Caries Research最新文献

Introduction: Dental caries is a sugar-dependent biofilm disease influenced by multiple factors, yet the genetic contribution to its development remains a subject of debate.

Methods: A cross-sectional census study was conducted with preschool children aged from 3 to 5 years old in Teresina, Brazil. Twin pairs (monozygotic [MZ] or dizygotic [DZ]) with complete or mixed primary dentition up to the eruption of the permanent lower incisors were included. Uncooperative children were excluded. Data were collected through questionnaires and clinical examinations using the ICDAS index. Tetrachoric correlations and multinomial logistic regression were used to assess coincidences. Multilevel Poisson regression identified associated factors (p < 0.05).

Results: Of the 325 eligible twin pairs, 219 (67.4%) participated in the data collection (87 MZ and 132 DZ). MZ twins exhibited a strong positive correlation for the presence of any lesion (rMZ = 0.776) and a very strong positive correlation for ICDAS 4+ lesions (rMZ = 0.920). DZ twins exhibited a moderate positive correlation for any lesion (rDZ = 0.581) and a strong positive correlation for ICDAS 4+ lesions (rDZ = 0.634). Environmental variables explained up to 50.6% of the variance in hierarchical models. Risk factors included being aged 4 to 5 years (OR = 2.650; p = 0.001), breastfeeding for 6 months or longer (OR = 2.172; p = 0.005), use of fluoride-free toothpaste (OR = 2.444; p = 0.004) and presence of hypomineralization of second primary molars (OR = 2.198; p = 0.005). Fluoridated water (OR = 0.239; p = 0.001) was a protective factor.

Conclusion: While environmental factors play a significant role in the onset of dental caries, genetic factors may contribute to the development of the disease.

Introduction: The aim of the study was to describe the association between household food insecurity and the prevalence of cavitated dental caries lesions in adolescents.

Methods: This is a cross-sectional study nested within a 13-year cohort study that began in 2010 with a representative sample of preschool children aged 1-5 years from Santa Maria, southern Brazil. Participants were followed up in several phases of the cohort study, and this analysis used data from the most recent reevaluation, when individuals were aged between 14 and 18 years. Dental caries was assessed using the World Health Organization (WHO) criteria (cavitated caries lesions). Household food insecurity was measured using the Brazilian Food Insecurity Scale (EBIA), considering households with individuals under 18 years of age. The association between the presence of different levels of household food insecurity and caries experience was analyzed using adjusted Poisson regression models. Results are presented as mean ratios (MR) with 95% Confidence Intervals (95% CI).

Results: Of the 406 adolescents assessed, 300 parents or guardians (73.9%) completed the food and nutrition insecurity questionnaire. Approximately 56.0% (95% CI: 50.2-61.7%) of households experienced some degree of food and nutrition insecurity. The prevalence of cavitated dental caries lesions was 38.0% (95% CI: 32.5-43.8%). Adolescents living in households with mild or moderate food insecurity had on average 62% higher mean surfaces with cavitated dental caries (MR 1.62; 95% CI: 1.28-2.06) than their counterparts without food insecurity. The presence of severe food insecurity was also associated with about twice the mean surface with cavitated dental caries (MR 1.92; 95% CI: 1.35-2.73).

Conclusion: In addition to the nutritional consequences, food insecurity compromises oral health and should be a priority to reduce social inequalities in oral diseases.

Introduction: Intraoral scanners with fluorescence technology (IOSFT) include a caries detection feature in addition to their standard scanning function. The aim of this study was to determine the diagnostic performance of the caries detection tool of the IOSFT Trios 4® on permanent premolar and molar surfaces when compared to visual and radiographic International Caries Detection and Assessment System (ICDAS).

Methods: Participants (n = 71, age 6-88 years) were examined under standardised conditions using ICDAS criteria for visual caries detection of occlusal and smooth surfaces. Bitewing (BW) radiographs were used to examine proximal surfaces using ICDAS radiographic criteria. Finally, participants underwent an intraoral scan of both the maxilla and the mandible according to the manufacturer's instructions. The automated caries detection (ACD) output on the IOSFT software was compared to the visual ICDAS scores obtained clinically for occlusal and free smooth (buccal and lingual) surfaces; the IOSFT caries detection output was compared to radiographic ICDAS scores from BW radiographs for interproximal (mesial and distal) surfaces. Sensitivity, specificity, and accuracy values for each tooth surface were calculated.

Results: Out of 3,684 permanent tooth surfaces examined, 461 surfaces with dental caries were included in the analysis. 392 were initial lesions (ICDAS 1-2), while 69 were moderate/severe (ICDAS 3-6). There was a moderate positive correlation (r = 0.4, p < 0.001) when comparing all ICDAS scores to IOSFT ACD categories for unrestored permanent occlusal surfaces. IOSFT ACD accuracy was higher for moderate/advanced lesions (ICDAS 3-6) lesions when compared to initial (ICDAS 1-2) ones (81% vs. 37.7%). For unrestored smooth surfaces, weak positive correlations were found when comparing all ICDAS scores to IOSFT ACD categories (r = 0.19, p < 0.001). Accuracy results for smooth surfaces were 93.5% for moderate/advanced and 77.1% for initial lesions. Correlations between BW ICDAS scores and IOSFT ACD scores for proximal surfaces were weak (r = 0.07, p = 0.019). Diagnostic accuracy was higher for moderate/advanced lesions when compared to initial ones (83.5% vs. 40.4%). There was a weak correlation between IOSFT ACD categories and ICDAS/visual categories for restored occlusal surfaces (r = 0.029, p = 0.68).

Conclusion: IOSFT cannot currently replace visual and radiographic exams for caries detection.

Introduction: This cohort study evaluated the clinical behavior of dental caries lesions classified as inactive on the occlusal surfaces of permanent molars, defining their risk for progression after 13 years, in comparison with sound occlusal surfaces.

Methods: Clinical assessments were undertaken at baseline (n = 258), after 1 year (n = 200), 4-5 years (n = 193), and 13 years (n = 102). Plaque and dental caries were recorded on the occlusal surfaces, as well as the eruption stage of permanent molars. Outcomes were progression by activity (active lesion, filling or extraction in the follow-up exam) and progression by severity (dentin cavity, filling or extraction in the follow-up exam). Predictors were occlusal site status, plaque accumulation on occlusal surfaces, eruption stage, type of molar, and dental arch, all of them collected at baseline. Logistic regression models were fitted using generalized estimating equations due to data clustering.

Results: A total of 601 occlusal surfaces were reexamined. For the activity criterion, progression rates were 8.7% for sound sites and 18.8% for caries lesions initially classified as inactive (p < 0.05). For the severity criterion, the respective rates were 5.8% and 13.4% (p < 0.001). Inactive occlusal caries lesions had about twice the risk for caries progression than sound surfaces, for both the activity criterion (adjusted OR = 2.09, 95% CI = 1.23-3.52) and the severity criterion (adjusted OR = 2.49, 95% CI = 1.42-4.35).

Conclusion: The vast majority (>80%) of lesions initially classified as inactive did not progress after 13 years. However, they showed higher risk for progression than sound occlusal surfaces of the same patients.

Introduction: The main cause of failure in restorations is the development of caries around restorations (CARs). Therefore, the aim of this study was to assess the evidence related to the development of CAR with fluoride-releasing restorative materials compared to non-fluoride releasing in deciduous and permanent teeth.

Methods: Randomized clinical trials were included. Literature searches were conducted without language/data restrictions in 6 databases and in the grey literature in June 2024. ROB2 tool assessed the risk of bias. Through meta-analyses, expressed by the risk difference (RD) with a 95% confidence interval, the outcome was evaluated considering the follow-up period (12, 18-24, and ≥36 months), type of dentition and fluoride-releasing restorative materials, number of surfaces treated, and the type of dental isolation performed. Meta-regression models were applied with the above variables as moderators. The certainty of the evidence was assessed by GRADE.

Results: Forty-six studies were selected. Among them, 29 presented some concerns and 9 showed high risk of bias. The type of dentition and dental materials, number of surfaces, and dental isolation did not influence the outcome (p > 0.05). Although after 36 months of follow-up, deciduous and permanent teeth restored with fluoride-releasing materials had a lower risk of CAR (RD -0.015 [-0.024, -0.006], p = 0.002, I2 = 0%), the moderators did not influence this effect by meta-regression models. The certainty of the evidence ranged from low to moderate.

Conclusion: Fluoride-releasing restorative materials were more effective in preventing CAR after 36 months of follow-up. However, this result should be interpreted with caution, considering the low to moderate certainty of the evidence, the included studies' risk of bias, and the small RD.

Introduction: Salivary matrix metalloproteinase-8 (MMP-8) concentration is considered a biomarker of oral health in adults, but studies in pediatric populations, especially with longitudinal data, are scarce.

Methods: We examined the associations of caries experience (DFT index) and gingivitis/calculus (CPITN) retrieved from public dental records with repeated salivary MMP-8 concentrations. Salivary MMP-8 were measured from 403 Finnish adolescents (50.1% girls) at the mean (SD) age of 11.4 (0.4) and 13.8 (0.5) years, using an ELISA kit. Oral health was determined on average 42 (27) days after saliva collection at baseline. The DFT index was categorized into no caries experience (DFT = 0) and having caries experience (DFT >0), and CPITN into no gingivitis/calculus (CPITN = 0) or having gingivitis/calculus (CPITN >0).

Results: Of the participants, 19.1% presented with caries experience, and 69.5% had gingivitis/calculus. The mean MMP-8 increased during follow-up by 0.125 ng/mL (95% CI: 0.05; 0.20, p = 0.006). MMP-8 at the two time points correlated weakly in all participants (r = 0.137, p = 0.006), especially in girls (r = 0.204, p = 0.004). The change in MMP-8 was not associated with caries experience or gingivitis/calculus in all participants or in gender-specific analyses (repeated measures ANOVA p > 0.05). Puberty status and medication use were not related to MMP-8 concentration.

Conclusions: Oral health indices retrieved from public health records were not associated with changes in MMP-8 concentrations in early adolescents over a 2-year follow-up. Salivary MMP-8 may not be a suitable biomarker of oral health in pediatric populations.

Introduction: This study aimed to investigate the association between online social capital and dental caries among adolescents.

Methods: A cross-sectional study was nested within a cohort and conducted with adolescents from Santa Maria, southern Brazil. Dental caries was assessed using the International Caries Detection and Assessment System (ICDAS), considering the number of teeth with cavitated lesions (scores 3, 5, and 6). Online social capital was measured using self-reported items on social media use, perceived digital support, and sense of digital belonging. Poisson regression models were used to estimate associations, adjusting for sociodemographic, behavioural, and psychosocial variables. Results are presented as rate ratios with 95% confidence intervals.

Results: A total of 406 adolescents were included. The mean number of teeth with cavitated caries was 1.45 (SD: 3.48). Adolescents who reported infrequent use of social media had a higher mean number of cavitated lesions compared to those who used social media daily. Higher levels of dental caries were also observed among those who reported low trust in online interactions. Similarly, a lack of perceived belonging in the digital environment was associated with a greater number of cavitated caries.

Conclusion: Infrequent social media use, low trust in online relationships, and a diminished sense of digital belonging were associated with higher levels of dental caries among adolescents.