RESUMEN
BACKGROUND: Silver diamine fluoride (SDF) is an antimicrobial agent and alternative treatment option that can be used to arrest dental decay. While there is optimism with SDF with regard to caries management, there is no true consensus on the number and frequency of applications for children. The purpose of this study was to examine the effectiveness of 38% SDF to arrest early childhood caries (ECC) at three different application regimen intervals. METHODS: Children with teeth that met International Caries Detection and Assessment System codes 5 or 6 criteria were recruited from community dental clinics into an open-label, parallel-group, randomized clinical trial from October 2019 to June 2021. Participants were randomized to one of three groups using sealed envelopes that were prepared with one of three regimens inside: visits one month, four months, or six months apart. Participants received applications of 38% SDF, along with 5% sodium fluoride varnish (NaFV), at the first two visits to treat cavitated carious lesions. Lesions were followed and arrest rates were calculated. Lesions were considered arrested if they were hard on probing and black in colour. Statistics included descriptive and bivariate analyses (Kruskal one-way analysis of variance and Pearson's Chi-squared test). A p-value of ≤ 0.05 was considered significant. RESULTS: Eighty-four children participated in the study (49 males and 35 females, mean age: 44.4 ± 14.2 months). Treatment groups were well matched with 28 participants per group. A total of 374 teeth and 505 lesions were followed. Posterior lesions represented only 40.6% of affected surfaces. Almost all SDF treated lesions were arrested for the one-month (192/196, 98%) and four-month (159/166, 95.8%) interval groups at the final visit. The six-month group experienced the lowest arrest rates; only 72% (103/143) of lesions were arrested (p < 0.001). The duration of application intervals was inversely associated with improvements in arrest rates for all lesions. CONCLUSIONS: Two applications of 38% SDF and 5% NaFV in one-month and four-month intervals were comparable and very effective in arresting ECC. Applications six months apart were less effective and could be considered inferior treatment. TRIAL REGISTRATION: ClinicalTrials.gov NCT04054635 (first registered 13/08/2019).
Asunto(s)
Cariostáticos , Caries Dental , Fluoruros Tópicos , Compuestos de Amonio Cuaternario , Compuestos de Plata , Humanos , Compuestos de Plata/uso terapéutico , Caries Dental/prevención & control , Fluoruros Tópicos/uso terapéutico , Compuestos de Amonio Cuaternario/uso terapéutico , Compuestos de Amonio Cuaternario/administración & dosificación , Femenino , Masculino , Cariostáticos/uso terapéutico , Preescolar , Niño , Fluoruro de Sodio/uso terapéuticoRESUMEN
Dental caries remains a significant public health issue for children globally, leading to adverse effects on health and development. Silver diamine fluoride (SDF) is a potential preventive agent that can prevent caries progression in children. This systematic review examined the effectiveness of silver diamine fluoride in arresting caries compared to other fluorides. An electronic search of MEDLINE, PubMed, EMBASE, Cochrane, Web of Science, Scopus databases was carried out examining articles in English from 2001 to 2023. Studies included in the analysis examined the application of SDF in children and adolescents with coronal caries lesions on primary teeth or permanent first molars. Fifteen studies, involving a total of 7895 children, were incorporated. The application regimen varied across studies. Most studies in this review consistently suggested that SDF is effective in arresting caries. An annual application of SDF effectively reduced Streptococcus mutans count. Adverse effects were primarily tooth staining and less commonly, oral mucosal irritation. A majority of studies showed a high risk of bias due to methodological insufficiencies. Overall, the evidence suggests that SDF is effective in arresting dental caries in children. It offers a viable, cost-effective, and minimally invasive treatment option, particularly suitable for use in low-resource settings. However, the aesthetic concern of tooth staining with SDF use remains a challenge. Further well-designed clinical trials may provide a fuller picture of SDF which can shape public health policy and shift towards a minimally invasive treatment approach.
Asunto(s)
Cariostáticos , Caries Dental , Fluoruros Tópicos , Compuestos de Amonio Cuaternario , Compuestos de Plata , Humanos , Compuestos de Plata/uso terapéutico , Caries Dental/prevención & control , Compuestos de Amonio Cuaternario/uso terapéutico , Fluoruros Tópicos/uso terapéutico , Niño , Adolescente , Cariostáticos/uso terapéuticoRESUMEN
Evaluation of micro tensile bond strength (µTBS) and marginal leakage of sodium fluoride (NaF) and nano-hydroxyapatite (n-HA) modified universal adhesives (UAs) bonded using etch-and-rinse (ER) and self-etch (SE) bonding technique to the carious affected dentin (CAD). One hundred and twenty primary molars were prepared for CAD on the occlusal surface. The occlusal CAD surface was flattened and underwent a polishing procedure. The specimens were divided into six groups using a random allocation method based on the UAs applied and the mode of etching used (n = 20) Group A1: UAs (ER), Group B1: UAs (SE), Group A2: UAs (NaF) + ER, Group B2: UAs (NaF) + SE, Group A3: UA (n-HA) + ER and Group B3: UAs (n-HA) + SE. Composite restoration was placed and samples were thermocycled. Microleakage, µTBS, and failure mode assessment were performed using a dye penetration test, universal testing equipment, and stereomicroscope respectively. The µTBS and microleakage results (mean ± SD) were examined using analysis of the variance (ANOVA) and Tukey post hoc tests. Group B1 (UAs + SE) demonstrated the maximum scores of microleakage (25.14 ± 9.12 nm) and minimum recorded value of µTBS (14.16 ± 0.55 MPa). In contrast, Group A3 (UAs (n-HA) + ER) displayed a minimum value of marginal leakage (12.32 ± 6.33 nm) and maximum µTBS scores (19.22 ± 0.92 MPa). The outcomes of the intergroup comparison analysis showed that Group A2 (UAs (NaF) + ER), Group B2 (UAs (NaF) + SE), Group A3 (UA (n-HA) + ER) and Group B3 (UAs (n-HA) + SE) presented comparable outcomes of marginal seal outcomes and µTBS scores (p > 0.05). NaF and n-HA-modified UAs displayed favorable bond strength and minimum marginal leakage to the deciduous affected dentin surface.
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Recubrimiento Dental Adhesivo , Caries Dental , Filtración Dental , Durapatita , Diente Molar , Nanopartículas , Fluoruro de Sodio , Resistencia a la Tracción , Diente Primario , Humanos , Caries Dental/terapia , Durapatita/química , Recubrimiento Dental Adhesivo/métodos , Recubrimientos Dentinarios/química , Ensayo de Materiales , Resinas Compuestas/química , Cariostáticos , Cementos DentalesRESUMEN
Recently, interest in tooth-colored fluoride-releasing dental materials has increased. Although physical and mechanical properties such as surface hardness, elastic modulus and surface roughness of the restorative materials have been investigated, the effect of different immersion media on these properties is still controversial. The aim of this study was to evaluate the nanohardness, elastic modulus and surface roughness of the fluoride release of tooth-colored restorative materials after immersion in acidic beverages. Prepared samples of three restorative materials (a highly viscous glass ionomer (EQUIA Forte; GC, Tokyo, Japan), a compomer (Dyract XP; Dentsply, Weybridge, UK), and a bioactive restorative material (Activa BioACTIVE; Pulpdent, MA, USA)) were randomly divided and immersed in distilled water, a cola and an orange juice for one week. The HYSITRON T1 950 TriboIndenter device (Hysitron, USA) with the Berkovich diamond indenter tip was used for all measurements. The nanohardness and elastic modulus of the samples were measured by applying a force of 6000 µN to five different points on the sample surface. Surface roughness measurements were evaluated on random samples by scanning five random 40 × 40 µm areas. The properties were measured at the initial and one week after immersion. The values of nanohardness, elastic modulus and surface roughness were tested for significant differences using a two-way analysis of variance (ANOVA) with repeated measures (p < 0.05). Tukey's honest significant difference (HSD) test was used for multiple comparisons. AB (Activa BioACTIVE) had the highest initial mean values for nanohardness. After post-immersion, the highest mean value for elastic modulus was the initial AB value. The lowest mean value for roughness of 100.36 nm was obtained for the initial DX (Dyract XP) measurement. Acidic beverages had a negative effect on the nanohardness, elastic modulus and surface roughness of the restorative materials.
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Bebidas Gaseosas , Módulo de Elasticidad , Fluoruros , Dureza , Ensayo de Materiales , Propiedades de Superficie , Fluoruros/química , Compómeros/química , Humanos , Materiales Dentales/química , Jugos de Frutas y Vegetales , Resinas Acrílicas/química , Restauración Dental Permanente/métodos , Agua/química , Cariostáticos/química , Cementos de Ionómero Vítreo/química , Citrus sinensis/química , Inmersión , Resinas Compuestas/química , Dióxido de SilicioRESUMEN
This study aims to retrospectively evaluate the differences in dental treatments rendered in general anesthesia (GA) for patients who did or did not receive application of silver diamine fluoride (SDF) prior to GA. 1559 patients (≤6 years) who completed treatment with GA for caries at University of California San Francisco (UCSF) between 2015 and 2019 were included in the study. At baseline patients' electronic health record was reviewed to collect planned treatment, complete dental treatment and demographics. Patients were identified as SDF group (N = 335, 21.49%) or comparison (N = 1224, 78.51%). Dental treatments rendered were compared between the SDF and comparison group with multi-variable regression, including variables for demographics and clinical findings at baseline. The initial analysis identified variations in gender, age, dental pain, pulp involvement, and initial treatment plans between the SDF and comparison groups at baseline. In an unadjusted analysis, the SDF group displayed a statistically significant increase in the number of crown procedures but a notable decrease in the number of pulp therapy and extraction treatments completed (p < 0.05). An adjusted multivariable model affirmed the inverse relationship between SDF application and completion of pulp therapy and extractions at the time of GA (p < 0.05). No significant association was identified with the total number of crowns needed and SDF. The model further indicated a positive correlation between the total count of pulp therapy and extractions completed with patient age and the wait-time for GA. In conclusion, pre-GA application of SDF to carious primary teeth is negatively correlated with completed pulp therapy and extraction. SDF application prior to dental treatment with GA may be a valuable tool to reduce invasive dental procedures in GA.
Asunto(s)
Anestesia General , Caries Dental , Fluoruros Tópicos , Compuestos de Amonio Cuaternario , Compuestos de Plata , Humanos , Fluoruros Tópicos/uso terapéutico , Compuestos de Plata/uso terapéutico , Femenino , Masculino , Estudios Retrospectivos , Caries Dental/prevención & control , Compuestos de Amonio Cuaternario/uso terapéutico , Preescolar , Niño , Cariostáticos/uso terapéutico , Anestesia Dental/métodos , Extracción Dental , CoronasRESUMEN
BACKGROUND: White spot lesions (WSL) are common side effects of orthodontic treatment with fixed appliances, in which the surface layer of enamel is demineralised. Thus, remineralisation, that is a partial or complete reversal, of these lesions can occur as they affect the surface enamel. Remineralisation with low-dose fluoride, in addition to optimal oral hygiene and diet, has been recommended to manage WSL. The aim of the planned trial is to assess the effectiveness of a fluoride-containing bioactive glass toothpaste (BioMin™) in its ability to remineralise post-orthodontic demineralised WSL. METHODS: A single-centre, double-blind randomised clinical trial to assess intervention with Bio-Min toothpaste on WSL forming on the teeth of young people completing orthodontic treatment. DISCUSSION: Remineralisation of WSL can vary depending on the individual and the site of the lesion. There is a range of oral fluoride delivery methods which include toothpastes, oral rinses, and gel preparations, which can aid remineralisation of these lesions. Identifying effective methods of remineralisation to manage this common and unsightly complication of fixed appliance therapy can improve the health and aesthetics of dentition. TRIAL REGISTRATION: ISRCTN.com International Standard Randomised Controlled Trials Number (ISRCTN) 14479893 . Registered on 14 May 2020.
Asunto(s)
Fluoruros , Remineralización Dental , Pastas de Dientes , Humanos , Método Doble Ciego , Remineralización Dental/métodos , Adolescente , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Femenino , Cariostáticos/uso terapéutico , Caries Dental/terapia , Caries Dental/prevención & control , Masculino , Esmalte Dental/efectos de los fármacos , Aparatos Ortodóncicos Fijos , NiñoRESUMEN
BACKGROUND: Fluoride plays a vital role in preventing dental caries, with its addition to oral care products significantly promoting oral hygiene. A no-rinse brushing method aims to increase fluoride retention in the oral cavity, as rinsing with water decreases fluoride levels in saliva, which could affect remineralization. While the no-rinse brushing method holds promise for improving fluoride retention in the oral cavity, critical inquiries persist regarding its safety. This study investigated the kinetics of oral fluoride and potential risks to fully assess its effectiveness and implications for oral health. METHODS: Ten healthy adults participated in a crossover study comparing the no-rinse with the rinse method. All subjects followed American Dental Association (ADA) brushing guidelines. Levels of fluoride in saliva (supernatant and sediment) and urine were measured over time, and plasma fluoride was measured one hour after brushing. Pharmacokinetic parameters were also calculated from the data. RESULTS: Participants using the no-rinse method had higher fluoride levels in supernatant immediately and up to 30 min post-brushing compared to the rinse method. Fluoride levels in sediment were higher only immediately after brushing. The total fluoride concentration in saliva remained elevated for up to 5 min with the no-rinse method. Systemic fluoride absorption showed no significant difference between the two methods based on blood and urine analysis. CONCLUSION: This research indicates that the no-rinse method can enhance fluoride retention in the oral cavity for up to 30 min after a single brushing. In addition, our findings suggest that this method does not significantly influence systemic fluoride levels or toxicity. REGISTRY: Thai Clinical Trials Registry, TCTR ( http://thaiclinicaltrials.org ). CLINICAL TRIAL REGISTRATION NUMBER: TCTR20231104001 (4/11/2023).
Asunto(s)
Estudios Cruzados , Fluoruros , Saliva , Cepillado Dental , Humanos , Fluoruros/farmacocinética , Fluoruros/orina , Fluoruros/análisis , Saliva/química , Adulto , Masculino , Femenino , Adulto Joven , Cariostáticos/farmacocinéticaRESUMEN
OBJECTIVE: The objective of this study is to investigate the beneficial effect of not rinsing for 30 min in arresting early childhood caries after SDF therapy. METHODS: This randomised clinical trial recruited 3- to 4-year-old kindergarten children with active (soft) dentine caries. A questionnaire was sent to the parents to collect children's demographic data and oral health-related behaviours. A dentist conducted an oral examination and measured the caries experience using dmft index and oral hygiene using visible plaque index. After 38 % SDF therapy, the children were randomly allocated into two groups. Children in group A were instructed to rinse with water immediately, whereas children in group B were asked to refrain from rinsing, drinking, or eating for 30 min. After six months, the same examiner determined the lesion activity (active/arrest) of the SDF-treated carious tooth surface. Generalized Estimating Equations was used to compare the proportion of caries arrest (caries-arrest rate) between the two groups. RESULTS: This study recruited 298 children with 1,158 decayed tooth surfaces receiving SDF therapy at baseline and evaluated 275 (92 %) children with 1,069 (92 %) SDF-treated tooth-surface at the six-month examination. The demographic background, oral hygiene and caries status of two groups were comparable at baseline (p > 0.05). The caries-arrest rate for group A and group B were 65 % (337/519) and 61 % (338/550), respectively (p = 0.28). CONCLUSION: This randomised clinical trial found not rinsing for 30 min after SDF therapy is not better than immediate rinsing in arresting early childhood caries. CLINICAL SIGNIFICANCE: Topical SDF application leaves an unpleasant taste in the mouth, which may affect the acceptance or even rejection of SDF therapy among young children. This study provides clinicians with information to make their decision on postoperative instruction after SDF therapy.
Asunto(s)
Cariostáticos , Índice CPO , Caries Dental , Fluoruros Tópicos , Compuestos de Amonio Cuaternario , Compuestos de Plata , Humanos , Caries Dental/prevención & control , Compuestos de Plata/uso terapéutico , Fluoruros Tópicos/uso terapéutico , Preescolar , Cariostáticos/uso terapéutico , Femenino , Masculino , Compuestos de Amonio Cuaternario/uso terapéutico , Higiene Bucal , Índice de Placa Dental , Resultado del Tratamiento , Antisépticos Bucales/uso terapéutico , Dentina/efectos de los fármacos , Dentina/patologíaRESUMEN
OBJECTIVE: To investigate caries preventive effects of 38 % silver diamine fluoride (SDF) pretreatment on neighboring tooth proximal to glass ionomer cement (GIC), including conventional GIC (CGIC) and resin-modified GIC (RMGIC) restorations in an in vitro model. METHODS: HUMAN TOOTH BLOCKS WERE RESTORED WITH: SDF+CGIC (Group 1), CGIC (Group 2), SDF+RMGIC (Group 3) or RMGIC (Group 4). Enamel specimen simulating proximal surface of neighboring tooth was placed in proximity to the restorations. The specimen underwent cariogenic challenge with cross-kingdom biofilm of Streptococcus mutans, Lacticaseibacillus casei and Candida albicans. After cariogenic challenge, the biofilm's growth kinetics, viability, and morphology were evaluated by propidium monoazide-quantitative polymerase chain reaction (PMA-qPCR), confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM), respectively. The enamel lesion depth, surface morphology and crystal characteristics were determined by micro-computed tomography (micro-CT), SEM and X-ray diffraction (XRD), respectively. RESULTS: PMA-qPCR demonstrated lower microbial growth in Group 1 and 3 compared with Group 2 and 4 (p < 0.05). CLSM showed the dead-to-live ratio in Groups 1-4 were 1.15±0.12, 0.53±0.13, 1.10±0.24 and 0.63±0.10, respectively (Group 1,3 > 2,4, p < 0.05). SEM revealed Groups 1 and 3 had scattered biofilm whereas Group 2 and 4 had confluent biofilm. Micro-CT showed the enamel lesion depths (µm) were 98±9, 126±7, 103±6 and 128±7 for Group 1 to 4, respectively (Group 1,3 < 2,4, p < 0.05). SEM revealed oriented and ordered enamel prismatic patterns in Group 1 and 3, not in Group 2 and 4. XRD showed the reflections of hydroxyapatite in Groups 1 and 3 were sharper than Groups 2 and 4. CONCLUSION: SDF pretreatment enhances the preventive effect of GIC on proximal enamel surface on neighboring tooth through inhibiting cariogenic biofilm, reducing enamel demineralization and promoting enamel remineralization. CLINICAL SIGNIFICANCE: SDF pretreatment of GIC restorations can help prevent caries on neighboring teeth, particular for patients with high caries risk.
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Biopelículas , Cariostáticos , Caries Dental , Esmalte Dental , Fluoruros Tópicos , Cementos de Ionómero Vítreo , Microscopía Electrónica de Rastreo , Compuestos de Amonio Cuaternario , Compuestos de Plata , Streptococcus mutans , Compuestos de Plata/uso terapéutico , Compuestos de Plata/farmacología , Humanos , Cementos de Ionómero Vítreo/uso terapéutico , Cementos de Ionómero Vítreo/farmacología , Caries Dental/prevención & control , Caries Dental/microbiología , Compuestos de Amonio Cuaternario/farmacología , Compuestos de Amonio Cuaternario/uso terapéutico , Biopelículas/efectos de los fármacos , Fluoruros Tópicos/uso terapéutico , Fluoruros Tópicos/farmacología , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Esmalte Dental/efectos de los fármacos , Streptococcus mutans/efectos de los fármacos , Restauración Dental Permanente/métodos , Microtomografía por Rayos X , Candida albicans/efectos de los fármacos , Difracción de Rayos X , Microscopía ConfocalRESUMEN
OBJECTIVES: This study assessed the effect of NaF/Chit suspensions on enamel and on S. mutans biofilm, simulating application of a mouthrinse. METHODS: The NaF/Chit particle suspensions were prepared at molar ratio [NaF]/Chitmon]≈0.68 at nominal concentrations of 0.2 % and 0.05 % NaF and characterized by Fourier transform infrared spectroscopy (FTIR), dynamic light scattering and zeta potential. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were measured. The S. mutans biofilm was formed for 7 days on eighty human enamel blocks that were divided into eight groups (n = 10/group): i) 0.05 % NaF solution; ii) 0.31 % Chit solution; iii) NaF/Chit(R=0.68) suspension at 0.05 % NaF; iv) 1.0 % HAc solution (Control); v) 0.2 % NaF solution; vi) 1.25 % Chit solution; vii) NaF/Chit(R=0.68) suspension at 0.2 % NaF; viii) 0.12 % chlorhexidine digluconate. The substances were applied daily for 90 s. S. mutans cell counts (CFU/mL) were performed, and the Knoop microhardness (KHN) of enamel samples were measured before and after biofilm formation. The KHN and CFU/mL data were analyzed by repeated measure ANOVA and Tukey's test (α = 0.05). RESULTS: Interactions between NaF and Chit were evidenced in solid state by FTIR spectra. The NaF/Chit complexes showed spontaneous microparticle formation and colloidal stability. The MIC and MBC ranged from 0.65 to 1.31 mg/mL. The NaF/Chit(R=0.68) suspension at 0.2 %NaF Group showed lower CFU/mL values than other groups. The NaF/Chit(R=0.68) suspensions Groups had the highest KHN values after biofilm formation. CONCLUSIONS: The NaF/Chit(R=0.68) complexes exhibited an antibacterial effect against S. mutans biofilm and reduced the enamel hardness loss. CLINICAL SIGNIFICANCE: The NaF/Chit(R=0.68) suspensions showed potential to be used as a mouthrinse for caries prevention.
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Antibacterianos , Biopelículas , Quitosano , Esmalte Dental , Pruebas de Sensibilidad Microbiana , Fluoruro de Sodio , Streptococcus mutans , Biopelículas/efectos de los fármacos , Streptococcus mutans/efectos de los fármacos , Esmalte Dental/efectos de los fármacos , Esmalte Dental/microbiología , Humanos , Antibacterianos/farmacología , Fluoruro de Sodio/farmacología , Quitosano/farmacología , Quitosano/química , Espectroscopía Infrarroja por Transformada de Fourier , Antisépticos Bucales/farmacología , Antisépticos Bucales/química , Coloides , Cariostáticos/farmacología , Cariostáticos/químicaRESUMEN
OBJECTIVE: To investigate the anticaries effects of graphene oxide (GO) and graphene quantum dots (GQDs) combined with casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on enamel in a biofilm-challenged environment. MATERIAL AND METHODS: GO and GQDs were synthesised using citric acid. The antibiofilm and biofilm inhibition effects for Streptococcus mutans were evaluated by scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), and colony-forming units (CFU). Remineralisation ability was determined by assessing mineral loss, calcium-to-phosphorus ratio, and surface morphology. To create a biofilm-challenged environment, enamel blocks were immersed in S. mutans to create the lesion and then subjected to artificial saliva/biofilm cycling for 7 days. Anticaries effects of GO, GQDs, GQDs@CPP-ACP, GO@CPP-ACP, and CPP-ACP were determined by broth pH and mineral changes after 7-day pH cycling. Biocompatibility was tested using a Cell Counting Kit-8 (CCK8) assay for human gingival fibroblasts (HGF-1). RESULTS: GQDs and GO presented significant antibiofilm and biofilm inhibition effects compared to the CPP-ACP and control groups (P < 0.05). The enamel covered by GQDs and GO showed better crystal structure formation and less mineral loss (P < 0.05) than that covered by CPP-ACP alone. After 7 days in the biofilm-challenged environment, the GO@CPP-ACP group showed less lesion depth than the CPP-ACP and control groups (P < 0.05). GO and GQDs showed good biocompatibility compared to the control group by CCK8 (P > 0.05) within 3 days. CONCLUSION: GO and GQDs could improve the anti-caries effects of CPP-ACP, and CPP-ACP agents with GO or GQDs could be a potential option for enamel lesion management. CLINICAL SIGNIFICANCE: GO and GQDs have demonstrated the potential to significantly enhance the anticaries effects of CPP-ACP. Incorporating these nanomaterials into CPP-ACP formulations could provide innovative and effective options for the management of enamel lesions, offering improved preventive and therapeutic strategies in dental care.
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Biopelículas , Caseínas , Caries Dental , Esmalte Dental , Grafito , Puntos Cuánticos , Streptococcus mutans , Grafito/química , Grafito/farmacología , Biopelículas/efectos de los fármacos , Caseínas/farmacología , Esmalte Dental/efectos de los fármacos , Streptococcus mutans/efectos de los fármacos , Humanos , Caries Dental/microbiología , Caries Dental/prevención & control , Microscopía Electrónica de Rastreo , Remineralización Dental/métodos , Cariostáticos/farmacología , Cariostáticos/química , Microscopía Confocal , Concentración de Iones de Hidrógeno , Ácido Cítrico/farmacología , Fibroblastos/efectos de los fármacos , Saliva Artificial/químicaRESUMEN
This comprehensive literature review examines the use of silver diamine fluoride (SDF) for the prevention and treatment of enamel carious lesions. SDF has been approved by different international drug associations as a caries-preventing agent to be used on deep carious lesions (dentin). However, SDF can cause staining of exposed tooth structures. Furthermore, the effect of SDF on the bond of adhesives to the tooth structure is still being determined. This review explores various studies on the use of SDF to treat enamel carious lesions, highlighting its effectiveness and preventive action. The literature suggests that SDF inhibits bacterial growth, promotes remineralization, and does not negatively affect adhesive retentions. Potassium iodide (KI) or glutathione (GSH) can reduce staining and discoloration. However, the reviewed studies have limitations. Further research, including well-designed clinical trials, is necessary to validate the findings and evaluate the long-term implications of SDF treatment. Conclusion: Despite the above-mentioned limitations, SDF shows potential as a therapy for enamel caries prevention, remineralization, and use as an adjuvant to other dental treatments, warranting further investigation and the refinement of application methods.
Asunto(s)
Cariostáticos , Caries Dental , Fluoruros Tópicos , Compuestos de Amonio Cuaternario , Compuestos de Plata , Compuestos de Plata/uso terapéutico , Humanos , Compuestos de Amonio Cuaternario/uso terapéutico , Compuestos de Amonio Cuaternario/farmacología , Caries Dental/prevención & control , Fluoruros Tópicos/uso terapéutico , Fluoruros Tópicos/administración & dosificación , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Remineralización Dental/métodos , Esmalte Dental/efectos de los fármacos , Esmalte Dental/patologíaRESUMEN
OBJECTIVES: Radiotherapy to the head and neck region (HN) bears the risk of a rampant development of caries, making intensified prevention necessary. Aim of this systematic review was to summarize the evidence on the efficacy of caries preventive measures in these patients. METHODS: Clinical studies investigating caries in patients with radiotherapy in the HN with at least 1 caries preventive intervention compared to any control were included. Reports in languages other than English or German were excluded. Records were identified on PubMed, Web of Science, Google Scholar, and Cochrane Library mid-January 2024. Risk of bias was assessed with RoB2. Results were summarized. Planned meta-analyses could not be performed, because of heterogenous data. RESULTS: Five studies were included, with a total of 355 participants. They were irradiated with up to 70 Gy and received different caries preventive interventions, including sodium fluoride or stannous fluoride gels, remineralizing solutions, an "Intraoral Fluoride Release System" and sucrose restricted diet. Caries score increased between 0.48 DMF-S and 9.2 DF-S per year. Largest differences in caries increments were measured between groups with insufficient and with rigorous fluoride application. CONCLUSIONS: The main limitations were compromised randomization, heterogeneity of patients and small sample sizes. Clinical studies on caries prevention after radiotherapy to the HN are lacking and the existing ones bear extensive limitations. However, the large effect size and broad consensus suggest the use of fluoride to be indispensable in preventing caries in these patients. The study was funded by the Medical Center - University of Freiburg and was not registered.
Asunto(s)
Caries Dental , Neoplasias de Cabeza y Cuello , Humanos , Caries Dental/prevención & control , Neoplasias de Cabeza y Cuello/radioterapia , Neoplasias de Cabeza y Cuello/prevención & control , Cariostáticos/uso terapéuticoRESUMEN
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Effectiveness of Calcium Phosphate derivative agents on the prevention and remineralization of caries among children- A systematic review & meta-analysis of randomized controlled trials. Singal K, Sharda S, Gupta A, Malik VS, Singh M, Chauhan A, Agarwal A, Pradhan P, Singh M. J Evid Based Dent Pract. 2022; 22(3):101746. SOURCE OF FUNDING: Indian Council of Medical Research. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.
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Fosfatos de Calcio , Caries Dental , Fluoruros , Remineralización Dental , Niño , Humanos , Fosfatos de Calcio/uso terapéutico , Cariostáticos/uso terapéutico , Cariostáticos/farmacología , Cariostáticos/administración & dosificación , Caries Dental/prevención & control , Fluoruros/administración & dosificación , Fluoruros/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Metaanálisis como Asunto , Revisiones Sistemáticas como AsuntoRESUMEN
OBJECTIVE: The objective was to evaluate the remineralization effects of fluoride varnish (Clinpro White varnish), self-assembling peptide (Curodont™ Repair) and their combined use on WSL after orthodontic treatment. MATERIALS AND METHODS: Thirty-two subjects, aged of 10-18 (mean age 13.91 ± 2.92) with 107 post-orthodontic WSL were included in the study. Subjects were divided into four groups as control, tricalcium phosphate (TCP) containing fluoride varnish (Clinpro White varnish) group, self-assembling P11-4 peptides (Curodont™ Repair) group and combined application of the two products. At the beginning, each subjects' caries risk profile was assessed by evaluating diet cariogenicity, plaque index, gingival bleeding index and stimulated salivary flow rate. Before the application of the remineralization agents, WSL baseline demineralization values were determined with QLF Inspektor™ Pro, laser fluorescence using DIAGNOdent and color values were measured by Vita EasyShade. Remineralization data were obtained by measuring ΔF, ΔQ, and lesion area with QLF. The aesthetic improvement after the remineralization process was evaluated with a spectrophotometer at six weeks, three and six months. RESULTS: No statistically significant differences were found between the groups in terms of criteria determining patients' caries risk profiles, DIAGNOdent data, and plaque index scores (p > 0.05). Intra-group evaluation following remineralization revealed statistically significant increases in ΔF and ΔQ with a decrease in lesion area for the fluoride varnish group at six months, for the peptide group at three months, and for the combined application group at three and six months (p < 0.05). In inter-group comparisons, ΔF and ΔQ values were found to be statistically significant only in the fluoride group at six months compared to the other groups (p < 0.05). While the L* value decreased significantly in all groups at six months, a statistically significant difference in ΔE* values was observed only in the control group between three and six months. CONCLUSION: Fluoride varnish with TCP showed highest remineralization at 6 months, and the remineralization was positively affected in the short term (three months) after the use of self-assembling P11-4 peptides and their combined application. CLINICAL RELEVANCE: Remineralization obtained after single application of agents tested in six months in-vivo showed parallel results. In an attempt to trigger subsurface remineralization, the combined use of fluoride with self-assembling peptides as biomimetic remineralization agent needs further evaluation.
Asunto(s)
Fluoruros Tópicos , Remineralización Dental , Humanos , Remineralización Dental/métodos , Adolescente , Estudios Prospectivos , Femenino , Niño , Masculino , Caries Dental/terapia , Cariostáticos/uso terapéutico , Péptidos/uso terapéutico , OligopéptidosRESUMEN
OBJECTIVE: The aim of this study was to investigate the effect of remineralization agents such as fluoride varnish and P11-4, alone and in combination with Er: YAG laser, on in-vitro hard tissue repair in artificial enamel lesions. MATERIALS AND METHODS: A total of sixty enamel surfaces of 4 × 5 mm in size were created on both the buccal and lingual sides of thirty extracted wisdom teeth. Remineralization agents were applied to the specimens that were grouped as follows: Group 1, control; Group 2, fluoride varnish (FV); Group 3, P11-4; Group 4, laser; Group 5, laser + FV; and Group 6, laser + P11-4. The fluorescence level was determined with DiagnoDent. The enamel mineral density, area and volume, and caries lesion area and volume were determined with micro-computed tomography (µCT), surface features were evaluated using scanning electron microscopy (SEM), and elemental analysis was performed using energy dispersive x-ray spectroscopy (EDS) . RESULTS: For specimens treated only with self-assembling peptide P11-4, the caries lesion area (mm2) values were 38.19 and 21.62, and the caries lesion volume (mm3) values were 6.27 and 2.99, respectively for pre- and post-treatment. In combination usage of self-assembling peptide P11-4 and laser, the caries lesion area (mm2) values were 38.39 and 16.91, and the caries lesion volume (mm3) values were 11.15 and 3.64, respectively for pre- and post-treatment. In the application of the P11-4 alone and in combination with laser, there was a statistically significant decrease in DiagnoDent values, an increase in enamel volume(mm3),enamel area(mm2) and mineral density(g/cm3) values and a decrease in caries lesion volume(mm3) and area(mm2) obtained by µCT, and an increase in %Ca and %F values obtained by SEM/EDS analysis (p < 0.05). It was discovered that the samples treated with P11-4 had a considerably higher rise in the Ca/P ratio than the samples treated with FV (p < 0.05). The calcium content increased significantly more when P11-4 application was combined with laser irradiation (p < 0.05). CONCLUSIONS: The combined use of self-assembling peptide P11-4 and laser accelerated the remineralization process and increased the remineralization capacity. CLINICAL RELEVANCE: FV and P11-4, alone or in combination with laser, can be successfully used as remineralization agents in initial enamel caries.
Asunto(s)
Caries Dental , Esmalte Dental , Fluoruros Tópicos , Láseres de Estado Sólido , Microscopía Electrónica de Rastreo , Espectrometría por Rayos X , Microtomografía por Rayos X , Caries Dental/terapia , Humanos , Técnicas In Vitro , Láseres de Estado Sólido/uso terapéutico , Esmalte Dental/efectos de los fármacos , Cariostáticos , Remineralización Dental/métodos , Propiedades de Superficie , Péptidos , OligopéptidosRESUMEN
OBJECTIVE: To study the effect of incorporating chitosan and fluoride-loaded chitosan nanoparticles into a glass-ionomer cement (GIC) to prevent secondary caries. MATERIALS AND METHODS: A standard cervical cavity (mesio-distal width 6 mm, cervico-occlusal width 2 mm, and depth 2 mm) was prepared on 30 molars for the following restoration groups: group 1, conventional GIC restoration; group 2, chitosan (10%) modified GIC restoration; group 3, fluoride loaded chitosan nanoparticles (10%) modified GIC restoration. The restored teeth were subjected to 1,500 thermal cycles before undergoing a multi-species cariogenic biofilm challenge. The restored teeth were examined by micro-computed tomography (micro-CT), scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDX). Data were analyzed by the one-way ANOVA, Tukey HDS, Kruskal Wallis, and Dunn's test. RESULTS: Micro-CT determined outer lesion depths for groups 1-3 were: 614 ± 20 µm, 589 ± 17 µm, and 560 ± 19 µm respectively. Both modifications with chitosan and fluoride-loaded chitosan nanoparticles significantly affected outer lesion depth (p < 0.05). The modification with fluoride-loaded chitosan nanoparticles statistically significantly decreased the outer lesion depth compared to all other groups (p < 0.05). SEM/EDX showed an increase of calcium, phosphorus, and fluoride at the root dentine adjacent to the restoration in groups 2 and 3 (modified GIC). This increase was statistically significantly higher in the group modified with fluorine-loaded nano chitosan particles compared to the other groups (p < 0.05). CONCLUSION: Incorporation of 10% chitosan and 10% fluoride-loaded chitosan nanoparticles into GIC restorative material can prevent secondary root caries development. 10% fluoride-loaded chitosan nanoparticles were more effective. CLINICAL SIGNIFICANCE: Glass ionomer cement modified with fluoride-loaded chitosan nanoparticles may be a promising restorative material in pediatric and preventive dentistry due to their controlled release properties.
Asunto(s)
Quitosano , Caries Dental , Fluoruros , Cementos de Ionómero Vítreo , Microscopía Electrónica de Rastreo , Nanopartículas , Espectrometría por Rayos X , Microtomografía por Rayos X , Cementos de Ionómero Vítreo/química , Quitosano/química , Nanopartículas/química , Fluoruros/química , Caries Dental/prevención & control , Humanos , Técnicas In Vitro , Cariostáticos/química , Diente Molar , Restauración Dental Permanente/métodos , Ensayo de Materiales , Propiedades de Superficie , Biopelículas/efectos de los fármacosRESUMEN
OBJECTIVES: The aim of this study was to quantitatively and comprehensively investigate the combined effects of arginine and fluoride on the suppression of pathogenicity using an in situ biofilm model and next-generation sequencing (NGS). METHODS: Using the in situ model, dental biofilms were formed and the viable bacterial counts and arginine activity in the arginine- and fluoride-containing dentifrice and control groups were measured. We also compared their effects on the bacterial microbiota and predictive functional factors in the control, arginine (arg), and arginine + fluoride (argF) groups using NGS analysis. RESULTS: Compared to the control treatment, the use of 8 % arginine and 1450 ppm fluoride toothpaste resulted in significantly high oral NH4+ concentrations without affecting the number of viable bacteria (P < 0.05). NGS analysis revealed that the oral microbiota of the control, arg, and argF groups were significantly different. Heat map analysis of the predicted functional factors revealed that the arg group had different properties from the other groups and activated specific substrate metabolic pathways; contrastingly, argF treatment inhibited the activity of these pathways and prevented an increase in the abundance of bacterial genera that utilize substrates such as sucrose, suggesting the synergistic effect of arginine and fluoride. CONCLUSIONS: This study indicates that the combination of arginine and fluoride has a synergistic effect on the bacterial microbiota and pathogenicity of dental biofilms compared with arginine alone. CLINICAL SIGNIFICANCE: Our findings suggest that the combination of arginine and fluoride could be used as an effective prebiotic and may inhibit the growth of bacteria associated with dental diseases.
Asunto(s)
Arginina , Biopelículas , Cariostáticos , Fluoruros , Pastas de Dientes , Arginina/farmacología , Biopelículas/efectos de los fármacos , Humanos , Fluoruros/farmacología , Pastas de Dientes/farmacología , Cariostáticos/farmacología , Sinergismo Farmacológico , Dentífricos/farmacología , Carga Bacteriana/efectos de los fármacos , Bacterias/efectos de los fármacos , Bacterias/clasificación , Microbiota/efectos de los fármacos , Placa Dental/microbiología , Adulto , Masculino , Adulto Joven , Secuenciación de Nucleótidos de Alto Rendimiento , Saliva/microbiologíaRESUMEN
INTRODUCTION: Nanotechnology offers new approaches and endless opportunities for remineralizing tooth decay without being toxic or causing allergies. This study aimed to determine the effect of nanosilver fluoride (NSF) on the remineralization potential of enamel caries-like lesions compared to 5% sodium fluoride varnish in permanent teeth. METHODS: Fifteen teeth (molars and premolars) were gathered, cleaned, and polished using a scaler. After sectioning the teeth mesiodistally and removing the roots, the thirty specimens were subjected to a demineralized solution to induce early enamel lesions and then assigned randomly into two equal groups. The test materials were applied, and then all the specimens were subjected to a pH cycling model for 30 days. DIAGNOdent and surface roughness were investigated, and an evaluation of the enamel Ca and P weight% for Ca/P ratio calculation was done using SEM-EDX to analyze the specimens at the end of the study. The data were analyzed using an independent t-test. RESULTS: The mean values for the DIAGNOdent measurements for NSF and NaF at baseline and after demineralization were not significantly different (p > 0.05). After treatment, NaF varnish showed a significantly higher mean DIAGNOdent measurement (11.8 ± 5.80) than NSF (4.7 ± 1.6). The mean surface roughness of the NaF group (1.64 ± 0.39) was much higher than NSF's mean surface roughness (1.07 ± 0.21). Specimens treated with NSF had statistically significant smoother surfaces (p < 0.001). The NSF group had a higher mean Ca/P ratio (2.9 ± 0.35) than NaF (2.2 ± 0.11). This difference was statistically significant (p = 0.012). CONCLUSION: The study reveals that nano silver fluoride is a more effective treatment than sodium fluoride varnish in enhancing teeth's clinical characteristics, particularly in terms of mineral content and surface roughness, suggesting it could be an improved strategy to prevent dental caries and maintain enamel integrity.