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PubMed1999

Periodontal esthetics and soft-tissue root coverage for treatment of cervical root caries.

As the pace of change accelerates in periodontics and esthetic dentistry, an increasing number of procedures are being developed that require knowledge and treatment from both fields. The synergy developed by combining these two fields of dentistry allows for better esthetic outcomes for our patients. Two of these procedures include esthetic crown lengthening and soft-tissue root coverage. As demonstrated in this article, soft-tissue root coverage can be performed on previously restored roots and as an option for treating root caries.

Anti-Bacterial Agents↗
PubMed1994

Multifactorial modeling for root caries prediction: 3-year follow-up results.

The study was part of a series aiming at the development of caries tests. The initial material (n = 104, age range 47-79 yr, mean 62 yr) was reduced to 96, who were observed for 3 yr. During the follow-up four subjects died, all due to myocardial infarction, and four refused to participate. Thorough oral examinations were conducted at the baseline, 1- and 3-yr registrations; coronal and root surface caries were registered separately according to WHO classification. The tests included salivary mutans streptococci, lactobacilli, candida/yeasts, secretion rate, buffer effect and sucrase activity, and quantitation of visible plaque. The association between prospective root caries increment and several tests was significant. Multifactorial modeling resulted in the combination of Past Root Caries Experience (OR 12.8), Lactobacilli (OR 8.6) and Candida (OR 2.8). At screening, the criterion "two or three positive tests" of these yielded acceptable accuracy (77.1) and a relative risk of 3.3.

Aged↗
PubMed1998

Comparison between Er:YAG laser and conventional technique for root caries treatment in vitro.

Effective ablation of dental hard tissues by means of the erbium-doped:yttrium-aluminum garnet (Er:YAG) laser has been reported recently, and its application to caries removal and cavity preparation has been expected. However, few studies have investigated the capability of the Er:YAG laser to treat caries. In the present study, the effectiveness of caries removal by using an Er:YAG laser in vitro was compared with that of conventional mechanical treatment. Thirty-one extracted human teeth with root caries were used. Half of the caries in each tooth was treated with the Er:YAG laser, and the other was removed with a conventional bur or was left untreated as a control. Laser treatment was performed by means of a combination of contact and non-contact irradiation modes with cooling water spray, with a new fiber delivery and contact probe system. Conventional bur treatment was conducted by means of a low-speed micromotor. Measurements of the time required for caries removal, histopathological observations of decalcified serial sections, scanning electron microscope (SEM) observations, and hardness measurements of the treated cavity-floor dentin were performed for each treatment. Due to the careful irradiation technique, a longer treatment time was required for the complete removal of carious dentin by the Er:YAG laser. However, the Er:YAG laser ablated carious dentin effectively with minimal thermal damage to the surrounding intact dentin, and removed infected and softened carious dentin to the same degree as the bur treatment. In addition, a lower degree of vibration was noted with the Er:YAG laser treatment. The SEM examination revealed characteristic micro-irregularities of the lased dentin surface. Our results show that the Er:YAG laser system is promising as a new technical modality for caries treatment.

Dental Cavity Preparation↗
PubMed2003

Treatment of root caries lesions with chlorhexidine-containing varnishes and dentin sealants.

PURPOSE: To evaluate the effects of chlorhexidine-containing varnishes and dentin sealants on the progress of demineralization, 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 color 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).

Adult↗
PubMed1993

The 48-month increment of root caries in an urban population of older adults participating in a preventive dental program.

The purpose of this study was to determine the effect of a 48-month preventive dental program on the incidence of root caries in an urban, geriatric, noninstitutionalized population residing in an optimally fluoridated area. The 466 participants were randomly assigned to one of three groups at baseline. Group A (control): 171 subjects using a placebo mouthrinse daily; group B: 147 subjects receiving semiannual applications of a topical APF gel (1.2% F-) with the daily use of a placebo mouthrinse; group C: 148 subjects using a fluoridated mouthrinse daily, ACT (0.05% F-). At baseline, the numbers of surfaces at risk, and decayed and filled surfaces were recorded. After 48 months, in addition, the number of reversed and new lesions were determined, and the incremental DMFS calculated. The data were analyzed by ANCOVA. The incremental DMFS were: A = 0.91, B = 0.27, C = 0.26. The incremental DMFS in groups B and C were significantly lower than in group A (P < .05). The number of reversed lesions in group C (1.53 +/- 2.03) was significantly greater than in group A (1.11 +/- 1.74) and group B (1.01 +/- 1.86) (P < .05). The number of new lesions in group B (1.36 +/- 2.00) was significantly less than in group A (1.99 +/- 2.65) (P < .05). The daily use of the fluoride mouthrinse significantly increased the number of reversed lesions.

Acidulated Phosphate Fluoride↗
PubMed1990

Artificial root caries in amalgam restorations: effect of light-cured fluoride releasing liners.

The purpose of this study was to examine artificial root caries when light-cured fluoride releasing liners were placed under amalgam restorations. Class V preparations in extracted third molars were used with gingival margins on root surfaces. Ten restorations were used for each of the following groups: 1) Amalgam alone; 2) Two layers of copal varnish and amalgam; 3) Vitrabond, amalgam; 4) Timeline, amalgam; 5) XR Ionomer, amalgam. The teeth were thermocycled and artificial caries were created using a liquid system acidified to pH 4.20 containing 2.2 mM calcium and phosphate but without fluoride. The teeth were sectioned, polished and photographed using polarized light. Areas of recurrent caries were measured using a sonic digitizing pad. The data were analyzed using ANOVA and Duncan's Multiple Range Test. Areas for root lesions for the different groups were: 1) 2.17 +/- 0.35; 2) 1.90 +/- 0.40; 3) 1.30 +/- 0.18; 4) 1.77 +/- 0.28; 5) 1.50 +/- 0.33. Groups 3 and 5 were statistically different from groups 1 and 2, while no differences were observed for enamel lesions. The use of the photo-activated/fluoride releasing liners significantly reduced lesion area.

Analysis of Variance↗
PubMed2005

Development of an in situ root caries model. A. In vitro investigations.

OBJECTIVES: The paper describes preliminary in vitro investigations, the objectives of which were to examine the influence of certain experimental parameters on artificial carious lesion formation in root hard tissues, and their remineralisation. These experiments formed part of a wider study that aimed to develop an in situ model of root caries, based on the existing coronal caries model used in Liverpool. The present studies examined the effects (a) of the anatomical origin of the dentine, the presence or absence of cementum, the exposure time and the type of demineralising system, on lesion development, and (b) of baseline lesion size on the extent and location of mineral re-precipitation. METHODS: Mineral content parameters in plano-parallel sections taken from dentine lesions were determined by computer-controlled transverse microradiography. RESULTS: The importance of the anatomical origin of the dentine on lesion formation was investigated by comparing in vitro lesion formation in premolar and molar dentine, and in dentine from apical, middle and coronal thirds of the root: no difference was observed between these sites. Lesions formed more rapidly in acid buffer solutions than in acid gel systems, and were more reliably produced when cementum was removed. The effect of baseline lesion size on subsequent in vitro remineralisation demonstrated that a small baseline mineral content was associated with a larger percentage mineral gain. The location of mineral deposition throughout the lesion was also influenced by baseline mineral content parameters. CONCLUSIONS: The results form a basis for the further development of an in situ dentinal caries model, providing data to suggest that manipulation of parameters involved in the preparation of artificial carious lesions has a significant effect on the behaviour of the lesion, particularly the phenomenon of remineralisation. Further work is needed to investigate the behaviour of the model in situ.

Bicuspid↗
PubMed1996

A new challenge--root caries in mature people.

The future will bring many more root surface carious lesions in mature adults. Although traditional materials and procedures are acceptable for some patients, most are served best by use of cariostatic resin-modified glass ionomer materials, followed by additional fluoride augmentation for optimum tooth root surface caries prevention.

Adult↗
PubMedDate not supplied

Risk factors for and the prevention of root caries in older adults.

With the absolute and relative number of elderly people rising in most countries, it is essential that dental practitioners be knowledgeable about the normal changes and disease processes that occur in aging individuals. Especially prevalent in the aging population is root surface caries. Several variables may increase the risk of developing root surface caries. Among these are poor oral hygiene, microbial plaque, periodontal disease, gender (male), coronal caries, dietary habits, xerostomia, low socio-economic status, and infrequent dental visits. While each of these has an effect, plaque seems to have the greatest influence on the susceptibility of teeth to root decay. Improved oral hygiene and regular dental visits, combined with the use of fluoride, may continuously convert active root caries lesions to inactive. In fact, prophylactic programs are more effective in converting active to inactive rather than preventing the development of new lesions. The conscientious dental practitioner must identify his/her older patients at risk for developing root lesions and place a major emphasis on the prevention and treatment thereof.

Aged↗
PubMed1988

In vitro root caries progression measured by 125I absorptiometry: comparison with chemical analysis.

Radiation from a 125I source and a non-image-forming detector was used for non-destructive measurements of root caries progression. Blocks were cut parallel to the cementum surface of unexposed human roots. These blocks were then individually demineralized in under-saturated calcium phosphate solutions over an 84-hour period. In order for the in vitro root surface demineralization to be followed, the changes in transmission (delta T) through the blocks were measured, by 125I absorptiometry, eight times during the course of the experiment. Chemical analyses of the calcium output (delta Ca) from the blocks into the demineralizing solutions were also performed, and the rate of demineralization (Vdem) was calculated from these values. The precision of 125I absorptiometry was calculated from 176 duplicate transmission measurements, and the coefficient of variation was found to be 0.20%. The correlation coefficient between delta T and total delta Ca for each of 22 cementum/dentin blocks ranged between r = 0.934 and r = 0.998. The progression of root hard-tissue lesions observed by these two methods and by the calculated Vdem was found to be proportional to the square and cubic roots of time. The study shows that 125I absorptiometry can be used for continuous non-destructive measurements of root hard-tissue demineralization in vitro.

Calcium↗
PubMed1997

A computer-assisted videodensitometric method to visualize mineral distributions in in vitro and in vivo formed root caries lesions.

A computer-assisted videodensitometry (CAV) method is presented for the microradiographical mineral determination and mineral visualization of in vitro and in vivo formed dentin lesions. The method employs as essential steps (1) image digitizing by a CCD camera, (2) conversion of gray values to equivalent aluminium thicknesses and (3) conversion of aluminium thickness to vol% of mineral. Procedure and accuracy are described. The CAV method is illustrated for dentin lesions formed in vitro as well as for clinical root caries lesions. The CAV method is especially advantageous for clinical lesions because it can be employed for very complex mineral distributions and irregular lesion outlines. In given areas of interest, the mineral distribution (in vol%) can be plotted in 3D form in pseudo-colors. Conventional microradiographical profiles can be obtained directly from the CAV images. For in vitro lesions, the mineral distribution parameters, lesion depth, mineral loss, and mineral acquisition values can be generated from CAV images with a reproducibility of better than 7%. The CAV method is a valuable tool in quantitative mineral studies of clinical lesions in extracted teeth as well as in in situ lesion investigations.

Absorptiometry, Photon↗
PubMed2004

Ten-year cross-sectional and incidence study of coronal and root caries and some related factors in elderly Swedish individuals.

OBJECTIVE: The 10-year incidence of dental caries was related to some associated factors in a random sample of 65, 75 and 85-year-old inhabitants of Gothenburg. SUBJECTS: Of the 208 persons examined at baseline, 102 (49%) participated in the follow-up examination; 56, 37 and nine, respectively, in the different age groups. For the purpose of time-trend comparisons, a new random sample of 98 individuals aged 55 years was examined. RESULTS: Ninety-five per cent of the participants had developed one or more carious lesions during the 10-year period and the incidence of coronal and root caries increased with age. In the 65-year-olds, 9% of the root surfaces had decayed during the period, compared with 25% in the 85-year-olds. Secondary caries predominated over primary caries and prosthetic crowns accounted for 70% of the restored tooth surfaces. Twenty per cent of the individuals were daily smokers and 61% were taking drugs with hyposalivatory side-effects. The mean saliva secretion rates were lower in the older groups compared with the 'younger' ones. The overall salivary counts of mutans streptococci and lactobacilli had increased during the period and the values were highest in the oldest age groups. Salivary levels of lactobacilli and mutans streptococci, number of teeth, daily numbers of cigarettes and drugs and oral hygiene were the best predictors of the incidence of caries. CONCLUSION: The findings indicate that there is an increased risk of dental caries with age owing to unfavourable caries-related factors.

Aged↗
PubMed2001

Coronal and root caries in Southern Chinese adults.

Southern China is the most prosperous part of China, but information useful for oral care planning is very limited. A large-scale epidemiological survey was conducted in 1996-97. The objectives of this report were to describe the coronal and root caries of the adult Southern Chinese and to analyze the influence of selected demographic and socio-economic factors on the disease pattern. A total sample of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds from 8 urban and 8 rural survey sites in Guangdong Province participated in an oral health interview and underwent clinical examination. World Health Organization examination procedures and diagnostic criteria were used. The weighted mean DMFT scores of the middle-aged and the elderly subjects were 4.8 and 16.1, respectively. People living in rural areas had a higher DMFT score than those living in urban areas (4.9 vs. 4.3 in the 35- to 44-year-olds and 16.5 vs. 14.7 in the 65- to 74-year-olds). In both age groups, MT was the major component of the DMFT score. Analysis of covariance showed that women and those who were economically less well off had higher DMFT scores in both age groups. The weighted prevalence rates of decayed/filled roots were 12% and 37%, with a mean of 0.2 and 0.7 teeth affected, in the middle-aged and the elderly, respectively. In conclusion, socio-economic factors had a considerable effect on the dental caries status of adults in Southern China.

Adult↗
PubMed1991

Factors associated with active and inactive root caries in patients with periodontal disease.

The aim of this study was to analyze a number of microbial, salivary, and dietary factors in patients with clinically active and inactive root caries. 147 patients, aged 30-78 years, referred for specialist treatment of periodontal disease, were randomly selected. 645 decayed and 539 filled root surfaces were found. Out of the carious lesions, 372 (58%) were recorded as clinically active and 273 (42%) as inactive. 30 patients showed no lesions (group 1), 46 had only fillings or inactive lesions (group 2), and 35 showed 1-2 (group 3) and 36 greater than or equal to 3 active lesions (group 4). The lactobacillus count differed significantly between all groups, except group 1 vs. 2, and the mutans streptococcus count between groups 1 vs. 4 and 2 vs. 3 and 4. Group 4 differed in plaque score from the other groups, and the salivary buffer effect differed between the inactive groups 1 and 2 and the active group 4. By stepwise multiple regression analysis, it was shown that lactobacillus count, plaque index, salivary buffer effect, dietary habit index, and number of exposed root surfaces contributed significantly to the coefficient of determination.

Adult↗
PubMed1991

Effects of phosphoprotein moieties on the remineralization of human root caries.

The noncollagenous proteins, especially phosphoprotein, have been shown to modulate biomineralization. The objective of this study was to investigate the remineralization potential of human tooth root organic matrices which did or did not contain soluble non-collagenous proteins including phosphoprotein. Human tooth roots were completely demineralized using conditions that either removed or did not remove soluble phosphoprotein and were then subjected to remineralization conditions. Removal of soluble phosphoprotein resulted in remineralization while no remineralization occurred in tooth roots that still contained soluble phosphoprotein. Transmission electron microscopy and microradiography demonstrated that demineralized cementum did not remineralize under any of the conditions used in this study. Collagenase digestion of demineralized and salt-reextracted tooth root organic matrices revealed that a nonsoluble phosphoprotein was present in the matrices. Amino acid analysis and SDS-PAGE showed that this nonsoluble phosphoprotein was similar in composition to the soluble phosphoprotein. This work suggests that the removal of soluble, noncollagenous proteins, especially phosphoprotein from root caries lesions, may enhance their remineralization potential.

Amino Acids↗
PubMed1997

Distribution of coronal and root caries experience among persons aged 60+ in South Australia.

This report provides epidemiological data describing caries experience among the population of non-institutionalized older adults in Adelaide and Mt Gambier. Subjects were selected in a stratified random sample of persons aged 60+ who were listed on the South Australian Electoral Database. Oral examinations were conducted by four calibrated dentists among 853 dentate persons aged 60 years and over. There was an average of 14.7 missing teeth, 8.3 filled teeth and 0.3 decayed teeth, and a further 0.2 teeth were present as retained roots. The mean number of missing teeth was higher (p < 0.05) in older compared with younger age groups, and in Mt Gambier compared with Adelaide. The mean DFS of 22.1 was significantly higher (p < 0.05) among younger persons, females and in Adelaide. Root surface caries affected an average of 3.1 surfaces, and was greater (p < 0.05) among persons aged 70-79 years, males and Adelaide residents. However, when root caries was expressed as an attack rate per 100 exposed surfaces, differences were statistically significant only among age groups. Analysis of specific teeth revealed that no more than 40 per cent of molars were retained, and between 30 and 58 per cent of retained molars had coronal fillings.

Age Factors↗
PubMed2002

Root caries.

Explore the source record for details and available documents.

Humans↗
PubMed1989

[Root caries--a rat model].

A increasing alveolar bone loss and typical root surface caries were reproduced after defined co-inoculation of germfree Wistar rats with S. mutans and A. viscosus. The gnotobiotic rats were re-conventionalized and performed a gingivectomy on the right upper jaw at the beginning of the 12 week experiment.

Actinomyces↗