Caries Research最新文献

Introduction: Dental sealants applied to occlusal pit-and-fissure surfaces have been shown to prevent caries and arrest occlusal noncavitated carious lesions (NCCLs). The American Dental Association (ADA) recommends that oral healthcare providers apply sealants on occlusal NCCLs. Though the evidence is clear that sealants are effective, few studies have examined the adoption of the ADA guideline by dentists and the duration of protection provided by sealants in a large real-world setting.

Methods: This study used observational electronic health record (EHR) data from a network of dental clinics to follow teeth over a 2 year time period from when they were diagnosed as having an occlusal NCCL until either they were treated with a restoration or the time period ended with no restoration. The objectives of the study were to determine: (1) the degree to which dentists adopted the guideline, (2) whether the duration of protection was different for teeth that received a sealant from teeth that did not receive a sealant, and (3) whether dentists' experience placing sealants was associated with the duration of protection.

Results: Overall, there were 7,299 teeth in the sample. Of those, dentists restored 591 teeth and applied sealants on 164. The sealant application rate for eligible teeth was 2.2%. Sealant application was associated with provider, with 1.9% of providers placing more than half of the sealants. By the end of the observation period, the proportion of teeth progressing to restorations was 8.2% for teeth that had not received a sealant and 3.0% for teeth that had received one (RR = 0.37; 95% CI: 0.16-0.88; p = 0.02). Multilevel survival analysis showed that teeth that had not received a sealant were restored sooner than teeth that had received a sealant (aHR = 0.11; 95% CI: 0.03-0.36; p < 0.01). Overall, teeth that received a sealant had an 89% reduced hazard of restoration within 2 years compared with teeth that did not receive sealants.

Conclusion: This study found that by arresting decay, the presence of sealants led to fewer restorations and delayed restorations compared with teeth not receiving a sealant or restoration in the 2 years following diagnosis of occlusal NCCL in clinical settings.

Introduction: This study examined the association between cardiovascular disease (CVD) history and their dental caries experience status.

Methods: Conducted from January 2021 to June 2023, this cross-sectional cohort study involved 7,138 participants who underwent oral examinations. Data on demographic background, oral health-related behaviors, and smoking status were collected using a structured questionnaire. Dental caries was diagnosed at the cavitation level according to the World Health Organization criteria and calculated into caries experience indices including decayed, missing, and filled teeth (DMFT), decayed teeth, missing teeth and filled teeth. Information on CVD history was obtained from the Taiwan National Health Insurance Research Database, including acute myocardial infarction, ischemic stroke, and coronary artery disease. Multivariate linear regression models were used to assess the association between CVD history and its dental caries experience status.

Results: Of the participants, 158 (2.2%) had a prior diagnosis of CVD. Participants with CVD history had a significantly higher mean DMFT index (21.21 ± 8.37) than did those without CVD history (13.4 ± 7.82; p < 0.0001). After adjusting for confounding factors, participants with CVD history had a mean DMFT index that was 2.11 higher (95% CI = 0.99, 3.24, p < 0.01) and 2.21 more missing teeth (95% CI = 1.42, 3.00, p < 0.0001) than did those without CVD history. Subgroup analyses indicated that participants aged ≥65 years were predominantly affected.

Conclusion: Older participants with CVD history were associated with an increased number of missing teeth. The present study design could not conclude a positive association between CVD history and its DMFT status, partly due to the lack of data on the reason for missing teeth.

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: This questionnaire-based investigation aimed to assess oral health behaviour (OHB) in 2-year-old children taking part in a birth cohort study and to identify relationships between general health, socioeconomic as well as psychosocial factors and OHB.

Methods: Factors examined were single-parent status, migration background, child's sex, parity, maternal age, education and social support, paternal employment, parental mental and physical health, and child health, data for which were collected at birth, 4 weeks, or 1 year. Participants who answered all OHB questions at 2 years (n = 730) were included. Nutritional score (NS), toothbrushing score (TS), and dental check-up score (CS) were used to calculate overall OHB score.

Results: Overall OHB in this cohort was good. 62% ate fruit or vegetables daily, 75% brushed 2-3 times daily, and 61% had already had a dental check-up. Children of single mothers had significantly lower OHB scores. NS was significantly higher for children with migration background, children of mothers with better physical health or higher educational level, but lower for children of mothers reporting poor social support. TS was significantly lower in children of single mothers and children of fathers reporting poorer mental health. CS was significantly higher in children of multiparous mothers. This study highlights the relevance of social support and parental health, in contributing to OHB patterns.

Conclusion: Families with special healthcare needs or less robust social support may have difficulty maintaining good OHB.

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: This in vitro study evaluated the validity and reliability of spectral-domain optical coherence tomography (SD-OCT) to detect approximal carious lesions compared to bitewing radiography.

Methods: Forty extracted human premolars and molars with fifty-four unrestored approximal surfaces (ICDAS ll score 0-3) were mounted in a patient-equivalent simulator and imaged by digital radiography (DR) and the prototype of an intraoral OCT probe. The lesion status of the tooth surfaces was validated histologically and by microtomography (µCT). Five calibrated raters with low to high level of clinical expertise analyzed the DR and OCT images at intervals of 2-4 weeks each. Intra- and interrater agreement (weighted Cohen's kappa κ, Fleiss' kappa), sensitivity, and specificity were calculated.

Results: The sensitivity of OCT (0.66-0.91) was higher than that of DR (0.46-0.82), as was the specificity (OCT: 0.67-0.92; DR: 0.33-0.58). Intrarater agreement with OCT was moderate to substantial (κ: 0.53-0.77; p < 0.001) and fair to substantial for DR (κ: 0.36-0.78; p < 0.05). The DR interpersonal agreement ranged from slight to substantial (κ: 0.1-0.74, Fleiss' κ: 0.23/0.24; p < 0.001) toward fair to substantial with OCT (κ: 0.27-0.62; Fleiss' κ: 0.23/0.18; p < 0.001). Agreement between histology and µCT was almost perfect (κ: 0.82; p < 0.001).

Conclusions: In a clinically oriented simulation, OCT was more sensitive in detecting early approximal carious lesions than DR without impairing specificity or reproducibility. Clinical studies will have to show whether OCT can confirm these promising results.

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: 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.