A Rare Cause of Pain in the Oral Cavity: Osteomyelitis of Tori.

A 63-year-old man presented with a 1-month history of worsening mouth pain, particularly under the tongue bilaterally, with left more than right. A physical examination revealed multiple dental caries and bilateral mandibular tori, with the left mandibular torus being exquisitely tender to palpation. Lab tests showed increased inflammatory markers in the absence of leukocytosis. A maxillofacial computed tomography scan revealed findings concerning for chronic osteomyelitis with osteolysis of the left mandibular torus. The patient was started on intravenous antibiotics and transferred to another institution for further management through their oral and maxillofacial surgery service. The surgical pathology after torectomy confirmed the diagnosis of acute osteomyelitis with osteonecrosis. Although rare, this case underscores the importance of familiarity with osteomyelitis in tori of the oral cavity, also highlighting the imaging and clinical correlation. Further research is necessary to understand the risk factors and optimal management strategies for similar cases.

Dental caries status and treatment need among pregnant women attending antenatal clinics in Dar-Es-Salaam region, Tanzania.

BACKGROUND: Literature shows that pregnant women are more susceptible to dental caries due to several reasons, including changes in salivary flow, reduced pH in the oral cavity, and sugary dietary cravings. The unmet need for care is of special concern, as the failure to obtain treatment can affect the health status of the mother and her unborn child. OBJECTIVES: To determine dental caries status and treatment needs among pregnant women attending antenatal clinics in the Dar-es-Salaam region. MATERIALS AND METHODS: A descriptive cross-sectional hospital-based study was conducted among 461 pregnant women aged 14-47 years. Informed consent was obtained from participants during data collection. Dental caries status and treatment need were diagnosed according to the WHO criteria. The Data collected was cleaned and analyzed using SPSS version 23.0 software for generating frequency distribution tables, chi-square tests, and logistic regression analysis. The Confidence Interval was 95% (p < 0.05). RESULTS: The overall prevalence of dental caries was 69%, with a mean DMFT score of 2.86 (± 3.39). Untreated dental decay was observed in 60.5% of study participants, which needed more restorative treatment (fillings & RCT) than a tooth extraction. Caries experiences differed significantly among the pregnant women in various gravidity. In logistic regression, dental caries experience was significantly higher among multigravida respondents (p-values = 0.04) (OR: 1.840, CI 1.021-3.319). CONCLUSION: This study demonstrated a high level of dental caries experience and the presence of treatment needs. Multiple pregnancies were a major factor that contributed to high levels of dental caries.

Oral microbiota: Taxonomic composition and functional profile in caries-free and in caries-affected individuals - A systematic review.

OBJECTIVE: To compare the oral microbiota among caries-free (CF) with caries-affected (CA) individuals, both at taxonomic and at functional levels. DESIGN: This systematic review was conducted following PRISMA guidelines. A structured search was carried out in MEDLINE/PUBMED, Web of Science, EMBASE, LILACS, SciELO, Scopus and Google Scholar databases up to September, 2023. Observational studies, without any restriction on date of publication and using next-generation targeted or untargeted sequencing methods for identification of microbial communities were included. Qualitative synthesis was performed from all included studies. RESULTS: 54 studies were included (43 cross-sectional; 11 cohort) comprising more than 3486 participants (at least 1666 CF and 1820 CA) whose saliva and/or dental plaque were used as clinical samples. Methodological quality was graded as "fair" for most of the studies. The abundance of 87 bacterial and 44 fungal genera were statistically different among CF and CA individuals. Atopobium spp., Capnocytophaga spp., Lactobacillus spp., Prevotella spp., Scardovia spp., Selenomonas spp. among others were frequently reported as being more abundant in CA individuals. Several functional patterns, such as lipids, carbohydrate, starch, sucrose, amino sugar metabolisms, among others, were identified as being specifically related to CF or to CA conditions. CONCLUSION: In spite of the variability among the included studies and of the predominance of qualitative synthesis, groups of microorganisms as well as specific functional profiles coded by the assessed microbiota are differently abundant among caries-affected and caries-free individuals. These results need to be interpreted with caution considering the limitations inherent to each assessed primary study.

A scoping review of early childhood caries, poverty and the first sustainable development goal.

BACKGROUND: Poverty is a well-known risk factor for poor health. This scoping review (ScR) mapped research linking early childhood caries (ECC) and poverty using the targets and indicators of the Sustainable Development Goal 1 (SDG1). METHODS: We searched PubMed, Web of Science, and Scopus in December 2023 using search terms derived from SDG1. Studies were included if they addressed clinically assessed or reported ECC, used indicators of monetary or multidimensional poverty or both, and were published in English with no date restriction. We excluded books and studies where data of children under 6 years of age could not be extracted. We charted the publication year, study location (categorized into income levels and continents), children age, sample size, study design, measures of ECC, types and levels of poverty indicators and adjusted analysis. The publications were also classified based on how the relation between poverty and ECC was conceptualized. RESULTS: In total, 193 publications were included with 3.4 million children. The studies were published from 1989 to 2023. Europe and North America produced the highest number of publications, predominantly from the UK and the US, respectively. Age-wise, 3-5-year-olds were the most studied (62.2%). Primary studies (83.9%) were the majority, primarily of cross-sectional design (69.8%). Non-primary studies (16.1%) included reviews and systematic reviews. ECC was mainly measured using the dmf indices (79.3%), while poverty indicators varied, with the most common used indicator being income (46.1%). Most studies measured poverty at family (48.7%) and individual (30.1%) levels. The greatest percentage of publications addressed poverty as an exposure or confounder (53.4%), with some studies using poverty to describe groups (11.9%) or report policies or programs addressing ECC in disadvantaged communities (11.4%). In addition, 24.1% of studies requiring adjusted analysis lacked it. Only 13% of publications aligned with SDG1 indicators and targets. CONCLUSION: The ScR highlight the need for studies to use indicators that provide a comprehensive understanding of poverty and thoroughly examine the social, political, and economic determinants and impact of ECC. More studies in low and middle-income countries and country-level studies may help design interventions that are setting- and economic context-relevant.

Development and validation of Tamil version of CARIES-QC questionnaire among socially marginalized school children in Chennai City.

BACKGROUND: The Caries Impacts and Experiences Questionnaire for Children (CARIES-QC), which was developed to assess dental caries-specific Child Oral Health Related Quality of Life (COHRQoL), has been translated into few world languages. AIM: To develop and validate the Tamil version of Caries Impacts and Experience Questionnaire for Children (CARIES-QC). DESIGN: This cross-sectional study was conducted among socially marginalized school children in Chennai City. The initial translation of the English CARIES-QC questionnaire to Tamil was made by two independent translators followed by an expert committee discussion to derive a prefinal version of the Tamil questionnaire. Subsequently, content validation was performed by bilingual subject experts followed by preliminary pilot testing among 30 school children aged 8-10 years studying in Adidravidar Welfare High School, Chennai, to produce the final version of the questionnaire. Convergent validity, discriminant validity, and test-retest reliability of the translated questionnaire were tested among 191 children. RESULTS: The content validation process revealed that the translated version had relevant questions and content coverage (Scale-wise Content Validity Index score = .91). The children with and without dental caries had mean CARIES-QC scores of 5.39 + 3.7 and 3.71 + 5.1, respectively, and their statistically significant difference (p-value = .04) between them indicates the scale's satisfactory discriminant validity. The Cronbach's alpha was .87 indicating the questionnaire's good internal consistency. CONCLUSION: The newly developed Tamil CARIES-QC questionnaire is a valid and reliable tool for assessing COHRQoL among Tamil-speaking school children.

Cross-sectional survey and analysis of factors influencing the prevalence of dental caries among older individuals aged 65-74 in Guangdong Province in 2021.

BACKGROUND: The prevalence of oral diseases is subject to change over time. In 2021, Guangdong Province conducted its fourth survey assessing the oral health status of individuals aged 65-74. MATERIALS AND METHODS: Evaluation criteria and potential influencing factors were identified. A sample of residents aged 65-74 from 13 designated monitoring sites in Guangdong Province was randomly selected for the study. Spearman correlation analysis was employed to investigate the clinical correlation between influencing factors and evaluation criteria. Negative binomial and zero-inflated negative binomial regression models were utilized to examine the factors influencing caries prevalence. In contrast, logistic regression was employed to identify the risk factors for caries occurrence. A p-value of ≤0.05 was considered statistically significant. RESULTS: The prevalence of caries rate of crowns, roots, and teeth were 76.36%, 52.25%, and 79.2%, respectively. Individuals with periodontal pockets exhibited a significantly higher risk of root caries. The presence of dental calculus significantly exacerbated the occurrence of crown, root, and dental caries, and increased the risk of crown and dental caries. Consuming sweet foods once or more a week notably increased the average root decayed score (D of roots), the prevalence rate of root caries, and the D score of the Decayed, Missing, and Filled teeth [DMFT] index in individuals already afflicted with this condition. Similarly, the consumption of sweetened drinks significantly elevated the risk of crown and root caries, exacerbating overall caries progression. Frequencies of manual toothbrush and toothpick cleaning showed a negative correlation with average tooth missing score (MT). In contrast, the frequency of manual/electric toothbrush and toothpick cleaning was negatively correlated with the DMFT index. Engaging in dental diagnosis and treatment behaviors significantly increased the number of filled crowns (F), MT, and DMFT scores while reducing the prevalence of dental caries. CONCLUSIONS: In Guangdong Province, caries prevalence among older individuals aged 65-74 remains substantial. Relevant professionals and institutions must provide comprehensive guidance and assistance to the older population, emphasizing the importance of reducing the consumption of sweets and sweetened beverages, adopting correct tooth brushing techniques and frequency (at least twice daily), timely treatment of periodontal diseases, conducting regular epidemiological caries surveys, and addressing economic barriers to accessing caries diagnosis and treatment services.

Clinical SWIR and CP-OCT imaging of interproximal lesions.

BACKGROUND: Enamel is highly transparent at short wavelength infrared imaging (SWIR) wavelengths allowing the detection of dental decay without the need for ionizing radiation. The purpose of this study was to use SWIR imaging methods including cross polarization optical coherence tomography (CP-OCT), occlusal transillumination (SWIR-OT), proximal transillumination (SWIR-PT), and occlusal reflectance (SWIR-R) to image interproximal lesions in vivo and compare the sensitivity with radiography. METHODS: Participants (n = 30) aged 18-80 each with a radiopositive interproximal lesion scheduled for restoration were enrolled in the study. Studies have shown that the opposing proximal surfaces across the contact will likely also have lesions. SWIR images were acquired of the adjoining teeth at each contact with an interproximal lesion scheduled for restoration. Lesion presence and depth were assessed on each side of the contact for radiography and each SWIR imaging method. Lesions on radiographs and in CP-OCT images were identified by a single examiner while lesions in SWIR images were identified by a contrast threshold via semi-automatic image segmentation. RESULTS: All SWIR imaging methods had significantly higher sensitivity (P < 0.05) than radiographs for the detection of interproximal lesions on the teeth opposite those restored. CP-OCT and SWIR-R imaging methods had significantly higher sensitivity than the other methods. SWIR imaging methods showed significantly higher lesion contrast than radiography. CONCLUSIONS: SWIR imaging methods can be used to detect interproximal lesions on posterior teeth with higher diagnostic performance than radiographs. CP-OCT appears well suited as a potential gold standard for the detection of interproximal lesions and assessment of their severity in vivo.

An investigation of the association between parenting style and child's dental caries: a cross-sectional study.

To investigate the association between parenting style and child's dental caries. Parents presenting with their children to the Department of Pediatric Dentistry at Tufts University School of Dental Medicine for an initial exam or re-care appointment completed a demographic survey and the parenting styles and dimensions questionnaire. Recruitment of subjects started in May 2019 and ended in February of 2020. Child's decayed, missing, and filled teeth (dmft) index, diet score, sex, and age were recorded, as were parent's race, education level, and form of payment. Adjustment for confounders was done using multivariable negative binomial regression. The sample size was 210 parent/child dyads. In the multivariable analysis, parenting style and child's dmft were not significantly associated (p > 0.05). Parents with an education level less than high school (p = 0.02) and at the high school graduate level (p = 0.008) were significantly associated with children who had higher dmft, compared to parents with a college degree or higher. Children with excellent diet scores had significantly lower dmft than children with a diet score in the "needs improvement" category (p = 0.003). There was no significant evidence that parenting style is associated with child's dental caries. Parent's education level and child's diet score were significantly associated with child's dmft, less than high school (p = 0.02) and at the level of high school graduate (p = 0.008). Pediatric dental professionals should be aware of these risk indicators.

Lacticaseibacillus rhamnosus inhibits the development of dental caries in rat caries model and in vitro.

OBJECTIVES: Dental caries result from a microbial imbalance in the oral cavity. Probiotics ecologically modulate the oral microflora to prevent caries. This study evaluated the anti-cariogenic effects of two Lacticaseibacillus rhamnosus strains in vitro and in vivo to provide a more theoretical basis for its clinical applications in caries prevention. METHODS: In the study, cariogenic biofilms were grown with L. rhamnosus (LGG) or L. rhamnosus ATCC 7469 and analyzed. Quantitative real-time PCR (qPCR), Scanning Electron Microscope (SEM), and Confocal laser scanning microscope (CLSM) were used to detect the changes in the composition and architectures; cariogenic activity was measured by the lactic acid production and Transverse Microradiography (TMR). The effects of LGG on the 12 Sprague-Dawley rat caries model were assessed using Keyes scores and micro-CT analysis. Oral microbiome changes were evaluated through 16S rRNA gene high-throughput sequencing. RESULTS: L. rhamnosus can reduce cariogenic bacteria in biofilm by 14.7 % to 48.9 %, with LGG exhibiting more potent inhibitory effects. Both strains of L. rhamnosus can adhere to the surface of biofilms, reduce the extracellular polysaccharides (EPS) matrix, and loosen the biofilm structure. L. rhamnosus inhibited cariogenic activity by reducing the lactic acid production in biofilms. The bovine enamel blocks presented lower mineral loss values and lesion depth values in the group Core+L.rh and Core+LGG. LGG-ingested rats had significantly lower levels of moderate dentin lesions and higher mineral density than the control group. The 16 s rRNA gene sequencing revealed that LGG regulated the beta diversity of the oral microbial community in the rat dental caries model. CONCLUSIONS: This study revealed the promising potential of L. rhamnosus, especially the LGG strain, in the ecological prevention of dental caries. CLINICAL SIGNIFICANCE: Probiotics may provide a strategy for preventing caries by regulating the oral microecological balance. The study revealed the promising anti-caries potential of the LGG probiotic strain in vivo and in vitro. It is expected that LGG could be used as an oral probiotic for the clinical prevention and treatment of caries.

Evaluation of Caries Risk Using Cariogram Among Orthodontic Patients Before and During Treatment: A Comparative Study.

Objective The primary objective was to examine the Cariogram parameters among orthodontic patients with fixed appliances and evaluate the impact of preventive measures on mitigating the risk of dental caries during orthodontic therapy. Materials and methods Patients visiting the representative orthodontic clinics across 14 districts of Kerala participated in the comparative cross-sectional study from January 2023 to January 2024. The sampling method employed in this study was convenience quota sampling, where study subjects were allocated from each of the low, moderate, and high caries risk profiles until the sample size reached the minimal requirement within each group. The baseline Cariogram scores were used to divide the consented participants into two distinct groups. The intervention group was provided with preventive initiatives, including toothpaste comprising 1,450 ppm fluoride, 0.2% NaF mouthwash, pre-cut strands of SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, as well as videos, pamphlets, and brochures that promoted oral health habits. In contrast, the control group received normal oral health education solely through the use of pamphlets and brochures. After six months, the Cariogram elements were re-evaluated for individuals in both groups. The independent sample t-test and paired t-test were applied to evaluate statistically significant differences between and within the two groups, respectively, using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, US). The distribution of patients based on their caries risk profiles was compared between groups at the commencement of the study and six months later using the Chi-square test. Results While the intervention group had 20 males and 22 females, the control group consisted of 21 males and 21 females. The average age in the intervention and control groups was 20.7±3.56 years and 21.2±3.12 years, respectively. Between the two groups, age (t=-0.68; p=0.50) and gender differences (λ2=0.05; p=0.83) were statistically insignificant. The percentage mean of the "Chance to avoid caries" associated with the intervention group increased significantly from 46.15±0.96 to 57.88±1.91, (p<0.001). On the other hand, the chance to avoid caries in the control group at the commencement of the treatment and six months later was found to be statistically insignificant. A statistically highly significant differences for all the Cariogram parameters were found when contrasted between the groups after six months of orthodontic treatment. The distribution of caries risk categorization between the control and intervention groups after six months of orthodontic treatment was found to be statistically significant (λ2=20.16; p<0.0001). Further, a statistically significant difference was observed during the pre-treatment phase and six months later in the intervention group (λ2=13.02; p=0.001). Conclusion The study findings reveal that it would be prudent to utilize 0.2% sodium fluoride mouth rinse, SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, along with toothpaste containing 1450 ppm fluoride daily, to mitigate the risk of dental cavities during orthodontic treatment, in comparison to the control group.

Integrating oral and social factors in individual caries risk assessments in preschool children-a registry-based study.

PURPOSE: To investigate the predictive ability of individual Caries Risk Assessments (CRA) regarding oral factors supplemented with social factors in relation to caries outcome in preschool children. Furthermore, to assess various models of CRA with oral and social factors included, aiming to identify the most suitable models for different age groups. METHODS: The design is a retrospective registry-based cohort study. Children visiting the dentists at ages 3 and 6 years were included. Data on oral and social factors were obtained from dental records, the Swedish Quality register for caries and periodontitis (SKaPa), and Statistics Sweden (SCB). Various models of CRA were designed, combining oral and social factors. Models were analyzed with univariable associations using simple logistic regression, and the results were presented as odds ratios (ORs). In addition, models were analyzed with area under the receiver operating characteristic (ROC) curve (AUC). Pairwise comparisons were conducted by DeLong's test, with p < 0.05 considered significant. RESULT: Oral factors were the most significant for caries outcome (OR 9.6), followed by social factors: foreign background (OR 4.6), low income (OR 2.83), low education of the mother (OR 2.77), single-parent family (OR 2.11), and having ≥ 3 siblings (OR 1.71), (p < 0.01). The predictive ability of CRA improved when models combining oral and social factors were used, compaired to CRA based solely on oral factors (p < 0.05). An increase of up to 15% was seen when CRA was conducted closer to the outcome. CONCLUSION: Models for Caries Risk Assessment including oral and social factors increase the predictive ability. Caries Risk Assessment has limited durability.

Effectiveness of preventive intervention programmes aiming to improve oral health in children who have undergone caries-related dental extractions: a rapid review.

OBJECTIVE: To determine the effectiveness of preventive interventions in children who have undergone caries-related dental extractions. METHODS: Rapid review across five databases (CENTRAL, Ovid Medline, Embase, Web of Science and Scopus). Quality was assessed using the Risk of Bias 2 tool. RESULTS: Five studies were included, all randomised controlled trials involving pre-and/or post-extractions activity. Three studies involved oral health education (computer game, motivational interviewing, visual aids), one delivered clinical prevention (fissure sealants), and one an enhanced prevention programme combining additional health education and a clinical intervention (fluoride varnish). Retention was mixed (55%-80% in the intervention groups). Of the three studies measuring caries, all reported less caries development in the test group. However, only a study involving a dental nurse-delivered structured conversation, informed by motivational interviewing, showed an improvement in oral health. Two studies reporting on plaque and gingival bleeding had conflicting results. A study reporting on subsequent dental attendance did not demonstrate a clear improvement. CONCLUSION: Few published studies have explored prevention-based interventions in high caries-risk children requiring dental extractions. Whilst evidence of clinical benefit of preventive interventions in this population is limited, the potential use of contemporary behaviour change techniques appears promising. There is an urgent need for more high-quality longer-term trials using contemporary methodologies.

Is too much sugar bitter? The impacts of sugars on health.

This paper reviews the associations between sugars consumption and non-communicable diseases. Systematic reviews demonstrate associations between sugars intake and dental caries, weight gain, type 2 diabetes and cardiovascular diseases. Children consuming more sugar-sweetened beverages (SSBs) are 1.55 times more likely to be overweight. In adults, higher consumption of SSBs is associated with a 27% higher relative risk of developing type 2 diabetes. In adults, greater free sugar consumption was positively associated with total CVD (HR 1.07; 95% CI: 1.03-1.10), ischaemic heart disease (HR 1.06; 95%CI: 1.02,1.10), and stroke (HR 1.10, 95% CI: 1.04, 1.17). Those consuming sugars higher than the recommended level of 10% of total energy are more likely to develop dental caries; 42 out of 50 studies involving children and 5 out of 5 in adults reported at least one positive association between sugars and caries. Reduction in sugars consumption requires a myriad of interventions to reduce supply and demand at national and global levels, fiscal policies, alongside high-quality research and promoting environments to reduce the burden of NCDs.

[Dental caries in two incas populations. a cross-sectional study]. / Caries dental en dos poblaciones incas. un estudio transversal.

Objective: Compare: frequency, severity and location of dental caries between archaeological populations of the Sacsayhuamán and Machupicchu samples. Material and Methods: This was a retrospective, cross-sectional and observational study. The variable dental caries was observed directly in the Sacsayhuamán and Machupicchu samples from the Cusco culture directorate. 39 individuals from the Sacsayhuamán sample with 566 teeth and 49 individuals from the Machupicchu sample with 467 teeth were analyzed. The unit of analysis was the tooth. The variable was statistically analyzed by frequencies and proportions and the differences were analyzed using the Chi test. -square. Results: In the Sacsayhuamán sample, pieces with cavities had a frequency of 31.8%, while in the Machupicchu sample they reached a frequency of 23,6%. Regarding the location: in the Sacsayhuamán sample: The following frequencies were obtained: occlusal caries 44,38%, coronary caries 3,37%, caries in the amelocemental line 32,58%, root caries 19,66%; while in the Machupicchu sample the following were obtained: occlusal caries in 60,91%, coronary caries in 3,62%, caries in the amelocemental line in 24,55%, root caries in 12,91%. Regarding severity, we found the following frequencies: in the Sacsayhuamán sample: enamel/cementum caries in 52,81%, dentin caries 33,71%, pulp involvement caries 13,14%, while in the Machupicchu sample: enamel/cementum caries 49,09%, cavities of dentin in (27,27%), caries involving pulp involvement 23,64%. Conclusions: When comparing the samples, differences were found with respect to the frequency of dental caries and with respect to the location, but no differences were found with respect to the severity.

Preventive effects of probiotics on dental caries in vitro and in vivo.

BACKGROUND: Dental caries is a common disease in the oral cavity, and the microorganisms in the cavity are colonized in the form of dental plaque biofilm. Streptococcus mutans is the main pathogen causing dental caries. Using probiotics to inhibit the growth and colonization of pathogenic bacteria, regulate mucosal immunity and improve oral microecological balance is an effective way to prevent or treat dental caries. The aim of this study was to evaluate the caries-prevention of probiotics in vitro and in rat caries models. METHODS: The probiotics used in this study are a combination of 4 strains of bacteria. After the fermentation of 4 strains (L. plantarum, L. salivarius, L. rhamnosus, and L. paracasei) was completed, they were mixed in equal volume proportions and used as samples to be tested. The mixture was then assessed the ability to inhibit the growth of S. mutans in vitro and in vivo. SPSS Statistics 22.0 (SPSS, Inc., Chicago, IL, USA) was used for analysis. RESULTS: In vitro the probiotics mixture could inhibit the growth of S. mutans and was able to remove biofilms formed by S. mutans. In a 42-day in vivo experiment, the probiotics group significantly reduced the level of S. mutans on the tooth surface of rats, reducing more than half the bacterial quantities compared with the caries model group (P < 0.05). The amount of S. mutans in the antagonist group was low and highly significant compared with the caries model group. Moreover, the mixture of 4 strains significantly reduced the caries scores (modified Keyes scoring method) in both the probiotic and antagonist groups (p < 0.05). CONCLUSIONS: The study showed that the combination of the four strains can reduce the cavity scores, and the four strains can be used as products in oral care products. At the same time, the study also suggests that probiotic therapy can be an effective way to prevent dental caries.

Diagnostic agreement between visual examination and an automated scanner system with fluorescence for detecting and classifying occlusal carious lesions in primary teeth.

OBJECTIVES: To investigate the in vivo diagnostic agreement between visual examination (VE) using the International Caries Detection and Assessment System (ICDAS) and an automated scanner system for detecting and classifying carious lesions in primary teeth. METHODS: 5-year-old children (n = 216) underwent VE and intraoral scanning (TRIOS 4, 3Shape TRIOS A/S, Copenhagen, Denmark). Dental caries experience was recorded for each tooth surface using ICDAS. An automated, fluorescence-based caries scoring system was applied to eligible primary teeth occlusal surfaces on the 3D models using commercially available software. The automated system classified surfaces as sound, initial caries (ICDAS 01/02), or moderate-extensive caries (ICDAS ≥03). The diagnostic agreement was investigated using multi-level modelling and intraclass correlation coefficients. Analyses were repeated at both the initial threshold (ICDAS ≥01) and the moderate-extensive threshold (ICDAS ≥03). RESULTS: 213 participants were included in the study, and 1525 primary molar occlusal surfaces were included in the analysis. The odds of detecting caries using the automated system were 46 % lower at the initial disease threshold (OR 0.54, 95 % CI 0.39-0.74) and 70 % lower at the moderate-extensive disease threshold (OR 0.30, 95 % CI 0.16-0.58) compared to VE. The intraclass correlation estimates at the initial and moderate-extensive thresholds were 0.90 (95 % CI 0.70-0.96) and 0.76 (95 % CI 0.22-0.94) respectively. CONCLUSION: The automated system is less likely to detect initial lesions and is more likely to underestimate lesion severity relative to visual examination using ICDAS. CLINICAL SIGNIFICANCE: Clinically, using the automated tool to replace thorough visual inspection in primary teeth could result in missed opportunities to provide professional or self-care to arrest or reverse early disease. Additionally, it could misclassify moderate lesions as initial caries, potentially leading to complications associated with the delayed management of dental caries.

Incorporating nanosilver with glass ionomer cement-A literature review.

OBJECTIVES: The objectives of this study were to retrieve and review studies that incorporated nanosilver with GIC and summarise the evidence regarding the properties of nanosilver-modified GIC. MATERIALS AND METHODS: Two independent researchers performed a literature search using the keywords (nanosilver OR nano-silver OR (nano silver) OR (silver nanoparticles)) AND (GIC OR (glass ionomer cement) OR (glass ionomer cements)) in PubMed, Web of Science and ScienceDirect. RESULTS: A total of 368 articles were identified. After removing duplicate results, titles and abstracts were screened for eligibility. Full texts of publications that investigated the manufacture and properties of nanosilver-modified GIC were retrieved and analysed. Finally, 21 studies were included. CONCLUSIONS: All of the studies reviewed in this investigation included the incorporation of nanosilver in GIC. The proportions of nanosilver added into GIC varied from 0.05 % to 50 %. Thirteen studies investigated the antimicrobial properties of nanosilver-modified GIC; all studies supported that adding nanosilver enhanced antimicrobial effectiveness. Nineteen studies reported the mechanical properties including compressive strength, flexure strength, tensile strength, and microhardness of nanosilver-modified GIC; but the results were inconclusive. Four studies tested the bonding strength of nanosilver-modified GIC to dentine and found that adding nanosilver would not influence the bonding property of GIC. Some studies explored fluoride release level, colour stability, and cytotoxicity of nanosilver-modified GIC; but the results were all inconclusive. CLINICAL SIGNIFICANCE: This literature review is the first study to retrieve and summarise the findings and evidence regarding nanosilver-modified GIC research. It can provide clinicians with clinically relevant information about novel GIC materials that can be used in their treatment decisions.

Epidemiology of dental caries in internally displaced children during wartime in Ukraine.

OBJECTIVE: Aim: To conduct a comprehensive analysis of the oral health status of this vulnerable population in order to collect objective data that will contribute to the development of effective strategies for maintaining and improving oral health in wartime conditions. PATIENTS AND METHODS: Material and Methods: This epidemiological study was carried out within the initial 6 months of the full-scale invasion of the country. The oral health indices of 1050 internally displaced children, aged 3 to 17 years, seeking dental care at the Municipal Children Dental Clinic in Poltava, were analyzed. RESULTS: Results: The total sample comprised 620 children aged 6-11 years (mean = 8.5, SD = 0.76), with a gender distribution of 52% boys and 48% girls. The participants were divided into three age groups: Group I (6-7 years), Group II (8-9 years), and Group III (10-11 years). The average prevalence of dental caries, as measured by the dmft + DMFT index, was 76.5%, with prevalence increasing with age. Specifically, the prevalence of dental caries based on the dmft index was lower in children of Group III (66.6%) compared to Group I (79.49%). CONCLUSION: Conclusions: The analysis of the oral status among internally displaced children aged 6-11 years revealed higher dental caries prevalence and intensity compared to local children. Notably, children aged 6-7 years showed a high rate of caries in temporary teeth.

An In Vitro Validation of DIAGNOdent Versus Radiography for the Detection of Caries Underneath Different Types of Restorations.

Objective This study aimed to assess the validity of DIAGNOdent as a diagnostic device for the detection of secondary dental caries underneath different types of restorations. Methods A total of 60 extracted human permanent molars were used in this experimental study (30 sound teeth and 30 teeth with proximal caries); 20 teeth (10 sound and 10 carious) were randomly allocated into one of three restoration groups: composite, amalgam, or resin-modified glass ionomer (RMGI). All teeth were examined using both KaVo DIAGNOdent Classic and digital radiographic sensors. Results In the composite-restored teeth, DIAGNOdent showed excellent sensitivity (90%) and specificity (90%). On the other hand, digital radiography had high sensitivity (80%) and poor specificity (20%). In amalgam-restored teeth, DIAGNOdent showed low sensitivity (30%) and excellent specificity (100%), while radiographs showed good sensitivity (70%) and low specificity (30%). In the RMGI-restored teeth, DIAGNOdent had excellent sensitivity (100%) and 70% specificity, while digital radiography had poor sensitivity (30%) and excellent specificity (90%). Conclusions DIAGNOdent showed superior results in detecting secondary caries lesions underneath composite and RMGI restorations when compared to digital radiography. On the other hand, radiography emerged as a preferable method for the detection of secondary caries underneath amalgam restorations. Based on our findings, DIAGNOdent can be used in dental clinics for the early diagnosis of hidden secondary caries underneath composite and RMGI restorations.

Association between high birth weight and dental caries at 4-5 years of age: a birth-cohort study.

OBJECTIVE: Early childhood caries has become a globally crucial oral health problem over the decades. Most studies have discussed the association between low birth weight and early childhood caries; however, studies focusing on high birth weight have been relatively limited. This study aimed to assess the impact of high birth weight on the incidence and severity of dental caries in 4-5-year-old children. SUBJECTS AND METHODS: Study subjects included 491 children from a birth cohort study at 4-5 years of age. Data on dental caries, prenatal and perinatal factors, and socio-demographic determinants were recorded. Logistic regression models adjusted for potential confounders were performed to analyze the data. Two-sided P-value < 0.05 was considered statistically significant. RESULTS: Of the 491 children, the prevalence of dental caries was 48.7%. High birth weight (≥ 4,000 g) was significantly associated with increased incidence of dental caries (OR, 2.000; CI 95% 1.062-3.765), and the relatively enhanced risk OR was further increased in subjects experiencing caries (dmft ≥ 3) (OR, 2.437; CI 95% 1.306-4.549) compared with the normal birth weight (2,500-3,999 g). CONCLUSIONS: High birth weight is a risk factor for early childhood caries. Particular attention should be paid to children with birth weight more than or equal to 4,000 g.