Search

Objective: To examine the relationship between the ICCMS™ (International Caries Classification and Managing System) features of root caries lesions and the underlying depth of the lesion towards the pulp. In order to control for bias, the study followed the tailored document for risk of bias assessment (RoB-tool) recently published. A pilot study showed that the outline of the pulp was much clearer on horizontal compared to vertical sections through the lesions (p = 0.03) and that the histological stereomicroscopical (SM) assessed lesion depth towards the pulp was not influenced by the cutting direction (p = 0.155). Material and methods: A sample of extracted permanent molar teeth (n = 100) were classified independently by two of the authors according to ICCMS™ as no sign of root caries lesion 0 = sound; 1 = initial lesion (non-cavitated); 2 = moderate lesion (cavity depth ≤ 2 mm) and 3 = extensive lesion (cavity depth > 2 mm). After horizontal sectioning (HS) through the lesion, the depth of the underlying lesion was SM assessed independently by two of the authors as 0 = no lesion; 1 = lesion in outer 1/3; 2 = middle 1/3; and 3 = inner 1/3 of the dentine towards the pulp. Results: Intra- and inter-reproducibility (weighted kappa values ≥ 0.83); the accuracy (Spearman's rho-values) = 0.94 and 0.95; and specificity/sensitivities/AUC values (three different thresholds) were ≥ 0.91, ≥ 0.93, and ≥ 0.96, respectively. Conclusion: Under the umbrella of the RoB-tool, the validity in terms of the reproducibility and accuracy of the ICCMS™ root caries scoring system was high. Clinical relevance: By means of the ICCMS™ root caries scoring system, the underlying lesion depth can be estimated, which must be considered when managing the lesion. [ABSTRACT FROM AUTHOR]

Aim: To describe the 2‐year clinical and combined with radiographic caries progression pattern in three cohorts of 2‐(a), 4‐(b), and 6‐yr‐old children (c). Design: Baseline sample comprised 600 children (each‐cohort: n = 200). Children's dental surfaces were clinically assessed at schools without air‐drying (epi) in terms of: Clinical (C) caries lesions (d/D) with ICDASepi‐merged system (C‐ICDASepi‐d/D:Sound/Initial‐epi/Moderate/Extensive); fillings (f/F), and missing teeth (m/M). Clinical ICDAS (C) and Radiographic ICDAS (R) indexes were combined (C + R). Caries experience (dmf + DMF) was expressed as: C‐dmfs + DMFS (Moderate/Extensive‐d/D); C‐ICDASepi‐dmfs + DMFS (including Initial‐epi‐d/D); C + R‐dmfs + DMFS; and C + R‐ICDASepi‐dmfs + DMFS. Follow‐up caries progression corresponded to more severe caries score. Results: Two‐year follow‐up sample was n = 352 (58.7%‐baseline sample): a: n = 81; b: n = 131; c: n = 140. Around 100% of children presented C + R‐ICDASepi‐dmf + DMF ≥ 1, with following C + R‐ICDASepi‐dmfs + DMFS means: a: 7.3 ± 14.1; b: 12.2 ± 19.5; c: 13.3 ± 16.9. Progression was about 60% in all cohorts, mainly corresponding, in cohort b and c, to occlusal and distal surfaces of lower first/second‐molar‐primary teeth, and in cohort a to buccal surfaces of upper primary‐incisor teeth. The addition of radiographs increased caries mean and prevalence in 10% as compared to only visual examination. Conclusions: Children showed a high C + R caries experience progression rate, mainly related to occlusal and proximal surfaces in lower‐molar teeth and buccal in upper‐incisor teeth. [ABSTRACT FROM AUTHOR]

Objectives: With this in vitro study we aimed to assess the possibility of precise application of sealant on accessible artificial white spot lesions (WSL) on approximal surfaces next to a tooth surface under operative treatment. A secondary aim was to evaluate whether the use of magnifying glasses improved the application precision.Material and Methods: Fifty-six extracted premolars were selected, approximal WSL lesions were created with 15% HCl gel and standardized photographs were taken. The premolars were mounted in plaster-models in contact with a neighbouring molar with Class II/I-II restoration (Sample 1) or approximal, cavitated dentin lesion (Sample 2). The restorations or the lesion were removed, and Clinpro Sealant was placed over the WSL. Magnifying glasses were used when sealing half the study material. The sealed premolar was removed from the plaster-model and photographed. Adobe Photoshop was used to measure the size of WSL and sealed area. The degree of match between the areas was determined in Photoshop.Results: Interclass agreement for WSL, sealed, and matched areas were found as excellent (κ = 0.98-0.99). The sealant covered 48-100% of the WSL-area (median = 93%) in Sample 1 and 68-100% of the WSL-area (median = 95%) in Sample 2. No statistical differences were observed concerning uncovered proportions of the WSL-area between groups with and without using magnifying glasses (p values ≥ .19). However, overextended sealed areas were more pronounced when magnification was used (p = .01). The precision did not differ between the samples (p = .31).Conclusions: It was possible to seal accessible approximal lesions with high precision. Use of magnifying glasses did not improve the precision. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the predictive power of the morphology of the distal surface on 1st and mesial surface on 2nd primary molar teeth on caries development in young children.Sample and methods: Out of 101 3-to 4-year-old children from an on-going study, 62 children, for whom parents’ informed consent was given, participated. Upper and lower molar teeth of one randomly selected side received a 2-day temporarily separation. Bitewing radiographs and silicone impressions of interproximal area (IPA) were obtained. One-year procedures were repeated in 52 children (84%). The morphology of the distal surfaces of the first molar teeth and the mesial surfaces on the second molar teeth (n=208) was scored from the occlusal aspect on images from the baseline resin models resulting in four IPA variants: concave-concave; concave-convex; convex-concave, and convex-convex. Approximal caries on the surface in question was radiographically assessed as absent/present.Results: Of the 52 children examined at follow-up, 31 children (60%) had 1–4 concave surfaces. In total 53 (25%) of the 208 surfaces were concave. A total of 22 children (43%) had 1–4 approximal lesions adding up to 59 lesions. Multiple logistic regression analyses disclosed that gender, surface morphology on one of the approximal surfaces (focus-surface), and adjacent-surface morphology were significantly related to caries development (p values ≤ 0.03). The odds ratio for developing caries in the focus-surface/adjacent-surface in the four IPA variants were convex-convex, 1.0; convex-concave, 5.5 (CI 2.0–14.7); concave-convex, 12.9 (CI 4.1–40.3); and concave-concave, 15.7 (CI 5.1–48.3).Conclusion: Morphology of approximal surfaces in primary molar teeth, in particular both surfaces being concave, significantly influences the risk of developing caries.Clinical relevance: The concave morphology of approximal surfaces can predict future caries lesions supporting specific home-care and in-office preventive strategies. [ABSTRACT FROM AUTHOR]

Purposes: To (1) investigate the influence of fissure sealants on impedance spectroscopy (ACIS) and laser fluorescence (LF) readings, (2) compare the performance of the ACIS device with the LF technique and visual inspection (ICDAS) in permanent molars with various degrees of occlusal caries, and (3) validate all methods against radiographs and histological hemi-sectioning. Methods: 102 permanent molars were randomly selected to represent different stages of occlusal caries, from clinically sound to minor cavities. The teeth were examined by one trained examiner and scored with CarieScan PRO, the DIAGNOdent pen and ICDAS at baseline, after bleaching, etching and placement of a clear fissure sealant. A digital radiograph was exposed at baseline. After the assessments, the actual lesion depth was histologically determined. Results: Bleaching did not affect the readings but significantly higher ACIS and LF-pen values were recorded after acid etching (P< 0.05). The placement of a fissure sealant increased the LF-pen readings significantly (P< 0.05) while no values could be obtained with the ACIS device. Both the baseline ACIS and LF-pen values were significantly associated (P< 0.05) with the lesion depth but visual inspection displayed the best correlation with radiographs and histology. The ACIS technology displayed high sensitivity and specificity for detecting extensive occlusal lesions. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to describe the caries experience, prevalence and distribution related to tooth type and surfaces in the primary and permanent dentition in children and adolescents in Denmark in 2012. In addition, to examine if explanatory factors influence the inter-municipality variation in caries experience.Materials and Methods: Data was collected in the public Child Dental Health Service. In total, 5636 caries registrations on 3-, 9-, 15- and 18-year-olds were collected in 35 of the 98 Danish municipalities. Caries experience was expressed by mean def-s/DMF-S and caries prevalence by def-s = 0/DMF-S = 0. Inter-municipality variations were illustrated. Multivariate regression analyses were applied to assess the influence of fluoride concentration in drinking water, proportion of immigrants and personal income on the inter-municipality variation in mean def-s/DMF-S.Results: Only 4.6% of 3-year-olds had def-s (mean = 0.25), compared to 44.9% of 9-year-olds (mean = 3.07), primarily located occlusally and interproximally on the primary molars. Mean DMF-S for the 9-, 15- and 18-year-olds were 0.27, 1.97 and 4.40, respectively. Caries were primarily located occlusally and in pits on the permanent molars, which also showed high frequencies of sealings. Mean def-s/DMF-S showed substantial inter-municipality variations, while the caries location in both dentitions was rather stable. The three background factors explained less than 25% of the variation in mean def-s/DMF.Conclusions: The caries distribution within the primary and permanent dentition among 3-, 9-, 15- and 18-year-olds followed definite patterns concerning location on teeth and surfaces. Background factors only explained a minor part of the variation. [ABSTRACT FROM AUTHOR]

Background Studies examining the efficacy of sealing occlusal caries lesions in the primary dentition are limited, and no studies have so far examined the efficacy of infiltrating occlusal lesions on primary molar teeth. Objectives This study aimed to evaluate the efficacy of infiltrating, sealing, or fluoride varnishing on the occlusal surfaces with initial caries lesions. Design Split-mouth design study was carried out with 50 children aged between 5 and 8 years with three occlusal lesions. After randomization, one lesion was infiltrated with ICON and varnished with Duraphat (I+F), one lesion was sealed with Delton and varnished with Duraphat (S+F), and one lesion only varnished with Duraphat (F). Results Lesion status could be followed on radiographs on 47 children after 2-3 years (mean=22 months). Seven lesions in the I+F group, 9 lesions in the S+F, and 17 lesions in the F group showed radiographic progression. A significant difference in lesion progression was only found between the I+F- and the F group of teeth ( P = 0.021). Conclusions Infiltration and sealing occlusal surfaces with initial caries lesions on primary molar teeth showed a high efficacy in arresting caries progression, significant for the I+F or borderline significant for the S+F compared with the F group. [ABSTRACT FROM AUTHOR]

Braga MM, Martignon S, Ekstrand KR, Ricketts DNJ, Imparato JCP, Mendes FM. Parameters associated with active caries lesions assessed by two different visual scoring systems on occlusal surfaces of primary molars - a multilevel approach. Community Dent Oral Epidemiol 2010; 38: 549-558. © 2010 John Wiley & Sons A/S The aim of this in vivo study was to evaluate the association between several parameters related to children and to their teeth, and the presence of active carious lesions assessed by two different visual indices on occlusal surfaces of primary molars. Occlusal surfaces of 757 primary molars in 139 children (3-12 years old) were classified as sound, or having inactive or active carious lesions using the Nyvad criteria (NY) and the International Caries Detection and Assessment System (ICDAS-II) and a supplemental lesion activity assessment system (ICDAS-LAA). Several parameters related to the tooth and to the child were recorded. Associations between these parameters and the presence of active carious lesions on occlusal surfaces were evaluated using logistic multilevel analysis. Second primary molar teeth and children with high caries experience were more frequently with active occlusal carious lesions compared to sound and inactive occlusal carious lesions classified by both visual scoring systems. Teeth with a mature dental plaque on the occlusal surface and younger children had more active caries than inactive occlusal carious lesions (excluding sound teeth in the analysis). A previous visit to a dentist was related to a lower frequency of active occlusal carious lesions classified by NY only, and upper primary molars presented with higher numbers of active occlusal carious lesions classified by ICDAS-LAA. Presence of mature dental plaque and tooth type are tooth-related variables associated with active carious lesions on occlusal surfaces of primary teeth, as well as anterior caries experience and age are variables related to the child. [ABSTRACT FROM AUTHOR]

This study examines the influence of sagittal occlusion on occlusal plaque formation in permanent first molars (PFM) in 72 7-10-yr-olds before loss of primary second molars. Of a total of 288 PFM, 140 (49%) were sealed and 23 (8%) filled. Occlusal plaque was recorded at two levels of examination: 1) visible plaque on the entire surface and 2) detailed macromorphologic mapping. Enamel caries was recorded after professional tooth cleaning. After 48 h without tooth brushing, plaque examinations were repeated. Stone models were used for 1) identification of interocclusal contact areas and 2) classification of sagittal molar occlusion. The detailed mapping of plaque on unfilled surfaces showed a clear pattern of preferential locations related to the macromorphology of the occlusal surfaces. Active caries was restricted to those anatomic structures where plaque accumulated. 48-h median plaque values on mandibular molars in normal and with one cusp distal occlusion were significantly lower (P < 0.01) compared to surfaces in 1/4, 1/2 and 3/4 distal molar occlusion. Maxillary molars with normal and with 1 cusp distal occlusion had lower median plaque values than other sagittal occlusion categories. In general, however, plaque scores were higher in maxillary teeth because more than 2/3 of these teeth were without occlusal contact in the distal part. Mandibular occlusal surfaces in normal and with one cusp distal occlusion had significantly fewer active lesions than teeth with 1/4, 1/2 and 3/4 cusp distal occlusion [ABSTRACT FROM AUTHOR]

Based on serially cut 200-μm-thick sections from 21 human mandibular third molars, a quantitative characterization was made of the morphology in the mesial and distal interlobal groove. Two parameters were used: depth of interlobal groove and structure angle. The interlobal groove depth varied between 0.13 and 0.55, taken in relation to the maximum crown height. The structure angle varied between 2° and 170°. If the structure angle was ≤ 25°, the interlobal groove was classified as a fissure; if the angle was > 25°, the interlobal groove was classified as a groove. Only in 18% of the sections did the interlobal groove manifest itself as a fissure. The study demonstrates that it was possible unambiguously to describe the two-dimensional profile of interlobal grooves by groove depth and structure angle. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate a treatment program designed to control occlusal caries on the basis of intensive patient education and professional toothcleaning. The sample consisted of 56 6-8-yr-old children with their permanent right first molars in different stages of eruption. Data from the program were compared with previous data recorded in a similar sample of children. After 1 yr the majority of children in the study group had their permanent right first molars in full occlusion. A significant decrease of surfaces with easily detectable plaque and an increase of surfaces without plaque was observed. The proportion of arrested lesions increased and active enamel lesions decreased. Fissure sealing was only needed in two teeth in contrast to more than 2/3 of molars in a comparable sample of children. The program proved to be an efficient alternative to fissure sealing in preventing occlusal caries in erupting teeth. [ABSTRACT FROM AUTHOR]