窝沟封闭和涂氟同时应用对乳磨牙龋病干预的研究

目的:探讨同时应用窝沟封闭和涂氟预防干预乳磨牙预防龋齿的效果,为学龄前儿童乳磨牙龋齿的预防提供新的干预措施。方法:通过Cariostat法对150名学龄前儿童乳磨牙进行龋蚀活跃性试验,将其分为龋活跃高危人群和低危人群,检查其乳磨牙患龋情况,计算龋均。随机抽取30名龋活跃高危人群儿童做为实验组1,30名龋活跃低危人群儿童做实验组2,应用窝沟封闭和多乐氟护齿剂同时对乳磨牙进行龋病预防干预;同时抽取30名龋活跃低危人群做对照组应用多乐氟护齿剂对乳磨牙进行龋病预防干预,于干预后6、12、18个月计算龋病发病率。结果:龋活跃高危人群和低危人群的患龋率分别为68.75%、28.6%,两组比较有显著性差异(P<0.05)。干预后6个月时,实验组1、实验组2、对照组龋病发病率分别为12.3%、11.6%、13.1%,三组比较无显著性差异(P>0.05);12个月时,龋病发病率分别为12.4%、11.8%、23.2%,实验组1、实验组2比较无显著性差异(P>0.05),实验组1、实验组2均显著低于对照组,有显著性差异(P<0.05);18个月时,龋病发病率分别为13.2%、12.9%、29.3%,实验组1、实验组2均显著低于对照组,有显著性差异(P<0.05),但实验组1、实验组2比较无显著性差异(P>0.05)。结论:同时应用窝沟封闭和涂氟对乳磨牙可以有效防龋,降低学龄前儿童的龋发病率。     

Calcium-phosphate-osteopontin particles for caries control

Caries is caused by acid production in biofilms on dental surfaces. Preventing caries therefore involves control of microorganisms and/or the acid produced. Here, calcium-phosphate-osteopontin particles are presented as a new approach to caries control. The particles are made by co-precipitation and designed to bind to bacteria in biofilms, impede biofilm build-up without killing the microflora, and release phosphate ions to buffer bacterial acid production if the pH decreases below 6. Analysis of biofilm formation and pH in a five-species biofilm model for dental caries showed that treatment with particles or pure osteopontin led to less biofilm formation compared to untreated controls or biofilms treated with osteopontin-free particles. The anti-biofilm effect can thus be ascribed to osteopontin. The particles also led to a slower acidification of the biofilm after exposure to glucose, and the pH always remained above 5.5. Hence, calcium-phosphate-osteopontin particles show potential for applications in caries control.     

Anticariogenic activity of macelignan isolated from Myristica fragrans (nutmeg) against Streptococcus mutans

The occurrence of dental caries is mainly associated with oral pathogens, especially cariogenic Streptococcus mutans. Preliminary antibacterial screening revealed that the extract of Myristica fragrans, widely cultivated for the spice and flavor of foods, possessed strong inhibitory activity against S. mutans. The anticariogenic compound was successfully isolated from the methanol extract of M. fragrans by repeated silica gel chromatography, and its structure was identified as macelignan by instrumental analysis using 1D-NMR, 2D-NMR and EI-MS. The minimum inhibitory concentration (MIC) of macelignan against S. mutans was 3.9 microg/ml, which was much lower than those of other natural anticariogenic agents such as 15.6 microg/ml of sanguinarine, 250 microg/ml of eucalyptol, 500 microg/ml of menthol and thymol, and 1000 microg/ml of methyl salicylate. Macelignan also possessed preferential activity against other oral microorganisms such as Streptococcus sobrinus, Streptococcus salivarius, Streptococcus sanguis, Lactobacillus acidophilus and Lactobacillus casei in the MIC range of 2-31.3 microg/ml. In particular, the bactericidal test showed that macelignan, at a concentration of 20 microg/ml, completely inactivated S. mutans in 1 min. The specific activity and fast-effectiveness of macelignan against oral bacteria strongly suggest that it could be employed as a natural antibacterial agent in functional foods or oral care products.     

Dental caries among the pre-Hispanic population from Gran Canaria

The island of Gran Canaria was inhabited in pre-Hispanic times by people of North African origin who arrived on the island towards the second half of the first millennium BC. In previous studies, we reported that there are some differences between the coastal inhabitants from Gran Canaria, mainly buried in tumuli, and those from the central mountains, mainly buried in caves. For example, the prevalence of auricular exostoses is higher among the population interred in coastal tumuli when compared with the inland population. This finding may be explained by the practice of marine activities, as supported by chroniclers' reports, by archaeological data, and by bone trace-element analysis, which point to a more intense consumption of marine products by the inhabitants of the coastal regions. Dental caries epidemiology is one of the most important ways in which the diet of past populations can be reconstructed. The purpose of this study is to assess the prevalence and intensity of caries among the pre-Hispanic population of Gran Canaria, in order to increase our knowledge about the dietary habits of these people, and to search for differences among the population buried in caves and that buried in tumuli. We studied a total of 791 individuals. Sex was estimated in 561 cases, and age at death, following Brothwell's criteria, in 549. We found that 66.95% of individuals buried in caves and 58.91% of those buried in tumuli showed at least one carious lesion. The proportion of carious teeth was significantly higher among the population buried in caves (median = 15.71%, interquartile range (IR) = 0-33.33%) than among the population buried in tumuli (median = 6.25%, IR = 0-20%, P = 0.001). Type of burial is the main factor associated with the proportion of carious teeth.These data suggest that the population buried in caves had a different dietary pattern from that of those buried in tumuli.     

含氟复合体充填材料充填根面龋对局部菌群变化的影响研究

目的观察根面龋充填后细菌分布变化,以及不同充填材料与主要致龋菌比例变化之间的关系。方法选择根面龋患者60例,采自身前后对照设计,采用细菌分离鉴定及菌落形成单位记数的检测方法,以充填前患牙龈沟菌丛为基线,追踪观察牙体复合体充填和银汞合金充填后即刻、1个月、6个月充填体周围1 mm范围内菌丛变化情况。结果根面龋充填后即刻充填体周围菌斑中的数量与种类显著减少,且放线菌、乳酸杆菌和变形链球菌3种菌落数量降低和占总菌落的百分率下降(P<0.01);根面龋充填后1个月细菌数量仍低于充填前水平,差异有显著性(P<0.05);且复合体组3种主要致龋菌落占总菌落的百分率低于银汞合金充填组,差异有显著性(P<0.05);根面龋充填后6个月细菌丛与充填前差异无显著性(P>0.05)。不同充填材料组3种菌落占总菌落的百分率无明显变化,差异无显著性(P>0.05)。结论无论采用何种材料,根面龋充填本身可改善菌斑的微生态环境,复合体充填根面龋后短期内可以有效地抑制充填体龋洞周围菌斑中主要致龋菌的比例。     

Treatment of Streptococcus mutans biofilms with a nonthermal atmospheric plasma

AIMS: A nonthermal atmospheric plasma, designed for biomedical applications, was tested for its antimicrobial activity against biofilm cultures of a key cariogenic bacterium Streptococcus mutans. METHODS AND RESULTS: The Strep. mutans biofilms were grown with and without 0.15% sucrose. A chlorhexidine digluconate rinse (0.2%) was used as a positive antimicrobial reference. The presence of sucrose and the frequency of plasma application during growth were shown to have a significant effect on the response to treatment and antibacterial activity. CONCLUSIONS: A single plasma treatment for 1 min on biofilms cultured without sucrose caused no re-growth within the observation period. However, with either single or repeated plasma treatments of 1 min, on biofilms cultured with 0.15% sucrose, growth was only reduced. SIGNIFICANCE AND IMPACT OF THE STUDY: In summary, there may be a role for nonthermal plasma therapies in dental procedures. Sucrose and associated growth conditions may be a factor in the survival of oral biofilms after treatment.     

Examiner agreement on caries detection and plaque accumulation during dental surveys of elders

Indices used to evaluate plaque accumulation and coronal caries have been widely accepted in epidemiological studies, yet their reliability cannot be guaranteed. The aim of this study was to evaluate the reliability of clinical criteria used in coronal and root caries diagnosis and oral hygiene evaluation as applied in elders. Nineteen elderly subjects, 73 years old on average, were examined at a first appointment by two independent examiners. They were re-examined two weeks later. Plaque accumulation was evaluated using the Plaque Index (PI) and coronal and root caries were detected according to the WHO criteria and Fejerskov et al (1991), respectively. Recurrent caries was recorded as recommended by WHO and by probing at the interface tooth-restoration. Inter- and intra-examiner agreement was evaluated using kappa statistics. The PI score showed good reliability except for examiner b, for whom a simplification of the 4-point scale in 3-point scale improved significantly the reliability. The prevalence of coronal caries was very low and intra- and inter-examiner agreement was poor. Most of the root caries lesions were covered by plaque and the kappa values indicated only poor agreement. Recurrent caries were found with good agreement using WHO criteria but the detection with the probe was not reliable. In conclusion, it seems that examiners should be trained carefully to maximise their reliability and that plaque should be removed to obtain reliable diagnoses of caries. Retraining and calibration may be necessary for surveys continuing over a long period.     

The oral metagenome in health and disease

The oral cavity of humans is inhabited by hundreds of bacterial species and some of them have a key role in the development of oral diseases, mainly dental caries and periodontitis. We describe for the first time the metagenome of the human oral cavity under health and diseased conditions, with a focus on supragingival dental plaque and cavities. Direct pyrosequencing of eight samples with different oral-health status produced 1 Gbp of sequence without the biases imposed by PCR or cloning. These data show that cavities are not dominated by Streptococcus mutans (the species originally identified as the ethiological agent of dental caries) but are in fact a complex community formed by tens of bacterial species, in agreement with the view that caries is a polymicrobial disease. The analysis of the reads indicated that the oral cavity is functionally a different environment from the gut, with many functional categories enriched in one of the two environments and depleted in the other. Individuals who had never suffered from dental caries showed an over-representation of several functional categories, like genes for antimicrobial peptides and quorum sensing. In addition, they did not have mutans streptococci but displayed high recruitment of other species. Several isolates belonging to these dominant bacteria in healthy individuals were cultured and shown to inhibit the growth of cariogenic bacteria, suggesting the use of these commensal bacterial strains as probiotics to promote oral health and prevent dental caries.