Caries Research最新文献

Introduction: The association between breastfeeding status and early childhood caries (ECC) remains inconclusive. Few studies evaluate the breastfeeding status including both duration and exclusivity according to the WHO recommendations on breastfeeding. This study aimed to investigate the association between breastfeeding status and ECC.

Methods: This prospective cohort study comprised 3,666 children whose breastfeeding status was precisely evaluated. Poisson regression models and multivariable linear regression models were employed to analyze the associations of breastfeeding status with risk of ECC, and mean decayed, missing, and filled primary tooth surfaces (dmfs) in 3-year-old children, respectively. The data were collected from 2014 to 2020, and the analysis was conducted in 2023.

Results: The prevalences of ECC in offspring breastfed for <6 months, 6-11 months, 12-24 months, and >24 months were 9%, 12%, 17%, and 23%, respectively. Offspring breastfed for 12-24 months and over 24 months had a 1.82 times (95% CI, 1.40-2.37; p < 0.001) and 2.48 times (95% CI, 1.63-3.75; p < 0.001) higher risk of ECC, compared to those breastfed for less than 6 months. Offspring breastfed for 12-24 months showed a mean dmfs increase of 0.32 (95% CI, 0.21-0.44; p < 0.001), while those breastfed for over 24 months had a mean dmfs increase of 0.51 (95% CI, 0.27-0.74; p < 0.001), compared to those breastfed for less than 6 months. Among offspring breastfed for over 24 months, those exclusively breastfed for at least 6 months had significantly lower mean dmfs compared to those exclusively breastfed for less than 6 months (p for heterogeneity = 0.003). A significant interaction was observed between breastfeeding duration and exclusive breastfeeding duration on the association with mean dmfs (p for interaction <0.001).

Conclusion: Our findings suggest that breastfeeding for over 12 months was associated with increased risk of ECC. Preventive interventions for dental caries should be implemented as early as possible, as breastfeeding is beneficial to children's health. The associations between breastfeeding duration and exclusivity with ECC should be investigated more thoroughly, particularly with adjustments for accurately measured sugar consumption.

Introduction: This study aimed to investigate the effectiveness of a nutritional counseling program for mothers of newborns to prevent sugar consumption in the first year of life on the occurrence of early childhood caries (ECC).

Methods: A multicentric randomized clinical trial (ClinicalTrials.gov - NCT03841123) was conducted in three state capitals of Brazil (n = 516). Mothers were randomly assigned to the intervention group (IG) or control group (CG) after delivery. The IG received face-to-face nutritional counseling based on UNICEF dietary guidelines after delivery, followed by monthly phone calls. The CG received standard counseling. Dietary intake was measured through structured questionnaires and 24-h recalls at 6 and 12 months. Dental clinical examination for ECC diagnosis was performed by calibrated dentists after the children completed the first year of life.

Results: The prevalence of ECC was 17.4% in the overall sample (49/290). The number of affected teeth ranged from 0 to 6 (mean 0.43). The IG had a 2.4 times probability of not consuming sugar in the first 6 months of life (RR 2.44; 95% CI: 1.18-5.00) and a significantly lower mean number of sweet items consumed at 12 months (p = 0.016). However, no significant differences between groups were found with regard to the occurrence of ECC (RR 1.33; 95% CI: 0.79-2.25) or the number of teeth affected by caries (p = 0.273).

Conclusion: The intervention to prevent and reduce sugar intake in the first year of life was not effective at reducing the occurrence of ECC or the number of teeth with carious lesions.

Introduction: Caries is the most widespread noncommunicable disease (NCD) globally and can predict fatality NCDs in the future, such as diabetes and cardiovascular diseases. Therefore, we hypothesized that the behavioral risk factors for those NCDs may be present in adolescents with caries. The objective was analyzing the association of unhealthy diet, tabagism, and alcohol with caries in adolescents.

Methods: This population-based study with a cross-sectional design used data from 2,515 adolescents aged 18-19 years, born in São Luís-MA, Brazil, and part of the RPS Cohort Consortium. The exposures were the latent variables of the unhealthy diet pattern (sugars, fast foods, and salty snacks) and addictive behaviors (tabagism and risk of alcohol dependence). The outcome was the number of decayed teeth. The model adjustment considered the socioeconomic status (head of household education, adolescent education, economic class, and monthly family income) as a distal determinant and the oral biofilm as a mediator between the exposures and the outcome, analyzed by structural equation modeling, using the Mplus 8.0 software.

Results: Unhealthy diet pattern was associated with a higher number of decayed teeth directly (SC = 0.092, p ≤ 0.001) and indirectly via dental biofilm (SC = 0.020, p ≤ 0.001). Addictive behaviors were associated with a higher number of decayed teeth indirectly via dental biofilm (SC = 0.019, p = 0.013). The unhealthy diet pattern and addictive behaviors were associated with each other (CP = 0.199, p < 0.001).

Conclusion: Besides sugars, other behavioral risk factors for NCDs underlie caries, emphasizing the importance of comprehensive adolescent health care.

Introduction: Finnish conscripts have proven to be an excellent study group for epidemiological research in oral health in recent decades. The aim of this cross-sectional study was to determine the geographical distribution of dental caries prevalence in young healthy males in Finland at the beginning of the 2020s. Associated dental caries risk factors were of interest as well.

Methods: The data were randomly collected from the eight biggest garrisons in Finland in July of 2021 by ten calibrated dentists. The study population consisted of 2077 male conscripts born between 2000 and 2002. Dental caries was recorded according to the ICDAS system. Wisdom teeth were excluded. Mean DMFT and mean DT values were calculated, and geomaps were constructed to visualize the geographical distribution. Generalized linear mixed models with logit link were conducted for the associated risk factors.

Results: The mean DMFT value of all conscripts was 3.29 (SD 3.91), while the mean DT value was 1.19 (SD 2.33). Living in areas with endemic fluoride levels in drinking water ≥0.3 mg/L decreased the odds for restorative treatment need.

Conclusion: While geographical distribution of dental caries prevalence has remained nearly the same as before, the overall restorative treatment need and treatment history have decreased countrywide.

Introduction: To prevent caries with targeted strategies and to act conservatively, it is essential oral healthcare providers perform an individual caries risk assessment (CRA). This study aimed to explore knowledge and application regarding CRA by Dutch fifth-year dental students (D5DSs) and practitioners (DDPs).

Methods: A survey was conducted through a questionnaire sent at random to a group of 1,500 members of the Royal Dutch Dental Association (KNMT) and to 213 D5DSs from all three dental schools in the Netherlands.

Results: Of the 374 DDP respondents (25%), 79% reported to perform CRA in routine practice. Female dentists reported using CRA in their daily practice more often than males (p = 0.008). The questionnaire was completed by 118 D5DSs (55%). All D5DS respondents reported using CRA and most students were familiar with Dutch prevention-oriented methods. Eighteen percent of them did not make an individual treatment plan based on caries risk. The familiarity of DDPs regarding Dutch prevention-oriented methods was lower than that of students (p < 0.001). In both groups of respondents, oral hygiene and diet were the two most important factors considered when assessing caries risk in patients, whatever their age.

Conclusion: CRA is applied less frequently in the general practice compared to student clinics at university. Our results suggest that dentists in the Netherlands could improve their knowledge about cariology by continuing education. Dental schools should emphasize implementation of the knowledge in clinical practice. In addition, a uniform and evidence-based method to perform CRA in the dental practice is needed.

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: Despite the notable progress in developing artificial intelligence-based tools for caries detection in bitewings, limited research has addressed the detection and staging of secondary caries. Therefore, we aimed to develop a convolutional neural network (CNN)-based algorithm for these purposes using a novel approach for determining lesion severity.

Methods: We used a dataset from a Dutch dental practice-based research network containing 2,612 restored teeth in 413 bitewings from 383 patients aged 15-88 years and trained the Mask R-CNN architecture with a Swin Transformer backbone. Two-stage training fine-tuned caries detection accuracy and severity assessment. Annotations of caries around restorations were made by two evaluators and checked by two other experts. Aggregated accuracy metrics (mean ± standard deviation - SD) in detecting teeth with secondary caries were calculated considering two thresholds: detecting all lesions and dentine lesions. The correlation between the lesion severity scores obtained with the algorithm and the annotators' consensus was determined using the Pearson correlation coefficient and Bland-Altman plots.

Results: Our refined algorithm showed high specificity in detecting all lesions (0.966 ± 0.025) and dentine lesions (0.964 ± 0.019). Sensitivity values were lower: 0.737 ± 0.079 for all lesions and 0.808 ± 0.083 for dentine lesions. The areas under ROC curves (SD) were 0.940 (0.025) for all lesions and 0.946 (0.023) for dentine lesions. The correlation coefficient for severity scores was 0.802.

Conclusion: We developed an improved algorithm to support clinicians in detecting and staging secondary caries in bitewing, incorporating an innovative approach for annotation, considering the lesion severity as a continuous outcome.

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: 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.