Publications

UNLABELLED: The Decayed, Missing and Filled Teeth (DMFT) index is widely used for detecting carious lesions, primarily focusing on established cavities, while the International Caries Detection and Assessment System (ICDA-S-II) is designed to identify incipient lesions.

AIM: The aim of this cross-sectional study was to assess the diagnostic effectiveness of the DMFT index compared to the ICDA-S-II criteria designed for early-stage carious lesion diagnosis in schoolchildren from Belém (Brazil).

MATERIALS AND METHOD: A cohort of 107 twelve-year-old schoolchildren from Belém (Brazil) underwent dental examinations by three calibrated examiners using the DMFT and ICDA-S-II indices. The ICDA-SII assessment involved prophylaxis, relative isolation, and a standardized drying period. Statistical analyses included ANOVA, chi-squared and G tests.

RESULTS: No statistically significant differences were observed among examiners for either the DMFT (p = 0.699) or the ICDA-S-II (p = 1.000) indices. Gender did not influence results (DMFT: p = 0.697; ICDA-S-II: p = 0.310). Caries-free prevalence differed significantly, at 32% according to DMFT and 2.8% according to ICDA-S-II (p<0.001).

CONCLUSIONS: The DMFT index consistently underestimated carious lesions, whereas the ICDA-SII index enhanced the identification of incipient potentially reversible lesions. DMFT and ICDAS-II indices have demonstrated their efficacy in cavity detection, with the most significant distinction arising in ICDAS-II in the identification of early-stage carious lesions.

UNLABELLED: An inflammatory radicular cyst (IRC) is an odontogenic cyst associated to a non-vital tooth, which may affect sound teeth. There is lack of consensus on whether to perform endodontic treatment on teeth involved in the extension of the lesion prior to surgical treatment.

AIM: To identify and quantify the therapies most often used on teeth with positive response to pulp tests that are involved in the extension of an IRC, and analyze the criteria upon which different authors based their decisions. Identify and evaluate the reliability of the dental pulp tests used for evaluation and deciding on treatment.

MATERIALS AND METHOD: A review was performed of articles indexed in four databases from 2011 to 2023. The review included studies describing diagnosis and treatment of teeth involved in the extension of an inflammatory cyst.

RESULTS: Fifteen articles were included in the review: nine case reports, five literature reviews and one comment to the editor. The case reports address 10 cystic lesions, directly associated with a total 21 sound teeth. Three of them report loss of tooth sensitivity, three report preemptive endodontic treatment of teeth with preserved sensitivity, two report recovery of previously lost sensitivity, and one reports preservation of sensitivity after surgical treatment. One of the literature reviews addresses the issue of treating teeth adjacent to a cystic lesion, while the other four, and the comment to the editor, discuss the methods for detecting sensitivity and vitality.

CONCLUSION: Clinical studies with long-term follow-up are needed in order to reach a consensus regarding treatment. Better understanding of pulp status is essential in order to select the treatment best suited to each clinical case.

UNLABELLED: The success of endodontic treatment depends on the effective disinfection of the root canal system.The literature describes many treatment protocols.

AIM: The purpose of this prospective in vivo study was to evaluate the healing status observed after endodontic treatment performed with foraminal cleaning in mandibular molars with apical periodontitis.

MATERIALS AND METHOD: Fifty mandibular molars were selected and instrumented with ProDesign Logic files. First, mechanized patency was performed with a 25/0.01 instrument; if it was easily achieved, a larger diameter instrument was chosen (30/0.01, 35/0.01, or 40/0.01) that best matched the apical foramen. Then, a respective shaping file corresponding to the patency file was selected for instrumentation. Irrigation was carried out with saline solution and 2% chlorhexidine gel. A 17% EDTA solution was used for the final irrigation and agitated with the EasyClean system. A device was used to standardize the initial, final, and subsequent digital radiographic examinations for the follow-up. A 3-level scoring system was used for evaluation, in which score 1 indicated complete lesion healing, score 2 incomplete healing, and score 3 no healing.

RESULTS: There was no significant difference between the frequencies of scores 1 and 2 assigned at the two assessment time points (p > 0.05). Complete healing (score 1) was observed in 58%, incomplete healing (score 2) in 42%, and no healing (score 3) in 0% of cases.

CONCLUSION: The endodontic preparation protocol followed by foraminal cleaning favored the healing process in teeth with apical periodontitis.

UNLABELLED: Oropharyngeal candidiasis (OC) is common among people living with HIV (PLWH). Persistent colonization of oral epithelial surfaces serves as an ecological niche for opportunistic pathogens and is a significant predisposing factor for OC development in PLWH. Mucosal colonization can lead to biofilm formation, directly impacting oral epithelium.

AIM: To assess Candida albicans and Candida dubliniensis colonization in subgingival biofilms of people living with HIV (PLWH) and undergoing antiretroviral therapy (ART).

MATERIALS AND METHOD: A sample of 51 PLWH who were receiving ART was studied, focusing on dental and periodontal parameters. Subgingival biofilm and mucosa samples were collected, and Candida spp. were identified using molecular techniques.

RESULTS: Men (average age: 41.11 ± 8.63) predominated. The main cause of HIV was sexual transmission. Fungal-related opportunistic diseases were observed in 18 patients, and LT CD4 counts were evaluated. A total 255 samples were collected, including 204 from gingivoperiodontal sites and 51 from oral mucosa. Candida spp. was detected in 55% of patients, with particular distribution patterns. Positive Candida spp. presence correlated with clinical attachment level and HIV treatments. Microscopic identification revealed the presence of hyphae at the time of microbiological sample collection. Molecular identification confirmed 16 Candida albicans and 36 Candida dubliniensis isolates, challenging their diagnostic importance.

CONCLUSIONS: The presence of yeast hyphae/pseudohyphae in subgingival biofilms indicates their role in gingivo-periodontal disease dysbiosis. PLWH in this Argentine region face challenges including limited access to healthcare. The study underscores the need for early oral health intervention, emphasizing the diagnostic significance of Candida.