between and within raters and between the raters and the gold standard ICDAS determination. This suggests that both photographs and 3D scans of pits and fissures are equally effective in diagnosing caries.
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Raphael SL, Foster Page LA, Hopcraft MS, Dennison PJ, Widmer RP, Evans RW. A survey of cariology teaching in Australia and New Zealand. BMC MEDICAL EDUCATION 2018; 18:75. [PMID: 29631580 PMCID: PMC5892021 DOI: 10.1186/s12909-018-1176-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The Australian and New Zealand chapter of the Alliance for a Cavity Free Future was launched in 2013 and one of its primary aims was to conduct a survey of the local learning and teaching of cariology in dentistry and oral health therapy programs. METHODS A questionnaire was developed using the framework of the European Organisation for Caries Research (ORCA)/Association of Dental Education in Europe (ADEE) cariology survey conducted in Europe in 2009. The questionnaire was comprised of multiple choice and open-ended questions exploring many aspects of the cariology teaching. The survey was distributed to the cariology curriculum coordinator of each of the 21 programs across Australia and New Zealand via Survey Monkey in January 2015. Simple analysis of results was carried out with frequencies and average numbers of hours collated and open-ended responses collected and compiled into tables. RESULTS Seventeen responses from a total of 21 programs had been received including 7 Dentistry and 10 Oral Health programs. Key findings from the survey were - one quarter of respondents indicated that cariology was identified as a specific discipline with their course and 41% had a cariology curriculum in written format. With regard to lesion detection and caries diagnosis, all of the program coordinators who responded indicated that visual/tactile methods and radiographic interpretation were recommended with ICDAS also being used by over half them. Despite all respondents teaching early caries lesion management centred on prevention and remineralisation, many taught operative intervention at an earlier stage of lesion depth than current evidence supports. Findings showed over 40% of respondents still teach operative intervention for lesions confined to enamel. CONCLUSION Despite modern theoretical concepts of cariology being taught in Australia and New Zealand, they do not appear to be fully translated into clinical teaching at the present time.
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Affiliation(s)
- Sarah L. Raphael
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
| | | | | | | | - Richard P. Widmer
- Department of Dentistry, Children’s Hospital at Westmead, Westmead, Australia
| | - R. Wendell Evans
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
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Abrams SH, Sivagurunathan KS, Silvertown JD, Wong B, Hellen A, Mandelis A, Hellen WMP, Elman GI, Mathew SM, Mensinkai PK, Amaechi BT. Correlation with Caries Lesion Depth of The Canary System, DIAGNOdent and ICDAS II. Open Dent J 2017; 11:679-689. [PMID: 29387284 PMCID: PMC5750685 DOI: 10.2174/1874210601711010679] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 10/17/2017] [Accepted: 11/06/2017] [Indexed: 12/04/2022] Open
Abstract
Introduction: The aim of this study was to correlate lesion depth of natural caries, measured with Polarized Light Microscopy (PLM), to Canary Numbers (CN) derived from The Canary System™ (CS), numerical readings from DIAGNOdent (DD), and lesion scores from ICDAS II. Methods: A total of 20 examination sites on extracted human molars and premolars were selected. The selected examination sites consisted of healthy and enamel caries on smooth and occlusal surfaces of each tooth. Two blinded dentists ranked each examination site using ICDAS II and the consensus score for each examined site was recorded. The same examination sites were scanned with CS and DD, and the CN and DD readings were recorded. After all the measurements were completed, the readings of the three caries detection methods were validated with a histological method, Polarized Light Microscopy (PLM). PLM performed by blinded examiners was used as the ‘gold standard’ to confirm the presence or absence of a caries lesion within each examined site and to determine caries lesion depth. Results: Pearson’s coefficients of correlation with caries lesion depth of CNs, DD readings and ICDAS scores were 0.84, 0.21 and 0.77, respectively. Mean ± SD CN for sound sites (n=3), caries lesion depths <800 µm (n=11), and caries lesion depths >800 µm (n=6) were 11±1, 55±15, and 75±22, respectively. Mean ± SD DD readings for sound sites, caries lesion depths <800 µm, and caries lesion depths >800 µm were 1±1, 7±11, and 8±9, respectively. Mean ± SD ICDAS II scores for sound sites, caries lesion depths <800 µm, and caries lesion depths >800 µm were 0±0, 2±1, and 2±1, respectively. The intra-operator repeatability for the Canary System was .953 (0.913, 0.978). Conclusion: This study demonstrated that the CS exhibits much higher correlation with caries lesion depth compared to ICDAS II and DD. CS may provide the clinician with more information about the size and position of the lesion which might help in monitoring or treating the lesion. The present extracted tooth study found that The Canary System correlates with caries lesion depth more accurately that ICDAS II and DIAGNOdent.
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Affiliation(s)
- Stephen H Abrams
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada.,Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | | | | | - Bonny Wong
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Adam Hellen
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Andreas Mandelis
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada.,Center for Advanced Diffusion Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Ontario, Canadas
| | | | - Gary I Elman
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | - S M Mathew
- University of Texas Health Science Center, San Antonio, Texas, USA
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Young DA, Alvear Fa B, Rogers N, Rechmann P. The Effect of Calibration on Caries Risk Assessment Performance by Students and Clinical Faculty. J Dent Educ 2017; 81:667-674. [PMID: 28572412 DOI: 10.21815/jde.017.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 02/09/2017] [Indexed: 11/20/2022]
Abstract
Caries management requires a complete oral examination and an accurate caries risk assessment (CRA). Performing Caries Management by Risk Assessment (CAMBRA) is inefficient when the caries risk level assignment is incorrect. The aim of this study was to evaluate the ability of faculty members and students at one U.S. dental school to correctly assign caries risk levels for 22 CRA cases, followed by calibration with guidelines on how to use the CRA form and a post-calibration test two months after calibration. Inter-examiner reliability to a gold standard (consensus of three experts) was assessed as poor, fair, moderate, good, and very good. Of the 162 students and 125 faculty members invited to participate, 13 students and 20 faculty members returned pre-calibration tests, for response rates of 8% and 16%, respectively. On the post-calibration test, eight students and 13 faculty members participated for response rates of 5% and 10%, respectively. Without guidelines and calibration, both faculty members and students when evaluated as one group performed only poor to fair in assigning correct caries risk levels. After calibration, levels improved to good and very good agreements with the gold standard. When faculty and students were evaluated separately, in the pre-calibration test they correctly assigned the caries risk level on average in only one-quarter of the cases (students 24.1%±13.3%; faculty 23.6%±17.5%). After calibration, both groups significantly improved their correct assignment rate. Faculty members (73.8% correct assignments) showed even significantly higher correct assignment rates than students (47.7% correct assignments). These findings suggest that calibration with a specific set of guidelines improved CRA outcomes for both the faculty members and students. Improved guidelines on how to use a CRA form should lead to improved caries risk assessment and proper treatment strategy for patients.
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Affiliation(s)
- Douglas A Young
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco.
| | - Bernadette Alvear Fa
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco
| | - Nicholas Rogers
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco
| | - Peter Rechmann
- Dr. Young is Professor, Department of Dental Practice, Arthur A. Dugoni School of Dentistry, University of the Pacific; Dr. Fa is Assistant Professor, Department of Integrated Reconstructive Dental Sciences, Arthur A. Dugoni School of Dentistry, University of the Pacific; Mr. Rogers is Administrative Lead for Personalized Instructional Programs, Department of Academic Affairs, Arthur A. Dugoni School of Dentistry, University of the Pacific; and Dr. Rechmann is Professor and Director of Clinical Sciences Research Group, Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco
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Mitchell J, Brackett M, Brackett W. Caries Management with the International Caries Detection and Assessment System II: Established Pit and Fissure Lesions. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2017; 13:10602. [PMID: 30800804 PMCID: PMC6338171 DOI: 10.15766/mep_2374-8265.10602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 06/22/2017] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Operative dentistry addresses the surgical management of caries, a significant portion of dental practice. Dental students, who typically develop their skill sets in this important discipline by creating idealized preparations in plastic teeth, are often confused by the wide variety of tooth anatomy and caries presentation they see when they subsequently treat patients. To address this significant clinical transition issue, we developed this resource on preparing the moderate carious lesion using a stepwise, structured technique. METHODS This resource consists of a flipped-classroom learning module and associated laboratory activity with an algorithm worksheet to practice critical thinking skills. Prior to the exercise, an interactive tutorial introduces the didactic background. The 4-hour class session starts with a short quiz and review, then learners use the worksheet to prepare and restore their tooth specimens. RESULTS Learner response has been very positive. Moreover, faculty note that learners' skills in treating patients in clinic are noticeably higher and require less faculty intervention than was previously the case. DISCUSSION Since new national curriculum standards for caries are currently being introduced, in addition to providing instruction to dental students, this resource presents an excellent opportunity to calibrate faculty members, who are a secondary learner group in this exercise, on a standard clinical protocol.
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Affiliation(s)
- Jan Mitchell
- Associate Professor, Restorative Sciences, Dental College of Georgia at Augusta University
| | - Martha Brackett
- Professor, Restorative Sciences, Dental College of Georgia at Augusta University
| | - William Brackett
- Professor, Restorative Sciences, Dental College of Georgia at Augusta University
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Taqi M, Razak IA, Ab-Murat N. Caries Risk Assessment in School Children Using Reduced Cariogram Model. Pak J Med Sci 2017; 33:948-952. [PMID: 29067071 PMCID: PMC5648970 DOI: 10.12669/pjms.334.13106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective: To estimate the percentage of children with low, moderate and high caries risk; and to determine the predictors of caries risk amongst 11-12 year old Pakistani school children. Methods: Subjects’ caries risk was assessed using the Cariogram programme. The survey was done among school children in Bhakkar district of Punjab, Pakistan. Caries and plaque level were assessed using the DMFT and Sillnes and Loe indices respectively, while diet content and frequency were assessed using a three-day diet diary. Results: A total of 226 children participated in this study, giving a response rate of 75%. Most subjects (39.8%) were in the low risk category with DMFT score of 0. The overall mean DMFT score was 1.49 (±0.63). Linear and multiple regressions were performed to evaluate the predictability of caries risk. Previous experience of dental caries was found to be the most relevant predictor of caries risk (40%). Conclusion: The levels of caries risk amongst Pakistani 11-12 year old school children were generally low. Past caries experience was the most significant factor in predicting future caries lesion in this sample population.
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Affiliation(s)
- Muhammad Taqi
- Muhammad Taqi, MSc. Department of Community Dentistry, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan, Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Ishak Abdul Razak
- Ishak Abdul Razak, PhD. Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Norintan Ab-Murat
- Norintan Ab-Murat, PhD. Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Mitchell J, Shoemaker A. Oral Health Care for Nurse Educators, Part 1: Birth to 6 Years Old. TEACHING AND LEARNING IN NURSING 2017. [DOI: 10.1016/j.teln.2016.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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The American Dental Association Caries Classification System for clinical practice: a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2016; 146:79-86. [PMID: 25637205 DOI: 10.1016/j.adaj.2014.11.018] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 10/23/2014] [Accepted: 11/14/2014] [Indexed: 11/23/2022]
Abstract
BACKGROUND The caries lesion, the most commonly observed sign of dental caries disease, is the cumulative result of an imbalance in the dynamic demineralization and remineralization process that causes a net mineral loss over time. A classification system to categorize the location, site of origin, extent, and when possible, activity level of caries lesions consistently over time is necessary to determine which clinical treatments and therapeutic interventions are appropriate to control and treat these lesions. METHODS In 2008, the American Dental Association (ADA) convened a group of experts to develop an easy-to-implement caries classification system. The ADA Council on Scientific Affairs subsequently compiled information from these discussions to create the ADA Caries Classification System (CCS) presented in this article. CONCLUSIONS The ADA CCS offers clinicians the capability to capture the spectrum of caries disease presentations ranging from clinically unaffected (sound) tooth structure to noncavitated initial lesions to extensively cavitated advanced lesions. The ADA CCS supports a broad range of clinical management options necessary to treat both noncavitated and cavitated caries lesions. PRACTICAL IMPLICATIONS The ADA CCS is available for implementation in clinical practice to evaluate its usability, reliability, and validity. Feedback from clinical practitioners and researchers will allow system improvement. Use of the ADA CCS will offer standardized data that can be used to improve the scientific rationale for the treatment of all stages of caries disease.
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Goolsby SP, Young DA, Chiang HK, Carrico CK, Jackson LV, Rechmann P. The Effects of Faculty Calibration on Caries Risk Assessment and Quality Assurance. J Dent Educ 2016. [DOI: 10.1002/j.0022-0337.2016.80.11.tb06214.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Susie P. Goolsby
- Department of General Practice and Department of Admissions; School of Dentistry; Virginia Commonwealth University
| | - Douglas A. Young
- Department of Dental Practice; Arthur A. Dugoni School of Dentistry; University of the Pacific
| | - Harmeet K. Chiang
- Department of General Practice; School of Dentistry; Virginia Commonwealth University
| | - Caroline K. Carrico
- Department of Periodontics; School of Dentistry; Virginia Commonwealth University
| | - Leonard V. Jackson
- Department of General Practice and Department of Admissions; School of Dentistry; Virginia Commonwealth University
| | - Peter Rechmann
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
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ABANTO J, BERTI GO, MIGUITA L, BONECKER M. Monitoring of caries disease by risk assessments and activity. ACTA ACUST UNITED AC 2016. [DOI: 10.1590/1981-863720160001000103122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Dental caries is a non-communicable disease and is considered a public health problem. For diagnosis and correct treatment, the study of risk assessment and caries activity is necessary. The caries risk assessment is a way to formalize the balance and imbalance of predictably disease to diagnose dental caries. Therefore, the caries risk assessment is performed through different evaluation systems. Another parameter of great importance to be studied is the activity of caries, because through it is done the correct treatment decision for the patient. The objective of this article is to inform the reader about: the concepts and caries risk factors; the different caries risk assessment systems described in the literature; and which systems are validated. In addition, this literature review provides for identification and evaluation of risk factors and activity of caries lesions in order to enable greater objectivity in the diagnosis and facilitate the decisions of a successful treatment.
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Evans RW, Clark P, Jia N. The Caries Management System: are preventive effects sustained postclinical trial? Community Dent Oral Epidemiol 2015; 44:188-97. [PMID: 26639787 PMCID: PMC5324629 DOI: 10.1111/cdoe.12204] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
Objectives To report, at two and 4 years post‐trial, on the potential legacy of a 3‐year randomized controlled clinical trial (RCT) of the Caries Management System (CMS) at private general dental practices. The CMS was designed to reduce caries risk and need for restorative care. Methods Nineteen dental practices located in city, urban, and rural locations in both fluoridated and nonfluoridated communities participated in the RCT. Eight practices were lost to follow‐up post‐trial; however, baseline mean DMFT balance between CMS and control practices was maintained. At the control practices, caries management following usual practice continued to be delivered. The patient outcome measure was the cumulative increment in the DMFT index score, and the practice outcome measures included the practice‐mean and practice‐median increments of patient DMFT index scores. In covariable analysis (patient‐level unit of analysis), as the patients were clustered by practices, mean DMFT increments were determined through multilevel modeling analysis. Practice‐mean DMFT increments (practice‐level unit of analysis) and practice‐median DMFT increments (also practice level) were determined through general linear modeling analysis of covariance. In addition, a multiple variable logistic regression analysis of caries risk status was conducted. Results The overall 4‐year post‐trial result (years 4–7) for CMS patients was a DMFT increment of 2.44 compared with 3.39 for control patients (P < 0.01), a difference equivalent to 28%. From the clinical trial baseline to the end of the post‐trial follow‐up period, the CMS and control increments were 6.13 and 8.66, respectively, a difference of 29% (P < 0.0001). Over the post‐trial period, the CMS and control practice‐mean DMFT increments were 2.16 and 3.10 (P = 0.055) and the respective increments from baseline to year 7 were 4.38 and 6.55 (P = 0.029), difference of 33%. The practice‐median DMFT increments during the 4‐year post‐trial period for CMS and control practices were 1.25 and 2.36 (P = 0.039), and the respective increments during the period from baseline to year 7 were 2.87 and 5.36 (P < 0.01), difference of 47%. Minimally elevated odds of being high risk were associated with baseline DMFT (OR = 1.17). Patients attending the CMS practices had lower odds of being high risk than those attending control practices (OR = 0.23, 95% CI = 0.06, 0.88). Conclusion In practices where adherence to the CMS protocols was maintained during the 4‐year post‐trial follow‐up period, patients continued to benefit from a reduced risk of caries and, therefore, experienced lower needs for restorative treatment.
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Affiliation(s)
- R Wendell Evans
- Population Oral Health, Sydney Dental School, University of Sydney, Sydney, NSW, Australia
| | - Paula Clark
- Population Oral Health, Sydney Dental School, University of Sydney, Sydney, NSW, Australia
| | - Nan Jia
- Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN, USA
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Wu AJ. Management of Salivary Hypofunction in Sjögren’s Syndrome. CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2015. [DOI: 10.1007/s40674-015-0023-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rechmann P, Featherstone JD. Quality Assurance Study of Caries Risk Assessment Performance by Clinical Faculty Members in a School of Dentistry. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.9.tb05805.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Peter Rechmann
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| | - John D.B. Featherstone
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
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Hurlbutt M, Young DA. A Best Practices Approach to Caries Management. J Evid Based Dent Pract 2014; 14 Suppl:77-86. [DOI: 10.1016/j.jebdp.2014.03.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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