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Contemporary Clinical Dentistry 2019Pit and fissure sealants (PFSs) are the most effective preventive materials in dentistry. Secondary caries around the sealed pits and fissures at the material-tooth...
CONTEXT
Pit and fissure sealants (PFSs) are the most effective preventive materials in dentistry. Secondary caries around the sealed pits and fissures at the material-tooth interface and the wear of the material remains the common problems. To address these problems, efforts have been made by incorporating zinc oxide (ZnO) and calcium fluoride (CaF) nanoparticles (NPs) into the sealants to develop caries-inhibiting and stress-bearing sealants.
AIM
Evaluation of antibacterial and mechanical properties of PFS containing ZnO and CaF NPs.
SETTINGS AND DESIGN
This was an study.
MATERIALS AND METHODS
A total of 196 fissure sealant samples were divided into six test groups and a control group. The test group samples were prepared by incorporating two concentrations (0.5 wt% and 1 wt%) of ZnO and CaF NPs into the sealants. The antibacterial activity was evaluated by direct contact test; compressive and flexural strengths were evaluated by a universal testing machine.
STATISTICAL ANALYSIS USED
Statistical analysis was done by one-way ANOVA and Tukey test.
RESULTS
Sealants containing 1 wt% ZnO and CaF NPs and their mixture exhibited significantly higher antibacterial activity against and when compared to control group ( < 0.001). Samples with ZnO NPs exhibited similar mechanical properties as conventional sealant (control group); however, the samples with CaF NPs showed inferior mechanical properties ( < 0.05).
CONCLUSION
The observations of the study infer that sealants containing 1 wt% ZnO and CaF NPs and their mixture exhibited superior antibacterial activity. The mechanical properties of samples containing ZnO and mixture of ZnO and CaF particles remained comparable to the conventional sealants.
PubMed: 32308323
DOI: 10.4103/ccd.ccd_805_18 -
Journal of Dental Research Feb 2018
Topics: Biofilms; Biomimetic Materials; Cariostatic Agents; Clinical Trials as Topic; Congresses as Topic; Dental Caries; Dental Research; Fluorides, Topical; Forecasting; Humans; Pit and Fissure Sealants; Tooth Remineralization
PubMed: 29355470
DOI: 10.1177/0022034517746371 -
Journal of the American Dental... Aug 2016
Topics: Dental Caries; Dental Devices, Home Care; Humans; Pit and Fissure Sealants; Toothbrushing
PubMed: 27470528
DOI: 10.1016/j.adaj.2016.05.007 -
Evidence-based Dentistry Jun 2022Data sources Four electronic databases, including Cochrane Oral Health's Trial Register, Cochrane CENTRAL, Medline and Embase were searched for finding the relevant... (Review)
Review
Data sources Four electronic databases, including Cochrane Oral Health's Trial Register, Cochrane CENTRAL, Medline and Embase were searched for finding the relevant literature. Two trial registries and references of the included papers were also searched.Study selection Both parallel-group and split-mouth randomised control trials were included. These involved comparison of different types of dental sealants or their comparison with a placebo/no sealant. There was no restriction regarding language or publication date.Data extraction and synthesis Two authors independently extracted the data from the selected papers which included study characteristics, details about participants, intervention, control, outcomes etc. Owing to inherent heterogeneity and inability to pool up the data, meta-analysis was not carried out and the results were summarised using narrative synthesis.Results A total of nine studies were included. Irrespective of the type of sealants, all the included studies have depicted the direction of the effect favouring the sealant use but the evidence is very low. Individual studies that compared sealants with placebo exhibited better performance by glass ionomer cement-based sealants (Odds ratio [OR] = 0.033; 95% confidence interval [CI] = 0.007-0.149) than resin-based sealants (OR = 0.76; 95% CI = 0.41-1.42).Conclusions Low quality evidence was found regarding the effectiveness of sealants for prevention of caries in primary molars.
Topics: Dental Caries; Dental Caries Susceptibility; Dentition, Permanent; Humans; Molar; Pit and Fissure Sealants
PubMed: 35750728
DOI: 10.1038/s41432-022-0262-y -
Caries Research 2016The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most... (Review)
Review
The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most up-to-date knowledge and evidence of the biological principles guiding diagnosis, risk assessment, and management of the caries process on occlusal surfaces. In addition, it considers the whole spectrum of the caries process on occlusal surfaces, ranging from the molecular ecology of occlusal biofilms to the management of deep occlusal caries lesions. Studies using molecular methods with focus on biofilms in relation to occlusal caries should explore the relationship between the function and the structural composition of these biofilms to understand the role of occlusal biofilms in caries development. State-of-the-art measures to evaluate risk for occlusal caries lesion activity, caries incidence, and progression should include the assessment of the occlusal biofilm and the stage of tooth eruption. Careful clinical examination of non-cavitated lesions, including assessment of the lesion activity status, remains the major tool to determine the immediate treatment need and to follow on the non-operative treatment outcome. Even medium occlusal caries lesions in the permanent dentition may be treated by non-invasive fissure sealing. By extending the criteria for non-invasive treatments, traditional restoration of occlusal surfaces can be postponed or even avoided, and the dental health in children and adolescents can be improved. Selective removal (incomplete) to soft dentin in deep carious lesions has greater success rates than stepwise excavation. Selective (complete) removal to firm dentin has a lower success rate due to increased pulp exposure.
Topics: Biofilms; Dental Caries; Dental Occlusion; Dental Plaque; Dental Pulp; Dentition, Permanent; Denture, Partial, Removable; Disease Progression; Humans; Incidence; Pit and Fissure Sealants; Risk Factors; Tooth Eruption
PubMed: 27658123
DOI: 10.1159/000448662 -
The Cochrane Database of Systematic... Aug 2014Poor or inequitable access to oral health care is commonly reported in high-, middle- and low-income countries. Although the severity of these problems varies, a lack of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Poor or inequitable access to oral health care is commonly reported in high-, middle- and low-income countries. Although the severity of these problems varies, a lack of supply of dentists and their uneven distribution are important factors. Delegating care to dental auxiliaries could ease this problem, extend services to where they are unavailable and liberate time for dentists to do more complex work. Before such an approach can be advocated, it is important to know the relative effectiveness of dental auxiliaries and dentists.
OBJECTIVES
To assess the effectiveness, costs and cost effectiveness of dental auxiliaries in providing care traditionally provided by dentists.
SEARCH METHODS
We searched the following electronic databases from their inception dates up to November 2013: the Cochrane Effective Practice and Organisation of Care (EPOC) Group's Specialised Register; Cochrane Oral Health Group's Specialised Register; the Cochrane Central Register of Controlled Trials (Issue 11, 2013); MEDLINE; EMBASE; CINAHL; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effectiveness; five other databases and two trial registries. We also undertook a grey literature search and searched the reference list of included studies and contacted authors of relevant papers.
SELECTION CRITERIA
We included randomised controlled trials (RCTs), non-randomised controlled clinical trials (NRCTs), interrupted time series (ITSs) and controlled before and after studies (CBAs) evaluating the effectiveness of dental auxiliaries compared with dentists in undertaking clinical tasks traditionally performed by a dentist.
DATA COLLECTION AND ANALYSIS
Three review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study and two review authors assessed the quality of the evidence from the included studies, according to The Cochrane Collaboration's procedures. Since meta-analysis was not possible, we gave a narrative description of the results.
MAIN RESULTS
We identified five studies (one cluster RCT, three RCTs and one NRCT), evaluating the effectiveness of dental auxiliaries compared with dentists in providing dental care traditionally provided by dentists, eligible for inclusion in this review. The included studies, which involved 13 dental auxiliaries, six dentists, and more than 1156 participants, evaluated two clinical tasks/techniques: placement of preventive resin fissure sealants and the atraumatic restorative technique (ART). Two studies were conducted in the US, and one each in Canada, Gambia and Singapore.Of the four studies evaluating effectiveness in placing preventive resin fissure sealants, three found no evidence of a difference in retention rates of those placed by dental auxiliaries and dentists over a range of follow-up periods (six to 24 months). One study found that fissure sealants placed by a dental auxiliary had lower retention rates than one placed by a dentist after 48 months (9.0% with auxiliary versus 29.1% with dentist). The same study reported that the net reduction after 48 months in the number teeth exhibiting caries (dental decay) was lower for teeth treated by the dental auxiliary than the dentist (3 with auxiliary versus 60 with dentist, P value < 0.001).One study showed no evidence of a difference in dental decay after treatment with fissure sealants between groups. The one study comparing the effectiveness of dental auxiliaries and dentists in performing ART reported no difference in survival rates of the restorations (fillings) after 12 months.All studies were at high risk of bias and the overall quality of the evidence was very low, as assessed using the GRADE approach. In addition, four of the included studies were more than 20 years old; the materials used and the techniques assessed were out of date. We found no eligible studies comparing the effectiveness of dental auxiliaries and dentists in the diagnosis of oral diseases and conditions, in delivering oral health education and other aspects of health promotion, or studies assessing participants' perspectives including the acceptability of care received. None of the included studies reported adverse effects. In addition, we found no studies comparing the costs and cost-effectiveness of dental auxiliaries and dentists, their impact on access and equity of access to care that met the pre-specified inclusion criteria.
AUTHORS' CONCLUSIONS
We only identified five studies for inclusion in this review, all of which were at high risk of bias and four were published more than 20 years ago, highlighting the paucity of high-quality evaluations of the relative effectiveness, cost-effectiveness and safety of dental auxiliaries compared with dentists in performing clinical tasks. No firm conclusions could be drawn from the present review about the relative effectiveness of dental auxiliaries and dentists.
Topics: Dental Atraumatic Restorative Treatment; Dental Auxiliaries; Dental Care; Dental Caries; Dental Restoration Failure; Dentists; Humans; Pit and Fissure Sealants; Randomized Controlled Trials as Topic; Time Factors; Treatment Outcome
PubMed: 25140869
DOI: 10.1002/14651858.CD010076.pub2 -
Operative Dentistry Jul 2022The aim of the present in vitro study was to examine the caries-inhibiting effect of a pit and fissure sealant (PFS) containing ion-releasing microcapsules under...
OBJECTIVE
The aim of the present in vitro study was to examine the caries-inhibiting effect of a pit and fissure sealant (PFS) containing ion-releasing microcapsules under cariogenic conditions in a biofilm artificial mouth.
METHODS AND MATERIALS
Forty-eight human third molars were divided into four groups (n=12 per group). Fissures were extended with burs and sealed with experimental PFS. The four groups of specimens were treated as follows: 1) EPFS 1: EPFS (Premier Dental) of increasing viscosity, containing microcapsules loaded with remineralizing agents (calcium, phosphate, and fluoride ions); 2) US: fluoride-releasing PFS (UltraSeal XT plus, UltraDent Products, South Jordan, UT, USA); 3) EPFS 2: experimental PFS of constant viscosity containing microcapsules loaded with calcium, phosphate, and fluoride ions; and 4) FT: glass ionomer cement (GIC) (GC Fuji Triage CAPSULE WHITE glass ionomer cement, GC Europe NV, Leuven, Belgium). FT and US were used as control groups. EPFS 1 and EPFS 2 were the experimental groups. Specimens were stored in distilled water for 14 days at 37°C, subjected to 10,000 thermocycles (5°C and 55°C) and finally exposed to microbiological cycling in a Streptococcus mutans-based artificial mouth for 10 days. Replicas were made for scanning electron microscopic (SEM) evaluation and specimens were cut for fluorescence microscopy.
RESULTS
Overall demineralization depths at the margin of Fuji Triage were significantly shallower than in the other groups (p<0.05). Overall demineralization depths adjacent to the experimental pit and fissure sealant EPFS 2 (59±15 μm) were comparable to the values of the resin-based pit and fissure sealant UltraSeal XT plus (58±10 μm, p≥0.05). SEM revealed surface roughness of the GIC-based PFS.
CONCLUSIONS
The experimental PFS with microcapsules containing active components for remineralization did not show a caries-inhibiting effect compared to a fluoride-releasing resin-based PFS. Lower demineralization depths adjacent to GIC sealants indicate an anticariogenic effect through fluoride ion release.
Topics: Calcium; Capsules; Cariostatic Agents; Dental Caries; Dental Caries Susceptibility; Fluorides; Glass Ionomer Cements; Humans; Phosphates; Pit and Fissure Sealants
PubMed: 35917241
DOI: 10.2341/20-048-L -
Dental Materials Journal Sep 2017This study assessed the effect of bur or Er:YAG laser preparation on marginal and internal adaptation of conventional and extended fissure sealing (FS) with a...
This study assessed the effect of bur or Er:YAG laser preparation on marginal and internal adaptation of conventional and extended fissure sealing (FS) with a 3-component etch-and-rinse (Optibond FL; OFL) and a 1-component self-etch (Scotchbond Universal; SB) adhesive system. Scanning electron microscope analysis was performed before and after thermocycling/occlusal load and additional optical coherence tomography evaluation was carried out for internal marginal assessment. Significant differences were observed between the groups (ANOVA, p<0.05). Laser-prepared and non-etched FS suffered from marginal degradation after fatigue. When enamel was etched with HPO and independently of the adhesive system, laser technique was equally effective to bur-preparation with percentages of continuous margins ranging from 96 to 99%, being laser less invasive than bur preparation. This is clinically relevant in paediatric dentistry as minimally invasive FS can be performed with laser and adhesive systems used as fissure sealants. Nevertheless, enamel etch with phosphoric acid is still necessary.
Topics: Acid Etching, Dental; Composite Resins; Dental Bonding; Dental Cavity Preparation; Dental Enamel; Dentin-Bonding Agents; Humans
PubMed: 28835596
DOI: 10.4012/dmj.2016-025 -
BMC Oral Health Oct 2023Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue... (Review)
Review
BACKGROUND
Tooth decay is an infectious disease which, in its initial phase, leads to the formation of cavities in the teeth through decalcification of the enamel and local tissue destruction. In addition to proper oral hygiene, prophylactic sealing of fissures and cavities with a sealant is a method of preventing the development of caries. The aim of this study is to summarise the effectiveness of fissure sealing of permanent teeth with fissure sealants compared to other preventive methods or no intervention.
METHOD
An umbrella review was carried out to achieve the purpose of our study. Searches were performed in Medline (via PubMed), Embase (via OVID), and Cochrane Library databases. Quality assessment of the included studies was performed using the AMSTAR2 tool. In addition, a manual search for recommendations/clinical practice guidelines on dental prophylaxis was performed.
RESULTS
204 publications were identified, of which 15 met the inclusion criteria. Based on the results of 3 systematic reviews, there was a statistically significant reduced odds of caries occurrence or development with prophylactic sealing of permanent teeth compared with no intervention - depending on the review and follow-up period odds ratio (OR) ranged from 0.06 [95%CI: (0.01-0.32)] to 0.28 [95%CI: (0.20-0.38)]. In the eight systematic reviews that analysed different sealants, there were no statistically significant differences between the types of materials used for prophylactic tooth sealing. For systematic reviews comparing the efficacy of fissure sealants with fluoride varnish, three reported no statistically significant difference in the efficacy of caries incidence, with only one systematic review based on 1 RCT finding a statistically significant difference in favour of fissure sealants.
CONCLUSION
Compared to the no intervention, dental sealing is an effective method for the prevention of dental caries. However, it is not possible to conclude conclusively which type of sealant and which of the available prophylactic methods is more effective in preventing caries.
Topics: Humans; Dental Caries; Dentition, Permanent; Fluorides; Pit and Fissure Sealants; Systematic Reviews as Topic
PubMed: 37891656
DOI: 10.1186/s12903-023-03499-6 -
Journal of the American Dental... Jan 2019
Topics: Dental Care; Diagnosis, Oral; Humans; Oral Health; Pit and Fissure Sealants
PubMed: 30611324
DOI: 10.1016/j.adaj.2018.11.016