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Alblooshi NA, Naseer TK, Bijle MN. Caries preventive potential of professionally deliverable fluoride-containing agents with incorporated arginine: A scoping review. JAPANESE DENTAL SCIENCE REVIEW 2024; 60:154-162. [PMID: 38828462 PMCID: PMC11141041 DOI: 10.1016/j.jdsr.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/08/2023] [Accepted: 05/12/2024] [Indexed: 06/05/2024] Open
Abstract
The scoping review objectives were to: 1) investigate the caries preventive potential of professionally deliverable fluoride (F)-containing agents with incorporated arginine (Arg); and 2) identify the future scope of research on Arg-F interventions for caries prevention. Of 150 identified records, 7 articles (6 in vitro investigations and 1 scoping review) were included for a complete review; with no clinical studies with/without appraisal. Arginine variants (L-Arg/Arg.HCl at 1% to 10% w/v.) were examined for a potential professional application aimed at caries prevention, as reported with in vitro studies. Of the included articles, four in vitro studies explored L-Arg enriched 5% NaF varnish (Duraphat®) as a promising caries preventive agent, while only one considered incorporating L-Arg in MI varnish®/nanohydroxyapatite and one investigated glass ionomer cement for primary/secondary and tertiary caries prevention. The scoping review highlighted the scope for incorporating Arg to professionally deliverable F-containing agents. No clinical data are available to make conclusive recommendations about the caries preventive potential of professionally deliverable F-containing agents with incorporated Arg. With Arg-F varnish being investigated predominantly through in vitro studies, the data so far suggest that Arg was incorporated exclusively in Duraphat®, while the potential of Arg to prevent caries in other F-containing varnishes remains unexplored.
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Affiliation(s)
- Nouf Ali Alblooshi
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Tiba Kahtan Naseer
- Department of Clinical Sciences, College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Mohammed Nadeem Bijle
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Diniz ACS, Silva TBD, Araujo MR, Bauer J, Firoozmand LM. Sealing moderate caries lesions with bioactive glass-ionomer: A split-mouth clinical trial. Dent Mater J 2024:2023-261. [PMID: 38945864 DOI: 10.4012/dmj.2023-261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Laboratory evidence has shown that 45S5 bioglass can help in dental remineralization, so its incorporation into resin-modified glass ionomer cement (RMGIC) has been studied. This randomized clinical trial aimed to determine the efficacy of RMGIC enriched with 10% 45S5 bioglass (RMGIC/45S5) in preventing the progression of moderate caries lesions. Sixty-six permanent molars with moderate caries lesions, were randomly sealed with RMGIC or RMGIC/45S5. After 1, 3-6 months, patients' oral health, material behavior, and caries evolution were evaluated. Chi-square and Fisher's exact test was employed. After one month, the RMGIC showed higher total retention and better clinical performance compared to RMGIC/45S5, both showed a predominance of sealed teeth or without caries progression. After 6 months, no materials retention, quality and caries progression difference was observed for both materials. Short-term clinical follow-up reveals worse retention and quality of RMGIC/45S5, only after 6 months no clinical/microscopic differences are observed between the materials.
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Affiliation(s)
| | | | - Mayenne Rabelo Araujo
- Department of Dentistry I and Dental Post-Graduation Program, Federal University of Maranhão
| | - José Bauer
- Department of Dentistry I and Dental Post-Graduation Program, Federal University of Maranhão
| | - Leily Macedo Firoozmand
- Department of Dentistry I and Dental Post-Graduation Program, Federal University of Maranhão
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Pandya JK, Wheatley J, Bailey O, Taylor G, Geddis-Regan A, Edwards D. Exploring deep caries management and barriers to the use of vital pulp treatments by primary care dental practitioners. Int Endod J 2024. [PMID: 38881192 DOI: 10.1111/iej.14113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/12/2024] [Accepted: 06/02/2024] [Indexed: 06/18/2024]
Abstract
AIM The European Society of Endodontology outlines best practices for the management of deep caries and the pulp. Despite evidence supporting vital pulp treatments (VPTs) as predictable alternatives to conventional endodontic treatment, studies have shown they are not widely adopted in the UK. This study aimed to explore the barriers to implementation of VPTs by primary care general dental practitioners (GDPs). METHODOLOGY Qualitative one-to-one semi-structured online interviews were conducted with purposively sampled UK GDPs. Interview transcripts were analysed using reflexive thematic analysis. Recurring themes were iteratively refined as additional transcripts were reviewed. RESULTS Eleven participants were interviewed. A range of barriers to the provision of VPTs were identified, which aligned with two core themes: 'Motivational barriers to service provision' and 'Educational access & opportunities'. Sub-themes included lack of access to materials and equipment, deficiencies in knowledge of treatment (including protocols, outcomes and prognosis), lack of confidence (in treatment efficacy and clinical ability), time constraints and public dental service funding and remuneration. CONCLUSIONS This study identifies barriers to the widespread adoption of VPTs among primary care GDPs in public and private settings. Economic constraints, practitioner confidence, time limitations and educational gaps are key challenges. Addressing these may require systemic changes such as policy interventions, education and improved resource allocation.
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Affiliation(s)
- Jay-Krishan Pandya
- Department of Restorative Dentistry, Newcastle Dental Hospital, Newcastle upon Tyne, UK
| | - Jennifer Wheatley
- Department of Restorative Dentistry, Newcastle Dental Hospital, Newcastle upon Tyne, UK
| | - Oliver Bailey
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Greig Taylor
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Andrew Geddis-Regan
- Department of Restorative Dentistry, University Dental Hospital of Manchester, Manchester, UK
| | - David Edwards
- Department of Restorative Dentistry, Newcastle Dental Hospital, Newcastle upon Tyne, UK
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
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Bhat R, Shetty S, Rai P, Kumar BK, Shetty P. Revolutionizing the diagnosis of irreversible pulpitis - Current strategies and future directions. J Oral Biosci 2024; 66:272-280. [PMID: 38508491 DOI: 10.1016/j.job.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Pulpitis primarily arises from the pulp space infection by oral microbiota. Vital pulp therapy is a minimally invasive approach that relies on assessing the severity of pulpal inflammation to facilitate repair. However, the current evaluation methods prescribed by the American Association of Endodontics are subjective, leading to ambiguity in assessment. Therefore, this review aims to explore molecular strategies for evaluating the severity of pulpal inflammation to accurately predict the success of pulp vitality preservation in clinical settings. METHODOLOGY This review was conducted by searching relevant keywords, such as irreversible pulpitis, pulpitis biomarkers, molecular diagnosis, inflammation, and genomic strategies, in databases such as PubMed, Web of Science, and Scopus to address the subjective nature of diagnosis. The data included in this review were collected up to April 2023. The literature search revealed well-documented limitations in clinically assessing the pulp inflammatory. Molecular approaches that aid in clinical differentiation between irreversible and reversible pulpitis may potentially enhance favorable outcomes in vital pulp therapy. Non-invasive diagnostic methods for pulpal assessment would also be valuable for determining whether the inflamed pulp is reversible, irreversible, or necrotic. CONCLUSION The present review examines the various molecular diagnostic approaches that have revolutionized the medical field and are considered the most promising empirical methodologies for the proactive detection of pulpal diseases. It also provides comprehensive insights into the current diagnostic methods, associated challenges, next-generation strategies, and future directions for diagnosing the severity of pulp inflammation.
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Affiliation(s)
- Raksha Bhat
- Nitte (Deemed to be University), Department of Conservative Dentistry & Endodontics, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Mangalore, 575018, Karnataka, India.
| | - Shishir Shetty
- Nitte (Deemed to be University), Department of Conservative Dentistry & Endodontics, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Mangalore, 575018, Karnataka, India.
| | - Praveen Rai
- Nitte (Deemed to be University), Department of Infectious Diseases and Microbial Genomics, Nitte University Centre for Science Education and Research (NUCSER), Mangalore, 575018, Karnataka, India.
| | - Ballamoole Krishna Kumar
- Nitte (Deemed to be University), Department of Infectious Diseases and Microbial Genomics, Nitte University Centre for Science Education and Research (NUCSER), Mangalore, 575018, Karnataka, India.
| | - Preethesh Shetty
- Nitte (Deemed to be University), Department of Conservative Dentistry & Endodontics, AB Shetty Memorial Institute of Dental Sciences (ABSMIDS), Mangalore, 575018, Karnataka, India.
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Beckman CKDC, de Lima Costa T, Puppin-Rontani RM, de Castilho ARF. Exploring the role of flavonoids in caries-affected dentin adhesion: A comprehensive scoping review. Arch Oral Biol 2024; 162:105942. [PMID: 38452415 DOI: 10.1016/j.archoralbio.2024.105942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/31/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The aim of this scoping review was to evaluate the available scientific evidence regarding the use of flavonoids in the treatment of caries-affected dentin focusing on bonding to dentin. METHODS A comprehensive literature search was performed in five databases from March 2022 and updated in April 2023: PubMed, EMBASE, Scopus, Web of Science, and Scielo. Additionally, the references of included studies were manually searched. Gray literature was excluded from the review. STUDY SELECTION Inclusion criteria included in vitro, in situ, and in vivo studies (animal or human) published in English. Abstracts, reviews, case reports, book chapters, doctoral dissertations, guidelines, and studies using pure plant extracts were excluded. Data collected from the selected studies were summarized and subjected to narrative and descriptive analysis. Out of the 91 studies identified, only 16 studies met the inclusion criteria. RESULTS The review analyzed eight different flavonoids (hesperidin, galardin, proanthocyanidin, genipin, quercetin, naringin, epigallocatechin-3-gallate, and other catechins subtypes) used as pretreatment or loaded into adhesive systems, primers, and phosphoric acid. The use of flavonoids improved the mechanical properties of the materials and modified the biological properties of the dentin, reducing collagen loss by the inhibition of proteolytic activity of matrix metalloproteinases (MMPs). CONCLUSIONS Based on the findings of this scoping review, it can be concluded that the use of flavonoids as pretreatment or incorporation into dental materials preserves collagen in the hybrid layer, inhibiting the MMPs activities, modifying the collagen fibrils of the dentin matrix and improving the mechanical properties of the dental adhesive systems. Therefore, it represents a promising approach for promoting dentin biomodification. This can result in more stable bonding of adhesive restorations to caries-affected dentin.
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Affiliation(s)
- Camilla Karoline de Carvalho Beckman
- Departamento de Ciências da Saúde e Odontologia Infantil, Área de Odontopediatria, Faculdade de Odontologia de Piracicaba (FOP) - Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Tainá de Lima Costa
- Departamento de Ciências da Saúde e Odontologia Infantil, Área de Odontologia Preventiva eSaúde Pública, Faculdade de Odontologia de Piracicaba (FOP) - Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
| | - Regina Maria Puppin-Rontani
- Departamento de Ciências da Saúde e Odontologia Infantil, Área de Odontopediatria, Faculdade de Odontologia de Piracicaba (FOP) - Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Departamento de Odontologia Restauradora, Área de Materiais Dentários, Faculdade de Odontologia de Piracicaba (FOP) - Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil
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Recchi AF, Azambuja RSD, Alves LS, Maltz M, Jardim JJ. Restorations performance after selective caries removal to soft dentine: 18-month follow-up of a controlled clinical trial. J Dent 2024:105099. [PMID: 38797489 DOI: 10.1016/j.jdent.2024.105099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVE This randomized controlled clinical trial aimed to evaluate the clinical performance of composite resin restorations placed after selective caries removal to soft dentin (SCRSD) or stepwise excavation (SW) over an 18-month period. METHODS Inclusion criteria were patients with permanent molars and/or premolars presenting deep caries lesions (≥50% of the dentin thickness). Teeth were submitted to SCRSD (n=76) or SW (n=76). Evaluations were performed based on FDI (World Dental Federation) criterion. Survival analysis was performed to estimate the survival of restorations and its association with clinical variables and socio-demographic characteristics (adjusted Weibull regression model). The study was registered on Registro Brasileiro de Ensaios Clínicos (ReBEC 65ntbc). RESULTS The follow-up period ranged from 6 to 18 months (mean±SD 16.3±3.4 months). Patients' ages ranged from 9 to 55 years (mean±SD 29±10.5 years). A total of 135 teeth (SCRSD=72; SW=63) from 101 patients were evaluated. There were 4 failures in the SCRSD group (2 loss of restoration in need of replacement and 2 marginal fractures in need of repair) and 2 in the SW group (fracture in need of repair). The association between explanatory variables and restoration failure showed similar success rates for SW (99.4%) and SCRSD (97.9%) (p=0.16). Patients presenting gingivitis (≥20% of sites with gingival bleeding) had 8.50 times more risk for failure than those with <20% of bleeding sites (p=0.03). CONCLUSION This study showed that placing a composite resin restoration over soft dentin (after SCRSD) did not affect its clinical performance after 18 months. CLINICAL SIGNIFICANCE SCRSD is a feasible treatment option for the management of deep caries lesions in permanent teeth as it preserves tooth vitality and tooth structure without compromising restoration longevity.
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Affiliation(s)
- Andrea Fontoura Recchi
- Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rafael Schultz de Azambuja
- Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Luana Severo Alves
- Department of Restorative Dentistry, School of Dentistry, Federal University of Santa Maria, Santa Maria, RS, Brazil.
| | - Marisa Maltz
- Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Juliana Jobim Jardim
- Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Hatipoğlu Ö, Martins JFB, Karobari MI, Taha N, Aldhelai TA, Ayyad DM, Madfa AA, Martin-Biedma B, Fernandez R, Omarova BA, Yi LW, Alfirjani S, Lehmann A, Sugumaran S, Petridis X, Krmek SJ, Wahjuningrum DA, Iqbal A, Abidin IZ, Intriago DMG, Elhamouly Y, Palma PJ, Hatipoğlu FP. Repair versus Replacement of Defective Direct Dental Restorations: A Multinational Cross-sectional Study with Meta-Analysis. J Dent 2024:105096. [PMID: 38796090 DOI: 10.1016/j.jdent.2024.105096] [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: 01/08/2024] [Revised: 04/22/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024] Open
Abstract
OBJECTIVES When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore international preferences for repair procedures and the clinical steps taken during the repair process. METHOD An 11-question survey was distributed to dentists across 21 countries via different platforms. The survey comprised two sections: the first included five questions aimed at gathering demographic information, while the second consisted of six questions focusing on participants' practices related to the repair of composite or amalgam restorations A meta-analysis was employed to ascertain the pooled odds ratio of repairing versus replacement. The statistical analysis was carried out using the RevMan 5.3 program and forest plots were generated using the same program to visualize the results. RESULTS The survey was completed by 3680 dental practitioners. The results indicated a strong tendency to repair defective composite restorations (OR: 14.23; 95% CI: 7.40, 27.35, p<0.001). In terms of amalgam, there was a significant tendency to replace the restorations (OR: 0.19; 95% CI: 0.12, 0.30, p<0.001). When repairing restorations, the most common protocols were etching with orthophosphoric acid and creating an enamel bevel, regardless of the restorative material used. CONCLUSION The findings of this study indicate that there exists a knowledge gap among dental practitioners regarding restoration repair. It is imperative that dental practitioners receive proper education and training on restoration repair, to ensure the usage of adequate protocols and restoration survival.
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Affiliation(s)
- Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Turkey.
| | | | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu 600077, India.
| | - Nessrin Taha
- Department of Conservative Dentistry Jordan University of Science and Technology Irbid.
| | | | - Daoud M Ayyad
- Head of the Endodontics Department faculty of dentistry, AL-QUDS University.
| | - Ahmed A Madfa
- Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Saudi Arabia.
| | | | - Rafael Fernandez
- Endodontist, associate professor from endodontic department at CES University, Medellín.
| | - Bakhyt A Omarova
- S. D. Asfendiyarov Kazakh National Medical University, Dentistry School, Departement of Therapeutic Dentistry. Kazakhstan, Almaty.
| | - Lim Wen Yi
- Department of Restorative Dentistry, National Dental Centre Singapore.
| | - Suha Alfirjani
- Department of Conservative Dentistry and Endodontics, University of Benghazi.
| | | | - Surendar Sugumaran
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
| | - Xenos Petridis
- Department of Endodontics, Section of Dental Pathology and Therapeutics, School of Dentistry, National and Kapodistrian University of Athens, Greece.
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000 Zagreb, Croatia.
| | | | - Azhar Iqbal
- Department of Operative Dentistry & Endodontics, Frontier Medical and Dental College, Abbottabad, Pakistan.
| | - Imran Zainal Abidin
- Department of Restorative Dentistry International Islamic University Malaysia.
| | | | - Yasmine Elhamouly
- Department of Pediatric and Community Dentistry Faculty of Dentistry, Pharos University in Alexandria, Egypt.
| | - Paulo Jorge Palma
- Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
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Ñaupari-Villasante R, Falconi-Páez C, Castro AS, Gutiérrez MF, Mendez-Bauer ML, Aliaga P, Dávila-Sánchez A, Arrais C, Reis A, Loguercio AD. Clinical performance of posterior restorations using a universal adhesive over moist and dry dentin: A 36-month double-blind split-mouth randomized clinical trial. J Dent 2024; 147:105080. [PMID: 38788919 DOI: 10.1016/j.jdent.2024.105080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVES To evaluate the influence of dentin moisture on the clinical behavior of a universal adhesive on posterior teeth after 36 months of follow-up. METHODS Forty-five patients participated in this study. Following a split-mouth design, three operators placed 90 Class I/Class II restorations over moist dentin (MD) or dry (DD) (n = 45) with resin composite (Filtek Bulk Fill) and a universal adhesive used in the etch-and-rinse mode (Single Bond Universal). Each restoration was evaluated according to the FDI and USPHS criteria (postoperative sensitivity, fracture and retention, marginal staining, marginal adaptation, and recurrence of caries) at baseline and after 6-, 12-, and 36 months. For statistical analysis, Kruskal Wallis analysis of variance rank (α = 0.05) and Kaplan-Meier survival analysis were used. RESULTS No significant difference between groups was observed in each FDI criterion after 36 months of clinical evaluation (p > 0.05). The retention rates (confidence interval 95 %) were 97.37 % (86.5 - 99.5) for both MD and DD without significant difference between them (p > 0.05). Eight restorations (MD = 4; DD = 4) showed minimal marginal staining defects (p > 0.05). Two restorations were lost (MD = 1; DD = 1). Fifteen restorations (MD = 8; DD = 7) presented minor marginal discrepancies according to the FDI criteria (p > 0.05). CONCLUSION The clinical performance of the universal adhesive when applied in etch-and-rinse mode was not influenced by dentin moisture in posterior bulk-fill composite restorations. CLINICAL SIGNIFICANCE The level of dentin moisture appears not to influence the clinical efficacy of a universal adhesive when applied using the etch-and-rinse technique in posterior composite resin restorations.
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Affiliation(s)
- Romina Ñaupari-Villasante
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, 84030-900, Ponta Grossa, Brazil
| | - Camila Falconi-Páez
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, 84030-900, Ponta Grossa, Brazil
| | - Andrea S Castro
- Department of Restorative Dentistry, School of Dentistry, Tuiuti University of Parana ́, Curitiba, Brazil
| | - Mario F Gutiérrez
- Universidad de los Andes, Facultad de Odontología, Av. Monseñor Álvaro del Portillo 12455, 7550000, Las Condes, Santiago, Chile; University of Chile, Faculty of Dentistry, Institute for Research in Dental Sciences, Av. Olivos 943, 8380544, Independencia, Santiago, Chile
| | - Maria L Mendez-Bauer
- Research Department, School of Dentistry, University Francisco Marroquin, Guatemala City, Guatemala
| | - Paulina Aliaga
- Departamento de Odontología Restauradora y Materiales Dentales. Escuela de Odontología Universidad San Francisco de Quito, Av. Pampite y Diego Robles, 170901, Quito, Ecuador
| | - Andrés Dávila-Sánchez
- Departamento de Odontología Restauradora y Materiales Dentales. Escuela de Odontología Universidad San Francisco de Quito, Av. Pampite y Diego Robles, 170901, Quito, Ecuador
| | - Cesar Arrais
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, 84030-900, Ponta Grossa, Brazil
| | - A Reis
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, 84030-900, Ponta Grossa, Brazil
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, 84030-900, Ponta Grossa, Brazil.
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Beresescu L, Stoica AM, Stepco E, Kovacs-Ivacson CA, Vlasa A, Benedek C, Beresescu GF. The Assessment of Resin-Based Composite Sealants' Effectiveness in Arresting Non-Cavitated Dentin Carious Lesions (ICDAS 3)-A 12 Month Follow-Up Preliminary Study. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:734. [PMID: 38792917 PMCID: PMC11123296 DOI: 10.3390/medicina60050734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/24/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: The therapeutic management of carious lesions remains a significant focus for researchers, given their persistently high prevalence despite being largely preventable. This study aimed to compare the effectiveness of a composite resin-based sealant material in halting extended non-cavitated dentin carious lesions when used therapeutically versus preventively on caries-free teeth over a period of twelve months. Materials and Methods: out of the 236 children examined, 45 were excluded from the study due to non-compliance with the inclusion criteria. Thus, the study included 191 children aged 10-12 years, and 764 molars in total. Results: among these molars, 171 were caries-free (ICDAS II code 0), forming the Control group, while 180 molars were classified with an ICDAS II score of 3, forming the Study group. All molars were sealed and evaluated at 6- and 12-month follow-up intervals. Both intervals revealed statistically significant differences (p < 0.05) in sealant retention and carious lesion development between sound (ICDAS code 0) and decayed (ICDAS code 3) teeth. Conclusions: the findings did not support the effectiveness of sealants in halting non-cavitated dentin carious lesions classified as ICDAS II with code 3 compared to their preventive application in sound teeth classified as ICDAS II with code 0.
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Affiliation(s)
- Liana Beresescu
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Alexandra Mihaela Stoica
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Elena Stepco
- Faculty of Dental Medicine, The State University of Medicine and Pharmacy “Nicolae Testemitanu”, MD-2004 Chisinau, Moldova
| | - Csinszka Andrea Kovacs-Ivacson
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Alexandru Vlasa
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Csilla Benedek
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
| | - Gabriela Felicia Beresescu
- Faculty of Dental Medicine, University of Medicine and Pharmacy, Science, and Technology George Emil Palade, 540139 Târgu-Mureș, Romania; (L.B.); (C.A.K.-I.); (A.V.); (C.B.); (G.F.B.)
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Muntean A, Mzoughi SM, Pacurar M, Candrea S, Inchingolo AD, Inchingolo AM, Ferrante L, Dipalma G, Inchingolo F, Palermo A, Bordea IR. Silver Diamine Fluoride in Pediatric Dentistry: Effectiveness in Preventing and Arresting Dental Caries-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:499. [PMID: 38671716 PMCID: PMC11049537 DOI: 10.3390/children11040499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/04/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Tooth decay is considered a global scourge by the World Health Organization (WHO) starting at an early age. In recent years, silver diamine fluoride (SDF) has regained interest, particularly in pediatric dentistry, used to prevent the development of carious lesions or arrest their progression. OBJECTIVE The aim of this study was to assess, through a systematic review of the literature, the effectiveness of SDF, used in pedodontics, in temporary teeth, in preventing or arresting dental caries. MATERIAL AND METHODS An electronic search was conducted on PubMed, Web of Science and Scopus. The effect of SDF on both temporary and permanent teeth has been considered. RESULTS The inclusion criteria identified 16 randomized controlled trials involving patients aged 18 months to 13 years and followed over a period of 12-30 months. CONCLUSIONS SDF is a practical, accessible and effective non-invasive way to prevent and arrest caries in temporary and permanent teeth. Its application requires regular monitoring. The resulting black spot is diminished by immediate application of potassium iodide but this may affect its effectiveness.
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Affiliation(s)
- Alexandrina Muntean
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Soundouss Myriam Mzoughi
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Mariana Pacurar
- Department of Orthodontics, Faculty of Dental Medicine, University of Medicine, Pharmacy Science and Technology “G. E. Palade” Targu Mures Romania, Gheorghe Marinescu Street, nr. 38, 540139 Târgu Mureș, Romania;
| | - Sebastian Candrea
- Department of Paediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A. Iancu Street, 400083 Cluj-Napoca, Romania; (A.M.); (S.M.M.); (S.C.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Laura Ferrante
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.D.I.); (A.M.I.); (L.F.); (G.D.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Ioana Roxana Bordea
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 15 V. Babes Street, 400012 Cluj-Napoca, Romania;
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Campbell F, Goldsmith R, Rogers H. Are we practising what we preach and are we all singing from the same hymn sheet? An exploration of teaching in paediatric caries management across UK dental schools. Int J Paediatr Dent 2024. [PMID: 38590044 DOI: 10.1111/ipd.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/17/2023] [Accepted: 02/07/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools. AIM To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools. DESIGN Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively. RESULTS Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy. CONCLUSION There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.
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Affiliation(s)
- Faith Campbell
- School of Dentistry, University of Dundee, Dundee, UK
- Glasgow Dental Hospital and School, Glasgow, UK
| | | | - Helen Rogers
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Wang Y, Wen J, Pan T, Cao Y, Lin H, Zhou Y. Comparing the effectiveness of caries arrest by micro-operative treatment to operative treatment: A 2-year randomized controlled clinical trial. Clin Oral Investig 2024; 28:222. [PMID: 38499947 DOI: 10.1007/s00784-024-05567-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/17/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES To compare the effectiveness of caries arrest by micro-operative treatment (sealing) to operative treatment (flowable resin composite restoration) through a 2-year randomized controlled clinical trial. MATERIALS AND METHODS A prospective randomized controlled trial was conducted among 7-9-year-old children. At baseline, 630 subjects were screened and 92 children who had at least one carious lesion classified as ICDAS 3 on the pit and fissure of first permanent molar were included. Then they were randomly assigned to the sealant group (73 lesions) and the flowable resin composite group (76 lesions) to receive the corresponding intervention. Lesions status in each group was evaluated every 6 months up to 24 months. Clinical progression of dental caries and materials retention were the outcomes used for group comparisons at p-value < 0.05. RESULTS After 24 months, three lesions (4.1%) in the sealant group clinically progressed to dentin caries. No lesion in the flowable composite group was observed a progression. The results of Life-table survival analysis show that the cumulative caries arrest rate had no statistically significant difference between the two groups (p = 0.075). However, the cumulative retention rate was 57.5% in the sealant group and 92.1% in the flowable composite group, with significant differences (p < 0.001). The multilevel mixed model showed the sealant had higher risk of retention failure than the flowable composite (OR = 8.66, p < 0.001), while tooth position did not influence material retention (p = 0.083). In addition, the results of Fisher Exact test show that dentin lesions had more retention failure than enamel lesions in the sealant group (p = 0.026). CONCLUSION Although sealing microcavitated carious lesions of the first permanent molar achieved lower retention rate than resin composite restoration, both sealing and restoration effectively arrested caries progression for two years. CLINICAL RELEVANCE To preserving dental structure and delaying or eliminating the need for operative procedures, microcavitated carious lesion can be arrested by sealing. TRIAL REGISTRATION Registered at http://www.chictr.org.cn ; Feb 15th, 2020; No. ChiCTR2000029862.
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Affiliation(s)
- Yinuo Wang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Jie Wen
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Ting Pan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Yina Cao
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China
| | - Huancai Lin
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China.
| | - Yan Zhou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-sen University, Guangzhou, China.
- Guangdong Provincial Clinical Research Center of Oral Diseases, Sun Yat-sen University, Guangzhou, China.
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Calazans FS, Ferreira TDMJ, Ñaupari-Villasante R, Mendonça RP, Ornellas G, Albuquerque EG, Tardem C, de Miranda MS, Barceleiro MO, Loguercio AD. Influence of surface sealants on the quality of posterior restorations with bulk-fill composites: A 4-year randomized clinical trial. Dent Mater 2024; 40:466-476. [PMID: 38142146 DOI: 10.1016/j.dental.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/25/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the clinical performance of surface sealants associated with a bulk-fill composite in posterior restorations after 4 years. METHODS A total of 174 posterior restorations were performed on 57 participants using a self-etch adhesive system and a bulk-fill composite. The groups were then divided into the following categories: 1) without surface sealant (NoS), 2) with surface sealant Biscover (Bisco, SBi), and 3) with surface sealant Permaseal (Ultradent, SPe). Restorations were evaluated using FDI criteria at baseline and after 1 and 4 years. Statistical analysis was conducted using Kaplan-Meier survival analysis and the Chi-square test (α = 0.05). RESULTS After 4 years, only one restoration was lost (1 in the NoS group). The fracture/retention rate (with 95% confidence interval) was 98% for NoS and 100% for both SBi and SPe (p = 0.76). The majority of secondary outcomes showed minor defects, with no significant differences among the groups (p > 0.05). However, significant differences were observed among the groups in terms of marginal staining and marginal adaptation (p = 0.03). In both items, twelve restorations (nine in NoS, one in SBi, and two in SPe) showed minor marginal discrepancies favoring the sealant groups (SBi and SPe). SIGNIFICANCE Regardless of the use of surface sealants, the bulk-fill composite restorations showed excellent clinical performance after 4 years. However, the groups that received sealants showed better marginal adaptation and less marginal discoloration compared to those that did not receive sealants.
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Affiliation(s)
- Fernanda Signorelli Calazans
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil
| | | | - Romina Ñaupari-Villasante
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
| | - Rafael Pinto Mendonça
- Department of Restorative Dentistry, Institute of Science and Technology of São José dos Campos, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - Giulia Ornellas
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil
| | - Elisa Gomes Albuquerque
- Operative Dentistry Department, School of Dentistry, Juiz de Fora Federal University, Juiz de Fora, MG, Brazil
| | - Chane Tardem
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil
| | - Mauro Sayao de Miranda
- Restorative Dentistry Department, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil
| | - Marcos O Barceleiro
- Department of Restorative Dentistry, School of Dentistry, Fluminense Federal University, Nova Friburgo, RJ, Brazil.
| | - Alessandro D Loguercio
- Department of Restorative Dentistry, School of Dentistry, Ponta Grossa State University, Ponta Grossa, PR, Brazil
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Kharbot B, Bulgun N, Cölfen H, Paris S. Effect of calcium-coacervate infiltration of artificial enamel caries lesions in de- and remineralizing conditions. J Dent 2024; 142:104838. [PMID: 38211686 DOI: 10.1016/j.jdent.2024.104838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 01/07/2024] [Accepted: 01/08/2024] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES Calcium-coacervate emulsions (CC) might be considered as mineral precursors to foster remineralization of carious dental hard tissues. This study analyzed the instant effect of repeated infiltration of artificial caries lesions with a CC emulsion as well as the effects of subsequent exposure of CC-infiltrated lesions to demineralizing and remineralizing environments. METHODS Bovine enamel specimens were partly covered with varnish to leave three exposed windows. Artificial enamel caries lesions were created (pH 4.95, 17d). Baseline controls (BL) were obtained by preparing a thin section of each specimen. Specimens were allocated to five groups. In three groups lesions were etched with 37 % phosphoric acid gel, infiltrated with dipotassium hydrogen phosphate and subsequently with a calcium coacervate emulsion, prepared by mixing CaCl2 ⋅ 2H2O with polyacrylic acid sodium salt (PAA-Na). Subsequently, the infiltration effect was either analyzed immediately (Inf.) or after exposition to either de- (Inf.+DS) or remineralizing solution (Inf.+RS) for 10 or 20 days, respectively. In two control groups specimens were exposed to either DS or RS, respectively without prior CC infiltration. Integrated mineral loss [ΔZ(vol%×µm)] was analyzed using transverse microradiography (TMR). RESULTS Infiltration of enamel caries lesions with coacervate solution resulted in only subtle immediate mineral gain even if repeated. When exposed to demineralizing conditions, infiltrated lesions showed significantly less mineral loss compared to untreated controls (p < 0.05; Kruskal Wallis) and exhibited characteristic mineral depositions within the lesion body. CONCLUSIONS While immediate mineral gain by infiltration was only modest, the CC-emulsion might be able to prevent demineralization in acidic conditions. CLINICAL SIGNIFICANCE Calcium coacervates might act protective against further demineralization when infiltrated into enamel caries lesions.
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Affiliation(s)
- Basel Kharbot
- Department of Operative, Preventive and Pediatric Dentistry, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - Neziha Bulgun
- Department of Operative, Preventive and Pediatric Dentistry, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Helmut Cölfen
- Physical Chemistry, Department of Chemistry, University of Konstanz, Konstanz, Germany
| | - Sebastian Paris
- Department of Operative, Preventive and Pediatric Dentistry, Center for Dental and Craniofacial Sciences, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
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Bastia R, Govind S, Assiry AA, Alessa NA, Kader MA, Adil AH, Karobari MI. Volumetric analysis after caries excavation with caries detecting dyes and chemomechanical caries removal agents using 3D scanner-a randomised clinical trial. BMC Oral Health 2024; 24:164. [PMID: 38302932 PMCID: PMC10835883 DOI: 10.1186/s12903-024-03907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
AIM This research aimed to use an extra-oral 3D scanner for conducting volumetric analysis after caries excavation using caries-detecting dyes and chemomechanical caries removal agents in individuals with occlusal and proximal carious lesions. METHODS Patients with occlusal (A1, A2, A3) and proximal carious lesions (B1, B2, B3) were treated with the conventional rotary technique, caries detecting dyes (CDD) and chemomechanical caries removal (CMCR) method on 90 teeth (n = 45 for each). Group A1, B1: Excavation was performed using diamond points. Group A2, B2: CDD (Sable Seek™ caries indicator, Ultradent) was applied and left for 10 s, and then the cavity was rinsed and dried. For caries removal, diamond points or excavators were used. Group A3 and B3: BRIX3000 papain gel was applied with a micro-brush for 20 s and was activated for 2 min, and then the carious tissue was removed with a sharp spoon excavator. Post-excavation cavity volume analysis was performed using a 3D scanner. The time required and the verbal pain score (VPS) for pain were scored during excavation. Post-restoration evaluation was performed at 1, 3, and 6 months FDI (Federation Dentaire Internationale) criteria. RESULTS Comparison of age, time and volume with study groups were made using Independent Sample' t' test and one-way analysis of variance (ANOVA) for two and more than two groups, respectively. Using Cohen's Kappa Statistics, evaluators 1 and 2 agreed on caries removal status aesthetic, functional and biological properties at different follow-ups. The chi-square test revealed that the rotary groups [A1(2.5 ± 0.4 min) B1(4.0 ± 0.4 min)] had significantly less (p = 0.000) mean procedural time than CDD [A2(4.5 ± 0.4 min) B2(5.7 ± 0.4 min)] and CMCR [A3(5.4 ± 0.7 min) B3(6.2 ± 0.6 min)] groups. The CMCR group showed better patient acceptance and less pain during caries excavation than the rotary and CDD groups. CMCR group showed significantly less mean caries excavated volume(p = 0.000). Evaluation of restoration after 1-, 3-, and 6-month intervals was acceptable for all the groups. CONCLUSION Brix3000 helps effectively remove denatured teeth with less pain or sensitivity. The time required for caries removal was lowest in the rotary method and highest in the brix3000 group, while the volume of caries removed was the lowest for brix3000 and highest for the rotary group.
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Affiliation(s)
- Roja Bastia
- Department of Conservative Dentistry and Endodontics, Institute of Dental Science, Siksha' O' Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, 751003, India
| | - Shashirekha Govind
- Department of Conservative Dentistry and Endodontics, Institute of Dental Science, Siksha' O' Anusandhan (Deemed to be) University, Bhubaneswar, Odisha, 751003, India
| | - Ali A Assiry
- Preventive Dental Science Department, Faculty of Dentistry, Najran University, Najran, Saudi Arabia.
| | - Noura Abdulaziz Alessa
- Department of Pediatric Dentistry and Orthodontics, Dental College, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Abdul Kader
- Department Restorative Dental science, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Adbul Habeeb Adil
- Dental Research Unit, Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospitals, Saveetha University, Chennai, India
| | - Mohmed Isaqali Karobari
- Dental Research Unit, Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospitals, Saveetha University, Chennai, India.
- Department of Restorative Dentistry & Endodontics, Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia.
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Algarni AA, Alwusaydi RM, Alenezi RS, Alharbi NA, Alqadi SF. Knowledge and attitude of dentists toward minimally invasive caries management in Almadinah Almunawwarah province, KSA. J Taibah Univ Med Sci 2024; 19:10-17. [PMID: 37868097 PMCID: PMC10585290 DOI: 10.1016/j.jtumed.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/02/2023] [Accepted: 08/28/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Over time, the management of dental caries has shifted towards minimally invasive dentistry (MID) and more conservative and evidence-based strategies. Although most dental schools have begun to incorporate MID caries management strategies in their curriculum; it has yet to be established whether these strategies are being implemented in everyday practice. In this study, we aimed to evaluate the knowledge and attitude of dentists working in Almadinah Almunawwarah province in KSA with regards to the implementation of MID in caries management. Methods This was a cross-sectional study which involved sending a self-administered and anonymous questionnaire to dentists practicing in both private and public clinics in Almadinah Almunawwarah, KSA. The questionnaire consisted of four sections: demographic data, dental education, clinical experience, and knowledge and attitude with regards to MID and the management of caries. For statistical analysis, we calculated simple descriptive statistics, including mean and frequency distributions; comparisons were performed using the Chi-squared test. Results A total of 130 dentists participated in the study; the majority of respondents were Saudi general dentists working in private dental clinics; there was a similar distribution of males and females and the age of the dentists ranged from 25 to 35 years. With regards to knowledge relating to selective caries removal (SCR), only 20% of subjects responded that SCR is based on lesion depth, while 74.6% reported that carious dentin consistency is important for SCR. Although 60% of respondents reported that they would assess a patient's risk of caries before commencing treatment, only 11.5% would perform risk assessment and non-surgical treatment in the first visit for caries management. Only 4.6% reported that they used the International Caries Detection and Assessment System (ICDAS) II criteria for the diagnosis of caries while 46.2% used the G.V. Black criteria. In addition, 53.8% of participants agreed that caries must be completely removed to prevent the progression of caries. Conclusion Dentists in Almadinah Almunawwarah province had reasonable levels of knowledge regarding the importance of MID in caries management. However, they did not fully implement certain concepts, such as caries risk assessment and the recently recommended criteria for the diagnosis of caries, in their everyday clinical practice.
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Affiliation(s)
- Amnah A. Algarni
- Department of Restorative Dental Sciences, Taibah University, Faculty of Dentistry, Almadinah Almunawwarah, KSA
| | | | - Raghad S. Alenezi
- Taibah University, College of Dentistry, Almadinah Almunawwarah, KSA
| | - Nada A. Alharbi
- Department of Prosthetic Dental Sciences, Taibah University, Faculty of Dentistry, Almadinah Almunawwarah, KSA
| | - Soha F. Alqadi
- Department of Pediatric Dentistry and Orthodontics, Taibah University, Faculty of Dentistry, Almadinah Almunawwarah, KSA
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Miletić I, Baraba A, Krmek SJ, Perić T, Marković D, Basso M, Ozkaya CA, Kemaloglu H, Turkun LS. Clinical performance of a glass-hybrid system in comparison with a resin composite in two-surface class II restorations: a 5-year randomised multi-centre study. Clin Oral Investig 2024; 28:104. [PMID: 38243032 PMCID: PMC10799110 DOI: 10.1007/s00784-024-05491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Abstract
OBJECTIVE To evaluate the 5-year clinical performance of a glass hybrid restorative system and a nano-hybrid resin composite in moderate to large two-surface class II cavities. MATERIALS AND METHODS This study was carried out by dental schools in Zagreb, Croatia; Izmir, Turkey; Belgrade, Serbia; and Milan, Italy. A total of 180 patients requiring two class-II two-surface restorations in the molars of the same jaw were recruited. The teeth were randomly restored with either a nano-hybrid resin composite (Tetric EvoCeram, Ivoclar Vivadent) or a glass-hybrid material (EQUIA Forte, GC). During the 5-year follow-up, two calibrated evaluators at each centre scored the restorations annually using the FDI-2 scoring system. The survival rates were calculated using the Kaplan-Meier method and compared using non-parametric matched pair tests (p < 0.05). RESULTS There were no statistically significant differences between the overall survival and success rates of the two types of restorations (p>0.05). The success rates (FDI-2 scores 1-3) for EQUIA Forte were 81.9% (average annual failure rate: 3.9%) and 90.7% for Tetric EvoCeram (average annual failure rate: 1.9%). The survival rates (FDI-2 scores 1-4) for EQUIA Forte and Tetric EvoCeram were 94.5% and 94.4%, respectively, with an average annual failure rate of 1.1%. CONCLUSIONS In terms of success and survival rates, both the glass-hybrid restorative system and the nano-hybrid resin composite have been shown to perform satisfactorily. CLINICAL RELEVANCE The results of this study indicate that EQUIA Forte can be one of the therapeutic options for moderate to large two-surface class II restorations of posterior teeth.
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Affiliation(s)
- Ivana Miletić
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10 000, Zagreb, Croatia.
| | - Anja Baraba
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10 000, Zagreb, Croatia
| | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10 000, Zagreb, Croatia
| | - Tamara Perić
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia
| | - Dejan Marković
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia
| | - Matteo Basso
- Center of Minimally Invasive, Aesthetic and Digital Oral Rehabilitation (CROMED), IRCCS Galeazzi Orthopaedic Institute, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Cigdem Atalayin Ozkaya
- Department of Restorative Dentistry, Ege University School of Dentistry, Erzene Mah. Ankara Cad. No:172/109, 35040, Bornova/Izmir, Turkey
| | - Hande Kemaloglu
- Department of Restorative Dentistry, Ege University School of Dentistry, Erzene Mah. Ankara Cad. No:172/109, 35040, Bornova/Izmir, Turkey
| | - Lezize Sebnem Turkun
- Department of Restorative Dentistry, Ege University School of Dentistry, Erzene Mah. Ankara Cad. No:172/109, 35040, Bornova/Izmir, Turkey
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Brum VDS, Borges MLV, Santos NMD, Kaufmann C, Rodrigues JDA. The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial. Braz Oral Res 2024; 38:e009. [PMID: 38198308 DOI: 10.1590/1807-3107bor-2024.vol38.0009] [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: 03/20/2023] [Accepted: 08/09/2023] [Indexed: 01/12/2024] Open
Abstract
This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.
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Affiliation(s)
- Vanessa Dos Santos Brum
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Maria Luiza Vieira Borges
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Nicole Marchioro Dos Santos
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Camila Kaufmann
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
| | - Jonas de Almeida Rodrigues
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, School of Dentistry, Porto Alegre, RS, Brazil
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Semprum-Clavier A, Rodriguez A, Salazar D, Afshari F, Manzotti A, Saleh-Hassan L, Viana M, Bedran-Russo A. Clinical Comparison of Three Indirect Pulp Capping Restorative Protocols: A Randomized Controlled Prospective Study. Oper Dent 2024; 49:11-19. [PMID: 38180467 DOI: 10.2341/22-094-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES The objective of this prospective double-blind clinical trial was to compare clinical outcomes of indirect pulp capping restorative protocols on permanent teeth over a 12-month period. METHODS AND MATERIALS Deep carious lesions in permanent teeth (90) were randomly assigned to three indirect pulp capping protocols (n=30: TheraCal LC, Dycal, and no liner). All teeth were restored with resin composite. The outcome measures were pain (VAS scale) and success rate (pulp vitality based on percussion, palpation, cold test, and radiographic findings), collected at screening, intervention, and 24-hour, 7-day, 3-month, 6-month, and 12-month follow-up visits. RESULTS There was no statistically significant difference in tooth sensitivity among the three indirect pulp capping protocols nor in success rates among the restorative protocols after 1 year of follow-up (p>0.1).The respective success rates, as defined by the tooth remaining vital, after 1 year were: 96.2% for TheraCal LC, 100% for Dycal, and 100% for no liner. CONCLUSIONS After 12-month evaluation, the success rate of indirect pulp capping therapy on permanent teeth was not affected by the pulp capping restorative protocol.
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Affiliation(s)
- A Semprum-Clavier
- *Adriana Semprum-Clavier, DDS, MS, clinical associate professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA ORCID ID: 0000-0003-1396-7520
| | - A Rodriguez
- Alexandra Rodriguez, DDS, MS, clinical associate professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - D Salazar
- Daisy Salazar, DDS, MS, clinical associate professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - F Afshari
- Fatemeh Afshari, DDS, MS, clinical professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - A Manzotti
- Anna Manzotti, DDS, MS, clinical assistant professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - L Saleh-Hassan
- Lina Saleh-Hassan, DDS, MS, clinical assistant professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
| | - M Viana
- Marlos Viana, DDS, MS, adjunct associate professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA, Department of Pharmaceutical Sciences, College of Pharmacy, University Illinois at Chicago, Chicago, IL, USA
| | - A Bedran-Russo
- Ana K Bedran-Russo, DDS, MS, PhD, professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, IL, USA
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20
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Brooks L, Edwards D, Field J, Ellis J. Exploring the declared and the formal and informal taught curricula at a UK dental school through the lens of pulp management. Br Dent J 2024; 236:117-123. [PMID: 38278909 DOI: 10.1038/s41415-024-6762-8] [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: 04/11/2023] [Revised: 09/01/2023] [Accepted: 09/13/2023] [Indexed: 01/28/2024]
Abstract
Introduction This paper explores the declared and formal and informal taught endodontic curriculum within an undergraduate dental programme in the UK as part of a wider study, which also investigates the learned curriculum. Management of the dental pulp was chosen due to the availability of clear internationally recognised guidelines.Method The declared curriculum was identified through existing course guides and seminar and practical session plans. The formal taught curriculum was identified by cataloguing all lectures, practical teaching sessions, seminars and handouts available to dental students. Questionnaires using clinical vignettes were used to explore the informal taught curriculum.Results Valid responses to the questionnaire were received from 25/40 (62.5%) clinical supervisors. Disparities between national guidelines and the declared and taught curriculum were primarily due to broad learning objectives and disparate information from lectures and supervising clinicians. Although the majority of formal teaching aligned with national guidelines, the main deviation occurred within the informal taught curriculum.Conclusion This study highlights disparities between current evidence-based guidelines and the declared and taught curriculum in relation to pulp management in a UK dental school. Recommendations are that all policies, procedures and protocols are updated and aligned to a contemporaneous evidence base annually, plus engagement with clinical lecturers, to enable more standardised teaching.
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Affiliation(s)
- Laura Brooks
- Restorative Dentistry, School of Dental Sciences, Framlington Place, Newcastle University, Newcastle upon Tyne, NE2 4BW, United Kingdom.
| | - David Edwards
- Restorative Dentistry, School of Dental Sciences, Framlington Place, Newcastle University, Newcastle upon Tyne, NE2 4BW, United Kingdom
| | - James Field
- University Dental Hospital, Heath Park, Cardiff University, Cardiff, CF14 4XY, United Kingdom
| | - Janice Ellis
- Restorative Dentistry, School of Dental Sciences, Framlington Place, Newcastle University, Newcastle upon Tyne, NE2 4BW, United Kingdom
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21
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Yaghmoor RB, Abdel-Hadi M, Petridis H, Allan E, Young AM. Effects of Novel Dental Composites on Streptococcus mutans Biofilms. J Funct Biomater 2023; 15:13. [PMID: 38248680 PMCID: PMC10817267 DOI: 10.3390/jfb15010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
With the phase-out of amalgam and the increase in minimally invasive dentistry, there is a growing need for high-strength composite materials that can kill residual bacteria and promote tooth remineralization. This study quantifies how antibacterial polylysine (PLS) and re-mineralizing monocalcium phosphate monohydrate (MCPM) affect Streptococcus mutans biofilms and the strength of dental composites. For antibacterial studies, the MCPM-PLS filler percentages were 0-0, 8-4, 12-6, and 16-8 wt% of the composite filler phase. Composite discs were immersed in 0.1% sucrose-supplemented broth containing Streptococcus mutans (UA159) and incubated in an anaerobic chamber for 48 h. Surface biomass was determined by crystal violet (CV) staining. Growth medium pH was measured at 24 and 48 h. Biofilm bacterial viability (CFU), exo-polysaccharide (water-soluble glucan (WSG) and water-insoluble glucan (WIG)), and extracellular DNA (eDNA) were quantified. This was by serial dilution plate counting, phenol-sulfuric acid microassay, and fluorometry, respectively. The biaxial flexural strengths were determined after water immersion for 1 week, 1 month, and 1 year. The MCPM-PLS wt% were 8-4, 8-8, 16-4 and 16-8. The normalized biomass, WSG, and WIG showed a linear decline of 66%, 64%, and 55%, respectively, as the PLS level increased up to 8%. The surrounding media pH (4.6) was all similar. A decrease in bacterial numbers with the 12-6 formula and a significant reduction with 16-8 compared to the 0-0 formulation was observed. The eDNA concentrations in biofilms formed on 12-6 and 16-8 formulations were significantly less than the 0-0 control and 8-4 formulations. Doubling MCPM and PLS caused a 14 and 19% reduction in strength in 1 week, respectively. Average results were lower at 1 month and 1 year but affected less upon doubling MCPM and PLS levels. Moreover, a 4% PLS may help to reduce total biomass and glucan levels in biofilms on the above composites. Higher levels are required to reduce eDNA and provide bactericidal action, but these can decrease early strength.
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Affiliation(s)
- Rayan B. Yaghmoor
- Department of Restorative Dentistry, College of Dental Medicine, Umm Al-Qura University, Makkah 24381, Saudi Arabia;
| | - Mohammad Abdel-Hadi
- Unit of Prosthodontics, Department of Restorative Dentistry, UCL Eastman Dental Institute, Rockefeller Building, London WC1E 6HX, UK; (M.A.-H.); (H.P.)
| | - Haralampos Petridis
- Unit of Prosthodontics, Department of Restorative Dentistry, UCL Eastman Dental Institute, Rockefeller Building, London WC1E 6HX, UK; (M.A.-H.); (H.P.)
| | - Elaine Allan
- Department of Microbial Diseases, UCL Eastman Dental Institute, Royal Free Hospital, London NW3 2QG, UK;
| | - Anne M. Young
- Department of Biomaterials and Tissue Engineering, UCL Eastman Dental Institute, Royal Free Hospital, London NW3 2QG, UK
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22
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Abdelaziz M. Detection, Diagnosis, and Monitoring of Early Caries: The Future of Individualized Dental Care. Diagnostics (Basel) 2023; 13:3649. [PMID: 38132233 PMCID: PMC10742918 DOI: 10.3390/diagnostics13243649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Dental caries remains a significant global health issue. It was highlighted by the World Health Organization's 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence of this problem may be linked to outdated concepts developed almost a century ago but are still guiding dentists' approach to caries management today. There is a need to reconsider professional strategies for preventing and managing the disease. Contemporary dentistry could benefit from embracing new concepts and technologies for caries detection and management. Dentists should explore, among others, alternative methods for caries detection such as optical-based caries detection. These tools have been established for over a decade and they align with current disease understanding and international recommendations, emphasizing early detection and minimally invasive management. This narrative review presents the current state of knowledge and recent trends in caries detection, diagnosis, monitoring, and management, offering insights into future perspectives for clinical applications and research topics.
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Affiliation(s)
- Marwa Abdelaziz
- Division of Cariology and Endodontology, Department of Preventive Dental Medicine and Primary Care, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland
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23
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Chua SKX, Sim YF, Wang WC, Mok BYY, Yu VSH. One-year outcome of selective caries removal versus pulpotomy treatment of deep caries: A pilot randomized controlled trial. Int Endod J 2023; 56:1459-1474. [PMID: 37795835 DOI: 10.1111/iej.13978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 07/20/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
AIM This study aimed to compare the outcome of SCR and Pulpotomy in teeth with deep caries extending at least 75% into dentine. METHODOLOGY This two-armed, parallel-group, randomized, superiority trial included vital mature permanent teeth with deep primary or secondary caries diagnosed radiographically as being at least 75% into the thickness of dentine, without clinical signs of symptomatic irreversible pulpitis or radiographic evidence of a periapical lesion. Carious teeth were blindly allocated to receive either SCR or Pulpotomy using computer-generated randomized patient codes concealed in opaque envelopes. All teeth were reviewed clinically and radiographically at 6 months and 1 year post-treatment. Using a significance level of p < .05, the log rank test and Cox proportional hazards regression were used to compare the outcome of SCR and Pulpotomy and to identify potential prognostic factors, respectively. RESULTS In all, 58 teeth in the SCR group and 55 teeth in the pulpotomy group completed treatment, after excluding 6 teeth because they did not complete the allocated treatment and another due to severe periodontal disease. At one year, 57/58 (98.3%) teeth from the SCR group and 48/55 (87.3%) teeth from the Pulpotomy group were available for analysis. One tooth in the Pulpotomy group (2.1%) and eight teeth in the SCR group (14.0%) required the further intervention of root canal treatment (p < .05). There were no other significant prognostic factors for survival. Overall, 91.4% of teeth treated with either SCR or Pulpotomy survived without requiring further intervention over a period of one year. No other adverse events occurred over the review period. CONCLUSION Within the limitations of this study, Pulpotomy fares better than SCR in preserving the remaining pulp and periapical health. As a treatment modality, Pulpotomy carries greater cost outlay to patient and takes a longer time to complete treatment than SCR. Long-term follow-up is needed to study the pulpal and restorative outcomes of Pulpotomy and SCR.
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Affiliation(s)
- S K X Chua
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - Y F Sim
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - W C Wang
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - B Y Y Mok
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
| | - V S H Yu
- National University Centre for Oral Health Singapore (NUCOHS), Singapore City, Singapore
- Faculty of Dentistry, National University of Singapore, Singapore City, Singapore
- Oral Care Health Innovation and Designs Singapore (ORCHIDS), National University of Singapore, Singapore City, Singapore
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24
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Bansal K, Shamoo A, Mani K, K PD, Verma A, Mathur VP, Tewari N. Silver diamine fluoride modified atraumatic restorative treatment compared to conventional restorative technique on carious primary molars-A randomized controlled trial. J Dent 2023; 138:104698. [PMID: 37704105 DOI: 10.1016/j.jdent.2023.104698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVE To compare the success of silver diamine fluoride-modified atraumatic restorative technique (SMART) with that of the conventional drill and fill method in restoring carious lesions in primary molars. METHOD Children (4-8years old) reporting to a tertiary care hospital setting with asymptomatic cavitated dentinal carious lesions in primary molars were randomly allocated to two groups; SMART and Conventional; and subsequently restored with Glass Ionomer Cement (GIC). Follow-up evaluations were carried out by blinded independent evaluator at 6-months intervals to assess the status of restorations. Primary outcome was the success of restorations at 24 months and the secondary outcome was the child's behaviour and acceptance of the treatment at the time of interventions. Two sample Z-test of proportion, logistic regression analysis and Chi-square test were used to compare the outcomes in two groups. RESULTS A total of 226 children (SMART group, 112 and conventional, 114) were included with 280 and 282 GIC restorations placed by the SMART and the conventional method respectively. At 24-months, 459 (81.6 %) primary molars were available for evaluation. Success rates of restorations was 38.4 % and 45.8 % % in SMART and conventional groups respectively (p = 0.105). The rate of acceptability of treatment in the SMART and conventional group was 79 % and 56 % (p<0.001) respectively. CONCLUSION There was no significant difference in the success rates of GIC restorations by SMART and conventional technique in carious primary molars at 24 months. SMART was better accepted by children as compared to the conventional restorative technique. CLINICAL SIGNIFICANCE SMART can be an alternative option to treat the asymptomatic carious lesions in primary molars and is well accepted by children than the conventional drill and fill technique thus implying that it has a useful role in un-cooperative children.
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Affiliation(s)
- Kalpana Bansal
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Azeema Shamoo
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kalaivani Mani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Pavithra Devi K
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ankita Verma
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay P Mathur
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Department of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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25
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Schwendicke F, Badakhsh P, Marques MG, Demarchi KM, Brant ARR, Moreira CL, Ribeiro APD, Leal SC, Hilgert LA. Subjective versus objective, polymer bur-based selective carious tissue removal: 2-year randomized clinical trial. J Dent 2023; 138:104728. [PMID: 37783372 DOI: 10.1016/j.jdent.2023.104728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVES We aimed to compare subjective (S) selective carious tissue removal using hand instruments versus objective (O) removal using a self-limiting polymer bur in a single-blind cluster-randomized controlled superiority trial. METHODS 115 children (aged 7-8 years) with ≥1 vital primary molar with a deep dentin lesion (>1/2 dentin depth) were included and randomized (60 S/55 O); all eligible molars in a child were treated identically (91 S/86 O). Cavities were prepared and carious tissue on pulpal walls selectively removed using hand instruments (S) or a self-limiting polymer bur (Polybur P1, Komet), followed by restoration using a glass hybrid material (Equia Forte, GC). Treatment time and satisfaction data have been reported in a 1-year-interim report. We here report on 2 year survival (tooth retained with or without further retreatments being needed, or tooth exfoliated), analyzed using multi-level Cox-regression analysis, as well as success (ART criteria 0/1, no pulpal complications, no re-intervention needed, or tooth extraction). RESULTS 71 restorations in S and 65 in O were examined after a mean (SD, range) of 22 (11; 3-31) months, of which 50 S and 48 O restorations were successful and 70 S and 65 O survived. The majority of failures were restorative, not pulpal, and distribution of ART codes was not significant different between groups. Risk of failure was not significantly associated with the removal protocol (HR; 95 % CI: 0.95; 0.51-1.78), and also not age, sex or dental arch, while single surfaced restorations showed significantly lower hazard (0.14; 0.06-0.37). CONCLUSION There was no significant difference in success or survival between objective and subjective carious tissue removal. CLINICAL SIGNIFICANCE In primary teeth, subjective selective excavation had no disadvantage compared with objective excavation, which required a separate instrument (polymer-based bur) for carious tissue removal. Polymer-based burs may be particularly useful when standardized excavation is needed.
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Affiliation(s)
- Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité- Universitätsmedizin, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - Puya Badakhsh
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité- Universitätsmedizin, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Marta Gomes Marques
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
| | | | | | - Cláudia Lúcia Moreira
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
| | - Ana Paula Dias Ribeiro
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil; Department of Restorative Dental Sciences, College of Dentistry, University of Florida, Gainesville, FL, United States
| | - Soraya Coelho Leal
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
| | - Leandro Augusto Hilgert
- School of Health Sciences, Department of Dentistry, University of Brasília, Brasília, Brazil
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Al-Badri H, Al-Shammaree SA, Banerjee A, Al-Taee LA. The in-vitro development of novel enzyme-based chemo-mechanical caries removal agents. J Dent 2023; 138:104714. [PMID: 37734529 DOI: 10.1016/j.jdent.2023.104714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/09/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVES Bromelain is a potent proteolytic enzyme that has a unique functionality makes it valuable for various therapeutic purposes. This study aimed to develop three novel formulations based on bromelain to be used as chemomechanical caries removal agents. METHODS The novel agents were prepared using different concentrations of bromelain (10-40 wt. %), with and without 0.1-0.3 wt. % chloramine T or 0.5-1.5 wt. % chlorhexidine (CHX). Based on the enzymatic activity test, three formulations were selected; 30 % bromelain (F1), 30 % bromelain-0.1 % chloramine (F2) and 30 % bromelain-1.5 % CHX (F3). The assessments included molecular docking, Fourier-transform infrared spectroscopy (FTIR), viscosity and pH measurements. The efficiency of caries removal was assessed by DIAGNOdent pen, measuring the excavation time and number of applications, followed by a morphological evaluation of the remaining dentine using scanning electron microscopy (SEM). The results were compared to Brix 3000 as a control. RESULTS The chloramine and chlorhexidine were chemically compatible with bromelain without compromising the enzyme activity. All experimental formulations showed higher viscosity and pH in comparison to Brix 3000. The DIAGNOdent readings were <20 in all groups, and the lowest readings were observed in F2. The excavation time and number of applications were lowest in F2 and F1. Both F2 and F3 produced smooth dentine surfaces with less tissue debris, but more patent dentine tubules were observed in F1 and F2. CONCLUSIONS The bromelain-contained formulations showed a potential to be used as chemomechanical caries removal agents in vitro. Further laboratory and clinical studies are needed to validate this claim. CLINICAL SIGNIFICANCE The bromelain from pineapple stem has broad specificity for cleavage the peptide bonds in denatured protein to facilitate their removal. The study proved the efficiency of this enzyme to remove the dental caries chemomechanically when used alone or conjugated with chloramine and/or chlorhexidine to enhance the disinfecting and cleansing properties.
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Affiliation(s)
- Huda Al-Badri
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq
| | | | - Avijit Banerjee
- Centre for Oral Clinical & Translational Sciences, King's College London, Guy's Hospital, London, UK
| | - Lamis A Al-Taee
- Department of Conservative and Aesthetic Dentistry, Baghdad College of Dentistry, University of Baghdad, Baghdad, Iraq.
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Heck K, Kunzelmann KH, Walter E, Kaisarly D, Hoffmann L, Litzenburger F. Proximal Caries Detection Using Short-Wave Infrared Transillumination at Wavelengths of 1050, 1200 and 1300 nm in Permanent Posterior Human Teeth. Diagnostics (Basel) 2023; 13:3257. [PMID: 37892078 PMCID: PMC10606242 DOI: 10.3390/diagnostics13203257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
This in vitro study aimed to investigate the diagnostic potential of short-wave infrared transillumination (SWIRT) at 1050, 1200 and 1300 nm for the detection of proximal caries in molars and premolars. It was compared to the diagnostic performance of bitewing radiography (BWR) and micro-computed tomography (µCT) as the reference standard. 250 sound or decayed proximal surfaces of permanent posterior extracted teeth were examined using (1) SWIRT at 1050, 1200 and 1300 nm with two camera systems of different resolutions, (2) BWR and (3) µCT. Thresholds were defined for both test methods and the reference standard for caries in general, enamel caries and dentin caries. All images were assessed by two examiners twice, at an interval of two weeks. SWIRT at wavelengths of 1050, 1200 and 1300 nm achieved sensitivity values more than 2.5 times higher than BWR (enamel caries 3.2-4.4 times; dentin caries 3.25-4.25 times) for the detection of proximal caries. Sensitivity values of SWIRT improved with the higher wavelength. No significant difference was found in diagnostic quality between the two camera systems. SWIRT at 1300 nm imaged proximal enamel caries with the highest accuracy, while the physical optimum for transillumination in dentin was located at a lower wavelength (<1000 nm).
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Affiliation(s)
- Katrin Heck
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (K.-H.K.); (E.W.); (D.K.); (F.L.)
| | - Karl-Heinz Kunzelmann
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (K.-H.K.); (E.W.); (D.K.); (F.L.)
| | - Elias Walter
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (K.-H.K.); (E.W.); (D.K.); (F.L.)
| | - Dalia Kaisarly
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (K.-H.K.); (E.W.); (D.K.); (F.L.)
| | - Lea Hoffmann
- Department of Orthodontics and Dentofacial Orthopedics, LMU University Hospital, LMU Munich, 80336 Munich, Germany;
| | - Friederike Litzenburger
- Department of Conservative Dentistry and Periodontology, LMU University Hospital, LMU Munich, 80336 Munich, Germany; (K.-H.K.); (E.W.); (D.K.); (F.L.)
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Hiltch G, Steier L, de Figueiredo JAP. Enhanced Clinical Decision-Making and Delivery of Minimally Invasive Care Using the ICCMS4D Integrated with Hands-Free Fluorescence-Based Loupes and a Chemomechanical Caries Removal Agent. Eur J Dent 2023; 17:1356-1362. [PMID: 37105220 PMCID: PMC10756833 DOI: 10.1055/s-0043-1764423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
The purpose of this case report was to evaluate an approach for enhanced clinical decision-making while providing minimally invasive treatment, using the combined International Caries Classification and Management System (ICCMS 4D) with hands-free fluorescence-enhanced loupes (Reveal, Designs for Vision Inc., New York City, NY, United States) and a chemo-mechanical caries removal agent (Papacárie Duo Gel, Formula & Acao, Sao Paulo, Brazil). In recent decades, a shift towards a conservative approach to caries management has developed. The use of adequate operative techniques and correct decision-making are of paramount importance for early caries detection and tooth-preserving operative care. The use of noninvasive fluorescence-based adjuncts for enhanced diagnostic accuracy has gained popularity. Fluorescence describes the absorption of photons by a molecule, followed by its partial emission at a longer wavelength. Fluorescence detection of bacterial activity is largely based on the red/orange fluorescence emanating from bacterial metabolism, and has been shown to be found particularly in active caries and mature anaerobic plaque. The combined approach of using the standardized visual International Caries Detection and Assessment System (ICDAS) with fluorescence as an operative adjunct was shown to enhance the advantages of both systems. The approach may potentially increase detection sensitivity without compromising the specificity of the visual tactile method. A recent hands-free device is aimed to combine simultaneous diagnosis and therapy (theragnosis) using fluorescence, while overcoming possible obstacles to workflow continuity. The "Reveal" fluorescence-enhanced loupes are fitted with a dual white light/fluorescence light, and are said to allow the clinician to conduct any operational procedure with optional fluorescence guidance, from detection to caries removal, to treatment completion. Using the described method, a comprehensive pathway that emphasizes evidence-based information, correct clinical decision-making, and a minimally invasive therapeutic approach was proposed. The approach may represent a potential advancement in providing minimally invasive caries care.
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Affiliation(s)
- Gal Hiltch
- Department of Dentistry, Federal University of Rio Grande do Sul—UFRGS, Porto Alegre, Brazil
| | - Liviu Steier
- Department of Preventive and Restorative Sciences, Dental School, University of Pennsylvania- UPENN, Philadelphia, Pennsylvania, United States
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Jakovljevic A, Jaćimović J, Aminoshariae A, Fransson H. Effectiveness of vital pulp treatment in managing nontraumatic pulpitis associated with no or nonspontaneous pain: A systematic review. Int Endod J 2023; 56 Suppl 3:340-354. [PMID: 35579062 DOI: 10.1111/iej.13776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The exposed pulp has been the topic of numerous studies, but well-designed and well-executed comparative trials on the outcome and treatment of these teeth have been limited. OBJECTIVES This study was conducted to answer the following questions: in patients with nontraumatic pulpitis associated with no or nonspontaneous pain in permanent teeth, (i) is direct pulp capping or pulpotomy (partial/full) as effective as selective or stepwise caries removal [Population/participants, Intervention(s), Comparator(s)/control, Outcome(s) (PICO) 1], (ii) is pulpotomy (partial/full) as effective as direct pulp capping (PICO 2) and (iii) is pulpotomy (partial/full) as effective as a pulpectomy (PICO 3), in terms of a combination of patient and clinical reported outcomes, with 'tooth survival' as the most critical outcome? METHODS A literature search was conducted using Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Central Register of Controlled Trials from inception to November 3rd 2021. Grey literature and contents of the major subject journals were examined. Eligibility criteria followed the PICO questions. Two independent reviewers performed study selection, data extraction and appraisal; disagreements were resolved by a third reviewer. The risk of bias was assessed by the revised Cochrane risk-of-bias tool for randomized trials. RESULTS Three randomized clinical trials (RCTs) were included in the review. No study fulfilled the criteria to answer PICO 1. There were no significant differences in the reported outcomes between investigated treatments in all included RCTs. None of the included studies reported the most critical outcome 'tooth survival'. A high loss of patients during the follow-up period was observed. DISCUSSION Although a few studies fulfilled strict eligible criteria, the results of this systematic review clearly highlight a paucity of available evidence. At the present time, clinical decisions cannot be substantiated by direct comparative trials. CONCLUSIONS Based on limited evidence, this systematic review discovered no significant differences in effectiveness between compared vital pulp treatments in managing nontraumatic pulpitis associated with no or nonspontaneous pain. Further high-quality RCTs are necessary to investigate the effectiveness of direct pulp capping or pulpotomy (partial/full) compared to selective or stepwise caries removal. REGISTRATION PROSPERO database (CRD42021259742).
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Affiliation(s)
- Aleksandar Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Jaćimović
- Central Library, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Anita Aminoshariae
- Department of Endodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Helena Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Tzanetakis GN, Koletsi D, Georgopoulou M. Treatment outcome of partial pulpotomy using two different calcium silicate materials in mature permanent teeth with symptoms of irreversible pulpitis: A randomized clinical trial. Int Endod J 2023; 56:1178-1196. [PMID: 37452640 DOI: 10.1111/iej.13955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/25/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023]
Abstract
AIM To assess the clinical and radiographic outcome of partial pulpotomy by comparing MTA Angelus and Total Fill BC, as pulpotomy agents, in mature teeth with deep caries and symptoms indicative of irreversible pulpitis. METHODOLOGY The study was designed as a parallel-two arm, double-blind, randomized superiority clinical trial registered at www. CLINICALTRIALS gov (NCT04870398). Symptomatic mature permanent teeth with deep caries fulfilling the inclusion criteria were randomly treated using either MTA Angelus or Total Fill BC. A partial pulpotomy was performed and following complete haemostasis, the capping material was placed over the remaining pulp tissue and a postoperative periapical radiograph was taken. Clinical and radiographic follow-up evaluation was performed for a median time of 2 years, whereas levels of pain intensity were evaluated preoperatively and for 7 days after intervention using Visual Analogue Scale. For the primary outcome (failure/success of treatment), the Kaplan-Meier survival curves for the capping materials were plotted and a log-rank test for equality of survivor functions was applied. A multivariable random effects Cox Regression model was also applied. For the secondary outcome (postoperatively reported pain), a multivariable mixed effects ordinal logistic regression was structured. RESULTS One hundred and thirty-seven teeth in 123 patients underwent partial pulpotomy using randomly either MTA Angelus (N = 74) or Total Fill BC (n = 63). The percentage failure for MTA Angelus and Total Fill BC was 10.8% (8/74) and 17.5% (11/63), respectively, but the difference was not statistically significant [adjusted HR: 1.83; 95% confidence interval (CI): 0.68, 4.91; p = .23]. Weak evidence was found that secondary caries involvement may impose a 3.54 times greater hazard for treatment failure (adjusted HR: 3.54; 95% CI: 1.00, 12.51; p = .05). For each passing minute of procedural bleeding control, there was also a 57% higher hazard for treatment failure (adjusted HR: 1.57; 95% CI: 0.99, 2.48; p = .05). The odds for higher postoperative pain were 4.73 times greater for the Total Fill BC compared to MTA Angelus (adjusted OR: 4.73; 95% CI: 2.31, 9.66; p < .001). CONCLUSIONS Both materials exhibited similar and favourable outcome rates after partial pulpotomy in teeth with deep caries and symptoms of irreversible pulpitis. Total Fill BC was associated with a higher level of postoperative pain intensities.
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Affiliation(s)
- Giorgos N Tzanetakis
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA
| | - Maria Georgopoulou
- Department of Endodontics, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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Duncan HF, Kirkevang LL, Peters OA, El-Karim I, Krastl G, Del Fabbro M, Chong BS, Galler KM, Segura-Egea JJ, Kebschull M. Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endod J 2023; 56 Suppl 3:238-295. [PMID: 37772327 DOI: 10.1111/iej.13974] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease. AIM To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. METHODS This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. RESULTS The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. CONCLUSION The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
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Affiliation(s)
- Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ikhlas El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bun San Chong
- Faculty of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nuernberg, Erlangen, Germany
| | - Juan J Segura-Egea
- Department of Stomatology, Endodontics Section, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Moritz Kebschull
- School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
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Matar MA, Darwish SS, Salma RS, Lotfy WA. Evaluation of the antibacterial activity of Enamelast® and Fluor defender® fluoride varnishes against Streptococcus mutans biofilm: an in vitro study in primary teeth. Eur Arch Paediatr Dent 2023; 24:549-558. [PMID: 37525011 PMCID: PMC10600041 DOI: 10.1007/s40368-023-00811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 06/02/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE The aim of the current work was to compare the antibacterial activity of Enamelast® and Fluor defender® fluoride varnish on biofilm generation by Streptococcus mutans on extracted primary teeth. METHODS Thirty-six primary molars were collected and sliced into seventy-two test model disks. All specimens were examined, and the cracked or broken ones were discarded. A total number of specimens (n = 54) were divided into two experimental analyses viz; biofilm formation (n = 27) and microscopic examination (n = 27). Specimens of each analysis were tested under different experimental conditions: a negative control group (n = 9), Fluor defender group (n = 9), and Enamelast group (n = 9). Following treatment, biofilms were generated by adherent Streptococcus mutans on the test model disks on three time intervals: 24 h (n = 3), 48 h (n = 3), and 72 h (n = 3) for each analysis. Then, for biofilm formation analysis, the biofilm was detected spectrophotometrically at 620 nm after being stained by crystal violet. For microscopical analysis, the surfaces of the test model disks were visualized by scanning electron microscopy (SEM), and each image was processed and analyzed using ImageJ software. RESULTS At 48 and 72 h, Enamelast® and Fluor defender®-treated group showed significantly (p < 0.001) slight adhered bacterial cells when compared with the negative control group as revealed by the absorbance and SEM. Compared with the Fluor defender®-treated group, the absorbance of the Enamelast®-treated group showed a significant (p < 0.001) increase by approximately 7- and 16.5-fold at 48 and 72 h, respectively. Similarly, SEM showed that the number of bacterial cells adhered to enamel surfaces in the Fluor defender®-treated group was significantly (p < 0.001) fewer than the Enamelast®-treated group by approximately 36.55% and 20.62% at 48 and 72 h after exposure, respectively. CONCLUSION We conclude that the anti-biofilm activity of Fluor defender® against Streptococcus mutans was significantly (p < 0.001) greater than Enamelast® fluoride varnish. The use of Fluor defender® is encouraged as a preventive measure in children with the high risk of developing dental caries.
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Affiliation(s)
- M A Matar
- Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - S S Darwish
- Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
| | - R S Salma
- Pediatric Dentistry Department, College of Dentistry El Alamein, Arab Academy for Science, Technology and Maritime Transport (AAST), Alamein, Egypt.
| | - W A Lotfy
- Microbiology Department, Faculty of Dentistry, Pharos University in Alexandria, Alexandria, Egypt
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Elkady DM, Khater AGA. Knowledge and attitudes toward evidence-based cariology and restorative dentistry among Egyptian dental practitioners: a cross-sectional survey. BMC Oral Health 2023; 23:622. [PMID: 37658399 PMCID: PMC10474780 DOI: 10.1186/s12903-023-03333-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND This is the first study to assess Egyptian dental practitioners' knowledge about conservative caries management approaches and investigate whether this knowledge transfers into clinical practice and the barriers to translating research into evidence-based practice. METHODS A sample of dental practitioners was surveyed using an online questionnaire. Convenience and snowball sampling were used to collect data from February to June 2022. We included graduated dentists from Egyptian universities who practiced in Egypt. Data were analyzed with descriptive statistics, and the associations between variables were checked using Kruskal Wallis and Chi-Square tests. RESULTS This study included 396 participants from throughout Egypt. There were significant correlations between specialty and participants' knowledge and behaviors toward evidence-based caries management (p = 0.002) and between specialization and tools used to detect carious lesions (p < 0.001). Most participants (59.1%) used G.V Black's classification, and (80.8%) removed caries based on the feature of dentin hardness and color, whereas (67%) removed caries until hard dentine remained. The participants' primary hurdle to staying up-to-date was their belief that the newly gained information would not be clinically applicable due to a lack of equipment or working in low-economic areas. Patient-related barriers were the major obstacles for participants in implementing evidence-based practice. CONCLUSION Egyptian dentists did not fully embrace minimal invasive approaches for caries management, and practitioners' experiences continue to shape decision-making. It emphasizes the imperative to practically educate dentists using effective knowledge translation dissemination to promote evidence adoption in daily practice and advocate value-based dental care to address the economic crisis's impact on Egypt's healthcare.
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Affiliation(s)
- Dina M Elkady
- Conservative Department, Faculty of Dentistry, Cairo University, Giza, Egypt
| | - Ahmad G A Khater
- Health Affairs Directorate, Egyptian Ministry of Health and Population, Banisuif, 62511, Egypt.
- Faculty of Oral and Dental Medicine, Ahram Canadian University, Giza, Egypt.
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Tabatabaian F, Vora SR, Mirabbasi S. Applications, functions, and accuracy of artificial intelligence in restorative dentistry: A literature review. J ESTHET RESTOR DENT 2023; 35:842-859. [PMID: 37522291 DOI: 10.1111/jerd.13079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE The applications of artificial intelligence (AI) are increasing in restorative dentistry; however, the AI performance is unclear for dental professionals. The purpose of this narrative review was to evaluate the applications, functions, and accuracy of AI in diverse aspects of restorative dentistry including caries detection, tooth preparation margin detection, tooth restoration design, metal structure casting, dental restoration/implant detection, removable partial denture design, and tooth shade determination. OVERVIEW An electronic search was performed on Medline/PubMed, Embase, Web of Science, Cochrane, Scopus, and Google Scholar databases. English-language articles, published from January 1, 2000, to March 1, 2022, relevant to the aforementioned aspects were selected using the key terms of artificial intelligence, machine learning, deep learning, artificial neural networks, convolutional neural networks, clustering, soft computing, automated planning, computational learning, computer vision, and automated reasoning as inclusion criteria. A manual search was also performed. Therefore, 157 articles were included, reviewed, and discussed. CONCLUSIONS Based on the current literature, the AI models have shown promising performance in the mentioned aspects when being compared with traditional approaches in terms of accuracy; however, as these models are still in development, more studies are required to validate their accuracy and apply them to routine clinical practice. CLINICAL SIGNIFICANCE AI with its specific functions has shown successful applications with acceptable accuracy in diverse aspects of restorative dentistry. The understanding of these functions may lead to novel applications with optimal accuracy for AI in restorative dentistry.
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Affiliation(s)
- Farhad Tabatabaian
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Siddharth R Vora
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Shahriar Mirabbasi
- Department of Electrical and Computer Engineering, Faculty of Applied Science, The University of British Columbia, Vancouver, British Columbia, Canada
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R R, Wani W, Sharma S, Kumar V, Chawla A, Kalaivani M, Logani A. Selective Removal to Soft Dentine versus Full Pulpotomy for Management of Proximal Deep Carious Lesions: A Randomized Controlled Non-Inferiority Trial. Caries Res 2023; 57:536-545. [PMID: 37552970 DOI: 10.1159/000530895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 04/25/2023] [Indexed: 08/10/2023] Open
Abstract
The management of the deep carious lesion with reversible pulpitis is a dilemma for the dentist. The current study compared selective removal to soft dentine (SRSD) and full pulpotomy (FP) for treating proximal deep carious lesions in teeth with reversible pulpitis. Visual-tactile examination and bitewing radiographs were used to determine the depth of carious lesion, and American Association of Endodontists recommendations were used to formulate pulp diagnosis. Sixty mandibular molar teeth from healthy patients between the ages of 16-35 years and a diagnosis of proximal deep carious lesion with reversible pulpitis were included. Teeth were randomly allocated to two study groups. SRSD group (n = 30): soft dentine was preserved over the pulpal aspect. A hard-setting calcium hydroxide cement liner and resin-modified glass ionomer cement base were applied over the remaining soft carious dentine. FP group (n = 30): complete caries removal followed by mineral trioxide aggregate FP was performed. The teeth in both groups were restored with composite resin restoration. The established criteria for outcome assessment of SRSD and pulpotomy were used. Accordingly, only asymptomatic teeth with no radiological evidence of periapical rarefaction were considered successful at the 12-month follow-up. Two-sample t test, Pearson χ2 test/Fisher's exact test, and percentage agreement were used for statistical evaluation. According to the per-protocol analysis, the success rate of both SRSD and FP treatment was 95.45% and 95.65%, respectively, and the actual difference between the two treatments was 1% (95% CI: [-10, 9]). The data suggests that both treatments (SRSD and FP) appear to have a good success rate (>95%) when used to manage permanent mandibular molar teeth with proximal deep carious lesion and reversible pulpitis. As SRSD is a noninvasive procedure, it should be favored over FP in these instances.
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Affiliation(s)
- Rechithra R
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Wasim Wani
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sidhartha Sharma
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Mani Kalaivani
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Undre MI, Chunawala Y, Choubey S, Shaikh MN, Ershad A, Qureshi S. Evaluation of the Success of Conventional and Biological Restorative Treatment Approaches for Caries in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2023; 16:591-597. [PMID: 37731796 PMCID: PMC10507310 DOI: 10.5005/jp-journals-10005-2644] [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: 09/22/2023] Open
Abstract
Background In order to compare the clinical and radiographic success of three treatment modalities-conventional restoration (CR), nonrestorative caries treatment (NRCT), and Hall technique (HT), with a 3-month to 1 year follow-up in deciduous molars with occlusal or proximal carious lesions. Design Children between the ages of 5 and 8 were chosen for the study, having a total of 120 teeth. They were split into three groups, each with 40 participants-CR, HT, and NRCT. Clinical and radiographic evaluation was done at 3, 6, 9, and 12 months. Data were statistically analyzed. Results The Chi-squared value and p-value were found to be insignificant when comparing clinical and radiographic ratings of all three groups at 3, 6, 9, and 12-month intervals. Conclusion Hall technique (HT) performed better than CR. NRCT was more acceptable to patients than CR. How to cite this article Undre MI, Chunawala Y, Choubey S, et al. Evaluation of the Success of Conventional and Biological Restorative Treatment Approaches for Caries in Primary Molars: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(4):591-597.
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Affiliation(s)
- Maryam I Undre
- Department of Dentistry, Masina Hospital, Byculla, Mumbai, Maharashtra, India
| | - Yusuf Chunawala
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Shikha Choubey
- Department of Pediatric and Preventive Dentistry, ITS Dental College, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Maheen N Shaikh
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Aliya Ershad
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Sana Qureshi
- Department of Pediatric & Preventive Dentistry, MA Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
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Dhar V, Pilcher L, Fontana M, González-Cabezas C, Keels MA, Mascarenhas AK, Nascimento M, Platt JA, Sabino GJ, Slayton R, Tinanoff N, Young DA, Zero DT, Pahlke S, Urquhart O, O'Brien KK, Carrasco-Labra A. Evidence-based clinical practice guideline on restorative treatments for caries lesions: A report from the American Dental Association. J Am Dent Assoc 2023; 154:551-566.e51. [PMID: 37380250 DOI: 10.1016/j.adaj.2023.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 02/07/2023] [Accepted: 04/01/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND An expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs together with the ADA Science and Research Institute's program for Clinical and Translational Research conducted a systematic review and developed recommendations for the treatment of moderate and advanced cavitated caries lesions in patients with vital, nonendodontically treated primary and permanent teeth. TYPES OF STUDIES REVIEWED The authors searched for systematic reviews comparing carious tissue removal (CTR) approaches in Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Trip Medical Database. The authors also conducted a systematic search for randomized controlled trials comparing direct restorative materials in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of the evidence and formulate recommendations. RESULTS The panel formulated 16 recommendations and good practice statements: 4 on CTR approaches specific to lesion depth and 12 on direct restorative materials specific to tooth location and surfaces involved. The panel conditionally recommended for the use of conservative CTR approaches, especially for advanced lesions. Although the panel conditionally recommended for the use of all direct restorative materials, they prioritized some materials over the use of others for certain clinical scenarios. PRACTICAL IMPLICATIONS The evidence suggests that more conservative CTR approaches may decrease the risk of adverse effects. All included direct restorative materials may be effective in treating moderate and advanced caries lesions on vital, nonendodontically treated primary and permanent teeth.
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Budală DG, Luchian I, Tatarciuc M, Butnaru O, Armencia AO, Virvescu DI, Scutariu MM, Rusu D. Are Local Drug Delivery Systems a Challenge in Clinical Periodontology? J Clin Med 2023; 12:4137. [PMID: 37373830 DOI: 10.3390/jcm12124137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/13/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Placing antimicrobial treatments directly in periodontal pockets is an example of the local administration of antimicrobial drugs to treat periodontitis. This method of therapy is advantageous since the drug concentration after application far surpasses the minimum inhibitory concentration (MIC) and lasts for a number of weeks. As a result, numerous local drug delivery systems (LDDSs) utilizing various antibiotics or antiseptics have been created. There is constant effort to develop novel formulations for the localized administration of periodontitis treatments, some of which have failed to show any efficacy while others show promise. Thus, future research should focus on the way LDDSs can be personalized in order to optimize future clinical protocols in periodontal therapy.
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Affiliation(s)
- Dana Gabriela Budală
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Ionut Luchian
- Department of Periodontology, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Monica Tatarciuc
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Oana Butnaru
- Department of Biophysics, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania
| | - Adina Oana Armencia
- Department of Surgery and Oral Health, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Dragoș Ioan Virvescu
- Department of Fixed Prosthodontics, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iasi, Romania
| | - Monica Mihaela Scutariu
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - Darian Rusu
- Department of Periodontology, Faculty of Dental Medicine, "Anton Sculean" Research Center for Periodontal and Peri-Implant Diseases, "Victor Babes" University of Medicine and Pharmacy, Piața Eftimie Murgu 2, 300041 Timisoara, Romania
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Aldeen RZ, Aljabban O, Almanadili A, Alkurdi S, Eid A, Mancino D, Haikel Y, Kharouf N. The Influence of Carious Lesion and Bleeding Time on the Success of Partial Pulpotomy in Permanent Molars with Irreversible Pulpitis: A Prospective Study. Bioengineering (Basel) 2023; 10:700. [PMID: 37370631 DOI: 10.3390/bioengineering10060700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
This prospective study aimed to evaluate the success rate of partial pulpotomy using mineral trioxide aggregate (MTA), in permanent molars with symptomatic irreversible pulpitis. Moreover, this study aimed to investigate the effect of carious lesion depth and activity and bleeding time on the outcome of partial pulpotomy. Forty permanent molars with deep and extremely deep carious lesions clinically diagnosed with symptomatic irreversible pulpitis were included. The status of the carious lesion was evaluated clinically and radiographically to determine its activity (rapidly or slowly progressing) and depth (deep or extremely deep). A partial pulpotomy was performed and MTA was used. Clinical and radiographic analysis were performed at 3, 6 and 12 months. Chi-square analysis and Fisher's exact test were used. Scanning electron microscope and energy dispersive X-rays were used to investigate the crystalline structures and their chemical composition onto MTA surfaces after immersion in several conditions. The partial pulpotomy was 88.9% successful, with no significant difference in outcome between deep and extremely deep carious lesions (p = 0.22) or between rapidly and slowly progressing lesions (p = 0.18). Nevertheless, all failed cases were associated with rapidly progressing lesions and extremely deep lesions. All failures occurred when the bleeding time was more than 3 min (p = 0.10). Different crystalline structures were detected on MTA surfaces, with higher calcium percentages in PBS conditions. Within the limitations of the present study, favorable results demonstrated that MTA might be recommended as a suitable agent for partial pulpotomy in permanent molars with irreversible pulpitis. The depth and activity of the carious lesion as well as the bleeding time are important factors in the success of partial pulpotomy treatment. The prolonged bleeding time and the extremely deep rapidly progressing caries could be related with the failure cases in partial pulpotomy treatment of irreversible pulpitis.
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Affiliation(s)
- Rami Zen Aldeen
- Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus 0100, Syria
| | - Ossama Aljabban
- Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus 0100, Syria
| | - Ahmad Almanadili
- Department of Oral Pathology, Faculty of Dentistry, Damascus University, Damascus 0100, Syria
| | - Saleh Alkurdi
- Department of Pediatric Dentistry, Faculty of Dentistry, Damascus University, Damascus 0100, Syria
| | - Ammar Eid
- Department of Endodontics, Faculty of Dentistry, Damascus University, Damascus 0100, Syria
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Youssef Haikel
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, Strasbourg University, 67000 Strasbourg, France
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
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Philip N, Suneja B. The revolutionary evolution in carious lesion management. J Conserv Dent 2023; 26:249-257. [PMID: 37398856 PMCID: PMC10309123 DOI: 10.4103/jcd.jcd_54_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/23/2023] [Accepted: 04/19/2023] [Indexed: 07/04/2023] Open
Abstract
Contemporary paradigms of dental caries management focus on the biological approaches to treating the disease and its principal symptom, the carious lesion. This narrative review traces the evolution of carious lesion management from the operative and invasive approaches of G. V. Black's era to the current period of minimally invasive biological approaches. The paper explains the rationale for adopting biological approaches to dental caries management and lists the five core principles of this management approach. The paper also details the aims, features, and the most recent evidence base for the different biological carious lesion management approaches. Based on current practice guidelines, collated clinical pathways for lesion management are also presented in the paper to aid clinicians in their decision-making. It is hoped that the biological rationale and evidence summarized in this paper will bolster the shift to modern biological carious lesion management approaches among dental practitioners.
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Affiliation(s)
- Nebu Philip
- Paediatric Dentistry, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Hatipoğlu Ö, Pertek Hatipoğlu F, Javed MQ, Nijakowski K, Taha N, El-Saaidi C, Sugumaran S, Elhamouly Y, Drobac M, Machado R, Abdullah T, Kobayashi H, Alfirjani S, Abidin IZ, Martín B, Maira K, Lim WY, Palma PJ, Martins JFB. Factors Affecting the Decision-Making of Direct Pulp Capping Procedures Amongst Dental Practitioners: A Multinational Survey from 16 Countries with Meta-Analysis. J Endod 2023:S0099-2399(23)00215-7. [PMID: 37094712 DOI: 10.1016/j.joen.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multicentered survey had three purposes: i) to investigate the factors that affect clinicians' decisions in DPC cases, ii) to determine which method of caries removal is preferred, and iii) to evaluate the preferred capping material for DPC. METHODS The questionnaire comprised three sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure and patients' age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. RESULTS A tendency towards more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR=2.86, 95% CI:2.46,2.32; p<0.001) as opposed to the clinical scenario with two pulp exposures (RR=1.38, 95% CI:1.24,1.53; p<0.001). Complete caries removal was significantly preferred to selective caries removal (RR=4.59, 95% CI: 3.70, 5.69; p<0.001). Among the capping materials, calcium silicate-based materials (CS) were preferred over calcium hydroxide-based materials (CH) (RR=0.58, 95% CI: 0.44,0.76; p<0.05). CONCLUSION While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of CS appears to have replaced CH.
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Affiliation(s)
- Ömer Hatipoğlu
- Department of Restorative Dentistry, Nigde Omer Halisdemir University, Turkey.
| | | | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences and Endodontics, College of Dentistry, Qassim University, Saudi Arabia.
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poland.
| | - Nessrin Taha
- Department of Conservative Dentistry, Jordan University of science and Technology Irbid, Jordan.
| | | | - Surendar Sugumaran
- Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamilnadu, India.
| | - Yasmine Elhamouly
- Pediatric Dentistry Pediatric and Community Dentistry Department, Faculty of Dentistry, Pharos University in Alexandria, Egypt.
| | - Milan Drobac
- Department of Conservative Dentistry and Endodontics, Faculty of Medicine, University of Novi Sad, Serbia.
| | - Ricardo Machado
- Clinical practice limited to Endodontics, Navegantes, Santa Catarina, Brazil.
| | - Thiyezen Abdullah
- Department of Orthodontic and Pediatric Dentistry, College of Dentistry, Qassim University, Saudi Arabia.
| | - Hiro Kobayashi
- Department of Removable Partial Prosthodontics, Tokyo Dental College, Japan.
| | - Suha Alfirjani
- Department of Conservative Dentistry and Endodontics, Dental school/university of Benghazi, Libya.
| | | | - Benjamín Martín
- Department of Conservative Dentistry, Universidade de Santiago de Compostela (USC), Spain.
| | - Kopbayeva Maira
- Department of Conservative Dentistry and Endodontics, Kazakh National Medical University Asfendiyarov, Kazakhstan.
| | - Wen Yi Lim
- Restorative Department, National Dental Centre Singapore, Singapore.
| | - Paulo J Palma
- Endodontic Institute, Faculty of Medicine, University of Coimbra, Portugal.
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Bijle MN, Abdalla MM, Hung IFN, Yiu CKY. The effect of synbiotic-fluoride therapy on multi-species biofilm. J Dent 2023; 133:104523. [PMID: 37080530 DOI: 10.1016/j.jdent.2023.104523] [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: 12/24/2022] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/22/2023] Open
Abstract
OBJECTIVES The study objective was to examine the effect of synbiotic-fluoride (SF) therapy within a multi-species cariogenic biofilm model system comprising of S. mutans, S. sanguinis, and S. gordonii. METHODS The SF therapy was prepared using 2% L-arginine (Arg), 0.2% NaF and probiotic L. rhamnosus GG (LRG). The 8 treatment groups were: Group 1: No treatment, Group 2: 2% Arg, Group 3: 0.2% NaF, Group 4: LRG, Group 5: 2% Arg+0.2% NaF, Group 6: 2% Arg+LRG, Group 7: 0.2% NaF+LRG, and Group 8: SF therapy (2% Arg+0.2% NaF +LRG). Multi-species biofilm model over 96 h comprising Streptococcus mutans, Streptococcus sanguinis, and Streptococcus gordonii was utilized. The biofilms received cariogenic challenge and SF therapy 2 × /day. The extracellular matrix components were analyzed for carbohydrates, proteins, and extra-cellular DNA (eDNA). The live/dead cells were imaged and quantified using confocal microscopy. The viable/dead bacterial concentrations were estimated using propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR). The gene expressions for gtfB, sagP, arcA, argG, and argH were measured using real-time reverse transcriptase qPCR. RESULTS Carbohydrates and protein content with SF therapy were higher than non-LRG containing groups, while eDNA content was lower than other groups (p<0.05). Live bacterial proportions determined using confocal imaging with SF therapy were the lowest (p<0.05). The 2% Arg+LRG and SF therapy showed higher viable L. rhamnosus GG than 0.2% NaF+LRG (p<0.05). The dead S. mutans with SF therapy were higher than the other groups (p<0.05) with no difference from 2% Arg+0.2% NaF and 2% Arg+LRG (p>0.05). The SF therapy significantly downregulates gtfB and upregulates sagP, arcA, argG, argH gene expression (p<0.05). CONCLUSION Synbiotic-fluoride therapy effectuates multi-fold changes in the multi-species biofilm matrix and cellular components leading to superior ecological homeostasis than its individual contents, prebiotics (arginine), probiotic (L. rhamnosus GG), and fluorides (NaF). CLINICAL SIGNIFICANCE The ecological-based synbiotic-fluoride caries-preventive therapy aids in maintaining biofilm homeostasis to preempt/restore dysbiosis thereby sustaining dynamic-diverse health-associated microbial stability significant as a preventive regimen for high caries-risk patients.
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Affiliation(s)
- Mohammed Nadeem Bijle
- Assistant Professor in Paediatric Dentistry, Department of Clinical Sciences, College of Dentistry, Ajman University, United Arab Emirates; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates.
| | - Mohamed Mahmoud Abdalla
- Postdoctoral Fellow, Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong; Associate Professor, Dental Biomaterials, Faculty of Dental Medicine Al-Azhar University, Cairo, Egypt.
| | - Ivan Fan Ngai Hung
- Ru Chien and Helen Lieh Professor in Health Sciences Pedagogy, Clinical Professor, Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Cynthia Kar Yung Yiu
- Clinical Professor in Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Demirel A, Orhan AI, Büyüksungur A. The assessment of internal adaptation and fracture resistance of glass ionomer and resin-based restorative materials applied after different caries removal techniques in primary teeth: an in-vitro study. PeerJ 2023; 11:e14825. [PMID: 37009156 PMCID: PMC10064991 DOI: 10.7717/peerj.14825] [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: 08/24/2022] [Accepted: 01/09/2023] [Indexed: 03/30/2023] Open
Abstract
Background
The aim of this study was to evaluate the 3-dimensional (3D) internal adaptation (IA) and fracture resistance (FR) of compomer and glass ionomers applied after conventional caries removal to sound dentin (CCRSD) and selective caries removal to firm dentin (SCRFD) in in-vitro.
Methods
Thirty extracted primary molars were randomly assigned to three main groups (n = 10) as glass hybrid restorative (GHR) (Equia Forte® HT), conventional glass ionomer (CGIR) (Voco Ionofil Molar) and compomer (Dyract XP). Each group was randomly divided into two subgroups according to caries removal technique as CCRSD (n = 5) and SCRFD (n = 5). The restoration procedures were completed after caries removal (CCRSD or SCRFD) in all samples. Then, specimens were subjected to IA and FR tests. Data were analyzed with Student’s t, one-way ANOVA, and Kruskal Wallis-H tests. The correlation between IA and FR results was analyzed with a Pearson test. The statistical significance level was considered as 5%.
Results
While CCRSD showed superior IA results than SCRFD for all restorative materials (p < 0.05), no statistical difference was found between CCRSD and SCRFD in FR assessment (p > 0.05). In CCRSD, compomer showed superior results for IA and FR than glass ionomers (p < 0.05). In SCRFD, it was found no significant difference between the restoratives for IA (p > 0.05). However, compomer showed superior FR results than glass ionomers (p < 0.05). There was moderate negative correlation between internal voids and FR without statistically significant difference (r = −0.333, p = 0.072).
Conclusions
Despite the advantages of SCRFD, it was found to be less superior than CCRSD in IA assessment. Therefore, when SCRFD is preferred, a peripheral seal should be provided for ideal restorative treatment. On the other hand, compomer mostly showed superior results compared to others.
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Affiliation(s)
- Akif Demirel
- Faculty of Dentistry, Pediatric Dentistry Department, Ankara University, Ankara, Yenimahalle, Turkey
| | - Ayşe Işıl Orhan
- Faculty of Dentistry, Pediatric Dentistry Department, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Arda Büyüksungur
- Faculty of Dentistry, Department of Basic Medical Sciences, Ankara University, Ankara, Yenimahalle, Turkey
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Mohammed SME, Awad SM, Wahba AH. Comparison of Clinical Outcomes of Silver-modified Atraumatic Restorative Technique vs Atraumatic Restorative Technique in Primary Teeth: A Randomized Controlled Trial. J Contemp Dent Pract 2023; 23:1140-1145. [PMID: 37073938 DOI: 10.5005/jp-journals-10024-3437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2023]
Abstract
AIM To compare the clinical outcomes of silver-modified atraumatic restorative technique (SMART) vs atraumatic restorative technique (ART) in primary teeth. MATERIALS AND METHODS This study was a randomized clinical trial conducted on 30 children. The study was split-mouth design, so each group was consisted of 30 children. Children aged 3-6 years old of both genders. Communication with the children was established. Gross debris from cavitation was removed. Carious dentin on walls was excavated using spoon excavator and low-speed contra with round or fissure bur. The areas to be treated were isolated with cotton rolls. For ART, glass ionomer cement (GIC) was applied according to the manufacturer's instructions. For silver-modified atraumatic restorative technique (SMART), a protective coating was applied to the lips and skin to prevent a temporary tattoo. Silver diamine fluoride (SDF) was applied carefully using bended microsponge brush. It was applied directly to only the affected tooth surface. The lesion was dried for 15 seconds with gentle flow of compressed air. After 1 week, GIC was applied according to the manufacturer's instructions. Clinical evaluation was done for all teeth at 6 and 12 months. The data were collected and then statistically analyzed using the Chi-square test to show the difference between groups. RESULTS The restoration of the first primary molar with ART restoration alone showed a lower success rate when compared with the restoration with a combination of SDF and ART (SMART technique), with percentages of 70% and 76.67% and 53.33% and 60% after 6 months and 12 months of follow-up, respectively. CONCLUSION Silver diamine fluoride is successful in arresting dentin caries and can be used to increase the efficacy of the ART technique in primary teeth. CLINICAL SIGNIFICANCE It is recommended to use SDF as a noninvasive approach to control dentin caries with the ART technique.
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Affiliation(s)
| | | | - Ahmed Hamdy Wahba
- Pediatric Department, Faculty of Dentistry, Mansoura University, Egypt
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Porto ICCDM, Lôbo TDLGF, Rodrigues RF, Lins RBE, da Silva MAB. Insight into the development of versatile dentin bonding agents to increase the durability of the bonding interface. FRONTIERS IN DENTAL MEDICINE 2023. [DOI: 10.3389/fdmed.2023.1127368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Despite the huge improvements made in adhesive technology over the past 50 years, there are still some unresolved issues regarding the durability of the adhesive interface. A complete sealing of the interface between the resin and the dentin substrate remains difficult to achieve, and it is doubtful whether an optimal interdiffusion of the adhesive system within the demineralized collagen framework can be produced in a complete and homogeneous way. In fact, it is suggested that hydrolytic degradation, combined with the action of dentin matrix enzymes, destabilizes the tooth-adhesive bond and disrupts the unprotected collagen fibrils. While a sufficient resin–dentin adhesion is usually achieved immediately, bonding efficiency declines over time. Thus, here, a review will be carried out through a bibliographic survey of scientific articles published in the last few years to present strategies that have been proposed to improve and/or develop new adhesive systems that can help prevent degradation at the adhesive interface. It will specially focus on new clinical techniques or new materials with characteristics that contribute to increasing the durability of adhesive restorations and avoiding the recurrent replacement restorative cycle and the consequent increase in damage to the tooth.
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Smith DK, Dhar VK. Response. J Am Dent Assoc 2023; 154:112. [PMID: 36543653 DOI: 10.1016/j.adaj.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Derek K Smith
- Director of Clinical and Translational Research, American Dental Association Science and Research Institute, Chicago, IL
| | - Vineet K Dhar
- Assistant Dean and Clinical Professor, University of Maryland School of Dentistry, Baltimore, MD
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Nagarkar S, Loguercio AD, Perdigão J. Evidence-based fact checking for selective procedures in restorative dentistry. Clin Oral Investig 2023; 27:475-488. [PMID: 36607490 DOI: 10.1007/s00784-022-04832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVES Similar to other dental specialties, there are many clinical procedures in restorative dentistry that may or may not be supported by good evidence. Thus, the effectiveness of these procedures is uncertain. The aim of this paper is to reduce this knowledge gap by critically inspecting selective procedures in restorative dentistry and exploring if these well-established or widely advocated treatment modalities are necessary for improving treatment outcomes based on the best available evidence. MATERIALS AND METHODS A MEDLINE search was conducted to identify research on selective procedures while focusing on clinical trials and systematic reviews. Due to their practical relevance in the decision-making process, cost-effectiveness analyses were also included. RESULTS Mixed results were identified regarding the included interventions. Some procedures had adequate evidence supporting them while others were mostly based on beliefs. CONCLUSIONS A critical review of the available literature indicates that some common restorative procedures lack adequate support from high-quality research evidence. CLINICAL RELEVANCE This paper attempts to highlight the need to critically examine the scientific validity of traditional knowledge and techniques through the context of current research evidence. This will not only help generate consensus between educators, clinicians, and researchers regarding restorative procedures but will also lead to improved patient care and outcomes.
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Affiliation(s)
- Sanket Nagarkar
- Park Dental Group, Minneapolis, MN, USA.,Department of Restorative Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Alessandro D Loguercio
- School of Dentistry, Department of Restorative Dentistry, State University of Ponta Grossa, Ponta Grossa, Paraná, Brazil
| | - Jorge Perdigão
- Division of Operative Dentistry, Department of Restorative Sciences, University of Minnesota, 515 SE Delaware St, 8-450 Moos Tower, Minneapolis, MN, 55455, USA.
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Pilcher L, Pahlke S, Urquhart O, O'Brien KK, Dhar V, Fontana M, González-Cabezas C, Keels MA, Mascarenhas AK, Nascimento MM, Platt JA, Sabino GJ, Slayton RL, Tinanoff N, Young DA, Zero DT, Tampi MP, Purnell D, Salazar J, Megremis S, Bienek D, Carrasco-Labra A. Direct materials for restoring caries lesions: Systematic review and meta-analysis-a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc 2023; 154:e1-e98. [PMID: 36610925 DOI: 10.1016/j.adaj.2022.09.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/26/2022] [Accepted: 09/28/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND The goal of restoring caries lesions is to protect the pulp, prevent progression of the disease process, and restore the form and function of the tooth. The purpose of this systematic review was to determine the effect of different direct restorative materials for treating cavitated caries lesions on anterior and posterior primary and permanent teeth. TYPE OF STUDIES REVIEWED The authors included parallel and split-mouth randomized controlled trials comparing the effectiveness of direct restorative materials commercially available in the United States placed in vital, nonendodontically treated primary and permanent teeth. Pairs of reviewers independently conducted study selection, data extraction, and assessments of risk of bias and certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation approach. The authors conducted pair-wise meta-analyses to summarize the evidence and calculated measures of association and their 95% CIs. RESULTS Thirty-eight randomized controlled trials were eligible for analysis, which included data on Class I and Class II restorations on primary teeth and Class I, Class II, Class III, Class V, and root surface restorations on permanent teeth. Included studies assessed the effect of amalgam, resin composite, compomer, conventional glass ionomer cement, resin-modified glass isomer cement, and preformed metal crowns. Moderate to very low certainty evidence suggested varying levels of effectiveness across restorative materials. CONCLUSIONS AND PRACTICAL IMPLICATIONS Owing to a relatively low event rate across various outcomes indicating restoration failure, there was limited evidence to support important differences between direct restorative materials used in practice.
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Yang X, Zhan C, Cheng T, Huang M, Ge W, Zhang Y, Chen T, Lu Y, Cui ZK, Hou J. Evaluation of the transdentinal capability of the intrinsic antibacterial cetylpyridinium chloride/cholesterol sterosomes in vitro and in vivo. Int Endod J 2023; 56:245-258. [PMID: 36336782 DOI: 10.1111/iej.13865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022]
Abstract
AIM Dentinal tubules serve as disease-causing channels for infiltration and penetration of bacteria and their by-products; which are regarded as the major driver of pathogenesis in pulpal inflammation and infection. In this study, we aimed to evaluate the transdentinal potential of nanoscale cetylpyridinium chloride/cholesterol (CPC/Chol) sterosomes, which are a recently developed type of cationic non-phospholipid liposomal nanocarrier; as well as their intrinsic and universal antibacterial activity. METHODOLOGY Cetylpyridinium chloride/cholesterol sterosomes were formulated, with a hydrodynamic diameter of 134 ± 4 nm, a low polydisperse index of 0.161 ± 0.007, and a positive zeta potential of 41 ± 3 mV at pH 7.4. Transdentinal diffusion ability of sterosomes was evaluated using human dentine blocks in vitro, and Wistar rat molar teeth in vivo. The intrinsic antibacterial activities of CPC/Chol sterosomes against Enterococcus faecalis, Streptococcus mutans, Fusobacterium nucleatum, and Porphyromonas gingivalis were further examined. RESULTS Cetylpyridinium chloride/cholesterol sterosomes successfully penetrated through the dentinal tubules, and diffused into the pulp, which could be internalized by dental pulp cells with a high efficiency. In addition, they exhibited substantial levels of intrinsic antibacterial activity against these Gram-positive and Gram-negative endodontic bacteria and their biofilms. CONCLUSIONS Given its high penetration and diffusion ability through the dentine and pulp, great potential for multi-drug delivery, and distinct intrinsic antibacterial activity; sterosome-based nanocarriers might serve as a promising therapeutic strategy aimed at targeting various specific pathways associated with pulpal diseases. This will help determine and characterize the most appropriate prophylactic and therapeutic targets for early intervention in our future dentistry practice.
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Affiliation(s)
- Xiaojun Yang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chaoning Zhan
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Tianjiao Cheng
- Department of Cell Biology, School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Southern Medical University, Guangzhou, China
| | - Minchun Huang
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weiwen Ge
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yiqing Zhang
- Department of Cell Biology, School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Southern Medical University, Guangzhou, China
| | - Ting Chen
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanli Lu
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhong-Kai Cui
- Department of Cell Biology, School of Basic Medical Sciences, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, Southern Medical University, Guangzhou, China
| | - Jin Hou
- Department of Stomatology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Souza TFD, Martins ML, Jural LA, Maciel IP, Magno MB, Coqueiro RDS, Pithon MM, Leal SC, Fonseca-Gonçalves A, Maia LC. Did the Use of Minimum Interventions for Caries Management Change during the COVID-19 Pandemic? A Cross-Sectional Study. Caries Res 2023; 57:459-469. [PMID: 36623490 DOI: 10.1159/000528837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/19/2022] [Indexed: 01/11/2023] Open
Abstract
The aim of this study was to evaluate changes in the frequency of use of minimum intervention (MI) techniques for caries management during the COVID-19 pandemic. A questionnaire was applied through the SurveyMonkeyTM platform to evaluate changes in the dentist's frequency of use of noninvasive, microinvasive, minimally invasive, and mixed interventions, nonaerosol or aerosol productive, to manage dental caries before and during COVID-19 pandemic. Differences in the use of MI techniques were analyzed by Wilcoxon test, and the effect size (ES) was calculated. An α = 0.05 was adopted. A total of 781 dentists answered the questionnaire; most of them were female (76.4%), with 30s (76.4%), graduated over 10-24 years ago (38%) in public dental schools (62%), graduated in southwest of Brazil (38%), that work in clinical environment (66.8%) and in private jobs (53.4%). During COVID-19, among the sample, 91 respondents were not working. In relation to the noninvasive techniques, only the use of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) decreased during the COVID-19 pandemic (p < 0.01; ES = 0.11). The frequency of sealants to repair defective restorations was the only microinvasive technique that increased during the pandemic (p < 0.01; ES = 0.03). Among the minimally invasive techniques, the use of atraumatic restorative treatment increased significantly (p < 0.01; ES = 0.06), while the use of air abrasion decreased (p = 0.02; ES = 0.04) during COVID-19 pandemic. Moreover, nonrestorative cavity control (mixed intervention) increased during pandemic period (p < 0.001; ES = 0.11). Although the results demonstrated differences in the use of some procedures, a very small magnitude of the effect was perceived, demonstrating that the influence of COVID-19 pandemic was very little, if any, in the use of MI techniques for caries management. Moreover, the use of MI strategies was already well established between Brazilian dentists before the pandemic period.
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Affiliation(s)
- Tainá Fontes de Souza
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil,
| | - Mariana Leonel Martins
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lucas Alves Jural
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Isadora Passos Maciel
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Matheus Melo Pithon
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Department of Health I, Universidade Estadual Do Sudoeste Da Bahia (UESB), Jequié, Brazil
| | - Soraya Coelho Leal
- Department of Dentistry, School of Health Sciences, Universidade de Brasília (UnB), Brasília, Brazil
| | - Andréa Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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