Lesions In Teeth Research Articles

Comparative Evaluation of Effect of Silver Diamine Fluoride and Glass Ionomer Cement on Microhardness of Artificial Caries Lesion in Primary Teeth: An In Vitro Study.

To evaluate the remineralizing potential of glass ionomer cement (GIC) and silver diamine fluoride (SDF) on artificially induced enamel caries lesions in primary teeth. The initial baseline surface microhardness (SMH) of 40 primary teeth was tested using Vickers hardness tester, followed by the creation of artificial caries lesions by immersion in the demineralizing solution. Microhardness assessments of demineralized samples were done, and samples were randomly divided into two groups of 20 specimens: in group I, GIC was applied on demineralized enamel, and in group II, SDF was applied on demineralized enamel. Samples were subjected to pH cycling. For group I, GIC from the enamel samples was carefully removed using a surgical blade, and changes in the SMH from both groups were analyzed using Vickers microhardness test. Surface microhardness (SMH) value after pH cycling of GIC (45 ± 10.23) and SDF (47.76 ± 6.69) is statistically highly significant (<0.001) compared to the baseline SMH of both test groups. Comparison of SMH between the two groups showed statistically nonsignificant results. The remineralization potential of SDF is comparable to GIC. So, SDF can be used as a remineralizing agent for incipient enamel caries. Owing to the remineralizing ability of GIC underneath the restorations, it can be used as a therapeutic sealant for incipient enamel caries lesions, where SDF staining is not always acceptable. A 38% SDF also can be used as a remineralizing agent for incipient enamel caries lesions in situations like noncompliant patients, inaccessibility to dental care, or conditions in which esthetics is not of concern. Sunny S, Sargod SS, Bhat SS, et al. Comparative Evaluation of Effect of Silver Diamine Fluoride and Glass Ionomer Cement on Microhardness of Artificial Caries Lesion in Primary Teeth: An In Vitro Study. Int J Clin Pediatr Dent 2023;16(6):858-863.

Tea and Coffee Discoloration in the Simulated Remineralization Process of Tooth Structure: Investigating the Influence of In-Office Bleaching Material on Arrested Stains

This study aimed to investigate the efficacy of an in-office dental bleaching agent (with 40% H2O2) on the simulated stained remineralized lesions of teeth using tea and coffee as staining solutions. Forty-eight sound premolar teeth were selected, root amputated, and embedded in a self-curing acrylic resin. Half of the samples were immersed in a tea solution and the remaining half were immersed in a coffee solution for 4 days (n = 24). From each study group, half of the samples went through the bleaching process, and the remaining half served as a control. The color change was observed with a paired t-test and two-way ANOVA (α = 0.05). The ANOVA findings observed a significant effect on the ΔΕ value (p =&lt; .001) due to independent factors. Additionally, individual stages, i.e., time points such as baseline, demineralization, staining, re-mineralization, and bleaching had a significant effect on ΔΕ value (p =&lt;.001). The t-test results observed significant variations between ΔΕ values of bleached and not bleached groups after the staining and remineralization process, irrespective of the staining solution used. It’s crucial to abstain from coffee and tea during and shortly after bleaching until thorough remineralization therapy is completed.

Comparative evaluation of the effectiveness of restorations in the cervical region of teeth by direct and indirect method

Restoration of cervical lesions of teeth is one of the most urgent problems of modern dentistry. Defects of the cervical region have different etiology, pathophysiology of the development of the defect formation process. The method of direct restoration of defects of various etiologies in the cervical region of the tooth is the most frequent method of restoration. According to many authors, this method is not always effective. One of the initial tasks in dentistry is to replace the lost tooth structure with a material whose composition and physical properties are similar to the natural tissues of the tooth. This goal can be achieved using CAD/CAM technology. The chemical stability of hybrid ceramics provides not only excellent biocompatibility, but also good physical, mechanical and optical properties.

Influence of silver fluoride plus potassium iodine on adhesive properties of primary carious dentin-resin interface: An in vitro study

This paper evaluated the influence of different protocols of silver fluoride (SF) pretreatment of artificial carious lesions on the adhesive interface of composite resin restorations and remineralization of deciduous dentin compared to silver diamine fluoride (SDF). Sixty-four deciduous molar teeth were randomly divided into 8 groups (n = 8) according to the restoration time (immediately – IM; 30 days after SDF/SF treatment – 30 D) and treatment before restoration (SDF 38 %; SDF 38 % + potassium iodide – KI; SF 38 %; SF 38 % +KI). After SDF/SF application, teeth in the IM group were restored with self-etch universal adhesive system/composite resin. Samples in the 30D groups were stored in artificial saliva (37 °C) for 30 days before receiving the same restoring protocol. Beams were obtained from all groups and subjected to bond strength tests (µTBS), ultrastructural qualitative analysis (FEG) and mineral analysis (SEM/EDX; Micro-Raman spectroscopy). The µTBS data were subjected to three-factor ANOVA and multiple comparisons (Holm-Sidak method). Bond strength values (MPa) for IM groups were 16.9 ± 2.7 (SDF); 17.6 ± 3.5 (SDF + KI); 16.8 ± 5.5 (SF); 18.4 ± 4.1 (SF + KI); and 14.9 ± 4.2 (SDF); 16.0 ± 5.4 (SDF + KI); 14.1 ± 3.6(SF); 16.4 ± 5.4 (SF + KI) for 30D groups. Bond strength wasn’t influenced by the moment of restoration (IM or 30D); the use of KI didn’t alter adhesion characteristics; SDF/SF solutions resulted in similar adhesive strength; calcium and phosphate expressions were identified at the interfaces on IM and 30D moments. However, 30D presented qualitative increase in these ions, compatible with remineralization. It was concluded that the adhesion of composite resin restorations in artificial caries lesions of deciduous teeth treated with SDF (38 %) and SF (38 %) had similar effects in vitro; the use of KI or the moment when restorations were accomplished did not influence the adhesion and all tested protocols promoted remineralization of carious dentin.

Enamel and dentin of human teeth. Fatigue strength

The article provides a brief overview of the studies regarding changes in the structure and composition of teeth after eruption. The factors of degenerative changes in tooth structures and their relationship with non-carious lesions have been analyzed. The study makes emphasis on the tooth durability and the factors influencing tissue fatigue, explaining increased tissue wear due to local factors. Understanding mechanisms of metabolism of teeth hard tissues is the key to the stability of restorative treatments and occurrence of non-carious tooth lesions. The evolution of views on this problem is noteworthy. The literature review reveals the initial predominance of mechanical actions, abrasion, and mineralization. It is later complemented by a detailed analysis of the influence of destructive stresses and deformation due to mechanical factors. All the leading works of the 2000s are dedicated to analyzing the ultrastructural features of enamel that affect its mechanical characteristics and can explain both the characteristics of the shape and intensity of mechanical tooth wear during the functioning of the stomatognathic system, as well as the durability of the performed restorations. The literature review covers 74 sources over the past 15 years.

In vitro remineralization of adjacent interproximal enamel carious lesions in primary molars using a bioactive bulk-fill composite

BackgroundSurface remineralization is recommended for the management of active non-cavitated interproximal carious lesions in primary teeth. According to the American Academy of Pediatric Dentistry, a recently recognized category of materials called bioactive restorative materials can be used for remineralization. This study aimed to evaluate the release of fluoride (F), calcium (Ca) and phosphate (P) ions from Predicta® Bioactive Bulk-fill composite compared with EQUIA Forte® and Filtek™ Z350 and to determine the remineralization effect of these 3 restorative materials on adjacent initial interproximal enamel carious lesions.MethodsThe release of F, Ca and P ions from 3 groups ((n = 10/group) (Group 1- Predicta®, Group 2- EQUIA Forte® and Group 3- Filtek™ Z350)) was determined at 1st, 4th, 7th and 14th days. After creating artificial carious lesions, human enamel samples were randomly assigned into 3 groups (n = 13/group) which were placed in contact with occluso-proximal restorative materials and exposed to a 14-day pH cycling period. Surface microhardness was determined using a Knoop microhardness assay at baseline, after artificial carious lesions formation and after pH cycling. The difference in the percentage of surface microhardness recovery (%SMHR) among groups was compared. Mineral deposition was analyzed with energy-dispersive x-ray spectroscopy (EDS) and the enamel surface morphology was evaluated with scanning electron microscopy (SEM). Kruskal-Wallis’s test with Dunn’s post hoc test and one-way ANOVA with Tukey’s post hoc test were used for data analysis.ResultsEQUIA Forte® released the highest cumulative amount of F and P ions, followed by Predicta® and Filtek™ Z350. Predicta® released higher amount of Ca ions than EQUIA Forte® and Filtek™ Z350. Predicta® demonstrated the highest %SMHR, followed by EQUIA Forte® and Filtek™ Z350. There was a significant difference in the %SMHR between Predicta® and Filtek™ Z350 (p < 0.05). However, EQUIA Forte® demonstrated the highest fluoride content, followed by Predicta® and Filtek™ Z350. The SEM images of EQUIA Forte® and Predicta® revealed the greater mineral deposition.ConclusionPredicta® demonstrated a marked increase in surface microhardness and fluoride content of adjacent initial interproximal enamel carious lesions in primary molars compared with Filtek™ Z350. Predicta® is an alternative restorative material to remineralize adjacent initial interproximal enamel carious lesions in primary molars, especially in high-risk caries patients.

Antibacterial effect of ozone versus chlorhexidine gel for disinfection of cavitated carious lesions in young permanent teeth

Purpose The study was directed to evaluate the antibacterial effect of ozone versus chlorhexidine gel for disinfection of cavitated carious lesions in young permanent teeth. Patients and methods Forty young permanent molars out of 20 children were allocated into two groups in a randomized technique according to the material used for cavity disinfection either ozone or chlorhexidine gel. Each child had two bilateral vital cavitated class I carious lesions in young permanent first molars. Dentin samples from deep caries lesions were collected before additionally after application of either ozone or chlorhexidine gel and cultured into freshly prepared appropriate media for microbiological examination. Results There were statistically significant decrease in both Streptococcus mutans and Lactobacillus bacterial count after application of either ozone or chlorhexidine gel in both groups. Conclusion Application of ozone or chlorhexidine gel as cavity disinfectant in deep carious lesions after incomplete dentin caries removal provide an obvious antibacterial effect reducing S. mutans and Lactobacillus counts.

Potential impact of metal crowns at varying distances from a carious lesion on its detection on cone-beam computed tomography scans with several protocols.

This study evaluated the impact of artifacts generated by metal crowns on the detection of proximal caries lesions in teeth at various distances using cone-beam computed tomography (CBCT). Additionally, the diagnostic impacts of tube current and metal artifact reduction (MAR) were investigated. Thirty teeth were arranged within 10 phantoms, each containing 1 first premolar, 1 second premolar, and 1 second molar. A sound first molar (for the control group) or a tooth with a metal crown was placed. Of the 60 proximal surfaces evaluated, 15 were sound and 45 exhibited enamel caries. CBCT scans were acquired using an OP300 Maxio unit (Instrumentarium, Tuusula, Finland), while varying the tube current (4, 8, or 12.5 mA) and enabling or disabling MAR. Five observers assessed mesial and distal surfaces using a 5-point scale. Multi-way analysis of variance was employed for data comparison, with P<0.05 indicating statistical significance. The area under the curve (AUC) varied from 0.40 to 0.60 (sensitivity: 0.28-0.45, specificity: 0.44-0.80). The diagnostic accuracy was not significantly affected by the presence of a metal crown, milliamperage, or MAR (P>0.05). However, the overall AUC and specificity were significantly lower for surfaces near a crown (P<0.05). CBCT-based caries detection was not influenced by the presence of a metal crown, variations in milliamperage, or MAR activation. However, the diagnostic accuracy was low and was further diminished for surfaces near a crown. Consequently, CBCT is not recommended for the detection of incipient caries lesions.

Assessment of The Impact of Quality of Canal Obturation, Coronal and Apical Seal on The Healing Of CBCT-Diagnosed Periapical Lesions in Endodontically Treated Teeth in Sri Lanka

Background: Previous literature has investigated the association between the attribute of coronal restoration and root canal obturation with the radiographic periapical status of endodontically treated teeth. Objectives: This study intends to assess the status of periapical lesions/pathology and, the main factors influencing the healing of periapical lesions of root canal-treated teeth clinically and radiographically exploiting CBCT. The quality of coronal restoration, canal obturation, and apical seal were selected to be assessed, as they have a greater impact on healing peri apical pathology. Method: This analysis was conducted at the Department of Restorative Dentistry and the Division of Oral Medicine and Radiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. All the patients who presented between January 2020 and January 2021, had root canal treatment done at least one year prior, were referred for CBCT assessment for some other conditions, and fulfilled the inclusion criteria, were selected. Root canal-treated teeth were recognized by radio-opaque filling material inside the canals in any anterior or posterior teeth. Results: A sum of 50 CBCT reports from 50 patients was encompassed in the dissertation. Median age was 26 (±4) years, with 37.5% of reports belonging to males. Statistical analysis was performed utilizing Statistical Package for Social Sciences (SPSS) version 20.0 software (IBM Corp). Out of fifty patients, 32 had been found to have adequate clinical coronal seal while 31 have been found to have adequate radiographical coronal seal. Further, 31 patients were found to have insufficient obturation and 28 were found to have adequate apical seal. A significant association was observed between periapical healing and adequate coronal restoration in root-filled teeth (p=0.048). However, the association between the healing of the periapical region, and adequate root canal obturation (p=0.09) and adequate apical seal (p=0.777) were found to be non-significant. Conclusion: The most influential factor for the healing of periapical lesions in endodontically treated teeth appears to be adequate coronal restoration, compared to root canal obturation and apical seal, in a cohort of patients in Sri Lanka

Comparative Efficacy of Smart Burs vs Conventional Burs in Removing Infected Dentin and Preserving Affected Dentin in Primary Teeth: A Randomised Control Study

Introduction: With the advent of time, the removal of caries has shifted from hand instruments to rotary instruments. A disadvantage of conventional burs is that they non selectively lead to over-preparation. A new polymer bur can be substituted to eliminate these undesirable effects. Aim: To compare and evaluate the efficacy of smart burs and conventional burs in removing infected dentine while preserving affected dentin in carious lesions in primary teeth. Materials and Methods: This was a double-blinded randomised controlled trial conducted in the Department of Paediatric and Preventive Dentistry at Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Nagpur, Maharashtra, India over a period of three months, from August 2023 to October 2023. A total of 40 children aged 6-12 years were selected and evaluated for caries removal efficacy using visual and tactile criteria, which were further confirmed by dye application and numerically scored. Group 1 included 20 children who underwent caries excavation with smart burs, while Group 2 included 20 children who underwent the procedure with diamond points. Statistical analysis was conducted using descriptive and inferential statistics, specifically the Chi-square test. Results: A total of 40 children aged 6-12 years were divided into two groups: Group 1 comprised 11 boys and 9 girls, whereas Group 2 included 10 boys and 10 girls. Of these, 12 cases (60%) showed complete caries removal after the first application of dye, regardless of which burs was used. However, 4 cases (20%) showed some residual caries when using smart burs, while 6 cases (30%) exhibited residual caries with diamond points at the base of the cavity preparation. Additionally, there were 4 cases (20%) with caries present at the base and/or in one wall of the cavity preparation when using smart burs, compared to 2 cases (10%) with conventional burs. Nonetheless, there was no statistically significant difference between the smart burs and the conventional diamond points regarding caries removal. Conclusion: It can be concluded that smart burs are equally effective in removing soft caries compared to conventional methods. Although the results were statistically insignificant, polymer burs were found to be more convenient and can be considered a viable alternative to conventional caries removal techniques.

Short-term Results of the Masking Effect of an Infiltrant Resin on Mild Molar Incisor Hypomineralization Lesions in Anterior Teeth.

This non-controlled clinical study evaluated the masking effect of an infiltrant resin on mild molar incisor hypomineralization (MIH) lesions. Thirty MIH-affected anterior teeth with creamy/ white opacities from 12 children aged 6-15 years received the application of an infiltrant resin (Icon- DMG). Standard photographs were taken before (T1), immediately after (T2), and 1 week after (T3) resin infiltration. Two calibrated examiners qualitatively analyzed the color match using the Fédération Dentaire Internationale (FDI) scale. The binomial distribution test analyzed the scores of the color match at T1 with T2 and T3, and McNemar's test analyzed the scores of the color match between T2 and T3 (α=0.05). There was a significant increase in color match between T1 and T2 (p=0.0005), between T1 and T3 (p=0.0005), and between T2 and T3 (p=0.0019). It was concluded that infiltrant resin was effective in improving the esthetic appearance of creamy/white opacities on MIH-affected anterior teeth.

Advancing dentin-pulp regeneration: clinical perspectives and insights from stem/progenitor cell transplantation (part II).

This systematic review evaluates clinical studies investigating regenerative endodontic procedures for mature/immature teeth utilizing stem cell transplantation. An electronic search of Scopus, PubMed, ISI Web Science, and Google Scholar was conducted up to January 2023. Outcome measures encompassed radiographic (periapical lesion, root length, apical foramen width, volume of the regenerated pulp) and clinical (post-operative pain, sensibility test) parameters. Among 3250 identified articles, five clinical studies were selected, comprising two randomized controlled trials (RCTs) for mature/immature teeth, and three case reports/series for mature teeth. Despite the promising potential, the included studies exhibited a notable risk of bias. The diversity in stem cells (e.g., dental pulp stem cells [DPSCs], umbilical cord mesenchymal stem cells [UC-MSCs]), scaffolds (Atecollagen, collagen membrane, platelet-poor plasma [PPP], leukocyte platelet-rich in fibrin [L-PRF]), and growth factors (granulocyte colony-stimulating factor [G-CSF]) emphasized the heterogeneity across interventions. In RCTs, DPSCs application increased root length and reduced apical foramen width in immature teeth, while UC-MSCs transplantation reduced apical lesions in mature teeth. Transplantation of DPSCs aggregates or UC-MSCs/PPP also elicited positive pulp responses and increased blood flow. In case reports/series, DPSCs application in teeth with irreversible pulpitis resulted in mineralization and increased the regenerated pulp' volume. Furthermore, transplantation of DPSCs with G-CSF/atelocollagen or L-PRF/collagen membrane led to positive pulp responses. While underscoring the potential of stem cell transplantation for regenerative endodontics in mature/immature teeth, the overall evidence quality and the limited number of available studies emphasize the need for cautious interpretation of results. Future well-designed clinical studies are essential to validate these findings further.

Clinical Comparison of Three Indirect Pulp Capping Restorative Protocols: A Randomized Controlled Prospective Study.

The objective of this prospective double-blind clinical trial was to compare clinical outcomes of indirect pulp capping restorative protocols on permanent teeth over a 12-month period. Deep carious lesions in permanent teeth (90) were randomly assigned to three indirect pulp capping protocols (n=30: TheraCal LC, Dycal, and no liner). All teeth were restored with resin composite. The outcome measures were pain (VAS scale) and success rate (pulp vitality based on percussion, palpation, cold test, and radiographic findings), collected at screening, intervention, and 24-hour, 7-day, 3-month, 6-month, and 12-month follow-up visits. There was no statistically significant difference in tooth sensitivity among the three indirect pulp capping protocols nor in success rates among the restorative protocols after 1 year of follow-up (p>0.1).The respective success rates, as defined by the tooth remaining vital, after 1 year were: 96.2% for TheraCal LC, 100% for Dycal, and 100% for no liner. After 12-month evaluation, the success rate of indirect pulp capping therapy on permanent teeth was not affected by the pulp capping restorative protocol.

Immunorecognition of Streptococcus mutans secreted proteins protects against caries by limiting tooth adhesion

IntroductionChildhood caries, a prevalent chronic disease, affects 60–90 % of children in industrialized regions, leading to lesions in both primary and permanent teeth. This condition precipitates hospital admissions, emergency room visits, elevated treatment costs, and missed school days, thereby impeding the child's academic engagement and increasing the likelihood of caries into adulthood. Despite multiple identified risk factors, significant interpersonal variability remains unexplained. The immune system generates a unique antibody repertoire, essential for maintaining a balanced and healthy oral microbiome. Streptococcus mutans is a primary contributor to the development of caries. MethodsEmploying mass spectrometry, we investigated the S. mutans proteins targeted by antibodies in children both with and without caries, delineating a fundamental suite of proteins discernible by the immune systems of a majority of individuals. Notably, this suite was enriched with proteins pivotal for bacterial adhesion. To ascertain the physiological implications of these discoveries, we evaluated the efficacy of saliva in thwarting S. mutans adherence to dental surfaces. ResultsAntibodies in most children recognized a core set of ten S. mutans proteins, with additional proteins identified in some individuals. There was no significant difference in the proteins identified by children with or without caries, but there was variation in antibody binding intensity to some proteins. Functionally, saliva from caries-free individuals, but not children with caries, was found to hinder the binding of S. mutans to teeth. These findings delineate the S. mutans proteome targeted by the immune system and suggest that the inhibition of bacterial adherence to teeth is a primary mechanism employed by the immune system to maintain oral balance and prevent caries formation. ConclusionsThese findings enhance our knowledge of the immune system's function in oral health maintenance and caries prevention, shedding light on how immunoglobulins interact with S. mutans proteins. Clinical SignificanceTargeting S. mutans proteins implicated in bacterial adhesion could be a promising strategy for preventing childhood caries.

ХАРАКТЕРИСТИКА ОБЪЕМА СТОМАТОЛОГИЧЕСКОЙ ТЕРАПЕВТИЧЕСКОЙ ПОМОЩИ, ОКАЗАННОЙ В ВИДЕ ПЛАТНЫХ МЕДИЦИНСКИХ УСЛУГ

The provision of paid medical services (PMS) is declared by Federal Law No. 323-FZ dated 21.11.2011 "On the basics of protecting the health of citizens in the Russian Federation" (Article 19) [1, 5, 7]. The procedure and conditions for the provision of PMS by medical organizations are established by the Decree of the Government of the Russian Federation of the same name dated May 11, 2023 No. 736 in the form of Rules [8, 10]. Any medical organization regardless of its organizational and legal form and form of ownership as well as an individual entrepreneur can be the provider of such services [3, 11]. An indispensable requirement for the provision of PMS is compliance with the procedures for the provision of medical care, clinical recommendations approved by non-profit professional organizations, and standards approved by the Ministry of Health of the Russian Federation [9, 10]. The provision of PMS is also regulated by the Law of the Russian Federation No. 23001 of February 7, 1992 "On Consumer Rights Protection". At the same time, there is a constant increase in the amount of PMS in the Russian Federation, their provision being an additional and quite significant source of funding for medical organizations [2, 4, 6].&#x0D; The article presents the analysis of the volume of medical services provided at the expense of citizens and in accordance with voluntary health insurance contracts in the dental department of the state medical organization for five years in the specialty of therapeutic dentistry. It is found that 71.8% of services were provided at the expense of citizens, and 28.2% were provided under voluntary medical insurance contracts. In the general structure of therapeutic and diagnostic measures, the removal of deposits on the teeth (69.3%) ranks the first, the treatment of caries being in the second place (15.0%), and the treatment of non-carious lesions of the teeth being in the third place (6.4%). The data obtained show a year-over-year increase in the volume of therapeutic and preventive care: by 1.3 times for caries, by 1.2 times for non-carious lesions of teeth, by 1.8 times for pulpitis, by 2.1 times for gingivitis. Patients do not show any interest in the paid treatment of periodontal diseases, so it takes less than one percent of the total volume of care (0.88% at the expense of citizens and 0.25% under voluntary health insurance contracts). The unfavorable epidemiological situation leads to a decrease in the volume of paid dental therapeutic care.

Efficacy of Different Fluoride Therapies on Hypersensitive Carious Lesions in Primary Teeth.

Background and Objectives: This prospective, comparative, double-cohort study aimed to compare the efficacy of silver diamine fluoride and potassium iodide (38% SDF+KI; Riva Star®) with sodium fluoride varnish (5% NaF; Duraphat®) in hypersensitive carious lesions in primary teeth to evaluate caries arrest and hypersensitivity relief. Materials and Methods: This study included thirty 2-5-year-olds (mean age = 3.67 ± 1.06 years; 16 males and 14 females) who required a desensitizing treatment for hypersensitive carious defects with visible dentin. A total of 15 of the participants were consecutively allocated to treatment with 5% NaF, and they were further compared to an equal number of participants treated with 38% SDF+KI solutions (n = 15). The treatments were performed following clinical evaluation of caries activity using the International Caries Classification and Management System (ICCMSTM) and the Bjørndal criteria (score of 0-9). Parental-reported hypersensitivity was evaluated using a visual analogue scale (0-10 = no to severe pain). Results: Clinical variables were evaluated at baseline and three months after treatment. Thereafter, a significant decline in hypersensitivity/pain led to lower final scores in the Riva Star® group (0.40 ± 1.12, p = 0.002) than in the Duraphat® group (1.40 ± 2.20, p = 0.004). The caries arrest effect was significantly higher in the Riva Star® group (86.7%) compared to the Duraphat® group three months after treatment (13.3%, p < 0.001). In both groups, there were no statistically significant differences in the children's behavior before, during, and after treatment. Conclusions: Ultimately, with both fluoride therapies reducing hypersensitivity/pain significantly, treatment with 38% SDF+KI was clearly more effective in caries arrest than 5% NaF varnish after a 3-month period.

Evaluation of the Effect of NovaMin and Er,Cr:YSGG Laser on Remineralization of Erosive Lesions of Primary Enamel Teeth: An In Vitro Study.

Introduction: The purpose of this in vitro study is to ascertain how NovaMin and Er,Cr:YSGG laser radiation affect the remineralization of primary tooth enamel lesions. Methods: 40 main teeth served as the study's sample size. These teeth were allocated into five groups at random. The first group served as a negative control (artificial saliva); the second group served as a positive control (APF gel 1.23%); the third group NovaMin, the fourth group Er,Cr:YSGG laser, the fifth group Er,Cr:YSGG laser and finally, the application of NovaMin. For the purpose of measuring microhardness, all samples were submitted to the dental materials laboratory three times. Results: The collected data were compared using the SPSS 28 program between the baseline measurement, after demineralization, and after remineralization. The data were analyzed using ANCOVA and Bonferroni tests. All groups demonstrated a considerable increase in microhardness as compared to the negative control group (P<0.05). With the exception of the third and fourth groups, there was no discernible difference in the rise in microhardness between the other groups. The third and fourth groups were compared, and the results revealed that NovaMin had a greater impact than laser therapy alone (P=0.023). Scanning electron microscopy (SEM) analysis backed up the findings. Conclusion: In comparison to using the Er,Cr:YSGG laser alone, using NovaMin alone can speed up the remineralization of erosion lesions on the surface of primary teeth.

Teaching of silver diamine fluoride for the management of dental caries and hypersensitivity – situation in the Southeast Asia dental schools

BackgroundUsing silver diamine fluoride (SDF) for caries management has raised dentists’ interests in Southeast Asia (SEA). However, information about the teaching of SDF in dental schools in SEA is limited. Therefore, this survey aimed to describe the extent to which SDF had been introduced into the education of undergraduate students in the dental schools in SEA.MethodsAn online questionnaire survey was conducted on the duration, method, contents, and barriers regarding the teaching of SDF. Teachers in charge of undergraduate program in pediatric dentistry and those in community dentistry in all the 90 dental schools in SEA were approached and we required each department to reply once only. Descriptive statistics and Chi-square test were used to describe and assess the differences between the two departments in the teaching of SDF.ResultsA total of 81 responses from the departments of 49 schools were received, giving a school-level response rate of 54% (49/90). SDF was taught in the undergraduate program in 86% (42/49) of the respondent schools, and 50% (21/42) of these schools had included SDF in the teaching for five or more years. Almost all (98%) of the departments taught SDF through lectures. Furthermore, 55% of them adopted SDF in clinical practice. Regarding the teaching content, the use of SDF for arresting cavitated caries lesion was the most commonly covered (82–97%), followed by for arresting early noncavitated lesions (69–82%), for preventing new caries development (66–79%) and for treating dental hypersensitivity (77%). There were variations in the post-treatment instruction taught. For the departments not teaching SDF, the most common reason (10/19, 53%) was that SDF was not available.ConclusionSDF is covered in the undergraduate program in most of the dental schools in SEA. The use of SDF to arrest cavitated caries lesions in primary teeth is usually taught. However, other applications of SDF, such as for prevention of caries and treatment of dental hypersensitivity, are less commonly mentioned in the teaching.

Assessment of Decision-Making and Material Selection for Vital Pulp Therapy in Deep Carious Lesions: A Study at the Faculty of Dentistry, King Abdulaziz University.

The purposes of this study were to assess decision-making, material selection, and management of deep carious lesions in permanent teeth requiring vital pulp therapy (VPT); investigate the intradepartmental and interdepartmental consensus in the management of those cases; and correlate this study's results to the current scientific literature, clinical experience, and postgraduate training among staff and postgraduate students at the Faculty of Dentistry,King Abdulaziz University. The survey included faculty from pedodontics, endodontics, and restorative/operative dentistry; postgraduate students; and interns, excluding specific categories such as retired faculty, external trainers, non-faculty hospital specialists, general practitioners, students, interns outside the institution, and other departments. An anonymous electronic questionnaire was developed and validated. Ethical approval was obtained, and the questionnaire was distributed to all 148 English-proficient members of the targeted populationvia email and WhatsApp, accompanied by a cover letter. The questionnaire encompassed demographic, education, experience, assessment, decision-making, and management sections. Data were collected and analyzed using Microsoft Excel, with results presented using categorical variables, Pareto charts, and statistical tests. There were 86 responses, representing 58% of the target population, with the key findings including the prominence of "Pre-operative vitality test result" as the most important factor in assessing deep carious lesions, with no significant differences among specialties. The (one-step and one-visit) management approach was preferred by 50% of participants, with no significant specialty differences. For deep carious lesions without pulpal exposure, glass ionomer (GI)/resin-modified glass ionomer (RMGI) base was the top choice, with no variation among all specialties. In cases with pulpal exposure, the one-visit approach (direct pulp capping (DPC), base, and restoration) was the most favored, with no specialty differences. Material availability significantly influenced decision-making, with no specialty variations. The study highlights the crucial role of pre-operative vitality tests in assessing deep carious lesions for VPT or root canal treatment (RCT). Participants generally favored VPT for cases with normal pulp vitality, with some departmental variation. Controlling bleeding post-pulpal exposure was a central concern. Mineral trioxide aggregate (MTA) was the most commonly used VPT material, followed by Ca(OH)2 and Biodentine. Factors such as treatment access, patient compliance, remaining dentin thickness, and oral hygiene had minimal impact on treatment choice. Limited availability of VPT materials was the primary reason for non-use. The survey's acceptable response rate raises concerns about potential non-response bias, though limitations include a lack of data on non-responders. Nevertheless, the survey's strength lies in its comprehensive coverage of key clinical aspects, engaging professionals from diverse specialties and educational levels who are collectively interested in addressing deep caries cases.

Acceptability of Silver Diamine Fluoride

Background: Silver diamine fluoride (SDF) can be used for active carious lesions in primary teeth and can be applied in dental clinics, in school, or in community-based settings with simple armamentarium and minimal support. Silver diamine fluoride causes darkening of carious enamel and dentin after its application. Method: An electronic literature search in Web of Science, Scopus, Science Direct, PubMed, Google Scholar, African Journal Online, Researchgate, and Google was done in June 2023. Search terms and keywords were combined by Boolean operators. Four independent investigators (research assistants) screened titles, abstracts, and full text of publications. The inclusion criteria were original research articles ( human studies) carried out in African regions and including observational studies (cohort, case-control, cross-sectional), experimental studies (clinical trials, randomized or not) designs, case reports, and case series investigating parents, caregivers, guardians or children acceptability or acceptance of silver diamine fluoride treatment procedure and post-treatment blackening/staining of teeth. Systematic reviews and review articles were excluded. Results: One article was included as it was assessed to meet the aim of the review. It was a hospital-based study. Parental acceptance of silver diamine fluoride treatment with its black staining was assessed using the Likert scale. Acceptance of post-treatment staining of teeth among parents was higher in posterior teeth than in anterior teeth. Conclusion: Only one study on the acceptability or acceptance of silver diamine fluoride treatment procedure and post-treatment staining of teeth was identified among African parents. More studies from the diverse ethnic population in Africa will contribute to the existing literature. J Rang Med Col. September 2023; Vol. 8, No. 2: 53-55