Short-Wavelength Infrared Imaging of Infected and Affected Dentin.

Stains produced by bacteria or those found in blood and food byproducts accumulate in highly porous caries lesions. They can interfere with accurate diagnosis and the selective removal of carious tissue during cavity preparations. Short-wavelength infrared (SWIR) imaging studies have shown that stain molecules do not absorb light beyond 1200 nm. The objective of this study was to image affected and infected dentin atSWIR wavelengths. Sections of 3 mm thickness were cut from the extracted teeth with deep dentinal lesions. The sound (normal), affected (stained), and infected (demineralized) dentin on each section were examined with reflected light at wavelengths from 400 to 1700 nm, red and green fluorescence, and with optical coherence tomography (OCT). Microcomputed tomography (microCT) was used to measure the mineral density at each location investigated. Significant (p < 0.05) differences were observed in the reflected light intensity at 400-850 nm and for fluorescence between the sound, affected, and infected dentin. SWIR imaging did not show significant reductions in reflectivity for the affected and infected dentin. SWIR images may be valuable for monitoring the lateral spread of dentinal lesions on the occlusal surfaces of teeth.

Effect of Laser Irradiation Modes and Photosensitizer Types on Antimicrobial Photodynamic Therapy (aPDT) for Streptococcus sobrinus in the Crown Dentin of Bovine Teeth: An Experimental In Vitro Study.

This study aimed to assess the impact of different laser irradiation modes and photosensitizer types on the bactericidal efficacy of antimicrobial photodynamic therapy (aPDT). Dentin plates were prepared by sectioning the crown dentin of bovine teeth infected with Streptococcus sobrinus (n = 11). Nine aPDTs involving the combination of three 1% solutions of photosensitizers (brilliant blue, BB; acid red, AR; and methylene blue, MB) and three irradiation modes of semiconductor lasers (50 mW for 120 s, 100 mW for 60 s, and 200 mW for 30 s) were performed for each infected dentin plate, and the control consisted of the specimens not applied with aPDT. The bactericidal effects in 10 groups were evaluated using both assays of the colony count (colony-forming-unit: CFU) and adenosine triphosphate (ATP) (relative-light-unit: RLU). The data obtained were analyzed using the Kruskal-Wallis test (α = 0.05). The most aPDT groups exhibited significantly lower RLU and CFU values compared with the control (p < 0.05). The effect of irradiation modes on RLU and CFU values was significant in the aPDT group using BB (p < 0.05) but not in the aPDT group using AR or MB. The aPDT performed with AR or MB exerted a remarkable bactericidal effect.

Biochemical and Mechanical Analysis of Occlusal and Proximal Carious Lesions.

A precise evaluation of caries excavation endpoint is essential in clinical and laboratory investigations. Caries invasion differentiates dentin into structurally altered layers. This study assessed these changes using Raman spectroscopy and Vickers microhardness. Ten permanent molars with occlusal and proximal carious lesions were assessed and compared at 130 points utilizing four Raman spectroscopic peaks: phosphate v1 at 960 cm-1, amide I (1650 cm-1), amide III (1235 cm-1) and the C-H bond of the pyrrolidine ring (1450 cm-1). The phosphate-to-amide I peak ratio and collagen integrity peak ratio (amide III: C-H bond) of carious zones were calculated and compared in both lesions. The former ratio was correlated to 130 Vickers microhardness indentations through lesions. The caries-infected dentin (CID) exhibited low phosphate peak, but higher amide I, III and C-H bond peaks than other zones in both lesions. The peaks in amide regions (I and III) varied in occlusal versus proximal lesions. A high correlation was found between mineral: matrix peak ratio and equivalent microhardness number within carious lesions, while the collagen integrity peak ratio was applied in proximal lesions only. Raman spectroscopy detected changes in the mineral and matrix contents within different carious zones and regions.

Bactericidal effect of antimicrobial photodynamic therapy (aPDT) on dentin plate infected with Lactobacillus acidophilus.

This study aimed to examine bactericidal effects of a new antimicrobial photodynamic therapy (aPDT) on dentin plates infected with Lactobacillus acidophilus (L. acidophilus). First, we measured the amount of reactive oxygen species (ROS) produced when new photosensitizer (PS), acid red (AR), and brilliant blue (BB) were irradiated with a semiconductor laser. ROS generated from each PS solution by laser irradiation was calculated as the total light emission amount (Relative Light Unit, RLU) using a chemiluminescence measuring device. Second, we examined bactericidal effects of the aPDT on dentin plates infected with L. acidophilus. The bactericidal effects on each group were evaluated by colony count assay and adenosine triphosphate assay. The experimental groups comprised two laser irradiation groups (650 nm laser, 650laser; and 940 nm laser, 940laser), two PS groups (BB and AR), four aPDT groups (650 nm laser irradiation with BB, 650laser-BB; 650 nm laser irradiation with AR, 650laser-AR; 940 nm laser irradiation with BB, 940laser-BB; 940 nm laser irradiation with AR, 940laser-AR), and a control. The ROS in all aPDT groups was significantly higher than in the control. RLU in all groups applied with laser irradiation was significantly lower than that in the control. However, only 650laser-BB showed significantly lower colony counts than the control. 650laser-BB was the most effective in sterilizing the infected dentin plates.

Systematic review on alternative methods for caries removal in permanent teeth.

INTRODUCTION: Dental caries is the most common chronic dental disease in the world. It is defined as a multifactorial microbial infectious disease characterized by demineralization of the inorganic and destruction of the organic substance of the tooth. The host, flora, and the substrate should be there for the formation of dental caries. There are various microorganisms responsible for caries. The treatment for caries is essential to prevent teeth from involving pulp, leading to further damage. There are various methods in removing caries such as minimally invasive technique, rotary method with different types of burs, chemomechanical caries removal, and lasers. There are no data in literature for various methods of removing caries in permanent teeth. MATERIALS AND METHODS: Research question was formulated based on the PICO strategy. A comprehensive electronic literature search was conducted, independently by two reviewers. Based on the specified inclusion and exclusion criteria's, the selected articles were subjected to quality assessment and the risk of bias was evaluated. OBJECTIVE: The objective of this study was to evaluate the efficiency of caries removal by various methods in permanent teeth. SEARCH STRATEGY: A search was performed in electronic database (i.e. PubMed and Medline) using search terms alone and in combination by means of PubMed search builder from January 1985 to January 2018. SELECTION CRITERIA: Studies were selected if they met the following criteria: in vivo studies comparing various methods of caries removal in permanent teeth. RESULTS: The search identified 338 publications, out of which 328 were excluded after examination of the title and 2 were excluded after examination of the abstract. Through the hand search, three articles were included. Eight articles were retrieved for more detailed evaluation from the search. A total of 11 publications fulfilled all the criteria for inclusion. CONCLUSION: With the available evidence, this review concludes that the studies included in this review have a high risk of quality evidence.

Characterization of polymicrobial biofilms obtained from saliva or carious lesions in dentin.

This study aimed to compare the formation of polymicrobial biofilms using carious dentin or saliva as inoculum for application in in vitro microbiological studies on caries research. For biofilm growth, combined samples of infected dentin or saliva from three donors were used. The biofilms were grown on glass coverslips, under a regimen of intermittent exposure (6 h day-1) to 1% sucrose for 4 days. Total bacterial loads, as well as specific aciduric bacteria and mutans streptococci loads were quantified and correlated with biofilm acidogenicity and susceptibility to chlorhexidine. The data were evaluated using the Student's-t, Mann Whitney and Kruskal-Wallis tests. The two biofilms showed similar microbial loads (total bacteria, aciduric bacteria and mutans streptococci) on day 4, and high acidogenicity after 48 h and were susceptible to chlorhexidine at different time intervals. In conclusion, both dentin and saliva can be used as an inoculum in in vitro studies of processes related to biofilm formation.

Effectiveness of Different Cleaning Solutions in Removing Residual Caries-Detector Dyes.

OBJECTIVE: Caries-detector dyes (CDDs) have proven useful in the identification and removal of carious dentin. However, residues of these cleaning agents may remain in the oral cavity. This study conducted spectrophotomectric analyses to evaluate the effectiveness of different cleaning agents in removing residual CDDs from the oral cavity. MATERIAL AND METHOD: Ninety freshly extracted human third-molar teeth were used in the study. Tooth occlusal surfaces were ground to expose dentin. Specimens were randomly distributed into 3 groups according to CDD [Seek Caries Indicator (SCI), Caries Detector (CD), Caries Marker (CM)], and each group was further divided into 3 sub-groups according to cleaning solution [distilled water (DW), 3% NaOCl, and 3% H2 O2 )]. CDDs were applied to dentin surfaces according to the manufacturer's instructions and then rinsed with a cleansing solution. The effectiveness of cleaning solutions in removing CDD residues was determined according to color change by comparing spectrophotometric measurements of tooth color before CDD application and after cleaning. Data were analyzed using two-way analysis of variance (ANOVA) and Tukey's HSD test (α = 0.05). RESULT: For all CDDs groups, the smallest color differences were observed in the 3% NaOCl sub-groups (P < .05), and the largest in the distilled water sub-groups (P > .05). When compared to the other CDD groups, the SCI group yielded the greatest color differences for all cleaning-agent sub-groups. CONCLUSION: Cleaning solutions such as 3% NaOCl or 3% H2 O2 can be used to remove residual CDD from dentin surfaces. CLINICAL SIGNIFICANCE: This study compared the effectiveness of three different cleaning agents in caries removal process.

Effect of antimicrobial photodynamic therapy (aPDT) on the sterilization of infected dentin in vitro.

The aim of this study was to evaluate the bactericidal effect of antimicrobial photodynamic therapy (aPDT) on an infected dentin model. Dentin plates were prepared from extracted human molars and infected through immersion in a solution of Streptococcus mutans. The nine experimental groups consisted of two laser irradiation groups (650 nm laser: 650 laser and 940 nm laser: 940 laser), two photosensitizer groups (methylene blue: MB, and azulenocyanine: Azc), four aPDT groups (650 nm laser irradiation of MB: 650 laser-MB, 650 nm laser irradiation of Azc: 650 laser-Azc, 940 nm laser irradiation of MB: 940 laser-MB and 940 nm laser irradiation of Azc: 940 laser-Azc) and a control. The bactericidal effects on each group were evaluated by colony count and adenosine triphosphate (ATP) assays. Based on the results of the colony count assay, the 650 laser-MB and 940 laser-MB groups formed significantly fewer colonies than the other experimental groups. Significantly fewer colonies were observed in the 940 laser-Azc group than in the control, but significant differences in the numbers of colonies were not observed between the 650 laser-Azc and control groups. The 940 laser group formed slightly fewer colonies than the 650 laser group, but the difference was not significant. In addition, the number of colonies in the MB group was significantly less than the number in the Azc group. The results of the ATP assay were similar to those of the colony count assay. aPDT with MB showed a significant bactericidal effect on dentin plates infected with S. mutans.

A Comparative Evaluation of the Efficacy of Different Caries Excavation Techniques in reducing the Cariogenic Flora: An in vivo Study.

BACKGROUND: Caries excavation is a noninvasive technique of caries removal with maximum preservation of healthy tooth structure. AIM: To compare the efficacy of three different caries excavation techniques in reducing the count of cariogenic flora. MATERIALS AND METHODS: Sixty healthy primary molars were selected from 26 healthy children with occlusal carious lesions without pulpal involvement and divided into three groups in which caries excavation was done with the help of (1) carbide bur; (2) polymer bur using slow-speed handpiece; and (3) ultrasonic tip with ultrasonic machine. Samples were collected before and after caries excavation for microbiological analysis with the help of sterile sharp spoon excavator. Samples were inoculated on blood agar plate and incubated at 37°C for 48 hours. After bacterial cultivation, the bacterial count of Streptococcus mutans was obtained. STATISTICAL ANALYSIS: All statistical analysis was performed using SPSS 13 statistical software version. Kruskal-Wallis analysis of variance, Wilcoxon matched pairs test, and Z test were performed to reveal the statistical significance. RESULTS: The decrease in bacterial count of S. mutans before and after caries excavation was significant (p < 0.001) in all the three groups. CONCLUSION: Carbide bur showed most efficient reduction in cariogenic flora, while ultrasonic tip showed almost comparable results, while polymer bur showed least reduction in cariogenic flora after caries excavation. HOW TO CITE THIS ARTICLE: Hassan AF, Yadav G, Tripathi AM, Mehrotra M, Saha S, Garg N. A Comparative Evaluation of the Efficacy of Different Caries Excavation Techniques in reducing the Cariogenic Flora: An in vivo Study. Int J Clin Pediatr Dent 2016;9(3):214-217.

Influence of Smear Layer on the Antimicrobial Activity of a Sodium Hypochlorite/Etidronic Acid Irrigating Solution in Infected Dentin.

INTRODUCTION: The aim of this study was to evaluate the influence of the smear layer on the antimicrobial activity of a 2.5% sodium hypochlorite (NaOCl)/9% etidronic acid (HEBP) irrigating solution against bacteria growing inside dentin tubules. METHODS: Dentin tubules were infected with Enterococcus faecalis by centrifugation. After 5 days of incubation, the smear layer had formed in half of the samples, which were then treated with 2.5% NaOCl either alone or combined with 9% HEBP for 3 minutes. The percentage of dead cells in infected dentinal tubules was measured using confocal laser scanning microscopy and the live/dead technique. The smear layer on the surface of the root canal wall was also observed by scanning electron microscopy. Results of the percentage of dead cells were compared using parametric tests after subjecting data to the normalized Anscombe transformation. The level of significance was P < .05. RESULTS: In the absence of the smear layer, 2.5% NaOCl alone and combined with 9% HEBP showed high antimicrobial activity without significant differences between the 2. The smear layer reduced the antimicrobial activity of 2.5% NaOCl significantly, whereas the solution with HEBP was not affected. No dentin tubules free of the smear layer were obtained in the 2.5% NaOCl group. In the case of 2.5% NaOCl/9% HEBP, 95.40% ± 3.63% of dentin tubules were cleaned. CONCLUSIONS: The presence of the smear layer reduced the antimicrobial activity of 2.5% NaOCl. The combination of 2.5% NaOCl/9% HEBP exerted antimicrobial activity that was not reduced by the smear layer.

Adhesion of a self-etching adhesive to caries-affected dentin treated with different methods for caries removal: a preliminary study / Avaliação de um sistema adesivo autocondicionante em dentina afetada por cárie tratada por diferentes mecanismos de remoção: estudo preliminar

Objetivo: O objetivo deste estudo foi avaliar a adesão (RU) de sistemas autocondicionantes à dentina afetada por cárie (CAD) e dentina normal (ND), após diferentes técnicas de remoção de tecido cariado. Materiais e Métodos: Foram utilizados vinte e quatro molares humanos extraídos, com lesão de cárie oclusal. A amostra foi aleatoriamente dividida em 5 grupos, de acordo com o método de remoção do tecido cariado: G1 - controle negativo (sem remoção); G2 - disco abrasivo; G3 – broca de aço de baixa velocidade; G4 - laser Nd:YAG (21,2 J/cm2 ); G5 - laser Er:YAG (80,24 J/cm2 ). Dentinas normais e afetados / infectados foram tratadas com o sistema adesivo (Clearfil SE Bond) e coroas de resina foram construídas. Resultados: ANOVA um fator mostrou diferença estatisticamente significante entre os grupos experimentais (p < 0,001), com um valor menor para a dentina infectada (G1), quando comparado com todos os grupos experimentais. Maior RU foi observada para ND irradiada com laser Er:YAG, quando comparado a CAD. Para os espécimes tratados com broca e laser Nd:YAG, a RU em ND e CAD foi semelhante. Conclusão: a dentina infectada não é um substrato adequado para a adesão; laser de Nd:YAG e brocas de aço mostraram-se adequados como ferramenta de tratamento das dentinas normal e afetada prévio à instalação de restaurações adesivas. Contudo, ambas as dentinas tratadas pelos laser de Er:YAG, não interagiram adequadamente com o sistema auto-condicionante resultando em fraca adesão

Objective: The aim of this study was to evaluate the adhesion of a self-etching system to cariesaffected dentin (CAD) and sound dentin (SD) after different caries removal techniques by using microtensile bond strength test (μTBS). Materials and Methods: Twenty-four extracted human molars with coronal carious lesions were used. The samples were randomly divided into 5 groups, according to caries removal method: G1 - negative control (no removal); G2 abrasive disc; G3 – slow speed steel bur; G4 - Nd:YAG laser (energy density 21.2 J/cm2 ); G5 - Er:YAG laser (energy density 80.24J/cm2 ). SD and CAD/ infected dentin substrates were tested. Self-etch system (Clearfil SE Bond) was applied and resin crowns were built up. Results: One-way ANOVA showed statistically significant difference between experimental groups (p < 0.001), with significantly lower results for infected dentin (G1), when compared to all other experimental groups. A statistically significant higher bond strength value was observed for SD irradiated with Er:YAG laser when compared to CAD. For bur and Nd:YAG laser specimens, SD and CAD showed the same bonding performance. Conclusion: infected dentin is not an adequate substrate for bonding; Nd:YAG laser and steel burs showed the same bonding performance for both SD and CAD; while both dentins, when irradiated by Er:YAG laser, did not adequately interact with self-etching system resulting in poor adhesion