Treatment Of Caries Research Articles

Production of Prophylactic Nanoformulation for Dental Caries and Investigation of Its Effectiveness by In Vitro and In Silico Methods

Background/Objectives: This study aimed to develop cinnamon bark essential oil (CEO), orange peel essential oil(OEO) and the combination of these two essential oils (OEO-CEO) loaded PLGA nanoparticles to prevent dental caries and to investigate their effectiveness in silico and in vitro methods. Methods: EO loaded PLGA nanoparticles were produced by single emulsion method. Detailed characterization studies were performed using different methods, and the controlled release profile was obtained. The antibacterial activity of the developed formulations was investigated on S. mutans and L. casei strains by in vitro and in silico methods. Additionally, the interaction mechanisms of EOs with DNA were evaluated. Results: Our findings showed that the average droplet size of EO-loaded PLGA nanoparticles varied between 243.1 ± 0.60 nm and 219 ± 4.49 nm, while PdI values varied between 0.069 ± 0.039 and 0.032 ± 0.01. In addition, the developed nanoparticles had high encapsulation efficiency (85.14% to 66.28%) and released the active ingredient in a continuous and controlled manner. Ames test showed that the genotoxicity of EOs was eliminated due to the encapsulation of EOs in PLGA nanoparticles and antibacterial tests showed that OEO-CEO-loaded PLGA nanoparticles were effective on L. casei and S. mutans. The antibacterial activity of EOs was also supported by in silico studies. Finally, it was revealed that EOs showed potential as antibacterial agents by interacting with DNA. Conclusions: The results showed that OEO-CEO-loaded PLGA nanoparticles have the potential to be a suitable nanoformulation for developing mouthwash or toothpaste for the prevention and treatment of dental caries.

Training received, knowledge, and use of Silver Diamine Fluoride among Italian dentists: a nationwide survey

ObjectiveTo investigate the education, knowledge and behaviour of Italian dentists regarding Silver Diamine Fluoride (SDF).MethodsA cross-sectional study was conducted from January to December 2022, through an online survey linked to an online continuing medical education (CME) course sent to Italian dentists. A priori power analysis estimated the necessary sample to be 1480 dentists with an anticipated frequency of 50% and a power of 99.99%. The questionnaire included 46 questions on participants ‘ demographic characteristics, training received, clinical knowledge of SDF, and attitudes and behaviours regarding its use. Descriptive statistics, bivariate, and mutlivariable regression analyses were performed to determine the association between the variables.ResultsThe response rate was 6.1% with 3876 respondents, evenly distributed geographically. Less than 10% of respondents had received training at undergraduate, postgraduate or masters level. A minority of dentists were familiar with the use of SDF for the treatment of dentine hypersensitivity (19.0%) and for the treatment of caries in children (22.2%) and adults (15.7%). The percentage of dentists who reported SDF use at least once was 20.6%. On mutlivariable analysis (χ2(11) = 995.9 p-value < 0.01), dentists who used SDF were positively associated with those who cared for patients with special needs, those who received good undergraduate or postgraduate training, and those who knew how to use SDF (p < 0.01). A second mutlivariable analysis (χ2(11) = 47.9 p-value < 0.01) revealed that younger respondents were associated with good training and knowledge of the use of SDF received during undergraduate studies, while older respondents were associated with good training received on managing hypersensitivity and caries in adults (p < 0.01).ConclusionsOverall, Italian dentists ‘ education, knowledge, and use of SDF were relatively poor. The majority of the sample ‘s responses were not consistent with scientific evidence. The use of SDF among Italian dentists is still far from being a reality. In Italy, it is necessary to increase training on SDF, primarily through the university, to hopefully increase its use, especially in non-invasive caries treatment.

The Influence of Posterior Class II Composite Restoration Location and Techniques on Marginal Sealing.

Background/Objectives: The success of treatment and prevention for secondary caries hinges significantly on the techniques employed in Class II composite restoration. Additionally, the location of the restored tooth within the oral cavity has emerged as a potential factor determining the quality of the restoration. A comprehensive understanding of these interrelated variables is crucial for advancing the efficacy and durability of dental composite restorations. The aim of this study was to assess how various restoration techniques and the specific location of the tooth restoration in the oral cavity affect marginal sealing, verified by the gap created in the tooth-restoration interface. Methods: Sixty extracted human teeth that had been indicated for orthodontic extraction were collected and embedded into a custom-made holder that was located in one of the four quadrants of a laboratory phantom head. Class II resin composite restorations, using flowable and packable composites, were performed on all teeth using two techniques: Pre-cure and Co-cure. The aging of the restored teeth was conducted using cyclic loading and thermocycling. After aging, the teeth were examined under a scanning electron microscope to measure the gap within the tooth-composite interface. Kolmogorov-Smirnov tests were used to assess the data distribution. Unpaired T-tests were employed to compare the mean gaps between the Pre-cure and Co-cure techniques. Additionally, unpaired T-tests were utilized to compare the mean gaps between the mesial and distal parts of the teeth. The Kruskal-Wallis test was used to compare the mean gaps among the four quadrants. The statistical significance was set at p = 0.05. Results: No significant difference in the gaps between the Pre-cure and Co-cure techniques was found (p = 0.212). The tooth's location did not generally affect the restoration's gap interface (p = 0.136). Conclusions: Flowable composites aid in restoring the deep margins of Class II composite restoration. Thus, the potential for further microleakage is similar for both the Pre-cure and Co-cure restoration techniques. The marginal seal of Class II composite restorations is effective when using both Pre-cure and Co-cure techniques, and the restoration site within the oral cavity does not significantly influence the tooth-composite interface seal.

Advanced Lasers and Their Applications in Dentistry.

The development of laser technology has revolutionized dentistry, offering complementary and alternative approaches to traditional techniques. Lasers have been successfully integrated into various dental procedures, enhancing treatment outcomes and patient care. Several types of lasers can increase the acid resistance of enamel, thus preventing caries. Laser fluorescence has been utilized for the pre-operative diagnosis of dental caries, enabling early detection and effective treatment planning. The therapeutic application of lasers in caries treatment aligns with the contemporary philosophy of minimally invasive procedures. Clinicians can use laser Doppler flowmetry as a supplementary tool for pulp vitality testing by detecting pulpal blood flow. Lasers are also employed in various pulp-related interventions, such as managing dentine hypersensitivity and performing root canal therapy. These procedures benefit from the precision and reduced invasiveness provided by laser technology. Furthermore, laser fluorescence serves as an additional tool for subgingival calculus detection. High-power and low-power lasers are used in both nonsurgical and surgical therapies to treat periodontal and peri-implant diseases, oral mucosa conditions, and even cancer based on their specific properties. Lasers are also utilized to accelerate bone regeneration, promote adhesive strength, and remove ceramic brackets. In summary, laser technology has significantly impacted contemporary dentistry by facilitating early diagnosis, minimally invasive treatments, and precise operative procedures, ultimately improving patient outcomes and expanding the scope of dental practice.

The Prevalence and Intensity of Dental Diseases Among Workers with Dangerous Working Conditions, Depending on the Presence or Absence of Previous Oral Sanitation

Relevance: to substantiate programs for the prevention of dental diseases at nuclear industry enterprises with dangerous working conditions, comparative studies of the dental status of employees, depending on the presence or absence of previous oral sanitation, are relevant. The purpose of the study: clinical and radiological comparison of indicators of the dental status of nuclear power plant workers with hazardous working conditions (OT), depending on the presence or absence of previous oral sanitation. Materials and methods: 78 employees of the Kalinin nuclear power plant with dangerous working conditions in the key age group of 35–44 years, who underwent therapeutic and surgical sanitation of the oral cavity a year ago, were examined. For comparison, 69 workers with OT of an identical gender and age group who refused to sanitize the oral cavity during periodic medical examinations were examined. The sequence of clinical and radiological examination corresponded to the modified WHO Dental Status Assessment Map (1995). Results: the positive effect of oral sanitation due to the removal of destroyed teeth, treatment of caries and its complications, as well as periodontal diseases is to reduce the prevalence of signs of dysfunction of the temporomandibular joint by 52.5 %, non-carious offspring 22.7 %, diseases of the oral mucosa 24.1 %, periodontal diseases 6.0 %. As a result of sanitation, the detection of poor oral hygiene is reduced by 54.7 %. The intensity of caries and periodontal diseases a year after sanitation is 12.8 and 27.8 % lower in comparison with workers with an unsanitized oral cavity. After rehabilitation, the prevalence of orthopedic treatment increases by 43.4 %. Conclusions: oral sanitation significantly improves the basic indicators of dental status for workers with dangerous working conditions at nuclear power plants. The positive effect of oral sanitation is largely preserved after a year in comparison with non-sanitized workers. Oral sanitation at the age of 35–44 years does not affect the prevalence of caries.

Assessment of knowledge, attitudes, and professional behavior toward silver diamine fluoride among postgraduate pediatric dentistry students

Background and Objectives: Silver diamine fluoride (SDF) is a clear solution composed of ammonia, silver, and fluoride ions, used as an alternative treatment for early childhood caries. The study sought to assess the educational experiences, knowledge, attitudes, and professional behavior of postgraduate pediatric dentists regarding SDF, as well as to explore the connections among these factors. Methods: Postgraduate pediatric dental students (n = 200) participated in the survey. The SDF evaluation covered education, clinical knowledge, attitudes, and professional behavior, as well as parental acceptance. Results: Despite the limited scope of undergraduate education regarding SDF, the majority of the respondents knew about its uses and limitations. In spite of their high knowledge and positive attitude, the clinical use of SDF was found lacking. There was a positive correlation between the constructs, and the associations were statistically significant (P = 0.00). Interpretation and Conclusion: Even with the knowledge and positive attitude, clinical use seemed lacking. This can be overcome by increasing SDF education and encouraging postgraduates to incorporate the use of SDF into their routine practice. Moreover, clinicians must stress the advantages of SDF to parents and encourage them to look beyond the esthetic limitations.

Mussel-inspired novel coating with cariogenic biofilm inhibition and in situ remineralization properties for caries treatment

A facile and dual-functional PDA@PC hybrid coating, prepared via the Michael addition and Schiff base reactions, exhibits remarkable performance in terms of antibiofilm activity and remineralization capabilities for dental caries management.

The proportion of secondary caries in the work load of dentist

Annotation. The aim of the study was to determine the proportion of teeth with secondary caries among carious lesions in children and adults to determine the amount of dentist’s work load for the primary and secondary teeth caries. A targeted epidemiological study of the dental status of 264 residents of Sumy oblast in the age group of 35-44 years old and 364 children aged 3, 6, 12 and 15 years was conducted. The analysis of the results determined the prevalence and intensity of caries. The intensity of adult dental caries was estimated by the integrated Decayed Missing Filled Teeth (DMFT) index and dft in children. It was found that the prevalence of caries among 3 year old children was 34.0% (95% CI: 25; 43), 6 years old – 69.0% (95% CI: 59; 78), 12 years old – 62.0% (95% CI: 52; 72), 15 years old – 68.0 (95% CI: 58; 77), adults - 100%. The intensity of caries at the age of 3 years by dft index was 1.54±0.11 teeth, 6 years (DMFT + dft) – 3.16±0.15 teeth, 12 years (DMFT) – 2.33±0.12, 15 years (DMFT) – 2.86±0.18 and in adults DMFT was 14.91±0.37 teeth. 64.0±13.0% of children at the age of 3 years, 52.9±6.0% – at the age of 6 years, 30.0±10.0% - at the age of 12 years, 48.5±6.1%, – at the age of 15 years and 47.2±2.9% of adults needed dental treatment for the primary caries. 36,0±13,0% of children at the age of 3 years, 47,1±6,0% – at the age of 6 years, 70,0±10,05% – at the age of 12 years, 51,5±6.1% – at the age of 15 years and 52,8±3,3% of adults needed dental treatment for secondary caries. Thus, almost half of dentist’s working time is precisely on repeated visits of patients for the elimination of the consequences of poor-quality treatment of primary teeth caries, which resulted from a number of reasons.

Silver Diamine Fluoride: Overcoming The Traditional Drill And Fill Technique In Children

Dental caries is a chronic, bacterial, multi-factorial dynamic process and remains a significant public health problem in children. Treatment of dental caries can be very challenging for the dentist, especially in young children. Silver Diamine Fluoride (SDF) offers a non-invasive alternative for managing dental caries in children, revolutionizing traditional drill and fill technique. Its unique properties, including antimicrobial activity, remineralization potential, and desensitizing effects, make it a versatile and effective agent for addressing carious lesions and improving oral health outcomes. Plenty of clinical evidence is available including many in-vivo and in-vitro studies that have demonstrated the successful use of SDF in preventive and curative aspects of clinical dentistry. While SDF offers significant benefits, dental professionals should carefully weigh the potential risks and benefits and adhere to recommended protocols to ensure safe and effective use. With the ongoing research and advancements in SDF, it continues to hold promise as a key component of preventive and restorative dentistry strategies aimed at improving oral health and reducing the burden of dental caries worldwide.

Study results of the stress-strain states of the crown parts of molars restored with composite, ceramic and zirconium onlays

The relevance of the research is determined by the significant need for effective restorative treatment of caries decayed teeth. The purpose of the study is comparison of the stress-strain states in simulated models of non-homogeneous composite structural elements for typical geometric characteristics of onlays made of composite, ceramic, and zirconium dioxide in the restoration of the decayed mandibular molar. Computer simulation models of biomechanical systems were obtained by digital scanning of the mandibular molar in STEP format. Control was carried out in the form of numerical characteristics and graphical visualization in the EXOCAD program. The numerical method of finite elements, information technologies and program codes of the ANSYS Workbench 12.1 system were used to solve applied problems of biomechanics. After testing the developed discrete models, they were checked for adequacy and coincidence of numerical results in areas of high voltage gradients using the tools and methods of the ANSYS 12.1 code system. The maximum displacements, gradients, and amplitudes of the Mises-equivalent stress in the structural elements of each biomechanical system were evaluated. The stress values were calculated using the method of linear scaling of the results of the numerical solution of the boundary value problems of the theory of elasticity for small deformations to correspond to the functional force load of the mandibular molar of 100 N. The estimated values of the coefficients of the strength reserve of the structural elements were calculated as the ratio of the strength limit values to the maximum calculated values of the Mises-equivalent stress, scaled by a coefficient of 10 for a force load of 100 N. It was established that the largest voltage gradients are registered at the border of the cement layer. However, the nature of force transmission, as well as stress distribution, was different for different structural materials. The maximum stress was observed in the model with a composite onlay in the local area of the surface of the force load in the cement layer. For the ceramic onlay, the maximum stress was found on the lower support surface of contact with the onlay, where its values were 1.4 times higher than on other surfaces. The analysis of the zones of maximum stress for the zirconium onlay revealed their predominant localization in the center of its occlusal surface and in the zone of change in its spatial configuration at the border with cement. The highest stress values, along with the lowest coefficients of safety margin, were found for the molar model restored with a composite onlay, which indicated the lowest endurance of this material to functional load. While the zirconium onlay provided optimal stress distribution and it was characterized by the largest safety factor, which makes this method the most acceptable for molar restoration. The obtained results should be taken into account when choosing a material for the prosthetics of lateral teeth with onlays.

TIMING OF CARIES TREATMENT OF PRIMARY MOLARS USING RUBBER DAM

Preservation of primary molars is extremely important in the process of forming both a temporary and, in the future, a permanent bite. Therefore, working with children of an early younger age requires adequate adaptation of the child both by the doctor and the guardian. The use of modern materials that provide highquality treatment of caries and its complications in children requires absolute isolation at the children's reception in order to be able to count on the success of the treatment. Numerous studies have been published in the literature, confirming the better preservation of restorations and sealants, during the installation of which rubber dam was used. We analyzed the treatment of 40 children diagnosed with acute middle caries of temporary molars. All treatment is divided into two stages, the duration of which we compared. The first stage included: adaptation of the child, photo protocol, analgesia and isolation of the working field, i.e. we included the application of a cofferdam to the first stage. The second stage is the direct treatment of caries: preparation and filling of the tooth, that is, the stages that are the most psycho-emotionally difficult for the child. In the first group, the stages of adaptation and treatment were the longest. In the second group, the adaptation stage was shorter, and the treatment stage, compared to the first group, took 5 minutes more, which is almost 20% of the total treatment time. The most emotionally and technically difficult stage for the child was shorter in time in the group where the rubber dam was used. In addition, the probable difference in the duration of the treatment stage in the studied groups was determined.

School-Based Fluoride Mouth-Rinse Programs and Dental Caries Treatment Expenditure: An Ecological Study of the NDB Open Data Japan.

The prevalence of dental caries is high in Japan, leading to a huge burden of overall expenditure on dental caries treatment for the population. School-based fluoride mouth-rinse (S-FMR) has been implemented as a public health intervention. However, its cost-effectiveness remains unclear, where universal health insurance covers a broad range of dental treatments at relatively low cost. The aim of the study was to determine whether S-FMR is associated with lower dental caries treatment expenditure in Japan, where the universal health insurance system widely covers dental treatments. In addition, the cost-benefit of S-FMR was estimated. This ecological study examined the association between S-FMR coverage and dental caries treatment expenditure in all 47 prefectures of Japan. Data were obtained from the National Database of Health Insurance Claims and Specific Health Checkups of Japan open data (NDB Open Data Japan), national survey data on the prevalence of S-FMR, and other census data for each prefecture. The outcome variable was the average annual treatment expenditure of for children aged 5-14 per child. The explanatory variable was the S-FMR coverage of children per prefecture, divided into quartiles: (Q1) 0.0%-0.48%, (Q2) 0.54%-6.9%, (Q3) 7.2%-25.0% and (Q4) 26.9%-80.4%. Linear regression analysis was performed with adjustment for the number of dental clinics per 100 000 individuals, per capita prefectural income, and percentage of the population aged between 5 and 14 years. The dental caries treatment expenditure was lower in prefectures with higher S-FMR coverage: (Q1) 2378 JPY, (Q2) 2215 JPY, (Q3) 2217 JPY and (Q4) 2065 JPY. Linear regression analysis showed that, compared to the prefectures with the lowest S-FMR coverage, the prefectures with the highest coverage exhibited significantly lower per person dental caries treatment expenditure by 186.0 (95% CI = 96.6, 275.4) JPY. When annual cost of S-FMR per person was lower, 200 JPY, S-FMR would save 0.9 billion JPY if all prefectures change from Q1 to Q4 (approximately 8.2 million USD). Although public healthcare insurance in Japan covers most dental treatments at a relatively low cost, the current findings suggest that S-FMR could still be a cost-effective public health intervention.

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.

Acceptability and feasibility of minimally invasive restorative procedures for patients with disability. A cohort study.

Unmet caries treatment needs are prevalent among peoplewith disability, partly due to difficulties of cooperation during conventionaldental treatment. This cohortstudy compared atraumatic restorativetreatment (ART), silver modified atraumatic restorative treatment (SMART), and conventional restorative treatment (CRT),in terms of feasibility andacceptability in patients referred forspecial care dentistry in a specialized university clinic. Patients referred for dental restorative carewere treated using either ART, SMART, or CRT approach. Acceptance,feasibility, and complexity for the provision of care according to the BDA Case Mix Tool wereassessed. ANOVA with Bonferroni correction and Chi-square testsinvestigated differences in age, gender, and BDA scores. Spearman Logistic Regression was used to correlate treatment selection with BDA scores. From a total of 150 patients, 74 were included (20.6±11.2 years of age) 26 chose ART, 35 SMART, 11 CRT and 2 were referred for sedation/GA. ART, SMART, and CRTwere feasible forall patients who had selected these options, with optimal placement of restorations for all patientsreceiving ART, 95.8% of patients receiving SMART, and all patients receiving CRT.Local anesthesia wasrequired for4of the 26patients receiving ART and for the 11 patients receiving CRT, but not required for any of thepatients receiving SMART (p=.001). BDA-complexity scores were significantly higher for patients receiving SMART (OR 3.730, 95% CI 0.0∼1.82, p ≤.001). ART and SMART are feasible and acceptableapproaches to restorative dental treatment in patients witha disability who have difficulty coping with conventional treatment.CRT is more likely to be selected by patients with lower BDA-scores. The survival of the restorations should be assessed to determine the effectiveness of these options and further research is required to confirm the results of this pilot study in a larger population.

Annual full mouth debridement reduces the need for dental treatment in personnel working in hazardous conditions

BACKGROUND: Relevant data on the need for dental treatment, including differentiated parameters of treatment needs in various groups of patients enrolled in care, are essential for the justification of compulsory health insurance financing and adequate staffing of the dental service. AIM: To compare the need for dental treatment in personnel of the Kalinin Nuclear Power Plant working in hazardous conditions, depending on the presence or absence of previous full mouth debridement. MATERIALS AND METHODS: A clinical and X-ray examination of the teeth and periodontal tissue was performed in two groups of personnel of the Kalinin Nuclear Power Plant working in hazardous conditions. One year prior to the examination, subjects in the first group voluntarily declined the proposed full mouth debridement, while subjects in the second group received therapeutic and surgical debridement according to the compulsory health insurance plan. RESULTS: The need for treatment of dental caries and its complications decreased by 27.8% following full mouth debridement. In particular, the need for single and double dental filling decreased by 46.0% and 53.5%, respectively; the need for primary and revision root canal therapy decreased by 48.0% and 43.3%, respectively; and the need for tooth extraction decreased by 81.1%. The need for flap surgery and periodontal pocket curettage decreased by 32.8% and 38.8%, respectively, while the requirement for calculus removal and local drug therapy increased by 7.1%. CONCLUSION: Personnel of the Kalinin Nuclear Power Plant working in hazardous conditions showed a high need for treatment of dental caries and periodontal diseases. There was a significant decrease in the need for dental filling, root canal therapy, and tooth extraction in subjects with previous full mouth debridement, with a shift toward less invasive periodontal disease treatment options. Specific data on dental treatment needs in personnel working in hazardous conditions can be used for financial planning and staffing of the dental service.

Examination of the effect of treatment of severe early childhood caries and fluoride varnish applications on salivary oxidative stress biomarkers and antioxidants

BackgroundSaliva contains a variety of biochemical compounds, including antioxidants, and serves as the body’s first line of defense against oxidative stress caused by free radicals. The aim of this study was to investigate the effects of dental treatments on salivary oxidative stress biomarkers in children aged 3–5 years with severe early childhood caries (S-ECC) compared to children without caries.MethodThis study was conducted on 20 children aged 3–5 years with severe early childhood caries (S-ECC) and 20 children without caries. Salivary oxidative stress biomarkers and antioxidants were measured after the initial examination (T0), after the end of restorative treatments (T1), and after fluoride varnish applications (T2). Post hoc Bonferroni test was used to compare normally distributed parameters between T0-T1-T2 times. Pearson correlation analysis was used to examine the relationships between parameters that conform to normal distribution. The Mann-Whitney U test was used to compare the parameters in the control and experimental groups. Significance was evaluated at the p < 0.05 level.ResultsThe mean dmft of the participants in the study group was 8.86 ± 14.5. Advanced oxidation protein products (AOPP), dityrosine (DT), kynurenine (KYN), advanced glycation end products (AGE), lipid hydroperoxides (LHP) and malondialdehyde (MDA) values decrease after the treatment of dental caries and protective fluoride varnish applications, while an increases in total thiol (TSH) and Cu/Zn-superoxide dismutase (Cu/Zn-SOD) values were observed after protective varnish applications compared to pre-treatment values. Antioxidant parameters at time T2 in the study group were statistically significantly higher than in the control group (p < 0.05). In the study group, there was no correlation between TSH and oxidative stress mediators in terms of changes at time T1 post-treatment compared to the pre-treatment period, while an inverse moderate relationship was found with AGE and LHP in terms of changes at time T2 post-treatment (p < 0.05).ConclusionsAn increase in salivary antioxidants was detected after dental restorations were completed and protective fluoride varnish application, while a decrease in oxidative stress markers was detected.Clinical relevanceFluoride varnish applications applied in the study group may further reduce the oral microbiome load and cause salivary oxidative stress markers to be significantly lower than in the control group.

The Effect of Green-Synthesized Nanoparticles on Dental Caries-Causing Bacteria: A Systematic Review.

In this study, a comprehensive search was conducted across multiple databases, including PubMed, Google Scholar, SID, Scopus, Medline, and Web of Science, as well as selected herbal medicine journals. The inclusion of herbal medicine journals was justified by the growing interest in green-synthesized nanoparticles derived from plant extracts, which are relevant to the focus of this review. Articles published between 2015 and 2023 were evaluated. To ensure a robust selection process, studies were assessed for quality using specific criteria beyond the AXIS checklist, including study design, sample size, and methodological rigor. Any discrepancies between reviewers were resolved through discussion or consultation with a third reviewer. This approach aimed to minimize bias and ensure the inclusion of high-quality studies that contribute meaningfully to the review's objectives. The primary objective of this review was to investigate the therapeutic implications of green-synthesized metallic nanoparticles, such as silver and zinc nanoparticles, in addressing dental caries, with a focus on their antibacterial properties and potential to improve current treatment modalities. In this study, PubMed, Google Scholar, SID, Scopus, Medline, Web of Science, and herbal medicine journals were searched, and articles from 2015 to 2023 were evaluated. In this study, 22 clinical trials were reviewed, and the effectiveness of synthesized nanoparticles was demonstrated in nearly all of them. The nanoparticles found to be most effective against tooth decay-causing bacteria include silver, zinc, selenium, nickel, and copper nanoparticles. To provide greater clarity, key findings, such as nanoparticle size, minimum inhibitory concentration (MIC) values, and specific antibacterial effects, are presented in a table. Additionally, a more in-depth comparison was made between these nanoparticles, focusing on their relative effectiveness under different conditions. For example, silver nanoparticles were consistently effective across various trials due to their strong antimicrobial properties, while zinc and copper nanoparticles showed efficacy in specific concentrations and against particular bacterial strains. Furthermore, green-synthesized nanoparticles were compared with those produced using traditional methods, evaluating factors, such as effectiveness, scalability, and safety, to provide a comprehensive understanding of their potential in dental caries treatment. According to the literature review, nanoparticles with antibacterial properties have the potential to serve as an alternative or complement to conventional chemical treatments for combating tooth decay. Future research should focus on exploring specific types of nanoparticles, such as green-synthesized metallic nanoparticles (e.g., silver and zinc), which have shown promising antibacterial effects. Additionally, more emphasis should be placed on optimizing synthesis methods that enhance biocompatibility and scalability for clinical use. The development of affordable treatment options using medicinal plants for green synthesis is particularly promising and should be further explored to make nanoparticle-based therapies more accessible in clinical settings.

Epidemiology of Chronic Pulpitis, Dental Caries, and Periapical Disease and Their Possible Risk Factors in an Adult Chinese Population in the Northern Regions of China

Background: Dental diseases and disorders are reported to affect specific ages, genders, and races of patients. Therefore, epidemiological investigations are necessary for understanding dental diseases and disorders. Objectives: This cross-sectional study aims to determine the prevalence and potential risk factors of chronic pulpitis, dental caries, and periapical disease in adults seeking treatment at the Tianjin Stomatological Hospital, Tianjin, a major referral center in the Northern region of China. Methods: A total of 3,245 males and females visited the Department of Adult Dentistry and the Department of Endodontics of the Tianjin Stomatological Hospital, Tianjin, China, for oral health concerns from January 17, 2020, to November 18, 2023. Among these patients, 615 (19%) were receiving treatment for chronic pulpitis, dental caries, and/or periapical diseases at the institute. Demographic parameters and clinical examination results of 496 patients (119 patients were excluded due to missing information) who were being treated for chronic pulpitis (long-term inflammation of the dental pulp), dental caries (a biofilm-mediated, sugar-driven, multifactorial, dynamic disease), and/or periapical disease (inflammation around the tooth root) with varying severity (moderate or severe) were included in the study. Results: Of the 496 patients, 300 (60%) were females, 328 (66%) were aged 60 years or older, and 295 (59%) had issues with mandibular teeth. Among the patients, 250 (50%), 301 (61%), and 151 (30%) were diagnosed with dental caries, chronic pulpitis, and periapical disease(s), respectively. Female gender (P = 0.041), age ≥ 60 years (P = 0.045), and issues with mandibular teeth (P = 0.046) were found to be associated with chronic pulpitis, dental caries, and periapical diseases in the patients. Conclusions: The prevalence of dental diseases and disorders in Han Chinese adults is 19% in the Northern regions of China. Chronic pulpitis and dental caries are the most prevalent dental diseases, while periapical diseases occur less frequently among Han Chinese adults in the Northern regions of China. Females, individuals aged ≥ 60 years, and issues with mandibular teeth are independent risk factors for the development of chronic pulpitis, dental caries, and periapical disease in adult patients in Northern regions of China. Policymakers in China should consider the findings of this study to reduce dental diseases and disorders in Chinese adults, especially in the Northern regions of China.

Preparation and Performance of Filled Resin Based on Long Afterglow Materials in Gingival Wall Lifting Surgery

The study was conducted to solve the problems of low monomer conversion rate and insufficient curing depth of dental resin complexes during curing in gingival wall elevation procedures. A dental composite resin was prepared by modifying the blue emitting long afterglow luminescent material. Then it was applied in the treatment of oral caries for experimental research. The results showed that the afterglow of the SMSED material showed high brightness and blue, with its thermoluminescence peak higher than that of the control group, reaching a maximum of 3 × 106. The curing performance was better. It was 9.17 % higher than CAED and 10.27 % higher than SAED. The accuracy of the measurements for the different resins in the study was about 5.67 %. In addition, the double bond conversion rate of the composite resin doped with 1 wt.% increased by 114.16 % compared to the composite resin without SMSED doping. The structure and size of composite resins containing 1 wt.% research materials were more stable. Overall, the cell survival rate for 1 – 3 days was higher than 70 %, indicating that the modified composite resin had lower toxicity to L929 cells. Overall, the performance of the dental composite resin prepared by modifying the blue emitting long afterglow luminescent material is significantly improved, indicating its effectiveness and practicality. It can be practically applied in the treatment of dental caries in gingival wall lifting surgery.

Economic evaluation of a community dental care model for people experiencing homelessness.

Aim The study aims to conduct economic evaluation of the Peninsula Dental Social Enterprise (PDSE) programme for people experiencing homelessness over an 18-month period, when compared to a hypothetical base-case scenario ('status quo').Methods A decision tree model was generated in TreeAge Pro Healthcare 2024. Benefit-cost analysis and cost-effectiveness analysis were performed using data informed by the literature and probabilistic sensitivity analysis (Monte Carlo simulation with 1,000 cycles). The pre-determined willingness-to-pay threshold was estimated to be £59,502 per disability-adjusted life year (DALY) averted. Costs (£) and benefits were valued in 2020 prices. Health benefits in DALYs included dental treatment for dental caries, periodontitis and severe tooth loss.Results The hypothetical cohort of 89 patients costs £11,502 (SD: 488) and £57,118 (SD: 2,784) for the base-scenario and the PDSE programme, respectively. The health outcomes generated 0.9 (SD: 0.2) DALYs averted for the base-case scenario, and 5.4 (SD: 0.9) DALYs averted for the PDSE programme. The DALYs averted generated £26,648 (SD: 4,805) and £163,910 (SD: 28,542) in benefits for the base-scenario and the PDSE programme, respectively. The calculated incremental benefit-cost ratio was 3.02 (SD: 0.5) and incremental cost-effectiveness ratio was £10,472 (SD: 2,073) per DALY averted. Uncertainty analysis demonstrated that the PDSE programme was 100% cost-effective.Conclusions Funding a targeted dental programme from the UK healthcare perspective that provides timely and affordable access to dental services for people experiencing homelessness is cost-effective.