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JAMA Pediatrics Apr 2024Dental caries is the world's most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure.... (Randomized Controlled Trial)
Randomized Controlled Trial
IMPORTANCE
Dental caries is the world's most prevalent noncommunicable disease and a source of health inequity; school dental sealant programs are a common preventive measure. Silver diamine fluoride (SDF) may provide an alternative therapy to prevent and control caries if shown to be noninferior to sealant treatment.
OBJECTIVE
To determine whether school-based application of SDF is noninferior to dental sealants and atraumatic restorative treatment (ART) in the prevalence of dental caries.
DESIGN, SETTING, AND PARTICIPANTS
The Silver Diamine Fluoride Versus Therapeutic Sealants for the Arrest and Prevention of Dental Caries in Low-Income Minority Children (CariedAway) study was a pragmatic noninferiority cluster-randomized clinical trial conducted from February 2018 to June 2023 to compare silver diamine fluoride vs therapeutic sealants for the arrest and prevention of dental caries. Children at primary schools in New York, New York, with at least 50% of the student population reporting as Black or Hispanic and at least 80% receiving free or reduced lunch were included. This population was selected as they are at the highest risk of caries in New York. Students were randomized to receive either SDF or sealant with ART; those aged 5 to 13 years were included in the analysis. Treatment was provided at every visit based on need, and the number of visits varied by child. Schools with preexisting oral health programs were excluded, as were children who did not speak English. Of 17 741 students assessed for eligibility, 7418 were randomized, and 4100 completed follow-up and were included in the final analysis.
INTERVENTIONS
Participants were randomized at the school level to receive either a 38% concentration SDF solution or glass ionomer sealants and ART. Each participant also received fluoride varnish.
MAIN OUTCOMES AND MEASURES
Primary study outcomes were the prevalence and incidence of dental caries.
RESULTS
A total of 7418 children (mean [SD] age, 7.58 [1.90] years; 4006 [54.0%] female; 125 [1.7%] Asian, 1246 [16.8%] Black, 3648 [49.2%] Hispanic, 153 [2.1%] White, 114 [1.5%] multiple races or ethnicities, 90 [1.2%] other [unspecified], 2042 [27.5%] unreported) were enrolled and randomized to receive either SDF (n = 3739) or sealants with ART (n = 3679). After initial treatment, 4100 participants (55.0%) completed at least 1 follow-up observation. The overall baseline prevalence of dental caries was approximately 27.2% (95% CI, 25.7-28.6). The odds of decay prevalence decreased longitudinally (odds ratio [OR], 0.79; 95% CI, 0.75-0.83) and SDF was noninferior compared to sealants and ART (OR, 0.94; 95% CI, 0.80-1.11). The crude incidence of dental caries in children treated with SDF was 10.2 per 1000 tooth-years vs 9.8 per 1000 tooth-years in children treated with sealants and ART (rate ratio, 1.05; 95% CI, 0.97-1.12).
CONCLUSIONS AND RELEVANCE
In this school-based pragmatic randomized clinical trial, application of SDF resulted in nearly identical caries incidence compared to dental sealants and ART and was noninferior in the longitudinal prevalence of caries. These findings suggest that SDF may provide an effective alternative for use in school caries prevention.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT03442309.
Topics: Child; Humans; Female; Male; Fluorides, Topical; Pit and Fissure Sealants; Dental Atraumatic Restorative Treatment; Dental Caries; Prevalence; Quaternary Ammonium Compounds; Silver Compounds
PubMed: 38436947
DOI: 10.1001/jamapediatrics.2023.6770 -
BDJ Open Mar 2024Dental caries is one of the prevalent conditions that threaten oral health. Arnebia euchroma (Royle) Johnst. root (AR) extracts exhibit anti-inflammatory, anti-cancer,...
BACKGROUND
Dental caries is one of the prevalent conditions that threaten oral health. Arnebia euchroma (Royle) Johnst. root (AR) extracts exhibit anti-inflammatory, anti-cancer, and antibacterial properties. This study was designed to investigate the antibacterial impact of AR extract on Streptococcus mutans (S. mutans) UA159 and the anti-caries effect on rats.
METHODS
The antibacterial activity of AR extract against S. mutans and its biofilm was determined using the bacterial sensitivity test, the biofilm sensitivity test, and the live-dead staining technique. By fluorescently tagging bacteria, the influence of bacterial adhesion rate was determined. Using a rat caries model, the anti-caries efficacy and safety of AR extract were exhaustively investigated in vivo.
RESULTS
AR extract inhibit not only the growth of S. mutans, but also the generation of S. mutans biofilm, hence destroying and eliminating the biofilm. Moreover, AR extract were able to inhibit S. mutans' adherence to saliva-encapsulated hydroxyapatite (HAP). Further, in a rat model of caries, the AR extract is able to greatly reduce the incidence and severity of caries lesions on the smooth surface and pit and fissure of rat molars, while exhibiting excellent biosafety.
CONCLUSIONS
AR extract exhibit strong antibacterial activity against S. mutans and can lower the incidence and severity of dental cavities in rats. These findings suggest that Arnebia euchroma (Royle) Johnst. could be utilized for the prevention and treatment of dental caries.
PubMed: 38431610
DOI: 10.1038/s41405-024-00196-6 -
Bioinformation 2023Mobile dental vehicle (MDVs) can be adopted to address the oral healthcare needs of different populations. Therefore, it is of interest to evaluate mobile dental clinic...
Mobile dental vehicle (MDVs) can be adopted to address the oral healthcare needs of different populations. Therefore, it is of interest to evaluate mobile dental clinic program in providing oral health services to underserved rural communities. A 2 x 2.5 meter box trailer is used by the UN, and it can be carried by a vehicle with all-wheel drive for all types of weather. There was a small box trailer with its weather proof canvas cover extended, changing it into four dental operators and an integrated waiting and teaching space. Clinical examination, scaling, polishing, health education, individual and group teaching in dental hygiene, fluoride applications, fissure sealants, amalgam and composite restorations, extractions, and minor oral surgery were all supplied at no cost to the patients. In a longitudinal study of 3 years in underserved rural areas, a total of 6326 patients were provided different dental treatments. It was found that 93.3% patients did not undergo any dental treatment in the past.
PubMed: 38415028
DOI: 10.6026/973206300191383 -
Journal of Dental Research May 2024Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and...
Analyses of National Health and Nutrition Examination Survey (NHANES) data suggested a significant decrease in sealant prevalence among children between 2011 to 2014 and 2015 to 2018. We explore whether this decrease could be associated with possible changes in 1) clinical sealant delivery, 2) dental materials (i.e., increased use of glass ionomer [GI] sealants resulting in an inability to detect sealant fragments that still provide preventive benefits or increased use of composite restorations leading to misclassifying sealants as restorations), and 3) examination sensitivity and specificity. We used NHANES data to estimate the prevalences of sealants, untreated caries, and restorations in ≥1 first permanent molar among children aged 7 to 10 y and used Medical Expenditure Panel Survey data to estimate the annual clinical delivery of sealants and fluoride treatments. We examined changes in outcomes between 2 periods ( < 0.05) controlling for selected sociodemographic characteristics. NHANES sealant examination quality was based on the reference examiner's replicate examinations. The adjusted prevalence of sealants decreased relatively by 27.5% (46.6% vs. 33.8%). Overall, untreated caries decreased. Untreated caries and restoration decreased among children without sealants. Annual clinical sealant delivery did not change, whereas fluoride treatment delivery increased. The decrease in sealant prevalence held when assessed for various age ranges and NHANES cycle combinations. While sealant examination specificity remained similar between the periods, sensitivity (weighted by the proportion of exams by each examiner) decreased relatively by 17.4% (0.92 vs. 0.76). These findings suggest that decreased sealant prevalence was not supported by decreased clinical sealant delivery nor increased use of composite restorations. Decreased examination sensitivity, which could be due to an increased use of GI sealants, could contribute to the decrease in sealant prevalence. The decrease in caries among children without sealants could suggest the increased use of GI sealants. However, we could not rule out that the decrease in caries could be attributable to increased fluoride treatment delivery.
Topics: Humans; Pit and Fissure Sealants; Child; Dental Caries; Molar; United States; Female; Male; Nutrition Surveys; Prevalence; Dental Restoration, Permanent; Glass Ionomer Cements
PubMed: 38410889
DOI: 10.1177/00220345241231774 -
Revista Cientifica Odontologica... 2023Root fractures are after caries and periodontal disease, the third cause of loss of dental units, being very common in posterior and endodontically treated teeth. The...
Root fractures are after caries and periodontal disease, the third cause of loss of dental units, being very common in posterior and endodontically treated teeth. The symptoms they produce are ambiguous and their diagnosis depends on the combination of multiple clinical and imaging factors. Among the diagnostic studies available to establish the origin of the symptoms is the cone beam computed tomography (CBCT). The objective of this case report is to describe the strategies used in the acquisition and interpretation of the CBCT in three patients with suspected root fractures. The use of a reduced field of view, with a voxel of 0.150 mm or less, accompanied by dynamic volume exploration made it possible to detect bone defects as an indirect sign for locating root fracture lines.
PubMed: 38390605
DOI: 10.21142/2523-2754-1004-2022-136 -
Heliyon Feb 2024The aim of this study was to evaluate the roughness, hardness, and color change of pit and fissure sealants of two commercial brands (Fluroshield ™ and Ultraseal XT...
Influence of incorporation of nanostructured silver vanadate decorated with silver nanoparticles on roughness, microhardness, and color change of pit and fissure sealants.
OBJECTIVE
The aim of this study was to evaluate the roughness, hardness, and color change of pit and fissure sealants of two commercial brands (Fluroshield ™ and Ultraseal XT ™) incorporated with nanostructured silver vanadate nanomaterial decorated with silver nanoparticles (β-AgVO) in concentrations (0% - control, 2.5% and 5%).
MATERIAL AND METHODS
Two commercial brands Fluroshield TM and Ultraseal XT ™ were used to make the samples with dimensions of 6 × 6 × 4 mm. The control group was made according to the manufacturer's instructions and in the groups with the addition of β-AgVO, the nanomaterial was added proportionally by mass at percentages of 2.5% and 5%. Roughness properties were evaluated using a 3D Laser Confocal Microscope (n = 10), Knoop microhardness by Microdurometer (n = 10), and color change by Portable Color Spectrophotometer on the CIEDE2000 system (n = 10). Data were evaluated by one-way ANOVA with Bonferroni adjustment and Tukey's mean comparison test at a 5% significance level.
RESULTS
Ultraseal XT ™ sealant roughness showed a significant difference between concentrations with the highest mean for the 5% group ( = 0.010). Regarding the hardness, both sealants showed no significant difference between the groups. Fluroshield ™ sealant showed a significant difference in ΔE00 between the control-2.5% 24.93 (3.49) and control-5% 28.41 (2.58).
CONCLUSION
It may be concluded that the incorporation of β-AgVO influenced the increase in roughness for Ultraseal XT ™ pit and fissure sealant, did not interfere with the microhardness of both sealants, and promoted a change in the color of Fluroshield ™ sealant within clinically acceptable limits.
PubMed: 38384570
DOI: 10.1016/j.heliyon.2024.e25525 -
Lasers in Medical Science Feb 2024The present work aimed at assessing chemical, topographical, and morphological changes induced by Nd : YAG laser treatment of dental enamels by means of energy...
The present work aimed at assessing chemical, topographical, and morphological changes induced by Nd : YAG laser treatment of dental enamels by means of energy dispersive X-ray spectroscopy (EDS), atomic force microscopy (AFM), and scanning electron microscopy (SEM). Fifteen human enamel specimens were obtained, three of samples were kept untreated as a control while the others twelve samples were equally divided into four groups where each group have a three samples according to treating approach as: G1:(untreated);G2: (treated with Nd:YAG laser, 100 mJ/pulse,10 Hz/1064nm); G3(treated with Nd:YAG laser, 500 mJ/pulse, 10 Hz/1064nm); G4(treated with Nd:YAG laser 1000 mJ/pulse, 10 Hz/1064nm), and finally G5(treated with Nd:YAG laser, 1000 mJ/pulse, 10 Hz/532nm) respectively. Beside many craters and cracks, the AFM results showed fractures with depths of 19.23 nm, 174.7 nm, 216.9 nm, 207.4 nm and 156.5 nm and width of 559.2 nm, 833.4 nm, 1115 nm, 695.0 nm, and 5142 nm for all Groups respectively. The highest surface roughness was found in G5 with 111.4 nm while the lowest surface roughness was found in G1 to be 14.3 nm. The inside surface of the fissures was also rough. The SEM micrographs revealed modifications to the morphology. EDS was used to measure the phosphorous (P), calcium (Ca), oxygen (O), and carbon (C) percentages presented in crater areas and their surroundings, Ca, P, O, and C levels were observed to vary significantly at the crater and its rim, a lower percentage of C wt% were realized corresponding to laser treatment of 1000 mJ/Pulse laser energy. However, it was not feasible to recognize a specific chemical arrangement in the craters. It is also concluded that the higher depth and particular edge of ablated part when teeth were irradiated by laser with 1000 mJ/10Hz/1064nm.
Topics: Humans; Lasers, Solid-State; Calcium; Spectrometry, X-Ray Emission; Microscopy, Electron, Scanning; Dental Enamel
PubMed: 38363355
DOI: 10.1007/s10103-024-04023-0 -
The Bulletin of Tokyo Dental College Mar 2024The morphogenetic process of development of the circumference of the mandibular fossa during tooth eruption, which involves the replacement of deciduous teeth with...
The morphogenetic process of development of the circumference of the mandibular fossa during tooth eruption, which involves the replacement of deciduous teeth with permanent teeth, is strongly affected by occlusion. To the best of our knowledge, no studies have investigated the effect of occlusion on this process. This study investigated the morphogenetic process of development during tooth eruption using dried skulls harvested from Indian donors. The average distance between the ala-major-squamosa suture and the foramen ovale according to age group was as follows: 3.24 mm in the 8-month-old group and 8.92 mm in the adult group. The average distance between the ala-major-squamosa suture and the apex of the articular tubercle according to age groups was as follows: 10.38 mm in the 8-month-old group and 19.34 mm in the adult group. The average distance between the point of intersection of the petrosquamous fissure and petrotympanic fissure located on the perpendicular line drawn posteriorly from the shortest distance of the medio-lateral axis between the ala-major-squamosa suture and the apex of the articular tubercle according to age group was as follows: 9.68 mm in the 8-month-old group and 14.3 mm in the adult group. These results suggest that the mandibular fossa is strongly affected by load due to occlusion, unlike the growth of the neurocranium. This indicates that the effect of occlusion is a secondary element in the morphogenetic process of development of the circumference of the mandibular fossa.
Topics: Temporomandibular Joint; Cephalometry; Temporal Bone; Dental Occlusion; Mandibular Condyle
PubMed: 38355117
DOI: 10.2209/tdcpublication.2023-0009 -
Journal of Dental Hygiene : JDH Feb 2024The purpose of this study was to determine dental hygiene students' perspectives regarding their knowledge and understanding about caries prevention strategies and...
The purpose of this study was to determine dental hygiene students' perspectives regarding their knowledge and understanding about caries prevention strategies and their intention to use these regimens in clinical practice. Dental hygienists' knowledge and understanding of caries prevention is critical because they are the primary providers of these regimens and the relevant education. This 2019 national cross-sectional online survey was designed by the University of Maryland (UMD), structured by the ADA staff for online administration, distributed and collected by the American Dental Hygienists' Association (ADHA) to 9533 email addresses, and de-identified response data were analyzed by UMD. The survey included questions on three caries preventive regimens: fluoride varnish, dental sealants, and silver diamine fluoride (SDF), and items on community water fluoridation (CWF), respondent's demographics and intent to use the regimens. Statistical analyses included descriptive statistics and analysis of variance. Significance was set at <0.05. Of the 235 surveys returned (response rate 2.5%) the majority were female, White and born in the United States. Over half were in associate degree programs; nearly a third were in baccalaureate programs. Respondents reported greater knowledge/understanding and intention to use fluoride varnish and dental sealants than SDF. Less than half (44.7%) reported knowledge/understanding of SDF and only 22.6% had a high level of confidence regarding applying it. Additionally, only 31.1% indicated they were extremely likely to use SDF upon graduation. To reduce the prevalence of caries, dental hygiene graduates must be well-versed with the latest science-based preventive procedures, including non-invasive caries prevention and control therapies. The results of this survey, albeit non representative of the general population of dental hygiene students, suggest a need for a more extensive review of the caries preventive regimen content, especially for silver diamine fluoride, of dental hygiene curricular programs.
Topics: Humans; Female; Male; Fluorides, Topical; Fluoridation; Oral Hygiene; Cross-Sectional Studies; Pit and Fissure Sealants; Dental Caries Susceptibility; Dental Caries; Fluorides; Students; Quaternary Ammonium Compounds; Silver Compounds
PubMed: 38346898
DOI: No ID Found