Explore the vast range of titles available.

Objectives To compare the effect of self-assembling peptide P11-4 with fluoride, casein phosphopeptide amorphous calcium phosphate fluoride (CPP-ACPF) varnish and 5% sodium fluoride varnish (NaF), on Streptococcus mutans (S. mutans) in dental plaque of preschoolers in addition to assessing change in plaque index after their intensive application. Methods Sixty-six preschoolers were randomly assigned into three groups to receive triple applications of P11-4 with fluoride, CPP-ACPF varnish or NaF. S. mutans count in supragingival plaque samples was assessed at baseline (T0) and after the third application by 48 h (T1), one month (T2) and 3 months (T3). Multivariable linear regression compared the effect of these materials on S. mutans log count at various time intervals. Baseline plaque index was compared to that at T2 and T3. Results All study groups presented a significant decrease in S. mutans count at T1, T2 and T3. Multivariable linear regression demonstrated a significant more reduction in S. mutans count in CPP-ACPF and NaF groups when compared to P11-4 with fluoride at T1. At T2 and T3, CPP-ACPF showed superior reduction in bacterial count than NaF and P11-4 with fluoride, with no significant difference between the latter two materials. Plaque index was significantly reduced at all study groups at T2 and T3, with CPP-ACPF being the most proficient. Conclusion CPP-ACPF presented superior antibacterial effect when compared to P11-4 with fluoride or NaF which exhibited comparable antibacterial effect. Clinical relevance Different remineralizing agents can have additive antibacterial effect against S. mutans that affects individual’s future caries experience.

Arresting Caries Treatment (ACT) has been proposed to manage untreated dental caries in children. This prospective randomized clinical trial investigated the caries-arresting effectiveness of a single spot application of: (1) 38% silver diamine fluoride (SDF) with tannic acid as a reducing agent; (2) 38% SDF alone; (3) 12% SDF alone; and (4) no SDF application in primary teeth of 976 Nepalese schoolchildren. The a priori null hypothesis was that the different treatments have no effect in arresting active cavitated caries. Only the single application of 38% SDF with or without tannic acid was effective in arresting caries after 6 months (4.5 and 4.2 mean number of arrested surfaces; p < 0.001), after 1 year (4.1 and 3.4; p < 0.001), and after 2 years (2.2 and 2.1; p < 0.01). Tannic acid conferred no additional benefit. ACT with 38% SDF provides an alternative when restorative treatment for primary teeth is not an option.

Background Silver diamine fluoride (SDF) is a simple and non-invasive agent used to arrest early childhood caries (ECC). This study aimed to investigate potential changes to the oral microbiome in children with ECC who were treated with SDF and sodium fluoride (NaF) varnish at three different frequency regimens. Methods Forty-five children ( n  = 15 per group) with ECC were recruited from community-based dental clinics in Winnipeg, Canada into an open-label, parallel-group, randomized clinical trial testing three different treatment frequency regimens of SDF. A total of 195 carious lesions were treated with two applications of 38% SDF and 5% NaF varnish (and assessed over three study visits one month, four months, or six months apart. Dental plaque samples were collected at each visit. Sequencing of the V4-16 S rRNA and ITS1 rRNA genes were used to study the supragingival plaque microbiome. Results Microbial diversity analyses showed no significant differences in the overall microbiome after SDF treatment. However, significant changes in the abundance of specific bacteria and fungi, particularly Lactobacillus spp., Bifidobacterium spp., and Candida spp., were observed after treatment. Furthermore, overabundance of Streptococcus mutans and Candida dubliniensis at baseline was observed in children who had at least one caries lesion not arrested after one SDF application, compared to those who had 100% arrest rates. The overall arrest rates for treated carious lesions were 75.9% at the second visit and 92.8% at the third visit. Arrest rates were higher for all lesions after two applications of SDF with NaF varnish, and applications one month and four months apart had higher arrest rates (95.9% and 98.5%) than six months (81.1%) apart. Conclusions Applications of SDF with NaF varnish were an effective modality for arresting ECC, with higher arrest rates after two SDF applications. No loss of diversity but changes in the abundance of specific bacteria and fungi were observed after SDF treatment. Trial registration ClinicalTrials.gove NCT04054635 (first registered 13/08/2019).

Enamel demineralisation can occur as a side effect during orthodontic treatment with fixed appliances. This study aimed to evaluate the efficacy of the self-assembling peptide P 11 -4 for remineralisation combined with fluorides, compared to application of fluoride varnish alone. De- and remineralisation was assessed by Quantitative light-induced fluorescence (QLF). Orthodontic brackets were bonded on 108 human enamel samples and white spot lesions were created. The samples were allocated randomly into three groups: Group I received no treatment, group II had a single application of fluoride varnish (22,600 ppm), and group III was treated with P 11 -4 following a single application of fluoride varnish. Quantitative light-induced fluorescence (QLF) measurements were performed at baseline, after demineralisation and after storage in remineralisation solution for 7 and 30 days. Non-parametric tests (Kruskal–Wallis test and Friedman test) were used for further analysis. After demineralisation, all samples showed a median ΔF -9.38% ± 2.79. After 30 days median ΔF values were as followed: group I = -9.04% ± 2.51, group II = -7.89 ± 2.07, group III = -6.08% ± 2.79). The median ΔF values differed significantly between all groups at all investigation times (p < 0.00001). Application of P 11 -4 with fluoride varnish was superior to the use of fluorides alone for remineralisation of enamel adjacent to brackets.

Background One of the most undesirable side effects of comprehensive orthodontic treatment is white spot lesions (WSLs). Despite many attempts at prevention of WSLs, its prevalence remains very high on debonding. There are many agents like fluoride toothpastes, fluoride varnishes, and fluoride mouth rinses, and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) is frequently used for the remineralization of WSLs. However, there is no consensus in the literature with respect to the success rates of these agents. Thus, the present study was designed to evaluate the efficacy of fluoride toothpaste alone and in combination with fluoride varnish and CPP-ACP plus crème in the remineralization of post-orthodontic WSLs. Methods Forty-five subjects in the age range of 16–25 years having at least one post-orthodontic WSL were included in the study. All the subjects were randomly divided into three groups (toothpaste group, varnish group, and CPP-ACP group). The efficacy of various remineralizing agents on the remineralization of WSLs was evaluated clinically and by DIAGNOdent immediately after debonding and subsequently after 1, 3, and 6 months of their use. Results Twice daily use of fluoride toothpaste alone had no significant effect on remineralization of WSLs at various intervals of observations ( P  = 0.078). Application of fluoride varnish along with twice daily use of fluoride toothpaste for 6 months significantly decreased the severity of WSLs ( P  < 0.01). Twice daily use of CPP-ACP plus crème along with fluoride toothpaste had significant effect on remineralization of WSLs at the end of 6 months of observation ( P  < 0.05). Between the group comparison showed that the mean visual and DIAGNOdent scores at various time intervals of observations were decreased more when fluoride varnish and CPP-ACP crème were used in addition to daily use of fluoride toothpaste, but the differences were not statistically significant ( P  > 0.05). Conclusions The use of fluoride varnish and CPP-ACP plus crème in addition to twice daily use of fluoride toothpaste had no additional benefit in the remineralization of post-orthodontic WSLs.

This randomized controlled clinical trial aimed to evaluate the effect of the casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF) and photobiomodulation (PBM) in the treatment of dentin hypersensitivity (DH), and the impact of this on the health-related quality of life (HRQL). Eighty teeth with DH were randomized into four groups and received three treatment sessions: PLACEBO = placebo + LASER application mimicking; CPP-ACPF = CPP-ACPF + LASER application mimicking; PBM = placebo + LASER active application; CPP-ACPF+PBM = CPP-ACPF + LASER active application. Tactile (exploratory probe) and evaporative (triple syringe) stimuli were used to measure DH and were recorded with the aid of a visual analogue scale (VAS) after the 1st, 2nd and 3rd treatment sessions and one-month follow-up. The HRQL was recorded in the DH experience questionnaire (DHEQ). The intragroup comparison showed a significant reduction in DH (p < 0.05) with both stimuli after one-month follow-up. The intergroup comparison with the evaporative stimulus showed that CPP-ACPF+PBM significantly reduced DH when compared to the rest of treatments, after one-month follow-up. CPP-ACPF+PBM group statistically differed from the other treatment groups in the DHEQ evaluation after one-month follow-up. After one-month follow-up, the association of CPP-ACPF with PBM was effective in the reduction of DH and promoted a positive impact on the HRQL of the participants of this study.

Purpose Glass ionomer fissure sealant (GIS) and fluoride varnish (NaFV) are two preventive interventions applicable to pre-school children. However, their application effects on young children’s behaviour are understudied. The study compared the effects of GIS and NaFV applications on dental anxiety (DA), cooperativeness and pain level in pre-school children when applied to primary second molars in outreach settings. Methods Four hundred and thirteen children were recruited for the study, out of which 228 were allocated to NaFV group whilstand 185 allocated to the GIS group. One calibrated examiner screened and randomly allocated the children into either group. Another calibrated examiner recorded the children’s DA level and cooperativeness with Frankl Behaviour Rating Scale (FBRS) and Venham Behaviour Rating Scale (VBRS) throughout the treatment period. Subjects self-reported their pain levels using Wong–Baker Faces Scale (WBFS). Results Significant difference in postoperative anxiety was found using VBRS, with children in NaFV group having more positive scores post-treatment ( p  = 0.016). Only the type of preventive interventions significantly affected postoperative DA and patient cooperation ( p  = 0.032), whereas no other clinical findings and socio-demographic factors significantly influenced the children’s behaviour postoperatively. Conclusion NaFV application is associated with less DA and more cooperative behaviour in pre-school children compared to GIS application although similar pain levels were recorded.

This 12-week clinical study evaluated the impact of 10% CPP-ACP and 5% sodium fluoride varnish regimes on the regression of nonorthodontic white spot lesions (WSLs). The study included 21 children with 101 WSLs who were randomised into four treatment regimes: weekly clinical applications of fluoride varnish for the first month (FV); twice daily self-applications of CPP-ACP paste (CPP-ACP); weekly applications of fluoride varnish for the first month and twice daily self-applications of CPP-ACP paste (CPP-ACP-FV); and no intervention (control). All groups undertook a standard oral hygiene protocol and weekly consultation. Visual appraisals and laser fluorescence (LF) measurements were made in weeks one and twelve. The majority of WSLs in the control and FV groups exhibited no shift in appearance, whereas, in the CPP-ACP and CPP-ACP-FV groups, the lesions predominantly regressed. The visual and LF assessments indicated that the extent of remineralisation afforded by the treatments was of the following order: control ~ FV < CPP-ACP ~ CPP-ACP-FV. Self-applications of CPP-ACP paste as an adjunct to standard oral hygiene significantly improved the appearance and remineralisation of WSLs. No advantage was observed for the use of fluoride varnish as a supplement to either the standard or CPP-ACP-enhanced oral hygiene regimes.

Objectives Fixed orthodontic appliances are associated with higher levels of plaque and saliva bacteria, which contribute to dental caries. The effects of combining xylitol and fluoride, both used in caries prevention, are uncertain. Thus, this study assessed the combined impact of fluoride and xylitol varnish on bacteria in saliva and biofilms around orthodontic brackets. Materials and Methods A single‐center, four‐arm, parallel‐group, triple‐blind, randomized clinical trial was conducted. A total of 120 patients who required fixed orthodontic treatment were included. Patients were sorted into one of the following groups at random: fluoride, xylitol, combined fluoride and xylitol, and control. Biofilm and saliva sampling was performed at two intervals: T0 (first session of bracket bonding, before application of the varnish) and T1 (6 weeks after application of the varnish). The number of Streptococcus mutans and Lactobacillus was counted using the CFU method. Results The relative number of S. mutans and lactobacilli in saliva and biofilm significantly decreased following the application of fluoride and combined fluoride/xylitol varnish (p < 0.05) and were more effective than xylitol varnish. There was no significant difference between fluoride and combined fluoride/xylitol varnishes regarding changes in S. mutans and Lactobacillus colonies in saliva and dental biofilms. Additionally, there was no significant difference between xylitol and the two other active varnishes regarding reduction in biofilm S. mutans and Lactobacillus. Conclusion There was no significant difference between fluoride and combined fluoride/xylitol varnishes regarding changes in the studied bacteria in saliva and dental biofilms, and they were more effective than xylitol varnish. Trial Registration The Iranian Registry of Clinical Trial identifier: IRCT20181121041713N4; https://fa.irct.ir/trial/58543

There is a lack of clinical studies comparing dentifrices with high fluoride (F) concentration. The aim was to evaluate a dentifrice containing 5,000 ppm F compared to a dentifrice containing 1,450 ppm F in caries-active adolescents. The design was a 2-year, single-blind randomized controlled trial and 211 adolescents of 279 (76%) completed the trial. The subjects were divided into two groups and were given one of the assigned F dentifrices for daily unsupervised toothbrushing: (1) Duraphat 5,000 ppm F and (2) Pepsodent Superfluor 1,450 ppm F, both as NaF. The outcome variables were caries incidence and progression of proximal and occlusal caries. The subjects were asked to fill in a questionnaire to evaluate their compliance and they were divided into two subgroups: subgroup A, excellent compliance, and subgroup B, poor compliance. The latter group (28%) comprised the subjects who did not brush twice a day or did not use the dentifrice regularly. Adolescents using 5,000 ppm F toothpaste had significantly lower progression of caries compared to those using 1,450 ppm F toothpaste (A: p < 0.01, B: p < 0.001), with a prevented fraction of 40%. Subjects using 5,000 ppm F toothpaste had significantly lower caries incidence for compliance B compared to those using 1,450 ppm F toothpaste (p < 0.05); the prevented fraction was 42%. This may indicate that 5,000 ppm F toothpaste has a greater impact on individuals who do not use toothpaste regularly or do not brush twice a day. Thus, 5,000 ppm F toothpaste appears to be an important vehicle for caries prevention and treatment of adolescents with a high caries risk.