Search Results (1,449)

White spot lesions (WSLs) are demineralized lesions of the enamel that form in the presence of bacterial plaque, affecting the aesthetics by modifying the refractive index of the enamel, giving the characteristic “chalky” aspect. They have various causes, including fixed orthodontic treatments, improper hygiene, fluorosis and genetic factors. Background/Objectives: Considering the latest need for dental aesthetics and the popularization of fixed orthodontic treatments, the need to effectively treat WSLs has increased. The objective of this research is to review the development of WSLs and their treatment with resin infiltration. Methods: The PubMed, Web of Science, Scopus and Google Scholar databases were searched for relevant reviews and studies. Out of all, 56 were included in this research. Results: Prophylactic measures, such as fluorized toothpaste and varnishes, have limited results. Standard caries treatment is too invasive as it removes too much healthy enamel for obturation retentivity. The resin infiltration resin process does not require drilling or tooth structure loss, making it a painless and minimally invasive treatment. The resin used has a refractive index comparable to that of healthy enamel, consequently restoring aesthetics and ensuring the prevention of caries evolvement. The treatment involves five important steps: prophylaxis, acid demineralization, alcohol drying, resin infiltration and UV light curing. Depending on the clinical case, the demineralization and drying steps may need to be repeated. Conclusions: Infiltrations with resin are painless and well tolerated by patients. Out of all minimally invasive treatments, they have an immediate satisfactory outcome, with results stable for a minimum of 45 months. Full article

Background: Oral health outcomes in children with Congenital Heart Defects (CHD) have significant implications. The aim of this systematic review and meta-analysis is to update the current understanding of oral health outcomes in children with CHD and compare caries prevalence between CHD children and healthy controls. Methods: All studies between 2014 and 2024 comparing oral health status between children with and without CHD were considered for inclusion. Studies had to use the DMF/dmf index (Decayed, Missing, Filled Teeth or Surface index), in permanent and deciduous teeth. Two separate meta-analyses were conducted: one analyzing DMFS scores and another focusing on dmft scores. Medline, Central, and Embase databases were screened. Twelve articles were included in the qualitative synthesis, and two studies were finally included in each quantitative synthesis. Results: Several studies identified significant differences in oral health outcomes, suggesting that children with CHD are at a higher risk of dental caries compared with healthy controls, particularly as they become older. However, the differences were not uniformly observed across all studies and age groups. Based on the meta-analysis, there was no statistically significant difference in either DMFS scores (MD: 0.07 [95% CI: −0.13, 0.27]; p = 0.48) or in dmft scores (MD: 1.39 [95% CI: −1.05, 3.83]; p = 0.26). Conclusions: This systematic review and meta-analysis highlight a possible increased risk of dental caries in children with CHD, although results were not statistically significant and varied across studies. More standardized and rigorous studies are required to provide clearer insights into oral health outcomes for this population. Full article

Background and Objectives: The most recent guidelines and recommendations regarding treatments of dental caries in children are shifting towards evidence-based minimal or non-invasive approaches aiming to preserve the vitality of teeth and potentially reduce the need for dental general anesthesia. This study investigated the treatment recommendations of dentists actively practicing pediatric dentistry in Germany regarding different patient cases with caries in primary teeth. Materials and Methods: The questionnaire was distributed on paper or online to pediatric dentists and general dentists practicing pediatric dentistry. Five cases of children with dental treatment needs representing a variety of clinical situations were selected for the questionnaire. Considering four different scenarios regarding pain symptoms (yes/no) and cooperation level (good/low) for each case resulted in 20 questions, where the preferred treatment option could be chosen out of 21 options ranging from observation only to extraction with/without different sedation techniques. The answers were categorized into three categories for each case and scenario according to guidelines, recent scientific evidence, and recommendations (recommended, acceptable, or not recommended/contraindicated). Results: In total, 222 participants responded to the survey (161 female; 72.5%). In 55.2% of the total 4440 answers, the participants chose a “recommended” treatment option, in 16.4% “acceptable”, but in 28.4%, a “not recommended” treatment, which ranged for the five cases between 18.7 and 36.1%. While pain and low cooperation levels led to more invasive and justified treatment choices (only 26.3% “not recommended”), less severe scenarios resulted more often in “not recommended” options (pain with good cooperation: 31.0%; or low cooperation without pain: 32.6%). The dentist’s age, experience, and educational background did not significantly correlate to choosing “not recommended” treatment options. Conclusions: A child’s pain and cooperation level greatly impact the treatment decisions made by dentists, with a risk of too-invasive treatment options in low-severity cases. Substantial disparities in treatment recommendations for caries in primary teeth persist among dental practitioners regardless of their age, experience, and educational background. Full article

Dental adhesives are essential in modern restorative dentistry and are constantly evolving. However, challenges like secondary caries from bacterial infiltration at the adhesive–tooth interface persist. While synthetic antibacterial agents in adhesives show promise, safety concerns have shifted interest toward natural options that are biocompatible, sustainable, and effective. Therefore, this study evaluated whether natural antibacterial compounds in dental adhesives can provide effective antimicrobial activity without compromising their integrity. This systematic review followed PRISMA 2020 statement guidelines. Four databases were screened, PubMed, Scopus, EMBASE, and Web of Science, without language or publication date restrictions until July 2024. The selection criteria were in vitro studies in which natural antimicrobial substances were incorporated into dental adhesives and the resulting composites were tested for their antibacterial and physicochemical properties. A quality assessment was conducted on the selected studies. Most of the studies reviewed reported significant antibacterial activity while retaining the adhesive’s integrity, generally achieved with lower concentrations of the natural agents. Higher concentrations increase the antimicrobial effectiveness but negatively impact the adhesive’s properties. This review highlights the promising role of natural antibacterial compounds in enhancing the functionality of dental adhesives while also pointing to the need for continued research to address current challenges. Full article

Background/Objectives: The rising use of antidepressants is linked to oral health risks, including xerostomia, caries, and periodontal disease. Recognizing these risks is essential for improving patient care. To systematically review oral manifestations in patients undergoing antidepressant treatment. Methods: This review follows the PRISMA guidelines and includes observational studies published in the last 21 years. A PICO-based question was developed to select relevant studies, which were assessed for quality using a modified STROBE checklist. Results: A total of 11 studies were analyzed, revealing a consistent association between antidepressant use and the increased risk of xerostomia, caries, and periodontal disease. Additional findings included taste dysfunction and oral bleeding complications. Among the antidepressants, selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) were most commonly associated with xerostomia and caries. However, no significant impact was observed on the chemical composition of saliva or on hemostasis in invasive dental procedures. Conclusions: Antidepressant use may lead to significant oral health issues, notably xerostomia and caries. Further studies are recommended to clarify the influence of specific antidepressants and confounding factors, such as treatment duration, dosage, and hygiene habits, on oral health outcomes. Full article

Dental caries are treated using dental composite restorative materials (DCRM). However, commercial DCRMs lack antibacterial activity. This research aimed to analyze the in vitro antibacterial activity of a series of copolymers consisting of a urethane–dimethacrylate monomer (UDMA), bisphenol A glycerolate dimethacrylate (Bis-GMA), triethylene glycol dimethacrylate (TEGDMA) and urethane–dimethacrylate monomer with two quaternary ammonium groups and a 1,3-bis(1-isocyanate-1-methylethyl)benzene core (QAn+TMXDI, where n = 8, 10, or 12 is the number of carbon atoms in the N-alkyl substituent). QAn+TMXDI contents in copolymers were 20 and 40 wt.%. The results of the Staphylococcus aureus and Escherichia coli adhesion test demonstrated that the logCFU/mL decreased as the length of the N-alkyl chain decreased and QAn+TMXDI content increased. The copolymers of QA8+TMXDI 40 wt.%, Bis-GMA 40 wt.%, and TEGDMA 20 wt.% showed the highest antibacterial activity, with a logCFU/mL of 2.39 for S. aureus and no viable E. coli cells. Full article

Aim: To examine the oral health of children and adolescents with and without diabetes mellitus. Background: Diabetes mellitus is the most common metabolic disease in childhood and demonstrates an increasing incidence. Many children live with gingivitis as a precursor to periodontitis. If left untreated, it can cause the development of periodontitis. The links between periodontitis and diabetes mellitus are known but have been little studied in the age group of children and adolescents. Materials and Methods: Clinical examination and collection of sulcus fluid from participants aged 5 to 21 years was performed. The following data were collected: demographic variables, caries prevalence, DMF-T, VPI, PUFA, salivary flow rate, HbA1c, PSI, and the concentration of IL-1β, IL-6, MMP-8, and TNF-α. Results: Patients with diabetes mellitus showed a significantly lower salivary flow rate with higher concentrations of MMP-8 and IL-1β. The data indicate that at this age, regular visits to the dentist are of great importance for the promotion of oral health in children and adolescents regardless of diabetes and that patients with diabetes mellitus in particular benefit from prevention, as they belong to the periodontitis risk group. Conclusions: Patients with low salivary flow rates and increased inflammatory mediators are high-risk patients for whom dental preventive measures play a major role. Full article

Streptococcus mutans is primarily found in biofilms on tooth surfaces and is associated with the development of dental caries. S. mutans synthesizes water-insoluble glucan (WIG) using sucrose as a substrate, inducing the formation of three-dimensional biofilms. WIG is produced by glucosyltransferases (GTFs) encoded by the tandem and highly homologous gtfB and gtfC genes. Conversely, the homologous recombination of gtfB and gtfC readily happens, producing natural variants without WIG. These WIG⁻ variants are thought to have ecologically pleiotropic functions; however, the molecular basis for their appearance is unclear. This study aimed to determine the sequence of the gtfB–gtfC regions of WIG⁻ variants. We sequenced the gtfB–gtfC regions of 23 WIG⁻ variants derived from S. mutans UA159 and revealed the presence of five alleles and four types of single homologous recombination patterns. Regardless of the allele type, the WIG⁻ variants showed low biofilm formation and GTF activity. To the best of our knowledge, this is the first study to report the presence of alleles in WIG⁻ variants. These findings provide important information for explaining the appearance of mechanisms in WIG⁻ variants. Full article

The oral microbiome, comprising bacteria, fungi, viruses, and protozoa, is essential for maintaining both oral and systemic health. This complex ecosystem includes over 700 bacterial species, such as Streptococcus mutans, which contributes to dental caries through acid production that demineralizes tooth enamel. Fungi like Candida and pathogens such as Porphyromonas gingivalis are also significant, as they can lead to periodontal diseases through inflammation and destruction of tooth-supporting structures. Dysbiosis, or microbial imbalance, is a key factor in the development of these oral diseases. Understanding the composition and functions of the oral microbiome is vital for creating targeted therapies for these conditions. Additionally, the kynurenine pathway, which processes the amino acid tryptophan, plays a crucial role in immune regulation, neuroprotection, and inflammation. Oral bacteria can metabolize tryptophan, influencing the production of kynurenine, kynurenic acid, and quinolinic acid, thereby affecting the kynurenine system. The balance of microbial species in the oral cavity can impact tryptophan levels and its metabolites. This narrative review aims to explore the relationship between the oral microbiome, oral diseases, and the kynurenine system in relation to certain systemic diseases. Full article

Infections are a common post-operative ailment for patients who have received a dental implant or device and can be attributed to biofilm formation in tissue or on the implant. Many current solutions for oral hygiene have side effects and affect the natural oral microbiome. 2-heptylcyclopropane-1-carboxylic acid (2CP) is a medium-chain fatty acid and synthetic diffusible signaling factor that can prevent and disperse biofilm. The purpose of this work was to evaluate an immersion strategy for coating hydroxyapatite (HAp) with 2CP to prevent biofilm attachment on and around natural teeth and dental implants. The release profile of 2CP-loaded and 2CP+oral rinse-loaded HAp coupons (n = 6) was assessed by a 3-day exposure to phosphate buffered saline (PBS). Antimicrobial properties against Porphyromonas gingivalis and cytocompatibility of 2CP-loaded HAp coupons (n = 4) were also assessed alone and in combination with 0.12% chlorhexidine gluconate oral rinse. The majority of 2CP is released by 12 h. 2CP, oral rinse, and 2CP+oral rinse significantly reduced P. gingivalis viability, though direct contact assay demonstrates a significant reduction in Saos-2 viability for oral rinse and 2CP+oral rinse coupons. Immersion or rinsing hydroxyapatite with 2CP could inhibit biofilm-associated dental infections and prevent further complications including caries, gingivitis, and peri-implantitis. Full article

Background/Objectives: School-based caries prevention can increase access to critical dental services and reduce oral health inequities. However, little is known regarding the incidence of dental caries in children participating in school caries prevention, and caries diagnosis is often interval censored. Methods: In this paper, we used data from a longitudinal, school-based, randomized clinical trial of minimally invasive treatments for dental caries to estimate the per-visit incidence rate and compare the hazard of dental caries in children receiving either silver diamine fluoride or glass ionomer dental sealants. To account for interval censoring, we used semiparametric transformation models for univariate failure time data and imputed caries incidence using G-imputation. Results: There were 3040 children that met inclusion criteria for analysis, 1516 (49.9%) of which were randomly assigned to receive silver diamine fluoride and 1524 (50.1%) were assigned to receive glass ionomer dental sealants and atraumatic restorations. There were no differences in the hazard of caries between treatments (HR = 0.99, 95% CI = 0.72, 1.24), while children with caries at baseline had a significant increase in the hazard of new caries (HR = 2.54, 95% CI = 2.26, 2.83) compared to those that were caries free. The per-visit caries incidence ranged from 4.8 to 11.1 at the individual level and increased with each successive study observation. Conclusions: School-based caries prevention can positively affect caries incidence, and the results can be used to inform future program design and implementation. Full article

Background: Streptococcus mutans and Streptococcus sobrinus are Gram-positive bacteria involved in the development of dental caries, as they are able to form biofilms on tooth enamel, ferment sugars into acids, and survive under acidic conditions. This ultimately leads to a local lowering of the pH value on the tooth surface, which causes enamel cavities. Hypothesis: One measure to reduce caries is to limit the growth of cariogenic bacteria by using two anti-bacterial agents with different mechanisms of action. The hypothesis of this study was that the anti-bacterial activity of ω-6 polyunsaturated arachidonic acid (AA) against S. mutans and S. sobrinus can be enhanced by the sesquiterpene alcohol trans, trans-farnesol (t,t-farnesol). Methods: The anti-bacterial activity of single and combined treatment was determined by the checkerboard assay. Bacterial viability was assessed by live/dead SYTO 9/propidium iodide (PI) staining on flow cytometry. Anti-biofilm activity was determined by MTT metabolic assay, crystal violet staining of biofilm biomass, SYTO 9/PI staining by spinning disk confocal microscopy (SDCM) and high-resolution scanning electron microscopy (HR-SEM). Results: t,t-Farnesol lowered the minimum inhibitory concentration (MIC) and the minimum biofilm inhibitory concentration (MBIC) of AA at sub-MICs. AA reduced the metabolic activity of preformed mature biofilms, while t,t-farnesol had no significant effect. The enhanced anti-bacterial effect of the combined t,t-farnesol/AA treatment was further evidenced by increased PI uptake, indicating membrane perforation. The enhanced anti-biofilm effect was further verified by SDCM and HR-SEM. Gene expression studies showed reduced expression of some biofilm-related genes. Conclusions: Altogether, our study suggests a potential use of the two naturally occurring compounds arachidonic acid and t,t-farnesol for preventing biofilm formation by the cariogenic bacteria S. mutans and S. sobrinus. These findings have implications for caries prevention. Full article

Background: Dental care has been transformed by neural networks, introducing advanced methods for improving patient outcomes. By leveraging technological innovation, dental informatics aims to enhance treatment and diagnostic processes. Early diagnosis of dental problems is crucial, as it can substantially reduce dental disease incidence by ensuring timely and appropriate treatment. The use of artificial intelligence (AI) within dental informatics is a pivotal tool that has applications across all dental specialties. This systematic literature review aims to comprehensively summarize existing research on AI implementation in dentistry. It explores various techniques used for detecting oral features such as teeth, fillings, caries, prostheses, crowns, implants, and endodontic treatments. AI plays a vital role in the diagnosis of dental diseases by enabling precise and quick identification of issues that may be difficult to detect through traditional methods. Its ability to analyze large volumes of data enhances diagnostic accuracy and efficiency, leading to better patient outcomes. Methods: An extensive search was conducted across a number of databases, including Science Direct, PubMed (MEDLINE), arXiv.org, MDPI, Nature, Web of Science, Google Scholar, Scopus, and Wiley Online Library. Results: The studies included in this review employed a wide range of neural networks, showcasing their versatility in detecting the dental categories mentioned above. Additionally, the use of diverse datasets underscores the adaptability of these AI models to different clinical scenarios. This study highlights the compatibility, robustness, and heterogeneity among the reviewed studies. This indicates that AI technologies can be effectively integrated into current dental practices. The review also discusses potential challenges and future directions for AI in dentistry. It emphasizes the need for further research to optimize these technologies for broader clinical applications. Conclusions: By providing a detailed overview of AI’s role in dentistry, this review aims to inform practitioners and researchers about the current capabilities and future potential of AI-driven dental care, ultimately contributing to improved patient outcomes and more efficient dental practices. Full article

Background: It can be affirmed that the parenting style of parents has an impact on the health-related behaviors of their children; the environment that parents create for their children can have an impact on both their habits and their oral health, and on the incidence of dental caries in children. The purpose of this study was to analyze the association between parenting style and childhood dental caries. Methods: Two researchers independently searched the English literature published up to May 2024 in four databases (PubMed, Web of Science, Scopus y Cochrane Library). The risk of bias was evaluated using the Modified Newcastle–Ottawa Quality Assessment Scale (NOS). This study is registered on PROSPERO (CRD42024573447). Results: Of the 130 studies identified, nine of them, with a total of 4250 participants, met our inclusion criteria. The evidence on the relationship between parenting styles and dental caries is varied. Of the studies reviewed, three showed a significant association between both factors, while four found no correlation, and two reported no significant differences in relation to parenting styles and the occurrence of dental caries. Conclusions: This discrepancy emphasizes the need for further research. Parenting styles impact child dental behavior on a global level, highlighting the relevance of recognizing these approaches in a dental context, given that parents have a fundamental role in guiding their children’s behaviors. Full article

Phosphate-based glasses are known for their excellent biocompatibility and adjustable degradation rates. In this study, we fabricated a rapidly soluble zinc-ion-releasing phosphate-based glass (RG) specifically designed for use in dental cavity liners. The aim of this study was to evaluate the ion-releasing properties and antibacterial effects of RG. Additionally, a dental resin incorporating RG was fabricated to serve as a cavity liner, and its effectiveness was investigated in vitro. The RG formulation exhibited high solubility and released high concentrations of Zn²⁺ at various pH values. To assess the antibacterial properties of RG, six bacterial species detected in deep carious regions were incubated in the presence of RG. In vitro antibacterial testing against six bacterial species revealed that RG exhibited strong bactericidal effects against these prevalent bacteria. Furthermore, using a dentin model infected with Lactobacillus casei or Streptococcus mutans, the experimental resin containing RG demonstrated an effective bactericidal effect in the dentinal tubules, highlighting its potential as a promising material for cavity liners or pulp-capping applications. Full article