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Biomedical subjects

Margherita Fontana

Publications and source records attributed to Margherita Fontana.

6 recordsLinked to original sources
PubMed2006

Assessing patients' caries risk.

BACKGROUND: Caries management historically has focused on the removal of cavitated carious tissue and restoration of the tooth. OVERVIEW: Assessing a patient's risk of developing caries is a vital component of caries management. A comprehensive caries assessment should consider factors such as past and current caries experience, diet, fluoride exposure, presence of cariogenic bacteria, salivary status, general medical history, behavioral and physical factors, and medical and demographic characteristics that may affect caries development. A caries risk assessment also should consider factors that may challenge the patient's ability to maintain good oral hygiene (for example, crowded dentition, deep fissures, wide open restorative margins or placement of oral appliances). CONCLUSIONS: and Practical Implications. The authors review the importance of caries risk assessment as a prerequisite for appropriate preventive and treatment intervention decisions and provide some practical information on how general practitioners can incorporate caries risk assessment into the management of caries.

Cariostatic Agents↗
PubMedDate not supplied

Fluoride varnish concentration gradient and its effect on enamel demineralization.

PURPOSE: Two of the 4 fluoride varnishes available on the American market today are sold in 10-mL tubes of 5% NaF varnish (Duraphat and Duraflor). Pilot studies have shown that a separation of contents within these tubes exists. The purpose of the current study was 4-fold: (1) to measure the fluoride concentration gradient in 10-mL tubes of fluoride varnish, based on resting position of the tube prior to use; (2) to compare and contrast fluoride concentration gradients of Duraphat, Duraflor, and CavityShield; (3) to compare this gradient to the ability to inhibit caries in an artificial caries environment; and finally, (4) to determine if quantitative light fluorescence (QLF) can detect differences in lesions developed when exposed to an artificial caries environment and fluoride varnish. METHODS: Human teeth specimens were subjected to a caries challenge and treated with a sample of fluoride varnish from 1 of 5 categories: Duraphat stored horizontally and vertically for 1 week, Duraflor stored horizontally and vertically for 1 week, or a CavityShield 0.4 mL "unidose." All specimens were then analyzed with the QLF system and with confocal microscopy. RESULTS: Results showed no significant fluoride ppm differences exist between groups (P=.29). It was shown that the order in which Duraflor varnish was dispensed from tubes significantly affected the fluoride concentration (P<.05). The order effect was not significant for Duraphat (P=.99). QLF data analysis showed there was no significant difference (P>.05) in the amount of remineralization obtained by using any varnish stored in any position. CONCLUSIONS: These results indicate that all 3 brands of fluoride varnish are able to remineralize incipient in vitro carious lesions, regardless of what part of the 10-mL tube the varnish is taken from. However, a fluoride concentration gradient exists in tubes of Duraflor. Also, QLF is able to detect demineralized and remineralized incipient lesions.

Analysis of Variance↗
PubMedDate not supplied

Early detection of secondary caries using quantitative, light-induced fluorescence.

The authors hypothesize that the arrestment and remineralization of these lesions could be improved if secondary caries could be detected and monitored at earlier stages. Traditional diagnostic techniques detect secondary caries when it is relatively advanced and when significant tissue has been lost. This in vitro study evaluated the Quantitative Light-induced Fluorescence (QLF) system for detecting and monitoring demineralization surrounding tooth-colored restorations. This investigation was divided into three studies. The first study evaluated QLF for the detection and measurement of chemically induced lesions surrounding resin composite restorations. The second study evaluated QLF for the detection of demineralization around different tooth-colored restorations (glass ionomer, resin composite, compomer and smart material) created in a microbial caries model. Finally, the third study tested whether QLF was effective at detecting early wall lesions adjacent to resin composite restorations. Data from Study 1 demonstrated the potential for QLF to detect very early secondary caries and to distinguish between the different stages of early demineralization. Study 2 confirmed the potential for QLF to detect early secondary caries created by cariogenic bacteria and concluded that the four types of materials differed in their ability to prevent secondary caries in this model, with the glass ionomer being the most effective and the non-fluoride releasing composite performing the worst, which allowed for the development of larger lesions. The results of Study 3 suggest a potential application of the QLF system to detect early wall lesions. Data from this investigation strongly suggest that QLF is a potentially viable technology to detect and monitor early secondary caries.

Analysis of Variance↗
PubMedDate not supplied

Fluoride releasing materials: their anti-cariogenic properties tested in in vitro caries models.

The anti-cariogenic properties of three fluoride-releasing materials on root surfaces were evaluated using two different caries models. Standardized cavities were prepared in dentin specimens and restored with either glass-ionomer, resin-modified glass-ionomer, polyacid-modified resin composite or resin composite material. Two groups of 56 specimens were demineralized using a microbial caries model for three days, while another 56 specimens were demineralized using a chemical demineralization model for three days. Lesions around the restorations were measured with a confocal laser scanning microscope. Glass ionomers demonstrated significant anti-cariogenic properties when exposed to the chemical model. However, no significant anti-cariogenic properties were observed with the microbial caries model. In conclusion, the fluoride releasing materials showed different anti-cariogenic properties in root surfaces under the different caries models, suggesting that caution should be exercised when trying to extrapolate the results of in vitro studies to the clinical situation.

Cariostatic Agents↗
PubMedDate not supplied

A screening test for unstimulated salivary flow measurement.

It is well established that saliva is an important factor for the health of both soft and hard tissues in the oral cavity. This study determined: 1) the correlation between unstimulated salivary flow assessed using the Modified Schirmer tear strip Test (MST), with gravimetric and volumetric measurements and 2) the MST value that would allow the most reliable identification of patients with severe (<0.1 ml/minute) and moderate (<0.2 ml/minute) hyposalivation. A retrospective clinical study was conducted using data from 90 patients seen at the Indiana University School of Dentistry. All patients had a sample of unstimulated whole saliva collected by drooling for five minutes for volumetric/gravimetric assessment, followed by placement of the Schirmer strip in the floor of the mouth for three minutes (MST). Results showed a non-linear association between the MST and volumetric/gravimetric methods, with moderate Spearman correlation coefficients (0.67-0.71). Analysis of ROC-curves suggests that a cutoff screening value of 25 mm/three minutes provides high sensitivity (77%) and positive predictive value (71%) without significantly affecting specificity (80%). In conclusion, this study supports use of the MST test as a screening tool for hyposalivation.

Adolescent↗