Fissures Of Teeth Research Articles

Amyloid-Mediated Remineralization in Pit and Fissure for Caries Preventive Therapy.

The pits and fissures of teeth have high caries susceptibility, and sealing these areas is considered as an effective method to prevent caries. However, long-term caries prophylaxis cannot be maintained because of the negative effects derived from the technical sensitivity and disadvantages of sealing materials. Herein, a new strategy is proposed to occlude fossae by amyloid-mediated biomimetic remineralization. In contrast to conventional inward blocking from the outside of fossae, amyloid-mediated biomimetic mineralization delivers an amyloid-like protein nanofilm into the deepest zone of the fossae and induces the formation of remineralized enamel inside. Such assembly from lysozyme conjugated with poly (ethylene glycol) enriches the interface with strongly bonded ionsand directs in situ nucleation to achieve enamel epitaxial growth. Not only is the structure of the enamel-like crystalline hydroxyapatite layer but also its mechanical stability is similar to that of natural enamel. Furthermore, the layer shows good biocompatibility and antibacterial properties. On the basis of the findings, it is demonstrated that amyloid-like protein aggregation may provide an enamel remineralization strategy to modify the current clinically available methods of pit and fissure sealing and shows great promise in preventing caries.

TYPES OF PIT AND FISSURE SEALANTS. INDICATIONS AND CONTRAINDICATIONS FOR SILANIZATION. REVIEW

Background: Dental sealants have been used to reduce the incidence and severity of dental caries in the pits and fissures of teeth for over 40 years. Since that time, numerous scientific discoveries have led to the development of multiple generations of new sealant materials. Aim: The aim of this paper is to summarize the findings of reviews regarding the types of pit and fissure sealants, indications and contraindications for their use. Methods and materials: Previous systematic reviews on this topic were used as the basis for the current review. Cochrane, MEDLINE, Embase, and a few other bibliographic databases were searched for English and Bulgarian-language articles. The year of publication of the searched articles was limited from 2000 to 2020. Only articles in English and Bulgarian languages were read in full. Results: A total of 114 articles were identified by the literature search, the title and abstract of the articles were examined. Twenty-four original research studies met the inclusion criteria. They were read in full, and evidence was extracted for types of pit and fissure sealants, as well as indications and contraindications for their use. Conclusion: Evidence derived from the literature led to the conclusion that sealants are effective in preventing pit and fissure occlusal carious. The selection of the material used for silanization is made depending on a few factors that should be considered, such as patient's and tooth age, child's behavior and ability to isolate the surfaces which are going to be sealed. Regular examinations are required to be able to determine the need for reapplication of sealants and to maximize the effectiveness and results of the treatment.

Evaluation of In situ Adaptability of Two Types of Fissure Sealants Placed with or Without Enameloplasty

Context: Literature has no consensus over the utility of enameloplasty before fissure sealant placement. Aim: The objective of the study was to explore the effect of enameloplasty using a scanned electron microscope on the adaptability of resin-modified glass ionomer versus flowable resin-based sealants. Settings and Design: An in vitro, experimental study was done from July to November 2017 at the NED University and Dow University of Health Sciences, Karachi, Pakistan. Materials and Methods: An in vitro experimental study was done, for which twenty extracted human molars and premolars were selected. They were divided into two groups on the basis of sealant type (resin-modified glass ionomer versus flowable resin-based sealant). The groups were further subdivided on the basis whether these were subjected to enameloplasty or not. All specimens were thermocycled, sectioned, dried, and gold sputtered before inspection under a scanning electron microscope (×50). Statistical Analysis Used: The adaptability of the sealant material in the tooth fissures was assessed on an ordinal scale. SPSS version 23.0 was used for data analysis. Mann–Whitney U-test and ordinal regression were applied at 0.05 level of significance. Results: There were no statistically significant differences between adaptability scores achieved with resin-modified glass ionomer-based sealant and flowable resin-based sealant (P = 0.96). Moreover, enameloplasty resulted in inferior adaptability of the two sealant materials (P = 0.02). Conclusions: Enameloplasty has shown to exert a negative influence over adaptation of the sealant material into the tooth fissure irrespective of the sealant chemistry.

Improving methods to prevent caries of the permanent tooth fissure area in children

Improving methods to prevent caries of the permanent tooth fissure area in children

In Vitro Experimental Study: Comparison of Tooth Fissure Morphology Patterns Various the Adaptability of two Fissure Sealants

In Vitro Experimental Study: Comparison of Tooth Fissure Morphology Patterns Various the Adaptability of two Fissure Sealants

A method for cantilever dental bridge material selection based upon mastication loads: finite element analysis

A method for cantilever dental bridge material selection based on mastication loads is proposed in the paper. The personalized cantilever dental bridge model was developed. Equivalent von Mises stresses investigated numerically in case of solid food segments mastication that concentrated in pontic and cantilever teeth fissures. It was shown that penetration of solid food (carrot, nut, biscuit) into cantilever tooth fissure may cause values of stresses higher than critical stresses of dental materials used. In contrast, stresses caused by penetration of food into pontic tooth fissure are not so high and proper selection of dental material may provide for required safety factor.

Accuracy of digital dental models using the low-cost DAVID laser scanner.

Accurate laser scanning of plaster casts using validated, low-cost hardware represents a key issue in 3D orthodontics. The aim of this study was to compare the accuracy of measurements taken from plaster casts (gold standard) with digital models of those casts created with a low-cost structural light DAVID laser scanner. Five different measurements were taken on each of 14 plaster casts by 2 independent observers with an electronic caliper. The measurements were repeated 10 times on all 14 plaster casts by each observer, with a 1-week interval between each set of measurements. All 14 plaster casts were digitized using a low-cost DAVID SLS 3 laser scanner. The same 5 measurements were performed on each of the 3D virtual surface models of the 14 plaster casts by 2 independent observers using Meshlab software in a manner similar to that used with the digital caliper. The measurements were repeated 10 times by the 2 observers with 1 week between each set of measurements. The laser-scanned models were more accurate than the plaster cast models in defining measurements based on simple tooth fissures. The accuracy of measurements based on complex tooth fissures were equivalent for the 2 types of model. For measurements based on interproximal dental contacts, the 2 methods of measurement were similar and both were notably poor in terms of accuracy. Three-dimensional virtual models obtained from the low-cost DAVID laser scanner can be used clinically, but only for certain types of measurements and indications.

Guest Editorial

Guest Editorial

Retention of moisture-tolerant fluoride-releasing sealant and amorphous calcium phosphate-containing sealant in 6-9-year-old children: A randomized controlled trial.

Pits and fissures of teeth have been recognized as the most susceptible areas for initiation of caries. The ability of the resin sealant to thoroughly fill pits, fissures, and/or morphological defects and remain completely intact and bonded to enamel surface is the primary basis for its caries prevention. The present study evaluated and compared the retention rates and development of caries in permanent molars of children sealed with amorphous calcium phosphate-containing (Aegis™) and moisture-tolerant fluoride-releasing (Embrace WetBond™) sealant over a period of 1 year. This was a double-blind, split-mouth, randomized controlled trial among children aged 6-9 years. Sixty-eight permanent mandibular first molars in 34 children were randomly assigned to be sealed with Aegis™ or Embrace Wetbond™ sealant. The follow-up examinations were conducted at 3, 6, and 12 months for evaluating the retention and development of caries. SPSS version 16.0 was used for the analysis. Within-group comparison of retention and development of caries at 3, 6, and 12 months was evaluated using the Friedman's test. The final sample was 32 children with 64 teeth. At 12 months, 23 of 32 (72%) sealants were completely retained in Aegis™, whereas 21 of 32 (65.6%) were retained in Embrace Wetbond™ group. There was no significant difference in the retention rates of Aegis™ and Embrace Wetbond™ sealants at 12 months (P > 0.05). Aegis™ was superior to Embrace Wetbond™ sealant as Aegis™ exhibited higher retention and lower caries scores.

Caries detection and quantification around stained pits and fissures in occlusal tooth surfaces with fluorescence.

Occlusal discoloration due to staining frequently occurs on the pits and fissures of teeth. Noncariogenic discoloration (non-CD) refers to the attachment of staining chromogens to sound surfaces, whereas cariogenic discoloration (CD) represents the discoloration of porous structures due to bacterial metabolites and mineral loss from the enamel surface. This study evaluated whether it is possible to distinguish between non-CD and CD on stained occlusal surfaces with fluorescence assessed by the quantitative light-induced fluorescence (QLF) technology. Sixty-two extracted human permanent teeth with suspected discolorations on the pit and fissure were examined. The maximum values of fluorescence loss (ΔFmax) and red fluorescence gain (ΔRmax) were calculated using QLF images. Using histology as the gold standard, it was found that 12 teeth were sound (non-CD), while 50 teeth had enamel and dentine caries (CD). The validity tests at the enamel histological caries level, ΔRmax (ρ = 0.80) were strongly correlated with the histology (P < 0.001). At the optimum threshold (105.0) of ΔRmax, it showed high levels of sensitivity and specificity (0.96 and 0.83, respectively). Therefore, QLF can be used to distinguish non-CD from CD on occlusal surfaces using red fluorescence values with high validity.

Knowledge and Practice of Pit and Fissure Sealants among dentists in Chennai

The study consisted of a questionnaire to determine the knowledge and utilization levels of sealants by undergraduate. Sealants are highly effective in preventing dental caries in the pits and fissures of teeth. A cross-sectional survey was conducted among students in Saveetha dental college. A self-administered structured questionnaire consisting of 10 items was used to assess their knowledge and practice regarding dental sealants The results suggest that dental practitioners had sufficient knowledge about dental sealants. They also acknowledge the importance of use of dental sealants and practice of dental sealants in clinics was found adequate.

The prevalence and intensity of the main dental diseases in children of Simferopol

At present, despite the availability of modern effective oral hygienemeans and prevention of dental diseases, which reduced their intensity, disease prevalence remains high. One method of dental caries preventing in children aged 6-7 years is a fissure sealing of molars, the most vulnerable areas of the newly erupted teeth, having a number of problems associated with a complex fissures relief. The purpose of this study was to investigate the prevalence and intensity of dental diseases and their development trends, as well as indicators of electrometric fissures of teeth in children aged 6-7 years of Simferopol. 87 children aged 6-7 years (first classes schools in Simferopol) were examined. In this case, assessed the state of hard dental tissues (CFt, CFf, CFDt, CFDf, cavities, fillings, chalk spots, depigmentation, complications in the structure of lesions), the state of periodontal tissue (PMA%, bleeding, Schiller-Pisarev test, CPITN) and oral hygiene (Silness-Loe, Stallard) were examined. For diagnosing electrometryof hard tissues of dental fissures DentEst apparatus was used. Studies of major dental diseases and electrometric indicators of hard tissues of molars fissures in children under study testifiesto a high caries incidence in temporary and permanent teeth and a tendency to increase of caries prevalence of permanent occlusion in these children, poor oral hygiene and the need to develop and implement treatment and preventive measures that not allow the development of caries process in the teeth of permanent occlusion.

Effect of irradiation times on the polymerization depth of contemporary fissure sealants with different opacities

The aim of this study was to evaluate the depth of curing of 10 contemporary blue light-activated dental flowable materials at several opacities, influenced by different irradiation times using FT-IR spectroscopy. Fifty-five specimens (n = 5) with a 5-mm diameter and 1-mm thickness of translucent (Opallis Flow T), yellowed (Master Flow A2; Opallis Flow A2; Natural Flow A2; Fluroshield Yellowed), and opaque materials (Master Flow OA2; Natural Flow O; Opallis Flow OA3.5; Opallis Flow OP; Fluroshield White) were obtained at six curing times (10s, 20s, 30s, 40s, 50s, and 60s) using a high-intensity LED (Coltolux, Coltène/Whaledent). The degree of conversion (DC) (%) was obtained using the Nexus 470 FTIR Spectrometer (Nicolet Instruments, USA). The FTIR-ATR spectra for uncured and cured samples were analyzed using a ZnSe crystal. The top and bottom surfaces of the cured specimens were analyzed to obtain the depth of curing. Two-way ANOVA was used to analyze the data. The highest curing depth was obtained by Natural Flow OA2, while the lowest was shown by Master Flow OA2. The shortest curing time generated similar depths of cure in comparison with the most extensive for Opallis Flow A2 and Fluroshield Yellowed. Therefore, depth of curing, influenced by the irradiation time, was dependent on the materials. Using the Natural Flow OA2 opaque sealant and the 10-s curing time for Opallis Flow A2 and Fluroshield Yellowed may represent alternative approaches to sealing tooth fissures.

Fissure sealants in children: a practical guide for the dental team

Dental caries remain a common disease in children and young people, with many forced to suffer toothache and infection as a result. Fissure sealing is a simple intervention available to the dental team that is effective at reducing decay in the pits and fissures of teeth.

Three‐dimensional study of human dental fissure enamel by synchrotron X‐ray microtomography

The three-dimensional morphology of human tooth fissures and the quantification of mineral distribution in fissure enamel are pertinent to the development and diagnosis of caries. Synchrotron X-ray microtomography was used to measure linear attenuation coefficients (at 25 keV) at high spatial resolution with a volume-imaging element (cubic voxel) of 4.9x4.9x4.9 microm3 in a block from a human premolar that included part of a stained fissure. From the linear attenuation coefficient, the mineral concentration, expressed as gHAp cm-3 (where HAp is stoichiometric hydroxyapatite), was calculated. The mean mineral concentration in bulk enamel was 2.84 gHAp cm-3. Well-defined regions (1.5-2.6 gHAp cm-3), extending up to approximately 130 microm from the base of some narrower lengths of the fissure and up to approximately 50 microm deep from the fissure surface, were attributed to hypomineralization. Other regions of low mineral concentration, some (1.4-2.3 gHAp cm-3) lying within the expected course of the fissure base and some (2.2-2.7 gHAp cm-3) deep to the pit, were also considered to be of developmental origin. However, a diffuse distribution of low mineral concentrations (2.2-2.7 gHAp cm-3) in the pit walls was attributed primarily to demineralization from caries. The fissure contained heterogeneous material (<or=0.5 gHAp cm-3) exhibiting partial mineralization.

Early treatment of incipient carious lesions: A two-year clinical evaluation

The purpose of this study was to quantify conservation of tooth structure and evaluate the efficacy of early treatment of questionable carious lesions in pits and fissures of posterior teeth using air abrasion followed by placement of preventive resin restorations. Ninety-three patients with 223 questionably carious teeth, mainly with darkly stained pits and fissures, were recruited from general dentistry clinics. After baseline evaluation, each tooth was randomly assigned to either an early treatment or control group. The authors used air abrasion to investigate the pits and fissures of teeth in the early treatment group. The teeth were sealed and restored with a flowable resin-based composite. All teeth in both groups were examined at six-month intervals to clinically evaluate the quality of the restorations and the caries status of the control teeth. After two years, two of the 113 restorations in the early treatment group required further treatment because of penetrating stain at a margin. In the control group, 14 teeth required treatment because of caries. The mean weight of the impression material--a surrogate measure of volume of removed tooth structure--in preparations that extended into dentin in the early treatment group was 0.0260 grams compared with 0.0281 g in the control group. There was no statistically significant difference between the impression weights (P = .390). After two years of a proposed five-year study, the authors concluded that conservation of tooth structure was not substantiated by early treatment. Treating questionable carious lesions early may not conserve tooth structure.

In vivo dental plaque-forming ability and cariogenicity of the bacterium Streptococcus bovis in gnotobiotic rats

Germ-free Fisher rats, fed on a high sucrose diet, were monoinfected with Streptococcus bovis strains. High levels of fissure caries were formed by three strains; one strain produced moderate levels; another produced only very low levels. No strain could produce approximal or buccal/lingual lesions. All strains could colonize the fissures of teeth in the lower jaw, as shown by scanning electron microscopy. The most cariogenic strains were associated with caries scores similar to those of Strep. salivarius and members of the mutans streptococci.

Finite element stress analysis of restored teeth

A bucco-lingual descretization of a sectioned molar tooth was developed from which a plane stain finite element analysis was utilized to determine the principal, shear and effective stresses at each of nine Guass points within each element. The model was uniformly loaded along the inclined occlusal surfaces to a level of 100 Newtons. The maximum effective and principal stresses were always at the fissure between the cusps at a value of 5.4 MPa in the enamel of sound whole tooth and 5.35 MPa in the amalgam of a pinned restoration. It was generally found that the insertion of a liner attenuates the stress dependent on cavity size. Wider cavities tend to reduce the maximum effective stresses. Stresses at the liner amalgam interface are lower than those at the tooth fissure, suggesting that fracture or deformation is unlikely to initiate from the amalgam base and propogate to the occlusal surface. Insertion of stainless steel retaining pins returns the maximum effective stress at the fissure to the higher levels found for a class I restoration.

Relative cariogenicity and in-vivo plaque-forming ability of the bacterium Streptococcus oralis in gnotobiotic WAG/RIJ rats

The rats, fed a high sucrose diet, were mono-infected with seven strains of Streptococcus oralis. Moderate levels of caries were induced by four strains, and three others induced low levels. Approximal lesions were induced by two strains; no buccal/lingual lesions were produced. Scanning electron microscopy showed that all strains colonized the tooth fissures, some strains producing a moderately abundant and dense plaque. The most cariogenic strains (PB178, PB180 and PB186) induced similar levels of caries to Streptococcus milleri.

Sucrose metabolism in situ by dental plaque in appliance-borne bovine enamel tooth fissure inserts in man

Sucrose metabolism of dental plaque which accumulated in fissure-like spaces between small bovine enamel cubes on removable U-shaped appliances was analysed using radiolabelled techniques. The appliances were worn by 8 dental students for 21 days. Half of the fissural inserts (3) on one wing of the appliance were exposed to a 10 per cent sucrose solution in normal saline and half (3) to normal saline as a control on the opposite wing, 8 × /day. At 21 days [ 14C]-sucrose (U) was applied directly to sucrose and saline-exposed inserts extra-orally for 60 min at 37 °C (non-dispersed plaques, NDP). Adjacent inserts on both sides of the appliances were removed. The plaque was dispersed in buffer by sonication, cultured and was exposed to radiolabelled sucrose for the same incubation period (dispersed plaques, DP). The following observations were made: (1) quantitative values for sucrose consumption and lactic acid, cell-bound and insoluble product, soluble polysaccharide, carbon dioxide and total volatile acid formation did not differ between sucrose and saline exposed DP or sucrose- and saline-exposed NDP; (2) all DP consumed more sucrose and formed higher quantitative levels of all products than NDP counterparts, p < 0.001; (3) sucrose-exposed DP and sucrose exposed NDP formed proportionally more lactic acid than saline-exposed counterparts, p < 0.05; (4) sucrose-exposed NDP formed proportionally more lactic acid and less soluble polysaccharide than sucrose exposed DP, p < 0.025; (5) concentrations of lactobacilli were higher in sucrose exposed plaques, p < 0.049