Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Sep 2000.> Search Strategy (You Saved Citations 1-300 From Set 82): ----------------------------------------------------------------------------- 1 Chlorhexidine/ 2887 2 chlorhexidine.mp. 3503 3 sebidin.mp. 3 4 tubulicid.mp. 21 5 or/1-4 3513 6 exp Cariostatic agents/ 19773 7 fluoride:.mp. 26298 8 ((sulfur or sulphur) adj3 hexafluoride:).mp. 519 9 difluoride:.mp. 457 10 tetrafluoride:.mp. 82 11 ossin.mp. 7 12 zymafluor.mp. 3 13 or/6-12 27675 14 exp Tooth demineralization/ 22611 15 demineralization.mp. 1616 16 caries.mp. 15276 17 caires.mp. 1 18 craies.mp. 0 19 careis.mp. 4 20 carise.mp. 0 21 (teeth adj3 cavit:).mp. 422 22 (tooth adj3 cavit:).mp. 217 23 (dental adj3 cavit:).mp. 276 24 (dentin adj3 cavit:).mp. 254 25 (enamel adj3 cavit:).mp. 182 26 (teeth adj3 decay:).mp. 374 27 (tooth adj3 decay:).mp. 321 28 (dental adj3 decay:).mp. 249 29 (dentin adj3 decay:).mp. 12 30 (enamel adj3 decay:).mp. 20 31 (active adj decay).mp. 9 32 (rampant adj3 decay:).mp. 14 33 (recurrent adj3 decay:).mp. 30 34 (white adj spot:).mp. 508 35 carious.mp. 2075 36 cariology.ti,ab. 56 37 (non-cavitated adj3 lesion:).mp. 15 38 (noncavitated adj3 lesion:).mp. 2 39 Tooth remineralization/ 475 40 (dental adj3 fissure:).mp. 98 41 (tooth adj3 fissure:).mp. 50 42 (teeth adj3 fissure:).mp. 97 43 caries-free.mp. 602 44 cariesfree.mp. 17 45 Cariogenic agents/ 728 46 precavit:.mp. 8 47 (filled adj3 teeth).mp. 510 48 (filled adj3 tooth).mp. 117 49 (oral adj fissure:).mp. 6 50 (tooth adj3 remineraliz:).mp. 28 51 (teeth adj3 remineraliz:).mp. 24 52 dft.mp. 411 53 dfs.mp. 1248 54 dmf:.mp. 6390 55 cariogeni:.mp. 1784 56 or/14-55 32213 57 (5 or 13) and 56 6551 58 exp Research design/ 125392 59 exp Clinical trials/ 113387 60 "comparative study"/ 896877 61 Placebos/ 19801 62 placebo$1.ti,ab. 61778 63 multicenter study.pt. 34559 64 clinical trial.pt. 284041 65 random:.ti,ab. 192625 66 (clinical adj trial:).ti,ab. 50230 67 (controlled clinical trial or randomized clinical trial).pt. 53737 68 practice guideline.pt. 4666 69 Feasibility studies/ 7254 70 clinical protocols/ 8146 71 (single blind: or double blind: or triple blind:).ti,ab. 56641 72 exp treatment outcome/ 95125 73 exp Epidemiologic research design/ 233512 74 Double-blind method/ 60389 75 or/58-74 1420940 76 risk:.mp. 412358 77 exp Risk/ 226237 78 or/75-77 1732532 79 57 and 78 1979 80 limit 79 to (human and english language) 1487 81 limit 80 to yr=1980-2000 1241 82 limit 81 to (adolescence < 13 to 18 years > or adult < 19 552 to 44 years > or middle age < 45 to 64 years > or "aged < 65 and over >" or "aged, < 80 and over >") 83 from 82 keep 1-300 300 *************************** <1> UI - 20316567 AU - Sgan-Cohen HD AU - Saadi S AU - Weissman A IN - Department of Community Dentistry, Hebrew University-Hadassah, Faculty of Dental Medicine, Jerusalem, Israel. TI - Dental knowledge and attitudes among Arab schoolteachers in northern Israel. SO - International Dental Journal 1999 Oct;49(5):269-74 AB - A representative random sample of 597 Arab school-teachers in northern Israel, was surveyed regarding sources and levels of knowledge and attitudes about dental caries prevention. Data were measured according to a self-administered questionnaire from a 91.4 per cent response rate. When ranking the effectiveness of different caries preventive measures teachers on average listed optimal water fluoridation as a lower priority compared to toothbrushing, dental visits, fluoride mouthrinses and eating fewer sweet products. Placing of fissure sealants was ranked as the second least effective caries preventive measure, with 39.6 per cent not knowing the effectiveness. Only 68.5 per cent of the school-teachers were aware of the anti-bacterial role of fluoride, and only a small minority knew of fluoride's potential in healing incipient caries. Teachers seemed less motivated to being involved in dental health school programmes which involved dedicating school time and their active involvement, such as fissure sealant programmes at school, supervision of brushing and flossing, and school mouthrinsing programmes. They revealed positive attitudes towards: informing parents about the importance of oral hygiene and teaching children about preventive dentistry. Teachers' main reported source of knowledge was the dental office. It is the responsibility of the dental profession to ensure that updated knowledge is correctly conveyed to schoolteachers, who are an important and potentially influential sector of dental health consumers and health education agents. <2> UI - 20305622 AU - Martin-Iverson N AU - Pacza T AU - Phatouros A AU - Tennant M IN - School of Oral Health Sciences, University of Western Australia. TI - Indigenous Australian dental health: a brief review of caries experience. [Review] [17 refs] SO - Australian Dental Journal 2000 Mar;45(1):17-20 AB - The indigenous community in Australia is an at risk population for oral diseases such as dental caries. The majority of communities are isolated and dental services in these areas are limited. Oral hygiene standards are poor and this combined with a diet rich in refined carbohydrates has led to high incidences of dental caries. In addition, diabetes, which is related to obesity (and a diet high in sugar and fat) has been linked to increases in oral disease. Caries prevalence was found to be low in areas where fluoridation levels in the water were high. The fact that the fluoride supplementation appears to improve oral health to a significant degree suggests that implementation of fluoride treatment programmes for school children and, where viable, fluoridation of water sources would be appropriate. In addition, dental education programmes should receive high priority. As with the rest of the community, these preventive measures will result in less need for emergency dental treatment in the future, better oral health for the community and reduced financial burden on the State. It is under these circumstances that oral health planners and providers must, in consultation with the relevant community representatives, develop appropriate mechanisms to address the needs of this group. The development of strategies that integrate with the plethora of general health strategies currently being implemented is just one means of achieving improved oral health outcomes for indigenous Australians. [References: 17] <3> UI - 20244915 AU - Yeung AL AU - Lo EC AU - Chow TW AU - Clark RK IN - Faculty of Dentistry, University of Hong Kong. TI - Oral health status of patients 5-6 years after placement of cobalt-chromium removable partial dentures. SO - Journal of Oral Rehabilitation 2000 Mar;27(3):183-9 AB - This study is a clinical survey of cobalt-chromium (Co-Cr) removable partial denture (RPD) wearers that aimed to investigate the effects of denture wearing on oral tissues. A random sample of patients who had received their dentures 5-6 years previously from a dental teaching hospital in Hong Kong was selected. Those who had been constantly wearing the RPDs were examined by one calibrated examiner under an optimal clinical setting. The patients' dental, periodontal and mucosal status were assessed. A total of 87 patients were examined. Mucosal lesions under the Co-Cr RPDs were uncommon in this study sample. However, there was a high prevalence of plaque, gingivitis and gingival recession, especially in dento-gingival surfaces in close proximity (within 3 mm) to the dentures. Thus, there is a special need for regular oral hygiene reinforcement, scaling and prophylaxis among RPD wearers. Despite a low caries incidence in the study sample, root caries were found to be associated with contact with the RPDs (P < 0.05) but coronal caries were not. It is recommended that coverage of the exposed root surfaces by RPD components should be avoided. Also, topical fluorides should be regularly applied onto exposed root surfaces as a preventive measure. <4> UI - 20237500 AU - Petersson LG AU - Magnusson K AU - Andersson H AU - Almquist B AU - Twetman S IN - Department of Preventive and Paediatric Dentistry, Medical and Dental Health Centre, Lanssjukhuset, Sweden. lars.g.petersson@lthalland.se TI - Effect of quarterly treatments with a chlorhexidine and a fluoride varnish on approximal caries in caries-susceptible teenagers: a 3-year clinical study. SO - Caries Research 2000 Mar-Apr;34(2):140-3 AB - The aim of this study was to compare the effect of two different dental varnishes on approximal caries incidence in teenagers with proven caries susceptibility during a 3-year period. Two hundred 13- to 14-year-old subjects exhibiting at least two approximal enamel caries lesions were selected to take part in the study. One hundred and eighty subjects participated after informed consent and were randomly assigned to two equally sized groups. One group was treated with a fluoride varnish (FV, Fluor Protector) containing 0.1% F every 3rd month and the participants of the other group were treated in the same mode with a chlorhexidine varnish (CV, Cervitec((R))) containing 1% chlorhexidine and 1% thymol. In total, each subject was treated 12 times during the experimental period. Approximal caries including enamel lesions (DMFS(appr)) were recorded from four bitewing radiographs exposed at the start and end of the study. The mean (+/-SD) caries prevalence at baseline was 2.2+/-3.4 in the FV group and 2.5+/-4.0 in the CV group. After 3 years, the average approximal caries incidence was 2.7+/-3.1 and 3.1+/-3.5 in the FV and CV groups, respectively. The differences at baseline and after 3 years were not statistically significant. In conclusion, treatments every 3rd month with either a fluoride- or a chlorhexidine/thymol-containing varnish showed a promising effect with low approximal caries incidence and progression in teenagers with proven caries susceptibility. <5> UI - 20308789 AU - Baranska-Gachowska M AU - Borkowski L AU - Ziaja M IN - Department of Pediatric Dentistry, Silesian Academy of Medicine, Zabrze, Poland. swr@infomed.slam.katowice.pl TI - Clinical evaluation of Ariston pHc restorations: 1-year results. SO - American Journal of Dentistry 1999 Nov;12 Spec No:S19-20 <6> UI - 20308788 AU - Care R AU - Berzina S AU - Rence-Bambite I AU - Mackevica I AU - Heintze SD AU - Reich E IN - Department of Operative Dentistry, Medical Academy of Latvia, Riga, Latvia. rcare@latnet.lv TI - Efficacy of a new caries-inhibitory restorative material and amalgam as control in 12-13 year-old Latvian adolescents with high caries prevalence: 1-year results. SO - American Journal of Dentistry 1999 Nov;12 Spec No:S16-7 <7> UI - 20289948 AU - Vogel GL AU - Zhang Z AU - Chow LC AU - Carey CM AU - Schumacher GE AU - Banting DW IN - American Dental Association Health Foundation, Paffenbarger Research Center, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA. jvogel@nist.gov TI - Effect in vitro acidification on plaque fluid composition with and without a NaF or a controlled-release fluoride rinse. SO - Journal of Dental Research 2000 Apr;79(4):983-90 AB - Plaque fluid ion concentration changes, especially fluoride, in response to the pH decrease associated with a cariogenic episode are important components of the caries process. A "controlled-release" (CR) fluoride rinse, based on the controlled release of fluoride in the presence of calcium, has been shown to form large fluoride reservoirs in resting plaque. In this study, the in vitro acid-induced release of fluoride, and other ions, was examined in 48-hour-fasted plaque fluid from subjects (n = 11) who received no rinse, or who used a 228-ppm CR or NaF fluoride rinse 1 hr before being sampled. After collection, the plaque was centrifuged to yield plaque fluid, acidified (0.1 microL of 0.5 mol/L HCl per milligram plaque), and then re-centrifuged before a second sample was obtained. Although previous studies indicated a higher plaque fluid fluoride after the new rinse relative to NaF, no statistically significant difference was observed here. Average fluoride release after acidification (average pH, 5.2) was statistically greater following the use of the CR rinse (153 micromol/L) compared with the NaF rinse (17 micromol/L). No fluoride release was seen in the no-rinse samples. The pH, free calcium, phosphate, acetate, propionate, and buffer capacity were not affected by the different amounts of fluoride deposited in the plaque. However, following acid addition, an increase in free calcium and phosphate was observed, which was also independent of the rinse. The large release of fluoride following acidification suggests that the new rinse may provide an improved cariostatic effect. <8> UI - 20229216 AU - Zaura-Arite E AU - ten Cate JM IN - Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. e.zaura@acta.nl TI - Effects of fluoride- and chlorhexidine-containing varnishes on plaque composition and on demineralization of dentinal grooves in situ. SO - European Journal of Oral Sciences 2000 Apr;108(2):154-61 AB - The aim of the study was to compare the effects of Cervitec, containing 1% chlorhexidine (CHX) and 1% thymol, Fluor Protector, containing 0.1% fluoride, their 1:1 mixture, and a placebo varnish on the percentage of mutans streptococci and lactobacilli in plaque and on the underlying dentin demineralization, as assessed by microradiography. Bovine dentine discs, fitted with three parallel grooves, received one of the varnish treatments into the first groove and on the adjacent part of the dentin surface. Volunteers (n = 23) wore the discs fixed to their partial dentures for four consecutive 3 wk periods. Microbiological analysis of plaque accumulated in the grooves showed no difference between groups. Fluoride varnishes (Fluor Protector and mixed varnish) had a significantly larger inhibitory effect on mineral loss in the treated groove than Cervitec or placebo. All treatment varnishes had more pronounced effect in panelists (n = 14) with higher degree of demineralization (mineral loss in placebo group > or = 1,200 vol% x microm). In these panelists, CHX-containing varnishes showed an inhibitory effect on demineralization in all grooves, also in the two non-varnished grooves. As fluoride varnishes had the largest localized effect on demineralization, and CHX varnishes were showing a peripheral effect, a combined treatment could be the preferred method to obtain an optimal caries preventive effect in caries-prone individuals. <9> UI - 99139131 AU - Morgan MV AU - Campain AC AU - Adams GG AU - Crowley SJ AU - Wright FA IN - School of Dental Science, University of Melbourne, Victoria, Australia. TI - The efficacy and effectiveness of a primary preventive dental programme in non-fluoridated areas of Victoria, Australia [see comments]. CM - Comment in: Community Dent Health 1999 Jun;16(2):123 SO - Community Dental Health 1998 Dec;15(4):263-71 AB - OBJECTIVE: To determine the efficacy and effectiveness of a primary preventive dental programme. DESIGN: A field trial comparing an intervention and control group over three years. The intervention group received a preventive programme which consisted of a weekly fluoride mouthrinse (0.2% neutral NaF), an annual application, replacement or repair of pit and fissure sealants, and an annual oral hygiene education programme. The control group received the oral hygiene education programme only. Examinations to record dental caries status were conducted annually for both study groups. SETTING: Five secondary colleges in two non-fluoridated regions of Victoria, Australia. SUBJECTS: 522 subjects aged 12-13 years and considered at high risk of developing dental caries were recruited for the study; 256 received the preventive programme and 266 acted as controls. OUTCOME MEASURES: Dental caries was diagnosed according to World Health Organization criteria. RESULTS: Subjects in the intervention group who completed the three-year preventive programme (efficacy) incurred an average of 1.49 fewer decayed, missing or filled tooth surfaces than the control group. The difference was highly statistically significant. The programme also had a statistically significant impact when analysed by intention-to-treat (effectiveness), even when it was assumed that subjects lost to follow-up received minimal future benefit. Approximately 70% of the improvement in oral health was in the pit and fissure surfaces, with the remainder in the smooth surfaces. CONCLUSION: A comprehensive preventive dental programme introduced into adolescent populations at high risk of developing dental caries can result in significant improvements in their dental health. Further research is required to clarify the public health impact of school-based fluoride mouth rinsing. <10> UI - 20205728 AU - Fine DH AU - Furgang D AU - Barnett ML AU - Drew C AU - Steinberg L AU - Charles CH AU - Vincent JW IN - Dental Research Center, New Jersey Dental School, Newark 07103, USA. TI - Effect of an essential oil-containing antiseptic mouthrinse on plaque and salivary Streptococcus mutans levels. SO - Journal of Clinical Periodontology 2000 Mar;27(3):157-61 AB - BACKGROUND: Clinical studies in which antimicrobial mouthrinses were shown to have significant antiplaque activity most frequently have used gingivitis as the clinically relevant endpoint. However, there is evidence to suggest that mouthrinses containing active agents effective against Streptococcus mutans, such as chlorhexidine, may also have a role in inhibiting dental caries. This clinical study was conducted to determine the effect of 2x-daily rinsing with an essential oil-containing antiseptic mouthrinse (Listerine Antiseptic) on levels of recoverable S. mutans and total streptococci in supragingival interproximal plaque and in saliva. Additionally, a follow-up in vitro study is reported which determined whether a differential susceptibility to the antiseptic mouthrinse exists among different strains of streptococci. METHOD: Following baseline saliva and plaque sampling for quantification of recoverable S. mutans and total streptococci, 29 qualifying subjects were randomly assigned either the essential oil mouthrinse or a sterile water control. They rinsed with 20 ml for 30s 2 x daily for 11 days and once on the 12th day, in addition to their usual oral hygiene procedures. On day 12, saliva and plaque samples were again collected and microbiological quantification performed. The procedures were repeated with the alternate rinse after a 1-week washout period. RESULTS: The essential oil mouthrinse produced respective reductions of 69.9% and 75.4% in total recoverable streptococci and in S. mutans in plaque, and corresponding reductions of 50.8% and 39.2% in saliva. The in vitro study revealed that streptococci from the mutans group were more susceptible to the bactericidal activity of the essential oil mouthrinse than streptococci from the mitis group. CONCLUSIONS: As antimicrobial mouthrinses are most frequently recommended to patients whose mechanical oral hygiene procedures are not adequate for the control of supragingival plaque and gingivitis, this study provides an additional rationale for the inclusion of the essential-oil mouthrinse as an adjunct to daily oral hygiene procedures. <11> UI - 20260031 AU - Moynihan P IN - Department of Child Dental Health, University of Newcastle Dental School, Newcastle upon Tyne. p.j.moynihan@ncl.ac.uk TI - The British Nutrition Foundation Oral Task Force report--issues relevant to dental health professionals. SO - British Dental Journal 2000 Mar 25;188(6):308-12 AB - A recent report on diet and oral health by the British Nutrition Foundation reviews the anatomy, microbiology and pathology of a number of oral diseases including dental caries, tooth-wear, oral cancer, periodontal disease and enamel defects. The role of nutritional factors in the aetiology and prevention of these oral diseases is discussed. The report states that improvements in the levels of caries in the UK are halting and remain unacceptably high in some 'at risk groups'--including the socially deprived. It states that a two-pronged attack, i.e. reduced frequency of consumption of sugary foods and use of fluoride is necessary to address the problem. To address the increased prevalence of oral cancer avoiding tobacco, limiting alcohol and increasing fruit and vegetable consumption are recommended. Recommendations for approaches to improve oral health are made for health authorities, industry, schools and health professionals and it is recommended that the Government make adequate resources available to improve oral health preventive strategies. <12> UI - 20227031 AU - Soderling E AU - Isokangas P AU - Pienihakkinen K AU - Tenovuo J IN - Institute of Dentistry, University of Turku, Finland. eva.soderling@utu.fi TI - Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. SO - Journal of Dental Research 2000 Mar;79(3):882-7 AB - Xylitol is effective as a non-cariogenic sugar substitute. Habitual xylitol consumption appears to select for mutans streptococci (MS) with impaired adhesion properties, i.e., they shed easily to saliva from plaque. One hundred sixty-nine mother-child pairs participated in a two-year study exploring whether the mothers' xylitol consumption could be used to prevent mother-child transmission of mutans streptococci. All mothers showed high salivary levels of mutans streptococci during pregnancy. The mothers in the xylitol group (n = 106) were requested to chew xylitol-sweetened gum (65% w/w) at least 2 or 3 times a day, starting three months after delivery. In the two control groups, the mothers received either chlorhexidine (n = 30) or fluoride (n = 33) varnish treatments at 6, 12, and 18 months after delivery. The children did not chew gum or receive varnish treatments. MS were assessed from the mothers' saliva at half-year intervals and from the children's plaque at the one- and two-year examinations. The MS were cultured on Mitis salivarius agars containing bacitracin. The salivary MS levels of the mothers remained high and not significantly different among the three study groups throughout the study. At two years of age, 9.7% of the children in the xylitol, 28.6% in the chlorhexidine, and 48.5% in the fluoride varnish group showed a detectable level of MS. In conclusion, therefore, habitual xylitol consumption by mothers was associated with a statistically significant reduction of the probability of mother-child transmission of MS assessed at two years of age. The effect was superior to that obtained with either chlorhexidine or fluoride varnish treatments performed as single applications at six-month intervals. <13> UI - 20162073 AU - Frame PS AU - Sawai R AU - Bowen WH AU - Meyerowitz C IN - Tri-County Family Medicine, Cohocton, New York 14826, USA. TI - Preventive dentistry: practitioners' recommendations for low-risk patients compared with scientific evidence and practice guidelines. [Review] [16 refs] SO - American Journal of Preventive Medicine 2000 Feb;18(2):159-62 AB - INTRODUCTION: The purpose of this article is to compare published evidence supporting procedures to prevent dental caries and periodontal disease, in low-risk patients, with the actual preventive recommendations of practicing dentists. METHODS: Methods included (1) a survey questionnaire of general dentists practicing in western New York State concerning the preventive procedures they would recommend and at what intervals for low-risk children, young adults, and older adults; and (2) review of the published, English-language literature for evidence supporting preventive dental interventions. RESULTS: The majority of dentists surveyed recommended semiannual visits for visual examination and probing to detect caries (73% to 79%), and scaling and polishing to prevent periodontal disease (83% to 86%) for low-risk patients of all ages. Bite-wing radiographs were recommended for all age groups at annual or semiannual intervals. In-office fluoride applications were recommended for low-risk children at intervals of 6 to 12 months by 73% of dentists but were recommended for low-risk older persons by only 22% of dentists. Application of sealants to prevent pit and fissure caries was recommended for low-risk children by 22% of dentists. Literature review found no studies comparing different frequencies of dental examinations and bite-wing radiographs to determine the optimal screening interval in low-risk patients. Two studies of the effect of scaling and polishing on the prevention of periodontal disease found no benefit from more frequent than annual treatments. Although fluoride is clearly a major reason for the decline in the prevalence of dental caries, there are no studies of the incremental benefit of in-office fluoride treatments for low-risk patients exposed to fluoridated water and using fluoridated toothpaste. CONCLUSIONS: Comparative studies using outcome end points are needed to determine the optimal frequency of dental examinations and bite-wing radiographs for the early detection of caries, and of scaling and polishing to prevent periodontal disease in low-risk persons. There is no scientific evidence that dental examinations, including scaling and polishing, at 6 month intervals, as recommended by the dentists surveyed in this study, is superior to annual or less frequent examinations for low-risk populations. There is also no evidence that in-office fluoride applications offer incremental benefit over less costly methods of delivering fluoride for low-risk populations. [References: 16] <14> UI - 20146914 AU - Moss SJ IN - Health Education Enterprises, New York, NY 10017, USA. healthee@ix.netcom.com TI - The case for retaining the current supplementation schedule. SO - Journal of Public Health Dentistry 1999 Fall;59(4):259-62 AB - Following ingestion of dietary fluoride, microquantities of fluoride return to the mouth in saliva, but in quantities large enough to facilitate the maintenance and reparative functions of enamel. Dietary fluoride supplements alone are unlikely to be the cause of the reported increase in fluorosis. Compliance continues to be extremely poor and few children use supplements for more than a year and a half. The amount of background fluoride resulting from dietary fluoride supplements appears to be very small. Considering the almost ubiquitous presence of fluoride dentifrice and the strong possibility of additional unintentional fluoride ingestion from many sources, the present fluorosis data is too amorphous to use as a basis for making reasonable risk/benefit evaluations. Very mild and mild fluorosis is not a serious problem for either the clinician or the patient. By altering the present recommended dosage we may deprive children from receiving a proven effective dose. One cannot make a risk/benefit decision concerning an esthetic problem without involving the patient's perception as well as the caries score. The apparent severity of the milder forms of fluorosis lessens with age and a community fluorosis index should be used only on populations who are older than 15 years. <15> UI - 20152119 AU - Papas A AU - Russell D AU - Singh M AU - Stack K AU - Kent R AU - Triol C AU - Winston A IN - Tufts University School of Dental Medicine, Boston, USA. apapas@infonet.tufts.edu TI - Double blind clinical trial of a remineralizing dentifrice in the prevention of caries in a radiation therapy population. SO - Gerodontology 1999 Jul;16(1):2-10 AB - OBJECTIVES: The purpose of this study is to determine the efficacy and safety of a specially formulated remineralizing toothpaste in controlling caries in a group of high risk, head and neck radiation patients. DESIGN: The study compares the performance of the remineralizing toothpaste with a leading conventional fluoride dentifrice using double-blind randomization. TEST PRODUCTS: The products compared both contain equivalent quantities of fluoride (1150 ppm). The remineralizing toothpaste also delivers soluble calcium and phosphate ions, the essential components of teeth. SUBJECTS: On completion, 50 subjects who received > 50 Gy of radiation to the head and neck. MEASUREMENTS: Examinations include coronal and root caries using the Pitts Diagnostic Criteria, salivary flow rate, plaque and gingival indices and microbiological counts over one year. RESULTS: At this point subjects are enrolled in the study at various phases. However, the current average for the net increment per month per subject is -0.12 (+/- 1.30) for coronal caries and 0.06 (+/- 0.73) for root caries in subjects using the remineralizing toothpaste and 0.53 (+/- 1.62) for coronal caries and 0.45 (+/- 0.98) for root caries in subjects using the conventional fluoride dentifrice. Non-parametric analysis of rank scores for net root surface increments/month was statistically significant (p = 0.02), suggesting lower net root surface increment/month for the remineralizing toothpaste relative to the conventional toothpaste. No significant differences were noted on coronal surfaces. CONCLUSIONS: The results to date indicate that the remineralizing toothpaste is significantly superior to the conventional fluoride dentifrice in preventing root caries in high risk patients. <16> UI - 20128584 AU - Marini I AU - Pelliccioni GA AU - Vecchiet F AU - Alessandri Bonetti G AU - Checchi L IN - Department of Oral Surgery, School of Dentistry, University of Bologna, Italy. TI - A retentive system for intra-oral fluoride release during orthodontic treatment. SO - European Journal of Orthodontics 1999 Dec;21(6):695-701 AB - The aim of this study was to test a particular type of intra-oral fluoride releasing device (IFRD), designed to release 0.04 mg/day of fluoride over a period of 6 months, using customized holders, in patients receiving orthodontic treatment. Discomfort, holder detachment, plaque accumulation near the device, and the presence of gingivitis, bleeding, white spot lesions, and/or decay was recorded in 76 orthodontic patients (53 experimental and 23 controls) before and after wearing the device for 12 months. The system proved to be easy and quick to use, and did not cause discomfort. There were no significant differences between the treated and the control groups for plaque index, bleeding, or the presence of gingivitis. In addition, no carious and/or white spot lesions occurred during the duration of this study in the test group. <17> UI - 20128565 AU - Helminen SE AU - Vehkalahti M AU - Lammi R AU - Ketomaki TM AU - Murtomaa H IN - Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Finland. TI - Dentists' decisions as to mode of preventive treatment in adolescents and young adults in Finland. SO - Community Dental Health 1999 Dec;16(4):250-5 AB - OBJECTIVE: To evaluate dentists' real-life decisions as to mode of preventive treatment in adolescents and young adults, in relation to these patients' oral-health status, and to the dentists' characteristics. DESIGN: A random sample of 206 adolescents and 239 young adults (mean ages 13 and 27 years) produced 411 (92%) individual oral health records providing data on actual clinical examinations and treatment courses carried out by 56 dentists in one administrative unit of the Finnish public oral health service during 1994-1996. OUTCOME MEASURES: Preventive measures were defined as active and passive, active including any kind of motivation or instructions given to a patient concerning home self-care, and passive prevention being topical application of fluoride. RESULTS: More adolescents had received both active and passive prevention than had young adults (active: 27% vs. 20%; passive: 85% vs. 70%). Of adolescents, 7% and of young adults 25% were given no preventive treatment. The mean number of active preventive measures per adolescent during the treatment course was 0.3 and of passive measures 1.0; for young adults 0.2 and 0.8, respectively. A subject's oral health status made no significant difference in active prevention given. Active measures were more frequently given to all patients by male dentists, 35% vs. 22% (P < 0.02), and passive measures by females, 82% vs. 52% (P < 0.001). The odds of active prevention for adolescents were 7.4 comparing male dentists to female; of passive 13.8 comparing female to male. CONCLUSIONS: Dentists should be motivated to make considered treatment decisions on preventive treatment. <18> UI - 20151476 AU - Kleber CJ AU - Milleman JL AU - Davidson KR AU - Putt MS AU - Triol CW AU - Winston AE IN - Health Science Research Center, Indiana University-Purdue University, Ft. Wayne, USA. kleber@ipfw@edu TI - Treatment of orthodontic white spot lesions with a remineralizing dentifrice applied by toothbrushing or mouth trays. SO - Journal of Clinical Dentistry 1999;10(1 Spec No):44-9 AB - 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. <19> UI - 20151475 AU - Wolinsky LE AU - Gnagne-Agnero ND AU - Chamkasem P AU - Jason S AU - Triol CW AU - Winston AE IN - UCLA School of Dentistry, USA. wolinsky@ucla.com TI - An in vitro assessment and a pilot clinical study of electrical resistance of demineralized enamel. SO - Journal of Clinical Dentistry 1999;10(1 Spec No):40-3 AB - Electrical resistance measurement was evaluated in vitro and in vivo as a method for comparing the remineralizing performance of toothpastes. In the in vitro study, areas of sound enamel on 12 unrestored, mature, extracted human molars and bicuspids, with electrical resistance readings greater than 99.99 M omega, were demineralized to an electrical resistance of 1 to 4 M omega. The teeth were divided into three groups. The change in electrical resistance was measured following a 15 cycle regimen of treatment, demineralization and salivary soaking. Treatments were five-minute exposures to either a 1:2 slurry in saliva of Enamelon (E), a remineralizing fluoride-toothpaste also containing soluble calcium and phosphate ions, a 1:2 slurry in saliva of Crest (C), a conventional fluoride toothpaste (P), or to saliva alone. Demineralization was performed with a 30-minute exposure to 0.1 M lactic acid 50% saturated with calcium hydroxyapatite. The salivary soaking was 1 hour in duration. The mean electrical resistance of the E, C and the saliva treated sites was 63.9 +/- 4.3, 37.6 +/- 9.5 and 2.1 +/- 0.7 M omega, respectively. The final resistance was statistically different for each group (p < 0.05). A pilot clinical study was then conducted to assess the electrical resistance technology in vivo. Eighteen adult subjects with at least one site of early enamel caries with an electrical resistance between 1.0 M omega and 20.00 M omega were randomly assigned to either Enamelon, Crest, or a non-fluoride placebo toothpaste and asked to brush twice daily. After three months, the mean resistance of the test sites was 23.57 M omega for E, 9.61 M omega for C and 13.24 M omega for P. However, the mean resistance changes did not proceed consistently over time. At the end of the study, the electrical resistance measurements on four sites out of twelve in Group E were suggestive of remineralization, whereas measurements on one site out of ten were suggestive of remineralization in Group C and two or three sites out of twelve were suggestive of remineralization in Group P. Progression of demineralization was possibly indicated in only one site, which was in Group C. There were insufficient subjects for statistical significance in the pilot clinical study. There were apparent problems with the variability of some measurements between visits in the in vivo study. Overall, however, the results of both studies indicate that with modifications to the equipment, electrical resistance measurements may be a means of comparing the remineralization performance of toothpastes. <20> UI - 20118602 AU - Moynihan PJ AU - Ferrier S AU - Jenkins GN IN - The Dental School, Newcastle upon Tyne. TI - The cariostatic potential of cheese: cooked cheese-containing meals increase plaque calcium concentration. SO - British Dental Journal 1999 Dec 25;187(12):664-7 AB - OBJECTIVE: Eating cheese by itself increases plaque calcium concentration - which is probably one mechanism of the well-established action of cheese in reducing experimental caries. The objective of the present study was to determine whether consumption of cheese as part of a cooked, mixed meal (ie as it is habitually consumed) is able to increase plaque calcium concentration. DESIGN: Plaque samples were obtained from 16 adult volunteers before and 5 minutes after consumption of either a 15 g cube of cheese, one of two cheese-containing test meals, or one of two control meals. Each subject tested each of the four meals on a separate occasion. Plaque calcium concentration was measured using atomic absorption spectrophotometry. RESULTS: The test meals increased plaque calcium concentrations to a significantly greater magnitude than the control meals (P < 0.05). A non-significant trend was observed towards a larger magnitude of change in plaque calcium concentration in the 8 subjects with the lowest, compared with the 8 subjects with the highest baseline concentration. CONCLUSION: The findings suggest that cheese-containing meals increase plaque calcium concentration and thus probably protect against dental caries. <21> UI - 20105826 AU - Hillman L AU - French AD AU - Treasure E TI - Changing trends in South Wales fluoride prescription dispensing (1993-7). SO - Community Dental Health 1999 Sep;16(3):145-8 AB - OBJECTIVE: To observe patterns of fluoride preparation dispensing by primary care practitioners in a health authority. DESIGN: Observational study. SETTING: The Prescription Pricing Agency of the Welsh Health Common Services Authority (WHCSA). SUBJECTS: Individuals who had exchanged a prescription for a fluoride preparation at a pharmacy in Bro Taf Health Authority in the six months from 1 January 1997 to 30 June 1997. METHOD: Information from each prescription including a fluoride preparation, passed to WHCSA from pharmacists during the study, was entered onto a database, including the prescriber's postcode and profession, the recipient's postcode and product information. Numbers of dental prescriptions were correlated to local levels of NHS primary dental care provision and caries prevalence data. Comparisons were made with a similar study undertaken in 1993. RESULTS: 415 dentists' prescriptions were dispensed within the area, of which 38.8% originated from five dentists. At least one prescription had been made by 89 of the 253 local primary dental care providers (35%). Within the area monitored in both 1993 and 1997, dental prescribing rates had almost halved. Of the 122 doctors' prescriptions that were dispensed over the six-month period, 98 were mouthwash preparations for adult patients and four were for children. CONCLUSION: NHS provision of fluoride supplementation was low and remained related to prescribing patterns of individuals rather than to evidence on local variations in dental caries prevalence. <22> UI - 20101045 AU - Gupta K AU - Tewari A AU - Sahni A AU - Chawla HS AU - Gauba K IN - Dept. of Dentistry, Govt. Medical College & Hospital, Chandigarh. TI - Remineralizing efficacy of a mineral enriched mouth rinse and fluoridated dentifrice on artificial carious lesions: an in vivo scanning electron microscopic study. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1998 Sep;16(3):67-71 AB - This comparative investigation was carried out to evaluate the remineralization potential on early artificial carious lesions under Scanning Electron Microscope (SEM) of a Mineral enriched mouthrinse and a fluoridated dentifrice using an in-vivo intra-oral removable appliance model. This findings revealed that the remineralization was found to have occurred in almost all the samples (in children) using non-fluoridated, fluoridated dentifrices as well as those using mineral enriched mouthrinse. However the qualitative analysis of the remineralization revealed that in case of non-fluoridated dentifrice group, the prismatic holes showed deposition of granular, variable sized particles with uneven distribution, while in fluoridated dentifrice group, deposits were found to have partially but more densely filled up the prism cores. In case of mineral enriched mouthrinse group these deposits were found to be in the form of amorphous globular precipitate. <23> UI - 20075337 AU - Wenderoth CJ AU - Weinstein M AU - Borislow AJ IN - Albert Einstein Medical Center, The Maxwell S. Fogel Department of Dental Medicine, Division of Orthodontics, Philadelphia, PA 19141-3098, USA. TI - Effectiveness of a fluoride-releasing sealant in reducing decalcification during orthodontic treatment. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1999 Dec;116(6):629-34 AB - Decalcification and caries during orthodontic treatment still remains a problem. A method to protect the susceptible area beneath and adjacent to bonded attachments, independent of patient compliance, would be extremely beneficial. A clinical trial was performed using a dual-cured lightly filled BIS-GMA fluoride-releasing sealant. The barrier effect of this material on white spot formation, gingival irritation, and plaque accumulation during fixed orthodontic therapy was examined. Twenty patients with a total of 225 metal brackets placed on anterior teeth participated in this study. Brackets were placed in both arches in a conventional manner with a chemically cured, unfilled bonding resin; 112 teeth (every other tooth) received the barrier material after bracket placement, while the remaining 113 teeth served as controls. Intraoral photographic slides were taken before and after treatment and were evaluated blindly by 7 observers for white spot formation. Gingival and plaque indexes were recorded initially and consecutively every 6 months. Observation time ranged from 5 to 18 months. The results of this prospective clinical study indicated that there was no significant difference (P >.05) between the decalcification rates of the treatment or control groups. Likewise there was no added benefit with respect to plaque accumulation or gingival irritation. <24> UI - 20006947 AU - Helminen SE AU - Vehkalahti M AU - Ketomaki TM AU - Murtomaa H IN - Department of Oral Public Health, Institute of Dentistry, University of Helsinki, Finland. sari.helminen@helsinki.fi TI - Dentists' selection of measures for assessment of oral health risk factors for Finnish young adults. SO - Acta Odontologica Scandinavica 1999 Aug;57(4):225-30 AB - Dentists' selection of measures for assessing oral health risk factors for young adults, in relation to their oral health status and to those dentists' characteristics, was studied in one administrative unit of the Finnish public oral health service. A random selection (n = 239) was made of all young adults born in the period 1966-71 and clinically examined during 1994. On the original oral health records of those selected, all notes were scrutinized concerning the most recent clinical examination and treatment course; in total 208 (87%) records. We found that assessment of risk factors to oral health was rare. The patient's diet had been recorded as assessed in 7% of all cases, use of fluoride in 8%, and oral hygiene habits in 14%. No salivary tests were performed; nor was patients' use of tobacco assessed. No correlation was detected between measures used by these dentists and their patients' oral health status (DMFT and DT scores, number of approximal incipient lesions, and number of healthy sextants by CPITN). The oral health status impelled only slightly assessments by bite-wing radiographs. Fewer than half (44%) of the dentists performed and recorded any kind of assessment measure; 4% assessed diet, hygiene, and use of fluoride for all their patients in our sample. A dentist's gender showed no correlation with number of measures used; younger dentists tended to perform and record assessments slightly more often than did older dentists, but in all age groups there were those who had not done this. The practice of risk-factor assessment should be more widespread and standardized, contributing to needs-based treatment and allocation of resources. <25> UI - 99365535 AU - Warren JJ AU - Levy SM IN - Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, USA. TI - A review of fluoride dentifrice related to dental fluorosis. [Review] [53 refs] SO - Pediatric Dentistry 1999 Jul-Aug;21(4):265-71 AB - Introduced to the commercial market 40 years ago, fluoride dentifrice now accounts for nearly all dentifrice purchased in the United States. During this same time, the prevalence and severity of dental caries has declined while dental fluorosis prevalence has increased. While the caries decline can be largely attributed to widespread fluoride dentifrice use, as well as many other sources of fluoride, several recent studies have attributed much of the increase in fluorosis prevalence to early use of fluoride dentifrice. This paper reviews these studies, as well as the efficacy of fluoride dentifrices with lower fluoride concentrations. Finally, recommendations regarding fluoride dentifrice to maintain caries prevention and reduce the risk of dental fluorosis are presented. [References: 53] <26> UI - 99365532 AU - Jackson RD AU - Kelly SA AU - Katz B AU - Brizendine E AU - Stookey GK IN - Oral Health Research Institute, Indiana University School of Dentistry, USA. TI - Dental fluorosis in children residing in communities with different water fluoride levels: 33-month follow-up. SO - Pediatric Dentistry 1999 Jul-Aug;21(4):248-54 AB - PURPOSE: The purpose of these examinations was to monitor changes, in the prevalence of dental fluorosis. METHODS: In February 1992 and December 1994, children who were residents of one of three communities with varying levels of fluoride in their communal water supply were examined for dental fluorosis. Since some children were available at both examination periods, it was also possible to determine changes in the incidence of dental fluorosis. RESULTS: The prevalence of fluorosis increased by approximately 14%, 20%, and 6% in the negligibly, optimally, and 4X optimally fluoridated communities, respectively. In the negligibly and optimally fluoridated communities, the incidence of dental fluorosis increased by 12% and 7%, respectively. In the 4X optimally fluoridated community, all the children examined had evidence of fluorosis at both examinations. CONCLUSION: Fluoride continues to be the primary therapeutic agent for the prevention of dental caries in adults and children. With the downward adjustment in the fluoride supplement schedule, continued monitoring of the prevalence of dental fluorosis in young children is needed to determine if any additional steps are even necessary to restrict fluoride intake during the years that enamel formation is occurring. <27> UI - 99396016 AU - Pearce EI AU - Margolis HC AU - Kent RL Jr IN - Department of pathology, Wellington School of Medicine, New Zealand. dentalhp@wnmeds.ac.nz TI - Effect of in situ plaque mineral supplementation on the state of saturation of plaque fluid during sugar-induced acidogenesis. SO - European Journal of Oral Sciences 1999 Aug;107(4):251-9 AB - Dental plaque fluid is normally supersaturated with respect to enamel mineral but this may change to a state of undersaturation when plaque pH falls following sugar exposure, placing the adjacent enamel at risk of caries. We have determined the saturation status of the fluid in both resting and fermenting plaque following mineral supplementation. Eleven subjects abstained from oral hygiene and rinsed their mouth 3 times/d for 3 d with a placebo solution or with test solutions designed to enrich plaque with hydroxyapatite or fluorhydroxyapatite. On the morning of day 4, plaque samples were collected before and after exposure to 10% sucrose. Compared to the placebo, use of the test rinses resulted in significantly higher concentrations of Ca, P and F in plaque residue. In plaque fluid, higher post-sucrose Ca2+ free concentrations and saturation levels with respect to enamel mineral and fluorapatite were found after use of the hydroxyapatite rinse compared to the placebo, effects that probably resulted from the release of cell-bound Ca2+ as well as from the dissolution of apatite. Thus, some evidence was obtained that the test mouthrinses can counteract the fall in saturation level found when plaque is exposed briefly to sucrose. Potential long-term benefits of the test mouthrinses deserve further study. <28> UI - 99391681 AU - Powell LV AU - Persson RE AU - Kiyak HA AU - Hujoel PP IN - Department of Restorative Dentistry, University of Washington, Seattle, Wash. 98195, USA. lvpowell@u.washington.edu TI - Caries prevention in a community-dwelling older population. SO - Caries Research 1999 Sep-Oct;33(5):333-9 AB - A clinical trial was conducted to compare the effect of different caries-preventive strategies on caries progression in lower-income, ethnically diverse persons 60 years of age and older. Two hundred and ninety-seven subjects were randomized into one of five experimental groups. Group 1 received usual care from a public health department or a private practitioner. Group 2 received an educational program of 2 h duration implemented twice a year. Group 3 received the educational program plus a 0.12% chlorhexidine rinse weekly. Group 4 received the education and chlorhexidine interventions and a fluoride varnish application twice a year. Group 5 received all the above interventions as well as scaling and root planing every 6 months throughout the 3-year study. A carious event was defined as the onset of a carious lesion, a filling, or an extraction on a surface which was sound at baseline. Two hundred and one subjects remained in the study for the 3-year period. Groups that received usual intraoral procedures (groups 3, 4, and 5) had a 27% reduction for coronal caries events (p = 0.09) and 23% for root caries events (p = 0.15), when compared to the groups that received no intraoral procedures (groups 1 and 2). Routine preventive treatments may have had only a small-to-moderate effect upon caries development. <29> UI - 99351666 AU - Emilson CG AU - Gisselsson H AU - Birkhed D IN - Department of Cardiology, Faculty of Odontology, Goteborg University, Sweden. emilson@odontologi.gu.se TI - Recolonisation pattern of mutans streptococci after suppression by three different modes of chlorhexidine gel application. SO - European Journal of Oral Sciences 1999 Jun;107(3):170-5 AB - Clinical studies have shown conflicting results for the reduction of approximal caries when chlorhexidine gel has been applied either in trays or by flossing. To investigate whether these modes of treatment affect the colonization of mutans streptococci (MS) differently, we quantified MS in saliva and on various tooth surfaces before and after a single chlorhexidine gel application. Twenty-one schoolchildren (15-16 yr old), with high numbers of salivary MS, were randomised into three groups. The subjects were treated with a 1% chlorhexidine gel applied either by: 1) interdental flossing; 2) individually designed mouth trays; or 3) a combination of polishing and flossing. Analysis of saliva and of dental plaque from 12 sites over an 8-wk period showed a greater reduction of both salivary MS counts and total number of colonised sites in the tray group than in the flossing group. The effect on MS in the polishing-flossing group approached that obtained in the tray group. In the interdental areas, more sites had no detectable MS (score 0) after tray treatment than after flossing, whereas the reduction of heavily colonised sites (scores 3+/-4) was higher in the flossing group. The reappearance of sites with score 3+/-4 after the gel treatment was more rapid in the flossing group than in the other two groups. In conclusion, the results showed a transient reduction of MS colonisation by all three methods, and that the application of the chlorhexidine gel both in mouth trays or as a combination of polishing and flossing was more effective in reducing the MS population than flossing alone. <30> UI - 99372539 AU - Gisselsson H AU - Birkhed D AU - Emilson CG IN - Department of Cariology, Faculty of Odontology, Goteborg University, Sweden. TI - Effect of professional flossing with NaF or SnF2 gel on approximal caries in 13-16-year-old schoolchildren. SO - Acta Odontologica Scandinavica 1999 Apr;57(2):121-5 AB - The aim of this study was to evaluate the effect of professional flossing with NaF and SnF2 gels on caries development on approximal tooth surfaces. Two-hundred-and-eighty 13-year-old schoolchildren were divided into 3 groups: (1) NaF (n = 97), (2) SnF2 (n = 85), and (3) placebo gel group (n = 98). The investigation was carried out double-blind. The children were treated 4 times a year for 3 years with 1% NaF gel, 1% SnF2 gel, or placebo gel. The treatment was carried out by dental nurses and the time required per visit was approximately 10 min. After 3 years, the mean approximal caries increment, including initial caries lesions, was 2.8 in the NaF, 2.4 in the SnF2, and 4.0 in the placebo gel group (P< 0.05 for SnF2 vs placebo); a reduction compared to the placebo of 30% and 39% in the NaF and SnF2 groups, respectively. Thus, professional flossing with NaF or SnF2 gel carried out 4 times a year may be considered as an interesting caries-preventing method for large-scale application in schoolchildren. <31> UI - 99333025 AU - Stephen KW TI - Use of fluoride [letter; comment]. CM - Comment on: Lancet 1999 May 1;353(9163):1462 SO - Lancet 1999 Jul 3;354(9172):74-5 <32> UI - 99312080 AU - Kumar JV AU - Swango PA IN - Bureau of Dental Health, New York State Department of Health, Albany 12237-0619, USA. jvk01@health.state.ny.us TI - Fluoride exposure and dental fluorosis in Newburgh and Kingston, New York: policy implications. SO - Community Dentistry & Oral Epidemiology 1999 Jun;27(3):171-80 AB - OBJECTIVES: This analysis was conducted to determine the changes in the effect of exposure to fluoridation and other sources of fluoride on dental fluorosis in children attending Newburgh and Kingston school districts in New York State. METHODS: Data for this analysis were obtained from two surveys conducted in the 1986 and 1995 school years. Analyses were limited to 3500, 7-14-year-old lifelong residents of a fluoridated or a nonfluoridated community. Dean's classification and DMFS index were used for recording dental fluorosis and caries, respectively. A questionnaire was used to collect fluoride exposure data. Regression procedures were used to estimate the effect of fluoridation, fluoride supplements, and brushing before the age of 2 years on dental fluorosis. RESULTS: Children examined in 1996 were at higher risk for both questionable and very mild to severe dental fluorosis if they received fluoride from water or daily tablet use, or started brushing before the age of 2 years. The increase in risk from 1986 to 1995 was greater for African-American children. CONCLUSION: This analysis showed that the risk of developing dental fluorosis did not decline over time in these communities. Continuous exposure to water fluoridation had an observable effect on dental fluorosis. However, implementation of fluoridation in Newburgh Town did not result in an increase in dental fluorosis prevalence. <33> UI - 99312085 AU - Stephen KW AU - Macpherson LM AU - Gorzo I AU - Gilmour WH IN - Dental Public Health Unit, University of Glasgow Dental School, Scotland, UK. k.stephen@dental.gla.ac.uk TI - Effect of fluoridated salt intake in infancy: a blind caries and fluorosis study in 8th grade Hungarian pupils. SO - Community Dentistry & Oral Epidemiology 1999 Jun;27(3):210-5 AB - Salt fluoridation is effective at inhibiting caries, but fluorosis prevalence data are deficient. OBJECTIVES: The purpose was to undertake a blind study of caries and tooth mottling in 8th grade school pupils from south-east Hungary who had resided (test) or not resided (control), until November 1985, in a 350 ppm F-/kg domestic salt-fluoridated area during their early years of life. METHODS: In Szeged, blind clinical caries and anterior tooth mottling scoring (+10% repeats) of 49 previously salt-fluoridated (mean age 14.14 years) and 59 non-salt-fluoridated subjects (mean age 14.08 years) were undertaken by one examiner, in June 1997. In addition, radiographic and photographic recordings were taken. In Glasgow, four dental and two lay staff scored the projected 35 mm colour transparencies (+10% repeats) of each pupil's six upper anterior teeth, for tooth mottling. All clinical, radiographic and photographic data were then analysed. RESULTS: Mean DMFS scores were 9.18 (SD=10.72) for test users and 4.51 (SD=6.24) for control users (P<0.01) and, based on repeat observations, clinical reliability=0.99; X-ray reliability=0.95. Clinically, three test children had fluorosis of 10 teeth, with eight teeth in two controls. Photographic scoring by the clinical examiner gave a 97.2% clinical match, while photographic agreements for all four dentist pairs were 92.5%-97.2%, with lay observers' agreements at 89.8%. For both groups, 10% repeats produced 98.5% agreements. In a sole test case "fluorosis" photographic unanimity was obtained, and non-unanimous "possible fluorosis" was recorded by two to four panel members for only three other test and two control subjects. CONCLUSIONS: No evidence was found that significant anterior tooth fluorosis resulted in subjects exposed previously to 350 ppm F-/kg domestic salt from birth to 2.3-4.8 years of age. However, no caries benefit was demonstrated after the 11.5-year salt fluoridation gap. Caries differences seemed social class-related, city-based controls having less disease than rural test subjects, in spite of an identical F- tablet regimen in all schools from 1987, until subjects were 10 years old. These data emphasise (a) the superiority of sustained community-delivered fluoridation and (b) the need to maintain constant fluoride delivery to tooth surfaces, certainly well beyond 10 years of age. <34> UI - 99225387 AU - Iijima Y AU - Takagi O AU - Ruben J AU - Arends J IN - Department of Preventive Dentistry, School of Dentistry, Nagasaki University, Nagasaki, Japan. iijima@net.nagasaki-u.ac.jp TI - In vitro remineralization of in vivo and in vitro formed enamel lesions. SO - Caries Research 1999 May-Jun;33(3):206-13 AB - Thin sections of natural white spot enamel lesions (WS) and of artificial in vitro lesions (VL) were remineralized simultaneously in vitro. The sections, clamped in a PMMA holder, were microradiographed at baseline and after remineralization in a calcium- and phosphate-containing solution (pH = 7.0; 1 ppm F) after 2 and 4 weeks. All data were analyzed with respect to baseline. The results show that the lesion depth values did not change significantly during 2 and 4 weeks of remineralization. The mineral accumulation (change in DeltaZ), however, was substantial and significant in WS and VL. In WS the change in mineral accumulation was roughly proportional to the amount of mineral at baseline. The WS accumulated more than two times the amount of mineral than VL in the same periods of remineralization. After 4 weeks of remineralization the maximum mineral value Vmax in the surface layer of the WS was nearly up to the sound enamel level thick approximate87 vol%. This study shows that the technique and calculation procedure described make this single section method attractive for longitudinal demineralization-remineralization studies in vitro or in situ. Both WS and VL samples obviously remineralized in vitro similarly with respect to the baseline. Furthermore, this in vitro work indicates that remineralization inhibitors present in saliva, and previously penetrated into the enamel tissue, do not influence remineralization later on. <35> UI - 99305402 AU - Donly KJ AU - Segura A AU - Wefel JS AU - Hogan MM IN - Department of Pediatric Dentistry, Dental School, University of Texas Health Sciences Center at San Antonio 78284, USA. TI - Evaluating the effects of fluoride-releasing dental materials on adjacent interproximal caries. SO - Journal of the American Dental Association 1999 Jun;130(6):817-25 AB - BACKGROUND: The authors examined several restorative materials to evaluate their ability to inhibit demineralization and enhance remineralization of incipient carious lesions on the interproximal enamel of teeth adjacent to those restored with the materials. METHODS: Twenty-one subjects in need of a crown on a mandibular molar and a Class II inlay on an adjacent tooth took part in this six-phase study. Artificial enamel lesions were created and positioned within the interproximal portion of a crown. Lesions were photographed with polarized light microscopy and characterized before and after 30-day intraoral exposures. Each phase included the placement of a new section in the crown model and a new Class II inlay restorative material in the adjacent tooth. RESULTS: Results demonstrated that nonfluoridated resin composite, fluoridated resin composite and resin-modified glass ionomer restorative materials, when placed in subjects who brushed with a fluoridated dentifrice, demonstrated significantly (P < .05) less enamel demineralization than the nonfluoridated resin composite control placed in subjects who brushed with a nonfluoridated dentifrice. The resin-modified glass ionomer cement, however, even when brushed with a nonfluoridated dentifrice, exhibited significantly (P < .05) less demineralization than the nonfluoridated resin composite control brushed with a nonfluoridated dentifrice. CONCLUSIONS: Resin-modified glass ionomer cement appears to significantly inhibit demineralization of interproximal enamel of teeth adjacent to those restored with the material. CLINICAL IMPLICATIONS: Resin-modified glass ionomer cement restorations can enhance prevention of enamel demineralization on adjacent teeth. <36> UI - 99330253 AU - van Dijken JW AU - Kieri C AU - Carlen M IN - Institution of Oral Biology, Dental School, Umea University, Sweden. TI - Longevity of extensive class II open-sandwich restorations with a resin-modified glass-ionomer cement. SO - Journal of Dental Research 1999 Jul;78(7):1319-25 AB - Several new techniques have been introduced for use in the esthetic restoration of posterior cavities to substitute for the presumed toxicity of amalgam. Composite-laminated glass-ionomer cement restorations, the sandwich technique, have been recommended for caries-risk patients. Clinical evaluation of the use of conventional glass-ionomer cements in the open-sandwich restoration has shown a high failure rate. The aim of this study was to evaluate the durability and cariostatic effect of a modified open-sandwich restoration utilizing a resin-modified glass-ionomer cement (RMGIC) in large cavities. The materials consisted of 274 mostly extensive Class II Vitremer/Z100 restorations performed by four dentists in 168 adults. Six experimental groups were investigated. In four groups a thick and in two groups a thin layer of cement was placed. Cavity conditioning before application of the RMGIC self-etching primer was done in 3 groups with polyacrylic acid and in one group with maleic acid; in two groups, only water rinsing was performed. The restorations were evaluated at baseline and after 6, 12, 24, and 36 months according to modified USPHS criteria (van Dijken, 1986). After 3 years, 239 restorations were evaluated. Twelve (5%) were estimated as non-acceptable. Two were replaced, and seven were repaired with resin composite. Tooth fractures were observed in 2.5%. Slight erosion of the RMGIC part was seen in 4%, and in one case operative treatment was indicated. Post-operative sensitivity was reported for 9 teeth. Forty-three percent of the patients were considered as caries-risk patients. Only one restoration showed secondary caries. The three-year results indicated that the modified open-sandwich restoration is an appropriate alternative to amalgam including extensive restorations. <37> UI - 99243312 AU - Kallestal C AU - Wang NJ AU - Petersen PE AU - Arnadottir IB IN - Department of Epidemiology and Public Health, Umea University, Sweden. carina.kallestal@epiph.umu.se TI - Caries-preventive methods used for children and adolescents in Denmark, Iceland, Norway and Sweden. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):144-51 AB - Denmark, Iceland, Norway, and Sweden have all had a similar decline in dental caries during the last 20 years, although the decline has come later in Iceland. The purpose of this study was to compare the caries-preventive methods used for children and adolescents in these four countries. Questionnaires were sent to random samples of dentists, dental hygienists, and dental nurses working with children during 1995 and 1996. The results showed that the use of preventive methods was generally consistent between the countries. Nevertheless there were differences between the countries concerning the choice of preventive strategy for risk patients and also in how prevention was implemented. Danish dental care providers chose oral hygiene education as the priority, which they put into practice. Apart from fluoride varnish for some patients, most of them did not use or recommend fluoride except fluoride toothpaste. The Norwegian and Icelandic dental care providers chose both oral hygiene education and the use of fluoride as priorities, while most Swedish dental care providers preferred to provide dietary advice and oral hygiene education, and additional fluoride for risk patients. The differences could not be explained by other variables than nationality, implying that there are differences between the dental cultures in the four countries. The informational basis of decisions on preventive strategies varied between the different dental professionals in each country as well as between the countries, indicating that national professional cultures are being shaped differently. Despite the differences in choice of preventive methods, the dental health of children varies little across the frontiers. This raises the question of the significance of the choice of preventive methods to the decline of dental caries and points towards an urgent need to develop evidence-based preventive strategies. <38> UI - 99184732 AU - Limeback H IN - Faculty of Dentistry, University of Toronto, Ontario, Canada. hlimeback@dental.utoronto.ca TI - A re-examination of the pre-eruptive and post-eruptive mechanism of the anti-caries effects of fluoride: is there any anti-caries benefit from swallowing fluoride?. [Review] [35 refs] SO - Community Dentistry & Oral Epidemiology 1999 Feb;27(1):62-71 AB - The belief that fluoridated water reduces caries incidence by half stems from years of fluoridation studies where the caries rates of people in various fluoridated and non-fluoridated communities were compared. By their nature, the water fluoridation trials were not able to distinguish between the topical effects of the fluoride in the water and the systemic effects of the fluoride that is inevitably swallowed and incorporated into developing teeth. Some attempts have been made to estimate the contribution of systemic fluoride to the control of dental caries but researchers are discovering that the topical effects of fluoride are likely to mask any benefits that ingesting fluoride might have. In this updated review of the pre-eruptive vs. post-eruptive benefits of fluoride in the prevention of dental caries, a re-examination of the literature, which is often cited to support the notion that swallowing fluoride, either in water or in pill form, was done in recognition of the mounting evidence for the topical mechanism as being the primary mechanism for the prevention of dental caries. Maximum benefits from exposing newly erupted teeth to topical fluoride in the oral cavity may have been seriously under-estimated. This has obvious implications for the use of systemic fluorides to prevent dental caries and forces everyone working in the field to examine more closely the risks and benefits of fluoride in all its delivery forms. [References: 35] <39> UI - 99144785 AU - Millett DT AU - Nunn JH AU - Welbury RR AU - Gordon PH IN - Unit of Orthodontics, Glasgow Dental Hospital and School, UK. TI - Decalcification in relation to brackets bonded with glass ionomer cement or a resin adhesive. SO - Angle Orthodontist 1999 Feb;69(1):65-70 AB - Forty randomly selected patients had brackets bonded on one side of the of the maxillary labial segment with glass ionomer cement. Teeth on the opposite side were bonded with a resin adhesive. Teeth were assessed for decalcification pretreatment, at debond, and at review using a standardized photographic technique and a modified DDE index. The mean number of teeth affected by decalcification and the mean extent of decalcification per tooth increased during the treatment period, but from debond to review both of these measurements decreased for teeth bonded with either material (p)<0.01, t-test). Decalcification appears to become less severe posttreatment, but does not appear to be significantly affected during 12 to 18 months of orthodontic treatment by bonding with glass ionomer cement. Dietary and other environmental factors, including fluoride preparations, may be of greater importance in the prevention of decalcification during fixed appliance therapy. <40> UI - 99120382 AU - Reiker J AU - van der Velden U AU - Barendregt DS AU - Loos BG IN - Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. TI - A cross-sectional study into the prevalence of root caries in periodontal maintenance patients. SO - Journal of Clinical Periodontology 1999 Jan;26(1):26-32 AB - The aim of this cross-sectional study was to investigate cross-sectionally the prevalence and several risk indicators of root caries in 45 periodontal maintenance patients, who had been actively treated for adult periodontitis 11-22 years ago. These patients were part of a routine 3-6 monthly maintenance schedule. Active and inactive root caries and root fillings were recorded, as well as coronal caries experience. Plaque and bleeding scores, number of exposed root surfaces, rate of saliva secretion, saliva buffering capacity, mutans streptococci counts and Lactobacilli were also scored. From the total of 45 study subjects, 37 patients (82%) showed root lesions (root caries and/or root fillings), while only 8 patients were free of any root lesions. On average, there were 4.3 root lesions per patient (range 0-19) in the present study. 10 patients had active root caries lesions. Of all damaged root surfaces, 9% were active lesions, mostly located on mandibular teeth at lingual and vestibular sites: 40% were inactive lesions often detected at vestibular sites. The remaining damaged root surfaces (51%) were restored; they were equally divided over both jaws. A higher number of root lesions was observed in those patients with >106 mutans streptococci/ml saliva. Although the actual number of lesions per patient was low in relation to the large number of sites with gingival recession, the results from this cross-sectional study in periodontal maintenance patients indicate that: (1) root caries can be regarded as a complication in periodontal maintenance patients; (2) the individual number of root lesions correlate with individual dental plaque scores; (3) a high number of root lesions is associated with high counts of salivary mutans streptococci; (4) no relation between root caries and coronal caries experience, salivary secretion rate or salivary buffering capacity seems present. Therefore, repeated oral hygiene instructions and adjunctive preventive measures including diet counseling and fluoride rinses, as well as fluoride and chlorhexidine varnishes, should be advocated in high-risk patients. <41> UI - 99110707 AU - Weerheijm KL AU - Kreulen CM AU - de Soet JJ AU - Groen HJ AU - van Amerongen WE IN - Departments of Cariology, Endodontology, Pedodontology, ACTA, Amsterdam, The Netherlands.K.Weerheijm@acta.nl TI - Bacterial counts in carious dentine under restorations: 2-year in vivo effects. SO - Caries Research 1999;33(2):130-4 AB - Little is known about the long-term effects of fluoride-releasing materials on carious dentine in vivo. The aim was to investigate the 2-year influence of a resin-modified glass ionomer cement (RM-GIC) and amalgam on the bacteriological counts of carious dentine that remained under class I restorations. To enable a split-mouth design, 33 molar pairs in 33 patients (mean age 15.1 years, SD 1.4) were selected, based on clinically and radiographically diagnosed occlusal dentine caries. The enamel of the carious molars was removed, and the carious dentine was sampled under aseptic conditions just beneath the dentinoenamel junction. The molars were alternately restored with RM-GIC or amalgam without further removal of carious dentine. The samples were processed for microbiological determination of total viable counts (TVC), mutans streptococci (MS), and lactobacilli (LB). The molar pairs of 25 patients were reevaluated after 2 years using the same clinical techniques and were permanently restored after complete caries removal. Both materials showed a substantial decrease in numbers of TVC and LB of the carious dentine after the 2-year period. Compared to amalgam, the decrease in the numbers of LB was significantly more pronounced for RM-GIC. No microorganisms were detected in only 11 molars (6 RM-GIC and 5 amalgam) after the 2-year period. Based on this study, we suggest that complete removal of carious dentine is still the best conservative treatment, irrespective of the restorative material used. <42> UI - 99051261 AU - Giertsen E AU - Emberland H AU - Scheie AA IN - Department of Odontology-Cariology, Faculty of Dentistry, University of Bergen, Norway. Elin.Giertsen@odont.uib.no TI - Effects of mouth rinses with xylitol and fluoride on dental plaque and saliva. SO - Caries Research 1999;33(1):23-31 AB - The aim of this study was to test the hypothesis that xylitol, alone and in combination with fluoride, affects the salivary flow rate and micro-biota, dental plaque accumulation, gingivitis development, and the acidogenic potential of plaque. Three groups, each of 10 subjects, rinsed for 1 min 3 times daily over two 4-week periods, first with 10 ml water (control), and thereafter with either 0.05% NaF, 40% xylitol, or with 0.025% NaF plus 20% xylitol according to a double-blind controlled design. They performed habitual mechanical tooth cleaning during the first 2 weeks of each period but abstained from interdental cleaning during the final 2 weeks. While mouth rinsing was continued, all mechanical oral hygiene was discontinued the last 2 days of each period to permit plaque accumulation. The last mouth rinse was administered in the clinic before the final examination. The following parameters were assessed: (1) unstimulated and paraffin-stimulated salivary secretion rates; (2) salivary micro-biota; (3) plaque index; (4) papillar bleeding; (5) plaque pH response to sucrose, and (6) lactate formation by dental plaque. No statistically significant differences in any of the parameters were found. In conclusion, three daily mouth rinses with fluoride and xylitol, separately or in combination, did not affect the salivary flow rate or micro-biota, dental plaque accumulation, gingivitis development, or the acidogenic potential of plaque. <43> UI - 99051260 AU - Caplan DJ AU - Slade GD AU - Biesbrock AR AU - Bartizek RD AU - McClanahan SF AU - Beck JD IN - Department of Dental Ecology, University of North Carolina and Chapel Hill, N.C. 27599-7450, USA; The Procter & Gamble Company, Mason, Ohio, USA. dan:caplan@unc.edu TI - A comparison of increment and incidence density analyses in evaluating the anticaries effects of two dentifrices. SO - Caries Research 1999;33(1):16-22 AB - This study aimed to determine whether incidence density (ID) calculations of caries incidence rates would provide a more sensitive means of detecting caries-preventive effects than would traditional techniques. A secondary analysis was conducted using data from a 1981 study in which three dentifrices were compared in a double-blind randomized clinical trial. Subjects were examined at baseline and 1, 2 and 3 years after baseline. Three-year DMFS increments were calculated for 1,754 subjects attending the baseline and 3-year examinations. Caries ID rates then were calculated for 2, 661 subjects who had at least two examinations, using each surface's net increment (-1, 0 or +1) as the numerator and the surface's time at risk as the denominator. Despite theoretical advantages, the ID method did not alter the conclusions drawn using DMFS increments, apparently because (a) subjects lost to follow-up were similar to those completing the study, and (b) loss to follow-up was similar among treatment groups. <44> UI - 99407364 AU - Fine DH AU - Furgang D AU - Bonta Y AU - DeVizio W AU - Volpe AR AU - Reynolds H AU - Zambon JJ AU - Dunford RG IN - Dental Research Center, University of Dentistry and Medicine of New Jersey, Newark 07103, USA. TI - Efficacy of a triclosan/NaF dentifrice in the control of plaque and gingivitis and concurrent oral microflora monitoring. SO - American Journal of Dentistry 1998 Dec;11(6):259-70 AB - PURPOSE: To compare the effect of a dentifrice containing 0.3% triclosan and 1100 ppm fluoride and a control dentifrice containing 1100 ppm fluoride on plaque, gingiva and the oral microflora in a long-term study simulating clinical usage. MATERIALS AND METHODS: 159 subjects entered the clinical study and 80 were randomly selected to participate in the microbiological evaluation. 71 subjects completed the detailed evaluation of the oral microflora after 6 months use. Plaque was collected at baseline, 3 months, and 6 months, and examined by darkfield microscopy, Gram stain, immunofluorescence, and selective and non-selective media. Changes in antimicrobial susceptibilities were determined for the first 6-month period and for 6 months post-therapy for 68 subjects who completed the entire study. Susceptibilities of whole plaque samples and MIC values for two pre-designated common plaque organisms, A. viscosus and V. parvula were performed. RESULTS: Multivariate ANOVA and non-parametric analyses revealed no statistical differences for any factor tested. No detrimental shifts were found in either; (1) the compositional make up of the normal flora, (2) the periodontopathic or cariogenic flora, or (3) the opportunistic flora in either group of dentifrice users. Both treatments resulted in decreases in Gram positive cocci over time. There was a reduction in spirochetes in the triclosan/fluoride group as compared to the control group. No overgrowth in opportunists, periodontal pathogens, or cariogenic flora was found in either group. No increase in the proportion of the whole plaque flora resistant to triclosan was found nor was an increase in the MIC values of either A. viscosus or V. parvula in either group. Overall, there appeared to be a general decrease in plaque bacteria in both groups over the course of the experiment. <45> UI - 99103303 AU - Gilmour AS AU - Edmunds DH IN - Department of Adult Dental Health, University of Wales College of Medicine, Health Park, Cardiff, UK. Gilmour@cf.ac.uk TI - The polarized light microscopic appearance of caries-like lesions adjacent to restored cavities in the crowns and roots of extracted human teeth. SO - Journal of Oral Rehabilitation 1998 Dec;25(12):929-39 AB - Longitudinal clinical studies indicate consistently that secondary caries is the major cause of failure of restorations. Recently there has been an increase in the number of fluoride-containing materials coming to the market place and this has renewed the debate about the cariostatic effectiveness of such materials. The present study examined the histologic appearance of caries-like lesions adjacent to a non-fluoride-containing material (amalgam), a low fluoride-containing material (composite) and a moderate fluoride-containing material (glass-ionomer). The artificial caries system used to produce lesions has been previously reported and is a microbial system using Streptococcus mutans NCTC 10832. The lesions produced were similar to naturally occurring lesions in many respects, indicating the usefulness of this in vitro technique. Variations in the appearance of lesions were found adjacent to the different materials and the effect of the fluoride contained within two of the materials is discussed. <46> UI - 99094527 AU - Petersson LG AU - Svanholm I AU - Andersson H AU - Magnusson K IN - Department of Preventive Dentistry, Medical and Dental Health Centre, Halmstad, Sweden. lars.g.petersson@lih.lthalland.se TI - Approximal caries development following intensive fluoride mouthrinsing in teenagers. A 3-year radiographic study [published erratum appears in Eur J Oral Sci 1999 Apr;107(2):154]. SO - European Journal of Oral Sciences 1998 Dec;106(6):1048-51 AB - Caries development on approximal surfaces was studied in 139 adolescents for a period of 3 yr. A test group was randomly sampled (n=69) and subjected to a new intensive mode of fluoride (F) mouthrinsings using 10 ml of 0.045% NaF neutral solution once a day for 3 d, twice a year in all, i.e., 6 rinses per year. A control group (n = 70) rinsed in a similar mode using fluoride-free tap water. The two groups received the same basic prophylactic program during the trial. Detection of approximal caries lesions and fillings was based on bitewing radiographs at baseline and after 3 yr. The test group developed an average of 2.75 + 4.76 (mean +/- SD) approximal DFS compared with 3.21 + 4.74 DFS in the control group (n.s.). However, among those teenagers who were caries free (DFS = 0) at baseline, the incidence of approximal carious and filled surfaces was 1.76+/-4.52 in the F-rinsing group (n = 26) compared with 2.76+/-5.01 DFS in the control group (n = 32), a 36% caries reduction which was statistically significant. The intensified mouthrinsing procedure seems to be a promising prophylactic mode for collective caries prevention. <47> UI - 99086084 AU - Yoder KM AU - Mabelya L AU - Robison VA AU - Dunipace AJ AU - Brizendine EJ AU - Stookey GK IN - Department of Oral Biology, Indiana University School of Dentistry, Indianapolis, USA. yoder@ipfw.edu TI - Severe dental fluorosis in a Tanzanian population consuming water with negligible fluoride concentration. SO - Community Dentistry & Oral Epidemiology 1998 Dec;26(6):382-93 AB - OBJECTIVES: To identify risk factors for dental fluorosis that cannot be explained by drinking water fluoride concentration alone. METHODS: Two hundred eighty-four Tanzanian children ages 9 to 19 (mean 14.0+/-SD 1.69), who were lifetime residents at differing altitudes (Chanika, 100 m; Rundugai, 840 m; and Kibosho, 1,463 m; Sites 1, 2, and 3 respectively) were examined for dental fluorosis and caries. They were interviewed about their food habits, environmental characteristics and use of a fluoride-containing food tenderizer known locally as magadi. Meal, urine, water and magadi samples supplied by the participants were analyzed for fluoride content. Urine samples were also analyzed for creatinine concentration. Four magadi samples from Sites 1 and 3 were analyzed for complete element composition. RESULTS: Of the 13 water samples from Site 2, 10 contained > or =4 mg/L F, ranging from 1.26 to 12.36 mg/L with a mean+/-SD of 5.72+/-4.71 mg/L. Sites 1 and 3 had negligible water fluoride of 0.05+/-0.05 and 0.18+/-0.32 mg/L respectively. Mean TFI fluorosis scores (range 0-9) for Site 2 were high: 4.44+/-1.68. In Sites 1 and 3, which both had negligible water fluoride, fluorosis scores varied dramatically: Site 1 mean maximum TFI was 0.01+/-0.07 and Site 3 TFI was 4.39+/-1.52. Mean DMFS was 1.39+/-2.45, 0.15+/-0.73 and 0.19+/-0.61 at Sites 1, 2, and 3, respectively. There were no restorations present. Urinary fluoride values were 0.52+/-0.70, 4.34+/-7.62, and 1.43+/-1.80 mg/L F at Sites 1, 2, and 3, respectively. Mean urinary fluoride values at Site 3 were within the normal urinary fluoride reference value range in spite of pervasive severe pitting fluorosis. Meal and magadi analyses revealed widely varied fluoride concentrations. Concentrations ranged from 0.01 to 22.04 mg/L F for meals and from 189 to 83211 mg/L F for magadi. Complete element analysis revealed the presence of aluminum, iron, magnesium, manganese, strontium and titanium in four magadi samples. There were much higher concentrations of these elements in samples from Site 3, which was at the highest altitude and had severe enamel disturbances in spite of negligible water fluoride concentration. An analysis of covariance model supported the research hypothesis that the three communities differed significantly in mean fluorosis scores (P<0.0001). Controlling for urinary fluoride concentration and urinary fluoride:urinary creatinine ratio, location appeared to significantly affect fluorosis severity. Urinary fluoride:urinary creatinine ratio had a stronger correlation than urinary fluoride concentration with mean TFI fluorosis scores (r=0.43 vs r= 0.25). CONCLUSIONS: The severity of enamel disturbances at Site 3 (1463 m) was not consistent with the low fluoride concentration in drinking water, and was more severe than would be expected from the subjects' normal urinary fluoride values. Location, fluoride in magadi, other elements found in magadi, and malnutrition are variables which may be contributing to the severity of dental enamel disturbances occurring in Site 3. Altitude was a variable which differentiated the locations. <48> UI - 99086087 AU - Chestnutt IG AU - Schafer F AU - Jacobson AP AU - Stephen KW IN - Lanarkshire Health Board, Hamilton, Scotland. TI - The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. SO - Community Dentistry & Oral Epidemiology 1998 Dec;26(6):406-11 AB - OBJECTIVE: To examine the effect of reported toothbrushing frequency and method of rinsing after brushing on caries experience and increment. METHODS: Data are presented from 2621 adolescents (mean age 12.5 years at outset) participating in a 3-year double-blind caries clinical trial. At baseline, examiners questioned each participant about their toothbrushing habits, and at subsequent examinations, this information was obtained using a self-administered computer-based questionnaire. Participants used a fluoride-containing dentifrice throughout and clinical examinations were conducted using a mirror, CPITN probe and fibre-optic transillumination. RESULTS: The reported brushing frequency increased throughout the trial. Caries experience at baseline was inversely related to toothbrushing frequency with mean DMFS=9.66, 8.12 and 7.63 respectively for <1/day, 1/day and >1/day brushers (P<0.001). Mean 3-year DMFS increments of 8.90, 6.63 and 5.48 (P<0.01) were observed in those reporting to brush <1/day, 1/day or >1/day, on not less than two of the three clinical examinations during the trial. Caries increment was also significantly related to the claimed method used to rinse post-brushing. Overall frequency of brushing and rinsing method accounted for over 50% of the explained variance in the ANOVA model used to analyse the DMFS increments. CONCLUSIONS: Stated toothbrushing frequency and rinsing method after brushing were found to be strongly correlated with caries experience and caries increment. These factors should be reflected in the design of oral health education material and taken into account in the design and analysis of caries clinical trials. <49> UI - 99126876 AU - Gunay H AU - Dmoch-Bockhorn K AU - Gunay Y AU - Geurtsen W IN - Department of Conservative Dentistry and Periodontology, Medical University Hannover, Germany. TI - Effect on caries experience of a long-term preventive program for mothers and children starting during pregnancy. SO - Clinical Oral Investigations 1998 Sep;2(3):137-42 AB - The aim of this three-phase prospective study was to determine the effects of a primary-primary prevention program on the oral health of children. Eighty-six pregnant women from various social backgrounds participated in the first phase of this study. In the second phase (at 3 years of age) 54 of the mother-child couples and in the third phase (at 4 years of age) 47 of the mother-child couples remained. Participants were recalled every 6 months and received individual prophylactic care. The following clinical parameters were assessed at each examination period for mother and child: DMF-S or dmf-s, proximal plaque index, and the salivary level of Streptococcus mutans (Dentocult SM). The control group consisted of 65 (at 3 years of age) and 45 (at 4 years of age) children from various kindergartens. All children in the second phase of the study group revealed a naturally healthy dentition with an API of 0-25% and a salivary S. mutans score of 0 (0-10(3) cfu/ml). In the third phase, only four of the 47 children of the study group showed caries, with a mean dmf-s of 1.5. No S. mutans could be detected in 20 (42.6%) children. Ten (21.3%) children of the study group showed a S. mutans score of > or = 2 (> 10(5) cfu/ml). In contrast, only 53 of the 65 children of the control group (second phase) and 26 of the 45 control children (third phase) revealed a naturally healthy dentition. The remaining 19 children of the control group revealed a mean dmf-s of 7.0 at 4 years of age. In the control group, no S. mutans could be detected in 25 (38.5%) children at 3 years of age whereas 21 (32.3%) children showed a S. mutans score of > or = 2. In the third phase, a salivary S. mutans score of > or = 2 was found in 27 (60%) children of the control group. The statistical comparison between the study and the control groups revealed significant differences for all results determined (P < 0.001). Additionally, all mothers revealed a significant improvement in oral health and a reduction of salivary S. mutans colonization. From our data we conclude that a pre- and postnatal prevention program (primary-primary vs primary prevention) may significantly improve the oral health of mother and child. <50> UI - 99035981 AU - Winston AE AU - Bhaskar SN IN - Technology and Clinical Research, Enamelon Inc., Brunswick, N.J. 08816, USA. TI - Caries prevention in the 21st century [see comments]. [Review] [87 refs] CM - Comment in: J Am Dent Assoc 1999 Feb;130(2):160, 162 SO - Journal of the American Dental Association 1998 Nov;129(11):1579-87 AB - While the incidence of caries has decreased during the past 50 years because of the introduction of water fluoridation and fluoride toothpastes, it is still widespread. Improved therapies, using topical treatments to replace lost calcium and phosphate minerals from early carious lesions, will reduce the need for surgical intervention in the future. Early caries detection techniques currently being developed will allow dentists to maximize the usefulness of these treatments. [References: 87] <51> UI - 99052546 AU - Biesbrock AR AU - Faller RV AU - Bartizek RD AU - Court LK AU - McClanahan SF IN - Procter & Gamble Company, Health Care Research Center, Cincinnati, Ohio, USA. biesbrock.ar@pg.com TI - Reversal of incipient and radiographic caries through the use of sodium and stannous fluoride dentifrices in a clinical trial. SO - Journal of Clinical Dentistry 1998;9(1):5-10 AB - Experimental evidence has clearly demonstrated that the early stages of lesion formation (enamel demineralization) are reversible following exposure to saliva and/or fluoride. Clinical evidence for remineralization has also been reported extensively in the literature. However, the literature is lacking with respect to data from well-controlled clinical studies regarding the quantitative contribution of remineralization to arrestment and reversal of caries. Retrospective analysis of an existing clinical trial database provided an opportunity to examine the incidence of clinical lesion reversals in a placebo-controlled, double-blinded caries clinical study. The clinical study examined three treatment groups: 1) 0.243% sodium fluoride/silica dentifrice, 2) 0.4% stannous fluoride/calcium pyrophosphate (positive control) dentifrice and 3) non-fluoridated placebo/calcium pyrophosphate (negative control) dentifrice. Clinical measures in this study included both radiographic and visual-tactile assessments of caries. Examination of all subjects revealed a statistically greater frequency for caries reversals in the sodium fluoride group as compared to the placebo group at Year 3, for both total and radiographic caries. In contrast, while caries reversals in the stannous fluoride group occurred with greater frequency than in the placebo group at Year 3, for both total and radiographic caries, the differences were not statistically significant. When only subjects who were "at risk" for potential reversals (i.e., those with a minimum of one carious lesion at baseline) were examined, a statistically greater frequency in caries reversals was observed in both the sodium fluoride (total, incipient, and radiographic caries) and stannous fluoride (total and radiographic caries) groups as compared to the placebo group at Year 3. Collectively, these data confirm the ability of both 0.243% sodium fluoride/silica and 0.4% stannous fluoride/calcium pyrophosphate dentifrices to clinically reverse caries. The results suggest that sodium fluoride may deliver a greater frequency of caries reversals than stannous fluoride, although these treatments were not found to be significantly different. <52> UI - 99006584 AU - Moon HS AU - Jung JY AU - Horowitz AM AU - Ma DS AU - Paik DI IN - Department of Preventive & Public Health Dentistry, College of Dentistry, Seoul National University, Korea. TI - Korean dental hygienists' knowledge and opinions about etiology and prevention of dental caries. SO - Community Dentistry & Oral Epidemiology 1998 Oct;26(5):296-302 AB - OBJECTIVES: Because of their formal education Korean dental hygienists have the potential to be the primary source of information on caries prevention for patients and the general public, and influence the use and adoption of caries preventive procedures. The purposes of this study were to determine the knowledge and opinions about caries etiology and prevention among Korean dental hygienists, and to describe associated factors. METHODS: A pre-tested, 20-item questionnaire was mailed to 1120 dental hygienists selected by stratified random sampling and allocated proportionately. A postcard reminder was sent to all dental hygienists after 1 week. Non-respondents were sent additional complete mailings after 3 and 7 weeks. The response rate was 77% (n=863). RESULTS: Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that dental hygienists who were taught to provide oral health education and believe that it is desirable to practice oral health education during dental hygiene school and those employed in health centers were likely to be more knowledgeable about caries etiology and prevention than other hygienists (P<0.05). In regression analysis of the perceived effectiveness of caries preventive procedures, hygienists who provided oral health education during their formal training tended to rate caries preventive procedures as being more effective than other dental hygienists (P<0.05). CONCLUSIONS: Overall, the results of this study suggest that most dental hygienists do not have up-to-date information on the etiology and prevention of dental caries, mechanisms of action of fluoride and effectiveness of preventive procedures. Efforts to increase the level of knowledge of Korean dental hygienists about caries prevention should focus on strategies to educate dental hygienists who have not been taught to provide oral health education, who do not have favorable opinions about the desirability of oral health education, and who had no experience with providing oral health education as part of their work, especially hygienists working in private clinics. Further, these efforts should include the revision of dental hygiene curricula and continuing education courses. <53> UI - 99027624 AU - Meng CL AU - Li CH AU - Wang WN IN - National Defense Medical Center, School of Dentistry, Taipei, Taiwan, Republic of China. TI - Bond strength with APF applied after acid etching. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1998 Nov;114(5):510-3 AB - One tenet of successful orthodontic therapy is to complete treatment without decalcification, hypocalcification, or discoloration of the natural dentition. Fluoride application has been shown to reduce demineralization of enamel. The purpose of this study was to see if fluoride could be incorporated into enamel before orthodontic bracketing without adversely affecting bond strength. Forty extract adolescent human premolars were randomly divided into two equal groups with 20 teeth each. Group 1 served as control group, and group 2 (experimental) was immersed in 1.23% acidulated phosphate fluoride for 4 minutes after acid etching. The buccal surfaces of all 40 teeth were then bonded with the same type of metal bracket and debonded with an Instron machine. The debonding interface was observed with scanning electron microscopy (SEM). The mapping was calculated with energy dispersive x-ray spectrometry. The results showed that the bond strength of group 1 was significantly greater than that of group 2. The enamel detachment (enamel fracture) was found in the experimental group only. Although the application of acidulated phosphate fluoride to a tooth can prevent dental decay or decalcification, the bond strength decreases and enamel detachment is found after debonding. The result shows that the application of acidulated phosphate fluoride after acid etching enamel has an adverse effect on orthodontic bond strength of human enamel. <54> UI - 98436038 AU - Kashani H AU - Emilson CG AU - Birkhed D IN - Department of Cariology, Faculty of Odontology, Goteborg University, Sweden. TI - Effect of NaF-, SnF2-, and chlorhexidine-impregnated birch toothpicks on mutans streptococci and pH in approximal dental plaque. SO - Acta Odontologica Scandinavica 1998 Aug;56(4):197-201 AB - The antimicrobial effect of birch toothpicks impregnated with 4% NaF, 8% SnF2, or 2% chlorhexidine was studied both in vitro and in vivo. A non-impregnated toothpick served as a control. In vitro, suspensions of Streptococcus mutans were exposed to the various toothpicks for 20 min and then cultured on blood agar. The results of this susceptibility test revealed the following ranking order with respect to inhibition: chlorhexidine > SnF2 > NaF and non-impregnated; with significant differences in colony-forming units (CFU) between these three groups. In vivo, 12 individuals used the 4 types of toothpick 3 times a day for 5 days in a procedure with a crossover design. Saliva and approximal plaque samples were collected at baseline and on various occasions up to 23 days after the treatment. At the same time, plaque-pH was measured at approximal sites 10 min after rinsing with 10% sucrose. The results of these in vivo experiments revealed lower proportions of mutans streptococci after using all four types of toothpick, but the reduction was significant only after 2 days for the toothpicks impregnated with SnF2 and chlorhexidine (P< 0.05). On the sampling occasions 9 and 23 days after the treatment, the mutans streptococci were more or less back to baseline levels again. In saliva no significant differences in the number of mutans streptococci were found either within or between the four treatments. No significant differences were found regarding decline in the plaque-pH between the NaF-, SnF2-, chlorhexidine-, and non-impregnated toothpicks on any of the sampling occasions. <55> UI - 98452103 AU - Gaffar A AU - Blake-Haskins JC AU - Sullivan R AU - Simone A AU - Schmidt R AU - Saunders F IN - Colgate Palmolive Technology Center, New Jersey, USA. TI - Cariostatic effects of a xylitol/NaF dentifrice in vivo. SO - International Dental Journal 1998 Feb;48(1):32-9 AB - Xylitol has been shown to reduce plaque acids, but its topical cariostatic effect has been equivocal. The purpose of the studies reported here was to optimise the xylitol/NaF combination in dentifrices for an improved anticaries activity. In the first study, the combination of 10 per cent xylitol with 1100 ppm F (NaF), 1100 ppm F (NaF), and placebo dentifrices were tested in a rat caries model to assess the cariostatic effect. The combination was significantly more effective than fluoride by itself (P = 0.05). The xylitol/NaF combination provided significantly more remineralisation of dentine than fluoride by itself. Collectively, results of these investigations confirm the improved anticaries effectiveness of the xylitol/NaF combination in a variety of animal and intra-oral models. A three-year clinical study confirmed these findings. <56> UI - 98429393 AU - Seppa L AU - Karkkainen S AU - Hausen H IN - Institute of Dentistry, University of Oulu, Finland. liisa.seppa@oulu.fi TI - Caries frequency in permanent teeth before and after discontinuation of water fluoridation in Kuopio, Finland. SO - Community Dentistry & Oral Epidemiology 1998 Aug;26(4):256-62 AB - The piped water of Kuopio, Finland, was fluoridated in 1959. Owing to strong opposition by different civic groups, water fluoridation was stopped at the end of 1992. OBJECTIVES: The aim of this study was to examine the consequences of the discontinuation on dental health. METHODS: In 1992 and 1995, independent random samples of all children aged 6, 9, 12 and 15 years were drawn from Kuopio and Jyvaskyla, a nearby low fluoride town whose distribution of demographic and socio-economic characteristics was fairly similar to Kuopio's. The total number of subjects examined was 550 in 1992 and 1198 in 1995. Caries was registered clinically and radiographically by the same two calibrated dentists in both towns. RESULTS: In 1992, the mean DMFS values were lower in the fluoridated town for the two older age groups, the percentage differences for 12- and 15-year-olds being 37% and 29%, respectively. For the two younger age groups no meaningful differences could be found. In 1995, the only difference with possible clinical significance was found in the 15-year-olds in favor of the fluoridated town (18%). In 1995, a decline in caries was seen in the two older age groups in the nonfluoridated town. In spite of discontinued water fluoridation, no indication of an increasing trend of caries could be found in Kuopio. The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995. In spite of that caries declined. CONCLUSIONS: These findings suggest that the decline of caries has little to do with professional preventive measures performed in dental clinics. <57> UI - 98429392 AU - Villa AE AU - Guerrero S AU - Villalobos J IN - Institute of Nutrition and Food Technology, INTA, Santiago, Chile. avilla@uec.inta.uchile.cl TI - Estimation of optimal concentration of fluoride in drinking water under conditions prevailing in Chile. SO - Community Dentistry & Oral Epidemiology 1998 Aug;26(4):249-55 AB - The purpose of this comparative study of caries and dental fluorosis experience in Chilean children was to estimate the optimal range of fluoride concentration in tap water under conditions currently prevailing in Chile. The sample included 2431 schoolchildren 7, 12 and 15 years old, life-long residents of five communities with fluoride concentrations in their tap water in the range 0.07-1.1 mg/L. The study population received an oral clinical examination including caries experience and an enamel fluorosis evaluation of the permanent dentition (Dean's scoring system). For 15-year-old children, the DMFT index changed from 5.06 to 2.60, and for 12-year-olds it changed from 3.10 to 1.36 when fluoride water concentration changed from 0.07 to 1.10 mg/L. For 7-year-old children the dmft index correspondingly changed from 3.67 to 1.59. The relationship between DMFT for 12-year-olds and water fluoride concentration was best fitted by a logarithmic function (r2=0.98). The Community Fluorosis Index (CFI) was used to assess enamel fluorosis in the study population, and it showed a linear relationship (r2=0.983) with increasing fluoride concentration of water for the 12-year-old group. Results obtained suggest that under current Chilean conditions, the optimal range of fluoride concentration in potable water should lie in the 0.5-0.6 mg/L range. <58> UI - 98449815 AU - Kashani H AU - Birkhed D AU - Arends J AU - Ruben J AU - Petersson LG AU - Odelius H IN - Department of Cariology, Faculty of Odontology, Goteborg University, Goteborg, Sweden. TI - Effect of toothpicks with and without fluoride on De- and remineralization of enamel and dentine in situ. SO - Caries Research 1998;32(6):422-7 AB - The aim of this investigation was to study the effect of the interproximal use of fluoride (F)-impregnated and non-impregnated birch toothpicks on the degree of de- and remineralization of enamel and dentine in situ. Ten volunteers with complete dentures in the upper jaw participated. Each subject had four specimens: (1) sound enamel, (2) demineralized enamel, (3) sound dentine and (4) demineralized dentine; placed pairwise at two approximal sites (15/16 and 25/26) of the maxillary prosthesis. The study involved three test periods (A, B and C), each lasting 4 weeks. In A, the subjects used F toothpicks (impregnated in 4% NaF) and, in B, nonimpregnated toothpicks 3 times daily. During period C, no toothpicks were used. Dentifrice or other F-containing products were not allowed during the 4-week periods. Transversal microradiography was used to determine lesion depth (ld) and mineral loss (DeltaZ). The results revealed that all the sound samples lost mineral during the three experimental periods; DeltaZ for both enamel and dentine was less for A and B compared with C (p<0.01) and less for A compared with B and C for dentine (p<0.05, p<0.01). The demineralized samples also lost mineral, apart from dentine, during periods A and B, i.e. when F-impregnated and non-impregnated toothpicks were used; ld for enamel and DeltaZ for dentine were less for A compared with C (p<0.05). Four weeks' use of toothpicks, especially F-impregnated toothpicks, thus reduces the demineralization of enamel and dentine at approximal sites in situ. <59> UI - 99025051 AU - Foster LV IN - Department of Oral and Dental Science, University of Bristol Dental School. TI - Three year in vivo investigation to determine the progression of approximal primary carious lesions extending into dentine. SO - British Dental Journal 1998 Oct 10;185(7):353-7 AB - OBJECTIVE: To investigate the proportion of a sample of approximal carious lesions extending up to 1 mm into dentine which progressed over a 3-year period and to examine factors which influenced that progression. DESIGN: Prospective, single centre, clinical study. SETTING: Restorative Clinic at Bristol Dental School, UK. SUBJECTS AND METHODS: Sixty-five adult patients were identified who each had an approximal carious lesion which extended up to 1 mm into the dentine and which were assessed at intervals of up to 36 months. All patients were given appropriate preventive advice. MAIN OUTCOME MEASURES: Progression of the lesions was determined by assessment of sequential bitewing radiographs. RESULTS: 29% of the lesions progressed within 8 months, 56% by 20 months and 69% by 36 months. After 36 months, lesions which extended over 0.5 mm and up to 1 mm into the dentine were significantly more likely to have progressed (92%) compared with shallower lesions which extended up to only 0.5 mm into dentine (50%). CONCLUSIONS: The depth of an approximal dentine lesion was the main clinical marker which related to its progression. It is recommended that operative intervention is considered for approximal lesions which extend deeper than 0.5 mm into the dentine, while preventive treatment and re-assessment may be considered for shallower lesions. <60> UI - 99009683 AU - Manning RH AU - Edgar WM IN - Department of Clinical Dental Sciences, School of Dentistry, University of Liverpool, UK. r.manning@eastman.ucl.ac.uk TI - In situ de- and remineralisation of enamel in response to sucrose chewing gum with fluoride or non-fluoride dentifrices. SO - Journal of Dentistry 1998 Nov;26(8):665-8 AB - OBJECTIVES: Enhancement of the remineralisation of artificial enamel lesions has been observed in an intraoral model whether subjects chewed gum sweetened with a non-cariogenic sweetener such as sorbitol [1-3] or sucrose [4] after meals or snacks, and with use of a conventional (1500 ppm F) fluoride dentifrice. Since most of the clinical surveys which have shown the potential cariogenicity of sucrose chewing gum [5] were conducted before use of fluoridated dentifrices became widespread, the effect of fluoride dentifrice on de- and remineralisation of artificial lesions in enamel in response to chewing sucrose-sweetened gum has been examined with the aim of attempting to resolve this apparent discrepancy. METHODS: Subjects wore an intraoral device bearing an enamel lesion and chewed one piece of sucrose gum for 20 min after each of three meals and two snacks daily for two 3-week periods, during which they used a dentifrice containing either 0 or 1500 ppm F in a double-blind, cross-over design. Measurement of the mineral content of the lesions was determined by microradiography or polarised light microscopy. RESULTS: It was found that remineralisation tended to occur with 1500 ppm F dentifrice, but demineralisation with non-F dentifrice; the difference in enamel mineral content between the two periods was significant (P < 0.05). CONCLUSIONS: The results indicate that the potential cariogenicity of sucrose-containing chewing gum may indeed be negated by the use of a conventional fluoride dentifrice. <61> UI - 98368988 AU - Iijima Y AU - Takagi O AU - Duschner H AU - Ruben J AU - Arends J IN - Department of Preventive Dentistry, School of Dentistry, Nagasaki University, Nagasaki, Japan. iijima@nova.dh.nagasaki-u.ac.jp TI - Influence of nail varnish on the remineralization of enamel single sections assessed by microradiography and confocal laser scanning microscopy. SO - Caries Research 1998;32(5):393-400 AB - Single-section techniques are attractive in enamel de- and remineralization investigations because they allow longitudinal studies in which mineral changes can be assessed by microradiography (TMR). Nail varnish (NV) is in general applied to coat the cut thin-section sides. The aims of this study were to investigate: (1) NV penetration depth in cut surfaces of demineralized enamel, (2) the influence of NV on cut surfaces of demineralized enamel on TMR, (3) the influence of NV penetration on a following remineralization. Cut surfaces of thin sections of demineralized enamel were NV coated; the NV was peeled off and the penetration depth assessed by confocal laser scanning microscopy. The NV penetration was 18+/-5 micrometer (mean+/-SD) in demineralized enamel. To evaluate the possible influence of NV on TMR, cut surfaces of thin sections of demineralized enamel were coated (twice) and microradiographed before and after nail varnishing. The NV effect (total effect of penetrated and surface NV) on the main parameters of TMR, Ld and DeltaZ, was less than 5% of the mean values. In the remineralization experiment (remineralization with 1.5 mM Ca2+, 0.9 mM phosphate, pH 7, 1 ppm F for 1 and 2 weeks), lesions in bulk samples, lesions in thin sections with NV-coated cut surfaces and lesions in thin sections in a PMMA (polymethylmethacrylate) holder were compared. (1) The remineralization of bulk samples and of NV-coated thin sections is different in one aspect. The amounts of mineral deposited in the lesions expressed as DeltaZ are comparable after 1 week. But because the NV penetrates part of the lesion outside, there was an Ld difference. The lesion depth difference between bulk lesions and NV-coated lesions in thin sections was statistically significant and was about 19% less in NV-coated lesions after 1 week; after 2 weeks of remineralization there was no difference in Ld between bulk- and NV-coated lesions any more. (2) There was no difference in remineralization efficacy between lesions in bulk samples and lesions in thin sections in the PMMA holder. <62> UI - 98430471 AU - Phipps KR AU - Orwoll ES AU - Bevan L IN - Oregon Health Sciences University, School of Dentist