Science.gov

Sample records for deep carious lesions

  1. Current status of conservative treatment of deep carious lesions.

    PubMed

    Mattos, Juliana; Soares, Giulia Marins; Ribeiro, Apoena de Aguiar

    2014-06-01

    Traditionally, deep carious lesions are treated by removal of all carious tissue, which may lead to pulp exposure. To minimize this risk, conservative carious tissue removal techniques have been proposed, including partial removal and stepwise excavation. However, there is no consensus in the literature about which is the better technique. Thus, the aim of this article is to describe and discuss the main techniques for carious tissue removal, according to scientific evidence. It was observed that both stepwise excavation and partial carious tissue removal presented lower pulp exposure rates and higher success rates. Clinical Relevance: Clinicians must be aware that conservative carious tissue removal techniques, such as stepwise excavation and partial carious tissue removal, present lower pulp exposure rates and higher success rates than traditional methods.

  2. Partial pulpotomy in young permanent teeth with deep carious lesions.

    PubMed

    Mejàre, I; Cvek, M

    1993-12-01

    The material comprised 37 young posterior teeth with deep carious lesions and exposed pulps, treated with partial pulpotomy and dressed with calcium hydroxide. The teeth were divided into two groups. Group 1 consisted of 31 teeth with no clinical or radiographic symptoms before treatment, Group 2 of 6 teeth with temporary pain, widened periodontal space periapically and/or productive osteitis, i.e. increased density of the surrounding alveolar bone. After an observation time of 24 to 140 months (mean = 56 months), healing had occurred in 29 of 31 teeth in Group 1 (93.5%) and in 4 of 6 teeth in Group 2. It was concluded that the present, as well as previously reported results indicate that partial pulpotomy may be an adequate treatment for young permanent molars with a carious exposure, although more studies are needed before the treatment can be recommended for routine clinical use.

  3. Randomized Clinical Trials on Deep Carious Lesions: 5-Year Follow-up.

    PubMed

    Bjørndal, L; Fransson, H; Bruun, G; Markvart, M; Kjældgaard, M; Näsman, P; Hedenbjörk-Lager, A; Dige, I; Thordrup, M

    2017-07-01

    Deep caries presents a dilemma in terms of which treatment that will render an optimal prognosis by maintaining pulp vitality with absence of apical pathology. Previously, 2 randomized clinical trials were performed testing the short-term effects of stepwise carious tissue removal versus nonselective carious removal to hard dentin with or without pulp exposure. The aim of this article was to report the 5-y outcome on these previously treated patients having radiographically well-defined carious lesions extending into the pulpal quarter of the dentin but with a well-defined radiodense zone between the carious lesion and the pulp. In this long-term study, 239 of 314 (76.2%) patients were analyzed. The stepwise removal group had a significantly higher proportion of success (60.2%) at 5-y follow-up compared with the nonselective carious removal to hard dentin group (46.3%) ( P = 0.031) when pulp exposures per se were included as failures. Pulp exposure rate was significantly lower in the stepwise carious removal group (21.2% vs. 35.5%; P = 0.014). Irrespective of pulp exposure status, the difference (13.3%) was still significant when sustained pulp vitality without apical radiolucency and unbearable pain was considered (95% confidence interval, 3.1-26.3, P = 0.045). After pulp exposure, only 9% ( n = 4) of the analyzed patients were assessed as successful, indicating that the prognosis is highly dubious following conventional pulp-capping procedures (direct pulp capping or partial pulpotomy) in deep carious lesions in adults. In conclusion, the stepwise carious removal group had a significantly higher proportion of pulps with sustained vitality without apical radiolucency versus nonselective carious removal of deep carious lesions in adult teeth at 5-y follow-up ( ClinicalTrials.gov NCT00187837 and NCT00187850).

  4. Treatment preferences of deep carious lesions in mature teeth: Questionnaire study among dentists in Northern Norway.

    PubMed

    Stangvaltaite, Lina; Kundzina, Rita; Eriksen, Harald M; Kerosuo, Eero

    2013-11-01

    To investigate preferred treatment methods of deep carious lesions in mature permanent teeth among dentists in Northern Norway. The survey included all 437 general dental practitioners in Northern Norway working in the private or the public dental health service. The participants received an invitation with a radiograph and a clinical picture of a deep carious lesion in a mature permanent tooth and a questionnaire asking about demographic characteristics and their preferred treatment methods related to different clinical deep caries diagnoses. The response rate was 56%. There was an over-representation of publicly employed dentists among the respondents; otherwise no systematic bias related to non-responders was detected. In the absence of carious exposure and no symptoms, total caries excavation was the preferred treatment method (49%) followed by stepwise excavation (45%). In cases of deep caries and no exposure with symptoms, the preferences were equally distributed between root canal treatment (39%) and stepwise excavation (38%). In the presence of carious exposure but no symptoms, the preferred treatment method was direct pulp capping (51%) and in carious exposure with symptoms root canal treatment was the preferred treatment method (91%). There is no uniform treatment method of deep carious lesions among dentists in Northern Norway.

  5. Stepwise Excavation Allows Apexogenesis in Permanent Molars with Deep Carious Lesions and Incomplete Root Formation.

    PubMed

    Hernandéz-Gatón, Patrícia; Serrano, César Ruiz; Nelson Filho, Paulo; De Castañeda, Esther Ruiz; Lucisano, Marília P; Silva, Raquel A B da; Silva, Léa A B da

    2015-01-01

    This study evaluated the stepwise excavation technique in 138 permanent molars with deep carious lesions and incomplete root formation within a 24-month clinical and radiographic follow-up period. In 96.7% of the cases, success was observed (no pain, integrity of restoration margins, absence of radiographic alterations and apexogenesis). The cases of failure (3.3%) were due to the loss of the temporary restoration. In conclusion, the stepwise excavation is a promising technique for permanent teeth with deep carious lesions and incomplete root formation as a minimally invasive approach because it allows the preservation of pulp vitality and occurrence of apexogenesis.

  6. Effect of Dycal on bacteria in deep carious lesions.

    PubMed

    Leung, R L; Loesche, W J; Charbeneau, G T

    1980-02-01

    Indirect pulp capping procedures are often dependent on use of calcium hydroxide which is placed directly over residual carious dentin. As the bacterial count was found to decrease a month after the calcium hydroxide was placed, this study was done to assess how much of the change was caused by the use of Dycal and how much was caused by the mechanical access procedures.

  7. Dentists' attitudes and behaviour regarding deep carious lesion management: a multi-national survey.

    PubMed

    Schwendicke, Falk; Stangvaltaite, Lina; Holmgren, Christopher; Maltz, Marisa; Finet, Marion; Elhennawy, Karim; Eriksen, Isabel; Kuzmiszyn, Tone Christiansen; Kerosuo, Eero; Doméjean, Sophie

    2017-01-01

    The present study aimed, using a questionnaire, to assess and compare behaviour, attitudes and beliefs of French, German and Norwegian dentists regarding deep carious lesion management. A mail survey was applied to simple random national samples of dentists. Descriptive analysis and logistic regression analysis were performed. Sample size was 661 (response rate, 33 %) in France, 622 (25 %) in Germany and 199 (33 %) in Norway. Hardness was the criterion used most often for assessing carious tissue removal in all three countries (>95 %), with most dentists aiming for only hard dentine remaining at the pulpal wall (>66 %); dentine colour was not found relevant by most respondents. The majority of French and German practitioners (>66 %) would perform complete excavation even for deep lesions, while most Norwegian dentists (84 %) opted for stepwise excavation. Most dentists thought complete removal was required to avoid lesion progression and were uncertain if remaining sealed bacteria would harm the pulp. Treatment decisions were guided by prior experience and familiarity. For example, stepwise removal was performed less often by dentists who were male, French, German or those in the private sector. Less invasive strategies for managing deep lesions have not widely entered clinical practice in France and Germany. Underlying beliefs shape decision-making. The present study is the first of its nature to analyse and compare deep carious lesion management between three European countries. It shows that there is an urgent need to practically educate dentists in less invasive strategies.

  8. Treatment of deep carious lesions by complete excavation or partial removal

    PubMed Central

    Thompson, Van; Craig, Ronald G.; Curro, Fredrick A.; Green, William S.; Ship, Jonathan A.

    2009-01-01

    Background The classical approach to treatment of deep carious lesions approaching the pulp mandates removing all infected and affected dentin. Several studies call this approach into question. Types of Studies Reviewed A search of five electronic databases using selected key words to identify studies relating to partial versus complete removal of carious lesions yielded 1,059 reports, of which the authors judged 23 to be relevant. Three articles reported the results of randomized controlled trials. Results The results of three randomized controlled trials, one of which followed up patients for 10 years, provide strong evidence for the advisability of leaving behind infected dentin, the removal of which would put the pulp at risk of exposure. Several additional studies have demonstrated that cariogenic bacteria, once isolated from their source of nutrition by a restoration of sufficient integrity, either die or remain dormant and thus pose no risk to the health of the dentition. PMID:18519994

  9. Clinical use of photodynamic antimicrobial chemotherapy for the treatment of deep carious lesions

    NASA Astrophysics Data System (ADS)

    Guglielmi, Camila De Almeida B.; Simionato, Maria Regina L.; Ramalho, Karen Müller; Imparato, José Carlos P.; Pinheiro, Sérgio Luiz; Luz, Maria A. A. C.

    2011-08-01

    The purpose of this study was to assess photodynamic antimicrobial chemotherapy (PACT) via irradiation, using a low power laser associated with a photosensitization dye, as an alternative to remove cariogenic microorganisms by drilling. Remaining dentinal samples in deep carious lesions on permanent molars (n = 26) were treated with 0.01% methylene blue dye and irradiated with a low power laser (InGaAIP - indium gallium aluminum phosphide; λ = 660 nm; 100 mW; 320 Jcm-2 90 s; 9J). Samples of dentin from the pulpal wall region were collected with a micropunch before and immediately after PACT and kept in a transport medium for microbiological analysis. Samples were cultured in plates of Brucella blood agar, Mitis Salivarius Bacitracin agar and Rogosa SL agar to determine the total viable bacteria, mutans streptococci and Lactobacillus spp. counts, respectively. After incubation, colony-forming units were counted and microbial reduction was calculated for each group of bacteria. PACT led to statistically significant reductions in mutans streptococci (1.38 log), Lactobacillus spp. (0.93 log), and total viable bacteria (0.91 log). This therapy may be an appropriate approach for the treatment of deep carious lesions using minimally invasive procedures.

  10. Antimicrobial photodynamic therapy as an adjunct for treatment of deep carious lesions-A systematic review.

    PubMed

    Cieplik, Fabian; Buchalla, Wolfgang; Hellwig, Elmar; Al-Ahmad, Ali; Hiller, Karl-Anton; Maisch, Tim; Karygianni, Lamprini

    2017-06-01

    For deep carious lesions, a more conservative treatment modality ("selective caries removal") has been proposed, where only the heavily contaminated dentine is removed. In this regard, effective adjuncts for cavity disinfection such as the antimicrobial photodynamic therapy (aPDT) can be valuable clinically prior to definitive restoration. Therefore, the aim of this study was to systematically assess clinical studies on the effectiveness of aPDT as a supplementary tool in the treatment of deep caries lesions. Searches were performed in four databases (PubMed, EMBASE, ISI Web of Science, ClinicalTrials.gov) from 1st January, 2011 until 21st June, 2016 for search terms relevant to the observed parameters, pathological condition, intervention and anatomic entity. The pooled information was evaluated according to PRISMA guidelines. At first, 1651 articles were recovered, of which 1249 full-text articles were evaluated, 270 articles thereof were reviewed for eligibility and finally 6 articles met all inclusion criteria. The aPDT protocols involved Methylene Blue, Toluidine Blue and aluminium-chloride-phthalocyanine as photosensitizers and diode lasers, light-emitting diodes and halogen light-sources. The data from five reports, utilizing both culture-dependent and -independent methods, disclosed significant reduction of cariogenic bacterial load after mechanical caries removal with adjunct aPDT. As these studies exhibit some methodological limitations, e.g. lack of positive controls, this systematic review can support the application of aPDT to a limited extent only in terms of reducing the microbial load in deep carious lesions before restorative treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal.

    PubMed

    Schwendicke, F; Frencken, J E; Bjørndal, L; Maltz, M; Manton, D J; Ricketts, D; Van Landuyt, K; Banerjee, A; Campus, G; Doméjean, S; Fontana, M; Leal, S; Lo, E; Machiulskiene, V; Schulte, A; Splieth, C; Zandona, A F; Innes, N P T

    2016-05-01

    The International Caries Consensus Collaboration undertook a consensus process and here presents clinical recommendations for carious tissue removal and managing cavitated carious lesions, including restoration, based on texture of demineralized dentine. Dentists should manage the disease dental caries and control activity of existing cavitated lesions to preserve hard tissues and retain teeth long-term. Entering the restorative cycle should be avoided as far as possible. Controlling the disease in cavitated carious lesions should be attempted using methods which are aimed at biofilm removal or control first. Only when cavitated carious lesions either are noncleansable or can no longer be sealed are restorative interventions indicated. When a restoration is indicated, the priorities are as follows: preserving healthy and remineralizable tissue, achieving a restorative seal, maintaining pulpal health, and maximizing restoration success. Carious tissue is removed purely to create conditions for long-lasting restorations. Bacterially contaminated or demineralized tissues close to the pulp do not need to be removed. In deeper lesions in teeth with sensible (vital) pulps, preserving pulpal health should be prioritized, while in shallow or moderately deep lesions, restoration longevity becomes more important. For teeth with shallow or moderately deep cavitated lesions, carious tissue removal is performed according toselective removal to firm dentine.In deep cavitated lesions in primary or permanent teeth,selective removal to soft dentineshould be performed, although in permanent teeth,stepwise removalis an option. The evidence and, therefore, these recommendations support less invasive carious lesion management, delaying entry to, and slowing down, the restorative cycle by preserving tooth tissue and retaining teeth long-term. © International & American Associations for Dental Research 2016.

  12. Analysis of multiple cytokine polymorphisms in individuals with untreated deep carious lesions reveals IL1B (rs1143643) as a susceptibility factor for periapical lesion development.

    PubMed

    Dill, Alisa; Letra, Ariadne; Chaves de Souza, Letícia; Yadlapati, Mamatha; Biguetti, Claudia Cristina; Garlet, Gustavo Pompermaier; Vieira, Alexandre R; Silva, Renato Menezes

    2015-02-01

    It has been proposed that individual genetic predisposition may contribute to persistent apical periodontitis. Cytokines are associated with levels of inflammation and are involved in caries, pulpal, and periapical tissue destruction. We hypothesized that polymorphisms in cytokine genes may contribute to an individual's increased susceptibility to apical tissue destruction in response to deep carious lesions. Subjects with deep carious lesions with or without periapical lesions (≥3 mm) were recruited at the University of Pittsburgh, Pittsburgh, PA, and the University of Texas at Houston, Houston, TX. Genomic DNA samples of 316 patients were sorted into 2 groups: 136 cases with deep carious lesions and periapical lesions (cases) and 180 cases with deep carious lesions but no periapical lesions (controls). Nine single-nucleotide polymorphisms in IL1B, IL6, TNF, RANK, RANKL, and OPG genes were selected for genotyping. Genotypes were generated by end point analysis using TaqMan chemistry (Invitrogen, Carlsbad, CA) in a real-time polymerase chain reaction instrument. Allele and genotype frequencies were compared among cases and controls using the PLINK program (http://pngu.mgh.harvard.edu/purcell/plink/). Ninety-three human periapical granulomas and 24 healthy periodontal ligament tissues collected postoperatively were used for messenger RNA expression analyses of IL1B. A single-nucleotide polymorphism in IL1B (rs1143643) showed allelic (P = .02) and genotypic (P = .004) association with cases of deep caries and periapical lesions. We also observed altered transmission of IL1B marker haplotypes (P = .02) in these individuals. IL1B was highly expressed in granulomas (P < .001). Variations in IL1B may be associated with periapical lesion formation in individuals with untreated deep carious lesions. Future studies could help predict host susceptibility to developing periapical lesions. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All

  13. Evaluation of primary carious dentin after cavity sealing in deep lesions: a 10- to 13-month follow-up.

    PubMed

    Chibinski, Ana Claudia R; Reis, Alessandra; Kreich, Eliane Maria; Tanaka, Jefferson Luis O; Wambier, Denise S

    2013-01-01

    This study's purpose was to describe the primary dentin reactions following restoration without complete removal of infected dentin. Fragments of carious dentin from 43 teeth with acute deep lesions were removed at baseline and compared to samples of carious dentin removed 60 days later, using scanning electron microscopy (SEM) photographs. At the follow-up periods (60 days; 10-13 months), restorations were evaluated using US Public Health Service criteria and standardized radiographs. A postprocessing routine of radiographs was used to identify changes in radiographic density between periods. At baseline, SEM photographs showed disorganized tissue and bacterial invasion. After 60 days, the dentin exhibited a better organization and signs of remineralization. Differences in restoration characteristics were detected for cavosurface discoloration (P=.008), wear (P<.001), and surface texture (P<.001) after 10 to 13 months. Digital subtraction radiographs showed that mean gray levels of carious and sound dentin increased after 10 to 13 months (P<.001). Differences in mean gray levels were detected between carious and sound dentin only for the 60-day images (P=.03). Removal of infected dentin wasn't fundamental for caries arrestment. Carious dentin tended to reorganize in a short period when properly sealed, and the remineralization process continued for longer periods. Correct diagnosis of pulp vitality seems fundamental for the success of this protocol.

  14. Indirect pulp capping versus pulpotomy for treating deep carious lesions approaching the pulp in primary teeth: a systematic review.

    PubMed

    Smaïl-Faugeron, V; Porot, A; Muller-Bolla, M; Courson, F

    2016-06-01

    To assess dental practice regarding the use of indirect pulp capping or pulpotomy in children with deep carious lesions approaching the pulp in primary teeth and to compare the efficacy of the two pulp treatments. Systematic review. We searched the Cochrane Library, PubMed via MEDLINE, and EMBASE as well as the reference lists of included reports and ClinicalTrials.gov (for ongoing trials). Eligible studies were surveys of dental practice sent to dentists regarding the use of indirect pulp capping and pulpotomy in children with deep carious lesions approaching the pulp in primary teeth and any type of clinical study. Two review authors independently extracted data and assessed risk of bias in duplicate. Of the 481 potentially eligible articles, 11 were included in the review: 8 described surveys of dental practice, 1 a non-randomised study, and 2 ongoing randomised trials. The surveys of dental practice showed an overall increase in the teaching and practice of indirect pulp capping in primary teeth. The non- randomised study found a statistically significant difference in favour of indirect pulp capping for clinical and radiological success at 3 years but with high overall risk of bias. Despite the success rate of indirect pulp capping for treating deep carious lesions approaching the pulp in primary teeth, practitioners still hesitate to practice this technique because of lack of evidence and studies on this topic. Thus, for strong evidence, investigators are encouraged to conduct randomised trials comparing the efficacy of indirect pulp capping and pulpotomy for treating deep carious lesions approaching the pulp in primary teeth.

  15. No Carious Cervical Lesions: Abfraction

    PubMed Central

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-01-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5. PMID:24324319

  16. No carious cervical lesions: abfraction.

    PubMed

    Shetty, Sumanth M; Shetty, Rashmi G; Mattigatti, Sudha; Managoli, Noopur A; Rairam, Surabhi G; Patil, Ashwini M

    2013-10-01

    Abfraction or Theory of Abfraction is a theory explaining the non-carious cervical lesions (NCCL). It suggests that they are caused by flexural forces, usually from cyclic loading; the enamel, especially at the cementoenamel junction (CEJ), undergoes this pattern of destruction by separating the enamel rods. Clinical aspect importance of these ineart lesions are at most important to be detected for early intervention and treatment modalities as options during the progression of the disease. How to cite this article: Shetty SM, Shetty RG, Mattigatti S, Managoli NA, Rairam SG, Patil AM. No Carious Cervical Lesions: Abfraction. J Int Oral Health 2013; 5(5):142-5.

  17. General dentists', pediatric dentists', and endodontists' diagnostic assessment and treatment strategies for deep carious lesions: A comparative analysis.

    PubMed

    Koopaeei, Mahshid Majlessi; Inglehart, Marita R; McDonald, Neville; Fontana, Margherita

    2017-02-01

    There is a large variation among clinicians when managing deep carious lesions (DCLs). The purpose of this study was to assess general dentists' (GDs), pediatric dentists' (PDs), and endodontists' (EDs) diagnostic methods, clinical decision-making considerations, treatment strategies, and knowledge, behavior, and attitudes related to the diagnosis and treatment of DCLs. A total of 175 GDs, 511 PDs, and 377 EDs responded to a nationwide Web-based survey. Most EDs (68%) and GDs (47%) practiced complete caries removal. PDs (31%) were more likely than GDs (12%) and EDs (4%) to remove carious tissues partially. Dentin hardness was the most important diagnostic criterion used during caries excavation (GDs, 90%; PDs, 72%; EDs, 88%). Only 30% of GDs, 17% of PDs, and 90% of EDs used diagnostic tests (for example, a cold test) when assessing pupal health. A substantial percentage of respondents considered endodontic treatment as a choice for treating DCLs in asymptomatic teeth in young patients (GDs, 40%; PDs, 30%; EDs, 40%). GDs rarely used a rubber dam when treating these lesions. Most respondents practiced complete caries removal until hard dentin was felt, using hardness as the primary excavation criterion, and did not use pulp diagnostic tests routinely before making decisions about treatment of teeth with DCLs. Efforts should be made to translate the growing body of evidence supporting the use of conservative caries removal criteria to preserve pulpal health and tooth structure integrity when managing DCLs. Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.

  18. Deep carious lesions and other consequences of caries among 18-year-olds at Public Dental Health Service in Northern Norway: A cross-sectional age cohort study.

    PubMed

    Stangvaltaite, Lina; Kundzina, Rita; Bolstad, Napat Limchaichana; Eriksen, Harald M; Kerosuo, Eero

    2015-08-01

    To document deep carious lesions and other consequences of caries (DCL-CC) in molars of 18-year olds leaving the free-of-charge Public Dental Health Service (PDHS). To explore the association between background factors and DCL-CC. The final study sample (n=1876) comprised 95% of individuals born in 1993 and registered in the PDHS in Troms County, Northern Norway. The most recent digital bitewing radiographs of each subject were examined for DCL-CC (deep untreated carious lesions, deep restorations, root canal obturations or extractions due to caries). Inter- and intra-observer kappa scores were 0.62 and 0.87, respectively. Information on background factors (gender, clinic location, history of medical problems, bitewing examination interval, DMFT score and planned recalls) were retrieved from dental records. About one-quarter of subjects (488) had at least one molar with DCL-CC. There were 848 molars in total with DCL-CC; the majority were deep restorations (70%), but 4% were deep untreated carious lesions. More than a quarter of DCL-CC were either root canal obturations (14%) or extractions (12%). Multivariable logistic regression analyses showed that a 1-unit increase in DMFT score was associated with deep untreated carious lesions and extractions due to caries. There was no association between urban/rural clinic location, which indicated socio-economic status, and either DMFT score or DCL-CC. Despite the existence of a free-of-charge dental service, more than one-quarter of the subjects in the present study had at least one molar with DCL-CC.

  19. A practice-based study on stepwise excavation of deep carious lesions in permanent teeth: a 1-year follow-up study.

    PubMed

    Bjørndal, L; Thylstrup, A

    1998-04-01

    This study reports results from a practice-based study in which deep carious lesions were treated by general dental practitioners using stepwise excavation. The material comprised 94 teeth with deep carious lesions which the clinicians considered would result in pulp perforation if treated by a single and terminal excavation. At the first visit excavation of the peripheral dentine was completed. The outermost part of the central and necrotic dentine was gently removed with a sharp excavator. Standardized assessments of the dentine colour and consistency were made before application of a calcium hydroxide-containing base material and temporary filling. The final excavation was completed after a treatment interval ranging from 2 to 19 months, with a median of 6 months. Reassessments of the dentine colour and consistency were made before complete removal of demineralized dentine. The central dentine was significantly browner and less softened after the sealing period. After removal of the dark-brownish dentine during the final excavation, the colour and consistency of the exposed central dentine was found to resemble that of the completely excavated peripheral dentine. Only five cases resulted in pulp perforation during the final excavation. The high success rate of teeth surviving the final treatment without pulp exposure after 1 year of observation shows that it was possible for dentists in general practice to administer and manage the treatment of deep carious lesions, a process which may prolong tooth survival compared with conventional endodontic techniques.

  20. Simulating Clinical Carious Lesions in Composition Teeth.

    ERIC Educational Resources Information Center

    Ambrose, E. R.; And Others

    1981-01-01

    A step-by-step technique to alter stock composition teeth and create simulated carious conditions that are ideal or otherwise is presented. The procedures provide the student with life-like lesions, suitable in texture and location and similar to conditions found in the oral cavity. (MLW)

  1. Managing Carious Lesions: Consensus Recommendations on Terminology.

    PubMed

    Innes, N P T; Frencken, J E; Bjørndal, L; Maltz, M; Manton, D J; Ricketts, D; Van Landuyt, K; Banerjee, A; Campus, G; Doméjean, S; Fontana, M; Leal, S; Lo, E; Machiulskiene, V; Schulte, A; Splieth, C; Zandona, A; Schwendicke, F

    2016-05-01

    Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.

  2. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study.

    PubMed

    Sawant, Ajinkya; Chunawalla, Yusuf; Morawala, Abdul; S Kanchan, Nupur; Jain, Kapil; Talathi, Rohan

    2017-01-01

    Early childhood caries discloses a distinct clinical pattern, and the teeth most often involved are the maxillary central incisors, lateral incisors, and the maxillary and man-dibular first molars. The maxillary incisors are most severely affected, with deep carious lesions usually involving the pulp. Teeth that have been endodontically treated often have little coronal tooth tissue remaining and as such require a post to retain the core and restoration .This study evaluated and compared the efficacy of EverStick glass fiber-reinforced composite post with ParaPost Taper Lux in primary maxillary anterior teeth. An in vivo study was conducted to evaluate and compare the longevity and failures of two fiber post systems in primary maxillary anterior teeth. A total of 60 severely mutilated primary maxillary anterior teeth from children aged 3 to 5 years were selected according to the inclusion criteria. These teeth were treated endodontically and were randomly assigned into two groups with 30 samples in each group, group I: EverStick glass fiber-reinforced composite post, group II: ParaPost Taper Lux post. The evaluation of dislodgment of posts, secondary caries, root fracture, and post fracture was carried out clinically and radiographically during every follow-up at 3, 6, 9, and 12 months interval. Statistical tests (Chi-square test, Fisher's exact probability test) suggested that dislodgment of the posts was significant between the two groups at 6, 9, and 12 months follow-ups. But within the group during subsequent follow-up intervals, dislodgment of posts as a mode of failure was not statistically significant. However, clinically failures were seen in both the study groups. Fiber post system has proved to be successful clinically in both primary and permanent teeth due to the mono-block effect with luting agent, post system, core material, and bonding to dentin. Thus, today the EverStick glass fiber post system provides a novel way of fabricating cost-effective and

  3. Evaluation of Novel Glass Fiber-reinforced Composite Technique for Primary Anterior Teeth with Deep Carious Lesions: A 12-month Clinical Study

    PubMed Central

    Sawant, Ajinkya; Chunawalla, Yusuf; Morawala, Abdul; Jain, Kapil; Talathi, Rohan

    2017-01-01

    Background Early childhood caries discloses a distinct clinical pattern, and the teeth most often involved are the maxillary central incisors, lateral incisors, and the maxillary and man-dibular first molars. The maxillary incisors are most severely affected, with deep carious lesions usually involving the pulp. Teeth that have been endodontically treated often have little coronal tooth tissue remaining and as such require a post to retain the core and restoration .This study evaluated and compared the efficacy of EverStick glass fiber-reinforced composite post with ParaPost Taper Lux in primary maxillary anterior teeth. Aim An in vivo study was conducted to evaluate and compare the longevity and failures of two fiber post systems in primary maxillary anterior teeth. Materials and methods A total of 60 severely mutilated primary maxillary anterior teeth from children aged 3 to 5 years were selected according to the inclusion criteria. These teeth were treated endodontically and were randomly assigned into two groups with 30 samples in each group, group I: EverStick glass fiber-reinforced composite post, group II: ParaPost Taper Lux post. The evaluation of dislodgment of posts, secondary caries, root fracture, and post fracture was carried out clinically and radiographically during every follow-up at 3, 6, 9, and 12 months interval. Results Statistical tests (Chi-square test, Fisher’s exact probability test) suggested that dislodgment of the posts was significant between the two groups at 6, 9, and 12 months follow-ups. But within the group during subsequent follow-up intervals, dislodgment of posts as a mode of failure was not statistically significant. However, clinically failures were seen in both the study groups. Conclusion Fiber post system has proved to be successful clinically in both primary and permanent teeth due to the mono-block effect with luting agent, post system, core material, and bonding to dentin. Thus, today the EverStick glass fiber post

  4. Bacteriology of deep carious lesions underneath amalgam restorations with different pulp-capping materials - an in vivo analysis

    PubMed Central

    NEELAKANTAN, Prasanna; RAO, Chandragiri Venkata Subba; INDRAMOHAN, Jamuna

    2012-01-01

    Microorganisms remaining in dentin following cavity preparation may induce pulp damage, requiring the use of pulp-capping agents with antimicrobial activity underneath permanent restorations. Objective The aims of this study were to analyze the bacteriological status of carious dentin and to assess the efficacy of different base underneath silver amalgam restorations. Material and Methods This study was conducted on 50 patients aged 13 to 30 years. Sterile swabs were used to take samples after cavity preparation, which was assessed by microbiological culture to identify the microorganisms present. Following this, cavities were restored with silver amalgam, using one of the materials being investigated, as the base: calcium hydroxide (Group II), polyantibiotic paste (Group III), a novel light-cured fluoride-releasing hydroxyapatite-based liner (Group IV) and mineral trioxide aggregate - MTA (Group V). In Group I, the cavities were restored with silver amalgam, without any base. After 3 months, the amalgam was removed and samples taken again and analyzed for the microbial flora. Results Lactobacilli were the most commonly isolated microorganisms in the samples of carious dentin. Groups IV and V showed negative culture in the 3-month samples. There was no statistically significant difference between Groups I, II and III. There was no significant difference between Groups IV and V (p>0.05). Both Groups IV and V showed significantly better results when compared to Groups I, II and III (p<0.05). Conclusions The hydroxyapatite-based liner and MTA performed significantly better in terms of antibacterial activity than the other materials. PMID:22666827

  5. Non carious cervical lesions. A review.

    PubMed

    Ceruti, P; Menicucci, G; Mariani, G D; Pittoni, D; Gassino, G

    2006-01-01

    Non-carious cervical lesions (NCCL) are characterized by a loss of hard dental tissue near the cement-enamel-junction. Commonly, their shape is like a wedge with the apex pointing inwards. Other times, they appear as regular depressions, like a dome or a cup. Their main characteristic is the presence of hard-mineralized tissue. According to the literature, the prevalence of cervical lesions is 85%, while their incidence is about 18% among permanent teeth. NCCL are currently classified as erosion, abrasion, or abfraction. Their etiology seems to be related to different factors: hexogen and endogen acids, mechanical abrasive action, tooth flexion under axial and non-axial loads. Moreover, it seems that a fundamental role is ascribable to tooth bending phenomena due to the strength components parallel or oblique to the occlusal level, which occur during the normal function as well as during parafunctions. The frequent therapeutic failures are probably due to the same factors causing the onset of the original lesion. Several materials have been proposed to restore NCCL: amalgam (abandoned), glass-ionomer cements, compomers, and composite resins. Early failures of these restorations have often been reported in the literature, probably due to the same factors which originally caused the lesions. Further investigations are required to determine more reliable restorative therapies.

  6. Prevalence of carious and non-carious cervical lesions in archaeological populations from North America and Europe.

    PubMed

    Ritter, André V; Grippo, John O; Coleman, Thomas A; Morgan, Michèle E

    2009-01-01

    The purpose of this study was to report the prevalence of carious and non-carious cervical lesions in the teeth of five archaeological populations. A secondary purpose was to report the association between age, gender, diet, tooth wear, carious cervical lesions, and non-carious cervical lesions. One hundred and four archaeological specimens from subjects originating from five distinct geographical areas were examined to detect the presence of carious cervical lesions, non-carious cervical lesions, and tooth wear. Data were tabulated and statistics used to describe prevalence and non-causal associations. Carious cervical lesions were prevalent in all populations except among Labradoreans, while non-carious cervical lesions were found predominantly in Mexicans. The authors found no association between non-carious cervical lesions and age, gender, and diet in any of the populations. Tooth wear was noted in all populations, but the highest rates of severe wear were noted among the Labradoreans and New Mexicans. Age was associated with tooth wear in all populations except Ohioans. There was no association between tooth wear and non-carious cervical lesions. The prevalence of carious cervical lesions among the five archaeological populations studied ranged from 0 to 65%. Non-carious cervical lesions were not prevalent among these populations, being found predominantly in Mexicans (26%). CLINICAL SIGNIFICANCE Historically, carious and non-carious cervical lesions can be found in individuals with no access to modern oral hygiene tools. The findings of this study are not conclusive, however, as the associations described are not causal. (J Esthet Restor Dent 21:324-335, 2009).

  7. Remineralization of initial enamel carious lesions using fluoridated milk in vitro.

    PubMed

    Ongtenco, Kristine L; Anthonappa, Robert P; Itthagarun, Anut; King, Nigel M; Lalloo, Ratilal; Nair, Raj G

    2014-11-01

    Milk is a universal dietary component and it is now recognized as an effective medium for the delivery of fluoride (F). This study sought (i) to evaluate fluoridated milk (2.5 ppm, 5 ppm, 10 ppm) for remineralizing carious lesions and (ii) to determine the optimum frequency for treating carious lesions with fluoridated milk. Artificial carious lesions, 90-180 μm deep, were created on extracted third molar teeth that were sectioned to produce specimens of 100-120 μm thickness. Specimens were randomly divided into 13 groups (n = 20) for treatment with deionized water, plain milk or fluoridated milk (2.5 ppm, 5 ppm, 10 ppm); once daily, twice daily or on alternate days as part of a 20-day pH cycling model. Lesion depth (LD) and mineral content were evaluated before and after pH cycling. Paired t-test, ANOVA and Student-Newman-Keuls tests were employed to make comparisons within and between the different groups. Fluoridated milk significantly reduced LD and increased the mineral content of the lesions compared to plain milk and deionized water (p < 0.05). The greatest reduction in LD was with 2.5 ppm F milk used twice daily (p < 0.05). Milk with 2.5 ppm F used twice daily demonstrated the greatest remineralization of artificial enamel carious lesions in vitro.

  8. Tooth brushing frequency and risk of new carious lesions.

    PubMed

    Holmes, Richard D

    2016-12-01

    Data sourcesMedline, Embase, CINHAL and the Cochrane databases.Study selectionTwo reviewers selected studies, and case-control, prospective cohort, retrospective cohort and experimental trials evaluating the effect of toothbrushing frequency on the incidence or increment of new carious lesions were considered.Data extraction and synthesisTwo reviewers undertook data abstraction independently using pre-piloted forms. Study quality was assessed using a quality assessment tool for quantitative studies developed by the Effective Public Health Practice Project (EPHPP). Meta-analysis of caries outcomes was carried out using RefMan and meta-regressions undertaken to assess the influence of sample size, follow-up period, caries diagnosis level and study methodological quality.ResultsThirty-three studies were included of which 13 were considered to be methodologically strong, 14 moderate and six weak. Twenty-five studies contributed to the quantitative analysis. Compared with frequent brushers, self-reported infrequent brushers demonstrated a higher incidence of carious lesions, OR=1.50 (95%CI: 1.34 -1.69). The odds of having carious lesions differed little when subgroup analysis was conducted to compare the incidence between ≥2 times/d vs <2 times/d; OR=1.45; (95%CI; 1.21 - 1.74) and ≥1 time/d vs <1 time/d brushers OR=1.56; (95%CI; 1.37 - 1.78). Brushing <2 times/day significantly caused an increment of carious lesions compared with ≥2/day brushing, standardised mean difference [SMD] =0.34; (95%CI; 0.18 - 0.49). Overall, infrequent brushing was associated with an increment of carious lesions, SMD= 0.28; (95%CI; 0.13 - 0.44). Meta-analysis conducted with the type of dentition as subgroups found the effect of infrequent brushing on incidence and increment of carious lesions was higher in deciduous, OR=1.75; (95%CI; 1.49 - 2.06) than permanent dentition OR=1.39; (95% CI: 1.29 -1.49). Meta-regression indicated that none of the included variables influenced the effect

  9. DISTRIBUTION OF CARIOUS AND NON-CARIOUS CERVICAL LESIONS AND GINGIVAL RECESSION AT AGE RELATED ASPECTS.

    PubMed

    Mamaladze, M; Khutsishvili, L; Zarkua, E

    2016-07-01

    The current study aims at differentiating carious and/or non-carious diseases developed in Class 5 region and detecting the distribution rate at the age aspects. The study was conducted at the Dental Clinicand Educational-Research Center "Unident" LTD and Dental Clinic "Dens". 256 patients were involved in the study. All patients underwent a routine dental examination, while rentgenovisiography and CT were performed in case of need. For gathering the detailed medical history and integrated study of Class 5 defects, a special questionnaire/survey, providing detailed information on each patient, was developed. The conducted study revealed the following: The patients were divided into 3 age groups: 16-30 of ages (77 patients, I study group), 30-50 of ages (97 patients, II study group) and 50-70 of ages (82, III study group), respectively. In total 5802 teeth were examined. The subject of our interest was identification of intact and damaged teeth (affected with caries and non-carious diseases) in the above-mentioned contingent. It was found that carious disease of cervical zone of tooth (Class 5) most often was revealed in 30-50 age group (202 cases), which is 1.8-fold higher than the same index in the I study group (144) and 1.4-fold higher in the III study group (183), respectively; The highest rate of non-carious lesions (erosion, abrasion, abfraction) of dental neck was recorded in examined 50-70 age group (294 cases), which was 4.6 -fold higher than in the I study group (64) and 2.1 -fold higher in II study group (140), respectively; The lowest incidence of gingival recession was in the I study group (65 cases), which is 6.3 -fold lower than in the II study group (412) and 7.5-fold lower than - the III group (493).

  10. Morphological analysis and chemical content of natural dentin carious lesion zones.

    PubMed

    Arnold, W H; Konopka, S; Kriwalsky, M S; Gaengler, P

    2003-10-01

    Dentin is one of the earliest bio-mineralization products to appear in the evolution of vertebrates. Dentin reactions to infection mimic earlier phylogenetic patterns, and carious lesions are divided into different zones which reflect the natural patho-morphological reaction of dentin to the carious attack. It was the aim of this study to investigate deep dentin carious lesions of human molars with combined polarization light microscopy, scanning electron microscopy and energy dispersive X-ray element analysis (EDX) for the determination of different zones of the carious lesions, their extent and the chemical content. Sixteen extracted teeth with deep dentin carious lesions were embedded in Technovit 9100 (Kulzer) and serial sections of 80 microm thickness were made. These sections were then examined with polarized light microscopy to identify the different zones of the lesions. The outlines of the zones were traced consecutively and 3D-reconstructions were made for the determination of the extent and calculation of the volumes of the different zones. From the volumes of the demineralizing dentin and the translucent zone a Dentin Demineralization Index (DDI) was calculated. Three sections of each lesion were then coated with carbon and studied with a scanning electron microscope. 3D-reconstruction of the teeth showed the rather stable translucent zone, interrupted by remnants of dead tracts, and very different volumes of demineralizing dentin. Therefore, with increasing size of the demineralizing dentin, the DDI increased. The chemical content was measured using energy dispersive X-ray analysis (EDX) in areas of intertubular dentin. The content of Ca, P, and C was significantly different in all zones. The Ca/P ratio was significantly different between sound dentin and demineralizing dentin. From the results we conclude that the mineral content of intertubular dentin of the translucent zone and demineralizing dentin is different from that of sound dentin, and the

  11. Biomimetic Remineralization of Carious Lesions by Self-Assembling Peptide.

    PubMed

    Kind, L; Stevanovic, S; Wuttig, S; Wimberger, S; Hofer, J; Müller, B; Pieles, U

    2017-07-01

    Caries is the most common disease in the world. Great efforts have been undertaken for prevention and to identify a regenerative treatment solution for dental caries. Self-assembling β-sheet forming peptides have previously shown to form 3-dimensional fiber networks supporting tissue regeneration. In particular, the self-assembling peptide P11-4 has shown potential in the treatment and prevention of dental caries. It has previously been shown that application of monomeric P11-4 solution to early carious lesions can increase net mineral gain by forming de novo hydroxyapatite crystals. The hypothesis for the mode of action was that monomeric self-assembling peptide P11-4 diffuses into the subsurface lesion body and assembles therein into higher order fibrils, facilitating mineralization of the subsurface volume by mimicking the natural biomineralization of the tooth enamel, and it remains within the lesion body as a scaffold built-in by the newly formed hydroxyapatite. The aim of the present study was to investigate the mechanism of action of the self-assembling peptide P11-4 supporting mineralization of carious enamel. By various analytical methods, it could be shown that the self-assembling peptide P11-4 diffuses into the subsurface lesion, assembles into higher formed aggregates throughout the whole volume of the lesion, and supports nucleation of de novo hydroxyapatite nanocrystals and consequently results in increased mineral density within the subsurface carious lesion. The results showed that the application of self-assembling peptide P11-4 can facilitate the subsurface regeneration of the enamel lesion by supporting de novo mineralization in a similar mode of action as has been shown for the natural formation of dental enamel.

  12. Is the morphology and activity of the occlusal carious lesion related to the lesion progression stage?

    PubMed

    Neves, Aline Almeida; Vargas, Daniel Otero Amaral; Santos, Thais Maria Pires; Lopes, Ricardo Tadeu; Sousa, Frederico Barbosa

    2016-12-01

    To investigate the relationship between degree of dentin demineralization with both lesion activity and morphology of the occlusal carious cavity. Occlusal sites (n=138) were identified by visual examination (Nyvad's scores 0-6) in 67 extracted teeth which were scanned in a high energy micro-CT. After 3D reconstruction, each stack was resliced in the mesio-distal direction and tooth mineral density (MD) was measured along a path from enamel to the deepest part of dentin in the slice showing the most severe carious involvement. Each site was classified in "open" or "closed" (if cavitated) depending on the morphology of the surrounding enamel walls as measured using micro-CT and as active or inactive in enamel or dentin by a clinical scoring system. Lesions showing dentin cavitation presented higher demineralization degree compared to non-cavitated, or enamel cavitated lesions. Inactive lesions presented lower demineralization degree compared to active lesions, although with a low effect size. According to the morphological aspect of the carious cavity, open enamel lesions showed lower dentin demineralization degree than closed lesion environments. Active lesions showed higher dentin demineralization degree than inactive ones, while lesions showing closed cavitation resulted in higher dentin demineralization degree only for enamel lesions. Including those parameters in treatment decisions may help to improve prognosis and increase effectiveness of the caries diagnostic systems in the clinical setting. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

    NASA Astrophysics Data System (ADS)

    Morais, A. P.; Pino, A. V.; Souza, M. N.

    2016-08-01

    This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

  14. Detection of questionable occlusal carious lesions using an electrical bioimpedance method with fractional electrical model

    SciTech Connect

    Morais, A. P.; Pino, A. V.; Souza, M. N.

    2016-08-15

    This in vitro study evaluated the diagnostic performance of an alternative electric bioimpedance spectroscopy technique (BIS-STEP) detect questionable occlusal carious lesions. Six specialists carried out the visual (V), radiography (R), and combined (VR) exams of 57 sound or non-cavitated occlusal carious lesion teeth classifying the occlusal surfaces in sound surface (H), enamel caries (EC), and dentinal caries (DC). Measurements were based on the current response to a step voltage excitation (BIS-STEP). A fractional electrical model was used to predict the current response in the time domain and to estimate the model parameters: Rs and Rp (resistive parameters), and C and α (fractional parameters). Histological analysis showed caries prevalence of 33.3% being 15.8% hidden caries. Combined examination obtained the best traditional diagnostic results with specificity = 59.0%, sensitivity = 70.9%, and accuracy = 60.8%. There were statistically significant differences in bioimpedance parameters between the H and EC groups (p = 0.016) and between the H and DC groups (Rs, p = 0.006; Rp, p = 0.022, and α, p = 0.041). Using a suitable threshold for the Rs, we obtained specificity = 60.7%, sensitivity = 77.9%, accuracy = 73.2%, and 100% of detection for deep lesions. It can be concluded that BIS-STEP method could be an important tool to improve the detection and management of occlusal non-cavitated primary caries and pigmented sites.

  15. Effects of Remineralization Agents on Artificial Carious Lesions.

    PubMed

    Savas, Selcuk; Kucukyilmaz, Ebru; Celik, Esra Uzer

    2016-11-15

    The purpose of this study was to evaluate the remineralization potentials of different agents on demineralized enamel surfaces. Four hundred and sixty extracted human molars with artificial carious lesions were divided into six groups: (1) control; (2) acidulated phosphate fluoride (APF); (3) Curodont Repair (CR); (4) silver diamine fluoride (SDF); (5) ammonium hexafluorosilicate (SiF); and (6) SiF plus cetylpiridinium chloride (SiF+CPC). They were subdivided according to immersion periods (seven out of 30 days). After demineralization and remineralization procedures, microhardness test (VHN), energy-dispersive X-ray spectroscopy analysis, and confocal laser scanning microscopy evaluation were performed. The data were statistically analyzed. By the 30-day remineralization, the mean differences in VHN values were ranked as follows, in order: (1) CR; (2) APF; (3) SiF; (4) SiF+CPC; (5) SDF; and (6) control (P<0.05). The calcium (Ca) content and calcium/phosphate ratio for all groups were significantly higher after 30 days (P<0.05). The greatest lesion depth changes were observed in the CR, APF, SiF, and SDF groups (P<0.05), while the greatest fluorescence changes were observed in the APF, SiF, and CR groups (P<0.05). The remineralization was most successful in the CR, APF, and SiF groups, with higher values than for those of the other treatments.

  16. Role of Brushing and Occlusal Forces in Non-Carious Cervical Lesions (NCCL).

    PubMed

    Sadaf, Durre; Ahmad, Zubair

    2014-12-01

    To assess the association of occlusal forces and brushing with non-carious cervical lesions (NCCL). It was a Cross-sectional study. The study was conducted in Dental clinics, Department of Surgery, The Aga Khan University Hospital Karachi. The study duration was from 1(st) January 2009 to 28(th) Feb 2009. Ninety patients visiting dental clinic were examined clinically. Presence of Non- carious cervical lesions, broken restorations, fractured cusps, presence of occlusal facets, brushing habits, Para functional habits were assessed. All the relevant information and clinical examination were collected on a structured Performa and was analyzed using SPSS version 14.0. . Chi square χ(2) test was applied to assess association among different categorical variables. Twenty three (26%) females and 67 (74%) males were included in the study. Thirty five of them (38.9%) were found to have Non-carious cervical lesions. Presence of NCCL has no association with gender (P value 0.458). A significant association was found between NCCL and teeth sensitivity (P value 0.002).The association between use of hard tooth brush and Non-carious cervical lesions was found significant (P value <0.001). However the association among Non-carious cervical lesions and fractured cups, broken restoration, teeth grinding, jaw clenching, pan chalia chewing and frequency of teeth brushing were insignificant. Hard tooth brushing and teeth sensitivity have significant association with Non-carious cervical lesions. The role of occlusal wear in the formation of NCCL is not significant.

  17. Imaging resin infiltration into non-cavitated carious lesions by optical coherence tomography.

    PubMed

    Schneider, Hartmut; Park, Kyung-Jin; Rueger, Claudia; Ziebolz, Dirk; Krause, Felix; Haak, Rainer

    2017-05-01

    Visualisation of the etching process and resin penetration at white spot carious lesions by spectral domain optical coherence tomography (SD-OCT). The non-cavitated carious lesions (ICDAS code 2) of four visually preselected extracted human molars and premolars were verified as enamel lesions by micro computed tomography (μCT). One region of interest (ROI) per tooth was marked by two drill-holes in occlusal-cervical direction. The lesions were imaged by SD-OCT. Lesions were infiltrated (Icon, DMG) according to the manufacturer's instructions. During each treatment step and after light curing of the infiltrant, the ROIs were imaged again by SD-OCT. Teeth were sectioned through the ROIs and section layers were imaged by scanning electron microscopy in order to compare with the OCT images. The image sequences for etching and infiltration were viewed in time lapse. During the etching process, numerous bubbles formed on the lesion surface. Using OCT, the process of resin penetration into the carious lesion body became visible. The early enamel carious lesion was completely infiltrated by the resin whereas infiltration of the advanced enamel carious lesion was incomplete and inhomogeneous. Resin infiltration can be increased by optimizing the etching process. Optical coherence tomography provides information about the process and degree of resin infiltration. Active acid application before resin infiltration is recommendable. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Antimicrobial effect of photodynamic therapy in carious lesions in vivo, using culture and real-time PCR methods.

    PubMed

    Araújo, Patricia Valente; Correia-Silva, Jeane de Fátima; Gomez, Ricardo Santiago; Massara, Maria de Lourdes de Andrade; Cortes, Maria Esperanza; Poletto, Luiz Thadeu de Abreu

    2015-09-01

    The aim of this study was to evaluate the antimicrobial effect of photodynamic therapy (PDT) in carious lesions in vivo by culture and real-time PCR methods. Ten teeth with deep active carious lesions were selected and five portions of carious dentin were removed for each tooth. Two increments were used as control, to represent the superficial and deep dentin, respectively. Methylene blue at 100mg/L was placed in contact with the cavity for 5min, before being irradiated with a halogen light source for 1min. Then, after PDT, other three portions were removed. The samples were processed in laboratory and the number of viable cfu was obtained. The real-time PCR analyses were performed in two increments of carious dentin, removed before and after PDT. The Streptococcus mutans DNA was isolated from carious dentin samples and amplification and detection of DNA were performed with real-time PCR. The cavities were then restored with glass-ionomer cement. Using conventional culture methods, the results demonstrated that viable bacteria were significantly reduced in all of the agar plates following photosensitization. No difference was found between both groups regarding S. mutans DNA quantification by real-time PCR. Although PDT may not affect the number of S. mutans DNA copies immediately after the treatment, clear reduction of the number of cfu was found. Despite its promising use for eliminating bacteria in dental caries treatment, further studies are necessary to establish an effective clinical protocol for the PDT. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. The isolation of Actinomyces naeslundii from sound root surfaces and root carious lesions.

    PubMed

    Brailsford, S R; Lynch, E; Beighton, D

    1998-01-01

    The isolation of Actinomyces naeslundii from sound, exposed root surfaces (n = 56) and soft and leathery root carious lesions (n = 71) was investigated. Root carious lesions were sampled after the removal of overlying plaque. Supragingival plaque or carious dentine was sampled using a sterile excavator, the samples were disaggregated and cultured on both selective and non-selective media. A. naeslundii isolates were identified to the genospecies using specific antisera. Significantly greater numbers and proportions of A. naeslundii genospecies 2 than A. naeslundii genospecies 1 were isolated from all sites sampled. There was no significant difference between the numbers and proportions of the two genospecies isolated from leathery and soft lesions. The relationship between the presence of A. naeslundii genospecies and aciduric and acidogenic organisms was investigated. Those sound exposed root surfaces from which A. naeslundii genospecies 1 and/or 2 were isolated yielded significantly lower numbers of lactobacilli and yeasts than the surfaces from which A. naeslundii were not isolated. This difference was also found in leathery lesions but not soft root carious lesions. The microflora of soft root carious lesions was found to comprise primarily gram-positive pleomorphic rods which formed 70+/-7.8% of the flora, while in plaque from exposed root surfaces and in infected dentine from leathery lesions the gram-positive pleomorphic rods represented only 35% of the flora.

  20. An in vitro comparison of detection methods for approximal carious lesions in primary molars.

    PubMed

    Chawla, N; Messer, L B; Adams, G G; Manton, D J

    2012-01-01

    This study aimed to compare and contrast in vitro six methods to determine the most accurate method for detecting approximal carious lesions in primary molars. Extracted primary molars (n = 140) were stored in 0.02% chlorhexidine solution and mounted in light-cured resin in pairs. The six carious lesion detection methods used by the three examiners to assess approximal carious lesions were visual inspection, digital radiography, two transillumination lights (SDI and NSK), and two laser fluorescence instruments (CDD and DDP). Five damaged teeth were discarded. The teeth (n = 135) were sectioned, serially ground, and examined under light microscopy using Downer's histological (HST) criteria as the gold standard. Intra- and inter-examiner reliability, agreement with HST, specificity, sensitivity, receiver operating characteristic (ROC) curves, and areas under the curve were calculated. This study found visual inspection to be the most accurate method when validated by histology. Transillumination with NSK light had the highest specificity, and digital radiography had the highest sensitivity for detecting enamel and/or dentinal carious lesions. Combining specificity and sensitivity into the area under ROC curves, enamel plus dentinal lesions were detected most accurately by visual inspection followed by digital radiography; dentinal lesions were detected most accurately by digital radiography followed by visual inspection. None of the four newly developed methods can be recommended as suitable replacements for visual inspection and digital radiography in detecting carious lesions on approximal surfaces of primary molars, and further developmental work is needed. Copyright © 2012 S. Karger AG, Basel.

  1. Validity of MicroCT for in vitro detection of proximal carious lesions in primary molars.

    PubMed

    Soviero, V M; Leal, S C; Silva, R C; Azevedo, R B

    2012-01-01

    This study aimed to validate the MicroCT for detection of proximal carious lesions in primary molars, using histology as the gold standard. Forty-eight proximal surfaces of primary molars were examined. Two calibrated examiners conducted the examinations independently. Proximal surfaces were visually scored, using ICDAS. Bitewing radiographs, Micro-CT and histological analyses used caries scores: 0=sound; 1=outer enamel; 2=inner enamel; 3=not spread dentine; 4=outer dentine; 5=inner dentine. Axial and sagital images were used for Micro-CT analysis, whilst for histology, tooth sections (400μm) were analyzed stereomicroscopically (×15). Inter-examiner agreement ranged from 0.87 to 0.93 kappa coefficient (k). Histological analysis revealed a frequency of sound tooth surfaces (18.8%) enamel carious lesions (E1) (48%) and dentine carious lesions (D1) (33.3%). MicroCT showed high correlation with histology (r(s)0.88). At both diagnostic thresholds (E1 and D1), sensitivity and accuracy were higher for MicroCT. Inter-device agreement between MicroCT and histology was k=0.81. No difference was found between MicroCT and histology as gold standards for detecting carious lesions using ICDAS. MicroCT can be used as a gold standard for detecting carious lesions in proximal surfaces in primary molars. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. GLASS IONOMER CEMENTS AND THEIR ROLE IN THE RESTORATION OF NON-CARIOUS CERVICAL LESIONS

    PubMed Central

    Francisconi, Luciana Fávaro; Scaffa, Polliana Mendes Candia; de Barros, Vivian Rosa dos Santos Paes; Coutinho, Margareth; Francisconi, Paulo Afonso Silveira

    2009-01-01

    Glass ionomer based materials are clinically popular in several areas of restorative dentistry, but restoration of cervical lesions has proven particularly successful. Various etiologies, conformations, locations and structural characteristics make non-carious cervical lesions more challenging to adhesive restorative procedures and marginal seal in the long run. Due to their characteristics, glass ionomer cements (GICs) have precise indication for these cases. Moreover, the use of a GIC base underneath composite resin, the so-called "sandwich" or mixed technique, allows associating the good characteristics of composite resins and GICs, and has been considered quite useful in the restoration of non-carious cervical defects. The aim of this paper is to critically review the literature and discuss peculiar features of GICs regarding their role in the restoration of non-carious cervical lesions. PMID:19936509

  3. Role of Brushing and Occlusal Forces in Non-Carious Cervical Lesions (NCCL)

    PubMed Central

    Sadaf, Durre; Ahmad, Zubair

    2014-01-01

    Objective: To assess the association of occlusal forces and brushing with non-carious cervical lesions (NCCL). Methodology: It was a Cross-sectional study. The study was conducted in Dental clinics, Department of Surgery, The Aga Khan University Hospital Karachi. The study duration was from 1st January 2009 to 28th Feb 2009. Ninety patients visiting dental clinic were examined clinically. Presence of Non- carious cervical lesions, broken restorations, fractured cusps, presence of occlusal facets, brushing habits, Para functional habits were assessed. All the relevant information and clinical examination were collected on a structured Performa and was analyzed using SPSS version 14.0. . Chi square χ2 test was applied to assess association among different categorical variables. Result: Twenty three (26%) females and 67 (74%) males were included in the study. Thirty five of them (38.9%) were found to have Non-carious cervical lesions. Presence of NCCL has no association with gender (P value 0.458). A significant association was found between NCCL and teeth sensitivity (P value 0.002).The association between use of hard tooth brush and Non-carious cervical lesions was found significant (P value <0.001). However the association among Non-carious cervical lesions and fractured cups, broken restoration, teeth grinding, jaw clenching, pan chalia chewing and frequency of teeth brushing were insignificant. Conclusion: Hard tooth brushing and teeth sensitivity have significant association with Non-carious cervical lesions. The role of occlusal wear in the formation of NCCL is not significant. PMID:25598758

  4. HPO2-4 content in enamel and artificial carious lesions.

    PubMed

    Arends, J; Davidson, C L

    1975-07-04

    The HPO2-4 and CO2-3 content was determined in sound enamel and in material collected from artificially produced carious lesions. The method described shows that the HPO2-4 content can be determined from the 875 cm(-1) infrared absorption band if correction for the CO2-3 contribution are made. The I.R. spectra show that the HPO2-4 content in sound human or bovine enamel is about 5% by weight. In artificially produced carious lesions (pH=4.0), the HPO2-4 content is in the order of 15 wt%. Most likely, the HPO2-4 ions in sound and carious enamel have a different enviroment.

  5. A randomized clinical trial on the sealing of occlusal carious lesions: 3-4-year results.

    PubMed

    Alves, Luana Severo; Giongo, Fernanda Cristina Mendes de Santa; Mua, Bruna; Martins, Vanessa Balbé; Barbachan E Silva, Berenice; Qvist, Vibeke; Maltz, Marisa

    2017-06-05

    This randomized clinical trial aimed to assess the efficacy of sealing occlusal carious lesions in permanent teeth. The sample consisted of 54 occlusal carious lesions in permanent molars and premolars of 49 patients aged 8-43 years (median: 19 years). The inclusion criteria comprised the presence of a cavity with no access allowing biofilm control. The maximum depth of the lesion was the middle third of the dentin thickness, as assessed by bitewing radiography. The teeth were randomly assigned to sealant treatment (n = 28) or restorative treatment (n = 26). Clinical and radiographic examinations were performed after 1 year and after 3-4 years. The outcomes depended on the clinical performance of the sealant/restoration and the control of caries progression observed radiographically. Survival analysis was performed to assess success rates. Over the 3-4 years of monitoring, 2 sealants were totally lost, 1 needed repair, and 1 showed caries progression, totaling 4 failures in the sealant group. In the restoration group, 1 failure was observed (in need of repair). The success rates were 76% and 94% in the sealant and the restoration groups, respectively (p > 0.05). The sealing of occlusal carious lesions in permanent teeth succeeded in controlling caries over a 3-4-year period. However, sealed carious lesions require patient compliance in attending regular follow-ups to control the occurrence of clinical failures of the sealants.

  6. Characterizing and identifying incipient carious lesions in dental enamel using micro-Raman spectroscopy.

    PubMed

    Mohanty, B; Dadlani, D; Mahoney, D; Mann, A B

    2013-01-01

    Early detection of dental caries is vital if improved patient outcomes are to be achieved by reversal of the demineralization process. Current techniques used by dentists for identifying carious lesions are effective in identifying more advanced lesions, but do not have sufficient sensitivity and specificity to detect them at the earliest stages. This study focused on characterizing the growth of incipient carious lesions in vitro using micro-Raman spectroscopy. The incipient carious lesions were grown on the buccal faces of human molars by controlled exposure to lactic acid. Lesions were cross-sectioned to expose the subsurface body of the lesion and then examined using micro-Raman spectroscopy. The intensity of the phosphate peaks in the Raman spectra was found to differ significantly between healthy enamel and the demineralized region of the lesions. The sensitivity of the phosphate peaks to the degree of demineralization was observed by taking a series of spectra over the cross section of the lesions. This revealed that the body of the lesion is highly demineralized, but in a narrow surface region (up to 10 µm) there is little demineralization. All the phosphate peaks were found to be sensitive to the degree of demineralization; however, changes in the intensity of the pronounced phosphate peak at 961 cm(-1) offer the most promise for identifying lesions. The results indicate that micro-Raman spectroscopy has both the sensitivity and selectivity to identify incipient carious lesions, but the presence of a surface layer with a relatively high mineral content could complicate the analysis.

  7. [Prevalence of non carious dental lesions in the department of Dakar].

    PubMed

    Kane, A W; Faye, B; Touré, B; Sarr, M; Lo, Ch Mb; Bâ, D A

    2004-12-01

    Non carious dental lesions are destructions of dental external surfaces originating from non bacterial cause in opposition to dental caries. We distinguish 5 types of non carious dental lesions: attrition, abrasion, abfraction, erosion and demastication. These lesions may be pathological or physiological. Data dealing with them are not very numerous in the literature. Their study shows a real interest in conservative dentistry because of problems both aesthetic and functional they set We carried out an epidemiological trial in the department of Dakar with as aim providing data on the prevalence of these lesions. Our results have disclosed the following rates of prevalence: 60% of attrition, 25,55% of abrasion, 7,22% of abfraction, 5,55% of demastication and 1,68% of erosion. The results indicate once more the importance of the need for clinical evaluation of those dental lesions.

  8. A system for simultaneous near-infrared reflectance and transillumination imaging of occlusal carious lesions

    PubMed Central

    Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2016-01-01

    Clinicians need technologies to improve the diagnosis of questionable occlusal carious lesions (QOC’s) and determine if decay has penetrated to the underlying dentin. Assessing lesion depth from near-infrared (NIR) images holds great potential due to the high transparency of enamel and stain to NIR light at λ=1300–1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. Unfortunately, NIR reflectance measurements alone are limited in utility for approximating occlusal lesion depth >200-μm due to light attenuation from the lesion body. Previous studies sought to combine NIR reflectance and transillumination measurements taken at λ=1300-nm in order to estimate QOC depth and severity. The objective of this study was to quantify the change in lesion contrast and size measured from multispectral NIR reflectance and transillumination images of natural occlusal carious lesions with increasing lesion depth and severity in order to determine the optimal multimodal wavelength combinations for estimating QOC depth. Extracted teeth with varying amounts of natural occlusal decay were measured using a multispectral-multimodal NIR imaging system at prominent wavelengths within the λ=1300–1700-nm spectral region. Image analysis software was used to calculate lesion contrast and area values between sound and carious enamel regions. PMID:27006524

  9. A system for simultaneous near-infrared reflectance and transillumination imaging of occlusal carious lesions.

    PubMed

    Simon, Jacob C; Darling, Cynthia L; Fried, Daniel

    2016-02-13

    Clinicians need technologies to improve the diagnosis of questionable occlusal carious lesions (QOC's) and determine if decay has penetrated to the underlying dentin. Assessing lesion depth from near-infrared (NIR) images holds great potential due to the high transparency of enamel and stain to NIR light at λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. Unfortunately, NIR reflectance measurements alone are limited in utility for approximating occlusal lesion depth >200-μm due to light attenuation from the lesion body. Previous studies sought to combine NIR reflectance and transillumination measurements taken at λ=1300-nm in order to estimate QOC depth and severity. The objective of this study was to quantify the change in lesion contrast and size measured from multispectral NIR reflectance and transillumination images of natural occlusal carious lesions with increasing lesion depth and severity in order to determine the optimal multimodal wavelength combinations for estimating QOC depth. Extracted teeth with varying amounts of natural occlusal decay were measured using a multispectral-multimodal NIR imaging system at prominent wavelengths within the λ=1300-1700-nm spectral region. Image analysis software was used to calculate lesion contrast and area values between sound and carious enamel regions.

  10. A system for simultaneous near-infrared reflectance and transillumination imaging of occlusal carious lesions

    NASA Astrophysics Data System (ADS)

    Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2016-02-01

    Clinicians need technologies to improve the diagnosis of questionable occlusal carious lesions (QOC's) and determine if decay has penetrated to the underlying dentin. Assessing lesion depth from near-infrared (NIR) images holds great potential due to the high transparency of enamel and stain to NIR light at λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. Unfortunately, NIR reflectance measurements alone are limited in utility for approximating occlusal lesion depth >200-μm due to light attenuation from the lesion body. Previous studies sought to combine NIR reflectance and transillumination measurements taken at λ=1300-nm in order to estimate QOC depth and severity. The objective of this study was to quantify the change in lesion contrast and size measured from multispectral NIR reflectance and transillumination images of natural occlusal carious lesions with increasing lesion depth and severity in order to determine the optimal multimodal wavelength combinations for estimating QOC depth. Extracted teeth with varying amounts of natural occlusal decay were measured using a multispectral-multimodal NIR imaging system at prominent wavelengths within the λ=1300-1700-nm spectral region. Image analysis software was used to calculate lesion contrast and area values between sound and carious enamel regions.

  11. Effect of Preventive Oral Hygiene Measures on the Development of New Carious lesions.

    PubMed

    Ashkenazi, Malka; Bidoosi, Mervat; Levin, Liran

    2014-01-01

    To evaluate the effect of preventive oral hygiene measures on the development of new carious lesions. Children regularly and irregularly attending recall appointments in a paediatric dental clinic were interviewed regarding their preventive measures performance. Newly developed carious lesions were also recorded. The files of 651 children were analysed. A significant negative correlation was found between newly developed carious lesions and total number (P < 0.001) and frequency (interval in months to the next dental examination) of recall appointments (P = 0.021), regular toothbrushing twice a day (P < 0.0001), regular brushing in the evening (P < 0.001), high fluoride concentration in toothpaste (P < 0.0001) and drinking water between meals (P = 0.015), but not with regular brushing in the morning or eating more than 6 times a day. Multivariate analysis revealed three of the variables independently correlated with the development of new carious lesions: brushing regularly twice a day, concentration of fluoride in the toothpaste greater than 1100 ppm and frequency of follow-ups. Regular toothbrushing twice a day is of high importance for caries prevention. Fluoride concentration of > 1100 ppm in toothpaste should be recommended for children (considering the child's age) in order to maximise the fluoride protective effect. The importance of attending periodic recall appointments in order to maintain long term oral health should be emphasised.

  12. Periodontal and Restorative Treatment of Gingival Recession Associated with Non-Carious Cervical Lesions: Case Study.

    PubMed

    Pereira, Analice Giovani; Teixeira, Daniela Navarro Ribeiro; Soares, Michelle Pereira Costa Mundim; Gonzaga, Ramon Corrêa de Queiroz; Fernandes-Neto, Alfredo Júlio; Soares, Paulo Vinícius

    2016-01-14

    The association between the presence of gingival recession and non-carious cervical lesions is a common finding in dentistry. These diseases have multifactorial etiology and the treatment should be multidisciplinary. Although traditionally the majority of professionals treat non-carious cervical lesions only with conventional restorative procedures, in most cases a combination of periodontal and restorative treatments provides the best functional and esthetic results. Thus, the objective of this case report was to present a new option for treatment, which consists of a subepithelial connective tissue graft associated with a coronally advanced flap placed on dentin and non-carious cervical lesions restored with lithium disilicate partial veneers. A patient complaining about the esthetic aspects of her teeth and cervical dentin hypersensitivity was submitted to occlusal adjustments and daily diet analysis in order to manage etiologic factors. Experienced operators then performed restorative and surgical treatments. Periodontal clinical attachment level (probing depth + gingival margin), bleeding on probing, plaque index, and the integrity of the restorations were observed. During the monitoring period, the treatment was effective, with good functional and esthetic results. The hypersensitivity disappeared, and neither inflammatory characteristics in gingival tissue nor failures in restorations were noted. It might be concluded that treatment with a combination of techniques can be effective and predictable for patients with gingival recession and non-carious cervical lesions that may or may not require restorative procedures under controlled conditions. Copyright© by the International Academy of Periodontology.

  13. Approximal and occlusal carious lesions: Restorative treatment decisions by California dentists.

    PubMed

    Rechmann, Peter; Doméjean, Sophie; Rechmann, Beate M T; Kinsel, Richard; Featherstone, John D B

    2016-05-01

    Investigators use questionnaire surveys to evaluate treatment philosophies in dental practices. The aim of this study was to evaluate the management strategies California dentists use for approximal and occlusal carious lesions. In May 2013, the authors e-mailed a questionnaire that addressed approximal and occlusal carious lesion management (detection and restorative threshold, preferred preparation type, and restorative materials) to 16,960 dentists in California. The authors performed a χ(2) statistical analysis to investigate the relationship between management strategies and respondent demographic characteristics. The authors received responses from 1,922 (11.3%) dentists; 42.6% of the respondents would restore approximal lesions at the dentinoenamel junction, and 33.4% would wait until the lesion reached the outer one-third of dentin. The preferred preparation type was the traditional Class II preparation. Dentists who graduated more recently (20 years or less) were more likely to delay approximal restorations (P < .0001); 49.9% of the more recent graduates would wait to restore an occlusal lesion until the outer one-third of dentin was involved, and 42.6% would restore a lesion confined to enamel. There is wide variety among California dentists regarding their restorative treatment decisions, with most dentists restoring a tooth earlier than the literature would advise. More recent dental graduates were more likely to place their restorative threshold at deeper lesions for approximal carious lesions. Clinical evidence shows that noncavitated carious lesions can be remineralized; therefore, early restorative treatment may no longer be necessary or appropriate. Noninvasive and minimally invasive measures should be taken into consideration. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  14. Carious lesions of permanent molars and oral health practices of parents and peers in Saudi male adolescents.

    PubMed

    Bakhurji, Eman; El Tantawi, Maha M; Gaffar, Balgis O; Al-Khalifa, Khalifa S; Al-Ansari, Asim A

    2017-07-01

    To assess the association between carious lesions in first and second permanent molars in adolescents and their parents' and peers' oral health practices. Methods: This cross-sectional study of 12-15 year-old male adolescents was conducted in  Dammam, Kingdom of Saudi Arabia, on February 2016. Data collection included dental examination to measure carious lesions and plaque. There was a questionnaire to assess oral health practices such as brushing with fluoridated toothpaste, current daily tobacco use, and daily consumption of sugary food and drinks. Logistic regression models assessed the association between first and second molars carious lesions with adolescents', parents', and peers' oral health practices. Results: Of 302 students, 294 participated. The mother's brushing was significantly associated with a lower odds of carious lesions in the first molar (odds ratio [OR] = 0.17, 95% confidence interval [CI]: 0.04 - 0.77). The mothers' sugary food intake and students' own brushing were significantly associated with carious lesions in the second molar (OR = 1.95 and 0.36, 95% CI: 1.01-9.89 and 0.12-0.89). Friends' intake of sugary drinks had a strong, but non-significant, association with second molar's carious lesions (OR=3.61, 95% CI: 0.35 - 7.44). Conclusion: In Saudi society, mothers have a major influence on their adolescent sons' carious lesions. Adolescents' oral health strategies should involve parents to reduce their risk of caries.

  15. Are Carious Lesions in Previously Sealed Occlusal Surfaces Detected as well on Colour Photographs as by Visual Clinical Examination?

    PubMed

    Hu, Xuan; Fan, Mingwen; Mulder, Jan; Frencken, Jo E

    2016-01-01

    To compare the level of agreement between carious lesion assessments according to the visual clinical examination and the colour photograph methods. Data on the presence of enamel/dentin carious lesions in previously sealed occlusal surfaces in first molars were obtained by two trained and calibrated examiners through visual clinical examination and from colour photographs 4 years after sealing. Kappa statistics were applied to calculate agreement between assessment methods. Data analysis was performed using sign, Bowker symmetry and McNemar's tests. The prevalence of dentin carious lesions was very low. The kappa coefficients for detecting enamel/dentin carious lesions using the two assessment methods were 0.65 (CI: 0.56-0.74) for examiner 1 and 0.70 (CI: 0.62-0.78) for examiner 2. Examiner 2 observed more enamel/dentin carious lesions on colour photographs than did examiner 1 (p = 0.008). Sensitivity analyses did not confirm this outcome. There was no difference in the detection of enamel/dentin carious lesions in previously sealed occlusal surfaces using colour photographs vs visual clinical examination. The colour photograph method is therefore equivalent to the visual clinical examination in detecting enamel/dentin carious lesions. More studies are required.

  16. Identification of the Microbiota in Carious Dentin Lesions Using 16S rRNA Gene Sequencing

    PubMed Central

    Obata, Junko; Takeshita, Toru; Shibata, Yukie; Yamanaka, Wataru; Unemori, Masako; Akamine, Akifumi; Yamashita, Yoshihisa

    2014-01-01

    While mutans streptococci have long been assumed to be the specific pathogen responsible for human dental caries, the concept of a complex dental caries-associated microbiota has received significant attention in recent years. Molecular analyses revealed the complexity of the microbiota with the predominance of Lactobacillus and Prevotella in carious dentine lesions. However, characterization of the dentin caries-associated microbiota has not been extensively explored in different ethnicities and races. In the present study, the bacterial communities in the carious dentin of Japanese subjects were analyzed comprehensively with molecular approaches using the16S rRNA gene. Carious dentin lesion samples were collected from 32 subjects aged 4–76 years, and the 16S rRNA genes, amplified from the extracted DNA with universal primers, were sequenced with a pyrosequencer. The bacterial composition was classified into clusters I, II, and III according to the relative abundance (high, middle, low) of Lactobacillus. The bacterial composition in cluster II was composed of relatively high proportions of Olsenella and Propionibacterium or subdominated by heterogeneous genera. The bacterial communities in cluster III were characterized by the predominance of Atopobium, Prevotella, or Propionibacterium with Streptococcus or Actinomyces. Some samples in clusters II and III, mainly related to Atopobium and Propionibacterium, were novel combinations of microbiota in carious dentin lesions and may be characteristic of the Japanese population. Clone library analysis revealed that Atopobium sp. HOT-416 and P. acidifaciens were specific species associated with dentinal caries among these genera in a Japanese population. We summarized the bacterial composition of dentinal carious lesions in a Japanese population using next-generation sequencing and found typical Japanese types with Atopobium or Propionibacterium predominating. PMID:25083880

  17. Identification of the microbiota in carious dentin lesions using 16S rRNA gene sequencing.

    PubMed

    Obata, Junko; Takeshita, Toru; Shibata, Yukie; Yamanaka, Wataru; Unemori, Masako; Akamine, Akifumi; Yamashita, Yoshihisa

    2014-01-01

    While mutans streptococci have long been assumed to be the specific pathogen responsible for human dental caries, the concept of a complex dental caries-associated microbiota has received significant attention in recent years. Molecular analyses revealed the complexity of the microbiota with the predominance of Lactobacillus and Prevotella in carious dentine lesions. However, characterization of the dentin caries-associated microbiota has not been extensively explored in different ethnicities and races. In the present study, the bacterial communities in the carious dentin of Japanese subjects were analyzed comprehensively with molecular approaches using the16S rRNA gene. Carious dentin lesion samples were collected from 32 subjects aged 4-76 years, and the 16S rRNA genes, amplified from the extracted DNA with universal primers, were sequenced with a pyrosequencer. The bacterial composition was classified into clusters I, II, and III according to the relative abundance (high, middle, low) of Lactobacillus. The bacterial composition in cluster II was composed of relatively high proportions of Olsenella and Propionibacterium or subdominated by heterogeneous genera. The bacterial communities in cluster III were characterized by the predominance of Atopobium, Prevotella, or Propionibacterium with Streptococcus or Actinomyces. Some samples in clusters II and III, mainly related to Atopobium and Propionibacterium, were novel combinations of microbiota in carious dentin lesions and may be characteristic of the Japanese population. Clone library analysis revealed that Atopobium sp. HOT-416 and P. acidifaciens were specific species associated with dentinal caries among these genera in a Japanese population. We summarized the bacterial composition of dentinal carious lesions in a Japanese population using next-generation sequencing and found typical Japanese types with Atopobium or Propionibacterium predominating.

  18. Detection of early carious lesions using contrast enhancement with coherent light scattering (speckle imaging)

    NASA Astrophysics Data System (ADS)

    Deana, A. M.; Jesus, S. H. C.; Koshoji, N. H.; Bussadori, S. K.; Oliveira, M. T.

    2013-07-01

    Currently, dental caries still represent one of the chronic diseases with the highest prevalence and present in most countries. The interaction between light and teeth (absorption, scattering and fluorescence) is intrinsically connected to the constitution of the dental tissue. Decay induced mineral loss introduces a shift in the optical properties of the affected tissue; therefore, study of these properties may produce novel techniques aimed at the early diagnosis of carious lesions. Based on the optical properties of the enamel, we demonstrate the application of first-order spatial statistics in laser speckle imaging, allowing the detection of carious lesions in their early stages. A highlight of this noninvasive, non-destructive, real time and cost effective approach is that it allows a dentist to detect a lesion even in the absence of biofilm or moisture.

  19. Assessment of chemomechanical removal of carious lesions using Papacarie Duo™: randomized longitudinal clinical trial.

    PubMed

    Matsumoto, Simone Ferreira Borges; Motta, Lara Jansiski; Alfaya, Thays Almeida; Guedes, Carolina Cardoso; Fernandes, Kristianne Porta Santos; Bussadori, Sandra Kalil

    2013-01-01

    Chemomechanical removal of carious lesions consists of the dissolution of carious tissue by the application of a natural or synthetic agent, followed by atraumatic mechanical removal. The aim of the present study was to assess the effectiveness of Papacarie Duo ® gel in the chemomechanical removal of carious lesions in primary teeth in comparison to the traditional method (low-speed bur). A randomized clinical trial was conducted with 20 children between 5 and 8 years of age. Two teeth were treated in each child (split-mouth design), with the randomization of two methods: Group 1 - chemomechanical caries removal with Papacarie Duo™; and Group 2 - removal of carious dentin tissue using a low-speed bur. Both methods involved restoration with glass ionomer cement and follow up. The following aspects were evaluated: time required for the procedure; pain (face evaluation scale); retention of the restorative material in the cavity; and the presence of secondary caries after 30 days. Chi-squared test, Student's t-test, and Wilcoxon test. No statistically significant differences between methods were found regarding time required for the procedure (P = 0.13), the occurrence of pain (P = 0.585), or restoration status at the 30-day clinical evaluation (P = 0.713). The findings of the present study demonstrate that the two methods achieve similar results. The advantages of minimally invasive treatment, such as chemomechanical caries removal with Papacarie Duo™, are its ease of use, patient comfort, and the fact that it causes less damage to dental tissue.

  20. Evaluation of different methods for monitoring incipient carious lesions in smooth surfaces under fluoride varnish therapy.

    PubMed

    Ferreira, Jainara Maria Soares; Silva, Milton Fernando Andrade; Oliveira, Andressa Feitosa Bezerra; Sampaio, Fábio Correia

    2008-07-01

    There are only a few studies relating visual inspection methods and laser fluorescence when monitoring regression of incipient carious lesions. The purpose of this study was to monitor incipient carious lesions in smooth surfaces under varnish fluoride therapy using visual inspection methods and laser fluorescence (LF). Active white spot lesions (n = 111) in upper front teeth of 36 children were selected. The children were subjected to four or eight applications of fluoride varnish in weekly intervals. The visual systems were activity (A) and maximum dimension in millimetres (D). They were applied together with LF readings (L) in the beginning of the study (W1), in the 5th week (W5), and in the 9th (W9) week. The mean (SD) of L values in W5 and W9 were 5.6 (3.8) and 4.5 (3.3), respectively; both were significantly different from the initial score of 7.4 (5.1) in W1. There was a positive correlation between D and L in W5 (r = 0.25) and W9 (r = 0.36; P < 0.05). The mean (SD) values of L were lower following the activity criteria. Our findings support the finding that incipient carious lesions in smooth surfaces under fluoride therapy can be monitored by laser fluorescence and visual inspection methods.

  1. Effects of enamel matrix derivative on remineralisation of initial enamel carious lesions in vitro.

    PubMed

    Xiang, Chenyang; Ran, Jinmei; Yang, Qingqing; Li, Wei; Zhou, Xuedong; Zhang, Linglin

    2013-04-01

    The purpose of this study was to investigate the effect of enamel matrix derivative on remineralisation of initial enamel carious lesions in vitro. Initial enamel carious lesions were created in bovine enamel blocks in vitro. The lesions were subjected to a pH-cycling regime of 24days. Each daily cycle included 4×3-min applications with one of four treatments: 1g/L NaF aqueous solution (positive control), 6% propylene glycol alginate (PGA) or distilled and deionised water (DDW) (both negative controls), and a gel of enamel matrix derivative and PGA (EMDgel). Samples were subjected to surface microhardness (SMH) testing, polarised light microscopy (PLM) and transverse microradiography (TMR) to measure SMH, mineral loss, lesion depth and mineral content of the surface layer and lesion body before and after pH-cycling. NaF samples showed the highest SMH recovery of all the groups (P<0.05). EMDgel samples showed significantly higher SMH recovery than did PGA ones (P<0.05). NaF samples showed significantly less mineral loss and shallower lesions than all other groups (P<0.05). The DDW and EMDgel samples showed significantly less mineral loss and shallower lesions than PGA samples. Mineral deposition predominated much more at the surface layer in the EMDgel group than in the PGA group (P<0.05). EMD, the active ingredient of EMDgel, may play an essential role in promoting remineralisation of initial enamel carious lesions. However, EMDgel as a whole did not cause detectable remineralisation of such lesions in vitro. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. A combined approach to non-carious cervical lesions associated with gingival recession

    PubMed Central

    Lee, HyeJin; Jin, Sung-Ho

    2016-01-01

    Non-carious cervical lesions (NCCLs) with gingival recession require specific consideration on both aspects of hard and soft tissue lesion. In the restorative aspect, careful finishing and polishing of the restorations prior to mucogingival surgery is the critical factor contributing to success. Regarding surgery, assessment of the configuration of the lesion and the choice of surgical technique are important factors. The precise diagnosis and the choice of the proper treatment procedure should be made on the basis of both restorative and surgical considerations to ensure the successful treatment of NCCLs. PMID:27508164

  3. Comparative efficacy of photo-activated disinfection and calcium hydroxide for disinfection of remaining carious dentin in deep cavities: a clinical study

    PubMed Central

    Sharma, Sidhartha; Shah, Naseem

    2014-01-01

    Objectives To comparatively evaluate the efficacy of photo-activated disinfection (PAD), calcium hydroxide (CH) and their combination on the treatment outcome of indirect pulp treatment (IPT). Materials and Methods Institutional ethical clearance and informed consent of the patients were taken. The study was also registered with clinical registry of India. Sixty permanent molars exhibiting deep occlusal carious lesion in patients with the age range of 18 - 22 yr were included. Clinical and radiographic evaluation and set inclusion and exclusion criteria's were followed. Gross caries excavation was accomplished. In group I (n = 20) PAD was applied for sixty seconds. In group II (n = 20), CH was applied to the remaining carious dentin, while in group III (n = 20), PAD application was followed by CH placement. The teeth were permanently restored. They were clinically and radiographically followed-up at 45 day, 6 mon and 12 mon. Relative density of the remaining affected dentin was measured by 'Radiovisiography (RVG) densitometric' analysis. Results Successful outcome with an increase in radiographic grey values were observed in all three groups. However, on inter-group comparison, this change was not significant (p > 0.05). Conclusions PAD and CH both have equal disinfection efficacy in the treatment of deep carious dentin. PAD alone is as effective for treatment of deep carious lesion as calcium hydroxide and hence can be used as an alternative to CH. They can be used independently in IPT, since combining both does not offer any additional therapeutic benefits. PMID:25110643

  4. Comparative efficacy of photo-activated disinfection and calcium hydroxide for disinfection of remaining carious dentin in deep cavities: a clinical study.

    PubMed

    Sharma, Sidhartha; Logani, Ajay; Shah, Naseem

    2014-08-01

    To comparatively evaluate the efficacy of photo-activated disinfection (PAD), calcium hydroxide (CH) and their combination on the treatment outcome of indirect pulp treatment (IPT). Institutional ethical clearance and informed consent of the patients were taken. The study was also registered with clinical registry of India. Sixty permanent molars exhibiting deep occlusal carious lesion in patients with the age range of 18 - 22 yr were included. Clinical and radiographic evaluation and set inclusion and exclusion criteria's were followed. Gross caries excavation was accomplished. In group I (n = 20) PAD was applied for sixty seconds. In group II (n = 20), CH was applied to the remaining carious dentin, while in group III (n = 20), PAD application was followed by CH placement. The teeth were permanently restored. They were clinically and radiographically followed-up at 45 day, 6 mon and 12 mon. Relative density of the remaining affected dentin was measured by 'Radiovisiography (RVG) densitometric' analysis. Successful outcome with an increase in radiographic grey values were observed in all three groups. However, on inter-group comparison, this change was not significant (p > 0.05). PAD and CH both have equal disinfection efficacy in the treatment of deep carious dentin. PAD alone is as effective for treatment of deep carious lesion as calcium hydroxide and hence can be used as an alternative to CH. They can be used independently in IPT, since combining both does not offer any additional therapeutic benefits.

  5. Resin penetration in artificial enamel carious lesions after using sodium hypochlorite as a deproteinization agent.

    PubMed

    Gómez, Ss; Bravo, P; Morales, R; Romero, A; Oyarzún, A

    2014-01-01

    To study the degree of penetration of an adhesive resin in artificial enamel carious lesions after using sodium hypochlorite as deproteinization agent. Twenty included human third-molars, extracted for surgical indication, were used. Artificial lesions were created in the buccal and lingual sides of each specimen through a cycle of demineralization-remineralization. Samples were then incubated in human saliva for 7 days at 37 ° C. After surface cleaning, lesions and the peripheral sound enamel were etched with 37% orthophosphoric acid for 20 seconds. One lesion of each specimen was treated with 5.25% sodium hypochlorite (NaOCl) for one minute. The other lesion of each specimen was used as a control. Experimental and control lesions were sealed with a fluid resin marked with Rhodamine B. Lesions were sectioned for microscopic observation by epifluorescence and polarized light. The images obtained were analyzed morphometrically. The micrometer measurements were made with ImageJ ® software. The level of significance was assessed at p<0.05. The average sealant depth penetration in the control group was 94.9 ± 28.6 μm versus 122.8 ± 25.3 μm in the experimental group. This represents Δ 20.1% significantly greater penetration when using sodium hypochlorite (p<0.001). The results demonstrated a significant penetration of the sealing resin when the conventional technique is complemented with the application of 5.25% sodium hypochlorite for one minute in artificial enamel carious lesions.

  6. Thermophotonic lock-in imaging of early demineralized and carious lesions in human teeth

    NASA Astrophysics Data System (ADS)

    Tabatabaei, Nima; Mandelis, Andreas; Amaechi, Bennett Tochukwu

    2011-07-01

    As an extension of frequency-domain photothermal radiometry, a novel dental-imaging modality, thermophotonic lock-in imaging (TPLI), is introduced. This methodology uses photothermal wave principles and is capable of detecting early carious lesions and cracks on occlusal and approximal surfaces as well as early caries induced by artificial demineralizing solutions. The increased light scattering and absorption within early carious lesions increases the thermal-wave amplitude and shifts the thermal-wave centroid, producing contrast between the carious lesion and the intact enamel in both amplitude and phase images. Samples with artificial and natural occlusal and approximal caries were examined in this study. Thermophotonic effective detection depth is controlled by the modulation frequency according to the well-known concept of thermal diffusion length. TPLI phase images are emissivity normalized and therefore insensitive to the presence of stains. Amplitude images, on the other hand, provide integrated information from deeper enamel regions. It is concluded that the results of our noninvasive, noncontacting imaging methodology exhibit higher sensitivity to very early demineralization than dental radiographs and are in agreement with the destructive transverse microradiography mineral density profiles.

  7. Detection of Occlusal Carious Lesion using the SoproLife(®) Camera: A Systematic Review.

    PubMed

    Doméjean, Sophie; Rongier, Julie; Muller-Bolla, Michéle

    2016-09-01

    The aim of this systematic review was to assess the in vivo scientific evidence regarding the ability of a recently developed light fluorescence device, SoproLife(®) (Sopro-Acteon group, La Ciotat, France) in detecting occlusal carious lesions. The PubMed database was searched for in vivo trials that evaluated the validity of the SoproLife(®) camera for the detection of occlusal carious lesions. Among the 11 articles originally identified with the keyword "Soprolife," only three articles were included. The three included surveys used the International Caries Detection and Assessment System (ICDAS)-II criteria as gold standard for the assessment of SoproLife(®) compared or not to other detection devices (DIAGNOdent(®) and Spectra Caries Detection Aid(®)). Two of the included studies reported only on permanent teeth or both primary and permanent teeth. The SoproLife(®) validity values varied markedly among studies with a sensitivity ranging between 0.43 and 0.95 and a specificity between 0.55 and 1. Interobserver reproducibility with the SoproLife(®) was reported in two of the three studies (0.98 and 0.72) and none of the studies reported about intraobserver reproducibility. No clear-cut conclusion can be made based on the three included clinical studies; further in vivo investigations are needed to confirm the validity of the SoproLife(®) camera in terms of detection of occlusal carious lesions.

  8. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions.

    PubMed

    Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A

    2014-01-01

    Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Dental plaque from children (N=20; aged 3-6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10-20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1-6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric potential of these strains may influence susceptibility in the

  9. Children with severe early childhood caries: streptococci genetic strains within carious and white spot lesions

    PubMed Central

    Gilbert, Kenneth; Joseph, Raphael; Vo, Alex; Patel, Trusha; Chaudhry, Samiya; Nguyen, Uyen; Trevor, Amy; Robinson, Erica; Campbell, Margaret; McLennan, John; Houran, Farielle; Wong, Tristan; Flann, Kendra; Wages, Melissa; Palmer, Elizabeth A.; Peterson, John; Engle, John; Maier, Tom; Machida, Curtis A.

    2014-01-01

    Background and objectives Mutans streptococci (MS) are one of the major microbiological determinants of dental caries. The objectives of this study are to identify distinct MS and non-MS streptococci strains that are located at carious sites and non-carious enamel surfaces in children with severe early childhood caries (S-ECC), and assess if cariogenic MS and non-cariogenic streptococci might independently exist as primary bacterial strains on distinct sites within the dentition of individual children. Design Dental plaque from children (N=20; aged 3–6) with S-ECC was collected from carious lesions (CLs), white spot lesions (WSLs) and non-carious enamel surfaces. Streptococcal isolates (N=10–20) from each site were subjected to polymerase chain reaction (PCR) to identify MS, and arbitrarily primed-PCR for assignment of genetic strains. Primary strains were identified as ≥50% of the total isolates surveyed at any site. In several cases, strains were characterized for acidurity using ATP-driven bioluminescence and subjected to PCR-determination of potential MS virulence products. Identification of non-MS was determined by 16S rRNA gene sequencing. Results Sixty-four independent MS or non-MS streptococcal strains were identified. All children contained 1–6 strains. In many patients (N=11), single primary MS strains were identified throughout the dentition. In other patients (N=4), primary MS strains were identified within CLs that were distinct from primary strains found on enamel. Streptococcus gordonii strains were identified as primary strains on enamel or WSLs in four children, and in general were less aciduric than MS strains. Conclusions Many children with S-ECC contained only a single primary MS strain that was present in both carious and non-carious sites. In some cases, MS and non-cariogenic S. gordonii strains were found to independently exist as dominant strains at different locations within the dentition of individual children, and the aciduric

  10. Assessment of the clinical status of primary root carious lesions using an enzymic assay.

    PubMed

    Collier, F I; Heath, M R; Lynch, E; Beighton, D

    1993-01-01

    The microflora of root carious lesions (n = 151) and sound root surfaces (n = 30) in 22 institutionalized, older patients was investigated using a standardized method of sampling. Material was removed using a sterile excavator and the numbers of bacteria in each sample were determined using conventional culturing techniques and by rapid (2 h) fluorogenic enzyme assay. Correlation between bacterial counts and enzyme assay result was 0.873 (p < 0.001). The numbers of bacteria and fluorogenic enzyme assay values were significantly (p < 0.001) greater from soft lesions than from leathery lesions while hard lesions and sound root surfaces had significantly (p < 0.001) lower values than the other lesion types and were not different from each other. A similar trend was apparent when these values were correlated with treatment needs. The fluorogenic enzyme assay may provide a rapid, objective measure of root caries severity which might be used in the monitoring and comparison of treatment protocols.

  11. Are topical fluorides effective for treating incipient carious lesions?: A systematic review and meta-analysis.

    PubMed

    Lenzi, Tathiane Larissa; Montagner, Anelise Fernandes; Soares, Fabio Zovico Maxnuck; de Oliveira Rocha, Rachel

    2016-02-01

    This systematic review and meta-analysis evaluated the effectiveness of professional topical fluoride application (gels or varnishes) on the reversal treatment of incipient enamel carious lesions in primary or permanent dentition. Literature searching was carried out by the authors in PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, Turning Research Into Practice, and ClinicalTrials.gov to verify the clinical trials available about the outcome. From 754 potentially eligible studies, 21 were selected for full-text analysis, 5 were included for review, and 3 for meta-analysis. The statistical analysis was performed only for studies assessing fluoride varnish; there were insufficient data to perform it for fluoride gel studies. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Pooled-effect estimates were expressed as the weighted mean difference between groups. The therapeutic methods ranged considerably regarding the fluoride application protocols. There was a significant trend of effectiveness of fluoride varnish on the reversal of incipient enamel carious lesions (P < .05). High heterogeneity was found in the meta-analysis. Fluoride varnish seems to be an effective treatment for the reversal of incipient carious lesions in primary and permanent dentition; however, further clinical trials concerning efficacy of topical fluorides for treating those lesions are still required, mainly regarding the fluoride gel. Considering the scientific evidence on topical fluorides, pediatric dentists can use fluoride varnishes as an adjuvant for the treatment of active white-spot lesions in primary or permanent dentition. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

  12. Non-carious cervical lesions: influence of morphology and load type on biomechanical behaviour of maxillary incisors.

    PubMed

    Soares, P V; Santos-Filho, P C F; Soares, C J; Faria, V L G; Naves, M F; Michael, J A; Kaidonis, J A; Ranjitkar, S; Townsend, G C

    2013-09-01

    The aim of this study was to measure the effect of simulating two different loads on maxillary incisors displaying eight morphological types of non-carious cervical lesions, unrestored and restored with an adhesive restoration, by quantifying the stress distributions generated using finite element analysis. Virtual models of maxillary incisors were generated using the CAD software (RhinoCeros). After composing virtual dental and supporting structures with and without non-carious cervical lesions, each model was meshed using a control mesh device (ANSYS Finite Element Analysis Software). All of the virtual models were subjected to two load types, oblique load and vertical load, to simulate occlusal forces of 100 N each. Comparisons were made between simulated teeth with non-carious cervical lesions, with and without composite resin restorations, and a simulated sound tooth. Data summarizing the stress distributions were obtained in MPa using von Mises criteria. Oblique loading on simulated non-carious cervical lesions resulted in greater stress concentration compared with vertical loading, and non-carious cervical lesions with acute angles displayed higher stress concentrations at the depth of the lesion. Restoring the lesions with an adhesive restoration, such as composite resin, appeared to overcome this stress concentration. Restoring NCCLs with adhesive restorative materials, such as a nanohybrid composite resin, appears to recover the biomechanical behaviour similar to sound teeth. © 2013 Australian Dental Association.

  13. [PREVALENCE OF NON-CARIOUS CERVICAL LESIONS AND ABFRACTIONS OF DENTAL HARD TISSUES IN AN ADULT IN DIFFERENT AGES].

    PubMed

    Iordanishvili, A K; Chernyj, D A; Jankovskij, V V; Orlov, A K; Drobkova, K O

    2015-01-01

    The article is devoted to gerontostomatological and gender-specific prevalence of non-carious lesions of the hard tissue of teeth in adults. The paper presents data of epidemiological study on prevalence of non-carious lesions of dental hard tissues (high abrasion, erosion, wedge-shaped defects, hyperesthesia). Allocated to four age groups: young adults surveyed--from 22 to 39 years; middle ages--from 40 to 59 years; older--from 60 to 74 years of age; senile age--from 75 to 87 years. To determine the frequency of occurrence of different forms of non-carious lesions of the hard tissue of teeth we have used the following: general scientific and special methods: poll, dental examination, groupings, statistical and mathematical methods of processing sample. We have ranked low incidence of non-carious lesions of the hard tissue of the teeth in the sample surveyed: high abrasion, erosion, wedge-shaped defects of solid tissues, hyperesthesia. The features of clinical course of non-carious lesions have been determined. In particular a rare combined lesion of the teeth with advanced erasibility, wedge defects and erosion has been noted. Significant combination of the pathological processes of the hard tissue of teeth with their hyperesthesia has been found. Features of different forms of non-carious lesions of the hard tissue of teeth in different age periods of life have been determined. Noted that older people, due to non-carious esions of the hard tissue of teeth were more likely to require medical intervention aimed at addressing the ncreased sensitivity and loss of hard tissue of teeth by dental therapeutic activities or dental prosthetics.

  14. Loading and composite restoration assessment of various non-carious cervical lesions morphologies - 3D finite element analysis.

    PubMed

    Soares, P V; Machado, A C; Zeola, L F; Souza, P G; Galvão, A M; Montes, T C; Pereira, A G; Reis, B R; Coleman, T A; Grippo, J O

    2015-09-01

    The present study analysed the effects of different occlusal loading on premolars displaying various non-carious cervical lesions morphologies, restored (or not) with composites, by 3D finite element analysis. A three-dimensional digital model of a maxillary premolar was generated using CAD software. Three non-carious cervical lesions morphological types were simulated: wedged-shaped, saucer and mixed. All virtual models underwent three loading types (100 N): vertical, buccal and palatal loading. The simulated non-carious cervical lesions morphologies were analysed with and without restorations to consider specific regions, such as the occlusal and gingival walls as well as the depth of the lesions. Data summarizing the stress distribution were obtained in MPa using Maximum Principal Stress. Palatal loads were responsible for providing the highest values of accumulated tensile stress on the buccal wall; 27.66 MPa and 25.76 MPa for mixed and wedged-shaped morphologies, respectively. The highest tensile values found on non-carious cervical lesions morphologies restored with composite resin were 5.9 MPa in the mixed morphology, similar to those found on sound models despite their morphologies and occlusal loading. The various non-carious cervical lesions morphologies had little effect on stress distribution patterns, whereas the loading type and presence of composite restorations influenced the biomechanical behaviour of the maxillary premolars. © 2015 Australian Dental Association.

  15. Insights into the Virulence Traits of Streptococcus mutans in Dentine Carious Lesions of Children with Early Childhood Caries.

    PubMed

    Bezerra, Daniela S; Stipp, Rafael N; Neves, Beatriz G; Guedes, Sarah F F; Nascimento, Marcelle M; Rodrigues, Lidiany K A

    2016-01-01

    Streptococcus mutans is an oral bacterium considered to play a major role in the development of dental caries. This study aimed to investigate the prevalence of S. mutans in active and arrested dentine carious lesions of children with early childhood caries and to examine the expression profile of selected S. mutans genes associated with survival and virulence, within the same carious lesions. Dentine samples were collected from 29 active and 16 arrested carious lesions that were diagnosed in preschool children aged 2-5 years. Total RNA was extracted from the dentine samples, and reverse transcription quantitative real-time PCR analyses were performed for the quantification of S. mutans and for analyses of the expression of S. mutans genes associated with bacterial survival (atpD, nox, pdhA) and virulence (fabM and aguD). There was no statistically significant difference in the prevalence of S. mutans between active and arrested carious lesions. Expression of the tested genes was detected in both types of carious dentine. The pdhA (p = 0.04) and aguD (p = 0.05) genes were expressed at higher levels in arrested as compared to active lesions. Our findings revealed that S. mutans is part of the viable microbial community in active and arrested dentine carious lesions. The increase in expression of the pdhA and aguD genes in arrested lesions is likely due to the unfavourable environmental conditions for microbial growth, inherent to this type of lesions. © 2016 S. Karger AG, Basel.

  16. [Prevalence and etiologic factors of non-carious cervical lesions. A study in a Senegalese population].

    PubMed

    Faye, B; Sarr, M; Kane, A W; Toure, B; Leye, F; Gaye, F; Dieng, M B

    2005-12-01

    The non carious cervical lesion (NCCL) is a loss of tooth tissue at the neck of affected teeth that is unrelated to tooth decay. They are commonly encountered in clinical practice and present in a variety of forms. The purpose of this paper is to determine the prevalence of the NCCL in a Senegalese population. From 655 patients, 112 with cervical lesions were identified i.e. a global prevalence of 17.10%. The prevalence rate for abrasion was reported to be 77.70%, 12.50% for abfraction and 9.80% for erosion. Etiological factors were studied for abrasion and erosion. 54% of the patients with abrasion used their toothbrush horizontally. For erosion, only external factors were identified: consumption of acidic drinks (9 patients) or alcohol (1 patient) and professional environment (1 patient). Dentists should consider these lesions in their daily practice.

  17. Effect of adhesive resin application on the progression of cavitated and non-cavitated incipient carious lesions.

    PubMed

    El-Kalla, Ibrahim H; Saudi, Hussein I A; El-Agamy, Rizk A I

    2012-06-01

    To evaluate the penetration of two different adhesive resin systems into cavitated and non-cavitated artificial carious lesions and the behavior of treated carious lesions under further acid attack. Artificial caries-like lesions were created on the proximal surface of 100 human primary molars by a demineralizing gel. The teeth were assigned to three groups according to the adhesive resin used. Group 1 (G1) was for Single Bond adhesive resin, Group 2 (G2) for Xeno V adhesive resin, and Group 3 (G3) was without any adhesive application. Each group was randomly and equally subdivided into subgroups a and b. In subgroup a, the teeth were kept with intact artificial caries-like lesion surfaces while in the subgroup b, a minute cavity was made at the center of artificial caries-like lesions using a sharp explorer. Each tooth was sectioned occluso-cervically into two halves through the center of the lesion; the sectioned surface was polished and examined under a reflected light microscope for estimating the depth of the carious lesion or penetration of the adhesive resin. All tooth halves were coated at the sectioned surface with two layers of acid resistant nail varnish and returned again to the demineralizing solution to assess the progression or arrest of the carious lesion after the second acid attack. The penetration depth of adhesive resins did not differ significantly between subgroups (P>0.05). After the second acid attack, the infiltrated carious lesions showed no lesion progression while the non-infiltrated lesions showed advanced caries progression.

  18. Selective removal of carious lesion with Er:YAG laser followed by dentin biomodification with chitosan.

    PubMed

    Curylofo-Zotti, Fabiana A; Tanta, Gabriela Solano; Zucoloto, Miriane Lucindo; Souza-Gabriel, Aline E; Corona, Silmara A M

    2017-08-01

    The aim of this study was to evaluate the effect of Er:YAG laser for selective removal of carious lesion, followed by biomodification with chitosan gel where the subsurface microhardness, chemical composition, and morphological changes of the residual caries-affected dentin were examined. Artificial dentinal lesions were created by pH-cycling method (14 days) in 104 bovine specimens (5 × 5 mm). Specimens were randomly divided according to the carious removal method: bur (low-speed handpiece) or Er:YAG laser (250 mJ/4 Hz). Specimens were treated with 35% phosphoric acid and were subdivided into two groups according to dentin biomodification: without chitosan (control) and 2.5% chitosan. Forty specimens were restored with an adhesive system and composite resin. Subsurface microhardness tests were performed in sound dentin, caries-affected dentin, residual caries-affected dentin, and after the restoration. The other 64 specimens were subjected to SEM-EDS atomic analysis. Data were statistically analyzed (p < 0.05). After the Er:YAG laser excavation, the microhardness value of residual caries-affected dentin was higher (p < 0.05) than bur-treated dentin. A significant decrease in the amount of Ca, P, and Ca/P ratio was found after the removal of carious lesions with Er:YAG laser (p < 0.05). The biomodification with chitosan did not influence the microhardness and atomic percentage of Ca, P, and Ca/P ratio of residual caries-affected dentin (p > 0.05). SEM analysis showed morphological changes on residual caries-affected dentin (p > 0.05). The selective removal of carious dentin with Er:YAG laser increased microhardness of residual caries-affected dentin, changing its surface morphology and chemical composition. The biomodification with chitosan did not influence the structural and chemical composition of residual caries-affected dentin.

  19. Restorative Thresholds for Carious Lesions: Systematic Review and Meta-analysis.

    PubMed

    Innes, N P T; Schwendicke, F

    2017-05-01

    Current evidence supports noninvasive/nonrestorative treatment of "early" carious lesions: those confined to enamel or reaching the enamel-dentin junction. The extent that dentists' thresholds for intervening restoratively have changed with this evidence is unknown. This systematic review aimed to determine dentists' and therapists' current lesion threshold for carrying our restorative interventions in adults/children and primary/permanent teeth. Embase, Medline via PubMed, and Web of Science were searched for observational studies, without language, time, or quality restrictions. Screening and data extraction were independent and in duplicate. Random-effects meta-analyses with subgroup and meta-regression analysis were performed. Thirty studies, mainly involving dentists, met the inclusion criteria. There was heterogeneity in sampling frames, methods, and scales used to investigate thresholds. The studies spanned 30 y (1983-2014), and sample representativeness and response bias issues were likely to have affected the results. Studies measured what dentists said they would do rather than actually did. Studies represented 17 countries, focusing mainly on adults ( n = 17) and permanent teeth ( n = 24). For proximal carious lesions confined to enamel (not reaching the enamel-dentin junction), 21% (95% confidence interval [CI], 15%-28%) of dentists/therapists would intervene invasively. The likelihood of a restorative intervention almost doubled (risk ratio, 1.98; 95% CI, 1.68-2.33) in high caries risk patients. For proximal lesions extending up to the enamel-dentin junction, 48% (95% CI, 40%-56%) of dentists/therapists would intervene restoratively. For occlusal lesions with enamel discoloration/cavitation but no clinical/radiographic dentin involvement, 12% (95% CI, 6%-22%) of dentists/therapists stated they would intervene, increasing to 74% (95% CI, 56%-86%) with dentin involvement. There was variance between countries but no significant temporal trend. A

  20. Different protocols to produce artificial dentine carious lesions in vitro and in situ: hardness and mineral content correlation.

    PubMed

    Moron, B M; Comar, L P; Wiegand, A; Buchalla, W; Yu, H; Buzalaf, M A R; Magalhães, A C

    2013-01-01

    This study compared dentine demineralization induced by in vitro and in situ models, and correlated dentine surface hardness (SH), cross-sectional hardness (CSH) and mineral content by transverse microradiography (TMR). Bovine dentine specimens (n = 15/group) were demineralized in vitro with the following: MC gel (6% carboxymethylcellulose gel and 0.1 M lactic acid, pH 5.0, 14 days); buffer I (0.05 M acetic acid solution with calcium, phosphate and fluoride, pH 4.5, 7 days); buffer II (0.05 M acetic acid solution with calcium and phosphate, pH 5.0, 7 days), and TEMDP (0.05 M lactic acid with calcium, phosphate and tetraethyl methyl diphosphonate, pH 5.0, 7 days). In an in situ study, 11 volunteers wore palatal appliances containing 2 bovine dentine specimens, protected with a plastic mesh to allow biofilm development. The volunteers dripped a 20% sucrose solution on each specimen 4 times a day for 14 days. In vitro and in situ lesions were analyzed using TMR and statistically compared by ANOVA. TMR and CSH/SH were submitted to regression and correlation analysis (p < 0.05). The in situ model produced a deep lesion with a high R value, but with a thin surface layer. Regarding the in vitro models, MC gel produced only a shallow lesion, while buffers I and II as well as TEMDP induced a pronounced subsurface lesion with deep demineralization. The relationship between CSH and TMR was weak and not linear. The artificial dentine carious lesions induced by the different models differed significantly, which in turn might influence further de- and remineralization processes. Hardness analysis should not be interpreted with respect to dentine mineral loss.

  1. Restoration of non-carious cervical lesions Part II. Restorative material selection to minimise fracture.

    PubMed

    Ichim, I P; Schmidlin, P R; Li, Q; Kieser, J A; Swain, M V

    2007-12-01

    It is still largely unknown as to what material parameter requirements would be most suitable to minimise the fracture and maximising the retention rate of the restoration of cervical non-carious lesions (NCCL). The present paper, as a first of its kind, proposes a radical approach to address the problems of material improvement, namely: numerical-based, fracture and damage mechanics materials optimisation engineering. It investigates the influence of the elastic modulus (E) on the failure of cervical restorative materials and aims to identify an E value that will minimise mechanical failure under clinically realistic loading conditions. The present work relies on the principle that a more flexible restorative material would partially buffer the local stress concentration. We employ a "most favourable" parametric analysis of the restorative's elastic modulus using a fracture mechanics model embedded into finite element method. The advanced numerical modelling adopts a Rankine and rotating crack material fracture model coupled to a non-linear analysis in an explicit finite element framework. The present study shows that the restorative materials currently used in non-carious cervical lesions are largely unsuitable in terms of resistance to fracture of the restoration and we suggest that the elastic modulus of such a material should be in the range of 1GPa. We anticipate that the presented methodology would provide more informative guidelines for the development of dental restorative materials, which could be tailored to specific clinical applications cognisant of the underlying mechanical environment.

  2. Behavior and progression of early carious lesions in early childhood: a 1-year follow-up study.

    PubMed

    Parisotto, Thaís Manzano; Santos, Marinês Nobre dos; Rodrigues, Lidiany Karla Azevedo; Costa, Luciana Scarlazzari

    2012-01-01

    The purpose of this 1-year follow-up study was to evaluate the behavior/progression of early carious lesions (active noncavitated carious lesions) by surface and type of tooth in early childhood. A total of 179 3-and 4-year-old preschoolers took part in this study. Clinical examinations were conducted by a calibrated examiner using a mirror, ball-ended probe, gauze for cleaning and drying of teeth, and artificial light. The World Health Organization criteria, with an added measurement of early carious lesions (ECLs), were employed for the caries examinations. Descriptive statistics and logistic regression were used in the statistical analysis. After a 1-year follow-up, the study population developed 1.60 ± 1.64 new carious lesions. Children with caries activity at baseline showed much higher risks of developing new lesions than caries-free children (odds ratio=17.3 for ECL development, OR=24.5 for cavitations/fillings). Most ECLs remained active/unchanged after 1 year, whereas approximately 36% were arrested. Approximately 10% of the ECLs became cavitated, were filled, or were missing due to caries at follow-up. ECLs turned into cavities or fillings more frequently in the posterior region. This study's findings support the conservative management of ECLs since, after 1 year, the majority of lesions were active/unchanged or were arrested on the smooth surfaces of primary teeth.

  3. [Effect of arginine dentifrice on remineralization of initial enamel carious lesions].

    PubMed

    Xu, Pengcheng; Deng, Meng; Zhou, Xue-dong; Li, Jiyao; Cheng, Lei; Xu, Xin

    2014-02-01

    To evaluate remineralization efficacy of an arginine containing dentifrice on initial enamel carious lesions in vitro. Human enamel blocks with early lesions were prepared and randomly divided into three treatment groups: negative control group (distilled and deionized water), positive control group (fluoride containing dentifrice and 0.14% sodium monofluorophosphate), and test dentifrice group (8.0% arginine and 0.14% sodium monofluorophosphate). The lesions were subjected to a pH-cycling regime for 10 days. Surface enamel microhardness of the enamel blocks from each group was measured before and after pH cycling, and the surface microhardness recovery was calculated. Then, specimens were analyzed for enamel fluoride uptake (EFU) through acid etching method, after which they were treated in demineralization solution for a 2 h period of acid challenge. The other specimens were sectioned and examined through polarized light microscopy. In the test dentifrice group, microhardness recovery and EFU were significantly higher than those in the negative control and positive groups. The test dentifrice group was significantly resistant to the acid challenge compared with the other groups. Conspicuous remineralization of enamel subsurface lesions was observed under polarized light microscopy among samples treated with test dentifrice, whereas the control groups showed no significant changes on enamel subsurface lesions. This study presents the potential superiority of Pro-Argin dentifrice over conventional fluoride dentifrice in promoting the remineralization of initial enamel lesions.

  4. Characteristics of non-carious cervical lesions--an ex vivo study using micro computed tomography.

    PubMed

    Hur, B; Kim, H-C; Park, J-K; Versluis, A

    2011-06-01

    The aetiology of non-carious cervical lesions (NCCLs) is not well understood and still controversial. The aim of this ex-vivo study was to examine the morphological characteristics of NCCLs for clinical evidence of enamel loss above the cemento-enamel junction (CEJ) as suggested by the abfraction theory. Fifty extracted human teeth with various types of NCCLs were collected and scanned by micro computed tomography. The reconstructed three-dimensional models were evaluated from multiple aspects, including longitudinal cross-section series. The location of internal line angle and proximal exits of the lesions were evaluated in relation to the level of CEJ. The coronal margins of the lesions were inspected for evidence of enamel loss above the CEJ using the bucco-lingual longitudinal sectional images. Coronal margins of the lesions were located along and/or under the CEJ for all of the 50 samples. In most of the lesions, regardless of lesion type, the proximal exits and internal line angles were located below the CEJ. This study did not detect clinical evidence of enamel loss above the occlusal margin of NCCLs as would have been expected according to the general abfraction mechanism.

  5. A pilot study to assess the morphology and progression of non-carious cervical lesions.

    PubMed

    Sugita, Iori; Nakashima, Syozi; Ikeda, Asaomi; Burrow, Michael F; Nikaido, Toru; Kubo, Shisei; Tagami, Junji; Sumi, Yasunori

    2017-02-01

    This longitudinal pilot study aimed to morphologically and quantitatively investigate the progress of non-carious cervical lesions (NCCLs) by using swept-source optical coherence tomography (SS-OCT). The samples examined comprised sets of NCCL epoxy resin replicas obtained from 10 lesions in 6 patients who attended annual dental visits over 4 or 5 years. SS-OCT images of the replicas were analyzed in terms of the maximum depth (Dmax) and corresponding vertical width (VW) - using an image analyzer to estimate progression of the NCCLs over time. It was found that differences between wedge- and saucer-shaped lesions were morphologically distinguished well by the OCT images. There were significant differences in dimensions among Dmax, VW and horizontal width (HW). HW was the largest and Dmax was the smallest. Although no significant differences in absolute values of annual progression rates were found among Dmax, VW and HW, the percentage increase in Dmax was significantly greater compared to VW and HW. The ratios of Dmax to corresponding VW ranged from 0.49 to 1.01 for the wedge-shaped lesions and from 0.13 to 0.44 for saucer-shaped lesions, respectively. The dimensional analysis demonstrated notable progression with large variations. The wedge-shaped lesions appeared to show greater Dmax values compared to the saucer-shaped lesions. With respect to the depth, the wedge-shaped lesions may progress at a greater rate compared to the saucer-shaped lesions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Carious lesions: diagnostic accuracy using pre-calibrated monitor in various ambient light levels: an in vitro study

    PubMed Central

    Hellén-Halme, K; Lith, A

    2013-01-01

    Objectives: This study investigated the effect of different monitor calibration modes under various ambient lighting conditions on the ability of observers to recognize proximal carious lesions of varying depths. Methods: 7 observers evaluated 100 teeth for proximal carious lesions on standardized digital radiographs using 3 set-ups: (1) pre-calibrated monitor for high ambient light (higher than 1000 lux), (2) pre-calibrated monitor for low ambient light (less than 50 lux) and (3) Barten calibration (Digital Imaging and Communication in Medicine) on the monitor in dimmed ambient light (less than 50 lux). Receiver operating characteristic curves were plotted for all observations. The criterion standard was histological examination of the teeth. The effects of three conditions were compared using a paired t-test. The level of significance was set to p < 0.05. Results: No significant difference was found in diagnostic accuracy for the detection of any type of proximal carious lesions between the different calibration modes of the monitor according to different ambient light levels. Conclusions: There is no evidence that any difference between ambient light levels affects the ability to detect carious lesions in digital radiographs as long as the monitor was calibrated in accordance with the surrounding light level. PMID:23775926

  7. Association between untreated carious lesions and asthma in adults at Rabat University Hospital, Morocco: a cross sectional study.

    PubMed

    Chala, Sanaa; Rouiffi, Saloua; Soualhi, Mouna; Bourkadi, Jamal Eddine; Abouqal, Redouane; Abdallaoui, Faïza

    2017-06-26

    Depending on risk factors, cumulative risk of developing more dental caries by age has been reported. However, the association between dental caries and asthma is less studied among adults. The aims of this study were to evaluate the severity of untreated carious lesions in a population of asthmatic adults and to evaluate the mediation of socio-economic and oral health behaviour variables. The study involved participants with diagnosed asthma (N = 100) and control (N = 100) subjects attending a tertiary hospital. Groups were matched by age and gender. Asthma was the exposure of interest. The outcome measure was the rate of carious lesions. Recorded variables included demographics, socio-economic status, tooth brushing habits and oral health status using WHO criteria. Poisson regression analysis examined the association between asthma and untreated dental caries. The adjusted model, after the inclusion of individuals' behaviours regarding oral health, social determinants and asthma, revealed a significant association between the number of untreated carious lesions and asthma (PR = 1.23; 95% CI 1.23-1.58; p < 0.001). Patients with asthma showed a greater number of untreated carious lesions. Looking forward, better understanding of the association between asthma and oral health may require exploiting the interactions of behavioural, social determinant and biological factors.

  8. Photomechanical studies on non-carious-cervical-lesions of the teeth (Invited Paper)

    NASA Astrophysics Data System (ADS)

    Kishen, A.; Tan, K. B. C.; Asundi, A.

    2005-06-01

    This study aims to examine the biomechanical factor underlying the origin of Non-Carious-Cervical-Lesions by examining the strain distribution in the enamel and dentine. A digital moire interferometry was utilized for this purpose. It is observed from this study that the enamel displayed marked strains in the lateral direction, while the dentine experienced marked strains in the axial and lateral directions during compression. The strains in the enamel and the dentine displayed both normal and shear components. The shear strain in the lateral direction within the enamel and the normal and shear strains in the axial and lateral directions within the coronal dentine concentrated at the cervical region. These experiments highlights that the biting loads will contribute to the loss of hard tissue in the cervical region.

  9. Application of diffusion-reaction equations to model carious lesion progress

    NASA Astrophysics Data System (ADS)

    Lewandowska, Katarzyna D.; Kosztołowicz, Tadeusz

    2012-04-01

    Nonlinear equations that describe the diffusion-reaction process with one static and one mobile substance are used to model a carious lesion process. The system under consideration consists of two initially separated substances A (an acid causing caries) and C (a static enamel mineral) which react chemically according to the formula A+C→0̸(inert). The so-called surface layer, which is formed in this process and in which chemical reactions can be neglected, is also included in this model. Changes in the substance concentrations are calculated approximately using the perturbation method. We show that the experimental data on the enamel mineral concentrations are well described by the analytical solutions of the diffusion-reaction equations.

  10. Radiographic display of carious lesions and cavitation in approximal surfaces: Advantages and drawbacks of conventional and advanced modalities.

    PubMed

    Wenzel, Ann

    2014-05-01

    Treatment strategies have changed with efforts on arresting carious lesions suspected to have an intact surface sparing operative treatment for cavitated lesions. Radiography is still the most recommended adjunct method in the diagnosis of clinically inaccessible approximal surfaces. BITEWING RADIOGRAPHY: The major drawback of bitewing radiography for caries diagnosis is that the clinical state of the surface cannot be determined; i.e. if cavitation has developed or the demineralized surface is still intact. Based on studies of the relationship between radiographic lesion depth and clinical cavitation in approximal surfaces, a threshold for operative treatment decision has been suggested when a lesion is observed radiographically more than one-third into dentine. However, the results from previous studies are contradictory and the majority of studies are ~25 years old. In addition, there are few longitudinal observational studies on the behaviour of dentinal carious lesions, particularly in adults. CONE BEAM COMPUTED TOMOGRAPHY: Cone beam CT is an advanced 3-dimensional radiographic modality, which seems much more accurate than intra-oral modalities for displaying cavitation in approximal surfaces. Nonetheless, there are several drawbacks with CBCT, such as radiation dose, costs and imaging artefacts. Therefore, CBCT cannot be advocated at current as a primary radiographic examination with the aim of diagnosing cavitated carious lesions. Bitewing radiography is, thus, still state-of-the-art as an adjunct in diagnosing carious lesions in clinically inaccessible approximal surfaces. The risk for cavitation is related to lesion depth, but new studies are needed in both child and adult populations to validate current thresholds for the operative treatment decision based on the radiographic lesion depth.

  11. Intraoral pH measurement of carious lesions with qPCR of cariogenic bacteria to differentiate caries activity.

    PubMed

    Kuribayashi, Megumi; Kitasako, Yuichi; Matin, Khairul; Sadr, Alireza; Shida, Kanako; Tagami, Junji

    2012-03-01

    A low pH environment is created by cariogenic bacteria. This study was aimed to measure pH of carious lesions intraorally using a micro-pH sensor, and assess predominant acid-producing cariogens by qPCR to differentiate caries activities. 103 dentine lesions classified as active or arrested caries based on the clinical and radiological examinations were collected from patients after intraoral measurement of the lesion surface pH using a micro-pH sensor. Quantitative detection of genomic DNA copies of target cariogenic bacteria (mutans streptococci and Lactobacillus spp.) in each lesion was performed using real-time PCR. Correlation between the pH ranges and the number of bacterial species was examined by Spearman test. 50 samples were diagnosed as active and 53 as arrested lesions. Statistically significant difference was observed on average surface pH value between active and arrested lesions (p<0.05). Prevalence of Lactobacillus spp. was higher in active lesions than in arrested lesions (76% vs. 58% of samples, respectively). When the carious lesions were categorised into four different pH ranges (up to 5.5, from 5.6 to 5.8, from 5.9 to 6.1 and 6.2 or above), increased prevalence of Lactobacillus spp. was observed with decrease of pH levels. A significant negative relationship was found between pH value and number of Lactobacillus spp. (r=-0.209, p<0.05) but no such correlation was found for mutans streptococci. Intraoral pH measurement might be clinically useful to determine acidity of the local environment of carious lesions as one aspect of the caries activity assessment. The population of certain bacteria may indicate activity of carious lesions. Intraoral pH measurement of the carious lesions using a micro-pH sensor may be a clinically feasible method for assessment of lesion acidity. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Chemical Profile of the Dentin Substrate in Non-Carious Cervical Lesions

    PubMed Central

    Karan, Kunal; Yao, Xiaomei; Xu, Changqi; Wang, Yong

    2009-01-01

    Objective The molecular structural nature of the dentin substrate in non-carious cervical lesions (NCCLs) is poorly understood. This investigation characterized the chemical structure including inhomogeneities, composition, mineral crystallinity, collagen organization of normal dentin and affected dentin substrates within NCCLs using Raman micro-spectroscopic mapping/imaging. Materials and Methods Three extracted human pre-molars affected with NCCLs were selected and cavities matching the natural lesion with respect to size and location were prepared on the lingual/palatal surface of each tooth to serve as controls. The specimens were sectioned to expose the gingival and occlusal margins of the NCCLs and the control cavities. Micro-Raman spectra and imaging acquired at 1.5 micrometer spatial resolution at positions perpendicular to the lesion surfaces. Results The Raman spectra and imaging comparisons showed the distinct compositional and structural alterations in mineral and matrix components of NCCL affected dentin. A heterogeneous hyper-mineralized layer, with characteristic features such as high phosphate/low carbonate content, high degree of crystallinity and partially denatured collagen were revealed in affected dentin substrate of NCCLs. Significance Generating Raman images based on different strategies from the same data set provides a powerful means to study the structural alterations within heterogeneous dental tissues. Direct overlay of the images indicated that the changes in chemical structure and composition are synchronized. Further studies are required to understand the role that these alterations play in response to acid etching and bonding to these clinically-relevant substrates. PMID:19464050

  13. Selective Laser Ablation of Carious Lesions using Simultaneous Scanned Near-IR Diode and CO2 Lasers.

    PubMed

    Chan, Kenneth H; Fried, Daniel

    2017-01-28

    Previous studies have established that carious lesions can be imaged with high contrast using near-IR wavelengths coincident with high water absorption, namely 1450-nm, without the interference of stains. It has been demonstrated that computer-controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, a point-to-point scanning system was developed integrating a 1450-nm diode laser with the CO2 ablation laser. This approach is advantageous since it does not require an expensive near-IR camera. In this pilot study, we demonstrate the feasibility of a combined NIR and IR laser system for the selective removal of carious lesions.

  14. Selective laser ablation of carious lesions using simultaneous scanned near-IR diode and CO2 lasers

    NASA Astrophysics Data System (ADS)

    Chan, Kenneth H.; Fried, Daniel

    2017-02-01

    Previous studies have established that carious lesions can be imaged with high contrast using near-IR wavelengths coincident with high water absorption, namely 1450-nm, without the interference of stains. It has been demonstrated that computer-controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, a point-to-point scanning system was developed integrating a 1450-nm diode laser with the CO2 ablation laser. This approach is advantageous since it does not require an expensive near-IR camera. In this pilot study, we demonstrate the feasibility of a combined NIR and IR laser system for the selective removal of carious lesions.

  15. Selective Laser Ablation of Carious Lesions using Simultaneous Scanned Near-IR Diode and CO2 Lasers

    PubMed Central

    Chan, Kenneth H.; Fried, Daniel

    2017-01-01

    Previous studies have established that carious lesions can be imaged with high contrast using near-IR wavelengths coincident with high water absorption, namely 1450-nm, without the interference of stains. It has been demonstrated that computer-controlled laser scanning systems utilizing IR lasers operating at high pulse repetition rates can be used for serial imaging and selective removal of caries lesions. In this study, a point-to-point scanning system was developed integrating a 1450-nm diode laser with the CO2 ablation laser. This approach is advantageous since it does not require an expensive near-IR camera. In this pilot study, we demonstrate the feasibility of a combined NIR and IR laser system for the selective removal of carious lesions. PMID:28626285

  16. Effect of oxalic acid pre-treatment in restorations of non-carious cervical lesions: A randomized clinical trial

    PubMed Central

    de Souza, André Mattos Brito; Colares, Regina Claudia Ramos; Mendonça, Juliano Satori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2014-01-01

    Context: Non-carious cervical lesions are usually associated with dentin hypersensitivity. The use of oxalic acid in restorations of these lesions could be beneficial in relieving pain. Aims: To evaluate the use of oxalic acid in restorations of non-carious cervical lesions. Settings and Design: A randomized clinical trial. Subjects and Methods: One operator placed 90 restorations in 20 volunteers of both sexes, with at least two lesions to be restored with the techniques: Control — Restoration with total-etch technique and Experimental — Restoration with pretreatment with oxalic acid followed by application of adhesive system. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners using a modified United States Public Health Service (USPHS) method at baseline, 6 and 12 months, taking into account the following criteria: Retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). Statistical analysis used: The data were statistically analyzed using the Fisher exact and McNemar tests. The level of significance was set at 5%. Results: After 1 year, the results of restorations clinically satisfactory obtained for the control and experimental group respectively were: R (97% / 89%), MI (100% / 100%), MD (100% / 100%), S (100% / 100%), C (100% / 100%), and AF (100% / 100%). Conclusions: The use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in non-carious cervical lesions after 1 year. PMID:25298641

  17. Effect of oxalic acid pre-treatment in restorations of non-carious cervical lesions: A randomized clinical trial.

    PubMed

    de Souza, André Mattos Brito; Colares, Regina Claudia Ramos; Mendonça, Juliano Satori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2014-09-01

    Non-carious cervical lesions are usually associated with dentin hypersensitivity. The use of oxalic acid in restorations of these lesions could be beneficial in relieving pain. To evaluate the use of oxalic acid in restorations of non-carious cervical lesions. A randomized clinical trial. One operator placed 90 restorations in 20 volunteers of both sexes, with at least two lesions to be restored with the techniques: Control - Restoration with total-etch technique and Experimental - Restoration with pretreatment with oxalic acid followed by application of adhesive system. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners using a modified United States Public Health Service (USPHS) method at baseline, 6 and 12 months, taking into account the following criteria: Retention (R), marginal integrity (MI), marginal discoloration (MD), postoperative sensitivity (S), caries (C), and anatomic form (AF). The data were statistically analyzed using the Fisher exact and McNemar tests. The level of significance was set at 5%. After 1 year, the results of restorations clinically satisfactory obtained for the control and experimental group respectively were: R (97% / 89%), MI (100% / 100%), MD (100% / 100%), S (100% / 100%), C (100% / 100%), and AF (100% / 100%). The use of oxalic acid as an agent of dentin pretreatment did not influence the clinical performance of restorations in non-carious cervical lesions after 1 year.

  18. Pilot Study of the Canary System Use in the Diagnosis of Approximal Carious Lesions in Primary Molars.

    PubMed

    Herzog, Karin; D'Elia, Mindi; Kim, Amy; Slayton, Rebecca L

    2015-01-01

    This study assessed the feasibility and ease of use of the Canary System in approximal carious lesion detection in primary molars. Forty healthy five- to 12-year-olds, who presented to the Center for Pediatric Dentistry in Seattle, Wash., U.S.A., for initial or recall exams, were enrolled. Participants had one to two primary molars, with or without approximal radiographic radiolucencies. Four Canary System scans were performed at the approximal area of each study tooth. The maximum Canary number of the four scans was compared to bitewing radiographs. Seventy-five teeth were included in the final analysis. All study patients easily tolerated being scanned with the Canary System. The overall sensitivity and specificity of the Canary System, when compared to bitewing radiographs, was 81 percent and 35 percent, respectively. Among teeth without radiographic radiolucencies, the Canary System identified 65 percent (31 of 48) of study teeth as having carious lesions. The Canary System is a safe approximal caries detection device in five- to 12-year-olds. When compared to bitewing radiographs, the specificity of the Canary System for approximal carious lesion detection in primary molars was low. However, this could indicate that the Canary System is detecting lesions earlier than radiographs.

  19. Qualitative and Quantitative Effect of a Protective Chlorhexidine Varnish Layer Over Resin-infiltrated Proximal Carious Lesions in Primary Teeth.

    PubMed

    Rai, Pritika; Pandey, R K; Khanna, Richa

    2016-01-01

    The purpose of this study was to assess the progression of noncavitated initial proximal carious lesions in primary teeth, infiltrated with low viscosity resins, both with and without an overlying layer of chlorhexidine varnish. Forty-five children, with at least two white spot lesions on the proximal surfaces of primary molars, were assessed. The clinical procedure of resin infiltration (DMG, ICON) was similar in both groups. In the test group, after infiltration a double layer of chlorhexidine varnish (Cervitec Plus) was coated on the surface. Participants were recalled after nine months. Radiographic assessment was performed with GIMP software using representative histograms of the lesion. McNemar and chi-square tests were used to measure clinical and radiographic scores within and between groups. A two-sided (α equals two) P-value less than 0.05 (P≤0.05) was considered statistically significant. The carious lesion with an International Caries Detection and Assessment System (ICDAS) three score had a statistically significant shift of pixel count distribution to a higher grayscale range in the test compared to the control group. The statistically significant positive histogram changes in the test group suggest benefits of an overlying chlorhexidine varnish layer on resin infiltration only when the carious surface had microcavitations.

  20. Radiographic detection of initial carious lesions on the proximal surfaces of teeth. Part I. The influence of exposure conditions

    SciTech Connect

    Arnold, L.V.

    1987-08-01

    The relationship between a number of technical exposure conditions and the diagnostic value of bitewing radiographs in the interpretation of initial proximal carious lesions was evaluated. The most important exposure factors for radiographs are tube voltage, filtration, and exposure time. Tube voltage and filtration were found to have an insignificant influence on the diagnostic quality. Exposure time proved to be the most critical factor in influencing diagnostic quality. The greatest difference in diagnostic quality, however, was caused by differences between observers.

  1. Salivary peptidome profiling analysis for occurrence of new carious lesions in patients with severe early childhood caries.

    PubMed

    Tian, Chang; Sun, Xiangyu; Liu, Xiaochen; Huang, Xin; Chen, Feng; Zheng, Shuguo

    2017-01-01

    This study aimed to identify differences of peptide profiles in stimulated whole saliva among children with and without occurrence of new carious lesions, and to provide a simple way for early diagnosis and prevention of the relapse of severe early childhood caries (s-ECC). Overall, 26 children aged 3-4 years were selected out from all the children in the kindergarten to be involved in the present study, among them 13 were diagnosed as s-ECC and underwent dental treatment, whilst the other 13 were matched by age and sex as control. Stimulated whole saliva samples were collected before treatment, and at 10 days and 4 months after treatment. During follow-up, 7 of the 13 children with s-ECC showed a relapse, and the new carious lesions were then treated. Salivary peptides were detected using the technique of magnetic beads combined with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Fifteen peptides showed significant differences in the group without occurrence of new carious lesions (CH group). On comparing the CH group and the other group with occurrence of new carious lesions (CR group), no significant differences were observed before treatment, whereas certain peptides showed significant differences at both 10 days and 4 months after treatment. Two peptides (experimental m/z values: 3162.0 Da and 3290.4 Da) exhibited a consistent tendency in cross-sectional and longitudinal comparisons among these groups; these may be associated with recurrence of s-ECC. Based on our findings, it is concluded that different saliva peptide peaks can be detected in s-ECC using MALDI-TOF MS combined with magnetic beads. Moreover, 2 specific peptides with m/z values 3162.0 Da and 3290.4 Da could be promising salivary protein biomarkers for diagnosis of recurrence of s-ECC.

  2. Clinical evaluation of resin composite and resin-modified glass ionomer cement in non-carious cervical lesions.

    PubMed

    Adeleke; Oginni, Ao

    2012-10-01

    The clinical performance of various tooth-coloured materials used to restore Non-Carious Cervical Lesions (NCCLs) has been evaluated. However, most of these evaluations were in western societies where soft diets requiring little mastication were common. The present study sets out to evaluate resin composite and RMGIC in the restoration of NCCLs among a Nigerian subpopulation group with fibrous diet requiring more rigorous mastication. The study included all adult patients that presented at the Dental Hospital, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria with non-carious cervical lesions over a period of six months. The teeth with non-carious cervical lesions in each patient were allocated into treatment with either resin composite or resin-modified glass ionomer cement by simple random sampling using ballots. The depth of the NCCLs was measured using a graduated flat ash periodontal probe. All the treatment was done by the first author according to the manufacturer's instructions. Patients were recalled and evaluated at 48- hours, 3- months, 6- months and 12- months using the USPHS criteria. Data analysis was done using SPSS version 15. The level of significance was put at 0.05. At the end of 12 months, 143 resin composite and 144 RMGIC restorations were evaluated, out of which 37 resin composite and 13 RMGIC restorations were dislodged, giving a retention rate of 74.1% and 91.0% respectively. The difference was statistically significant (p<0.05). For marginal discolouration, marginal adaptation, abrasion wear resistance, post operative sensitivity, and secondary caries, there were no statistically significant differences in the performance of resin composite and RMGIC. There was more retention failure of both resin composite and RMGIC restorations in NCCLs in mandibular teeth than in maxillary teeth. The differences were statistically significant (p<0.05). RMGIC demonstrated a higher retention rate in the restoration of non-carious

  3. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms.

    PubMed

    Chu, Chun Hung; Mei, Lei; Seneviratne, Chaminda Jayampath; Lo, Edward Chin Man

    2012-01-01

    BACKGROUND. Silver diamine fluoride (SDF) has been shown to be a successful treatment for arresting caries. However, the mechanism of SDF is to be elucidated. AIM. To characterize the effects of SDF on dentine carious induced by Streptococcus mutans and Actinomyces naeslundii. DESIGN.  Thirty-two artificially demineralized human dentine blocks were inoculated: 16 with S. mutans and 16 with A. naeslundii. Either SDF or water was applied to eight blocks in each group. Biofilm morphology, microbial kinetics and viability were evaluated by scanning electron microscopy, colony forming units, and confocal microscopy. The crosssection of the dentine carious lesions were assessed by microhardness testing, scanning electron microscopy with energy-dispersive x-ray spectroscopy and Fourier transform infrared spectroscopy. RESULTS. Biofilm counts were reduced in SDF group than control (P < 0.01). Surfaces of carious lesions were harder after SDF application than after water application (P < 0.05), in S. mutans group, Ca and P weight percentage after SDF application than after water application (P < 0.05). Lesions showed a significantly reduced level of matrix to phosphate after SDF treatment (P < 0.05). CONCLUSION. Present study showed that SDF posses an anti-microbial activity against cariogenic biofilm of S. mutans or A. naeslundii formed on dentine surfaces. SDF slowed down demineralization of dentine. This dual activity could be the reason behind clinical success of SDF. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

  4. Contemporary concepts in carious tissue removal: A review.

    PubMed

    Schwendicke, Falk

    2017-09-19

    Based on a changed understanding of the disease caries and its pathogenesis, strategies for carious tissue removal have changed, too. This review aims to summarize these changes and to provide clinical recommendations. Removing all carious dentin from a cavity is not needed any longer to manage caries or the carious lesion. Instead, the carious lesion should be treated in a way allowing to arrest its activity, while preserving sound tooth tissue and pulp vitality. For teeth with vital pulps, a number of removal strategies have been developed: (1) Nonselective (complete) removal, which is not recommended any longer, (2) Selective removal to firm dentin, where firm dentin is left centrally and hard dentin peripherally, allowing the placement of a long-lasting restoration while avoiding the removal of remineralizable tissue; this is recommended for shallow or moderately deep lesions; (3) Selective removal to soft dentin, where soft or leathery dentin is left in proximity to the pulp and sealed beneath a restoration; this is recommended for deep lesions; (4) Stepwise removal; which combines different strategies and is also suitable for deep lesions, at least in adult patients. Alternatives include not removing but sealing the lesions using resins (for shallow, noncavitated lesions) or stainless steel crowns (the Hall Technique, for cavitated lesions in primary molars), or opening up the lesion and regularly cleaning it (nonrestorative cavity control, currently not supported by sufficient evidence). Dentists should tailor their carious tissue removal strategy according to tooth type and, more importantly, lesion depth. © 2017 Wiley Periodicals, Inc.

  5. Clinical performance of self-assembling peptide P11 -4 in the treatment of initial proximal carious lesions: A practice-based case series.

    PubMed

    Schlee, Markus; Schad, Till; Koch, Jan H; Cattin, Philippe C; Rathe, Florian

    2017-09-03

    The aim of the present study was to investigate the clinical performance of self-assembling peptide P11 -4 on non-cavitated initial proximal carious lesions 12 months after treatment. Twenty-six patients, aged between 18 and 65 years, with 35 carious lesions were included in this practice-based, uncontrolled, prospective case series. The opacity and size of the proximal lesions were evaluated visually at baseline and at day 360 using standardized single-tooth or bite-wing and digital-subtraction radiography. Pairwise evaluation of images was carried out in a randomized and blinded manner with respect to the time point. Twelve months after treatment of the proximal carious lesions, the visual evaluation showed a predominant shift toward regression of the initial lesions. Radiographic assessment yielded regression of the caries in 17 of 28 cases; four of 28 were regarded as unchanged, and seven of 28 lesions showed progression of the carious lesion. Combined assessment of clinical radiographs and digital subtraction radiographs confirmed the radiographic assessment, with 20 of 28 lesions showing total or partial regression, four unchanged, and four progressing. Radiographic and digital subtraction analyses suggest that initial proximal carious lesions can regress after treatment with P11 -4, but additional factors might influence the overall treatment outcome. © 2017 John Wiley & Sons Australia, Ltd.

  6. Two-year clinical evaluation of three adhesive systems in non-carious cervical lesions

    PubMed Central

    ELİGUZELOGLU DALKILİC, Evrim; OMURLU, Huma

    2012-01-01

    Objectives Adhesive systems are continuously being introduced to Dentistry, unfortunately often without sufficient clinical validation. The aim of this study was to evaluate the clinical performance of cervical restorations done with three different adhesive systems. Material and methods 158 non-carious cervical lesions of 23 patients were restored with a nanofilled composite resin (Filtek Supreme, 3M/ESPE) combined with Single Bond (3M/ESPE, group SI), Clearfil SE (Kuraray Medical Inc., group CL) and Xeno III (De Trey Dentsply, group XE). In groups SI-B, CL-B and XE-B, the outer surface of the sclerotic dentin was removed by roughening with a diamond bur before application of the respective adhesive systems. In groups CL-BP and XE-BP, after removal of the outer surface of the sclerotic dentin with the bur, the remaining dentin was etched with 37% phosphoric acid and the self-etch adhesive systems Clearfil SE and Xeno III were applied, respectively. Lesions were evaluated at baseline, and restorations after 3 months, 1 year and 2 years using modified USPHS criteria. Results After 2 years, no significant difference was found between the retention rates of the groups (p >0.05). Although groups CL and SI showed significantly better marginal adaptation than group XE (p<0.05) at 2 years, no significant difference was found between the marginal adaptation of the groups SI-B, CL-B and XE-B (p>0.05). After 2 years no significant difference was observed among the marginal staining results of all groups (p>0.05). Conclusion Although all adhesive systems showed similar retention rates, Clearfil SE and Single Bond showed better marginal adaptation than Xeno III after 2 years of follow-up. PMID:22666836

  7. Clinical features and factors associated with non-carious cervical lesions and dentin hypersensitivity.

    PubMed

    Yoshizaki, K T; Francisconi-Dos-Rios, L F; Sobral, M A P; Aranha, A C C; Mendes, F M; Scaramucci, T

    2017-02-01

    Determining the factors associated with NCCLs and DH in populations could guide the implementation of specific preventive measures. This study evaluated the clinical features and factors associated with non-carious cervical lesions (NCCLs) and dentin hypersensitivity (DH) in a Brazilian population. The participants were 118 patients at the Dentistry Clinic of our dental school. They completed an interview to obtain personal information and determine the possible factors associated with NCCLs and DH. Clinical examination was undertaken to record the NCCLs, shape of the lesion and certain occlusal factors. DH was diagnosed by air and probe tests. Data were analysed with the multilevel Poisson regression and prevalence ratios, and the respective 95% confidence intervals were calculated. The prevalence of NCCLs and DH among patients was 67·8% and 51·7%, respectively. Of a total number of 2902 teeth examined, 9·65% had NCCLs and 5·82% were sensitive to air. The most affected teeth for both conditions were the premolars. Most of the NCCLs were wedge-shaped and located in the maxilla. The factors associated with NCCLs and DH were age and presence of premature occlusal contacts. NCCLs were also significantly associated with consumption of wine and alcoholic beverages, and DH with consumption of acidic fruits and juices. NCCLs were a common finding, with higher frequency in more advanced age groups, the maxilla and premolars. A significant association occurred between NCCLs, premature contacts and consumption of wine and alcoholic beverages. DH was associated with NCCLs, premature contacts and with the consumption of acidic fruits and juices. © 2016 John Wiley & Sons Ltd.

  8. How mechanical stresses modulate enamel demineralization in non-carious cervical lesions?

    PubMed

    Leal, Noélia M S; Silva, Juscelino L; Benigno, Maria Ivone M; Bemerguy, Eliane A; Meira, Josete B C; Ballester, Rafael Y

    2017-02-01

    To introduce an experimental non-carious cervical lesion (NCCL) model for studying the influence of presence and type of stress (tension or compression) on acid effects involved in NCCL formation on the enamel near the cement-enamel junction (CEJ). 108 bovine incisors were cut into 18 × 3×3 mm(3) beams, with a notch in the cervical region to generate a standardized area of stress concentration. Half of the specimens were immersed in distilled water and the other half in acetic acid solution (pH 4.5) for 72h. Each group was divided into three subgroups. Two subgroups underwent 800gf static loading, with the specimen positioned in a bending jig with the buccocervical region under either tension or compression. The load was applied simultaneously to immersion (in water or in acid). The third subgroup was not subjected to loading. Transversal and longitudinal 0.05 mm plates of the specimens were analyzed under a light microscope (40, 100 and 200×) to measure the enamel demineralization depth and to assess the presence of cracks, fractures and gaps at the enamel-dentin junction. The demineralization depth data were submitted to ANOVA and Tukey's test at a 5% significance level. Enamel demineralization depth (μm) was higher under tension (158±19 in transversal sections and 229±32 in longitudinal sections) than under compression (transversal: 129±16 and longitudinal: 167±10) or unstressed condition (transversal: 138±21 and longitudinal: 187±21). Specimens immersed in acid and subjected to tensile stress presented enamel micro fractures and wider gaps in the dentin-enamel junction. Enamel demineralization was significantly higher in the presence of tensile stress, due to wider gaps between dentin and enamel, stress corrosion cracking and increased enamel permeability to acid. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Flowable composites for restoration of non-carious cervical lesions: Three-year results.

    PubMed

    May, Sabine; Cieplik, Fabian; Hiller, Karl-Anton; Buchalla, Wolfgang; Federlin, Marianne; Schmalz, Gottfried

    2017-03-01

    To evaluate the clinical performance of two flowable composites for restoring Class-V non-carious cervical lesions (NCCLs), one with novel (ND; N'Durance(®) Dimer Flow, Septodont) and one with modified conventional matrix composition (FS; Filtek™ Supreme XTE Flow, 3M-ESPE). The null hypothesis was that both flowable composites perform equally regarding clinical quality and survival. 50 patients received one ND and one FS restoration of NCCLs in premolars using Clearfil Protect Bond (Kuraray) as an adhesive. Restorations were evaluated by two examiners at baseline (BL), 18 and 36 months employing FDI criteria. Non-parametric statistical analyses and χ(2) tests were applied (α=0.05). 48 patients with both restorations under risk participated in the 36-mo recall. One patient terminated participation after the 18-mo recall. One ND restoration failed at the 18-mo recall (fracture). One FS restoration failed during clinical examination at the 36-mo recall (debonding). 95.8% of restorations each were rated clinically acceptable at 36-mo. No significant differences for all selected FDI criteria were recorded between ND and FS at each examination time point except for the criteria surface staining at 36-mo and marginal staining at 18-mo and 36-mo, where FS showed significantly better results. For each material, no significant differences over time were detected, except for loss of surface lustre for FS (BL to 18 months). Within the limitations of the study, the null hypothesis that materials perform equally could not be rejected. Both flowable composites performed equally regarding survival and similarly regarding clinical performance. Copyright © 2016 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  10. Retention of tooth-colored restorations in non-carious cervical lesions--a systematic review.

    PubMed

    Santos, Maria Jacinta Moraes Coelho; Ari, Nilgun; Steele, Shawn; Costella, John; Banting, David

    2014-01-01

    The aim of this review was to assess the effect of different adhesive systems and tooth preparation on the retention of tooth-colored restorative materials placed in non-carious cervical lesions (NCCLs). Randomized clinical trials with a minimum of 3 years of follow-up that evaluated the effectiveness of tooth-colored materials, adhesive systems, and preparation techniques for the restoration of NCCLs were selected. The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE (OVID), the Latin American and Caribbean Health Sciences Literature database (LILACS), and Medline (OVID) electronic databases were searched from 1990 to 2013. Twenty-seven randomized clinical trials were included and reviewed. Meta-analysis was used to determine the relative risk of loss of tooth-colored NCCL restorations between different categories of adhesive systems. The effect of tooth preparation could not be similarly analyzed. The current best evidence indicates that a glass ionomer cement has a significantly lower risk of loss of a NCCL restoration compared to either a three-step etch-and-rinse or a two-step etch-and-rinse adhesive system; a three-step etch-and-rinse adhesive system has a significantly lower risk of loss of a NCCL restoration compared to a two-step etch-and-rinse adhesive system. No significant difference could be observed in the risk of loss of a tooth-colored NCCL restoration between a three-step etch-and-rinse adhesive system and either a two-step self-etch or a one-step self-etch adhesive system.

  11. 3-year clinical effectiveness of one-step adhesives in non-carious cervical lesions.

    PubMed

    Moretto, S G; Russo, E M A; Carvalho, R C R; De Munck, J; Van Landuyt, K; Peumans, M; Van Meerbeek, B; Cardoso, M V

    2013-08-01

    Despite representing an important component of current dental adhesives, HEMA has been said to negatively influence the long-term stability of adhesion to dentine and enamel. The aim of this randomised clinical trial was to evaluate the 3-year clinical performance of two one-step self-etch adhesives. Thirty patients had 175 non-carious cervical lesions restored with composite (Gradia Direct Anterior, GC) using either the HEMA-rich adhesive Clearfil Tri-S Bond (C3S; Kuraray) or the HEMA-free adhesive G-Bond (GB; GC). The restorations were evaluated by two examiners at baseline, 6, 12, 24 and 36 months regarding retention, caries recurrence, marginal integrity and discoloration and post-operative sensitivity. The data were statistically analysed with GEE and McNemar tests (p<0.05). The recall rate at 6 and 12 months was 100% and decreased to 96.7% at 24 and 36 months. At 3 years, the retention rate was 93.8% for C3S and 98.8% for GB (p=0.14). A pairwise comparison showed no significant differences between the two adhesives for all the parameters evaluated, irrespective of the recall (p>0.05). After 3 years, both adhesives presented an increase in the percentage of clinically acceptable marginal discoloration (C3S: 32.9% and GB: 26.8%) normally associated to clinically acceptable marginal defects (C3S: 35.8% and GB: 26.5%). Only 1 dentine margin of a GB restoration presented a severe marginal defect (1.2%) and 1 C3S restoration presented caries recurrence. The overall 3-year clinical success rate was 92.6% for C3S and 97.6% for GB (p=0.16). Both one-step self-etch adhesives presented an equally favourable clinical effectiveness at 3 years. HEMA is a monomer frequently present in dental adhesives in order to increase their wettability and hydrophilicity. However, this monomer negatively influences hydrolytic stability and durability of the adhesive interface complex. In this 3-year clinical trial no significant difference in bonding effectiveness was noticed between a

  12. Cysteine Cathepsins in Human Carious Dentin

    PubMed Central

    Nascimento, F.D.; Minciotti, C.L.; Geraldeli, S.; Carrilho, M.R.; Pashley, D.H.; Tay, F.R.; Nader, H.B.; Salo, T.; Tjäderhane, L.; Tersariol, I.L.S.

    2011-01-01

    Matrix metalloproteinases (MMPs) are important in dentinal caries, and analysis of recent data demonstrates the presence of other collagen-degrading enzymes, cysteine cathepsins, in human dentin. This study aimed to examine the presence, source, and activity of cysteine cathepsins in human caries. Cathepsin B was detected with immunostaining. Saliva and dentin cysteine cathepsin and MMP activities on caries lesions were analyzed spectrofluorometrically. Immunostaining demonstrated stronger cathepsins B in carious than in healthy dentin. In carious dentin, cysteine cathepsin activity increased with increasing depth and age in chronic lesions, but decreased with age in active lesions. MMP activity decreased with age in both active and chronic lesions. Salivary MMP activities were higher in patients with active than chronic lesions and with increasing lesion depth, while cysteine cathepsin activities showed no differences. The results indicate that, along with MMPs, cysteine cathepsins are important, especially in active and deep caries. PMID:21248362

  13. Diagnostic accuracy of carious lesions in digital radiographs at a public dental clinic - can it be improved by optimizing viewing conditions and further education?.

    PubMed

    Milosavljevic, Aleksandar; Westerberg, Jane; Hellén-Halme, Kristina

    2016-01-01

    This study investigated the diagnostic accuracy of digital dental radiograpny for detecting carious lesions on approximal surfaces before and after optimization of the environ- ment, and after joint training on evaluation and review of x-rays. A further aim was to evaluate differences in diagnostic accuracy between general dental practitioners (GDPs) and dental hygienists (DHs). One hundred extracted teeth (premolars and molars) underwent standardized radiography. Eleven participants (seven GDPs and four DHs) evaluated digital images for approximal carious lesions in three sessions: (1) at current conditions with no optimization or further training, (2) under optimized viewing conditions, and (3) under optimized viewing conditions after a short educational session. Receiver operating characteristic curves were,used to evaluate the results. Histological evaluation was made and served as a cri- terion standard for differentiating sound teeth and teeth with carious lesions. Kappa statistics evaluated intra-observer agreement. Diagnostic accuracy in the GDP group differed sig- nificantlyfor all types of carious lesions between the first and third evaluations (p=0.002), and also between the second and third (p=0.015). Diagnostic accuracy also differed significantly for carious lesions into the dentin between the first and third evaluations (p=0.010) and between the second and third (p=0.015). Most of the staff had optimized the environment when evaluating digital radiographs. A short educational session highlighting the difficulty of caries diagnostics in digital dental radiography can increase diagnostic accuracy. Diagnostic accuracy in the detection of approximal carious lesions on digital radiographs did not differ between GDPs and DHs.

  14. The prevalence and pattern of cavitated carious lesions in primary dentition among children under 5 years age in Sirsa, Haryana (India).

    PubMed

    Sachdeva, Anshul; Punhani, Neha; Bala, Madhu; Arora, Suraj; Gill, Gurdeep Singh; Dewan, Neeraj

    2015-01-01

    To determine the prevalence and pattern of cavitated carious lesions in primary dentition in children below 5 years of age in Sirsa, Haryana. The aim of this study was to evaluate the status of dental caries in primary dentition and compute data for planning anticipatory programs in children aged less than 5 years. The study was conducted among children attending the outpatient department of pedodontics, JCD Dental College, Sirsa, Haryana (India) from April to December 2014. This study consisted of 576 children of both sexes (311 males and 265 females) up to 5 years of age. Dentition status and treatment proforma (WHO, 1997) was used to assess the prevalence of cavitated carious lesions. Selection of children for the study was done by simple random sampling method. Chi-square test and t-test were used to compute data for statistical analysis. 33.85% of children in the study population showed presence of cavitated carious lesions. Males showed slightly higher prevalence of cavitated carious lesions than females (P = 0.35). Incidence of caries was higher in mandibular arch in both the sexes (males P = 0.9, females P = 0.7) and in posterior teeth (both sex wise and arch wise). Higher caries prevalence was noticed in maxillary anterior teeth (P = 0.04) and mandibular posterior teeth (P = 0.7). Primary second molars showed highest caries prevalence (P = 0.39) in both the arches and sexes. The mean prevalence of cavitated carious lesions in primary dentition was found to be 33.85%. Males were more affected than females. Mandibular molars and maxillary anterior teeth were the predominantly affected teeth. Mandibular anterior teeth were least affected. The increase in incidence of cavitated carious lesions shows that there is necessity of implementing dental health awareness programs and modifications in types of food consumed are needed to eliminate the cause of decay.

  15. A comparison of the preventive effects of lanthanides and fluoride on human experimental root surface carious-like lesions.

    PubMed

    Zhang, W; Jin, H; Liu, A

    1999-02-01

    To investigate the mechanisms of lanthanides prevention of human root surface carious-like lesions and to compare the effectiveness of lanthanum (La) with that of cerium (Ce) and fluoride (F). Various treatment procedures were also compared. Acetic buffers containing lanthanum, cerium, and fluoride (500 ppm) were used individually or in combination to treat 48 cementum-dentin samples. The acid-resistant capacity of various treatment procedures was evaluated by means of scanning electron microscope, electron microprobe, and polarizing light microscope analyses. The acid-resistant effects of lanthanide element were comparable to those of fluoride, and their acid-resistant effects were even stronger when combined with fluoride and cerium. These effects are likely due to the formation of La(Ce)HAP, FLa(Ce)HAP, and lanthanum/cerium phosphate compounds. Combined F/La(Ce) was more effective in the prevention of root surface caries than were lanthanides alone.

  16. Effects of non-carious cervical lesion size, occlusal loading and restoration on biomechanical behaviour of premolar teeth.

    PubMed

    Zeola, L F; Pereira, F A; Machado, A C; Reis, B R; Kaidonis, J; Xie, Z; Townsend, G C; Ranjitkar, S; Soares, P V

    2016-12-01

    Information on fracture biomechanics has implications in materials research and clinical practice. The aim of this study was to analyse the influence of non-carious cervical lesion (NCCL) size, restorative status and direction of occlusal loading on the biomechanical behaviour of mandibular premolars, using finite element analysis (FEA), strain gauge tests and fracture resistance tests. Ten buccal cusps were loaded on the outer and inner slopes to calculate the strain generated cervically. Data were collected for healthy teeth at baseline and progressively at three lesion depths (0.5 mm, 1.0 mm and 1.5 mm), followed by restoration with resin composite. The magnitude and distribution of von Mises stress and maximum principal stress were simulated at all stages using FEA, and fracture strength was also determined (n = 7 per group). There were significant effects of the lesion size and loading directions on stress, strain and fracture resistance (p < 0.05). Fracture resistance values decreased with increase in lesion size, but returned to baseline with restorations. Combined assessment of computer-based and experimental techniques provide an holistic approach to characterize the biomechanical behaviour of teeth with both unrestored and restored NCCLs. © 2016 Australian Dental Association.

  17. Antimicrobial Capacity of Casein Phosphopeptide/Amorphous Calcium Phosphate and Enzymes in Glass Ionomer Cement in Dentin Carious Lesions

    PubMed Central

    PINHEIRO, SÉRGIO LUIZ; AZENHA, GIULIANA RODRIGUES; DE MILITO, FLÁVIA; DEMOCH, YASMIN MARIALVA

    2015-01-01

    Objective To evaluate the ability of casein phosphopeptide/amorphous calcium phosphate (CPP/ACP) and lysozyme, lactoferrin, and lactoperoxidase (LLL) added to glass ionomer cement (GIC) to inhibit the growth of S. mutans in a caries model. Material and methods Eighty permanent third molars were selected. The dentin of these teeth was exposed and flattened. Except for the coronal dentin, the specimens were waterproofed, autoclaved, and submitted to cariogenic challenge with standard strain of S. mutans. The carious lesions were sealed as follows: group 1 (n=20): GIC without additives; group 2 (n=20): GIC + CPP/ACP; group 3 (n=20): GIC + LLL; group 4 (n=20): GIC + CPP/ACP + LLL. S. mutans counts were performed before the caries were sealed (n=5), after 24 hours (n=5), at 1 month (n=5), and at 6 months (n=5). The results were analyzed using descriptive statistical analysis and the Kruskal-Wallis test (Student-Newman-Keuls test). Results GIC + LLL caused a significant reduction of S. mutans 1 month after sealing (p<0.01); however, there was a significant growth of S. mutans 6 months after sealing. GIC, GIC + CPP/ACP, and GIC + CPP/ACP + LLL showed similar behavior with significant reduction of S. mutans after 24 hours (p<0.05) and increase after 1 and 6 months. Conclusion The addition of LLL to GIC increases the antimicrobial action of GIC on S. mutans. This leads to control of bacterial biofilm for 1 month, thus stopping the progression of carious lesions. PMID:27688392

  18. Diagnostic yield of ink-jet prints from digital radiographs for the assessment of approximal carious lesions: ROC-analysis.

    PubMed

    Schulze, Ralf K W; Grimm, Stefanie; Schulze, Dirk; Voss, Kai; Keller, Hans-Peter; Wedel, Matthias

    2011-08-01

    To investigate the diagnostic quality of different quality, individually calibrated ink-jet printers for the very challenging dental radiographic task of approximal carious lesion detection. A test-pattern evaluating resolution, contrast and homogeneity of the ink-jet prints was developed. 50 standardized dental radiographs each showing two neighbouring teeth in natural contact were printed on glossy paper with calibrated, randomly selected ink-jet printers (Canon S520 and iP4500, Epson Stylus Photo R2400). Printing size equalled the viewing size on a 17″ cathode-ray-tube monitor daily quality-tested according to German regulations. The true caries status was determined from serial sectioning and microscopic evaluation. 16 experienced observers evaluated the radiographs on a five-point confidence scale on all prints plus the viewing monitor with respect to the visibility of a carious lesion. A non-parametric Receiver-Operating Characteristics (ROC-) analysis was performed explicitly designed for the evaluation of readings stemming from identical samples but different modality. Significant differences are expressed by a critical ratio z exceeding ±2. Diagnostic accuracy was determined by the area (Az) underneath the ROC-curves. Average Az-values ranged between 0.62 (S520 and R2400) and 0.64 (monitor, iP4500), with no significant difference between modalities (P=0.172). Neither significant (range mean z: -0.40 (S520) and -0.11 (iP4500)) nor clinically relevant differences were found between printers and viewing monitor. Our results for a challenging task in dental radiography indicate that calibrated, off-the-shelf ink-jet printers are able to reproduce (dental) radiographs at quality levels sufficient for radiographic diagnosis in a typical dental working environment. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Carious lesions and maize consumption among the Prehispanic Maya: an analysis of a coastal community in northern Yucatan.

    PubMed

    Cucina, Andrea; Cantillo, Cristina Perera; Sosa, Thelma Sierra; Tiesler, Vera

    2011-08-01

    Patterns of carious lesions were analyzed in the Classic period coastal Maya population of Xcambó, a salt production and administration center in northern Yucatan. To this end, the study investigated caries in the permanent dentitions of 163 adult skeletons, 23 from the Early Classic (AD 250-550) and 140 from the Late Classic period (AD 550-750), equally distributed between sexes. The archaeological and bioarchaeological evidence indicates a wealthy and socially homogeneous population dedicated to salt production and administration in the Early Classic that switched to pure administrative functions in the Late Classic. The results indicate an increase in caries from 7.4% and 21.2% (males and females respectively) from the Early Classic to 14.0% in males and 27.4% in females from the Late Classic period. The rate of caries in the Early and in the Late Classic phases of continuous occupation is not consistent with a simple interpretation of a heavier reliance on maize during the latter phase, characterized by a sedentary lifestyle, particularly for the male segment of the society now dedicated completely to the administration of the salt mines. Rather, the increase in caries rates in both sexes is best explained within a broader context of overall food habits, new cariogenic foods for both sexes, and the changes in lifestyle imposed by the increased socioeconomic role of the site. Our conclusions stress the limitations imposed by interpreting carious lesions solely in terms of single dietary components, such as maize consumption, without taking into account broader aspects of cultural and socioeconomic relevance. Copyright © 2011 Wiley-Liss, Inc.

  20. Blue-laser-diode-excited fluorescence spectroscopy of natural carious lesions

    NASA Astrophysics Data System (ADS)

    Girkin, John M.; Rousseau, Christel; Hall, Andrew F.; Strang, Ronnie; Whitters, C. John; Creanor, Steve L.; Cribeiro, Adriana

    2004-05-01

    We report on the use of a blue laser diode to excite natural fluorescence from a range of dental samples. Sixty teeth with naturally occurring lesions were examined. The lesions were classified on visual inspection as falling into three classes as shiny lesions, dull lesions and brown lesions. The resulting fluorescence was then examined using a fibre optically coupled spectrometer in a series of wavelength bands. By examining the intensity ratios in the two wavelength bands 480-500nm and 620 to 640nm we were able to classify the lesion types and thus provide a quantifiable measurement of lesion types. This method has application for detection of dental caries as well as demonstrating potential application to evaluate lesions which may represent different degrees of caries activity.

  1. Effects of zinc and fluoride on the remineralisation of artificial carious lesions under simulated plaque fluid conditions.

    PubMed

    Lynch, R J M; Churchley, D; Butler, A; Kearns, S; Thomas, G V; Badrock, T C; Cooper, L; Higham, S M

    2011-01-01

    The aim was to study the effects of zinc (Zn) and fluoride (F) on remineralisation at plaque fluid concentrations. Artificial carious lesions were created in 2 acid-gel demineralising systems (initially infinitely undersaturated and partially saturated with respect to enamel) giving lesions with different mineral distribution characteristics (high and low R values, respectively) but similar integrated mineral loss values. Lesions of both types were assigned to 1 of 4 groups and remineralised for 5 days at 37°C. Zn and F were added, based on plaque fluid concentrations 1 h after application, to give 4 treatments: 231 μmol/l Zn, 10.5 μmol/l F, Zn/F combined and an unmodified control solution (non-F/non-Zn). Subsequently remineralisation was measured using microradiography. High-R lesions were analysed for calcium, phosphorus, F and Zn using electron probe micro-analysis. All lesions underwent statistically significant remineralisation. For low-R lesions, remineralisation was in the order F(a) < non-F/non-Zn(a) < Zn(a, b) < Zn/F(b), and for high-R lesions F(a) < non-F/non-Zn(b) < Zn(b) < Zn/F(c) (treatments with the same superscript letter not significantly different, at p < 0.05). Qualitatively, remineralisation occurred throughout non-F/non-Zn and Zn groups, predominantly at the surface zone (F) and within the lesion body (Zn/F). Electron probe micro-analysis revealed Zn in relatively large amounts in the outer regions (Zn, Zn/F). F was abundant not only at the surface (F), but also in the lesion body (Zn/F). Calcium:phosphate ratios were similar to hydroxyapatite (all). To conclude, under static remineralising conditions simulating plaque fluid, Zn/F treatment gave significantly greater remineralisation than did F treatment, possibly because Zn in the Zn/F group maintained greater surface zone porosity compared with F, facilitating greater lesion body remineralisation. Copyright © 2011 S. Karger AG, Basel.

  2. Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis

    NASA Astrophysics Data System (ADS)

    Ornellas, Pâmela Oliveira; Antunes, Leonardo Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

    2016-09-01

    This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration's tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

  3. Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis.

    PubMed

    Ornellas, Pâmela Oliveira; Antunes, Leonardo Dos Santos; Fontes, Karla Bianca Fernandes da Costa; Póvoa, Helvécio Cardoso Corrêa; Küchler, Erika Calvano; Iorio, Natalia Lopes Pontes; Antunes, Lívia Azeredo Alves

    2016-09-01

    This study aimed to perform a systematic review to assess the effectiveness of antimicrobial photodynamic therapy (aPDT) in the reduction of microorganisms in deep carious lesions. An electronic search was conducted in Pubmed, Web of Science, Scopus, Lilacs, and Cochrane Library, followed by a manual search. The MeSH terms, MeSH synonyms, related terms, and free terms were used in the search. As eligibility criteria, only clinical studies were included. Initially, 227 articles were identified in the electronic search, and 152 studies remained after analysis and exclusion of the duplicated studies; 6 remained after application of the eligibility criteria; and 3 additional studies were found in the manual search. After access to the full articles, three were excluded, leaving six for evaluation by the criteria of the Cochrane Collaboration’s tool for assessing risk of bias. Of these, five had some risk of punctuated bias. All results from the selected studies showed a significant reduction of microorganisms in deep carious lesions for both primary and permanent teeth. The meta-analysis demonstrated a significant reduction in microorganism counts in all analyses (p<0.00001). Based on these findings, there is scientific evidence emphasizing the effectiveness of aPDT in reducing microorganisms in deep carious lesions.

  4. Pain during Removal of Carious Lesions in Children: A Randomized Controlled Clinical Trial

    PubMed Central

    Motta, Lara Jansiski; Bussadori, Sandra Kalil; Campanelli, Ana Paula; da Silva, André Luis; Alfaya, Thays Almeida; de Godoy, Camila Haddad Leal; Navarro, Maria Fidela de Lima

    2013-01-01

    The aim of the present study was to assess pain and the need for anesthesia during chemomechanical caries removal with Papacarie gel and the traditional method (low-speed bur) in pediatric patients. A randomized, controlled, clinical trial with a “split-mouth” design was carried out involving 20 children (10 girls and 10 boys) aged four to seven years. Forty primary teeth (two per child) were randomly allocated to either Group 1 (G1: chemomechanical caries removal with Papacarie gel) or Group 2 (G2: removal of carious dentin with low-speed bur). A face scale was used to classify the sensation of pain during the procedure (1: absence of pain; 2: mild pain; 3: moderate pain; 4: moderately intense pain; 5: intense pain; and 6: extremely intense pain). Statistical analysis of the data was performed using the Wilcoxon-Mann-Whitney (U) test. Pain scores were higher in G2, with statistically significant differences in comparison to G1 (U = 148.0; W = 358.0; P = 0.041). Chemomechanical caries removal with Papacarie provides a lesser degree of pain in comparison to conventional caries removal and does not require the use of local anesthesia. The clinical trial registration number is NCT01811420. PMID:24363672

  5. Pain during Removal of Carious Lesions in Children: A Randomized Controlled Clinical Trial.

    PubMed

    Motta, Lara Jansiski; Bussadori, Sandra Kalil; Campanelli, Ana Paula; da Silva, André Luis; Alfaya, Thays Almeida; de Godoy, Camila Haddad Leal; Navarro, Maria Fidela de Lima

    2013-01-01

    The aim of the present study was to assess pain and the need for anesthesia during chemomechanical caries removal with Papacarie gel and the traditional method (low-speed bur) in pediatric patients. A randomized, controlled, clinical trial with a "split-mouth" design was carried out involving 20 children (10 girls and 10 boys) aged four to seven years. Forty primary teeth (two per child) were randomly allocated to either Group 1 (G1: chemomechanical caries removal with Papacarie gel) or Group 2 (G2: removal of carious dentin with low-speed bur). A face scale was used to classify the sensation of pain during the procedure (1: absence of pain; 2: mild pain; 3: moderate pain; 4: moderately intense pain; 5: intense pain; and 6: extremely intense pain). Statistical analysis of the data was performed using the Wilcoxon-Mann-Whitney (U) test. Pain scores were higher in G2, with statistically significant differences in comparison to G1 (U = 148.0; W = 358.0; P = 0.041). Chemomechanical caries removal with Papacarie provides a lesser degree of pain in comparison to conventional caries removal and does not require the use of local anesthesia. The clinical trial registration number is NCT01811420.

  6. The prevalence and morphological types of non-carious cervical lesions (NCCL) in a contemporary sample of people.

    PubMed

    Igarashi, Yuriko; Yoshida, Satoru; Kanazawa, Eisaku

    2017-03-08

    Non-carious cervical lesions (NCCLs) were examined in 6541 extracted human teeth and classified based on the morphology of the lesions. As a result, NCCLs were found on 38.7% of teeth (41.6% on maxillary teeth and 36.0% on mandibular teeth), and were most frequent on canines and first premolars. According to the new method of classification, the morphology of NCCLs was classified both by the surface contour (SC) and by the cross-sectional contour (CC). Three types of NCCLs appeared to be dominant. The causes of these NCCLs were discussed based on their morphologies, positions where these NCCLs were frequently found, and the results of previous studies. NCCLs with a horizontal oval SC and a round CC (Type I), which were frequent on the labial surfaces of maxillary canines and buccal surfaces of maxillary first premolars, may be associated with wear by friction and chemical degradation. NCCLs with a vertical oval SC and a round CC (Type II), which were frequent on the lingual surfaces of mandibular incisors and canines, might be mainly related to chemical degradation. NCCLs with a horizontal oval SC and a wedge shape CC (Type III), which were extensively found on the buccal surfaces of maxillary premolars, had formed most probably due to wear by friction and microstructural loss by stress. This new method can classify the morphology of NCCLs more precisely and deduce the mechanisms of the formation of NCCLs more clearly than former methods.

  7. OCT assessment of non-cavitated occlusal carious lesions by variation of incidence angle of probe light and refractive index matching.

    PubMed

    Park, Kyung-Jin; Haak, Rainer; Ziebolz, Dirk; Krause, Felix; Schneider, Hartmut

    2017-07-01

    This study evaluated (1) the detection and assessment of non-cavitated occlusal carious lesions by spectral domain optical coherence tomography (SD-OCT) and (2) the impact of varying angle of incidence (AI) of probe light and refractive index matching (RIM). Nine extracted human molars with 18 occlusal lesions (ICDAS code 2) were visually selected. 18 regions of interest (ROI) were imaged with SD-OCT under varying AI (0°, ±5°, ±10°, ±15°) and with/without application of glycerine at 0°. X-ray micro computed tomography (μCT) was used as a validation standard. μCT and OCT signals were categorized according to the lesion extent: 1-sound, 2-lesion limited to half of enamel, 3-lesion limited to enamel, 4-lesion into dentin. Agreement between both methods was assessed. Intra- and inter-examiner reproducibility analyses were conducted. Cohen's kappa coefficient (κ), Spearman's rho correlation (rs) and Wilcoxon test (α=0.05). Slight to moderate agreement (κ=0.153) between μCT and OCT was obtained at an AI of 0° (Wilcoxon: p=0.02). With variation of Al a substantial agreement (κ=0.607) was observed (p=0.74). Spearman's correlation between both methods was 0.428 at 0°, 0.75 with varying AI and 0.573 with glycerine. Kappa values for intra-and inter-examiner analysis ranged between 0.81 and 0.88 and between 0.25 and 0.73, respectively. Variation of AI improves the detectability of non-cavitated occlusal carious lesions. RIM can enhance signal-to-noise ratio. OCT could provide additional diagnostic information in single and longitudinal assessments of occlusal carious lesions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Remineralization effects of two pediatric dentifrices and one regular dentifrice on artificial carious lesion in primary teeth: An in vitro study

    PubMed Central

    Advani, Shweta; Sogi, Suma; Hugar, Shivayogi; Indushekar, K. R.; Kiran, K.; Hallikerimath, Seema

    2014-01-01

    Aim: The aim of the following study is to know the efficacy of remineralization of two pediatric dentifrices and one regular dentifrice on artificial carious lesions in primary teeth. Materials and Methods: A total of 21 teeth coated with nail varnish leaving a window of 1 mm were subjected to demineralization for 72 h. These 21 teeth were then sectioned into two equal parts with a diamond disc. The 42 sections obtained were then evaluated under the stereomicroscope and the demineralization values were noted. The 42 sections were divided into three groups: Group 1: Kidodent, Group 2: Cheeriogel, Group 3: Colgate Total and subjected to remineralization respectively for 7 days. The specimens were again evaluated under the stereomicroscope for the remineralisation values. Results: All the three dentifrices showed remineralization with artificial carious lesions. Colgate Total showed higher remineralization rates compared with the other two pediatric dentifrices. Kidodent showed a slightly higher remineralisation rate compared with Cheeriogel which was not significant. Conclusion/Hypothesis: The pediatric dentifrices also showed remineralization with artificial carious lesions. Hence, we conclude that, this amount of remineralization was more or less, when compared to the regular dentifrice which showed higher remineralization rates, which could lead to adverse effects, like fluorosis if not used judiciously. On basis of which we hypothetize: Pediatric dentifrices have an appropriate fluoride content, as required by the children, and also does not minimize the cariostatic effects. PMID:25254193

  9. Remineralization effects of two pediatric dentifrices and one regular dentifrice on artificial carious lesion in primary teeth: An in vitro study.

    PubMed

    Advani, Shweta; Sogi, Suma; Hugar, Shivayogi; Indushekar, K R; Kiran, K; Hallikerimath, Seema

    2014-05-01

    The aim of the following study is to know the efficacy of remineralization of two pediatric dentifrices and one regular dentifrice on artificial carious lesions in primary teeth. A total of 21 teeth coated with nail varnish leaving a window of 1 mm were subjected to demineralization for 72 h. These 21 teeth were then sectioned into two equal parts with a diamond disc. The 42 sections obtained were then evaluated under the stereomicroscope and the demineralization values were noted. The 42 sections were divided into three groups: Group 1: Kidodent, Group 2: Cheeriogel, Group 3: Colgate Total and subjected to remineralization respectively for 7 days. The specimens were again evaluated under the stereomicroscope for the remineralisation values. All the three dentifrices showed remineralization with artificial carious lesions. Colgate Total showed higher remineralization rates compared with the other two pediatric dentifrices. Kidodent showed a slightly higher remineralisation rate compared with Cheeriogel which was not significant. The pediatric dentifrices also showed remineralization with artificial carious lesions. Hence, we conclude that, this amount of remineralization was more or less, when compared to the regular dentifrice which showed higher remineralization rates, which could lead to adverse effects, like fluorosis if not used judiciously. On basis of which we hypothetize: Pediatric dentifrices have an appropriate fluoride content, as required by the children, and also does not minimize the cariostatic effects.

  10. Four-year randomized clinical trial of oxalic acid pretreatment in restorations of non-carious cervical lesions.

    PubMed

    Albuquerque, Nadine Luísa Guimarães; de Souza, André Mattos Brito; de Moraes, Maria Denise Rodrigues; Mendonça, Juliano Sartori; Rodrigues, Lidiany Karla Azevedo; Santiago, Sérgio Lima

    2016-03-01

    The aim of this study was to evaluate the efficiency of oxalic acid (BisBlock) on restorations of non-carious cervical lesions. One operator placed 90 restorations randomly divided into two groups in 20 patients under cotton rolls isolation: Control Group-two-step etch-and-rinse adhesive technique; and Experimental Group-two-step etch-and-rinse adhesive technique with oxalic acid pretreatment after acid-etched dentin. The restorative adhesive system used was XP Bond/Durafill. The restorations were directly assessed by two independent examiners, using the modified United States Public Health Service (USPHS) criteria at the baseline and 4 years. Data were statistically analyzed using the Fisher and McNemar tests (p < 0.05). Fifteen patients (75%) were available for recall after 4 years. The McNemar test detected significant differences within the Experimental Group between the baseline and 4-year evaluations for retention (p < 0.05). For the Control Group, there was no significant difference (p > 0.05) between the periods. The Fisher test showed no statistically significant difference between the groups for all other criteria (p > 0.05). After 4 years of service, the use of oxalic acid did not influence the clinical performance of restorations when it was used under composite resin restorations.

  11. Effect of CPP-ACP Paste on Enamel Carious Lesion of Primary Upper Anterior Teeth Assessed by Quantitative Light-Induced Fluorescence: A One-Year Clinical Trial.

    PubMed

    Sitthisettapong, Thanya; Doi, Takashi; Nishida, Yuhei; Kambara, Masaki; Phantumvanit, Prathip

    2015-01-01

    The purpose of this clinical trial was to evaluate the effect of 1 year of daily application of 10% w/v CPP-ACP (casein phosphopeptide-amorphous calcium phosphate) paste in addition to regular toothbrushing with fluoridated toothpaste on the remineralization of enamel carious lesions in preschool children using quantitative light-induced fluorescence (QLF). A total of 103 Thai children (aged 2(1)/2-3(1)/2 years) with high caries risk who had at least 1 enamel carious lesion (ICDAS 1-3) on the labial surface of the upper anterior teeth were assigned to receive either CPP-ACP paste (n = 53) or placebo control (n = 50) following toothbrushing with fluoridated toothpaste after lunch at school. QLF measurement was performed at baseline, 6 months and 1 year. At 1 year, a significant reduction in fluorescence loss (ΔF), lesion area and lesion volume (ΔQ; p ≤ 0.001) of the lesions were found over time in both groups. However, no significant difference was observed between the groups (p = 0.79, 0.98 and 0.88, respectively). There was no statistically significant difference between the odds of ΔQ transition to a stage of regression or arrest compared with progression from baseline to 1 year between the two groups (OR = 1.03, 95% CI 0.31-3.39). The daily application of 10% w/v CPP-ACP paste on a school day for 1 year resulted in no improvement of enamel carious lesion remineralization in the primary upper anterior teeth as assessed by QLF. The lesion improvement was not superior to remineralization from regular toothbrushing with fluoridated toothpaste alone in these children. © 2015 S. Karger AG, Basel.

  12. Clinical evaluation of different adhesives used in the restoration of non-carious cervical lesions: 24-month results.

    PubMed

    Tuncer, D; Yazici, A R; Özgünaltay, G; Dayangac, B

    2013-03-01

    The aim of this study was to compare after 24 months the clinical performance of cervical restorations placed with the use of an etch-and-rinse and an all-in-one adhesive. Twenty-four patients with at least one pair of non-carious cervical lesions participated in this study. One hundred and twenty-three cervical lesions were restored (62 etch-and-rinse adhesive, Solobond M; 61 all-in-one adhesive, Futurabond NR). A nanohybrid resin composite, Grandio, was used as the restorative material. Restorations were evaluated according to modified USPHS criteria by two independent examiners. The survival rates of the restorations were calculated by the Kaplan-Meier estimator and log-rank test. The restorations in each category were compared using the Pearson chi-square test, while the performance of restorations at the baseline and at each recall time was evaluated by McNemar's test (p < 0.05). The recall rate of patients was 100%. The retention rates were 82% and 75% at 6 months and 77% and 62% at 12 months for Solobond M and Futurabond NR, respectively. At the 24-month recall, the retention rate was 69% for Solobond M and 49% for Futurabond NR, and this difference was statistically significant (p < 0.05). No statistically significant difference was found for colour match, marginal staining, or marginal adaptation between the adhesives (p > 0.05). None of the restorations had secondary caries, loss of anatomical form, or surface texture changes. Cervical restorations placed with an etch-and-rinse adhesive showed higher retention than an all-in-one adhesive. © 2013 Australian Dental Association.

  13. In vitro effects of nano-hydroxyapatite paste on initial enamel carious lesions.

    PubMed

    de Carvalho, Fabíola Galbiatti; Vieira, Basílio Rodrigues; Santos, Rogério Lacerda Dos; Carlo, Hugo Lemes; Lopes, Pablo Queiroz; de Lima, Bruno Alessandro Silva Guedes

    2014-01-01

    The purpose of this study was to analyze the protective effect of remineralizing agents on enamel caries lesions using surface Knoop microhardness testing (KHN) and atomic force microscopy (AFM). Forty-eight human enamel blocks were assigned to four groups (N=12): (1) control (without agent); (2) fluoride varnish (Duraphat); (3) nano-HAP paste (Desensibilize Nano P); and (4) casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (MI Paste Plus). Incipient caries-like lesions were artificially developed. Cariogenic challenge (pH-cycling) was performed for seven days. The pastes were applied before each immersion in demineralization solution, and the varnish was applied only once. KHN values were obtained at baseline, after incipient enamel lesion, and after challenge. The percentage of surface hardness recovery (%SMHR) was performed, and the surface morphology was evaluated by atomic force microscopy (AFM). ANOVA, Tukey's, and student paired t tests were applied at P<.05. After the cariogenic challenge, the nano-HAP group showed significantly higher KHN and %SMHR values than varnish. The CPP-ACP group showed no increase in KHN. The nano-HAP group showed, via AFM, a protective layer formation with globular deposits on the surface. SMHR and AFM morphology revealed that nano-hydroxyapatite paste showed a protective effect against in vitro enamel caries development.

  14. Effect of dentifrices on their remineralizing potential in artificial carious lesions: An in situ study

    PubMed Central

    Damle, Satyawan Gangaramji; Bector, Aditi; Damle, Dhanashree; Kaur, Simranjeet

    2016-01-01

    Background: The eventual sequel of dental caries is determined by the dynamic equilibrium between pathological factors which lead to demineralization and protective elements, which in turn leads to remineralization. Remineralization is the natural process for noncavitated demineralized lesions and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. Hence, the present study was designed to evaluate the efficacy of fluoride dentifrices in remineralizing artificial caries-like lesions in situ. Materials and Methods: A double-blind, randomized study with an initial washout period of 7 days was carried out for 3 weeks. Twenty volunteers were enrolled, who wore the intraoral cariogenicity test appliance having enamel slabs incorporated into them, for 3 weeks. 10 participants were instructed to use Group A dentifrice (fluoride) and the other 10 Group B dentifrice (nonfluoride) for brushing their teeth. The enamel slabs were analyzed by surface microhardness testing and scanning electron microscopy (SEM) at 3 intervals. Results: No significant differences was seen in the microhardness values recorded for Group A and Group B at baseline and after demineralization (P > 0.05); however Group B exhibited lesser microhardness compared to Group A, after intra-oral exposure (P < 0.05). In the SEM analysis, the Group A enamel surfaces had more regular and longer crystallites to those of the Group B. Conclusion: Fluoride dentifrices avert the decrease in enamel hardness and loss of minerals from the enamel surface to a large extent as compared to the nonfluoride dentifrices. PMID:26962320

  15. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions.

    PubMed

    Lawson, Nathaniel C; Robles, Augusto; Fu, Chin-Chuan; Lin, Chee Paul; Sawlani, Kanchan; Burgess, John O

    2015-10-01

    To compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs). 37 adults were recruited with 3 or 6 NCCLs (>1.5mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan-Meier method was used to compare the retention between adhesive materials. Clinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (p<0.0001). Both Scotchbond Universal self-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively. Scotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively. 24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Antimicrobial effect of a novel ozone- generating device on micro-organisms associated with primary root carious lesions in vitro.

    PubMed

    Baysan, A; Whiley, R A; Lynch, E

    2000-01-01

    The aims of this present study were (1) to assess the antimicrobial effect of ozone from a novel ozone-generating device (Heolozone, USA) [0.052% (v/v) in air delivered at a rate of 13.33 ml.s(-1)] on primary root carious lesions (PRCLs) and (2) to evaluate the efficacy of ozone specifically on Streptococcus mutans and Streptococcus sobrinus. In study 1, 40 soft PRCLs from freshly extracted teeth were randomly divided into two groups to test the antimicrobial effect on PRCLs from exposure to ozonated water for either 10 or 20 s. Half of a lesion was removed using a sterile excavator. Subsequently, the remaining lesion was exposed to the ozonised water for a period of either 10 or 20 s (corresponding to 0. 069 or 0.138 ml of ozone, respectively). Using paired Student t tests, a significant (p<0.001) reduction (mean +/- SE) was observed in the ozone-treated groups with either a 10-second (log(10) 3.57+/-0.37) or 20-second (log(10) 3.77+/-0.42) ozone application compared with the control groups (log(10) 5.91+/-0.15 and log(10) 6.18+/-0.21, respectively). In study 2, 40 sterile saliva-coated glass beads were randomly divided into two groups for each micro-organism. One glass bead was put into each bijou bottle with 3 ml of Todd-Hewitt broth. S. mutans and S. sobrinus were inoculated anaerobically overnight. Each glass bead was then washed with 2 ml of phosphate-buffered saline. Immediately, 10 s of ozone gas was applied to each glass bead in the test groups. There was a significant (p<0.0001) reduction (mean +/- SE) in ozone-treated samples for S. mutans (log(10) 1.01+/-0.27) and S. sobrinus (log(10) 1.09+/-0.36) compared with the control samples (log(10) 3.93+/-0.07 and log(10) 4.61+/-0.13, respectively). This treatment regime is an effective, quick, conservative and simple method to kill micro-organisms in PRCLs. Ozone gas application for a period of 10 s was also capable of reducing the numbers of S. mutans and S. sobrinus on saliva-coated glass beads in vitro.

  17. Absence of carious lesions at margins of glass-ionomer cement and amalgam restorations: An update of systematic review evidence

    PubMed Central

    2011-01-01

    Background This article aims to update the existing systematic review evidence elicited by Mickenautsch et al. up to 18 January 2008 (published in the European Journal of Paediatric Dentistry in 2009) and addressing the review question of whether, in the same dentition and same cavity class, glass-ionomer cement (GIC) restored cavities show less recurrent carious lesions on cavity margins than cavities restored with amalgam. Methods The systematic literature search was extended beyond the original search date and a further hand-search and reference check was done. The quality of accepted trials was assessed, using updated quality criteria, and the risk of bias was investigated in more depth than previously reported. In addition, the focus of quantitative synthesis was shifted to single datasets extracted from the accepted trials. Results The database search (up to 10 August 2010) identified 1 new trial, in addition to the 9 included in the original systematic review, and 11 further trials were included after a hand-search and reference check. Of these 21 trials, 11 were excluded and 10 were accepted for data extraction and quality assessment. Thirteen dichotomous datasets of primary outcomes and 4 datasets with secondary outcomes were extracted. Meta-analysis and cumulative meta-analysis were used in combining clinically homogenous datasets. The overall results of the computed datasets suggest that GIC has a higher caries-preventive effect than amalgam for restorations in permanent teeth. No difference was found for restorations in the primary dentition. Conclusion This outcome is in agreement with the conclusions of the original systematic review. Although the findings of the trials identified in this update may be considered to be less affected by attrition- and publication bias, their risk of selection- and detection/performance bias is high. Thus, verification of the currently available results requires further high-quality randomised control trials. PMID

  18. Non-carious cervical lesions (NCCLs) in a random sampling community population and the association of NCCLs with occlusive wear.

    PubMed

    Yang, J; Cai, D; Wang, F; He, D; Ma, L; Jin, Y; Que, K

    2016-12-01

    This study investigated the prevalence, risk factors and association of occlusive wear with non-carious cervical lesions (NCCLs) in the general Chinese population. A total of 1320 subjects were recruited, and multistage and random sampling methods of survey spots were performed. All age groups comprised similar numbers of participants and equal numbers of males and females. Each subject completed a structured interview, and all teeth of each subject were examined by a practitioner to determine NCCLs and occlusive wear. Binary logistic regression was conducted by analysing the association of risk factors with the occurrence of NCCLs. Bivariate correlation analysis was performed by determining the association of NCCLs dimension or depth with the range of occlusive wear facets. Clinical assessment showed that the overall prevalence of subjects diagnosed with NCCLs was 63%. The proportion of subjects or teeth with NCCLs significantly increased with age. Pre-molars were the most commonly affected teeth. Single variables and interactive effects of variables associated with the occurrence of NCCLs include the following: age group, intensity of toothbrushing, frequency of fresh fruit consumption and interactive effect between intensity of toothbrushing and frequency of fresh fruit consumption. A weak positive correlation of the grading index was found between NCCLs dimension, size or depth and range of occlusive wear facets. This study reported the higher prevalence of NCCLs in the general Chinese population. Implementation of a combined strategy to reduce risk factors of NCCLs could be more effective than individual techniques; meanwhile, the occurrence of NCCL could be related to the wear degree of occlusive defects in the population studied. © 2016 John Wiley & Sons Ltd.

  19. Prevalence and risk factors of non-carious cervical lesions related to occupational exposure to acid mists.

    PubMed

    Bomfim, Rafael Aiello; Crosato, Edgard; Mazzilli, Luiz Eugênio Nigro; Frias, Antonio Carlos

    2015-01-01

    This study evaluates the prevalence and risk factors of non-carious cervical lesions (NCCLs) in a Brazilian population of workers exposed and non-exposed to acid mists and chemical products. One hundred workers (46 exposed and 54 non-exposed) were evaluated in a Centro de Referência em Saúde do Trabalhador - CEREST (Worker's Health Reference Center). The workers responded to questionnaires regarding their personal information and about alcohol consumption and tobacco use. A clinical examination was conducted to evaluate the presence of NCCLs, according to WHO parameters. Statistical analyses were performed by unconditional logistic regression and multiple linear regression, with the critical level of p < 0.05. NCCLs were significantly associated with age groups (18-34, 35-44, 45-68 years). The unconditional logistic regression showed that the presence of NCCLs was better explained by age group (OR = 4.04; CI 95% 1.77-9.22) and occupational exposure to acid mists and chemical products (OR = 3.84; CI 95% 1.10-13.49), whereas the linear multiple regression revealed that NCCLs were better explained by years of smoking (p = 0.01) and age group (p = 0.04). The prevalence of NCCLs in the study population was particularly high (76.84%), and the risk factors for NCCLs were age, exposure to acid mists and smoking habit. Controlling risk factors through preventive and educative measures, allied to the use of personal protective equipment to prevent the occupational exposure to acid mists, may contribute to minimizing the prevalence of NCCLs.

  20. Association between the number of early carious lesions and diet in children with a high prevalence of caries.

    PubMed

    Llena, C; Leyda, A; Forner, L; Garcet, S

    2015-03-01

    An investigation was conducted in a population of paediatric patients with a high risk of caries in order to assess the association between caries history (CH) and the number of early carious lesions (ECLs) and the frequency and timing of cariogenic food and beverage intake, sugar-containing medication, the frequency and efficacy of tooth brushing, and the use of topical fluorides. Study design: descriptive study. One hundred children aged 6-15 years with≥ ECL of a permanent tooth and not enrolled in any dental health educational or preventive programme were selected. For diagnosis it was used an explorer according to the ICDAS II criteria. The participants completed a closed-list questionnaire on the frequency and timing of cariogenic food intake. There was a nonsignificant tendency to present more ECLs and a greater CH among patients who consumed cariogenic foods and beverages. A significant relationship (p<0.05) was observed between cariogenic beverages and the number of ECL or CH. Using the number of ECLs as dependent variable, regular fluoridated rinses (p=0.003), frequent sugar-containing medication (p=0.007), and cariogenic beverage consumption (p=0.024) were identified as explanatory parameters in the linear regression model. The Student t-test was used to compare ECL and CH with dietetic factors, fluoridated rinses, sugar- containing medicines, and the frequency and efficacy of tooth brushing. Linear regression analysis correlated the number of ECLs to the mentioned explanatory variables. The frequent consumption of sugary beverages and medications, and failure to regularly use fluoridated rinses, were positively correlated to an increased number of ECLs in patients with a high prevalence of caries.

  1. Effect of 10% carbamide peroxide bleaching on sound and artificial enamel carious lesions.

    PubMed

    Pinto, Cristiane Franco; Paes Leme, Adriana Franco; Cavalli, Vanessa; Giannini, Marcelo

    2009-01-01

    This study evaluated the effect of 10% carbamide peroxide (CP) bleaching on Knoop surface microhardness (KHN) and morphology of sound enamel and enamel with early artificial caries lesions (CL) after pH-cycling model (pHcm). Human dental enamel blocks were randomly divided into 6 groups (n=10): 1 - sound enamel bleached (S) with CP (Rembrandt/Den-Mat); 2 - S and submitted to pHcm; 3 - CL bleached with CP; 4 - CL stored in artificial saliva and submitted to pHcm; 5 - CL treated with placebo gel and submitted to pHcm; 6 - CL bleached with CP and submitted to pHcm. Enamel blocks with known initial KHN values were demineralized (groups 3 to 6) and submitted to 12 day pHcm (groups 2, 4, 5 and 6). After demineralization and treatments, KHN was determined and the specimens were examined using scanning electron microscopy (SEM). Data were analyzed statistically by ANOVA and Tukey's test at 5% significance level. The results showed that among CL groups (3 to 6) only the group 3 presented remineralization after treatments. S groups (1 and 2) showed higher KHN and presented less formation of porosities on enamel surface than CL groups after treatments. In conclusion, bleaching procedures on enamel with CL did not exacerbate the demineralization, but should be indicated with caution.

  2. Practitioner, patient, and caries lesion characteristics associated with type of material used to restore carious teeth: findings from The Dental PBRN

    PubMed Central

    Makhija, Sonia K; Gordan, Valeria V.; Gilbert, Gregg H.; Litaker, Mark S.; Rindal, D. Brad; Pihlstrom, Daniel J.; Qvist, Vibeke

    2011-01-01

    Background The authors conducted a study to identify factors associated with material use by dentists in The Dental Practice-Based Research Network (DPBRN) when placing the first restoration on permanent tooth surfaces. Methods A total of 182 DPBRN practitioner-investigators provided data on 5,599 posterior teeth with caries. Practitioner-investigators completed an enrollment questionnaire that included the dentist’s age, gender, practice workload, practice type, and years since graduation. When a consented patient presented with a previously un-restored carious surface, practitioner-investigators recorded patient and tooth characteristics. Results Amalgam was used more often than direct resin-based composite (RBC) for posterior carious lesions. Practitioner/practice characteristics (years since graduation and type of practice); patient characteristics (gender, race, age, and dental insurance); and lesion characteristics (tooth location and surface, pre-and post-operative depth) were associated with the type of restorative material used. Conclusions There are several practitioner/practice, patient, and lesion characteristics significantly associated with use of amalgam and RBC: region, years since graduation, dental insurance, tooth location and surface, and pre-and post-operative depth. Clinical implications Amalgam remains a material commonly used by United States dentists to restore posterior caries lesions. PMID:21628683

  3. Stress analysis of occlusal forces in canine teeth and their role in the development of non-carious cervical lesions: abfraction.

    PubMed

    Romeed, Shihab A; Malik, Raheel; Dunne, Stephen M

    2012-01-01

    Non-carious cervical tooth lesions for many decades were attributed to the effects of abrasion and erosion mainly through toothbrush trauma, abrasive toothpaste, and erosive acids. However, though the above may be involved, more recently a biomechanical theory for the formation of these lesions has arisen, and the term abfraction was coined. The aim of this study was to investigate the biomechanics of abfraction lesions in upper canine teeth under axial and lateral loading conditions using a three-dimensional finite element analysis. An extracted human upper canine tooth was scanned by μCT machine (Skyscan, Belgium). These μCT scans were segmented, reconstructed, and meshed using ScanIP (Simpleware, Exeter, UK) to create a three-dimensional finite element model. A 100 N load was applied axially at the incisal edge and laterally at 45° midpalatally to the long axis of the canine tooth. Separately, 200 N axial and non-axial loads were applied simultaneously to the tooth. It was found that stresses were concentrated at the CEJ in all scenarios. Lateral loading produced maximum stresses greater than axial loading, and pulp tissues, however, experienced minimum levels of stresses. This study has contributed towards the understanding of the aetiology of non-carious cervical lesions which is a key in their clinical management.

  4. Clinical effectiveness of a one-step self-etch adhesive in non-carious cervical lesions at 2 years.

    PubMed

    Ermis, R Banu; Van Landuyt, Kirsten L; Cardoso, Marcio Vivan; De Munck, Jan; Van Meerbeek, Bart; Peumans, Marleen

    2012-06-01

    A 2-year randomized, controlled prospective study evaluated the clinical effectiveness of a one-step self-etch adhesive and a "gold-standard" three-step etch-and-rinse adhesive in non-carious Class-V lesions. The null hypothesis tested was that the one-step self-etch adhesive does perform clinically equally well as the three-step etch-and-rinse adhesive. A total of 161 lesions in 26 patients were restored with Clearfil AP-X (Kuraray). The restorations were bonded either with the "all-in-one" adhesive Clearfil S3 Bond (Kuraray) or with the three-step etch-and-rinse adhesive Optibond FL (Kerr). The restorations were evaluated at baseline and after 6 months, 1 and 2 years, regarding their retention, marginal adapation, marginal discoloration, caries occurrence, preservation of tooth vitality and post-operative sensivity. Retention loss, severe marginal defects and/or discoloration that needed intervention (repair or replacement) and the occurrence of caries were considered as clinical failures. The recall rate at 2 years was 93.8%. Only one Clearfil S3 Bond restoration was lost at the 2-year recall. All other restorations were clinically acceptable. The number of restorations with defect-free margins decreased severely during the 2-year study period (to 6.7% and 25.3% for Clearfil S3 Bond and Optibond FL, respectively). The Clearfil S3 Bond restorations presented significantly more small marginal defects at the enamel side than the Optibond FL restorations (Clearfil S3 Bond: 93.3%; Optibond FL: 73.3%; p = 0.000). Superficial marginal discoloration increased in both groups (to 53.3% and 36% for Clearfil S3 Bond and Optibond FL, respectively) and was also more pronounced in the Clearfil S3 Bond group (p = 0.007). After 2 years, the simplified one-step self-etch adhesive Clearfil S3 Bond and the three-step etch-and-rinse adhesive Optibond FL were clinically equally successful, even though both adhesives were characterized by progressive degradation in marginal

  5. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm.

    PubMed

    Mei, May-Lei; Chu, Chun-Hung; Low, Kan-Hung; Che, Ching-Ming; Lo, Edward-Chin-Man

    2013-11-01

    This in vitro study investigated the effects of silver diamine fluoride (SDF) on dentine carious lesion with cariogenic biofilm. Thirty human dentine blocks were inoculated with Streptococcus mutans and Lactobacillus acidophilus dual-species biofilm to create carious lesion. They were equally divided into test and control group to receive topical application of SDF and water. After incubation anaerobically using micro-well plate at 37oC for 7 days, the biofilms were evaluated for kinetics, morphology and viability by colony forming units (CFU), scanning electron microscopy (SEM), and confocal microscopy (CLSM), respectively. The carious lesion underwent crystal characteristics analysis, evaluation of the changes in chemical structure and density of collagen fibrils using x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and immune-labeling. The log CFU of S. mutans and L. acidophilus in the test group was significantly lower than control group. SEM and CLSM showed confluent biofilm in control group, but not in test group. XRD showed the loss of crystallinity of dentine due to the dissolution of hydroxyapatite crystal structure in test group was less than control group. FTIR showed that log [Amide I: HPO42-] for test vs. control group was 0.31±0.10 vs. 0.57±0.13 (p<0.05). The gold-labeling density in test vs. control group was 8.54±2.44/µm2 vs. 12.91±4.24/µm2 (p=0.04). SDF had antimicrobial activity against the cariogenic biofilms and reduced demineralization of dentine.

  6. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm

    PubMed Central

    Mei, May L.; Low, Kan H.; Che, Ching M.; Lo, Edward CM.

    2013-01-01

    Objectives: This in vitro study investigated the effects of silver diamine fluoride (SDF) on dentine carious lesion with cariogenic biofilm. Study Design: Thirty human dentine blocks were inoculated with Streptococcus mutans and Lactobacillus acidophilus dual-species biofilm to create carious lesion. They were equally divided into test and control group to receive topical application of SDF and water. After incubation anaerobically using micro-well plate at 37oC for 7 days, the biofilms were evaluated for kinetics, morphology and viability by colony forming units (CFU), scanning electron microscopy (SEM), and confocal microscopy (CLSM), respectively. The carious lesion underwent crystal characteristics analysis, evaluation of the changes in chemical structure and density of collagen fibrils using x-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and immune-labeling. Results: The log CFU of S. mutans and L. acidophilus in the test group was significantly lower than control group. SEM and CLSM showed confluent biofilm in control group, but not in test group. XRD showed the loss of crystallinity of dentine due to the dissolution of hydroxyapatite crystal structure in test group was less than control group. FTIR showed that log [Amide I: HPO42-] for test vs. control group was 0.31±0.10 vs. 0.57±0.13 (p<0.05). The gold-labeling density in test vs. control group was 8.54±2.44/µm2 vs. 12.91±4.24/µm2 (p=0.04). Conclusions: SDF had antimicrobial activity against the cariogenic biofilms and reduced demineralization of dentine. Key words:Caries, caries arrest, dentine, silver, silver diamine fluoride, fluoride, biofilm,cariogenic. PMID:23722131

  7. Depth and activity of carious lesions as indicators for the regenerative potential of dental pulp after intervention.

    PubMed

    Bjørndal, Lars; Demant, Sune; Dabelsteen, Sally

    2014-04-01

    Studies on dental regeneration involving interventions for pulp therapy such as regeneration and revascularization procedures are promising for the injured tooth; however, a complete replication of the original pulp tissue does not seem to take place. In cases in which we wish to preserve or maintain parts of the pulp during treatment, it is apparent that the effectiveness of healing or biological regeneration is dependent on the degree of inflammation of the pulp tissue. Thus, the control or prevention of a pulp infection is still a major issue for the clinicians. Data indicate that the typical reason for performing endodontic treatment is deep caries. The biological concept of vital pulp therapy associated with deep caries takes the treatment and evaluation of the unexposed as well as the exposed pulp into account. Interestingly, the clinical diagnosis is typically the same. Deep caries with reversible pulpitis may receive differing treatments such as excavation procedures aiming to avoid pulp exposure or more pulp invasive treatments such as pulp capping or pulpotomy. This should not be the case. Consequently, huge treatment variation is noted among clinicians based on the same caries diagnosis. Which treatment should be selected? High-quality trials are needed, and it is important to obtain information on the actual lesion depth and an estimate of the lesion activity before treatment. These may be basic indicators for the regenerative potential of dental pulp. Recent clinical trials dealing with the treatment of deep caries lesion are discussed, including pulp invasive and noninvasive concepts, to attempt to solve the task of getting the best clinical outcome for adult patients. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  8. Functional remineralization of carious dentin

    NASA Astrophysics Data System (ADS)

    Pugach, Megan Kardon

    A primary goal of dental tissue engineering is the biological reconstruction of tooth substrate destroyed by caries or other diseases affecting tooth mineralization. Traditionally, dentists treat caries by using invasive techniques to remove the diseased dental tissue and restore the lesion, ideally preventing further progression of decay. Success in strategies associated with remineralization of enamel and root caries have contributed to the less invasive prospect of remineralization of dentinal carious lesions. The central hypothesis of this dissertation is that carious dentin lesions can be remineralized if the lesions contain residual mineral. Caries Detector (CD) stained zones (pink, light pink, transparent and normal) of arrested carious dentin lesions were characterized according to microstructure by atomic force microscopy (AFM) imaging, mineral content by digital transverse microradiography, and nanomechanical properties by AFM-based nanoindentation. CD-stained and unstained zones had significantly different microstructure, mineral content and nanomechanical properties. Furthermore, the most demineralized carious zone contained residual mineral. To obtain reproducible, standardized dentin caries lesions, we characterized the lesions from an artificial carious dentin lesion model using a 0.05M acetate demineralization buffer. The artificial caries-like lesions produced by the buffer had similar mineral content and nanomechanical properties in the stained and unstained zones as natural dentin lesions. Both natural and artificial lesions had significant correlations between mineral content and nanomechanical properties. Mineral crystallite size and shape was examined by small angle x-ray scattering. Both natural and artificial carious dentin had different mineral sizes than normal dentin. Collagen in natural and artificial carious dentin lesions was examined by trichrome stain, AFM high-resolution imaging, and UV resonance Raman spectroscopy, to determine if

  9. Remineralization potential of bioactive glass and casein phosphopeptide-amorphous calcium phosphate on initial carious lesion: An in-vitro pH-cycling study

    PubMed Central

    Mehta, Adit Bharat; Kumari, Veena; Jose, Rani; Izadikhah, Vajiheh

    2014-01-01

    Aims: The aim of this study was to evaluate and compare the remineralization potential of bioactive-Glass (BAG) (Novamin®/Calcium-sodium-phosphosilicate) and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) containing dentifrice. Materials and Methods: A total of 30 sound human premolars were decoronated, coated with nail varnish except for a 4 mm × 4 mm window on the buccal surface of crown and were randomly divided in two groups (n = 15). Group A — BAG dentifrice and Group B — CPP-ACP dentifrice. The baseline surface microhardness (SMH) was measured for all the specimens using the vickers microhardness testing machine. Artificial enamel carious lesions were created by inserting the specimens in de-mineralizing solution for 96 h. SMH of demineralized specimens was evaluated. 10 days of pH-cycling regimen was carried out. SMH of remineralized specimens was evaluated. Statistical Analysis: Data was analyzed using ANOVA and multiple comparisons within groups was done using Bonferroni method (post-hoc tests) to detect significant differences at P < 0.05 levels. Results: Group A showed significantly higher values (P < 0.05) when compared with the hardness values of Group B. Conclusions: Within the limits; the present study concluded that; both BAG and CPP-ACP are effective in remineralizing early enamel caries. Application of BAG more effectively remineralized the carious lesion when compared with CPP-ACP. PMID:24554851

  10. ["Carious" and "noncarious" lesions of the hard dental tissues. Ultrastructural (SEM) and microanalytical (EDS) analyses of teeth from the 3rd century B.C].

    PubMed

    Caltabiano, C; Leonardi, R; Martinez, G; Viscuso, O; Romeo, M; Caltabiano, R

    1996-05-01

    The study was carried out on 80 teeth (70 of permanent dentition and 10 of primary one) of mandibular and maxillary bones. The teeth owned to subjects lived in the III c.b.C. in Sicily, and they were found in Naxos necropolis. The teeth were examined as far as carious and non carious lesions, then they were prepared for instrumental analyses by Scanning Electron Microscopy (SEM) and Energy dispersed X ray spectrometry (EDS). To an objective examination of the sample no caries were detected in the teeth sample apart one tooth, on the other hand there was an extensive occlusal abrasion, from a macroscopic point of view there were no difference as far teeth morphology. SEM examination pointed out all around dentinal tubules a circle of sclerotic dentin as reaction to occlusal wear. The amelocemental junction showed from a ultramicroscopic point of view an overlap of cementum onto enamel. EDS analysis pointed out a higher P concentration on the crown versus the root in all the teeth of the sample.

  11. Thirteen-year randomized controlled clinical trial of a two-step self-etch adhesive in non-carious cervical lesions.

    PubMed

    Peumans, M; De Munck, J; Van Landuyt, K; Van Meerbeek, B

    2015-03-01

    The objective of this randomized controlled clinical trial was to evaluate the 13-year clinical performance of a mild two-step self-etch adhesive in non-carious cervical lesions with and without prior selective phosphoric acid-etching of the enamel cavity margins. A total of 100 non-carious cervical lesions in 29 patients were restored with Clearfil AP-X (Kuraray Noritake). The composite restorations were bonded following two different approaches: (1) application of Clearfil SE Bond (Kuraray Noritake) following a self-etch approach (CSE-NE); (2) selective phosphoric acid-etching of enamel cavity margins before application of Clearfil SE Bond (CSE-E). The restorations were evaluated after 6 months, 1, 2, 3, 5, 8 and 13 years of clinical service regarding retention, marginal integrity and discoloration, caries occurrence, preservation of tooth vitality and post-operative sensitivity. The patient recall rate at 13 years was 62%. Six restorations, 4 of the CSE-NE group and 2 of the CSE-E group, were clinically unacceptable due to loss of retention (1 CSE-NE, 1 CSE-E), a severe marginal defect (2 CSE-NE, 1 CSE-E) and caries occurrence in combination with a severe marginal defect (1 CSE-NE) leading to a clinical success rate of 86% (CSE-NE) and 93% (CSE-E). Ageing of the restorations was characterized by a further increase in the percentage of restorations with a clinically acceptable small marginal defect (CSE-NE: 87%; CSE-E: 83%) and/or superficial marginal discoloration (CSE-NE: 53%; CSE-E: 56%). The presence of small marginal defects (CSE-NE: 86%; CSE-E: 68%) and superficial marginal discoloration (CSE-NE: 41%; CSE-E: 20%) at the incisal enamel side was more frequently noticed in the CSE-NE group than in the CSE-E group. The difference, however, was not statistically significant (McNemar, p>0.05). After 13 years, the clinical effectiveness of Clearfil SE Bond in non-carious Class-V lesions remained excellent, with selective acid-etching of the enamel cavity margins

  12. Relationships between a clinical-visual scoring system and two histological techniques: a laboratory study on occlusal and approximal carious lesions.

    PubMed

    Kidd, E A M; Banerjee, A; Ferrier, S; Longbottom, C; Nugent, Z

    2003-01-01

    One aim of the present laboratory study was to determine whether a visual scoring system (ERK) developed for occlusal caries could be applied to approximal lesions. A new histological technique (autofluorescence, AF) recognises dentine that is soft and would be removed with an excavator during operative treatment. A second aim was to investigate the relationship between the visual scoring system (ERK) and AF of dentine both occlusally and approximally. The sample comprised 93 extracted teeth chosen to represent the range of visual scores on approximal and occlusal surfaces. After sectioning through the investigation site, the cut faces were examined in a stereomicroscope and the depth of demineralization was scored. Autofluorescence was viewed with a confocal laser scanning microscope. Results showed reasonable correlation between the visual scores and the stereomicroscope histological evaluations for occlusal surfaces and non-cavitated approximal surfaces. However, cavitated approximal surface lesions were less advanced histologically than cavitated occlusal carious lesions. The AF technique indicated that several lesions with intact surfaces would have had soft, excavatable dentine, whereas several with microcavities would not.

  13. Clinical evaluation of an all-in-one adhesive in non-carious cervical lesions with different degrees of dentin sclerosis.

    PubMed

    Ritter, André V; Heymann, Harald O; Swift, Edward J; Sturdevant, John R; Wilder, Aldridge D

    2008-01-01

    This randomized clinical trial compared the performance of an all-in-one adhesive (iBond) applied in sclerotic and non-sclerotic non-carious cervical lesions with that of a three-step etch-prime-bond adhesive (Gluma Solid Bond, SB). One-hundred and five lesions were randomly assigned to four groups according to adhesive, sclerosis scale and technique: 1) SB applied to lesions with sclerosis scale 1 and 2 (n=26); 2) iBond applied to lesions with sclerosis scale 1 and 2 (n=28); 3) iBond applied to lesions with sclerosis scale 3 and 4 (n=25) and 4) iBond applied with prior acid-etching to lesions with sclerosis scale 3 and 4 (n=26). A microfilled composite (Durafill VS) was used as the restorative material. The restorations were evaluated for retention, color match, marginal adaptation, anatomic form, cavosurface margin discoloration, secondary caries, pre- and post-operative sensitivity, surface texture and fracture at insertion (baseline), 6, 18 months and at 3 years using modified USPHS evaluation criteria (Alfa=excellent; Bravo=clinically acceptable; Charlie=clinically unacceptable). There was a high percentage of Bravo scores for marginal adaptation (4%-32%) and marginal discoloration (18%-60%) in Groups 2, 3 and 4, but all groups had <5% Charlie scores at 6 months and <10% Charlie scores at 18 months for retention and marginal discoloration, respectively. However, it should be noted that 13% of the restorations in Group 4 were not retained at three years.

  14. Comparing natural and artificial carious lesions in human crowns by means of conventional hard x-ray micro-tomography and two-dimensional x-ray scattering with synchrotron radiation

    NASA Astrophysics Data System (ADS)

    Botta, Lea Maria; White, Shane N.; Deyhle, Hans; Dziadowiec, Iwona; Schulz, Georg; Thalmann, Peter; Müller, Bert

    2016-10-01

    Dental caries, one of the most prevalent infectious bacterial diseases in the world, is caused by specific types of acid-producing bacteria. Caries is a disease continuum resulting from the earliest loss of ions from apatite crystals through gross cavitation. Enamel dissolution starts when the pH-value drops below 5.5. Neutralizing the pH-value in the oral cavity opposes the process of demineralization, and so caries lesions occur in a dynamic cyclic de-mineralizing/remineralizing environment. Unfortunately, biomimetic regeneration of cavitated enamel is not yet possible, although remineralization of small carious lesions occurs under optimal conditions. Therefore, the development of methods that can regenerate carious lesions, and subsequently recover and retain teeth, is highly desirable. For the present proceedings we analyzed one naturally occurring sub-surface and one artificially produced lesion. For the characterization of artificial and natural lesions micro computed tomography is the method of choice when looking to determine three-dimensional mineral distribution and to quantify the degree of mineralization. In this pilot study we elucidate that the de-mineralized enamel in natural and artificially induced lesions shows comparable X-ray attenuation behavior, thereby implying that the study protocol employed herein seems to be appropriate. Once we know that the lesions are comparable, a series of well-reproducible in vitro experiments on enamel regeneration could be performed. In order to quantify further lesion morphology, the anisotropy of the enamel's nanostructure can be characterized by using spatially resolved, small-angle X-ray scattering. We wanted to demonstrate that the artificially induced defect fittingly resembles the natural carious lesion.

  15. Effectiveness on oral pain of 808-nm diode laser used prior to composite restoration for symptomatic non-carious cervical lesions unresponsive to desensitizing agents.

    PubMed

    Femiano, Felice; Femiano, Rossella; Lanza, Alessandro; Lanza, Michele; Perillo, Letizia

    2017-01-01

    This study compares sensitivity reduction after dental restoration with and without prior diode laser (DL) irradiation for cervical dentine hypersensitivity (CDH) from non-carious cervical lesions (NCCLs) unresponsive to desensitizing agents. Eighty-eight teeth of 28 subjects (21 females; age 23-64 years), with CDH from NCCL were included in this study. NCCLs of each oral quadrant were randomized in two groups (study group (SG)) to estimate the sensitivity reduction after dental restoration (SG-1) compared with the DL irradiation used prior to restoration placement (SG-2). The subjects were asked to rate the sensitivity experienced during air stimulation using a visual analog scale before (baseline), immediately after, and at 6 and 12 months from restoration. The outcomes showed a significant reduction of discomfort compared to baseline for NCCLs of SG-2 with the decrease of 78.5, 78.9, and 78.1 % immediately and at 6 and 12 months after restoration, respectively; in comparison with the decrease of 70.1, 67, and 65.3 % for NCCLs of SG-1 immediately and at 6 and 12 months after restoration, respectively; and compared to baseline. The DL irradiation prior to dental restoration can further improve the painful symptomatology of CDH from NCCL unresponsive to desensitizing agents.

  16. Eighteen-month randomized clinical trial on the performance of two etch-and-rinse adhesives in non-carious cervical lesions.

    PubMed

    da Costa, Thays Regina Ferreira; Ferri, Letícia Dias; Loguercio, Alessandro Dourado; Reis, Alessandra

    2014-12-01

    An 18-month randomized, controlled prospective study evaluated, in an intra-individual comparison, the clinical performance of two-step etch-and-rinse adhesives in non-carious cervical lesions (NCCL). 35 subjects, with at least two similar sized NCCL participated in this study. After sample size calculation, 70 restorations were placed, according to one of the following groups: Adper Single Bond 2 (SB) and Ambar (AM). The restorations were placed incrementally using a resin composite (Opallis). The restorations were evaluated at baseline and after 6 and 18 months according to the FDI criteria. The differences in the ratings of the two materials after 6 and 18 months were tested with Fisher's exact test (α = 0.05), and the performance of the each material at baseline and after 6 and 18 months was evaluated by Wilcoxon test (α = 0.05). All subjects attended the 18-month recall. No significant differences were observed between the materials for any criteria evaluated. Only four restorations (two from each material) were lost after 18 months. Thus, the retention rates of both materials at 18 months were 94.2% (95% CI 81-98%). Nine restorations (four Ambar and five Adper Single Bond 2) showed marginal discoloration which was solved with a polishing procedure. Both adhesive systems showed acceptable clinical retention rates after 18 months.

  17. A critical review of non-carious cervical (wear) lesions and the role of abfraction, erosion, and abrasion.

    PubMed

    Bartlett, D W; Shah, P

    2006-04-01

    The terms 'abfraction' and 'abrasion' describe the cause of lesions found along the cervical margins of teeth. Erosion, abrasion, and attrition have all been associated with their formation. Early research suggested that the cause of the V-shaped lesion was excessive horizontal toothbrushing. Abfraction is another possible etiology and involves occlusal stress, producing cervical cracks that predispose the surface to erosion and abrasion. This article critically reviews the literature on abrasion, erosion, and abrasion, and abfraction. The references were obtained by a MEDLINE search in March, 2005, and from this, hand searches were undertaken. From the literature, there is little evidence, apart from laboratory studies, to indicate that abfraction exists other than as a hypothetical component of cervical wear.

  18. Measurement of surface hardness of primary carious lesions in extracted human enamel -measurement of Knoop hardness using Cariotester.

    PubMed

    Shimizu, Akihiko; Yamamoto, Takatsugu; Nakashima, Syozi; Nikaido, Toru; Sugawara, Toyotaro; Momoi, Yasuko

    2015-01-01

    The clinical feasibility of a novel device called a Cariotester was investigated by measuring the Knoop hardness (KHN) of white spot lesions diagnosed as ICDAS code 1, 2 or 3. To obtain an equation for converting the Cariotester indentation depth into the KHN, a regression analysis was performed between the depth and measured KHN for human enamel. The Cariotester was then used to measure the indentation depth for white spots (ICDAS code 1, 2 or 3) in extracted teeth, and the KHN values were determined using the above equation. The KHN was 219.9±19.7, 162.4±24.0 and 31.7±17.5 for code 1, 2 and 3 lesions, respectively, which was 30, 49 and 90% lower than that for healthy enamel. Using the formula reported in the literature, the mineral density was calculated to be 87.7 vol.% for healthy enamel, and 75.1, 66.1 and 35.5 vol.% for code 1, 2 and 3 lesions, respectively.

  19. Large deep neural networks for MS lesion segmentation

    NASA Astrophysics Data System (ADS)

    Prieto, Juan C.; Cavallari, Michele; Palotai, Miklos; Morales Pinzon, Alfredo; Egorova, Svetlana; Styner, Martin; Guttmann, Charles R. G.

    2017-02-01

    Multiple sclerosis (MS) is a multi-factorial autoimmune disorder, characterized by spatial and temporal dissemination of brain lesions that are visible in T2-weighted and Proton Density (PD) MRI. Assessment of lesion burden and is useful for monitoring the course of the disease, and assessing correlates of clinical outcomes. Although there are established semi-automated methods to measure lesion volume, most of them require human interaction and editing, which are time consuming and limits the ability to analyze large sets of data with high accuracy. The primary objective of this work is to improve existing segmentation algorithms and accelerate the time consuming operation of identifying and validating MS lesions. In this paper, a Deep Neural Network for MS Lesion Segmentation is implemented. The MS lesion samples are extracted from the Partners Comprehensive Longitudinal Investigation of Multiple Sclerosis (CLIMB) study. A set of 900 subjects with T2, PD and a manually corrected label map images were used to train a Deep Neural Network and identify MS lesions. Initial tests using this network achieved a 90% accuracy rate. A secondary goal was to enable this data repository for big data analysis by using this algorithm to segment the remaining cases available in the CLIMB repository.

  20. Characterization of a human tooth with carious lesions using conventional and synchrotron radiation-based micro computed tomography

    NASA Astrophysics Data System (ADS)

    Dziadowiec, Iwona; Beckmann, Felix; Schulz, Georg; Deyhle, Hans; Müller, Bert

    2014-09-01

    In a dental office, every day X rays of teeth within the oral cavity are obtained. Caries induces a mineral loss and, therefore, becomes visible by reduced X-ray absorption. The detailed spatial distribution of the mineral loss, however, is inaccessible in conventional dental radiology, since the dose for such studies is intolerable. As a consequence, such measurements can only be performed after tooth extraction. We have taken advantage of synchrotron radiation-based micro computed tomography to characterize a human tooth with a rather small, natural caries lesion and an artificially induced lesion provoked by acidic etching. Both halves of the tooth were separately visualized from 2400 radiographs recorded at the beam line P07 / PETRA III (HASYLAB at DESY, Hamburg, Germany) with an asymmetric rotation axis at photon energy of 45 keV. Because of the setup, one finds an energy shift in the horizontal plane, to be corrected. After the appropriate three-dimensional registration of the data with the ones of the same crown using the better accessible phoenix nanotom® m of General Electric, Wunstorf, Germany, one can determine the joint histogram, which enable to calibrate the system with the conventional X-ray source.

  1. Composite resin restorations of non-carious cervical lesions in patients with diabetes mellitus and periodontal disease: pilot study.

    PubMed

    Nassar, Carlos A; Nassar, Patrícia O; Secundes, Mayron B; Busato, Priscilla do Monte Ribeiro; Camilotti, Veridiana

    2012-01-01

    Diabetes mellitus is a set of metabolic diseases characterized by hyperglycemia resulting from absolute or relative deficiency in insulin secretion by the pancreas and/or impaired insulin action in target tissues. Oral health maintenance through health care, as well as metabolic control are important measures for the overall health of diabetic patients. The objective of this study was to determine the relationship between biocompatibility of composite resin restorations with different nanoparticles, polishing in abfraction lesions in anterior and posterior teeth with periodontal tissues in patients with diabetes mellitus. We selected 20 patients--10 patients with diabetes mellitus and 10 patients without diabetes mellitus-, but with a total of 30 restorations in each group receiving composite resin restorations, who were evaluated for periodontal purposes: Plaque Index, Gingival Index; Probing Depth, Clinical Attachment Level and Bleeding on Probing. In addition, the restorations will receive assessments according to criteria for Marginal Adaptation, Anatomical Shape, Marginal Discoloration, ormation of caries, Post-operative Sensitivity and Retention. The total period was 90 days. The results showed a significant improvement in periodontal parameters assessed (p < 0.05) in both groups. With regard to assessments of the restorations, it was observed that there was no statistically significant difference (p > 0.05) among all criteria evaluated within the 90-day period. Thus, we conclude that in a short period (90 days) there is clinical biocompatibility of composite resin with nanoparticles restorations in abfraction lesions and periodontal tissues of patients with diabetes mellitus, regardless the type of polish these restorations receive.

  2. Laser treatments of deep-seated brain lesions

    NASA Astrophysics Data System (ADS)

    Ward, Helen A.

    1997-06-01

    The five year survival rate of deep-seated malignant brain tumors after surgery/radiotherapy is virtually 100 percent mortality. Special problems include: (1) Lesions often present late. (2) Position: lesion overlies vital structures, so complete surgical/radiotherapy lesion destruction can damage vital brain-stem functions. (3) Difficulty in differentiating normal brain form malignant lesions. This study aimed to use the unique properties of the laser: (a) to minimize damage during surgical removal of deep-seated brain lesions by operating via fine optic fibers; and (b) to employ the propensity of certain lasers for absorption of dyes and absorption and induction of fluorescence in some brain substances, to differentiate borders of malignant and normal brain, for more complete tumor removal. In the method a fine laser endoscopic technique was devised for removal of brain lesions. The results of this technique, were found to minimize and accurately predict the extent of thermal damage and shock waves to within 1-2mm of the surgical laser beam. Thereby it eliminated the 'popcorn' effect.

  3. Clinical long-term retention of etch-and-rinse and self-etch adhesive systems in non-carious cervical lesions. A 13 years evaluation.

    PubMed

    van Dijken, Jan W V; Sunnegårdh-Grönberg, Karin; Lindberg, A

    2007-09-01

    The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems. A total of 337 Class V restorations of three three-step etch-and-rinse, one two-step etch-and-rinse and three self-etch adhesive systems were placed in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline and then every 6 months during a 13 years follow-up. Dentin bonding efficiency was determined by the percentage of lost restorations. During the 13 years, 275 restorations could be evaluated. The cumulative loss rate at 13 years was 60.3%, with significant different failures rates for the different systems varying between 26.3 and 94.7%. Three materials fulfilled the ADA 18 months full acceptance criteria. Three systems showed already at 18 months or earlier catastrophical debonding rates. The annual failure rates for the three-step etch-and-rinse systems were: Allbond 2 4.1%, Clearfil LB 2.0% and Denthesive 7.3%. For the two-step etch-and-rinse Gluma 2000 6.5%, and for the self-etch systems ART 3.2%, Denthesive 2 5.7% and PUB 3 4.5% A continuous degradation of the resin-dentin bond was observed for all bonding systems during the follow-up expressed by the increasing loss rates. A wide variation of dentin bonding effectiveness was seen between the systems independent to adhesion strategy.

  4. Effect of dentin roughness on the adhesive performance in non-carious cervical lesions: a double-blind randomized clinical trial.

    PubMed

    Loguercio, Alessandro D; Luque-Martinez, Issis Virginia; Fuentes, S; Reis, Alessandra; Muñoz, Miguel Angel

    2017-09-26

    This double-blind randomized clinical trial evaluates the influence of dentin roughening (RO) on the clinical behavior of a new universal multi-mode adhesive (Tetric N-Bond Universal; Ivoclar-Vivadent) applied as self-etch and as etch-and-rinse in non-carious cervical lesions (NCCLs). A total of 192 restorations were randomly placed in 48 patients according to the following groups: ER - Etch-and-rinse (no preparation); SE - self-etch (no preparation); ER+RO and; SE+RO. The resin composite Empress Direct (Ivoclar-Vivadent) was placed incrementally. The restorations were evaluated after one week (baseline), 6 and 18 months, using the FDI and USPHS criteria. Statistical analyses were performed using appropriate tests (α=0.05). Fifteen restorations were lost at 18 months (3 for SE, 2 for ER, 5 for SE+RO and 5 for ER+RO) (p >0.05 between groups). Post-operative sensitivity wasn't observed in any of the recall periods. Eighty-four restorations were considered to have minor discrepancies in marginal adaptation at the 18-month recall using the FDI criteria (24 for SE, 18 for ER, 22 for SE+RO and 20 for ER+RO; p >0.05 between groups). Nineteen restorations were considered to have minor discrepancies in marginal discoloration at the 18-month recall (10 for SE, 03 for ER, 05 for SE+RO and 01 for ER+RO; p >0.05 between groups). The dentin roughening before application of Tetric N-Bond Universal as self-etch and etch-and-rinse didn't affect the clinical behavior of composite restorations placed in NCCLs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. In vivo remineralization of artificial enamel carious lesions using a mineral-enriched mouthrinse and a fluoride dentifrice: a polarized light microscopic comparative evaluation.

    PubMed

    Bansal, K; Gauba, K; Tewari, A; Chawla, H S; Sahni, A

    2010-01-01

    Remineralization process is accelerated by the presence of fluoride ions in the oral environment, but this mechanism of caries reversal will be further enhanced if the concentration of calcium, phosphate and fluoride ions is supersaturated with respect to that of oral fluids. This in vivo study was carried out to evaluate and compare the remineralizing efficacy of a urea-based mineral-enriched mouthrinse and a fluoridated dentifrice using an in vivo intraoral appliance model and polarized light microscopic evaluation technique. The specimens were prepared from sound teeth and artificial caries was produced using an artificial caries medium in vitro and enamel specimens were inserted in removable orthodontic appliances that were to be worn by 14 children of 10-15 years of age. They were divided into three groups - nonfluoridated dentifrice, fluoridated dentifrice and mineral-enriched mouthrinse groups. After the 6-month experimental period, during which the enamel specimens inserted in the intraoral appliance were subjected to one of the agents (either fluoride, nonfluoride dentifrice or mouthrinse) in vivo, the specimens were retrieved from the patients and were evaluated using the polarized light microscopic technique. On analysis, mineral gain occurred in all groups, viz. nonfluoride dentifrice group, fluoride dentifrice and mineral-enriched mouthrinse group. However, it was found to be complete in the mouthrinse group, i.e. both at the surface and at the subsurface (67%), while in the fluoridated dentifrice group, 43% of the samples showed mineral gain in both zones. In the nonfluoridated dentifrice group also, remineralization occurred but was limited either to the surface or the subsurface zone. Urea-based mineral-enriched mouthrinse was shown to be more efficacious in the process of remineralization of artificial carious lesions.

  6. A 24-month follow-up of flowable resin composite as an intermediate layer in non-carious cervical lesions.

    PubMed

    Reis, Alessandra; Loguercio, Alessandro D

    2006-01-01

    This study compared the clinical performance of a microhybrid resin composite to lined Class V restorations or to those restorations without a flowable resin composite over a 24-month period. Nineteen patients with at least 2 pairs of equivalent cervical erosion/attrition/abfraction lesions, under occlusion, were enrolled in this study. A total of 74 restorations were placed, half for each group (Single-Bond + Filtek-Flow + Filtek Z250 or Single-Bond + Filtek Z250). According to the manufacturers' instructions, 2 calibrated operators placed all restorations. Two other independent examiners evaluated the restorations at baseline and after 24 months, according to the USPHS criteria and modified criteria for color match. The classic alpha score was divided into A1 for "not detectable" and A2 for "slightly discernible" filling. Statistical analysis was conducted using Fisher's exact test (alpha=0.05). For each group, 8 restorations were lost after 24 months (retention rate of 89.2%). All the restorations showed a trend toward dark yellowing after 24 months (color match A2).

  7. Clinical, mineral and ultrastructural changes in carious dentin of primary molars after restoration.

    PubMed

    Chibinski, Ana Claudia Rodrigues; Wambier, Letícia; Reis, Alessandra; Wambier, Denise Stadler

    2016-06-01

    Partial caries removal has been shown to be an effective method to treat deep carious lesions in deciduous teeth. Nevertheless, the possibility of keeping infected dentin in the cavity still requires additional investigation. The objective of this research was to describe changes in primary infected dentin after restoration with glass ionomer cement. Dentin from 45 primary molars with deep and active carious lesions was evaluated using clinical and laboratory criteria, before and 60 days after restoration. The clinical analysis evaluated dentin colour (CO), dentin consistency (COS) and laser fluorescence (LF). The laboratory procedures assessed bacterial contamination and mineral content (MC), and evaluated the dentin ultrastructure and collagen content. Data on CO, COS, LF and colony forming units were analysed using the Wilcoxon signed-rank test; MC, bacterial counts and collagen evaluations were evaluated using the Student's t-test. After 60 days, lower values of LF were observed, together with a lower bacterial count, and a higher COS was found, with an increase in calcium, phosphorus and collagen contents. Differences were not detected for CO or for fluorine content. Baseline samples showed enlarged tubules with bacterial invasion; 60-day samples showed better organised tissue, with a more compact intertubular dentin and narrower tubules. It is concluded that appropriate cavity sealing can promote beneficial changes in deep carious lesions of primary teeth, even in the presence of infected dentin. © 2016 FDI World Dental Federation.

  8. Permeability of normal versus carious dentin.

    PubMed

    Pashley, E L; Talman, R; Horner, J A; Pashley, D H

    1991-10-01

    Although a number of reports have been published demonstrating that carious dentin is less permeable than normal dentin, these reports have been qualitative rather than quantitative. The purpose of this in vitro study was to apply a quantitative technique to the study of the permeability of carious human teeth before and after excavation, before and after removal of the smear layer and before and after preparation of a control cavity of similar size and depth in normal dentin subjected to the same measurements, for comparative purposes. Dentin permeability was measured as a hydraulic conductance. The permeability values measured at each step in the protocol were expressed as a percent of the maximum permeability of both cavities, permitting each tooth the serve as its own control. Carious lesions exhibited a slight degree of permeability (2.3 +/- 0.6% of controls) which remained unchanged after excavation of the lesions. Removal of the smear layer in the excavated carious lesions increased the permeability significantly to 6.9 +/- 3.2%. Preparation of a control cavity of the same area and depth increased the permeability slightly. Removal of its smear layer increased the permeability of the dentin 91%. These results confirm previous qualitative studies that carious dentin, even after excavation and removal of the smear layer has a very low permeability.

  9. Subtraction Radiographic Assessment of Underlying Dentin After Partial Carious Dentin Removal in Primary Teeth.

    PubMed

    Phonghanyudh, Araya; Ruangdit, Chayathorn; Pornprasertsuk-D Amrongsri, Suchaya; Phanthumvanit, Prathip

    2017-09-21

    To assess the one-year outcome of glass-ionomer cement (GIC) restorations with partial carious dentin removal in primary molars using digital subtraction radiographs. Children ages 6-8 years were recruited. Forty-nine primary molars with deep carious lesions were studied. The carious dentin was removed at the dentoenamel junction (DEJ) and restored with GIC. Digital radiographs were taken immediately after restoration, and at 6 and 12 months after restoration. The sets of digital radiographs were subtracted and analysed using Image-Pro Plus software. At the 12-month follow-up, 38 of the original 49 primary molars were analysed. No postoperative pain or signs of pulp pathology were reported. 76% and 87% of molars showed an increase in density of the studied areas compared to control areas at 6- and 12- month follow-ups, respectively. The density of digital subtraction radiographs increased to 5.3 and 8.2 at 6 and 12 months from baseline, respectively. The mean density of the areas under restoration at 6 months and 12 months was statistically significantly higher than at baseline (paired t-test; p < 0.05). Using digital subtraction radiographs, GIC restorations with partial carious dentin removal in primary molars showed a high potential for dentin remineralisation after 1 year.

  10. Exploring How U.S. Dental Schools Teach Removal of Carious Tissues During Cavity Preparations.

    PubMed

    Nascimento, Marcelle M; Behar-Horenstein, Linda S; Feng, Xiaoying; Guzmán-Armstrong, Sandra; Fontana, Margherita

    2017-01-01

    Approaches for managing carious tissues during cavity preparations vary considerably among clinicians, which may reflect inconsistencies in the teaching of this subject by dental schools. The aims of this study were to investigate practices related to the preclinical and clinical teaching of caries removal at U.S. dental schools and the relationship between that teaching and requirements for U.S. dental licensure examinations. The electronic survey included questions about terminology, methods, instruments and materials, treatment planning, criteria for clinical exams, faculty calibration sessions, and licensure exams. The faculty members at U.S. dental schools responsible for teaching cariology were invited to participate; 54 of the 65 schools had identified a contact person at the time of the survey in October 2015. Of those 54 invited to participate, 43 completed the survey (response rate of 79.6%). Most of the respondents indicated that depth of carious lesions was a clinical determinant of the amount of carious dentin being removed in cavity preparations. Caries removal was used as a criterion in restorative clinical examinations by 95% of responding schools. Marked differences were observed regarding the criteria used for assessment and removal of carious tissues, management of deep carious lesions, and definition of "caries remaining at cavity preparations," which is considered a critical error on licensure exams. Faculty calibration sessions on caries removal were reported to occur in 65% of these schools and at different time frames. Overall, the study found a wide range of teaching practices related to caries removal. Best evidence in caries management needs to be aligned with teaching and the criteria used to calibrate faculty members and examiners.

  11. Light diffuse reflectance for detection and differentiation of teeth caries lesions

    NASA Astrophysics Data System (ADS)

    Borisova, E.; Uzunov, Tz.; Valkanov, S.; Avramov, L.

    2007-05-01

    One of the goals of the contemporary dentistry is differentiation between carious stages that must be fast, non-invasive procedure, which will allow to the dentists to make reliable judgments. One suitable candidate for such method is reflectance spectroscopy. The objectives of current study are to determine the feasibility of applying the light reflectance spectroscopy technique for detection of different carious stages; therefore reflectance spectra of teeth illuminated at 450- 900 nm light were recorded. There are obtained reflectance signals from the healthy enamel, dentine and different lesion stages of the investigated teeth. These spectra are compared to that, obtained by non-carious tooth lesions - fluorosa and odontolithiasis, resembling on initial carious stages. There is observed a significant decrease of the intensity of the reflected light in blue region in the case of caries. Reflectance signals, obtained from non-carious lesions also have significantly different character and could be used for differentiation between them and initial carious stages. An algorithm for differentiation between carious stages is proposed with diagnostic accuracy achieved up to 86,1% between precarious stage and sound tooth and 100% for determination of deep cavitation. Some comments about role of teeth enamel structure and anisotropy factor of dental layers on the results obtained are also made.

  12. A three-year clinical evaluation of a one-step self-etch and a two-step etch-and-rinse adhesive in non-carious cervical lesions.

    PubMed

    Häfer, Matthias; Jentsch, Holger; Haak, Rainer; Schneider, Hartmut

    2015-03-01

    The aim of the study was to assess a one-step self-etch adhesive (Futurabond M, 1-SE) and a two-step etch-and-rinse adhesive (Solobond M, 2-ER) used in combination with the nano-hybrid composite (Amaris) in a prospective clinical study on non-carious cervical lesions. 110 restorations were placed in 40 patients and graded over 36 months according to aesthetical, functional and biological criteria (Clinical Oral Investigations 2007;11:5). The four-step etch-and-rinse adhesive Syntac classic (4-ER) combined with the nano-hybrid composite Tetric EvoCeram was used as a control. Cumulative failure rates (CFR), retention rates and Kaplan-Meier survival curves were calculated for each observation period. After 3 years, the CFR of 33.3% in the 2-ER group was significantly higher compared to those of the 1-SE group (9.1%, p = 0.019) and of the 4-ER group (8.3%, p = 0.035). Additionally, retention rates in the 1-SE and the 4-ER groups were higher compared to 2-ER (p = 0.012 each) after 36 months. Annual failure rates ranged between 2.8% for 4-ER, 3.0% for 1-SE and 11.1% for 2-ER. During the study, restorations in all groups showed progressive marginal deterioration within the limits of clinical acceptance. After 3 years, restorations in the 2-ER and the 4-ER group showed more small defects at dentin than at enamel margins. The 1-SE group was clinically as successful as the 4-ER, with both performing better than the 2-ER group. Futurabond M/Amaris can be recommended for the restoration of sclerotic non-carious cervical lesions. Number protocol 192/2008. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. A 7-year randomized prospective study of a one-step self-etching adhesive in non-carious cervical lesions. The effect of curing modes and restorative material.

    PubMed

    van Dijken, Jan W V; Pallesen, Ulla

    2012-12-01

    The aim of this study was to evaluate the clinical retention of a one-step self-etching adhesive system (Xeno III) in Class V non-carious cervical lesions and the effect of restorative material and curing techniques on longevity of the restorations. A total of 139 Class V restorations were placed with the self-etching primer Xeno III and a resin composite (Tetric Ceram) or a poly-acid modified resin composite (Dyract AP) in non-carious cervical lesions without intentional enamel involvement. The materials were cured with a conventional continuous light, a soft-start or a pulse-delay curing mode. The restorations were evaluated at baseline, 6, 12, 18 and 24 months and then yearly during a 7 year follow-up with modified USPHS criteria. Dentine bonding efficiency was determined by the percentage of lost restorations. During the 7 years, 135 restorations could be evaluated. No post-operative sensitivity was reported by the participants. Overall relative cumulative loss rate frequencies for the adhesive system at 6 and 18 months and 7 years, independent of curing technique and restorative material, were 0.8%, 6.9% and 23.0%, respectively. The self-etching adhesive fulfilled at 18 months the full acceptance ADA criteria. Tetric Ceram showed at 7 years a 20.9% loss of retention and Dyract AP a 25.0% loss rate (Log rank p = 0.48). The loss rates for the 3 curing techniques: continuous, soft start and pulse delay were 17%, 27.9% and 24.4%, respectively (Log rank p = 0.52). No secondary caries was observed. The single-step self-etching adhesive showed acceptable clinical long-time retention rates to dentine surfaces independent of restorative material and curing technique used. Copyright © 2012 Elsevier Ltd. All rights reserved.

  14. Randomized in vivo evaluation of photodynamic antimicrobial chemotherapy on deciduous carious dentin

    NASA Astrophysics Data System (ADS)

    Steiner-Oliveira, Carolina; Longo, Priscila Larcher; Aranha, Ana Cecília Corrêa; Ramalho, Karen Müller; Mayer, Marcia Pinto Alves; de Paula Eduardo, Carlos

    2015-10-01

    The aim of this randomized in vivo study was to compare antimicrobial chemotherapies in primary carious dentin. Thirty-two participants ages 5 to 7 years underwent partial caries removal from deep carious dentin lesions in primary molars and were subsequently divided into three groups: control [chlorhexidine and resin-modified glass ionomer cement (RMGIC)], LEDTB [photodynamic antimicrobial chemotherapy (PACT) with light-emitting diode associated with toluidine blue solution and RMGIC], and LMB [PACT with laser associated with methylene blue solution and RMGIC]. The participants were submitted to initial clinical and radiographic examinations. Demographic features and biofilm, gingival, and DMFT/DMFS indexes were evaluated, in addition to clinical and radiographic followups at 6 and 12 months after treatments. Carious dentin was collected before and after each treatment, and the number of Streptococcus mutans, Streptococcus sobrinus, Lactobacillus casei, Fusobacterium nucleatum, Atopobium rimae, and total bacteria was established by quantitative polymerase chain reaction. No signs of pain or restoration failure were observed. All therapies were effective in reducing the number of microorganisms, except for S. sobrinus. No statistical differences were observed among the protocols used. All therapies may be considered as effective modern approaches to minimal intervention for the management of deep primary caries treatment.

  15. Comparison of cross-sectional hardness and transverse microradiography of artificial carious enamel lesions induced by different demineralising solutions and gels.

    PubMed

    Magalhães, A C; Moron, B M; Comar, L P; Wiegand, A; Buchalla, W; Buzalaf, M A R

    2009-01-01

    The aims of this study were: (1) to correlate surface (SH) and cross-sectional hardness (CSH) with microradiographic parameters of artificial enamel lesions; (2) to compare lesions prepared by different protocols. Fifty bovine enamel specimens were allocated by stratified randomisation according to their initial SH values to five groups and lesions produced by different methods: MC gel (methylcellulose gel/lactic acid, pH 4.6, 14 days); PA gel (polyacrylic acid/lactic acid/hydroxyapatite, pH 4.8, 16 h); MHDP (undersaturated lactate buffer/methyl diphosphonate, pH 5.0, 6 days); buffer (undersaturated acetate buffer/fluoride, pH 5.0, 16 h), and pH cycling (7 days). SH of the lesions (SH(1)) was measured. The specimens were longitudinally sectioned and transverse microradiography (TMR) and CSH measured at 10- to 220-microm depth from the surface. Overall, there was a medium correlation but non-linear and variable relationship between mineral content and radicalCSH. radicalSH(1) was weakly to moderately correlated with surface layer properties, weakly correlated with lesion depth but uncorrelated with integrated mineral loss. MHDP lesions showed the highest subsurface mineral loss, followed by pH cycling, buffer, PA gel and MC gel lesions. The conclusions were: (1) CSH, as an alternative to TMR, does not estimate mineral content very accurately, but gives information about mechanical properties of lesions; (2) SH should not be used to analyse lesions; (3) artificial caries lesions produced by the protocols differ, especially considering the method of analysis.

  16. Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine): a case report

    PubMed Central

    Grosgogeat, Brigitte; Seux, Dominique; Farge, Pierre

    2013-01-01

    The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth. PMID:24303363

  17. Conservative approach of a symptomatic carious immature permanent tooth using a tricalcium silicate cement (Biodentine): a case report.

    PubMed

    Villat, Cyril; Grosgogeat, Brigitte; Seux, Dominique; Farge, Pierre

    2013-11-01

    The restorative management of deep carious lesions and the preservation of pulp vitality of immature teeth present real challenges for dental practitioners. New tricalcium silicate cements are of interest in the treatment of such cases. This case describes the immediate management and the follow-up of an extensive carious lesion on an immature second right mandibular premolar. Following anesthesia and rubber dam isolation, the carious lesion was removed and a partial pulpotomy was performed. After obtaining hemostasis, the exposed pulp was covered with a tricalcium silicate cement (Biodentine, Septodont) and a glass ionomer cement (Fuji IX extra, GC Corp.) restoration was placed over the tricalcium silicate cement. A review appointment was arranged after seven days, where the tooth was asymptomatic with the patient reporting no pain during the intervening period. At both 3 and 6 mon follow up, it was noted that the tooth was vital, with normal responses to thermal tests. Radiographic examination of the tooth indicated dentin-bridge formation in the pulp chamber and the continuous root formation. This case report demonstrates a fast tissue response both at the pulpal and root dentin level. The use of tricalcium silicate cement should be considered as a conservative intervention in the treatment of symptomatic immature teeth.

  18. The Study of Carious Teeth by Laser-Induced Breakdown Spectroscopy

    NASA Astrophysics Data System (ADS)

    Hamzaoui, S.; Nouir, R.; Jaidene, N.

    2017-03-01

    The aim of this work is a multi-component analysis of the element composition of the enamel and carious parts of teeth and the quantification of enamel demineralization using laser-induced breakdown spectroscopy (LIBS). For each tooth the P/Ca ratios of the emission line intensities in the enamel part and those in the carious regions were compared. Since zinc is a trace element, the same procedure was performed for Zn/Ca ratios in the enamel and carious parts. These comparisons showed that the mineral loss from carious lesions occurs at different rates for the studied elements. Calcium has the highest casualty rate. On the other hand, the zinc level diminishes also in the carious region but at a lower rate. The lines were obtained from plume plasma emission generated on the enamel and carious regions.

  19. Lesion Detection in CT Images Using Deep Learning Semantic Segmentation Technique

    NASA Astrophysics Data System (ADS)

    Kalinovsky, A.; Liauchuk, V.; Tarasau, A.

    2017-05-01

    In this paper, the problem of automatic detection of tuberculosis lesion on 3D lung CT images is considered as a benchmark for testing out algorithms based on a modern concept of Deep Learning. For training and testing of the algorithms a domestic dataset of 338 3D CT scans of tuberculosis patients with manually labelled lesions was used. The algorithms which are based on using Deep Convolutional Networks were implemented and applied in three different ways including slice-wise lesion detection in 2D images using semantic segmentation, slice-wise lesion detection in 2D images using sliding window technique as well as straightforward detection of lesions via semantic segmentation in whole 3D CT scans. The algorithms demonstrate superior performance compared to algorithms based on conventional image analysis methods.

  20. Two-year clinical performance of Clearfil SE and Clearfil S3 in restoration of unabraded non-carious class V lesions.

    PubMed

    Brackett, Martha Goël; Dib, Alejandro; Franco, Guillermo; Estrada, Blanca E; Brackett, William W

    2010-01-01

    This study was undertaken to evaluate the two-year clinical performance of a self-etching primer and a self-etching adhesive, both of which employ the same acidic monomer. Forty pairs of restorations of AP-X hybrid resin composite (Kuraray Co, Ltd, Osaka, Japan) were placed in caries-free cervical erosion/abfraction lesions. Based on insensitivity to air, the dentin in 62% of these lesions was considered to be sclerotic. The restorations were placed with no abrasion of tooth surfaces, except for cleaning with plain pumice and no use of phosphoric acid etching, which is counter to the manufacturer's instructions that call for etching of unprepared enamel. One restoration from each pair was placed using Clearfil SE Bond, an adhesive employing a self-etching primer, and the other was placed using Clearfil S3 Bond, a self-etching adhesive. To emulate the results likely to occur in a private practice, the restorations were placed by well-educated, experienced clinicians who had no particular expertise in adhesive dentistry research and who placed the restorations according only to their interpretation of the manufacturer's instructions. The restorations were clinically evaluated at baseline and at 6, 12 and 24 months, using modified Ryge/USPHS criteria. For both products, retention of 81%-84% of the restorations was observed over two years, which is lower than has been previously observed with these products and is likely due to limitations in the manufacturer's instructions compounded by inexperience of the operators in adhesive dentistry research. One restoration placed with each adhesive demonstrated secondary caries, which was probably attributable to the study being conducted in a non-fluoridated area and which reduced the percentages of clinically successful restorations to 78%-81%. No statistically significant difference (p = 0.50) between the two adhesives was observed in overall performance.

  1. Stress-strain Analysis of Premolars With Non-carious Cervical Lesions: Influence of Restorative Material, Loading Direction and Mechanical Fatigue.

    PubMed

    Machado, A C; Soares, C J; Reis, B R; Bicalho, A A; Raposo, Lha; Soares, P V

    Noncarious cervical lesions (NCCLs) are characterized by a loss of dental structure at the cementoenamel junction (CEJ) caused by stress, biocorrosion, and attrition. Variations in occlusal loading can promote different stress and strain patterns on the CEJ. Restoration of NCCLs is part of lesion management; however, there is still no conclusive restorative protocol for NCCLs. This study aimed to evaluate the stress and strain distribution of maxillary premolars with NCCLs according to three factors: 1) restorative technique; 2) direction of occlusal loading; and 3) mechanical fatigue. Three-dimensional (3D) finite element analysis (FEA) and strain gauge testing were used to assess stress and strain, respectively. 3D-FEA orthotropic, linear, and elastic models were generated: sound tooth (SO); unrestored NCCL; or NCCL restored with glass ionomer; flowable composite resin; nanofilled composite resin (CR); lithium disilicate ceramic; and nanofilled composite resin core associated with a lithium disilicate laminate (CL). A 150-N compressive static load was applied in two conditions: axially in both cusps (Al); and at a 45° angle to the long axis of the tooth applied to the palatine cusp (Ol). For the experimental tests, specimens were treated as described previously, and one strain gauge was attached to the buccal surface of each tooth to record tooth strains before and after cyclic loading (200,000 cycles, 50 N). FEA showed that the association of NCCL and Ol resulted in higher stress values. CR and CL restorations showed the closest biomechanical behavior to SO for both loading types. Loaded Al or Ol specimens showed higher strain values after mechanical fatigue. Lower stress and strain were observed with Al when compared with Ol. The restoration of NCCLs with composite resin only or associated with ceramic laminates seems to be the best approach because the results for those groups were similar in biomechanical behaviors to sound teeth.

  2. Long-term dentin retention of etch-and-rinse and self-etch adhesives and a resin-modified glass ionomer cement in non-carious cervical lesions.

    PubMed

    van Dijken, Jan W V; Pallesen, Ulla

    2008-07-01

    The aim of this study was to evaluate the clinical long-term retention to dentin of seven adhesive systems. A total of 270 Class V restorations of four etch-and-rinse, one self-etch adhesive system and a resin-modified glass ionomer cement were placed in non-carious cervical lesions without intentional enamel involvement. The restorations were evaluated at baseline, 6, 12, 18, and 24 months and then every year during a 13-year follow-up. Dentin bonding efficiency was determined by the percentage of lost restorations. During the 13 years, 215 restorations could be evaluated. The cumulative loss rate at 13 years was 53.0%, with significant different failures rates for the different systems varying between 35.6 and 86.8%. Four systems fulfilled the ADA 18-month full acceptance retention criteria. Two systems showed at 18 months and earlier high debonding rates. The annual failure rates for the etch-and-rinse systems were Optibond 3.1%, Permagen 13.0%, Scotchbond MP 4.8%, Syntac classic 2.8%; for the self-etch system P&S 4.4%; and the resin-modified glass ionomer cement Vitremer 2.7%. It can be concluded that all systems showed a continuous degradation of the bond with a wide variation, which was independent of the adhesion strategy. Three bonding systems showed a cumulative failure rate after 13 years between 36 and 41% with the best retention for the resin-modified glass ionomer cement and a four-step etch-and-rinse system.

  3. Evaluation of the effect of a CO2 laser and fluoride on the reduction of carious lesions progression in primary teeth: an in vitro study

    NASA Astrophysics Data System (ADS)

    Zancopé, Bruna R.; Cesar, Marina M. C.; Rodrigues, Lidiany K. A.; Nobre-dos-Santos, Marinês

    2014-02-01

    This study aimed at investigating if CO2 laser irradiation (λ =10.6μm - 11.3 J/cm2) combined with fluoridated products, enhances the CaF2 formation on enamel surface and inhibits lesion progression of demineralized primary enamel. Thus, 135 demineralized primary enamel specimens (DES) were allocated to 9 groups (n=15) as follows: 1- DES only, 2- DES + pH cycling (control), 3- 1.23% acidulated phosphate fluoride gel (APF), 4- 1.23% fluoride foam (FF), 5- 5% fluoride varnish (FV), 6- CO2 Laser (L), 7 - Laser during APF application, 8-Laser during FF application and 9-Laser during FV application. Except for the demineralized enamel group, all specimens were submitted to a 7 day pH cycling regime. The knoop hardness number (KHN) was determined by cross-sectional microhardness analysis. After treatments application, three specimens of each group had their surface examined for CaF2 formation by scanning electron microscopy (SEM). The data was analyzed by ANOVA and Student's t-test (α= 0.05). Enamel mineral loss (ΔS) for groups 1 to 9 were respectively,(8,676.28+/-1,077.46b),(12,419.54+/-1,050.21a),(8,156.80+/-1,279.90b),(8,081.32+/-1,019.69b),(8,820.86+/-1,805. 99b),(8,723.45+/-1,167.14b),(9,003.17+/-796.90b),(8.229,03+/-961.25b),(9,023.32+/-1,1069b). The results showed statistically significant difference between control and all treatments groups (p<0.05). However there was no difference among them (p>0.05). SEM observations showed evidences of melting, fusion and calcium fluoride formation on enamel surface. In conclusion, laser irradiation alone or combined with fluoridated products inhibited lesion progression of demineralized primary enamel surface. However, no synergistic effect was observed when CO2 laser irradiation and fluoridated products application were combined.

  4. Evaluation of cavitated and non-cavitated carious lesions using the WHO basic methods, ICDAS-II and laser fluorescence measurements.

    PubMed

    Goswami, Mridula; Rajwar, Anju Singh

    2015-01-01

    This study was aimed to compare the diagnostic outcome of the WHO criteria, ICDAS-II criteria and laser fluorescence measurements in measuring the caries ratings of children. Cross-sectional study. The study involved 31 children between 3 and 14 years of age, attending the Department of Pedodontics at Maulana Azad College of Dental Sciences, New Delhi. The surface-related caries status was registered according to the WHO basic method criteria (1997). Additionally, the ICDAS-II visual criteria and the DIAGNOdent readings were documented. The data were analysed with ezANOVA and Excel 2000 (Microsoft Corporation, Redmond, WA, USA). The mean ICDAS-II values amounted to 8.76 ± 0.72. The mean values for DMFS/def were 7.67 ± 0.91, whereas for DIAGNOdent it amounted to 4.00 ± 0.62. In conclusion, this study showed the diagnostic potential of the ICDAS-II criteria in comparison to the traditional WHO criteria by means of the non-cavitated caries lesions additionally detected. The DIAGNOdent use in field studies that already apply detailed visual criteria seems to bring limited additional information.

  5. Deep dermal granuloma annulare presenting as an eyelid tumor in a child, with review of pediatric eyelid lesions.

    PubMed

    Cronquist, S D; Stashower, M E; Benson, P M

    1999-01-01

    A case of deep dermal granuloma annulare (GA) involving the eyelid of a child is reported. GA presenting in the periocular region is rare and may mimic other lesions. The differential diagnosis of pediatric eyelid lesions is reviewed.

  6. Bilateral pallidal hemorrhage in toxoplasmosis update of acute symmetric lesions of deep nuclei.

    PubMed

    Finelli, Pasquale F; Wrubel, Gregory L

    2015-08-01

    As acute symmetric lesions of deep gray nuclei are often associated with an impaired level of consciousness and neuroimaging by itself cannot distinguish between etiologies, diagnosis may be problematic. Appreciation of the cause of the various neuroimaging patterns in conjunction with the history, examination and laboratory investigations allows for accurate diagnosis in the vast majority of cases. Given the metabolic vulnerability of deep gray nuclei, other than bi-thalamic infarction, it follows that toxic-metabolic and hypoxic-ischemic events account for the majority of cases. Nevertheless, the differential diagnosis is broad and diverse. We here describe two cases of bilateral pallidal hemorrhage in AIDS-associated toxoplasmosis, and review conditions recently described with acute symmetric deep gray nuclei lesions on neuroimaging. © The Author(s) 2015.

  7. Bilateral pallidal hemorrhage in toxoplasmosis update of acute symmetric lesions of deep nuclei

    PubMed Central

    Wrubel, Gregory L

    2015-01-01

    As acute symmetric lesions of deep gray nuclei are often associated with an impaired level of consciousness and neuroimaging by itself cannot distinguish between etiologies, diagnosis may be problematic. Appreciation of the cause of the various neuroimaging patterns in conjunction with the history, examination and laboratory investigations allows for accurate diagnosis in the vast majority of cases. Given the metabolic vulnerability of deep gray nuclei, other than bi-thalamic infarction, it follows that toxic-metabolic and hypoxic-ischemic events account for the majority of cases. Nevertheless, the differential diagnosis is broad and diverse. We here describe two cases of bilateral pallidal hemorrhage in AIDS-associated toxoplasmosis, and review conditions recently described with acute symmetric deep gray nuclei lesions on neuroimaging. PMID:26427898

  8. In vitro study of the effect of a pulsed 10.6μm CO2 laser and fluoride on the reduction of carious lesions progression in bovine root dentin

    NASA Astrophysics Data System (ADS)

    Parisotto, Thaís M.; Sacramento, Patrícia A.; Alves, Marcelo C.; Puppin-Rontani, Regina M.; Gavião, Maria Beatriz D.; Nobre-dos-Santos, Marin"s.

    2010-02-01

    The aim of the present study was to evaluate the combined in vitro effects a pulsed 10.6 μm CO2 laser and fluoride on the reduction of carious lesion progression in root dentin. Sixty five slabs of previously demineralized bovine root dentin were assigned into five groups (n=13): control (no treatment), acidulated phosphate fluoride gel 1.23% (FFA), CO2 Laser (L), FFA+L, L+FFA. The lasered groups were irradiated with 4.0J/cm2. After a 7 day pH cycling regime, the knoop hardness number (KHN) was determined by cross-sectional microhardness testing (5g, 5s, 10-60 μm, 10 μm interval). The data was analyzed by ANOVA and Student's t-test (α= 0.05). A significant interaction between KHN and the indentation depths was found (p<0.05). At 10-20 μm, FFA+L (KHN:12.12+/-0.95/13.07+/-1.03) and FFA (KHN:12.86+/-4.54/12.60+/-3.93) inhibited caries progression when compared to control group (KHN:8.76+/-0.95/9.50+/-1.03) (p<0.05), but did not differ with neither each other nor from group L (p>0.05). At 30 μm, the KHN was significantly higher than the control only in the FFA group (KHN:15.35+/-1.16). At 40 μm, the groups FFA (KHN: 15.87+/-3.76), L (KHN: 15.57+/-5.71) and L+FFA (KHN:15.50+/-5.08) were capable of significantly inhibiting caries progression, however they did not differ each other (p>0.05). At depths of 50-60 μm, only group L (KHN:17.05+/-1.29/18.26+/-1.30) differed statistically from the control (KHN:13.43+/-1.24/13.81+/-1.25), but not from the other groups. In conclusion, CO2 laser alone was able to inhibit caries progression in the deepest layers. However, no synergistic effect was obtained when CO2 laser irradiation and FFA application and were combined.

  9. Classification of breast MRI lesions using small-size training sets: comparison of deep learning approaches

    NASA Astrophysics Data System (ADS)

    Amit, Guy; Ben-Ari, Rami; Hadad, Omer; Monovich, Einat; Granot, Noa; Hashoul, Sharbell

    2017-03-01

    Diagnostic interpretation of breast MRI studies requires meticulous work and a high level of expertise. Computerized algorithms can assist radiologists by automatically characterizing the detected lesions. Deep learning approaches have shown promising results in natural image classification, but their applicability to medical imaging is limited by the shortage of large annotated training sets. In this work, we address automatic classification of breast MRI lesions using two different deep learning approaches. We propose a novel image representation for dynamic contrast enhanced (DCE) breast MRI lesions, which combines the morphological and kinetics information in a single multi-channel image. We compare two classification approaches for discriminating between benign and malignant lesions: training a designated convolutional neural network and using a pre-trained deep network to extract features for a shallow classifier. The domain-specific trained network provided higher classification accuracy, compared to the pre-trained model, with an area under the ROC curve of 0.91 versus 0.81, and an accuracy of 0.83 versus 0.71. Similar accuracy was achieved in classifying benign lesions, malignant lesions, and normal tissue images. The trained network was able to improve accuracy by using the multi-channel image representation, and was more robust to reductions in the size of the training set. A small-size convolutional neural network can learn to accurately classify findings in medical images using only a few hundred images from a few dozen patients. With sufficient data augmentation, such a network can be trained to outperform a pre-trained out-of-domain classifier. Developing domain-specific deep-learning models for medical imaging can facilitate technological advancements in computer-aided diagnosis.

  10. Fully automatic detection of deep white matter T1 hypointense lesions in multiple sclerosis.

    PubMed

    Spies, Lothar; Tewes, Anja; Suppa, Per; Opfer, Roland; Buchert, Ralph; Winkler, Gerhard; Raji, Alaleh

    2013-12-07

    A novel method is presented for fully automatic detection of candidate white matter (WM) T1 hypointense lesions in three-dimensional high-resolution T1-weighted magnetic resonance (MR) images. By definition, T1 hypointense lesions have similar intensity as gray matter (GM) and thus appear darker than surrounding normal WM in T1-weighted images. The novel method uses a standard classification algorithm to partition T1-weighted images into GM, WM and cerebrospinal fluid (CSF). As a consequence, T1 hypointense lesions are assigned an increased GM probability by the standard classification algorithm. The GM component image of a patient is then tested voxel-by-voxel against GM component images of a normative database of healthy individuals. Clusters (≥0.1 ml) of significantly increased GM density within a predefined mask of deep WM are defined as lesions. The performance of the algorithm was assessed on voxel level by a simulation study. A maximum dice similarity coefficient of 60% was found for a typical T1 lesion pattern with contrasts ranging from WM to cortical GM, indicating substantial agreement between ground truth and automatic detection. Retrospective application to 10 patients with multiple sclerosis demonstrated that 93 out of 96 T1 hypointense lesions were detected. On average 3.6 false positive T1 hypointense lesions per patient were found. The novel method is promising to support the detection of hypointense lesions in T1-weighted images which warrants further evaluation in larger patient samples.

  11. Fully automatic detection of deep white matter T1 hypointense lesions in multiple sclerosis

    NASA Astrophysics Data System (ADS)

    Spies, Lothar; Tewes, Anja; Suppa, Per; Opfer, Roland; Buchert, Ralph; Winkler, Gerhard; Raji, Alaleh

    2013-12-01

    A novel method is presented for fully automatic detection of candidate white matter (WM) T1 hypointense lesions in three-dimensional high-resolution T1-weighted magnetic resonance (MR) images. By definition, T1 hypointense lesions have similar intensity as gray matter (GM) and thus appear darker than surrounding normal WM in T1-weighted images. The novel method uses a standard classification algorithm to partition T1-weighted images into GM, WM and cerebrospinal fluid (CSF). As a consequence, T1 hypointense lesions are assigned an increased GM probability by the standard classification algorithm. The GM component image of a patient is then tested voxel-by-voxel against GM component images of a normative database of healthy individuals. Clusters (≥0.1 ml) of significantly increased GM density within a predefined mask of deep WM are defined as lesions. The performance of the algorithm was assessed on voxel level by a simulation study. A maximum dice similarity coefficient of 60% was found for a typical T1 lesion pattern with contrasts ranging from WM to cortical GM, indicating substantial agreement between ground truth and automatic detection. Retrospective application to 10 patients with multiple sclerosis demonstrated that 93 out of 96 T1 hypointense lesions were detected. On average 3.6 false positive T1 hypointense lesions per patient were found. The novel method is promising to support the detection of hypointense lesions in T1-weighted images which warrants further evaluation in larger patient samples.

  12. Laser-scanned fluorescence of nonlased/normal, lased/normal, nonlased/carious, and lased/carious enamel

    NASA Astrophysics Data System (ADS)

    Zakariasen, Kenneth L.; Barron, Joseph R.; Paton, Barry E.

    1992-06-01

    Research has shown that low levels of CO2 laser irradiation raise enamel resistance to sub-surface demineralization. Additionally, laser scanned fluorescence analysis of enamel, as well a laser and white light reflection studies, have potential for both clinical diagnosis and comparative research investigations of the caries process. This study was designed to compare laser fluorescence and laser/white light reflection of (1) non-lased/normal with lased/normal enamel and (2) non-lased/normal with non-lased/carious and lased/carious enamel. Specimens were buccal surfaces of extracted third molars, coated with acid resistant varnish except for either two or three 2.25 mm2 windows (two window specimens: non-lased/normal, lased/normal--three window specimens: non-lased/normal, non-lased carious, lased/carious). Teeth exhibiting carious windows were immersed in a demineralizing solution for twelve days. Non-carious windows were covered with wax during immersion. Following immersion, the wax was removed, and fluorescence and laser/white light reflection analyses were performed on all windows utilizing a custom scanning laser fluorescence spectrometer which focuses light from a 25 mWatt He-Cd laser at 442 nm through an objective lens onto a cross-section >= 3 (mu) in diameter. For laser/white light reflection analyses, reflected light intensities were measured. A HeNe laser was used for laser light reflection studies. Following analyses, the teeth are sectioned bucco-lingually into 80 micrometers sections, examined under polarized light microscopy, and the lesions photographed. This permits comparison between fluorescence/reflected light values and the visualized decalcification areas for each section, and thus comparisons between various enamel treatments and normal enamel. The enamel specimens are currently being analyzed.

  13. A deep learning framework for supporting the classification of breast lesions in ultrasound images

    NASA Astrophysics Data System (ADS)

    Han, Seokmin; Kang, Ho-Kyung; Jeong, Ja-Yeon; Park, Moon-Ho; Kim, Wonsik; Bang, Won-Chul; Seong, Yeong-Kyeong

    2017-10-01

    In this research, we exploited the deep learning framework to differentiate the distinctive types of lesions and nodules in breast acquired with ultrasound imaging. A biopsy-proven benchmarking dataset was built from 5151 patients cases containing a total of 7408 ultrasound breast images, representative of semi-automatically segmented lesions associated with masses. The dataset comprised 4254 benign and 3154 malignant lesions. The developed method includes histogram equalization, image cropping and margin augmentation. The GoogLeNet convolutionary neural network was trained to the database to differentiate benign and malignant tumors. The networks were trained on the data with augmentation and the data without augmentation. Both of them showed an area under the curve of over 0.9. The networks showed an accuracy of about 0.9 (90%), a sensitivity of 0.86 and a specificity of 0.96. Although target regions of interest (ROIs) were selected by radiologists, meaning that radiologists still have to point out the location of the ROI, the classification of malignant lesions showed promising results. If this method is used by radiologists in clinical situations it can classify malignant lesions in a short time and support the diagnosis of radiologists in discriminating malignant lesions. Therefore, the proposed method can work in tandem with human radiologists to improve performance, which is a fundamental purpose of computer-aided diagnosis.

  14. Remote effect of deep-seated vascular brain lesions on cerebral blood flow

    SciTech Connect

    Attig, E.; Capon, A.; Demeurisse, G.; Verhas, M. )

    1990-11-01

    We measured regional cerebral blood flow using the xenon-133 inhalation method, at approximately 1 month after onset, in 60 stroke patients who had no evidence of major carotid artery stenosis or occlusion. Their single lesions (43 infarcts and 17 hematomas) were located in the capsulothalamolenticular region, sparing the cortex. Hemispheric mean cerebral blood flow was reduced on the side of the lesion in 25 patients and on both sides in 20. Regional hypoperfusion was observed in 46 patients (ipsilaterally in 34, bilaterally in 10, and contralaterally in two). Regional hypoperfusion was observed most frequently in the frontal lobe, particularly in the motor and premotor cortices of the prerolandic area. The 46 patients with regional hypoperfusion were compared with the 14 patients without regional hypoperfusion, considering the size and location of the lesion as well as the functional and analytic motor performances. As a rule, the lesion was slightly smaller and more posterior and the functional (p less than 0.001) and analytic (p less than 0.05) motor performances were significantly better in the 14 patients without regional hypoperfusion. Since the xenon-133 inhalation method examines cortical blood flow, we can attribute blood flow reductions resulting from deep-seated lesions to a functional depression akin to diaschisis. Interpretation of the clinical consequences and pathogenesis of this phenomenon requires further sequential and pathologic studies.

  15. Effects of subthalamic deep brain stimulation on blink abnormalities of 6-OHDA lesioned rats.

    PubMed

    Kaminer, Jaime; Thakur, Pratibha; Evinger, Craig

    2015-05-01

    Parkinson's disease (PD) patients and the 6-hydroxydopamine (6-OHDA) lesioned rat model share blink abnormalities. In view of the evolutionarily conserved organization of blinking, characterization of blink reflex circuits in rodents may elucidate the neural mechanisms of PD reflex abnormalities. We examine the extent of this shared pattern of blink abnormalities by measuring blink reflex excitability, blink reflex plasticity, and spontaneous blinking in 6-OHDA lesioned rats. We also investigate whether 130-Hz subthalamic nucleus deep brain stimulation (STN DBS) affects blink abnormalities, as it does in PD patients. Like PD patients, 6-OHDA-lesioned rats exhibit reflex blink hyperexcitability, impaired blink plasticity, and a reduced spontaneous blink rate. At 130 Hz, but not 16 Hz, STN DBS eliminates reflex blink hyperexcitability and restores both short- and long-term blink plasticity. Replicating its lack of effect in PD patients, 130-Hz STN DBS does not reinstate a normal temporal pattern or rate to spontaneous blinking in 6-OHDA lesioned rats. These data show that the 6-OHDA lesioned rat is an ideal model system for investigating the neural bases of reflex abnormalities in PD and highlight the complexity of PD's effects on motor control, by showing that dopamine depletion does not affect all blink systems via the same neural mechanisms. Copyright © 2015 the American Physiological Society.

  16. A Clinical Study on the Effect of Injection Sites on Efficacy of Anesthesia and Pulpal Blood Flow in Carious Teeth.

    PubMed

    Zheng, Q H; Hong, Q C; Zhang, L; Ye, L; Huang, D M

    2017-10-04

    This randomized clinical trial evaluated the efficiency of maxillary infiltration anesthesia in carious teeth at two different injection sites and their impact on the laser Doppler recordings of pulpal blood flow (PBF) during a caries excavation procedure. The null hypothesis tested was that there are no differences in the efficiency of anesthesia and PBF reduction between maxillary infiltrations at the two injection sites. One hundred twenty patients were divided into three groups according to the degree of carious lesion of their maxillary left central incisors (moderate caries, deep caries, or no caries). Forty patients in each group randomly received infiltrations over the root apex of maxillary left central incisors (site X) or over the midpoint of the line connecting the root apexes of both maxillary left central and lateral incisors (site Y) using 0.9 mL 2% lidocaine with 1:100,000 adrenaline. Teeth were pulp tested at five-minute intervals after injection except for the period of cavity cutting, which was done 12 minutes after injection. The PBF changes after injection were monitored by laser Doppler flowmetry. The observation period in this study was 60 minutes. Success of anesthesia was defined as no or mild pain on cavity cutting by visual analog scale recordings. Deep caries group showed significantly higher baseline PBF (p<0.05). All groups showed 100% success of anesthesia and similar duration time (p>0.05). Subgroups that had the injection at site Y showed significantly less reduction of PBF (p<0.05). Cavity-cutting procedures increased the amplitude of the PBF around the lowest value after injection. Independent of the cavity depth, carious anterior teeth anesthetized by infiltration further from the apex had significantly less reduction on the pulpal blood flow compared with teeth anesthetized by infiltration at the apex.

  17. Microtensile bond strength of glass ionomer cements to artificially created carious dentin.

    PubMed

    Choi, Kyungho; Oshida, Yoshiki; Platt, Jeffrey A; Cochran, Michael A; Matis, Bruce A; Yi, Keewook

    2006-01-01

    In this laboratory study, the microtensile bond strengths of a conventional glass ionomer cement (GIC) and a resin modified glass ionomer cement (CRMGIC) to artificially created carious dentin and sound dentin were compared, and the ultrastructural morphology of the fractured interface was examined with a low-vacuum scanning electron microscope (SEM). The specimens were divided into 4 groups: 1) a conventional GIC (Ketac-Fil Plus Aplicap) placed on sound dentin; 2) a conventional GIC placed on artificially created carious dentin; 3) an RMGIC (Photac-Fil Aplicap) placed on sound dentin and 4) an RMGIC placed on artificially created carious dentin. Artificial carious lesions were created using a chemical demineralizing solution of 0.1 M/L lactic acid and 0.2% carbopol. GIC buildups were made on the dentin surfaces according to the manufacturer's directions. After storage in distilled water at 37 degrees C for 24 hours, the teeth were sectioned vertically into 1 x 1 x 8-mm beams for the microtensile bond strength test. The microtensile bond strength of each specimen was measured, and failure mode was determined using an optical microscope (40x). The fractured surfaces were further examined with SEM. Two-way analysis of variance showed that the mean microtensile bond strengths of a GIC and an RMGIC to carious dentin were significantly lower than those to sound dentin, and the mean microtensile bond strengths of Photac-Fil to both sound and carious dentin were significantly higher than those of Ketac-Fil Plus. Chi-square tests indicated that there was a significant difference in failure mode between the sound dentin and carious dentin groups. In sound dentin groups, cohesive failure in GIC was pre- dominant; whereas, mixed failure was predominant in carious dentin groups. SEM examination showed that the specimens determined to be cohesive failures under light microscopy in the Photac-Fil/Sound Dentin group were actually mixed failures under high magnification of SEM.

  18. Modification of amino acid residues in carious dentin matrix.

    PubMed

    Kleter, G A; Damen, J J; Buijs, M J; Ten Cate, J M

    1998-03-01

    The Maillard reaction between sugar and protein has been postulated as the cause for the browning and arrestment of caries lesions. This reaction has been implicated as the cause for decreased degradability of collagen in vivo. The aim of the present study was to verify the occurrence of the reaction in vivo. Carious and sound dentin samples were taken from extracted human teeth and analyzed for the fluorescence characteristic of the Maillard reaction and oxidation and, by HPLC, for Maillard products. In addition, physiological cross-links were analyzed by HPLC. Oxidation- and Maillard reaction-related fluorescence increased in collagenase digests from carious dentin. Advanced Maillard products (carboxymethyllysine and pentosidine) increased, whereas furosine, a marker for the initial reaction, was not observed consistently. This implies no direct addition of sugars to protein, but rather the addi-tion of smaller metabolites and glycoxidation products. In addition, the physiological cross-links hydroxylysinonorleucine and dihydroxylysinonorleucine decreased in carious dentin. Also for hydroxylysylpyridinoline, a decrease was observed, but not consistently. In conclusion, the caries process modifies amino acids in dentin collagen, which can lead to increased resistance against proteolysis and ultimately to caries arrestment.

  19. Effectiveness and efficiency of chemomechanical carious dentin removal.

    PubMed

    Magalhães, Cláudia Silami de; Moreira, Allyson Nogueira; Campos, Wagner Reis da Costa; Rossi, Fernanda Magalhães; Castilho, Guilherme Augusto Alcaraz; Ferreira, Raquel Conceição

    2006-01-01

    The aims of this in vitro study were both to determine the time necessary for removal of carious dentin (efficiency) and the Knoop Hardness Number (KHN) of the remaining dentin (effectiveness), using a chemomechanical method (Carisolv) or hand excavation. Thirty human molars were bisected through occlusal carious lesions into two equal halves. Each half was randomly excavated by hand in circular movements with a spoon excavator or using Carisolv gel according to the manufacturer's instructions. The duration of carious dentin removal was recorded. Tooth sections were resin-embedded, ground flat and polished. Dentin KHN was determined at distances of 100, 200, 300, 400 and 500 microm from the cavity floor. Data were analyzed by Wilcoxon's test (alpha= 0.01), ANOVA and Student's t test (alpha= 0.05). The median of the time necessary for chemomechanical excavation was significantly greater than for hand excavation. KHN means (+/- SD) at 100, 200, 300, 400, 500 microm for chemomechanical method were, respectively: 15.6 (+/- 4.96), 18.0 (+/- 6.22), 21.3 (+/- 9.30), 24.3 (+/- 9.25), 28.5 (+/- 11.80); and for hand excavation were: 21.2 (+/- 10.26), 23.4 (+/- 9.49), 28.2 (+/- 11.62), 31.0 (+/- 12.17), 34.3 (+/- 11.95). It may be concluded that hand excavation presented higher efficiency and effectiveness than chemomechanical excavation.

  20. Novel Approaches for Diagnosing Melanoma Skin Lesions Through Supervised and Deep Learning Algorithms.

    PubMed

    Premaladha, J; Ravichandran, K S

    2016-04-01

    Dermoscopy is a technique used to capture the images of skin, and these images are useful to analyze the different types of skin diseases. Malignant melanoma is a kind of skin cancer whose severity even leads to death. Earlier detection of melanoma prevents death and the clinicians can treat the patients to increase the chances of survival. Only few machine learning algorithms are developed to detect the melanoma using its features. This paper proposes a Computer Aided Diagnosis (CAD) system which equips efficient algorithms to classify and predict the melanoma. Enhancement of the images are done using Contrast Limited Adaptive Histogram Equalization technique (CLAHE) and median filter. A new segmentation algorithm called Normalized Otsu's Segmentation (NOS) is implemented to segment the affected skin lesion from the normal skin, which overcomes the problem of variable illumination. Fifteen features are derived and extracted from the segmented images are fed into the proposed classification techniques like Deep Learning based Neural Networks and Hybrid Adaboost-Support Vector Machine (SVM) algorithms. The proposed system is tested and validated with nearly 992 images (malignant & benign lesions) and it provides a high classification accuracy of 93 %. The proposed CAD system can assist the dermatologists to confirm the decision of the diagnosis and to avoid excisional biopsies.

  1. Microbiome of Deep Dentinal Caries Lesions in Teeth with Symptomatic Irreversible Pulpitis

    PubMed Central

    Rôças, Isabela N.; Rachid, Caio T. C. C.; Lima, Kenio C.; Assunção, Isauremi V.; Gomes, Patrícia N.; Siqueira, José F.

    2016-01-01

    This study used a next-generation sequencing approach to identify the bacterial taxa occurring in the advanced front of caries biofilms associated with pulp exposure and irreversible pulpitis. Samples were taken from the deepest layer of dentinal caries lesions associated with pulp exposure in 10 teeth diagnosed with symptomatic irreversible pulpitis. DNA was extracted and the microbiome was characterized on the basis of the V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. Bacterial taxa were mapped to 14 phyla and 101 genera composed by 706 different OTUs. Three phyla accounted for approximately 98% of the sequences: Firmicutes, Actinobacteria and Proteobacteria. These phyla were also the ones with most representatives at the species level. Firmicutes was the most abundant phylum in 9/10 samples. As for genera, Lactobacillus accounted for 42.3% of the sequences, followed by Olsenella (13.7%), Pseudoramibacter (10.7%) and Streptococcus (5.5%). Half of the samples were heavily dominated by Lactobacillus, while in the other half lactobacilli were in very low abundance and the most dominant genera were Pseudoramibacter, Olsenella, Streptococcus, and Stenotrophomonas. High bacterial diversity occurred in deep dentinal caries lesions associated with symptomatic irreversible pulpitis. The microbiome could be classified according to the relative abundance of Lactobacillus. Except for Lactobacillus species, most of the highly prevalent and abundant bacterial taxa identified in this study have been commonly detected in infected root canals. The detected taxa can be regarded as candidate pathogens for irreversible pulpitis and possibly the pioneers in pulp invasion to initiate endodontic infection. PMID:27135405

  2. Microbiome of Deep Dentinal Caries Lesions in Teeth with Symptomatic Irreversible Pulpitis.

    PubMed

    Rôças, Isabela N; Alves, Flávio R F; Rachid, Caio T C C; Lima, Kenio C; Assunção, Isauremi V; Gomes, Patrícia N; Siqueira, José F

    2016-01-01

    This study used a next-generation sequencing approach to identify the bacterial taxa occurring in the advanced front of caries biofilms associated with pulp exposure and irreversible pulpitis. Samples were taken from the deepest layer of dentinal caries lesions associated with pulp exposure in 10 teeth diagnosed with symptomatic irreversible pulpitis. DNA was extracted and the microbiome was characterized on the basis of the V4 hypervariable region of the 16S rRNA gene by using paired-end sequencing on Illumina MiSeq device. Bacterial taxa were mapped to 14 phyla and 101 genera composed by 706 different OTUs. Three phyla accounted for approximately 98% of the sequences: Firmicutes, Actinobacteria and Proteobacteria. These phyla were also the ones with most representatives at the species level. Firmicutes was the most abundant phylum in 9/10 samples. As for genera, Lactobacillus accounted for 42.3% of the sequences, followed by Olsenella (13.7%), Pseudoramibacter (10.7%) and Streptococcus (5.5%). Half of the samples were heavily dominated by Lactobacillus, while in the other half lactobacilli were in very low abundance and the most dominant genera were Pseudoramibacter, Olsenella, Streptococcus, and Stenotrophomonas. High bacterial diversity occurred in deep dentinal caries lesions associated with symptomatic irreversible pulpitis. The microbiome could be classified according to the relative abundance of Lactobacillus. Except for Lactobacillus species, most of the highly prevalent and abundant bacterial taxa identified in this study have been commonly detected in infected root canals. The detected taxa can be regarded as candidate pathogens for irreversible pulpitis and possibly the pioneers in pulp invasion to initiate endodontic infection.

  3. Microbiological analysis after complete or partial removal of carious dentin using two different techniques in primary teeth: A randomized clinical trial

    PubMed Central

    Singhal, Deepak Kumar; Acharya, Shashidhar; Thakur, Arun Singh

    2016-01-01

    Background: The management of deep carious lesions can be done by various techniques but residual caries dilemma still persists and bacterial reduction in cavities treated by either partial or complete caries removal techniques is debatable. So the objective of the present randomized clinical trial was to compare microbial counts in cavities submitted to complete caries removal and partial caries removal using either hand instruments or burs before and after 3 weeks of restoration. Materials and Methods: Primary molars with acute carious lesions in inner half of dentine and vital pulp were randomly divided into three groups of 14 each: Group A: Partial caries removal using hand instruments atraumatic restorative treatment (ART) only; Group B: Partial caries removal using bur; Group C: Complete caries removal using bur and caries detector dye. Dentine sample obtained after caries removal and 3 weeks after restoration, were subjected to microbial culture and counting (colony-forming units [CFU]/mg of dentine) for total viable bacterial count, Streptococcus spp., mutans streptococci, Lactobacillus spp. Results: Three techniques of caries removal showed significant (P < 0.05) reduction in all microorganisms studied after 3 weeks of evaluation, but there was no statistically significant difference in percentage reduction of microbial count among three groups. Conclusion: Results suggest the use of partial caries removal in a single session as compared to complete caries removal as a part of treatment of deep lesions in deciduous teeth in order to reduce the risk of pulp exposure. Partial caries removal using ART can be preferred for community settings as public health procedure for caries management. PMID:26962313

  4. Functionally tailored transcortical approach of deep-seated lesions: an alternative to the transulcal approach? a technical case report.

    PubMed

    Bresson, D; Madadaki, C; Poisson, I; Habas, C; Mandonnet, E

    2013-01-01

    It is commonly believed that sulci offer a natural path to reach deep-seated lesions. However, it has also been argued that this approach carries a risk of damaging the vessels during the opening of the sulcus.We therefore were prompted to test the possibility of finding a transcortical path identified as non-functional by intraoperative brain mapping. A successful resection is presented of a left posterior is thmusclear cell ependymoma through a selected corridor based on functional mapping in an awake patient.MRI performed at 12 months showed no tumour recurrence. Pre- and postoperative extensive testing confirmed an improvement of the patient's cognitive functions. Therefore, we were able to demonstrate the feasibility of a functionally tailored transcortical approach as an alternative to the transulcal approach for deep-seated lesions. This concept should be validated in a larger patient series.

  5. Comparison of reflectance spectra of sound and carious enamel

    NASA Astrophysics Data System (ADS)

    Analoui, Mostafa; Ando, Masatoshi; Stookey, George K.

    2000-03-01

    Development of dental caries is associated with the loss of minerals and change in the enamel structure. In this study, we have measured and compared reflectance spectra of sound and carious enamel, to investigate its utility in detection and analysis of dental caries. One hundred twenty, 3-mm diameter human enamel cores, with no sign of fluorosis, tetracycline stain, hypoplasia, fracture and restorations, were prepared. The enamel surfaces then were ground and polished. Specimens were placed on a fitted holder with either black or white color for background, with no fluorescence. The baseline spectra were measured using a spectrophotometer with enclosed diffused illumination. Spectra measured from 380 to 780 nm at 5 nm intervals. All measurements were corrected to compensate for the spectrum of illumination. The specimens were divided into two groups and exposed to a demineralizing solution, for 48 and 96 hours, respectively. Reflectance spectra of specimens were measured following lesion induction. All specimens were sectioned and analyzed by transverse microradiography (TMR), where lesion depth and mineral loss ((Delta) Z) were measured. Dimensionality of multi-spectral data was reduced through its conversion to L*a*b* color coordinates and principal component analysis (PCA). Multiple linear regression analysis showed low correlation between L*a*b* and lesion depth and mineral loss. PCA analysis showed higher correlation coefficient, compared to L*a*b*. Preliminary results of this study suggest that multi-spectral measurement and analysis of the tooth surface could be useful in predicting the depth and severity of an early carious lesion.

  6. Variable resolution electromagnetic tomography (VARETA) in evaluation of compression of cerebral arteries due to deep midline brain lesions.

    PubMed

    Fernández-Bouzas, Antonio; Harmony, Thalía; Fernández, Thalía; Ricardo-Garcell, Josefina; Santiago, Efraín

    2004-01-01

    Hemispheric tumors produced electroencephalographic (EEG) delta activity mainly due to deafferentation of cerebral cortex. In small, deep midline lesions that compressed cerebral arteries, the most important abnormality should have been in EEG theta band that selectively responded to brain ischemia. Frequency domain-variable resolution electromagnetic tomography (FD-VARETA) has been applied satisfactorily to the study of brain tumors, cerebral infarcts, and brain hemorrhages and was shown to localize areas of hypoperfusion. Twelve patients with deep midline lesions compressing different cerebral arteries were studied. Computer tomography (CT) and/or magnetic resonance imaging (MRI) as well as quantitative EEG with source calculation in frequency domain were obtained. Brain electromagnetic tomographies (BETs) were calculated to evaluate localization and extension of functional abnormalities. Ten of twelve cases presented abnormal sources in theta band as main abnormal source. In only two cases was the main source in delta band, but these cases also had abnormal Z values in theta band. In four patients there were only abnormal values in theta range. Sources of abnormal theta activity were observed in regions irrigated by the arteries compressed. In deep midline lesions, compression of cerebral arteries producing relative ischemia may explain abnormal EEG sources in theta band. Patients with main source in theta band showed vascular compression and some patients exhibited vasogenic edema. Thus, theta might be due to relative ischemia produced by both hypoperfusion and edema. Once again, VARETA has found to be very useful in evaluation of functional abnormalities.

  7. pH gradient and distribution of streptococci, lactobacilli, prevotellae, and fusobacteria in carious dentine

    PubMed Central

    Nguyen, Ky-Anh T.; Browne, Gina V.; Simonian, Mary; Hunter, Neil

    2013-01-01

    Objectives Caries process comprises acidogenic and aciduric bacteria that are responsible for lowering the pH and subsequent destruction of hydroxyapatite matrix in enamel and dentine. The aim of this study was to identify the correlation between the pH gradient of a carious lesion and proportion and distribution of four bacterial genera; lactobacilli, streptococci, prevotellae, and fusobacteria with regard to total load of bacteria. Materials and methods A total of 25 teeth with extensive dentinal caries were sampled in sequential layers. Using quantitative real-time PCR of 16S rRNA gene, we quantified the total load of bacteria as well as the proportion of the abovementioned genera following pH measurement of each sample with a fine microelectrode. Results We demonstrated the presence of a pH gradient across the lesion with a strong association between the quantity of lactobacilli and the lowest pH range (pH 4.5–5.0; p = 0.003). Streptococci had a tendency to occupy the most superficial aspect of the carious lesion but showed no correlation to any pH value. Prevotellae showed clear preference for the pH range 5.5–6.0 (p = 0.042). The total representation of these four genera did not reach more than one quarter of the total bacterial load in most carious samples. Conclusion We revealed differential colonization behavior of bacteria with respect to pH gradient and a lower than expected abundance of lactobacilli and streptococci in established carious lesions. The data indicate the numerical importance of relatively unexplored taxa within the lesion of dentinal caries. Clinical relevance The gradient nature of pH in the lesion as well as colonization difference of examined bacterial taxa with reference to pH provides a new insight in regard to conservative caries management. PMID:23771212

  8. pH gradient and distribution of streptococci, lactobacilli, prevotellae, and fusobacteria in carious dentine.

    PubMed

    Kianoush, Nima; Nguyen, Ky-Anh T; Browne, Gina V; Simonian, Mary; Hunter, Neil

    2014-01-01

    Caries process comprises acidogenic and aciduric bacteria that are responsible for lowering the pH and subsequent destruction of hydroxyapatite matrix in enamel and dentine. The aim of this study was to identify the correlation between the pH gradient of a carious lesion and proportion and distribution of four bacterial genera; lactobacilli, streptococci, prevotellae, and fusobacteria with regard to total load of bacteria. A total of 25 teeth with extensive dentinal caries were sampled in sequential layers. Using quantitative real-time PCR of 16S rRNA gene, we quantified the total load of bacteria as well as the proportion of the above-mentioned genera following pH measurement of each sample with a fine microelectrode. We demonstrated the presence of a pH gradient across the lesion with a strong association between the quantity of lactobacilli and the lowest pH range (pH 4.5-5.0; p = 0.003). Streptococci had a tendency to occupy the most superficial aspect of the carious lesion but showed no correlation to any pH value. Prevotellae showed clear preference for the pH range 5.5-6.0 (p = 0.042). The total representation of these four genera did not reach more than one quarter of the total bacterial load in most carious samples. We revealed differential colonization behavior of bacteria with respect to pH gradient and a lower than expected abundance of lactobacilli and streptococci in established carious lesions. The data indicate the numerical importance of relatively unexplored taxa within the lesion of dentinal caries. The gradient nature of pH in the lesion as well as colonization difference of examined bacterial taxa with reference to pH provides a new insight in regard to conservative caries management.

  9. The relationship between the color of carious dentin stained with a caries detector dye and bacterial infection.

    PubMed

    Iwami, Yukiteru; Shimizu, Ayako; Narimatsu, Masahiro; Kinomoto, Yoshifumi; Ebisu, Shigeyuki

    2005-01-01

    This in vitro study aimed to design a method for the objective evaluation of carious dentin using numerical values. This study also investigated the relationship between the color of carious dentin stained with a caries detector dye using this objective method and the rate of bacterial detection as detected by a polymerase chain reaction (PCR). In 15 molars with occlusal dentin caries and three extracted sound molars, dentin was removed in multiple steps with 300 microm removed each step. Before and after every removal, images of a color-matching sticker and carious surfaces stained with a caries detector dye were acquired simultaneously using a CCD camera and dentinal tissue samples were removed with a round bur. Next, corrected L*, a* and b* values of the carious surfaces (CIE 1976 L*a*b* color system) were calculated from the color changes of the stickers in the images. In addition, bacterial DNA in the dentinal tissue was detected by PCR. From evaluations of the receiver operating characteristic curves for the L*, a* and b* values, the L* value was determined to be a more useful parameter than a* or b* for detecting bacterial infection using the caries detector dye. The bacterial detection rates of carious dentin decreased as the L* values of carious dentin stained with the dye increased. When the L* values were more than 60, the dentin had no bacterial infection. This study clarified the relationship between the colors of lesions stained with a caries detector dye and the rates of bacterial detection.

  10. First-time isolation of Candida dubliniensis from plaque and carious dentine of primary teeth.

    PubMed

    Kneist, S; Borutta, A; Sigusch, B W; Nietzsche, S; Küpper, H; Kostrzewa, M; Callaway, A

    2015-08-01

    To determine those organisms of the genus Candida associated with dental caries by investigating samples from active carious lesions. Within the genus Candida, the species Candida albicans and Candida dubliniensis are capable of forming chlamydospores and germ tubes. Until it became possible in 1995 to differentiate between the two species taxonomically, C. dubliniensis was falsely identified as C. albicans. Whilst the importance of C. albicans for rapidly progressing early childhood caries (ECC) has been recognised, so far there have been only reports about C. dubliniensis in connection with children/mothers who have been infected with HIV or already developed AIDS. In the present study, C. dubliniensis was for the first time isolated from plaque and carious dentine of a healthy five-year-old boy. As part of the investigation, a number of samples were collected from individual children affected by active dental caries. Amongst the samples, one in particular indicated that Candida species might be involved. The patient was a five-year-old boy with ECC of the primary dentition, scheduled for restorative treatment under general anaesthesia. Before treatment, a salivary, plaque (region of 54/55) and soft carious dentine sample from the tooth 51 was taken before extraction. The counts of yeasts, lactobacilli (LB) and mutans streptococci were determined in the samples. The boy's dmft was 11, which was dominated by the d component. In the saliva of the boy, LB and mutans streptococci (MS) were detected. In plaque and carious dentine, MS and most interestingly C. dubliniensis were present. The yeasts were visualised in carious dentine by means of scanning electron micrographs. Plaque and carious dentine may be a further habitat of C. dubliniensis.

  11. Effects of dentifrices on artificial caries like lesions: an in vitro pH cycling study.

    PubMed

    Rana, R; Itthagarun, A; King, N M

    2007-08-01

    To evaluate remineralising effects of three dentifrices, Vicco by Vicco Labs, India, Perioe Cavity Care by LG Care, Korea and Colgate Total by Colgate-Palmolive, Thailand on artificial caries like lesions. In vitro single-section and pH cycling model. Extracted third molars were painted with nail varnish, leaving 1 mm wide windows before placing demineralising solution for 96h to produce artificial carious lesions 150-200 miocrom deep. Teeth were then cut longitudinally into 100-150 microm thick sections and randomly assigned to three groups. Polarised light microscopy and microradiography were used to evaluate lesion depth, before and after the 10 day pH cycle. Sections in Group A were treated with Vicco by Vicco Labs, India (-ve control), Group B were treated with Perioe Cavity Care by LG Care, Korea and Group C were treated with Colgate Total by Colgate-Palmolive, Thailand. Mean lesion depths in Groups B and C reduced by 7% and 12% respectively, whereas lesion depth increased by 13% in Group A. Comparisons made among groups using ANOVA and Student-Newman-Keuls tests showed that three groups were significantly different from each other (p < 0.05). Perioe Cavity Care and Colgate Total remineralised initial carious lesions. However, the remineralising potential of Colgate Total was higher than that of Perioe Cavity Care.

  12. White spots on enamel: treatment protocol by superficial or deep infiltration (part 2).

    PubMed

    Attal, Jean-Pierre; Atlan, Anthony; Denis, Maud; Vennat, Elsa; Tirlet, Gilles

    2014-03-01

    In this 2nd part, the current treatment of white spot lesions by erosion/infiltration is presented, beginning with a reminder of the principle of superficial infiltration, which enables most early carious lesions, fluorosis and post-traumatic lesions to be treated. However, this technique has met with frequent failures in cases of MIH or deep lesions of traumatic origin or those associated with fluorosis. For this reason a new deep infiltration technique is proposed: thanks to its global treatment concept, this enables all white spots to be treated. The place of whitening in these treatment options is discussed, with explanations of the main reasons for its failures. Copyright © 2014 CEO. Published by Elsevier Masson SAS. All rights reserved.

  13. The Evaluation of the Vector System in Removal of Carious Tissue

    PubMed Central

    Yildirim, Mine; Seymen, Figen; Keklikoglu, Nurullah

    2010-01-01

    The aim of this study was to evaluate the Vector system in comparison to the conventional technique in cavity preparation. Four extracted primary teeth with no restorations and similar fissure carious lesions and four permanent teeth extracted for orthodontic reasons were used. Class I preparations were made provided that the caries depth remained within the dentin limits. Two teeth were treated with an aerator, the other two had carious tissue removed with the Vector system. Prepared cavities were evaluated with scanning electron microscopy for the surface roughness of the dentine and enamel and for the carious tissue removal efficiency. This pilot study determined that it is possible to remove carious tissue and perform cavity preparation with the Vector system. According to this preliminary evaluation of surface quality, a cavity prepared with the Vector treatment system, allows for a slicker floor, and a more regular enamel-dentine line than that prepared with an aerator. However, the Vector system requires a longer treatment time which we believe may be a negative point, especially for young patients. PMID:20454647

  14. Radiofrequency Lesions through Deep Brain Stimulation Electrodes in Movement Disorders: Case Report and Review of the Literature.

    PubMed

    Pérez-Suárez, Javier; Torres Díaz, Cristina V; López Manzanares, Lydia; Navas García, Marta; Pastor, Jesús; Barrio Fernández, Patricia; G de Sola, Rafael

    2017-01-01

    Although there are few reports of radiofrequency lesions performed through deep brain stimulation (DBS) electrodes in patients with movement disorders, experience with this method is scarce. We present 2 patients who had been previously treated with DBS of subthalamic nuclei (STN) and the ventral intermediate (VIM) nucleus of the thalamus for Parkinson's disease and essential tremor, respectively, and underwent a radiofrequency lesion through their DBS electrodes after developing a hardware infection. The authors conduct a review of the literature regarding this method. Both patients had a good clinical outcome after 20 and 8 months, respectively, as assessed by a reduction in Fahn-Tolosa-Marin Scale and Unified Parkinson's Disease Rating Scale scores. The second patient underwent a second DBS system implantation surgery after his radiofrequency treatment to optimize his management, achieving optimal clinical control with lower current and drug requirements than before the radiofrequency intervention. No adverse effects were observed. Radiofrequency lesions through DBS electrodes allow the creation of small and localized lesions. Its effectiveness and low-risk profile, in addition to its low cost, make this procedure suitable and a possible alternative in the therapeutic repertoire for the surgical treatment of movement disorders. © 2017 S. Karger AG, Basel.

  15. Deep subsurface thermal lesions in tissue using an Nd:YAG laser and cryogen spray cooling: preliminary in vitro results

    NASA Astrophysics Data System (ADS)

    Ramli, Rahayu; Durand, Daniel; Fried, Nathaniel M.

    2004-07-01

    Surface cooling methods are used in dermatology to protect the skin surface during cosmetic laser procedures. This study investigates cryogen spray cooling of the tissue surface during laser production of deep subsurface tissue legions. Nd:YAG laser radiation with a wavelength of 1.06 microns, output power of 30 Watts, a 7.5-mm-diameter spot, and a pulse duration of 1 s, was delivered to porcine liver and skin samples, maintained at 33 - 37°C and monitored with embedded micro-thermocouples. The cryogen spray was delivered intermittently between laser pulses, with a pulse duration of 60 milliseconds, reptition rate of 0.333 Hz, and a 2-cm-diameter spot. Gross and histologic pathology was used to measure tissue lesion dimensions. Liver lesions measured 4.9 +/- 1.2 mm in diameter, while preserving the tissue surface to depth of 2.1 +/- 0.4 mm (n = 5). Surface temperatures remained below 40°C, while lesion temperatures ranged between 60 - 70°C. Skin lesions appeared 1 mm below the skin surface and measured ~ 2-mm-diameter (n = 4). This technique may be used to target subsurface anatomical structures in the male reproductive tract for noninvasive male sterilization. In vivo experiments will be necessary to optimize the laser heating and cryogen cooling parameters.

  16. Melanoma Is Skin Deep: A 3D Reconstruction Technique for Computerized Dermoscopic Skin Lesion Classification

    PubMed Central

    Satheesha, T. Y.; Prasad, M. N. Giri; Dhruve, Kashyap D.

    2017-01-01

    Melanoma mortality rates are the highest amongst skin cancer patients. Melanoma is life threating when it grows beyond the dermis of the skin. Hence, depth is an important factor to diagnose melanoma. This paper introduces a non-invasive computerized dermoscopy system that considers the estimated depth of skin lesions for diagnosis. A 3-D skin lesion reconstruction technique using the estimated depth obtained from regular dermoscopic images is presented. On basis of the 3-D reconstruction, depth and 3-D shape features are extracted. In addition to 3-D features, regular color, texture, and 2-D shape features are also extracted. Feature extraction is critical to achieve accurate results. Apart from melanoma, in-situ melanoma the proposed system is designed to diagnose basal cell carcinoma, blue nevus, dermatofibroma, haemangioma, seborrhoeic keratosis, and normal mole lesions. For experimental evaluations, the PH2, ISIC: Melanoma Project, and ATLAS dermoscopy data sets is considered. Different feature set combinations is considered and performance is evaluated. Significant performance improvement is reported the post inclusion of estimated depth and 3-D features. The good classification scores of sensitivity = 96%, specificity = 97% on PH2 data set and sensitivity = 98%, specificity = 99% on the ATLAS data set is achieved. Experiments conducted to estimate tumor depth from 3-D lesion reconstruction is presented. Experimental results achieved prove that the proposed computerized dermoscopy system is efficient and can be used to diagnose varied skin lesion dermoscopy images. PMID:28512610

  17. Dysexecutive behaviour following deep brain lesions--a different type of disconnection syndrome?

    PubMed

    Krause, Martin; Mahant, Neil; Kotschet, Katya; Fung, Victor S; Vagg, Daniel; Wong, Chong H; Morris, John G L

    2012-01-01

    The suppression of automatic prepotent behaviour in favour of more successful, more 'appropriate' behaviour is the primary function of the frontal lobe. Five frontal-subcortical circuits connect the frontal lobe to the basal ganglia and the thalamus. We report 17 patients with small lesions in the downstream structures of the frontal-subcortical circuits displaying severe dysexecutive behaviour. Positron emission tomography (PET) demonstrated hypometabolism of the frontal lobe in some of these patients. The literature on frontal lobe dysfunction after lesions in the basal ganglia and thalamus is discussed and the semiology of frontal lobe dysfunction in relation to the frontal-subcortical circuits is highlighted. Derived from our findings we suggest a disconnection syndrome of the frontal lobe caused by lesions in the downstream structures of the frontal-subcortical circuits.

  18. Radiopaque Tagging Masks Caries Lesions following Incomplete Excavation in vitro.

    PubMed

    Schwendicke, F; Meyer-Lueckel, H; Schulz, M; Dörfer, C E; Paris, S

    2014-06-01

    One-step incomplete excavation seals caries-affected dentin under a restoration and appears to be advantageous in the treatment of deep lesions. However, it is impossible to discriminate radiographically between intentionally left, arrested lesions and overlooked or active lesions. This diagnostic uncertainty decreases the acceptance of minimally invasive excavation and might lead to unnecessary re-treatment of incompletely excavated teeth. Radiopaque tagging of sealed lesions might mask arrested lesions and assist in discrimination from progressing lesions. Therefore, we microradiographically screened 4 substances (SnCl2, AgNO3, CsF, CsCH3COO) for their effect on artificial lesions. Since water-dissolved tin chloride (SnCl2×Aq) was found to stably mask artificial lesions, we then investigated its radiographic effects on progressing lesions. Natural lesions were incompletely excavated and radiopaque tagging performed. Grey-value differences (△GV) between sound and carious dentin were determined and radiographs assessed by 20 dentists. While radiographic effects of SnCl2×Aq were stable for non-progressing lesions, they significantly decreased during a second demineralization (p < .001, t test). For natural lesions, tagging with SnCl2×Aq significantly reduced △GV (p < .001, Wilcoxon). Tagged lesions were detected significantly less often than untagged lesions (p < .001). SnCl2×Aq was suitable to mask caries-affected dentin and discriminate between arrested and progressing lesions in vitro. Radiopaque tagging could resolve diagnostic uncertainties associated with incomplete excavation.

  19. Comparison of four lasers (λ = 650, 808, 980, and 1075 nm) for noninvasive creation of deep subsurface lesions in tissue

    NASA Astrophysics Data System (ADS)

    Chang, Chun-Hung; Wilson, Christopher R.; Fried, Nathaniel M.

    2015-07-01

    Lasers have been used in combination with applied cooling methods to preserve superficial skin layers (100's μm's) during cosmetic surgery. Preservation of a thicker tissue surface layer (millimeters) may also allow development of other noninvasive laser procedures. We are exploring noninvasive therapeutic laser applications in urology (e.g. laser vasectomy and laser treatment of female stress urinary incontinence), which require surface tissue preservation on the millimeter scale. In this preliminary study, four lasers were compared for noninvasive creation of deep subsurface thermal lesions. Laser energy from three diode lasers (650, 808, and 980 nm) and a Ytterbium fiber laser (1075 nm) was delivered through a custom built, side-firing, laser probe with integrated cooling. An alcohol-based solution at -5 °C was circulated through a flow cell, cooling a sapphire window, which in turn cooled the tissue surface. The probe was placed in contact with porcine liver tissue, ex vivo, kept hydrated in saline and maintained at ~ 35 °C. Incident laser power was 4.2 W, spot diameter was 5.3 mm, and treatment time was 60 s. The optimal laser wavelength tested for creation of deep subsurface thermal lesions during contact cooling of tissues was 1075 nm, which preserved a surface layer of ~ 2 mm. The Ytterbium fiber laser provides a compact, low maintenance, and high power alternative laser source to the Neodymium:YAG laser for noninvasive thermal therapy.

  20. Posterior Reversible Encephalopathy Syndrome with Extensive Deep White Matter Lesions Including the Temporal Pole

    PubMed Central

    Ohira, Junichiro; Mori, Nobuyuki; Kajikawa, Shunsuke; Nakamura, Takeshi; Arisato, Tetsuya; Takahashi, Makio

    2016-01-01

    Posterior reversible encephalopathy syndrome (PRES) typically affects the posterior subcortical white matter. We report the case of a 55-year-old man with atypical PRES, who had malignant hypertension and renal dysfunction. Magnetic resonance imaging of the brain revealed extensive vasogenic edema in the deep white matter including the temporal pole, as well as in the brainstem and cerebellum. Antihypertensive therapy and hemodialysis contributed to both clinical and radiological improvement. Involvement of the deep white matter including the temporal pole, which is rarely affected in an ischemic stroke, should be recognized as a potential sign of PRES. PMID:27904123

  1. [Effect of infiltration technique and polishing on the roughness of artificial carious enamel surfaces].

    PubMed

    Yuan, Chang-qing; Dou, Guo-wen; Deng, Jing; Geng, Guo-liang; Sun, Pei; Cao, Ying-xiu

    2013-08-01

    To study the surface roughness of early carious lesions which were treated with resin infiltration and polished with different materials, and to provide reference for selection of appropriate polishing system. Fifty-four labial surface specimens of mandibular incisors were created out of bovine teeth. They were randomly divided into 6 groups. One group was sound enamel group. Another group was early enamel carious group. Other specimens were treated with a partially saturated acidic buffer solution for preparation of initial artificial enamel caries. These initial artificial enamel caries were treated with resin infiltration. Then they were randomly divided into 4 groups according to polishing or not and type of polishing tool (rubber cups, polishing discs, HiLuster polishers). The surface roughness of specimens in all groups were measured with Form Talysurf PGI 800. Arithmetical mean deviation of the assessed profile (Ra) and the maximum height of the profile(Rz) were used as measurement parameter. SPSS 17.0 software package was used for data analysis. Comparison of sound enamel surfaces and early carious surfaces revealed no significant difference in surface roughness(P>0.05), but the mean value of the latter one was higher. After infiltration, the roughness of surfaces without polishing was significantly higher than that of early carious surfaces(P<0.05). After infiltration and polishing with different tools, there was no significant difference in surface roughness of every two groups (P>0.05). The roughness of polishing groups after infiltration was significantly smaller than that of group without polished after infiltration (P<0.05). Comparison of polishing surfaces after infiltration and early carious surfaces revealed no significant difference in surface roughness (P>0.05). After early caries being treated with infiltration technique, the roughness of teeth surfaces increases significantly. Those surfaces should be polished. Rubber cup and polishing discs

  2. In vitro investigation of fluorescence of carious dentin observed with a Soprolife® camera.

    PubMed

    Panayotov, Ivan; Terrer, Elodie; Salehi, Hamideh; Tassery, Hervé; Yachouh, Jacques; Cuisinier, Frédéric J G; Levallois, Bernard

    2013-04-01

    Our aim was to determine the origin of the red fluorescence of carious dentine observed with the Soprolife® camera. We conducted in vitro studies to evaluate the origin of the red fluorescence using acids and matrix metalloproteinase (MMP) to mimic caries and methylglycoxal (MGO) to evaluate the effect of glycation reactions on the red fluorescence. In every step of these models, we detected the changes of dentin photonic response with Soprolife® in daylight mode and in treatment mode. A Raman spectroscopy analysis was performed to determine the variations of the dentin organic during the in vitro caries processes. Raman microscopy was performed to identify change in the collagen matrix of dentine. The red fluorescence observed in carious dentine using a Soprolife® camera corresponds to the brownish color observed using daylight. Demineralization using nitric acid induces a loss of the green fluorescence of dentine. The red fluorescence of carious dentine is resistant to acid treatment. Immersion of demineralized dentine in MGO induces a change of color from white to orange-red. This indicates that the Maillard reaction contributes to lesion coloration. Immersion of demineralized dentine in an MMP-1 solution followed by MGO treatment results in a similar red fluorescence. Raman microspectroscopy analysis reveals accumulation of AGE's product in red-colored dentine. Our results provide important information on the origin of the fluorescence variation of dentine observed with the Soprolife® camera. We demonstrate that the red fluorescence of carious dentine is linked to the accumulation of Advanced Glycation End products (AGE). The study provides a new biological basis for the red fluorescence of carious dentine and reinforces the importance of the Soprolife® camera in caries diagnostics.

  3. Deep versus periventricular white matter lesions and cognitive function in a community sample of middle-aged participants.

    PubMed

    Soriano-Raya, Juan José; Miralbell, Júlia; López-Cancio, Elena; Bargalló, Núria; Arenillas, Juan Francisco; Barrios, Maite; Cáceres, Cynthia; Toran, Pere; Alzamora, Maite; Dávalos, Antoni; Mataró, Maria

    2012-09-01

    The association of cerebral white matter lesions (WMLs) with cognitive status is not well understood in middle-aged individuals. Our aim was to determine the specific contribution of periventricular hyperintensities (PVHs) and deep white matter hyperintensities (DWMHs) to cognitive function in a community sample of asymptomatic participants aged 50 to 65 years. One hundred stroke- and dementia-free adults completed a comprehensive neuropsychological battery and brain MRI protocol. Participants were classified according to PVH and DWMH scores (Fazekas scale). We dichotomized our sample into low grade WMLs (participants without or with mild lesions) and high grade WMLs (participants with moderate or severe lesions). Analyses were performed separately in PVH and DWMH groups. High grade DWMHs were associated with significantly lower scores in executive functioning (-0.45 standard deviations [SD]), attention (-0.42 SD), verbal fluency (-0.68 SD), visual memory (-0.52 SD), visuospatial skills (-0.79 SD), and psychomotor speed (-0.46 SD). Further analyses revealed that high grade DWMHs were also associated with a three- to fourfold increased risk of impaired scores (i.e.,<1.5 SD) in executive functioning, verbal fluency, visuospatial skills, and psychomotor speed. Our findings suggest that only DWMHs, not PVHs, are related to diminished cognitive function in middle-aged individuals. (JINS, 2012, 18, 1-12).

  4. Production of Artificial Lesions for Teaching Cavity Preparation in the Phantom Head.

    ERIC Educational Resources Information Center

    Treasure, Patrick

    1990-01-01

    To teach the modern concepts of cavity preparation, it is desirable to have a supply of natural teeth exhibiting suitable carious lesions. This paper describes a simple method for producing consistent artificial lesions in extracted natural teeth. (MLW)

  5. Production of Artificial Lesions for Teaching Cavity Preparation in the Phantom Head.

    ERIC Educational Resources Information Center

    Treasure, Patrick

    1990-01-01

    To teach the modern concepts of cavity preparation, it is desirable to have a supply of natural teeth exhibiting suitable carious lesions. This paper describes a simple method for producing consistent artificial lesions in extracted natural teeth. (MLW)

  6. Dentine microhardness after different methods for detection and removal of carious dentine tissue.

    PubMed

    Mollica, Fernanda Brandão; Rocha Gomes Torres, Carlos; Gonçalves, Sergio Eduardo de Paiva; Mancini, Maria Nadir Gasparoto

    2012-01-01

    There are several methods for identifying carious dentinal tissue aiming to avoid removal of healthy dentinal tissue. The purpose of this study was to test different methods for the detection of carious dentinal tissue regarding the amount of carious tissue removed and the remaining dentin microhardness after caries removal. The dentin surfaces of 20 bovine teeth were exposed and half of the surface was protected with nail polish. Cariogenic challenge was performed by immersion in a demineralizing solution for 14 days. After transverse cross-section of the crown, the specimens were divided into four groups (n=10), according to the method used to identify and remove the carious tissue: "Papacárie", Caries-detector dye, DIAGNOdent and Tactile method. After caries removal, the cross-sectional surface was included in acrylic resin and polished. In a microhardness tester, the removed dentin thickness and the Vickers microhardness of the following regions were evaluated: remaining dentin after caries removal and superficial and deep healthy dentin. ANOVA and Tukey's test (α=0.05) were performed, except for DIAGNOdent, which did not detect the presence of caries. Results for removed dentin thickness were: "Papacárie" (424.7 ± 105.0; a), Caries-detector dye (370.5 ± 78.3; ab), Tactile method (322.8 ± 51.5; bc). Results for the remaining dentin microhardness were: "Papacárie" (42.2 ± 10.5; bc), Caries-detector dye (44.6 ± 11.8; abc), Tactile method (24.3 ± 9.0; d). DIAGNOdent did not detect the presence of carious tissue; Tactile method and "Papacárie" resulted in the least and the most dentinal thickness removal, respectively; Tactile method differed significantly from "Papacárie" and Caries-detector dye in terms of the remaining dentin microhardness, and Tactile method was the one which presented the lowest microhardness values.

  7. Lower extremity deep venous thrombosis with fatal pulmonary thromboembolism caused by benign pelvic space-occupying lesions--an overview.

    PubMed

    Rosenfeld, Hannah; Byard, Roger W

    2012-05-01

    Venous stasis predisposes to thrombosis. One hundred and sixty cases of fatal pulmonary thromboembolism were reviewed to determine how many cases had deep venous thromboses associated with venous blood flow reduction caused by external pressure from benign pelvic masses. Three cases were identified, representing 2% of cases overall (3/160): a 44-year-old woman with a large uterine leiomyoma (1048 g); a 74-year-old man with prostatomegaly and bladder distension (containing 1 L of urine); and a 70-year-old man with prostatomegaly and bladder distension (containing 3 L of urine). Although a rare cause of fatal deep venous thrombosis and pulmonary thromboembolism, space-occupying pelvic lesions can lead to extrinsic pressure on adjacent veins reducing blood flow and causing stasis and thrombosis. Individuals with large pelvic masses may, therefore, be at increased risk of pulmonary thromboembolism from deep venous thrombosis, particularly in the presence of concurrent risk factors such as immobility, thrombophilias, malignancy, and significant cardiopulmonary disease.

  8. Psoriasiform lesions induced by tumour necrosis factor antagonists: a skin-deep medical conundrum.

    PubMed

    Carter, J D; Gerard, H C; Hudson, A P

    2008-08-01

    Rarely, tumour necrosis factor (TNF)alpha antagonist therapy has been associated with de novo psoriasiform eruptions. This is unusual in that these same drugs are used to treat psoriasis. Most of these cases involve the palms and soles, yet palmoplantar pustular psoriasis represents only 1.7% of all cases of psoriasis. Keratoderma blenorrhagicum is a psoriasiform rash that occurs primarily on the palms and soles of some patients with reactive arthritis. It is grossly and histologically indistinguishable from pustular psoriasis. Chlamydia trachomatis is a common aetiological agent for reactive arthritis, and in vitro studies have shown that chlamydial replication is inversely proportional to TNFalpha levels. Three patients taking TNFalpha antagonists are presented who developed such lesions and who were found to be positive for C trachomatis DNA in the affected skin. It is proposed that these psoriasiform lesions may not be psoriasis, but rather keratoderma blenorrhagicum.

  9. Production of cerium-apatite in sound and carious dental enamel under in vitro conditions.

    PubMed

    Kiss, J; Bánóczy, J; Fehérváry, E; Gintner, Z; Albrecht, M

    1990-01-01

    Incipient dental caries--according to up-to-date concepts in dental research--means a demineralization without cavity formation. At this stage the carious process is reversible, and remineralization can be achieved in the presence of locally applied fluorides. In chrystalchemical experiments, however, by treating natural apatites with lanthanides, [Ce, La, Pr, Nd, Sm, Eu, Tb ... Y, Sc] a more resistant complex could be developed. In this study extracted human molar teeth were kept for 60 days in Cerium (III)-nitrate solution, in order to investigate the incorporation of Ce3+ into human sound and carious enamel by light-microscopic-, and electron microprobe methods. Ce3+ was incorporated in sound enamel as well as into the incipient carious lesion, showing the histological characteristics of a remineralizing lesion. The mean values of the microprobe analysis data showed an increase in Ce3+ changing place with the Ca2+ the developing cerium-apatite being more hard and resistant from a mineralophysical point of view.

  10. Preventing Advanced Carious Lesions with Caries Atraumatic Restorative Technique.

    PubMed

    Byrd, Tammi O

    2016-06-01

    An alternative approach to controlling dental caries and preventing the associated pain, called atraumatic restorative technique (ART), is described for populations in need, where dental hygienists restore decayed teeth with glass ionomer restorations without prior removal of all decayed tooth structure. There are populations whose decay needs are not adequately being met within the current oral health care delivery system. These include those in poverty conditions, vulnerable children, and the elderly who are often in long-term care facilities without adequate resources or opportunities for traditional dentistry. ART provides a viable option for controlling caries and relieving the pain of untreated decay. The purpose of this article is to suggest that the evidence surrounding ART be viewed objectively and that dental hygienists, with additional education in this approach, can contribute to relieving the pain of untreated dental decay. Evidence suggests that teeth can be effectively restored with ART. Dental hygienists represent an appropriate workforce to provide ART with their current background and education combined plus a brief training program; it is suggested that dental hygiene educational programs include ART within the curriculum. Along with dental sealants and fluoride varnish application, ART can be an important component of a comprehensive preventive program to address the unmet needs of vulnerable populations. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Carious lesions in the heroin addicted patient. A case report.

    PubMed

    Shen, E C; Fu, E

    1998-08-01

    Heroin abuse is destroying the health of many individuals in our society. Much of the information that has appeared in the literature has concerned itself with the general health of addicts; the oral health status of these individuals has not been studied to the same extent. This report will present and discuss the management of a case involving the effects of long-term heroin abuse on the dentition.

  12. Effect of fluoride in phosphate buffer solution on bonding to artificially carious enamel.

    PubMed

    Wang, Hao; Shimada, Yasushi; Tagami, Junji

    2007-09-01

    The purpose of the present study was to evaluate the effect of fluoride on resin bonding to artificially carious enamel. Specimens from demineralized human enamel sections were prepared using two commercially available adhesives (Clearfil SE Bond, Kuraray; Single Bond, 3M) and a composite resin (Clearfil AP-X, Kuraray) according to manufacturers' instructions. They were then immersed in phosphate buffered saline solution with varied fluoride concentrations at 0, 0.1, 0.5, 1, and 10 ppm. After immersion in each solution for one, three, or seven days, microshear bond strength was measured. The bond strengths of both adhesive systems to artificially carious enamel significantly increased after immersion in fluoride-phosphate buffer solution. Based on the findings obtained, we thus proposed not to remove the white enamel lesions for bonding in the clinic. They might be preserved and treated using fluoride applications.

  13. Chemical treatment of cavity walls following manual excavation of carious dentin.

    PubMed

    Nordbø, H; Brown, G; Tjan, A H

    1996-04-01

    To improve the conditioning of cavity walls resulting from minimal mechanical preparation of carious lesions, such as is done in modified Class II tunnel preparations. Proximal carious lesions in premolars and molars were excavated manually and the cavity walls studied using a stereomicroscope and by scanning electron microscopy (SEM) following treatment with either polyacrylic acid, sodium hypochlorite, the enzyme preparation Pronase, or sequential combinations of the agents. Polyacrylic acid (10%) was used according to the manufacturer's instructions, while concentrated sodium hypochlorite (5.25%) was applied with either intermittent scrubbing or with ultrasonic energy for 5-10 minutes, or the cavity wall was incubated with the agent at +/- 37 degrees C for periods up to 24 hours. Incubation with the proteolytic enzyme preparation Pronase was carried out at 37 degrees C for a period up to 48 hours. Manual excavation did not remove all carious dentin, neither did treatment with polyacrylic acid. Scrubbing or sonication with ample amounts of sodium hypochlorite, followed by treatment with polyacrylic acid, or prolonged incubation with sodium hypochlorite, removed most of the remaining carious dentin. However, the "cleanest" surfaces were obtained after 48 hours of incubation with Pronase. Spots of thicker, soft layers of decayed dentin that were left intentionally at some locations could be disintegrated only by the Pronase treatment. It was concluded that treatment with sodium hypochlorite and polyacrylic acid in tandem, or with Pronase may represent potential supplements to conventional cavity cleaning that deserve further investigation. In the clinic more efficient cavity cleaning may improve the bonding ability and thus reduce the risk of marginal ridge fracture in teeth with Class II tunnel restorations.

  14. Imaging natural occlusal caries lesions with optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Douglas, Shane M.; Fried, Daniel; Darling, Cynthia L.

    2010-02-01

    Several studies have demonstrated that polarization-sensitive optical coherence tomography (PS-OCT) can be used to nondestructively measure the severity of demineralization in the important occlusal surfaces. The purpose of this study was to assess the potential of PS-OCT and OCT methods for the measurement of the depth of natural occlusal carious lesions. Teeth were screened for potential occlusal lesions using near infrared imaging (NIR). A PS-OCT system operating at 1310-nm was used to acquire polarization resolved images of the area of interest on the occlusal surface. The teeth were serial sectioned to 200 μm thickness and examined with polarized light microscopy (PLM) and Transverse Microradiography (TMR) for comparison. The lesion depth measured nondestructively with PS-OCT was compared to the lesion depth measured with PLM and TMR to assess the performance of these methods and determine if polarization sensitivity is required. The lesion depth measured using OCT correlated well with the lesion depths measured with TMR and PLM. Although polarization sensitivity provided better contrast it was not necessary to have polarization sensitivity to identify deep occlusal lesions.

  15. Deep learning based classification of morphological patterns in RCM to guide noninvasive diagnosis of melanocytic lesions (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Kose, Kivanc; Bozkurt, Alican; Ariafar, Setareh; Alessi-Fox, Christi A.; Gill, Melissa; Dy, Jennifer G.; Brooks, Dana H.; Rajadhyaksha, Milind

    2017-02-01

    In this study we present a deep learning based classification algorithm for discriminating morphological patterns that appear in RCM mosaics of melanocytic lesions collected at the dermal epidermal junction (DEJ). These patterns are classified into 6 distinct types in the literature: background, meshwork, ring, clod, mixed, and aspecific. Clinicians typically identify these morphological patterns by examination of their textural appearance at 10X magnification. To mimic this process we divided mosaics into smaller regions, which we call tiles, and classify each tile in a deep learning framework. We used previously acquired DEJ mosaics of lesions deemed clinically suspicious, from 20 different patients, which were then labelled according to those 6 types by 2 expert users. We tried three different approaches for classification, all starting with a publicly available convolutional neural network (CNN) trained on natural image, consisting of a series of convolutional layers followed by a series of fully connected layers: (1) We fine-tuned this network using training data from the dataset. (2) Instead, we added an additional fully connected layer before the output layer network and then re-trained only last two layers, (3) We used only the CNN convolutional layers as a feature extractor, encoded the features using a bag of words model, and trained a support vector machine (SVM) classifier. Sensitivity and specificity were generally comparable across the three methods, and in the same ranges as our previous work using SURF features with SVM . Approach (3) was less computationally intensive to train but more sensitive to unbalanced representation of the 6 classes in the training data. However we expect CNN performance to improve as we add more training data because both the features and the classifier are learned jointly from the data. *First two authors share first authorship.

  16. Frameless Stereotactic Insertion of Viewsite Brain Access System with Microscope-Mounted Tracking Device for Resection of Deep Brain Lesions: Technical Report

    PubMed Central

    Chakraborty, Shamik; Lall, Rohan; Fanous, Andrew A; Boockvar, John; Langer, David J

    2017-01-01

    The surgical management of deep brain tumors is often challenging due to the limitations of stereotactic needle biopsies and the morbidity associated with transcortical approaches. We present a novel microscopic navigational technique utilizing the Viewsite Brain Access System (VBAS) (Vycor Medical, Boca Raton, FL, USA) for resection of a deep parietal periventricular high-grade glioma as well as another glioma and a cavernoma with no related morbidity. The approach utilized a navigational tracker mounted on a microscope, which was set to the desired trajectory and depth. It allowed gentle continuous insertion of the VBAS directly to a deep lesion under continuous microscopic visualization, increasing safety by obviating the need to look up from the microscope and thus avoiding loss of trajectory. This technique has broad value for the resection of a variety of deep brain lesions. PMID:28331774

  17. Frameless Stereotactic Insertion of Viewsite Brain Access System with Microscope-Mounted Tracking Device for Resection of Deep Brain Lesions: Technical Report.

    PubMed

    White, Tim; Chakraborty, Shamik; Lall, Rohan; Fanous, Andrew A; Boockvar, John; Langer, David J

    2017-02-04

    The surgical management of deep brain tumors is often challenging due to the limitations of stereotactic needle biopsies and the morbidity associated with transcortical approaches. We present a novel microscopic navigational technique utilizing the Viewsite Brain Access System (VBAS) (Vycor Medical, Boca Raton, FL, USA) for resection of a deep parietal periventricular high-grade glioma as well as another glioma and a cavernoma with no related morbidity. The approach utilized a navigational tracker mounted on a microscope, which was set to the desired trajectory and depth. It allowed gentle continuous insertion of the VBAS directly to a deep lesion under continuous microscopic visualization, increasing safety by obviating the need to look up from the microscope and thus avoiding loss of trajectory. This technique has broad value for the resection of a variety of deep brain lesions.

  18. Stereotactic exploration of deep-seated or surgically unamenable intracranial space-occupying lesions.

    PubMed

    Colombo, F; Benedetti, A; Alexandre, A

    1980-01-01

    Stereotactic biopsy of surgically unamenable intracranial lesions has been performed in our Neurosurgical Division since 1977. Riechert's apparatus is employed. An originally developed biopsy instrument and its advantages are described. Stereotactic coordinates of the biopsy site are found by CT scanner data using the technique described earlier by us. The series consists of 20 patients in whom a variable number of biopsy samples (from 1 to 5) was taken. Mortality and morbidity were nil. In 2 cases the stereotactic exploration led to a therapeutic maneuver: a cystic craniopharingioma and a cerebellar hematoma were extirpated. The clinical, neurological and histological features of 5 paradigmatic cases are illustrated. The relevance of histological diagnosis for adequate treatment is stressed. The indications for this surgical procedure are discussed.

  19. Large scale deep learning for computer aided detection of mammographic lesions.

    PubMed

    Kooi, Thijs; Litjens, Geert; van Ginneken, Bram; Gubern-Mérida, Albert; Sánchez, Clara I; Mann, Ritse; den Heeten, Ard; Karssemeijer, Nico

    2017-01-01

    Recent advances in machine learning yielded new techniques to train deep neural networks, which resulted in highly successful applications in many pattern recognition tasks such as object detection and speech recognition. In this paper we provide a head-to-head comparison between a state-of-the art in mammography CAD system, relying on a manually designed feature set and a Convolutional Neural Network (CNN), aiming for a system that can ultimately read mammograms independently. Both systems are trained on a large data set of around 45,000 images and results show the CNN outperforms the traditional CAD system at low sensitivity and performs comparable at high sensitivity. We subsequently investigate to what extent features such as location and patient information and commonly used manual features can still complement the network and see improvements at high specificity over the CNN especially with location and context features, which contain information not available to the CNN. Additionally, a reader study was performed, where the network was compared to certified screening radiologists on a patch level and we found no significant difference between the network and the readers.

  20. Guided fluorescence diagnosis of childhood caries: preliminary measures correlate with depth of carious decay

    NASA Astrophysics Data System (ADS)

    Timoshchuk, Mari-Alina; Zhang, Liang; Dickinson, Brian A.; Ridge, Jeremy S.; Kim, Amy S.; Baltuck, Camille T.; Nelson, Leonard Y.; Berg, Joel H.; Seibel, Eric J.

    2014-02-01

    The current rise in childhood caries worldwide has increased the demand for portable technologies that can quickly and accurately detect and diagnose early stage carious lesions. These lesions, if identified at an early stage, can be reversed with remineralization treatments, education, and improvements in home care. A multi-modal optical prototype for detecting and diagnosing occlusal caries demineralization in vivo has been developed and pilot tested. The device uses a 405-nm laser as a scanned illumination source to obtain high resolution and high surface contrast reflectance images, which allows the user to quickly image and screen for any signs of demineralized enamel. When a suspicious region is located, the device can be switched to perform dual laser fluorescence spectroscopy using 405-nm and 532-nm laser excitations. These spectra are used to compute an auto-fluorescence (AF) ratio of the suspicious region and the percent difference of AF ratios from a healthy region of the same tooth. The device was tested on 7 children's teeth in vivo with clinically diagnosed carious lesions. Lesion depth was then visually estimated from the video image using the 405-nm scanned light source, and within a month the maximum drill depth was assessed by a clinician. The researcher and clinicians were masked from previous measurements in a blinded study protocol. Preliminary results show that the ratiometric percent difference measurement of the AF spectrum of the tooth correlates with the severity of the demineralization as assessed by the clinician after drilling.

  1. Pulpotomy of Symptomatic Permanent Teeth with Carious Exposure Using Mineral Trioxide Aggregate

    PubMed Central

    Barngkgei, Imad Hassan; Halboub, Esam Saleh; Alboni, Roula Safouh

    2013-01-01

    Introduction To evaluate the clinical and radiographic outcomes of pulpotomy treatment with mineral trioxide aggregate (MTA) in symptomatic mature permanent teeth with carious exposure. Materials and Methods Ten patients aged 27-54 years presented with 11 symptomatic permanent teeth (n=11). Each offending carious tooth was clinically and radiographically determined. We removed caries as conservatively as possible; however pulp exposure was inevitable. ProRoot MTA pulpotomy was performed on these teeth. The patients were followed-up clinically and radiographically for 24-42 months. Results Immediate relief of patients` symptoms occurred. Moreover, teeth responses to the electric pulp tester were within normal range on follow-up appointment and the radiographs did not reveal any abnormality/lesion in the periapical areas. Conclusion Pulpotomy using MTA could be a good alternative for root canal therapy (RCT) for managing symptomatic mature permanent teeth with carious exposure, however further large-scale multicenter clinical trials are highly encouraged to confirm this hypothesis. PMID:23717332

  2. Mineral element analysis of carious and sound rat dentin by electron probe microanalyzer combined with back-scattered electron image.

    PubMed

    Tjäderhane, L; Hietala, E L; Larmas, M

    1995-11-01

    We recently demonstrated the advantages of back-scattered electron images (COMPO) in the visualization of dentinal caries, and the relationship of the change in the dentin fluorescence pattern in caries lesions. However, the exact nature of these changes is not known. In this paper, the nature of the changes in the areas with reduced mineral content in COMPO images was investigated. We examined the relation of changes in mineral elements and the appearance of soft carious and sound dentin in COMPO images using a scanning electron microscope (SEM) equipped with an electron probe microanalyzer (EPMA). Rat molars with small dentinal caries lesions just under the DEJ were chosen for the study. The Ca, P, Na, Mg, Zn, F, and total contents were determined by EPMA from five different dentin sites, and the Ca/P and Mg/Ca ratios were calculated. Generally, the lowest contents were found in caries lesions and highest in mantle dentin, with the exceptions of Mg and Zn. The Ca/P ratio was lowest in mantle dentin and highest in carious dentin. The results confirm that the change in fluorescence in the dentinal caries lesion is correlated with the very initial changes in mineral content, and that EPMA used in combination with COMPO images is a useful tool for determining small changes in mineral elements in the carious and adjacent areas of dentin.

  3. Apoptosis Activation in Human Carious Dentin. An Immunohistochemical Study

    PubMed Central

    Loreto, C.; Psaila, A.; Musumeci, G.; Castorina, S.; Leonardi, R.

    2015-01-01

    The exact mechanisms and enzymes involved in caries progression are largely unclear. Apoptosis plays a key role in dentin remodelling related to damage repair; however, it is unclear whether apoptosis in decayed teeth is activated through the extrinsic or the intrinsic pathway. This ex vivo immunohistochemical study explored the localization of TRAIL, DR5, Bcl-2 and Bax, the main proteins involved in apoptosis, in teeth with advanced caries. To evaluate TRAIL, DR5, Bcl-2 and Bax immunoexpressions twelve permanent carious premolars were embedded in paraffin and processed for immunohistochemistry. The results showed that TRAIL and DR5 were overexpressed in dentin and in pulp vessels and mononuclear cells; strong Bax immunostaining was detected in dilated dentinal tubules close to the lesion, and Bcl-2 staining was weak in some dentin areas under the cavity or altogether absent. These findings suggest that both apoptosis pathways are activated in dental caries. Further studies are required to gain insights into its biomolecular mechanisms. PMID:26428882

  4. Early detection of the carious conditions by laser-induced fluorescence spectroscopy

    NASA Astrophysics Data System (ADS)

    Borisova, Ekaterina G.; Uzunov, Tzonko T.; Gisbreht, Alexander I.; Avramov, Lachezar A.

    2003-09-01

    The aim of this study was to investigate the natural intrinsic fluorescence in sound and diseased human teeth and the correspondence of such autofluorescence to the stages of the dental lesions. Direct visual examination was used for comparison. Different stages of caries lesions are detected, by using a nitrogen laser (337 nm), light-emitting diode (LED) (440 nm) and argon laser (488 nm). Besides caries, there were investigated samples of the fluorosa dentis and odontolithiasis, for better determination of the influence of other teeth pathologies over the teeth autofluorescence spectra. There was observed a significant decrease in the intensity of the autofluorescence signal in the case of caries. The carious lesions revealed characteristic emission of endogenous fluorophores with fluorescence band in the red spectral region. Healthy hard dental tissue exhibited no emission bands in the red. An algorithm for early diagnosis is created on the basis of collected significant statistical material.

  5. Critical evaluation of ex vivo restoration of carious equine maxillary cheek teeth infundibulae following high-pressure gas and micro-particle abrasion.

    PubMed

    Dixon, P M; Savill, D; Horbyl, A; Reardon, R J M; Liuti, T

    2014-06-01

    Infundibular caries of the equine maxillary cheek teeth is an important disorder that can lead to dental fracture or apical infection. Treatment by removing food debris and carious dental tissue from affected infundibulae using high-pressure abrasion with aluminium hydroxide micro-particles, followed by filling the cleaned defect with endodontic restorative materials is a recommended treatment. However, although anecdotally considered a successful treatment option, there is currently no objective evidence to support this claim. Forty maxillary cheek teeth (CT) that contained 55 infundibulae with caries (mainly grade 2) were extracted post-mortem from 21 adult horses. Five of the CT were sectioned prior to treatment to facilitate visual examination of the carious infundibulae. The remaining carious infundibulae were cleaned using high-pressure abrasion with aluminium hydroxide particles and five CT were sectioned to assess the efficacy of this cleaning process. The remaining 30 CT containing 39 carious infundibulae were then filled with a composite restorative material. The efficacy of this restoration was assessed by computed tomography imaging followed by direct visual examination after sectioning the teeth. Only 46% (18/39) of restored infundibulae, all with shallow (mean 9.6 mm deep) defects, were fully cleaned of food debris and carious material, and filled with restorative material to their full depth. Of these 18, 11 had peripheral defects around the restoration, leaving just 18% (7/39) of restorations without any gross defects. The remaining 54% (21/39) of infundibulae (mean depth of infundibular caries defect, 18.3 mm) still contained food debris and/or carious material in more apical locations, with infundibulae with the deepest caries defects being the least effectively cleaned. The findings of this study indicate that high-pressure micro-particle abrasion is only effective in cleaning food debris from shallow, carious CT infundibulae and consequently

  6. Dentine microhardness after different methods for detection and removal of carious dentine tissue

    PubMed Central

    MOLLICA, Fernanda Brandão; TORRES, Carlos Rocha Gomes; GONÇALVES, Sergio Eduardo de Paiva; MANCINI, †Maria Nadir Gasparoto

    2012-01-01

    There are several methods for identifying carious dentinal tissue aiming to avoid removal of healthy dentinal tissue. Objectives The purpose of this study was to test different methods for the detection of carious dentinal tissue regarding the amount of carious tissue removed and the remaining dentin microhardness after caries removal. Material and methods The dentin surfaces of 20 bovine teeth were exposed and half of the surface was protected with nail polish. Cariogenic challenge was performed by immersion in a demineralizing solution for 14 days. After transverse cross-section of the crown, the specimens were divided into four groups (n=10), according to the method used to identify and remove the carious tissue: "Papacárie", Caries-detector dye, DIAGNOdent and Tactile method. After caries removal, the cross-sectional surface was included in acrylic resin and polished. In a microhardness tester, the removed dentin thickness and the Vickers microhardness of the following regions were evaluated: remaining dentin after caries removal and superficial and deep healthy dentin. Results ANOVA and Tukey's test (α=0.05) were performed, except for DIAGNOdent, which did not detect the presence of caries. Results for removed dentin thickness were: "Papacárie" (424.7±105.0; a), Caries-detector dye (370.5±78.3; ab), Tactile method (322.8±51.5; bc). Results for the remaining dentin microhardness were: "Papacárie" (42.2±10.5; bc), Caries-detector dye (44.6±11.8; abc), Tactile method (24.3±9.0; d). Conclusions DIAGNOdent did not detect the presence of carious tissue; Tactile method and "Papacárie" resulted in the least and the most dentinal thickness removal, respectively; Tactile method differed significantly from "Papacárie" and Caries-detector dye in terms of the remaining dentin microhardness, and Tactile method was the one which presented the lowest microhardness values. PMID:23032207

  7. Treatment of deep caries lesions in adults: randomized clinical trials comparing stepwise vs. direct complete excavation, and direct pulp capping vs. partial pulpotomy.

    PubMed

    Bjørndal, Lars; Reit, Claes; Bruun, Gitte; Markvart, Merete; Kjaeldgaard, Marianne; Näsman, Peggy; Thordrup, Marianne; Dige, Irene; Nyvad, Bente; Fransson, Helena; Lager, Anders; Ericson, Dan; Petersson, Kerstin; Olsson, Jadranka; Santimano, Eva M; Wennström, Anette; Winkel, Per; Gluud, Christian

    2010-06-01

    Less invasive excavation methods have been suggested for deep caries lesions. We tested the effects of stepwise vs. direct complete excavation, 1 yr after the procedure had been carried out, in 314 adults (from six centres) who had received treatment of a tooth with deep caries. The teeth had caries lesions involving 75% or more of the dentin and were centrally randomized to stepwise or direct complete excavation. Stepwise excavation resulted in fewer pulp exposures compared with direct complete excavation [difference: 11.4%, 95% confidence interval (CI) (1.2; 21.3)]. At 1 yr of follow-up, there was a statistically significantly higher success rate with stepwise excavation, with success being defined as an unexposed pulp with sustained pulp vitality without apical radiolucency [difference: 11.7%, 95% CI (0.5; 22.5)]. In a subsequent nested trial, 58 patients with exposed pulps were randomized to direct capping or partial pulpotomy. We found no significant difference in pulp vitality without apical radiolucency between the two capping procedures after more than 1 yr [31.8% and 34.5%; difference: 2.7%, 95% CI (-22.7; 26.6)]. In conclusion, stepwise excavation decreases the risk of pulp exposure compared with direct complete excavation. In view of the poor prognosis of vital pulp treatment, a stepwise excavation approach for managing deep caries lesions is recommended.

  8. Effects of chloramines and sodium hypochlorite on carious dentin.

    PubMed

    Tonami, Ken-ichi; Araki, Kouji; Mataki, Shiro; Kurosaki, Norimasa

    2003-06-01

    In chemo-mechanical caries removal procedures, chloramines are typically used for chemical softening of carious dentin. However, the specific effect of chloramines to be compared to sodium hypochlorite has not been sufficiently clarified. In present study, the effect of chloramines used in the Carisolv-system on carious dentin mechanical properties and morphology were investigated, using Vickers hardness test and scanning electron microscopy (SEM). Sections of permanent teeth with dentin caries were treated with chloramines, prepared by mixing amino acids (glutamic acid, lysine, and leucine) with sodium hypochlorite or with sodium hypochlorite alone or with purified water. There was a tendency that the application of the sodium hypochlorite solution softened the sound dentin and/or inner layer of carious dentin more than the application of the chloramines solution did. In SEM observations, the application of chloramines resulted in opening dentinal tubules in the outer layer of carious dentin: Occluded dentinal tubules were seen after sodium hypochlorite application. There is a possibility that the amino acids in the Carisolv-system decrease the aggressive effect of sodium hypochlorite on sound dentin and/or inner layer of carious dentin and also would enhance the disrupting effect on degenerated collagen in carious dentin outer layer.

  9. Carious Dentine Provides a Habitat for a Complex Array of Novel Prevotella-Like Bacteria

    PubMed Central

    Nadkarni, Mangala A.; Caldon, C. Elizabeth; Chhour, Kim-Ly; Fisher, Ilana P.; Martin, F. Elizabeth; Jacques, Nicholas A.; Hunter, Neil

    2004-01-01

    Previous analysis of the microbiology of advanced caries by culture and real-time PCR emphasized the high incidence and abundance of gram-negative anaerobic species, particularly Prevotella-like bacteria. The diversity of Prevotella-like bacteria was further explored by analyzing pooled bacterial DNA from lesions of carious dentine. This was achieved by amplification of a region of the 16S ribosomal DNA with a Prevotella genus-specific forward primer and a universal bacterial reverse primer, followed by cloning and sequencing. Cultured Prevotella species commonly associated with oral tissues constituted only 12% of the Prevotella clones isolated from advanced carious lesions. The remaining 88% consisted of a diverse range of phylotypes. These included five clusters of previously recognized but uncultured oral Prevotella spp. and a major cluster containing Prevotella-like bacteria most closely related to uncharacterized rumen bacteria. Cluster-specific primers were designed, and the numbers of bacteria within clusters were quantified by real-time PCR, confirming the abundance of these organisms. The data indicated that advanced dental caries provides a unique environment for a complex array of novel and uncultured Prevotella and Prevotella-like bacteria which, in some cases, may dominate the diverse polymicrobial community associated with the disease. PMID:15528720

  10. Distribution of the amelogenin protein in developing, injured and carious human teeth

    PubMed Central

    Mitsiadis, Thimios A.; Filatova, Anna; Papaccio, Gianpaolo; Goldberg, Michel; About, Imad; Papagerakis, Petros

    2014-01-01

    Amelogenin is the major enamel matrix protein with key roles in amelogenesis. Although for many decades amelogenin was considered to be exclusively expressed by ameloblasts, more recent studies have shown that amelogenin is also expressed in other dental and no-dental cells. However, amelogenin expression in human tissues remains unclear. Here, we show that amelogenin protein is not only expressed during human embryonic development but also in pathological conditions such as carious lesions and injuries after dental cavity preparation. In developing embryonic teeth, amelogenin stage-specific expression is found in all dental epithelia cell populations but with different intensities. In the different layers of enamel matrix, waves of positive vs. negative immunostaining for amelogenin are detected suggesting that the secretion of amelogenin protein is orchestrated by a biological clock. Amelogenin is also expressed transiently in differentiating odontoblasts during predentin formation, but was absent in mature functional odontoblasts. In intact adult teeth, amelogenin was not present in dental pulp, odontoblasts, and dentin. However, in injured and carious adult human teeth amelogenin is strongly re-expressed in newly differentiated odontoblasts and is distributed in the dentinal tubuli under the lesion site. In an in vitro culture system, amelogenin is expressed preferentially in human dental pulp cells that start differentiating into odontoblast-like cells and form mineralization nodules. These data suggest that amelogenin plays important roles not only during cytodifferentiation, but also during tooth repair processes in humans. PMID:25540624

  11. Distribution of the amelogenin protein in developing, injured and carious human teeth.

    PubMed

    Mitsiadis, Thimios A; Filatova, Anna; Papaccio, Gianpaolo; Goldberg, Michel; About, Imad; Papagerakis, Petros

    2014-01-01

    Amelogenin is the major enamel matrix protein with key roles in amelogenesis. Although for many decades amelogenin was considered to be exclusively expressed by ameloblasts, more recent studies have shown that amelogenin is also expressed in other dental and no-dental cells. However, amelogenin expression in human tissues remains unclear. Here, we show that amelogenin protein is not only expressed during human embryonic development but also in pathological conditions such as carious lesions and injuries after dental cavity preparation. In developing embryonic teeth, amelogenin stage-specific expression is found in all dental epithelia cell populations but with different intensities. In the different layers of enamel matrix, waves of positive vs. negative immunostaining for amelogenin are detected suggesting that the secretion of amelogenin protein is orchestrated by a biological clock. Amelogenin is also expressed transiently in differentiating odontoblasts during predentin formation, but was absent in mature functional odontoblasts. In intact adult teeth, amelogenin was not present in dental pulp, odontoblasts, and dentin. However, in injured and carious adult human teeth amelogenin is strongly re-expressed in newly differentiated odontoblasts and is distributed in the dentinal tubuli under the lesion site. In an in vitro culture system, amelogenin is expressed preferentially in human dental pulp cells that start differentiating into odontoblast-like cells and form mineralization nodules. These data suggest that amelogenin plays important roles not only during cytodifferentiation, but also during tooth repair processes in humans.

  12. Deep Inspiration Breath Hold [(18)F]FDG PET-CT on 4-rings scanners in evaluating lung lesions: evidences from a phantom and a clinical study.

    PubMed

    Caobelli, Federico; Puta, Erinda; Kaiser, Stefano Ren; Massetti, Valentina; Andreoli, Michela; Mostarda, Angelica; Soffientini, Alberto; Pizzocaro, Claudio; Guerra, Ugo Paolo

    2014-01-01

    To investigate the clinical feasibility of a Deep Inspiration Breath Hold (DIBH) (18)F-FDG PET-CT acquisition in apnea and compare the results obtained between these acts of acquisition in apnea and in Free Breathing in the evaluation of lung lesions. A pre-clinical phantom study was performed to evaluate the shortest simulated DIBH time according to the minimum detectable lesion that can be detected by our ultrasound scanner. This study was conducted by changing acquisition time and sphere-to-background activity ratio values and by using radioactivity densities similar to those generally found in clinical examinations. In the clinical study, 25 patients with pulmonary lesions underwent a standard whole body (18)F-FDG PET-CT scan in free breathing followed by a 20s single thorax acquisition PET/CT in DIBH acquisition. The phantom study indicated that a 20-s acquisition time provides an accurate evaluation of smallest sphere shaped lesions. In the clinical study, PET-CT scans obtained in DIBH studies showed a significant reduction of misalignment between the PET and CT scan images and an increase of SUVmax compared to free breathing acquisitions. A correlation between the %BH-index and lesion displacement between PET and CT images in FB acquisition was demonstrated, significantly higher for lesions with a displacement>8mm. The single 20s acquisition of DIBH PET-CT is a feasible technique for lung lesion detection in the clinical setting. It only requires a minor increase in examination time without special patient training. 20s DIBH scan provided a more precise measurement of SUVmax, especially for lesions in the lower lung lobes which usually show greater displacement between PET and CT scan images in FB acquisition. Copyright © 2013 Elsevier España, S.L. and SEMNIM. All rights reserved.

  13. Relative contributions of local cell and passing fiber activation and silencing to changes in thalamic fidelity during deep brain stimulation and lesioning: a computational modeling study.

    PubMed

    So, Rosa Q; Kent, Alexander R; Grill, Warren M

    2012-06-01

    Deep brain stimulation (DBS) and lesioning are two surgical techniques used in the treatment of advanced Parkinson's disease (PD) in patients whose symptoms are not well controlled by drugs, or who experience dyskinesias as a side effect of medications. Although these treatments have been widely practiced, the mechanisms behind DBS and lesioning are still not well understood. The subthalamic nucleus (STN) and globus pallidus pars interna (GPi) are two common targets for both DBS and lesioning. Previous studies have indicated that DBS not only affects local cells within the target, but also passing axons within neighboring regions. Using a computational model of the basal ganglia-thalamic network, we studied the relative contributions of activation and silencing of local cells (LCs) and fibers of passage (FOPs) to changes in the accuracy of information transmission through the thalamus (thalamic fidelity), which is correlated with the effectiveness of DBS. Activation of both LCs and FOPs during STN and GPi-DBS were beneficial to the outcome of stimulation. During STN and GPi lesioning, effects of silencing LCs and FOPs were different between the two types of lesioning. For STN lesioning, silencing GPi FOPs mainly contributed to its effectiveness, while silencing only STN LCs did not improve thalamic fidelity. In contrast, silencing both GPi LCs and GPe FOPs during GPi lesioning contributed to improvements in thalamic fidelity. Thus, two distinct mechanisms produced comparable improvements in thalamic function: driving the output of the basal ganglia to produce tonic inhibition and silencing the output of the basal ganglia to produce tonic disinhibition. These results show the importance of considering effects of activating or silencing fibers passing close to the nucleus when deciding upon a target location for DBS or lesioning.

  14. Application of concentrated deep sea water inhibits the development of atopic dermatitis-like skin lesions in NC/Nga mice

    PubMed Central

    2012-01-01

    Background Mineral water from deep-sea bedrock, formed over thousands of years, is rich in minerals such as Ca, Mg, Na, K, Fe and others. Our present study was to investigate the preventive effects of natural deep-sea water on developing atopic dermatitis (AD). Methods We elicited AD by application of DNCB (2,4-dinitro-chlorobezene) in Nc/Nga mouse dorsal skin. Deep Sea water (DSW) was filtered and concentrated by a nanofiltration process and reverse osmosis. We applied concentrated DSW (CDSW) to lesions five times per week for six weeks, followed by evaluation. 1% pimecrolimus ointment was used as positive control. The severity of skin lesions was assessed macroscopically and histologically. Levels of inflammatory mediators and cytokines in the serum were detected by Enzyme-linked immunosorbent assay (ELISA) and the levels of CD4+ and CD8+ spleen lymphocytes were determined by flow cytometry analysis. Results DNCB-treated mice showed atopic dermatitis-like skin lesions. Treatment of mice with CDSW reduced the severity of symptoms in the skin lesions, including edema, erythema, dryness, itching, and transepidermal water loss (TEWL). Histological analyses demonstrated that epidermal thickness and infiltration of inflammatory cells were decreased after CDSW treatment. Given these interesting observations, we further evaluated the effect of CDSW on immune responses in this AD model. Treatment AD mice with CDSW inhibited up-regulation of IgE, histamine, and pro-inflammatory cytokines in the serum. Also, the CD4+/CD8+ ratio in spleen lymphocyte was down-regulated after treatment with CDSW. Finally, cytokines, especially IL-4 and IL-10 which are important for Th2 cell development, were reduced. Conclusions Our data suggests that topical application of CDSW could be useful in preventing the development of atopic dermatitis. PMID:22834904

  15. Comparison of endoscope- versus microscope-assisted resection of deep-seated intracranial lesions using a minimally invasive port retractor system.

    PubMed

    Hong, Christopher S; Prevedello, Daniel M; Elder, J Bradley

    2016-03-01

    Tubular brain retractors may improve access to deep-seated brain lesions while potentially reducing the risks of collateral neurological injury associated with standard microsurgical approaches. Here, microscope-assisted resection of lesions using tubular retractors is assessed to determine if it is superior to endoscope-assisted surgery due to the technological advancements associated with modern tubular ports and surgical microscopes. Following institutional approval of the tubular port, data obtained from the initial 20 patients to undergo transportal resection of deep-seated brain lesions were analyzed in this study. The pathological entities of the resected tissues included metastatic tumors (8 patients), glioma (7), meningioma (1), neurocytoma (1), radiation necrosis (1), primitive neuroectodermal tumor (1), and hemangioblastoma (1). Surgery incorporated endoscopic (5 patients) or microscopic (15) assistance. The locations included the basal ganglia (11 patients), cerebellum (4), frontal lobe (2), temporal lobe (2), and parietal lobe (1). Cases were reviewed for neurological outcomes, extent of resection (EOR), and complications. Technical data for the port, surgical microscope, and endoscope were analyzed. EOR was considered total in 14 (70%), near total (> 95%) in 4 (20%), and subtotal (< 90%) in 2 (10%) of 20 patients. Incomplete resection was associated with the basal ganglia location (p < 0.05) and use of the endoscope (p < 0.002). Four of 5 (80%) endoscope-assisted cases were near-total (2) or subtotal (2) resection. Histopathological diagnosis, presenting neurological symptoms, and demographics were not associated with EOR. Complication rates were low and similar between groups. Initial experience with tubular retractors favors use of the microscope rather than the endoscope due to a wider and 3D field of view. Improved microscope optics and tubular retractor design allows for binocular vision with improved lighting for the resection of deep

  16. [High-Definition Exoscope System for Microneurosurgery:Use of an Exoscope in Combination with Tubular Retraction and Frameless Neuronavigation for Microsurgical Resection of Deep Brain Lesions].

    PubMed

    Nagatani, Kimihiro; Takeuchi, Satoru; Feng, Dongxia; Mori, Kentaro; Day, J Diaz

    2015-07-01

    The high-definition exoscope (VITOM®, Karl Storz GmbH & Co., Tuttlingen, Germany) is a new equipment that can be used as an alternative to the operating microscope in neurosurgery. Several neurosurgeons have recently reported that the exoscope allows for long working distances and great depth of field. Herein, we review reported cases of exoscope use in neurosurgery. We also describe the advantages of the exoscope compared to the operating microscope and endoscope. Furthermore, we introduce a novel technique for microsurgical resection of deep brain lesions, in which the exoscope is used along with tubular retraction and frameless neuronavigation. Before the operation, neuronavigation is registered and the surgical trajectory is planned to avoid damaging the functional cortex and eloquent white matter tracts. By using intraoperative neuronavigation, the tubular retractor (NICO BrainPath®, NICO Corporation, Indianapolis, US), which is designed to split the white matter when gently inserted, is inserted transcortically into the brain to reach the lesion, along the preplanned trajectory. After insertion, the tubular retractor is fixed in place using a self-retaining arm. This creates a narrow corridor that enables the use of the exoscope (for optimum visualization), bimanual dissection technique, and long bayoneted surgical instruments. The large focal distance of the exoscope allows it to be placed sufficiently further away from the surgical site, permitting the passage of long surgical instruments under the scope. Although obtaining surgical access to deep-seated brain lesions is challenging, we consider that this technique facilitates a safe surgical approach for lesions in deep locations.

  17. Spectroscopic investigations of carious tooth decay.

    PubMed

    Thareja, R K; Sharma, A K; Shukla, Shobha

    2008-11-01

    We report on the elemental composition of healthy and infected part of human tooth using laser induced breakdown spectroscopy (LIBS). We have used prominent constituent transitions in laser-excited tooth to diagnose the state of the tooth. A nanosecond laser pulse (355nm, 5ns) was used as an ablating pulse and the sodium (3s2S-3p2P) at 588.99 and (3s2S-3p2P) at 589.99nm, strontium (5s21S-1s5P) at 460.55nm, and calcium (3d3D-4f 3F0) at 452.55nm transitions for spectroscopic analysis. The spectroscopic observations in conjunction with discriminate analysis showed that calcium attached to the hydroxyapatite structure of the tooth was affected severely at the infected part of the tooth. The position-time plots generated from two-dimensional (2D) images conclusively showed a decrease in calcium concentration in the infected region of the irradiated tooth. Using the technique, we could distinguish between the healthy and carious parts of the tooth with significant accuracy.

  18. Performance comparison of deep learning and segmentation-based radiomic methods in the task of distinguishing benign and malignant breast lesions on DCE-MRI

    NASA Astrophysics Data System (ADS)

    Antropova, Natasha; Huynh, Benjamin; Giger, Maryellen

    2017-03-01

    Intuitive segmentation-based CADx/radiomic features, calculated from the lesion segmentations of dynamic contrast-enhanced magnetic resonance images (DCE-MRIs) have been utilized in the task of distinguishing between malignant and benign lesions. Additionally, transfer learning with pre-trained deep convolutional neural networks (CNNs) allows for an alternative method of radiomics extraction, where the features are derived directly from the image data. However, the comparison of computer-extracted segmentation-based and CNN features in MRI breast lesion characterization has not yet been conducted. In our study, we used a DCE-MRI database of 640 breast cases - 191 benign and 449 malignant. Thirty-eight segmentation-based features were extracted automatically using our quantitative radiomics workstation. Also, 2D ROIs were selected around each lesion on the DCE-MRIs and directly input into a pre-trained CNN AlexNet, yielding CNN features. Each method was investigated separately and in combination in terms of performance in the task of distinguishing between benign and malignant lesions. Area under the ROC curve (AUC) served as the figure of merit. Both methods yielded promising classification performance with round-robin cross-validated AUC values of 0.88 (se =0.01) and 0.76 (se=0.02) for segmentationbased and deep learning methods, respectively. Combination of the two methods enhanced the performance in malignancy assessment resulting in an AUC value of 0.91 (se=0.01), a statistically significant improvement over the performance of the CNN method alone.

  19. Clinical effect of photodynamic therapy on primary carious dentin after partial caries removal.

    PubMed

    Neves, Pierre Adriano Moreno; Lima, Leonardo Abrantes; Rodrigues, Fernanda Cristina Nogueira; Leitão, Tarcisio Jorge; Ribeiro, Cecília Cláudia Costa

    2016-05-20

    This study was conducted to assess the clinical effect of photodynamic therapy (PDT) in the decontamination of the deep dentin of deciduous molars submitted to partial removal of carious tissue. After cavity preparation, dentin samples were taken from the pulp wall of nineteen deciduous molars before and after PDT application. Remaining dentin was treated with 0.01% methylene blue dye followed by irradiation with an InGaAlP diode laser (λ - 660 nm; 40 mW; 120 J/cm2; 120 s). Dentin samples were microbiologically assessed for the enumeration of total microorganisms, Lactobacillus spp. and mutans streptococci. There was no significant difference in the number of colony-forming units (CFU) for any of the microorganisms assessed (p > 0.05). Photodynamic therapy, using 0.01% methylene blue dye at a dosimetry of 120 J/cm2 would not be a viable clinical alternative to reduce bacterial contamination in deep dentin.

  20. CXCR-4 Targeted, Short Wave Infrared (SWIR) Emitting Nanoprobes for Enhanced Deep Tissue Imaging and Micrometastatic Cancer Lesion Detection.

    PubMed

    Zevon, Margot; Ganapathy, Vidya; Kantamneni, Harini; Mingozzi, Marco; Kim, Paul; Adler, Derek; Sheng, Yang; Tan, Mei Chee; Pierce, Mark; Riman, Richard E; Roth, Charles M; Moghe, Prabhas V

    2015-12-16

    Realizing the promise of precision medicine in cancer therapy depends on identifying and tracking cancerous growths to maximize treatment options and improve patient outcomes. This goal of early detection remains unfulfilled by current clinical imaging techniques that fail to detect lesions due to their small size and suborgan localization. With proper probes, optical imaging techniques can overcome this by identifying the molecular phenotype of tumors at both macroscopic and microscopic scales. In this study, the first use of nanophotonic short wave infrared technology is proposed to molecularly phenotype small lesions for more sensitive detection. Here, human serum albumin encapsulated rare-earth nanoparticles (ReANCs) with ligands for targeted lesion imaging are designed. AMD3100, an antagonist to CXCR4 (a classic marker of cancer metastasis) is adsorbed onto ReANCs to form functionalized ReANCs (fReANCs). fReANCs are able to preferentially accumulate in receptor positive lesions when injected intraperitoneally in a subcutaneous tumor model. fReANCs can also target subtissue microlesions at a maximum depth of 10.5 mm in a lung metastatic model of breast cancer. Internal lesions identified with fReANCs are 2.25 times smaller than those detected with ReANCs. Thus, an integrated nanoprobe detection platform is presented, which allows target-specific identification of subtissue cancerous lesions. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. A case of secondary somatosensory epilepsy with a left deep parietal opercular lesion: successful tumor resection using a transsubcentral gyral approach during awake surgery.

    PubMed

    Maesawa, Satoshi; Fujii, Masazumi; Futamura, Miyako; Hayashi, Yuichiro; Iijima, Kentaro; Wakabayashi, Toshihiko

    2016-03-01

    Few studies have examined the clinical characteristics of patients with lesions in the deep parietal operculum facing the sylvian fissure, the region recognized as the secondary somatosensory area (SII). Moreover, surgical approaches in this region are challenging. In this paper the authors report on a patient presenting with SII epilepsy with a tumor in the left deep parietal operculum. The patient was a 24-year-old man who suffered daily partial seizures with extremely uncomfortable dysesthesia and/or occasional pain on his right side. MRI revealed a tumor in the medial aspect of the anterior transverse parietal gyrus, surrounding the posterior insular point. Long-term video electroencephalography monitoring with scalp electrodes failed to show relevant changes to seizures. Resection with cortical and subcortical mapping under awake conditions was performed. A negative response to stimulation was observed at the subcentral gyrus during language and somatosensory tasks; thus, the transcortical approach (specifically, a transsubcentral gyral approach) was used through this region. Subcortical stimulation at the medial aspect of the anterior parietal gyrus and the posterior insula around the posterior insular point elicited strong dysesthesia and pain in his right side, similar to manifestation of his seizure. The tumor was completely removed and pathologically diagnosed as pleomorphic xanthoastrocytoma. His epilepsy disappeared without neurological deterioration postoperatively. In this case study, 3 points are clinically significant. First, the clinical manifestation of this case was quite rare, although still representative of SII epilepsy. Second, the location of the lesion made surgical removal challenging, and the transsubcentral gyral approach was useful when intraoperative mapping was performed during awake surgery. Third, intraoperative mapping demonstrated that the patient experienced pain with electrical stimulation around the posterior insular point

  2. Clinical and microbiological evaluation of the carious dentin before and after application of Papacarie gel.

    PubMed

    Gupta, Swarnika; Singh, Chanchal; Yeluri, Ramakrishna; Chaudhry, Kalpna; Munshi, Autar Krishen

    2013-01-01

    To evaluate clinically and microbiologically the efficacy of Papacarie in the removal of carious dentin in both permanent and primary teeth. Thirty permanent and primary molars with dentinal carious lesions were excavated and subjected to clinical and microbiological assessment before and after application of Papacarie. The gel was further tested for in vitro antimicrobial efficacy against standard cariogenic micro-organisms using agar diffusion assay. Papacarie was able to differentiate between infected and affected dentin clinically along with high patient comfort during caries excavation. The mean time taken for caries removal and restoration was observed to be 4.17 +/- 0.40 min. and 8.57 +/- 0.45 min. for permanent teeth and 4.21 +/- 0.36 min. and 9.24 +/- 0.58 min. for primary teeth. There was a significant reduction in the total viable colony forming units from the dentin samples before and after application of Papacarie. It was also observed that Papacarie had no inhibitory effect on standard cariogenic microorganisms in the agar diffusion assay. Papacarie is an effective caries removal method clinically in both permanent and primary teeth. The number of viable microorganisms after complete caries excavation using Papacarie still appears to be high and this bacterial count should be tackled by a suitable restorative material with potent antimicrobial activity.

  3. CXCR-4 Targeted, Short Wave Infrared (SWIR) Emitting Nanoprobes for Enhanced Deep Tissue Imaging and Micrometastatic Lesion Detection

    PubMed Central

    Zevon, Margot; Ganapathy, Vidya; Kantamneni, Harini; Mingozzi, Marco; Kim, Paul; Adler, Derek; Sheng, Yang; Tan, Mei Chee; Pierce, Mark; Riman, Richard E.; Roth, Charles M.; Moghe, Prabhas V.

    2016-01-01

    Realizing the promise of precision medicine in cancer therapy depends on identifying and tracking of cancerous growths in order to maximize treatment options and improve patient outcomes. However, this goal of early detection remains unfulfilled by current clinical imaging techniques that fail to detect diseased lesions, due to their small size and sub-organ localization. With proper probes, optical imaging techniques can overcome this limitation by identifying the molecular phenotype of tumors at both macroscopic and microscopic scales. In this study, we propose the first use of nanophotonic short wave infrared technology to molecularly phenotype small sub-surface lesions for more sensitive detection and improved patient outcomes. To this end, we designed human serum albumin encapsulated rare-earth (RE) nanoparticles (ReANCs)[1, 2] with ligands for targeted lesion imaging. AMD3100, an antagonist to CXCR4 (a chemokine receptor involved in cell motility and a classic marker of cancer metastasis) was adsorbed onto ReANCs to form functionalized ReANCs (fReANCs). Functionalized nanoparticles were able to discriminate and preferentially accumulate in receptor positive lesions when injected intraperitoneally in a subcutaneous tumor model. Additionally, fReANCs, administered intravenously, were able to target sub-tissue tumor micro-lesions, at a maximum depth of 10.5 mm, in a lung metastatic model of breast cancer. Internal lesions identified with fReANCs were 2.25 times smaller than those detected with unfunctionalized ReANCs (p < .01) with the smallest tumor being 18.9 mm3. Thus, we present an integrated nanoprobe detection platform that allows target-specific identification of sub-tissue cancerous lesions. PMID:26514367

  4. Dentin Matrix Protein 1 and Dentin Sialophosphoprotein in Human Sound and Carious Teeth: An Immunohistochemical and Colorimetric Assay

    PubMed Central

    Martini, D.; Trirè, A.; Breschi, L.; Mazzoni, A.; Orsini, G.; Teti, G.; Falconi, M.; Ruggeri, A.

    2013-01-01

    Dentin matrix protein 1 (DMP1) and dentin sialophosphoprotein (DSPP) are extracellular matrix proteins produced by odontoblasts involved in the dentin mineralization. The aim this study was to compare the distribution of DMP1 and DSPP in human sound dentin vs human sclerotic dentin. Sixteen sound and sixteen carious human molars were selected, fixed in paraformaldehyde and processed for immunohistochemical detection of DMP1 and DSPP by means of light microscopy, transmission electron microscopy (TEM) and high-resolution field emission in-lens scanning electron microscopy (FEI-SEM). Specimens were submitted to a pre-embedding or a post-embedding immunolabeling technique using primary antibodies anti DMP1 and anti-DSPP and gold-conjugated secondary antibodies. Other samples were processed for the detection of DMP1 and DSPP levels. Dentin from these samples was mechanically fractured to powder, then a protein extraction and a protein level detection assay were performed. DMP1 and DSPP were more abundant in carious than in sound samples. Immunohistochemical analyses in sclerotic dentin disclosed a high expression of DMP1 and DSPP inside the tubules, suggesting an active biomineralization of dentin by odontoblasts. Furthermore, the detection of small amounts of these proteins inside the tubules far from the carious lesion, as shown in the present study, is consistent with the hypothesis of a preventive defense of all dentin after a noxious stimulus has undermined the tooth. PMID:24441185

  5. Image processing with the radial Hilbert transform of photo-thermal imaging for carious detection

    NASA Astrophysics Data System (ADS)

    El-Sharkawy, Yasser H.

    2014-03-01

    Knowledge of heat transfer in biological bodies has many diagnostic and therapeutic applications involving either raising or lowering of temperature, and often requires precise monitoring of the spatial distribution of thermal histories that are produced during a treatment protocol. The present paper therefore aims to design and implementation of laser therapeutic and imaging system used for carious tracking and drilling by develop a mathematical algorithm using Hilbert transform for edge detection of photo-thermal imaging. photothermal imaging has the ability to penetrate and yield information about an opaque medium well beyond the range of conventional optical imaging. Owing to this ability, Q- switching Nd:YAG laser at wavelength 1064 nm has been extensively used in human teeth to study the sub-surface deposition of laser radiation. The high absorption coefficient of the carious rather than normal region rise its temperature generating IR thermal radiation captured by high resolution thermal camera. Changing the pulse repetition frequency of the laser pulses affects the penetration depth of the laser, which can provide three-dimensional (3D) images in arbitrary planes and allow imaging deep within a solid tissue.

  6. Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans

    NASA Astrophysics Data System (ADS)

    Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

    2016-04-01

    This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features.

  7. Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans

    PubMed Central

    Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

    2016-01-01

    This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features. PMID:27079888

  8. Computer-Aided Diagnosis with Deep Learning Architecture: Applications to Breast Lesions in US Images and Pulmonary Nodules in CT Scans.

    PubMed

    Cheng, Jie-Zhi; Ni, Dong; Chou, Yi-Hong; Qin, Jing; Tiu, Chui-Mei; Chang, Yeun-Chung; Huang, Chiun-Sheng; Shen, Dinggang; Chen, Chung-Ming

    2016-04-15

    This paper performs a comprehensive study on the deep-learning-based computer-aided diagnosis (CADx) for the differential diagnosis of benign and malignant nodules/lesions by avoiding the potential errors caused by inaccurate image processing results (e.g., boundary segmentation), as well as the classification bias resulting from a less robust feature set, as involved in most conventional CADx algorithms. Specifically, the stacked denoising auto-encoder (SDAE) is exploited on the two CADx applications for the differentiation of breast ultrasound lesions and lung CT nodules. The SDAE architecture is well equipped with the automatic feature exploration mechanism and noise tolerance advantage, and hence may be suitable to deal with the intrinsically noisy property of medical image data from various imaging modalities. To show the outperformance of SDAE-based CADx over the conventional scheme, two latest conventional CADx algorithms are implemented for comparison. 10 times of 10-fold cross-validations are conducted to illustrate the efficacy of the SDAE-based CADx algorithm. The experimental results show the significant performance boost by the SDAE-based CADx algorithm over the two conventional methods, suggesting that deep learning techniques can potentially change the design paradigm of the CADx systems without the need of explicit design and selection of problem-oriented features.

  9. Impact of cysts during radiofrequency lesioning in deep brain structures—a simulation and in vitro study

    NASA Astrophysics Data System (ADS)

    Johansson, Johannes D.; Loyd, Dan; Wårdell, Karin; Wren, Joakim

    2007-06-01

    Radiofrequency lesioning of nuclei in the thalamus or the basal ganglia can be used to reduce symptoms caused by e.g. movement disorders such as Parkinson's disease. Enlarged cavities containing cerebrospinal fluid (CSF) are commonly present in the basal ganglia and tend to increase in size and number with age. Since the cavities have different electrical and thermal properties compared with brain tissue, it is likely that they can affect the lesioning process and thereby the treatment outcome. Computer simulations using the finite element method and in vitro experiments have been used to investigate the impact of cysts on lesions' size and shape. Simulations of the electric current and temperature distributions as well as convective movements have been conducted for various sizes, shapes and locations of the cysts as well as different target temperatures. Circulation of the CSF caused by the heating was found to spread heat effectively and the higher electric conductivity of the CSF increased heating of the cyst. These two effects were together able to greatly alter the resulting lesion size and shape when the cyst was in contact with the electrode tip. Similar results were obtained for the experiments.

  10. Detection of intaoral lesions using a fluorescence camera

    NASA Astrophysics Data System (ADS)

    Thoms, Michael

    2006-02-01

    Optical methods for the detection of carious lesions, calculus and plaque have the advantage of being minimally invasive. The use of endogeneous fluorescence markers like porphyrins could simplify the application of fluorescence techniques in the dental practice. It is known that porphyrins are produced by some of the bacterial species that are present in the oral cavity. Since porphyrins have an excitation band at about 400nm they have the potential to be used as fluorescent markers of locations in the oral cavity where the production of bacteria is out of the limits of healthy regions. Further, modern and efficient GaN-based semiconductor diodes emit light in this spectral range and thus make the implementation of fluorescence sensors with excitation at this wavelength easy. Carious lesions, calculus and plaque have been measured using a self build fluorescence camera using GaN-diodes for illumination at 405nm. Further, emission spectra under this excitation were recorded. For the latter purpose freshly extracted teeth were used. It has been found that already in the case of an initial carious lesion red porphyrin-fluorescence is emitted whereas it is absent in healthy enamel. In already brown coloured carious lesions the emission bands of porphyrin are present but the observed overall fluorescence intensity is lower, probably due to the absorption of the fluorescence by the carious defect itself. In dental calculus, dental plaque and subgingival concrements porphyrin originated luminescence was found as well. Since in these cases the emission spectra differ slightly it can be concluded that they originate from different types of porphyrins and thus also from different bacteria. These results show that this fluorescence technique can be a promising method to diagnose carious lesions, calculus and plaque.

  11. Ablation of human carious dentin with a nanosecond pulsed laser at a wavelength of 5.85 μm: relationship between hardness and ablation depth

    NASA Astrophysics Data System (ADS)

    Ishii, Katsunori; Kita, Tetsuya; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2014-02-01

    Less invasive treatment and preservation of teeth, referred to as minimal intervention, are strong requirements in dentistry. In our previous study, the fundamental ablation properties of human dentin at wavelengths around 5.8 μm were investigated, and the results indicated that the wavelength of 5.85 μm was optimal for selective removal of carious dentin with less damage to normal dentin. The purpose of this study was to investigate the relationship between the ablation depth and hardness of human dentin including carious lesion. A nanosecond pulsed laser produced by difference-frequency generation was used for irradiations to human carious dentin. It was observed that correlation between ablation depth and Vickers hardness after 2 s laser irradiation at the wavelength of 5.85 μm and the average power density of 30 W/cm2. On the other hand, ablations did not depend on Vickers hardness at the wavelength of 6.00 μm. A nanosecond pulsed laser with the wavelength at 5.85 μm is useful for selective ablation of human carious dentin in accordance with the hardness.

  12. Carious growth monitoring with optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Freitas, A. Z.; Zezell, D. M.; Mayer, M. P. A.; Ribeiro, A. C.; Gomes, A. S. L.; Vieira, N. D., Jr.

    2006-02-01

    Optical Coherence Tomography was used to monitor subsurface caries evolution process in vitro. Human tooth was used and bacteria were employed to induce caries lesions. Twenty-five human third molars, were used in this study. The teeth were cut longitudinally at mesio-distal direction; the surfaces were coated with nail varnish except for two squared windows (2x4 mm); at the cement-enamel junction. Artificial lesions were induced by a S. Mutans microbiological culture. The samples (N = 50) were divided into groups according to the demineralization time: 3, 5, 7, 9 and 11 days. The culture medium, was changed each 48 hours. After the demineralization process the samples were rinsed with double-deionized water and stored in a humid environment. The OCT system was implemented with average power of 96 μW in the sample arm, providing a 23 μm of axial resolution. The images were produced with lateral scans step of 10 μm. The detection system was composed by a detector, a demodulator and a computer. With the images generated by OCT it was possible to determine the lesion depth as function of sample exposition time to microbiological culture. We observed that the depth of the lesion in the root dentine increased from 70 μm to 230 μm, depending of exposure time, and follows the bacterial population growth law. This OCT system accurately depicts hard dental tissue and it was able to detect early caries in its structure, providing a powerful contactless high resolution image of lesions.

  13. Subcortical deep gray matter pathology in patients with multiple sclerosis is associated with white matter lesion burden and atrophy but not with cortical atrophy: a diffusion tensor MRI study.

    PubMed

    Cappellani, R; Bergsland, N; Weinstock-Guttman, B; Kennedy, C; Carl, E; Ramasamy, D P; Hagemeier, J; Dwyer, M G; Patti, F; Zivadinov, R

    2014-05-01

    The association between subcortical deep gray matter, white matter, and cortical pathology is not well understood in MS. The aim of this study was to use DTI to investigate the subcortical deep gray matter alterations and their relationship with lesion burden, white matter, and cortical atrophy in patients with MS and healthy control patients. A total of 210 patients with relapsing-remitting MS, 75 patients with progressive MS, and 110 healthy control patients were included in the study. DTI metrics in whole brain, normal-appearing white matter, normal-appearing gray matter, and subcortical deep gray matter structures were compared. The association between DTI metrics of the subcortical deep gray matter structures with lesion burden, normalized white matter volume, and normalized cortical volume was investigated. DTI measures were significantly different in whole brain, normal-appearing white matter, and normal-appearing gray matter among the groups (P < .01). Significant differences in DTI diffusivity of total subcortical deep gray matter, caudate, thalamus, and hippocampus (P < .001) were found. DTI diffusivity of total subcortical deep gray matter was significantly associated with normalized white matter volume (P < .001) and normalized cortical volume (P = .033) in healthy control patients. In both relapsing and progressive MS groups, the DTI subcortical deep gray matter measures were associated with the lesion burden and with normalized white matter volume (P < .001), but not with normalized cortical volume. These findings suggest that subcortical deep gray matter abnormalities are associated with white matter lesion burden and atrophy, whereas cortical atrophy is not associated with microstructural alterations of subcortical deep gray matter structures in patients with MS. © 2014 by American Journal of Neuroradiology.

  14. Quantitative Microbiological Study of Human Carious Dentine by Culture and Real-Time PCR: Association of Anaerobes with Histopathological Changes in Chronic Pulpitis

    PubMed Central

    Martin, F. Elizabeth; Nadkarni, Mangala A.; Jacques, Nicholas A.; Hunter, Neil

    2002-01-01

    The bacteria found in carious dentine were correlated with the tissue response of the dental pulps of 65 teeth extracted from patients with advanced caries and pulpitis. Standardized homogenates of carious dentine were plated onto selective and nonselective media under anaerobic and microaerophilic conditions. In addition, real-time PCR was used to quantify the recovery of anaerobic bacteria. Primers and fluorogenic probes were designed to detect the total anaerobic microbial load, the genera Prevotella and Fusobacterium, and the species Prevotella melaninogenica, Porphyromonas endodontalis, Porphyromonas gingivalis, and Micromonas (formerly Peptostreptococcus) micros. The pulpal pathology was categorized according to the cellular response and degenerative changes. Analysis of cultured bacteria showed a predominance of gram-positive microorganisms, particularly lactobacilli. Gram-negative bacteria were also present in significant numbers with Prevotella spp., the most numerous anaerobic group cultured. Real-time PCR analysis indicated a greater microbial load than that determined by colony counting. The total number of anaerobes detected was 41-fold greater by real-time PCR than by colony counting, while the numbers of Prevotella and Fusobacterium spp. detected were 82- and 2.4-fold greater by real-time PCR than by colony counting, respectively. Real-time PCR also identified M. micros, P. endodontalis, and P. gingivalis in 71, 60, and 52% of carious samples, respectively. Correlation matrices of the real-time PCR data revealed significant positive associations between M. micros and P. endodontalis detection and inflammatory degeneration of pulpal tissues. These anaerobes have been strongly implicated in endodontic infections that occur as sequelae to carious pulpitis. Accordingly, the data suggest that the presence of high levels of these bacteria in carious lesions may be indicative of irreversible pulpal pathology. PMID:11980945

  15. An experimental study of the effect of strontium pre-treatment on calcium release from carious and non-carious teeth.

    PubMed

    Riyat, Manminder; Sharma, Dinesh Chandra

    2010-03-01

    The administration of strontium salt is known to be beneficial for bones in preventing calcium loss and osteoporosis. Therefore, we decided to study if strontium treatment affects calcium release from teeth in vitro. Extracted carious as well as non-carious teeth were washed, cleaned, and dried. These were individually immersed in 25 ml of 1% lactic acid at 37 degrees C for 24 h, and the amount of calcium released was measured. The rate of calcium release from these teeth was again determined after their exposure to M/4 strontium chloride for 1 month at 37 degrees C. It was found that: (1) the rate of calcium release from non-carious teeth was significantly higher than carious teeth, possibly because there was more calcium present, (2) the rate of calcium release was almost halved after strontium treatment in both groups of teeth, (3) the Vicker's microhardness of non-carious teeth was higher than those of carious teeth, and (4) strontium treatment did not affect hardness. Strontium treatment may be beneficial in reducing loss of calcium from intact teeth-non-carious as well as carious-and this beneficial effect of strontium is unrelated to change in teeth hardness.

  16. Imaging carious dental tissues with multiphoton fluorescence lifetime imaging microscopy

    PubMed Central

    Lin, Po-Yen; Lyu, Hong-Chou; Hsu, Chin-Ying Stephen; Chang, Chia-Seng; Kao, Fu-Jen

    2011-01-01

    In this study, multiphoton excitation was utilized to image normal and carious dental tissues noninvasively. Unique structures in dental tissues were identified using the available multimodality (second harmonic, autofluorescence, and fluorescence lifetime analysis) without labeling. The collagen in dentin exhibits a strong second harmonic response. Both dentin and enamel emit strong autofluorescence that reveals in detail morphological features (such as dentinal tubules and enamel rods) and, despite their very similar spectral profiles, can be differentiated by lifetime analysis. Specifically, the carious dental tissue exhibits a greatly reduced autofluorescence lifetime, which result is consistent with the degree of demineralization, determined by micro-computed tomography. Our findings suggest that two-photon excited fluorescence lifetime imaging may be a promising tool for diagnosing and monitoring dental caries. PMID:21326645

  17. Fluorine mapping in sound and carious fissures of human teeth using PIGE

    NASA Astrophysics Data System (ADS)

    Yamamoto, H.; Nomachi, M.; Yasuda, K.; Iwami, Y.; Ebisu, S.; Sakai, T.; Fukuda, M.

    2005-04-01

    By using the PIGE technique at JAERI Takasaki, we measured fluorine (F) distribution in a micro area of occlusal fissures in the enamel of human teeth. The fissures were classified into three groups: Group I, no caries; Group II, incipient caries; Group III, advanced caries. The extracted teeth were embedded in epoxy resin and cut along the longitudinal axis through the fissures. The F concentration in the fissure at the cut surface was measured. A 1.7 MeV proton beam accelerated by the TIARA single-ended accelerator was delivered to a micro-beam apparatus. The beam spot size was about 1 μm with a beam current of about 100 pA. A nuclear reaction, 19F (p,αγ)16O, was used to measure the F concentration and gamma-rays from this reaction were detected with a 4″ NaI(Tl) detector. X-rays induced by proton were detected with a Ge detector to measure calcium concentration and the beam intensity was monitored with the X-ray yield from a copper foil for quantitative analysis. The obtained results were shown as two-dimensional mapping. In all specimens, an F concentration was observed around the fissure. The F concentration varied depending on the location of the fissure and decreased towards the inner part of the tooth. The maximum F concentration values in the measured area ranged from 3500-11700 ppm (mean = 6000 ppm) in Group I, 2400-10700 ppm (mean = 6300 ppm) in Group II, and 5200-16900 ppm (mean = 9300 ppm) in Group III. Although high F concentrations tended to be measured in the carious fissures, high values were also recognized in the sound fissures. More studies are necessary to clarify the relationship between F and carious lesions.

  18. Two-year clinical trial of a universal adhesive in total-etch and self-etch mode in non-carious cervical lesions☆

    PubMed Central

    Lawson, Nathaniel C.; Robles, Augusto; Fu, Chin-Chuan; Lin, Chee Paul; Sawlani, Kanchan; Burgess, John O.

    2016-01-01

    Objectives To compare the clinical performance of Scotchbond™ Universal Adhesive used in self- and total-etch modes and two-bottle Scotchbond™ Multi-purpose Adhesive in total-etch mode for Class 5 non-carious cervical lesions (NCCLs). Methods 37 adults were recruited with 3 or 6 NCCLs (>1.5 mm deep). Teeth were isolated, and a short cervical bevel was prepared. Teeth were restored randomly with Scotchbond Universal total-etch, Scotchbond Universal self-etch or Scotchbond Multi-purpose followed with a composite resin. Restorations were evaluated at baseline, 6, 12 and 24 months for marginal adaptation, marginal discoloration, secondary caries, and sensitivity to cold using modified USPHS Criteria. Patients and evaluators were blinded. Logistic and linear regression models using a generalized estimating equation were applied to evaluate the effects of time and adhesive material on clinical assessment outcomes over the 24 month follow-up period. Kaplan–Meier method was used to compare the retention between adhesive materials. Results Clinical performance of all adhesive materials deteriorated over time for marginal adaptation, and discoloration (p <0.0001). Both Scotchbond Universal self-etch and Scotchbond Multi-purpose materials were more than three times as likely to contribute to less satisfying performance in marginal discoloration over time than Scotchbond Universal total-etch. The retention rates up to 24 months were 87.6%, 94.9% and 100% for Scotchbond Multi-purpose and Scotchbond Universal self-etch and total-etch, respectively. Conclusions Scotchbond Universal in self- and total- etch modes performed similar to or better than Scotchbond Multipurpose, respectively. Clinical significance 24 month evaluation of a universal adhesive indicates acceptable clinical performance, particularly in a total-etch mode. PMID:26231300

  19. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides.

    PubMed

    Schmidlin, Patrick; Zobrist, Katja; Attin, Thomas; Wegehaupt, Florian

    2016-01-01

    To assess the re-hardening potential of enamel matrix derivatives (EMD) and self-assembling peptides in vitro, hypothesizing that these materials may increase the mineralization of artificial carious lesions and improve hardness profiles. Forty-eight enamel samples were prepared from extracted bovine lower central incisors. After embedding and polishing, nail varnish was applied, leaving a defined test area. One third of this area was covered with a flowable composite (non-demineralized control). The remaining area was demineralized in an acidic buffer solution for 18 d to simulate a carious lesion. Half the demineralized area was then covered with composite (demineralized control), while the last third was left open for three test and one control treatments: (A) Application of enamel-matrix proteins (EMD - lyophilized protein fractions dissolved in acetic acid, Straumann), (B) self-assembling peptides (SAP, Curodont), or (C) amine fluoride solution (Am-F, GABA) for 5 min each. Untreated samples (D) served as control. After treatment, samples were immersed in artificial saliva for four weeks (remineralization phase) and microhardness (Knoop) depth profiles (25-300 µm) were obtained at sections. Two-way ANOVA was calculated to determine differences between the areas (re-hardening or softening). Decalcification resulted in significant softening of the subsurface enamel in all groups (A-D). A significant re-hardening up to 125 µm was observed in the EMD and SAP groups. This study showed that EMD and SAP were able to improve the hardness profiles when applied to deep demineralized artificial lesions. However, further research is needed to verify and improve this observed effect.

  20. In vitro re-hardening of artificial enamel caries lesions using enamel matrix proteins or self-assembling peptides

    PubMed Central

    Schmidlin, Patrick; Zobrist, Katja; Attin, Thomas; Wegehaupt, Florian

    2016-01-01

    ABSTRACT Objectives To assess the re-hardening potential of enamel matrix derivatives (EMD) and self-assembling peptides in vitro, hypothesizing that these materials may increase the mineralization of artificial carious lesions and improve hardness profiles. Material and Methods Forty-eight enamel samples were prepared from extracted bovine lower central incisors. After embedding and polishing, nail varnish was applied, leaving a defined test area. One third of this area was covered with a flowable composite (non-demineralized control). The remaining area was demineralized in an acidic buffer solution for 18 d to simulate a carious lesion. Half the demineralized area was then covered with composite (demineralized control), while the last third was left open for three test and one control treatments: (A) Application of enamel-matrix proteins (EMD - lyophilized protein fractions dissolved in acetic acid, Straumann), (B) self-assembling peptides (SAP, Curodont), or (C) amine fluoride solution (Am-F, GABA) for 5 min each. Untreated samples (D) served as control. After treatment, samples were immersed in artificial saliva for four weeks (remineralization phase) and microhardness (Knoop) depth profiles (25-300 µm) were obtained at sections. Two-way ANOVA was calculated to determine differences between the areas (re-hardening or softening). Results Decalcification resulted in significant softening of the subsurface enamel in all groups (A-D). A significant re-hardening up to 125 µm was observed in the EMD and SAP groups. Conclusions This study showed that EMD and SAP were able to improve the hardness profiles when applied to deep demineralized artificial lesions. However, further research is needed to verify and improve this observed effect. PMID:27008255

  1. Analysis of carious dentine using FTIR and ToF-SIMS.

    PubMed

    Almhöjd, Ulrica S; Norén, Jörgen G; Arvidsson, Anna; Nilsson, Åke; Lingström, Peter

    2014-09-01

    Apart from the Maillard reaction, other processes, such as esterification, take place in carious tissue. The aim of the present study was to analyse sound and carious dentine in terms of ester groups and their reaction with hydrazine derivate using Fourier Transform Infrared Spectroscopy (FTIR) and Time-of-Flight Secondary Ion Mass Spectrometry (ToF-SIMS). Carious and sound dentine from human premolars were excavated in three series (Experimental Parts I-III) and separated into inner and outer layers of carious dentine. The excavated tooth material was analysed with FTIR (Part I). Carious and sound dentine were also exposed to different chemical treatments and analysed with FTIR-Attenuated Total Reflectance (FTIR-ATR; Part II) and ToF-SIMS (Part III). The FTIR absorption spectra showed that the carious tissue contained ester groups, not detected in sound dentine. The results also indicated a higher occurrence of ester groups in the inner dental caries layer than in the outer ones. Potential binding to these ester groups by hydrazine derivative was observed after different chemical treatments with both FTIR-ATR and ToF-SIMS. The results of the present study revealed ester groups unique to the carious dentine which, after reaction with hydrazine derivative, form a covalent bond not found in sound dentine. The staining of carious unique groups would be clinically helpful in detection and prevention unnecessary removal of sound dentine.

  2. Neuropeptide Y Y1 receptor in human dental pulp cells of noncarious and carious teeth.

    PubMed

    El Karim, I A; Lamey, P-J; Linden, G J; Lundy, F T

    2008-10-01

    To determine the distribution of the NPY Y1 receptor in carious and noncarious human dental pulp tissue using immunohistochemistry. A subsidiary aim was to confirm the presence of the NPY Y1 protein product in membrane fractions of dental pulp tissue from carious and noncarious teeth using western blotting. Twenty two dental pulp samples were collected from carious and noncarious extracted teeth. Ten samples were processed for immunohistochemistry using a specific antibody to the NPY Y1 receptor. Twelve samples were used to obtain membrane extracts which were electrophoresed, blotted onto nitrocellulose and probed with NPY Y1 receptor antibody. Kruskal-Wallis one-way analysis of variance was employed to test for overall statistical differences between NPY Y1 levels in noncarious, moderately carious and grossly carious teeth. Neuropeptide Y Y1 receptor immunoreactivity was detected on the walls of blood vessels in pulp tissue from noncarious teeth. In carious teeth NPY Y1 immunoreactivity was observed on nerve fibres, blood vessels and inflammatory cells. Western blotting indicated the presence and confirmed the variability of NPY Y1 receptor protein expression in solubilised membrane preparations of human dental pulp tissue from carious and noncarious teeth. Neuropeptide Y Y1 is expressed in human dental pulp tissue with evidence of increased expression in carious compared with noncarious teeth, suggesting a role for NPY Y1 in modulation of caries induced pulpal inflammation.

  3. Restoration of Non-carious Tooth Defects by Dentists in The Dental Practice-Based Research Network - DPBRN

    PubMed Central

    Nascimento, Marcelle M.; Gordan, Valeria V.; Qvist, Vibeke; Bader, James D.; Rindal, D. Brad; Williams, O. Dale; Gewartowski, Daniel; Fellows, Jeffrey L.; Litaker, Mark S.; Gilbert, Gregg H.

    2011-01-01

    Objective To quantify the reasons for placing restorations on non-carious tooth defects (NCTD) by Dental Practice-Based Research Network (DPBRN) dentists, and associated tooth, patient and dentist characteristics. Methods Data were collected on placement of 1,301 restorations due to NCTD by 178 DPBRN dentists. Information included: (1) main clinical occurrence or reason, other than dental caries, for restoring previously un-restored permanent tooth surfaces, (2) characteristics of patients who received treatment, (3) dentists’ and dental practices’ characteristics, (4) tooth and surfaces restored, and (5) restorative materials employed. Results Restorations were most often placed to treat abrasion, abfraction, and erosion (AAE) lesions (46%) and tooth fracture (31%). Patients older than 40 years received restorations mainly due to AAE (p<0.0001). Premolar and anterior teeth were mostly restored due to AAE; molar teeth were mostly restored due to tooth fracture (p<0.0001). Directly placed resin-based composite (RBC) was largely used to restore AAE and tooth fracture (p<0.0001). Conclusion AAE and tooth fracture are the main reasons for restoring non-carious tooth surfaces among DPBRN practices. Premolar and anterior teeth of patients older than 40 years are most likely to receive restorations due to AAE; molars are most likely to receive restorations due to tooth fracture. Both types of NCTD are most often restored with RBC. PMID:22130438

  4. Dentin microhardness of primary teeth undergoing partial carious removal.

    PubMed

    Dalpian, Débora Martini; Casagrande, Luciano; Franzon, Renata; Dutra, Giovana Martins Cezar; de Araujo, Fernando Borba

    2012-01-01

    To evaluate the dentin microhardness of primary teeth undergoing indirect pulp capping (IPC) after partial caries removal. Primary molars were treated with IPC, restored with self-etching primer (Clearfil SE Bond; CSE), and filled with composite resin (Filtek Z250) with (n = 10) or without (n = 7) a calcium hydroxide base liner (Dycal; Dy). After tooth exfoliation, the microhardness of the demineralized dentin remaining under the restoration (n = 17) was analyzed and compared with that of sound and carious primary dentin (n = 20). Microhardness measurements were obtained from the deepest portion of the cavity until the roof of the pulp chamber. Data were analyzed by Kruskal-Wallis test (p < 0.05). There was no difference in microhardness values at all depths between the treated groups (DY and CSE), but when the exfoliated carious teeth were included, the CSE had significantly higher values at 35-microm depth. This difference was only detected in the DY group after a depth of 200 microm. At 700 microm, there was no difference in microhardness values between all 4 groups. Primary teeth that underwent IPC showed the same microhardness, regardless of the capping material used.

  5. Assessment of non-carious root surface defects in areas of gingival recession: A descriptive study

    PubMed Central

    Jacob, Caroline-Annette; Nainar, Deepavalli-Arumuga

    2016-01-01

    Background The purpose of this descriptive study was to observe the distribution of four different classes of non-carious cervical root surface discrepancies in teeth with gingival recession. Additionally to explore the different treatment modalities in the literature for each of these defects. Material and Methods A total of 150 subjects with at least one labial gingival recession were included in the study. 1400 teeth were evaluated using 2.5 X magnification loupes and UNC -15 probe for the presence of the cemento-enamel junction and step like defects according to Pini-Prato’s classification: A-, identifiable CEJ without defect; A+, identifiable CEJ with defect; B-, unidentifiable CEJ without defect, B+, unidentifiable CEJ with defect. Further a comprehensive electronic and hand search of pubmed indexed journals was performed to identify appropriate treatment modalities for these defects and their predictability following restorative/surgical or combination of both. Results A total of 1400 teeth with exposed root surfaces were examined (793 Maxillary; 607 mandibular). 499 teeth were A-, 405 were A+, 322 were B+ and 174 were B-. The distribution of these defects in different teeth was: 36% premolars, 32% molars, 21% incisors and 11% canines, collectively 68% in the aesthetic zone. Conclusions Majority of these lesions are in the maxillary aesthetic zone. Hence the presence of the CEJ and the defect must be taken into account while managing these defects surgically. Key words:Cervical abrasion, gingival recession, magnification loupes, root coverage, step defects. PMID:27703607

  6. Polarization resolved near-IR imaging of sound and carious dental enamel

    NASA Astrophysics Data System (ADS)

    Darling, Cynthia L.; Chan, Kenneth H.; Fried, Daniel

    2011-03-01

    A thorough understanding of how polarized near-IR light is reflected from and transmitted through sound and carious dental hard tissues is important for the development of optical imaging devices. New optical imaging tools employing non-ionizing radiation are needed for the detection and assessment of dental caries. In this investigation, an automated system was developed to collect images for the full 16-element Mueller Matrix. The polarized light was controlled by linear polarizers and liquid crystal retarders and the 36 images were acquired as the polarized near-IR light is reflected from the occlusal surface or transmitted through thin sections of extracted human whole teeth. Previous near-IR imaging studies suggest that polarization imaging can be exploited to obtain higher contrast images of early dental caries due to the rapid depolarization of incident polarized light by the highly scattering areas of decay. In this study, the reflectance from tooth occlusal surfaces with demineralization and transmitted light through tooth thin sections with caries lesions were investigated. Major differences in the Mueller matrix elements were observed in both sound and demineralized enamel. This study suggests that polarization resolved optical imaging can be exploited to obtain higher contrast images of dental decay.

  7. Removal effects of the Nd:YAG laser and Carisolv on carious dentin.

    PubMed

    Yamada, Y; Hossain, M; Kawanaka, T; Kinoshita, J; Matsumoto, K

    2000-10-01

    The purpose of this study was to investigate the removal effect of the Nd:YAG laser irradiation and Carisolv on carious dentin. Many previous studies have reported several simple and alternative techniques, such as lasers and chemicals, for caries removal. Carisolv was applied on the surface of 20 extracted human anterior and molar teeth for 1 min and then the Nd:YAG laser was irradiated with a continuous water spray for another 1 min. The energy densities were varied from 2 to 6W with a repetition rate of 20 pps. As caries removal progressed, the cavity was carefully assessed by DIAGNOdent. Each lesion was photographed before and after treatment, and the treated cavity was observed microscopically using a stereoscope and with scanning electron microscope (SEM). Thermal change at the time of laser irradiation was measured by thermovision. Our results revealed that application of Carisolv followed by Nd:YAG laser irradiation at 4-6W pulse energy effectively removed dentin caries. The total procedure was usually repeated once or twice for complete caries removal. From the SEM study, it was found that the cavity surface treated with the laser revealed various patterns of microirregularity, often accompanied by microfissure propagation. There was also no smear layer. It was revealed that Nd:YAG laser and Carisolv could provide an alternative technique for caries removal instead of the conventional mechanical drilling and cutting.

  8. Aesthetic restoration of deciduous anterior teeth after removal of carious tissue with Papacárie.

    PubMed

    Motta, Lara J; Martins, Manoela D; Porta, Kristianne P; Bussadori, Sandra K

    2009-01-01

    The development of conservative techniques for the removal of carious tissue and the improvement of dental restoration materials allow better preservation of the dental structure. Chemomechanical caries removal is a conservative and atraumatic alternative. Papacárie is a papain-based material developed to act only on the carious dentin, allowing its easy removal with a blunt curette. This study aims to present a clinical case of aesthetic restoration of both upper deciduous central incisors after the removal of carious tissue with Papacárie.

  9. [Biological evaluation of means for chemomechanical removal of carious dentine].

    PubMed

    Chechina, G N; Vinnichenko, Iu A; Rudenko, O E

    2007-01-01

    Biological evaluation of the 1st domestically developed and produced preparation for chemomechanical removal of carious dentine Caricleans (firm "VladMiVa", Belgorod) was performed in the CRIS with the use of express techniques of the hemolytic activity (HA) and cytotoxic effect (CTE). It was established that according to HA data both gels of the Caricleans preparation were nontoxic. CTE of 2 gels was also determined on 2 cells lines - LECH (lung embryon cell human) and HeLa; higher sensitivity was received on HeLa cells, the toxic effect of gel #2 of the Caricleans preparation was higher. The received results allowed the authors come to the conclusion that taking into account high sensitivity, high specificity and high cost of the CTE-test not to recommend its use for evaluation of the preparations for short-term action in stomatology.

  10. Minimal intervention dentistry: part 4. Detection and diagnosis of initial caries lesions.

    PubMed

    Guerrieri, A; Gaucher, C; Bonte, E; Lasfargues, J J

    2012-12-01

    The detection of carious lesions is focused on the identification of early mineral changes to allow the demineralisation process to be managed by non-invasive interventions. The methods recommended for clinical diagnosis of initial carious lesions are discussed and illustrated. These include the early detection of lesions, evaluation of the extent of the lesion and its state of activity and the establishment of appropriate monitoring. The place of modern tools, including those based on fluorescence, is discussed. These can help inform patients. They are also potentially useful in regular control visits to monitor the progression or regression of early lesions. A rigorous and systematic approach to caries diagnosis is essential to establish a care plan for the disease and to identify preventive measures based on more precise diagnosis and to reduce reliance on restorative measures.

  11. Structural and thermal behaviour of carious and sound powders of human tooth enamel and dentine

    NASA Astrophysics Data System (ADS)

    Tiznado-Orozco, Gaby E.; García-García, R.; Reyes-Gasga, J.

    2009-12-01

    Powder from carious human tooth enamel and dentine were structurally, chemically and thermally analysed and compared against those from sound (healthy) teeth. Structural and chemical analyses were performed using x-ray diffraction, energy-dispersive x-ray spectroscopy and transmission electron microscopy. Thermal analysis was carried out by thermogravimetric analysis, Fourier transform infrared spectroscopy and x-ray diffraction. Results demonstrate partially dissolved crystals of hydroxyapatite (HAP) with substitutions of Na, Mg, Cl and C, and a greater weight loss in carious dentine as compared with carious enamel. A greater amount of thermal decomposition is observed in carious dentine as compared with sound dentine, with major variations in the a-axis of the HAP unit cell than in the c-axis. Variations in shape and intensity of the OH-, CO_{3}^{2-} and PO_{4}^{3-} FTIR bands were also found.

  12. Subclinical concentrations of chlorhexidine inhibit gelatinase activity of carious dentine in vitro.

    PubMed

    Trufello, A Mustakis; Orellana, B Urzúa; Moraga, C Lozano; Puente, C Lefimil; Morales-Bozo, I

    2014-03-01

    There is evidence that dentine matrix gelatinases are involved in the destruction of carious dentine after demineralization by bacterial acids. It has also been observed that chlorhexidine, in very low concentrations, inhibits the activity of these enzymes in mammalian cells. The goal of this study was to determine if the gelatinase activity of carious dentine may be inhibited by chlorhexidine in clinical use concentrations. Gelatinolytic activity was evaluated through zymography and identified by Western blot. The inhibitory effects of chlorhexidine at concentrations of 0.01%, 0.04%, 0.08% and 1% on the enzymatic activity of softened carious dentine samples were determined. In carious dentine, five bands of gelatinolytic activity were detected, with molecular sizes of 86, 75, 38, 33 and 32 kDa. The two bands of the greatest molecular size corresponded to latent and active metalloproteinase-9, respectively. Concentrations of chlorhexidine that were greater than or equal to 0.04% were sufficient to inhibit gelatinolytic activity in the observed bands of carious dentine. These results support the use of chlorhexidine in clinical use concentrations for the treatment and control of dentine caries. Our study demonstrates for the first time the inhibitory effect of chlorhexidine on gelatinases from carious human dentine. © 2014 Australian Dental Association.

  13. Carious Exposure versus Mechanical Exposure for MTA Pulpotomy in Primary Teeth.

    PubMed

    Çelik, Burcu Nihan; Sarı, Şaziye

    2016-01-01

    Introduction. The etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposure. This study clinically and radiographically evaluated the success of MTA pulpotomies conducted to treat carious and mechanical pulp exposure. Materials and Methods. This study was conducted with 50 mandibular primary molar teeth. Teeth were divided into 2 groups according to status of the exposure site, with teeth surrounded by carious dentin placed in a carious exposure group and those surrounded by sound dentin in a mechanical exposure group. MTA pulpotomies were performed for both groups. Treatment was followed up clinically and radiographically for 18 months. Results. Clinical and radiographic success rates at 18 months were 100% for both groups. Success rates did not vary significantly between the groups (p = 1.000). Pulp canal obliteration was only seen in the carious exposure group, observed in 2 teeth (8.3%). Conclusion. The long term success rates achieved in this study indicate that MTA can be used as a vital pulpotomy material for the long term success in primary teeth with either mechanical or carious exposure. The findings of the present study highlight the fact that treatment prognosis is dependent upon diagnosis and selection of the appropriate materials for treatment.

  14. Carious Exposure versus Mechanical Exposure for MTA Pulpotomy in Primary Teeth

    PubMed Central

    2016-01-01

    Introduction. The etiology of exposure determines pulpal response, making it crucial to distinguish between mechanical and carious exposure. This study clinically and radiographically evaluated the success of MTA pulpotomies conducted to treat carious and mechanical pulp exposure. Materials and Methods. This study was conducted with 50 mandibular primary molar teeth. Teeth were divided into 2 groups according to status of the exposure site, with teeth surrounded by carious dentin placed in a carious exposure group and those surrounded by sound dentin in a mechanical exposure group. MTA pulpotomies were performed for both groups. Treatment was followed up clinically and radiographically for 18 months. Results. Clinical and radiographic success rates at 18 months were 100% for both groups. Success rates did not vary significantly between the groups (p = 1.000). Pulp canal obliteration was only seen in the carious exposure group, observed in 2 teeth (8.3%). Conclusion. The long term success rates achieved in this study indicate that MTA can be used as a vital pulpotomy material for the long term success in primary teeth with either mechanical or carious exposure. The findings of the present study highlight the fact that treatment prognosis is dependent upon diagnosis and selection of the appropriate materials for treatment. PMID:27995139

  15. Characterization of dentin, enamel, and carious lesions by a polarization-sensitive optical coherence tomography system

    NASA Astrophysics Data System (ADS)

    Chen, Yueli; Otis, Linda; Piao, Daqing; Zhu, Quing

    2005-04-01

    Enamel and dentin are the primary components of human teeth. Both of them have a strong polarization effect. We designed a polarization-sensitive optical coherence tomography (PSOCT) system to study the spatially resolved scattering and polarization phenomena of teeth. The system is constructed in free space to avoid the complexity of polarization control in fiber-based PSOCT. The structural features of enamel were evaluated in five human teeth that had no visible evidence of caries. The teeth were subsequently sectioned in mesial distal orientation and coronal orientation. Then the structural aspects of dentin were evaluated. OCT images were made of the mantel dentin near the dentin-enamel junction. Five teeth with interproximal and occlusal caries were also studied. With two channel and phase-retardation images, PSOCT provided better functional contrast and more detailed structural information than conventional OCT. For a better description of the measured PSOCT data, we classify these features by two types, i.e., the local textural features and the global structural features. This study indicates that PSOCT has the potential to be a powerful tool for research of dental formation and caries diagnosis.

  16. The effect of different fluoride application methods on the remineralization of initial carious lesions

    PubMed Central

    2016-01-01

    Objectives The purpose of this study was to assess the effect of single and combined applications of fluoride on the amount of fluoride release, and the remineralization and physical properties of enamel. Materials and Methods Each of four fluoride varnish and gel products (Fluor Protector, FP, Ivoclar Vivadent; Tooth Mousse Plus, TM, GC; 60 Second Gel, A, Germiphene; CavityShield, CS, 3M ESPE) and two fluoride solutions (2% sodium fluoride, N; 8% tin(ii) fluoride, S) were applied on bovine teeth using single and combined methods (10 per group), and then the amount of fluoride release was measured for 4 wk. The electron probe microanalysis and the Vickers microhardness measurements were conducted to assess the effect of fluoride application on the surface properties of bovine teeth. Results The amount of fluoride release was higher in combined applications than in single application (p < 0.05). Microhardness values were higher after combined applications of N with FP, TM, and CS than single application of them, and these values were also higher after combined applications of S than single application of A (p < 0.05). Ca and P values were higher in combined applications of N with TM and CS than single application of them (p < 0.05). They were also increased after combined applications of the S with A than after single application (p < 0.05). Conclusions Combined applications of fluoride could be used as a basis to design more effective methods of fluoride application to provide enhanced remineralization. PMID:27200280

  17. The effect of different fluoride application methods on the remineralization of initial carious lesions.

    PubMed

    Byeon, Seon Mi; Lee, Min Ho; Bae, Tae Sung

    2016-05-01

    The purpose of this study was to assess the effect of single and combined applications of fluoride on the amount of fluoride release, and the remineralization and physical properties of enamel. Each of four fluoride varnish and gel products (Fluor Protector, FP, Ivoclar Vivadent; Tooth Mousse Plus, TM, GC; 60 Second Gel, A, Germiphene; CavityShield, CS, 3M ESPE) and two fluoride solutions (2% sodium fluoride, N; 8% tin(ii) fluoride, S) were applied on bovine teeth using single and combined methods (10 per group), and then the amount of fluoride release was measured for 4 wk. The electron probe microanalysis and the Vickers microhardness measurements were conducted to assess the effect of fluoride application on the surface properties of bovine teeth. The amount of fluoride release was higher in combined applications than in single application (p < 0.05). Microhardness values were higher after combined applications of N with FP, TM, and CS than single application of them, and these values were also higher after combined applications of S than single application of A (p < 0.05). Ca and P values were higher in combined applications of N with TM and CS than single application of them (p < 0.05). They were also increased after combined applications of the S with A than after single application (p < 0.05). Combined applications of fluoride could be used as a basis to design more effective methods of fluoride application to provide enhanced remineralization.

  18. Enamel bevelling and retention of composite restorations in non-carious cervical lesions.

    PubMed

    Ahmed, Khaled

    2016-09-01

    Data sourcesMedline, Web of Science, Latin American and Caribbean Health Sciences Literature database (LILACS), Brazilian Library in Dentistry (BBO), the Cochrane Library, abstracts of the annual conference of the International Association for Dental Research (IADR), System for Information on Grey literature in Europe (SIGLE), ProQuest Dissertations and Theses Fulltext database as well as the Periódicos Capes Theses, Current Controlled Trials, International Clinical trials registry platform, the ClinicalTrials.gov, Rebec and the EU Clinical Trials Register.Study selectionRandomised clinical trials (RCTs) that compared the retention rates of restorations in NCCLs placed with or without bevel with at least one year follow-up were considered.Data extraction and synthesisData were abstracted using standardised forms and study quality was assessed using the Cochrane risk of bias tool. Marginal discolouration scores were dichotomised into yes and no, and risk differences for retention rate and marginal discolouration were calculated for each study for analysis.ResultsFour studies were included. Two studies were considered to be at high risk of bias and not included in the meta-analysis. The overall risk difference was 0.0 (95%CI; 0.04 to 0.04) for the retention rate and 0.05 ((95%CI; 0.02 to 0.13) for the marginal discolouration, suggesting that enamel beveling does not influence retention rate or marginal discolouration.ConclusionsOne may conclude that there is no difference between bevelled and non-bevelled technique over the short-term follow-up of 12-18 months of clinical service, although this conclusion was based on only two low risk of bias RCTs. Additionally, there is not enough evidence to support this conclusion over longer-term follow-ups. There is a need for better standardisation and the reporting of RCTs investigating this technique variation after longer-term follow-up periods.

  19. Detection of Carious Lesions and Restorations Using Particle Swarm Optimization Algorithm

    PubMed Central

    Naebi, Mohammad; Saberi, Eshaghali; Risbaf Fakour, Sirous; Naebi, Ahmad; Hosseini Tabatabaei, Somayeh; Ansari Moghadam, Somayeh; Bozorgmehr, Elham; Davtalab Behnam, Nasim; Azimi, Hamidreza

    2016-01-01

    Background/Purpose. In terms of the detection of tooth diagnosis, no intelligent detection has been done up till now. Dentists just look at images and then they can detect the diagnosis position in tooth based on their experiences. Using new technologies, scientists will implement detection and repair of tooth diagnosis intelligently. In this paper, we have introduced one intelligent method for detection using particle swarm optimization (PSO) and our mathematical formulation. This method was applied to 2D special images. Using developing of our method, we can detect tooth diagnosis for all of 2D and 3D images. Materials and Methods. In recent years, it is possible to implement intelligent processing of images by high efficiency optimization algorithms in many applications especially for detection of dental caries and restoration without human intervention. In the present work, we explain PSO algorithm with our detection formula for detection of dental caries and restoration. Also image processing helped us to implement our method. And to do so, pictures taken by digital radiography systems of tooth are used. Results and Conclusion. We implement some mathematics formula for fitness of PSO. Our results show that this method can detect dental caries and restoration in digital radiography pictures with the good convergence. In fact, the error rate of this method was 8%, so that it can be implemented for detection of dental caries and restoration. Using some parameters, it is possible that the error rate can be even reduced below 0.5%. PMID:27212947

  20. Parental attitudes to the care of the carious primary dentition.

    PubMed

    Tickle, M; Milsom, K M; Humphris, G M; Blinkhorn, A S

    2003-10-25

    To examine parents' attitudes to the dental care of their children, taking into account the family's socio-economic background, dentally-related behaviour including the child's level of dental anxiety and dental treatment history. A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined; dmft and its components were recorded. A postal questionnaire was sent to the children's parents to measure their preferences for dental care with reference to two scenarios, (1) if their child had a carious but asymptomatic primary tooth, or (2) if their child had a carious primary tooth which was causing toothache. Parents were also asked to provide information on the dental attendance pattern of their child and an assessment of their child's dental anxiety. Family socio-economic status was recorded using the Townsend material deprivation index of the electoral ward in which they resided. Questionnaires were distributed to the home addresses of the 1,745 children who were clinically examined, and 1,437 were returned, giving a response rate of 82%. In both scenarios the majority of parents were happy to leave the decision on treatment to the dentist. In the asymptomatic tooth scenario, approximately one third of parents wanted the tooth to remain untreated but periodically monitored, only 6% expressed a desire to have their child's tooth restored. Multivariate analysis showed that parents of children who had a filling (OR 4.32 95%CI 2.21-8.43) or extraction (OR 2.24 95%CI 1.11-4.53) in the past were significantly more likely to want restorative care for their children. In the scenario where the child had toothache, multivariate analysis confirmed that parents had a preference for an intervention (extraction or filling) if they lived in a deprived area (Townsend score OR 1.10, 95% CI 1.04, 1.16) or if their child had had an extraction (OR 4.35, 95% CI 1.59, 11.88) or filling (OR 2.39, 95% CI 1.05, 5.45) in the

  1. Randomized control trial comparing calcium hydroxide and mineral trioxide aggregate for partial pulpotomies in cariously exposed pulps of permanent molars.

    PubMed

    Chailertvanitkul, P; Paphangkorakit, J; Sooksantisakoonchai, N; Pumas, N; Pairojamornyoot, W; Leela-Apiradee, N; Abbott, P V

    2014-09-01

    To compare the treatment outcomes when calcium hydroxide and mineral trioxide aggregate are used for partial pulpotomy in cariously exposed young permanent molars in a randomized control trial. Eighty-four teeth in 80 volunteers (aged 7-10 years) with reversible pulpitis and carious pulp exposures were randomly divided into two groups. Exposed pulps were severed using high-speed round burs until fresh pulp was seen. Cavities were irrigated with 2.5% sodium hypochlorite, and the pulp exposures were photographed and measured. Dycal or ProRoot MTA was placed on the pulp. Vitremer was placed over the material until the remaining cavity was 2 mm deep; amalgam was then placed. Teeth were evaluated for clinical symptoms and radiographic periapical changes after 24 h, 3 months, 6 months, 1 year and 2 years. Mean survival times and incidence of extraction were calculated using exact binomial confidence intervals. The median survival time for both ProRoot MTA and Dycal groups was 24 months. Three teeth had unfavourable outcomes with the incidence rate of 0.20/100 tooth-months with ProRoot MTA (95% CI: 0.02-0.71) and 0.11/100 tooth-months with Dycal (95% CI: 0.001-0.60). The incidence of unfavourable outcomes was 0.05/100 (95% CI: 0.001-0.30) and 2.38/100 (95% CI: 0.29-8.34) tooth-months in teeth with small (<5 mm(2) ) and large (>5 mm(2) ) pulp exposure areas, respectively. Partial pulpotomy in teeth of young patients with reversible pulpitis, either using ProRoot MTA or Dycal, resulted in favourable treatment outcomes for up to 2 years. The incidence of unfavourable outcomes tended to be higher in teeth with pulp exposure areas larger than 5 mm(2) . © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  2. Laser light passage through restored and carious posterior teeth.

    PubMed

    Chandler, N P; Pitt Ford, T R; Monteith, B D

    2014-08-01

    Laser Doppler flowmetry (LDF) has been used to investigate pulpal blood flow as a means of pulp vitality testing. Transmission of laser light from the tooth surface to the pulp space may be influenced by caries and restorations. One hundred and twenty-two first and second molars that had caries into dentine, restorations or significant loss of coronal tissue were sectioned in half axio-bucco-lingually. The two sections were illuminated with a laser from their buccal and lingual aspects 2 mm coronal to the amelocemental junction. Light reaching the pulp space was recorded. Buccal and lingual illumination sites were equally effective for 67 teeth (55%). Buccal sites alone were effective for 35 teeth (29%), despite over one-third of these surfaces being restored or featuring enamel or dentine caries. A lingual position alone was effective for 20 teeth (16%). Caries affected light transmission, but for over half the teeth, the pulp could be illuminated from all four probe positions. No effect was found when the influence of mesial and distal restorations on transmission into the corresponding tooth section was examined. The pulp spaces of most (84%) restored, and carious posterior teeth could be illuminated by laser light from their buccal aspect and these teeth could potentially be vitality tested using LDF. © 2014 John Wiley & Sons Ltd.

  3. Abfraction lesions--where do they come from? A review of the literature.

    PubMed

    Antonelli, John R; Hottel, Timothy L; Garcia-Godoy, Franklin

    2013-01-01

    The theory of non-carious cervical lesions (NCCLs) suggests that tooth flexure arising from cyclic, eccentric occlusal forces causes their formation and progression in vulnerable cervical regions of teeth. The etiology is still controversial. Attrition, corrosion, abrasion and stress-corrosion might act alone or in combination to initiate and perpetuate lesions. This review of the literature provides the basis for the diagnosis that can be used in consideration of treatment options.

  4. Assessment of cavitation in artificial approximal dental lesions with near-IR imaging

    NASA Astrophysics Data System (ADS)

    Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2017-02-01

    Bitewing radiography is still considered state-of-the-art diagnostic technology for assessing cavitation within approximal carious dental lesions, even though radiographs cannot resolve cavitated surfaces but instead are used to measure lesion depth in order to predict cavitation. Clinicians need new technologies capable of determining whether approximal carious lesions have become cavitated because not all lesions progress to cavitation. Assessing lesion cavitation from near-infrared (NIR) imaging methods holds great potential due to the high transparency of enamel in the NIR region from λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. The objective of this study was to measure the change in lesion appearance between non-cavitated and cavitated lesions in artificially generated lesions using NIR imaging modalities (two-dimensional) at λ=1300-nm and λ=1450-nm and cross-polarization optical coherence tomography (CP-OCT) (thee-dimensional) λ=1300-nm. Extracted human posterior teeth with sound proximal surfaces were chosen for this study and imaged before and after artificial lesions were made. A high speed dental hand piece was used to create artificial cavitated proximal lesions in sound samples and imaged. The cavitated artificial lesions were then filled with hydroxyapatite powder to simulate non-cavitated proximal lesions.

  5. Near-IR multi-modal imaging of natural occlusal lesions

    NASA Astrophysics Data System (ADS)

    Lee, Dustin; Fried, Daniel; Darling, Cynthia L.

    2009-02-01

    Reflectance and transillumination imaging show demineralization with high contrast in the near-IR. The objective of this study is to use lesion size and contrast acquired in reflectance and transillumination near-infrared imaging modes to estimate the severity of natural occlusal caries lesions. Previous studies have shown that near-infrared (NIR) light can be used to effectively image artificial carious lesions. However, its efficacy on natural lesions requires further exploration. Fifty extracted teeth with varying amounts of occlusal decay were examined using a NIR imaging system operating at 1310-nm. Image analysis software was used to calculate contrast values between sound and carious tooth structure. After imaging, teeth were histologically sampled at 1-mm intervals in order to determine lesion depth. Lesion contrast in transillumination mode significantly increased with lesion depth (p<0.001), while lesion contrast in reflectance mode did not increase. The lesion area demonstrated a significant increase with lesion severity in both imaging modes. These results suggest that lesion contrast and area can be used to estimate lesion severity in NIR images.

  6. Assessment of cavitation in artificial approximal dental lesions with near-IR imaging.

    PubMed

    Simon, Jacob C; Darling, Cynthia L; Fried, Daniel

    2017-01-28

    Bitewing radiography is still considered state-of-the-art diagnostic technology for assessing cavitation within approximal carious dental lesions, even though radiographs cannot resolve cavitated surfaces but instead are used to measure lesion depth in order to predict cavitation. Clinicians need new technologies capable of determining whether approximal carious lesions have become cavitated because not all lesions progress to cavitation. Assessing lesion cavitation from near-infrared (NIR) imaging methods holds great potential due to the high transparency of enamel in the NIR region from λ=1300-1700-nm, which allows direct visualization and quantified measurements of enamel demineralization. The objective of this study was to measure the change in lesion appearance between non-cavitated and cavitated lesions in artificially generated lesions using NIR imaging modalities (two-dimensional) at λ =1300-nm and λ=1450-nm and cross-polarization optical coherence tomography (CP-OCT) (thee-dimensional) λ =1300-nm. Extracted human posterior teeth with sound proximal surfaces were chosen for this study and imaged before and after artificial lesions were made. A high speed dental hand piece was used to create artificial cavitated proximal lesions in sound samples and imaged. The cavitated artificial lesions were then filled with hydroxyapatite powder to simulate non-cavitated proximal lesions.

  7. Evaluation of the shear bond strength of nanocomposite on carious and sound deciduous dentin.

    PubMed

    Deshmukh, Seema; Nandlal, B

    2012-01-01

    The aim of the study was to evaluate and compare the shear bond strength of conventional composites with nanocomposites in carious and sound deciduous dentin with the use of self-etching adhesive. Human primary molars were ground to obtain flat dentin surfaces and divided into two groups: Carious dentin and sound dentin group. The carious teeth specimens were prepared by removing infected dentin and area with affected dentin was used for bonding composite. Teeth with carious and sound dentin were subdivided in two groups (n = 15) based on the type of the composite into conventional composite group and nanocomposite group. The composite was bonded to the teeth with self-etching adhesive. All the bonded specimens were stored in distilled water for 24 hours at 37°C before shear bond testing. Independent t-test and analysis of variance were applied to the results. The results indicated that the nanocomposite offered significantly higher bond strength compared to conventional composite. In addition presence of affected dentin significantly reduced the bond strength of both the composite types. How to cite this article: Deshmukh S, Nandlal B. Evaluation of the Shear Bond Strength of Nanocomposite on Carious and Sound Deciduous Dentin. Int J Clin Pediatr Dent 2012;5(1): 25-28.

  8. Biochemical composition of carious dentin and different layers of sound dentin.

    PubMed

    Magnus, Larissa; Maltz, Marisa; Bavaresco, Caren; Bastos, Lucelen F; Hashizume, Lina N

    2013-01-01

    The aim of this study was to evaluate the concentrations of calcium (Ca), inorganic phosphate (Pi) and fluoride (F) in carious dentin and in different layers of sound dentin. The samples examined were 52 permanent teeth (26 sound and 26 carious), which were subjected to two experiments to assess the mineral content of: 1) two layers (internal and external) of sound dentin and 2) sound and carious dentin. Ca and Pi were analyzed using a colorimetric method with arsenazo III (C22H18As2N4O14S2) and molybdate reagents, and F was analyzed using a specific electrode. A non-parametric test, the Mann-Whitney test, was used to verify differences between groups. Sound dentin showed a higher concentration of fluoride in the internal layer than in the external layer (P = 0.03), but no inter-layer differences in Ca or Pi concentration were evident. Lower concentrations of Ca, Pi and F were observed in carious dentin than in sound dentin (P < 0.05). The results of this study suggest that the internal layer of sound dentin has a higher fluoride content than the external layer, and that carious dentin has lower concentrations of Ca, Pi and F than sound dentin.

  9. Carious deciduous teeth are a potential source for dental pulp stem cells.

    PubMed

    Werle, Stefanie Bressan; Lindemann, Daniele; Steffens, Daniela; Demarco, Flávio Fernando; de Araujo, Fernando Borba; Pranke, Patrícia; Casagrande, Luciano

    2016-01-01

    The objectives of this study are to isolate, cultivate, and characterize stem cells from the pulp of carious deciduous teeth (SCCD) and compare them to those retrieved from sound deciduous teeth (SHED--stem cells from human exfoliated deciduous teeth). Cells were obtained of dental pulp collected from sound (n = 10) and carious (n = 10) deciduous human teeth. Rate of isolation, proliferation assay (0, 1, 3, 5, and 7 days), STRO-1, mesenchymal (CD29, CD73, and CD90) and hematopoietic surface marker expression (CD14, CD34, CD45, HLA-DR), and differentiation capacity were evaluated. Isolation success rates were 70 and 80 % from the carious and sound groups, respectively. SCCD and SHED presented similar proliferation rate. There were no statistical differences between the groups for the tested surface markers. The cells from sound and carious deciduous teeth were positive for CD29, CD73, and CD90 and negative for CD14, CD34, CD45, and HLA-DR and were capable of differentiating into osteogenic, chondrogenic, and adipogenic lineages. SCCD demonstrated a similar pattern of proliferation, immunophenotypical characteristics, and differentiation ability as those obtained from sound deciduous teeth. These SCCD represent a feasible source of stem cells. Decayed deciduous teeth have been usually discarded once the pulp tissue could be damaged and the activity of stem cells compromised. These findings show that stem cells from carious deciduous teeth can be applicable source for cell-based therapies in tissue regeneration.

  10. Evaluation of the Shear Bond Strength of Nanocomposite on Carious and Sound Deciduous Dentin

    PubMed Central

    Nandlal, B

    2012-01-01

    ABSTRACT Aim: The aim of the study was to evaluate and compare the shear bond strength of conventional composites with nanocomposites in carious and sound deciduous dentin with the use of self-etching adhesive. Methodology: Human primary molars were ground to obtain flat dentin surfaces and divided into two groups: Carious dentin and sound dentin group. The carious teeth specimens were prepared by removing infected dentin and area with affected dentin was used for bonding composite. Teeth with carious and sound dentin were subdivided in two groups (n = 15) based on the type of the composite into conventional composite group and nanocomposite group. The composite was bonded to the teeth with self-etching adhesive. All the bonded specimens were stored in distilled water for 24 hours at 37°C before shear bond testing. Independent t-test and analysis of variance were applied to the results. Results: The results indicated that the nanocomposite offered significantly higher bond strength compared to conventional composite. In addition presence of affected dentin significantly reduced the bond strength of both the composite types. How to cite this article: Deshmukh S, Nandlal B. Evaluation of the Shear Bond Strength of Nanocomposite on Carious and Sound Deciduous Dentin. Int J Clin Pediatr Dent 2012;5(1): 25-28. PMID:25206130

  11. Gold-tip electrodes--a new "deep lesion" technology for catheter ablation? In vitro comparison of a gold alloy versus platinum-iridium tip electrode ablation catheter.

    PubMed

    Lewalter, Thorsten; Bitzen, Alexander; Wurtz, Sabine; Blum, Robert; Schlodder, Karsten; Yang, Alexander; Lickfett, Lars; Schwab, Jörg O; Schrickel, Jan W; Tiemann, Klaus; Linhart, Markus; Zima, Endre; Merkely, Bela; Lüderitz, Berndt

    2005-07-01

    Gold-tip electrodes. Radiofrequency (RF) catheter ablation is widely used to induce focal myocardial necrosis using the effect of resistive heating through high-frequency current delivery. It is current standard to limit the target tissue-electrode interface temperature to a maximum of 60-70 degrees C to avoid char formation. Gold (Au) exhibits a thermal conductivity of nearly four times greater than platinum (Pt-Ir) (3.17 W/cm Kelvin vs 0.716 W/cm Kelvin), it was therefore hypothesized that RF ablation using a gold electrode would create broader and deeper lesions as a result of a better heat conduction from the tissue-electrode interface and additional cooling of the gold electrode by "heat loss" to the intracardiac blood. Both mechanisms would allow applying more RF power to the tissue before the electrode-tissue interface temperature limit is reached. To test this hypothesis, we performed in vitro isolated liver and pig heart investigations comparing lesion depths of a new Au-alloy-tip electrode to standard Pt-Ir electrode material. Mean lesion depth in liver tissue for Pt-Ir was 4.33+/-0.45 mm (n=60) whereas Au electrode was able to achieve significantly deeper lesions (5.86+/-0.37 mm [n=60; P<0.001]). The mean power delivered using Pt-Ir was 6.95+/-2.41 W whereas Au tip electrode delivered 9.64+/-3.78 W indicating a statistically significant difference (P<0.05). In vitro pig heart tissue Au ablation (n=20) increased significantly the lesion depth (Au: 4.85+/-1.01 mm, Pt-Ir: 2.96+/-0.81 mm, n=20; P<0.001). Au tip electrode again applied significantly more power (P<0.001). Gold-tip electrode catheters were able to induce deeper lesions using RF ablation in vitro as compared to Pt-Ir tip electrode material. In liver and in pig heart tissue, the increase in lesion depth was associated with a significant increase in the average power applied with the gold electrode at the same level of electrode-tissue temperature as compared to platinum material.

  12. Materials for Paediatric Dentistry. Part 1: Background to the Treatment of Carious Primary Teeth.

    PubMed

    Jenkins, Natalie

    2015-12-01

    Dental caries is a disease that affects many people, including children, and presents numerous challenges to healthcare providers. As clinicians it is important that we consider the advantages and disadvantages of treating carious primary teeth, and make an informed decision about when it is appropriate or not. This paper describes the background to the treatment of carious primary teeth, looking at the differences between primary and permanent teeth, and the relevance of this. It also suggests points to consider when looking at restoration survival studies, as the ability to appraise the literature critically is important for us all in this 'evidence-based' age. CPD/Clinical Relevance: Our early life experiences have the ability to shape our future attitudes and behaviour. Children with carious teeth require careful management so that pain and suffering is minimized, and positive attitudes towards dentistry are fostered.

  13. Site specific properties of carious dentin matrices biomodified with collagen cross-linkers

    PubMed Central

    Bedran-Russo, Ana K.; Karol, Sachin; Pashley, David H.; Viana, Grace

    2014-01-01

    Purpose To assess in non-cavitated carious teeth the mechanical properties of dentin matrix by measuring its reduced modulus of elasticity and the effect of dentin biomodification strategies on three dentin matrix zones: caries-affected, apparently normal dentin below caries-affected zone and sound dentin far from carious site. Methods Nano-indentations were performed on dentin matrices of carious molars before and after surface modification using known cross-linking agents (glutaraldehyde, proanthocyanidins from grape seed extract and carbodiimide). Results Statistically significant differences were observed between dentin zones of demineralized dentin prior to surface biomodification (P< 0.05). Following surface modification, there were no statistically significant differences between dentin zones (P< 0.05). An average increase of 30-fold, 2-fold and 2.2-fold of the reduced modulus of elasticity was observed following treatments of the three dentin zones with proanthocyanidin, carbodiimide and glutaraldehyde, respectively. PMID:24479274

  14. A competing risk survival analysis model to assess the efficacy of filling carious primary teeth.

    PubMed

    Stephenson, J; Chadwick, B L; Playle, R A; Treasure, E T

    2010-01-01

    In recent years a strategy of selective, symptom-based intervention of carious primary teeth has been developed amongst some British general dental practitioners. Practice-based studies appear to provide evidence that policies of restoration of symptomless carious primary teeth do not confer any significant benefits above those associated with non-restorative care. However, results from these studies contrast with those of many clinical trials and prospective studies of primary molar restorations. In the current investigation, cohort study data from 5,168 carious primary molar teeth from 2,654 British children aged 4-5 years at baseline, augmented with Dental Practice Board treatment data, was utilised to assess the effect of restorative treatment on the likelihood of carious teeth subsequently progressing to either exfoliation or extraction. The effect of demographic and tooth level covariates on the fate of these teeth was also assessed. Multivariate multilevel parametric survival models were applied to the analysis of the carious-exfoliation and carious-extraction transitions to which the teeth were subject, assuming an underlying data hierarchy with teeth nested within individuals. Time of occurrence of caries affected survival experience, with teeth in which caries occurred later in life being associated with higher survival rates to extraction. Amongst filled teeth, later fillings were also associated with higher survival rates to extraction. Demographic and tooth level variables had a limited effect on survival experience. Treatment was found to be significantly associated with survival with respect to extraction, with survival rates of over 80% at 14 years, double those of untreated teeth.

  15. SEM evaluation of resin-carious dentin interfaces formed by two dentin adhesive systems

    PubMed Central

    Hsu, Kuang-Wei; Marshall, Sally J.; Pinzon, Lilliam M.; Watanabe, Larry; Saiz, Eduardo; Marshall, Grayson W.

    2008-01-01

    Objectives We investigated the influence of dentin tubule direction and identifiable zone of carious dentin on the microstructure and the thickness of the hybrid-like layer (HL) formed by self-etch and etch-rinse adhesive systems. Methods An etch-rinse and a self-etching adhesive were bonded to dentin carious zones divided into groups with parallel or perpendicular orientation relative to the dentin tubules at the resin-carious dentin interface (N = 5/variable). Bonds were prepared to each of the four zones of carious dentin apparent after staining with Caries Detector: pink, light pink, transparent and apparently normal Six non-carious third molars were controls. The microstructure and thickness of the HL were determined by SEM.and compared using three-way ANOVA and Tukey's multiple comparisons (p<0.05). Results Etch-rinse controls gave thicker HLs than self-etching systems; ; orientation did not affect thickness for the self-etch system. Perpendicular orientations gave thicker HLs than parallel for the pink zone bonded with the etch-rinse system. For both adhesives, HL thickness in the pink zone were significantly greater than in light pink for the perpendicular group, but no significant differences were found among other variables. HL microstructure was more granular and rougher for the etch rinse than for the self etching system. Pores and cracks were obvious in the more demineralized zones, Resin tags were shorter and irregular in the transparent zone and often were completely absent in the outer demineralized zones (pink, light pink). Significance Microstructure of bonded interfaces varies markedly depending on adhesive system, tubule orientation and carious zone. PMID:18155289

  16. Deep-diving dinosaurs

    NASA Astrophysics Data System (ADS)

    Hayman, John

    2012-08-01

    Dysbaric bone necrosis demonstrated in ichthyosaurs may be the result of prolonged deep diving rather than rapid ascent to escape predators. The bone lesions show structural and anatomical similarity to those that may occur in human divers and in the deep diving sperm whale, Physeter macrocephalus.

  17. Imaging caries lesions and lesion progression with polarization-sensitive optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Fried, Daniel; Xie, John; Shafi, Sahar; Featherstone, John D. B.; Breunig, Thomas; Le, Charles Q.

    2002-06-01

    New diagnostic tools are needed for the characterization of dental caries in the early stages of development. If carious lesions are detected early enough, they can be arrested without the need for surgical intervention. The objective of this study was to demonstrate that polarization sensitive optical coherence tomography (PS-OCT) can be used for the imaging of early caries lesions and for the monitoring of lesion progression over time. High-resolution polarization resolved images were acquired of natural caries lesions and simulated caries lesions of varying severity created over time periods of 1 to 14 days. Linearly polarized light was incident on the tooth samples and the reflected intensity in both orthogonal polarizations was measured. PS-OCT was invaluable for removing the confounding influence of surface reflections and native birefringence and for resolving the surface structure of caries lesions. This study demonstrated that PS-OCT is well suited for the resolution of interproximal and occlusal caries, early root caries, and secondary caries around composite fillings. Longitudinal measurements of lesion progression established a strong correlation (p<0.001) between the reflected light from the lesion area and the square root of time indicating that PS-OCT is well suited for monitoring changes in enamel mineralization over time.

  18. Molecular Insights into Covalently Stained Carious Dentine Using Solid-State NMR and ToF-SIMS.

    PubMed

    Almhöjd, Ulrica S; Lingström, Peter; Nilsson, Åke; Norén, Jörgen G; Siljeström, Sandra; Östlund, Åsa; Bernin, Diana

    2017-01-01

    Dyes currently used to stain carious dentine have a limited capacity to discriminate normal dentine from carious dentine, which may result in overexcavation. Consequently, finding a selective dye is still a challenge. However, there is evidence that hydrazine-based dyes, via covalent bonds to functional groups, bind specifically to carious dentine. The aim of this study was to investigate the possible formation of covalent bonds between carious dentine and 15N2-hydrazine and the hydrazine-based dye, 15N2-labelled Lucifer Yellow, respectively. Powdered dentine from extracted carious and normal teeth was exposed to the dyes, and the staining reactions were analysed using time-of-flight secondary ion mass spectrometry (ToF-SIMS), solid-state 13C-labelled nuclear magnetic resonance (NMR) and 15N-NMR spectroscopy. The results showed that 15N2-hydrazine and 15N2-labelled Lucifer Yellow both bind to carious dentine but not to normal dentine. It can thus be concluded that hydrazine-based dyes can be used to stain carious dentine and leave normal dentine unstained. © 2017 S. Karger AG, Basel.

  19. Do educational methods affect students' ability to remove artificial carious dentine? A randomised controlled trial.

    PubMed

    Rosa, Q F; Barcelos, T M; Kaizer, M R; Montagner, A F; Sarkis-Onofre, R; Masotti, A S; Jardim, P S; Pereira-Cenci, T; Oliveira, E F; Cenci, M S

    2013-08-01

    This trial aimed to evaluate the influence of two educational methods on students' ability to remove artificial carious dentine. Traditional lecture and lecture plus a live demonstration of artificial carious tissue removal were compared in a blind two-parallel-group design. Twenty-six students were randomly divided into two groups, and their skills were evaluated according to the following criteria: time spent on the dentine excavation procedure (in min), students' perceived confidence in conducting the procedure (graded assessed on a scale from 0 to 10), and the outcome of artificial carious tissue removal, evaluated by measuring the residual dyed artificial carious dentine layer (in μm). Statistical analyses were carried out using a t-test to compare the students' confidence and time spent on the procedure, and a two-way ANOVA was used to compare residual artificial decayed dentine with educational methods and tooth region (incisal, medium, and cervical thirds) as factors. There were no differences between the methods regarding excavation time (P = 0.898) and students' confidence (P = 0.382). The residual artificial carious dentine results showed that the educational method (P < 0.001) and cavity region (P < 0.001) were statistically significant, as was their interaction (P = 0.040). The lecture plus live demonstration group presented the best results for artificial caries removal. Although there were no differences between the two groups for the cervical region, the best results for the lecture plus live demonstration group was in the other two-thirds of the tooth. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. An oral lesion as the primary clinical manifestation of sarcoidosis.

    PubMed

    Gill, I; Siddiqi, J

    2017-03-16

    An oral lesion as the first clinical presentation of sarcoidosis is extremely rare. We present the case of a 39-year-old woman who was referred to the oral and maxillofacial surgery department with a persistent asymptomatic nodular lesion in the hard palate. This was located adjacent to a grossly carious upper first molar and a provisional diagnosis of chronic periapical granuloma was made. An incisional biopsy of the lesion was carried out, which unexpectedly revealed the presence of a non-caseating granulomatous inflammatory reaction. A referral was sent to the respiratory medicine team and a diagnosis was later confirmed of stage II sarcoidosis. This case report highlights the need for clinicians to be aware of all possible causes of oral lesions, including rare manifestations of underlying systemic disease.

  1. Clinical monitoring of smooth surface enamel lesions using CP-OCT during nonsurgical intervention.

    PubMed

    Chan, Kenneth H; Tom, Henry; Lee, Robert C; Kang, Hobin; Simon, Jacob C; Staninec, Michal; Darling, Cynthia L; Pelzner, Roger B; Fried, Daniel

    2016-12-01

    Studies have shown that cross-polarization optical coherence tomography (CP-OCT) can be used to image the internal structure of carious lesions in vivo. The objective of this study was to show that CP-OCT can be used to monitor changes in the internal structure of early active carious lesions on smooth surfaces during non-surgical intervention with fluoride. Lesions on the smooth surfaces of teeth were imaged using CP-OCT on 17 test subjects. Lesion structural changes were monitored during fluoride varnish application at 6-week intervals for 30 weeks. The lesion depth (Ld ), integrated reflectivity (ΔR), and surface zone thickness (Sz ) were monitored. A distinct transparent surface zone that may be indicative of lesion arrestment was visible in CP-OCT images on 62/63 lesions before application of fluoride varnish. The lesion depth and internal structure were resolved for all the lesions. The overall change in the mean values for Ld , ΔR, and Sz for all the lesions was minimal and was not significant during the study (P > 0.05). Only 5/63 lesions manifested a significant increase in Sz during intervention. Even though it appears that most of the lesions manifested little change with fluoride varnish application in the 30 weeks of the study, CP-OCT was able to measure the depth and internal structure of all the lesions including the thickness of the important transparent surface zone located at the surface of the lesions, indicating that CP-OCT is ideally suited for monitoring lesion severity in vivo. Lasers Surg. Med. 48:915-923, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Influence of caries detection dye on bond strength of sound and carious affected dentin: An in-vitro study.

    PubMed

    Singh, Udai Pratp; Tikku, Ap; Chandra, Anil; Loomba, Kapil; Boruah, Lalit Chandra

    2011-01-01

    The objective of this study was to evaluate the influence of caries detection dye on the in-vitro tensile bond strength of adhesive materials to sound and carious affected dentin. Forty healthy and carious human molars were ground to expose superficial sound dentin and carious affected dentin. Caries Detector dye was applied to sound and carious affected dentin and rinsed. Subsequently the dentin was etched with 37% phosphoric acid and rinsed leaving a moist dentin surface. The adhesive (Single bond) was applied in single layers and light cured. A posterior composite (Filtek Z 250) were used to prepare the bond strength specimens with a 3 mm in diameter bonding area. Control and experimental groups were made with and without application of dye respectively. Each group includes both sound and carious affected dentin. After 24 hour immersion in distilled water, tensile bond strength (MPa) was measured using an Instron testing machine. Analysis of variance (ANOVA) was used to evaluate the data. The tensile bond strength were significantly less in experimental subgroup than control subgroups. The tensile bond strengths were higher in sound and carious affected dentin without application of caries detection dyes.

  3. Ablation of healthy and carious enamel and dentin by erbium:YAG laser irradiation

    NASA Astrophysics Data System (ADS)

    Roth, Klaus K.; Duczynski, Edwin W.

    1995-04-01

    The purpose of this study was to determine the ablation rates of healthy and carious enamel and dentin on extracted human permanent molars and premolars. Measurements were taken using a flash lamp pumped pulsed 2.94 micrometers CrEr:YAG laser (pulse length 200 microsecond(s) , energy density 2-20 J/cm2, f equals 1-2 Hz). Teeth were cut into slices of 2 mm thickness and the ablation rates of 1450 craters were measured as a function of the energy density and pulse number. Clearly higher degrees of ablation were observed in dentin than in enamel with most effective ablation rates in carious enamel and dentin. Ablation thresholds in enamel, dentin and caries could not be detected. However, it could not be shown that there is any selectivity in caries removal by Erbium:YAG laser radiation.

  4. Cerium chloride reduces enamel lesion initiation and progression in vitro.

    PubMed

    Wegehaupt, F J; Buchalla, W; Sener, B; Attin, T; Schmidlin, P R

    2014-01-01

    Determination of the potential of cerium chloride to reduce artificial carious mineral loss and lesion depth progression. A total of 160 enamel samples were prepared from 40 bovine lower central incisors. Crowns were sectioned into four pieces, embedded in acrylic resin, ground flat and allocated to eight groups (S1-S4 and D1-D4; n = 20). Specimens of groups D1-D4 were stored (for 7 days) in a demineralizing buffer solution to induce caries-like lesions. Afterwards, samples were treated for 30 s with one of the following solutions: placebo (S1 and D1), amine fluoride (S2 and D2), cerium chloride (S3 and D3) and a combination of fluoride and cerium chloride (S4 and D4). After another 7 (D1-D4) or 14 (S1-S4) days in demineralizing buffer solution, integrated mineral loss and lesion depth were determined by transversal microradiography and compared by Scheffé's post hoc tests. In groups S1-S4, the highest values for integrated mineral loss and lesion depth were observed for group S1 (placebo), the lowest values for group S4. The results in groups S2-S4 were not significantly different. In groups D1-D4, the highest values for integrated mineral loss and lesion depth were observed for group D1 (placebo), the lowest values in groups D3 and D4. In group D2, integrated mineral loss and lesion depth were significantly lower as compared to D1, but significantly higher compared to groups D3 and D4. Cerium chloride and its combination with fluoride are able to significantly reduce carious mineral loss and the progression of lesion depth.

  5. Systematic review of noninvasive treatments to arrest dentin non-cavitated caries lesions

    PubMed Central

    de Assunção, Isauremi Vieira; da Costa, Giovanna de Fátima Alves; Borges, Boniek Castillo Dutra

    2014-01-01

    AIM: To systematically review the literature on the efficacy of noninvasive methods of arresting the progression of non-cavitated occlusal carious lesions in dentin. METHODS: The Medline/PubMed, LILACS, SciELO and Scopus databases were searched to identify relevant publications through to November 2013. Only clinical trials evaluating the ability of noninvasive methods to arrest the progression of occlusal non-cavitated carious lesions in dentin were included. Screening, data extraction and quality assessment were conducted independently and in duplicate. RESULTS: Of 167 citations identified, nine full text articles were screened and five were included in the analysis. All papers reported on occlusal fissure sealing using a self-curing glass ionomer (n = 1) or resin-based (n = 4) sealant. Only the use of resin-based sealant to obliterate occlusal fissures arrested the progression of non-cavitated occlusal carious lesions in dentin. CONCLUSION: Occlusal fissure sealing with a resin-based sealant may arrest the progression of non-cavitated occlusal dentinal caries. Further clinical trials with longer follow-up times should be performed to increase scientific evidence. PMID:24868513

  6. Strontium concentrations and isotope ratios in enamel of healthy and carious teeth in southern Shaanxi, China.

    PubMed

    Li, Zixia; He, Maoyong; Peng, Bin; Jin, Zhangdong

    2013-09-15

    As the trace element strontium (Sr) plays a significant role in dental health, it is important to determine the Sr concentration and isotope composition ((87)Sr/(86)Sr) of teeth and whether these values are related to caries formation, age and sex. A total of 160 permanent teeth were collected from 7- to 79-year-old people from the southern Shaanxi area of China, including 100 healthy teeth and 60 carious teeth (men and women each accounted for half of the samples). The concentration and isotope composition of Sr elements in the dental enamel of the teeth were measured using inductively coupled plasma mass spectrometry (ICP-MS) and thermal ionization mass spectrometry (TIMS). A significantly lower Sr concentration was found in the enamel of the carious teeth than in that of the healthy teeth for individuals of varying ages and sex. The Sr concentration in human carious teeth ranged between 79.70 µg/g and 85.80 µg/g; while the Sr concentration in healthy teeth ranged between 128 µg/g and 156.77 µg/g. Our results also demonstrated that the (87)Sr/(86)Sr ratio did not appear to be affected by the caries formation, age or sex. The (87)Sr/(86)Sr ratio in the enamel of the healthy and carious teeth of individuals of varying ages and genders ranged between 0.710935 and 0.711037, which falls into the range of (87)Sr/(86)Sr ratios found in the local, naturally occurring water, soils and rocks. Sr plays a significant role in dental health, and there is a negative correlation between Sr and the occurrence of dental caries. The (87)Sr/(86)Sr ratio of teeth reflects the (87)Sr/(86)Sr ratio of the associated environment, and there is no significant relationship with the frequency of dental caries, age or sex. Copyright © 2013 John Wiley & Sons, Ltd.

  7. Effectiveness of Photogem® activated by LED on the decontamination of artificial carious bovine dentin

    NASA Astrophysics Data System (ADS)

    Giusti, J. S. M.; Santos-Pinto, L.; Pizzolitto, A. C.; Kurachi, C.; Bagnato, V. S.

    2006-05-01

    The aim of this study was the evaluation of the effectiveness of photodynamic therapy on the decontamination of artificially induced carious bovine dentin, using Photogem® as the photosensitizer agent and an LED device as a light source. Dentin samples obtained from bovine incisors were immersed in sterile broth supplemented by Lactobacillus acidophillus 108 colony formation units (CFU) and Streptococcus mutans 108 CFU. Different concentrations of photosensitizer, PA = 1 mg/ml, PB = 2 mg/ml, and PC = 3 mg/ml, and two fluences, D = 24 J/cm2 and D = 48 J/cm2, were investigated. After CFU counting per milligram of carious dentin and statistical analysis, we observed that the photodynamic therapy (PDT) parameters used were effective for bacterial reduction in the in vitro model under study. The best result was achieved with the application of Photogem® at 2 mg/ml and photoactivated under 24 J/cm2 showing a survival factor of 0.14. At higher photosensitizer concentrations, a higher dark toxicity was observed. We propose a simple mathematical expression for the determination of PDT parameters of photosensitizer concentration and light fluence for different survival factor values. Since LED devices are simpler and cheaper compared to laser systems, it would be interesting to verify their efficacy as a light source in photodynamic therapy for the decontamination of carious dentin.

  8. Minimal invasive treatment using 6.02 micrometer DFG laser for carious dentin

    NASA Astrophysics Data System (ADS)

    Awazu, Kunio; Ishii, Katsunori; Saiki, Masayuki; Yasuo, Kenzo; Yamamoto, Kazuyo; Yoshikawa, Kazushi

    2010-11-01

    Conventional laser light sources for the treatment of a hard tissue in dental are good for removal of caries. However these lasers cannot achieve to give a selective treatment effect for caries without a side effect for normal tissue. The objective of this study is to develop the minimal invasive treatment technique of carious dentin by selective absorption effect using the laser with a wavelength of 6.02 μm which corresponds to an absorption peak of organic matters called amide 1 band. Mid-infrared nanosecond pulsed laser by difference-frequency generation was used for the experiment of selective treatment. A tunable wavelength range, pulse width and repetition rate is from 5.5 to 10 μm, 5 ns and 10 Hz, respectively. The laser with a wavelength of 6.02 μm and predetermined energy parameters was irradiated to a carious dentin model. After laser irradiation, the surface and cross-sectional surface of samples were observed. Average power density about 15 W/cm2 realized to excavate a demineralized region selectively. In the same energy condition, serious side effect was not observed on the surface of normal dentin. A wavelength of 6.02 μm realizes a selective excavation of carious dentin. Using 6.02 μm is a novel and promising technique toward to next-generation dental treatment procedure for realizing minimal intervention.

  9. Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth.

    PubMed

    Hegde, Swaroop; Sowmya, B; Mathew, Sylvia; Bhandi, Shilpa H; Nagaraja, Shruthi; Dinesh, K

    2017-01-01

    Root canal treatment has been a routine treatment option for carious exposure of the dental pulp. In the context of minimally invasive dentistry, direct pulp capping (DPC) procedure with a reliable biomaterial may be considered as an alternative provided the pulp status is favorable. Mineral trioxide aggregate (MTA), a bioactive cement with excellent sealing ability and biocompatibility is capable of regenerating relatively damaged pulp and formation of dentin bridge when used as DPC agent. Biodentine is comparatively a new biomaterial claimed to possess properties similar to MTA and is currently explored for vital pulp therapy procedures. The aim of the present study was to evaluate the clinical response of pulp-dentin complex after DPC with MTA and biodentine in carious teeth. Twenty-four permanent molars with carious exposure having no signs and symptoms of irreversible pulpitis were selected and assigned to one of the two groups, Group I - MTA and Group II - biodentine. Patients were recalled at 3 weeks, 3 months, and 6 months for clinical and radiographic evaluation. Fisher's exact test was used along with Chi-square test for statistical analysis. Over a period of 6 months, MTA and biodentine showed 91.7% and 83.3% success rate, respectively, based on the subjective symptoms, pulp sensibility tests, and radiographic appearance. MTA and biodentine may be used as DPC agents when the pulpal diagnosis is not more than reversible pulpitis.

  10. Clinical evaluation of mineral trioxide aggregate and biodentine as direct pulp capping agents in carious teeth

    PubMed Central

    Hegde, Swaroop; Sowmya, B.; Mathew, Sylvia; Bhandi, Shilpa H.; Nagaraja, Shruthi; Dinesh, K.

    2017-01-01

    Background: Root canal treatment has been a routine treatment option for carious exposure of the dental pulp. In the context of minimally invasive dentistry, direct pulp capping (DPC) procedure with a reliable biomaterial may be considered as an alternative provided the pulp status is favorable. Mineral trioxide aggregate (MTA), a bioactive cement with excellent sealing ability and biocompatibility is capable of regenerating relatively damaged pulp and formation of dentin bridge when used as DPC agent. Biodentine is comparatively a new biomaterial claimed to possess properties similar to MTA and is currently explored for vital pulp therapy procedures. Aim: The aim of the present study was to evaluate the clinical response of pulp-dentin complex after DPC with MTA and biodentine in carious teeth. Subjects and Methods: Twenty-four permanent molars with carious exposure having no signs and symptoms of irreversible pulpitis were selected and assigned to one of the two groups, Group I - MTA and Group II - biodentine. Patients were recalled at 3 weeks, 3 months, and 6 months for clinical and radiographic evaluation. Fisher's exact test was used along with Chi-square test for statistical analysis. Results: Over a period of 6 months, MTA and biodentine showed 91.7% and 83.3% success rate, respectively, based on the subjective symptoms, pulp sensibility tests, and radiographic appearance. Conclusion: MTA and biodentine may be used as DPC agents when the pulpal diagnosis is not more than reversible pulpitis. PMID:28855754

  11. The deep penetrating nevus.

    PubMed

    Strazzula, Lauren; Senna, Maryanne Makredes; Yasuda, Mariko; Belazarian, Leah

    2014-12-01

    The deep penetrating nevus (DPN), also known as the plexiform spindle cell nevus, is a pigmented lesion that commonly arises on the head and neck in the first few decades of life. Histopathologically, the DPN is wedge-shaped and contains melanocytes that exhibit deep infiltration into the dermis. Given these features, DPN may clinically and histopathologically mimic malignant melanoma, sparking confusion about the appropriate evaluation and management of these lesions. The goal of this review is to summarize the clinical and histopathological features of DPN and to discuss diagnostic and treatment strategies for dermatologists.

  12. Mixed periapical lesion: differential diagnosis of a case.

    PubMed

    Krithika, C; Kota, S; Gopal, K S; Koteeswaran, D

    2011-03-01

    A radicular cyst associated with carious teeth is a very common odontogenic lesion in the oral cavity, but calcifications in residual radicular cysts are quite rare. We report one such case where a routine pre-implant radiographic assessment revealed a mixed periapical radiopaque radiolucent lesion in the right maxillary central incisor region. Histological and radiographic studies show that there is a slow increase in the mineralized deposits within the cyst lumen with time. This becomes prominent histochemically in cysts more than 8 years old and radiographically 6 years later, as seen in our case. In this paper we would like to highlight the importance of a residual radicular cyst with calcifications in the differential diagnosis of a mixed periapical radiopaque radiolucent lesion.

  13. Mixed periapical lesion: differential diagnosis of a case

    PubMed Central

    Krithika, C; Kota, S; Gopal, KS; Koteeswaran, D

    2011-01-01

    A radicular cyst associated with carious teeth is a very common odontogenic lesion in the oral cavity, but calcifications in residual radicular cysts are quite rare. We report one such case where a routine pre-implant radiographic assessment revealed a mixed periapical radiopaque radiolucent lesion in the right maxillary central incisor region. Histological and radiographic studies show that there is a slow increase in the mineralized deposits within the cyst lumen with time. This becomes prominent histochemically in cysts more than 8 years old and radiographically 6 years later, as seen in our case. In this paper we would like to highlight the importance of a residual radicular cyst with calcifications in the differential diagnosis of a mixed periapical radiopaque radiolucent lesion. PMID:21346087

  14. Two pre-treatments for bonding to non-carious cervical root dentin.

    PubMed

    Flury, Simon; Peutzfeldt, Anne; Lussi, Adrian

    2015-12-01

    To investigate the effect of airborne-particle abrasion or diamond bur preparation as pre-treatment steps of non-carious cervical root dentin regarding substance loss and bond strength. 45 dentin specimens-produced from crowns of extracted human incisors by grinding the labial surfaces with silicon carbide papers (control) were treated with one of three adhesive systems (Group 1A-C; A: OptiBond FL, B: Clearfil SE Bond, or C: Scotchbond Universal; n= 15/adhesive system). Another 135 dentin specimens (n = 15/group) produced from the labial, non-carious cervical root part of extracted human incisors were treated with one of the adhesive systems after either no pre-treatment (Group 2A-C), pre-treatment with airborne-particle abrasion (CoJet Prep and 50 µm aluminum oxide powder; Group 3A-C), or pre-treatment with diamond bur preparation (40 µm grit size; Group 4A-C). Substance loss caused by the pre-treatment was measured in Groups 3 and 4. After treatment with the adhesive systems, resin composite was applied and all specimens were stored (37°C, 100% humidity, 24 hours) until measurement of micro-shear bond strength (µSBS). Data were analyzed with a nonparametric ANOVA followed by Kruskal-Wallis and Wilcoxon rank sum tests (level of significance: α = 0.05). Overall substance loss was significantly lower in Group 3 (median: 19 µm) than in Group 4 (median: 113 µm; P < 0.0001). There were no significant differences in µSBS between the adhesive systems (A-C) in Group 1, Group 3, and Group 4 (P 0.133). In Group 2, OptiBond FL (Group 2A) and Clearfil SE Bond (Group 2B) yielded significantly higher µSBS than Scotchbond Universal (Group 2C; P ≤ 0.032). For OptiBond FL and Clearfil SE Bond, there were no significant differences in µSBS between the ground crown dentin and the non-carious cervical root dentin regardless of any pre-treatment of the latter (both P = 0.661). For Scotchbond Universal, the µSBS to non-carious cervical root dentin without pre-treatment was

  15. Molecular and Histological Association Between Candida albicans from Oral Soft Tissue and Carious Dentine of HIV-Positive Children.

    PubMed

    Blignaut, Elaine; van Heerden, Willie F P

    2015-10-01

    Candida albicans and caries are frequently investigated among healthy and immunosuppressed individuals. The objective of this study was to demonstrate the presence of C. albicans on both oral soft and hard tissue and to investigate, at molecular level, the genetic subtype of the organism from the two oral sites. Tongue swabs and dentine scrapings from 362 HIV-positive children, referred for the extraction of carious primary teeth, were cultured on CHROMagar and identified to species level with ID32C. Histological staining of extracted carious teeth was also done. In patients with positive C. albicans cultures from both the tongue and carious dentine, DNA fingerprinting of such paired isolates was performed, using Southern blot hybridisation with the Ca3 probe. Yeasts were cultured from the tongue of 151 (41.7 %) individuals and 57 (37.7 %) simultaneously yielded positive C. albicans cultures from carious dentine. Nine different yeast spp. were identified from the tongue using the ID32C commercial system, but C. albicans was the only species recovered from carious dentine and histological investigation demonstrated fungal elements penetrated into the dentine and not limited to superficial debris on the floor of the cavity. Twelve of 13 paired isolates of C. albicans revealed identical fingerprinting patterns. The findings from this study demonstrated that in a particular individual, the same genetic subtype of C. albicans was capable of colonising both oral soft tissue and carious dentine. This renders carious teeth a constant source, or reservoir, of potentially infectious agents and, particularly among immunosuppressed individuals, should therefore not be left unattended.

  16. Laser-induced breakdown spectroscopy of dental lesions: diagnostic and therapeutic monitoring tool

    NASA Astrophysics Data System (ADS)

    Borisova, Ekaterina; Uzunov, Tzonko; Penev, Dimitar; Genova, Tsanislava; Avramov, Latchezar

    2016-01-01

    The carious decay develops a tiny area of demineralization on the enamel, which could be detected by element analytic techniques such as laser-induced breakdown spectroscopy (LIBS). That demineralization can quickly turn into a large lesion inside the tooth, it is often discovered too late to prevent the kind of decay that leads to cavities. The same optical LIBS detection approach could be used for monitoring of the caries removal using laser ablation or drilling techniques. For LIBS measurements we applied LIBS 2500Plus (Ocean Optics Inc., Dunedin, USA) system, which consists of seven spectrometric channels, covering spectral region from 200 to 980 nm, which optical resolution 0,05 nm, the spectrometers are connected with sample fiber bundle for 7-channels spectral system to the chamber for solid and liquid samples, Q-switched Nd:YAG laser, at 1 064 nm, with energy per pulse - 40 mJ, which is applied to induce plasma in the samples. LIBS spectra were obtained after single shot of the laser in the region of pathology. Samples investigated by LIBS are extracted teeth from patients, with periodontal problems on different stage of carious lesions, and their LIBS spectra are compared with the LIBS signals obtained from normal enamel and dentine tissues to receive complete picture of the carious lesion development. The major line of our investigations is related to the development of a methodology for real-time optical feedback control during selective ablation of tooth tissues using LIBS. Tooth structures, with and without pathological changes, are compared and their LIBS element analysis is used to differentiate major changes, which occur during tooth carious process and growth.

  17. Effect of lateral excursive movements on the progression of abfraction lesions.

    PubMed

    Wood, Ian David; Kassir, Ali Sabet Abbas; Brunton, Paul Anthony

    2009-01-01

    The theory of abfraction suggests that tooth flexure arising from occlusal loads causes the formation and progression of abfraction lesions. The current study investigated whether reducing occlusal loading by adjusting the occlusion on a tooth during lateral excursive movements had any effect on the rate of progression of existing abfraction lesions. Recruited were 39 subjects who had two non-carious cervical lesions in the maxillary arch that did not need restoration and were in group function during lateral excursive movements of the mandible. One of the teeth was randomly selected to have the excursive occlusal contacts reduced by using a fine grain diamond bur. Centric occlusal contacts were not reduced. Impressions of the lesion were taken over a 30-month period to enable monitoring of the wear rate, and duplicate dies were poured into epoxy resin to allow for sectioning. The size of the lesions was measured using stereomicroscopic analysis of the sectioned epoxy resin dies, and the results were analyzed using an Independent t-test. No statistically significant difference in wear rates between the adjusted and non-adjusted teeth was found (p > 0.05). Within the limitations of the current study, it was concluded that occlusal adjustment does not appear to halt the progression of non-carious cervical lesions; consequently, this procedure cannot be recommended.

  18. Selective excavation of human carious dentin using the nanosecond pulsed laser in 5.8-μm wavelength range

    NASA Astrophysics Data System (ADS)

    Kita, Tetsuya; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    Less-invasive treatment of caries has been needed in laser dentistry. Based on the absorption property of dentin substrates, 6 μm wavelength range shows specific absorptions and promising characteristics for the excavation. In our previous study, 5.8 μm wavelength range was found to be effective for selective excavation of carious dentin and restoration treatment using composite resin from the irradiation experiment with bovine sound and demineralized dentin. In this study, the availability of 5.8 μm wavelength range for selective excavation of human carious dentin was investigated for clinical application. A mid-infrared tunable nanosecond pulsed laser by difference-frequency generation was used for revealing the ablation property of human carious dentin. Irradiation experiments indicated that the wavelength of 5.85 μm and the average power density of 30 W/cm2 realized the selective excavation of human carious dentin, but ablation property was different with respect to each sample because of the different caries progression. In conclusion, 5.8 μm wavelength range was found to be effective for selective excavation of human carious dentin.

  19. Microbiological characterization and effect of resin composites in cervical lesions

    PubMed Central

    Carlo, Bonfanti; Piccinelli, Giorgio; Faus-Matoses, Vicente; Cerutti, Antonio

    2017-01-01

    Background Non carious cervical lesions associated to muscle hyperfunctions are increasing. Microhybrid resin composites are used to restore cervical abfractions. The purpose of this study was to investigate if resin composites modify tooth plaque, inducing an increment of cariogenic microflora and evaluate their effect, in vivo and in vitro, against S. mutans. Material and Methods Eight abfractions were restored with two microhybrid resin composites (Venus, Heraeus-Kulzer® and Esthet-X, Dentsply®), after gnatological therapy, in three patients with muscle hyperfunctions. For each abfraction three samples of plaque were taken from the cervical perimeter: before the restoration, one week and three months after restoration. The samples were evaluated both by traditional microbiological methods and by Polymerase Chain Reaction (PCR). In vitro, disk-shaped specimens of the two composites were prepared to estimate the effects against pre-cultured S. mutans, after incubation at 37°C for 24h and assessed by a turbidimetric technique. Results In vivo no differences were found in plaque growth, for all samples, before and after restoration with both composites; in vitro, instead, a significant reduction of S. mutans growth was found between specimens of two composites (Mann-Whitney U-test p>0,06). Conclusions In this study a relevant consideration was elicited: composite materials, in vivo, do not modify plaque composition of non carious cervical lesions to a potential cariogenic plaque. Key words:Abfraction, restoration, S. mutans, composite, class V. PMID:28149461

  20. Repair of artificial lesions using an acidic remineralization model monitored with cross-polarization optical coherence tomography

    NASA Astrophysics Data System (ADS)

    Kang, Hobin; Darling, Cynthia L.; Fried, Daniel

    2011-03-01

    It is difficult to completely remineralize carious lesions because diffusion into the interior of the lesion is inhibited as new mineral is deposited in the outermost layers. In previous remineralization studies employing polarization sensitive optical coherence tomography (PS-OCT), two models of remineralization were employed and in both models there was preferential deposition of mineral in the outer most layer. In this study we attempted to remineralize the entire lesion using an acidic remineralization model and demonstrate that this remineralization can be monitored using PS-OCT. Artificial lesions approximately 100-150 μm in-depth were exposed to an acidic remineralization regimen and the integrated reflectivity from the lesions was measured before and after remineralization. Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Although there was a higher degree of remineralization, there was still incomplete remineralization of the body of the lesion.

  1. Pink lesions.

    PubMed

    Giacomel, Jason; Zalaudek, Iris

    2013-10-01

    Dermoscopy (dermatoscopy or surface microscopy) is an ancillary dermatologic tool that in experienced hands can improve the accuracy of diagnosis of a variety of benign and malignant pigmented skin tumors. The early and more accurate diagnosis of nonpigmented, or pink, tumors can also be assisted by dermoscopy. This review focuses on the dermoscopic diagnosis of pink lesions, with emphasis on blood vessel morphology and pattern. A 3-step algorithm is presented, which facilitates the timely and more accurate diagnosis of pink tumors and subsequently guides the management for such lesions.

  2. Caries detection and diagnosis, sealants and management of the possibly carious fissure.

    PubMed

    Deery, C

    2013-06-01

    The diagnosis and management of 'stained' or possibly carious pits and fissures is a difficult clinical problem. Historically, clinicians have restoratively intervened at an early stage because of concern that caries will progress unless completely removed and a restoration placed. However, this approach is destructive of tooth tissue and in the longer term may compromise the tooth as it enters the restoration re-restoration cycle. This paper aims to update the reader on developments in sealant technology and the use of sealants in caries prevention and management with an emphasis on the options available to manage the questionable fissure.

  3. Optical Spectroscopy Study of Transparent Non-Carious Human Dentin and Dentin-Enamel Junction

    SciTech Connect

    Marshall, G.W.; Marshall, S.J.; Gallagher, R.R.; Demos, S.

    1999-12-14

    Improving our knowledge of the morphology, composition and properties of the dentin, enamel, and the dentin-enamel junction (DEJ) is vital for the development of improved restorative materials and clinical placement techniques. Most studies of dental tissues have used light microscopy for characterization. In our investigation, the spectroscopic properties of normal and non-carious transparent human root dentin, and the dentin-enamel junction were investigated using emission imaging microscopy, and micro-spectroscopy. Experimental results reveal new information on the structural and biochemical characteristics of these dental tissues.

  4. Treatment of cariously involved fused maxillary primary lateral and central incisors.

    PubMed

    ElBadrawy, H E; Diab, M

    2001-01-01

    A 3-and-a-half-year-old male child presented with fused cariously involved right maxillary primary central and lateral incisors as well as a previously traumatized non-vital left primary central incisor with a draining fistula. The child also had other restorative needs and the decision taken was to address all needs under a G.A. With respect to the fused incisors, these were split and root canals treatment was performed for all three incisors which were then restored with stainless steel crowns with esthetic facings.

  5. Silver diamine fluoride (SDF) may be better than fluoride varnish and no treatment in arresting and preventing cavitated carious lesions.

    PubMed

    Beltrán-Aguilar, Eugenio D

    2010-06-01

    Silver diamine fluoride: A caries "silver-fluoride bullet." Rosenblatt A, Stamford TCM, Niederman R. J Dent Res 2009;88(2):116-25. Eugenio D. Beltrán-Aguilar, DMD, MPH, MS, DrPH, Diplomate ABDPH PURPOSE/QUESTION: The authors conducted a systematic review of clinical studies on the effectiveness of silver diamine fluoride to arrest and prevent dental caries at the cavitated level. NIH Grant (DOI:10.1177/0022034508329406) Systematic review Level 2: Limited-quality patient-oriented evidence STRENGTH OF THE RECOMMENDATION GRADE: Grade B: Limited-quality patient-oriented evidence.

  6. Resin infiltration of deproteinised natural occlusal subsurface lesions improves initial quality of fissure sealing

    PubMed Central

    Kielbassa, Andrej M; Ulrich, Ina; Schmidl, Rita; Schüller, Christoph; Frank, Wilhelm; Werth, Vanessa D

    2017-01-01

    The aim of this ex vivo study was to evaluate the infiltration capability and rate of microleakage of a low-viscous resin infiltrant combined with a flowable composite resin (RI/CR) when used with deproteinised and etched occlusal subsurface lesions (International Caries Detection and Assessment System code 2). This combined treatment procedure was compared with the exclusive use of flowable composite resin (CR) for fissure sealing. Twenty premolars and 20 molars revealing non-cavitated occlusal carious lesions were randomly divided into two groups and were meticulously cleaned and deproteinised using NaOCl (2%). After etching with HCl (15%), 10 premolar and 10 molar lesions were infiltrated (Icon/DMG; rhodamine B isothiocyanate (RITC)-labelled) followed by fissure sealing (G-ænial Flo/GC; experimental group, RI/CR). In the control group (CR), the carious fissures were only sealed. Specimens were cut perpendicular to the occlusal surface and through the area of the highest demineralisation (DIAGNOdent pen, KaVo). Using confocal laser-scanning microscopy, the specimens were assessed with regard to the percentage of caries infiltration, marginal adaption and internal integrity. Within the CR group, the carious lesions were not infiltrated. Both premolar (57.9%±23.1%) and molar lesions (35.3%±22.1%) of the RI/CR group were uniformly infiltrated to a substantial extent, albeit with significant differences (P=0.034). Moreover, microleakage (n=1) and the occurrence of voids (n=2) were reduced in the RI/CR group compared with the CR group (5 and 17 specimens, respectively). The RI/CR approach increases the initial quality of fissure sealing and is recommended for the clinical control of occlusal caries. PMID:28621326

  7. Support for the role of Candida spp. in extensive caries lesions of children.

    PubMed

    Signoretto, Caterina; Burlacchini, Gloria; Faccioni, Fiorenzo; Zanderigo, Massimiliano; Bozzola, Nicolò; Canepari, Pietro

    2009-01-01

    Candida spp. are frequently detected in the mouths of children with extensive caries lesions compared with caries-free subjects. In this study we evaluated the presence of Candida spp. in association with mutans streptococci and lactobacilli in the saliva of children with dental decay, before and after anti-caries treatment. Samples of saliva from 14 children with caries lesions and from 13 caries-free subjects were evaluated for the presence of mutans streptococci, lactobacilli and Candida spp. by culture. Eleven of 14 carious subjects hosted Candida spp. in their saliva as against only 2 out of 13 subjects without caries lesions. Carious subjects were treated by adopting a conventional protocol for caries disease (rinses with a mouthwash containing 0.2% chlorhexidine and fluorine). After treatment, the salivary bacterial counts decreased for mutans streptococci and in some cases for lactobacilli, but large numbers of Candida spp. remained in the saliva of several children. The latter were treated with the antifungal drug nystatin (oral rinses) and evaluation of the level of yeasts in the saliva showed disappearance of the microorganism in several cases. The results indicate that antiseptic treatment alone for dental decay is not sufficient for the eradication of microorganisms potentially responsible for caries lesions, in particular when yeasts are present. We hypothesize that the oral cavity of children could act as a reservoir of fungi, and eradication could be needed to prevent both exacerbation of caries lesions, and colonization by Candida spp. of other host sites.

  8. Pulpotomy versus pulpectomy for carious vital primary incisors: randomized controlled trial.

    PubMed

    Howley, Brega; Seale, N Sue; McWhorter, Alton G; Kerins, Carolyn; Boozer, Kent B; Lindsey, Donna

    2012-01-01

    The purpose of this prospective, randomized, split-mouth investigation was to compare the success rates of formocresol pulpotomies (FC) and Vitapex(®) pulpectomies (RCT) in asymptomatic carious vital primary incisors. Matched contralateral pairs of asymptomatic, carious, vital primary incisors were randomized to receive FC or RCT by 2 standardized operators and restored with stainless steel crowns. Seventy-four incisors were followed clinically and radiographically for up to 23 months. Two standardized examiners evaluated radiographic findings using separate pulpotomy and pulpectomy scales (modified Zurn/Seale). Incisors present at each interval (5-9, 10-14, and 15-23 months) showed no clinical failures. One FC incisor was lost early and counted as a failure. Though not significantly different, there were higher numbers of successful radiographic outcomes for FC than RCT at each observation interval. Cumulative final radiographic success was 89% (n=33) for FC and 73% (n=27) for RCT. (P=.11). Anecdotal claims that pulpotomies are unsuccessful in primary incisors are unfounded. There was no significant difference in success rates of pulpotomies and pulpectomies in the pulp treatment of asymptomatic vital primary incisors. Intracanal resorption of Vitapex(®) was seen in all pulpectomy teeth and did not affect pulpectomy outcome.

  9. Imaging simulated secondary caries lesions with cross polarization OCT

    NASA Astrophysics Data System (ADS)

    Stahl, Jonathan; Kang, Hobin; Fried, Daniel

    2010-02-01

    The clinical diagnosis of secondary caries has been found to account for the replacement of the majority of intra-coronal restorations. Current methods to diagnose the presence of these lesions at early stages are considered insufficient due to their low sensitivity. Polarization-sensitive optical coherence tomography (PS-OCT) imaging studies have confirmed its effectiveness for imaging carious subsurface lesions in enamel and dentin. The objective of this study was to determine if PS-OCT can be used to nondestructively image demineralization through resin restorations on extracted teeth with both simulated and natural lesions. Simulated secondary caries lesions were created by exposing cavity preparations made in extracted human teeth to a demineralizing solution for 48 hours and subsequently restoring with resin. Negative control restorations were also prepared on each tooth. Optical changes in demineralized versus control preparations beneath restorations were measured as a function of depth using PS-OCT. PS-OCT images indicated that a significant increase in reflectivity and depth occurred in the simulated lesions compared with the control preparations. This study suggests that PS-OCT is well-suited to nondestructively detect early caries lesions in enamel beneath composite restorations.

  10. Comparative study of substance P and neurokinin A in gingival crevicular fluid of healthy and painful carious permanent teeth

    PubMed Central

    Heidari, Alireza; Shahrabi, Mahdi; Rokouei, Mehrak; Amirzargar, Aliakbar; Rahbar, Pegah

    2017-01-01

    Background: It is shown that neuropeptides can be transported from pulp chamber to periodontal ligament through apical foramen and accessory canals. Therefore, clinical pulpal pain leads to expression of preinflammatory neuropeptides such as substance P (SP) and neurokinin A (NKA) in gingival crevicular fluid (GCF). This study aimed to evaluate levels of SP and NKA in GCF of carious and healthy permanent teeth, comparatively. Materials and Methods: This cross-sectional study was performed on twenty children referred to Department of Pediatric Dentistry, Tehran University of Medical Sciences, who had a painful permanent first molar. Sampling was done by sterile paper cone from GCF of the mentioned teeth and the intact tooth of the other side of the jaw in the same patient. Values of SP and NKA were measured by ELISA test. Results: The mean concentration of SP in GCF of painful carious and healthy teeth was 2.65 ± 0.56 and 1.83 ± 0.65 pcgr/ml, respectively. This value was 2.29 ± 0.29 and 1.61 ± 0.35 pcgr/ml for NKA concentration in carious and healthy teeth as well. Conclusion: Significant higher levels of both SP and NKA in GCF of painful carious teeth were observed, which is in line with previous studies’ findings. PMID:28348619

  11. Comparative study of substance P and neurokinin A in gingival crevicular fluid of healthy and painful carious permanent teeth.

    PubMed

    Heidari, Alireza; Shahrabi, Mahdi; Rokouei, Mehrak; Amirzargar, Aliakbar; Rahbar, Pegah

    2017-01-01

    It is shown that neuropeptides can be transported from pulp chamber to periodontal ligament through apical foramen and accessory canals. Therefore, clinical pulpal pain leads to expression of preinflammatory neuropeptides such as substance P (SP) and neurokinin A (NKA) in gingival crevicular fluid (GCF). This study aimed to evaluate levels of SP and NKA in GCF of carious and healthy permanent teeth, comparatively. This cross-sectional study was performed on twenty children referred to Department of Pediatric Dentistry, Tehran University of Medical Sciences, who had a painful permanent first molar. Sampling was done by sterile paper cone from GCF of the mentioned teeth and the intact tooth of the other side of the jaw in the same patient. Values of SP and NKA were measured by ELISA test. The mean concentration of SP in GCF of painful carious and healthy teeth was 2.65 ± 0.56 and 1.83 ± 0.65 pcgr/ml, respectively. This value was 2.29 ± 0.29 and 1.61 ± 0.35 pcgr/ml for NKA concentration in carious and healthy teeth as well. Significant higher levels of both SP and NKA in GCF of painful carious teeth were observed, which is in line with previous studies' findings.

  12. Antibacterial Activity of Two Chemomechanical Caries Removal Gels on Carious Dentin of Primary Teeth: An in vitro Study.

    PubMed

    Gulzar, Shabnam; Arora, Ruchi; Shah, Altaf H; Bhardwaj, Bhupendra; Abusalim, Ghadah; Khalil, Hesham S; Wyne, Amjad H

    2016-12-01

    Chemomechanical caries removal (CMCR) is an effective method of caries removal especially for primary teeth as they cause less discomfort when compared with conventional caries removal. The most significant thing about caries removal is the elimination of cariogenic bacteria. This study compares the antibacterial activity of two CMCR gels. A total of 40 primary molar teeth with carious dentin were split along the long axis in a laboratory. Total viable count (TVC) was taken for the teeth before splitting as a measure of colony-forming units per milliliter (CFU/mL). Each half was treated with either Carisolv or Carie-Care CMCR gels. Clean dentin samples were evaluated for Streptococcus mutans (SM) and Lactobacillus acidophilus (LB) after removal of carious tissue using the caries removal gels using serial dilutions and incubating on specific agar plates. The results showed significant reduction in mean TVC after use of both the CMCR gels. Both gels reduced the CFU/mL of SM and LB to a significant level (p < 0.05). However, there was no significant difference between the antibacterial activities of the two CMCR gels. The CMCR gels (Carisolv and Carie-Care) significantly reduced the residual TVC as well as SM and LB in carious primary dentin. Both CMCR gels had a similar antibacterial activity on the carious dentin of primary teeth. The CMCR gels tested have a significant antibacterial activity and can be effectively used for elimination of caries-causing bacteria in primary teeth.

  13. SEM-EDX analysis of brushing abrasion of chitosan and propolis based toothpastes on sound and artificial carious primary enamel surfaces.

    PubMed

    Ozalp, Serife; Tulunoglu, Ozlem

    2014-09-01

    The objective of this study was to assess the brushing abrasion effects of toothpastes containing chitosan and propolis on sound and demineralized primary tooth enamel. Pairs of enamel specimens were prepared from human extracted primary teeth, embedded in epoxy resin and polished. An artificial subsurface lesion was created in one specimen from each pair. All samples were divided into four groups (Chitodent, Aagaard propolis, Elmex, and Control) and brushed with slurry of toothpastes and artificial saliva in a brushing machine. The brushing abrasion depths were evaluated using computer-guided optical profilometry. No significant differences existed in terms of brushing depths between artificial carious enamel and brushed sound enamel specimens (P>0.05). The abrasion values of the sound enamel samples brushed with Aagaard propolis and control samples were significantly lower than the Elmex group (P<0.05). The lowest brushing abrasion values of demineralized enamel specimens were observed in the Chitodent group (P>0.05). The tested toothpastes exhibited similar effects in terms of brushing abrasion on both sound and artificially demineralized enamel. Based on mean values without statistical significance, the lowest brushing abrasion values in the demineralized brushed enamel samples were detected in the Chitodent group. © 2013 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Remineralization of early enamel caries lesions using different bioactive elements containing toothpastes: An in vitro study.

    PubMed

    Wang, Yu; Mei, Li; Gong, Lin; Li, Jialing; He, Shaowei; Ji, Yan; Sun, Weibin

    2016-09-14

    Demineralization can be arrested or reversed when remineralization agents are applied to incipient carious or non-cavitated carious lesions. A large number of therapeutic agents including non-fluoridated products have been developed to promote enamel remineralization. This study aims to evaluate the efficacy of different bioactive elements containing toothpastes in remineralization of artificial enamel lesions. Artificial carious lesions were created on 40 human enamel slabs, and were randomly divided into four groups: (1) control group (no treatment), (2) casein phosphopeptide-amorphous calcium phosphate group (CPP-ACP, GC Tooth Mousse), (3) 8% arginine and calcium carbonate group (ACC, Colgate Sensitive Pro-Relief), (4) calcium sodium phosphosilicate group (CSP, NovaMin®). All samples were subjected to 15 days of pH-cycling. Subsequently, a one-hour acid resistance test was carried out. Surface hardness of the samples was assessed using the Knoop hardness test, and surface morphology and roughness were assessed by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Data were analyzed using one-way ANOVA, Tukey's test and paired t test. The three tested toothpastes exhibited a significantly higher remineralization efficacy compared with the control group (P< 0.05 for all). After pH-cycling, the specimens treated with Colgate Sensitive Pro-Relief and NovaMin® showed a significant higher surface hardness (P< 0.001 and P= 0.03, respectively) and lower surface roughness (P< 0.05 for both) compared those treated with GC Tooth Mousse. While after the acid resistance test, all groups showed a significant loss of surface hardness (P< 0.001 for all) and significant increase of surface roughness (P< 0.05). The specimens treated with Colgate Sensitive Pro-Relief and NovaMin® still showed a significant higher surface hardness and lower surface roughness in comparison with those treated with GC Tooth Mousse (P< 0.05 for all). No significant difference was

  15. Alternative rubber dam isolation technique for the restoration of Class V cervical lesions.

    PubMed

    Owens, Barry M

    2006-01-01

    This article describes an expedited, atraumatic technique of restoring cervical abrasion-erosion, abfraction or carious lesions using an alternative placement sequence of the dental rubber dam for adequate field isolation. As shown by this technique, the rubber dam retainer is modified and positioned on the tooth with subsequent placement of the dental dam material over theretainer and tooth. This technique saves time and provides good retraction of the gingival tissue and isolation of the cavity preparation from contamination (saliva, hemorrhage) that can potentially cause post-operative symptoms and possible restoration replacement.

  16. Optical Assessment of Caries Lesion Structure and Activity

    NASA Astrophysics Data System (ADS)

    Lee, Robert Chulsung

    technology will be employed for the detection and monitoring of early carious lesions without the use of ionizing radiation, thereby enabling conservative non-surgical intervention and the preservation of healthy tissue structure.

  17. Selective removal of carious dentin using a nanosecond pulsed laser with a wavelength of 6.02 μm

    NASA Astrophysics Data System (ADS)

    Ishii, Katsunori; Saiki, Masayuki; Yasuo, Kenzo; Yamamoto, Kazuyo; Yoshikawa, Kazushi; Awazu, Kunio

    2010-04-01

    Conventional laser light sources for the treatment of a hard tissue in dental (Er:YAG laser, Er,Cr:YSGG laser and CO2 laser etc.) are good for removal of caries. However these lasers cannot achieve to give a selective treatment effect for caries without a side effect for normal tissue. The objective of this study is to develop the less-invasive treatment technique of carious dentin by selective absorption effect using the laser with a wavelength of 6.02 μm which corresponds to an absorption peak of organic matters called amide 1 band. Mid-infrared nanosecond pulsed laser by difference-frequency generation was used for the experiment of selective treatment. A tunable wavelength range, pulse width and repetition rate is from 5.5 to 10 μm, 5 ns and Hz, respectively. The laser with a wavelength of 6.02 μm and predetermined energy parameters was irradiated to the plate of carious dentin model which is made by soaking in lactic acid solution. After laser irradiation, the surface and cross-sectional surface of samples were observed by a scanning electron microscope (SEM). Average power density about 15 W/cm2 realized to excavate a demineralized region (carious dentin model) selectively in a SEM observation. In the same energy condition, serious side effect was not observed on the surface of normal dentin. A wavelength of 6.02 μm realizes a selective excavation of carious dentin. Using 6.02 μm is a novel and promising technique toward to next-generation dental treatment procedure for realizing MI.

  18. The iontophoresis of lignocaine with epinephrine into carious dentine for pain control during cavity preparation in human molars.

    PubMed

    Smitayothin, The Late Korporn; Vongsavan, Kadkao; Rirattanapong, Praphasri; Kraivaphan, Petcharat; Vongsavan, Noppakun; Matthews, Bruce

    2015-08-01

    To determine the effectiveness of the iontophoretic delivery of lignocaine with epinephrine through carious dentine for pain control during cavity preparation. The experiments were carried out on 56 carious molars that required class I restorations in 42 subjects (aged 15-20 years). The overhanging enamel and soft caries were removed then the sensitivity of the exposed dentine was tested with drilling, probing and air blast stimuli. The subject indicated the intensity of any pain produced by marking a visual analogue scale (VAS). The cavity was then filled with 20% w/v lidocaine with 0.1% w/v epinephrine and a 200 μA iontophoretic current applied for 2 min after which the sensitivity of the dentine was re-tested. If the dentine was not anaesthetized, the treatment and testing were repeated up to 6 times. The total duration (min) of iontophoresis required to anaesthetize the dentine was: 2 in 7 teeth, 4 in 17 teeth, 6 in 14 teeth, 8 in 4 teeth, and 10 in 7 teeth. The remaining 7 teeth were not anaesthetized even after 14 min of iontophoresis. The iontophoretic delivery of lignocaine with epinephrine anaesthetized dentine for cavity preparation in 49 of 56 (87.5%) of carious molars. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Treatment Outcomes of Mineral Trioxide Aggregate Pulpotomy in Vital Permanent Teeth with Carious Pulp Exposure: The Retrospective Study.

    PubMed

    Linsuwanont, Pairoj; Wimonsutthikul, Kongthum; Pothimoke, Uht; Santiwong, Busayarat

    2017-02-01

    This study aimed to illustrate the treatment outcomes of mineral trioxide aggregate (MTA) pulpotomy in vital permanent teeth with carious pulp exposure. MTA pulpotomy was performed in 66 vital permanent teeth with carious pulp exposure including teeth with signs and symptoms of irreversible pulpitis and the presence of periapical radiolucency. Patients were assessed for clinical and radiographic outcomes by 2 examiners. The relationship between treatment outcomes and factors was analyzed by means of univariate analysis and binary logistic regression. Fifty patients (a total of 55 teeth) attended the follow-up examination. The age of the patients ranged from 7-68 years old (mean = 29 years old). For the follow-up period as far as 62 months, 48 teeth showed successful outcomes (success rate = 87.3%). Teeth with clinical signs of irreversible pulpitis and the presence of periapical radiolucency could be treated successfully by MTA pulpotomy with success rates of 84% and 76%, respectively.Three of 7 failed cases required pulpectomy after MTA pulpotomy to relieve painful pulpitis. Four other failed cases were asymptomatic, and failure was detected from radiographic examination. The relationship between treatment outcomes and treatment factors could not be detected statistically. Teeth with carious pulp exposure can be treated successfully by MTA pulpotomy. Clinical signs of irreversible pulpitis and the presence of periapical radiolucency should not be considered as a contraindication for pulpotomy. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  20. Minimally invasive treatment of carious dentin with a nanosecond pulsed laser at 5.8 μm wavelength

    NASA Astrophysics Data System (ADS)

    Ishii, Katsunori; Saiki, Masayuki; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2012-01-01

    Conventional lasers, Er:YAG laser and Er,Cr:YSGG laser, lack the ability for selective excavation to discriminate carious tissue only because they use the laser tissue interaction derived from a strong absorption of water. Based on the absorption property of carious dentin, characteristic absorption bands around 6 μm are candidate for selective excavation. Our group has already observed the difference of ablation depth between demineralized and normal dentin in the wavelength range from 5.75 to 6.60 μm. Also this study has showed the effectiveness of 5.8 μm. Objective of this study is to determine optimal irradiation parameters of selective excavation by using 5.8 μm. Bovine dentin plates demineralized by soaking in lactic acid solution were used as a carious dentin model. A nanosecond pulsed laser at 5.8 μm wavelength was obtained by difference-frequency generation technique. The laser delivers 5 ns pulse width at a repetition rate of 10 Hz. After irradiation, morphological change and measurement of ablation depth was observed with a scanning electron microscope and a confocal laser microscope, respectively. In 5.8 μm wavelength, high ablation efficiency with a low thermal side effect was observed. 5.8 μm wavelength provides a selective excavation technique for minimal intervention.

  1. Near-IR polarization imaging of sound and carious dental enamel

    NASA Astrophysics Data System (ADS)

    Darling, Cynthia L.; Jiao, Jane J.; Lee, Chulsung; Kang, Hobin; Fried, Daniel

    2010-02-01

    A thorough understanding of how polarized near-IR light propagates through sound and carious dental hard tissues is important for the development of dental optical imaging systems. New optical imaging tools for the detection and assessment of dental caries (dental decay) such as near-IR imaging and optical coherence tomography can exploit the enhanced contrast provided by polarization sensitivity. In this investigation, an automated system was developed to collect images for the full 16-element Mueller Matrix. The polarized light was controlled by linear polarizers and liquid crystal retarders and the 36 images were acquired as the polarized near-IR light propagates through the enamel of extracted human thin tooth sections. In previous work, we reported that polarized light is rapidly depolarized by demineralized enamel, and sound and demineralized dentin.1 The rapid depolarization of polarized light by dental caries in the near-IR provides high contrast for caries imaging and detection. In this initial study, major differences in the Mueller matrix elements were observed in both sound and demineralized enamel which supports this approach and warrants further investigation.

  2. Near-IR Polarization Imaging of Sound and Carious Dental Enamel.

    PubMed

    Darling, Cynthia L; Jiao, Jane J; Lee, Chulsung; Kang, Hobin; Fried, Daniel

    2010-01-01

    A thorough understanding of how polarized near-IR light propagates through sound and carious dental hard tissues is important for the development of dental optical imaging systems. New optical imaging tools for the detection and assessment of dental caries (dental decay) such as near-IR imaging and optical coherence tomography can exploit the enhanced contrast provided by polarization sensitivity. In this investigation, an automated system was developed to collect images for the full 16-element Mueller Matrix. The polarized light was controlled by linear polarizers and liquid crystal retarders and the 36 images were acquired as the polarized near-IR light propagates through the enamel of extracted human thin tooth sections. In previous work, we reported that polarized light is rapidly depolarized by demineralized enamel, and sound and demineralized dentin.(1) The rapid depolarization of polarized light by dental caries in the near-IR provides high contrast for caries imaging and detection. In this initial study, major differences in the Mueller matrix elements were observed in both sound and demineralized enamel which supports this approach and warrants further investigation.

  3. Polarized light propagation through sound and carious enamel at 1310-nm

    NASA Astrophysics Data System (ADS)

    Darling, Cynthia L.; Fried, Daniel

    2006-02-01

    A thorough understanding of how polarized near-IR light propagates through sound and carious dental hard tissues is important for the development of dental optical imaging systems. New optical imaging tools for the detection and assessment of dental caries (dental decay) such as near-IR imaging and optical coherence tomography can exploit the enhanced contrast provided by polarization sensitivity. Stokes polarimetry was used to monitor the state of polarization (SOP) and degree of polarization (DOP) of incident linearly and circularly polarized light as it propagates through extracted human whole teeth, thin tooth sections and single apatite crystals. These measurements at 1310-nm suggest that the DOP is maintained through sound tooth enamel and transparent dentin and that circularly polarized light is typically depolarized more rapidly than linearly light. Polarized light is rapidly depolarized by demineralized enamel and sound and demineralized dentin. The rapid depolarization of polarized light by dental caries in the near-IR provides high contrast for caries imaging and detection.

  4. Visualization and quantification of healthy and carious dentin structure using confocal laser scanning microscopy

    NASA Astrophysics Data System (ADS)

    Kimura, Yuichi; Wilder-Smith, Petra B. B.; Krasieva, Tatiana B.; Arrastia-Jitosho, Anna-Marie A.; Liaw, Lih-Huei L.; Matsumoto, Koukichi; Berns, Michael W.

    1996-04-01

    In this study, a fluorescence technique was developed for visualization of dentin using confocal laser scanning microscopy (CLSM). Eighteen extracted human teeth were used: 13 showing no clinical signs of caries and 5 with visually apparent decay. Preliminary study: All teeth were horizontally sectioned to approx. 200 micrometers thickness and pre-treated as follows: no pretreatment; vacuum only; ultrasonication only; sodium hypochlorite (NaOCl) only; vacuum and NaOCl; ultrasonication and NaOCl; or vacuum, ultrasonication and NaOCl. Samples were stained with Rhodamine 123 fluorescent dye at a concentration of 10-5 M in phosphate buffer saline for 1 to 24 hours. Caries study: Dentin surfaces, some with pre-existing caries, were visualized using CLSM. Most dentin tubules in sound dentin appeared open using CLSM, but most dentin tubules in carious dentin appeared closed or narrowed. Surface images obtained using CLSM were similar to those seen by SEM, but additional subsurface imaging was possible using CLSM at depth intervals of 1 micrometers to a depth of 30 - 50 micrometers . This technique shows good potential for non-invasive surface and subsurface imaging of dentin structures.

  5. Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm

    NASA Astrophysics Data System (ADS)

    Lee, Chulsung; Lee, Dustin; Darling, Cynthia L.; Fried, Daniel

    2010-07-01

    The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (p<0.05). The Ge-enhanced CMOS camera equipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity.

  6. Nondestructive assessment of the severity of occlusal caries lesions with near-infrared imaging at 1310 nm

    PubMed Central

    Lee, Chulsung; Lee, Dustin; Darling, Cynthia L.; Fried, Daniel

    2010-01-01

    The high transparency of dental enamel in the near-infrared (NIR) at 1310 nm can be exploited for imaging dental caries without the use of ionizing radiation. The objective of this study is to determine whether the lesion contrast derived from NIR imaging in both transmission and reflectance can be used to estimate lesion severity. Two NIR imaging detector technologies are investigated: a new Ge-enhanced complementary metal-oxide-semiconductor (CMOS)-based NIR imaging camera, and an InGaAs focal plane array (FPA). Natural occlusal caries lesions are imaged with both cameras at 1310 nm, and the image contrast between sound and carious regions is calculated. After NIR imaging, teeth are sectioned and examined using polarized light microscopy (PLM) and transverse microradiography (TMR) to determine lesion severity. Lesions are then classified into four categories according to lesion severity. Lesion contrast increases significantly with lesion severity for both cameras (p<0.05). The Ge-enhanced CMOS camera equipped with the larger array and smaller pixels yields higher contrast values compared with the smaller InGaAs FPA (p<0.01). Results demonstrate that NIR lesion contrast can be used to estimate lesion severity. PMID:20799842

  7. Selective excavation of human carious dentin using a nanosecond pulsed laser with a wavelength of 5.85 μm

    NASA Astrophysics Data System (ADS)

    Kita, Tetsuya; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2013-06-01

    Less-invasive treatment of caries has been needed in laser dentistry. Based on the absorption property of dentin substrates, 6 μm wavelength range shows specific absorptions and promising characteristics for the excavation. In our previous study, 5.8 μm wavelength range was found to be effective for selective excavation of carious dentin and restoration treatment using composite resin from the irradiation experiment with bovine sound and demineralized dentin. In this study, the availability of 5.8 μm wavelength range for selective excavation of human carious dentin was investigated for clinical application. A mid-infrared tunable nanosecond pulsed laser by difference-frequency generation was used for revealing the ablation property of human carious dentin. Irradiation experiments indicated that the wavelength of 5.85 μm and the average power density of 30 W/cm2 realized the selective excavation of human carious dentin, but ablation property was different with respect to each sample because of the different caries progression. In conclusion, the wavelength of 5.85 μm could realize the selective excavation of human carious dentin, but it was necessary to evaluate the stage of caries progression in order to control the ablation property.

  8. [Benign vocal fold lesions].

    PubMed

    Pickhard, A; Reiter, R

    2013-05-01

    Benign vocal fold lesions are grouped in lesions arising from the epithelium like papillomas, lesions affecting the Reinke's space (nodules, polyps, cysts, Reinkes's edema as a form of chronic laryngitis) and lesions affecting the arytenoid (granulomas). A multifactorial genesis is assumed. Main symptoms are dysphonia and hyperfunctional vocal behavior that might also be a cause of these lesions. © Georg Thieme Verlag KG Stuttgart · New York.

  9. A Fourier Transform Infrared Spectroscopy Analysis of Carious Dentin from Transparent Zone to Normal Zone

    PubMed Central

    Liu, Y.; Yao, X.; Liu, Y.W.; Wang, Y.

    2015-01-01

    It is well known that caries invasion leads to the differentiation of dentin into zones with altered composition, collagen integrity and mineral identity. However, understanding of these changes from the fundamental perspective of molecular structure has been lacking so far. In light of this, the present work aims to utilize Fourier transform infrared spectroscopy (FTIR) to directly extract molecular information regarding collagen's and hydroxyapatite's structural changes as dentin transitions from the transparent zone (TZ) into the normal zone (NZ). Unembedded ultrathin dentin films were sectioned from carious teeth, and an FTIR imaging system was used to obtain spatially resolved FTIR spectra. According to the mineral-to-matrix ratio image generated from large-area low-spectral-resolution scan, the TZ, the NZ and the intermediate subtransparent zone (STZ) were identified. High-spectral-resolution spectra were taken from each zone and subsequently examined with regard to mineral content, carbonate distribution, collagen denaturation and carbonate substitution patterns. The integrity of collagen's triple helical structure was also evaluated based on spectra collected from demineralized dentin films of selected teeth. The results support the argument that STZ is the real sclerotic layer, and they corroborate the established knowledge that collagen in TZ is hardly altered and therefore should be reserved for reparative purposes. Moreover, the close resemblance between the STZ and the NZ in terms of carbonate content, and that between the STZ and the TZ in terms of being A-type carbonate-rich, suggest that the mineral that initially occludes dentin tubules is hydroxyapatite newly generated from odontoblastic activities, which is then transformed into whitlockite in the demineralization/remineralization process as caries progresses. PMID:24556607

  10. A preliminary study on the screening of emerging drug resistance among the caries pathogens isolated from carious dentine.

    PubMed

    Smiline, Girija A S; Pandi, Suba K; Hariprasad, P; Raguraman, R

    2012-01-01

    Dental caries being the commonest unmet public health problem indicates its need to urge the dentists to overcome this problem globally. Caries exhibit in different types and is found to be associated with co-aggregation property of microbial flora with other oral hygienic factors. In spite of the surgical removals, excavations and administration of antimicrobials for carious dentine, there seems to be repeated infection and chronic prevalence of caries. A complete understanding of microbial etiology and prevention of emerging drug-resistant strains will aid in the eradication of this chronic dentine problem condition from the oral cavity. This study is aimed to isolate the predominant bacterial pathogens associated with caries and to screen for the emergence of drug resistance among the isolated caries pathogens. Carious dentine specimens were collected from 75 endodontic patients and the samples were processed microbiologically to isolate the caries pathogens. Identification of the strains was done by standard biochemical characterization studies. Statistical analysis of the isolates was done by Pearson Chi-square test and Fisher's exact test. The predominant isolates were subjected to antimicrobial sensitivity test using Kirby Bauer's method. The results were recorded and analyzed for drug resistance. Carious dentine samples yielded a high percentage of Lactobacillus sp., and Candida albicans from different type of caries. Among the study population, dentinal caries was the most predominant type affecting most males with other associated risk factors. Nearly 47.3% of the isolated Lactobacillus sp. and 55.5% of the yeast C. albicans were screened to show resistance against the antimicrobials used for the study. This study concludes by stating that Lactobacillus sp., and C. albicans are mostly involved in the caries etiology and show resistance to the commonest antimicrobial agent. This implicates the need for periodical antimicrobial susceptibility examination of

  11. Deep Earthquakes.

    ERIC Educational Resources Information Center

    Frohlich, Cliff

    1989-01-01

    Summarizes research to find the nature of deep earthquakes occurring hundreds of kilometers down in the earth's mantle. Describes further research problems in this area. Presents several illustrations and four references. (YP)

  12. Multiple radiopaque mandibular lesions in a patient with Apert syndrome.

    PubMed

    Costa, Fábio Wildson Gurgel; Rodrigues, Rodrigo Rodrigues; Batista, Ana Cristina Beviláqua; Ribeiro, Thyciana Rodrigues; Pereira, Karuza Maria Alves

    2012-12-01

    Apert syndrome (acrocephalosyndactyly) is a rare congenital malformation characterized by craniosynostosis, craniofacial anomalies, and symmetric syndactyly of the hands and feet. Oral manifestations usually include bifid uvula, a Byzantine arch palate associated with lateral swellings of the palatine processes, severe maxillary dental crowding associated with teeth malposition, severe open bite, dental caries, and gingival and periodontal disorders. Florid osseous dysplasia is an asymptomatic lesion mostly encountered during casual dental radiographic examinations as multiple sclerotic masses in 2 or more quadrants, usually in tooth-bearing regions. A 32-year-old woman diagnosed with Apert syndrome was seen in our department for a routine dental examination. Radiographic evaluation showed multiple radiopaque lesions in the mandible. All teeth with radiopaque lesions gave positive responses to vitality tests, and the patient did not report any symptoms. Based on the clinical and radiographic findings, the diagnosis of florid osseous dysplasia in a patient with Apert syndrome was made. Because there were no signs of an intraoral infectious process or endodontic needs, the patient was followed during revisions for Apert syndrome, and the only treatment provided was conservative management of the many carious lesions observed during the clinical examination. To our knowledge, this is the first study reporting the occurrence of florid osseous dysplasia in a patient with Apert syndrome. Conservative management should be performed in asymptomatic cases. Although rare, our case report highlights the importance of florid osseous dysplasia as a condition that may mimic lesions with an endodontic origin in patients with Apert syndrome. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  13. Skin lesion of blastomycosis

    MedlinePlus

    ... gov/ency/article/000865.htm Skin lesion of blastomycosis To use the sharing features on this page, please enable JavaScript. A skin lesion of blastomycosis is a symptom of an infection with the ...

  14. [Effect of different surface managements on micro-tensile bond strength of non -carious sclerotic dentin to resin].

    PubMed

    Wang, Xue; Qiu, Li-hong; Li, Zi-mu; Sun, Hai-yan

    2013-12-01

    To evaluate the micro-tensile bond strength of 3 different surface managements to non-carious sclerotic dentin. Fifteen periodontal patients' occlusal wearing molars which were above 3rd degree were selected. The teeth were equally cut into two pieces along the buccolingual direction, and each piece was randomly divided into 3 groups. Group 1 was processed with polishing, group 2 was processed with EX-26 diamond bur and group 3 was processed with 5# round bur. All teeth were subjected to Optibond treatment, and then filled with composite resin (Premisa) and saved in normal artificial saliva (37 degrees centigrade) for 24 hours. At last, fatigue test pieces were made, the micro-tensile bond strength was evaluated and every specimen was examined under stero-microscope. The micro-tensile bond strength was analyzed with one-way analysis of variance using SPSS17.0 software package. The micro-tensile bond strength of the 3 groups were (10.48±1.29) MPa, (21.52±0.97) MPa and(16.30±1.02) MPa, respectively. The bond strength of EX-26 diamond bur group was significantly greater than that of the other 2 groups (P<0.05). The bond strength of 5# round bur group was significantly greater than that of polishing group (P<0.05). The breakage mostly happened in adhesive dentine surface. Non-carious sclerotic dentin which is processed with diamond bur has better micro-tensile bonding strength.

  15. Selective treatment of carious dentin using a mid-infrared tunable pulsed laser at 6 μm wavelength range

    NASA Astrophysics Data System (ADS)

    Saiki, Masayuki; Ishii, Katsunori; Yoshikawa, Kazushi; Yasuo, Kenzo; Yamamoto, Kazuyo; Awazu, Kunio

    2011-03-01

    Optical technologies have good potential for caries detection, prevention, excavation, and the realization of minimal intervention dentistry. This study aimed to develop a selective excavation technique of carious tissue using the specific absorption in 6 μm wavelength range. Bovine dentin demineralized with lactic acid solution was used as a carious dentin model. A mid-infrared tunable pulsed laser was obtained by difference-frequency generation technique. The wavelength was tuned to 6.02 and 6.42 μm which correspond to absorption bands called amide I and amide II, respectively. The laser delivers 5 ns pulse width at a repetition rate of 10 Hz. The morphological change after irradiation was observed with a scanning electron microscope, and the measurement of ablation depth was performed with a confocal laser microscope. At λ = 6.02 μm and the average power density of 15 W/cm2, demineralized dentin was removed selectively with less-invasive effect on sound dentin. The wavelength of 6.42 μm also showed the possibility of selective removal. High ablation efficiency and low thermal side effect were observed using the nanosecond pulsed laser with λ = 6.02 μm. In the near future, development of compact laser device will open the minimal invasive laser treatment to the dental clinic.

  16. Genotypic Diversity and Virulence Traits of Streptococcus mutans Isolated from Carious Dentin after Partial Caries Removal and Sealing

    PubMed Central

    Damé-Teixeira, Nailê; Arthur, Rodrigo Alex; Parolo, Clarissa Cavalcanti Fatturi

    2014-01-01

    The aim of this study was to compare the genotypic diversity and virulence traits of Streptococcus mutans isolated from carious dentin before and after partial dentin caries removal (PDR) and sealing. Carious dentin samples were obtained three months before and after the PDR and cavity sealing. Up to seven isolates of each morphological type of S. mutans were selected and strain identity was confirmed using gtfB primer. Genotyping was performed by arbitrary primer-PCR (AP-PCR). Acidogenesis and acidurance of the genotypes were evaluated as virulence traits. A paired t-test and a Wilcoxon test were used to compare the virulence of genotypes. A total of 48 representative S. mutans isolates were genotyped (31 before and 17 after the sealing). At least one of the genotypes found before the sealing was also found on dentin after the sealing. The number of genotypes found before the sealing ranged from 2 to 3 and after the sealing from 1 to 2 genotypes. No difference was observed in the acidogenesis and acidurance between genotypes isolated before and after the sealing. In conclusion, genotypic diversity of S. mutans decreased after the PDR and sealing, but the virulence traits of S. mutans remained unchangeable. PMID:24578618

  17. Example based lesion segmentation

    NASA Astrophysics Data System (ADS)

    Roy, Snehashis; He, Qing; Carass, Aaron; Jog, Amod; Cuzzocreo, Jennifer L.; Reich, Daniel S.; Prince, Jerry; Pham, Dzung

    2014-03-01

    Automatic and accurate detection of white matter lesions is a significant step toward understanding the progression of many diseases, like Alzheimer's disease or multiple sclerosis. Multi-modal MR images are often used to segment T2 white matter lesions that can represent regions of demyelination or ischemia. Some automated lesion segmentation methods describe the lesion intensities using generative models, and then classify the lesions with some combination of heuristics and cost minimization. In contrast, we propose a patch-based method, in which lesions are found using examples from an atlas containing multi-modal MR images and corresponding manual delineations of lesions. Patches from subject MR images are matched to patches from the atlas and lesion memberships are found based on patch similarity weights. We experiment on 43 subjects with MS, whose scans show various levels of lesion-load. We demonstrate significant improvement in Dice coefficient and total lesion volume compared to a state of the art model-based lesion segmentation method, indicating more accurate delineation of lesions.

  18. Deep learning

    NASA Astrophysics Data System (ADS)

    Lecun, Yann; Bengio, Yoshua; Hinton, Geoffrey

    2015-05-01

    Deep learning allows computational models that are composed of multiple processing layers to learn representations of data with multiple levels of abstraction. These methods have dramatically improved the state-of-the-art in speech recognition, visual object recognition, object detection and many other domains such as drug discovery and genomics. Deep learning discovers intricate structure in large data sets by using the backpropagation algorithm to indicate how a machine should change its internal parameters that are used to compute the representation in each layer from the representation in the previous layer. Deep convolutional nets have brought about breakthroughs in processing images, video, speech and audio, whereas recurrent nets have shone light on sequential data such as text and speech.

  19. Deep earthquakes

    SciTech Connect

    Frohlich, C.

    1989-01-01

    Earthquakes are often recorded at depths as great as 650 kilometers or more. These deep events mark regions where plates of the earth's surface are consumed in the mantle. But the earthquakes themselves present a conundrum: the high pressures and temperatures at such depths should keep rock from fracturing suddenly and generating a tremor. This paper reviews the research on this problem. Almost all deep earthquakes conform to the pattern described by Wadati, namely, they generally occur at the edge of a deep ocean and define an inclined zone extending from near the surface to a depth of 600 kilometers of more, known as the Wadati-Benioff zone. Several scenarios are described that were proposed to explain the fracturing and slipping of rocks at this depth.

  20. Deep learning.

    PubMed

    LeCun, Yann; Bengio, Yoshua; Hinton, Geoffrey

    2015-05-28

    Deep learning allows computational models that are composed of multiple processing layers to learn representations of data with multiple levels of abstraction. These methods have dramatically improved the state-of-the-art in speech recognition, visual object recognition, object detection and many other domains such as drug discovery and genomics. Deep learning discovers intricate structure in large data sets by using the backpropagation algorithm to indicate how a machine should change its internal parameters that are used to compute the representation in each layer from the representation in the previous layer. Deep convolutional nets have brought about breakthroughs in processing images, video, speech and audio, whereas recurrent nets have shone light on sequential data such as text and speech.

  1. A microbiological study of primary root-caries lesions with different treatment needs.

    PubMed

    Beighton, D; Lynch, E; Heath, M R

    1993-03-01

    Samples of altered or carious dentin for microbiological culture were obtained from 301 primary root-caries lesions in 59 patients by means of a standardized sampling procedure. This involved the cleansing of each root surface of extraneous supragingival plaque by means of a hand-held toothbrush and distilled water and the collection of the sample with a sterile dental excavator passed through the entire vertical dimension of each lesion. The total number of colony-forming units (cfu) in each sample and the numbers of mutans streptococci (primarily Streptococcus mutans), lactobacilli, yeasts, and Gram-positive pleomorphic rods (GPPR) were determined. Individual bacterial counts were expressed as log10 (cfu per sample), as a percentage of the total number of bacteria per sample, and as a frequency of isolation from lesions with different clinical diagnostic criteria. Clinical measurements of each lesion were made for color, texture, position relative to the gingival margin, and treatment need. Lesions classified as soft yielded significantly more bacteria, mutans streptococci, lactobacilli, and GPPR than leathery lesions, which yielded more bacteria than hard lesions. Lesions were classified into 5 treatment categories: soft and restore, leathery and restore, leathery and debride of caries; leathery and treat therapeutically; and hard no treatment. The total numbers of bacteria, mutans streptococci, lactobacilli, GPPR, and yeasts decreased significantly with decreasing treatment need. The frequency of isolation of mutans streptococci, lactobacilli, and yeasts was significantly greater from lesions requiring restoration and from lesions situated within 1 mm of the gingival margin. We suggest that the majority of root caries is initiated adjacent to the gingival margin.

  2. Treatment of orthodontic white spot lesions with a remineralizing dentifrice applied by toothbrushing or mouth trays.

    PubMed

    Kleber, C J; Milleman, J L; Davidson, K R; Putt, M S; Triol, C W; Winston, A E

    1999-01-01

    This pilot study investigated the effect of a remineralizing fluoride dentifrice (Enamelon) on newly formed incipient carious lesions using two methods of application. Teenage orthodontic patients with obvious white spot lesions on their teeth were selected to begin treatment within 30 days after debanding. At baseline, the surface enamel of the test teeth was cleaned by air etching with 50 microns alumina at 150 psi. Lesion size (mm2) was measured using a calibrated periodontal probe and surface appearance was quantified as shiny (0), dull (1), or chalky (2). Twice daily for 3 months, one group with a total of 27 lesions brushed with the remineralizing dentifrice, while a second group with 41 total lesions brushed and used a mouth tray to apply the paste directly to the lesions for 5 min. In order to promote treatment compliance, test group assignment was based on subject and parental preference. After 1, 2, and 3 months, lesion size was reduced by 5% (ns), 10% (p < 0.05) and 22% (p < 0.01), respectively, for the brushing group, and 16% (p < 0.05), 37% (p < 0.01) and 30% (p < 0.01) for the combined brushing and tray group, respectively. The dull appearance of the lesions treated by brushing improved slightly over 3 months. However, the lesions receiving combined brushing and tray applications became significantly (p < 0.01) less dull by 28%, 44% and 61% after 1, 2, and 3 months, respectively, indicating the formation of a shiny, intact surface layer. In conclusion, brushing with a remineralizing dentifrice significantly reduced the size of new orthodontic white spots within 2 months, while brushing combined with topical tray applications reduced lesion size within 1 month with concomitant formation of a shiny enamel surface layer. Thus, the combined brushing and mouth tray treatment significantly accelerated the remineralization process.

  3. Light- and electronmicroscopic study of infiltration of resin into initial caries lesions--a new methodological approach.

    PubMed

    Arnold, W H; Gaengler, P

    2012-01-01

    It was the purpose of this pilot study to investigate resin infiltration into various types of initial subsurface caries lesions using a combined microscopic technique with polarized light microscopy and fluorescence microscopy and subsequent scanning microscopy with EDX-element analysis. Six extracted premolars with initial caries lesions were used. Five were infiltrated with resin after imbibition of the subsurface carious pore volume of enamel with sodium fluorescein solution. After light curing the unbound dye was removed by washing out in water. Serial sections were cut through the lesions and investigated with polarized light microscopy, fluorescence microscopy and simultaneously with both microscopic techniques. The same sections were then studied with scanning electron microscopy and EDX-element analysis to prove the infiltration of the resin into the lesions. The results showed, that the combination technique adds further morphologic information to infiltration behaviour of the resin. The individual volume of early acute lesions versus chronic lesions involving dentin, and the fluorescein bound by resin was well documented in serial sections. The EDX calcium and phosphorus signals correlate negatively with the lesion extension, and the carbon signal correlates positively, thus labelling the resin infiltration. It could be demonstrated that resin infiltration is dependent from the pore volume of the lesion. It can be concluded that the combined polarized light microscopy with fluorescence microscopy is an advantageous tool for studying infiltration of resin into hard tissues. © 2011 The Authors Journal of Microscopy © 2011 Royal Microscopical Society.

  4. Deep Lysimeter

    DOEpatents

    Hubbell, Joel M.; Sisson, James B.

    2004-06-01

    A deep lysimeter including a hollow vessel having a chamber, a fill conduit extending into the chamber through apertures, a semi-permeable member mounted on the vessel and in fluid communication with the fill conduit, and a line connection for retrieving the lysimeter.

  5. Deep Trouble.

    ERIC Educational Resources Information Center

    Popke, Michael

    2002-01-01

    Discusses how the safety-related ruling by the National Federation of State High School Associations to eliminate the option of using 18-inch starting platforms in pools less than 4 feet deep may affect operators of swimming pools and the swim teams who use them. (EV)

  6. Deep Fish.

    PubMed

    Ishaq, Omer; Sadanandan, Sajith Kecheril; Wählby, Carolina

    2017-01-01

    Zebrafish ( Danio rerio) is an important vertebrate model organism in biomedical research, especially suitable for morphological screening due to its transparent body during early development. Deep learning has emerged as a dominant paradigm for data analysis and found a number of applications in computer vision and image analysis. Here we demonstrate the potential of a deep learning approach for accurate high-throughput classification of whole-body zebrafish deformations in multifish microwell plates. Deep learning uses the raw image data as an input, without the need of expert knowledge for feature design or optimization of the segmentation parameters. We trained the deep learning classifier on as few as 84 images (before data augmentation) and achieved a classification accuracy of 92.8% on an unseen test data set that is comparable to the previous state of the art (95%) based on user-specified segmentation and deformation metrics. Ablation studies by digitally removing whole fish or parts of the fish from the images revealed that the classifier learned discriminative features from the image foreground, and we observed that the deformations of the head region, rather than the visually apparent bent tail, were more important for good classification performance.

  7. Metatranscriptomics reveals overall active bacterial composition in caries lesions

    PubMed Central

    Simón-Soro, Aurea; Guillen-Navarro, Miriam; Mira, Alex

    2014-01-01

    Background Identifying the microbial species in caries lesions is instrumental to determine the etiology of dental caries. However, a significant proportion of bacteria in carious lesions have not been cultured, and the use of molecular methods has been limited to DNA-based approaches, which detect both active and inactive or dead microorganisms. Objective To identify the RNA-based, metabolically active bacterial composition of caries lesions at different stages of disease progression in order to provide a list of potential etiological agents of tooth decay. Design Non-cavitated enamel caries lesions (n=15) and dentin caries lesions samples (n=12) were collected from 13 individuals. RNA was extracted and cDNA was constructed, which was used to amplify the 16S rRNA gene. The resulting 780 bp polymerase chain reaction products were pyrosequenced using Titanium-plus chemistry, and the sequences obtained were used to determine the bacterial composition. Results A mean of 4,900 sequences of the 16S rRNA gene with an average read length of 661 bp was obtained per sample, giving a comprehensive view of the active bacterial communities in caries lesions. Estimates of bacterial diversity indicate that the microbiota of cavities is highly complex, each sample containing between 70 and 400 metabolically active species. The composition of these bacterial consortia varied among individuals and between caries lesions of the same individuals. In addition, enamel and dentin lesions had a different bacterial makeup. Lactobacilli were found almost exclusively in dentin cavities. Streptococci accounted for 40% of the total active community in enamel caries, and 20% in dentin caries. However, Streptococcus mutans represented only 0.02–0.73% of the total bacterial community. Conclusions The data indicate that the etiology of dental caries is tissue dependent and that the disease has a clear polymicrobial origin. The low proportion of mutans streptococci detected confirms that they

  8. Effect of three different pastes on remineralization of initial enamel lesion: an in vitro study.

    PubMed

    Vyavhare, S; Sharma, D S; Kulkarni, V K

    2015-01-01

    Dental caries in enamel is unique as enamel is both acellular and avascular. Fluoride is one of the most effective remineralizing agents in caries prevention. The purpose of the study was to assess whether nano-hydroxyapatite and CPP-ACP can be used as an alternative to fluoride for remineralization of early carious lesions. Initial artificial carious lesions were prepared in enamel with demineralization solution. The treatment materials used as remineralizing agents were Nano-hydroxyapatite (10%), CPP - ACP (10%), NaF (1000 ppm) and Deionized water (negative control). Surface microhardness (SMH) measurements were performed before/after demineralization and after 3, 6, 9 and 12 days of pH cycling and the percentage surface microhardness recovery (%SMHR) was calculated. The specimens were then examined by scanning electron microscope. Percentage surface microhardness recovery of nano-hydroxyapatite and fluoride was significantly greater than CPP - ACP and negative control. There was no significant difference of %SMHR between n-HA and fluoride at different time periods in the pH cycling. SEM analysis revealed n-HA particles were deposited on the demineralized enamel surface which formed a new surface layer. When observed under SEM CPP - ACP failed to show any significant surface remineralization while surface globular crystal depositions with multiple discrete porosities were evident with fluoride. It was concluded that nano-hydroxyapatite and fluoride had the potential to remineralize initial enamel lesions. CPP - ACP can be used as an effective adjunct to fluoride therapy but cannot be used as an alternative to fluoride.

  9. Tooth-colored filling materials for the restoration of cervical lesions: a 24-month follow-up study.

    PubMed

    Folwaczny, M; Loher, C; Mehl, A; Kunzelmann, K H; Hinkel, R

    2000-01-01

    The recently developed resin-modified glass ionomer cements and the polyacid-modified composites are promising alternatives to conventional materials for restoring cervical defects. This clinical study evaluated the clinical condition of cervical fillings 24 months following placement. The study subjects were 197 cervical restorations placed on incisors, canines and premolars in 37 patients for restoration of erosion/non-carious lesions (69 cases), primary carious lesions (57 cases) and the replacement of deficient restorations (71 cases). The teeth were randomly divided into four groups for restoration with either Tetric (composite, Group A: n = 36), Dyract (compomer, Group B: n = 79), Fuji II LC (resin-modified glass ionomer cement, Group C: n = 51) or Photac-Fil (resin-modified glass ionomer cement, Group D: n = 31). The evaluation was done single-blind at baseline, 8 and 24 months after the placement of the fillings, according to a modified USPHS rating scale. The assessment criteria were color stability, anatomical form, surface texture, marginal integrity, marginal discoloration and loss of filling. Statistical analysis was completed using Pearson chi-square and Fisher's exact test at a significance level of 5% (p < 0.05). After the 24-month period, the composite restorations showed superior results. The compomer fillings demonstrated conditions that were only slightly worse. A substantial number of the resin-modified glass-ionomer fillings were evaluated with bravo or even charlie scores in respect to at least one of the criteria assessed.

  10. A Study of the Potential to Detect Caries Lesions at the White-Spot Stage Using V(Z) Technique

    NASA Astrophysics Data System (ADS)

    Bakulin, E. Y.; Denisova, L. A.; Maev, R. Gr.

    Current wide-spread methods of non-destructive methods of caries diagnostics, such as X-ray techniques, do not provide the possibility to efficiently detect enamel caries lesions at the beginning ("white-spot") stage, when the tooth tissue is only slightly altered and no loss of the tissue occurs. Therefore, it is of paramount importance to develop new, more sensitive methods of caries diagnostics. In this paper, certain aspects of the ultrasonic approach to the problem are discussed - in particular, detection of the enamel's surface caries at the white-spot stage with a focused ultrasonic sensor positioned in front of the caries lesion (without cross-sectioning the tooth). Theoretical model using V(z) approach for layered media was applied to perform computer simulations resulting in V(z) curves for the different parameters of carious tissue and the degree of degradation. The curves were analyzed and it was shown that, comparing to a short-pulse/echo technique, V(z) approach provides much better distinction between sound and carious enamel and even makes possible to evaluate the degree of demineralization.

  11. Discrimination of healthy and carious teeth using laser-induced breakdown spectroscopy and partial least square discriminant analysis.

    PubMed

    Gazmeh, Meisam; Bahreini, Maryam; Tavassoli, Seyed Hassan

    2015-01-01

    In the laser drilling of teeth, a microplasma is generated which may be utilized for elemental analysis of ablated tissue via a laser-induced breakdown spectroscopy (LIBS) technique. In this study, LIBS is used to investigate the possibility of discrimination of healthy and carious tooth tissues. This possibility is examined using multivariate statistical analysis called partial least square discriminant analysis (PLS-DA) based on atomic and ionic emission lines of teeth LIBS spectra belonging to P, Ca, Mg, Zn, K, Sr, C, Na, H, and O elements. Results show an excellent discrimination and prediction of unknown tooth tissues. It is shown that using the PLS-DA method, the spectroscopic analysis of plasma emission during the laser drilling, would be a promising technique for caries detection.

  12. Deep endometriosis: definition, pathogenesis, and clinical management.

    PubMed

    Vercellini, Paolo; Frontino, Giada; Pietropaolo, Giuliana; Gattei, Umberto; Daguati, Raffaella; Crosignani, Pier Giorgio

    2004-05-01

    "Deep endometriosis" includes rectovaginal lesions as well as infiltrative forms that involve vital structures such as bowel, ureters, and bladder. The available evidence suggests the same pathogenesis for deep infiltrating vesical and rectovaginal endometriosis (i.e., intraperitoneal seeding of regurgitated endometrial cells, which collect and implant in the most dependent portions of the peritoneal cavity and the anterior and posterior cul-de-sac, and trigger an inflammatory process leading to adhesion of contiguous organs with creation of false peritoneal bottoms). According to anatomic, surgical, and pathologic findings, deep endometriotic lesions seem to originate intraperitoneally rather than extraperitoneally. Also the lateral asymmetry in the occurrence of ureteral endometriosis is compatible with the menstrual reflux theory and with the anatomic differences of the left and right hemipelvis. Peritoneal, ovarian, and deep endometriosis may be diverse manifestations of a disease with a single origin (i.e., regurgitated endometrium). Based on different pathogenetic hypotheses, several schemes have been proposed to classify deep endometriosis, but further data are needed to demonstrate their validity and reliability. Drugs induce temporary quiescence of active deep lesions and may be useful in selected circumstances. Progestins should be considered as first-line medical treatment for temporary pain relief. However, in most cases of severely infiltrating disease, surgery is the final solution. Great importance must be given to complete and balanced counseling, as awareness of the real possibilities of different treatments will enhance the patient's collaboration.

  13. Aetiology of abfraction lesions.

    PubMed

    Lyons, K

    2001-09-01

    The aetiology of abfraction lesions is complex. Most evidence indicates that physical loading forces are a major contributing factor, although they are unlikely to be entirely responsible. Intraoral chemical influences and toothbrush abrasion, combined with the dynamics of inter-occlusal activity such as chewing, swallowing, and parafunction, lead to stress corrosion and may contribute to abfraction lesions. The multifactorial aetiology that operates in the initiation and progression of these lesions has made investigation difficult. Various theories have been proposed and numerous surveys and studies conducted, but the primary causal factor has yet to be definitively determined. This review concludes that occlusal loading is the initiating factor in the development of abfraction lesions.

  14. Caries Detection Methods Based on Changes in Optical Properties between Healthy and Carious Tissue

    PubMed Central

    Karlsson, Lena

    2010-01-01

    A conservative, noninvasive or minimally invasive approach to clinical management of dental caries requires diagnostic techniques capable of detecting and quantifying lesions at an early stage, when progression can be arrested or reversed. Objective evidence of initiation of the disease can be detected in the form of distinct changes in the optical properties of the affected tooth structure. Caries detection methods based on changes in a specific optical property are collectively referred to as optically based methods. This paper presents a simple overview of the feasibility of three such technologies for quantitative or semiquantitative assessment of caries lesions. Two of the techniques are well-established: quantitative light-induced fluorescence, which is used primarily in caries research, and laser-induced fluorescence, a commercially available method used in clinical dental practice. The third technique, based on near-infrared transillumination of dental enamel is in the developmental stages. PMID:20454579

  15. Management of pulps exposed during carious tissue removal in adults: a multi-national questionnaire-based survey.

    PubMed

    Stangvaltaite, Lina; Schwendicke, Falk; Holmgren, Christopher; Finet, Marion; Maltz, Marisa; Elhennawy, Karim; Kerosuo, Eero; Doméjean, Sophie

    2016-12-20

    The aim of the present study was to investigate and compare the management of pulps exposed during carious tissue removal by French, German, and Norwegian general dental practitioners (GDPs). We further aimed to assess possible dentist- and patient-related factors associated with these management decisions. A structured questionnaire was send via mail to a simple random sample of dentists. The analyzed sample consisted of 661 (33%) French GDPs, 622 (25%) German GDPs, and 199 (34%) Norwegian GDPs. No single management method gained uniform consensus in any of the three countries. However, the most preferred management option in all three countries was direct pulp capping (DPC) (68-93%) mainly performed with calcium hydroxide paste/slurry (CH). Alternatively, root canal treatment was performed (7-22%). The reasons that guided GDPs were the same in all three countries; "good results" and "ease of use, familiar with the technique." Having read scientific articles about cariology/operative dentistry in the last 5 years increased the odds for the preference of DPC instead of root canal treatment (OR = 2.1, 95% CI 1.3-3.2). Among GDPs in France, Germany, and Norway, there was no uniform management option for pulp exposures during carious tissue removal. DPC with CH was the most preferred management, even though the current evidence suggests DPC with mineral trioxide aggregate (MTA) to be more successful. The outcome expectations and the assumed ease of use were reasons for GDPs' choice. Moreover, knowledge on current evidence towards such management options influenced treatment decisions. GDPs are encouraged to adopt management options based on current scientific evidence.

  16. Preinvasive lesions

    Cancer.gov

    This definition is for allocation of lesions with preinvasive/borderline properties. It is currently aimed at newly identified neoplasms, which may be similar to those described in humans. In mouse pathology, many adenomas may be preinvasive/borderline lesions. However, their inclusion in the preinvasive category can be justified only upon development of better diagnostic criteria.

  17. Imaging Pediatric Vascular Lesions

    PubMed Central

    Nguyen, Tuyet A.; Krakowski, Andrew C.; Naheedy, John H.; Kruk, Peter G.

    2015-01-01

    Vascular anomalies are commonly encountered in pediatric and dermatology practices. Most of these lesions are benign and easy to diagnose based on history and clinical exam alone. However, in some cases the diagnosis may not be clear. This may be of particular concern given that vascular anomalies may occasionally be associated with an underlying syndrome, congenital disease, or serious, life-threatening condition. Defining the type of vascular lesion early and correctly is particularly important to determine the optimal approach to management and treatment of each patient. The care of pediatric patients often requires collaboration from a multitude of specialties including pediatrics, dermatology, plastic surgery, radiology, ophthalmology, and neurology. Although early characterization of vascular lesions is important, consensus guidelines regarding the evaluation and imaging of vascular anomalies does not exist to date. Here, the authors provide an overview of pediatric vascular lesions, current classification systems for characterizing these lesions, the various imaging modalities available, and recommendations for appropriate imaging evaluation. PMID:26705446

  18. Nondestructive monitoring of the repair of enamel artificial lesions by an acidic remineralization model using polarization-sensitive optical coherence tomography.

    PubMed

    Kang, Hobin; Darling, Cynthia L; Fried, Daniel

    2012-05-01

    It is difficult to completely remineralize carious lesions because diffusion into the interior of the lesion is inhibited as new mineral is deposited in the outermost layers. In previous remineralization studies employing polarization sensitive optical coherence tomography (PS-OCT), two models of remineralization were employed and in both models there was preferential deposition of mineral in the outer most layer. In this study we attempted to remineralize the entire lesion using an acidic remineralization model and demonstrate that this remineralization can be monitored using PS-OCT. Artificial lesions approximately 100-150 μm in-depth were exposed to an acidic remineralization regimen and the integrated reflectivity from the lesions was measured before and after remineralization using PS-OCT. Automated integration routines worked well for assessing the integrated reflectivity for the lesion areas after remineralization. Although there was a high degree of remineralization, there was still incomplete remineralization of the body of the lesion. This study demonstrated that PS-OCT can be used to non-destructively measure changes in lesion structure and severity upon exposure to an acidic remineralization model. This study also demonstrated that automated algorithms can be used to assess the lesion severity even with the presence of a weakly reflective surface zone. Copyright © 2011 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  19. Deep smarts.

    PubMed

    Leonard, Dorothy; Swap, Walter

    2004-09-01

    When a person sizes up a complex situation and rapidly comes to a decision that proves to be not just good but brilliant, you think, "That was smart." After you watch him do this a few times, you realize you're in the presence of something special. It's not raw brainpower, though that helps. It's not emotional intelligence, either, though that, too, is often involved. It's deep smarts. Deep smarts are not philosophical--they're not"wisdom" in that sense, but they're as close to wisdom as business gets. You see them in the manager who understands when and how to move into a new international market, in the executive who knows just what kind of talk to give when her organization is in crisis, in the technician who can track a product failure back to an interaction between independently produced elements. These are people whose knowledge would be hard to purchase on the open market. Their insight is based on know-how more than on know-what; it comprises a system view as well as expertise in individual areas. Because deep smarts are experienced based and often context specific, they can't be produced overnight or readily imported into an organization. It takes years for an individual to develop them--and no time at all for an organization to lose them when a valued veteran walks out the door. They can be taught, however, with the right techniques. Drawing on their forthcoming book Deep Smarts, Dorothy Leonard and Walter Swap say the best way to transfer such expertise to novices--and, on a larger scale, to make individual knowledge institutional--isn't through PowerPoint slides, a Web site of best practices, online training, project reports, or lectures. Rather, the sage needs to teach the neophyte individually how to draw wisdom from experience. Companies have to be willing to dedicate time and effort to such extensive training, but the investment more than pays for itself.

  20. [Comparative study of immunocompetent cells of dental pulp of intact teeth, teeth with carious lesion and its complications combined with parodontitis].

    PubMed

    Moskovskiĭ, A V

    2007-01-01

    Results of the comparative immunohistochemical study of dental pulp by means of monoclonal antibodies to CD3, CD20, capital ES, CD68 are described. Pulp from the patients with caries, acute and chronic pulpitis in combination with periodontitis on different stages was studied, the qualitative and quantitative feature of dental pulp immune cells--T- and B-lymphocytes and macrophages was determined.

  1. Monitoring of sound and carious surfaces under sealants over 44 months.

    PubMed

    Fontana, M; Platt, J A; Eckert, G J; González-Cabezas, C; Yoder, K; Zero, D T; Ando, M; Soto-Rojas, A E; Peters, M C

    2014-11-01

    Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 (i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair. © International & American Associations for Dental Research.

  2. Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

    PubMed Central

    Fontana, M.; Platt, J.A.; Eckert, G.J.; González-Cabezas, C.; Yoder, K.; Zero, D.T.; Ando, M.; Soto-Rojas, A.E.; Peters, M.C.

    2014-01-01

    Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 (i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair. PMID:25248613

  3. Deep morphea.

    PubMed

    Bielsa, Isabel; Ariza, Aurelio

    2007-06-01

    Deep morphea encompasses a variety of clinical entities in which inflammation and sclerosis are found in the deep dermis, panniculus, fascia, or superficial muscle. Morphea profunda, eosinophilic fasciitis, and disabling pansclerotic morphea of children are included in this group, but overlapping of the extent and depth of cutaneous involvement in these various conditions precludes their distinction on the sole basis of clinical or even histologic examination. Furthermore, the limits between morphea profunda and generalized morphea, which usually are classified outside this group, are not clear. Histologically, all these disorders show similar inflammatory and sclerotic findings, the primary difference being the depth of these changes. Associated clinical findings, including arthralgias, arthritis, contractures, or carpal tunnel syndrome, are frequent. Although visceral complications are uncommon, pulmonary, esophageal, and even cardiac abnormalities have been reported. Eosinophilia, hypergammaglobulinemia, and increased erythrocyte sedimentation rate may be present with disease activity. Laboratory studies may demonstrate autoantibody production. Treatment is nonstandardized but UVA irradiation and antiinflammatory or immunosuppressive drugs (mainly antimalarial agents and corticosteroids) may be beneficial.

  4. Rehardening of caries-like lesions in root surfaces by saliva substitutes.

    PubMed

    Turssi, Cecilia P; Lima, Renata Q V; Faraoni-Romano, Juliana J; Serra, Mônica C

    2006-12-01

    This study sought to evaluate whether root dentine caries-like lesions could be remineralised by saliva substitutes. Root dentine slabs (3 x 3 x 2 mm) were cut from bovine incisors, ground flat, polished and pre-tested for Knoop microhardness (KHN) at five locations spaced 500 microm apart and 500 microm from the left edge of each sectioned piece. After 60 out of the 100 slabs had been selected based upon their KHN values, specimens were coated with wax except for their outer surface. Specimens were then cycled through a highly cariogenic challenge model to induce caries-like lesions, whose formation was confirmed by KHN measurements located 500 microm from the right edge of the specimen. According to a randomised complete block design, the experimental units (n = 15) were exposed to 1.5 ml of saliva substitutes, based on either mucin (MC) or carboxymethylcellulose (CM), to natural human saliva (HS) or to 100% relative humidity (RH) over 20 days. Remineralisation was verified by KHN measurements located 1000 microm apart from the right edge of the specimen. Analysis of variance indicated a significant (p < 0.0001) difference among the KHN values attained by the carious root dentine after exposure to the remineralising agents. Tukey's test ascertained that remineralisation was greatest with MC, intermediate with CM and least with HS, but rehardening did not reach the pre-caries lesion formation values. Saliva substitutes may provide partial remineralisation to preformed caries-like lesions in root dentine.

  5. Nonsurgical endodontic therapy along with minimal invasive treatment utilizing Bhasker's hypothesis for the management of infected radicular cystic lesion: A rare case report

    PubMed Central

    Salaria, Sanjeev Kumar; Kamra, Shilpa; Ghuman, Simrat Kaur; Sharma, Garima

    2016-01-01

    Radicular cyst (RC) is the most common odontogenic cyst of inflammatory origin affecting the jaws; involves the roots of the carious or traumatic non-vital tooth. Different therapeutic modalities, such as nonsurgical endodontic therapy or surgical enucleation with primary closure, decompression etc., were proposed for the management of such lesions. Presenting a case of a 28-year-old otherwise healthy male patient who reported with pain and swelling with respect to tooth #41, 31. Diagnosis of infected RC at a rare location was established on the basis of clinical, radiographical and fine needle aspiration cytological examination. Looking after the clinical characteristics, origin, extension, size of cystic lesion and patient cooperation; nonsurgical endodontic therapy utilizing Bhasker's hypothesis was opted. One year post-operative result suggested that nonsurgical endodontic therapy along with minimally invasive treatment utilizing Bhasker's hypothesis is an effective tool to transform infected radicular cystic lesion to healthy periapical periodontal tissue. PMID:27994430

  6. Oral Lesions in Neonates

    PubMed Central

    Rao, Roopa S; Majumdar, Barnali; Jafer, Mohammed; Maralingannavar, Mahesh; Sukumaran, Anil

    2016-01-01

    ABSTRACT Oral lesions in neonates represent a wide range of diseases often creating apprehension and anxiety among parents. Early examination and prompt diagnosis can aid in prudent management and serve as baseline against the future course of the disease. The present review aims to enlist and describe the diagnostic features of commonly encountered oral lesions in neonates. How to cite this article: Patil S, Rao RS, Majumdar B, Jafer M, Maralingannavar M, Sukumaran A. Oral Lesions in Neonates. Int J Clin Pediatr Dent 2016;9(2):131-138. PMID:27365934

  7. Multifocal vascular lesions.

    PubMed

    Levin, Laura E; Lauren, Christine T

    2016-09-01

    Multifocal vascular lesions are important to recognize and appropriately diagnose. Generally first noticed on the skin, multifocal vascular lesions may have systemic involvement. Distinguishing among the different types of multifocal vascular lesions is often based on clinical features; however, radiological imaging and/or biopsy are frequently needed to identify distinct features and guide treatment. Knowledge of the systemic associations that can occur with different vascular anomalies may reduce life-threatening complications, such as coagulopathy, bleeding, cardiac compromise, and neurologic sequelae. This review provides a synopsis of the epidemiology, pathogenesis, presentation, workup, and treatment of several well-recognized multifocal vascular tumors and malformations.

  8. Incidental vertebral lesions.

    PubMed

    Coumans, Jean-Valery C E; Walcott, Brian P

    2011-12-01

    Incidental vertebral lesions on imaging of the spine are commonly encountered in clinical practice. Contributing factors include the aging population, the increasing prevalence of back pain, and increased usage of MR imaging. Additionally, refinements in CT and MR imaging have increased the number of demonstrable lesions. The management of incidental findings varies among practitioners and commonly depends more on practice style than on data or guidelines. In this article we review incidental findings within the vertebral column and review management of these lesions, based on available Class III data.

  9. Deep blast

    NASA Astrophysics Data System (ADS)

    From southern New Mexico to the Great Slave Lake of Canada, scientists from the United States and Canada recently detonated 10 underground chemical explosions to generate a clearer picture of the Earth's crust and upper mantle. Called Project Deep Probe, the experiment is designed to see through the crust and into the upper mantle to a depth of 300 miles.In the United States, Earth scientists from Rice University, Purdue University, and the University of Oregon are participating in the project. “Researchers hope to get a picture of the upper mantle beneath the Rocky Mountains and the Colorado Plateau, to understand the role the mantle played in formation and uplift,” says Alan Levander of Rice. To enhance that “picture,” 750 portable seismographs were placed along a roughly north-south line extending from Crownpoint, New Mexico to Edmonton, Alberta. The seismic recordings will be used to enhance weak seismic waves that penetrated the upper mantle.

  10. Odontoblastic differentiation of dental pulp stem cells from healthy and carious teeth on an original PCL-based 3D scaffold.

    PubMed

    Louvrier, A; Euvrard, E; Nicod, L; Rolin, G; Gindraux, F; Pazart, L; Houdayer, C; Risold, P Y; Meyer, F; Meyer, C

    2017-01-21

    To isolate and characterize dental pulp stem cells (DPSCs) obtained from carious and healthy mature teeth extracted when conservative treatment was not possible or for orthodontic reasons; to evaluate the ability of DPSCs to colonize, proliferate and differentiate into functional odontoblast-like cells when cultured onto a polycaprolactone cone made by jet-spraying and prototyped into a design similar to a gutta-percha cone. DPSCs were obtained from nine carious and 12 healthy mature teeth. Then cells were characterized by flow cytometry and submitted to multidifferentiation to confirm their multipotency. These DPSCs were then cultured on a polycaprolactone cone in an odontoblastic differentiation medium. Cell proliferation, colonization of the biomaterial and functional differentiation of cells were histologically assessed. For the characterization, a t-Student test was used to compare the two groups. In all cell cultures, characterization highlighted a mesenchymal stem cell phenotype (CD105+, CD90+, CD73+, CD11b-, CD34-, CD45-, HLA-DR-). No significant differences were found between cultures obtained from carious and healthy mature teeth. DPSCs from both origins were able to differentiate into osteocytes, adipocytes and chondrocytes. Cell colonization was observed both on the surface and in the thickness of polycaprolactone cones as well as a mineralized pericellular matrix deposit composed of type I collagen, alkaline phosphatase, osteocalcin and dentin sialophosphoprotein. DPSCs were isolated from both carious and healthy mature teeth. They were able to colonize and proliferate within a polycaprolactone cone and could be differentiated into functional odontoblast-like cells. © 2017 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  11. Uterine Vascular Lesions

    PubMed Central

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

  12. Bilateral lacrimal caruncle lesions

    PubMed Central

    Okumura, Yuta; Takai, Yoshiko; Yasuda, Shunsuke; Terasaki, Hiroko

    2017-01-01

    ABSTRACT A 65-year-old man was referred to our hospital for the treatment of a lesion on the medial lacrimal canthus of both eyes. He had a history of perinuclear anti-neutrophil cytoplasmic antibodies, i.e., pANCA-positive interstitial pneumonia. Orbital magnetic resonance imaging excluded space occupying lesions, and laboratory testing excluded thyroid-related diseases. The masses were excised, and histopathological examinations showed sebaceous gland hyperplasia and inflammatory changes around the gland. In addition, the specimen from the left eye showed a retention cyst possibly caused by an infection. It was also possible that the use of steroid was involved in the development of the lesions. A relationship between the ANCA and the lesions was not completely eliminated. PMID:28303065

  13. Talar Dome Lesion

    MedlinePlus

    ... the talus. During this period of immobilization, nonweightbearing range-of-motion exercises may be recommended. Oral medications. Nonsteroidal anti- ... in reducing the pain and inflammation. Physical therapy. Range-of-motion and strengthening exercises are beneficial once the lesion ...

  14. Thalamic lesions in multiple sclerosis by 7T MRI: clinical implications and relationship to cortical pathology

    PubMed Central

    Harrison, Daniel M.; Oh, Jiwon; Roy, Snehashis; Wood, Emily T.; Whetstone, Anna; Seigo, Michaela A.; Jones, Craig K.; Pham, Dzung; van Zijl, Peter; Reich, Daniel S.; Calabresi, Peter A.

    2014-01-01

    Objective Pathology in both cortex and deep gray matter contribute to disability in multiple sclerosis (MS). We used the increased signal-to-noise ratio of 7-tesla (7T) MRI to visualize small lesions within the thalamus and to relate this to clinical information and cortical lesions. Methods 7T MRI scans were obtained on 34 MS cases and 15 healthy volunteers. Thalamic lesion number and volume were related to demographic data, clinical disability measures, and lesions in cortical gray matter. Results Thalamic lesions were found in 24/34 of MS cases. Two lesion subtypes were noted: discrete, ovoid lesions, and more diffuse lesional areas lining the periventricular surface. The number of thalamic lesions was greater in progressive MS compared to relapsing remitting (mean ± SD, 10.7 ± 0.7 vs. 3.0 ± 0.7, respectively, p < 0.001). Thalamic lesion burden (count and volume) correlated with EDSS score and measures of cortical lesion burden, but not with white matter lesion burden or white matter volume. Conclusions 7T MRI allows identification of thalamic lesions in MS, which are associated with disability, progressive disease, and cortical lesions. Thalamic lesion analysis may be a simpler, more rapid estimate of overall gray matter lesion burden in MS. PMID:25583851

  15. Traditional lesion detection aids.

    PubMed

    Neuhaus, K W; Ellwood, R; Lussi, A; Pitts, N B

    2009-01-01

    Lesion detection aids ideally aim at increasing the sensitivity of visual caries detection without trading off too much in terms of specificity. The use of a dental probe (explorer), bitewing radiography and fibre-optic transillumination (FOTI) have long been recommended for this purpose. Today, probing of suspected lesions in the sense of checking the 'stickiness' is regarded as obsolete, since it achieves no gain of sensitivity and might cause irreversible tooth damage. Bitewing radiography helps to detect lesions that are otherwise hidden from visual examination, and it should therefore be applied to a new patient. The diagnostic performance of radiography at approximal and occlusal sites is different, as this relates to the 3-dimensional anatomy of the tooth at these sites. However, treatment decisions have to take more into account than just lesion extension. Bitewing radiography provides additional information for the decision-making process that mainly relies on the visual and clinical findings. FOTI is a quick and inexpensive method which can enhance visual examination of all tooth surfaces. Both radiography and FOTI can improve the sensitivity of caries detection, but require sufficient training and experience to interpret information correctly. Radiography also carries the burden of the risks and legislation associated with using ionizing radiation in a health setting and should be repeated at intervals guided by the individual patient's caries risk. Lesion detection aids can assist in the longitudinal monitoring of the behaviour of initial lesions. Copyright 2009 S. Karger AG, Basel

  16. Dermabrasion and staged excision of facial lesions in a neurofibromatosis case for improvement of facial appearance.

    PubMed

    Karabekmez, Furkan Erol; Duymaz, Ahmet; Karacor, Zeynep

    2013-01-01

    Neurofibromatosis may present with different skin lesions. Disfiguring lesions on the face might be challenging for the surgeon or clinician to correct and may have adverse effects on patients' social lives, especially in young women. To present the dermabrasion technique combined with serial excisions of a deeper accompanying lesion to treat superficial facial lesions in a young neurofibromatosis patient. Dermabrasion was applied to superficial lesions on the face, and staged excision was applied to the deeper lesion located on the forehead. We obtained high patient satisfaction with the result. The deep lesion was excised totally, and superficial lesions were decreased with dermabrasion. Dermabrasion may become a good alternative in cases of neurofibromatosis with superficial facial lesions.

  17. IMP-3 expression in melanocytic lesions.

    PubMed

    Yu, Limin; Xu, Haodong; Wasco, Matthew J; Bourne, Patricia A; Ma, Linglei

    2010-03-01

    Insulin-like growth factor-II mRNA-binding protein 3 (IMP-3 ), a member of the insulin-like growth factor mRNA-binding protein family, is expressed in several human malignancies, including melanomas. However, the expression of IMP-3 has not been explored in melanoma in situ, various histologic subtypes of invasive melanomas and atypical Spitz tumors. IMP-3 immunostain was performed in 157 melanocytic lesions. Nearly all benign (8/8), dysplastic (8/8) and Spitz nevi (8/9) were negative for IMP-3. Focal IMP-3 positivity was observed in 5/12 melanoma in situ and 4/15 superficial melanomas (Breslow depth deep melanomas (Breslow depth >1 mm) and 25/52 metastatic melanomas demonstrated strong IMP-3 staining. IMP-3 expression differs significantly between non-desmoplastic melanomas (superficial and deep) and benign or dysplastic or Spitz nevi (p = 0.0427, respectively). Four of 23 desmoplastic melanomas expressed IMP-3 , which was significantly different from deep melanomas (p = 0.0109). IMP-3 stained 7 of 10 atypical Spitz tumors. The difference between atypical Spitz tumors and Spitz nevi was statistically significant (p = 0.0256). A malignant circumstance, such as non-desmoplastic melanoma or atypical Spitz tumor, can be inferred when IMP-3 is expressed, suggesting potential diagnostic value of IMP-3 in melanocytic lesions.

  18. Assessing burn depth in tattooed burn lesions with LASCA Imaging.

    PubMed

    Krezdorn, N; Limbourg, A; Paprottka, F J; Könneker; Ipaktchi, R; Vogt, P M

    2016-09-30

    Tattoos are on the rise, and so are patients with tattooed burn lesions. A proper assessment with regard to burn depth is often impeded by the tattoo dye. Laser speckle contrast analysis (LASCA) is a technique that evaluates burn lesions via relative perfusion analysis. We assessed the effect of tattoo skin pigmentation on LASCA perfusion imaging in a multicolour tattooed patient. Depth of burn lesions in multi-coloured tattooed and untattooed skin was assessed using LASCA. Relative perfusion was measured in perfusion units (PU) and compared to various pigment colours, then correlated with the clinical evaluation of the lesion. Superficial partial thickness burn (SPTB) lesions showed significantly elevated perfusion units (PU) compared to normal skin; deep partial thickness burns showed decreased PU levels. PU of various tattoo pigments to normal skin showed either significantly lower values (blue, red, pink) or significantly increased values (black) whereas orange and yellow pigment showed values comparable to normal skin. In SPTB, black and blue pigment showed reduced perfusion; yellow pigment was similar to normal SPTB burn. Deep partial thickness burn (DPTB) lesions in tattoos did not show significant differences to normal DPTB lesions for black, green and red. Tattoo pigments alter the results of perfusion patterns assessed with LASCA both in normal and burned skin. Yellow pigments do not seem to interfere with LASCA assessment. However proper determination of burn depth both in SPTB and DPTB by LASCA is limited by the heterogenic alterations of the various pigment colours.

  19. Assessing burn depth in tattooed burn lesions with LASCA Imaging

    PubMed Central

    Krezdorn, N.; Limbourg, A.; Paprottka, F.J.; Könneker; Ipaktchi, R.; Vogt, P.M

    2016-01-01

    Summary Tattoos are on the rise, and so are patients with tattooed burn lesions. A proper assessment with regard to burn depth is often impeded by the tattoo dye. Laser speckle contrast analysis (LASCA) is a technique that evaluates burn lesions via relative perfusion analysis. We assessed the effect of tattoo skin pigmentation on LASCA perfusion imaging in a multicolour tattooed patient. Depth of burn lesions in multi-coloured tattooed and untattooed skin was assessed using LASCA. Relative perfusion was measured in perfusion units (PU) and compared to various pigment colours, then correlated with the clinical evaluation of the lesion. Superficial partial thickness burn (SPTB) lesions showed significantly elevated perfusion units (PU) compared to normal skin; deep partial thickness burns showed decreased PU levels. PU of various tattoo pigments to normal skin showed either significantly lower values (blue, red, pink) or significantly increased values (black) whereas orange and yellow pigment showed values comparable to normal skin. In SPTB, black and blue pigment showed reduced perfusion; yellow pigment was similar to normal SPTB burn. Deep partial thickness burn (DPTB) lesions in tattoos did not show significant differences to normal DPTB lesions for black, green and red. Tattoo pigments alter the results of perfusion patterns assessed with LASCA both in normal and burned skin. Yellow pigments do not seem to interfere with LASCA assessment. However proper determination of burn depth both in SPTB and DPTB by LASCA is limited by the heterogenic alterations of the various pigment colours. PMID:28149254

  20. Frequent hemorrhagic lesions in cerebral toxoplasmosis in AIDS patients.

    PubMed

    Bhagavati, Satyakam; Choi, Jan

    2009-04-01

    Cerebral toxoplasmosis is a frequent complication in immunosuppressed patients such as AIDS (acquired immunodeficiency syndrome). Frequently, lesions are located deep in the brain which are inaccessible for biopsy making rapid diagnosis dependent on accurate interpretation of neuroimaging findings. The commonest cranial CT findings reported in toxoplasmosis are ring enhancing hypodense lesions in basal ganglia or cortical gray matter. Hemorrhage has only rarely been described and is usually seen following antitoxoplasma treatment. We reviewed the records of 11 AIDS patients with cerebral toxoplasmosis and found multiple hemorrhagic cerebral, cerebellar, or brain stem lesions in 7 of 11 patients. Six patients had hemorrhage at the time of initial clinical presentation and one developed hemorrhage following 2 weeks of antitoxoplasma treatment. We conclude that hemorrhagic lesions are frequently found on cranial MRI scans in cerebral toxoplasmosis. AIDS patients presenting with hemorrhagic cerebral lesions should be considered for a trial of presumptive antitoxoplasma treatment.

  1. In situ effect of sodium fluoride or titanium tetrafluoride varnish and solution on carious demineralization of enamel.

    PubMed

    Comar, Livia P; Wiegand, Annette; Moron, Bruna M; Rios, Daniela; Buzalaf, Marília A R; Buchalla, Wolfgang; Magalhães, Ana C

    2012-08-01

    This study evaluated the effect of titanium tetrafluoride (TiF(4)) formulations on enamel carious demineralization in situ. Thirteen subjects took part in this cross-over, split-mouth, double-blind study performed in three phases of 14 d each. In each subject, two sound and two predemineralized specimens of bovine enamel were worn intra-orally and plaque accumulation was allowed. One sound and one predemineralized specimen in each subject was treated once with sodium fluoride (NaF) varnish or solution (Treatment A); TiF(4) varnish or solution (Treatment B); or placebo varnish or no treatment (Treatment C). The initially sound enamel specimens were exposed to severe cariogenic challenge (20% sucrose, eight times daily for 5 min each time), whereas the predemineralized specimens were not. Eleven subjects were able to finish all experimental phases. The enamel alterations were quantified by surface hardness and transversal microradiography. Demineralization of previously sound enamel was reduced by all test formulations except for the NaF solution, while both TiF(4) formulations were as effective as NaF varnish. For the predemineralized specimens, enamel surface hardness was increased only by TiF(4) formulations, while subsurface mineral remineralization could not be seen in any group. Within the experimental protocol, TiF(4) was able to decrease enamel demineralization to a similar degree as NaF varnish under severe cariogenic challenges, while only TiF(4) formulations remineralized the enamel surface. © 2012 Eur J Oral Sci.

  2. How to make choice of the carious removal methods, Carisolv or traditional drilling? A meta-analysis.

    PubMed

    Li, R; Zhao, Y; Ye, L

    2014-06-01

    Despite Carisolv has been used to remove carious dentine for 14 years, it still has not reached consensus regarding its effectiveness and efficacy. We undertook a systematic review and meta-analysis of published randomised controlled trials (RCTs) to assess the effectiveness and efficacy of the chemomechanical caries removal (CMCR) system - Carisolv. A systematic electronic literature search was conducted to identify RCTs comparing the use of Carisolv with a control (rotary instruments) in patients with dental caries. Results were expressed as risk ratios (RRs) or mean differences with accompanying 95% confidence intervals (CIs). The outcome measurement included the complete caries removal rate (CCR: the number of cases with complete caries removal in study and control groups after different treatment), the treatment time (min) and the use of local anaesthesia. The meta-analysis was performed with the fixed-effect or random-effect model according to the heterogeneity. Six studies involving 578 teeth met our inclusion criteria. There was no statistically significant difference in CCR between Carisolv group and rotary instruments group; in Carisolv group, the treatment time (min) was significantly longer no matter whether the caries was located in coronal or root area, while the use of local anaesthesia was less. Compared with rotary instruments, Carisolv did not show increased CCR. Carisolv reduced the use of local anaesthesia although it took longer treatment time. However, the results should be interpreted cautiously due to the heterogeneity among study designs. Further large-scale, well-designed RCTs are needed. © 2014 John Wiley & Sons Ltd.

  3. Deep breathing after surgery

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000440.htm Deep breathing after surgery To use the sharing features on ... way to do so is by doing deep breathing exercises. Deep breathing keeps your lungs well-inflated ...

  4. Monitoring pigmented skin lesions

    NASA Astrophysics Data System (ADS)

    Wallace, Vincent P.; Bamber, Jeffery C.; Ott, Robert J.; Crawford, Diane C.; Mortimer, Peter S.

    2002-06-01

    The rising incidence of skin cancer has led to an increase in the number of patients with skin lesions that require diagnosis, mostly using subjective visual examination. Successful treatment depends on early diagnosis. Unfortunately diagnostic accuracy, even by experts, can be as low as 56%; therefore, an accurate, objective diagnostic aid is greatly needed. Reflectance characteristics of pigmented skin lesions were documented to evaluate their diagnostic potential. Reflectance spectra in the wavelength range 320-1100nm were obtained from 260 lesions. Differences between spectra from benign and malignant lesions were utilized by extracting features with the best discriminating power. Discrimination was evaluated using two techniques: multivariate statistical analysis and artificial neural networks, using histology as the standard. Each technique was tested in a blind study and assessed in terms of its ability to diagnose new cases and compared to the clinical diagnosis. The artificial neural network achieved the best diagnostic performance for discriminating between malignant melanoma and benign nevi, having a sensitivity of 100% and a specificity of 65%. Utilization of visible and infrared techniques for monitoring skin lesions has lead to improvements in diagnostic accuracy. We conclude that these techniques are worthy of further development and evaluation in clinical practice as a screening tool.

  5. Meniscal Ramp Lesions

    PubMed Central

    Chahla, Jorge; Dean, Chase S.; Moatshe, Gilbert; Mitchell, Justin J.; Cram, Tyler R.; Yacuzzi, Carlos; LaPrade, Robert F.

    2016-01-01

    Meniscal ramp lesions are more frequently associated with anterior cruciate ligament (ACL) injuries than previously recognized. Some authors suggest that this entity results from disruption of the meniscotibial ligaments of the posterior horn of the medial meniscus, whereas others support the idea that it is created by a tear of the peripheral attachment of the posterior horn of the medial meniscus. Magnetic resonance imaging (MRI) scans have been reported to have a low sensitivity, and consequently, ramp lesions often go undiagnosed. Therefore, to rule out a ramp lesion, an arthroscopic evaluation with probing of the posterior horn of the medial meniscus should be performed. Several treatment options have been reported, including nonsurgical management, inside-out meniscal repair, or all-inside meniscal repair. In cases of isolated ramp lesions, a standard meniscal repair rehabilitation protocol should be followed. However, when a concomitant ACL reconstruction (ACLR) is performed, the rehabilitation should follow the designated ACLR postoperative protocol. The purpose of this article was to review the current literature regarding meniscal ramp lesions and summarize the pertinent anatomy, biomechanics, diagnostic strategies, recommended treatment options, and postoperative protocol. PMID:27504467

  6. Salivary protein characteristics from saliva of carious lesionfree and high caries adults.

    PubMed

    Castro, Ramiro J; Herrera, Raúl; Giacaman, Rodrigo A

    2016-09-01

    It has been argued that specific salivary proteins could have a protective effect against caries, but data from the many available studies are rather contradictory. The purpose of this study was to analyze whether there is a relationship between protein concentration, electrophoretic profile and concentration of salivary IgA and the presence or absence of caries in adults. Adults with high caries activity (HC) and without caries lesions (CF), assessed by ICDAS criteria, were asked to provide unstimulated saliva samples. Protein concentration (μg/mL) was determined using the Bradford method. Western blotting was used to detect IgA. Data were compared using Student's t test at p<0.05. Total protein concentration in CF was higher (50.65±7.5 μg/mL) than in HC individuals (26.80±2.5 μg/mL) (p=0.001). More protein bands were visualized in the gels from CF than the HC group (p=0.001). CF subjects showed higher salivary IgA concentration (11.27±0.5 μg) than HC individuals (1.71±0.2μg) (p=0.001).Salivary composition in high caries experience and cariesfree young adults seems to differ in terms of the type and amount of proteins. Further research is needed to expand these findings.

  7. Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children.

    PubMed

    Naidu, Sarika; Tandon, Shobha; Nayak, Rashmi; Ratnanag, P Venkat; Prajapati, Deepesh; Kamath, Namitha

    2016-01-01

    To assess the effect of combined use of chlorhexidine and fluoride varnish on the remineralization of incipient carious lesions in young children. Twenty caries-active children (80 lesions) were randomly divided into four groups and subjected to initial examination. Caries status was assessed visually and with the aid of DIAGNOdent. Baseline enamel biopsies were obtained. Subjects of groups I and II received fluoride and chlorhexidine varnish respectively. Group III received both fluoride and chlorhexidine varnish alternatively, for a period of 4 weeks. Group IV served as the control. At 3-month follow-up, the incipient lesions were assessed again with DIAGNOdent and enamel biopsy. Increased calcium, phosphate, and fluoride levels were noticed in groups I, II, III compared to group IV, at the 3-month follow-up (p < 0.001). The combined therapy with fluoride and chlorhex-idine varnish may be considered an alternative therapy for early reversal of incipient lesions. Naidu S, Tandon S, Nayak R, Ratnanag PV, Prajapati D, Kamath N. Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children. Int J Clin Pediatr Dent 2016;9(4):296-302.

  8. Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children

    PubMed Central

    Tandon, Shobha; Nayak, Rashmi; Ratnanag, P Venkat; Prajapati, Deepesh; Kamath, Namitha

    2016-01-01

    Aim To assess the effect of combined use of chlorhexidine and fluoride varnish on the remineralization of incipient carious lesions in young children. Materials and methods Twenty caries-active children (80 lesions) were randomly divided into four groups and subjected to initial examination. Caries status was assessed visually and with the aid of DIAGNOdent. Baseline enamel biopsies were obtained. Subjects of groups I and II received fluoride and chlorhexidine varnish respectively. Group III received both fluoride and chlorhexidine varnish alternatively, for a period of 4 weeks. Group IV served as the control. At 3-month follow-up, the incipient lesions were assessed again with DIAGNOdent and enamel biopsy. Results Increased calcium, phosphate, and fluoride levels were noticed in groups I, II, III compared to group IV, at the 3-month follow-up (p < 0.001). Conclusion The combined therapy with fluoride and chlorhex-idine varnish may be considered an alternative therapy for early reversal of incipient lesions. How to cite this article Naidu S, Tandon S, Nayak R, Ratnanag PV, Prajapati D, Kamath N. Efficacy of Concomitant Therapy with Fluoride and Chlorhexidine Varnish on Remineralization of Incipient Lesions in Young Children. Int J Clin Pediatr Dent 2016;9(4):296-302. PMID:28127159

  9. Endoscopic laser stereotaxis: management of brain lesions

    NASA Astrophysics Data System (ADS)

    Zamorano, Lucia J.; Chavantes, Maria C.; Moure, Federico; Diaz, Fernando

    1994-05-01

    Image-guided stereotaxis is an accurate and safe method of directing therapy to target volumes defined in 2D multi-planes or 3D perspectives using computer reconstruction of image data. The major limitations of stereotactic techniques are the lack of intraoperative visualization and the ability to directly monitor the procedures, and changes of intracranial coordinates after decompression of cystic lesions or aspiration of cerebrospinal fluid in the management of intraventricular lesions. Stereotactic neuroendoscopy involves integration of rigid-flexible endoscopy and the Nd-YAG laser in 2D/3D multiplanar image-guided stereotactic procedures. The major advantages of endoscopic laser surgery include being minimally invasive (burrhole or small craniotomy surgery), direct intraoperative visualization, hemostasis, evacuation or resection assessment, and wide exploration of intracranial cavities or ventricles. We used endoscopic laser surgery in the management of 202 patients undergoing biopsy, aspiration, resection, and internal decompression of deep and subcortical intracranial lesions, and for different types of fenestration procedures. Image-guidance combined with endoscopic techniques may offer a safe, accurate alternative to conventional neurosurgical procedures in treating small solid, cystic, intraventricular lesions, and in fenestration procedures.

  10. Remineralization of caries lesions extending into dentin.

    PubMed

    ten Cate, J M

    2001-05-01

    Remineralization is one aspect of the overall process of tooth decay. However, it is primarily studied in shallow lesions. The aim of this study was to explore whether caries lesions in enamel and extending into the dentin can be remineralized. A single-section model was developed for the longitudinal and non-destructive monitoring of changes in enamel and dentin. Lesions at least 200 microm into dentin were formed in undersaturated acetate buffers. Next, the lesions were divided into groups (three treatment and one control) and remineralized. The treatments were: weekly immersion in 1,000 ppm fluoride, single treatment with methanehydroxybisphosphonate, and a constant level of 1 ppm fluoride. De- and remineralization was assessed by transverse microradiography. Remineralization was observed in enamel, but also in dentin, indicating that, deep into dentin, the pores become supersaturated to apatite formation. Treatments affected remineralization only in the outer part of enamel. Both findings are explained by a relatively fast diffusion of mineral ions, with precipitation being rate-limiting. The results suggest that dentin remineralization, underneath enamel, can be achieved and could possibly be used in clinical treatment strategies.

  11. Clinical performance of a resin-modified glass-ionomer and two polyacid-modified resin composites in cervical lesions restorations: 1-year follow-up.

    PubMed

    Chinelatti, M A; Ramos, R P; Chimello, D T; Palma-Dibb, R G

    2004-03-01

    The aim of this study was to assess the clinical performance of a resin-modified glass-ionomer cement (Vitremer) and two polyacid-modified resin composites (F2000 and Freedom) over 1 year. Nineteen patients with at least three cervical lesions were selected, providing an initial sample size of 87 restorations (29 per material), being 78 to non-carious and nine to carious lesions. Restorations were evaluated at baseline, 6 months and 1 year after placement, using modified US Public Health Service criteria: colour match, marginal discoloration, caries, anatomical form, marginal integrity and surface texture. At baseline, restorations were considered as acceptable for all criteria. At 1-year recall, 21 restorations per material were re-examined. Freedom was rated Bravo or Charlie for all the examined criteria and Vitremer earned an Alfa rating solely for the criterion caries. On the contrary, F2000 showed the best overall results, although presenting significant alteration in colour match. Statistical analysis of data was performed using chi-square and Mc Nemar tests. As to the evaluated periods, significant difference was observed solely between baseline and 1-year recall. Freedom and Vitremer were statistically different (P < 0.01) as to anatomical form and surface texture. For F2000, significant difference (P < 0.05) was noticed as to colour match and anatomical form. After 1-year follow-up, F2000 showed the most acceptable results as to the analysed criteria.

  12. Toolkits and Libraries for Deep Learning.

    PubMed

    Erickson, Bradley J; Korfiatis, Panagiotis; Akkus, Zeynettin; Kline, Timothy; Philbrick, Kenneth

    2017-03-17

    Deep learning is an important new area of machine learning which encompasses a wide range of neural network architectures designed to complete various tasks. In the medical imaging domain, example tasks include organ segmentation, lesion detection, and tumor classification. The most popular network architecture for deep learning for images is the convolutional neural network (CNN). Whereas traditional machine learning requires determination and calculation of features from which the algorithm learns, deep learning approaches learn the important features as well as the proper weighting of those features to make predictions for new data. In this paper, we will describe some of the libraries and tools that are available to aid in the construction and efficient execution of deep learning as applied to medical images.

  13. Intraventricular mass lesions

    SciTech Connect

    Morrison, G.; Sobel, D.F.; Kelley, W.M.; Norman, D.

    1984-11-01

    Determining the precise etiology of an intraventricular mass can be a difficult diagnostic problem. CT and angiographic findings were reviewed in a series of 73 patients who had intraventricular masses. The histologic diagnosis can be suggested preoperatively by an analysis of the frequency of lesions occurring at a given ventricular location, lesion density before and after administration of contrast material, age, and sex of the patient, morphologic appearance of the mass, and presence or absence of hydrocephalus. Angiography is useful when meningioma, choroid plexus papilloma and carcinoma, or arteriovenous malformation are considered.

  14. High contrast optical imaging methods for image guided laser ablation of dental caries lesions

    NASA Astrophysics Data System (ADS)

    LaMantia, Nicole R.; Tom, Henry; Chan, Kenneth H.; Simon, Jacob C.; Darling, Cynthia L.; Fried, Daniel

    2014-02-01

    Laser based methods are well suited for automation and can be used to selectively remove dental caries to minimize the loss of healthy tissues and render the underlying enamel more resistant to acid dissolution. The purpose of this study was to determine which imaging methods are best suited for image-guided ablation of natural non-cavitated carious lesions on occlusal surfaces. Multiple caries imaging methods were compared including near-IR and visible reflectance and quantitative light fluorescence (QLF). In order for image-guided laser ablation to be feasible, chemical and physical modification of tooth surfaces due to laser irradiation cannot greatly reduce the contrast between sound and demineralized dental hard tissues. Sound and demineralized surfaces of 48 extracted human molar teeth with non-cavitated lesions were examined. Images were acquired before and after laser irradiation using visible and near-IR reflectance and QLF at several wavelengths. Polarization sensitive-optical coherence tomography was used to confirm that lesions were present. The highest contrast was attained at 1460-nm and 1500-1700-nm, wavelengths coincident with higher water absorption. The reflectance did not decrease significantly after laser irradiation for those wavelengths.

  15. Imaging of noncarious cervical lesions by means of a fast swept source optical coherence tomography system

    NASA Astrophysics Data System (ADS)

    Stoica, Eniko T.; Marcauteanu, Corina; Bradu, Adrian; Sinescu, Cosmin; Topala, Florin Ionel; Negrutiu, Meda Lavinia; Duma, Virgil Florin; Podoleanu, Adrian Gh.

    2014-01-01

    Non-carious cervical lesions (NCCL) are defined as the loss of tooth substance at the cemento-enamel junction and are caused by abrasion, erosion and/or occlusal overload. In this paper we proved that our fast swept source OCT system is a valuable tool to track the evolution of NCCL lesions in time. On several extracted bicuspids, four levels of NCCL were artificially created. After every level of induced lesion, OCT scanning was performed. B scans were acquired and 3D reconstructions were generated. The swept source OCT instrument used in this study has a central wavelength of 1050 nm, a sweeping range of 106 nm (measured at 10 dB), an average output power of 16 mW and a sweeping rate of 100 kHz. A depth resolution determined by the swept source of 12 μm in air was experimentally obtained. NCCL were measured on the B-scans as 2D images and 3D reconstructions (volumes). For quantitative evaluations of volumes, the Image J software was used. By calculating the areas of the amount of lost tissue corresponding to each difference of Bscans, the final volumes of NCCL were obtained. This swept source OCT method allows the dynamic diagnosis of NCCL in time.

  16. A 12-year clinical evaluation of a three-step dentin adhesive in noncarious cervical lesions.

    PubMed

    Wilder, Aldridge D; Swift, Edward J; Heymann, Harald O; Ritter, André V; Sturdevant, John R; Bayne, Stephen C

    2009-05-01

    The authors conducted a study to evaluate the clinical performance of a dual-cured, three-step dentin adhesive (OptiBond Dual Cure, Kerr, a subsidiary of Sybron Dental Specialties, Orange, Calif.; no longer on the market) at 12 years. The authors restored 100 noncarious cervical lesions without use of macromechanical retention or enamel bevels. In one-half of the lesions (group A), the authors etched only the enamel; in the other half (group B), they etched both enamel and dentin. After etching, they applied a light-cured primer and dual-cured adhesive to enamel and dentin in both groups. They restored the preparations with a resin-based composite. They performed direct evaluations by using modified U.S. Public Health Service criteria at insertion (baseline) and at one year and 12 years after insertion. The 12-year retention rates were 93 percent in group A and 84 percent in group B, for an overall retention rate of 89 percent. Except for marginal discoloration in both groups and retention in group B, the restorations in both groups had Alfa ratings of 88 percent or greater in all of the direct clinical evaluation categories. The 12-year clinical performance, including retention rate, of a dual-cured dental adhesive was excellent and was not affected by dentin acid-etching. This clinical study provides additional evidence for the long-term durability of a three-step etch-and-rinse adhesive in non-carious cervical lesions.

  17. Direct pulp capping after a carious exposure versus root canal treatment: a cost-effectiveness analysis.

    PubMed

    Schwendicke, Falk; Stolpe, Michael

    2014-11-01

    Excavation of deep caries often leads to pulpal exposure even in teeth with sensible, nonsymptomatic pulps. Although direct pulp capping (DPC) aims to maintain pulpal health, it frequently requires follow-up treatments like root canal treatment (RCT), which could have been performed immediately after the exposure, with possibly improved outcomes. We quantified and compared the long-term cost-effectiveness of both strategies. A Markov model was constructed following a molar with an occlusally located exposure of a sensible, nonsymptomatic pulp in a 20-year-old male patient over his lifetime. Transition probabilities or hazard functions were estimated based on systematically and nonsystematically assessed literature. Costs were estimated based on German health care, and cost-effectiveness was analyzed using Monte Carlo microsimulations. Despite requiring follow-up treatments significantly earlier, teeth treated by DPC were retained for long periods of time (52 years) at significantly reduced lifetime costs (545 vs 701 Euro) compared with teeth treated by RCT. For teeth with proximal instead of occlusal exposures or teeth in patients >50 years of age, this cost-effectiveness ranking was reversed. Although sensitivity analyses found substantial uncertainty regarding the effectiveness of both strategies, DPC was usually found to be less costly than RCT. We found both DPC and RCT suitable to treat exposed vital, nonsymptomatic pulps. DPC was more cost-effective in younger patients and for occlusal exposure sites, whereas RCT was more effective in older patients or teeth with proximal exposures. These findings might change depending on the health care system and underlying literature-based probabilities. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

  18. Treatment of acetabular chondral lesions with microfracture technique

    PubMed Central

    Mella, Claudio; Nuñez, Alvaro; Villalón, Ignacio

    2017-01-01

    Introduction: Acetabular cartilage lesions are frequently found during hip arthroscopy. In the hip joint they mostly occur secondary to a mechanical overload resulting from a pre-existing deformity as hip dysplasia or femoroacetabular impingement (FAI). Lesions identified during arthroscopy can vary greatly from the earliest stages to the most advanced (full-thickness lesions). These lesions occur in the acetabulum in the early stages of joint damage. Microfractures are indicated in full-thickness chondral defects. Ideally, these lesions must be focal and contained. Methods: The procedure begins debriding all the unstable chondral tissue of the lesion. The edges should have a net cut towards stable and healthy cartilage. It is recommended to make as many perforations as possible using arthroscopic awls. They should be ideally 4 mm deep and must have a vertical orientation to the surface. The suggested distance between perforations is of 3–4 mm. Once the treatment of the chondral lesion with the microfractures is complete, the labrum must be repaired. The repair of the labrum transforms in most of the cases the defect in a contained lesion containing better the clot in the lesion after the microfractures have been performed. It is also important to correct the bone deformity that has caused this lesion, which mostly corresponds to a “cam” deformity. Conclusion: Clinical studies confirm good short- and medium-term results in full-thickness chondral lesions treated with microfractures in the absence of osteoarthritis. However, it is difficult to determine if these results are only due to the microfractures, as this treatment is always complemented with several other factors and surgical procedures, such as labrum repair, correction of underlying bone deformity or change in postoperative activity of operated patients. PMID:28612705

  19. Micro-tensile bond strength of self-etching primer adhesive systems to human coronal carious dentin.

    PubMed

    Doi, J; Itota, T; Torii, Y; Nakabo, S; Yoshiyama, M

    2004-10-01

    The aim of this study was to evaluate the micro-tensile bond strengths of three self-etching primer adhesive systems to normal dentin (ND), caries-affected dentin (CAD) and caries-infected dentin (CID). Human extracted molars with caries were used, and flat dentin surfaces ground by 600-grit SiC paper were prepared. The surfaces were dyed using Caries-Detector solution, treated with Clearfil SE Bond, Mac-Bond II and UniFil Bond, and then covered with resin composites according to manufacturer's instructions. After immersion in 37 degrees C water for 24 h, the teeth were serially sectioned into multiple slices. Each slice was distinguished into ND, CAD and CID groups by the degree of staining, and the bond strength was measured in a universal testing machine. Scanning electron microscopic (SEM) observation was also performed. For statistical analysis, anova and Scheffe's test were used (P < 0.05). The bond strengths of the three adhesive systems to CAD and CID were significantly lower than those to ND. There was significant difference in the bond strength to ND between Clearfil SE Bond and UniFil Bond, but no significant differences to CAD and CID among the three adhesive systems. On SEM, the hybrid layers in CAD and CID showed more porous structures compared with ND. The results indicated that the bond strengths to CAD and CID were not affected by a variety of self-etching primer adhesive systems because of the porous hybrid layer formation in carious dentin.

  20. Chronic cutaneous lesions of sarcoidosis.

    PubMed

    Marchell, Richard M; Judson, Marc A

    2007-01-01

    Sarcoidosis involvement of the skin is common. The skin lesions of sarcoidosis may be nonspecific, showing a nondiagnostic inflammatory reaction pattern on histologic evaluation. Nonspecific skin lesions are often associated with an acute presentation of sarcoidosis and, in general, portend a good prognosis. Specific sarcoidosis skin lesions reveal typical sarcoid granulomas on histologic examination. These lesions tend to be chronic and require therapy for resolution. This article will review the epidemiology, diagnostic evaluation, and description of the various chronic skin lesions of sarcoidosis. Various images of these skin lesions will be demonstrated.

  1. Tumorous lesions of the hand.

    PubMed

    Johnson, J; Kilgore, E; Newmeyer, W

    1985-03-01

    A retrospective study was conducted of 543 tumorous lesions of the hand seen in a busy office practice for a 5-year period from April 1976 to April 1981. The lesions were grouped as benign lesions, of either the soft tissue or skeletal type, or as malignant lesions. The overall chance that a hand tumor was malignant was 2% (11 of 543). There was significant association of palmar radial ganglion and carpal tunnel syndrome (15%). Ganglions recur more often after aspiration than after surgery. Certain lesions, particularly a mucous cyst, have a high postoperative complication rate. A few of these unique lesions are described.

  2. Molecular and structural evaluation of dentin caries-like lesions produced by different artificial models.

    PubMed

    Pacheco, Larissa Ferreira; Banzi, Éfani Caroline de Freitas; Rodrigues, Eliana; Soares, Luís Eduardo Silva; Pascon, Fernanda Miori; Correr-Sobrinho, Lourenço; Puppin-Rontani, Regina Maria

    2013-01-01

    This study evaluated structural and molecular issues of dentin caries-like lesions produced by different artificial models (ACL) compared with natural caries lesions (NCL). One hundred twenty-four sound occlusal dentin blocks and 47 carious blocks were obtained and surface hardness was analyzed (SH1). They were assigned to groups according to ACL: GB: Biological; GC: Chemical; GIS: In situ; GNC: natural caries (control). Blocks from groups 1, 2 and 3 were submitted to caries lesion induction. NCL and ACL blocks were submitted to surface hardness (SH 2), FT-Raman and µEDXRF analysis. All blocks were longitudinally sectioned and one of the halves was submitted to cross-sectional hardness (CSH) and the other to SEM analysis. SH1 and SH2 data were submitted to t test (unpaired and paired, respectively), CSH and SEM data to two-way and one-way ANOVA respectively, and Tukey and t tests, respectively (p<0.05). Data from FT-Raman/µEDXRF were submitted to one-way ANOVA and Dunnett multiple-comparisons test (a=0.05). GB and GNC showed lowest SH2 values that were significantly different from GC and GIS. Regarding CSH, GB and GNC showed no significant difference between them. SEM showed similar caries lesion depth for GB and GNC, being significantly higher than for GC and GIS. µEDXRF showed similar values of calcium and phosphate for GB and GNC; GNC values were significantly different from GIS. No significant difference was found among the groups concerning phosphate, carbonate and CH bonds values. For collagen type I, GC values were significantly different compared to other groups. It may be concluded that caries-like lesions produced by GB were the closest model to NCL.

  3. Skin lesions in psoriasis.

    PubMed

    Goodfield, M

    1994-05-01

    Psoriatic skin disease is common; it occurs at all ages and co-exists with joint disease in approximately 10% of cases. All areas of skin, scalp and nails may be involved. In the typical case, the skin lesions are easy to recognize. Atypical forms of skin involvement and lesions at unusual sites are less easily diagnosed by non-specialists. The cause is unknown, but there is a clear genetic element, with external factors being important in precipitation and exacerbations of the condition. Topical treatment is successful in most patients, but in resistant cases combinations of systemic therapy and ultraviolet radiation usually give good control. Although there is no cure, the majority of sufferers live normal lives and, with the exception of severe erythrodermic or generalized pustular psoriasis, there is no mortality. Morbidity, particularly social and occupational, is more of a problem than is often acknowledged.

  4. The effect of variation in occlusal loading on the development of abfraction lesions: a finite element study.

    PubMed

    Rees, J S

    2002-02-01

    Abfraction or non-carious cervical tooth loss is poorly understood and one factor thought to contribute to the development of these lesions is the effect of occlusal loading. The aim of this study was to examine the effect that varying the position of an occlusal load would have on the stress contour in the cervical region of a lower second premolar using a two-dimensional plane strain finite element model. A 500 N load was applied vertically to either of the cusp tips or in various positions along the cuspal inclines. It was found that loads applied to the inner aspects of the buccal or the lingual cuspal inclines produced maximum principal stress values of up to 358 MPa that exceed the known failure stresses for enamel.

  5. Acute periodontal lesions.

    PubMed

    Herrera, David; Alonso, Bettina; de Arriba, Lorenzo; Santa Cruz, Isabel; Serrano, Cristina; Sanz, Mariano

    2014-06-01

    This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute

  6. Gram stain of skin lesion

    MedlinePlus

    ... Names Skin lesion gram stain Images Viral lesion culture References Hall GS, Woods GL. Medical bacteriology. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods . 22nd ed. Philadelphia, PA: Elsevier ...

  7. Vibration sonoelastography and the detectability of lesions.

    PubMed

    Parker, K J; Fu, D; Graceswki, S M; Yeung, F; Levinson, S F

    1998-11-01

    Vibration sonoelastography has been developed for the detection of hard lesions in relatively soft tissue. The basic concept is to propagate low-amplitude and low-frequency shear waves (with displacements below 0.1 mm and frequencies typically below 1000 Hz) through deep organs, and displaying the vibration response in real-time using advanced color Doppler imaging techniques. A hard inhomogeneity, such as a tumor, will produce a localized disturbance in the vibration pattern, forming the basis for detection even when the tumor is isoechoic on B-scan images. This paper focuses on the important quantitative issues concerning the detectability or inherent contrast of lesions. The specific factors of lesion size, relative stiffness and vibration frequency are studied using theoretical models, finite element methods and experimental measurements on tissue-mimicking materials. The results indicate that detectability increases with vibration (shear wave) frequency; however, loss mechanisms ultimately limit the penetration of higher vibration frequencies (in the kHz range).

  8. Multiple sclerosis deep grey matter: the relation between demyelination, neurodegeneration, inflammation and iron.

    PubMed

    Haider, Lukas; Simeonidou, Constantina; Steinberger, Günther; Hametner, Simon; Grigoriadis, Nikolaos; Deretzi, Georgia; Kovacs, Gabor G; Kutzelnigg, Alexandra; Lassmann, Hans; Frischer, Josa M

    2014-12-01

    In multiple sclerosis (MS), diffuse degenerative processes in the deep grey matter have been associated with clinical disabilities. We performed a systematic study in MS deep grey matter with a focus on the incidence and topographical distribution of lesions in relation to white matter and cortex in a total sample of 75 MS autopsy patients and 12 controls. In addition, detailed analyses of inflammation, acute axonal injury, iron deposition and oxidative stress were performed. MS deep grey matter