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Bacterial Infections of the Oral Cavity
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
P. S. Manoharan, Praveen Rajesh
The use of nonoperative prevention-oriented strategy for caries management is often put aside in favor of restoration placement. One approach is caries management by risk assessment (CAMBRA). The goal is to determine if caries is reduced in high-risk patients receiving treatment with a nonoperative anti-caries agent. The general approach to active caries should be preventive treatment like advice to take less sugar, brushing twice daily with effective fluoride toothpaste, using dental floss, and stimulating saliva by use of sugar-free gums such as xylitol. When active fissure caries have been diagnosed, and fissures are with susceptible morphologic characteristics, sealant with a low-filled resin is indicated.
Functional signatures of ex-vivo dental caries onset
Published in Journal of Oral Microbiology, 2022
Dina G. Moussa, Ashok K. Sharma, Tamer A Mansour, Bruce Witthuhn, Jorge Perdigão, Joel D. Rudney, Conrado Aparicio, Andres Gomez
In this study, we used the reproducible taxonomically diverse oral microcosm biofilm model of dental caries developed by Rudney et al. as detailed in [23,27]. Briefly, 11 supragingival dental plaque samples from high caries risk subjects were collected at the University of Minnesota (Institutional Review Board #1403M48865). Subjects were examined following a formal caries risk assessment (CAMBRA) [30]. All subjects had experienced active carious lesions and previous restorations, and were still at high risk for future caries. All subjects were in good general health and had not taken antibiotics within 3 months of plaque sampling. The microcosm biofilms were grown on hydroxyapatite (HA) discs in CDC biofilm reactor without (NS) or with sucrose (WS) to simulate the oral conditions in the flow of saliva and dietary carbohydrates across biofilm surfaces as described in [23,27]. Each pair of NS and WS microcosm was grown from a single plaque inoculum mimicking health and sucrose-induced dysbiotic models that evolved from the same patient.
Effectiveness of the ICCMS caries management system for children: a 3-year multicentre randomised controlled trial
Published in Acta Odontologica Scandinavica, 2022
Stefania Martignon, Andrea Cortes, Luis Fernando Gamboa, Sofia Jácome-Liévano, Maria Cristina Arango-De-la-Cruz, Olga Lucia Cifuentes-Aguirre, Natalia Fortich-Mesa, Ketty Ramos-Martínez, Johanna Sanjuán-Acero, Lizelia Alfaro, Lofthy Mejía, Margarita Usuga-Vacca
Since its launch, research using ICCMS has reported its use in multiple settings: for epidemiology and public health purposes [10–14]; evaluating its use among dental practitioners [15], students [16], and the former two plus educators [17]. A recent randomised clinical trial (2021) [18] comparing caries incidence in young adults after one year of either ICCMS or CAMBRA caries risk management found no significant differences (p > .05). To date, however, no research has looked at wider outcomes from the use of the ICCMS system. This multicentre randomised controlled trial (RCT) aimed to assess multiple outcomes over 3 years, in 6–7-year-old Colombian children to compare the effectiveness of ICCMS vs. CCMS. These included, primarily, assessing the progression control in caries risk and caries lesions, and secondarily, oral-health-related knowledge, attitudes and practices, and the number of appointments for patients in each group.
Threshold values affect predictive accuracy of caries risk assessment
Published in Acta Odontologica Scandinavica, 2019
Anna Senneby, Jessica Neilands, Gunnel Svensäter, Björn Axtelius, Madeleine Rohlin
As there is a skewed distribution of caries disease within the same region, today’s challenge is to identify the individuals at an increased risk of developing caries lesions. Doing this enables the tailoring of interventions to those at increased risk and the reduction of the number of redundant examinations and interventions for those at lower risk. Contemporary methods used to identify individuals at increased risk of caries lesion development include, for example, previous caries experience, tests using genotypes of microbiota, salivary buffering capacity, and salivary flow rate. The accuracy of these methods, as suggested in a recent systematic review [1], varies considerably and evidence of the validity of these methods is limited [1,2]. For caries risk assessment systems/guidelines, such as the Cariogram and Caries Management by Risk Assessment (CAMBRA), evidence of the validity is also limited [3,4]. The results of the reviews indicate that the level of performance of collecting information on several factors is not more accurate than collecting information on just one [1] or a few [3]. Data collection process needs to be quick, inexpensive, and be acceptable to those to whom it is applied. Given this, previous caries experience is interesting as the method is often used in dental practice and besides considered the most accurate single predictor in school children and adolescents [2].