Fissure Caries Research Articles

OPTIMIZATION AND IMPROVEMENT OF CARIES TREATMENT IN THE FIELD OF PERMANENT TEETH FISSURES IN CHILDREN

Dental caries is the most common dental disease in children. The problem of timely diagnosis, prevention and adequate treatment of this pathology occupies one of the leading places in pediatric therapeutic dentistry. However, before applying the sealant, the dentist faces the difficult task of assessing the condition of the fissure, diagnosing a possible latent carious lesion, and choosing adequate tactics for therapeutic and preventive measures. Fissure caries occupies the first place in the structure of carious lesions of the teeth. Based on this, the problem of prevention and treatment of fissure caries is extremely urgent. It has been established that fissure caries occurs immediately after teething. The high incidence of fissure caries is associated with the features of the anatomical structure of the fissures, the accumulation of food residues and the formation of aggressive dental plaque in the natural recesses of the tooth and a longer period of hypomineralization compared with smooth tooth surfaces. There is a direct relationship between the initial level of mineralization of the enamel of fissure teeth and the risk of fissure caries.

Prevalence of type of dental caries among the patients visiting a tertiary health care center in the Western region of Nepal

Introduction: Dental caries is one of the major public health problems globally due to its high prevalence and significant social impact. The objective of the present study was to assess the most prevalent type of dental caries among the studied population. Methods: This cross-sectional study was conducted among 300 participants. The data were collected by intraoral examination of the subjects, where the type of dental caries in each patient was examined. The surfaces infected with dental caries were recorded as occlusal pit and fissure caries, root caries, smooth surface caries, and recurrent caries. Descriptive statistical methods were applied for data analysis. Results: The most prevalent type of dental caries was found to be the occlusal pit and fissure caries 595(66.04%) followed by smooth surface caries 220(24.42%), recurrent caries 54(5.99%) and root caries 32(3.55%). The occlusal pit and fissure caries was more prevalent in the mandibular arch 298(67.73%). Males had more prevalence of different types of dental caries. Based on the age group, 40 to 50 years age group had the most prevalent type of occlusal pit and fissure caries 60(20%). Conclusions: The results showed a high prevalence of occlusal pit and fissure caries in the study population followed by smooth surface caries, recurrent caries, and root caries.

Identification of chemical transformations in enamel apatite during the development of fissure caries at the nanoscale by means of synchrotron infrared nanospectroscopy: A pilot study

The spectral data sets obtained in our work using classical micro Fourier transform infrared spectroscopy (μFTIR) and modern broadband synchrotron infrared nanospectroscopy (SINS) methods, as well as their analysis and comparison with the known μFTIR spectroscopic results, provide new fundamental information on the mechanisms of pathological processes development in the carious fissure region of a human tooth at the level of enamel apatite crystallites (nano level). The infrared vibration signatures detected in our nanoscale study allowed us to establish gradient changes in chemical composition (phase transformations) occurring within the enamel roads at the level of apatite nanocrystals forming a prism, also to estimate changes in the crystallinity coefficient and the proportion of acid phosphates, as well as the depth of bacteria metabolism products (acid invasion). The results of the comparative study of this technique demonstrate that the combination of s-SNOM, IR spectroscopy and synchrotron broadband source in the SINS method provides excellent chemical sensitivity, sufficient for the providing of chemical identification of phase transformations with enhanced spatial resolution of ∼25 nm and the depth of useful signal output of several tens of nanometers. These advantages of SINS claim to be an advanced approach for investigations of objects of biological nature at a qualitatively new level.

Survival Analysis of Glass Ionomer Cement and Resin-Based Sealant Retention: A 10-Year Follow-Up Study.

Background and Objective: Sealant application is a proven method to prevent occlusal caries; however, long-term studies on this topic are scarce. This study aimed to assess the survival rate and clinical effectiveness of glass ionomer cement (GIC) and resin-based sealants (RBSs) on second permanent molars over a long-term follow-up period. Materials and methods: Sixteen patients aged 11-13 years with all four completely erupted permanent second molars were enrolled in the study. All patients attended 1-year and 3-year follow-ups; however, one participant did not respond after 10 years and was excluded from the final analyses. The oral health status evaluation was based on WHO criteria. A total of 32 teeth received an RBS (Clinpro), and a further 32 teeth were sealed with GIC (Fuji IX). The sealant retention was determined according to the Kilpatrick criteria after 1 year, 3 years, and 10 years, respectively. Statistical analysis included a chi-square test, the Kaplan-Meier method, and the Cox proportional hazard model. Results: At baseline, seven boys and eight girls participated in the study, with a mean age of 12.3 ± 0.9 years. The 1-year follow-up results revealed that 90% of the RBSs and 43.3% of the GIC sealants were completely retained, and no caries lesions were recorded (p = 0.01). The 3-year follow-up results showed that 23.3% of the RBSs and 0% of the GIC sealants demonstrated complete retention (p = 0.034). Moreover, 10.0% of the occlusal surfaces in the RBS group and 13.3% of the occlusal surfaces in the GIC group were filled (p > 0.05). A total of 6.7% of the RBSs showed complete retention. One-third of the sealed teeth (30.0% of the teeth sealed with RBSs and 36.7% of teeth applied with GIC) were filled after 10 years. The Kaplan-Meier analysis demonstrated a higher survival rate in the RBS group when compared with the GIC over the entire follow-up period (p = 0.001). Conclusions: Although the survival rate of RBSs was higher than GIC sealants, their effectiveness in preventing fissure caries in permanent second molars did not differ significantly over a 10-year follow-up.

In vitro analysis of material micro-leakage in pit and fissure sealants

A preferable choice of material offers superior resistance against micro-leakage for clinical applications in preventing dental caries in pits and fissures is of interest. A total of 45 extracted human premolars were cleaned, stored in a saline solution, and randomly divided into three groups, each intended for treatment with one of the sealants: Fuzi VII, ClinPro, and Embrace Wetbond. The application of the sealants followed the manufacturers' instructions strictly. The teeth were subjected to thermal cycling to simulate oral conditions. Marginal micro-leakage was then assessed by dye penetration method using a 0.5% methylene blue dye. Teeth were sectioned, and dye penetration was measured under a stereomicroscope. The results showed that all the tested materials exhibited some degree of micro-leakage. Within the limitations of this in vitro study, it was concluded that Embrace Wetbond exhibited superior performance in terms of minimizing marginal micro-leakage among the tested pit and fissure sealants.

Efficacy of Glass Ionomer Cement as Pit and Fissure Sealant in Permanent First Molars.

Background/Objectives Pit and fissure caries constitute a predominant portion, approximately 90% in permanent posterior teeth and 44% in primary teeth among children and adolescents. Among various preventive modalities, pit and fissure sealants play a pivotal role in safeguarding these vulnerable areas. Categorized by materials such as glass ionomer, composites, and polyacid-modified glass ionomers, these sealants offer effective protection. This study aims to evaluate the efficacy of glass ionomer-based pit and fissure sealants in terms of retention rate at 12-month post-procedure period in permanent first molars. Methodology This study was conducted at the Department of Operative Dentistry, Nishtar Institute of Dentistry, Multan, Pakistan. Fifty-six children, aged 7 to 12 years, presenting with pit and fissure caries in permanent first molar teeth were enrolled. Glass ionomer sealantwas meticulously applied to the affected pits and fissures. The efficacy was assessed after 12 months based on predefined criteria. Results The age of participants ranged from 7 to 12 years, with a mean age of 9.24 ± 1.38 years. Among the 56 patients, 23 (41.2%) were male and 33 (58.8%) were female. Sealant retention was noted in 31 (55.35%) patients, while 25 (44.65%) experienced sealant loss. In the 7 to 9-year age group, 19 demonstrated complete sealant retention, whereas in the 10 to 12-year age group, 12 exhibited complete retention. Concerning gender distribution, 17 males and 14 females exhibited complete sealant retention. Conclusion Glass ionomer-based sealants demonstrate excellent properties for pit and fissure sealing owing to their low technique sensitivity, cost-effectiveness, and favorable retention rates. Therefore, they represent an optimal choice for this preventive dental procedure.

Silver diamine fluoride – ‘The silver bullet’ in pediatric dentistry: An overview of past, present and prospects

Various fluoride-containing topical agents like sodium fluoride, acidulated phosphate fluoride, Silver fluoride, and Silver diamine fluoride (SDF) have also been developed to prevent and intercept dental caries, particularly in children. SDF in 38% concentration for preventing and arresting dental caries in children. SDF is applied exclusively to carious lesions, both cavitated and non-cavitated, forming a protective layer on demineralized enamel and dentin. This layer enhances resistance to acid dissolution and enzymatic digestion of collagen, promoting mineralization and the formation of hydroxyapatite and fluorapatite SDF is a versatile treatment option for caries management, offering benefits in various clinical scenarios, including difficult access cases, high caries risk patients, and prevention of pit and fissure caries. The present article discusses the utility of SDF in dentistry, with an emphasis on pediatric dentistry

In Vitro Evaluation of Viscosity, Depth of Penetration, Microleakage, and Shear Bond Strength of Conventional and Hydrophilic Sealants.

Sealants are effective in preventing and arresting pit and fissure caries. Newer brands of sealants continue to be developed despite the lack of scientifically based information addressing the caries-preventive properties of these materials. Hence, laboratory in vitro tests play a vital role in providing the necessary information regarding the efficacy of new products in a short period of time. To compare and evaluate the viscosity, resin tag length, microleakage, and shear bond strength between conventional and hydrophilic sealants. A total of 40 extracted third molars were selected. Only 20 were evaluated for microleakage and resin tag length and another 20 for shear bond strength evaluation between group I-ClinPro and group II-UltraSeal XT hydro. After sealant placement, specimens were immersed in 0.1% rhodamine dye, followed by thermocycling. Microleakage testing was done using a confocal laser scanning microscope and resin tag length evaluation using a scanning electron microscope (SEM) and shear bond strength using an Universal Instron machine. Viscosity was assessed using an Anton Paar viscometer. Results were subjected to statistical analysis using Statistical Package for the Social Sciences (SPSS) software version 20. Viscosity and mean microleakage scores for group I (0.92 MPa and 1.50) were found to be higher than for group II (0.72 MPa and 0.60). Mean resin tag length and mean shear bond strength for group I (7.46 ± 0.95 μm and 13.71 ± 0.94 MPa) were found to be less compared to group II (10.03 ± 1.00 μm and 20.39 ± 0.98 MPa). The results were found to be statistically significant (p < 0.05). Group II was found to be less viscous, which resulted in the formation of resin tags of sufficient length and showed less microleakage and higher shear bond strength than group I. Prabakar J, Jeevanandan G, Kengadaran S. In Vitro Evaluation of Viscosity, Depth of Penetration, Microleakage, and Shear Bond Strength of Conventional and Hydrophilic Sealants. Int J Clin Pediatr Dent 2023;16(5):745-750.

Optical methods for caries detection and determination of caries removal end points.

The modern standard in dentistry requires minimally invasive treatment, as it allows preserving the teeth vitality. The purpose of this study was to evaluate the possibility of laser spectroscopy and quantitative light-induced fluorescence to determine the caries removal end point. Materials and methods: the study was conducted on ten third molars extracted for medical reasons. Measurements were carried out at different stages of preparation of the carious cavity using laser spectroscopy (DIAGNOdent-pen) and quantitative light-induced fluorescence (Qraypen). Results: both methods were effective in differentiating affected and infected dentin. The following indicators of carious tissues were obtained. DIAGNOdent-pen: carious enamel — 28.8±8; soft dentin — 68.3±14; firm dentin (pigmented and non-pigmented) — 23.7±8 and 9.2±3 respectively; healthy dentin (hard) — 4.7±3. For Qraypen: carious enamel — ΔF=25.7±9, ΔR=26; soft dentin — ΔF=26.6±9 ΔR=28.75; firm dentin — ΔF=18.4±9, ΔR=0—10 (no difference between pigmented and non-pigmented was observed); healthy dentin (hard) — ΔF=13.7±8, ΔR=0. Conclusion: methods of laser spectroscopy and quantitative light-induced fluorescence can be used for diagnostics and to assess the quality of preparation of carious cavities, effectively detect fissure caries and selectively remove infected dentin.

SEM study of resin tags depth for filled pit and fissure sealants using subpressure and adhesive system - An experimental analysis

Background: Pit and fissure caries account for about 90% of the caries of permanent posterior teeth and 44% of caries within the first teeth in children and adolescents. Sealant application may be a preventive conservative approach. However, it is still challenging to bolster the retention of the filled sealant and to chop back the microleakage. Aims and Objectives: To evaluate and compare the depth of resin tags of three filled pit and fissure sealants (PFS) using subpressure and adhesive system under scanning electron microscope (SEM). Materials and Methods: This study was in vitro experimental study. Forty-five orthodontically extracted premolars were prepared for resin tag depth measurement and divided according to materials and subgroups. Group A- Resin-based filled PFS, Group B- Resin modified glass ionomer-based filled PFS, Group C- Giomer based filled PFS. Subgroup 1- Only sealant application, Subgroup 2- Subpressure application, Subgroup 3-Adhesive system + Subpressure application. Samples were subjected to thermocycling. The sectioned tooth fragments were polished using a carbide stone and then mounted under SEM for analysis. Photographs of the sections were obtained and the resin tag lengths were measured. Unpaired t-test and one-way analysis of variance test used for analysis. Results were considered significant when P&lt;0.05. Results: The depth of resin tags of the tested materials differed significantly for Giomer-based and resin-modified glass ionomer-based filled PFS group with P&lt;0.05. Whereas Resin-based filled PFS group was not found significant P&gt;0.05 for the depth of resin tags. Conclusion: This study concludes that Giomer based filled PFS group and Resin-modified glass ionomer-based filled PFSs showed the highest Resin tag depth respectively when compared with Resin-based filled PFSs. The Subpressure application group was more effective followed by Adhesive+subpressure application group and Control group.

Comparative Evaluation of the Microleakage and Shear Bond Strength of Three Filled Pit and Fissure Sealants Using Subpressure and Adhesive System: An Experimental Analysis.

Pit and fissure caries account for about 90% of caries in children and adolescents. Sealant application may be a preventive conservative approach. But it's still challenging to bolster the retention of the filled sealant and to chop back the microleakage. Aim is to evaluate and compare the microleakage and shear bond strength (SBS) of three filled pit and fissure sealants (PFS) using a subpressure and adhesive system: an experimental analysis. A total of 90 orthodontically extracted premolars were prepared for microleakage and SBS and divided according to materials and subgroups. Group I: resin-based filled PFS, group II: resin-modified glass ionomer-based filled PFS, and group III: giomer-based filled PFS. Subgroup 1: only sealant application, subgroup 2: subpressure application, and subgroup 3: adhesive system + subpressure application. Samples were subjected to thermocycling. Microleakage was assessed with a dye penetration method under a stereomicroscope, and SBS was assessed with a universal testing machine. Unpaired t-test and one-way analysis of variance (ANOVA) test were used for analysis. Significant when p < 0.05. The SBS showed significant results for subpressure application and giomer-based filled PFS with p < 0.05. The microleakages score differed significantly for the subpressure application group with p < 0.05. Giomer-based filled PFS showed the least microleakage score. This study concluded that giomer-based filled PFS showed statistically significant results. The subpressure technique significantly reduces microleakage and increases SBS. Waghmode SK, Devendrappa SN, Hadakar SG, et al. Comparative Evaluation of the Microleakage and Shear Bond Strength of Three Filled Pit and Fissure Sealants Using Subpressure and Adhesive System: An Experimental Analysis. Int J Clin Pediatr Dent 2023;16(S-1):S97-S100.

Dynamics of Morphological Changes in Oral Fluid in the Prevention of Fissure Caries in Children

The purpose of the study was to investigate the morphological properties of oral fluid in dynamics in the application of the developed set of measures for the prevention of fissure caries of the first permanent molars in children. Materials and methods. 62 children aged 6 years with fissure caries of the first permanent molars (main group) and 31 children without signs of carious lesions (control group) were examined. The study of the crystal formation of oral fluid was carried out according to the method of Leus P. A. (1977). The mineralizing potential of oral fluid was expressed as an average score depending on the types of crystals detected. Results and discussion. The analysis of the results of the study showed that 6 months after the start of preventive measures in the oral fluid of the children of the main group, a slight increase in type I crystals was noted in comparison with the initial data (40.18 ± 4.65% of cases, p&gt;0.5), at the same time, the number of children, in whom type III crystals were observed, decreased in the main group (16.45 ± 2.32%, p&gt;0.5), and increased in the control group (19.32 ± 2.47% of cases, p&gt;0.5) in comparison with the initial data. After two years of observation, in the children of the main group, type I crystals were most often detected in the oral fluid (48.41 ± 4.23% of cases), in the children of the control group, on the contrary, the number of children with this type of crystals decreased and was almost one and a half times less than among children of the main group (p&lt;0.05). On the other hand, the number of children in the control group, in whom type III crystals were detected, was two times higher than among children in the main group (22.34 ± 2.87% and 11.51 ± 2.56% of cases, respectively, p&lt;0.05). Conclusion. It was established that in children who received a complex of preventive measures, 6 months after the implementation of preventive measures, the mineralizing potential of oral fluid was, on average, 2.73 ± 0.07 points, which is slightly higher compared to the fissure detected at the beginning of caries prevention (2.57 ± 0.12 points respectively, p&gt;0.05). In the children of the control group, the mineralizing potential of oral fluid changed less noticeably (from 2.64 ± 0.11 points at the beginning of observation to 2.66 ± 0.11 points, p&gt;0.5). After two years of observation, it was found that in the main group the mineralizing potential of oral fluid continued to increase, while in the children of the control group it decreased and reached almost the initial level (2.65 ± 0.07 points in the second year of observation and 2.64 ± 0.08 points at the beginning, p&gt;0.05). Thus, it can be concluded that the proposed measures are quite effective

Prevalence of sealant in an Italian paediatric population: an epidemiological study.

The use of sealants is an effective measure for the prevention of pit and fissure caries in children and it has been well documented by several studies In order to plan and establish a preventive national programme, it is important to know the epidemiological pattern in an Italian paediatric population, correlated to the risk of caries, DMFT and other sociodemographic factors. This study was conducted on 2,442 children aged between 6 and 12 years attending the paediatric dentistry department of the University of L'Aquila, Italy. In addition to the oral examination, a questionnaire was administered on bad habits and the family perception of sealing. For descriptive analysis, the sample was stratified into two groups based on the presence/absence of at least one tooth with sealant. The differences between discrete and nominal variables, reported as absolute and percentage frequencies, were assessed by applying the χ2 test or the Fisher's exact test, as appropriate. Continuous variables were expressed in terms of mean values and their standard deviation(±DS) and the differences between the two groups under consideration were analysed through Student's t-test. The tests used are two-way and a significance level of 5% was applied. The statistical analysis was carried out using the statistical package STATA/IC 15.0 (StataCorp LLC, Texas, USA). The application of sealants to healthy occlusal surfaces is the best aid in preventing the development of caries in these areas, and this is especially important in childhood and adolescence, when the incidence of this pathology is particularly high.

Silver diamine fluoride therapy for dental care.

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is used to control early childhood caries, arrest root caries, prevent fissure caries and secondary caries, desensitise hypersensitive teeth, remineralise hypomineralised teeth, prevent dental erosion, detect carious tissue during excavation and manage infected root canals. SDF is commonly available as a 38% solution containing 255,000 ppm silver and 44,800 ppm fluoride ions. Silver is an antimicrobial and inhibits cariogenic biofilm. Fluoride promotes remineralisation and inhibits the demineralisation of teeth. SDF also inactivates proteolytic peptidases and inhibits dentine collagen degradation. It arrests caries without affecting dental pulp or causing dental fluorosis. Indirect pulp capping with SDF causes no or mild inflammatory pulpal response. However, direct application of SDF to dental pulp causes pulp necrosis. Furthermore, SDF stains carious lesions black. Patients must be well informed before SDF treatment. SDF therapy is simple, painless, non-invasive, inexpensive, and requires a simple armamentarium and minimal support. Both clinicians and patients generally accept it well. In 2021, the World Health Organization included SDF as an essential medicine that is effective and safe for patients. Moreover, it can be used for caries control during the COVID-19 pandemic because it is non-aerosol-generating and has a low risk of cross-infection.

Bacterial Flora in Dental Cavities after Traditional and Alternative Methods for Cavity Preparation

The aim of the study was to establish the qualitative and quantitative composition of microbial flora of dental cavities (DCs) after traditional and alternative preparation, including different methods of isolating the working field. Material and Methods: Our study included 60 patients (mean age of 25.0±3.1 years) with DC Class 1 (Black's classification) without concomitant somatic pathology. To accomplish the study’s aim, 60 teeth were prepared. The main group (MG) consisted of 45 teeth prepared under absolute isolation with a rubber dam (RD). In the MG, 15 teeth were treated traditionally with a diamond bur with red and yellow markings (MG-1), 15 teeth were treated by ultrasound with a diamond tip (MG-2), and 15 teeth underwent hydrokinetic preparation (MG-3) with the Aquacut device (Velopex). In the comparison group (CG), which included 15 teeth, DCs were treated traditionally with a dental bur without the RD. The MG and CG were comparable in terms of the initial state of dental and microbiological status. The study of the qualitative and quantitative composition of the DC microflora showed that all DCs contained pathogenic β-hemolytic streptococcus in the CG. At the same time, the maximum number of cases (80%) was moderately contaminated.. MG-1 and MG-2, as in the CG, were characterized by the predominance of β-hemolytic streptococcus at the bottom of the treated cavity. At the same time, the incidence of moderate contamination decreased by 4 times and single contamination increased in the cultures to 80%, compared to the CG (P=0.001). In MG-3, β-hemolytic streptococcus also dominated in the bottom of DCs after RD setting. The number of colonies was single (66.7% of cases) and moderate (33.3% of cases), indicating a significant increase in single and a decrease in moderate infestation, compared to the CG (P&lt;0.01). Analysis of the quantitative characteristics of the microbial composition of the cavity floor after preparation of fissure caries showed the highest bacterial contamination in CG: β-hemolytic streptococcus predominated, averaging 251.20±2.5CFU/tampon. Lactobacillus and Neisseria spp. were detected much less frequently (3.16±1.6 and 1.99±1.3 CFU/tampon, respectively). There was a 10-fold decrease in the number of β-hemolytic hemolytic streptococcus cultures in MG-1 (25.12±2.0 CFU/tampon), MG-2 (25.12±2.0 CFU/tampon) and MG-3 (19.95±2.0 CFU/tampon), compared to the CG (P=0.000). The opportunistic microorganisms in the treatment of hard tissues by different methods (burr, ultrasound, hydrokinetic) under absolute isolation conditions were identified in almost equal numbers, with the Lactobacillus contamination being significantly lower in MG-1, MG-2, and MG-3 than in the CG (P&lt;0.01). Conclusion: After the preparation of DCs, a single presence of opportunistic microorganisms, moderate or single contamination with pathogenic bacteria, and absence of anaerobic bacteria were noted. Absolute isolation with RD provides a reduction of microbial infection regardless of the preparation method, and the maximum positive effect is DC preparation with dental burr and ultrasound.

The Assessment of Sealants' Effectiveness in Arresting Non-Cavitated Caries Lesion-A 24-Month Follow-Up.

Dental sealants are excellent means to prevent pits and fissure caries. Nowadays, the application of sealants is extended to therapeutic use in arresting non-cavitated carious lesions. This relatively new concept still lacks evidence to support its routine use. The aim of this study was to evaluate the effectiveness of a resin-based sealant applied on first permanent molars with carious lesions (ICDAS 1–3), in comparison with its effectiveness when applied on sound surfaces (ICDAS 0). Included in the study were 114 children aged between six and eight years old, with a high caries risk (according to the CAMBRA system), with all four permanent molars erupted and with deep pits and fissures. A total number of 407 molars were sealed and assessed. A total of 49 were excluded (they had caries, which according to the ICDAS II classification were classified with code 4–6 or had older sealants or fillings). Out of these 407 molars, 213 were sound (code 0) and 194 had caries lesions as follows: 56 teeth classified as code 1, 79 teeth classified as code 2, and 59 teeth classified as code 3 according to the ICDAS II classification. The retention of the sealant and carious lesions were assessed clinically at 6, 12, 18, and 24 months. Regarding sealant retention, a statistically significant difference (p < 0.05) among the two types of sealed teeth, sound (ICDAS 0) and decayed (ICDAS 3), showed at 18- and 24-month follow-up intervals. Regarding caries lesions, a statistically significant difference (p < 0.05) showed between sound (ICDAS 0) and decayed (ICDAS 3) molars at 24-month follow-up. Our study results supported the resin-based sealant effectiveness in arresting incipient carious lesions, which according to the ICDAS II classification have received codes 1 and 2 but did not support sealant effectiveness in arresting caries lesions classified according to the same classification with code 3.

Assessment of influence of LED curing units used on microhardness of resin-modified glass ionomer sealants

Aim: Resin modified glass ionomer (RMGI) is class of material that can be used as sealant for preventing and arresting the progression of caries in pits and fissures. As these are hybrid materials, their properties can be affected by factors related to the polymerization process. Therefore, this study aimed to evaluate the influence of different generations of LED curing units (Elipar DeepCure-L and VALO Grand) on Knoop microhardness values (KHN) of RMGI sealants (Clinpro XT and Vitremer). Methods: Forty cylindrical specimens (6mm ø x 1 mm high) were prepared according to the manufacturer’s instructions and divided into four groups (n=10) according to the type of RMGI and LED used. The KHN of the top surface of each sample was calculated 7 days after light-curing. Data were submitted to two-way ANOVA (α = 0.05). Results: Vitremer had higher KHN values than Clinpro XT after using both LEDs (p&lt;0.0001), but especially when light-cured with the use of VALO Grand (p&lt;0.0001). Whereas the KHN value of Clinpro was not influenced by the LED device (p&gt;0.05). Conclusions: Top surface microhardness values of RGMI sealants were affected by both material composition and generations of LED curing units used. Third generation LED curing units seemed to be more efficient for the polymerization of RMGI-based sealants.

Treatment of Fissure Caries of Children with Severe Rheumatic Diseases with Difficulty in Opening the Mouth.

Background:Pediatric dentists face difficulties in treating tooth decay of children with difficulty in opening the mouth. This is especially true, as the main disease is accompanied by such symptoms as arthritis, osteoarthritis, myositis, myalgia, sclerosis, and oral atrophy.Aim:The aim was to increase the level of treatment of fissure tooth decay for children with rheumatic diseases, using the silicone key method (SKM).Materials and Methods:A dental examination of 82 children was carried out, with diagnoses: systemic lupus erythematosus, juvenile systemic scleroderma, juvenile dermatomyositis, and juvenile rheumatoid arthritis. Evaluation of the intensity of caries using indices: decayed, missing, and filled teeth (DMFT)(average). Assessment and measurement of the degree of mouth opening (MMO) by Sh. M. Batashvili. The SKM was used to treat fissure tooth decay.Results:During the dental examination of the oral cavity of all children with RD, multiple caries lesions were found. In the first age group of index indicators (DMFT) (on average) - 4.88, in the second age group DMFT (on average) - 7.58 - these values corresponded to high scores for the degree of dental caries, which requires frequent appointment to the dentist. Oral hygiene of children with difficult opening of the mouth is unsatisfactory, which leads to a rapid increase of caries. Restriction of moth opening <4 mm was found in 57 children with RD (69, 51%) that made it difficult to treat caries.Conclusion:Using SKM will improve the quality of caries treatment and provide a stable result of treatment in patients with difficulty opening the mouth in severe somatic pathologies.

Development of a Visualisation Approach for Analysing Incipient and Clinically Unrecorded Enamel Fissure Caries Using Laser-Induced Contrast Imaging, MicroRaman Spectroscopy and Biomimetic Composites: A Pilot Study

This pilot study presents a practical approach to detecting and visualising the initial forms of caries that are not clinically registered. The use of a laser-induced contrast visualisation (LICV) technique was shown to provide detection of the originating caries based on the separation of emissions from sound tissue, areas with destroyed tissue and regions of bacterial invasion. Adding microRaman spectroscopy to the measuring system enables reliable detection of the transformation of the organic–mineral component in the dental tissue and the spread of bacterial microflora in the affected region. Further laboratory and clinical studies of the comprehensive use of LICV and microRaman spectroscopy enable data extension on the application of this approach for accurate determination of the boundaries in the changed dental tissue as a result of initial caries. The obtained data has the potential to develop an effective preventive medical diagnostic approach and as a result, further personalised medical treatment can be specified.

Sealants for preventing dental caries in primary teeth.

Sealants for preventing dental caries in primary teeth.