Search Results (9)

The aim of this randomized clinical trial was to evaluate the efficacy of two different remineralising toothpastes in preventing dental caries and promoting oral health. Patients aged 6–18 years old with healthy and fully erupted first permanent molars (C1 and C2 DIAGNOdent scores) were enrolled and randomized into two groups according to the home-hydroxyapatite-based remineralising treatment used: the Trial group used zinc carbonate hydroxyapatite-based treatment (Biorepair Total Protective Repair), while the Control group used magnesium strontium carbonate hydroxyapatite conjugated with chitosan toothpaste (Curasept Biosmalto Caries Abrasion & Erosion). Dental and periodontal parameters were measured over a six-month period, including the DIAGNOdent Pen Index (primary outcome), BEWE Index, Plaque Index, Bleeding Score, Schiff Air Index, and ICDAS assessed with DIAGNOcam. A total of 40 patients were equally allocated in the two groups and finally analyzed. A significant reduction in the DIAGNOdent Pen score was reported in the Trial group after 1 month of treatment, while in the Control group, no significant change was found. The Trial group also showed a significant reduction in plaque levels after 3 months of treatment, while in the Control group, it occurred after 1 month. However, the Bleeding Score and Schiff Air Index showed no significant differences between the groups, suggesting that additional measures may be required to address gingival inflammation and hypersensitivity. The ICDAS index also showed no statistically significant changes, due to the limited duration of this study. Overall, zinc-hydroxyapatite-based toothpaste was more effective than magnesium strontium carbonate hydroxyapatite toothpaste in enhancing enamel remineralisation in the short-term period. The assigned treatments did not result in significant improvements in the oral indexes assessed in this study. Full article

Background: Anti-cariogenic properties of silver nanoparticles and fluorides have been probed mainly in vitro and with the objetive to evaluate the remineralizing effects of an applied silver nanoparticle compound plus fluoride varnish, a randomized split-mouth clinical trial was conducted in children aged 6 to 7 years. Methods: The project was approved by the ethics committee of the faculty. Primary molars were randomly distributed into two groups, as follows: Group A was treated with a compound based on silver nanoparticles plus fluoride varnish (SNP-FV), and Group B was treated with a silver diamine fluoride compound (SDF-KI), which is the current standard treatment. Laser fluorescence with a DIAGNOdent pen was used for the evaluation, with follow-up examinations at 15 days, 6 months, and 12 months. ANOVA test was used to compare the groups. The results showed a decrease in demineralization was observed after treatment with SNP-FV; similar results were observed after treatment with SDF-KI. Within each group, there were favorable changes. In the SDF-KI group, the differences in demineralization were 25.63 at 15 days, 29.37 at 6 months, and 30.6 at one year (p < 0.05). Meanwhile, in the SNP-FV group, the decreases were 22.7 at 15 days, 28.78 at 6 months, and 31.11 at one year (p < 0.05). Conclusions: The SNP-FV combined treatment represents an alternative remineralizing treatment for the management of carious lesions in the dentin of primary molars. Full article

This study aims to compare the diagnostic reliability of ICDAS-II visual criteria, light-induced fluorescence (using the VistaCam iX, Dürr Dental, Bietigheim-Bissingen, Germany), and laser-induced fluorescence (using the DIAGNOdent Pen, KaVo, Biberach, Germany) on occlusal caries. Permanent and temporary molars were selected according to the inclusion criteria. Out of 160 teeth that met the inclusion criteria, 139 were chosen and examined by two previously trained and calibrated examiners. The kappa value was 0.95 for both VistaCam iX and DIAGNOdent Pen. Results from visual examination and the readings of the two fluorescence devices were computed, lesions being divided into non-cavitated, enamel lesions, and lesions extended to dentin. All statistical analyses were performed using R (version 4.2.2). Spearman’s rank correlation was computed to assess the relationship between the scores of diagnostics reliabilities of the three methods mentioned above. There was a positive, statistically significant Spearman’s rank correlation coefficient, ρ = 0.25, between VistaCam iX and ICDAS II, and a positive, not statistically significant Spearman’s rank correlation coefficient, ρ = 0.11, between DiagnoDent Pen and ICDAS II. Considering the temporary teeth, there was a positive, statistically significant Spearman’s rank correlation coefficient, ρ = 0.52, between VistaCam iX and DiagnoDent Pen; a positive, statistically significant Spearman’s rank correlation coefficient, ρ = 0.35, between VistaCam iX and ICDAS II; and the lowest, not statistically significant Spearman’s rank correlation coefficient, ρ = 0.16, between DiagnoDent Pen and ICDAS II. Conclusions: In conclusion, ICDAS II and light-induced fluorescence are better diagnostic methods than the laser-induced fluorescence devices for detecting occlusal caries. Clinical Significance: This study may support clinicians in selecting the most efficient tool for diagnosing carious lesion in the earliest stages possible. Furthermore, such technologies raise the availability for more preventive approaches, as opposed to invasive procedures. Full article

This in vitro study aimed to compare outcomes of dental caries detection using visual inspection classified according to the International Caries Detection and Assessment System (ICDAS) with objective assessments using a well-established laser fluorescence system (Diagnodent pen) and a novel diffuse reflectance spectroscopy (DRS) device. One hundred extracted permanent premolars and molars were utilized, including sound teeth, teeth with non-cavitated caries, or teeth with small cavitated lesions. A total of 300 regions of interest (ROIs) were assessed using each detection method. Visual inspection, being a subjective method, was performed by two independent examiners. The presence and extent of caries were histologically verified according to Downer’s criteria, serving as a reference for other detection methods. Histological results revealed 180 sound ROIs and 120 carious ROIs, categorized into three different extents of caries. Overall, there was no significant difference between the detection methods in sensitivity (0.90–0.93) and false negative rate (0.05–0.07). However, DRS exhibited superior performance in specificity (0.98), accuracy (0.95), and false positive rate (0.04) compared to other detection methods. Although the tested DRS prototype device exhibited limited penetration depth, it shows promise as a method, particularly for the detection of incipient caries. Full article

(1) Objective: The aim of this study was to compare the demineralization around brackets bonded with different types of adhesive agents in a cariogenic suspension environment. (2) Methods: In the study, 60 extracted upper first premolar teeth were divided into three groups with 20 teeth in each group. In Group 1, Transbond XT Primer + Transbond XT Light Cure Adhesive (3M Unitek, Monrovia, CA, USA), in Group 2, GC Ortho Connect Light Cure Adhesive (GC Crop, Tokyo, Japan) and in Group 3, Transbond™ Plus Self Etching Primer + Transbond XT Light Cure Adhesive (3M Unitek, Monrovia, CA, USA) adhesive agents were used. In Group 1 and 2, buccal enamel surfaces were etched for 30 s, washed for 15 s and dried for 15 s. All groups were bonded with Gemini metal (3M Unitek, Monrovia, CA, USA) brackets. Gingival, occlusal and proximal enamel surfaces of the brackets were measured with a DIAGNOdent pen (KaVo, Biberach, Germany), and demineralization values were recorded. Measurements were performed after bracketing (T0) and after 28 days in a cariogenic environment (T1), which was renewed every 48 h. The Kolmogorov–Smirnov test was used to determine whether or not the data were homogeneously distributed, the Wilcoxon test was used for comparisons within groups, and the Mann–Whitney U and Kruskal–Wallis tests were used for comparisons between groups. (3) Results: In all groups, demineralization values on all enamel surfaces of the brackets were found to be statistically significantly higher in the T1 period than in the T0 period (p < 0.05). In the T1 period, demineralization values of occlusal enamel surfaces in Groups 1 and 2 were found to be significantly higher than in Group 3 (p < 0.05). The amount of increase in occlusal enamel surface demineralization value between T0 and T1 periods in Groups 1 and 2 was significantly higher than in Group 3 (p < 0.05). There was no statistically significant difference in demineralization values of proximal and gingival enamel surfaces between the groups in the T1 period (p > 0.05). (4) Conclusion: Significantly less occlusal enamel surface demineralization was observed in teeth in which the Transbond™ Plus Self Etching Primer adhesive agent was not applied with acid etching. Full article

The aim of this study was to compare the demineralizations of the enamel surfaces around different types of orthodontic brackets in an artificial cariogenic environment. A total of 90 extracted human maxillary first premolar teeth were used in this in vitro study. The teeth were divided into 6 groups, 5 study and 1 control, each consisting of 15 samples. Victory metal, Gemini metal, Clarity self-ligating ceramic, APC Clarity Advanced ceramic and Clarity Advanced ceramic brackets (3M Unitek, Monrovia, Calif) used in the study groups were bonded to the teeth with the direct technique. The gingival, occlusal and proximal enamel surfaces adjacent to the brackets were measured with a DIAGNOdent pen (KaVo, Biberach, Germany) (T0). Then, the teeth were placed in a cariogenic suspension environment containing Streptococcus mutans, sucrose and artificial saliva. The teeth were removed from the cariogenic suspension at the end of 28 days. Enamel surfaces were remeasured with DIAGNOdent and the values were recorded (T1). Whether the obtained data were homogeneously distributed or not was determined by the Kolmogorov–Smirnov test, within-group comparisons were performed with the Wilcoxon test, and between-group comparisons were performed with Mann–Whitney U and Kruskal–Wallis tests. Significance level was accepted as p < 0.05. In all groups, the demineralization values of the enamel surfaces in the gingival, proximal and occlusal surfaces adjacent to the brackets were significantly higher in the T1 period than in the T0 period (p < 0.05). In the T1 period of Gemini metal, Clarity self-ligating ceramic and Clarity advanced ceramic bracket groups, the demineralization values of the proximal enamel surfaces were found to be significantly higher than the Victory metal and APC Clarity Advanced ceramic bracket groups (p < 0.05). In the T1 period, the demineralization values of the occlusal enamel surfaces of the Victory metal, APC Clarity Advanced ceramic bracket groups and control group were significantly lower than the Gemini metal, Clarity self-ligating ceramic and Clarity Advanced ceramic bracket groups (p < 0.05). Significant increases in enamel demineralization values were observed as a consequence of increased retention areas for microbial dental plaque on enamel surfaces adjacent to the bracket. Considering the importance of minimizing enamel demineralization in fixed orthodontic treatments, less enamel demineralization in Victory metal and APC Clarity Advanced ceramic bracket groups showed that these brackets can be preferred in patients with poor oral hygiene. Full article

In this study, we compare the efficacy and diagnostic concordance of the ICDAS, the radiographic criterion and the instrument known as the DIAGNOdent fluorescence laser pen on occlusal caries lesions using a histological section as the gold standard. Of 100 teeth that did not present cavitated occlusal lesions or occlusal fillings, 80 were chosen through a randomization program and examined by two previously trained and calibrated researchers. Subsequently, the teeth were sectioned with a diamond disk and observed under an optical microscope. The results were studied for caries with a limit established in enamel and caries with extension to dentin. The intra-examiner (0.821–0.933) and inter-examiner (0.817–0.924) reproducibility obtained for both ICDAS and DIAGNOdent for the diagnosis of borderline enamel caries was high. Similarly, intra-examiner (0.686–1.000) and inter-examiner (0.809–0.944) reproducibility for diagnosis of caries with dentin extension was also high for both methods. The sensitivity obtained was 0.76 (ICDAS), 0.87 (DIAGNOdent) and 0.58 (Rx), whereas the specificity obtained was 0.66 (ICDAS), 0.4 (DIAGNOdent) and 0.77 (Rx) for lesions limited to enamel. For lesions with extension to dentin, the sensitivity obtained was 0.73 (ICDAS), 0.82 (DIAGNOdent) and 0.09 (Rx), and the specificity obtained was 0.79 (ICDAS), 0.52 (DIAGNOdent) and 0.97 (Rx). Sensitivity increases in both cases by combining diagnostic methods. In conclusion, ICDAS and DIAGNOdent are better diagnostic methods than Rx for the detection of occlusal caries, and the combination of these methods helps to obtain a better diagnosis. Full article

Ozone is an allotropic form of oxygen, so in the medical field ozone therapy has special effects. Starting from the premise that bio-oxidative ozone therapy reduces the number of bacteria, in the present study two approaches were proposed: to evaluate the biological effects of ozone gas on the tooth enamel remineralization process and to demonstrate its impact on the morphology and confluence of human primary gingival cells, namely keratinocytes (PGK) and fibroblasts (HGF). The ozone produced by HealOzone was applied in vivo to 68 M1s (first permanent molars), both maxillary and mandibular, on the occlusal surfaces at pit and fissure. The molars included in the study recorded values between 13 and 24 according to the DIAGNOdent Pen 2190 scale, this being the main inclusion/exclusion criterion for the investigated molars. Because the gas can make contact with primary gingival cells during the ozonation process, both human gingival fibroblasts and keratinocytes were exposed to different doses of ozone (20 s, 40 s, 60 s), and its effects were observed with the Olympus IX73 inverted microscope. The contact of ozone with the human primary gingival cells demonstrates cell sensitivity to the action of ozone, this being higher in fibroblasts compared to keratinocytes, but it is not considered toxic because all the changes are reversible at 48 h after exposure. Full article

The purpose of this study was to evaluate which of the techniques and acids included in this in vitro research can induce artificial caries lesions in the most natural way. White spot lesions were created using six different demineralizing solutions in liquid form (lactic acid; orthophosphoric acid; formic acid; and an acid solution that contains calcium chloride, sodium phosphate and acetic acid) and gel form (hydrochloric acid and orthophosphoric acid). Radiographs, photographs and readings with a DIAGNODent™ pen, VITA Easyshade and a scanning electron microscope (SEM) were made in the initial situation, after 30 min, 1 h, 24 h and 96 h of demineralization. The total color change (ΔE) values in most cases presented statistically significant differences. SEM images showed different aspects of the enamel surface for each type of acid. Only in the case of exposed dentine did the DIAGNODent™ pen record significant differences. There was no noticeable radio-translucency of the teeth treated for a short period of time, but after 24 h, the absence of enamel and major demineralization of dentine were visible. Acids in the liquid state can penetrate and demineralize dental structures deeper than those that are more viscous. This study should be repeated with a protocol that includes remineralization. Using weaker acids would be another direction that could lead to more interesting findings. Full article