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Objective: To assess the effectiveness of the REFIX technology in the remineralization process of initial caries simulated on bovine enamel. The assessment involved the analysis of backscatter intensity, which was determined from laser speckle images. Method: Twenty‐one bovine teeth were divided into three groups: G1 and G7 were submitted to treatment with the REFIX technology for 1 and 7 days, respectively. The control group was treated with deionized water. Results: A significant difference in backscatter was found between the carious and sound areas in all groups (p = 0.0038, p < 0.0001, and p = 0.0002 for the control group, G1, and G7, respectively). The intergroup comparison revealed no significant difference among the groups studied. Conclusion: REFIX technology did not alter the optical properties of the samples of bovine teeth with simulated initial caries lesions after 1 and 7 days of treatment. [ABSTRACT FROM AUTHOR]

Background: Inequalities in immigrants' oral health are often masked in population-level data. Therefore, this paper was planned to assess the prevalence data on oral health diseases, namely dental caries, and periodontitis, among immigrants worldwide. Methods: Following a systematic search in Scopus, Embase, and PubMed for studies published between 2011 and 2023, 1342 records were identified. Following title and abstract screening, 76 studies remained for full-text eligibility-screening based on predefined inclusion criteria. Thirty-two studies were included in the review. Results: Dental caries figures were higher in immigrant populations compared to the local population, regardless of host countries, age, gender, or nationality. In children, the overall mean and standard deviation (SD) for decayed, missing, and filled teeth in the primary dentition (d3mft) was 3.63(2.47), and for D3MFT (permanent dentition), it was 1.7(1.2). Upon comparing overall mean caries counts in children and adults with their control groups in the included studies, untreated dental caries (D3T and d3t) constituted the dominant share of caries experience (D3MFT and d3mft) in immigrant children. For the local population, the highest proportion of caries experience was attributed to filled teeth (FT and ft). Dentin caries prevalence among immigrants ranged from 22% to 88.7% in the primary dentition and 5.6% to 90.9% in the permanent dentition. Gingivitis ranged from 5.1% to 100%. Oral health varied greatly between studies. Regarding oral health accessibility, 52% to 88% of immigrant children had never been to a dentist, suggesting a very limited level of accessibility to dental health services. Conclusion: It is imperative to develop interventions and policies that have been customized to address the oral health disparities experienced by immigrant populations. Additionally, host countries should actively implement measures aimed at enhancing the accessibility of oral health care services for these individuals. The utilization of available data is crucial in establishing a hierarchy of objectives aimed at enhancing the oral health of immigrant populations. Trial registration: The Scoping review protocol was registered at OSF Registries with registration number (https://doi.org/10.17605/OSF.IO/MYXS4). [ABSTRACT FROM AUTHOR]

Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel. [ABSTRACT FROM AUTHOR]

Abstract Background The aim of this systematic review is to evaluate the diagnostic performance of Artificial Intelligence (AI) models designed for the detection of caries lesion (CL). Materials and methods An electronic literature search was conducted on PubMed, Web of Science, SCOPUS, LILACS and Embase databases for retrospective, prospective and cross-sectional studies published until January 2023, using the following keywords: artificial intelligence (AI), machine learning (ML), deep learning (DL), artificial neural networks (ANN), convolutional neural networks (CNN), deep convolutional neural networks (DCNN), radiology, detection, diagnosis and dental caries (DC). The quality assessment was performed using the guidelines of QUADAS-2. Results Twenty articles that met the selection criteria were evaluated. Five studies were performed on periapical radiographs, nine on bitewings, and six on orthopantomography. The number of imaging examinations included ranged from 15 to 2900. Four studies investigated ANN models, fifteen CNN models, and two DCNN models. Twelve were retrospective studies, six cross-sectional and two prospective. The following diagnostic performance was achieved in detecting CL: sensitivity from 0.44 to 0.86, specificity from 0.85 to 0.98, precision from 0.50 to 0.94, PPV (Positive Predictive Value) 0.86, NPV (Negative Predictive Value) 0.95, accuracy from 0.73 to 0.98, area under the curve (AUC) from 0.84 to 0.98, intersection over union of 0.3–0.4 and 0.78, Dice coefficient 0.66 and 0.88, F1-score from 0.64 to 0.92. According to the QUADAS-2 evaluation, most studies exhibited a low risk of bias. Conclusion AI-based models have demonstrated good diagnostic performance, potentially being an important aid in CL detection. Some limitations of these studies are related to the size and heterogeneity of the datasets. Future studies need to rely on comparable, large, and clinically meaningful datasets. Protocol PROSPERO identifier: CRD42023470708

Background: The aim of this systematic review is to evaluate the diagnostic performance of Artificial Intelligence (AI) models designed for the detection of caries lesion (CL). Materials and methods: An electronic literature search was conducted on PubMed, Web of Science, SCOPUS, LILACS and Embase databases for retrospective, prospective and cross-sectional studies published until January 2023, using the following keywords: artificial intelligence (AI), machine learning (ML), deep learning (DL), artificial neural networks (ANN), convolutional neural networks (CNN), deep convolutional neural networks (DCNN), radiology, detection, diagnosis and dental caries (DC). The quality assessment was performed using the guidelines of QUADAS-2. Results: Twenty articles that met the selection criteria were evaluated. Five studies were performed on periapical radiographs, nine on bitewings, and six on orthopantomography. The number of imaging examinations included ranged from 15 to 2900. Four studies investigated ANN models, fifteen CNN models, and two DCNN models. Twelve were retrospective studies, six cross-sectional and two prospective. The following diagnostic performance was achieved in detecting CL: sensitivity from 0.44 to 0.86, specificity from 0.85 to 0.98, precision from 0.50 to 0.94, PPV (Positive Predictive Value) 0.86, NPV (Negative Predictive Value) 0.95, accuracy from 0.73 to 0.98, area under the curve (AUC) from 0.84 to 0.98, intersection over union of 0.3–0.4 and 0.78, Dice coefficient 0.66 and 0.88, F1-score from 0.64 to 0.92. According to the QUADAS-2 evaluation, most studies exhibited a low risk of bias. Conclusion: AI-based models have demonstrated good diagnostic performance, potentially being an important aid in CL detection. Some limitations of these studies are related to the size and heterogeneity of the datasets. Future studies need to rely on comparable, large, and clinically meaningful datasets. Protocol: PROSPERO identifier: CRD42023470708 [ABSTRACT FROM AUTHOR]

Background: This study compared natural root caries lesions with artificial root caries lesions prepared with one of the two demineralising solutions. Methods: Twelve natural root caries lesions on upper incisors and 24 artificial root lesions were prepared on sound root surfaces using 50 mM acetic acid, 1.5 mM CaCl2, 0.9 mM KH2PO4 at pH 5.0 or 80 mL/L Noverite K‐702 polyacrylate solution, 500 mg/L hydroxyapatite, 0.1 mol/L lactic acid at pH 4.8 (n = 12/group) for 96 hours. Lesions were scanned using micro‐CT. Inciso‐gingival oriented images were analysed and mineral density calculated at 7.5 μm increments from the surface to 225‐μm deep. Sectioned lesions were analysed by Knoop microhardness up to 250 μm from the lesion surface. Data were analysed by the Dunn's test with Bonferroni correction. Results: Natural and artificial lesion mean mineral densities were not statistically different (P > 0.05). Mineral density from the surface to 75 μm was greater in natural lesions and from 150 to 225 μm was greater in artificial lesions (P < 0.05). Microhardness values were statistically higher in artificial lesions (P < 0.05); no difference was found among artificial lesions produced by the two solutions (P > 0.05). Mineral density and microhardness of natural and artificial root caries are different from each other. A greater mineralized surface layer existed on natural lesions. [ABSTRACT FROM AUTHOR]

Resin infiltration is an effective method to mask vestibular white spots. If needed, external bleaching is usually recommended before infiltration, whilst in clinical practice, this sequence may not always be feasible. This in vitro study evaluated the effect of bleaching after resin infiltration regarding surface roughness and color using bovine incisors. Unlike for the untreated specimens (control, n = 25), artificial caries lesions were created within the test group (n = 25) using a demineralization solution at 37 °C for five days (pH = 4.95). The lesions were subsequently infiltrated using a resin infiltrant (Icon, DMG, Hamburg, Germany), followed by polishing. Afterwards, all specimens were bleached with a 10% carbamide peroxide gel (Opalescence, Ultradent, South Jordan, UT, USA) for 8 h/day over a ten-day period. Between bleaching treatments, specimens were stored in an opaque container with moistened paper tissues at 37 °C. Surface roughness was measured using a profilometer, and color in the L*a*b* space was assessed spectrophotometrically before and after bleaching. Bleaching increased the L*-values of both infiltrated (mean ± SD; ΔL* = 3.52 ± 1.98) and untreated (control) specimens (ΔL* = 3.53 ± 2.30) without any significant difference between the groups (p = 0.983). Bleaching also induced a significant increase in the mean surface roughness of both infiltrated (p < 0.001) and untreated (p = 0.0134) teeth. In terms of clinical relevance; it can be concluded that bleaching resin-infiltrated enamel is as effective as bleaching sound enamel.

orthodontic treatment is an undesirable side effect of treatment that arises because the fixed appliance tends to accumulate plaque. The aim of this study was to examine the white spot lesions (WSL), caries incidence, and decayed, missing, and filled teeth (DMFT) indices in patients with fixed orthodontic treatments. Methodology: The records of 150 patients treated at Necmettin Erbakan University Department of Orthodontics between 2018 and 2022 who met the study selection criteria were examined. Traditional methods and 2D color photographs were used to detect cavities. Pretreatment (T0) and post-treatment (T1) recordings were made. Results: Overall, 118 patients (78.6%) developed at least 1 new WSL during treatment and 49 patients (32.6%) developed active caries lesions. Increases in WSL, caries incidence, and the DMFT index were important during the treatment process. The length of treatment and the number of oral hygiene warnings were significantly associated with the development of new lesions. Conclusion: Individuals undergoing fixed orthodontic treatment have a significant incidence of WSLs and caries lesions. Patients and physicians should pay strict attention to this problem to effectively prevent caries occurrence during treatment. [ABSTRACT FROM AUTHOR]

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Background/purpose: Monitoring the effects of different caries-preventive agents on initial caries lesions in orthodontic patients is important. Therefore, the purpose of this study is to investigate the efficacy of different preventive methods in preventing occlusal and proximal incipient lesions (ILs) during fixed orthodontic treatment. Materials and methods: Forty-eight subjects at the beginning of fixed orthodontic treatment were included. All subjects were well educated and motivated to use the fluoride toothpaste (Colgate Total, 1450 ppm F) three times a day during the study period. Four different groups were created with a split-mouth design: placebo, fluoride gel, fluoride varnish, and chlorhexidine varnish. The occlusal surfaces of the second molar teeth were assessed with DIAGNOdent pen (DD) during the first 12 months (6th and 12th), and the proximal surfaces of each quadrant were monitored using bitewing radiographs until the 24th month (baseline and 24th month). Results: The mean DD values increased in each group during the first 6 months compared to the baseline, but a significant increment was only obtained in the control and fluoride gel groups (p 0.05). No significant differences were found between the four methods in terms of caries progression for proximal ILs after 24 months. Conclusion: Effective toothbrushing with 1450 ppm fluoridated toothpaste and topical fluoride gel application seems to be inadequate for prevention of new proximal ILs during fixed orthodontic treatment. Fluoride and chlorhexidine varnish showed more protection in relation to occlusal surfaces.

Benefits of cone beam computed tomography (CBCT) over traditional panoramic radiography for diagnosis and treatment planning have been reported. This article presents a case where CBCT was used to identify the potential route of caries infection from the oral cavity to an impacted mandibular second molar. [ABSTRACT FROM AUTHOR]

In recent years the concept of minimally invasive dentistry has offered a more conservative approach to restoration of teeth with caries lesions. Several techniques have been suggested for treatment of proximal lesions, but their results have been less than ideal. The aim of this article is to present a new technique for ultraconservative restoration of small interproximal caries lesions that avoids the disadvantages of both the tunnel and the proximal slot restorative techniques. Two cases, of patients with high and low caries risk, are presented to illustrate the technique. The proposed technique can be considered the most conservative alternative to conventional Class 2 or slot-cavity treatment approaches. [ABSTRACT FROM AUTHOR]

The infectious disease denial caries results in lesions that may affect enamel, dentin, pulp, and cementum. If a caries lesion has progressed to the stage at which it requires restorative intervention, it is important that the clinician understand the tissue changes in the dentin that are likely to have taken place during lesion development. Until the present, no major distinction between the restorative treatment of active (rapidly progressing) and arrested (slowly progressing) lesions has been made, despite the fact that the two conditions exhibit major differences in tissue changes in the pulp-dentin complex. Intratubular changes and tertiary dentin formation will affect the outcome of the restorative treatment. In unaffected dentin and in rapidly progressing lesions, permeable tubules persist, and when the preparation of carious teeth results in the opening of unaffected dentin, greater care must be taken in all phases of the restorative procedures than if the dentin is impermeable. An active, deep lesion can be changed to an arrested lesion by a two-step excavation approach. Optimal assessment of the prevailing clinical conclusions can only be made on the basis of thorough knowledge of the biology of the pulp-dentin organ. (Quintessence Int 2001.'32. 717-736) [ABSTRACT FROM AUTHOR]

• Laser speckle imaging was used to evaluate enamel remineralization induced by bioactive materials. • Treatments based on bioactive remineralizing materials may represent the best approach to repair enamel wihite-spot lesions. • Laser speckle imaging may represent an ideal approach for early detection and assessment of remineralization of early caries lesions. This study aimed at evaluating the remineralization effect promoted by different bioactive fillers on simulated early caries lesions in enamel (ECLE). Forty sound bovine incisors were used to prepare buccal enamel specimens (6 × 6 × 2 mm). The specimens were divided into two areas (3 × 3 mm²): control (CTR) and experimental (EXP). All the enamel specimens were then submitted to a specific protocol for a period of 48 h to induce simulated caries lesions. Subsequently, the specimens were treated for 7 days (2 min, twice a day) with a slurry pastes containing different bioactive particles (P/L ratio: 1 g/mL). All the specimens were analyzed by laser speckle before and after treatments. The results showed after the first analysis that the ECLE had very low average intensity (back-scattered light). Conversely, after application of the bioactive pastes, higher average intensity was always detected; this was comparable to CTR sound specimens. In conclusion, innovative pastes/gels developed for enamel remineralization should contain bioactive particles that when applied daily on early caries lesions may "boost" the remineralization process to reestablish a sound enamel. [ABSTRACT FROM AUTHOR]

Background/purpose Monitoring the effects of different caries-preventive agents on initial caries lesions in orthodontic patients is important. Therefore, the purpose of this study is to investigate the efficacy of different preventive methods in preventing occlusal and proximal incipient lesions (ILs) during fixed orthodontic treatment. Materials and methods Forty-eight subjects at the beginning of fixed orthodontic treatment were included. All subjects were well educated and motivated to use the fluoride toothpaste (Colgate Total, 1450 ppm F) three times a day during the study period. Four different groups were created with a split-mouth design: placebo, fluoride gel, fluoride varnish, and chlorhexidine varnish. The occlusal surfaces of the second molar teeth were assessed with DIAGNOdent pen (DD) during the first 12 months (6th and 12th), and the proximal surfaces of each quadrant were monitored using bitewing radiographs until the 24th month (baseline and 24th month). Results The mean DD values increased in each group during the first 6 months compared to the baseline, but a significant increment was only obtained in the control and fluoride gel groups (p < 0.05). Fluoride and chlorhexidine varnish had significantly more preventive effects than the control and the fluoride gel for occlusal surfaces at the 6th and 12th month and for intact proximal surfaces at the 24th month, but no significant differences were found between the two varnish groups (p > 0.05). No significant differences were found between the four methods in terms of caries progression for proximal ILs after 24 months. Conclusion Effective toothbrushing with 1450 ppm fluoridated toothpaste and topical fluoride gel application seems to be inadequate for prevention of new proximal ILs during fixed orthodontic treatment. Fluoride and chlorhexidine varnish showed more protection in relation to occlusal surfaces. [ABSTRACT FROM AUTHOR]

Background This study presents the correlation between laser speckle images and detection of incipient caries lesions from changs in the microstructure of the surface of tooth enamel. Methods We used 30 healthy deciduous molar teeth collected from the Biobank Human Teeth, Faculty of Dentistry, University of São Paulo who had carious lesions induced by the pH cycling method. The samples were evaluated for the diagnosis of caries by two methods ICDAS and speckle pattern of coherent light scattering after 5, 10 and 15 days and the results were statistically analyzed using α = 0.05 significance level. Results A significant difference was observed between the image of the speckle scattering of healthy and injured areas within the 3 study groups, but not when comparing the three groups, showing us that it is an innovative technique that needs further study, but can be used as a diagnostic method for the detection of early caries lesions. Conclusion It can be concluded that the analysis of scattering speckle pattern is a diagnostic technique that provides information on the microstructure of the surface of tooth enamel which has sensitivity for detection of incipient caries lesions. [ABSTRACT FROM AUTHOR]

Proximal caries infiltration has been shown to be efficacious in hampering caries lesion progression when performed by dentists working in a university setting. The aim of this randomized split-mouth, placebo-controlled clinical trial was to assess the efficacy of resin infiltration of proximal caries lesions being performed by several dentists in private practices, in combination with individualized oral hygiene plus noninvasive measures compared with these alone. In this study, 87 children and young adults (with 238 pairs of proximal caries lesions radiographically extending into the inner half of the enamel [E2] or the outer third of the dentin [D1]) were randomly allocated to either 1 of 2 treatments. Test lesions were infiltrated, and a mock treatment was performed in control lesions by 5 German private practitioners. All patients received instructions for a noncariogenic diet, flossing and fluoridation, and individualized noninvasive interventions. The primary outcome was radiographic lesion progression (pairwise comparison) evaluated independently by 2 evaluators who were blinded to treatment allocation. After approximately 10 mo (mean ± SD 307 ± 43 d), 92 of 148 lesion pairs in 24 of 38 treated patients who were at high caries risk could be re-evaluated clinically as well as radiographically using individualized bitewing holders, as at baseline; 186 of 204 lesion pairs in 70 of 77 patients (35 of 38 high-risk patients) could be evaluated after 18 mo (mean 542 ± 110 d). No unwanted effects were observed. After 10 mo, progression was recorded in 2 of 92 test lesions (2%) and in 22 of 92 control lesions (24%) (P= 0.001, McNemar/Obuchowski test; relative risk reduction, 91; 95% confidence interval, 62%-98%). After 18 mo, lesion progression was recorded in all included patients in 10 of 186 test lesions (5%) and in 58 of 186 control lesions (31%) (P< 0.001; relative risk reduction, 83; 95% confidence interval, 67%-91%). Thus, resin infiltration seems to be more efficacious in reducing lesion progression compared with individualized noninvasive measures alone over a period of 18 mo when performed in a private practice setting by various practitioners (German Clinical Trials Register / Deutsches Register Klinischer Studien DRKS00009963). [ABSTRACT FROM AUTHOR]

Nablus mask-like facial syndrome (NMLFS) (OMIM: 608156) is an extremely rare genetic syndrome first reported by Ahmad Teebi in 2000. Although it is a rare condition, it is characterized by distinctive facial features such as, expressionless facial appearance, tight, glistening facial skin, low anterior hairline, sparse eyebrows, small palpebral fissures (blepharophimosis), hypertolerism, bulbous nose with prominent columella, abnormally short nose and flat nasal bridge, abnormal ear configuration, bilateral longitudinal cheek dimples, everted lower lip, long philtrum, and maxillary hypoplasia. In addition, a happy and friendly disposition is considered to be the common symptom of this syndrome. Previous studies revealing the intraoral findings of this rare symptom are inadequate and the present report is the first one that presents a dental case involving Nablus syndrome in detail. The aim of this report is to contribute to the current literature through our oral findings in an NMFLS patient, presented at our clinic with toothache and through our treatment approach., Competing Interests: The authors declare no conflict of interest., (©2023 The Author(s). Published by MRE Press.)

The aims of this laboratory study were to compare the effects of lesion baseline severity, mineral distribution and substrate on remineralization and progression of caries lesions created in root dentin. Lesions were formed in dentin specimens prepared from human and bovine dentin using three protocols, each utilizing three demineralization periods to create lesions of different mineral distributions (subsurface, moderate softening, extreme softening) and severity within each lesion type. Lesions were then either remineralized or demineralized further and analyzed using transverse microradiography. At lesion baseline, no differences were found between human and bovine dentin for integrated mineral loss (x0394;Z). Differences in mineral distribution between lesion types were apparent. Human dentin lesions were more prone to secondary demineralization (x0394;x0394;Z) than bovine dentin lesions, although there were no differences in x0394;L. Likewise, smaller lesions were more susceptible to secondary demineralization than larger ones. Subsurface lesions were more acid-resistant than moderately and extremely softened lesions. After remineralization, differences between human and bovine dentin lesions were not apparent for x0394;x0394;Z although bovine dentin lesions showed greater reduction in lesion depth L. For lesion types, responsiveness to remineralization (x0394;x0394;Z) was in the order extremely softened>moderately softened>subsurface. More demineralized lesions exhibited greater remineralization than shallower ones. In summary, some differences exist between human and bovine dentin and their relative responsiveness to de- and remineralization. These differences, however, were overshadowed by the effects of lesion baseline mineral distribution and severity. Thus, bovine dentin appears to be a suitable substitute for human dentin in mechanistic root caries studies. [ABSTRACT FROM AUTHOR]

Objective This in situ study evaluated the effect of fluoride varnish combined with CO 2 laser in controlling enamel demineralization caused by cariogenic challenges. Design In a crossover study conducted in 2 phases of 14 days each, 14 volunteers ( n = 14) wore palatal appliances with bovine enamel slabs treated with fluoride varnish + CO 2 laser (FV + CO 2 ), fluoride varnish (FV), nonfluoride placebo varnish (PV) and nonfluoride placebo varnish + CO 2 laser (PV + CO 2 ). Drops of sucrose solution were dripped onto enamel slabs allowing the accumulation of biofilm. At the first phase, half of the volunteers received 4 enamel slabs treated with FV while the remainders received slabs exposed to the PV with and without CO 2 laser. In the second phase, the vonlunteers were reversed treatments. The slabs were evaluated for cross-sectional microhardness (CSMH) and the concentration of loosely bound fluoride (CaF 2 ) and firmly bound fluoride (FAp). The concentration of fluoride in biofilm were also determined. Results Two-way ANOVA showed that the CSMH values were higher in laser-irradiated enamel, regardless of the fluoride varnish. Friedman test showed that FV group presented significantly larger amount of fluoride in biofilm ( P < 0.05). In the enamel, the largest amount of fluoride was found in the groups FV + CO 2 , which was not different from FV ( P > 0.05). Conclusion The synergistic effect of fluoride varnish and CO 2 laser on enamel demineralization was not observed, however, CO 2 laser reduces enamel demineralization. Clinical significance CO 2 laser might reduce the demineralization of subsurface enamel, although its association with a high concentrated fluoride therapy may not result in a positive synergistic interaction. [ABSTRACT FROM AUTHOR]

The penetration of cariogenic oral bacteria into enamel and dentin during the caries process triggers an immune/inflammatory response in the underlying pulp tissue, the reduction of which is considered a prerequisite to dentinogenesis-based pulp regeneration. If the role of odontoblasts in dentin formation is well known, their involvement in the antibacterial response of the dental pulp to cariogenic microorganisms has yet to be elucidated. Our aim here was to determine if odontoblasts produce nitric oxide (NO) with antibacterial activity upon activation of Toll-like receptor-2 (TLR2), a cell membrane receptor involved in the recognition of cariogenic Gram-positive bacteria. Human odontoblast-like cells differentiated from dental pulp explants were stimulated with the TLR2 synthetic agonist Pam2CSK4. We found that NOS1, NOS2, and NOS3 gene expression was increased in Pam2CSK4-stimulated odontoblast-like cells compared to unstimulated ones. NOS2 was the most up-regulated gene. NOS1 and NOS3 proteins were not detected in Pam2CSK4-stimulated or control cultures. NOS2 protein synthesis, NOS activity and NO extracellular release were all augmented in stimulated samples. Pam2CSK4-stimulated cell supernatants reduced Streptococcus mutans growth, an effect counteracted by the NOS inhibitor L-NAME. In vivo, the NOS2 gene was up-regulated in the inflamed pulp of carious teeth compared with healthy ones. NOS2 protein was immunolocalized in odontoblasts situated beneath the caries lesion but not in pulp cells from healthy teeth. These results suggest that odontoblasts may participate to the antimicrobial pulp response to dentin-invading Gram-positive bacteria through NOS2-mediated NO production. They might in this manner pave the way for accurate dental pulp healing and regeneration. [ABSTRACT FROM AUTHOR]

Background The resin-based pit and fissure sealant is considered a successful tool in caries prevention, however there is a growing evidence of its use in controlling already established caries in posterior teeth. The aim of this clinical trial is to verify the efficacy of pit and fissure sealants in arresting dentinal caries lesions compared to partial excavation and restorative treatment in primary molar teeth. Methods Thirty six patients with occlusal cavitated primary molar reaching outer half of dentin were selected. The patients were randomly allocated into two groups: sealant application (experimental group - n = 17) and restoration with composite resin (control group - n = 19). Clinical and radiograph evaluation were performed after 6, 12 and 18 months. The chi-square test was used to verify the distribution of characteristics variables of the sample among the groups. The survival rate of treatments was evaluated using Kaplan-Meier survival and log-rank test. Fishe's Exact and logistic regression tests were calculated in each evaluation period (α = 5%). Results The control group showed significantly better clinical survival after 18 months (p = 0.0025). In both groups, no caries progression was registered on the radiographic evaluations. Conclusions Sealing had similar efficacy in the arrestment of caries progression of cavitated occlusal lesions compared to partial excavation of the lesions, even though the frequency of retreatments was significantly higher in sealed lesions. [ABSTRACT FROM AUTHOR]