Dent. J.2014, 2(1), 41-51; doi:10.3390/dj2010041 - published online 19 February 2014 Show/Hide Abstract
Abstract: ICDAS (the International Caries Detection and Assessment System) is a new approach to the detection and classification of dental caries, starting with the stage showing the earliest visual changes. Methodology: This article describes the implementation of the ICDAS at the School of Dentistry, International Medical University, and Kuala Lumpur, Malaysia in a step-by-step systematically planned process. Beginning with the setting up of a Task Force in 2011 for the evaluation and preparation of the training resources and the running of exploratory training exercises, it finally culminated in carrying out training workshops for the entire staff and students. After the internal processes had been completed, an international expert (KE) was invited to evaluate the process and conduct another workshop using the resources developed within the University, including a reference set of carious teeth. The overall time taken was one and a half years. Conclusions: The implementation of the ICDAS has been comprehensively set into motion within the context of our local curriculum and oral healthcare delivery arrangements. However, this will be an ongoing process with further quality assurance measures being required clinically together with the continuing training of new staff. Sharing this ‘framework’ of the ICDAS implementation process should considerably ease the path and reduce the time period of future implementations by other dental teaching institutions.
Dent. J.2014, 2(1), 22-40; doi:10.3390/dj2010022 - published online 19 February 2014 Show/Hide Abstract
Abstract: This comprehensive community health intervention aimed to improve the oral health and reduce the incidence of dental caries in Tabuk schoolchildren. The program supports the public health pyramid that provides a framework to improve health and included creating and evaluating a school oral health surveillance system, applying fluoride varnish and dental sealants on high- and medium-caries risk children, and providing treatment for existing diseases. In a pilot phase, 48 children (26 males 22 females; mean age 6.42; dmft 9.33, Decayed, Missing, or Filled Primary and Permanent Teeth (DMFT) 3.27) received the dental services, both treatment and prevention. Three hundred seventy-eight composite resin or resin-modified light-cured glass ionomer restorations were placed. One-hundred and eighteen teeth received pulp therapy (pulpotomy or pulpectomy), ten of which received stainless steel crowns. A total of 72 teeth were extracted due to caries. To understand the effects of dental disease on children, as perceived by parents, an oral health-related quality of life survey was completed and analyzed. Results found an underestimation of the role the teeth play, particularly primary teeth, in the general health and wellbeing of the child. The program’s main evaluation effort focused on the process and outcome objectives, including the number of children received care, number of teeth received restorations and sealants, and number of children received fluoride varnish, etc. Analyzing the effect of the program on oral hygiene revealed an improvement in oral health, as a direct result of oral health educational sessions and one-to-one counseling. There is an urgent need to expand the program to include all primary schools.
Dent. J.2014, 2(1), 11-21; doi:10.3390/dj2010011 - published online 23 January 2014 Show/Hide Abstract
Abstract: After tooth extraction, the alveolar bone undergoes a remodeling process, which leads to horizontal and vertical bone loss. These resorption processes complicate dental rehabilitation, particularly in connection with implants. Various methods of guided bone regeneration (GBR) have been described to retain the original dimension of the bone after extraction. Most procedures use filler materials and membranes to support the buccal plate and soft tissue, to stabilize the coagulum and to prevent epithelial ingrowth. It has also been suggested that resorption of the buccal bundle bone can be avoided by leaving a buccal root segment (socket shield technique) in place, because the biological integrity of the buccal periodontium (bundle bone) remains untouched. This method has also been described in connection with immediate implant placement. The present case report describes three consecutive cases in which a modified method was applied as part of a delayed implantation. The latter was carried out after six months, and during re-entry the new bone formation in the alveolar bone and the residual ridge was clinically evaluated as proof of principle. It was demonstrated that the bone was clinically preserved with this method. Possibilities and limitations are discussed and directions for future research are disclosed.
Dent. J.2014, 2(1), 1-10; doi:10.3390/dj2010001 - published online 21 January 2014 Show/Hide Abstract
Abstract: AIDS progression is faster in children than adults. Little is known about the oral health status of children living with HIV. Aim: To carry out a literature review about the oral health conditions of children living with HIV in order to observe if this specific population presents different oral health conditions compared to children without HIV infection. Methods: A documental study of literature review was carried out. Studies were searched at PubMed using “oral health”, “children”, “HIV” and “AIDS” as keywords. Papers published between 2001 and 2011 were included. After applying the exclusion criteria and complete reading of the selected studies, other articles were selected from the references lists of the first ones. Results: Firstly, 24 studies were identified. Among them, 65.5% were excluded according to the exclusion criteria. From the five selected articles, another five from the references of these were included. Only one article compared the oral health conditions of children living with HIV with controls without HIV infection. Conclusions: Only 10 papers contained information on the oral health conditions of children living with HIV, and just one compared the results with controls. The few studies found were insufficient to establish the oral health condition profile of children living with HIV. This lack of information could represent the lack of interest of researchers and health authorities in more integrative care and can result in neglect with this specific population of children.
Dent. J.2013, 1(4), 41-60; doi:10.3390/dj1040041 - published online 16 December 2013 Show/Hide Abstract
Abstract: Aim: Calcium silicate-based materials are hydraulic self-setting materials with physico-chemical properties suitable for endodontic surgery and good biological/clinical outcomes. The study aim was to evaluate the bio-properties (biointeractivity and apatite-forming ability) and selected physical properties (porosity, water sorption, solubility, and setting time) of Biodentine, a tricalcium silicate material for endodontics and restorative dentistry, compared to that of ProRoot MTA (Mineral Trioxide Aggregate) as gold standard material. Methods: Biodentine and ProRoot MTA pastes were prepared and analyzed for calcium release and alkalinizing activity (3 h–28 days), setting time, water sorption, porosity, solubility, surface microstructure and composition, and apatite-forming ability in simulated body fluid. Results: Biodentine showed higher calcium release, alkalinizing activity, and solubility but higher open and apparent porosity, water sorption, and a markedly shorter setting time. Calcium phosphate (CaP) deposits were noted on material surfaces after short ageing times. A CaP coating composed of spherulites was detected after 28 days. The thickness, continuity, and Ca/P ratio of the coating differed markedly between the materials. Biodentine showed a coating composed by denser but smaller spherulites, while ProRoot MTA showed large but less dense aggregates of spherulitic deposits. Conclusions: Biodentine showed a pronounced ability to release calcium and extended alkalinizing activity interlinked with its noticeable porosity, water sorption, and solubility: open porosities provide a broad wet biointeractive surface for the release of the calcium and hydroxyl ions involved in the formation of a CaP mineral. Biodentine is a biointeractive tricalcium silicate material with interesting chemical-physical properties and represents a fast-setting alternative to the conventional calcium silicate MTA-like cements.
Dent. J.2013, 1(4), 31-40; doi:10.3390/dj1040031 - published online 4 November 2013 Show/Hide Abstract
Abstract: Obesity is a chronic disease characterized by excess body fat, which can lead to other health problems, including insulin resistance, non-alcoholic fatty liver disease, polycystic ovary syndrome, hypertension, dyslipidemia, sleep apnea, asthma, heart attack, stroke, atherosclerosis and metabolic syndrome. Currently, obesity and dental caries are major public health concerns and dietary habits are a very important common component of their etiological factors, showing some correlation with the sociodemographic characteristics of individuals presenting these diseases. In relation to caries experience, the literature suggests a correlation between obesity and dental caries in children and adolescents, in primary and/or permanent dentition, though divergent results exist regarding assessment based on the method recommended by the WHO (1997), i.e., restricted to carious lesions with cavitation. Some studies indicate greater prevalence of proximal carious lesions in obese adolescents compared with those with normal weight. Salivary changes, such as the concentrations of phosphate, sialic acid, proteins and immunoglobulins and in peroxidase activity could explain the increased probability of obese children presenting greater risk of dental caries. Thus, it is important to consider the contribution of salivary parameters in caries experience of overweight children and adolescents and the implementation of preventive measures in this population.