Current Issue : July - September Volume : 2016 Issue Number : 3 Articles : 4 Articles
Background: As a low-cost and easily operated treatment, the use of professionally applied topical fluoride was\napproved for preventing dental caries and remineralising early enamel caries or white spot lesions. It is also used to\narrest dentine caries. The aim of this study is to investigate the clinical efficacy of professional fluoride therapy in\nremineralising and arresting caries in children.\nMethod: A systematic search of publications from 1948 to 2014 was conducted using four databases: PubMed,\nCochrane Library, ISI Web of Science and Embase. The key words used were (fluoride) AND (remineralisation OR\nremineralization OR arresting) AND (children caries OR early childhood caries). The title and abstract of initially\nidentified publications were screened. Clinical trials about home-use fluorides, laboratory studies, case reports,\nreviews, non-English articles and irrelevant studies were excluded. The full texts of the remaining papers were\nretrieved. Manual screening was conducted on the bibliographies of the remaining papers to identify relevant\narticles.\nResults: A total of 2177 papers were found, and 17 randomised clinical trials were included in this review. Ten\nstudies investigated the remineralising effect on early enamel caries using silicon tetrafluoride, fluoride gel, silver\ndiamine fluoride or sodium fluoride. Seven studies reported an arresting effect on dentine caries using silver\ndiamine fluoride or nano-silver fluoride. Meta-analysis was performed on four papers using 5 % sodium fluoride\nvarnish to remineralise early enamel caries, and the overall percentage of remineralised enamel caries was 63.6 %\n(95 % CI: 36.0 % - 91.2 %; p < 0.001). Meta-analysis was also performed on five papers using 38 % silver diamine\nfluoride to arrest dentine caries and the overall proportion of arrested dentine caries was 65.9 % (95 % CI: 41.2 % -\n90.7 %; p < 0.001).\nConclusion: Professionally applied 5 % sodium fluoride varnish can remineralise early enamel caries and 38 % silver\ndiamine fluoride is effective in arresting dentine caries....
Background: Poor oral health is a chronic condition that can be extremely costly to manage. In Australia, publicly\nfunded dental services are provided to community members deemed to be eligibleââ?¬â?those who are socio-economically\ndisadvantaged or determined to be at higher risk of dental disease. Historically public dental services have\nnominally been allocated based on the size of the eligible population in a geographic area. This approach has\nbeen largely inadequate for reducing disparities in dental disease, primarily because the approach is treatment-focused,\nand oral health is influenced by a variety of interacting factors. This paper describes the developmental process of a\nmulti-dimensional community-level risk assessment model, to profile a communityââ?¬â?¢s risk of poor oral health.\nMethods: A search of the evidence base was conducted to identify robust frameworks for conceptualisation of risk\nfactors and associated performance indicators. Government and other agency websites were also searched to identify\npublicly available data assets with items relevant to oral diseases. Data quality and analysis considerations were\nassessed for the use of mixed data sources.\nResults: Several frameworks and associated indicator sets (twelve national and eight state-wide data collections\nwith relevant indicators) were identified. Determination of the system inputs for the Model were primarily\ninformed by the World Health Organisationââ?¬â?¢s (WHO) operational model for an Integrated Oral Health-Chronic\nDisease Prevention System, and Australiaââ?¬â?¢s National Oral Health Plan 2004ââ?¬â??2013. Data quality and access informed\nthe final selection of indicators.\nConclusions: Despite limitations in the quality and regularity of data collections, there are numerous data sources\navailable that provide the required data inputs for community-level risk assessment for oral health. Assessing risk in this\nway will enhance our ability to deliver appropriate public oral health care services and address the uneven distribution\nof oral disease across the social gradient....
Background: The aim of this prospective placebo-controlled pilot study was to evaluate short-term effects of a\nmouthrinse containing aluminium triformate (ATF) on gingival inflammation and plaque formation in periodontal\npatients who are in the maintenance phase. ATF has styptic (astringent) and anti-inflammatory effects.\nMethods: Forty non-smoking periodontal patients with modified sulcus bleeding index (MSBI) �40 % were randomly\ndivided into two groups. The participants received a masked mouthrinse (ATF or placebo) and were instructed with the\nrinsing protocol of 3 daily rinses during 30 s for 7 days. One blinded investigator (CE) performed all clinical examinations.\nThe primary outcome was reduction in gingival inflammation as measured by MSBI. The secondary outcomes were\nreduction of the amount of plaque as measured by plaque index (PI) and approximal plaque index (API) and the\noccurrence of side effects. The patients were evaluated at the start and the end of the rinsing period, including the\ncompliance of the patients.\nResults: MSBI was reduced in both groups compared to baseline, but the ATF group showed significantly more\nreduction in MSBI compared to the placebo group (ATF: 17.6 %, placebo: 7.6 %, p = 0.035). ATF and placebo had no\neffects on dental plaque. Patients reported ATF mouthrinse not to have side effects other than oral sensation, whereas\ncompliance of the patients was good. Almost all patients in the ATF group reported reduction of gum bleeding after\n1 week of rinsing with ATF.\nConclusions: This short-term pilot clinical trial is a firm basis to design a long-term controlled clinical trial to show\nwhether ATF helps to inhibit further periodontal breakdown in maintenance patients with high MSBI....
Abstract\nBackground: The treatment of periodontitis begins with a non-surgical phase that includes scaling and root\nplaning(SRP) and on occasion the use of systemic antibiotics. The goal was to systematically evaluate in systemic\nhealthy adults the effect of the concomitant administration of amoxicillin (amx) and metronidazole (met) adjunctive\nto SRP compared to SRP alone.\nMethods: The PubMed-MEDLINE, Cochrane-CENTRAL and EMBASE databases were searched up to November 2014\nto identify appropriate studies. Probing Pocket Depth (PD), Clinical Attachment Level (CAL), Bleeding on Pocket\nProbing(BOP) and Plaque Indices(PI) were selected as outcome variables. Based on the extracted data a meta-analysis\nwas conducted.\nResults: A total of 526 unique articles were found, 20 studies met the eligibility criteria. A meta-analysis showed that\nSRP + amx + met provided significantly better effects overall and more pronounced PD reduction in periodontal\npockets initially measuring �6 mm (DiffM:-0.86 mm, p < 0.00001) and gain in CAL(DiffM:+0.75 mm,\np = 0.0001). The meta-analysis for the secondary inflammatory parameter BOP showed that SRP + amx + met provided\nfull mouth significantly greater reduction in BOP than SRP alone (DiffM:-6.98 %, p = 0.0001).\nConclusion: Adjunctive systemic amoxicillin and metronidazole medication to SRP significantly improved the clinical\noutcomes with respect to mean PD, CAL and BOP compared to SRP alone. There is moderate to strong evidence in\nsupport of the recommendation that adjunctive amx +met therapy to SRP significantly improves the clinical outcomes,\nwith respect to mean PD and CAL compared to SRP alone especially in initially deep (�6 mm) pockets. No major side\neffects associated with the intake of amx + met were reported. This treatment regimen is an efficacious, minimally\ninvasive, practical and inexpensive approach for periodontitis therapy. The key components are mechanical tooth and\npocket debridement, supportive treatment of the disease with systemic antibiotics and attention to proper self-care....
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