scholarly journals The benefits of association of early diagnosis with bioactive materials for management of dental caries

2021 ◽  
Vol 10 (5) ◽  
pp. 700-705
Author(s):  
Angélica Feltrin Dos Santos ◽  
Tainara Tonon Castelluccio ◽  
Gerson Aparecido Foratori-Junior ◽  
Daniela Rios ◽  
Linda Wang ◽  
...  
Keyword(s):  
Dental Caries ◽  
Smart Materials ◽  
Correct Diagnosis ◽  
Minimal Invasive ◽  
White Spot Lesion ◽  
Caries Risk ◽  
Bioactive Materials ◽  
Minimally Invasive Dentistry ◽  
Risk Condition ◽  
Caries Management

The concept of minimally invasive dentistry certainly promoted significant changes towards more conservative dental caries management, which allows for quality information regarding the diagnosis, prognosis, and clinical management of dental caries even regarding the maintenance of restorative procedures. This case report aimed to highlight the relevance and feasibility of a streamlined caries disease management based on caries-risk determination and minimal invasive concepts associated with bioactive materials. A 13-year-old female patient sought dental care. Clinically, active white spot lesion on the occlusal surface of right upper first premolar coming from the fissures was noteworthy under moist condition. Bitewing radiography confirmed an interproximal carious lesion involving dentin. The cavity preparation was performed as more conservative as possible, removing the carious tissue selectively and treated with bioactive materials. After 12-month follow-up, successful performance of the restoration was seen while the patient caries-risk condition seems to be under control. This clinical case demonstrates that a correct diagnosis associated with smart materials and appropriate restorative procedures can offer effective and conservative results. Evidence-based treatment benefits patient avoiding unnecessary dental compromising and the maintenance of oral health.

scholarly journals Salivary sIgA and PRAP-1 Protein in Relation to Dental Caries: A Comparative Study

2020 ◽  
Vol 11 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Aseel Al-ani ◽  
Douglas A. MacDonald ◽  
Maha Ahmad
Keyword(s):  
Dental Caries ◽  
Secretory Iga ◽  
Enzyme Linked Immunosorbent Assay ◽  
Caries Risk ◽  
Confounding Variables ◽  
High Caries Risk ◽  
Caries Management ◽  
Assessment Guidelines ◽  
Unstimulated Saliva ◽  
The Relationship

Aim: Certain individuals are more prone to dental caries than others are. Caries risk may be related in the secretion of certain defensive salivary proteins including secretory IgA (sIgA) and proline-rich acidic protein (PRAP-1). In this study, we investigated the relationship between PRAP-1 and sIgA leading to the susceptibility of development of dental caries in adults and explored the differences in the levels of sIgA and PRAP-1 between men and women. Materials and Methods: Unstimulated saliva samples were collected from 28 patients with high caries risk and 32 control subjects with low caries risk according to caries management by risk assessment guidelines. sIgA and PRAP-1 levels in clarified saliva samples were measured using the enzyme-linked immunosorbent assay. Results: According to our results, sIgA and PRAP-1 levels did not demonstrate statistically significant differences as a function of caries risk or gender, even when potential confounding variables such as age and numbers of teeth were taken into consideration. Estimates of effect size, however, revealed small- to medium-sized effects and suggest that significant results may have been found if larger sample sizes were used. Conclusion: The results of this study indicate that caries risk and salivary levels of sIgA and PRAP-1 do not appear to be significantly associated. Statistically significant findings could emerge if the sample size was larger.

scholarly journals Non-Fluoridated Remineralising Agents - A Review of Literature

2021 ◽  
Vol 10 (9) ◽  
pp. 638-644
Author(s):  
Akriti Batra ◽  
Vabitha Shetty
Keyword(s):  
Dental Caries ◽  
Minimally Invasive ◽  
Medical Model ◽  
Acid Dissolution ◽  
Invasive Approach ◽  
Non Invasive ◽  
Minimally Invasive Dentistry ◽  
Phosphate Mineral ◽  
Modifiable Factors ◽  
Caries Management

Dental caries is not merely a continuous and one-way process of demineralisation of the mineral phase, but repeated episodes of demineralisations and remineralisation. The remineralisation process is a natural repair mechanism to restore the minerals again, in ionic forms, to the hydroxyapatite (HAP) crystal lattice. It occurs under nearneutral physiological pH conditions whereby calcium and phosphate mineral ions are redeposited within the caries lesion from saliva and plaque fluid resulting in the formation of newer HAP crystals, which are larger and more resistant to acid dissolution. An insight into the caries process’s multifactorial aetiopathogenesis has resulted in a paradigm shift towards minimally invasive dentistry. This era of personalised care using the medical model for caries management assimilates the signs of examining, diagnosing, intercepting, and managing dental caries at a microscopic level. Fluoride mediated salivary remineralisation system is considered the cornerstone of non-invasive approach for managing non-cavitated carious lesions. However, the effect of fluoride was found to be limited to the outer surface of the tooth, and it was observed that fluoride does not influence the modifiable factors in dental caries such as the biofilm. Hence, fluoride does not reduce the cariogenic challenge especially for high-risk individuals. Due to this gap in the conventional fluoride therapies, non-fluoridated remineralising systems have emerged, which interact with the tooth by delivering calcium and phosphorous ions, modifying the biofilm and neutralising the organic acids. This review re-examines the philosophy behind non-fluoridated remineralisation, their mode of action, availability in the market and evidence-based studies of the most promising advancements in remineralisation approaches. KEY WORDS Caries, Minimally Invasive Dentistry, Remineralisation, Non-Fluoridated Remineralising Systems

scholarly journals Evidence-Based Caries Management for All Ages-Practical Guidelines

2021 ◽  
Vol 2 ◽  
Author(s):  
John D. B. Featherstone ◽  
Yasmi O. Crystal ◽  
Pamela Alston ◽  
Benjamin W. Chaffee ◽  
Sophie Doméjean ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Clinical Trials ◽  
Dental Caries ◽  
Clinical Outcomes ◽  
Assessment System ◽  
Risk Level ◽  
Caries Risk ◽  
Caries Risk Assessment ◽  
Management Procedures ◽  
Caries Management

Introduction: The purpose of the present paper is to provide step-by-step guidelines for dental healthcare providers to manage dental caries based upon caries risk assessment (CRA) for ages 0–6 years and 6 years through adult. The manuscript reviews and updates the CAMBRA (caries management by risk assessment) system which includes CRA and caries management recommendations that are guided by the assessed risk level.Caries Risk Assessment: CAMBRA CRA tools (CRAs) have been evaluated in several clinical outcomes studies and clinical trials. Updated CAMBRA CRAs for ages 0–6 years and 6 years through adult are provided. These CRAs have been refined by the addition of a quantitative method that will aid the health care provider in determining the caries risk of individuals.Caries Management Based Upon Risk Assessment: Guidelines for individualized patient care are provided based upon the caries risk status, results of clinical exams and responses of the patient to questions in the CRA. These guidelines are based upon successful outcomes documented in several clinical outcomes studies and clinical trials. The paper includes a review of successful caries management procedures for children and adults as previously published, with additional emphasis on correct use of silver diamine fluoride (SDF) for children. The caries management plan for each individual is based upon reducing the caries risk factors and enhancing the protective factors with the additional aid of behavior modification. Beneficially altering the caries balance is coupled with minimal intervention restorative dentistry, if appropriate. These methods are appropriate for the management of dental caries in all patients.

scholarly journals Nonrestorative Management of Dental Caries

2021 ◽  
Vol 9 (10) ◽  
pp. 121
Author(s):  
Ollie Yiru Yu ◽  
Walter Yu-Hang Lam ◽  
Amy Wai-Yee Wong ◽  
Duangporn Duangthip ◽  
Chun-Hung Chu
Keyword(s):  
Dental Caries ◽  
Oral Hygiene ◽  
Treatment Plan ◽  
Policy Statement ◽  
Evidence Based ◽  
Caries Risk ◽  
Minimal Intervention ◽  
Etiological Factors ◽  
Caries Management ◽  
Plaque Control

The World Dental Federation (FDI) policy statement in 2016 advocated evidence-based caries-control measures for managing dental caries. The caries management philosophy has shifted from the traditional surgical manners to minimal intervention dentistry. Minimal intervention dentistry aims to extend the longevity of natural teeth. It places the nonrestorative approaches as a priority. The nonrestorative approaches for caries management aim to tackle the etiological factors of dental caries. Caries can be prevented or reversed by restricting the sugar intake and its frequency in the diet, improving oral hygiene practices, and using fluoride toothpaste. This article aims to present strategies for the nonrestorative management of dental caries, which are divided into four components to address the different etiological factors of dental caries. The first component is controlling dental plaque. Strategies for plaque control include oral hygiene instruction, motivational interviewing, mechanical plaque control, and chemical plaque control. The second component for nonrestorative management is reducing the risk of caries by identifying caries risk factors and protective factors, assessing personal caries risk, and customizing a treatment plan. Evidence-based measures for caries prevention include using fluoride, and dental sealants should be provided. The third component includes topical treatment to remineralise early carious lesions. The last component is long-term follow-up. Appropriate strategy adoption for the nonrestorative management of dental caries prolongs the life span of the teeth and sustains the good oral health of patients.

scholarly journals A Comparison of Four Caries Risk Assessment Methods

2021 ◽  
Vol 2 ◽  
Author(s):  
John D. B. Featherstone ◽  
Yasmi O. Crystal ◽  
Pamela Alston ◽  
Benjamin W. Chaffee ◽  
Sophie Doméjean ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Dental Caries ◽  
Pediatric Dentistry ◽  
Assessment Methods ◽  
Risk Level ◽  
Care Providers ◽  
Caries Risk ◽  
Caries Risk Assessment ◽  
Comparison Results ◽  
Caries Management

Introduction: Caries risk assessment (CRA) is essential as the basis for successful management of dental caries. Of the many published CRA tools, four well-known ones are CAMBRA, Cariogram, American Dental Association (ADA), and American Academy of Pediatric Dentistry (AAPD) CRAs. The predictive accuracy of CAMBRA and Cariogram CRA tools have been examined in clinical outcomes studies in thousands of patients and the tools are widely used all over the world. The purpose of the present paper is three-fold, namely (1) to briefly review, compare and contrast these four CRA methods, (2) to provide a concise method for CRA introducing a quantitative component to the CAMBRA forms (CAMBRA 123), and (3) to guide the choice of CRA methods that will support caries management decisions.Comparison of Caries Risk Assessment Methods: In the present evaluation, the above-mentioned four CRA methods for ages 0–6 years and 6 years-adult were compared using 26 hypothetical patients (13 per age group). Comparison results show that Cariogram and CAMBRA categorized patients into identical risk categories. Each of the ADA and AAPD tools gave different results than CAMBRA and Cariogram in several comparison examples. CAMBRA 123 gave the same caries risk level results as the Cariogram and the CAMBRA methods for all hypothetical patients for both age groups.Conclusions: Both the Cariogram and the CAMBRA CRA methods are equally useful for identifying the future risk of dental caries. CAMBRA 123 shows promise as an easy-to-use quantitative method for CRA in clinical practice. The health care providers will be the ones to decide which CRA method will allow them to establish individualized, successful caries management therapies and how to combine these for the best care of their patients.

scholarly journals Simplified Prediction Model for Accurate Assessment of Dental Caries Risk among Participants Aged 10-18 Years

2018 ◽  
Vol 246 (2) ◽  
pp. 81-86 ◽  
Author(s):  
Jung-Min Kim ◽  
Jun-Seon Choi ◽  
Yoon-Hyeong Choi ◽  
Hee-Eun Kim
Keyword(s):  
Dental Caries ◽  
Prediction Model ◽  
Accurate Assessment ◽  
Caries Risk

scholarly journals THE CARIES MANAGEMENT SYSTEM: UPDATING COST-EFFECTIVENESS WITH 4-YEAR POSTTRIAL DATA

2016 ◽  
Vol 32 (3) ◽  
pp. 107-115 ◽  
Author(s):  
Emma Warren ◽  
Bradley H. Curtis ◽  
Nan Jia ◽  
R. Wendell Evans
Keyword(s):  
Cost Effectiveness ◽  
Dental Caries ◽  
Management System ◽  
Controlled Trial ◽  
Lifetime Cost ◽  
Age Distribution ◽  
Real Life ◽  
Caries Management

Objectives: Long-term follow-up of the Caries Management System (CMS) protocol demonstrated that regular monitoring and noninvasive management of dental caries is effective in reducing the number of caries-related events over a 7-year period. This analysis complements the authors’ original economic evaluation of the CMS by re-evaluating the per-protocol cost-effectiveness of the CMS approach.Methods: An individual patient-simulation Markov model was developed previously, based on 3-year randomized-controlled trial (RCT) data, to simulate the incidence and progression of dental caries, and resultant interventions, and to evaluate the lifetime cost-effectiveness of the CMS versus standard dental care from the Australian private dental practitioner perspective (in which the baseline age distribution was similar to that of the Australian population). The 4-year posttrial follow-up data are used to re-evaluate the long-term cost-effectiveness of the CMS in a more real-life setting.Results: The reduction in caries risk was maintained among those practices within which the CMS protocols were adhered to. The per-protocol model appears to be reasonably accurate at predicting the risk of restorative events in the posttrial follow-up period. The per-protocol lifetime cost per restorative event avoided is AUD1,980 (USD1,409; 1 AUD = 0.71 USD).Conclusions: The current analysis confirms that the CMS approach is both effective, when the protocols are adhered to appropriately, and cost-effective compared with standard care in the Australian private practice setting.

Sign in / Sign up

Export Citation Format

Share Document