Initial Caries Research Articles

Effect of ionizing radiation and cariogenic biofilm challenge on root-dentin caries.

To evaluate the effect of ionizing radiation and cariogenic biofilm challenge using two continuous flow models, normal and reduced salivary flow, on the development of initial root-dentin caries lesions. Microcosm biofilms were grown under two salivary flow rates (0.06 and 0.03mLmin-1) and exposed to 5% sucrose (3 × daily, 0.25mLmin-1, 6min) dripped over non-irradiated and irradiated root-dentin blocks for up to 7days. The vibration modes of root dentin, matrix/mineral (M/M), and carbonate/mineral (C/M) ratios were evaluated by FTIR. The mineral density was assessed by micro-CT. With normal salivary flow, FTIR revealed an increase in the organic matrix (amide III) and a decrease in the mineral phase (ν4, ν2 PO43-, AII + ν2 CO32-, C/M) in caries lesions. Irradiated dentin exhibited a reduction in the mineral phase (ν1, ν3 PO43-, ν2 CO32-, C/M). Differences in mineral densities were not significant. With reduced salivary flow, FTIR also revealed increased organic matrix (amide III) for irradiated caries lesions and decrease in mineral phase (v4, v2 PO43-, v2 CO32-, and C/M) in caries lesions. ν1, ν3 PO43- precipitated on the surface of irradiated dentin and a lower mineral density was observed. Initial caries lesions differed between non-irradiated and irradiated dentin and between normal and reduced salivary flow rates. Significant mineral loss with exposure of the organic matrix and low mineral density were observed for irradiated dentin with a reduced salivary flow rate. Ionizing radiation associated with a reduced salivary flow rate enhanced the progression of root-dentin caries.

ASSESSMENT OF DENTAL CARIOUS LESIONS BY ICDAS II

Introduction. The largest amount of information about the dental caries is provided by the International Caries Detection and Assessment II system (ICDAS II), which is known as evidence-based approach to clinical visual detection of dental caries and enables to detect the stage and depth of carious lesions from the slightest changes in dental enamel to visible cavities affecting dentin. This system has been developed by the group of leading experts in the field of cariology. The results obtained by determining the ICDAS II index contribute to making right clinical decision in the choice of prevention and treatment methods, as well as to predicting the carious progression. The aim of the study is to assess the prevalence and intensity of initial dental caries in people using the ICDAS II index. Materials and methods. A total of 32 patients aged 12 to 25 years were examined. During the dental examination, we assessed the prevalence of dental caries using the ICDAS II. Clinical findings were recorded in oral follow-up charts proposed by the ICDAS Foundation for Epidemiological Studies, which allow us to record dental hard tissue status using six codes: three for assessing carious changes in enamel and three for assessing carious changes in dentine in a sequence of growing severity. Statistical processing of the findings was performed using Student's t-test. Results. Carious lesions were detected in all study participants, their total number was 285, of which 140 (49.1%) had the code 1 and 145 (50.8%) had the code 2 according to the ICDAS II. On average, each of the participants had 9.28 ± 0.67 foci of enamel demineralization. The average number of lesions with codes 1 and 2 by the ICDAS II was respectively 4.54 ± 0.51 and 4.74 ± 0.38 (p> 0.05). The average intensity of dental caries increased with age from 8.29 ± 0.83 in 12-15 year old individuals to 9.39 ± 1.20 in 18-25 year old individuals (p> 0.05), mainly by the growth of the average number of the mean number of caries lesions with the code 1 according to the ICDAS II. Mostly carious lesions are found on the masticatory surfaces, their total number made up 159 (55.7%). 101 (35.4%) caries lesions were found on the vestibular and oral parts of the tooth surfaces, and 25 (8.9%) average lesions were detected on the proximal surfaces. The average intensity of caries detected on the chewing surfaces of the teeth was 5.15 ± 0.49 and was significantly higher than on the vestibular and oral (3.33 ± 0.57, p <0.05) and proximal (0.79 ± 0, 20, p <0.001) surfaces. Conclusion. The obtained results showed a high intensity of carious lesions, with their predominance in the active stages in the two age groups under the study. This proves the appropriateness of using diagnostic ICDAS criteria for early detection of initial caries and its proper treatment.

Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to investigate the efficacy of fluorescence-based methods, visual inspections, and photographic visual examinations in initial caries detection. A literature search was undertaken in the PubMed and Cochrane databases. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed, and eligible articles published from 1 January 2009 to 30 October 2019 were included if they met the following criteria: they (1) assessed the accuracy of methods of detecting initial tooth caries lesions on occlusal, proximal, or smooth surfaces in both primary and permanent teeth (in clinical); (2) used a reference standard; (3) reported data regarding the sample size, prevalence of initial tooth caries, and accuracy of the methods. Data collection and extraction, quality assessment, and data analysis were conducted according to Cochrane standards Quality Assessment of Diagnostic Accuracy Studies-2. Statistical analyses were performed using Review Manager 5.3 and STATA 14.0. A total of 12 eligible articles were included in the meta-analysis. The results showed that the sensitivity and specificity of fluorescence-based methods were 80% and 80%, respectively; visual inspection was measured at 80% and 75%, respectively; photographic visual examination was measured at 67% and 79%, respectively. We found that the visual method and the fluorescence method were reliable for laboratory use to detect early-stage caries with equivalent accuracy.

Caries prevalence and caries experience (ICDAS II criteria) of 5-, 12- and 15-year-old Greek children in relation to socio-demographic risk indicators. Trends at the national level in a period of a decade.

To study the caries status of 5, 12 and 15-year-old Greek children, assess how disease parameters are related to socio-demographic indicators and identify relevant trends at the national level. A stratified cluster sample of 3702 children in total was randomly selected and examined clinically for caries (ICDAS II criteria). Caries experience was outlined by adapting ICDAS0-6 criteria to the d/D component of the WHO dmf/DMF index configuration. Percentages (%) of caries experience-free children, of children with initial caries (ICDAS1-2), and the mean d1-2t/D1-2T, d3-6mft/D3-6MFT and d3-6mfs/D3-6MFS indices were calculated. The probability of presenting with d1-2t/D1-2T ≥ 1 was assessed by binary logistic regression analysis, whereas negative binomial regression models examined the effect of socio-demographic parameters on d3-6mfs/D3-6MFS indices (level of significance: p ≤ 0.05). 60.1%, 48.1%, and 34.7% of the 5, 12, and 15-year-old children, respectively, had no caries experience at the defect level (d3-6mft/D3-6MFT = 0). Initial lesions (ICDAS1-2) were detected in 17.7%, 19.3% and 17.4% of the 5, 12 and 15-year-olds, accordingly. Mean d1-2t/D1-2T was 0.93, 1.70, and 2.51, whereas mean d3-6mft/D3-6MFT was 1.48, 1.61, and 2.46 for the 5, 12, and 15-year-olds, respectively. Children with higher educated parents and 15-year-old urban residents exhibited significantly less caries experience at the defect level. Initial caries lesions presented a significantly higher probability of being detected in urban-residing 5- and 15-year-olds, while no consistent trend could be identified for parental education level. Caries prevalence and experience levels declined for all age groups in ten years. Although the dental health of Greek children has improved disparities remain, calling for organised primary and secondary preventive interventions.

Dentin Opaquer: A Pediatric Aesthetic Enhancement Technique

Introduction: Early childhood caries in young children can be initial dental caries and caries involving most of the tooth structure resulting in pulpal involvement causing loss of tooth structure. There is a need for tooth restoration for functional and aesthetic reasons. Dentine opaquer can be used to fulfill both the criteria. Aim: The aim was to determine the efficacy of dentine opaquer to mask the underlying color of caries treated with restorative material and omega metal post after pulpectomy. Methods: A report of 2 cases performed in the Department of Pediatric and Preventive Dentistry in, Krishnadevaraya College of Dental Sciences and Hospital Bangalore. Two different treatments using dentine opaquer as the restorative material and as core buildup over glass ionomer cement were performed. Results: Both the cases showed favorable outcomes and better masking efficiency of dentine opaquer as restorative material and core build up material over glass ionomer cement. Conclusions: Dentine opaquer is a composite with a compatible shade and better retention on the tooth surface, as core build up material and along with omega loop demonstrated adequate retention, was easy to administer as a chair side technique and resulted in least resistant masticatory forces.

IMPACT OF BARIATRIC SURGERY IN ANXIETY AND ORAL CONDITION OF OBESE INDIVIDUALS: A COHORT PROSPECTIVE STUDY.

ABSTRACT Background: Obesity and bariatric surgery may be related with mental and oral disorders.Aim:To evaluate the impact of bariatric surgery on anxiety, initial dental caries lesion and gingival bleeding in obese patients. Methods: Eighty-nine patients were divided in two groups: Control Group (CG) - obese patients and Experimental Group (EG) - patients submitted to bariatric surgery. EG was analyzed before and 12 months after bariatric surgery; for the CG, was respected an interval of 12 months between the evaluations. International Caries Detection and Assessment System, Gingival Bleeding Index and Trace-State Anxiety Inventory were used. Medical profile, anthropometrics data, sociodemographic and behavioral variables were considered. Results: There were no statistically significant differences between groups in evaluation times regarding to initial dental caries lesion and anxiety. However, the number of teeth with initial dental caries lesion (p=0.0033) and gingival bleeding (p<0.0001) increased significantly after bariatric surgery in EG. Conclusion: These results reinforce the need for multi-professional team follow-up, including dental care, for both obese and bariatric patients.

The effect of Remin Pro on the microhardness of initial enamel lesions in primary teeth

Remineralization is currently considered a treatment option for many clinicians. The present study was conducted to compare the effect of three remineralizing agents on microhardness of initial caries lesions in primary teeth. In this in vitro study, 96 enamel samples were prepared. Microhardness was first measured for all the samples using the Vickers microhardness test. After developing the initial caries lesions, the microhardness of all the demineralized samples was measured, and the samples were then divided into four groups (n = 24). Casein phosphopeptide-amorphous calcium phosphate in Group 1, Remin Pro in Group 2, and acidulated phosphate fluoride gel in Group 3 were placed on the samples for 4 min. The control group received no treatments. The microhardness of the samples was measured again following a pH cycle of 5 days. The data were analyzed by ANOVA and the post hoc test at the significance level of P < 0.05. The mean microhardness reduced significantly in all the groups following the development of initial caries lesions and after the pH cycle of 3 days (P < 0.001). After the remineralization and pH cycle of 5 days, the mean microhardness was significantly lower in the control group compared to the other three groups (P < 0.001) and had increased in the three treated groups. The microhardness recovery rate also increased in the treated groups compared to the control group, but no significant differences were observed between the three groups themselves (P > 0.05). Remin Pro can be used as an effective substance for preventing tooth caries in children.

Farklı Remineralizasyon Ajanlarının Lazer ve Ozon Tedavisi ile Kombine Kullanımının Başlangıç Çürüklerine Etkisinin İn-Vitro Olarak İncelenmesi

Amaç: Bu in vitro çalışmanın amacı, başlangıç mine çürüğü olan dişler üzerinde florür, kazein fosfopeptid amorf kalsiyum fosfat (CPPACP), novamin ile lazer uygulaması ve ozon uygulamasının tek başına veya birlikte kullanımının, remineralizasyon etkinliğini değerlendirmektir. Gereç ve Yöntemler: Bu amaçla sığır dişleri toplanarak, başlangıç çürüğü elde edilmiştir. Her grupta 15 diş olacak şekilde 11 grup (florür, CPP-ACP, novamin, lazer, lazer+florür, lazer+CPP-ACP, lazer+novamin, ozon, ozon+florür, ozon+CPP-ACP, ozon+novamin) oluşturulmuştur. Tedavi etkinliği mikrosertlik ölçümü, taramalı elektron mikroskobu (SEM) görüntüleri ve enerji dağılımlı X-ışını spektroskopisi (EDX) mineral analizi yapılarak değerlendirilmiştir. Elde edilen verilerin istatistiksel analizi, tek yönlü ve 3 yönlü varyans analizi kullanılarak yapılmıştır (p<0,05). Bulgular: Mikrosertlik verileri karşılaştırıldığında en yüksek değer lazer+florür grubunda izlenirken, en düşük ozon grubunda gözlenmiştir. EDX analiziyle kalsiyum (Ca) ve fosfat (P) oranları değerlendirildiğinde en yüksek Ca değeri lazer+novamin grubunda izlenirken, en yüksek P değeri novamin, lazer+CPP-ACP, lazer+novamin ve ozon+novamin gruplarında bulunmuştur. SEM değerlendirmesi sonucunda, tüm grupların mine yüzeyleri sağlam ve demineralize örneğe göre morfolojik değişimler göstermiştir. Sonuç: Çalışmamızın sonuçlarına göre Er:YAG lazer ve kombine remineralize edici ajan uygulaması, başlangıç çürüğünün remineralizasyonunda etkili bir metot olarak bulunmuştur. Ozon uygulamasının başlangıç çürüğünün remineralizasyonundaki etkinliği ileri çalışmalarla araştırılmalıdır.

Influence of fluoride preparations for the prevention of dental caries on the enamel solubility

The aim of the study is to evaluate the effectiveness of a number of popular fluorine-containing caries prophylactic drugs by determining the level of solubility of tooth enamel in laboratory conditions. For testing fluorine-containing preparations, three observation groups were formed: Group I - using the preparation with the content of fluorides 4%; Group II - with a preparation for deep fluoridation of enamel, consisting of a liquid saturated with fluorine, copper and magnesium, as well as a suspension of calcium hydroxide; Group III - with a three-component gel based on carboxymethyl cellulose (CMC) the content of fluorides 1.5%. The study was carried out by using the method of «enamel windows» and modeling in the laboratory the processes of both natural and pathological solubility of tooth enamel and determining the level of its solubility by analyzing the decalcifying solution of the oral fluid for the content of calcium and phosphorus ions in it. In the course of the study of fluorinated karyoprophylactic preparations on the enamel surface, according to the observation group, the most active karyoprophylactic fluorinated compositions were identified. The data obtained from laboratory studies allow us to formulate clear recommendations for practical health care for the most effective use of the properties of the tested fluorine-containing drugs for prophylactic purposes or in relation to the therapy of focal demineralization of enamel: to obtain the most effective result of the prevention of dental caries in the conditions of practical dental treatment, we recommend applying gel fluoride preparations, and in the treatment of initial caries of the enamel of the teeth, give preference to systems for deep fluoridation of the enamel of the teeth.

Effect of S. mutans combinations with bifidobacteria/lactobacilli on biofilm and enamel demineralization.

The present study evaluated the ability of Bifidobacterium and Lactobacillus species associated with streptococci to increase insoluble extracellular polysaccharide (EPS) production and initial caries lesion progression. Bovine enamel blocks (n = 190; 4 mm x 4 mm) were prepared, selected according to initial surface hardness (SH), and divided into two groups: a) double combinations: S. mutans with Bifidobacterium or Lactobacillus, and b) triple combinations: S. mutans and S. sobrinus with Bifidobacterium or Lactobacillus species. The blocks were exposed to the bacterial associations for 7 days. Subsequently, quantity of EPS from biofilms and caries lesion depth were determined by means of colorimetric and cross-sectional enamel hardness (ΔKHN) analysis. The data were submitted to one-way analysis of variance, followed by the Bonferroni test (p < 0.05). S. mutans with B. animalis or B. dentium produced a higher quantity of EPS; S. mutans + B. animalis led to the highest ∆KHN. S. mutans + S. sobrinus + B. longum induced greater EPS and ∆KHN values. In conclusion, associations of B. animalis and B. longum with streptococci promoted EPS production and caries lesion progression.

Identifying risk factors of severe early childhood caries in infants from Bosnia and Herzegovina.

The aim of the study was to investigate risk factors for S-ECC among infants under 24 months of age living in Banja Luka, Bosnia and Herzegovina. A cross-sectional population-based study was carried out. Considering inclusion criteria, the total sample consisted of 192 examined infants under 24 months of age. Parents/caregivers were interviewed ahead of each dental examination of children. Following data collection, outcome measures were: the presence/absence of S-ECC (children with at least one active early carious lesion on the smooth surfaces of the maxillary anterior teeth/caries-free children) and the severity of dental caries (no caries, initial caries and cavitated caries lesion). Overall results of the study indicated that 22.9% of infants had initial caries, while 12.0% (95% CI: 8.1-17.3) of infants had at least one cavitated carious lesion. Multivariate logistic regression analysis showed that the age of infants (p < 0.001) and family monthly income (p = 0.003) variables were statistically significant predictors for the development of caries. This research found that the most important risk predictors for the development and severity (intensity) of S-ECC in infants under 24 months of age were low monthly income of parents and the infant's age.

Early childhood caries in multilingual community.

The aim of the study was to determine the prevalence and severity of early childhood caries (ECC) among different social groups of preschool children in ethnic and multilingual diverse community such as South Backa District (SBD), Republic of Serbia. This survey was a cross-sectional analytical study and sample type has been projected by simple random choice of 13-71 months old children together with their parents of varied socioeconomic status (SES) and nationality in SBD. Preschool children were randomly selected through a two-stage cluster sampling procedure and parents were invited to answer the questionnaire regarding SES, native language, education, and income issues. The WHO caries diagnostic criterion was used and the severity of ECC was defined by Wine's modified criteria. The data was further analyzed using the SPSS for Windows Microsoft Excel, version 21. The percentage of caries-free children was compared using the χ2 test, and one-way ANOVA was used to compare the mean disease indices at the 5% significance. A total of 341 children were examined and the prevalence of ECC was 30.5%. "White spot" initial caries lesions were the most prevalent form and the highest disease frequency was found in male children (p = 0.038), who did not speak official Serbian language (p = 0.009), in children of the part-time employed parents (p < 0.001), with elementary education (p = 0.001), in low monthly income families (p = 0.023), and Roma ethnic group. The complex interaction of risk factors like social environment along with ethnicity and Serbian language ignorance had a significant influence on the prevalence and severity of ECC in preschool children of this multi-ethnic region.

Initiation of the carious process associated with exogenous factors among children with renal disorders

Introduction: Diagnosed non-cavity lesions of the D1b type are indicative criteria for caries risk among different groups in child’s age. Aim: The purpose of the study is to investigate the role of exogenous factors related to the initiation of the carious process among children with diagnosed pyelonephritis. Materials and Methods: Children from 0 to 18 years of age with diagnosed pyelonephritis, as well as a control group of participants without common health disorders, are included in the study. The object of the study is the reversible D1b type carious lesion. By means of an enquiry exogenous factors for initial caries are registered and analyzed: applied forms of endogenous and topical fluoride prophylaxis, frequency of sugar intake, oral hygiene care. Conclusion: Among both groups, the significance and application of exogenous indicators related to the initiation and management of the carious process are determined, even in conditions of disturbed common health status.

REVIEW ON ROLE OF METAL SALT IN THE RE-MINERALIZATION OF DENTAL CARIES

Dental caries is a most common disease that affects large number of people. It is a worldwide public health problem, affecting numerous urban and rural communities. White-spot lesions (WSL) are the earliest macroscopic evidence of enamel caries. Typically, the enamel surface layer stays intact during subsurface demineralization, but, without treatment, will eventually collapse into a full cavity. Near-neutral pH of saliva is endowed with a natural buffering capacity. Natural demineralization of tooth at an early stage is reversed by saliva, which contains calcium ions, phosphate ions, buffering agents, fluoride, and other substances. The strategy for aided remineralisation is to have ions directly delivered to where and when they are needed the most. Several mechanisms are available for aided remineralisation. The most well known is the delivery of topical and systemic fluoride, which has been proven to be a highly effective measure for prevention of caries. However limitations and risks associated with the use of fluoride as a remineralising agent fuelled the need to develop newer non-toxic techniques that deliver calcium and phosphate ions directly into subsurface lesion and/or boost remineralising properties of saliva. Encouraging microscopic changes in the demineralized enamel surface following the treatment with different concentration of metal salts, involving zinc, strontium, magnesium, in addition to stannous fluoride, many metal salts are in use for the treatment of dental caries. Microscopic examination was conducted on teeth samples before and after pH-cycling procedure and following the treatment with the selected metal salt under polarized microscope (100X). The best obvious remineralisation was found following treatment with stannous fluoride, followed by zinc chloride. The stannous fluoride was the best in the remineralisation of initial caries, results for other metals seem to be promising if used for prevention of dental caries. Mineralization of teeth is determined by major inorganic elements as calcium, phosphorous in addition to other elements that occur in traces within tooth structure (Thylstrup and Fejerskov, 1996 Murry, 1996 Peter, 2004). Fluoride now a day is widely used either systemically or topically to increase resistance of teeth surface, it has been well documented as a major contributing factor in the decline of the incidence and severity of dental caries in many countries (Murry, 1996 Curzon,1999).So far fluoride has been considered to play an almost unique role in the prevention of dental caries however there is no reason to dismiss the role of other elements as being potential cariostatic agents. Different concentrations of different metal ions as zinc and copper have been tested for better effect on remineralisation in vitro (Dedhiya, et al., 1974 Fang et al., 1980). However controversy is present in the literature concerning their effectiveness in prevention of dental caries when used topically at effective concentrations (Torredo et al., 2004 Elzbieta et al., 2008 Curzon, 1983).

Success of resin infiltration treatment on interproximal tooth surfaces in young adults-A practice-based follow-up study.

ObjectivesArresting active initial caries lesions is part of the modern caries controlling system. Resin infiltration (RI) system has been found a promising method in arresting interproximal initial lesions. The aim was to investigate whether RI arrests progression of active caries lesions.Materials and methodsParticipants (n = 20) of the retrospective study were patients in the Dental Teaching Unit, City of Oulu, Finland, mean age 26 years (SD5.2). Indication for RI was radiographically diagnosed progressing (ICDAS 1–3) interproximal lesions (n = 54). RI treatments were performed in 2015–2017. Controls were initial lesions in the same bitewing radiographs without RI or other treatment (n = 24). For analyzes teeth were categorized as lower and upper premolars and molars. The change in lesions during the follow‐up period was recorded surface wise as follows: deterioration / improvement from ICDAS score 3/improvement from ICDAS score 2/improvement per se/at follow‐up, lesion was less diffuse/no change. The changes in each tooth surface were analyzed between RI intervention and control teeth by using Chi‐square test. Proportions of successful and failed surfaces were given.ResultsThe mean length of follow‐up period was 17.4 m (SD7.2). Arresting of caries lesions (ICDAS scores 2 and 3) was distinctly better in RI group (63.0%) compared with the controls (29.1%). The situation progressed among 29.2% of the controls whereas the respective proportion among the intervention group was 14.8%. Progression of lesions was more distinct in all tooth groups in the control group. Outcome was successful despite the lesion depth.ConclusionsResin infiltration seems effective in arresting progression of initial caries lesions with monitoring period of 1.5 years.

Efficacy of P11-4 for the treatment of initial buccal caries: a randomized clinical trial

To investigate the safety and efficacy of Self-Assembling Peptide P11-4 (SAP P11-4) compared to placebo or fluoride varnish (FV), a randomized, controlled, blinded, split-mouth study with sequential design was conducted. Subjects presenting two teeth with White-Spot-Lesions (WSLs) were included and teeth were randomly assigned to test or control. Control received placebo at baseline (D0) and test SAP P11-4, all received FV at Day 90 (D90). Standardized photographs were taken at each visit, and WSL size changes were morphometrically assessed. Hierarchical Linear Modelling, considering paired and sequential design, was used to test four hypotheses. SAP P11-4 lesions (test, D90–D0) showed significant WSL size reduction compared to placebo (control, D90–D0; p = 0.008) or FV (control, D180–D90; p = 0.001). Combination of SAP P11-4 and delayed FV after 90 days (test, D180–D0), showed a significant difference compared to FV alone (control D270–D90; p = 0.003). No significant difference on FV efficacy was found when SAP P11-4 was applied 3 months before FV (test D270–D90; control D270–D90, p = 0.70). SAP P11-4 treatment resulted in superior caries regression compared to either placebo or FV, and FV efficacy seems not to be affected by SAP P11-4. SAP P11-4 was found to be a safe and effective WSL treatment.

Sealing Proximal Non- and Micro-Cavitated Carious Lesions Using a One-Session Separator Technique: A 2-Year Randomised Clinical Study

The presence of initial caries accounts for the majority of approximal carious lesions in many countries. The aim of this clustered, split-mouth, randomised, controlled clinical trial was to use a metal separator to widen the approximal space in a one-visit session before sealing and to evaluate patient acceptance, together with the efficacy of the proximal sealing in arresting incipient carious lesions after 2 years. A total of 48 patients with a mean age of 41.9 years were selected. They had at least one pair of proximal initial carious lesions, including the distal surface of the canines to the mesial surface of the third molars (bite-wing score D1–D3). The patient’s caries risk at baseline was analyzed using a Cariogram. All surfaces were examined for mutans streptococci (ms) counts. The separator technique made it possible to diagnose whether or not a microcavity was present. After 2 years, 212 surfaces in 45 subjects were examined using the same as baseline standardized digital follow-up radiographs. Two analyses were performed, one sensitive, where a progression or a regression was assessed if one of the examiners made one of those diagnoses, and one conservative, where unchanged. For both analyses, the sealed test surfaces showed a significantly higher regression (67 and 29%) compared to the control group (13 and 2%) p < 0.0001. It did not appear that the baseline variables, such as the caries risk, surface diagnoses, or ms counts, influenced the caries outcome. In the test group, there was no difference in caries progression if there was a microcavity or not. The separation treatment was well accepted by the patients. The method of separation for diagnosis and sealing treatment in a single session appears to be a clinically applicable method for the control of proximal carious lesions.

Effects of Additional Use of Bioactive Glasses or a Hydroxyapatite Toothpaste on Remineralization of Artificial Lesions in vitro

Objectives: This in vitro study aimed to evaluate and compare the effect of two different bioactive glasses, a hydroxyapatite-containing, fluoride-free toothpaste (HTP) and a fluoride toothpaste (FTP) on the remineralization behavior of initial caries lesions. Materials and Methods: A total of 100 bovine enamel samples were randomly allocated to five groups of 20 samples each: NC = negative control group (artificial saliva); HTP = HTP group (Karex); FTP = FTP group (Elmex caries protection, 1,400 ppm); FTP + BG_nano = FTP followed by Actimins bioactive glass; FTP + BG_amorph = FTP followed by Schott bioactive glass. Radiographic documentation (advanced transversal microradiography; aTMR) was applied before and after all samples were exposed to a demineralizing gel for 10 days. Over a period of 28 days, samples were covered twice a day (every 12 h) with a toothpaste slurry of the respective test group or with artificial saliva in NC for 60 s and brushed with 15 brushing strokes. Samples in FTP + BG_nano and FTP + BG_amorph were additionally treated with the respective bioactive glass slurry for 30 s after brushing with the FTP. In the meantime, all samples were stored in artificial saliva. After 28 days, the structure of all samples was assessed again using aTMR and compared to the values measured after demineralization. The statistical evaluation of the integrated mineral loss was performed using Kruskal-Wallis test followed by a post hoc Conover test. Results: The FTP revealed the significantly highest increase of mineral content while the HTP showed the significantly lowest remineralization. Compared to artificial saliva, the use of the HTP or the combined application of FTP followed by bioactive glasses (FTP + BG_nano and FTP + BG_amorph) showed no significant remineralization. Conclusion: Under remineralizing in vitro conditions, brushing with 1,400 ppm FTP induced significantly more remineralization compared to storage in artificial saliva. The additional administration of both bioactive glasses as well as the substitutional brushing with an HTP resulted in significantly less remineralization compared to brushing with 1,400 ppm FTP.

Evaluating the Retention of Resin-Based Sealant and a Glass Ionomer Sealant among 7-10 Year-Old Children: A Randomized Controlled Trial

Over the past three decades, there has been a substantial improvement in the oral health of children as evidenced by declines in the prevalence and severity of dental decay because of the outstanding scientific advances in restorative materials and techniques as well as in the understanding of its principles. The fissures of permanent molars are usually the first tooth surfaces to be affected by caries in younger age groups as young permanent teeth have specific occlusal morphology with deep and narrow pits and fissures that cannot be adequately cleaned, and therefore present particularly vulnerable places for the development of initial caries

Oral Health Status among Children with Repaired Esophageal Atresia.

Esophageal atresia (EA) is a congenital anomaly, presenting multifactorial etiology. Swallowing problems and gastroesophageal reflux disease may accompany EA, which have adverse effects on oral health. In this descriptive study, intraoral examination of the children with repaired EA and of the dental patients without systemic/chronic disease was performed. Dental caries, dental erosion, and halitosis status were evaluated using the International Caries Detection and Evaluation System II, and the Basic Erosive Wear Examination indices as well as the Halimeter, respectively. There were 19 (n = 12 male; n = 7 female) case subjects and 16 (n = 10 male; n = 6 female) control subjects whose age ranged between 14 and 72 months. Among cases, 15 children had dental caries (78.9%; initial caries n = 4, moderate caries n = 4, and extensive caries n = 7). Of the controls, 13 had dental caries (81.2%; initial caries n = 5, moderate caries n = 5, and extensive caries n = 3). Although the median scores of decayed, missing, filled teeth (dmft) and decayed, missing, filled surfaces (dmfs)-for primary dentition-were not statistically significantly different between two groups, both dmft and dmfs were found to be higher among the case subjects (p = 0.172 for dmft; p = 0.230 for dmfs). Furthermore, six children with repaired EA had dental abnormalities (in shape, number, or calcification) and six children with repaired EA had dental erosion. The Halimeter measurement was performed for five case children of whom three had oral malodor, and for seven control children of whom two had oral malodor. Regular dental counseling adopting the multidisciplinary team approach for patients with EA is necessary to ensure better general and oral health.