Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.104
Filtrar
1.
BMC Oral Health ; 21(1): 458, 2021 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-34544397

RESUMO

BACKGROUND: The aim of this study is to explore the spatial heterogeneity of the retention of PFS in children aged 7-9 years in Shanxi Province, North China and investigate the risk factors associated with PFS retention. METHODS: In this study, 937 children aged 7-9 years from Shanxi Province, China were randomly selected, all of whom had at least one first permanent tooth sealed with PFS in 2016. The children were surveyed after 12 months (in 2017) and 24 months (in 2018). The Geo-detector model was used to explore the spatial heterogeneity of the retention rate of PFS and analyze the influence and interactions of the ecological factors on PFS. RESULTS: 3299 teeth from 937 children were analyzed. The PFS full retention rates after 12 months (in 2017) and 24 months (in 2018) were 81.6% and 75.1%, respectively. The incidence of caries of the first molar was 2.1% after 12 months and 5.4% after 24 months. The spatial heterogeneity of the PFS retention rate after 24 months was significant, which was shown as the retention rate of PFS increased from north to south after 24 months. Remarkably, the natural environmental factors exerted greater influence than the socioeconomic and medical resources factors after 12 months, where the interaction of fluorine in water (FW) had the strongest explanatory power of 52% (P < 0.05). The medical resources were important ecological factors after 24 months, and the percentage of medical technicians (PMT) had the strongest explanatory power of 70% (P < 0.05). CONCLUSION: The natural environmental factors and medical resources factors are important ecological factors determining the spatial pattern. The government should strengthen medical and technician construction in North China, comprehensively control fluoride in water, optimize the allocation of medical resources, and promote the balanced development of regional medicine.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Criança , China/epidemiologia , Dentição Permanente , Humanos , Dente Molar , Selantes de Fossas e Fissuras/uso terapêutico
2.
Acta Odontol Latinoam ; 34(1): 183-187, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34570164

RESUMO

The aim of this descriptive ex vivo study was to evaluate qualitatively the depth of pit and fissures (P&F) of the enamel in human mandibular third molars. Fifty (n=50) extracted human mandibular third molars were cleaned and disinfected. All tooth surfaces were coated with nail varnish except for a 1-mm margin around the periphery of the occlusal surface. The teeth were immersed for 48 hours at 37 °C in 1% methylene blue dye solution prepared in artificial saliva. After cleaning, the crowns were separated from the root at the cementoenamel junction and subsequently sectioned longitudinally in buccolingual direction at the location of the central fossa. All sections were examined using a stereoscopic microscope and photographed. The images were downloaded on a computer. The length of penetration of the P&F was recorded using the following scoring system: C1: P&F extended to half of the enamel thickness; C2: P&F extended beyond half of the enamel thickness without reaching the dentine-enamel junction; C3: P&F extended to the dentine-enamel junction. For pits, C1, C2 and C3 were observed in 35, 9 and 6 teeth, respectively, while for fissures, C1, C2 and C3 were observed in 15, 18 and 17 teeth, respectively. The P&F detected in the samples extended to the deepest portions of enamel, quite frequently reaching the enamel-dentine junction. Clinicians should recognize that even if pits and fissures are not clinically obvious, they penetrate deep into the enamel and frequently reach the dentine-enamel junction. Effective treatment is recommended to block access to P&F, thus preventing ingress of bacteria.


Assuntos
Infiltração Dentária , Selantes de Fossas e Fissuras , Esmalte Dentário , Humanos , Dente Molar , Dente Serotino
3.
Acta Odontol Latinoam ; 34(2): 183-187, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34570867

RESUMO

The aim of this descriptive ex vivo study was to evaluate qualitatively the depth of pit and fissures (P&F) of the enamel in human mandibular third molars. Fifty (n=50) extracted human mandibular third molars were cleaned and disinfected. All tooth surfaces were coated with nail varnish except for a 1-mm margin around the periphery of the occlusal surface. The teeth were immersed for 48 hours at 37 °C in 1% methylene blue dye solution prepared in artificial saliva. After cleaning, the crowns were separated from the root at the cementoenamel junction and subsequently sectioned longitudinally in buccolingual direction at the location of the central fossa. All sections were examined using a stereoscopic microscope and photographed. The images were downloaded on a computer. The length of penetration of the P&F was recorded using the following scoring system: C1: P&F extended to half of the enamel thickness; C2: P&F extended beyond half of the enamel thickness without reaching the dentine-enamel junction; C3: P&F extended to the dentine-enamel junction. For pits, C1, C2 and C3 were observed in 35, 9 and 6 teeth, respectively, while for fissures, C1, C2 and C3 were observed in 15, 18 and 17 teeth, respectively. The P&F detected in the samples extended to the deepest portions of enamel, quite frequently reaching the enamel-dentine junction. Clinicians should recognize that even if pits and fissures are not clinically obvious, they penetrate deep into the enamel and frequently reach the dentine-enamel junction. Effective treatment is recommended to block access to P&F, thus preventing ingress of bacteria.


Assuntos
Infiltração Dentária , Selantes de Fossas e Fissuras , Esmalte Dentário , Humanos , Dente Molar , Dente Serotino
4.
Eur J Paediatr Dent ; 22(3): 180-188, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34544245

RESUMO

AIM: The aim of the present prospective study was to evaluate the retention and effectiveness of two types of sealants (clear vs. opaque) on early pit and fissure occlusal non-cavitated ICDAS II #1-3, caries lesions of permanent posterior teeth of children. MATERIALS AND METHODS: Study Design: 6986 pit and fissure occlusal surfaces were randomly sealed with clear or opaque sealants out of which, 5828 sealants were placed on sound and 1158 on questionable surfaces, while 3508 were clear and 3478 opaque sealants. The mean age of the sample at initial sealant placement was 9.5 (±2.9) years and the follow-up time was 12-48 months. The median (IQR, range) follow-up time was 17.9 (8.7-28.6) months. Study inclusion and exclusion criteria applied to the combined database in order to select the study sample. Teethmate™ F-1 natural and opaque sealants (Kuraray, Hattersheim am Main, Germany) were applied following the standard procedure of preparation with moisture control kept by cotton rolls handled Dri-Angles" and a 30 seconds acid-etch with 37% ortho-phosphoric acid gel was used followed by 10 sec air-water spraying washing and polymerization for 20x2 sec. Sealants were applied on sound tooth surfaces (ICDAS #0) with no visible defects or on surfaces with early caries lesions (ICDAS #1-3), randomly and interchangeably on the upper or lower Jaw. Total retention was considered when all pits and fissures were completely sealed, while partial or complete loss was scored as one code, although was registered separately. STATISTICS: Separate analyses were performed for each type of failure (loss of sealant or restoration). Cumulative probabilities of failure over time after sealant placement, overall or by specific characteristics, were calculated using the Kaplan-Meier method. Association between these characteristics and the hazard of failure were investigated using appropriate Cox proportional hazard models. RESULTS: Sealed surfaces with ICDAS II # 1-3, showed 100% higher probability of having a restoration and 60% higher probability of sealant loss, with both differences being statistically significant (aHR=2.03, p=0.046), adjusted for age, sex, type of sealant and location of surface. Opaque sealants presented statistically significant (p 0.009) higher re-application rate, while fissures had 70% statistically significant (p<0.001) higher probability for resealing with time compared to pits, with gender not affecting sealant retention while the earlier a sealant was placed on children's teeth, the more probable it was to need resealing or restoration (p <0.012). CONCLUSIONS: The therapeutic use of sealants on occlusal surfaces of posterior permanent molars with early carious lesions (ICDAS II 1-3) is inferior compared to sound surfaces, showing higher sealant failures and restorations.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Criança , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Seguimentos , Humanos , Dente Molar , Selantes de Fossas e Fissuras/uso terapêutico , Estudos Prospectivos
5.
J Evid Based Dent Pract ; 21(3): 101587, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34479663

RESUMO

OBJECTIVE: This meta-evaluation aimed to summarize all available evidence regarding different fissure sealants on occlusal caries prevention, arrest, retention rate, adverse effect, and cost-effectiveness; when compared with no intervention, other preventive or minimally-invasive procedures. MATERIALS AND METHODS: The systematic reviews and meta-analyses were identified via four electronic databases and manual searching. Two independent reviewers performed study selection, data extraction, quality assessment with AMSTAR-2. RESULTS: Among the 366 records yielded, 38 systematic reviews were identified as eligible 24 of them included meta-analyses. Moderate evidence has supported the efficacies of resin-based sealants (RBS) in occlusal caries prevention, arrest and cost-effectiveness compared to no interventions. Low to very low certainty of evidence suggested similar effectiveness of glass-ionomer cements in caries prevention with RBS and more superior performance of resin infiltration in arresting non-cavitated occlusal lesions. CONCLUSION: This meta-evaluation supports the use of RBS on permanent molars to reduce occlusal caries occurrence, arrest lesion progression and alleviate oral health inequalities between individuals of different socioeconomic status. This meta-evaluation also advocates further research on glass-ionomer cements and resin infiltration with respect to their efficacies in caries prevention and arrest.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Cimentos de Ionômeros de Vidro , Humanos , Dente Molar
6.
Dent Mater ; 37(10): 1529-1541, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34412907

RESUMO

OBJECTIVES: Microleakage is a determinant factor of failures in sealant application. In this study, DMAEM (dodecylmethylaminoethyl methacrylate), a pH-responsive antibacterial agent, was incorporated into resin-based sealant for the first time. The objectives of this study were to: (1) investigate the long-term performance of DMAEM-modified sealants against oral microbial-aging; and (2) investigate the long-term preventive effect of DMAEM-modified sealants on microleakage. METHODS: Depth-of-cure and cytotoxicity of DMAEM-modified sealants were measured. Then, an aging model using biofilm derived from the saliva of high caries experience children was conducted. After aging, microhardness and surface roughness were measured. Biofilm activity, lactic acid production and exopolysaccharide (EPS) production were measured. 16S rRNA gene sequencing were also performed. The effects of DMAEM on microleakage were tested using an in vitro microleakage assessment. RESULTS: The addition of DMAEM with a mass fraction of 2.5-10% did not affect depth-of-cure values and cytotoxicity of sealants. Adding 2.5-10% DMAEM did not affect the surface roughness and microhardness after aging. Compared to control, adding 2.5-10% DMAEM reduced biofilm metabolic activity by more than 80%. The lactic acid production and EPS production were reduced by 50% in DMAEM groups. DMAEM-modified sealants maintained the microbial diversity of biofilm after aging, they also inhibited the growth of lactobacillus. The 5% and 10% DMAEM groups exhibited a significant reduction in microleakage compared to control. SIGNIFICANCE: The long-term antibacterial activities against oral microbial-aging and the long-term microecosystem-regulating capabilities enabled DMAEM-modified sealant to prevent microleakage in sealant application and thus prevent dental caries.


Assuntos
Cárie Dentária , Infiltração Dentária , Biofilmes , Criança , Cárie Dentária/prevenção & controle , Infiltração Dentária/prevenção & controle , Humanos , Concentração de Íons de Hidrogênio , Selantes de Fossas e Fissuras , RNA Ribossômico 16S
7.
J Evid Based Dent Pract ; 21(2): 101542, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34391554

RESUMO

OBJECTIVE: Reporting of randomized controlled trials (RCTs) in dentistry remains suboptimal. Considering the positive impact of the Consolidated Standards of Reporting Trials (CONSORT) guidelines on the quality of evidence in RCTs, the main objective of this systematic review was to determine whether RCTs on dental caries prevention conform to these guidelines. The secondary objective was to assess the association between CONSORT adherence and the year and impact factor of the journal in which the study was published. METHODS: A systematic search was conducted in different databases using appropriate terms to retrieve RCTs that assessed the caries-preventive effect of at least 2 of the following materials-fluoride varnish, resin-based fissure sealants, and ionomer-based fissure sealants-on the occlusal surfaces of permanent molars. Since the first CONSORT statement was published in 1996, a time frame from 1997 to 2020 was established for the identification of studies. Selected articles were assessed according to their adherence to the CONSORT statement, risk of bias (Cochrane risk of bias tool, RoB 2.0), and journal impact factor based on the InCites Journal Citation Reports. The year of publication and other relevant data were also recorded. SPSS (SPSS Statistics 25.0, IBM©) was used to perform the linear correlation analyses to determine the relationship between the article CONSORT score (previously determined) and the year of publication and journal impact factor. A significance level of 5% was established for all analyses. RESULTS: Of 3196 references retrieved, 30 articles were selected and evaluated. Using RoB 2.0, 8 studies were classified as having a high risk of bias, 16 as having some concerns about the risk of bias assessment, and 6 as having a low risk of bias. Concerning CONSORT adherence, 77% of the studies adequately reported the intervention domain, since the methodology for the application of fluoride varnish or sealant materials was thoroughly described. However, the participants' setting and location, random sequence generation, randomization, and the flowchart description of the losses/exclusions domains were poorly reported. Meanwhile, the allocation concealment process was not reported in 83% of the articles. Correlation analyses indicated a positive relationship between CONSORT adherence and the year of publication, as well as the journal impact factor. CONCLUSION: When assessing clinical trials on the prevention of occlusal caries, most RCTs examined followed the CONSORT statement. However, some methodological domains remain poorly reported, demonstrating the need to improve CONSORT compliance in these RCTs.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Cárie Dentária/prevenção & controle , Fluoretos , Humanos , Dente Molar , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Braz Oral Res ; 35: e058, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34346946

RESUMO

This study aimed to evaluate the efficacy of non-invasive and micro-invasive treatments on the arrest of occlusal enamel carious lesions in erupting permanent molars. This two-arm randomized clinical trial included 27 subjects, aged 5-11 years, with 64 erupting permanent molars presenting active occlusal enamel carious lesions (as assessed by the International Caries Detection and Assessment System [ICDAS]; scores 1-3). The sample was randomly assigned into two treatment groups: 1) resin-modified glass ionomer cement sealant (Clinpro XT Varnish; 3M ESPE) and 2) 4-week topical fluoride varnish application (Duraphat; Colgate). All children and parents received oral hygiene and dietary instructions. Teeth were evaluated at baseline and 3, 6, 9, and 12 months regarding the eruption stage, biofilm accumulation, as well as severity and activity of the carious lesions. The Kaplan-Meier method was used to evaluate the survival estimates for inactivation of the carious lesions for both treatment groups. Multivariate Cox regression models with shared frailty were performed to identify factors associated with the outcome (p < 0.05). After 12 months, 22% and 3% of the lesions treated with topical fluoride varnish and sealant, respectively remained active. The adjusted model demonstrated that younger children had a higher probability of active enamel carious lesions arresting (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.22-0.78; p=0.01). However, the probability of active enamel carious lesions arresting after sealant application was 8.85 times higher compared with fluoride varnish applications (p=0.01). Sealing is a more effective approach than fluoride varnish for arresting occlusal enamel carious lesions in erupting permanent molars.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Criança , Cárie Dentária/terapia , Fluoretos , Fluoretos Tópicos/uso terapêutico , Cimentos de Ionômeros de Vidro , Humanos , Dente Molar , Selantes de Fossas e Fissuras/uso terapêutico
9.
Cochrane Database Syst Rev ; 7: CD013039, 2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34280957

RESUMO

BACKGROUND: Traditionally, cavitated carious lesions and those extending into dentine have been treated by 'complete' removal of carious tissue, i.e. non-selective removal and conventional restoration (CR). Alternative strategies for managing cavitated or dentine carious lesions remove less or none of the carious tissue and include selective carious tissue removal (or selective excavation (SE)), stepwise carious tissue removal (SW), sealing carious lesions using sealant materials, sealing using preformed metal crowns (Hall Technique, HT), and non-restorative cavity control (NRCC). OBJECTIVES: To determine the comparative effectiveness of interventions (CR, SE, SW, sealing of carious lesions using sealant materials or preformed metal crowns (HT), or NRCC) to treat carious lesions conventionally considered to require restorations (cavitated or micro-cavitated lesions, or occlusal lesions that are clinically non-cavitated but clinically/radiographically extend into dentine) in primary or permanent teeth with vital (sensitive) pulps. SEARCH METHODS: An information specialist searched four bibliographic databases to 21 July 2020 and used additional search methods to identify published, unpublished and ongoing studies.  SELECTION CRITERIA: We included randomised clinical trials comparing different levels of carious tissue removal, as listed above, against each other, placebo, or no treatment. Participants had permanent or primary teeth (or both), and vital pulps (i.e. no irreversible pulpitis/pulp necrosis), and carious lesions conventionally considered to need a restoration (i.e. cavitated lesions, or non- or micro-cavitated lesions radiographically extending into dentine). The primary outcome was failure, a composite measure of pulp exposure, endodontic therapy, tooth extraction, and restorative complications (including resealing of sealed lesions). DATA COLLECTION AND ANALYSIS: Pairs of review authors independently screened search results, extracted data, and assessed the risk of bias in the studies and the overall certainty of the evidence using GRADE criteria. We measured treatment effects through analysing dichotomous outcomes (presence/absence of complications) and expressing them as odds ratios (OR) with 95% confidence intervals (CI). For failure in the subgroup of deep lesions, we used network meta-analysis to assess and rank the relative effectiveness of different interventions. MAIN RESULTS: We included 27 studies with 3350 participants and 4195 teeth/lesions, which were conducted in 11 countries and published between 1977 and 2020. Twenty-four studies used a parallel-group design and three were split-mouth. Two studies included adults only, 20 included children/adolescents only and five included both. Ten studies evaluated permanent teeth, 16 evaluated primary teeth and one evaluated both. Three studies treated non-cavitated lesions; 12 treated cavitated, deep lesions, and 12 treated cavitated but not deep lesions or lesions of varying depth.  Seventeen studies compared conventional treatment (CR) with a less invasive treatment: SE (8), SW (4), two HT (2), sealing with sealant materials (4) and NRCC (1). Other comparisons were: SE versus HT (2); SE versus SW (4); SE versus sealing  with sealant materials (2); sealant materials versus no sealing (2).  Follow-up times varied from no follow-up (pulp exposure during treatment) to 120 months, the most common being 12 to 24 months. All studies were at overall high risk of bias. Effect of interventions Sealing using sealants versus other interventions for non-cavitated or cavitated but not deep lesions There was insufficient evidence of a difference between sealing with sealants and CR (OR 5.00, 95% CI 0.51 to 49.27; 1 study, 41 teeth, permanent teeth, cavitated), sealing versus SE (OR 3.11, 95% CI 0.11 to 85.52; 2 studies, 82 primary teeth, cavitated) or sealing versus no treatment (OR 0.05, 95% CI 0.00 to 2.71; 2 studies, 103 permanent teeth, non-cavitated), but we assessed all as very low-certainty evidence. HT, CR, SE, NRCC for cavitated, but not deep lesions in primary teeth The odds of failure may be higher for CR than HT (OR 8.35, 95% CI 3.73 to 18.68; 2 studies, 249 teeth; low-certainty evidence) and lower for HT than NRCC (OR 0.19, 95% CI 0.05 to 0.74; 1 study, 84 teeth, very low-certainty evidence). There was insufficient evidence of a difference between SE versus HT (OR 8.94, 95% CI 0.57 to 139.67; 2 studies, 586 teeth) or CR versus NRCC (OR 1.16, 95% CI 0.50 to 2.71; 1 study, 102 teeth), both very low-certainty evidence. CR, SE, SW for deep lesions The odds of failure were higher for CR than SW in permanent teeth (OR 2.06, 95% CI 1.34 to 3.17; 3 studies, 398 teeth; moderate-certainty evidence), but not primary teeth (OR 2.43, 95% CI 0.65 to 9.12; 1 study, 63 teeth; very low-certainty evidence). The odds of failure may be higher for CR than SE in permanent teeth (OR 11.32, 95% CI 1.97 to 65.02; 2 studies, 179 teeth) and primary teeth (OR 4.43, 95% CI 1.04 to 18.77; 4 studies, 265 teeth), both very low-certainty evidence. Notably, two studies compared CR versus SE in cavitated, but not deep lesions, with insufficient evidence of a difference in outcome (OR 0.62, 95% CI 0.21 to 1.88; 204 teeth; very low-certainty evidence). The odds of failure were higher for SW than SE in permanent teeth (OR 2.25, 95% CI 1.33 to 3.82; 3 studies, 371 teeth; moderate-certainty evidence), but not primary teeth (OR 2.05, 95% CI 0.49 to 8.62; 2 studies, 126 teeth; very low-certainty evidence). For deep lesions, a network meta-analysis showed the probability of failure to be greatest for CR compared with SE, SW and HT. AUTHORS' CONCLUSIONS: Compared with CR, there were lower numbers of failures with HT and SE in the primary dentition, and with SE and SW in the permanent dentition. Most studies showed high risk of bias and limited precision of estimates due to small sample size and typically limited numbers of failures, resulting in assessments of low or very low certainty of evidence for most comparisons.


Assuntos
Coroas , Tratamento Dentário Restaurador sem Trauma/métodos , Cárie Dentária/terapia , Selantes de Fossas e Fissuras/uso terapêutico , Adolescente , Adulto , Viés , Criança , Pré-Escolar , Cárie Dentária/patologia , Falha de Restauração Dentária/estatística & dados numéricos , Dentina , Dentição Permanente , Humanos , Pessoa de Meia-Idade , Metanálise em Rede , Ensaios Clínicos Controlados Aleatórios como Assunto , Dente Decíduo
10.
Caries Res ; 55(4): 322-332, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34284374

RESUMO

Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3-4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0-1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group - application of 5% NaFV at 3-monthly intervals or GIS group - 1 single placement of GIS. A parental questionnaire was used to collect information on the children's sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (p = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.


Assuntos
Cárie Dentária , Fluoretos Tópicos , Resinas Acrílicas , Pré-Escolar , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Fluoretos , Fluoretos Tópicos/uso terapêutico , Humanos , Dente Molar , Selantes de Fossas e Fissuras/uso terapêutico , Dióxido de Silício
11.
J Clin Pediatr Dent ; 45(3): 177-185, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34192755

RESUMO

OBJECTIVES: To investigate the effect of Co-curing versus Staged-curing and No-bonding on retention of different resin-based sealants (RBS). STUDY DESIGN: For shear bond strength (SBS) and microleakage tests, 90 extracted premolars were divided equally into 3 groups (I, II, III). Each group was further subdivided equally into 3 subgroups (a, b, c). No-bonding subgroups did not receive a bonding agent, Staged-curing subgroups received a bonding agent that was cured before sealant application, while Co-curing subgroups received a bonding agent that was cured after sealant application. Seal-it was applied for group I, Helioseal-F for group II and Clinpro for group III. SBS buttons were tested using Instron machine, while microleakage specimens were examined using micro-CT. RESULTS: Clinpro showed the highest SBS values in Staged-curing and No-bonding groups (8.72±2.39, 12.51±3.16) respectively. Staged-curing was significantly greater in SBS values than those for other groups (P<0.05). There was a significant difference in microleakage values of Staged-curing among different RBS (P = 0.003), while there was no significant difference in values of No-bonding and Co-curing among different RBS (P = 0.541, P = 0.521). CONCLUSIONS: The use of a bonding agent as Staged-curing was more effective in improving sealant retention than No-bonding and Co-curing.


Assuntos
Colagem Dentária , Selantes de Fossas e Fissuras , Esmalte Dentário , Humanos , Teste de Materiais , Cimentos de Resina , Resistência ao Cisalhamento
12.
Technol Health Care ; 29(5): 1021-1027, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34180435

RESUMO

BACKGROUND: Dental caries is one of the most common diseases around the world. The newly erupted permanent posterior teeth are at great risk due to the complex occlusal morphology of pits and fissures, infraocclusion and incomplete maturation of enamel. Pit and fissure sealants are the treatment of choice in such conditions. OBJECTIVES: To compare the successful outcome of pit and fissure sealants bonded with etch-and-rinse adhesive system and self-etch adhesive systems in newly erupted permanent first molars. METHODS: This randomized clinical trial was conducted at the Fatimah Jinnah Dental Hospital from June 2017 to May 2019. Children aged between 6 to 9 years who fulfilled the inclusion criteria were recruited for this study after parents' consent. Patients were randomly divided into two groups by the lottery method. Thirty patients with 60 first molar teeth in Group A were treated with etch-and-rinse adhesive system, while the other thirty patients with 60 first molar teeth in Group B were treated with self-etch adhesive system. After adhesive placement, all children received the same fissure sealants in newly erupted maxillary and mandibular permanent first molar. Each group was clinically evaluated at 6 and 12 months follow-up visit. Modified United States Public Health Service (USPHS) criteria were used for direct clinical evaluation of successful outcomes such as sealant retention and marginal discoloration. RESULTS: Successful outcome was statistically significant in Group B compared to Group A (60% vs. 30% p= 0.020) at 12 months follow-up. Stratification analysis was performed with respect to age in which a successful outcome was not significant (p= 0.43) between groups for 6 to 7 years of age, while it was significant (p= 0.012) between groups in 8 to 9 years of age children. CONCLUSION: Self-etch adhesive system is better than etch-and-rinse adhesive system in terms of long-term sealant retention. In addition, the bonding procedure is simple with relatively short clinical application time therefore it would offer great benefit to clinicians in treating pediatric patients.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Adesivos , Criança , Cárie Dentária/prevenção & controle , Humanos , Mandíbula , Dente Molar
13.
J Dent ; 110: 103687, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33961937

RESUMO

OBJECTIVE: To conduct economic evaluation of two sealing methods (placement of resin sealant or glass ionomer ART sealant) in preventing pit and fissure caries in permanent first molars (PFMs) in schoolchildren. MATERIALS AND METHODS: An outreach dental program was conducted in two randomly selected primary schools, one was covered by the national government-funded dental sealing service (group 1) and the other was not (group 2). Resin or ART sealant (sealant using glass ionomer material with the aid of the finger-press technique) was applied to all of the eligible PFMs in group 1 and group 2 students (grade 1 or 2), respectively. All the applications was provided at school. The cost for sealant application was recorded for each method. After 18 months, a cost minimisation analysis was performed based on the efficacy results of the two methods. RESULTS AND CONCLUSION: In total, 445 sealants were applied to 126 children in group 1, and 668 sealants were applied to 203 children in group 2. Dental caries incidence was 29.4 % in group 1 and 28.6 % in group 2 after 18 months. Logistic regression analysis showed no statistically significant difference (p = 0.552) between the two groups. Cost minimisation analysis was used to evaluate the economic performance. The analytical model showed that the ART sealant was economically better than resin sealant. Sensitivity analysis showed that the life expectancy of the equipment/instrument used in sealant applications was the major parameter affecting the cost. The cost of using ART sealant over the study period was lower than that of using resin sealant. Overall, ART sealant is a less costly alternative for pit and fissure caries prevention in outreach dental services. CLINICAL SIGNIFICANCE: While pit and fissure sealing using ART sealant was as effective as using resin sealant in dental caries prevention, the cost of using ART sealant was lower than that of using resin sealant. Therefore, ART sealant could be a good alternative to resin sealant for pit and fissure caries prevention in outreach dental services for rural populations who have the greatest need.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Criança , Cárie Dentária/prevenção & controle , Cimentos de Ionômeros de Vidro/uso terapêutico , Humanos , Dente Molar , Selantes de Fossas e Fissuras/uso terapêutico
14.
Biomed Res Int ; 2021: 5544196, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33834066

RESUMO

Objectives: The aim of this study was to evaluate the protective effect of using four different fluoride bioactive enamel sealers against an acidic erosion challenge. Materials and Methods: A sample of 50 freshly extracted sound upper premolars had their buccal surface bonded to 50 orthodontic brackets using Transbond PLUS color change adhesive; the first four groups had four compositions of fluoride bioactive glasses based on 37 mol% SiO2, 43.9-53.9 mol% CaO, 6.1 mol% P2O5 and CaF2, and 0-10 mol% of Na2O applied to their surfaces and the fifth group served as control (which was not treated by any bioactive sealer). All specimens were challenged by 1% citric acid for 18 minutes which was stirred by a magnetic stirrer. The enamel surfaces next to the orthodontic brackets were examined by SEM. The Wilcoxon signed-rank test was used to compare the area covered by the fluoride bioactive pastes before/after erosion (p < 0.05). Samples from the layer formed on top of the examined teeth were tested before/after erosion to be examined by the attenuated total reflectance Fourier-transform infrared spectroscopy (FTIR/ATR). Results: The FTIR/ATR test showed that fluoride bioactive pastes' applications resulted in the formation of a hydroxyapatite-rich layer; the SEM analysis showed that the aforementioned layer significantly resisted erosion challenge when compared to the control group (p < 0.05). Conclusions: Fluoride bioactive pastes can efficiently protect the enamel surfaces next to orthodontic brackets from acidic erosion challenges.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Fluoretos/farmacologia , Vidro/química , Braquetes Ortodônticos , Substâncias Protetoras/farmacologia , Simulação por Computador , Cristalização , Esmalte Dentário/ultraestrutura , Selantes de Fossas e Fissuras , Resinas Sintéticas/química , Espectroscopia de Infravermelho com Transformada de Fourier , Temperatura
15.
Pediatr Dent ; 43(2): 82-87, 2021 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-33892830

RESUMO

Purpose: The purpose of this study was to evaluate the effect of fluoride varnish in preventing dental caries of permanent first molars (PFMs). Methods: The study was designed to be a stratified-cluster randomized controlled trial with classes used as the unit of randomization. Classes stratified by district were followed for 36 months. All eligible children of the selected classes were included in the trial. The children in the test group were applied fluoride varnish biannually. The outcomes were measured at the individual level. Results: In total, 107 classes (51 in the test group, 56 in the control group) were recruited for the trial. Among the 5,397 total subjects, 5,005 and 4,596 children completed the 24-month and 36-month course, respectively. There were no group differences at baseline (P>0.05). The mean decayed and filled surfaces scores of the test group were significantly lower than those of the control group at the 36-month follow-up (P<0.05). The caries processing speed of PFMs increased from 24 months to 36 months; however, group differences were not significant (ß equals 0.01; P>0.05). Conclusions: Biannual application of fluoride varnish can effectively prevent dental caries of six- to seven-year-old children. Nevertheless, the use of fluoride varnish with additional treatments (such as pit and fissure sealants) should be considered for optimized benefit after 24 months.


Assuntos
Cárie Dentária , Fluoretos Tópicos , Cariostáticos , Criança , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Fluoretos , Humanos , Dente Molar , Selantes de Fossas e Fissuras
16.
Dent Mater J ; 40(3): 758-765, 2021 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-33678731

RESUMO

The purpose of this study was to characterize a chlorhexidine-encapsulated nanotube modified pit-and-fissure sealant for biofilm development prevention. HS (commercial control); HNT (HS+15wt%Halloysite®-clay-nanotube); CHX10% (HS+15wt% HNT-encapsulated with chlorhexidine 10%); and CHX20% (HS+15wt% HNT-encapsulated with CHX20%) were tested. Degree-of-conversion (DC%), Knoop hardness (KHN), and viscosity were analyzed. The ability of the sealant to wet the fissures was evaluated. Specimens were tested for zones of inhibition of microbial growth. S. mutans biofilm was tested by measuring recovered viability. Data were statistically analyzed (p<0.05). DC% was significantly higher for the HNT-CHX groups. For KHN, CHX10% presented a lower mean value than the other groups. Adding HNT resulted in higher viscosity values. The biofilm on CHX10% and CHX20% sealants presented remarkable CFU/mL reduction in comparison to the HS. The experimental material was able to reduce the biofilm development in S. mutans biofilm without compromising the sealant properties.


Assuntos
Nanotubos , Selantes de Fossas e Fissuras , Biofilmes , Clorexidina/farmacologia , Teste de Materiais
17.
J Mech Behav Biomed Mater ; 117: 104414, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33647728

RESUMO

The application of pit and fissure sealants is a well-established method to prevent and treat early childhood caries. Resin-based sealants with antibacterial properties provide additional benefits for caries prevention in a cariogenic oral environment. The objective of this study was to evaluate the effect of an antibacterial core-shell AgBr/cationic polymer nanocomposite (AgBr/BHPVP) on the properties of a resin-based pit and fissure sealant. A commercialized pit and fissure sealant without fluoride, Concise (3M, ESPE, USA), was used as the parent material and negative control. Experimental antibacterial sealants were formulated by the addition of AgBr/BHPVP nanoparticles at mass fractions of 0.5, 1.0, and 1.5 wt% to the parent material. A fluoride-releasing sealant, Clinpro (3M, ESPE), was used as the positive control. Bacterial colony-forming unit (CFU) counts, metabolic activity tests, field emission-scanning electron microscopy (FE-SEM), and confocal laser scanning microscopy (CLSM) observations were used to evaluate the antibacterial properties of AgBr/BHPVP-modified sealants against Streptococcus mutans before and after five months of aging. The Vickers microhardness, degree of conversion, and microleakage level of the sealants were also investigated. According to the results of CFU counts and metabolic tests, sealants containing AgBr/BHPVP showed better contact-killing bactericidal activity against S. mutans than the two commercial sealants, irrespective of aging conditions (both P < 0.05). The AgBr/BHPVP-modified sealants also showed a significant inhibitory effect on the planktonic S. mutans around the cured sealant surfaces. In addition, the Vickers microhardness, degree of conversion, and microleakage level of the parent material were not damaged by modification with AgBr/BHPVP (P > 0.05). AgBr/BHPVP-modified pit and fissure sealant with a dual bactericidal mechanism is a promising option for the prevention of pit and fissure caries.


Assuntos
Cárie Dentária , Nanocompostos , Antibacterianos/farmacologia , Pré-Escolar , Cárie Dentária/prevenção & controle , Fluoretos , Humanos , Desempenho Físico Funcional , Selantes de Fossas e Fissuras
18.
J Am Dent Assoc ; 152(4): 269-276.e2, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33775286

RESUMO

BACKGROUND: Untreated caries (UC), although highly prevalent, is largely preventable. Information on the contribution of different teeth to UC prevalence and severity could be helpful in evaluating UC surveillance protocols and the relative benefits of caries prevention interventions. METHODS: The authors combined data from 3 cycles (2011-2016) of the National Health and Nutrition Examination Survey for participants aged 6 through 11 years, 12 through 19 years, 20 through 34 years, 35 through 49 years, 50 through 64 years, 65 through 74 years, and 75 years and older. For each age group the authors calculated the contribution of successive permanent tooth types (for example, first molars and second molars) to UC prevalence and severity. RESULTS: UC prevalence and the percentage of prevalence detected by means of screening molars were, respectively, 5% and 95% among participants aged 6 through 11 years; 16% and 92% among participants aged 12 through 19 years; 29% and 86% among participants aged 20 through 34 years; 26% and 70% among participants aged 35 through 49 years; 21% and 48% among participants aged 50 through 64 years; 16% and 36% among participants aged 65 through 74 years; and 17% and 25% among participants 75 years and older. Among adults aged 50 years and older, no teeth appeared to capture a disproportionate share of UC prevalence. Molars accounted for 87%, 79%, and 56% of severity among participants aged 6 through 11 years, 12 through 19 years, and 20 through 34 years, respectively. After age 34 years, molars accounted for less than 50% of severity. CONCLUSIONS: Molars are the tooth type most susceptible to UC well into adulthood. PRACTICAL IMPLICATIONS: Molars could be used as sentinel teeth for surveillance of UC and adults could benefit from caries prevention that targets molars.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Adulto , Idoso , Criança , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Suscetibilidade à Cárie Dentária , Dentição Permanente , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Vigilância em Saúde Pública , Adulto Jovem
19.
Pediatr Dent ; 43(1): 10-16, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33662243

RESUMO

Purpose: The purpose of this study was to examine the effects of a companion canine on physiologic responses, discomfort level, and behavior in children undergoing sealant placement using a dental isolation system (Isodry®). Methods: Forty-seven healthy six- to 10-year-olds who needed sealants were randomly assigned to a control group (N =23) or experimental group (N =24) that utilized an emotional support canine in the child's lap. Preoperative baseline anxiety was obtained. Pulse, pulse oximetry, and behavior (measured by Frankl and Houpt scales) were recorded at various time points (beginning, at first sealant placement, switching the isolation system to the other side, second side sealant placement, and end) throughout the procedure. Participants reported a comfort level utilizing the FACES scale. Participants in the intervention group were asked, "Did you like having the dog in your lap?" The dentist rated the difficulty of and time required for the procedure. Results: Baseline anxiety was similar; no significant differences in physiologic measurements or FACES ratings were found between groups. The intervention group had significantly lower Houpt ratings for all three variables when the isolation system was repositioned (P=0.002, P=0.03, and P=0.05) and had higher Frankl scores at isolation repositioning and when completing sealants on the second side (P=0.02 and P=0.03, respectively). Both groups had similar ratings from the dentist. Conclusions: Animal-assisted therapy (AAT) should be studied more rigorously to substantiate its effectiveness in enhancing cooperative behavior in children for dental procedures. High levels of satisfaction were observed among pediatric users of AAT.


Assuntos
Terapia Assistida com Animais , Cárie Dentária , Animais , Criança , Cães , Humanos , Projetos Piloto , Selantes de Fossas e Fissuras
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...