Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak.</p

Introduction of “qpdb” teeth numbering system

This manuscript introduces a new method for teeth numbering system. The primary rationale of lunching this system was to solve previous numbering systems' drawbacks. Furthermore, to keep simplicity and ease of reading and inputting data. The outcome of a questionnaire disseminated among 66 personnel showed the confusion existing among currently used tooth numbering systems. The ‘qpdb’ system divided the oral cavity into four quadrants, each quadrant represented by alphabetical English letter (q, p, d &amp; b). In spite of being a promising system, this new system lacks the real usage and application, and need more future studies to prove its validity

3-year randomized clinical trial to evaluate the performance of posterior composite restorations lined with ion-releasing materials

Abstract To evaluate the impact of using ion-releasing liners on the 3-year clinical performance of posterior resin composite restorations after selective caries excavation with polymer burs. 20 patients were enrolled in this trial. Each patient had two deep carious lesions, one on each side of the mouth. After selective caries removal using polymer bur (PolyBur P1, Komet, Brasseler GmbH Co. KG, Lemgo, Germany), cavities were lined with bioactive ionic resin composite (Activa Bioactive Base/Liner, Pulpdent, Watertown, MA, USA) or resin-modified glass ionomer liner (Riva Light Cure, SDI, Bayswater, Victoria, Australia). All cavities were then restored with nanofilled resin composite (Filtek Z350XT, 3M Oral Care, St. Paul, MN, USA). All the tested materials were placed according to the manufacturers’ instructions. Clinical evaluation was accomplished using World Dental Federation (FDI) criteria at baseline and after 6 months, 1, 2, and 3 years. Data were analyzed using Mann–whitney U and Friedman tests (p  0.05). Resin composite restorations showed acceptable clinical performance over 3 years either lined with bioactive ionic or resin-modified glass ionomer liners after selective caries excavation preserving pulp vitality. After the 3-year follow-up period, Activa Bioactive and Riva Light Cure liners were clinically effective and they exhibited with the overlying composite restorations successful clinical performance. Trial registration number: NCT05470959. Date of registration: 22/7/2022. Retrospectively registered

Effect of ethanolic extract of propolis on antibacterial and microshear bond strength of glass-ionomer restorations to dentin

Objectives: This study was conducted to evaluate the effect of ethanolic extract of propolis on antibacterial and microshear bond strength of glass ionomer restorations to dentin. Materials and methods: Conventional glass ionomer cement (Equia forte, GC Tokyo, Japan), resin-modified glass ionomer (Fuji II LC, GC Tokyo, Japan) and propolis powder (dried extract from honey bees) materials were used in this study. Both conventional glass ionomer and resin-modified glass ionomer were modified by two different concentrations of ethanolic extract of propolis (10 % and 25 % EEP). For antibacterial test, Streptococcus mutans strain was spread on agar petri dishes using a sterile swab. Discs of both glass ionomer restorative materials (without adding EEP, with 10 % EEP and with 25 % EEP) were fabricated within the agar plates. Antibacterial activity was evaluated by measuring the inhibition zones around each disc. For microshear bond strength test, 60 healthy human permanent molars were prepared by cutting occlusal surface and expose the dentin at the height of contour of all teeth then conditioned using poly acrylic acid conditioner, both glass ionomer restorative materials (without adding EEP, with 10 % EEP and with 25 % EEP) were mixed and applied on conditioned dentin surface by using tygon tube. Microshear bond strength was evaluated by the universal testing machine. Results: Two-way ANOVA test revealed that both glass ionomer type and different concentrations of EEP had significant effect on the antibacterial test results and microshear bond strength values (p < 0,05). Glass ionomer restorative material with 25%EEP had the highest antibacterial values whereas glass ionomer restorative material without modifications (control groups) had the lowest values. Resin-modified glass ionomer without any modification (control group) had the highest bond strength while resin-modified glass ionomer with 25%EEP had the lowest bond strength. Conclusions: Incorporation of ethanolic extract of propolis to glass ionomer restorative material increases the antibacterial effects of both conventional GIC and RMGI. Inspite of this advantage, it seems that it has deleterious effect on microshear bond strength to dentin

Microhardness and elemental analysis of ion-releasing restoration/ dentin interface following enzymatic chemomechanical caries excavation

Abstract Background This study was conducted to compare chemical, elemental and surface properties of sound and carious dentin after application of two restorative materials resin-modified glassionomer claimed to be bioactive and glass hybrid restorative material after enzymatic chemomechanical caries removal (CMCR) agent. Methods Forty carious and twenty non-carious human permanent molars were used. Molars were randomly distributed into three main groups: Group 1 (negative control) - sound molars, Group 2 (positive control) - molars were left without caries removal and Group 3 (Test Group) caries excavated with enzymatic based CMCR agent. After caries excavation and restoration application, all specimens were prepared Vickers microhardness test (VHN), for elemental analysis using Energy Dispersive Xray (EDX) mapping and finally chemical analysis using Micro-Raman microscopy. Results Vickers microhardness values of dentin with the claimed bioactive GIC specimens was statistically higher than with glass hybrid GIC specimens. EDX analysis at the junction estimated: Calcium and Phosphorus of the glass hybrid GIC showed insignificantly higher mean valued than that of the bioactive GIC. Silica and Aluminum mean values at the junction were significantly higher with bioactive GIC specimens than glass hybrid GIC specimen. Micro-raman spectroscopy revealed that bioactive GIC specimens showed higher frequencies of v 1 PO 4, which indicated high level of remineralization. Conclusions It was concluded that ion-releasing bioactive resin-based restorative material had increased the microhardness and remineralization rate of carries affected and sound dentin. In addition, enzymatic caries excavation with papain-based CMCR agent has no adverse effect on dentin substrate

Effect of Grape Seeds Versus Tooth Brushing and Dental Flossing on Plaque Accumulation in High Caries Risk Participants

Objective the purpose of this study was to assess the effect grape seeds mouthwash on plaque accumulation in high caries risk individuals. Materials and methods: 66 students were recruited in the study. All students were high caries risk patients. They were divided into three groups according to the protocol they followed for one year. Plaque scores were calculated for each patient at baseline and after one year to show the effect of each preventive protocol. Statistical analysis was done using Chi-Square teat to calculate significance between groups. Result: Chi-Square Test showed that there was no statistical significant difference in the plaque score between the three groups at baseline (p value&gt; 0.05). Regarding the plaque scores at 1-year, Chi-Square Test showed that there was no statistical significant difference between group 1, and group 2. There was a statistical significant difference between group 3 and both groups 1 and 2 at 1-year (p value= 0.000). Conclusion: Grape seeds extract mouthwash can improve the plaque score after 1 year. Natural grape seeds extract is an effective substitute to synthetic agents such as chlorhexidine and fluoride for reducing plaque accumulation

Effect of Personalized Caries Treatment Protocol Versus Standard of Care on Salivary Flow Rate of High Caries Risk Patients

Objective: this study was carried out to assess the effect of different caries prevention protocols on salivary flow in high caries risk patients. Materials and methods: 66 participants were involved in the study (n=22). All of them were considered as high-risk participants. They were randomly divided into three groups according to a proposed caries management system. Group one (I1) received personalized caries management system. Group two (I2) received a combined therapy of chlorhexidine and fluoride mouthwash. Group three (I0) received standard preventive measures (control group). Results: Chi-square test showed that there was no statistically significant difference in the saliva score at baseline between all groups (p&gt;0.05). After one year Chi-square test also showed no statistically significant difference between all groups (p&gt;0.05). Conclusions: No measurable effect was observed for any of the study groups on the salivary flow rate

Inhibition of Caries around Restoration by Ion-Releasing Restorative Materials: An In Vitro Optical Coherence Tomography and Micro-Computed Tomography Evaluation

The objective of this study was firstly to assess the demineralization inhibitory effect of ion-releasing restorations in enamel adjacent to restoration using a biofilm caries model and secondly to compare the effect to that in a chemical caries model. Fifty-six bovine incisors were filled with either Surefil one (SuO), Cention N (CN) (both ion-releasing materials), Ketac-Molar (GIC) or Powerfill resin composite (RC). The restored teeth were then randomly divided into 2 groups according to the used caries model (biofilm or chemical caries model). The micro-computed tomography (MicroCt) and optical coherence tomography (OCT) outcome measures used to evaluate demineralization inhibition effects were lesion depth, LD and increase in OCT integrated reflectivity, ΔIR, at five different depths. It was observed that all outcome measures of CN were statistically the same as those of GIC and conversely with those of RC. This was also the case for SuO except for LD, which was statistically the same as RC. When comparing the two caries models, LD of the biofilm model was statistically deeper (p < 0.05) than the chemical model for all four materials. In conclusion, CN and SuO have similar demineralization inhibitory effects as GIC, and the biofilm caries model is more discriminatory in differentiating demineralization inhibitory effects of ion-releasing restorative material

Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak