Sealing Occlusal Dentin Caries in Permanent Molars

2016 ◽  
Vol 2 (1) ◽  
pp. 73-86 ◽  
Author(s):  
V. Qvist ◽  
M.K. Borum ◽  
K.D. Møller ◽  
T.R. Andersen ◽  
P. Blanche ◽  
...  
Keyword(s):  
Cox Regression ◽  
Resin Composite ◽  
Permanent Tooth ◽  
Drop Out ◽  
Permanent Teeth ◽  
Occlusal Caries ◽  
Second Molar ◽  
Non Invasive ◽  
Dentin Caries ◽  
Caries Lesions

The purpose of this study was to investigate the possibility of postponing restorative intervention of manifest occlusal caries in young, permanent dentition by non-invasive sealing. This RCT-designed study included 521 occlusal lesions in 521 patients aged 6 to 17 y. Based on clinical and radiographic assessments, all lesions required restorative treatment. After randomization (ratio 2:1), 368 resin sealings and 153 composite–resin restorations were performed by 68 dentists in 9 municipalities. The primary aims were to 1) analyze survival of sealings until replacement by restoration, 2) compare longevity of sealings and restorations until retreatments, and 3) compare effectiveness of sealings and restorations to halt caries progression in sealed lesions and beneath restorations. Furthermore, we aimed to identify factors influencing longevity and the effectiveness of sealings and restorations. Treatments were annually controlled, clinically and radiographically. After 7 y, the drop out rate was 8%, and 54% of the treatments were completed due to age. Of the sealings, 48% were retreated, including 31% replaced by restorations; 12% were still functioning. Of the restorations, 7% were repaired/renewed and 20% were still functioning. No endodontics was performed. Kaplan–Meier and Cox regression survival analyses were performed on 341 sealings and 152 restorations in first and second molar teeth. The 7-y survival was 37% (CI, 29% to 45%) for sealings and 91% (CI, 85% to 96%) for restorations (P < 0.001). The median survival time for sealings not replaced by restorations was 7.3 y (CI, 6.4 y to NA). Survival of sealings was increased in patients with low caries risk and/or excellent oral hygiene, second molars compared with first molars, and lesions not extending the middle one-third of the dentin. Survival of sealings was not influenced by municipality, sex, eruption stage or clinical surface cavitation. The results underline that it is possible to postpone or avoid restorative intervention of occlusal dentin caries lesions in young permanent teeth by non-invasive sealing. Knowledge Transfer Statement: The first restoration can ultimately be fatal for a young permanent tooth. A restoration may not be the final treatment but the start of an ongoing treatment with still more loss of tooth substance. The present study shows the possibility of treating occlusal dentin caries lesions with non-invasive resin sealings instead of conventional resin composite restorations in children and adolescents. Improved oral health can be expected.

Acid Profiles and pH of Carious Dentin in Active and Arrested Lesions

1994 ◽  
Vol 73 (12) ◽  
pp. 1853-1857 ◽  
Author(s):  
S. Hojo ◽  
M. Komatsu ◽  
R. Okuda ◽  
N. Takahashi ◽  
T. Yamada
Keyword(s):  
Dental Caries ◽  
Organic Acids ◽  
Clear Relationship ◽  
Permanent Teeth ◽  
Clinical Classification ◽  
Dentin Caries ◽  
Caries Lesions

Organic acids in caries lesions play important roles in initiation and progress of dental caries. We investigated relationships between clinical types of dentin caries and acid profile or pH in the lesions. Caries lesions in dentin from 76 permanent teeth were classified into active, arrested, situated beneath a restoration, and unclassified types. The pH of carious dentin was distinctly lower than that of sound dentin (p < 0.001). Carious dentin with a high percentage of lactate had a lower pH than that with a high percentage of acetate and propionate (p < 0.001). Dentin from active lesions showed a mean pH of 4.9, and the dominant acid was lactate (mean percentage, 88.2). In contrast, carious dentin from arrested lesions showed a higher pH, 5.7, with acetate and propionate as the dominant acids (mean percentages of acetate and propionate, 64.0 and 18.2, respectively). The acid profile (mean percentages of acetate and propionate, 54.0 and 27.7, respectively) and pH (mean 5.8) of carious dentin sampled from lesions beneath a restoration were similar to those of dentin from arrested lesions. This study showed a clear relationship between clinical classification of dentin caries and acid profile and pH, suggesting that both factors are important in dentin caries etiology.

scholarly journals A retrospective clinical study on the resin infiltration of proximal caries lesions: the operator’s effect

2021 ◽  
Author(s):  
E. Diab ◽  
D. Hesse ◽  
C. C. Bonifacio
Keyword(s):  
Cox Regression ◽  
Side Surface ◽  
Dental Students ◽  
Permanent Teeth ◽  
Cox Regression Analysis ◽  
Resin Infiltration ◽  
Retrospective Clinical Study ◽  
Shared Frailty ◽  
Caries Lesions ◽  
And Training

Abstract Purpose This retrospective university-based study investigated the effect of operators’ training and previous experience on the success of resin infiltration (RI) in arresting proximal non-cavitated caries lesions in primary and permanent teeth. Methods Information was collected regarding RI of proximal non-cavitated caries lesions in primary and permanent teeth with a follow-up period up to 32 months. Factors investigated were: operators’ clinical experience and training, patient’s age, tooth, arch, mouth-side, surface treated, tooth separation, and baseline lesion depth. Kaplan–Meier survival and Cox regression analysis with shared frailty were used (α = 5%). Results A total of 130 proximal surfaces treated on 115 teeth of 43 children (11 ± 4.4 years) were evaluated. Survival of RI was 46% up to 32 months. Lesions treated by non-trained dentists were more likely-to-present progression than those performed by non-trained dental students under supervision (HR 2.41, 95% CI: 1.00–5.80); conversely, no difference was found between non-trained dental students under supervision and trained dentists (HR 0.52, 95% CI: 0.16–1.70). Additionally, dentin lesions were 59% more-likely-to-present progression than enamel lesions (HR 0.41, 95% CI: 0.17–0.99). Conclusion The operator’s experience and training could influence the success of RI on proximal non-cavitated caries lesions and it should be taken into consideration when choosing this treatment modality.

scholarly journals Study protocol for a diagnostic randomized clinical trial to evaluate the effect of the use of two clinical criteria in the assessment of caries lesions around restorations in adults: the Caries Cognition and Identification in Adults (CaCIA) trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Cácia Signori ◽  
◽  
Bruna Lorena Pereira Moro ◽  
Juliana Lays Stolfo Uehara ◽  
Vitor Henrique Digmayer Romero ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Oral Health ◽  
Cox Regression ◽  
Treatment Decision ◽  
Diagnosis And Treatment ◽  
Permanent Teeth ◽  
Diagnostic Strategy ◽  
Clinical Criteria ◽  
The Impact ◽  
Caries Lesions

Abstract Background The assessment of restored teeth in dentistry remains a challenge, mainly related to the detection of caries around restorations. There is a diversity of clinical criteria available to assess the caries lesions, resulting in differences in the dentists’ diagnosis and treatment decisions. In addition, there is a lack of evidence regarding the best criteria to detect caries lesions around the restorations. Thus, the present protocol aims to evaluate the effect of using 2 visual criteria to assess restored teeth on the outcomes related to oral health in adults. Methods The design protocol of the Caries Cognition and Identification in Adults trial correspond to a triple-blind randomized, controlled clinical trial with parallel-groups. Two groups will be compared: patients who will receive the diagnosis and treatment decision according to FDI (World Dental Federation) criteria—FDI group; and patients who will receive diagnosis and treatment decision according to the “Caries Associated with Restorations or Sealants” criteria defined by the International Caries Classification and Management System (ICCMS group). The participants will be followed up after 6, 12, 18, 24, and 60 months, and the restoration failure will be the primary outcome. The analysis will be conducted through Cox regression with shared frailty. The impact of oral health on quality of life and the cost-effectiveness of the methods used will be the secondary outcomes. Two-tailed analyzes will be used, considering a level of significance of 5%. Discussion This is the first clinical trial to assess the effect of using two visual methods to detect caries lesions around restorations on the outcomes related to oral health in adults. The findings of this study will define what is the best diagnostic strategy for the assessment of caries around restorations in permanent teeth. Trial registration NCT03108586 (registered 11 April 2017).

scholarly journals Diagnosis of Dentin Caries – Ultraviolet Fluorescence

2014 ◽  
Vol 41 (2) ◽  
pp. 55-60 ◽  
Author(s):  
Ts. Uzunov ◽  
T. Uzunov ◽  
R. Grozdanova ◽  
D. Kosturkov
Keyword(s):  
Permanent Teeth ◽  
Fluorescence Detector ◽  
Non Invasive ◽  
Dentin Caries ◽  
Near Ultraviolet ◽  
Fluorescent Method ◽  
Metabolic Products ◽  
Wide Availability ◽  
Carious Process ◽  
Indicator Dye

Summary The technology advance in recent years determines the need of construction of modern appliances for early diagnosis of dental caries, which are categorized by great precision, non-invasiveness, easy usage and wide availability. Such non-invasive and accurate tool for diagnostics of caries is Caries Detector (LED), Bulgarian product by “Optica Laser”. The detector emits a specific wavelength of near ultraviolet light, which causes fluorescence to porphyrins - metabolic products of the life cycle of caries-inducing bacteria. The purpose of the study is piloting a new diagnostic tool for detection and monitoring of caries excavation based on fluorescence - LED UV caries detector of company “Optica laser”. Subjected to examination by caries indicator dye and UV caries detector were sixty permanent teeth with deep dentine caries. Two methods were used to assess the dentin caries - UV fluorescence detector of “Optica Laser” and staining with caries indicator - dye (Sable ™ Seek®). It was found that among all sixty teeth, the fields, closed by margins of carious process overlap. Fifty-four of tested teeth has shown bigger field of images with staining method and six - smaller in comparison to the fluorescent method. Ultraviolet fLuorescence caries detector of “Optica Laser” company is affordable and easy applicable method for controlled excavation of dentine caries. The detector can be used in daily dental practice equally with other methods. The unit has a number of advantages - non-invasiveness, lack of interaction with tooth structures, speed, reliability, efficiency, predictability and repeatability of results.

scholarly journals Severe Impaction of the Primary Mandibular Second Molar Accompanied by Displacement of the Permanent Second Premolar

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Junko Matsuyama ◽  
Shoko Kinoshita-Kawano ◽  
Sachiko Hayashi-Sakai ◽  
Tomoe Mitomi ◽  
Tomiko Sano-Asahito
Keyword(s):  
Permanent Tooth ◽  
Permanent Teeth ◽  
Primary Tooth ◽  
Second Primary ◽  
Primary Molar ◽  
Second Molar ◽  
First Case ◽  
Tooth Impaction ◽  
Normal Functional ◽  
Mandibular Second Molar

Tooth impaction is defined as any tooth that fails to erupt into a normal functional position and remains unerupted beyond the time at which it should normally erupt. Reports of impaction and eruption failure in primary teeth are relatively rare compared to permanent teeth. We report 2 rare cases where the second premolar was located on the occlusal side of the impacted mandibular second primary molar. In the first case, the succedaneous permanent tooth erupted after extraction of the primary tooth, fenestration, and traction. In the second case, the succedaneous permanent tooth erupted without fenestration or traction. Although the etiology of the tooth displacement was unknown in both cases, inhibition of the eruptive movement of the primary molar may have been associated with displacement of the succedaneous permanent premolar.

scholarly journals Update on Nonsurgical, Ultraconservative Approaches to Treat Effectively Non-Cavitated Caries Lesions in Permanent Teeth

2011 ◽  
Vol 05 (02) ◽  
pp. 229-236 ◽  
Author(s):  
Boniek Castillo Dutra Borges ◽  
Juliane de Souza Borges ◽  
Larissa Sgarbosa Napoleao de Araujo ◽  
Claudia Tavares Machado ◽  
Alex Jose Souza dos Santos ◽  
...  
Keyword(s):  
High Speed ◽  
Operative Procedure ◽  
Permanent Teeth ◽  
New Paradigm ◽  
Invasive Approach ◽  
Dental Tissues ◽  
Non Invasive ◽  
Minimally Invasive Dentistry ◽  
Surgical Methods ◽  
Caries Lesions

ABSTRACTDental caries on tooth surfaces is still a problem in many industrialized countries. For many years, dentistry was influenced by a mechanical approach characterized by the use of high-speed rotary cutting instruments, and dentists predominantly used surgical methods to address caries. This included radical removal of diseased portions of the tooth, along with material-driven geometric extensions to areas that were assumed to be caries-resistant. This concept of extension for prevention was introduced by G. V. Black and influenced dentists for more than 120 years. Recently, a new paradigm of operative conservatism, sometimes referred to as “minimally invasive dentistry,” has gained popularity. This paradigm is designed to promote maximum preservation of healthy dental structures over a lifetime. The aim of this review is to discuss the efficacy of current nonsurgical treatments for non-cavitated caries lesions in permanent teeth. Based on results obtained from clinical trials, this review evaluates treatments such as consumption of CPP-ACP added gums, resin infiltration and fissure sealing. Although in a few cases an invasive approach is needed to arrest caries progression, the non-surgical approach generally provides potential benefits that include conserving structure by delaying intervention or minimizing the operative procedure. All current non-invasive methods are effective in treating non-cavitated caries lesions. The adoption of non-invasive approaches in the management of these lesions can preserve dental tissues, thus increasing tooth longevity. (Eur J Dent 2011;5:229-236)

scholarly journals Detection of Non-Cavitated Occlusal Caries with Impedance Spectroscopy and Laser Fluorescence: an In Vitro Study

2014 ◽  
Vol 8 (1) ◽  
pp. 28-32 ◽  
Author(s):  
Diana Mortensen ◽  
Katrine Dannemand ◽  
Svante Twetman ◽  
Mette Kirstine Keller
Keyword(s):  
Impedance Spectroscopy ◽  
Laser Fluorescence ◽  
In Vivo Studies ◽  
Permanent Teeth ◽  
Occlusal Caries ◽  
Posterior Teeth ◽  
Diagnodent Pen ◽  
Occlusal Surfaces ◽  
Caries Lesions

Objective: To evaluate the performance of an impedance spectroscopy technology for detecting non-cavitated occlusal caries lesions in permanent teeth in vitro. The method was compared with a commonly used laser fluorescence device and validated against histology. Material and Methodology: A non-cavitated sample of 100 extracted posterior teeth was randomly selected and assessed for caries on enamel and dentin level with aid of CarioScan PRO (ACIS) and DIAGNOdent pen (LF pen) by three examiners. After the measurements, the extension of the lesion was histologically determined as gold standard. Sensitivity, specificity, accuracy and receiver-operating curves were calculated. Intra- and inter-examiner reproducibility was expressed by intra class correlation coefficients. Results: The histological caries prevalence was 99% and 41% exhibited dentin caries. The ACIS technique displayed high specificities but almost negligible sensitivities at readings >50. A similar pattern was noted for the LF pen at readings >30. The intra- and inter-examiner reproducibility varied between 0.47 and 0.98 and the values were generally lower for the ACIS technique than for the LF pen. The inter-examiner agreement reached excellent levels with both methods. Conclusions: In vitro, the ACIS technique showed a low ability to disclose occlusal caries lesions in the enamel and/or dentin of non-cavitated permanent molars. However, further in vivo studies of permanent occlusal surfaces are needed to mirror the clinical situation.

scholarly journals Occlusal Caries: Biological Approach for Its Diagnosis and Management

2016 ◽  
Vol 50 (6) ◽  
pp. 527-542 ◽  
Author(s):  
Joana Christina Carvalho ◽  
Irene Dige ◽  
Vita Machiulskiene ◽  
Vibeke Qvist ◽  
Azam Bakhshandeh ◽  
...  
Keyword(s):  
Dental Health ◽  
Molecular Ecology ◽  
Complete Removal ◽  
Success Rates ◽  
Occlusal Caries ◽  
Non Invasive ◽  
Occlusal Surfaces ◽  
Careful Clinical Examination ◽  
Lower Success Rate ◽  
Caries Lesions

The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most up-to-date knowledge and evidence of the biological principles guiding diagnosis, risk assessment, and management of the caries process on occlusal surfaces. In addition, it considers the whole spectrum of the caries process on occlusal surfaces, ranging from the molecular ecology of occlusal biofilms to the management of deep occlusal caries lesions. Studies using molecular methods with focus on biofilms in relation to occlusal caries should explore the relationship between the function and the structural composition of these biofilms to understand the role of occlusal biofilms in caries development. State-of-the-art measures to evaluate risk for occlusal caries lesion activity, caries incidence, and progression should include the assessment of the occlusal biofilm and the stage of tooth eruption. Careful clinical examination of non-cavitated lesions, including assessment of the lesion activity status, remains the major tool to determine the immediate treatment need and to follow on the non-operative treatment outcome. Even medium occlusal caries lesions in the permanent dentition may be treated by non-invasive fissure sealing. By extending the criteria for non-invasive treatments, traditional restoration of occlusal surfaces can be postponed or even avoided, and the dental health in children and adolescents can be improved. Selective removal (incomplete) to soft dentin in deep carious lesions has greater success rates than stepwise excavation. Selective (complete) removal to firm dentin has a lower success rate due to increased pulp exposure.

scholarly journals Treatment of lesions on the vestibular surfaces of permanent teeth with the use of liquid resin of low viscosity

2019 ◽  
Vol 129 (3) ◽  
pp. 110-112
Author(s):  
Ilona Szewczak ◽  
Beata Kubić-Filiks ◽  
Jolanta Szymańska
Keyword(s):  
Professional Life ◽  
Permanent Teeth ◽  
Liquid Resin ◽  
Non Invasive ◽  
Low Viscosity ◽  
White Spots ◽  
Invasive Method ◽  
Caries Lesions ◽  
Methods Of Treatment

Summary One of the methods of treatment of initial stages of dental caries, lesions characterized by demineralization, and white spots on the vestibular surfaces of permanent teeth, is infiltration with liquid resin of low viscosity. It is a non-invasive method which is worth recommending and popularizing among patients. On the basis of available literature the therapeutic method of infiltration with liquid resin of low viscosity is presented. The use of resin of low viscosity allows for obtaining appropriate esthetic and functional appearance of teeth, which is a vital step in improvement of quality of social and professional life of patient.

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