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Objective: To investigate the antibacterial and enamel remineralization performances as well as physicochemical properties and biocompatibility of a fluoride-coated clear aligner plastic (FCAP). Materials and methods: FCAP and normal clear aligner plastic (CAP) was bought from the manufacturer (Angelalign Technology Inc, China). The FCAP was observed under scanning electron microscopy. Its element composition, resistance to separation, contact angle, and protein adhesion performance were characterized. Colony-forming unit (CFU) count and 3-(4,5)-dimethylthiazol(-z-y1)-3,5-diphenyltetrazolium bromide (MTT) assay were used to evaluate the antibacterial ability of Streptococcus mutans. Fluoride release-recharge patterns were obtained. Apatite formation was evaluated after immersing FCAP in artificial saliva. Enamel remineralization capability was evaluated in the demineralization model (immersing samples in demineralization solution for 36 h) and pH cycling model (immersing samples in demineralization solution and remineralization solution in turns for 14 days). Cell Counting Kit-8 (CCK-8) and live/dead cell staining kits were used for cytotoxicity assay. Results: The FCAP showed uniformly distributed fluoride and did not compromise protein adhesion performance. CFU count (5.47 ± 0.55 for CAP, 3.63 ± 0.38 for FCAP) and MTT assay (0.41 ± 0.025 for CAP, 0.28 ± 0.038) indicated that the FCAP had stronger antibacterial activity compared with normal CAP (P < 0.05 for both evaluations). The FCAP could release fluoride continuously for 14 days and could be recharged after immersing in NaF solution. The FCAP could induce the formation of hydroxyapatite in artificial saliva and could reduce the microhardness decrease, color change, and mineral loss of enamels in both two models (P < 0.05 for all evaluations). CCK-8 and live/dead cell staining analyses showed that the coating did not compromise the biocompatibility of the clear aligner (P > 0.05 for CCK-8 evaluation). Conclusions: The FCAP had antibacterial, fluoride recharge, and enamel remineralization abilities while it did not compromise physicochemical properties and biocompatibility. Clinical relevance: The FCAP has the potential to prevent enamel demineralization during clear aligner treatment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the cost‐effectiveness of retaining one or more compromised first permanent molars (cFPMs) affected by dental caries or enamel hypomineralization, compared to timely extraction, in children aged 8 years. Methods: A Markov model was developed to simulate the lifetime of a cFPM. Two management strategies were compared: extraction facilitating spontaneous space closure or maintenance of teeth with restorations. Ten health states were utilized to capture long‐term outcomes including various tooth restorations, prostheses or a retained gap at the cFPM site. Outcomes were expressed as Quality Adjusted Tooth‐Years (QATYs). The model was informed by survey data on patient preferences for treatment outcomes and UK data on costs. Discounted costs and QATYs were calculated over 62 years. Results: Regardless of the number of cFPMs, retaining cFPMs was more effective than early removal, generating an additional 2.3 QATYs per cFPM. Early removal of one or two cFPM under general anaesthetic (GA) was more expensive than retention and hence never cost‐effective. Retaining a cFPM was more expensive than early removal under local anaesthesia or where four cFPMs were extracted under GA. In these cases, retaining cFPMs was cost‐effective if a QATY was valued at £100 or £35, respectively. Results were robust to sensitivity analysis. Conclusion: Preserving a cFPM was more cost‐effective than the early loss of one, or two cFPMs under GA. Preservation of four cFPMs was cost‐effective if sufficient value was placed on a QATY. These findings can guide clinical practice on management of cFPMs alongside patient/payer values on maintaining teeth. [ABSTRACT FROM AUTHOR]

Purpose: The primary objective of the review was to assess the effectiveness of self-assembling P11-4 peptide (SAP) with or without any fluoride agents (FA) in remineralization of the White spot lesions (WSLs)/incipient carious lesions (ICLs) compared to other enamel remineralizing agents/non-intervention/placebo. Methods: Human RCTs published during the period from 1st January 2000–30th June 2021 were searched in the electronic bibliographic databases and scanning reference lists of articles from PubMed, Google Scholar, and The Cochrane Central Register of Controlled Trials. The Risk-of-Bias was assessed using version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2) tool for all included studies. The statistical heterogeneity between studies was assessed by the Cochrane Q test and I2 test. A random-effects model was used considering the variations in true effects size between the included studies. The quality of the evidence for remineralizing effectiveness of SAP/SAP + FA was done using the GRADEpro GDT software which employs GRADE. Results: Four out of eight included trials were assessed to have "high risk" of bias. Mean difference for Laser fluorescence outcome assessment method (SAP v/s FA) was – 4.89 (95% CI: − 17.35 to 7.57; p = 0. 44; I2 = 89%). The combined risk ratio observed through Nyvad criteria (SAP v/s FA) was 0.12 (95% CI: 0.01–1.59; p = 0.11; I2 = 71%). Mean difference for Laser fluorescence outcome assessment method (SAP + FA v/s FA) was – 11.52 (95% CI: – 14.43 to – 8.61; p = < 0.001;I2 = 0%). The combined risk ratio for ICDAS outcome assessment method (SAP + FA v/s FA) was 0.27 (95% CI: 0.03–2.84; p = 0.15; I2 = 53%). Conclusion: Considering the results observed from the included trials we are uncertain whether SAP/SAP + FA increases/decreases the remineralizing/regeneration of WSLs/ICLs. [ABSTRACT FROM AUTHOR]

Background: Graphene-based materials have great prospects for application in dentistry and medicine due to their unique properties and biocompatibility with tissues. The literature on the use of graphene oxide in orthodontic treatment was reviewed. Methods: This systematic review followed the PRISMA protocol and was conducted by searching the following databases: PubMed, Scopus, Web of Science, and Cochrane. The following search criteria were used to review the data on the topic under study: (Graphene oxide) AND (orthodontic) ALL FIELDS. For the Scopus database, results were narrowed to titles, authors, and keywords. A basic search structure was adopted for each database. Initially, a total of 74 articles were found in the considered databases. Twelve articles met the inclusion criteria and were included in the review. Results: Nine studies demonstrated the antibacterial properties of graphene oxide, which can reduce the demineralization of enamel during orthodontic treatment. Seven studies showed that it is biocompatible with oral tissues. Three studies presented that graphene oxide can reduce friction in the arch-bracket system. Two studies showed that it can improve the mechanical properties of orthodontic adhesives by reducing ARI (Adhesive Remnant Index). Three studies demonstrated that the use of graphene oxide in the appropriate concentration can also increase the SBS (shear bond strength) parameter. One research study showed that it can increase corrosion resistance. One research study suggested that it can be used to accelerate orthodontic tooth movement. Conclusion: The studies included in the systematic review showed that graphene oxide has numerous applications in orthodontic treatment due to its properties. [ABSTRACT FROM AUTHOR]

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Objective To evaluate the effect of high-fluoride mouth rinse and high-fluoride toothpaste on the development of demineralized lesions (DLs) during orthodontic treatment. Trial design Three-armed parallel-group randomized controlled trial. Methods The trial was performed with 270 adolescent orthodontic patients. Randomization was performed in blocks of 30, enrolling the patients into one of the following groups: the fluoride mouth rinse (FMR) group receiving 0.2% sodium fluoride (NaF) mouth rinse plus 1450 ppm fluoride (F) toothpaste; high-fluoride toothpaste (HFT) group receiving 5000 ppm F toothpaste; and the Control (CTR) group receiving 1450 ppm F toothpaste. Inclusion criteria were patients scheduled for treatment in both arches with fixed appliances and age between 12 and 20 years. The primary outcome variable was the proportion of participants with at least one new demineralized lesion as assessed on digital photos taken before and after treatment, analysed by a blinded clinician. The analysis included all teeth or teeth in the aesthetic zone, i.e. all central incisors, lateral incisors, and canines. A random sample of 30 participants was assessed to check intra- and inter-reliability. For pairwise comparison between groups, Fisher's non-parametric permutation test was used for continuous variables. Blinding was employed during the caries registration and data analysis. Recruitment October 2010 to December 2012 Results In total, 270 patients were randomized, of which 22 were excluded during treatment. Therefore, 248 participants were included in the study. The number of patients with an increase of ≥1 DL, including only central- and lateral incisors and canines, during orthodontic treatment, was significantly lower in the HFT group, 51/85 60%, compared to the CTR group, 64/82 78%, RR 0.77 (CI 0.62; 0.95), P =.01 and in the FMR group, 47/81 58%, compared to the CTR group, RR 0.74 (CI 0.60; 0.92), P <.01. Conclusions To prevent demineralized lesions in the aesthetic zone, high-fluoride mouth rinse and high-fluoride toothpaste may be recommended. Limitations The protocol was not registered, and the present study did not use a double-blinded design. [ABSTRACT FROM AUTHOR]

The high incidence of demineralization around orthodontic brackets has led to the development of preventive measures. Incorporation of antibacterial or remineralizing agents into orthodontic adhesives is an attractive method. This single-center, split-mouth, randomized controlled clinical trial was conducted to assess the effect of a modified composite containing TiO2 nanoparticles on the Streptococcus mutans population and to prevent demineralization around orthodontic brackets. Each participant was assigned a random sequence (AB or BA). During the bonding session, the control lateral incisor was bonded with a conventional composite and the contralateral incisor was bonded with a composite containing nano TiO2 particles (1%weight). The eligibility criteria included the presence of S. mutans in the dental plaque and absence of active caries, fractures or cracks. The S. mutans count in the dental plaque immediately around the brackets was evaluated at baseline and 1, 3, and 6 months after bonding. The specificity of the colonies was determined by PCR. The DIAGNOdent score was assessed at baseline and re-assessed every month up to the sixth month. Salivary samples were collected at T0, T1, and T3 to assess the amount of Ti released from the composite. The cytotoxicity of the modified composites was evaluated using an MTT assay. Participants, examiners, and data analyzers were blinded to the test and intervention groups. Forty-two patients ranging from 12 to 25 years were enrolled in this study. The amount of Ti released into saliva was insignificant and far below the toxic level. There was no significant difference between the S. mutans counts of the studied tooth S. mutans counts at any time point evaluated. DIAGNOdent scores on both sides increased significantly after the first month. However, this increase was higher on the test side (p < 0.001), and a significant difference of 2.6 scores remained throughout the study period. No severe adverse events were observed. Orthodontic composites containing TiO2 nanoparticles may prevent demineralization induced around brackets during orthodontic treatment. However, the antibacterial effects were not statistically significant. Registration: The protocol was registered with the IRCT.ir (IRCT20140215016582N6). [ABSTRACT FROM AUTHOR]

Kleefstra syndrome (KS) is a rare genetic disorder (prevalence < 1 / 1 000 000) characterised by autistic spectrum disorder (ASD), childhood hypotonia, and seizures. A typical facial appearance includes microcephaly, arched eyebrows, synophrism, hypertelorism, a short nose, midface hypoplasia, prognathism, and tongue protrusion. This case report presents a 19-year-old female with KS from a dentist's perspective. The patient demonstrates limited mouth opening with a slight deviation of the mandible on the left side. The mandibular prognathism and anterior open bite are visible. A generalised inflammatory gingival enlargement is most likely a response to local irritants like plaque and calculus but is enhanced by the patient's mouth breathing habit. Also, the tongue is unusually large—macroglossia. Dental anomalies were diagnosed by digital panoramic radiograph, including dilaceration of the maxillary left second premolar and taurodontism. The patient was qualified to be treated under general anaesthesia with multiple extractions, restorations, hygienisation procedures, and tooth remineralisation. This individual should also be considered for orthodontic treatment and an eventual tongue reduction procedure. In the case of KS, multidisciplinary cooperation as well as frequent dental check-ups with fluoride prophylaxis are recommended. Unfortunately, dental treatment is still not an integral part of taking care of disabled children and youth with rare diseases. [ABSTRACT FROM AUTHOR]

Molar incisor hypomineralization (MIH) and hypomineralized second primary molars (HSPM) are dental enamel developmental defects with significant prevalence and psychophysical impact, posing a public health concern. We examined the relationship between HSPM and MIH in 426 children aged 7 to 10 years (213 with MIH, 213 without MIH). The frequency of HSPM was higher in children with MIH (37.1% vs. 11.3%, p < 0.001). However, there was no correlation between MIH severity and presence of HSPM (p = 0.296). In patients with both defects (n = 79), 90% of severe MIH cases were associated with severe HSPM, while 87.8% of mild MIH cases were associated with mild HSPM (p < 0.001). The involvement of permanent incisors by MIH was not influenced by the presence of HSPM or HSPM severity. HSPM exhibited a positive predictive value of 76.7, negative predictive value of 58.8, sensitivity of 37.1% (95% CI = 30.6–43.6%), and specificity of 88.7% (95% CI = 84.5–93%). The odds ratio for MIH based on HSPM was 4.64 (95% CI). HSPM may serve as a predictor of MIH, but its absence does not rule out the occurrence of MIH. The results highlight the need for surveillance programs in children presenting with HSPM to facilitate early diagnosis and preventive measures for MIH-related complications. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate descriptively and quantitatively teeth affected by enamel hypomineralization (EH) using optical coherence microtomography (OCT). Methods: Twenty teeth were classified according to the European Academy of Pediatric Dentistry's molar incisor hypomineralization (MIH) index and separated into groups according to the degree of EH severity. For each tooth, scans were performed on both the affected and the non-affected areas, and their corresponding optical images were captured. Results: In the qualitative analyses, in most of the images bright lines were observed in relation to the enamel surface and a high level of photon scattering immediately below the enamel surface. This showed that the shading distribution can be identified as hypomineralized areas in which the scattering signal can be used as a diagnostic criterion. In the quantitative analyses, Tukey's test was performed to evaluate the means of the optical attenuation coefficient, which did not present significant differences. However, considering the correlation, homogeneity and contrast analyses, a statistically significant difference was observed between the groups. The group with severe MIH showed greater homogeneity and correlation, but less contrast. Conclusion: Currently, MIH has its severity measured by essentially clinical means. OCT processing techniques reveal advances in the diagnostic imaging of MIH, showing that image texture analysis can be a promising and useful method to aid in its diagnosis. [ABSTRACT FROM AUTHOR]

Statement of the Problem: Surface roughness of zirconia is an important parameter that determines the success of zirconia restorations. When zirconia surfaces are left rough, higher susceptibility to hydrothermal aging, plaque accumulation and color changes would occur. Therefore, polish retention of these restorations is considered as a challenge. Purpose: The purpose of this in vitro study was to determine the effect of hydrothermal degradation, pH- cycling, and simulated tooth brushing on surface roughness, topography, and polish retention of an yttrium-stabilized monolithic zirconia. Materials and Method: In this experimental study, 64 specimens of yttria-stabilized tetragonal zirconium oxide (20×4×2mm) were prepared (ZirKonzahn, Steger, Ahrntal). The specimens were wet- polished (standard polishing), and divided into 8 groups (n=8). Four control groups were assessed in non-aged condition while in 4 experimental groups the artificially ageing was done. Different finishing and polishing procedures were performed in 8 groups. The surface roughness values including mean surface roughness (Ra) and mean height of surface roughness (Rz) was measured by a profilometer. The results were analyzed using two-way ANOVA and Tukey’s HSD test (α=0.05). One representative specimen of each group was inspected under a scanning electron microscope (SEM) for assessment of surface topography. Results: The effects of surface treatments on Ra (p<.001) and Rz (p<.001) parameters were significant. Ageing had no significant effect on Ra (p=.086) and Rz (p=.067) values. Maximum Ra and Rz parameters were recorded following grinding (p<.001) and minimum values were recorded after glazing, which were significantly lower than the values in grinding group (p<.001). Polishing and glazing diminished the surface roughness (Ra) of ground zirconia similarly (p=.995). Conclusion: Aging had no significant effect on surface roughness of zirconia, irrespective of surface treatment type. Grinding yielded maximum surface roughness. Intra oral polishing yielded a surface roughness comparable to standard polishing and glazing. [ABSTRACT FROM AUTHOR]

Molar incisor hypomineralization (MIH) is an understudied and underrecognized clinical entity occurring in children. We performed a cross-sectional study to determine the real-world prevalence of MIH among school children undergoing routine dental checkups at one primary and middle school in Bucharest, Romania. Our study cohort consisted of 266 children with evaluable data, of which 143 (53.8%) were males, with a median age of 10 years old (interquartile range: 8–11 years). In this study cohort, we have identified a prevalence of 14.3% (n = 38 cases) of MIH. Among patients diagnosed with MIH, hypomineralizations were present in 47.4% of children on the maxillary first molar, 92.1% on the mandibular first molar, 94.7% on the maxillary incisor, 36.8% on the mandibular incisor, and 5.3% on the deciduous second molar. We identified the maxillary incisor and the mandibular first molar as the most important examined sites significantly associated with the presence of MIH (p < 0.0001 each), highlighting the importance of paying focused attention to these sites during routine dental care in children. In order to establish the diagnosis of MIH, findings of hypomineralization should be present on at least one permanent first molar, according to the case definition currently in use; this definition does not include findings on the incisors. Thus, our finding that hypomineralization of the maxillary incisors is significantly associated with MIH is particularly important. While incisor hypomineralization is not diagnostic of MIH, based on our results, we conclude that it should raise the suspicion of MIH and lead to an attentive examination of the permanent molars in order to establish timely diagnosis. [ABSTRACT FROM AUTHOR]

Teeth consist of 3 mineralized tissues: enamel, dentin, and cementum. Tooth malformation, the most common craniofacial anomaly, arises from complex genetic and environmental factors affecting enamel structure, size, shape, and tooth eruption. Hyaluronic acid (HA), a primary extracellular matrix component, contributes to structural and physiological functions in periodontal tissue. Transmembrane protein 2 (TMEM2), a novel cell surface hyaluronidase, has been shown to play a critical role during embryogenesis. In this study, we demonstrate Tmem2 messenger RNA expression in inner enamel epithelium and presecretory, secretory, and mature ameloblasts. Tmem2 knock-in reporter mice reveal TMEM2 protein localization at the apical and basal ends of secretory ameloblasts. Micro–computed tomography analysis of epithelial-specific Tmem2 conditional knockout (Tmem2 - CKO) mice shows a significant reduction in enamel layer thickness and severe enamel deficiency. Enamel matrix protein expression was remarkably downregulated in Tmem2 - CKO mice. Scanning electron microscopy of enamel from Tmem2 - CKO mice revealed an irregular enamel prism structure, while the microhardness and density of enamel were significantly reduced, indicating impaired ameloblast differentiation and enamel matrix mineralization. Histological evaluation indicated weak adhesion between cells and the basement membrane in Tmem2 - CKO mice. The reduced and irregular expressions of vinculin and integrin β1 suggest that Tmem2 deficiency attenuated focal adhesion formation. In addition, abnormal HA accumulation in the ameloblast layer and weak claudin 1 immunoreactivity in Tmem2 - CKO mice indicate impaired tight junction gate function. Irregular actin filament assembly was also observed at the apical and basal ends of secretory ameloblasts. Last, we demonstrated that Tmem2 -deficient mHAT9d mouse ameloblasts exhibit defective adhesion to HA-containing substrates in vitro. Collectively, our data highlight the importance of TMEM2 in adhesion to HA-rich extracellular matrix, cell-to-cell adhesion, ameloblast differentiation, and enamel matrix mineralization. [ABSTRACT FROM AUTHOR]

Dental fluorosis is a specific disturbance in enamel formation that leads to subsurface porosity during the late secretory and maturation phases due to excessive fluoride ingestion. The conventional management of teeth discolored by fluorosis involves performing vital tooth bleaching, microabrasion, placement of veneers or crowns, etc. The ultimate choice of treatment is based on the severity of the disease. This paper highlights a clinical case of generalized mild fluorosis treated using the resin infiltration technique, thus reviewing the mechanism of action and clinical procedure. [ABSTRACT FROM AUTHOR]

SignificanceIt is not sufficient to detect caries lesions on tooth surfaces; it is also necessary to measure the activity of the lesions to determine if intervention is needed. Changes in the reflectivity of lesion areas during dehydration with forced air at short wavelength infrared (SWIR) wavelengths can be used to assess lesion activity since these changes represent the evaporation dynamics of water from the lesion.AimThe aim of this study is to develop new optical methods for assessing lesion activity on tooth surfaces utilizing the strong water absorption band near 1950-nm.ApproachThe time-resolved reflectivity of 20 active and arrested caries lesions on the surfaces of human extracted teeth was monitored at 1300 to 2000 nm using broadband light sources and an extended range InGaAs camera during drying with air.ResultsMultiple parameters representing the rate of change of the lesion reflectivity correlated with the presence of a highly mineralized outer surface zone indicative of lesion arrest measured with x-ray microtomography (microCT). Performance at 1950-nm was higher than for other wavelengths.ConclusionsThis study demonstrates that SWIR imaging near 1950-nm has great potential for the assessment of lesion activity.

SignificanceWe have developed a clinical probe capable of acquiring near-simultaneous short-wavelength infrared (SWIR) reflectance and occlusal transillumination images of lesions on tooth proximal and occlusal surfaces. We hypothesize that dual images will aid in differentiating between shallow and deep occlusal lesions and reduce the potential of false positives (FPs).AimThe aim of this study was to test the performance of the dual reflectance and occlusal transillumination probe on extracted teeth prior to commencing clinical studies.ApproachThe dual probe was 3D printed and the imaging system uses an InGaAs camera and broadband superluminescent diode light sources that emit broadband light at 1300 nm for occlusal transillumination and 1600-nm light for cross-polarization reflectance. The diagnostic performance of the dual probe was assessed using 120 extracted teeth with approximal and occlusal lesions. Reflectance and transillumination images were fused into single images to enhance the contrast between sound and lesion areas. The lesion contrast in both modes did not increase significantly with either the lesion depth or the distance from the occlusal surface for approximal lesions. In addition, the diagnostic performance of radiography, the individual reflectance and transillumination images, dual images, and fused images were compared using micro-computed tomography as the gold standard.ResultsReflectance imaging at 1600 nm yielded the highest diagnostic accuracy for lesions on both occlusal and proximal surfaces while radiography yielded the lowest number of FPs.ConclusionThis study demonstrates that simultaneous acquisition of both reflectance and transillumination SWIR images is possible with a single clinical device.

Objective: To investigate the effect of a 5% sodium fluoride varnish with functionalized tri-calcium phosphate (fTCP) on post-orthodontic white spot lesions. A secondary aim was to study if the patients and their clinicians perceived clinical improvements. Method and materials: Fifty-nine patients with at least two visible WSLs on their maxillary incisors, canines, or first premolars present at the debonding of fixed appliances (baseline) were enrolled and assigned to a Varnish group (Clinpro White Varnish, 3M Espe) receiving topical applications at baseline and after 8 weeks, or a Control group treated with a fluoride-free mock product. The primary endpoint was white spot lesion appearance after 16 weeks, assessed from photographs using the modified ICDAS white spot lesion score (0 to 3). The patients and the dental examiners rated the white spot lesions subjectively with aid of a visual analog scale. Results: Fifty-seven patients completed the study. After 16 weeks, 62% of the white spot lesions in the Varnish group were completely reversed (score 0) compared to 39% in the Control group. The treatment effect was statistically significant (OR 0.22; 95% CI 0.08 to 0.59, P = .003) after adjusting for baseline oral hygiene index and type of tooth. A significant correlation (P < .05) was observed between patients' and orthodontists' perception of the lesions. Conclusion: The 5% sodium fluoride varnish with fTCP appeared clinically effective in reversing post-orthodontic white spot lesions 16 weeks after debonding. The patients and the clinicians agreed on the obtained esthetic improvements. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate masking effects of resin infiltration on labial white spot lesions (WSL), by comparing the latter with a remineralization approach (using hydroxyapatite and fluorides) and conventional oral care (using fluoride-free toothpaste). Method and materials: Fifteen patients with at least three WSL were enrolled for a within-person randomized controlled trial, thus allowing for intrapersonal comparisons. Each WSL per tooth in every patient was randomly assigned to one of the following groups. Group 1: lesions were resin-infiltrated with Icon (RI; DMG); Group 2: Remin Pro (RP; VOCO) was used as remineralizing agent; and Group 3 (control): affected teeth were brushed with Complete Care toothpaste (CC; Himalaya). RP and CC were applied by means of a polishing brush, using a low-speed handpiece (5 min), and these procedures were repeated chairside thrice daily for 7 consecutive days. Digital photographs were captured before and after lesion treatment under standardized conditions. The CIE L*a*b* color system was used to analyze the optical outcome, and intrapersonal color differences were statistically evaluated. Results: Compared to RP and CC, RI showed prompt and subjectively satisfactory color improvements, and this was primarily driven by L* and b* shifts. Statistical analysis of the objective color differences (ΔE*) between the three groups revealed significant differences for RI vs RP (P = .029), RI vs CC (P < .001), and RP vs CC (P = .001). Conclusion: Resin infiltration is considered a time-effective treatment option for esthetically camouflaging WSL, while RP and CC failed to improve lesion appearance and oral health in the current short-term trial. [ABSTRACT FROM AUTHOR]

Objective: To analyse the available evidence regarding the incidence and severity of white spot lesions (WSLs), plaque accumulation and salivary caries-associated bacteria(SCB) in clear aligners (CA) verses conventional fixed (CF) orthodontic appliances. Methods: Electronic searches of MEDLINE, Scopus, Embase, Google Scholar, Clinical trial registry, OpenGrey and ProQuest were done for all relevant studies. Eligibility criteria were; Randomized Controlled Trials and Non-Randomized Studies that compared the incidence and severity of WSLs, plaque accumulation and SCB between CA and CF appliances in patients undergoing orthodontic treatment. The risk of bias(ROB) and certainty of evidence was assessed independently by two reviewers using Cochrane's ROB and GRADEpro, respectively. Standardized mean difference (SMD) was used to estimate the effect size using STATA 17 software. Results: A total of 14 studies met the eligibility criteria, and eight were suitable for meta-analysis. The qualitative results showed lower incidence and severity of WSLs, plaque accumulation, and SCB in CA group compared to CF appliances. The pooled results showed significantly lower plaque accumulation(SMD − 1.58;95%CI:-2.57,0.58;p = 0.002) in CA compared to CF appliances. Conclusions: A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances. However, the results of the present study should be interpreted with caution given the high ROB among some of the included studies as well as the marked heterogeneity across the studies. Clinical relevance: For patients who can be treated with either CA or CF appliances, CA may be a better choice concerning oral health. Registration: Open Science Framework (DOI:https://doi.org/10.17605/osf.io/kcpvb). [ABSTRACT FROM AUTHOR]

Background: Nanoparticles and regenerative biomineralization are new caries prevention technologies. This study assessed the remineralizing effect of self-assembling peptide (P11-4), Nanosilver Fluoride (NSF) and sodium fluoride (NaF) on white spot lesions (WSLs) in permanent teeth. Methods: Sixty six young adults with WSLs on buccal surfaces in permanent teeth and ICDAS code 1 or 2, were randomly assigned to one of three groups; P11-4, NSF or NaF. Assessment of ICDAS scores, lesion activity (Nyvad scores) and diagnodent readings of lesions were done at baseline and after 1, 3, 6 and 12 months of agents' application. Comparisons between groups were made using chi squared test and comparison within groups were made using McNemar test. Multilevel binary logistic regression was used to assess the effect of agents on change of ICDAS scores after 3, 6 and 12 months (reduction versus no reduction). Results: There were 147 teeth in 66 patients; mean ± SD age = 13.46 ± 4.31 years. There were significant differences in the change of ICDAS scores among the three groups after 3 and 6 months (p = 0.005). The reduction in ICDAS score increased steadily in all groups across time with the greatest increase in the P11-4 group: 54.5% after 12 months. Lesion activity (Nyvad scores) showed significant differences among the three groups with the greatest percentage of inactive cases in the P11-4 group. Multilevel binary logistic regression showed non-significant reduction of ICDAS in P11-4 and NSF varnishes compared to NaF varnish (AOR = 2.56, 95% CI: 0.58, 8.77 and AOR = 2.12, 95% CI: 0.59, 7.64 respectively). Conclusion: P11-4 and NSF varnish reduced the ICDAS scores, caries activity and diagnodent readings of WSLs in permanent teeth. However, the change in ICDAS scores was not significantly different from NaF. Trial registration: This trial was prospectively registered on the clinicaltrials.gov registry with ID: NCT04929509 on 18/6/2021. [ABSTRACT FROM AUTHOR]

Dental fluorosis is a long-existing public health issue resulting from inequitable access to potable water. Socially disadvantaged rural communities in fluoride-endemic areas, where a conventional irrigation system is absent and groundwater containing natural fluoride is the predominant source of drinking water, face a significant oral public health threat. This study aimed to determine the association between water fluoride levels and dental fluorosis. A systematic review aligned with PRISMA principles was conducted using the SPIDER search methodology and relevant keywords on many search engines, such as Google Scholar, PubMed, Elsevier, Sage, Web of Science, Cochrane, and Scopus. This review sought to ascertain the PICO model's application as a search strategy tool. The reviewers gathered and assessed 1164 papers from January 2010 to January 2023. In total, 24 research papers from diverse databases were included. Using the Newcastle–Ottawa Scale, grades resulting from several data screens were evaluated. According to a previous systematic review, there may be publication bias in studies examining the association between fluoride in drinking water and dental fluorosis. The findings of this systematic review indicate that subpar fluoride is detrimental to human health. The author outlines legislative tools and technological advancements that might reduce fluoride levels. [ABSTRACT FROM AUTHOR]

Background: In general, bioactive glasses (BAGs) can react with tissue minerals and promote remineralization. However, the application of BAG in bonding agents and its impact on bond strength remain uncertain due to insufficient information and limited research in this area. Materials and Methods: This study employed a randomized controlled design to assess the effects of composite-bonding agents with varying BAG contents on shear bond strength and fracture pattern in sound and demineralized teeth, with and without thermocycling. Thus, 80 healthy third molars were randomly divided into two groups: sound teeth and demineralized teeth. Five bonding agents were applied to the prepared dentin surfaces, including four experimental composite-bonding agents with varying BAG content (0, 0.2, 0.5, and 2 wt%) and the Adper Single Bond commercial bonding as control. The shear bond strength of all samples was measured using a universal tester. The type of failure of each specimen was determined using a stereomicroscope. Kruskal-Wallis nonparametric test was performed on the obtained shear bond strength data followed by Mann-Whitney post hoc test with Bonferroni correction to determine statistical significance. The level of significance was considered P < 0.05 for all tests and was adjusted by Bonferroni correction. Results: Demineralization significantly decreased shear bond strength in the teeth samples. Adper Single Bond exhibited the highest shear bond strength values. The addition of BAG did not have a significant influence on shear bond strength, regardless of demineralization or thermocycling condition. Adhesive failure was the predominant type of failure in all groups. Conclusion: The incorporation of BAG filler up to 2 wt% did not result in significant changes in shear bond strength. Experimental adhesive bonding agents with 2 wt% BAG content demonstrated shear bond strengths comparable to the commercial bonding agent in sound nontreated, sound thermocycled, demineralized nontreated, and demineralized thermocycled groups. [ABSTRACT FROM AUTHOR]

Objectives: White spot lesions (WSL) are prevalent in patients using orthodontic appliances. The presence of ion‐releasing compounds in the tooth‐appliance interface may limit enamel demineralization to control WSL incidence. Thus, this study aims to evaluate the mineral formation on SiNb‐containing experimental orthodontic resins and the influence of these fillers on the physicochemical and biological properties of developed materials. Materials and Methods: The SiNb particles were synthesized via the sol–gel route and characterized by their molecular structure and morphology. Photopolymerizable orthodontic resins were produced with a 75 wt% Bis‐GMA/25 wt% TEGDMA and 10 wt%, 20 wt%, or 30 wt% addition of SiNb. A control group was formulated without SiNb. These resins were tested for their degree of conversion, softening in solvent, cytotoxicity in fibroblasts, flexural strength, shear bond strength (SBS), and mineral deposition. Results: The addition of 10 wt% of SiNb did not impair the conversion of monomers, cytotoxicity, and flexural strength. All groups with SiNb addition presented similar softening in solvent. The presence of these particles did not affect the bond strength between metallic brackets and enamel, with SBS values ranging from 16.41 to 18.66 MPa. The mineral deposition was observed for all groups. Conclusion: The use of niobium silicate as filler particles in resins may be a strategy for the adhesion of orthodontic appliances. The 10 wt% SiNb concentration resulted in a material with suitable physicochemical and biological properties while maintaining the bond strength to tooth enamel and promoting mineral deposition. [ABSTRACT FROM AUTHOR]

Objectives: This study sought to evaluate the remineralization of ex vivo human teeth using commercially available artificial saliva, SalivaMAX®, a supersaturated calcium phosphate rinse (SSCPR). Methods: early enamel lesions were artificially induced on ex vivo human teeth by chemical means. The teeth were exposed to the SSCPR for two minutes (experimental) or dH2O (control) four times per day for a total of 35 days. At time points of 0, 2.5, 21, and 35 days, micro-CT was utilized to determine the mineral density profile across the lesion and evaluate lesion depth. The relative percent remineralization was calculated from the initial lesion depth (Time 0) at each evaluation time. Student's t-test was used to compare the extent of remineralization between the SSCPR and control groups for statistical significance at each time. To evaluate the changes in percent remineralization over time, a two-way ANOVA was used. Results: At Time 0 and 2.5 days, there was no difference in the percent remineralization between the SSCPR and control groups (p > 0.05). After 21 days, the teeth exposed to the SSCPR remineralized 56.7 ± 3.7%, while the control only remineralized 10.7 ± 11.0% (p < 0.0001). At day 35, the remineralization was 73.7 ± 5.4% and 18.2 ± 10.8% (p < 0.0001) for the SSCPR and control groups, respectively. Conclusions: A marked increase in remineralization occurred with the use of the SSCPR. Notably, the remineralization of the SSCPR occurred deep within the tooth and progressed toward the surface over time. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the impact of theobromine and casein phospho-peptides/amorphous calcium phosphate with fluoride (CPP-ACPF) on the resin-dentine bond strength, microhardness, and dentine morphology. Methods: A total of 18 sound human molars for micro-tensile bond strength (µTBS), 20 sound human premolars for microhardness, and 30 premolars for Scanning electron microscopy/energy-dispersive X-ray spectroscopy (SEM/EDX) were used. Based on the pre-treatment used, teeth were split into six groups; sound dentine, demineralized dentine, and demineralized dentine treated with theobromine (Sigma Aldrich) and MI paste plus (GC International, USA) for two-time intervals; 5 min and 1 month. The bonded teeth were sectioned to produce 1 mm2 resin-dentine sticks which were evaluated for µTBS using a universal testing device (Instron 3365, USA). The dentine microhardness was tested by using the Vickers microhardness tester (Nexus 4000 TM, Netherlands). The pre-treated dentine surface was examined using SEM/EDX (Neoscope JCM-6000 plus Joel benchtop SEM, Japan). µTBS results were analysed with two-way ANOVA. Microhardness and EDX results were analysed with two-way mixed model ANOVA. The significance level was set at (p ≤ 0.05). Results: While both remineralizing materials at the two-time intervals demonstrated µTBS comparable to sound dentine (46.38 ± 12.18), the demineralized group demonstrated statistically the lowest µTBS (p < 0.001). Whether used for 5 min or 1 month, theobromine significantly increased the microhardness (50.18 ± 3.43) and (54.12 ± 2.66) respectively (p < 0.001), whereas MI paste only increased the hardness (51.12 ± 1.45) after 1 month (p < 0.001). Conclusions: The pre-treatment of demineralized dentine with theobromine for 5 min or 1 month could enhance its bond strength and microhardness while for MI paste plus, only 1-month application was efficient to ensure remineralization. [ABSTRACT FROM AUTHOR]

Background: Resin infiltration is a micro-invasive treatment for molar incisor hypomineralisation (MIH). In this study it was aimed to evaluate the masking effect of resin infiltration treatment (ICON) on hypomineralised enamel surface of permanent anterior teeth by using laser fluorescence, spectrophotometer, and cross-polarisation photography. Methods: A total of 116 permanent central incisors in 37 patients were included in the study. The resin infiltration treatment (Icon®) was applied to the teeth with MIH; the healthy teeth received no treatment (control). Hypomineralised enamel lesions were evaluated by ICDAS II criteria. DIAGNOdent Pen was used to assess the lesions and healthy enamel surface quantitatively. Colour changes in enamel lesions were evaluated by using a spectrophotometer (VITA EasyShare). Each enamel lesion was imaged using a cross-polarization technique before and after treatment. All photos were assessed using Image J to evaluate the changes in lesion size. Enamel lesions were evaluated before; immediately after; 1; 3; and 6 months after treatment. Statistical significance was set as p < 0.05. Results: After the resin infiltration, significant decreases were found in the mean DIAGNOdent values for the treatment group (p < 0.05). The colour differences before and after treatment significantly differed in all follow-ups (p < 0.05). In the treatment group, lesion areas decreased significantly after treatment (p < 0.05). Conclusions: The resin infiltration treatment has a masking effect on MIH lesions without cavities, with stable outcomes after six months. The cross-polarization photography technique may be use to evaluate the lesion size instead of photography with flash. Trial registration. NCT04685889 (registered 28 December 2020). [ABSTRACT FROM AUTHOR]

Background: enamel demineralization is a common side effect of orthodontic therapy with fixed braces. The aim of the present in vitro study was to compare a conventional adhesive system and a modern adhesive system (APC Flash-Free [FF] technology) with regard to the demineralization of enamel by Streptococcus sobrinus (S. sobrinus). Methods: this in vitro study included premolar teeth and compared APC FF adhesive brackets (Group A, n = 15) with conventional adhesive brackets (Group B, n = 15) from the same company. Specimens were incubated with a positive control group (PCG, n = 5) and a negative control group (NCG, n = 5) in an S. sobrinus suspension for three weeks. To evaluate the grade of enamel demineralization, the samples were analyzed using a polarizing microscope. Results: the test specimens of group B with conventionally bonded bracket adhesive showed significantly greater (+10.8 μm) demineralization with regard to the penetration depth of the demineralization than the PCG (p = 0.012). Thus, there was a difference from group A with the new bracket adhesive of the FF brackets (+7.29 μm). Significantly, demineralization was more pronounced cervically than coronally in both groups, and it occurred cervically more frequently than grade 3 demineralization (p = 0.001). Conclusions: it seems plausible that new orthodontic bracket adhesives and the modern FF adhesive system positively contribute to the reduction in enamel demineralization during orthodontic treatment. [ABSTRACT FROM AUTHOR]

Background. Hypomineralization of the incisors and first molars (MIH) is distinguished by a systemic enamel maturation condition that influences minimum single permanent first molar and is frequently linked to incisor enamel deficiencies. The estimated incidence of MIH is 12.9% (11.7–14.3%). To our knowledge, no case series has been presented in the literature that discusses the resin infiltration technique for aesthetic management of MIH of enamel. Aim. This case series discusses four cases where MIH has been effectively managed by the resin infiltration technique. Case presentation. The diagnosis of MIH was made after careful evaluation of the defects during clinical follow-up, considering the patient’s previous medical history, and making a diagnostic evaluation with other enamel abnormalities. The same dental professional applied resin infiltration (Icon, DMG America; Englewood, USA), and there were regular follow-ups after the procedure. After the resin infiltration procedure, the patients were asked about their comfort throughout the procedure, satisfaction with the results, and whether they would suggest this intervention to others. Results. At follow-up, patients remarked that they felt at ease throughout the procedure, expressed satisfaction with the results, and said they would recommend this course of treatment to others. Conclusion. High patient contentment with resin infiltration treatment was reported in all four cases, which successfully obscured MIH on teeth of the maxillary anterior region. [ABSTRACT FROM AUTHOR]

As antibiotic resistance is increasing daily, the desire to treat an infection without causing any harmful effects assumes increasing importance. Ozone gas is a reactive antioxidant. Its role in blood circulation and uplifting immunity is an ideal complement to achieving curative care treatments. Aside from treatments, the therapeutic and biological effects of ozone may have positive results by reducing tooth demineralization, its antimicrobial capabilities rely upon its ability to oxidize, which produces free radicals, and has immediate action on microbes. The usage of ozone in dentistry is recommended for a variety of purposes, which comprises carious lesion treatments, root canal disinfection, post-surgical treatment, tooth bleaching, periodontal problems, prosthodontics, and orthodontics. Ozone has the potential to be a promising alternative therapy in dentistry. However, well-designed research is needed to analyze ozone's utilization in the field of dentistry to determine its importance from a clinical perspective so that the general public can benefit from it. This systematic review aims to describe the technique in which ozone can be advantageous as well as the many ways of applications of ozone therapy in dentistry. [ABSTRACT FROM AUTHOR]

Purpose: Using a systematic review to answer the following question: What are the treatment patterns for mild and severe molar hypomineralization in permanent teeth? Methods: Electronic searches were conducted to identify randomized clinical trials (RCT) that related treatment to molar hypomineralization- (MH) affected permanent molars in children from five to 16 years old. Data extraction and risk of bias evaluation, using the Cochrane risk of bias tool, were performed for all included studies. Studies were selected according to PICOS criteria. RCTs relating mild and severe MH to treatments on permanent molars were included. Studies analyzing clinical techniques, whether single or any association of techniques for restorative and desensitizing treatments, were included. Studies involving another disease or comparing different types of enamel defects related to trauma and hereditary were excluded. The certainty of the evidence was evaluated using the GRADE approach. Results: The electronic search was performed on MEDLINE via PubMed, Embase, Cochrane Library, and Grey literature up to May 9, 2022. Of the 5,201 studies initially identified, 88 were fully assessed and 14 RCTs were included. A total of 2,399 interventions were analyzed in 576 patients. Certainty of evidence was found to be of low quality for the outcomes remineralization, structural integrity maintenance, and decay prevention, and very low quality for hypersensitivity decrease and retention. Conclusions: Mild molar hypomineralization needs remineralization, desensitization, sealants, and close follow-up. Severe MH requires restoration both to treat hypersensitivity and reconstruct the affected teeth. Yellow-brown defects have a poor prognosis. [ABSTRACT FROM AUTHOR]

Introduction: Molar incisor hypomineralization (MIH) is a developmental enamel defect affecting permanent molars and incisors, leading to dental challenges. The prevalence and associated risk factors of MIH vary globally, highlighting the need for region-specific studies. The primary objectives of this cross-sectional study were to determine the prevalence of MIH in 7- to 11-year-old school children, investigate associated risk factors, and analyze the clinical manifestations. Materials and methods: A random sample of 10,000 children aged 7 to 11 years from 10 primary schools in North Kerala underwent oral examinations. The study utilized a two-part proforma, including demographic details, parental interviews, and clinical assessments using a modified developmental defect of enamel index. The data were analyzed using the chi-square test and SPSS software. Ethical approval and parental consent were obtained. Results: Out of 2170 children examined, the prevalence of MIH was 8.2%. Males showed a higher prevalence (62.92%), with maxillary molars being predominantly affected. The study revealed significant associations between MIH and antenatal factors, antibiotic usage, and maternal illnesses. Maxillary molars were more frequently affected than mandibular molars, with specific teeth showing varying degrees of susceptibility. Conclusion: As children's age increased, the severity of MIH defects in the first permanent molars escalated, indicating progressive enamel defects. The prevalence of MIH was more pronounced in the upper arch, with both maxillary and mandibular first permanent molars being equally affected. The study identified factors such as polychlorinated biphenyls (PCBs)/dioxins, medical illness problems, malnutrition, fluoride exposure, common medical diseases, and genetic disorders as potential contributors to MIH defects. Early diagnosis and intervention are crucial for managing the challenges posed by MIH-affected teeth. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopadie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Patients with salivary gland hypofunction typically complain of dry mouth, difficulty chewing, swallowing and/or speaking; they hardly tolerate spicy, acidic, and crunchy food and often report taste changes or difficulty wearing dentures. It can also increase the chance of developing dental decay, demineralization of teeth, tooth sensitivity, and oral infections. The goals of treating xerostomia include identifying possible causes, relieving discomfort, and preventing complications. In this study, we investigate the most effective frequency to increase salivary secretion, without side effects on the skin and orofacial structures. Transcutaneous electric nerve stimulation (TENS) is a simple, inexpensive, and non-invasive modality that uses electric current to activate nerves for therapeutic reasons. It is a non-pharmacological method of pain management for which it is widely used. The application of electric impulses to one or more of the three components of the salivary reflex arch should theoretically improve salivary secretion and lessen the various long-term effects of hyposalivation. For this study a total of 23 published studies in the last 10 years were analyzed. The study is made on narrative review of the published articles that go into the related subject, evaluation of the impact of a transcutaneous electrical nerve stimulation (TENS) system on patients' dry mouth and salivary flow rates. The TENS unit was effective in increasing the quantity of stimulated saliva and was also found to be more effective in increasing saliva in diabetic individuals. From the results of the study, it can be concluded that TENS was effective in increasing the salivary flow rate in hyposalivatory patients with residual saliva. [ABSTRACT FROM AUTHOR]

The formation of white spot lesions, or enamel demineralization, around fixed orthodontic attachments is a common complication after the end of fixed orthodontic treatment. This article is a contemporary review of measures for the prevention of white spot lesions during orthodontic treatment with fixed appliances. Preventive programs must be included for all orthodontic patients by educating and oral hygiene motivation for using topical fluoride agents, casein phosphopeptide-amorphous calcium phosphate agents, high-fluoride toothpaste, fluoride mouthwashes, gels and varnishes during and after the orthodontic treatment so as antimicrobial agents and resin infiltration. Reducing the risk of WSL formation by using these methods and early treatment with the appropriate technique is recommended to obtain healthier and more aesthetic results. [ABSTRACT FROM AUTHOR]

Resin infiltration (RI) is used to mask enamel opacities. There are three recommended etching cycles. However, anecdotal evidence suggests that favorable esthetics outcomes can be obtained by increasing the etching cycles. This study aimed to evaluate the effects of repeated etching cycles during RI application on esthetic changes and surface roughness of demineralized enamel at multiple treatment stages. Artificial demineralization was prepared on the buccal surface of ninety sound extracted premolars. The teeth were divided into nine groups (n = 10); with each consecutive group having one additional etching cycle up to nine etching cycles. Resin infiltrant was performed twice, first for 3 min (Resin 1) and again for 1 min (Resin 2). Surface roughness and esthetic changes were assessed using a profilometer (Ambios XP-200) and Minolta spectrophotometer, respectively, at baseline (sound enamel), etching, resin 1, resin 2, 7 days, and 28 days post resin applications. Data were analyzed with two-way ANOVA (p < 0.05). There was a significant interaction between the different stages and various groups of etching cycles on surface roughness, F(48, 126) = 3.48, p < 0.001. There was a significant interaction between the different stages and various groups of etching cycles on color changes, F(4, 126) = 1.177, p = 0.045. The surface roughness of demineralized enamel infiltrated with RI was less than that of sound enamel (baseline). There is a significant difference in color changes between resin 1 and resin 2 (p < 0.05). After five etching cycles, RI improved the esthetic of the color of teeth similar to the baseline. Surface roughness and color changes remained constant for 28 days. RI can be considered an effective and predictable treatment option for the restoration of early enamel lesions owing to its better surface characteristics and reliable masking effects. The color stability and surface roughness stay unaltered for up to 28 days. [ABSTRACT FROM AUTHOR]

Background: Molar incisor hypomineralization (MIH) is the hypomineralization of systemic origin of one to four permanent first molars, frequently associated with affected incisors. It is presented as demarcated enamel opacities of different colors, occasionally undergoing posteruptive breakdown. The characteristic feature of MIH is the clear demarcation between the affected and sound enamel. There is an asymmetry of defects present in the molars and incisors where one molar or incisor can be severely affected, while the contralateral tooth may be clinically sound or have only minor defects. Aim: The study aimed to assess and compare the knowledge, perceptions, and clinical experience of general dental practitioners (GDPs), pediatric dentists (PDs), and other dental specialists (DSs) in Northern India about MIH. Methodology: Online survey methods were used to collect the responses from Northern Indian dentists regarding their knowledge and perceptions about MIH. The survey tool focused on participants' sociodemographics, clinical experience, perceptions, clinical management, and preferences for further training. The level of knowledge regarding MIH was compared among the three groups. Data analysis utilized Chi-square and one-way analysis of variance followed by Tukey's post hoc test using SPSS Statistics version 26. Results: The majority of respondents had observed MIH in their practice (77.3%). The participants who had a postgraduate degree had a significantly higher knowledge score value than GDPs (P < 0.001). Conclusion: Dissemination of evidence on MIH to dental practitioners, especially to GDPs, is highly needed to assure confidence in MIH diagnosis at an early stage when it can be best managed. [ABSTRACT FROM AUTHOR]

Copyright of RSBO: Revista Sul-Brasileira de Odontologia is the property of UNIVILLE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A paradental cyst (PC) is one of the inflammatory odontogenic cysts, which occurs on partially erupted or impacted mandibular third molar found on their mesial and distal or buccal aspects. It is one of the rarity included in the year 1992 by the WHO as one of the histological typing of odontogenic tumors. It has been hypothesized that reduced enamel epithelium is one of its sources of origin or expansion of the dental follicle unilaterally which could be secondary to the destruction of periodontium. This entity holds a lower prevalence rate of 3%-5% of all odontogenic cysts. It is likely that many cases of PC are diagnosed as inflamed dentigerous cyst. The present case report focuses on a case of PC affecting the permanent mandibular third molar. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to systematically review the ability of resin infiltration to conceal demineralized enamel lesions to normal enamel translucency and to maintain color stability. Materials and Methods: A literature search of PubMed, MEDLINE, Web of Science, and Scopus databases and a manual search of articles from 2009 to 2021 for randomized controlled trials (RCTs) and clinical efficacy trials (nonrandomized) were performed. Methodological quality and risk of bias (RoB) of included papers was assessed using Cochrane Collaboration Risk of Bias Tool 2.0 for RCTs and ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool for nonrandomized studies. Results: A total of 352 titles and abstracts were reviewed. Eight RCTs and three clinical efficiency studies were included in this review. The masking effects of the demineralized enamel lesion were reported immediately after resin infiltration, and the color stability of this material was up to 24 months, with no adverse effects noted. For RCTs, four studies were classified as "some concerns" and four were as "low RoB." For nonrandomized studies, all of the studies presented an overall moderate RoB. Conclusion: Resin infiltration achieves the best esthetic outcomes compared with microabrasion and remineralization therapy. Color stability was achieved with this material for up to 24 months and no adverse effects were noted. Factors contributing to the esthetic outcomes of the resin include the elimination of the hypermineralized surface layer, the homogeneity of the resin itself, and polishing after resin infiltration. Longitudinal follow-up and improved control of confounding variables should characterize future high-quality systematic reviews. [ABSTRACT FROM AUTHOR]

Background: Patient demand for esthetic dental treatments is increasing, and among different techniques, tooth bleaching is a popular procedure for smile improvement. There is a controversy over the demineralizing effect of hydrogen peroxide (HP) containing bleaching agents on tooth enamel. The aim of this study was to evaluate the effect of HP and its combinations with hydroxyapatite (HA) and bioactive glass (BG) on enamel demineralization and tooth color changes. Materials and Methods: Three groups of 20 teeth were used. Bleaching regimens included HP alone, HP + HA, and HP + BG. Bleaching was repeated at six periods of 15 min. Energy dispersive spectrometry was performed to evaluate calcium, phosphorus, sodium, magnesium, and fluoride content of superficial enamel before and after bleaching. Tooth color was evaluated by spectrophotometer before and after bleaching and ΔE values were calculated. Data were statistically analyzed using SPSS version 17. Results: Ca and P content was increased significantly in group HP + BG (P < 0.05). There was no significant difference in ΔE values between the three groups (P > 0.05).(p value = 0.34). Conclusion: Addition of BG to HP can increase superficial enamel mineral content after bleaching and has no effect on tooth color changes in comparison to HP alone. [ABSTRACT FROM AUTHOR]

Background and Aim: One of the main reasons that patients seek orthodontic treatment is aesthetics. Unfortunately, treatment with fixed orthodontic appliances can at times increase the chances of developing white spot lesions on the surfaces of teeth, thus creating a new aesthetic issue for the patient. The prevalence of white spot lesions (WSL) reported after treatment varies from 2% to 97%, and these lesions can occur despite increased attention to hygiene. Hence the aim of this study was to assess the effect of Amine fluoride mouthwash in preventing white spot lesions during fixed orthodontic therapy. Materials and Methods: Study participants were randomly divided into two groups (Group A - experimental 25 patients and Group B - control 25 patients). The pre-intervention and post-intervention intra-oral digital photographs were analysed by using ImageJ software to assess the percentage of the facial surface affected on the teeth (10 maxillary teeth), which had white spot lesions. Results: The mean value of WSLs showed significant difference between the experimental and control groups. Mean values of WSL in the experimental group decreased from 2 to 1.54 with a mean difference of 0.46 after 6 months of follow-up which indicated that amine fluoride mouthwash was effective in preventing WSLs during fixed orthodontic treatment. Conclusion: WSLs scores were significantly reduced in patients who received the mouthwash when compared to patients who followed standard oral hygiene regimen with fluoridated toothpaste only. In clinical practice, amine fluoride mouthwash is an effective method for the prevention of WSLs during fixed orthodontic treatment. [ABSTRACT FROM AUTHOR]

(1) Background: Molar-incisor hypomineralization (MIH) is a clinical condition affecting permanent teeth in children, with a documented rising trend in the last two decades. The aim of the present study was to analyze and synthesize the available evidence on caries experience (dmft/DMFT) and MIH in children. (2) Methods: A systematic review and meta-analysis were conducted according to the PRISMA statement. (3) Results: 59 papers published between 2007 and 2022 were included in the qualitative synthesis and 18 in the meta-analysis. The total sample of subjects was 17,717 (mean: 896), of which 2378 (13.4%) had MIH (mean: 119), with a girl/boy ratio of 1:1. The mean age of the enrolled participants was 8.6 (age range 7–10 years). Meta-analysis showed that MIH has a positive correlation with both dmft (effect size of 0.67, 95% CI [0.15, 1.19]) and DMFT (effect size of 0.56, 95% CI [0.41, 0.72]); (4) Conclusions: Children with MIH should be diagnosed correctly and on time. Treatment and management options for moderate and severe forms of MIH should consider prognosis based on known risk factors, and secondary and tertiary prevention policies should also consider the multifactorial nature of caries etiology. [ABSTRACT FROM AUTHOR]

This study investigated the prevalence and associations of molar–incisor hypomineralisation (MIH) in 8–9 year‐old children in Oslo. A total of 3013 children in one age cohort participated in the study during their regular dental examination at the Public Dental Service. Hypomineralised enamel defects were recorded according to the European Academy of Paediatric Dentistry criteria for MIH. Information on health and medications used during pregnancy and in the child's first 3 years of life was obtained from a questionnaire administered to parents. The overall prevalence of MIH was 28.2%, with no gender difference. A higher prevalence of MIH was found in children who had been ill or had used medication in early life and in those whose mother had been ill during pregnancy. No association was found between MIH and prematurity or maternal use of medication during pregnancy. The multivariable analyses showed that children with MIH were more likely to have suffered from illness in early life (OR = 1.41, 95% CI: 1.17–1.70), used antibiotics during the first year of life (OR = 1.68, 95% CI: 1.19–2.35), experienced tooth pain (OR = 1.33, 95% CI: 1.03–1.72), and experienced pain while toothbrushing (OR = 2.17, 95% CI: 1.46–3.23) than children without MIH. The prevalence of MIH was high in the children participating in this study. [ABSTRACT FROM AUTHOR]

The objective of the research was to examine the scientific literature concerning restorative materials with bioactive properties for the purpose of covering dentin. Searches were performed in various databases including MEDLINE, Scopus, Web of Science, Cochrane Library, Lilacs/BBO, and Embase. Inclusion criteria involved studies that utilized the terms "dentin" and "bioactive", along with "ion-releasing", "smart materials", "biomimetic materials" and "smart replacement for dentin". The information extracted included the title, authors, publication year, journal and the country of affiliation of the corresponding author. The studies were categorized based on their study design, type of material, substrate, analytical method, and bioactivity. A total of 7161 records were recovered and 159 were included for data extraction. Most of the publications were in vitro studies (n = 149), testing different types of materials in sound dentine (n = 115). Most studies were published in Dental Materials (n = 29), and an increase in publications could be observed after the year 2000. Most of the articles were from the USA (n = 34), followed by Brazil (n = 28). Interfacial analysis was the most investigated (n = 105), followed by bond strength (n = 86). Bioactivity potential was demonstrated for most tested materials (n = 148). This review presents insights into the current trends of bioactive materials development, clearly showing a severe lack of clinical studies. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of fluoride-containing whitening products on sound enamel and on artificial caries lesions during a cariogenic challenge. Materials and methods: Bovine enamel specimens (n = 120) with three areas [non-treated sound enamel (NSE), treated sound enamel (TSE), and treated artificial caries lesion (TACL)] were randomly assigned to the four groups: whitening mouthrinse (WM: 2.5% hydrogen peroxide-100 ppm F−), placebo mouthrinse (PM: 0% hydrogen peroxide-100 ppm F−), whitening gel (WG: 10% carbamide peroxide-1130 ppm F−), and deionized water (negative control; NC). The treatments (2 min for WM, PM, and NC, and 2 h for WG) were carried out during a 28-day pH-cycling model (6 × 60 min demineralization/day). Relative surface reflection intensity (rSRI) and transversal microradiography (TMR) analyses were performed. Fluoride uptake (surface and subsurface) was measured in additional enamel specimens. Results: For TSE, a higher value of rSRI was observed in WM (89.99% ± 6.94), and a greater decrease in rSRI was observed for WG and NC, and no sign of mineral loss was verified for all groups (p > 0.05). For TACL, rSRI significantly decreased after pH-cycling for all experimental groups with no difference between them (p < 0.05). Higher amounts of fluoride were found in WG. WG and WM exhibited intermediate values of mineral loss, similar to PM. Conclusions: The whitening products did not potentialize the enamel demineralization under a severe cariogenic challenge, and they did not exacerbate mineral loss of the artificial caries lesions. Clinical relevance: Low concentrated hydrogen peroxide whitening gel and mouthrinse containing fluoride do not intensify the progression of caries lesions. [ABSTRACT FROM AUTHOR]

Aim: The present study aims to evaluate the efficacy of naturally-derived bovine hydroxyapatite (Cerabone) versus demineralized freeze-dried bone allograft both combined with platelet-rich fibrin for treatment of grade II mandibular furcation defects. Method: This clinical study included 20 systemically healthy patients, with grade II mandibular furcation defects, performed over 6 months. Control group comprised of open flap debridement + demineralized freeze-dried bone allograft + platelet-rich fibrin and test group comprised of open flap debridement + Cerabone + platelet-rich fibrin. Clinical parameters included: Plaque index, Modified Sulcular bleeding index, Vertical probing pocket depth, Horizontal probing depth, Probing clinical attachment level, Radiographic furcation depth, and radiographic bone fill percentage. Results: Both groups showed satisfactory bone regeneration and improvement in clinical parameters. The test group exhibited greater reduction in vertical probing pocket depth, horizontal probing depth, and higher radiographic bone fill percentage when compared to control group, although these findings were not statistically significant. Conclusion: Both bone grafts were equally effective in treatment of grade II furcation defects. Further long-term studies are required to explore their maximum regenerative potential. [ABSTRACT FROM AUTHOR]