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Caries management strategies for primary molars: 1-yr randomized control trial results.
- Source :
-
Journal of dental research [J Dent Res] 2014 Nov; Vol. 93 (11), pp. 1062-9. Date of Electronic Publication: 2014 Sep 12. - Publication Year :
- 2014
-
Abstract
- Minimal invasive approaches to managing caries, such as partial caries removal techniques, are showing increasing evidence of improved outcomes over the conventional complete caries removal. There is also increasing interest in techniques where no caries is removed. We present the 1-yr results of clinical efficacy for 3 caries management options for occlusoproximal cavitated lesions in primary molars: conventional restorations (CR; complete caries removal and compomer restoration), Hall technique (HT; no caries removal, sealing in with stainless steel crowns), and nonrestorative caries treatment (NRCT; no caries removal, opening up the cavity, teaching brushing and fluoride application). In sum, 169 children (3-8 yr old; mean, 5.56 ± 1.45 yr) were enrolled in this secondary care-based, 3-arm, parallel-group, randomized clinical trial. Treatments were carried out by specialist pediatric dentists or postgraduate trainees. One lesion per child received CR, HT, or NRCT. Outcome measures were clinical failure rates, grouped as minor failure (restoration loss/need for replacement, reversible pulpitis, caries progression, etc.) and major failure (irreversible pulpitis, abscess, etc.). There were 148 children (87.6%) with a minimum follow-up of 11 mo (mean, 12.23 ± 0.98 mo). Twenty teeth were recorded as having at least 1 minor failure: NRCT, n = 8 (5%); CR, n = 11 (7%); HT, n = 1 (1%) (p = .002, 95% CI = 0.001 to 0.003). Only the comparison between NRCT and CR showed no significant difference (p = .79, 95% CI = 0.78 to 0.80). Nine (6%) experienced at least 1 major failure: NRCT, n = 4 (2%); CR, n = 5 (3%); HT, n = 0 (0%) (p = .002, 95% CI = 0.001 to 0.003). Individual comparison of NRCT and CR showed no statistically significant difference in major failures (p = .75, 95% CI = 0.73 to 0.76). Success and failure rates were not significantly affected by pediatric dentists' level of experience (p = .13, 95% CI = 0.12 to 0.14). The HT was significantly more successful clinically than NRCT and CR after 1 yr, while pairwise analyses showed comparable results for treatment success between NRCT and CR (ClinicalTrials.gov NCT01797458).<br /> (© International & American Associations for Dental Research.)
- Subjects :
- Cariostatic Agents therapeutic use
Child
Child, Preschool
Crowns
Dental Cavity Preparation methods
Dental Plaque Index
Dental Restoration Failure
Dental Restoration, Permanent methods
Disease Progression
Fluorides, Topical therapeutic use
Follow-Up Studies
Humans
Oral Hygiene education
Periodontal Abscess etiology
Periodontal Index
Pulpitis etiology
Retreatment
Toothbrushing methods
Treatment Outcome
Dental Caries prevention & control
Molar pathology
Tooth, Deciduous pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1544-0591
- Volume :
- 93
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of dental research
- Publication Type :
- Academic Journal
- Accession number :
- 25216660
- Full Text :
- https://doi.org/10.1177/0022034514550717