A Randomized, Double-Blind, Placebo-Controlled Clinical Trial of a Mouthwash Containing Glycyrrhiza uralensis Extract for Preventing Dental Caries

This study sought to confirm the effect of using a mouthwash containing Glycyrrhiza uralensis extract for oral health management by investigating changes in the pH of dental plaque and bacteria that cause dental caries. A randomized, double-blind, placebo-controlled study was conducted on 60 subjects categorized in either the Glycyrrhiza uralensis extract gargle group (n = 30) or the saline gargle group (n = 30). Scaling was conducted in order to ensure the homogeneity of the oral environment, while gargling was performed once daily before the subjects went to bed for 5 days based on the group. Caries activity was assessed using the Cariview test, while detection of the bacteria that cause dental caries was confirmed using microbiological analysis. All clinical measurements and evaluations were conducted by two trained dental hygienists under the supervision of a dentist. Based on the analysis of dental caries activity and dental caries-causing bacteria, the Glycyrrhiza uralensis extract gargle group showed a clear decrease in bacteria compared to the saline gargle group. Glycyrrhiza uralensis extract demonstrated no risk of tooth demineralization. It also showed excellent antibacterial activity through inhibition and effective reduction of bacteria that cause dental caries. Therefore, the mouthwash containing Glycyrrhiza uralensis extract is an effective oral care product suitable for use as an effective dental caries prevention agent.

The structure and prevalence of superficial carious and non-carious lesions of permanent and deciduous enamel in children who presented for routine dental care in various districts of St. Petersburg

Relevance. To increase the effectiveness of prevention and treatment protocols, it is above all necessary to consider the activity of caries, especially at the early enamel lesion stage, in the form of a white spot, to make the correct diagnosis based on a clinical examination, which assesses the location, change in surface hardness, symmetry, contour shape, depth, color and opacity of the lesion. Different causes of superficial enamel discoloration, in the form of white spots, are paramount for the restorative treatment as the quality of the enamel preparation affects the marginal fit and the durability of the restoration. However, poor oral hygiene, disturbance in eating behavior affect the course of non-carious hard-tissue diseases, which caries may complicate. Purpose – to optimize the diagnosis of initial dental enamel lesions to improve the caries prevention quality.Materials and methods. The study examined 460 children living in the Central and Krasnoselsky districts of St. Petersburg. The following indices assessed hard tissue condition: OHI-S, Greene and Vermillion; OHI by O'Leary T., Drake R., Naylor; White spot lesions index, Gorelick L, Geiger A. M, Gwinnett A. J., DMFT and df; caries activity.Results. The total prevalence of superficial (initial) lesions of hard tissues was 37.82%, i.e. 174 people out of 460 examined patients had superficial enamel lesions according to the criteria of I and II categories. The study found enamel changes in the age groups: 5-6 years (130) – 36 people (27.69%); 12 years old (175) – 62 people (35.42%); 15 years old (155) – 76 people (49.03%).Conclusions. Focusing on the caries activity signs rather than a precise differential diagnosis of the lesion nature is necessary to provide well-timed treatment and prevention upon detecting initial enamel lesion at a dental check-up.

COMPARISON OF SALIVATION RATE AND VISCOSITY OF ORAL LIQUID IN ADOLESCENTS 15-18 YEARS OLD WITH CARIES, WHO STUDY IN DIFFERENT EDUCATIONAL ESTABLISHMENTS

Caries is the most widespread stomatological disease among children, teenagers, and adults. After their eruption, hard tooth tissues are under the constant influence of oral liquid, property, and composition of which constantly change under the influence of different factors, such as local and general. Local and general factors, among which there is the state of hygiene of oral cavity, presence of somatic pathologies, psycho-emotional state of patient and others, influence the indexes of oral liquid. Considerable influence of the development of pathology of hard tissues has increased the secretion of saliva, its viscosity. Worsening of these indexes speeds the formation of dental plaque and change of its microbial composition, which, in turn, results in the demineralization of enamel. Therefore, a study of the speed of salivation and viscosity of mouth liquid in teenagers with caries is a pressing problem for the further planning of prophylactic measures in them. Undertaken studies of the speed of salivation certify the difference of indexes for teenagers, that study in different establishments of education. Thus, among 15 and 16-years-old teenagers that attend school an index was higher for schoolchildren as compared to the college students (p0,01), which could be explained by better stomatological status for them: the school attenders had the compensated degree of activity of caries, and college students ̶ compensated, subcompensated and decompensated. For schoolchildren speed of salivation improves from the age of 15 to 16 (p0,01), and for the students of the college, it remains almost at the same level. Students of university at 17 and 18 years had an index of the speed of salivation, that met a standard and did not have a reliable difference in different age-old periods, but had a reliable difference when compared to the index of college students. Speed of salivation for college attenders decreased with age and had the worst result in 18 years old. Leaning on the obtained data, there is ap necessity of the study of this index, according to the degree of activity of caries. From all examined patients, the best index of the speed of salivation was in teenagers with the compensated degree of caries activity, the worst ̶ in decompensated. The students of different educational establishments have the educed reliable difference of speed of salivation. The worst indexes were found in the examined college students, regardless of the degree of caries activity. The received results need a more detailed study of the reasons of origin of the cariogenic situation of this contingent of teenagers. The viscosity of oral liquid has a considerable influence on the state of the hard tissues of teeth. Its increase results in the considerable accumulation of dental stratifications, increase in the amount of microflora that results in focal demineralization. We found the dependence of this index on the degree of caries activity in attenders of different educational establishments. The viscosity of the oral liquid increases with the increase of index of intensity of caries and reaches a maximum for teenagers with the decompensated degree of caries activity. The worst index is found in college students with the decompensated degree of caries activity. Even at the identical degree of caries activity, the viscosity of mouth liquid in teenagers, that study in a college is higher than in those, who attend school or university. The received results of research need a more detailed study of factors that influence on the origin of the cariogenic situation in the mouth cavity for college students. The results of our research testify to the presence of the highly expressed cariogenic situation in the oral cavity of teenagers, that study in a college that is expressed in the decline of the index of the speed of salivation and increase of viscosity of the oral liquid. Indexes that were studied deteriorate depending on age and degree of caries activity, and reach the maximum in 18-years-old college students. Both, speed of salivation and viscosity of oral liquid were the worst in teenagers with the decompensated degree of caries activity. The received results have to be directed for the development of prophylactic measures at this contingent to increase the resistance of hard tooth tissues for prevention of appearance and development of caries in them.

ASSESSMENT OF THE DENTIFRICE INFLUENCE ON ENAMEL MATURE IN THE ASPECT OF AGE AND CARIES ACTIVITY IN 6–7, 12, 15 YEAR OLD SCHOOLCHILDREN

It is possible to increase the effectiveness of preventive dental measures by a differentiated approach to the use of toothpastes [3]. The most intensive incorporation of calcium and fluorides into the composition of the hard tissues of teeth occurs during their formation and mineralization [4, 5]. At the end of the growth and mineralization of the teeth, the enamel and dentin of the teeth become less permeable to fluoride, but the need for them does not disappear. Also, a number of authors note that the need for ions with different caries activity may differ. The purpose of our study was to study the effectiveness of the use of toothpastes in 6–7, 12, 15-year-old schoolchildren with various caries activity. We examined 532 children, attending organized children's groups in Yekaterinburg. By a randomization procedure based on the method of random numbers, children were divided into groups according to the type of paste used: calcium-containing, fluorine-containing, combined use of calcium and fluorine-containing pastes, paste based on organosilicon glycerohydrogel. The toothpastes effectiveness was assessed by the change in enamel resistance by functional methods: electrometry and Enamel Resistance Test. The annual increase in caries was taken into account. It was found that calcium-containing toothpastes are most effective in the first month of use, then the effect of their use weakens. Fluoride toothpastes lead to a persistent but slow increase in enamel resistance. The combined use of calcium and fluoride toothpastes gives a quick and lasting effect. A paste based on organosilicon glycerohydrogel gives a persistent decrease in enamel electrometry, with the best results in the group of schoolchildren with high caries activity.

Micro-CT Mineral Density Profile as Reference Standard for Early Carious Lesion Activity Assessment.

A challenging and crucial component to clinical caries diagnosis is diagnosing the activity of early lesions because it may have a significant impact on treatment decisions. This study aims to utilize microtomographic (micro-CT) scans of the enamel smooth surface layer to serve as a reference standard for future ex vivo caries activity assessment validation studies. Sound and non-cavitated (ICDAS 1-3) smooth surfaces (n=59) of extracted permanent teeth were examined for caries activity by calibrated individuals via visual-tactile examination. Each surface was scanned via micro-CT and line plot analysis generated plots of the mineral density against lesion depth, where the AUC was calculated. AUC thresholds were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner’s ICCMS assessment of sound, inactive, and active lesions, respectively. Diagnostic thresholds were associated with caries ICCMS activity classification using AUC mineral density values of the most external 96 μm of enamel. The established thresholds demonstrated 76.3% agreement with the ICCMS assessment in identifying demineralized lesions (k=0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrates quantifiable differences among demineralized, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and technological caries examinations.

Ammonium hexafluorosilicates as potential anti-caries agents: the problem of cation selection

In the last decade, ammonium hexafluorosilicate (AHFS) and ammonium hexafluorosilicates with biologically active cations (AHBAC), which have certain advantages over traditional fluoride medicinal substances, have been actively studied as anti-caries agents. In particular, an important feature of the action of AHFS is its ability to cause prolonged occlusion of the dentinal tubules with a precipitate of calcium fluoride; when using AHBAС there is a possibility of strengthening the anti-caries activity of the substance due to the pharmacological potential of the cation. The purpose of the review is to analyze the effects of the cation on the physicochemical properties and biological activity of ammonium hexafluorosilicates as potential anti-caries agents. Research methods – bibliosemantic, content analysis. It was drew the attention to the peculiarity of the AHBAC structure: salt structures are formed on the basis of systems of strong interionic H-bonds, mainly of the NH···F type, which have a significant effect on the properties of hexafluorosilicates in the crystalline state and their behavior in solutions. It was demonstrated the non-trivial nature of the change of solubility in water of AHBAC with heterocyclic and aromatic cations, which consists in the decrease of solubility with increasing number of hydrophilic fragments in the structure of cations. Adequate 2D QSPR models for interpretation and virtual screening of AHBAC water solubility have been constructed. Accounting for the effect of H-bonds on the solubility of AHBAC was detailed. It was assumed that the process of hydrolysis of AHBAC in aqueous solutions can be stimulated by elongation of the Si–F anion bonds due to the effects of H-bonds. It is shown that the thermal stability of AHBAC with pyridinium cations symbatically correlates with the number of strong and medium H-bonds in salt structures. The action of the pharmacological effects of the cation on the biological activity of AHBAC is manifested in the form of an increase in the caries-prophylactic efficacy of AHBAC in comparison with a similar effect of AHFS. Attempts to establish a relationship between the anti-caries activity of AHBAC and a certain pharmacological action of the cation have led to mixed results. This obviously reflects the complex mechanism of the influence of the biological activity of the cation on the caries-prophylactic efficacy of hexafluorosilicates, which is not limited to any one, albeit dominant, type of activity.

INDICATORS OF CARIES OF PERMANENT TEETH TAKING INTO ACCOUNT THE DEGREE OF ITS ACTIVITY IN ADOLESCENTS STUDYING IN DIFFERENT EDUCATIONAL INSTITUTIONS

In recent years, there has been noted a tendency to deterioration of dental health in children and teenagers. Therefore, it is important to study the dental status of children who attend different educational establishments to identify risk factors for dental diseases and develop means of their elimination. The survey of adolescents studying in various educational institutions (school, college, university) in Chernivtsi was conducted according to the generally accepted method. The study of the prevalence (%) and intensity of caries (CPV of teeth) was taking into account the degree of caries activity in each age period: compensated (1st), subcompensated (2nd), decompensated (3rd). A total of 107 schoolchildren, 317 college students, and 116 university students were surveyed. Adolescents are 15 to 18 years old. To conduct the study, the average rates of caries in each age group were calculated to determine the degree of caries activity in each age period, taking into account the area where adolescents live. The following indicators were obtained for the Chernivtsi region: – 15 years: compensated form – up to 4 caries-affected teeth, subcompensated – 5-7, decompensated – 8 or over; – 16 years: compensated – up to 5, subcompensated – 6-8, decompensated – 9 or over; – 17 years: compensated – up to 7, subcompensated – 8-10, decompensated – 11 or over; – 18 years: compensated – up to 8, subcompensated – 9-11, decompensated 12, or over. Our research showed that college students in all studied age periods (15, 16, 17, and 18 years) had worse results than teenagers in the comparison groups (schoolchildren of 15-16 years, university students of 17-18 years). About 62% of all examined teenagers had the first degree of caries activity, 19.5% had the 2nd, and 18.5% had the 3rd degree of caries. Teenagers enrolled in college were divided according to the degree of caries activity: in the 1st degree – 36.3%, 2nd – 32.2%, 3rd – 31.5%, at school: 1st degree – 100%, at university: 1st degree – 97.4%, 2nd – 2.6%. At the age of 18, the number of college students who have a decompensated degree of caries activity increases to 36.6% due to a decrease in the number in the group with a subcompensated degree. University students in 100% of cases had a compensated degree of caries activity. Caries intensity rates in each age group are lower in schoolchildren than in college students and are the lowest in university students. In teenagers with the first degree of caries activity, the highest rate of caries intensity was observed in college (15-18 year adolescents), and the lowest – at school (15-16 years). University students, despite being 17-18 years old, had lower rates than college teens. All students had the first degree of caries activity. When comparing the rate of caries intensity in the studied 15 year-olds with the compensated degree of caries activity, it was found that in schoolchildren it is 1.7 times lower than in college students, in 16 year-olds – 1.5 times. At the age of 17 and 18 – 1.7 times, compared to university students. Thus, our research showed that college students of all studied age groups had worse indices than teenagers in the comparison groups. They have a more severe course of caries. The results suggest that further studies into the causes of caries in college students need to be conducted.