Journal of Clinical Medicine

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22 pages, 6277 KiB

Open AccessFeature PaperArticle

Effect of the Adhesive Strategy on Clinical Performance and Marginal Integrity of a Universal Adhesive in Non-Carious Cervical Lesions in a Randomized 36-Month Study

by Rainer Haak, Gesa Stache, Hartmut Schneider, Matthias Häfer, Gerhard Schmalz and Ellen Schulz-Kornas

J. Clin. Med. 2023, 12(18), 5776; https://doi.org/10.3390/jcm12185776 - 5 Sep 2023

Cited by 1 | Viewed by 1211

Abstract

The effectiveness of a universal adhesive applied in three application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA) over 36 months. In 50 patients, three (n = 21) or four ( [...] Read more.

The effectiveness of a universal adhesive applied in three application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA) over 36 months. In 50 patients, three (n = 21) or four (n = 29) non-carious cervical lesions (NCCL) were restored with Venus^® Diamond Flow (Kulzer GmbH, Hanau, Germany). The adhesive iBond^® Universal (iBU, Kulzer, Germany) was used in self-etch (SE), etch-and-rinse (ER), or selective-enamel-etch mode (SEE). The etch-and-rinse adhesive OptiBond^TM FL served as a control (OFL, Kerr GmbH, Herzogenrath, Germany). The restorations were clinically assessed (FDI criteria) at 14 days (BL), 6, 12, 24, and 36 months. Additionally, QMA was conducted on all restorations of 11 randomly selected patients. FDI criteria and marginal gap and perfect margin were compared between and within groups and recalls using McNemar, Wilcoxon, or Mann–Whitney U-tests (α = 0.05). Starting with 12 months, cumulative failure rates were lower in iBU-SE (0.0%, p = 0.016) and iBU-ER groups (2.1%, p = 0.07) compared to OFL (16.7%). At two years, iBU-SEE also showed fewer failures (0.0% SEE vs. 34.6% OFL, p = 0.016), as did iBU-SE compared to iBU-ER after 36 months (2.2 and 19.6%, p = 0.039). From BL, the iBU-SEE group always had the fewest marginal gaps and the highest percentage of perfect margins. From BL, iBU-SEE (0%, p = 0.008) and iBU-ER (0.2%, p = 0.027) showed significantly fewer marginal gaps compared to OFL (2.5%) and more perfect margins were found with iBU-SEE starting at 6 months (p = 0.054). The SEE and ER modes ensured the most excellent marginal quality, with differences from the control appearing earlier with QMA than clinically. In restoring NCCls, iBU showed superior clinical performance over OFL, especially in modes SE and SEE. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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13 pages, 2280 KiB

Open AccessArticle

The Detection of Dental Pathologies on Periapical Radiographs—Results from a Reliability Study

by Theresa Meusburger, Annika Wülk, Andreas Kessler, Katrin Heck, Reinhard Hickel, Helena Dujic and Jan Kühnisch

J. Clin. Med. 2023, 12(6), 2224; https://doi.org/10.3390/jcm12062224 - 13 Mar 2023

Cited by 4 | Viewed by 3367

Abstract

(1) Background: Caries, periapical lesions, periodontal bone loss (PBL), and endo-perio lesions are common dental findings that require an accurate diagnostic assessment to allow appropriate disease management. The purpose of this reliability study was to compare the inter- and intra-rater reliability for the [...] Read more.

(1) Background: Caries, periapical lesions, periodontal bone loss (PBL), and endo-perio lesions are common dental findings that require an accurate diagnostic assessment to allow appropriate disease management. The purpose of this reliability study was to compare the inter- and intra-rater reliability for the detection of the above-mentioned pathologies on periapical radiographs. (2) Methods: Fourteen dentists (three with more than two years and eleven with less than two years of work experience) participated in a training workshop prior to data acquisition. A total of 150 radiographs were assessed by all raters in two rounds. Cohen’s Kappa (CK) values and a binary logistic regression were calculated. (3) Results: The reliability was found in a moderate and substantial range of agreement: caries (mean inter-rater CK value/first round 0.704/mean inter-rater CK value/second round 0.659/mean intra-rater CK value 0.778), periapical lesions (0.643/0.611/0.768), PBL (0.454/0.482/0.739) and endo-perio lesion (0.702/0.689/0.840). The regression model revealed a significant influence of the clinical experience, and furthermore, periapical pathologies and PBL were identified less reliably in comparison to caries and endo-perio lesions. (4) Conclusions: The dentist’s ability to detect the chosen pathologies was linked with significant differences. Periapical lesions and PBL were identified less reliably than caries and endo-perio lesions. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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17 pages, 1813 KiB

Open AccessArticle

Clinical Outcomes and Quantitative Margin Analysis of a Universal Adhesive Using a Randomized Clinical Trial over Three Years

by Rainer Haak, Melissa Sophie Werner, Hartmut Schneider, Matthias Häfer and Ellen Schulz-Kornas

J. Clin. Med. 2022, 11(23), 6910; https://doi.org/10.3390/jcm11236910 - 23 Nov 2022

Cited by 3 | Viewed by 1531

Abstract

The effectiveness of a universal adhesive applied in different application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA). In each of the 22 patients, four non-carious cervical lesions (NCCL) were restored with [...] Read more.

The effectiveness of a universal adhesive applied in different application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA). In each of the 22 patients, four non-carious cervical lesions (NCCL) were restored with Filtek^™ Supreme XTE (3M). The adhesive Scotchbond^™ Universal (SBU, 3M) was applied in self-etch (SE), selective-enamel-etch (SEE) or etch-and-rinse (ER) modes. The etch-and-rinse adhesive OptiBond^™ FL (OFL, Kerr) served as a control. The restorations were clinically evaluated (FDI criteria) after 14 days (BL), 6, 12, 24, and 36 months. Additionally, QMA was conducted on all restorations of 11 randomly selected patients. The FDI criteria and marginal gap were statistically compared between the groups at each recall as well as for the time periods between recalls. The cumulative failure rate was non-significantly higher in the OFL group when compared to all of the SBU groups. Marginal adaptation in the OFL and SBU-SE/ER groups was significantly decreased (BL-36 m, p: 0.004) in comparison to the SBU-SEE group (BL-36 m, p: 0.063). More marginal gaps were found in the OFL group than in the SBU-SEE (BL to 36 m, p: 0.063–0.003) and SBU-ER (24/36 m, p: 0.066/0.005) groups as well as in the SBU-SE group when compared to the SBU-SEE (12–36 m, p_i ≤ 0.016) and SBU-ER (24/36 m, p: 0.055/0.001) groups. SBU-SEE performed most effectively. The clinical evaluation and QMA corresponded, yet QMA detected group differences earliest after 6 months and is thus a valuable extension to clinical evaluations. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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13 pages, 1520 KiB

Open AccessArticle

The Influence of Coordinative Skills on the Oral Health of Children and Adolescents in Permanent Dentition

by Henrike Kolbow, Wieland Kiess, Christian Hirsch, Mandy Vogel, Annett Schrock and Wieland Elger

J. Clin. Med. 2022, 11(21), 6472; https://doi.org/10.3390/jcm11216472 - 31 Oct 2022

Cited by 1 | Viewed by 1582

Abstract

Removing dental plaque by using a toothbrush is the most important measure for oral hygiene. The aim of the present study was to estimate the impact of the coordination skills of children and adolescents on their oral health (plaque level, DMF/T: decayed, missing, [...] Read more.

Removing dental plaque by using a toothbrush is the most important measure for oral hygiene. The aim of the present study was to estimate the impact of the coordination skills of children and adolescents on their oral health (plaque level, DMF/T: decayed, missing, filled teeth). Within a prospective cohort study, 996 children (10 to 18 years) were examined. The results of three coordination tests from the Motorik Modul (MoMo) were included to evaluate the coordination skills. Other parameters taken into account were age, sex, orthodontic treatment and socioeconomic status (SES). Univariate and various multivariate analyses were performed to evaluate relationships. Better results in precision coordination tests were significantly related to a better oral hygiene (backward balancing: logistic regression OR 0.86, 95%CI: 0.73–0.99, p = 0.051, proportional odds model OR 0.86, 95%CI: 0.75–0.99, p = 0.037; one-leg-stand: logistic regression OR 0.78, 95%CI: 0.63–0.96, p = 0.018, proportional odds model OR 0.77, 95%CI: 0.64–0.92, p = 0.003). Higher scores on one-leg-stand were significantly related to a lower caries prevalence (logistic regression OR 0.81, 95%CI: 0.66–0.99, p = 0.037; Poisson regression exp(ß) 0.82, 95%CI: 0.74–0.91, p < 0.001). Coordination test under a time constraint (jumping side-to-side) showed no significant relation. Oral hygiene was poorer in younger children, boys and low SES. Caries prevalence increased with low SES and increasing age. The present results suggest that oral health is influenced by coordinative skills. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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16 pages, 1762 KiB

Open AccessArticle

Effects of the Dental Caries Preventive Procedure on the White Spot Lesions during Orthodontic Treatment—An Open Label Randomized Controlled Trial

by Yudai Shimpo, Yoshiaki Nomura, Toshiko Sekiya, Chihiro Arai, Ayako Okada, Kaoru Sogabe, Nobuhiro Hanada and Hiroshi Tomonari

J. Clin. Med. 2022, 11(3), 854; https://doi.org/10.3390/jcm11030854 - 6 Feb 2022

Cited by 14 | Viewed by 3193

Abstract

(1) Background: The aim of this study was to assess the preventive effect of tooth surface disinfection treatment, in addition to fluoride application, during fixed orthodontic treatment. (2) Methods: An open label randomized control trial for the evaluation of the dental caries preventive [...] Read more.

(1) Background: The aim of this study was to assess the preventive effect of tooth surface disinfection treatment, in addition to fluoride application, during fixed orthodontic treatment. (2) Methods: An open label randomized control trial for the evaluation of the dental caries preventive procedure was performed for the patients with high caries risk who had been visited at Department of Orthodontics, Tsurumi University Dental Hospital for orthodontics treatment. The follow-up period was six months. White spot lesions (WSLs) were evaluated by quantitative light-induced fluorescence (QLF). Cariogenic bacteria were monitored and evaluated by bacterial culture. In addition, the oral microbiome was evaluated by a next-generation sequence (NGS). (3) Results: By the mixed effect modeling, tooth surface disinfection treatment significantly reduced cariogenic bacteria and all parameters obtained by QLF. (4) Conclusions: Tooth surface disinfection treatment, in addition to PMTC and fluoride application, were effective for dental caries prevention and keeping a healthy microbiome during orthodontic treatment. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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11 pages, 820 KiB

Open AccessCommunication

Identifying and Avoiding Risk of Bias in Caries Diagnostic Studies

by Jan Kühnisch, Mila Janjic Rankovic, Svetlana Kapor, Ina Schüler, Felix Krause, Stavroula Michou, Kim Ekstrand, Florin Eggmann, Klaus W. Neuhaus, Adrian Lussi and Marie-Charlotte Huysmans

J. Clin. Med. 2021, 10(15), 3223; https://doi.org/10.3390/jcm10153223 - 22 Jul 2021

Cited by 10 | Viewed by 2843

Abstract

Caries diagnostic studies differ with respect to their design, included patients/tooth samples, use of diagnostic and reference methods, calibration, blinding and data reporting. Such heterogeneity makes comparisons between studies difficult and could represent a substantial risk of bias (RoB) when it is not [...] Read more.

Caries diagnostic studies differ with respect to their design, included patients/tooth samples, use of diagnostic and reference methods, calibration, blinding and data reporting. Such heterogeneity makes comparisons between studies difficult and could represent a substantial risk of bias (RoB) when it is not identified. Therefore, the present report aims to describe the development and background of a RoB assessment tool for caries diagnostic studies. The expert group developed and agreed to use a RoB assessment tool during three workshops. Here, existing instruments (e.g., QUADAS 2 and the Joanna Briggs Institute Reviewers’ Manual) influenced the hierarchy and phrasing of the signalling questions that were adapted to the specific dental purpose. The tailored RoB assessment tool that was created consists of 16 signalling questions that are organized in four domains. This tool considers the selection/spectrum bias (1), the bias of the index (2) and reference tests (3), and the bias of the study flow and data analysis (4) and can be downloaded from the journal website. This paper explores possible sources of heterogeneity and bias in caries diagnostic studies and summarizes the relevant methodological aspects. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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Review

Jump to: Research

22 pages, 4028 KiB

Open AccessReview

Caries Management—The Role of Surface Interactions in De- and Remineralization-Processes

by Jasmin Flemming, Christian Hannig and Matthias Hannig

J. Clin. Med. 2022, 11(23), 7044; https://doi.org/10.3390/jcm11237044 - 28 Nov 2022

Cited by 18 | Viewed by 2784

Abstract

Background: Bioadhesion and surface interactions on enamel are of essential relevance for initiation, progression and prevention of caries and erosions. Salivary proteins on and within initial carious and erosive lesions can facilitate or aggravate de- and remineralization. This applies for the pellicle layer, [...] Read more.

Background: Bioadhesion and surface interactions on enamel are of essential relevance for initiation, progression and prevention of caries and erosions. Salivary proteins on and within initial carious and erosive lesions can facilitate or aggravate de- and remineralization. This applies for the pellicle layer, the subsurface pellicle and for proteins within initial carious lesions. Little is known about these proteinaceous structures related to initial caries and erosion. Accordingly, there is a considerable demand for an understanding of the underlying processes occurring at the interface between the tooth surface and the oral cavity in order to develop novel agents that limit and modulate caries and erosion. Objectives and findings: The present paper depicts the current knowledge of the processes occurring at the interface of the tooth surface and the oral fluids. Proteinaceous layers on dental hard tissues can prevent or aggravate demineralization processes, whereas proteins within initial erosive or carious lesions might hinder remineralization considerably and restrict the entry of ions into lesions. Conclusions: Despite the fact that organic–inorganic surface interactions are of essential relevance for de- and remineralization processes at the tooth surface, there is limited knowledge on these clinically relevant phenomena. Accordingly, intensive research is necessary to develop new approaches in preventive dentistry. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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27 pages, 1792 KiB

Open AccessReview

Current Strategies to Control Recurrent and Residual Caries with Resin Composite Restorations: Operator- and Material-Related Factors

by Moataz Elgezawi, Rasha Haridy, Moamen A. Abdalla, Katrin Heck, Miriam Draenert and Dalia Kaisarly

J. Clin. Med. 2022, 11(21), 6591; https://doi.org/10.3390/jcm11216591 - 7 Nov 2022

Cited by 22 | Viewed by 7571

Abstract

This review addresses the rationale of recurrent and/or residual caries associated with resin composite restorations alongside current strategies and evidence-based recommendations to arrest residual caries and restrain recurrent caries. The PubMed and MEDLINE databases were searched for composite-associated recurrent/residual caries focusing on predisposing [...] Read more.

This review addresses the rationale of recurrent and/or residual caries associated with resin composite restorations alongside current strategies and evidence-based recommendations to arrest residual caries and restrain recurrent caries. The PubMed and MEDLINE databases were searched for composite-associated recurrent/residual caries focusing on predisposing factors related to materials and operator’s skills; patient-related factors were out of scope. Recurrent caries and fractures are the main reasons for the failure of resin composites. Recurrent and residual caries are evaluated differently with no exact distinguishment, especially for wall lesions. Recurrent caries correlates to patient factors, the operator’s skills of cavity preparation, and material selection and insertion. Material-related factors are significant. Strong evidence validates the minimally invasive management of deep caries, with concerns regarding residual infected dentin. Promising technologies promote resin composites with antibacterial and remineralizing potentials. Insertion techniques influence adaptation, marginal seal, and proximal contact tightness. A reliable diagnostic method for recurrent or residual caries is urgently required. Ongoing endeavors cannot eliminate recurrent caries or precisely validate residual caries. The operator’s responsibility to precisely diagnose original caries and remaining tooth structure, consider oral environmental conditions, accurately prepare cavities, and select and apply restorative materials are integral aspects. Recurrent caries around composites requires a triad of attention where the operator’s skills are cornerstones. Full article

(This article belongs to the Special Issue Recent Advances in the Management of Dental Caries)

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