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1.
Monogr Oral Sci ; 32: 185-194, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39321775

RESUMO

Molar incisor hypomineralisation (MIH) is defined as hypomineralisation of systemic origin of one to four first permanent molars with or without the involvement of the permanent incisors. In addition to opacities and posteruptive breakdown, hypersensitivity may be a common problem, especially in the molars. Children then often report that hot and cold drinks and meals, toothbrushing, and even air flow cause pain. Therapy approaches to reduce and stop the hypersensitivity include the sealing of affected teeth. Fissure sealants can be placed in mildly affected molars that show no breakdowns in the occlusal surfaces. Thereby, resin-based sealants can be considered for fully erupted teeth, whereas glass ionomers are the treatment of choice in difficult clinical conditions as an interim treatment where isolation is inadequate and the molar has not fully erupted. The aim of this chapter is to describe the phenomenon of hypersensitivity in MIH-affected teeth, to discuss treatment approaches including the placement of sealants as well as the management of posteruptive breakdowns, and to present data on oral health-related quality of life in children suffering from hypersensitivity.


Assuntos
Dente Molar , Selantes de Fossas e Fissuras , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Hipoplasia do Esmalte Dentário/terapia , Criança , Sensibilidade da Dentina/prevenção & controle , Qualidade de Vida
2.
Evid Based Dent ; 25(3): 162-163, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39256484

RESUMO

DESIGN: A prospective, randomized, split-mouth clinical study by the two previously trained and calibrated pediatric dentists without blinding operators and patients due to different protocols in both treatment groups. An SDF + potassium iodide (KI) and SDF + KI + glass ionmer cement (GIC) on International Caries Detection and Assessment System (ICDAS) 1/2 molar was received by each patient on either side of mouth. The local Ethics Committee approved this study. DATA SOURCE: Sample size calculation was not performed due to the lack of published studies on the longevity of SMART sealant on MIH-affected molars and the absence of research on the apparent difference between the effectiveness of SMART and SDF treatments in preventing further caries and sensitivity. STUDY SELECTION: These were children between the ages of 6 years to 13 years, who visited the Pediatric Dentistry Clinic at XX University School of Dentistry for routine exams and treatment between July 2019 to May 2020. They were in good health and had at least two fully erupted permanent first molars with MIH as per the European Academy of Pediatric Dentistry, ICDAS code 1/2. This study recorded 12 months of treatment outcomes on hypomineralised molars of 48 children with a follow-up of three years. Children were excluded with specific syndromes associated with enamel malformation, lack of cooperation, ongoing orthodontic treatment, and teeth with ICDAS 3/4/5/6 lesions, existing restorations, fluorosis, or pulpal symptoms. DATA ANALYSIS: Mann-Whitney U Test was used to assess differences between independent groups (SDF and SMART) and the Friedman Test between dependent groups at different time points. Kaplan-Meier analysis to evaluate the cumulative survival of SMART sealants and survival of caries-free hypomineralised molars in both groups. Chi-Square test was used to compare the success percentages of the SDF and SMART groups. To assess the changes in success percentages at three different time intervals for the caries preventive effect of SDF and SMART, and to evaluate the retention percentages for the SMART group. McNemar's test with a Bonferroni correction was used for significant differences. Cohen's kappa test indicated that the inter-examiner reliability determining the presence of MIH was 0.87. The intra-examiner reliability for US Public Health Service (USPHS)-Modified criteria was 0.90. The statistical significance level was set at p < 0.05 for all statistical analyses. RESULTS: At 12, 24 and 36 months the caries preventive effect was 100%, 67.9%, and 65.4% for SDF + KI-treated teeth; and 100%, 97.6%, and 94.7% for SMART (SDF + KI + GIC) respectively. During the recall period, there was no substantial difference in hypersensitivity scores between the groups. There was no hypersensitivity in teeth at 18 months and beyond. Compared to the baseline Schiff Cold Air Sensitivity Scale (SCASS) score 26 molar with initial hypersensitivity to hypomineralisation had a massive reduction at evaluation periods. The mean survival probabilities for the caries-preventive effect were considerably lower in SDF + KI-treated teeth (31.01 months) than in SMART-treated teeth (35.61 months) (p < 0.001). CONCLUSION: Considering the limitation of the study, both SMART (SDF + KI + GIC) sealants and 6-monthly application of SDF + KI, provided similar and substantial levels of desensitisation on the permanent MIH molars. When used as a sealing material on non-cavitated permanent MIH molars, the clinical retention rate for SMART was 88.7%, 73.1%, and 66.6% at 1, 2, and 3 years respectively. The caries preventive effect of SMART (SDF + KI + GIC) sealants was superior to SDF + KI application in hypomineralised teeth, however, a long-term monitoring and review is essential due to the gradual decrease in retention of SMART sealants.


Assuntos
Cárie Dentária , Dente Molar , Humanos , Criança , Cárie Dentária/prevenção & controle , Cárie Dentária/terapia , Adolescente , Estudos Prospectivos , Feminino , Masculino , Tratamento Dentário Restaurador sem Trauma/métodos , Fluoretos Tópicos/administração & dosagem , Fluoretos Tópicos/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Hipoplasia do Esmalte Dentário/terapia , Hipoplasia do Esmalte Dentário/prevenção & controle , Iodeto de Potássio/uso terapêutico , Iodeto de Potássio/administração & dosagem , Odontologia Baseada em Evidências , Resultado do Tratamento , Cimentos de Ionômeros de Vidro/uso terapêutico , Incisivo , Hipomineralização Molar
3.
BMC Pediatr ; 24(1): 492, 2024 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-39095746

RESUMO

BACKGROUND: In the 21st century, dental caries remains a global burden, particularly severely affecting the growth and quality of life of 12-year-old children. Fortunately, pit and fissure sealing (PFS) procedures can effectively prevent molars from caries. Hence, this study focused on the relationship between PFS and oral epidemiological factors in 12-year-old children. METHODS: A cross-sectional survey was conducted in 12-year-old children from 11 cities in Zhejiang Province. Their dental conditions were collected through questionnaires, as well as basic information such as relevant family information, oral health knowledge and behavior. Then, logistic regression analysis was used to identify the influencing factors associated with PFS. RESULTS: A total of 1204 children were included, with 252 in the PFS group and 952 in the non-PFS group. There were significant differences between the two groups in terms of decayed, missing and filled teeth (DMFT) score, first permanent molar DMFT score, residential area, educational level of parents, tooth-brushing frequency, use of dental floss, oral examination in a medical institution, having taken courses on oral health care, as well as having knowledge that tooth brushing could effectively prevent gingival inflammation, PFS could protect teeth, and oral disease may affect general health. According to further logistic regression analysis, the independent factors influencing PFS included use of dental floss [odds ratios (OR) = 1.672, 95% confidence intervals (CI) = 1.235-2.263, P = 0.001], having taken courses on oral health care (OR = 0.713, 95% CI = 0.515-0.988, P = 0.042), having knowledge that tooth brushing is effective in preventing gingival inflammation (OR = 0.627, 95% CI = 0.389-0.987, P = 0.044) and having knowledge that PFS can protect teeth (OR = 0.589, 95% CI = 0.438-0.791, P < 0.001). CONCLUSION: PFS can reduce the mean DMFT score of 12-year-old children. Independent influencing factors of PFS consist of use of dental floss, having taken courses on oral health care, oral health behavior and knowledge level.


Assuntos
Cárie Dentária , Selantes de Fossas e Fissuras , Humanos , Estudos Transversais , China/epidemiologia , Criança , Feminino , Masculino , Cárie Dentária/prevenção & controle , Cárie Dentária/epidemiologia , Selantes de Fossas e Fissuras/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Modelos Logísticos , Escovação Dentária/estatística & dados numéricos , Saúde Bucal , Índice CPO , Higiene Bucal , Comportamentos Relacionados com a Saúde , Inquéritos e Questionários
4.
J Clin Pediatr Dent ; 48(4): 149-159, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39087225

RESUMO

This clinical trial aimed to evaluate and compare the retention and cariostatic effects of hydrophilic and hydrophobic resin-based sealants (RBSs) for sealing pits and fissures in the permanent molars of uncooperative children. A split-mouth and double-blind randomized clinical trial (RCT) was conducted among 6- to 9-year-old uncooperative children. One hundred and four sound mandibular and maxillary first permanent molars were randomly allocated to be sealed with group I (UltraSeal XT® hydro™) or group II (Helioseal-F) in 34 uncooperative children. Clinical evaluation was performed by two investigators using the Color, Coverage and Caries system to assess sealant retention and cariostatic effect at 3-, 6- and 12-month intervals. Data analysis was performed using Friedman's and Mann-Whitney U tests. The final analysis included 31 children with 49 pairs of teeth. No significant differences were observed between the retention and cariostatic effects of hydrophilic and hydrophobic RBSs at the 3-, 6- and 12-month intervals (p = 0.23, p = 0.638, and p = 0.706, respectively) (p = 0.175, p = 0.065, and p = 0.171, respectively). After 12 months of follow-up, the hydrophilic RBSs showed an outcome equivalent to that of conventional hydrophobic RBSs in terms of retention and cariostatic effects. Therefore, hydrophilic RBSs could be considered as the sealing material of choice when isolation is difficult, particularly in uncooperative children.


Assuntos
Interações Hidrofóbicas e Hidrofílicas , Selantes de Fossas e Fissuras , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Criança , Método Duplo-Cego , Masculino , Feminino , Resinas Compostas/uso terapêutico , Cárie Dentária/prevenção & controle , Dente Molar
5.
BMC Oral Health ; 24(1): 943, 2024 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-39143632

RESUMO

BACKGROUND: Self-adhering flowable composites are an innovative step in reducing the chair time of pit and fissure sealant treatment. This study aimed to compare the clinical performance of self-adhering flowable composite (SELF-ADH) and resin-based pit and fissure sealant (RBs). METHODS: This is a double-blinded, randomized, split-mouth clinical trial conducted on 80 fully erupted permanent mandibular first molars from 40 children aged 6 to 12 years. For each participant, two permanent molars were randomly treated with SELF-ADH or RB. All sealants were assessed at 3, 6, and 12-month follow-ups considering retention, marginal integrity, marginal discolouration, colour matching, surface texture, and caries recurrence. To analyse the data, logistic regression and Fisher's exact tests were used (significance level P < 0.05). RESULTS: At the 12-month follow-up, the number of fully retained sealants in the SELF-ADH group was significantly higher than that in the RB group (P < 0.001). Also, The success rate of marginal integrity in the SELF-ADH group was significantly greater than the the RB group (P = 0.031), while the rate of sealant marginal discolouration was higher in the RB group (P < 0.001). The incidence of recurrent caries in teeth with partial loss of sealant in both groups (P = 0.004, P < 0.001) increased significantly over time. CONCLUSION: The retention and marginal integrity of the self-adhering flowable composite were significantly greater than those of the resin-based sealant. Therefore, due to the small number of work steps, flowable self-adhering composites can be used as alternatives to resin-based pit and fissure sealants. TRIAL REGISTRATION: This study was approved by the Ethics Committee of Kerman University of Medical Sciences with the code IR.KMU.REC.1399.556 and Iraninan Registry of Clinical Trials (IRCT) code IRCT20180521039763N4, as well as full compliance with the Declaration of Helsinki.


Assuntos
Resinas Compostas , Cárie Dentária , Selantes de Fossas e Fissuras , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Criança , Resinas Compostas/uso terapêutico , Resinas Compostas/química , Feminino , Masculino , Método Duplo-Cego , Cárie Dentária/prevenção & controle , Dente Molar
6.
J Evid Based Dent Pract ; 24(3): 102010, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39174168

RESUMO

OBJECTIVES: To compile the evidence from systematic reviews (SRs) about the use of sealants for preventing and arresting pit and fissure occlusal caries in primary and permanent teeth. MATERIALS AND METHODS: A search was performed in six databases and gray literature up to May 2023. Systematic reviews (SRs) that included randomized trials (RCTs) and nonrandomized clinical trials (n-RCTs) aiming to answer the PICO-based focused question "are pit and fissure sealants (I) more effective than other interventions, control or no treatment (C) in preventing and arresting occlusal caries (O) in primary and permanent teeth (P)?", were included. The methodological quality was assessed using the AMSTAR-2. The overlap between reviews was calculated (corrected covered, CCA). RESULTS: Among the 25 included SRs, 18 underwent meta-analysis. Eighteen SRs considered sealing enamel caries lesions, one considered sealing dentine caries, and six considered both. Seventeen SRs were devoted to preventive sealing (RCT only, n = 12; RCT and n-RCT, n = 5), while eight were devoted to prevention and arrest of dental caries (RCT only, n = 5; RCT and n-RCT, n = 3). Nine SRs showed positive results for the primary dentition, and the most frequent periods of follow-up were at least 6 (n = 5) and 12 months (n = 4). According to our meta-analysis, a significant association between resin-based sealants (RBS) and dental caries prevention was detected at 6 months (n = 1) and over longer follow-up periods (n = 4), and the DMFT and dmft indices decreased (n = 2). RBS was better than fluoride varnish at preventing dentine caries (n = 1). A lower caries incidence rate was observed in the resin-modified glass ionomer group at 6 months (n = 1). Overall, the sealants were superior (n = 11), similar (n = 21), or inferior (n = 1) to the other treatments. The AMSTAR-2 scores for studies on preventive sealing were critically low (n = 8), low (n = 6), moderate (n = 1) and high (n = 2) for studies on preventive sealing and critically low (n = 5), low (n = 2) and high (n = 1) for studies on the prevention and arrest of caries lesions. The overlap was low (CCA = 3%). CONCLUSION: This overview suggests that pit and fissure sealants are not inferior to other interventions in preventing and arresting dental caries lesions in primary and permanent teeth.


Assuntos
Cárie Dentária , Dentição Permanente , Selantes de Fossas e Fissuras , Selantes de Fossas e Fissuras/uso terapêutico , Humanos , Cárie Dentária/prevenção & controle , Dente Decíduo , Revisões Sistemáticas como Assunto
7.
Dent Med Probl ; 61(4): 541-548, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39121242

RESUMO

BACKGROUND: Pit and fissure sealants are the most commonly used preventive measure against caries in permanent molars. Advancements in dental materials have led to the development of hydrophilic sealants. However, their clinical efficacy must be evaluated and compared with that of conventional hydrophobic sealants. OBJECTIVES: This study aimed to clinically evaluate and compare the retention, marginal adaptation and marginal discoloration of hydrophilic and hydrophobic pit and fissure sealants over a 12-month follow-up period. MATERIAL AND METHODS: The study was a split-mouth, double-blind, randomized controlled trial. A sample size calculation was performed, and 120 first permanent molars (60 in each group) were selected for inclusion in the study. According to the split-mouth design, the sample was randomly divided into 2 groups. Group A was treated with a hydrophilic sealant (UltraSeal® XT Hydro), while Group B was treated with a hydrophobic sealant (Conseal F). The sealants in both groups were applied in accordance with the manufacturer's instructions by a single operator. The sealants were evaluated clinically using visual and tactile methods by 2 independent examiners who were blinded to the procedure in accordance with the modified United States Public Health Service (USPHS) clinical rating system at placement and at 1, 3, 6, and 12 months. RESULTS: After 12 months of follow-up, the Conseal F sealant showed significantly better retention (p = 0.001), marginal adaptation (p = 0.023) and reduced marginal discoloration (p = 0.004) in comparison to the UltraSeal XT Hydro sealant. CONCLUSIONS: The Conseal F (hydrophobic) sealant demonstrated superior retention, marginal adaptation and marginal discoloration compared to the UltraSeal XT Hydro (hydrophilic) sealant.


Assuntos
Adaptação Marginal Dentária , Interações Hidrofóbicas e Hidrofílicas , Selantes de Fossas e Fissuras , Humanos , Método Duplo-Cego , Feminino , Masculino , Dente Molar , Cárie Dentária/prevenção & controle , Resinas Compostas/uso terapêutico
8.
Community Dent Health ; 41(3): 208-214, 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39105567

RESUMO

OBJECTIVE: To determine the effectiveness of preventive interventions in children who have undergone caries-related dental extractions. METHODS: Rapid review across five databases (CENTRAL, Ovid Medline, Embase, Web of Science and Scopus). Quality was assessed using the Risk of Bias 2 tool. RESULTS: Five studies were included, all randomised controlled trials involving pre-and/or post-extractions activity. Three studies involved oral health education (computer game, motivational interviewing, visual aids), one delivered clinical prevention (fissure sealants), and one an enhanced prevention programme combining additional health education and a clinical intervention (fluoride varnish). Retention was mixed (55%-80% in the intervention groups). Of the three studies measuring caries, all reported less caries development in the test group. However, only a study involving a dental nurse-delivered structured conversation, informed by motivational interviewing, showed an improvement in oral health. Two studies reporting on plaque and gingival bleeding had conflicting results. A study reporting on subsequent dental attendance did not demonstrate a clear improvement. CONCLUSION: Few published studies have explored prevention-based interventions in high caries-risk children requiring dental extractions. Whilst evidence of clinical benefit of preventive interventions in this population is limited, the potential use of contemporary behaviour change techniques appears promising. There is an urgent need for more high-quality longer-term trials using contemporary methodologies.


Assuntos
Cárie Dentária , Saúde Bucal , Extração Dentária , Humanos , Cárie Dentária/prevenção & controle , Criança , Educação em Saúde Bucal/métodos , Selantes de Fossas e Fissuras/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Entrevista Motivacional , Fluoretos Tópicos/uso terapêutico
9.
J Indian Soc Pedod Prev Dent ; 42(2): 119-125, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38957909

RESUMO

BACKGROUND: Dental caries is a multifactorial disease that manifests itself in primary and permanent dentitions. Pit and fissure sealants have become the most effective noninvasive treatment for addressing teeth with deep pits and fissures in children. The purpose of the present study was to evaluate the behavior of the child when administering the pit and fissure sealant using the rubber dam and MiniDam. METHODOLOGY: Fifty-two children in the age range of 9-12 years were randomly allocated into two groups: Group I, rubber dam and Group II, MiniDam. The children were randomly assigned into two groups with 26 members in Group 1 (rubber dam isolation) and 26 members in Group 2 (MiniDam isolation). Children's anxiety was assessed using the modified Venham scale and heart rate. The children's pain intensity was assessed using Memojis Pain Scale. The data collected were tabulated and statistically analyzed using SPSS software. The level of significance was established at 0.05. RESULTS: Intergroup comparison of heart rates showed a statistically significant difference for both the groups at various intervals (P value 0.05), that is, before placing the dam, with the dam, and during treatment. Pain and anxiety scores showed a statistically significant difference in both the groups before and after the procedure (P < 0.05). CONCLUSIONS: The use of MiniDam can offer a better option for the pit/fissure sealant procedure due to its unique qualities, including simplicity of placement, improved behavior management, and less chair time in children.


Assuntos
Comportamento Infantil , Ansiedade ao Tratamento Odontológico , Selantes de Fossas e Fissuras , Diques de Borracha , Humanos , Selantes de Fossas e Fissuras/uso terapêutico , Criança , Ansiedade ao Tratamento Odontológico/prevenção & controle , Masculino , Feminino , Medição da Dor , Frequência Cardíaca , Cárie Dentária/terapia , Cárie Dentária/prevenção & controle
10.
Sci Rep ; 14(1): 16768, 2024 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-39039132

RESUMO

This study evaluated the biocompatibility, bioactivity, porosity, and sealer/dentin interface of Sealer Plus BC (SP), Bio-C Sealer (BIOC), TotalFill BC Sealer (TF), and AH Plus (AHP). Dentin tubes filled with the sealers and empty tubes (control group) were implanted in the subcutaneous tissue of rats for different periods (n = 6 per group/period). Number of inflammatory cells (ICs), capsule thickness, von Kossa reaction, interleukin-6 (IL-6) and osteocalcin (OCN) were evaluated. Porosity and voids in the interface dentin/sealers were assessed by micro-computed tomography. The data were submitted to ANOVA/Tukey's tests (α = 0.05). Greater capsule thickness, ICs and IL-6 immunolabeling cells were observed in AHP. No significant difference in thickness of capsule, ICs, and IL-6- immunolabeling cells was detected between SP and TF, in all periods, and after 30 and 60 days between all groups. At 60 days all groups had reduction in capsule thickness, ICs and IL-6 immunolabeling cells. Von Kossa-positive and birefringent structures were observed in the capsules around the sealers. BIOC, SP, and TF exhibited OCN-immunolabeling cells. All sealers had porosity values below 5%, besides low and similar interface voids. BIOC, SP and TF are biocompatible, bioactive, and have low porosity and voids. The dentin-tube model used is an alternative for evaluating bioceramic materials.


Assuntos
Materiais Biocompatíveis , Dentina , Teste de Materiais , Animais , Porosidade , Dentina/química , Dentina/metabolismo , Materiais Biocompatíveis/química , Materiais Biocompatíveis/farmacologia , Ratos , Cerâmica/química , Interleucina-6/metabolismo , Microtomografia por Raio-X , Masculino , Ratos Wistar , Selantes de Fossas e Fissuras/química
11.
Braz Oral Res ; 38: e053, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38922213

RESUMO

To evaluate the effect of acidic challenge on erosion depth and topographic characteristics of different materials used as occlusal sealants. Two hundred specimens of five sealant materials (Fuji IX, Ketac Molar, Fuji II, Equia and Clinpro) and forty bovine teeth enamel samples (control) were prepared and exposed to acidic challenge. The specimens were immersed in four different solutions (orange juice, coke drink, citric acid or distilled water) under mildly shaken conditions for 3 days. The erosion depth profiles were measured using a profilometer and Scanning Electron Microscope (SEM). Two-way ANOVA with Tukey post-hoc test was performed to evaluate the interactions. Sealant material and acidic challenge had significant effects on erosion depth. Among the materials, Fuji II presented the highest mean of erosion depth after immersion in orange juice, coke drink, and citric acid. All materials groups presented higher erosion depth values after immersion in the citric acid solution, except Clinpro. Bovine enamel presented higher erosion depth values compared to all materials when submitted to erosive challenge. Sealant materials submitted to the acidic challenge presented different degrees of erosion and topographic modification; however, they are less susceptible to erosion than bovine teeth enamel.


Assuntos
Ácido Cítrico , Esmalte Dentário , Teste de Materiais , Microscopia Eletrônica de Varredura , Selantes de Fossas e Fissuras , Propriedades de Superfície , Erosão Dentária , Bovinos , Animais , Erosão Dentária/prevenção & controle , Erosão Dentária/induzido quimicamente , Esmalte Dentário/efeitos dos fármacos , Selantes de Fossas e Fissuras/química , Análise de Variância , Fatores de Tempo , Propriedades de Superfície/efeitos dos fármacos , Cimentos de Ionômeros de Vidro/química , Cimentos de Ionômeros de Vidro/uso terapêutico , Reprodutibilidade dos Testes , Bebidas Gaseificadas/efeitos adversos , Valores de Referência , Concentração de Íons de Hidrogênio , Resinas Compostas/química
12.
Pediatr Dent ; 46(3): 179-185, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38822502

RESUMO

Purpose: The purpose of the study was to determine whether visiting only a pediatric dentist (as opposed to visiting only a general dentist) was associated with the provision of preventive dental services for a U.S.-based pediatric population (those 18 years and younger). Methods: This study analyzed pooled Medical Expenditure Panel Survey data from 2018 and 2019 to compare the use of certain preventive dental services (i.e., examination, radiographs, prophylaxis, dental sealant, and fluoride treatment) among those who reported visiting a pediatric dentist versus those who visited a general dentist. Survey procedures were used in Stata 14.0 to perform multivariable logistic regression analyses. Results: Controlling for demographic and insurance variables, children who visited only pediatric dentists had statistically significantly greater odds of receiving radiographs (adjusted odds ratio [AOR] equals 1.22; 95 percent confidence interval [95% CI] equals 1.01 to 1.48; P=0.04), fluoride treatment (AOR equals 1.57; 95% CI equals 1.30 to 1.90; P≤0.001), and sealants (AOR equals 1.63; 95% CI equals 1.24 to 2.16; P=0.001) compared to children who visited only general dentists. There was no statistically significant difference in the provision of periodic examinations and prophylaxis services. Conclusion: Based on the nationally representative data evaluated, pediatric dentists are more likely to provide more optimal preventive services than general dentists (i.e., radiographs, fluoride treatments, and sealants) to children in the United States.


Assuntos
Assistência Odontológica para Crianças , Odontopediatria , Humanos , Criança , Estados Unidos , Assistência Odontológica para Crianças/estatística & dados numéricos , Adolescente , Masculino , Feminino , Pré-Escolar , Odontologia Geral/estatística & dados numéricos , Odontologia Preventiva/estatística & dados numéricos , Selantes de Fossas e Fissuras/uso terapêutico , Lactente , Odontólogos/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos
13.
Braz Oral Res ; 38: e044, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38747831

RESUMO

The aim of this study was to identify and analyze the characteristics of the 100 most cited articles about dental sealants (DS) in dentistry. In September 2023, a search was performed in the Web of Science Core Collection (WoS-CC) database. The following information was extracted from each article: number and density of citations, year of publication, authorship, journal, impact factor, keywords, study design, theme, continent, country, and institution. The citations of the WoS-CC were compared with those of the Scopus and Google Scholar databases. The VOSviewer software was used to generate collaborative networks. The number of citations ranged from 33 to 205. The articles were published between 1961 and 2016. Buonocore MG (7%) was the most prominent author among the most cited. The Journal of the American Dental Association was the most frequent journal (25%) and Journal of Dental Research (7.6) had the highest impact factor. Most studies had interventional (41%) and laboratory (31%) designs, mainly addressing DS effectiveness in the prevention and control of dental caries (86%). There was a predominance of publications from North America (46%) and the USA was the country with the highest number of articles (44%). The most frequent institutions were the Centers for Disease Control and Prevention (USA) and the University of Rochester (USA) (6% each). "Retention" was the most frequent keyword. In conclusion, the 100 most cited articles were mostly interventional and laboratory studies, addressing the retention and efficacy of DS. Most of the articles were concentrated in North America and Europe, demonstrating a little collaboration from other continents.


Assuntos
Bibliometria , Pesquisa em Odontologia , Selantes de Fossas e Fissuras , Selantes de Fossas e Fissuras/uso terapêutico , Humanos , Pesquisa em Odontologia/estatística & dados numéricos , Fator de Impacto de Revistas , Publicações Periódicas como Assunto/estatística & dados numéricos , Cárie Dentária/prevenção & controle , Odontologia/estatística & dados numéricos
14.
J Dent Res ; 103(7): 705-711, 2024 07.
Artigo em Inglês | MEDLINE | ID: mdl-38716723

RESUMO

This study aimed to compare the clinical effectiveness of resin-based fissure sealants (FS) and fluoride varnish (FV) in children at high caries risk. A practice-based split-mouth randomized clinical trial was conducted at 9 Public Dental Service (PDS) clinics in Norway. In total, 409 children age 6 to 10 y at high caries risk (d3mft > 0) meeting inclusion criteria were recruited by dentists and dental hygienists during routine examination. Eligibility criteria were 2 fully erupted first permanent molars (FPMs) in the same jaw, with sound occlusal surfaces or with initial caries. Participation was voluntary, caregivers and eligible children were informed about the study, and written parental consent was obtained. FS and FV were randomly applied on contralateral FPMs in the same jaw, with each participant serving as their own control. FS was applied at baseline and thereafter maintained according to clinicians' conventional procedures, whereas FV was applied at baseline, 6 mo, and 12 mo. The study outcome was success, with no need for invasive treatment (caries control), while failure was defined as dentin carious lesion or restoration. Two-level mixed-effects logistic regression analysis was used to compare FS and FV groups. Of 409 recruited children, 369 (90%) children/tooth pairs were examined after 36 mo. Intention-to-treat analysis showed 94.1% adjusted predicted probability (aPP) of success (95% confidence interval [CI] 91.7 to 96.4) in the FS group and 89.6% aPP (95% CI 86.5 to 92.7) in the FV group. In the adjusted analysis, the FV group had a lower OR for success compared with the FS group (OR 0.54, 95% CI 0.24 to 0.87). In the population studied, the clinical effectiveness of FS was statistically significantly higher compared with FV but below the estimated minimal clinically important difference of 10%.


Assuntos
Cariostáticos , Cárie Dentária , Fluoretos Tópicos , Selantes de Fossas e Fissuras , Criança , Feminino , Humanos , Masculino , Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Dente Molar , Selantes de Fossas e Fissuras/uso terapêutico , Resultado do Tratamento
15.
J Clin Pediatr Dent ; 48(3): 177-181, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38755997

RESUMO

Patients being reported for vitamin D deficiency (VDD) are increasing, particularly among the children and adolescents. This study aims to manifest the clinical and dental evaluations of a child with VDD, referred to the dental office. A 10-year-old British Asian boy was referred to the paediatric specialist dentistry clinic by the general dentist for dental management. The medical history depicted that the patient was diagnosed with VDD, secondary hyperparathyroidism and delayed growth. Moreover, his mother had the VDD during pregnancy. The patient was breast fed and had rickets in infancy. He was prescribed vitamin D supplements at the age of 16 months. He had received multiple dental treatments under local anaesthesia but with limited cooperation. Clinical examination revealed that the patient had chronological enamel hypoplasia shown as bands at the occlusal third on specific teeth. Suboptimal hygiene with general plaque induced gingivitis, dental caries in permanent and primary teeth, and delayed the teeth eruption. Preventions included appropriate oral hygiene and dietary advice, fluoride varnish application and fissure sealant placement. The treatments included anterior direct composite restoration, posterior composite restoration, stainless steel crowns and extractions. Thorough medical history is essential to understand the underlying causes of dental defects. Early dental intervention can restore the patient appearance and function and prevent further dental damage.


Assuntos
Hipoplasia do Esmalte Dentário , Deficiência de Vitamina D , Humanos , Masculino , Hipoplasia do Esmalte Dentário/etiologia , Criança , Deficiência de Vitamina D/complicações , Hiperparatireoidismo Secundário/complicações , Hiperparatireoidismo Secundário/etiologia , Cárie Dentária/terapia , Selantes de Fossas e Fissuras/uso terapêutico , Transtornos do Crescimento/etiologia , Coroas , Raquitismo/complicações , Gengivite , Gravidez , Restauração Dentária Permanente/métodos , Feminino , Extração Dentária
16.
Medicina (Kaunas) ; 60(5)2024 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-38792917

RESUMO

Background and Objectives: The therapeutic management of carious lesions remains a significant focus for researchers, given their persistently high prevalence despite being largely preventable. This study aimed to compare the effectiveness of a composite resin-based sealant material in halting extended non-cavitated dentin carious lesions when used therapeutically versus preventively on caries-free teeth over a period of twelve months. Materials and Methods: out of the 236 children examined, 45 were excluded from the study due to non-compliance with the inclusion criteria. Thus, the study included 191 children aged 10-12 years, and 764 molars in total. Results: among these molars, 171 were caries-free (ICDAS II code 0), forming the Control group, while 180 molars were classified with an ICDAS II score of 3, forming the Study group. All molars were sealed and evaluated at 6- and 12-month follow-up intervals. Both intervals revealed statistically significant differences (p < 0.05) in sealant retention and carious lesion development between sound (ICDAS code 0) and decayed (ICDAS code 3) teeth. Conclusions: the findings did not support the effectiveness of sealants in halting non-cavitated dentin carious lesions classified as ICDAS II with code 3 compared to their preventive application in sound teeth classified as ICDAS II with code 0.


Assuntos
Resinas Compostas , Cárie Dentária , Selantes de Fossas e Fissuras , Humanos , Cárie Dentária/prevenção & controle , Criança , Selantes de Fossas e Fissuras/uso terapêutico , Feminino , Masculino , Seguimentos , Resinas Compostas/uso terapêutico , Dente Molar , Resultado do Tratamento
17.
Medicina (Kaunas) ; 60(5)2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38792939

RESUMO

Background and Objective: Sealant application is a proven method to prevent occlusal caries; however, long-term studies on this topic are scarce. This study aimed to assess the survival rate and clinical effectiveness of glass ionomer cement (GIC) and resin-based sealants (RBSs) on second permanent molars over a long-term follow-up period. Materials and methods: Sixteen patients aged 11-13 years with all four completely erupted permanent second molars were enrolled in the study. All patients attended 1-year and 3-year follow-ups; however, one participant did not respond after 10 years and was excluded from the final analyses. The oral health status evaluation was based on WHO criteria. A total of 32 teeth received an RBS (Clinpro), and a further 32 teeth were sealed with GIC (Fuji IX). The sealant retention was determined according to the Kilpatrick criteria after 1 year, 3 years, and 10 years, respectively. Statistical analysis included a chi-square test, the Kaplan-Meier method, and the Cox proportional hazard model. Results: At baseline, seven boys and eight girls participated in the study, with a mean age of 12.3 ± 0.9 years. The 1-year follow-up results revealed that 90% of the RBSs and 43.3% of the GIC sealants were completely retained, and no caries lesions were recorded (p = 0.01). The 3-year follow-up results showed that 23.3% of the RBSs and 0% of the GIC sealants demonstrated complete retention (p = 0.034). Moreover, 10.0% of the occlusal surfaces in the RBS group and 13.3% of the occlusal surfaces in the GIC group were filled (p > 0.05). A total of 6.7% of the RBSs showed complete retention. One-third of the sealed teeth (30.0% of the teeth sealed with RBSs and 36.7% of teeth applied with GIC) were filled after 10 years. The Kaplan-Meier analysis demonstrated a higher survival rate in the RBS group when compared with the GIC over the entire follow-up period (p = 0.001). Conclusions: Although the survival rate of RBSs was higher than GIC sealants, their effectiveness in preventing fissure caries in permanent second molars did not differ significantly over a 10-year follow-up.


Assuntos
Cárie Dentária , Cimentos de Ionômeros de Vidro , Selantes de Fossas e Fissuras , Humanos , Cimentos de Ionômeros de Vidro/uso terapêutico , Feminino , Masculino , Criança , Seguimentos , Selantes de Fossas e Fissuras/uso terapêutico , Adolescente , Cárie Dentária/prevenção & controle , Dente Molar , Análise de Sobrevida , Resinas Compostas/uso terapêutico , Cimentos de Resina/uso terapêutico
18.
BMC Oral Health ; 24(1): 553, 2024 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-38735954

RESUMO

BACKGROUND: Deep learning, as an artificial intelligence method has been proved to be powerful in analyzing images. The purpose of this study is to construct a deep learning-based model (ToothNet) for the simultaneous detection of dental caries and fissure sealants in intraoral photos. METHODS: A total of 1020 intraoral photos were collected from 762 volunteers. Teeth, caries and sealants were annotated by two endodontists using the LabelMe tool. ToothNet was developed by modifying the YOLOX framework for simultaneous detection of caries and fissure sealants. The area under curve (AUC) in the receiver operating characteristic curve (ROC) and free-response ROC (FROC) curves were used to evaluate model performance in the following aspects: (i) classification accuracy of detecting dental caries and fissure sealants from a photograph (image-level); and (ii) localization accuracy of the locations of predicted dental caries and fissure sealants (tooth-level). The performance of ToothNet and dentist with 1year of experience (1-year dentist) were compared at tooth-level and image-level using Wilcoxon test and DeLong test. RESULTS: At the image level, ToothNet achieved an AUC of 0.925 (95% CI, 0.880-0.958) for caries detection and 0.902 (95% CI, 0.853-0.940) for sealant detection. At the tooth level, with a confidence threshold of 0.5, the sensitivity, precision, and F1-score for caries detection were 0.807, 0.814, and 0.810, respectively. For fissure sealant detection, the values were 0.714, 0.750, and 0.731. Compared with ToothNet, the 1-year dentist had a lower F1 value (0.599, p < 0.0001) and AUC (0.749, p < 0.0001) in caries detection, and a lower F1 value (0.727, p = 0.023) and similar AUC (0.829, p = 0.154) in sealant detection. CONCLUSIONS: The proposed deep learning model achieved multi-task simultaneous detection in intraoral photos and showed good performance in the detection of dental caries and fissure sealants. Compared with 1-year dentist, the model has advantages in caries detection and is equivalent in fissure sealants detection.


Assuntos
Aprendizado Profundo , Cárie Dentária , Selantes de Fossas e Fissuras , Humanos , Cárie Dentária/diagnóstico , Selantes de Fossas e Fissuras/uso terapêutico , Projetos Piloto , Fotografia Dentária/métodos , Adulto , Masculino , Feminino
19.
Eur Arch Paediatr Dent ; 25(4): 491-500, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38755490

RESUMO

AIM: To compare the shear bond strength and penetration ability of self-etch sealant with and without enamel deproteinization. MATERIALS AND METHODS: A total of 37 sound extracted teeth were selected and 31 teeth were used for testing shear bond strength of self-etch sealant. For this, crowns portions of selected teeth were cut longitudinally with a diamond disc into a mesial and distal half, thereby yielding 62 samples. They were further divided into two groups; in Group 1, samples were deproteinised with 5.25% sodium hypochlorite and a sealant cylinder was built on the proximal surface. In Group 2, sealant cylinders were built without deproteinising the surface. Shear bond strength was tested using Universal Testing Machine. The remaining six teeth were used for penetration evaluation of self-etch sealant. In Group 1, the occlusal surface was deproteinised with 5.25% sodium hypochlorite and self-etch sealant was directly applied. In Group 2, sealant was applied without deproteinisation. The samples obtained after sectioning were observed under scanning electron microscope for sealant penetration. Mann-Whitney test and Chi-square analysis were utilised for statistical analysis. RESULTS: The results showed that the shear bond strength of the two groups was statistically not significant (p = 0.23). However, the comparison of % penetration revealed a statistically significant difference between the groups (p = 0.016). CONCLUSION: Deproteinising the enamel surface prior to application of self-etch sealant enhanced the penetration ability of the sealant but did not show any effect on shear bond strength.


Assuntos
Colagem Dentária , Esmalte Dentário , Análise do Estresse Dentário , Teste de Materiais , Selantes de Fossas e Fissuras , Resistência ao Cisalhamento , Hipoclorito de Sódio , Humanos , Colagem Dentária/métodos , Selantes de Fossas e Fissuras/química , Propriedades de Superfície , Estresse Mecânico , Condicionamento Ácido do Dente , Microscopia Eletrônica de Varredura , Resinas Compostas/química , Cimentos de Resina/química , Adesivos Dentinários/química
20.
J Dent ; 147: 105098, 2024 08.
Artigo em Inglês | MEDLINE | ID: mdl-38797490

RESUMO

OBJECTIVES: This study aimed to assess the clinical outcomes of utilizing silver diamine fluoride + potassium iodide (SDF + KI) treatment and Silver-Modified Atraumatic Restorative Technique (SMART/SDF + KI + Glass Ionomer Cement) over a three-year period on hypomineralised permanent molars with initial carious lesions. METHODS: 112 hypomineralised permanent molars with ICDAS 1 or 2 lesions were selected in 48 children. The teeth were randomized into SDF + KI and SMART (SDF + KI + GIC) groups (n = 56 teeth/group) in a split-mouth design. Hypersensitivity and caries development were evaluated in both groups. Schiff Cold Air Sensitivity Scale (SCASS) was used for evaluation of hypersensitivity, and the modified USPHS criteria were utilised for clinical assessments of SMART sealants at 1,6,12,18,24 and 36 months. Fisher's Exact test, Kaplan-Meier Survival Curves, Log-rank test, Mann Whitney U test, and Friedman test was performed for the statistical analysis. RESULTS: The caries preventive effect was 100 %, 67.9 % and 65.4 % for SDF + KI-treated teeth; and 100 %, 97.6 % and 94.7 % for SMART(SDF + KI + GIC)-treated teeth at 12, 24 and 36 months, respectively. The mean survival probabilities for caries-preventive effect were significantly lower in SDF + KI-treated teeth (31.01 months) than SMART-treated teeth (35.61 months), (p < 0.001). Twenty-six molars with initial hypersensitivity due to hypomineralization demonstrated a significant reduction at all evaluation periods compared to baseline SCASS scores (p < 0.001). Additionally, there was no significant difference in hypersensitivity scores between the groups during the re-call periods, and none of the teeth exhibited hypersensitivity at the 18-month and beyond evaluations. CONCLUSIONS: During the three-year assessment, both groups demonstrated effectiveness in reducing sensitivity in hypomineralised molars. However, SMART (SDF + KI + GIC) sealants offered better protection against tooth decay over time, despite experiencing gradual retention loss. CLINICAL SIGNIFICANCE: Both SMART (SDF + KI + GIC) sealants and SDF + KI proved effective in alleviating hypersensitivity in hypomineralised molars for up to three years. SMART (SDF + KI + GIC) sealants showed greater caries-preventive effect compared to SDF + KI. However, continuous long-term monitoring is crucial due to the gradual decline in retention of SMART (SDF + KI + GIC) sealants. CLINICALTRIALS REGISTRATION NUMBER: NCT03862014.


Assuntos
Cariostáticos , Cárie Dentária , Sensibilidade da Dentina , Fluoretos Tópicos , Cimentos de Ionômeros de Vidro , Dente Molar , Iodeto de Potássio , Compostos de Amônio Quaternário , Compostos de Prata , Humanos , Compostos de Prata/uso terapêutico , Cárie Dentária/prevenção & controle , Compostos de Amônio Quaternário/uso terapêutico , Fluoretos Tópicos/uso terapêutico , Masculino , Feminino , Estudos Prospectivos , Criança , Cimentos de Ionômeros de Vidro/uso terapêutico , Iodeto de Potássio/uso terapêutico , Cariostáticos/uso terapêutico , Sensibilidade da Dentina/prevenção & controle , Resultado do Tratamento , Tratamento Dentário Restaurador sem Trauma/métodos , Selantes de Fossas e Fissuras/uso terapêutico , Seguimentos
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