Faculty Bibliography

OBJECTIVE: The aim of the present study was to determine if a sugarless mint containing CaviStat (an arginine bicarbonate calcium carbonate complex) is capable of preventing the development of dental caries in the primary molars and first permanent molars of 10 1/2- to 11-year-old Venezuelan children. METHODS: Two-hundred children were entered into this one-year study who showed the following: (i) age between 10 1/2 and 11 years; (ii) first and second primary molars still present; (iii) sound primary molars or early caries lesions in any of these teeth; and (iv) at least some caries in the primary or permanent teeth as evidence of caries activity. Out of the 200 children initially selected, 195 finished and provided complete data. Children entered into the study were examined and then randomly divided into two groups (A and B), with distribution performed on the basis of the DMFS levels of the first permanent molars. All subjects were examined visually by a single examiner using good artificial light, mirror, and probe. Group A received a sugarless confection containing CaviStat (BasicMints); Group B received a sugarless mint control that contained all ingredients except for the CaviStat. Packaging and appearance of both types of mints were identical, except for their A and B designations. RESULTS: Mean differences in DMFS, defs, and DMFS + defs scores between Groups A and B were determined. In the first permanent molars and some early erupting premolars and second molars, the data showed 75.6% fewer caries in Group A than in Group B children after six months, and 50.7% fewer after 12 months. Corresponding defs scores showed reduced development of dental caries in deciduous molars of 76.7% after six months and 131.3% after 12 months. Combined DMFS and defs scores showed 76.2 and 74.8% fewer caries lesions at six and 12 months, respectively. As exfoliation of primary molars occurred during the study period (approximately equal in the two groups), a proportion correction was made to allow for caries score reductions due to lesions lost because of such exfoliation. When this was done, the results at the end of the study still showed larger caries reductions in Group A than in the Group B subjects, and statistical analyses showed these differences were still highly significant (p < 0.001). Noncavitated caries lesions in the first permanent molars were also determined. These showed once again less caries development in Group A than in Group B subjects, and did so at both six and twelve months (57.0 and 52.4%, respectively). Levels of statistical significance at these times were p = 0.013 and 0.005. CONCLUSION: It was evident from this clinical trial that mint confections containing CaviStat are able to inhibit both caries onset and caries progression. As a result, one can conclude that CaviStat mint confection technology is a simple and economical means for reducing substantially one of the most prevalent diseases in these children

ACT This consensus statement supports implementation of caries management by risk assessment in clinical practice by using the following principles: modification of the oral flora, patient education, remineralization, and minimal operative intervention. The statement includes a list of supporters

The aim of this article is to present a practical caries risk assessment procedure and form for patients who are age 6 through adult. The content of the form and the procedures have been validated by outcomes research after several years of experience using the factors and indicators that are included

AIM: Determine the efficacy of 2-year continuous subantimicrobial dose doxycycline (SDD; 20 mg bid) on alveolar bone in post-menopausal osteopenic, oestrogen-deficient women undergoing periodontal maintenance in a 2-year double-blind, placebo-controlled, randomized clinical trial. MATERIAL AND METHODS: One-hundred and twenty-eight subjects randomized to SDD or placebo (n=64 each). Posterior vertical bite wings taken at baseline, 1 and 2 years for alveolar bone density (ABD), using radiographic absorptiometry (RA) and computer-assisted densitometric image analysis (CADIA), and alveolar bone height (ABH). Statistical analyses utilized generalized estimating equations; primary analyses were intent to treat (ITT). Results are presented as SDD versus placebo. RESULTS: Under ITT, there was no statistically significant effect of SDD on ABD loss (RA: p=0.8; CADIA: p=0.2) or ABH loss (p=0.2). Most sites (81-95%) were inactive. For subgroup analyses, mean CADIA was higher with SDD for non-smokers (p=0.05) and baseline probing depths > or =5 mm (p=0.003). SDD was associated with 29% lower odds of more progressive ABH loss in women >5 years post-menopausal (p=0.05) and 36% lower among protocol-adherent subjects (p=0.03). CONCLUSIONS: In post-menopausal osteopenic women with periodontitis, SDD did not differ overall from placebo. Based on exploratory subgroup analyses, additional research is needed to determine the usefulness of SDD in non-smokers, subjects >5 years post-menopausal and in deeper pockets. Protocol registered at (ClinicalTrials.gov). Identifier: NCT00066027

AIMS: To determine the clinical efficacy of a 2-year continuous sub-antimicrobial dose doxycycline (SDD; 20 mg bid) in post-menopausal, osteopenic, oestrogen-deficient women on periodontal maintenance. MATERIALS AND METHODS: One-hundred and twenty-eight subjects were randomized to SDD (n=64) or placebo (n=64). Clinical measurements were performed at posterior interproximal sites at baseline and every 6 months during this 2-year randomized, double-blind, placebo-controlled clinical trial with adjunctive, no-cost 3-4-month periodontal maintenance. Statistical analyses of secondary outcomes from this clinical trial used Generalized Estimating Equations in primarily intent-to-treat analyses. RESULTS: For the placebo group, 3.4% of the sites showed improvement in clinical attachment levels (CAL) and 2.7% had progressive loss in CAL; for the SDD group, 5.0% of the sites showed an improvement in CAL and 2.2% had progressive loss in CAL. This difference (2.1% of sites) was more favourable in the SDD group than in the placebo [odds ratio (OR)=0.81 [corrected] 95% confidence interval (CI): 0.67-0.97, p=0.03] in these well-maintained patients, whereas probing depths, bleeding on probing and supragingival plaque did not differ significantly between groups (p>0.2). However, in exploratory subgroup analysis of non-smokers, SDD showed reduced bleeding versus placebo (27%versus 33%; p=0.05). In protocol-adherent subjects, the odds of bleeding were 34% lower for SDD (p=0.05). CONCLUSIONS: Analyses of secondary outcomes of this clinical trial indicated that SDD may be of benefit in reducing progressive attachment loss in post-menopausal females; additional research is needed to confirm these findings. Protocol registered at (ClinicalTrials.gov). Identifier:NCT00066027