Selective removal compared to complete removal for deep carious lesions

Selective Caries Removal: A Case Report with 21-Year Follow-Up

Dental caries remains the most prevalent chronic disease globally, and its management should adhere to the principles of minimal intervention dentistry. This study reports a series of successful cases involving the selective removal of carious tissue in permanent molars, with follow-up periods of up to 21 years. Six permanent molars with severe and deep carious lesions were treated with selective caries removal and restored with high-viscosity glass ionomer cement. Clinical examination revealed that the teeth were free from pain and sensitivity. Follow-up assessments were conducted at 7 and 21 years posttreatment. Treatment success was defined by the absence of clinical and radiographic signs, symptoms of pulp alterations, and lesion arrest. Successful minimally invasive approaches were observed with selective removal of carious tissue and maintenance of pulp vitality for up to 21 years.

Effectiveness of the use of platelet-rich fibrin associated with open flap debridement compared to open flap debridement alone for the treatment of periodontal intrabony defects: Overview of systematic reviews

In the recent years, platelet-rich fibrin (PRF) has gained importance in regenerative medicine due to its attributed tissue-inducing properties. However, it is still unclear whether there are benefits from using PRF with open flap debridement (OFD) for the treatment of intrabony defects compared to OFD alone. For this reason, in this study, we performed an overview of systematic reviews with Friendly Summaries of the Body of Evidence using Epistemonikos methodology on the use of PRF with OFD compared to OFD alone for the treatment of intrabony defects. We performed a systematic search in the Epistemonikos database. We extracted data from the included systematic reviews and reanalyzed the data of primary studies and generated a summary of the findings table. We used Review Manager (RevMan) v5.3 software and GRADEpro software for data analysis and data presentation. Eighteen systematic reviews were included after full-text screening, which had 16 clinical trials. Results were reported by the mean difference (MD); the following outcomes were analyzed: change in intrabony defect depth (MD: 1.37 mm more), change in radiographic bone defect filling (MD: 37.26% more), change in probing depth (MD: 1.22 mm more), change in clinical attachment level (MD: 1.32 mm more), and change in gingival margin level (MD: 0.31 more). We concluded that applying PRF with OFD to treat an intrabony defect has some clinical advantages compared to OFD alone.

Photoinactivation of multispecies cariogenic biofilm mediated by aluminum phthalocyanine chloride encapsulated in chitosan nanoparticles

This study aimed to characterize the aluminum phthalocyanine chloride (AlClPc) encapsulated in chitosan nanoparticles (CN) and apply it in antimicrobial photodynamic therapy (aPDT) on multispecies biofilm composed of Streptococcus mutans, Lactobacillus casei, and Candida albicans to analyze the antimicrobial activity and lactate production after treatment. Biofilms were formed in 24-well polystyrene plates at 37 °C for 48 h under microaerophilia. The following groups were evaluated (n = 9): as a positive control, 0.12% chlorhexidine gluconate (CHX); phosphate-buffered saline (PBS) as a negative control; 2.5% CN as release vehicle control; the dark toxicity control of the formulations used (AlClPc and AlClPc + CN) was verified in the absence of light; for aPDT, after 30 min incubation time, the photosensitizers at a final concentration of 5.8 × 10^-3 mg/mL were photoirradiated for 1 min by visible light using a LED device (AlClPc + L and AlClPc + CN + L) with 660 nm at the energy density of 100 J/cm². An in vitro kit was used to measure lactate. The biofilm composition and morphology were observed by scanning electron microscopy (SEM). The antimicrobial activity was analyzed by quantifying colony forming units per mL (CFU/mL) of each microorganism. Bacterial load between groups was analyzed by ANOVA and Tukey HSD tests (α = 0.05). A lower lactate dosage was observed in the aPDT AlClPc + CN + L and CHX groups compared to the CN and AlClPc groups. The aPDT mediated by the nanoconjugate AlClPc + CN + L showed a significant reduction in the viability of S. mutans (3.18 log10 CFU/mL), L. casei (4.91 log10 CFU/mL), and C. albicans (2.09 log10 CFU/mL) compared to the negative control PBS (p < 0.05). aPDT using isolated AlClPc was similar to PBS to the three microorganisms (p > 0.05). The aPDT mediated by the nanoconjugate AlClPc + CN + L was efficient against the biofilm of S. mutans, L. casei, and C. albicans.