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2.
J Dent ; 105: 103570, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33385533

RESUMO

OBJECTIVE: To evaluate the influence of fluoride varnish (FV) therapies or resin infiltration (RI) to maintain the structural integrity of Molar Incisor Hypomineralization (MIH) -affected teeth. METHODS: Fifty-one children aged 6-12 years with at least one incisor and one first permanent molar with yellow/brown MIH opacities were included. Patients were randomly allocated into three groups: FV - Fluoride Varnish (Duraphat); FV+etch - Fluoride Varnish (Duraphat) after enamel etching with 37% phosphoric acid; or RI - Resin Infiltration system (Icon). Opacities were monitored for 18 months. The primary outcome was the loss of integrity due to post-eruptive enamel breakdown (PEB). Covariables included sex, age, DMFT index, opacity colour, plaque index, number of MIH-affected teeth, and number of MIH-affected surfaces. Fisher's Exact was used to test the association of treatments with PEB, the Kaplan-Meyer method analysed the survival rates and Cox-regression determined which covariables would predict failure (α=0.05). RESULTS: From a total of 235 teeth, the PEB rate for RI (6.1%) was significantly lower (p<0.05) than FV (17.9%; OR 3.0, 95%CI 1.07, 8.48) and FV+etch (17.3%; OR 3.1, 95%CI 1.13, 8.73). DMFT index >3, brown opacities, cusp involvement, and age between 6-8 years predicted PEB (p<0.05). CONCLUSIONS: Resin infiltration positively influenced the structural integrity maintenance of MIH-affected teeth by decreasing the risk of enamel breakdown over18 months follow-up. Registry of Clinical Trials (RBR-8wwk3n). CLINICAL RELEVANCE: Resin infiltration proved to be a more efficacious intervention to maintain the structural integrity of MIH-affected teeth than fluoride varnish therapies.


Assuntos
Hipoplasia do Esmalte Dentário , Fluoretos Tópicos , Criança , Hipoplasia do Esmalte Dentário/tratamento farmacológico , Fluoretos , Fluoretos Tópicos/uso terapêutico , Humanos , Incisivo , Dente Molar , Prevalência
3.
BMC Oral Health ; 21(1): 35, 2021 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472613

RESUMO

BACKGROUND: Silver diamine fluoride (SDF) is a minimally-invasive preventive service used in the U.S. to avert and arrest caries since 2014. No studies document survival outcomes based in real world delivery. We analyzed 12-month survival outcomes of SDF applied independently or concurrently with other restorative procedures among a population receiving community dental care. METHODS: We analyzed data on SDF applications from de-identified dental claims on Oregon Health Plan patients served by Advantage Dental in 2016, who had been seen in 2015 (patient n = 2269; teeth n = 7787). We compared survival rates of SDF alone, SDF applied with a sedative filling, and SDF with a same-day restoration. Failure was defined as a restoration or extraction of the tooth 7 to 365 days after initial application. Survival was defined as a patient returning 180 or more days after application whose tooth did not have a restoration or extraction. Differences were assessed through Wilcoxon equality of survivor function tests and log-rank equality of survivor tests to compare failure rates, Cox Proportional Hazards models to assess factors associated with survival of SDF, and Kaplan-Meier survival estimate to calculate the probability of survival over time. RESULTS: SDF alone had an overall survival rate of 76%. SDF placed with sedative filling and with a same-day restoration had survival rates of 50% and 84% respectively, likely reflecting treatment intent. SDF alone survived exceptionally well on primary cuspids, permanent molars, and permanent bicuspids and among patients aged 10 to 20 years, with modest variation across caries risk assessment categories. A single annual application of SDF was successful in 75% of cases. Among SDF failures on permanent dentition, more than two-thirds of teeth received a minor restoration. CONCLUSION: SDF is a minimally invasive non-aerosolizing option that prevented non-cavitated lesions and arrested early decay among community dentistry patients when applied independently or concurrently with restorative procedures. Professional organizations, policy makers, providers, and payors should broaden optional SDF use by informing clinical guidelines, reimbursement policies, and treatment decisions. Future research should address clinical, social, service delivery, workforce, and economic outcomes using diverse population-based samples, and the mechanisms underlying single application success and caries prevention potential.


Assuntos
Cárie Dentária , Clínicas Odontológicas , Adolescente , Adulto , Cariostáticos/uso terapêutico , Criança , Cárie Dentária/tratamento farmacológico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Humanos , Oregon , Compostos de Amônio Quaternário , Compostos de Prata/uso terapêutico , Adulto Jovem
4.
J Dent ; 105: 103561, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33347946

RESUMO

OBJECTIVE: The authors conducted a case series to determine arrest of root surface caries lesions in older adults when teeth were treated topically with 38 % silver diamine fluoride (SDF). METHODS: The study was a prospective, single center case series. The patients were 62 older adults (age ≥55 years) who sought treatment at a dental school clinic. To be included, a patient needed to have at least one active root caries lesion. Lesions were rinsed and then dried with air, isolated, and then 38 % SDF was applied for two minutes with a microbrush. Treated lesions were re-evaluated at 2-3 weeks. Treatment was repeated every six months. Survival analysis methods for clustered data were used to estimate the caries lesion arrest probability over time separately for root surfaces and at crown margins. RESULTS: Fifty-five participants returned for follow-up (44 % female, mean age (SD) 79.8 (7.4)). The probability of a lesion arresting with treatment ranged from 82.9 to 91.6%. Arrest rates at 18 months were slightly higher in root surfaces than around crown margins, 91.6 % (95 % CI 69.1-97.1) versus 89.8 % (95 % CI 71.6-96.3). All furcal lesions (n = 7) were arrested by 6 months, 100 % (95 % CI 59-100). CONCLUSION AND CLINICAL SIGNIFICANCE: Repeated application of 38 % SDF at 6-month intervals was effective in arresting decay of root surface lesions and lesions around crowns in older adults. Study outcomes support SDF treatment for older adult patients who are frail and residing in nursing homes or dependent living facilities.


Assuntos
Cárie Dentária , Cárie Radicular , Idoso , Cariostáticos/uso terapêutico , Cárie Dentária/tratamento farmacológico , Feminino , Fluoretos Tópicos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Compostos de Amônio Quaternário/uso terapêutico , Cárie Radicular/tratamento farmacológico , Compostos de Prata
5.
Rev. ADM ; 77(6): 301-305, nov.-dic. 2020.
Artigo em Espanhol | LILACS | ID: biblio-1151065

RESUMO

A finales de 2019 se identificó el virus SARS-CoV-2 (por su significado en inglés Severe Acute Respiratory Syndrome Coronavirus 2) como agente etiológico de la COVID-19 (por su significado en inglés coronavirus disease 2019) en la ciudad de Wuhan, China. Debido a su rápida propagación al resto del mundo durante el primer trimestre del año 2020, la Organización Mundial de la Salud (OMS) la declaró pandemia mundial en marzo del mismo año. Por el potencial de contagio de COVID-19 se ha considerado que el entorno clínico en el que se desenvuelve la odontología puede ser de alto riesgo para el paciente, el odontólogo y sus asistentes si no se tienen las medidas de bioseguridad adecuadas. En un principio se vieron suspendidas las consultas regulares; sin embargo, al volver a la actividad laboral se han adaptado protocolos para el control de infecciones como reforzar el uso de barreras de protección y minimizar tratamientos que involucren aerosoles. La caries es uno de los principales motivos de consulta en la odontología pediátrica, por lo que en este escrito se sugieren algunos protocolos basados en la mínima invasión que prescinden de instrumental rotatorio para salvaguardar al paciente en riesgo de contagio, reduciendo el número de visitas y tiempo en consulta e incluso controlando algunos aspectos de salud bucal fuera de consulta clínica por medio de estrategias preventivas que pueden llevarse a cabo desde casa. Esto significa también mantener la tranquilidad por parte de los tutores del paciente ante la pandemia que se vive actualmente (AU)


At the end of 2019, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified as the etiological agent of COVID-19 in the city of Wuhan China. Due to its rapid spread to the rest of the world during the first trimester of 2020, the WHO declared a global pandemic in March of the same year. Due to the contagion potential of COVID-19, it has been considered that the clinical environment in which dentistry operates may be in high risk for the patient if the appropriate biosafety measures are not taken, initially clinical practices were suspended. However, when returning to work, protocols have been adapted to the infection control procedures, reinforced the use of protective barriers, and minimize treatments that involve aerosols. Caries is one of the main reasons for consultation in Pediatric Dentistry, this article suggests some protocols based on minimal invasion that dispense with rotating instruments to safeguard the patient from the risk of contagion, reducing the number of visits and time in consultation and even controlling some aspects of the oral health outside the dental visit through preventive strategies that can be carried out from home. Modifications to Dental Home. This should include maintaining tranquility and calm on the part of the patient's tutors in the face of the pandemic that we are currently experiencing (AU)


Assuntos
Humanos , Pré-Escolar , Criança , Infecções por Coronavirus , Assistência Odontológica para Crianças/métodos , Aerossóis , Selantes de Fossas e Fissuras , Remineralização Dentária , Protocolos Clínicos , Fluoretos Tópicos/uso terapêutico , Fatores de Risco , Resinas Compostas , Controle de Infecções Dentárias/métodos , Cárie Dentária/terapia , Placa Dentária/prevenção & controle , Tratamento Dentário Restaurador sem Trauma
6.
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
7.
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
8.
BMC Oral Health ; 20(1): 151, 2020 05 24.
Artigo em Inglês | MEDLINE | ID: mdl-32448221

RESUMO

BACKGROUND: The mechanism of action of silver diammine fluoride (SDF) on plaque micro-ecology is seldom studied. This study investigated micro-ecological changes in dental plaque on extensive caries of deciduous teeth after topical SDF treatment. METHODS: Deciduous teeth with extensive caries freshly removed from school children were collected in clinic. Unstimulated saliva collection and initial plaque sampling were done before tooth extraction, then each caries was topically treated with 38% SDF in vitro. After intervention, each tooth was stored respectively in artificial saliva at 37 °C. Repeated plaque collections were done at 24 h and 1 week post-intervention. Post-intervention micro-ecological changes including microbial diversity, microbial metabolism function as well as species correlations were analyzed and compared after pyrosequencing of the DNA from the plaque sample using Illumina MiSeq platform. RESULTS: After SDF application, microbial diversity decreased (P > 0.05), although not statistically significant. Microbial community composition post-intervention was noticeably different from that of supragingival and pre-intervention plaque as well as saliva. At 1 week post-intervention, the relative content of Pseudomonas, Fusobacterium and Pseudoramibacter were higher than before, while most of the other bacteria were reduced, although the changes were not statistically significant (P > 0.05). The inter-microbial associations became more complex, much more positive associations among survived bacteria were observed than negative ones. COG function classification diagram showed carbohydrate transportation and metabolic functions in the plaque were significantly reduced at 24 h and 1 week post-intervention. CONCLUSIONS: SDF has extensive antimicrobial effect on dental plaque, which may reduce carbohydrate metabolism in dental plaque and help promote new balance of the plaque flora.


Assuntos
Amônia/uso terapêutico , Cárie Dentária/tratamento farmacológico , Placa Dentária/tratamento farmacológico , Fluoretos Tópicos/uso terapêutico , Compostos de Prata/uso terapêutico , Criança , Placa Dentária/microbiologia , Humanos , Compostos de Amônio Quaternário , Dente Decíduo
9.
BMC Oral Health ; 20(1): 119, 2020 04 19.
Artigo em Inglês | MEDLINE | ID: mdl-32306953

RESUMO

BACKGROUND: Intensified preventive regimen based on a 'high-risk' approach has been proposed instead the routine prevention that is generally given to the whole population. The effectiveness of these regimens may still be an issue. Therefore, the aim of this study was to compare two preventive programs carried out in a Public School for kindergarten children. METHODS: The data from clinical examinations were used to assess the caries risk for 121 children. Children with at least 2 carious lesions were considered as high risk for dental caries development. These children were randomized into two groups. Half (High risk basic-HRB group) were provided the basic prevention regimen (oral-hygiene instruction and hands-on brushing practice for teachers and caregivers, daytime tooth brushing supervised by teachers at least once a week, newly erupted first permanent molar sealant, provision of toothbrush, fluoride-containing dentifrice, and a guidebook), which was also given to low-risk children (Low risk basic-LRB group). The other half (High risk intensive-HRI group) were additionally given an intensified preventive regimen (F-varnish application, primary molar sealant, and silver diamine fluoride (SDF) application on carious lesions). Clinical examinations were performed semiannually to determine the dmfs caries increment of the three groups. RESULTS: The 89 children completed the 24-month examination were 3- to 5-year-old with 19, 35, and 35 children in the LRB, HRB, and HRI group, respectively. The new caries development at 24 months of the HRB group (75%) was higher than that of the HRI group (65.7%) and the LRB group (21.1%). One-way analysis of variance (ANOVA) indicated no significant differences of caries increment between the HRB and HRI groups at the end of our study (p = 0.709). CONCLUSIONS: The negligible difference in caries increment between the HRI and HRB groups implies that intensified prevention produced minimal additional benefit. Offering all children only basic prevention could have obtained virtually the same preventive effect with substantially less effort and lower cost. TRIAL REGISTRATION: Thai Clinical Trials Registry (TCTR), TCTR20180124001. Registered 24 January 2018 - Retrospectively registered.


Assuntos
Cárie Dentária/prevenção & controle , Higiene Bucal/métodos , Escovação Dentária , Cariostáticos/uso terapêutico , Pré-Escolar , Dentifrícios/uso terapêutico , Feminino , Fluoretos Tópicos/uso terapêutico , Humanos , Masculino , Dente Molar , Tailândia
10.
Trials ; 21(1): 140, 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32019596

RESUMO

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


Assuntos
Cariostáticos/uso terapêutico , Ensaios Clínicos Fase II como Assunto , Cárie Dentária/prevenção & controle , Compostos de Amônio Quaternário/uso terapêutico , Compostos de Prata/uso terapêutico , Fluoreto de Sódio/uso terapêutico , Cariostáticos/farmacologia , Pré-Escolar , Método Duplo-Cego , Feminino , Fluoretos Tópicos/farmacologia , Fluoretos Tópicos/uso terapêutico , Seguimentos , Hong Kong , Humanos , Masculino , Ensaios Clínicos Pragmáticos como Assunto , Compostos de Amônio Quaternário/farmacologia , Compostos de Prata/farmacologia , Fluoreto de Sódio/farmacologia , Dente Decíduo/efeitos dos fármacos , Resultado do Tratamento
11.
Sci Rep ; 10(1): 2578, 2020 02 13.
Artigo em Inglês | MEDLINE | ID: mdl-32055001

RESUMO

The high prevalence and heavy socio-economic burden for caries of first permanent molars (FPMs) make the prevention of this disease a major public health goal. Current guidelines recommend a preference of fissure sealant (FS) over fluoride varnish (FV) based on two recent systematic reviews. However, evidences of these two studies are weak because of scarce data and some limitations. Besides, an up-to-date large scale randomized controlled trial (RCT) reported commensurate effectiveness of these two techniques. Thus, in order to more accurately compare the clinical efficacy between FS and FV on caries prevention for FPMs, we carried out this systematic review and meta-analysis. A total of 8 RCTs involving 3289 participants and 6878 FPMs fulfilled the inclusion criteria. Our meta-analysis for the first time showed that there was no statistical difference on caries incidence or occlusal DMFS increment between sealant group and fluoride varnish group at 2~3 years' follow-up. In that sense, biannual applications of FV or FS may be equally effective on caries prevention for FPMs. These results do not support routine recommendation of FS over FV, thus shedding light on current conceptions. Our findings endow clinicians with a window to reconsider the choice between these two techniques.


Assuntos
Cárie Dentária/tratamento farmacológico , Fluoretos Tópicos/uso terapêutico , Dente Molar/efeitos dos fármacos , Selantes de Fossas e Fissuras/uso terapêutico , Cárie Dentária/patologia , Cárie Dentária/prevenção & controle , Guias como Assunto , Humanos , Dente Molar/patologia
12.
Eur J Orthod ; 42(3): 326-330, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-31197364

RESUMO

BACKGROUND: Self-applied and professional fluorides are key elements to limit caries-related side-effects during orthodontic treatment with fixed appliances. OBJECTIVE: To evaluate the effectiveness of a new fluoride varnish formula containing 1.5% ammonium fluoride in preventing white spot lesions (WSLs) in adolescents undergoing multi-bracket orthodontic treatment. SUBJECTS AND METHODS: The study employed a randomized controlled triple-blinded design with two parallel arms. One hundred eighty-two healthy adolescents (12-18 years) referred to three orthodontic specialist clinics were eligible and consecutively enrolled. Informed consent was obtained from 166 patients and they were randomly allocated to a test or a placebo group (with aid of a computer program, generating sequence numbers in blocks of 15). In the test group, fluoride varnish was applied in a thin layer around the bracket base every sixth week during the orthodontic treatment, while patients in the placebo group received a varnish without fluoride. The intervention started at onset of the fixed appliances and continued until debonding. The endpoint was prevalence and severity of WSLs on the labial surfaces of the maxillary incisors, canines, and premolars as scored from high-resolution pre- and post-treatment digital photos with aid of a four-level score. RESULTS: One hundred forty-eight patients completed the trial, 75 in the test group and 73 in the placebo group (dropout rate 10.8%). The total prevalence of WSL's on subject level after debonding was 41.8% in the test group and 43.8% in the placebo group. The number of patients exhibiting more severe lesions (score 3 + 4) was higher in the placebo group (P < 0.05); the absolute risk reduction was 14% and the number needed to treat was 7.1. LIMITATIONS: The multicentre design with somewhat diverging routines at the different clinics may have increased risk for performance bias. No health-economic evaluation was carried out. CONCLUSIONS: Regular applications of an ammonium fluoride varnish reduced the prevalence of advanced WSL during treatment with fixed orthodontic appliances. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (NCT03725020). PROTOCOL: The protocol was not published before trial commencement.


Assuntos
Cárie Dentária/etiologia , Cárie Dentária/prevenção & controle , Braquetes Ortodônticos/efeitos adversos , Adolescente , Cariostáticos , Fluoretos , Fluoretos Tópicos/uso terapêutico , Humanos , Aparelhos Ortodônticos/efeitos adversos , Aparelhos Ortodônticos Fixos/efeitos adversos
13.
Indian J Dent Res ; 31(6): 963-966, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33753669

RESUMO

Background: Some studies have reported topical application of 1.0%-2.0% fluoride gel in a custom tray for 4-5 minutes every day for the prevention of radiation-related dental caries. However, in Japan, the concentration of fluoride used by patients is limited to less than 0.15%. The efficacy of a low-concentration fluoride gel in a custom tray for the prevention of radiation-related dental caries has not been investigated. Methods and Material: In this preliminary study, we enrolled 13 patients with head and neck cancer who underwent radiotherapy. They wore a custom tray containing 0.145% sodium fluoride gel during sleep every night and were examined for newly developed dental caries 1 year later. Results: No new dental caries were found in the 13 patients 1 year after radiotherapy, and no adverse events were observed. Conclusions: We conclude that low-concentration fluoride gel in a custom tray during sleep could prevent radiation-related dental caries, and we plan to conduct a multi-center phase III randomized controlled trial to examine the efficacy of this method for the prevention of radiation-related dental caries.


Assuntos
Cárie Dentária , Neoplasias de Cabeça e Pescoço , Cariostáticos , Cárie Dentária/prevenção & controle , Fluoretos , Fluoretos Tópicos/uso terapêutico , Neoplasias de Cabeça e Pescoço/prevenção & controle , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Fluoreto de Sódio
14.
Biomed Res Int ; 2019: 9101642, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31781651

RESUMO

Objective: This in vitro study is aimed at investigating the caries preventive effectiveness of 445 nm diode laser in combination with topical fluoridation. Materials and methods: A total of 30 caries-free bovine teeth were used in this study. Eighteen teeth were covered with nail varnish except four windows on the labial surface. The windows were assigned to no treatment/control (C), laser (L) (0.3 W, 60 s, and 90 J/cm2), fluoride (F), and fluoride followed by laser (FL) treatment groups. Artificial caries lesions were created, and the teeth were sectioned and investigated under polarized light microscopy for quantitative measurement of the resulted lesion depth. Ten teeth were used for surface temperature measurement and two teeth for scanning electron microscopy (SEM). Extra twelve human molars were used for the intrapulpal temperature measurement. The absorbance of fluoride at 445 nm was measured. Results: The means of lesion depth for the C, L, F, and FL groups were 123.48 (±21.93), 112.33 (±20.42), 99.58 (±30.68), and 89.03 (±30.38) µm, respectively. The pairwise differences of the L, F, and FL groups compared with the C group were significant (p < 0.05). The differences between groups were tested: FL versus L p=0.02, F versus L p=0.16, and FL versus F p=0.91, and the difference of the F versus FL was not significant (p=0.91). Temperature increment at the enamel surface and pulp roof were ∆T = 16.67 (±4.11) and 2.12 (±0.66)°C, respectively. The topical fluoride absorbance at 445 nm is five orders higher than that at 810 nm. SEM shows that after laser irradiation the enamel surface was intact and without thermal damage. Conclusions: The 445 nm laser irradiation may be useful for caries prevention, and its effectiveness is lower than those previously achieved using the argon ion laser.


Assuntos
Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Lasers Semicondutores/uso terapêutico , Terapia com Luz de Baixa Intensidade , Animais , Bovinos , Cárie Dentária/tratamento farmacológico , Cárie Dentária/radioterapia , Suscetibilidade à Cárie Dentária , Esmalte Dentário/ultraestrutura , Polpa Dentária/ultraestrutura , Humanos , Microscopia Eletrônica de Varredura , Microscopia de Polarização , Dente Molar/ultraestrutura , Temperatura , Dente/ultraestrutura
15.
Niger J Clin Pract ; 22(11): 1546-1552, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31719276

RESUMO

Objectives: The aim of this in vitro study was to evaluate the effects of casein phosphopeptides (CPP)-ACPF, NovaMin+ fluoride-containing toothpaste and Xylitol+ fluoride containing cream on demineralized areas on the enamel surface. Materials and Methods: A total of 100 enamel slab samples was prepared to investigate in the laboratory experiments. For this purpose, a total of 50 freshly extracted third molar teeth which completed root formation split into two portions in the mesiodistal direction. Enamel surfaces were immersed in a pH cycling protocol as described in the literature to simulate oral conditions for 9 days in order to evaluate the effect of test materials on the artificial enamel lesions. Then the remineralization agents were applied on the enamel surfaces, and we analyzed their effects. Results: We used Vickers Microhardness with the purpose of calculating the amount of lost or acquisition of minerals on the enamel surface qualitatively; inductively coupled plasma atomic emission spectroscopy (ICP-AES) to define the calcium and phosphorus ions that dissolved in acid. One-way ANOVA and Tukey's T Post-Hoc tests were performed to distinguish significant differences among groups (P < 0.05). Conclusions: Remineralization was provided in all treated groups, according to the data obtained from all tests. NovaMin was more effective in increasing acid resistance. It was also found that all three experimental groups were effective in increasing the surface hardness, but CPP-ACPF and NovaMin are more effective than Xylitol. However, there was no statistically significant difference between the experimental groups.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Fluoretos Tópicos/uso terapêutico , Fluoretos/uso terapêutico , Vidro , Desmineralização do Dente/tratamento farmacológico , Remineralização Dentária/métodos , Cremes Dentais , Xilitol/uso terapêutico , Cálcio , Caseínas/uso terapêutico , Fluoretos/farmacologia , Dureza , Humanos , Cremes Dentais/farmacologia , Xilitol/administração & dosagem , Xilitol/farmacologia
16.
BMC Oral Health ; 19(1): 228, 2019 10 24.
Artigo em Inglês | MEDLINE | ID: mdl-31651325

RESUMO

BACKGROUND: Interest in aqueous silver diamine fluoride (SDF) has been growing as a treatment for caries arrest. A cross-sectional study was conducted to identify factors associated with caregiver acceptance of SDF treatment for children presenting with caries at 8 Federally Qualified Health Centers. The study purpose was to examine associations between caregiver acceptance of SDF treatment for children with caries and (1) sociodemographic and acculturation characteristics of caregivers and (2) clinical assessments of the children by dentists. METHODS: A caregiver survey collected information on: sociodemographic characteristics; acculturation characteristics, measured using the validated Short Acculturation Scale for Hispanics (SASH); perceived benefits and barriers of SDF treatment, including caregiver comfort; and perceived health-related knowledge. Chart reviews were conducted to assess: the medical / dental insurance of pediatric patients; cumulative caries experience, measured using decayed, missing, filled teeth total scores (dmft / DMFT); whether operating room treatment was needed; and a record of caregiver acceptance of SDF treatment (the outcome measure). Standard logistic regression models were developed for caregiver acceptance of SDF treatment for their children as the binary outcome of interest (yes / no) to calculate unadjusted odds ratios (OR) and adjusted ORs for covariates of interest. RESULTS: Overall, 434 of 546 caregivers (79.5%) accepted SDF treatment for their children. A U-shaped relationship between caregiver odds of accepting SDF treatment and age group of pediatric patients was present, where caregivers were most likely to accept SDF treatment for their children who were either < 6 years or 9-14 years, and least likely to accept SDF treatment for children 6 to < 9 years. The relationship between acculturation and caregiver acceptance of SDF treatment depended upon whether or not caregivers were born in the United States: greater acculturation was associated with caregiver acceptance of SDF treatment among caregivers born in this country, and lower acculturation was associated with caregiver acceptance of SDF treatment among caregivers born elsewhere. CONCLUSIONS: Caregiver acceptance of SDF treatment is high; child's age and caregiver comfort are associated with acceptance. Providers need to communicate the risks and benefits of evidence-based dental treatments to increasingly diverse caregiver and patient populations.


Assuntos
Aculturação , Cuidadores/psicologia , Cárie Dentária/terapia , Consentimento dos Pais , Odontopediatria , Compostos de Amônio Quaternário/uso terapêutico , Compostos de Prata/uso terapêutico , Adulto , Criança , Centros Comunitários de Saúde , Estudos Transversais , Feminino , Fluoretos Tópicos/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Saúde Bucal , Inquéritos e Questionários
17.
Medicine (Baltimore) ; 98(30): e16634, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31348316

RESUMO

INTRODUCTION: Dental caries is the most frequent oral disease worldwide and the main cause of tooth loss in children and young adults. One of the most frequently affected areas is the occlusal surfaces of the first permanent molars (FPM) due to their morphological complexity. At present, several preventive treatments can reduce the incidence of this disease in school populations. In Mexico, the most commonly used technologies are those derived from some presentation of fluoride; on the other hand, research on this topic has been limited. OBJECTIVE: To determine the cost-effectiveness of two different methods for preventing the incidence of caries on the FPM of schoolchildren (6-8 years of age) from public primary schools. MATERIAL AND METHODS: This is a randomized experimental design. Participants will be assigned to two treatment groups of 114 each. In the first group, pit and fissure sealants will be applied, whereas the second group will receive a fluoride varnish. The work will be carried out in schoolchildren that attend public elementary schools in the state of Hidalgo, Mexico. The result variable will be the incidence of caries and the total cost of each of the interventions will be calculated in order to calculate the intervention's cost-effectiveness. CONCLUSION: This work will allow us to compare the cost-effectiveness of the pit and fissure sealants and the fluoride varnish in order to determine which offers the best results.


Assuntos
Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Criança , Análise Custo-Benefício , Método Duplo-Cego , Feminino , Fluoretos Tópicos/administração & dosagem , Fluoretos Tópicos/economia , Humanos , Masculino , México , Selantes de Fossas e Fissuras/economia , Projetos de Pesquisa
18.
J Dent ; 88: 103171, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31325466

RESUMO

OBJECTIVES: To find out the effects of placement of atraumatic restorative treatment (ART) restorations on parental satisfaction and oral health related quality of life (OHRQoL) of preschool children with SDF-treated or untreated dentine caries lesions. METHODS: In a randomized controlled trial conducted in Hong Kong, preschool children who had cavitated dentine caries lesions were randomly assigned to receive application of silver diamine fluoride (SDF) solution or placebo (tonic water) on their caries lesions 10 weeks before receiving ART restorations. Parents were asked to rate their satisfaction with their child's teeth using a 5-point scale (5 = very satisfied, 1 = very dissatisfied) before and six months after the restorative treatment. Besides, the Chinese version of Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to assess the children's OHRQoL. RESULTS: A total of 194 children participated in this study, with 101 and 93 children receiving SDF and placebo application before ART restorations, respectively. There was no significant difference in parental satisfaction and C-ECOHIS score between the SDF and placebo groups at baseline. At the 6-month follow-up, the mean parental satisfaction score regarding their child's dental health status increased significantly (p < 0.001) from 2.2 ± 0.7 to 2.8 ± 1.0 in the SDF group and from 2.3 ± 0.8 to 2.7 ± 0.9 in the placebo group. However, no significant changes (p > 0.05) in C-ECOHIS scores were found in either of the two groups after ART restoration placement. CONCLUSIONS: Placement of ART restorations can improve parental satisfaction with the health and appearance of their child's teeth but has no significant effect on the OHRQoL. CLINICAL SIGNIFICANCE: This study provides valuable information about the effects of ART restoration placement on SDF-treated or untreated dentine caries lesions regarding parental satisfaction and OHRQoL of preschool children.


Assuntos
Cariostáticos/administração & dosagem , Tratamento Dentário Restaurador sem Trauma , Cárie Dentária/tratamento farmacológico , Pais/psicologia , Qualidade de Vida , Compostos de Amônio Quaternário/uso terapêutico , Compostos de Prata/uso terapêutico , Criança , Pré-Escolar , Tratamento Dentário Restaurador sem Trauma/psicologia , Cárie Dentária/psicologia , Dentina/efeitos dos fármacos , Fluoretos Tópicos/uso terapêutico , Hong Kong , Humanos , Saúde Bucal , Satisfação Pessoal , Resultado do Tratamento
19.
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
20.
Biomed Res Int ; 2019: 1271523, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31317022

RESUMO

Fixed orthodontic treatments often lead to enamel demineralization and cause white spot lesions (WSLs). The aim of this study was to evaluate the mineralization degree of 2 types of WSLs based on ICDAS index and compare the remineralizing efficacy of 3 oral hygiene practices after 1 month and 3 months. 80 mild demineralized and 80 severe demineralized enamel specimens were randomized into three treatments: fluoride toothpaste (FT), fluoride varnish plus fluoride toothpaste (FV+FT), and CPP-ACP plus fluoride toothpaste (CPP-ACP+FT). Microhardness tester, DIAGNODent Pen 2190, and scanning electron microscope were used to evaluate the changes of mineralization degree. Both qualitative and quantitative indicators suggested that the mild and severe white spot lesions were different in the degree of mineralization. Severe WSLs demineralized much more seriously than mild lesions even after 3 months of treatment. Despite the variation in severity, both lesions had the same variation trend after each measure was applied: FT had weak therapeutic effect, FV + FT and CPP-ACP + FT were effective for remineralization. Their remineralizing efficacy was similar after 1 month, and combined use of CPP-ACP plus F toothpaste was more effective after 3 months. In order to fight WSLs, early diagnosis was of great importance, and examination of the tooth surface after air-dry for 5 seconds was recommended. Also, when WSLs were found, added remineralizing treatments were required.


Assuntos
Dente Pré-Molar/efeitos dos fármacos , Cárie Dentária/prevenção & controle , Fluoretos/uso terapêutico , Dente Pré-Molar/patologia , Fosfatos de Cálcio/uso terapêutico , Cárie Dentária/patologia , Fluoretos Tópicos/uso terapêutico , Microscopia Eletrônica de Varredura , Higiene Bucal/métodos , Remineralização Dentária , Cremes Dentais/uso terapêutico
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