Caries Progression Research Articles

Antibacterial Activity and Shear Bond Strength of Orthodontic Adhesive Containing Various Sizes of Chitosan Nanoparticles: An In Vitro Study.

White spot lesions are common after orthodontic treatment. Chitosan nanoparticles (CS-NPs) have emerged as promising antibacterial agents that inhibit the growth of Streptococcus mutans. The aim of the study was to investigate the nano-effect of adhesives containing CS-NPs on S. mutansand their effects on shear bond strength. The inhibitory effects of two sizes of CS-NPs were assessed using the disc agar diffusion method. Four wells were created in the petri dishes, and each was inoculated with broth (negative control), chlorhexidine (positive control), CS-NPs (20 nm), or CS-NPs (131 nm). An Instron machine was used to evaluate shear bond strength by allocating 24 teeth into three groups, and all measurements were recorded in megapascals. Caries progression was assessed using the International Caries Detection and Assessment System and surface profilometry. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBMCorp., Armonk, New York, United States) for a one-way ANOVA followed by Tukey's multiple comparison test. Disc agar diffusion showed a reduction in S. mutans in the CS-NPgroup compared to the control (p < 0.001), with no statistical significance between the sizes of 20 and 131 nm (p = 0.95). Regarding shear bond strength, no differences were recorded when adhesive-containing CS-NPs and the control were compared (p = 0.44). Additionally, no differences were found within the CS-NP groups (p = 0.91). Caries assessments showed excellent agreement, as indicated by a weighted kappa. Profilometry readings showed higher surface roughness in the control than in the CS-NP groups (p < 0.001), with no statistically significant difference between the CS-NP groups (p = 0.72). CS-NPs of both sizes tested had similar antibacterial effects. In addition, the incorporation of CS-NPs did not affect shear bond strength.

Investigating the impact of kallikrein 4 gene polymorphism on caries severity and development in divers age groups of pregnant women during caries prevention

Relevance. The progression of caries during pregnancy is significantly influenced by the resistance of dental tissues against demineralization. The degree of resistance in dental enamel is influenced by its genetic determinants, encompassing structural and morphological properties. The kallikrein 4 (KLK4) gene plays a pivotal role as a primary enzyme in dental enamel formation. Consequently, evaluating the effectiveness of various preventive measures on dental enamel necessitates consideration of KLK4 gene mutations.Material and methods. An examination was conducted on a cohort of 322 pregnant women. Key indices assessed included OHI-S, DMF, DMFs, ∆DMF, and ∆DMFs. Oral fluid analysis encompassed parameters such as Ca, P, Ca/P-molar ratio, рН, Ca2+, pK+, pNa+. The sediment of oral fluid was examined for ∆рН and ∆Ca. DNA sample was isolated from venous blood obtained from the participants.Results. The G/G polymorphism of the KLK4 gene at positions G2664153A and G2142А did not exhibit a statistically significant association with an increase in the ∆DMFs index during caries prevention, a finding consistent across both discussed tools for exogenous caries prevention in this study. In case of heterozygous KLK4 G/A polymorphism with the dominant G allele, the application of Enamel Sealing Liquid showed a tendency towards higher ∆DMF and ∆DMFs indices over a 12-month follow-up period. When pregnant patients with heterozygous dominant G allele mutations were treated with the triple-component calcium-fluorine-phosphate-containing gel, there were no observed elevations in these indices. The amplified production of KLK4 A/A polymorphism was associated with a statistically significant rise in ∆DMF and ∆DMFs indices, accompanied by alterations in certain oral fluid parameters. These changes included reduced active calcium levels and Ca/P molar ratio, along with elevated levels of phosphates and electrolytes. Enhanced demineralizing activity was observed in the oral fluid sediment.Conclusion. The effectiveness of caries prevention tools during pregnancy is contingent upon the genotypic diversity of KLK4 gene polymorphism at the G2664153A and G2142А mutation points.

Assessment of the Changes in the Salivary Profile and Its Clinical Correlation in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy: A Follow-up Study.

To assess the changes in salivary profile and its clinical correlation in patients with acute lymphoblastic leukemia (ALL) undergoing chemotherapy. Children who have been diagnosed with ALL undergoing chemotherapy at Bharati Hospital, Pune, were included in the study. Those children were included who fulfilled the following inclusion and exclusion criteria. Stimulated salivary samples were collected in sterile vials at 1-, 3-, and 6-month intervals and ware assessed for salivary pH and buffering capacity. Caries and oral manifestations were also checked at each interval. A total of 25 children with ALL undergoing chemotherapy were included to participate in the study. The results were analyzed using Statistical Package for the Social Sciences software. There was a statistically significant difference in the change in salivary pH during the 1st and 6th months of chemotherapy (p-value of 0.001). Salivary buffering capacity was also found to be low in these patients during the 1st month of chemotherapy, which gradually increased during the entire course of chemotherapy (p-value of 0.011). Progression of dental caries was seen during the entire course of treatment. All the major changes were seen in the 1st month, that is, the induction phase of chemotherapy. Hence, we can say this is the most affected phase of chemotherapy. The parents and children should be educated and motivated to maintain proper oral hygiene. Whenever possible, all preventive dental procedures should be undertaken before the start of chemotherapy to avoid future complications. Paranjape MN, Shah P, Patil S, et al. Assessment of the Changes in the Salivary Profile and Its Clinical Correlation in Children with Acute Lymphoblastic Leukemia Undergoing Chemotherapy: A Follow-up Study. Int J Clin Pediatr Dent 2023;16(S-3):S268-S271.

Polyketides/nonribosomal peptides from Streptococcus mutans and their ecological roles in dental biofilm.

Streptococcus mutans is the major etiological agent of dental caries in humans. S. mutans overgrowth within dental biofilms can trigger biofilm dysbiosis, ultimately leading to the initiation or progression of dental caries. Polyketides and nonribosomal peptides (PKs/NRPs) are secondary metabolites with complex structures encoded by a cluster of biosynthetic genes. Although not essential for microbial growth, PKs/NRPs play important roles in physiological regulation. Three main classes of hybrid PKs/NRPs in S. mutans have been identified, including mutanobactin, mutanocyclin, and mutanofactin, encoded by the mub, muc, and muf gene clusters, respectively. These three hybrid PKs/NRPs play important roles in environmental adaptation, biofilm formation, and interspecies competition of S. mutans. In this review, we provide an overview of the major hybrid PKs/NRPs of S. mutans, including mutanobactin, mutanocyclin, and mutanofactin and address their ecological roles in dental biofilms. We place specific emphasis on important questions that are yet to be answered to provide novel insights into the cariogenic mechanism of S. mutans and facilitate improved management of dental caries. We highlight that S. mutans PKs/NRPs may be potential novel targets for the prevention and treatment of S. mutans-induced dental caries. The development of genomics, metabolomics, and mass spectrometry, together with the integration of various databases and bioinformatics tools, will allow the identification and synthesis of other secondary metabolites. Elucidating their physicochemical properties and their ecological roles in oral biofilms is crucial in the identification of novel targets for the ecological management of dental caries.

Inhibitory effect of Streptococcus mutans antisense vicK RNA regulating the cariogenicity of oral streptococci multi-species biofilm

Objective: To investigate the regulative effects of Streptococcus mutans (Sm) antisense vicK RNA (ASvicK) on the multi-species biofilm formed by three common oral streptococci (Sm, Streptococcus sanguinis, and Streptococcus gordonii) (Sm+Ss+Sg). Methods: ASvicK over-expression strain was constructed by using a recombinant plasmid, and three-species biofilm UA159+Ss+Sg and ASvicK+Ss+Sg were cultured. The phenotypes of biofilms were detected by scanning electron microscopy (SEM). Crystal violet (CV) assay was used to detect biofilm biomass. Lactate kit and anthrone-sulfuric acid colorimetric assay were used to determine the abilities of lactic acid and exopolysaccharides production, respectively. The proportions of three-species and expression levels of the cariogenic-related genes in biofilms were detected by TaqMan fluorescence quantitative PCR and real-time fluorescence quantitative PCR. A biofilm demineralization model of human enamel slabs was further constructed, and the hardness of enamel surface was detected. Results: Compared to UA159+Ss+Sg, over-expression of ASvicK could inhibit biofilm formation and lactic acid production in ASvicK+Ss+Sg biofilm significantly decreased by 78.93% (P<0.001) and 62.23% (P<0.001), respectively. With ASvicK over-expression, the amounts of water-insoluble and-soluble glucoses in ASvicK+Ss+Sg biofilm were reduced respectively by 39.13% (P<0.001) and 68.00% (P<0.001). Compared to the UA159+Ss+Sg Group, the proportion of Sm, the cariogenic bacteria, showed 33.00% reduction (P<0.01) in Sm+Ss+Sg biofilm, and the gene expressions of cariogenic-relative genes vicK/X, gtfB/C/D, and ftf significantly decreased (P<0.05). The micro-hardness value of enamel slabs after demineralization by ASvicK+Ss+Sg biofilm was significantly increased to 183.84% (P<0.001). Conclusions: ASvicK over-expression could reduce the Sm proportion and weaken the cariogenicity of oral Streptococcus biofilm, thereby possibly slowing down the progression of caries.

Bacterial dynamics in the progression of caries to apical periodontitis in primary teeth of children with severe early childhood caries.

Early childhood caries (ECC) are a prevalent chronic disease in young children. However, there has been limited research on the microbiota in different tissue levels of the same tooth in children with ECC. This study aimed to investigate the dynamic changes in bacterial diversity during the progression of Severe Early Childhood Caries (S-ECC) within the same tooth, from the tooth surface to the root canal, by collecting tissue samples from different areas of the affected tooth. Twenty primary teeth with periapical periodontitis were selected from 20 children aged 3-5 years, with 100 samples collected from the different layers: uncavitated buccal enamel surface without white spot lesion (surface), the outermost layer of the dentin carious lesion (superficial), the inner layer of carious dentin (deep), necrotic pulp tissue (pulp), and root exudate (exudate). The taxonomy of each OTU representative sequence was analyzed against the 16S rRNA database. Comparisons of alpha diversity between groups were performed. The number of shared and unique genera between groups counted. Beta diversity was contrasted to evaluate differences in bacterial community composition, and the relationships between the microbiota and samples were analyzed. The heatmap analysis of the 30 most abundant genera was used, which highlighted their relative distribution and abundance. The significantly abundant taxa (phylum to genera) of bacteria among the different groups were identified. The differences of relative abundance between bacterial genera among the five groups were analyzed. Significant Spearman correlations were noted, and visualization of the co-occurrence network was conducted. Bacterial 16S rRNA gene sequencing showed that most genera were present in all layers, with the number of shared genera increasing as the disease advanced. The bacterial communities and core genera in the co-occurrence network changed with progression to severe ECC. An increase in both the quantity and complexity of bacterial interactions was observed. This study emphasized the importance of paying attention to the relationship between microbial species rather than just checking changes in bacterial species structure when investigating the role of bacteria in disease progression.

The in vitro assessment of rheological properties and dentin remineralization of saliva substitutes containing propolis and aloe vera extracts.

Saliva substitutes with enhanced dentin remineralization properties were expected to help manage caries progression in patients with xerostomia. This in vitro study examined the rheological properties and remineralization action of experimental saliva substitutes containing propolis extract and aloe vera extract on demineralized dentin. Four experimental saliva substitutes were formulated with varying concentrations of propolis extract (P) and aloe vera extract (A) were prepared. A commercial saliva substitute (Biotene Oral Rinse) was used as a commercial comparison. The rheological properties and viscosity of these materials were measured using a strain-controlled rheometer (n = 3). The remineralizing actions of saliva substitutes on demineralized dentin after 2 weeks were determined using ATR-FTIR and SEM-EDX (n = 8). The results were expressed as a percentage increase in the mineral-to-matrix ratio. Biotene demonstrated a significantly higher viscosity (13.5 mPa·s) than experimental saliva substitutes (p<0.05). The addition of extracts increased the viscosity of the saliva substitutes from 4.7 mPa·s to 5.2 mPa·s. All formulations showed minimal shear thinning behavior, which was the viscoelastic properties of natural saliva. The formulation containing 5 wt% of propolis exhibited the highest increase in the median mineral-to-matrix ratio (25.48%). The SEM-EDX analysis revealed substantial mineral precipitation in demineralized dentin, especially in formulations with 5 wt% or 2.5 wt% of propolis. The effect of the aloe vera extract was minimal. The addition of propolis and aloe vera extracts increased the viscosity of saliva substitutes. the addition of propolis for 2.5 or 5 wt% to saliva substitutes increased mineral apatite precipitation and tubule occlusion. To conclude, the saliva substitute containing propolis extract demonstrated superior remineralizing actions compared with those containing only aloe vera extract.

Salivary antioxidents in relation to caries severity among a group of young adults

Background: Saliva represents the body's stages of toxicological, hormonal, immunological, and markers of many infectious disease and disorders, so that it's an ideal tool for monitoring oral and systemic health.&#x0D; Antioxidants help the body's defensive system by reducing oxidative stress.&#x0D; &#x0D; Aims of the study: The study was directed to estimate the carious lesion experience (DMFS) in relation to salivary superoxide dismutase and total protein among adults by age and gender.&#x0D; &#x0D; Materials and methods: Caries experiences was assessed according to DMFS index, after investigation eighty peoples of an age 19-22 years for both genders. Stimulated salivary samples were together and chemically assessed to detect selected salivary antioxidants (superoxide dismutase, total protein), under standardized condition. Total protein and superoxide dismutase were measured by spectrophotometric examination.&#x0D; &#x0D; Results: With not-significant differences, total protein was found to be higher in the caries active group than in the caries free group, but salivary superoxide dismutase was the opposite. with statistically not-significant differences, females had a greater average of the salivary total protein than men, whereas men had a greater average of salivary superoxide dismutase than females. the first group (19-20 years) had a not-significant greater average salivary total protein and salivary superoxide dismutase than the second group (21-22 years).&#x0D; Conclusion: Salivary superoxide dismutase is the important factor in dental caries prevention. As a result, alterations in salivary content are crucial in the development and progression of dental caries.

Silver Diamine Fluoride Renaissance in Paediatric Dentistry: A 24-Month Retrospective and Cross-Sectional Analysis.

Background and Objectives: Silver diamine fluoride (SDF) has been incorporated into the treatment of dental caries in children, mainly in countries with high caries prevalence. In Europe, however, SDF started to gain popularity during the COVID-19 pandemic. This study aimed to investigate the efficacy of SDF and to evaluate dentists'/parents' acceptance of SDF use in paediatric patients treated in a German university setting. Materials and Methods: A retrospective analysis of all patients treated with SDF between 2017 and 2020 was carried out. Only teeth with no reported clinical/radiographic evidence of irreversible pulpal inflammation were included. The outcome measures were success, minor failures (caries progression, reversible pulpitis) and major failures (irreversible pulpitis, abscess). The treatment acceptance by dentists and the parents of SDF-treated children was cross-sectionally evaluated using questionnaires. Descriptive statistics and Kaplan-Meier survival analysis were performed. Results: A total of 93 patients (mean age 5.3 ± 2.9 years) with 455 treated teeth (418 primary/91.9%; 37 permanent/8.1%) were included and followed up for up to 24 months (19.9 ± 10.5 months). SDF was used for dental caries (98.2%) and hypersensitivity relief on MIH teeth (1.8%). Most teeth did not show any failure (total success 84.2%). A total of 5 teeth (1.1%) showed minor failures, and 67 teeth (14.7%) showed major failures (p = 0.001). Success/failure rates were not affected by patient compliance, gender, dentition, or operator (p > 0.05). In total, 30 questionnaires were collected from parents (mean age 36.8 ± 6.4 years). SDF was applied on anterior (n = 2/6.7%), posterior (n = 15/50%) and anterior/posterior teeth (n = 13/43.3%). At the 1-week follow-up, 80% of parents noticed black teeth discoloration. Treatment satisfaction was higher for posterior (95.2%) than for anterior teeth (36.4%; p < 0.001). In the 27 responses from clinicians, SDF was generally considered a viable option in paediatric dentistry (n = 23; 85%). Conclusions: SDF was found to be effective and well-accepted by parents and dentists for caries inactivation in a paediatric dentistry German university setting.

Household smoking impact on the oral health of 5- to 7-years-old children

BackgroundChildren’s exposure to secondhand smoke, particularly by their parents, could adversely affect their oral health. Thereby, this study aimed to assess the oral health status of children subjected to household smoking and the impact of smoking patterns on the severity of oral health deterioration.MethodsA total of 210 healthy children were enrolled in this case-control study and allocated into children subjected to household smoking (HS) and control groups. Participants’ guardians were asked to complete a questionnaire regarding sociodemographic characteristics and parental smoking habits. All participants were subjected to clinical dental examination to assess dental caries (ICDAS), hypomineralized primary molars (HSPM), and gingival status (GI). Stimulated saliva samples were collected to assess saliva composition and characteristics. Urine samples were collected and analyzed for cotinine concentration. Data were analyzed using SPSS (v.25) software at a test value of p ≤ 0.05. The t-student test was used to find significant differences between participants’ age, gingival index score, saliva pH, flow rate, sIgA, and cotinine level. The Chi-square test was used to test for the significance of parental employment, number of rooms, gender, sweets consumption, brushing frequency, and HMPM. The correspondence analysis was used to test for significance of parents’ levels of education, type of house ventilation, ICDAS score, smoking form, frequency, and smoking pattern. The correlation between cotinine level and sIgA was tested for association using Bivariate correlation test.ResultsThe HS group showed a significantly increased risk for dental caries (p < 0.000), HSPM lesions (p = 0.007), and GI score (p < 0.000). A significant reduction in salivary flow rate, saliva pH, and sIgA were evident in HS group (p < 0.000). Parental consumption of more than 20 cigarettes/day was accompanied by increased dental caries activity (p < 0.000) and higher risk for increased severity of gingival inflammation (p < 0.000) of children in the HS group. Children of parents who smoke cigarettes and use the hubble/bubble anywhere in the house found to have greater distribution of HSPM (p < 0.000). Reduced sIgA values were found to be significantly associated with increased cotinine concentrations in HS children (p < 0.000).ConclusionsFrequent exposure to household smoking could be associated with an increased risk of dental caries progression, enamel hypomineralization, gingival inflammation, and saliva characteristics changes in children.

Antibacterial efficacy of NanoCare, Fullerene (C60) activated by UV light, and Morinda Oleifera against S.Mutans and bond integrity of composite resin to caries affected dentin

AimAssessment of the impact of contemporary disinfection techniques Moringa Oleifera (M. Oleifera), NanoCare Plus Silver Gold® (Nanocare), and Fullerene (C60) on survival rates of S.Mutans and shear bond strength (SBS) of composite to the carious affected dentin (CAD) Material and methodsSixty mandibular molars having caries progression till the middle 1/3rd of the dentin were disinfected. The CAD surface of twenty samples was inoculated with S.mutans. Based on different disinfection regimens samples were arbitrarily assigned to four groups (n:15) Group 1: 2 % CHX, Group 2:NanoCare, Group 3:Fullerene (C60), and Group 4 (M. Oleifera. This was followed by calculating the survival rate of S.mutans. Ten samples from each group were then restored with composite restoration and thermocycled. Assessment of SBS and failure mode was performed using a universal testing machine and stereomicroscope at 40X magnification. Statistical significance among groups was assessed using analysis of variance (ANOVA) and Tukey's test at a significance level of p = 0.05 ResultsGroup 2 samples treated with NanoCare exhibited the lowest survival rate (0.39 ± 0.02 CFU/ml) of S.Mutans. However, Group 1 (CHX) samples exhibited the highest survival count (0.51±0.10 CFU/ml). Furthermore, the highest composite to CAD bond was observed in Group 3 Fullerene(C60) (18.44±0.25 MPa) samples and the lowest SBS was observed in Group 1 (CHX) (12.48±1.69 MPa) CONCLUSIONFullerene(C60) and Moringa Oleifera extract hold promise as potential substitutes for chlorhexidine (CHX) in clinical applications, offering the potential for improved S.Mutans elimination and enhanced bond strength to CAD surface

CO2 laser irradiation combined with fluoridated dentifrice improved its protective effect on caries lesion progression regardless of the acidulated phosphate fluoride gel application: An in situ study.

This in situ study aimed to investigate the efficacy of CO2 laser at a 10.6-µm wavelength combined with 1.23% acidulated phosphate fluoride (APF) and fluoridated dentifrice with 1100µg F/g (FD) to control enamel caries progression. Sixteen volunteers wore palatal appliances containing eight demineralized enamel specimens for four 14-day phases under sucrose exposure. These specimens were submitted to CO2 laser irradiation and APF alone or combined with FD. Treatment groups were non-fluoridated dentifrice-NFD, NFD + CO2 laser, NFD + APF, NFD + CO2 laser + APF, FD, FD + CO2 laser, FD + APF, and FD + CO2 laser + APF. Mineral loss, calcium fluoride (CaF2), fluorapatite (FAp), and fluoride in the biofilm were analyzed by analysis of variance followed by the Student-Newman-Keuls test, p < 0.05. The highest mineral loss inhibition was noted when FD and CO2 laser irradiation were combined, which did not significantly differ from the FD + CO2 laser + APF group. The CaF2, FAp, and F in the biofilm were more pronounced when the FD and APF were combined. The CO2 laser irradiation promoted a slightly higher concentration of CaF2 in the enamel and F in the biofilm. Although APF promotes the high formation of CaF2 and FAp, the combined use of FD with CO2 laser overcomes the APF effect in inhibiting the progression of artificial caries-like lesions in situ. Under the in situ design of this study, remineralization of white spot lesions was achieved through CO2 laser irradiation and daily use of fluoridated dentifrice. Future clinical trials are encouraged to substantiate this finding.

Sugar Substitute Stevia Inhibits Biofilm Formation, Exopolysaccharide Production, and Downregulates the Expression of Streptococcal Genes Involved in Exopolysaccharide Synthesis.

Acid production by sucrose fermentation disturbs the balance in dental plaque by lowering the oral pH. As a consequence of the profound effect of sucrose on caries initiation and progression, many studies have been directed towards finding non-cariogenic artificial sweeteners that can be used as a substitute to sucrose. Existing literature shows that dietary sucrose upregulates the expression of biofilm associated genes involved in exopolysaccharide (EPS) production. In this study, we aimed to investigate the effect of the sugar substitute stevia on biofilm formation, EPS secretion, and streptococcal genes encoding glucan-binding proteins (Gbps) and glucosyltransferases (Gtfs), which are essential for the synthesis of EPS. Streptococcus mutans and Streptococcus gordonii were grown as biofilm cultures with or without stevia and sucrose. Biomass was quantified for biofilm and EPS production by crystal violet staining and the phenol-sulfuric acid method, respectively. Expression of gtfB and gbpB genes was studied by RT-PCR. The quantities of biofilm were significantly lower when grown in the presence of stevia compared to sucrose in both species (p < 0.05). The proportion of EPS in the biofilm pellet decreased with increasing concentrations of stevia in both species but remained nearly unchanged with sucrose with respect to the control. In both streptococcal species, exposure of stevia decreased the expression of gtfB and gbpB genes compared to sucrose (p < 0.05). In comparison to the untreated control, the expression was decreased in the presence of stevia in both species, while it increased 2.5- to 4-fold in S. mutans and 1.5- to 2.5-fold in S. gordonii in the presence of sucrose. The ability of stevia to inhibit biofilm formation, reduce EPS production, and downregulate the expression of gtfB and gbpB genes in S. mutans and S. gordonii may have potential therapeutic applications in controlling dental plaques and caries.

Modern Trends in Oral Biology Research

Modern Trends in Oral Biology Research

Effectiveness of MI Varnish™ and PreviDent® Varnish in Noncavitated Interproximal Lesions: A Randomized Clinical Trial.

Evaluating the remineralization efficacy of noncavitated proximal incipient lesions with Colgate® PreviDent® and MI™ varnishes in comparison to the industry standard (1.23%) acidulated phosphate fluoride (APF) gel. Parallel randomized controlled, multicenter, single-blinded trial. By flipping a coin, 18 patients with 91 lesions were divided into three groups. The Colgate® PreviDent (n = 33), MI varnish (n = 30), and control (APF gel) groups (n = 28) were identified as the three arms. We conducted an initial assessment and therapy as well as follow-ups at 3 and 6 months to evaluate the course of the caries lesion. Caries progression was significantly reduced on treated surfaces across both groups. Nine surfaces in the Colgate® PreviDent® group with white spots and dryness did not change, one surface turned into a white patch without dryness, and another surface changed to a sound surface; only two surfaces were discontinued from treatment (restored) due to a misdiagnosis by the operator (n = 2). Nine of the surfaces in the MI™ group maintained their white patches with dryness, whereas one developed a new white patch that was not dry. Only MI varnish™-treated teeth exhibited dramatic radiographic improvement. Caries on the outside enamel were either unchanged or restored to healthy levels. Caries on the inner surface of the enamel also did not change. Remineralizing noncavitated early-stage lesions may be done with both MI™ and Colgate® PreviDent® varnishes. Despite this, radiographic results did not vary significantly across the three groups. In situations of rather advanced incipient caries seen on radiographs, the MI varnish™ might be recommended. Helal N, Azzahrani GS, Azzouz LZ. Effectiveness of MI VarnishTM and PreviDent® Varnish in Noncavitated Interproximal Lesions: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(5):751-757.

A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children.

The study evaluated the effectiveness of nanosilver fluoride (NSF) in arresting dental caries in 4-8-year-old school children. The two-arm, parallel-group randomized controlled trial included a total of 148 children aged 4-8 years with active carious lesions. Children were randomly divided into two groups: group I-NSF (n = 74); and group II-water (placebo and n = 74). Baseline data were recorded using the International Caries Detection and Assessment System (ICDAS) II criteria, and the teeth were treated with either of the solutions. Later, the teeth were evaluated by two blinded examiners for the lesion activity using ICDAS II criteria at 1, 3, and 6-month intervals. The obtained data were analyzed using the Chi-squared test for intergroup comparison and Cochran's Q test for intragroup comparison. Cohen's κ test was used to check the interexaminer and intraexaminer variability. Carious teeth treated with NSF have shown 56.3, 59.2, and 62% arrested carious lesions, whereas the placebo group has shown 0, 2.9, and 4.4% arrested lesions at 1, 3, and 6-month intervals, respectively. NSF showed a high statistically significant difference (p < 0.001) in arresting dental caries compared to the control group at all the time intervals. Nanosilver fluoride (NSF) is found to be effective in arresting dental caries without staining carious lesions. Therefore, it can be used to reduce the bacterial load for caries stabilization in the initial phase of the comprehensive treatment protocol for the management of children with active caries lesions. Most of the decayed teeth in the primary dentition remain untreated either because of inaccessible dental services or the uncooperativeness of children. Hence, there is an absolute need for a cariostatic agent which arrests the progression of caries in a simple and noninvasive manner. The results of this study evidence that NSF effectively arrests dental caries in primary teeth. Hence, this can be a very economical way of arresting caries in the population who don't have access to regular dental treatment. Devi C, Chandrasekhar R, Vinay C, et al. A Randomized Controlled Trial Evaluating the Effectiveness of Nanosilver Fluoride in Arresting Dental Caries in School Children. Int J Clin Pediatr Dent 2023;16(5):667-670.

Supragingival mycobiome of HIV-exposed-but-uninfected children reflects a stronger correlation with caries-free-associated taxa compared to HIV-infected or uninfected children.

Highly active antiretroviral treatment (HAART) has greatly reduced opportunistic infections in HIV-infected individuals. However, even with the use of HAART, HIV-infected individuals are still at an increased risk of oral diseases, including dental caries. Dental caries development is associated with microbial community shifts leading to community dysbiosis. HIV infection can significantly alter the bacteriome and mycobiome composition in the oral cavity; however, these impacts have not been assessed for caries initiation and progression. The aim of this study was to characterize the mycobiome for supragingival plaque samples from HIV-infected (HI), HIV-exposed-but-uninfected (HEU), and HIV-unexposed-and-uninfected (HUU) children with and without caries. To accomplish this, ITS1 amplicons of 127 samples were sequenced. We found that HIV infection and exposure resulted in changes to the supragingival plaque mycobiome for both health and caries. Overall, a reduction in community diversity as caries progressed was observed, with HI children having the lowest diversity and HEU children the highest. Candida albicans was the most abundant species identified, with 177 different amplicon sequence variants (ASVs). Two C. albicans ASVs dominated the data (53.0% and 38.5% of all taxonomic assignments). The more frequent ASV dominated HI and HUU communities, whereas the second dominated HEU communities. HEU children also had the lowest abundance of C. albicans and the highest number of health-associated taxa (taxa statistically associated with caries-free teeth).IMPORTANCEGlobally, caries is among the most frequent chronic childhood disease, and the fungal component of the microbial community responsible is poorly studied despite evidence that fungi contribute to increased acid production exacerbating enamel demineralization. HIV infection is another global health crisis. Perinatal HIV exposure with infection are caries risk factors; however, the caries experience in the context of perinatal HIV exposure without infection is less clear. Using high-throughput amplicon sequencing, we find taxonomic differences that become pronounced during late-stage caries. Notably, we show a stronger correlation with health-associated taxa for HIV-exposed-but-uninfected children when compared to unexposed and uninfected children. This aligns with a lower incidence of caries in primary teeth at age 6 or less for exposed yet uninfected children. Ultimately, these findings could contribute to improved risk assessment, intervention, and prevention strategies such as biofilm disruption and the informed design of pro-, pre-, and synbiotic oral therapies.

Predictive validity of the reduced Cariogram model for caries increment in non-cavitated and cavitated lesions: cohort study

BackgroundThe aim of this study is to assess the caries prediction of the reduced Cariogram by comparing baseline caries risk profiles with non-cavitated and cavitated lesions over periods of six, twelve, and 18 months.MethodsFrom May 2016 to October 2017, seven schools in Bhakkar, Pakistan, participated in a cohort study. First base line examination was conducted followed by examinations at 6, 12 and 18 months. Children intraoral examinations were performed on portable dental chair with in school premises by a trained examiner. A modified ICDAS index was used to measure caries at baseline and at follow-up examinations after 6, 12, and 18-months. A receiver operating curve (ROC) analysis was performed to evaluate its effectiveness for predicting dental caries increment.ResultsAbout 40% of children had a low-risk status, 30.5% medium risk, and 29.7% high risk, at baseline risk assessment. At 18 months, 73% of high-risk children, 59% of medium-risk children, and 41% of low-risk children showed a caries increment. For the reduced Cariogram model, the area under the curve on the 6, 12 and 18 months follow-up was 0.63, 0.65 and 0.70 respectively.ConclusionsOur findings indicates that a reduced Cariogram can predict the progression of caries in both cavitated and non-cavitated lesions and model exhibits a level of discriminatory ability. While it might not achieve a very high accuracy, it suggests that the model is able to predict caries increment effectively than random guessing.

Novel Remineralizing and Antibiofilm Low-Shrinkage-Stress Nanocomposites to Inhibit Salivary Biofilms and Protect Tooth Structures.

Recurrent caries remain a persistent concern, often linked to microleakage and a lack of bioactivity in contemporary dental composites. Our study aims to address this issue by developing a low-shrinkage-stress nanocomposite with antibiofilm and remineralization capabilities, thus countering the progression of recurrent caries. In the present study, we formulated low-shrinkage-stress nanocomposites by combining triethylene glycol divinylbenzyl ether and urethane dimethacrylate, incorporating dimethylaminododecyl methacrylate (DMADDM), along with nanoparticles of calcium fluoride (nCaF2) and nanoparticles of amorphous calcium phosphate (NACP). The biofilm viability, biofilm metabolic activity, lactic acid production, and ion release were evaluated. The novel formulations containing 3% DMADDM exhibited a potent antibiofilm activity, exhibiting a 4-log reduction in the human salivary biofilm CFUs compared to controls (p < 0.001). Additionally, significant reductions were observed in biofilm biomass and lactic acid (p < 0.05). By integrating both 10% NACP and 10% nCaF2 into one formulation, efficient ion release was achieved, yielding concentrations of 3.02 ± 0.21 mmol/L for Ca, 0.5 ± 0.05 mmol/L for P, and 0.37 ± 0.01 mmol/L for F ions. The innovative mixture of DMADDM, NACP, and nCaF2 displayed strong antibiofilm effects on salivary biofilm while concomitantly releasing a significant amount of remineralizing ions. This nanocomposite is a promising dental material with antibiofilm and remineralization capacities, with the potential to reduce polymerization-related microleakage and recurrent caries.

The Efficacy of Fluoride Rinse on Caries Increment, Plaque Occurrence and Gingival Status in Children Undergoing Orthodontic Treatment. A Randomized Controlled Clinical Trial with Results after 6- and 12 Months

This triple blinded RCT two arms study determines the efficacy of fluoride rinse (0.32% NaF-solution) for a period of 6 and 12 months (6m,12m) on the caries increment, plaque occurrence and gingival conditions in 10-15 year old Danes undergoing orthodontic treatment. Estimations showed that 24 subjects were required in the Test Group (TG) as well as in the Control Group (CG) at the end of the study. A total of 61 subjects were randomly assigned to TG (n=30) and the CG(n=31). Participants rinsed twice a week with 10 ml NaF solution (TG) or 10 ml of a placebo solution (CG). One assessor recorded at baseline, after 6-and 12 months caries (ICDAS index) and plaque and gingival status (Løe index). Four participants in each group dropped out during the study period. At patient level 27% in TG and 59% in CG showed caries progression during 12 month (p&lt;0.05). Parametric tests confirmed that CG-participants had significant higher progression rate than TG-participants from 0m to 12m (p=0.014). The preventive fraction was 77% in favour of the TG-participants. Similar calculations from baseline to 6 months after, there were no significant caries increment difference between TG and CG. At 0m and 12m there was no significant difference in the plaque index and the gingival index between the two groups (p-values&gt;0.05). The study conclusion was that rinsing twice a week with a 0.32% NaF solution during orthodontic treatment with fixed appliance had a significant effect on caries progression in children and adolescents during a treatment period of 12 months.