Associations between caries activity,salivary buffer tests and caries increment in Mongolian children

The aim of the study was to evaluate caries increment in combination with a caries activity test (CAT21 Test) and a salivary buffer test (CAT21 Buf Test)—to predict future caries activity in Mongolian preschool children living in Ulaanbaatar City. The effectiveness of combining both tests and deft (decayed, extracted, filled teeth) means was also investigated. The caries prevalence in subjects was 94%, and deft mean value was 6.8. The caries increment after one year was 2.3 teeth. From the distribution of CAT21 Test scores a low risk was found in 38.6% and high risk in 61.4% of the examined children. From the CAT21 Buf Test scores, the high risk (lower buffer capacity) was found in 79.8% of the examined children. When the combination CAT21 Test and CAT21 Buf Test scores were divided into four groups (low-low/lowhigh/ high-low/high-high), the mean def-teeth showed a significant difference among the four groups (ANOVA P < 0.001). One year after the caries increment was evaluated in combination with the CAT21 Test scores and CAT21 Buf Test scores, the low-low risk group showed the lowest mean def-teeth. On the other hand, the high-high risk group showed the highest mean def-tooth (ANOVA P < 0.05). Based on these results, the CAT21 Test and CAT21 Buf Test are useful for clinical application of preschool children in predicting future caries activity. Furthermore, when the CAT21 Test and the CAT21 Buf Test were combined, a higher correlation was shown with the caries status.     

Caries activity test in Mongolian and Japanese children

The main objective of this study was to investigate the relationship between a caries activity test (CAT21 Test), and caries status. The subjects of this study were 419 preschool children, of Okayama City, Japan and, of Ulaanbaatar City, Mongolia. In all, subjects were examined for dental caries using a mouth mirror and probe. Then buccal plaque samples were obtained, incubated at 37°C for 48 hours, and scored as per the manufacturer's instructions for the Cariostat method. The following results were obtained:

• 1.The caries prevalence and mean deft of the two subjects was 55.0% and 3.2 for Japanese, so 92.4% and 6.6 for Mongolians, respectively.
• 2.Results of the CAT21 Test score distribution are as follows: 14% of the Japanese, 7.6% of the Mongolians had a CAT score of 0 (very low risk), 38% of the Japanese, 12.4% of the Mongolians had a 1.0 (low risk), 16.3% of the Japanese, 17.9% of the Mongolians had a 2.0 (middle risk), 25.5% of the Japanese, 36.6% of the Mongolians had a 3.0 (high risk), and 6.2% of the Japanese, 25.5% of the Mongolians had a 4.0 (very high risk) score.
• 3.There was a statistically significant difference in the CAT21 Test scores and dental caries indices of Japanese and Mongolian preschool children (ANOVA P< 0.01, P< 0.001).

From these results, it was suggested that the CAT21 Test is useful in clinical application     

Detection of mutans streptococci in plaque samples from Mongolian preschool and school children

Mutans streptococci, in particular Streptococcus mutans and Streptococcus sobrinus, are generally considered to be the principal microbial pathogen of dental caries. The objective of the study was to isolate S. mutans and S. sobrinus, identify them by PCR, and to compare their presence with the caries status and caries risk in Mongolian preschool and school children. Forty one preschool children aged 3–5 years and 40 school children aged 12–15 years were enrolled in this study. As assessed using Cariostat test, 75.6% of preschool children had high caries risk and 37.5% of school children had high caries risk. In preschool children, the prevalence of S. mutans and S. sobrinus were 100% and 36.6%, respectively; 63.4% were positive for S. mutans alone and 36.6% were positive for both S. mutans and S. sobrinus. In school children, the prevalence of S. mutans and S. sobrinus were 100% and 25.0%, respectively; 75.0% carried S. mutans alone and 25.0% had both S. mutans and S. sobrinus. The percentage of children positive for both S. mutans and S. sobrinus in the high caries risk group were significantly higher than those in the low risk group of either preschool (42.0% vs. 10.0%, P< 0.001) or school children (46.6% vs. 12.0%, P<0.001). Moreover, the caries status of children positive for both S. mutans and S. sobrinus were significantly higher than those positive for S. mutans alone (P< 0.01 for preschool children, and P< 0.05 for school children).     

Relationship between the IgA antibody response against Streptococcus mutans GbpB and severity of dental caries in childhood

ObjectiveExplore the associations between the severity of dental caries in childhood, mutans streptococci (MS) levels and IgA antibody response against Streptococcus mutans GbpB. Moreover, other caries-related etiological factors were also investigated.Design36–60 month-old children were grouped into Caries-Free (CF, n = 19), Early Childhood Caries (ECC, n = 17) and Severe Early Childhood Caries (S-ECC, n = 21). Data from socio-economic-cultural status, oral hygiene habits and dietary patterns were obtained from a questionnaire and a food-frequency diary filled out by parents. Saliva was collected from children for microbiological analysis and detection of salivary IgA antibody reactive with S. mutans GbpB in western blot.ResultsS-ECC children had reduced family income compared to those with ECC and CF. There was difference between CF and caries groups (ECC and S-ECC) in MS counts. Positive correlations between salivary IgA antibody response against GbpB and MS counts were found when the entire population was evaluated. When children with high MS counts were compared, S-ECC group showed significantly lower IgA antibody levels to GbpB compared to CF group. This finding was not observed for the ECC group.ConclusionsThis study suggests that children with S-ECC have reduced salivary IgA immune responses to S. mutans GbpB, potentially compromising their ability to modify MS infection and its cariogenic potential. Furthermore, a reduced family income and high levels of MS were also associated with S-ECC.     

The effect of dietary intervention on paraffin-stimulated saliva and dental health of children participating in a randomized controlled trial

ObjectivesThe aim was to study the impact of dietary intervention on the properties of paraffin-stimulated saliva, and on dental caries.Study designAt 7 months of age 1062 infants (540 intervention; 522 controls) started in the prospective, randomized Special Turku Intervention Project (STRIP) aimed at restricting the child's saturated fat and cholesterol intake to prevent atherosclerosis of adult age (www.clinicaltrials.gov NCT 00223600). At 3 years of age, every fifth child was invited to an oral sub-study, and 148 (78 boys) children attended. At 6, 9, 12 and 16 years of age 135, 127, 114 and 88 children were restudied, respectively. Dietary intakes of carbohydrates, protein, saturated fat, calcium, phosphate, and fibre were regularly recorded using 4-day food records. Height and weight were regularly monitored. Paraffin-stimulated saliva samples were collected at 6, 9, 12 and 16 years of age, and analyzed for flow rate, buffer capacity, calcium, phosphate and proteins. Dental health was recorded and expressed as d₃mft/D₃MFT, and as time of caries onset.ResultsDietary intakes of calcium, phosphate and fibre, and salivary flow rate increased with time in both groups (p < 0.001, GLM for repeated measures). Fibre intake and salivary flow rate were higher in the intervention than in the control group (p = 0.042 and p = 0.0394, respectively, GLM for repeated measures). There were no correlations between dietary intakes and salivary concentrations of calcium or phosphate. Children who did not have caries experience (d₃mft/D₃MFT = 0) during the entire follow-up had higher salivary calcium than those who had caries already at 3 years of age. The association between salivary calcium and caries onset was significant up to 12 years of age. Toothbrushing frequency was statistically significantly associated with caries-onset at ages 6 (gamma statistic 0.457, p = 0.046) and 12 years (gamma statistic 0.473, p = 0.019).ConclusionsThe current long-term dietary intervention increased children's paraffin-stimulated salivary flow rate. The concentration of salivary calcium was directly correlated to dental health. Higher salivary flow rate in the intervention group is believed to be due to higher fibre intake in the intervention group.     

Level of caries activity and an estimate in the increase of permanent teeth caries: a three-year follow up study in preschool senior children

The aim of this study was to examine relationships between the level of caries activity in preschool senior children and the increase of dental caries 3 years after the permanent teeth erupted. A total of 1133 preschool senior children aged 5–6 years were examined yearly during 3-year duration. A Caries Activity Test (Cariostat Test) was used at the first examination of this study. The results were as follows;

• 1.The caries prevalence rate of the subjects was 84.1% and the mean dft was 5.89 at the first examination.
• 2.There was a significant relationship between the CAT score and dft at the first examination (P < 0.001).
• 3.The subjects were divided into 3 risk groups by CAT score: low-risk group (20.4%), middle-risk group (43.3%) and high-risk group (36.3%).
• 4.Increments of DFT from 1 year to 3 years after the permanent tooth erupted for the high-risk group were more than twice for those of the low-risk group (P < 0.001). The prevalence of the permanent tooth decay for the high-risk group was also higher than that of the low-risk group (P < 0.001).

The results showed that the usage of the CAT Test for preschool senior children was useful to predict increase in permanent teeth caries over 3-year duration.     

A Study of dental caries prevalence in 12–14 year old school children in Ibadan,Nigeria

The aim of the study was to determine dental caries prevalence among a representative sample of 12–14 year old school children in Ibadan, Nigeria with a view of determining Restorative Index and Met Need Index of the studied population. Dental caries was diagnosed according to the WHO method. Out of the 577 children in the age group, 65 children (11.2%) had dental caries experience as expressed with the DMFT index. More than 85% of the children were caries free. A mode of one DMFT was the highest score for the children although a 14-year-old pupil had DMFT score of 6. Female children had higher mean DMFT score of 2.03 ± 1.13 compared with 1.78 ± 1.0 for males (P > 0.05). The Restorative Index (RI) and Met Need Index (MNI) for the children were very low as only the 14-year-old children had an RI of 3.45% and MNI of 0.11. Restorative Index reflects the restorative care of those who have suffered the disease and it is measured as a ratio of filled to filled plus decayed teeth percent that is F/F+D percent. Met Need Index is an indication of treatment received by an individual and it is measured by the ratio of the mean missing plus filled teeth to mean decayed, missing and filled teeth that is M+F/DMF. Since cost of management, which may be out of the reach of these children, has been identified as one of the factors militating against their receiving treatment, the result of this study suggest that oral health education with emphasis on correcting snacking habits of school children is desirable.     

Change in salivary levels of chromogranin A in children by hearing dental air turbine noise

Dental fear in children can be a psychological barrier for maintenance of oral health, thus it is important to objectively evaluate the responses to stress stimuli produced during dental treatments. In this study, we analyzed the stress responses of 15 preschool (3- to 6-year) and 22 school-aged (6- to 12-year) children to dental air turbine noise by measuring salivary levels of chromogranin A (CgA), a marker of psychological stress. Salivary CgA was significantly increased during exposure to the noise in the school-aged subjects, especially in those who had previously experienced tooth excavation, while there was no significant difference in CgA levels before and during noise exposure in those without such experience. In the preschool children, the noise did not induce increased secretion of CgA even in those with previous excavation experience. In addition, the levels of dental fear were assessed using a dental subscale of children's fear survey schedule (CFSS-DS), while reactions during dental care were scored according to the Frankl Behavior Rating scale. In the school-aged children, change in salivary CgA level was not correlated with CFSS-DS (r = 0), while there was a weak negative correlation with Frankl score (r = ?10.202). Our results indicate that air turbine noise causes psychological stress in school-aged children, especially in those who have previously received dental treatments.     

Salivary antioxidants and oral health in children with autism

Individuals with autism vary widely in abilities, intelligence, and behaviours. Autistic children have preferences for soft and sweetened food making them susceptible to caries. A wide spectrum of medical and behavioural symptoms is exhibited by children with autism, which makes routine dental care very difficult in them. Mental retardation is evident in approximately 70% of individuals with autism and most psychiatric disorders including autism are associated with increased oxidative stress.ObjectivesTo evaluate the oral health status of children with autism and to determine the salivary pH and total salivary antioxidant concentration (TAC).Materials and methods101 subjects with autism between age group of 6 and 12 year were part of the study and 50 normal healthy siblings of same age group were taken as control group. Oral health status was analysed using oral hygiene index-simplified and dentition status index. The salivary total anti-oxidant level was estimated using phosphomolybdic acid using spectrophotometric method and the salivary pH using the pH indicating paper. The results were statistically analyzed using Mann–Whitney U test.ResultsA statistically very highly significant difference was seen in the mean oral hygiene index scores (autistic group – 1.2 and control group – 1, P < 0.001) and the mean salivary total antioxidant concentration (autistic group – 5.7 μg/ml and control group – 38 μg/ml, P < 0.001). No statistical significant difference was observed in the dental caries status and the salivary pH of autistic group and the control group.ConclusionsSimilar dental caries status was observed in children with autism and their healthy normal siblings. Oral hygiene was poor in children with autism whereas the Salivary TAC was significantly reduced in autistic children.     

Risk behaviors and its association with caries activity and dental caries in Japanese children

The aim of this study was to assess risk behaviors and its association with caries activity and dental caries in Japanese children. The subjects were 392 young Japanese children who underwent dental health check-up at 18, 30 and 42 months of age. Oral examinations, Cariostat tests and dental health questionnaires were carried out at each time. The caries prevalence of children was 1.5% at 18 months, 9.9% at 30 months and 28.1% at 42 months. Caries activity based on the Cariostat scores of children was correlated with caries status (caries-free/carious) at 42 months. In children with caries during each examination period at 42 months, eating snacks while playing was ranked as the most important behavioral risk (P < 0.001), followed by breast-feeding (P < 0.01), non setting of time for snacks (P < 0.05) and frequency of snacks (P < 0.05) at 18 months old; non brushing by mother (P < 0.05) and eating snacks while playing (P < 0.05) were ranked highest at 30 months old. In addition, eating snacks while playing (P < 0.001) at 42 months old was the only a significant factor for children with caries. Caries activity and risk behaviors were associated with caries experience at different age periods of childhood.     

Antimicrobial peptides in saliva of children with severe early childhood caries

ObjectiveControversies exist regarding the relationship between the concentrations of antimicrobial peptides (AMPs) and presence of dental caries in children. Thus, the aim of this study was to examine levels of AMPs in saliva of caries-free (CF), early childhood caries (ECC) and severe early childhood caries (S-ECC) children to determine if the levels of these salivary peptides individually or in combinations were related to caries severity and mutans streptococci levels.Design36 to 60 month-old children were selected to participate in this study. Children were grouped into CF group (n = 29), ECC group (n = 25) and S-ECC group (n = 29). Saliva was collected from children for microbiological analysis by culture. Salivary concentrations of cathelicidin LL-37, human β-defensin 2 (hBD-2), human β-defensin 3 (hBD-3) and histatin-5 (HTN-5) were determined by ELISA.ResultsSalivary concentrations of AMPs did not differ among CF, ECC and S-ECC groups. Data showed positive correlations between mutans streptococci levels and salivary hBD-2 or HTN-5. Positive correlations were found between hBD-2, hBD-3, LL-37 and HTN-5. Combinations among AMPs, mainly LL-37, were positively associated with caries levels.ConclusionsSalivary concentrations of AMPs individually were not associated with the severity of early childhood caries. The stimulus of caries appears to trigger a biological response, however, with a combination of these peptides.     

Oral health conditions in children with and without school-based oral preventive program

ObjectivesTo assess the degree of plaque, gingivitis and caries in children who either did or did not take part in a regular oral preventive program, thus establishing an overview of the oral health condition of those populations.MethodsA population of 325 Brazilian children aged 8–12 years old, from two public schools, whose parents granted permission, were divided into two groups according to their school. The main group (G1) consisted of 203 children from the school, which has the preventive program, while the control group (G2) consisted of 122 children from the school without the program. The children were examined clinically by a single examiner to assess plaque and gingival status, as well as caries prevalence in order to assess their oral health status. Data was inserted in SPSS 11.0 and the Mann-Whitney test with a significance level of 5% was used for data analyses of the independent variables, while the Student t test was used for comparison between averages.ResultsThe mean plaque score and mean gingival bleeding score of G2 were higher than G1 (P< 0.05). Regarding the percentage of caries-free children, it was 31.0% with a mean DMFT+dmft of 2.07 (± 2.87) in G1 and 21.3% with a mean DMFT+dmft of 3.03 (± 2.79) in G2 (P> 0.05).ConclusionIt was concluded that the oral preventive program seemed to demonstrate a satisfactory impact on the oral health condition of the target children when compared to the ones who were not enrolled in a school-based program.     

Association between obesity and dental caries in a group of preschool children in Mexico

Objective: The aim of this study was to determine the association between obesity and caries by utilizing the data of a cohort of preschool children aged 4‐5 years. Methods: Data were obtained from a cohort of 1,160 children. Dental caries detection was performed according to the World Health Organization criteria. The caries index was measured as the number of decayed (d), extracted (e), and filled (f) teeth (t) (deft), or surfaces (defs). The body mass index (BMI) in units of kg/m² was determined, and children were categorized according to age‐ and gender‐specific criteria as normal weight (5th‐85th percentile), at‐risk overweight (≥85th‐<95th percentile), and overweight (≥95th percentile). Odds ratios were determined for at‐risk overweight and overweight children using logistic regression. Results: The prevalence of dental caries was 17.9 percent. A slightly higher percentage of dental caries was found in boys (19.6 percent) than in girls (16.4 percent). From the total sample, the mean BMI was 17.10 ± 3.83. Approximately 53.7 percent of children were classified as normal weight, 14.2 percent as at‐risk overweight, and 32.1 percent as overweight. At‐risk overweight children were higher among girls (17.1 percent) than among boys (11.3 percent). When adjusted for covariates, the logistic regression model showed that there was a significant association between at‐risk overweight children (P < 0.001), overweight children (P < 0.001), and caries in the primary dentition. Mean (SD) deft value of the sample was 1.08 (2.34), while the corresponding defs value was 1.43 (3.29). Conclusion: Obesity appears to be associated with dental caries in the primary dentition of preschool Mexican children.     

Presence of Streptococcus mutans or Streptococcus sobrinus in Cariostat®-inoculated plaque samples from Japanese mother-child pairs

The aim of this study was to determine the presence of Streptococcus mutans or Streptococcus sobrinus in Cariostat-inoculated plaque samples obtained from Japanese mother-child pairs through a conventional PCR technique and to establish the presence of these bacteria and caries risk. Oral examination and caries risk assessment using the Cariostat^® were carried out on 168 children, aged 6–31 months, and their mothers. The presence of S. mutans and S. sobrinus in Cariostat-inoculated plaque samples was checked through PCR and tested for relevance with caries risk. A significant correlation (P < 0.001) was found between caries risk of mothers and presence of S. mutans or S. sobrinus in plaque samples from their children in the 19–31-month-old age range. However, no significant relationship found between the presence of either strain in the plaque of younger children (6–18 months) and caries risk of mothers. Likewise, high caries risk was seen in 49.1% of the 19–31-month-old children of highrisk mothers (P < 0.001) and 27% of the 6–18-month-old children of high-risk mothers (P < 0.05). The effectiveness of the Cariostat method for prediction of caries risk can be improved by detecting the presence of S. mutans and S. sobrinus in plaque samples obtained from mothers and their children through conventional PCR techniques.     

The association of Enamelin,Lactoferrin, and Tumour necrosis factor alpha gene polymorphisms with high caries susceptibility in Chinese children under 4 years old

ObjectiveThe aim of this study was to assess the role of ENAM rs3796703, LTF rs1126478, and TNF-α rs1800629 in high caries susceptibility.DesignThe present case–control study included 1005 unrelated children under 4 years old: 505 with severe caries (dmft index ≥4) and 500 who were caries-free (dmft index = 0 and without white-spot lesions). Questionnaires were obtained from parents and gardians about the children’s diet and oral behavioural habits. All the children received dental examinations and oral swabbing for human genomic DNA collection. ENAM rs3796703, LTF rs1126478, and TNF-α rs1800629 were genotyped by Sanger sequencing.ResultsThe frequency of the ENAM rs3796703 T allele (6.7% in the caries group and 4.2% in the caries-free group), CT genotype (12.7% in the caries group and 8.4% in the caries-free group), TNF-α rs1800629 A allele (4.8% in the caries group and 6.8% in the caries-free group), and AG genotype (8.7% in the caries group and 13.2% in the caries-free group) were significantly different between the caries and caries-free groups (p < 0.05). No significant difference was found in the LTF rs1126478 allele frequency and genotype distribution between the two groups. The ENAM rs3796703 CT genotype increased caries susceptibility by 60.9% compared to the CC genotype (β = 0.746, OR = 1.609), and the TNF-α rs1800629 AG genotype reduced caries susceptibility by 47.4% compared to the GG genotype (β = −0.642, OR = 0.526). In terms of habits covariates, prolongation of night feeding time by 1 month increased caries susceptibility by 3.3% (β = 0.033, OR = 1.033); additionally, sweets and acidic drinks consumption 1–2 times per day increased caries susceptibility by 218.2% (β = 1.158, OR = 3.182), and consumption 3 or more times pe/r day increased susceptibility by 883.5% (β = 2.286, OR = 9.835) compared to non-consumption. Topical fluoride application decreased caries susceptibility by 43.0% (β = −0.562, OR = 0.570).ConclusionsThe ENAM and TNF-α genes are likely associated with caries experience in Chinese children. The ENAM rs3796703 CT genotype might be involved in caries susceptibility, while TNF-α rs1800629 AG genotype might be involved in caries protection.     

A comparison of salivary IgA in children with Down syndrome and their family members

The aim of this study was to compare total IgA in the whole saliva of children with Down syndrome with levels in sibling and parent groups. IgA measurements were presented as the concentration in saliva (μg/ml) and also adjusted for salivary flow rate (SFR; μg/min). Twenty children with Down syndrome, ten siblings and twenty parents were recruited. Stimulated whole saliva was collected from the participants and SFR calculated. The measurement of salivary IgA (sIgA) was carried out using an indirect competitive Enzyme-Linked Immunosorbent Assay. The difference in the mean SFR between children with Down syndrome, parents and siblings were not statistically significant. The mean salivary concentration of IgA was higher in children with Down syndrome (95.1 μg/ml) compared with siblings (48.3 μg/ml; p = 0.004). When adjusted for SFR children with Down syndrome had mean sIgA levels of 98.8 μg/min and the siblings 48.6 μg/min (p = 0.008). The children with Down syndrome had sIgA levels similar to those of the parents (92.5 μg/ml; 93.2 μg/min). There was a positive correlation between age and sIgA concentration in the siblings (p = 0.008) but not for children with Down syndrome (p = 0.363). This suggests that under similar environmental influences, the levels of sIgA in children with Down syndrome are higher than in the siblings, from a very young age.     

Impact of glycemic control on oral health status in type 2 diabetes individuals and its association with salivary and plasma levels of chromogranin A

ObjectiveTo evaluate the effect of glycemic control status in type 2 diabetes mellitus (T2DM) individuals on clinical oral health indicators and to compare the concentrations of plasma and salivary chromogranin A (CHGA) among nondiabetic subjects and T2DM patients, exploring their associations.DesignIn this cross-sectional study, 32 patients with controlled T2DM, 31 with poorly controlled T2DM and 37 nondiabetic subjects underwent a clinical and periodontal examination. CHGA concentrations were determined in saliva and plasma with ELISA.ResultsPoorly controlled T2DM group exhibited significantly higher mean buffering capacity, plaque index and bleeding on probing than other groups (P < 0.05). No difference was found to DMFT (decayed, missed and filled teeth) index between groups. Sites with clinical attachment loss (CAL) of 4 and 5–6 mm were significantly higher in both diabetic groups compared to control group (P < 0.05). Poorly controlled T2DM group had significantly higher sites with CAL ≥ 7 mm than other groups (P = 0.001). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P < 0.05). In both diabetic groups, probing depths 5–6 mm and CAL 5–6 mm were associated with higher salivary CHGA concentration (P < 0.05).ConclusionsThe findings revealed that T2DM patients were more prone to periodontal tissue damage than to caries risk. The results also provide some evidence that the degree of attachment loss deteriorates significantly with poor glycemic control in T2DM (CAL ≥ 7 mm). Moreover, the results suggest that high concentrations of salivary CHGA are associated with worse periodontal parameters and T2DM, and this could be related to the pathogenesis of both diseases.     

A randomized controlled trial by the 3DS for dental caries

The aim of this study is to evaluate the povidone-iodine for the suppression of oral cariogenic bacteria and compare its effects to that of fluoride in children. We carried out a randomized controlled trial to compare the effects of povidone-iodine to those for sodium fluoride. Pre-school children (n = 210) with more than 10⁵ cfu/ml mutans streptococci in their stimulated saliva were randomly sampled and randomly allocated into three groups. We planned the preventive program by 3DS (Dental Drag Delivery System). The groups that provided preventive programs were the povidone-iodine group (n = 70) and the sodium fluoride group (n = 70). A control group (n = 70) received no intervention. Povidone-iodine or sodium fluoride was applied to the tooth surface using custom made trays. Subsequent home care was obligatory for one month. After one month, the salivary levels of mutans streptococci were low level when compared to the based data. However the difference in salivary levels of mutans streptococci among groups was not statistically significant when comparing the povidone-iodine group with the sodium fluoride group (P = 0.625). After 2.5 years follow up, differences in incidence of new dental caries among the three groups were not statistically significant (P = 0.583). Clinical application of anti-microbial drugs may be effective, but only a single intervention is not sufficient to reduce the incidence of new dental caries.     

Long-term clinical evaluation of direct resin composite restorations in vital vs. endodontically treated posterior teeth — Retrospective study up to 13 years

ObjectivesThis retrospective study evaluated and compared the survival rate of Class II posterior direct resin based composite (RBC) restorations made in vital teeth (VT) and endodontically treated teeth (ETT). The influence of risk factors on the long-term performance of restorations was also investigated.MethodsPatients (n = 245) receiving RBC posterior restorations between 2004 and 2012 were selected. A total of 597 restorations (485 in VT, 112 in ETT) with minimum 2.5–3 mm remaining cusp thickness, made with the same brand of RBC and adhesive, were evaluated using the USPHS criteria. Data were analyzed with Mann–Whitney, Chi-square and Fisher’s Exact Test, Extended Cox-regression and Kaplan–Meier analysis (p < 0.05). Relative risk ratio was estimated for each evaluated parameter.ResultsThe mean observation period was 8.6 ± 2.3 years. An annual failure rate in VT and ETT of 0.08% and 1.78%, respectively, was detected. The reasons of failures included restoration fracture, secondary caries in VT; vertical root fracture, cusp fracture, restoration fracture, secondary caries and loss of adhesion in ETT. Significantly better performance was observed in RBCs of VT for each evaluated parameter. Among the evaluated risk factors only occlusal stress affected negatively the survival of RBC in ETT (Hazard Ratio 37.1; CI_95% 8.4–163.7).SignificanceAlthough, there is significant difference in the success rate of RBCs in VT (98.97%) and ETT (76.8%), the long-term (6–13 years) durability of Class II RBCs with 2.5–3 mm cusp thickness in ETT is also clinically acceptable. The presence of occlusal stress decreases the survival of RBCs in ETT.