Background: Early childhood caries (ECC) is the most common chronic disease in young children and a public health problem worldwide. It is characterized by the presence of atypical and fast progressive caries lesions. The aggressive form of ECC, severe early childhood caries (S-ECC), can lead to destruction of the whole crown of most of the deciduous teeth and cause pain and sepsis, affecting the child's quality of life. Although the multifactorial etiology of ECC is known, including social, environmental, behavioral, and genetic determinants, there is a consensus that this disease is driven by an imbalance between the oral microbiome and host, or dysbiosis, mediated by high sugar consumption and poor oral hygiene. Knowledge of the microbiome in healthy and caries status is crucial for risk monitoring, prevention, and development of therapies to revert dysbiosis and restore oral health. Molecular biology tools including next-generation sequencing methods and proteomic approaches have led to the discovery of new species and microbial biomarkers that could reveal potential risk profiles for the development of ECC and new targets for anti-caries therapies. This narrative review summarized some general aspects of ECC, such as definition, epidemiology, and etiology, the influence of oral microbiota in the development and progression of ECC based on the current evidence from genomics, transcriptomic, proteomic, and metabolomic studies and the effect of antimicrobial intervention on oral microbiota associated with ECC. Conclusion: The evaluation of genetic and proteomic markers represents a promising approach to predict the risk of ECC before its clinical manifestation and from there to plan efficient therapeutic interventions for ECC in its initial stages, avoiding irreversible dental cavitation.

Odontoblasts are cells specialized in dentin matrix deposition and the first line of defense when the dentin–pulp complex is injured by pathological processes, such as dental caries and trauma. Natural compounds, such as flavonoids, could be useful to stimulate odontoblast activity and reparative dentinogenesis in vital pulp therapies, especially in immature permanent teeth. This study evaluated the effect of flavonoids on odontoblast secretory activity and the expression of dentinogenesis markers. The effect of flavonoids was evaluated on phenotypic mineralization markers (alkaline phosphatase (ALP) activity and mineralized nodule deposition) by colorimetric assays and on the expression of Alpl , Mmp2 , Mmp9 , Dmp1 , and Dspp genes in odontoblast‐like cells by quantitative polymerase chain reaction. Most of the flavonoids did not show toxicity between 100 and 25 μM. In distinct concentrations, epigallocatechin gallate (EGCG), taxifolin, myricetin, quercetin, and kaempferol stimulated the activity of ALP and increased mineralized nodule deposition. However, the highest effect on those phenotypic markers was observed after EGCG and taxifolin treatments. Then, they were selected for evaluation of gene expression. mRNA levels of Dmp1 and Dspp highly increased with taxifolin treatment, and Alpl expression was increased for both taxifolin and EGCG groups, without difference between them. Mmp2 and Mmp9 expression was not affected by these flavonoids. In conclusion, EGCG and taxifolin positively affect phenotypic mineralization markers; in particular, taxifolin highly stimulates early‐ and late‐stage dentinogenesis genes.

This study aimed to evaluate the effects of experimental bioactive glass solutions on dentinal fluid flow and hydraulic conductance in vitro. Dentin blocks of 50 bovine incisors were divided into 5 groups according to the desensitizing agent used (n = 10): Group 1—control (no treatment); Group 2—Bioglass^® 45S5; Group 3—Bioglass^® F18; Group 4—Biosilicate gel; Group 5—Desensibilize Nano P (FGM). Treatments were applied for 20 min daily over 15 days. The specimens were subjected to a citric acid challenge to simulate oral demineralizing conditions. Dentinal fluid flow and hydraulic conductance were evaluated before and after the desensitizing procedures and the acidic challenge. Scanning electron microscopy (SEM) provided qualitative dentin surface analysis. Dentinal fluid flow and hydraulic conductance data were analyzed by two-way repeated measures ANOVA and Tukey’s test (α = 0.05). The control group showed the highest dentinal fluid flow and hydraulic conductance values after the acid challenge (p < 0.05). After product application, Bioglass^® 45S5 and Bioglass^® F18 showed the lowest dentinal fluid flow (0.463 ± 0.124 Lp and 0.549 ± 0.239 Lp, respectively) and hydraulic conductance values (0.025 ± 0.007 Lp and 0.026 ± 0.007 Lp, respectively), differing significantly from Biosilicate Gel and Desensibilize Nano P (p < 0.0001). Biosilicate Gel and Desensibilize Nano P showed higher dentinal fluid flow (0.864 ± 0.180 Lp and 0.840 ± 0.173 Lp, respectively) and hydraulic conductance values (0.047 ± 0.010 Lp and 0.046 ± 0.009 Lp, respectively) after application (p < 0.0001). After the acid challenge, no significant differences were observed among the groups (p > 0.05), although all experimental groups showed numerically lower values than the control group. Bioactive glass-based desensitizing agents reduced dentinal fluid flow and hydraulic conductance, suggesting dentinal tubule occlusion. Bioglass^® 45S5 and Bioglass^® F18 showed the most stable performance, maintaining lower values even after the acid challenge, suggesting potential for the management of dentin hypersensitivity.

This study evaluated the color change (ΔE₀₀) and penetration depth (PD) of white spot lesions (WSLs) infiltrated with the resin infiltrant (Icon^®) functionalized with methacrylate epigallocatechin-3-gallate (EGCG). To introduce polymerizable double bonds, EGCG was reacted with methacryloyl chloride (EM). Subsequently, the Icon resin infiltrant (I) was loaded with neat EGCG (IE) or EGCG–methacrylate (IEM) at 2 wt% each. WSLs were created on bovine enamel blocks and treated with I, IE, or IEM. Sound and untreated enamel surfaces were used as controls (C). Infiltrant PD (%) was determined by Confocal Laser Scanning Microscopy (CLSM, n = 12) analysis. For color change (ΔE₀₀) determination (n = 14), ΔL, Δa, and Δb, half of each sample was kept sound as a reference area. The color was determined with a spectrophotometer. Data were statistically evaluated (p = 0.05). Surface morphology was obtained as a qualitative response variable using 3D CLSM. PD (%) did not differ statistically for I, IE, and IEM (p = 0.780). Groups I and IEM showed similar performance on color change (ΔE₀₀) compared to the control group, while IE exhibited intermediate results, with no significant difference observed between the untreated, I, and IEM groups (p < 0.001). IEM promoted the masking of the WSL color without interfering with the PD.

This study evaluated the short-term clinical and microbiological performance of resin-modified glass ionomer cement (RM-GIC) cement containing chlorhexidine (CHX) for atraumatic restorative treatment (ART) in primary teeth. The clinical trial was conducted in 36 children that received ART in primary molars either with GIC (group I, n = 18) or GIC containing 1.25% CHX (group II, n = 18). The survival rate of restorations was checked 7 days, 3, and 6 months after their application when saliva and biofilm were collected for microbiological assessment of mutans streptococci (MS) counts. Data were analyzed using the Kruskal–Wallis/Mann–Whitney U tests for clinical analysis and microbiological evaluations (p < 0.05). The survival rate of restorations was similar comparing groups I with II. Microbiological analysis showed a significant reduction in MS levels 7 days after the treatment in both saliva and biofilm of children treated with RM-GIC containing CHX (group II); however, MS counts at 3 and 6 months did not differ from the initial counts. A total of 1.25% CHX improved the microbiological properties of GIC in the short term without impairing the clinical performance of ART restorations. Glass ionomer cement (GIC) containing CHX could be an alternative in ART procedures with the objective of promoting an additional antimicrobial effect, which is interesting for children with high counts of MS during the initial phase of adaptation to dental treatment. da Silva ME, de Sena MD, Colombo NH, et al. Short-term Clinical and Microbiological Performance of Resin-modified Glass Ionomer Cement Containing Chlorhexidine for Atraumatic Restorative Treatment. Int J Clin Pediatr Dent 2023;16(S-1):S27–S32.