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Objective: Primary outcome of this retrospective study was the comparison of state examination results under simulated treatment conditions in times of Covid-19 versus patient treatment under non-pandemic conditions. Additionally, correlation analysis was performed between students’ self- and examiners’ assessment of the treatment results.Methods: Within 4 hours, 22 examinees each had to place a multi-surface adhesive anterior and posterior restoration, performed an endodontic treatment on a maxillary premolar and a periodontal debridement of one quadrant. All treatments were performed on a model fixed in a phantom head. Compliance with the prescribed hygiene and social distancing guidelines and self-assessment of the practical performance was part of the practical examination as well. One examiner per examination part evaluated anonymously the final results. The historical control was based on the exam results of a cohort from 2019. Mean values (standard deviation), non-parametric correlations (Spearman's Rho) and group comparisons (Mann-Whitney) were calculated for statistical analysis.Results: Examination results under simulated treatment conditions were significantly worse (p

Objective: The aim of the study was to assess older people's preferences and expectations for preventive oral care in their own home. Background: With increasing age, the use of dental services declines and oral health becomes secondary, yet good oral health contributes to quality of life and has a positive impact on general health. Thus, the healthcare system should offer a care structure in which oral health can be maintained into old age. To provide patient‐centred care, patient preferences in additional preventive oral care need to be explored. Materials and Methods: In this qualitative study, semi‐structured interviews were conducted with community‐dwelling individuals aged ≥65 years to understand their preferences and expectations for oral care in a home‐based setting. Interviews were recorded, transcribed verbatim and analysed thematically. Results: Fourteen dental patients were included. Three overarching themes were identified. The desire for independence was predominant when addressing their future capability to perform oral hygiene. When addressing possible future oral health support, self‐determination and independence were important to them. Concerns about dependency in inpatient care facilities and the associated reduction in oral care were evident. Frequency, costs and the practice environment played a decisive role when thinking about additional preventive measures for their future. Conclusion: The results of this study provide important information about older people's preferences and expectations for preventive oral care in the home environment and relate to three core themes of (1) changes in oral hygiene skills and perceptions, (2) support and (3) organisational factors. These must be considered when planning and implementing preventive oral care. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to systematically compare barriers/facilitators providing oral hygiene to young children and dependent older people and to generate ideas to improve the implementation of oral hygiene measures. Background: Many older people, like children, rely on third‐party assistance for teeth cleaning. Barriers/facilitators in providing oral care services have been described in recent works. The aim of our study was to compare these results for both groups and to increase knowledge on analogies/differences in barriers/intermediaries. Methods: We performed a systematic review. Studies reporting on knowledge, attitudes and beliefs acting as barriers/facilitators for provision of teeth cleaning were included. Thematic analysis was used and identified themes translated to domains and constructs of the theoretical domains framework and aligned to the behaviour change wheel. Based on three published reviews in children or older people, our search (PubMed via Medline), Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science, Google Scholar, last search (21 January 2023) encompassed both populations dated from their last publication (28 February 2018). The review was registered (Prospero, CRD42021278944). For quality assessment, the Newcastle‐Ottawa Scale (NOS) was used. Results: Seventeen articles were identified (older people (n = 8), children (n = 9)). Deficits exist for both in terms of "knowledge/skills" among caregivers, with special difficulties in children with challenging behaviour and older people. "Capability" as one of the main elements of behavioural factors that are the basis for behaviour to take place (COM‐B, Capability, Opportunity, Motivation–Behaviour) is most often mentioned for children and "opportunity" for older people. Conclusions: Most of the facilitators and barriers affecting oral care provision in children are also relevant in older people. Approaches for the development of strategies for better implementation of oral hygiene measures in older people are presented. [ABSTRACT FROM AUTHOR]

Objectives: This cluster‐randomized controlled community trial aimed to assess the efficacy and costs of fluoride varnish (FV) application for caries prevention in a high‐risk population in South Africa. Methods: 513 children aged 4–8 years from two schools in a township in South Africa were randomly allocated by class to the FV or Control (CO) groups. In addition to supervised toothbrushing with fluoridated toothpaste in both groups, FV was applied in 3‐month intervals by trained local non‐professional assistants. Intraoral examinations were conducted at baseline, 12, 21 and 24 months. Primary outcome was the increment of teeth with cavitated lesions (i.e. newly developed or progressed, formerly non‐cavitated lesions), requiring restoration or extraction over the study period. Additionally, treatment and re‐treatment costs were analyzed. Results: 513 children (d1‐4mft 5.9 ± 4.3 (mean ± SD)) were randomly allocated to FV (n = 287) or CO (n = 226). 10.2% FV and CO teeth received or required a restoration; 3.9% FV and 4.1% CO teeth were extracted, without significant differences between groups. While FV generated high initial costs, follow‐up costs were comparable in both groups, resulting in FV being significantly more expensive than CO (1667 ± 1055 ZAR vs. 950 ± 943 ZAR, p <.001). Conclusions: Regular FV application, in addition to daily supervised toothbrushing, had no significant caries‐preventive effect and was not cost‐effective in a primary school setting within a peri‐urban, high‐risk community in South Africa. Alternative interventions on community or public health level should be considered to reduce the caries burden in high‐risk communities. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the buffering capacity of restorative materials during a simulated carious and intrinsic erosive attack. Materials and Methods: Cavities with a volume of 130 μl were milled (Cerec MC XL) out of blocks of Ceram X Mono (CM), Quixfil (QX), Filtek Supreme (FS), Apa Fill 3 (AF), an experimental dual-curing composite containing a bioactive glass (EX), Dyract eXtra (DY), Beautifil (BE), Equia Fil (EQ), Telio CAD (TL) (negative control), TheraCal (TC; positive control), and extracted teeth (ED). 80 μl of lactic acid (pH 4.5) and hydrochloric acid (pH 2.6) were each pipetted into the cavities of two samples of each material. Change of pH in the solutions was measured continuously for 12 min using a calibrated pH electrode. Results: CM, AF, and FS (final pH 3.0-3.2) neutralized hydrochloric acid to a significantly lesser extent than did BE, EQ, DY and QX (final pH 5.0-5.6) (p < 0.05, ANOVA Scheffe). The lactic-acid buffering capacity of CM, BE, and AF was equivalent (final pH 6.3-7.4) to that of ED (7.5), but was surpassed by FS (pH 8.0). pH values for EX and TC (final pH 9.2-11.3) increased significantly (p < 0.05) in response to both acids. Conclusions: Conventional restorative materials do not buffer better than human teeth. However, the experimental composite demonstrates that buffering against carious and intrinsic erosive acid attacks is technically feasible. [ABSTRACT FROM AUTHOR]

Purpose: To review experimental and marketed techniques for the treatment of infected dentin as a potential substitute for conventional rotary excavation.Materials and Methods: A hand and systematic search of Medline (via DIMDI) was performed. Additionally, manufacturers' data about relevant clinical studies were checked. After classification of the identified techniques described, relevant studies are cited to allow an overview of the different treatment options.Results: Excavation, disinfection and sealing techniques for the treatment of infected dentin can be differentiated. Besides several mechanical approaches, chemo-mechanical excavation, enzymatic digestion and photo ablation are discussed. Disinfection techniques can be undertaken with even less invasive approaches like gasiform ozone application, photodynamic therapy or local application of antibacterial materials. Additionally, or alternatively, the sealing of carious dentin is discussed using fluoride-releasing cements, dentin adhesives or antibacterial resin materials.Conclusion: Although some of the techniques are still experimental and much clinical research has to be done, many different approaches are so promising, or already established, that hopefully the days of radical excavation with rotary instruments are numbered. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effects of chlorhexidine-containing varnishes and dentin sealants on the progress of demineralizatton, cariogenic bacteria and clinical appearance of root caries lesions. Methods: 68 lesions in 22 adult patients, with a mean age of 51.3 ± 13.8 years were enrolled in this study. After the removal of soft, infected dentin, all lesions were randomly sealed with (1.) Cervitec, used as control (CE), (2.) EC 40 (EC), (3.) Prime and Bond NT (PB) or (4.) Seal & Protect (SP). Clinical appearance, laser fluorescence diagnosis (DIAGNOdent) and bacteriological status were recorded at intervals of 1 and 3 months. Results: Regarding alteration of surface texture and coler of the lesions, differences between the groups were not detected. Application of EC resulted in suppressed MS counts after 3 months (P< 0.05). Initial lower MS counts were observed in the CE group (P= 0.053). Laser fluorescence values increased in the chlorhexidine groups (CE = 27.9 ± 17.5, EC = 28.3 ± 26.0) but remained stable in the sealant groups (PB = 15.1 ± 22.0, SP = 10.2 ± 7.3), (P< 0.05). [ABSTRACT FROM AUTHOR]

Purpose: To assess the effectiveness and side effects of three sonoabrasive systems and conventional rotary cavity preparation. Materials and Methods: Standardized artificial carious lesions were placed in 48 human premolars at mesial and distal surfaces. Three dentists prepared eight cavities each using (1) diamond burs, (2) Sonicflex 2000 L/N (HS), (3) an experimental air sealer (HS.EXP), and (4) the Piezon Cavity System (PCS). A small hemispherical preparation tip (Sonicsys micro) was utilized with the airscalers in Groups 2 and 3. Loss of substance was determined by weighing. Residual caries and damage to the adjacent tooth were assessed by two calibrated investigators. Each cavity was digitally photographed prior to planimetrical measuring of its circumferential dimension. Quality of the cavities' margins was examined by SEM. Results: Rotary preparation required less time (4 minutes 53 seconds) than oscillating preparation with HS (6 minutes 45 seconds) or PCS (7 minutes 45 seconds), (Scheffé, P< 0.05). Preparation with HS.EXP (5 minutes 52 seconds) was not different from rotary and HS. 64% of all cavities were completely excavated, 28% showed distinct and 8% marked residual caries. However, χ²-tests did not reveal differences in caries removal between the systems. Oscillating preparation with HS as well as the experimental air sealer in combination with the hemisphere resulted in less trauma to adjacent tooth surfaces than rotary preparation and the PCS system, (χ²-tests P< 0.05). HS.EXP caused less loss of substance (Scheffé, P< 0.05). Regarding circumferential extension of the cavities, there were no differences between the groups. [ABSTRACT FROM AUTHOR]