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- Al Mulla, Anas H, et al.
(författare)
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On Caries Risk Profiles Using Cariogram and Caries Prevention with Fluoridated Toothpaste in Orthodontic Patients
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective. The aims of this thesis were to: 1) analyse caries-related factors shortly after orthodontic treatment, 2) demonstrate the usefulness of the Cariogram by presenting orthodontic patients with different caries-risk profiles, 3) compare two different toothpastes with different post brushing techniques using an in situ caries model with orthodontic bands, and 4) test the hypothesis that toothpaste slurry rinsing, combined with some other simple post-brushing advice (in this thesis called the “modified F toothpaste technique, MFTT“), would reduce the number of decayed and filled tooth surfaces (DFS) in a 2-year randomised clinical trial in orthodontic patients. Materials and Methods. In Study I, a total of 100 patients were divided into two groups (50 in each), based on their pre-bonding DFS. A high- (DFS ≥ 5) and a low- (DFS ≤ 2) caries group were created. In Study II, three cases were selected to present the three caries risk groups, i.e. high, medium and low. In Study III, 20 orthodontic patients were randomised into two groups: 1) a test group using 5,000 ppm F with no post-brushing water rinsing and 2) a control group using 1,450 ppm F with 3 times post-brushing water rinsing. On the upper first premolars, orthodontic stainless steel bands were applied, leaving 2-3 mm of space away from the exposed buccal surface in order to accumulate plaque and create an area for initial caries development. The teeth were extracted after 8 and 9 weeks and were then analysed using Quantitative Light-induced Fluorescence (QLF). Moreover, the oral F retention was studied using the two brushing techniques. The Study IV population consisted of 100 orthodontic patients randomly divided into two groups. Each patient was examined before the beginning of orthodontic treatment (baseline) and shortly after de- bonding (follow-up) within a 2-year study period. The test group patients were instructed to use the MFTT, in which various behavioural factors were standardised in order to improve the caries preventive effect of F toothpaste. The control group patients were given the routine clinic oral hygiene instructions. Results. In Study I, the low-caries group displayed lower DFS (p < 0.001), lactobacilli (p < 0.001) and mutans streptococci (p < 0.001) and higher Cariogram values (p < 0.001). Study II showed that the Cariogram was a useful tool for distinguishing between low, medium and high caries risk patients. In Study III, in comparison to the control group, the test group regimen resulted in a non- significant smaller QLF lesion area and lower average QLF loss of fluorescence (p < 0.05). The highest F concentration under the band was found in the test group (p < 0.001). In Study IV, the clinical (p < 0.001), radiographic (p < 0.001) and clinical + radiographic (p < 0.001) ΔDFS (incidences) were significantly reduced in the test group in comparison to the controls, with prevented fractions of 87%, 78% and 83% respectively. Conclusions. 1) Patients with high DFS before orthodontic treatment ran a higher risk of developing caries. They had significantly higher numbers of mutans streptococci and lactobacilli and had less chance of avoiding new cavities according to the Cariogram. 2) The Cariogram may be a useful pedagogic model for illustrating a patient’s caries risk in the orthodontic clinic. 3) The combination of using a 5,000 ppm F toothpaste and no post-brushing water rinsing had better anti-caries potential and resulted in elevated oral F retention, compared with a 1,450 ppm F toothpaste with 3 times post-brushing water rinsing. 4) Compared with routine oral hygiene instructions including F toothpaste, the use of the MFTT significantly reduces the incidence of new caries lesions in orthodontic patients.
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| 2. |
- Stensson, Malin, 1970, et al.
(författare)
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On Oral Health in Young People with Asthma
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Objective. The aim of this thesis was to investigate the oral health of young individuals with and without asthma. Material. In Study I, a group of 3- (n=66) and 6-year-old children (n=61) with asthma and two healthy control groups (n=62 and n=55 respectively) participated. In Study II, 3-year-old children with asthma (n=64) and a healthy control group (n=50) were followed from 3 to 6 years of age. In Study III, adolescents with severe and long-term asthma (n=20) and a healthy control group (n=20) were included. In Study IV, young adults with long-term asthma (n=20) and a healthy control group (n=20) participated. Methods. A clinical examination was performed and the prevalence of caries, gingival inflammation, plaque and the numbers of mutans streptococci and lactobacilli in saliva were determined. In Study II, the caries increment between 3 and 6 years of age was investigated. A radiographic examination was conducted in all the studies, apart from in the 3-year-old children. The participants or their parents were interviewed regarding various oral health-related factors. To assess the caries risk, a computer program, the “Cariogram”, was used. In Studies III and IV, the salivary secretion rate and plaque pH, after a sucrose rinse for up to 40 min at two approximal sites, were measured. In Study IV, gingival crevicular fluid, periodontal pockets and the plaque formation rate were determined. Results. In Study I, the mean ± SD dfs in the 3-year-olds with asthma was 1.4±3.2 compared with 0.5±1.2 in the control group (p<0.05). The corresponding figures for the 6-year-olds were 2.5±3.9 and 1.8±2.8 (NS). The 3-year-old children with asthma had more gingival bleeding than the healthy controls (p<0.05). Children with asthma reported a higher consumption of sugar-containing drinks and were more frequently mouth breathers than the control groups (p<0.05). Children with asthma and an immigrant background had a higher mean dfs than children with an immigrant background in the control group. In the follow-up study (Study II), the increment of initial caries was higher for children with asthma compared with the control group (p<0.05). At both 3 and 6 years of age, asthmatic children were more frequently mouth breathers than their controls (only statistically significant in the 6-year-olds). In Study III, the mean ± SD DFS was 4.9±5.5 in adolescents with asthma compared with 1.4±2.3 in the control group (p<0.01). The Cariogram data in the control group showed that 75% had a “chance of avoiding caries” compared with 54% in the asthma group (p<0.01). A lower initial and final pH in plaque was found in the asthma groups (only statistically significant in Study III). More gingival inflammation (p<0.05), more frequent mouth breathing (NS) and a lower salivary secretion rate were found in the adolescents and young adults with asthma compared with the control groups (p<0.05). The mean ± SD DFS was 8.6±10.6 in the young adult asthma group compared with 4.0±5.2 in the controls (NS). Conclusions. The results of this thesis indicate that young individuals with asthma have a higher caries prevalence, more gingival inflammation and are more frequently mouth breathers compared with healthy individuals of the same age. In younger children with asthma, a higher intake of sugary drinks was more common and, in the older age group (adolescents and young adults), a lower salivary secretion rate and plaque pH were found in the asthma groups compared with the control groups.
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