-
Molecules (Basel, Switzerland) Apr 2021Periodontal diseases like gingivitis and periodontitis are primarily caused by dental plaque. Several antiplaque and anti-microbial agents have been successfully... (Review)
Review
Periodontal diseases like gingivitis and periodontitis are primarily caused by dental plaque. Several antiplaque and anti-microbial agents have been successfully incorporated into toothpastes and mouthwashes to control plaque biofilms and to prevent and treat gingivitis and periodontitis. The aim of this article was to review recent developments in the antiplaque, anti-gingivitis, and anti-periodontitis properties of some common compounds in toothpastes and mouthwashes by evaluating basic and clinical studies, especially the ones published in the past five years. The common active ingredients in toothpastes and mouthwashes included in this review are chlorhexidine, cetylpyridinium chloride, sodium fluoride, stannous fluoride, stannous chloride, zinc oxide, zinc chloride, and two herbs-licorice and curcumin. We believe this comprehensive review will provide useful up-to-date information for dental care professionals and the general public regarding the major oral care products on the market that are in daily use.
Topics: Anti-Infective Agents, Local; Cetylpyridinium; Chlorides; Humans; Mouthwashes; Periodontal Diseases; Plant Extracts; Sodium Fluoride; Tin Fluorides; Toothpastes; Zinc Compounds
PubMed: 33916013
DOI: 10.3390/molecules26072001 -
JMIR Research Protocols Jan 2022The sensitivity of teeth with molar incisor hypomineralization (MIH) can affect children's quality of life and is a challenging problem for dentists. Remineralizing...
BACKGROUND
The sensitivity of teeth with molar incisor hypomineralization (MIH) can affect children's quality of life and is a challenging problem for dentists. Remineralizing agents such as sodium fluoride varnish seem to reduce the sensitivity of teeth with MIH, but long-term clinical trials with large samples are still needed for more evidence about its effectiveness as a desensitizing agent before its clinical recommendation.
OBJECTIVE
This randomized clinical trial aims to compare three treatment interventions for teeth with MIH and hypersensitivity.
METHODS
A total of 60 children aged 6-10 years presenting with at least one first permanent molar with sensitivity and no loss of enamel will be randomly assigned to three groups: the control group (sodium fluoride varnish; Duraphat, Colgate); experimental group I (4% titanium tetrafluoride varnish); and experimental group II (a coating resin containing surface prereacted glass-ionomer filler; PRG Barrier Coat, Shofu). The sodium fluoride varnish and 4% titanium tetrafluoride varnish will be applied once per week for 4 consecutive weeks and the PRG Barrier Coat resin will be applied in the first session and the application will be simulated the following 3 weeks to guarantee the blinding of the study. The primary outcome will be sensitivity level measured at different moments (before each material application, immediately after application or simulation, and 1, 2, 4, and 6 months after the last application/simulation) by one examiner using the Wong-Baker FACES Pain Rating Scale, the Schiff Cold Air Sensitivity Scale, and the FLACC (Face, Legs, Activity, Cry, Consolability) scale. As secondary outcomes, parental satisfaction and child self-reported discomfort after the treatment will be measured with a questionnaire prepared by the researcher. The data will undergo statistical analysis and the significance level will be set at 5%.
RESULTS
The project was funded in 2018, and enrollment was completed in November 2019. The recruitment of participants is currently underway and the first results are expected to be submitted for publication in 2022.
CONCLUSIONS
If found effective in reducing the patient's sensitivity long term, these agents can be considered as a treatment choice, and the findings will contribute to the development of a treatment protocol for teeth with sensitivity due to MIH.
TRIAL REGISTRATION
Brazilian Registry of Clinical Trials Universal Trial Number U1111-1237-6720; https://tinyurl.com/mr4x82k9.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/27843.
PubMed: 34989687
DOI: 10.2196/27843 -
Journal of Dentistry Oct 2022To assess the clinical evidence for professionally applied fluoride therapy to prevent and arrest caries in older adults. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the clinical evidence for professionally applied fluoride therapy to prevent and arrest caries in older adults.
DATA/SOURCES
Two independent researchers searched the English literature published up to 31st Dec 2021 in five databases (PubMed, Scopus, the Cochrane Library, EMBASE, and Web of Science) for clinical trials with a comparison group on professionally applied fluoride therapy for caries prevention or arrest at older adults aged ≥60 years with any follow-up period. The outcomes were the mean difference in the number of new caries/caries-prevented fraction and caries arrest rate. The Cochrane guidelines were used for the risk of bias assessment.
STUDY SELECTION/RESULTS
Five hundred and twenty-seven studies were identified, and seven studies were finally included. Five studies were rated as having 'low risk'. The root caries-prevented fraction of 38% silver diamine fluoride (SDF) solution, 5% sodium fluoride (NaF) varnish, and 1.23% acidulated phosphate fluoride (APF) gel were 25-71%, 64%, and 32%, respectively. Meta-analysis indicated a decrease in the number of new root caries by 0.55 (95% CI: 0.32-0.78; p < 0.001) and an overall proportion of arrested root caries of 42% (95% CI: 33% to 49%; p < 0.001) after receiving 38% SDF application at the 24-month follow-up.
CONCLUSIONS
According to the findings, 5% NaF varnish and 1.23% APF gel prevented root caries, whereas 38% SDF solution prevented and arrested root caries in older adults. More well-designed clinical trials should be conducted to investigate various methods in caries prevention and arrest in older adults.
CLINICAL SIGNIFICANCE
Preventive measures effective in other age groups may not suit older adults, as caries type and associated risk factors vary. To date, no systematic review has evaluated professionally applied fluoride therapy in older adults. Evidence from clinical trials in older adults could aid clinical practice and public health measures. The International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42022307025.
Topics: Aged; Humans; Acidulated Phosphate Fluoride; Cariostatic Agents; Dental Caries; Fluorides; Fluorides, Topical; Quaternary Ammonium Compounds; Root Caries; Silver Compounds; Sodium Fluoride
PubMed: 36058347
DOI: 10.1016/j.jdent.2022.104273 -
Journal of Dentistry Dec 2020The aim of this randomised non-inferiority clinical trial was to compare the effectiveness of semi-annual (every six months) applications of 25 % silver nitrate (AgNO)... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The aim of this randomised non-inferiority clinical trial was to compare the effectiveness of semi-annual (every six months) applications of 25 % silver nitrate (AgNO) solution followed by 5 % sodium fluoride (NaF) varnish to semi-annual applications of 38 % silver diamine fluoride (SDF) solution in arresting early childhood caries (ECC).
METHODS
Three-year-old children with active cavitated carious lesions were recruited and randomly assigned to two intervention groups. Children in Group A received semi-annual applications of 25 % AgNO solution followed by 5 % NaF varnish on carious lesions. Children in Group B received semi-annual applications of 38 % SDF solution followed by a placebo varnish. One trained dentist assessed ECC status at baseline and in all follow-up examinations. An independent operator performed the interventions. The dentist, the children, and their caretakers were blinded to the intervention allocation. Data were analysed using a non-inferiority test. Group A's non-inferiority would be accepted if the lower limit of the 95 % confidence interval (CI) for the difference in the mean number of arrested decayed surfaces (ds) was greater than -0.5.
RESULTS
At baseline, 1,070 children were recruited, and 535 children were assigned to each group. After 30 months, the mean arrested ds in Groups A (n = 447) and B (n = 433) were 3.7 ± 3.6 and 3.6 ± 3.7, respectively (p = 0.694). The difference in the mean arrested ds between the two groups was 0.088 (95 % CI: -0.351 to 0.526).
CONCLUSION
Semi-annual application of 25 % AgNO followed by 5 % NaF is at least as effective as the semi-annual application of 38 % SDF in arresting ECC.
CLINICAL SIGNIFICANCE
Silver and fluoride products are effective in arresting caries. As a simple, non-invasive, and inexpensive strategy, it can be used in young children, elderly adults, and people with special needs.
Topics: Aged; Cariostatic Agents; Child; Child, Preschool; Dental Caries; Dental Caries Susceptibility; Fluorides; Fluorides, Topical; Humans; Quaternary Ammonium Compounds; Silver Compounds; Sodium Fluoride
PubMed: 33166594
DOI: 10.1016/j.jdent.2020.103522 -
International Journal of Environmental... Jul 2022Background: There is limited information on the effectiveness of 38% silver diamine fluoride (SDF) in managing enamel caries. Objective: This study aimed to compare... (Randomized Controlled Trial)
Randomized Controlled Trial
Background: There is limited information on the effectiveness of 38% silver diamine fluoride (SDF) in managing enamel caries. Objective: This study aimed to compare effectiveness of 38% SDF and 5% Sodium fluoride (NaF) varnish in arresting enamel caries in young children when applied semiannually over 18 months. Methods: A randomized controlled trial was conducted on children aged 1−3 years who had at least one active carious surface. They were allocated into two groups: Group 1 (38% SDF) and Group 2 (5% NaF varnish). Visual-tactile examination was used to assess extent of carious lesions. Enamel caries that did not progress to dentin were classified as having caries arrest. Intention-to-treat analysis was performed. Results: At baseline, 290 children with 1974 tooth surfaces with enamel caries were recruited. Caries arrest rates at the tooth surface level in Group 1 and Group 2 were 59.1% and 58.8%, respectively (p = 0.873), at 18 months. The multilevel logistic regression analysis revealed that tooth position, tooth surface, extent of enamel caries at baseline, caries experience, and brushing with fluoride toothpaste influenced caries arrest (p < 0.05). Conclusion: The semiannual application of 38% SDF and 5% NaF varnish had comparable effectiveness in arresting enamel caries in primary teeth.
Topics: Cariostatic Agents; Child; Child, Preschool; Dental Caries; Dental Caries Susceptibility; Fluorides, Topical; Humans; Quaternary Ammonium Compounds; Silver Compounds; Sodium Fluoride
PubMed: 35897363
DOI: 10.3390/ijerph19158992 -
JAMA Cardiology Aug 2023Recurrent coronary events in patients with recent myocardial infarction remain a major clinical problem. Noninvasive measures of coronary atherosclerotic disease...
IMPORTANCE
Recurrent coronary events in patients with recent myocardial infarction remain a major clinical problem. Noninvasive measures of coronary atherosclerotic disease activity have the potential to identify individuals at greatest risk.
OBJECTIVE
To assess whether coronary atherosclerotic plaque activity as assessed by noninvasive imaging is associated with recurrent coronary events in patients with myocardial infarction.
DESIGN, SETTING, AND PARTICIPANTS
This prospective, longitudinal, international multicenter cohort study recruited participants aged 50 years or older with multivessel coronary artery disease and recent (within 21 days) myocardial infarction between September 2015 and February 2020, with a minimum 2 years' follow-up.
INTERVENTION
Coronary 18F-sodium fluoride positron emission tomography and coronary computed tomography angiography.
MAIN OUTCOMES AND MEASURES
Total coronary atherosclerotic plaque activity was assessed by 18F-sodium fluoride uptake. The primary end point was cardiac death or nonfatal myocardial infarction but was expanded during study conduct to include unscheduled coronary revascularization due to lower than anticipated primary event rates.
RESULTS
Among 2684 patients screened, 995 were eligible, 712 attended for imaging, and 704 completed an interpretable scan and comprised the study population. The mean (SD) age of participants was 63.8 (8.2) years, and most were male (601 [85%]). Total coronary atherosclerotic plaque activity was identified in 421 participants (60%). After a median follow-up of 4 years (IQR, 3-5 years), 141 participants (20%) experienced the primary end point: 9 had cardiac death, 49 had nonfatal myocardial infarction, and 83 had unscheduled coronary revascularizations. Increased coronary plaque activity was not associated with the primary end point (hazard ratio [HR], 1.25; 95% CI, 0.89-1.76; P = .20) or unscheduled revascularization (HR, 0.98; 95% CI, 0.64-1.49; P = .91) but was associated with the secondary end point of cardiac death or nonfatal myocardial infarction (47 of 421 patients with high plaque activity [11.2%] vs 19 of 283 with low plaque activity [6.7%]; HR, 1.82; 95% CI, 1.07-3.10; P = .03) and all-cause mortality (30 of 421 patients with high plaque activity [7.1%] vs 9 of 283 with low plaque activity [3.2%]; HR, 2.43; 95% CI, 1.15-5.12; P = .02). After adjustment for differences in baseline clinical characteristics, coronary angiography findings, and Global Registry of Acute Coronary Events score, high coronary plaque activity was associated with cardiac death or nonfatal myocardial infarction (HR, 1.76; 95% CI, 1.00-3.10; P = .05) but not with all-cause mortality (HR, 2.01; 95% CI, 0.90-4.49; P = .09).
CONCLUSIONS AND RELEVANCE
In this cohort study of patients with recent myocardial infarction, coronary atherosclerotic plaque activity was not associated with the primary composite end point. The findings suggest that risk of cardiovascular death or myocardial infarction in patients with elevated plaque activity warrants further research to explore its incremental prognostic implications.
Topics: Humans; Male; Female; Plaque, Atherosclerotic; Prospective Studies; Cohort Studies; Sodium Fluoride; Coronary Artery Disease; Myocardial Infarction; Death
PubMed: 37379010
DOI: 10.1001/jamacardio.2023.1729 -
JACC. Cardiovascular Imaging Mar 2022
Topics: Biomarkers; Cardiovascular Diseases; Heart Disease Risk Factors; Humans; Inflammation; Predictive Value of Tests; Risk Factors
PubMed: 34922869
DOI: 10.1016/j.jcmg.2021.11.007 -
Brazilian Dental Journal 2022Fluoride toothpastes market to children should contain a minimum concentration of 1000 ppm of fluoride (F), which must be chemically soluble to provide anti-caries...
Fluoride toothpastes market to children should contain a minimum concentration of 1000 ppm of fluoride (F), which must be chemically soluble to provide anti-caries effect. Therefore, we determined the concentrations of total fluoride (TF) and total soluble fluoride (TSF) in toothpastes marketed to children in Brazil and Mexico and analyzed the current regulations in force in both countries. Twenty-four brands were found and purchased in Brazil (19 formulated with NaF/SiO2, three with Na2FPO3/CaCO3 and two with Na2FPO3/SiO2) and six in Mexico (all with NaF/SiO2). TF and TSF concentrations were determined after the purchase (fresh samples) but fluoride stability in Na2FPO3/CaCO3-formulations was checked after 18 months. The analyses were performed with an ion-specific electrode and the results expressed in ppm F (mg F/kg). The TF concentrations found ranged from 476.0 to 1385.3 ppm F and they were close the declared by the manufactures (500 to 1450 ppm F). The TF concentrations found were not greater than 1500 ppm F, in accordance with the current regulations of both countries. However, toothpastes presenting TSF concentrations lower than 1000 ppm F were found either in low fluoride toothpaste (500 ppm F) formulated with NaF/SiO2 as in fresh and aged Na2FPO3/CaCO3-toothpastes, originally fabricated with 1000-1100 ppm of TF. In conclusion, although most toothpastes analyzed showed TSF concentration higher than 1000 ppm F, the regulations in force in both countries allow that products not in agreement with the best available evidence are available in the market.
Topics: Aged; Brazil; Calcium Carbonate; Cariostatic Agents; Child; Dental Caries; Fluorides; Humans; Mexico; Silicon Dioxide; Sodium Fluoride; Toothpastes
PubMed: 35508036
DOI: 10.1590/0103-6440202204522 -
Brazilian Dental Journal 2022This study synthesized and tested experimental gels containing fluoride (F-) and stannous (Sn2+) ions for the control of dental erosion. Enamel and dentin polished... (Randomized Controlled Trial)
Randomized Controlled Trial
This study synthesized and tested experimental gels containing fluoride (F-) and stannous (Sn2+) ions for the control of dental erosion. Enamel and dentin polished specimens were eroded (1% citric acid solution, 10 min) and randomly allocated into 5 groups (n=10): Placebo - Hydroxypropyl Methylcellulose (HMC) gel; F+Sn+HMC - 7,500 ppm F- / 15,000 ppm Sn2+; F+HMC - 7,500 ppm F-; Commercial acidulated phosphate fluoride gel (12,300 ppm F-); and Control - no treatment. After treatment (applied for 60 s), specimens underwent an erosion-remineralization cycling (5 min in 0.3% citric acid solution, 60 min in artificial saliva, 4×/day, 20 days). Surface loss (SL, in µm) was determined after the 5th, 10th and 20th days of cycling (α=0.05). For enamel, after 5 and 10 days, F+Sn+HMC presented the lowest SL, which did not differ from the commercial gel. After 20 days, no differences were found between commercial, F+HMC, and F+Sn+HMC groups. Placebo did not differ from the control at any time points, and both groups presented the highest SL when compared to the other groups. For dentin, on the 5th day, F+Sn+HMC, F+HMC and commercial did not differ significantly, showing lower SL than the control and the placebo. On the 10th day, F+Sn+HMC and commercial presented the lowest SL compared to control and placebo. After 20 days, only the commercial gel showed lower SL than the control and placebo. Thus, the experimental F+Sn+HMC gel was able to control the progression of tooth erosion.
Topics: Citric Acid; Fluorides; Gels; Humans; Sodium Fluoride; Tin Compounds; Tooth Erosion
PubMed: 36043569
DOI: 10.1590/0103-6440202204808