Effects of novel bioactive glasses on promoting remineralization of artificial dentin caries / 北京大学学报(医学版)

OBJECTIVE@#To investigate the effects of novel bioactive glasses (BG) including PSC with high phosphorus component and FBG with fluorine-doped element on promoting remineralization of artificial dentin caries.@*METHODS@#(1) BGs were used in this study as follows: PSC (10.8%P2O5-54.2%SiO2-35.0%CaO, mol.%) were synthesized using phytic acid as the phosphorus precursor through sol-gel method. FBG (6.1%P2O5-37.0%SiO2-53.9%CaO-3.0%CaF2, mol.%) and 45S5(6.0%P2O5-45.0%SiO2-24.5%CaO-24.5%Na2O, mol.%) were synthesized by traditional melt method. (2) The above BGs were soaked in simulated body fluid (SBF) for 24 hours. Then X-ray diffraction (XRD) was used to analyze the formation of hydroxyapatite (HA) crystals. (3) Prepared 1 mm thick dentin slices were soaked in 17% ethylene diamine tetraacetic acid (EDTA) for 1 week to demineralize the dentin. Then the dentin slices treated by BG were soaked in SBF for 1 week. Field emission scanning electron micro-scopy (FE-SEM) was used to observe the surface morphology of the dentin slices. (4) Four cavities were prepared to 1 mm depth in each 2 mm thick dentin slice, then were treated with lactic acid for 2 weeks to form the artificial dentin caries. Wax, mineral trioxide aggregate (MTA), PSC and FBG were used to fill four cavities as blank control group, MTA group, PSC group and FBG group respectively. Then the spe-cimens were soaked in SBF for 4 weeks. The changes of depth and density of demineralized dentin were analyzed using Micro-CT before filling and after 2 and 4 weeks filling.@*RESULTS@#(1) PSC and FBG promoted mineral formation on the surfaces of the demineralized dentin. And the speed was faster and crystallinity was higher in PSC group than the FBG and 45S5 groups. (2) The increased mineral density of artificial dentin caries in PSC group were (185.98 ± 55.66) mg/cm3 and (213.64 ± 36.01) mg/cm3 2 and 4 weeks after filling respectively, which were significantly higher than the control group [(20.38 ± 7.55) mg/cm3, P=0.006; (36.46 ± 10.79) mg/cm3, P=0.001]. At meanwhile, PSC group was also higher than MTA group [(57.29 ± 10.09) mg/cm3; (111.02 ± 22.06) mg/cm3], and it had statistical difference (P=0.015; P=0.006). The depth of remineralized dentin in PSC group were (40.0 ± 16.9) μm and (54.5 ± 17.8) μm 2 and 4 weeks respectively, which were also statistically different from the control group (P =0.010;P=0.001). There were no statistical differences between the control group and MTA group. The above effects of FBG group were between PSC and MTA.@*CONCLUSION@#PSC has advantages in the speed, quality and depth of mineral deposition in the demineralized layer of artificial dentin caries. It would be expected to be an ideal material to promote the remineralization of dentin caries.

Saliva microbiota and metabolite in individuals with caries or periodontitis / 中华口腔医学杂志

Objective: To detect and analyze the characteristics of oral microbiota in species composition, function and metabolism among caries, periodontitis and oral healthy individuals, hunting for the microbiome-derived biomarkers with specificity and sensitivity to estimate the occurrence of these two diseases. Methods: Saliva samples were collected from 10 patients with high caries risk [decayed-missing-filled teeth (DMFT)≥6, HC group] in Department of Endodontics, 10 patients with periodontitis of grade Ⅱ A-Ⅲ C (PG group) in Department of Periodontology and 10 oral healthy individuals (HH group) from School of Stomatology, The Fourth Military Medical University during from March 2022 to June 2022. A baseline examination was conducted on all participants, including their oral conditions of caries and periodontal health. Metagenomic sequencing (Illumina PE150 platform) and liquid chromatography-mass spectrometry were used to detect microorganisms and their metabolites in the samples respectively. The sequencing data were analyzed to obtain the information of microbial taxonomic composition, functional genes and metabolites in each group of samples. The basic oral conditions and saliva samples of subjects in each group were evaluated and collected by the same professional endodontist. Results: There were no significant difference in baseline characteristics such as age and sex among the subjects in each group (P>0.05). DMFT in HC group (9.0±1.7) was significantly higher than that in HH group (0) and PG group (0) (F=243.00, P<0.001). Sequencing data analysis showed that the taxonomic compositions of salivary microbiota in each group were mainly Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria and Fusobacteria at the phylum level, and Streptococcus, Neisseria, Rothia, Prevotella at the genus level. Differential analysis showed that, compared with the HH group, HC group and PG group had significant differences in taxonomic composition (P<0.05), and the most significant among them was Prevotella. At the species level, Prevotella pallens was the most significant change in HC group, and Porphyromonas gingivalis in PG group. Metabolite analysis showed that there were significant differences in metabolites between HC group and PG group. The results showed that, compared with the HH group, the most significant metabolite change was 3-hydroxy-1, 5-diphenylpentan-1-one in HC group (P=0.001) and N1 acetylspermine in PG group (P=0.002) respectively. Compared with the PG group, the metabolite of HC group with the most significant difference is D-glucosamine 6-phosphate (P=0.006). The metabolism gene function analysis showed that, the enrichment of carbohydrate metabolism related genes was highest in HC group, followed with HH group, and it was lowest in PG group. In addition, compared with the HH group, the abundance of functional genes related to glucose metabolism, such as ABC transporter and phosphotransferase system, were significantly decreased in PG group (P<0.05), but significantly increased in HC group (P<0.05). Conclusions: There is a significant correlation between the alternation of carbohydrate metabolism of salivary microbiota with the occurrence of caries and periodontitis. In the future, Prevotella pallens and 3-hydroxy-1, 5-diphenylpentan-1-one may be the potential biomarkers of caries; while Porphyromonas gingivalis and N1 acetylspermine work in the predictions of periodontitis.

Construction of a caries diagnosis model based on microbiome novelty score / 华西口腔医学杂志

OBJECTIVES@#This study aimed to analyze the bacteria in dental caries and establish an optimized dental-ca-ries diagnosis model based on 16S ribosomal RNA (rRNA) data of oral flora.@*METHODS@#We searched the public databa-ses of microbiomes including NCBI, MG-RAST, EMBL-EBI, and QIITA and collected data involved in the relevant research on human oral microbiomes worldwide. The samples in the caries dataset (1 703) were compared with healthy ones (20 540) by using the microbial search engine (MSE) to obtain the microbiome novelty score (MNS) and construct a caries diagnosis model based on this index. Nonparametric multivariate ANOVA was used to analyze and compare the impact of different host factors on the oral flora MNS, and the model was optimized by controlling related factors. Finally, the effect of the model was evaluated by receiver operating characteristic (ROC) curve analysis.@*RESULTS@#1) The oral microbiota distribution obviously differed among people with various oral-health statuses, and the species richness and species diversity index decreased. 2) ROC curve was used to evaluate the caries data set, and the area under ROC curve was AUC=0.67. 3) Among the five hosts' factors including caries status, country, age, decayed missing filled tooth (DMFT) indices, and sampling site displayed the strongest effect on MNS of samples (P=0.001). 4) The AUC of the model was 0.87, 0.74, 0.74, and 0.75 in high caries, medium caries, low caries samples in Chinese children, and mixed dental plaque samples after controlling host factors, respectively.@*CONCLUSIONS@#The model based on the analysis of 16S rRNA data of oral flora had good diagnostic efficiency.

Expert consensus on early childhood caries management / 国际口腔科学杂志·英文版

Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.

Índice CPOD y ceo-d en niños de 5 a 8 años de una escuela en una localidad de Ecuador / CPOD and ceo-d index in children between 5 and 8 years old from a school in a locality in Ecuador

Las enfermedades orales son las más comunes de las enfermedades crónicas y uno de los problemas más importantes de salud pública debido a su prevalencia, su impacto en los individuos y la sociedad y el costo de su tratamiento. En el caso de los niños este efecto se multiplica por las consecuencias que se derivan para la edad adulta. El objetivo de este estudio fue estimar los índices ceo-d en niños escolares de 5 a 8 años en la Unidad Educativa "Alejandro Dávalos Calle", Ecuador. Para ello, bajo una investigación exploratoria, descriptiva, no experimental, de campo y de corte transversal. Se seleccionó como población los niños entre 5 y 8 años de edad en el periodo académico 2017-2018; la muestra estuvo conformada por 96 niños de ambos sexos, previo a consentimiento informado y cumpliendo las normas de bioéticas. Se realizaron revisión de historia clínica de los infantes y se les aplico encuestas validadas por expertos, a estudiantes, representantes y docentes. Se obtuvo prevalencia a caries en el 100% de los niños, 47% con dientes obturados y 64% perdieron piezas dentales, no se encontró evidencia estadísticamente significativa entre la presencia de caries y el sexo. El CEOD moderado, identificándose como factores de riesgos el desconocimiento de las medidas higiénicas bucal, baja frecuencia en la revisión odontológica y una dieta altamente cariogénica en estos niños. Se recomienda diseñar campañas educativas integrales que oriente a buenas prácticas de higiene bucal con el objetivo de prevenir y minimizar el número de personas afectadas por este mal(AU)

Oral diseases are the most common of the chronic diseases and one of the most important public health problems due to their prevalence, their impact on individuals and society, and the cost of their treatment. In the case of children, this effect is multiplied by the consequences that are derived for adulthood. The objective of this study was to estimate the ceo-d indices in school children aged 5 to 8 years at the "Alejandro Dávalos Calle" Educational Unit, Ecuador. For this, under an exploratory, descriptive, non-experimental, field and cross-sectional investigation. Children between 5 and 8 years of age in the academic period 2017-2018 were selected as the population; The sample consisted of 96 children of both sexes, prior to informed consent and complying with bioethical norms. The infants' clinical history was reviewed and surveys validated by experts, students, representatives, and teachers were applied. Caries prevalence was obtained in 100% of the children, 47% with filled teeth and 64% lost teeth, no statistically significant evidence was found between the presence of caries and sex. The CEOD is high, identifying as risk factors the ignorance of oral hygiene measures, low frequency in dental check-ups and a highly cariogenic diet in these children. It is recommended to design comprehensive educational campaigns that guide good oral hygiene practices in order to prevent and minimize the number of people affected by this disease(AU)

Polymorphisms in DSSP (rs36094464) and RUNX2 (rs566712) genes contribute to the susceptibility of dental caries in childhood / Los polimorfismos en los genes DSSP (rs36094464) y RUNX2 (rs566712) contribuyen a la susceptibilidad de la caries dental en la infancia

SUMMARY: Dental caries corresponds to an ecological and non-contagious, dynamic and chronic disease of multifactorial origin; currently there is evidence of how genetic factors could be included as predisposing agents to suffer it, however this evidence is diverse and incipient. a cross-sectional study was p erformed to investigate the possible associations of DSPP (rs36094464), RUNX2 (rs566712) and KLK4 (rs198968) polymorphisms in early childhood caries. Saliva samples of children (2-11years old) were collected and genotyped for DSPP (rs36094464), RUNX2 (rs566712) and KLK4 (rs198968) polymorphisms. Through the ceft index their caries history was determined and the gene variants were students through molecular biology techniques. polymorphisms of the DSSP (rs36094464) and RUNX2 (rs566712) are associated and contribute to the susceptibility of dental caries disease in early childhood, as they are related to their history of caries. KLK4 (rs198968) polymorphisms are not associated. In conclusions, the studied polymorphisms on DSSP and RUNX2 genes are associated with changes in the tooth microarchitecture, favoring the appearance of microlesions that would contribute to dental caries disease susceptibility in early childhood. Also, no association was found for the studied polymorphism of the KLK4 gene with dental caries disease susceptibility.

RESUMEN: La caries dental corresponde a una enfermedad crónica, no contagiosa, dinámica y de origen multifactorial. Actualmente existe evidencia de cómo los factores genéticos podrían incluirse como agentes predisponentes, sin embargo, esta evidencia es diversa e incipiente. Se realizó un estudio transversal para investigar las posibles asociaciones entre los polimorfismos DSPP (rs36094464), RUNX2 (rs566712) y KLK4 (rs198968) y la caries en la infancia. Se colectaron muestras de saliva de niños (de 2 a 11 años de edad) y se genotipificaron para los polimorfismos DSPP (rs36094464), RUNX2 (rs566712) y KLK4 (rs198968). Mediante el índice ceft se determinó su historial de caries y se estudiaron las variantes genéticas mediante técnicas de biología molecular. Los datos obtenidos indican que los polimorfismos del DSSP (rs36094464) y RUNX2 (rs566712) están asociados y contribuyen a la susceptibilidad de la enfermedad de caries dental en la infancia, ya que están - además - relacionados con el historial de caries. En conclusión, los polimorfismos estudiados en los genes DSSP y RUNX2 se asocian a la aparición de microlesiones que contribuirían a la susceptibilidad a la enfermedad de caries dental en la infancia. Creemos que este estudio es importante para la odontopediatría porque destaca el papel de DSSP (rs36094464) y RUNX2 (rs566712) y la susceptibilidad a la caries dental durante la infancia, además resalta la utilidad de la evaluación genética para la predicción y prevención de la caries dental y porque aporta evidencia que indica que los factores genéticos están implicados en la etiología de la caries.

Do untreated caries influence the school leaving of adolescents? A cohort study

Abstract The objective was assess the influence of untreated caries and socioeconomic status (SES) on school dropout among adolescents. A six-year cohort study was conducted with random sample of adolescents (12 years-old) who had been evaluated initially in 2012 from Santa Maria, Brazil. Sex, socioeconomic status (mother's education and household income), and untreated caries were collected at the baseline. The outcome variable was collected at the follow-up through self-report and was divided into three categories: adolescents who only studied, who studied and employed, and who school dropouts. A multinomial regression model was performed to assess the influence of oral disease and SES on school leaving, through relative risk ratio (RRR) and 95% confidence interval (95% CI). From of 1,134 adolescents evaluated at the baseline, 768 participants with a mean age of 17.5 years were re-evaluated at follow-up (67.8% response rate). Male (RRR: 2.31; 95%CI: 1.19-4.48) and adolescents with untreated caries at the baseline had an increment in school-leaving (RRR: 2.26; 95%CI: 1.12-4.56). Mothers with low education (RRR: 2.24; 95%CI: 1.09-4.61) had a higher probability of having children who leave school. Untreated caries and low SES in early adolescence can influence the tendency to school dropouts.

Resumo O objetivo foi avaliar a influência da cárie dentária não tratada e do status socioeconômico (SES) sobre o abandono escolar dos adolescentes. Foi realizado um estudo de coorte de seis anos de acompanhamento com uma amostra aleatória de adolescentes (12 anos de idade) avaliados inicialmente em 2012 em Santa Maria, Brasil. Sexo, status socioeconômico (educação da mãe e renda familiar) e cárie não tratada foram coletados no início do estudo. A variável de desfecho foi coletada no acompanhamento por meio do autorrelato e foi dividida em três categorias: adolescentes que apenas estudavam, aqueles que estudavam e trabalhavam e quem tinha abandonado a escola. Um modelo de regressão multinomial foi realizado para avaliar a influência da doença bucal e do SES sobre o abandono escolar, por meio da razão de risco relativo (RRR) e intervalo de confiança de 95% (IC95%). Dos 1.134 adolescentes avaliados no início do estudo, 768 participantes com idade média de 17,5 anos foram reavaliados no acompanhamento (taxa de resposta de 67,8%). Meninos (RRR: 2,31; IC 95%: 1,19- 4,48) e adolescentes com cárie não tratada no início do estudo tiveram um incremento no abandono escolar (RRR: 2,26; IC 95%: 1,12-4,56). Mães com baixa escolaridade (RRR: 2,24; IC95%: 1,09-4,61) tiveram maior probabilidade de ter filhos que abandonaram a escola. Cárie dentária não tratada e baixo SES no início da adolescência pode influenciar a tendência de evasão escolar.

Community interventions and strategies for caries control in Latin American and Caribbean countries

Abstract Dental caries remains highly prevalent in Latin American and Caribbean countries (LACC). However, this disease can be controlled through interventions that implement evidence-based strategies in an affordable manner and that target all population groups instead of the most affluent only. Therefore, the aim of this report was to summarize the main scientifically documented community interventions and strategies based on restriction of sugars consumption, use of fluoride, and the use of occlusal sealants for caries control in LACC. A critical literature review was carried out in a systematic manner that included defined search strategies, independent review of the identified publications, and compilation of results in this report. Three systematic searches were conducted using the PubMed, LILACS, and SciELO databases to identify studies related to community interventions and strategies for caries control in LACC. Of the 37 publications identified, twenty-six focused on fluoride use, eight on occlusal sealant use, and three on the restriction of sugar consumption. Documented community interventions for sugars restriction were scarce in the region and were based on food supplementation, sugar replacement, and education. Thus, local and/or national policies should prioritize investment in upstream, coherent, and integrated population-wide policies such as taxes on sugary drinks and stronger regulation of advertising and promotion of sugary foods and drinks mainly targeting children. The main fluoride-based strategies used drinking water, refined domestic salt, cow milk, toothpaste and, to a lesser extent, mouth-rinses, acidulated phosphate fluoride (APF) gels, and varnishes to deliver fluoride to the population. Evidence of fluoride use was seen in Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Haiti, Honduras, Mexico, Nicaragua, Panama, Paraguay, Peru, Uruguay, and Venezuela. Studies reporting the use of occlusal sealants were mainly located in Brazil, Chile, Colombia, Costa Rica, Peru, Mexico, and Venezuela. Community interventions restricting sugar consumption should be implemented at the individual level and through public policies. The use of fluoride must be monitored at the local, regional, and national levels so as to achieve maximum anti-caries effect while also minimizing the risk of dental fluorosis. Moreover, fluoridated water and salt programs, used as a mutually exclusive community level strategy for caries control, should expand their benefits to reach non-covered areas of the LACC while also simultaneously providing adequate surveillance of the fluoride concentration delivered to the population. Regulating the concentration of soluble fluoride (for anti-caries effect) in dentifrice formulations is also necessary in order to provide the population with an effective strategy for disease control. Targeting culturally appropriate, economically sustainable caries control interventions to rural populations and native ethnic groups such as indigenous people, quilombolas (African-origin), and riverside Amazonian people remains a crucial challenge.

Timing of sugar introduction in diet and early childhood caries: a population-based study in preschoolers / Momento de introdução de açúcar na dieta e cárie na primeira infância: um estudo de base populacional em pré-escolares

Abstract Introduction Sugar ingestion is the most important isolated factor related to dental caries. Contact with sugary foods at an early age may represent a risk to the oral health of preschool children. Objective To evaluate the timing of the introduction of sugar in the diet of preschoolers and its association with early childhood caries. Material and method Cross-sectional population-based study with 888 five-year-old preschoolers from public and private schools. Parents answered a questionnaire on sociodemographic data, eating habits and oral health. The variables timing of sugar introduction (>1 year and ≤1 year) and dental caries experience were dichotomized and data were analyzed using descriptive statistics and Poisson regression (p<0.05). Result The introduction of sugar in the diet occurred during the first twelve months of life for 73.8% of preschoolers. There was no association between the timing of sugar introduction and early childhood caries (p>0.05). The interruption of exclusive breastfeeding and low family income increased the prevalence of preschoolers having early contact with sugar by 32% and 23%, respectively (p<0.05). The prevalence of early childhood caries was 42.3% and was associated with a lower level of maternal education, low income, increased frequency of ingestion of candy and the use of nonfluoridated toothpaste (p<0.05). Conclusion The introduction of sugar in the diet occurred during the first year of life in most preschoolers and there was no association with early childhood caries.

Resumo Introdução A ingestão de açúcar é um importante fator relacionado à cárie dentária. O contato com alimentos açucarados em idade precoce pode representar risco para a saúde bucal de crianças em idade pré-escolar. Objetivo Avaliar o momento de introdução do açúcar na dieta de pré-escolares e sua associação com a cárie na primeira infância. Material e método Estudo transversal de base populacional com 888 pré-escolares de cinco anos de escolas públicas e privadas. Os pais responderam questionário sobre dados sociodemográficos, hábitos alimentares e saúde bucal. As variáveis ​​tempo de introdução do açúcar (> 1 ano e ≤1 ano) e experiência de cárie dentária foram dicotomizadas e os dados foram analisados ​​por meio de estatística descritiva e regressão de Poisson (p <0,05). Resultado A introdução do açúcar na dieta ocorreu nos primeiros doze meses de vida para 73,8% dos pré-escolares. Não houve associação entre o momento de introdução do açúcar e a cárie na primeira infância (p> 0,05). A interrupção do aleitamento materno exclusivo e a baixa renda familiar aumentaram a prevalência de pré-escolares com contato precoce com açúcar em 32% e 23%, respectivamente (p <0,05). A prevalência de cárie na primeira infância foi de 42,3% e esteve associada à menor escolaridade materna, baixa renda, maior frequência de ingestão de doces e uso de dentifrício não fluoretado (p <0,05). Conclusão A introdução de açúcar na dieta ocorreu durante o primeiro ano de vida na maioria dos pré-escolares e não houve associação com cárie na primeira infância.

Contributions of school context to caries on anterior teeth: a multilevel analysis

ABSTRACT OBJECTIVE To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents. METHODS A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05). RESULTS The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24-2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13-1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05-3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07-1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78-3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05-0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98-0.99) were associated with the outcome. CONCLUSIONS Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19.

Evaluation of caries risk reduction following preventive programs in orthodontic patients, using Cariogram computer model: A quasi-experimental trial

ABSTRACT Objective: This study evaluated the effectiveness of preventive strategies on caries risk reduction in patients undergoing orthodontic treatment, using the Cariogram program. Methods: In this quasi-experimental study, samples were selected using a convenience quota sampling technique, in a public dental school. At first, caries risk profile was determined for each subject using the Cariogram before brackets bonding. The sample size consisted of 36 patients. The intervention group (n = 18) received preventive programs, and the control group (n = 18) was trained based on the routine oral health education by means of pamphlets. Then, Cariogram parameters were calculated for patients in both groups after six months. Results: The age range of participants was from 12 to 29 years. The mean percentage of the "Actual chance of avoiding new cavities" section in the intervention group increased from 45.72 ± 21.64 to 62.50 ± 17.64. However, the mean percentage of other parameters - such as "Diet", "Bacteria" and "Susceptibility" - decreased after six months (p< 0.001). Besides, the differences in the mean percentage between intervention and control group at the end of the study period (T1) related to the Cariogram parameters were statistically significant (p< 0.001). Accordingly, the mean percentage of 'Actual chance of avoiding new cavities'' parameter in the intervention group (62.50) was statistically higher than in the control group (42.44) (p< 0.001). Conclusion: Implementing different preventive approaches is able to reduce the caries risk in patients undergoing fixed orthodontic treatment, which can be clearly demonstrated using Cariogram program.

RESUMO Objetivo: O presente estudo usou o software Cariogram para avaliar a eficácia de estratégias preventivas para redução do risco de cáries em pacientes sob tratamento ortodôntico. Métodos: Nesse estudo quase-experimental, as amostras foram selecionadas por meio de uma técnica de amostragem por cota de conveniência, em uma faculdade pública de Odontologia. Inicialmente, o perfil de risco de cárie foi determinado para cada indivíduo usando o Cariogram antes da colagem dos braquetes. A amostra consistiu de 36 pacientes: o grupo experimental (n = 18) recebeu programas preventivos, e o grupo controle (n = 18) recebeu orientações sobre a saúde bucal por meio de folhetos. Após seis meses, os parâmetros obtidos por meio do Cariogram foram calculados novamente para os pacientes de ambos os grupos. Resultados: A faixa etária dos participantes foi de 12 a 29 anos. A porcentagem média da seção "Probabilidade real de prevenir novas cáries" no grupo experimental aumentou de 45,72 ± 21,64 para 62,50 ± 17,64. Por outro lado, a porcentagem média de outros parâmetros - como "Dieta", "Bactérias" e "Suscetibilidade" - diminuiu após seis meses (p< 0,001). Além disso, as diferenças nas porcentagens médias entre o grupo experimental e o grupo controle ao fim do estudo (T1), relacionadas aos parâmetros do Cariogram, foram estatisticamente significativas (p< 0,001). Assim, a porcentagem média do parâmetro "Probabilidade real de prevenir novas cáries" no grupo experimental (62,50) foi estatisticamente maior do que no grupo controle (42,44) (p< 0,001). Conclusão: A implementação de diferentes abordagens preventivas pode reduzir o risco de cárie em pacientes sob tratamento ortodôntico com aparelhos fixos, o que pode ser observado claramente por meio do software Cariogram.

Dental pain prevalence associated with caries experience in pediatric patients in a clinical sample in Mexico

Abstract The aim of this study was to identify if the prevalence of dental pain (past and / or present) is associated with caries experience in Mexican children, as well as to characterize factors associated with dental pain. A cross-sectional study was conducted in a consecutive sample of 309 children 2 to 12 years old who were patients at a dental school clinic in Toluca, Mexico. Data were collected from clinical records. The dependent variable had three categories: 0 = have never had dental pain, 1 = had dental pain before the appointment, and 2 = current dental pain. Non-parametric statistical tests were used in the analysis. A multivariate multinomial logistic regression model was generated in Stata 11.0. Average age was 5.71 ± 2.43 years and 50.8% were boys. The joint dmft+DMFT index was 9.11 ± 4.19. It was observed that 56.6% of children did not report having experienced dental pain, 30.7% reported having previously had dental pain, and 12.6% had pain when the clinical appointment took place. In the multivariate model, variables associated (p < .05) with previous dental pain were age (OR = 1.13); the dmft + DMFT index (OR = 1.13), having had a last dental visit for curative/emergency reasons (OR = 2.41) and prior experience of dental trauma (OR = 2.59). For current pain, only the joint dmft + DMFT index (OR = 1.10, p < 0.05) had significant associations. Almost half of the children had experienced dental pain in their lifetime. Since caries experience is a factor associated with dental pain, decreasing caries levels may ameliorate suffering from dental pain in children.

Socioeconomic and intraoral polarization of untreated caries and tooth loss among male adolescents

Abstract The aim of this study was to investigate the intraoral distribution of untreated caries and tooth loss and estimate the impact of different socioeconomic factors on the occurrence of these outcomes. A cross-sectional study was conducted with 652 18-year-old male adolescents from the city of Sapucaia do Sul, Brazil, who conscripted for military service. The participants answered a questionnaire addressing sociodemographic variables. Two trained and calibrated examiners performed the clinical examinations for the diagnosis of dental caries using the criteria of the World Health Organization. Tooth group and adolescent were the units of analysis for the primary outcomes of the study. Poisson regression analysis with robust variance was performed, with the calculation of crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). The prevalence of caries experience and untreated caries was 70.2% and 39.3%, respectively, and 9.4% of the adolescents had missing teeth. Sixty-seven percent of the untreated caries and 98.8% of missing teeth were in first molars. The probability of dental caries and tooth loss was significantly higher among adolescents with less schooling (PR = 2.56; 95%CI: 1.97-3.32 and PR = 3.28; 95%CI: 1.61-6.65, respectively) and those whose mothers had less schooling (PR = 1.31; 95%CI: 1.03-1.67 and PR = 2.30; 95%CI: 1.18-4.50, respectively). In conclusion, the occurrence of untreated dental caries and tooth loss was concentrated in the first molars of adolescents. Moreover, the prevalence of both conditions was higher among adolescents with low schooling and whose mothers had low schooling, reflecting the strong intraoral and socioeconomic polarization of these outcomes.

Influence of caries activity and number of saliva donors: mineral and microbiological responses in a microcosm biofilm model

Abstract Objective this study evaluated the mineral and microbiological response of biofilms originating from different types of saliva inoculum with distinct levels of caries activity. Methodology the biofilms grown over enamel specimens originated from saliva collected from a single donor or five donors with two distinct levels of caries activity (caries-active and caries-free) or from pooling saliva from ten donors (five caries-active and five caries-free). The percentage surface hardness change (%SHC) and microbiological counts served as outcome variables. Results the caries activity of donors did not affect the %SHC values. Inoculum from five donors compared to a single donor showed higher %SHC values (p=0.019). Higher lactobacilli counts were observed when saliva from caries-active donors was used as the inoculum (p=0.017). Pooled saliva from both caries activity levels showed higher mutans streptococci counts (p<0.017). Conclusion Overall, pooled saliva increased the mineral response of the derived biofilms, but all the inoculum conditions formed cariogenic biofilms and caries lesions independently of caries activity.

Salivary biochemical indices related to early childhood caries / 华西口腔医学杂志

OBJECTIVES@#This study aimed to compare the salivary biochemical indices between caries-free individuals and those with early childhood caries (ECC), and construct a saliva-based caries diagnostic model by analyzing the correlation between salivary biochemical indices and caries severity.@*METHODS@#A total of 120 children aged 4-6 years were selected and divided into two groups: individuals with ECC (C group, @*RESULTS@#The NO@*CONCLUSIONS@#Salivary biochemical indices can contribute to the diagnosis and risk assessment of ECC.

Analysis of dental caries and the impact factors of caries in children aged 3-5 years old in Changdu, Xizang / 华西口腔医学杂志

OBJECTIVES@#To investigate caries status and its impact factors in preschool children in plateau and to provide reference for caries prevention in highlands.@*METHODS@#Examination of caries was performed on 1 597 children aged 3-5 years old in 11 kindergartens in Changdu, Xizang, in accordance with the 4th National Oral Health Survey standards and methods. Their parents were surveyed with the questionnaire regarding oral hygiene habit and consciousness about oral health and related factors. All the data were collected and analyzed.@*RESULTS@#The prevalence of caries among children aged 3-5 years old in Changdu was 52.85%, with dmft index of 2.44. The caries rate and dmft of children aged 3 years old were lower than those of children aged 4 and 5 years old (@*CONCLUSIONS@#The prevalence of ca-ries in children aged 3-5 years old in Changdu increases with aging. Good oral hygiene and eating habits and regular oral examination can reduce the rate of caries.

Guideline on caries prevention and clinical practice for children under three years of age / 中华口腔医学杂志

Caries of children under 3 years old has such characteristics as early onset, multiple tooth involvement and rapid development. It may affect the mastication and digestive functions of the children, as well as oral and systemic development, and may become a risk factor for systemic diseases. In order to standardize the prevention and treatment of the caries of the infants and toddlers, to fully utilize the existing medical resources to prevent caries, to reduce the incidence rate and to increase the treatment rate, and to improve the oral health statuses of the infants and toddlers in China, the Society of Pediatric Dentistry and the Society of Preventive Dentistry of the Chinese Stomatological Association convened experts of pediatric dentistry and preventive dentistry from 19 universities and hospitals to conduct profound discussions on this topic, and finally developed the present guideline on diagnosis, prevention, clinical practice and effect evaluation for caries of children under 3 years old suitable to China's conditions.

Evaluation of therapeutic effect and health economics of general anesthesia and routine outpatient dental treatment in children with severe early child caries / 华西口腔医学杂志

OBJECTIVES@#To evaluate the efficacy and health economics of the comprehensive therapy for the children with severe early child caries (S-ECC) under dental general anesthesia (DGA) and conventional outpatient treatment to provide references for dentists and parents in the choice of clinical treatment.@*METHODS@#A retrospective cohort study was conducted on S-ECC children aged 36-71 months and who received dental treatment under general anesthesia or routine outpatient situation. The filled tooth survival rate, treatment cost, and cost-filled tooth survival time of the two groups were compared, and the curative effect and health economics was evaluated.@*RESULTS@#The filled tooth survival rate of the DGA group was higher than that of the routine outpatient group (@*CONCLUSIONS@#Compared with the conventional outpatient treatment group, the treatment outcomes of S-ECC under general anesthesia were better, and the costs were higher. However, no significant difference was observed in the total medical cost-filled tooth survival time between these two groups, and the conventional outpatient treatment did not have evident economic advantages.

Iron deficiency and early childhood caries: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUNDS@#Previous surveys have found that children with iron deficiency (ID) were likely to suffer from early childhood caries (ECC). We aimed to assess the scientific evidence about whether ID is intrinsically related to ECC.@*METHODS@#The medical subject headings (MeSH) terms and free words were searched on PubMed, Web of Science, Cochrane, China National Knowledge Infrastructure, Wanfang, and the Database for Chinese Technical Periodicals from March 2020 to September 2020. Two researchers independently screened the articles. Data extraction and cross-checking were performed for the studies that met the inclusion criteria. Meta-analysis was performed using the Cochrane Collaboration's Review Manager 5.3 software.@*RESULTS@#After excluding duplication and irrelevant literature, 12 case-control studies were included in the study. The meta-analysis demonstrated that children with ECC were more likely to have ID (odds ratio [OR] = 2.63, 95% confidence interval [CI]: [1.85, 3.73], P < 0.001). There was no statistically significant association found between the level of serum ferritin and ECC (weighted mean difference (WMD) = -5.80, 95% CI: [-11.97, 0.37], P = 0.07). Children with ECC were more likely to have iron-deficiency anemia (OR = 2.74, 95% CI: [2.41,3.11], P < 0.001). The hemoglobin (HGB) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -9.96, 95% CI: [-15.45, -4.46], P = 0.0004). The mean corpuscular volume (MCV) levels in the ECC group were significantly lower compared with that in the ECC-free group (WMD = -3.72, 95% CI: [-6.65, -0.79], P = 0.01).@*CONCLUSIONS@#ID was more prevalent in children with ECC, and the markers of iron status in the ECC group, such as serum ferritin, HGB, and MCV, were relatively lower than the ECC-free group.

Especificidad y Sensibilidad de Sistema ICDAS TM versus Índice COPD en la Detección de Caries / Specificity and Sensitivity of the ICDAS TM System versus the DMFT Index in Caries Detection

RESUMEN: La caries dental no tratada es la enfermedad crónica más frecuente en adultos y la caries no tratada en dientes temporales es la décima enfermedad crónica más frecuente. En Chile los adultos presentan un COPD promedio entre 3,76 - 22,16, pero los estudios no son en población representativa y no existen estudios comparativos entre ceod/ COPD e ICDASTM. A nivel mundial, su prevalencia puede alcanzar el 100 % de la población estudiada. Se buscará evaluar si existen diferencias en la sensibilidad y especificidad en la detección de caries utilizando ICDASTM y ceod/COPD. Se realizó una revisión sistemática cualitativa realizando una búsqueda sobre los índices de caries ceod/COPD y sistema ICDASTM, tanto en Chile como a nivel mundial, en las bases de datos Medline, ClinicalKey y SciELO encontrando 3.581, de ellos, 21 se leyeron por completo y 14 cumplieron nuestros criterios. La sensibilidad y especificidad es mayor con ICDASTM que con el índice ceod/COPD y entrega hasta un 43 % más información al detectar lesiones no cavitadas, pero necesita de mayor tiempo para su realización y más recursos al utilizar luz, aire comprimido y una profilaxis previa al examen. Capacitaciones previas, conocimientos y experiencia en ICDASTM son fundamentales para el mejor resultado, estudios demostraron que mientras mayor experiencia, la sensibilidad y especificidad aumentaba a diferencia del índice ceod/COPD. Se deben realizar más estudios comparativos entre ambos índices e incluir ICDASTM en niños por su capacidad de detectar lesiones no cavitadas las cuales son las más prevalentes en dientes temporales.

ABSTRACT: Untreated dental caries is the most frequent chronic disease in adults and untreated caries in primary teeth is the tenth most frequent chronic disease. In Chile, adults have an average DMFT between 3.76-22.16, but the studies are not in a representative population and there are no comparative studies between dmft/DMFT and ICDASTM. Worldwide, its prevalence can reach 100 % of the population studied. The objective of the study was to evaluate if there are differences in the sensitivity and specificity in the detection of caries using ICDASTM and dmft/DMFT. A qualitative systematic review was done, carrying out a search on the dmft/DMFT index and the ICDASTM system, both in Chile and worldwide, in the Medline, ClinicalKey and SciELO databases, finding 3,581, of which, 21 were read completely and 14 met the inclusion and exclusion criteria. The sensitivity and specificity is greater with ICDASTM than with the dmft/DMFT index and delivers up to 43 % more information when detecting non-cavitated lesions, but it needs more time for its realization and more resources because it needs to use light, compressed air and prophylaxis before the examination. Previous training, knowledge and experience in ICDASTM are fundamental for the best results. Studies showed that the greater the experience, the sensitivity and specificity increased, unlike the dmft/DMFT index. More comparative studies should be conducted between both indexes and include ICDASTM in children for their ability to detect non-cavitated lesions, which are the most prevalent in temporary teeth.