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1.
J Am Dent Assoc ; 151(10): 755-763, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32979954

RESUMO

BACKGROUND: Nonsurgical caries management, particularly silver diamine fluoride (SDF) and Hall-style crowns, present alternative options for populations that have barriers to traditional treatment. The authors aimed to assess changes in the teaching and utilization of these modalities in pediatric dental residency programs. METHODS: The authors e-mailed a 29-question electronic survey regarding the utilization and teaching of nonsurgical caries management agents to US pediatric dentistry residency program directors. Data were compared with results from a similar survey conducted in 2015 to analyze trends, report protocols, barriers for utilization, and possible reasons for changes. RESULTS: Respondents from 82 programs completed the surveys (89% response rate). Although only 26% of respondents reported using SDF in 2015, 100% reported its utilization in 2020 (P < .001). The Hall-style crown technique is taught didactically in 90% of programs, and 69.5% of respondents use it at least sporadically in their clinics. Long wait times for the operating room (4 weeks-14 months) and sedation (1 week-12 months) motivate increased utilization of SDF, interim therapeutic restorations, and Hall-style crowns. Guidelines supporting off-label utilization of SDF have also resulted in its increased utilization. CONCLUSIONS: US pediatric residency programs have universally adopted SDF for caries arrest in the primary dentition, and this trend seems to extend to other nonsurgical caries management agents. These changes are likely driven by diverse barriers to delivery of traditional restorative care. PRACTICAL IMPLICATIONS: The rapid increases in teaching and utilization of minimal intervention techniques provide clinicians with more options for caries management in patients with barriers to traditional treatment.


Assuntos
Cárie Dentária , Internato e Residência , Cariostáticos/uso terapêutico , Criança , Coroas , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Humanos , Odontopediatria , Compostos de Amônio Quaternário , Compostos de Prata
3.
Quintessence Int ; 51(10): 854-862, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32577707

RESUMO

OBJECTIVE: To investigate the effect of a 5% sodium fluoride varnish with functionalized tri-calcium phosphate (fTCP) on post-orthodontic white spot lesions. A secondary aim was to study if the patients and their clinicians perceived clinical improvements. METHOD AND MATERIALS: Fifty-nine patients with at least two visible WSLs on their maxillary incisors, canines, or first premolars present at the debonding of fixed appliances (baseline) were enrolled and assigned to a Varnish group (Clinpro White Varnish, 3M Espe) receiving topical applications at baseline and after 8 weeks, or a Control group treated with a fluoride-free mock product. The primary endpoint was white spot lesion appearance after 16 weeks, assessed from photographs using the modified ICDAS white spot lesion score (0 to 3). The patients and the dental examiners rated the white spot lesions subjectively with aid of a visual analog scale. RESULTS: Fifty-seven patients completed the study. After 16 weeks, 62% of the white spot lesions in the Varnish group were completely reversed (score 0) compared to 39% in the Control group. The treatment effect was statistically significant (OR 0.22; 95% CI 0.08 to 0.59, P = .003) after adjusting for baseline oral hygiene index and type of tooth. A significant correlation (P < .05) was observed between patients' and orthodontists' perception of the lesions. CONCLUSION: The 5% sodium fluoride varnish with fTCP appeared clinically effective in reversing post-orthodontic white spot lesions 16 weeks after debonding. The patients and the clinicians agreed on the obtained esthetic improvements.


Assuntos
Cárie Dentária , Fluoretos Tópicos , Fluoretos , Fosfatos de Cálcio , Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Humanos
4.
Niger J Clin Pract ; 23(5): 589-595, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32367863

RESUMO

Background: The prevalence of white spot lesions/tooth demineralization during orthodontic fixed appliance therapy ranges widely from 2 to 96% of patients. The purpose of this study was to evaluate measures used by orthodontists practicing in Nigeria to manage demineralization during and after fixed orthodontic treatment and how it compares with the available evidence-based information. Method: Study group comprised of 60 practitioners (21 orthodontists and 39 orthodontic residents) in Nigeria. Self-administered questionnaires were used to obtain information on the measures they use to prevent the occurrence of demineralization at the onset and during orthodontic treatment, as well as the management of its occurrence at treatment completion. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 17.0. Descriptive statistics were used. Level of significance was set at P < 0.05. Results: Responses obtained showed that 96.7% of orthodontic practitioners routinely advised their patients on tooth cleaning methods; the use of manual orthodontic toothbrush (78.3%) and dental floss (51.7%) being popularly recommended methods. However, 51.7% used a specific demineralization preventive protocol at the start of treatment. Oral hygiene instruction was observed to be the most commonly adopted protocol (51.7%), followed by fluoride rinses (41.7%) (considered relatively ineffective). Extraoral hygiene instruction was the most common treatment protocol used when tooth demineralization occurred during and after treatment (56.7% and 73.3% respectively). Approximately 92% of the orthodontists agreed on the need for the development of a basic protocol to prevent demineralization. Conclusion: The demineralization preventive measures used by Nigerian orthodontists and orthodontic residents are inconsistent and not based on evidence-based information. The development of standardized demineralization prevention protocol was therefore recommended.


Assuntos
Cárie Dentária/prevenção & controle , Higiene Bucal/métodos , Aparelhos Ortodônticos/efeitos adversos , Ortodontia Corretiva/métodos , Ortodontistas , Padrões de Prática Odontológica , Desmineralização do Dente/prevenção & controle , Adulto , Cariostáticos/uso terapêutico , Odontologia Baseada em Evidências/métodos , Feminino , Fluoretos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Braquetes Ortodônticos/efeitos adversos , Inquéritos e Questionários , Escovação Dentária
5.
Int J Nanomedicine ; 15: 3181-3191, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32440117

RESUMO

Objective: The aim of this concise review is to summarize the use of silver nanomaterials for caries prevention. Methods: Two researchers independently performed a literature search of publications in English using Embase, Medline, PubMed, and Scopus databases. The keywords used were (silver nanoparticles OR AgNPs OR nano silver OR nano-silver) AND (caries OR tooth decay OR remineralisation OR remineralization). They screened the title and abstract to identify potentially eligible publications. They then retrieved the full texts of the identified publications to select original research reporting silver nanomaterials for caries prevention. Results: The search identified 376 publications, and 66 articles were included in this study. The silver nanomaterials studied were categorized as resin with silver nanoparticles (n=31), silver nanoparticles (n=21), glass ionomer cement with silver nanoparticles (n=7), and nano silver fluoride (n=7). Most (59/66, 89%) studies investigated the antibacterial properties, and they all found that silver nanomaterials inhibited the adhesion and growth of cariogenic bacteria, mainly Streptococcus mutans. Although silver nanomaterials were used as anti-caries agents, only 11 (11/66, 17%) studies reported the effects of nanomaterials on the mineral content of teeth. Eight of them are laboratory studies, and they found that silver nanomaterials prevented the demineralization of enamel and dentin under an acid or cariogenic biofilm challenge. The remaining three are clinical trials that reported that silver nanomaterials prevented and arrested caries in children. Conclusion: Silver nanoparticles have been used alone or with resin, glass ionomer, or fluoride for caries prevention. Silver nanomaterials inhibit the adhesion and growth of cariogenic bacteria. They also impede the demineralization of enamel and dentin.


Assuntos
Cárie Dentária/tratamento farmacológico , Cárie Dentária/prevenção & controle , Nanoestruturas/uso terapêutico , Prata/uso terapêutico , Cariostáticos/farmacologia , Cariostáticos/uso terapêutico , Cárie Dentária/microbiologia , Esmalte Dentário/efeitos dos fármacos , Dentina/efeitos dos fármacos , Humanos , Prata/farmacologia
6.
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
7.
Br J Nurs ; 29(5): 290-296, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32167815

RESUMO

Poor oral hygiene is an important risk factor for the development of non-ventilator hospital-associated pneumonia (NV-HAP), which imposes a significant burden on the NHS. This study aimed to establish whether the use of a 24-hour oral care kit and an oral care assessment tool can meet the needs of patients on an acute stroke unit. In comparison with the same period the preceding year, the introduction of the oral care kit and assessment tool improved compliance with oral care by more than 4 times; the overall costs of antibiotics to treat NV-HAP patients fell by 79%, with the number of doses falling by 70%, and the mortality rate decreased from 27% to 20%. According to a survey of multidisciplinary team (MDT) members keeping oral care tools available at the point of use saved time, and the oral health of patients on the unit improved after the introduction of the oral care kit and assessment tool. Almost all MDT members would recommend the use of the kit over previous interventions.


Assuntos
Antibacterianos/uso terapêutico , Infecção Hospitalar/prevenção & controle , Cuidados de Enfermagem/métodos , Saúde Bucal , Higiene Bucal/enfermagem , Pneumonia/prevenção & controle , Idoso , Cariostáticos/uso terapêutico , Feminino , Humanos , Masculino , Pneumonia/epidemiologia , Fatores de Risco
8.
Recent Pat Biotechnol ; 14(1): 41-48, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31448718

RESUMO

BACKGROUND: Early childhood caries is a sugar-dependent disease with multifactorial modulating factors affecting deciduous dentition. It is defined as the presence of at least one decayed tooth, absence of a tooth due to caries or the existence of a temporary restoration in a tooth in a child between zero and 71 months of age. No BRP varnish was found in intellectual property banks, therefore it was registered and deposited with patent number BR1020160190142. OBJECTIVE: The objective of this study was to evaluate the dose-response concentration of alcoholic extract of Brazilian red propolis (BRP), in the form of dental varnish, against Streptococcus mutans (S. mutans) in children. METHODS: Twenty-four children, aged between 36 and 71 months, of both genders and without caries, were selected to participate in this pilot study and grouped randomly into four groups to receive different concentrations of BRP varnish (1%, 2.5%, 5% and 10%). The varnish was applied to the surface of all second deciduous molars. The antimicrobial activity was observed in saliva, which was collected in two phases: before applying the BRP varnish and after use. RESULTS: There was microbiological reduction of S. mutans in the oral cavity of the children in all the tested concentrations. The highest percentage reduction of S. mutans was observed at the concentration of 2.5% (P = 0.0443). CONCLUSION: The BRP extract in the form of dental varnish has antimicrobial activity against S. mutans and constitutes a possible alternative in the prevention of dental caries.


Assuntos
Cariostáticos , Cárie Dentária/prevenção & controle , Própole , Cariostáticos/administração & dosagem , Cariostáticos/farmacologia , Cariostáticos/uso terapêutico , Criança , Pré-Escolar , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Patentes como Assunto , Projetos Piloto , Própole/administração & dosagem , Própole/farmacologia , Própole/uso terapêutico , Saliva/microbiologia , Streptococcus mutans/efeitos dos fármacos
9.
Braz Oral Res ; 33: e114, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800865

RESUMO

This in vitro study aimed to evaluate the effect of different toothpastes on dental enamel subjected to an erosive cycle with and without exposure to cigarette smoke. Bovine enamel specimens were randomly allocated into 12 groups (n = 12). For the in vitro simulation of smoking, half the groups underwent an exposure cycle of 20 cigarettes per day for 5 days. Subsequently, all groups were subjected to a 5-day erosion cycle intercalating demineralization (1 min; 1% citric acid; pH = 3.5) and treatment with toothpaste slurries (2 min) of NaF, SnF2, F/Sn/Chitosan, F/CaSiO3/Na3PO4, and F/bioactive glass. The control group was immersed in distilled water. Surface microhardness (SMH) was measured initially, after exposure to smoke, and after the erosive cycle, and %SMH was calculated. At the end of the experimental cycle, surface roughness, profilometry, and atomic force microscopy (AFM) were performed. SMH increased after exposure to cigarette smoke (p < 0.05). After the erosive cycle, there were no differences between the presence and absence of cigarette smoke exposure in SMH and roughness (p > 0.05). Besides increasing enamel SMH, cigarette smoke did not prevent enamel loss after the erosion cycle (p < 0.05). In profilometry, roughness and surface loss had the lowest values in the groups treated with SnF2 and F/Sn/Chitosan (p < 0.05). AFM showed lower mineral loss with F/CaSiO3/Na3PO4 and F/Sn/Chitosan. For all groups, except F/CaSiO3/Na3PO4, cigarette smoke resulted in higher enamel wear. F/Sn/Chitosan showed the best results against erosion.


Assuntos
Fumar Cigarros/efeitos adversos , Esmalte Dentário/efeitos dos fármacos , Erosão Dentária/etiologia , Erosão Dentária/prevenção & controle , Cremes Dentais/uso terapêutico , Animais , Compostos de Cálcio/uso terapêutico , Cariostáticos/uso terapêutico , Bovinos , Quitosana/uso terapêutico , Testes de Dureza , Humanos , Microscopia de Força Atômica , Valores de Referência , Reprodutibilidade dos Testes , Saliva/química , Silicatos/uso terapêutico , Propriedades de Superfície/efeitos dos fármacos , Fatores de Tempo , Fluoretos de Estanho/uso terapêutico , Desmineralização do Dente/induzido quimicamente , Desmineralização do Dente/prevenção & controle , Água/química
10.
J Pak Med Assoc ; 69(12): 1876-1882, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31853120

RESUMO

To find the best option to treat White Spot Lesion in existing caries treatments, and to identify the selected articles discussing etiology of caries along with White spot lesion. Null hypothesis was that "Only anticariogenic agent can cure White Spot Lesion". PRISMA guidelines were used to conduct the systematic analysis. An electronic customized search was performed using mesh terminologies on PubMed database based on inclusion criteria that included studies with; any treatment option that can treat or prevent WSL; and minimally invasive treatment options that may be altered to treat WSL. While exclusion criteria comprised studies with treatment of rampant caries, severe early childhood caries and root caries. Inclusion criteria for etiological factors incorporated studies with factors that lead to white spot lesion or carious lesion. Finally, therapeutic agents of dental caries were analyzed. Only the use of anti-cariogenic agent cannot cure White Spot Lesion. Hence study fails to prove the null hypothesis. Although combination of anti-cariogenic agents with a re-mineralizing agent can provide additional options for the treatment or prevention of WSL.


Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/tratamento farmacológico , Fluoretos/uso terapêutico , Criança , Humanos , Guias de Prática Clínica como Assunto
11.
Cochrane Database Syst Rev ; 2019(11)2019 11 17.
Artigo em Inglês | MEDLINE | ID: mdl-31742669

RESUMO

BACKGROUND: Early dental decay or demineralised lesions (DLs, also known as white spot lesions) can appear on teeth during fixed orthodontic (brace) treatment. Fluoride reduces decay in susceptible individuals, including orthodontic patients. This review compared various forms of topical fluoride to prevent the development of DLs during orthodontic treatment. This is the second update of the Cochrane Review first published in 2004 and previously updated in 2013. OBJECTIVES: The primary objective was to evaluate whether topical fluoride reduces the proportion of orthodontic patients with new DLs after fixed appliances. The secondary objectives were to examine the effectiveness of different modes of topical fluoride delivery in reducing the proportions of orthodontic patients with new DLs, as well as the severity of lesions, in terms of number, size and colour. Participant-assessed outcomes, such as perception of DLs, and oral health-related quality of life data were to be included, as would reports of adverse effects. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 1 February 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 1) in the Cochrane Library (searched 1 February 2019), MEDLINE Ovid (1946 to 1 February 2019), and Embase Ovid (1980 to 1 February 2019). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Parallel-group, randomised controlled trials comparing the use of a fluoride-containing product versus a placebo, no treatment or a different type of fluoride treatment, in which the outcome of enamel demineralisation was assessed at the start and at the end of orthodontic treatment. DATA COLLECTION AND ANALYSIS: At least two review authors independently, in duplicate, conducted risk of bias assessments and extracted data. Authors of trials were contacted to obtain missing data or to ask for clarification of aspects of trial methodology. Cochrane's statistical guidelines were followed. MAIN RESULTS: This update includes 10 studies and contains data from nine studies, comparing eight interventions, involving 1798 randomised participants (1580 analysed). One report contained insufficient information and the authors have been contacted. We assessed two studies as at low risk of bias, six at unclear risk of bias, and two at high risk of bias. Two placebo (non-fluoride) controlled studies, at low risk of bias, investigated the professional application of varnish (7700 or 10,000 parts per million (ppm) fluoride (F)), every six weeks and found insufficient evidence of a difference regarding its effectiveness in preventing new DLs (risk ratio (RR) 0.52, 95% confidence interval (CI) 0.14 to 1.93; 405 participants; low-certainty evidence). One placebo (non-fluoride) controlled study, at unclear risk of bias, provides a low level of certainty that fluoride foam (12,300 ppm F), professionally applied every two months, may reduce the incidence of new DLs (12% versus 49%) after fixed orthodontic treatment (RR 0.26, 95% CI 0.11 to 0.57; 95 participants). One study, at unclear risk of bias, also provides a low level of certainty that use of a high-concentration fluoride toothpaste (5000 ppm F) by patients may reduce the incidence of new DLs (18% versus 27%) compared with a conventional fluoride toothpaste (1450 ppm F) (RR 0.68, 95% CI 0.46 to 1.00; 380 participants). There was no evidence for a difference in the proportions of orthodontic patients with new DLs on the teeth after treatment with fixed orthodontic appliances for the following comparisons: - an amine fluoride and stannous fluoride toothpaste/mouthrinse combination versus a sodium fluoride toothpaste/mouthrinse, - an amine fluoride gel versus a non-fluoride placebo applied by participants at home once a week and by professional application every three months, - resin-modified glass ionomer cement versus light-cured composite resin for bonding orthodontic brackets, - a 250 ppm F mouthrinse versus 0 ppm F placebo mouthrinse, - the use of an intraoral fluoride-releasing glass bead device attached to the brace versus a daily fluoride mouthrinse. The last two comparisons involved studies that were assessed at high risk of bias, because a substantial number of participants were lost to follow-up. Unfortunately, although the internal validity and hence the quality of the studies has improved since the first version of the review, they have compared different interventions; therefore, the findings are only considered to provide low level of certainty, because none has been replicated by follow-up studies, in different settings, to confirm external validity. A patient-reported outcome, such as concern about the aesthetics of any DLs, was still not included as an outcome in any study. Reports of adverse effects from topical fluoride applications were rare and unlikely to be significant. One study involving fluoride-containing glass beads reported numerous breakages. AUTHORS' CONCLUSIONS: This review found a low level of certainty that 12,300 ppm F foam applied by a professional every 6 to 8 weeks throughout fixed orthodontic treatment, might be effective in reducing the proportion of orthodontic patients with new DLs. In addition, there is a low level of certainty that the patient use of a high fluoride toothpaste (5000 ppm F) throughout orthodontic treatment, might be more effective than a conventional fluoride toothpaste. These two comparisons were based on single studies. There was insufficient evidence of a difference regarding the professional application of fluoride varnish (7700 or 10,000 ppm F). Further adequately powered, randomised controlled trials are required to increase the certainty of these findings and to determine the best means of preventing DLs in patients undergoing fixed orthodontic treatment. The most accurate means of assessing adherence with the use of fluoride products by patients and any possible adverse effects also need to be considered. Future studies should follow up participants beyond the end of orthodontic treatment to determine the effect of DLs on patient satisfaction with treatment.


Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos/uso terapêutico , Braquetes Ortodônticos/efeitos adversos , Cariostáticos/administração & dosagem , Fluoretos/administração & dosagem , Humanos , Antissépticos Bucais/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
J Dent ; 88: 103165, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31279925

RESUMO

OBJECTIVES: This clinical trial investigated the efficacy of silver diamine fluoride (SDF) in arresting dentine caries in primary molars of preschoolers. Time required for treatment, adverse effects, parental aesthetic perception, anxiety and oral health related to quality of life (OHRQoL) was evaluated. MATERIALS AND METHODS: Children, 2-5 years old, with active dentine caries lesions on the occlusal surface of primary molars were randomly allocated to test group (SDF) or control group (atraumatic restorative treatment/ART). The dmf-t/DMF-T and ICDAS indexes determined the presence of caries and activity. The main outcome after 3, 6 and 12-month follow-up was assessed by a blind examiner. The time required to perform the treatments was recorded and a facial image scale was applied to assess anxiety before and after treatment. Adverse events and aesthetic perception were assessed through questions addressed to caregivers; and the OHRQoL through the B-ECOHIS questionnaire. RESULTS: In 68 patients that were randomized, the mean number of treated teeth per child was 2.42(1.04) and 2.09(1.18) in the SDF and ART groups (p = 0.074), respectively. The mean difference of arrested lesions between the groups after 12 months was -0,07(0.05; - 0.17-0.30). The time required to treat with SDF was lower than the ART (p < 0.001). There was no difference in the percentage of adverse events + aesthetic perception (p = 0.709), and the change in anxiety (p = 0.155). There was a less impact in OHRQoL after ART treatment, but only when the parents' distress subscale was considered (p = 0.012). CONCLUSION: SDF requires much less chair-time and have similar results as ART in arresting caries lesion, anxiety, adverse effects, aesthetic perception and quality of life.


Assuntos
Cariostáticos/uso terapêutico , Tratamento Dentário Restaurador sem Trauma/métodos , Cárie Dentária/tratamento farmacológico , Fluoretos Tópicos/uso terapêutico , Dente Molar/efeitos dos fármacos , Compostos de Amônio Quaternário/uso terapêutico , Compostos de Prata/uso terapêutico , Dente Decíduo/efeitos dos fármacos , Pré-Escolar , Tratamento Dentário Restaurador sem Trauma/psicologia , Dentina , Feminino , Humanos , Masculino , Qualidade de Vida , Resultado do Tratamento
13.
J Appl Oral Sci ; 27: e20180589, 2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31116280

RESUMO

OBJECTIVE: The aim of this in vitro study was to determine the effects of remineralization promoting agents containing casein phosphopeptide-stabilized amorphous calcium phosphate (CPP-ACP), or CPP-ACP in combination with fluoride (CPP-ACPF) on artificial white spot lesions (WSLs) after 6 and 12 weeks. METHODOLOGY: White spot lesions were created on 123 sectioned premolars (246 specimens) with a demineralization solution during a 96 hours pH-cycling regime. Two experimental groups were created: a CPP-ACP group (Tooth Mousse™), and a CPP-ACPF group (Mi Paste Plus™). Additionally, two control groups were created, one using only a conventional toothpaste (1450 ppm fluoride) and another one without any working agents. All teeth were also daily brushed with the conventional toothpaste except the second control group. Tooth Mousse™ and Mi Paste Plus™ were applied for 180 seconds every day. The volume of demineralization was measured with transverse microradiography. Six lesion characteristics regarding the lesion depth and mineral content of WSLs were also determined. RESULTS: The application of CPP-ACP and CPP-ACPF had a significant regenerative effect on the WSLs. Compared to Control group 1 and 2 the volume of demineralization after 6 weeks decreased significantly for CPP-ACP (respectively p<0.001 and p<0.001) and CPP-ACPF (respectively p=0.001 and p=0.003). The same trend was observed after 12 weeks. For the CPP-ACPF group, WSL dimensions decreased significantly between 6 and 12 weeks follow-up (p=0.012). The lesion depth reduced significantly after application of CPP-ACP and CPP-ACPF but increased significantly in the Control groups. Mineral content increased for CPP-ACP and CPP-ACPF after an application period of 12 weeks, but this was only significant for CPP-ACP. CONCLUSIONS: Long-term use of CPP-ACP and CPP-ACPF in combination with a conventional tooth paste shows beneficial effects in the recovery of in vitro subsurface caries lesions.


Assuntos
Cariostáticos/química , Caseínas/química , Cárie Dentária/tratamento farmacológico , Fluoretos/química , Remineralização Dentária/métodos , Análise de Variância , Cariostáticos/uso terapêutico , Caseínas/uso terapêutico , Esmalte Dentário/efeitos dos fármacos , Fluoretos/uso terapêutico , Humanos , Concentração de Íons de Hidrogênio , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo , Cremes Dentais/química , Cremes Dentais/uso terapêutico , Resultado do Tratamento
14.
J Dent Child (Chic) ; 86(1): 32-39, 2019 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992099

RESUMO

Purpose: In the United States, silver diamine fluoride (SDF) is a new method to arrest dental caries. Protocols for using SDF are under development as the research evolves and experience is gained with different populations and settings. The purpose of this study was to develop a comprehensive SDF protocol for young children tailored to safety net dental clinics (SNDCs).
Methods: We developed the SDF protocol for SNDCs through a two-step process: (1) an expert panel of pediatric dentists reviewed, modified, and expanded existing SDF protocols including clinical, pre- and post-clinical components; and (2) the new SDF protocol was implemented in three SNDCs in North Carolina with on-site didactic training, clinical observations and discussion. We obtained feedback from SNDC dentists, staff, and administrators to further refine the SDF protocol.
Results: The SDF protocol was tailored to SNDCs based on recommendations from SNDCs themselves. Suggested improvements were primarily non-clinical in nature, such as the provision of laminated SDF information with color pictures of staining in each operatory, a timer for SDF procedure, and templates for documentation, coding, and billing.
Conclusion: To facilitate SDF use in SNDCs, we developed an expert-consensus protocol that incorporated the clinical experience of SNDCs that implemented the protocol. (J Dent Child 2019;86(1):32-9)
Received September 17, 2018; Last Revision November 7, 2018; Accepted November 7, 2018.


Assuntos
Cariostáticos , Cárie Dentária , Compostos de Amônio Quaternário , Provedores de Redes de Segurança , Compostos de Prata , Cariostáticos/uso terapêutico , Criança , Pré-Escolar , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Humanos , North Carolina , Compostos de Amônio Quaternário/uso terapêutico , Compostos de Prata/uso terapêutico
15.
J Dent Child (Chic) ; 86(1): 40-46, 2019 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-30992100

RESUMO

Purpose: Low-income children with high caries risk are disproportionately affected by poor access to dental care. Retail-based clinics (RBCs) can provide accessible ancillary oral health care. The purposes of this study were: (1) to measure caregivers' acceptance rate of an oral health screening, fluoride varnish (FV) application, and caries risk assessment offered to children on a walk-in basis in an RBC; and (2) to categorize the caries risk and demographics among the participants.
Methods: Screenings and FV applications were provided to children younger than 18 years at a Walgreens Health Care Clinic in Baltimore, Md., USA, from October 2016 to October 2017. The acceptance rate and caries risk using the American Dental Association caries risk assessment form were documented. Descriptive statistics and Fisher's exact test were used to analyze the data.
Results: Eighty-five children and their caretakers were approached and 32 (38 percent) agreed to participate. Most children had high caries risk (84.3 percent) and a dental home (81.2 percent), but only 50 percent reported visiting their dentist in the last year.
Conclusion: Our results demonstrate modest acceptance of FV application for children on a convenience basis. This population had predominantly high caries risk, with poor adherence to follow-up with their dental home. Retail-based dental care should not replace the dental home but could support it by increasing access to preventive dental care in children. (J Dent Child 2019;86(1):40-6)
Received July 2, 2018; Last Revision August 13, 2018; Accepted August 13, 2018.


Assuntos
Cuidadores , Cariostáticos , Cárie Dentária , Fluoretos Tópicos , Baltimore , Cuidadores/psicologia , Cariostáticos/uso terapêutico , Criança , Assistência Odontológica para Crianças , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Humanos , Saúde Bucal , Aceitação pelo Paciente de Cuidados de Saúde , Projetos Piloto , Pobreza , Medição de Risco , Inquéritos e Questionários
16.
Oral Health Prev Dent ; 17(2): 139-146, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30968069

RESUMO

PURPOSE: To assess caries prevalence and periodontal condition in adolescents in Poland and investigate the factors related to oral health. MATERIALS AND METHODS: A national survey was carried out among 615 15-year-olds of both sexes living in urban and rural areas. Subjects were selected via cluster sampling. The mean DMFT and its components, the tooth distribution pattern of caries and percentage of subjects with gingival bleeding and gingival pockets were analysed. The information regarding sociodemographic, oral hygiene and nutritional variables was collected via questionnaire to evaluate their relationships with caries and periodontal parameters. The t-test, bivariate and multivariate logistic analyses were conducted to evaluate the differences and dependent variables of caries prevalence and gingivitis. RESULTS: Caries prevalence was 94.0%, and DMFT was 5.75 ± 3.74. Higher DMFT, DT and MT values were found in rural areas. 50% of the subjects carried about 75% of the total caries burden. Severe caries (DMFT ≥7) was associated with toothbrushing less than twice a day, not using a fluoridated dentifrice, frequent consumption of snacks and absence of pit-and-fissure sealants. The prevalence of gingival bleeding was 37.4% and shallow pockets 2.8%, which were higher in males and rural areas. Gingival bleeding was associated with toothbrushing less than a twice a day, not using dental floss and consumption of fresh fruits and vegetables less than once a week. CONCLUSION: The prevalence of oral diseases in Poland is very high. Additional strategies must be implemented to promote oral health early on to improve oral hygiene practices and nutritional habits.


Assuntos
Índice CPO , Cárie Dentária/epidemiologia , Bolsa Gengival/epidemiologia , Índice Periodontal , Escovação Dentária/estatística & dados numéricos , Adolescente , Cariostáticos/uso terapêutico , Dieta , Feminino , Fluoretos/uso terapêutico , Frutas , Humanos , Masculino , Saúde Bucal , Higiene Bucal/estatística & dados numéricos , Polônia/epidemiologia , Prevalência , População Rural , Distribuição por Sexo , Cremes Dentais/uso terapêutico , Verduras
17.
Rev. ADM ; 76(2): 77-80, mar.-abr. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1005030

RESUMO

La OMS y la FDI han publicado que entre el 60 y 90% de los escolares padecen caries. En nuestro país, el Sistema de Vigilancia Epidemiológica de Patologías Orales (SIVEPAB) 2012, reporta un 85% de caries a nivel nacional en población pediátrica. Los agentes anticariogénicos como el diamino y el fluoruro de plata son un tratamiento alentador, este agente puede actuar como bactericida o bacteriostático en función de su concentración y su capacidad para inhibir el crecimiento de estreptococos del grupo viridans, y por ende, de la caries. Problema: ¿Cuál es la efectividad bactericida del diamino fluoruro de plata (Saforide®) a diferente concentración sobre la microbiota cariogénica de escolares? Objetivo: Determinar la eficacia bactericida del diamino fluoruro de plata (DFP) a diferentes concentraciones en el crecimiento bacteriano de Streptococcus mitis, S. mutans y S. salivarius en muestras de saliva y dentina en escolares. Material y métodos: Se llevó a cabo un estudio experimental con una variable independiente, el efecto bactericida del diamino fluoruro de plata y se tomó el halo de inhibición como la dependiente. Se utilizaron medidas descriptivas como prueba de comparación y análisis de varianza usando post-hoc Tukey≠ con una confianza del 95%, y análisis de datos exploratorios. Resultados: Se analizaron 100 muestras, de las cuales 48.3% correspondió a S. mutans, 41.4% a S. salivarius y 10.3% a S. mitis, se obtuvo una mayor zona de inhibición para las tres bacterias al 38% mostrando una diferencia estadísticamente significativa 12% (p < 0.05). También se observó un efecto bacteriostático al 12%, no así para el 38%, donde se encontró un efecto bactericida Conclusión: Nuestros resultados sugieren que al 38% de la concentración hay un claro efecto bactericida en el grupo de estreptococos viridans y el 12% no se recomienda para la detención de caries debido al efecto bacteriostático (AU)


WHO and FDI have ruled that 60-90% of schoolchildren are affected by caries. In our country, the System of Epidemiological Surveillance of Oral Pathologies (SIVEPAB) (SIVEPAB) 2012. Report a rate of 85% of caries nationally in pediatric population. Anticariogenic diamino agents such as silver fluoride are an encouraging decrease in treatment for these high rates of tooth decay in our country, this agent can act as bactericidal or bacteriostatic based on their concentration and their ability to inhibit endogenous metalloproteinase (MMP-2, 8, 9). Problem: What will be the bactericidal effectiveness of silver diamine fluoride different concentration on cariogenic Streptococci saliva samples taken from school and dentin? Objective: Determine the bactericidal effectiveness Silver diamine fluoride (SDF) to different concentration on bacterial growth of Streptococcus mitis, S. mutans, and S. salivarius in saliva samples and dentin in school. Material and methods: An experimental study was conducted as an independent variable the bactericidal effect of silver diamine fluoride was taken as dependent inhibition halo. Descriptive measures were used as a comparison test and analysis of variance using Post-hoc Tukey with 95% confidence, and exploratory data analysis. Results: One hundred samples, of which 48.3% corresponded to S. mutans, 41.4% to S. salivarius and 10.3% to S. mitis, were analyzed, we obtained a larger zone of inhibition for all three organisms at 38% showing a statistically significant difference from 12% (p < 0.05). It was also observed that the 12% sample bacteriostatic effect, not to the concentration of 38% was found a bactericidal effect. Conclusion: Our results suggest that 38% concentration has a bactericidal effect on Streptococcus viridans group and 12% showed not recommended for the arrest or detention of dentine caries bacteriostatic effect (AU)


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Serviços de Odontologia Escolar , Streptococcus mutans/efeitos dos fármacos , Cariostáticos/uso terapêutico , Fluoretos Tópicos/uso terapêutico , Cárie Dentária/prevenção & controle , Saliva/microbiologia , Análise de Variância , Resultado do Tratamento , Compostos de Prata/uso terapêutico , Meios de Cultura , Dentina/microbiologia , México
18.
Methods Mol Biol ; 1922: 379-392, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30838592

RESUMO

As laboratory models are bridges to in vivo caries studies, they must mirror clinical conditions, where demineralization and remineralization alternate constantly (i.e., pH cycling) and are only interrupted during the very short period of application of investigational products, such as toothpaste or mouth rinse. In view of this, models have been developed, based on pH cycling, to study the anticaries or caries remineralizing effects of substances. The pH cycling models have long been accepted and utilized by the scientific community and the toothpaste industry as an appropriate alternative to animal caries testing, particularly for ionic fluoride-based dentifrices. Several pH cycling models have been developed and described in the literature over the years. However, in this chapter, we crudely categorize them into two types: according to what the investigational product is tailored to achieve, i.e., prevention of caries development (net demineralization) or remineralization of early caries (net remineralization). Thus the models are termed "demineralization" or "remineralization" models and are described in details here together with their disadvantages and applications.


Assuntos
Cariostáticos/farmacologia , Cárie Dentária/patologia , Cárie Dentária/prevenção & controle , Dentifrícios/farmacologia , Fluoretos/farmacologia , Animais , Cariostáticos/uso terapêutico , Bovinos , Esmalte Dentário/efeitos dos fármacos , Esmalte Dentário/patologia , Dentifrícios/uso terapêutico , Fluoretos/uso terapêutico , Humanos , Concentração de Íons de Hidrogênio , Dente/efeitos dos fármacos , Dente/patologia , Desmineralização do Dente/patologia , Desmineralização do Dente/prevenção & controle
19.
Cochrane Database Syst Rev ; 3: CD007868, 2019 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-30829399

RESUMO

BACKGROUND: Caries (dental decay) is a disease of the hard tissues of the teeth caused by an imbalance, over time, in the interactions between cariogenic bacteria in dental plaque and fermentable carbohydrates (mainly sugars). Regular toothbrushing with fluoride toothpaste is the principal non-professional intervention to prevent caries, but the caries-preventive effect varies according to different concentrations of fluoride in toothpaste, with higher concentrations associated with increased caries control. Toothpastes with higher fluoride concentration increases the risk of fluorosis (enamel defects) in developing teeth. This is an update of the Cochrane Review first published in 2010. OBJECTIVES: To determine and compare the effects of toothpastes of different fluoride concentrations (parts per million (ppm)) in preventing dental caries in children, adolescents, and adults. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 August 2018); the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 7) in the Cochrane Library (searched 15 August 2018); MEDLINE Ovid (1946 to 15 August 2018); and Embase Ovid (1980 to 15 August 2018). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials (15 August 2018). No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials that compared toothbrushing with fluoride toothpaste with toothbrushing with a non-fluoride toothpaste or toothpaste of a different fluoride concentration, with a follow-up period of at least 1 year. The primary outcome was caries increment measured by the change from baseline in the decayed, (missing), and filled surfaces or teeth index in all permanent or primary teeth (D(M)FS/T or d(m)fs/t). DATA COLLECTION AND ANALYSIS: Two members of the review team, independently and in duplicate, undertook the selection of studies, data extraction, and risk of bias assessment. We graded the certainty of the evidence through discussion and consensus. The primary effect measure was the mean difference (MD) or standardised mean difference (SMD) caries increment. Where it was appropriate to pool data, we used random-effects pairwise or network meta-analysis. MAIN RESULTS: We included 96 studies published between 1955 and 2014 in this updated review. Seven studies with 11,356 randomised participants (7047 evaluated) reported the effects of fluoride toothpaste up to 1500 ppm on the primary dentition; one study with 2500 randomised participants (2008 evaluated) reported the effects of 1450 ppm fluoride toothpaste on the primary and permanent dentition; 85 studies with 48,804 randomised participants (40,066 evaluated) reported the effects of toothpaste up to 2400 ppm on the immature permanent dentition; and three studies with 2675 randomised participants (2162 evaluated) reported the effects of up to 1100 ppm fluoride toothpaste on the mature permanent dentition. Follow-up in most studies was 36 months.In the primary dentition of young children, 1500 ppm fluoride toothpaste reduces caries increment when compared with non-fluoride toothpaste (MD -1.86 dfs, 95% confidence interval (CI) -2.51 to -1.21; 998 participants, one study, moderate-certainty evidence); the caries-preventive effects for the head-to-head comparison of 1055 ppm versus 550 ppm fluoride toothpaste are similar (MD -0.05, dmfs, 95% CI -0.38 to 0.28; 1958 participants, two studies, moderate-certainty evidence), but toothbrushing with 1450 ppm fluoride toothpaste slightly reduces decayed, missing, filled teeth (dmft) increment when compared with 440 ppm fluoride toothpaste (MD -0.34, dmft, 95%CI -0.59 to -0.09; 2362 participants, one study, moderate-certainty evidence). The certainty of the remaining evidence for this comparison was judged to be low.We included 81 studies in the network meta-analysis of D(M)FS increment in the permanent dentition of children and adolescents. The network included 21 different comparisons of seven fluoride concentrations. The certainty of the evidence was judged to be low with the following exceptions: there was high- and moderate-certainty evidence that 1000 to 1250 ppm or 1450 to 1500 ppm fluoride toothpaste reduces caries increments when compared with non-fluoride toothpaste (SMD -0.28, 95% CI -0.32 to -0.25, 55 studies; and SMD -0.36, 95% CI -0.43 to -0.29, four studies); there was moderate-certainty evidence that 1450 to 1500 ppm fluoride toothpaste slightly reduces caries increments when compared to 1000 to 1250 ppm (SMD -0.08, 95% CI -0.14 to -0.01, 10 studies); and moderate-certainty evidence that the caries increments are similar for 1700 to 2200 ppm and 2400 to 2800 ppm fluoride toothpaste when compared to 1450 to 1500 ppm (SMD 0.04, 95% CI -0.07 to 0.15, indirect evidence only; SMD -0.05, 95% CI -0.14 to 0.05, two studies).In the adult permanent dentition, 1000 or 1100 ppm fluoride toothpaste reduces DMFS increment when compared with non-fluoride toothpaste in adults of all ages (MD -0.53, 95% CI -1.02 to -0.04; 2162 participants, three studies, moderate-certainty evidence). The evidence for DMFT was low certainty.Only a minority of studies assessed adverse effects of toothpaste. When reported, effects such as soft tissue damage and tooth staining were minimal. AUTHORS' CONCLUSIONS: This Cochrane Review supports the benefits of using fluoride toothpaste in preventing caries when compared to non-fluoride toothpaste. Evidence for the effects of different fluoride concentrations is more limited, but a dose-response effect was observed for D(M)FS in children and adolescents. For many comparisons of different concentrations the caries-preventive effects and our confidence in these effect estimates are uncertain and could be challenged by further research. The choice of fluoride toothpaste concentration for young children should be balanced against the risk of fluorosis.


Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos/uso terapêutico , Cremes Dentais/uso terapêutico , Adolescente , Adulto , Cariostáticos/administração & dosagem , Criança , Índice CPO , Dentição Permanente , Fluoretos/administração & dosagem , Humanos , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Dente Decíduo , Cremes Dentais/química
20.
Oral Health Prev Dent ; 17(2): 179-185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30874251

RESUMO

PURPOSE: To evaluate the inhibitory effects of different toothpastes on demineralisation of incipient enamel lesions using a toothbrush simulator. MATERIALS AND METHODS: Fifty enamel specimens were prepared from extracted human molars. The specimens were randomly assigned to the following groups (n = 10/group): 1. no treatment (control); 2. toothpaste containing arginine (ProRelief, Colgate;); 3. fluoride toothpaste (Pronamel, Sensodyne GlaxoSmithKlein); 4. tooth mousse containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) (Recaldent, GC); 5. toothpaste (Restore, Dr. Collins) containing bioactive glass (NovaMin, GlaxoSmithKlein). All specimens were exposed to pH cycling. The remineralising agents were applied to the samples with a toothbrush simulator for 2 min twice a day for five days. The weight percentage of mineral changes for the elements calcium (Ca), phosphorus (P), sodium (Na) and silica (Si) were measured by SEM energy-dispersive x-ray spectroscopy (SEM-EDX). SEM revealed properties of treated enamel surfaces. The data were analysed using one-way ANOVA. RESULTS: Statistically significantly higher levels of Ca and P were found in all groups compared to the control (p < 0.05). CONCLUSIONS: The toothpastes' efficacy of inhibiting demineralisation depended on the active ingredients in the respective toothpaste. The demineralisation inhibition efficacy of the tested toothpastes depended on the active ingredients in the toothpaste.


Assuntos
Esmalte Dentário/ultraestrutura , Desmineralização do Dente/tratamento farmacológico , Remineralização Dentária , Cremes Dentais/uso terapêutico , Arginina/uso terapêutico , Cálcio , Cariostáticos/uso terapêutico , Caseínas/uso terapêutico , Esmalte Dentário/química , Fluoretos/uso terapêutico , Vidro , Humanos , Técnicas In Vitro , Microscopia Eletrônica de Varredura , Dente Molar , Fósforo , Dióxido de Silício , Espectrometria por Raios X , Escovação Dentária/métodos
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