Retention Rate of Hydrophilic and Hydrophobic Resin-Based Sealant under Field Conditions: A Split-Mouth Randomized Controlled Clinical Trial.

OBJECTIVES: The aim of this study was to evaluate and compare the clinical retention rate between hydrophilic and hydrophobic resin-based sealant placed under field setting and related factors. MATERIALS AND METHODS: Sixty-six children with 106 pairs of teeth in the same arch with matching International Caries Detection and Assessment System (ICDAS) scores ranging from 0 to 2 were recruited. This study was a split-mouth design with each tooth in the pair randomly assigned into either hydrophobic resin-based sealant group (Concise white sealant, 3M. EPSE, St. Paul, Minnesota, USA) or hydrophilic resin-based sealant group (UltraSeal XT hydro sealant, Ultradent Products, South Jordan, Utah, USA). A dental therapist performed all procedures in a field setting on a mobile dental unit with a mobile saliva ejector. The retention rate was evaluated by two calibrated dentists and classified as fully retained, partially retained, and total loss. STATISTICAL ANALYSIS: The outcomes were analyzed using McNemar's, chi-squared, and Fisher's exact test with a significance level of 0.05. RESULTS: After 12 months, 65 children with 105 pairs of teeth remained in this study. At 8-month follow-up, fully retained, partially retained, and total loss of material were found at 82.9, 15.2, and 1.9% in the hydrophobic group and 70.5, 26.7, and 2.9% in the hydrophilic group, respectively. At the 12-month follow-up, the outcomes were reduced, respectively, to 80, 17.1, and 2.9% in the hydrophobic group and 68.6, 27.6, and 3.8% in the hydrophilic group. There was no significant difference between the two groups (p > 0.05). Arch type was associated with the retention rate (p < 0.05), whereas ICDAS scores showed no correlation (p > 0.05). CONCLUSION: Both hydrophilic and hydrophobic resin-based sealant can be used under field conditions, with no significant difference in terms of retention rate.

Current Management of Dens Evaginatus Teeth Based on Pulpal Diagnosis.

INTRODUCTION: Dens evaginatus (DE) is a dental anomaly with a supernumerary tubercle projection that typically contains dentin and pulp tissue. However, the tubercle projection can fracture, exposing the dentin and potentially the dental pulp, which induces pulpal diseases. Managing DE should be primarily based on the clinical diagnosis of the pulp. METHODS: The literature search in prevalence, prophylaxis, and management of dens evaginatus was performed in PubMed database as well as by manual search, in which the related contents were collected and descriptively analyzed. RESULTS: Of the 264 searched literatures, 62 articles were included for this scoping review. The prophylactic management of the tubercle of DE teeth with a normal pulp should be performed as early as possible by the prep-and-fill technique or the reinforcement technique to preserve tooth vitality and continued root development, with the former reported to be superior compared with the latter. Furthermore, DE teeth with reversible pulpitis should be managed with the prep-and-fill technique. For DE teeth with irreversible pulpitis, vital pulp therapy, ie, partial or full/coronal pulpotomy, should be considered when the pulpal inflammation is limited to the coronal pulp to preserve the vitality of the radicular pulp that induces apexogenesis. A pulpectomy should be performed if the pulpal inflammation has progressed into the radicular pulp. For DE teeth with pulpal necrosis (or after pulpectomy) and immature roots, mineral trioxide aggregate apexification or regenerative endodontic procedures are the treatment options. For DE teeth with pulpal necrosis and complete root formation, nonsurgical root canal treatment is the treatment of choice. A flow chart of the decision-making for managing DE teeth based on pulpal diagnosis is proposed. CONCLUSION: DE teeth should be properly managed, by prophylaxis or treatment, depending on pulpal diagnosis and related factors.

Success Rate and Related Factors of Vitapex Pulpectomy in Primary Teeth: A Retrospective Study.

OBJECTIVES: Our aims were to evaluate the Vitapex pulpectomy (PE) success rate, Vitapex resorption rate, and their associated factors in primary teeth. MATERIAL AND METHODS: This retrospective study evaluated the clinical records of Vitapex PE-treated patients at the Pediatric Dental Clinic, Faculty of Dentistry, Mahidol University, from 2013 to 2019. The patient's and pulpectomized tooth's characteristics, procedure, materials used, and type of operator were recorded. A dentist evaluated and compared the periapical lesion, root status, obturation quality, and Vitapex resorption on preoperative, immediate, and follow-up digital radiographs. PE failure was defined as radiographic lesion progression. STATISTICAL ANALYSIS: The Kaplan-Meier method was used to estimate the Vitapex PE success rate and Vitapex resorption rate. Multivariate Cox regression was used to determine the related factors. RESULTS: In total, 647 Vitapex PE teeth from 448 patients (19-121-month-old) were analyzed. The follow-up periods ranged from 6 to 60 months. The success rate was 88.9 and 68.1% at the 12- and 24-month follow-up, respectively, and remained stable at 53.8% at the 36 to 60-month follow-ups. The factors related to Vitapex PE failure were age and a preoperative pathologic lesion. More than 50% of the pulpectomized teeth presented Vitapex resorption faster than physiologic root resorption at the 12-month follow-up. The patients' age at treatment and the obturation quality were significantly related to the Vitapex resorption rate. CONCLUSIONS: The success rate of Vitapex PE decreased time dependently and was related to the patient's age at treatment and a preoperative lesion. The Vitapex resorption was faster than root resorption and was associated with the patient's age at treatment and the root filling extravasation.

Effect of an N95 respirator and a surgical mask-covered N95 on the cardiovascular responses of dentists treating paediatric patients: A crossover clinical trial.

BACKGROUND: The studies on cardiovascular alterations when using an N95 respirator or surgical mask-covered N95 during dental treatments are limited. AIM: To investigate and compare the cardiovascular responses of dentists treating paediatric patients while wearing an N95 respirator or a surgical mask-covered N95. DESIGN: This was a crossover clinical trial in 18 healthy dentists wearing an N95 respirator or surgical mask-covered N95 during the dental treatment of paediatric patients. Oxygen saturation (SpO2 ), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were monitored at baseline, intraoperation, and postoperation. The data were analyzed using the generalized estimating equation. RESULTS: The mean SpO2 , HR, SBP, DBP, and MAP significantly changed from baseline up to the end of the procedures after wearing an N95 by 3.1%, 19.3%, 11.5%, 17.7%, and 13.8% and after wearing a surgical mask-covered N95 by 3.0%, 20.2%, 5.3%, 13.9%, and 8.8%, respectively (p < .05). No significant differences in these values were found between groups (p > .05). CONCLUSIONS: N95 respirators and surgical mask-covered N95s significantly impact the cardiovascular responses of dentists treating paediatric patients with no differences between the two types of masks.

Rare Genetic Variants in Human APC Are Implicated in Mesiodens and Isolated Supernumerary Teeth.

The activation of Wnt/ß-catenin signalling is a prerequisite for odontogenesis. APC, a member of the AXIN-CK1-GSK3ß-APC ß-catenin destruction complex, functions to modulate Wnt/ß-catenin signalling to establish regular teeth number and positions. APC loss-of-function mutations are associated with the over-activation of WNT/ß-catenin signalling and subsequent familial adenomatous polyposis (FAP; MIM 175100) with or without multiple supernumerary teeth. The ablation of Apc function in mice also results in the constitutive activation of ß-catenin in embryonic mouse epithelium and causes supernumerary tooth formation. The objective of this study was to investigate if genetic variants in the APC gene were associated with supernumerary tooth phenotypes. We clinically, radiographically, and molecularly investigated 120 Thai patients with mesiodentes or isolated supernumerary teeth. Whole exome and Sanger sequencing identified three extremely rare heterozygous variants (c.3374T>C, p.Val1125Ala; c.6127A>G, p.Ile2043Val; and c.8383G>A, p.Ala2795Thr) in APC in four patients with mesiodentes or a supernumerary premolar. An additional patient with mesiodens was compound as heterozygous for two APC variants (c.2740T>G, p.Cys914Gly, and c.5722A>T, p.Asn1908Tyr). Rare variants in APC in our patients are likely to contribute to isolated supernumerary dental phenotypes including isolated mesiodens and an isolated supernumerary tooth.

Effectiveness of applying proximal enamel caries with fluoride-releasing sealant and fluoride varnish on caries progression in permanent teeth: A 12-month split-mouth randomized clinical trial.

BACKGROUND: Few studies report on managing initial proximal caries with sealants, and no reports focus on fluoride-releasing sealants. AIM: To compare the effectiveness between applications of a fluoride-releasing sealant and fluoride varnish on proximal enamel caries to control caries progression in permanent teeth. DESIGN: This was a split-mouth randomized controlled trial in forty-four 11- to 16-year-old children with radiographic caries in at least one contralateral pair of teeth with proximal enamel caries. The lesions were evaluated using DIAGNOdent and were also assessed visually after tooth separation. The lesions in each subject were randomly sealed with a fluoride-releasing sealant (Helioseal® F) or applied with fluoride varnish (Duraphat®). The fluoride varnish-treated lesion was reapplied at 3 and 6 months. Clinical examination, bitewing radiograph evaluation, and DIAGNOdent assessment were performed at 6 and 12 months. The caries progression outcome variables were regression, no change, and progression. The data were analyzed with the McNemar-Bowker test. RESULTS: Radiographic examination and DIAGNOdent assessment demonstrated no significant differences in the percentages of regression, no change, or progression at the 12-month follow-up (p > .05). CONCLUSION: Applications of a fluoride-releasing sealant and of fluoride varnish three times resulted in a nonsignificant difference in caries progression of initial proximal caries at the 12-month follow-up.

Outcomes and Predisposing Factors of Two Prophylactic Treatments in Dens Evaginatus Premolars: A Retrospective Study.

INTRODUCTION: Dens evaginatus (DE) in premolars may contain a pulpal extension inside the occlusal tubercle. DE prophylaxis should be performed to prevent pulpal exposure due to tubercle fracture. The aim of this study was to compare the outcomes of 2 prophylactic treatments, that is, prep and fill (PF) and reinforcement (RF), in DE premolars based on clinical and radiographic data, and to identify the predisposing factors. Furthermore, DE prevalence was reported. METHODS: The DE premolar data were collected from dental and radiographic records at the Faculty of Dentistry, Mahidol University, and Bangkok Hospital, Thailand during 2000-2020. Their prevalence and characteristics were determined. Only DE teeth treated with PF or RF prophylaxis were included. Outcomes and possible predisposing factors of the 2 prophylactic groups were evaluated and statistically analyzed. RESULTS: Initially, 303 DE premolars from 110 patients were identified, with the highest prevalence observed in second mandibular premolars (37.21%). The prevalence of contralateral, same quadrant, and opposite arch DE premolars was 50.91%, 39.09%, and 34.55%, respectively. A total of 216 DE teeth met the criteria with an ∼82% recall rate, with 190 and 26 premolars treated by PF and RF, respectively. With mean recall periods of ∼31 and 23 months, the outcomes in the PF and RF group were 95.79% and 80.77% success, respectively, which were significantly different (P = .01). No significant predisposing factor was found. CONCLUSION: Prophylactic treatment in DE premolars with PF provided a significantly higher success rate than those treated with RF.

Odontogenic gene expression profile of human dental pulp-derived cells under high glucose influence: a microarray analysis.

Hyperglycemia, a major characteristic of diabetes, is considered to play a vital role in diabetic complications. High glucose levels have been found to inhibit the mineralization of dental pulp cells. However, gene expression associated with this phenomenon has not yet been reported. This is important for future dental therapeutic application. OBJECTIVE: Our study aimed to investigate the effect of high glucose levels on mineralization of human dental pulp-derived cells (hDPCs) and identify the genes involved. METHODOLOGY: hDPCs were cultured in mineralizing medium containing 25 or 5.5 mM D-glucose. On days 1 and 14, RNA was extracted and expression microarray performed. Then, differentially expressed genes (DEGs) were selected for further validation using the reverse transcription quantitative polymerase chain reaction (RT-qPCR) method. Cells were fixed and stained with alizarin red on day 21 to detect the formation of mineralized nodules, which was further quantified by acetic acid extraction. RESULTS: Comparisons between high-glucose and low-glucose conditions showed that on day 1, there were 72 significantly up-regulated and 75 down-regulated genes in the high-glucose condition. Moreover, 115 significantly up- and 292 down-regulated genes were identified in the high-glucose condition on day 14. DEGs were enriched in different GO terms and pathways, such as biological and cellular processes, metabolic pathways, cytokine-cytokine receptor interaction and AGE-RAGE signaling pathways. RT-qPCR results confirmed the significant expression of pyruvate dehydrogenase kinase 3 (PDK3), cyclin-dependent kinase 8 (CDK8), activating transcription factor 3 (ATF3), fibulin-7 (Fbln-7), hyaluronan synthase 1 (HAS1), interleukin 4 receptor (IL-4R) and apolipoprotein C1 (ApoC1). CONCLUSIONS: The high-glucose condition significantly inhibited the mineralization of hDPCs. DEGs were identified, and interestingly, HAS1 and Fbln-7 genes may be involved in the glucose inhibitory effect on hDPC mineralization.

The efficacy of dental sealant used with bonding agent on occlusal caries (ICDAS 2-4): A 24-month randomized clinical trial.

BACKGROUND: Bonding before sealant application enhances retention on saliva-contaminated sound teeth; however, there are few studies of bonding's efficacy on sealant retention on occlusal caries. AIM: To evaluate a bonding agent's efficacy on sealant retention on occlusal caries and caries transition. DESIGN: One hundred twenty pairs of first permanent molars with occlusal caries (ICDAS 2-4) from 98 children aged 7.3-9.9 years were included. One molar was randomly selected to use bonding (Adper™ Single Bond 2, 3M ESPE) applied before sealant application (Helioseal® clear, Ivoclar Vivadent). Bonding was not used on the contralateral tooth. Retention was determined using Simonsen's criteria; caries transition was evaluated using ICDAS scores, DIAGNOdent values, and bitewings at baseline, 6, 12, and 24 months. Data were analyzed with McNemar's and Fisher's exact tests. RESULTS: Bonding agent use significantly increased sealant retention rates (P < .001). Bonded (B) sealants had a higher retention rate (83.3%) than non-bonded (NB) sealants (53.7%). The difference in the caries-transition rate was not significant between the groups (P > .05). Three teeth (1.4%; NB:B = 2:1) were restored due to radiographic dentin-caries progression. CONCLUSIONS: Using a bonding agent before applying sealant on permanent molar occlusal caries (ICDAS 2-4) significantly enhanced sealant retention. Caries progression was rarely detected at the 24-month follow-up.

Odontogenic gene expression profile of human dental pulp-derived cells under high glucose influence: a microarray analysis

Abstract Hyperglycemia, a major characteristic of diabetes, is considered to play a vital role in diabetic complications. High glucose levels have been found to inhibit the mineralization of dental pulp cells. However, gene expression associated with this phenomenon has not yet been reported. This is important for future dental therapeutic application. Objective Our study aimed to investigate the effect of high glucose levels on mineralization of human dental pulp-derived cells (hDPCs) and identify the genes involved. Methodology hDPCs were cultured in mineralizing medium containing 25 or 5.5 mM D-glucose. On days 1 and 14, RNA was extracted and expression microarray performed. Then, differentially expressed genes (DEGs) were selected for further validation using the reverse transcription quantitative polymerase chain reaction (RT-qPCR) method. Cells were fixed and stained with alizarin red on day 21 to detect the formation of mineralized nodules, which was further quantified by acetic acid extraction. Results Comparisons between high-glucose and low-glucose conditions showed that on day 1, there were 72 significantly up-regulated and 75 down-regulated genes in the high-glucose condition. Moreover, 115 significantly up- and 292 down-regulated genes were identified in the high-glucose condition on day 14. DEGs were enriched in different GO terms and pathways, such as biological and cellular processes, metabolic pathways, cytokine-cytokine receptor interaction and AGE-RAGE signaling pathways. RT-qPCR results confirmed the significant expression of pyruvate dehydrogenase kinase 3 (PDK3), cyclin-dependent kinase 8 (CDK8), activating transcription factor 3 (ATF3), fibulin-7 (Fbln-7), hyaluronan synthase 1 (HAS1), interleukin 4 receptor (IL-4R) and apolipoprotein C1 (ApoC1). Conclusions The high-glucose condition significantly inhibited the mineralization of hDPCs. DEGs were identified, and interestingly, HAS1 and Fbln-7 genes may be involved in the glucose inhibitory effect on hDPC mineralization.

High Glucose Affects Proliferation, Reactive Oxygen Species and Mineralization of Human Dental Pulp Cells.

Diabetes is a group of metabolic disorders that can lead to damage and dysfunction of many organs including the dental pulp. Increased inflammatory response, reduction of dentin formation and impaired healing were reported in diabetic dental pulp. Hyperglycemia, which is a main characteristic of diabetes, was suggested to play a role in many diabetic complications. Therefore our aim was to investigate the effects of high glucose levels on proliferation, reactive oxygen species (ROS) production and odontogenic differentiation of human dental pulp cells (HDPCs). HDPCs were cultured under low glucose (5.5mM Glucose), high glucose (25 mM Glucose) and mannitol (iso-osmolar control) conditions. Cell proliferation was analyzed by MTT assay for 11 days. Glutathione and DCFH-DA assay were used to assess ROS and antioxidant levels after 24 h of glucose exposure. Odontogenic differentiation was evaluated and quantified by alizarin red staining on day 21. Expression of mineralization-associated genes, which were alkaline phosphatase, dentin sialophosphoprotein and osteonectin, was determined by RT-qPCR on day 14. The results showed that high glucose concentration decreased proliferation of HDPCs. Odontogenic differentiation, both by gene expression and mineral matrix deposit, was inhibited by high glucose condition. In addition, high DCF levels and low reduced glutathione levels were observed in high glucose condition. However, no differences were observed between mannitol and low glucose conditions. In conclusion, the results clearly showed the negative effect of high glucose condition on HDPCs proliferation and differentiation. Moreover, it also induced ROS production of HDPCs.

High glucose affects proliferation, reactive oxygen species and mineralization of human dental pulp cells

Abstract Diabetes is a group of metabolic disorders that can lead to damage and dysfunction of many organs including the dental pulp. Increased inflammatory response, reduction of dentin formation and impaired healing were reported in diabetic dental pulp. Hyperglycemia, which is a main characteristic of diabetes, was suggested to play a role in many diabetic complications. Therefore our aim was to investigate the effects of high glucose levels on proliferation, reactive oxygen species (ROS) production and odontogenic differentiation of human dental pulp cells (HDPCs). HDPCs were cultured under low glucose (5.5mM Glucose), high glucose (25 mM Glucose) and mannitol (iso-osmolar control) conditions. Cell proliferation was analyzed by MTT assay for 11 days. Glutathione and DCFH-DA assay were used to assess ROS and antioxidant levels after 24 h of glucose exposure. Odontogenic differentiation was evaluated and quantified by alizarin red staining on day 21. Expression of mineralization-associated genes, which were alkaline phosphatase, dentin sialophosphoprotein and osteonectin, was determined by RT-qPCR on day 14. The results showed that high glucose concentration decreased proliferation of HDPCs. Odontogenic differentiation, both by gene expression and mineral matrix deposit, was inhibited by high glucose condition. In addition, high DCF levels and low reduced glutathione levels were observed in high glucose condition. However, no differences were observed between mannitol and low glucose conditions. In conclusion, the results clearly showed the negative effect of high glucose condition on HDPCs proliferation and differentiation. Moreover, it also induced ROS production of HDPCs.

Resumo O diabetes abrange um grupo de distúrbios metabólicos que podem levar a danos e disfunções de muitos órgãos, incluindo a polpa dentária. Aumento da resposta inflamatória, redução da formação de dentina e comprometimento da cicatrização foram relatados na polpa dentária diabética. A hiperglicemia, que é uma característica determinante do diabetes, desempenha um papel importante em muitas complicações diabéticas. Portanto, nosso objetivo foi investigar os efeitos dos altos níveis de glicose na proliferação, produção de espécies reativas de oxigênio (ROS, em inglês) e diferenciação odontogênica das células da polpa dental humana (HDPCs, em inglês). As HDPCs foram cultivadas em condições de baixa glicose (glicose 5,5 mM), alta glicose (glicose 25 mM) e manitol (controle iso-osmolar). A proliferação celular foi analisada pelo ensaio MTT por 11 dias. Glutationa e DCFH-DA foram utilizados para avaliar os níveis de ROS e antioxidantes após 24 h de exposição à glicose. A diferenciação odontogênica foi avaliada e quantificada pela coloração com vermelho de alizarina no dia 21. A expressão de genes associados à mineralização, que eram fosfatase alcalina, sialofosfoproteína de dentina e osteonectina, foi determinada por RT-qPCR no dia 14. Os resultados mostraram que a alta concentração de glicose diminuiu a proliferação de HDPCs. A diferenciação odontogênica, tanto pela expressão gênica quanto pelo depósito da matriz mineral, foi inibida pela condição de alta glicose. Além disso, altos níveis de DCF e níveis reduzidos de glutationa foram observados na condição de alta glicose. No entanto, não foram observadas diferenças entre o manitol e as condições de baixa glicose. Em conclusão, os resultados mostraram claramente o efeito negativo da condição de alta glicose na proliferação e diferenciação de HDPCs. Além disso, essa condição também induziu a produção de ROS em HDPCs.

WHO Global Consultation on Public Health Intervention against Early Childhood Caries.

Early Childhood Caries (ECC) is prevalent around the world, but in particular the disease is growing rapidly in low- and middle-income countries in parallel with changing diet and lifestyles. In many countries, ECC is often left untreated, a condition which leads to pain and adversely affects general health, growth and development, and quality of life of children, their families and their communities. Importantly, ECC is also a global public health burden, medically, socially and economically. In many countries, a substantial number of children require general anaesthesia for the treatment of caries in their primary teeth (usually extractions), and this has considerable cost and social implications. A WHO Global Consultation with oral health experts on "Public Health Intervention against Early Childhood Caries" was held on 26-28 January 2016 in Bangkok (Thailand) to identify public health solutions and to highlight their applicability to low- and middle-income countries. After a 3-day consultation, participants agreed on specific recommendations for further action. National health authorities should develop strategies and implement interventions aimed at preventing and controlling ECC. These should align with existing international initiatives such as the Sixtieth World Health Assembly Resolution WHA 60.17 Oral health: action plan for promotion and integrated disease prevention, WHO Guideline on Sugars and WHO breastfeeding recommendation. ECC prevention and control interventions should be integrated into existing primary healthcare systems. WHO public health principles must be considered when tackling the effect of social determinants in ECC. Initiatives aimed at modifying behaviour should focus on families and communities. The involvement of communities in health promotion, and population-directed and individual fluoride administration for the prevention and control of ECC is essential. Surveillance and research, including cost-effectiveness studies, should be conducted to evaluate interventions aimed at preventing ECC in different population groups.

PREVALENCE, SEVERITY AND FACTORS ASSOCIATED WITH DENTAL FLUOROSIS AMONG CHILDREN AGED 8-10 YEARS IN BANGKOK, THAILAND.

This study aimed to evaluate the prevalence and factors associated with dental fluorosis in permanent incisors among children aged 8-10 years in Bangkok, Thailand. We studied 707 children selected by stratified randomization and examined each of them to determine their Dean's fluorosis index. Parents of the studied children were asked to fill out a questionnaire. The study was conducted from July to October 2014. Chi-square test and multiple logistic regression analysis were used to study the association between various factors and fluorosis among study subjects. Dental fluorosis was found in 18.4% of subjects. Sixteen point one percent and 2.3% of 707 subjects had very mild fluorosis and mild fluorosis, respectively. Factors significantly associated with dental fluorosis were family income (aOR=1.77; 95% CI: 1.10-2.86, p=0.02) and history of taking fluoride supplements (aOR=1.66; 95% CI: 1.07-2.61, p=0.03). This study indicated that the prevalence of fluorosis had increased in Bangkok, but the majority was very mild level.

Early childhood caries and related factors in Vientiane, Lao PDR.

The objectives of this study were to determine the prevalence of early childhood caries and the oral health status in children aged 36-47 months in Vientiane, the capital city of Lao PDR. This study also aimed to assess the feeding practices, snack consumption, oral hygiene practices, and dental visits of children at this age. A total of 400 children were selected for oral examination and their caretakers were interviewed. The results showed the prevalence of dental caries was 82% with mean decayed, missing and filled teeth (dmft) +/- SD 5.5 +/- 4.3 teeth. No missing teeth were found (mt = 0), and the mean filled teeth (ft) was only 0.02. The teeth most affected by dental caries were the upper right and left central incisors, followed by the upper right and left lateral incisors, lower molars, upper molars, upper canines, lower canines and lower central incisors. The least affected were the lower right and left lateral incisors. Factors that affected dmft were tooth brushing frequency, brushing with parental assistance or supervision, time brushing started, feeding pattern, and the type of milk, candy and sweet beverages consumption. It can be concluded that children in the studied area had a high prevalence of caries and a high level of severity. Thus, oral health care programs should be promoted in Vientiane.

Clinical evaluation of 3Mix and Vitapex as treatment options for pulpally involved primary molars.

OBJECTIVE: The aim of this study was to compare the clinical and radiographic success of 3Mix and Vitapex((R)) for root canal treatment of pulpally involved primary molars. METHODS: Fifty teeth from 37 healthy children aged 3-8 years with pulpally involved primary molars needing root canal procedures were treated with 3Mix or Vitapex((R)) before restoration with stainless steel crowns. The research employed a prospective single-blinded randomized design. The subjects were followed up clinically and radiographically at 6 and 12 months, respectively. The outcome was compared using a Z-test with a significance level of 0.05. RESULTS: Both groups showed 100% and 96% clinical success at 6 and 12 months, respectively. At 6 months, radiographic success of 3Mix and Vitapex((R)) was 84% and 80%, respectively, and at 12 months, radiographic success of 3Mix and Vitapex((R)) was 76% and 56%, respectively. Considering the radiographic findings at the end of 6 and 12 months, no statistically significant differences were found between the two groups (P = 0.356 and 0.068, respectively). CONCLUSION: 3Mix and Vitapex((R)) can be used as a root canal treatment agent in pulpally involved primary teeth.

Remineralization of enamel subsurface lesions by xylitol chewing gum containing funoran and calcium hydrogenphosphate.

The aim of the present study was to determine the remineralization effects of xylitol chewing gum containing funoran and calcium hydrogenphosphate on enamel subsurface lesions in humans. The study was a double-blind, randomized, cross-over design, with 4 types of gum: (1) xylitol gum, (2) xylitol gum containing funoran and calcium hydrogenphosphate, (3) sugar gum, and (4) gum base as a control. Seven subjects were instructed to wear removable lingual appliances, with half-slab insets of human enamel containing demineralized subsurface lesions. They were told to chew gum for 20 minutes 4 times per day for 7 days. Upon completion of each treatment the enamel half-slabs were paired with their respective demineralized control half-slabs, embedded, sectioned, and subjected to microradiography and densitometric image analysis, for measurement of the level of remineralization. The mean area of remineralization (deltaZd-deltaZr) and mean percent remineralization (%R) in those chewing xylitol gum containing funoran and calcium hydrogenphosphate were significantly higher than the corresponding values for xylitol gum, sugar gum and gum base. Chewing xylitol gum containing funoran and calcium hydrogenphosphate has a significant effect on the remineralization of initial caries-like lesions of the teeth.

Salivary secretory IgA, pH, flow rates, mutans streptococci and Candida in children with rampant caries.

The aim of this study was to determine the levels of secretory IgA (SIgA), pH, flow rates, mutans streptococci (MS) and Candida in saliva of children with rampant caries compared to those caries-free. Thirty children (age 62-123 months) were enrolled and divided into two groups: Group I, children with rampant caries, Group II, caries-free children. The average salivary flow rate was measured from the volume yielded within 5 minutes and the pH was determined using a pH-electrode. Measurement of SIgA was performed using an immunoassay kit. The levels of MS and Candida were determined by culture on Mitis-Salivarius Bacitracin agar and Sabouraud dextrose agar. It was found that children with rampant caries presented with significantly higher levels of salivary SIgA, MS and Candida. However, the mean values for salivary flow rates and pH were similar between the groups. The results reveal that children with rampant caries had significantly higher levels of SIgA, MS and Candida in their oral cavities. This finding tends to support the hypothesis that higher levels of salivary SIgA may reflect a past exposure of the host to cariogenic microorganisms.

Microtensile bond strength of a total-etching versus self-etching adhesive to caries-affected and intact dentin in primary teeth.

BACKGROUND: The objec tives of this study were to determine microtensile bond strengths of two dentin adhesives and to compare the micromorphological structure of the resin/dentin interface in caries-affected dentin with that of intact dentin. METHODS: The authors randomly divided 40 proximal dentinal carious primary teeth and 40 noncarious anterior primary teeth into two groups (self-etching and total-etching). They used a caries-detecting dye as an indicator of the need to remove the outer carious dentin. The authors restored the teeth with a hybrid resin-based composite. After 24 hours' storage in 37 C water, specimens were sectioned and shaped to form a curved section with a cross-sectional area of 1 square millimeter, then tension was applied until they fractured. The authors prepared the resin/dentin interfaces for the two bonding systems and examined them in 10 occlusal carious and 10 noncarious teeth. STATISTICAL ANALYSIS: The bond strengths for intact and caries-affected dentin within the same group were analyzed via a t test. The authors compared the remaining dentin thickness (RDT) and dentin hardness using analysis of variance and the least significant difference test at the .05 level of significance. RESULTS: The self-etching adhesive demonstrated no statistical difference in bond strength between intact and caries-affected dentin. However, the total-etching adhesive demonstrated different bond strengths for intact and caries-affected dentin. Moreover, the RDT of specimens with intact and caries-affected dentin was not significantly different, whereas the dentin hardness of caries-affected dentin was significantly lower than that of intact dentin. The authors found a thicker hybrid layer in intact and caries-affected dentin of specimens in the total-etching group. CONCLUSION: The adhesives exhibited significantly different bond strengths in intact dentin of primary teeth. However, they exhibited similar bond strengths in caries-affected dentin.

Plaque and saliva fluoride levels after placement of fluoride releasing pit and fissure sealants.

PURPOSE: The objectives of this study were to investigate the fluoride levels in plaque and saliva before and after applying fluoride-containing pit and fissure sealants, and compare the fluoride release of 2 types of sealants at the different time intervals. METHODS: Eighteen children ages 6 to 9 years were randomly divided into 2 groups: Group 1--sealant containing fluorosilicate glass (Helioseal-F); and group 2--sealant containing methacryloyl fluoride-methyl methacrylate copolymer (Teethmate-F). Saliva and plaque samples were collected before and after the sealants were placed on their 4 first permanent molars. Fluoride levels were determined using the microdiffusion method. Fluoride concentrations before and after placing the sealants were analyzed by paired t test, and the fluoride concentrations between the 2 sealants were compared by t test, with the level of significance at 0.05. RESULTS: There was no significant difference between salivary fluoride levels before and after sealant placement application in both groups. The plaque fluoride level of Helioseal-F group at 24 hours was significantly higher than the baseline level (P = .03), and was not different afterwards. The plaque fluoride levels after sealant with Teethmate-F were not significantly different when compared to the baseline. However, there were no significant differences between salivary and plaque fluoride levels of the 2 groups at different time intervals. CONCLUSIONS: The groups sealed with sealant containing fluorosilicate glass showed significant increase of plaque fluoride level only at 24 hours after sealant placement.