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PubMed1985

Depth of penetration of in vitro root surface lesions.

An acidified gel system was used to produce artificial caries lesions in root surfaces and in enamel. The teeth were exposed to the gel system for two weeks and four weeks, after which the lesions were examined by polarized light microscopy and photographed by standardized techniques. The depths of penetration of the lesions were measured from these standardized photomicrographs. The lesions in root surfaces were deeper than those in enamel for all teeth. After two but not four weeks of exposure in the gel system, the lesions in the root surfaces of anterior teeth were deeper than those in pre-molars.

Aged↗
PubMedDate not supplied

Caries progression and inhibition in human and bovine root dentine in situ.

Since the use of bovine instead of human dentine to evaluate cariogenic and anticariogenic substances is not well established, this in situ study was conducted. Eleven volunteers wore palatal acrylic devices containing 4 dentine slabs (2 human and 2 bovine). Sucrose solution (20%) was dripped over all slabs 4 times a day, simulating a cariogenic challenge. Dentifrice slurries, fluoridated or not, were dripped over specified dentine slabs 3 times a day to evaluate caries reduction. After 14 days, the biofilm formed on the dentine slabs was collected for microbiological analysis. In dentine, mineral loss (DeltaZ) and lesion depth (LD) were determined by cross-sectional microhardness and by polarized light microscopy, respectively. The total streptococci and mutans streptococci counts in the biofilm formed either on human or on bovine slabs, whether treated or not with fluoride dentifrice, were not statistically different. The DeltaZ and the LD values of dentine treated with fluoride dentifrice were significantly lower than the values of dentine treated with non-fluoride dentifrice. The differences in the DeltaZ and LD values between the human and bovine dentine were not statistically significant. The results suggest that bovine dentine can be used instead of human to evaluate caries development and inhibition.

Animals↗
PubMed2002

Coverage of carious roots by a subepithelial connective tissue graft.

PURPOSE: To assess whether coverage of an untreated or restored carious root lesion with a subepithelial connective tissue graft would provide a predictable, esthetically acceptable result and prevent further caries progression. MATERIALS AND METHODS: Twenty-seven teeth from 13 patients with root caries and gingival recessions of 3.4 +/- 0.2 mm (mean +/- SEM) were treated with subepithelial connective tissue grafts. Eighteen teeth had untreated caries, and the other nine had composite or glass-ionomer restorations. The carious dentin and the plastic restorations were removed prior to the surgical procedure. The exposed roots were thoroughly planed and covered by a subepithelial connective graft with no further root treatment or conditioning. The teeth were examined periodically from 1-6 years post-treatment for retention of root surface coverage and presence of carious lesions. RESULTS: The mean root coverage recession left after the treatment was 0.3 +/- 0.1 mm, with coverage of 92.4 +/- 2.4%. Significant differences (P< 0.05) were found between the coverage of roots with carious lesions that had not been restored and those that had restorations removed. However, since the number of teeth with restorations was limited, further study is required to confirm this difference. In 18 cases, complete coverage of the recession was achieved. The results were stable, and no further recessions or recurrent caries were detected.

Adult↗
PubMed2001

Antimicrobial effectiveness of electro-chemically activated water as an endodontic irrigation solution.

AIM: The aim of this in vitro study was to evaluate the antimicrobial effectiveness of electro-chemically activated water (ECA) as an endodontic irrigation solution. METHODOLOGY: The root canals of 60 caries-free, single-rooted, adult, maxillary, anterior human teeth were instrumented and irrigated in a similar method to that used for in vivo root canal treatment. The external root surface of each tooth was sealed, maintaining the access cavities patent and the root canals were inoculated with a suspension containing four bacteria. The teeth were randomly divided into four groups (n = 15). Each group was irrigated ultrasonically with one of the following solutions: distilled water (control), NaOCl (3.5%), and ECA, the latter at pHs 7.0 and 9.0. Antimicrobial effectiveness was established directly after irrigation and again 7 days later, by counting colony-forming units on blood agar plates and by spectrophotometric analysis. RESULTS: Large numbers of bacteria were present in the canals of teeth irrigated with distilled water. No bacteria were observed following irrigation with NaOCl. Neither of the ECA solutions were found to be effective against all the bacteria. Although some reduction in the number of bacteria was evident in the ECA groups, this was not statistically significant (P > 0.05) when compared to sodium hypochlorite. CONCLUSION: Within the confines of this study ECA did not demonstrate antimicrobial effectiveness.

Adult↗
PubMed1993

Caries incidence in patients with dementia.

One in ten persons over the age of 65 and as many as half the population aged 85 and over have Alzheimer's disease. Review of the literature reveals substantial decrements in oral health in persons with dementia as measured by denture hygiene, coronal decayed, missing and filled teeth, filled teeth (cervical), percentage of the population with caries, Oral Hygiene Index-simplified, and of sites with plaque, gingival bleeding and calculus. A study of caries incidence is described in 23 male veterans with moderate and advanced dementia of the Alzheimer's type, using a comparison group of male veterans from the Department of Veterans Affairs Dental Longitudinal Study, matching 2:1 for age, number of teeth and education. Baseline findings indicate significant differences in the numbers of coronal surfaces with decay, root decayed and/or filled teeth and root decayed and/or filled surfaces. Mean annual increments of coronal caries in the dementia group were 2.29 +/- 4.29 per 100 surfaces at risk, over twice that in the comparison group (0.88 +/- 1.14). For root caries, mean annual increments in the dementia group were 2.38 +/- 5.57 per 100 available surfaces, versus 0.31 +/- 0.69 in the comparison group. Despite these large mean differences, the marked variability in these small samples statistical significance in caries increments between the two groups. The article concludes by suggesting some potential modifications to clinical trials of caries preventive agents and some overall research issues in populations with dementia.

Aged↗
PubMed2002

Dental caries in persons over the age of 80 living in Kungsholmen, Sweden: findings from the KEOHS project.

OBJECTIVES: The Kungsholmen Elders Oral Health Study (KEOHS) evaluated the oral health status of generally healthy, community-dwelling persons over the age of 80 living in Kungsholmen, an area in central Stockholm. This paper reports findings regarding the prevalence and severity of dental caries among the dentate participants. BASIC RESEARCH DESIGN: Caries examinations were conducted on eligible persons participating in the Kungsholmen Project, an ongoing, longitudinal study of older adults. SETTING: Caries examinations were carried out between 1994 and 1996 at two local clinics by three standardised examiners using defined visual, tactile criteria. PARTICIPANTS: Among 296 potentially eligible participants, 159 were examined, and a total of 129 had at least one tooth. MAIN OUTCOME MEASURES: The caries examination identified decayed and filled surfaces and missing teeth. RESULTS: Of the dentate subjects examined, 80% had teeth in both arches; 98% had at least one coronal filling; 81% had one or more restored root surfaces. Depending upon age and gender, between 36% and 56% of those examined had untreated coronal caries, and between 54% and 75% had untreated root caries. CONCLUSIONS: These findings document the substantial and ongoing impact of dental caries in a sample of generally healthy, community-dwelling older adults and underscore the importance of continued caries prevention and treatment in the aged.

Age Factors↗
PubMed1997

Penetration of varnishes into demineralized root dentine in vitro.

In this paper the penetration of three different varnishes employed in caries prevention (Duraphat, Fluor Protector and Cervitec) into demineralized dentine is quantified using confocal laser scanning microscopy. The results show that the varnish penetration into lesions about 85 microns in depth if for Cervitec about 35 microns and considerably less for Duraphat and Fluor Protector. The penetration is into the dentinal tubules and is influenced by dentinal tubule direction. The drying procedure--pretreatment of the dentine--influences the penetration, though sizeably only for Cervitec applications. This paper shows that varnish penetration into the tissue and presumably 'sealing' tubules completely or partly is valuable with respect to root caries prevention and hypersensitivity.

Adolescent↗
PubMed2003

Root surface debridement and endotoxin removal.

OBJECTIVE: This study assessed associations between the number of standardized scaling strokes and the reduction of endotoxin on the root surface. BACKGROUND: Therapy of periodontally involved teeth attempts removal of accretions by scaling and root planing. The amount of mechanical therapy required to free the root surface from etiologic factors remains unknown. METHODS: Twenty-four extracted human caries-free single rooted teeth with at least 5 mm attachment loss were used. A region of interest (ROI) which contained subgingival calculus was defined on the root surface of each tooth. Standardized force instrumentation was applied using a force-measuring curet. Fifty working strokes were applied to every ROI. Forces applied were recorded. The force recordings were converted from Millivolts into Newtons (N). After every unit of 5 strokes, presence of calculus was evaluated and scaling debris was collected. Endotoxin concentration was determined in the debris samples. RESULTS: The endotoxin values for strokes 1-5 were statistically significantly greater than the values from all other stroke intervals. Complete calculus removal occurred after a mean of 9.3 strokes. The endotoxin concentration reached a minimal level with concentrations of 0.03-0.306 EU/ml after calculus removal was complete. CONCLUSION: These findings suggest that completion of calculus removal coincides with endotoxin levels associated with clinically healthy teeth.

Chromogenic Compounds↗
PubMed2004

Investigation of the effect of the coronal restoration quality on the composition of the root canal microflora in teeth with apical periodontitis by means of T-RFLP analysis.

AIM: To investigate the effect of the radiographic and clinical quality of coronal restorations on the composition of the root canal flora of teeth with necrotic pulps and teeth with root fillings associated with apical periodontitis. METHODOLOGY: Twenty-eight necrotic pulps and 35 root filled canals with signs of apical periodontitis were studied. Both the coronal filling (presence of radiographically or clinically deficient margins and/or secondary caries) and the root filling (homogeneity and length) were scored. Bacterial root canal samples were taken with sterile paper points under rubber dam and using measures to prevent contamination. A DNA-based nonculture bacterial identification technique was used, namely terminal restriction fragment length polymorphism (T-RFLP) analysis. RESULTS: Twelve samples were negative for bacterial DNA. A total of 33 different terminal restriction fragments (TRFs) were detected. The Fusobacterium nucleatum/Streptococcus mitis group was the most frequently encountered TRF. The mean number of TRFs per necrotic pulp was 6.2 and 5.8 for the groups with acceptable and unacceptable coronal restorations, respectively. This difference was not significant. In the root filled group, these values (respectively, 5.2 and 8.6) were statistically significantly different (P < 0.05). The following parameters in root filled teeth had no significant influence on the mean numbers of TRFs detected: the length and homogeneity of the root filling and the type of tooth (anterior-premolar-molar). CONCLUSION: T-RFLP allowed the rapid assessment of bacterial biodiversity in root canal samples. The technique revealed the presence of bacteria that have rarely been described in the root canals of teeth with apical periodontitis. Biodiversity in the root filled group was high, as compared with culture-dependent studies where monoinfections were more frequently reported. Only in root filled teeth did defective coronal restorations have a statistically significant influence on the mean numbers of detected TRFs per sample.

Adult↗
PubMed2001

ER-YAG laser pretreatment effect on in vitro secondary caries formation around composite restorations.

PURPOSE: This in vitro study determined if Er-YAG laser used in instead of acid-etching influenced artificial secondary caries formation in enamel and root surfaces. MATERIALS AND METHODS: Class V cavities were prepared in buccal and lingual surfaces of 10 extracted caries-free molars, with cervical margins in the root surface and occlusal margins in enamel. The specimens were randomly assigned to 2 groups: Group 1: Enamel and dentin etched with 35% phosphoric acid gel (Scotchbond 15s, rinse 10s; n=5 teeth with 2 cavities per specimen, 10 occlusal and 10 root surface margins at caries risk). Group 2: Enamel and dentin surfaces conditioned using a pulsed Er-YAG laser (KAVO) with 2.94 microm wavelength, 250 micros pulse duration, 300 mJ for enamel and 250 mJ for root surface pulse energy, 2 Hz repetition rate, and water cooling (n=5 teeth with 2 cavities per specimen, 10 occlusal and 10 root surface margins at caries risk). The cavity preparations were restored with a wet-bonding technique (Scotchbond 1 adhesive system) and a hybrid resin, light-cured composite (Z100, A3 shade), according to the manufacturer's instructions. Acid-resistant varnish was applied leaving the restoration and a 1 mm rim of adjacent surface enamel and root surface exposed. The specimens were thermocycled (5-50 degrees C, 500 cycles, dwell time 30s). Following artificial caries formation (2.2 mM calcium, 2.2 mM phosphate, 50 mM acetic acid, 5.0 mg/L fluoride, pH 4.25, 10 days), longitudinal sections (3/tooth, 30 occlusal and cervical caries risk sites per group) were taken for polarized light microscopic examination (water imbibition). Primary surface lesion depth and wall lesion frequency was determined and compared between groups (Student's t-test). RESULTS: Er-YAG laser irradiation resulted in a 56% reduction in primary enamel surface lesion depth (116 microm mean depth) when compared with the acid-etched group (263 microm mean depth), and a 39% decrease in root surface lesion depth (194 microm mean depth) compared with that (316 microm mean depth) for acid-etching pretreatment (P< 0.05). Wall lesion frequency was similar (P>0.05) between treatment groups.

Acetates↗
PubMed1997

The caries-preventive effect of titanium tetrafluoride on root surfaces in situ as evaluated by microradiography and confocal laser scanning microscopy.

The aim of the present study was to investigate the cariostatic effect of titanium tetrafluoride (TiF4) on in situ-induced lesions on human root surfaces. Analysis of the samples was carried out by quantitative microradiography (TMR) and confocal laser scanning microscopy (CLSM). Pre-molar roots, sectioned into four pieces, were used for sample preparation. Before they were mounted into the recesses prepared in the acrylic intra-oral appliances, two root pieces from each tooth were treated with 4% TiF4 for 1 min, while the remaining two pieces served as controls. The appliances were worn by 12 volunteers for 4 wks. After 4 wks with no fluoride supplementation, the root pieces were removed and analyzed by TMR and CLSM. The TMR results showed that the TiF4 treatment reduced lesion depth and total mineral loss by 56% and 62%, respectively. CLSM images agreed well with the TMR measurements. A dense light-reflecting surface layer with almost intact subsurface structures was evident in the TiF4-treated samples.

Bicuspid↗
PubMedDate not supplied

Caries prevention in a community-dwelling older population.

A clinical trial was conducted to compare the effect of different caries-preventive strategies on caries progression in lower-income, ethnically diverse persons 60 years of age and older. Two hundred and ninety-seven subjects were randomized into one of five experimental groups. Group 1 received usual care from a public health department or a private practitioner. Group 2 received an educational program of 2 h duration implemented twice a year. Group 3 received the educational program plus a 0.12% chlorhexidine rinse weekly. Group 4 received the education and chlorhexidine interventions and a fluoride varnish application twice a year. Group 5 received all the above interventions as well as scaling and root planing every 6 months throughout the 3-year study. A carious event was defined as the onset of a carious lesion, a filling, or an extraction on a surface which was sound at baseline. Two hundred and one subjects remained in the study for the 3-year period. Groups that received usual intraoral procedures (groups 3, 4, and 5) had a 27% reduction for coronal caries events (p = 0.09) and 23% for root caries events (p = 0.15), when compared to the groups that received no intraoral procedures (groups 1 and 2). Routine preventive treatments may have had only a small-to-moderate effect upon caries development.

Aged↗
PubMed1998

In vitro evaluation of the cytotoxicity and genotoxicity of root canal medicines on human pulp fibroblasts.

An intracanal medicine is often required because microorganisms in the dentinal tubes may be difficult to eliminate completely by instrumentation. Phenolic compounds are widely used in dental treatment as sedatives for the dental pulp or as disinfectants for caries and the root canal. In this study, propidium iodide fluorescence and DNA precipitation assay were used to investigated the cytotoxic and genotoxic effects of camphorated phenol and camphorated parachlorophenol on cultured human pulp fibroblasts in vitro. Both medicines reduced the content of double-stranded polynucleic acid of fibroblasts over a 24-h culture period in a concentration-dependent manner. Camphorated parachlorophenol was more cytotoxic than camphorated phenol. But, both medicines did not cause genotoxicity on pulp cells. The advantage of these experimental methods are simplicity and rapidity. Furthermore, this experimental system may be useful for preliminary cytotoxicity and genotoxicity screening of various dental medicines in vitro.

Anti-Infective Agents, Local↗
PubMed1992

Oral disease beliefs, behaviors, and health status of Korean-Americans.

Previous research with other ethnic minorities has shown that culture and age cohort, as well as language and economic limitations, act as barriers to obtaining dental care and maintaining good oral health. This study compared self-reported oral health attitudes, self-efficacy, and dental practices of 20 younger and 23 elderly Korean-Americans. Oral assessments were also conducted to determine plaque and gingival status, and root and coronal caries. Significant differences emerged in health self-efficacy (P less than .01) and preventive health orientation (P less than .002). Elderly had fewer teeth (P less than .0001), more decayed and filled root surfaces (P less than .05 and P less than .004, respectively), and more decayed and filled coronal surfaces (P less than .001 and P less than .03). Both groups showed higher levels of distal and mesial plaque than occlusal and cervical plaque; however, the elderly had higher rates of both (P less than .0001). Gingival status was also worse for the elderly, on distal and mesial (P less than .01), facial (P less than .01), and lingual (P less than .01) surfaces. These differences are striking, since the elderly reported visiting the dentist more recently (P less than .0001); but most of these visits were for prosthodontic and emergency care. Better preventive dental care and education are necessary for elderly immigrants who have not been exposed to preventive dentistry in their home countries.

Adult↗
PubMed2005

[The effect of matrix metalloproteinase-1 on root surface dentin matrix: a scanning electron microscope observation].

OBJECTIVE: To observe the effect of matrix metalloproteinase-1 (MMP-1) from human host on degradation of dentin organic matrix of root dentin. METHODS: The freshly extracted caries-free impacted teeth were selected. Teeth were cut transversely under the enamel-cementum junction into dentin sections with a thickness of about 5 mm. Then all sections with removal of cementum, pulp and predentin were randomly divided into four groups. In the first group, dentin sections were demineralized with acid solution for 21 days, and then incubated with MMP-1 solution for 7 days; the second group were only treated with acid solution for 21 days; the third group were only attacked by MMP-1 solution for 7 days; and the fourth group were untreated as a control. Then all sections were dehydrated in ascending strength of alcohol, critically dried, coated with platinum, and then observed under scanning electron microscope(SEM). RESULTS: The dentin sections of root surface attacked by acid and MMP-1 showed that demineralization of dentin mineral and degradation of dentin matrix fibrae synchronously happened. The dentin matrix fibrae wasn't degradated in the groups treated with acid or MMP-1. CONCLUSION: The proteinases from human host may play an important role in the development of root surface caries. MMP-1 may distinctly degradate the organic matrix of demineralized dentin.

Dental Cementum↗