Advanced Caries Research Articles

Health Education On Prevention Of Advanced Caries With Atraumatic Restorative Treatment (ART) In Elementary School Students

Peserta didik sekolah merupakan individu yang terorganisir dalam kurun waktu tertentu dan selama itu kualitasnya terus ditingkatkan guna mencapai suatu tujuan yaitu peningkatan kualitas kesehatan gigi dan mulut. Tujuannya yaitu untuk meningkatnya pengetahuan dan sikap kader tentang kesehatan gigi dan meningkatkan ketrampilan kader dalam upaya pencegahan penyakit karies gigi dengan tehnik ART. Hasil observasi diperoleh masalah pada mitra Masih tinggi angka kesakitan gigi pada anak SD yang artinya dalam setiap anak sudah terjadi gigi berlubang 1 sampai 5 gigi bermasalah karies dini (lobang gigi). Pelaksana kegiatan yaitu Jeanne d’Arc Zavera Adam, S.Pd, M.Kes dan tim. Selain itu, kegiatan ini melibatkan mahasiswa tingkat III jurusan kesehatan gigi Poltekes Kemenkess Manado, para perawat gigi Puskesmas Tateli, kader UKGS dan para guru. Peserta didik SD Inpres Muntong diberikan edukasi agar dapat menurunkan angka karies lebih parah lagi (DMF-T) dan menurunkan angka kesakitan akibat karies sehingga tidak mengganggu proses belajar siswa. Kegiatan ini dilaksanakan pada Agustus 2024 berlokasi di SD Inpres Muntong Kabupaten Minahasa. Hasil kegiatan dilakukan tindakan Penambalan ART pada para peserta didik SD Inpres Muntong yang berjumlah 127 orang. Jumlah gigi yang dilakukan fissure sielant sebanyak 212 gigi, jumlahnya lebih banyak dari peserta karena setiap anak rata 2 gigi yang ditambal. Kesimpulan kegiatan ini yaitu pelaksanaan tindakan pencegahan karies lanjut yang dilakukan di SD Negeri Inpres Muntong telah berjalan dengan baik.

AI-initiated second opinions: a framework for advanced caries treatment planning

Integrating artificial intelligence (AI) into medical and dental applications can be challenging due to clinicians’ distrust of computer predictions and the potential risks associated with erroneous outputs. We introduce the idea of using AI to trigger second opinions in cases where there is a disagreement between the clinician and the algorithm. By keeping the AI prediction hidden throughout the diagnostic process, we minimize the risks associated with distrust and erroneous predictions, relying solely on human predictions. The experiment involved 3 experienced dentists, 25 dental students, and 290 patients treated for advanced caries across 6 centers. We developed an AI model to predict pulp status following advanced caries treatment. Clinicians were asked to perform the same prediction without the assistance of the AI model. The second opinion framework was tested in a 1000-trial simulation. The average F1-score of the clinicians increased significantly from 0.586 to 0.645.

Dental pulp mesenchymal stem cells-response to fibrin hydrogel reveals ITGA2 and MMPs expression

Regenerative endodontic procedures (REP) aim at reestablishing tooth vitality by replacing the irreversibly damaged dental pulp removed by the dental practitioner with a new functional one. The current treatment of advanced caries relies on the replacement of the inflamed or necrosed dental pulp with an inert filling material. This leads to a functional but non-vital tooth, which lacks the ability to sense dental tissue damage, and to protect from further bacterial attack. Therapeutic strategies inspired by tissue engineering called REP propose to regenerate a fully functional dental pulp directly in the canal space. Promising results were obtained using dental pulp mesenchymal stem cells (DP-MSCs) in combination with bio-inspired artificial and temporary 3D hydrogels made of extracellular matrix molecules such as collagen and fibrin biomacromolecules. However, the uncontrolled mechanisms of DP regeneration from DP-MSCs in 3D biomacromolecules fail to regenerate a fully functional DP and can induce fibrotic scarring or mineralized tissue formation to a non-negligible extent. The lack of knowledge regarding the early molecular mechanisms initiated by DP-MSCs seeded in ECM-made hydrogels is a scientific lock for REP. In this study, we investigated the early DP-MSC–response in a 3D fibrin hydrogel. DP-MSCs isolated from human third molars were cultured for 24 h in the fibrin hydrogel. The differential transcript levels of extracellular and cell surface genes were screened with 84-gene PCR array. Out of the 84 genes screened, 9 were found to be overexpressed, including those coding for the integrin alpha 2 subunit, the collagenase MMP1 and stromelysins MMP3, MMP10 and MMP12. Over-expression of ITGA2 was confirmed by RT-qPCR. The expression of alpha 2 integrin subunit protein was assessed over time by immunoblot and immunofluorescence staining. The increase in the transcript level of MMP1, MMP3, MM10 and MMP12 was confirmed by RT-qPCR. The overexpression of MMP1 and 3 at the protein level was assessed by immunoblot. MMP3 expression by DP-MSCs was observed by immunofluorescence staining. This work demonstrates overexpression of ITGA2 and of MMP1, 3, 10 and 12 by DP-MSCs cultured in a fibrin hydrogel. The main preliminary extracellular and cell surface response of the DP-MSCs to fibrin hydrogel seems to rely on a ITGA2/MMP3 axis. Further investigations are needed to precisely decipher the role of this axis in dental pulp tissue building. Nevertheless, this work identifies extracellular and cell surface molecules that could be potential checkpoints to be targeted to guide proper dental pulp tissue regeneration.

Immediate Implant Placement at an Inflammatory Periapical Cyst Site in the Aesthetic Area

A healthy 47-year-old woman consulted the Oral Surgery and Implantology Unit of the University Hospitals of Geneva with a request to treat her painful tooth 11 and replace the missing tooth 21. The dental history revealed that the patient had lost teeth 21 and 22 due to advanced caries. On clinical examination, tooth 11 showed an ill-fitting prosthetic crown with overhanging margins, an increased localized probing depth of 8 mm in the disto-vestibular area, and sensitivity to percussion. The edentulous site 21 showed horizontal bone atrophy. Radiological examination revealed a well-defined unilocular radiotransparent lesion surrounded by a thin radiolucent border, located at the apex of tooth 11 and measuring 10 × 8 mm. The treatment consisted of extraction of 11, enucleation of the apical lesion, and insertion of implants at sites 11 and 21 with simultaneous bone augmentation in a single surgical procedure, with aesthetic and functional results at 3-year follow-up without any complications. Our case highlights that immediate implant placement in cases of cystic periapical lesions represents a good valid alternative to standard treatment.

Fungi and bacteria occupy distinct spatial niches within carious dentin.

The role of bacteria in the etiology of dental caries is long established, while the role of fungi has only recently gained more attention. The microbial invasion of dentin in advanced caries especially merits additional research. We evaluated the fungal and bacterial community composition and spatial distribution within carious dentin. Amplicon 16S rRNA gene sequencing together with quantitative PCR was used to profile bacterial and fungal species in caries-free children (n = 43) and 4 stages of caries progression from children with severe early childhood caries (n = 32). Additionally, healthy (n = 10) and carious (n = 10) primary teeth were decalcified, sectioned, and stained with Grocott's methenamine silver, periodic acid Schiff (PAS) and calcofluor white (CW) for fungi. Immunolocalization was also performed using antibodies against fungal β-D-glucan, gram-positive bacterial lipoteichoic acid, gram-negative endotoxin, Streptococcus mutans, and Candida albicans. We also performed field emission scanning electron microscopy (FESEM) to visualize fungi and bacteria within carious dentinal tubules. Bacterial communities observed included a high abundance of S. mutans and the Veillonella parvula group, as expected. There was a higher ratio of fungi to bacteria in dentin-involved lesions compared to less severe lesions with frequent preponderance of C. albicans, C. dubliniensis, and in one case C. tropicalis. Grocott's silver, PAS, CW and immunohistochemistry (IHC) demonstrated the presence of fungi within carious dentinal tubules. Multiplex IHC revealed that fungi, gram-negative, and gram-positive bacteria primarily occupied separate dentinal tubules, with rare instances of colocalization. Similar findings were observed with multiplex immunofluorescence using anti-S. mutans and anti-C. albicans antibodies. Electron microscopy showed monomorphic bacterial and fungal biofilms within distinct dentin tubules. We demonstrate a previously unrecognized phenomenon in which fungi and bacteria occupy distinct spatial niches within carious dentin and seldom co-colonize. The potential significance of this phenomenon in caries progression warrants further exploration.

Mines of cytokine: A treasure trove in pulpal and periapical diseases.

Pulpitis is a special disease of dental pulp. It causes localized inflammation, due to various inflammatory mediators such as cytokines and chemokines. These inflammatory mediators are responsible for various reparative and resorptive processes in the dental pulp. The balance between these processes ultimately determines the viability of the tooth. Due to the important properties of various inflammatory markers, the correlation of cytokinin gene expression in various stages of inflammation becomes necessary to focus on. Several studies in the past have focused on the importance of such correlation to help in diagnostic applications. The nature of these inflammatory mediators can help us in diagnostic evaluation. Several attempts have been made to focus on these associations so that it can assist in making clinical decisions effectively. The data available are vast but are the most neglected topic. This review article briefly outlines and summarizes the importance of various inflammatory mediators such as cytokinin and chemokines in various pathways of pulpal and periapical inflammation in explanatory and diagrammatic forms. Knowledge gained about pulpal inflammatory response may aid in understanding the molecular level of inflammatory pulpal and periapical diseases, which shall modify our future diagnostic modalities. Several medicaments are used in the treatment of minimal to advanced dental caries which leads to periapical infections. Thorough understanding of these medicaments can resolve secondary infection and can improve the prognosis of the treated tooth.

Detection of caries and determination of treatment needs using DentMA teledentistry: A deep learning approach

Background: Teledentistry is considered capable of detecting dental caries remotely without direct contact with patients. Deep learning (DL) algorithms are trained with sufficient datasets to find patterns and models based on learning. By using a DL model, we propose a conceptual framework for the screening of dental caries using smartphones: the DentMA application, a new breakthrough in teledentistry technology. In this study, the DentMA teledentistry application was used for mobile screening for caries. Purpose: This study aimed to analyze the use of DentMA teledentistry to detect dental caries, enamel-dentin caries, and untreated caries, and to determine treatment needs in children. Methods: The participants of this study were 124 children aged 4–6 years. The study was conducted by having the participants’ mothers take intraoral clinical photos of the participants using the DentMA teledentistry application on their smartphones. For the photo to be taken, each participant was directed to sit upright, with the head looking straight ahead and the mouth open. Results: The results showed that DentMA teledentistry was capable of detecting dental, enamel-dentin, and untreated caries in children, and its ability to predict dental treatment needs was good (p < 0.005). Teledentistry screening using a mobile phone can detect not only caries but also a relationship between the complaints and the medical histories of patients with dental caries. Conclusion: The DentMA teledentistry application can detect dental caries in children according to the individuals’ complaints, including enamel-dentin caries and advanced caries, and can help determine treatment needs.

Retrospective comparison of articaine buccal infiltration and lidocaine intraosseous anesthesia in carious mandibular molars.

It is vital to identify more efficient anesthesia techniques for the restorative or endodontic treatment of mandibular molars. Both articaine buccal infiltration anesthesia (ABI) and lidocaine inferior alveolar nerve block anesthesia (LIANB) may not provide profound anesthesia, necessitating supplementary anesthesia. This study aimed to investigate whether lidocaine intraosseous lidocaine intraosseous anesthesia (LIO) is more suitable than ABI as primary anesthesia for caries treatment of mandibular molars. This study retrospectively analyzed patients treated for advanced caries according to the International Caries Detection and Assessment System (ICDAS) 5 and 6. The study involved 48 patients, split evenly between those receiving ABI and LIO, and examined the anesthesia success rate, pain during anesthesia, onset time, duration, and post-anesthesia lower lip numbness using Chi-square and Independent T-tests. In the ABI group, 17 patients (70.8%) did not require additional anesthesia, whereas all 24 patients (100%) in the LIO group did not require additional anesthesia (P < 0.001). ABI was associated with significantly higher pain during anesthesia, slower onset time, and longer duration of anesthesia than LIO. There was no significant difference in post-anesthesia lower lip numbness between the two methods. Intraosseous anesthesia using lidocaine is more effective for treating severe caries in the mandibular molars because of its higher success rate, decreased pain during anesthesia, faster onset, and shorter recovery time.

Video game playing and oral health in school-age children: A cross-sectional study in Turkey.

The aim of this study is to evaluate the relationship of video game playing with oral/dental health and harmful oral habits in school-age children. The daily video gamer (n = 77) and occasional video gamer (n = 77) children between 6 and 12 years old were included in the study. A questionnaire inquiring socio-demographic characteristics, video gaming and abnormal oral habits of the children was filled by parents. The children were examined intraorally and decayed-missing-filled tooth, the International Caries Detection and the Assessment-II System scores, dental plaque and gingival indices were recorded. Of the children; 42.9% daily video gamers played video games for between 1 and 2 h and 57.1% played for ≥2 h while all of the occasional video gamers spent for between 1 and 2 h on video game per day. The daily video gamer and occasional video gamer children were not different in terms of socio-demographic characteristics, frequency of having daily tooth brushing habit, using children's toothpaste and having regular dental checkup (P > 0.05). No statistically significant difference was present between the groups in terms of frequencies of abnormal oral habits and having at least one abnormal oral habit (P > 0.05). Severe gingivitis and advanced caries lesions were more common in daily video gamer group (14.2% vs. 3.9%, P = 0.025 and 90.9% vs. 70.9%, P = 0.026, respectively). Daily video gaming time was weakly correlated with plaque index (r = 0.26, n = 77, P = 0.024). Daily video gaming for ≥2 h increased the risk for severe gingivitis (odds (95% confidence interval) = 4.53 (1.07-19.23), P = 0.041) while daily video gaming for between 1 and 2 h decreased the risk for having abnormal oral habit (odds (95% confidence interval) = 0.39 (0.16-0.93), P = 0.034). In school age, daily video gaming may worsen oral and dental health compared with occasional video gaming. Particularly, an excessive video gaming time seems to be associated with poor oral health in school children.

COMPARISON OF ANTIBACTERIAL CHITOSAN OF HARUAN FISH SCALES (Channa striata) WITH Chlorhexidine gluconate AGAINST Lactobacillus acidophilus

Background: Lactobacillus acidophilus plays an important role in the development of caries, especially advanced caries. Mouthwash such as chlorhexidine is the main choice to prevent the colonization of caries-causing bacteria, but in long-term use it causes side effects, so that new, more biocompatible materials are needed, namely chitosan of Haruan fish scales (Channa striata), which contains an amine group (Nh2). Purpose: To analyze and compare the antibacterial effectiveness of chitosan haruan fish scales at concentrations of 2.5%, 5%, 7.5%, and 10% with chlorhexidine gluconate 0.2% on the growth of Lactobacillus acidophilus bacteria. Method: True Experimental Laboratory Research with a procedure consisting of making chitosan from Haruan fish scales through the processes of deproteination, demineralization, and deacetylization followed by an antibacterial test with 5 treatment groups on the growth of Lactobacillus acidophilus bacteria using the diffusion method with inhibition zone parameters on the test material. Result: Haruan fish scale chitosan has the lowest antibacterial effectiveness, namely a concentration of 2.5% with an average inhibition zone value of 8.6 mm, and the highest is a 10% concentration with an inhibition zone average value of 21.3 mm, and a concentration of Haruan fish scale chitosan. 10% had antibacterial effectiveness comparable to 0.2% chlorhexidine gluconate against the growth of Lactobacillus acidophilus bacteria. Conclusion: Haruan fish scale chitosan concentrations of 2.5%, 5%, 7.5%, and 10% had antibacterial effectiveness against the growth of Lactobacillus acidophilus bacteria, and a concentration of 10% was comparable to 0.2% chlorhexidine gluconate in inhibiting the growth of Lactobacillus acidophilus bacteria. Keywords : Caries, chitosan haruan fish scales, Lactobacillus acidophilus.

Evaluation of Direct and Indirect Pulp Capping With Biodentine in Vital Permanent Teeth With Deep Caries Lesions.

Pulp capping is a procedural method of preserving pulp vitality following deep caries damage or accidental pulp exposure. Biodentine is a calcium silicate material that has been promoted for use in pulp capping among various clinical applications. This study evaluated the outcome of pulp capping with Biodentine following curettage of deep caries in the case series of permanent mature teeth. The study was carried out on 40 teeth with advanced caries treated by direct and indirect pulp capping using Biodentine, within a follow-up of six months. This was carried out at the Department of Conservative Dentistry-Endodontics of the CCTD Ibn Rochd-Casablanca. Results: In this study, 43 teeth from 37 patients were treated with direct pulp capping and indirect pulp capping using Biodentine. The success rate of pulp capping was 90% at one month, 85% at three months, and 80% at six months. The results of the studies conducted using Biodentine indicate that it is a suitable material for direct and indirect pulp capping, due to its bioactivity and ability to form a dentinal bridge.

Microbial Indicators of Dental Health, Dysbiosis, and Early Childhood Caries

Dental caries lesions are a clinical manifestation of disease, preceded by microbial dysbiosis, which is poorly characterized and thought to be associated with saccharolytic taxa. Here, we assessed the associations between the oral microbiome of children and various caries risk factors such as demographics and behavioral and clinical data across early childhood and characterized over time the salivary and dental plaque microbiome of children before clinical diagnosis of caries lesions. Children (N = 266) were examined clinically at ~1, 2.5, 4, and 6.5 y of age. The microbiome samples were collected at 1, 2.5, and 4 y. Caries groups consisted of children who remained caries free (International Caries Detection and Assessment System [ICDAS] = 0) at all time points (CFAT) (n = 50); children diagnosed with caries (ICDAS ≥ 1) at 6.5 y (C6.5), 4 y (C4), or 2.5 y of age (C2.5); and children with early caries or advanced caries lesions at specific time points. Microbial community analyses were performed on zero-radius operational taxonomic units (zOTUs) obtained from V4 of 16S ribosomal RNA gene amplicon sequences. The oral microbiome of the children was affected by various factors, including antibiotic use, demographics, and dietary habits of the children and their caregivers. At all time points, various risk factors explained more of the variation in the dental plaque microbiome than in saliva. At 1 y, composition of saliva of the C4 group differed from that of the CFAT group, while at 2.5 y, this difference was observed only in plaque. At 4 y, multiple salivary and plaque zOTUs of genera Prevotella and Leptotrichia were significantly higher in samples of the C6.5 group than those of the CFAT group. In conclusion, up to 3 y prior to clinical caries detection, the oral microbial communities were already in a state of dysbiosis that was dominated by proteolytic taxa. Plaque discriminated dysbiotic oral ecosystems from healthy ones better than saliva.

Prevalence of Dental Caries in Patients on Renal Replacement Therapy—A Systematic Review

Patients under renal replacement therapy (RRT) often show oral problems, including dry mouth, periodontal and dental diseases. This systematic review aimed to evaluate the caries burden in patients on RRT. Therefore, a systematic literature search based on the databases PubMed, Web of Science and Scopus was performed by two independent individuals in August 2022. Search terms were: "caries" AND "dialysis", "caries" AND "renal replacement therapy", "caries" AND "kidney". The systematic process was complemented by manual search. Studies on adult patients (age ≥ 18 years), treated by any form of RRT and explicitly reporting caries prevalence or incidence were checked for their eligibility and subsequently analyzed qualitatively. For all included studies, a quality appraisal was applied. From the systematic search, 653 studies were identified, of which 33 clinical investigations were included in the qualitative analysis. The majority (31 studies) of all included patients underwent hemodialysis (HD), with a sample size between 28 and 512 participants. Eleven studies investigated a healthy control group. Oral examinations were heterogeneous across studies; the caries burden was primarily assessed by decayed-(D-T), missing- and filled-teeth index (DMF-T). The number of decayed teeth ranged between 0.7 and 3.87 across studies. Only six out of these 11 studies found significant differences in caries prevalence/incidence between RRT and controls, whereby only four studies confirmed worse caries burden in RRT individuals. No information was provided on caries stadium (initial caries, advanced caries, invasive treatment need), caries activity or location (e.g., root caries) across studies. Most of the included studies were assessed to be of moderate quality. In conclusion, patients on RRT suffer from a high prevalence of dental caries. Alongside a need for further research in the field, improved, multidisciplinary, patient-centered dental care concepts are required to support dental and overall oral health in individuals on RRT.

Artificial intelligence (AI) in restorative dentistry: Performance of AI models designed for detection of interproximal carious lesions on primary and permanent dentition.

The objective of this study was to evaluate the effectiveness of deep learning methods in detecting dental caries from radiographic images. A total of 771 bitewing radiographs were divided into two groups: adult (n = 554) and pediatric (n = 217). Two distinct semantic segmentation models were constructed for each group. They were manually labeled by general dentists for semantic segmentation. The inter-examiner reliability of the two examiners was also measured. Finally, the models were trained using transfer learning methodology along with computer science advanced tools, such as ensemble U-Nets with ResNet50, ResNext101, and Vgg19 as the encoders, which were all pretrained on ImageNet weights using a training dataset. Intersection over union (IoU) score was used to evaluate the outcomes of the deep learning model. For the adult dataset, the IoU averaged 98%, 23%, 19%, and 51% for zero, primary, moderate, and advanced carious lesions, respectively. For pediatric bitewings, the IoU averaged 97%, 8%, 17%, and 25% for zero, primary, moderate, and advanced caries, respectively. Advanced caries was more accurately detected than primary caries on adults and pediatric bitewings P < 0.05. The proposed deep learning models can accurately detect advanced caries in permanent or primary bitewing radiographs. Misclassification mostly occurs between primary and moderate caries. Although the model performed well in correctly classifying the lesions, it can misclassify one as the other or does not accurately capture the depth of the lesion at this early stage.

Outcome of Direct Pulp Capping Using Calcium Hydroxide: A Long-term Retrospective Study

IntroductionThis retrospective study evaluated the long-term outcome of direct pulp capping in mature teeth using specific case selection and treatment procedures. MethodsTeeth with pulp exposure due to advanced caries and clinical diagnosis of reversible pulpitis were treated by direct pulp capping. Treatments were conducted over a period of 15 years by a single operator. Under magnification, caries was completely removed, the exposed pulp examined, and capped with either pure calcium hydroxide or a calcium hydroxide-based cement. The cavity was restored and the long-term outcome evaluated from 1 to >35 years. Teeth that were asymptomatic, responded to sensibility pulp tests within normal limits, and showed no radiographic periapical changes were categorized as success. Teeth with no response to pulp tests and/or showing radiographic evidence of apical periodontitis were classified as failures. The effects of independent variables (sex, age, symptoms, number and size of pulp exposures, bleeding time, capping material, bases used over the capping material, and final coronal restoration) on the outcome were evaluated. ResultsIn general, 225 teeth from 148 patients were available for follow-up examination in at least one of the evaluated periods. The success rate of the direct pulp capping procedure was 100%, 95%, 95%, 86%, and 89% at 1-, 5-, 10-, 20-, and 35-year follow-up examination, respectively. The main variable significantly affecting the treatment outcome in all follow-up periods was the quality/presence of coronal restoration (P < .001). Other isolated variables associated with the outcome included the size and number of pulp exposures at the 20-year follow-up, and the exposure size, capping material, and restoration type at the 35-year follow-up. Multiple regression analysis confirmed the results for exposure size (P < .05), and disclosed a higher proportion of failures at 5 years when varnish was used as the base. ConclusionsA very high success rate of the direct pulp capping with calcium hydroxide was observed, especially in the first 10 years following treatment. The main variable influencing the outcome was the quality of the coronal restoration.

Identification of a new familial case of 3q29 deletion syndrome associated with cleft lip and palate via whole-exome sequencing.

Many unbalanced large copy number variants reviewed in the paper are associated with syndromic orofacial clefts, including a 1.6Mb deletion on chromosome 3q29. The current report presents a new family with this recurrent deletion identified via whole-exome sequencing and confirmed by array comparative genomic hybridization. The proband exhibited a more severe clinical phenotype than his affected mother, comprising right-sided cleft lip/alveolus and cleft palate, advanced dental caries, heart defect, hypospadias, psychomotor, and speech delay, and an intellectual disability. Data analysis from the 3q29 registry revealed that the 3q29 deletion increases the risk of clefting by nearly 30-fold. No additional rare and pathogenic nucleotide variants were identified that could explain the clefting phenotype and observed intrafamilial phenotypic heterogeneity. These data suggest that the 3q29 deletion may be the primary risk factor for clefting, with additional genomic variants located outside the coding sequences, methylation changes, or environmental exposure serving as modifiers of this risk. Additional studies, including whole-genome sequencing or methylation analyses, should be performed to identify genetic factors underlying the phenotypic variation associated with the recurrent 3q29 deletion.

To What Extent is Each Area of Oral-Maxillofacial Surgery Practiced in the United States Today?

To What Extent is Each Area of Oral-Maxillofacial Surgery Practiced in the United States Today?

Relationship Between Dental Caries and YKL-40 Levels in Saliva.

YKL-40, a new biomarker of localized inflammation, is secreted by macrophages and regulates inflammation and immune responses. The aim of this study was to investigate YKL-40 levels in saliva and compare the level of this mediator in healthy and unhealthy oral cavity. 80 children (42-girl, 38-boy), aged 6-15 (mean±SD: 9.35±2.08) were included in this cross-sectional study. The children were divided into four groups: Group-I (control, n=20, dmft/DMFT=0), Group-II (n=20, exist of dental caries), Group-III (n=20, exist of advanced dental caries without pulp exposure), and Group-IV (n=20, exist of advanced dental caries with pulp exposure). The dmft/DMFT, dmfs/DMFS, and the number of advanced dental caries according to the ICDAS and pufa/PUFA index were recorded. Saliva was collected and YKL-40 concentrations were measured. The highest level of YKL-40 was obtained in Group IV, followed by Groups III, II, and I, respectively (p<0.01). There was a positive correlation between YKL-40 and the number of caries There were no statistically significant difference in YKL-40 levels in terms of age and gender (p>0.05). The advanced dental caries with pulp exposure may play an important role in the increasing levels of YKL-40 in saliva.

Automated recognition of dental caries using K-Means and PCA based algorithm

Tooth decay was low in pre-agricultural societies. For the past 10,000 years, globally, we can see an increase in tooth decay between 1650 and 1800 that the science of modern dentistry developed. Dental caries are derived from the Latin word for “ROTTEN” or “DECAY” teeth are unevenly distributed, according to WHO(World Health Organization), and by literature study, we can say that more than 90% of the adults have problems with dental caries. Driven by sugar, it is a multi-factorial, dynamic disease that causes demineralization of the dental hard tissue in phases. Caries can occur at any age, affecting both primary and permanent dentitions where damage is caused to the tooth&apos;s crown leading to exposed root surfaces in old age. Tooth decay occurs in three stages 1) ENAMEL 2) DENTIN 3) PULPITIN. This primer aims to provide an “AUTOMATED NON-SUPERVISED” method for detecting dental caries based on color images. Visual-tactile inspection is not sustainable for curing. A computer-aided system for advanced Dental caries using image processing. It is a method that helps the medical doctor to diagnose and detect dental diseases accurately. The study says that an accurate computed image processing system can enhance medical practitioners’ performance and reduce errors and diagnosis time.

Assessment of Oral Health and Treatment Needs in Population with Visual Impairment

Background: Visually impaired individuals when compared to healthy have poor oral health status as they cannot visualize the plaque deposits on the tooth surface, leading to poor understanding of the importance of oral hygiene which results in development of dental caries as well as inflammatory disease of the periodontium and loss of tooth structure. Aim: The study aims to assess the oral health and treatment needs of patients with visual impairment using WHO Oral Health Assessment form for adults 2013. Materials and Methods: A cross-sectional study was conducted on 207 visually impaired patients who visited the special care dentistry department, a unit of Oral Medicine and Radiology in a private dental college &amp; hospital and a private blind institute. WHO Oral Health Assessment form was filled after oral examination was done using Type III clinical examination. Statistical Analysis: Descriptive analysis was used to describe the frequencies and percentages. Chi-square test was used to determine statistical significance. Results and Conclusion: Dental caries were present in 129 (62.3%) study participants. Oral mucosal lesion was prevalent in 14% of the study population. 146 (71%) participants required prompt dental treatment such as scaling, restorations, extractions, 58 (28%) participants required immediate dental treatment due to presence of pain or infection of dental origin such as advanced dental caries, periapical abscess and OPMD. Only 3 (1%) participants out of 207 did not require any dental treatment. The findings of the study suggest that the dental treatment needs are high and unmet in the visually impaired population.