The burden of root caries: Updated perspectives and advances on management strategies

AlQranei, Mohammed S.; Balhaddad, Abdulrahman A.; Melo, Mary Anne S.

doi:10.1111/ger.12511

Cited by 47 publications

(51 citation statements)

References 118 publications

(264 reference statements)

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“…Therefore, the invading microorganisms involved in root caries may be less dependent on carbohydrates than earlier thought. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

“…Root caries is a multifactorial disease that exhibits softened, brownish, and irregular tissue on the root surface in the proximity of the cementoenamel junction. [ 1 ] Various risk predictors of root caries have been identified in two recent systematic reviews of observational longitudinal[ 2 ] and cross-sectional[ 3 ] studies, namely age, socioeconomic status, gingival recession, oral hygiene status, and smoking.…”

Section: Introductionmentioning

confidence: 99%

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Perspective and practice of root caries management: A multicountry study – Part II: A deeper dive into risk factors

et al. 2021

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Background: The potential of an improved understanding to prevent and treat a complex oral condition such as root caries is important, given its correlation with multiple factors and the uncertainty surrounding the approach/material of choice. Deeper insights into risk factors may improve the quality of treatment and reduce the formation of root surface caries. Aim: The present work aims to gain knowledge about dentists’ opinions and experiences on assessing the risk factor related to the development of root caries and to help identify any overlooked factors that may contribute to less efficacious clinical outcomes. Methodology: A questionnaire related to root surface caries was distributed among practicing dentists in nine different countries, namely the United Kingdom, Libya, Jordan, Saudi Arabia, Egypt, Brazil, India, Malaysia, and Iraq. Questionnaire responses were analyzed, and the results were compared among the groups. Results: Dentists around the world ranked the oral hygiene status of patients as the most important factor in the development of root surface caries. Patients with poor oral hygiene, active periodontal disease, reduced salivary flow, and gingival recession are perceived to have a higher risk of developing new root surface caries. There is a greater focus on prevention in the UK and greater levels of untreated dental disease in other countries, especially those recovering from civil wars. Conclusion: This work identified some overlooked factors that may have contributed to the less efficacious clinical outcomes reported in the literature. It is hoped that this deep dive into risk factors coupled with the findings presented in Part I of this study will be used as a basis for a more comprehensive investigation into the management of patients with root surface caries.

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“…Therefore, the invading microorganisms involved in root caries may be less dependent on carbohydrates than earlier thought. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perspective and practice of root caries management: A multicountry study – Part II: A deeper dive into risk factors

et al. 2021

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“…A great variety and incidence of cervical lesions play a surprisingly substantial, yet unrecognized, health burden on the global population (Wierichs et al 2018). The major population bearing with these clinical complications are elderly patients, in whom aging-related caries risk factors impose a significant clinical problem, and the incidence of root caries is highest (AlQranei et al 2020). The restorative management of cervical caries, root caries, and noncarious cervical lesions (NCCLs) often is complex, technically demanding, and least durable (Wierichs et al 2018).…”

Section: Introductionmentioning

confidence: 99%

“…For these reasons, the development of composites with anticaries responsiveness that could increase cervical restorations’ life span has great significance (AlQranei et al 2020). Understanding the complexity of caries as a dynamic process triggered by dysbiotic biofilms over composites has encouraged the design of new multifunctional materials, such as those with combinatorial responsive ion-releasing and antibacterial functionality (Balhaddad et al 2020).…”

Section: Introductionmentioning

confidence: 99%

Bifunctional Composites for Biofilms Modulation on Cervical Restorations

et al. 2021

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Cervical composites treating root carious and noncarious cervical lesions usually extend subgingivally. The subgingival margins of composites present poor plaque control, enhanced biofilm accumulation, and cause gingival irritation. A potential material to restore such lesions should combine agents that interfere with bacterial biofilm development and respond to acidic conditions. Here, we explore the use of new bioresponsive bifunctional dental composites against mature microcosm biofilms derived from subgingival plaque samples. The designed formulations contain 2 bioactive agents: dimethylaminohexadecyl methacrylate (DMAHDM) at 3 to 5 wt.% and 20 wt.% nanosized amorphous calcium phosphate (NACP) in a base resin. Composites with no DMAHDM and NACP were used as controls. The newly formulated 5% DMAHDM–20% NACP composite was analyzed by micro-Raman spectroscopy and transmission electron microscopy. The wettability and surface-free energy were also assessed. The inhibitory effect on the in vitro biofilm growth and the 16S rRNA gene sequencing of survival bacterial colonies derived from the composites were analyzed. Whole-biofilm metabolic activity, polysaccharide production, and live/dead images of the biofilm grown over the composites complement the microbiological assays. Overall, the designed formulations had higher contact angles with water and lower surface-free energy compared to the commercial control. The DMAHDM-NACP composites significantly inhibited the growth of total microorganisms, Porphyromonas gingivalis, Prevotella intermedia/nigrescens, Aggregatibacter actinomycetemcomitans, and Fusobacterium nucleatum by 3 to 5-log ( P < 0.001). For the colony isolates from control composites, the composition was typically dominated by the genera Veillonella, Fusobacterium, Streptococcus, Eikenella, and Leptotrichia, while Fusobacterium and Veillonella dominated the 5% DMAHDM–20% NACP composites. The DMAHDM-NACP composites contributed to over 80% of reduction in metabolic and polysaccharide activity. The suppression effect on plaque biofilms suggested that DMAHDM-NACP composites might be used as a bioactive material for cervical restorations. These results may propose an exciting path to prevent biofilm growth and improve dental composite restorations’ life span.

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“…Consequently, recurrent caries will destroy more hard tissue and further affect the pulp tissue. Recently, due to the aging of the global population, especially in developed countries, the risk of root dentin exposure to caries or recurrent caries is also increasing [ 3 , 4 ]. Recurrent root caries are more difficult to approach because of their location, which increases the difficulty of treatment by the dentist.…”

Section: Introductionmentioning

confidence: 99%

Anti-Demineralization Effects of Dental Adhesive-Composites on Enamel–Root Dentin Junction

et al. 2021

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Oral biofilm reactor (OBR) and pH cycling (pHC) artificial caries model were employed to evaluate the anti-demineralization effects of four composite filling systems on enamel–root dentin junction. Sixty-four enamel–root dentin blocks (6 mm × 6 mm × 2 mm) each with a cylindrical cavity were randomly assigned to the pHC and OBR group, then four subgroups (n = 8) and filled with either the Beautifil II (BEF, SPRG-filler-containing) or Estelite (EST) composite after the adhesive (either Single Bond Universal (SBU) or FL Bond II (FL, SPRG-filler-containing)). The demineralization lesions of filling interface were examined by micro-computerized tomography (μCT) and swept-source-optical coherence tomography (SS-OCT). According to the degree of interface damage, the caries lesions were sorted into four types: Type A and B (no attachment loss); Type C and D (attachment loss). EST/SBU showed the worst demineralization lesion and attachment loss (100% Type D), while BEF/FL exhibited the shallowest lesion depth (p < 0.05, 145 ± 45 μm on enamel, 275 ± 35 μm on root dentin) and no attachment loss (75% Type A and 25% Type B). Using FL adhesive alone does not effectively reduce enamel demineralization. BEF plays a leading role in acid resistance. The combination of BEF and FL showed a cumulative synergistic effect on anti-demineralization.

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The burden of root caries: Updated perspectives and advances on management strategies

Cited by 47 publications

References 118 publications

Perspective and practice of root caries management: A multicountry study – Part II: A deeper dive into risk factors

Perspective and practice of root caries management: A multicountry study – Part II: A deeper dive into risk factors

Bifunctional Composites for Biofilms Modulation on Cervical Restorations

Anti-Demineralization Effects of Dental Adhesive-Composites on Enamel–Root Dentin Junction

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