Carious Dentin Research Articles

Copper Oxide Nanoparticles Loaded in Adhesive to Carious Dentin. An In Vitro Study Assessing μTBS, Degree of Conversion, EDX, and SEM

This In Vitro study investigated the effects of incorporating copper nanoparticles (CuNPs) into an etch-and-rinse (ER) adhesive on the survival rate of Streptococcus mutans (S. mutans), micro tensile bond strength (μTBS), and degree of conversion (DC) when applied to carious dentin. Mandibular teeth with carious lesions were selected, and S. mutans was inoculated on carious-affected dentin (CAD). The samples were divided into four groups based on the concentration of CuNPs in the OptiBond FL primer: Group 1 had unmodified ER adhesive, Group 2 had 0.1 wt% CuNPs, Group 3 had 0.5 wt% CuNPs, and Group 4 had 1 wt% CuNPs. The survival rate of S. mutans was assessed, and the samples were restored to evaluate μTBS and failure modes. The DC was measured using Fourier Transform Infrared Spectroscopy (FTIR). Statistical analysis using ANOVA and Tukey tests determined significant differences across groups in antibacterial efficacy, μTBS, and DC. The results indicated that the 1 wt% CuNPs group (Group 4) exhibited the lowest bacterial survival, while the unmodified ER adhesive group (Group 1) showed the highest S. mutans survival. The highest bond strength to the CAD was observed in the 0.5 wt% CuNPs group (Group 3), with Group 1 demonstrating the lowest μTBS. These findings suggest that incorporating CuNPs into an ER adhesive system, particularly at a concentration of 0.1 wt%, can effectively provide antimicrobial properties to the adhesive interface while simultaneously enhancing bond strength and achieving a favorable degree of conversion with carious-affected substrates.

Parental acceptance of dental treatment with SDF in children with CP.

This study aims to evaluate parental acceptance of dental treatment with silver diamine fluoride (SDF) in children with cerebral palsy (CP). The present study is a case-control study with 80 children in the age range of 6-11 years. Group I consisted of children diagnosed with CP and Group II consisted of children without any Special Health Care Needs and systemic conditions. Preoperative and postoperative behavior assessment was done using Frankl's behavior Rating Scale. 38 % SDF application was done in any one primary molar with occlusal dentinal caries. A well-designed validated structured questionnaire with 10 questions was developed to assess the parental acceptance of dental treatment with SDF. The questionnaire comprised 10 close-ended questions with subdivisions on socio-demographic details, the reason for the previous and current dental visit, and acceptance of dental treatment with SDF. The data were analyzed using SPSS (version 26, IBM, Chicago, USA). Continuous variables were expressed as mean±standard deviation (M±SD). Categorical variables were expressed as frequency (n) and percentage (%). The chi-square test was used for qualitative analysis. The level of significance was set at 5%. The number of children showing positive behavior on Frankl's behavior Rating Scale increased from 55% to 70% after dental treatment with SDF and this difference was statistically significant in Group I (p-value<0.001). 87.5% of parents in Group I had accepted the discoloration caused after dental treatment with SDF compared to 80% in Group II. In Group I, 95% of parents agreed strongly, while in Group II, 82.5% agreed strongly that SDF can be done on un-cooperative and special health care needs children. This difference in agreement seen between parents of Group I and Group II was found to be statistically significant (p-value=0.02). Also, the acceptance of SDF was found to be higher in parents who were educationally more qualified in Group I. This difference in the acceptance level of SDF seen based on the educational status of parents was statistically significant (p-value<0.001). Parental acceptance of SDF for dental treatment was higher in Group I (children with CP) as a greater number of parents accepted dental treatment despite discoloration with the modality being noninvasive and less time-consuming. Improved behavior rating was observed among children in both groups after dental treatment with SDF.

Effect of Surface Treatments on Shear-bond Strength of Glass Ionomer Cements to Silver Diamine Fluoride-treated Simulated Carious Dentin.

This study investigated the effect of different surface treatments on the shear bond strength (SBS) and failure modes of self-cured (SC) and light-cured (LC) high-viscosity glass ionomer cements (HVGICs) to silver diamine fluoride (SDF)-treated simulated carious dentin (SCD). Extracted human premolars were sectioned and pH cycled for 10 days to simulate carious dentin. The demineralized specimens were treated with 38% SDF (Riva Star) for 2 minutes, washed, stored in deionized distilled water at 37°C for 2 weeks, and subjected to the following surface treatments (n=14): T1 - no treatment (control); T2 - 10 seconds polyacrylic acid (PAA); T3 - 5 seconds phosphoric acid (PPA); T4 - 5 seconds PPA plus universal adhesive (Zipbond); and T5 - 5 seconds PPA plus resin-modified GIC adhesive (Riva bond LC). SC (Riva Self-cure HV) and LC (Riva Light-cure HV) HVGICs were applied to the conditioned specimens and stored in artificial saliva at 37°C for 1 week. SBS and failure modes were subsequently determined. Statistical analyses were performed using Kruskal-Wallis/post-hoc Mann-Whitney U and Chi-square tests (α=0.05). The highest SBS was observed when SC and LC were restored with T2 and T5, respectively. Significant differences in SBS were as follows: SC - T2, T1 > T5, T3; LC - T5, T4, T3 > T2. SC generally exhibited adhesive failures, while LC presented both adhesive and mixed failures. The preferred method for preparing SDF-treated carious dentin before restoration application is PAA for SC and PPA plus RMGIC adhesive for LC HVGICs.

Remineralization Effect of Bioactive Glass With and Without Fluoride and Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on Artificial Dentine Caries: An In Vitro Study

Remineralization Effect of Bioactive Glass With and Without Fluoride and Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) on Artificial Dentine Caries: An In Vitro Study

Efficacy of silver diamine fluoride (SDF) in arresting dentin caries against inter-kingdom biofilms of Streptococcus mutans and Candida albicans.

To compare, in vitro, the efficacy of three proprietary silver diamine fluoride (SDF) products in mitigating progression of dentinal caries induced by an inter-kingdom, dual-species, bacterial-yeast biofilm. Human dentin blocks were demineralized to create artificial caries lesions and randomized into three SDF test groups: Saforide, Topamine, T-SDF, and an aqueous control (n = 26 per group). After application of foregoing SDF variants, the blocks were incubated with Streptococcus mutans and Candida albicans for 24 h for biofilm development, and subsequently subjected to a microbe-induced, pH-cycling process for 7 days, to mimic the oral eco-system. The biofilm cell viability and surface topography were assessed by colony-forming units (CFUs) and scanning electron microscopy respectively. The lesion depth and mineral density were evaluated by micro-computer tomography. SDF precipitate and matrix-to-mineral ratio were evaluated by X-ray diffraction and Fourier transform infrared spectroscopy, respectively. Standard, accepted methodology was used for all these evaluations and procedures. After pH cycling, the SDF groups demonstrated comparable inhibition of the biofilm relative to the control. the log CFU of S. mutans for Saforide, Topamine, T-SDF, and control were 6.69±0.73, 6.48±0.56, 6.63±0.66, and 8.01±0.45, respectively. For C. albicans, the log CFU were 4.86±0.44, 4.72±0.53, 4.92±0.29, and 5.60±0.27, respectively. The log CFU of S. mutans and C. albicans in the SDF groups were significantly lower than the control group (p<0.001). Further, the lesion depth decreased by approximately 14.79±7.00% in the SDF groups, while it increased by 11.07±8.61% in the control (p<0.001), and the mineral density increased by 16.36±4.58% in the SDF group, as opposed to a 5.59±2.64% reduction in the control (p<0.001) implying their caries mitigating effect. These findings were corroborated by SEM images of the lesions. SDF significantly mitigated dentin caries due to an assault by a polymicrobial plaque biofilm whilst arresting mineral loss and lesion growth. There was no difference in the caries-arresting efficacy of the compared SDF variants.

Assessment of Severity and Pattern of Early Childhood Caries Using ICDAS II Criteria: A Descriptive Cross-sectional Study

Introduction: Early childhood caries is highly prevalent worldwide. The International Caries Detection and Assessment System incorporates both the non-cavitated and cavitated carious lesions with acceptable reliability. The objective of the present study was to assess the severity and pattern of early childhood caries among children visiting outpatient department of a dental college in Nepal. The study also aimed to compare the severity and pattern based on individual tooth type. Methods: A cross-sectional study was conducted among children of age group 24-71 months in primary dentition stage. The International Caries Detection and Assessment System II criteria was used to detect dental caries, and its severity and pattern. The ethical approval was taken from the institutional ethical committee (IRC Ref. No.: 1, 36, 2079/2080 IRC PDCH 2022 21).Results: The dental cries in children of age group 48-60 months was 1338 (33.46%) and dentinal caries (Code 5) was observed in 112 (8.37%). Multi-surface caries was 644 (16.15%), and occlusal surface caries was 481 (12.06%). Among the study population, 227 (5.69%) of the teeth assessed were associated with restoration and sealants. Enamel caries among the maxillary second molars (55/65) (Code 3) was in 94 (23.5%), and the dentinal caries (Code 5) in maxillary central incisors (51/61)was in 90 (22.78%). Conclusions: Majority of the children enrolled in the study had multiple cavitated and non-cavitated carious teeth involving different surfaces. Severity and pattern of caries also varied among individual tooth type.

Effectiveness of glass-ionomer sealant versus fluoride varnish application to prevent occlusal caries among preschool children over 18–24 months – A randomised controlled trial

ObjectivesTo compare the clinical efficacies of 5 % sodium fluoride varnish (NaFV) and glass-ionomer sealant (GIS) in preventing occlusal caries in primary second molars (PSMs). Materials and MethodsA total of 736 children were recruited from 18 kindergartens and randomised into either Group 1- receiving NaFV quarterly, or Group 2 - single placement of GIS at baseline. Interventions were performed on 1431 and 1264 PSMs in Group 1 and Group 2, respectively. The primary outcome was the development of ICDAS≥4 dentine caries at the occlusal surfaces of PSMs. ResultsA total of 736 children (383 in Group 1; 353 in Group 2) received the intervention. After 18–24 months, 479 children with 1764 PSMs were reviewed. Despite a low GIS retention rate of 2.4 % by 18–24 months, only 17.1 % of PSM in the GIS group developed caries into dentine. No significant difference was identified when compared to the proportion of PSMs with caries into dentine in the NaFV group (17.0 %). Regression analysis with GEE revealed that only baseline dft score and plaque level had a significant influence on development of ICDAS≥4 dentine caries in PSMs. ConclusionsQuarterly-applied NaFV and a single placement of medium viscosity GIS have similar clinical efficacies in preventing occlusal caries among preschool children. Clinical SignificanceThere is no significant difference between quarterly-applied NaFV and GIS in preventing occlusal caries at PSMs. Dental clinicians can choose to use either of these preventive methods after considering their own and parents’ preferences, children's cooperation and other practical factors.

Influence of Academic Training and Professional Experience on the Management of Deep Caries Lesions.

Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor's degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master's degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16-30 years. Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions.

Association between DEFB1 rs11362 and Caries Susceptibility in Permanent Dentition: A Cross Sectional Study.

Dental caries is a multifactorial chronic bacterial infectious disease. Variations in the predisposition of the general population to dental cavities suggest that genetic and immunological factors play significant roles in its pathogenesis. This study aims to explore the impact of the Beta-Defensin 1 (DEFB1) rs11362 polymorphism on caries susceptibility in permanent dentition among the Bai Kuyao and Zhuang ethnic groups in China. A sample of 754 adolescents aged 12-15 was randomly selected from primary and junior high schools in Nandan County, Guangxi, China. All adolescents underwent clinical examinations, and DNA samples were collected. The genotype of DEFB1 rs11362 was determined using single nucleotide polymorphism (SNP) typing. The concentration of human β Defensin 1 (hBD-1) protein in saliva was measured using a double-antibody sandwich enzyme-linked immunosorbent assay (ELISA). The distribution of the DEFB1 rs11362 T allele was lower in the Bai Kuyao group compared to the Zhuang group. The disparity in the rs11362 genotype was statistically significant in the superficial dentin caries subgroup of the Bai Kuyao population (p = 0.017). Following adjustment for all potential confounding variables, the analysis revealed a heightened risk of superficial dental caries among CT genotype carriers in the Bai Kuyao population under a co-dominant model (odds ratios (OR) = 2.70; 95% confidence intervals (CI) [1.35-5.44]; p = 0.005), and an increased risk among CC genotype carriers in the Bai Kuyao population under a dominant model (OR = 2.35; 95% CI [1.18-4.67]; p = 0.015). A significant difference (p < 0.05) was noted in the distribution of rs11362 genotypes and salivary hBD-1 levels among the Bai Kuyao group. Salivary hBD-1 levels were notably higher in the CC genotype group (4.12 ± 2.07 ng/mL) compared to both the CT (2.77 ± 1.62 ng/mL) and TT genotype groups (2.32 ± 0.98 ng/mL). The DEFB1 rs11362 polymorphism showed an association with caries susceptibility in permanent teeth and influenced hBD-1 protein expression in saliva. Consequently, the DEFB1 polymorphism likely represents a concealed risk factor for caries.

Shear Bond Strength of Different Adhesive Systems to Silver Diamine Fluoride - Treated Carious Dentine

Shear Bond Strength of Different Adhesive Systems to Silver Diamine Fluoride - Treated Carious Dentine

COMPARATIVE EVALUATION OF BEHAVIOUR OF CHILDREN AND TIME TAKEN BY THREE TECHNIQUES OF CARIES REMOVAL: CHEMOMECHANICAL CARIES REMOVAL, CARIES REMOVAL WITH SMART BURS AND CONVENTIONAL CARIES REMOVAL- A CLINICAL PROSPECTIVE STUDY

Background: Many chemomechanical caries removal (CMCR) agents have been introduced and marketed since 1970s, with each new one being better and effective than the previously introduced. CMCR and Smart Burs (mechanical caries removal) are minimally invasive treatment approaches which selectively remove caries-infected tissue while leaving intact caries-affected tissue-conserving tooth structure. Aim: to compare the effectiveness of different caries removal techniques in primary teeth using the BRIX-3000, conventional caries removal , and Smart Burs in removing dentinal caries. The time taken for caries removal, the efficacy of caries removal and patient acceptance will be evaluated for clinical success with different caries removal techniques. Materials and methods: the study will be carried in thirty primary teeth in children aged 5-10 years with asymptomatic carious lesion. The teeth will be randomly divided into three groups depending on type of caries removal method used. Results: There was statistically significant difference among the groups with respect to childs behaviour , time taken and efficiency of caries removal Conclusion:The time taken to remove caries by Conventional method was observed to be significantly lower as compared to that taken by smart burs and Brix - 3000. The clinical efficacy of caries removal was highest with conventional method followed by almost comparable effectiveness by smart burs and Brix-3000. However,Patient acceptance during caries removal was found to be highest with Brix - 3000 followed by Smart burs and least by Conventional method.

Pink tooth of mummery in mandibular left incisor

A 76-year-old male patient reported to our department with a chief complaint of discolored lower front tooth since 2–3 years. He had a history of some minor trauma to the teeth 5 years back, post which no dental treatment was undertaken. There was no episode of pain or any other associated discomfort. His medical history was non-contributory. On clinical examination, tooth 31 was found to be discolored giving it a generalized pinkish-yellow hue, prominently on the labio-proximal aspect. Neither fracture nor dentinal caries were evident in relation to the concerned teeth [Figure 1]. However, the patient had resorbed ridges due to his age. No swelling, sinus tract or erythema were detected. The vertical and the axial percussions were unproductive. A provisional diagnosis of internal resorption of tooth was given based on the patient’s history and clinical picture, which confirmed the same.

Near-infrared light transillumination (NIR-LT) vs clinical-visual inspection/FOTI to detect interproximal caries lesions in vivo.

To evaluate the ability of near-infrared light transillumination (NIR-LT) to detect interproximal enamel and dentinal caries lesions compared to clinical-visual inspection (VI) aided by fibre-optic transillumination (FOTI). From 170 Finnish adolescents aged 15-17 years, 5294 interproximal surfaces of premolars and molars were examined first clinical-visually aided by FOTI (VI&#43;FOTI) using the International Caries Detection and Assessment System (ICDAS) classification. Subsequently, the surfaces were examined using NIR-LT. The extent of lesions was determined using the modified NIR-LT classification based on the Söchtig criteria. For the analyses, data on upper and lower premolars and molars were combined. Distributions of lesions were presented as frequencies. Differences between VI&#43;FOTI and NIR-LT at the tooth and tooth surface levels were analysed by Chi-square and Fisher's exact tests. Sensitivity and specificity of the NIR-LT method to detect any lesion was performed using VI&#43;FOTI as the gold standard. By VI&#43;FOTI, 92.4% surfaces were classified as sound and by NIR-LT, 88.2%. Enamel caries lesions were found on 7.0% of the surfaces by VI&#43;FOTI and on 11.6% by NIR-LT. Enamel lesions identified by NIR-LT were nearly double for all examined teeth groups, except for lower molars it was 1.3-fold. In 66% of the surfaces, the differences between NIR-LT and VI&#43;FOTI findings were statistically significant (p<0.001). The sensitivity for all teeth of NIR-LT was 48.4% and the specificity was 91.1%. Radiation-free NIR-LT method shows considerable potential as a supplementary method for early detection of caries lesions among low caries prevalence adolescents.

Effects of silver diammine fluoride with/without potassium iodide on enamel and dentin carious lesions in primary teeth.

To assess the effects of SDF and SDF+KI treatment on enamel and dentin carious lesions in primary teeth using x-ray Microtomography (XMT) and back scattered scanning electron microscopy (BSE-SEM). Artificial enamel caries of 3 caries free primary teeth were created by immersion of the samples in 50 ml demineralization solution for 72 h. Three other teeth with natural dentin caries were selected. Both groups were divided into 3 subgroups: EC-Enamel Control; ES-Enamel with SDF application; ESK-Enamel with SDF followed by KI application; DC-Dentin Control; DS-Dentin with SDF application; DSK-Dentin with SDF followed by KI application. Each tooth was imaged using XMT at 3 time points: (1) Pretreatment; (2) after immersion in remineralization solution for 120 h, with or without SDF or SDF+KI; (3) after subsequent immersion in demineralization solution for 72 h. The change of radiopacities of the lesions in these time points were assessed from the XMT images. After the XMT scans, all teeth were investigated microscopically using BSE-SEM. In EC, no change in linear attenuation coefficient (LAC) was observed after remineralization, but LAC reduction was observed after subsequent demineralization. For ES, thin layer of high LAC material was deposited on the enamel surface after remineralization, and further reduction of LAC was observed after demineralization. In ESK, the surface layer was lost after SDF+KI, and small reduction of LAC was observed after demineralization. In DC, no LAC change was observed after remineralization, but reduction of LAC was detected after demineralization. In DS, high LAC material was formed on the carious dentin surface and randomly inside the lesion. No further LAC change was found after demineralization. In DSK, thick layer of high LAC material was deposited on the carious surface and inside the dentinal tubules. No further LAC reduction was found after subsequent demineralization. SDF and SDF+KI did not protect artificial enamel under acid attack even though Ag products were deposited in the porous enamel. However, SDF and SDF+KI shows protective properties against acid challenges and Ag products are deposited in carious dentin lesion without tubular structure randomly; and within dentinal tubules when these structures are retained.

Chemo mechanical caries removal CMCR: Efficacy of Carisolv gel in primary molar teeth.

To evaluate the efficacy of CariSolv gel with respect to chemo-mechanical caries removal in primary molar teeth. The cross-sectional study was conducted at the Department of Paediatric Dentistry, Bakhtawar Amin Dental College and Hospital, Multan, Pakistan, from July to December 2022, and comprised patients of either gender aged 6-12 years having vital, primary molar teeth with clinical and radiographic evidence of carious lesion. Freshly prepared CariSolv gel 0.2 ml to 1.0ml was applied to carious dentine for a minimum of 30 seconds, using chemo-mechanical caries removal hand instruments. The cavity preparation was rinsed and dried. Image caries detector dye was applied by micro brush for 10 seconds. After the cavity preparation was washed and dried, any red-stained dentine indicated residual infected dentine. A maximum of 3 chemo-mechanical caries removal cycles were allowed. Data was analysed using SPSS 26.0. Of the 134 patients, 74(55.2%) were boys and 60(44.8%) were girls. The overall mean age was 8.55±1.58 years. The procedure was successful in 115(85.8%) cases. Age and gender were not significantly associated with the outcome (p>0.05). Chemo-mechanical caries removal method using CariSolv gel was found to be a viable alternative to traditional drilling techniques for caries removal in primary molar teeth.

Modified experimental adhesive with sepiolite nanoparticles on caries dentin treated with femtosecond laser and photodynamic activated erythrosine. An in vitro study

AimTo assess the effect of CAD surface conditioners and their effect on Ra and SBS of tooth-colored filling material adhered to CAD surface with adhesive modified with 1 % Sep-NPs. Also, the DC of modified EA and its effect on the rheological properties. MethodsNinety human molars with carious extension up to the middle third of occlusal dentin were included. The teeth were then arbitrarily allocated into three groups based on the type of surface conditioning received (n = 30) Group 1 (PA), Group 2 (FS laser), and Group 3 (Ery PS). Ten samples from each group underwent Ra analysis using a stylus profiler. Twenty samples from each cohort were distributed into two subcategories based on the application of unmodified EA (A) and Sep-infiltrated EA (B). Composite restoration was built followed by SBS and failure mode analysis. Scanning electron microscopy and Energy dispersive X-ray EDX were assessed of sepiolite NPs. Degree of conversion (DC) and rheological analysis of the modified adhesive and unmodified adhesive were also performed. One-way analysis of variance (ANOVA) and the Tukey post hoc test were employed to conduct comparisons between the different groups. ResultsThe highest score of Ra and bond strength were displayed by Group 1B (PA + Sep-NPs filled EA) (17.32 ± 1.43 MPa) samples. Nevertheless, the lowest values were established by Group 3A (Ery-PS + EA) (13.45 ± 0.80 MPa) treated teeth. An increase in Ra resulted in a rise in SBS.DC decreased with the incorporation of 1 % Sep-NPs in EA compared to unmodified EA. ConclusionConditioning of CAD with PA and FS laser shows high surface roughness and favorable adhesion to experimental adhesive modified with 1 % Sep-NPs. Modified adhesive with 1 % Sep-NPs decreases DC and rheological properties.

A randomised clinical trial to arrest caries using silver diamine fluoride therapy with two postoperative instructions

ObjectiveThe objective of this study is to investigate the beneficial effect of not rinsing for 30 min in arresting early childhood caries after SDF therapy. MethodsThis randomised clinical trial recruited 3- to 4-year-old kindergarten children with active (soft) dentine caries. A questionnaire was sent to the parents to collect children's demographic data and oral health-related behaviours. A dentist conducted an oral examination and measured the caries experience using dmft index and oral hygiene using visible plaque index. After 38 % SDF therapy, the children were randomly allocated into two groups. Children in group A were instructed to rinse with water immediately, whereas children in group B were asked to refrain from rinsing, drinking, or eating for 30 min. After six months, the same examiner determined the lesion activity (active/arrest) of the SDF-treated carious tooth surface. Generalized Estimating Equations was used to compare the proportion of caries arrest (caries-arrest rate) between the two groups. ResultsThis study recruited 298 children with 1,158 decayed tooth surfaces receiving SDF therapy at baseline and evaluated 275 (92 %) children with 1,069 (92 %) SDF-treated tooth-surface at the six-month examination. The demographic background, oral hygiene and caries status of two groups were comparable at baseline (p > 0.05). The caries-arrest rate for group A and group B were 65 % (337/519) and 61 % (338/550), respectively (p = 0.28). ConclusionThis randomised clinical trial found not rinsing for 30 min after SDF therapy is not better than immediate rinsing in arresting early childhood caries. Clinical significanceTopical SDF application leaves an unpleasant taste in the mouth, which may affect the acceptance or even rejection of SDF therapy among young children. This study provides clinicians with information to make their decision on postoperative instruction after SDF therapy.

Evaluation of The Role of Music and Bach Flower Remedies in The Management of Anxious Pediatric Dental Patients: A Randomised Clinical Trial

Objective: Dental fear and anxiety describe negative feelings towards the dental environment, particularly significant in pediatric dentistry due to their cognitive, behavioral, and physical impacts on children. Managing this anxiety through positive dentist-child relationships and behavioral guidance techniques is crucial. This study aims to evaluate the effectiveness of passive distraction using music and Bach flower remedy in reducing dental fear and anxiety in children aged 6-8 years. Methods: This randomized controlled clinical study included 12 children (n=4 for each group) aged 6-8 years, randomly assigned to Group 1 (control), Group 2 (Bach flower remedy), or Group 3 (passive distraction with music) for treating superficial dentin caries in primary teeth without local anesthesia. Dental fear and anxiety levels were assessed using objective (heart rate, oxygen saturation, systolic and diastolic blood pressure) and subjective (Facial Image Scale and Venham’s Picture Test) measures before and after treatment. Results: The study included 12 children (6 female, 6 male) with a mean age of 7.3±0.8 years. In Group 2, heart rate significantly decreased after treatment (97.8 ± 10.1 to 90.5 ± 8.8, p.05). Conclusion: In this study, although passive distraction with music and Bach flowers did not have a significant effect on physiological and projective measurement tools in children with dental fear and anxiety, a decrease in heart rate was observed in children exposed to Bach flowers.

Comparative analysis of microbiome in coronal and root caries

BackgroundThe global rise in the elderly population has increased the prevalence of root caries. Streptococcus mutans, Lactobacilli and Actinomyces are considered the primary pathogens of dental caries in culture-based studies. This study aimed to investigate bacterial profiles in coronal and root caries lesions and determine the association of specific bacterial genera at each site.MethodsDentine samples from carious lesions were collected from 22 extracted teeth using an excavator. Microbial DNA was extracted from the samples using a protocol developed for this study. 16S rRNA gene amplicon sequencing was employed for microbial analysis. PCR amplification targeted the V3-V4 region of the bacterial 16S rRNA, and the amplicon sequencing used an Illumina MiSeq system (2 × 300 bp paired-end reads). Statistical analysis was performed by the Phyloseq and DESeq2 packages in R.ResultsIn coronal caries, Olsenella, Lactobacillus and Prevotella were the most prevalent genera, comprising approximately 70% of the microbiome community. In the root caries, however, although Olsenella, Prevotella and Lactobacillus remained the dominant genera, they accounted for only half of the microbiome community. This study identified significant differences in alpha diversity indices between the coronal and root caries. LEfSE analysis revealed several unique genera in each caries lesion.ConclusionThe microbiome of root caries lesions was richer and more complex than the coronal caries microbiota. The results suggest that lesion-related variations in the oral microflora may be detected in carious dentine.

Photoactivated rose bengal-doped TiO2 nanoparticles modified fifth-generation adhesive on the survival rate of Streptococcus mutants and mechanical properties of tooth-colored restorative material to carious dentin.

Assessment of the antimicrobial, micro tensile bond strength (μTBS), and degree of conversion (DC) of fifth-generation adhesive modified using photoactivated 0.5% rose bengal (RB) and photoactivated RB-doped titanium dioxide nanoparticles (TiO2NPs) in different concentrations (2% and 5%) as compared with the unmodified adhesive bonded to the carious affected dentin (CAD). Forty mandibular molars with caries progression up to the middle third of the dentin, as per the International Caries Detection and Assessment System (ICDAS) score of 4 and 5 were included. Specimens were divided into four groups based on etch and rinse adhesive (ERA) modification group 1: unmodified ERA, group 2: photoactivated 0.5% RB photosensitizer (PS) modified ERA, group 3: photoactivated RB-doped 2 wt% TiO2NPs adhesive, group 4: photoactivated RB-doped 5 wt% TiO2NPs adhesive. Followed by adhesive and composite restoration on the CAD surface. All the specimens were thermocycled and an assessment of μTBS and failure pattern analysis was performed. The antibacterial potency of RB and RB-doped TiO2NPs (2% and 5%) followed by their activation using visible light against Streptococcus mutans (S.mutans) were tested. The survival rate of S.mutans was assessed using the Kruskal-Wallis test. The analysis of μTBS involved the use of ANOVA, followed by a post-hoc Tukey honestly significant difference (HSD) multiple comparisons test. Group 1 (Unmodified ERA) (0.52 ± 0.31 CFU/mL) treated samples unveiled the highest means of bacterial survival and lowest μTBS (11.32 ± 0.63 MPa). Nevertheless, group 4: photoactivated RB-doped 5 wt% TiO2NPs adhesive displayed the lowest outcomes of S.mutans survival (0.11 ± 0.02 CFU/mL) and highest bond strength (18.76 ± 1.45 MPa). The photoactivated RB-doped 2 wt% TiO2NPs in adhesive demonstrated promising enhancements in both μTBS and antibacterial efficacy against S.mutans. However, it is noteworthy that this modification led to a decrease in the DC of the adhesive. RESEARCH HIGHLIGHTS: Unmodified ERA-treated samples unveiled the highest bacterial survival and the lowest μTBS. Photoactivated RB-doped 5 wt% TiO2NPs adhesive displayed the lowest S.mutans survival rate and highest bond strength. DC decreased with an increase in concentration of TiO2.