Proposal of dental demineralization diagnosis with OCT echo based on multiscale entropy analysis.

Optical coherence tomography (OCT) has been widely used for the diagnosis of dental demineralization. Most methods rely on extracting optical features from OCT echoes for evaluation or diagnosis. However, due to the diversity of biological samples and the complexity of tissues, the separability and robustness of extracted optical features are inadequate, resulting in a low diagnostic efficiency. Given the widespread utilization of entropy analysis in examining signals from biological tissues, we introduce a dental demineralization diagnosis method using OCT echoes, employing multiscale entropy analysis. Three multiscale entropy analysis methods were used to extract features from the OCT one-dimensional echo signal of normal and demineralized teeth, and a probabilistic neural network (PNN) was used for dental demineralization diagnosis. By comparing diagnostic efficiency, diagnostic speed, and parameter optimization dependency, the multiscale dispersion entropy-PNN (MDE-PNN) method was found to have comprehensive advantages in dental demineralization diagnosis with a diagnostic efficiency of 0.9397. Compared with optical feature-based dental demineralization diagnosis methods, the entropy features-based analysis had better feature separability and higher diagnostic efficiency, and showed its potential in dental demineralization diagnosis with OCT.

Over 300 Radiation Caries Papers: Reflections From the Rearview Mirror.

Radiation caries (RC) is an aggressive oral toxicity in head and neck cancer survivors, which develops 6 to 12 months after head and neck radiotherapy. It initially affects the tooth cervical/incisal surfaces, and if not promptly diagnosed/managed, progresses to dental crown amputation and risk of osteoradionecrosis. It results from a multidimensional cluster of treatment-induced oral symptoms, including hyposalivation, dietary changes, and oral hygiene impairment. Although recognized as a frequent complication of radiotherapy and extensively assessed by a myriad of retrospective, in vitro, and in situ studies, RC patients are still orphans of clinically validated methods for risk prediction, prevention, and treatment of early lesions. This review provides a historical overview of science-based concepts regarding RC pathogenesis and treatment, emphasizing the growing demand for interventional clinical studies (randomized trials).

Evaluation of tooth demineralization using laser-fluorescence in dental school patients undergoing orthodontic treatment: A clinical study.

BACKGROUND: Adverse effects can occur during orthodontic treatment. OBJECTIVE: To evaluate the relationship between prevalence and severity of enamel demineralization using a laser-fluorescence device, with length of orthodontic treatment time. METHOD: A cross-sectional study was conducted in 60 patients in a university orthodontic clinic. A clinical examination to establish demineralization at four sites on each tooth (premolar to premolar) was performed using the DIAGNOdent pen. The dependent variable was enamel demineralization, from which the prevalence (at least one affected site), extension (percentage of affected teeth) and adjusted average (average of the mean DIAGNOdent values per tooth) were calculated. The length of time for orthodontic treatment was determined in months. Various sociodemographic and clinical covariates were included. RESULTS: Average number of months under orthodontic treatment was 26.37 ± 24.81 months. Prevalence of enamel demineralization was 80.0%, its extension was 21.9% ± 17.2 and adjusted average of DIAGNOdent values was 6.09 ± 1.75. By quadrant, the teeth most affected were 14 (34.4%), 24 (25.0%), 31 (30.2%) and 44 (33.3%). No significant relationship (p> 0.05) was observed between enamel demineralization and length of time under orthodontic treatment. CONCLUSIONS: A high prevalence of dental demineralization was observed. In this sample, no relationship was observed between months under treatment and dental demineralization, or with other variables included in the study.

Effect of erosive challenge before and after the restoration of primary teeth.

The aim of this in vitro study was to investigate the erosive effect of a soft drink on primary teeth before and after restoration. Enamel blocks were obtained from 64 primary canines (N = 144) and divided into 3 groups (n = 48): 1, erosive challenge before and after restoration; 2, erosive challenge after restoration; and 3, no erosive challenge (control). The blocks received standardized preparations and were restored with 1 of 4 materials (n = 12): composite resin, bulk-fill composite resin, conventional glass ionomer cement, or resin-modified glass ionomer cement. The erosive challenge consisted of immersing the blocks in a cola soft drink for 1 minute at 25°C, 4 times a day for 5 days. The microhardness, roughness, marginal infiltration, and marginal adaptation of the specimens in all 3 groups were evaluated. Data were analyzed with the Kruskal-Wallis and Bonferroni tests. The results showed that the erosive challenge significantly altered all of the evaluated properties of all of the restorative materials (P < 0.05). The erosive challenge decreased the microhardness and marginal adaptation and increased the roughness and marginal infiltration of the tested materials. Composite resin had the highest values for microhardness and marginal adaptation as well as the lowest roughness value and dye infiltration score both with and without the erosive challenge. Subjecting teeth to erosive challenge before and after restoration altered the enamel microhardness and roughness significantly more than did erosive challenge only after restoration. Composite resin was the material least affected by the erosive challenge.

Giómeros fluidos en la eliminación de sensibilidad en molar permanente afectada con Hipomineralización Incisivo Molar (HIM). Reporte de caso / Fluid giomers in the elimination of sensitivity in permanent molar affected by Molar Incisor Hypomineralization (HIM). Case report

RESUMEN: El principal motivo de consulta de los pacientes afectados con hipomineralización incisivo molar grado B 3 II, según la Academia Europea de Odontología Pediátrica (EAPO) es la estética y sensibilidad, provocando dolor a los cambios térmicos y a la hora de realizar el cepillado dental, esto puede conllevar a una rápida progresión de caries dental, por disminuir el cepillado. En el presente caso se describe la reconstrucción y sellado de fosas profundas de la pieza 46 afectada con hipomineralización incisivo molar, mejorando la calidad de vida relacionada a la salud bucal del paciente y eliminando la sensibilidad en una sola cita.

ABSTRACT: The main reason for consultation of patients affected by molar incisor hypomineralization level B 3 II (EAPO) is aesthetics and sensitivity, causing pain with thermal changes, when consuming cold drinks and when brushing the teeth. This can lead to a rapid progression of tooth decay, by decreasing the brushing. In the present case, the reconstruction and sealing of deep pits of the tooth 46 affected by molar incisor hypomineralization are described, improving the quality of life related to the patient's oral health and eliminating sensitivity in a single appointment.

Casein phosphopeptide-amorphous calcium phosphate nanocomplex (CPP-ACP) in dentistry: state of the art / Nanocomplejo de fosfopéptido de caseína-fosfato de calcio amorfo (CPP-ACP) en Odontología: estado del arte

ABSTRACT Saliva and external agents containing different concentrations of sodium fluoride (NaF) promote the dental remineralization process. However, these resources may not be sufficient to counteract the multiple factors involved in the process of dental caries, especially in high-risk patients. There are alternatives that have been extensively researched, such as casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) which provides essential ions, like phosphate and calcium, acting as an adjuvant in the remineralization process. Manufacturers of CPP-ACP-based products also suggest that it can produce desensitizing effects. This nanocomplex has been used experimentally with some dental cements and adhesive systems, but it is important to clarify the effects of this procedure, and the remineralizing/desensitizing advantages it offers. The objective of this topic review was to present the state of the art on CPP-ACP nanocomplex. In terms of dental caries prevention, this remineralizing option is not better than NaF. CPP-ACP provides a dental desensitizing action, but it is temporary, similar or less effective than other alternatives such as potassium nitrate or NaF. The experimental incorporation of CPP-ACP into dental cements should be controlled for not to compromise the physico-chemical properties of the material. The use of dental products based on this nanocomplex as dental surface pretreatment may decrease the bond strength of adhesive materials, but this effect is material dependent.

RESUMEN La saliva y agentes externos que contienen diferentes concentraciones de fluoruro de sodio (NaF) favorecen el proceso de remineralización dental. No obstante, estos recursos podrían no ser suficientes para contrarrestar los múltiples factores involucrados en el proceso de caries dental, especialmente en pacientes con alto riesgo. Existen alternativas que han sido ampliamente investigadas, como el fosfopéptido de caseína-fosfato de calcio amorfo (CPP-ACP) que aporta iones esenciales como fosfato y calcio, actuando como coadyuvante en el proceso de remineralización. Los fabricantes de productos basados en CPP-ACP también sugieren que este es capaz de generar efectos desensibilizantes. Este nanocomplejo ha sido utilizado de forma experimental con algunos cementos dentales y sistemas adhesivos, pero es importante esclarecer los efectos de dicha incorporación y las ventajas remineralizantes/desensibilizantes que ofrece esta alternativa. El objetivo del presente artículo de revisión de tema consistió en presentar el estado del arte sobre el nanocomplejo CPP-ACP. En términos de prevención de caries dental, esta opción remineralizante no es superior al NaF. El nanocomplejo ejerce acción desensibilizante dental, pero esta es transitoria, similar o inferior a otras alternativas como nitrato de potasio o NaF. La incorporación experimental de CPP-ACP en cementos dentales debe ser controlada para no comprometer las propiedades fisicoquímicas del material. La utilización de productos dentales a base de este nanocomplejo como pretratamiento de la superficie dental puede disminuir la resistencia de unión de materiales adhesivos, pero este efecto es material-dependiente.

Dental demineralization and caries in patients with head and neck cancer.

Concurrent chemoradiation (CCR) therapy is a standard treatment for patients with locally advanced head and neck cancer (HNC). It is well documented that CCR causes profound acute and late toxicities. Xerostomia (the symptom of dry mouth) and hyposalivation (decreased salivary flow) are among the most common treatment side effects in this cohort of patients during and following treatment. They are the result of radiation-induced damage to the salivary glands. Patients with chronic hyposalivation are at risk for demineralization and dental cavitation (dental caries), often presenting as a severe form of rapidly developing decay that results in loss of dentition. Usual post-radiation oral care which includes the use of fluoride, may decrease, but does not eliminate dental caries associated with radiation-induced hyposalivation. The authors conducted a narrative literature review regarding dental caries in HNC population based on MEDLINE, PubMed, CLNAHL, Cochrane database, EMBASE, and PsycINFO from 1985 to 2014. Primary search terms included head and/or neck cancer, dental caries, dental decay, risk factor, physical symptom, physical sequellea, body image, quality of life, measurement, assessment, cost, prevention, and treatment. The authors also reviewed information from National Institute of Dental and Craniofacial Research (NIDCR), American Dental Association (ADA), and other related healthcare professional association web sites. This literature review focuses on critical issues related to dental caries in patients with HNC: potential mechanisms and contributing factors, clinical assessment, physical sequellea, negative impact on body image and quality of life, potential preventative strategies, and recommendations for practice and research in this area.