Titanium tetrafluoride and dental caries: a systematic review

A scoping review on the association between early childhood caries and life on land: The Sustainable Development Goal 15

BACKGROUND

The Sustainable Development Goal 15 (SDG15) deals with protecting, restoring, and promoting the sustainable use of terrestrial ecosystems, sustainably managing forests, halting and reversing land degradation, combating desertification and halting biodiversity loss. The purpose of this scoping review was to map the current evidence on the association between SDG 15 and Early Childhood Caries (ECC).

METHODS

This scoping review was reported in accordance with the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. Formal literature searches were conducted in PubMed, Web of Science, and Scopus in March 2023 using key search terms. Studies with the criteria (in English, with full text available, addressing component of life on land, focusing on dental caries in humans, with results that can be extrapolated to control ECC in children less than 6 years of age) were included. Retrieved papers were summarised and a conceptual framework developed regarding the postulated link between SDG15 and ECC.

RESULTS

Two publications met the inclusion criteria. Both publications were ecological studies relating environmental findings to aggregated health data at the area level. One study concluded that the eco-hydrogeological environment was associated with human health, including caries. The other reported that excessive calcium was associated with the presence of compounds increasing groundwater acidity that had an impact on human health, including caries. The two ecological studies were linked to SDG 15.1. It is also plausible that SDG 15.2 and SDG 15.3 may reduce the risk for food insecurity, unemployment, gender inequality, zoonotic infections, conflict and migration; while SDG 15.4 may improve access to medicinal plants such as anticariogenic chewing sticks and reduction in the consumption of cariogenic diets.

CONCLUSIONS

There are currently no studies to support an association between ECC and SDG15 although there are multiple plausible pathways for such an association that can be explored. There is also the possibility of synergistic actions between the elements of soil, water and air in ways that differentially affect the risk of ECC. Studies on the direct link between the SDG15 and ECC are needed. These studies will require the use of innovative research approaches.

An AMSTAR assessment of the methodological quality of systematic reviews of oral healthcare interventions published in the Journal of Applied Oral Science (JAOS)

BACKGROUND

Systematic reviews are not an assembly of anecdotes but a distillation of current best available evidence on a particular topic and as such have an important role to play in evidence-based healthcare. A substantial proportion of these systematic reviews focus on interventions, and are able to provide clinicians with the opportunity to understand and translate the best available evidence on the effects of these healthcare interventions into clinical practice. The importance of systematic reviews in summarising and identifying the gaps in evidence which might inform new research initiatives is also widely acknowledged. Their potential impact on practice and research makes their methodological quality especially important as it may directly influence their utility for clinicians, patients and policy makers. The objectives of this study were to identify systematic reviews of oral healthcare interventions published in the Journal of Applied Oral Science (JAOS) and to evaluate their methodological quality using the evaluation tool, AMSTAR.

METHODS

Potentially eligible systematic reviews in JAOS were identified through an electronic search of the Scientific Electronic Library Online (SciELO). Details of the relevant aspects of methodology as reported in these systematic reviews were extracted from the full text publications. Methodological quality was assessed independently by two reviewers using the AMSTAR questionnaire.

RESULTS

Five systematic reviews were identified, one of which was subsequently excluded as it was a review of a diagnostic test. Summary AMSTAR scores for the four included reviews were: 1, 5, 2 and 4 out of a maximum score of 11 (range 1-5, mean 3) with only one of the reviews scoring 5.

CONCLUSION

AMSTAR evaluation of the methodological quality of the relatively small number of systematic reviews published in JAOS illustrated that there was room for improvement. Pre-publication and editorial appraisal of future systematic reviews might benefit from the application of tools such as AMSTAR and is to be recommended.

Role of titanium tetrafluoride (TiF(4)) in conservative dentistry: A systematic review

The role of fluoride to reduce demineralization and enhance remineralization of dental hard tissue has been well documented. Different forms of fluoride solutions have been topically used in dentistry as prophylactic agents against tooth decay. In the recent past, metal fluorides, especially titanium tetrafluoride, have become popular in the fraternity of dental research due to their unique interaction with dental hard tissue. Many studies on titanium tetrafluoride, with positive and negative conclusions, have been published in many research journals. This gives the reader a plethora of inconclusive results with one study neutralizing the outcome of other, which confuses us regarding the present status of titanium tetrafluoride in the field of dentistry. This is an endeavor to organize and present the various studies of this unique compound, to provide us with a lucid overall review of its versatile potential application in dentistry, along with its fallacy/drawbacks. We have discussed its role as a cariostatic agent, pit and fissure sealant, tooth desensitizer, against dental erosion, as a root canal irrigant and others.

Nanoleakage Inhibition Within Hybrid Layer Using New Protective Chemicals and Their Effect on Adhesion

Hybrid-layer degradation occurs because of acidic properties of currently used adhesive systems. Titanium tetrafluoride couples with tooth surface, and titanium compounds are not substituted. Caffeic acid phenethyl esther inhibits endogenous matrix metalloproteinases that cause hybrid-layer degradation. It was hypothesized that titanium tetrafluoride and caffeic acid phenethyl esther application on exposed dentine surfaces before adhesive applications would inhibit nanoleakage and hybrid-layer degradation without compromising the bond strength of the adhesives. In ultracut thin sections, human dentine–chemical agent–adhesive composite interfaces were observed under transmission electron microscope with complementary scanning electron microscopy. Microtensile bond strength tests were also accomplished. Titanium tetrafluoride and titanium tetrafluoride + caffeic acid phenethyl esther applications decreased bond strength values. Caffeic acid phenethyl esther showed decreased silver nitrate penetration for cements based on Bisphenol glycydilmethacrylate and methyl methacrylate, whereas cement based on 4-methacryloyloxyethyl trimellitate anhydride methyl methacrylate showed almost no infiltration. Caffeic acid phenethyl esther application before cementation could inhibit nanoleakage and biodegradation of the hybrid layer.