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Purpose: The aim of the study was to compare the 36-month clinical performances of a micro-hybride resin based composites (RBC) and a type II resin modified glass ionomer cement (RMGIC) in the treatment of cervical caries lesions. Methods: Thirty-three patients (23 females, 10 males) with at least two cervical caries lesions participated in this study. A total of 110 restorations were randomly placed, half using RBC (Spectrum TPH3, Dentsply Sirona) with respective adhesive system (Prime & Bond NT, Dentsply Sirona) the other half using the RMGIC (Riva Light Cure, SDI, Bayswater, Victoria, Australia). Restorations were assessed at baseline, and after 6, 12, 18, 24 and 36 months using modified USPHS criteria. The data were analyzed statistically (p < 0.05). Results: Recall rate was 90.91% at 36 months. Of the RBC lesions 84.3% (n = 43) and of the RMGIC restorations 92.2% (n = 47) were fully retained at 36 months. There was no significant difference between two materials in terms of retention and marginal adaptation (p > 0.05). No relation was found between caries activity, cavity dimensions and marginal adaptation (p > 0.05) but RMGIC restorations showed significantly more discoloration than RBC restorations after 36 months (p < 0.001). Conclusions: Considering the middle-term outcomes, both materials showed clinically successful performance in the treatment of cervical caries lesions. [ABSTRACT FROM AUTHOR]

New methods are needed for the nondestructive measurement of tooth demineralization and remineralization and to monitor the progression of incipient caries lesions (tooth decay) for effective nonsurgical intervention and to evaluate the performance of anti-caries treatments such as chemical treatments or laser irradiation. Studies have shown that optical coherence tomography (OCT) has great potential to fulfill this role, since it can be used to measure the depth and severity of early lesions with an axial resolution exceeding 10-μm. It is easy to apply in vivo and it can be used to image the convoluted topography of tooth occlusal surfaces. In this paper we present early results from two clinical studies underway to measure the effect of fluoride intervention on early lesions. CP-OCT was used to monitor early lesions on enamel and root surfaces before and after intervention with fluoride varnish. The lesion depth and internal structure were resolved for all the lesions examined and some lesions had well defined surface zones of lower reflectivity that may be indicative of arrested lesions. Changes were also noted in the structure of some of the lesions after fluoride intervention.

Background: Caries in the elderly has been associated with dependence, oral-health status and -care practices. This cross-sectional study aimed to investigate the association between root/coronal caries and individual factors among institutionalised elderly people in Bogotá, Colombia, using the International Caries Detection and Assessment System severity and activity criteria (ICDAS). Methods: A total of 226 institutionalised elderly were clinically examined for root and coronal caries in 40 institutions. Caries risk was assessed with Cariogram, and demographics, oral health knowledge and practices, oral health-related quality of life and denture-use habits using a questionnaire. Results: Participants (mean age: 80.1 ± 9.3 years; 63.7% female) presented a mean number of 10.8 ± 7.3 teeth and 19.4 ± 18.8 exposed root surfaces. Prevalence of Coronal-ICDAS caries experience (C-ICDAS DF) was of 100% and of 54.4% for C-ICDAS D; mean number of C-ICDAS DFS was 16.76 ± 27.36, with 50.9% of subjects having ≥ one active C-ICDAS DS. Prevalence of Root Caries Index was of 49.1% and of R-ICDAS DF of 46%; mean number of R-ICDAS DFS was 2.03 ± 2.78, with 40.3% of subjects having ≥ one active R-ICDAS DS. Most individuals had a systemic condition (94.2%) and required oral-hygiene assistance (58%). Logistic regression analyses showed significant associations (p < 0.05): for coronal active caries when having over six teeth (OR: 2.7), and for root caries, when having coronal caries (OR: 2.41), being a man (OR: 1.95), and having over 14 teeth (OR: 0.30). Those presenting with > eight exposed root surfaces were 4.04 more likely to have root caries and 2.4 times more likely to have active root caries. Conclusion: In the institutionalised elderly population in Bogotá significant associations were found, both for the presence as for the activity status of root and coronal caries, with individual clinical factors including coronal caries, exposed root surfaces and number of teeth. [ABSTRACT FROM AUTHOR]

The role of the host immune system in caries progression is mainly speculative, and it is believed that it entails the enzymatic degradation of the dentin organic matrix. The aim of this study was to evaluate the proteolytic effect of human neutrophil enzymes on root caries progression. For this, specimens of bovine root dentin were divided into 4 groups (n = 30): caries (C), caries + neutrophils (C + N), no caries (Control), and no caries + neutrophils (Control + N). Streptococcus mutans biofilm (105 CFU/mL) was grown on the root surface to artificially induce root carious lesions (C and C + N groups). Specimens were then exposed to neutrophils (5 × 106 cells/mL) for 48 h (C + N and Control + N groups). Caries development and neutrophil exposures were repeated a 2nd and 3rd time. Caries depth (CD) and dentin demineralization (DD) were assessed by infiltration of rhodamine B using fluorescence microscopy. Collagen fibril ultrastructure was characterized under a polarized microscope with Picrosirius red staining. There were no significant differences (p > 0.05) in CD and DD between the C and C + N groups for 1, 2, and 3 caries-neutrophil exposures. Immature collagen was significantly less present in the carious groups (C, p = 0.003; C + N, p = 0.01) than in the noncarious groups in the most superficial 200 µm. We thus concluded that human neutrophil enzymes did not influence short-term root caries progression, and immature collagen fibrils were more susceptible to degradation during S. mutans-induced root caries progression. [ABSTRACT FROM AUTHOR]

• Different calcium phosphate additives in F varnishes have distinct remineralising efficacy. • Combined use of F varnishes with 5000 ppm F toothpastes improved remineralisation. • Proanthocyanidin as an adjunct to F regimens improved remineralisation in dentine subsurface. • Increased mineral density was not necessarily translated into improved hardness of dentine. To evaluate the remineralising effects of fluoride (F) varnishes containing bioavailable calcium-phosphate compound (Ca-P) based remineralisation systems and 5000 ppm F toothpaste (FTP) on root caries lesions (RCLs) and the potential effects of proanthocyanidin (PA) for the treatments of RCLs when used as an adjunct to F regimens. Demineralised root dentine and a pH-cycling model were used to mimic RCLs and the oral environment. Remineralising effects of MI VarnishTM (MIV) containing casein phosphopeptide–amorphous calcium phosphate (CPP-ACP) and Clinpro™ White Varnish (CPWV) containing tri-calcium phosphate (TCP) along with FTP and PA were evaluated regarding the birefringence, elemental composition, mechanical properties and mineral density of remineralised dentine with DuraphatTM as a comparison. MIV, CPWV and DuraphatTM promoted the incorporation of F into RCLs and increased mineral density but did not change microhardness of root dentine significantly. Surface microhardness increased significantly when MIV or CPWV was used with 5000 ppm FTP. Application of PA with F regimens significantly increased subsurface mineral density. When PA was applied with MIV or CPWV along with FTP, the highest ion uptake and relative mineral gain (%ΔZ) was achieved, and significant increase of microhardness was up to 30 μm depth. Generally, MIV was associated with a higher mineral content gain than CPWV. Treatment of carious root surfaces remains challenging due to the complex pathological processes and difficulty in restoring the highly organised structure of root dentine. Treatment strategies targeting both remineralisation and preservation of the dentinal organic matrix have the potential to improve the fluoride-mediated remineralisation approaches. [ABSTRACT FROM AUTHOR]

This study aimed to assess the survival of glass ionomer cement (GIC) restorations performed using the atraumatic restorative treatment (ART) in elderly patients. The systematic review protocol was registered in the PROSPERO database. The records were searched until August 2020 in eight electronic bibliographic databases, and included randomized and non-randomized clinical trials and observational studies, with no restrictions on the language or year of publication. Study selection and data extraction were performed independently by two reviewers. Data were extracted, summarized, collected for qualitative analysis, and evaluated for individual risk of bias using the Joanna Briggs Institute's Critical Appraisal Tool. The literature search retrieved 5,186 records; however, only seven studies fulfilled the eligibility criteria and were included. The studies were published between 2002 and 2019. A total of 1,239 restorations were investigated at intervals of 6, 12, 24, and 60 months of follow-up. Some studies had a low risk of bias, while others had moderate and high risk of bias. In general, GIC restorations placed using ART were considered satisfactory. The 6-month, 12-month, and 24-month survival rates ranged from 81.3% to 97.2%, 72.2% to 94%, and 63% to 87%, respectively; additionally, the survival rate for the longest follow-up period (60 months) was 85%. Given the best evidence-based information regarding caries removal, we highlight the need to provide a conservative and effective technique for use in elderly patients. ART is a promising and viable alternative that guarantees the survival of restorations in elderly patients. [ABSTRACT FROM AUTHOR]

Introduction: Previous studies have shown that a calcium prerinse can increase intraoral fluoride retention from a fluoride rinse. To explore the potential of this approach to control root caries, we assessed intraoral fluoride bioavailability after a calcium prerinse in older adults with normal to low salivary flow rates., Methods: In a 2-period crossover trial (NCT04239872), 20 participants (65-80 y old), with low or normal salivary flow rate, rinsed for 1 min with a 0.05% NaF mouth rinse (226 ppm F, F only) or with this rinse immediately after a 1-min rinse with 150 mM calcium lactate (Ca→F). Dental biofilm and saliva samples were collected before and up to 2 h after the rinse(s). Fluoride concentrations in saliva (whole and clarified) and dental biofilm (fluid and solid phases) were blindly determined. Data were statistically analyzed by a mixed-effects model for the effect of treatment, time, and their interaction ( α = 5%)., Results: The Ca→F group resulted in significantly higher fluoride concentrations in all variables analyzed, for almost all of the collection time points. The effect was greater in the biofilm solids and whole saliva (compatible with the formation of calcium fluoride deposits) and still significant ( P < 0.001) after 2 h in the biofilm fluid and clarified saliva, suggesting that fluoride stored in insoluble particles was released, increasing free fluoride., Conclusion: The use of a calcium prerinse before a fluoride rinse was able to prolong intraoral fluoride bioavailability in older adults., Knowledge Transfer Statement: A calcium prerinse increased intraoral fluoride bioavailability in older individuals. This approach could be used to improve root caries control without the need to increase the fluoride concentration in dental products., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Root caries is preventable and can be arrested at any stage of disease development. The aim of this study was to investigate the potential mineral exchange and fluorapatite formation within artificial root carious lesions (ARCLs) using different toothpastes containing 5,000 ppm F, 1,450 ppm F or bioactive glass (BG) with 540 ppm F., Materials and Methods: The crowns of each extracted sound tooth were removed. The remaining roots were divided into four parts (n = 12). Each sample was randomly allocated into one of four groups: Group 1 (Deionised water); Group 2 (BG with 540 ppm F); Group 3 (1,450 ppm F) and Group 4 (5,000 ppm F). ARCLs were developed using demineralisation solution (pH 4.8). The samples were then pH-cycled in 13 days using demineralisation solution (6 h) and remineralisation solution (pH 7) (16 h). Standard tooth brushing was carried out twice a day with the assigned toothpaste. X-ray Microtomography (XMT) was performed for each sample at baseline, following ARCL formation and after 13-day pH-cycling. Scanning Electron Microscope (SEM) and 19 F Magic angle spinning nuclear magnetic resonance ( 19 F-MAS-NMR) were also performed., Results: XMT results showed that the highest mineral content increase (mean ± SD) was Group 4 (0.09 ± 0.05), whilst the mineral content decreased in Group 1 (-0.08 ± 0.06) after 13-day pH-cycling, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4 (p < 0.05). SEM scans showed that mineral contents within the surface of dentine tubules were high in comparison to the subsurface in all toothpaste groups. There was evidence of dentine tubules being either partially or completely occluded in toothpaste groups. 19 F-MAS-NMR showed peaks between - 103 and - 104ppm corresponding to fluorapatite formation in Groups 3 and 4., Conclusion: Within the limitation of this laboratory-based study, all toothpastes were potentially effective to increase the mineral density of artificial root caries on the surface, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4., (© 2024. Crown.)

Abstract A few investigations of caries biofilms have identified Scardovia spp.; however, little is known about its involvement in caries pathogenesis. The purpose of this study was to assess the gene expression profile of Scardovia spp. in root caries, and compare it with other microorganisms. Clinical samples from active root caries lesions were collected. Microbial mRNA was isolated and cDNA sequenced. The function and composition of the Scardovia were investigated using two methods: a) de novo assembly of the read data and mapping to contigs, and b) reads mapping to reference genomes. Pearson correlation was performed (p < 0.05). Proportion of Scardovia inopinata and Scardovia wiggsiae sequences ranged from 0-6% in the root caries metatranscriptome. There was a positive correlation between the transcriptome of Lactobacillus spp. and Scardovia spp. (r = 0.70; p = 0.03), as well as with other Bifidobacteriaceae (r = 0.91; p = 0.0006). Genes that code for fructose 6-phosphate phosphoketolase (the key enzyme for “Bifid shunt”), as well as ABC transporters and glycosyl-hydrolases were highly expressed. In conclusion, “Bifid shunt” and starch metabolism are involved in carbohydrate metabolism of S. inopinata and S. wiggsiae in root caries. There is a positive correlation between the metabolism abundance of Lactobacillus spp., Bifidobacteriaceae members, and Scardovia in root caries.

Objective: Restoring noncarious cervical lesions are challenging to clinical practice. This study aimed to compare the clinical performance/longevity of glass ionomer cements (GIC) and composite resins (CR) used for noncarious cervical lesions (NCCL) through a systematic review and meta-analysis (MA). Data: Randomized and controlled clinical trials and nonrandomized clinical trials, which compared the clinical performance/longevity of CR and GIC (conventional and/or resin-modified) in the treatment of NCCL, were included. Source: The methodological quality and risk of bias were evaluated using the Cochrane Collaboration tool. Seven MAs were performed considering (1) the clinical performance of the parameters in common: retention, marginal discoloration, marginal adaptation, secondary caries, color, anatomic form, surface texture and (2) a follow-up time of 12, 24 and 36 months. The prevalence of successful restorations and the total number of restorations per clinical parameter/follow-up time were used to calculate the relative risk (95% CI). Study selection: After screening of the studies, 13 studies were used for quantitative synthesis. The risk difference (CI 95%, α, I2) between GIC and CR for anatomic form was 0.00 (-0.02, 0.02; p = 0.83; 0%); for color was -0.02 (-0.08, 0.04; p = 0.48; 80%); for surface texture was -0.02 (-0.06, 0.02; p = 0.31; 63%); for secondary caries was -0.00 (-0.01, 0.01; p = 0.87; 0%); for marginal discoloration was 0.01 (-0.01, 0.03; p = 0.23; 3%); for marginal adaptation was 0.01 (-0.01, 0.04; p = 0.34; 32%) and for retention was 0.07 (0.02, 0.12; p = 0.003; 76%). Conclusion: GIC showed a clinical performance significantly higher than CR in regard to retention, whereas for the other parameters, GIC was similar to CR. Clinical significance: NCCLs is increasingly prevalent among the population and this type of lesion causing defects in the tooth that affect not only aesthetics but also everyday habits, such as drinking, eating and teeth brushing, due to the sensitivity these lesions cause.

Root caries (RC) are considered a major oral health problem in the elderly, different studies showing its complexity and multifactorial nature. The aim of this study is to evaluate in a group of patients, the prevalence of RC and the correlation with etiological factors. Material and method. This study was conducted on a group of 320 patients aged between 55 and 85 years old, which came for consultation and treatment during 2015-2017. Of these, 180 patients showed a number of 280 RC. RC diagnosis was performed according to the modified Dental Decay and Assessment Code (ICDAS II). Each patient received a consultation card and in addition, each one completed a questionnaire about risk factors that may cause RC. Results. The present study analyzed the prevalence of root caries and the correlation between root caries index (RCI) and several categories of etiological factors. Of the total group of 320 patients, 180 (36%) patients had RC, 92 (51%) were males and 88 (49%) females. It was found that the number of RC at the maxillary is higher (57%) compared to the mandible (43%). Half of the RC are located on the facial aspect of the teeth, proximal areas are interested in relatively equal proportions (27% on mesial surfaces and 23% on distal surfaces). The incidence of root caries is related to risk factors like age (p=0.037) and gingival recession (p=0.013), dental hygiene (p=0.039), alcohol consumption (p = 0.034), smoking (p = 0.050) and financial situation (p = 0.021). Conclusions. Knowledge of risk factors and their correlation with the RCI may lead to the development of some preventive protocols and individual curative treatment in accordance with the risk group of each patient.

Introduction: Prevention of root caries among geriatric population is of concern for both general and oral health. It is generally accepted that appropriate prevention regimes for root caries should be based on accurate risk assessments. Aim: This study aims to assess the risk indicators for root caries in geriatric population of Lucknow. Materials and Methods: A cross-sectional study was designed to determine the risk indicators for root caries in elderly population of Lucknow. A sample of 295 subjects was taken, aged 60–74 years. Data collection was done using a pro forma and all relevant information was noted. Statistical analysis was performed using Statistical Package for the Social Sciences 17.0 (Chicago, Inc., USA). Chi-square test and multiple logistic regression analysis were applied to know the statistical significance. Results: The prevalence of root caries was 93.5%. Statistically significant differences (P < 0.05) observed across family income, education, tobacco history, oral hygiene index simplified, and community periodontal index. Conclusion: Overall, the prevalence of root caries was very high among geriatric population. Oral health policies and preventive measures are needed focusing on the special needs and socially deprived population to improve the quality of life.

Objective: To assess the prevalence and severity of periodontitis based on different diagnostic methods in a historical Austrian population from the early middle ages. Background: The description of the oral health status of archaeological material can provide interesting insights into prevalence, severity, and extent of oral diseases. Herein, the periodontal health status of the skeletal remains of medieval Avars (700‐800 AD), which were considered as one of the earliest Avarian settlements in Austria, was investigated. Methods: The skeletal remains of 128 Avars were examined; age and gender were estimated by standard forensic methods and tooth loss and root caries were recorded. Periodontitis was assessed by (a) measurement of the alveolar bone levels (ABL) and (b) evaluation of the interdental septa. Results: A mean ABL of 4.8 mm was determined, root caries tended to accumulate in teeth with a higher alveolar bone loss, and on average, 6.2 teeth were lost antemortem. Independent of the diagnostic method >90% of the subjects were judged as periodontally diseased, and age and tooth type were significant predictors. However, on the tooth level the presence of periodontitis varied considerably depending on the diagnostic method; that is, 7.6% versus 47.2% of the teeth were judged as healthy based on ABL or interdental septa, respectively. Conclusion: The periodontal status of the skeletal remains of medieval Avars revealed a considerable high prevalence of periodontitis (ie, >90% of this population displayed periodontal tissue breakdown). However, the diagnostic method, disease definition, and data presentation should be considered when comparing results of archaeological material. [ABSTRACT FROM AUTHOR]

Objectives: To assess the occurrence of coronal and root caries in adults with diabetes mellitus (DM). Materials and methods: This study was performed accordingly to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. A search strategy was adapted for six databases, as well as gray literature. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tools for observational studies. Revman 5.3 was used to conduct five meta-analyses. The quality of evidence of meta-analysis was evaluated by GRADE. Results: From 4047 titles retrieved, 29 studies were included in qualitative synthesis and 20 in quantitative synthesis. Findings showed a higher mean of DMFT in DM individuals compared with healthy controls (mean difference = 1.71; 95% CI 1.08–2.33; p < 0.01; I2 = 55%). Individuals with type 2 DM were three times more likely to have root caries in comparison with non-DM individuals (OR = 3.17; 95% CI 1.19–8.49; p = 0.02; I2 = 70%). Individuals with uncontrolled glycemic levels within the population with DM had higher prevalence of caries than individuals with controlled DM (OR = 3.82; 95% CI 1.12–13.07; p < 0.01; I2 = 89%; DMFT index mean difference = 2.61; 95% CI 1.14–4.08; p < 0.01; I2 = 75%). Conclusions: Diabetes mellitus may increase the occurrence of coronal and root caries in adults. Poor glycemic control turned diabetic individuals more likely to have caries. Clinical relevance: Dental caries can be an oral sign to indicate poor glycemic control in individuals with DM. Strategies to prevent root caries should be adopted in individuals with type 2 DM. Besides, dental and medical treatments should synergistically explore whether dietary habits are healthy for controlling both, DM and caries. [ABSTRACT FROM AUTHOR]

This study was aimed to evaluate the effect of a novel surface pre-reacted glass-ionomer (S-PRG) filler-containing cement for root caries. We prepared the cements using five different S-PRG filler amounts (0, 10, 20, 30, and 40 wt%). Compressive strength, ion release, acid buffering capacity, and microstructure of the as-prepared cements were evaluated. The compressive strength was statistically significant; it was highest for 0 wt% S-PRG cement. Ion release in 0 wt% S-PRG was highest for F- and Al, whereas in 40 wt% S-PRG it was highest for B. For 20, 30, and 40 wt% S-PRG cements, Na and Sr release was higher compared to the other ions. The acid buffering capacity was significantly higher in the 40 wt% S-PRG cement than in the others. In the microstructural analysis, no difference of surface structure was observed among each of the S-PRG filler contents (0-40 wt% S-PRG). [ABSTRACT FROM AUTHOR]

Aim: There are no nationally representative epidemiological studies available reporting on the different recession types according to the 2018 classification system or focusing on the aesthetic zone. The aims of this cross‐sectional study were (a) to provide estimates on the prevalence, severity and extent of mid‐buccal GRs according to the 2018 classification and (b) to identify their risk indicators in the adult U.S. population from the NHANES database. Materials and Methods: Data from 10,676 subjects, representative of 143.8 millions of adults, were retrieved from the NHANES 2009–2014 database. GR prevalence was defined as the presence of at least one mid‐buccal GR ≥1 mm. GRs were categorized following the 2018 World Workshop classification system (RT1, RT2, RT3) and according to different severity cut‐offs. An analysis for GR risk indicators was also performed, selecting subjects without periodontitis. Results: The patient‐level prevalence of mid‐buccal GRs (all types) was 91.6%, while it decreased to 70.7% when considering only the aesthetic zone. When focusing on RT1 GRs, the patient‐level prevalence (whole mouth) was 12.4%, while it was 5.8% considering only the aesthetic zone. The majority of RT1 GRs were considered as mild (1–2 mm). The whole‐mouth patient‐level prevalence of RT2 and RT3 GRs was 88.8% and 55.0%, respectively. Age (35–49 years), gender (female), ethnicity (non–Hispanic Whites), last dental visit (>6 months before), tooth type (incisors) and the arch (mandible) resulted as risk indicators associated with the presence of RT1 GR. Conclusions: Mid‐buccal GRs affect almost the entire US population. Age, gender, ethnicity, dental care exposure, tooth type and arch were identified as risk indicators for RT1 GRs. [ABSTRACT FROM AUTHOR]

Tooth extraction is one of the dental treatments which should be considered the last option. A decrease in the number of teeth may result in poor dietary habits and deterioration of quality of life. The number of extracted teeth can serve as an indicator of socio-economic and oral hygiene level. Extraction of permanent teeth is performed for several reasons including dental caries, periodontal disease, orthodontic reasons, impacted teeth and root stumps. To assess the prevalence of root stumps in middle aged in Chennai A retrospective cross-sectional study was conducted using the patient records from the Department of Oral maxillofacial surgery, Saveetha Dental College, Chennai from February 2019 to February 2020, and patients who had root stumps were selected by nonprobability sampling. Data was collected and then subjected to statistical analysis. Microsoft Excel/2016 data spreadsheet was used and later exported to the Statistical Package for Social Science for Windows (version 20.0, SPSS Inc., Chicago Ill., USA). The prevalence of root stumps was more in males and age groups of 50-55 years showed maximum root stumps. There is no significant difference between gender and the number of root stumps in each patient P=0.562 The study concluded that the prevalence of root stumps in the middle age group seems to be high when compared to other literature. Considering the limitations of this study extensive research needs to be done to find the prevalence of root stumps in other populations and to spread awareness among the public about root stumps which are in situ. [ABSTRACT FROM AUTHOR]

Aim: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. Methods: 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. Results: 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 individual 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 individual. [ABSTRACT FROM AUTHOR]

The prevalence of caries is set to increase in the coming years as a result of a growing ageing population and a concomitant reduction in levels of edentulousness. Evidence for management of caries in older adults is scarce compared to that for the child population, however, similar principles of risk assessment, prevention and minimal intervention should be applied by dental health professionals. Early identification of high-risk older adults facilitates the implementation of risk reduction strategies, such as topical fluoride regimes. When operative intervention cannot be avoided, Atraumatic Restorative Technique (ART) may allow for conservative cavity preparation and has the advantage of being suitable for the domiciliary setting. [ABSTRACT FROM AUTHOR]

Geriatric dentistry is the delivery of dental care to older adults involving diagnosis, prevention, management and treatment of problems associated with age related diseases. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. There is evidence that oral diseases impact cardiovascular, endocrine and pulmonary health particularly in the elderly, which will certainly provide additional stimuli for the elderly to seek dental care. Improving the quality of life at old age will demand tooth retention and consequently the need for restorative care. Retaining teeth disease free and maintaining them amidst multitude of risk factors associated with old age, is a multifaceted challenge. . The future implications of Geriatric dental care are of considerable importance. Commitment by dentists to meet the oral health needs of this geriatric population is key to the improvement and change in the current status of this population. This review article discusses various dental diseases seen in geriatric patients and their management. [ABSTRACT FROM AUTHOR]

Background: There is an increase in longevity of teeth retained in elderly population, leading to increased risk of root caries. Therefore, new and affordable preventive strategies are in need to reduce this problem. Hence, the aim and objective of the study was to assess and compare the root caries remineralization effect of plain milk, 5ppm of fluoridated milk, and 5ppm of NaF in deionized water. Materials and Methods: The study was an in vitro experimental design. Sixty root samples were divided into five groups (sound root, demineralized root treated in deionized water, plain milk, 5-ppm fluoridated milk, and 5-ppm fluoridated deionized water) of 12 samples each after baseline surface microhardness analysis and standardization was carried out in the study. All groups except the sound root were subjected to demineralization procedure for 4 days at 37°C. The demineralized four groups were treated to test solutions and subjected to pH cycling for 14 days. This was followed with assessment of postintervention surface microhardness. Student's paired t test was used for comparing surface within groups. One-way analysis of variance test and post hoc Tukey's test were conducted for between groups' comparison. Results: There was a significant difference between groups (P < 0.05). The results of post hoc showed that significant difference was found between the group sound root and demineralized treated with 5-ppm fluoridated milk and 5-ppm fluoridated deionized water with an effect size of 2.15 and 2.87, with CI (–26.8 to –8.1) and (–36 to –17.3), respectively. There was a significant difference in all the groups when compared within the group (P < 0.05). Conclusion: Plain milk, 5-ppm fluoridated milk, and 5-ppm fluoridated deionized water showed remineralizing potential against demineralized in vitro root caries samples. 5-ppm fluoridated deionized water and 5-ppm fluoridated milk have a better effect compared to plain milk. [ABSTRACT FROM AUTHOR]

Background: The prevalence of root caries in Australia is expected to increase due to an ageing population and increase in tooth retention. This report presents findings from the Australian National Study of Adult Oral Health 2017-18.Methods: A stratified random sample of 15 731 Australians aged ≥15 years participated in a telephone or online survey. Of those, 5022 dentate people underwent an oral assessment. Carious root surfaces were defined as ≥1 mm of affected dentine/cementum. Prevalence was defined as the percentage with ≥one natural tooth with untreated caries on root surfaces. Severity was measured as the mean number of root surfaces with caries.Results: Prevalence of untreated root caries in the Australian adult dentate population was 8.2% and increased with increasing age (range 2%-17.8%). Men (9.3%) compared to women (7.2%), people living in remote (18.0%) versus regional (9.3%) and major cities (7.6%), and those with the lowest household income (15.4%) compared to middle (7.6%) and highest tertile (3.2%) had untreated root caries. The average number of decayed or filled root surfaces in the Australian adult population was 1.1 (95% CI 0.9, 1.2).Conclusions: Root caries was associated with older age, living outside a major city and lower income. [ABSTRACT FROM AUTHOR]

Introduction: Increasing age, long-term deleterious habits, and increased bone resorption leading to the gingival recession have become a significant reason for poor geriatric oral health among which root caries are the most prevalent ones among the Indian population. Methodology: A cross-sectional study was conducted among the geriatric population above 60 years of age and those who gave voluntary consent for participating in the study were included in the study and were briefed about the questionnaire. The self-administered questionnaire was given and complete oral examination was done. Results were analyzed using the SPSS 22 version using descriptive analysis and Chi-square test. Result: Percentage of deleterious habits amongst males was higher than that of females i.e. 56%. Thus, males were reported with root caries more than females. The percentage of married people suffering from root caries was 85%. The most prevalent occupation among the geriatric population was found to be the farmers with 37%. Religion with maximum percentage and frequency was found to be Hinduism with 84%. Educational statuses with 6th to 12th standards were reported with maximum root caries, i.e. 55%. Conclusion: The study showed that criteria including income, gender, marital status, occupation, religion, and educational status were significant in assessing the prevalence of root caries. Whereas the risk factors such as habits, methods of cleaning, and brushing techniques influenced the root caries among the geriatric population. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical performance of cavities with no lining and lining with resin-modified glass ionomer (RMGIC) for the treatment of root surface carious lesions. Materials and methods: The study included 39 patients (mean age, 39.6 years) who visited the university hospital for the treatment of at least 2 root surface carious lesions. After caries removal, the depth, length, and height of the cavities were measured. Using a paired-tooth design and simple randomization technique, the cavities were assigned to one of two groups that were either unlined or lined with RMGIC (Glass Liner II). All cavities were restored with a nanohybrid resin-based composite (Clearfil Majesty Esthetic). One hundred restorations (50 lined, 50 unlined) were placed. Two examiners other than the operator blindly evaluated the restorations at the follow-ups according to the modified Havemann criteria for marginal adaptation, anatomic form, marginal staining, caries in the adjacent tooth structure, caries at the cavosurface margin, and tooth sensitivity. Chi-square, Fisher's exact, Mann-Whitney U, and Cochran Q tests were used for the analysis (p < 0.05). Results: At the 5-year follow-up, 12 restorations were failed. However, there was no significant difference between the marginal adaptation and marginal staining of the materials (p = 0.526 and p = 0.893, respectively). Four caries lesions were detected in the adjacent tooth structure and at the cavosurface margin at the 5-year assessment. Conclusion: There was no significant difference in the clinical performance of the lined and unlined restorations. Clinical relevance: The clinical performance of both unlined and RMGIC-lined cavities at the 5-year post-restoration assessment was acceptable. Trial registration: NCT03802539 [ABSTRACT FROM AUTHOR]

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Objectives: To examine whether there is an association between periodontal disease and each of root caries and coronal caries among adults (aged 35 and over), using a nationally representative sample of adults in England, Northern Ireland and Wales. Material and Methods: In this cross‐sectional study, data from the Adult Dental Health Survey 2009 were used. Adults aged 35 years or older who had periodontal and caries assessment were included. Two sets of negative binomial regression were conducted for each of coronal caries and root caries adjusting for periodontal diseases, dental visits, country, sex, age, education, job classification, oral hygiene and smoking. Results: Overall, 4738 were included in the analysis. Periodontal disease was significantly associated with each of coronal and root caries. In the fully adjusted model, those with PD/ LoA ≥ 4 mm had 1.03 rate ratio (RR) for coronal caries (95% CI: 1.01‐1.05). In the model pertaining to root caries, the RR for those with periodontitis was 1.23 (95% CI: 1.16‐1.30). Smoking, sex, age and oral hygiene were the variables that showed a consistent and significant association with coronal and root caries. Conclusion: Individuals with periodontal diseases appeared to be at higher risk of coronal and root caries. While root exposure could be a plausible explanation for the relationship between periodontitis and root caries, the association with coronal caries could be attributed to the irritation of carious cavities, or common risk factors such as poor oral hygiene, or co‐occurrence of different health risk behaviours related to both caries and periodontitis and socioeconomic conditions. [ABSTRACT FROM AUTHOR]

Aim: To describe the distribution of enamel-, dentin-, root- and secondary caries within an elderly population in Northern-Norway.Material and methods: A study population (n = 1 173) was divided into age groups: 65-69 (seniors), 70-74 (young elderly), 75-79 (elderly) and 80-94 (old elderly). Seven examiners registered presence, location and severity of caries lesions on x-rays and intra-oral photos. Severity of approximal, occlusal, secondary and root caries was graded (D1-2: into enamel; D3-5: into dentin, root caries), and decayed missing filled surfaces/teeth (DMFS/DMFT) were calculated. T-test, ANOVA and a Bonferroni correction were used.Results: The seniors had more primary caries (DS1-5) compared to the oldest age groups, while the old elderly had significantly more secondary caries than the other groups (p < .05). Of those ≥65 years 13.8% were affected with root caries, 21% among the oldest. About 48% of the old elderly had one or more surfaces with untreated caries lesions into dentin, while for the other groups the number was 35% (p < 0.05).Conclusion: Individuals seem to maintain good oral health up to at least 80 years of age. Those older than 80 years have more root caries needing more intensified caries-controlling measures and a higher prevalence of untreated dentin lesions often in need of operative treatment. [ABSTRACT FROM AUTHOR]

Dental caries is the most common type of oral health problem globally. Despite credible scientific advances and the fact that caries is preventable, the disease continues to be a major public health problem. In developing countries, changing lifestyles and dietary patterns are markedly increasing the incidence of caries. The prevalence of dental caries was associated with oral hygiene practice, sugar consumption and implementation of the preventive oral health program. The aim of the study is to assess the prevalence of dental caries in school going children in the age group of 5 - 14 years using the International Caries Detection and Assessment System (ICDAS II). The retrospective study was conducted in a university hospital setting, among 100 school children of Chennai in the Department of Pedodontics and Preventive Dentistry in December 2019. The study was conducted between the age group of 5 - 14 years. Each student was examined intraorally by using the ICDAS system. This data was entered in the Excel sheet for tabulation and SPSS importing was done, Chi - Square association test was performed. 25.25% of females were highly prevalent in code 2. The highest coding percentage was seen in code 2 and females were highly prevalent which showed p value = 0.354 (p>0.05) (not significant). Age group of 5-8 years had the highest prevalence of dental caries (23%) which showed p value = 0.354 (p>0.05) (not significant). Within the limitations of the study age group of 5-8 years were highly prevalent to dental caries. The surfaces with early caries lesion (ICDAS code 2) are more common in the surveyed population. [ABSTRACT FROM AUTHOR]

A few investigations of caries biofilms have identified Scardovia spp.; however, little is known about its involvement in caries pathogenesis. The purpose of this study was to assess the gene expression profile of Scardovia spp. in root caries, and compare it with other microorganisms. Clinical samples from active root caries lesions were collected. Microbial mRNA was isolated and cDNA sequenced. The function and composition of the Scardovia were investigated using two methods: a) de novo assembly of the read data and mapping to contigs, and b) reads mapping to reference genomes. Pearson correlation was performed (p < 0.05). Proportion of Scardovia inopinata and Scardovia wiggsiae sequences ranged from 0-6% in the root caries metatranscriptome. There was a positive correlation between the transcriptome of Lactobacillus spp. and Scardovia spp. (r = 0.70; p = 0.03), as well as with other Bifidobacteriaceae (r = 0.91; p = 0.0006). Genes that code for fructose 6-phosphate phosphoketolase (the key enzyme for "Bifid shunt"), as well as ABC transporters and glycosyl-hydrolases were highly expressed. In conclusion, "Bifid shunt" and starch metabolism are involved in carbohydrate metabolism of S. inopinata and S. wiggsiae in root caries. There is a positive correlation between the metabolism abundance of Lactobacillus spp., Bifidobacteriaceae members, and Scardovia in root caries. [ABSTRACT FROM AUTHOR]

Root caries is one of the most significant dental problems among older adults. In order to prevent tooth loss due to root caries, the risk factors must be identified. The objectives of the study were to evaluate the prevalence of root caries and the associated risk factors among patients attending Ras Al-Khaimah College of Dental Sciences (RAKCODS) hospital. Cross-sectional descriptive study was done in RAKCODS based on random sampling using 212 participants, both genders with age 35 and above, during 6 months period, the risk factor associated with root caries were analyzed by multiple regression assay. The prevalence of root caries was 39.6% among the tested patient. Among the independent factors age, educational qualification, fluoride-containing toothpaste, smoking habit, dry mouth syndrome, plaque index and number of missing teeth showed a statistically significant influence on root caries Prevalence. According to the result of our study root caries is one of the significant oral health problems among patients attending RAKCODS hospital and the above mentioned factors play an important role in root caries prevalence. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the efficacy of three topical fluoride treatments to arrest initial root carious lesions. Materials and Methods: Forty patients participated in a randomised study. Of the 60 root carious lesions that were included, 20 were randomised for treatment with the Carisolv® chemo-mechanical technique and the Duraphat (2.23% F) fluoride varnish, 20 with Duraphat alone and 20 with stannous fluoride solution (8%). The lesions were treated at baseline and after three and six months; a clinical evaluation was carried out on these occasions and after 1 year. Results: All but four lesions were categorised as arrested caries during the 1-year follow-up period: 18 in the Carisolv/Duraphat group and 19 each in the Duraphat and the stannous fluoride groups, respectively. There was a minor reduction in the mean size of the lesions of around 0.1 to 0.2 mm height and width and a moderate change in colour from a lighter to a darker appearance. No obvious differences were found between the groups. The mean percentage of mutans streptococci in plaque from all lesions was 3.5% at baseline, and it decreased to 1.8% during the year. The decrease was, however, not statistically significant, and no significant differences were found between the groups. Conclusions: It can be concluded that the frequent topical application of fluoride could be a successful treatment for incipient root carious lesions, irrespective of the type of fluoride treatment used. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the capability of different adhesive systems to inhibit in vitro caries formation. Method and Materials: Four materials were tested: Gluma Comfort Bond (GL; Heraeus Kulzer), Gluma Comfort Bond + Desensitizer (GL+; Heraeus Kulzer), iBond (iB; Heraeus Kulzer), and One-up Bond F (OUB; Tokuyama). Bovine roots were ground to obtain flat mesial and distal dentin surfaces. Nail varnish was applied to the entire root surface except for two 10 mm X 2 mm windows on the flattened surfaces. The adhesives were applied to the exposed areas according to the manufacturers' instructions. The roots were incubated at 37°C for 1 week in a suspension of Streptococcus mutans and Lactobacillus acidophilus. Control groups either received no root surface treatment or were etched with 37% phosphoric acid (without immersion in the bacterial suspension). Specimens were sectioned perpendicular to the long axis of the roots, stained for 24 hours with Rhodamine B, and analyzed with confocal laser microscopy. The data were analyzed by 1-way ANOVA and Fisher's PLSD test at 95% confidence level. Results: Lesions in the OUB, iB, and GL+ groups were significantly shallower than those in the notreatment group. Acid etching did not produce any measurable lesions. Mean lesion depth in the GL group was similar to that in the no-treatment group. There was no significant difference between mean lesion depths in the GL+, GL, and iB groups. Conclusion: Fluoride- and glutaraldehyde-containing adhesive systems might be an aid in root caries prevention. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to determine the caries-protective effect of 3 different desensitizing agents (Seal & Protect 2.0, D/Sense 2, and Gluma Desensitizer) on root dentin in vitro. Method and materials: The root surfaces of 60 freshly extracted, cariesfree human molars were used. After removing the cementum, the teeth were coated with an acid-resistant nail varnish, exposing 2 rectangular windows of 2 X 3 mm each on the root surface. One window served as an untreated control, and the other window was treated with 1 of the desensitizing agents. The specimens were randomly distributed among the following experimental groups: group A, D/Sense 2; group B, Seal & Protect 2.0; and group C, Gluma Desensitizer. Subsequently, all specimens were demineralized for 14 days with acidified gel (HEC, pH 4.8, 37°C). Two dentinal slabs were cut from each window. The slabs were ground to a thickness of 80 μm and immersed in water. The demineralization depth was determined using a polarized light microscope. Results: The nontreated control specimens showed lesions with a mean depth of 84.9 μm (± 6.0). In the specimens treated with the desensitizing agents, lesion depth was generally significantly reduced. Statistical analysis revealed significantly lower values for the specimens in group B in comparison with the others. Conclusion: Within the limitations of an in vitro investigation, it can be concluded that the demineralization of the root surface can be hampered by applying the desensitizing agents tested. [ABSTRACT FROM AUTHOR]

Purpose: The use of transverse microradiography (TMR) to quantify the amount of mineral lost during demineralization of tooth tissue has long been established. In the present study, the use of an en-face Optical Coherence Tomography (OCT) technology to detect and quantitatively monitor the mineral changes in root caries was investigated and correlated with TMR.Materials and Methods: We used an OCT system, developed initially for retina imaging, and which can collect A-scans, B-scans (longitudinal images) and C-scans (en-face images) to quantitatively assess the development of root caries. The power to the sample was 250 microW, wavelength lambda = 850 nm and the optical source linewidth was 16 microm.Results: Both the transversal and longitudinal images showed the caries lesion as volumes of reduced reflectivity. Quantitative analysis using the A-scan (reflectivity versus depth curve) showed that the tissue reflectivity decreased with increasing demineralization time. A linear correlation (r = 0.957) was observed between the mineral loss measured by TMR and the percentage reflectivity loss in demineralized tissue measured by OCT.Conclusion: We concluded that OCT could be used to detect incipient root caries, and that the reflectivity loss in root tissue during demineralization, measured by OCT, could be related to the amount of mineral lost during the demineralization. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study aimed to evaluate the different surface characteristics of dentin cavity walls created after preparation with five different caries removal techniques: hand excavation, slow-speed bur excavation, air abrasion, Carisolv gel, and Er:YAG laser ablation. Materials and Methods: Fifty extracted human teeth (premolars and molars) with root caries were used. Ten cavities were prepared using each excavation method. SEM observations were made of each treatment type. Results: Each excavation technique produced a different and characteristic dentin surface. The hand-excavated, bur-excavated and air-abraded dentin surfaces remained covered with a residual, rather unevenly distributed and packed smear layer, with the characteristic tracks resulting from scraping, bur movement, or the stream of pressurized air bearing abrasive particles. The use of Carisolv gel resulted in the creation of a flaky surface (packed smear layer and remnants of debris) with the presence of partly occluded dentinal tubules. The use of Er:YAG laser resulted in an irregular, crater-like but clean surface with very little smear layer. Vaporization of intertubular dentin was greater than of peritubular dentin. A limited dentin melting effect was observed in three of the ten samples. Conclusion: Distinct differences in appearance were found among the samples treated with the different caries excavation methods. [ABSTRACT FROM AUTHOR]

We performed a comprehensive microbiome analysis of root caries lesions using 22 teeth extracted from patients with severe periodontitis. The carious lesions were mechanically collected and cryo-pulverized following tooth extraction. Differences in the microbiome were compared between independent lesions at the supragingival site (SG) and lesions extending beyond the gingival margin (GCB). DNA was extracted and the microbiome was characterized on the basis of the V3-V4 hypervariable region of the 16S rRNA gene using paired-end sequencing on an Illumina MiSeq device. The microbiota in root caries lesions showed compositionally distinct microbiota depending on the location. The most abundant OTUs in the SG group were Streptococcus (26.0%), Actinomyces (10.6%), and Prevotella (7.6%). GCB presented Prevotella (11.1%) as the most abundant genus, followed by Fusobacterium (9.6%) and Actinomyces (8.7%). The SG group showed a lack of uniformity in microbiota compared with the GCB group. The bacterial profiles of GCB varied considerably among patients, including periodontal pathogens such as Porphyromonas, Selenomonas, Filifactor, Peptococcus, and Tannerella. Periodontal pathogens inhabit root caries lesions that extend beyond the gingival margin. This study provides a new perspective for elucidating the microbial etiology of root caries.

Background: Root caries affect the oral health and quality of life of older adults. This study examines the breadth of global research on this topic, aiming to clarify its expansive scope and to shed light on pertinent trends for new researchers in the field., Objective: To identify key advances in root caries research as highlighted in high-quality articles from the Social Science Citation Index (SSCI) as well as to explore emerging trends and perspectives., Materials and Methods: Using the Web of Science (WoS) database, we conducted a comprehensive review of articles related to root caries in older adults. Our focus was on finding high-quality SSCI articles, identifying major contributors, journals and research trends and exploring areas such as dentistry, oral surgery and medicine for potential future research., Results: Our analysis included 192 articles, each of which was subjected to bibliometric and VOS viewer evaluations. The results revealed a concentration of studies in dentistry, oral surgery and medicine, with gaps identified in areas like anthropology, biochemistry, molecular biology and chemistry. A notable deficiency was found in root caries management., Conclusion: We discuss research gaps and propose future directions based on our findings, emphasising interdisciplinary research approaches., (© 2024 Gerodontology Association and John Wiley & Sons Ltd.)

Objectives: Despite the increase in the root caries prevalence, little is still known about how dentists manage this condition. The present study aimed to evaluate the knowledge of dentists on diagnosing and recording root caries lesions (RCL)., Methods: The survey consisted of three domains: (1) dentists' knowledge on diagnosing, recording and managing RCL; (2) information about their current general clinical routines; and (3) their demographics. The four Swiss Universities distributed the survey via e-mail lists for alumni or professionals participating in continuing education. The data was quality checked. Construct validity, internal reliability and intraclass correlation (ICC) were assessed., Results: The survey was answered by 383 dentists from 25(out of 26) cantons [mean(SD) working experience: 22.5(12) years]. The majority replied that they see less than 5 patients with RCL per week, whereas 41 have at least 5 per week, and 40 % (157 dentists) do not distinguish RCL from coronal caries in their patients' medical records. When diagnosing active RCL, tactile sensation was the most predominant criterion (n = 380), whereas color (n = 224) and visual appearance (n = 129) of the lesion were less often selected. The most often chosen risk factors for RCL were poor oral hygiene and presence of biofilm.The responses were significantly influenced by the participants' place of education, their age and working area., Conclusion: The present survey highlights the huge diversity in diagnosing, recording and assessing risk factors of RCL. The benefits of an appropriate diagnosis, recording and management of risk factors of RCL should be highlighted in under- and postgraduate dental education., Clinical Significance: A great diversity in diagnosing, recording and assessing risk factors of RCL was observed, which migh strongly impact how dentists manage RCL. The study emphasizes the necessity for intensive efforts to bridge the gap between guideline recommendations and their implementation in private dental practices., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aims: The aim of this study was to examine the effectiveness of topical fluorides in prevention of root caries-related treatment in high caries risk Veterans., Methods: This retrospective analysis of longitudinal data examined the effectiveness of professionally applied or prescription (Rx) fluoride treatment, in VHA clinics from FY 2009-2018. Professional fluoride treatments included 5% Sodium Fluoride (NaF) varnish (22 600 ppm fluoride), 2% NaF gel/rinse (9050 ppm fluoride), and 1.23% APF gel (12 300 ppm fluoride). The Rx for daily home use was 1.1% NaF paste/gel (5000 ppm fluoride). Outcomes studied were new root caries restorations or extractions and percent of patients with treatment over 1 year. Logistic regressions were adjusted for age, gender, race, ethnicity, chronic medical or psychiatric conditions, number of medication classes, anticholinergic drugs, smoking, baseline root caries treatment, preventive care, and time between first-last restoration in the index year., Results: Root caries at baseline was associated with a high risk for new root caries. Veterans without root caries during the index year who received a fluoride gel/rinse intervention were 32-40% less likely to receive caries-related treatment for root caries during the follow-up period. Once Veterans had root caries, fluorides did not exhibit a positive effect., Conclusion: In older adults with high caries risk, early fluoride prevention is key, before root caries requires treatment., (© 2023 Special Care Dentistry Association and Wiley Periodicals LLC.)

Significance: Managing caries is imperative in a rapidly aging society. Current diagnoses use qualitative indices. However, a quantitative evaluation of hardness in a clinical setting may lead to more accurate diagnoses. Previously, hardness meter using indenter with light for tooth monitoring (HAMILTOM) was developed to quantitatively measure tooth hardness. Herein, the physical interpretation of dentin hardness measured using HAMILTOM and the dentin hardness measurement mechanism are discussed., Aim: This study evaluates the mechanism of dentin hardness measurements using HAMILTOM physically and compare the invasiveness to dentin by HAMILTOM with those using a dental probe for palpation., Approach: Eleven bovine dentin samples were used to create caries models. HAMILTOM measured the dark areas, and its indentations were observed using scanning electron microscopy. Also, its invasiveness was evaluated by comparing the results with those from dental probe palpation., Results: The indentation areas were smaller than the dark areas in HAMILTOM, which may be due to exuded water from the dentin sample and the elastic recovery of dentin sample. Additionally, the dental probe indentation was deeper than the HAMILTOM indentations., Conclusions: The results demonstrate that the indentation areas were smaller than the dark areas measured by HAMILTOM, which might contain the influence of exuded water and the deformation of dentin sample. Also, HAMILTOM is less invasive than dental probe palpation. In the future, HAMILTOM may become a standard hardness measuring method to diagnose root caries., (© 2024 The Authors.)

Aim: The epidemiological relationship between periodontitis and caries remains controversial, and evidence synthesis is currently lacking. Therefore, this systematic review was designed to answer the following PECO question: 'In human adults (P), do subjects suffering from periodontitis (E) have higher presence/number of untreated carious lesions and caries experience (O) than subjects not suffering from periodontitis (C)?'., Materials and Methods: Observational studies that met specific inclusion criteria established to answer to the PECO question were included. Two review authors independently searched for eligible studies, screened the titles and abstracts, carried out the full text analysis, extracted the data and performed the risk of bias assessment. In case of disagreement, a third review author took the final decision during ad hoc consensus meetings. Data synthesis was carried out through random-effects meta-analyses., Results: A total of 18 studies on 21 cohorts, involving 135,018 participants, were included. Meta-analyses showed a significant association between periodontitis and the presence of at least one tooth with either untreated carious lesions (odds ratio [OR] = 1.63; 95% confidence interval [CI]: 1.32-2.01; p <.00; I 2  = 83.0%) or caries experience (decayed and filled teeth ≥ 1) (OR = 1.27; 95% CI: 1.01-1.59; p = .038; I 2  = 90.0%). Moreover, subjects with periodontitis exhibited a higher number of surfaces (difference in means [MD] = 0.86; 95% CI: 0.46-1.27; p <.001; I 2  = 0.0%) and teeth (MD = 0.35; 95% CI: 0.28-0.42; p <.001; I 2  = 69.6%) with untreated carious lesions, as well as a higher number of teeth with caries experience (standardized difference in means  [SMD] = 1.46; 95% CI: 0.15-2.78; p = .029; I 2  = 98.9%) compared with those without periodontitis. Sensitivity analyses focusing on severe periodontitis as exposure mostly showed consistent results. Estimates for caries experience were only slightly attenuated in adjusted models compared with crude models. Subgroup analyses by caries location also indicated that periodontitis was associated only with root caries, while it was not with caries affecting the anatomical crown., Conclusions: Periodontitis was found to be associated with the presence and number of treated/untreated root carious lesions. Therefore, caries-specific preventive measures (e.g., fluorides) should be considered for individuals with periodontitis., (© 2023 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.)

Background and Objectives : Caredyne ZIF-C is a novel, capsule-mixed zinc-containing prototype glass ionomer cement (GIC). Zinc ions are reported to inhibit root dentin demineralization, dentin collagen degradation, bacterial growth, acid production, and in vitro bacterial biofilm formation. However, the effectiveness of GICs against initial root caries lesions is unclear. Therefore, this study aimed to evaluate the efficacy of GICs, especially the new zinc-containing Caredyne ZIF-C GIC, as tooth-coating materials in patients with initial active root caries. Materials and Methods : A total of 58 lesions in 47 older adults (age > 65 years) were randomly allocated to one of the following three groups: Caredyne ZIF-C, Fuji VII (a conventional GIC), and sodium fluoride (NaF). All the lesions were treated with the assigned materials without removing the infected dentin, and the rates of dental plaque attachment and coating material fall-out were evaluated after 3, 6, and 12 months. The failure rate was defined as the number of teeth that needed restoration due to caries progression. Results : The plaque attachment rates tended to be lower in the material-coated root surfaces than in the healthy exposed root surfaces after 3, 6, and 12 months, although the differences among the three groups were not significant. Moreover, the coating material fall-out rate tended to be lower in the Caredyne ZIF-C group than in the Fuji VII group. There was no significant difference in the failure rate among the three groups at the 12 months mark. Conclusions : Though this pilot study offers a new direction for suppressing the progression of initial active root caries by controlling plaque attachment using GICs including Caredyne ZIF-C, clinical studies with a larger sample size are needed.

Introduction: This in vitro study aimed to evaluate the effect of three different chemical agents on stain removal and mineral uptake of artificial dentin caries (ADC) lesions treated with silver diamine fluoride (SDF)., Methods: Baseline L*a*b* values were determined in polished human permanent dentin blocks, and ADC lesions were induced with an acid gel for 1 week. Samples were assigned to four groups; in three groups, half of each sample received SDF (30% SDF for 3 min), while the other half received SDF followed by a bleaching treatment protocol (garlic extract, bentonite, or 35% hydrogen peroxide). The fourth group had one SDF-treated half and one half without SDF. Color changes (ΔE) were measured by spectrometry, and transversal microradiography was used to quantify integrated mineral loss (ΔZ) 24 h after treatment (SDF or SDF + bleaching). A two-way mixed ANOVA was applied to thirty percent., Results: SDF application increased mineral uptake by ADC (p = 0.001). The type of chemical agent evaluated (p &lt; 0.0001), time (p = 0.01), and their interaction (p &lt; 0.0001) bleached the ADC treated with SDF. However, 35% hydrogen peroxide was the only compound with a bleaching effect (p &lt; 0.001), without returning to baseline color. None of the compounds altered the mineral uptake effect of SDF (p = 0.30)., Conclusion: This in vitro study showed mineral uptake effect in ACD within 24 h after SDF application and the ability of hydrogen peroxide to partially remove (reduction of 24%) the staining caused by SDF without affecting its mineral uptake effect., (© 2023 S. Karger AG, Basel.)

Introduction: This research aimed to assess the association of root biofilm bacteriome with root caries lesion severity and activity in institutionalised Colombian elderlies and was conducted to gather data on the root caries bacteriome in this population., Methods: A bacteriome evaluation of biofilm samples from sound and carious root surfaces was performed. Root caries was categorised (ICDAS Root criteria) based on severity (sound surfaces, initial: non-cavitated, moderate/extensive combined: cavitated) and activity status (active and inactive). DNA was extracted and the V4 region of the 16S rRNA gene was sequenced; afterwards the classification of features was conducted employing amplicon sequence variants and taxonomic assignment via the Human Oral Microbiome Database (HOMD). Bacterial richness, diversity (Simpson's and Shannon's indices), and relative abundance estimation were assessed and compared based on root caries severity and activity status (including Sound surfaces)., Results: A total of 130 biofilm samples were examined: sound (n = 45) and with root caries lesions (n = 85; by severity: initial: n = 41; moderate/extensive: n = 44; by activity: active: n = 60; inactive: n = 25). Species richness was significantly lower in biofilms from moderate/extensive and active groups compared to sound sites. There was a higher relative abundance of species like Lechtotricia wadei, Capnocytophaga granulosa, Cardiobacterium valvarum, Porphyromonas pasteri - in sound sites; Dialister invisus, Streptococcus mutans, Pseudoramibacter alactolyticus and Bacteroidetes (G-5) bacterium 511 - in moderate/extensive lesions, and Fusobacterium nucleatum subsp. animalis, Prevotella denticola, Lactobacillus fermentum, Saccharibacteria (TM7) (G-5)bacterium HMT 356 - in active lesions., Conclusion: Root caries bacteriome exhibited differences in species proportions between the compared groups. Specifically, cavitated caries lesions and active caries lesions showed higher relative abundance of acidogenic bacteria., (© 2023 S. Karger AG, Basel.)

Caries preventive varnishes containing only fluoride might differ from those containing a combination of fluoride and antimicrobial components in terms of mineralization properties and their impact on the cariogenic biofilm. We compared a fluoride and a fluoride + chlorhexidine (CHX)/cetylpyridinium chloride (CPC) varnish on root caries formation in vitro. One hundred bovine root dentin samples were allocated to five groups (n = 20/group): (1) 7700 ppm fluoride varnish (Fluorprotector S (F)), (2) experimental placebo varnish for F (F-P), (3) 1400 ppm fluoride + 0.3% CHX/0.5% CPC varnish (Cervitec F (CF)), (4) experimental placebo varnish for CF (CF-P), (5) untreated control. Cariogenic challenge was provided using a multi-station, continuous-culture 3-species (Streptococcus mutans (SM), Lactobacillus rhamnosus (LR), Actinomyces naeslundii (AN)) biofilm model for 10 days. Mineral loss (ΔZ) was evaluated using transversal microradiography and bacterial counts in the biofilm assessed as colony-forming units. Fluorescence in situ hybridization (FISH) and confocal microscopy were performed to assess the three-dimensional biofilm architecture. Mean ± SD (vol% × μm) ΔZ was significantly lower for F (9133 ± 758) and CF (9835 ± 1677) compared to control (11362 ± 919) (p < 0.05), without significant differences between F and CF. SM counts were significantly lower and LR counts significantly higher in F- and CF-biofilms compared to control. AN counts were significantly higher in the F-biofilms than in all other groups. According to FISH, SM and LR invaded dentinal tubules only in the control-group. In the CF-group, the basal biofilm layer did not contain SM and AN. Both F and CF varnishes had similar caries-preventive effects and a considerable impact on biofilm structure and composition.