Predictive research methods of enamel and dentine for initial caries detection

Creating a common language: defining individualized, personalized and precision prevention in public health

Background

Because of the limited success of population-based prevention methods and due to developments in genomic screening, public health professionals and health policy makers are increasingly interested in more individualized prevention strategies. However, the terminology applied in this field is still ambiguous and thus has the potential to create misunderstandings.

Methods

A narrative literature review was conducted to identify how individualized, personalized and precision prevention are used in research papers and documents. Based on the findings a set of definitions were created that distinguish between these activities in a meaningful way.

Results

Definitions were found only for precision prevention, not for individualized or personalized prevention. The definitions of individualized, personalized and precision medicine were therefore used to create the definitions for their prevention counterparts. By these definitions, individualized prevention consists of all types of prevention that are individual-based; personalized prevention also consists of at least one form of -omic screening; and precision prevention further includes psychological, behavioral and socioeconomic data for each patient.

Conclusions

By defining these three key terms for different types of individual-based prevention both researchers and health policy makers can differentiate and use them in their proper context.

Efficiency of dental caries prevention with the use of polymer-based toothpastes modified by the electromagnetic field

The most important problems of modern dentistry cover not only the early diagnosis but also prevention of dental caries, including the one based on the use of various hygienic products and therapeutic agents. Normally, the processes of re- and demineralization in the oral cavity are in a state of dynamic. However, in the presence of cariogenic factors, the balance is shifted towards demineralization. In the event of initial caries, enamel remineralization is possible only to a certain extent, and specifically, for a reversible degree of carious lesion. There was an idea about structural changes in polymer-based consumable dental materials including toothpastes. The purpose of the study is to increase the efficiency of dental caries prevention based on the activation of metabolic processes in dental hard tissues with the use of R.O.C.S. Active Calcium toothpastes (Russian-Swiss "DRC-Group" company) modified by an electromagnetic field. As a result of the experimental part of the study, certain changes in the properties of the R.O.C.S. Active Calcium toothpastes under the electromagnetic field influence including microstructural transformation of the toothpaste (an increase in the size of the polymer matrix particles and a decrease in the distance between them confirmed by the electron microscopy findings), confirmed by the transmission electron microscopy results. The investigations with the help of X-ray microanalysis made it possible to clarify the chemical composition of the surface layer of the tooth enamel, for the first time to reveal in detail the concentration of micro- and macroelements of organic and inorganic nature, to trace the changes occurring under controlled tooth cleaning with the R.O.C.S. Active Calcium toothpaste treated with an electromagnetic field. The obtained results promote the further studies of laws in change of physical and mechanical properties of treatment-and-prophylactic means under the electromagnetic field influence in respect of dental caries preventive maintenance efficiency increase.

Pathology-specific molecular profiles of saliva in patients with multiple dental caries-potential application for predictive, preventive and personalised medical services

BACKGROUND

Improving the quality of life is part of the global agenda. The focus is predominantly on prevention of socially significant diseases. Combating dental caries-related diseases is a top priority as it has a huge impact on people's social lives. Therefore, the purpose of the work was to study the changes in the molecular composition of saliva from subjects with multiple caries lesions using spectroscopic methods of analysis to identify potential tissue markers of caries development for predictive, preventive and personalised medical services.

OBJECTIVES AND METHODS

The molecular composition of mixed saliva (oral fluid) from subjects with and without multiple caries was analysed with the use of spectroscopic techniques, FTIR with synchrotron radiation for the excitation. The IR spectra of the oral fluid as well as the calculated mineral-organic, carbon-phosphate, Amide II/Amide I and protein/thiocyanate ratios were compared between subjects with and without multiple caries.

RESULTS

This complex analysis of the obtained experimental data determined that the molecular composition of the oral fluid from those with multiple caries differed from those without caries; the organic-mineral balance in the oral fluid of those with multiple caries shifted towards a reduction in the mineral complexes, accompanied by an increase in the organic component. The thiocyanate content increased more than twofold, accompanied by increased carboxyl groups of esters, lipids and carbohydrates.

CONCLUSION

The detected features in the IR spectra of mixed saliva as well as the calculated changes in the ratios between organic and inorganic components can be used as biomarkers of cariogenesis in the oral cavity, as a diagnostic criterion in the analysis of the oral fluid samples.

Clinical and laboratory evaluation of microstructural changes in the physical, mechanical and chemical properties of dental filling materials under the influence of an electromagnetic field

Restorative filling materials used for dental caries prevention and treatment consist of various components including monomers or oligomers, which play a significant role in forming the main structure of these materials, as well as in characterising their physical, mechanical and chemical properties. The necessity for the development and improvement of structural characteristics of polymeric dental filling materials intended for caries prevention and their life duration increase served as the initiating factor of our research. According to the research purpose and challenges, we studied the changes in the physical, mechanical and chemical properties of composite filling materials with and without electromagnetic field influence. The investigations in vivo include the study of microstructural features of polymeric filling materials by scanning electron microscopy (SEM) and the investigations in vitro include the study of sealed and extracted human teeth chips by using X-ray spectral analysis. We also evaluated the changes in the strength characteristics of dental filling materials with and without electromagnetic field influence. The analysis of the obtained data indicates the presence of structural changes in polymeric dental filling materials, including the material microstructure condensation confirmed by the SEM results, an increase in the strength and adhesion characteristics and certain regularities of the chemical elemental composition concentration change in the area of hard tooth tissue and dental filling material. These scientific data will provide tooth caries prevention and promote the increase of treatment quality.

Age-related differences of tooth enamel morphochemistry in health and dental caries

Currently, dental caries is the main reason of patient visits to dentists. A great deal of scientific work is dedicated to the study of enamel caries. The reason for this is the necessity for more detailed study of the pathogenesis of dental caries and other pathological processes occurring in tooth enamel. The application of modern high-technological methods of research has made it possible to study enamel structure in detail. Hard dental tissues are composed of organic and inorganic components and water. The organic substance consists of proteins, lipids, and carbohydrates. At different ages, caries intensity may vary. The carious process often develops during the first months after the tooth eruption but much less in adulthood and old age. These processes are mainly associated with the mechanisms of ionic exchange between the oral cavity and hard dental tissues. Different groups of teeth are differently affected by the carious process. Previous studies have revealed that age is an important factor influencing on the structure and chemical composition of hard dental tissues. Various recent works at the Department of Therapeutic Dentistry of Voronezh N.N. Burdenko State Medical Academy (VSMA) have studied not only the structural-morphological features of the enamel in children and adults but also the level of metabolic processes inside it. As a result of aging, teeth change both the enamel structure and the level of its ionic processes, but unfortunately, these changes have not been well characterized in teeth with conventional age-specific differences.