Challenges in differential diagnosis and treatment of cervical root resorption vs. root caries.

External cervical root resorption may be occasionally mistaken for root caries and vice versa. Radiographical and clinical differential diagnoses of cervical root resorption and root caries are essential for correct treatment planning and a successful treatment outcome. This article reviews the contemporary literature and summarises the prevailing professional consensus pertaining to external cervical root resorption. Clinical diagnostics which help distinguish cervical root resorption from root caries are outlined and treatment approaches of external cervical root resorption are discussed.

Novel Resin-Based Antibacterial Root Surface Coating Material to Combat Dental Caries.

Root caries caused by cariogenic bacteria are a burden on a large number of individuals worldwide, especially the elderly. Applying a protective coating to exposed root surfaces has the potential to inhibit the development of caries, thus preserving natural teeth. This study aimed to develop a novel antibacterial coating to combat root caries and evaluate its effectiveness using the antibacterial monomer dimethylaminohexadecyl methacrylate (DMAHDM). DMAHDM was synthesized and incorporated into a resin consisting of 55.8% urethane dimethacrylate (UDMA) and 44.2% TEG-DVBE (UV) at a 10% mass fraction of glass filler. Multiple concentrations of DMAHDM were tested for their impact on the resin's mechanical and physical properties. S. mutans biofilms grown on resin disks were analyzed for antibacterial efficacy. Cytotoxicity was assessed against human gingival fibroblasts (HGFs). The results showed an 8-log reduction in colony-forming units (CFUs) against S. mutans biofilm (mean ± sd; n = 6) (p < 0.05) when 5% DMAHDM was incorporated into the UV resin. There was a 90% reduction in metabolic activity and lactic acid production. A low level of cytotoxicity against HGF was observed without compromising the physical and mechanical properties of the resin. This coating material demonstrated promising physical properties, potent antibacterial effects, and low toxicity, suggesting its potential to protect exposed roots from caries in various dental procedures and among elderly individuals with gingival recession.

Long-term clinical comparison of a resin-based composite and resin modified glass ionomer in the treatment of cervical caries lesions.

This 72-month study compared the clinical effectiveness of a resin-based composite (RBC) (Spectrum TPH3, Dentsply Sirona) with a resin-modified glass ionomer cement (RMGIC) (Riva Light Cure, SDI) in restoring cervical caries lesions (CCLs). Thirty-three patients, each with at least two CCLs, were enrolled. After caries removal, the dimensions of the cavities were recorded. In a split-mouth study design, a total of 110 restorations were randomly placed. Fifty-five restorations were placed with RBC using an etch-and-rinse adhesive system (Prime&Bond NT, Dentsply Sirona), while the remaining 55 were restored with RMGIC. The restorations were assessed at baseline, 6, 12, 18, 24, 36, 60, and 72 months according to modified USPHS criteria. Statistical analysis included Pearson Chi-square, Friedman tests, Kaplan Meier, and Logistic Regression analysis (p < 0.05). After 72 months, 47 restorations in 19 patients were evaluated (55% follow-up rate). Seventy-five percent of the RBC (n = 26) and 74% (n = 21) of the RMGIC restorations were fully retained. There were no significant differences between materials regarding retention and marginal adaptation (p > 0.05). Cavity dimensions, caries activity, and retention exhibited no correlation (p > 0.05). The increase in marginal staining in both groups over time was significant (p < 0.001). RMGIC restorations exhibited higher discoloration than RBC restorations (p = 0.014). At 72 months, three secondary caries lesions were detected in both restoration groups: two RMGIC and one RBC. There were no reports of sensitivity. After 72 months, both RBC and RMGIC restorations were clinically successful, with similar retention and marginal adaptation scores. However, it is noteworthy that RMGIC restorations tend to discoloration over time compared to RBC. The trial is registered in the database of "Clinical Trials". The registration number is NCT0372-2758, October 29, 2018.

Enhancing Intraoral Fluoride Retention in Older Adults: A Randomized Crossover Study.

INTRODUCTION: Previous studies have shown that a calcium prerinse can increase intraoral fluoride retention from a fluoride rinse. To explore the potential of this approach to control root caries, we assessed intraoral fluoride bioavailability after a calcium prerinse in older adults with normal to low salivary flow rates. METHODS: In a 2-period crossover trial (NCT04239872), 20 participants (65-80 y old), with low or normal salivary flow rate, rinsed for 1 min with a 0.05% NaF mouth rinse (226 ppm F, F only) or with this rinse immediately after a 1-min rinse with 150 mM calcium lactate (Ca→F). Dental biofilm and saliva samples were collected before and up to 2 h after the rinse(s). Fluoride concentrations in saliva (whole and clarified) and dental biofilm (fluid and solid phases) were blindly determined. Data were statistically analyzed by a mixed-effects model for the effect of treatment, time, and their interaction (α = 5%). RESULTS: The Ca→F group resulted in significantly higher fluoride concentrations in all variables analyzed, for almost all of the collection time points. The effect was greater in the biofilm solids and whole saliva (compatible with the formation of calcium fluoride deposits) and still significant (P < 0.001) after 2 h in the biofilm fluid and clarified saliva, suggesting that fluoride stored in insoluble particles was released, increasing free fluoride. CONCLUSION: The use of a calcium prerinse before a fluoride rinse was able to prolong intraoral fluoride bioavailability in older adults. KNOWLEDGE TRANSFER STATEMENT: A calcium prerinse increased intraoral fluoride bioavailability in older individuals. This approach could be used to improve root caries control without the need to increase the fluoride concentration in dental products.

Decision making and management of root caries: A practice-based survey.

OBJECTIVES: With increasing life expectancy and improved preventive measures, teeth are retained longer, leading to a rise in prevalence of root caries lesions (RCL). However, little is known about how dentists manage this condition. The present survey aimed to evaluate the knowledge of Swiss dentists on decision making and management of RCL. METHOD: The survey evaluated dentists' knowledge, clinical routines, and demographics concerning RCL. Dentists were contacted via email and local newsletters, and 383 dentists from 25 (out of 26) cantons responded. Mann-Whitney U test, χ2 test, intraclass correlation coefficients, Spearman correlation and Chi Square were used. RESULTS: The dentists had a mean(SD) working experience of 22.5(12) years. Most dentists correctly classified an inactive (67%) and an active (81%)RCL. Although the inactive lesion did not call for restorative treatments, 61% of the dentist declared they would restore it. From the active lesion,83% would restore it. The invasive treatments leaned toward complete caries excavation with composite resin as preferred restorative material. There were significant correlations between material choice and expected success rates. Among the non-invasive options, oral hygiene instructions and (highly-)fluoridated toothpaste were favored. Most dentists declared having a recall system for such patients, with biannual follow-ups preferred. The dentists' place of education significantly influenced restorative decisions (p < 0.001), while participants' age (≥60years) impacted activity status (p = 0.048) and restorative decisions (p = 0.02). CONCLUSION: Material preferences for non-invasive or invasive management varied greatly and there were minimal differences in the management of inactive or an active RCL. Moreover, diagnosing active lesions appeared easier than diagnosing inactive ones. CLINICAL SIGNIFICANCE: Despite diverse material preferences for (non-)invasive treatments, a strong positive correlation existed between the chosen restorative material and its expected 2-year success rate. Moreover, diagnosing active lesions appeared easier than diagnosing inactive ones. The outcome emphasis the need to align guideline recommendations with their application in private dental practices.

Depression and dental caries in US adults, NHANES 2015-2018.

PURPOSE: This study aimed to investigate the link between depression and untreated dental caries among adults in the United States. METHODS: Data were collected from the National Health and Nutrition Survey (2015-2018); respondents aged 20 years or older who completed a patient health questionnaire and underwent a comprehensive oral examination were included. Participants were categorized into three groups according to depressive symptoms as follows: those with no, mild, or moderate to severe depression. Data were weighted, and multiple potential covariates were included in the analysis to provide national estimates and account for the complex sample design. A multivariable weighted logistic regression model was performed to test the hypothesis that varying degrees of depression in American adults are associated with untreated dental caries. Subgroup analyses were performed based on age and gender after adjusting for potential covariates. A P value of <.05 was considered significant. RESULTS: Among 8740 participants, the prevalence of untreated coronal and root caries was 20.50% and 12.92%, respectively. Moderate to severe depression was a significant risk factor (odds ratio, 1.25; 95% confidence interval, 1.09-1.66) for untreated root caries. The risk of untreated root caries increased by 87% in young adults (aged 20-44 years) and by 46% in women with moderate to severe depression. The suest analysis revealed that the impact of moderate to severe depressive disorder on untreated root caries was non-significantly different between the age subgroup (p=0.09) and sex subgroup (p=0.51). However, depression was non-significantly associated with untreated coronal caries (mild depression: OR, 1.07; 95% CI, 0.85-1.34; moderate to severe depression 1.06; 95% CI, 0.83-1.36; respectively). CONCLUSION: The results of this study suggested a significant association between moderate and severe depression and untreated root caries; however, the association with untreated coronal caries was non-significant. In the United States, moderate and severe depression in adults is associated with root caries.

Evaluation of toothpastes for treating root carious lesions - a laboratory-based pilot study.

BACKGROUND: Root caries is preventable and can be arrested at any stage of disease development. The aim of this study was to investigate the potential mineral exchange and fluorapatite formation within artificial root carious lesions (ARCLs) using different toothpastes containing 5,000 ppm F, 1,450 ppm F or bioactive glass (BG) with 540 ppm F. MATERIALS AND METHODS: The crowns of each extracted sound tooth were removed. The remaining roots were divided into four parts (n = 12). Each sample was randomly allocated into one of four groups: Group 1 (Deionised water); Group 2 (BG with 540 ppm F); Group 3 (1,450 ppm F) and Group 4 (5,000 ppm F). ARCLs were developed using demineralisation solution (pH 4.8). The samples were then pH-cycled in 13 days using demineralisation solution (6 h) and remineralisation solution (pH 7) (16 h). Standard tooth brushing was carried out twice a day with the assigned toothpaste. X-ray Microtomography (XMT) was performed for each sample at baseline, following ARCL formation and after 13-day pH-cycling. Scanning Electron Microscope (SEM) and 19F Magic angle spinning nuclear magnetic resonance (19F-MAS-NMR) were also performed. RESULTS: XMT results showed that the highest mineral content increase (mean ± SD) was Group 4 (0.09 ± 0.05), whilst the mineral content decreased in Group 1 (-0.08 ± 0.06) after 13-day pH-cycling, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4 (p < 0.05). SEM scans showed that mineral contents within the surface of dentine tubules were high in comparison to the subsurface in all toothpaste groups. There was evidence of dentine tubules being either partially or completely occluded in toothpaste groups. 19F-MAS-NMR showed peaks between - 103 and - 104ppm corresponding to fluorapatite formation in Groups 3 and 4. CONCLUSION: Within the limitation of this laboratory-based study, all toothpastes were potentially effective to increase the mineral density of artificial root caries on the surface, however there was evidence of mineral loss within the subsurface for Groups 1, 3 and 4.

A cost-effectiveness analysis of fluoride varnish application in preventing Root caries in elderly persons: a Markov simulation study.

BACKGROUND: Root caries are prevalent issues that affect dental health, particularly among elderly individuals with exposed root surfaces. Fluoride therapy has shown effectiveness in preventing root caries, but limited studies have addressed its cost-effectiveness in elderly persons population. This study aimed to evaluate the cost-effectiveness of a fluoride treatment program for preventing root caries in elderly persons within the context of Chinese public healthcare. METHODS: A Markov simulation model was adopted for the cost-effectiveness analysis in a hypothetical scenario from a healthcare system perspective. A 60-year-old subject with 23 teeth was simulated for 20 years. A 5% sodium fluoride varnish treatment was compared with no preventive intervention in terms of effectiveness and cost. Tooth years free of root caries were set as the effect. Transition probabilities were estimated from the data of a community-based cohort and published studies, and costs were based on documents published by the government. The incremental cost-effectiveness ratio (ICER) was calculated to evaluate cost-effectiveness. Univariate and probabilistic sensitivity analyses were performed to evaluate the influence of data uncertainty. RESULTS: Fluoride treatment was more effective (with a difference of 10.20 root caries-free tooth years) but also more costly (with a difference of ¥1636.22). The ICER was ¥160.35 per root caries-free tooth year gained. One-way sensitivity analysis showed that the risk ratio of root caries in the fluoride treatment group influenced the result most. In the probabilistic sensitivity analysis, fluoride treatment was cost-effective in 70.5% of the simulated cases. CONCLUSIONS: Regular 5% sodium fluoride varnish application was cost-effective for preventing root caries in the elderly persons in most scenarios with the consideration of data uncertainty, but to a limited extent. Improved public dental health awareness may reduce the incremental cost and make the intervention more cost-effective. Overall, the study shed light on the economic viability and impact of such preventive interventions, providing a scientific basis for dental care policies and healthcare resource allocation.

Tobacco products and oral conditions among US adults: NHANES 2017-2020.

OBJECTIVES: Smoking is a major global health problem with serious systemic and oral consequences. This study aims at assessing the influence of smoking cigarettes and other types of smoked tobacco on oral conditions (OCs) using a representative sample of US adults. METHODS: Pre-pandemic data from the National Health and Nutrition Examination Survey 2017-2020 were utilized, and 7840 adults aged ≥30 years were included in our analyses. Descriptive statistics, logistic, and negative binomial regression models were performed to assess the relationship between tobacco products and OCs including, tooth loss (TL), coronal (CC) and root caries (RC). RESULTS: Overall, 16.29% of our sample were current cigarette smokers (CCS). TL (17.25%) and untreated RC (28.26%) were more evident among CCS. In the adjusted regression models, smoking cigarettes was associated with RC (AOR: 3.20, 95% CI; 2.02, 5.09), untreated CC (IRR: 3.08, 95% CI: 1.50, 6.31), and TL (IRR: 2.18, 95% CI: 1.64, 2.88). Regarding the type of used tobacco product in the past 5 days, cigarettes were the most common type (15.03%). The adjusted model indicated that e-cigarette smokers had the highest odds of untreated RC (AOR: 5.17, 95% CI: 2.19, 12.23) and the highest rate of TL (IRR: 2.21, 95% CI: 1.45, 3.35). Further, cigar smokers had the highest rate of teeth with untreated CC (IRR: 3.25, 95% CI: 1.46, 7.25). CONCLUSIONS: Using tobacco products is associated with poor OCs. Dentists, being the primary oral health care providers, can play a crucial role in counseling and supporting smokers to quit as part of their routine dental examination.

Root caries in older adults: A co-citation network analysis (1980-2023).

BACKGROUND: Root caries affect the oral health and quality of life of older adults. This study examines the breadth of global research on this topic, aiming to clarify its expansive scope and to shed light on pertinent trends for new researchers in the field. OBJECTIVE: To identify key advances in root caries research as highlighted in high-quality articles from the Social Science Citation Index (SSCI) as well as to explore emerging trends and perspectives. MATERIALS AND METHODS: Using the Web of Science (WoS) database, we conducted a comprehensive review of articles related to root caries in older adults. Our focus was on finding high-quality SSCI articles, identifying major contributors, journals and research trends and exploring areas such as dentistry, oral surgery and medicine for potential future research. RESULTS: Our analysis included 192 articles, each of which was subjected to bibliometric and VOS viewer evaluations. The results revealed a concentration of studies in dentistry, oral surgery and medicine, with gaps identified in areas like anthropology, biochemistry, molecular biology and chemistry. A notable deficiency was found in root caries management. CONCLUSION: We discuss research gaps and propose future directions based on our findings, emphasising interdisciplinary research approaches.

Diagnosing and recording root caries: A survey among Swiss dentists.

OBJECTIVES: Despite the increase in the root caries prevalence, little is still known about how dentists manage this condition. The present study aimed to evaluate the knowledge of dentists on diagnosing and recording root caries lesions (RCL). METHODS: The survey consisted of three domains: (1) dentists' knowledge on diagnosing, recording and managing RCL; (2) information about their current general clinical routines; and (3) their demographics. The four Swiss Universities distributed the survey via e-mail lists for alumni or professionals participating in continuing education. The data was quality checked. Construct validity, internal reliability and intraclass correlation (ICC) were assessed. RESULTS: The survey was answered by 383 dentists from 25(out of 26) cantons [mean(SD) working experience: 22.5(12) years]. The majority replied that they see less than 5 patients with RCL per week, whereas 41 have at least 5 per week, and 40 % (157 dentists) do not distinguish RCL from coronal caries in their patients' medical records. When diagnosing active RCL, tactile sensation was the most predominant criterion (n = 380), whereas color (n = 224) and visual appearance (n = 129) of the lesion were less often selected. The most often chosen risk factors for RCL were poor oral hygiene and presence of biofilm.The responses were significantly influenced by the participants' place of education, their age and working area. CONCLUSION: The present survey highlights the huge diversity in diagnosing, recording and assessing risk factors of RCL. The benefits of an appropriate diagnosis, recording and management of risk factors of RCL should be highlighted in under- and postgraduate dental education. CLINICAL SIGNIFICANCE: A great diversity in diagnosing, recording and assessing risk factors of RCL was observed, which migh strongly impact how dentists manage RCL. The study emphasizes the necessity for intensive efforts to bridge the gap between guideline recommendations and their implementation in private dental practices.

Mechanism of dentin hardness measurements using a dentin hardness measuring device with a light-emitting diode.

Significance: Managing caries is imperative in a rapidly aging society. Current diagnoses use qualitative indices. However, a quantitative evaluation of hardness in a clinical setting may lead to more accurate diagnoses. Previously, hardness meter using indenter with light for tooth monitoring (HAMILTOM) was developed to quantitatively measure tooth hardness. Herein, the physical interpretation of dentin hardness measured using HAMILTOM and the dentin hardness measurement mechanism are discussed. Aim: This study evaluates the mechanism of dentin hardness measurements using HAMILTOM physically and compare the invasiveness to dentin by HAMILTOM with those using a dental probe for palpation. Approach: Eleven bovine dentin samples were used to create caries models. HAMILTOM measured the dark areas, and its indentations were observed using scanning electron microscopy. Also, its invasiveness was evaluated by comparing the results with those from dental probe palpation. Results: The indentation areas were smaller than the dark areas in HAMILTOM, which may be due to exuded water from the dentin sample and the elastic recovery of dentin sample. Additionally, the dental probe indentation was deeper than the HAMILTOM indentations. Conclusions: The results demonstrate that the indentation areas were smaller than the dark areas measured by HAMILTOM, which might contain the influence of exuded water and the deformation of dentin sample. Also, HAMILTOM is less invasive than dental probe palpation. In the future, HAMILTOM may become a standard hardness measuring method to diagnose root caries.

Clinical parameters that affect performance and patient satisfaction of root-retained overdentures: A systematic review of randomised controlled clinical trials.

OBJECTIVE: To evaluate clinical parameters that affect the performance of root-supported overdentures (ROD) and to identify the possible factors that may affect it. BACKGROUND: ROD still serve as an alternative and successful treatment plan nowadays for partially edentulous patients. Nonetheless, there is not yet conclusive evidence about their clinical evaluation. MATERIALS AND METHODS: A search strategy was developed following a PIO (Population, Intervention, Outcome) framework including an electronic search in the following databases: PubMed, Cochrane Library and Scopus. The systematic search included only randomised controlled clinical trials (RCTs), published until January 2023 in English language and was performed by two independent reviewers. Quality assessment of the included studies was conducted according to the Cochrane Risk of Bias tool. RESULTS: The final selection of studies included 11 RCTs. Clinically relevant variables derived from this search were: Complications, with caries being the most frequently reported, periodontal aspects and bone changes around abutment teeth. Additionally, methods and clinical suggestions for the maintenance of these restorations and patient-related outcomes were assessed. According to the risk of bias assessment, nine studies were considered of high risk, whereas only 2 of low risk. A meta-analysis was not feasible. CONCLUSION: Within the limitations of this systematic review, ROD remain a viable treatment plan, offering better denture stability and bone preservation around abutment teeth and high patient satisfaction. Thorough oral hygiene and regular follow-ups are of utmost importance. Further well-designed RCTs are necessary for firmer conclusions.

Clinical Investigation of the Inhibitory Effects of Tooth-Coating Materials on Initial Active Root Caries: A Pilot Randomized Controlled Trial.

Background and Objectives: Caredyne ZIF-C is a novel, capsule-mixed zinc-containing prototype glass ionomer cement (GIC). Zinc ions are reported to inhibit root dentin demineralization, dentin collagen degradation, bacterial growth, acid production, and in vitro bacterial biofilm formation. However, the effectiveness of GICs against initial root caries lesions is unclear. Therefore, this study aimed to evaluate the efficacy of GICs, especially the new zinc-containing Caredyne ZIF-C GIC, as tooth-coating materials in patients with initial active root caries. Materials and Methods: A total of 58 lesions in 47 older adults (age > 65 years) were randomly allocated to one of the following three groups: Caredyne ZIF-C, Fuji VII (a conventional GIC), and sodium fluoride (NaF). All the lesions were treated with the assigned materials without removing the infected dentin, and the rates of dental plaque attachment and coating material fall-out were evaluated after 3, 6, and 12 months. The failure rate was defined as the number of teeth that needed restoration due to caries progression. Results: The plaque attachment rates tended to be lower in the material-coated root surfaces than in the healthy exposed root surfaces after 3, 6, and 12 months, although the differences among the three groups were not significant. Moreover, the coating material fall-out rate tended to be lower in the Caredyne ZIF-C group than in the Fuji VII group. There was no significant difference in the failure rate among the three groups at the 12 months mark. Conclusions: Though this pilot study offers a new direction for suppressing the progression of initial active root caries by controlling plaque attachment using GICs including Caredyne ZIF-C, clinical studies with a larger sample size are needed.

Effectiveness of fluorides in root caries prevention, Department of Veterans Affairs (2009-2018).

AIMS: The aim of this study was to examine the effectiveness of topical fluorides in prevention of root caries-related treatment in high caries risk Veterans. METHODS: This retrospective analysis of longitudinal data examined the effectiveness of professionally applied or prescription (Rx) fluoride treatment, in VHA clinics from FY 2009-2018. Professional fluoride treatments included 5% Sodium Fluoride (NaF) varnish (22 600 ppm fluoride), 2% NaF gel/rinse (9050 ppm fluoride), and 1.23% APF gel (12 300 ppm fluoride). The Rx for daily home use was 1.1% NaF paste/gel (5000 ppm fluoride). Outcomes studied were new root caries restorations or extractions and percent of patients with treatment over 1 year. Logistic regressions were adjusted for age, gender, race, ethnicity, chronic medical or psychiatric conditions, number of medication classes, anticholinergic drugs, smoking, baseline root caries treatment, preventive care, and time between first-last restoration in the index year. RESULTS: Root caries at baseline was associated with a high risk for new root caries. Veterans without root caries during the index year who received a fluoride gel/rinse intervention were 32-40% less likely to receive caries-related treatment for root caries during the follow-up period. Once Veterans had root caries, fluorides did not exhibit a positive effect. CONCLUSION: In older adults with high caries risk, early fluoride prevention is key, before root caries requires treatment.

Effect of Three Chemical Agents on Stain Removal from Dentin Caries Lesions Treated with Silver Diamine Fluoride.

INTRODUCTION: This in vitro study aimed to evaluate the effect of three different chemical agents on stain removal and mineral uptake of artificial dentin caries (ADC) lesions treated with silver diamine fluoride (SDF). METHODS: Baseline L*a*b* values were determined in polished human permanent dentin blocks, and ADC lesions were induced with an acid gel for 1 week. Samples were assigned to four groups; in three groups, half of each sample received SDF (30% SDF for 3 min), while the other half received SDF followed by a bleaching treatment protocol (garlic extract, bentonite, or 35% hydrogen peroxide). The fourth group had one SDF-treated half and one half without SDF. Color changes (ΔE) were measured by spectrometry, and transversal microradiography was used to quantify integrated mineral loss (ΔZ) 24 h after treatment (SDF or SDF + bleaching). A two-way mixed ANOVA was applied to thirty percent. RESULTS: SDF application increased mineral uptake by ADC (p = 0.001). The type of chemical agent evaluated (p < 0.0001), time (p = 0.01), and their interaction (p < 0.0001) bleached the ADC treated with SDF. However, 35% hydrogen peroxide was the only compound with a bleaching effect (p < 0.001), without returning to baseline color. None of the compounds altered the mineral uptake effect of SDF (p = 0.30). CONCLUSION: This in vitro study showed mineral uptake effect in ACD within 24 h after SDF application and the ability of hydrogen peroxide to partially remove (reduction of 24%) the staining caused by SDF without affecting its mineral uptake effect.

Association of Root Biofilm Bacteriome with Root Caries Lesion Severity and Activity.

INTRODUCTION: This research aimed to assess the association of root biofilm bacteriome with root caries lesion severity and activity in institutionalised Colombian elderlies and was conducted to gather data on the root caries bacteriome in this population. METHODS: A bacteriome evaluation of biofilm samples from sound and carious root surfaces was performed. Root caries was categorised (ICDAS Root criteria) based on severity (sound surfaces, initial: non-cavitated, moderate/extensive combined: cavitated) and activity status (active and inactive). DNA was extracted and the V4 region of the 16S rRNA gene was sequenced; afterwards the classification of features was conducted employing amplicon sequence variants and taxonomic assignment via the Human Oral Microbiome Database (HOMD). Bacterial richness, diversity (Simpson's and Shannon's indices), and relative abundance estimation were assessed and compared based on root caries severity and activity status (including Sound surfaces). RESULTS: A total of 130 biofilm samples were examined: sound (n = 45) and with root caries lesions (n = 85; by severity: initial: n = 41; moderate/extensive: n = 44; by activity: active: n = 60; inactive: n = 25). Species richness was significantly lower in biofilms from moderate/extensive and active groups compared to sound sites. There was a higher relative abundance of species like Lechtotricia wadei, Capnocytophaga granulosa, Cardiobacterium valvarum, Porphyromonas pasteri - in sound sites; Dialister invisus, Streptococcus mutans, Pseudoramibacter alactolyticus and Bacteroidetes (G-5) bacterium 511 - in moderate/extensive lesions, and Fusobacterium nucleatum subsp. animalis, Prevotella denticola, Lactobacillus fermentum, Saccharibacteria (TM7) (G-5)bacterium HMT 356 - in active lesions. CONCLUSION: Root caries bacteriome exhibited differences in species proportions between the compared groups. Specifically, cavitated caries lesions and active caries lesions showed higher relative abundance of acidogenic bacteria.

The action of microbial collagenases in dentinal matrix degradation in root caries and potential strategies for its management: a comprehensive state-of-the-art review

Abstract Conventional views associate microbial biofilm with demineralization in root caries (RC) onset, while research on their collagenases role in the breakdown of collagen matrix has been sporadically developed, primarily in vitro. Recent discoveries, however, reveal proteolytic bacteria enrichment, specially Porphyromonas and other periodontitis-associated bacteria in subgingivally extended lesions, suggesting a potential role in RC by the catabolism of dentin organic matrix. Moreover, genes encoding proteases and bacterial collagenases, including the U32 family collagenases, were found to be overexpressed in both coronal and root dentinal caries. Despite these advancements, to prove microbial collagenolytic proteases' definitive role in RC remains a significant challenge. A more thorough investigation is warranted to explore the potential of anti-collagenolytic agents in modulating biofilm metabolic processes or inhibiting/reducing the size of RC lesions. Prospective treatments targeting collagenases and promoting biomodification through collagen fibril cross-linking show promise for RC prevention and management. However, these studies are currently in the in vitro phase, necessitating additional research to translate findings into clinical applications. This is a comprehensive state-of-the-art review aimed to explore contributing factors to the formation of RC lesions, particularly focusing on collagen degradation in root tissues by microbial collagenases.

Research progress on dental materials for preventing root caries / 口腔疾病防治

@#The high incidence and untreated rate of root caries, a common and frequently occurring oral disease with challenging treatment in elderly individuals, is the main cause of tooth loss among elderly people, as rapid development results in pulpitis and periapical periodontitis or residual crown and root, which has been regarded as one of the common chronic oral diseases seriously affecting the quality of life of elderly people. Thus, early intervention and prevention are important. Traditional dental materials for preventing root caries have been widely used in clinical practice; however, they have the disadvantages of tooth coloring, remineralization and low sterilization efficiency. A series of new dental materials for preventing root caries have gradually become a research hotspot recently, which have the advantages of promoting the mineralization of deep dental tissue, prolonging the action time and enhancing adhesion. Future caries prevention materials should be designed according to the characteristics of root surface caries and the application population and should be developed toward simplicity, high efficiency and low toxicity. This review describes current research regarding anti-caries prevention material application, serving as a theoretical underpinning for the research of root caries prevention materials, which is important for both promotion in the effective prevention of root caries and improvement in the status of oral health and the quality of life among old people.

In Vitro Models Used in the Formation of Root Caries Lesions-A Review of the Literature.

The management of root caries remains a challenge for clinicians due to its unique anatomical location and structure. There is increasing interest in utilising artificial root caries lesions to develop new strategies for remineralisation. An ideal protocol has not yet been agreed upon. The aim of this review is to provide a structured overview of previously reported in vitro root caries models. The literature was screened and mined for information mainly on substrate selection, model systems utilised, and variables used in the models. Human roots (60%) were the most frequently used substrates, followed by bovine roots (40%). Chemical models (69%) were the most frequently utilised model systems, followed by microbiological models (27%), to form root caries lesions. Acetate buffer solution (80%), pH 5.0 or above (40%), and a demineralisation time of five days (25%) were the common variables used in the chemical systems, while mono-species biofilm was most frequently used (73%) in microbiological models and Streptococcus mutans was the most common bacterial strain utilised in these models (80%). This review highlights the variability amongst the experimental approaches, discusses the advantages and limitations of these approaches, and emphasises that standardisation of experimental conditions along with sustained research will benefit root caries research.