PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Root Caries”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

The effect of stannous and sodium fluoride on coronal caries, root caries and bone loss in rice rats.

Sixty rice rats (Oryzomys palustris) were divided by littermate into 3 groups of 20 each. The 3 groups received either SnF2 (1000 parts/10(6) F), NaF (1000 parts/10(6] or double-distilled water (control). Test solutions were topically applied to molar teeth, twice daily, for 7 days. All rats were also provided with double-distilled drinking water and diet 2000 ad libitum. Experiments ended after 9 weeks. Alveolar bone loss, root and coronal caries were recorded and scored. SnF2 significantly reduced bone loss (p less than 0.05), but NaF did not. Root caries was significantly different in all 3 groups (p less than 0.05). SnF2 and NaF both reduced coronal caries significantly (p less than 0.05) in comparison to the control. However, the fluoride groups were not significantly different from each other. SnF2 may influence root caries via remineralization and an antimicrobial effect of the stannous ion.

Animals↗

Systematic review of the effectiveness and cost-effectiveness of HealOzone for the treatment of occlusal pit/fissure caries and root caries.

OBJECTIVES: To assess the effectiveness and cost-effectiveness of HealOzone (CurOzone USA Inc., Ontario, Canada) for the management of pit and fissure caries, and root caries. The complete HealOzone procedure involves the direct application of ozone gas to the caries lesion on the tooth surface, the use of a remineralising solution immediately after application of ozone and the supply of a 'patient kit', which consists of toothpaste, oral rinse and oral spray all containing fluoride. DATA SOURCES: Electronic databases up to May 2004 (except Conference Papers Index, which were searched up to May 2002). REVIEW METHODS: A systematic review of the effectiveness of HealOzone for the management of tooth decay was carried out. A systematic review of existing economic evaluations of ozone for dental caries was also planned but no suitable studies were identified. The economic evaluation included in the industry submission was critically appraised and summarised. A Markov model was constructed to explore possible cost-effectiveness aspects of HealOzone in addition to current management of dental caries. RESULTS: Five full-text reports and five studies published as abstracts met the inclusion criteria. The five full-text reports consisted of two randomised controlled trials (RCTs) assessing the use of HealOzone for the management of primary root caries and two doctoral theses of three unpublished randomised trials assessing the use of HealOzone for the management of occlusal caries. Of the abstracts, four assessed the effects of HealOzone for the management of occlusal caries and one the effects of HealOzone for the management of root caries. Overall, the quality of the studies was modest, with many important methodological aspects not reported (e.g. concealment of allocation, blinding procedures, compliance of patients with home treatment). In particular, there were some concerns about the choice of statistical analyses. In most of the full-text studies analyses were undertaken at lesion level, ignoring the clustering of lesions within patients. The nature of the methodological concerns was sufficient to raise doubts about the validity of the included studies' findings. A quantitative synthesis of results was deemed inappropriate. On the whole, there is not enough evidence from published RCTs on which to judge the effectiveness of ozone for the management of both occlusal and root caries. The perspective adopted for the study was that of the NHS and Personal Social Services. The analysis, carried out over a 5-year period, indicated that treatment using current management plus HealOzone cost more than current management alone for non-cavitated pit and fissure caries (40.49 pounds versus 24.78 pounds), but cost less for non-cavitated root caries ( 14.63 pounds versus 21.45 pounds). Given the limitations of the calculations these figures should be regarded as illustrative, not definitive. It was not possible to measure health benefits in terms of quality-adjusted life-years, due to uncertainties around the evidence of clinical effectiveness, and to the fact that the adverse events avoided are transient (e.g. pain from injection of local anaesthetic, fear of the drill). One-way sensitivity analysis was applied to the model. However, owing to the limitations of the economic analysis, this should be regarded as merely speculative. For non-cavitated pit and fissure caries, the HealOzone option was always more expensive than current management when the probability of cure using the HealOzone option was 70% or lower. For non-cavitated root caries the costs of the HealOzone comparator were lower than those of current management only when cure rates from HealOzone were at least 80%. The costs of current management were higher than those of the HealOzone option when the cure rate for current management was 40% or lower. One-way sensitivity analysis was also performed using similar NHS Statement of Dental Remuneration codes to those that are used in the industry submission. This did not alter the results for non-cavitated pit fissure caries as the discounted net present value of current management remained lower than that of the HealOzone comparator ( 22.65 pounds versus 33.39 pounds). CONCLUSIONS: Any treatment that preserves teeth and avoids fillings is welcome. However, the current evidence base for HealOzone is insufficient to conclude that it is a cost-effective addition to the management and treatment of occlusal and root caries. To make a decision on whether HealOzone is a cost-effective alternative to current preventive methods for the management of dental caries, further research into its clinical effectiveness is required. Independent RCTs of the effectiveness and cost-effectiveness of HealOzone for the management of occlusal caries and root caries need to be properly conducted with adequate design, outcome measures and methods for statistical analyses.

Adolescent↗

Root caries and root defects in urban and rural adults: the Florida Dental Care Study.

As part of the Florida Dental Care Study--a longitudinal study of risk factors for changes in dental health--the authors examined and interviewed 873 adults aged 45 years and older. During the examination, clinicians noted the number of teeth present and the participant's dental condition, including presence of root caries and fillings or noncarious defects on the roots. The interview was conducted to collect demographic and other information such as the adults' perceptions about dental care and their perceptions about their own dental health. The authors found that men, African-Americans, adults living in rural areas and those living in poverty were significantly more likely to have root caries than other participants. The data reported in this article will serve as baseline information for subsequent research.

Aged↗

Assessing root caries in populations: the evolution of the root caries index.

This paper traces the history of the epidemiologic assessment of root caries over the past 30 years. This history clearly points out that a critical junction has been reached between the state-of-the art for the reporting of root caries and the demand placed on research and service components of the oral health system. If progress is to be made, it is imperative that a uniform reporting method for root caries be adopted. This paper introduces the Root Caries Index (RCI) as an index that should prove to be a feasible and utilitarian method for reporting root caries data in descriptive and analytic epidemiologic studies as well as assessing the results of preventive and treatment agents, clinical trials. The Root Caries Index represents, in the evolution of a root caries measurement method, a refinement of the delineation of the true intraoral "population at risk" to the disease process. The resulting index is a true attack rate for supragingival root caries lesions. This development should permit more meaningful comparison of populations, clearer interpretations regarding risk factors, and more precise assessment of preventive and treatment agents.

Adolescent↗

Micromorphological and micronanalytical characterization of stagnating and progressing root caries lesions.

Root caries is the predominant disease of the tooth tissues in the elderly population and differs in progression and micromorphology from coronal dentin caries. Therefore, different clinical concepts are needed for the treatment of these progressing and arrested lesions. It was the aim of this study to investigate the three-dimensional structure and volume of stagnating and progressing root caries lesions and to determine the mineral composition of the different lesion zones to achieve a better understanding of the natural history of root caries lesion formation. Of 21 extracted human teeth of patients between 42 and 77 years of age with stagnating and progressing root caries lesions serial sections were cut and investigated with polarized light and scanning electron microscopy. From the polarized light micrographs 3D reconstructions were made to determine the volumes of the lesion zones and their relations expressed in a demineralization index (DI). With increasing size of the demineralizing zone the DI increased indicating an increase in the size of the translucent zone. The 3D reconstructions showed distinct differences between stagnating and progressing root caries lesions. In the hypermineralized translucent dentin not all dentin tubules were obliterated by intratubular dentin and within the translucent dentin scattered dead tracts were found. Electron dispersive X-ray (EDX) analysis showed that the intertubular dentin of the translucent dentin was also demineralized to a certain extent. The results indicate distinct morphological differences between progressing and stagnating root caries lesions which may have consequences for treatment strategies.

Adult↗

Human root caries: microbiota of a limited number of root caries lesions.

The microbiota of root caries lesions of different grades of severity were studied. Fourteen lesions were examined. The experimental design of the study allowed correlation of histopathologically distinguishable stages with specific and distinct microbial populations. Dentin samples were ground in a sterile mortar and cultured anaerobically on nonselective Columbia blood agar plates supplemented with 5% hemolyzed human blood and on media selective for Lactobacillus spp. and streptococci. The cultivable microbiota were quantitatively speciated using Rapid ID 32A, Rapid ID 32 Strep, API 20 Strep, APIZYM, and API50 CH tests and SDS-PAG electrophoresis. In initial as well as in advanced lesions gram-positive bacteria accounted for approximately 90% of the CFUt. The proportion of Actinomyces, and in particular A. naeslundii was significantly higher (p < 0.05) in initial lesions than in advanced lesions. In contrast, the percentage of Streptococcus and especially S. mutans was higher (p < 0.05) in advanced than in initial lesions. Surprisingly low (0.8% of the CFUt) was the percentage of lactobacilli in advanced lesions. Gram-negative bacteria formed a minor part of the microbiota in both initial and advanced lesions. Among the gram-negative isolates, Prevotella, Selenomonas, and Bacteroides spp. were most noticeable. In advanced lesions, only the outermost layer of 0.5 mm thickness was populated by a high number of bacteria; the following segments harbored a negligible number of bacteria only. It is concluded that root caries is a continuous destruction process which is restricted to a subsurface zone of limited depth. The necrotic dentin is successively worn away, leading to a saucer-shaped cavitation which is repopulated by plaque. The creation of cavitations favors an aciduric flora. This might explain the succession of bacterial populations observed during the destruction process.

Actinomyces↗

Ultrastructural study on human root caries.

Superficial root caries lesions of incisors and premolars of 24 patients aged 52-60 years were studied by scanning electron microscopy and transmission electron microscopy. In the predominantly gram-positive bacteria of the root dental plaque, a great number of corncob configurations were observed. Bacterial infiltration into cementum occurred without any gradient of demineralization and mainly followed the borders between calcified cementum bundles as well as incremental lines. The narrow channels which were filled initially by a single row of gram-positive bacteria broadened progressively with simultaneous destruction of the apatite minerals and the collagenous matrix. Root dentin invasion showed great similarities to coronal dentin with an important gradient of demineralization. In the deep layers, sclerosed tubules contained sometimes rhombohedral crystals. In more superficial layers, bacterial invasion occurred initially in still partially sclerosed tubules. Tubular lumens as well as lateral side branches which had lost their peritubular dentin were filled with gram-positive microorganisms. An important diffuse destruction of the apatite minerals was observed at this stage in the intertubular dentin which still presented typical cross-banded collagen fibrils. The confluence of enlarged dentinal tubules filled by numerous microorganisms led to large bacterial zones with complete destruction of root dentin.

Bacteria↗

Relationship between root caries and coronal decay.

The relationship between caries on root surfaces and untreated coronal lesions was analyzed. A representative sample of 5028 persons was examined, their mean ages being 47.3 years for men and 47.7 for women. Poor dental health on root surfaces was associated with poor dental health in the coronal areas of the teeth. Subjects with root caries had fewer teeth and fewer fillings, more retained roots and more teeth with untreated coronal decay than did people with no root caries. Compared with the subjects without untreated coronal decay, those with from one to three decayed coronal surfaces showed an odds ratio of 4.5 of having caries on root surfaces. This ratio was 10.1 for the subjects who had more than three decayed coronal surfaces. It was concluded that factors related to the occurrence of decay are of a similar type whether caries is situated on root surfaces or in the coronal areas of the teeth, and therefore the prevention of caries in both sites may be accomplished by similar means.

Adult↗

[Dental caries in the elderly. 2. Root caries. Symptoms and treatment guidelines].

Guidelines for treatment of root surface caries in the elderly are presented. Caries susceptibility of these surfaces may be reduced by the absorbtion of fluoride and other minerals from the oral fluids. Early signs of root caries are a matte appearance and a softening of the root surface. Discoloration and cavity formation appear later. Insufficient filling margins on the root and the cemento-enamel junction are typical sites for root caries development. Early diagnosis through thorough clinical examination is important, since preventive treatment of primary root caries lesions has a better long term prognosis than restorative treatment. Glass-ionomers are a natural choice for the restoration of root caries lesions. Fluorides are efficient for root caries prevention in the elderly dental patient. An annual caries increment exceeding 2 lesions is considered indicative of a reinforced prophylactic program; when exceeding 5 lesions, the patient should be examined after a few months, to ascertain stop in caries progression.

Aged↗

Root caries.

Increasing interest in root caries has resulted in several reports during the year. Problems with diagnosis, epidemiology, structural histopathology, and treatments have clarified some problems concerning root caries. Only active lesions should be registered, but it is important to search for lesions in the periodontal pocket. In several countries, root caries have been found in 30% to 50% of elderly people. In structural investigations, remineralization may occur as irregular precipitation of crystals clearly distinguishable from those of normal sound dentin. Presence of plaque with gram-positive bacteria is closely associated with root caries. Treatment with varnish containing chlorhexidine and thymol may have a reducing effect. Little has been written about the operative treatment of root caries.

Dental Caries↗

The predominant aciduric microflora of root-caries lesions.

The etiology of root caries is not fully understood, and although mutans streptococci, lactobacilli, and A. naeslundii have been implicated in its initiation and progression, this study was designed to determine the potential role of other microbial species and the nature of predominant aciduric microflora in the root caries process. We isolated the predominant aciduric microflora from root-caries lesions (n = 14) and sound root surfaces in subjects with (n = 13) or without (n = 10) root caries, using both a "most probable numbers" method and conventional plating methods. The predominant aciduric bacteria from root lesions were lactobacilli and A. israelii, while from sound root surfaces in subjects with root caries, A. gerencseriae comprised over 60% of aciduric isolates. Mutans streptococci were not among the aciduric isolates. Subjects without root caries harbored fewer bacteria, and S. anginosus (pH 4.8) and S. oralis (pH 5.2) were the predominant aciduric bacteria. The microbial etiology of root caries is more complex than was previously appreciated, and factors underlying the microbial succession occurring during the disease process are not known. Taxa with previously unrecognized aciduric characteristics have been isolated routinely, and the role of these organisms in the root caries process requires further investigation.

Actinomyces↗

Root caries among Benghazi patients.

A total of 420 Benghazi patients were clinically examined for root caries. Root caries was not limited to older patients and the proportion of root caries among young adults was similar to that of the older age groups. Most of the lesions were located proximally and underneath restorations rather than labially or lingually. Our results may serve as baseline data for further studies on root caries in the Libyan Arab Jamahiriya.

Adolescent↗

Root caries in older people attending a general dental practice in East Sussex.

With increasing numbers of older people retaining their natural dentitions, dentists are becoming increasingly aware of the problem of dental caries occurring on exposed root surfaces--root caries. This study reports the prevalence of root caries in a selected older population, living in the community and attending a general dental practice in Bexhill, East Sussex. A total of 146 non-institutionalised people, aged at least 55 years with at least 12 teeth, were examined. Most of the subjects (88.4%) had evidence of root caries, males and denture wearers having more lesions than females and non-denture wearers, respectively. Active coronal caries was present in only 11.6% of the subjects, whereas active (soft or leathery) root caries lesions were present in 31.5% of the subjects. The teeth and surfaces most commonly affected by root caries were found to be similar to those seen in previous epidemiological surveys. The majority of active root caries lesions were within 1 mm of the gingival margin, while inactive lesions tended to be greater than or equal to 1 mm from the gingival margin. Colour of root caries lesions was not diagnostic of caries activity. A more detailed method of recording root caries lesions is also described.

Aged↗

Oral hygiene and root caries occurrence in Slovenian adults.

This study investigated root caries related findings made in connection with basic clinical dental routines. A total of 410 adults, mean age 42.8 years, seeking dental care in two Slovenian communities, rural Ravne and urban Ljubljana, during a three-month period, were clinically examined for root caries. Primary root caries was defined as a softened yellowish-brown lesion gently penetrable by an explorer and situated principally on a root surface. Past root caries was defined as fillings at a similar location. A subject's oral hygiene was judged clinically as good, fair or poor, based on presence of dental plaque and subgingival calculus. Subjects' background variables included age, gender, and number of teeth. Subjects had on average 23.1 teeth, from which 0.8 teeth had primary root caries and 0.4 had fillings on root surfaces. Primary root caries occurred in 42 per cent of subjects, in 38 per cent of men and 45 per cent of women (P = 0.21), but fillings on root surfaces in only 19 per cent of the subjects, 11 per cent of men and 25 per cent of women (P = 0.001). The strongest factors explaining the presence of root caries, with control for other factors, were poor oral hygiene (odds ratio 3.1), smaller number of teeth (odds ratio 2.3 to 2.7), and older age (odds ratio 2.1). In conclusion, in everyday clinical dental practice, more emphasis should be placed on patients' proper oral hygiene and their encouragement and motivation to achieve it.

Adult↗

Salivary findings, daily medication and root caries in the old elderly.

Root caries is one of the main dental problems among the dentate old elderly. The aim of our study was to evaluate the occurrence of root caries in 196 dentate elderly (mean age 79.3) in relation to their salivary flow rate, buffering capacity and salivary microbial counts. These subjects participated in the oral health component of the Helsinki Aging Study in 1990-1991. Clinical oral examinations included assessment of the state of root surfaces and salivary flow rates, both paraffin-wax-stimulated and unstimulated. Salivary buffering capacity and the growth of salivary mutans streptococci, lactobacilli and yeasts were determined by means of commercially available kits. Root caries occurred in 52% of men and in 35% of women (p < 0.05). Number of decayed (DRS) and decayed or filled (DFRS) root surfaces correlated (r = 0.16 to 0.26) with salivary microbial counts. No correlation appeared between DRS and subjects' salivary flow rates. Basic estimates on the association between DRS and salivary findings showed that microbial counts only produced significant odds ratios, from 2.0 to 3.5. However, in a log-linear model high salivary mutans streptococci and yeast counts together with male gender were associated with greater occurrence of root caries.

Aged↗

Root caries and some related factors in 88-year-old carriers and non-carriers of Streptococcus sobrinus in saliva.

The prevalence of caries on exposed root surfaces in 88-year-old subjects with and without salivary levels of Streptococcus sobrinus was studied. Ninety-two individuals were examined with regard to root caries lesions and fillings. The root caries index (RCI) was calculated and related to salivary flow rate and buffer capacity, plaque score and salivary counts of Streptococcus mutans, S. sobrinus and lactobacilli. In 89 subjects with exposed root surfaces, all but 2 harbored mutans streptococci; 51 subjects carried S. mutans only, 35 both S. sobrinus and S. mutans, and 1 S. sobrinus only. The RCI was significantly higher in persons with than those without S. sobrinus (p < 0.05). Subjects with both S. sobrinus and S. mutans had higher counts of total mutans streptococci and lactobacilli than subjects with only S. mutans (p < 0.05). The RCI was significantly correlated to S. sobrinus and S. mutans (p < 0.05). The positive correlation between the RCI and S. sobrinus was still significant when the other tested variables were kept constant, whereas the correlation between the RCI and S. mutans was weaker when S. sobrinus and lactobacilli were kept constant. The D-component of the RCI (DSr%) was significantly correlated to S. sobrinus, S. mutans and lactobacilli, whereas the F-component of the RCI showed no significant correlation to any of the tested variables. A stepwise multiple correlation showed that the variance of DSr% was best explained in the S. sobrinus carriers by S. sobrinus and the salivary buffer effect, and in the non-carriers by S. mutans.

Aged↗

Impact of treatment provision on the epidemiological recording of root caries.

The estimation of root caries prevalence and the identification of risk factors for decay depend upon the successful identification of carious lesions in epidemiological studies. Root surface restorations can either be placed to manage decay or cervical wear/sensitivity. The handling of data for restorations during epidemiological surveys is critical to the accurate assessment of caries prevalence. The objective of this study was to determine the relative frequency of dentists' placing root surface restorations according to their reason for placement. Data for 696 restorations were recorded from 35 dentists. Forty-five % of restorations were placed because of decay compared with 55% for cervical wear/sensitivity. There were no significant differences in proportion of placement of restoration with age of the patient or between regular and irregular attenders of different ages. Using these data a correction factor was developed for inclusion in the Root Caries Index (RCI) to make allowance for the proportion of restorations placed because of wear/sensitivity. When this correction factor was introduced into an existing data-set for root caries, the RCI was reduced for all groups. This reduction was greatest in regular attenders. When these data were analysed without making allowance for treatment effects, there was a significant difference in RCI between regular and irregular attenders. When the correction factor was applied to these data, this difference was eliminated.

Adult↗

Root caries: prevention and chemotherapy.

PURPOSE: Root caries is a problem of importance among dentate elderly. Greater life expectancies at both birth and age 65, combined with improvements in tooth retention across all age groups, have resulted in an increasing number of Americans who have retained their teeth into old age. This increase in numbers of teeth combined with the increase in the percent of teeth with recession has in turn resulted in older persons with more root surfaces at risk for caries than ever before. The purpose of this article is to review the literature on the prevention and chemotherapeutic approach to root caries. METHODS: A review of the literature and synthesis of this information resulted in recommendations for the improved root caries risk assessment and the development of clinical examination protocols and strategies for prevention and treatment. RESULTS: Clinicians can better identify persons at risk for root caries in their practice. People who are older, have moderate to severe periodontal bone loss and gingival recession, are impaired, have poor oral hygiene, take multiple medications, have partials, have retained root tips and the recently unemployed or retired are all at increased risk for root caries. Examination strategies should include the use of at least annual bite-wing radiographs (vertical bite-wings in persons with significant attachment loss) and careful examination of the proximal tooth surfaces. Once identified as low, moderate or high risk, daily and professionally applied fluoride therapies should be combined with dietary modifications, and in high risk individuals, antimicrobial agents for both the remineralization of early lesions and prevention of further root caries.

Adult↗