Dental Caries

Bonding to demineralized dentin of a diseased tooth has shown to be a significant clinical issue. This study evaluated the effect of 0.2% NaF-(NaF), MI Paste™-(CPP-ACP) and the self-assembling peptide 'P 11−4 ′ (Ace-QQRFEWEFEQQ-NH 2) contained in Curodont™ Repair, have on microtensile bond strength-(µTBS) of two different adhesive systems (Adper™ Single Bond-(SB) or Clearfil™ SE Bond (CSE)) and wettability of deminer-alized dentin slices after remineralising agents were applied. The highest µTBS were found for the demineralized dentin-(DD) treated with CPP-ACP; both adhesives systems (p < 0.05) did not significantly difference from P 11-4 treatment associated with SB, and also presented higher values than sound dentin-(SD/SB) (p < 0.01). DD treated with P 11−4 associated with CSE did not differ from DD/CSE (p > 0.05). The NaF treatment associated with CSE recovered the bond strength values of SD/CSE and associated with CSE demonstrated lower µTBS than other groups, although significantly higher than DD (p < 0.05). P 11−4 and CPP-ACP increased significantly the wettability of demineralized dentin (p < 0.05); etching acid improved wettability for all groups (p < 0.05), whilst NaF did not affect the wettability of demineralized dentin (p > 0.05). Morphological analysis of the dentin surface and dentin-resin interface revealed unique features of the applied remineralizing agent. The results indicated that self-assembling peptide P 11−4 associated with SB and CPP-ACP associated with SB or CSE significantly enhanced the bond strength to demineralized dentin (p < 0.05). We conclude that by modifying the dentine surface and restoring conditions found on sound dentin, this can enhance the interfacial bonding.

It is evident from the number of published scientific papers on Early Childhood Caries (ECC) that interest in this problem has grown in recent years. Many authors have been trying to devise a clear definition or classification for ECC. The aim of this review was to inventory the prevalence of ECC and to seek a consensus regarding definition and diagnosis. Further attention was paid to the aetiological factors including the role of microrganisms. Finally, education, parenting and treatment procedures were discussed. For this review, epidemiological studies on caries prevalence in children aged between 0 and 36 months were compiled through a systematic approach using Medline. This clearly showed that ECC continues to be a serious public health problem and that there is a great variety of definitions and diagnoses used worldwide, reflected in the prevalence data. This review confirms the multicausal aetiology and the need for further research. The authors strongly support the recommend...

It has been argued that specific salivary proteins could have a protective effect against caries, but data from the many available studies are rather contradictory. The purpose of this study was to analyze whether there is a relationship between protein concentration, electrophoretic profile and concentration of salivary IgA and the presence or absence of caries in adults. Adults with high caries activity (HC) and without caries lesions (CF), assessed by ICDAS criteria, were asked to provide unstimulated saliva samples. Protein concentration (μg/mL) was determined using the Bradford method. Western blotting was used to detect IgA. Data were compared using Student&#39;s t test at p&lt;0.05. Total protein concentration in CF was higher (50.65±7.5 μg/mL) than in HC individuals (26.80±2.5 μg/mL) (p=0.001). More protein bands were visualized in the gels from CF than the HC group (p=0.001). CF subjects showed higher salivary IgA concentration (11.27±0.5 μg) than HC individuals (1.71±0.2μg...

Objectives: Elimination of etiological factors is great importance in the treatment of dentin hypersensitivity (DH). The aim of this study is to compare the effect of DH etiology and risk factors on different treatment methods [5% sodium fluoride (Duraphat fluoride varnish), 5% glutaraldehyde-35% hydroxyethyl methacrylate (Gluma desensitizer), 8% arginine and calcium carbonate-containing desensitizing paste (Pro-Argin) and erbium-doped yttrium aluminum garnet (Er:YAG) laser]. Methods: 40 patients (16 male and 24 females) with 200 teeth affected by DH and bruxism were included in this study. The patients were divided into two main groups. In the first group, there were patients who could not regularly use the night guard for bruxism due to individual reasons, and who could not complied advices on nutrition and oral hygiene habits (Group-A). The second group consisted of patients who could regularly use the night guard and could complied advices (Group-B). Then, both groups were divided into five subgroups: Group 1: Duraphat fluoride varnish, Group 2: Gluma desensitizer, Group 3: Pro-Argin, Group 4: Er:YAG laser Group 5: Control. DH was assessed with a visual analog scale (VAS); before the treatment, immediately, 1, 4, and 12 weeks after the treatment. The obtained data were evaluated statistically. Results: In both groups, it was seen that the most effective treatment methods were the Er:YAG laser and Pro-Argin. Gluma desensitizer and Duraphat fluoride varnish were also found to be effective in DH compared with control group, but they were not found to be as successful as the Er:YAG laser and Pro-Argin in the long term. It was found that all treatment methods, including the control group, applied to Group-B significantly increased their activities compared to Group-A in the 4 and 12 weeks (p<0.05). Conclusions: It has been found that the success rates of all treatment methods are increased when the etiological factor can be eliminated. It was also observed that Er:YAG laser and Pro-Argin demonstrated statistically similar success rates in both groups. It was seen that Er:YAG laser and Pro-Argin could have hope for long-term DH treatment.

To assess oral health and oral health associated factors in 12-year-olds and to establish determinants explaining variation in oral health among children representing two areas in the Barents region - Arkhangelsk in North-West Russia and Tromsø in Northern Norway. The samples consisted of Russian (N=590) and Norwegian (N=264) 12-year-olds and their parents selected according to stratified one-stage cluster design. The study included clinical examination (children) and self-reports (children and parents). The child&#39;s oral health was recorded under field conditions. Statistical analyses were conducted on pooled samples of subjects. The mean DMFT/S-scores were 3.0/4.4 for the Russian and 1.2/1.5 for the Norwegian children (p&lt;0.001). In multiple logistic regressions, country of origin (OR=3.8) and filling obtained during last dental visit (OR=5.0) were showing the strongest association with child&#39;s dental caries (χ(2)=87; p&lt;0.001). Among parent&#39;s variables showing the ...

Purpose: The objective of the present study was to evaluate whether sensitivity to bitter taste and perception of sweet taste have an influence on dental caries in urban and rural areas. Materials and methods: The caries experience in 181 children, aged 12 years, from rural and urban areas of southern Brazil, was assessed according to World Health Organization guidelines. Sensitivity to the bitterness of phenylthiocarbamide was determined using the Harris–Kalmus procedure, and the sweet taste thresholds of sucrose were measured by Nilsson and Holm's method. Results: The caries index (DMFT > 0) was 3.73 (SD = 2.26) in the rural area and 3.51 (SD = 2.14) in the urban area. The sensitivity to bitter taste and sweet taste perception showed significant association with the gender of schoolchildren (P = 0.04). Girls were predominant in the high sweet perception taster group (62.3%) and the bitter taster group (59.4%). No significant difference in sweet perception status could be observed between the groups of low and high caries severity. The genetic ability to taste bitterness significantly influenced the levels of caries only in children from the urban area (P = 0.005). Bitter non-tasters presented higher severity of caries. A positive correlation was observed between sensitivity to bitter taste and sweet taste perception among children in the rural (r = 0.42, P = 0.002) and urban areas (r = 0.36, P = 0.001). Conclusions: These findings suggest that the bitter non-tasters are more susceptible to dental caries than the tasters in the urban area.

Pediatricians are in an ideal position to advise families about the prevention and management of oral diseases in children. The objective of the study was to determine knowledge, attitude, and practices regarding the prevention of oral diseases among pediatricians in Italy. A systematic random sample of 1000 pediatricians received a questionnaire on socio-demographic and practice characteristics; knowledge on risk factors; attitude and practices towards the prevention of oral diseases. A total of 507 pediatricians participated. More than half knew the main risk factors for oral diseases and this knowledge was higher in primary care pediatricians (p = 0.007), in those with a higher number of hours worked per week (p = 0.012), and who believed that oral diseases may be prevented (p = 0.017). Pediatricians with higher knowledge about the main risk factors (p = 0.006) believe that they have an important role in preventing oral diseases and that they can perform an oral examination. Almo...

Objective To assess the effectiveness of motivational interviewing in preventing early childhood caries compared with conventional oral health education. Study design Twelve health care units in southern Brazil were randomly allocated in 2 groups of 6 and professionals in 1 group were trained in motivational interviewing. The mothers/children and external examiners were blinded to the intervention. The data were collected by calibrated examiners using questionnaires and a clinical examination based on modified International Caries Detection and Assessment System criteria. Of the 674 children born in the catchment area in the year 2013, 469 received the intervention (224 in the conventional oral health education group, 245 in the motivational interviewing group), and 320 were examined by the end of the study (145 in the conventional oral health education group, 175 in the motivational interviewing group), with mean age of 30 months. The final follow-up was 68%, after 3 years. Results Mean of decayed, missing, and filled surfaces at the end of the study period for the whole sample was 1.34 (95% CI 0.97-1.71). The caries rate per 100 surface-year in the conventional oral health education group was 1.74 (95% CI 1.14-2.34) and in the motivational interviewing group, it was 0.92 (95% CI 0.63-1.20). To correct for clustering effect and unbalanced factors, multilevel Poisson regression was fitted and the effect of motivational interviewing on the incidence rate ratio was 0.40 (95% CI 0.21-0.79). Conclusions An intervention based on the principles of motivational interviewing style was more effective in reducing the number of surfaces affected by early childhood caries compared with conventional oral health education intervention. (J Pediatr 2018;■■:■■-■■). Trial registration ClinicalTrials.gov NCT02578966, Brazilian Registry of Clinical Trials RBR-8fvwxq. M otivational interviewing is a strategy aimed at changing behavior based on the premise that the reasons to do so are individual and subjective. 1 In this patient-centered approach, patients are responsible for making the choices among the different alternatives and encouraged to make their own decisions. 1,2 Motivational interviewing has emerged as an alternative to address a series of undesirable behaviors, such as unhealthy eating habits, lack of physical activity, and smoking. 3-5 Motivational interviewing has shown different degrees of effect in preventing early childhood caries in clinical trials involving pregnant women and mothers of young children. Although some studies indicate that it can prompt behavioral changes, 6 reduce the severity of carious lesions, 7 and decrease the number of decayed teeth, 8,9 others found no clinical effect. 6 These differences cannot be explained by methodologic differences alone. Although the number of motivational interviewing sessions may provide a partial explanation, contextual factors that affect the incidence of new lesions may also be relevant. Those studies addressed different populations, namely indigenous Canadians, African Ameri-cans, and Asian immigrants. The aim of this study was to assess the effectiveness of motivational interviewing compared with conventional oral health education in preventing early childhood caries in a public health service. Methods This was a randomized community-based trial with parallel groups, whereby children/mothers and external examiners did not know to which intervention group the children's mothers had been allocated. The project was approved by the GHC Research Ethics Committee (protocol no. 13-063 and CAAE no. 15015013.0.0000.5530). The protocol remained unchanged throughout the study. The trial was registered in the Brazilian Registry of Clinical Trials (ReBEC:

The erroneous claim that 50 percent of U.S. schoolchildren have never had a cavity has taken on the virtues of truth through frequent and widespread restatement. The 50-percent caries-free statement is an excessively optimistic misrepresentation by the media of the 1986-87 survey of oral health among schoolchildren by the National Institute of Dental Research because it only tells part of the story--it ignores dental disease in the primary dentition. This article documents that numerous public policy papers reflect failure to consider primary tooth caries data. Consequently, a significant disease burden has been overlooked. The article reviews the persistent underreporting of children&#39;s caries experience in policy documents and the dental literature, and reviews additional epidemiologic studies of caries reported in U.S. dental literature since 1985. Dental caries remains the single most common disease of childhood that is not self-limiting or amenable to a course of antibiotics...

Key Words: dental caries, preschool, racdethnicity, Head Start, socioeconomic status, feeding practices. ... California is among the most popu-lated and ethnically diverse states in the country. It is also among the states with the lowest proportion of the population with ...

In situ caries models serve purposes other than just being a simpler way to obtain data than running a clinical trial. However, variation in information obtained not only among individuals but also, in particular, depending on different locations of the models within the oral cavity have so far been given little attention. In the present review, the aim has been to characterize the different designs of in situ caries models and to describe some important factors which may vary within the oral cavity and thus influence the outcome of the way the different in situ models are used. Advantages and disadvantages of in vivo models vs. in situ models are discussed. In the latter case, the distinction is made between dental appliance models and so-called &quot;single tooth&quot; models. The review concludes that in situ models differ distinctly with regard to their &quot;biological potential&quot;. Because of regional differences in salivary film velocity, pH, and composition of the microfl...

Previous studies suggest that salivary and pulp-derived host enzymes, matrix metalloproteinases (MMPs), may be involved in dentin caries pathogenesis. To study the inhibition of acid-activated human salivary MMPs by non-antimicrobial chemically modified tetracyclines (CMTs), we used a functional activity assay with 125I-labeled gelatin as a substrate. To address the role of MMPs in the progression of fissure caries in vivo, we administered the MMP inhibitors CMT-3 and zoledronate to young rats per os for 7 weeks, 5 days a week. Caries lesions were visualized by Schiff reagent in sagittally sectioned mandibular molars. Marked reduction in gelatinolytic activity of human salivary MMPs was observed with CMT-3. CMT-3 and zoledronate, both alone and in combination, also reduced dentin caries progression in the rats. These results suggest that MMPs have an important role in dentin caries pathogenesis, and that MMP inhibitors may prove to be useful in the prevention of caries progression.

Host-associated microbial communities are influenced by both host genetics and environmental factors. However, factors controlling the human oral microbiome and their impact on disease remain to be investigated. To determine the combined and relative effects of host genotype and environment on oral microbiome composition and caries phenotypes, we profiled the supragingival plaque microbiome of 485 dizygotic and monozygotic twins aged 5-11. Oral microbiome similarity always increased with shared host genotype, regardless of caries state. Additionally, although most of the variation in the oral microbiome was determined by environmental factors, highly heritable oral taxa were identified. The most heritable oral bacteria were not associated with caries state, did not tend to co-occur with other taxa, and decreased in abundance with age and sugar consumption frequency. Thus, while the human oral microbiome composition is influenced by host genetic background, potentially cariogenic tax...

Objectives: The present study aimed to assess the antibacterial activity against bacteria with cariogenic relevance , toxic and genotoxic potential of the plants Anacardium occidentale L. and Anadenanthera macrocarpa (Benth.) Bernam. Design: Using a microdilution technique, the extracts were submitted to minimum inhibitory concentration (MIC) testing against Streptococcus mitis (ATCC 903), Streptococcus mutans (ATCC 25175), Streptococcus oralis (ATCC 10557), Streptococcus salivarius (ATCC 7073), Streptococcus sanguinis (ATCC 15300) and Streptococcus sobrinus (ATCC 27609). The toxicity of the extracts was then verified against eukaryotic cells. Additionally, a micronucleus assay was performed to investigate the potential mutagenic effects of the extracts on rat ery-throcytes. The Student's t-test, Bonferroni test, and one-way ANOVA followed by Tukey's tests were used for statistical analysis, at a significance level of 5%. Results: While the A. occidentale extract was able to inhibit all of the tested strains, with S. mutans and S. mitis being the most susceptible to that extract́sextract́s action, the A. macrocarpa did not show antimicrobial activity. Interestingly, the hemolytic, oxidant and antioxidant activities were slightly observed for either extract, even at high concentrations (1000 mg/mL). The micronucleus assay showed no significant changes in the cells exposed to the extracts. Conclusion: The A. occidentale extract has potential as an antimicrobial agent with low eukaryotic cell toxicity or mutagenic activity. The A. macrocarpa extract, although absent of antibacterial activity might as well be a safe and effective phytotherapeutic alternative.

ABSTRACT : The root canal system is an arborizational, anastomotic, byzanthine, labyrinthine complexity, morphologically comparable to a mosaic. While primary canals exist, the tributaries, accessory branches and lumina of dentinal tubules harbour extensive tissue and microflora which if left untreated remains vector for persistent and refractory pathology. Therefore root canal  shaping and cleaning is of utmost importance in the success of root canal treatment. Number of systems are available for effective shaping accounting from hand files to nickel titanium rotary files to the new single file concept “WAVE ONE” KEYWORDS : Wave One, Reciprocating Motion, Nickel Titanium, Reverse  Balanced Force Technique, vCJD
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