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@#Antimicrobial peptides have antibacterial effects on various pathogenic microorganisms, including natural antimicrobial peptides and synthetic antimicrobial peptides. According to the structure of natural antimicrobial peptides, synthetic antimicrobial peptides can be obtained by recombining different functional domains, adjusting the original amino acid sequence, or completely redesigning the peptides from scratch. Antimicrobial peptides can inhibit the growth of various cariogenic microorganisms and the formation of microbial biofilms. They also reduce acid production and acid resistance of microorganisms. Natural antimicrobial peptide genes can be used as genetic susceptibility markers for predicting the development of caries, thus, showing potential applications in the prevention and treatment of dental caries. The instability of natural antimicrobial peptides and the inability to achieve targeted sustained release limit their application in the prevention and treatment of oral caries. Synthetic antimicrobial peptides can enhance their stability and the antibacterial effect. Synthetic antimicrobial peptides can also be polymerized with common oral adhesives to reduce the incidence of microleakage after filling treatment for caries and to prevent the occurrence of secondary caries. The pH-sensitive antimicrobial peptides are slowly released to promote remineralization in the process of caries. However, the safety and biocompatibility of synthetic antimicrobial peptides are worse than those of natural antimicrobial peptides. Moreover, the combined effect of antibacterial peptides and anticaries drugs, such as fluoride, is still uncertain. Therefore, in this paper, we will review the design methods, application and underlying mechanisms of antimicrobial peptides to introduce novel methods and ideas for the prevention and treatment of dental caries.
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@#Glass ionomer cement (GIC) is widely used as a common filling material in dentistry but still exhibits problems with secondary caries and fractures. Thus, the antibacterial and anti-caries performance of GIC needs to be further improved. In recent years, natural antimicrobial components have become more desirable due to their good biological properties and low drug resistance. In this review, the natural antimicrobial ingredients in GIC modification are classified, reviewed and summarized according to the different sources of antimicrobial ingredients. In terms of animal origin, chitosan and casein phosphopeptide-amorphous calcium phosphate exhibit antimicrobial properties without affecting the mechanical properties of materials; propolis and bioactive enzymes have good biocompatibility; in terms of plant origin, polyphenols help improve the antimicrobial and mechanical properties of the material; arginine has a good remineralization effect; and plant essential oils have a certain ion release effect. In terms of microbial origin, antibiotics greatly improve the antibacterial properties of materials; in addition, the combined application of natural antimicrobial ingredients also exhibited excellent performance. Despite these advantages, the optimal addition concentration and biocompatibility in vivo are questions that need to be further explored before clinical applications can be achieved.
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Los cambios en la vida, así como también en el campo de la Odontología, deben ser para mejorar siempre en todos los aspectos posibles. Y muchos de los cambios recientes en la Odontología Restauradora están encaminados a la utilización de materiales estéticos para remplazo de restauraciones metálicas previas, sin generar certeza total de ser mejores opciones. Esto ha generado un marcado incremento en la tendencia a practicar, más enfáticamente, el remplazo de restauraciones previas (AU)
Changes in life, as so in the field of Dentistry, should always be for the improvement on most possible aspects. Many of the recent changes in Restorative Dentistry are focus on the use of cosmetic materials to replace previous metallic restorations, without total certainty of being better options. This has generated a marked increase in the tendency to practice, more emphatically, the replacement of previous restorations (AU)
Subject(s)
Humans , Male , Female , Dental Restoration Failure , Dental Caries/therapy , Dental Materials , Dental Restoration, Permanent , Recurrence , Metal Ceramic Alloys , Esthetics, Dental , Conservative TreatmentABSTRACT
Objective: The purpose of this study was to evaluate the knowledge among dental students at King Khalid University, Jazan University, and Najran University in the kingdom of Saudi Arabia about when to repair or replace defective direct composite restoration. Materials and Methods: A questionnaire-based survey was formulated, pursuing the information about management (repair/replacement) of defective composite restorations and distributed among 200 dental students of three universities in the southern region of the kingdom of Saudi Arabia. The data were collected with the help of an online questionnaire. Data entry and the analysis were done using the statistical software package SPSS version 20.0. It was presented using descriptive statistics in the form of frequencies and percentages for qualitative variables, and range means and standard deviations for age, quantitative variable. Analytic statistics were done using Chi-Square tests (χ2) to test the significant difference between categorical variables. The level of significance, the p-value was 0.01(p<0.01). Results: The decision to choose between composite repair or replacement was influenced by whether this topic was taught to them at various undergraduate levels during Bachelor of Dental Surgery. The reason associated with the decision to repair defective composite restorations, 76% reported as cost-effective followed by Increased longevity (71%), the permanent filling (70%), patient's preference for repair (65%), and least time consuming (50%). 67% participants preferred significantly (p<0.001) repair due to secondary caries in the previously restored tooth with composite, followed by the small surface defect in a composite restoration (65%), risk of pulpal damage significantly (p<0.001) in a defective composite restoration (62.5%) and more invasive and destructive treatment option (35%). More than half of respondents 123 (61.5%) reported that they were not taught about composite repair during the Bachelor of Dental Surgery. Conclusion: It is suggested with the help of our study that didactic and clinical training components regarding composite repair should be seriously included in the teaching curriculum of dental institutions as it is in the best interest of the patient. Dental students should be provided with clinical training on this topic so that they can follow proper decision-making protocols available during repair or replacement of defective resin composite restorations. Other researches in the future can be carried out for refining the guidelines and techniques utilized for composite repair. (AU)
Objetivo: O objetivo deste estudo foi avaliar o conhecimento entre estudantes de odontologia da King Khalid University, Jazan University e Najran University, no reino da Arábia Saudita, sobre quando reparar ou substituir restaurações de resina composta direta defeituosas. Material e Métodos: Foi formulada uma pesquisa baseada em questionário, buscando informações sobre o manejo (reparo / substituição) de restaurações de resina composta e distribuída entre 200 estudantes de odontologia de três universidades da região sul do reino da Arábia Saudita. Os dados foram coletados com o auxílio de um questionário online. A entrada e análise dos dados foram feitas com o software estatístico SPSS versão 20.0. Foi apresentado por meio de estatística descritiva na forma de frequências e percentuais para as variáveis qualitativas, e amplitude de médias e desvios-padrão para a idade, variável quantitativa. A estatística analítica foi feita usando testes de qui-quadrado (χ2) para testar a diferença significativa entre as variáveis categóricas. Ao nível de significância, o valor de p foi de 0,01 (p <0,01). Resultados: A decisão de escolher entre o reparo ou substituição do compósito foi influenciada pelo fato de este tópico ter sido ensinado a eles em vários níveis de graduação durante o Bacharelado em Odontologia. O motivo associado à decisão de reparar restaurações de resina composta defeituosas, 76% relataram como custo-benefício seguido por maior longevidade (71%), restauração definitva (70%), preferência do paciente para reparo (65%) e menos demorado ( 50%). Sessenta e sete por cento dos participantes preferiram o reparo significativamente (p <0,001) devido a cárie secundária no dente previamente restaurado com resina composta, seguido pelo pequeno defeito de superfície em uma restauração composta (65%), risco de dano pulpar significativamente (p <0,001) em um restauração de resina composta com defeito (62,5%) e opção de tratamento mais invasiva e destrutiva (35%). Mais da metade dos entrevistados, 123 (61,5%) relataram que não foram ensinados sobre reparo de resina composta durante o Bacharelado em Odonotlogia. Conclusão: É sugerido com a ajuda de nosso estudo que os componentes do treinamento didático e clínico sobre reparo de resina composta devem ser seriamente incluídos no currículo de ensino de instituições odontológicas, pois é do interesse do paciente. Os estudantes de odontologia devem receber treinamento clínico sobre este tópico para que possam seguir os protocolos de tomada de decisão adequados disponíveis durante o reparo ou substituição de restaurações de resina composta com defeito. Outras pesquisas no futuro podem ser realizadas para refinar as diretrizes e técnicas utilizadas para reparo de resina (AU)
Subject(s)
Humans , Composite Resins , Dental Caries , PolymerizationABSTRACT
@#Dental resin materials have been widely used in the treatment of dental defects. However, the polymerization shrinkage of the resin materials tends to cause microleakage and accumulation of bacterial plaque, which leads to secondary dental caries. Endowing dental resin with antibacterial properties is an important way to solve this problem. Adding antibacterial agents to dental resin is the main method to give it antibacterial properties. Antimicrobial agents are mainly divided into three types: release type, non-release type and mixed type. In terms of antibacterial effects, the selection and addition of antibacterial agents will affect the antibacterial and mechanical properties of dental resin materials; and the long-term antibacterial effect of antimicrobial agents in the oral cavity remains to be verified; as antimicrobial agents or other environmental factors can lead to drug resistance and even dormant persistent bacteria. In recent years, researchers have been committed to improving the antibacterial effect by modifying antibacterial agents. The sustained release of antimicrobial agents via carriers is also the main research direction. This paper reviews the research progress on the antibacterial properties of dental resin materials.
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Objective@#Objective To evaluate the effect of repairing posterior teeth with subgingival defects with onlays after deep margin elevation and to provide a reference for clinical application.@*Methods @#Eighty-six cases of posterior teeth with subgingival defects were treated with resin filling to elevate the subgingival margin to the superior gingival margin and were then restored with onlays of cast porcelain. Patients were followed up at 1 week, 6 months and 12 months. The wear and tear of the restorations, fractures of the restorations, loss of the restorations, marginal closeness, marginal staining, secondary caries and gingival health were examined. Assessment of efficacy with reference to American public health service standards was conducted.@*Results @#One week after the operation, there was no loss of follow-up. Eighty-six cases of onlays had no prosthetic wear, prosthetic fracture, prolapse of the prosthesis, edge adhesion, edge coloration, secondary caries, etc., and the gums were healthy. At 6 months after surgery, 2 patients were lost to follow-up and 4 of the remaining 84 onlays were detached. After re-adhesion, there was no shedding. At 12 months after surgery, 5 cases were lost to follow-up and 81 cases of onlays demonstrated no further prosthetic wear, prosthetic fracture, prolapse of the prosthesis, edge adhesion, edge coloration, secondary caries, etc., and the gums were healthy. The success rate after 12 months of repair was 95.1% (77/81).Conclusion For posterior teeth with a subgingival defect, onlays of cast porcelain have the advantages of a high success rate, co@*Conclusion@# For posterior teeth with a subgingival defect, onlays of cast porcelain have the advantages of a high success rate, convenient clinical operation and no influence on periodontal health to restore posterior teeth after deep margin elevation.
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10.3969/j.issn.2095-4344.2013.25.025
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O objetivo desse estudo foi avaliar a influência da técnica de preparo cavitário e de materiais restauradores contendo flúor na prevenção da secundária. Dentes humanos foram seccionados em 72 blocos e distribuídos em dois grupos. Cavidades com 1,6 mm de diâmetro foram preparadas com pontas diamantadas ou laser de Er:YAG laser (6 Hz, 300 mJ, 47 J.cm elevado a 2). Cada grupo foi dividido em três subgrupos e restaurados com cimento de ionômero de vidro, ionômero de vidro modificado por resina ou uma resina composta. Os espécimes foram termociclados e submetidos a ciclagem de pH. As lesões de cárie artificial foram ranqueadas utilizando uma escala ordinal por inspeção visual. Os testes de Kruskal-Wallis e Dunn (α = 0,05) não demonstraram diferenças no desenvolvimento de lesões entre as cavidades resturadas com o mesmo material e preparadas com pontas diamantadas ou laser de Er:YAG laser. O laser de Er:YAG utilizado para o preparo cavitário com 6 Hz, 300 mJ, 47 J.cm elevado a 2 não demonstrou a habilidade de garantir maior ácido resistência aos preparo.
The objective of this study was to evaluate the influence of the cavity preparation technique and fluoride-containing restorative materials on the prevention of the secondary caries. Human teeth were sectioned into 72 blocks and distributed into 2 groups. Cavities measuring 1.6 mm were performed with diamond burs or Er:YAG laser (6 Hz, 300 mJ, 47 J.cm to the -2 power). Each group was divided into 3 sub-groups, and restored with a glass-ionomer cement, resinmodified glass-ionomer, or composite resin. The specimens were thermal cycled and submitted to pH cycling. Artificial caries were scored using an ordinal scale based on visual inspection. Kruskal-Wallis and Dunn test ((α = 0,05) showed no differences in the caries lesion development between the cavities restored with the same material and prepared with diamond burs or Er:YAG laser. The Er:YAG laser used for cavity preparation used with 6 Hz, 300 mJ, 47 J.cm to the -2 power did not show the ability to guarantee significantly more acid-resistance against acid challenge.
Subject(s)
Statistics, Nonparametric , Composite Resins , Dental Caries , Dental Cavity Preparation , Lasers, Solid-State , Fluorine , Glass Ionomer CementsABSTRACT
This retrospective study evaluated the clinical performance and the reasons for failure of anterior and posterior composite restorations placed by undergraduate dental students over a 3-year period. All cavities were restored using Prime & Bond 2.1 and TPH (Dentsply), according to the manufacturer's indications. One hundred and two patients who had received composite restorations by third and forth year undergraduate students were recalled and examined to analyze the quality of the restorations. The restorations were evaluated using the modified USPHS system. Two hundred and fifty-six composite restorations, 170 in anterior teeth and 86 in posterior teeth, were evaluated. Eighty-five percent of the restorations were considered satisfactory after 3 years. Class II and class IV restorations presented the highest prevalence of failure. Loss of the restoration and deficient marginal adaptation were the main causes of failure. No restoration failed due to secondary caries. Most restorations placed by dental students were considered satisfactory after long-term evaluation. Failure was more prevalent in larger restorations and was not associated with secondary caries.
Este estudo retrospectivo avaliou o comportamento clínico e as razões de falhas de restaurações de resina composta em dentes anteriores e posteriores, realizadas por alunos de graduação em odontologia, após 3 anos de acompanhamento. Cento e dois pacientes que tiveram restaurações de resina composta colocadas por alunos do terceiro ou quarto ano foram rechamados e examinados para analisar a qualidade das restaurações. Todas as cavidades foram restauradas utilizando Prime & Bond 2.1 e TPH (Dentsply), de acordo com as orientações do fabricante. As restaurações foram avaliadas utilizando o sistema USPHS modificado. Duzentas e cinquenta e seis restaurações de resina composta, 170 em dentes anteriores e 86 em posteriores foram avaliadas. Destas restaurações, 85 por cento foram consideradas satisfatórias após 3 anos. Cavidades de classe II e classe IV apresentaram maior prevalência de falhas. Perda de restaurações e adaptação marginal deficiente foram as maiores causas de falhas. Nenhuma restauração falhou em decorrência de cárie secundária. Em conclusão, restaurações de resina composta feitas por estudantes de odontologia foram na sua maioria consideradas satisfatórias após 3 anos. Falhas das restaurações foram mais prevalentes em restaurações maiores e não esteve associada com cárie secundária.
Subject(s)
Adult , Humans , Middle Aged , Young Adult , Dental Restoration Failure , Dental Restoration, Permanent/methods , Dentistry, Operative/education , Education, Dental/methods , Students, Dental , Acetone , Chi-Square Distribution , Composite Resins , Dental Restoration, Permanent/classification , Polymethacrylic Acids , Retrospective StudiesABSTRACT
Background: The importance of tooth sectioning is realized in disasters such as earthquake, airplane crash investigation, terror, micro leakage studies, age estimation etc. The objective of this study was to develop a simple method to make thin sections (approximately 100 mm) from freshly extracted teeth. Methods: One hundred and twenty human premolars recently extracted for orthodontic purpose were used for this study. The teeth were stored in 0.5% chorlaramine for 2 weeks and were not allowed to dry at any stage of the experiment. The teeth were thoroughly washed in distilled water teeth and then were sectioned buccolingually from crown to the root portion. Results: A detailed embedding-cutting-mounting procedure is described. The prepared thin ground sections were then examined under a Polarised light microscope for the enamel and the dentine, as well as the caries lesions can clearly be distinguished. Conclusion: This is an effective and efficient method for preparation of ground sections in which the hard tissue details are preserved.
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Optical coherence tomography (OCT) which was brought into existence in early 90s of 20 century is a noninvasive technique for creating cross-sectional images of transparent or semi-transparent internal biological tissue structure.In recent years applicability research in the field of stomatology has made great progress.The micro structure changes of surface layer of the lesions in oral hard and soft tissues could be detected by this technique,with its unique feature to detect insidious secondary caries beneath dental restorations that couldn't be found by current clinical techniques easily.In this review,secondary caries etiopathogenisis and diagnosis,principle were discussed firstly and then imaging observation of OCT to detect early second caries around dental restoration and monitoring on risk factors inducing secondary caries are reviewed.It indicated that OCT technique has great potential on diagnosis of secondary caries.
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Objetivo: O objetivo deste estudo foi analisar as características de cárie secundária e sua relação com a presença de restaurações com defeitos marginais como gap, degrau negativa (NL, a falta de material restaurador) e degrau positiva (PL, saliência). Materiais e Métodos: Oitenta superfícies proximais de restaurações de resina classe II foram fotografados e analisados utilizando um microscópio estereoscópico (X40). Foi registrada a presença de cáries secundárias externas, gaps, NL, PL e após a remoção de restaurações, a presença de lesão interna. Todos os exames foram realizados em 10 pontos bem definidos. Resultados: A prevalência de cárie secundária e gap foram associados com margem gengival. As restaurações com defeitos marginais (NL e PL) não foram associados a qualquer local específico (vestibular, lingual ou gengival). Observou-se uma relação entre esses defeitos com a prevalência de cárie secundária. A presença da lesão interna foi associada com lesão externa. Embora, em 141 pontos foi observada lesão interna, sem a presença de lesão externa. A maioria destas lesões mostraram envolvimento de esmalte interno. Apenas 8 por cento tinham desmineralização restrito a dentina, que poderia sugerir cárie residuais.
Objective: The aim of this study was to analyze the features of secondary caries and their relationship with the presence of restorations marginal defects as gap, negative ledge (NL, lack of restorative material) and positive ledge (PL, overhang). Materials and methods: Eighty proximal surfaces of Class II resin restorations were photographed and analyzed using a stereomicroscope (X40). It was recorded the presence of external secondary caries, gaps, NL, PL and after the restorations removal, the presence of internal lesion. All the exams were done in 10 welldefined points. Results: The prevalence of secondary caries and gap were associated with gingival margin. The restorations marginal defects (NL and PL) were not associated with any specific location (buccal, lingual or gingival). It was observed a relationship between these defects with secondary caries prevalence (gap: p= 0.004; NL and PL: p= 0.017). This association could be explained by the biofilm accumulation usually observed in the interface tooth surface/ restoration marginal defects. The presence of internal lesion was associated with external lesion. Although, in 141 points was observed internal lesion without the presence of external lesion. The majority of these lesions showed internal enamel involvement. Only 8 percent had demineralization restricted to dentine, which could suggest residual caries. Conclusion: The results of this study showed that secondary caries lesion frequently began externally on the interface tooth/restoration, where diagnose, control and arrestment of the lesions is possible.
Subject(s)
Composite Resins , Dental Caries , Microscopy , Dental Restoration, Permanent/adverse effects , Surface PropertiesABSTRACT
O objetivo deste estudo foi analisar morfologicamente o início da lesão de cárie secundária. Trinta e três superfícies proximais adjacentes a restaurações de resina classe II foram examinadas ao estereomicroscópio (40x) para a presença de carie e gap. Sessenta sítios (39 sadios, 7 com lesões, 14 adjacentes a lesões) foram preparados para exame utilizando microscopia de luz polarizada. As lesões foram observadas em 52,7% dos corte úmidos e 85,0% dos cortes secos. Os cortes secos demonstraram lesões maiores. Analises posteriores foram realizadas nos cortes secos. Cem por cento das secções observadas no estereomicroscópio, 87,2% das lesões hígidas, e 71,4% dos sítios adjacentes a lesões demonstraram áreas desmineralizadas. A análise morfológica indicou que a lesão cariosa inicia na superfície de esmalte externa na interface entre dente e restauração. Dois padrões distintos de desenvolvimento de carie foram observados, relacionados à direção dos prismas de esmalte: (1) a direção dos prismas no esmalte adjacente foi paralela à parede da cavidade (a parte mais profunda da penetração da cárie foi localizada na parede da cavidade), e (2) a direção dos prismas corria na direção apical (a parte mais profunda da penetração da cárie foi obliqua à parede da cavidade). O padrão 1 pode ser confundido por uma parede da lesão. A prevalência de lesões adjacentes às restaurações foi similar em sítios com (85,7%) e sem (84,0%) gaps. Os achados suportam o pressuposto de que o inicio da lesão de cárie secundária in vivo não está relacionado à presença de um gap e segue a direção dos prismas de esmalte.
The aim was to analyze morphologically the initiation of secondary caries lesion. 33 proximal surfaces adjacent to Class II resin restorations were examined by stereomicroscope (x40) for the presence of caries and gap. 60 sites (39 sound, 7 with lesions, 14 adjacent to lesions) were prepared for examination using polarized light microscopy. Lesions were observed in 52.7% of the wet sections and 85.0% of the dried sections. Dried ground sections displayed larger lesions. Further analyses were performed on dried sections. 100% of ground sections from the stereomicroscope carious sites, 87.2% from sound sites, and 71.4% from sites adjacent to lesions displayed demineralized areas. Morphological analysis indicated that caries lesion initiates at the external enamel surface in the interface between tooth and restoration. Two distinct patterns of caries development were observed, related to the direction of enamel rods: (1) the direction of the rods in the adjacent enamel was parallel to the cavity wall (the deepest part of caries penetration was located at the cavity wall), and (2) the direction of the rods ran in the apical direction (the deepest part of caries penetration was oblique to the cavity wall). The pattern 1 could be mistaken for a wall lesion. The prevalence of lesions adjacent to restorations was similar in the sites with (85.7%) and without (84.0%) gaps. The findings support the assumption that secondary caries initiation in vivo is not related to the presence of a gap and follows the direction of the enamel rods.
Subject(s)
Composite Resins , Dental Caries , Histology , Microscopy , Dental Restoration, Permanent/adverse effectsABSTRACT
O objetivo deste estudo foi avaliar o grau de concordância entre Odontopediatras e Clínicos gerais quando ao diagnóstico de cárie secundária e substituição de restaurações em molares decíduos. Para isso, examinaram um quarenta (40) molares decíduos restaurados. Em seguida responderam a um questionário com três perguntas: 1. Em sua opinião existe cárie neste dente? 2. Em sua opinião essa restauração deveria ser substituída? 3. Caso sua resposta seja positiva, qual ou quais os motivos da substituição? O teste Kappa evidenciou um nível de concordância leve 0,14 (p<0,05) entre os Odontopediatras e Clínicos quanto ao diagnóstico de cárie secundária. Quanto a decisão de substituir ou não a restauração e qual o motivo, a concordância foi sofrível 0,28 (p<0,05) e 0,32 (p<0,05), respectivamente. Concluiu-se que entre os Odontopediatras e os Clínicos gerais houve divergência quanto ao diagnóstico e decisão de substituição de restauração; a cárie secundária foi o principal motivo da substituição. Existe a necessidade de estabelecer critérios para o diagnóstico de cárie secundária e substituição de restaurações.
The aim of this study was to evaluate the agreement degree between Pedodontist and General Dentist about the diagnosis of secondary caries and the restoration replacement in primary molars. One group of Pedodontist and another group of general practioners evaluated 40 restored primary molars. In the following stepe each examinator had to answer a questionary, which had three questions: 1. In your opinion, is there caries in this tooth? 2. In your opinion, should this restoration be replaced? 3. If your answer is positive, what are the reasons for the replacement? The Kappa statistics indicated a light level of agreement 0,14 (p<0,05) between Pedodontist and General Practitioners about the diagnosis of secondary caries. About the replacement decision of the restoration and the reason for it, the agreement was critical 0,28 (p<0,05) and 0,32 (p<0,05), respectively. It was concluded that there was divergency about the diagnosis and the replacement decision of restoration among the Pedodontists and Clinical Practitioners; the secondary caries was the main reason for the replacement. There is a need to establish criterials to judge the diagnosis of secondary caries and replace the restorations.
Subject(s)
Dental Caries/diagnosis , Dental Caries , Dental Restoration, PermanentABSTRACT
La caries secundaria también denominada caries recurrente constituye una de las razones principales de reemplazo de las restauraciones. Es una lesión de caries que se localiza adyacente a una restauración, y puede originarse como una lesión externa y /o lesión de pared. El diagnóstico clínico, esta basado en la presencia de pigmentación y brecha marginal, ambos signos no son criterios absolutos para el diagnóstico de caries secundaria. En la siguiente revisión se exponen estudios recientes de la asociación entre caries secundaria con los siguientes aspectos: brecha marginal, pigmentación marginal, dentina afectada y material restaurador.
The secondary or recurrent caries is one of the main reasons for replacement of restorations. The lesion secondary caries occurs at the margin of an existing restoration, and consist of two parts, an outer lesion and/or a wall lesion. The clinical diagnosis, is based on the presence of staining and ditching marginal, both signs are not absolute criteria for the diagnosis of secondary caries. The next literature review presents recent studies of the association between secondary caries to the following: marginal ditching, marginal staining, affected dentin and restorative material.
ABSTRACT
This study determined the validity of marginal ditching and staining as criteria for the diagnosis of secondary caries around amalgam restorations. One hundred and twenty-four Class I amalgam restorations on extracted human teeth were submitted to standardized clinical examinations. A calibrated examiner recorded the presence of ditching in the tooth/restoration interface, the occurrence of bluish-grey staining on the occlusal surface, and their relationship with the presence and severity of secondary carious lesions. Examinations were repeated after 4 days to calculate the intra-examiner reliability. Stereomicroscopic inspection of the serial tooth sections was used as the gold-standard. Six teeth were lost during the study. Of the 118 remaining teeth, 19 (16 percent) showed occlusal bluish-grey staining and 26 showed more than 0.20 mm wide marginal ditches. Of the latter, 14 presented narrow ditches (0.20-0.45 mm), while 12 presented wide ditches (0.45 mm). The evaluation criteria presented low sensitivity and positive predictive values. Positive and negative likelihood ratios showed that the criteria exhibited, indistinctly, the same odds to determine a positive or negative result for a diseased or healthy tooth. It was concluded that marginal ditching and staining were not valid criteria for the diagnosis of secondary caries around occlusal amalgam restorations.
Este estudo determinou a validade de fendas marginais e manchamentos oclusais como critérios para o diagnóstico de cárie adjacente a restaurações de amálgama. Cento e vinte e quatro dentes humanos extraídos, restaurados com amálgama Classe I, foram submetidos a exame clínico em condições padronizadas. Um examinador treinado registrou a presença de fendas na interface dente/restauração, a ocorrência de manchamento cinza-azulado na superfície oclusal e sua relação com a presença e severidade de lesões secundárias de cárie. Os exames foram repetidos após 4 dias para cálculo da confiabilidade intraexaminador. A inspeção de cortes seriados ao estereomicroscópio foi utilizada como padrão-ouro. Seis dentes foram perdidos durante o estudo. Dos 118 restantes, 19 (16 por cento) apresentaram manchamento oclusal cinza/azulado e 26 apresentavam fendas marginais com largura superior a 0,20 mm, sendo que destes 14 tinham fendas estreitas e 12 fendas amplas. Os critérios de avaliação apresentaram valores de sensibilidade e preditivo positivo extremamente baixos, enquanto a razão de verossimilhança positiva e a razão de verossimilhança negativa evidenciaram que os critérios apresentaram a mesma chance de determinar um resultado positivo ou negativo para um dente doente ou hígido, indistintamente. Pode ser concluído que fendas/valamentos e manchamentos oclusais não se mostraram como critérios válidos para determinar presença de cárie adjacente a restaurações de amálgama.
Subject(s)
Humans , Dental Restoration Failure , Dental Amalgam/therapeutic use , Dental Caries Activity Tests/methods , Dental Caries/complications , Dental Leakage/complications , Tooth Discoloration/etiology , Dental Marginal Adaptation , Dental Caries/diagnosis , Dental Caries/therapy , Dental Leakage/diagnosis , Dental Restoration, Permanent/methods , Observer Variation , Odds Ratio , RecurrenceABSTRACT
Objective:To compare the caries removal efficiency of Carisolv with that of drilling in deciduous teeth.Methods:Thirty-two children,aged from 6 to 9 years,with symmetric coronal medium or deep caries in deciduous teeth,were involved in the clinical study.According to a split-mouth design,in each patient,caries tissue was removed by using a round bur on one side,and Carisolv on the other side.After caries removal,the teeth were restored with composite resin.Patients were asked to fill in a postoperative questionnaire,including patient acceptance of technique preference.6 months after operation the restorations were checked.Results:The time(min) for Carisolv caries removal and for drilling method were 4.33?1.25 and 2.58?0.82 respectively(P0.05).Conclusion:Carisolv is a time-consuming technique,but the majority of patients accepte Carisolv because of less pain.Carisolv may have no effect on the incidence of marginal microleakage and secondary caries.
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0.05). Secondary caries were 6.85% and 9.20% in the group of ART, 6.35% and 8.62% in drill +glass ionomer restoration, 16.9% and 21.50% in amalgam restorations, respectively( P