Association of MMP9, MMP13 and MMP20 genes polymorphism with dental caries: A meta-analysis

ObjectivesGenetic factors can be involved in dental caries as the most common chronic oral diseases. The association between polymorphism of MMP9, MMP13 and MMP20 genes with tooth decay has been studied but contradictory outcomes have been indicated. Thus, a meta-analysis was done to get comprehensive outcomes in this path.Materials and methodsAll articles in English by March 2022 were searched with correlated keywords from known database as PubMed, Scopus, Embase and Web of Science, and the articles were selected in several stages based on exclusion and inclusion criteria. Comprehensive meta-analysis software v.2.0 was used for Meta-analysis.ResultsFinally, 11 related articles were selected for meta-analysis. According to the results, MMP9 and MMP20 polymorphisms were not related with increased susceptibility to caries in the studied models, but in the case of MMP13, a significant association was observed between gene polymorphism and caries risk.ConclusionThe results about MMP13 gene polymorphism showed that guanine G allele and GG genotype have a protective role and decrease the risk of dental caries. It should be noted that, these conclusions could be promoted by studies contain large sample sizes. Finding the genetic factors influencing tooth decay can help increase our current knowledge of caries pathology, predict its occurrence, and target genes at the molecular level to prevent it.     

Prophylactic antibiotic regimens in dental implant failure: A systematic review and meta-analysis

BackgroundIn this systematic review and meta-analysis, the authors examine the efficacy of antibiotic prophylaxis (AP) and specific antibiotic regimens for prevention of dental implant failure in patients who are healthy overall.Types of Studies ReviewedThe authors independently conducted electronic database and manual searches to identify randomized controlled trials (RCTs). The authors selected articles on the basis of eligibility criteria and assessed for risk of bias by using the Cochrane Handbook. Implant failure was the primary outcome studied; perimucositis or implantitis, prosthetic failure, and adverse events were secondary outcomes studied. The authors conducted random effects meta-analysis for risk ratios of dichotomous data and used OpenMeta[Analyst] (Center for Evidence Synthesis, Brown School of Public Health) for qualitative assessment of administration schedules.ResultsWith duplicates removed, the authors screened 1,022 abstracts, reviewed 21 full-text articles, and included 8 RCTs that included 2,869 implants in 1,585 patients. Meta-analysis results indicated that AP resulted in a statistically significantly lower number of implant failures for all regimens combined (implant, P = .005; patient, P = .002), as well as preoperative (implant, P = .01; patient, P = .007), pre- and postoperative (implant, P = .04), and postoperative AP only (implant, P = .02), compared with no antibiotics. The authors found no statistically significant differences in analysis of comparative antibiotic treatments or secondary outcomes. The authors identified confounding variables.Conclusions and Practical ImplicationsAlthough meta-analysis results suggested that AP may reduce implant failure, definitive conclusions cannot be achieved yet. The overall nonsignificant differences reported in individual trials, limitations discussed, implant infection outcomes, and antibiotic-associated risks must be considered. Thus, the results for implant failure outcomes may not warrant the indiscriminate use of antibiotics in patients who are healthy who are receiving dental implants. Investigators must conduct large-scale RCTs to determine the efficacy of AP and various regimens, independent of confounding variables.     

Five-year clinical evaluation of universal adhesive applied following different bonding techniques: A randomized multicenter clinical trial

ObjectivesTo evaluate the clinical performance of a universal adhesive system (Futurabond U, Voco) when applied following different adhesive strategies in non-carious cervical lesions (NCCLs) after 5 years.MethodsFifty participants were included. Futurabond U (Voco) was applied in NCCLs using four adhesive strategies (n = 50 each): only self-etch (SE); selective enamel etching + self-etch (SET + SE); etch-and-rinse with dry dentin (ERD); and etch-and-rinse with wet dentin (ERW). All cavities were restored with Admira Fusion composite resin (Voco). Restorations were evaluated after 1, 3, and 5 years using the World Federation criteria (FDI) and the modified United States Public Health Service (USPHS) criteria.ResultsAfter 5 years, retention rates were 81 % (65.8–90.5) for SE, 87 % (73.2–94.4) for SET + SE, 84 % (69.6–92.6) for ERD, and 78 % (63.6–88.9) for ERW (p > 0.05). Thirty-five restorations were considered to have minor discrepancies in marginal adaptation at the 5-year recall (14 for SE, 9 for SET + SE, 6 for ERD, and 6 for ERW; p > 0.05). Sixteen restorations were detected as a minor marginal discoloration (6 for SE, 4 for SET + SE, 1 for ERD, and 5 for ERW; p > 0.05) and one restoration showed a recurrence of caries (1 for ERW; p > 0.05) at the 5-year recall. No restorations showed postoperative sensitivity after 5 years.SignificanceNCCLs restorations using a universal adhesive showed satisfactory clinical performance after 5 years, regardless of the adhesive strategy.     

Impact of visual inspection and radiographs for caries detection in children through a 2-year randomized clinical trial: The Caries Detection in Children–1 study

BackgroundVisual inspection (VIS) with radiographic examination (RAD) is the recommended diagnostic strategy for detecting caries in children; however, this recommendation is based on accuracy studies. The authors conducted a clinical trial to compare the detection and subsequent treatment of carious lesions in primary molars performed with VIS alone and with RAD.MethodsChildren (3-6 years old) were randomly assigned to 2 groups according to the diagnostic strategy used for caries detection on primary molars: VIS or RAD. Participants were diagnosed and treated according to the management plan related to the allocated group. The primary outcome was the number of new operative interventions during the 2-year follow-up period. Other secondary outcomes were also compared. Comparisons were performed with Mann-Whitney test using an intention-to-treat approach.ResultsOf the 252 children included and randomized, 216 were followed-up after 2 years (14.3% attrition rate). There was no difference between the groups for the primary outcome (P = .476). For the secondary outcomes, the RAD group had more restoration replacements (P = .038) and more restorations performed since the beginning of the study (P = .038) compared with the VIS group. In addition, the RAD group had a higher number of false-positive results than the VIS group (P < .001).ConclusionsSimultaneous use of VIS and RAD for caries diagnosis in primary molars of children who seek dental treatment does not provide additional benefits compared with VIS alone.Practical ImplicationsDentists should perform VIS only, not RAD, for detecting carious lesions in preschool-aged children.ClinicalTrials.gov: NCT02078453.     

Tooth-level predictors of tooth loss and exposed bone after radiation therapy for head and neck cancer

BackgroundThe objective of this study was to identify tooth-level risk factors for use during preradiation dental care management to predict risk of tooth failure (tooth lost or declared hopeless) and exposed bone after radiation therapy (RT) for head and neck cancer (HNC).MethodsThe authors conducted a prospective observational multicenter cohort study of 572 patients receiving RT for HNC. Participants were examined by calibrated examiners before RT and then every 6 months until 2 years after RT. Analyses considered time to tooth failure and chance of exposed bone at a tooth location.ResultsThe following pre-RT characteristics predicted tooth failure within 2 years after RT: hopeless teeth not extracted pre-RT (hazard ratio [HR], 17.1; P < .0001), untreated caries (HR, 5.0; P < .0001), periodontal pocket 6 mm or greater (HR, 3.4; P = .001) or equaling 5 mm (HR, 2.2; P = .006), recession over 2 mm (HR, 2.8; P = .002), furcation score of 2 (HR, 3.3; P = .003), and any mobility (HR, 2.2; P = .008). The following pre-RT characteristics predicted occurrence of exposed bone at a tooth location: hopeless teeth not extracted before RT (risk ratio [RR], 18.7; P = .0002) and pocket depth 6 mm or greater (RR, 5.4; P = .003) or equaling 5 mm (RR, 4.7; P = .016). Participants with exposed bone at the site of a pre-RT dental extraction averaged 19.6 days between extraction and start of RT compared with 26.2 days for participants without exposed bone (P = .21).ConclusionsIndividual teeth with the risk factors identified in this study should be considered for extraction before RT for HNC, with adequate healing time before start of RT.Practical ImplicationsThe findings of this trial will facilitate evidence-based dental management of the care of patients receiving RT for HNC. This clinical trial was registered at Clinicaltrials.gov. The registration number is NCT02057510.     

Impact of motivational interviewing on early childhood caries: A systematic review and meta-analysis

BackgroundThe authors aimed to assess the scientific evidence on motivational interviewing for the clinical reduction of early childhood caries compared with traditional dental health education.MethodsSearch terms were selected on the basis of Medical Subject Headings and non–Medical Subject Headings terms. The main key words were motivational interviewing, early childhood caries, and education. Potentially eligible studies involved the clinical assessment of caries rate in children whose parents or caregivers received motivational interviewing as an intervention. The authors assessed the risk of bias using the Cochrane risk-of-bias tool. In March 2019, the authors performed an electronic database search of literature published in English within the following databases: Scopus, Cochrane, PubMed, and Embase.ResultsOf 329 articles retrieved initially, 14 were eligible for inclusion in the systematic review and 3 articles contributed to the meta-analysis. For statistical analysis, the mean difference of continuous data was analyzed at a 95% confidence interval using the random-effects model.ConclusionsOverall, the evidence presented in this review was limited. Although the results of the meta-analysis showed that motivational interviewing is as effective as dental health education in controlling early childhood caries, we need more and better designed and reported interventions to assess its impact on early childhood caries accurately.     

Proanthocyanidin encapsulation for sustained bioactivity in dentin bioadhesion: A two-year study

ObjectivesTo determine the long-term effect on the stability of dentin-resin interfaces after the addition of polylactide (PLA) capsules containing proanthocyanidin (PAC) to adhesive resin.MethodsSub-micron (SM) and micron (M) size capsules containing PACs were produced using a combination of emulsification and solvent evaporation techniques and characterized. Human dentin surfaces (n = 8) were etched (35% glycolic acid) and primed (15% enriched Vitis vinifera extract solution - VV_e), followed by the application of an experimental adhesive containing 0 (control), 1.5 wt% of SM or M PAC-filled PLA capsules light cured for 40 s. A crown was built using commercial composite. After 24 h-immersion (37 °C) in simulated body fluid, specimens were serially sectioned into resin-dentin beams. Microtensile bond strength (TBS), micro-permeability and fracture pattern were assessed immediately and after 1 and 2 years. Data were statistically analyzed using two-way ANOVA and post-hoc test (α = 0.05).ResultsPolydisperse capsules were manufactured with average diameter of 0.36 µm and 1.08 µm for SM and M, respectively. The addition of capsules did not affect TBS (p = 0.889). After 2 years, TBS significantly decreased in SM (p = 0.006), whereas M showed similar initial values (p = 0.291). Overall, less micro-permeability was found in M than the control and SM group (p < 0.001). After 2 years, fractured surfaces from capsule-containing groups failed within the adhesive layer while control fractured at the bottom of the hybrid layer.SignificanceThe addition of PAC-filled PLA microcapsules in a dental adhesive did not affect the bond strength while increased and sustained the protection against micro-permeability in the interface, likely due to release of PACs.     

Impact of SARS-CoV-2 on saliva: TNF-⍺, IL-6, IL-10, lactoferrin,lysozyme, IgG,IgA, and IgM

ObjectivesUnderstanding the role of certain salivary components, such as TNF-?, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM, in airway defense during the ongoing SARS-CoV-2 pandemic is essential. The salivary immune barrier of patients with COVID-19 may play a role in their prognosis. The present study aims to evaluate the impact of SARS-CoV-2 on saliva composition.MethodsA longitudinal study was carried out with male and female firefighters aged 24–48 years. The study sample (n = 34) was divided into 3 groups: asymptomatic volunteers with a negative polymerase chain reaction (PCR) test for SARS-CoV-2 (group 1, Control, n = 21); patients with symptoms of COVID-19 of less than 7 days’ duration and a diagnosis of SARS-CoV-2 infection by PCR (group 2, COVID-19, n = 13); and recovered patients from group 2 who were free of COVID-19 symptoms for at least 2 months (group 3, post-COVID-19 recovery, n = 13). All groups underwent real-time PCR to detect the presence of SARS-CoV-2, as well as analysis of the salivary concentrations of TNF-?, IL-6, IL-10, lactoferrin, lysozyme, IgG, IgA, and IgM by the ELISA method.ResultsLactoferrin concentrations were significantly decreased in the infected group (COVID-19) when compared to those not infected by SARS-CoV-2 (control) (p = 0.032). IgA concentrations were decreased in the COVID-19 and post-COVID-19 groups compared to the control group (p = 0.005 and p = 0.016, respectively). Comparison of the COVID-19 and post-COVID-19 groups also revealed an increase in IgM concentrations during acute SARS-CoV-2 infection (p = 0.010).ConclusionSARS-CoV-2 alters the composition of the salivary immune barrier.     

The impact of salivary lactoperoxidase and histatin-5 on early childhood caries severity in relation to nutritional status

IntroductionEarly childhood caries is a multifactorial disease. Saliva plays an important role in initiation and protection against caries, and its composition is greatly affected by nutritional status. This study was conducted to determine the impact of salivary lactoperoxidase and histatin-5 on the severity of ECC in relation to nutritional status.Materials and methodsThe sample consisted of 120 children aged 5 years, classified into eight groups: mild ECC in underweight children, mild ECC in normalweight children, moderate ECC in underweight children, moderate in ECC normal weight children, severe ECC in underweight children, severe ECC in normalweight, caries-free (control) underweight children and caries-free normalweight children. Each group consisted of 15 children. Stimulated saliva was collected. Salivary lactoperoxidase was analysed using Human LPO/ Lactoperoxidase ELISA Kit (CLIA)-LS-F29892, and salivary histatin-5 was analysed using Human Histatin-5 ELISA Kit MBS705083_48T.ResultsLactoperoxidase and histatin-5 concentrations were significantly higher in caries-free children than in children with ECC, and they were higher in children with mild ECC than in children with moderate ECC or in children with severe ECC. They were significantly higher among children with normal weight than among those who were underweight (p < 0.01). ECC and nutritional status recorded non-significant interactions with both LPO and HST-5 (p > 0.01), but there was significant interaction between these two variables and LPO and HST-5 together (p < 0.01). The Pearson's correlation coefficient test recorded significant negative correlations between ECC severity and both salivary lactoperoxidase and histatin-5 among the eight study groups, whereas significant positive correlations were recorded between BMI values and both salivary lactoperoxidase and histatin-5 among the eight study groups.ConclusionSalivary lactoperoxidase and histatin-5 may be affected by nutritional status, and these two parameters may play an important role in caries prevention at high concentrations. There is interaction between these two parameters and ECC severity and nutrition.     

Photobiomodulation vs NSAIDs in the management of postoperative dentoalveolar pain

BackgroundPostoperative pain, the most common complication of dentoalveolar surgery, is routinely controlled by non-steroidal anti-inflammatory drugs (NSAIDs). However, despite its proven efficacy, the long-term consumption of NSAIDs is associated with several serious and adverse effects. As a result, photobiomodulation (PBM) or low-level laser therapy (LLLT) is used in many treatment modalities to reduce pain, inflammation, and promote healing.Aim of the studyTo compare the analgesic effects of LLLT and Ibuprofen after surgical dental extraction.Materials and methodsA clinical trial study was conducted at Umm Al-Qura University Dental Clinics, involving 46 healthy patients between 20 and 60 years of age. The recruited patients were divided into two groups of 23 patients each. Group 1 (positive control group) was prescribed Ibuprofen and Group 2 (experimental group) was treated with LLLT. The pain was measured on days 1, 2, and 7 using the Numeric Pain Rating Scale (NPRS).ResultsThe mean level of pain decreased with both treatments. On the first postoperative day, the pain level in the laser therapy group was significantly lower than in the control group (U = 62.5, p = 0.024). The results indicated a significant decrease in pain level on the second postoperative day for both the control and experimental groups (Z = ?3.61, p < 0.005, and Z = ?3.1, p = 0.002, respectively). However, the pain level was lower in the control group, although the difference was not statistically significant (U = 79, p = 0.102).ConclusionConsidering the constraints of this study, NSAIDs were found to be significantly better at reducing pain than LLLT.     

Association between metabolic syndrome and tooth loss: A systematic review and meta-analysis

BackgroundThe authors conducted a systematic review and meta-analysis to verify the existence and level of scientific evidence concerning the association between metabolic syndrome (MetS), as the main exposure, and tooth loss (TL), as the outcome.Types of Studies ReviewedThrough electronic databases and partially through gray literature, the authors identified observational studies in adults. The authors used no date or language restrictions. The authors evaluated the studies’ methodological quality by using the Newcastle-Ottawa Scale. The authors conducted a random-effects model meta-analysis. The authors assessed the quality of evidence by using the Grading of Recommendations Assessment, Development and Evaluation criteria.ResultsTwelve studies met the eligibility criteria, and 9 were retained for the meta-analysis. Most were cross-sectional studies with good methodological quality. Participants with MetS had fewer teeth (standardized mean difference, −2.77; 95% confidence interval, −4.56 to −0.98) and an increased likelihood of lacking functional dentition (odds ratio, 2.37; 95% confidence interval, 1.89 to 2.96) than did those without MetS. The overall quality of evidence was very low.Conclusions and Practical ImplicationsBetter-conducted longitudinal studies are necessary to establish a causal relationship between MetS and TL to inform the best strategies to prevent TL in populations with MetS.     

A Study to assess the awareness and use of Silver Diammine Fluoride and Hall Technique among dental professionals and dental students in the Eastern Province

BackgroundA major shift has occured in the trend of dealing with dental caries from primary to secondary prevention, specially after SDF approval off-label by US FDA in recent years and Hall Technique (HT) in the last decade.ObjectivesTo determine the frequency of awareness and use of Silver Diammine Fluoride (SDF) and Hall technique among dental professionals in the Eastern province of Saudi Arabia.MethodsThis cross-sectional study was conducted in a public hospital, metropolitan city of Middle Eastern region between March 15, 2019 & January 31, 2020. Dental practitioners were requested, with their consent, to fill up a digitally designed survey. Chi-square test on SPSS-20.0 was applied to compare frequency of awareness and use of SDF and HALL Technique among the survey participants.ResultsThe awareness of SDF was found to be 73.6% among specialists, 54.9% among graduates and 29.6% among students whereas awareness of HALL technique for stainless steel crown in pediatric dentistry was found statistically similar in all participants groups i.e. 42.7% in students, 55.5% in graduates and 54.9% in specialist group (p = 0.125).ConclusionThe results show potential with regards to awareness of dental specialists & postgraduate residents but inadequate among general dentists and students though all were keen advocates and found committed to its use to help the community. It points towards a further need of the of education for all groups. Those non- invasive techniques are very useful tools in general but specifically during Covid-19 pandemic where they can play a major role in preventing the spread of infection, arresting decay, alleviating pain and anxiety without resorting to aggressive treatment like pulp treatment/extraction. Low response rate may be improved in future through the respondents’ counselling and regular follow up.     

Evaluation of eye movement patterns during reading of mixed dentition panoramic radiographs in dental students

ObjectivesThis study aimed to clarify effective eye movement patterns during mixed dentition panoramic radiographic reading in dental students.MethodsSixty fifth-year dental students (19 women and 41 men) participated in the study and visually observed mixed dentition panoramic radiograph. Eye movement patterns during reading were classified into group R for clockwise (right rotation), group L for counterclockwise (left rotation), or group S for few fixations and mainly saccades. The reading results, number of fixations, number of blinks, pupil area, and average amplitude were compared among the three groups.ResultsParticipants in group R had significantly better reading performance (P < 0.001, analysis of variance) and tended to have larger pupil areas than the other groups. Participants in group S had poorer reading performance, significantly fewer fixations, significantly more blinks, smaller pupil area, and greater average amplitude than the other groups (P < 0.001, respectively, analysis of variance, Kruskal–Wallis test).ConclusionsWhen reading panoramic radiographs in the mixed dentition phase, observations in a clockwise order are recommended, as they are associated with improved learning performance. Frequent eye movements may indicate lower levels of interest or difficulty with the task and are associated with poorer learning performance. Classifying eye movement patterns while observing a test image provides suggestions that can be used to improve education in diagnostic imaging of pediatric dentistry.     

Zirconia-ceramic versus metal-ceramic posterior multiunit tooth-supported fixed dental prostheses: A systematic review and meta-analysis of randomized controlled trials

BackgroundThe authors aimed to compare the survival and complication rates of zirconia-ceramic (ZC) versus metal-ceramic (MC) restorative material in multiunit tooth-supported posterior fixed dental prostheses (FDP).Types of Studies ReviewedThe authors conducted a systematic search of randomized controlled trials (RCTs), with no time or language restrictions, up to May 2019 using the MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials databases, followed by a manual search.ResultsThe authors included 7 RCTs in the review and 5 RCTs in the meta-analysis. All studies had a low risk of bias. The authors included 330 participants (177 ZC and 173 MC tooth-supported FDP) in the meta-analysis, which revealed a medium-term survival rate of 95.4% (95% confidence interval [CI], 90.5% to 99.1%) for ZC FDP compared with 96.9% (95% CI, 94.3% to 99.4%) for MC FDP, with no significant differences (P = .364). The biological or technical complications did not show statistically significant differences, except in the global ceramic veneering chipping analysis (P = .023; risk difference [RD], 22.3%; 95% CI, 3.0% to 41.6%) and their subanalysis: minor chipping or chipping that can be solved with polishing (P = .044; RD, 19.5%; 95% CI, 0.5% to 38.4%), and major chipping or chipping that needs repair in the laboratory (P = .023; RD, 6.0%; 95% CI, 0.8% to 11.3%).Conclusions and Practical ImplicationsPosterior multiunit ZC restorations are considered a predictable treatment in the medium term, although they are slightly more susceptible to chipping of the veneering ceramic than MC restorations.     

Treatment options for large posterior restorations: a systematic review and network meta-analysis

BackgroundThe best treatment option for large caries in permanent posterior teeth is still a matter of uncertainty in dental literature. The authors conducted a network meta-analysis to address the challenges related to rehabilitation of these teeth.Types of Studies ReviewedThe authors selected prospective and retrospective studies that compared at least 2 different treatment alternatives for permanent teeth with a minimum of 5 years of follow-up. The authors searched databases from MEDLINE, Scopus, Cochrane Library, and Web of Science in October 2019 without language or year of publication restrictions.ResultsFrom 11,263 studies identified, 43 studies fulfilled the eligibility criteria and were included in the final review. Only 13 studies were randomized controlled trials and were classified as low risk of bias. Gold (annual failure rate of 0.29%) and metal ceramic (annual failure rate of 0.52%) crowns performed better for indirect restorations and direct resin composite performed better for direct restorations (annual failure rate of 2.19%). The most substantial comparisons were between feldspathic and glass ceramics, followed by direct resin composite and amalgam; there were no statistically significant differences between these interventions. Results of the pairwise meta-analysis showed mainly glass ionomer as significantly more prone to failure than amalgam and direct composite resin.Conclusions and Practical ImplicationsReference standard direct and indirect materials except for glass ionomer can be used for restorations of large posterior caries.     

Salivary factors related to caries in pregnancy: A systematic review and meta-analysis

BackgroundThe authors of this meta-analysis aimed to assess saliva-related caries risk factors, including calcium and phosphate, hydrogen ion concentration, buffer capacity, Streptococcus mutans and Lactobacillus counts, flow rate, and decayed, missing and filled teeth index in each trimester during pregnancy.Types of Studies ReviewedThe authors searched electronic databases up to July 1, 2019. Eligible observational studies were included. The authors assessed the quality of the included studies by using the Joanna Briggs Institute scale. To estimate the effects of pregnancy, standardized mean differences with 95% confidence intervals were pooled using the random-effects model. Subgroup analysis and meta-regression were used to explore heterogeneity. Publication bias was assessed using Begg and Egger tests.ResultsTwenty-nine studies were included in the meta-analysis, representing 1,230 pregnant women in the case groups and 715 in the control groups (nonpregnant women). The results showed that salivary calcium concentration decreased in the third trimester, salivary phosphate decreased in the second and third trimesters, saliva hydrogen ion concentration decreased in the first and third trimesters, stimulated saliva flow rate increased in the third trimester, and salivary S mutans count increased in the second and third trimesters. In addition, the results showed that saliva calcium, phosphate, S mutans, and buffer capacity amounts had changed from the first trimester to the third.Conclusions and Practical ImplicationsIn the third trimester, most salivary factors related to caries change and can increase the risk of developing caries in the future. Interventions and screening for caries prevention in pregnancy should start in the first or second trimesters.     

Caries risk and social determinants of health: A big data report

BackgroundOral health is influenced by social determinants of health (SDH), predisposing people and communities to greater risk of developing caries. This study evaluated the association between caries risk in adults and SDH such as ZIP Codes, systemic diseases, payment methods, and race or ethnicity.MethodsThe BigMouth Dental Data Repository (n = 57,211) was used to extract clinical and SDH data from patients’ dental electronic health records for 2019. Caries risk categories were used as ZIP Code data was merged with the Social Deprivation Index, a composite measure of area-level deprivation based on 7 demographic characteristics collected in the American Community Survey.ResultsThe results showed that the odds of being in the high caries risk group were higher for people in the 49- to 64-year age group (adjusted odds ratio [aOR], 2.24; 95% CI, 2.08 to 2.40; P ≤ .001), men (aOR, 1.19; 95% CI, 1.13 to 1.25; P ≤ .001), people who had comorbidities (diabetes: aOR, 1.16; 95% CI, 1.08 to 1.24; P ≤ .001; cardiovascular disease: aOR, 1.40; 95% CI, 1.32 to 1.50), and people with an Social Deprivation Index score above the 75th percentile (aOR, 2.39; 95% CI, 2.21 to 2.58; P ≤ .001). In addition, Hispanic and Black people had higher odds of being at high caries risk than other races or ethnicities (Hispanic: aOR, 3.05; 95% CI, 2.32 to 4.00; Black: aOR, 2.05; 95% CI, 1.02 to 4.01).ConclusionsThis study shows the association of caries risk with higher social deprivation, reinforcing the role of structural and upstream factors in oral health. This study is unique in using recorded ZIP Code information and assessing caries risk levels for those regions.Practical ImplicationsThe physical and structural environment should be considered contributors to caries risk in people.     

Effect of calcium silicate-based endodontic sealer on the retention of fiber posts cemented at different time intervals

ObjectiveTo evaluate the effect of BC HiFlow, a new calcium silicate-based endodontic sealer, compared with a resin epoxy-based sealer after 2 different times of cementation on the pull-out bond strength of glass-fiber–reinforced composite posts cemented with a self-adhesive resin cement (RelyX Unicem).MethodologySixty human maxillary central incisors were decoronated, prepared and obturated with gutta-percha and sealer. Roots were distributed into 5 groups according to the sealer and time of post cementation: (1) AH Plus sealer with immediate post fixation, (2) BC HiFlow with immediate post fixation, (3) AH Plus and post fixation after 7 days, (4) BC HiFlow and post fixation after 7 days, and (5) fiber post fixation in canals obturated with gutta-percha only (no sealer). After 1 week of post cementation, the pull-out test was performed and the failure mode was examined under a digital microscope. Data were analyzed using ANOVA followed by Tukey's post hoc and t tests (p < .05).ResultsWith immediate post cementation, AH Plus group showed significantly higher pull-out retentive strength than the BC HiFlow and control groups (p = .009 and p < .001, respectively). There was no significant difference between the groups when the posts were cemented 7 days after obturation (p = .726). The time of post cementation had a significant influence on the canals obturated with AH Plus (p = .003). The time did not significantly affect the canals obturated with BC HiFlow (p = .289). The prominent type of failure was mixed mode in all groups.ConclusionBC HiFlow sealer did not affect the pull-out bond strength of glass-fiber–reinforced composite posts cemented with a self-adhesive resin cement immediately after or 7 days after obturation. For immediate post cementation, AH Plus increased the pull-out bond in comparison to BC HiFlow.     

Use of calcium-containing bioactive desensitizers in dental bleaching: A systematic review and meta-analysis

BackgroundTopical application of calcium-containing bioactive desensitizers (CBs) has been used to minimize bleaching-induced tooth sensitivity (TS). This study answered the research question “Is the risk of TS lower when CBs are used with dental bleaching in adults compared with bleaching without desensitizers?”Types of Studies ReviewedThe authors included randomized clinical trials comparing topical CB application with a placebo or no intervention during bleaching. Searches for eligible articles were performed in MEDLINE via PubMed, Cochrane Library, Brazilian Library in Dentistry, Latin American and Caribbean Health Sciences Literature, Scopus, Web of Science, Embase, and gray literature without language and date restrictions and updated in September 2022. The risk of bias was evaluated using Risk of Bias Version 2.0. The authors conducted meta-analyses with the random-effects model. The authors assessed heterogeneity with the Cochrane Q test, I² statistics, and prediction interval. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty of the evidence.ResultsAfter database screening, 22 studies remained, with most at high risk of bias. No difference in the risk of TS was detected (risk ratio, 0.95; 95% CI, 0.90 to 1.01; P = .08, low certainty). In a visual analog scale, the intensity of TS (mean difference, ?0.98; 95% CI, ?1.36 to ?0.60; P < .0001, very low certainty) was lower for the CB group. The color change was unaffected (P > .08).Practical ImplicationsAlthough topical CB dental bleaching did not reduce the risk of TS and color change, these agents slightly reduced the TS intensity, but the certainty of the evidence is very low.     

Are dental patients able to perceive erosive tooth wear on anterior teeth?: An internet-based survey assessing awareness and related action

BackgroundErosive tooth wear (ETW) is irreversible loss of dental hard tissue. The authors examined patients’ ability to recognize ETW relative to sound teeth and teeth with caries.MethodsUsing Amazon’s crowdsourcing service, the authors recruited participants (N = 623) to view standardized images of buccal surfaces of teeth (sound, ETW, or caries). Participants reported whether a dental condition existed (yes or no), likelihood to seek care, and esthetic attractiveness for teeth with no, initial, moderate, or severe signs of ETW or caries.ResultsDental patients showed poor recognition of cases of ETW, especially compared with sound and caries-affected teeth at each level of severity. Patients were less likely to schedule a dental appointment for care or treatment of teeth with ETW than for teeth with caries at each level of severity. Patients also found ETW more esthetically attractive than caries at each level of severity and found initial ETW more attractive than sound teeth.ConclusionsDental patients struggle to recognize ETW, in general and compared with caries, at each level of severity and particularly for early stages of ETW. These recognition difficulties likely arise, in part, from tooth esthetic attractiveness standards (smooth and shiny teeth look more esthetic), possibly leading to lack of appropriate care-seeking behavior.Practical ImplicationsThis internet-based tool may be used to assess dental patients’ awareness and ability to recognize cases of ETW. Improved patient awareness might lead to seeking professional care to prevent or delay ETW progression.