Caries-preventive Effect Research Articles

Caries Preventive Effect and Retention of Moisture Tolerant Resin Based and Glass Ionomer Cement Sealants: A Systematic Review

Caries Preventive Effect and Retention of Moisture Tolerant Resin Based and Glass Ionomer Cement Sealants: A Systematic Review

Is fluoride the best we've got? The most common toothpaste active ingredients and their influence on caries and oral health: A brief review of the literature

Aim of the study Toothpaste is a paste or gel to be used with a toothbrush to maintain and improve oral health and aesthetics. Nowadays there is a great variety of ingredients that might have different effects on caries development or oral health in general. Society continues to seek ways to replace fluoride or include more natural ingredients in everyday hygiene products. The aim of our study is to present current knowledge of various ingredients in toothpastes regarding their influence on teeth and intraoral soft tissues and the possibility of replacing fluoride with other substances. Material and methods Our review is based on the analysis of materials collected in„Pubmed”, „Google Scholar” and other scientific articles using keywords: „toothpaste”, „fluoride”, „ingredients”, “hydroxyapatite”, „chlorhexidine”, “triclosan”, “propolis”, “aloe vera”, “charcoal”, “oleanolic acid”, “SLS”, “xylitol” Conclusions Despite numerous studies, there is space for further research in finding substances that might improve toothpastes with or without extracting fluoride from them. Fluoride has the most proven effectiveness in caries prevention, with fluorosis as its most damaging side effect, while hydroxyapatite shows promising results. Although, there are many substances that might be useful in oral health care products.

Is SDF better than the SMART (silver modified atraumatic restorative technique) in the management of molar incisor hypomineralisation molars with initial caries?

A prospective, randomized, split-mouth clinical study by thetwo previously trained and calibrated pediatric dentists without blinding operators and patients due to different protocols in both treatment groups. An SDF + potassium iodide (KI) and SDF + KI + glass ionmer cement(GIC) on International Caries Detection and Assessment System (ICDAS) 1/2 molar was received by each patient on either sideof mouth. The local Ethics Committee approved this study. Sample size calculation was not performed due to the lack of published studies on the longevity of SMART sealant on MIH-affected molarsand the absence of research on the apparent difference between the effectiveness of SMART and SDF treatments in preventing further caries and sensitivity. These were children between the ages of 6 years to 13 years, who visited the Pediatric Dentistry Clinic at XX University School of Dentistry for routine exams and treatment between July 2019 to May 2020. They were in good health and had at least two fully erupted permanent first molars with MIH as per the European Academy of Pediatric Dentistry, ICDAS code 1/2. This study recorded 12 months of treatment outcomes on hypomineralised molars of 48 children with a follow-up of three years. Children were excluded with specific syndromes associated with enamel malformation, lack of cooperation, ongoing orthodontic treatment, and teeth with ICDAS 3/4/5/6 lesions, existing restorations, fluorosis, or pulpal symptoms. Mann-Whitney U Test was used to assess differences between independent groups (SDF and SMART) and the Friedman Test between dependent groups at different time points. Kaplan-Meier analysis to evaluate the cumulative survival of SMART sealants and survival of caries-free hypomineralised molars in both groups. Chi-Square test was used to compare the success percentages of the SDF and SMART groups. To assess the changes in success percentages at three different time intervals for the caries preventive effect of SDF and SMART, and to evaluate the retention percentages for the SMART group. McNemar's test with a Bonferroni correction was used for significant differences. Cohen's kappa test indicated that the inter-examiner reliability determining the presence of MIH was 0.87. The intra-examiner reliability for US Public Health Service (USPHS)-Modified criteria was 0.90. The statistical significance level was set at p < 0.05 for all statistical analyses. At 12, 24 and 36 months the caries preventive effect was 100%, 67.9%, and 65.4% for SDF + KI-treated teeth; and 100%, 97.6%, and 94.7% for SMART (SDF + KI + GIC) respectively. During the recall period, there was no substantial difference in hypersensitivity scores between the groups. There was no hypersensitivity in teeth at 18 months and beyond. Compared to the baseline Schiff Cold Air Sensitivity Scale (SCASS) score 26 molar with initial hypersensitivity to hypomineralisation had a massive reduction at evaluation periods. The mean survival probabilities for the caries-preventive effect were considerably lower in SDF + KI-treated teeth (31.01 months) than in SMART-treated teeth (35.61 months) (p < 0.001). Considering the limitation of the study, both SMART (SDF + KI + GIC) sealants and 6-monthly application of SDF + KI, provided similar and substantial levels of desensitisation on the permanent MIHmolars. When used as a sealing material on non-cavitated permanent MIHmolars, the clinical retention rate for SMART was 88.7%, 73.1%, and 66.6% at 1, 2, and 3 years respectively. The caries preventive effect of SMART (SDF + KI + GIC) sealants was superior to SDF + KI application in hypomineralised teeth, however, a long-term monitoring and review is essential due to the gradual decrease in retention of SMART sealants.

Preventing proximal enamel caries in neighboring tooth with glass ionomer cement restoration and silver diamine fluoride pretreatment

ObjectiveTo investigate caries preventive effects of 38 % silver diamine fluoride (SDF) pretreatment on neighboring tooth proximal to glass ionomer cement (GIC), including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations in an in vitro model. Methods: Human tooth blocks were restored withSDF+CGIC (Group 1), CGIC (Group 2), SDF+RMGIC (Group 3) or RMGIC (Group 4). Enamel specimen simulating proximal surface of neighboring tooth was placed in proximity to the restorations. The specimen underwent cariogenic challenge with cross-kingdom biofilm of Streptococcus mutans, Lacticaseibacillus casei and Candida albicans. After cariogenic challenge, the biofilm's growth kinetics, viability, and morphology were evaluated by propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. The enamel lesion depth, surface morphology and crystal characteristics were determined by micro-computed tomography (micro-CT), SEM and X-ray diffraction (XRD), respectively. ResultsPMA-qPCR demonstrated lower microbial growth in Group 1 and 3 compared with Group 2 and 4 (p < 0.05). CLSM showed the dead−to-live ratio in Groups 1–4 were 1.15±0.12, 0.53±0.13, 1.10±0.24 and 0.63±0.10, respectively (Group 1,3 > 2,4, p < 0.05). SEM revealed Groups 1 and 3 had scattered biofilm whereas Group 2 and 4 had confluent biofilm. Micro-CT showed the enamel lesion depths (µm) were 98±9, 126±7, 103±6 and 128±7 for Group 1 to 4, respectively (Group 1,3 < 2,4, p < 0.05). SEM revealed oriented and ordered enamel prismatic patterns in Group 1 and 3, not in Group 2 and 4. XRD showed the reflections of hydroxyapatite in Groups 1 and 3 were sharper than Groups 2 and 4. ConclusionSDF pretreatment enhances the preventive effect of GIC on proximal enamel surface on neighboring tooth through inhibiting cariogenic biofilm, reducing enamel demineralization and promoting enamel remineralization. Clinical significanceSDF pretreatment of GIC restorations can help prevent caries on neighboring teeth, particular for patients with high caries risk.

Effects of NaF versus SDF treatment on microhardness of artificial radiation caries at cervical and root areas.

This study aimed to compare the effect of silver diamine fluoride (SDF) and fluoride varnish (NaF) on the Vickers microhardness (VHN) of enamel and dentin after radiotherapy and pH-cycling. Human premolars were cut longitudinally, embedded and serially polished. The VHN of enamel/dentin and irradiated enamel/dentin were evaluated. The irradiated specimens were treated with either NaF or SDF, subjected to pH-cycling then VHN test for 4 days. Consequently, they were subjected to energy-dispersive X-ray (EDX) analysis. Radiation adversely affect enamel VHN (p<0.05), whereas dentin VHN was not affected (p>0.05). After pH-cycling, a significant decrease in dentin VHN was observed on day 2 for all groups, whereas enamel VHN was significantly decreased in the control group on day 4. SDF-treated enamel demonstrated higher VHN than that of NaF on day 3. Caries prevention effect of SDF and NaF were observed on enamel, where SDF was proved to be superior to NaF.

Clinical comparison of silver diamine fluoride (SDF) or silver-modified atraumatic restorative technique (SMART) on hypomineralised permanent molars with initial carious lesions: 3-year results of a prospective, randomised trial

ObjectivesThis study aimed to assess the clinical outcomes of utilizing silver diamine fluoride + potassium iodide (SDF + KI) treatment and Silver-Modified Atraumatic Restorative Technique (SMART/SDF + KI + Glass Ionomer Cement) over a three-year period on hypomineralised permanent molars with initial carious lesions. Methods112 hypomineralised permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF + KI and SMART (SDF + KI + GIC) groups (n = 56 teeth/group) in a split-mouth design. Hypersensitivity and caries development were evaluated in both groups. Schiff Cold Air Sensitivity Scale (SCASS) was used for evaluation of hypersensitivity, and the modified USPHS criteria were utilised for clinical assessments of SMART sealants at 1,6,12,18,24 and 36 months. Fisher's Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis. ResultsThe caries preventive effect was 100 %, 67.9 % and 65.4 % for SDF + KI-treated teeth; and 100 %, 97.6 % and 94.7 % for SMART(SDF + KI + GIC)-treated teeth at 12, 24 and 36 months, respectively. The mean survival probabilities for caries-preventive effect were significantly lower in SDF + KI-treated teeth (31.01 months) than SMART-treated teeth (35.61 months), (p < 0.001). Twenty-six molars with initial hypersensitivity due to hypomineralization demonstrated a significant reduction at all evaluation periods compared to baseline SCASS scores (p < 0.001). Additionally, there was no significant difference in hypersensitivity scores between the groups during the re-call periods, and none of the teeth exhibited hypersensitivity at the 18-month and beyond evaluations. ConclusionsDuring the three-year assessment, both groups demonstrated effectiveness in reducing sensitivity in hypomineralised molars. However, SMART (SDF + KI + GIC) sealants offered better protection against tooth decay over time, despite experiencing gradual retention loss. Clinical significanceBoth SMART (SDF + KI + GIC) sealants and SDF + KI proved effective in alleviating hypersensitivity in hypomineralised molars for up to three years. SMART (SDF + KI + GIC) sealants showed greater caries-preventive effect compared to SDF + KI. However, continuous long-term monitoring is crucial due to the gradual decline in retention of SMART (SDF + KI + GIC) sealants. ClinicalTrials registration numberNCT03862014.

Comparing Fluoride Varnish, Fissure Sealant and Ozone for Children Caries Prevention

Background: Caries is the most prevalent oral health disease in children globally. Well-known method such as fluoride varnish and fissure sealant has been used to prevent caries overtime. Ozone therapy considered as a new innovation in caries prevention for children which has not been studied much for its effectiveness compared to the other popular method. Objective: This review aimed to compare caries preventive methods with fluoride varnish (FV), fissure sealant (FS) and ozone (O) for children and decide which method is the most effective. Literature Study: PubMed, SpringerLink, EBSCOhost and Science direct were searched from December 2021 to January 2022. The criteria included all randomized controlled trials and clinical trials comparing the caries preventive effect between FV, FS and O on children’s permanent teeth. Discussion: A total of 12 articles were included. Regarding dentin caries prevention, 2 studies found resin FS in favour of no FS and 2 studies found FV in favor of controls. 1 study agreed glass ionomer FS and no FS comparable. 3 studies agreed FV and FS were comparable. 1 study agreed resin FS and glass ionomer FS comparable. 1 study also found FV, FS and O comparable. Regarding dentin remineralization, 2 studies found O were comparable with FS dan calcium hydroxide base. These methods are safe for children. Conclusion: Fluoride varnish, fissure sealant and ozone are effective in preventing children’s caries with their own benefits and drawbacks. None of the methods is superior over another as there were a variety of the data reported.

Sociodemographic, biological, and timing characteristics of dental caries and fluorosis using mixed-type cluster analysis on 12-year-olds in Ho Chi Minh city, 1989–2019

ObjectivesIn 1990, Ho Chi Minh City started Community water fluoridation (CWF) at 0.7 ppm F, and in 2000, it was adjusted to 0.5 ppm F. Here, we analyzed dental caries and fluorosis data in Ho Chi Minh City to explore commonalities associated with CWF among 12-year-old children. MethodsDental caries and fluorosis data were collected in 1989, 2003, 2012, and 2019 (N = 4773). Trained dentists scored dental caries using the WHO detection criteria and fluorosis using Dean's Fluorosis Index. We used these data and the k-prototypes method by the R package to identify clusters of participants with shared clinical and water fluoride levels. ResultsWe used datasets 1 (4773 participants) and 2 (4194 participants, missing fluorosis data in 1989). K-prototypes analysis identified three clusters in each dataset. Cluster 1, with 80 % of the sample at 0.5 ppm F area characterized by low caries and fluorosis scores. Cluster 2 with 60 % of the sample non-fluoridated area had high caries and low fluorosis scores. Cluster 3, with 75 % of the sample in 0.7 ppm area, had low caries but borderline high fluorosis scores. ConclusionIdentifying three clusters based on clinical and environmental scores supports the decision to fluoridate the water to prevent caries (0–0.7 ppm) and the shift from 0.7 to 0.5 ppm to keep the caries preventive effect while reducing the risk of fluorosis. Clinical significanceOur results support the effectiveness of CWF in preventing dental caries and the appropriateness of changing the F concentration to reduce the risk of fluorosis while maintaining its effectiveness.

In vitro caries-preventive effect of a mineralization-promoting peptide combined with fluoride gel on sound primary teeth.

Mineralization-promoting peptide-3 (MPP3) is a new biomimetic remineralization agent. To assess the remineralization efficiency of MPP3, either alone or in combination with fluoride gel. The samples were divided into four groups: control, 1.23% fluoride gel, 10% MPP3 gel, and 1.23% fluoride gel + 10% MPP3. Following the application of remineralization agents (4 min), the samples remained in a pH-cycling model (37°C, 4 weeks). Microhardness, microcomputed tomography (micro-CT), polarized light microscopy (PLM), and field emission scanning electron microscopy (FE-SEM) analysis were conducted. RM-ANOVA, one-way ANOVA, and intraclass correlation coefficient (ICC) were used for statistical analysis, and a significance level of p < .05 was employed. Mineralization-promoting peptide 3 and fluoride gel + MPP3 increased the microhardness of the enamel compared with initial values in each group (p < .05). Mineralization-promoting peptide 3 successfully maintained the mineral density of enamel, although the cariogenic pH-cycling and PLM results indicated that the lesion depth (μm) was significantly lower in the fluoride gel + MPP3 group (27.0336 ± 12.53650) than in the control group (37.3907 ± 12.76002, p < .05). The combined use of MPP3 with fluoride gel enhanced the caries-protective and mineralization-promoting effects of fluoride. Mineralization-promoting peptide 3 may be a potential agent that can be employed to improve the physical properties of enamel.

Air abrasion with additional water supply for sealing fissures of permanent teeth in children

Relevance. The prevalence of caries in permanent teeth of 6-year-old children in Russia reaches 13%. In view of tooth enamel mineralization completion within a few years after the eruption, the role of primary prevention is especially significant. Fissure sealing is one of the preventive measures. At the same time, the effectiveness of dental caries prevention in children within the first year after tooth eruption reaches sufficiently high rates.Material and methods. The study involved 58 children. The experimental group included 30 children (105 teeth) who had the fissures sealed by air abrasion with additional water supply using a "Rondoflex plus 360" handpiece ("KaVo", Germany). The control group included 28 children (89 teeth) who underwent standard non-invasive sealing. Sealing effectiveness was assessed in 3, 6, 12, 18, and 24 months using the E.M. Melnichenko formula modified by the authors. Statistical data were represented by percentage; the χ2 test identified inter-group differences.Results. The experimental group showed the best sealant retention (up to 76.19% after 24 months). In the control group, the percentage of retained sealant was 48.31% by the end of the follow-up period. After 1 and 2 years, the total sealant loss was 11.24% and 22.48%, respectively. This fact may be associated with the failure of the sealant adhesion to the tooth enamel under the influence of a constant chewing load.Conclusion. Analyzing two-year follow-up results, we found that caries developed in 3.81% of cases in the main group, and the control group revealed caries in 12.37%. Thus, the effectiveness of fissure sealing using air abrasion with additional water supply is 63.4% higher compared to the non-invasive technique (χ2 =16.638, p&lt;0.001).

The F word revisited

Dental UpdateVol. 50, No. 6 CommentThe F word revisitedFJ Trevor BurkeFJ Trevor BurkeSearch for more papers by this authorFJ Trevor BurkePublished Online:13 Jun 2023https://doi.org/10.12968/denu.2023.50.6.473AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article References National Institute of Dental and Craniofacial Research. The story of fluoridation. Available at: https://tinyurl.com/uw36c6v5 (accessed May 2023). Google ScholarRandall RC, Wilson NH. Glass-ionomer restoratives: a systematic review of a secondary caries treatment effect. J Dent Res 1999; 78: 628–637. https://doi.org/10.1177/00220345990780020101 Medline, Google ScholarWiegand A, Buchalla W, Attin T. Review on fluoride-releasing restorative materials – fluoride release and uptake characteristics, antibacterial activity and influence on caries formation. Dent Mater 2007; 23: 343–362. https://doi.org/10.1016/j.dental.2006.01.022 Medline, Google ScholarYengopal V, Mickenautsch S, Bezerra AC, Leal SC. Caries-preventive effect of glass ionomer and resin-based fissure sealants on permanent teeth: a meta analysis. J Oral Sci 2009; 51: 373–382. https://doi.org/10.2334/josnusd.51.373 Medline, Google Scholar FiguresReferencesRelatedDetails 2 June 2023Volume 50Issue 6ISSN (print): 0305-5000ISSN (online): 2515-589X Metrics History Published online 13 June 2023 Published in print 2 June 2023 Information© MA Dentistry Media LimitedPDF download

In vitro and in situ caries-preventive effect of a new combined fluoride and calcium experimental nanocomposite solution.

To assess the in vitro and in situ effect of experimental combined fluoride and calcium nanocomposite solutions on dental caries prevention. Nanocompound mesoporous silica (MS) with calcium (Ca) and sodium fluoride (NaF) - (MSCaNaF); MS with NaF (MSNaF), NaF solution (positive control), and deionized water (negative control - CG) were studied. The specimens (n=130) were submitted in vitro to a multispecies biofilm in the presence of 2% sucrose. After 24 h and 48 h, the culture medium pH, the percent of surface mineral loss (%SML), and lesion depth (ΔZ) were analyzed. In the in situ study, 10 volunteers participated in four phases of 7-days each. The products were applied on the specimens (n=240) before 20% sucrose solution drips. The polysaccharides (SEPS and IEPS), %SML and roughness (Sa) were evaluated. There was an in vitro decrease in pH values in 24h and 48h, compared to baseline. The MSCaNaF and MSNaF groups obtained lower values of %SML and ΔZ (p < 0.05) than CG and NaF after 24h and were similar to NaF after 48h (p<0.05). In situ results showed similar SEPS and IEPS among all groups after 48h. An after 7-days, the nanocomposites had similar values (p>0.05), while NaF was similar to CG (p>0.05). After 48h, the MSCaNaF and MSNaF reduced the %SML (p<0.05). After 7-days, both experimental nanocomposites were similar to NaF (p>0.05). Regarding Sa, MSCaNaF was better than NaF for both periods (p<0.05). The nanocomposites controlled the in vitro and in situ enamel demineralization, mainly in the initial periods.

ЭФФЕКТИВНОСТЬ ЭКЗОГЕННОЙ ПРОФИЛАКТИКИ КАРИЕСА ПРИ ПОМОЩИ ТРЕХКОМПОНЕНТНОГО КАЛЬЦИЙ-ФТОР-ФОСФАТ-СОДЕРЖАЩЕГО ГЕЛЯ У БЕРЕМЕННЫХ ЖЕНЩИН С РАЗЛИЧНЫМ УРОВНЕМ РЕЗИСТЕНТНОСТИ ЗУБНОЙ ЭМАЛИ

Subject. Dental prophylaxis in pregnant women is frequently ineffective, and the indicators to characterize the dental caries intensity, and its growth rate during pregnancy have been persisted at a fairly high level. The tooth tissues resistance degree to aggressive factors of the oral cavity may be considered to be the significant. The teeth resistance to caries is determined by morphological structure of the enamel. A three-component calcium-phosphate-fluorine-containing gel improves the quality characteristics of tooth enamel, which is confirmed by the data of the KOSRE-test (clinical determination of enamel remineralization rate) and the electrical conductivity of tooth enamel. The dynamic assessment of using the three-component calcium-phosphate-fluorine-containing gel effectiveness as a mean of preventing caries in pregnant women with different levels of tooth enamel resistance to demineralization processes has been quoted.&#x0D; Objectives. Evaluation of the effectiveness of caries prevention using the three-component calcium-phosphate-fluorine-containing gel in pregnant women with different levels of resistance.&#x0D; Methodology. Clinical examining and observing 126 pregnant women with different levels of resistance have been performed. As a means of caries prevention, the three-component calcium-phosphate-fluorine-containing gel with the ratio Ca:F:P = 2:1:1 was used.&#x0D; Results. After applying a three-component calcium-phosphate-fluorine-containing gel the tooth enamel electrical conductivity of women with different levels of resistance has significantly decreased in comparison with the initial values. According to the KPUP Index data any statistically significant increasing in new carious cavities hasn’t been noticed after a year after using the three-component calcium-phosphate-fluorine-containing gel. By the way a low degree of tooth enamel compliance to the acid influencing, and the statistically significant rate of artificial demineralization focus recovering have been noted after using the gel.&#x0D; Conclusion. The caries-prophylactic measures have been determined to have to be administered for pregnant women with taking into account the tooth resistance level, because the teeth enamel at pregnant women with different levels of resistance has dissimilar resistance to demineralization processes. &#x0D; The three-component calcium-phosphate-fluorine-containing gel prescribed by using application is considered to be the versatile mean of caries prevention for pregnant women with different levels of resistance that has been confirmed by improving the electrical conductivity of tooth enamel to be the indicator of its mineralization, the data of the KOSRE-test, and the values of the DMFT Index (sum of all surfaces of permanent and milk teeth affected by caries, filled and removed) in observation dynamics.

Experimental study of the transformation of 2-aminophenylacetic acid hexafluorosilicate into 2-oxindol under mild conditions

Currently, ammonium hexafluorosilicates are being actively studied as new anti-caries agents, which, according to the results of researches on rats, show a more significant caries-preventive effectiveness compared to sodium fluoride with a simultaneous significant improvement of the biochemical indicators of the dental pulp and the absence of hepatotoxic effects. Previously, we’ve synthesized 2-, 3-, 4-aminophenylacetic acid hexafluorosilicates (2-, 3-, 4-APhHFS); in an attempt to recrystallize the 2-APhHFS salt from ethanol, a red crystalline product was obtained.&#x0D; The purpose of the research – considering the potential prospects of 2-, 3-, 4-APhHFS, it is expedient to establish the composition and structure of the recrystallization product of 2-APhHFS. Mass spectra were recorded on MX-1321 and VG 7070 spectrometers (VG Analytical), X-ray structural analysis was carried out on an Xcalibur E diffractometer.&#x0D; As follows from the comparison of the external inspection of the original 2-APhHFS and its recrystallization product (RP) samples, they differ significantly: light brown amorphous 2-APhHFS and red crystalline RP. The characteristics of the mass spectra of 2-APhHFS and RP are also different. The structure of RP as 2-oxindole was objectively established by X-ray diffraction data.&#x0D; The recrystallization process of 2-APhHFS to obtain 2-oxindole does not require heating of the reaction mixture, i.e., it is carried out under extremely mild conditions. It is possible that it's connected with the participation of the protonated form of 2-aminophenylacetic acid in the composition of 2-APhHFS in chemical transformations.&#x0D; Thus, caution should be exercised in experiments with both solutions and, apparently, solid samples of 2-APhHFS during salt purification procedures or other manipulations. The high lability of 2-aminophenylacetic acid hexafluorosilicate limits the possibilities of using standard purification methods (sublimation, recrystallization) for this compound.

Prevention of dental caries in children with Down syndrome

Objectives: to study the effectiveness of dental caries prevention of children with Down syndrome. Sixteen children with Down syndrome (DS) aged 7 to 16 years were included in the case-control study. Indices of dental caries prevalence (DMFT) and caries experience were studied, caries risk assessment was performed by applying Cariogram software. Dental caries (DC) prevention measures included: health education, guided oral cavity hygiene and topical applications of fluoride preparations. To the subjects of the research group (L₁, nr=8) topically was applied solution Gluftored, Vladmiva, that containing nanofluorides, and to the children of the control group (L₀, nr=8) was applied the fluoride varnish Belak-F, Vladmiva. The study was approved by the Research Ethics Committee and was conducted after obtaining written consent from the children’s parents or their legal representatives. Implementation of complex preventive measures over 2 years to children with DS in L₁ provided statistically significant reduction of dental caries and caries risk indicators in comparison with the L₀ group. Conclusions: The superior efficacy of complex preventive measures including topical applications of nanofluoride was demonstrated.

Caries Prevention Using Silver Diamine Fluoride: A 12-Month Clinical Trial

ObjectiveThis clinical trial aimed to compare the caries-preventive effect of annual application of 38% silver diamine fluoride solution (SDF) with 5% sodium fluoride varnish (FV) to the anterior primary teeth of children. The hypothesis was that SDF was superior to FV at 1 year. Secondary objectives were to determine the child's cooperation and the parent's satisfaction and assess adverse effects. MethodWe recruited 688 3- to 4-year-old children and randomly allocated them to receive SDF or FV (positive control) on their 6 upper anterior teeth. Tooth-surface status was recorded using the decayed, missing, and filled surfaces index. A trained observer rated the child's cooperation as “totally cooperative” or “not totally cooperative.” We used a questionnaire to determine the parent's satisfaction as “satisfied,” “neutral,” or “dissatisfied.” Adverse effects (yes/no) were evaluated 1 day and about 1 year after treatment. ResultsOf the children, 434 (SDF, n = 209; FV, n = 225) completed the trial. The mean new decayed tooth surfaces developed for SDF and FV groups were 0.4 ± 1.5 and 0.4 ± 1.3, respectively (P = .65). Child's cooperation for SDF and FV therapy was 71% (244/344) and 70% (241/344), respectively (P = .89). Parent's satisfaction for SDF and FV therapy was 71% (148/209) and 69% (155/225), respectively (P = .29). Adverse effects were found neither at 1 day nor at about 1 year after treatment for either treatment arm. ConclusionsSDF is not superior to FV for caries prevention in primary upper anterior teeth at 1-year follow-up. Child's cooperation and parent's satisfaction were similarly high with SDF and FV therapy at 1-year follow-up. Neither short-term nor long-term adverse effects were observed. This study is registered at ClinicalTrials.gov (NCT04399369).

Ecological influence by colonization of fluoride-resistant Streptococcus mutans in oral biofilm.

Dental caries is one of the oldest and most common infections in humans. Improved oral hygiene practices and the presence of fluoride in dentifrices and mouth rinses have greatly reduced the prevalence of dental caries. However, increased fluoride resistance in microbial communities is concerning. Here, we studied the effect of fluoride-resistant Streptococcus mutans (S. mutans) on oral microbial ecology and compare it with wild-type S. mutans in vitro. Biofilm was evaluated for its polysaccharide content, scanning electron microscopy (SEM) imaging, acid-producing ability, and related lactic dehydrogenase (LDH), arginine deiminase (ADS), and urease enzymatic activity determination. Fluorescence in situ hybridization (FISH) and quantitative real-time polymerase chain reaction (qRT-PCR) were used to evaluate the S. mutans ratio within the biofilm. It was followed by 16S rRNA sequencing to define the oral microbial community. Fluoride-resistant S. mutans produced increased polysaccharides in presence of NaF (P < 0.05). The enzymatic activities related to both acid and base generation were less affected by the fluoride. In presence of 275 ppm NaF, the pH in the fluoride-resistant strain sample was lower than the wild type. We observed that with the biofilm development and accumulative fluoride concentration, the fluoride-resistant strain had positive relationships with other bacteria within the oral microbial community, which enhanced its colonization and survival. Compared to the wild type, fluoride-resistant strain significantly increased the diversity and difference of oral microbial community at the initial stage of biofilm formation (4 and 24 h) and at a low fluoride environment (0 and 275 ppm NaF) (P < 0.05). Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis revealed that fluoride-resistant strain enhanced the metabolic pathways and glucose transfer. Fluoride-resistant S. mutans affected the microecological balance of oral biofilm and its cariogenic properties in vitro, indicating its negative impact on fluoride's caries prevention effect.

Correction of metabolic changes in the tissues of oral cavity of rats using a complex of drugs under the conditions of pathological factors

Hypoxia is a typical pathological process that occurs when tissues are insufficiently supplied with oxygen or when its utilization is impaired. One of the most important pathogenetic factors in the development of tissue hypoxia is the disintegration of the structure of mitochondrial membranes which occurs under the influence of various etiological factors. In children who suffered hypoxia in the antenatal period, the frequency of developmental delays is significantly increased, and the incidence of caries is also shown to increase as compared to healthy children. Based on the above, this work is relevant for modern dentistry. The work is devoted to the study of the state of the maxillofacial system and tissues of the oral cavity of rats under the influence of the complex of drugs under the conditions of intrauterine hypoxia, cariogenic diet, thyroid insufficiency and fluorine deficiency. The subjects of the study were 25 female white rats of the Wistar line of herd breeding from the vivarium of the SE “ISMFS NAMS” kept on a standard vivarium diet. The animals were divided into three groups – intact (7 rats), pathology model (8 rats), pathology model and drug complex (8 rats). Animals were removed from the experiment under thiopental anesthesia (40 mg/kg). Lower jaws and pulp were removed. As a result of the research, it was established that the proposed treatment-prophylactic complex has a pronounced caries-prophylactic and periodontoprotective effect. The caries-preventive effectiveness of the complex was due to its ability to stimulate the mineralizing function of the dental pulp, namely, to increase the activity of alkaline phosphatase of the pulp, as an indicator of the activation of osteoblasts, against the background of a decrease in the activity of acid phosphatase, a marker of osteoclasts.

Comparison of interproximal delivery and flow characteristics by dentifrice dilution and application of prepared toothpaste delivery technique.

In home care, the toothpaste technique, which can enhance the caries-preventive effect without changing the amount of dentifrice and fluoride ion concentration, is of great significance. This study aimed to construct a model and experimental system that reproduces the interdental part and to clarify the relationship between the change in dentifrice viscosity due to dilution and washout in the high-risk approximal area of caries. Additionally, the effectiveness of the toothpaste technique and appropriate devices for delivering dentifrice to the interdental area at a low dilution were investigated. Diluted toothpaste samples were prepared (: ×1.00, ×1.25, ×1.50, ×1.75, ×2.00, ×3.00, and ×4.00). An acrylic interproximal model was created for this experiment. The flow characteristics and viscosity by dentifrice dilution were measured. In the case of low dilution of 57% (1.75×) or more, it was shown that the dentifrice in the high-risk area may be washed out early because of the decrease in viscosity, and the caries-preventive effect may be reduced. It was also suggested that to keep the dentifrice in the interdental area for 120 s at the end of brushing, a dilution must be devised to a concentration of at least 50% (2.00×). The prepared toothpaste delivery (PTD) method of delivering dentifrice to the interdental area while maintaining it at a low dilution is an effective toothpaste technique in terms of dentifrice dilution and viscosity. The use of finger brushes in the PTD method could increase the efficiency of dentifrice delivery.

Effects of a 445 nm diode laser and silver diamine fluoride in preventing enamel demineralisation and inhibiting cariogenic bacteria

ObjectiveTo study the effects of a 445 nm diode laser (L) and silver diamine fluoride (F) on preventing enamel demineralisation and inhibiting cariogenic bacteria. MethodsThirty-three enamel slices were sectioned each into four blocks for four groups to receive L with F (LF), F, L and Water (W, control). Ten blocks from each group were used to evaluate demineralisation. Surface morphology, lesion depth and nanohardness of the blocks after pH-cycling were studied by scanning electron microscopy (SEM), nanohardness test, and micro-computed tomography, respectively. Twenty-three blocks per group were used for biofilm assessment. Morphology, viability, and growth kinetics of the Streptococcus mutans biofilm were assessed by SEM, confocal laser scanning microscopy, and the counting of colony-forming units (CFUs), respectively. ResultsSEM images of LF-treated enamel showed an intact surface compared with other groups. Nanohardness (GPa) for LF, F, L and W were 1.43±0.17, 1.01±0.11, 1.04±0.13 and 0.73±0.14, respectively (p < 0.001; LF>F, L>W). Their lesion depths (µm) were 46±8, 52±6, 88±13 and 111±9, respectively (p < 0.001; LF, F<L<W). SEM showed few bacteria for LF and F compared with other groups. Their dead-live ratio were 1.67±0.13, 1.60±0.15, 0.39±0.05 and 0.32±0.05, respectively (p < 0.001; LF, F>L>W). Log CFUs for LF, F, L and W were 4.2±0.3, 4.5±0.2, 7.9±0.3 and 9.4±0.2, respectively (p < 0.05; LF<F<L<W). Two-way ANOVA analysis revealed an interaction effect on nanohardness and Log CFUs between the laser irradiation and SDF treatment (p < 0.001). ConclusionThis study showed a superior caries preventive effect of a combined treatment of the diode laser and SDF. Because diode laser and SDF are affordable and readily available, clinicians can provide this treatment to their patients for caries prevention. Clinical significance statementDiode lasers are handy, afforable and readily avaliable to clinicians. This study provides information of use of 445 nm diode laser for caries prevetion. The laser irradiation hopefully can be added before conventional topical SDF application.