BackgroundThis quasi-clinical trial compared the effects of Oral7® and salt-soda mouthwash on the development of dental caries, salivary gland function, radiation mucositis, xerostomia and EORTC QLQ H&N C35 scores in head and neck cancer patients who underwent radiotherapy.MethodsWe included patients with histopathologically diagnosed head and neck cancers who had received radiation, with an Eastern Cooperative Oncology Group (ECOG) performance status 0–1 and age range of 15–60 years. Patients with prior radiotherapy and chemotherapy, edentulous status, total parotidectomy, sicca syndrome or on xerosis-induced medications were excluded. We assigned 15 patients each to the Oral7® and salt-soda groups.ResultsThere was no significant difference in the mean Decayed, Missing and Filling Teeth (DMFT) score between groups. Head and neck cancer patients who were on Oral7® had a significantly better quality of life than those on salt-soda in relation to the swallowing problems, social eating, mouth opening, xerostomia and illness scales. Patients who were on Oral7® had a significantly lower xerostomia score than patients on salt-soda mouthwash. Patients on Oral7® had a significantly lower mucositis score in week 5–7 compared to patients in the salt-soda group.ConclusionOral7® showed advantages over salt-soda solution in relation to reducing xerostomia, easing radiation-induced mucositis, and improving quality of life, despite the non-significant difference in the dental caries assessment.
This systematic review aimed to provide a synthesis of the evidence relating to how the provision of Vitamin D supplements influences oral health status. An electronic database search was performed across six databases using a standardised search strategy. The PICO framework was used to define the review question. The screening and selection followed PRISMA process. The quality of reporting was assessed using CONSORT guidelines, and the bias was assessed using the revised Cochrane tool RoB2. A total of 1812 studies were retrieved. 1427 studies were excluded due to unmet inclusion criteria. Full texts of 75 potential studies were retrieved and ultimately six studies met the inclusion criteria. There were limitations in the quality of reporting of studies (between 49% and 73%). 70% of the risk of bias items were in the low risks category. Vitamin D interventions varied with respect to dosage and duration. Qualitative syntheses identified significantly better oral health outcomes. Heterogeneity of study design, intervention and outcomes precluded quantitative synthesis. Few clinical trials investigated the effect of Vitamin D supplementation on oral health. There is considerable heterogeneity among studies interventions and oral health outcomes. Quality of reporting of studies have limitations and there is evidence of study biases. Nonetheless, qualitative synthesis of the evidence suggest that Vitamin D supplements improve oral health outcomes, particularly periodontal health. Calcium may also play a significant role. Further high-quality trials are required of comparable Vitamin D supplements with similar oral health outcomes focus to inform quantitative synthesis of the evidence.
Complete pulpotomy as a treatment option for caries exposure in mature permanent teeth with complete root formation still remains controversial due to lack of evidence on the long-term success. This article highlights a rare complete pulpotomy case done on a mature permanent tooth that survived for 20 years. A 34-year-old female presented with dull spontaneous pain on her right mandibular first molar and showed positive response to both cold test and electrical pulp test. The tooth was previously restored with tooth coloured restoration at the disto-occlusal surface and pre-operative periapical radiograph revealed large radiopacity covering the entire pulp chamber with calcified canals. The tooth was diagnosed as previously initiated therapy with symptomatic apical periodontitis. Endodontic treatment was initiated. All canals were located and corrected working length achieved followed by cleaning and shaping using HyFlex CM rotary files with copious irrigation of 2.5% sodium hypochlorite solution. Intracanal medication (non-setting calcium hydroxide) was placed and the tooth was restored with temporary restoration. After two weeks, obturation was done using single cone technique with EndoRez sealer. Universal composite resin was placed as permanent restoration and follow-up was done after one month and three months respectively without symptoms and evidence of periapical lesion. This minimally invasive pulpotomy procedure may be an alternative treatment option for mature permanent teeth whenever carious exposure to the pulp occurs.
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