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: Streptococcus mutans adherence to the tooth surface and subsequent biofilm development is modulated by the carbohydrate source, but the corresponding effect on bacterial proteome has not been previously studied. This study aimed to assess the effect of different carbohydrates on S. mutans viability and bacterial proteome at 2 time points, early attachment (8 h) and biofilm maturation (24 h).

Methods: Hydroxyapatite (HAp) discs coated with parotid saliva proteins were inoculated with S. mutans UA159 in tryptone soy broth without dextrose supplemented with one of the following carbohydrates (n = 12/treatment/time point): 1% sucrose; 0.525% glucose + 0.525% fructose; 10% xylitol; 10% xylitol + 1% sucrose; or culture medium without supplementation as negative control. Once inoculated, HAp discs were incubated for 8 h or 24 h at 37°C and 10% CO2. After each incubation period, adhered bacteria were quantified using the plate-counting method for 6 HAp discs/group, and the remaining 6 HAp discs/group were used to extract bacterial cell wall proteins. Extracted proteins were analyzed using liquid chromatography coupled with mass spectrometry and then classified by their biological process. The study was conducted in three independent assays, and the number of bacteria adhered to the HAp discs was determined at each time point and analyzed by two-way ANOVA followed by Bonferroni test (α = 5%).

Results: The results suggest that xylitol significantly repressed bacterial adherence and metabolism at 8 h and 24 h; however, bacterial adherence and metabolism were significantly enhanced when xylitol was combined with sucrose, showing no negative effect on S. mutans at both time points. Bacterial proteome was modulated by the carbohydrate source.

Conclusion: The cariogenicity of S. mutans biofilms may be reduced by the alternative sweetener xylitol; however, the combination with fermentable sugars may inhibit such a beneficial effect.

Introduction: Hydroxyapatite (HAP) is promoted as biomimetic material in dentistry. The aim of the study was to investigate whether HAP-containing formulations can reduce erosive/abrasive tissue loss and to analyse components in these formulations.

Methods: Two HAP toothpastes with and two without fluoride and a HAP mouthrinse were investigated, controls were active agent-free toothpaste, SnF2 toothpaste and F/Sn mouthrinse. For 10 days, human enamel samples were eroded for 2 min, 6×/day in 0.5% citric acid and immersed for 2 min, 2×/day in toothpaste slurries or mouthrinse. Half were additionally brushed for 15 s, 2×/day. The particulate fraction was extracted and examined morphologically and with element analyses. Other parameters were REA, RDA, fluoride and calcium content.

Results: The F/Sn mouthrinse almost completely prevented tissue loss; none of the HAP formulations reduced tissue loss compared to the negative control, two increased it instead. Brushing increased tissue loss in all groups except the F/Sn mouthrinse. All toothpastes contained amorphous particles of different sizes. Elemental analysis identified Si and O, and additionally, Ca and P were present in small amounts on the particles of the HAP toothpastes and one HAP+F toothpaste. In the liquid phase, elevated calcium levels were found in one HAP toothpaste and in both HAP+F toothpastes; in the formulation with the highest value, the fluoride concentration was low. REA and RDA values were not associated with tissue loss.

Conclusions: Whether alone or in combination with fluoride, HAP formulations had either no or a detrimental effect on erosive tissue loss and could not reduce abrasion. In the context of erosive tooth wear, HAP seems to be neither an alternative to fluoride nor a suitable supplement to it.

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: This study aimed to examine the effects of age, period (historical events), and cohort (generational impact) (APC) on caries prevalence and mean DMFT among Singapore schoolchildren from 2007 to 2019.

Methods: Anonymised records of all 6-year-old primary 1 (P1), 11-year-old primary 6 (P6), and 14-year-old secondary 3 (S3) students before the start of each school year between 2007 and 2019 were extracted from the Integrated Dental Electronic Assessment System (IDEAS), categorised by school level, ethnicity, and sex. Poisson regression and partial least squares regressions were applied to estimate APC effects.

Results: In total, 502,339 P1, 535,579 P6, and 496,725 S3 records were included from 2007 to 2019, with 1,058,589 (69.0%) Chinese, 187,948 (12.2%) Malay, and 152,618 (9.9%) Indian students; 245,447 (48.8%) P1, 259,389 (48.4%) P6, and 243,941 (49.1%) S3 students were girls. Overall, the APC effects on caries prevalence and mean DMFT showed a strong age effect, with the lowest prevalence in the youngest P1 group and the highest in the oldest S3 group. Period and cohort effects were identified, with the prevalence decreasing among those born after 1995 and the lowest prevalence rate in 2013. Similarly, period and cohort effects on mean DMFT were also detected, with decreased mean DMFT after period 2009 and the highest mean DMFT (0.72 in P6 and 1.13 in S3) in cohort 1995.

Conclusion: Caries prevalence and DMFT increased with age. While both decreased in individuals born after 1995, mean DMFT began to rise again in those born after 2003.

Introduction: The aim of this cross-sectional study was to explore the degree whereby dentists differentiate between repair versus replacement for failed restorations. A random selection of adult patients from North Norway was chosen from the larger Tromsø 7 study.

Methods: A randomized sample of 3,653 persons (11.5% of the total number of individuals invited to the Tromsø 7 study, 51.5% women, aged 40-93 years) were included. Based on FDI's clinical criteria for the evaluation of restorations - 2010, 17 calibrated dentists evaluated patients by clinical and radiographical pictures in a specially designed software developed for this purpose. The dental practitioners' opinions gave rise to the reported treatment decisions. Descriptive statistics and multivariable multilevel mixed-effect logistic regression models (STATA 17/SE) were performed.

Results: The participants' DMFT values ranged from 0 (0.9%) to 24 (8.8%) (median DMFT 21.3, mean 20.0). A total of 90.062 teeth (24.7 teeth per patient) were assessed. Re-treatment suggestions were made for 3,006 restorations, i.e., an average of 3.3% re-treatments. Of these, 25.3% (n = 814) were suggested for repair and 74.7% (n = 2,192) for replacement. Dental treatment was suggested for 1,597 patients and varying from 1 to 14 suggestions per patient. Secondary caries (37.6%) and restoration fracture (15.2%) were found to be most frequently used indications for re-treatment, surface properties the least. No significant difference was found between assessing dentists based on sex or age. Clustering by dentist level was checked using intra-class correlation coefficients, demonstrating that 16% of the variance in suggestions for restoration re-treatment was explained at the dentist level. Thus, a wide range of treatment suggestions was noted among the dentists.

Conclusion: Need for restoration revision seems low in North Norway. There is a tendency towards larger and more indirect restorations, and the diagnosis of secondary caries is still a matter of uncertainty.

Introduction: The present study aimed to identify the 100 most-cited articles concerning atraumatic restorative treatment (ART) through a bibliometric analysis.

Methods: The search was conducted in the Web of Science database in December 2023. Scopus and Google Scholar were used to compare the number of citations. The following data were extracted from the articles: title, authors, number of citations, access type, institution, country, continent, year of publication, journal, keywords, study design, and theme. Collaborative networks were generated using the VOSviewer software. Google Trends was used to investigate the global popularity of "atraumatic restorative treatment" research.

Results: The 100 selected articles, published between 1996 and 2019, were cited 5,092 times, ranging from 21 to 239 citations. CariesResearch (12%) and Community Dentistry and Oral Epidemiology (12%) published the highest number of articles. Clinical study (52%) was the most prevalent study design. The main theme addressed was restoration longevity (43%). Conventional high-viscosity glass ionomer was the most used restorative material (69%). The country with the highest number of articles was The Netherlands (33%) and Europe was the continent with most publications (38%). The Radboud University of Nijmegen had the highest number of articles (25%). Frencken was the most prominent author (38%). The most common keyword was "atraumatic restorative treatment" (n = 60). According to Google Trends, Tanzania was the country that searched the most about ART.

Conclusion: The 100 most-cited articles on ART were mainly composed of clinical studies focusing on the longevity of restorations and originated in Europe.

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.