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Objective: A systematic review was conducted to assess scientific knowledge concerning the effect of haematopoietic stem cell transplantation (HSCT) on the occurrence of caries, periodontal conditions and tooth loss, and to evaluate the prevalence of these diseases in adult HSCT survivors (PROSPERO 152906). Methods: PubMed and Embase were searched for papers, published from January 2000 until November 2020 without language restriction, assessing prevalence, incidence or parameters of caries, periodontal conditions and tooth loss in HSCT recipients (≥80% transplanted in adulthood). Bias risk was assessed with checklists from Joanna Briggs Institute, and data synthesis was performed by narrative summary. Results: Eighteen papers were included (1618 subjects). Half were considered at high risk of bias. Longitudinal studies did not show caries progression, decline in periodontal health or tooth loss after HSCT. The prevalence in HSCT survivors ranged from 19% to 43% for caries, 11% to 67% for periodontitis, and 2% to 5% for edentulism. Certainty in the body of evidence was very low. Conclusions: Haematopoietic stem cell transplantation, on the short term, may have little to no effect on caries, periodontal conditions and tooth loss. Caries and periodontitis may be more common in HSCT survivors compared with the general population, whereas edentulism may be comparable. However, the evidence for all conclusions is very uncertain. [ABSTRACT FROM AUTHOR]

Background: Evaluation of a new vertical dimension of occlusion (VDO) in complex restorative treatments is considered a necessary step prior to placement of restorations. Objectives: This randomised controlled trial (RCT) aimed to assess the effects of using an evaluation of a VDO increase before restorative treatment in patients with moderate‐to‐severe tooth wear, on OHRQoL, freeway space (FWS) and interventions to restorations. Methods: Forty‐two patients with tooth wear were included and randomly allocated to either a test phase with a Removable Appliance (RA) or no test phase. Restorative treatment consisted of restoration of all teeth using composite restorations in an increased VDO. OHIP‐score, freeway space (FWS) and clinical acceptability of restorations were assessed at baseline and at recall appointments (1 month and 1 year). Intervention to restoration was scored in case of material chipping or when the abutment tooth had increased sensitivity that could be linked to occlusal overloading. ANCOVA analyses, Univariate Cox regression, t‐tests and descriptive analyses were performed (p <.05). Results: Clinical follow‐up after 1 year was completed for 41 patients. No significant effect of testing the VDO with a RA could be found on the OHIP‐score (p =.14). Reduction of FWS in the RA group, compared to the control group, was significantly lower at 1 year (p =.01, 95% CI −1.09 to −0.15). No effect on early interventions to restorations was found (p =.94). Conclusion: This RCT showed that a removable appliance is not indicated to functionally test the increased VDO prior to restorative treatment in patients with tooth wear. [ABSTRACT FROM AUTHOR]

Aim: To compare manual and powered tooth brushing (MT and PT) with respect to patient compliance to brushing frequency advice, plaque removal and severity of oral mucositis (OM) in patients undergoing hematopoietic stem cell transplantation (HSCT) after high‐dose chemotherapy. Materials & methods: A randomized controlled trial was conducted. Forty‐six patients scheduled to receive myeloablative conditioning regimen before autologous HSCT were included and randomly assigned to control (MT, n = 23) or test (PT, n = 23) groups. Starting at day 1 (day of hospital admission for HSCT), brushing frequency (patient recorded diary), plaque scores (Plaque Control Index) and oral mucositis (Oral Mucositis Nursing Index) were recorded daily. Data for days 1 to 17 were analysed using regression analysis and general linear models. Results: Few patients maintained 4 times per day brushing, but most brushed at least 2 times per day throughout the study. In PT, overall plaque scores were lower by 6.98% (p =.006) as compared to MT. No differences were seen in OM scores between the groups (p =.968). A small but significant positive correlation was found between plaque scores and OM severity: R2=0.15 (p <.01). Conclusions: Powered tooth brushing resulted in lower plaque scores, but was not associated with reduced OM severity. Individual plaque scores were positively related to OM severity. [ABSTRACT FROM AUTHOR]

Aim: To investigate the prevalence of non‐carious cervical lesions (NCCLs) and their association with individual and tooth‐related factors in adults from the 1982 Pelotas Birth Cohort. Materials and methods: Participants were interviewed and clinically examined at the age of 31. NCCL was defined as loss of dental tissue without bacterial involvement in the cervical region. Independent variables were the socioeconomic, demographic, behavioural, and clinical characteristics. Associations were tested using a multilevel Poisson regression model. Results: Five‐hundred and thirty‐nine participants were clinically examined, with a 26% prevalence of NCCLs, which were more prevalent in the maxilla (56.5%) and in premolars (72.9%). In the multilevel analysis, women presented lower prevalence than men [prevalence ratio (PR) 0.59 (0.48–0.73)]; those who reported smoking at both 22 and 30 years of age had more NCCLs than those who never smoked [PR 1.65 (1.31–2.07)]; and high‐frequency brushers presented higher prevalence than low‐frequency brushers [PR 1.26 (1.03–1.55)]. Gingival recession increased 10 times the prevalence of NCCLs [PR 10.03 (8.15–12.35)], while the presence of periodontal pockets (≥4 mm) reduced the prevalence of NCCLs [PR 0.43 (0.28–0.66)]. Conclusions: NCCLs were more prevalent in males, smokers, and those with higher frequency of toothbrushing. While the presence of periodontal pockets was associated with a lower prevalence of NCCLs, gingival recession was a strong clinical indicator for the presence of NCCLs. [ABSTRACT FROM AUTHOR]

Background: The Tooth Wear Evaluation System (TWES) is a type of tooth wear index. To date, there is the lack of data comparing the reliability of the application of this index on gypsum cast records and digital greyscale intra‐oral scan records. Objectives: A comparative evaluation between the use of gypsum cast records and digital greyscale intra‐oral scan records with the reliability of tooth wear scoring using the TWES amongst a group of patients with tooth wear. Methods: Records for 10 patients with moderate to severe tooth wear (TWES ≥ 2) were randomly selected from a larger clinical trial. TWES grading of the occlusal/incisal, buccal and palatal/lingual surfaces was performed to determine the levels of intra‐ and interobserver agreement. Intra‐observer reproducibility was based on the findings of one examiner only. For the interobserver reproducibility, the findings of two examiners were considered. One set of models/ records were used per patient. Cohen's weighted kappa (κW) was used to ascertain agreement between and within the observers. Comparison of agreement was performed using t tests (P <.05). Results: For the scoring of the of the total occlusal/incisal surfaces, the overall levels of intra‐ and interobserver agreement were significantly higher using the gypsum cast records than with the digital greyscale intra‐oral scan records, (P <.001) and (P <.001), respectively. For the overall buccal surfaces, only a significant difference was found in the intra‐observer agreement using gypsum casts, (P =.013). For the palatal/lingual surfaces, a significant difference was only reported in the interobserver agreement using gypsum casts, (P =.043). At the occlusal/incisal surfaces, grading performed using gypsum casts, culminated in significantly higher TWES scores than with the use of the digital greyscale intra‐oral scans (P <.001). At the buccal and palatal/lingual surfaces, significantly higher wear scores were obtained using digital greyscale intra‐oral scan records (P <.009). Conclusions: The TWES can offer a reliable means for the scoring of wearing occlusal/incisal surfaces using gypsum casts. The reliability offered by digital greyscale intra‐oral scans for consecutive scoring was in general, inferior. [ABSTRACT FROM AUTHOR]

Background Over the last two decades, progress in prevention and treatment of caries and periodontal diseases has been translated to better oral health and improved tooth retention in the adult population. The ageing population and the increasing expectations of good oral health-related quality of life in older age pose formidable challenges to clinical care and healthcare systems. Aims The objective of this workshop was to critically review scientific evidence and develop specific recommendations to: (i) prevent tooth loss and retain oral function through prevention and treatment of caries and periodontal diseases later in life and (ii) increase awareness of the health benefits of oral health as an essential component of healthy ageing. Methods Discussions were initiated by three systematic reviews covering aspects of epidemiology of caries and periodontal diseases in elders, the impact of senescence on caries and periodontal diseases and the effectiveness of interventions. Recommendations were developed based on evidence from the systematic reviews and expert opinion. Results Key messages included: (i) the ageing population, trends in risk factors and improved tooth retention point towards an expected increase in the total burden of disease posed by caries and periodontal diseases in the older population; (ii) specific surveillance is required to monitor changes in oral health in the older population; (iii) senescence impacts oral health including periodontitis and possibly caries susceptibility; (iv) evidence indicates that caries and periodontal diseases can be prevented and treated also in older adults; (v) oral health and functional tooth retention later in life provides benefits both in terms of oral and general quality of life and in terms of preventing physical decline and dependency by fostering a healthy diet; (vi) oral healthcare professionals and individuals should not base decisions impacting tooth retention on chronological age but on level of dependency, life expectancy, frailty, comfort and quality of life; and (vii) health policy should remove barriers to oral health care for vulnerable elders. Conclusions Consensus was reached on specific actionable priorities for public health officials, oral healthcare professionals, educators and workforce planners, caregivers and relatives as well as for the public and ageing patients. Some priorities have major implications for policymakers as health systems need to adapt to the challenge by systemwide changes to enable (promote) tooth retention later in life and management of deteriorating oral health in increasingly dependent elders. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective The purpose of this study was to evaluate the 3D-stereophotogrammetry technique to detect differences in facial appearance after a simulated rehabilitation. Materials and Methods Eleven volunteers without tooth wear participated. A 3D-stereophotograph was taken in five different situations: resting position, teeth in occlusion, and teeth in occlusion with a 1 mm-, 3 mm- or 5 mm resin block between the first molars. Cephalometric measurements were performed on the 3D-stereophotographs using the software program Maxilim® (Medicim NV Mechelen, Belgium). Four anatomical parameters were analyzed: (1) Subnasale-Gnathion, (2) Subnasale-Stomion, (3) Stomion-Gnathion, and (4) Masseter right-Masseter left. A paired Student's T-test was applied to detect significant differences ( p < 0.05). Results Statistically significant changes in facial appearance of the lower facial height were detected in all measured positions, teeth in occlusion, 1 mm-, 3 mm-, and 5 mm block ( p < 0.05). For the main distance (Subnasale-Gnathion) the mean measured differences were, respectively, 3.2 mm; 5.2 mm; and 6.7 mm. Conclusions With 3D-stereophotograph imaging technology, it was possible to detect changes in facial appearance after an artificial increase of vertical dimension of occlusion. This finding implies that reconstruction of loss of tooth substance may cause a visible change in facial appearance of the patient. Clinical Significance This study reveals a new 3D imaging technique that may be used for a better and more comprehensive treatment planning in patients with severe tooth wear. (J Esthet Restor Dent 28:397-404, 2016) [ABSTRACT FROM AUTHOR]

White AJ, Yorath C, ten Hengel V, Leary SD, Huysmans M-CDNJM, Barbour ME. Human and bovine enamel erosion under 'single-drink' conditions. Eur J Oral Sci 2010; 118: 604-609. © 2010 Eur J Oral Sci Tooth-surface pH is lowered, during drinking, to a value close to the pH of the drink itself. After the drink is swallowed, the pH rises to baseline values but this process can take several minutes. Few techniques can quantify enamel erosion at timescales representative of single drinks. The objective of this study was to compare human and bovine erosion over acid-exposure times of 2 s to 1 h. Human and bovine enamel softening was compared in vitro using nanoindentation (2-60 s of exposure to acid) and tissue loss was compared using optical profilometry (1-60 min of exposure to acid). Nanoindentation revealed statistically significant softening after 2 s (human) and 5 s (bovine); there were no significant differences in hardness reduction for the two tissues at any time-point. Profilometry demonstrated statistically significant tissue loss after 20 min (human) and 10 min (bovine); bovine tissue loss progressed 30% faster than human tissue loss. These results support the use of bovine enamel as a substitute for human enamel in erosion studies, with the understanding that for moderate exposure times bovine enamel erodes 30% faster than human enamel. Nanoindentation can be used to detect enamel dissolution at timescales comparable to the oral dwell-time of a single 'mouthful' of a beverage. [ABSTRACT FROM AUTHOR]

The prevention of dental erosion with fluoride is still largely unknown territory. It was the aim of this study to determine the erosion-inhibiting effect of topical neutral 1% sodium fluoride (NaF) application and an application of a 4% titanium tetrafluoride (TiF4 ) solution compared with no treatment. Ten bovine incisors were selected and three enamel samples prepared from each tooth. One sample from each tooth was assigned to one of three experimental groups. The experimental treatments were: no fluoride application (control); 4 min application of neutral 1% NaF gel; and 4 min application of 4% TiF4 solution. All of the specimens were repeatedly exposed to 50 mm citric acid solution containing 0.4 mm CaCl2 , and 2.2 mm KH2 PO4 at pH 3.0 over four consecutive days. The acid exposure was performed in intervals and the intensity was increased over the days of the experiment. Enamel dissolution was determined by calcium content measurement of the acid solution after exposure, using atomic absorption spectroscopy. A statistically significant erosion-inhibiting effect was found for both NaF and TiF4 treatments compared with the control group from an erosion exposure time of 3 min. The reduction of calcium loss, however, was higher for the TiF4 -treated specimens than the NaF-treated. From 16 min of erosion exposure, the erosion-inhibiting effect was significantly stronger in the TiF4 than the NaF group. The relative reduction of calcium loss compared with the control group remained stable for the TiF4 group, whereas for the NaF group the relative reduction decreased with cumulative erosion time. It is concluded that topical TiF4 application provides a potential treatment option in erosion prevention. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the in vitro diagnostic performance for approximal caries and occlusal dentine caries diagnosis of the Digora® system for digital radiography in relation to the exposure time. Radiographs were made of 220 extracted human posterior teeth and cuspids at exposure time levels of 3%, 6%, 10%, 20%, and 78% of the exposure time needed for E-speed film (image sets I, II, III, IV, and V, respectively). The image sets were put in random order (III, I, IV, II, V) and assessed independently by 3 observers using a 5-point confidence scale. True caries status was determined histologically after sectioning of the teeth. Evaluated parameters were: interexaminer K, sensitivity, specificity, Dz¾ (the distance of one operating point to the diagonal in the ROC domain) and area under the ROC curve. The Spearman correlation coefficients between the parameters and both exposure time and order of viewing of the sets were calculated. For approximal surfaces, the ranges of mean parameter values were: sensitivity 26-33%, specificity 93-95%, Dz¾ 0.63-0.84, area 0.61-0.69. For occlusal surfaces, the ranges were: sensitivity 52-60%, specificity 91-95%, Dz¾ 1.03-1.34, area 0.79-0.87. Out of 24 pairwise comparisons between sets V and I, 5 were significant. Out of 24 comparisons between set V and II, only 2 were significant. It was concluded that diagnostic performance is unlikely to be impaired for an exposure time as short as 6% of E-speed film exposure. When reducing the exposure time to 3% of E-speed him exposure, caries diagnosis may be impaired. [ABSTRACT FROM AUTHOR]