scholarly journals Paediatric Dentistry Discussion Paper and Case Report Management of small carious lesions in primary teeth: Caries removal versus fluoride application and periodic ‘observation’ until exfoliation

1997 ◽  
Vol 42 (6) ◽  
pp. 372-374
Author(s):  
Theo Gotjamanos
Keyword(s):  
Case Report ◽  
Primary Teeth ◽  
Paediatric Dentistry ◽  
Discussion Paper ◽  
Carious Lesions ◽  
Caries Removal

Caries removal strategies for deep carious lesions in primary teeth: Systematic review

2020 ◽  
Vol 30 (4) ◽  
pp. 392-404
Author(s):  
Elody Aïem ◽  
Clara Joseph ◽  
Anaïs Garcia ◽  
Violaine Smaïl‐Faugeron ◽  
Michèle Muller‐Bolla
Keyword(s):  
Systematic Review ◽  
Primary Teeth ◽  
Carious Lesions ◽  
Deep Carious Lesions ◽  
Caries Removal

Determining Treatibility of Primary Teeth with Pulpal Exposure

2013 ◽  
Vol 37 (4) ◽  
pp. 345-350 ◽  
Author(s):  
S Doğan ◽  
L Durutürk ◽  
AI Orhan ◽  
I Batmaz
Keyword(s):  
Success Rate ◽  
Primary Teeth ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Success Rates ◽  
Exposure Site ◽  
Carious Lesions ◽  
Deep Carious Lesions ◽  
Caries Removal ◽  
The Difference

Objectives: To determine rates of pulpal exposure during caries removal with an excavator or a bur, to assess success rates of vital pulp therapies in both cases, to analyze pulpal bleeding as an indicator of primary teeth treatability. Study Design: Of the 352 primary mandibular molars with deep carious lesions, 141 with pulp exposed during the removal of caries were grouped according to type of instrument causing pulpal exposure and existence of bleeding at the exposure site. Teeth suitable for direct pulp capping or formocresol pulpotomy were treated and followed up for two years. Results: The difference between the rates of pulpal exposure with an excavator (52.5%) or a bur (47.5%) was insignificant. The treatment success rate of teeth with pulp exposed by an excavator (15.8%) was significantly lower than teeth with pulp exposed by a bur (48.8%), regardless of whether bleeding existed at the exposure site or not; however, when bleeding existed, this difference was insignificant (15.8% and 40.6%, respectively). Conclusions: Pulpal exposure possibility during caries removal caused by an excavator and a bur was similar, the treatment success rate was lower when the exposure was caused by an excavator, the existence of pulpal bleeding resulted in mistakes in diagnoses.

scholarly journals How to Intervene in the Caries Process: Dentin Caries in Primary Teeth

2020 ◽  
Vol 54 (4) ◽  
pp. 306-323
Author(s):  
Ruth M. Santamaría ◽  
Mohamed Hassan Abudrya ◽  
Gülsün Gül ◽  
MHD Said Mourad ◽  
Grace Felix Gomez ◽  
...  
Keyword(s):  
Primary Teeth ◽  
Randomized Clinical Trials ◽  
Glass Ionomer Cement ◽  
Cochrane Collaboration ◽  
Cochrane Library ◽  
Success Rates ◽  
Carious Lesions ◽  
Restorative Materials ◽  
Caries Removal ◽  
Materials Used

For an ORCA/EFCD consensus, this review systematically assessed available evidence regarding interventions performed and materials used to manage dentin carious lesions in primary teeth. A search for systematic reviews (SRs) and randomized clinical trials (RCTs) with a follow-up of at least 12 months after intervention was performed in PubMed, LILACS, BBO, and the Cochrane Library. The risk of bias tool from the Cochrane Collaboration and the PRISMA Statement were used for assessment of the included studies. From 101 screened articles, 2 SRs and 5 RCTs, which assessed the effectiveness of interventions in terms of pulp vitality and success of restoration, and 10 SRs and 1 RCT assessing the success of restorative materials were included. For treatments involving no carious tissue removal, the Hall technique showed lower treatment failure for approximal carious lesions compared to complete caries removal (CCR) and filling. For the treatment of deep carious lesions, techniques involving selective caries removal (SCR) showed a reduction in the incidence of pulp exposure. However, the benefit of SCR over CCR in terms of pulp symptoms or restoration success/failure was not confirmed. Regarding restorative materials, preformed metal crowns (PMCs) used to restore multisurface lesions showed the highest success rates compared to other restorative materials (amalgam, composite resin, glass ionomer cement, and compomer), and in the long term (12–48 months) these were also less likely to fail. There is limited evidence supporting the use of PMCs to restore carious lesions with single cavities. Among nonrestorative options, silver diammine fluoride was significantly more effective in arresting caries than other treatments for treating active carious lesions of different depths. Considerable heterogeneity and bias risk were observed in the included studies. Although heterogeneity observed among the studies was substantial, the trends were similar. In conclusion, less invasive caries approaches involving selective or no caries removal seem advantageous in comparison to CCR for patients presenting with vital, symptomless, carious dentin lesions in primary teeth. There is evidence in favor of PMCs for restoring multisurface carious lesions in primary molars.

Dentin Topographic Features following Chemomechanical Caries Removal in Primary Teeth

2016 ◽  
Vol 40 (6) ◽  
pp. 472-479 ◽  
Author(s):  
RM Kotb ◽  
MA Elkateb ◽  
AM Ahmed ◽  
KY Kawana ◽  
OA El Meligy
Keyword(s):  
Primary Teeth ◽  
Complete Removal ◽  
Smear Layer ◽  
Dentinal Tubules ◽  
Topographic Features ◽  
Carious Lesions ◽  
Drilling Method ◽  
Caries Removal ◽  
Amorphous Surface ◽  
Conventional Drilling

Aim: Study the topographic features of dentin after caries removal with a chemomechanical agent (Papacarie) compared with the conventional drilling method. Study design: The sample included 7 exfoliated and extracted primary teeth with carious dentin lesions, not reaching the pulp. Each tooth was sectioned longitudinally through the center of the carious lesions into two halves. The teeth were then divided into two groups according to the method of caries removal. Following caries removal, dentin topography and the cut section were examined using the scanning electron microscope. Results: Papacarie produced an irregular, porous, rough and globular dentin appearance. The dentin surfaces were generally free of smear layer, visible bacteria and the dentinal tubules were opened. The dentin cut surfaces showed patent dentinal tubules with open orifices. The drilling method created a smooth and amorphous surface with a continuous smear layer occluding the dentinal tubules. Numerous bacteria were also observed. The cut dentin surfaces showed patent dentinal tubules with their orifices plugged with smear layer. Conclusions: Papacarie produced a rough and porous surface with partial or complete removal of the smear layer and opened dentinal tubules, while the drill produced a smooth surface with uniform smear layer occluding the dentinal tubules.

scholarly journals Selective Caries Removal in Permanent Teeth (SCRiPT) for the treatment of deep carious lesions: a randomised controlled clinical trial in primary care

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jan E. Clarkson ◽  
Craig R. Ramsay ◽  
David Ricketts ◽  
Avijit Banerjee ◽  
Chris Deery ◽  
...  
Keyword(s):  
Dental Health ◽  
Controlled Clinical Trial ◽  
Trial Registry ◽  
Posterior Teeth ◽  
Carious Lesions ◽  
Randomised Controlled Clinical Trial ◽  
Deep Carious Lesions ◽  
Caries Removal ◽  
Randomised Controlled ◽  
Selective Caries Removal

Abstract Background Dental caries is one of the most prevalent non-communicable disease globally and can have serious health sequelae impacting negatively on quality of life. In the UK most adults experience dental caries during their lifetime and the 2009 Adult Dental Health Survey reported that 85% of adults have at least one dental restoration. Conservative removal of tooth tissue for both primary and secondary caries reduces the risk of failure due to tooth-restoration, complex fracture as well as remaining tooth surfaces being less vulnerable to further caries. However, despite its prevalence there is no consensus on how much caries to remove prior to placing a restoration to achieve optimal outcomes. Evidence for selective compared to complete or near-complete caries removal suggests there may be benefits for selective removal in sustaining tooth vitality, therefore avoiding abscess formation and pain, so eliminating the need for more complex and costly treatment or eventual tooth loss. However, the evidence is of low scientific quality and mainly gleaned from studies in primary teeth. Method This is a pragmatic, multi-centre, two-arm patient randomised controlled clinical trial including an internal pilot set in primary dental care in Scotland and England. Dental health professionals will recruit 623 participants over 12-years of age with deep carious lesions in their permanent posterior teeth. Participants will have a single tooth randomised to either the selective caries removal or complete caries removal treatment arm. Baseline measures and outcome data (during the 3-year follow-up period) will be assessed through clinical examination, patient questionnaires and NHS databases. A mixed-method process evaluation will complement the clinical and economic outcome evaluation and examine implementation, mechanisms of impact and context. The primary outcome at three years is sustained tooth vitality. The primary economic outcome is net benefit modelled over a lifetime horizon. Clinical secondary outcomes include pulp exposure, progession of caries, restoration failure; as well as patient-centred and economic outcomes. Discussion SCRiPT will provide evidence for the most clinically effective and cost-beneficial approach to managing deep carious lesions in permanent posterior teeth in primary care. This will support general dental practitioners, patients and policy makers in decision making. Trial Registration Trial registry: ISRCTN. Trial registration number: ISRCTN76503940. Date of Registration: 30.10.2019. URL of trial registry record: https://www.isrctn.com/ISRCTN76503940?q=ISRCTN76503940%20&filters=&sort=&offset=1&totalResults=1&page=1&pageSize=10&searchType=basic-search.

scholarly journals Could COVID‐19 change the way we manage caries in primary teeth? Current implications on Paediatric Dentistry

2020 ◽  
Vol 30 (5) ◽  
pp. 523-525
Author(s):  
Alaa BaniHani ◽  
Collette Gardener ◽  
Daniela Prócida Raggio ◽  
Ruth M. Santamaría ◽  
Sondos Albadri
Keyword(s):  
Primary Teeth ◽  
Paediatric Dentistry ◽  
The Way

scholarly journals Treatment of a Patient with Multiple Impacted Teeth

2007 ◽  
Vol 77 (4) ◽  
pp. 735-741 ◽  
Author(s):  
Richard Scott Conley ◽  
Scott B. Boyd ◽  
Harry L. Legan ◽  
Christopher C. Jernigan ◽  
Craig Starling ◽  
...  
Keyword(s):  
Case Report ◽  
Treatment Planning ◽  
Orthodontic Treatment ◽  
Primary Teeth ◽  
Permanent Tooth ◽  
Permanent Teeth ◽  
Treatment Sequence ◽  
Impacted Teeth ◽  
Case Complexity ◽  
Multiple Primary

Abstract An impacted or missing permanent tooth can add significant complications to an otherwise straightforward case. When multiple impacted teeth are present, the case complexity increases further. Developing a treatment sequence, determining appropriate anchorage, and planning and executing sound biomechanics can be a challenge. The following case report illustrates a patient reportedly diagnosed with mild scleroderma as an adolescent. He presented for orthodontic treatment as an adult with multiple retained primary teeth and multiple impacted teeth. Diagnosis, treatment planning, and various methods of managing guided eruption of impacted teeth will be discussed. Following orthodontic treatment that required extraction of multiple primary and permanent teeth as well as exposure and ligation of multiple permanent teeth by an oral surgeon, the patient finished with a significantly improved functional and esthetic result.

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