An in vivo comparison of radiographic and clinical examination with separation for assessment of approximal caries in primary teeth.

AIM: To compare in vivo, clinical examination (CE) and bitewing radiographs (BW) for the detection of cavitations and initial approximal lesions in deciduous molars with validation after temporary separation (TS) and direct visual examination (DE) of the approximal surfaces. MATERIALS AND METHODS: Thirty children aged 4 to 8 years without visual cavitations or restorations and with at least one approximal contact. Two calibrated examiners evaluated 355 surfaces of primary molars, which were then validated through TS and DE. RESULTS: Of the 280 surfaces considered sound by CE, 24.6% were cavitated after separation. Comparing BW and DE, it was observed that, when the radiolucency involved the inner half of dentin, 68.4% of lesions were cavitated. The sensitivity and specificity of CE and BW were 0.14 and 0.43, and 0.80 and 0.75, respectively. CONCLUSION: DE identified a greater number of pre-cavitated lesions and cavities. BW were useful for detection of decayed surfaces, but with low specificity for diagnosis of sound surfaces, while detection of sound or decayed approximal areas by means of CE alone was not possible. The combination of methods was effective in obtaining an accurate diagnosis of caries in the primary dentition.

Comparison of microleakage of different margin types around Class V resin restorations in primary teeth.

AIM: This in vitro study compared the effect of a concave with a straight-bevelled cavity margin on the microleakage of Class V composite resin restorations in primary teeth. MATERIALS AND METHODS: Standardised Class V cavity preparations were made in vitro on the buccal (all margins placed in enamel) and on the lingual (margins placed in enamel and cementum) surfaces of 20 sound primary molars. The teeth were randomly assigned to two groups of 10 each: in Group 1, a concave bevel was made with a high-speed No. 04 tungsten carbide bur and in Group 2, a straight bevel was made with a high-speed No. 556 tungsten carbide bur. The teeth were restored incrementally with Adper Single Bond 2 (3M) adhesive and Filtek Z 350 (3M) composite resin. All specimens were subsequently thermocycled and immersed in 50% silver nitrate solution. Microleakage of the restorations was then assessed by silver penetration. A grading scale of 0 to 4 was used as the scoring criterion. RESULTS: At the enamel margins no statistically significant differences were observed between the two groups (p>>0.05). Occlusal walls in enamel, in both groups, exhibited less leakage than the cervical walls in cementum (p<0.01) and Group 1 showed better results than Group 2 in decreasing microleakage at the cementum margins (p <0.05). CONCLUSION: Based on the results, it was concluded that concave-beveled cavity preparations may reduce but did not totally eliminate microleakage at the cementum margins of Class V composite resin restorations in primary teeth.

Retrospective study on the occurrence of primary incisor trauma in preschool children of a low-income area in Brazil.

AIM: The objective of this study was to investigate the occurrence of trauma in primary incisors in a sample of preschool Brazilian children living in a low-income area of Rio de Janeiro, Brazil. METHODS: For the study 527 dental records of a Municipal Children's Hospital were evaluated, and the following related factors were recorded: gender age, tooth affected, type and cause of trauma. Data were tabulated and subjected to statistical analysis (chi-square test). RESULTS: There were no significant differences in the prevalence of injuries among boys and girls. Children 10 to 24 months-old were the most affected (p < 0.05). The maxillary central incisor was the most affected tooth (p < 0.05), with predominance of lateral luxation and concussions (p > 0.05). The most common cause of trauma was associated with child's own-height fall (p < 0.05). CONCLUSION: Based on the results, it was concluded that the high incidence of incisor trauma in deciduous teeth should be viewed with concern, requiring the implementation of health policies aimed primarily at the prevention of such accidents.