Caries Therapy Research Articles

Ginsenoside RB1 Influences Macrophage–DPSC Interactions in Inflammatory Conditions

Unresolved inflammation and tissue destruction are supposed to underlie the failure of dental pulp repair. As crucial regulators of the injury response, dental pulp stem cells (DPSCs) play a key role in pulp tissue repair and regeneration. M2 macrophages have been demonstrated to induce osteogenic/odontogenic differentiation of DPSCs. Ginsenoside Rb1 (GRb1) is the major component of ginseng and manifested an anti-inflammatory role by promoting M1 macrophage polarised into M2 macrophage in inflammatory disease. However, whether GRb1 facilitates odontogenic differentiation of DPSCs via promoting M2 macrophage polarisation under inflammatory conditions has yet to be established. Human monocyte leukemic cells (THP-1) differentiated macrophages were induced into M1 subsets and then treated with GRb1. After that, the conditioned medium was added to DPSCs. The cell co-cultured system was then subjected to odontogenic differentiation in osteogenic media. Effects of GRb1 on human dental pulp stem cells' (hDPSCs') osteogenic/odontogenic differentiation under inflammatory conditions were assessed by alkaline phosphatase (ALP) staining, Alizarin Red S (ARS) staining, and quantitative polymerase chain reaction testing. Results demonstrated that GRb1 could facilitate the polarisation of macrophages from the M1 subtype to the M2 subtype. Conditioned medium from GRb1 + M1 macrophages, in comparison with M1 macrophages, may markedly increase the gene expression of ALP, DSPP, and DMP1. Moreover, ALP and ARS staining uncovered that the osteogenic/odontogenic differentiation ability of hDPSCs was strengthened in the M1 + GRb1 co-culture group. GRb1 plays a crucial role in the inflammatory response and reparative dentine formation after dental pulp injury. Findings show that GRb1 modulates the interaction between macrophages and DPSCs during inflammation. The current study discusses modifications of deep caries therapy.

Stimuli-responsive graphdiyne-silver nanozymes for catalytic ion therapy of dental caries through targeted biofilms removal and remineralization

Clinical mechanical decontamination and irrigants are not consistently effective in preventing intractable biofilm-induced dental caries, especially when biofilms have caused demineralization. Constructing stimuli-responsive nanocatalysts with improved catalytic activity for plaque biofilm removal and remineralization enhancement remains challenging. Herein, a coordination-reduction strategy driven by L-cysteine and graphdiyne (GDY) is employed to anchor low-dose Ag nanoparticles/Ag+ to GDY nanosheets to obtain GDY/L-cys/Ag (GLA) nanozymes. Subsequently, biomimetic approach is used to encapsulate GLA into a GS ointment composed of gelatin methacryloyl and sodium alginate to form biodegradable and adhesive GLA/GS. GLA demonstrates acidic plaque biofilm-activated peroxidase-like activity, surpassing affinity toward H2O2 than natural horseradish peroxidase, effectively catalyzing low-dose H2O2 into highly toxic hydroxyl radicals (•OH). This catalytic activity simultaneously enhances Ag+ release triggered by acidic plaque biofilms, generating additional reactive oxygen species that can suppress plaque biofilms on ex vivo human teeth by the synergistic effect of catalysis and released ions. Importantly, GLA/GS serves as template nucleation sites crosslinked to rich Ca2+, thereby attracting PO43- from saliva, prompting growth into hydroxyapatite on tooth enamel, facilitating rapid remineralization. Due to the safe nanocatalytic ion therapy, in an in vivo rodent model, GLA/GS + H2O2 effectively prevents dental caries without influencing surrounding oral tissues.

Association between failed eradication of 7-day triple therapy for Helicobacter pylori and untreated dental caries in Japanese adults

Helicobacter pylori (H. pylori) infection is a cause of gastric disorders and is treated mainly by pharmacotherapy with antimicrobial agents. An association has been reported between dental caries and H. pylori infection. As antimicrobial agents are less effective inside dental caries because of impaired blood circulation, the presence of untreated dental caries (decayed teeth) may influence the success of H. pylori eradication treatment. In this cross-sectional study, we examined whether failed eradication of H. pylori was associated with decayed teeth in Japanese adults. Enrolled were 226 participants who received dental checkups among those treated for eradication of H. pylori at Asahi University Hospital between April 2019 and March 2021. Treatment efficacy was assessed by urea breath test. Eradication failed in 38 participants (17%), decayed teeth in 32 participants (14%), and number of 0.34 teeth per participants. Multivariate logistic regression analyses showed that failed eradication of H. pylori was associated with decayed teeth (presence: odds ratio, 2.672; 95% confidence interval, 1.093–6.531) after adjusting for gender, age, and brushing frequency. These results indicate that failed eradication of H. pylori was associated with decayed teeth and suggest that untreated dental caries may impact treatment for eradication of H. pylori.

Treatment strategies for deep caries

Deep caries occurs when caries progresses to the deep dentin layer, and further progression has the risk of pulp exposure, which may affect pulp vitality and tooth longevity. Currently, there are no objective standards for the diagnosis of deep caries. In addition, traditional therapy for deep caries emphasizes complete debridement of the decayed tissue, resulting in an incremental high risk of pulp exposure. There are different views on how to deal with the remaining dentin after caries removal, and root canal treatment is often adopted directly after pulp exposure. In recent years, due to advances in dental pulp biology, bioactive pulp-capping materials, and clinical evidence-based medicine, the principle of deep caries treatment has shifted to pulp protection. Based on the latest international research progress, evidence-based medicine and expert consensus, we present a series of advancements in this article, including the terminology of deep caries, pathological changes and defense mechanisms of the pulp close to the deep caries, treatment principles of deep caries, technical strategies for carious tissues removal, and the decision-making of treatment protocols after pulp exposure, with the aim of enhancing the understanding of deep caries among dentists, as well as providing a reference for the clinical diagnosis and treatment of deep caries.

The short-term impact of comprehensive caries treatment on the supragingival microbiome of severe early childhood caries.

Children affected by severe early childhood caries (S-ECC) usually need comprehensive caries treatment due to the extensive of caries. How the oral microbiome changes after caries therapy within the short-term warrant further study. This study aimed to investigate the short-term impact of comprehensive caries treatment on the supragingival plaque microbiome of S-ECC children. Thirty-three children aged 2-4 years with severe caries (dt > 7) were recruited. Comprehensive caries treatment was performed under general anesthesia in one session and included restoration, pulp treatment, extraction, and fluoride application. Supragingival plaque was sampled pre- and 1-month posttreatment. The genomic DNA of the supragingival plaque was extracted, and bacterial 16S ribosomal RNA gene sequencing was performed. Our data showed that the microbial community evenness significantly decreased posttreatment. Furthermore, comprehensive caries treatment led to more diverse microbial structures among the subjects. The interbacterial interactions reflected by the microbial community's co-occurrence network tended to be less complex posttreatment. Caries treatment increased the relative abundance of Corynebacterium matruchotii, Corynebacterium durum, Actinomyces naeslundii, and Saccharibacteria HMT-347, as well as Aggregatibacter HMT-458 and Haemophilus influenzae. Meanwhile, the relative abundance of Streptococcus mutans, three species from Leptotrichia, Neisseria bacilliformis, and Provotella pallens significantly decreased posttreatment. Our results suggested that comprehensive caries treatment may contribute to the reconstruction of a healthier supragingival microbiome.

Phycocyanin-Incorporated Zirconium Dioxide Nanoparticles Activated by Photodynamic Therapy for Caries Affected Dentin Disinfection: “An Examination of Adhesive Bond Strength And Scanning Elemental Analysis”

Aim: The purpose of the present study was to examine the effect of various disinfection regimes on the antimicrobial efficacy and bond integrity of CAD against two varieties of bacteria: lacto-bacilli and S. mutans. Material and methods: The investigation used SBS, SEM, elemental analysis, disinfection procedures, and failure mode analysis. Biofilm was grown on CAD samples. The specimens were randomly separated into five groups for disinfection: Group 1 received CHX treatment, Group 2 (Phycocyanain) PC treatment, Group 3 PC-PDT, Group 4 PC@ZrO2 NP-PDT, and Group 5 CO2 therapy. After disinfection, CFUs were measured, specimens were reconstituted, and SBS was tested using a universal testing machine (UTM). Stereomicroscope analyzed failures. Kruskal-Walis tested group survival rates. ANOVA and Post Hoc Tukey were used to calculate bond value mean and standard deviation for different disinfection techniques. All analyses used p<0.05. Results: The highest survival rate of S. mutans and Lactobacillus was found in group 2 CAD disinfected with PC only with no activation by PDT. The lowest survival rate of both bacteria was seen in Group 4: PC@ZrO2NP-PDT. Conclusion: PC@ZnO2NP-PDT demonstrated robust antibacterial activity against lactobacillus and S. mutans, albeit with lower bond values when compared to CHX and CO2.

PH-Responsive Biomaterials for the Treatment of Dental Caries-A Focussed and Critical Review.

Dental caries is a common and costly multifactorial biofilm disease caused by cariogenic bacteria that ferment carbohydrates to lactic acid, demineralizing the inorganic component of teeth. Therefore, low pH (pH 4.5) is a characteristic signal of the localised carious environment, compared to a healthy oral pH range (6.8 to 7.4). The development of pH-responsive delivery systems that release antibacterial agents in response to low pH has gained attention as a targeted therapy for dental caries. Release is triggered by high levels of acidogenic species and their reduction may select for the establishment of health-associated biofilm communities. Moreover, drug efficacy can be amplified by the modification of the delivery system to target adhesion to the plaque biofilm to extend the retention time of antimicrobial agents in the oral cavity. In this review, recent developments of different pH-responsive nanocarriers and their biofilm targeting mechanisms are discussed. This review critically discusses the current state of the art and innovations in the development and use of smart delivery materials for dental caries treatment. The authors' views for the future of the field are also presented.

Amyloid hexapeptide prevent dental caries by antibiofilm formation

ObjectivesBiofilm formed by cariogenic microbes is the direct cause of dental caries, therefore, prevention of dental caries should be anti-biofilm-based. Previously, we found the amyloid hexapeptides efficiently inhibited biofilm formation by aggregating into amyloid fibrils agglutinating microbes. This study aimed to select the most stable amyloid hexapeptide GIDLKI (GI6) and study its anti-caries effect. MethodsBiofilms of multi-species bacteria, derived from mixed saliva, were cultured to evaluate the anti-biofilm formation effect of GI6. And then, the primary cariogenic bacterium Streptococcus mutans (S.mutans) was cultured in BHI with various pH, gradient concentrations of sucrose, glucose, and calcium ions to evaluate the anti-biofilm formation effects of GI6. Then models of human enamel block caries and twenty male SPF-SD rat caries induced by S. mutans biofilm were constructed, and confocal laser scanning microscopy, scanning electron microscopy, and micro-computed tomography were applied to investigate the anti-biofilm formation, anti-caries effects and use safety of GI6. ResultsGI6 could inhibit the multi-species bacteria biofilm formation and remained effective in anti-biofilm activity against S. mutans in environments closely related to caries. GI6 suppressed S. mutans biofilm formation and thus prevented or alleviated the development of caries in human tooth blocks and rat teeth. GI6 did not affect the intestinal flora, serum biochemical parameters, and the pathological changes of various organs. ConclusionsAmyloid hexapeptides, including but not limited to GI6, are novel effective anti-caries agents that can be used to prevent dental caries safely. Clinical significanceThis study explored the anti-biofilm formation and anti-caries effect of GI6 in vitro, highlighting the anti-biofilm formation therapy for dental caries and setting a foundation for the practical application of GI6 for the treatment of dental caries.

Potentialities of photoactivated disinfection in dentistry

Infection control is an essential part of dental practice. Oral antiseptics should be highly effective against the most common oral pathogens without causing microbial resistance, biocompatible with the human tissues with no interaction with fillings materials. Photoactivated disinfection (PAD) is based on activation of photosensitizers - specific substances releasing active oxygen forms after absorption of the light. The active oxygen forms destroy bacterial cell structures without affecting human cells. The overwhelming majority of Russian and international researchers have reported high effectiveness of PAD in periodontics, implantology and endodontics, whereas the use of PAD in caries treatment and prevention is not so fully understood yet. Earlier studies have demonstrated high sensitivity of cariogenic bacteria to PAD, suggesting it as an additional minimally invasive caries therapy improving treatment effectiveness. PAD spares dental tissues without reduction in the effectiveness of disinfection. It is particularly important in treatment of deep carious lesions and disinfection of thin dentine layer near the pulp. Effectiveness of PAD in caries treatment has been demonstrated for both permanent and deciduous dentition. PAD doesn't affect bond strength to fillings, improves plasticity of dental pulp and dental hard tissues mineralization in children. Effective control of a wide range of bacteria without causing resistance makes PAD a prospective method of treatment and prevention of caries.

FORMULATION OF GARGLE FROM TRIGONA SP. PROPOLIS EXTRACT AND ITS ACTIVITY AGAINST STREPTOCOCCUS MUTANS

Objective: In this research, the formulations of a gargle with Trigona sp. propolis extracts as an alternative of dental caries therapy and test its activity against Streptococcus mutans was carried out.
 Methods: The experimental laboratory have been carried out with the following stages of work, material collection and processing, extraction of Trigona sp. propolis by maceration with 95% ethanol, phytochemical screening, determination of minimum inhibitory concentration, formulation of the gargle, activity, contact time and stability test of the formulas.
 Results: Phytochemical screening showed that Trigona sp. propolis extracts containing flavonoids, polyphenols, quinones, monoterpenoids and sesquiterpenoids. Minimum inhibitory concentration was 0.25% w/v. The formulation of gargle from Trigona sp. propolis extract were a yellow solution with mint odor and taste of mint and sweet. The antibacterial activity of gargle preparation and formulas from the market as a comparison, showed that the formula with a concentration of 1% w/v gave a significant difference to the market preparation. The formulation of gargle from Trigona sp. propolis extract has good inhibition against bacteria S. mutans with a contact time of 60 seconds and is physically stable during the 35 d of storage time.
 Conclusion: The formulation of gargle from Trigona sp. propolis extract is an excellent preparation to be developed in the future in the treatment of dental caries.

Inflammation of the Human Dental Pulp Induces Phosphorylation of eNOS at Thr495 in Blood Vessels.

The activity of endothelial nitric oxide synthase (eNOS) in endothelial cells increased with the phosphorylation of the enzyme at Ser1177 and decreased at Thr495. The regulation of the phosphorylation sites of eNOS at Ser1177 and Thr495 in blood vessels of the healthy and inflamed human dental pulp is unknown. To investigate this, healthy and carious human third molars were immersion-fixed and decalcified. The localization of eNOS, Ser1177, and Thr495 in healthy and inflamed blood vessels was examined in consecutive cryo-sections using quantitative immunohistochemical methods. We found that the staining intensity of Ser1177 in healthy blood vessels decreased in inflamed blood vessels, whereas the weak staining intensity of Thr495 in healthy blood vessels strongly increased in inflamed blood vessels. In blood vessels of the healthy pulp, eNOS is active with phosphorylation of the enzyme at Ser1177. The phosphorylation of eNOS at Thr495 in inflamed blood vessels leads to a decrease in eNOS activity, contributing to eNOS uncoupling and giving evidence for a decrease in NO and an increase in O2− production. Since the formation of the tertiary dentin matrix depends on intact pulp circulation, eNOS uncoupling and phosphorylation of eNOS at Thr495 in the inflamed pulp blood vessels should be considered during caries therapy.

The Anticariogenic Efficacy of Nano Silver Fluoride.

Dental caries is a common chronic disease, and anyone can be at threat of it throughout their lifespan. In school-aged children, dental caries is the most frequent disease related with oral health. Contemporary dental caries management focuses on non-restorative, non-invasive, and micro-invasive therapeutic techniques that effectively eliminate the caries progression at the lesion level and decrease the loss of healthy tooth structure. One of these strategies is to use caries apprehending agents with antibacterial and remineralizing characteristics. Due to recent regulatory approval in the United States, the use of silver diamine fluoride (SDF) for the therapy of dental caries has received substantial interest. SDF has successfully prevented and reversed both primary tooth caries and permanent teeth root caries. Even though SDF is an effective anti-caries agent, but it is associated with certain drawbacks like gum irritation, metallic taste, and irreversible dark stains on applying on cavities. As an alternative agent Nano Silver Fluoride (NSF) is preferable because it performs like SDF without tooth staining. It has comparable preventive and antibacterial activities as SDF. Further, it is ergonomic, economic and safe in children and adults. The current article aims to highlight the superior properties of NSF as a better anti-caries agent outstripping the limitations of discoloration of SDF.

On the Pathogenicity of the Oral Biofilm: A Critical Review from a Biological, Evolutionary, and Nutritional Point of View.

Plaque control is one of the most recommended approaches in the prevention and therapy of caries and periodontal diseases. However, although most individuals in industrialized countries already perform daily oral hygiene, caries and periodontal diseases still are the most common diseases of mankind. This raises the question of whether plaque control is really a causative and effective approach to the prevention of these diseases. From an evolutionary, biological, and nutritional perspective, dental biofilms have to be considered a natural phenomenon, whereas several changes in human lifestyle factors during modern evolution are not “natural”. These lifestyle factors include the modern “Western diet” (rich in sugar and saturated fats and low in micronutrients), smoking, sedentary behavior, and continuous stress. This review hypothesizes that not plaque itself but rather these modern, unnatural lifestyle factors are the real causes of the high prevalence of caries and periodontal diseases besides several other non-communicable diseases. Accordingly, applying evolutionary and lifestyle medicine in dentistry would offer a causative approach against oral and common diseases, which would not be possible with oral hygiene approaches used on their own.

Effects of Artificial Intelligence on Caries Therapy Selection

Effects of Artificial Intelligence on Caries Therapy Selection

An Overview on Smart Polymers as the Backbone to Hard Tissue Formation

The tooth which is made up of enamel, dentin and cementum mineralized structures and bone have high degree of hardness. Dental caries is another common human illness. Secondary caries causes caries therapy to fail over time. After a fracture or defect, bones have a moderate capacity to self-heal. Hard tissue regeneration comes at a high cost to society, which is likely to rise substantially as the population ages. As a result, developing appropriate biomaterials for hard tissue repair and regeneration is a critical job, particularly in countries with a significant senior population. Smart materials which can also be termed responsive materials are synthetic materials that can sense external stimuli and change one or more characteristic. Smart materials made up of polymer are most often utilized in the bio-medical area because they combine natural polymers high biocompatibility with synthetic polymers adjustable and functional characteristics.

Dental caries diagnosis using terahertz spectroscopy and birefringence.

Dental caries is a widespread chronic infectious disease which may induce a series of oral and general problems if untreated. As a result, early diagnosis and follow-up following radiation-free dental caries therapy are critical. Terahertz (THz) waves with highly penetrating and non-ionizing properties are ideally suited for dental caries diagnosis, however related research in this area is still in its infancy. Here, we successfully observe the existence of THz birefringence phenomenon in enamel and demonstrate the feasibility of utilizing THz spectroscopy and birefringence to realize caries diagnosis. By comparing THz responses between healthy teeth and caries, the transmitted THz signals in caries are evidently reduced. Concomitantly, the THz birefringence is also unambiguously inhibited when caries occurs due to the destruction of the internal hydroxyapatite crystal structure. This THz anisotropic activity is position-dependent, which can be qualitatively understood by optical microscopic imaging of dental structures. To increase the accuracy of THz technology in detecting dental caries and stimulate the development of THz caries instruments, the presence of significant THz birefringence effect induced anisotropy in enamel, in combination with the strong THz attenuation at the caries, may be used as a new tool for caries diagnosis.

Ozone Therapy for Early Childhood Caries (ECC) Treatment: An In Vivo Prospective Study

The present study aimed to evaluate the effectiveness of ozone therapy in (1) increasing the compactness of decayed dentin (main aim), (2) reducing dentin hypersensitivity, (3) decreasing the salivary bacterial count, and (4) improving the quality of life in ECC-affected children during a 3-month follow-up. A total of 20 subjects uncooperative with conventional restorative treatment were treated with a 60 s ozone application/week (OzoneDTA®) for 4 weeks. Patients were evaluated at T0 = baseline; T1 = after ozone cycle and T2, T3, T4 = 1, 2, 3-month follow-up, respectively. Dentin compactness was evaluated according to the Affected Dentine Scale (ADS) proposed by the authors; dentin hypersensitivity was recorded with the Wong–Baker Faces Pain Rating Scale (WBFPRS); salivary bacteria were measured with the Saliva Check Mutans Test and quality of life with the Early Childhood Oral Health Impact Scale (ECOHIS). ADS values and salivary bacteria count results were analyzed using non-parametric tests. Statistically significant differences were detected for both parameters between T0 and T1 (p < 0.01). At T1, dentin hypersensitivity was resolved and quality of life improved. Ozone therapy is a simple and painless approach, which might be useful for controlling caries’ progression in uncooperative children until appropriate cooperation is achieved.

Biology of selective caries removal: a systematic scoping review protocol

IntroductionPrimary goal of restorative caries therapy is to preserve pulp vitality and the dentition. Whereas the conventional approach of complete caries removal aims at the elimination of all affected substances...

In vitro evaluation of laser vs. handpiece for tooth preparation

Background:The erbium-doped yttrium aluminium garnet (Er:YAG) laser has been revealed to effectively ablate dental hard tissues, and its utilisation to caries eradication and cavity preparation is envisaged. Nevertheless, only a limited research has been performed on the Er:YAG laser's capacity to treat caries.Aim and Objectives:The efficiency of caries elimination with an Er:YAG laser in vitro was equated to that of traditional mechanical therapy in this study.Methodology:The investigation made use of teeth that had suffered from root caries. The Er:YAG laser was used to treat half of each tooth, while the other half was either removed with a conventional bur or left untouched as a control. Each therapy was evaluated in terms of how long it took to remove cavities, histological examinations of decalcified serial sections, scanning electron microscopy (SEM) analyses and the density of the dentin.Result:A longer treatment time was required for the Er:YAG laser to completely eradicate carious dentin because of its precise irradiation strategy. However, the Er:YAG laser was effective in removing diseased and softening carious dentin with little heat injury to neighbouring intact dentin, much as the bur treatment. It was also shown that the Er:YAG laser treatment had a lower amount of vibration than other methods. The SEM study of the lased dentin surface revealed characteristic micro-irregularities.Conclusion:The Er:YAG laser system appears to be a potential novel technical option for caries therapy, based on our findings.

Are Saliva Tests Important in the Prediction of Carious Disease?

(1) Background: The appearance and progression of carious lesions represent a complex phenomenon of interactions of microbial factors (the action of bacteria on the tooth), of the factors related to the host, to the diet, and to the time factor. Which hasan influence on the rate of microbismof the oral cavity on the installation of carious disease? (2) Methods: In order to correctly assess the cariogenic risk of an individual, it is recommended to perform twoor more tests based on different principles (microbiological, clinical, epidemiological). The representative data series for the investigation were analyzed statistically and by applying the Pearson correlation test considering the coefficient of determination R for all pairs of data series. (3) Results: Salivary tests played animportant role in establishing control sessions, in carrying out prophylactic caries therapy, and establishing prognosis. The existence of a statistical associationwas confirmed between the prevalence of dental caries and the results of salivary tests for the study group. (4) Conclusions: The results of the saliva tests can be used in oral health promotion.