[Non-restorative cavity treatment: from guidelines to the practice]. / Niet-restauratieve caviteitsbehandeling: van richtlijn naar de praktijk.

The new KIMO guidelines 'Oral Health Care for Children' approach caries as a behavioural related disease and unequivocally assign priority to causal caries treatment, emphasising lifestyle and behavioural changes. The 5-step concept of non-restorative caries treatment (NRCT) is recommended as treatment of choice for cavitated dentine lesions in primary dentition. Communicative aspects of NRCT are supported by limited technical interventions, for the purpose of effective oral care. A balance between aetiological and symptomatic treatment is sought for each child individually, in close cooperation with the parents. Technical aspects per tooth range from limited interventions like making cavities accessible for brushing, applying fluoride varnish or SDF, covering the cavity with a layer of glass ionomer cement to treatment like ART restoration or the Hall technique, in cases of necessity. Lifestyle changes lead to sustainable treatment results and enhance the quality of life of the child or young person.

[Neurotoxicity of sedatives and anaesthetics in young children]. / Neurotoxiciteit van sedativa en anesthetica bij jonge kinderen.

Many histological studies, animal experiments and also human studies during the past 30 years have proven that the use of general anaesthesia in young children under the age of four can have a permanent effect on the brain, which is still developing, and can therefore cause learning and/or behaviour problems later in life. This knowledge has to be taken seriously into account in the discussion with parents whether general anaesthesia is really necessary for the treatment of Early Childhood Caries in very young children.

Comparison of proximal contacts of Class II resin composite restorations in vitro.

This study investigated the tightness of the proximal contact when placing posterior resin composite restorations with circumferential and sectional matrix systems in an in vitro model using a special measuring device (Tooth Pressure Meter). A manikin model was used with an artificial first molar in which an MO-preparation was ground, simulating the clinical situation of an amalgam replacement. This preparation was duplicated, resulting in 160 identically prepared teeth. These teeth were divided into 8 groups (n=20). In 2 groups, circumferential matrix bands (flat or contoured) in a Tofflemire retainer were applied. In the remaining 6 groups, 3 different separation rings were combined with 2 types of sectional matrix bands. All the cavities were restored using Clearfil Photo Bond and Clearfil AP-X. The tightness of the proximal contact was measured using the Tooth Pressure Meter. Data were statistically analyzed using SPSS 12. ANOVA was used to find differences in proximal contact tightness between the groups. Tukey tests were used to find differences between the homogeneous subgroups. The use of sectional matrices combined with separation rings resulted in tighter proximal contacts compared to when circumferential systems were used (p<0.001). The use of these devices is therefore recommended when posterior resin composite restorations are placed.

A randomized clinical trial on proximal contacts of posterior composites.

OBJECTIVE: The objective of this study was to investigate clinical changes in proximal contact strength inserting Class II composite resin restorations according to one of three randomly assigned protocols. MATERIALS AND METHODS: Seventy-one Class II restorations (MO/DO) were placed by two calibrated operators. Restorations were randomly assigned to one of three groups: one using a circumferential and two a sectional matrix system with separation rings. Proximal contacts were measured by one independent observer with a Tooth Pressure Meter immediately before treatment, and directly after finishing the restoration. RESULTS: Compared to the situation before treatment groups with a sectional matrix system resulted in a statistical significant stronger mean proximal contact strengths (p<0.05), whereas the use of a circumferential matrix system with hand-instrument resulted in a lower proximal contact strength (p<0.05). CONCLUSION: Class II posterior composite resin restorations placed with a combination of sectional matrices and separation rings resulted in a stronger proximal contact than when a circumferential matrix system was used.