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Muller-Bolla M.,University of Nice Sophia Antipolis | Muller-Bolla M.,CNRS Biometrics Innovations and Interfaces | Lupi-Pegurier L.,University of Nice Sophia Antipolis | Bardakjian H.,McGill University | And 2 more authors.
Community Dentistry and Oral Epidemiology

Objectives A split-mouth randomized clinical trial was carried out to assess the effectiveness of a school-based dental sealant (SBDS) program for French children from low-income backgrounds. The secondary objectives were to determine the effectiveness of the program according to the baseline individual caries risk (ICR) and to assess the sealant retention. Methods The study included 276 pupils from Nice. The sealing was performed in the first or second grades. The permanent first molars were randomized into two groups: one received resin-based sealant and the other no treatment. Active caries on permanent and temporary teeth, visible plaque, Streptococcus mutans (SM) and Lactobacillus counts were recorded at baseline to assess ICR. An intent-to-treat analysis was performed based on the occurrence of new caries at 1 year of follow-up (study outcome). Univariate and multivariable conditional tooth-matched logistic regression analyses (Proc phreg; SAS) were used to assess the effectiveness of the SBDS program. Results At 1 year of follow-up, 253 children (421 pairs) remained in the analysis. In the adjusted analysis, first permanent molars that received sealants were less at risk of developing new caries at 1 year of follow-up compared with those from the control group (OR = 0.26, 95% CI: 0.14-0.49). Independently of the treatment, SM count, and all other covariates, only the variable 'active caries at baseline' remained related to new caries on first molars at 1 year (OR = 3.11, 95% CI: 1.27-7.62). The effect of the sealants was significant only when the analyses included subjects with active caries (OR = 0.25; 95% CI: 0.12-0.50) or with a high SM count (>10 5, OR = 0.20; 95% CI: 0.10-0.41) at baseline. At the 1-year follow-up, total retention was recorded in 52.7% (n = 222) of the treated teeth. Conclusion The 1-year effectiveness of the SBDS program was demonstrated in low socio-economic areas. Selection of schoolchildren according to individual caries risk factors should be considered in a SBDS program. © 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Source

Behin P.,Lille 2 University of Health and Law | Stoclet G.,CNRS Materials and Transformations Unit of UMET | Ruse N.D.,University of British Columbia | Sadoun M.,CNRS Biometrics Innovations and Interfaces
Dental Materials

Objectives The aim of this study was to compare the viscoelastic properties of high pressure (HP) polymerized urethane dimethacrylate (UDMA) with those of control, ambient pressure thermo-polymerized and photo-polymerized, UDMA and to assess the effect of varying polymerization parameters (protocol, temperature, and initiator) on the viscoelastic properties of HP polymerized UDMA. Methods The viscoelastic properties of the two control polymers, polymerized under atmospheric pressure, and four experimental polymers, polymerized under HP, were determined via dynamic mechanical analysis (DMA), in three point bending configuration. Atomic force microscopy (AFM) was used to characterize fractured polymer surface morphologies. Results The results showed that: HP-polymerization lead to a polymer with significantly higher Tg and E′rub, indicative of a higher crosslink density; modifying the polymerization protocol resulted in a significant increase in tan δ; increasing the polymerization temperature lead to a significant decrease in E′rub and Tg; and that the polymer with no initiator had the lowest E′, E″, Tg, and E′rub and the highest tan δ, suggesting that under this conditions a polymer with significantly reduced crosslink density had been obtained. A characteristic nodular appearance was seen for the two control polymers under AFM, while a modified surface morphology was present in the case of HP polymerized materials. Significance The DMA results suggest that polymerization under HP resulted in polymers with an increased crosslink density and that the higher polymerization temperature or the lack of initiator was detrimental to the viscoelastic properties determined. Changes in polymer network morphology were identified by AFM characterization. © 2014 Academy of Dental Materials. Source

Smail-Faugeron V.,French Institute of Health and Medical Research | Smail-Faugeron V.,CNRS Biometrics Innovations and Interfaces | Fron-Chabouis H.,CNRS Biometrics Innovations and Interfaces | Courson F.,Assistance Publique Hopitaux de Paris | Courson F.,CNRS Biometrics Innovations and Interfaces
BMC Oral Health

Background: To ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implications about the usefulness of paediatric oral health interventions in practice. Methods: We conducted a methodological survey including all paediatric dentistry reviews from the COHG. We extracted data on characteristics of included reviews, then assessed the methodological quality using a validated 11-item quality assessment tool (AMSTAR). Finally, we coded each review to indicate whether its authors concluded that an intervention should be implemented in practice, was not supported or was refuted by the evidence, or should be used only in research (inconclusive evidence).Results: We selected 37 reviews; most concerned the prevention of caries. The methodological quality was high, except for the assessment of reporting bias. In 7 reviews (19%), the research showed that benefits outweighed harms; in 1, the experimental intervention was found ineffective; and in 29 (78%), evidence was insufficient to assess benefits and harms. In the 7 reviews, topical fluoride treatments (with toothpaste, gel or varnish) were found effective for permanent and deciduous teeth in children and adolescents, and sealants for occlusal tooth surfaces of permanent molars. Conclusions: Cochrane reviews of paediatric dentistry were of high quality. They provided strong evidence that topical fluoride treatments and sealants are effective for children and adolescents and thus should be implemented in practice. However, a substantial number of reviews yielded inconclusive evidence. © 2014 Smaïl-Faugeron et al.; licensee BioMed Central Ltd. Source

Smail-Faugeron V.,French Institute of Health and Medical Research | Smail-Faugeron V.,CNRS Biometrics Innovations and Interfaces | Fron-Chabouis H.,CNRS Biometrics Innovations and Interfaces | Courson F.,Assistance Publique Hopitaux de Paris | And 3 more authors.
BMC Medical Research Methodology

Background: Split-mouth randomized controlled trials (RCTs) are popular in oral health research. Meta-analyses frequently include trials of both split-mouth and parallel-arm designs to derive combined intervention effects. However, carry-over effects may induce bias in split- mouth RCTs. We aimed to assess whether intervention effect estimates differ between split- mouth and parallel-arm RCTs investigating the same questions. Methods. We performed a meta-epidemiological study. We systematically reviewed meta- analyses including both split-mouth and parallel-arm RCTs with binary or continuous outcomes published up to February 2013. Two independent authors selected studies and extracted data. We used a two-step approach to quantify the differences between split-mouth and parallel-arm RCTs: for each meta-analysis. First, we derived ratios of odds ratios (ROR) for dichotomous data and differences in standardized mean differences (SMD) for continuous data; second, we pooled RORs or SMDs across meta-analyses by random-effects meta-analysis models. Results: We selected 18 systematic reviews, for 15 meta-analyses with binary outcomes (28 split-mouth and 28 parallel-arm RCTs) and 19 meta-analyses with continuous outcomes (28 split-mouth and 28 parallel-arm RCTs). Effect estimates did not differ between split-mouth and parallel-arm RCTs (mean ROR, 0.96, 95% confidence interval 0.52-1.80; mean SMD, 0.08, -0.14-0.30). Conclusions: Our study did not provide sufficient evidence for a difference in intervention effect estimates derived from split-mouth and parallel-arm RCTs. Authors should consider including split-mouth RCTs in their meta-analyses with suitable and appropriate analysis. © 2014 Smaïl-Faugeron et al.; licensee BioMed Central Ltd. Source

Joseph C.,University Claude Bernard Lyon 1 | Velly A.M.,University of Minnesota | Velly A.M.,McGill University | Pierre A.,University of Nice Sophia Antipolis | And 2 more authors.
European Archives of Paediatric Dentistry

Aim: To describe the dental health status of 6-year-old children using the ICDAS-II advanced method and to evaluate the association between the known caries risk factors with the cavitated caries lesion (WHO basic method) or with both non-cavitated and cavitated caries lesion caries (ICDAS II). Methods: In this cross-sectional study, a questionnaire was used to evaluate oral health and dietary habits of children. A clinical examination and a Cario analysis test (Pierre Fabre Oral care) were performed. STATISTICS: Logistic regression analyses were used to assess the association between caries and daily tooth-brushing, dietary habits, visible plaque and salivary factors. Results: There were 341 children (52% female and 6.25±0.46 years of age) in this study. Using the ICDAS-II advanced method, 39% of the children were caries-free. This proportion was larger (67.2%) using the WHO method. In multivariate models, visible dental plaque and Streptococcus mutans count were associated with caries experience registered as ICDAS-II codes 1-6 or codes 3-6. The absence of daily tooth-brushing with fluoridated toothpaste was associated only with caries experience ICDAS-II codes 3-6. Conclusion: The use of WHO or ICDAS-II method changed the proportion of caries-free children but not the clinical caries risk factors associated with caries experience. Source

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