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1.
Isr Med Assoc J ; 12(21): 806-811, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31814344

RESUMO

BACKGROUND: Untreated dental caries or even dental manipulations, such as a tooth extraction, might cause direct spread of an odontogenic infection and consequently the development of life-threatening conditions such as deep neck infections (DNI). The most common source of DNI is of odontogenic origin (38.8-49%). Abscess formation or cellulitis can lead to life-threatening complications, despite new diagnostic imaging technology and widespread availability of antibiotics. OBJECTIVES: To demonstrate the dangers of DNI, which can create life-threatening situations. METHODS: Five cases of DNI of odontogenic origin, which were referred to the oral and maxillofacial surgery unit, are presented. RESULTS: Clinical manifestations included trismus, dysphagia, dysphonia, dyspnea, and infection symptoms. In all cases, computed tomography confirmed diagnosis and extent of abscess. Complications included mediastinitis, respiratory distress, osteomyelitis of the jaws, and in rare cases the mandibular condyle. Treatment included securing the airway, immediate surgical drainage, removal of the infection source, and antibiotic therapy. All patients were discharged in stable and improved condition. CONCLUSIONS: DNI treatment on an emergency basis requires proper diagnosis and effective management. To confirm diagnosis and prevent serious complications, it is essential for physicians to recognize the spaces of the head and neck that are likely to be affected by DNI.


Assuntos
Abscesso , Antibacterianos/administração & dosagem , Celulite (Flegmão) , Cárie Dentária/complicações , Drenagem/métodos , Pescoço , Procedimentos Cirúrgicos Bucais/métodos , Extração Dentária/efeitos adversos , Abscesso/diagnóstico , Abscesso/etiologia , Abscesso/fisiopatologia , Abscesso/cirurgia , Adulto , Idoso , Celulite (Flegmão)/diagnóstico , Celulite (Flegmão)/etiologia , Celulite (Flegmão)/fisiopatologia , Celulite (Flegmão)/cirurgia , Feminino , Humanos , Masculino , Mediastinite/diagnóstico , Mediastinite/etiologia , Mediastinite/terapia , Pessoa de Meia-Idade , Pescoço/diagnóstico por imagem , Pescoço/patologia , Osteomielite/diagnóstico , Osteomielite/etiologia , Osteomielite/terapia , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
2.
Rev. cient. odontol ; 7(2): 86-96, jul.-dic. 2019. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1046732

RESUMO

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


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


Assuntos
Humanos , Masculino , Feminino , Cárie Dentária/diagnóstico , Cárie Dentária/prevenção & controle
3.
J Contemp Dent Pract ; 20(10): 1179-1183, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31883253

RESUMO

AIM: The purpose of this study was to find the correlation between dental caries and teeth loss in relation to gender, age, treatments with different therapies, time period being hospitalized, sugar consumption, smoking, and oral hygiene in mental disordered patients. OBJECTIVE: Evaluating therapeutic treatments in patients with mental illnesses, focusing on the effects on oral health. MATERIALS AND METHODS: This is a longitudinal cohort study conducted on patients who have been hospitalized from 5 years to 30 years. Patients were observed for 7 months (January 2019-July 2019) in the psychiatric hospital "Ali Mihali", in Vlora, Albania. In our study, 200 patients participated, of which 103 were females (51.5%) and 97 were males (48.5%). RESULTS: In the present study, we analyzed the oral health of patients within the age class of 30-70 years. We divided them into four age groups: 30-40, 41-50, 51-60, and 61-70 years. According to the ANOVA test, a strongest influence on caries manifestation and missing teeth was noticed during the time the patient was being hospitalized, with p values = 0.000 in both cases. The treatments done with different therapies also had a strong influence on the teeth loss with a p value = 0.001, while in carious teeth the p value was 0.004. This study showed that there is a strong statistically significant correlation between sugar consumption and smoking, in relation to caries manifestation and teeth loss, with p values = 0.000, respectively. CONCLUSION: These patients are a vulnerable group, if we consider their oral health. The present study proved that the most important reasons for their poor dental health are: bad oral hygiene, smoking, sugar consumption, adverse effects of medications, and the time period that these patients have been hospitalized. CLINICAL SIGNIFICANCE: By knowing the factors that have worsened the oral health of mental disordered patients, we can try to raise the awareness about caries reduction and to avoid teeth loss. How to cite this article: Canga M, Malagnino I, Malagnino G, et al. Evaluating Therapy Treatments in Patients with Mental Disorders in Relation to Oral Health. J Contemp Dent Pract 2019;20(10):1179-1183.


Assuntos
Cárie Dentária , Transtornos Mentais , Feminino , Humanos , Estudos Longitudinais , Masculino , Saúde Bucal , Higiene Bucal
4.
Clin Ter ; 170(5): e373-e381, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31612196

RESUMO

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


Assuntos
Anti-Infecciosos/administração & dosagem , Cárie Dentária/dietoterapia , Distúrbios do Metabolismo do Ferro/tratamento farmacológico , Lactoferrina/administração & dosagem , Descoloração de Dente/diagnóstico , Adulto , Criança , Cárie Dentária/diagnóstico , Placa Dentária/diagnóstico , Feminino , Humanos , Distúrbios do Metabolismo do Ferro/diagnóstico , Masculino , Gravidez , Saliva/metabolismo , Descoloração de Dente/tratamento farmacológico
5.
Rev Col Bras Cir ; 46(4): e20192224, 2019.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31644721

RESUMO

OBJECTIVE: to evaluate the oral conditions and the main predisposing factors for dental treatment of patients on the waiting list for liver and simultaneous pancreas-kidney transplantation, in a single center. METHODS: we evaluated 100 patients in the waiting list, 50 candidates for liver transplantation and 50 for simultaneous kidney-pancreas transplantation, from August 2015 to February 2018. We correlated extra and intraoral examinations with pre-transplant demographic variables. RESULTS: the main oral alteration in the pancreas-kidney and liver transplant candidates were decayed, lost and filled teeth, present in 83% and 100% of the candidates, respectively (p=0.03). The need for dental treatment was equal in both groups: 71% and 70%. In liver transplant candidates, the predisposing factors for dental treatment were age, color and etiological diagnosis of liver cirrhosis. We did not identify predisposing factors for dental treatment in candidates for simultaneous pancreas-kidney transplant. CONCLUSION: candidates for liver and for simultaneous pancreas-kidney transplantation had poor oral hygiene, with cavities, residual roots, gingivitis and periodontitis, revealing that dental evaluation should be part of the transplantation waiting list.


Assuntos
Cárie Dentária , Transplante de Rim , Transplante de Fígado , Saúde Bucal , Transplante de Pâncreas , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Listas de Espera
6.
Acta Odontol Latinoam ; 32(2): 97-102, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31664300

RESUMO

The aim of the present study was to validate and establish a cut off point and the predictive value of an adhesion test (AA-MSMG), as a microbiological method for evaluating cariogenic risk. The study is based on a variant (20% sucrose) of a selective medium descripted by Gold et al. (MSMG). This method differentiates mutans group streptococci (MGS) by exacerbating the production of insoluble extracellular polysaccharide which gives adhesion to surfaces such as glass, plastic and dental enamel. Caries assessment according to ICDAS was conducted in 154 patients (aged >21 years) who were attended at Preventive and Community Dentistry Department, School of Dentistry, University of Buenos Aires, Argentina, between August 2017 to August 2018. The study population was assigned to groups according to the presence/ absence of caries lesions: Group A: ICDAS lesion code = 0 (L=0) on all dental surfaces (n=23); and Group B: L>1 (n=131). After mouth-rinsing with distilled water, saliva samples were collected with fasting and hygiene protocol, and sent immediately to the Microbiological Diagnosis Laboratory, Microbiology Department, School of Dentistry, University of Buenos Aires. Samples were homogenized and serially diluted to the tenth. 100 pl of the dilutions were cultured in 25 cm2 sterile plastic flasks containing 9.9 ml of modified selective medium described by Gold (MSMG-selective and differential medium). Cultures were incubated in an anaerobic atmosphere at 36 ± 1°C for 48 hours. The supernatants were eluted and the samples washed with sterile distilled water. Colony forming unit counts were performed by calibrated researchers (Kappa >0.75) using a stereoscopic microscope at 50X. Mutans group streptococci (MGS) counts ranged from 1x104 to 1x105 CFU/ml in group A, and were higher than 1x106 CFU/ml in Group B. Statically analysis of results (ROC) showed that the AAMSMG has a satisfactory predictive value (91%) and established a cutoff point in 1.68x105 UFC / ml. This would indicate that individuals whose MGS saliva counts are higher than the cutoff value would be 5 times more likely to develop dental caries. Adherence assay could be a useful microbiological predictor of caries risk.


Assuntos
Cárie Dentária , Saliva/microbiologia , Streptococcus mutans/isolamento & purificação , Adulto , Argentina , Contagem de Colônia Microbiana , Cárie Dentária/microbiologia , Humanos , Antissépticos Bucais , Valor Preditivo dos Testes , Dente/microbiologia , Adulto Jovem
7.
J Orofac Orthop ; 80(6): 327-335, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31591652

RESUMO

PURPOSE: To evaluate the progression of demineralization during orthodontic treatment, the assessment of lesion activity is important in addition to the detection of lesion extent. This study aimed to evaluate the ability of laser fluorescence measurements to differentiate between active and inactive initial lesions in vitro. METHODS: In all, 63 extracted, permanent human teeth were available for the study. On each occlusal investigation site, surface extent and activity of caries lesions were classified visually using ICDAS/ICCMS (International Caries Detection and Assessment System/International Caries Classification and Management System) criteria, following laser fluorescence measurements. Teeth were hemisected and assessed for lesion depth. Methyl red dye was applied to validate lesion activity on the sections. A Mann-Whitney U-test was performed to evaluate differences between laser fluorescence measurements for active and inactive lesions. For visual and laser fluorescence findings, diagnostic accuracy (Az, sensitivity and specificity) were calculated. RESULTS: A total of 19 sound surfaces and 44 surfaces with ICDAS codes 1/2 were classified visually. The differences in laser fluorescence measurements between active and inactive lesions were not significant for the initial lesions (p > 0.05). Sensitivity/specificity for lesion depth was 90.5/92.3% (Az = 0.894), respectively, for visual assessment and 69.1/76.9% (Az = 0.745), respectively, for laser fluorescence. Sensitivity/specificity for activity assessment was 68.6/85.0% (Az = 0.768) for the visual method. For laser fluorescence measurements, no diagnostic accuracy values could be calculated for caries activity assessment. CONCLUSION: The visual detection and activity assessment of initial lesions was more suitable than the laser fluorescence method. Based on the results of this in vitro study, use of laser fluorescence cannot be recommended for distinguishing between active and inactive initial caries lesions on occlusal surfaces.


Assuntos
Cárie Dentária , Dente Molar , Diagnóstico Bucal , Humanos , Lasers , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
8.
Cien Saude Colet ; 24(9): 3529-3537, 2019 Sep 09.
Artigo em Português | MEDLINE | ID: mdl-31508770

RESUMO

Caries Assessment Spectrum and Treatment (CAST) is an instrument developed for caries detection to be used in epidemiological surveys; it has been validated and is believed to provide a clearer picture of the oral health status than the criteria provided by the World Health Organization (WHO). This article aims to compare the epidemiological survey results using the CAST instrument and the WHO criteria in the same population. 680 schoolchildren aged 6-8 years from Federal District, Brazil, were evaluated by two examiners trained to use the CAST. The visible plaque index (VPI) and gingival bleeding index (GBI) were also evaluated. The maximum CAST codes per tooth were converted into the dmf/DMF, the mean scores for primary and permanent dentition were calculated. The mean age was 7.45(± 0.91) years. The prevalence of caries differed when CAST and the WHO criteria were applied. In the primary dentition, it was 65.44% and 61.61%, and for the permanent dentition, 38.19% and 10.2%, respectively. It was possible to calculate the mean dmft [2.4(± 2.7)] and the DMFT [0.16(± 0.53)] using CAST. VPI was associated with higher maximum CAST scores p < 0,005. The way CAST results are presented showed a higher sensibility to identify the presence and severity of carious lesions in comparison to the WHO criteria.

9.
Stomatologiia (Mosk) ; 98(4): 34-37, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31513146

RESUMO

The aim of this work was to study the influence of components of dental status on the local immunity of the oral cavity; we compared the results of the study of patients with squamous cell carcinoma (SCC) of the oral mucosa and patients without neoplasm. The study involved 136 patients with squamous cell carcinoma of the oral mucosa and 57 patients without neoplasms. In the role of the constituent characteristics of dental status were examined: the use of removable and fixed dentures, dental caries, dental plaque, sharp edges of fullings. Matrix metalloproteinases (MMPs) 2, 8 and 9, as well as their tissue inhibitors 1 and 2 were assessed in oral fluid. The results suggest the influence of all factors on local immune status of the oral cavity as proved by the significant changes in MMPs level. The use of removable dentures resulted in the pronounced decrease of MMPs and should be considered in oral SSC screening and non-invasive diagnostics.


Assuntos
Carcinoma de Células Escamosas , Cárie Dentária , Neoplasias Bucais , Saúde Bucal , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/etiologia , Humanos , Mucosa Bucal , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/etiologia
11.
Ciênc. Saúde Colet ; 24(9): 3529-3537, set. 2019. tab, graf
Artigo em Português | LILACS-Express | ID: biblio-1019677

RESUMO

Resumo O CAST (Caries Assessment Spectrum and Treatment) é um instrumento desenvolvido para a detecção de cárie a ser utilizado em levantamentos epidemiológicos. Foi validado e tem se mostrado efetivo, fornecendo um diagnóstico mais preciso do estado de saúde bucal do que o critério OMS, recomendado pela Organização Mundial da Saúde. O objetivo deste artigo é comparar a apresentação dos resultados de cárie dentária utilizando o instrumento CAST e o critério OMS, numa mesma população. Foram avaliados por dois examinadores treinados na utilização do instrumento CAST 680 escolares de 6 a 8 anos do Distrito Federal, Brasil. A avaliação constou do índice de placa visível (IPV) e do índice de sangramento gengival (ISG). Os escores CAST dente foram convertidos em componentes ceo/CPO e calculados os ceod/CPOD. Os pais responderam a um questionário sociodemográfico. A idade média foi 7,45 anos (± 0,91). A prevalência de cárie na dentição decídua foi de 65,44% e 61,61%, considerando o CAST e o critério da OMS, respectivamente; na dentição permanente: 38,19% e 10,2%, respectivamente. A média do ceod foi de 2.4 (± 2.7) e a média do CPOD 0.16 (± 0.53). o IPV foi associado a maiores CAST máximos p < 0,005. O instrumento CAST demonstrou maior sensibilidade em identificar a presença e gravidade de lesões cariosas quando comparado ao critério OMS.


Abstract Caries Assessment Spectrum and Treatment (CAST) is an instrument developed for caries detection to be used in epidemiological surveys; it has been validated and is believed to provide a clearer picture of the oral health status than the criteria provided by the World Health Organization (WHO). This article aims to compare the epidemiological survey results using the CAST instrument and the WHO criteria in the same population. 680 schoolchildren aged 6-8 years from Federal District, Brazil, were evaluated by two examiners trained to use the CAST. The visible plaque index (VPI) and gingival bleeding index (GBI) were also evaluated. The maximum CAST codes per tooth were converted into the dmf/DMF, the mean scores for primary and permanent dentition were calculated. The mean age was 7.45(± 0.91) years. The prevalence of caries differed when CAST and the WHO criteria were applied. In the primary dentition, it was 65.44% and 61.61%, and for the permanent dentition, 38.19% and 10.2%, respectively. It was possible to calculate the mean dmft [2.4(± 2.7)] and the DMFT [0.16(± 0.53)] using CAST. VPI was associated with higher maximum CAST scores p < 0,005. The way CAST results are presented showed a higher sensibility to identify the presence and severity of carious lesions in comparison to the WHO criteria.

12.
Niger J Clin Pract ; 22(8): 1157-1162, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31417061

RESUMO

Background: The aims of this study are to present sociodemographic and familial characteristics, clinical and systemic findings, dental treatment needs, and concomitant dental anomalies in patients with amelogenesis imperfecta (AI) and to evaluate time-varying conditions in these long-term follow-up patients. Materials and Methods: Records of patients with AI who were examined in the Department of Pediatric Dentistry between 1999 and 2017 were reviewed. Information about sociodemographic characteristics, history of AI and consanguinity in family, systemic conditions, reasons for referral to the clinic, oral hygiene habits and gingival health, occlusion findings, and performed treatments were gathered. Dental anomalies in radiographs were also evaluated. Baseline and final situations of the patients were assessed. Statistical analyses were performed. Results: Of 75 patients aged 3-15 years with follow-ups up to 12 years, 34 had AI in their families and 15 were born from consanguineous marriages. Nephrocalcinosis has been observed in 5 patients. Main reasons for referral to the clinic were related to esthetic and hypersensitivity concerns. Twenty-two patients had gingivitis, and during follow-up process, gingival problems could not be completely prevented due to poor oral hygiene habits. Vertical dimension loss, open-bite, and cross-bite were seen in 16, 15, and 10 patients, respectively. Of the patients, 63% experienced restorative, 33% stainless steel crown, 17% endodontic, 8% prosthetic treatments, and 24% had retreatment needs. Concomitant dental anomalies were dens invaginatus, taurodontism, ectopic eruption, delayed eruption, hypodontia, and pulpal calcification. Conclusion: Early diagnosis and interventions considering the time-varying conditions with long-term follow-ups provide significant improvements in clinical maintenance of patients with AI.


Assuntos
Amelogênese Imperfeita/diagnóstico por imagem , Amelogênese Imperfeita/terapia , Esmalte Dentário/anormalidades , Reabilitação Bucal/métodos , Radiografia Panorâmica , Adolescente , Amelogênese Imperfeita/genética , Criança , Pré-Escolar , Cárie Dentária/terapia , Sensibilidade da Dentina/epidemiologia , Sensibilidade da Dentina/terapia , Estética Dentária , Feminino , Gengivite/epidemiologia , Humanos , Masculino , Má Oclusão , Nefrocalcinose/epidemiologia , Nefrocalcinose/terapia , Índice de Higiene Oral , Aço Inoxidável
13.
Cochrane Database Syst Rev ; 8: CD012595, 2019 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-31425627

RESUMO

BACKGROUND: School dental screening refers to visual inspection of children's oral cavity in a school setting followed by making parents aware of their child's current oral health status and treatment needs. Screening at school intends to identify children at an earlier stage than symptomatic disease presentation, hence prompting preventive and therapeutic oral health care for the children. This review evaluates the effectiveness of school dental screening in improving oral health status. It is an update of the original review, which was first published in December 2017. OBJECTIVES: To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 4 March 2019), the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Register of Studies, to 4 March 2019), MEDLINE Ovid (1946 to 4 March 2019), and Embase Ovid (15 September 2016 to 4 March 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status when searching the electronic databases; however, the search of Embase was restricted to the last six months due to the Cochrane Centralised Search Project to identify all clinical trials and add them to CENTRAL. SELECTION CRITERIA: We included randomised controlled trials (RCTs) (cluster or parallel) that evaluated school dental screening compared with no intervention or with one type of screening compared with another. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: We included seven trials (five were cluster-RCTs) with 20,192 children who were 4 to 15 years of age. Trials assessed follow-up periods of three to eight months. Four trials were conducted in the UK, two were based in India and one in the USA. We assessed two trials to be at low risk of bias, two trials to be at high risk of bias and three trials to be at unclear risk of bias.None of the trials had long-term follow-up to ascertain the lasting effects of school dental screening.None of the trials reported the proportion of children with untreated caries or other oral diseases, cost effectiveness or adverse events.Four trials evaluated traditional screening versus no screening. We performed a meta-analysis for the outcome 'dental attendance' and found an inconclusive result with high heterogeneity. The heterogeneity was found to be, in part, due to study design (three cluster-RCTs and one individual-level RCT). Due to the inconsistency, we downgraded the evidence to 'very low certainty' and are unable to draw conclusions about this comparison.Two cluster-RCTs (both four-arm trials) evaluated criteria-based screening versus no screening and showed a pooled effect estimate of RR 1.07 (95% CI 0.99 to 1.16), suggesting a possible benefit for screening (low-certainty evidence). There was no evidence of a difference when criteria-based screening was compared to traditional screening (RR 1.01, 95% CI 0.94 to 1.08) (very low-certainty evidence).In one trial, a specific (personalised) referral letter was compared to a non-specific one. Results favoured the specific referral letter with an effect estimate of RR 1.39 (95% CI 1.09 to 1.77) for attendance at general dentist services and effect estimate of RR 1.90 (95% CI 1.18 to 3.06) for attendance at specialist orthodontist services (low-certainty evidence).One trial compared screening supplemented with motivation to screening alone. Dental attendance was more likely after screening supplemented with motivation, with an effect estimate of RR 3.08 (95% CI 2.57 to 3.71) (low-certainty evidence).Only one trial reported the proportion of children with treated dental caries. This trial evaluated a post screening referral letter based on the common-sense model of self-regulation (a theoretical framework that explains how people understand and respond to threats to their health), with or without a dental information guide, compared to a standard referral letter. The findings were inconclusive. Due to high risk of bias, indirectness and imprecision, we assessed the evidence as very low certainty. AUTHORS' CONCLUSIONS: The trials included in this review evaluated short-term effects of screening. We found very low-certainty evidence that is insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening, there is no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty evidence to conclude that personalised or specific referral letters may improve dental attendance when compared to non-specific counterparts. We also found low-certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) may improve dental attendance in comparison to screening alone. For children requiring treatment, we found very-low certainty evidence that was inconclusive regarding whether or not a referral letter based on the 'common-sense model of self-regulation' was better than a standard referral letter.We did not find any trials addressing possible adverse effects of school dental screening or evaluating its effectiveness for improving oral health.


Assuntos
Cárie Dentária/prevenção & controle , Saúde Bucal , Odontopediatria , Serviços de Odontologia Escolar/métodos , Instituições Acadêmicas , Odontopatias/diagnóstico , Adolescente , Criança , Pré-Escolar , Humanos , Medicina Preventiva , Ensaios Clínicos Controlados Aleatórios como Assunto , Serviços de Odontologia Escolar/estatística & dados numéricos
14.
Gen Dent ; 67(5): 24-28, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31454318

RESUMO

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


Assuntos
Assistência Odontológica/tendências , Cárie Dentária , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Feminino , Seguimentos , Humanos , Fatores de Risco , Dente
15.
J Pak Med Assoc ; 69(7): 950-954, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31308560

RESUMO

OBJECTIVE: To assess and compare the dental caries status among children using two methods.. METHODS: The cross-sectional study was conducted in October-November 2017 at five government and two private schools in Bhakkar, Punjab, Pakistan. It comprised children aged 11-12 years. World Health Organisation standards and the modified International Caries Detection and Assessment Systems methods were used were used to determine the dental caries status of each subject. Results of the two methods were compared at all cut- offs where appropriate, using SPSS 17. RESULTS: Of the 183 subjects, 101(55.2%) were boys. Those aged 12 years were 112(61.2%) while 71(38.8%) were aged 11 years. There was no statistically significant difference in values of the Decayed Missing and Filled Surface / Decayed Missing and Filled Teeth index as well as the prevalence of dental caries between two methods (p>0.05 each). Intra-examiner reproducibility was higher with the World Health Organisation method compared to the other index used (p<0.05). CONCLUSIONS: Modified International Caries Detection and Assessment Systems method can be used in epidemiological surveys as it was found to provide results similar to the World Health Organisation criteria at cut-off point 2.


Assuntos
Cárie Dentária/epidemiologia , Criança , Estudos Transversais , Índice CPO , Cárie Dentária/diagnóstico , Estudos de Viabilidade , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Prevalência , Reprodutibilidade dos Testes , Organização Mundial da Saúde
16.
Nutrients ; 11(7)2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31261961

RESUMO

Taste and diet preferences are complex and influenced by both environmental and host traits while affecting both food selection and associated health outcomes. The present study genotyped 94 single nucleotide polymorphisms (SNPs) in previously reported taste and food intake related genes and assessed associations with taste threshold (TT) and preferred intensity (PT) of sweet, sour and bitter, food preferences, habitual diet intake, and caries status in healthy young Swedish men and women (n = 127). Polymorphisms in the GNAT3, SLC2A4, TAS1R1 and TAS1R2 genes were associated with variation in TT and PT for sweet taste as well as sweet food intake. Increasing PT for sweet was associated with increasing preference and intake of sugary foods. Similarly, increasing TT for sour was associated with increasing intake of sour foods, whereas the associations between food preference/intake and TT/PT for bitter was weak in this study group. Finally, allelic variation in the GNAT3, SLC2A2, SLC2A4, TAS1R1 and TAS1R2 genes was associated with caries status, whereas TT, PT and food preferences were not. It was concluded that variations in taste receptor, glucose transporter and gustducin encoding genes are related to taste perception, food preference and intake as well as the sugar-dependent caries disease.


Assuntos
Cárie Dentária/genética , Comportamento Alimentar , Polimorfismo de Nucleotídeo Único , Percepção Gustatória/genética , Paladar/genética , Adolescente , Cárie Dentária/diagnóstico , Feminino , Frequência do Gene , Predisposição Genética para Doença , Transportador de Glucose Tipo 2/genética , Transportador de Glucose Tipo 4/genética , Humanos , Masculino , Fenótipo , Receptores Acoplados a Proteínas-G/genética , Fatores de Risco , Suécia , Transducina/genética , Adulto Jovem
17.
J Appl Oral Sci ; 27: e20180700, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166415

RESUMO

INTRODUCTION: Alternatives for the treatment of caries disease, such as minimally invasive approaches, have been developed in recent years. OBJECTIVE: To carry out clinical and radiographic evaluations of three cavity liners after selective caries removal. METHODOLOGY: Thirty-six primary molars with deep occlusal caries lesions without pulp involvement (from children of both genders, aged between 5 and 8 years) were randomly divided into the following groups: calcium hydroxide cement (CHC) group; mineral trioxide aggregate (MTA) group and Portland cement with added zirconium oxide (PCZ) group. The following-up period was 6- and 12-month. The clinical and radiographic success rates were evaluated through chi-square test. The radiographic measurements were compared by ANOVA followed by Tukey's test (p<0.05). RESULTS: Thirty-six patients were included, but thirty-four returned for 12-month follow-up. The overall success rate of the therapy for the three groups was 94.11% and no statistically significant differences occurred in the comparison among groups (p>0.05). Nineteen radiographs were selected to measure the dentin barrier thickness. The intragroup comparison presented a statistically significant increase of the dentin barrier for all groups, at 12-month follow-up. However, the MTA group showed increase of the dentin barrier, over time, 6- to 12-month follow-up. The intergroup comparison revealed no statistically significant differences (p>0.05). CONCLUSION: The clinical and radiographic data showed that all cavity liners provided effective treatment of primary teeth after selective caries removal.


Assuntos
Compostos de Alumínio/uso terapêutico , Compostos de Cálcio/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Cárie Dentária/terapia , Forramento da Cavidade Dentária/métodos , Óxidos/uso terapêutico , Silicatos/uso terapêutico , Zircônio/uso terapêutico , Análise de Variância , Criança , Pré-Escolar , Cárie Dentária/diagnóstico por imagem , Cimentos Dentários/uso terapêutico , Cavidade Pulpar/anatomia & histologia , Cavidade Pulpar/efeitos dos fármacos , Restauração Dentária Permanente/métodos , Combinação de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Radiografia Dentária , Fatores de Tempo , Dente Decíduo , Resultado do Tratamento
18.
Niger J Clin Pract ; 22(6): 833-841, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31187770

RESUMO

Objective: To evaluate the mechanical properties of a glass hybrid (GH) restorative system (EQUIA Forte/GC) and compare it with a microhybrid composite (G-aenial Posterior/GC) by compressive strength (CS) and fracture resistance (FR) tests. Materials and Methods: Cylindrical specimens were subjected to a CS test (n = 12). There were about 48 mandibular molars were used for a FR test and divided into four groups: Group 1 (positive control), sound teeth; Group 2 (negative control), extended size Class 2 cavities prepared on the mesial surfaces of teeth; Group 3, extended size Class 2 cavities restored with a composite; and Group 4, extended size Class 2 cavities restored with GH. Specimens were subjected to loading until a fracture occurred. Data were analyzed statistically (α = 0.05). Results: The fracture modes were examined by scanning electron microscope (SEM). The CS values of the composite and GH were 278.20 ± 17.34 MPa and 164.62 ± 25.72 MPa, respectively (P < 0.05). No differences were observed between the FR of restored groups (P > 0.05). Conclusions: The GH exhibited sufficient mechanical properties as a restorative material, and could be preferred for extensive caries lesions on posterior teeth.


Assuntos
Resinas Compostas , Força Compressiva , Cárie Dentária/terapia , Vidro , Fraturas dos Dentes/diagnóstico por imagem , Preparo da Cavidade Dentária , Restauração Dentária Permanente , Humanos , Teste de Materiais , Microscopia Eletrônica de Varredura , Dente Molar
19.
Lasers Med Sci ; 34(8): 1655-1663, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31201666

RESUMO

The aim of this study is to assess the extent of early carious lesions using the International Caries Detection and Assessment System (ICDAS) II and DIAGNOdent pen compared with microCT examination. Forty-eight molars and premolars were qualified for the study. The visual and the DIAGNOdent pen device examinations were carried out by two examiners. The actual extent of the lesions was determined using micro-CT examination. The optimal cutoff test value was determined using the Youden index. For the two methods, inter- and intra-examiner reproducibility was calculated using intraclass correlation coefficient. The sensitivity, specificity, and accuracy of these methods were compared using the mid-P McNemar test. The level of significance was set at p < 0.05. In terms of the enamel threshold for the ICDAS II scale, insignificantly higher mean evaluated parameters were noticed in comparison with the DIAGNOdent pen device. For the dentin threshold, all the assessed parameters had higher mean values on the ICDAS II scale compared with the DIAGNOdent pen. The optimal cutoff points of the enamel and dentin thresholds are lower than that suggested by the manufacturer. The ICDAS II and the DIAGNOdent pen device were characterized by high inter - and intra-observer reproducibility of the test results. To improve the diagnostic efficiency of the DIAGNOdent pen, modifying the cutoff values recommended by the manufacturers should be considered. After modifying the cutoff values, the combination ICDAS II and DIAGNOdent pen device would be the better choice in order to detect caries on occlusal surfaces.


Assuntos
Cárie Dentária/diagnóstico por imagem , Cárie Dentária/diagnóstico , Oclusão Dentária , Microtomografia por Raio-X , Área Sob a Curva , Fluorescência , Humanos , Processamento de Imagem Assistida por Computador , Valor Preditivo dos Testes , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
20.
J Endod ; 45(8): 1024-1029, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31248699

RESUMO

INTRODUCTION: The accurate detection of periradicular lesions located under a nonperforated cortical plate poses a challenge in endodontic microsurgery. Optical coherence tomography (OCT) is a noninvasive imaging method that has been successfully used in many dental applications. In this study, we investigated if spectral-domain OCT (SD-OCT) could be used to determine simulated periradicular lesions. METHODS: Twenty-eight cavities with different depths were prepared on bone plates obtained from 5 porcine mandibles. Both 3-dimensional SD-OCT imaging and micro-computed tomographic (micro-CT) imaging were used to image the bottom of the air-filled cavity and the cavity filled with soft tissue for comparison. The residual bone thickness under the cavity was measured by SD-OCT and micro-CT imaging and compared using the Pearson correlation. RESULTS: The air-filled lesions were readily detected; yet, filling of the cavity with soft tissue diminished the appearance of the lesion boundaries in the SD-OCT images. The optical values of residual bone thickness obtained from SD-OCT ranged from 0.14-2.11 mm, which corresponded to the range of 0.26-1.18 mm from micro-CT imaging. A strong correlation was found between the 2 imaging modalities (r = 0.96; range, 0.94-0.98). The slope (1.56) of the linear regression matched the bulk refractive index of bone tissues. CONCLUSIONS: SD-OCT allows for visualization of the lesion boundaries via intact bone surfaces and may be a promising, practical, and nonirradiating adjunct tool for chairside localization of periradicular lesions in bone.


Assuntos
Cárie Dentária , Tomografia de Coerência Óptica , Animais , Cárie Dentária/diagnóstico por imagem , Suínos
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