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1.
J Indian Soc Pedod Prev Dent ; 38(3): 266-273, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33004725

RESUMO

Aim: This longitudinal, observational study was conducted in the schools of Yamunanagar, Haryana, to evaluate and compare the predictive value of formal type of caries risk assessment using reduced Cariogram software, including only seven factors and informal type among 8-9 years' school-going children. Methods: A.total of 111 school-going children were included in the study. Risk profile for each child was created using cariogram as well as informal factors. The same children were scheduled for re-examination at an interval of 9 and 18 months. The caries status was recorded again using the Collapsed International Caries Detection and Assessment System (ICDAS) concept. Statistical Analysis: The precoded data were transferred to the computer and analyzed using the SPSS software (version 17.0). Data were analyzed for the identification of children with lesion progression and numbers of lesions progressing using the Transition Scoring System. Results: Cariogram being a multifactorial model gives significant individual weightage to each etiological factor causing dental caries as compared to informal caries risk assessment which though easy to implement yet unstructured unlike cariogram and thus does not guarantee consistent implementation. Conclusion: Cariogram is a perfect option for patient motivation and supports the clinician in decision making for planning preventive strategies for the patients. Along with this, a combination of the factors for informal caries risk assessment can help in making a simple yet multifactorial model which can be applied in daily practice.


Assuntos
Cárie Dentária/diagnóstico , Criança , Humanos , Medição de Risco , Instituições Acadêmicas , Software
2.
Stomatologiia (Mosk) ; 99(5): 11-18, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034171

RESUMO

PURPOSE OF THE STUDY: The aim of the work is a spectroscopic investigation and comparison of the molecular composition of dentine and gingival fluids as well as of their diagnostic potential for the preventive screening of dentin caries. MATERIAL AND METHODS: Applying infrared spectroscopy including synchrotron radiation the samples of biological fluids taken from the oral cavity (dentine fluid, fluid from the gingival sulcus and blood) were studied for the patients with the progressive dentine caries. The part of this research was undertaken with the infrared microspectroscopy beamline at the Australian Synchrotron. RESULTS: Dentine and gingival fluids were shown to have no less complicated composition than the blood serum. Having all this in mind, in spite that these two fluids are derivatives of the blood serum, and a majority of the molecular groups observed in all of the three fluids can be detected in their IR-spectra, it follows that there is a number of signature modes that are in fact present in the IR spectra of only dentine and gingival fluids. This fact indicates at the molecular exchange between them under certain conditions. It means the high diagnostic potential in the study of the pathologic processes occurring in the oral fluid of a human. We have observed and fixed an increase of thiocyanates and esters in the samples of both dentine and gingival fluids under the development of dentin caries. CONCLUSION: Utilization of the gingival fluid for screening taking into account that its sampling is not such a complicated challenge as dentine fluid sampling will promote a transition to the personalized medicine, the development of high-technology healthcare and technology of the health preservation as a whole.


Assuntos
Cárie Dentária , Dentina , Austrália , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Gengiva , Humanos , Análise Espectral
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(9): 654-660, 2020 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-32878401

RESUMO

Objective: To establish and to evaluate a computer-aided system based on deep-learning for detection and diagnosis of dental approximal caries on periapical radiographs. Methods: One hundred and sixty human premolars and molars extracted for orthodontic or periodontal reasons were obtained from Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Fujian Medical University. A total of 160 periapical radiographic images were divided into a training dataset (n=80) and a test dataset (n=80). A deep-learning based computer-aided caries diagnosis system was established and trained. The performances of computer-aided diagnosis system and human observer were compared using receiver operating characteristic (ROC) curves, precision-recall (P-R) curves, the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The AUC values of human observers and caries diagnosis system was compared by using an online statistical tool (SPSSAU 20.0). Chi-square test was used to analyze the differences between human observers and caries diagnosis system (ɑ=0.05). Results: The AUC values of human observers and caries diagnosis system were 0.729 (95%CI: 0.650-0.808) and 0.762 (95%CI: 0.685-0.839), respectively (P>0.05). No significant differences were found for the specificity, PPV and NPV between the caries diagnosis system and human observers (P all>0.05). The caries diagnosis system was significantly more sensitive in detecting dental proximal caries than human observers (P<0.05). For the diagnosis of level-1 caries (caries limited to outer 1/2 of enamel), the sensitivity of human observers and computer-aided detection system were 27% and 77%, respectively (P<0.05). Conclusions: The computer-aided diagnosis system provided similar accuracy as human observers and significantly better sensitivity than human observers, especially for shallow caries in enamel.


Assuntos
Cárie Dentária/diagnóstico , Radiografia Dentária Digital , Área Sob a Curva , Esmalte Dentário , Humanos , Variações Dependentes do Observador , Curva ROC , Sensibilidade e Especificidade
4.
N Z Med J ; 133(1518): 10-18, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32683428

RESUMO

AIMS: There is mounting concern that there is increasing severity in the oral health burden of children who have dental caries. This study aims to describe the current dentally examined rates of severe early childhood caries (S-ECC) among children aged five years within the Canterbury District Health Board (CDHB) region, overall and by major ethnic groups. METHODS: A retrospective analysis of routine oral health data collected from all children aged five years attending the CDHB child oral health services for their routine oral health check between 1 January 2018 and 31 December 2019, inclusive. RESULTS: The sample included 10,766 children, of whom 1,822 (16.9%) were Maori, 499 (4.6%) were Pacific and 8,445 (78.4%) were non-Maori/non-Pacific. Overall, 1,980 (18.4%) were classified as having S-ECC, and significant ethnic differences emerged between Maori, Pacific, non-Maori/non-Pacific children (26.2%, 40.1% and 15.4%, respectively; p<0.001). CONCLUSIONS: Despite considerable public investment, Canterbury's children are carrying a heavy oral health burden, which is unequally shared. Risk factors for and the consequence of this burden have significant health and wellbeing implications, now and for the future. Systemic changes and interventions are necessary to redress this childhood oral health epidemic.


Assuntos
Cárie Dentária/etnologia , Grupos Étnicos , Doenças Negligenciadas , Saúde Bucal , Criança , Pré-Escolar , Cárie Dentária/diagnóstico , Surtos de Doenças , Feminino , Seguimentos , Humanos , Masculino , Nova Zelândia/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença
5.
Lasers Med Sci ; 35(7): 1629-1636, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32382936

RESUMO

The aim of this study is to evaluate the ability of quantitative light-induced fluorescence (QLF) to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. Sixty extracted permanent teeth had one occlusal site selected and were categorized according to the International Caries Detection and Assessment System (ICDAS) criteria. The teeth were divided into three groups (n = 20): ICDAS 1, ICDAS 2, and ICDAS 3. The teeth were assessed by a trained examiner using QLF in two phases: (A) before and (B) after treatment with resin infiltrant. The caries lesions were evaluated using the following QLF parameters: area (mm2); ΔF, fluorescence loss (%); and ΔQ, fluorescence loss integrated over the lesion area (%*mm2). The resin infiltrant (Icon™) was applied on the occlusal surface following the manufacturer's recommendations. The teeth were then sectioned and prepared for polarized light microscopy analysis. The penetration of resin infiltrant was measured with ImageJ. The groups showed a statistically significant difference in all QLF parameters before and after caries infiltration, with the reduction of fluorescence values posttreatment (p < 0.05). Infiltrant penetration was observed in all groups, with a statistical difference between all groups (p < 0.05). The reduction in QLF parameters after resin infiltration suggests that QLF is able to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant.


Assuntos
Cárie Dentária/diagnóstico , Esmalte Dentário/efeitos da radiação , Fluorescência Quantitativa Induzida por Luz , Resinas Sintéticas/farmacologia , Cárie Dentária/patologia , Esmalte Dentário/efeitos dos fármacos , Humanos , Dente/patologia
6.
Clin Oral Investig ; 24(5): 1869-1876, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32300980

RESUMO

OBJECTIVES: To assess how to control, detect, and treat secondary caries. This review serves to inform a joint ORCA/EFCD consensus process. METHODS: Systematic and non-systematic reviews were performed or consulted and narratively synthesized. RESULTS: Secondary (or recurrent) caries is defined as a lesion associated with restorations or sealants. While the restorative material itself has some influence on secondary caries, further factors like the presence and size of restoration gaps, patients' caries risk, and the placing dentist's experience seem more relevant. Current detection methods for secondary caries are only sparsely validated and likely prone for the risk of over-detection. In many patients, it might be prudent to prioritize specific detection methods to avoid invasive overtreatment. Detected secondary caries can be managed either by repair of the defective part of the restoration or its complete replacement. CONCLUSIONS: There is sparse data towards the nature of secondary caries and how to control, detect, and treat it. CLINICAL SIGNIFICANCE: Despite often claimed to be a major complication of restorations, there is surprisingly little data on secondary caries. Longer-term studies may be needed to identify differences in secondary caries risk between materials and to identify characteristic features of progressive lesions (i.e., those in need of treatment).


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Cárie Dentária/terapia , Restauração Dentária Permanente , Materiais Dentários , Humanos
7.
Rev. cient. odontol ; 8(1): e007-e007, ene.-abr. 2020. ilus., tab.
Artigo em Espanhol | LILACS, LIPECS | ID: biblio-1095499

RESUMO

El Sistema Internacional de Clasificación y Manejo de la Caries (ICCMS) es un conjunto de protocolos clínicos basados en tener un mejor enfoque en el diagnóstico, tratamiento y prevención de la caries dental. Consiste en modificar los factores de riesgo y tratar los dientes con lesiones de caries activas para preservar la estructura del diente y restaurarlo solo cuando sea necesario. El objetivo de este estudio es presentar las herramientas de diagnóstico actuales para mejorar el proceso de toma de decisiones al seleccionar un plan de tratamiento y permitirnos una atención más individualizada en cada paciente. (AU)


The International System of Classification and Management of Caries (ICCMS) is a comprehensive set of clinical protocols aimed at providing a better approach to the diagnosis, treatment and prevention of dental caries. Modification of risk factors, treatment of teeth with active caries lesions and the preservation of the structure of dental enamel in order to restore tooth structure only when necessary are ideal approaches that odontopediatricians should incorporate into daily practice. The objective of this study was to present the current diagnostic tools to improve the decision-making process when selecting treatment plans and provide more individualized care to each patient. (AU)


Assuntos
Humanos , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle
8.
Artigo em Inglês | MEDLINE | ID: mdl-32344544

RESUMO

BACKGROUND: Early diagnosis of occlusal caries is of paramount importance for a minimally invasive approach in dentistry. The aim of the present in vivo clinical prospective study was to compare the diagnostic outcomes of visual subjective evaluation between the International Caries Detection and Assessment System (ICDAS-II) and an intraoral fluorescence-based camera (VistaCam iX Proof, Dürr Dental, Bietigheim-Bissingen, Germany) for the detection of pits and fissures in early caries lesions of posterior teeth. METHODS: The study included 1011 posterior teeth in 255 patients aged 13-20 years (mean age 16 ± 2.2 years). Two blinded operators evaluated all the occlusal surfaces and the first assigned an ICDAS-II code, while the second assessed the VistaCam score: sound enamel (score 0-1.2); initial enamel decay (score 1.2-1.5); dentine caries (score 1.5-3). RESULTS: Some 283 (28%) of the assessed teeth were ICDAS-II code 0; 334 (33%) code 1; 189 (18.7%) code 2; 176 (17.4%) code 3; and 29 (2.9%) code 4. The level of agreement between the two procedures was expressed by using Cohen's and Fleiss' kappa statistics and performing McNemar's test. VistaCam assessed in 513 (50.7%) sound enamel; in 292 (28.9%) initial enamel decay; and in 206 (20.4%) dentine caries. CONCLUSIONS: This comparative study showed a poor agreement between the two diagnostic methods, especially between ICDAS-II 0, 1 and 2 codes and fluorescence assessments.


Assuntos
Cárie Dentária , Dente , Adolescente , Adulto , Cárie Dentária/diagnóstico , Diagnóstico Precoce , Alemanha , Humanos , Estudos Prospectivos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Adulto Jovem
9.
Lasers Med Sci ; 35(7): 1621-1628, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32333336

RESUMO

The aim of this study was to compare the clinical performance of clinical-visual examination using the International Caries Detection and Assessment System (ICDAS) II, digital bitewing radiography, near-infrared light transillumination (NIR-LT), and laser fluorescence (LF) for the detection of non-cavitated proximal enamel and dentin caries. The study included 335 patients, aged 12-18 years, with no cavities in the posterior teeth. Clinical-visual inspections of 335 non-cavitated proximal caries were performed by two examiners. For enamel caries, clinical validation included a combination of clinical-visual and digital bitewing radiography assessments. For dentin caries, the clinical validation was opening the cavity. The accuracy rate, sensitivity, specificity, predictive values, and areas under receiver operating characteristic curves were determined. The agreement between the examiners' measurements was calculated using the kappa coefficient. The sensitivity, specificity, and accuracy of the methods were compared using the McNemar test. The significance level was set at p < 0.05. Digital bitewing radiography had the highest sensitivity (0.96) and accuracy (0.96), and LF had the lowest sensitivity (0.38) and accuracy (0.39). After separation of the lesions into enamel and dentin caries, clinical-visual examination had the highest sensitivity (0.98) and accuracy (0.98) for enamel caries, while digital bitewing radiography had the highest sensitivity (0.97) and accuracy (0.97) for dentin caries. The NIR-LT method had a higher sensitivity for enamel caries (0.86). Each method also differed significantly from the others (p < 0.001). Digital bitewing radiography gave the best prediction of proximal enamel and dentin caries. NIR-LT showed good potential for detection of proximal caries.


Assuntos
Cárie Dentária/diagnóstico por imagem , Cárie Dentária/diagnóstico , Esmalte Dentário/efeitos da radiação , Dentina/efeitos da radiação , Raios Infravermelhos , Lasers , Radiografia Interproximal , Transiluminação , Cárie Dentária/patologia , Esmalte Dentário/diagnóstico por imagem , Dentina/diagnóstico por imagem , Dentina/patologia , Fluorescência , Humanos , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos Testes , Adulto Jovem
10.
J Dent ; 93: 103276, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31927031

RESUMO

OBJECTIVES: The aim of this birth cohort study was to identify concurrent associations between early childhood caries and putative risk and protective factors. METHODS: Data were collected in seven waves over five years. The study outcome measure, d3-6mfs, was modelled in a set of sequential negative binomial regressions that introduced the variables in steps starting from health determinants most distal to the child and ending with the more proximal ones. The goodness of fit of each model at each step was tested using the quasi-likelihood under independence model criterion (QIC). A final model included all significant factors identified in the sequential modelling. Bacterial composition of the child's saliva was determined by 16S RNA gene sequencing. RESULTS: Overall, 467 children (48.6 % female) participated, of whom 419 (89.7 %) had at least one follow-up visit after baseline. Of the 419 children included in the analyses, 133 (31.7 %) had their saliva samples sequenced for microbiomic determination. Independent protectors of surface cavitation included water fluoridation, and older age of mothers. Risk for d3-6mfs was significantly higher among children whose mothers were current smokers (IRR 3.29, 95 % CI 1.09-9.88, p = 0.034), children who went to bed with a bottle (IRR 2.67, 95-6.88, p = 0.041) and whose saliva sample sequencing over time showed higher percentages of Streptococcus mutans (IRR 1.39, 95 % CI 1.11-1.74, p = 0.005). Model fit was mostly improved by child's proximal variables. Household and mother covariates did not substantially improve model fit. CONCLUSION: This analysis highlights the relevance and importance of child-proximal risk factors in childhood dental cavitation. CLINICAL SIGNIFICANCE: The study findings inform clinical decision making for the management of early childhood caries at both the individual and population level. At an individual and family level these risk factors should be incorporated into caries risk assessment tools for more precise identification of risk and evidence-informed interventions by health professionals.


Assuntos
Cárie Dentária/diagnóstico , Idoso , Austrália/epidemiologia , Criança , Pré-Escolar , Estudos de Coortes , Cárie Dentária/epidemiologia , Feminino , Humanos , Masculino , Mães , Streptococcus mutans
11.
Rev. cient. odontol ; 7(2): 86-96, jul.-dic. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1046732

RESUMO

El diagnóstico de caries dental ya no es más como el diagnóstico tradicional que mencionaba histológicamente el inicio y el final de una cavidad. Se ha demostrado que los criterios de diagnóstico y las herramientas utilizadas en la detección de lesiones de caries afectan la toma de decisiones para su tratamiento. Hoy en día, la caries dental es considerada un proceso; por ello, en el presente artículo, se describen nuevas propuestas que nos ayudarán con el diagnóstico, manejo y control de dicha enfermedad. Los criterios Cambra e Icdas son los que teóricamente tienen sustento bajo evidencia científica de lo que es actualmente la patología y su desarrollo, por lo que se describen los antecedentes históricos de su desarrollo, sus principales características, y se proponen opciones de integración al proceso diagnóstico actual a favor de una mayor conservación de la estructura dentaria. (AU)


The diagnosis of dental caries is no longer like the traditional diagnosis that histologically mentioned at the beginning and end of a cavity. It has been shown that the diagnostic criteria and tools used in the detection of caries lesions affect the decision-making process for caries treatment. Today tooth decay is considered as a process; That is why in this article new proposals are presented that will help us with the diagnosis, management and control of said disease. The criteria Cambra and Icdas, are those that theoretically have sustenance under scientific evidence of what is currently the pathology and its development; Therefore, the historical background of the development of Cambra and Icdas, its main characteristics are described, and integration options are proposed to the current diagnostic process in favor of greater preservation of the dental structure. (AU)


Assuntos
Humanos , Masculino , Feminino , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle
12.
Curr Top Med Chem ; 19(31): 2824-2828, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31724502

RESUMO

BACKGROUND: West Syndrome is a rare epileptic encephalopathy involving infantile spasms, altered electroencephalographic pattern with hypsarrhythmia, and psychomotor development delay. It arises in paediatric patients, generally within the first year of life, in symptomatic or idiopathic form depending on the presence of hereditary features or not. CASE REPORT: In this report it is described the case of a West syndrome patient affected by multiple caries, gingival enlargement, dental eruption abnormalities, high-arched palate and MIH, treated at the dental clinic of University of Bari "Aldo Moro". DISCUSSION: West patients present with multiple oral abnormalities, including altered eruption timing, teeth agenesis, teeth shape and position abnormalities, plaque and calculus accumulation, malocclusions and bad oral habits (mouth breathing, nails biting). CONCLUSION: West Syndrome patients' oral hygiene is generally bad due to their motor difficulty and to their low compliance towards dentists, which entails general anaesthesia to perform dental treatment. West Syndrome pharmacological treatment is usually based on antiepileptic drugs and/or ACTH. These medications are well known for their ability to induce gingival enlargement, increasing the possibility of plaque accumulation and gingivitis development.


Assuntos
Cárie Dentária/tratamento farmacológico , Epilepsia Generalizada/tratamento farmacológico , Anormalidades Dentárias/tratamento farmacológico , Anticonvulsivantes/uso terapêutico , Criança , Cárie Dentária/diagnóstico , Epilepsia Generalizada/diagnóstico , Feminino , Humanos , Anormalidades Dentárias/diagnóstico
13.
Niger J Clin Pract ; 22(11): 1576-1582, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31719280

RESUMO

Aims: To evaluate the diagnostic abilities of near-infrared light transillumination (using the DIAGNOcam) and bitewing radiographs in detecting cavitated proximal carious lesions in primary molars. Subjects and Methods: The study was a cross-sectional analytical, clinical study. The proximal surfaces of primary molars of healthy 5- to 8-year-old children were radiographically screened for the presence of carious lesions in the enamel or outer third of dentin (D1). Two trained and calibrated examiners evaluated the depth of caries in bitewing radiographs and DIAGNOcam images and then verified the presence of cavitation by direct visual examination using the "International Caries Detection and Assessment System" after temporary tooth separation. Results: A total of 236 proximal lesions were included in the study. Most of the clinically cavitated lesions (51.9%) were D1 radiographically and in outer dentin lesions (scores 3 and 4) by the DIAGNOcam (37% and 48.1%, respectively). Although DIAGNOcam showed higher sensitivity (0.852) compared to the radiographs (0.519), it showed slightly less specificity (0.569) compared to the radiographs (0.579). However, DIAGNOcam showed higher value of the area under the curve (AUC = 0.722; P < 0.001) compared to the radiographic method (AUC = 0.561; P = 0.308). Conclusions: The DIAGNOcam showed higher sensitivity and better accuracy than bitewing radiographs in diagnosing cavitated proximal lesions in primary molars and can be generally considered as an alternative to radiographs to detect cavitation without the hazards of ionizing radiation in children.


Assuntos
Cárie Dentária/diagnóstico , Microrradiografia/instrumentação , Microrradiografia/métodos , Radiografia Interproximal/métodos , Radiografia Dentária/métodos , Dente Decíduo/diagnóstico por imagem , Transiluminação , Criança , Pré-Escolar , Estudos Transversais , Cárie Dentária/patologia , Esmalte Dentário/diagnóstico por imagem , Esmalte Dentário/patologia , Dentina/diagnóstico por imagem , Dentina/patologia , Feminino , Humanos , Masculino , Dente Molar/patologia , Radiografia Dentária Digital , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
14.
Artigo em Inglês | MEDLINE | ID: mdl-31731559

RESUMO

Caries measurement methods vary considerably in terms of the stages of lesion considered making the comparison problematic among different surveys. In this cross-sectional study, four caries measurement methods, the WHO-DMFT, the International Caries Detection and Assessment System (ICDAS), the Caries Assessment Spectrum and Treatment (CAST), and the Nyvad Criteria were tested in a sample of children. Five-hundred 12-year old children (236 males and 264 females) were examined four times by four calibrated examiners. The calibration process showed that Cohen's Kappa exceeded the criterion of K = 0.75 and K = 0.80 for inter/intra-examiner agreement, respectively. In the survey, the total number of misclassification errors for the four methods amounted to 312 observations (67.94% regarding enamel lesions). The greatest difference among methods was shown by number of sound teeth (p < 0.01): WHO-DMFT n = 9505, 74.14%; ICDAS n = 2628, 20.49%; CAST n = 5053, 39.41%; and Nyvad Criteria n = 4117, 32.11%. At the level of dentinal Distinct/Active Cavity lesions, no statistically significant difference was observed (p = 0.40) between ICDAS (n = 1373, 10.71%), CAST (n = 1371, 0.69%), and Nyvad Criteria (n = 1720, 13.41%). In the severe caries levels, all methods were partially in agreement, while no accordance was found for the initial (enamel) lesions. A common language in caries detection is critical when different studies are compared.


Assuntos
Índice CPO , Cárie Dentária/diagnóstico , Técnicas e Procedimentos Diagnósticos/normas , Criança , Estudos Transversais , Esmalte Dentário , Dentina , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Medição de Risco
15.
Clin Ter ; 170(5): e373-e381, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31612196

RESUMO

Among the various pathologies of the oral cavity, the formation of "unsightly black spots" on the surface of the tooth, universally known as Black Stain (BS) has recently been acquiring more interest. Usually BS is typically found in individuals in prepubertal age, even though it has been identified in adults associated with microbial exchange and / or with iron metabolism disorders. Microbial exchange concerns the possible exchange of bacteria between family members which can take place directly, through effusions, or indirectly, through brushes, cutlery or glasses. For this reason, it is recommended that toothbrushes of family members not be left damp and in contact with each other. The bathroom, being a warm-humid environment, is in fact an optimal habitat for microbial proliferation. Of specific importance in BS is the accumulation of iron in tissues and secretions which, together with chromogenic bacteria, are the primary cause of this pathology. In fact, among the metabolic products synthesized by bacteria in the oral cavity, hydrogen sulfide is of considerable interest, since upon reacting with iron available in saliva, in pathological conditions (iron metabolism disorders), it forms black precipitates consisting of ferric sulfide. These precipitates bind to the surface of the teeth, tending to form a stria that usually follows the contour of the gingiva, with an unsightly and variable chromatic intensity. In physiological situations, iron homeostasis is defined as the state of equilibrium between iron present in tissues and in secretions and that which is present in the circulation. Instead, in pathological conditions, defined as iron metabolism disorders, there is an accumulation of iron in tissues and secretions and a lack of it in the circulation. It is also important to remember that subjects affected by BS are more protected from carious processes than healthy subjects, probably due to a significant predominance of chromogenic bacteria compared to those responsible for caries. It should also be remembered that in young subjects BS tends to regress with pubertal development and the transition to adult life. In any case, using common professional hygiene procedures, it is possible to remove BS as well as plaque and tartar deposits. In particular, with ultrasonic scalers, polishing pastes and powders carried by air and water jets, the surfaces of the teeth can be restored to their natural healthy state. All the techniques for removing the precipitates, are not enough however, to fix and permanently eradicate their appearance, as these precipitates last only for short periods and recur very frequently. Due to the frequent recurrences, new oral microbiota control therapies are emerging; among these the use of lactoferrin (Lf) in the dental field and particularly in the treatment of BS appears to be very promising. Taken togheter, here the effect of Lf in subjects affected by BS has been investigated.


Assuntos
Anti-Infecciosos/administração & dosagem , Cárie Dentária/dietoterapia , Distúrbios do Metabolismo do Ferro/tratamento farmacológico , Lactoferrina/administração & dosagem , Descoloração de Dente/diagnóstico , Adulto , Criança , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Feminino , Humanos , Distúrbios do Metabolismo do Ferro/diagnóstico , Masculino , Gravidez , Saliva/metabolismo , Descoloração de Dente/tratamento farmacológico
16.
PLoS One ; 14(10): e0223376, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31584966

RESUMO

OBJECTIVE: To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries. METHODS: This qualitative study involved one on one interviews with eight GDP's who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis. RESULTS: GDP's indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care. CONCLUSION: The GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals' caries management, including appropriate recording of diagnosis and risk assessment.


Assuntos
Pesquisa Biomédica , Cárie Dentária/epidemiologia , Odontólogos , Odontologia Geral , Atenção Primária à Saúde , Adulto , Cárie Dentária/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
17.
Community Dent Oral Epidemiol ; 47(6): 520-527, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31576591

RESUMO

OBJECTIVES: To develop child- and parent-reported toolkits for active caries and caries experience in children and adolescents, ages 8-17. METHODS: A sample of 398 child/parent dyads recruited from 12 dental practices in Los Angeles County completed a computer-assisted survey that assessed oral health perceptions. In addition, children received a dental examination that identified the presence or absence of active caries and caries experience. A Multiple Adaptive Regression Splines model was used to identify a subset of survey items associated with active caries and caries experience. The splines and coefficients were refined by generalized cross-validation. Sensitivity and specificity for both dependent variables were evaluated. RESULTS: Eleven child self-reported items were identified that had sensitivity of 0.82 and specificity of 0.45 relative to active caries. Twelve parent-reported items had a sensitivity of 0.86 and specificity of 0.50. Seven child self-reported items had a sensitivity of 0.86 and specificity of 0.34, and 11 parent-reported items had a sensitivity of 0.86 and specificity of 0.47 for caries experience. CONCLUSIONS: The survey items identified here are useful in distinguishing children with and without active caries and with and without caries experience. This research presents a path towards using children's and their parents' reports about oral health to screen for clinically determined caries and caries exposure. The items identified in this study can be useful when clinical information is unavailable.


Assuntos
Cárie Dentária , Autorrelato , Adolescente , Criança , Assistência Odontológica , Cárie Dentária/diagnóstico , Feminino , Humanos , Masculino , Saúde Bucal , Pais , Inquéritos e Questionários
18.
Public Health Res Pract ; 29(3)2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31569206

RESUMO

Objectives and importance of study: An increase in hospitalisations for complicated dental decay among Western Australian children, particularly those who are disadvantaged, is well documented. An informed, targeted distribution of limited resources is needed to effectively assist children who are most at risk. This study developed an integrated school-by-school Index of Dental Risk based on known primary risk variables for dental decay, poverty and Indigenous status. STUDY TYPE: Population-based research. METHODS: All data were collected from open web-based sources that were freely available, so no ethics approval was required. All data were collected in 2011 from 1112 Western Australian schools. Data included the nationally agreed Socio-Economic Indexes for Areas, and Accessibility/Remoteness Index of Australia. RESULTS: The Index of Dental Risk was categorised into four risk profiles for each Western Australian school: low (0-4), medium (5-9), medium-high (10-14) and high (15-18). We found that 57% of schools had a medium risk profile or higher (≥5). Nine schools had the highest risk category of 18. CONCLUSIONS: This study is the first to develop a simple Index of Dental Risk that can be applied at the individual school level to efficiently target resources. This evidence based resource allocation has the potential to reduce overall cost burdens of oral health-related pathology in the community.


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle , Odontologia Baseada em Evidências/normas , Saúde Bucal/normas , Guias de Prática Clínica como Assunto , Medição de Risco/normas , Serviços de Saúde Escolar/normas , Adolescente , Austrália , Criança , Feminino , Humanos , Masculino
19.
Apunts, Med. esport (Internet) ; 54(203): 91-101, jul.-sept. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-187687

RESUMO

INTRODUCTION: The purpose of the study was to evaluate the salivary concentrations of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNFalfa) and correlate the findings with the caries index, body mass index (BMI), potency of lower limbs (vertical jump), cardiorespiratory fitness, and risk of developing cardiovascular diseases in girls practicing volleyball. MATERIAL AND METHODS: Two studies were performed: 1) a cross-sectional study (n = 120) on the association of IL-6 and TNFalfa with the caries index, anthropometric measures, physical tests, and experience in volleyball practice; 2) longitudinal study (n = 63) on the effects of 8 weeks of training on salivary IL-6 and TNFalfa in girls with intermediate experience in volleyball and competitive girls. RESULTS: The median levels of IL-6 were 1.98 [1.55-3.11] pg/ml and TNFalfa, 0.46 [0.28-0.59] pg/ml and these did not correlate with the caries index, BMI, training volume, training practice, or cardiovascular risk. A correlation was observed between IL-6 and TNFalfa (r = 0.34; p < 0.001), IL-6 and vertical jump height (r = -0.28, p < 0.005), and TNFα and age (r = 0.33; p < 0.001). After 8 weeks of training, TNFα levels increased in the intermediate and competitive groups (p < 0.05), while IL-6 levels decreased only in the intermediate level group (p < 0.05). CONCLUSION: the median levels of IL-6 and TNFalfa did not correlate with the caries index, BMI, training volume, experience practice, or cardiovascular risk. Salivary levels of IL-6 were downmodulated in the group with intermediate experience and TNFalfa was upmodulated by training


INTRODUCCIÓN: el objetivo del estudio fue evaluar las concentraciones salivales de interleukina-6 (IL-6) y factor de necrosis tumoral alfa (TNFalfa) y correlacionarlas con el índice de caries, el índice de masa corporal (IMC), potencia muscular de miembros inferiores (salto vertical), la aptitud cardiorrespiratoria y riesgo de desarrollar enfermedades cardiovasculares en niñas que practican voleibol. MATERIAL Y MÉTODOS: se realizaron dos estudios: 1) un estudio transversal (n = 120) sobre la asociación de IL-6 y TNFalfa con índice de caries, medidas antropométricas, pruebas físicas y experiencia en la práctica de voleibol; 2) estudio longitudinal (n = 63) sobre el efecto de 8 semanas de entrenamiento em IL-6 y TNFalfa salivales en niñas con experiencia intermedia en voleibol y chicas competitivas. RESULTADOS: los niveles medianos de IL-6 fueron 1.98 [1.55 - 3.11] pg/ml y TNFalfa fue 0.46 [0.28 - 0.59] pg/ml y no se correlacionaron con el índice de caries, el IMC, el volumen de entrenamiento, la práctica de entrenamiento y el riesgo cardiovascular. Se observó una correlación entre IL-6 y TNFalfa (r = 0.34; p < 0.001), IL-6 y altura de salto vertical (r = -0.28, p < 0.005), y TNFalfa y edad (r = 0.33; p < 0.001). Después de 8 semanas de entrenamiento, los niveles de TNFalfa aumentaron en los grupos intermedios y competitivos (p < 0.05), mientras que los niveles de IL-6 disminuyeron solo en el grupo intermedio (p < 0.05). CONCLUSIÓN: los niveles medianos de IL-6 y TNFalfa no se correlacionaron con el índice de caries, el IMC, el volumen de entrenamiento, la experiencia práctica y el riesgo cardiovascular. Los niveles salivales de IL-6 se modificaron a la baja en el grupo con experiencia intermedia y el TNFα se moduló al alza mediante el entrenamiento


Assuntos
Humanos , Feminino , Criança , Adolescente , Interleucina-6/análise , Fator de Necrose Tumoral alfa/análise , Voleibol/fisiologia , Cárie Dentária/diagnóstico , Índice de Massa Corporal , Força Muscular/fisiologia , Perna (Membro)/fisiologia , Biomarcadores/análise , Estudos Transversais
20.
Gen Dent ; 67(5): 24-28, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31454318

RESUMO

Dental caries is a significant oral health issue and public health concern. Currently conceptualized as a dynamic and multifactorial process, caries is a continuum of disease stages, during which tooth damage may be reversed or controlled, depending on lesion progression. The International Caries Detection and Assessment System, when used in conjunction with the Lesion Activity Assessment (ICDAS-LAA), reflects the dynamic caries process and allows the classification of cavitated lesions according to their severity and progression, which is essential to selecting the appropriate treatment. This case report describes the diagnosis and treatment of a patient who had caries in the past and in whom old lesions remained untreated. The ICDAS-LAA was used to assess caries accurately and guide treatment decisions. The patient maintained a dietary journal for 2 weeks to help establish her risk of developing caries. Treatment involved a minimally invasive dentistry approach, which consisted of remineralization via fluoride applications, placement of a composite resin restoration, microabrasion, and periodic maintenance. During the 28-month follow-up period, rigorous control of caries risk factors was achieved, and the results were satisfactory, demonstrating the effectiveness of the ICDAS-LAA in diagnosing and managing carious lesions.


Assuntos
Assistência Odontológica/tendências , Cárie Dentária , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Feminino , Seguimentos , Humanos , Fatores de Risco , Dente
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