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1.
Artigo em Inglês | MEDLINE | ID: mdl-33499023

RESUMO

Qualitative research collects non-numerical data that explores human behaviour, attitudes, beliefs and personality characteristics unamendable to quantitative research. The qualitative research questions are open-ended, evolving and non-directional. The study design is flexible and iterative. Purposive sampling is commonly used. The sample size is determined by theoretical saturation. Data collection is generally through in-depth interviews, focus groups and observations. Qualitative research commonly uses thematic analysis and framework analysis, although there is no consensus on analysing qualitative data. The reporting format can be comprehensive, a summary, developmental or selective, subject to the research question. Qualitative research's potential functions are to describe the form or nature of what exists (contextual), to examine the reasons for or associations between what exists (explanatory), to appraise the effectiveness of what exists (evaluative), and to aid the development of strategies (generative). Qualitative research can be time consuming to conduct because it explores evolving questions; difficult to generalise because it recruits limited participants; and arduous when it comes to making systematic comparisons because responses are subjective. However, qualitative research can provide depth and detail, create openness, simulate people's individual experiences and avoid pre-judgements. This concise review provides an overview and suggestions for dental researchers when conducting a qualitative study.

2.
J Dent ; 105: 103581, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33434634

RESUMO

OBJECTIVES: This study investigated the effects of a new strontium-doped bioactive glass and fluoride on hydroxyapatite crystallization. METHODS: We designed an in vitro experiment with calcium phosphate (CaCl2·2H2O + K2HPO4 in buffer solution) with different concentrations of strontium-doped bioactive glass (1 mg/mL or 5 mg/mL), and different concentrations of fluoride (0 ppm, 1 ppm or 5 ppm). Tris-buffered saline served as negative control. After incubation at 37 ℃ for 48 h, the shape and organization of crystals were examined by transmission electron microscopy (TEM) and electron diffraction. Structure of the crystals was assessed by powder X-ray diffraction (P-XRD) and unit cell parameters were calculated. Characterization of the crystals were performed by Raman spectroscopy and Fourier Transform Infrared Spectroscopy (FTIR). RESULTS: TEM and selected-area electron diffraction revealed that the precipitates in all experimental groups were crystalline apatite. There was an interaction between strontium and fluoride with different concentrations on crystal thickness (p = 0.008). P-XRD indicated the formation of strontium-substituted-fluorohydroxyapatite and strontium-substituted-hydroxyapatite in the groups with both bioactive glass and fluoride. Expansion or contraction of crystal unit cell was influenced by the concentrations of strontium and fluoride. Raman spectra showed strong phosphate band at 960 cm-1 in all experimental groups and displayed no obvious shift. FTIR results confirmed the formation of apatite. CONCLUSIONS: The results of this study suggest that strontium-doped bioactive glass and fluoride have synergistic effects on hydroxyapatite crystallization. CLINICAL SIGNIFICANCE: Strontium-doped bioactive glass and fluoride have synergistic effects on hydroxyapatite crystallization by producing strontium-substituted-hydroxyapatite and strontium-substituted-fluorohydroxyapatite with enhanced bioactivity and reduced solubility which could be beneficial for caries management.

3.
J Dent ; 104: 103526, 2020 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-33188846

RESUMO

OBJECTIVES: Aim of this systematic review was to summarize the factors that affect the success rate of atraumatic restorative treatment (ART) restorations in children. DATA/SOURCES: Two independent reviewers conducted a literature search in the databases PubMed, Medline and Web of Science until October 2019 with no initial time limit. Articles reporting on clinical outcomes of ART restorations placed in children were included. STUDY SELECTION: A total of 67 articles were included in this review reporting on clinical outcomes of ART restorations placed in children in 47 studies. The overall estimated success rate and 95 % confidence interval (CI) of ART restorations were 0.71 (0.65-0.77) and 0.67 (0.56-0.78) at the 12-month and the 24-month follow-up, respectively. Operator was one of the significant factors associated with the success rate of ART restorations. ART restorations placed by dental students/therapists had a significantly lower success rate compared with those placed by dentists. Besides, type of restoration (single-surface vs. multiple-surface restoration) was also associated with the success rate of ART restorations. Other factors including dentition, restorative material, clinical setting, and moisture control method had no significant influence on the success rate of ART restorations in children. CONCLUSION: It is concluded that ART approach can be used to manage cavitated caries lesions in children. Operator and type of restoration are significant factors influencing the success rate of ART restorations. CLINICAL SIGNIFICANCE: This study provides valuable information on the factors that affect success rate of ART restorations in children, which helps clinicians to make informed decisions on provision of ART restorations in children.

4.
J Dent ; 103: 103512, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33157159

RESUMO

OBJECTIVES: To investigate the remineralising and staining effects of sodium fluoride (NaF) with silver nanoparticles (AgNPs) on artificial dentine caries. METHODS: Human dentine blocks with artificial caries were divided into four groups. Group 1 received 5 % NaF (22,600 ppm fluoride) with 4000 ppm AgNPs; group 2 received 4000 ppm AgNPs; group 3 received 5 % NaF, group 4 received deionised water (negative control). All groups underwent three biochemical cycles. Each cycle included Streptococcus mutans biofilm challenge and remineralisation process. The lesion depth, mineral-organic content, surface morphology and crystal characteristics of dentine blocks were evaluated using micro-computed tomography, Fourier transform infrared spectroscopy, scanning electron microscopy (SEM) and X-ray diffraction. Colour change of dentine blocks was assessed using spectrophotometry. RESULTS: The mean lesion depths of groups 1-4 were 151.13 ± 29.13 µm, 172.38 ± 23.44 µm, 190.41 ± 32.81 µm and 221.24 ± 27.91 µm, respectively. The hydrogen phosphate-to-amide I ratios of groups 1-4 were 5.98 ± 0.36, 3.86 ± 0.56, 4.00 ± 0.67 and 2.53 ± 0.40, respectively. There was no significant interaction effect between AgNPs and NaF. SEM showed less exposure of dentine collagen fibres in group 1 when compared to other groups. X-ray diffraction revealed presence of silver chloride and metallic silver in group 1 and 2. There was no significant difference in colour change among the four groups (p = 0.74). CONCLUSIONS: NaF solution with AgNPs can remineralise dentine caries without staining. CLINICAL SIGNIFICANCE: Sodium fluoride solutions that include silver nanoparticles have potential uses in the management of caries.

5.
J Dent ; 103: 103522, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33166594

RESUMO

OBJECTIVE: The aim of this randomised non-inferiority clinical trial was to compare the effectiveness of semi-annual (every six months) applications of 25 % silver nitrate (AgNO3) solution followed by 5 % sodium fluoride (NaF) varnish to semi-annual applications of 38 % silver diamine fluoride (SDF) solution in arresting early childhood caries (ECC). METHODS: Three-year-old children with active cavitated carious lesions were recruited and randomly assigned to two intervention groups. Children in Group A received semi-annual applications of 25 % AgNO3 solution followed by 5 % NaF varnish on carious lesions. Children in Group B received semi-annual applications of 38 % SDF solution followed by a placebo varnish. One trained dentist assessed ECC status at baseline and in all follow-up examinations. An independent operator performed the interventions. The dentist, the children, and their caretakers were blinded to the intervention allocation. Data were analysed using a non-inferiority test. Group A's non-inferiority would be accepted if the lower limit of the 95 % confidence interval (CI) for the difference in the mean number of arrested decayed surfaces (ds) was greater than -0.5. RESULTS: At baseline, 1,070 children were recruited, and 535 children were assigned to each group. After 30 months, the mean arrested ds in Groups A (n = 447) and B (n = 433) were 3.7 ± 3.6 and 3.6 ± 3.7, respectively (p = 0.694). The difference in the mean arrested ds between the two groups was 0.088 (95 % CI: -0.351 to 0.526). CONCLUSION: Semi-annual application of 25 % AgNO3 followed by 5 % NaF is at least as effective as the semi-annual application of 38 % SDF in arresting ECC. CLINICAL SIGNIFICANCE: Silver and fluoride products are effective in arresting caries. As a simple, non-invasive, and inexpensive strategy, it can be used in young children, elderly adults, and people with special needs.

6.
J Dent ; 104: 103520, 2020 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-33152407

RESUMO

OBJECTIVES: To develop and validate a questionnaire for assessing chewing function of Chinese older adults. METHODS: The chewing function questionnaire was validated on older adults recruited from a dental hospital, an elderly home and three community centers in Hong Kong. The participants were asked to indicate their ability to chew on each of the 20 selected food items and to self-rate their overall chewing ability. Chewing function was objectively assessed by asking the participant to chew a color-changeable gum for 90 s. The color of the chewed gum was assessed using a colorimeter. Participant's maximum bite force was also measured by an electronic detector. RESULTS: A total of 211 elders participated in this study. Ten out of the 20 food items were selected to create the final unidimensional chewing function questionnaire (CFQ). The overall Cronbach's alpha value for the CFQ was 0.912. The weighted kappa value of each food item ranged from 0.6 to 1. In general, participants with larger color change of the chewed gum had significantly higher median rank of the CFQ total score and of the score of each food item (p < 0.01). The CFQ total score was correlated with the color change of the chewed gum as measured by colorimeter (p < 0.001), the maximum bite force (p < 0.001) and self-rated chewing ability (p < 0.001). CONCLUSION: The new unidimensional chewing function questionnaire is a valid and reliable questionnaire for assessing self-rated chewing ability of Chinese older adults. CLINICAL SIGNIFICANCE: The newly developed self-reported questionnaire can be used to assess the chewing function of Chinese older adults and dentists can use the information obtained to discuss with their patients regarding the need for oral function rehabilitation, such as the treatment need for fixed or removable dental prosthesis.

7.
BMC Oral Health ; 20(1): 284, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33066773

RESUMO

BACKGROUND: Poor oral hygiene and high hormone levels during pregnancy can lead to a deterioration in periodontal health. This study assessed the effectiveness of a family-centered behavioral and educational counselling program on improving the periodontal health of women during pregnancy and postpartum. METHODS: A randomized controlled trial was conducted among pregnant women (10th-22nd gestational week) and their husbands. Participating families were randomized into test and control groups. Intervention in the test group included explanation of oral health education (OHE) pamphlets, oral hygiene instruction, individualized feedback, and proposed solutions to overcome barriers in self-care. Reinforcements were implemented in the 3rd trimester of pregnancy and six months postpartum. In the control group, only OHE pamphlets were distributed. The assessed outcomes were bleeding on probing (BOP), periodontal pocket (Poc), loss of clinical attachment (LoA), and Visible Plaque Index (VPI). The data collection was carried out at baseline (T0), in the 32nd gestational week (T1), and 12 months postpartum (T2). RESULTS: Altogether 589 pregnant women were recruited, and 369 attended all three visits (test:188; control:181). In the test group, the mean VPI score at T0 was 0.19, which decreased to 0.14 at T1 and 0.15 at T2. In the control group, the mean VPI decreased from 0.19 at T0 to 0.16 at T1, but increased to 0.22 at T2. A main effect of time and intervention and an interaction between time and intervention were detected (all p < 0.05), indicating that the intervention effect differed between T1 and T2. The test group showed a significantly greater decrease over time than the control group did. Similarly, the mean BOP% decreased more significantly over time in the test group (T0:57%, T1:46%, T2:35%) than in the control group (T0:58%, T1:52%, T2:46%). For Poc and LoA, there were improvements in both study groups at 12 months postpartum, compared with during pregnancy (p < 0.001). CONCLUSIONS: Providing family-centered, behavioral, and educational counselling to pregnant women at an early stage of pregnancy and with reinforcements can improve their oral hygiene and reduce gingival inflammation. The effect can be sustained over an extended period and is greater than that of distributing oral health leaflets alone. TRIAL REGISTRATION: Clinicaltrials.gov , #NCT02937194. Registered 18 October 2016. Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02937194?cond=Family-centered+oral+health+promotion+for+new+parents+and+their+infants&draw=2&rank=1.

8.
Clin Oral Investig ; 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32895767

RESUMO

OBJECTIVES: To investigate the associations between dental conditions, sliver diamine fluoride (SDF) application, parental satisfaction, and oral health-related quality of life (OHRQoL) of preschool children. MATERIALS AND METHODS: In a clinical trial conducted in Hong Kong, preschool children who had carious lesions into dentine were randomly assigned to receive an application of SDF solution or placebo on their caries lesions 10 weeks before they received restorations. Additionally, a random sample of caries-free children was also recruited. Parents of the study children rated their satisfaction with their child's teeth using a 5-point scale (5 = very satisfied, 1 = very dissatisfied) 10 weeks after SDF or placebo application. Besides, the Chinese version of the Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to assess the children's OHRQoL. RESULTS: There were 127, 133, and 154 children in the SDF, placebo, and caries-free groups, respectively. The parents whose child had 4 or more decayed teeth reported lower satisfaction scores (mean = 2.0 ± 0.7) with their child's dental health status compared with those of parents whose child had fewer (mean = 2.6 ± 0.9) or no (mean = 3.7 ± 0.7) decayed teeth (p < 0.001). These parents also reported higher C-ECOHIS scores. However, there was no significant difference in parental satisfaction and children's OHRQoL between the SDF and placebo groups (p > 0.05). CONCLUSIONS: In this study population, parental satisfaction and children's OHRQoL were associated with children's dental caries status but not with SDF application. CLINICAL RELEVANCE: This study provides valuable information about the factors, including SDF application, that can influence parental satisfaction and OHRQoL of preschool children.

9.
J Dent ; 100: 103435, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32712307

RESUMO

OBJECTIVE: To compare the success rates of restoring untreated and SDF-treated dentine caries lesions in primary teeth with atraumatic restorative treatment (ART) approach. METHOD: Cavitated dentine caries lesions in preschool children were randomly allocated to two groups to be applied with either 38% silver diamine fluoride (SDF) solution or tonic water (control) ten weeks before being restored with the ART approach. Status of the restorations were assessed every six months by a blinded independent examiner. Multilevel logistic regression and multilevel survival analyses were conducted to assess the restoration success rates. RESULTS: A total of 194 children (SDF group, 101; control group, 93) were included, with 260 and 249 ART restorations placed in the SDF and the control groups, respectively. At 24-month follow-up, 88 (87 %) and 84 (90 %) children remained in the SDF and the control groups, respectively. There was no significant difference between the ART restoration success rates of the two study groups (p > 0.05). The success rate of ART restorations was associated with the class of restorations. Class I restorations had the highest success rate (∼50 %), followed by Class V (∼35 %), Class II (∼15 %) and Class III (<10 %). Besides, the mean time used to place an ART restoration in a SDF-treated caries lesion was shorter than that in untreated lesion (4.8 vs. 5.1 min, p = 0.006). CONCLUSION: Prior SDF application does not significantly affect the success rate of ART restorations placed in primary teeth. Besides, it is faster to place ART restorations in caries lesions that have been previously treated with SDF. CLINICAL SIGNIFICANCE: Prior application of silver diamine fluoride solution on cavitated dentine caries lesions in primary teeth can shorten the average time required to place an ART restoration while not jeopardizing the success rate of the restorations.

10.
Oral Dis ; 2020 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-32702140

RESUMO

OBJECTIVES: To compare the prevalence of chronic periodontitis between men who had semen abnormalities and those who had normozoospermia through a case-control study. MATERIALS AND METHODS: Male patients who visited the assisted reproduction clinic of a large general hospital and were diagnosed with semen abnormalities were included in the case group. The control group was composed of patients of the same clinic with normozoospermia. The semen analysis included sperm concentration, count and progressive and total motility, which were measured in the laboratory. A questionnaire and clinical periodontal examination were conducted for all participants. Logistic regression was performed to explore the relationship between chronic periodontitis and male infertility. RESULTS: A total of 192 participants were included: 63 participants (32.8%) had some type of semen abnormality (case group), while 129 participants (67.2%) had normozoospermia (control group). The case group had a significantly higher prevalence of moderate/severe periodontitis than the control group (33.3% vs. 17.8%, p = .012). The logistic regression showed that participants who had moderate/severe periodontitis had a greater chance of having semen abnormalities after adjusting for other confounding factors (OR = 3.377, p = .005). CONCLUSIONS: Periodontitis is associated with semen abnormalities and sperm motility in men.

11.
Arch Oral Biol ; 117: 104833, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32682021

RESUMO

OBJECTIVES: To investigate the antibacterial effect of a new bioactive glasses on cariogenic bacteria. METHODS AND MATERIALS: A newly developed bioactive glass named Huaxi bioactive glass-ceramic (HX-BGC) and its antibacterial effects were investigated. 3 M™ Specialty Glass 19933 (SG) was used as the positive control while deionized water was used as a negative control. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) of HX-BGC and SG against four cariogenic bacteria (Streptococcus mutans, Streptococcus sobrinus, Lactobacillus acidophilius, Lactobacillus rhamnosus) were determined by a microdilution method. Subsequently, bacterial growth and acid production were assessed by co-culturing the four cariogenic bacteria species with HX-BGC or SG at different concentrations anaerobically at 37 °C. Optical density (at 660 nm) was assessed by a microplate reader and the acidity of the supernatant was measured by a pH electrode at 6, 12, 24, and 48 h. Microbial kinetics, morphology and viability were evaluated by counting colony forming units (CFU), scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM), respectively. RESULTS: The MBC of HX-BGC againstS.mutans, S.sobrinus, L.acidophilus and L.rhamnosus were 15.63 mg/mL, 15.63 mg/mL, 7.81 mg/mL and 62.5 mg/mL, respectively. The optical density (7.8 mg/mL) value of the bacterial suspensions did not change during the 48 h of culture. The acidity of bacterial suspension kept steady at around pH 8.8. Results from counting the CFU indicated that HX-BGC had stronger antibacterial effect when compare to SG, which is consistent with the SEM and CLSM results. CONCLUSIONS: HX-BGC inhibits acid production and growth of cariogenic bacteria.


Assuntos
Antibacterianos/farmacologia , Cerâmica/farmacologia , Cárie Dentária , Vidro , Cárie Dentária/prevenção & controle , Lactobacillus acidophilus , Lactobacillus rhamnosus , Testes de Sensibilidade Microbiana , Streptococcus mutans , Streptococcus sobrinus
12.
Int J Nanomedicine ; 15: 2829-2839, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32368057

RESUMO

Objective: To investigate the remineralizing and staining effects of sodium fluoride (NaF) solution with polyethylene glycol-coated silver nanoparticles (PEG-AgNPs) on artificial dentine caries. Materials and Methods: Demineralized human dentine blocks were allocated to three groups. The blocks in group 1 underwent a topical application of a 12% silver diamine fluoride (SDF, 14,150 ppm fluoride) solution. The blocks in group 2 received a topical application of a 2.5% NaF (11,310 ppm fluoride) with PEG-AgNPs (400 ppm silver). The blocks in group 3 received deionized water. All blocks were subjected to pH cycling for 8 days. The surface morphology and cross-sectional features were investigated using scanning electron microscopy (SEM). The color parameters, crystal characteristics, lesion depth, and collagen degradation of the blocks were assessed using digital spectrophotometry, X-ray diffraction (XRD), micro-computed tomography, and spectrophotometry with a hydroxyproline assay, respectively. Results: The SEM showed that dentine collagen was exposed in group 3 but not in groups 1 and 2. The mean lesion depths in groups 1 to 3 were 118±7 µm, 121±14 µm, and 339±20 µm, respectively (groups1,2<3; p<0.001). The data indicated that fluoridated PEG-AgNPs introduced no significant color effect on dentine, but SDF caused distinct discoloration. The XRD indicated that silver chloride was formed in group 1, and fluorapatite was detected in groups 1 and 2. The concentration of hydroxyproline liberated from collagen was significantly less in groups 1 and 2 than in group 3. Conclusion: The use of NaF solution with PEG-AgNPs can remineralize artificial dentine caries and inhibit collagen degradation without causing significant tooth staining.


Assuntos
Cárie Dentária/tratamento farmacológico , Dentina/efeitos dos fármacos , Nanopartículas Metálicas/uso terapêutico , Fluoreto de Sódio/farmacologia , Remineralização Dentária/métodos , Colágeno , Cor , Dentina/metabolismo , Dentina/patologia , Fluoretos/farmacologia , Fluoretos Tópicos/química , Fluoretos Tópicos/farmacologia , Humanos , Hidroxiprolina/metabolismo , Nanopartículas Metálicas/administração & dosagem , Nanopartículas Metálicas/química , Microscopia Eletrônica de Varredura , Dente Serotino/efeitos dos fármacos , Dente Serotino/patologia , Dente Serotino/ultraestrutura , Polietilenoglicóis/química , Compostos de Amônio Quaternário/química , Compostos de Amônio Quaternário/farmacologia , Prata , Compostos de Prata/química , Compostos de Prata/farmacologia , Fluoreto de Sódio/administração & dosagem , Difração de Raios X , Microtomografia por Raio-X
13.
Artigo em Inglês | MEDLINE | ID: mdl-32455849

RESUMO

This study aimed to investigate the relationships among sicca symptoms, oral health conditions, salivary profiles and oral Candida in Sjögren's syndrome (SS) patients. Eighty-five SS patients (mean age = 50.5) and 40 healthy non-SS individuals (mean age = 51.4) were recruited. They self-completed the Sicca Symptoms Inventory (SSI). Decayed, missing and filled surface (DMFS) scores, salivary flow rates, pH and oral Candida colonization were determined. Mean SSI summary scores of SS patients and non-SS individuals were 11.1 and 5.4 respectively (p < 0.001). The most prevalent sicca symptoms in SS patients were eye irritation (93%), dry throat or nose (88%) and need of fluid for mouth wetting (88%). SS patients had significantly lower whole salivary flow rates than the non-SS individuals. Candida strains were isolated from over 60% of SS patients but not in non-SS patients. C. albicans was the predominant species. SSI summary score was negatively correlated to salivary flow rates while SSI summary and domain scores were positively correlated to the number of filled surfaces (FS) and DMFS scores and oral Candida counts. In conclusion, SS patients had more severe sicca symptoms than non-SS individuals. SSI scores were negatively correlated to the salivary flow rates but positively correlated to caries experience and oral Candida colonization.


Assuntos
Saúde Bucal , Síndrome de Sjogren , Candida , Estudos de Casos e Controles , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Síndrome de Sjogren/complicações
14.
Int J Nanomedicine ; 15: 3207-3215, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32440119

RESUMO

Objectives: The first objective of this study was to prepare sodium fluoride (NaF) solution with various concentrations of polyethylene glycol-coated silver nanoparticles (PEG-AgNPs). The second objective was to study the antibacterial activity against Streptococcus mutans and the tooth-staining effect of the solution. Methods: PEG-AgNPs were prepared via the one-step chemical reduction of silver acetate with thiolated polyethylene glycol. The PEG-AgNPs were characterized with ultraviolet-visible spectrometry and transmission electron microscopy. The half maximal inhibitory concentration (IC50) for the PEG-AgNPs against Streptococcus mutans and human gingival fibroblasts (HGF-1) were determined. The staining effect on dentin and enamel for the 2.5% NaF solutions with PEG-AgNPs at 12,800, 6400, 1600, and 400 ppm was investigated using digital spectrophotometry. The IC50 of the fluoridated silver nanoparticles against Streptococcus mutans were measured. Results: The PEG-AgNPs have an average diameter of 2.56±0.43 nm and showed excellent stability at high ionic strength (2.5% NaF) for 18 months. The IC50 of PEG-AgNPs against Streptococcus mutans was found to be 21.16±1.08 ppm silver, which was half of IC50 against HGF-1 cells (42.36±1.12 ppm), providing a working range to kill bacteria with no harm to human cells. The formulations with different concentrations of PEG-AgNPs showed no significant staining of teeth. Combining PEG-AgNPs with NaF significantly expanded the therapeutic window against Streptococcus mutans by reducing its IC50. Conclusion: A biocompatible solution of NaF with PEG-AgNPs was developed. Because it has antibacterial activity against Streptococcus mutans and no tooth-staining effect, it can be used as an anti-caries agent.


Assuntos
Cárie Dentária/tratamento farmacológico , Fluoretos/síntese química , Fluoretos/uso terapêutico , Nanopartículas Metálicas/química , Prata/uso terapêutico , Coloração e Rotulagem , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Cariostáticos/farmacologia , Cariostáticos/uso terapêutico , Cárie Dentária/microbiologia , Gengiva/efeitos dos fármacos , Humanos , Nanopartículas Metálicas/ultraestrutura , Testes de Sensibilidade Microbiana , Polietilenoglicóis/química , Prata/farmacologia , Espectrofotometria Ultravioleta , Streptococcus mutans/efeitos dos fármacos
15.
Artigo em Inglês | MEDLINE | ID: mdl-32325972

RESUMO

Objectives: The objectives of this cross-sectional study were to investigate the fear level of kindergarten children in the general population during dental outreach in a familiar kindergarten setting, and to explore the factors associated with the dental fear of kindergarten children. Method: Consecutive sampling method was used to select kindergarten children aged 3 to 5 to participate in a questionnaire survey and an outreach service. A behavioural observation type of instrument for dental fear and anxiety assessment-Frankl Behaviour Rating Scale (FBRS)-was chosen to investigate the fear level of the children. Bivariate analyses between various factors and children's dental fear and anxiety were carried out using Chi-square test. Results: A total of 498 children participated in this study. Almost half (46%) of the children have had caries experience, and the mean dmft score was 2.1 ± 3.4. The prevalence of dental caries was 32%, 43%, and 64% in the 3-, 4- and 5-year-olds, respectively. Only 4% of the children scored negatively for dental fear and anxiety (95% CI 2.3%-5.7%). Children at three years of age displayed more dental fear and anxiety than children of older ages, but the difference in dental fear and anxiety among the genders and caries status was not statistically significant. Most of the children (92%) brushed daily, but only 20% of them used toothpaste. Most (85%) of them had never visited the dentist, and over 70% of them were mainly taken care by their parents. High levels of positive and cooperative behaviour and low levels of fear were found in this population. No statistical significance was found between the child's dental fear and any factors except age. Conclusion: Children generally displayed low fear or anxiety levels in a dental outreach consisting of a non-invasive oral examination and preventive treatment in a familiar kindergarten setting. Conducting regular outreach dental services to kindergartens by providing oral examination and simple remineralisation therapies could be a promising strategy to not only control childhood caries, but also manage and reduce dental fear and encourage long term dental attendance in line with the medical model.


Assuntos
Ansiedade ao Tratamento Odontológico , Pré-Escolar , Estudos Transversais , Ansiedade ao Tratamento Odontológico/epidemiologia , Cárie Dentária/epidemiologia , Feminino , Hong Kong/epidemiologia , Humanos , Masculino , Inquéritos e Questionários
16.
Healthcare (Basel) ; 8(2)2020 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-32260395

RESUMO

Fear and anxiety constitute an important theme in dentistry, especially with children. Anxiety and the fear of pain during dental treatment can lead to avoidance behaviour, which contributes to perpetuating fear and anxiety of dental care. Understanding and assessing dental fear and anxiety in children is important for delivering successful dental care with high satisfaction in this age group. Among the vast assessment method options available today, self-report assessment, parental proxy assessment, observation-based assessment, and physiological assessment are the four major types for dental fear and anxiety in children. Each method has its own merits and limitations. The selection of a method should be based on the objectives, validity, and setting of the assessment. The aim of this paper is to review and discuss the assessment methods for dental fear and anxiety in children.

17.
Artigo em Inglês | MEDLINE | ID: mdl-32183484

RESUMO

OBJECTIVE: The objective of this study was to compare the caries, periodontal status, and toothbrushing practices of Chinese elderly people with and without dementia. METHODS: This cross-sectional study recruited Chinese people aged 65 years or over attending daycare centers in Hong Kong. The participants' dementia status was identified from their medical record. Their demographic information and toothbrushing practices were obtained through a questionnaire survey. Caries experience, periodontal status, and oral hygiene were measured using the Decayed, Missing, and Filled Teeth (DMFT) Index, Community Periodontal Index, and Visible Plaque Index (VPI), respectively. The case matching process, using the propensity score, was conducted to match the participants in dementia and nondementia groups. The chi-square test and t-test were conducted for analysis. RESULTS: A total of 341 elderly people participated in this study. After case matching by gender and age, 129 participants with dementia were matched with 99 participants without dementia. The mean age and mean DMFT of the dementia group versus the nondementia group were 80.9 ± 7.5 vs. 79.4 ± 6.7 (p = 0.428) and 22.5 ± 7.9 vs. 19.2 ± 9.3 (p = 0.041), respectively. There was no significant difference of periodontal status observed. The VPI of dementia and nondementia groups were 77% and 63%, respectively (p = 0.027). Though they had no difference in frequency of toothbrushing, more dementia participants encountered difficulties in toothbrushing than those without dementia (57% vs. 8%, p < 0.001). CONCLUSION: Compared with elderly people without dementia, Chinese elderly people with dementia had more caries experience and poorer oral hygiene in Hong Kong. They were more likely to have difficulty in performing toothbrushing.


Assuntos
Demência , Saúde Bucal , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Índice CPO , Demência/epidemiologia , Cárie Dentária , Feminino , Nível de Saúde , Hong Kong/epidemiologia , Humanos , Masculino , Escovação Dentária
18.
BMC Oral Health ; 20(1): 40, 2020 02 05.
Artigo em Inglês | MEDLINE | ID: mdl-32024501

RESUMO

BACKGROUND: Silver diamine fluoride (SDF) solution gains increasing popularity in arresting dentine caries in clinical practice. The aim of this systematic review was to summarize the findings from laboratory studies on the influence of SDF application on the bond strength of dentine to various adhesives and to glass ionomer cements (GICs). METHODS: Two independent reviewers conducted a literature search in the databases Medline, Ovid, PubMed and Web of Science until 15th August 2019 using the search keywords ['bond strength'] AND ['silver diamine fluoride' OR 'silver diammine fluoride' OR 'SDF' OR 'silver fluoride' OR 'diamine silver fluoride']. Articles investigating the effect of SDF application on the bond strength of dentine to various adhesives and to GICs were included in this review. Information on how SDF application influenced the bond strength was extracted from the included articles. Besides, related information, e.g. test method of bond strength, concentration and brand of SDF, type of adhesive system and GIC, testing dental substrate, protocol of specimen preparation, and failure mode was also reviewed. RESULTS: A total of 13 articles were included in this review, with 8 and 6 studies investigating the effect of SDF application on the bond strength of dentine to various adhesives and to GICs, respectively. Sound dentine as well as demineralized dentine created by chemical methods, e.g. immersing in a demineralizing solution, was commonly adopted as the testing dental substrate. The microtensile bond strength (mTBS) test was the predominant method employed. However, the bond strength values had large variations among studies, ranging from <10 to 162 Mpa. Regarding the bond strength to different adhesives, 4 studies indicated that SDF application followed by rinsing with water had no significant influence. However, another 4 studies reported reduced bond strength after SDF application. Regarding the bond strength to GICs, 4 studies concluded that SDF application had no adverse impact on the bond strength. CONCLUSIONS: No solid conclusion can be drawn on the effect of SDF application on the bond strength of dentine to adhesives and to GICs due to the high degree of variation of the included studies.


Assuntos
Colagem Dentária , Cimentos Dentários , Dentina/metabolismo , Cimentos de Ionômeros de Vidro/química , Compostos de Amônio Quaternário/farmacologia , Compostos de Prata/química , Fluoretos Tópicos/farmacologia , Humanos , Compostos de Prata/farmacologia , Estresse Mecânico
19.
Trials ; 21(1): 140, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019596

RESUMO

BACKGROUND: Silver diamine fluoride (SDF) solution is effective in arresting early childhood caries (ECC). Previous studies have suggested that it might exert a preventive effect in managing ECC. However, no well-designed clinical trials have yet been performed to study the effect of SDF on caries prevention. The objective of this randomised clinical trial is to determine whether 38% SDF solution is superior to 5% sodium fluoride (NaF) varnish in preventing new carious lesions in primary anterior teeth. METHODS/DESIGN: This is a phase II, single-centre, randomised, double-blind, active-controlled, parallel-group pragmatic trial. The hypothesis tested is that 38% SDF would be more effective than 5% NaF in preventing new caries development in primary anterior teeth. Approximately 730 3-year-old children who are generally healthy and with parental consent will be recruited from Hong Kong kindergartens. This sample size will be sufficient for appropriate statistical analysis of a superiority trial with 90% power, allowing for a 20% drop-out rate. Stratified randomisation will be adopted for allocating the intervention. The intervention will either be 38% SDF or 5% NaF (as a positive control) therapy on primary upper anterior teeth. A single trained examiner will conduct a dental examination every 6 months until 30 months in kindergarten. Another operator will provide fluoride therapy immediately after each dental examination. The examiner, children and children's parents will be blinded to the treatment allocation. A questionnaire survey will be conducted to study the children's oral health-related behaviours and socioeconomic backgrounds. Chi-square tests, t tests, regression analyses and survival analyses will be adopted for data analysis. DISCUSSION: The effectiveness of 38% SDF in preventing ECC remains uncertain. If the results are as anticipated, care standards using 5% NaF for ECC prevention will be changed. In addition, the results will be widely available and increase the adoption of SDF in other countries to reduce the global burden of ECC. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04075474. Registered on 30 Aug 2019.


Assuntos
Cariostáticos/uso terapêutico , Ensaios Clínicos Fase II como Assunto , Cárie Dentária/prevenção & controle , Compostos de Amônio Quaternário/uso terapêutico , Compostos de Prata/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Cariostáticos/farmacologia , Pré-Escolar , Método Duplo-Cego , Feminino , Fluoretos Tópicos/farmacologia , Fluoretos Tópicos/uso terapêutico , Seguimentos , Hong Kong , Humanos , Masculino , Ensaios Clínicos Pragmáticos como Assunto , Compostos de Amônio Quaternário/farmacologia , Compostos de Prata/farmacologia , Fluoreto de Sódio/farmacologia , Dente Decíduo/efeitos dos fármacos , Resultado do Tratamento
20.
BMC Oral Health ; 20(1): 56, 2020 02 17.
Artigo em Inglês | MEDLINE | ID: mdl-32066428

RESUMO

BACKGROUND: Children's oral health status (OHS) can be influenced by their oral health practices and many parental factors. This study aimed to investigate pathways from parental factors to oral health practices and status of children in Hong Kong. METHODS: Using a combination of random and purposive sampling of Hong Kong households, 432 families with children aged 5-7 participated in a cross-sectional survey. Data on socioeconomic status, smoking, and oral health knowledge, attitudes, and practices, as well as OHS of parents and parents' knowledge of and attitudes towards their children's oral health, were collected through a questionnaire. Tooth status, periodontal status, and oral hygiene data were also collected through clinical examination. Correlations of oral health behaviors (OHB) and OHS within families were assessed by confirmatory factor analysis. A conceptual model of the parental influences on children's oral health practices and status was tested by a structural equation model (SEM). Chi-square test, chi-square/df, nonnormed fit index, comparative fit index, and root mean square error of approximation were used to assess the model fit. RESULTS: Fit indexes for confirmatory factor analysis and SEM showed good fit. Positive correlations of OHB and OHS were found within the families that ranged from 0.74 to 0.98 for OHB and 0.30 to 0.43 for OHS. SEM showed better socioeconomic status of mothers led to better oral health knowledge and attitude (γ = 0.75, P < 0.001) and also towards their children's better oral health knowledge and attitude (γ = 0.44, P < 0.01). Parents' attitudes towards their children's oral health (ß = 0.40, P = 0.04) and mothers' OHB (ß = 0.60, P < 0.001) were positively associated with OHB of children. Positive OHB of children (ß = - 0.48, P < 0.01) in turn led to better oral health. CONCLUSIONS: Correlations of OHB and OHS between mothers and children were stronger than those of fathers. Children's OHS was directly affected by their mothers' OHB, which in turn were affected by parents' oral health knowledge, attitudes, and practices.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Saúde Bucal , Higiene Bucal , Pais , Adulto , Criança , Pré-Escolar , Estudos Transversais , Feminino , Hong Kong , Humanos , Classe Social , Inquéritos e Questionários
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