scholarly journals The accuracy of laser fluorescence (DIAGNOdent) in assessing caries lesion activity on root surfaces, around crown margins, and in furcations in older adults

BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Chelsea Mitchell ◽  
Hiba Zaku ◽  
Peter Milgrom ◽  
Lloyd Mancl ◽  
David B. Prince

AbstractThe authors conducted a case series to assess accuracy of DIAGNOdent (DD) in assessment of activity of dental caries lesions in root surfaces and in furcations and at crown margins. The study was a prospective, single center case series. The patients were 123 adults (age ≥ 55 years). To be included, a patient needed to have at least one active root caries lesion. The study was conducted at the Roseman College of Dental Medicine in South Jordan, Utah, USA and at area nursing homes. Lesions were rinsed and dried with air, and DD readings were obtained. Lesions were then isolated and 38% silver diamine fluoride was applied repeatedly for two minutes with a microbrush. DD readings and treatments were repeated every six months. Mean DD values were significantly different between active (unarrested) and inactive (arrested) caries for all comparisons, p-value < 0.0001. The optimal cut-off values for DD were between 20 and 35 except optimal cut-offs were higher for furcation and crown margin surfaces, particularly in the posterior (optimal cut-offs 40–45). This study demonstrates DD is a potentially valuable tool for assessing lesion activity in root surfaces, at restoration margins, and in furcations.

2021 ◽  
Vol 105 ◽  
pp. 103561
Author(s):  
Chelsea Mitchell ◽  
Andrew J Gross ◽  
Peter Milgrom ◽  
Lloyd Mancl ◽  
David B Prince

2020 ◽  
Vol 54 (5-6) ◽  
pp. 459-465
Author(s):  
Sebastian Paris ◽  
Avijit Banerjee ◽  
Peter Bottenberg ◽  
Lorenzo Breschi ◽  
Guglielmo Campus ◽  
...  

<b><i>Aim:</i></b> To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. <b><i>Methods:</i></b> A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. <b><i>Results:</i></b> Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient’s individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.


2011 ◽  
Vol 69 (6) ◽  
pp. 321-327 ◽  
Author(s):  
Lars G. Petersson ◽  
Kerstin Magnusson ◽  
Ulf Hakestam ◽  
Amir Baigi ◽  
Svante Twetman

1999 ◽  
Vol 78 (9) ◽  
pp. 1525-1534 ◽  
Author(s):  
S.R. Brailsford ◽  
R.B. Tregaskis ◽  
H.S. Leftwich ◽  
D. Beighton

2020 ◽  
Author(s):  
Suchitra Nelson ◽  
Jeffrey M Albert ◽  
Peter Milgrom

BACKGROUND The majority of dental caries lesions in older adults are at the gumline, at the edges of failed fillings and crowns, and in the surfaces of roots after gum recession. These lesions are difficult to restore with conventional surgical treatments using a dental drill and restorations often fail. Clinical guidelines are general and apply treatments that were designed for younger individuals in the dental care of older adults. OBJECTIVE This study will compare the effectiveness of 2 evidence-based nonsurgical strategies to manage dental caries lesions in adults aged 62 or older: (1) biannual topical application of silver diamine fluoride versus (2) atraumatic restorative treatment + biannual fluoride varnish. METHODS A cluster randomized clinical trial is being conducted in 22 publicly subsidized and other low-income housing facilities/sites (Arm 1: 11 sites, 275 participants; Arm 2: 11 sites, 275 participants). At baseline, participants will be screened for caries lesions. Those with nonurgent lesions will be treated according to the treatment arm to which the housing site was randomly assigned. The primary outcomes are caries lesion arrest, tooth sensitivity, and tooth pain at 52 weeks after treatment. Analytic methods for the primary aim include a generalized estimating equation approach to determine noninferiority of silver diamine fluoride relative to atraumatic restorative treatment + fluoride varnish treatment. RESULTS The trial was funded in April 2019. Enrollment began in September 2019 and results are expected in June 2023. CONCLUSIONS This study will inform the standard of care for treating caries lesions in older adults. If effective, either of these interventions has broad applicability in clinical and community-based settings. CLINICALTRIAL ClinicalTrials.gov NCT03916926; https://clinicaltrials.gov/ct2/show/NCT03916926 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17840


Author(s):  
Mohammed Mohammed Ali Alsamhari ◽  
Mohammed Mohammed Ali Al-Najhi ◽  
Hassan Abdulwahab Al-Shamahy ◽  
Omar Ahmed Ismael Al-dossary

Background and objectives: Knowledge of the pathogenicity of the primary etiological factor of root caries, the microbial biofilm, might provide important information for the development of diagnosis and treatment strategies. This study assessed the numbers and revealed the proportion of Mutans streptococci , which is potential important cariogenic organisms, in biofilms collected from lesions at root surfaces with active caries lesions (ARC), inactive caries lesions, and sound root surfaces (SRS). Material and methods: Samples were cultured in MSB agar for Mutans streptococci counts, and brain-heart infusion agar for total viable anaerobic counts. After incubation, the number of colony-forming units (CFUs) was determined and compared between groups by the Mann-Whitney U test with a significance level set at 95%. The proportion of counts of Mutans streptococci in the total viable microorganisms was also analyzed by Chi-square test. 108 samples (36 from each surface) from 36 patients were cultured and analyzed. Results: The mean±SD for the counts of active root caries lesions was 7.47±9.89 10, significantly higher than that of inactive root caries lesions (2.5±0.97) and sound root surfaces (3.03±0.71). In conclusion, a trend towards higher counts was evident for ARC. In the ARC lesions among the dominant oral anaerobic bacteria, we could not identify streptococcal colonies (unspecified) in 11% while in IRC lesions it occurred in 47%, and SRS it occurred in 47%. In addition, in ARC the samples were ≥0.1-≥10 (CFU x10) ≥0.1-≥10 colonies of Streptococcus mutans. Conclusion: In conclusion, a trend towards higher counts was evident for ARC and for most samples, the proportion of Streptococcus mutans was low relative to the viable number of total viable anaerobic microorganisms.                   Peer Review History: Received: 5 September 2021; Revised: 10 October; Accepted: 24 October, Available online: 15 November 2021 Academic Editor:  Ahmad Najib, Universitas Muslim Indonesia,  Indones UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency.  Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Rawaa Souhil Al-Kayali, Aleppo University, Syria, [email protected] Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected] Similar Articles: ASSOCIATION BETWEEN THE STREPTOCOCCUS MUTANS BIOFILM FORMATION AND DENTAL CARIES EXPERIENCE AND ANTIBIOTICS RESISTANCE IN ADULT FEMALES CLINICAL FEATURES, AGE AND SEX DISTRIBUTIONS, RISK FACTORS AND THE TYPE OF BACTERIA ISOLATED IN PERIODONTITIS PATIENTS IN SANA'A, YEMEN


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