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Monographs in Oral Science

Marcela Rocha de Olivera Carrilho
Case reports and clinical trials conducted in different countries (i.e., the United States, Canada, Brazil, Germany, Finland, Sweden, Japan, India, and Sri Lanka) tend to find a positive relationship between the presence of more retained teeth in older ages and the prevalence of root caries in older adults. As this tendency has been shown to prevail globally, it is estimated that the predicted demographic elderly expansion may cause, in near future, a significant increment in the number of older population requiring an effective means of preventing and treating root surface caries...
2017: Monographs in Oral Science
Alessandra Reis, Paulo Vinícius Soares, Juliana de Geus, Alessandro D Loguercio
This chapter describes the clinical performance of restorations placed in root caries lesions. The prevalence of root caries and other types of cervical lesions, caused by abfraction, erosion, and abrasion (non-carious cervical lesions) are high, mainly in the elderly; and therefore, restorative procedures are indicated. We will revise the restorative materials used to restore these types of lesions and present evidence-based findings to provide clinicians with better evidence for choosing them. Additionally, some steps of the restorative procedure for the placement of resin-based composites will be revised and common clinical questions related to these steps will be answered based on high evidence level, produced by randomized clinical trials and systematic reviews of the literature...
2017: Monographs in Oral Science
Michael F Burrow, Margaret A Stacey
The prevalence of root caries among the elderly is increasing. The lesion shape can vary considerably from a broad shallow saucer-shape to a deeper defined cavity. The variety of shapes poses a series of complications when considering restorative management. This is accompanied with a paucity of clinical evidence on treatment techniques and clinical outcomes. The current philosophy centered on conservative management of root caries will most likely provide patients with the greatest chance of maintaining their teeth...
2017: Monographs in Oral Science
Ana K Bedran-Russo, Camila A Zamperini
Dental caries is the most prevalent infectious chronic disease in children and adults. With a globally aging population, new demands in the management of dental caries are awakened by the rampant increase in the incidence of dental root caries. Like crown caries, root caries requires bacterial driven tissue demineralization followed by the degradation of the extracellular dentin matrix. Due to the complex composition and ultrastructure, preventive strategies targeting the mineral phase of dentin are insufficient for managing the prevention and progression of root caries...
2017: Monographs in Oral Science
Marília Afonso Rabelo Buzalaf, Juliano Pelim Pessan
The limited effect of fluoride on root caries has prompted the study of new preventive therapies, which involve recently developed functional peptides, lasers, phosphate-based technologies, among several other approaches. Most of the specific peptides currently investigated have been developed based on the available information related to the protective action of salivary proteins, including statherin-derived peptides. Other peptides include 8DSS, self-assembling peptide P11-4, antimicrobial peptides, and casein phosphopeptides combined with amorphous calcium phosphate...
2017: Monographs in Oral Science
Ana Carolina Magalhães
Root caries lesions (RCLs) are highly prevalent in elderly and can negatively impact the quality of life. Therefore, preventive therapies should be applied to control or to arrest RCLs. This chapter will discuss the application of fluoride, a conventional preventive therapy, to control RCLs. Among the self-applied products, there is strong evidence that 5,000 ppm F toothpaste is more effective in arresting RCLs (by increasing hardness) and in preventing new lesions (PF of 51%) compared to 1,100-1,450 ppm F toothpastes, in 6-month clinical trials...
2017: Monographs in Oral Science
Marisa Maltz, Luana Severo Alves, Julio Eduardo do Amaral Zenkner
As the thick biofilm in the presence of fermentable carbohydrates is the main etiological factor of dental caries, the frequent and systematic removal of this colony by means of an effective biofilm control should result in the prevention of caries lesions or in the arrest of the local carious process. However, the role of biofilm control in the management of dental caries has been questioned. This chapter will discuss the biofilm control and oral hygiene practices on root surfaces. Laboratory and clinical studies describing the effect of biofilm control and oral hygiene practices on the arrestment of root carious lesions are described...
2017: Monographs in Oral Science
Iain A Pretty
The early detection of root caries is essential for the implementation of appropriate preventive therapeutic regimes. Subsequent monitoring of lesions is required to determine the outcomes of such therapies. While much research activity has been seen in the detection and monitoring of enamel caries, this has not been seen in root caries - despite the possibilities for shorter clinical trials due to the more rapid remineralization and arrest of such lesions. The main stay of both clinical practice and research has been the use of visual tactile criteria including, hardness, texture, the presence or absence of cavitation, and color...
2017: Monographs in Oral Science
Thiago Saads Carvalho, Adrian Lussi
Despite certain similarities in the etiology of root caries (RC) and coronal caries, there are notable differences in their histology, namely with regard to the demineralization process, which should be taken into consideration when assessing lesion activity. In this chapter, we present the histological changes to the dentin and pulp, occurring physiologically or in response to caries lesions. We focus on the histological features specific to RC lesions, discussing the assessment of lesion activity. The physiological changes occurring to the dentin and pulp are the formation of secondary dentin and the sclerosis of dentin tubules, while tertiary dentin is formed during pathologic stimuli from caries lesions...
2017: Monographs in Oral Science
Sophie Doméjean, Avijit Banerjee
Patients' susceptibility to coronal and root caries (RC) is modulated by a range of biological, environmental, social, psychological, and behavior-related factors. These factors, considered either in isolation or combined into specific models, contribute to the overall patient susceptibility/risk of new lesion occurrence and/or of existing lesion progression, allowing the oral healthcare team to define specific and individualized preventive and curative regimens. Various caries susceptibility/risk assessment (CRA) protocols/models have been developed to assist the oral healthcare practitioner/team in a logical systematic approach to synthesize information about the caries disease process with its multifactorial etiology...
2017: Monographs in Oral Science
Ole Fejerskov, Bente Nyvad
Root surfaces, which with increasing age become exposed to dental biofilms, will react to the intermittent pH fluctuations at the interface between the biofilm and the cementum/dentin surface. If dental biofilm is left undisturbed in stagnation sites in the dentition, the underlying mineral surfaces may gradually develop dental caries characterized by a subsurface loss of mineral. In root surfaces, the demineralization is accompanied by microbial invasion of the cementum and dentin resulting in a pulpo-dentinal defense reaction...
2017: Monographs in Oral Science
Tchilalo Boukpessi, Suzanne Menashi, Catherine Chaussain
Similar to coronal caries, root caries results from a disequilibrium of the de-remineralization balance in favor of the demineralization process. It mainly involves a bacterial shift in favor of an increase in the proportion of acidogenic and aciduric bacteria. This process permanently damages the dental mineralized tissues, namely the dental cementum and dentin. In addition to the demineralization and exposure of the dentin or the cementum organic matrix, acid production by cariogenic bacteria induces the activation of endogenous (host-derived) enzymes within the dentin and saliva...
2017: Monographs in Oral Science
Thuy Do, Nailê Damé-Teixeira, Monika Naginyte, Philip D Marsh
Following gingival recession, which increases with age, the root surface becomes exposed, creating new environments for microbial colonization and biofilm formation. The formation of root surface biofilms is influenced by the availability and composition of saliva and gingival crevicular fluid; they provide components for the conditioning film (acquired root surface pellicle) and also act as a source of nutrients. The early bacterial colonizers of the root surface are similar to those found on the enamel, and Gram-positive species such as Streptococcus sanguinis, S...
2017: Monographs in Oral Science
Nailê Damé-Teixeira, Clarissa Cavalcanti Fatturi Parolo, Marisa Maltz
Variations in organic and inorganic composition and morphology may determine different susceptibilities of root surfaces to caries. Subsequent to gingival recession, root surfaces become exposed and those areas where Sharpey's fibers system was once inserted into the cementum are converted into canals for microbial penetration. In the presence of a cariogenic root biofilm, the fermentable carbohydrate from diet is converted into organic acid, and the root caries lesion is initiated in the exposed root site...
2017: Monographs in Oral Science
Martina Hayes, Francis Burke, Patrick Finbarr Allen
Population aging and the concomitant reduction in tooth loss will have a profound effect on dentistry. In particular, an increase in the prevalence of root caries can be expected. Root caries is not evenly distributed across the population and identification of high-risk groups or individuals would facilitate targeted prevention strategies. Unfortunately, the lack of consensus in the literature on the diagnosis and measurement of root caries makes comparison of studies extremely challenging. At present, we do not have an adequately validated risk assessment tool for root caries...
2017: Monographs in Oral Science
Martina Hayes, Francis Burke, Patrick Finbarr Allen
High quality epidemiological data are essential for both the development of national oral health policies and cost-effective targeting of resources. Unfortunately, a high level of clinical heterogeneity between studies in this area makes it difficult, and inappropriate, to try to produce any definitive figures on the global prevalence or incidence of root caries. Published studies have reported wide ranges for the prevalence of root caries (25-100%) and the mean Root Caries Index (9.7-38.7). The reported range for annual root caries incidence is also wide, from 10...
2017: Monographs in Oral Science
Thiago S Carvalho, Adrian Lussi, Thomas Jaeggi, Dein L Gambon
Erosive tooth wear in children is a common condition. Besides the anatomical differences between deciduous and permanent teeth, additional histological differences may influence their susceptibility to dissolution. Considering laboratory studies alone, it is not clear whether deciduous teeth are more liable to erosive wear than permanent teeth. However, results from epidemiological studies imply that the primary dentition is less wear resistant than permanent teeth, possibly due to the overlapping of erosion with mechanical forces (like attrition or abrasion)...
2014: Monographs in Oral Science
Anne Peutzfeldt, Thomas Jaeggi, Adrian Lussi
When substance loss caused by erosive tooth wear reaches a certain degree, oral rehabilitation becomes necessary. Until some 20 years ago, the severely eroded dentition could only be rehabilitated by the provision of extensive crown and bridge work or removable overdentures. As a result of the improvements in resin composite restorative materials, and in adhesive techniques, it has become possible to rehabilitate eroded dentitions in a less invasive manner. However, even today advanced erosive destruction requires the placement of more extensive restorations such as overlays and crowns...
2014: Monographs in Oral Science
Marília Afonso Rabelo Buzalaf, Ana Carolina Magalhães, Annette Wiegand
In recent years, different agents have been discussed as potential alternatives to fluoride in the prevention of dental erosion. These agents are intended to form acid-resistant layers on the surface, to induce repair of eroded lesions by mineral precipitation or to prevent the enzymatic degradation of demineralised collagen. The application of adhesives and/or fissure sealants is considered to be an effective alternative to fluoride, but requires professional application and, depending on the product used, a re-sealing of the surface every several months...
2014: Monographs in Oral Science
Marie-Charlotte Huysmans, Alix Young, Carolina Ganss
The role of fluoride in erosion therapy has long been questioned. However, recent research has yielded positive results. In this chapter, an overview of the literature is provided regarding the application of fluorides in the prevention and treatment of erosion and erosive wear. The results are presented and discussed for different fluoride sources such as monovalent and polyvalent fluorides, and for different vehicles such as toothpastes, solutions and rinses, as well as varnishes and gels. It is concluded that fluoride applications are very likely to be of use in the preventive treatment of erosive wear...
2014: Monographs in Oral Science
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