Abstract
This study aimed to assess the prevalence, extent, and associated factors of underlying dentin shadows (UDS) in the occlusal surfaces of permanent posterior teeth among 12-year-old schoolchildren from southern Brazil. A population-based cross-sectional study that included a representative sample of 1,528 schoolchildren was conducted in Porto Alegre, southern Brazil (participation rate: 83.2%). A questionnaire on sociodemographic characteristics, behavioral habits, and access to dental services was sent to parents/legal guardians of each student selected. Caries examination included the recording of non-cavitated and cavitated lesions, including the presence of UDS, as defined by the ICDAS Group (i.e., a shadow of discolored dentin visible through an apparently intact enamel surface that may or may not show signs of localized breakdown - ICDAS Code 4). The association between predictor variables and UDS prevalence was assessed using survey Poisson regression models. The prevalence of UDS was 6.3% (95%CI = 1.2 -11.3). The mean number of affected teeth among the schoolchildren presenting UDS was 1.51 (95%CI = 1.40 -1.61), ranging from 1 to 6. Type of school (public, PR = 2.23, 95%CI = 1.22 -4.07) and caries experience (DMFT 1-2, PR = 2.41, 95%CI = 1.15 -5.04; DMFT ≥ 3, PR = 3.09, 95%CI = 1.52 -6.27) were significantly associated with UDS prevalence. In conclusion, this population-based cross-sectional study found a low prevalence of UDS in the occlusal surfaces of the permanent posterior teeth of 12-year-old southern Brazilian schoolchildren. Overall caries experience and type of school were associated with UDS in this population.
Highlights
Submitted: May 15, 2020 Accepted for publication: February 2, 2021 Last revision: March 18, 2021Underlying dentin shadows (UDS) appear as a shadow of discolored dentin visible through an apparently intact enamel surface that may or may not show signs of localized breakdown.[1]
According to the International Caries Detection and Assessment System (ICDAS), underlying dentin shadows (UDS) are classified as Code 4
UDS showed an important involvement of the dentin tissue, which affected the middle to the inner third of the dentin thickness.[2,3,4,5]
Summary
Submitted: May 15, 2020 Accepted for publication: February 2, 2021 Last revision: March 18, 2021Underlying dentin shadows (UDS) appear as a shadow of discolored dentin visible through an apparently intact enamel surface that may or may not show signs of localized breakdown.[1]. Two clinical studies by our research group investigated the radiographic pattern of ICDAS 4 lesions in permanent posterior teeth of adolescents and young adults.[6,7] After 956 and 1427 UDS were assessed, most cases of clinically detectable UDS were found to have either no radiolucent image, or an image restricted to the enamel-dentin junction. According to these findings, most cases of UDS would not require restorative treatment
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