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The role of mechanical control of biofilm in the salivary pH after sucrose exposure in children with early childhood caries.
Lima-Holanda, AT, de Sousa, ET, Nobre-Dos-Santos, M, Steiner-Oliveira, C
Scientific reports. 2021;(1):7496
Abstract
This quasi-experimental study sought to investigate if the mechanical control of biofilm (3-times-a-day) modifies the saliva's ability to buffer the oral environment after 20% sucrose rinse (SR20%) in children with early childhood caries (ECC). Here, SR20% reduced the saliva's pH in both groups and the mechanical control of biofilm had a greater effect on this parameter after SR20% in CF children. The mechanical control of biofilm evidenced a higher buffering capacity in CF children before SR20%, which was not observed after SR20%. Otherwise, the absence of mechanical control of biofilm showed that buffering capacity was comparable in the two groups before SR20%, whereas after SR20% the saliva's buffering capacity of CF children was higher than ECC children. When biofilm was mechanically controlled, carbonic anhydrase VI activity did not change after SR20% whereas the absence of mechanical control of biofilm reduced this enzyme activity after SR20%. In conclusion, the mechanical control of biofilm did not change saliva's ability to buffer the oral environment after SR20% in children with ECC. On the other hand, CF children appeared to regulate more effectively the saliva's pH than ECC children while the absence of mechanical control of biofilm mediated their pH-modifying ability after SR20%.
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Characterization of Lactobacilli isolated from carious dentin after selective caries removal and cavity sealing.
Damé-Teixeira, N, Ev, LD, Bitello-Firmino, L, Soares, VK, Dalalba, RS, Rup, AG, Maltz, M, Parolo, CCF
Archives of oral biology. 2021;:104988
Abstract
OBJECTIVE To characterize lactobacilli isolated from residual carious dentin after selective caries removal (SCR), by observing the changes detected in their prevalence, diversity, and cariogenic potential after starvation stress caused by cavity sealing (CS). DESIGN Lactobacilli were cultured from carious dentin lesions (n = 16 patients) treated in a clinical trial, three months before and after CS. Presumptive lactobacilli were selected, isolated, and analyzed by Gram staining. Housekeeping gene sequences were used to identify the species (groEL, rpoA, pheS, and 16S rRNA). RESULTS N = 86 Lactobacillus spp. (n = 41 before and n = 45 after sealing) were genotyped by AP-PCR and analyzed for their cariogenic potential (acid production and acid tolerance). The proportion of lactobacilli to the total anaerobic counts was high, and a significant decrease was observed after sealing (median before sealing = 78.9; 25th-75th = 60.25-97.35; median after sealing = 0.00; 25th-75th = 0.00-77.08; p = 0.001). L. paracasei was the most prevalent species of lactobacilli in carious dentin (p = 0.02). L. rhamnosus prevalence increased to a proportion similar to L. paracasei after CS (p = 0.001). A total of 28 and 14 different genotypes were found before and after CS, respectively. There was no difference between the L. paracasei and the L. rhamnosus isolated from carious dentin, neither regarding acid production nor acid tolerance. CONCLUSIONS Although there was a significant reduction in lactobacilli in the residual carious dentin after SCR, some strains were capable of surviving after three months of CS. However, the sealed available nutrients are low and not sufficient for caries progression. Also, we believe that a longer follow up period may eliminate all the residual lactobacilli. L. paracasei prevailed in carious dentin in a proportion similar to L. rhamnosus in the sealed dentin. Characterization of lactobacilli after SCR and sealing may help the understanding the importance of genotyping of lactobacilli in carious microbiota.
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Oroactive dental biomaterials and their use in endodontic therapy.
Patel, E, Pradeep, P, Kumar, P, Choonara, YE, Pillay, V
Journal of biomedical materials research. Part B, Applied biomaterials. 2020;(1):201-212
Abstract
Dental biomaterials have revolutionized modern therapies. Untreated dental caries remains the major etiological factor for endodontic treatment, and together with a decreasing rate of tooth loss escalates the importance of continuously improving the materials used for endodontic therapies. Endodontic biomaterials are used for vital pulp therapies, irrigation, intracanal medicaments, obturation and regenerative procedures. These materials offer several functions including: antimicrobial activity, mechanical reinforcement, aesthetics, and therapeutic effects. Vital pulp therapies have seen an improvement in clinical results with an incremental approach to build on the strengths of past materials such as calcium hydroxide and calcium silicates. While sodium hypochlorite remains the gold standard for canal irrigation, numerous nanoparticle formulations have been developed to promote sustained antimicrobial action. Gutta-percha based bulk fillers remain the most common materials for root filling. However, while multiple studies focus on the development of novel formulations containing drugs, glass derivatives or ionic-, polymeric-, or drug- loaded nanoparticles, a lack of reliable and long-term clinical evidence obligates further study as experienced clinicians prefer to use what has worked for decades. This review delves in to the biochemistry of the materials to scrutinize their shortcomings, and where opportunity lies to further enhance their efficacy in endodontic practice. © 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 108B:201-212, 2020.
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Application of Antibiotics/Antimicrobial Agents on Dental Caries.
Qiu, W, Zhou, Y, Li, Z, Huang, T, Xiao, Y, Cheng, L, Peng, X, Zhang, L, Ren, B
BioMed research international. 2020;:5658212
Abstract
Dental caries is the most common oral disease. The bacteriological aetiology of dental caries promotes the use of antibiotics or antimicrobial agents to prevent this type of oral infectious disease. Antibiotics have been developed for more than 80 years since Fleming discovered penicillin in 1928, and systemic antibiotics have been used to treat dental caries for a long time. However, new types of antimicrobial agents have been developed to fight against dental caries. The purpose of this review is to focus on the application of systemic antibiotics and other antimicrobial agents with respect to their clinical use to date, including the history of their development, and their side effects, uses, structure types, and molecular mechanisms to promote a better understanding of the importance of microbial interactions in dental plaque and combinational treatments.
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Do probiotics promote oral health during orthodontic treatment with fixed appliances? A systematic review.
Hadj-Hamou, R, Senok, AC, Athanasiou, AE, Kaklamanos, EG
BMC oral health. 2020;(1):126
Abstract
BACKGROUND Treatment with fixed orthodontic appliances has been associated with significant biofilm accumulation, thus putting patients at a higher risk of oral health deterioration. The use of probiotics has been proposed to be useful in the prevention or treatment of oral pathologies such as caries and diseases of periodontal tissues. Our aim was to investigate the effects of probiotic use on inflammation of the gingival tissues and the decalcification of the enamel in patients being treated with fixed orthodontic appliances. METHODS We searched without restrictions 8 databases and performed hand searching until September 2019. We searched for randomized controlled trials (RCTs) evaluating whether individuals with fixed orthodontic appliances benefit from probiotic treatment in terms of the inflammation of the gingivae and decalcification of the enamel. Following the selection of studies and the extraction of pertinent data, we appraised the risk of bias and the confidence in the observed effects based on established methodologies. RESULTS From the final qualifying studies, three did not show any statistically significant effect on gingival inflammation after probiotic administration of up to 1 month. Similarly, non-significant differences were noted in another study regarding white spot lesions development (mean administration for 17 months). No adverse effects were reported and the level of evidence was considered moderate. CONCLUSIONS Supplementation of orthodontic patients with probiotics did not affect the development of inflammation in the gingivae and decalcification in the enamel. Additional RCTs, with longer intervention and follow-up periods, and involving different combinations of probiotic strains are required. TRIAL REGISTRATION PROSPERO (CRD42018118008).
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Association of LTF, ENAM, and AMELX polymorphisms with dental caries susceptibility: a meta-analysis.
Sharifi, R, Jahedi, S, Mozaffari, HR, Imani, MM, Sadeghi, M, Golshah, A, Moradpoor, H, Safaei, M
BMC oral health. 2020;(1):132
Abstract
BACKGROUND This meta-analysis evaluated the association of LTF, ENAM, and AMELX polymorphisms with dental caries susceptibility. METHODS We searched the Scopus, PubMed/Medline, Web of Science, and Cochrane Library databases to retrieve articles published by October 2019. Review Manager 5.3 software was used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The results of publication bias tests were retrieved by Comprehensive Meta-Analysis 2.0 software. RESULTS A total of 150 relevant records were identified; out of which, 16 were entered into the analysis (4 studies assessed LTF, 11 ENAM, and 11 AMELX polymorphisms). Of all polymorphisms, there was a significant association only between ENAM rs3796704 polymorphism and dental caries susceptibility. Both ENAM rs3796704 and AMELX rs17878486 polymorphisms had a significant association with dental caries risk in the Caucasian ethnicity and the studies including caries-free control group. CONCLUSIONS The results of this meta-analysis showed that the G allele and the GG genotype of ENAM rs3796704 were associated with an increased risk of caries in the case group compared with the control group. But there was no association between LTF rs1126478, ENAM (rs1264848 and rs3796703), and AMELX (rs946252, rs17878486, and rs2106416) polymorphisms and dental caries susceptibility.
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Application of green tea extracts epigallocatechin-3-gallate in dental materials: Recent progress and perspectives.
Liao, S, Tang, Y, Chu, C, Lu, W, Baligen, B, Man, Y, Qu, Y
Journal of biomedical materials research. Part A. 2020;(12):2395-2408
Abstract
Because of excellent biocompatibility, antioxidant activity, and anti-caries ability, epigallocatechin-3-gallate (EGCG) has been widely studied in the treatment of oral diseases, such as periodontal disease, oral cancer, and dental caries. To reach the site of the lesion or achieve sustained release, play the role of anti-caries, anti-inflammatory, or to maintain or improve the physical properties of the modified material,EGCG need to be cross-linked or embedded with dental adhesives, barrier membranes, bone replacement materials, tissue regeneration materials, and antimicrobial anti-caries materials to better prevent or treat oral diseases. This article reviews the applications of EGCG in oral materials, involving various areas of the oral cavity, reveals their excellent potential, and sees shortcomings in these research to promote the better development of EGCG applications in oral materials such as oral repair materials, bone tissue engineering materials and antibacterial and anti-caries materials.
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Novel rechargeable calcium phosphate nanoparticle-filled dental cement.
Xie, X, Wang, L, Xing, D, Qi, M, Li, X, Sun, J, Melo, MAS, Weir, MD, Oates, TW, Bai, Y, et al
Dental materials journal. 2019;(1):1-10
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Abstract
The objectives were to develop a novel rechargeable cement containing amorphous calcium-phosphate nanoparticles (nanoACP) to suppress tooth decay. Five cements were made with: (1) 60% glass particles (experimental control); (2) 40% glass+20% nanoACP; (3) 30% glass+30% nanoACP; (4) 20% glass+40% nanoACP; (5) 10% glass+50% nanoACP. Groups 1-4 had enamel bond strengths similar to Transbond XT (3M) and Vitremer (3M) (p>0.1). The nanoACP cement had calcium and phosphate ion release which increased with increasing nanoACP fillers. The recharged cement had substantial ion re-release continuously for 14 days after a single recharge. Ion re-release did not decrease with increasing recharge/re-release cycles. Groups 3-5 maintained a safe pH of medium (>5.5); however, control cements had cariogenic pH of medium (<4.5) due to biofilm acid. Therefore, nanoACP cement (1) had good bond strength to enamel, (2) possessed calcium and phosphate ion recharge/re-release capability, and (3) raised biofilm pH to a safe level to inhibit caries.
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Efficacy of caries and gingivitis prevention strategies among children and adolescents with intellectual disabilities: a systematic review and meta-analysis.
Zhou, N, Wong, HM, Wen, YF, McGrath, C
Journal of intellectual disability research : JIDR. 2019;(6):507-518
Abstract
BACKGROUND Dental caries and periodontal diseases are the most common oral diseases among human beings. Individuals with intellectual disabilities (IDs) have poor oral health and limited access to dental care. The aim of this study was to investigate the efficacy of strategies in caries and gingivitis prevention among children and adolescents with ID. METHODS Four electronic databases (PubMed, Cochrane Library, Web of Science and Scopus) were searched from their commencement date to 17 April 2017. Randomised or non-randomised controlled trials evaluating the efficacy of interventions in caries and gingivitis prevention were included if the participants were children and adolescents with ID. Gingival index and caries experiences were reported in the format of mean difference and standard error. Meta-analysis was conducted if data could be pooled from two or more studies using similar outcome measurements and intervention. RESULTS A total of 1455 articles published in English were identified. Fourteen studies formed the basis of qualitative analysis; six studies were feasible to perform quantitative analysis. Meta-analysis favoured fluoride to placebo in caries prevention [Z = 2.02, P < 0.05, 95% CI: -0.71 (-1.40, -0.02)], while the effectiveness of chlorhexidine remained elusive. CONCLUSIONS Both mechanical and chemical approaches had been applied to caries and gingivitis prevention among children and adolescents with ID. Insufficient evidence supported the efficacy of chlorhexidine nor powered toothbrush, while fluoride was suggested to be an effective caries preventive strategy in fluoride-deficient areas. More well-designed randomised controlled trials using integration strategies are encouraged in further studies.
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Critical Appraisal of Oral Pre- and Probiotics for Caries Prevention and Care.
Zaura, E, Twetman, S
Caries research. 2019;(5):514-526
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Abstract
In recent years, the concept of preventing caries-related microbial dysbiosis by enhancing the growth and survival of health-associated oral microbiota has emerged. In this article, the current evidence for the role of oral pre- and probiotics in caries prevention and caries management is discussed. Prebiotics are defined as "substrates that are selectively utilized by host microorganisms conferring a health benefit." With regard to caries, this would include alkali-generating substances such as urea and arginine, which are metabolized by some oral bacteria, resulting in ammonia production and increase in pH. While there is no evidence that urea added to chewing gums or mouth rinses significantly contributes to caries inhibition, multiple studies have shown that arginine in consumer products can exert an inhibitory effect on the caries process. Probiotics are "live microorganisms which when administrated in adequate amounts confer a health benefit on the host." Clinical trials have suggested that school-based programs with milk supplemented with probiotics and probiotic lozenges can reduce caries development in preschool children and in schoolchildren with high caries risk. Due to issues with research ethics (prebiotics) and risk of bias (prebiotics, probiotics), the confidence in the effect estimate is however limited. Further long-term clinical studies are needed with orally derived probiotic candidates, including the health-economic perspectives. In particular, the development and evaluation of oral synbiotic products, containing both prebiotics and a probiotic, would be of interest in the future management of dental caries.