Caries Activity Research Articles

Minimally invasive dentistry: history, theory and perspectives

The article is a literature review concerning certain aspects of the history of Russian dentistry. In this regard, minimally invasive methods are discussed, including air-abrasive, laser, sonic and ultrasonic preparation, as well as atraumatic restorative treatment without mechanical preparation. Indications for minimally invasive methods, assessment of caries activity and prognosis, causes and mechanisms of the accelerated restoration cycle are discussed. The need to preserve dental tissues has been undervalued in the past. Non-selective preparation to hard dentin is currently considered hypertherapy. The concept of minimally invasive dentistry is also applied in endodontics and periodontology. In patients with gingival recession, it is important to protect atrophic tissues from further damage. After a tooth extraction, excessive socket curettage should be avoided. The research in dentistry should be protected from conflicts of interest. Patients should be objectively informed about treatment options, given recommendations based on clinical indications, wishes and possibilities. It is also necessary to develop economic measures in order to reorient private dental clinics to receive patients with compulsory medical insurance and the use of minimally invasive methods.

Changes in Dental Biofilm Proteins' Secondary Structure in Groups of People with Different Cariogenic Situations in the Oral Cavity and Using Medications by Means of Synchrotron FTIR-Microspectroscopy.

This work unveils the idea that the cariogenic status of the oral cavity (the presence of active caries lesions) can be predicted via a lineshape analysis of the infrared spectral signatures of the secondary structure of proteins in dental biofilms. These spectral signatures that work as natural markers also show strong sensitivity to the application in patients of a so-called modulator-a medicinal agent (a pelleted mineral complex with calcium glycerophosphate). For the first time, according to our knowledge, in terms of deconvolution of the complete spectral profile of the amide I and amide II bands, significant intra- and intergroup differences were determined in the secondary structure of proteins in the dental biofilm of patients with a healthy oral cavity and with a carious pathology. This allowed to conduct a mathematical assessment of the spectral shifts in proteins' secondary structure in connection with the cariogenic situation in the oral cavity and with an external modulation. It was shown that only for the component parallel β-strands in the amide profile of the biofilm, a statistically significant (p < 0.05) change in its percentage weight (composition) was registered in a cariogenic situation (presence of active caries lesions). Note that no significant differences were detected in a normal situation (control) and in the presence of a carious pathology before and after the application of the modulator. The change in the frequency and percentage weight of parallel β-strands in the spectra of dental biofilms proved to be the result of the presence of cariogenic mutans streptococci in the film as well as of the products of their metabolism-glucan polymers. We foresee that the results presented here can inherently provide the basis for the infrared spectral diagnosis of changes (shifts) in the oral microbiome driven by the development of the carious process in the oral cavity as well as for the choice of optimal therapeutic treatments of caries based on microbiome-directed prevention measures.

The Turkish version of Caries Impacts and Experiences Questionnaire for Children: Translation, reliability, and validity.

Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) has been developed to assess the oral health-related quality of life (OHRQoL) associated with caries. This study aimed to evaluate the validity and reliability of the CARIES-QC in the Turkish-speaking population following its translation and adaptation into Turkish (CARIES-QC/T). Two hundred and fifty children between the ages of 5 and 16 years who have active dental caries were included in the study and answered the Turkish-translated and cross-culturally adapted final version of CARIES-QC/T. Test-retest reliability and internal consistency were used to examine the reliability of the CARIES-QC/T. Factor structure of CARIES-QC/T was analyzed using exploratory factor analysis (EFA), and convergent validity was determined. Cronbach's alpha and McDonald's ômega values were 0.907 and 0.908, respectively. For the CARIES-QC/T scale, the intraclass correlation coefficient (ICC) value was 0.933, and polychoric correlations ranged from 0.390 to 0.794. The convergent validity of the items revealed a statistically significant correlation with the global question (rs = 0.821, p < .001). The EFA results of CARIES-QC/T suggested a one-factor solution and explained 59.7% of the total variance. The findings provided supporting evidence that the CARIES-QC/T could be used as a tool for measuring OHRQoL in healthy Turkish-speaking children aged 5-16 years with active caries.

Evaluation and Comparison of the Efficacy of Chemo-Mechanical, Mechanical Methods of Caries Removal under Self-Illuminated Light Microscope and Stereomicroscope – An In Vitro Study

BACKGROUND&#x0D; There are different caries removal methods including conventional rotary caries removal, atraumatic restorative therapy, air abrasion, lasers, and chemo-mechanical caries removal (CMCR). Chemo-mechanical caries removal is an alternative treatment for active caries, that involves the caries removal of only infected dental tissue and acts by the dissolution of carious lesions with natural or synthetic agents.&#x0D; Aim&#x0D; Comparison of chemo-mechanical material (CariSolv) and the mechanical method (Smart bur &amp; Carbide bur) of caries removal under a self-illuminated microscope and stereomicroscope in terms of efficacy and time duration.&#x0D; METHODS&#x0D; Tooth was sectioned in 4 parts and grouped into 4 as group 1, group 2, group 3, and group 4. Each group was treated with different caries removal methods of carbide bur, smart bur, CariSolv and control group. Examined under self-illuminated and stereomicroscope at 10 different points from middle to periphery.&#x0D; RESULTS&#x0D; Carbide bur specimens have a negligible amount of affected dentin and there is a destruction of dentinal tubules when compared to the smart bur group &amp; CariSolv group. Showing affected dentin thickness in 4 groups at 10 different positions from the middle part of the lesion to the periphery (i.e., towards CEJ &amp; cusp tip) by using a stereomicroscope.&#x0D; CONCLUSIONS&#x0D; The CariSolv group demonstrated the presence of affected dentine higher and took twice the time to remove caries but was easy to induce and conserved the healthy tooth structure when compared to carbide and smart bur groups. Less amount of affected dentine was seen in the carbide bur group but there was a destruction of sound dentine.&#x0D;

Comparison of Caries Activity of Some Children's Beverages Inoculated with Streptococcus mutans

Comparison of Caries Activity of Some Children's Beverages Inoculated with <i>Streptococcus mutans</i>

Comparison of Caries Activity of Some Children's Beverages Inoculated with Streptococcus mutans

Comparison of Caries Activity of Some Children's Beverages Inoculated with <i>Streptococcus mutans</i>

Clinical performance of sealants under different humidity control conditions: a split-mouth 1-year randomized trial.

Sealants are an effective method of prevention and treatment for early caries lesions. This study analyzed the 1-year clinical performance of resin-based and ionomeric sealants applied to permanent teeth under different humidity conditions. The investigation was a triple-blind randomized clinical trial (RCT) with a four arms split-mouth design, divided according to the sealant protocol: (1) Resin-based sealant applied with rubber dam isolation, (2) Resin-based sealant applied with cotton rolls isolation, (3) Ionomeric sealant applied with rubber dam isolation and (4) Ionomeric sealant applied with cotton rolls isolation. Fifty-eight patients started the study (232 teeth), and 47 (188 teeth) remained until the 1-year recall. The modified USPHS criteria were used in the analyzes to investigate surface texture, retention and the presence of secondary caries lesions around the sealants; in the following periods: baseline, after 3, 6, 9, and 12months by two calibrated examiners. Data were analyzed by the Mann-Whitney and Friedman tests. There was no difference between the types of sealants (p > 0.05). The type of humidity control influenced the superficial texture (p = 0.0012) and the retention of sealants (p = 0.0023). The sealant displacement was greater under cotton rolls isolation. Only one active caries lesion in enamel was found in the 9th month. It may be concluded that sealants effectively prevented caries, even when they were partially or totally lost, regardless of the material. The rubber dam isolation with a rubber dam promoted lower surface roughness and improved the retention rates. International Clinical Trials Registry Platform: #1111-1215-2832 (07/26/2018).

Dental extractions do not predict further use of dental general anesthesia in people with disabilities: A longitudinal analysis.

This paper describes treatments completed under dental general anesthesia (DGA) for a cohort of adults with disabilities. This patient cohort was followed up a number of years later to determine outcomes and identify factors that predict further use of DGA. A retrospective patient record review and cross-sectional survey was carried out on a convenience sample of 64 patients who had previously received dental treatment under general anesthesia. Patient record review extracted data on patient demographics and treatment provided under DGA. Cross-sectional survey a number of years post-DGA collected data on oral care habits and current oral health based on a standardized clinical examination. Statistical analysis was carried out to identify predictors of repeat DGA. Participants received extensive treatment under DGA including preventive care, restorations, extractions, and root canal treatment. At follow-up 89.1% of participants had gingival disease and 56.3% had active dental caries. The mean number of teeth present was 21.2 (SD 6.9, range 6-32). Only caries risk status was found to be a significant predictor (p=0.03) with those with a high caries risk status 6.9 times (95%CI 1.2-39.3) more likely to receive a second DGA. Dentists extract teeth for people with disabilities under DGA in the mistaken belief that this will avoid the need for further DGA. This study found that extraction of teeth does not prevent the need for repeated episodes of DGA. Therefore, dentists should stop extracting teeth for this reason. Rather, if dentists want to avoid further DGA, they should do the basics well: consistent, evidence-based caries risk assessment and risk reduction.

Effect of the association of microparticles and nano-sized β-calcium glycerophosphate in conventional toothpaste on enamel remineralization: In situ study

ObjectivesThis in situ study aimed to assess the remineralizing effect of a fluoride toothpaste supplemented with β-calcium glycerophosphate in both micro (β-CaGPm) and nano-sized forms (β-CaGPn). MethodsThis blind and cross-over study was performed in 4 phases, each spanning 3 days. Twelve volunteers utilized palatal appliances containing four bovine enamel blocks with artificial caries lesions. Volunteers were randomly assigned to the following treatment groups: Placebo (no F-β-CaGPm-β-CaGPn); 1100 ppm F alone (1100F); 1100F plus 0.5% micrometric β-CaGP (1100F-0.5%β-CaGPm); and 1100F plus 0.25%nano-sized β-CaGP (1100F-0.25%β-CaGPn). Participants were instructed to brush their natural teeth with the palatal appliances in the mouth for 1 min (3 times/day), ensuring that the enamel blocks were exposed to the natural toothpaste slurries. Following each phase, evaluations were conducted to determine the percentage of surface hardness recovery (%SHR), integrated recovery of subsurface hardness (ΔIHR), profile subsurface lesion through polarized light microscopy (PLM), as well as fluoride (F), calcium (Ca), and phosphorus (P) concentrations within the enamel. Data were analyzed by ANOVA and Student-Newman-Keuls test (p < 0.001). ResultsTreatment with 1100F-0.25%β-CaGPn resulted in %SHR ∼69 % and ∼40 % higher when compared to 1100F and 1100F-0.5%β-CaGPm (p < 0.001). The reduction in lesion body (ΔIHR; PLM) was ∼40 % higher with 1100F-0.25%β-CaGPn (p < 0.001) compared to 1100F. The addition of β-CaGPm and β-CaGPn did not influence enamel F concentration (p > 0.001). Treatment with 1100F-0.25%β-CaGPn led to an increase in the concentration of Ca and P in the enamel (p < 0.001). ConclusionThe addition of 0.25%β-CaGPn into 1100F formulation increased the bioavailability of calcium and phosphate, promoting a higher remineralizing effect. Clinical significanceToothpaste containing 1100F-0.25%β-CaGPn showed a potential of higher remineralization to 1100 ppm F and 1100 ppm F micrometric β-CaGP could be a strategy for patients at caries activity.

Association between Salivary Cortisol Levels, Dental Anxiety, and Dental Caries in Children: A Cross-Sectional Study.

This study aimed to investigate the relationship between dental caries, dental anxiety, and salivary cortisol levels in children visiting pediatric dental clinics and their implications on pediatric oral health. A cross-sectional study was conducted at a dental university in the UAE. A total of 60 children, aged 4-12 years, were included. Salivary cortisol levels were measured using an Enzyme-Linked Immunosorbent Assay (ELISA) kit. Dental caries status was evaluated, and dental anxiety levels were assessed using the Modified Dental Anxiety Scale (MDAS). Statistical analyses, including Mann-Whitney U test and Pearson's correlation coefficient, were performed to determine significant differences and associations. The study group showed significantly higher salivary cortisol levels compared to the control group (p < 0.0001). A strong positive correlation was found between salivary cortisol levels and dental caries status (p < 0.001). However, no significant difference in dental anxiety levels was observed between the study and control groups (p = 0.85). A strong positive correlation was found between dental anxiety levels and dental caries status (p < 0.001). The findings indicate a significant association between salivary cortisol levels and dental caries, suggesting that higher cortisol levels are associated with active caries. Dental anxiety levels were positively correlated with dental caries. Understanding the relationship between these variables can contribute to better oral health strategies and interventions for children, emphasizing the importance of managing dental anxiety and stress in pediatric dental care. This study highlights the potential of salivary cortisol as a biomarker for assessing stress and its impact on oral health in children. By addressing dental anxiety and stress, dental professionals can provide child-friendly dental care, enhance preventive measures, and improve oral health outcomes in pediatric patients.

Oral health status treatment needs among 12 years old children living in orphanages and parental homes in Bangalore city: a cross sectional study

Background: Enjoying good oral health includes more than just having healthy teeth. Many children have inadequate oral and general health because of active and uncontrolled caries. In orphans the oral hygiene practices are usually neglected which may affect various aspects of life, including function, appearance, interpersonal relationships and even career opportunities. Aim of study was to assess oral health status, treatment needs among 12 years old children living in orphanages and compare with that of children living in parental homes and attending government school. Methods: A descriptive cross sectional comparative study was carried out among 460 twelve year old children living in orphanages and parental home. Oral health status and treatment needs was assessed using the World health Organization’s oral health assessment (tooth surface) form for children- 2013. Proportion was calculated using chi-square test and T-test. Results: Present study found mean decayed surface, mean missing surface and mean filled surface was higher in orphanage children (4.57±3.9), (0.17±0.91) and (3.2±0.37) and as compared to school children i.e. (3.88±3.91), (0.16±0.370) and (2.3±0.14). 68.7% school children required prompt treatment (including scaling) 24.3% required immediate treatment due to pain or infection of dental and oral origin, 5.7% required preventive or routine treatment. Conclusions: The study highlighted untreated caries, less filled component and high missing component among orphanage children compared to school children. There is need for dental care, primary prevention such as oral health education programmes in schools.

The efficacy of combined arginine and probiotics as an add-on to 1450 ppm fluoride toothpaste to prevent and control dental caries in children – A randomized controlled trial

ObjectivesTo determine how daily consumption of a lozenge combining arginine and two probiotic strains affects the Relative Risk Reduction (RRR) in children regarding dental caries transitions and lesion activity at tooth surface level during 10–12 months. MethodsA total of 21,888 tooth surfaces in 288 children were examined. The intervention group (n = 141) received a lozenge containing 2% arginine, Lacticaseibacillus rhamnosus, LGG® (DSM33156), and Lactobacillus paracasei subsp. paracasei, L. CASEI 431® (DSM33451). The placebo group (n = 147) received a placebo lozenge. Both groups received 1,450 ppm F- toothpaste. Primary canines, molars, and first permanent molars were examined clinically (ICDAS0–6) and radiographically (R0–6) at baseline and follow-up. Sealed, filled, and missing surfaces were also included. Caries activity was computed as a sum of each caries lesion's location, color, texture, cavitation, and gingival bleeding. RRRs were computed with cluster effect on surface level. ICH-GCP was followed, including external monitoring. ResultsA total of 19,950 surfaces were analyzed after excluding 1,938 tooth surfaces. No statistically significant differences were found between the groups. The RRRs showed less caries progression (13.6%, p = 0.20), more regression (0.3%, p = 0.44), and fewer active caries lesions (15.3%, p = 0.15) in the intervention group. ConclusionDaily consumption of a lozenge combining arginine and probiotics for 10–12 months given to 5–9-years-old children characterized being with low caries risk demonstrated a marked, though not statistically significant RRR for caries progression, regression, and number of active lesions in the intervention group compared to the placebo-group. ClinicalTrials.gov (NCT03928587). Clinical significanceSince all the RRRs were in favor of the intervention group and the PF of combined arginine and probiotics is high (81.6%) compared to fluoride toothpaste (24.9%) and arginine-fluoride toothpaste alone (19.6%) the combined pre-and probiotics approach may be a future additional tool regarding caries prevention and control.

Relevance of Sociocultural Inequalities and Parents' Origins in Relation to the Oral Health of Preschoolers in Lanzarote, Spain.

Approaching inequalities to achieve health equity requires joint action. Early childhood caries affects disadvantaged population groups. The objective of this study was to determine the relevance of sociocultural inequalities and parental origin with respect to oral health in preschool children in Lanzarote. A transversal epidemiological study was carried out. Sociocultural data and information about parental origin were collected via a questionnaire. The decayed and filled teeth (dft), decayed teeth (dt), filled teeth (ft), restorative index (RI), plaque index (PI) and gingival index (GI) were obtained via an investigator's examination. Statistical analysis of the data indicated that children of semi-skilled manual workers (28.15%) had the highest prevalence of caries (46.9%). Additionally 43.7 of the mothers had second grade and first cycle studies. When relating the medium and high level of education, there were statistically significant differences in relation to the cod index (p = 0.046). When the origin was foreign (48.4%), preschoolers presented 10.7% more active or untreated caries than Spaniards (p = 0.038). Low socioeconomic cultural level and foreign origin is associated with a more deficient state of oral health in preschoolers. Oral health programs are needed to minimize social inequalities.

A Cross-Sectional Study of Oral Health Status and Behavioral Risk Indicators among Non-Smoking and Currently Smoking Lithuanian Adolescents.

The purpose of this study was to evaluate oral health status, behavioral risk indicators, and the impact of smoking on oral health among Lithuanian adolescents. This representative cross-sectional study was conducted among 15-year-old Lithuanian adolescents. The method of multistage cluster sampling was used. A total of 1127 adolescents met the inclusion criteria. Two originally created self-reported questionnaires were used in this study. Dental caries, periodontal status, and oral hygiene status were evaluated by four trained researchers. A p-value ≤ 0.05 was set to indicate statistically significant differences. Statistical analysis included Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests. Out of all the participants, 9.6% self-reported being a current tobacco smoker. The mean PI value was 1.14 ± 0.69 among all the participants. Currently smoking adolescents had more active caries lesions (D-S) than those who did not smoke (13.2 ± 16.4 vs. 9.8 ± 10.7, p = 0.023). Considering periodontal status, non-smoking adolescents had significantly lower mean PSR index scores than current smokers (0.52 ± 0.51 vs. 0.61 ± 0.50, p = 0.0298). Tobacco smoking and the consumption of energy drinks were significantly associated (OR = 3.74, 95% CI 2.66-5.26, p < 0.001) among participants. Currently smoking adolescents tended to have improper dietary habits, especially a higher consumption of energy drinks; thus, they were more likely to have active dental caries lesions, as well as poorer periodontal status, than their non-smoking peers.

Microcomputed Tomography Mineral Density Profile as Reference Standard for Early Carious Lesion Activity Assessment

Early caries diagnosis is crucial to treatment decisions in dentistry and requires identification of lesion activity: whether a carious lesion is active (progressively demineralizing) or arrested (progressively remineralizing). This study aimed to identify microtomographic (micro-CT) differences between active and arrested smooth surface enamel lesions, to quantify those micro-CT differences by creating thresholds for ex vivo caries activity assessment to serve as a future reference standard, and to validate those thresholds against the remaining sample. Extracted human permanent teeth (n = 59) were selected for sound surfaces and non-cavitated smooth surface carious lesions. Each surface was then examined for caries activity by calibrated individuals via visual-tactile examination using the International Caries Classification and Management System (ICCMS) activity criteria. Each tooth was scanned via micro-CT and the mineral density was plotted against lesion depth. The area under the curve (AUC) was calculated and represented the loss of density for the outermost 96 μm of enamel. AUC thresholds obtained from micro-CT were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner’s lesion assessment of sound, inactive, and active lesions, respectively. The established AUC thresholds demonstrated moderate agreement with the assessment in identifying demineralized lesions (k = 0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrated quantifiable differences among demineralized lesions, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and laboratorial dental caries evaluations.

Morphological structure of enamel caries in the dynamic process of demineralization and remineralization

According to modern ideas, the carious process at the white spot stage is reversible, so all the attention of scientists is directed to the development of means to restore the crystal lattice of tooth enamel. The purpose of the study is to evaluate morphological changes in caries at the white spot stage and the process of structural remineralization of the carious lesion area. Clinically active initial lesions were detected visually, using optical magnification and positive staining. Structural changes in enamel were studied by scanning electron microscopy of surface impressions obtained from the surface of demineralized enamel. Remineralizing therapy was carried out by applying ApaCare restorative gel (Germany) with nanodispersed highly active hydroxyapatite. Determination of the intensity of dental caries by the DMFT and dmft index showed 9.04 ± 0.40 points on average in the group of subjects, children with code 1 according to the ICDAS index made up 50.8%. Colour reactions showed 7.80 ± 0.21 points on average in the group. SEM visualized characteristic structural changes in the area of the carious spot – an increase in the porosity of the enamel surface with exposure of the fine crystalline structure and destruction of interprismatic fibrillar structures. When using a remineralizing agent, a roller-like deposition of an amorphous remineralizing substance is characteristic, and at the final stage, a smooth enamel surface with a fine crystal lattice is restored. The restoration of the prismatic structure of the enamel occurs due to the mineralization of the preserved fibrillar walls in the interprismatic space. Clinically, at this stage, the enamel visually restores its original shine, smoothness, and colour. In 81.8% of cases, the dye did not penetrate the previously demineralized enamel. The high level of non-cavitated active caries lesions can be largely controlled by the use of remineralizing agents. Further research involves studying the quantitative characteristics of the processes of de- and remineralization of tooth enamel.

Salivary elemental signature of dental caries: a systematic review and meta-analysis of ionomics studies.

Trace- and macro-chemical elements are crucial for cellular physiological functioning, and their alterations in biological fluids might be associated with an underlying pathological state. Hence, this study aimed to examine and summarize the published literature concerning the application of salivary ionomics for caries diagnosis. An extensive search of studies was conducted using PubMed, EMBASE, Web of Science, and Scopus, without any language and year restriction for answering the following PECO question: "In subjects (i.e., children, adolescents, or adults) with good systematic health, are there any variations in the salivary concentrations of trace- or macro-elements between caries-free (CF) individuals and caries-active (CA) subjects?" A modified version of the QUADOMICS tool was used to assess the quality of the included studies. The Review Manager Version 5.4.1. was used for data analyses. The analysis of salivary chemical elements that significantly differed between CF and CA subjects was also performed. Thirty-four studies were included, involving 2299 CA and 1669 CF subjects, having an age range from 3 to 64years in over 16 countries. The meta-analysis revealed a statistically significant difference (p < 0.05) in the salivary levels of calcium, phosphorus, chloride, magnesium, potassium, sodium, and zinc between CA and CF subjects, suggesting higher levels of calcium, phosphorus, potassium, and sodium in CF subjects while higher levels of chloride, magnesium, and zinc in CA patients. Half of the included studies (17/34) were considered high quality, while the remaining half were considered medium quality. Only zinc and chloride ions were found to be higher significantly and consistent in CF and CA subjects, respectively. Conflicting outcomes were observed for all other salivary chemical elements including aluminum, bromine, calcium, copper, fluoride, iron, potassium, magnesium, manganese, sodium, ammonia, nitrite, nitrate, phosphorus, lead, selenium, and sulfate ions.

Feasibility of minimum intervention oral healthcare delivery for individuals with dental phobia

BackgroundPeople with dental phobia often present with more active dental caries and fewer teeth. Minimally Intervention oral Healthcare offers a possible solution to address the high care needs of this group. The aim was to determine this patient group’s eligibility and willingness to participate and the effect of MIOC, compared to treatment as usual (TAU), on their oral health outcomes for planning a future randomised controlled trial (RCT). Minimum intervention oral healthcare (MIOC) comprises of four interlinked domains. In the first domain, we identified and diagnosed the disease status and participants’ anxiety status (≥ 19 MDAS). In the second domain, an individualised prevention-based personalised care plan was designed. During this process, patients with dental phobia were exposed to the dental environment in a stepped manner (‘graded exposure’) and had their urgent care provided with conscious sedation. In the 3rd domain, we took a minimally invasive operative approach to restore teeth while preserving tooth substance and limiting the use of fear-provoking stimuli (e.g., rotary instruments) when possible. At the review and the recall appointment(s) (4th domain), the patients’ oral health care behaviours, disease risk/susceptibility and fear levels were re-assessed.MethodsThis two-arm randomised feasibility trial (N = 44) allocated participants to the experimental arm (MIOC) or the control arm (treatment as usual [TAU]). The primary outcomes were the eligibility and willingness to participate and feasibility to conduct a trial of MIOC for people with dental phobia. The secondary outcomes were oral health status, oral health related quality of life and care completion. A written and verbal consent for participation and dental care provision were obtained.ResultsForty-four people diagnosed with dental phobia were allocated randomly to the two study arms. At the six-month recall after completed care, the outcome of each study arm was assessed. It was feasible to conduct a clinical trial (eligibility rate [56%], completion rate [81%], declined to participate [12%]). The intervention group showed improvements in all health care outcomes, and oral health related quality of life.ConclusionA clinical trial of MIOC vs TAU in people with dental phobia is feasible. Preliminary findings suggest that patients in the MIOC arm are more likely to successfully complete their course of treatment. The study was ‘retrospectively registered’ on 02/05/2018 (ISRCT15294714) with the International Standard Randomised Controlled Trial (ISRCT).

Anticaries Potential of Temu Kunci-Serai Ethyl Acetate Extract Combination: In Vitro and Molecular Studies Approach

Dental caries is one of the problems in dental disorders suffered by many people. There have been many ways of handling such as using temu kunci and lemongrass plants. This study aims to determine the antibacterial activity of caries in vitro and predict the mechanism of action of the bacteria that cause caries Streptococcus mutans. Temu kunci and lemongrass were extracted using ethyl acetate solvent. antibacterial tests against Streptococcus mutans were carried out using diffusion tests with a combination treatment of temu kunci: serai extracts 5% b/v: 5% b/v, 5% b/v: 10% b/v, and 10% b/v: 5% b/v. The positive control used amoxicillin and DMSO as a negative control. Potency as an anticaries drug of drived compound from Temu Kunci and Serai were evaluated by molecular docking using glucosyltransferase (3AIC). The results showed that the combination of temu kunci and serai with concentration 10% b/v: 5% b/v has potential as anticaries against Streptococcus mutans. Molecular studies depicted that Panduratin A, Isopanduratin, and 1,3-O-di-p-coumaroylglycerol have great activity toward 3AIC, respectively. Especially for Panduratin A and Isopanduratin, those compound depicted great and similar binding affinity (-8.4 kcal mol-1) that lower than Acarbose as native ligand (-8.3 kcal mol-1). Furthermore, those compound binding similarity ilustrated activity mechanism similarly with native ligand toward receptor. Additionally, the profiling drug-target interaction suggested Temu Kunci’s derived compounds have great potential as anticaries treatment.

Unexpected lower level of oral periodontal pathogens in patients with high numbers of systemic diseases.

Periodontal disease is associated with systemic conditions such as diabetes, arthritis, and cardiovascular disease, all diseases with large inflammatory components. Some, but not all, reports show periopathogens Porphyromonas gingivialis and Tannerella forsythia at higher levels orally in people with one of these chronic diseases and in people with more severe cases. These oral pathogens are thought to be positively associated with systemic inflammatory diseases through induction of oral inflammation that works to distort systemic inflammation or by directly inducing inflammation at distal sites in the body. This study aimed to determine if, among patients with severe periodontal disease, those with multi-morbidity (or many chronic diseases) showed higher levels of periodontal pathogens. A total of 201 adult subjects, including 84 with severe periodontal disease were recruited between 1/2017 and 6/2019 at a city dental clinic. Electronic charts supplied self-reported diseases and conditions which informed a morbidity index based on the number of chronic diseases and conditions present. Salivary composition was determined by 16S rRNA gene sequencing. As expected, patients with severe periodontal disease showed higher levels of periodontal pathogens in their saliva. Also, those with severe periodontal disease showed higher levels of multiple chronic diseases (multimorbidity). An examination of the 84 patients with severe periodontal disease revealed some subjects despite being of advanced age were free or nearly free of systemic disease. Surprisingly, the salivary microbiota of the least healthy of these 84 subjects, defined here as those with maximal multimorbidity, showed significantly lower relative numbers of periodontal pathogens, including Porphyromonas gingivalis and Tannerella Forsythia, after controlling for active caries, tobacco usage, age, and gender. Analysis of a control group with none to moderate periodontal disease revealed no association of multimorbidity or numbers of medications used and specific oral bacteria, indicating the importance of severe periodontal disease as a variable of interest. The hypothesis that periodontal disease patients with higher levels of multimorbidity would have higher levels of oral periodontal pathogens is false. Multimorbidity is associated with a reduced relative number of periodontal pathogens Porphyromonas gingivalis and Tannerella forsythia.