Carious Primary Molars Research Articles

A Primary Care Randomized Controlled Trial of Hall and Conventional Restorative Techniques.

To investigate treatment outcomes of different restorative techniques undertaken by dental therapists for primary molar carious lesions in a sample of children in New Zealand primary care. This was a randomized controlled trial with children aged 3 to 8 y in New Zealand's Whanganui region. Children meeting inclusion criteria were randomly allocated to treatment with either the Hall technique (HT), in which a stainless-steel crown (SSC) is placed without any carious tissue removal or tooth preparation, or a non-Hall conventional restorative approach (NHT), including tooth preparation with selective carious tissue removal; this included SSC, amalgam, composite, or glass ionomer cement (GIC) restorations. Restorative outcomes after 12 and 24 mo were categorized as success, minor failure, or major failure. Of the 295 eligible children, 149 and 146 were allocated to the HT and NHT groups, respectively, with a total of 570 carious primary molars treated by 13 dental therapists. The participant follow-up rates at 12 and 24 mo were 95% and 91%. SSCs were the most commonly used restoration in the NHT group (60%), followed by GIC (28%). SSCs were the most successful restorations regardless of whether they were placed with the HT or NHT, with success rates of 89% and 92% at 12 mo and 85% and 86% at 24 mo. In the NHT group, the treatment material was a predictor of minor failure at 12 and 24 mo, with significantly more failures with GICs. SSCs placed by dental therapists are a highly successful restoration for the primary dentition, regardless of whether they are placed with the HT or conventionally. The high failure rate of glass ionomer restorations means that they cannot be recommended for widespread use in New Zealand primary care (Australian New Zealand Clinical Trials Registry, ACTRN12614000844640). The findings of this study can be used by policy makers and clinicians when deciding on which materials and which approach to use to maximize success and to minimize retreatment rates when providing restorative treatment for carious primary molars in children's primary oral health care. Results also suggest that undertaking research in the primary care setting may enhance translation of new knowledge and techniques into clinicians' hands.

Comparison of different diagnostic techniques in detecting smooth surface caries in primary molars using the histological gold standard: An in vitro study.

This in vitro study evaluated the caries status of the smooth surfaces of primary molars using the DIAGNOdent pen, Vistacam iX, and Bitewing radiography as compared to histologic assessment. 68 primary molars were selected, and their mesial or distal caries status were determined using DIAGNOdent pen, Bitewing radiography, and Vistacam iX. To achieve reference standards, the teeth were sectioned and directly assessed by a stereomicroscope. The Mc Nemar test was used to compare the sensitivity, specificity, and accuracy of the methods. The spearman rank correlation coefficient (r) was also determined to compare the extent of caries with histology. The statistical significance level was set at α = 0.05. Regarding D1 as a cut-off point for histological assessments, sensitivity, specificity, and accuracy of DIAGNOdent pen were 82 %, 75 %, and 80 % while the values were 63 %, 100 % and 62 % for bitewing radiography and 56 %, 100 % and 59 % for Vistacam iX. Regarding D3 as a cut-off point for histological analysis; Sensitivity, specificity, and accuracy rates of DIAGNOdent pen were 71 %, 86 % and 80 % while these values were 71 %, 73 % and 72 % for bitewing radiography and 50 %, 78 % and 67 % for Vistacam iX. In conclusion, the DIAGNOdent pen shows the highest performance and accuracy to detect smooth surface caries both at D1 and D3 among the three methods. Although VistaCam iX and bitewing radiography showed better performance at D3 compared to D1, their performances were lower than the DIAGNOdent pen.

Addition of Povidone-Iodine to Fluoride Varnish for Dental Caries: A Randomized Clinical Trial.

Dental caries is the most common chronic childhood disease. Products of metabolism by bacteria populating the tooth surface induce development and progression of cavities. We sought to determine whether a polyvinylpyrrolidone-iodine (PVP-I; povidone-iodine) and NaF topical varnish was superior to one containing only NaF in prevention of new dental caries lesions in a single-center randomized active-controlled trial based on a double-blind, parallel-group design. The site was Pohnpei State, Federated States of Micronesia. The study population was healthy children 49 to 84 mo old who were enrolled in early childhood education: 284 were randomized (1:1 allocation), and 273 were included in year 1 analysis and 262 in year 2. The test varnish contained 10% PVP-I and 5.0% NaF. The comparator contained only 5.0% NaF but was otherwise identical. Varnishes were applied every 3 mo during 2 y. The primary outcome was the surface-level primary molar caries lesion increment (d2-4mfs) at 2 y. Caries lesion increments from baseline to year 1 and year 2 were compared between conditions with log-linear regression, adjusting for age and sex and whether the tooth was sound at baseline (free of caries lesions). At year 1, the caries lesion increment for primary molars sound at baseline was 0.9 surfaces (SD = 1.5) for the test varnish versus 1.8 (SD = 2.2) for the comparator varnish with fluoride alone (adjusted rate ratio, 0.50; 95% CI, 0.31 to 0.81; P = .005). At year 2, the caries lesion increment for primary molars sound at baseline was 2.3 surfaces (SD = 2.8) for the test varnish as compared with 3.3 (SD = 2.7) for the comparator (adjusted rate ratio, 0.74; 95% CI, 0.52 to 1.03; P = .073). Teeth that were already cavitated at baseline did not show a preventive effect. There were no harms. A dental varnish containing PVP-I and NaF is effective in the primary prevention of cavities in the primary dentition (NCT03082196). This study demonstrates that periodic application of a varnish containing NaF and PVP-I is effective in prevention of caries lesions and useful in assessing the potential of combined treatment.

No differences in pain or infection in children with carious primary molars treated with a preventive strategy, a biological strategy, or caries removal and restoration

No differences in pain or infection in children with carious primary molars treated with a preventive strategy, a biological strategy, or caries removal and restoration

A 24-month retrospective study of preformed metal crowns: the Hall technique versus the conventional preparation method.

Conventional and Hall Technique (HT) Preformed Metal Crowns (PMCs) are used for treatment of carious primary molars. The aim was to evaluate the clinical and radiographic success of conventional and HT PMCs in a postgraduate dental setting. A retrospective study using patients' electronic case-notes and radiographic images of carious primary molars treated with either conventional or HT PMCs was conducted to assess clinical and radiographic success/failure. A Kaplan-Meier curve was used to assess PMC survival. 187 PMCs (110 HT and 77 conventional) in 65 children (34 females and 31 males) at 6, 12, 18 and 24months were assessed. At 24months, the success rates of conventional and HT PMCs were 97.6% and 93.5%, respectively. Two HT (perforated/abscessed) and four conventional (abscessed) PMCs failures occurred. There was no significant difference in success/failure (p = 0.362) at 12months, but the HT was more successful at 24months (p = 0.002) with similar survival times for both methods. HT and conventionally placed PMCs, when placed in a postgraduate paediatric dentistry setting, were clinically and radiographically very successful at 6, 12, 18 and 24months post operatively with a slightly higher success of the HT at 24months.

MicroTensile Bond Strength of Glass Ionomer Cement to Silver Fluoride and Potassium Iodide-Treated Carious Primary Dentin.

Purpose: A case control study was performed to investigate the effect of silver diamine fluoride (SDF) and potassium iodide (KI) [Riva Star, SDI] on the microtensile bond strength between glass ionomer cement and carious primary dentin and to evaluate the mode of restoration failure. Methods: Forty carious primary molars were sectioned into halves through the carious lesions and randomly allocated to test and control groups. The test specimens were treated with SDFand KI with concentration of 0.06 gm/ml fluoride ions and the control specimens with deionized water. The samples were stored in artificial saliva for 14 days in normal room temprature, and the dentin surfaces were conditioned and restored with Fuji IX GP Extra. After 24 hours in artificial saliva, the specimens were prepared for microtensile bond strength testing and stressed with tension at 1 mm / minute until failure. Mean bond strengths were compared using the paired t test and the failure mode was recorded. Results: The mean microtensile strength for the test group was 7.4 MPa (±5.1 SD) and 6.3 (±4.6) for the control group (P>0.05). Most common failure mode was the mixed failure in both groups. Conclusion: Silver diamine fluoride and potassium iodide does not adversely affect the bond strength between glass ionomer cement and carious primary dentin in vitro.

Silver Diamine Fluoride in Arresting Dentinal Caries in School Children

Background: In recent years, remineralisation of caries lesions has gained acceptance in the practice ofminimally invasive dentistry and caries arrest treatment is being promoted as a part of basic oral health care.Silver diamine fluoride(SDF) has shown to be effective in arresting active caries in primary teeth. Whether ahigher caries arrest rate can be achieved through more frequent application is unknown, hence in our studywe had sought to explore this aspect. Aim: To evaluate the effectiveness of three different frequencies ofapplication of SDF in arresting active dentinal caries primary teeth.Methodology: 48 children aged 5-8 years were divided into three groups, group 1 who received monthlyapplications of SDF for three months, group 2 who received three monthly applications of SDF for 6 monthsand group 3 received 6 monthly applications. Active caries surfaces were recorded at baseline examinationand SDF was applied. No attempt was made to excavate caries. Active and arrested caries were recorded at6 months and one year for all the groups. Results: Allthree application protocols were effective in arrestingcaries at the end of 6 months and one-year. Inter-group comparison of active caries surfaces showed nostatistically significant differences at the end of 6 months. At one year follow up there were statisticallysignificant differences between the three groups, with caries arrest rate highest in group I, followed by groupII and then group III.Conclusion: Significant caries arrest was seen in all three application protocols of SDF at the end of sixmonths as well as one year follow up. The one monthly application of SDF was most effective in arrestingdentin caries in primary molars of children followed by the three monthly application and the 6 monthlyapplication. Increasing the frequency of application of SDF solution can increase the caries arrest rate.

Hall Technique for Carious Primary Molars: A Review of the Literature.

The high frequency of caries in primary teeth and its inadequate treatment are major public health problems during childhood. Nowadays, the Hall technique is one of the methods used for biological sealing in carious lesions in primary molars. Thus, the bacteria will be sealed from oral environment and the caries will be inactive. The objective of this article was to provide an updated search on the Hall technique description, indication, contraindication, advantages, concerns, success and failure, cost-effectiveness, acceptability, and preference in pediatric dentistry, and to compare the Hall technique with traditional crown preparation and conventional treatment options for carious primary molars. A discussion of the recently published articles on the Hall technique reveals that the Hall technique is considered a promising restorative option with high acceptability and longevity; with low failure rate for managing carious primary molars compared to conventional treatment modalities used in primary care settings. Furthermore, the survival rate of stainless steel crowns (SSCs) is considered high, whether provided using Hall technique or traditional preparation by a pediatric dentist. Thus, the Hall technique can be an effective addition to the clinician’s range of treatment options for carious primary molars. However, it should be chosen in restricted cases.

Prevalence and Pattern of Dental Caries and Their Asssociation with Age and Gender in Preschool Children: An Observational Study.

ContextDental caries is the most common oral disease in preschool children. It is considered to be due to multifactorial etiology, affecting primary molars with various caries patterns.AimThe aim of the study was to determine prevalence and patterns of dental caries in primary molars of preschool children. Prevalence and patterns of dental caries were correlated with age and gender.Settings and designThe study design adopted was analytical observational study.Materials and methodsCaries examination was done using plain mouth mirror, probe, and tweezers with cotton pellets under standardized environment. Children's age was measured in years, and the age in years and months were merged with nearest round off number.Statistical analysis usedObtained data were subjected to statistical analysis using SPSS software. Test for significance was done with the help of Chi-square test.ResultsIn Maxilla, max. rt 2nd molars (p value = 0.036), max rt 1st molars (p value = 0.035), max lt 1st primary molars (0.095), and max lt 2nd primary molars (p value = 0.005) showed significantly different caries patterns at different ages of preschool children, while no significant differences were observed in caries patterns in male and female gender. In mandible, man. lt 2nd primary molars (p value = 0.005), and man. rt 2nd primary molars (p value = 0.004) showed significantly different caries patterns in different ages of preschool children, while Mand. Lt 1st primary molars (p value = 0.389) and Mand. Rt 1st primary molars (p value = 0.272) showed nonsignificant differences in caries patterns with different ages of preschool children. A nonsignificant difference in caries patterns was noted in male and female gender.ConclusionMandibular primary molars were more vulnerable for caries development when compared to maxillary primary molars in preschool children. The number of caries patterns present in mandibular and maxillary primary molars, were as follows: Mn. Rt 1st PM > Mn. 1st Lt PM & max lt 1st PM > max lt 2nd PM and max rt 1st PM > Mn. Rt 2nd PM > Mn. Lt 2nd PM > max rt 2nd PM.How to cite this articleSrivastava VK. Prevalence and Pattern of Dental Caries and Their Asssociation with Age and Gender in Preschool Children: An Observational Study. Int J Clin Pediatr Dent 2020;13(5):442–450.

Use of the Hall technique by specialist paediatric dentists: a global perspective.

Background The Hall technique (HT) is popular with UK paediatric dentists (PDs). Global PDs perception/use of HT is unknown.Aim To investigate global PDs opinions/use of HT.Materials and methods A cross-sectional questionnaire of 26 questions was sent to specialist PDs across the globe.Results Responses of 709 PDs from six continents were obtained. The majority (n = 654, 92.32%) had heard about HT but only 50.6% (n = 358) used it, with wide country variations. Respectively, 37.5%, 31.5% and 31% were neutral, against or supportive of HT when they initially heard about it. Only 17% of HT users said it was always the treatment of choice for non-pulpal asymptomatic carious primary molars (NPACPMs), 62% would take a pre-operative radiograph, 65% would consider using high speed drills before HT, 63% would never consider HT under general anaesthesia, 56% would use HT under N2O sedation. Finally, in a clinical scenario of a NPACPM in a cooperative 6-year-old, 75% of PDs would choose conventional restorative methods over the HT.Conclusion The HT is recognised, but not used, by an outright majority of PDs across the globe. Identifiable barriers such as lack of training, perception as substandard dentistry and perceived lack of evidence reduced its use.

Clinical Comparison of Eggshell Derived Calcium Hydroxyapatite with Dycal® as Indirect Pulp Capping Agents in Primary Molars

Objective: To evaluate and compare the efficacy of eggshell derived calcium hydroxyapatite with Dycal ® as indirect pulp capping material in primary molars. Material and Methods: A total of 32 carious primary molars from 22 children (6-10-years) were screened, of which 26 primary molars meeting inclusion criteria were selected and equally divided into two groups. At the first appointment, the infected dentin was excavated using a spoon excavator after treating the carious part with Carie-Care™ chemomechanical caries removal agent. After this, eggshell derived calcium hydroxyapatite in Group 1 and Dycal ® in Group 2 were used as liners followed by restoration of the cavity with type IX glass ionomer cement. Clinical assessment for pain and radiographic assessment for measurement of the amount of reparative dentin thickness formation was performed at baseline, 8 weeks and 3 months. The data were subjected to statistical analysis by one-way ANOVA and Kruskal-Wallis tests . Results: Higher mean reparative dentin formation was found in eggshell derived calcium hydroxyapatite group than Dycal ® group at the end of 8 weeks and 3 months and the difference was significant statistically (p<0.001) . Conclusion: Eggshell derived calcium hydroxyapatite seems to be a suitable alternative to Dycal ® (calcium hydroxide) that can be used as a liner for indirect pulp capping in primary molars.

Survival rate of stainless steel crown restorations according to depth of caries in primary molars

The purpose of this retrospective study was to compare outcome of preformed stainless steel crown restorations according to depth of caries in primary molars. The study subjects consisted primary molars having dentin caries extending at least one-fourth of dentin without signs and symptoms of irreversible pulpitis. A total 295 primary molars received preformed stainless steel crown restorations without any base materials were included in this study. Survival rates were compared using a Kaplan-Meier analysis test. There was no significant difference between depth of caries and survival period in primary molars. And also there was no significant difference with or without pulp therapy. The results of this study suggest that neither the amount of caries nor pulp therapy affect the survival period of primary molars significantly. Proper restoration is more important to achieve sealing for stopping caries progression.

Effect of Interproximal Caries in Primary Molars on Clinical Parameters and Levels of Some Biochemical Markers in Gingival Crevicular Fluid.

This study aims to investigate the relationship between dental caries and periodontal health by examining the clinical parameters and levels of some biochemical markers in the gingival crevicular fluid (GCF) of the teeth. In 22 children, 22 maxillary primary canine teeth and a pair of primary molars in a total of 38 quadrants were examined. The control group (C) consisted of children who had at least 1 caries-free primary maxillary canine. The test group (T) consisted of children who had a pair of primary molars where the interproximal contact was lost due to the caries in the same quadrant. Their primary molars were restored with compomer. The teeth were evaluated based on clinical values (plaque index, gingival index, and probing depth) and biochemical values in GCF before (C0, T0) and after a 6-month treatment (C1, T1). While total amounts of interleukin-1 beta and vascular endothelial growth factor in GCF in T0 were significantly higher than in C0 (P < 0.001), osteocalcin was statistically insignificant (P > 0.05). Clinic parameters in T0 were significantly higher than in C0 and T1. Also these parameters in C0 were higher than in C1 (P < 0.01). Clinical and biochemical parameters in GCF in the teeth with interproximal caries might show symptoms of periodontitis.

Success rates of mineral trioxide aggregate, ferric sulfate, and sodium hypochlorite pulpotomies: A prospective 24-month study

Several medicaments have been used as alternatives to formocresol (FC) for pulpotomy in primary molars with deep carious lesions. However, no prospective study has observed and compared the outcomes of different medicaments. The aim of this prospective study was to compare 12- and 24-month success rates among sodium hypochlorite (NaOCl), ferric sulfate (FS), and mineral trioxide aggregate (MTA) pulpotomies performed in primary molars. A total of 108 primary molars in 27 children (18 boys and nine girls) were selected. All subjects exhibited one primary molar indicated for indirect pulp therapy (IPT; control group) and three carious primary molars indicated for pulpotomy with 5% NaOCl, 15.5% FS, and MTA. Clinical and radiographic assessments for determining success rates were performed using established criteria before and at 12 and 24 months after treatment. All data were analyzed using the chi-square test. Clinical treatment success was observed for all teeth during the first 12 months. At 24 months, the clinical and radiographic success rates were both 100% in the control and MTA groups, both 92.6% in the NaOCl group, and 92.6% and 88.9%, respectively, in the FS group. There were no significant differences in the clinical (p=0.328) and radiographic (p=0.164) success rates among the four groups. NaOCl is easily available and less expensive than MTA, and our results suggest that the outcomes of NaOCl pulpotomy and MTA pulpotomy are similar. Therefore, NaOCl may be a practical alternative to FC for pulpotomy in primary molars.

Clinical, Radiographical and Histopathological Evaluation of Amniotic Membrane Allograft Pulpotomy in Primary teeth

Background: A novel dehydrated Human Amniotic Membrane (dHAM) allograft is a placental based scaffold that has been widely used in a verity of medical fields due to its unique regenerative ability in wound healing. Objective: To evaluate clinically, radiographically, and histopathologically the efficacy of dehydrated Human Amniotic Membrane allograf as a pulpotomy agent in primary teeth. Materials and Methods: I- Clinical and radiographical evaluation: This split-mouth, randomized clinical trial was conducted on 40 deeply carious primary molars indicated for pulpotomy. They were selected from 16 healthy children aged 4-8 years. They were randomly allocated into two equal groups (20 molars/each). Group 1: dHAM pulpotomy in one quadrant and Group 2: Formocresol (FC) pulpotomy in the contralateral. All molars were treated with the conventional pulpotomy technique. All patients were recalled for clinical and radiographical evaluation at 3, 6, and 9 months post-treatment. II- Histopathological assessment: A total of 30 healthy lower first primary molars and canines that indicated for serial extraction were selected for histopathological evaluation. The dHAM allograft and formocresol pulpotomies were performed (12 teeth/each group), where the other 6 teeth were used as a control. Six teeth from each experimental group were extracted at post-treatment intervals; one and three months. The samples were prepared for histopathological evaluation. All data were subjected to the exact test. Fisher exact test and Monte Carlo test were also used. The level of significance was set at P 0.05). II-Histopathological results: The overall evaluation at 1-month interval showed better histopathological criteria for dHAM group than FC group, but the difference was only significantly better on the degree of the inflammatory response (p<0.05). Whereas at 3-month interval, the dHAM group displayed significantly better histopathological criteria compared to the FC group (p<0.05). Conclusion: The dHAM allograft with its regenerative, biologic biocompatibility properties and its ability to deliver growth factors has shown successful outcome comparable to gold standard formocresol. Hence, it can be recommended as an alternative promising pulpotomy agent.

Efficacy of 30% silver diamine fluoride compared to atraumatic restorative treatment on dentine caries arrestment in primary molars of preschool children: A 12-months parallel randomized controlled clinical trial

ObjectivesThis clinical trial investigated the efficacy of silver diamine fluoride (SDF) in arresting dentine caries in primary molars of preschoolers. Time required for treatment, adverse effects, parental aesthetic perception, anxiety and oral health related to quality of life (OHRQoL) was evaluated. Materials and methodsChildren, 2–5 years old, with active dentine caries lesions on the occlusal surface of primary molars were randomly allocated to test group (SDF) or control group (atraumatic restorative treatment/ART). The dmf-t/DMF-T and ICDAS indexes determined the presence of caries and activity. The main outcome after 3, 6 and 12-month follow-up was assessed by a blind examiner. The time required to perform the treatments was recorded and a facial image scale was applied to assess anxiety before and after treatment. Adverse events and aesthetic perception were assessed through questions addressed to caregivers; and the OHRQoL through the B-ECOHIS questionnaire. ResultsIn 68 patients that were randomized, the mean number of treated teeth per child was 2.42(1.04) and 2.09(1.18) in the SDF and ART groups (p = 0.074), respectively. The mean difference of arrested lesions between the groups after 12 months was -0,07(0.05; - 0.17-0.30). The time required to treat with SDF was lower than the ART (p < 0.001). There was no difference in the percentage of adverse events + aesthetic perception (p = 0.709), and the change in anxiety (p = 0.155). There was a less impact in OHRQoL after ART treatment, but only when the parents' distress subscale was considered (p = 0.012). ConclusionSDF requires much less chair-time and have similar results as ART in arresting caries lesion, anxiety, adverse effects, aesthetic perception and quality of life.

Evaluation of clinical performance and success of Fuji II and Fuji IX in restoring occlusal caries of primary molars over a one year follow up: A Randomized Clinical Trial

Introduction: Dental practitioners frequently face a notable challenge in selecting an ideal restorative material. Glass ionomer cement (GIC) has been a frequently used material as a substitute to amalgam in restoring primary dentition. Aim of the study: To clinically evaluate GC Fuji II LC (Light-Cured, Resin-Reinforced Glass Ionomer Restorative) and GC Fuji IX GP EXTRA (Packable Glass Ionomer) when used to restore occlusal caries in lower second primary molars. Materials and Methods: Seventy-six molars in 38 children were included in this study. Inclusion criteria included patients; (1) Free from any medical conditions. (2) Aged 5-7 years old. (3) Reported with bilateral restorable decayed second primary molars with simple occlusal decay. (4) Clinically; no signs of irreversible pulpitis. Split-mouth technique was used and a single operator performed all restorations. Examined restorative materials were randomly allocated to either side of the mouth. Cavities were prepared in the utmost conservative manner. Both Fuji II and Fuji IX were prepared according to manufacturers’ instructions. Clinical assessment was performed after 3, 6, 9 and 12 months according to United States Public Health Services (USPHS) evaluation criteria and rating system. Statistical Analyses included Wilcoxon signed-rank test as well as Friedman’s test followed by Dunn’s test. Results: Among the treated 38 subjects; there were18 boys (47.4%) and 20 girls (52.6%). Mean ± standard deviation values for age were 5.7 ± 0.8 years old with a minimum of 5 and a maximum of 7 years old. After 12 months, a statistically significant difference was noted between marginal adaptation, anatomic form, secondary caries and marginal discoloration scores in the two materials. Conclusions: Fuji II and Fuji IX showed comparable marginal adaptation. Fuji II restorations showed better results regarding anatomic form, secondary caries and marginal discoloration when compared to Fuji IX.

Clinical and Radiographic Evaluation of Compomer and Composite used for Restoring Primary Teeth

This study assessed different restorative materials in primary teeth over a one-year period. Sixty carious primary molars were selected from 30 patients; ages 5-10 years. Class I and II cavities were divided into four groups: Group I: 15 Class I cavities were restored with a compomer, Group II: 15 Class I cavities were restored with a resin composite, Group III: 15 Class II cavities were restored with a compomer and Group IV: 15 Class II cavities were restored with a resin composite. Each child had two teeth restored, one with compomer and the other with composite resin as control. Direct clinical and radiographic evaluations were performed by one examiner after 24 hours, 6- and 12-months. Indirect clinical evaluations were performed using a Scanning Electron Microscope after 24 hours and 12-months periodically. Clinical and radiographic evaluations revealed no significant differences between the compomer and resin composite at 6- and 12-months. Indirect clinical evaluation showed good marginal interfaces between the restorations and the tooth structure throughout the evaluation periods. Both materials presented significant clinical and radiographic performances in Class I and II restorations of primary molars after one year.

Management of carious primary molars within the community dental setting in Wales: a retrospective observational study.

Background Tertiary prevention is still an integral part of a child's healthcare. In community dental service (CDS), we aim to try to restore carious primary teeth in young children as a means of caries control.Aim To assess the survival rates of individual carious primary molars within CDS, based on the type of dental interventions.Design Retrospective observational study.Methods Fifty patients' notes were reviewed, and patients were selected using a defined protocol. The Kaplan-Meier method was used to estimate the survival curves.Results Out of 251 teeth, the estimated survival rates of teeth restored with stainless steel crowns (SSC) was the highest at 46.7 months, GIC-restored teeth at 45.8 months and unrestored teeth at 18.2 months. There was no correlation seen between the survival rates and the number of further interventions required. The difference between the survival rates of teeth restored with GIC, SSC and unrestored was statistically significant (p <0.05). There was minimal use of SSCs within this sample.Conclusion Our present findings indicate that restored teeth have higher survival rates than unrestored teeth. However, it must be emphasised that restorative treatment may not always be feasible and other factors should be considered in the treatment planning.

Managing cavitated primary molar caries lesions

Managing cavitated primary molar caries lesions