Recurrent Caries Research Articles

Effect of a chemically-modified-curcumin on dental resin biodegradation

IntroductionPrevious studies have shown Streptococcus mutans (S. mutans) esterase is a key mediator of dental composite biodegradation, which can contribute to recurrent caries. This study is to investigate the inhibitory effects of a novel Chemically-Modified-Curcumin (CMC 2.24) on esterase activities and related dental material biodegradation.MethodsDental adhesive materials and composite resins were incubated in S. mutans suspension with CMC 2.24 and other compounds, including doxycycline, Chemically-Modified-Tetracycline (CMT-3), and curcumin for 4 weeks. The pre- and post-incubation surface roughness were evaluated by either laser diffraction pattern and/or a 3D laser scanning microscope. Esterase enzyme inhibition assays were performed with the same test groups and activities were determined spectrophotometrically.ResultsAmong all experimental groups, CMC 2.24 significantly reduced surface roughness of dental composite (p < 0.01) and adhesive (p < 0.01) materials compared to bacteria-only group. Additionally, CMC 2.24 reduced porcine esterase activity by 46.5%, while other compounds showed minimal inhibition. In the S. mutans esterase assay, CMC 2.24 showed inhibition of 70.0%, while other compounds showed inhibition ranging from 19% to 36%.ConclusionOur study demonstrated that CMC 2.24 inhibited biodegradation of dental composite material more effectively than its mother compound, curcumin. Moreover, the mechanism of this biodegradation was likely mediated through bacterial esterase activity. Doxycycline achieved similar inhibition by completely eradicating S. mutans with its antibiotic action; hence, it is not recommended for long-term use.

Clinical evaluation of single bond universal adhesive in non-carious cervical lesions: a 36-month retrospective study.

To evaluate the 36-month clinical performance of Single Bond Universal Adhesive (SBU; 3M ESPE, Germany) in non-carious cervical lesions (NCCLs) using different modes of adhesion according to the FDI criteria. The primary outcome was the retention loss of the restorations, while the secondary outcomes included marginal staining, marginal adaptation, post-operative sensitivity and tooth vitality, recurrence of caries erosion and abfraction, and tooth integrity, all evaluated according to the FDI criteria. In this study, the SBU Adhesive was applied to 246 NCCLs of 25 patients using different modes of adhesion: Self-etch (SE), selective-enamel-etching (SLE), and etch-and-rinse (ER). All lesions were restored with the same nanohybrid resin composite. The restorations were evaluated at the 1st, the 6th, 12th, 18th, and 36th month using the FDI criteria. The differences between SE, SLE, and ER groups were tested using the Kruskal-Wallis and Mann-Whitney U tests where a value of p < 0.05 was accepted as a criterion for statistical significance. After 36-month the recall rate was 96%. The retention loss rates were 29.33% for SE, 16.66% for SLE, and 3.89% for ER modes. Interactions between time periods and adhesive modes were found to be statistically significant (p < 0.05) for all FDI criteria. ER mode performed significantly better than SE mode for marginal staining, marginal adaptation and recurrence of caries, erosion and abfraction criteria after the 36th month (p < 0.05). There was no statistically significant difference between SE and SLE mode (p > 0.05), nor between SLE and ER mode (p > 0.05). After the 36-month evaluation of all adhesive modes used in the study, restorations performed with the ER adhesion mode were clinically good (2), while those performed with the SE adhesion mode and SLE adhesion mode were clinically satisfactory (3) according to the FDI criteria. The primary outcome, retention loss, was significantly lower in the ER mode compared to SE and SLE modes. For secondary outcomes, the ER mode showed better performance in marginal staining, marginal adaptation, and the recurrence of caries, erosion, and abfraction highlighting its clinical advantages for mid-term success in non-carious cervical lesions. Restorations performed with the SE adhesion mode of universal adhesives exhibit clinically acceptable behavior after 36 months of evaluation, although with less success than those performed with the ER adhesion mode. Clinical trials number- NCT06227715, Clinical trials link: https://clinicaltrials.gov/study/NCT06227715.

Exploring the behavioural determinants of compliance in resilient high-caries-risk patients who improved caries severity

Abstract Background The caries severity in childhood may predict caries conditions in the future and even in adulthood in caries risk models. Nevertheless, the rate of recurrent caries after treatment of severe early childhood caries is high and correlated with behavioural factors, rather than clinical indicators. Compliance with the caries control programme has been demonstrated to prevent root caries development in head and neck cancer patients, suggesting that compliance with treatment protocols is a more important key to bringing about successful outcomes than treatment protocols themselves. However, only few studies defined the triggers of compliance in patients with long-term successful treatment outcomes, especially in children. Furthermore, driven forces of compliant behaviours from patients’ aspects have not been described in the dental literature before. Regarding the need to improve current caries control interventions for children, in this study, behavioural determinants that shaped compliance of resilient children were investigated with a qualitative study design, for its advantage in revealing what an individual really feels which incorporates their experience without restriction from previous literature. Resilience was defined as improvement in caries conditions between primary and mixed or permanent dentitions. Methods Interviews were performed with the patient group, including eight resilient children (M/F = 5/3) and their ten caregivers (M/F = 2/8), and the dentist group, including ten paediatric dentists (M/F = 6/4; clinical experience mean = 26.9 years, minimum = 16 years). Thematic analysis was used to identify main themes. Results Four themes were identified: (1) dental things/teeth are their priority, (2) normalising, (3) tiger parenting/conscientiousness, and (4) trust. These determinants were identically described by both the patient and dentist groups. Dentists' suggestions were the priority, providing the norms in daily life of resilient patients and their caregivers. These patients found no excuses for failing to take dentists' advice, not only because they trusted their dentists, but also because they and their caregivers were conscientious about putting dentists' orders into practice. Conclusions It is implementing suggested oral health behaviours daily, but not merely agreeing with professional advice, that alters the fate of teeth in these resilient patients.

Comparative Study Between 0.125mm, 0.35mm and 0.75mmVoxel Sizes of Cone Beam Computed Tomography in Diagnosis of Secondary Caries Lesions Under Composite Restorations (An In vitro Study)

The aim of this study was to assess the diagnostic accuracy of Cone Beam Computed Tomography (CBCT) with different voxel sizes in detection of simulated recurrent caries beneath composite restoration. In this study, a total of 40 proximal slots of class II cavities were prepared on 40 extracted human premolars and molars. Then, 20 teeth were randomly selected out of these sample and artificial carious lesions were created on these teeth by a round diamond bur no .2(study group). All cavities were restored by using composites resin and radiographed with CBCT unit (Cranex 3D) using 5x5mm field of view at three voxel sizes 0.35mm, 0.125mm, 0.75mm. Intra- and inter-observer agreements were calculated with Kappa statistics (κ). The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ac curacy. The AUCs value for CBCT with voxel sizes 0.35mm, 0.125mm, 0.75mm was 0.983 ,0.900,0.817, respectively. The kappa value for inter-observer agreement was 0.993,0.989,0.938; respectively. Diagnostic Accuracy of CBCT was high in detecting the simulated small secondary proximal caries under composite restoration, voxel size 0.125mm can be used to detect caries lesions with adequate accuracy and the least patient exposure dose.

Phone-Based Parental Support Program for Caries Prevention in Children: A Randomized Controlled Trial.

Children referred for comprehensive dental care under general anesthesia, due to severe early childhood caries, have a high risk of continued caries progression in posttreatment years. To assess the effect of a phone-delivered, motivational interviewing-based parental support program on caries recurrence and oral health habits in preschool children treated under general anesthesia for severe early childhood caries. The prospective design of this 2-arm randomized clinical trial (allocation ratio 1:1; blinded outcome assessment) comprised 151 patients from pediatric dental departments in the Stockholm region of Sweden. Inclusion criteria were healthy children aged <6 y with early childhood caries who were scheduled for treatment under general anesthesia. Control group parents received standard advice on toothbrushing and sugar reduction. Intervention group parents received planned phone counseling with an oral health coach every other week for 1 y, based on motivational interviewing principles, offered in Arabic, English, Polish, Turkish, and Swedish. The primary outcome was caries progression 1 and 2 y postsurgery, assessed using the International Caries Detection and Assessment System. Secondary outcomes were parent-reported daily toothbrushing and dietary habits. Sixty-five percent of the control group and 77% of the intervention group experienced caries relapse on at least 1 new surface after 1 y (nonsignificant). At the 2-y follow-up, relapse rates were 53% (control group) and 71% (intervention group; P < 0.05) compared with baseline. The intervention group was significantly less likely to engage in adverse oral health behaviors such as snacking on sweets (intervention group, 10%; control group 33%) and sweet drinks (intervention group 9%; control group, 29%) after 1 y. No group differences in daily fluoride toothpaste brushing occurred. The motivational interviewing-based parental support program improved dietary habits but showed no effect on caries recurrence in children treated under general anesthesia for early childhood caries.ClinicalTrials.gov NCT02487043. The findings of this study can assist clinicians, public health leaders, and researchers in tailoring preventative behavior-focused programs for early childhood caries. These results may improve the understanding of how behavioral interventions that involve parents of young children affect caries prevention, highlighting approaches that are less likely to be effective and guiding future efforts toward more promising strategies for high-risk populations.

Comparison of Shear Bond Strength for Onestep Self-etch versus Universal Adhesives on Contaminated and Decontaminated Dentin Surfaces: An In-vitro Study

Introduction: Ensuring strong adhesion of composite resin to dentin requires isolation, as moisture contamination from gingival fluid, blood, or saliva can weaken the bond. This can lead to microleakage, restoration loss, recurrent caries, postoperative sensitivity and discolouration. Long-lasting restorations are crucial in adhesive dentistry, but contamination often results in adhesion failure. To restore bond strength, various decontamination procedures are recommended. Aim: To evaluate and compare the effects of different contaminants and ethanol decontamination on the shear bond strength of onestep self-etch versus universal adhesives to dentin. Materials and Methods: This in-vitro study, conducted in the Department of Conservative Dentistry and Endodontics at Sibar Institute of Dental Sciences in Guntur, Andhra Pradesh, India, from July 2023 to October 2023, utilised the buccal surfaces of 70 human molars. The molars were divided into two groups (n=35): Group 1 - One-step self-etch adhesive and Group 2 - Universal adhesive. Each group was further subdivided into five sub-groups (n=7): Control (Subgroup A), Saliva contamination (Subgroup B) Blood contamination (Subgroup C) Saliva contamination followed by ethanol decontamination (Subgroup D) and Blood contamination followed by ethanol decontamination (Subgroup E) followed by ethanol decontamination. A plastic tube loaded with composite resin was placed over the dentin surface and light-cured. Shear bond strength at the dentincomposite interface was evaluated using a Universal Testing Machine (UTM). One-way Analysis of Variance (ANOVA) for intergroup comparison followed by Tukey’s post-hoc test for multiple comparisons was performed. Differences were considered significant at p-value ≤0.05 between groups. Results: The average shear bond strength (MPa) for subgroups in both adhesive groups showed a statistically significant difference (p-value ≤0.05). Subgroup A had the highest bond strength (25.786 MPa and 46.943 MPa) and subgroup C had the lowest (8.986 MPa and 9.871 MPa). In both groups, the mean shear bond strength followed this order: Subgroup A &gt; D &gt; E &gt; B &gt; C. Comparison between Group 1 and Group 2 using an independent t-test showed no statistically significant difference in any subgroup (p-value &gt;0.05). Conclusion: The present in-vitro study found that blood and saliva contamination reduced shear bond strength to dentin, with blood having a greater impact. Decontamination with ethanol improved bond strength in both adhesive groups.

Visibility of Recurrent Caries Through Universal Shade Resin Composite Restorations.

This in vitro study aimed to investigate whether color differences in the stained cavity floor simulating recurrent caries can be detected using various restored resin composites. Artificial teeth were made with conventional resin composite (Estellite Sigma Quick A3; ET), and class V cavities were prepared. To simulate the color of caries, a dot was marked in the center of the cavity floor using four different magic pens. The cavities were filled with ET and two universal shade resin composites (UC, Omnichroma; OMI, Essentia Universal; ESS). For photographic analysis, a standard correction color chart was used. The color difference (ΔE00) between (i) the lab value at the center of the cavity and (ii) the average lab value at 1 mm mesial and distal to the center of the cavity was calculated. The data were statistically746o-way ANOVA (p < 0.05). For visual analysis, 25 dentists were asked to complete a questionnaire to determine whether the color differences were noticeable. In the photographic analysis, UC showed larger ΔE00 values than ET in all colors. Visual analysis revealed higher detection rates for UC than ET. Universal shade resin composite tends to reflect the color of the cavity more effectively than conventional resin composite.

MMP inhibition, marginal integrity and cytotoxicity of zinc-releasing GIC

ObjectivesThe degradation of the restorative-dentin interface due to endogenous dentin enzymes, such as matrix metalloproteinases (MMPs), is a significant issue that accelerates the deterioration of the dentin matrix and leads to the failure of restorative treatments. Caredyne Restore (CR), a novel glass ionomer cement (GIC) with zinc ions in its formulation, represents the latest effort to mitigate this issue. This investigation aimed to evaluate the MMPs inhibitory effect, marginal integrity, and cytotoxicity of CR compared to a conventional GIC, Fuji IX (FIX). MethodsThe inhibitory effect of CR on MMPs activity was evaluated using in-situ zymography to visualize the endogenous gelatinolytic activity in the GIC-dentin interface. Additionally, CR's sealing properties were investigated using dye-assisted confocal laser microscopy (CLSM) to assess marginal leakage across the GIC-dentin interface. Both in-situ zymography and CLSM observations were conducted 1 day and seven days after pH cycling. Finally, the cytotoxicity of the GIC eluates was examined on rat dental pulp cells (RPCC2A). Assay measurements were performed after 24 and 48 h of incubation with test solutions prepared using various GIC eluate concentrations. ResultsThe MMPs activity of the CR specimens was significantly lower than that of FIX specimens after seven days of pH cycling. Signs of marginal leakage were also lower in the CR specimens. Comparison of CR and FIX eluates at the same concentration showed no significant difference in terms of biocompatibility. ConclusionsCaredyne restore is capable of inhibiting endogenous enzyme activity and improving sealing properties, while maintaining sufficient biocompatibility. Clinical significanceZinc ions released from Caredyne Restore offer a safe way to improve the quality of dental restorations and promote minimally invasive treatment, especially in lesions where the dentin matrix is susceptible to enzymatic degradation and recurrent caries.

COMPARATIVE EFFECTIVENESS OF GLASS IONOMER VS. COMPOSITE RESIN IN PEDIATRIC DENTISTRY: A META-ANALYSIS

Background: Paediatric dentistry is essential for maintaining children's oral health, with the choice of restorative materials significantly impacting treatment outcomes. Glass Ionomer Cement (GIC) excels in chemical bonding and fluoride release, aiding in caries prevention. Composite Resin, noted for its aesthetic appeal and strength, is favoured for restorations that are both visible and bear significant masticatory forces. Objective: This study aims to compare the clinical effectiveness of GIC versus Composite Resin in podiatric dentistry, specifically assessing caries reduction, restoration durability, marginal integrity, and the prevention of secondary caries. Methods: Following PRISMA guidelines, a comprehensive literature search was conducted using databases such as PubMed, Scopus, and Google Scholar. Included were randomized controlled trials (RCTs) that compared GIC and Composite Resin in paediatric molar restorations. Outcomes measured included caries prevention, durability, marginal integrity, and secondary caries recurrence. Data were analysed using random-effects models. Results: Analysis of ten studies involving 1,430 paediatric patients revealed that GIC provided a 22% relative reduction in caries incidence (RR: 0.78, 95% CI: 0.72–0.84, p &lt; 0.001). Composite Resin offered enhanced durability with an RR of 0.82 (95% CI: 0.75–0.90, p = 0.002). GIC was superior in preventing secondary caries (RR: 0.76, 95% CI: 0.70–0.80, p = 0.003), whereas Composite Resin excelled in maintaining marginal integrity (RR: 0.81, 95% CI: 0.76–0.88, p = 0.004). Conclusion: GIC and Composite Resin each provide unique benefits in paediatric dentistry. GIC is optimal for caries prevention, while Composite Resin is ideal for ensuring durability and superior aesthetic outcomes. Selection should be tailored based on individual patient needs and specific clinical conditions.

Physical/mechanical and antibacterial properties of composite resin modified with selenium nanoparticles

BackgroundAccumulation of biofilm over composite resin restorations is one of the principal causes of recurrent caries. Therefore, this study aimed to develop antibacterial composite resins by crystalline selenium nanoparticles (SeNPs), assessing the antibacterial, mechanical, and physical properties of the composite resin after SeNPs incorporation.MethodsSeNPs were synthesized via a green method. The nanoparticles were characterized by UV-Vis spectroscopy, fourier transform infrared (FT-IR) spectroscopy and transmission electron microscopy (TEM). The nano-filled composite (Filtek™ Z350XT ) was considered as a control group (G0). Two concentrations of SeNPs (0.005 wt% and 0.01 wt%.) were added to the tested resin composite (G1& G2), respectively. The physical/mechanical and antibacterial properties of the composite specimens (n = 10/group) were characterized. A one-way ANOVA was conducted to analyze these data followed by Bonferroni post hoc test for pairwise comparison.ResultsModified composites with SeNPs showed antibacterial activity against E. coli and S. mutans. Mechanical properties including diametral tensile strength, compressive strength, or surface roughness were not affected by nano-incorporation compared to control. Furthermore, the degree of conversion showed no statistical difference. However, SeNPs incorporation into resin composite produces color change that can be visually perceived.ConclusionsThe green synthesized SeNPs significantly improved the antimicrobial properties of the dental composite without compromising mechanical performance. However, it shows color change after SeNPs incorporation.

Deciphering the killing mechanisms of potassium iodide in combination with antimicrobial photodynamic therapy against cross-kingdom biofilm.

The co-existence of S. mutans and C. albicans is frequently detected in root caries and early child caries and is reported to be associated with recurrent caries. The aim of this study was to investigate the effects of potassium iodide (KI) in combination with toluidine blue O-mediated antimicrobial photodynamic therapy (aPDT) on S. mutans and C. albicans mixed-species biofilm, as well as the antibiofilm mechanisms involved. Mixed-species biofilm was constructed of S. mutans and C. albicans on dentin blocks. The antibiofilm efficacy, cytotoxicity and antibiofilm mechanism of KI in combination with aPDT were determined and evaluated. KI+TBO-aPDT treatment caused reduction in microorganism counts, metabolic activity, and biofilm biomass of mixed-species biofilm without inducing cytotoxicity to hDPCs (human dental pulp cells). Observations such increased ROS (reactive oxygen species) levels, impaired cell membrane function, cell apoptosis and reduced expression in several genes seem to be artifacts of reduced growth and general killing by KI+TBO-aPDT treatment. These data suggested that KI in combination with aPDT as an innovative approach to combat S. mutans and C. albicans biofilm, and thus as an optional treatment for caries.

The effect of silver and calcium fluoride nanoparticles on antibacterial activity of composite resin against Streptococcus mutans: An in vitro study.

Recurrent caries were attributed to the lack of antibacterial properties of the dental materials. Silver nanoparticles (AgNPs) and calcium fluoride nanoparticles (CaF2NPs) are broad-spectrum antibacterial agents. The object of the study was to investigate the antibacterial properties of composite-incorporated AgNPs and CaF2NPs on Streptococcus mutans. This experimental study forty-eight disks containing 0.5, 1, and 1.5% wt AgNPs s (n = 24) and 5, 10, and 15% wt CaF2NPs were prepared from flowable composite resin (n = 24). The third group consisted of 9 types of the combination of AgNPs and CaF2NPs (n = 72). A field emission scanning electron microscope with an energy-dispersive X-ray spectroscopy analysis system was used to test for the presence of nanoparticles in composite resins. The antibacterial efficacy of dental composite was evaluated by disk diffusion agar test. The minimum inhibitory concentration (MIC) and minimal bactericidal concentration were conducted. Data were analyzed using one-way ANOVA and multiple Tukey HSD (Honestly Significant Difference) tests. Significance level was set at 0.05. Nanoparticles added to composite produce bacterial inhibition zone. The greatest inhibition of bacterial growth was recorded in the third group which contained both nanoparticles (P < 0.05). MIC values decreased after adding CaF2 NPs to the AgNPs-containing composite. The results of the FE-SEM test indicate the presence of AgNPs and CaF2NPs in the dental composite resin sample. On the other hand, the formation of AgNPs and their elemental nature were proved using energy dispersive X-ray microanalysis EDX analysis. According to the results, composite resins containing 0.5% of AgNPs s and 15% of CaF2NPs exhibited a significantly lower antibacterial activity compared to the 1.5% and 1% of AgNPs s with 15% of CaF2NPs (P < 0.05). Dental composite resins-containing CaF2NPs and AgNPs showed anti-bacterial activity against S. mutans.

Clinical, radiographic and biochemical assessment of proximal cavities restored with composite resin using incremental vs. bulk packing techniques: One-year randomized clinical trial

BackgroundBulk-fill resin composites may suffer from recurrent caries around compound proximal restorations in posterior teeth, especially at the proximo-gingival interface.Over 12 months, will the bulk fill technique affect the caries recurrence rate at gingival margins when compared to the conventional incremental packing technique? How early will the first clinical, radiographical, and biochemical evidence of caries recurrence occur?MethodsAfter randomization, in 30 patients with two compound (OM or OD) supragingival lesions, one tooth was restored using the bulk fill technique on one side (group 1) (n = 15). In contrast, the other tooth on the other side was restored utilizing the incremental layering technique (group 2) (n = 15). Both teeth received restorative material (X-tra fil, Voco, Cuxhaven, Germany). The FDI criteria were used to evaluate restorations. As for the periodontal assessment, the gingival index, plaque index, papillary bleeding scoring index and periodontal pocket depth were evaluated. The gingival crevicular fluid (GCF) specimens were gathered, and MMP-9 was extracted and quantitated by ELISA. A customized radiographic template was designed, and 3D printed digital bitewing radiographs were taken. Assessments were done clinically, radiographically and biochemically at baseline (1 week) and after 3, 6 and 12 months. Data was statistically analyzed.ResultsThe null hypothesis was accepted clinically; no statistically significant differences appeared between bulk and incrementally filled posterior restorations. As for the radiographic assessment, the null hypothesis was accepted except for increased periodontal ligament width at 3 months. The null hypothesis for the biochemical evaluation was rejected as there were significant changes in levels of MMP-9 at different testing times.Conclusions1. With similar results but less sensitivity and significant time saving, the bulk fill technique can be considered an efficient alternative to the incremental fill technique in restoring proximal cavities. 2. Early evidence of caries recurrence can be correlated to an increase in the MMP-9 level in gingival crevicular fluid, followed by an increase in radiographic periodontal ligament width measurement.Trial registrationAn ethical approval from the Research Ethics Committee at the Faculty of Dentistry, October 6 University, (Approval No. RECO6U/5-2022). The study was registered at the Pan African Clinical Trials Registry on 24/07/2023 with an identification number (PACTR202307573531455).

MODIFICATION OF GLASS IONOMER FILLING MATERIAL BY METAL NANOPARTICLES AND THEIR COMPOUNDS: EFFECT ON ANTI-MICROBIAL ACTIVITY

Background: Glass ionomer filling materials are widely used in stomatology, but do not have an antimicrobial effect that effectively prevents the development of secondary and recurrent dental caries. Researchers are attempting to modify these materials by introducing various biologically active additives into them. The aim of the study was to evaluate the antimicrobial properties of a dental ionomer filling material modified withadditives based on high–energy nanoparticles of silver, copper, titanium and their compounds. Material and methods: Colloidal aqueous and alcoholic solutions of metals and their oxides with stabilizers were obtained by the electroerosion method. Citric acid, cetylpyridinium chloride and Trilon B were used as stabilizers. The zeta potential and the distribution of particles of the dispersed phase in solutions were measured. Samples of dental glass ionomer cement "Cemion-Aqua" were impregnated with colloidal solutions of nanoparticles. The microbiological activity of glass ionomer fillings samples in relation to plaque was determined by disc diffusion and suspension methods. Results: The results showed that modification of glass ionomer cement samples with silver hydrosols in citric acid solutions with concentrations of 0.04% and 0.0025% increases the zone of radial lysis of microbial plaque colonies around the cement samples by 1.5 and 2.5 times compared with the control. By the suspension method, it was determined that silver hydrosols in a solution of citric acid and without it reduce the formation of colonies of microorganisms to several units up to 72 hours of exposure compared with the control. And copper hydrosols in solutions of cetylpyridinium chloride prevent an increase in the number of colonies of microorganisms after 24 hours of exposure compared with the control. Silver hydrosol in a solution of citric acid with a concentration of 0.0025% and silver alcohol sol reduce the number of colonies of microorganisms to several units after 3 hours of exposure.

Assessment of Periodontitis Risk Factors in Endodontically Treated Teeth: A Cross-Sectional Study.

The aim of the study was to collect data about the prevalence and risk factors of apical periodontitis in a population of endodontically treated patients. The study group included 151 patients (52 males, 99 females; mean age 48.36 ± 15.708 yrs.) with 391 endodontically treated teeth (mean follow-up of 5.25 ± 1.759 yrs.). According to the initial tooth diagnosis, root-filled teeth were divided into Group A, root-filled teeth treated for pulpitis or for the purpose of prosthetic pulpectomies (vital pulp group), and Group B, root-filled teeth with non-vital pulp (necrotic pulp). Clinical and radiographic evaluation of the root and its periapical area were performed to establish the success/failure of endodontic therapy, the quality of the root canal fillings (length, density, taper), and coronal restoration. The presence of recurrent caries, periodontal pathology, or endo-periodontal lesions were also recorded. Univariate and multivariate analyses were used to determine the risk factors for apical periodontitis and calculate their odds ratios (ORs). For the root-filled vital pulp tooth group, the highest risks for apical periodontitis are associated with inadequate homogeneity (OR 30.938), periodontitis (OR 9.226), and over-filling (OR 8.800). For the root-filled non-vital pulp tooth group, the highest risks are associated with periodontitis (OR 4.235) and age over 60 yrs. (OR 4.875). For the necrotic pulp tooth group, multivariate analysis identified an age > 60 yrs., filled molars, intracanal posts, poor coronal restoration quality, under-filling, and periodontitis as significant combined risk factors. Inadequate root canal filling and periodontitis in both groups were risk factors associated with most cases of apical periodontitis. Other risk factors include age > 60 yrs., poor coronal restoration quality, and the presence of intracanal posts in root-filled teeth with necrotic pulp.

Influence of different viscosity and chemical composition of flowable composite resins: A 48-month split-mouth double-blind randomized clinical trial

ObjectivesTo evaluate the clinical performance of two flowable composites based on methacrylate and one based on ormocer in treating non-carious cervical lesions (NCCLs) after 48-month evaluation in a split-mouth double-blind clinical study design. MethodsA total of 183 restorations were performed on NCCLs using a universal adhesive system (Futurabond U, Voco GmbH) with selective enamel etching on 27 participants: two participants received twelve restorations each, three received nine restorations each, and 22 participants received six restorations each. Three different flowable composites were employed (n = 61): a low-viscosity methacrylate-based composite (GrandioSO Flow, LVM), a high-viscosity methacrylate-based composite (GrandioSO Heavy Flow, HVM), and an ormocer-based flowable composite (Admira Fusion Flow, ORM). All restorations were evaluated using FDI and USPHS criteria after 48 months. Statistical analysis was conducted using Kaplan-Meier Survival analysis and Kruskal-Wallis analysis of variance rank (α = 0.05). ResultsAfter 48 months, 17 restorations were lost: LVM 6, HVM 9, ORM 2. The retention rates (95 % confidence interval) were 89.4 % for LVM, 80.4 % for HVM, and 95.6 % for ORM, with a significant difference between HVM vs. LVM and HVM vs. ORM (p < 0.05). Minor defects were observed in 30 restorations for marginal staining criteria (LVM 12, HVM 10, ORM 8) and in 71 restorations for marginal adaptation criteria (LVM 24, HVM 20, ORM 27) without significant difference between groups (p > 0.05). No restorations showed postoperative sensitivity or recurrence of caries. SignificanceThe increased viscosity of flowable composites could reduce the clinical longevity in NCCLs after 48 months. Ormocer-based and low-viscosity methacrylate-based flowable composites showed a successful clinical performance in NCCLs after 48 months.

Comparison of the clinical performance of self-adhering flowable composite and resin-based pit and fissure sealant: a randomized clinical trial in pediatric patients

BackgroundSelf-adhering flowable composites are an innovative step in reducing the chair time of pit and fissure sealant treatment. This study aimed to compare the clinical performance of self-adhering flowable composite (SELF-ADH) and resin-based pit and fissure sealant (RBs).MethodsThis is a double-blinded, randomized, split-mouth clinical trial conducted on 80 fully erupted permanent mandibular first molars from 40 children aged 6 to 12 years. For each participant, two permanent molars were randomly treated with SELF-ADH or RB. All sealants were assessed at 3, 6, and 12-month follow-ups considering retention, marginal integrity, marginal discolouration, colour matching, surface texture, and caries recurrence. To analyse the data, logistic regression and Fisher’s exact tests were used (significance level P < 0.05).ResultsAt the 12-month follow-up, the number of fully retained sealants in the SELF-ADH group was significantly higher than that in the RB group (P < 0.001). Also, The success rate of marginal integrity in the SELF-ADH group was significantly greater than the the RB group (P = 0.031), while the rate of sealant marginal discolouration was higher in the RB group (P < 0.001). The incidence of recurrent caries in teeth with partial loss of sealant in both groups (P = 0.004, P < 0.001) increased significantly over time.ConclusionThe retention and marginal integrity of the self-adhering flowable composite were significantly greater than those of the resin-based sealant. Therefore, due to the small number of work steps, flowable self-adhering composites can be used as alternatives to resin-based pit and fissure sealants.Trial registrationThis study was approved by the Ethics Committee of Kerman University of Medical Sciences with the code IR.KMU.REC.1399.556 and Iraninan Registry of Clinical Trials (IRCT) code IRCT20180521039763N4, as well as full compliance with the Declaration of Helsinki.

Clinical study of cervical caries treatment the effectiveness by assessing composite restorations condition

Background. Cervical caries is a fairly common teeth pathology and its treatment is carried out in complicated clinical conditions. Therefore, increasing the term of functioning of composite restorations is an urgent task. Aim. Identification of the effectiveness of a differential approach to dissection of hard dental tissues depending on the depth of enamel microcracks and implementation of professional hygiene in the treatment of cervical caries in the short- and long-term periods. Materials &amp; Methods. The study involved 50 people (average age [23.28±5.52] years) in whom cervical caries was treated in 72 teeth. All patients were divided into three equal groups based on the number of restorations according to the selected dissection technique and the chara­cteristics of professional hygiene. The dissection technique depended on the depth of the enamel microcracks in Main Group I (MG I), the dissection was carried out within the limits of clinically intact hard dental tissues in Control Group (CG) and Main Group II (MG II). The dental biofilm was removed from the vestibular surface of the teeth by the method of air-abrasive cleaning using the erythritol-based powder in MG I and MG II, the vestibular surface of the tooth was cleaned of dental deposits with a polishing paste without fluoride in CG. The quality of restorations was assessed based on the United States Public Health Service (USPHS) criteria on the day of restoration, 6 and 12 months later. The effectiveness of the prescribed treatment was identified by the dynamic indicators of the dental pulp electroexcitability and the electrical conductivity of the enamel. Results. There were no partial or completely destroyed restorations in all terms of the observation period. Composite restorations were preserved according to the criteria of "anatomical shape" and "color matching". One year later restoration defects were absent in 61 teeth (84.72%): in MG I – in 22 (91.67%), in CG – in 19 (79.17%), in MG II – in 20 (83.33%). Recurrent caries and symptoms of hypersensitivity were not identified in MG I. A slightly greater effectiveness of the treatment was noted in MG II group in comparison with CG (by 4.16%) that confirms the importance of removing the dental biofilm before restoration by the method of air-abrasive clea­ning using erythritol. Conclusions. The analysis of the state of restorations in the long-term period showed that the dissection technique and the features of professional hygiene affected their quality before restoration. The number of high-quality composite restorations was by 10.42% more on average in MG I than in the other groups. The obtained results make it possible to recommend the proposed method for using in practical dentistry. Keywords: electroodontology, electroodontometry, microcracks.

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

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

Re-intervention in restorative dentistry: Knowledge and attitudes of senegalese dentists

Replacing or repairing a defective restoration has become a daily practice in dentistry. It is therefore necessary to know how to evaluate a restoration to decide whether or not to re-intervene and then to choose whether to replace, repair, or refrain from doing so by setting up a monitoring system. The best-known evaluation criteria accepted by the scientific community are the modified Ryge / USPHS criteria and the FDI criteria. In Senegal, no such study has been carried out, and it was with this in mind that our study was carried out, involving 158 dental surgeons. The results showed a predominance of men (70.89%). The average age was relatively young at 37. The study confirmed that re-intervention is common practice among the dentists surveyed: the majority (77.72%) had done a re-intervention less than a week before the survey. The most common reason encountered by dentists for their last re-intervention was fracture of the tooth or restorative material with a rate of 36.71%, then we have caries recurrence and advanced decay and wear with the same rate of 17.09%, followed by pain or hypersensitivity with a rate of 16.46%. After diagnosis, 73% replaced the restoration deemed defective, versus 22% who chose to repair the restoration. Clinical evaluation criteria were used by only 12.66% of the sample. The majority, 74.05% of practitioners, take into account the benefit/risk/cost ratio. The results of this study show the limits of dental surgeons' knowledge in re-intervention, as well as the lack of codification of parameters related to this practice. It is therefore necessary to develop training programs and teaching units for both initial and continuing training.