ORCID Profile
0000-0002-4570-0620
Current Organisations
University of Melbourne
,
Rijksuniversiteit Groningen
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Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.JDENT.2013.05.002
Abstract: To investigate and clarify physical and chemical properties of enamel affected by molar incisor hypomineralisation (MIH). A series of in vitro studies were performed on extracted molars affected by MIH and sound teeth for controls. Tooth sections underwent Vickers microhardness testing before lapping and subsequent transverse microradiographic analysis and examination under polarised light microscopy. Carbonate content was determined by CO2 release from acid digestion. Unprepared and fractured surfaces were examined under scanning electron microscopy. MIH-affected molars demonstrated a severe degree of hypomineralisation with an average mineral content of only 58.8%vol% mineral. Vickers microhardness was significantly reduced in MIH compared with controls (1.8±1.1 v 4.4±1.0 GPa, p<0.05) and polarised light microscopy revealed the bulk of MIH lesions had a porosity of ≤5% but also substantial areas of ≥10% and smaller areas exceeding 25% porosity. A surface layer was frequently observed on both intact and broken-down lesions and cervical regions of MIH teeth were typically spared. Carbonate content of MIH enamel was higher than control s les (6.6±2.1 v 4.4±1.1 wt%, p<0.05). Scanning electron microscopy showed that both the enamel rod and surface ultrastructure were defective. Clinical characteristics did not consistently correlate with all properties. The properties of MIH-affected enamel significantly differ from those of normal enamel and were highly variable, however some common characteristics were observed. Implications for aetiology and clinical management are discussed.
Publisher: MDPI AG
Date: 26-10-2023
DOI: 10.3390/JCM12216762
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.ARCHORALBIO.2017.08.008
Abstract: To systematically assess and contrast reported differences in microstructure, mineral density, mechanical and chemical properties between molar-incisor-hypomineralization-affected (MIH) enamel and unaffected enamel. Studies on extracted human teeth, clinically diagnosed with MIH, reporting on the microstructure, mechanical properties or the chemical composition and comparing them to unaffected enamel were reviewed. Electronic databases (PubMed, Embase and Google Scholar) were screened hand searches and cross-referencing were also performed. Twenty-two studies were included. Fifteen studies on a total of 201 teeth investigated the structural properties, including ten (141 teeth) on microstructure and seven (60 teeth) on mineral density six (29 teeth) investigated the mechanical properties and eleven (87 teeth) investigated the chemical properties of MIH-affected enamel and compared them to unaffected enamel. Studies unambiguously found a reduction in mineral quantity and quality (reduced Ca and P content), reduction of hardness and modulus of elasticity (also in the clinically sound-appearing enamel bordering the MIH-lesion), an increase in porosity, carbon/carbonate concentrations and protein content compared to unaffected enamel. were ambiguous with regard to the extent of the lesion through the enamel to the enamel-dentin junction, the Ca/P ratio and the association between clinical appearance and defect severity. There is an understanding of the changes related to MIH-affected enamel. The association of these changes with the clinical appearance and resulting implications for clinical management are unclear. MIH-affected enamel is greatly different from unaffected enamel. This has implications for management strategies. The possibility of correlating the clinical appearance of MIH-affected enamel with the severity of enamel changes and deducing clinical concepts (risk stratification etc.) is limited.
Publisher: S. Karger AG
Date: 2020
DOI: 10.1159/000510843
Abstract: b i Aim: /i /b To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. b i Methods: /i /b A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. b i Results: /i /b Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient’s in idual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the in idual.
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.JDENT.2011.05.002
Abstract: Dental products containing calcium phosphate and fluoride are claimed to enhance enamel remineralization over fluoride products. To compare remineralization of enamel subsurface lesions by dental products with added calcium phosphate in a double-blind, randomized, cross-over in situ study. Human enamel specimens with subsurface lesions were prepared and inserted into intra-oral appliances worn by volunteers. A slurry (1g product plus 4 ml H(2)O) of each product was rinsed for 60s, 4 times per day for 10 days. Six products were tested (i) placebo, (ii) 1000 ppm F, (iii) 5000 ppm F, (iv) Tooth Mousse (TM), (v) TM plus 900 ppm F (TMP) and (vi) Clinpro with 950 ppm F. Calcium, inorganic phosphate and fluoride levels were measured in post-rinse/saliva s les using ion chromatography. Mineral content was measured using transverse microradiography. Only TM and TMP significantly increased salivary calcium and phosphate levels. The products produced remineralization in the following order from lowest to highest: placebo<1000 ppm F=Clinpro<5000 ppm F<TM<TMP. Clinpro was not significantly different to 1000 ppm F whereas TM and TMP were superior to 5000 ppm F with TMP producing the highest level of enamel lesion remineralization.
Publisher: Elsevier BV
Date: 07-2023
Publisher: MRE Press
Date: 2020
DOI: 10.17796/1053-4625-44.1.4
Abstract: Purpose: Molar Incisor Hypomineralization (MIH) is a developmental enamel anomaly of systemic origin affecting the first permanent molars and often the permanent incisors. Despite MIH being a prevalent anomaly, its diagnosis and management are challenging for practitioners including poor anesthesia, failure of restorations, rapid enamel breakdown, poor resin adhesion, and related child anxiety. This study aimed to evaluate knowledge regarding and management of MIH amongst orthodontists and dentists. Study design: The study was performed from March to September 2017 and included 336 dentists and 32 orthodontists. Questionnaires comprised questions on MIH diagnosis, socio-demographic characteristics of the subjects, and photographs of a case of MIH with related questions regarding management. Results: Our results showed that 48% of dentists and 25% of orthodontists misdiagnosed MIH with misdiagnosis associated with graduation prior to 1986 (p & 0.001). Amongst dentists, 59% applied a fluoridated product and 34% applied fissure sealants in the case of moderate MIH. The application of fluoride was associated with graduation after 1986 (p & 0.0001).Conclusion: Large disparities about knowledge and management of MIH exist between dental practitioners in France. Education regarding diagnosis and management of MIH is necessary.
Publisher: Springer Science and Business Media LLC
Date: 18-04-2015
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.CCT.2015.07.005
Abstract: The Hall Technique (HT) is a carious primary molar treatment that does not require local analgesia, carious tissue removal or tooth preparation. The carious lesions in carefully selected teeth are sealed with a stainless steel crown (preformed metal crown). The study aims are to determine the clinical effectiveness, acceptability and cost-effectiveness of the HT for management of carious lesions in young dental patients. Children, aged 3-7years, with a primary molar tooth with a carious lesion extending no further than the middle third of dentine, with no signs or symptoms of pulp inflammation or infection, and attending one of three community agencies are recruited. Target s le size is 220. A control tooth with an intra-coronal restoration is sourced from the same mouth. The primary outcome is the period of time free from further treatment. The assessments are scheduled at 6, 12 and 24months. In addition to the clinical assessment, acceptability of the HT will be assessed via questionnaires among patients and their primary carers at baseline, 6, 12 and 24months. Cost-outcome description and cost-effectiveness analysis from healthcare provider and societal perspective will be conducted. The clinical effectiveness, acceptability and cost-effectiveness of the HT in the community dental setting will be evaluated. The results of this study will determine the implementation of HT in the management of dental caries in young children.
Publisher: Wiley
Date: 11-11-2019
DOI: 10.1111/ADJ.12658
Abstract: The aim of this study was to investigate the effect of treatment with the saliva biomimetic, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and SnF Twenty-four participants were randomized into two groups. Both groups used 0.4% SnF Both groups showed significantly reduced resting saliva flow rate (P < 0.001) postradiotherapy. There were no significant differences in flow rates and fluoride concentration between groups. The CPP-ACP group exhibited a significant (P < 0.05) 51% reduction in coronal surface caries progression compared with the placebo group. Resting salivary flow rate was significantly reduced in head-and-neck cancer patients following radiotherapy and use of CPP-ACP with SnF
Publisher: Wiley
Date: 03-2017
DOI: 10.1111/JCPE.12685
Abstract: Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio-economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management. To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases. One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report. There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc-γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end-products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub-optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases.
Publisher: Springer Science and Business Media LLC
Date: 05-02-2016
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.1016/J.AJODO.2013.10.017
Abstract: In this retrospective study, we examined and compared the pretreatment and posttreatment arch widths and buccal corridor changes in subjects who had received orthodontic treatment either with or without premolar extractions. Pretreatment and posttreatment casts, frontal smiling photographs, and lateral cephalograms of 30 extraction and 27 nonextraction patients were analyzed to determine any significant differences in arch widths, buccopalatal inclinations of the teeth, and buccal corridor widths and areas, both within and between the 2 groups. Relationships between buccal corridor measurements and corresponding arch widths and buccopalatal inclinations of the teeth were also examined. There was a significant increase in the posttreatment maxillary intercanine width in the extraction group but not in the nonextraction group. Both the pretreatment and posttreatment arch widths between the maxillary first molars and at the level of the posterior rugae were greater in the nonextraction group than in the extraction group. There were no significant differences in any buccal corridor widths or areas measured between the extraction and nonextraction subjects. Because they reflect different morphologies, there are likely to be significant differences in average maxillary anterior and posterior posttreatment arch widths in those treated with or without extractions. However, these arch width differences are not likely to be discernible in extraction and nonextraction patients as differences in the buccal corridor widths and areas.
Publisher: Wiley
Date: 02-1995
DOI: 10.1111/J.1834-7819.1995.TB05608.X
Abstract: Despite dramatic reductions in caries in fluoridated communities, the disease continues to occur during childhood and adolescence and there is a sustained caries susceptibility of pits and fissures. Pit and fissure sealants have been available to the dental profession for the past two decades. Closely following community water fluoridation, this use of adhesive technology is now recognized as a major cornerstone of modern preventive dentistry. However, the technique appears to have been slow in implementation by the dental profession. Recent expanded utilization of sealants in the public sector, particularly in Victoria, has increased the awareness of the procedure amongst the public and is heightening demand. A review of the pertinent literature and current trends in utilization of sealants is presented. The case is made for expanded utilization of sealants in both the public and private sectors of dental health care delivery in Australia.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.AJODO.2013.10.019
Abstract: This study was designed to assess the influence that the buccal corridor might have on the frontal facial attractiveness of subjects who had received orthodontic treatment with or without 4 premolar extractions. Posttreatment full-face frontal smiling photographs of 30 premolar extraction and 27 nonextraction patients were evaluated by 20 orthodontists, 20 dentists, and 20 laypeople using a visual analog scale. The ratings were analyzed according to rater group, rater sex, and number of years in practice for orthodontists and dentists to search for any statistically significant differences in the ratings on the basis of treatment groups, subject sex, and buccal corridor widths and areas. Orthodontists and dentists gave higher mean overall frontal facial attractiveness scores than did laypeople. There were no significant differences in how men and women rated the study subjects. The number of years in practice did not affect how the orthodontists rated, but it did affect the ratings of the dentists. Female subjects were consistently rated as significantly more attractive than male subjects. There was no difference in ratings for the extraction and nonextraction subject groups. The buccal corridor widths and areas did not affect the frontal facial attractiveness ratings. If treatment has been carried out with thorough diagnosis and careful planning, neither the choice of extraction or nonextraction treatment, nor the resulting buccal corridor widths or areas appeared to affect the subjects' frontal facial attractiveness.
Publisher: Wiley
Date: 27-11-2014
DOI: 10.1111/ADJ.12255
Abstract: This study investigated the physical properties and ion release of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-modified calcium silicate-based cements (CSCs) and compared the properties of a trial mineral trioxide aggregate (MTA) with two commercially available CSCs, Biodentine(™) and Angelus(®) MTA. The setting time, solubility, compressive strength and Vickers surface microhardness of the three CSCs incorporated with 0%, 0.5%, 1.0%, 2.0% and 3.0% (w/w) CPP-ACP were investigated. Release of calcium (Ca(2+) ), phosphate ions (Pi ) and pH of the test cements were measured after 24, 72, 168 and 336 h of storage. The addition of up to 1.0% CPP-ACP into Biodentine(™) and 0.5% into the other cements did not adversely affect their physical properties except for the setting time. The addition of 0.5% CPP-ACP increased Ca(2+) released from Biodentine(™) (after 168 and 336 h), Angelus(®) MTA (after 168 h) and the trial MTA (after 72 h). The addition of 1.0-3.0% CPP-ACP increased Ca(2+) and Pi released from all the cements. Biodentine(™) released more Ca(2+) particularly in the early stages and showed shorter setting time and higher mechanical properties than the other cements. The mechanical properties of Angelus(®) MTA and the trial MTA were similar. All the cements produced highly alkaline storage solutions. Up to 1.0% CPP-ACP in Biodentine(™) improves Ca(2+) and Pi release and 0.5% CPP-ACP in Angelus(®) MTA and the trial MTA improves Ca(2+) release without altering the mechanical properties and solubility. The addition of CPP-ACP into CSCs prolonged the setting time.
Publisher: Elsevier BV
Date: 10-2020
Publisher: Elsevier BV
Date: 11-2021
Publisher: Springer Science and Business Media LLC
Date: 09-12-2018
DOI: 10.1007/S00784-017-2299-4
Abstract: This cross-sectional study compared the caries experience in 15-year-olds with and without demarcated hypomineralised lesions (DHL) in permanent teeth. One thousand three hundred and two 15-year-old adolescents from two ongoing birth cohorts (GINIplus15 and LISAplus15) were examined to determine non-cavitated carious lesions (NCCL) and the DMF index. Furthermore, DHL was scored on all permanent teeth/surfaces according to the molar-incisor hypomineralisation criteria of the European Academy of Paediatric Dentistry (MIH/EAPD). Adolescents with DHL were categorised into those with a minimum of one DHL in the permanent dentition (DHL ≥ 1), with DHL on at least one first permanent molar (MIH/EAPD) and with DHL on at least one first permanent molar and permanent incisor (MIH/Severe). The study was conducted in the metropolitan area of Munich. The proportion of children without caries amounted to 63.7% (DMF > 0) and 26.0% (D Caries and DHL are prevalent and influenced the dental health of 15-year-old adolescents. A significant positive association existed between the presence of caries and DHL. Children with MIH/EAPD or MIH/Severe had a higher probability to develop carious lesions in the permanent dentition.
Publisher: SAGE Publications
Date: 08-07-2016
Abstract: The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination. The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation and real-time communication with a remotely located oral health professional. It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19–AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67–AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30–AU$48.87) per resident. Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination.
Publisher: Springer Science and Business Media LLC
Date: 13-07-2016
DOI: 10.1007/S40368-016-0235-Y
Abstract: This was to investigate the association of peripartum events with the occurrence of MIH. This study, carried out between 2010 and 2011, was based on objective information noted in child health booklets on putative risk factors for MIH during the Peripartum period, aged between 6 to 28 years. The target population consisted of patients with MIH and a control group. Among the 849 patients examined by two calibrated paediatric dentists, 75 patients with MIH were recorded. These patients attended for consultation either at the teaching dental hospital of Bordeaux (France) or at a private dental practice (Bordeaux, France). Pearson's Chi-squared test was used and Odds ratios (OR) with 95 % test-based confidence intervals (CI) were calculated. Correlations were observed between hypoxia during delivery and occurrence of MIH (OR = 6.1 CI = 1.7-21.85), and also between birth by caesarean section and MIH (OR = 2.9 CI = 1.2-6.9). There was no association between prematurity and MIH. Peripartum events such as hypoxia during birth or delivery by caesarean section are suggested to be risk factors for the occurrence of MIH in this population.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.JDENT.2018.03.005
Abstract: Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPM) involve qualitative structural developmental anomalies of tooth enamel affecting the first permanent molars (and often incisors) and the second primary molars, respectively. A putative relationship between HSPM and MIH has been reported in the scientific literature. The aim was to determine whether children with HSPM are more likely to develop MIH. A systematic search using PubMed/Medline, Embase and Cochrane Library electronic databases for publications from 2001 to August 2017 investigating the link between MIH and HSPM was undertaken. Four reviewers selected the studies independently, extracted the data according to PRISMA statement, and assessed the bias risk with the Newcastle-Ottawa Scale (NOS) criteria. From 645 potentially eligible studies, 14 were selected for full text analysis and 5 were included in the meta-analysis. Cross-sectional and cohort studies were reported and 4662 participants were included. The meta-analyses were performed with a random model calculated an OR total of 4.66 (95% CI 2.11-10.26 P < 0.001). The weighted mean of the co-occurrence of HSPM and MIH prevalence was 19.94%. The high heterogeneity (I Early detection and preventive intervention could reduce MIH complications.
Publisher: FapUNIFESP (SciELO)
Date: 2022
Publisher: S. Karger AG
Date: 24-07-2018
DOI: 10.1159/000490196
Abstract: Toothpastes are the most universally accepted form of fluoride delivery for caries prevention. To provide anti-caries benefits, they must be able to release fluoride during the time of tooth brushing or post brushing into the oral cavity. However, there is no standard accepted procedure to measure how much fluoride in a toothpaste may be (bio) available for release. The European Organization for Caries Research proposed and supported a workshop with experts in fluoride analysis in toothpastes and representatives from industry. The objective of the workshop was to discuss issues surrounding fluoride analysis in toothpaste and reach consensus on terminology and best practices, wherever the available evidence allowed it. Participants received a background paper and heard presentations followed by structured discussion to define the problem. The group also reviewed evidence on the validity, reliability and feasibility of each technique (namely chromatography and fluoride electroanalysis) and discussed their strengths and limitations. Participants were able to reach a consensus on terminology and were also able to identify and summarize the advantages and disadvantages of each technique. However, they agreed that most currently available methods were developed for regulatory agencies several decades ago, utilizing the best available data from clinical trials then, but require to be updated. They also agreed that although significant advances to our understanding of the mechanism of action of fluoride in toothpaste have been achieved over the past 4 decades, this clearly is an extraordinarily complex subject and more work remains to be done.
Publisher: Wiley
Date: 18-01-2013
Publisher: Wiley
Date: 02-03-2012
Publisher: Wiley
Date: 11-05-2015
DOI: 10.1111/JICD.12162
Abstract: To investigate the displacement of Biodentine Twenty plastic teeth with prepared occlusal cavities were ided into four groups and had Biodentine The lowest values of Biodentine Within the limitations of this in vitro study, a GIC-loaded SSC can be seated on Biodentine
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.JOEN.2017.11.005
Abstract: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) and CPP-ACP with fluoride (CPP-ACFP) have been shown to provide bioavailable ions to promote mineralization. Hence, the aim of this study was to evaluate the materials' biocompatibility and osteogenic/calcification potential for endodontic applications. Human and mouse osteoblast-like and fibroblast-like cell lines were incubated with 0.05%-3.0% w/v CPP-ACP and CPP-ACFP, and toxicity, proliferation, alkaline phosphatase, interleukin (IL)-1α, and IL-6 production, collagen type I, osteocalcin, and osteopontin production, and mineralization/calcification were determined. CPP-ACP and CPP-ACFP were non-toxic and had no significant effect on proliferation or production of the inflammatory cytokine IL-1α. Alkaline phosphatase activity of the osteoblast-like cells was significantly increased (P < .05) by CPP-ACP and CPP-ACFP, as was the production of the osteotropic cytokine IL-6, the formation of calcium mineral deposits, and the secretion of mineralization-related proteins (collagen type I and osteocalcin). CPP-ACP and CPP-ACFP are biocompatible and have the potential to induce osteoblastic differentiation and mineralization. Potential applications include apexification, perforation repair, vital pulp therapy, and regenerative endodontic procedures.
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.TRIPLEO.2009.08.034
Abstract: Multifocal epithelial hyperplasia (MEH) presents as painless, single or multiple nodular or papular lesions with a sessile base, ranging in diameter from 0.1 cm to 1.0 cm, frequently coalescing. Lesion color varies from red to white, depending on the extent of keratinization. The condition appears mainly in children and adolescents and regresses spontaneously. The etiological factors and pathogenesis of MEH are speculative. A 13-year-old boy presented to the Royal Dental Hospital of Melbourne for dental examination revealing several asymptomatic, exophytic, pink, sessile, smooth-surfaced nodules on the lateral borders of the tongue and lingual surface of the lower lip. The subject is of Somalian background and one of 11 siblings aged 2 to 22 years old living with his parents in an overcrowded residence. Examination of other family members revealed the presence of similar lesions in 2 younger sisters. An incisional biopsy confirmed the diagnosis of MEH histopathologically.
Publisher: Springer Science and Business Media LLC
Date: 17-01-2020
DOI: 10.1038/S41598-020-57435-7
Abstract: Sub-optimal nutrition and dental caries are both common with significant short and long-term implications for child health and development. We applied twin statistical methods to explore the relationship between body mass index (BMI) and dental caries. We measured BMI at 18 months and six years of age and cumulative dental caries experience at six years in 344 twin children. Dental caries in primary teeth was categorised into ‘any’ or ‘advanced’ and BMI was analysed as both a continuous and categorical variable. Statistical analyses included multiple logistic regression using generalized estimating equations and within/between-pair analyses. There was no association between BMI and ‘any’ dental caries experience at either time-point, neither overall nor in within/between pair analyses. However, ‘advanced’ dental caries at six years was associated with a within-pair difference in BMI of −0.55 kg/m 2 (95% CI −1.00, −0.11, p = 0.015). A within-pair increase of 1 kg/m 2 in BMI was associated with a lower within-pair risk of advanced dental caries (OR 0.68, 95% CI 0.52, 0.90, p = 0.007). These findings reveal a possible causal relationship between lower BMI and dental caries. As dental outcomes were only measured at one time point, the direction of this potentially causal relationship is unclear.
Publisher: Springer Science and Business Media LLC
Date: 08-2012
DOI: 10.1007/BF03262866
Publisher: MDPI AG
Date: 04-03-2023
Abstract: Objective: To evaluate oral health conditions and oral health-related quality of life in community-dwellers aged ≥ 45 years in the Canton of Bern, Switzerland. Materials and Methods: One hundred subjects (63% males mean age: 73 years), selected randomly using a cluster procedure within the Canton of Bern, underwent a clinical oral examination after completing questionnaires on socio-economic level, medical history, oral health behaviour, and Geriatric Oral Health Assessment Index (GOHAI). Descriptive analyses and multinomial regression models were applied to investigate the association between oral health diseases (dental caries and periodontitis) and specific participant characteristics. Results: The mean number of decayed, missing, and filled teeth (DMFT) was 0.30, 4.20, and 8.75, respectively the mean DMFT score = 13.35. Dental caries prevalence (ICDAS 0) was 15% and periodontitis prevalence was 46%. Logistic regression models revealed that living in an urban area was associated with lower odds (OR 0.03, 95%CI 0.00–0.36) of having periodontal disease. Male gender was associated with lower odds for dental caries (OR 0.31, 95%CI 0.09–1.01) and total lack of professional tooth cleaning was associated with higher odds for dental caries (OR 41.99, 95%CI 0.01–0.38). Ordinal logistic regression revealed that both the presence of dental caries (RR 12.80, 95%CI 1.47–111.20) and periodontal disease (RR 6.91, 95%CI 1.16–84.00) were statistically significantly associated with rheumatoid arthritis. Conclusion: Within the study limitations, untreated dental caries and periodontal disease are prevalent in the Swiss population, despite the high level of self-performed oral hygiene and access to the dental care system.
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-04-2015
DOI: 10.5664/JCSM.4604
Publisher: Mark Allen Group
Date: 02-02-2017
DOI: 10.12968/DENU.2017.44.2.100
Abstract: Molar Incisor Hypomineralization (MIH) poses a significant challenge to clinicians worldwide. Since its description in 2001, extensive research has provided some insight into the condition, its aetiology, natural history and management. An appreciation of the unique clinical features and management considerations of MIH is essential to maximize patient outcomes. Early diagnosis is the first of several key steps in developing an appropriate management plan, which must account for short- and long-term needs of the patient. While traditional caries preventive approaches are important, more proactive restorative strategies may also be useful. CPD/Clinical Relevance: This review provides clinicians with an update of the recent literature and discusses the contemporary management of MIH.
Publisher: Wiley
Date: 22-10-2019
DOI: 10.1111/IPD.12433
Abstract: To address challenges presented to clinicians to diagnose and treat molar incisor hypomineralisation (MIH), a new assessment tool was created. To explore the reproducibility and validity of a new instrument developed to assess MIH. Inter-rater and test-retest reliabilities were examined using Cronbach's alpha. Thirty-five oral health professionals scored clinical photographs for the presence/absence of MIH and other enamel defects using the new index. Face, content, and construct validities were assessed. A panel of six experienced researchers assessed face validity. Construct validity was determined by examining hypothesised associations with clinical variables reported to change concurrently or as modifiers of the MIH outcome. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were also assessed. The index reflected the hypothesised associations regarding the presence, prevalence, and severity of MIH, demonstrating construct validity. Researchers indicated that codes and definitions were clear and suitable for international use. The index showed satisfactory scores of sensitivity/specificity and PPV/NPV. Examiners achieved "Substantial" to "Almost perfect" levels of agreement in clinical presentation and lesion extension. The tested MIH index had reasonably solid properties providing confidence that it is a reliable and valid instrument for use in population-based and clinical screenings for diagnosis of MIH and other enamel defects.
Publisher: Wiley
Date: 09-2007
DOI: 10.1111/J.1834-7819.2007.TB00495.X
Abstract: Dental fluorosis is a condition of enamel hypomineralization due to the effects of excessive fluoride on ameloblasts during enamel formation. Delayed degradation of enamel matrix proteins or inhibited protein removal results in impaired and incomplete crystal growth, producing hypomineralized and porous enamel. Severely fluorosed teeth may undergo post-eruptive surface breakdown and post-eruptive dark brown to black staining. A 13 year old girl presented with severely discoloured maxillary central incisors. Initial aesthetic management of these teeth was conservative, including in-office tooth whitening, microabrasion and take-home whitening. Dark brown to black staining of the teeth was reduced successfully without the need for gross mechanical preparation of the enamel. Further improvement of aesthetics was achieved with composite veneers. Conservative treatment options such as tooth whitening and microabrasion can dramatically improve severely discoloured fluorosed teeth. This can provide a satisfactory interim outcome or minimize the removal of discoloured enamel and dentine prior to the provision of composite veneers. The use of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) may enhance remineralization and decrease postoperative sensitivity following tooth whitening and microabrasion procedures in hypomineralized teeth.
Publisher: Oxford University Press (OUP)
Date: 11-07-2017
DOI: 10.1093/EJO/CJX044
Abstract: To analyse the skeletal and dento-alveolar effects of the modified Louisiana State University activator (MLSUA) in Class II treatment. A test group of 46 participants (25 females, 21 males) with Class II malocclusion treated with MLSUA followed by fixed appliances was compared with a matched Class II control group. Lateral cephalograms were taken at T1 (initial records), T2 (completion of MLSUA treatment), and T3 (before deband). The participants were also ided into two groups: pre-pubertal and pubertal according to skeletal maturity and three groups of different vertical facial patterns at the start of the treatment: brachyfacial, mesofacial, and dolichofacial. Statistical comparisons were performed with t-tests and analysis of variance (ANOVA). Statistically significant supplementary mandibular growth (Co-Gn) in the test group (2.6 mm) was associated with improvement of overjet (OJ), overbite (OB), and molar relationship. Short-term mandibular growth was greater in pubertal than pre-pubertal groups (2.4 mm, P < 0.05). Mandibular incisors retroclined by 2.1 degrees after MLSUA treatment. The brachyfacial group showed greater reduction in the ANB angle and forward movement of pogonion. Mandibular, palatal, and occlusal plane angles showed insignificant change regardless of the facial type. MLSUA treatment corrected the Class II malocclusion by accelerating mandibular growth in the short-term with minimal dento-alveolar compensation, and the correction was maintained before deband. The treatment may be more effective if started at puberty. The mandibular, palatal, and occlusal planes remained stable throughout the treatment. Brachyfacial patients showed more favourable horizontal growth.
Publisher: Elsevier BV
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 12-05-2016
DOI: 10.1007/S40368-016-0230-3
Abstract: This was to investigate the perception of general dental practitioners (GDPs), specialist dentists and dental students regarding the prevalence, severity and aetiological factors of molar incisor hypomineralisation (MIH). Questionnaires were distributed to 407 general and specialist dentists who were members of the Saudi Dental Association and 222 fourth and fifth year dental students at College of Dentistry, King Saud University, Riyadh. The questionnaires investigated the perception and knowledge of MIH, including clinical experience, treatment, views on aetiology and need for further training in management of MIH. A total of 230 (56.5 %) dental practitioners and 149 (67.1 %) dental students completed the questionnaire. The majority of GDPs (76.9 %) and specialists (86.3 %) had encountered MIH in their practice. The majority of specialist dentists (56.1 %) and GDPs (60.4 %) reported that MIH could come second to dental caries as a public health concern. A range of possible aetiological factors were identified by both students and dentists with genetics the most common. The majority of GDPs (90.5 %) and specialists (72.4 %) reported a need for further training in MIH, in particular, regarding treatment. The majority of dental students (64 %) had not heard of MIH and most were in favour of including MIH-associated cases in the undergraduate curriculum of paediatric dentistry. Students were more likely to request training in diagnosis than treatment. MIH is a condition encountered by Saudi dentists who advocated the need for clinical training regarding MIH-aetiological and therapeutic fields. Students have little exposure to MIH and are likely to have similar concerns upon commencement of dental practice.
Publisher: Wiley
Date: 11-09-2021
DOI: 10.1111/IPD.12715
Abstract: Knowledge of molar incisor hypomineralization (MIH) has relevance for paediatric dentists. To assess final‐year German dental students’ knowledge, attitudes, and beliefs regarding MIH. A previously validated questionnaire was posted to the 31 German dental schools. Demographic covariates as well as knowledge regarding diagnosis and prevalence, and attitudes and beliefs around aetiology and management were collected. Twenty‐two (71%) dental schools responded and a total of 877 students participated. Most (97%) were familiar with MIH and 88% were aware of the diagnostic criteria for MIH however, only 42% knew how to implement them. One‐third were able to identify MIH and 16% reported diagnostic confidence when doing so 90% assumed the MIH prevalence to be %. Two‐thirds of the respondents implicated genetic components as the main aetiological factor of MIH. Resin composite (60%) and preformed metal crowns (46%) were the dental materials most often suggested for restorative management. Almost all (98%) respondents were interested in receiving more clinical training. German students were familiar with MIH however, they reported low levels of knowledge and confidence regarding its prevalence and diagnosis. Standardized nationwide, up‐to‐date curricula should be implemented to educate future dentists in Germany.
Publisher: Wiley
Date: 21-05-2008
DOI: 10.1111/J.1834-7819.2008.00021.X
Abstract: The aim of this in vitro study was to investigate the effect of Tooth Mousse and ozone on the bleaching effectiveness of peroxide (P). Sixty enamel specimens were stained by tea infusion. P (8% carbamide peroxide solution) and the P/TM (50:50) blend were prepared freshly as required. The specimens were ided randomly into six groups: Group A - ozone followed by P Group B - ozone concurrently with P Group C - P alone Group D - ozone followed by P/TM Group E - ozone concurrently with P/TM and Group F - P/TM alone. Ozone exposure was of 40 seconds duration. Digital photographic images were recorded at baseline and endpoint under standardized lighting and desiccation conditions. CIELAB L*a*b* values were determined. The addition of TM to P or the application of ozone with P did not significantly affect bleaching effectiveness compared with P alone. The application of ozone prior to P significantly decreased bleaching effectiveness as indicated by the DeltaL*, Deltaa*, DeltaE and %L* values. The addition of TM to the P did enhance the aesthetic by increasing the lustre and translucency of the treated enamel. The results of this study suggest that Tooth Mousse may be applied concurrently with the bleach, and not reduce bleaching effectiveness.
Publisher: SAGE Publications
Date: 03-11-2009
Abstract: Orthodontic patients have an increased risk of white-spot lesion formation. A clinical trial was conducted to test whether, in a post-orthodontic population using fluoride toothpastes and receiving supervised fluoride mouthrinses, more lesions would regress in participants using a remineralizing cream containing casein phosphopeptide- amorphous calcium phosphate compared with a placebo. Forty-five participants (aged 12–18 yrs) with 408 white-spot lesions were recruited, with 23 participants randomized to the remineralizing cream and 22 to the placebo. Product was applied twice daily after fluoride toothpaste use for 12 weeks. Clinical assessments were performed according to ICDAS II criteria. Transitions between examinations were coded as progressing, regressing, or stable. Ninety-two percent of lesions were assessed as code 2 or 3. For these lesions, 31% more had regressed with the remineralizing cream than with the placebo (OR = 2.3, P = 0.04) at 12 weeks. Significantly more post-orthodontic white-spot lesions regressed with the remineralizing cream compared with a placebo over 12 weeks.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.JDENT.2017.05.020
Abstract: Dentists have a range of options for managing molars with severe molar-incisor hypomineralization (MIH), each with different long-term implications. The cost-effectiveness of managing molars with severe MIH was assessed. A mixed public-private-payer perspective within German healthcare was adopted. In iduals with one to four severely MIH-affected molars were followed over their lifetime. We compared: (1) removal of the tooth/teeth and orthodontic alignment of the second and third molars (Ex/Ortho) (2) restoration of the tooth using resin composite (Comp) (3) restoration using an indirect metal crown after temporizing it using a preformed metal crown (PMC/IR). The health outcome was tooth retention years. Transition probabilities were estimated based on the best available evidence. Cost calculations were based on German dental fee catalogues. Monte-Carlo microsimulations were performed for cost-effectiveness-analysis. If extraction was performed at the optimal age (9.5/11 years for maxillary/mandibular molars), Ex/Ortho was most cost-effective (67 years, 446-938 Euro). Comp (51 years, 1911 Euro) and PMC/IR were dominated (50 years, 2033 Euro). This cost-effectiveness ratio was also determined when >1 molar was treated. If extraction was performed later, assuming no spontaneous alignment, Ex/Ortho was more costly than Comp, at least when only 1 molar was treated. For molars with severe MIH, extraction at the optimal age and, if needed, orthodontic alignment can be cost-effective, especially when >1 molar is affected. For single molars where the chance of spontaneous alignment is low, Comp might also be considered. These findings apply to German healthcare and within the limitations of this study only. When deciding how to manage molars with severe MIH, both tooth retention, with lower costs but higher needs for re-treatments, and tooth removal, with possible need for orthodontic alignment, can be considered. Considering cost-effectiveness, the latter may be preferable, especially if the age of extraction is chosen correctly, or several molars are affected.
Publisher: Wiley
Date: 10-07-2013
DOI: 10.1002/SCA.21102
Abstract: The aim of this in vivo study was to evaluate the short and a longer term effect on enamel of the application of a crème containing 10% CPP-ACP and 900 ppm fluoride, in orthodontically planned, high caries-risk patients. Epoxy resin replicas of upper lateral incisors were obtained from polyvinyl siloxane (PVS) impressions, before and after etching. The right incisors were left untreated in order to control saliva remineralizing potential. The upper left surfaces were coated with a pea-size amount of the crème. Replicas were obtained at 3 weeks and 6 months and analyzed by SEM and non-contact surface white light profilometry. In the treated s le the profilometric roughness parameters at 3 weeks were statistically significantly lower than the control group values (p < 0.05). At 3 weeks SEM images of the enamel surface showed fewer irregularities. After 6 months, differences between test and control groups were not present on SEM images and profilometric values. CPP-ACP and fluoride crème had positive in vivo effects on enamel surfaces. Significant differences in surface roughness existed after a 3-week period of crème use.
Publisher: Wiley
Date: 22-05-2014
DOI: 10.1111/IPD.12040
Abstract: Current molar hypomineralisation (MH) indices do not guide clinicians in management of affected dentitions, and treatment is based on in idual judgment. The aims of this study were to describe characteristics of MH and molar incisor hypomineralisation (MIH) and trial the new Molar Hypomineralisation Severity Index (MHSI). First permanent molars (FPMs) and permanent incisors (PIs) in 283 affected children were examined for hypomineralisation characteristics [defect colour, location, post-eruptive breakdown (PEB) restorations placed/replaced/atypical sensitivity]. The MHSI scores were compared with treatment received (152 children). Mean (SD) affected teeth/dentition were as follows: FPMs: 3.2 (1.0) and PIs: 1.6 (1.6). Affected FPMs showed no arch or quadrant predilection maxillary central PIs were affected particularly. As affected FPMs/dentition increased, MIH diagnoses also increased (P = 0.009). Among FPMs, defects most prevalent were brown (47%) and cuspal (74%) 67% showed PEB. Before study entry, 43% of FPMs had restorations placed/replaced. Among PIs, white defects were common (65%) on smooth surfaces sensitivity was rare. Affected FPMs received more restorations and extractions than unaffected FPMs (P = 0.0001). As MHSI scores increased, FPM treatments/dentition increased (number, invasiveness). All characteristics were significant in predicting treatment (logistic regression model). A spectrum from MH to MIH occurred. The MHSI characteristics were predictive of the treatment of affected FPMs and can guide management.
Publisher: Wiley
Date: 14-02-2014
DOI: 10.1111/ADJ.12142
Abstract: The purpose of this study was to evaluate and compare the relative efficacy of a resin fissure sealant, nano-filled self-adhesive protective coating, resin infiltrant, glass ionomer cement (GIC), and GIC containing casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in preventing the formation of subsurface lesions of enamel (SLE) adjacent to orthodontic brackets by acting as an enamel surface sealant (ESS). Eighty-five enamel specimens with molar tubes bonded at their centre were randomly ided into five groups, each treated with a different material at the bracket's periphery. Specimens were stored in an acetate demineralization solution at pH 4.5 for 7 days at 37 °C then imaged using quantitative light-induced fluorescence (QLF) to determine the difference in fluorescence (∆F) between sound- and acid-exposed enamel. Lesion cross-sections were then examined using backscattered scanning electron microscopy (SEM) to measure lesion depth. The use of GIC alone or incorporating CPP-ACP significantly reduced ∆F compared with other materials. Backscattered SEM images showed no measurable demineralization for enamel treated with either GIC material in contrast with other groups, which showed statistically significant demineralization levels. The fluoride-releasing effects and CPP-ACP benefits of the GIC materials show promise as an effective ESS in inhibiting enamel demineralization adjacent to orthodontic brackets.
Publisher: Wiley
Date: 14-10-2010
DOI: 10.1111/J.1600-0579.2010.00615.X
Abstract: Mandatory continuing professional development (CPD) was introduced in 2005 in Victoria, Australia to ensure that dental practitioners maintained their skills, knowledge and kept up-to-date with current topics in dentistry. The aim of this study was to investigate the participation, impact on practice and attitudes of Victorian dentists and dental specialists to CPD activities since the commencement of mandatory CPD. A cross-sectional survey of a random s le of registered dentists and dental specialists (n = 895) was conducted from May to August 2008 using an anonymous, postal, self-administered questionnaire. The response rate was 66%. More than three quarters of practitioners believed mandatory CPD is a reasonable requirement for continued registration. Dentists reported attending an average of 30.9 h of certifiable clinical CPD whilst specialists attended an average of 33.2 h of certifiable clinical CPD over a 12-month period. Nearly three quarters of respondents reported changing their practice as a result of CPD activities, whilst one quarter attended CPD mainly to meet the mandatory requirements. Overall there was a positive attitude towards mandatory CPD and a high level of participation in CPD activities by Victorian dentists and specialists in 2007, although nearly half of the respondents attended <20 h of certified clinical CPD during 2007. A number of barriers exist, particularly for rural and female practitioners in accessing CPD, and further research is required to examine the benefits derived from mandatory CPD.
Publisher: Springer Science and Business Media LLC
Date: 06-2010
DOI: 10.1007/BF03262731
Publisher: S. Karger AG
Date: 2007
DOI: 10.1159/000104796
Abstract: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has been shown to remineralize enamel subsurface lesions in situ. The aim of this study was to investigate the effects of CPP-ACP in a fruit-flavoured sugar-free chewing gum containing citric acid on enamel remineralization, and acid resistance of the remineralized enamel, using an in situ remineralization model. The study utilized a double-blind, randomized, crossover design with three treatments: (i) sugar-free gum (2 pellets) containing 20 mg citric acid and 18.8 mg CPP-ACP, (ii) sugar-free gum containing 20 mg citric acid alone, (iii) sugar-free gum not containing CPP-ACP or citric acid. Ten subjects were instructed to wear removable palatal appliances, with 4 half-slab insets of human enamel containing demineralized subsurface lesions and to chew gum (2 pellets) for 20 min 4 times per day for 14 days. At the completion of each treatment the enamel half-slabs were removed and half of the remineralized lesion treated with demineralization buffer for 16 h in vitro. The enamel slabs (remineralized, acid-challenged and control) were then embedded, sectioned and subjected to microradiography to determine the level of remineralization. Chewing with gum containing citric acid and CPP-ACP resulted in significantly higher remineralization (13.0 ± 2.2%) than chewing with either gum containing no CPP-ACP or citric acid (9.4 ± 1.2%) or gum containing citric acid alone (2.6 ± 1.3%). The acid challenge of the remineralized lesions showed that the level of mineral after acid challenge was significantly greater for the lesions exposed to the gum containing CPP-ACP.
Publisher: Walter de Gruyter GmbH
Date: 2021
Abstract: Objective: To systematically review and quantify the effectiveness of interventions in reducing caries development during orthodontic treatment and evaluate the quality of evidence for the development of clinical guidelines. Materials and methods: A comprehensive literature search of the Cochrane, EMBASE and MEDLINE databases was conducted to identify eligible randomised controlled trials (RCTs). The risk of bias was assessed using the Cochrane risk of bias (RoB 2) tool. In order to facilitate the development of clinical guidelines, the quality of the evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results: A total of 18 RCTs were included in the qualitative synthesis, of which 10 had a high risk of bias, and eight had minor concerns. Three RCTs that investigated the efficacy of fluoride interventions during fixed orthodontic treatment were included in the quantitative synthesis. The pooled effect size resulted in a risk reduction of 0.23 (95% CI: -0.35, -0.11, p 0.001) in the intervention group compared to controls. The GRADE evaluation identified the evidence as moderate due to the limited number of RCTs and moderate heterogeneity (I-squared statistic of 49.3%). Conclusions: Although fluoride is the most effective evidence-based preventive intervention during orthodontic treatment, large RCTs are required to provide high quality evidence. Further studies are needed to evaluate the caries preventive effects of oral hygiene programs, chlorhexidine, CPP-ACP and other interventions.
Publisher: Springer Science and Business Media LLC
Date: 26-02-2014
DOI: 10.1007/S40368-014-0115-2
Abstract: Molar-incisor hypomineralisation (MIH) is a global dental problem, yet little is known about the knowledge of the general dental practitioners (GDPs) and dental nurses (DNs) regarding this defect in South East Asia. To assess and compare the knowledge of the GDPs and DNs in Malaysia regarding the frequency of occurrence of MIH within their practice, its diagnosis, putative aetiological factors and management. A questionnaire was distributed to GDPs and DNs during a nationwide dental conference in Melaka, Malaysia and who were asked to answer questions about demographic variables, knowledge, attitudes and practices in the management of MIH. Descriptive statistics and bivariate analysis were performed. A 5% level of statistical significance was applied for the analyses. A response rate of 58.2% (131/225) was obtained. Most respondents were aware of MIH and encountered it in their practice (GDPs = 82.5%, DNs = 82.4%). The condition was observed by respondents less in primary molars compared to first permanent molars. Full agreement between GDPs and DNs did not exist concerning the aetiological factors and management of MIH. Glass ionomer cements were the most popular material used in treating MIH. Most respondents (GDPs = 93%, DNs = 76.5%) indicated that they had not received sufficient information about MIH and were willing to have clinical training in the diagnosis and therapeutic modalities of MIH. MIH is identified and encountered by most respondents. Agreement did not exist between GDPs and DNs concerning MIH frequency of occurrence within their practice, its diagnosis, aetiological factors and management.
Publisher: Springer Science and Business Media LLC
Date: 06-2012
DOI: 10.1007/BF03262856
Publisher: S. Karger AG
Date: 2012
DOI: 10.1159/000337099
Abstract: i Background/Aims: /i This study aimed to compare and contrast in vitro six methods to determine the most accurate method for detecting approximal carious lesions in primary molars. i Methods: /i Extracted primary molars (n = 140) were stored in 0.02% chlorhexidine solution and mounted in light-cured resin in pairs. The six carious lesion detection methods used by the three examiners to assess approximal carious lesions were visual inspection, digital radiography, two transillumination lights (SDI and NSK), and two laser fluorescence instruments (CDD and DDP). Five damaged teeth were discarded. The teeth (n = 135) were sectioned, serially ground, and examined under light microscopy using Downer’s histological (HST) criteria as the gold standard. Intra- and inter-examiner reliability, agreement with HST, specificity, sensitivity, receiver operating characteristic (ROC) curves, and areas under the curve were calculated. i Results: /i This study found visual inspection to be the most accurate method when validated by histology. Transillumination with NSK light had the highest specificity, and digital radiography had the highest sensitivity for detecting enamel and/or dentinal carious lesions. Combining specificity and sensitivity into the area under ROC curves, enamel plus dentinal lesions were detected most accurately by visual inspection followed by digital radiography dentinal lesions were detected most accurately by digital radiography followed by visual inspection. i Conclusions: /i None of the four newly developed methods can be recommended as suitable replacements for visual inspection and digital radiography in detecting carious lesions on approximal surfaces of primary molars, and further developmental work is needed.
Publisher: Wiley
Date: 15-02-2013
DOI: 10.1111/IPD.12025
Abstract: Molar incisor hypomineralisation (MIH) is a problematic condition with several characteristics for which infiltrant resins could theoretically improve clinical outcomes. To investigate whether caries infiltrant resin can penetrate MIH-affected enamel. Molar incisor hypomineralisation lesions (n = 21) were infiltrated using either the standard protocol or with the addition of a sodium hypochlorite (NaOCl) irrigation step. Lesions were sectioned and examined microscopically for infiltrant penetration before undergoing Vickers hardness testing. The surfaces of several lesions were also examined using scanning electron microscopy (SEM). Infiltrant resin could penetrate MIH lesions however, the pattern was erratic. Two lesions were confined to inner enamel, and no infiltration occurred. On average, the resin penetrated to a depth of 0.67 ± 0.39 mm and 23.1 ± 15.2% of the area of the lesion. Microhardness increased in areas of resin penetration by 1.0 ± 0.7 GPa representing a proportional increase of 2.2 ± 2.5 times. There were no significant differences in results based on either the infiltration protocol or the type of MIH lesion. Caries infiltrant resin is capable of penetrating MIH enamel lesions however, the pattern, extent, and change in hardness produced are currently unpredictable.
Publisher: Wiley
Date: 16-11-2020
DOI: 10.1111/CDOE.12599
Publisher: Netherlands Tijdschrift voor Tandheelkunde (NTvT)
Date: 09-04-2021
Publisher: Elsevier BV
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 25-02-2020
Publisher: Elsevier BV
Date: 07-2018
Publisher: Wiley
Date: 20-02-2011
Publisher: Wiley
Date: 28-06-2019
DOI: 10.1002/OA.2785
Publisher: Springer Science and Business Media LLC
Date: 07-2021
DOI: 10.1186/S12903-021-01674-1
Abstract: Comprehensive caries care has shown effectiveness in controlling caries progression and improving health outcomes by controlling caries risk, preventing initial-caries lesions progression, and patient satisfaction. To date, the caries-progression control effectiveness of the patient-centred risk-based CariesCare International (CCI) system, derived from ICCMS™ for the practice (2019), remains unproven. With the onset of the COVID-19 pandemic a previously planned multi-centre RCT shifted to this “Caries OUT” study, aiming to assess in a single-intervention group in children, the caries-control effectiveness of CCI adapted for the pandemic with non-aerosols generating procedures (non-AGP) and reducing in-office time. In this 1-year multi-centre single-group interventional trial the adapted-CCI effectiveness will be assessed in one single group in terms of tooth-surface level caries progression control, and secondarily, in idual-level caries progression control, children’s oral-health behaviour change, parents’ and dentists’ process acceptability, and costs exploration. A s le size of 258 3–5 and 6–8 years old patients was calculated after removing half from the previous RCT, allowing for a 25% dropout, including generally health children (27 per centre). The single-group intervention will be the adapted-CCI 4D-cycle caries care, with non-AGP and reduced in-office appointments’ time. A trained examiner per centre will conduct examinations at baseline, at 5–5.5 months (3 months after basic management), 8.5 and 12 months, assessing the child’s CCI caries risk and oral-health behaviour, visually staging and assessing caries-lesions severity and activity without air-drying (ICDAS-merged Epi) fillings/sealants missing/dental-sepsis teeth, and tooth symptoms, synthetizing together with parent and external-trained dental practitioner (DP) the patient- and tooth-surface level diagnoses and personalised care plan. DP will deliver the adapted-CCI caries care. Parents’ and dentists’ process acceptability will be assessed via Treatment-Evaluation-Inventory questionnaires, and costs in terms of number of appointments and activities. Twenty-one centres in 13 countries will participate. The results of Caries OUT adapted for the pandemic will provide clinical data that could help support shifting the caries care in children towards in idualised oral-health behaviour improvement and tooth-preserving care, improving health outcomes, and explore if the caries progression can be controlled during the pandemic by conducting non-AGP and reducing in-office time. Trial registration : Retrospectively-registered-ClinicalTrials.gov-NCT04666597-07/12/2020: rs/app/action/SelectProtocol?sid=S000AGM4& selectaction=Edit& uid=U00019IE& ts=2& cx=uwje3h . Protocol-version 2: 27/01/2021.
Publisher: Springer Science and Business Media LLC
Date: 09-2013
Abstract: Cochrane Oral Health Group's Trials Register, CENTRAL, Medline via OVID, EMBASE via OVID no restrictions on language or date of publication. Parallel group and split mouth randomised and quasi-randomised controlled trials comparing stepwise, partial and no dentinal caries removal with complete caries removal in unrestored primary and permanent teeth were included in this review. Title and abstract screening was by two reviewers, with disagreements resolved by a third. Full texts of eligible studies were assessed by the team until consensus, and data extraction was by three reviewers independently and in triplicate. Two reviewers assessed risk of bias. Trial authors were contacted where possible . Eight trials (all assessed as high risk of bias) with 934 participants and 1372 teeth were included in this updated review (Previously complete or ultraconservative removal of decayed tissue in unfilled teeth, Ricketts, 2006) with four new trials being included. There were a number of different comparisons in the trials (stepwise or partial or no dentinal caries removal compared to complete caries removal) with one study including more than one of these comparisons. Four studies investigated primary teeth, three permanent teeth and one included both.For stepwise caries removal, (four studies), there was a 56% reduction in incidence of pulp exposure (RR 0.44, 95% CI 0.33 to 0.60, P < 0.00001) compared to complete caries removal. The mean pulp exposure incidence was 34.7% in the complete caries removal group and 15.4% in the stepwise groups. There was no difference in signs and symptoms of pulp disease (RR 0.78, 95% CI 0.39 to 1.58, P = 0.50).In the two partial caries removal studies, the incidence of pulp exposure reduction was 77% for the partial caries removal group (RR 0.23, 95% CI 0.08 to 0.69, P = 0.009) with a mean pulp exposure incidence of 21.9% in the complete caries removal groups and 5% in the partial caries removal groups. There was insufficient evidence to determine whether or not there was a difference in signs and symptoms of pulp disease (RR 0.27, 95% CI 0.05 to 1.60, P = 0.15), or restoration failure (one study showing no difference and another study showing no failures in either group).There were two very different studies which looked at no dentinal caries removal compared to complete caries removal. There was some evidence of no difference between these techniques for the outcome of signs and symptoms of pulp disease and reduced risk of restoration failure, favouring no dentinal caries removal, from one study. There were no instances of pulp disease or restoration failure in either group from the second study. Meta-analysis of these two studies was not carried out because of the substantial clinical differences between the studies. For management of dentinal caries, both stepwise and partial excavation showed clinical advantage over complete caries removal by reducing the incidence of pulp exposure in symptomless, vital, carious primary as well as permanent teeth. The review found no difference in signs or symptoms of pulpal disease between stepwise excavation and complete caries removal.There was insufficient evidence to determine whether there was a difference in signs and symptoms of pulp disease or a difference in the risk of restoration failure with partial caries removal.For the two no dentinal caries removal studies, the one investigating permanent teeth found no difference in restoration failure and the one investigating primary teeth found a statistically significant difference in restoration failure favouring the intervention.Due to the short term follow-up, low reporting of patient centred outcomes and high risk of bias, further high quality, long-term clinical trials are still required to assess the most effective intervention.
Publisher: Wiley
Date: 28-12-2016
DOI: 10.1111/ADJ.12432
Abstract: The aim of this study was to compare the flexural strength and Vickers hardness of tooth-coloured restorative materials with and without applying a self-adhesive coating for up to 6 months. Specimens were prepared from three resin composites (RC), two resin-modified glass-ionomer cements (RM-GIC) and two conventional glass-ionomer cements (CGIC). All materials were tested both with and without applying G-Coat Plus (GCP). Specimens were conditioned in 37 °C distilled deionized water for 24 h, and 1, 3 and 6 months. The specimens were strength tested using a four-point bend test jig in a universal testing machine. The broken specimen's halves were used for Vickers hardness testing. Representative specimens were examined under an environmental scanning electron microscope. Data analysis showed that regardless of time and materials, generally the surface coating was associated with a significant increase in the flexural strength of the materials. Applying the GCP decreased the hardness of almost all materials significantly (P < 0.05) and effect of time intervals on hardness was material dependent. The load-bearing capacity of the restorative materials was affected by applying self-adhesive coating and ageing. The CGIC had significantly higher hardness but lower flexural strength than the RM-GIC and RC.
Publisher: Wiley
Date: 17-10-2018
DOI: 10.1111/ADJ.12550
Abstract: The aim of this literature review is to explore the treatment methods for root caries in laboratory and clinical research in the last decade. A systematic search of publications in PubMed and Web of Science databases was performed. The timespan was limited to the last 10 years and English language. Further retrieval was conducted using the search terms of specific therapies or treatments. Eighty-two articles were included in this systematic review and full texts were retrieved. Types of studies included laboratory studies and clinical trials. Therapeutic approaches for root caries without risk of pulp exposure can be categorized into non-invasive and restorative treatment. Non-invasive treatments which targeted different causative factors of root caries have been developed in the last decade. Accordingly, several artificial caries model systems have been proposed for the study of root caries in the laboratory. Carious tissue excavation techniques and restorative materials and procedures have been modified to improve the prognosis of invasive treatment. It is of importance to determine the most appropriate therapy for root caries and further clinical trials are needed to draw firm conclusions concerning the efficacy and consistency of the various treatment methods proposed.
Publisher: Wiley
Date: 08-08-2019
DOI: 10.1111/ADJ.12710
Abstract: The management of carious lesions in children and adolescents can have lifelong implications for the patient. The aim of this study was to assess the decision-making process of dentists when managing carious lesions in children and adolescents. Approximately, 11 000 dentists listed as members of the Australian Dental Association Inc. (ADA) and Australian and New Zealand Society of Paediatric Dentistry (ANZSPD) were emailed a link in April 2017 to a 19-question survey delivered by SurveyMonkey™. In this study, 887 responses were received. In 'enamel-limited' carious lesions, dentists intervened most frequently in primary tooth approximal (365, 41.1%), followed by permanent tooth occlusal (295, 33.3%) and approximal (244, 27.5%), and primary tooth occlusal (203, 22.9%) surface carious lesions. Age, university of graduation, practicing state, decade of graduation and frequency of treatment of children between 6 and 15 years were significant demographic factors influencing the restorative threshold. Australian dentists reported significant variation in their management of approximal and occlusal carious lesions in both primary and permanent teeth. A substantial proportion of respondents would intervene surgically on non-cavitated enamel-limited lesions.
Publisher: Springer International Publishing
Date: 2016
Publisher: Hindawi Limited
Date: 03-03-2022
DOI: 10.1111/PEDI.13324
Abstract: To investigate the oral health of children and adolescents with type 1 diabetes (T1D) and its associations with diabetes-related and lifestyle factors. Cross-sectional study at a large tertiary hospital pediatric diabetes clinic. Oral examination determined dental caries experience and gingival health. Secondary outcome measures included salivary characteristics, oral hygiene and dietary practices, and diabetes-related factors. Eighty children and adolescents with T1D participated mean (SD) age and HbA Poor oral health is common in children with T1D, regardless of HbA1c. Given potential implications for short- and long-term systemic health, this study demonstrates the need for targeted strategies to improve oral health in children with T1D.
Publisher: Wiley
Date: 07-05-2022
DOI: 10.1111/IPD.12790
Abstract: Despite intensive efforts for categorizing demarcated enamel opacities, often related to molar incisor hypomineralization (MIH), there is a lack of descriptive criteria aiming to describe them physically outside the scope of color and size. This is most likely due to the indices focusing on molar, not anterior, teeth. To map and classify demarcated lesions on permanent anterior teeth using reflected and transilluminated light. The association between classification and related lesion characteristics was also examined. Permanent anterior teeth with demarcated opacities related to MIH were selected. For each tooth, standardized photographs were taken using transmitted and reflected light. Each lesion was mapped and classified according to its color, lesion size, surface integrity, and type. The data were analyzed using the chi‐square and Fisher's exact tests. A logistic regression analysis was performed to identify the risk of PEB. There were significant relationships between lesion size, color, and type with surface integrity. Lesion type and size were more important than lesion color for assessing the risk of PEB. There was also a significant relationship between lesion size and lesion color. Lesion size and type are significant clinical parameters for assessing the risk of PEB on enamel opacities related to MIH.
Publisher: Wiley
Date: 28-04-2016
DOI: 10.1111/CDOE.12229
Abstract: Molar incisor hypomineralization (MIH) is a common developmental dental defect of permanent teeth, which can increase the risk of dental caries, infection and hospitalization. The etiology is currently unclear although prenatal or early childhood health factors are suspected. The aim of this systematic review was to assess the strength of evidence linking etiological factors with MIH. A systematic search was conducted using the Medline and Embase electronic databases for studies investigating environmental etiological factors of MIH. Two reviewers assessed the eligibility of studies. The level of evidence and bias was determined for all eligible studies according to Australian National Health and Medical Research Council guidelines for systematic reviews of etiology and the Newcastle-Ottawa Scale. From a total of 2254 studies identified through electronic and hand searching, 28 were eligible for inclusion. Twenty-five of these investigated MIH and three investigated a related condition in primary teeth, hypomineralized second primary molars (HSPM), and these were analysed separately. A limited number of studies reported significant associations between MIH and pre- and perinatal factors such as maternal illness and medication use in pregnancy, prematurity and birth complications. Early childhood illness was implicated as an etiological factor in MIH in several studies, in particular fever, asthma and pneumonia. The studies investigating HSPM revealed an association with maternal alcohol consumption, infantile fever and ethnicity. However, the validity of these findings is impaired by study design, lack of adjustment for confounders, lack of detail and consistency of exposures investigated and poor reporting. Childhood illness is likely to be associated with MIH. Further prospective studies of the etiology of MIH/HSPM are needed.
Publisher: Wiley
Date: 04-11-2017
DOI: 10.1111/IPD.12272
Abstract: Resin infiltration may alter the mechanical properties of enamel hypomineralised lesions (HL) however, variable surface layer (SL) thickness may affect resin penetration. To determine the thickness of the SL of HL and to investigate the effect of resin infiltration on the mechanical properties of HL. The thickness of the SL over HL was determined using polarised light microscopy. Etching time using 15% HCl gel to remove the SL of 52 s les was determined. Selected HL and control areas of 21 teeth were infiltrated with Icon Ninety-six point five per cent of HL had a detectable SL with mean thickness of 58 ± 29 μm. Application of HCl for 120 s produced a mean MIH erosion depth of 58 ± 12 μm. Eleven of 21 s les had evidence of infiltration using visual examination. The infiltrant penetrated some of the HL leading to an increase in KHN (111 ± 75 KHN) which, when compared to adjacent non-infiltrated HL (96 ± 52 KHN), was not statistically significantly different (P = 0.56). There was marked variation in the SL thickness of HL. Resin infiltration of HL did not increase microhardness significantly.
Publisher: Springer International Publishing
Date: 2016
Publisher: Springer Science and Business Media LLC
Date: 24-04-2020
Publisher: MDPI AG
Date: 11-12-2022
Abstract: Many older in iduals with dementia (OIWD) show care-resistant behavior for oral care. Providing care despite resistance is considered to be involuntary care. Although involuntary care should be minimized, in some OIWD it may be necessary to avoid health risks. This study aims to assess the attitudes of healthcare providers with regard to involuntary oral care provision for OIWD who show care-resistant behavior. An online questionnaire consisting of general questions and case specific questions was administered via social media and networking to in iduals involved in the oral care of OIWD. A total of 309 participants were included in this study. The outcomes of the questionnaires were categorized per case. In all cases, a discrepancy was seen between the assessment of oral health problems as potentially harmful (range: 73.1–93.5%) and the willingness to provide involuntary care (range: 31.1–63.4%). Hence, many healthcare providers are aware of the subsequent potential health risks related to not providing care, but are still reluctant to provide involuntary oral care. Therefore, many OIWD who show care-resistant behavior potentially do not receive the necessary oral care they require.
Publisher: Wiley
Date: 23-04-2008
Publisher: Elsevier BV
Date: 02-2021
Publisher: Springer Science and Business Media LLC
Date: 03-2007
DOI: 10.1007/BF03262569
Publisher: MDPI AG
Date: 28-04-2023
DOI: 10.3390/DJ11050117
Abstract: Background: Molar incisor hypomineralisation (MIH) is a common disorder of tooth development, which has recently been found to be associated with a higher prevalence of hypodontia. The aim of this international multicentre study is to determine the association between MIH and other developmental anomalies in different populations. Methods: Investigators were trained and calibrated for the assessment of MIH and dental anomalies and ethical approvals obtained in each participating country. The study aimed to recruit 584 children with MIH and 584 children without MIH. Patients aged 7–16 years who attend specialist clinics will be invited to participate. Children will undergo a clinical examination to determine the presence and severity of MIH, using an established index. The presence of any other anomalies, affecting tooth number, morphology, or position, will be documented. Panoramic radiographs will be assessed for dental anomalies and the presence of third permanent molars. Statistical analysis, using a chi squared test and regression analysis, will be performed to determine any differences in dental anomaly prevalence between the MIH and non-MIH group and to determine any association between dental anomalies and patient characteristics. Conclusion: This large-scale study has the potential to improve understanding about MIH with benefits for patient management.
Publisher: Springer Science and Business Media LLC
Date: 09-07-2020
DOI: 10.1007/S00784-020-03431-0
Abstract: To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. Managing an in idual’s caries risk using non-invasive means (oral hygiene measures including flossing/interdental brushes, fluoride application) is recommended, as both proximal and secondary carious lesions may be prevented or their activity reduced. For proximal lesions, only cavitated lesions (confirmed by visual-tactile, or radiographically extending into the middle/inner dentine third) should be treated invasively/restoratively. Non-cavitated lesions may be successfully arrested using non-invasive measures in low-risk in iduals or if radiographically confined to the enamel. In high-risk in iduals or if radiographically extended into dentine, for these lesions, additional micro-invasive (lesion sealing and infiltration) treatment should be considered. For restoring proximal lesions, adhesive direct restorations allow minimally invasive, tooth-preserving preparations. Amalgams come with a lower risk of secondary lesions and may be preferable in more clinically complex scenarios, dependent on specific national guidelines. In structurally compromised (especially endodontically treated) teeth, indirect cuspal coverage restorations may be indicated. Detection methods for secondary lesions should be tailored according to the in idual’s caries risk. Avoiding false positive detection and over-treatment is a priority. Bitewing radiographs should be combined with visual-tactile assessment to confirm secondary caries detections. Review/refurbishing/resealing/repairing instead of replacing partially defective restorations should be considered for managing secondary caries, if possible. An in idualized and lesion-specific approach is recommended for intervening in the caries process in adults. Dental clinicians have an increasing number of interventions available for the management of dental caries. Many of them are grounded in the growing understanding of the disease. The best evidence, patients’ expectations, clinicians’ expertise, and the in idual clinical scenario all need to be considered during the decision-making process.
Publisher: Springer Science and Business Media LLC
Date: 16-02-2021
Publisher: Wiley
Date: 24-04-2018
DOI: 10.1111/ADJ.12608
Abstract: To evaluate changes in xerostomia status, salivary characteristics and gland volumes 2 years following radiotherapy in nasopharyngeal carcinoma patients. Xerostomia scores, salivary flow rates, pH and buffering capacity were measured at pre-radiotherapy, mid-radiotherapy, 2 weeks, 3 months and 2 years post-radiotherapy. Salivary gland volumes and their correlation with radiation dose were also assessed. Mean radiation dose to oral cavity, parotid and submandibular glands (SMG) was 44.5, 65.0 and 38.6 Gy respectively. Parotid and SMG volumes decreased 33% at 3 months post-radiotherapy volumes at 2 years post-radiotherapy were 84% and 51% of pre-radiotherapy levels, respectively. Correlations were observed between parotid gland volume per cent reduction and its radiation dose and between resting salivary flow rate reduction and post-radiotherapy re-radiotherapy SMG volume ratio. Salivary flow rates and resting saliva pH remained significantly low at 2 years post-radiotherapy (both flow rates, P = 0.001 resting saliva pH, P = 0.005). Similarly, xerostomia scores remained significantly higher compared with pre-radiotherapy levels. Submandibular gland volumetric shrinkage persisted 2 years after radiotherapy. Xerostomia scores remained significantly higher, and salivary flow rates and resting saliva pH remained significantly lower, suggesting that study participants were still at risk for hyposalivation-related oral diseases.
Publisher: Wiley
Date: 16-02-2009
Publisher: Springer Science and Business Media LLC
Date: 08-2017
Abstract: Child-friendly minimum intervention dentistry (MID) dominates modern thinking and practice around delivery of oral care for children. It is an enormous challenge for our profession to move away from the narrow focus of a mechanistic, cavity-orientated surgical approach for managing dental caries to one which embraces new strategies for caries prevention and management, delivered in the context of a partnership with children, families and other adults involved in the child's life environment. It is also time for a shift in the orientation of dentistry towards 'patient self-care' becoming a core goal of dental care, where dentists help their patients assume responsibility for achieving and maintaining their own oral health, and that of their children. Holistic care, which improves oral health and maximises ability to maintain oral health, should be regarded with the same importance and rewarded with a similar level of remuneration as 'traditional operative dentistry'. This paper gives an overview of a model of care involving the principles of this new approach, and the application of MID in clinical practice for primary teeth.
Publisher: Wiley
Date: 09-2010
DOI: 10.1111/J.1834-7819.2010.01234.X
Abstract: To investigate, in vitro, the effect on enamel erosion of the addition of 0.2% w/v casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) to four commercially-available soft drinks, two of which were carbonated. Enamel specimens (n=27) were sectioned from sound extracted human third molar teeth and polished to a mirror finish. Exposed enamel windows of 1 mm2 were created by painting the surface with acid-resistant nail varnish. Four citric flavoured soft drinks (pH range 2.2 to 2.4) and distilled deionized water (DDW) were tested. Each drink was tested with and without 0.2% CPP-ACP w/v. The specimens were placed into 50 mL of solution at 37 °C for 30 minutes, rinsed and varnish removed. The s les were profiled with a white light profilometer and erosive depths recorded. All soft drinks tested caused enamel erosion but adding 0.2% w/v CPP-ACP significantly reduced (p<.05) erosive depth in all test solutions in comparison with the solutions without CPP-ACP. The erosive depths for all solutions with 0.2% CPP-ACP did not differ significantly from those of DDW. Adding CPP-ACP at 0.2% w/v significantly decreased the erosivity of all four soft drinks. The erosivity of the soft drinks with 0.2% CPP-ACP added did not differ significantly from that of distilled water.
Publisher: Wiley
Date: 26-10-2018
DOI: 10.1111/ADJ.12567
Abstract: Dental caries and enamel defects (DDE) are prevalent amongst children. The presence of DDE, especially enamel hypomineralization, may increase caries experience. The reported prevalence of hypomineralized second primary molars (HSPM) is 2.7-21.8%, although the occurrence in Australian children remains unknown. These HSPM represent a potential predictive factor for molar-incisor hypomineralization (MIH). In total, 623 children aged 3-5 years from 30 randomly selected kindergartens participated. The HSPM were recorded using an index combining the European Academy of Paediatric Dentistry MIH Judgment Criteria and modified DDE Index. Caries was recorded using International Caries Detection and Assessment System criteria. In total, 144 HSPM were observed in 88 of the 623 (14.1%) children, a tooth-level prevalence of 5.8%. The prevalence of dentinal carious lesions was 13.2%, and caries prevalence (d The relationship between an increase in HSPM lesion extent and increasing number of HSPM per child was statistically significant. A positive association between HSPM severity and extent at tooth level existed (P < 0.05). There was a positive relationship between the extent of HSPM and carious lesion severity (P < 0.05). In this population, children with HSPM did not have overall greater caries experience.
Publisher: Elsevier BV
Date: 02-2021
DOI: 10.1016/J.JDENT.2021.103913
Abstract: Epigenetic modulation of gene expression may be important in dental conditions, including dental caries and enamel hypomineralisation. The aims of this study were to assess associations between DNA methylation in cord blood leucocytes at birth, and caries experience and enamel hypomineralisation at six years of age. The study s le was from a birth cohort study of twins. Dental examinations at six years identified the presence/absence of (i) 'any caries' (untreated and treated caries), (ii) 'advanced caries' (untreated, advanced caries and/or past treatment) and (iii) hypomineralised second primary molars (HSPM). Genome-wide analysis of DNA methylation was performed on cord blood of 27 twin pairs (14 dizygotic and 13 monozygotic) using the Illumina Infinium MethylationEPIC BeadChip array. Differentially methylated CpGs (DMCpGs) and regions (DMRs) associated with each dental outcome were investigated, while accounting for the relatedness of twins. Results with a false discovery rate <0.05 were treated as statistically significant. 19 children had 'any caries', 15 had 'advanced' caries, and 18 had HSPM. No DMCpGs were associated with 'any caries', 16 and 19 DMCpGs were associated with 'advanced caries' and HSPM, respectively. DMRs were identified in association with all three outcomes. Genes implicated by these analyses included PBX1, ACAT2, LTBP3 and DDR1 which have been linked with dental tissue development in genetic studies. This exploratory study identified differential methylation in several genes at birth associated with dental caries and HSPM at six years. Further research may provide valuable insights into aetiology of dental disease and/or reveal novel molecular-based approaches for early risk stratification. Epigenetic differences at birth are likely to be associated with dental health at six years and may be valuable biomarkers of early influences on dental health.
Publisher: Wiley
Date: 31-05-2013
DOI: 10.1111/ADJ.12048
Abstract: In recent decades a desire has driven the uptake of the minimum intervention dentistry (MID) philosophy to end the destructive 'drill and fill' mentality prevalent amongst dental training programmes since the establishment of formalized dental training courses more than 100 years ago. This change in attitude has been concomitant with the decrease in caries prevalence in large sectors of the community and a better understanding of the caries process. One of the pivotal arms of MID is caries risk assessment, and early and accurate caries detection is a major part of this procedure. There is great variation between the diagnostic decisions between in idual clinicians, and the development of valid detection aids may decrease this variation and improve the clinical decision making process as it relates to dental caries.
Publisher: Wiley
Date: 31-05-2013
DOI: 10.1111/ADJ.12049
Abstract: Preservation of natural tooth structure requires early detection of the carious lesion and is associated with comprehensive patient dental care. Processes aiming to detect carious lesions in the initial stage with optimum efficiency employ a variety of technologies such as magnifying loupes, transillumination, light and laser fluorescence (QLF® and DIAGNOdent® ) and autofluorescence (Soprolife® and VistaCam®), electric current/impedance (CarieScan(®) ), tomographic imaging and image processing. Most fluorescent caries detection tools can discriminate between healthy and carious dental tissue, demonstrating different levels of sensitivity and specificity. Based on the fluorescence principle, an LED camera (Soprolife® ) was developed (Sopro-Acteon, La Ciotat, France) which combined magnification, fluorescence, picture acquisition and an innovative therapeutic concept called light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT). This article is rounded off by a Soprolife® illustration about minimally or even non-invasive dental techniques, distinguishing those that preserve or reinforce the enamel and enamel-dentine structures without any preparation (MIT1- minimally invasive therapy 1) from those that require minimum preparation of the dental tissues (MIT2 - minimally invasive therapy 2) using several clinical cases as ex les. MIT1 encompasses all the dental techniques aimed at disinfection, remineralizing, reversing and sealing the caries process and MIT2 involves a series of specific tools, including microburs, air abrasion devices, sonic and ultrasonic inserts and photo-activated disinfection to achieve minimal preparation of the tooth. With respect to minimally invasive treatment and prevention, the use of lasers is discussed. Furthermore, while most practices operate under a surgical model, Caries Management by Risk Assessment (CaMBRA) encourages a medical model of disease prevention and management to control the manifestation of the disease, or keep the oral environment in a state of balance between pathological and preventive factors. Early detection and diagnosis and prediction of lesion activity are of great interest and may change traditional operative procedures substantially. Fluorescence tools with high levels of magnification and observational capacity should guide clinicians towards a more preventive and minimally invasive treatment strategy.
Publisher: Springer Science and Business Media LLC
Date: 08-05-2023
DOI: 10.1186/S12909-023-04306-0
Abstract: Limited data exists regarding the perspectives of newly graduated dental practitioners (NGDPs) and final-year students (FYS) about their preparedness for dental practice. This information is crucial to inform developments in ongoing professional development for newly qualified dental practitioners and future reviews and development of accreditation standards, policies, and the professional competencies of newly qualified dental practitioners. Thus, the primary goal of this paper was to describe the perceptions of preparedness for dental practice of NGDPs and FYSs. In idual semi-structured interviews were conducted between March and July 2020. All interviews were audiotaped, transcribed, and analysed using a thematic analysis. Eighteen NGDPs and four FYS from across Australia participated in the qualitative interviews. A strong theme from the data was that respondents believed they were well prepared for common challenges in dental practice and patient care. A second prominent theme was participants’ awareness of specific areas of limitation in their knowledge and specific skills including (list them). This data highlights a high level of self-awareness and potential for self-directed learning of NGDPs. It also provides specific content areas for future curriculum developers. Newly graduated dental practitioner and final-year student participants were satisfied with the theoretical and evidence-based information in their formal learning and teaching activities to begin practicing as dental practitioners. In some areas, NGDPs felt underprepared, mostly attributed to limited clinical treatment exposure, and other contextual elements of clinical practice, and thought transitional support may be required. The research reinforces the value of seeking and learning from students’ and NGDPs’ perspectives.
Publisher: Wiley
Date: 25-03-2018
DOI: 10.1111/JICD.12333
Abstract: The aim of the present study was to determine the degree of surface staining and roughness of resin composites (RC) after finishing and polishing with different methods and immersion in three soft drinks. A microhybrid, a nanohybrid, and a hybrid composite were selected. The specimens were prepared and ided into three groups of 36 after 24 hours, and designated as either unpolished or polished using Sof-Lex discs or Enhance point. Each group was further ided into three subgroups, immersed in distilled water, coffee, or cola for 1 week (N = 12). Color change (∆E) was measured by a spectrophotometer after each treatment. The ∆E was calculated using the following formula: ∆E = ([∆L]2+[∆a]2+[∆b]2)1/2. Surface roughness (Ra) was measured after 24 hours and 1 week. To observe the Ra, a scanning electron microscope was used. A moderate correlation between Ra and ∆E was determined. Only coffee caused perceptible ∆E. The effect of Ra on staining was statistically significant (P < .05), but immersion in solutions for 7 days did not increase the Ra of RC. The highest Ra values were obtained from hybrid RC. The Enhance point created the greatest roughness. Coffee was associated with the greatest ∆E for all materials and polishing methods.
Publisher: Springer Science and Business Media LLC
Date: 19-06-2021
DOI: 10.1007/S40368-021-00641-2
Abstract: Pulpectomy may be indicated in restorable primary teeth exhibiting irreversible pulpitis or pulpal necrosis. The purpose of this study was to compare the cleaning and shaping efficacy of NiTi systems (Reciproc Fifty-seven maxillary second primary molars were scanned using micro-CT. Teeth with three ergent roots were ided randomly (n = 15) according to instrument type (K file, MTwo®, and Reciproc® Blue). Teeth with root fusion were instrumented manually as a separate group (n = 12). Pre- and post-instrumentation micro-CT images were superimposed, and the instrumentation area (IA) and procedural complications were recorded. No statistically significant differences in IA between file systems was observed in the non-fused teeth. The mean IA of fused roots was significantly lower than in the non-fused distobuccal (p = 0.003) and palatal (p < 0.001) roots. The root segment had a significant effect on IA (p 60%) occurred in both non-fused and fused primary teeth with fewer procedural complications observed after manual instrumentation.
Publisher: Wiley
Date: 31-05-2013
Publisher: Springer Science and Business Media LLC
Date: 10-2020
Publisher: Wiley
Date: 05-10-2015
DOI: 10.1111/JICD.12195
Abstract: Mineral trioxide aggregate (MTA) is a calcium silicate-based cement (CSC) commonly used in endodontic procedures involving pulpal regeneration and hard tissue repair, such as pulp capping, pulpotomy, apexogenesis, apexification, perforation repair, and root-end filling. Despite the superior laboratory and clinical performance of MTA in comparison with previous endodontic repair cements, such as Ca(OH)
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.JDENT.2019.04.004
Abstract: In order to address the severe caries burden among Cambodian children and limited access to dental care this study had two objectives: (1) To evaluate the caries preventive effect of hand-mixed GIC Fissure Sealants (FS) placed on first permanent molars of 6-8 year-old Cambodian children using two protocols in the SEAL Cambodia Project and (2) validate the SEAL Cambodia population-based intervention. The study had four groups, two cohorts, and investigated two clinical protocols (original and modified) for FS placement to compare caries preventive fraction. Three groups were followed up at 1y and two were followed up at 2y. The modified protocol involved control of the temperature of the material, the timing of mixing and placement, and adjustment of the occlusion. Data analysis examined differences in caries incidence by group. At 1 and 2 y, 62.8%, and 68.0% follow-up rates were achieved, respectively. The baseline mean dmft for the first and second cohorts was 8.0 (SD 3.9) and 9.9 (SD 4.3) respectively. The original protocol did not render a statistically significant preventive benefit. A preventive fraction of 89.1% at 1 y and 32.3% at 2 y was achieved using the modified protocol in the second cohort (P 8 realised half the preventive fraction at 2 y compared to those with dmft <8 (22.3% and 45.8% respectively). The modified FS protocol increased the caries preventive effect, although it was lower than that reported in other studies. This study builds evidence for the use of glass ionomer cement Fissure Sealants (FS) for the prevention of caries at a population level. It showed that improving the field-based clinical protocol for application of FS had a large impact on clinical success.
Publisher: Elsevier BV
Date: 12-1996
DOI: 10.1111/J.1467-842X.1996.TB01078.X
Abstract: Wearing mouthguards while playing contact sports reduces the prevalence and severity of orofacial injuries. We report on a 1991-92 promotion of mouthguard use among amateur football players in Melbourne. Four questionnaires were completed by players (1991 season: middle: n = 638, 49 per cent response: late: n = 770, 51 per cent: 1992: early: n = 505, 26 per cent: late: n = 698, 54 per cent), in four age groups (16-19, 20-23, 24-29, 30-44 years), about perceived mouthguard value and usage, injury experience, and awareness of a promotional message. Over the two seasons, mouthguard ownership and consistent wear increased and dental injuries decreased. Ownership of mouthguards increased among: 20-23 year olds and 30-44 year olds (13 and 16 per cent) managers, tradespersons, salespersons, labourers and the unemployed (14-19 per cent) residents of northern and western regions (12 and 13 per cent) those with 6 to 10 years of education (29 per cent) players in old boys' networks (13 per cent) and those with English as a first language (8 per cent). Consistent wear was high at matches (89 per cent) but low at training (13 per cent), owing to perceived lack of physical contact. Of dental injuries reported by 25-31 per cent, fractures predominated over luxations and avulsions. Fractures and avulsions were more common at matches than training luxations predominated at training. When a mouthguard was not worn, the likelihood of a fractured or avulsed tooth was at least twice that when a mouthguard was worn. Some injuries occurred despite the wearing of mouthguards. The promotional message appeared effective in increasing mouthguard use newspapers and football journals provided effective message locations for players, and ground signs and the electronic scoreboard for spectators.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2016
Publisher: Springer Science and Business Media LLC
Date: 15-09-2015
Publisher: Springer Science and Business Media LLC
Date: 10-2020
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.JDENT.2017.12.002
Abstract: We aimed to systematically review and meta-analyze the global, super-regional, regional and national prevalence of molar-incisor-hypomineralization (MIH) and to determine the numbers of prevalent and incident cases on different spatial scales. The review was registered (PROSPERO CRD42017063842). Five electronic databases (Medline, EMBASE, LILACS, Web of Science, Google Scholar) were searched systematically. Observational studies on the prevalence of MIH were included and the prevalence on different spatial scales (global, super-regional, regional, national) synthesized using random-effects meta-analyses. The prevalence was then regressed on a large set of methodological, socioeconomic and environmental variables to estimate the global burden (incident and prevalent cases) of MIH. Of 2239 identified studies, 99 studies on 113,144 participants from 43 countries were included. The meta-analysis yielded a mean (95% CI) prevalence of 13.1% (11.8-14.5%), with significant differences between super-regions, regions and countries. The number of prevalent cases in 2015 was estimated at 878 (791-971) million people, while the number of incident cases in 2016 was 17.5 (15.8-19.4) million. Of these, 27.4% (23.5-31.7%) (in mean, 240 million prevalent and 4.8 million incident cases, respectively) were or will be in need of therapy due to pain, hypersensitivity or posteruptive breakdown. Heavily populated countries contribute significantly to the burden of prevalent cases, while growing countries like India, but also Pakistan or Indonesia rank first with respect to the number of incident cases. MIH is highly prevalent across the globe. Certain (mainly low- and middle income) countries shoulder the majority of this burden. Clinical significance The consistently high prevalence and the large proportion of cases in need of care should be considered by both clinicians in their daily practice and healthcare planners and policy makers.
Publisher: Springer Science and Business Media LLC
Date: 23-08-2019
DOI: 10.1007/S00784-019-03058-W
Abstract: To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics) active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. In idual decisions should consider factors modifying these thresholds. Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions. Carious lesion activity, cavitation and cleansability determine intervention thresholds. Invasive treatments should be applied restrictively and with these factors in mind.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JDENT.2022.104113
Abstract: To investigate the trajectory of maternal intake of sugar-sweetened beverages (SSB) during the first five years of their child's life and its effect on the child's dental caries at five years-of-age. This is an ongoing prospective population-based birth cohort study in Adelaide, Australia. Mothers completed questionnaires on their SSB intake, socioeconomic factors and health behaviors at the birth of their child and at the ages of one, two and five years. Child dental caries measured as decayed, missing, or filled tooth surfaces was collected by oral examination. Maternal SSB intake was used to estimate the trajectory of SSB intake. The trajectories then became the main exposure of the study. Dental caries at age five years were the primary outcomes. Adjusted mean- and prevalence-ratios were estimated for dental caries, controlling for confounders. 879 children had dental examinations at five years-of-age. Group-based trajectory modeling identified three trajectories of maternal SSB intake: 'Stable low' (40.8%), 'Moderate but increasing' (13.6%), and 'High early' trajectory (45.6%). Multivariable regression analysis found children of mothers in the 'High early' and 'Moderate but increasing' groups to have greater experience of dental caries (MR: 1.37 (95%CI 1.01-1.67), and 1.24 (95%CI 0.96-1.60) than those in the 'Stable low' trajectory, respectively. Maternal consumption of SSB during pregnancy and in the early postnatal period influenced their offspring's oral health. It is important to create a low-sugar environment from early childhood. The results suggest that health promotion activities need to be delivered to expecting women or soon after childbirth.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JEBDP.2017.05.001
Abstract: Dental Health Services Victoria publishes evidence-based clinical practice guidelines (CPGs) to assist public oral health practitioners to provide high-quality dental care. How well these CPGs are implemented into practice is unknown. The aim of this study was to assess adherence to selected CPGs. An electronic auditing tool was developed using clinical indicators derived for "stainless steel crown (SSC)," "restorative care for children under general anesthetic (GA)," and "direct restorative materials" CPG. Six trained dentists audited a random s le of 204 dental records of children aged 3-12 years from 2 major public dental agencies. In total, 319 material-based treatments were audited, comprising 170 resin composite, 81 glass ionomer cement, 64 SSC, and 4 amalgam restorations. Adherence to the current guidelines varied from 94% of the SSC to none of the amalgam treatments audited. Almost half (47%) of the resin composite restorations and 5% of glass ionomer cement restorations were nonadherent to the relevant guideline. Average adherence was up to 72% of cases. Clinicians need to consider recording the rationale upon which their professional judgment is based when they decide not to follow an appropriate CPG.
Publisher: Springer Science and Business Media LLC
Date: 23-05-2022
DOI: 10.1186/S12909-022-03476-7
Abstract: Limited data regarding the perspectives of other observers (i.e. those who educate, employ or receive care from) of new graduates’ preparedness to practice is available. The present study aimed to explore perceptions of different observers regarding the preparedness to practice and work readiness of newly qualified dental professionals. This broader range of perspectives is crucial to inform the development of educational programs, including continuing professional development, for newly qualified dental professionals, by clarifying the skills, knowledge and behaviours expected by the dental profession and wider public. Nineteen in idual qualitative interviews were undertaken. Interview participants included clinical demonstrators ( n = 9 2 Oral Health Therapists 5 Dentists and 2 Prosthetists), dental course convenors ( n = 4), representatives of large employers ( n = 2), and consumers ( n = 4). According to this erse group of respondents, dental students receive adequate theoretical and evidence-based information in their formal learning and teaching activities, which prepares them for practice as dental professionals. There were no specific clinical areas or procedures where preparedness was highlighted as a major concern. Notwithstanding this, specific graduate skills which would benefit from further training and consolidation were identified, including areas where higher levels of experience would be beneficial. Nonetheless, respondents indicated that new graduates were aware of their limitations and had developed self-discipline and ethics that would allow them to identify conditions/situations where they would not have the experience or expertise to provide care safely. From an observer perspective, dental students appeared to have gained adequate theoretical and evidence-based information in their formal learning and teaching activities to prepared them to commence practicing safely as dental professionals. Areas were identified in which new graduates were underprepared and when transitional support may be required.
Publisher: Wiley
Date: 02-02-2021
DOI: 10.1111/IPD.12755
Abstract: Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a multifaceted syndrome with a variable phenotype. Few studies have described the associated dental characteristics and their relationship with medical co‐morbidities and no Australian data exist. To determine the clinical manifestations and correlations between oral and medical conditions in children with 22q11.2DS. A retrospective observational study. Children genetically diagnosed with 22q11.2DS at the Royal Children's Hospital Melbourne were selected their medical and dental characteristics were collated and analysed. The study population (n = 57 mean age 11.5 years, range 2‐27 years) experienced a range of medical conditions involving multiple medical systems of whom 44 (77.2%) had caries experience, 7 (12.3%) developmentally missing teeth, and 31 (54.4%) developmental defects of enamel (DDE). Smaller proportions of primary teeth were affected by DDE in children with congenital heart disease (2.2% vs 9.7% P = .02), and cardiac surgery (0.2% vs 9% P = .001). Conversely, children with hypoparathyroidism (n = 2) had significantly higher proportions of primary teeth affected by DDE (27.5% vs 4% P = .02). Significant associations existed between medical conditions (congenital heart disease, history of cardiac surgery, and hypoparathyroidism) and primary dentition DDE in children with 22q11.2 DS.
Publisher: Wiley
Date: 12-2006
DOI: 10.1111/J.1834-7819.2006.TB00445.X
Abstract: The development of white spot demineralization associated with fixed appliance orthodontic treatment is a significant clinical problem. Both established and experimental methods for prevention of such lesions in day-to-day clinical practice are presented and discussed.
Publisher: S. Karger AG
Date: 2013
DOI: 10.1159/000346134
Abstract: Molar-incisor hypomineralisation (MIH) is a problematic and costly condition. Caries remineralising agents are often recommended for MIH management despite the lack of evidence that these lesions have the capacity for increasing their mineral content. Following surface layer removal ± NaOCl pre-treatment and 14-day exposure to a CPP-ACFP solution at pH 5.5, MIH lesions were analysed using transverse microradiography and polarised light microscopy. Lesions were highly variable but treatment with the remineralising solution increased mineral content (1,828 ± 461 vol% min·µm, %R = 17.7 ± 5.7) and porosity decreased demonstrating the proof of concept that the mineral content of developmentally hypomineralised enamel can be improved after eruption.
Publisher: Wiley
Date: 21-05-2008
Publisher: Wiley
Date: 11-12-2021
DOI: 10.1111/IPD.12750
Abstract: Wnt/β‐Catenin signalling and DMP1 have key roles in tertiary dentinogenesis. To compare the relationship between remaining dentine thickness (RDT), tertiary dentine thickness (TDT), β‐catenin and dentine matrix protein 1 (DMP1) in carious second primary molar teeth with normal (SPM) and hypomineralised enamel (HSPM). Extracted carious SPM and HSPM were fixed, sectioned (5 μm) and stained with haematoxylin and eosin or with indirect immunofluorescence for β‐catenin and DMP1. Image analysis was performed to determine RDT, TDT, β‐catenin and DMP1 intensity in the odontoblast layer and dentine‐pulp complex. Carious SPM (n = 11 mean RDT = 1536.1 μm) and HSPM (n = 12 mean RDT = 1179.9 μm) had mean TDT 248.6 μm and 518.1 μm, respectively ( P = .02). There were no significant differences in intensity values in the odontoblast layer and dentine‐pulp complex for β‐catenin and DMP1 for both groups. There was no observable variation in Wnt/β‐catenin and DMP1 expression between HSPM and SPM despite a statistically significant twofold increased TDT in HSPM compared with SPM that had similar RDT. Thus, the observed increased TDT in HSPM is more likely due to an earlier onset of repair processes rather than an lified response to caries.
Publisher: Wiley
Date: 11-07-2018
DOI: 10.1111/ADJ.12626
Abstract: Developmental hypomineralized lesions of enamel (DHL) may represent a significant caries-risk factor. The aim of this study was to determine the association between carious lesion severity and DHL in 6- to 12-year-old schoolchildren from Melbourne, Australia. The s le was derived from randomly selected schools in inner Melbourne. A full dental examination was performed at the school. Socio-demographic data, caries experience (DMFT/dmft/ICDAS II) and the consequences of untreated carious lesions (PUFA ufa) were measured. DHL, molar incisor hypomineralization (MIH) and hypomineralized second primary molar (HSPM) presence were assessed using the European Academy of Paediatric Dentistry (EAPD) criteria. Of the children examined (n = 327), 26.9% had DHL. The prevalence of MIH and HSPM was 14.7% and 8%, respectively. Almost 20% of children had severe carious lesions (ICDAS 5 & 6) in at least one permanent or primary tooth. Ordinal regression analyses indicated that DHL (OR = 2.17 95% CI: 1.35-3.49) and being born overseas (OR = 2.59, 95% CI: 1.66-4.06) increased the likelihood of severe carious lesions. One of four children had DHL. DHL-affected children had an increased likelihood of presenting untreated severe carious lesions compared with DHL-free children.
Publisher: Mary Ann Liebert Inc
Date: 06-2018
Abstract: To assess the use of Teledentistry (TD) in delivering specialist dental services at the Royal Children's Hospital (RCH) for rural and regional patients and to conduct an economic evaluation by building a decision model to estimate the costs and effectiveness of Teledental consultations compared with standard consultations at the RCH. A model-based analysis was conducted to determine the potential costs of implementing TD at the RCH. The outcome measure was timely consultations (whether the patient presented within an appropriate time according to the recommended schedule). Dental records at the RCH of those who presented for orthodontic or pediatric dental consultations were assessed. A cost-effectiveness analysis (CEA), comparing TD with the traditional method of consultation, was conducted. One-way sensitivity analysis was performed to test the robustness of the results. Results and Materials: A total of 367 TD appropriate consultations were identified, of which 241 were timely (65.7%). The mean cost of a RCH consultation was A$431.29, with the mean TD consult costing A$294.35. This represents a cost saving of A$136.95 per appointment. The CEA found TD to be a dominant option, with cost savings of A$3,160.81 for every additional timely consult. The model indicated that 36.7 days of clinic time may be freed up at the RCH to treat other patients and expand capacity. These results were robust when performing one-way sensitivity analysis. When taking a societal perspective, the implementation of TD is likely to be a cost-effective alternative compared with the standard practice of face-to-face consultation at the RCH.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.ARCHORALBIO.2019.104591
Abstract: Description of the odontoblast lifecycle, an overview of the known complex molecular interactions that occur when the health of the dental pulp is challenged and the current and future management strategies on vital and non-vital teeth. A literature search of the electronic databases included MEDLINE (1966-April 2019), CINAHL (1982-April 2019), EMBASE and EMBASE Classic (1947-April 2019), and hand searches of references retrieved were undertaken using the following MESH terms 'odontoblast*', 'inflammation', 'dental pulp*', 'wound healing' and 'regenerative medicine'. Odontoblasts have a sensory and mechano-transduction role so as to detect external stimuli that challenge the dental pulp. On detection, odontoblasts stimulate the innate immunity by activating defence mechanisms key in the healing and repair mechanisms of the tooth. A better understanding of the role of odontoblasts within the dental pulp complex will allow an opportunity for biological management to remove the cause of the insult to the dental pulp, modulate the inflammatory process, and promote the healing and repair capabilities of the tooth. Current strategies include use of conventional dental pulp medicaments while newer methods include bioactive molecules, epigenetic modifications and tissue engineering. Regenerative medicine methods are in their infancy and experimental stages at best. This review highlights the future direction of dental caries management and consequently research.
Publisher: MDPI AG
Date: 03-08-2020
Abstract: The Centres for Disease Control and Prevention and the World Health Organization have developed preparedness and prevention checklists for healthcare professionals regarding the containment of COVID-19. The aim of the present protocol is to evaluate the impact of the COVID-19 outbreak among dentists in different countries where various prevalence of the epidemic has been reported. Several research groups around the world were contacted by the central management team. The online anonymous survey will be conducted on a convenience s le of dentists working both in national health systems and in private or public clinics. In each country/area, a high (~5–20%) proportion of dentists working there will be invited to participate. The questionnaire, developed and standardized previously in Italy, has four domains: (1) personal data (2) symptoms/signs relative to COVID-19 (3) working conditions and PPE (personal protective equipment) adopted after the infection’s outbreak (4) knowledge and self-perceived risk of infection. The methodology of this international survey will include translation, pilot testing, and semantic adjustment of the questionnaire. The data will be entered on an Excel spreadsheet and quality checked. Completely anonymous data analyses will be performed by the central management team. This survey will give an insight into the dental profession during COVID-19 pandemic globally.
Publisher: Springer Science and Business Media LLC
Date: 24-12-2019
DOI: 10.1038/S41598-019-56233-0
Abstract: Human microbiomes are predicted to assemble in a reproducible and ordered manner yet there is limited knowledge on the development of the complex bacterial communities that constitute the oral microbiome. The oral microbiome plays major roles in many oral diseases including early childhood caries (ECC), which afflicts up to 70% of children in some countries. Saliva contains oral bacteria that are indicative of the whole oral microbiome and may have the ability to reflect the dysbiosis in supragingival plaque communities that initiates the clinical manifestations of ECC. The aim of this study was to determine the assembly of the oral microbiome during the first four years of life and compare it with the clinical development of ECC. The oral microbiomes of 134 children enrolled in a birth cohort study were determined at six ages between two months and four years-of-age and their mother’s oral microbiome was determined at a single time point. We identified and quantified 356 operational taxonomic units (OTUs) of bacteria in saliva by sequencing the V4 region of the bacterial 16S RNA genes. Bacterial alpha ersity increased from a mean of 31 OTUs in the saliva of infants at 1.9 months-of-age to 84 OTUs at 39 months-of-age. The oral microbiome showed a distinct shift in composition as the children matured. The microbiome data were compared with the clinical development of ECC in the cohort at 39, 48, and 60 months-of-age as determined by ICDAS-II assessment. Streptococcus mutans was the most discriminatory oral bacterial species between health and current disease, with an increased abundance in disease. Overall our study demonstrates an ordered temporal development of the oral microbiome, describes a limited core oral microbiome and indicates that saliva testing of infants may help predict ECC risk.
Publisher: Elsevier BV
Date: 04-2015
Publisher: Wiley
Date: 19-06-2012
DOI: 10.1111/J.1834-7819.2012.01706.X
Abstract: Quantitative light-induced fluorescence (QLF) and digital photography (DP) have been proposed as clinical methods for measuring changes in enamel mineral content. The aim of this study was to compare the ability of QLF and DP with the in vitro gold standard transverse microradiography (TMR) to measure the remineralization of enamel subsurface lesions. Subsurface lesions were formed in enamel (n = 40) and exposed to remineralization solutions for 10 days. Changes were analysed by DP, QLF and TMR to determine percentage changes in luminescence (%L), fluorescence (%F) and mineral content (%R), respectively and correlation between these parameters determined. The correlations between TMR and QLF (r = 0.63), TMR and DP (r = 0.59), and DP and QLF (r = 0.64) were all moderate but statistically significant (p < 0.001). The variability in %L and, to a lesser extent, %F values significantly impacted on the potential role of DP and QLF as methods by which mineral content changes produced by remineralization treatments could be accurately measured. Both QLF and DP provided data that correlated moderately with TMR data. QLF images were easier to analyse, free of glare and had less variability compared with those produced using DP.
Publisher: Elsevier BV
Date: 12-2021
Publisher: Elsevier BV
Date: 08-2018
Publisher: S. Karger AG
Date: 07-10-2019
DOI: 10.1159/000503309
Abstract: A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough “round table” discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.
Publisher: Springer Science and Business Media LLC
Date: 18-08-2016
Publisher: SAGE Publications
Date: 22-07-2010
Abstract: Growing interest in the treatment and prevention of Molar/Incisor Hypomineralization (MIH) warrants investigation into the protein composition of hypomineralized enamel. Hypothesizing abnormality akin to amelogenesis imperfecta, we profiled proteins in hypomineralized enamel from human permanent first molars using a biochemical approach. Hypomineralized enamel was found to have from 3- to 15-fold higher protein content than normal, but a near-normal level of residual amelogenins. This distinguished MIH from hypomaturation defects with high residual amelogenins (amelogenesis imperfecta, fluorosis) and so typified it as a hypocalcification defect. Second, hypomineralized enamel was found to have accumulated various proteins from oral fluid and blood, with differential incorporation depending on integrity of the enamel surface. Pathogenically, these results point to a pre-eruptive disturbance of mineralization involving albumin and, in cases with post-eruptive breakdown, subsequent protein adsorption on the exposed hydroxyapatite matrix. These insights into the pathogenesis and properties of hypomineralized enamel hold significance for prevention and treatment of MIH.
Publisher: Wiley
Date: 17-10-2014
DOI: 10.1111/IPD.12069
Abstract: Reduced bond strengths of resin composites to hypomineralised enamel increase restorative failure. To investigate if the adhesion of resin composite to hypomineralised enamel can be improved by pre-treatments: resin infiltration, oxidative pre-treatment followed by a resin infiltration, or oxidative pre-treatment. Twenty-one enamel specimens in each of five Groups: 1) Normal enamel 2) Hypomineralised enamel 3) Hypomineralised enamel pre-treated with a resin infiltrant, (Icon(®)) 4) Hypomineralised enamel pre-treated with 5.25% sodium hypochlorite then treatment with resin infiltrant 5) Hypomineralised enamel pre-treated with 5.25% sodium hypochlorite. A resin composite rod was bonded to each specimen using Clearfil™ SE bond as the adhesive (hereafter termed 'routine bonding'), then subjected to microshear bond strength (MSBS) testing. Overall, the mean MSBS between the five groups differed significantly (P = 0.001). Pre-treatment of hypomineralised enamel with 5.25% sodium hypochlorite with or without subsequent resin infiltration in Groups 4 and 5 prior to routine bonding resulted in increased mean MSBS compared to Groups 2 and 3, with mean MSBS values not differing significantly when compared to routine bonding to normal enamel. Increased bond strength of resin composite to hypomineralised enamel was obtained by pre-treatment of hypomineralised enamel specimens with 5.25% sodium hypochlorite with or without subsequent resin infiltration.
Publisher: Elsevier BV
Date: 10-2012
DOI: 10.1111/IDJ.12007
Publisher: Elsevier BV
Date: 06-2007
DOI: 10.1016/J.AJODO.2006.09.043
Abstract: The demineralization of enamel adjacent to orthodontic brackets is a significant clinical problem. The purpose of this in-vitro study was to investigate the effect of sodium fluoride (Colgate Neutrafluor 9000 ppm) (NaF) and 10% casein phosphopeptide-amorphous calcium phosphate (GC Tooth Mousse) (TM) on enamel demineralization adjacent to orthodontic brackets. Forty specimens were sectioned from the buccal or lingual surfaces of extracted sound third molars. Twenty specimens had molar tubes bonded with composite resin (Transbond XT, 3M, St Paul, Minn) (CR), and 20 were bonded with resin-modified glass ionomer cement (Fuji Ortho LC, GC America, Alsip, Ill) (RMGIC). A 2-mm window for enamel demineralization was prepared. The specimens were randomly ided into 4 treatment groups: control, TM, TM/NaF (50/50 w/w), and NaF. The treatment solutions were placed around the bracket margins, and the specimens were immersed inverted into a carbopol demineralization solution at 37 degrees C. The enamel specimens were exposed for 96 hours, with the demineralization and topical solutions changed every 4 hours. Quantitative light-induced fluorescence (QLF) images were taken every 8 hours under controlled conditions. The difference in fluorescence (DeltaF) and the proportional DeltaF (%F) change between baseline and 96 hours was calculated. RMGIC significantly reduced DeltaF and %F when compared with CR (ANOVA, P = .029 and P = .034, respectively). Application of TM with CR, NaF with CR, and TM/NaF with CR significantly reduced DeltaF and %F compared with the control CR (Tukey post-hoc test, P <.001). Application of TM/NaF with RMGIC significantly reduced DeltaF and %F compared with the control RMGIC (Tukey post-hoc test, P = .008, P = .019, respectively). With the limitations of any in-vitro study, the following clinical conclusions can be drawn. The use of RMGIC alone can significantly decrease enamel demineralization compared with CR. The application of TM/NaF can provide significant additional prevention of enamel demineralization when RMGIC is used for bonding. The application of TM, NaF, or TM/NaF can significantly prevent enamel demineralization when CR is used for bonding. The use of both agents should be recommended for any at-risk orthodontic patient to provide preventive actions and potentially remineralize early (subclinical) enamel demineralization.
Publisher: Springer Science and Business Media LLC
Date: 10-05-2017
DOI: 10.1038/S41598-017-01745-W
Abstract: Molar Incisor Hypomineralisation (MIH) and Hypomineralised Second Primary Molars (HSPM) involve prevalent qualitative structural developmental anomalies of tooth enamel affecting the first permanent molars (and often incisors) and the second primary molars, respectively. These demarcated hypomineralised lesions of enamel manifest as white-cream or yellow-brown opacities, with possible post-eruptive localised loss of enamel. Aetiological hypotheses have involved contemporary life factors (i.e. environmental pollutant exposure or early childhood medications) in contrast to factors not limited to a specific time period (i.e. hypoxia at birth or genetic predisposition). Evidence of MIH in ancient populations would reinforce aetiological factors present for many centuries. By means of microtomographic and X-ray fluorescence analyses the present study provides evidence that (i) two archaeological specimens: “S407” (Sains-en-Gohelle, France, 12 th –16 th centuries) and “B335” (Beauvais, France, 15 th –18 th centuries) were MIH-affected, and (ii) one in idual “S323” was affected by HSPM and MIH (Sains-en-Gohelle, France, 7 th –11 th centuries).
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.ARCHORALBIO.2016.11.008
Abstract: Molar Incisor Hypomineralisation (MIH) is a structural anomaly that affects the quality of tooth enamel and has important consequences for oral health. The developmentally hypomineralised enamel has normal thickness and can range in colour from white to yellow or brown with or without surface breakdown. The possibility of finding MIH in 'ancient populations' could downplay several current aetiological hypotheses (e.g., dioxin derivatives, bisphenols, antibiotics) without excluding the possible multifactorial aspect of the anomaly. In an archaeological context, chemical elements contained in the burial ground can stain teeth yellow or brown and therefore might create a taphonomic bias. The purpose of the present study is to test a proposed diagnostic guide enabling determination of the pathological or taphonomic cause of enamel discolouration and defects that resemble MIH present on 'ancient teeth'. Two s le groups including MIH discoloration (n=12 teeth) from living patients, taphonomic discoloration (n=9 teeth) and unknown discoloration (n=2 teeth) from medieval specimens were tested. Three non-destructive methods-Raman spectroscopy, X-ray micro-computed tomography and X-ray fluorescence were utilised. Hypomineralised enamel has decreased mineral density (p<0.0001) and increased phosphate/β-carbonate ratio (p<0.01) compared to normal enamel whereas relative concentrations of manganese, copper, iron and lead are similar. In taphonomic discoloration, relative concentrations of these elements are significantly different (p<0.05) to normal enamel whereas mineral density and Raman spectra profile are comparable. Enamel hypomineralisation can be distinguished from taphonomic staining in archaeological teeth.
Publisher: Springer Science and Business Media LLC
Date: 28-04-2015
DOI: 10.1007/S40368-015-0178-8
Abstract: With the development of the European Academy of Paediatric Dentistry (EAPD) judgment criteria, there has been increasing interest worldwide in investigation of the prevalence of demarcated opacities in tooth enamel substance, known as molar–incisor hypomineralisation (MIH). However, the lack of a standardised system for the purpose of recording MIH data in epidemiological surveys has contributed greatly to the wide variations in the reported prevalence between studies. The present publication describes the rationale, development, and content of a scoring method for MIH diagnosis in epidemiological studies as well as clinic- and hospital-based studies. The proposed grading method allows separate classification of demarcated hypomineralisation lesions and other enamel defects identical to MIH. It yields an informative description of the severity of MIH-affected teeth in terms of the stage of visible enamel destruction and the area of tooth surface affected (i.e. lesion clinical status and extent, respectively). In order to preserve the maximum amount of information from a clinical examination consistent with the need to permit direct comparisons between prevalence studies, two forms of the charting are proposed, a short form for simple screening surveys and a long form desirable for prospective, longitudinal observational research where aetiological factors in demarcated lesions are to be investigated in tandem with lesions distribution. Validation of the grading method is required, and its reliability and usefulness need to be tested in different age groups and different populations.
Publisher: Springer Science and Business Media LLC
Date: 18-05-2023
Publisher: S. Karger AG
Date: 2020
DOI: 10.1159/000507692
Abstract: This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the in idual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia.
Publisher: Wiley
Date: 25-10-2018
DOI: 10.1111/EDT.12444
Abstract: Traumatic dental injuries (TDI) are a public health problem, given their prevalence and consequences. However, their epidemiology is uncertain due to a general lack of quality data capture. The aim of this study was to evaluate the validity and usability of a mobile phone-based application for community-based surveillance of traumatic dental injuries. A mobile phone-based application, Dental Trauma Tracker (DTT), was developed. This system involves a mobile application for general users to report TDIs and a Web application for researchers to generate epidemiological data. The DTT evaluation used mixed methods and was conducted in three phases: (a) validation of a trauma identification system using preselected TDI images (b) design evaluation by experts and (c) usability evaluation measured by the reporting of three fictitious TDI cases and using the System Usability Scale (SUS). In the first phase, 182 participants participated. Most images showed over 95% accuracy, indicating that they adequately represented the type of dentoalveolar trauma being evaluated (κ = 0.75). The design evaluation identified nine usability problems-four of them with a "High priority" to be fixed, four with "Low priority," and one "No fix necessary." A total of 29 volunteers participated in the usability evaluation. The mean time for users to complete all of the reports was 7.8 ± 3.0 minutes. Mean SUS score was 67.4 ± 21.9 (Range: 0-100 worst to best). The global agreement between cases registered with the gold standard was also "Substantial" (κ = 0.71). This preliminary evaluation confirmed the App's usability, using a s le of potential users, as well as reporting on the results of an expert panel review of the DTT. These are the minimum requirements necessary before further expansion and widespread implementation occurs to confirm these results.
Publisher: SAGE Publications
Date: 14-07-2021
DOI: 10.1177/00220345211018182
Abstract: Glass ionomer cements (GICs) are considered the material of choice for restoration of root carious lesions (RCLs). When bonding to demineralized dentin, the collapse of dentinal collagen during restorative treatment may pose challenges. Considering its acidic nature and collagen biomodification effects, proanthocyanidin (PAC) could be potentially used as a dentin conditioner to remove the smear layer while simultaneously acting to biomodify the dentinal collagen involved in the bonding interface. In this study, 6.5% w/v PAC was used as a conditioner for sound (SD) and laboratory demineralized (DD) root dentin before bonding to resin-modified GIC (FII), casein phosphopeptide–amorphous calcium phosphate (CPP-ACP)–modified GIC (FVII), or a high-viscosity GIC (FIX). Root dentin conditioned with deionized distilled water (DDW) or polyacrylic acid (PAA) served as controls. Results indicated FII showed higher shear bond strength (SBS) on SD than the other 2 GICs, especially in PAA-conditioned s les FIX showed significantly higher SBS than FII and FVII on PAA- or PAC-conditioned DD. In each category of GIC, PAA and PAC did not have a significant influence on SBS in most cases compared to DDW except for a significant decrease in PAC-conditioned SD bonded to FII and a significant increase in PAA-conditioned DD bonded to FIX. The bonding interface between GIC and SD was generally more resistant to the acid-base challenge than DD. Although the alterations in failure modes indicated a compromised interfacial interaction between GICs and PAC-treated root dentin, biomodification effects of PAC on dentin were observed from Raman microspectroscopy analysis in terms of the changes in mineral-to-matrix ratio and hydroxyproline-to-proline ratio of dentin adjacent to the bonding interface, especially of DD. Results from this study also indicated the possibility of using in situ characterization such as Raman microspectroscopy as a complementary approach to SBS test to investigate the integrity of the bonding interface.
Publisher: S. Karger AG
Date: 2023
DOI: 10.1159/000530556
Publisher: S. Karger AG
Date: 2021
DOI: 10.1159/000512483
Abstract: Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians’ management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians’ adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.ACTBIO.2019.02.020
Abstract: Treatment of carious root surfaces remains challenging due to the complex pathological processes and difficulty in restoring the original structure of root dentine. Current treatments targeting the de-/re-mineralisation processes are not entirely satisfactory in terms of the protection of the dentinal organic matrix and the highly organised structure of dentine. In this in vitro study, a cross-linking agent - proanthocyanidin (PA) was used in conjunction with a fluoride-based treatment - silver diamine fluoride otassium iodide (SDF/KI) to putatively stabilise the organic dentinal framework as well as strengthen the collagen-mineral phase interaction. The effectiveness of this strategy was evaluated 24 h after application in terms of the distribution of ion uptake and microstructure of dentine after treatment as well as analysis of the nano-mechanical properties using a dynamic behaviour model. Results showed that in idual use of SDF/KI significantly improved the surface microhardness and integrated mineral density (Z) up to 60 µm depth and the recovery of creep behaviour of demineralised dentine in the surface area compared to that treated with deionised distilled water (DDW). The combined treatment of PA and SDF/KI achieved a more homogenous mineral distribution throughout the lesions than SDF/KI alone a more significant incremental increase in surface microhardness and Z was observed. Specifically, a superior effect on the subsurface area occurred with PA + SDF/KI, with significant improvements in microhardness, elastic modulus and recovery of creep behaviour of the demineralised dentine. Application of SDF/KI induced small discrete crystal formation distributed over the dentine surface and PA contributed to the formation of slit-shaped orifices of the dentinal tubules that were partially occluded. STATEMENT OF SIGNIFICANCE: Demographic transitions and improved oral health behaviour have resulted in increased tooth retention in elderly people. As a consequence, the risk of root dentine caries is increasing due to the age-associated gingival recession and the related frequent exposure of cervical root dentine. Root caries is difficult to repair because of the complex aetiology and dentine structure. The recovery of dentine quality depends not only on reincorporation of minerals but also an intact dentinal organic matrix and the organic-inorganic interfacial structure, which contribute to the biomechanics of dentine. With the capability of dentine modification, cross-linking agents were applied with a fluoride regimen, which improved its treatment efficacy of root caries regarding the distribution of ion uptake and recovery of dentine biomechanics.
Publisher: Japanese Society for Dental Materials and Devices
Date: 2015
DOI: 10.4012/DMJ.2015-017
Abstract: This study evaluated the push-out bond strength of 0%, 0.5%, 1.0%, 2.0% and 3.0% (w/w) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP)-modified calcium silicate-based cements (CSCs). The push-out bond strength of a trial MTA was also compared with two CSCs (Biodentine(™) and Angelus(®) MTA). Three hundred 1 mm thick horizontal root sections were prepared from 60 singlerooted human teeth. The canal space of each section was enlarged and filled with the cements. The sections were stored in a phosphate buffer solution. After incubation for 2 months, the push-out bond strength was measured and the data were analyzed using one way analysis of variance followed by Tukey's test. The addition of CPP-ACP to the test cements increased the push-out bond strength (p<0.05). The push-out bond strength of Biodentine(™) was higher than the other cements (p<0.05). There was no statistically significant difference between Angelus(®) MTA and the trial MTA with most of CPP-ACP concentrations.
Publisher: Wiley
Date: 23-09-2012
DOI: 10.1111/JICD.12001
Abstract: The aim of this laboratory study was to investigate the effect of three commercial bleaching agents and Tooth Mousse(™) containing 10% w/w casein phosphopeptide-amorphous calcium phosphate on the hardness of tooth enamel. Sixteen human enamel specimens were exposed to one of three commercial bleaching agents with or without subsequent exposure to Tooth Mousse(™) . Nanoindentation was used to measure the hardness and reduced modulus before and after treatments. When bleaching materials were applied for a short period of time following the manufacturers' instructions, there was an increase in enamel hardness and reduced modulus for some bleaching groups, with no statistically significant difference from the baseline values. After extended bleaching periods a statistically significant decrease in enamel hardness and reduced modulus was found and after applying Tooth Mousse(™) post-bleaching, the hardness and reduced modulus returned to close to baseline values. The application of bleaching agents for an extended period of time significantly decreases enamel hardness and the reduced modulus. The application of Tooth Mousse(™) after bleaching was able to reestablish the baseline enamel hardness and reduced modulus, decreasing the adverse effects of bleaching enamel.
Publisher: Springer Science and Business Media LLC
Date: 17-07-2013
DOI: 10.1007/S40368-013-0067-Y
Abstract: To investigate the prevalence of molar-incisor hypomineralisation (MIH) amongst primary schoolchildren of Shiraz, Iran, taking into account the possible influence of biographic and socio-demographic parameters. A randomised cluster s le of 9- to 11-year-old children (N = 810) had their first permanent molars and incisors (index teeth) evaluated using the European Academy of Paediatric Dentistry criteria for MIH. The examinations were conducted at schools by a calibrated examiner. Prevalence of MIH was assessed based on biographic and socio-demographic parameters including area of residency, school type, father's level of education, weight-for-age and height-for-age. Of the children examined, 164/810 (20.2%) had MIH and 53.7% of them presented with MIH lesions in all first molars. Mild defects represented by demarcated yellow brown opacities comprised 35.5% of the total MIH lesions. The prevalence of MIH was significantly greater in girls, children with healthy body weight and height, those whose fathers did not have a tertiary education and from families of low socio-economic status. Regression analyses indicated that none of the biographic and socio-demographic variables represented a significant risk factor in the occurrence of MIH except for body weight. Obesity was negatively correlated to MIH (OR = 0.45 95% CI 0.25-0.82). The prevalence of MIH in a group of Iranian children was 20.2%. Biographic and socio-demographic parameters appeared to have no significant correlation with MIH except body weight, which warrants further research.
Publisher: Wiley
Date: 27-12-2022
DOI: 10.1111/IPD.13040
Abstract: Molar–incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) involve qualitative structural developmental anomalies of tooth enamel, affecting the first permanent molars (FPM) and the second primary molars, respectively. This developmental anomaly of systemic origin has important consequences for oral health. To determine the prevalence of MIH and HSPM in south‐western France and explore the distribution of hypomineralised lesions on permanent and primary molars. Amongst 856 children (aged 7–9 years) in schools randomly selected by the Academy of Bordeaux (Ministry of Education), the FPM, permanent incisors and the second primary molars were examined by two examiners trained and calibrated for the diagnostic criteria for MIH and HSPM of the European Academy of Paediatric Dentistry. Molar–incisor hypomineralisation was present in 160 children (18.7%) and HSPM in 81 children (9.5%) 4.9% had both HSPM and MIH (42 of 856). Hypomineralised lesions were present in 1–4 FPM in affected in iduals (mean = 2.4) and were distributed in an asymmetrical manner with widely varying severity at the tooth and in idual level. A child with HSPM was more likely to have MIH than a child without HSPM (95% CI OR = 6.0 [3.7–9.7] p .0001). Molar–incisor hypomineralisation and HSPM have three main asymmetrical characteristics: tooth location, severity of hypomineralisation and number of teeth affected.
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2019
Abstract: To explore the relative contributions of genetic and environmental influences on dental caries risk and to investigate fetal and developmental risk factors for dental caries. We recruited children from 250 twin pregnancies midgestation and collected demographic, health, and phenotypic data at recruitment, 24 and 36 weeks’ gestational age, birth and 18 months, and 6 years of age. 25-hydroxyvitamin D was quantified in mothers at 28 weeks’ gestation and in infants at birth. Dental caries and enamel defects were measured at six years of age. We compared concordance for the presence of any caries and advanced caries in monozygotic and dizygotic twin pairs. To investigate environmental risk factors for caries, we fitted multiple logistic regression models using generalized estimating equations to adjust for twin correlation. A total of 345 twins underwent dental assessment, with 111 (32.2%) showing signs of any caries and 83 (24.1%) having advanced caries. There was no evidence of higher concordance in monozygotic twins compared with dizygotic twins, with a difference of 0.05 (95% confidence interval −0.14 to 0.25 P = .30) and 0.00 (95% confidence interval −0.26 to 0.26 P = .50) for any caries and advanced caries, respectively, suggesting that environmental factors, rather than genetics, are the predominant determinant of caries risk. After adjusting for potential confounders, lack of community water fluoridation, hypomineralized second primary molars, dichorionic placenta, and maternal obesity were associated with caries. Environmental rather than genetic factors drive dental caries risk and arise as early as prenatal life.
Publisher: Wiley
Date: 20-06-2011
Publisher: Springer Science and Business Media LLC
Date: 18-08-2022
DOI: 10.1186/S12909-022-03684-1
Abstract: The current study explored the perspectives of preparedness for dental practice from a range of relevant stakeholders (i.e., educators, employers, final-year students, graduates, practitioners, and professional associations) using an anonymous online survey in which participants described either their preparedness for practice, or the preparedness of graduates they have encountered, across six domains. A total of 120 participants completed the survey. Participants were from several Australian states and territories regional, rural, and urban locations and working in the public and private sector. Students and new graduates generally felt prepared for activities in all the identified domains. Stakeholders reported consistently that the knowledge of dental profession graduates was at the required level to enter practice in Australia in a safe way. Activities involving the knowledge of clinical entrepreneurship and financial solvency were the dimensions where students and graduates felt least prepared (e.g., explaining fees, negotiating finances). In the domains involving clinical and technical competencies, students and new graduates self-assessed as less prepared around managing dental trauma and medical emergencies. On the other hand, activities around social and community orientation, and to a lesser extent professional attitudes and ethical judgements, were the dimensions where students and graduates felt the most prepared. Present findings indicate that there appear to be good standards of preparedness for practice for graduate dental professionals. This exploratory study provides insights into the nature of preparedness for Australian dental professionals and provides a basis for targeting education and professional development to address areas of need.
Publisher: SAGE Publications
Date: 03-08-2019
Abstract: The etiology of hypomineralized second primary molars (HSPM) is unclear, but genetic and environmental factors have been proposed. The aim of this study was to investigate the relative contribution of genes and environment to the etiology of HSPM and to identify potential environmental risk factors in a longitudinal twin cohort. Children from twin pregnancies ( N = 250) were recruited antenatally, and detailed demographic, health, and phenotypic data were collected at recruitment, 24- and 36-wk gestation, birth, and 18 mo of age. 25-Hydroxyvitamin D was quantified for mothers at 28-wk gestation and infants at birth. Dental examinations were conducted on the twins at 6 y of age to determine the presence, severity, and extent of HSPM per standardized criteria. To investigate associations of environmental risk factors with HSPM, multiple logistic regression models were fitted with generalized estimating equations to adjust for twin correlation. Within- and between-pair analyses were performed for unshared continuous variables: birthweight and birth 25-hydroxyvitamin D. Twin-twin concordance for monozygotic (MZ) and dizygotic (DZ) pairs was calculated and compared after adjusting for identified risk factors. A total of 344 twins underwent the 6-y-old dental assessment HSPM occurred in 68 (19.8%). After adjusting for potential confounders, vitamin D levels at birth, infantile eczema, dizygosity, in vitro fertilization, socioeconomic position, and maternal smoking beyond the first trimester of pregnancy demonstrated the strongest associations with HSPM. Overall concordance for HSPM was 0.47 (95% CI, 0.32 to 0.62) with weak evidence ( P = 0.078) of higher concordance in MZ twins (0.63 95% CI, 0.38 to 0.89) as compared with DZ twins (0.41 95% CI, 0.24 to 0.58). After adjusting for known risk factors, there was no evidence ( P = 0.172) for an additive genetic influence. These findings suggest that shared and unshared environmental factors, such as maternal smoking later in pregnancy and infantile eczema, are important in the etiology of HSPM.
Publisher: S. Karger AG
Date: 2019
DOI: 10.1159/000496542
Abstract: Molar-incisor hypomineralization (MIH) is a condition that is defined based on its peculiar clinical presentation. Original reports on the etiology of the condition and possible risk factors were inconclusive, and we refuted the original suggestion that MIH is an idiopathic condition and suggested that MIH has complex inheritance and is due to the interaction of more than one gene and the environment. Our group was the first to suggest MIH has a genetic component that involves genetic variation in genes expressed during dental enamel formation. Later we expanded this work to include genes related to the immune response. In this report, we provide a rationale to explain the variation seen in the clinical presentation of MIH, which can affect just one molar out of the four or just a portion of a particular molar.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2017
DOI: 10.1007/S40368-017-0293-9
Abstract: Despite clear assessment criteria, studies of molar incisor hypomineralisation (MIH) and hypomineralised second primary molars (HSPM) are marked by inconsistency in outcome measurements. This has detracted from meaningful comparisons between studies and limited interpretation. To provide a comprehensive manual as a companion to assist researchers in planning epidemiological studies of MIH and HSPM, with particular reference to outcome measurement. This manual begins with a succinct review of the clinical problems and evidence for management of the conditions. The subsequent sections guide researchers through diagnosis of MIH and HSPM and implementation of both the long and short forms of a recently proposed grading system. MIH and HSPM can often be confused with fluorosis, enamel hypoplasia, amelogenesis imperfecta, and white spot lesions but can be distinguished by a number of unique clinical features. Based on the grading system, a standardised protocol is proposed for clinical examinations. Intra and inter-examiner reliability is of key importance when outcome measurement is subjective and should be reported in all epidemiological studies of MIH. The manual concludes with an exercise forum aimed to train examiners in the use of the grading system, with answers provided. The use of a standardised protocol, diagnostic and grading criteria will greatly enhance the quality of epidemiological studies of MIH.
Publisher: SAGE Publications
Date: 20-04-2016
Abstract: Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided. Dental caries is the name of the disease, and the carious lesion is the consequence and manifestation of the disease—the signs or symptoms of the disease. The term dental caries management should be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereas carious lesion management controls the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions’ clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1) selective removal of carious tissue—including selective removal to soft dentine and selective removal to firm dentine 2) stepwise removal—including stage 1, selective removal to soft dentine, and stage 2, selective removal to firm dentine 6 to 12 mo later and 3) nonselective removal to hard dentine—formerly known as complete caries removal (technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.
Publisher: Springer International Publishing
Date: 22-08-2014
Publisher: Wiley
Date: 04-09-2018
DOI: 10.1111/ADJ.12647
Abstract: Poor oral health in children with cardiac conditions can have negative effects on quality of life and increased risk of infective endocarditis. The aim of this study was to investigate the caries experience in children with cardiac conditions attending the Royal Children's Hospital, Melbourne. Medical and dental records of 428 children aged <12 years were examined. Cardiac and other medical diagnoses, decayed, missing and filled surfaces/teeth were recorded and analysed. Children referred for reasons other than caries management (NRCM) was analysed separately to address confounding of referral reason on caries experience. Mean age of overall study population was 4.9 (SD 2.4) years, caries prevalence 52.1%, mean dmft 3.65 (SD 4.8), mean dmfs 6.19 (SD 11.3), enamel defects prevalence 29.2%. Mean age of NRCM group was 4.6 (SD 2.4) years, caries prevalence 37.5%, mean dmft 2.37 (SD 4.2), mean dmfs 4.22 (SD 9.4), enamel defects prevalence 23.0%. Untreated carious lesions accounted for 89.9% of caries experience. Caries experience was associated with low socio-economic status, absence of comorbidity and enamel defect presence. High disease levels were observed. Age, socio-economic status and enamel defects were associated with caries experience, not severity of cardiac diagnoses. Early referral for dental care and improved access should be facilitated.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Springer Science and Business Media LLC
Date: 14-01-2019
DOI: 10.1007/S40368-019-00416-W
Abstract: Decamarcated hypomineralised lesions of enamel include those developmental defects that are related to MIH, HSPM or any other demarcated opacities of systemic origin. The present study's aims are to determine MIH/HSPM prevalence, caries lesion severity and their association in a s le of 6-12-year-old schoolchildren from Talca, Chile. The s le (N = 577) was derived from selected primary schools in urban Talca. A full dental examination was performed at the school by one calibrated examiner. Socio-demographic data and caries experience (DMFT/dmft/merged ICDAS II and PUFA ufa) were measured in primary and permanent dentitions. MIH/HSPM was assessed using a modified EAPD protocol. Binary and multilevel binary regression analyses were calculated. The prevalence of MIH/HSPM or other demarcated hypomineralised lesions was 24.4%. MIH and HSPM was 15.8% and 5%, respectively. The presence of HSPM predicted MIH (OR 3.7 95% CI 1.65-8.15) when corrected by demographic factors. Of the children examined, 35% had no teeth with a score greater than ICDASII Code 0 and 26% had one or more severe carious lesions (Code C). Toothwise multilevel binary regression analyses demonstrated that teeth with MIH/HSPM (OR 3.70) from low-SES children (OR 1.93) had higher odds for carious lesions compared with defect-free teeth from high-SES participants. MIH/HSPM lesions were associated with carious lesion occurrence and increased disease severity. The prevalence of MIH and HSPM was similar to other reports. Increased awareness of MIH/HSPM in schools and primary health settings may help to identify children at risk early.
Publisher: Springer International Publishing
Date: 2016
Publisher: SAGE Publications
Date: 20-04-2016
Abstract: The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according to selective removal to firm dentine. In deep cavitated lesions in primary or permanent teeth, selective removal to soft dentine should be performed, although in permanent teeth, stepwise removal is an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term.
Publisher: Springer Berlin Heidelberg
Date: 02-10-2015
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-041185
Abstract: The long-term goal of the Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study is to identify and evaluate the relative importance and timing of critical factors that shape the oral health of young children. It will then evaluate those factors in their inter-relationship with socioeconomic influences. SMILE is a single-centre study conducted in Adelaide, Australia. All newborns at the main three public hospitals between July 2013 and August 2014 were eligible for inclusion. The final recruited s le at birth was 2181 mother/infant dyads. Participants were followed up with questionnaires when the child was 3 and 6 months of age, and 1, 2 and 5 years of age. Oral epidemiological examinations and anthropometric assessments were conducted at age 2 and 5 years. SMILE has contributed comprehensive data on dietary patterns of young children. Intakes of free sugars, core and discretionary foods and drinks have been detailed. There was a sharp increase in free sugars intake with age. Determinants of dietary patterns, oral health status and body weight during the first 5 years of life have been evaluated. Socioeconomic characteristics such as maternal education and household income and area-level socioeconomic profile influenced dietary patterns and oral health behaviours and status. Funding has been obtained to conduct oral epidemiological examinations and anthropometric assessments at age 7–8 years. Plans are being developed to follow the cohort into adolescent years.
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.JOEN.2013.10.030
Abstract: This review and case report present the treatment of a 10-year-old boy with both permanent maxillary lateral incisors demonstrating Oehlers type II dens invaginatus and pulpal involvement. Treatment was complicated by dental anxiety, supraventricular tachycardia, immature tooth development, and facial cellulitis. An infected necrotic pulp of the permanent maxillary left lateral incisor was treated by apexification and endodontic treatment with mineral trioxide aggregate. The necrotic pulp of the permanent maxillary right lateral incisor was treated with canal debridement and dressing under general anesthesia. Periapical healing of both teeth occurred, with the right lateral incisor showing continued root growth, thickening of the dentinal root walls, and completed apex formation. This tooth responded normally to pulp testing. Twenty-eight months after initial treatment, the right lateral incisor displayed progressive sclerosis of the canal. This case demonstrates possible pulpal regeneration of an infected maxillary right lateral incisor with dens invaginatus and an immature apex after minimal canal debridement.
Publisher: Wiley
Date: 21-05-2008
DOI: 10.1111/J.1834-7819.2008.00022.X
Abstract: Continuing professional development (CPD) has been long considered an integral component of professional practice across a range of health professions. It is believed to ensure the maintenance of practitioner clinical competence and knowledge of current concepts. This study investigated the participation in and attitudes of Victorian dental personnel to CPD activities. A self-administered cross-sectional survey of a random s le of registered dental care providers (n = 451) was conducted from March to June 2005 using an anonymous, postal, self-administered questionnaire. The response rate was low (48.1 per cent). Nearly 90 per cent of respondents attended a CPD course in 2004, with the mean hours of attendance ranging from 8.3 to 36.9 hours, depending on registration category. Nearly half of the dentists attended more than 20 hours of CPD courses, while less than 20 per cent of prosthetists attended more than 15 hours of CPD courses. Three-quarters of respondents supported mandatory CPD as a condition of registration. There was a high level of participation in continuing professional development activities by surveyed Victorian dental care providers in 2004, although more than half of the dentists and specialists, and nearly two-thirds of therapists, hygienists and prosthetists would fail to meet the new DPBV mandatory requirements for CPD.
Publisher: Springer Science and Business Media LLC
Date: 10-12-2015
DOI: 10.1007/S40368-015-0215-7
Abstract: This was to explore the socio-behavioural risk factors for ECC in Cambodia. Early childhood caries (ECC) is a significant health problem in Cambodia. A convenience s le of 362 primary caregiver-child dyads were selected. The children were aged between birth and 6 years old and participated in a structured interview and intra-oral examination. ECC was diagnosed in 244 of 362 (65.6%) children and 178 (50.6%) had severe early childhood caries (sECC). There were significant associations between caries experience and tooth brushing, dietary, and nursing habits. The odds ratio (OR) for sECC in those children who started brushing before the age of 18 months was 0.41 (CI 0.18, 0.93). However, for those children who continued to breast-feed after the age of 2 years the OR was 5.31 (CI 1.50, 18.79). The most prominent risk factors for ECC in the present study were lack of tooth brushing and breast-feeding past the age of 2 years.
Publisher: Wiley
Date: 02-02-2017
DOI: 10.1111/JICD.12259
Abstract: The aim of the present study was to determine the validity of quantitative light-induced fluorescence-digital (QLF-D) in regard to the detection and quantification of developmental demarcated hypomineralized lesions of enamel in vitro when compared to micro-computed tomography (CT) determination of lesion characteristics. A secondary aim was to develop a protocol for 3-D analysis using micro-CT. Twenty-four hypomineralized defects were classified as cream/white (CW), yellow/brown (YB), and post-eruptive breakdown. Teeth were scanned using micro-CT. Grayscale and chromatic vertical sections were constructed. Mineral density and porosity percentage were calculated. Fluorescence loss and red fluorescence were determined from images. Linear mixed models were computed. Mineral density and porosity mean values by lesion type were statistically different (P<.001). CW lesions had lower fluorescence loss than YB and broken lesions. Red fluorescence was emitted by the majority of the defects, and the means between lesion types were statistically different (P<.001). The mixed model indicated that mineral density was not correlated with fluorescence loss and lesion type. The present findings support QLF-D as a method to detect hypomineralized lesions of different clinical presentation, with red fluorescence putatively related to the severity of the defects. The micro-CT 3-D approach is a reliable method to analyze structural changes in hypomineralized enamel.
Publisher: Elsevier BV
Date: 10-2021
DOI: 10.1016/J.JDENT.2021.103797
Abstract: Hypomineralised second primary molars (HSPM) are common developmental enamel defects. The aims of this study were to use surface-level data to explore the clustering of HSPM at four levels (family, child, tooth, surface). This study of 172 twin pairs was nested within the Peri ostnatal Epigenetic Twin Study. HSPM was measured by standardised oral examinations at age 6 years. Multilevel logistic regression models were fitted to assess the correlation structure of surface level data and variation in HSPM. The associations between surface level risk factors and HSPM were then explored using the multilevel logistic regression model using the best fitting correlation structure. The prevalence of HSPM was 68 (19.8%) children, with a total of 141 (10.3%) teeth and 264 tooth surfaces (6.3%) affected. Multilevel models revealed that a hierarchical structure accounting for correlation at the family, child and tooth level best accounted for the variation in HSPM. The estimated variances from the best fitting model (Model 3) were largest at the family level (12.27, 95% CI 6.68, 22.51) compared with 5.23 at the child level and 1.93 at the tooth level. Application of regression analysis utilising this three-level correlation structure identified tooth/surface level factors in addition to the previously identified familial and in idual risk factors for HSPM. In addition to familial (environmental and genetic) and unique child-level factors, the aetiology of HSPM is likely to be influenced by local tooth-level factors.
Publisher: Wiley
Date: 24-10-2019
DOI: 10.1111/IPD.12581
Abstract: To assess the efficacy of treatment using a minimally invasive approach (selective removal of carious tissue, restoration and preventive strategies) in immature permanent molars with MIH. A total of 281 patients, aged 6-8 years, with carious lesions (ICDAS 5-6), severe MIH, and incomplete root formation (one tooth atient) were included. After clinical and radiographic examinations, selective carious tissue removal was performed, and the teeth received interim restoration for 6 months and were then restored with composite resin. Clinical and radiographic follow-up was undertaken, 6, 12, 18, and 24 months. A protocol of preventive oral care measures was established and repeated at each follow-up, including diet counselling, oral hygiene instruction, dental plaque control, and topical application of fluoride varnish containing CPP-ACP. All clinical procedures and evaluations were done by a single operator. Clinical and radiographic success was observed 24 months after treatment in 96.8% of the cases. Failures were due to enamel fracture at restoration margins, resulting in pulpitis and absence of apex closure. Selective removal of carious tissue, interim, and subsequently definitive restoration, combined with home and professional preventive measures, maintained marginal integrity of restorations in immature permanent molars with severe MIH, confirmed by pulp vitality and occurrence of apexogenesis.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Wiley
Date: 21-05-2008
DOI: 10.1111/J.1834-7819.2008.00026.X
Abstract: Worldwide, molar incisor hypomineralization (MIH) affects a substantial number of children and impacts greatly on treatment need and dental anxiety, yet there is little information regarding its prevalence, aetiology, presentation and management. The aims of this survey were to assess awareness and perceptions of the Australian paediatric dental community concerning MIH, and to describe current treatment strategies. A questionnaire, based upon a previous European study, was sent to all Australian members of the Australian and New Zealand Society of Paediatric Dentistry. The questionnaire sought information on clinical experience of MIH, knowledge of prevalence, aetiology and contemporary management strategies for MIH. One hundred and thirty useable responses were received (58.8 per cent response rate) of which 36 were paediatric dentists, 6 paediatric dentistry postgraduate students, 59 general dentists, 14 dental therapists and 14 specialists in other fields. Most (98.5 per cent) respondents were familiar with MIH and encountered it in their practice. The majority (73.1 per cent) estimated that MIH occurred in between 5 to 25 per cent of their clinical practice and almost all (96.9 per cent) considered it to be a clinical problem. Only 16.9 per cent of respondents were aware of existing prevalence data and 96.9 per cent valued investigating the prevalence of MIH. No consensus existed regarding the aetiology of MIH or its restorative management. Paediatric dentists used preformed crowns significantly more than non-specialists, however glass ionomer cements were popular with all groups. MIH is a well recognized and widely encountered clinical condition. MIH presents several clinical problems and is worthy of further investigation. Currently, no consistent clinical management strategies are utilized.
Publisher: Wiley
Date: 25-01-2013
No related grants have been discovered for David Manton.