Browsing by Subject "Dental Caries"

Now showing 1 - 10 of 27
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    Ability of Caries Detection Methods to Determine Caries Lesion Activity
    (2019-12) Aldawood, Fatma; Ando, Masatoshi; Hara, Anderson T.; Diefenderfer, Kim E.
    Background: Non-cavitated caries lesions form due to acid diffusion and demineralization of enamel subsurface with an intact surface layer (SL). Caries lesions progress when the outcome of demineralization and remineralization processes over time is net mineral loss. Lesions that continue to demineralize are called active, while those that display no evidence of further demineralization are called inactive. Micro-computed-tomography (µCT) analysis provides objective non-destructive measurements of the thickness of the surface layer (SL) and severity of caries lesions. Aims: 1) To investigate if visual/tactile suspected active non-cavitated early white spot lesions present a thinner surface layer than inactive ones; 2) To investigate if there is an association between the thickness of the surface layer (SLT) and caries activity, as determined by QLF during dehydration (△QD); 3) To determine lesion severity by comparing lesion volume and maximum depth correlation with △Q value at 15 s from QLF during dehydration. Materials and Methods: Thirty extracted human premolars exhibiting non-cavitated approximal white spot early lesions stored in 0.1.-percent thymol/4C and treated with 5.0-percent NaOCl/30 min were included in the study. Fifteen active and 15 inactive lesions were determined by visual/tactile examinations by consensus of two experienced examiners. Roughness measurements (Ra) were acquired using non-contact optical profilometry. Two-dimensional minimum (2D-min), maximum (2D-max), average (2D-avg) SL and three-dimensional (3D) analyses, volume and depth of lesions were determined from µCT image analysis. A series of fluorescence images were acquired at baseline (hydrated), at 1 s, at 5 s, at 10 s and at 15 s by QLF. During image acquisition, surfaces were dehydrated with continuous-compressed-air. △Q and △Q/s (△QD) were calculated. Data were analyzed using two-sample t-tests and Pearson correlation coefficients (p < 0.05). Results: Surface roughness of active and inactive lesions was not significantly different (p > 0.08). Overall lesion volume and depth in dentin were significantly larger in active lesions (p = 0.022, p = 0.009). SL thickness of active and inactive lesions was not significantly different (2D = 0.121, 3D = 0.080, 2D-avg = 0.446, 2D-min = 0.197, 2D-max = 0.122). △QD at 1s was significantly larger for active lesions (p = 0.046). ΔQ at 15 s of dehydration had a moderate positive association with lesion volume (r = 0.56). △QD had a weak negative association with SL thickness (2D-avg) and (2D-min). Conclusions: 1) Active and inactive non-cavitated lesions show no difference in SL thickness; 2) QLF during dehydration (△QD) does not correlate well with SL thickness; 3) ΔQ at 15 s of dehydration correlates moderately well with lesion volume and is consistent with caries activity assessed by visual/tactile examination.
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    Artificial biofilm thickness and salivary flow effects on fluoride efficacy – A model development study
    (2017-10-26) Lippert, Frank; Hara, Anderson T.; Churchley, David; Lynch, Richard J. M.
    This laboratory model development study investigated the interaction between artificial biofilm thickness and salivary flow rate on fluoride-mediated prevention of enamel caries lesion formation. This 5-day pH cycling study on sound bovine enamel specimens utilized a continuous flow model and followed a 4 (agarose biofilm thickness-‘no biofilm’/1/2/3mm)×2 (remineralizing solution flow rate-0.05/0.5ml/min)×2 (fluoride-0/383ppm as sodium fluoride) factorial design. Vickers surface microhardness change was the outcome measure. Data were analyzed with three-way ANOVA. The three-way interaction gel thickness×flow rate×fluoride concentration was significant (p=0.0006). 383ppm fluoride caused less softening than 0ppm regardless of gel thickness or flow rate. 0.5ml/min flow rate caused less softening than 0.05ml/min for ‘no biofilm’ and 1mm biofilm thickness regardless of fluoride concentration, for 2 and 3mm with 0ppm F but not for 383ppm F. For 0.05ml/min, softening was reduced as gel thickness increased from ‘no biofilm’-1-2mm, but not from 2-3mm. For 0.5ml/min, ‘no biofilm’ caused more softening than 1, 2, and 3mm, but 1, 2, and 3mm were not different from each other for both 0 and 383ppm F. The present findings suggest that the efficacy of fluoride in preventing enamel demineralization is affected by both biofilm thickness and salivary flow rate, with both thicker biofilms and higher flow rate resulting in less demineralization.
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    Chlorhexidine as a recurrent marginal caries inhibitor : a televison microscope evaluation
    (1978) Gleiser, Rogerio, 1952-
    This study investigated the effectiveness of chlorhexidine and a cavity varnish in reducing the incidence of recurrent caries around amalgam restorations in vitro. This was accomplished by: (1) inserting amalgam restorations into Class V preparations to which a varnish (Copalite), a 1 percent chlorhcxidine gluconate solution, or chlorhexidine followed by the varnish were applied; (2) exposing the teeth with the restorations to a severe ciogenic challenge; and (3) measuring with the television microscope instrumentation the changes which occurred in the width of the gap between the amalgam and the cavity wall. Four groups of 12 intact bicuspids, previously extracted for orthodontic purposes and mounted in squares of self-curing resin, were used. Upon completion of the Class V Cavity preparations, the three treatments performed, and the cavity restored with amalgam, the teeth were exposed to a cariogenic challenge for six weeks, with a weekly change in the "artificial plaque" created by Streptococcus mutans. A group of teeth which received no treatment before the restoration was inserted served as controls. The television microscope measurement instrumentation which allowed a magnification of 250 X and measurements as small as one micron were used to identify and measure the width of the gap between the amalgam and the cavity wall before and after the teeth were exposed to the cariogenic challenge. The conclusions of this study were: (1) The use of chlorhexidine or a varnish or a combination of both produced a significantly smaller enlargement of the amalgam-cavity wall gap width when no treatment was performed before the insertion of the restoration. (2) Chlorhcxidine by itself or in combination with the varnish did not prove to be more effective in preventing the enlargement of the gap than the varnish. (3) The experimental model in which a cariogenic challenge was developed produced decalcifications that closely resembled those produced in the mouth situation. (4) The television microscope measurement instrumentation accurately measured the amalgam-cavity wall gap widths. (5) The evaluation did not permit a correlation between the increase in gap width and the carious process. It is the author's suggestion that for this purpose, future studies should be performed with histologic evaluations of enamel ground sections as one of the evaluation methods. (6) Before recommending the clinical use of chlorhcxidine as a recurrent marginal caries inhibitor, further research is necessary.
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    Combined Effects of Soda Drinks and Nicotine on Streptococcus Mutans Metabolic Activity and Biofilm Activity
    (2019) Mokeem, Lamia Sami; Gregory, Richard; Cook, Norman Blaine; Windsor, Jack; Eckert, George
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    A critical clinical and television radiographic evaluation of indirect pulp capping
    (1967) Traubman, Lionel; Bixler, David; Shafer, William G.; Phillips, Ralph W.
    The purpose of this study was to quantitatively measure the rate and amount of calcification and secondary dentin deposition below deep carious lesions of otherwise radiographically and clinically sound teeth treated by calcium hydroxide - methyl cellulose indirect pulp capping. Standardized, reproducible serial radiographs of 50 treated young posterior teeth were exposed preoperatively at one, three, six, nine and, in some cases, 12 months. At the final appointment, the silver amalgam restorations were removed and all residual caries was excavated. A barium sulphate radiographic indicator paste identified the pulpal floor level at the first and last appointments. Ninety per cent of the teeth studied remained asymptomatic and were not pulpally exposed. Television density and linear measurement instrumentation was utilized to register calcification changes, pulpal floor thicknesses, and secondary dentin deposition. Following treatment, increased secondary dentin deposition and Calcification activity, or sclerosis, was initiated. Higher levels of calcification activity were related to increased thickness of pulpal floors, but this dimension had little influence on the total amount of reparative dentin formed. The rate of reparative dentin formation was highest during the first month and steadily diminished with time. Calcification activity experienced a cyclical change, or "exchange," with an initial activity peak. This was followed by an apparent, but temporary mobilization of mineral content •out of the affected dentin. With time, a steady rise in calcification level was observed. Measurement of longitudinal records showed that apparent pulp exposures can be avoided by allowing significant amounts of protective secondary dentin to form, before complete caries excavation.
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    Design of the Prevention of Adult Caries Study (PACS): A randomized clinical trial assessing the effect of a chlorhexidine dental coating for the prevention of adult caries
    (BMC, 2010-10-05) Vollmer, William M.; Papas, Athena S.; Bader, James D.; Maupomé, Gerardo; Gullion, Christina M.; Hollis, Jack F.; Snyder, John J.; Fellows, Jeffrey L. Fellows; Laws, Reesa L.; White, B. Alexander; PACS Collaborative Research Group; Social and Behavioral Sciences, School of Public Health
    Background Dental caries is one of the primary causes of tooth loss among adults. It is estimated to affect a majority of Americans aged 55 and older, with a disproportionately higher burden in disadvantaged populations. Although a number of treatments are currently in use for caries prevention in adults, evidence for their efficacy and effectiveness is limited. Methods/Design The Prevention of Adult Caries Study (PACS) is a multicenter, placebo-controlled, double-blind, randomized clinical trial of the efficacy of a chlorhexidine (10% w/v) dental coating in preventing adult caries. Participants (n = 983) were recruited from four different dental delivery systems serving four diverse communities, including one American Indian population, and were randomized to receive either chlorhexidine or a placebo treatment. The primary outcome is the net caries increment (including non-cavitated lesions) from baseline to 13 months of follow-up. A cost-effectiveness analysis also will be considered. Discussion This new dental treatment, if efficacious and approved for use by the Food and Drug Administration (FDA), would become a new in-office, anti-microbial agent for the prevention of adult caries in the United States.
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    Effect of a stable 30 per cent stannous fluoride solution on recurrent caries around amalgam restorations
    (1968) Alexander, William Everett, 1938-; Swartz, Marjorie L.; Garner, La Forrest Dean, 1933-; Shafer, William G.
    This was a study to evaluate the effectiveness of a stable 30 per cent stannous fluoride solution on recurrent caries around the margins of amalgam restorations. Two hundred ninety deciduous and permanent teeth were restored in 34 children, ages six to nine years. Cavity preparations were treated with either stable 30 per cent stannous fluoride solution or a placebo solution (double blind technique) prior to the placement of amalgam restorations. A comprehensive coded system was used to record the description and position of conditions associated with recurrent caries after a one-year period. Children receiving the stannous fluoride treatment experienced a 58.9 per cent reduction in recurrent caries when compared to the control children. The children receiving the stannous fluoride treatment showed a 60.7 and 46.7 per cent reduction in recurrent carious lesions in permanent and deciduous teeth, respectively, when compared to the control children. The reduction in recurrent caries was attributed to the anticariogenic effect of the stannous fluoride treatment. Conditions associated with recurrent caries were mainly inadequate extension in fissures and grooves, overextension of the cavity preparation, marginal fractures of enamel and amalgam, marginal excess, and deterioration of the amalgam margin. Recurrent caries around the margins of restorations appeared to depend on (1) the caries susceptibility of the adjacent tooth structure,(2) the extension of the cavity preparation, and (3) the condition of the amalgam-enamel margin.
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    Effect of Bottled Water and Fluoride Toothpaste Usage on Caries Lesion Remineralization
    (2023) Qaw, Masoumah Samir; Lippert, Frank; Al Dehailan, Laila; Hara, Anderson T; Cook, N. Blaine
    Background: The importance of fluoride in the prevention of dental caries has been well documented in the literature, as it inhibits demineralization of the tooth structure and enhances remineralization. One of the major public health policies to prevent caries is to provide the population with an adequate amount of fluoride through community water fluoridation. Nowadays many people drink bottled water instead of tap water due to its easy access, convenience, and low cost. Besides fluoride, other minerals present in tap and bottled water, such as calcium and magnesium, are also important in decreasing dental caries prevalence. However, our knowledge of the role of bottled water in caries prevention and especially when combined with fluoride toothpaste usage is still poor. Objectives: The aim of this in-vitro study was to evaluate the effects of some bottled waters on fluoride toothpaste efficacy in enhancing caries lesion remineralization. Methodology: Early caries lesions were created in bovine enamel specimens and stratified into treatment groups based on Vickers surface microhardness (VHN). The present study followed a two (fluoride and fluoride-free toothpaste) by five (four bottled waters and tap water) factorial design. The treatment groups were bottled water with the following attributes: a) 309.9 ppm Ca/1.20 ppm F; b) 118.4 ppm Ca/0.16 ppm F; c) 1.00 ppm Ca/1.01 ppm F; d) 0.1 ppm Ca/0.04 ppm F, and tap water (48.7 ppm Ca/0.7 ppm F). The five water groups were paired either with 1100 ppm fluoride or fluoride-free toothpaste, yielding 10 groups. Specimens were pH-cycled for 10 days with the daily regimen comprised of twice daily toothpaste slurry, with four exposures to water in between. VHN was measured, again, and the difference calculated (ΔVHN). Data were analyzed using two-way ANOVA at a 5-percent significance level. Results: The two-way interaction between water and toothpaste was significant (p < 0.001). All groups except fluoride-free toothpaste/bottled water with 0.1 ppm Ca/0.04 ppm F (p = 0.411) had significant increases in VHN after pH cycling (p ≤ 0.023). Fluoridated toothpaste resulted in a higher rate of remineralization compared to fluoridefree toothpaste (all p < 0.001). Bottled water with 1.20 ppm F/309.9 ppm Ca exhibited the greatest extent of remineralization within fluoride toothpaste groups (p < 0.001) and higher remineralization than lower fluoride water in fluoride-free toothpaste groups (p ≤ 0.006). Within the fluoridated toothpaste group, tap water exhibited significantly less remineralization compared to all bottled waters (all p < 0.001). Conclusion: Within the limitation of this study, bottled water with higher fluoride and calcium concentrations might improve fluoridated toothpaste efficacy by enhancing remineralization of early enamel caries-like lesions.
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    The effect of pit and fissure morphology and sealant viscosity on sealant penetration and microleakage
    (2017) Zawam, Omelkher Muftah; Soto, Armando E.; Hara, Anderson T.; Cook, Norman Blaine
    Background: The ability of sealants to prevent caries is directly related to the sealant being retained in teeth. The longer the material remains bonded to the occlusal surface, the more protection it provides to the tooth. Objective: The aim of this in-vitro study was to evaluate the influence of pit and fissure morphologies and sealant viscosity on sealant penetration and micro-leakage. 82 Study Hypothesis: The low viscosity dental sealant will express better penetration ability and less microleakage in permanent molars with any pit and fissure morphology than the high viscosity sealant. Material and methods: Permanent extracted molars (n = 150) were distributed into two groups based on two types of sealant (high and low viscosity) Permanent extracted molars (n = 150) were selected using the International Caries Detection Assessment system (ICDAS) criteria 0-1. Teeth were stored in 0.1-percent thymol and distilled water. Teeth were assigned to three subgroups according to the fissure’s morphology. Enamel was etched with 35-percent phosphoric acid for 30 seconds; two different light cured sealants were placed, Group A: Delton and Group B: Ultra X Plus. Specimens were thermocycled for 500 cycles between two water baths, having a 40°C temperature differential (4°C to 48°C). Teeth were coated with nail varnish and wax, except in the occlusal areas. All specimens were immersed in 1-percent methylene blue dye at 37°C for 24 hours. Specimens were sectioned longitudinally in a bucco-lingual direction, and the sections were photographed and analyzed by a previously trained examiner for fissure morphology, sealant penetration, and microleakage using a standardized grading system. Data were entered and statistically analyzed, at the 5-percent significance level. Results: Viscosity of sealant and morphology of fissures had significant effects on sealant penetration (p < 0.001). The interaction between viscosity of sealant and morphology of fissures was not significant (p = 0.4236). The sealant penetration for Delton was significantly higher than the UltraSeal XT Plus (p < 0.0001). The sealant penetration for fissure I-type was significantly lower than fissures U and V-types (p < 0.0001). Sealant penetration for Y-type was significantly lower than U and V-types (p < 83 0.0001). However, the viscosity of sealant and morphology of fissures did not have significant effect on microleakage (p = 0.5891 and p = 0.4857). The interaction between the viscosity of the sealant material and the morphology of pit and fissures was not significant (p = 0.6657). Conclusion: The results of the present study indicated the viscosity of the sealant and the morphology did not affect the microleakage. On the other hand, the viscosity of sealant affected the penetration ability of dental sealant. The low viscosity dental sealant (Delton) exhibited a better penetration than the high viscosity sealant (UltraSeal XT Plus). As the morphology of pit and fissure directly affected the penetration ability, the fissures types U and V exhibited a better penetration than fissure types Y and I.
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    The Effect of Silver Diamine Fluoride on Caries Lesion Remineralization as a Function of Lesion Baseline Mineral Distribution
    (2022) AlMady, Fahad; Lippert, Frank; Hara, Anderson; Al Dehailan, Laila; Capin, Oriana
    Purpose: The primary objective of this laboratory study was to investigate whether the ability of SDF to remineralize caries lesion is modulated by their baseline mineral distribution. The exploratory objective was to determine whether the staining caused by SDF is modulated by lesion mineral distribution. Materials and methods: This in vitro study utilized bovine permanent enamel specimens. SDF was compared to the clinical reference standard, 5% sodium fluoride varnish (FV), and deionized water (DIW) was the negative control. By utilizing three lesion creation protocols (methylcellulose [MeC], hydroxyethylcellulose [HEC], Carbopol [C907]), artificial caries lesions with different mineral distributions (n=20 per subgroup) were created in the enamel specimens Interventions were applied and the lesions remineralized using artificial saliva. Changes in mineral loss, lesion depth, mineral density of the surface zone, and lesion mineral distribution were determined using transverse microradiography. Throughout the study, color of the lesion and changes thereof were measured using a spectrophotometer. Data were analyzed by using two-way ANOVA. Pair-wise comparisons were performed using Fisher’s Protected Least Significant Differences to control the overall significance level at 5%. Results: For changes in mineral loss, DIW in MeC showed significantly greater change (more remineralization) than both SDF (p<0.01) and FV (p=0.01), which were not different from one another (p=0.13). There were no statistically significant differences between SDF and FV in the other lesions (C907 – p=0.18; HEC – p=0.56). For changes in lesion depth, there was no statistically significant interaction between study factors lesion protocol and treatments (p=0.23) as well as the individual factors lesion protocols (p=0.08) and treatments (p=0.82). For changes in surface zone mineral density, SDF showed significant change in mineral density compared to FV (p=0.02); however, SDF was not different from with DIW (p=0.25). For lesion mineral distribution, MeC exhibited the greater mineral loss in the lesion body and lowest mineral density at the surface zone. HEC lesions were the deepest but exhibited modest differences in mineral loss between the lesion body and the surface zone. C907 lesions were somewhat between MeC and HEC. SDF in MeC had the highest mineral gain in the surface zone, while DIW resulted in the highest mineral gain in the lesion body. SDF in HEC showed the highest mineral gain in the surface area compared to FV and DIW, with all treatments resulting in the largest mineral gain to a similar extent in the lesion body. In C907, SDF showed the most mineral gain in the lesion body compared to DIW and FV, while differences in the surface zone between treatments were less pronounced. For color changes post intervention, SDF showed more darkening in C907 and HEC lesions compared to MeC (p<0.01) and compared to FV and DIW. For post remineralization, SDF treated C907 lesions became significantly whiter (p<0.01) compared to SDF in MeC and HEC which continued to get darker. Conclusion: SDF did exhibit different remineralization abilities and behaviors and the modulation was based on lesion baseline mineral distribution. Staining resulting from SDF treatment varied significantly based on lesion mineral distribution.