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Tassery H, Miletic I, Turkun LS, Sauro S, Gurgan S, Banerjee A, Basso M, Khelafia S, Terrer E, Pilliol V, Slimani A. Preventive management of carious lesions: from non-invasive to micro-invasive operative interventions. Br Dent J 2024; 236:603-610. [PMID: 38671111 DOI: 10.1038/s41415-024-7292-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 04/28/2024]
Abstract
Understanding that dental carious lesions occur as a result of the action of micro-organisms in the dental plaque biofilm, where demineralisation on the tooth surface is the first sign of the disease, such incipient lesions can be treated using preventive, non-operative and minimally invasive operative dentistry. If the caries process is left unmanaged, the lesions progress towards cavitation, leading to more invasive treatments. This article discusses the principles of preventive, non-invasive and micro-invasive treatments of early carious lesions, outlining the clinical situations where these therapies can be applied.
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Affiliation(s)
- Hervé Tassery
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France; LBN, Université de Montpellier, UR-UM104, Montpellier, France.
| | - Ivana Miletic
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gunduliceva ul. 5, 10000 Zagreb, Croatia
| | - Lezize Sebnem Turkun
- Department of Restorative Dentistry, Ege University School of Dentistry, Izmir 35040, Turkey
| | - Salvatore Sauro
- Dental Biomaterials and Minimally Invasive Dentistry, Department of Dentistry, CEU Cardenal Herrera University, CEU Universities, 46115 Valencia, Spain; Department of Therapeutic Dentistry, I. M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Sevil Gurgan
- Department of Restorative Dentistry, Faculty of Dentistry, Hacettepe University, Ankara 06100, Turkey
| | - Avijit Banerjee
- Conservative and Minimally Invasive Dentistry, Centre of Oral Clinical Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King´s College London, London, SE1 9RT, UK
| | - Matteo Basso
- Department of Biomedical, Surgical and Dental Sciences, University of Milano, Via Festa del Perdono 7, 20122 Milano, Italy
| | - Saber Khelafia
- Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Elodie Terrer
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Virginie Pilliol
- Ecole de Médecine Dentaire de Marseille, Université d'Aix-Marseille, 13385 Marseille, France; Institut Hospitalo-Universitaire Méditerranée-Infection, Aix-Marseille Université, MEPHI, AP-HM, 19-21 Boulevard Jean Moulin, 13385 Marseille, CEDEX 05, France
| | - Amel Slimani
- LBN, Université de Montpellier, UR-UM104, Montpellier, France; Faculté d'Odontologie, Université de Montpellier, 34193 Montpellier, France
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Effect of a Lactobacillus Salivarius Probiotic on a Double-Species Streptococcus Mutans and Candida Albicans Caries Biofilm. Nutrients 2017; 9:nu9111242. [PMID: 29135948 PMCID: PMC5707714 DOI: 10.3390/nu9111242] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/26/2017] [Accepted: 11/08/2017] [Indexed: 01/03/2023] Open
Abstract
The aim of the study was to evaluate the anti-cariogenic effects of Lactobacillus salivarius by reducing pathogenic species and biofilm mass in a double-species biofilm model. Coexistence of S. mutans with C. albicans can cause dental caries progression or recurrence of the disease in the future. Fifty-nine children with diagnosed early childhood caries (ECC) were recruited onto the study. The condition of the children's dentition was defined according to the World Health Organization guidelines. The participants were divided into children with initial enamel demineralization and children showing dentin damage. The study was performed on the S. mutans and C. albicans clinical strains, isolated from dental plaque of patients with ECC. The effect of a probiotic containing Lactobacillus salivarius on the ability of S. mutans and C. albicans to produce a double-species biofilm was investigated in an in vitro model. The biomass of the formed/non-degraded biofilm was analyzed on the basis of its crystal violet staining. The number of colonies of S. mutans and C. albicans (CFU/mL, colony forming units/mL) forming the biofilm was determined. Microorganism morphology in the biofilm was evaluated using a scanning electron microscope (SEM). In vitro analysis demonstrated that the presence of S. mutans increased the number of C. albicans colonies (CFU/mL); the double-species biofilm mass and hyphal forms produced in it by the yeast. L. salivarius inhibited the cariogenic biofilm formation of C. albicans and S. mutans. Under the influence of the probiotic; the biofilm mass and the number of S. mutans; C. albicans and S. mutans with C. albicans colonies in the biofilm was decreased. Moreover; it can be noted that after the addition of the probiotic; fungi did not form hyphae or germ tubes of pathogenic potential. These results suggest that L. salivarius can secrete intermediates capable of inhibiting the formation of cariogenic S. mutans and C. albicans biofilm; and may inhibit fungal morphological transformation and thereby reduce the pathogenicity of C. albicans; weakening its pathogenic potential. Further research is required to prove or disprove the long-term effects of the preparation and to achieve preventive methods.
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