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This research aimed to analyze of the relative share, frequency and correlation of restorations in both dental dentitions in childhood. The decayed, missing, and filled permanent teeth (DMFT) index is one of the most commonly used indices in epidemiologic surveys of dental caries. It quantifies dental health status based on the number of carious, missing and filled teeth. A total of 602 schoolchildren in Varna, aged 3-18 years were selected for this study. The children have a determined high caries risk DMFT index >1. The patients are divided into 16 groups according to age limit. The research takes place in the Faculty of Dental Medicine, Medical University of Varna, in the time period 2016-2018. This study is retrospective, based on medical data of the participants. Pearson's correlation and simple linear regression were used to estimate the correlation between restorations, DMF (T+t) and age. The average value of determining the level of caries of the examined groups of children is DMF (T+t) =5.46±3.95 (range 0-20). With the correlation analysis we proved a direct dependence of the ratio. The number of preventive fillings with photopolymers and composites increased with increasing age of the studied children (r=0.725; p

A clinical and functional examination of the maxillofacial area was performed in 280 patients with the defects of the lateral teeth being replaced with ceramic crown inlays or light-cured composites three years ago. Computer methods were used to assess the articulation, occlusion and tone of the masticatory muscles on the T-Scan III and Bio EMG III devices. In a third of the lateral teeth, an unreasonable increase in indications to composite fillings has been established – when more than 50.0% of the occlusal surface is destroyed. Indicators of dental status are significantly better when using ceram- ic inlays compared with fillings made of composite material in the long term after treatment of multiple caries. Ceramic crown inlays prevent occlusal-articulatory disorders and dysfunction of the masticatory apparatus, characteristic in long-term periods for patients with multiple caries when replacement of lateral teeth defects with fillings made of composite.

BackgroundHistorically, lack of evidence for effective management of decay in primary teeth has caused uncertainty, but there is emerging evidence to support alternative strategies to conventional fillings, which are minimally invasive and prevention orientated.ObjectivesThe objectives were (1) to assess the clinical effectiveness and cost-effectiveness of three strategies for managing caries in primary teeth and (2) to assess quality of life, dental anxiety, the acceptability and experiences of children, parents and dental professionals, and caries development and/or progression.DesignThis was a multicentre, three-arm parallel-group, participant-randomised controlled trial. Allocation concealment was achieved by use of a centralised web-based randomisation facility hosted by Newcastle Clinical Trials Unit.SettingThis trial was set in primary dental care in Scotland, England and Wales.ParticipantsParticipants were NHS patients aged 3–7 years who were at a high risk of tooth decay and had at least one primary molar tooth with decay into dentine, but no pain/sepsis.InterventionsThree interventions were employed: (1) conventional with best-practice prevention (local anaesthetic, carious tissue removal, filling placement), (2) biological with best-practice prevention (sealing-in decay, selective carious tissue removal and fissure sealants) and (3) best-practice prevention alone (dietary and toothbrushing advice, topical fluoride and fissure sealing of permanent teeth).Main outcome measuresThe clinical effectiveness outcomes were the proportion of children with at least one episode (incidence) and the number of episodes, for each child, of dental pain or dental sepsis or both over the follow-up period. The cost-effectiveness outcomes were the cost per incidence of, and cost per episode of, dental pain and/or dental sepsis avoided over the follow-up period.ResultsA total of 72 dental practices were recruited and 1144 participants were randomised (conventional arm,n = 386; biological arm,n = 381; prevention alone arm,n = 377). Of these, 1058 were included in an intention-to-treat analysis (conventional arm,n = 352; biological arm,n = 352; prevention alone arm,n = 354). The median follow-up time was 33.8 months (interquartile range 23.8–36.7 months). The proportion of children with at least one episode of pain or sepsis or both was 42% (conventional arm), 40% (biological arm) and 45% (prevention alone arm). There was no evidence of a difference in incidence or episodes of pain/sepsis between arms. When comparing the biological arm with the conventional arm, the risk difference was –0.02 (97.5% confidence interval –0.10 to 0.06), which indicates, on average, a 2% reduced risk of dental pain and/or dental sepsis in the biological arm compared with the conventional arm. Comparing the prevention alone arm with the conventional arm, the risk difference was 0.04 (97.5% confidence interval –0.04 to 0.12), which indicates, on average, a 4% increased risk of dental pain and/or dental sepsis in the prevention alone arm compared with the conventional arm. Compared with the conventional arm, there was no evidence of a difference in episodes of pain/sepsis among children in the biological arm (incident rate ratio 0.95, 97.5% confidence interval 0.75 to 1.21, which indicates that there were slightly fewer episodes, on average, in the biological arm than the conventional arm) or in the prevention alone arm (incident rate ratio 1.18, 97.5% confidence interval 0.94 to 1.48, which indicates that there were slightly more episodes in the prevention alone arm than the conventional arm). Over the willingness-to-pay values considered, the probability of the biological treatment approach being considered cost-effective was approximately no higher than 60% to avoid an incidence of dental pain and/or dental sepsis and no higher than 70% to avoid an episode of pain/sepsis.ConclusionsThere was no evidence of an overall difference between the three treatment approaches for experience of, or number of episodes of, dental pain or dental sepsis or both over the follow-up period.Future workRecommendations for future work include exploring barriers to the use of conventional techniques for carious lesion detection and diagnosis (e.g. radiographs) and developing and evaluating suitable techniques and strategies for use in young children in primary care.Trial registrationCurrent Controlled Trials ISRCTN77044005.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 24, No. 1. See the NIHR Journals Library website for further project information.

Background/ hypothesis: Secondary caries has been suggested as the main reason for restoration replacement. We hypothesized that more caries-associated bacteria are found on composite resin restoration material, compared to sound tooth tissue. Methods: Both restored and unrestored dentin and enamel samples were placed in a full denture of eight subjects for 20 weeks. The microbiological composition of approximal plaque and the association between caries-associated bacteria and red autofluorescence of dental plaque was studied. Every 4 weeks the specimens were microradiographed using transversal wavelength independent microradiography (T-WIM). After 1 and 20 weeks red fluorescence pictures and plaque samples were taken. Samples were cultured for total anaerobic counts, mutans streptococci, lactobacilli, candida and Actinomyces odontolyticus. Results: Lesion depth in the dentin and enamel was positively associated with lactobacilli, and lesion depth in dentin was positively associated with A. odontolyticus, whereas no association was found between mutans streptococci and lesion depth. The red-fluorescent bacteria A. odontolyticus and lactobacilli did not correlate with red fluorescent plaque, indicating that red fluorescence is probably not caused by a single species of these bacteria. After 20 weeks, a higher proportion of combined mutans streptococci and lactobacilli was found on restored tissue compared to non-restored tissue (P = 0.04). Conclusion: The higher proportion of caries-associated bacteria on restored tissue indicates that the ecology on the surface of primary lesions differs from that on lesions next to composite, and that secondary caries next to composite may differ from the primary caries process.

Background There is a lack of evidence for effective management of dental caries (decay) in children’s primary (baby) teeth and an apparent failure of conventional dental restorations (fillings) to prevent dental pain and infection for UK children in Primary Care. UK dental schools’ teaching has been based on British Society of Paediatric Dentistry guidance which recommends that caries in primary teeth should be removed and a restoration placed. However, the evidence base for this is limited in volume and quality, and comes from studies conducted in either secondary care or specialist practices. Restorations provided in specialist environments can be effective but the generalisability of this evidence to Primary Care has been questioned. The FiCTION trial addresses the Health Technology Assessment (HTA) Programme’s commissioning brief and research question “What is the clinical and cost effectiveness of restoration caries in primary teeth, compared to no treatment?” It compares conventional restorations with an intermediate treatment strategy based on the biological (sealing-in) management of caries and with no restorations. Methods/Design This is a Primary Care-based multi-centre, three-arm, parallel group, patient-randomised controlled trial. Practitioners are recruiting 1461 children, (3–7 years) with at least one primary molar tooth where caries extends into dentine. Children are randomized and treated according to one of three treatment approaches; conventional caries management with best practice prevention, biological management of caries with best practice prevention or best practice prevention alone. Baseline measures and outcome data (at review/treatment during three year follow-up) are assessed through direct reporting, clinical examination including blinded radiograph assessment, and child/parent questionnaires. The primary outcome measure is the incidence of either pain or infection related to dental caries. Secondary outcomes are; incidence of caries in primary and permanent teeth, patient quality of life, cost-effectiveness, acceptability of treatment strategies to patients and parents and their experiences, and dentists’ preferences. Discussion FiCTION will provide evidence for the most clinically-effective and cost-effective approach to managing caries in children’s primary teeth in Primary Care. This will support general dental practitioners in treatment decision making for child patients to minimize pain and infection in primary teeth. The trial is currently recruiting patients. Trial registration Protocol ID: NCTU: ISRCTN77044005

Cognitive elements play a key role in dental anxiety. Nevertheless, relatively little is known about how dental treatments and frequency of visits to the dentist are related to dental fear and its cognitive antecedents. This study aimed to explore the relationships between dental visits, past treatment experiences, expectations on the aversiveness/probability of negative dental events, and dental fear in children. The participants were 147 children (60% female; mean age=12.0yr) who completed a questionnaire comprising measures of dental treatment-related experience (attendance, fillings, and extractions), perceived aversiveness and probability of dental events, and dental anxiety. Bivariate correlations and multiple linear regression analyses were used to analyze the data. A higher frequency of dental visits was associated with less dental fear and a decreased belief in the probability of negative events occurring during treatment. The type of treatments received was not directly linked to dental fear. However, having received fillings was significantly associated with the perceived probability of negative dental events, whereas extractions were positively associated with these expectations but negatively associated with the perceived aversiveness of possible dental events. Regular dental visits, as well as dental treatments, can influence, in different ways, cognitive elements associated with dental anxiety in children. Refereed/Peer-reviewed

Contains fulltext : 70049.pdf (Publisher’s version ) (Closed access) BACKGROUND/HYPOTHESIS: Secondary caries has been suggested as the main reason for restoration replacement. We hypothesized that more caries-associated bacteria are found on composite resin restoration material, compared to sound tooth tissue. METHODS: Both restored and unrestored dentin and enamel samples were placed in a full denture of eight subjects for 20 weeks. The microbiological composition of approximal plaque and the association between caries-associated bacteria and red autofluorescence of dental plaque was studied. Every 4 weeks the specimens were microradiographed using transversal wavelength independent microradiography (T-WIM). After 1 and 20 weeks red fluorescence pictures and plaque samples were taken. Samples were cultured for total anaerobic counts, mutans streptococci, lactobacilli, candida and Actinomyces odontolyticus. RESULTS: Lesion depth in the dentin and enamel was positively associated with lactobacilli, and lesion depth in dentin was positively associated with A. odontolyticus, whereas no association was found between mutans streptococci and lesion depth. The red-fluorescent bacteria A. odontolyticus and lactobacilli did not correlate with red-fluorescent plaque, indicating that red fluorescence is probably not caused by a single species of these bacteria. After 20 weeks, a higher proportion of combined mutans streptococci and lactobacilli was found on restored tissue compared to non-restored tissue (P = 0.04). CONCLUSION: The higher proportion of caries-associated bacteria on restored tissue indicates that the ecology on the surface of primary lesions differs from that on lesions next to composite, and that secondary caries next to composite may differ from the primary caries process.