Caries Research最新文献

Introduction: Dental caries with pulp involvement potentially impacts the oral health-related quality of life (OHRQoL). This meta-analysis aimed to evaluate whether clinical consequences of pulp involvement due to dental caries impacts OHRQoL of children and adolescents.

Methods: Observational studies evaluating whether children/adolescents (population) with pulp involvement due to caries (exposition) compared with those without it (comparison) have more negative impact on their OHRQoL (outcome) were included. A systematic search was undertaken in August 2022 in seven databases. Alerts were set until August 2023. JBI Critical Appraisal tool for cross-sectional studies was used for methodological quality assessment. Random-effects meta-analyses were performed to calculate mean differences (MD) or standardized mean differences (SMD) of impact on OHRQoL. For studies with dichotomous outcome, meta-analysis calculated the odds ratio (OR). Robustness, heterogeneity, certainty of evidence, and publication bias were evaluated.

Results: From 29 included studies, 14 assessed preschoolers, nine assessed schoolchildren, four assessed adolescents, and two assessed children/adolescents. PUFA was the main index used to assess the exposure. ECOHIS (preschoolers) and CPQ (children/adolescents) were the main tools used to assess the outcome. Only five articles fully adhered to the quality criteria. The meta-analyses found the following main results: (a) preschoolers: MD -10.79 (-16.50; -5.09); (b) schoolchildren: MD -5.12 (-7.51; -2.72); (c) adolescents: MD -1.86 (-4.59; 0.87); (d) overall impact: SMD -2.18; (CI: -3.21;-1.15) and OR 0.52 (CI: 0.30; 0.90).

Conclusion: Pulp involvement impacted OHRQoL of children negatively. In adolescents, this impact was not observed. Results must be interpreted with caution due to very low certainty of evidence.

Introduction: Erosive tooth wear (ETW) is a multifactorial condition of increasing prevalence in the younger population. This study aimed to explore the association between different ETW phenotypes with MMP2 and COMT single-nucleotide variants and selected environmental factors.

Methods: Saliva samples, erosive wear, and dental caries experience data and dietary/behavioral information from 16- to 18-year-old patients (n = 747) were used. Genotypes were obtained, and phenotypes were further analyzed considering diet and behavioral data, using logistic regression as implemented in PLINK, with an alpha of 0.05.

Results: When comparing individuals' ETW-free with those with mild ETW, an association was found with COMT rs6269 (p = 0.02). The comparison between ETW-free individuals with individuals with severe ETW also showed an association with COMT rs6269 under the recessive model (p = 0.03). Logistic regression showed that in the presence of less common alleles of MMP2 rs9923304 and COMT rs6269, ETW was more likely to occur when individuals drank wine. The GG genotype of COMT rs6269 was associated with the presence of lower (p = 0.02) and higher (p = 0.02) caries experience when individuals with ETW only in enamel were compared with individuals with ETW involving dentin.

Conclusion: The results support a role of genes in ETW, with wine consumption being identified as a significant modulator, suggesting that gene-environment interactions may contribute to the development of ETW.

Introduction: Acquired pellicle (AP) acts as a membrane preventing acids from coming into direct contact with the tooth. Possibly, individuals with different dental health status present changes in its composition that could disrupt this function. Thus, the aim of this study was to compare the protein composition of the AP in adolescents with erosive tooth wear (ETW), caries, or sound.

Methods: Calibrated examiners in BEWE index and ICDAS-merged Epi criteria assessed ETW and caries in a sample of 454 systemically healthy adolescents aged 12-15 years old. Thirty subjects from that sample were selected for this study: ETW group (n = 10; total BEWE ≥9 and absence of dentinal caries lesions); caries group (n = 10; total BEWE <9 and with at least one dentinal caries lesion), and sound group (n = 10; total BEWE <9 and absence of dentinal caries lesions). Two-hour-formation AP samples were taken from buccal, occlusal/incisal, palatal/lingual tooth surfaces. Protein composition was analysed by liquid chromatography-tandem mass spectrometry. Using mean reporter ion values, relative abundances of proteins were compared among the three groups to calculate for fold changes. Twofold protein increases or decreases were reported (t test, p < 0.05). Gene Ontology (GO) of included proteins was assigned.

Results: Mean age of participants was 13.1 ± 1.14 years and 56.6% were females. The prevalence of ETW was of 66.6% and of dentinal caries of 33.3%. The GO analyses showed that the majority of detected proteins were stress response related. The ETW group disclosed upregulated relative abundance of antileukoprotease (2.85-fold in ETW vs. sound and 2.34-fold in ETW group vs. caries group); histatin (2.42-fold in ETW group vs. sound group and 2.20-fold in ETW group vs. caries group), and prolactin-induced protein (2.30-fold in ETW group vs. sound group and 2.06-fold in ETW group vs. caries group) (p < 0.05). Hemoglobin subunits alpha (HBA) and beta (HBB) showed decreased relative abundances in the ETW and caries groups when compared to the sound group (HBA: 0.42-fold in ETW group and 0.40-fold in caries group; HBB: 0.45-fold in ETW group and 0.38-fold in caries group; p < 0.05).

Conclusion: AP from individuals with ETW showed differences when compared to other dental conditions, with relative abundance increasing of some stress response-associated proteins in ETW and a decrease in proteins related to salivary protection against acid challenges.

Introduction: The present study evaluated the association between drug use and erosive tooth wear (ETW) in prisoners.

Methods: This is a cross-sectional, descriptive, and analytical research carried out in Southern Brazil. Data collection took place through the application of questionnaires and clinical examination. ETW was assessed using the BEWE index and the use of illicit substances using the Screening Test for Involvement with Alcohol, Smoking and Other Substances (WHO). Data were tabulated and statistics were performed using the STATA 14.0 software.

Results: A total of 653 volunteers participated in the research, and prisoners were mostly male (94.0%), self-declared as black (53.5%), with average age of 34 years (SD = 10.17). It was possible to identify that 81.3% of prisoners have used some type of drug during their lives, the most prevalent being alcohol (74.2%) followed by cocaine (46.0%). Through clinical examination, it was detected that 49.6% of prisoners evaluated showed some degree of erosive wear (BEWE >0). In the univariate analysis, prisoners with higher schooling (≥8 years) and age between 18 and 29 years had statistical association with ETW index ≥3, respectively (p = 0.010) and (p = 0.015). In the multivariate analysis, there was no association between dental wear and drug use.

Conclusion: It was possible to observe high consumption of drugs by prisoners and the prevalence of ETW; however, the hypothesis that drug consumption would be associated with the presence of ETW in the prison population was rejected.

Introduction: Root caries (RC) remains a global health problem leading to negative impacts on an elderly person's well-being causing oral health-related quality of life issues, such as inadequate nutrition and detrimental oral functionality. The present systematic review with meta-analysis is designed to synthesize existing research findings on the prevalence and experience of root caries globally over the past 30 years. It aims to describe its distribution by country and explore its links with various socioeconomic indicators.

Methods: Selection criteria: Three electronic databases (PubMed, Embase, and Scopus) were screened for observational epidemiological studies (cross-sectional and cohort studies) reporting the prevalence of RC and/or mean RC experience between 1990 and 2023. No languages were applied. Study selection, data extraction, and quality assessment were done in duplicate. Risk of bias was graded with customized quality assessment tools (Study Quality Assessment Tools NHLBI, NIH).

Data collection and analysis: studies reporting on (1) root-caries experience (mean and SD) and (2) root-caries prevalence (%) were used to synthesize the results. It was assessed as decayed, missing, and filled teeth (RDMFT).

Results: A total of 91 publications were included in the descriptive analysis; the estimated overall pooled mean RC was 2.87 teeth and the global estimated random-effects pooled RC prevalence was 41%. Low gross national income (GNI) countries reported a low mean number of RC (1.35 GNI

Conclusion: This study highlights the high caries burden among adult population globally by estimating overall trends and comparing against factors including area, GNI, and Gini index. The large magnitude of these inequities indicates that oral health equity can only be achieved taking into account socioeconomic factors on a global scale. The lack of uniform data collecting among studies as well as knowledge gap regarding the incidence and experience of RC in different countries.

Introduction: The aim of the study was to investigate the caries-preventive effect of fluoride-free toothpastes, containing either herbal agents or (nano-)hydroxyapatite.

Methods: Bovine dentin specimens each having a sound (ST) and a demineralized area (DT) were prepared and randomly allocated to eleven groups (n = 187). Treatments during pH cycling (28 days; 6 × 120 min demineralization/day) were brushing 2×/day with 0 ppm F- [NaF0], 500 ppm F- [NaF500], 1,100 ppm F- [NaF1100], grape seed extract [GSE], (nano-)hydroxyapatite, melaleuca oil [MO1, MO2, MO-CU], and propolis + myrrh [PM1, PM2] containing dentifrices. Dentifrice slurries were prepared with deionized water (1:3 w/w). Differences in integrated mineral loss (∆∆Z) and lesion depth (∆LD) were evaluated before and after pH cycling using transversal microradiography.

Results: The correlation between ΔΔZ/ΔLD and F- concentration (NaF0, NaF500, NaF1100) was strong for the DT (rΔΔZ, DT = 0.681; p < 0.001) and very strong for ST (rΔΔZ, ST = 0.861; p < 0.001), indicating a fluoride dose-response for both baseline substrate conditions. For ΔΔZDT and ΔLDDT, only NaF1100 and GSE revealed significant differences compared with NaF0 (p < 0.001; ANOVA). For ΔΔZST and ΔLDST, significant differences could be found for NaF1100 and NaF500 compared to all fluoride-free groups (p ≤ 0.002; ANOVA), without significant difference between fluoride-free groups (p = 1.000; ANOVA). For DT and ST, a hypermineralized surface layer and no surface loss could only be observed when fluoride was present.

Conclusion: A dose-response for fluoride concentrations was observed in this mild demineralization pH-cycling model. Fluoride-free dentifrices containing GSE or melaleuca oil showed certain preventive effect against further progression of root caries lesions. However, surface loss was observed for all fluoride-free dentifrices.

Introduction: The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC) is a disease-specific questionnaire that assesses the impact of caries on the oral health-related quality of life of children. This study aimed to establish a baseline for caries-specific impact on schoolchildren in Saudi Arabia and to examine its association with dental care utilization.

Methods: This cross-sectional study used random stratified cluster sampling among 4th-6th graders in Jeddah. Two surveys were administered: (1) a general parental survey and (2) CARIES-QC, a self-reported survey for children. Clinical examinations were conducted using the decayed, missing due to caries, and filled teeth (DMFT/dmft) index. Descriptive statistics provided CARIES-QC baseline estimates, and multilevel linear regression was performed to examine the relationships between CARIES-QC scores, DMFT/dmft index, and care utilization.

Results: A total of 805 children aged 8-13 years participated. The overall median CARIES-QC score was six (interquartile range, 3-11). A higher DMFT/dmft index was associated with a higher CARIES-QC score (p < 0.05). Children who had never visited a dentist had lower CARIES-QC scores (β = -1.18, 95% confidence interval: -2.33; -0.02, p = 0.045) than those who had visited a dentist in the past 12 months. After adjusting for reasons for dental visits, the CARIES-QC scores were not associated with prior dental visits (p = 0.086).

Conclusion: A higher DMFT/dmft index was associated with higher CARIES-QC scores, but prior dental care utilization was not significantly associated with improved CARIES-QC scores. Future research should explore other factors that influence the relationship between care utilization and caries-specific quality of life.

Introduction: The aim of this in vitro study was to evaluate the accuracy of near-infrared imaging (NIRI) generated by the iTero Element 5D scanner for detecting proximal caries lesions in deciduous molars, compared with visual inspection (VI), bitewing (BW) radiography, and histological examination (reference standard).

Methods: Sound deciduous molars and those with caries lesions (ICDAS 0 to 5) on the proximal surface were included, while teeth with marginal crest breakdown, restoration on the mentioned surfaces, or extensive dentin resorption were excluded. A total of 182 deciduous molars, divided into 91 pairs of first and second molars, were evaluated by two blinded examiners. Two distinct thresholds were considered for the assessment of caries detection methods: enamel lesion (D1) and dentin lesion (D3). Specificity, sensitivity, accuracy, and area under the ROC curve (AUC) were calculated for each method in the statistical analysis.

Results: All evaluated methods demonstrated high specificity at D1, with 1.00 for VI and 0.95 for NIRI and BW, and at D3, 0.99 for BW and 0.98 for NIRI and VI, without statistical differences. The sensitivity and accuracy of NIRI at D1 were 0.44 and 0.55, while those of VI were 0.46 and 0.58, and of BW were 0.60 and 0.68, respectively. And sensitivity and accuracy of NIRI at D3 were 0.14 and 0.69, while those of VI were 0.37 and 0.77, and of BW were 0.51 and 0.82, respectively. No difference in sensitivity and accuracy was observed between NIRI and VI at D1 (p = 0.589); however, NIRI presented the lowest accuracy at D3. At D1, no statistical difference was observed between the AUC of BW and VI (p = 0.1124), nor between NIRI and VI (p = 0.2523). However, at D3, statistical differences were observed between the AUCs of the three evaluated methods: VI versus NIRI (p = 0.0005), VI versus BW (p = 0.0281), and NIRI versus BW (p < 0.0001).

Conclusion: NIRI showed accuracy comparable to VI at the D1 threshold but was less effective than BW radiography at both D1 and D3 thresholds.

Introduction: This study assessed the influence of social support, oral health beliefs, and health behaviours on dental caries incidence among children living in underprivileged neighbourhoods.

Methods: Data from a cohort study with 12-year-old schoolchildren (N = 312) selected from public schools in Manaus, Brazil, and their parents or guardians were analysed. Socio-economic characteristics, sex, oral health beliefs, social support (SSA questionnaire), oral health-related behaviours (sugar consumption, frequency of toothbrushing, use of fluoride toothpaste), and dental caries (DMFT index) were assessed at age 12 years. Dental caries incidence over 12-month period was registered according to the number of new cavitated teeth. The hypothesis was that socio-economic disadvantage, lower social support, unfavourable oral health beliefs, and inadequate behaviours would increase the risk of dental caries incidence. Statistical analysis was conducted using confirmatory factor analysis and structural equation modelling.

Results: Unfavourable oral health beliefs indirectly predicted higher dental caries incidence (β = 0.041) via sugar consumption and frequency of toothbrushing. Unfavourable oral health beliefs directly predicted higher sugar consumption (β = 0.148) and lower frequency of toothbrushing (β = -0.218). Lower frequency of toothbrushing directly predicted higher dental caries incidence (β = -0.140). Sex (β = -0.017) and social support (β = -0.016) were indirectly linked to dental caries incidence.

Conclusions: Our findings suggest that incidence of dental caries in socially underprivileged children results from the complex relationships between social support, oral health beliefs, and oral health behaviours.