Relationship between the salivary concentrations of proteinase-3 and interleukin-8 and severe early childhood caries.

BACKGROUND: Severe early childhood caries (S-ECC) is a multifactorial transmissible infectious disease continuing to affect infants and toddlers worldwide. Saliva plays a modulatory role in the pathogenesis of dental caries. OBJECTIVES: The present study aimed to assess the salivary levels of proteinase-3 (PR3) and interleukin-8 (IL-8) as pro-inflammatory cytokines related to the function of neutrophils in association with S-ECC and its treatment. MATERIAL AND METHODS: Fifty children aged 36-60 months were recruited (25 caries-free controls and 25 S-ECC patients). Saliva sampling was performed in all participants. In the S-ECC group, sampling was repeated 6-8 weeks after restorative treatment. The salivary concentrations of PR3 and IL-8 were determined using the enzyme-linked immunosorbent assay (ELISA). The χ2 test, Fisher's exact test, the independent t test, and the paired t test were applied at p < 0.05. RESULTS: The baseline salivary concentrations of PR3 and IL-8 in the S-ECC group were significantly higher than in the caries-free group (p < 0.001). A significant reduction occurred in the levels of these cytokines following restorative treatment in the S-ECC group (p < 0.001), although they were still significantly higher than in the caries-free group (p < 0.05). CONCLUSIONS: The salivary levels of PR3 and IL-8 were significantly affected by the presence of dental caries in children, implying their potential efficiency as non-invasive indicators in the determination of the caries risk and treatment effectiveness.

Relationship between the salivary concentration of matrix metalloproteinases 8 and 20 and severe early childhood caries.

BACKGROUND: Dental caries is initiated through mineral dissolution by bacterial acids and collagen degradation by endogenous proteolytic enzymes, mainly collagenolytic matrix metalloproteinases (MMPs). OBJECTIVES: The present research aimed to evaluate the relationship between severe early childhood caries (S-ECC) and salivary MMP-8 and MMP-20 concentrations. MATERIAL AND METHODS: Fifty children aged 36-60 months were assigned to either the caries-free (control) group or the S-ECC group. Standard clinical examinations were performed, and approx. 1 mL of expectorated unstimulated whole saliva was collected from all participants. In the S-ECC group, the sampling was repeated 3 months after restorative treatment. All samples were analyzed for the salivary concentrations of MMP-8 and MMP-20, using the enzyme-linked immunosorbent assay (ELISA). Statistical analysis employed the t test, the Mann-Whitney U test, the χ2 test, Fisher's exact test, and the paired samples t test. The level of significance was set at 0.05. RESULTS: At baseline, the subjects in the S-ECC group presented with significantly elevated levels of MMP-8 as compared to the control group. However, the salivary concentration of MMP-20 did not exhibit a significant difference between the 2 groups. A significant reduction occurred in the levels of MMP-8 and MMP-20 3 months after restorative treatment in the S-ECC group. CONCLUSIONS: The salivary levels of MMP-8 and MMP-20 were significantly affected by dental restorative treatment in children. Furthermore, MMP-8 was observed to be a better indicator of the dental caries status than MMP-20.

Estimating and comparing the duration of adolescent growth peak in skeletal class I and III subjects using cervical vertebral maturation method.

BACKGROUND: Estimating skeletal maturation and growth potential is essential for developing adolescents' best orthodontic treatment plan. The purpose of this study was to compare the duration of adolescent growth peak in subjects of skeletal classes I and III using the cervical vertebral maturation (CVM) method. METHODS: This retrospective cross-sectional study included 116 Iranian subjects (skeletal class I = 68, skeletal class III = 48) aged 8-16 years old and without previous orthodontic treatments. Using Steiner and Wits analyses, two independent examiners traced pre-treatment lateral cephalograms to determine the subjects' skeletal relationship. The skeletal maturation was then assessed using Baccetti's CVM method. The onset and duration of adolescent growth peak (interval of CS3-CS4) were compared between two skeletal classes and two genders using independent samples t test. RESULTS: In skeletal class I and III subjects, the adolescent peak had a mean duration of 1.62 (± 1.33) and 2.00 (± 1.27) years, respectively. The average difference of 0.38 years (4.6 months) between the two groups was statistically significant (p < 0.001). Furthermore, the onset age of adolescent growth peak was 11.91 (± 1.32) and 12.08 (± 1.31) years old in class I and III subjects, respectively. This age difference was not statistically significant (p = 0.630). Males' adolescent growth peak occurred 1.44 years later (p < 0.001) and lasted 0.20 years less (p < 0.001). CONCLUSIONS: The adolescent growth peak started at a similar age in class I and III subjects, but the latter experienced the peak for 4.6 months longer. Moreover, females had an earlier and more extended adolescent growth peak.

Antibacterial effect of an herbal toothpaste containing Bamboo salt: a randomized double-blinded controlled clinical trial.

BACKGROUND: The inclusion of herbal antibacterial agents in the composition of toothpastes is becoming increasingly popular, due to lower side effects. The present study intended to investigate the antibacterial efficacy of a herbal toothpaste containing Bamboo salt on cariogenic oral bacteria. METHODS: The present double-blinded parallel randomized controlled clinical trial was conducted on 60 dental students (age range: 18-30). Following the baseline saliva sampling, the participants were randomly assigned into the case and control groups, to use the Bamboo salt herbal toothpaste and conventional non-herbal toothpaste, respectively. They were instructed to brush their teeth twice a day using the Bass technique. Saliva sampling was repeated after four weeks. The salivary counts of Streptococcus mutans and Lactobacillus at baseline and 4-week follow-up were determined and presented as the logarithm of colony-forming units per milliliter (log CFU/mL). RESULTS: A significant decrease in salivary Streptococcus mutans and Lactobacillus was observed using both toothpastes (*P < 0.001). The difference between the antibacterial efficacy of two toothpaste types on Streptococcus mutans and Lactobacillus was not statistically significant (P = 0.530, and P = 0.137, respectively). CONCLUSION: Due to the comparable efficacy of the investigated herbal toothpaste with conventional toothpaste, it potentially qualifies as a complementary agent for self-care oral hygiene procedures. TRIAL REGISTRATION: This trial was registered in the "Iranian Registry of Clinical Trials" (IRCT20210414050964N1) on 21/06/2021.

Evaluating the Preemptive Analgesic Effect of Photo-biomodulation Therapy on Pain Perception During Local Anesthesia Injection in Children: A Split-mouth Triple-blind Randomized Controlled Clinical Trial.

To evaluate the impact of photobiomodulation therapy (PBMT) on injection pain perception and compare it with a topical oral anesthetic gel. A total of 30 patients of 6 to 9 years-old seeking pulpotomy treatment of maxillary secondary primary molars of both sides were considered for this split-mouth triple-blind randomized clinical trial. On one side of the maxilla, the low-level laser (diode laser, 808 nm, 250 mW; 16.25 J; 32.5 J cm-2 ) was irradiated upon the buccal gingiva of the tooth, while a Benzocaine 20% topical anesthetic gel was applied on the other side. A gel with the same taste (strawberry) was applied for the placebo. The Wong-Baker Faces Pain Rating Scale was used to evaluate the injection pain and postoperation pain at two timestamps, 1 h and 24 h after treatment. Patients' heart rate was also evaluated. Paired t, Wilcoxon signed-rank test, McNemar and Friedman tests were used for statistical analyses. Results demonstrated that PBMT could significantly decrease the injection pain perception and heart rate alternations compared to the topical anesthetic gels (P = 0.000). However, no significant differences were documented between the two methods concerning the 1-h (P = 0.26) and 24-h (P = 1.00) postoperation pain. PBMT can be an effective nonpharmacological technique for controlling injection pain.

In Vitro Effects of Three Fluoride-Free Pastes on Remineralization of Initial Enamel Carious Lesions.

Purpose: The purpose of this study was to compare the efficacy of nanohydroxyapatite (NHA), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and calcium sodium phosphosilicate (NovaMin®) in remineralization of early enamel lesions and compare enamel surface changes using a scanning electron microscope (SEM). Methods: Thirty human premolars were sectioned into halves and randomly assigned to five groups (control, demineralization, NHA, CPP-ACP, NovaMin®; n equals 12). Ten samples in each of the three test groups were demineralized and treated with their designated paste for two minutes in 24-hour intervals for 30 days. They were subjected to the Vickers microhardness test on days 15 and 30, and their microhardness values were compared to the control and demineralization groups. The remaining two samples of each group were observed through SEM. Analysis of variance, Tukey's test, and paired t-tests were applied at P<0.05. Results: On day 15, a significant increase in surface microhardness compared to the control was only observed in the CPP-ACP group (P<0.05). Microhardness scores of all paste groups significantly increased between days 15 and 30 (P<0.001), while no significant differences were observed between them on day 30. In SEM images of all test groups, surface integrity increased, although NHA-treated samples had the most homogenous surface. Conclusion: Since all three pastes significantly remineralized incipient enamel lesions, they are potentially qualified for caries prevention.

Effect of topical fluoride on microshear bond strength of primary enamel to composite, microhardness of enamel and its surface morphology: An in vitro study.

Background. This in vitro study aimed to evaluate the microshear bond strength (µSBS), microhardness and morphological characteristics of primary enamel after treating with sodium fluoride (NaF) and acidulated phosphate fluoride (APF). Methods. Forty-eight primary canines were cut into mesial and distal sections and assigned to five groups randomly: group 1 (immersed in saliva as a control), group 2 (treated with NAF and immersed in saliva for 30 minutes), group 3 (treated with APF and immersed in saliva for 30 minutes), group 4 (treated with NAF and immersed in saliva for 10 days), and group 5 (treated with APF and immersed in saliva for 10 days). Composite resin (Filtek Z250) was bonded on the specimens (n=15) for measuring the µSBS. After storage in 37°C artificial saliva for 24 hours, µSBS and Vickers hardness tests (10 readings) were performed. The data were analyzed using one-way ANOVA and Kolmogorov-Smirnov, Levene's and Tukey HSD tests (P<0.05). Morphological analysis of enamel and modes of failure were carried out under a scanning electron microscope (SEM) on two remaining specimens. Results. Significant differences in µSBS were only noted between groups 2 and 4 (P=0.024). Group 3 showed a significant decrease in hardness after storage in artificial saliva (P<0.001), with a significantly lower hardness than the other groups (P<0.001). The SEM observations showed irregular particles in groups 3 and 5; uniform, smooth and thin coats were seen in groups 2 and 4. Conclusion. Fluoride therapy with NaF and APF gels prior to restorative treatments had no adverse effects on the microshear bond strength.

Effect of two fluoride varnishes on the color stability of three resin-based restorative materials: an in vitro study.

AIM: The aim of the present study was to evaluate the effect of two fluoride varnishes on color stability of three resin-based restorative materials. METHODS: Fifty-four discs (14.5 × 1.7 mm) were fabricated from A2 and A3 shades of a compomer (F2000), a flowable composite (Z350), and a hybrid composite (Z250), and incubated at 37°C for 48 h. Dura Shield (colored) and Fluor Protector (colorless) fluoride varnishes were applied onto the discs. The coating was cleaned using a low-speed handpiece and nylon bristle brush after 24 h of storage in distilled water. A second coating was then applied. A control group with no coating was immersed in distilled water and used. The CIE L*a*b* color scale was measured before the treatments and following each cleaning utilizing a spectrophotometer. RESULTS: The colored fluoride varnish exhibited the highest overall color change (∆E) after the first and the second cleaning procedures in all the materials. Among these, the greatest color change was observed in the A3 shade of F2000, followed by the A3 shade of Z-250. The ∆E was less than 3.3 in all groups, and was therefore clinically acceptable. CONCLUSION: Color changes following the application of fluoride varnishes were found to be clinically acceptable in all groups.

Assessment of Microshear Bond Strength: Self-Etching Sealant versus Conventional Sealant.

OBJECTIVE: Recently, self-etching fissure sealants have been introduced to reduce technical sensitivity; however, their efficacy should be assessed. The aim of this study was to assess of the microshear bond strength of self-etching and conventional fissure sealants. MATERIALS AND METHODS: Thirty non-carious third molars were randomly divided into three groups (N=10). Microcylinders of Concise fissure sealant were bonded to prepared buccal and lingual surfaces using the two following procedures. In the first group, phosphoric acid was used to prepare the substrate; whereas in group two, Concise was used in combination with Prompt L-Pop. In group 3, a self-etching fissure sealant (Enamel Loc) was utilized per se. After 24 hours, the samples were subjected to 500 rounds of thermocycling and shear bond testing using a microtensile tester machine with a crosshead speed of 0.5mm/min. Data were analyzed using one-way repeated measure ANOVA and Bonferroni Post HOC tests (SPSS version 16). RESULTS: THE MEAN AND STANDARD DEVIATION OF MICROSHEAR BOND STRENGTH OF THE GROUPS WERE AS FOLLOWS: Group 1: Concise+ etching (14.59 ± 1.19 MPa), Group 2: Concise+Prompt L-Pop (12.86 ± 1.98 MPa), and Group 3: Enamel Loc (5.59 ± 0.72 MPa). One-way ANOVA revealed that all the differences were significant and the conventional sealant exhibited the highest mean bond strength. CONCLUSION: Conventional sealant using phosphoric acid etch application prior to fissure sealant application demonstrated more bond strength in comparison with that of self-etch bonding and self-etch sealant.

Effects of Three Mastic Gums on the Number of Mutans Streptococci, Lactobacilli and PH of the Saliva.

OBJECTIVE: In the recent years, herbal oral hygiene products have gained increasing attention. The aim of this study was to assess the effects of three types of mastic gums on the level of Mutans streptococci, Lactobacilli and pH of the saliva. MATERIALS AND METHODS: Forty-two students in the age range of 20-30 years were divided into three parallel groups; each of them separately used pure mastic gum, xylitol mastic gum and probiotic mastic gum for three weeks. Number of microorganisms and pH of the saliva were assessed before and after the intervention. The data were analyzed using Wilcoxon Signed Rank, paired-sample-t, Kruskal-Wallis and Tukey's post-hoc tests and Oneway ANOVA. RESULTS: Level of Mutans streptococci showed a significant reduction compared to its baseline value in all three groups (P<0001 for all). Salivary Lactobacillus count increased in the groups using pure and xylitol mastic gums but decreased in the group using probiotic type, albeit these changes were only significant in the group using probiotic mastic gum (P<0.001). Use of pure and xylitol mastic gums increased the pH of the saliva but not significantly. In the group using probiotic mastic gum, the pH of the saliva decreased significantly (P=0.029). CONCLUSION: Three weeks use of all mastic gums resulted in a significant drop in the number of Mutans streptococci in the saliva. However, the drop in the saliva pH due to the use of probiotic mastic gum is not in favor of dental health.

Dentinogenesis imperfecta associated with osteogenesis imperfecta.

This paper presents a case with dentinogenesis imperfecta (DI) associated with osteogenesis imperfecta. Systemic and dental manifestations of OI and its medical and dental treatments are discussed in this paper. A 5-year-old child with the diagnosis of OI was referred to the Dental School of Shaid Beheshti University of Medical Sciences. On clinical examination yellow/brown discoloration of primary teeth with the attrition of the exposed dentin and class III malocclusion was observed. Enamel of first permanent molars was hypoplastic. Radiographic examinations confirmed the diagnosis of DI. A histological study was performed on one of the exfoliating teeth, which showed abnormal dentin. Primary teeth with DI were more severely affected compared to permanent teeth; enamel disintegration occurred in teeth with DI, demonstrating the need for restricts recalls for these patients.

Association of salivary sCD14 concentration levels with early childhood caries.

BACKGROUND: Early childhood caries (ECC) is a severe type of dental caries affecting infants and pre-school children. Because of the infectious nature of the disease, the immunologic response by the host plays an essential role in its development. OBJECTIVE: This study investigated the association between the presence of salivary sCD14 and ECC. METHODS: This study was carried out on 40 healthy children, of whom 20 were caries-free (CF) and 20 had ECC, within the ages of 36 to 71 months. Unstimulated saliva of the children was collected with disposable needle-less syringe from buccal and labial vestibules. Seven children with ECC received complete treatments. Saliva was collected for a second time after 3 months from this group. The sCD14 levels in salivary samples were analyzed by ELISA method. RESULTS: Mean concentrations of sCD14 in ECC and CF groups were 57.82 and 31.92 ng/ml respectively (p=0.008). After three months, the mean concentration of sCD14 among the treated children decreased to 11.38 ng/ml, which was significantly lower compared to that of ECC children before intervention (p<0.001), and also CF children (p<0.05). CONCLUSION: The increased levels of sCD14 can be considered as a marker of inflammation and innate immune response during ECC.