Caries Research最新文献

Introduction: Dental caries is a disease with high prevalence and concern worldwide, especially among the elderly population. Considering the impact of saliva on the disease development process, protein biomarkers may be potentially useful to monitor the clinical course of the disease.

Methods: This study recorded clinical data and conducted a proteomic analysis of the saliva of eighty elderly individuals (60-84 years). Participants were classified into a no active caries (NC) group and low caries activity (LC) and high caries activity (HC) groups. We hypothesized that the protein profile between the groups would be different and could be used to learn about disease progression and identify potential markers for caries severity in the aged population. All participants had their unstimulated total saliva collected for 5 min. Further correlations were tested to find target proteins strongly linked to clinical variables of caries disease, i.e., the visible dental plaque index, root caries experience, salivary flow, buffering capacity and pH, and percentage of sugar intake. To achieve this, groups with different dental caries statuses were compared.

Results: In total, 1,299 proteins were identified, of which 665 could be quantified in all samples. Of these, 16 proteins had statistically different abundances between the groups with and without dental caries activity (p < 0.05; fold-change [FC] 1.23). Furthermore, 31 proteins differentially regulated in saliva, including 22 downregulated and 9 upregulated proteins, were found in the HC group compared with the LC group (p < 0.05; FC 1.23). When correlated with caries disease-related clinical parameters, 87 candidates were identified and 19 maintained significances from the primary data analysis (p < 0.05). In the gene ontology analysis, most of the regulated proteins were related to innate immunity processes, calcium ions activity, action against bacteria, and cell adhesion.

Conclusion: This study identified potential proteins that may help distinguish different caries activity status on people over 60 years of age. Ultimately, future studies could investigate whether the differential abundance of regulated proteins is a result of the caries process itself or the underlying factors that contribute to its development.

Introduction: This study conducted a molecular dynamics simulation to elucidate the interactions in silico between a sugarcane cystatin (CaneCPI-5) and hydroxyapatite, aiming to deepen the understanding of its potential role in modulating the dental enamel demineralization process.

Methods: The CaneCPI-5 protein structure was modeled using homology with SWISS-MODEL, based on the multicystatin template PDB-ID 4LZI. Molecular dynamics simulations were conducted with the protein positioned randomly in a box containing a hydroxyapatite surface (001 face). Molecular dynamics simulations were then carried out for 500 ns with control of temperature and pressure using the GROMACS package. The free energy of interaction between CaneCPI-5 and the hydroxyapatite surface was calculated using the MM/GBSA method based on trajectory frames.

Results: For several initial orientations, the protein rapidly migrated to anchor to the surface, ensuring minimal distance between its amino acid residues and the surface. Most residues interacting with the surface phosphates were positively charged. Arginine 81, alanine 105 and arginine 107 were found to be key residues. During the simulations, similar values were observed for all orientations in terms of root-mean-square deviation, radius of gyration, and root mean square fluctuation. The free energy calculation showed strong protein-hydroxyapatite interactions, except for one of the initial orientations.

Conclusion: This study demonstrates that CaneCPI-5 has affinity for hydroxyapatite surfaces, with positively charged residues, particularly arginine. The stable binding observed throughout the simulations suggests that this protein may contribute to mechanisms that influence the integrity of dental enamel in demineralizing conditions.

Introduction: Adverse childhood experiences (ACEs) are negative events occurring before age 18 that may impact health. Children exposed to ACEs often receive inadequate preventive care and have a higher prevalence of diseases like dental caries. However, research on this topic remains limited. This study evaluated the association between ACEs and dental caries in adolescents.

Methods: This is a cross-sectional study nested in a cohort performed with a representative sample of preschools from Santa Maria, southern Brazil. This study used data from the last follow-up, with individuals aged between 14 and 18. Data collection was performed through structured questionnaires administered face-to-face and oral clinical examinations. All research team was previously trained and calibrated. Dental caries was measured by International Caries Detection and Assessment System (ICDAS). ACE was evaluated by questions of the Brazilian version of the Adverse Childhood Experiences-International Questionnaire (ACE-IQ), considering alcohol and drug use, suicidal intent, imprisonment, divorce, or death of family members. The co-occurrence of ACEs was also evaluated. Sociodemographic and behavioral variables were used as covariables. Poisson regression models were used to investigate the associations with results present in rate ratio (RR) and 95% confidence interval (CI).

Results: A total of 406 adolescents were examined. The mean of teeth with dental caries was 1.45 (standard deviation 3.6). The rate of dental caries was 56% higher in adolescents who lived with someone who has been sent to prison (RR: 1.56; 95% CI: 1.02-1.90) and 22% higher in adolescents who witnessed their parents' divorce (RR: 1.22; 95% CI: 1.02-1.45) compared to those counterparts. The other ACEs separately were not associated with dental caries. Adolescents exposed to one, two, or more ACEs concomitantly had significantly higher caries rates compared to those with no exposure.

Conclusion: Individuals who witnessed parental divorce or imprisonment exhibited higher rates of dental caries. Moreover, exposure to one, two, or more concurrent ACEs was associated with higher dental caries rates compared to no exposure. These findings underscore the importance of considering specific ACEs within the family environment when assessing their impact on dental caries.

Introduction: Leveraging data from a cohort study of Quebec youth with a family history of obesity, this study aimed to (i) identify neighbourhood socio-environmental typologies in childhood and (ii) estimate their associations with the incidence of dental caries in adolescence.

Methods: We used baseline (2005-2008) and second follow-up (2012-2015) data from the ongoing QUALITY cohort study in Montreal, Canada, which included 512 children aged 8-10 years with ≥1 biological parent with obesity at baseline. Based on prior literature and data availability, we selected three key neighbourhood-level indicators - social disorder, social deprivation, and material deprivation - measured in both school and residential settings. Latent class analysis was used to derive the socio-environmental typologies by combining social disorder, social deprivation, and material deprivation of the social environment in school and residential neighbourhoods. The outcome was dental caries incidence, assessed as the change in the Decayed, Missing, Filled Surface index. Negative binomial regression was performed to estimate incidence ratios (IRs) and corresponding 95% confidence intervals (CIs).

Results: Only three neighbourhood socio-environmental typologies were identified. Type 1 neighbourhoods: high social disorder, high social deprivation, and low material deprivation; type 2 neighbourhoods: median social disorder, median social deprivation, and median material deprivation; type 3 neighbourhoods: low social disorder, low social deprivation, and high material deprivation. Compared to type 1, the IRs (95% CIs) were 0.9 (0.6-1.2) for type 2 and 0.8 (0.6-1.1) for type 3.

Conclusion: Neighbourhoods with lower social disorder and social deprivation may offer a protective effect against dental caries in youth.

Introduction: Dental caries in childhood remains a major global public health issue. In response to persistently high caries levels among children, Chile implemented a national programme (Sembrando Sonrisas) including daily supervised toothbrushing and biannual fluoride varnish applications in nurseries. This study aimed to examine the association between these interventions and caries experience in preschool children, and to assess related socioeconomic inequalities.

Methods: We analysed aggregated municipality-level data (n = 346) on dental caries outcomes in 5-year-olds, coverage of fluoride varnish applications, delivery of toothbrushing materials (toothbrushes and 1,000 ppm fluoride toothpaste), exposure to community water fluoridation (CWF), rurality, and socioeconomic deprivation. The primary outcome was the caries experience of children covered by the programme since its national rollout in 2015. Univariate and multivariate weighted linear regression models assessed associations between programme interventions and caries experience, adjusting for deprivation and CWF. Socioeconomic inequalities in caries experience were evaluated using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII). The distribution of programme delivery across socioeconomic deciles was assessed using weighted regression models.

Results: Data on 309,360 5-year-olds were included. Complete delivery of toothbrushing materials was associated with lower caries experience (50.1% vs. 55.0%), a 4.9% difference (95% CI: 2.5%, 7.2%) after adjustment. CWF exposure was associated with a 7.5% lower caries experience (95% CI: 4.2%, 10.9%). The combination of both interventions showed the lowest caries levels, with a 13.4% difference compared to areas with neither intervention (95% CI: 7.5%, 19.3%). Fluoride varnish application was not significantly associated with caries experience. Delivery of interventions was equitable across socioeconomic groups. However, caries experience was significantly higher in the most deprived municipalities (SII = 14.7%, 95% CI: 11.7%, 17.7%; RII = 0.283, p < 0.001).

Conclusion: Lower caries experience was associated with supervised daily toothbrushing and CWF exposure, but not with fluoride varnish application. Despite equitable programme coverage, substantial socioeconomic inequalities persist. As this ecological study cannot establish causality, further research is needed to evaluate long-term trends and the role of broader determinants in improving child oral health.

Introduction: This study compared the diagnostic accuracy of interproximal caries detection using intraoral bitewing radiographs, assessed by both human operators and an artificial intelligence (AI) program, a near-infrared reflectance imaging (NIRI) system with operator-conducted assessment, and histological evaluation as the reference.

Methods: 100 posterior teeth with or without caries were mounted on 10 typodonts. Initially, 180 surfaces were examined, but eight were excluded for different reasons. Therefore, 171 proximal surfaces were analyzed. NIRI imaging was performed using the iTero Element 5D®, and radiographs were analyzed by operators and an AI program, Denti.AI. Results were compared with histology, assessing sensitivity (Se), specificity (Sp), positive (PPV) and negative (NPV) predictive values, F1-score, areas under receiver operating characteristic curves (AUCs), and the Fleiss Kappa coefficient (k).

Results: The statistical analysis results for each diagnostic test were as follows: examiner radiographic assessment (Se = 52%, Sp = 84.6%, PPV = 71.6%, NPV = 70.3%, F1-score = 60%, AUC = 0.684, k = 0.459); NIRI (Se = 37%, Sp = 98.9%, PPV = 96.4%, NPV = 67.8%, F1-score = 52%, AUC = 0.673, k = 0.475); AI-guided radiographic assessment (Se = 13.7%, Sp = 95.9%, PPV = 71%, NPV = 59.8%, F1-score = 23%, AUC = 0.548). McNemar's test showed a p < 0.05 for all diagnostic tests.

Conclusion: Both the operator-conducted NIRI system and examiner radiographic assessment demonstrated superior detection capabilities compared to the AI program. Among these methods, the examiner radiographic assessment yielded the best results, followed by the NIRI system, demonstrating its potential for clinical use.

Introduction: There is little discussion in the literature on the pathway linking oral health problems and academic performance (AP) in children. This study investigated the hypothesis that the influence of dental caries on academic performance is mediated through toothache and impacted sleep and study activities.

Methods: This cross-sectional study on children aged 12-14 years collected data on the exposure (decayed tooth index), outcome (school examination results), and mediator (school absence due to toothache, and oral health impact on sleep and study performances using the Child-Oral Impact on Daily Performance instrument) variables. It used mediation analysis to examine the indirect effects of a single and two serial mediators using model 4 (caries → mediator → AP) and model 6 (caries → mediator 1 → mediator 2 → AP), respectively, in PROCESS macro add-on software in IBM SPSS v24. Analyses were carried out separately for boys and girls at a 5% significance level.

Results: In model 4, school absence due to toothache (boys: 95% CI: 0.42, 1.01; girls: 95% CI: 0.58, 0.98), and impacted sleep (95% CI: 0.13, 0.41; 95% CI: 2.17, 13.03), and study (95% CI: 0.05, 0.42; 95% CI: 0.54, 0.94) performance were significant single mediators in both sexes. In model 6, school absence due to toothache and impacted sleep activity (boys: 95% CI: 0.02, 0.29 and girls: 95% CI: 1.37, 12.81), and school absence due to toothache and impacted study activity (girls: 95% CI: 1.37, 12.81) were significant two serial-mediators.

Conclusion: This study provides empirical evidence showing that dental caries and toothache can impact academic performance as they disrupt sleep and study performances to influence the learning and cognition process. The finding bridges the understanding of the mechanism underpinning the relationship and thus, further emphasizes the importance of caries prevention in children with high caries risk for improving their health outcomes and educational experience.

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: 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.