Bioactive Restorative Materials Applied over Coronal Dentine-A Bibliometric and Critical Review.

The objective of the research was to examine the scientific literature concerning restorative materials with bioactive properties for the purpose of covering dentin. Searches were performed in various databases including MEDLINE, Scopus, Web of Science, Cochrane Library, Lilacs/BBO, and Embase. Inclusion criteria involved studies that utilized the terms "dentin" and "bioactive", along with "ion-releasing", "smart materials", "biomimetic materials" and "smart replacement for dentin". The information extracted included the title, authors, publication year, journal and the country of affiliation of the corresponding author. The studies were categorized based on their study design, type of material, substrate, analytical method, and bioactivity. A total of 7161 records were recovered and 159 were included for data extraction. Most of the publications were in vitro studies (n = 149), testing different types of materials in sound dentine (n = 115). Most studies were published in Dental Materials (n = 29), and an increase in publications could be observed after the year 2000. Most of the articles were from the USA (n = 34), followed by Brazil (n = 28). Interfacial analysis was the most investigated (n = 105), followed by bond strength (n = 86). Bioactivity potential was demonstrated for most tested materials (n = 148). This review presents insights into the current trends of bioactive materials development, clearly showing a severe lack of clinical studies.

Probiotics and dairy products in dentistry: A bibliometric and critical review of randomized clinical trials.

The oral environment is an essential part of the human microbiome. The consumption of probiotic products may improve the oral microbiota and reduce the risk of diseases. This paper presents a bibliometric and critical review of randomized clinical trials (RCTs) that used probiotics to analyze oral parameters in humans. RCTs carried out with no age, gender, and ethnicity restrictions and published in the pre-COVID-19 period were included. Furthermore, the utilization of probiotic dairy products to improve oral health is discussed. The bibliometric review demonstrated that 'Microbiology,' 'Dental caries,' and 'Streptococcus mutants' were the most highlighted keywords. Furthermore, Sweden and India have the highest number of publications. The most prevalent outcomes were 'salivary parameters,' 'periodontal disease,' and 'dental caries.' The most used vehicles for probiotic administration were pharmaceutical formulas and dairy products. The administration of probiotic dairy products could modify the oral microbiota (reductions in S. mutans counts), influence the caries development and periodontal disease in children, adolescents, adults, and the elderly, and improve gingival health. The main probiotic dairy products investigated were milk, fermented milk, yogurt, kefir, curd, and cheese. Lacticaseibacillus paracasei SD1 was the most used probiotic culture. The studies demonstrated that the probiotic effect lasted 2-4 weeks after discontinuing consumption. However, the results depended on the subject type, study design, probiotic strain and concentration, and dairy product type. In conclusion, probiotic dairy products are promising alternatives to improve oral health.

Are yellow-brownish opacities in hypomineralized teeth more prone to breakage than white-creamy ones? A systematic review.

OBJETIVE: To evaluate all the available evidence assessing if in hypomineralized teeth, yellow-brownish opacities are more prone to post-eruptive breakdown (PEB) compared to white-creamy opacities. MATERIALS AND METHODS: Observational studies that evaluated the occurrence of PEB in hypomineralized teeth were considered for inclusion. Electronic searches were performed up to January 2022 in MedLine, LILACS, BBO, Cochrane Library, Web of Science, Scopus, and EMBASE. Neither publication date nor language restrictions were imposed to the searches. Two researchers independently performed the study selection, data extraction, and quality assessment of the included studies according to the Newcastle-Ottawa Scale (NOS). Datasets from studies were grouped for narrative synthesis based on the severity of the PEB (enamel or dentin), type of tooth (molar or incisor), unit of analysis (subject or tooth or tooth surface), and follow-up period (in months). The certainty of evidence was evaluated using the GRADE approach. RESULTS: Nine studies were included, five cohort and three cross-sectional. All studies assessed the opacities and PEB by visual examination and diagnosed MIH according to EAPD criteria. In the cohort studies, considering all follow-up periods (ranging from 6 to 36 months), dark opacities fractured more than light opacities, at both enamel and enamel/dentin levels, and molars fractured more than incisors. In two out of three cross-sectional studies, dark opacities also fractured more than light opacities, but the deep of the PEB (enamel or dentin breakdown) or the type of tooth (molar or incisor) was not considered in the analysis. CONCLUSION: Although it seems plausible to state that darker demarcated opacities in MIH patients broke more often than light ones, based on this systematic review of the literature, the certainty of the available evidence about this association is still very low. CLINICAL RELEVANCE: More reliable and valid research is still necessary to support any future recommendation that MIH children who present yellow-brownish opacities should be monitored at shorter intervals compared to those who present only white-creamy opacities.

Recommendations from paediatric dentistry associations of the Americas on breastfeeding and sugar consumption and oral hygiene in infants for the prevention of dental caries: A bibliometric review.

BACKGROUND: The Internet provides a plethora of information on health issues related to children's oral health. AIM: Identify online recommendations of paediatric dentistry associations of the Americas (PDAAs) regarding breastfeeding practices, weaning, sugar introduction and initiating oral hygiene. DESIGN: Websites of PDAAs were accessed to record recommendations/questions (Q) relevant to early childhood that specifically covered issues about exclusive breastfeeding-Q1, indications of bottle feeding-Q2, when and how to start weaning-Q3 and Q4, respectively, association of breast milk and dental caries-Q5, when to start oral hygiene and how to introduce it-Q6 and Q7, respectively, and guidance on the introduction of sugar-Q8. Similarity/dissimilarity frequencies between the associations (Euclidean distances) were calculated. RESULTS: From 35 countries on the two American continents, 21 associations were affiliated with the International Association of Paediatric Dentistry and/or the Latin American Pediatric Dentistry Association, whereas eight did not have websites. Higher (P < .05) dissimilarities for Q6 (68.2%), Q7 (72.7%), and Q8 (62.1%) were observed. Results were similar for Q1 and Q5 (P > .05). No association mentioned Q2, Q3 or Q4 responses, whereas Q7 was the most frequently discussed issue. CONCLUSION: Not all of the investigated issues are mentioned on websites of PDAAs, potentially stymieing efforts by both the layperson and health professional to gather information.

Effects of rapid maxillary expansion on temporomandibular joints.

OBJECTIVE: To evaluate the impact of rapid maxillary expansion (RME) on the condylar position, disc joint, joint space, and interarticular relationship in growing patients. MATERIALS AND METHODS: A systematic search was performed in nine databases. The clinical studies selected included those with pre- and post-magnetic resonance, conventional computed tomography or cone beam tomography in growing patients. Risk of bias assessment was performed using the Cochrane Collaboration tool for controlled clinical studies and National Heart, Lung, and Blood Institute (NHLBI) Quality Assessment for Before-After Studies With No Control Group. RESULTS: Initially, 4303 records were identified. Only eight studies fulfilled the criteria and were included in the qualitative analysis. Of those, two were controlled clinical studies with a risk of uncertain to high bias. The remaining papers had a low to moderate risk of bias. Results showed that RME in children and adolescents promoted the following: remodeling in the head and or condylar branch, changes in condylar position and joint space, maintenance of improved symmetry between the condyles, and no ability to modify the position or shape of the articular disc. CONCLUSIONS: RME in growing patients is able, in the short term, to modify the condyle-fossa relationship but does not change the position or shape of the articular disc. The intercondylar symmetric relationship is maintained or improved. Although the NHLBI score shows low to moderate risk of bias, the clinical relevance of these review findings is limited by Cochrane and Grades of Recommendation, Assessment, Development and Evaluation scores.

Assessment of the effectiveness of invisible aligners compared with conventional appliance in aesthetic and functional orthodontic treatment: A systematic review.

To seek scientific evidence to support the effectiveness of invisible aligners, in the aesthetic and functional aspects, compared with that of conventional braces. An electronic search was performed with a complementary grey literature search for in vivo research. No language restrictions were applied. Scopus, PubMed, Web of Science, Cochrane, ClinicalTrials and GreyLiterature databases were used. Studies were first selected by title and abstract; those potentially eligible were read in full. Non-randomized studies were assessed for risk of bias using the tools Methodological Index for Non-randomized Studies (MINORS) and Cochrane Collaboration Common Scheme for Bias as a function of the presence of randomization. The search found 559 studies, of which 55 were potentially eligible. A total of 4 articles were included in this systematic literature review: three non-randomized controlled studies and one randomized controlled study, three with low risk of bias (RoB) and one with moderate RoB. Three studies showed time of correction of dental crowding shorter or equal to that of the control group and only one study showed less time of correction using conventional braces. Invisible aligners were deficient with respect to anterior/posterior and vertical corrections compared with fixed orthodontic appliances. Invisible aligners are effective in promoting dental alignment, but present clinical limitations in relation to the conventional system.

Effectiveness of casein phosphopeptide-amorphous calcium phosphate-containing products in the prevention and treatment of white spot lesions in orthodontic patients: A systematic review.

The purpose of the present systematic review was to evaluate the effectiveness of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-containing products in the prevention and treatment of active white spot lesions (WSL) in orthodontic patients. Searched the Scopus, PubMed, Web of Science, Cochrane, Virtual Health Language, ClinicalTrials, and Open Gray databases without limitations on the year or language of publication. We included controlled clinical trials with patients with fixed orthodontic appliances under the use of CPP-ACP-containing products compared to control, placebo, or other interventions in the prevention and treatment of WSL around orthodontic braces. Case reports, editorials, in vitro studies, annals of congress, and reviews were excluded. To assess the risk of bias, the revised version of the Cochrane tool for randomized trials (RoB 2.0) and Risk Of Bias In Non-randomized Studies for non-randomized trials were used. The biases were graded low, moderate, and high according to the tools used. Of the 599 articles found, 11 met the inclusion criteria. Of these, nine were randomized, controlled clinical trials and two were non-randomized. Two studies were considered to have moderate bias risk, and the most-used CPP-ACP presented form was a cream for topical applications. Although CPP-ACP-containing products did not differ from other fluoride products, they were able to reduce WSL and neutralize the pH around the orthodontic braces. Products containing CPP-ACP are effective in preventing and treating WSL around the braces. However, further studies with the same measurement method and periods of use, and other forms of presentation of CPP-ACP are needed.

Clinical efficacy of nano-hydroxyapatite in dentin hypersensitivity: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the desensitizing effect of nano-hydroxyapatite (n-HAP) on dentine hypersensitivity (DH). SOURCES: Seven electronic databases were searched on April 27, 2018. STUDY SELECTION: Randomized clinical trials (RCTs) were included based on the PICO strategy: Participants - Humans with DH; Intervention - n-HAP-containing desensitizing; Comparison -n-HAP-free treatments or placebo/negative control; and Outcomes - relief of DH. The risk of bias was classified by the Cochrane guidelines. Five meta-analyses were performed to evaluate the efficacy of n-HAP with regard to pain assessment stimuli (primary outcome); comparison of n-HAP with other treatments or placebo/negative control, and effectiveness of at-home and in-office n-HAP use (secondary outcomes). The quality of the evidence was evaluated using the GRADE. DATA: Six RCTs with 4 weeks of follow-up were included in the meta-analysis. For the primary outcome, n-HAP showed a better desensitizing effect for evaporative stimuli (SMD -1.09 [-1.24, -0.94], p < 0.00001) and tactile stimuli (SMD -0.93 [-1.42, -0.43]) than other treatments (p = 0.0002). However, there was no difference between n-HAP and other treatments for the cold stimuli (SMD -0.17 [-0.81, 0.48], p = 0.61). In an overall analysis, n-HAP-containing treatment showing the most significant desensitizing effect (SMD -0.93 [-1.19, -0.68], p < 0.00001) with a high quality of evidence for pooled results. In the secondary outcomes, n-HAP showed the best effect in the overall analysis (p < 0.05) with moderate quality evidence. CONCLUSIONS: The n-HAP-containing treatment showed better clinical performance than other treatments for DH relief. However, long-term follow-up RCTs are required in the future before definitive recommendations can be made. CLINICAL SIGNIFICANCE: Dentin hypersensitivity is a common global condition and its multifactorial etiology has led to the development of several treatments. The n-HAP-containing treatment showed greater DH relief when compared to other desensitizing agents, placebo or negative control.

Does the adhesive strategy influence the post-operative sensitivity in adult patients with posterior resin composite restorations?: A systematic review and meta-analysis.

OBJECTIVES: A systematic review and meta-analysis were performed on the risk and intensity of postoperative sensitivity (POS) in posterior resin composite restorations bonded with self-etch (SE) and etch-and-rinse (ER) adhesives. SOURCE: A comprehensive search was performed in the MEDLINE via PubMeb, Scopus, Web of Science, LILACS, BBO and Cochrane Library and SIGLE without restrictions. The abstracts of the annual conference of the IADR (1990-2014), unpublished and ongoing trials registry were also searched. Dissertations and theses were searched using the ProQuest Dissertations and Periodicos Capes Theses databases. STUDY SELECTION: We included randomized clinical trials that compared the clinical effectiveness of SE and ER used for direct resin composite restorations in permanent dentition of adult patients. The risk/intensity of POS was the primary outcome. The risk of bias tool of the Cochrane Collaboration was used. The meta-analysis was performed on the studies considered 'low' risk of bias. DATA: After duplicates removal, 2600 articles were identified but only 29 remained in the qualitative synthesis. Five were considered to be 'high' risk of bias and eleven were considered to be 'unclear' in the key domains, yielding 13 studies for meta-analysis. The overall relative risk of the spontaneous POS was 0.63 (95% CI 0.35 to 1.15), while the stimuli-induced POS was 0.99 (95% CI 0.63 to 1.56). The overall standardized mean difference was 0.08 (95%CI -0.19 to 0.35). No overall effect was revealed in the meta-analyses, meaning that no influence of the ER or SE strategy on POS. SIGNIFICANCE: The type of adhesive strategy (ER or SE) for posterior resin composite restorations does not influence the risk and intensity of POS. CRD42014006617.

Traumatic dental injury in permanent teeth of young patients attended at the federal University of Rio de Janeiro, Brazil.

BACKGROUND/AIM: Risk factors for dental trauma, such as gender and age, have not been studied in much detail in the past. So, this study was to determine the frequency of Traumatic dental injuries (TDI) and the association of gender and age with the different types of injuries in permanent teeth of patients treated at the Dental Trauma Surveillance Center, Federal University of Rio de Janeiro, Brazil. MATERIAL AND METHODS: Data from records of 1022 patients were evaluated, and patients with TDI in permanent teeth were included and descriptively analyzed. The Chi-squared test and logistic regression were also used (P ≤ 0.05). RESULTS: A total of 352 (34.4%) records from patients (mean age 9.29 ± 1.97) with 676 affected permanent teeth were included in the final sample. Children (55.7%) have a higher frequency of TDI than adolescents (42.9%). Falls (54.3%) was the most common cause, and the street (37.5%) was the most frequent place of occurrence. Enamel and dentin fracture without pulp exposure (69.2%) was the most common TDI for both genders (P = 0.16). Avulsion (29.2%) was the most frequent injury to supportive tissues for both genders; however, this was more numerous in girls (P < 0.001). Intrusive luxation was more common in boys (P = 0.01). According to logistic regression, intrusive luxation affects girls less (OR = 0.394; IC = 0.178-0.875) than boys, while girls have more chance of suffering from avulsion (OR = 1.912; IC = 1.197-3.055) and avulsion was less frequent in children (OR = 0.588; IC = 0.373-0.928). CONCLUSIONS: Enamel and dentin fractures without pulp exposure and avulsion were the most common TDI. Gender (female) and age (adolescent) were considered risk factors for the occurrence of avulsion. However, male gender was a risk factor for the occurrence of intrusive luxation. So public health policies and educational programs aimed at prevention need to be developed, and the differences among groups should be respected.

Influencia del consumo de azúcar, uso de medicamentos e higiene oral en la prevalencia de caries en bebés / Influence of sugar consumption, medicines uses and oral hygiene in the babies caries prevalence

El presente estudio tuvo por objetivo analizar el perfil odontológico de los pacientes atendidos en la Clínica de Bebés de una institución de enseñanza superior de Río de Janeiro, Brasil, y la influencia del consumo de azúcar, uso frecuente de medicamentos e higiene oral en la prevalencia de caries de aparición temprana en bebés de 0 a 36 meses de edad. Se utilizó la documentación indirecta a través de investigación en las historias clínicas de los pacientes. Fueron seleccionadas 525 historias clínicas válidas y los datos obtenidos fueron tabulados y analizados en el  programa Epi Info 6.04. La media de edad fue de 21,4 ± 8,3  meses, 53 por ciento género masculino. Un 35 por ciento de los pacientes poseían bajo consumo de azúcar, un 81 por ciento acostumbraba a endulzar alimentos, especialmente con sacarosa (94 por ciento). El uso frecuente de medicamentos  relatado en 29 por ciento, especialmente vitaminas (74 por ciento) y un total de 84 por ciento higienizaban sus dientes. Presencia de caries en 38 por ciento de los casos con un ceo-d medio de 3,21. Se observó un consumo de azúcar directamente relacionado a la presencia de caries (p<0,05Qui-cuadrado). Hubo una relación proporcional entre edad de los pacientes y caries (p<0,05). No hubo relación entre uso de medicamentos y caries (p>0,05). Se observó que el hábito de higiene dental tuvo relación inversamente proporcional a la prevalencia de caries (p<0,05). Se concluyó que el uso de medicamentos no tiene relación con caries en la población estudiada, en cuanto el consumo de azúcar e higiene ejercen un papel preponderante en sus índices en bebés

The prevalence of early childhood caries in children from 0-36 months and its relationship with sugar consumption, medicines uses and oral hygiene, has been study in this research. We used non direct documentation through patient records research from a baby clinic of Rio de Janeiro higher education institution. From a total of 1066 records, we selected 525 valid records and the results were listed and analyzed using Epi Info 6.04 software. We found an average age of 21.4 ± 8.3 month, where 53 percent were male. Approximately 1/3 of the babies (35 percent) had low sugar consumption; moreover 81 percent of the babies were used to sweeten their food, especially with sucrose (94 percent). The frequently use of medicine were found in 29 percent, especially vitamins with a value of 74 percent; and a total of 84 percent did oral hygiene where 77 percent used tooth brush and 51 percent used past tooth. Caries were present in 38 percent of the babies, and an average dmf-t found was 3.208. We observed that the sugar consumption was directly related to the presence of dental carie (p<0.05 Chi-square test). We also found a proportional relationship between patient age and the presence of dental caries (p<0.05). There were not relationship between medicine uses and the presence of dental caries (p>0.05). We observed that the dental hygienic had a proportional inverse relationship to the presence of dental caries (p<0.05). We concluded that the medicine uses had not relationship with dental carie considering our patient records. However, sugar consumption and the dental hygienic habit play a fundamental role in the babies carie prevalence