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PubMedDate not supplied

Cariostatic effect of fluoride-containing restorative systems associated with dentifrices on root dentin.

OBJECTIVE: The aim of this in vitro study was to evaluate the interaction between two sources of fluoride (restorative systems and dentifrices) in inhibiting artificial root caries development. METHODS: One hundred and eighty tooth segments were embedded in polyester resin, and sanded flat. Cylindrical cavities 1.0mm-deep and 1.5mm-diameter were prepared in root dentin and randomly restored by fluoride-containing restorative systems: Ketac-fil/Espe (Ke), Fuji II LC/GC Corp (Fj), F2000/3M (F2), Surefil/Dentsply (Su) or a control: Filtek Z250/3M (Z2). Ten experimental groups were made to test the association among the five restorative systems and two dentifrices: with F(-) (Sensodyne Baking Soda) or without F(-) (Sensodyne Original) (n=18). After surface polishing, a 1mm-wide margin around the restorations was demarcated and initial dentin surface Knoop microhardness values (KHN(i)) were obtained. The specimens were submitted to a pH-cycling model, and to applications of slurries of dentifrice. Afterwards the final dentin surface Knoop microhardness values (KHN(f)) were measured. RESULTS: The differences between KHN(i) and KHN(f), and the covariate KHN(i) were considered by the ANCOVA and Tukey's test (alpha=0.05). The interaction between restorative system and dentifrice was statistically significant (p=0.0026). All restorative systems provided some protection against artificial caries challenge when associated with the fluoride-containing dentifrice treatment. The means (standard deviation) of reductions in Knoop hardness values for systems associated with the fluoride-containing dentifrice were: Ke: 40.0(1.02)(a), Fj: 41.9(1.02)(b), F2: 43.3(1.04)(c), Su: 43.5(1.00)(c), Z2: 44.0(1.02)(c); and with the non-fluoride-containing dentifrice were: Ke: 42.9(1.02)(a), Fj: 44.7(1.01)(b), F2: 45.2(1.09)(bc), Su: 46.0(0.99)(c), Z2: 46.6(0.99)(c) (statistical differences were expressed by different letters). CONCLUSION: The cariostatic effect shown by the fluoride-containing dentifrice could enhance that shown by Ketac-fil and Fuji II LC, and could mask that shown by F2000.

Analysis of Variance↗
PubMed1996

Major clinical findings from a dental survey of elderly people in three different English communities.

A random sample of 2280 subjects aged 60 years or over from three areas of England were examined clinically in order to assess their dental health and needs. Between 33% (south of England) and 57% (north of England) were edentulous. Twenty per cent of all dentate subjects were edentulous in one arch and thus still required a complete denture. Amongst the dentate subjects geographical differences were small, but social class and behavioural differences were large. Dental non-attenders were the group who stood out as having much poorer oral health, averaging six fewer natural teeth than attenders. Nearly 50% of all teeth either had coronal fillings or needed them. Root caries was common, 20-22% of vulnerable teeth were affected and there was an age related increase in disease risk. The mean number of teeth with decayed roots per subject (0.8) was similar to the mean number with decayed coronal surfaces (0.9). Moderate tooth wear and moderate periodontal disease were both widespread. A minority of subjects had a functional dentition of 21 or more teeth. Major changes in the dental status of older adults have taken place in the last 30 years and these will continue, resulting in lower levels of edentulousness but a large need for maintenance of existing restorations.

Age Factors↗
PubMed1990

Dental caries, mutans streptococci, lactobacilli, and saliva secretion rate in adults.

In 718 Swedish patients, equally divided into four age groups (19-25, 26-45, 46-60, greater than 60 yr), salivary levels of mutans streptococci and lactobacilli, saliva secretion rate, and DMFS were registered. No significant differences were found between the various age groups either in salivary factors or in caries (D). Number of missing (M) and filled (F) surfaces increased with age. Prevalence of root caries, which increased with age, was significantly correlated to number of exposed root surfaces independent of age. Of the total study group, 50% had greater than or equal to 10(6) mutans streptococci and 40% had greater than or equal to 10(5) lactobacilli per mL saliva. Three percent had a saliva secretion rate of less than or equal to 0.5 mL/min. Correlation analyses showed that both mutans streptococci and lactobacilli significantly correlated to the caries prevalence but the r-value never exceeded 0.34.

Adult↗
PubMed2002

The prevalence and experience of oral diseases in Adelaide nursing home residents.

BACKGROUND: The twenty-first century will see the evolution of a population of dentate older Australians with dental needs very different from those of older adults in past years. This study provided comprehensive information concerning oral disease prevalence in older South Australian nursing home residents. METHODS: This paper presents cross-sectional baseline results. RESULTS: Most of the 224 residents, from seven randomly selected nursing homes, were functionally dependent, medically compromised, cognitively impaired and behaviourally difficult older adults who presented many complex challenges to carers and to dental professionals. Two-thirds (66 per cent) were edentulous with many dental problems and treatment needs. Dentate residents had a mean of 11.9 teeth present, higher than previously reported. The prevalence and experience of coronal and root caries and plaque accumulation was very high in dentate residents; especially males, those admitted more than three years previously, those who ate fewer food types and those who were severely cognitively impaired. These residents had more retained roots, decayed teeth and missing teeth, and fewer filled teeth when compared with data for community-dwelling older adults. CONCLUSIONS: This study highlighted the poor oral health status of these nursing home residents and the great impact of dementia on their high levels of oral diseases.

Aged↗
PubMed1986

Dental caries prevalence in early Polynesians from the Hawaiian Islands.

We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands.

Adolescent↗
PubMed1998

Differential activation of human neutrophils by Streptococcus mutans isolates from root surface lesions and caries-free and caries-active subjects.

Phagocytosis of bacterial pathogens is an important defense mechanism and may contribute to regulating Streptococcus mutans-induced dental caries, particularly at root surfaces. This study was undertaken to examine and compare differences in polymorphonuclear leukocyte or neutrophil activation by clinical isolates of S. mutans collected from the saliva of caries-free or caries-active individuals with S. mutans isolates from root surface lesions. S. mutans clinical isolates (5 caries-free, 5 caries-active, 5 root caries isolates and a laboratory strain) were incubated with neutrophils in the presence of normal human serum and the luminol dependent chemiluminescence was measured for 1 h at 37 degrees C. Results indicated that the caries active and laboratory strains activated neutrophils equally. The mean integration stimulated by caries-free strains, however, displayed a 25-30% enhanced neutrophil activation over the caries-active and laboratory strains. In contrast, neutrophil activation by root caries strains of S. mutans was 45-50% lower than all other S. mutans strains, possibly suggesting a natural selection for S. mutans strains that can evade neutrophil recognition and subsequent phagocytosis. Stimulation of neutrophils with the cell wall and membrane surface component preparations indicated that extracts from all four groups activated neutrophils significantly. Again, caries-free preparations activated neutrophils significantly more than caries active, laboratory strain and root caries isolates. This selection may become more important on root surfaces due to increased exposure to crevicular fluid and neutrophils. The data provide evidence for the presence or onset of mechanisms or biological alterations in S. mutans developed to circumvent neutrophil recognition and/or phagocytosis, thus increasing S. mutans survival and colonization on tooth surfaces, resulting in an enhanced risk of dental caries, particularly at root surfaces.

Adult↗
PubMed1990

Automatic pH-cycling caries model applied on root hard tissue.

The development of a caries lesion is a dynamic process that includes frequently alternating periods of de- and remineralization, a process for which no in vitro models currently exists. The aim of this study was to develop a model which could repeatedly generate identical pH versus time curves over extended periods of time. To test the model demineralization studies on cementum/dentin were performed. Cementum/dentin blocks were repeatedly subjected to de- and remineralizing solutions delivered by a computerized pump system connected to a pH-meter and a recorder. pH versus time curves similar to those produced in plaque after carbohydrate intake were generated 18 times during 15 h followed by a remineralizing period of 9 h every day for 16 days. The intra-day and inter-day variation of the pH-cycling model were found to be low. The mineral change of the blocks was followed by 125I absorptiometry and the transmission through the blocks during the experimental period increased in average by 1.4 +/- (SE) 0.18%. Microradiographic analysis of the transversal sections of the blocks confirmed the development of lesions resembling root caries.

Absorptiometry, Photon↗
PubMed1989

Caring for the dentate elderly.

The proportional increase of elderly persons in most communities and increasing tooth retention among them betoken considerable change in gerodontic needs. Servicing dentate older patients will occupy progressively more practising time. This committment requires the development of somewhat different skills, knowledge and philosophy from those customarily propounded in dental teaching to date which has concentrated mostly on matters relevant to young and middle-aged persons. Dentists must become proficient in managing clinical entities of prevalence in the elderly. Xerostomia, a frequent, but often neglected symptom can have distressing consequences. Practitioners have a responsibility to detect it, analyse its likely cause or causes and select appropriate therapy. Root caries is re-emerging as a common finding. Its aetiology must be understood in order to institute effective preventive measures and treatment. Dentate elderly persons typically have heavily restored teeth subject to various iatrogenic problems. Some of the restorative work required can be provided exactly as for younger patients. However, optimum care is not necessarily the most elaborate. It is often desirable, when health or financial considerations dictate, to adopt expedients which reduce treatment extent and/or expense. Adhesive materials are extremely useful. The 'sandwich technique' for bonding composite resin to dentine via glass ionomer cement often facilitates the provision of extensive restorations in a minimally invasive fashion. Adhesive procedures can also be applied to treat attrition, mend fatigue fractures, splint teeth deficient in periodontal support, and provide simplified cosmetic treatment for elderly patients.

Aged↗
PubMed1996

A critical evaluation of methods for root coverage.

Gingival recession is the exposure of root surfaces due to apical migration of the gingival tissue margins. Although it seldom results in tooth loss, marginal tissue recession is associated with thermal and tactile sensitivity, esthetic complaints, and a tendency toward root caries. This article reviews the current surgical procedures for the coverage of exposed root surfaces, including their advantages and disadvantages. Today, the outcome of root coverage procedures is predictable, aesthetically acceptable, and, together with the use of guided tissue regeneration, at the forefront of regenerative procedures.

Citrates↗
PubMed1985

Observations of dental diseases among prehistoric populations of Hungary.

The incidence of dental disease among people in developing countries today raises questions about the variation in the oral health of prehistoric populations. Considering these questions, we offer observations describing several types of dental disease which occurred among certain prehistoric populations of Hungary. The dental remains of 162 individuals recovered from seven sites of the Neolithic, Copper, and Bronze Age periods were examined for evidence of caries, hypoplasia, and periodontal disease. Appropriate methods were used to describe and record these dental lesions. The incidence of dental caries was low by comparison to other prehistoric agriculturists except for two forms of root caries: cervical and cemental. These types accounted for 68% of all the carious teeth recorded. Enamel hypoplasia was also lower than expected, occurring on only 4% of the total number of teeth. Periodontal abscesses were rare but other milder forms of periodontal lesions were frequent. Alveolar bone resorption occurred in varying degrees and followed the expected age distribution. The few exceptions were children or adolescents whose crania had other lesions suggesting a mineral metabolic disturbance. The lower incidence of enamel caries is likely due to high fluoride ingestion which also may have influenced the expression of enamel hypoplasia. No clear population trends were seen in dental disease incidence except for cemental caries which were found among Copper and Bronze Age remains.

Adolescent↗
PubMed2005

Treatment of gingival recession: comparison of two techniques of subepithelial connective tissue graft.

BACKGROUND: The increasing interest in esthetics and the subsequent need to solve related problems such as hypersensitivity and root caries have favored the development of many surgical procedures that permit the coverage of exposed roots. This clinical study was conducted to examine the coverage of gingival recession defects, where two different subepithelial connective tissue graft (SCTG) techniques (Langer and Langer and modified tunnel) were used. METHODS: Thirty one patients (21 females and 10 males), each contributing Miller Class I and II gingival recessions, were selected. Recession defects were randomly treated by using the Langer and Langer technique (17 patients) or the modified tunnel technique (14 patients). Vertical recession, probing depth (PD), and attachment level were assessed at baseline and 6 months postoperatively. RESULTS: Six months after the surgery, a significant reduction in recession depth was noticed in both groups. There was also a decrease of PD and attachment level for both groups, but not statistically significant. In comparison, at 6 months, statically significant differences were found between the tunnel and Langer and Langer techniques for root coverage and attachment gain. The percentage of root coverage was 96.4% and 75.5% in the tunnel and Langer and Langer groups, respectively. CONCLUSIONS: The present study suggests that the use of SCTG in combination with a tunnel procedure may result in an increased amount of root coverage and clinical attachment gain compared to the Langer and Langer technique. Further comparative studies are necessary to understand the periodontal healing generated by the tunnel procedure and Langer and Langer technique.

Adolescent↗
PubMed2006

Immediate implant placement: treatment planning and surgical steps for successful outcomes.

Diagnosis and treatment planning are key factors in achieving successful outcomes after placing and restoring implants placed immediately after tooth extraction. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. Some or all of the following suggestions, depending on individual circumstances, should be considered when evaluating a patient for dental implants: thorough medical and dental histories, clinical photographs, study casts, periapical and panogram radiographs as well as a linear tomography or computerised tomography of the proposed implant sites. Reasons for tooth extraction include but are not limited to: insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts, root resorption, teeth with deep furcation invasions being considered as abutments for fixed partial dentures and questionable teeth in need of endodontic retreatment.

Animals↗
PubMed2005

Immediate implant placement: diagnosis, treatment planning and treatment steps/or successful outcomes.

Diagnosis and treatment planning are key factors in achieving successful outcomes after placing and restoring implants placed immediately after tooth extraction. The efficacy of immediate implant placement has been established and shown to be predictable if reasonable guidelines are followed. Some or all of the following suggestions, depending on individual circumstances should be considered when evaluating a patient for dental implants: thorough medical and dental histories, clinical photographs, study casts, periapical and panogram radiographs, as well as a linear tomography or computerized tomography of the proposed implant sites. Reasons for tooth extraction include, but are not limited to, insufficient crown to root ratios, remaining root length, periodontal attachment levels, periodontal health of teeth adjacent to the proposed implant sites, unrestorable caries, root fractures with large endodontic posts, root resorption, teeth with deep furcation invasions being considered as abutments for fixed partial dentures, and questionable teeth in need of endodontic retreatment. Teeth requiring root amputations, hemisections or advanced periodontal procedures may have a questionable prognosis, and patients should be given the implant option before these procedures are implemented. Similarly, nonvital teeth, fractured at the gingival margin with roots shorter than 13 mm should be considered for the implant option. This review will describe the steps for immediate implant placement at the time of extraction as well as the "gap" and socket preservation.

Animals↗
PubMedDate not supplied

[Clinical aspects of the evolution of dental caries and periodontal disease in patients treated with corticosteroids].

Patients treated with adrenal glucocorticoids may run a higher risk of dental caries, both as a result of their medical condition and of the physical and physiological effects of their pharmacotherapy. Our clinical study reports about patients treated with glucocorticoids who were also having an odonto-periodontal condition. They were examined and we found rampant caries and periodontal diseases. The slow evolution of asymptomatic periodontal disease encouraged destruction of teeth in root caries. The rampant caries were correlated with immunodeficiency and treatment of these caries must take into account the general treatment.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Functional status and untreated dental caries among nursing home residents aged 65 and over.

This descriptive study examined the relationship between untreated dental caries and functional status among 958 dentate nursing home residents aged 65 and over. Functional status was measured by the Physical Self-Maintenance Scale (PSMS). The PSMS assessment revealed that 32% of subjects were unable to perform all activities, and only 10% could perform all activities. Overall, 59% of subjects had untreated coronal decay and 46% had untreated root decay. In bivariate analysis, untreated coronal and root caries experiences were significantly associated with PSMS limitations, lack of dental care utilization, sex, and number of remaining teeth. Stratified analysis suggested an interaction between functional status and dental care utilization. Among subjects who had received dental care in the preceding year, PSMS status was not significantly related to untreated caries experience; but among subjects who had not received care, PSMS status was significantly related to untreated caries experience. In logistic regression analysis of untreated root decay, a significant interaction was found between PSMS status and dental care utilization. However, in logistic regression analysis of untreated coronal caries, no significant interaction was found; significant independent effects were found for dental care utilization and number of remaining teeth, but not for PSMS status.

Aged↗
PubMed1993

In vivo studies with a dicalcium phosphate dihydrate/MFP system for caries prevention.

Recent basic studies have shown that increasing supersaturation with respect to dicalcium phosphate dihydrate (DCPD), above and beyond the amount present in saliva, enhanced the efficacy of fluoride in vitro. Since the combination of monofluorophosphate (MFP) with DCPD abrasive is unique for fluoride stability, dentifrices containing the combination were evaluated in a variety of in vivo tests. MFP with silicon dioxide (silica) abrasive at an equivalent fluoride concentration was used for comparison. The influence of slurries of DCPD or silicon dioxide on the intraoral plaque pH was measured following sucrose challenge in humans. The data indicated that DCPD slurries were more effective than silica in preventing plaque pH drop when compared to silica. A toothpaste containing MFP and DCPD was significantly more effective than an MFP/silica toothpaste. A toothpaste containing radiolabeled DCPD was applied topically in rats' teeth during a cariogenic challenge. The results showed that calcium45 was incorporated into the enamel with a concomitant reduction in enamel solubility. In a rat caries study using MFP/DCPD, matching placebo and MFP/silica, MFP/DCPD dentifrice showed a significantly greater reduction in smooth surface caries. Two dentifrices were also tested in an in situ human model for fluoride uptake in artificial root caries lesions where MFP/DCPD provided a significantly higher fluoride uptake than MFP/silica. A second in situ study in humans evaluated the same dentifrices. MFP/DCPD increased salivary plaque calcium and fluoride. These results of laboratory, animal and in situ studies taken together indicate that the MFP/DCPD combination is unique in providing extra supersaturation in saliva and plaque with concomitant enhanced anticaries efficacy.

Animals↗
PubMedDate not supplied

[Corono-radicular caries: a histoclinical approach].

Due to aging and gingival recession, the radicular structures are exposed to cariogenic attacks from the oral cavity. This phenomenon leads to a constantly higher frequency of root caries. The aspect of these carious lesions was analysed by a histological and an SEM study. To conclude the study, a clinical description of the lesions and an epidemiological survey were realized on 112 patients for 16 months.

Adult↗