A randomized clinical trial on the sealing of occlusal carious lesions: 3-4-year results.

This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8-43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3-4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3-4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

A randomized clinical trial on the sealing of occlusal carious lesions: 3-4-year results

Abstract This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8–43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3–4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3–4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

Radiolucent halos beneath composite restorations do not justify restoration replacement.

PURPOSE: To determine the correlation between the presence of radiolucent areas (RA) beneath composite restorations and gaps and remaining demineralized tissue (RDT). METHODS: 50 extracted teeth (sound and carious) were studied. After caries removal, cavities were filled. Artificial cavities were created and filled in the sound teeth. Samples were sectioned and analyzed with stereomicroscopy. RESULTS: Gap/RDT was observed in 38.9% [95% confidence interval (CI) =28.2-50.5] and 68.9% (95% CI = 57-78.6) of sound and carious teeth, respectively, (P = 0.001). Gap/RDT was associated with RA (P < 0.001). Sensitivity, specificity, predictive positive values (PPV), predictive negative value, and accuracy for carious teeth were 77.1% (95% CI = 63.7-87.3), 54.5% (95% CI = 33.8-74.1), 78.7% (95% CI = 65.3- 88.7), 52.2% (95% CI = 32.1-71.7), and 70% (95% CI = 58.5-79.8), and for sound teeth were 73.7% (95% CI = 62.9-82.6), 59.1% (95% CI = 47.0-70.4), 67.5% (95% CI = 56.9-76.9), 66.1% (95% CI = 53.4-77.3), and 66.9% (95% CI = 58.9-74.3). Only the PPV differed between the sound and carious teeth (P = 0.024).There was a correlation between radiolucency and gap/RDT, but a high number of false positives were found.

Effects of lactose-containing stevioside sweeteners on dental biofilm acidogenicity.

The aim of this study was to evaluate the effect of a commercial lactose-containing stevioside sweetener on biofilm acidogenicity in vivo. Nine volunteers refrained from brushing their teeth for 3 days in five phases. On the 4th day of each phase, the pH of the biofilm was measured by the "Strip method". Interproximal plaque pH was measured before and up to 60 minutes after a 10 mL mouthrinse for 1 minute with the test solutions: I - sweetener with 93% lactose and 7% stevioside; II - sweetener with 6.8% saccharin, 13.6% cyclamate, and 0.82% stevioside; III - 18% sucrose solution (positive control); IV - mineral water (negative control); and V- 93% lactose solution. The results revealed that the most pronounced pH fall was found with sucrose (positive control), followed by the 93% lactose solution, the sweetener with lactose + stevioside, the sweetener with saccharin + cyclamate + stevioside, and finally water (negative control). According to the area under the curve, the two sweeteners containing stevioside were significantly different, and the sweetener with lactose + stevioside was significantly different from water but not from sucrose. The critical pH for dentin demineralization (pH ≤ 6.5) was reached by all volunteers after rinsing with sucrose solution, lactose solution, and the stevioside + lactose sweetener. Analysis of the data suggests that lactose-containing stevioside sweeteners may be cariogenic, especially to dentin.

Concentração de flúor no biofilme dental de indivíduos expostos a diferentes fontes de flúor de base comunitária / Dental biofilm fluoride concentration of subjects exposed to different community-based fluoride sources

O objetivo deste estudo foi comparar a concentração de flúor do biofilme dental de indivíduos residenteste em áreas com água fluoretada (AF) ou sal fluoretado (SF) e determinar o efeito do dentifrício fluoretado na concentração de flúor [F] do biofilme dental destes indivíduos. Dezesseis indivíduos resendentes em Montevidéu (SF) e dezesseis indivíduos residentes em Porto Alegre (AF) participaram deste estudo randomizado, cruzado e duplo-cego. Profilaxia dental e raspagem supragengivel foram realizaras antes de cada fase experimental. Durante as fases experimentais (14 dias/cada), os indivíduos escovaram os dentes, 2x/dia, com dentifrício fluoretado (DF) ou dentifrício não-fluoretado (DNF). As amostras de biofilme dental foram coletadas 8 horas após a última escovação. As análises de [F] no biofilme dental foram realizadas com um íon epecífico e as leituras foram convertidas em μgF¯/g de biofilme. Equações de estimativas generalizadas foram aplicadas para analisar a variância de medidas repetidas e as diferenças em cada desfecho. Uma maior [F] no biofilme foi observada na área com SF(2.69±0.10 IC 2.48–2.89) em comparação a área com AF (2.44±0.06 IC 2.32-2.57) quando do uso regular de DNF (p = 0.047). Entretanto, não houve diferença significativa na [F] no biofilme entre as áreas com SF (2.60±0.12 IC 2.37-2.83) e AF (2.81±0.10 CI 2.62-3.01) quando do uso de FD (p = 0.153). Adicionalmente, não foi observada diferença siginifcativa na [F] do biofilme quando DF e DNF foram usados nas áreas com SF (p = 0.294) e AF (p = 0.320). A maior [F] no biofilme observada na área com SF, sob uso regular DNF, pode não ter significância clínica, uma vez que ela desapareceu quando o DF foi usado...

The aim of this study was to compare the fluoride concentration in dental biofilm of subjects living in fluoridated- salt (FS) or water (FW) areas and to determine the effect of fluoride dentifrice on the fluoride concentration [F] in dental biofilm of these subjects. Sixteen individuals residing in Montevideo (FS) and sixteen individuals living in Porto Alegre (FW) participated in this randomized, double-blind, crossover study. Dental prophylaxis and scaling were performed prior to each experimental phase. During the experimental phases (14d/each) subjects brushed their teeth, 2x/day, with fluoridated dentifrice (FD) or non-fluoridated fluoride (NFD). Dental biofilm samples were collected 8 hours after the last toothbrushing. Analyses were performed with a fluoride ion-specific electrode and the reading was transformed into μgF¯/g biofilm. Generalized estimating equations were used to analyze the variance for repeated measures and the differences in each outcome. Higher biofilm [F] was found in FS (2.69±0.10 CI 2.48–2.89) compared to FW (2.44±0.06 CI 2.32-2.57) areas under regular use of NFD (p = 0.047). However, no significant differences were found on dental biofilm [F] between FW (2.60±0.12 CI 2.37-2.83) and FS (2.81±0.10 CI 2.62-3.01) areas under FD use (p = 0.153). Furthermore, no significant difference was observed in the biofilm [F] when FD or NFD were used in the FS (p = 0.294) and FW (p = 0.320) areas. The higher dental biofilm [F] was found in FS areas under NFD use may not have clinical significance once it disappeared when FD was used...