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  • NLM标题： Caries Res
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  • 1.

    【2hr】Candida albicans and Early Childhood Caries: A Systematic Review and Meta-analysis

    包量

    机译 白色念珠菌和幼儿龋病：系统评价和荟萃分析
    摘要：Oral Candida albicans has been detected in children with early childhood caries (ECC), and has demonstrated cariogenic traits in animal models of the disease. Conversely, other studies found no positive correlation between C. albicans and caries experience in children, while suggesting it may have protective effects as a commensal organism. Thus, this study aimed to examine whether oral C. albicans is associated with ECC. Seven electronic databases were searched. The data from eligible studies were extracted and the risk of bias was evaluated. A fixed effects model (Mental-Haenszel estimate) was used for meta-analysis, and the summary effect measure was calculated by odds ratio (OR) and 95% CI. Fifteen cross-sectional studies were included for the qualitative assessment, and nine studies for meta-analysis. Twelve studies revealed higher oral C. albicans prevalence in ECC children than in caries-free children, while two studies indicated an equivalent prevalence. A pooled estimate, OR (6.51) and 95% CI (4.94, 8.57), indicated significantly higher ECC experience in children with oral C. albicans than those without C. albicans (P<0.01). The odds of experiencing ECC in children with C. albicans versus children without C. albicans was 5.26 for salivary, 6.69 for plaque, and 6.3 for oral swab sample. This systematic review indicates that children with oral C. albicans have (>5 times) higher odds of having ECC compared to those without C. albicans. Further prospective cohort studies are needed to determine whether C. albicans could be a risk factor for ECC, and whether it is dependent on different sample sources (saliva/plaque).
  • 2.

    【2hr】Analysis of the Cariogenic Potential of Various Almond Milk Beverages Using Streptococcus mutans Biofilm Model In Vitro

    包量

    机译 使用变形链球菌生物膜模型体外分析各种杏仁奶饮料的致癌潜力
    摘要：To evaluate the cariogenic properties of almond milk beverages, six almond milks, along with soy and whole bovine milk, were analyzed for their abilities to support Streptococcus mutans biofilm formation, acid production, and their capacity to buffer changes in pH. Biofilm formation by S. mutans was analyzed using an in vitro 96-well plate model and measured by crystal violet staining. Acid production by S. mutans was evaluated by a colorimetric L-Lactate assay and pH measurement of bacterial cultures. Buffering capacity was assessed by pH titration assay. Soy milk supported the most biofilm growth, while the least was observed with unsweetened almond milk (P<0.001, respectively). Among almond milks, sucrose sweetened milk led to the highest level of biofilm formation (P<0.001), while the least was observed with unsweetened milk (P<0.05). Sucrose sweetened almond milk yielded the lowest pH (4.56±0.66), followed by Soy milk and bovine milk; the highest pH was with unsweetened almond milk (6.48±0.5). When analyzed by pH titration, the unsweetened almond milk displayed the weakest buffering capacity while bovine milk showed the highest buffering capacity (P<0.001). These results suggest that the almond milk beverages, except those that are sweetened with sucrose, possess limited cariogenic properties, while Soy milk exhibits the most cariogenic potential. As milk alternatives become increasingly popular, dentists must counsel their patients that almond milk, especially sucrose sweetened varieties, have cariogenic potential. For patients who are lactose-intolerant or suffer from milk allergy, almond milks may be a better alternative than soy-based products.
  • 3.

    【2hr】REDEFINING THE PHENOTYPE OF DENTAL CARIES

    包量

    机译 重新定义龋齿的表型
    摘要：Dental caries is a multifactorial infectious disease and a major public health problem estimated to affect 60-90% of school children as well as a vast number of adults. The aim of this work was to define patterns of progression of the disease based on longitudinal data in contrast to using a cross-sectional assessment. dmft/DMFT scores were collected at ages 5, 12, 14, 16, 17, and 18 from 876 individuals. We tested our newly defined phenotypes for association with genetic variants in genes shown to be associated with caries. We generated genotyping data using Taqman chemistry in markers of genes involved in processes such as enamel formation and salivary contributions. Kallikrein 4 (KLK4) was found to show a significant association with the created phenotypes (p=0.0008 in a recessive model for low caries experience in the primary dentition vs. high caries experience in the primary dentition, and p=0.0004 in a recessive model for caries free primary dentition vs. high caries experience in the primary dentition).
  • 4.

    【2hr】Diversity in antagonistic interactions between commensal oral streptococci and Streptococcus mutans

    包量

    机译 共生口服链球菌与变形链球菌之间拮抗作用的多样性
    摘要：Arginine metabolism via the arginine deiminase system (ADS) of oral bacteria generates ammonia, which can increase the pH of oral biofilms and decrease the risk for dental caries. Antagonistic interactions between ADS-positive and cariogenic bacteria in oral biofilms may be an important ecological determinant of caries. This study investigated the antagonistic potential and mechanisms of clinical isolates of arginolytic streptococci on and by Streptococcus mutans UA159, a well-characterized cariogenic human isolate. Low-passage isolates of Streptococcus gordonii, Streptococcus sanguinis, Streptococcus parasanguinis, Streptococcus australis and Streptococcus cristatus inhibited the growth of S. mutans to various degrees when they were inoculated on growth media first or simultaneously with S. mutans. The antagonistic effects of arginolytic strains against S. mutans and the production of H2O2 by these strains were enhanced during growth in a less-rich medium or when galactose was substituted for glucose as the primary carbohydrate source. Pyruvate oxidase was the dominant pathway for H2O2 production by arginolytic strains, but lactate oxidase activity was also detected in some strains of S. gordonii and S. cristatus. UA159 inhibited the growth of all tested arginolytic strains when inoculated first, especially in aerobic conditions. However, the antagonistic effects of S. mutans on certain strains of S. gordonii and S. australis were not observed during anaerobic growth in the presence of arginine. Thus, arginolytic commensal streptococci may have a synergistically positive impact on the ecology of oral biofilms by moderating biofilm pH while antagonizing the growth and virulence of caries pathogens.
  • 5.

    【2hr】Identification of Caries Risk Determinants in Toddlers: Results ofthe GUSTO birth cohort study

    包量

    机译 幼儿龋齿风险决定因素的识别：结果GUSTO出生队列研究
    摘要：The aim of the study was to identify risk determinants leading to early childhood caries (ECC) and visible plaque (VP) in toddlers. Data for mother-child pairs participating in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort were collected from pregnancy to toddlerhood. Oral examinations were performed in 543 children during their clinic visit at 24 months to detect ECC and VP. Following logistic regression, ECC and VP were jointly regressed as primary and secondary outcomes, respectively, using bivariate probit model. ECC prevalence was 17.8% at 2 years of age, with 7.3% of children having a VP score >1. ECC was associated with night-time breastfeeding (3 weeks) and biological factors, including Indian ethnicity (lower ECC rate), higher maternal childbearing age and existing health conditions, maternal plasma folate <6 ng/mL, child BMI and plaque index, while VP was associated with psycho-behavioural factors, including frequency of dental visits, brushing frequency, lower parental perceived importance of baby teeth, and weaning onto solids. Interestingly, although higher frequency of dental visits and tooth-brushing were associated with lower plaque accumulation, they were associated with increased ECC risk, suggesting that these establishedcaries-risk factors may be a consequence rather than the cause of ECC. Inconclusion, Indian toddlers may be less susceptible to ECC, compared to Chineseand Malay toddlers. The study also highlights a problem-driven utilizationpattern of dental services (care sought for treatment) in Singapore, in contrastto the prevention-driven approach (care sought to prevent disease) in Westerncountries.
  • 6.

    【2hr】Genes involved in the enamel development are associated with calcium and phosphorous level in saliva

    包量

    机译 搪瓷发育中涉及的基因与唾液中的钙和磷水平有关
    摘要：Saliva components play a crucial role in the integrity of the dental enamel and in the caries susceptibility. The saliva characteristics are controlled by many factors, including genetic factors. Therefore, this study aimed to evaluate the association between the genetic variations in genes expressed in enamel development with calcium and phosphorous levels in saliva. We collected 276 unrelated 12-year-old children from private and public schools. Saliva was collected for DNA extraction from oral cells and for measurement of calcium and phosphorous. Inductively Coupled Plasma-Mass Spectrometry determined calcium and phosphorous levels in whole saliva. Fifteen genetic variations in 9 genes were analyzed. Genotype was determined by real time polymerase chain reactions. Data were analyzed using Plink with an alpha of 5%. Genetic variations in AMELX, AMNB and ESRRB were associated calcium level in saliva (p<0.05). A borderline association was observed in ENAM allele distribution showed with phosphate level in saliva (p=0.049). In conclusion, our results is the first to report that genetic variations contribute to calcium and phosphorous levels in saliva
  • 7.

    【2hr】Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts

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    机译 将统计模型与具有多个零计数的龋齿指数的研究问题匹配
    摘要：Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two datasets, one consisting of fictional dmft counts in two groups and the other on DMFS among schoolchildren from a randomized clinical trial (RCT) comparing three toothpaste formulations to prevent incident dental caries, are analysed with negative binomial hurdle (NBH), zero-inflated negative binomial (ZINB), and marginalized zero-inflated negative binomial (MZINB) models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the RCT were similar despite their distinctive interpretations. Choice of statistical model class should match the study’s purpose, while accounting for the broad decline in children’s caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts.
  • 8.

    【2hr】In vitro validation of Quantitative Light-induced Fluorescence (QLF) for the diagnosis of enamel fluorosis in permanent teeth

    包量

    机译 定量光诱导荧光（QLF）在体外诊断恒牙釉质氟中毒的体外验证
    摘要：This study aimed to validate Quantitative Light-induced Fluorescence (QLF) as a diagnostic tool for mild and moderate enamel fluorosis in permanent teeth, comparing it to visual diagnosis and histological assessment completed using polarized light microscopy (PLM). The buccal surfaces of 139 teeth were visually classified using the Thylstrup and Fejerskov Index (TFI) into sound (TFI 0; n=17), mild (TFI 1–2; n=69) and moderate (TFI 3–4; n=43) fluorosis. Fluorosis was then assessed with QLF (variables ΔF, A and ΔQ at 5-, 15- and 30-radiance thresholds) using as reference areas the entire surface and a region of interest (ROI), identified as the most representative region of a fluorosis lesion. PLM images of longitudinal thin sections including the ROI were assessed for histological changes. Correlations among TFI, PLM, and QLF were determined. A ROC curve was conducted to determine QLF’s diagnostic accuracy when compared to the TFI and PLM assessments. This was used to assess the probability that the images were correctly ranked according to severity as determined by PLM and TFI. A positive correlation was found between QLF and PLM, and between QLF and TFI. QLF showed highest sensitivity and specificity for the diagnosis of mild fluorosis. There was also a strong agreement between TFI and PLM. The selection of a ROI resulted in a stronger correlation with TFI and PLM than when the entire surface was used. The study results indicate that defining a ROI for QLF assessments is a valid method for the diagnosis of mild and moderate enamel fluorosis.
  • 9.

    【2hr】Unstimulated Saliva-Related Caries Risk Factors in Individuals with Cystic Fibrosis: A Cross-Sectional Analysis of Unstimulated Salivary Flow, pH, and Buffering Capacity

    包量

    机译 囊性纤维化患者唾液相关龋齿的未刺激因素：未刺激唾液流量，pH和缓冲能力的横断面分析
    摘要：Salivary flow rate, pH, and buffering capacity are associated with dental caries, but studies from the cystic fibrosis (CF) literature are inconclusive regarding these salivary factors and caries. The aim of this study was to evaluate these factors and their associations with dental caries in individuals with CF. Unstimulated whole saliva was collected from individuals ages 6–20 years at Seattle Children’s Hospital CF Clinic (U.S.A.) (N=83). Salivary flow rate was measured in mL/minute. Salivary pH was assessed using a laboratory pH meter. Buffering capacity was assessed by titration with HCl. The outcome measure was caries prevalence, defined as the number of decayed, missing, or filled primary and permanent tooth surfaces. Spearman’s rank correlation coefficient and the t-test were used to test for bivariate associations. Multiple variable linear regression models were used to: 1) run confounder-adjusted analyses; and 2) assess for a potential interactions. There was no significant association between salivary flow rate or buffering capacity and caries prevalence. There was a significant negative association between salivary pH and caries prevalence, but this association was no longer significant after adjusting for age. There was no significant interaction between salivary flow rate and buffering capacity or between antibiotic use and the three salivary factors. Our results indicate that unstimulated salivary factors are not associated with dental caries in individuals with CF. Future studies should investigate other potential saliva-related caries risk factors in individuals with CF such as cariogenic bacteria levels, salivary host defense peptide levels, and medication use.
  • 10.

    【2hr】Association between type, amount and pattern of carbohydrate consumption with dental caries in 12-year-olds in Puerto Rico

    包量

    机译 波多黎各12岁儿童碳水化合物摄入的类型，数量和方式与龋齿的关系
    摘要：ObjectiveTo identify the types, food sources, and pattern of carbohydrates that significantly contribute to dental caries in Puerto Rican children.
  • 11.

    【2hr】Orange/Red Fluorescence of Active Caries by Retrospective QLF Image Analyses

    包量

    机译 回顾性QLF图像分析法分析活性龋的橙色/红色荧光
    摘要：This retrospective clinical study determined the association of caries activity and orange/red fluorescence on QLF images of surfaces that progressed to cavitation as determined by clinical visual examination. A random sample of QLF images from 565 children (5-13years) previously enrolled in a longitudinal study was selected. Buccal, lingual and occlusal surfaces’ images obtained after professional brushing at baseline and every 4 months over a 4-year period were analyzed for Red Fluorescence (RF). Surfaces that progressed (N=224) to cavitation according to International Caries Detection and Assessment System (ICDAS 0/1/2/3/4 to 5/6/filling) and surfaces that did not progress (N=486) were included. QA2 image analysis software outputs the percentage increase of the red/green components as ΔR and Area of ΔR (Area△R) at different thresholds. Mixed-model ANOVA was used to compare progressive and non-progressive surfaces to account for correlations of RF (ΔR and AreaΔR) between surfaces within a subject. The first analysis used the first observation for each surface or the first available visit if the surface was unerupted (baseline), while the second analysis used the last observation prior to cavitation for surfaces that progressed and last observation for surfaces that did not progress (final). There was a significant (p<0.05) association between RF and progression to cavitation at thresholds ΔR0, ΔR10, ΔR20, ΔR60, ΔR70, ΔR80, ΔR90 and ΔRMax at baseline and for ΔR0 and ΔR10 at final observation. Quantification of orange/red fluorescence may help to identify lesions that progress to cavitation. Future studies identifying microbiological factors causing orange/red fluorescence and its caries activity are indicated.
  • 12.

    【2hr】Early caries predicts low oral health-related quality of life at later age

    包量

    机译 早期龋齿预示着与口腔健康相关的生活质量降低
    摘要：Oral health-related quality of life (OHRQOL) is the perceived impact of one’s own oral health on daily life. Oral diseases influence children’s OHRQOL directly, but OHRQOL might also be related to oral health experiences from the past. We investigate the relation between dental caries at the age of 6 with OHRQOL assessed at the age of 10. This study was conducted within the Generation R Study, a population-based prospective cohort study. Caries experience was assessed with the decayed, missing and filled teeth -index (dmft) at a median (90%range) age of 6.09 (5.73-6.80). OHRQOL was assessed with a short form of the Child Oral Health Impact Profile at the children’s age of 9.79 (9.49-10.44). In total, n= 2833 children participated in this study, of which n= 472 (16.6%) had mild caries (dmft 1-3) and n= 228 (8.0%) had severe caries (dmft>3). The higher the dmft-score at the age of 6, the lower the OHRQOL at the age of 10 (p<0.001). The children with severe caries at the age of 6 had significant higher odds to be in the lowest OHRQOL quartile at the age of 10 (OR=1.69; 95% CI=1.17-2.45). Our study highlights the importance of oral health during childhood, because those who get a compromised start to oral health are much more likely to follow a trajectory which will lead to poor oral health (-related quality of life) later. OHRQOL is not only related to current oral health experiences, but also to oral health experiences from the past.
  • 13.

    【2hr】Caregiver's education level and child's dental caries in African Americans: A path analytic study

    包量

    机译 非洲裔美国人的看护者的教育水平和儿童龋齿：路径分析研究
    摘要：The objective of this study was to investigate the influence of caregiver education level on children's dental caries mediated by both caregiver and child oral health behaviors. Participants were 423 low-income African American kindergarteners and their caregivers who were part of a school-based randomized clinical trial. Path analysis tested the hypothesis that caregiver education level affected untreated dental caries and cumulative overall caries experience (decayed or filled teeth) through the mediating influence of frequency of dental visits, use of routine care, and frequency of toothbrushing for both caregiver and child. The results supported the hypothesis: Caregivers who completed high school were 1.76 times more likely to visit dentists themselves compared with those who did not complete high school (e0.56=1.76, 95%CI: 1.03-2.99), which in turn was associated with 5.78 times greater odds of dental visits among their children (e1.76=5.78, 95%CI: 3.53-9.48). Children's dental visits, subsequently, were associated with 26% fewer untreated decayed teeth compared with children without dental visits (e-0.31=0.74, 95%CI: 0.60-0.91). However, this path was not present in the model with overall caries experience. Additionally, caregiver education level was directly associated with 34% less untreated decayed teeth (e-0.42=0.66, 95% CI: 0.54-0.79) and 28% less decayed or filled teeth (e-0.32=0.72, 95%CI: 0.60-0.88) among the children. This study overcomes important conceptual and analytic limitations in the existing literature. The findings confirm the role of caregiver education in child dental caries and indicate that caregiver's behavioral factors are important mediators of child oral health.
  • 14.

    【2hr】Blood levels of the heavy metal, lead, and caries in children ages 24-72 months: NHANES III

    包量

    机译 24-72个月儿童的重金属，铅和龋齿的血液水平：NHANES III
    摘要：Lead remains a significant pollutant. It has acute toxic and chronic effects on many tissues and accumulates in teeth and bones. The researchers for this study investigated the association of blood lead levels and the extent/severity of caries as measured by the number of decayed/filled teeth of children 24 to72 months using data from the Third National Health and Nutrition Examination Survey (NHANES III) accounting for the excess zero caries in the analysis and using less than 2 μg/dL as the reference blood lead level (N=3127). Zero-inflated negative binomial (ZINB) regression models indicated unadjusted extent/severity mean ratios of 1.79, 1.88, and 1.94 for the number of decayed/filled teeth in children whose blood lead levels were 2-5 μg/dL, 5-10 μg/dL, and >10 μg/dL, respectively when compared with children having less than 2 μg/dL blood lead levels. The results did not attenuate when other variables were added to the model for the 5-10 μg/dL, and >10 μg/dL levels of exposure. The adjusted extent/severity mean ratios were 1.84, 2.14, and 1.91, respectively for the categories. This study indicated a strong association of blood lead levels and increasing numbers of carious teeth in children 24 to72 months. These findings support other studies in an innovative analysis handling cases children with no caries. The findings may inform caries risk assessment.
  • 15.

    【2hr】Characterization of the Arginolytic Microflora Provides Insights into pH Homeostasis in Human Oral Biofilms

    包量

    机译 Arginolytic菌群的表征提供了人类口腔生物膜pH稳态的见解。
    摘要：A selected group of oral bacteria commonly associated with dental health is capable of producing alkali via the arginine deiminase system (ADS), which has a profound impact on the pH of human oral biofilms. An increased risk for dental caries has been associated with reduced ADS activity of the bacteria in oral biofilms. Arginolytic bacterial strains from dental plaque samples of caries-free (CF) and caries-active (CA) adults were isolated and characterized to investigate the basis for differences in plaque ADS activity between individuals. Fifty-six ADS-positive bacterial strains were identified by 16S rRNA gene sequencing and their ADS activity levels were compared under standard growth conditions. The spectrum of bacterial ADS activity ranged from 45.2 to 688.0 units (mg protein)−1. Although Streptococcus sanguinis was the most prevalent species, other Streptococcus were also represented. Biochemical assays carried out using twenty-seven ADS-positive strains under conditions known to induce or repress ADS gene expression, showed substantial variation in arginolytic activity in response to pH, oxygen, and the availability of carbohydrate or arginine. This study reveals that the basis for the wide spectrum of arginolytic expression observed among clinical strains is, at least in part, attributable to differences in the regulation of the ADS within and between species. The results provide insights into the microbiological basis for inter-subject differences in ADS activity in oral biofilms and enhance our understanding of dental caries as an ecologically-driven disease in which arginine metabolism moderates plaque pH and promotes dental health.
  • 16.

    【2hr】Genetic Susceptibility to Dental Caries Differs between the Sexes: A Family-based Study

    包量

    机译 性别对龋病的遗传易感性：基于家庭的研究
    摘要：Many of the factors affecting susceptibility to dental caries are likely influenced by genetics. In fact, genetics accounts for up to 65% of inter-individual variation in dental caries experience. Sex differences in dental caries experience has been widely reported, with females usually exhibiting higher prevalence and severity of disease across all ages. The cause for this sex bias is currently uncertain, although may be partly explained by the differential effects of genetic factors between the sexes: gene-by-sex interactions. In this family-based study (N=2,663; 740 families; ages 1–93 years), we assessed dental caries via intra-oral examination and generated six indices of caries experience (DMFS, dfs, and indices of both pit-and-fissure surface caries and smooth surface caries in both primary and permanent dentitions). We used likelihood-based methods to model the variance in caries experience conditional on the expected genetic sharing among relatives in our sample. This modeling framework allowed us to test two lines of evidence for gene-by-sex interactions: (1) whether the magnitude of the cumulative effect of genes differs between the sexes, and (2) whether different genes are involved. We observed significant evidence of gene-by-sex interactions for caries experience in both the primary and permanent dentitions. In the primary dentition, the magnitude of the effect of genes was greater in males than females. In the permanent dentition, different genes may play important roles in each of the sexes. Overall, this study provides the first direct evidence that sex differences in dental caries experiences may be explained, in part, by gene-by-sex interactions.
  • 17.

    【2hr】Early Childhood Caries is Associated with Genetic Variants in Enamel Formation and Immune Response Genes

    包量

    机译 幼儿龋病与牙釉质形成和免疫反应基因的遗传变异有关。
    摘要：Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of unequal contributions of risk factors and protective factors that influence the disease. The aim of this study was to assess genetic and environmental factors that may contribute to ECC. Two hundred fifty-nine unrelated children were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire and caries experience data were collected by clinical examination. Twenty-three markers in ten genes were studied. Genotyping of the selected polymorphisms was carried out by real-time PCR. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries-free. The genotype TT in ALOX15 (rs7217186) was a risk factor for ECC whereas the genotypes GG in ENAM (rs1264848), AG and GG in KLK4 (rs198968), CT in LTF (rs4547741), and GG in TUFT1 (rs3790506) were protective for EEC. In conclusion, environmental factors and gene-interactions can act as protective or risk factors for early childhood caries. These factors together contribute to the presence and severity of the disease.
  • 18.

    【2hr】Caries: Review of Human Genetics Research

    包量

    机译 龋齿：人类遗传学研究述评
    摘要：The NIH Consensus Development Program released a statement in 2001 () and listed six major clinical caries research directions. One of these directions was the need for genetic studies to identify genes and genetic markers of diagnostic, prognostic, and therapeutic value. This last decade has seen a steep increase in studies investigating the presence of genetic factors influencing individual susceptibility to caries. This review revisits recent caries human genetic studies and provides a perspective for future studies in order to fulfill their promise of revolutionizing our understanding of and the standard of care for the most prevalent bacteria-mediated non-contagious disease in the world.
  • 19.

    【2hr】Characteristics, detection methods, and treatment of questionable occlusal carious lesions: findings from The National Dental Practice-Based Research Network

    包量

    机译 可疑咬合龋问题的特征，检测方法和治疗：基于全国牙科实践研究网络的发现
    摘要：Questionable occlusal carious lesions (QOC) can be defined as an occlusal tooth surface with no cavitation and no radiographic radiolucencies, but caries is suspected due to roughness, surface opacities, or staining. An earlier analysis of data from this study indicates ⅓ of patients have a QOC. The objective of this report is to quantify the characteristics of these common lesions, diagnostic aids used, and treatment of QOC. A total of 82 dentist and hygienist practitioner-investigators from the United States and Denmark in The National Dental Practice-Based Research Network participated. When consented patients presented with a QOC, information was recorded about the patient, tooth, lesion, and treatments. 2,603 QOC from 1,732 patients were analyzed. Lesions were usually associated with a fissure, on molars, and varied from yellow to black in color. Half presented with a chalky luster and had a rough surface when examined with an explorer. There was an association between color and luster, 10% were chalky-light, 47% were shiny-dark, and 42% were mixtures. A higher proportion of chalky than shiny lesions were light (22% vs. 9%; p < 0.001). Lesions light in color were less common in adults than pediatric patients (9% vs. 32%; p < 0.001). Lesions that were chalky and light were more common among pediatric than adult patients (22% vs. 6%, p < 0.001). This is the first study to investigate characteristics of QOC in routine clinical practice. Clinicians commonly face this diagnostic uncertainty. Determining the characteristics of these lesions are relevant when making diagnostic and treatment decisions.
  • 20.

    【2hr】A Fourier Transform Infrared Spectroscopy Analysis of Carious Dentin from Transparent Zone to Normal Zone

    包量

    机译 龋牙从透明区到正常区的傅立叶变换红外光谱分析
    摘要：It is well known that caries invasion leads to the differentiation of dentin into zones with altered composition, collagen integrity and mineral identity. However, understanding of these changes from the fundamental perspective of molecular structure has been lacking so far. In light of this, the present work aims to utilize Fourier transform infrared spectroscopy (FTIR) to directly extract molecular information regarding collagen's and hydroxyapatite's structural changes as dentin transitions from the transparent zone (TZ) into the normal zone (NZ). Unembedded ultrathin dentin films were sectioned from carious teeth, and an FTIR imaging system was used to obtain spatially resolved FTIR spectra. According to the mineral-to-matrix ratio image generated from large-area low-spectral-resolution scan, the TZ, the NZ and the intermediate subtransparent zone (STZ) were identified. High-spectral-resolution spectra were taken from each zone and subsequently examined with regard to mineral content, carbonate distribution, collagen denaturation and carbonate substitution patterns. The integrity of collagen's triple helical structure was also evaluated based on spectra collected from demineralized dentin films of selected teeth. The results support the argument that STZ is the real sclerotic layer, and they corroborate the established knowledge that collagen in TZ is hardly altered and therefore should be reserved for reparative purposes. Moreover, the close resemblance between the STZ and the NZ in terms of carbonate content, and that between the STZ and the TZ in terms of being A-type carbonate-rich, suggest that the mineral that initially occludes dentin tubules is hydroxyapatite newly generated from odontoblastic activities, which is then transformed into whitlockite in the demineralization/remineralization process as caries progresses.
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