763 research outputs found
Italian Deprivation Index and Dental Caries in 12-Year-Old Children: A Multilevel Bayesian Analysis
Evidence from the literature has shown that people with a
lower socioeconomic status enjoy less good health than
people with a higher socioeconomic status. The Italian deprivation
index (DI) was used with the aim to evaluate the
association between the DMFT index and risk factors for dental
caries, including city population and DI. The study included
4,305 12-year-old children living in 38 cities classified by
demographic size as small, midsize and large. Zero-inflated
negative binomial multilevel regression models were used
to assess risk factors for DMFT and to address excess of zero
DMFT and overdispersion through a Bayesian approach. The
difference in the average level of DMFT among children living
in cities with different DI quintile was not statistically significant
(p = 0.578). The DI and ln(population), included as
city-level fixed effects in the two-level variance components
model, were not statistically significant. Consuming sweet
drinks on average increased the mean DMFT of a susceptible
child, while having a highly educated mother reduced it. Un-observed heterogeneity among cities was detected for the
probability to be non-susceptible to caries (city-level variance
= 0.26 with 95% credibility interval 0.09–0.57), while no
territorial effect was found for the mean DMFT of the susceptible
children. Our results suggest that the DI and city population
did not play a role in explaining between-city variability.
Interventions against social deprivation can be influential
on the perception of oral health in Italian 12-year-old
children to the extent that they can also affect individual
level factors
Concentration in saliva and antibacterial effect of xylitol chewing gum : in vivo and In vitro study
Purpose. The saliva concentration of xylitol released from two chewing gums was recorded, the first containing xylitol as the only sweetener (100% xylitol) and the second containing only 22% of the polyol. In addition, the in vitro antibacterial effect of the two chewing gums was evaluated. Materials and Methods. The salivary concentration of Xylitol in 32 subjects was determined before and at 0.30, 1.00, 2.00, 5.00, and 10.00 min while using the chewing gums, and at 15.00, 20.00, and 25.00 min after the gums were discarded. In vitro antibacterial activity was determined on a pooled subgingival plaque sample obtained from four patients with periodontal disease. Cariogenic and periodontal bacteria were evaluated before and 15 min, 60 min, and 24 h after gum contact. Results. Using the 100% xylitol chewing gum, saliva levels increased bimodally, one peak after 30 s (1.49 \ub1 1.41 log\u3bcg/L) and a second one at a 10-min evaluation (1.41 \ub1 1.11 log\u3bcg/L); the 22% chewing gum peaked only two minute after contact (1.21 \ub1 1.24 log\u3bcg/L). Overall, a statistically significantly higher salivary concentration of xylitol was detected using the 100% xylitol gum. All bacteria decreased after the addition of the two chewing gums; the 100% gum achieved a greater decrease than the 22% gum. Conclusion. The use of both chewing gums increased the concentrations of xylitol in saliva, with a statistically significantly higher concentration using the 100% xylitol gum. Cariogenic and periodontal bacteria were reduced by both chewing gums; 100% xylitol gum produced the highest and longest lasting effect. This study opens up to the use of xylitol against periodontal disease
Comparison of ICDAS, CAST, Nyvad’s Criteria, and WHO-DMFT for Caries Detection in a Sample of Italian Schoolchildren
Caries measurement methods vary considerably in terms of the stages of lesion considered making the comparison problematic among different surveys. In this cross-sectional study, four caries measurement methods, the WHO-DMFT, the International Caries Detection and Assessment System (ICDAS), the Caries Assessment Spectrum and Treatment (CAST), and the Nyvad Criteria were tested in a sample of children. Five-hundred 12-year old children (236 males and 264 females) were examined four times by four calibrated examiners. The calibration process showed that Cohen\u2019s Kappa exceeded the criterion of K = 0.75 and K = 0.80 for inter/intra-examiner agreement, respectively. In the survey, the total number of misclassification errors for the four methods amounted to 312 observations (67.94% regarding enamel lesions). The greatest difference among methods was shown by number of sound teeth (p < 0.01): WHO-DMFT n = 9505, 74.14%; ICDAS n = 2628, 20.49%; CAST n = 5053, 39.41%; and Nyvad Criteria n = 4117, 32.11%. At the level of dentinal Distinct/Active Cavity lesions, no statistically significant difference was observed (p = 0.40) between ICDAS (n = 1373, 10.71%), CAST (n = 1371, 0.69%), and Nyvad Criteria (n = 1720, 13.41%). In the severe caries levels, all methods were partially in agreement, while no accordance was found for the initial (enamel) lesions. A common language in caries detection is critical when different studies are compared
Xerostomia induced by radiotherapy: an overview of the physiopathology, clinical evidence, and management of the oral damage
Background: The irradiation of head and neck cancer (HNC) often causes damage to the salivary glands. The resulting salivary gland hypofunction and xerostomia seriously reduce the patient\u2019s quality of life.
Purpose: To analyze the literature of actual management strategies for radiation-induced hypofunction and xerostomia in HNC patients.
Methods: MEDLINE/PubMed and the Cochrane Library databases were electronically evaluated for articles published from January 1, 1970, to June 30, 2013. Two reviewers independently screened and included papers according to the predefined selection criteria.
Results: Sixty-one articles met the inclusion criteria. The systematic review of the literature suggests that the most suitable methods for managing the clinical and pathophysiological consequences of HNC radiotherapy might be the pharmacological approach, for example, through the use of cholinergic agonists when residual secretory capacity is still present, and the use of salivary substitutes. In addition, a modified diet and the patient\u2019s motivation to enhance oral hygiene can lead to a significant improvement.
Conclusion: Radiation-induced xerostomia could be considered a multifactorial disease. It could depend on the type of cancer treatment and the cumulative radiation dose to the gland tissue. A preventive approach and the correct treatment of the particular radiotherapeutic patient can help to improve the condition of xerostomia
Efficacy of nano-hydroxyapatite on caries prevention-a systematic review and meta-analysis.
Introduction/objectives: The review systematically explored in vivo or in situ studies investigating the efficacy of nano-hydroxyapatite (nHA) to reduce initiation of or to remineralize initial caries lesions.
Data: Prospective controlled (non-)randomized clinical trials investigating the efficacy of a nHA compared to any other (placebo) treatment or untreated/standard control.
Sources: Three electronic databases (Central Cochrane, PubMed-MEDLINE, Ovid EMBASE) were screened. Outcomes were, e.g., ICDAS score, laser fluorescence, enamel remineralization rate, mineral loss, and lesion depth. No language or time restrictions were applied. Risk of bias and level of evidence were graded using the Risk of Bias 2.0 tool and GRADE profiler.
Study selection/results: Five in vivo (and 5 in situ) studies with at least 633 teeth (1031 specimens) being assessed in more than 420 (95) patients were included. No meta-analysis could be performed for in vivo studies due to the high heterogeneity of the study designs and the variety of outcomes. In situ studies indicate that under demineralization conditions, NaF was able to hinder demineralization, whereas nHA did not; simultaneously, nHA did not differ from the fluoride-free control. In contrast, under remineralizing conditions, nHA and NaF show the same remineralizing potential. However, the level of evidence was very low. Furthermore, six studies showed a high risk of bias, and six studies were funded/published by the manufacturers of the tested products.
Conclusion: The low number of clinical studies, the relatively short follow-up periods, the high risks of bias, and the limiting grade of evidence do not allow for conclusive evidence on the efficacy of nHA.
Clinical relevance: No conclusive evidence on the efficacy of nHA could be obtained based on the low number of clinical studies, the relatively short follow-up periods, the high risks of bias, the limiting grade of evidence, and study conditions that do not reflect the everyday conditions
Root canal morphology of the mandibular second premolar: a systematic review and meta- analysis
Background: The aim of this paper was to systematically review the root canal configuration (RCC) and morphology literature of the mandibular second premolar (Mn2P).
Methods: Systematic research of five electronic databases was performed to identify published literature concerning the root canal configuration (RCC) of the Mn2P up through July 2020. Studies were selected according to predefined search terms and keywords inclusion criteria: “root canal configuration”, “root canal system”, “root canal morphology”, “mandibular second premolar”, “mandibular premolars”, “morphology” and “anatomy”. Further possible studies were identified by cross-referencing and screening the bibliographies of the selected articles.
Results: From 1622 retrieved studies, 44 studies investigating the internal morphology of 17,839 Mn2Ps were included. Most examined Mn2Ps were single-rooted (89.5–100%); two-rooted (0.1–8%) and three-rooted (0.1–3.5%) Mn2Ps at lower frequency. Most frequent RCCs reported were 1–1–1/1 (55.3–99.6%) followed by 1–1–2/2 (0.5–57%) and 2–2–2/2 (0.6–18%). The meta-analysis of seven studies demonstrated that a significantly higher number of RCC type 1–2–1/1 (OR [95%CI] = 2.05 [1.27, 3.33]) and 2–2–2/2 (OR [95%CI] = 2.32 [0.65, 8.63]) were observed in male than in female patients.
Conclusions: Different RCC research methods have been reported. Whereas clearing and radiographs were com- monly used in the past, CBCT has been prevalent in recent years. A globally high frequency of a 1–1–1/1 RCC in the Mn2P has been reported. Nevertheless, the probability that different, more complicated RCCs can appear in Mn2Ps should not be underestimated and, thus, should be taken into consideration when making decisions during an endo- dontic treatment
Multiproxy archaeological investigation and Garden Archaeology in the Charterhouse of Calci (Tuscany, central Italy) and its territory: results and research data
A wide-ranging archaeological research programme at the Charterhouse and in the broader area of the Municipality of Calci has been performed since 2018. The archaeological research included the collection of legacy and aerial archaeology data, invasive and non-invasive investigations, as well as natural scientific analysis in the monastic complex. Special attention was paid to the archaeological investigations of three different monks’ cells gardens (the Prior’s, the Apothecary’s, and the Master’s), and stratigraphic excavations were combined with archeozoological and archaeobotanical analyses to define the horticultural practices implemented over the centuries of occupation of the Charterhouse. Among the three case studies, the most representative is the Prior’s meditation garden, where the excavation explored the phases prior to the construction of the building (14th century), the 18th-century renovation in the current form, and its abandonment at the end of the 20th century. Pollen analysis has allowed to reconstruct the richness of herbal species characterising an ever-blooming garden, with flowers and ornamental plants, such as roses, lilac, and water lilies, and also vegetables. According to charcoal and fruit-remain analyses, the Charterhouse exploited local hilly woods, satisfying the requirements of fuel by maquis and thermophilous deciduous forest. The agricultural practices included the cultivation of fruit trees, such as chestnut, olive, almond, and vine. Finally, archaeozoological analysis attests the domestic cat as the most frequent taxon in all contexts, probably common in the monastery as a pet and cell companion. This paper presents an overview and a discussion of the results of the investigations conducted and the complete archaeological dataset
The role of vitamins in oral health. A systematic review and meta-analysis
The association between vitamins and oral health have recently been discussed, yielding increased attention from medical and dental perspectives. The present review aimed to systematically evaluate and appraise the most recently scientific papers investigating the role of vitamins in the prevention and treatment of the main oral diseases as hard dental pathological processes and gum/periodontal disease. Randomized controlled trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, reporting associations
between vitamins and oral diseases or the use of vitamins to prevent or treat oral diseases in patients of any age were included. PubMed, Embase and Scopus were searched to November 2019 using an ad hoc prepared search string. All the papers meeting the inclusion criteria were subjected to a quality assessment. The search identified 1597 papers; 741 were selected after removing duplicates. A total of 334 articles were excluded after title and abstract evaluation; 407 were assessed and 73 papers were full-text assessed; other 14 papers were discharged after full text evaluation, leaving finally 58 papers included. In general, there is weak evidence supporting the association between vitamins and both gingival/periodontal disease and hard dental pathological processes
Systematic review and meta-analysis on physical barriers to prevent root dentin demineralization.
The present review systematically analyzed in vitro and in situ studies investigating physical diffusion barriers (sealants, desensitizer or adhesives) to prevent the development or the progression of root (dentin) demineralization. Three electronic databases (PubMed-Medline, CENTRAL, Ovid-EMBASE) were screened for studies from 1946 to 2022. Cross-referencing was used to identify further articles. Article selection and data abstraction were done in duplicate. Languages were not restricted. The type of outcome was not restricted, and their mean differences (MD) were calculated using fixed- or random-effects models. Risk of Bias was graded using Risk of Bias 2.0 tool. From 171 eligible studies, 34 were selected for full-text analysis evaluating 69 different materials, and 17 studies-still evaluating 36 different materials-were included (3 in situ and 14 in vitro). Ten studies evaluated desensitizers; 8 adhesives; and 1 infiltration. Meta-analyses were possible for all 17 studies. Meta-analyses revealed that lesion depth after no treatment was significantly higher than after the application of single-step adhesives (MD[95%CI] = - 49.82[- 69.34; - 30.30]) and multi-step adhesives (MD[95%CI]=-60.09 [-92.65, -27.54]). No significant differences in the lesion depth increase between single- and multi-step adhesives could be observed (MD[95%CI]=30.13 [-21.14, 81.39]). Furthermore, compared to no treatment the increase of the lesion depth was significantly hampered using desensitizers (MD[95%CI] = - 38.02[- 51.74; - 24.31]). Furthermore, the included studies presented unclear or high risk. A physical diffusion barrier can significantly hamper the increase of lesion depth under cariogenic conditions. Furthermore, multi-step adhesives seem not to be more effective than single-step adhesives. However, this conclusion is based on only few in vitro and in situ studies
Topical application of chlorhexidine gel with brush-on technique in the tailored treatment of plaque induced gingivitis
Aim: This study aimed to assess the action of a chlorhexidine-based brush-on gel application in the treatment of plaque-related gingivitis. Methods: The enrollment involved consecutive patients diagnosed with plaque-induced gingivitis. Each participant's full mouth plaque score and gingival index were recorded at the first appointment (t0) and at follow ups after 1 week (t1), 2 weeks (t2) and 3 weeks (t4). All patients were randomly sorted into two groups: A study group, who was given instruction to brush their gums daily with a chlorhexidine gel, and a control group who received a placebo gel. The two groups' data at baseline were compared using a chi-square test, while the t-Student and Mann-Whitney tests were employed to analyze the index's trends, both separately and compared. Results: In total, 30 patients were enrolled, 15 referring to the study group and 15 to the control group. The study group had an 87% decrease in their plaque score and an 84% decrease in their gingival index (p < 0.05). The control group displayed a reduction in plaque score and gingival index of 74% and 84%, respectively (p < 0.05). The plaque score decreased statistically more significantly in the study group than in the control group. Conclusion: Topical employment of a chlorhexidine-containing brush-on gel appears to be a useful home tool in the treatment of plaque-induced gingivitis, associated with professional debridement
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