Abstract
BackgroundA recently proposed treatment protocol for dental caries in primary teeth, called Ultra Conservative Treatment (UCT), keeps medium to large cavities open so that children can keep them clean with tooth brushing and fluoride toothpaste. However, carious lesions have been related to malocclusion and decrease of space for the eruption of the permanent successor.MethodsThis cross-sectional study evaluated dental casts of 235 schoolchildren, aged 6–7 years old of six public schools in deprived suburban areas, and with at least two cavitated dentin carious lesions. The casts were grouped according to the location of cavitated dentin lesions into non-proximal cavity (NPC), proximal cavity with buccal or lingual surface contact point to adjacent tooth (PCCP) and proximal cavity without contact to adjacent tooth (PCWC), as well as the absence of primary molars due carious lesions (PMA). The relationship between location of cavitated dentin lesions or absence of primary molars with C+D+E and D+E space was analyzed.ResultsChildren with absence of primary molars exhibited the smallest C+D+E and D+E space in the maxilla (P < 0.001) and mandible (P < 0.001), followed by proximal cavity without buccal or lingual surface contact. No significant difference was observed between NPC and PCCP groups in upper and lower arches.DiscussionPCWC are associated with minor (less than the leeway space) C+D+E and D+E space loss in both arches, and additional space loss is noted when primary molars are prematurely lost. These results may have implications for orthodontic and restorative dental care decisions in children.
Highlights
Efforts to improve global oral health have led to the development of new materials, techniques and oral health protocols for use in communities that suffer from limited access to oral health services (Marcenes et al, 2013; Peres et al, 2010; Yee & Sheiham, 2002)
Ultra Conservative Treatment (UCT) is one such new protocol and it implies restoring small cavities in primary teeth according to the Atraumatic Restorative Treatment (ART) method and cleaning medium-and large-size cavities plaque-free with toothbrush and fluoride toothpaste
All primary molars were grouped according to the possible impact of the condition on tooth migration (Fig. 1): Non-Proximal Cavity (NPC, which included occlusal, buccal and/or lingual cavitated dentin carious lesions and sound teeth), Proximal Cavity with buccal or lingual surface Contact Point to adjacent tooth (PCCP), Proximal Cavity Without Contact to adjacent tooth (PCWC) and Primary Molar Absent (PMA)
Summary
Efforts to improve global oral health have led to the development of new materials, techniques and oral health protocols for use in communities that suffer from limited access to oral health services (Marcenes et al, 2013; Peres et al, 2010; Yee & Sheiham, 2002). One study even identified children with cavitated primary teeth as being less prone to presenting malocclusion in the primary dentition than those that had sound primary teeth (Stahl & Grabowski, 2004), whereas a 6-year longitudinal study suggested that large cavities tend to decrease the space for the erupting premolars (Northway, Wainright & Demirjian, 1984). These contrasting results are partly explained by the different research methods used and the composition of the populations in which the studies were performed. We tested the null hypothesis that there is no difference in C+D+E and D+E spaces in schoolchildren in relation to the status of the proximal surface of posterior primary molars
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