Progression Of Carious Lesions Research Articles

Antibacterial, cytotoxic and mechanical properties of a orthodontic cement with phosphate nano-sized and phosphorylated chitosan: An in vitro study

ObjectivesEvaluate, in vitro, the effect of incorporating nano-sized sodium trimetaphosphate (TMPnano) and phosphorylated chitosan (Chi-Ph) into resin-modified glass ionomer cement (RMGIC) used for orthodontic bracket cementation, on mechanical, fluoride release, antimicrobial and cytotoxic properties. MethodsRMGIC was combined with Chi-Ph (0.25%/0.5%) and/or TMPnano (14%). The diametral compressive/tensile strength (DCS/TS), surface hardness (SH) and degree of conversion (%DC) were determined. For fluoride (F) release, samples were immersed in des/remineralizing solutions. Antimicrobial/antibiofilm activity was evaluated by the agar diffusion test and biofilm metabolism (XTT). Cytotoxicity in fibroblasts was assessed with the resazurin method. ResultsAfter 24 h, the RMGIC-14%TMPnano group showed a lower TS value (p < 0.001); after 7 days the RMGIC-14%TMPnano-0.25%Chi-Ph group showed the highest value (p < 0.001). For DCS, the RMGIC group (24 h) showed the highest value (p < 0.001); after 7 days, the highest value was observed for the RMGIC-14%TMPnano-0.25%Chi-Ph (p < 0.001). RMGIC-14%TMPnano, RMGIC-14%TMPnano-0.25%Chi-Ph, RMGIC-14%TMPnano-0.5%Chi-Ph showed higher and similar release of F (p > 0.001). In the SH, the RMGIC-0.25%Chi-Ph; RMGIC-0.5%Chi-Ph; RMGIC-14%TMPnano-0.5%Chi-Ph groups showed similar results after 7 days (p > 0.001). The RMGIC-14%TMPnano-0.25%Chi-Ph group showed a better effect on microbial/antibiofilm growth, and the highest efficacy on cell viability (p < 0.001). After 72 h, only the RMGIC-14%TMPnano-0.25%Chi-Ph group showed cell viability (p < 0.001). ConclusionThe RMGIC-14%TMPnano-0.25%Chi-Ph did not alter the physical-mechanical properties, was not toxic to fibroblasts and reduced the viability and metabolism of S. mutans. Clinical relevanceThe addition of phosphorylated chitosan and organic phosphate to RMGIC could provide an antibiofilm and remineralizing effect on the tooth enamel of orthodontic patients, who are prone to a high cariogenic challenge due to fluctuations in oral pH and progression of carious lesions.

Effectiveness of biomimetic nanohydroxyapatite on remineralisation of carious lesion: A systematic review

Dental caries is a prevalent infectious disease of the dental hard tissue. Simple non-invasive remineralization of dental caries may be sufficient to stop the progression of incipient carious lesions. Research question was formulated based on the PICO strategy. A comprehensive electronic literature search was conducted, independently by two reviewers. Based on the specified inclusion and exclusion criteria, the selected articles were subjected to quality assessment and the risk of bias evaluation was done.The objective of this study was to conduct a systematic review of the literature on effectiveness of nanohydroxyapatite on remineralization of caries in comparison with other conventional remineralizing agents.A search was performed in electronic database (i.e. PubMed, Cochrane and google scholar) using search terms alone and in combination by means of PubMed search builder from January 2010 to January 2023. Studies were selected if they met the following criteria: randomized clinical trials comparing nanohydroxyapatite and other remineralizing agents for caries remineralization. Nanohydroxyapatite has comparable efficacy on remineralization of dental caries. Biomimetic hydroxyapatite-containing, fluoride-free oral care products are effective in remineralization of dental caries, especially in children. Additional long-term studies employing standardized protocols are necessary to draw definitive findings about the effect of hydroxyapatite on remineralization of dental caries. Nano-hydroxyapatite is a biomimetic and have a remineralizing effect on early carious lesions.

Impact of Orthodontic Treatment on the Incidence of Dental Caries in Adolescents: A Prospective Cohort Study.

Orthodontic treatment is a widely embraced intervention aimed at enhancing dental aesthetics and correcting malocclusions among adolescents. However, concerns persist regarding its potential impact on oral health, particularly on the development of dental caries. This study aimed to systematically investigate the relationship between orthodontic treatment and the incidence of new carious lesions among adolescents. A prospective cohort design involving adolescents aged 12-18 years was employed. A total of 82 patients met the inclusion criteria. In addition, an age-matched control group of 82 participants who did not undergo orthodontic treatment was included. The study included both a treatment group undergoing orthodontic treatment (braces or aligners) and an age-matched control group that did not undergo any orthodontic intervention. Demographic characteristics, orthodontic treatment details, and oral hygiene practices were documented at baseline and throughout the study period. Dental examinations at six-month intervals post-treatment were conducted to track the incidence and progression of carious lesions. The demographic characteristics, baseline oral health status, orthodontic treatment details, and oral hygiene practices were comparable between the treatment and control groups. Post-orthodontic treatment assessment revealed a slightly higher incidence of new carious lesions in the treatment group (14.6%) than in the control group (9.8%), although this difference was not statistically significant (p = 0.15). Dental examinations at six-month intervals demonstrated a gradual increase in caries incidence over time in both groups, with no substantial disparities observed. This study provides a comprehensive examination of the relationship between orthodontic treatment and the incidence of new carious lesions among adolescents. While a trend towards higher caries incidence in the treatment group was observed, the difference was not statistically significant. These findings contribute to the existing body of knowledge and emphasize the need for ongoing research to guide clinical practice.

Caries in Primary Molars: Is Silver Diamine Fluoride Effective in Prevention and Treatment? A Systematic Review

In recent years, pediatric dentistry has evolved considerably in terms of both the techniques and materials used. A clear, odorless liquid called silver diamine fluoride (SDF) is recommended for molars affected by hypoplasia and dentinal hypersensitivity. In adults and children who are at a high risk of developing caries, it is also helpful to prevent the progression of carious lesions. Teeth too compromised to be reconstructed that are not accompanied by discomfort or infection can be treated with SDF. The current review aims to provide an overview of the most recent research over the last 10 years on the potential of SDF, focusing on the clinical evidence of professionally applied fluoride therapy to prevent and arrest caries in children’s primary molars. Research was conducted according to the guidelines of the PRISMA statement. “silver diamine fluoride”, “primary molar”, and “primary molars” were the search terms utilized on the databases Scopus, Web of Science, and PubMed, with the Boolean operator “AND” and “OR”. Of these 195 studies, 13 primary studies were included in this review. The quality of the included papers was assessed using the reputable Cochrane risk of bias assessment for randomized trials. The studies reviewed consistently support the effectiveness of SDF in stopping the progression of existing caries in deciduous molars; on the contrary, there is insufficient evidence to draw conclusions about SDF being effective for the prevention of carious lesions in deciduous molars.

Inhibition of incipient caries lesion progression by different fluoridated varnishes.

The aim of this in vitro study was to evaluate the potential of different fluoridated varnishes to inhibit the progression of incipient caries lesions after cariogenic challenge. Seventy-five enamel specimens of bovine teeth were prepared and selected based on the initial surface microhardness (SMH). The specimens were first subjected to artificial demineralization (in buffer solution) after which SMH was re-analyzed (SM1). They were then randomly assigned to five experimental groups: 1- CONTROL (pH cycling), 2 - MI VAR (MI Varnish with RECALDENTTM - CPP-ACP), 3 - PROFL (Profluorid®), 4 - CLIN (ClinproTM White Varnish with TCP), and 5 - DUR (Duraphat®) (n=15). The varnishes were applied in a thin layer and the specimens were then subjected to pH cycling for eight days. The SMH and cross-sectional microhardness (CSMH) were then analyzed (SM2). The fluoride and calcium ion concentrations in the solution were analyzed by the indirect method and atomic absorption spectrophotometry, respectively. Data were statistically analyzed by Student's t-test, ANOVA/Tukey-Kramer, or Kruskall-Wallis/Dunn tests for individual comparisons (p˂0.05). All varnishes led to significantly higher surface and subsurface remineralization compared with the control group but did not differ from each other. The varnishes with the highest fluoride release were: PROFL and CLIN, followed by MI VAR and DUR. The varnishes with significantly higher release of calcium were: DUR, CLIN, and PROFL. In conclusion, all commercial fluoridated varnishes tested have good potential to inhibit the progression of demineralization, regardless of the ion release mechanisms.

CO2 laser irradiation combined with fluoridated dentifrice improved its protective effect on caries lesion progression regardless of the acidulated phosphate fluoride gel application: An in situ study.

This in situ study aimed to investigate the efficacy of CO2 laser at a 10.6-µm wavelength combined with 1.23% acidulated phosphate fluoride (APF) and fluoridated dentifrice with 1100µg F/g (FD) to control enamel caries progression. Sixteen volunteers wore palatal appliances containing eight demineralized enamel specimens for four 14-day phases under sucrose exposure. These specimens were submitted to CO2 laser irradiation and APF alone or combined with FD. Treatment groups were non-fluoridated dentifrice-NFD, NFD + CO2 laser, NFD + APF, NFD + CO2 laser + APF, FD, FD + CO2 laser, FD + APF, and FD + CO2 laser + APF. Mineral loss, calcium fluoride (CaF2), fluorapatite (FAp), and fluoride in the biofilm were analyzed by analysis of variance followed by the Student-Newman-Keuls test, p < 0.05. The highest mineral loss inhibition was noted when FD and CO2 laser irradiation were combined, which did not significantly differ from the FD + CO2 laser + APF group. The CaF2, FAp, and F in the biofilm were more pronounced when the FD and APF were combined. The CO2 laser irradiation promoted a slightly higher concentration of CaF2 in the enamel and F in the biofilm. Although APF promotes the high formation of CaF2 and FAp, the combined use of FD with CO2 laser overcomes the APF effect in inhibiting the progression of artificial caries-like lesions in situ. Under the in situ design of this study, remineralization of white spot lesions was achieved through CO2 laser irradiation and daily use of fluoridated dentifrice. Future clinical trials are encouraged to substantiate this finding.

Hall technique for the management of carious primary molar teeth among African children - a review

Background: Hall technique involves cementing preformed metal crowns or stainless steel crowns on the tooth with the use of luting glass ionomer cements, without the use of local anaesthesia, caries removal and tooth preparation of any kind. It can be an intervention to stop the progression of active untreated carious lesion in primary molar teeth among African children. This article reviews the available studies on Hall technique used for the management of carious primary molar teeth among African children. Method: An electronic literature search in Web of science, Scopus, PubMed, Google Scholar, African journals online, ResearchGate and Google was conducted in June, 2023 using the Population-Concept-Context framework. Search terms and keywords were combined by Boolean operators. Three independent investigators (research assistants) screened titles, abstracts and full text of publications. The inclusion criteria were original research articles, case report, case series related to Hall technique for the management of carious primary molar teeth studies conducted in African continent, published in English language and in electronic databases. Results: Four articles were included as they were assessed to meet the aim of the review. The study design of the articles was three randomised controlled clinical trial and one case report. One study was identified each from Egypt, Morocco, Nigeria and Sudan respectively. All the identified studies in African continent were hospital based. Conclusion: Hall technique can be an intervention for management of carious primary molar teeth in resource poor locality in Africa and globally. Studies on Hall technique for the management of carious primary molar teeth identified in Africa were few and restricted to few countries. IMC J Med Sci. 2024; 18(1):003. DOI: https://doi.org/10.55010/imcjms.18.003 *Correspondence:Obehi. O Osadolor, University of Nigeria Teaching Hospital, Ituku- ozalla, Enugu State, Nigeria. E-mail: osadolorobehi@yahoo.com

Current Approaches to Diagnosis of Early Proximal Carious Lesion: A Literature Review.

Integrating technological tools with clinical visual examination for caries detection and diagnosis can improve preventative measures in dentistry, resulting in decreased treatment expenses and reduced time and costs associated with testing potential anticaries agents. This article provides an overview of the conventional and new emerging modern technologies that can assist dental professionals in the early detection and diagnosis of dental caries. These technologies aid in assessing the progression of carious lesions and monitoring them quantitatively or qualitatively over time.Traditional techniques (visual, tactile, and radiographic) have limitations in diagnosing early proximal caries accurately.Novel methods like fluorescence and transillumination, as well as advanced tools like OCT (optical coherence tomography), laser fluorescence, and QLF (quantitative light-induced fluorescence), are effective for early caries detection. Optical methods like fluorescence and transillumination are particularly successful in identifying initial caries stages. Moreover, this reviewhighlights the clinical relevance of these methods and discusses potential future technologies like terahertz imaging and artificial intelligence (AI)-based approaches.

Silver Diamine Fluoride: A Review

BACKGROUND The burden of untreated dental caries among African children is high. Silver diamine fluoride (SDF) is a simple, non- technique sensitive intervention to stop the progression of active untreated carious lesion in primary teeth among children. Silver diamine fluoride (SDF) 38% solution contains 44,800 ppm fluoride ions and its stains teeth after use. &#x0D; METHOD An electronic literature search in Web of science, Scopus, PubMed, Google Scholar, African journal online, Researchgate and Google was done in May,2023. Search terms and keywords were combined by Boolean operators. Two independent investigators (research assistants) screened titles, abstracts and full text of publications. The inclusion criteria were original research articles, case report, case series related to silver diamine fluoride ( human studies) conducted in African region and in electronic databases.&#x0D; RESULTS Ten articles were included as they were assessed to meet the aim of the review. The study design of the articles were four invitro studies, three randomized controlled clinical trial, one randomized clinical trial, one split-mouth, self-controlled clinical trial and one split-mouth, randomized controlled clinical study. 90 % of the studies identified was conducted in Egypt, while 10 % of the studies was conducted in Nigeria.&#x0D; CONCLUSION Studies on silver diamine fluoride (SDF) identified in African countries were few and restricted to few countries. Silver diamine fluoride can be used as an intervention for active and progressing untreated carious lesion in primary teeth among children though it stains teeth after use. More studies from the diverse ethnic population in Africa will contribute to the existing literature.

Effect of Light-Curable Resin-Modified Glass Ionomer Varnish on Non-Cavitated Proximal Caries Lesions in Primary Molars: A Randomized Controlled Trial.

The purpose of this study was to radiographically and clinically assess, after six and twelve months, the additive effect of light-curable resin-modified glass ionomer (LCRMGI) varnish on preventive standard-of-care measures (sodium fluoride varnish, oral hygiene instructions, and dietary counseling) for the treatment of non-cavitated proximal carious lesions in primary molars. This prospective, split-mouth, randomized clinical trial recruited 5-8-year-old children with at least one pair of bilateral non-cavitated proximal carious lesions in the enamel or outer third of the dentin. The lesions were randomized into one of two groups: experimental (which received LCRMGI varnish with the preventive standard-of-care measures) or control (which received the preventive standard-of-care measure). A total of 47 out of 53 participants, with 70 out of 80 pairs, completed the study. Radiographically, lesions in the experimental groups were more likely to regress after six (OR = 3.25) and twelve months (OR = 2.67), but it was not statistically significant (p = 0.052 and p = 0.055, respectively). Clinically, the experimental group showed significantly higher regression rates than the control group after six and twelve months (p = 0.041 and p = 0.003, respectively). The LCRMGI varnish demonstrated promising potential as an adjuvant to preventive standard-of-care measures in promoting regression and inhibiting the progression of non-cavitated proximal carious lesions.

Matrix Metalloproteinases in Oral Health—Special Attention on MMP-8

Matrix metalloproteinases (MMPs) are a large family of Ca2+ and Zn2+ dependent proteolytic enzymes, able to cleave the various components of the extracellular matrix (ECM), as well as a range of other regulatory molecules. Several reports have proven the important role of both MMPs and their endogenous inhibitors, TIPMs, in oral health, the initial development of the tooth, and during enamel maturation. In this mini-review, we aim to summarize the literature information about the functions of MMPs, paying more attention to MMP-8 (collagenase-2 or neutrophil collagenase) in the development and progression of periodontitis, peri-implantitis, and carious lesions. We also emphasize the role of particular gene variants in MMP8 as predisposing factors for some oral diseases.

Effect of whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge.

To investigate the effect of fluoride-containing whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge. Bovine enamel specimens (n = 120) with three areas [non-treated sound enamel (NSE), treated sound enamel (TSE), and treated artificial caries lesion (TACL)] were randomly assigned to the four groups: whitening mouthrinse (WM: 2.5% hydrogen peroxide-100ppm F-), placebo mouthrinse (PM: 0% hydrogen peroxide-100ppm F-), whitening gel (WG: 10% carbamide peroxide-1130ppm F-), and deionized water (negative control; NC). The treatments (2min for WM, PM, and NC, and 2h for WG) were carried out during a 28-day pH-cycling model (6 × 60min demineralization/day). Relative surface reflection intensity (rSRI) and transversal microradiography (TMR) analyses were performed. Fluoride uptake (surface and subsurface) was measured in additional enamel specimens. For TSE, a higher value of rSRI was observed in WM (89.99% ± 6.94), and a greater decrease in rSRI was observed for WG and NC, and no sign of mineral loss was verified for all groups (p > 0.05). For TACL, rSRI significantly decreased after pH-cycling for all experimental groups with no difference between them (p < 0.05). Higher amounts of fluoride were found in WG. WG and WM exhibited intermediate values of mineral loss, similar to PM. The whitening products did not potentialize the enamel demineralization under a severe cariogenic challenge, and they did not exacerbate mineral loss of the artificial caries lesions. Low concentrated hydrogen peroxide whitening gel and mouthrinse containing fluoride do not intensify the progression of caries lesions.

Effect of silver nanoparticles associated with fluoride on the progression of root dentin caries in vitro.

To assess the anti-proteolytic effect and potential to inhibit dentin root caries progression of a silver nanoparticle and fluoride solution (CNanoF) in comparison to silver diamine fluoride (SDF). 48 specimens of root dentin artificial caries lesion were treated with 38% SDF, CNanoF, CNano or F (n = 6 per group). Ph cycling with demineralization and remineralization solutions simulated caries lesion progression. In addition, specimens were incubated with or without bacterial collagenase in the remineralization solution to induce dentin proteolytic degradation. Dentin degradation was assessed by weight loss rate and hydroxyproline (Hyp) release. Changes in cross-sectional microhardness, and lesion permeability and collagen integrity as determined by confocal laser scanning microscopy indicated potential for further demineralization inhibition. The effect of the solutions on the activity of metalloproteinases (MMP) -2 and -9 was also investigated. Statistical analysis consisted of ANOVA, Kruskal-Wallis, and linear mixed models with post-hoc pairwise Tukey, Dunn, and t-tests (α = 0.05). Treatment with SDF resulted in lower weight loss rate than did other solutions, but all groups showed similar Hyp release (p = 0.183). SDF resulted in greater microhardness at superficial layers of the caries lesions (p<0.05), while there were no differences among CNanoF, CNano, and F. Lesion permeability was similar among all groups after pH cycling (p>0.05), with or without the use of collagenase (p = 0.58). No statistically significant difference was noted among solutions regarding collagen integrity after pH cycling; however, SDF-treated dentin had a significant decrease in collagen integrity when collagenase was used (p = 0.003). Interestingly, only SDF was able to completely inactivate MMP-2 and -9. CNanoF and SDF both potentially prevent dentin degradation during caries lesion progression in vitro; however, SDF was more effective at inhibiting further tissue demineralization.

Chapter 9.2: Non-Operative Treatment of Coronal Caries.

Nonoperative treatment of coronal caries is defined as a series of nonoperative measures interfering with the initiation of new caries lesions and the rate of caries lesion progression. This treatment aims to keep the caries process at subclinical level and to arrest caries lesion progression at clinical and/or radiographic levels. This chapter considers the implementation of the nonoperative treatment of caries disease in daily practice with a focus on its biological determinants. The treatment planning is based on the information gathered through patients' anamnesis, clinical and radiographic examinations together with patients' risk assessment. For most caries inactive patients, the implementation of core measures of the nonoperative treatment is sufficient to control the caries disease, while for caries active patients both professionally and self-applied additional measures are required. Clinical cases illustrating successes and limitations of the nonoperative treatment for the whole dentition are presented. Patients/parents should take responsibility for their own or their child's oral health and the dental professional team should help them to achieve this goal. It is relevant that patients/parents understand that the nonoperative treatment of caries disease is evidence-based. Nevertheless, as any other treatment, successes and failures are likely to occur, and these are to a great extent dependent on patients'/parents' compliance. Finally, the dental team should keep its knowledge constantly updated to provide the best available treatment for their patients in daily practice.

Chapter 7: Technological Aids and Coronal Caries.

In recent decades, dentistry has developed significantly in all areas. While in the past, caries was mainly treated operatively, the today's management has shifted toward noninvasive, minimal invasive, and, only if needed, invasive treatment options. Aiming at enabling the most noninvasive or conservative treatment option requires early caries detection, which, however, remains challenging. The progression of early or noncavitated caries lesions can nowadays be successfully controlled, as well as lesions arrested by oral hygiene procedures combined with the use of fluorides, sealants, or resin infiltration. Methods such as near-infrared light transillumination, fibre-optic transillumination, digital fibre-optic transillumination, laser fluorescence, or quantitative light fluorescence measurements were introduced in the dental market to provide X-ray-free caries detection, assessment, and monitoring. For approximal surfaces that are not directly visible, bitewing radiography is still the standard in detecting caries lesions. The use of artificial intelligence has become the most recent technological aid for the detection of caries lesions on bitewing radiographs and clinical images and has to be understood as an emerging technology, which requires extensive research in the future. The aim of this chapter is to give an overview of different possibilities to detect coronal caries lesions and suggestions of how to improve this process.

Treatment of hypomineralized maxillary central and canine teeth with resin infiltration technique: A case report

Aim: The resin infiltration technique is a minimally invasive approach that can be used to treat white spot lesions and arrest the progression of caries lesions. In this case report, it is aimed to eliminate the existing aesthetic problem by treating enamel hypomineralization in the maxillary central and canine teeth with the resin infiltration technique. Methodology: A 17-year-old male patient was referred to our clinic because of an aesthetic problem caused by a white spot lesion in his maxillary central and canine teeth. After clinical and radiological examination, his treatment options were evaluated, and we decided to treat it with the resin infiltration technique. After cleaning the surfaces of the teeth with a prophylaxis pad (Ultrapro Tx, Ultradent, South Jordan, UT, USA), isolation was achieved by applying a gingival barrier (Gingival Barrier, SDI, Bayswater, VIC, Australia). The adjacent teeth were protected using Teflon tape. A 15% hydrochloric acid gel (Icon Etch, DMG, Hamburg, Germany) was applied to the enamel surfaces for two minutes by mixing with a brush. After, the acid was removed using a water spray for 30 seconds. Ethanol (Icon Dry, DMG, Hamburg, Germany) was applied for 30 seconds and air dried. Then, a low-viscosity resin infiltrant (Icon Infiltrant; DMG, Hamburg, Germany) was applied to the tooth surfaces for three minutes by slight massage. After the application, the resin was light polymerized for 40 seconds (D-Light Pro, GC, Tokyo, Japan). The whole procedure was performed in such a way that there were two consecutive cycles. Results: Aesthetics improved after the procedure. The patient was followed up with control sessions. Conclusion: White spot lesions can be treated with a minimally invasive approach using the resin infiltration technique with appropriate indication. How to cite this article: Tüzel S, Çokkeçeci İT, Üçtaşlı MB, Arısu HD. Treatment of hypomineralized maxillary central and canine teeth with resin infiltration technique: A case report. Int Dent Res 2022;12(Suppl.1):124-7. https://doi.org/10.5577/intdentres.452 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Клініко-статистична оцінка психоемоційного статусу підлітків на стоматологічному прийомі

The purpose of the study was to assess the level of personal and reactive anxiety in teenagers of the Transcarpathian region during a dental appointment and establish the correlational dependence of parameters. Materials and methods. An assessment of psycho-emotional state and dental status of 384 adolescents aged 12-18 years who were patients of the “University Dental Polyclinic” was carried out. The patient's appeal was both urgent and for the purpose of rehabilitation, planned. Depending on the level of personal anxiety, patients were divided into clinical groups to determine the prevalence, intensity and activity of caries. The first group included 244 teenagers (175 girls and 69 boys) who were diagnosed with a high level of personal anxiety. The second group consisted of 105 adolescents (48 girls and 57 boys) in whom basic anxiety was moderate, the third group consisted of 35 adolescents with low anxiety (10 girls and 25 boys). The level of reactive and personal anxiety was assessed according to the methodology of Ch. D. Spielberger (adapted by Yu. L. Khanin). Indicators of the prevalence, intensity and activity of caries (CPV index) were determined in the examined subjects according to generally accepted methods. Results and discussion. The level of reactive and personal anxiety is determined to be high in both boys and girls, and reactive anxiety caused by visiting the dentist reaches the maximum percentage indicators in both groups and has a significantly higher percentage than personal anxiety. Significant differences in caries activity indicators of the first and second groups and the first and third groups were established, in particular, significantly lower indicators of absent and compensated caries (p &lt;0.05) and significantly higher indicators of subcompensated and decompensated caries (p &lt;0.05). The indicators of decompensated caries differed significantly between the indicators of the second and third groups (25.8%; 14.3%; p &lt;0.05). Conclusion. High personal anxiety is a factor in the formation and progression of carious lesions of hard tissues in adolescents, a direct relationship between the level of personal anxiety and the course of caries in adolescents has been established, with an increase in personal anxiety, the percentage of decompensated caries increases. That is, high personal anxiety is a factor in the progression of dental caries in teenagers

ANALYSIS OF THE DENTAL STATUS OF TEENAGERS IN THE TRANSCARPATIA REGION

Dental status includes an index assessment of clusters that characterize the state of hygiene, the presence of periodontal tissue diseases, and the state of the hard tissues of the teeth. The calculation of these indicators gives a clear idea of the state of the problem and dictates the ways of preventive and therapeutic tactics both in groups and individually. The level of patient anxiety, both personal and reactive, caused by a visit to the dentist, plays a significant role during the appointment with the doctor, affects the trust during communication and affects the quality of dental services in general. The second component of high-quality dental treatment is the determination of the level of dental morbidity in groups, depending on the level of anxiety as a basic factor. Dental status includes an index assessment of clusters that characterize the state of hygiene, the presence of periodontal tissue diseases, and the state of the hard tissues of the teeth. The calculation of these indicators gives a clear idea of the state of the problem and dictates the ways of preventive and therapeutic tactics both in groups and individually.&#x0D; The aim of the research. To assess the dental status of adolescents in Transcarpathian region and establish the correlational dependence of parameters.&#x0D; Materials and methods. An assessment of the dental status of 384 adolescents aged 12-18 years who were patients of LLC "University Dental Polyclinic" was carried out. The patient's appeal was both urgent and for the purpose of rehabilitation, planned.&#x0D; Indicators of the prevalence, intensity and activity of caries (CPV index) were determined in the examined subjects according to generally accepted methods. The state of hygiene in adolescents was determined according to the OHI-S index and Fedorov-Volodkina. The condition of the periodontal tissues in the examined adolescents was determined according to the PMA index. Statistical analysis of the obtained data was carried out on a personal computer using licensed programs ˝MS Excel 7˝ for the operating system˝ Windows˝ and the standard program package "STATISTICA" v. 6.0.&#x0D; Conclusions. High personal anxiety is a factor in the formation and progression of carious lesions of hard tissues in adolescents, a direct relationship between the level of personal anxiety and the course of caries in adolescents has been established, with an increase in personal anxiety, the percentage of decompensated caries increases. That is, high personal anxiety is a factor in the progression of dental caries in teenagers. Significant differences in PMA index indicators were established between clinical groups (p&lt;0,05). In the first group of teenagers with a high level of personal anxiety, the indicators of the index corresponded to a severe degree of gingivitis, in the second and third groups, the indicators corresponded to an average degree of gingivitis.&#x0D; When assessing the state of hygiene in adolescents of clinical groups, significant differences were established between the indicators of the first and second and the first and third groups according to the OHI-S, DI-S and CI-S indicators of the I.G. index. Green, I.R.Vermillion and indicators of the Fedorov-Volodkina index (р&lt;0.05), the indicators in the first group were significantly higher than in the second and third groups. According to the Fedorov-Volodkina index, a significantly higher index was established in patients of the first group than in the second and third.&#x0D; A direct relationship between the level of personal anxiety and the state of hygiene in adolescents has been established, with an increase in personal anxiety, the deterioration of hygiene is noted. That is, high personal anxiety is a factor in the progression of gingivitis.

Understanding dental caries as a non-communicable and behavioral disease: Management implications.

New paradigms in caries conceptualization have emerged during the last decades, leading to intense debate and discussion on how to approach the disease, both from a preventive and a therapeutic perspective. Among many new ideas, research discoveries and technologies, one major concept can be highlighted that created a deep frontier between the old and the new paradigm in caries conceptualization; the non-communicable nature of the disease, firmly associated with behaviors and lifestyles. This article synthetizes the conceptual construction of dental caries as a non-communicable disease (NCD) based on the current evidence and discusses the appropriate management of the disease in this context. Dental caries has shifted from being considered transmissible and infectious to an ecological and non-communicable disease. Environmental factors such as frequent sugars intake, disrupt the symbiosis of the dental biofilm leading to a dysbiosis, which favors caries lesion initiation and progression. As an NCD, dental caries shares characteristics with other NCDs such as cardiovascular and chronic respiratory diseases, cancer and diabetes, including long duration and slow progression, not being transmissible from person-to-person, being strongly related to modifiable behavioral risk factors, and affecting preferentially disadvantaged populations with a strong inequality gradient. Given the high prevalence of dental caries, and its consequences on people's health and quality of life, a recognizable conceptual view of caries as a NCD is required to target an effective management. Current understanding of dental caries supports prevention through acting on the modifiable risk factors (behaviors) and involves management based on an interdisciplinary approach. Communicating these modern concepts among researchers, clinicians and policymakers is needed to decrease the global high burden of the disease.

Effects of the crosslinking of chitosan/DCPA particles in the antimicrobial and mechanical properties of dental restorative composites

The development of restorative materials containing antibacterial agents is an alternative to reduce the progression of caries lesions. Objectiveto compare the influence of the degree of crosslinking of chitosan particles loaded with dibasic calcium phosphate (DCPA) on the mechanical properties, degree of conversion (DC), and antimicrobial properties of experimental composites. MethodsChitosan/DCPA particles were synthesized by the electrospraying, crosslinked by 0, 8, or 16 h in glutaraldehyde, and characterized by zeta potential and minimum inhibitory concentration (MIC) against S. mutans. Experimental resin composites of Bis-GMA and TEGDMA and 59.5% of barium glass were synthesized, chitosan/DCPA particles were added at 0 or 0.5 wt% with the different crosslinking time. The materials were subject to DC analysis, three-point bending test at 24 h and 7 days, and antimicrobial assays. Data were submitted to one-way ANOVA and Tukey test (α = 0.05). ResultsThe particles with longer crosslinking time presented higher zeta potential and MIC, and the composite containing these particles showed significantly higher biofilm inhibition than the control group. The other two groups were similar to each other and the control. The composite containing particles with 88 h crosslinking time showed the lowest flexural strength at 7 days in water, and materials with non-crosslinked particles and longer crosslinking time presented flexural strength similar to control. The flexural modulus and DC showed no statistical difference among groups. Significancecomposite resin containing 0.5% chitosan/DCPA particles crosslinked by 16 h showed a reduction of biofilm formation without affecting the mechanical properties in relation to the control.