Caries Research最新文献

Background: Developmental defects of enamel (DDE) are a result of disturbances during formation and maturation of the enamel. Evaluating the most-cited DDE papers can provide important tools that point to the gaps and strengths of this important topic in dentistry.

Summary: This bibliometric study analyzed the 100 most-cited papers on DDE. Using a combined keyword search strategy, the 100 most-cited papers were selected in the Web of Science Core Collection. Papers that addressed any type of DDE were included. The extracted data were title, number of citations, study theme, authorship, journal, type of DDE, type of dentition (primary or permanent), type of diagnosis, study design, year, and country of publication. The bibliometric networks were generated through VOSviewer software. The 100 papers had a range from 78 to 459 citations. The main themes of studies were etiopathogenesis (53%), prevalence and incidence (22%), and diagnosis (8%). The authors with the highest number of citations were Goodman AH and Rose JC (459 citations). Most articles were published in dental journals (47%). The most studied types of DDE were fluorosis and amelogenesis imperfecta in the permanent dentition (47%). Observational (24%) and non-systematic reviews (24%) were the most common study designs and ranged from 1977 to 2019. The country with the highest number of publications was the USA (41%).

Key messages: Most of the top 100 DDE papers were about fluorosis and amelogenesis imperfecta, with top papers from three continents with English as the native language. This topic is of great importance in dentistry, and the need for further studies is highlighted, especially regarding the diagnosis and treatment of some DDEs.

Introduction: This research aimed to assess the association of root biofilm bacteriome with root caries lesion severity and activity in institutionalised Colombian elderlies and was conducted to gather data on the root caries bacteriome in this population.

Methods: A bacteriome evaluation of biofilm samples from sound and carious root surfaces was performed. Root caries was categorised (ICDAS Root criteria) based on severity (sound surfaces, initial: non-cavitated, moderate/extensive combined: cavitated) and activity status (active and inactive). DNA was extracted and the V4 region of the 16S rRNA gene was sequenced; afterwards the classification of features was conducted employing amplicon sequence variants and taxonomic assignment via the Human Oral Microbiome Database (HOMD). Bacterial richness, diversity (Simpson's and Shannon's indices), and relative abundance estimation were assessed and compared based on root caries severity and activity status (including Sound surfaces).

Results: A total of 130 biofilm samples were examined: sound (n = 45) and with root caries lesions (n = 85; by severity: initial: n = 41; moderate/extensive: n = 44; by activity: active: n = 60; inactive: n = 25). Species richness was significantly lower in biofilms from moderate/extensive and active groups compared to sound sites. There was a higher relative abundance of species like Lechtotricia wadei, Capnocytophaga granulosa, Cardiobacterium valvarum, Porphyromonas pasteri - in sound sites; Dialister invisus, Streptococcus mutans, Pseudoramibacter alactolyticus and Bacteroidetes (G-5) bacterium 511 - in moderate/extensive lesions, and Fusobacterium nucleatum subsp. animalis, Prevotella denticola, Lactobacillus fermentum, Saccharibacteria (TM7) (G-5)bacterium HMT 356 - in active lesions.

Conclusion: Root caries bacteriome exhibited differences in species proportions between the compared groups. Specifically, cavitated caries lesions and active caries lesions showed higher relative abundance of acidogenic bacteria.

Introduction: This study investigated the changes in the acquired enamel pellicle (AEP) proteome when this integument is formed in vivo after treatment with sugarcane-derived cystatin (CaneCPI-5), hemoglobin (HB), and a statherin-derived peptide (StN15), or their combination and then exposed to an intrinsic acid challenge. The effectiveness of these treatments in preventing intrinsic erosion was also evaluated.

Methods: Ten volunteers, after prophylaxis, in 5 crossover phases, rinsed with the following solutions (10 mL, 1 min): control (deionized water-H2O) - group 1, 0.1 mg/mL CaneCPI-5 - group 2, 1.0 mg/mL HB - group 3, 1.88 × 10-5M StN15 - group 4, or a blend of these - group 5. Following this, AEP formation occurred (2 h) and an enamel biopsy (10 µL, 0.01 m HCl, pH 2.0, 10 s) was conducted on one incisor. The biopsy acid was then analyzed for calcium (Arsenazo method). The vestibular surfaces of the other teeth were treated with the same acid. Acid-resistant proteins in the residual AEP were then collected and analyzed quantitatively via proteomics.

Results: Compared to control, treatment with the proteins/peptide, mixed or isolated, markedly enhanced acid-resistant proteins in the AEP. Notable increases occurred in pyruvate kinase PKM (11-fold, CaneCPI-5), immunoglobulins and submaxillary gland androgen-regulated protein 3B (4-fold, StN15), Hb, and lysozyme C (2-fold, StN15). Additionally, a range of proteins not commonly identified in the AEP but known to bind calcium or other proteins were identified in groups treated with the tested proteins/peptide either in isolation or as a mixture. The mean (SD, mM) calcium concentrations released from enamel were 3.67 ± 1.48a, 3.11 ± 0.72a, 1.94 ± 0.57b, 2.37 ± 0.90a, and 2.38 ± 0.45a for groups 1-5, respectively (RM-ANOVA/Tukey, p < 0.05).

Conclusions: Our findings demonstrate that all treatments, whether using a combination of proteins/peptides or in isolation, enhanced acid-resistant proteins in the AEP. However, only HB showed effectiveness in protecting against intrinsic erosive demineralization. These results pave the way for innovative preventive methods against intrinsic erosion, using "acquired pellicle engineering" techniques.

Introduction: Visual imaging of subsurface caries lesions is of vital interest in dentistry, which can be obtained by invasive radiography technique as well as by available non-destructive imaging approaches. Thus, as a first step toward the development of a new innovative approach, Spectral-domain optical coherence tomography (SD-OCT) was applied to detect the lesion depth in comparison to the established reference technique (transverse microradiography [TMR]).

Methods: Bovine enamel specimens were demineralized for 5 days, following previous studies. For OCT, the resulting artificial lesions were scanned three-dimensionally (SD-OCT) and semi-automated measured (CarLQuant). For TMR, specimens were sectioned and the lesion depth was manually determined (Inspektor Research System).

Results: The range of lesion depth detected with OCT was 24.0-174.0 μm (mouth rinse study), 18.0-178.0 μm (toothpastes study) and with TMR 59.2-198.0 μm (mouth rinse study), 33.2-133.4 μm (toothpastes study). We found a strong correlation between both methods in terms of lesion depth (Spearman rankwith outlierp < 0.001, Rho = 0.75, Spearman rankwithout outlierp = 0.001, Rho = 0.79). The two methods produce similar results (Passing-Bablok regression, 1.16). As deeper is the lesion, the smallest is the difference between both methods as indicated by Bland-Altman-plots.

Conclusion: Especially in the case of deep lesions, the values obtained by both methods are in agreement, and OCT can potentially substitute TMR to detect and assess lesion depth with the benefit of being non-destructive.

Introduction: The identification of salivary molecules that can be associated to dental caries could provide insights about caries risk and offer valuable information to develop caries prediction models. However, the search for a universal caries biomarker has proven elusive due to the multifactorial nature of this oral disease. We have therefore performed a systematic effort to identify caries-associated metabolites and proteins in saliva samples from adolescents that had a caries experience and those that were caries-free.

Methods: Quantification of approximately 100 molecules was performed by the use of a wide range of techniques, ranging from nuclear magnetic resonance metabolomics to ELISA, Luminex or colorimetric assays, as well as clinical features like plaque accumulation and gingival index. In addition, simplified dietary and oral hygiene habits questionnaires were also obtained.

Results: The caries-free group had significantly lower consumption of sweetened beverages and higher tooth brushing frequency. Surprisingly, very few compounds were found to individually provide discriminatory power between caries-experienced and caries-free individuals. The data analysis revealed several potential reasons that could underly this lack of association value with caries, including differences in metabolite concentrations throughout the day, a lack of correlation between metabolite concentrations in plaque and saliva, or sex-related differences, among others. However, when multiple compounds were combined by multivariate analysis and random forest modeling, a combination of 3-5 compounds were found to provide good prediction models for morning (with an AUC accuracy of 0.87) and especially afternoon samples (AUC = 0.93).

Conclusion: While few salivary biomarkers could differentiate between caries-free and caries-experienced adolescents, a combination of markers proved effective, particularly in afternoon samples. To predict caries risk, these biomarkers should be validated in larger cohorts and longitudinal settings, considering factors such as gender differences, and variations in oral hygiene and diet.

Red-fluorescing dentine indicates bacterial contamination [Caries Res 2002; 36: 315-319]. We investigated effect of removal of red fluorescent dentine caries on shear bond strength and fracture mode of 4 adhesive approaches. Sixty-five carious teeth and 50 noncarious controls were distributed into 4 groups: Clearfil™ self-etch (CSE), OptiBond™ FL total etch (OTE), Scotchbond™ Universal total etch (STE) and self-etch (SSE). Samples were excited at 405 nm and viewed through 530 nm filter. Carious samples were ground flat exposing strongly red-fluorescing (StrongRF) dentine, on which a composite cylinder was placed, using one of 4 adhesives. After 22 h in water, shear bond strength and fracture mode were analysed. StrongRF was removed; composite cylinders were placed on weakly red-fluorescing (WeakRF) dentine and tested as described above. Finally, red-fluorescing dentine was removed, and composite cylinders were placed on non-fluorescing (NonRF) dentine and tested. Composites were placed at 3 corresponding heights in controls. After 22 h in water, shear bond strength testing and fracture mode analysis were performed. Differences were tested using Mann-Whitney or Wilcoxon tests (p ≤0.05). Median (Q1, Q3) shear bond strength on StrongRF was SSE 14.4 (9.2, 18.2) MPa >CSE 10.2 (6.4, 17.3) MPa >STE 9.1 (6.9, 11.2) MPa >OTE 6.8 (4.0, 10.8) MPa. Shear bond strength increased statistically significantly for all adhesives on WeakRF: SSE 19.8 (13.6, 24.3) MPa >STE 19.5 (12.7, 23.1) MPa >CSE 17.5 (12.0, 22.5) MPa >OTE 15.8 (11.9, 20.9) MPa. Only STE 25.6 (22.4, 29.1) MPa and CSE 22.1 (17.6, 24.6) MPa were significantly different on NonRF compared to WeakRF. For controls tested at corresponding depths, superficial shear bond strength was OTE 18.7 (16.0, 22.1) MPa >STE 18.4 (12.0, 25.9) MPa >CSE 18.1 (12.7, 20.7) MPa >SSE 13.0 (9.6, 17.8) MPa. This was significantly higher compared to StrongRF except for SSE. Central shear bond strength was not significantly different to WeakRF, deep shear bond strength was significantly lower for SSE and CSE but higher for OTE compared to carious. Conclusion: StrongRF dentine should be removed for higher shear bond strength, but WeakRF dentine can often be preserved without compromising adhesive bond strength.

Introduction: The Core Curriculum in Cariology (CCC) was developed by ORCA and ADEE in 2010. This article summarizes challenges for the implementation of the CCC at university/country level identified at the "Education Platform" of the ORCA 2022 conference in Cagliari, Sardinia.

Methods: Participants from universities from 3 European (Italy, Poland, and UK), 2 Asian (India and Russia), and 3 American countries (Brazil, Colombia, and USA) led the presentations, discussion, and generation of statements. Presentations were transcribed and summarized through qualitative content analysis. Key themes were identified, transformed into key topics, and sent to the panel for agreement.

Results: Regardless of the wide variety of dental schools per country, from few (Poland n = 10) to many (India n = 318, Brazil n = 563) or from country/continent itself, frequent challenges to CCC implementation were highlighted. These included lack of agreement on a basic CCC as standard (96%), insufficient support or reimbursement for caries prevention and management (90%), separation between cariology and restorative dentistry (68%), focus on restorative/surgical management with prevention and nonoperative management being disconnected (73%). The group agreed that the integration of cariology and restorative dentistry remains essential to enhancing evidence-based decision-making, resulting in a shift of emphasis from cure to care.

Conclusion: There is variation in the level of implementation of the CCC. A frequent challenge is the disconnect between cariology and restorative dentistry. The CCC should be disseminated and promoted as a uniform blueprint/framework to facilitate the implementation of a common cariology curriculum among universities within each country, as well as internationally.

Introduction: This study aimed to determine the association between residing in municipalities with armed conflict and dental caries among adults in Colombia.

Methods: Data from 9,194 individuals aged 18-79 years, who participated in the Fourth National Oral Health Survey in 2014, were linked with information on the presence and intensity of the armed conflict experienced in their municipality of residence between 2000 and 2012 (extracted from the Resource Centre for Conflicts Analysis). Dental caries was determined through clinical examinations and summarised using the numbers of decayed teeth (DT), decayed and filled teeth (DFT), and decayed, missing, and filled teeth (DMFT). Two-level negative binomial regression models were fitted, with adults nested within municipalities, to test the association between armed conflict indicators and caries outcomes after adjustment for covariates.

Results: The mean DT, DFT, and DMFT scores were 1.75 (SD = 2.36), 6.03 (SD = 4.53), and 10.27 (SD = 7.11), respectively. Of the 197 municipalities included in the analysis, 12.2% experienced conflict permanently and 18.3% experienced high-intensity conflict. In crude analysis, adults living in municipalities with more presence and intensity of armed conflict had lower DT and DMFT, but not DFT scores. After adjustment for covariates, only the (high) intensity of conflict was associated with lower DT (rate ratio: 0.64; 95% confidence interval [CI]: 0.47-0.87), DFT (RR: 0.82; 95% CI: 0.71-0.95), and DMFT scores (RR: 0.81; 95% CI: 0.74-0.89).

Conclusions: This study found that Colombian adults residing in municipalities with high intensity of conflict had lower levels of untreated disease and caries experience.

Introduction: The aim was to assess the effectiveness of a distributed, targeted toothbrush and toothpaste programme on referrals for tooth extraction under Dental General Anaesthetic (DGA), in children of high-risk families compared to usual care.

Methods: A recruiter and assessor-blinded, clustered parallel randomised control trial (RCT). Families with one or more children aged between 3 and 10 years having undergone a DGA operation for extraction of carious teeth, were approached within hospitals in the North West of England. Families were randomised at the cluster level in a 1:1 ratio. All eligible children within the family consented to the study. The primary outcome was participant referral for a DGA 6-24-month post-randomisation.

Results: A total of 961 families (1,671 children) were randomised, 482 families (832 children) to the intervention, and 479 families (839 children) to the control group. Families (1,662 children, 955 families) were included in the final analysis (825 intervention, 837 control). Marginal regression models (generalised estimating equation approach) taking into account cluster membership were used to model the effectiveness of the intervention at 24 and 48 month follow-up, including the variables, age, sex, and IMD quintile. Seventy-six children (9.2%) in the intervention group had a DGA referral within 2 years compared to 57 children (6.8%) in the control group. The study found no effect of a clinically meaningful difference between the intervention group and usual care (risk ratio 1.36, 95% CI: 0.98-1.89) in reducing referral for DGA for a targeted postal toothpaste/toothbrush program in a contemporary, population with previous family experience of DGA residing in an area of high deprivation.

Conclusion: The target of the intervention (families of children with a DGA) was the correct focus given the referrals observed over 2 and 4 years. The study can aid policymakers, local authorities and commissioners to understand repeat DGA within families and further need for intervention.