Bennett Amaechi | University of Texas Health Science Center at San Antonio (UTHSCSA) (original) (raw)

Papers by Bennett Amaechi

European Journal of Dentistry, May 12, 2023

Objectives To investigate the effects of radiofrequency (RF) energy, applied through a power toot... more Objectives To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established. Materials and Methods Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively. Statistical Analysis Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests. Results At each time, RF treatment significantly (p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques. Conclusion The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste. Investigate the effects of bipolar radiofrequency (3 W, 3 MHz) applied via a power toothbrush on the structural morphology (chain formation) of periodontal disease-causing biofilm, ultrastructure (cell wall and cell components) of the bacteria, and the thickness of bacteria plaque biofilm.

Frontiers in Cellular and Infection Microbiology, Nov 24, 2022

Dentistry journal, Mar 13, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of Dental Education

ObjectivesInteractive scenario‐based learning (SBL) cases were developed using the SoftChalk plat... more ObjectivesInteractive scenario‐based learning (SBL) cases were developed using the SoftChalk platform to deliver content about patients’ access to healthcare barriers and patient management strategies connecting oral to systemic health. The interactive cases were designed to engage the digital‐savvy learners, meet them where they are by leveling up, and seek their feedback to determine flipped (FC) or modified flipped classroom (MFC) content delivery approaches.MethodsHealth professions students completed interactive SBL cases (Phase‐I) and completed interactive SBL cases (Phase‐I) using either FC, assigning content outside of class time preparation, or MFC as allocated time at the beginning of the class deliveries, and a 12‐item post‐completion survey. The senior dental student cohort (Phase‐II) completed an anonymous Qualtrics survey that assessed their confidence leading to clinical competence 2 years after the interactive SBL case deliveries. The final survey (Phase‐III) of firs...

Biomimetics

Hydroxyapatite, Ca5(PO4)3(OH), is a biomimetic active ingredient, which is used in commercial ora... more Hydroxyapatite, Ca5(PO4)3(OH), is a biomimetic active ingredient, which is used in commercial oral care products such as toothpastes and mouthwashes worldwide. Clinical studies (in vivo) as well as in situ and in vitro studies have shown the preventive effects of hydroxyapatite in various field of oral care. In some products, hydroxyapatite is combined with other active ingredients, to achieve an additional antibacterial effect or to promote gum health. This review analyzes the efficacy of six selected natural and nature-inspired ingredients that are commonly used together with hydroxyapatite. These additional actives are either antibacterial (lactoferrin, xylitol, and zinc) or promote gum health (allantoin, bisabolol, and hyaluronic acid). A systematic literature search was performed, and all studies found on each ingredient were analyzed. In summary, all analyzed ingredients mentioned in this review are well described in scientific studies on their beneficial effect for oral healt...

BackgroundDental caries remains a global problem that causes disproportionate suffering in unders... more BackgroundDental caries remains a global problem that causes disproportionate suffering in underserved populations. Simple interventions are needed to improve patient experience, clinical and cost-effectiveness, and access to care. The self-assembling peptide P11-4 is a recently developed, non-invasive treatment that regenerates enamel in initial caries lesions.Studies reviewedWe conducted a systematic review and meta-analysis on the effectiveness of the P11-4 products Curodont™ Repair (CR) and Curodont™ Repair Fluoride Plus (CRFP) on initial caries lesions. Primary outcomes were lesion progression after 24 months, caries arrest, and cavitation. Secondary outcomes were changes in merged International Caries Detection and Assessment System (ICDAS) score, Quantitative Light Fluorescence, esthetic appearance, and lesion size.ResultsSix clinical trials comparing CR to controls met the inclusion criteria. Results of this review represent two primary and two secondary outcomes. When compa...

Frontiers in Dental Medicine

Children are prone to develop dental caries. This is supported by epidemiological data confirming... more Children are prone to develop dental caries. This is supported by epidemiological data confirming early childhood caries (ECC) as a highly prevalent disease affecting more than every second child worldwide. ECC is known to result from an imbalance between re- and demineralization where demineralization dominates due to frequent acid production by cariogenic bacteria present in oral biofilms. The application of oral care formulations containing remineralizing agents helps to prevent dental caries. As young children are sensitive and usually swallow (intended or unintended) a majority of toothpaste or other oral care products during daily dental care, all ingredients, especially the actives, should be non-toxic. Biomimetic hydroxyapatite [HAP; Ca5(PO4)3(OH)] is known to have favorable remineralizing properties combined with an excellent biocompatibility, i.e., it is safe if accidently swallowed. Several clinical trials as well as in situ and in vitro studies have shown that HAP remine...

The Journal of Prosthetic Dentistry, 2021

STATEMENT OF PROBLEM Denture stomatitis is a chronic inflammatory condition caused by the formati... more STATEMENT OF PROBLEM Denture stomatitis is a chronic inflammatory condition caused by the formation of Candida albicans biofilm on denture bases. It is associated with aggravating intraoral pain, itching, and burning sensations. It can also potentiate cardiovascular diseases and aspiration pneumonia. The problem has thus far eluded efficient, toxic-free, and cost-effective solutions. PURPOSE The purpose of this in vitro study was to investigate the effectiveness of organoselenium to inhibit the formation of C. albicans biofilm on the surface of acrylic resin denture base materials when it is either incorporated into the acrylic resin material or coated on the denture surface as a light-polymerized surface sealant. MATERIAL AND METHODS Sixty heat-polymerized polymethyl methacrylate disks were fabricated and assigned to 4 groups (n=15): disks coated with a light-polymerized organoselenium-containing enamel surface sealant (DenteShield), disks impregnated with 0.5% organoselenium (0.5% selenium), disks impregnated with 1% organoselenium (1% selenium), and disks without organoselenium (control). C. albicans biofilm was grown on each disk which had been placed in a well of the microtiter plate containing 1-mL brain heart infusion broth inoculated with C. albicans. The plates were incubated aerobically at 37 °C for 48 hours. A confocal laser scanning microscope was used to determine the biofilm thickness, biomass, and live/dead cell ratio. Biofilm morphology was examined with scanning electron microscopy, whereas microbial viability was quantified by the spread plate method. The data were analyzed by using ANOVA and Tukey-Kramer multiple comparisons (α=.05). RESULTS The microbial viability, biofilm thickness, biofilm biomass, and live/dead cell ratio were lower (P<.001) on disks in the test groups (DenteShield, 0.5% selenium, 1% selenium) when compared with the control group, with these variables being lowest in the 0.5% selenium and 1% selenium groups. The 0.5% selenium and 1% selenium groups did not differ significantly from each other in any of the variables (P>.05). Scanning electron microscope images showed inhibition of both biofilm growth and yeast to hyphae transition in the DenteShield, 0.5% selenium, and 1% selenium groups, with visible disruption of the biofilm morphology. CONCLUSIONS The present study demonstrated that organoselenium, whether incorporated into or coated on the surface of an acrylic resin denture base material, has the potential to inhibit Candida albicans biofilm growth on denture surfaces and as such can be clinically useful for the prevention of denture stomatitis.

The Journal of the American Dental Association, 2021

BACKGROUND The authors aimed to evaluate the effect of a novel radiofrequency (RF) toothbrush on ... more BACKGROUND The authors aimed to evaluate the effect of a novel radiofrequency (RF) toothbrush on tooth stains and shades compared with a sonic vibrating toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. METHODS The authors conducted a single-blind prospective study over 6 weeks. Participants were randomized to 1 of 2 study groups to receive either an RF toothbrush (ToothWave, Home Skinovations [test]) or a sonic vibrating toothbrush (SmileSonic powered toothbrush, Ranir [control]) and performed twice-daily toothbrushing with fluoridated toothpaste (Crest Cavity Protection, Procter & Gamble) for 6 weeks. Tooth stains and shades were assessed using the Lobene Stain Index and VITA Bleachedguide 3D-MASTER shade guide (VITA North America) at baseline and after 4 and 6 weeks of toothbrushing. In addition, the VITA Easyshade Advance 4.0 spectrophotometer (VITA North America) was used for shade evaluation. Safety was evaluated by means of oral soft-tissue examinations at each visit. Percentage reduction from baseline was compared between the groups. Statistical analyses were conducted using Mann-Whitney nonparametric model. RESULTS Eighty-six participants (43 in each group) completed the study with fully evaluable data. At baseline, the groups did not differ significantly in mean measurement scores. Percentage reductions of the measured scores were significantly greater (more extrinsic stain removal and whitening) in the test group than in the control group (P < .001). Both toothbrushes were well-tolerated, and no device-related adverse events were reported during the study. CONCLUSIONS The RF toothbrush produced substantial benefits in the reduction of tooth stains and whitening of tooth shade compared with a powered toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. PRACTICAL IMPLICATIONS The novel RF toothbrush is a safe and effective tool for stain removal and tooth whitening and can serve as an alternative to other whitening agents. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT03885609.

Current Journal of Applied Science and Technology, 2021

Aim: The aim of this study was to evaluate the erosive potential of saliva on dental enamel sucki... more Aim: The aim of this study was to evaluate the erosive potential of saliva on dental enamel sucking the acidic candies, and their effects on the pH, titratable acidity (TA) and buffering capacity (β) of saliva. Methodology: Human enamel specimens (n = 216) were randomly in 17 acidic candy groups and one negative control (paraffin wax) group. Three human volunteers sucked each candy for 5 min while spitting into a covered and chilled vial. The pH, TA and β were measured immediately after the saliva collection. For erosive challenge, each specimen was immersed in saliva at room temperature for 120 min without agitation. The erosion was measured by surface microhardness (SMH) tester and with 3D non-contact optical profilometer for depth of surface loos (DSL). Percentage of SMH change (%SMHC) was calculated. ANOVA followed by Tukey test and Pearson correlation were performed (α=0.05). Results: All candies lowered saliva pH below 5.5, and produced significant DSL (P<0.05) and %SMHC (P...

Journal of Dentistry, 2021

OBJECTIVES The aim of this randomized, double-blind, two-arm crossover in situ study was to inves... more OBJECTIVES The aim of this randomized, double-blind, two-arm crossover in situ study was to investigate whether nano-hydroxyapatite (nanoHAP) dental lotion (Apagard Deep Care) applied immediately after tooth-brushing with nanoHAP toothpaste (Apagard M-plus) enhances the remineralization promotion and the demineralization inhibition efficacies of nanoHAP toothpastes. METHODS 64 sound enamel blocks and 64 blocks bearing artificially-produced initial caries were produced from human permanent molar teeth. During each treatment period, lasting 14 days per arm, two blocks, one sound and one lesion-bearing, were exposed to either 5% nanoHAP-containing or placebo dental lotion after tooth-brushing with 5% nanoHAP toothpaste, via an intra-oral appliance worn by 30 adults in each of the study groups. Baseline and post-test mineral loss were quantified using transverse microradiography (TMR). One-sided t-test of one group mean was used for intragroup comparison, while two-sided t-test of two independent means was used to compare the two dental lotions. RESULTS Pairwise comparison (baseline vs. post-test) indicated significant (p<.001) remineralization by nanoHAP toothpaste in both groups. However, when compared against each other, there was a significantly (p<.001) greater percentage of remineralization with nanoHAP lotion [58.4(±1.8)%] than with placebo lotion [37.7(±2.2)%]. TMR examination showed absolute demineralization inhibition in sound enamel blocks exposed to either lotions. CONCLUSIONS Toothpaste containing 5% nanoHAP effectively remineralized initial caries and inhibited demineralization of healthy enamel; however, the application of a dental lotion containing 5% nanoHAP after brushing resulted in superior remineralization compared to a placebo lotion. CLINICAL SIGNIFICANCE Dental lotion containing 5% nanohydroxyapatite used immediately after toothbrushing with 5% nanohydroxyapatite toothpaste can serve as an adjunct to enhance the clinical benefits of the toothpaste.

Scientific Reports, 2021

The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite ... more The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite is not inferior to a fluoride toothpaste in prevention of caries in children. This double-blinded randomized control trial compared two toothpastes regarding the occurrence of caries lesions using International Caries Detection and Assessment System (ICDAS) ≥ code 1 on the primary dentition within 336 days. The test group used a fluoride-free hydroxyapatite toothpaste three times daily while control group used a toothpaste with fluoride. 207 children were included in the intention-to-treat analysis; 177 of them finished the study per protocol. An increase in caries ICDAS ≥ code 1 per tooth was observed in 72.7% of the hydroxyapatite-group (n = 88), compared with 74.2% of the fluoride-group (n = 89). The exact one-sided upper 95% confidence limit for the difference in proportion of participants with ICDAS increase ≥ 1 (-1.4%) was 9.8%, which is below the non-inferiority margin of 20% demo...

Current Journal of Applied Science and Technology, 2021

Objective: Color stability of at-home bleaching and resin infiltration is one of the main goals o... more Objective: Color stability of at-home bleaching and resin infiltration is one of the main goals of these procedures. The primary aim of present study was to evaluate color stability of at-home bleaching and resin infiltration to four common colorants present in Indian foods (turmeric, beetroot, coffee and artificial food colorants). Materials and Methods: 128 human maxillary central incisors were used in this study. Teeth were randomly divided into groups as (i) subjected and (ii) not-subjected to microabrasion. Further, the teeth in each group (abraded/non-abraded) were randomly distributed to four subgroups (16 teeth/subgroup). Subgroups were control, bleached, combined treatment with at-home bleaching followed by resin infiltration and infiltrated. After treatment procedures the teeth were immersed in the four different food colorants. Objective photographic color change evaluation from pre-/ post staining was done using the CIEDE2000 formula. Statistical Analyses: Data were anal...

Journal of Conservative Dentistry, 2020

Objectives: The primary objective of this study was to investigate the effectiveness in reducing ... more Objectives: The primary objective of this study was to investigate the effectiveness in reducing dentin hypersensitivity in noncarious cervical lesions (NCCLs) by home-based desensitizing toothpaste (TP), in-office Gluma desensitizer application, and resin-modified glass-ionomer cement (RMGIC) restoration. The secondary objective was to evaluate the long-term outcome of the? glass-ionomer cement restoration following the application of bioactive glass-containing desensitizer TP. Materials and Methods: A total of 73 patients or 151 teeth were included in the study and randomly allotted to one of the four different treatment groups. Pre- and postoperative symptom and air-blast/tactile sensitivity scores were recorded for statistical analysis. Postoperative sensitivity was analyzed at 1, 4, and 12 weeks after treatment. Nonparametric statistical tests were employed. Results: Kruskal–Wallis test noted a significant reduction in postoperative sensitivity at all time periods with the RMGIC group compared to other treatment options. Significantly higher patient dropout was observed in desensitizing TP regimen. Conclusions: This interim 12-week report on dentin hypersensitivity management of NCCLs concludes that resin-modified glass-ionomer restoration was able to achieve a significant instant reduction in sensitivity and patient satisfaction compared to other noninvasive at-home and in-office procedures. Clinical relevance: This interim 12-week report on dentin hypersensitivity management of noncarious cervical lesions concludes that resin-modified glass-ionomer restoration was able to achieve a significant reduction in sensitivity, and patient satisfaction was higher compared to other noninvasive at-home and in-office procedures.

Nigerian Journal of Clinical Practice, 2020

Objective: The present study compared the ability of bleaching, resin infiltration and microabras... more Objective: The present study compared the ability of bleaching, resin infiltration and microabrasion to restore the appearance of existing white spot lesions (WSL) on tooth surfaces as close as possible to that of the original healthy enamel. Materials and Methods: Sixty extracted human teeth with WSL were randomly assigned to three treatment groups (20/group). Prior to treatment, the colour of the surrounding healthy enamel and the WSL were measured as the baseline and pre-treatment (PreRX) colours respectively using spectrophotometer based on CIE L*A*B. The L-value was used for the statistical comparison. WSLs in each group were treated respectively by bleaching, infiltration or microabrasion following the manufacturer's instructions. Colour measurement was repeated after treatment. Both intragroup and intergroup comparisons were performed using ANOVA followed by Tukey's multiple comparison test (α=0.05). Result: In all groups the mean L-values were significantly higher in PreRX WSL (P < 0.01; Tukey) compared to baseline (sound enamel). After treatment the difference in mean L-value between baseline and WSL increased significantly (P < 0.01, Tukey) in Bleaching and Microabrasion groups by 1.4% and 1% respectively, but decreased in Infiltration group by 3.4%. Thus resin infiltration decreased the L-value of the WSL, bringing it closer to the L-value of the sound enamel while bleaching and microabrasion increased the L-value. Conclusions: Among the three treatment modalities investigated in this study, resin infiltration was the most effective in masking the WSLs.

Journal of Dentistry Open Access, 2020

Objective: Esthetic management of stained fluorotic teeth mainly depends on clinical presentation... more Objective: Esthetic management of stained fluorotic teeth mainly depends on clinical presentation of the condition. Clinical presentation of fluorotic teeth is varied and clinician must be able to appreciate this and choose the appropriate treatment option. Clinical Considerations: Contemporary esthetic procedures allow these teeth to be restored to have appearance similar to normal healthy teeth in the most minimalistic invasive manner. This case report aims to highlight the three-treatment combination for esthetic correction of fluorotic teeth. Also, inform about the advantages, drawbacks of various treatment choices and apprise the clinician of the appropriate esthetic conservative management protocol for dental fluorosis with diverse clinical appearance. Conclusion: The combination of microabrasion, dentist supervised at-home bleaching and resin infiltration is the most minimalistic invasive treatment option for changing the appearance of stained fluorotic teeth to normal health...

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2019

The aim of this ex-vivo study was to measure the sensitivity, specificity, and receiver operating... more The aim of this ex-vivo study was to measure the sensitivity, specificity, and receiver operating characteristic (ROC) area under the curve (AUC) of a caries diagnostic system based on photothermal radiometry and modulated luminescence (PTR/LUM) and compare them to the values for digital intraoral radiography (IR) and cone beam computed tomography (CBCT) in detecting recurrent decay. Study design Class 2 composite restorations were prepared on 70 proximal surfaces: 35 with caries and 35 without caries. The gingival floor of the restored surfaces was assessed for caries under the restorations using each of the three modalities. Statistical calculations and analysis were performed using the R statistical computing environment. Results The average scores for sensitivity among the 6 observers were 0.89 for PTR/LUM, 0.38 for IR, and 0.40 for CBCT. Sensitivity for PTR/LUM was statistically greater than sensitivity for IR and CBCT. Average scores for specificity were 0.83, 0.80, and 0.70 for PTR/LUM, IR, and CBCT, respectively. There was no statistical difference in specificity. The AUC was 0.65 for IR and 0.59 for CBCT, which were statistically different. PTR/LUM showed moderate intra-observer agreement. Conclusion PTR/LUM, which involves non-ionizing radiation, can serve as a sensitive adjunct in early caries detection and monitoring. Dayo AF, Amaechi BT, Noujeim M, et al. Comparison of photothermal radiometry and modulated luminescence, intraoral radiography, and cone beam computed tomography for detection of natural caries under restorations. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2019.

European Journal of Dentistry, May 12, 2023

Objectives To investigate the effects of radiofrequency (RF) energy, applied through a power toot... more Objectives To investigate the effects of radiofrequency (RF) energy, applied through a power toothbrush, on the structural morphology of dental plaque and its bacteria components. Previous studies showed that a toothbrush powered by RF (ToothWave) effectively reduces extrinsic tooth stains, plaque, and calculus. However, the mechanism by which it reduces dental plaque deposits is not fully established. Materials and Methods Multispecies plaques at sampling time points of 24, 48, and 72 hours were treated with the application of RF using ToothWave with the toothbrush bristles 1 mm above the plaque surface. Groups that underwent the same protocol but without RF treatment served as paired controls. Confocal laser scanning microscope (CLSM) was used to determine cell viability at each time point. Plaque morphology and bacteria ultrastructure were viewed using scanning electron microscope (SEM) and transmission electron microscope (TEM), respectively. Statistical Analysis Data were analyzed statistically using analysis of variance (ANOVA) and Bonferroni post-tests. Results At each time, RF treatment significantly (p < 0.05) reduced the viable cells in plaque and caused a substantial disruption of plaque morphology, while the untreated plaque had intact morphology. Cells in treated plaques showed disrupted cell walls, cytoplasmic material, huge vacuoles, and heterogeneity in electron density, while these organelles remained intact in untreated plaques. Conclusion The application of RF via a power toothbrush can disrupt plaque morphology and kill bacteria. These effects were enhanced by the combined application of RF and toothpaste. Investigate the effects of bipolar radiofrequency (3 W, 3 MHz) applied via a power toothbrush on the structural morphology (chain formation) of periodontal disease-causing biofilm, ultrastructure (cell wall and cell components) of the bacteria, and the thickness of bacteria plaque biofilm.

Frontiers in Cellular and Infection Microbiology, Nov 24, 2022

Dentistry journal, Mar 13, 2023

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Journal of Dental Education

ObjectivesInteractive scenario‐based learning (SBL) cases were developed using the SoftChalk plat... more ObjectivesInteractive scenario‐based learning (SBL) cases were developed using the SoftChalk platform to deliver content about patients’ access to healthcare barriers and patient management strategies connecting oral to systemic health. The interactive cases were designed to engage the digital‐savvy learners, meet them where they are by leveling up, and seek their feedback to determine flipped (FC) or modified flipped classroom (MFC) content delivery approaches.MethodsHealth professions students completed interactive SBL cases (Phase‐I) and completed interactive SBL cases (Phase‐I) using either FC, assigning content outside of class time preparation, or MFC as allocated time at the beginning of the class deliveries, and a 12‐item post‐completion survey. The senior dental student cohort (Phase‐II) completed an anonymous Qualtrics survey that assessed their confidence leading to clinical competence 2 years after the interactive SBL case deliveries. The final survey (Phase‐III) of firs...

Biomimetics

Hydroxyapatite, Ca5(PO4)3(OH), is a biomimetic active ingredient, which is used in commercial ora... more Hydroxyapatite, Ca5(PO4)3(OH), is a biomimetic active ingredient, which is used in commercial oral care products such as toothpastes and mouthwashes worldwide. Clinical studies (in vivo) as well as in situ and in vitro studies have shown the preventive effects of hydroxyapatite in various field of oral care. In some products, hydroxyapatite is combined with other active ingredients, to achieve an additional antibacterial effect or to promote gum health. This review analyzes the efficacy of six selected natural and nature-inspired ingredients that are commonly used together with hydroxyapatite. These additional actives are either antibacterial (lactoferrin, xylitol, and zinc) or promote gum health (allantoin, bisabolol, and hyaluronic acid). A systematic literature search was performed, and all studies found on each ingredient were analyzed. In summary, all analyzed ingredients mentioned in this review are well described in scientific studies on their beneficial effect for oral healt...

BackgroundDental caries remains a global problem that causes disproportionate suffering in unders... more BackgroundDental caries remains a global problem that causes disproportionate suffering in underserved populations. Simple interventions are needed to improve patient experience, clinical and cost-effectiveness, and access to care. The self-assembling peptide P11-4 is a recently developed, non-invasive treatment that regenerates enamel in initial caries lesions.Studies reviewedWe conducted a systematic review and meta-analysis on the effectiveness of the P11-4 products Curodont™ Repair (CR) and Curodont™ Repair Fluoride Plus (CRFP) on initial caries lesions. Primary outcomes were lesion progression after 24 months, caries arrest, and cavitation. Secondary outcomes were changes in merged International Caries Detection and Assessment System (ICDAS) score, Quantitative Light Fluorescence, esthetic appearance, and lesion size.ResultsSix clinical trials comparing CR to controls met the inclusion criteria. Results of this review represent two primary and two secondary outcomes. When compa...

Frontiers in Dental Medicine

Children are prone to develop dental caries. This is supported by epidemiological data confirming... more Children are prone to develop dental caries. This is supported by epidemiological data confirming early childhood caries (ECC) as a highly prevalent disease affecting more than every second child worldwide. ECC is known to result from an imbalance between re- and demineralization where demineralization dominates due to frequent acid production by cariogenic bacteria present in oral biofilms. The application of oral care formulations containing remineralizing agents helps to prevent dental caries. As young children are sensitive and usually swallow (intended or unintended) a majority of toothpaste or other oral care products during daily dental care, all ingredients, especially the actives, should be non-toxic. Biomimetic hydroxyapatite [HAP; Ca5(PO4)3(OH)] is known to have favorable remineralizing properties combined with an excellent biocompatibility, i.e., it is safe if accidently swallowed. Several clinical trials as well as in situ and in vitro studies have shown that HAP remine...

The Journal of Prosthetic Dentistry, 2021

STATEMENT OF PROBLEM Denture stomatitis is a chronic inflammatory condition caused by the formati... more STATEMENT OF PROBLEM Denture stomatitis is a chronic inflammatory condition caused by the formation of Candida albicans biofilm on denture bases. It is associated with aggravating intraoral pain, itching, and burning sensations. It can also potentiate cardiovascular diseases and aspiration pneumonia. The problem has thus far eluded efficient, toxic-free, and cost-effective solutions. PURPOSE The purpose of this in vitro study was to investigate the effectiveness of organoselenium to inhibit the formation of C. albicans biofilm on the surface of acrylic resin denture base materials when it is either incorporated into the acrylic resin material or coated on the denture surface as a light-polymerized surface sealant. MATERIAL AND METHODS Sixty heat-polymerized polymethyl methacrylate disks were fabricated and assigned to 4 groups (n=15): disks coated with a light-polymerized organoselenium-containing enamel surface sealant (DenteShield), disks impregnated with 0.5% organoselenium (0.5% selenium), disks impregnated with 1% organoselenium (1% selenium), and disks without organoselenium (control). C. albicans biofilm was grown on each disk which had been placed in a well of the microtiter plate containing 1-mL brain heart infusion broth inoculated with C. albicans. The plates were incubated aerobically at 37 °C for 48 hours. A confocal laser scanning microscope was used to determine the biofilm thickness, biomass, and live/dead cell ratio. Biofilm morphology was examined with scanning electron microscopy, whereas microbial viability was quantified by the spread plate method. The data were analyzed by using ANOVA and Tukey-Kramer multiple comparisons (α=.05). RESULTS The microbial viability, biofilm thickness, biofilm biomass, and live/dead cell ratio were lower (P<.001) on disks in the test groups (DenteShield, 0.5% selenium, 1% selenium) when compared with the control group, with these variables being lowest in the 0.5% selenium and 1% selenium groups. The 0.5% selenium and 1% selenium groups did not differ significantly from each other in any of the variables (P>.05). Scanning electron microscope images showed inhibition of both biofilm growth and yeast to hyphae transition in the DenteShield, 0.5% selenium, and 1% selenium groups, with visible disruption of the biofilm morphology. CONCLUSIONS The present study demonstrated that organoselenium, whether incorporated into or coated on the surface of an acrylic resin denture base material, has the potential to inhibit Candida albicans biofilm growth on denture surfaces and as such can be clinically useful for the prevention of denture stomatitis.

The Journal of the American Dental Association, 2021

BACKGROUND The authors aimed to evaluate the effect of a novel radiofrequency (RF) toothbrush on ... more BACKGROUND The authors aimed to evaluate the effect of a novel radiofrequency (RF) toothbrush on tooth stains and shades compared with a sonic vibrating toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. METHODS The authors conducted a single-blind prospective study over 6 weeks. Participants were randomized to 1 of 2 study groups to receive either an RF toothbrush (ToothWave, Home Skinovations [test]) or a sonic vibrating toothbrush (SmileSonic powered toothbrush, Ranir [control]) and performed twice-daily toothbrushing with fluoridated toothpaste (Crest Cavity Protection, Procter & Gamble) for 6 weeks. Tooth stains and shades were assessed using the Lobene Stain Index and VITA Bleachedguide 3D-MASTER shade guide (VITA North America) at baseline and after 4 and 6 weeks of toothbrushing. In addition, the VITA Easyshade Advance 4.0 spectrophotometer (VITA North America) was used for shade evaluation. Safety was evaluated by means of oral soft-tissue examinations at each visit. Percentage reduction from baseline was compared between the groups. Statistical analyses were conducted using Mann-Whitney nonparametric model. RESULTS Eighty-six participants (43 in each group) completed the study with fully evaluable data. At baseline, the groups did not differ significantly in mean measurement scores. Percentage reductions of the measured scores were significantly greater (more extrinsic stain removal and whitening) in the test group than in the control group (P < .001). Both toothbrushes were well-tolerated, and no device-related adverse events were reported during the study. CONCLUSIONS The RF toothbrush produced substantial benefits in the reduction of tooth stains and whitening of tooth shade compared with a powered toothbrush (CVS Health SmileSonic Pro Advanced Clean Sonic Toothbrush, Ranir) that earned the American Dental Association Seal of Acceptance. PRACTICAL IMPLICATIONS The novel RF toothbrush is a safe and effective tool for stain removal and tooth whitening and can serve as an alternative to other whitening agents. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT03885609.

Current Journal of Applied Science and Technology, 2021

Aim: The aim of this study was to evaluate the erosive potential of saliva on dental enamel sucki... more Aim: The aim of this study was to evaluate the erosive potential of saliva on dental enamel sucking the acidic candies, and their effects on the pH, titratable acidity (TA) and buffering capacity (β) of saliva. Methodology: Human enamel specimens (n = 216) were randomly in 17 acidic candy groups and one negative control (paraffin wax) group. Three human volunteers sucked each candy for 5 min while spitting into a covered and chilled vial. The pH, TA and β were measured immediately after the saliva collection. For erosive challenge, each specimen was immersed in saliva at room temperature for 120 min without agitation. The erosion was measured by surface microhardness (SMH) tester and with 3D non-contact optical profilometer for depth of surface loos (DSL). Percentage of SMH change (%SMHC) was calculated. ANOVA followed by Tukey test and Pearson correlation were performed (α=0.05). Results: All candies lowered saliva pH below 5.5, and produced significant DSL (P<0.05) and %SMHC (P...

Journal of Dentistry, 2021

OBJECTIVES The aim of this randomized, double-blind, two-arm crossover in situ study was to inves... more OBJECTIVES The aim of this randomized, double-blind, two-arm crossover in situ study was to investigate whether nano-hydroxyapatite (nanoHAP) dental lotion (Apagard Deep Care) applied immediately after tooth-brushing with nanoHAP toothpaste (Apagard M-plus) enhances the remineralization promotion and the demineralization inhibition efficacies of nanoHAP toothpastes. METHODS 64 sound enamel blocks and 64 blocks bearing artificially-produced initial caries were produced from human permanent molar teeth. During each treatment period, lasting 14 days per arm, two blocks, one sound and one lesion-bearing, were exposed to either 5% nanoHAP-containing or placebo dental lotion after tooth-brushing with 5% nanoHAP toothpaste, via an intra-oral appliance worn by 30 adults in each of the study groups. Baseline and post-test mineral loss were quantified using transverse microradiography (TMR). One-sided t-test of one group mean was used for intragroup comparison, while two-sided t-test of two independent means was used to compare the two dental lotions. RESULTS Pairwise comparison (baseline vs. post-test) indicated significant (p<.001) remineralization by nanoHAP toothpaste in both groups. However, when compared against each other, there was a significantly (p<.001) greater percentage of remineralization with nanoHAP lotion [58.4(±1.8)%] than with placebo lotion [37.7(±2.2)%]. TMR examination showed absolute demineralization inhibition in sound enamel blocks exposed to either lotions. CONCLUSIONS Toothpaste containing 5% nanoHAP effectively remineralized initial caries and inhibited demineralization of healthy enamel; however, the application of a dental lotion containing 5% nanoHAP after brushing resulted in superior remineralization compared to a placebo lotion. CLINICAL SIGNIFICANCE Dental lotion containing 5% nanohydroxyapatite used immediately after toothbrushing with 5% nanohydroxyapatite toothpaste can serve as an adjunct to enhance the clinical benefits of the toothpaste.

Scientific Reports, 2021

The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite ... more The aim of this trial was to determine whether a toothpaste with microcrystalline hydroxyapatite is not inferior to a fluoride toothpaste in prevention of caries in children. This double-blinded randomized control trial compared two toothpastes regarding the occurrence of caries lesions using International Caries Detection and Assessment System (ICDAS) ≥ code 1 on the primary dentition within 336 days. The test group used a fluoride-free hydroxyapatite toothpaste three times daily while control group used a toothpaste with fluoride. 207 children were included in the intention-to-treat analysis; 177 of them finished the study per protocol. An increase in caries ICDAS ≥ code 1 per tooth was observed in 72.7% of the hydroxyapatite-group (n = 88), compared with 74.2% of the fluoride-group (n = 89). The exact one-sided upper 95% confidence limit for the difference in proportion of participants with ICDAS increase ≥ 1 (-1.4%) was 9.8%, which is below the non-inferiority margin of 20% demo...

Current Journal of Applied Science and Technology, 2021

Objective: Color stability of at-home bleaching and resin infiltration is one of the main goals o... more Objective: Color stability of at-home bleaching and resin infiltration is one of the main goals of these procedures. The primary aim of present study was to evaluate color stability of at-home bleaching and resin infiltration to four common colorants present in Indian foods (turmeric, beetroot, coffee and artificial food colorants). Materials and Methods: 128 human maxillary central incisors were used in this study. Teeth were randomly divided into groups as (i) subjected and (ii) not-subjected to microabrasion. Further, the teeth in each group (abraded/non-abraded) were randomly distributed to four subgroups (16 teeth/subgroup). Subgroups were control, bleached, combined treatment with at-home bleaching followed by resin infiltration and infiltrated. After treatment procedures the teeth were immersed in the four different food colorants. Objective photographic color change evaluation from pre-/ post staining was done using the CIEDE2000 formula. Statistical Analyses: Data were anal...

Journal of Conservative Dentistry, 2020

Objectives: The primary objective of this study was to investigate the effectiveness in reducing ... more Objectives: The primary objective of this study was to investigate the effectiveness in reducing dentin hypersensitivity in noncarious cervical lesions (NCCLs) by home-based desensitizing toothpaste (TP), in-office Gluma desensitizer application, and resin-modified glass-ionomer cement (RMGIC) restoration. The secondary objective was to evaluate the long-term outcome of the? glass-ionomer cement restoration following the application of bioactive glass-containing desensitizer TP. Materials and Methods: A total of 73 patients or 151 teeth were included in the study and randomly allotted to one of the four different treatment groups. Pre- and postoperative symptom and air-blast/tactile sensitivity scores were recorded for statistical analysis. Postoperative sensitivity was analyzed at 1, 4, and 12 weeks after treatment. Nonparametric statistical tests were employed. Results: Kruskal–Wallis test noted a significant reduction in postoperative sensitivity at all time periods with the RMGIC group compared to other treatment options. Significantly higher patient dropout was observed in desensitizing TP regimen. Conclusions: This interim 12-week report on dentin hypersensitivity management of NCCLs concludes that resin-modified glass-ionomer restoration was able to achieve a significant instant reduction in sensitivity and patient satisfaction compared to other noninvasive at-home and in-office procedures. Clinical relevance: This interim 12-week report on dentin hypersensitivity management of noncarious cervical lesions concludes that resin-modified glass-ionomer restoration was able to achieve a significant reduction in sensitivity, and patient satisfaction was higher compared to other noninvasive at-home and in-office procedures.

Nigerian Journal of Clinical Practice, 2020

Objective: The present study compared the ability of bleaching, resin infiltration and microabras... more Objective: The present study compared the ability of bleaching, resin infiltration and microabrasion to restore the appearance of existing white spot lesions (WSL) on tooth surfaces as close as possible to that of the original healthy enamel. Materials and Methods: Sixty extracted human teeth with WSL were randomly assigned to three treatment groups (20/group). Prior to treatment, the colour of the surrounding healthy enamel and the WSL were measured as the baseline and pre-treatment (PreRX) colours respectively using spectrophotometer based on CIE L*A*B. The L-value was used for the statistical comparison. WSLs in each group were treated respectively by bleaching, infiltration or microabrasion following the manufacturer's instructions. Colour measurement was repeated after treatment. Both intragroup and intergroup comparisons were performed using ANOVA followed by Tukey's multiple comparison test (α=0.05). Result: In all groups the mean L-values were significantly higher in PreRX WSL (P < 0.01; Tukey) compared to baseline (sound enamel). After treatment the difference in mean L-value between baseline and WSL increased significantly (P < 0.01, Tukey) in Bleaching and Microabrasion groups by 1.4% and 1% respectively, but decreased in Infiltration group by 3.4%. Thus resin infiltration decreased the L-value of the WSL, bringing it closer to the L-value of the sound enamel while bleaching and microabrasion increased the L-value. Conclusions: Among the three treatment modalities investigated in this study, resin infiltration was the most effective in masking the WSLs.

Journal of Dentistry Open Access, 2020

Objective: Esthetic management of stained fluorotic teeth mainly depends on clinical presentation... more Objective: Esthetic management of stained fluorotic teeth mainly depends on clinical presentation of the condition. Clinical presentation of fluorotic teeth is varied and clinician must be able to appreciate this and choose the appropriate treatment option. Clinical Considerations: Contemporary esthetic procedures allow these teeth to be restored to have appearance similar to normal healthy teeth in the most minimalistic invasive manner. This case report aims to highlight the three-treatment combination for esthetic correction of fluorotic teeth. Also, inform about the advantages, drawbacks of various treatment choices and apprise the clinician of the appropriate esthetic conservative management protocol for dental fluorosis with diverse clinical appearance. Conclusion: The combination of microabrasion, dentist supervised at-home bleaching and resin infiltration is the most minimalistic invasive treatment option for changing the appearance of stained fluorotic teeth to normal health...

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2019

The aim of this ex-vivo study was to measure the sensitivity, specificity, and receiver operating... more The aim of this ex-vivo study was to measure the sensitivity, specificity, and receiver operating characteristic (ROC) area under the curve (AUC) of a caries diagnostic system based on photothermal radiometry and modulated luminescence (PTR/LUM) and compare them to the values for digital intraoral radiography (IR) and cone beam computed tomography (CBCT) in detecting recurrent decay. Study design Class 2 composite restorations were prepared on 70 proximal surfaces: 35 with caries and 35 without caries. The gingival floor of the restored surfaces was assessed for caries under the restorations using each of the three modalities. Statistical calculations and analysis were performed using the R statistical computing environment. Results The average scores for sensitivity among the 6 observers were 0.89 for PTR/LUM, 0.38 for IR, and 0.40 for CBCT. Sensitivity for PTR/LUM was statistically greater than sensitivity for IR and CBCT. Average scores for specificity were 0.83, 0.80, and 0.70 for PTR/LUM, IR, and CBCT, respectively. There was no statistical difference in specificity. The AUC was 0.65 for IR and 0.59 for CBCT, which were statistically different. PTR/LUM showed moderate intra-observer agreement. Conclusion PTR/LUM, which involves non-ionizing radiation, can serve as a sensitive adjunct in early caries detection and monitoring. Dayo AF, Amaechi BT, Noujeim M, et al. Comparison of photothermal radiometry and modulated luminescence, intraoral radiography, and cone beam computed tomography for detection of natural caries under restorations. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2019.