Učinak prevalencije i težine molarno-incizalne hipomineralizacije na kvalitetu života povezanu s oralnim zdravljem: sistematizirani pregled i metaanaliza

Objectives: The aim of this systematic review and meta-analysis is to assess the association between the MIH presence as well as the severity and OHRQoL in children. Material and methods: Relevant studies were identified in PubMed, Embase, Cochrane and Google Scholar. Studies involving MIH and OHRQoL in children were included. A methodological quality assessment of included studies was performed using the Newcastle-Ottawa Scale (NOS) and its adapted version for cross-sectional studies. Random effects models were used to estimate summary effect measures for the association between MIH presence (presence vs. absence) as well as severity (moderate/severe MIH vs. no MIH) and OHRQoL using generic inverse variance meta-analyses. Tests for heterogeneity, publication bias and sensitivity of results were also performed. Results: Out of 1696 identified publications 11 studies reporting on 5,017 children were included in the meta-analysis assessing the impact of MIH presence. There was no statistically significant association between the presence of MIH and lower OHRQoL in affected children (OR = 1.72, 95% CI = 0.99–2.98). Concerning MIH severity and its impact on OHRQoL, a sum of 6 studies were included in the meta-analysis involving a total of 2,595 children. There was a significant association between moderate/severe MIH and lower OHRQoL in affected children (OR = 3.43, 95% CI = 1.69–6.98). Conclusion: Moderate/Severe MIH has a significant and clinically relevant negative impact on OHRQoL, and it should therefore be addressed adequately. Future research should also consider the impact of a uniform MIH diagnosis and precise severity criteria.Svrha istraživanja: Cilj ovog sistematiziranog pregleda i metaanalize bio je procijeniti povezanost između MIH-a i OHRQoL-a u djece. Materijali i metode: Pronađena su relevantna istraživanja u bazama PubMed, Embase, Cochrane i Google Scholar. Uključena su istraživanja koja su obrađivala MIH i OHRQoL u djece. Metodološka procjena kvalitete tih istraživanja obavljena je s pomoću ljestvice Newcastle-Ottawa (NOS) i njezine prilagođene verzije za presječne studije. Za procjenu sažetih mjera učinka za povezanost između prisutnosti MIH-a (prisutnost prema odsutnosti) upotrijebljeni su modeli slučajnih učinaka, a za težinu (umjereni/teški MIH prema odsutnosti MIH-a) i OHRQoL upotrijebljena je generička metaanaliza inverzne varijance. Obavljeni su i testovi heterogenosti, pristranosti objave i osjetljivosti rezultata. Rezultati: Od 1696 identificiranih časopisa, u metaanalizu procjene utjecaja prisutnosti MIH-a uključeno je 11 istraživanja koja su izvještavala o 5017 djece. Nije bilo statistički značajne povezanosti između prisutnosti MIH-a i nižega OHRQoL-a u pogođene djece (OR = 1,72, 95 % IP = 0,99–2,98). Kad je riječ o težini MIH-a i njegova utjecaja na OHRQoL, zbroj od 6 istraživanja uključen je u metaanalizu koja obuhvaća ukupno 2595 djece. Postojala je značajna povezanost između umjerenoga/teškoga MIH-a i nižega OHRQoL-a u pogođene djece (OR = 3,43, 95 % IP = 1,69 – 6,98)

Current erosion indices—flawed or valid? Summary

The problem of erosive tooth wear appears increasingly to be encountered by clinicians and researchers. An adequate way of defining and recording erosive tooth wear is essential in order to assess the extent of this clinical phenomenon, both on an individual level and in the population, and for the adequate provision of preventive and therapeutic measures. Well-established erosion indices have been used in most of these studies, although in many cases modifications have been made to suit the different research aims. This use of different indices is one reason why it still cannot be claimed that there is enough current knowledge on this clinical phenomenon. This article summarises the proceedings of a workshop to discuss the topic of dental erosion indices. The result of the workshop is the proposal for a new scoring system (Basic Erosive Wear Examination, BEWE) designed for use both within the research field and for dental clinicians, with the aims of standardising assessment of erosion for international comparisons, raising awareness and providing guidelines for treatment of erosive tooth wear in dental practice

Verwendung von Fluoriden zur Kariesprävention

For a few decades, a decrease in the caries burden in all age groups has been observed in Germany. The regular use of fluoride preparations is described as the main reason for the caries decline. It is well established that topical fluoride application directly to the tooth surfaces in the oral cavity, in particular fluoride-containing toothpastes and fluoride varnishes, is responsible for the decline. Several mechanisms of action, such as the formation of a calcium fluoride layer, remineralization, and the effects on bacterial plaque, were determined to be responsible for the overall clinical effect. All these mechanisms can be effective on enamel and root dentin in patients of all ages. There is a dose-response relationship between the fluoride concentration in the applied preparations and the average caries reduction achieved.There are no general toxicological concerns about topical fluoride application. Fluoride toothpastes should be used from the eruption of the first deciduous tooth. The amount of toothpaste used should be limited to the recommended volumes to avoid the development of enamel fluorosis. The professionally performed application of highly concentrated fluoride varnishes, in addition to having a high caries-inhibiting effectiveness, also exhibits advantages in cases of increased caries risk and existing demineralization. This is also the case for the application on root dentin, where significant primary and secondary preventive effects have been demonstrated by application of highly concentrated fluoride preparations

Dental Caries in European Adults and Senior Citizens 1996-2016: ORCA Saturday Afternoon Symposium in Greifswald, Germany - Part II.

This review assesses the development of oral health habits and status in European adults (35-44 years old) and senior citizens (65-74 years old) over the period of 1996-2016. There seem to be good opportunities for improving oral health habits by brushing twice daily with fluoride toothpaste among adults, as only 33-85% reported doing so. Caries experience was extensive among adults (≥92%). In adults of 23 countries, the mean DMFT score ranged from 6.6 to 17.6 (median 12.1). In senior citizens of 21 countries, the mean DMFT score varied from 14.7 to 25.5 (median 22.0). Repeated cross-sectional studies on caries trends in adults revealed a reduction of the DMFT value by 20%, referring to country-wide data. Among senior citizens, the corresponding reduction was 13%, with a shift in the DMFT components, i.e., with lower MT and higher FT scores. Edentulousness in the age group of 35- to 44-year-olds started disappearing in Europe from the year 2000, and had been markedly reduced in some countries during the last decade. However, the eradication of edentulousness among 65- to 74-year-olds has not yet been reported. Further epidemiological surveys should apply caries diagnostic criteria that, besides representing our contemporary understanding of oral health care, allow comparisons with previous surveys using the WHO criteria. In conclusion, in the last two decades, a decline in caries was observed among European adults, and to a lesser extent among senior citizens. It is expected that the decline in caries will contribute to better oral health of individuals

New method of measuring subjective well-being: prospective validation study of the ‘Daily Experience Sampling Questionnaire’ (DESQ) in patients with psoriasis and healthy subjects in Germany

Objectives To validate the newly developed Daily Experience Sampling Questionnaire (DESQ) that measures affective subjective well-being (SWB). The DESQ is an end-of-day diary in which respondents retrospectively rate their SWB at six different, randomly determined moments; it is completed over 1 week. The DESQ shall provide an alternative or complementary approach to existing methods of near-time SWB measurement (experience sampling, Day Reconstruction Method). The primary research objective was to determine criterion validity of the DESQ.Design Prospective, non-interventional study.Setting Participants were recruited in Hamburg, Germany, at a specialised outpatient clinic (patients) and via different channels (healthy participants).Participants 101 adults with diagnosed and stable psoriasis (46 women, 55 men); 105 adults without psoriasis (49 women, 56 men).Primary and secondary outcome measures Participants completed the DESQ for 3 weeks. In weeks 2 and 3, they also performed experience sampling. Criterion validity was determined by weekwise intraclass correlations (ICC) between both methods. Sensitivity to change was determined by the correlation between changes in both methods from weeks 2 to 3. For convergent validity, related concepts such as life satisfaction were measured. Retest reliability was determined using DESQ values of weeks 2 and 3.Results Criterion validity was excellent (ICC: patients=0.86, 95% CI 0.81 to 0.91; healthy participants=0.86, 95% CI 0.79 to 0.91). Sensitivity to change was r=0.57 and r=0.56, respectively. Correlations with convergent criteria were mostly significant and higher in constructs more proximal to SWB. The ICC indicating retest reliability was 0.77 in patients (95% CI 0.68 to 0.84) and 0.81 in healthy participants (95% CI 0.73 to 0.86).Conclusions The DESQ is a valid, reliable and feasible instrument for SWB measurement in people with psoriasis and healthy people. Its approach of end-of-day evaluations of single moments may also lend itself to the measurement of other highly time-variant constructs such as pain, fatigue or depression

In vitro activity of photoactivated disinfection using a diode laser in infected root canals

OBJECTIVE To investigate the lethal activity of photoactivated disinfection (PAD) on Enterococcus faecalis (ATCC 29212) and mixed populations of aerobic or anaerobic bacteria in infected root canals using a diode laser after the application of a photosensitizer (PS). MATERIALS AND METHODS First, the bactericidal activity of a low power diode laser (200 mW) against E. faecalis ATCC 29212 pre-treated with a PS (toluidine blue) for 2 min were examined after different irradiation times (30 s, 60 s and 90 s). The bactericidal activity in the presence of human serum or human serum albumin (HSA) was also examined. Second, root canals were infected with E. faecalis or with mixed aerobic or anaerobic microbial populations for 3 days and then irrigated with 1.5% sodium hypochlorite and exposed to PAD for 60 s. RESULTS Photosensitization followed by laser irradiation for 60 s was sufficient to kill E. faecalis. Bacteria suspended in human serum (25% v/v) were totally eradicated after 30 s of irradiation. The addition of HSA (25 mg/ml or 50 mg/ml) to bacterial suspensions increased the antimicrobial efficacy of PAD after an irradiation time of 30 s, but no longer. The bactericidal effect of sodium hypochlorite was only enhanced by PAD during the early stages of treatment. PAD did not enhance the activity of sodium hypochlorite against a mixture of anaerobic bacteria. CONCLUSIONS The bactericidal activity of PAD appears to be enhanced by serum proteins in vitro, but is limited to bacteria present within the root canal