Dental Caries

Bonding to demineralized dentin of a diseased tooth has shown to be a significant clinical issue. This study evaluated the effect of 0.2% NaF-(NaF), MI Paste™-(CPP-ACP) and the self-assembling peptide 'P 11−4 ′ (Ace-QQRFEWEFEQQ-NH 2) contained in Curodont™ Repair, have on microtensile bond strength-(µTBS) of two different adhesive systems (Adper™ Single Bond-(SB) or Clearfil™ SE Bond (CSE)) and wettability of deminer-alized dentin slices after remineralising agents were applied. The highest µTBS were found for the demineralized dentin-(DD) treated with CPP-ACP; both adhesives systems (p < 0.05) did not significantly difference from P 11-4 treatment associated with SB, and also presented higher values than sound dentin-(SD/SB) (p < 0.01). DD treated with P 11−4 associated with CSE did not differ from DD/CSE (p > 0.05). The NaF treatment associated with CSE recovered the bond strength values of SD/CSE and associated with CSE demonstrated lower µTBS than other groups, although significantly higher than DD (p < 0.05). P 11−4 and CPP-ACP increased significantly the wettability of demineralized dentin (p < 0.05); etching acid improved wettability for all groups (p < 0.05), whilst NaF did not affect the wettability of demineralized dentin (p > 0.05). Morphological analysis of the dentin surface and dentin-resin interface revealed unique features of the applied remineralizing agent. The results indicated that self-assembling peptide P 11−4 associated with SB and CPP-ACP associated with SB or CSE significantly enhanced the bond strength to demineralized dentin (p < 0.05). We conclude that by modifying the dentine surface and restoring conditions found on sound dentin, this can enhance the interfacial bonding.

Matériaux de travail p.32 C1.3-Sa G Démarche qualité p.32 C1.2-Sa E Biocompatiblité, micro-organismes et asepsie p.33 C3.1-Sa F Matériaux à empreintes p.34 " Plâtres et isolants p.36 " Résines dentaires et cires p.37 " Revêtements compensateurs p.38 " Alliages dentaires p.39 Environnement et sécurité p.41 C2.3-Sa G Equipement de protection individuel p.42 " Ergonomie du poste de travail p.43 Étapes pré-prothétiques p.44 C1.3-Sa G Dispositif médical sur mesure p.45 C2.3-Sa B Portes empreintes p.45 C3.2-Sa D Maquettes d'occlusion p.47 " Enregistrement de l'occlusion p.49 Prothèses amovibles p.51

Prevalence varies according to different authors. Thus, it was found 0.38% in Turkey, 0.13% in Saudi Arabia, 0.43% in India. Prevalence in syndromic patients is significantly higher. Tooth transpositions are observed at a rate of 14.29% in patients with Down's syndrome and at a rate of 4.1% in cleft palate patients. According to most researchers, transposition is more frequent in women, in the maxilla, as a unilateral condition and in the left facial half [4]. Unilateral tooth transpositions have been reported far more

Background: To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. Methods: A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. Results: The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (χ 2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. Conclusion: In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.

Objective. To investigate whether formocresol, in Buckley's original formulation, is mutagenic in vivo to lymphocyte cultures obtained from the peripheral blood of children aged from 5 to 10 years old. These children were recruited from those attending the dental clinics of Recife City Council and the University of Pernambuco School of Dentistry, Brazil.

It is evident from the number of published scientific papers on Early Childhood Caries (ECC) that interest in this problem has grown in recent years. Many authors have been trying to devise a clear definition or classification for ECC. The aim of this review was to inventory the prevalence of ECC and to seek a consensus regarding definition and diagnosis. Further attention was paid to the aetiological factors including the role of microrganisms. Finally, education, parenting and treatment procedures were discussed. For this review, epidemiological studies on caries prevalence in children aged between 0 and 36 months were compiled through a systematic approach using Medline. This clearly showed that ECC continues to be a serious public health problem and that there is a great variety of definitions and diagnoses used worldwide, reflected in the prevalence data. This review confirms the multicausal aetiology and the need for further research. The authors strongly support the recommend...

It has been argued that specific salivary proteins could have a protective effect against caries, but data from the many available studies are rather contradictory. The purpose of this study was to analyze whether there is a relationship between protein concentration, electrophoretic profile and concentration of salivary IgA and the presence or absence of caries in adults. Adults with high caries activity (HC) and without caries lesions (CF), assessed by ICDAS criteria, were asked to provide unstimulated saliva samples. Protein concentration (μg/mL) was determined using the Bradford method. Western blotting was used to detect IgA. Data were compared using Student&#39;s t test at p&lt;0.05. Total protein concentration in CF was higher (50.65±7.5 μg/mL) than in HC individuals (26.80±2.5 μg/mL) (p=0.001). More protein bands were visualized in the gels from CF than the HC group (p=0.001). CF subjects showed higher salivary IgA concentration (11.27±0.5 μg) than HC individuals (1.71±0.2μg...

Introduction: There is evidence to suggest that an association exists between oral infections and coronary heart disease (CHD). Subjects presenting lesions of endodontic origin (LEOs) or pulpal inflammation had an increased risk of developing CHD. However, findings concerning systemic manifestations of apical periodontitis (AP) remain controversial. An association between CD14 gene polymorphisms and atherosclerosisassociated diseases has been shown, but there are no data regarding an association between CD14 polymorphism and AP. This study evaluated associations between clinical oral health status, CD14 polymorphisms, and CHD. Methods: A case-controlled clinical trial was designed to compare middle-aged adults with acute myocardial infarction or unstable angina (n = 51) within 12 months of the acute event defined as first manifestation with healthy controls (n = 49). Participants were matched for age, sex, and socioeconomic status. Indicators of oral disease and compliance were evaluated. CD14 polymorphisms were analyzed by restriction fragment length polymorphism-polymerase chain reaction. Results: CHD subjects had a higher prevalence of oral diseases and lower compliance to oral preventive strategies than healthy controls. Multivariate analysis showed a positive association between missing teeth (odds ratio [OR] = 1.37; 95% confidence interval [CI], 1.02-1.85), the number of LEOs (OR = 4.37; 95% CI, 1.69-11.28), chronic periodontitis (OR = 5.87; 95% CI, 1.17-29.4), and CHD. No statistically significant association emerged between the CD14 C(À260)T and the CD14 C(À159)T polymorphism, endodontic or periodontal disease, and CHD. Conclusions: Chronic oral diseases may increase the risk of CHD and may be an unconventional risk factor for CHD. (J Endod 2012;38:1570-1577

Objectives: Elimination of etiological factors is great importance in the treatment of dentin hypersensitivity (DH). The aim of this study is to compare the effect of DH etiology and risk factors on different treatment methods [5% sodium fluoride (Duraphat fluoride varnish), 5% glutaraldehyde-35% hydroxyethyl methacrylate (Gluma desensitizer), 8% arginine and calcium carbonate-containing desensitizing paste (Pro-Argin) and erbium-doped yttrium aluminum garnet (Er:YAG) laser]. Methods: 40 patients (16 male and 24 females) with 200 teeth affected by DH and bruxism were included in this study. The patients were divided into two main groups. In the first group, there were patients who could not regularly use the night guard for bruxism due to individual reasons, and who could not complied advices on nutrition and oral hygiene habits (Group-A). The second group consisted of patients who could regularly use the night guard and could complied advices (Group-B). Then, both groups were divided into five subgroups: Group 1: Duraphat fluoride varnish, Group 2: Gluma desensitizer, Group 3: Pro-Argin, Group 4: Er:YAG laser Group 5: Control. DH was assessed with a visual analog scale (VAS); before the treatment, immediately, 1, 4, and 12 weeks after the treatment. The obtained data were evaluated statistically. Results: In both groups, it was seen that the most effective treatment methods were the Er:YAG laser and Pro-Argin. Gluma desensitizer and Duraphat fluoride varnish were also found to be effective in DH compared with control group, but they were not found to be as successful as the Er:YAG laser and Pro-Argin in the long term. It was found that all treatment methods, including the control group, applied to Group-B significantly increased their activities compared to Group-A in the 4 and 12 weeks (p<0.05). Conclusions: It has been found that the success rates of all treatment methods are increased when the etiological factor can be eliminated. It was also observed that Er:YAG laser and Pro-Argin demonstrated statistically similar success rates in both groups. It was seen that Er:YAG laser and Pro-Argin could have hope for long-term DH treatment.

Purpose: The purpose of this study was to determine if increased body mass index (BMI) is associated with an increased risk for dental caries. Methods: Caries severity averages were calculated for a convenience sample of 178 children, ages 8 to 11 years, who participated in the University of Louisville Dental School-based dental treatment program "Smile Kentucky." Caries severity averages were then analyzed against the children's BMI, with gender and age used as covariates. Results: The mean caries average for permanent molars significantly increased with increased BMI, even after adjusting for age and gender. The mean overall caries average did not vary significantly with patient age, BMI, or gender and may be due to confounding mixed dentition events such as eruption, extraction, variable teeth exfoliation, etc. Conclusions: Elevated body mass index is associated with an increased incidence of permanent molar interproximal caries. (Pediatr Dent 2006;28:23-28)

The school health department in the Ministry of Education in Syria attempted to improve the oral health of school children by introducing a programme that was educational and preventionoriented in 1991. The department employed a suf®ciently high number of dentists, oral hygienists and auxiliary personnel to cover many primary schools in the country. Fluoride mouth rinsing programmes were introduced on a wide scale and good oral health behaviour practices were taught as part of the school's teaching programme (1). Abstract ± Objectives: In the early 1990s, the Ministry of Education in Syria introduced a school oral health programme based on preventive and educational activities only. A restorative component was missing at that time. A few years later, the Atraumatic Restorative Treatment (ART) approach was considered an option to complement the oral health programme but little was known about the longevity of ART restorations in permanent teeth. The null hypothesis which was researched in this trial was: there is no difference between the survival of restorations placed through the ART approach using glass ionomer and those produced through the traditional approach using amalgam (MTA) in permanent dentitions after 3 years. Methods: Using a parallel group design, 679 grade 2 children, with a mean age of 7.5 years, participated. A total of 369 children were treated through the ART and 310 children through the MTA approach. Eight dentists produced a total of 1118 single-and multiple-surface restorations. Results: The 3-year dropout of the single-surface restorations was 15.3%. Testing the null hypothesis for all single-and multiple-surface restorations revealed a statistically signi®cant difference between the two approaches in favour of the ART approach (P 0.04). The study showed a 3-year cumulative survival percentage of single-surface ART and MTA restorations of 82.1 (SE 1.9%) and 76.9% (SE 2.3%), respectively. The difference was not statistically signi®cant. The number of 3-year surviving multiple-surface restorations was too low for further analyses. The main failure characteristics for both single-surface ART and MTA restorations were restoration missing and gross marginal defect. The 3-year survival percentage of both single-surface ART and MTA restorations varied widely among the eight operators resulting in an operator effect (P 0.01). Conclusions: The null hypothesis was rejected in favour of the ART approach. It is recommended to select the ART approach to complement the educational and preventive activities of the school oral health programme in Syria.

To assess oral health and oral health associated factors in 12-year-olds and to establish determinants explaining variation in oral health among children representing two areas in the Barents region - Arkhangelsk in North-West Russia and Tromsø in Northern Norway. The samples consisted of Russian (N=590) and Norwegian (N=264) 12-year-olds and their parents selected according to stratified one-stage cluster design. The study included clinical examination (children) and self-reports (children and parents). The child&#39;s oral health was recorded under field conditions. Statistical analyses were conducted on pooled samples of subjects. The mean DMFT/S-scores were 3.0/4.4 for the Russian and 1.2/1.5 for the Norwegian children (p&lt;0.001). In multiple logistic regressions, country of origin (OR=3.8) and filling obtained during last dental visit (OR=5.0) were showing the strongest association with child&#39;s dental caries (χ(2)=87; p&lt;0.001). Among parent&#39;s variables showing the ...

Oral cancer and its treatment can cause a variety of problems to patients, also as regards maintaining their daily oral hygiene. Surgery mutilates tissues which may hamper cleaning the teeth and mucosal surfaces. The patient may have complicated reconstructive structures that also need continuous attention. Radiotherapy-induced hyposalivation further complicates the situation and decreases the quality of life. Consequently, dental caries, mucosal diseases such as candidosis and sialadenitis become problematic to treat. Hence every effort should be focused on prevention. In caries prevention intensified fluoride therapy together with dietary counseling is needed. Oral cancer patients also need to be frequently referred to dental hygienists for professional cleaning. Drinking enough daily and moisturizing mucosal surfaces with commercial dry-mouth products, vegetable oils, milk products and respective topical agents need to be individually recommended. In addition, patients with severe dry mouth cases may also benefit from the prescription of pilocarpine tablets. In oral candidosis, the microbiological diagnosis must be confirmed before administration of antifungal drugs in order to avoid the selection pressure to resistant strains.

Purpose: The objective of the present study was to evaluate whether sensitivity to bitter taste and perception of sweet taste have an influence on dental caries in urban and rural areas. Materials and methods: The caries experience in 181 children, aged 12 years, from rural and urban areas of southern Brazil, was assessed according to World Health Organization guidelines. Sensitivity to the bitterness of phenylthiocarbamide was determined using the Harris–Kalmus procedure, and the sweet taste thresholds of sucrose were measured by Nilsson and Holm's method. Results: The caries index (DMFT > 0) was 3.73 (SD = 2.26) in the rural area and 3.51 (SD = 2.14) in the urban area. The sensitivity to bitter taste and sweet taste perception showed significant association with the gender of schoolchildren (P = 0.04). Girls were predominant in the high sweet perception taster group (62.3%) and the bitter taster group (59.4%). No significant difference in sweet perception status could be observed between the groups of low and high caries severity. The genetic ability to taste bitterness significantly influenced the levels of caries only in children from the urban area (P = 0.005). Bitter non-tasters presented higher severity of caries. A positive correlation was observed between sensitivity to bitter taste and sweet taste perception among children in the rural (r = 0.42, P = 0.002) and urban areas (r = 0.36, P = 0.001). Conclusions: These findings suggest that the bitter non-tasters are more susceptible to dental caries than the tasters in the urban area.

Protozoa of the nose, mouth, and pharynx of 30 randomly chosen male caries patients at an odontological clinic of the National Autonomous University of Mexico, in Mexico City, were surveyed by culture from swabs. Culture tubes from swabs were observed every other day for 5 weeks. Pathogens found included Entamoeba histolytica, Naegleria fowleri, Acanthamoeba castellanii, A. culbertsoni, A. polyphaga, and Giardia lamblia. Such isolations of pathogens suggest that patients may be healthy carriers of cysts and trophic forms of protozoa responsible for several human diseases. Amoebae responsible for primary amoebic meningoencephalitis were well represented in the samples. Small pathogenic freeliving amoebae have not been isolated before from healthy males in Mexico. Many species of free-living cyst-forming protozoa and some commensals without cysts were also cultured from swabs.

Chemomechanical removal of dental caries has considerable potential in the treatment of patients with management problems, especially in paediatric dentistry. The aim of this study was to assess the acceptance and success of the technique in young nervous patients. A group of 20 patients, aged between 4 and 10 years with a high level of dental anxiety was selected. The study achieved a success rate of over 90% in acceptance of cavity preparation by this procedure followed by placement of a restoration. The length of time required for cavity preparation was comparable with conventional methods. The need for local anaesthesia was reduced or eliminated and the children did not complain of any pain during the procedure. It is concluded that chemomechanical caries removal in vivo in primary teeth is an effective alternative to conventional mechanical caries removal and is advantageous in patients who have a phobia to the dental handpiece and/or injections.

Pediatricians are in an ideal position to advise families about the prevention and management of oral diseases in children. The objective of the study was to determine knowledge, attitude, and practices regarding the prevention of oral diseases among pediatricians in Italy. A systematic random sample of 1000 pediatricians received a questionnaire on socio-demographic and practice characteristics; knowledge on risk factors; attitude and practices towards the prevention of oral diseases. A total of 507 pediatricians participated. More than half knew the main risk factors for oral diseases and this knowledge was higher in primary care pediatricians (p = 0.007), in those with a higher number of hours worked per week (p = 0.012), and who believed that oral diseases may be prevented (p = 0.017). Pediatricians with higher knowledge about the main risk factors (p = 0.006) believe that they have an important role in preventing oral diseases and that they can perform an oral examination. Almo...

Objective To assess the effectiveness of motivational interviewing in preventing early childhood caries compared with conventional oral health education. Study design Twelve health care units in southern Brazil were randomly allocated in 2 groups of 6 and professionals in 1 group were trained in motivational interviewing. The mothers/children and external examiners were blinded to the intervention. The data were collected by calibrated examiners using questionnaires and a clinical examination based on modified International Caries Detection and Assessment System criteria. Of the 674 children born in the catchment area in the year 2013, 469 received the intervention (224 in the conventional oral health education group, 245 in the motivational interviewing group), and 320 were examined by the end of the study (145 in the conventional oral health education group, 175 in the motivational interviewing group), with mean age of 30 months. The final follow-up was 68%, after 3 years. Results Mean of decayed, missing, and filled surfaces at the end of the study period for the whole sample was 1.34 (95% CI 0.97-1.71). The caries rate per 100 surface-year in the conventional oral health education group was 1.74 (95% CI 1.14-2.34) and in the motivational interviewing group, it was 0.92 (95% CI 0.63-1.20). To correct for clustering effect and unbalanced factors, multilevel Poisson regression was fitted and the effect of motivational interviewing on the incidence rate ratio was 0.40 (95% CI 0.21-0.79). Conclusions An intervention based on the principles of motivational interviewing style was more effective in reducing the number of surfaces affected by early childhood caries compared with conventional oral health education intervention. (J Pediatr 2018;■■:■■-■■). Trial registration ClinicalTrials.gov NCT02578966, Brazilian Registry of Clinical Trials RBR-8fvwxq. M otivational interviewing is a strategy aimed at changing behavior based on the premise that the reasons to do so are individual and subjective. 1 In this patient-centered approach, patients are responsible for making the choices among the different alternatives and encouraged to make their own decisions. 1,2 Motivational interviewing has emerged as an alternative to address a series of undesirable behaviors, such as unhealthy eating habits, lack of physical activity, and smoking. 3-5 Motivational interviewing has shown different degrees of effect in preventing early childhood caries in clinical trials involving pregnant women and mothers of young children. Although some studies indicate that it can prompt behavioral changes, 6 reduce the severity of carious lesions, 7 and decrease the number of decayed teeth, 8,9 others found no clinical effect. 6 These differences cannot be explained by methodologic differences alone. Although the number of motivational interviewing sessions may provide a partial explanation, contextual factors that affect the incidence of new lesions may also be relevant. Those studies addressed different populations, namely indigenous Canadians, African Ameri-cans, and Asian immigrants. The aim of this study was to assess the effectiveness of motivational interviewing compared with conventional oral health education in preventing early childhood caries in a public health service. Methods This was a randomized community-based trial with parallel groups, whereby children/mothers and external examiners did not know to which intervention group the children's mothers had been allocated. The project was approved by the GHC Research Ethics Committee (protocol no. 13-063 and CAAE no. 15015013.0.0000.5530). The protocol remained unchanged throughout the study. The trial was registered in the Brazilian Registry of Clinical Trials (ReBEC:

The erroneous claim that 50 percent of U.S. schoolchildren have never had a cavity has taken on the virtues of truth through frequent and widespread restatement. The 50-percent caries-free statement is an excessively optimistic misrepresentation by the media of the 1986-87 survey of oral health among schoolchildren by the National Institute of Dental Research because it only tells part of the story--it ignores dental disease in the primary dentition. This article documents that numerous public policy papers reflect failure to consider primary tooth caries data. Consequently, a significant disease burden has been overlooked. The article reviews the persistent underreporting of children&#39;s caries experience in policy documents and the dental literature, and reviews additional epidemiologic studies of caries reported in U.S. dental literature since 1985. Dental caries remains the single most common disease of childhood that is not self-limiting or amenable to a course of antibiotics...

Background. Bisphosphonates are becoming recognized increasingly as having a significant impact on dental therapies. This case report describes adverse clinical sequelae and successful treatment following periodontal surgery in a dental patient receiving bisphosphonate treatment. Case Description. A 78-year-old woman experienced a nonhealing interproximal wound subsequent to a minor periodontal procedure performed to facilitate restoration of an adjacent tooth. Her medical history revealed that she had been taking an oral bisphosphonate every day for the previous five years for treatment of osteoporosis. After three months of periodic débridement and meticulous oral home care, one of the authors recovered a large piece of necrotic bone. The wound healed after the author performed surgery at the site. Clinical Implications. Dentists should exercise caution when considering surgical procedures for patients with a history of oral bisphosphonate use. Thorough treatment of nonhealing wounds in these patients can lead to favorable outcomes.

Key Words: dental caries, preschool, racdethnicity, Head Start, socioeconomic status, feeding practices. ... California is among the most popu-lated and ethnically diverse states in the country. It is also among the states with the lowest proportion of the population with ...

The study evaluated the clinical performance and marginal adaptation of direct and semi-direct class II composite restorations in a split-mouth design over 3.5 years. Design. 44 upper posterior teeth in 11 adults with primary carious lesions were treated with 22 direct and 22 semi-direct restorations. Conventional cavities were prepared for both types of restorations. A fine fine hybrid composite (APH) and a multifunctional adhesive system (Prisma universal bond 3) were used for all restorations. The incremental '3-sited light curing' technique was applied to direct restorations. Semi-direct inlays were prefabricated on silicone casts and post-cured using light and heat. Clinical performance was evaluated using modified USPHS parameters, while marginal adaptation was judged on replicas, using SEM and a standardized evaluation technique. Results. Clinical results after 3.5 years revealed a 100% retention rate with no fractures, sensitivity or recurrent caries for both types of restorations. SEM-evaluation of the occlusal margins showed at the tooth-restoration interface relatively low rates of marginal openings over the observation period (4-8%). Marginal restoration fractures ranged between 1 and 2%, marginal tooth fractures between 3 and 9%. Differences between the restorative techniques and after the different time observation periods were not statistically significant. Proportions of marginal fractures and openings at the restoration-luting composite interface were less than 10% after 3.5 years. Conclusion. The results indicated no significant differences for direct and semi-direct fine hybrid composite restorations in medium size cavities in posterior teeth with respect to clinical performance and marginal adaptation over 3.5 years.

In situ caries models serve purposes other than just being a simpler way to obtain data than running a clinical trial. However, variation in information obtained not only among individuals but also, in particular, depending on different locations of the models within the oral cavity have so far been given little attention. In the present review, the aim has been to characterize the different designs of in situ caries models and to describe some important factors which may vary within the oral cavity and thus influence the outcome of the way the different in situ models are used. Advantages and disadvantages of in vivo models vs. in situ models are discussed. In the latter case, the distinction is made between dental appliance models and so-called &quot;single tooth&quot; models. The review concludes that in situ models differ distinctly with regard to their &quot;biological potential&quot;. Because of regional differences in salivary film velocity, pH, and composition of the microfl...

We report the demonstration of time-correlated single-photon counting (TCSPC) fluorescence lifetime imaging (FLIM) to ex vivo decayed and healthy dentinal tooth structures, using a white-light supercontinuum excitation source. By using a 100 fs-pulsed Ti:Sapphire laser with a low-frequency chirp to pump a 30-cm long section of photonic crystal fibre, a ps-pulsed white-light supercontinuum was created. Optical bandpass interference filters were then applied to this broad-bandwidth source to select the 488-nm excitation wavelength required to perform TCSPC FLIM of dental structures. Decayed dentine showed significantly shorter lifetimes, discriminating it from healthy tissue and hard, stained and thus affected but noninfected material. The white-light generation source provides a flexible method of producing variable-bandwidth visible and ps-pulsed light for TCSPC FLIM. The results from the dental tissue indicate a potential method of discriminating diseased tissue from sound, but stained tissue, which could be of crucial importance in limiting tissue resection during preparation for clinical restorations.

Objectives: The aim of this study was to use tooth eruption sequence, and a tooth-and surface-specific caries analysis method to determine: (1) the temporal relationship between tooth eruption and caries onset; (2) the validity of pre-existing concepts of caries progression; and (3) the relationship of certain putative health behaviors with caries prevalence. Methods: A total of 2428 Arizona children aged 6-36-months, who were recruited from WIC programs (a federal program for low-income children at nutritional risk), health fairs and private day care centers, received visual dental caries examinations. Additionally, an oral health behavior survey was administered to the parents of the 1529 children recruited from the WIC programs. Results: Dental caries was detected soon after tooth eruption, and by 34-36 months of age 25% of this population had caries. Maxillary anterior caries developed as early as 10-12 months of age. Fissure caries of the molars, either by itself or with maxillary anterior caries, was seen as early as 13-15 months of age. Posterior proximal caries was seen as early at 19-21 months, and only was present in conjunction with the other patterns. Over 40% of the 13-36-month-old children whose parents completed the survey still used a bottle. Night-time bottle use was associated with maxillary anterior caries in 24-

Previous studies suggest that salivary and pulp-derived host enzymes, matrix metalloproteinases (MMPs), may be involved in dentin caries pathogenesis. To study the inhibition of acid-activated human salivary MMPs by non-antimicrobial chemically modified tetracyclines (CMTs), we used a functional activity assay with 125I-labeled gelatin as a substrate. To address the role of MMPs in the progression of fissure caries in vivo, we administered the MMP inhibitors CMT-3 and zoledronate to young rats per os for 7 weeks, 5 days a week. Caries lesions were visualized by Schiff reagent in sagittally sectioned mandibular molars. Marked reduction in gelatinolytic activity of human salivary MMPs was observed with CMT-3. CMT-3 and zoledronate, both alone and in combination, also reduced dentin caries progression in the rats. These results suggest that MMPs have an important role in dentin caries pathogenesis, and that MMP inhibitors may prove to be useful in the prevention of caries progression.

aIm: This was to evaluate the retention of fissure sealants (FS) and their effectiveness after resealing on caries reduction applied to first permanent molars, in a sample of children stratified according to their caries risk status in a private practice setting. mETHODs: The sample was 1,274 FS applied on first permanent molars (FPM) of 380 children (6 to 8 years old). Follow-up and monitoring for resealing was 3 years after FS placement, having at least one recall visit per year. Caries risk was based on baseline dmft index: low (dmft=0), moderate (dmft=1-4), high (dmft >4), with almost half of the teeth belonging to the high-risk group. All sealed teeth were evaluated and recorded for FS failure and resealing in case of partial/total loss, as well as caries development. Survival analysis using the Cox Proportional Hazards regression model was used for data evaluation. REsulTs: Of the 1,274 sealed surfaces, 927 (72.8%) needed no intervention 185 (14.5%) needed only resealing and 162 (12.7%) developed caries during the study. Of 162 carious surfaces, 107/ 675 (15.9 %) were from the high caries risk children, compared with 17/144 (11.8 %) and 38/455 (8.3 %) from the moderate and low caries risk group respectively. The highest number of failures, 4.9% and resealing were found at first recall, declining to 1.4% at the end of the study. Development of caries followed a steady rate of 6-8% per year. Cox proportional hazards model indicated, regardless if resealing or caries development was considered a failure or resealing was a success and caries development a failure, only the high dmft index appeared in both cases to significantly increase the chance (158% and 173% respectively) of FS failure and caries development compared with moderate and low dmft index. Other variables when inserted into the hazard model, such as age, sex and number of visits, either did not show a significant effect or only marginally affected FS retention, without modifying the association between caries risk and sealant failure. CONClusIONs: Children of a high baseline caries risk status showed lower FS retention rates and higher occlusal caries prevalence following FS loss compared with those of moderate and low risk status. Resealing does not seem to dramatically change the final outcome of the higher risk group to develop more caries, necessitating other more effective measures to increase the retention of FS on these highly vulnerable areas.

Objectives: The assessment of bitewing radiographs requires knowledge of radiographic anatomy and pathology, and the comprehension of possible effects of superposition which may lead to false positive diagnoses. Based on a clinical case report in which non-carious radiolucencies were discovered on the mesial surfaces of upper molars, this phenomenon, which has not been reported before, was explained. Due to the anatomical characteristics of the rhombic tooth, in particular the crown's receding mesial surface from the mesiobuccal towards the distopalatal side, which is combined with an often prominent palatal cusp and a smaller mesiodistal diameter at the cervical neck, radiolucencies -normally typical caries indicators -can sometimes be observed on the mesial surfaces of upper primary and first permanent molars on bitewings. These triangular-shaped radiolucencies (TSRs) can therefore be attributed to the effects of superposition. The aim of the present epidemiological study was to assess the radiographic frequency of TSRs. Methods: As part of a clinical-radiographic follow-up examination involving 11-12 year old children (n 5 113), both the caries status (World Health Organization (WHO) standard) and the frequency of TSRs were recorded. Results: TSRs were most frequently present on upper second primary molars (60.3%). 35.5% of the upper first primary molars and 24.8% of the upper first permanent molars displayed TSRs. However, none of the lower primary and/or permanent molars displayed this phenomenon. Conclusion: In the mesial surface of upper primary and permanent molars where the frequency of TSRs was fairly high, it may be essential to distinguish this change from approximal caries. The British Institute of Radiology Triangular radiolucencies 24 J Kühnisch et al Dentomaxillofacial Radiology

Host-associated microbial communities are influenced by both host genetics and environmental factors. However, factors controlling the human oral microbiome and their impact on disease remain to be investigated. To determine the combined and relative effects of host genotype and environment on oral microbiome composition and caries phenotypes, we profiled the supragingival plaque microbiome of 485 dizygotic and monozygotic twins aged 5-11. Oral microbiome similarity always increased with shared host genotype, regardless of caries state. Additionally, although most of the variation in the oral microbiome was determined by environmental factors, highly heritable oral taxa were identified. The most heritable oral bacteria were not associated with caries state, did not tend to co-occur with other taxa, and decreased in abundance with age and sugar consumption frequency. Thus, while the human oral microbiome composition is influenced by host genetic background, potentially cariogenic tax...

Purpose: The purpose of this retrospective study was to explore clinical outcomes for NuSmile anterior preveneered stainless steel crowns. Methods: A convenience sample of healthy children treated with anterior crowns was selected from a teaching clinic and private offi ce. Crowns were placed by either a private practice dentist or pediatric dental resident. Clearly defi ned clinical outcomes were assessed by 3 calibrated examiners at recall, including: (1) presence; (2) chipping; (3) wear; (4) crazing; and (5) marginal location by clinical and radiographic examination. examiners at recall, including: (1) presence; (2) chipping; (3) wear; (4) crazing; and (5) marginal location by clinical and radiographic examination. examiners at recall, including: (1) presence; (2) chipping; (3) wear; (4) crazing; and (5) marginal location by clinical and radiographic examination. Factors affecting placement-such as operator experience and behavior-were also assessed. Results: Results: In 46 subjects (21 females, 25 males; mean In 46 subjects (21 females, 25 males; mean age at placement=4 years, 2 months), 226 crowns with a mean post-placement time of 12.9 months were evaluated. Only 2 crowns matched natural teeth, with NuSmile crowns lighter in 83% of subjects. Most crowns were normal in size. Eighty-eight percent resisted fracture for 6 months. All but 3 crowns resisted color change for 6 months. Canine crowns were the least successful, but overall 91% of crowns retained good to excellent clinical appearance. Conclusions: NuSmile anterior preveneered crowns are a clinically successful restoration for primary incisors with early childhood caries. (Pediatr Dent 2007;29:377-81) .

A national study of care and outcomes in children born with a unilateral cleft lip and palate (UCLP) was performed over a 15-month period. Two cohorts of children ('5-year-olds' and '12-year-olds') were examined. There were 57 active cleft teams in the U.K. with 105 consultant orthodontists involved in the care of these children. Only 36 teams could provide basic data such as patients names. Of the patients, 47-51 per cent had neonatal appliances. The dental arch relationships were measured with the Goslon Index and a Five-Year-Old Index, 37-39 per cent of both age groups were either 'poor' or 'very poor'. Seventy per cent of the 12-year-old patients had a Skeletal III relation and 42 per cent of bone grafts were seriously deficient or failed. Dental treatment for active caries was needed by 40 per cent of 5-year-olds and 20 per cent of 12-year-olds. In addition, the training of recently appointed consultant orthodontists involved in the care of these children was scrutinized. As a whole, the results were disappointing with standards of care not significantly raised in the last decade. Recommendations have been made to the Department of Health and the implications for the orthodontic profession are explored. Overall, it seems that fewer orthodontists will need to be involved in a centralized care model for these children.

Background: The perceptions of parents and children regarding oral health are useful to oral public health and clinical practice in pediatric dentistry. The primary aim of the present study was to evaluate the correlation between the total and item scores of the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) (parental version and child's self-reports) and the Early Childhood Oral Health Impact Scale (ECOHIS). Subsequently, the discriminative validity of these assessment tools regarding dental caries was compared. Methods: One hundred twenty-one children randomly selected in the city of Diamantina (Brazil) were submitted to oral examinations. Parents answered the ECOHIS and SOHO-5p (parental version) and children answered the SOHO-5c (child's self-reports). Statistical analysis involved the Mann-Whitney test as well as the calculation of Spearman's correlation coefficients. Results: A significant correlation was found between the SOHO-5p and ECOHIS (r = 0.85), whereas no significant correlations were found between the SOHO-5c and SOHO-5p (r = 0.00) or between the SOHO-5c and ECOHIS (r = −0.41). Significant differences in the impact on quality of life were found between children with severe decay and no severe decay (caries free, with initial or established caries) both the ECOHIS and SOHO-5p (p ≤0.05), whereas no difference was found in SOHO-5c (p > 0.05). Conclusions: The ECOHIS and SOHO-5p were correlated with each other. The accounts of the children differed from their parents' reports and were not capable of discriminating dental caries in advanced stages of progression.

A magnitude do problema da cárie dental no Brasil demanda, sem duvida, ampla utilização de medidas preventivas de alcance coletivo, dentre as quais o processo de adição de fluoreto em águas tratadas ocupa espaço privilegiado. Este processo em diversas localidades "oficialmente fluoretadas" vem sendo, entretanto, marcado pela descontinuidade e/ou interrupção, situações nas quais ocorre evidente prejuízo à saúde bucal da população. Então, devido à grande importância do fluoreto no controle da cárie dentária e manutenção da saúde bucal, este trabalho visou avaliar através do método de SPADNS indicado pela American Public Health Association (APHA) para a determinação de fluoreto os níveis de fluoreto na água fornecida pela CESAMA (Companhia de Saneamento e Pesquisa do Meio ambiente de Juiz de Fora) em bairros residenciais de população de baixa renda de Juiz de Fora, tendo como ponto de coleta referencial as creches comunitárias. Apesar da melhora nos níveis de fluoreto na água fornecida a população, quando se compara esta pesquisa com os níveis obtidos na pesquisa realizada por BANDINI et al., 1999, o trabalho permite concluir que existe uma necessidade de um acompanhamento nos níveis de fluoreto como forma de se obter uma distribuição mais regular, com valores mais próximos do valor ideal.

Objectives: The present study aimed to assess the antibacterial activity against bacteria with cariogenic relevance , toxic and genotoxic potential of the plants Anacardium occidentale L. and Anadenanthera macrocarpa (Benth.) Bernam. Design: Using a microdilution technique, the extracts were submitted to minimum inhibitory concentration (MIC) testing against Streptococcus mitis (ATCC 903), Streptococcus mutans (ATCC 25175), Streptococcus oralis (ATCC 10557), Streptococcus salivarius (ATCC 7073), Streptococcus sanguinis (ATCC 15300) and Streptococcus sobrinus (ATCC 27609). The toxicity of the extracts was then verified against eukaryotic cells. Additionally, a micronucleus assay was performed to investigate the potential mutagenic effects of the extracts on rat ery-throcytes. The Student's t-test, Bonferroni test, and one-way ANOVA followed by Tukey's tests were used for statistical analysis, at a significance level of 5%. Results: While the A. occidentale extract was able to inhibit all of the tested strains, with S. mutans and S. mitis being the most susceptible to that extract́sextract́s action, the A. macrocarpa did not show antimicrobial activity. Interestingly, the hemolytic, oxidant and antioxidant activities were slightly observed for either extract, even at high concentrations (1000 mg/mL). The micronucleus assay showed no significant changes in the cells exposed to the extracts. Conclusion: The A. occidentale extract has potential as an antimicrobial agent with low eukaryotic cell toxicity or mutagenic activity. The A. macrocarpa extract, although absent of antibacterial activity might as well be a safe and effective phytotherapeutic alternative.

Objectives: This field demonstration trial evaluates the long-term effects of introducing daily toothbrushing with fluoride toothpaste in a Chinese kindergarten (test group) compared to caries development in children who had no organized preventive program (control group). Methods: In the test group teacher-supervised toothbrushing was initiated with 1,000 ppm MFP toothpaste in addition to oral health education activities. Test and control children were examined at baseline (n=289, aged 3 years) and annually thereafter. Results: After three years, 251 children (87%) were still in the trial. Caries development (dmfs) calculation included only those children who were present at both baseline and subsequent annual examinations. At baseline the mean dmfs was 4.8 in the test group and 6.5 in the control group (NS). After three years the caries increment was 6.2 and 8.4 in the test group and the control group, respectively Pc.05).

ABSTRACT : The root canal system is an arborizational, anastomotic, byzanthine, labyrinthine complexity, morphologically comparable to a mosaic. While primary canals exist, the tributaries, accessory branches and lumina of dentinal tubules harbour extensive tissue and microflora which if left untreated remains vector for persistent and refractory pathology. Therefore root canal  shaping and cleaning is of utmost importance in the success of root canal treatment. Number of systems are available for effective shaping accounting from hand files to nickel titanium rotary files to the new single file concept “WAVE ONE” KEYWORDS : Wave One, Reciprocating Motion, Nickel Titanium, Reverse  Balanced Force Technique, vCJD
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Objectives. Qualitative comparison of the clinical, radiographic and histological outcomes in a small sample of cariously exposed primary molars, extracted after unsucessful pulp treatment by two vital pulpotomy methods. Subjects and methods. The primary molars were extracted, because of treatment failure, during a longitudinal clinical investigation of the relative efficacy of 20% Buckley's Formocresol versus calcium hydroxide powder as pulp dressings in vital pulp therapy (in press). Fifty-two child patients were sequentially enrolled in the longitudinal clinical investigation, 26 boys and 26 girls. Primary molar teeth requiring vital pulp therapy were randomly allocated to either the formocresol group (F) or the calcium hydroxide group (C). Coronal pulp amputation was prescribed only in teeth with vital, cariouslyexposed pulp tissue. All cases were reviewed using predefined clinical and radiological criteria. Seventy-nine cariously-exposed primary molars required vital pulp therapy. Forty-four teeth were included in group F and 35 in group C. Five per cent (n = 2) of teeth in group F and 11 per cent of teeth (n = 4) in group C were terminated from the trial due to clinical and/or radiographic failure. Of the six teeth extracted, five were sufficiently intact to be retained for histological evaluation. Results. Post-extraction radiographs taken before specimen preparation showed reactionary dentine barrier (bridge) formation in teeth treated with calcium hydroxide. However, the narrowing of root canals, indicative of appositional reactionary dentine deposition, was seen in both groups (F and C). Histological examination confirmed these findings and revealed that pus cells were evident in all specimens examined. There was also histological evidence of resorption of reactionary dentine within the root canal and that forming the calcified barrier (dentine bridge). Conclusion. The clinical and radiographic outcomes for the five teeth correlate well with the reported findings from decalcified histological section. Although numbers are small, the histological findings may indicate possible reasons for treatment failure. There are few reports of this sort in the literature of this under-researched treatment modality.

Oral diseases, represented primarily by dental caries and gingivitis, are major health problems among school-age children and adolescents. Despite the improvement in oral health, as seen in the systematic decline in dental caries observed in industrialised countries, the contrary is the case in many developing countries [WHO, 2000;. Also, in many developed countries a trend for a stagnation in caries decline has been noted . As a result, dental caries is still common among children and adolescents, affecting approximately 80% of 15-year-olds , while gingivitis is present in a majority of children and adolescents, worldwide .

The development of incipient caries, or white spot lesions (WSLs), is a significant clinical problem in orthodontics. The purpose of this study was to retrospectively determine the incidence and severity of WSLs by examining pretreatment and posttreatment digital photographs. Methods: A total of 332 consecutive finished patients from a university graduate orthodontic clinic were evaluated. Initial and final digital images were compared to assess WSLs. The facial surfaces of the anterior 8 maxillary teeth were analyzed. The percentage area of WSL per total facial tooth surface was calculated to control for magnification differences. Reliability of the method was assessed by comparison with direct clinical examination data. Patient and operator factors, and treatment complexity and outcomes were evaluated as predictors of WSL incidence and severity. Results: Agreement between direct clinical examination and digital photo data was excellent, with an intraclass correlation coefficient 0.88 and a 0.3% average difference between methods. The incidence of at least 1 WSL on the labial surface of the anterior 8 maxillary teeth was 36%. The order of incidence was lateral incisor (34%), canine (31%), premolar (28%), and central incisor (17%). Conclusions: Risk factors for the development of incipient caries during orthodontic treatment were young age (preadolescent) at the start of treatment, number of poor hygiene citations during treatment, unfavorable clinical outcome score, white ethnic group, and inadequate oral hygiene at the initial pretreatment examination. The use of computer software to evaluate digital photos retrospectively is a valid method for assessing the incidence and severity of WSLs on the maxillary anterior incisors, canines, and premolars.