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1.
Clin Oral Investig ; 28(6): 350, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38822893

RESUMEN

OBJECTIVES: The study continues our longitudinal observation of wear aiming to further monitoring of progression and lesion morphology and to identify relationships with assumed aetiological factors. MATERIALS AND METHODS: Molars (FDI #36 or #46) of 74 participants (23.8 ± 2.2 years) were scanned (Trios 3, 3Shape) at the third follow-up (T3; observation period 1,111 ± 10 days). Data sets from T3, T2 (24-month follow-up) and T1 (12-month follow-up) were superimposed with baseline in a 3D analysis software (GOM Inspect). Wear was quantified as maximum vertical tissue loss (µm; median, 95% CI) in various occlusal areas (4/5 cusps and 2 ridges). Morphologies were classified into cupping (C), facet (F), and combined cupping-facet (CF). Aetiological factors were assessed with questionnaires. RESULTS: Wear increased at T3 significantly at low rates in all areas of the occlusal surface (median between 7.0 (4.0;10.5) and 9.5 (6.0;15.0) µm). There was a clear trend for higher loss values in males, but no association with other factors such as nutrition. C and CF showed significantly higher loss values than F. Areas without initial wear developed F first, which either persisted or developed into C and CF. CONCLUSIONS: Wear continued at low rates with C/CF morphology and sex as significant factors. Cupped lesions seem to develop from facets and thus may not be a valid diagnostic criterion for erosive tooth wear. CLINICAL RELEVANCE: Wear is a cumulative process that apparently follows complex mechanisms that cannot be conceptualized in simplified terms; C and CF may be indicators for higher progression rates.


Asunto(s)
Desgaste de los Dientes , Humanos , Masculino , Femenino , Estudios Longitudinales , Adulto Joven , Imagenología Tridimensional/métodos , Diente Molar/patología , Adulto , Encuestas y Cuestionarios
2.
Clin Oral Investig ; 28(7): 367, 2024 Jun 11.
Artículo en Inglés | MEDLINE | ID: mdl-38861170

RESUMEN

OBJECTIVES: Fixed orthodontic appliances may increase the risk for caries and white spot lesions. The aim of this retrospective study was to determine the long-term associations between both in orthodontic patients. MATERIALS AND METHODS: 103 patients aged 36.6 ± 6.5 years whose fixed appliance orthodontic treatment had finished at least 15 years ago were included. Current clinical data and photographs (T3), panoramic x-ray and photographs from before treatment (T0), after debonding (T1) and at 2-year follow-up (T2) were available. Parameters of interest were dentine caries, "Missing/Filled Teeth" (MFT), "White Spot Lesion" (WSL) index and "Periodontal Screening and Recording" index (PSR; T3 only). RESULTS: At T0, 30.4% had no caries experience decreasing to 25.6%, 22.4% and 6.8% at T1, T2 and T3 resp. The median MFT (95% CI) at T0, T1, T2 and T3 was 2 (1;3), 3 (2;4), 3 (2;4) and 7 (6;9) resp. increasing significantly at each time point (p < 0.001 each); 30.1% had WSL at debonding. Patients with caries experience at T0 had a 2.4-fold increased risk of WSL at debonding. Dentine caries, caries experience and WSL at T1 were significantly associated with incident caries at T2, but not at T3. PSR at T3 had a significant association with previous caries incidence and WSL. CONCLUSIONS: Caries experience prior to orthodontic treatment may constitute a risk indicator for WSL, and caries experience and WSL at its end for caries incidence in the near term. CLINICAL RELEVANCE: Present caries and WSL may help identifying orthodontic patients with special need for prevention and counselling.


Asunto(s)
Caries Dental , Radiografía Panorámica , Humanos , Caries Dental/epidemiología , Estudios Retrospectivos , Masculino , Femenino , Adulto , Factores de Riesgo , Aparatos Ortodóncicos Fijos/efectos adversos , Índice CPO
3.
Eur J Orthod ; 46(1)2024 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-38128566

RESUMEN

OBJECTIVE: To investigate the extent to which post-orthodontic white spot lesions (WSLs) change in appearance over a period of ≥15 years and whether an association with caries data exists. SUBJECTS AND METHODS: Seventy-two patients treated with a Herbst-Multibracket appliance at age 14.0 ± 2.7 years for 20.1 ± 5.1 months who attended a recall 18.3 ± 2.9 years post-treatment. Post-treatment (T1) intraoral photographs were assessed by a panel of five dentists using a modified version of the WSL-Index by Gorelick. For affected incisors, photographs from before treatment (T0) and recall (T3) were evaluated. In addition, the WSL-Change Index by Pancherz and Muehlich was assessed for all adequately visible incisors considering T1, T2 (if available), and T3. Radiographic (T0, T1, and T2-if available) and clinical (T3) MFT data were used. RESULTS: 37.5% of the patients exhibited WSLs on ≥ 1 incisor at T1; in total, 81 incisors (14.9%) were affected. At T3, 48% of the WSLs had improved. The modified WSL-Index decreased from 1.2 ± 0.4 to 0.8 ± 0.6 (P < .001), with a score 0 in 28% of the previously affected incisors. When comparing T2 vs. T3, additional improvement after T2 occurred in 11% of the teeth. While no difference existed at T0, the MFT values at T1, T2, and T3 were higher (P ≤ .05) in patients with WSLs at T1 than in those without. LIMITATIONS: The homogeneity of the subjects was limited and no patient-reported outcome was assessed. CONCLUSIONS: Long-term, post-orthodontic WSLs showed spontaneous full recovery in 28% and improvement in 48% of the teeth. Patients affected with WSLs exhibited higher post-treatment MFT values.


Asunto(s)
Caries Dental , Soportes Ortodóncicos , Humanos , Niño , Adolescente , Caries Dental/diagnóstico por imagen , Caries Dental/terapia , Caries Dental/etiología , Aparatos Ortodóncicos Fijos , Soportes Ortodóncicos/efectos adversos
4.
J Evid Based Dent Pract ; 24(1S): 101946, 2024 01.
Artículo en Inglés | MEDLINE | ID: mdl-38401951

RESUMEN

Over the past 50 years, digitization has gradually taken root in dentistry, starting with computer tomography in the 1970s. The most disruptive events in digital dentistry were the introduction of digital workflow and computer-aided manufacturing, which made new procedures and materials available for dental use. While the conventional lab-based workflow requires light or chemical curing under inconsistent and suboptimal conditions, computer-aided manufacturing allows for industrial-grade material, ensuring consistently high material quality. In addition, many other innovative, less disruptive, but relevant approaches have been developed in digital dentistry. These will have or already impact prevention, diagnosis, and therapy, thus impacting patients' oral health and, consequently, their oral health-related quality of life. Both software and hardware approaches attempt to maintain, restore, or optimize a patient's perceived oral health. This article outlines innovations in dentistry and their potential impact on patients' oral health-related quality of life in prevention and therapy. Furthermore, possible future developments and their potential implications are characterized.


Asunto(s)
Diseño de Prótesis Dental , Calidad de Vida , Humanos , Diseño de Prótesis Dental/métodos , Diseño Asistido por Computadora
5.
Clin Oral Investig ; 27(6): 2775-2785, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36625960

RESUMEN

OBJECTIVES: Tooth wear causes irreversible cumulated surface loss and already occurs at a young age. Therefore, the objective of this clinical prospective observational study was to monitor the occlusal surface of a mandibular first molar in young adults for a period of 24 months. Furthermore, potential aetiological factors obtained by a questionnaire were considered. MATERIALS AND METHODS: The study teeth (FDI #36 or #46) of 81 participants (mean age 22.8 ± 2.2 years) were scanned with the intraoral scanner (IOS, Trios 3, 3Shape) at the second follow-up (T2) after an observation period of 24 months. Standard-tessellation-language datasets were superimposed with baseline (T0) and T2 scans in 3D analysis software (GOM Inspect). The maximum vertical substance loss was measured between T0 and T2 at 6/7 areas (4/5 cusps and 2 ridges) of each study tooth and data compared to the already published data of the first follow-up (T1) after 12-month observation period. The morphology of tooth wear was classified into three groups: cupping (C), facet (F) and combined cupping-facet (CF). The analysis of aetiological factors, such as acid impacts, was based on a questionnaire filled out by participants at time points T0, T1 and T2. Non-parametric tests were used for statistical analysis (p < 0.05). RESULTS: The buccal load-bearing cusps (mesiobuccal: median 15 µm, 95%CI 11/18 µm; mesiolingual 8 µm, 0/11 µm) were most affected by tooth wear. Loss values increased significantly at T2 compared to T1 for all areas, although significantly less than in the first 12 months (T0-T1). Areas that already exhibited F at T0 mostly displayed them also at T2 and only rarely developed further into C or CF. The only association between aetiological factors and loss values could be detected for sex as males had significantly higher loss values than females. CONCLUSIONS: Progression of tooth wear could be clearly shown with high interindividual variations in loss values among participants. This indicates the need for individual monitoring with IOS. CLINICAL RELEVANCE: IOSs show the potential for patient-specific monitoring to detect the progression of tooth wear. Thus, data of 24 months fills the gap of tooth wear data for young adults in literature. Further studies over a longer observation period are highly recommended to gain more information about the dynamic of tooth wear and aetiological factors.


Asunto(s)
Atrición Dental , Desgaste de los Dientes , Diente , Masculino , Femenino , Adulto Joven , Humanos , Adulto , Desgaste de los Dientes/diagnóstico por imagen , Desgaste de los Dientes/etiología , Diente Molar , Estudios Prospectivos
6.
Clin Oral Investig ; 26(2): 1869-1878, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34498100

RESUMEN

OBJECTIVES: To investigate tooth wear in young adults, intraoral scanning was used for digital monitoring of the mandibular first molar over 12 months. A possible influence of aetiological factors obtained by a questionnaire on tooth wear was investigated. MATERIALS AND METHODS: A total of 109 participants (mean age at the start of the study: 21.0 ± 2.2 years) were included in this clinical study. At baseline (T0), an intraoral scan (Trios 3, 3Shape) of the study tooth (FDI # 36 or #46) was conducted. After a mean observation period of 373 ± 19 days, a second intraoral scan (T1, n = 94) of the same tooth as at T0 was performed and standard tessellation language datasets were superimposed with 3D analysis software (GOM Inspect). The occlusal surface of the study tooth was divided into 7 areas (5 cusps, 2 ridges) and maximum vertical substance loss was measured between T0 and T1 (n = 91). Three types of tooth wear were defined: cupping (C), facet (F) and combined cupping-facet (CF). Furthermore, a questionnaire on aetiological factors, such as dietary behaviour, was filled out at T0. Data were analysed with non-parametric tests (p < 0.05). RESULTS: Only one study tooth exhibited no tooth wear at T0, whereas 3 teeth showed C, 47 teeth F and 40 teeth CF. A progression of vertical substance loss for all three types was shown. Most affected were the mesiobuccal cusps (43, 38/47 µm; median, 95%CI) followed by distobuccal (36, 33/39 µm), mesiolingual (35, 26/40 µm), distolingual (34, 27/36 µm) and distal (31, 25/34 µm). On mesial and distal ridges, only F was detected with the lowest vertical substance loss of all areas (mesial ridge: 0, 0/0 µm; distal ridge: 0, 0/0 µm). An association between aetiological factors and loss values could not be shown. CONCLUSIONS: All study teeth showed clear signs of wear, and after only 1 year, further substance loss was detectable. This result is of significance for young adults. CLINICAL RELEVANCE: Since data of young adults regarding tooth wear are scarce, the results give a first idea of the amount of vertical loss per year and its relation to aetiological factors such as dietary behaviour. Therefore, further studies over a longer observation period are highly recommended.


Asunto(s)
Atrición Dental , Desgaste de los Dientes , Humanos , Incisivo , Diente Molar , Desgaste de los Dientes/etiología , Adulto Joven
7.
Clin Oral Investig ; 26(3): 2909-2919, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35018500

RESUMEN

OBJECTIVES: To evaluate interdental biofilm reduction and composition after powered toothbrushing with a side-to-side (sonic) toothbrush compared to manual toothbrushing following single brushing exercises in periodontally healthy young adults. MATERIALS AND METHODS: All participants brushed with a side-to-side toothbrush without toothpaste in four different modes: toothbrush (a) inactivated without instruction (OFF-NI), (b) activated without instruction (ON-NI), (c) inactivated with instruction (OFF-I), and (d) activated with instruction (ON-I) at consecutive visits (single brushing exercises). Before and after brushing, the Approximal Plaque Index (API) was assessed at three interdental spaces and plaque samples were taken from two interdental sites. Biofilm reduction and composition were analyzed microbiologically by total bacterial load and 16S rRNA sequencing. RESULTS: Thirty participants (age: 22.9 ± 2.5 years) completed the study. Most participants showed no or incomplete plaque removal assessed by API following single brushing exercises, while the frequency of API reduction was higher after ON-NI compared to OFF-I (p = 0.023). Irrespective of the brushing mode, a significant reduction of total bacterial load was detected with lower bacterial counts after OFF-NI compared to ON-NI (p = 0.008) and ON-I (p = 0.007). Biofilm composition showed slight changes in the relative abundances of bacterial taxa, regardless of the brushing mode. CONCLUSIONS: Manual and powered toothbrushing with a side-to-side toothbrush, with and without instruction, showed incomplete interdental biofilm removal in periodontally healthy young adults following single brushing exercises. CLINICAL RELEVANCE: Data has to be validated in further studies on other groups, however, in periodontally healthy young adults, additional devices seem to be necessary for sufficient interdental cleaning.


Asunto(s)
Biopelículas , Cepillado Dental , Adulto , Índice de Placa Dental , Diseño de Equipo , Humanos , ARN Ribosómico 16S , Adulto Joven
8.
Caries Res ; 55(3): 215-224, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33752205

RESUMEN

Intraoral scanners (IOS) have been used to quantify tooth wear, but so far they have not been systematically validated for monitoring of tissue loss. The aim of this in vitro study was to investigate whether progression of tissue loss can be detected with an IOS and whether IOS values agree with those obtained with noncontacting profilometry (PRO) serving as a standard method. Model jaws were mounted in a phantom head positioned in a dental chair. Flattened areas were prepared on the non-load-bearing cusps of the first molars (model teeth; n = 16) in order to fix flat enamel samples with an experimental area and a reference area. After baseline PRO and IOS, the experimental enamel area was stepwise etched with 35% H3PO4 gel (4 × 30 s and 4 × 15 s). After each etching, PRO and IOS was performed and the vertical tissue loss between the reference and experimental areas was measured, each at the same 3 measurement points. Furthermore, cupped cusps were simulated by stepwise preparation of the load-bearing cusps of the model teeth with a spherical diamond bur, and the maximum vertical depth after each preparation step was measured only by IOS. Trios3 (3Shape, Denmark), Carestream CS3600 (Carestream, USA) and an optical profilometer (MicroProf, Fries, Germany) were used to measure the flat areas of the enamel samples, whereas only IOS were used to measure curved surfaces on the load-bearing cupped cusps of the model teeth. The IOS data were analyzed with an external software (GOM Inspect, Germany) and with the respective internal IOS software. PRO revealed a mean (±SD) tissue loss of 17.1 ± 4.7 µm after 30-s etching steps and 10.1 ± 5.1 µm after the 15-s etching steps. IOS and software types were able to detect the progression of tissue loss after each etching step (p ≤ 0.001 each); Bland-Altmann plots revealed good agreement with PRO regardless of the order of tissue loss, and no systematic difference was found. Increasing cupped lesion depths were detected by all IOS, with no significant differences between IOS and analysis methods. IOS were able to detect small amounts of tissue loss under simulated clinical conditions and seem to be a promising tool for monitoring even initial erosive tooth wear.


Asunto(s)
Atrición Dental , Desgaste de los Dientes , Diseño Asistido por Computadora , Alemania , Humanos , Imagenología Tridimensional
9.
Caries Res ; 54(1): 2-6, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31610535

RESUMEN

Our understanding of erosive tooth wear and its contributing factors has evolved considerably over the last decades. New terms have been continuously introduced, which frequently describe the same aspects of this condition, whereas other terms are being used inappropriately. This has led to unnecessary confusion and miscommunication between patients, professionals, and researchers. A group of 15 experts, selected by the European Organization for Caries Research (ORCA) and the Cariology Research Group of the International Association for Dental Research (IADR), participated in a 2-day workshop to define the most commonly used terms in erosive tooth wear. A modified Delphi method was utilized to reach consensus. At least 80% agreement was achieved for all terms discussed and their definitions related to clinical conditions and processes, basic concepts, diagnosis, risk, and prevention and management of erosive tooth wear. Use of the terms agreed on will provide a better understanding of erosive tooth wear and intends to enable improved communication on this topic.


Asunto(s)
Caries Dental , Atrición Dental , Desgaste de los Dientes , Consenso , Caries Dental/prevención & control , Humanos , Erosión de los Dientes/prevención & control , Desgaste de los Dientes/prevención & control
10.
Caries Res ; 53(2): 119-136, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30041245

RESUMEN

Toothpastes are the most universally accepted form of fluoride delivery for caries prevention. To provide anti-caries benefits, they must be able to release fluoride during the time of tooth brushing or post brushing into the oral cavity. However, there is no standard accepted procedure to measure how much fluoride in a toothpaste may be (bio) available for release. The European Organization for Caries Research proposed and supported a workshop with experts in fluoride analysis in toothpastes and representatives from industry. The objective of the workshop was to discuss issues surrounding fluoride analysis in toothpaste and reach consensus on terminology and best practices, wherever the available evidence allowed it. Participants received a background paper and heard presentations followed by structured discussion to define the problem. The group also reviewed evidence on the validity, reliability and feasibility of each technique (namely chromatography and fluoride electroanalysis) and discussed their strengths and limitations. Participants were able to reach a consensus on terminology and were also able to identify and summarize the advantages and disadvantages of each technique. However, they agreed that most currently available methods were developed for regulatory agencies several decades ago, utilizing the best available data from clinical trials then, but require to be updated. They also agreed that although significant advances to our understanding of the mechanism of action of fluoride in toothpaste have been achieved over the past 4 decades, this clearly is an extraordinarily complex subject and more work remains to be done.


Asunto(s)
Caries Dental , Pastas de Dientes , Cariostáticos , Fluoruros , Humanos , Reproducibilidad de los Resultados
11.
Caries Res ; 51(1): 52-57, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27992868

RESUMEN

Abrasives may counteract the efficacy of anti-erosion toothpastes either due to physical effects or due to interaction with active agents. This study aimed to investigate whether the amount of abrasives is a determinant for the efficacy of Sn2+-containing toothpastes with or without chitosan additive. Enamel samples were eroded (0.50 wt% citric acid, pH 2.5; 6 × 2 min/day) on a shaking desk - 30/min in experiment 1 (E1) and 35/min in experiments 2 (E2) and 3 (E3) - and immersed in toothpaste slurries (2 × 2 min). Half of the samples were additionally brushed (15 s, load 200 g) within the immersion time. The toothpastes contained 0, 5, 10, 15, and 20% silica. In E1 and E2 the active ingredients were F- (700 ppm as amine fluoride, 700 ppm as NaF) and Sn2+ (3,500 ppm as SnCl2); in E3 chitosan (0.5%) was additionally added. The placebo contained 20% silica. Tissue loss was determined profilometrically. In E1, slurries completely inhibited tissue loss; distinct surface deposits occurred. With brushing, tissue loss significantly increased up to an abrasive content of 10%, but decreased significantly with higher amounts; 20% silica revealed similar values as the abrasive-free formulation. In E2, all slurries inhibited tissue loss distinctly irrespective of the amounts of abrasives. With brushing, a similar trend as in E1 was observed but with much less efficacy. The chitosan-containing formulations in E3 were much more effective; similar results as in E1 were found. In conclusion, the amount of abrasives had no effect when toothpastes were applied as slurries, but played an important role with brushing.


Asunto(s)
Cariostáticos/farmacología , Quitosano/farmacología , Fluoruros/farmacología , Dióxido de Silicio/farmacología , Fluoruros de Estaño/farmacología , Abrasión de los Dientes/prevención & control , Erosión de los Dientes/prevención & control , Pastas de Dientes/farmacología , Análisis de Varianza , Cariostáticos/uso terapéutico , Quitosano/uso terapéutico , Ácido Cítrico/farmacología , Caries Dental/prevención & control , Esmalte Dental/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Fluoruros/uso terapéutico , Humanos , Dióxido de Silicio/uso terapéutico , Estadísticas no Paramétricas , Fluoruros de Estaño/uso terapéutico , Cepillado Dental , Pastas de Dientes/uso terapéutico
12.
Caries Res ; 50(5): 443-454, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27529698

RESUMEN

Profilometry is established in erosion research. However, in the case of dentine, factors such as the demineralised organic matrix, desiccation effects, or type of measuring device may have an impact on the measurement results, which were investigated in the present study. Dentine specimens were eroded with citric acid (1%, pH 2.6) for 5, 10, 15, 20, 30, 60, 90, and 120 min (n = 15 each). For each specimen, tissue loss was determined under various conditions - before/after enzymatic matrix removal, under standardised wet and desiccated (2/10 min) conditions - with non-contact and contact profilometry. In the presence of matrix, under wet conditions, non-contact profilometry revealed almost no tissue loss. Values (mean ± SD) ranged between 0.3 ± 0.7 µm (5 min) and 3.4 ± 1.5 µm (120 min). Contact profilometry increased values significantly (range: 2.9 ± 1.1 to 30.6 ± 5.8 µm). Desiccation (2 min) significantly increased values, except for 5 min of demineralisation, for non-contact profilometry (range: 0.8 ± 1.3 to 22.1 ± 5.5 µm), and decreased values for contact profilometry up to 15 min and increased them as from 90 min (range: 0.9 ± 1.2 to 33.0 ± 5.5 µm); results after 10 min of desiccation were comparable. After the removal of matrix, under wet conditions, values were distinctly higher (non-contact: 3.5 ± 0.8-55.5 ± 7.4 µm; contact: 4.2 ± 1.3-57.8 ± 8.1 µm). Desiccation (10 min) lowered values by about 2-5 µm due to specimen deformation. Bland-Altman comparisons of various outcomes revealed distinct significant proportional and relative biases. Loss of mineralised tissue cannot be adequately quantified in the presence of matrix. Desiccation leads to matrix shrinkage and specimen deformation. Most importantly, tissue loss values obtained in the presence or absence of matrix are not proportional. Therefore, if mineral status is the target criterion, matrix removal and moisture control are prerequisites.


Asunto(s)
Dentina/patología , Desmineralización Dental/inducido químicamente , Erosión de los Dientes/inducido químicamente , Ácido Cítrico/efectos adversos , Dentina/efectos de los fármacos , Desecación , Humanos , Imagenología Tridimensional , Microscopía Electrónica de Rastreo , Estadísticas no Paramétricas , Propiedades de Superficie
13.
Caries Res ; 50(2): 170-9, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27115419

RESUMEN

There is no standard for testing anti-erosive/anti-abrasive agents, making the assessment and comparison of study results difficult. Factors which are varied in study designs are amongst others the erosive medium regarding concentration and pH or movement type of acid. The present study therefore investigated the impact of these factors on dimension of tissue loss and on efficacy of active agents used as anti-erosive/anti-abrasive therapeutics. In 8 experiments, consisting of 8 groups each (n = 20 each), resulting in a total of 64 groups, enamel specimens were demineralised (10 days, 6 × 2 min/day) using different acids (1, 0.5 and 0.3% citric acid at native pH 2.3, 2.5 and 2.8, respectively, and 0.3% citric acid adjusted to pH 3.6) with two different movement types (jerky or smooth). Specimens were immersed (2 × 2 min/day) in slurries of 1,450 ppm F- toothpaste (NaF), 1,450 ppm F- and 3,436 ppm Sn2+ toothpaste (NaF/SnF2), 970 ppm F- and 3,000 ppm Sn2+ gel (SnF2) or placebo, or were additionally brushed during immersion (15 s, 200 g). All groups were in between stored in a mineral salt solution. Tissue loss was determined profilometrically. Movement type, pH and concentration of acid had a substantial impact on study outcome. The combination of jerky movement and concentrated acid masked, to some extent, differences between erosive and erosive-abrasive tissue loss. The acid at low concentration (0.3%), independent of pH, was too mild to produce any tissue loss. The model with the best ability to demonstrate effects of abrasive impacts and active agents used the 1% acid concentration combined with smooth acid movements.


Asunto(s)
Fluoruro de Sodio/uso terapéutico , Fluoruros de Estaño/uso terapéutico , Abrasión de los Dientes/prevención & control , Erosión de los Dientes/prevención & control , Ácido Cítrico/farmacología , Esmalte Dental/patología , Humanos , Concentración de Iones de Hidrógeno , Imagen Óptica , Proyectos de Investigación , Fluoruro de Sodio/farmacología , Estadísticas no Paramétricas , Fluoruros de Estaño/farmacología , Abrasión de los Dientes/inducido químicamente , Abrasión de los Dientes/terapia , Desmineralización Dental/prevención & control , Erosión de los Dientes/inducido químicamente , Erosión de los Dientes/terapia , Cepillado Dental , Pastas de Dientes/farmacología , Pastas de Dientes/uso terapéutico , Resultado del Tratamiento
14.
Caries Res ; 50(5): 462-470, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27577928

RESUMEN

This study investigated the isolated and combined effect of a single application of TiF4 or NaF varnish versus daily use of a solution containing a low concentration of TiF4/NaF against tooth erosion in vitro. A total of 90 bovine enamel and 108 root dentin samples were treated as follows: control (no treatment), solution containing TiF4/NaF (500 ppm F-, pH 4.4), NaF varnish (24,500 ppm F-, pH 5.0), TiF4 varnish (24,500 ppm F-, pH 1.0), TiF4 varnish + solution, and NaF varnish + solution. The erosive challenges were performed 4 × 90s/day (0.1% citric acid, pH 2.5) and, between them, the samples were immersed in artificial saliva. The tooth loss was measured using contact profilometry (after 7 days for dentin and after 7, 10, and 14 days for enamel). All treatments were effective in reducing tooth loss, except NaF varnish for enamel on day 7 (p < 0.0001). TiF4/NaF solution and TiF4 varnish did not differ with respect to enamel loss for 10 days; thereafter, TiF4 varnish lost its protective effect compared to TiF4/NaF solution. The combination of vehicles was more effective in reducing enamel loss than both varnishes on their own but not compared to the solution. For dentin, TiF4 varnish was more effective than NaF varnish, while TiF4/NaF solution and NaF varnish were similar. The combination of vehicles improved the protective effect only when compared to NaF varnish on its own (p < 0.0001). Both types of TiF4 applications, isolated or combined, were effective against tooth erosion, but some differences in their performance were seen between enamel and dentin.


Asunto(s)
Cariostáticos/farmacología , Fluoruros Tópicos/farmacología , Fluoruros/farmacología , Fluoruro de Sodio/farmacología , Titanio/farmacología , Erosión de los Dientes/prevención & control , Análisis de Varianza , Animales , Bovinos , Ácido Cítrico/efectos adversos , Esmalte Dental/efectos de los fármacos , Dentina/efectos de los fármacos , Humanos , Concentración de Iones de Hidrógeno/efectos de los fármacos , Microscopía Electrónica de Rastreo , Saliva Artificial/farmacología , Espectrometría por Rayos X , Factores de Tiempo , Erosión de los Dientes/inducido químicamente , Erosión de los Dientes/diagnóstico por imagen , Resultado del Tratamiento
15.
Clin Oral Investig ; 18(2): 535-43, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-23592063

RESUMEN

OBJECTIVES: To determine the effect on resin composite-to-dentin bond strength of incorporation of an acidic tin-chloride pretreatment in two adhesive systems. MATERIALS AND METHODS: Human molars were ground to expose mid-coronal dentin. For microtensile bond strength (µTBS) testing, dentin was treated with Optibond FL or Clearfil SE according to one of six protocols (n = 22/group). Group 1: Phosphoric acid etching, Optibond FL Prime, Optibond FL Adhesive (manufacturer's instructions; control); Group 2: Tin-chloride pretreatment, Optibond FL Prime, Optibond FL Adhesive; Group 3: Phosphoric acid etching, tin-chloride pretreatment, Optibond FL Prime, Optibond FL Adhesive; Group 4: Clearfil SE Primer, Clearfil SE Bond (manufacturer's instructions; control); Group 5: Phosphoric acid etching, Clearfil SE Primer, Clearfil SE Bond; and Group 6: Tin-chloride pretreatment, Clearfil SE Primer, Clearfil SE Bond. The molars were then built up with resin composite (Clearfil Majesty Esthetic). After storage (1 week, 100 % humidity, 37 °C) the µTBS was measured and failure mode was determined. Additionally, pretreated dentin surfaces were evaluated using SEM and EDX. The µTBS results were analyzed statistically by a Welch Two Sample t-test and a Kruskal-Wallis test followed by exact Wilcoxon rank sum tests with Bonferroni-Holm adjustment for multiple testing (α = 0.05). RESULTS: When Optibond FL was used, partial or total replacement of phosphoric acid with tin-chloride decreased µTBS significantly. In contrast, when Clearfil SE was used, inclusion of a tin-chloride pretreatment in the adhesive procedure increased µTBS significantly. CONCLUSIONS: Tin-chloride pretreatment had a beneficial influence on the bond promoting capacity of the MDP-containing adhesive system Clearfil SE.


Asunto(s)
Cementos Dentales , Dentina/química , Compuestos de Estaño/química , Humanos , Microscopía Electrónica de Rastreo , Espectrometría por Rayos X , Propiedades de Superficie
16.
J Dent ; 145: 104978, 2024 06.
Artículo en Inglés | MEDLINE | ID: mdl-38556195

RESUMEN

OBJECTIVES: Intraoral scanners (IOS) display disclosed plaque, and the scientific literature has reported that plaque levels can be monitored on intraoral scans using one IOS system (Dexis 3800; control IOS). This study aimed to investigate whether this is also possible with other IOS systems (i700, Primescan, Trios 5; test IOS). MATERIALS AND METHODS: Ten participants (29.6 ± 5.5 years) were enrolled. After plaque accumulation and subsequent toothbrushing, intraoral scans were performed with the control IOS and the three test IOS. All scans were aligned and the vestibular/oral surfaces of the Ramfjord teeth (16, 21, 24, 36, 41, 44) were analysed with automated planimetry using a predefined threshold value. The proportion of pixels assigned to plaque-covered areas was expressed as a percentage of the total number of pixels (P%). We then assessed whether the planimetrically determined plaque-covered areas corresponded to those identified visually. This revealed that a threshold correction (P%corr) was required for approximately 20 % (i700 and Trios 5) to over 65 % (Primescan) of the images. RESULTS: Bland-Altman analysis showed no significant systematic bias and limits of agreement ranging from approximately -20 to +20 P% units, with a tendency towards lower values at higher plaque coverage. Manual correction improved the agreement and halved the limits of agreement. All test IOS could detect a reduction in plaque after brushing, as well as the typical site-dependant plaque distribution patterns. CONCLUSIONS: All test IOS appeared to be suitable for plaque monitoring. Planimetric methods must be adapted to the colour representation of the IOS. CLINICAL SIGNIFICANCE: Plaque monitoring using IOS opens a new field of application in preventive dentistry.


Asunto(s)
Placa Dental , Procesamiento de Imagen Asistido por Computador , Cepillado Dental , Humanos , Placa Dental/diagnóstico por imagen , Adulto , Cepillado Dental/instrumentación , Femenino , Masculino , Procesamiento de Imagen Asistido por Computador/métodos , Adulto Joven , Índice de Placa Dental , Fotografía Dental/instrumentación , Fotografía Dental/métodos
17.
Clin Oral Investig ; 17(1): 217-25, 2013 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-22431144

RESUMEN

OBJECTIVES: To evaluate the effect of a tin-containing fluoride (Sn/F) mouth rinse on microtensile bond strength (µTBS) between resin composite and erosively demineralised dentin. MATERIALS AND METHODS: Dentin of 120 human molars was erosively demineralised using a 10-day cyclic de- and remineralisation model. For 40 molars, the model comprised erosive demineralisation only; for another 40, the model included treatment with a NaF solution; and for yet another 40, the model included treatment with a Sn/F mouth rinse. In half of these molars (n = 20), the demineralised organic matrix was continuously removed by collagenase. Silicon carbide paper-ground, non-erosively demineralised molars served as control (n = 20). Subsequently, µTBS of Clearfil SE/Filtek Z250 to the dentin was measured, and failure mode was determined. Additionally, surfaces were evaluated using SEM and EDX. RESULTS: Compared to the non-erosively demineralised control, erosive demineralisation resulted in significantly lower µTBS regardless of the removal of demineralised organic matrix. Treatment with NaF increased µTBS, but the level of µTBS obtained by the non-erosively demineralised control was only reached when the demineralised organic matrix had been removed. The Sn/F mouth rinse together with removal of demineralised organic matrix led to significantly higher µTBS than did the non-erosively demineralised control. The Sn/F mouth rinse yielded higher µTBS than did the NaF solution. CONCLUSIONS: Treatment of erosively demineralised dentin with a NaF solution or a Sn/F mouth rinse increased the bond strength of resin composite. CLINICAL RELEVANCE: Bond strength of resin composite to eroded dentin was not negatively influenced by treatment with a tin-containing fluoride mouth rinse.


Asunto(s)
Cariostáticos/química , Resinas Compuestas/química , Recubrimiento Dental Adhesivo , Materiales Dentales/química , Dentina/ultraestructura , Antisépticos Bucales/química , Fluoruros de Estaño/química , Desmineralización Dental/patología , Erosión de los Dientes/patología , Adhesividad , Colagenasas/farmacología , Análisis del Estrés Dental/instrumentación , Dentina/efectos de los fármacos , Humanos , Curación por Luz de Adhesivos Dentales , Ensayo de Materiales , Microscopía Electrónica de Rastreo , Cementos de Resina/química , Fluoruro de Sodio/química , Espectrometría por Rayos X , Estrés Mecánico , Propiedades de Superficie , Resistencia a la Tracción , Remineralización Dental
18.
Artículo en Inglés | MEDLINE | ID: mdl-36767148

RESUMEN

In diagnostic accuracy studies, the test of interest is typically applied only once in each patient. This paper illustrates some possibilities that arise when diagnoses are carried out by a sufficiently large number of multiple raters. In a dental study, sixty-one examiners were asked to diagnose 49 tooth areas with different grades of tissue loss (minor, moderate, and advanced) to decide whether dentine was exposed (positive status) or not (negative status). The true status was determined by histology (reference). For each tooth, the rate of correct decisions reflecting the difficulty to diagnose this tooth and the positive rate reflecting the perception of the tooth by the raters was computed. Meta-analytical techniques were used to assess the inter-tooth variation and the influence of tooth-specific factors on difficulty or perception, respectively. A huge variation in diagnostic difficulty and perception could be observed. Advanced tissue loss made diagnoses more difficult. The background colour and tissue loss were associated with perception and may hint to cues used by the raters. The use of multiple raters in a diagnostic accuracy study allows detailed investigations which make it possible to obtain further insights into the decision-making process of the raters.


Asunto(s)
Diente , Humanos , Odontología
19.
Am J Dent ; 25(6): 351-64, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-23409626

RESUMEN

Dental erosion is induced by the exposure to acids, and together with physical impacts, contributes to the wear and tear of the dentition throughout a lifetime. It is a multifactorial condition, and so far several etiological and protecting factors have been identified. Based on a thorough diagnosis and identification of the acid sources, current preventive and therapeutic strategies focus on causal strategies bringing the acid exposure to a safe level, and/or strengthening the tooth surface against demineralization. There is increasing knowledge about the erosion inhibiting potential of fluorides particularly of compounds with polyvalent metal cations. The paper critically reviews the current literature providing a brief overview on what is known about diagnosis, prevalence, etiology and risk factors with the main focus on preventive and therapeutic strategies.


Asunto(s)
Enfermedades Dentales/etiología , Enfermedades Dentales/patología , Humanos , Enfermedades Dentales/prevención & control , Enfermedades Dentales/terapia
20.
Odontology ; 100(1): 67-75, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21556727

RESUMEN

This study evaluated the correlation between three strip-type, colorimetric tests and two laboratory methods with respect to the analysis of salivary buffering. The strip-type tests were saliva-check buffer, Dentobuff strip and CRT(®) Buffer test. The laboratory methods included Ericsson's laboratory method and a monotone acid/base titration to create a reference scale for the salivary titratable acidity. Additionally, defined buffer solutions were prepared and tested to simulate the carbonate, phosphate and protein buffer systems of saliva. The correlation between the methods was analysed by the Spearman's rank test. Disagreement was detected between buffering capacity values obtained with three strip-type tests that was more pronounced in case of saliva samples with medium and low buffering capacities. All strip-type tests were able to assign the hydrogencarbonate, di-hydrogenphosphate and 0.1% protein buffer solutions to the correct buffer categories. However, at 0.6% total protein concentrations, none of the test systems worked accurately. Improvements are necessary for strip-type tests because of certain disagreement with the Ericsson's laboratory method and dependence on the protein content of saliva.


Asunto(s)
Saliva/química , Adulto , Tampones (Química) , Pruebas de Química Clínica , Colorimetría , Humanos , Concentración de Iones de Hidrógeno , Persona de Mediana Edad , Juego de Reactivos para Diagnóstico , Tiras Reactivas , Reproducibilidad de los Resultados , Proteínas y Péptidos Salivales/química , Volumetría
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