-
General Dentistry 2002Literature over the past decade has suggested that dental caries be treated as a curable and preventable infectious disease. The emphasis is placed on early detection... (Review)
Review
Literature over the past decade has suggested that dental caries be treated as a curable and preventable infectious disease. The emphasis is placed on early detection and intervention, including chemical therapies and minimally invasive strategies. There are now new detection technologies commercially available to help detect carious lesions early; however, what seems to be lacking is a clear strategy on how to merge these new technologies in a way consistent with today's changing paradigm of caries management. There is a real danger that these early detection technologies may be used to unnecessarily and overaggressively "drill and fill" using Black's "extension for prevention" preparations. This paper will review the literature and key strategies for caries management and early detection and suggest one way (not necessarily the only way) in which they may be used in harmony. Two relatively new detection technologies (DIAGNOdent and DIFOTI) will be reviewed.
Topics: Anti-Infective Agents, Local; Cariostatic Agents; Chlorhexidine; Coloring Agents; Dental Caries; Dental Caries Susceptibility; Dental Cavity Preparation; Dental Enamel; Dental Fissures; Dental Restoration, Permanent; Disease Progression; Fiber Optic Technology; Fluorescence; Fluorides; Humans; Lasers; Pit and Fissure Sealants; Radiography, Bitewing; Risk Assessment; Root Caries; Technology, Dental; Transillumination
PubMed: 12640848
DOI: No ID Found -
Community Dentistry and Oral... Jun 1988An epidemiological survey of prevalence and severity of dental caries was carried out in an urban population of children in Madagascar. The study population comprised...
An epidemiological survey of prevalence and severity of dental caries was carried out in an urban population of children in Madagascar. The study population comprised 1257 children in the age groups 4-5 yr to 14-15 yr equally distributed by sex. The children were examined according to the recording system for the Danish Child Dental Services. The caries experience in the primary dentition as well as in the permanent dentition was high. For example, among 6-yr-olds a mean number of 11.8 defs and 5.2 deft was observed and 82% of the children were affected by caries in primary teeth. In particular, primary molars in the mandibular and incisors in the maxilla were affected and approximal caries was frequent. Among 12-yr-olds mean DMFS was 4.0 and DMFT 2.4 and 75% of the children had caries in permanent teeth. In permanent teeth caries was located predominantly to mandibular molars and occlusal surfaces. In both dentitions almost all decay was untreated, indicating lack of dental treatment available due to the shortage of dental manpower. The establishment of a child dental service system is a matter of urgency. Dental health education and primary health care should be organized.
Topics: Adolescent; Child; Child, Preschool; DMF Index; Dental Caries; Dental Fissures; Female; Humans; Madagascar; Male; Tooth, Deciduous; Urban Population
PubMed: 3163963
DOI: 10.1111/j.1600-0528.1988.tb00566.x -
Monographs in Oral Science 2000Quantitative light induced fluorescence (QLF) is a nondestructive diagnostic method for the longitudinal assessment of early caries lesions in time. When a tooth becomes... (Comparative Study)
Comparative Study Review
Quantitative light induced fluorescence (QLF) is a nondestructive diagnostic method for the longitudinal assessment of early caries lesions in time. When a tooth becomes carious the fluorescence radiance at the location of the caries lesion decreases. The fluorescence image of enamel with incipient lesions can be digitized and then the fluorescence loss in the lesion can be quantified in comparison to the fluorescence radiance level of sound enamel. Changes in fluorescence radiance and lesion area can be followed in time to measure lesion development. The amount of fluorescence radiance loss is related to the mineral loss in the lesion. The technique can be used in vitro, in situ and in vivo to monitor mineral changes in lesions. Applications of QLF are found in the testing of products designed to inhibit demineralization and promote remineralization of caries. The method has been successfully applied to smooth surfaces as well as occlusal surfaces, but application on approximal lesions is not yet possible.
Topics: Cariostatic Agents; Dental Caries; Dental Enamel; Dental Fissures; Fluorescence; Humans; Image Processing, Computer-Assisted; Light; Longitudinal Studies; Minerals; Tooth Demineralization; Tooth Remineralization
PubMed: 10949838
DOI: 10.1159/000061639 -
Journal of Ayub Medical College,... 2019This study was conducted to compare the adaptation of resin-based sealants with that of Resin modified glass ionome-based sealants in various tooth fissure morphologies. (Comparative Study)
Comparative Study
BACKGROUND
This study was conducted to compare the adaptation of resin-based sealants with that of Resin modified glass ionome-based sealants in various tooth fissure morphologies.
METHODS
It was an in vitro experimental study done at the Dow University and NED University, Karachi, Pakistan. Ten extracted human molars were randomly assigned to two groups, (n=5) each. Fissure sealant material (Resin based sealant or resin modified glass ionomer-based sealant) was applied on the occlusal surface of the tooth according to manufacturer's recommendations. Specimens were thermocycled and then sectioned into three longitudinal parts in the bucco- lingual direction. Specimens were examined using scanning electron microscope for the adaptation of the sealant in the occlusal fissure. Mann-Whitney -U test and Kruskall-Wallis test were applied to compare the adaptability scores of sealant materials in the tooth fissure. Level of significance was kept at 0.05.
RESULTS
There were no significant differences in the adaptability scores among U-shaped (p-value=0.35), V-shaped (p-value=0.89), IK-shaped (p-value=0.52), I-shaped (p-value- =0.41) and Y-shaped (p-value=1.00) fissure patterns. Similarly, there were no significant differences observed between the resin-based sealant (p-value=0.95) versus RMGIC based sealant (p-value=0.63) for the adaptability scores in various tooth fissure morphologies.
CONCLUSIONS
No significant difference was found between resin-based sealants and resin modified glass ionomerbased sealants for the adaptation in various tooth fissure patterns.
Topics: Dental Fissures; Glass Ionomer Cements; Humans; Molar; Pakistan; Pit and Fissure Sealants
PubMed: 31535519
DOI: No ID Found -
The European Journal of Prosthodontics... Mar 1998Field trial data two years after the placement of 278 composite or laminate (sandwich) composite sealant restorations by 14 Community Dental Officers, in patients... (Clinical Trial)
Clinical Trial Comparative Study
Field trial data two years after the placement of 278 composite or laminate (sandwich) composite sealant restorations by 14 Community Dental Officers, in patients ranging in age from 6 to 16 years, in the West of Scotland, is reported. No restorations were lost and in 76% of the restored teeth, fissure sealant was partly retained. The most common sites of loss of sealant were from the buccal fissures of mandibular molars and from the surface of the restoration. Only 5% of the treated teeth showed complete loss of fissure sealant and the authors considered that after 2 years, 90% of restorations were adequate or only required the simple addition of further fissure sealant.
Topics: Adolescent; Chi-Square Distribution; Child; Community Dentistry; Composite Resins; Dental Caries; Dental Fissures; Dental Marginal Adaptation; Dental Restoration Failure; Dental Restoration Wear; Dental Restoration, Permanent; Glass Ionomer Cements; Humans; Pit and Fissure Sealants; Scotland
PubMed: 9680884
DOI: No ID Found -
Lasers in Medical Science May 2010We studied the in vivo validity of dentinal fissure caries diagnosis by visual examination, bitewing radiography, and use of a laser-induced fluorescence device... (Clinical Trial)
Clinical Trial Comparative Study
We studied the in vivo validity of dentinal fissure caries diagnosis by visual examination, bitewing radiography, and use of a laser-induced fluorescence device (DIAGNOdent). A total of 144 and second molars with macroscopically intact occlusal surfaces in 41 Chinese young adults were examined visually, by bitewing radiography, and by DIAGNOdent. Visual examination after pit and fissure opening was used as the reference standard. The sensitivity and specificity of detecting caries that had extended into the dentin were, respectively, 0.89 and 0.44 by visual detection of opacity or discoloration after air drying, 0.13 and 1.00 by bitewing radiography to detect radiolucency extending into the dentin, and 0.70 and 0.84 by DIAGNOdent testing with a cut-off score of 40. Caries detection by a combination of visual examination and DIAGNOdent had a sensitivity of 0.67 and specificity of 0.94. Receiver operating characteristic analysis showed that this combined approach was superior to the other methods.
Topics: Adolescent; Dental Fissures; Female; Fluorescence; Humans; Lasers; Male; Molar; Radiography, Bitewing; Young Adult
PubMed: 19259758
DOI: 10.1007/s10103-009-0655-6 -
Journal of Dental Research Aug 2012To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501... (Comparative Study)
Comparative Study Randomized Controlled Trial
To investigate the effectiveness of topical fluorides in preventing fissure caries, we conducted a randomized controlled trial with parallel groups. In total, 501 children (1,539 molars, 3,078 sites), mean age 9.1 years, who had at least one sound permanent first molar with deep fissures or fissures with signs of early caries were recruited. They were randomly allocated among four groups: (1) resin sealant, single placement; (2) 5% NaF varnish, semi-annual application; (3) 38% silver diamine fluoride (SDF) solution, annual application; and (4) placebo control. Follow-up examinations were conducted every 6 months by a masked examiner. After 24 months, 485 children (97%) were examined. Proportions of pit/fissure sites with dentin caries in the sealant, NaF, SDF, and control groups were 1.6%, 2.4%, 2.2%, and 4.6%, respectively. A multi-level logistic regression analysis accounting for the effects of data clustering and confounding factors showed that fissures in any of the three treatment groups had significantly lower risks of carious cavity development into dentin than did controls (p < 0.05). We concluded that placement of resin sealant, semi-annual application of NaF varnish, and annual application of SDF solution are all effective in preventing pit and fissure caries in permanent molars (ClinicalTrials.gov number CT01446107).
Topics: Acid Etching, Dental; Cariostatic Agents; Child; Composite Resins; Dental Caries; Dental Fissures; Dentin; Female; Fluorides, Topical; Follow-Up Studies; Humans; Male; Molar; Phosphoric Acids; Pit and Fissure Sealants; Placebos; Quaternary Ammonium Compounds; Silver Compounds; Sodium Fluoride; Treatment Outcome
PubMed: 22736448
DOI: 10.1177/0022034512452278 -
American Journal of Dentistry Feb 2005To examine the ultrastructure of bonding to occlusal enamel fissures using phosphoric acid etching in combination with a pit and fissure sealant (Clinpro Sealant), a...
PURPOSE
To examine the ultrastructure of bonding to occlusal enamel fissures using phosphoric acid etching in combination with a pit and fissure sealant (Clinpro Sealant), a total-etch single-bottle adhesive (One-Step) followed by the fissure sealant, and two single-step self-etch adhesives (Adper Prompt and Xeno III) followed by the fissure sealant.
METHODS
Sections of bonded enamel fissures retrieved from specimens bonded in vivo were polished, and rinsed with phosphoric acid to bring surfaces into relief. They were examined, first under non-dehydrated conditions with field emission-environmental SEM, to evaluate the marginal integrity of the bonds. The same specimens were then re-examined under dehydrated conditions with conventional SEM to capture more detailed ultrastructural features. Extent of resin penetration into etched enamel was further evaluated by TEM examination of sections taken from undemineralized unstained bonded specimens. These sections were further examined after HCl demineralization and staining.
RESULTS
All occlusal fissure walls examined were lined with remnant aprismatic enamel. Full penetration of resins into the bottom of the fissures, and gap-free interfaces were not observed in any of the specimens, irrespective of whether total-etch or self-etch adhesives were used with the sealant. Phosphoric acid did not penetrate well into the fissures and although hybridization of the etched aprismatic enamel was observed with or without the use of the total-etch adhesive, etching was inconsistent and gaps were frequently observed. Entrapment of bacteria within the fissure walls was frequently seen. The more aggressive self-etch adhesive Adper Prompt created etching in aprismatic enamel that approached that of phosphoric acid etching. The moderately aggressive self-etch adhesive Xeno III produced 1 mm thick hybrid layers in the aprismatic enamel fissure wall.
Topics: Acid Etching, Dental; Adolescent; Adult; Bicuspid; Bisphenol A-Glycidyl Methacrylate; Composite Resins; Dental Bonding; Dental Enamel; Dental Fissures; Dental Marginal Adaptation; Dental Restoration Failure; Dental Restoration, Permanent; Dentin-Bonding Agents; Humans; Methacrylates; Microscopy, Electron, Scanning; Microscopy, Electron, Transmission; Organophosphates; Pit and Fissure Sealants; Resin Cements
PubMed: 15810478
DOI: No ID Found -
Journal of Dentistry Apr 2014The aim of this in vitro study was to evaluate the penetration of an infiltrant and a sealant, when applied as recommended, into fissure caries lesions. (Comparative Study)
Comparative Study
OBJECTIVES
The aim of this in vitro study was to evaluate the penetration of an infiltrant and a sealant, when applied as recommended, into fissure caries lesions.
METHODS
The fissure systems of extracted human teeth were classified according to the international caries detection and assessment system (ICDAS, codes: 0, 1, 2). Within each ICDAS-code ten teeth were either etched with 37% H3PO4-gel for 60s and subsequently sealed ('Fissure Sealing'; Helioseal; Ivoclar Vivadent) or etched with 15% HCl-gel for 120s and subsequently infiltrated ('Resin Infiltration'; Icon; DMG). Additionally, ten teeth with ICDAS-code 2 were etched with 37% H3PO4-gel for 120s and infiltrated ('Soft-Etch-Infiltration'). Specimens were cut perpendicular to their surfaces, polished, and confocal microscopic images were obtained. Lesion depths (LDmax) and penetration depths (PDmax) were measured and percentage penetration was calculated as PPmax=PDmax/LDmax×100.
RESULTS
Baseline LDmax [median (interquartile range)] for ICDAS-code 2 lesions was 1192 (805-1512)μm. In ICDAS-code 2 lesions PPmax was significantly higher for specimens treated with 'Resin Infiltration' [41 (30-78)%] compared to 'Soft-Etch-Infiltration' [11 (0-21)%] or 'Fissure Sealing' [5 (0-9)%] (p<0.05; Mann-Whitney test). PPmax did not differ significantly between groups in ICDAS-code 0 and 1 lesions (p>0.05).
CONCLUSION
The fissure sealant when applied after etching with H3PO4-gel only penetrates superficially into non-cavitated fissure caries lesions. Penetration of an infiltrant is superior in particular after etching with HCl-gel.
CLINICAL SIGNIFICANCE
Compared with sealing, infiltration of fissure caries lesions leads to more deeply infiltrated lesions, which might in turn result in superior abilities to hamper caries progression.
Topics: Acid Etching, Dental; Composite Resins; Dental Caries; Dental Enamel; Dental Fissures; Fluorescein; Fluorescent Dyes; Humans; Hydrochloric Acid; Materials Testing; Microscopy, Confocal; Phosphoric Acids; Pit and Fissure Sealants; Random Allocation; Resins, Synthetic; Surface Properties
PubMed: 24444600
DOI: 10.1016/j.jdent.2014.01.006 -
Texas Dental Journal Mar 2010There have been both large and small changes in operative dentistry in the last 30 years. Extension for prevention is no longer the mantra. The design features of...
There have been both large and small changes in operative dentistry in the last 30 years. Extension for prevention is no longer the mantra. The design features of amalgam preparations have moved into the smallest preparations possible to gain full access to the carious dentin. The default Class 2 amalgam or resin composite is a slot preparation with no preparation of the occlusal fissures. Class 1 fissure caries once implied the entire fissure system was to be cut out. Now only the known carious portions of the fissure are cut away, the tooth is restored, and the remaining fissures in that tooth are sealed. Resin composite preparations have no depth requirements and saucer shaped boxes are more favorable for lowering shrinkage strains on the bonded walls. Re-mineralization of proximal lesions that can be seen on a radiograph is now a proven successful service for many lesions that are at or just into the dentin by radiographic interpretation. The largest paradigm shift has been in the decision that in vital teeth with normal pulps soft dentin can be left over a vital asymptomatic pulp with every expectation that the direct restoration will be successful long term.
Topics: Adult; Child; Composite Resins; Dental Amalgam; Dental Atraumatic Restorative Treatment; Dental Caries; Dental Cavity Preparation; Dental Fissures; Dental Materials; Dental Restoration, Permanent; Dentistry, Operative; Humans; Pit and Fissure Sealants; Surface Properties; Tooth Remineralization
PubMed: 20391946
DOI: No ID Found