Search Results (91)

Chronic atrophic gastritis and intestinal metaplasia (IM) are gastric precancerous conditions (GPCs) associated with an increased risk of gastric cancer. Early detection and accurate characterization of GPC are therefore crucial for risk stratification and the implementation of preventive strategies. In the absence of clear mucosal changes observed through white-light imaging (WLI) or virtual chromoendoscopy, endocytoscopy can help unveil the presence of GPC by enabling in vivo assessment of nuclear and cellular structures at ultra-high magnification. Endocytoscopy is typically performed using WLI following dye-based staining of the mucosa. In this case, we demonstrate that combining endocytoscopy with the texture and color enhancement imaging (TXI) mode substantially improves the assessment of the gastric mucosa. In a 61-year-old man undergoing esophagogastroduodenoscopy, WLI showed multifocal erythema in the stomach, without clearly visible lesions on either WLI or narrow-band imaging. Conventional endocytoscopy revealed multiple small spots of IM with characteristic changes in glandular structures, which were even more evident when using the TXI mode. Histological analysis of targeted biopsies confirmed small foci of IM in both the antrum and corpus. The patient was enrolled in a surveillance program because of his clinical background. The combination of endocytoscopy with the TXI mode significantly enhances the delineation of mucosal and cellular architecture, supporting a more accurate optical diagnosis. Full article

Amorphous calcium phosphate (ACP) is a well-established bioceramic material known to promote the remineralization of dental hard tissues. White spot lesions (WSLs) represent the initial stage of enamel demineralization and are frequently observed in patients with fixed orthodontic appliances or inadequate oral hygiene. Although recommendations for remineralizing agents include both the prevention of lesion progression and the stimulation of tissue remineralization, the clinical efficacy of ACP-based materials remains under debate. This systematic review, registered in the PROSPERO database (CRD42024540595), aims to evaluate the clinical efficacy of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-based products in the remineralization of WSLs and to compare these outcomes with those achieved using non-bioceramic approaches. Inclusion criteria comprised randomized clinical trials, prospective cohort studies, and pilot studies conducted on human subjects with WSLs affecting permanent teeth. Studies involving artificial WSLs or non-cariogenic enamel lesions were excluded. The quality of the included studies was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Fourteen articles met the inclusion criteria and were analyzed. The main findings indicate that CPP-ACP is clinically effective in promoting the remineralization of WSLs, although the results were inconsistent across studies. Comparisons with placebo and resin infiltration treatments revealed greater efficacy for CPP-ACP. The combination of CPP-ACP with fluoride appeared to further enhance the remineralizing effect on WSLs. Additional standardized clinical studies with longer follow-up periods are warranted to confirm these outcomes. Full article

Background: Early caries management is essential to enable reversal of white spot lesions without the further need for operative interventions, especially in primary dentition. Silver-based compounds can be quite effective in arresting caries lesions; however, a major drawback is teeth staining. This study aimed to evaluate the remineralization potential and aesthetic effects of novel, green-synthesized nano-silver fluoride (NSF) on artificial white spot lesions in primary teeth in comparison to 38% silver diamine fluoride (SDF) and silver diamine fluoride/potassium iodide (SDF/KI). Materials and Methods: NSF was synthesized using green tea extract. Sixty primary teeth specimens with artificial enamel lesions were randomly divided into five groups depending on the applied material: 38% SDF, 38% SDF/KI, single and double application of NSF, and control group. Treatments were followed by pH cycling. Surface microhardness and photographic analysis were conducted to assess remineralization and staining. Statistical analysis was conducted using non-parametric tests including Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. Results: The greatest increase in microhardness was observed in the group receiving double NSF application. Its remineralizing potential was comparable to that of 38% SDF/KI, with no statistically significant difference (p = 1.000). Importantly, NSF-treated samples exhibited no teeth discoloration, unlike the black staining observed in SDF and SDF/KI groups. Conclusions: Green-synthesized NSF is a promising alternative to conventional SDF and SDF/KI, offering remineralization benefits without compromising aesthetics. The eco-friendly formulation and non-staining properties support its potential for clinical use in pediatric dentistry. Full article

Fixed orthodontic appliances, which are cemented to tooth surfaces, complicate the maintenance of oral hygiene and create a rough surface that is favorable for bacteria attachment. Additionally, the presence of orthodontic appliances may conceive a unique environment that interacts with cariogenic microorganisms, fostering a distinct microbial ecosystem compared to that of the patients without orthodontic appliances, thus increasing the vulnerability of tooth surfaces to demineralization and caries formation. Silver (Ag) has shown strong antimicrobial effects and has been extensively investigated in the medical field. Here, we aim to review the antibacterial properties and potential side effects of silver nanoparticles (AgNPs) when incorporated into orthodontic bonding reagents. This valuation could contribute to the development of novel bonding reagents designed to prevent the formation of white spot lesions and caries during orthodontic treatments. Full article

Background: Due to limitations of fluoride (F) treatment as a main caries preventive measure, it is important to consider the use of other dental caries preventive measures to reduce caries prevalence, especially in its early stages. Recently, new remineralizing agents appeared on the market, with their commercial availability in a variety of oral care products. Objectives: The purposes include providing a scoping review that represents caries remineralizing efficacies of only commercially available products and their existing adverse effects (if it is presented) and ensuring that only evidence-based approved products are included. Methods: The following databases were used in searching scientific literature on 28 October 2024: PubMed, PubMed Advanced Search, MeSH database, and PubMed Clinical Queries. The study selection criteria were as follows: for laboratory, in vitro, and/or in situ—remineralization of enamel-scanning electron microscopy, spectroscopy, microhardness test, light microscopy, profilometry, transverse microhardness microradiography, integrated mineral loss, light microscopy, photothermal radiometry; if it was a randomized controlled trial—CONSORT protocol, ICDAS system (to detect dental caries), diagnostic additional devices; antibacterial ability-colony forming units, DNA-based sequencing, scanning electron microscopy, crystal violet staining, and confocal laser scanning microscopy. Results: This review includes 98 papers: 14 of them describing the current status of caries patterns in the world, 60 studies (45 laboratory studies and 15 RCTs), and 24 systematic reviews were analyzed in order to detect whether new remineralizing agents can replace fluoride in further caries prevention. Conclusions: All reviewed new remineralization agents could be used without additives to treat early caries lesions, but the combination with F promotes better remineralization. Only HAP demonstrated its potential to serve as an alternative to fluoride in oral care products. However, further clinical studies are needed to prove its role in the remineralizing process of initial caries lesions. One also needs to ensure that both the clinical trials and in vitro lab studies use the best gold standards to validate any changes in the tooth structure, both remineralization and demineralization. Full article

White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety of therapeutic approaches are available; however, recent research indicates that combined treatment strategies may yield superior clinical outcomes compared to monotherapy. The aim of this study was to critically compare the efficacy of combining multiple treatment techniques for WSLs compared to using these techniques alone. A systematic search was conducted in PubMed, Scopus, and Cochrane databases according to PRISMA guidelines. The PICO strategy was used to formulate the research question: Which clinical approaches combined or isolated (C) influence the treatment and prevention effectiveness (O) of white spot lesions (I) in humans (P) in the last ten years (T)? Inclusion criteria focused on clinical studies from the last ten years evaluating the combined use of at least two treatment techniques for WSL, resulting in a total of 8 randomized controlled trials selected from an initial pool of 1185 articles. Our results suggest that combined treatment strategies, including resin infiltration with fluoride varnish and ozone therapy combined with fluoride application, demonstrated enhanced efficacy in lesion masking and remineralization compared to single-treatment approaches. CPP-ACP and hydroxyapatite-based creams improved aesthetics, particularly when used alongside fluoride varnish. Our study concluded that the combination of remineralization agents like fluoride gel, infiltrative resins, and antimicrobial treatments offers superior outcomes on white spot lesion treatment than using these techniques alone. However, long-term clinical studies are needed to standardize treatment protocols and confirm durability. Full article

(1) Background: White spot lesions (WSLs) on enamel result from demineralization and are an early sign of dental caries. Glass ionomer cement (GIC) has been widely used for its remineralization potential, and zinc-containing GIC (zGIC) has been introduced to enhance this effect. However, its efficacy compared to conventional GIC (cGIC) remains unclear. This study aimed to evaluate and compare the remineralization effects of cGIC and zGIC on WSLs. (2) Methods: Thirty-six bovine enamel specimens were prepared, demineralized for four days, and divided into three groups: control, cGIC, and zGIC. Half of each specimen’s treated window was covered with varnish, and a two-week pH cycling protocol was conducted. Mineral density (MD) changes were assessed using microcomputed tomography (Micro-CT) at five time points: pre-demineralization, after demineralization, immediately after treatment, and 1- and 2-weeks post-treatment. Scanning electron microscopy (SEM) was also performed. (3) Results: MD values in the zGIC and cGIC groups were significantly higher than in the control group throughout every post-treatment assessment (p < 0.05). zGIC demonstrated significantly higher MD than cGIC (p < 0.05), and SEM images revealed inferior mineral deposition. (4) Conclusions: These findings suggest that zGIC is more effective in remineralizing WSLs than cGIC over two weeks. Full article

Idiopathic nephrotic syndrome (NS) is associated with immune dysfunction and increased susceptibility to infections. Oral health may influence systemic inflammation and disease progression. This study aimed to evaluate the salivary levels of interleukin-6 (IL-6) and interleukin-18 (IL-18) in children with NS and their association with dental health, particularly caries prevalence and the consequences of untreated caries. A cross-sectional study was conducted on 86 children aged 5–17 years, including 40 NS patients and 46 healthy controls. Clinical dental examinations assessed caries prevalence using the dmft/DMFT index and the impact of untreated caries using the pufa/PUFA index. Unstimulated saliva samples were collected, and IL-6 and IL-18 concentrations were measured using enzyme-linked immunosorbent assay. NS patients exhibited a significantly lower prevalence of active carious lesions than controls (50% vs. 72%, p = 0.039). The DMFT index was lower in the NS group (p = 0.003). Salivary IL-6 levels were significantly reduced in NS patients compared to controls (p = 0.015), while IL-18 levels showed no significant difference. IL-6 positively correlated with decayed permanent teeth and pulp/periapical tissue diseases, whereas IL-18 correlated with white spot lesions and pulp infections. IL-6 and IL-18 could serve as potential non-invasive indicators of disease progression in NS patients. Full article

In 2022, an outbreak of fungal rot disease affected luffa crops in Shanghai and Zhejiang Province. Infected plants exhibited symptoms including yellowing, chlorosis, wilting, and water-soaked occurred on leaves and fruits. Dark brown, concave lesions developed, often accompanied by white or pale pink mold under moist conditions. Fourteen pathogen strains, morphologically resembling Fusarium species, were isolated. Molecular analysis confirmed Fusarium incarnatum as the causative agent. Pathogenicity tests on luffa plants fulfilled Koch’s postulates, with inoculated plants displaying the same symptoms. Re-isolation of the fungus from the inoculated plants confirmed its role in the disease. To our knowledge, this is the first report of F. incarnatum causing leaf spot and fruit rot on luffa in China. Moreover, the soil bacterial strain Bacillus velezensis BV171 displayed strong inhibition of F. incarnatum mycelia growth and promoted the growth of sponge gourd plants. These findings lay the foundation for the development of diagnostic tools, disease management strategies, and the breeding of resistant luffa varieties. Full article

Background: We compared the camouflage effect of three white spot lesion (WSL) treatments (infiltration, nano-hydroxyapatite (nHAP) remineralization, and microabrasion) and color stability of the treated surfaces. Methods: Fifty sound extracted teeth were used in the study. WSLs were created on 40 buccal dento-enamel specimens through the use of acidic methylcellulose gel. These specimens were randomly assigned to treatment groups (n = 10 per group): negative controls, nano-hydroxyapatite (nHAP), resin infiltration, and microabrasion. After the treatment, all 50 specimens were immersed in coffee for 7 days. Color measurements were performed four times: at baseline (T0), after the demineralization procedure (T1), after the treatments (T2), and after immersion in coffee (T3). Results: No restoration of the initial enamel color was observed in any of the groups. The ICON and MA groups exhibited the highest masking effect, with the mean ΔE_T0-T2 = 7.46, although the differences among the study groups were insignificant. All three treatments increased the resistance of WSLs to discoloration in coffee compared to the negative control group; however, infiltration (∆E_T2-T3 = 4.13) and microabrasion (∆E_T2-T3 = 3.49) showed a better color stability tendency than nHAP remineralization (∆E_T2-T3 = 7.26). Conclusions: Despite its well-known remineralizing and desensitizing effects, nHAP showed the least masking effect for WSLs and lower color stability compared to resin infiltration and microabrasion. However, none of the methods allowed for complete restoration of the original color. After the discoloration procedure, the color changes in the white spots treated with microabrasion and infiltration were comparable to those of the sound enamel. Full article

Objectives: This study aims to review the scientific literature on the prevention of white spot lesions (WSLs) associated with fixed orthodontic treatment. WSLs result from enamel demineralization and pose aesthetic and functional challenges. The study evaluates the effectiveness of various preventive interventions to reduce the risk of WSLs during orthodontic care. Methods: A comprehensive literature search was conducted using MeSH terms such as “white spot”, “fixed orthodontic treatment”, “CPP-ACP”, “topical fluoride”, and “demineralized lesion”, combined with the Boolean operator ‘AND’. Databases searched included PubMed, EMBASE, Scopus, and OpenGrey, focusing on studies published between January 2014 and September 2024. The inclusion criteria required studies to evaluate interventions aimed at reducing WSL risk in patients undergoing fixed orthodontic treatment. A total of 41 articles were screened, with 17 selected based on relevance and methodological rigor. Results: The review identified several effective strategies for preventing WSLs. Topical fluoride applications, particularly high-concentration varnishes, significantly reduced WSL prevalence, with some studies favoring fluoride varnish over other interventions. CPP-ACP and CPP-ACPF formulations demonstrated potential for remineralizing demineralized enamel, especially when combined with fluoride toothpaste. High-fluoride toothpaste and acidulated phosphate fluoride mouthwash were effective in reducing lesion incidence, emphasizing the importance of patient compliance in daily oral hygiene routines. Professional interventions, such as fluoride varnish applications, showed enhanced outcomes when re-applied periodically. Conclusions: Preventing WSLs during orthodontic treatment is crucial for ensuring the aesthetic and functional success of therapy. Strategies combining fluoride-based interventions with casein phosphopeptide formulations offer significant benefits. However, patient education and adherence to recommended oral hygiene practices remain critical. Further research is needed to compare the long-term effectiveness of these interventions and to explore new technologies for WSL prevention. Full article

Peptide-based biomimetic treatments have gained increased attention in the dental field due to their biocompatibility and minimally invasive qualities. These biomimetic approaches can replicate the native architecture of dental tissues, thus contributing to higher success rates and improved longevity of restorations. The aim of this study was first to examine the biocompatibility and stability of an amelogenin peptide-based chitosan hydrogel (P26-CS) against salivary enzymes. Second, we aimed to evaluate its efficacy in biomimetically repairing human dental lesions in situ. White spot lesions (WSLs) in enamel and non-carious cervical lesions (NCCLs) in dentin were artificially created. Chitosan (CS) improved peptide stability, while remineralization of enamel sections with P26-CS was not impeded by salivary enzymes. The peptide was not cytotoxic, irritating, or sensitizing. Fluorescently labeled P26-CS penetrated ~300 μm into the enamel of WSLs and ~100 μm into the dentin of NCCLs. After peptide treatment, quantitative light-induced fluorescence (QLF) and microcomputed tomography (μCT) indicated a gain in mineral density of WSLs. In NCCLs, scanning electron microscopy showed that the dentin was covered by a mineral layer of needle-shaped crystals. Our results show that the repair of artificial WSLs and NCCLs was achieved by P26 peptide-guided remineralization and demonstrate its potential to repair dental lesions. Full article

Plant microbiomes play a major role in plant health, growth, and development, enhancing resistance to pathogen invasion. However, despite the extensive research on the phyllosphere microbiome, it remains unclear how the microbiome of leaves in proximity to diseased leaves responds to pathogen invasion. We investigate the response of the maize phyllosphere microbiome to maize white spot by assessing the microbiome dynamics associated with the white spot portion and the area in proximity using 16S and ITS high-throughput sequencing analysis. Our results showed that the bacterial diversities were higher in the diseased portion and area in proximity to the spot than those in healthy plants. At the same time, lower fungal diversity was recorded in the diseased portion compared to portions in proximity to it and healthy leaves. The spot portion had a significant influence on the microbial composition. The diseased portion, the area in proximity to it, and the healthy leaves were dominated by the bacterial genera Sphingomonas, Delftia, Chryseobacterium, Stenotrophomonas, Methylobacterium-methylorubrum, and Bacteroides. Still, the abundance of Sphingomonas decreased in the healthy leaves with a corresponding increase in Stenotrophomonas. Conversely, the fungal genus Setophoma dominated the diseased portion, while the fungal pathogens Cladosporium, Alternaria, and Exserohilum were highly abundant in the samples from the area in proximity to it. In addition, a co-occurrence network analysis revealed a complex fungal network in healthy leaves and those in proximity to leaves infected with white spot compared to the diseased portion. This study suggests that the area in proximity to the maize leaf infected with white spot disease is colonized by more harmful plant pathogenic fungi for disease progression. Full article

Background/Objectives: To investigate the role of multimodal imaging, including ultra-widefield fundus autofluorescence (UWFAF), in diagnosing and monitoring syphilitic chorioretinitis, focusing on the detection of placoid appearance and white dots/spots. We aim to classify syphilitic chorioretinitis as a white dot syndrome, given evident features in the context of recent case reports and previously unavailable multimodal imaging. Methods: This single-institution study was conducted as a consecutive, observational case series. Five eyes from three patients were diagnosed with syphilitic chorioretinitis using multimodal imaging, including ultra-widefield pseudocolor fundus photography and intravenous fluorescein angiography, UWFAF, and swept-source optical coherence tomography, upon laboratory results. Results: In all five eyes with serologically confirmed syphilitic chorioretinitis, UWFAF revealed hyperautofluorescent white dots and spots scattered in the fundus, a finding minimally apparent with fluorescein angiography. Two eyes did not show evidence of classic placoid lesions. The hyperautofluorescence resolved after standard neurosyphilis treatment with intravenous course of penicillin. Conclusions: The presence of dots and spots identified through UWFAF may indicate syphilitic chorioretinitis and support its classification as a white dot syndrome. Based on the presence of hyperautofluorescent placoid lesions in some but not all cases with dots and spots, this study highlights the utility of multimodal imaging, including the more recent availability of UWFAF, in diagnosing syphilitic chorioretinitis. Future research is needed to determine whether the dots and spots in syphilitic chorioretinitis represent direct spirochete infiltration or a secondary inflammatory response. Full article

Dental caries is a widespread issue impacting global oral health. White spot lesions, the earliest stage of caries, compromise enamel’s esthetics and integrity. Remineralization therapies, both fluoride and non-fluoride based, aim to restore enamel, but limited comparative data exist on their effects on lesion depth and microhardness. Thus, the aim of this systematic review was to evaluate the efficacy of remineralizing agents on lesion depth and microhardness of human teeth. The literature search included the following five databases: PubMed, Web of Science, Scielo, SCOPUS, and EMBASE from the period 2012 to October 2022. Studies evaluating lesion depth and microhardness in human teeth after the application of a remineralizing agent were considered for review. The meta-analysis was performed using RevMan 5.4 (The Cochrane Collaboration, Copenhagen, Denmark). A random effect model was used to pool estimate of effect and its 95% confidence intervals (CIs) for surface microhardness and depth lesion. Subgroup analyses were performed considering the presence of fluoride or not in the remineralization agent. Thirty-three studies were included in the qualitative review. Of these, twenty-six studies were included in the meta-analysis. The main risks of bias associated with the studies included a lack of blinding of the test operator and failure to obtain sample size. To conclude, fluorinated agents are more effective in remineralizing artificially induced white spot lesion than non-fluoride remineralizing agents. Full article