Extensive Carious Lesions Research Articles

Clinical Performance of Composite Resin Restorations of Primary Incisors with Extensive Carious Lesions Retained by Glass Fiber Post or Biological Post.

Intracanal posts enhance the resistance of the restoration to mechanical loads and masticatory forces in primary teeth with extensive carious breakdown. This study was done to investigate the clinical performance of composite resin restoration retained by either glass fiber post or biological post in the restoration of primary anterior teeth with extensive carious lesions. A total of 21 children (with 82 primary anterior teeth) who met the inclusion criteria were involved in the study. The 82 primary maxillary incisors were randomly allocated into two equal groups: groups I (glass fiber post) and II (biological post). All the teeth underwent pulpectomy, followed by glass fiber post or biological post, followed by celluloid strip crown restoration. Clinical analysis of all the teeth in the two groups was performed at 1, 3, 6, 9, and 12 months to assess the success of treatment procedures. Statistical Package for the Social Sciences (SPSS) software version "17" was used for statistical analysis. Pearson's Chi-squared test and Fisher's exact test were utilized to evaluate the success of both treatment procedures. The significance level was predetermined at p < 0.05. At the end of the 12-month follow-up period, 89.4 and 84.2% of composite resin restorations of primary incisors with extensive carious lesions were retained by glass fiber and biological posts, respectively. The intergroup comparison revealed no statistically significant differences pertaining to retention loss, marginal discoloration, and marginal adaptation at all follow-up intervals (p > 0.05). Since biological posts are inexpensive and economical, they may replace the commercial post systems available to pediatric dentists. Jaiswal N, Garg N, Pathivada L, et al. Clinical Performance of Composite Resin Restorations of Primary Incisors with Extensive Carious Lesions Retained by Glass Fiber Post or Biological Post. Int J Clin Pediatr Dent 2023;16(6):850-857.

Prevalence and severity of dental caries using ICDAS in predicting treatment needs in Mexican school-age children.

Evaluate the prevalence and severity of caries in permanent teeth and their association with the treatment needs of 8-12-year-old Mexican schoolchildren. The cross-sectional study was conducted on 1139 8-12-year-old schoolchildren attending two public primary schools in State of Mexico. The study used the International Caries Detection and Assessment System (ICDAS) to examine the prevalence of caries and identify treatment needs in schoolchildren. Other variables considered were age, gender, oral hygiene, dental visits ≤6 months, toothbrushing frequency, and the mother's years of education. A logistic regression model was used to identify the association between independent variables and treatment needs. In all analyses, two-tailed p values ≤ 0.05 were considered statistically significant. The prevalence of caries lesions was 82.1% (82.2% boys vs. 81.9% girls) considering all lesion categories (ICDAS 1-6), while the distribution of the severity of caries was 17.9% (ICDAS 0), 13.9% (ICDAS 1-2), 28.3% (ICDAS 3-4) and 39.9% (ICDAS 5-6). The treatment needs index was 77.3%. The logistic regression model showed that the schoolchildren with moderate (ICDAS 3-4) and extensive carious (ICDAS 5-6) lesions were, respectively, 61% Odds Ratio ((OR) = 1.61; p = 0.036) and 77% (OR = 1.77; p = 0.013) more likely to present treatment needs. Other variables, such as poor oral hygiene (OR = 1.52; p = 0.009), the mother's low level of education (OR = 1.53; p = 0.007), and a lack of dental visits (OR = 1.42; p = 0.030) were associated with dental treatment needs. The results obtained show that the 8-12-year-old Mexican schoolchildren presented a high level of treatment needs for moderate and extensive carious lesions (ICDAS 3-6). These findings reiterate the importance of implementing oral health prevention, promotion, and intervention programs to help protect the oral health of school-age children.

Comparison of three-dimensional printed resin crowns and preformed stainless steel crowns for primary molar restorations: a randomized controlled trial.

The importance of aesthetics in children has increased over time. Therefore, this multicenter randomized clinical trial aimed to analyze and compare three-dimensional (3D)-printed resin crowns (RCs) as a potential alternative to stainless-steel crowns (SSCs) for restoring primary molars with extensive carious lesions. According to the null hypothesis, no statistically significant difference was observed in restoration failure between RC and SSC groups. A total of 56 primary molars after pulp treatment at two dental hospitals were included. After pulp treatment, the teeth were randomly divided into two groups: SSCs (n = 28) and RCs (n = 28). At 1 week and 3, 6 and 12 months, the Quigley-Hein plaque index (QHI), gingival index (GI), occlusal wear, and survival rate were assessed by examination, radiography and alginate impressions. No significant difference in QHI was observed between the two groups. However, the GI at 12 months and occlusal wear in the RC group were significantly higher than those in the SSC group (p < 0.05). The survival rates were 100% in the SSC group and 82.1% in the RC group (p = 0.047). Cracks and discoloration were also observed in the RCs. Within the limitations of this study, 3D-printed RCs are aesthetically superior to SSCs and clinically easy to repair. However, if clinical effectiveness and safety are improved, RCs could potentially become a viable aesthetic alternative in the future.

Restoration of a Vital Tooth With Extensive Crown Destruction Using Glass Fiber and Polyethylene Fiber-reinforced Composite Resin: A Clinical Case.

Conservative restorative dentistry has been evolving in the last 25 years, focusing mainly on the development of direct restorative materials. Resin-based composites remain an excellent conservative alternative for restoration of teeth with extensive caries lesions. Over time, several strategies have been proposed to improve the mechanical properties of these composites so that they can adequately withstand masticatory forces. Glass fiber-reinforced resin-based composites and their use in situations where there is great loss of tooth structure have gained popularity due to their favorable mechanical properties. Combined techniques with polyethylene fibers can further enhance their clinical performance. This study presents a brief review of their most important qualities and potential use in direct restorative procedures. In addition, a clinical case is described where a vital tooth with extensive coronal destruction was restored using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. The reinforcement of both the remaining tooth structure and the restoration with fibers is a valid treatment option since the network structure formed by the fiber reinforcement can increase the longevity of the direct composite restorations. There are few reports in the literature describing the use of a combined technique using polyethylene fibers embedded in glass fiber-reinforced flowable resin under resin-based composite. Thus, clinical follow-up of this case is required.

Evaluation of the Outcome of Modified Open Sandwich Technique and Conventional Composite Resin Restoration: For Managing Class II Cavity of Primary Molars Among 4- 8 years Old Children

Background: Dental caries is the most prevalent disease in humans, especially during early childhood. The restoration of such an extensive carious lesion should be done properly to reestablish their anatomy and hence their masticatory, phonetic, esthetic, and space-maintainer functions in the dental arches. Composite resins are the most commonly used tooth-colored restorative material, but many difficulties occur particularly when used directly in posterior restorations. The objective of the study was to compare the clinical effectiveness of the Modified Open Sandwich Technique and Conventional Composite Resin Restoration for managing class II caries on primary molars. Material &amp; Methods: This was a randomized control trial and was conducted in the Department of Pedodontics, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from October, 2021 to September, 2022. In our study we included 68 patients with proximal dental caries of primary molars with reversible pulpitis. The patients were divided by using random sampling technique into two groups – Group A (The modified open sandwich technique, n=34) and Group B (The conventional composite resin restoration, n=34). Results: In total 68 patients from both the groups completed the study. In our study we found mean±SD of age was 5.37±1.24 years. 76.5% of cases of the modified open sandwich technique restorations were &amp; 82.4% of the conventional composite resin restoration were &lt; 6 years. Mandibular primary molars were 64.7% and 53% for the modified open sandwich technique and conventional composite resin restoration respectively. Conventional composite resin restorations showed 32.4% postoperative sensitivity and the modified open sandwich technique restorations showed 11.8%. After 12 months of follow-up, no secondary caries developed. Good marginal adaptation in 100% of cases were found in the modified open sandwich technique and 88.2% for conventional composite restorations. Conclusion: In our study we found that postoperative sensitivity developed more in conventional composite restorations in comparison to the modified open sandwich technique. Initially marginal adaptation showed better in the modified open sandwich method technique. So, conventional and modified open sandwich composite resin techniques were acceptable for primary molar teeth considering secondary caries and marginal adaptation.

The Oral Health of a Group of 19th Century South Australian Settlers in Relation to Their General Health and Compared with That of Contemporaneous Samples.

The aims of this study are to determine the oral health status of a rare sample of 19th-century migrant settlers to South Australia, how oral conditions may have influenced their general health, and how the oral health of this group compares with contemporaneous samples in Australia, New Zealand, and Britain. Dentitions of 18 adults and 22 subadults were investigated using non-destructive methods (micro-CT, macroscopic, radiographic). Extensive carious lesions were identified in seventeen adults and four subadults, and from this group one subadult and sixteen adults had antemortem tooth loss. Sixteen adults showed evidence of periodontal disease. Enamel hypoplastic (EH) defects were identified in fourteen adults and nine subadults. Many individuals with dental defects also had skeletal signs of comorbidities. South Australian individuals had the same percentage of carious lesions as the British sample (53%), more than other historic Australian samples, but less than a contemporary New Zealand sample. Over 50% of individuals from all the historic cemeteries had EH defects, suggesting systemic health insults during dental development were common during the 19th century. The overall oral health of the South Australian settlers was poor but, in some categories, (tooth wear, periapical abscess, periodontal disease), better than the other historic samples.

OROFACIAL MANIFESTATIONS OF RUSSEL SILVER SYNDROME: CASE REPORT

Silver-Russel syndrome is characterized by delayed intrauterine growth and clinically shows facial asymmetry and developmental and speech delay. The present study reports a clinic case of a Silver-Russel syndrome carrier and confirms the importance of early dental treatment in these patients. This case is a 12-year-old male patient who attended the dental service for patients with special needs. The patient was short and malnourished; had digestive problems and difficulty sucking and swallowing; and shortening of the fifth finger and presented café au lait spots on the dorsal region. Intraoral examination revealed a narrow palate, delayed tooth eruption, extensive caries lesions, and malocclusion. A panoramic x-ray was taken and revealed crown development of teeth 18, 28, 38, and 48; rhizogenesis; physiological root resorption in teeth 55, 65, and 75; and taurodontism in teeth 17, 27, 37, and 47. This patient now is under medical supervision.

Dentists’ Self-evaluated Ability in Diagnosing and Updating About Pulpotomy

This study aimed to self-evaluate the knowledge of different dental professionals' profiles in Brazil on diagnosing and indicating pulpotomy in primary teeth and how these groups updated on this theme. Three groups (G1: professors, G2: specialists, and G3: professionals) answered an online questionnaire containing 20 questions and returned 416 questionnaires. Data were subjected to Chi-square associative tests and t tests, with P < .05. G1 and G2 reported to indicate pulpotomy, highlighting the tendency of these groups towards seeking updates on this subject. All 3 groups used academic materials for updating. However, G2 had a high demand for updates through congresses, whilst G3 had a high demand for updates through social media (Google and Google Scholar). The most cited indication by G1 and G2 was "accidental pulp exposure" and by G3 was "teeth with extensive carious lesions that have involved the pulp with radiographic confirmation." All 3 groups opted for pulpotomy to keep the tooth in the arch. Thus, G1 and G2 are the groups who are more updated on the subject, using mainly academic materials, which can be associated with the fact that such groups indicated pulpotomy in primary teeth. The lower interest in searching about pulpotomy in G3 can be understood as a nonclinical application of the topic for this group. Professionals who work directly with paediatric dentistry (professors or specialists) felt more capable of diagnosing and treating cases of pulpotomy. In addition, most of the professionals used scientifically based sources for getting information and actualisation on the subject of pulp therapies.

Posts in Primary Teeth-Past to Present: A Review of Literature.

ABSTRACTEarly childhood caries is indeed a devastative situation for both patients’ parents and pediatric dentists. The primary goal in treating severe early childhood caries is to restore normal function such as maintenance of mesiodistal and vertical dimension, prevention of alteration of mastication, phonetics (due to premature loss), development of parafunctional habits, and prevention of psychological problems affecting the self-esteem of a child. The restoration of primary dentition with extensive carious lesions is a complex clinical challenge of several dimensions. The severity of this condition in maxillary anterior teeth has prompted the extraction of teeth due to inadequate esthetic treatment options. The only concern with the severely destructed primary incisors is a lack of crown structure, which fails to support and adhere to a composite crown. Clinicians have preferred many restorative modalities for esthetic rehabilitation of badly decayed anterior primary teeth with numerous root canal retentive post and core systems with appropriate techniques to preserve those teeth until they are replaced by permanent teeth. This review highlights the various posts, their indications, principles, ideal properties, and the current concepts on their use in pediatric dentistry.How to cite this articleMartin AG, Shivashakarappa PG, Arumugam S, et al. Posts in Primary Teeth–Past to Present: A Review of Literature. Int J Clin Pediatr Dent 2021;14(5):705–710.

Downregulation of Salivary Proteins, Protective against Dental Caries, in Type 1 Diabetes.

Saliva, an essential oral secretion involved in protecting the oral cavity’s hard and soft tissues, is readily available and straightforward to collect. Recent studies have analyzed the salivary proteome in children and adolescents with extensive carious lesions to identify diagnostic and prognostic biomarkers. The current study aimed to investigate saliva’s diagnostic ability through proteomics to detect the potential differential expression of proteins specific for the occurrence of carious lesions. For this study, we performed bioinformatics and functional analysis of proteomic datasets, previously examined by our group, from samples of adolescents with regulated and unregulated type 1 diabetes, as they compare with healthy controls. Among the differentially expressed proteins relevant to caries pathology, alpha-amylase 2B, beta-defensin 4A, BPI fold containing family B member 2, protein S100-A7, mucin 5B, statherin, salivary proline-rich protein 2, and interleukin 36 gamma were significantly downregulated in poorly-controlled patients compared to healthy subjects. In addition, significant biological pathways (defense response to the bacterium, beta-defensin activity, proline-rich protein activity, oxygen binding, calcium binding, and glycosylation) were deregulated in this comparison, highlighting specific molecular characteristics in the cariogenic process. This analysis contributes to a better understanding of the mechanisms involved in caries vulnerability in adolescents with unregulated diabetes.

Influence of Preparation Design and Restorative Material on Fatigue and Fracture Strength of Restored Maxillary Premolars.

Extensive carious lesions and/or large preexisting restorations possibly contribute to crack formation, ultimately resulting in a fracture that may lead to the loss of a tooth cusp. Hence, preparation design strategy in conjunction with the restorative material selected could be influential in the occurrence of a cuspal fracture. The purpose of this in vitro study was to evaluate the fatigue behavior and fracture strength of maxillary premolars restored with direct composite and indirect ceramic inlays and overlays, with different preparation depths in the presence or absence of cuspal coverage, and analyze their failure types. Sound maxillary premolars (N=90; n=10) were divided into nine groups: group C: control; group DCI3: direct composite inlay 3 mm; group DCI5: direct composite inlay 5 mm; group ICI3: indirect ceramic inlay 3 mm; group ICI5: indirect ceramic inlay 5 mm; group DCO3: direct composite overlay 3 mm; group DCO5: direct composite overlay 5 mm; group ICO3: indirect ceramic overlay 3 mm; group ICO5: indirect ceramic overlay 5 mm. In indirect ceramic, lithium disilicate restoration groups, immediate dentin sealing was applied. After restoration, all specimens were tested in fatigue (1,200,000 cycles, 50 N, 1.7 Hz). Samples were critically appraised, and the specimens without failure were subjected to a load to failure test. Failure types were classified and the data analyzed. Zero failures were observed in the fatigue testing. The following mean load to failure strengths (N) were recorded: group ICO5: 858 N; group DCI3: 829 N; group ICO3: 816 N; group C: 804 N; group ICI3: 681 N; group DCO5: 635 N; group DCI5: 528 N; group DCO3: 507 N; group ICI5: 482 N. Zero interaction was found between design-depth-material (p=0.468). However, significant interactions were found for the design-depth (p=0.012) and design-material (p=0.006). Within restorations at preparation depth of 3 mm, direct composite overlays obtained a significantly lower fracture strength in comparison to indirect ceramic onlays (p=0.013) and direct composite inlays (p=0.028). In restorations at depth 5 mm, significantly higher fracture load values were observed in indirect ceramic overlays compared with the inlays (p=0.018). Indirect ceramic overlays on 3 mm were significantly stronger than the deep inlays in ceramic (p=0.002) and tended to be stronger than the deep direct composite inlays. Severe, nonreparable fractures were observed with preparation depth of 5 mm within ceramic groups. The preparation depth significantly affected the fracture strength of tooth when restored with either composite or ceramic materials. Upon deep cavity preparations, cuspal coverage proved to be beneficial when a glass ceramic was used as the restorative material. Upon shallow cavity preparations, a minimally invasive approach regarding preparation design used in conjunction with a direct composite material was favorable.

Corrección de mordida cruzada posterior vestibular en dentición primaria. Reporte de dos casos clínico

La mordida cruzada posterior vestibular cruzada bucal o mordida en tijera ocurre cuando las cúspides linguales de los molares superiores ocluyen vestibularmente a las fosas centrales de los molares inferiores o cuando las caras palatinas de los dientes superiores están en contacto con las caras vestibulares de los dientes inferiores. Pueden ser funcionales, causadas por inclinación de los molares inferiores hacia lingual o por asimetrías mandibulares. El tratamiento temprano es recomendado para normalizar las relaciones transversales y promover un correcto desarrollo de la oclusión. Se presentan dos casos de mordida cruzada posterior vestibular unilateral en dentición primaria y mixta temprana. Caso 1: paciente masculino de 5 años de edad, presentó lesiones extensas de caries, normoclusión, mordida cruzada posterior vestibular unilateral derecha y fue tratado mediante aparato fijo tipo Bi-Helix con bandas cementadas a los segundos molares primarios. Caso 2: paciente masculino de 5 años de edad, presentó lesiones extensas de caries, normoclusión y mordida cruzada posterior vestibular unilateral Izquierda. Fueron colocadas pistas directas de resina. En ambos casos se logró una relación trasversal satisfactoria, corrigiendo la mordida cruzada vestibular. Conclusión: La mordida cruzada posterior vestibular puede presentarse debido a desviación mandibular por interferencias oclusales y a inclinaciones inapropiadas de los molares primarios. Cuando esta es la etiología, el tratamiento es exitoso al utilizar pistas directas de resina, eliminación de contactos prematuros y expansor inferior tipo Bi-Helix.

Association between dental caries risk indicators and various stages of caries in newly erupted permanent teeth

Background/Aim. Identification of caries risk indicators involved in the disease development is of great importance. The aim of this study was to assess the association between distinctive risk indicators and different stages of caries disease process in children. Methods. The cross-sectional study was conducted on a sample (n = 327) of school children ages 7?11. A questionnaire submitted to parents was used to record the data regarding demographic characteristics, children's dietary habits, oral hygiene habits and oral health behaviors. Caries was assessed using the International Caries Detection and Assessment System (ICDAS) II and subjects were stratified according to the highest and most prevalent caries lesion stage. The data obtained were analyzed using the ?2 or Fisher`s exact test and multinomial logistic regression. Results. Caries lesions were detected in 56.6% of examinees observed in the study. Compared to caries-free subjects, appearance of initial caries lesions was statistically significantly influenced by maternal education level (p = 0.021), paternal occupational status (p = 0.023), toothbrushing frequency (p &lt; 0.001), and caries status of deciduous teeth (p = 0.027). Maternal educational level (p = 0.026), paternal occupational status (p = 0.003), sweets and snacks taking frequency (p = 0.005), toothbrushing frequency (p &lt; 0.001), and fluoridate dentifrice usage (p = 0.027) were associated with moderate caries lesions. Maternal educational level (p &lt; 0.001), sweets and snacks taking frequency (p = 0.022) and toothbrushing frequen-cy (p &lt; 0.001) were associated with extensive caries lesions. Maternal educational level (p = 0.02) and brushing frequency (p &lt; 0.001) were statistically significantly associated with the highest prevalence of initial caries lesions. Maternal educational level (p = 0.025), toothbrushing frequency (p &lt; 0.001) and frequency of dental check-ups (p = 0.016) were statistically significantly associated with the highest prevalence of moderate caries lesions. Conclusion. Parental socioeconomic indicators and children's behavior related to oral health were involved in the changes from caries-free status to different caries stages.

Restorative material choices for extensive carious lesions and hypomineralisation defects in children: a questionnaire survey among Finnish dentists.

This survey assessed Finnish dentists' treatment decisions and choices of restorative materials in selected paediatric dental patient cases, with special emphasis on stainless steel crowns (SSCs). A questionnaire with patient descriptions and tooth photographs was e-mailed to members of Finnish Dental Society (n=3,747). The respondents were asked to choose their preferred treatment in cases describing 1) extensive occlusal carious lesion in a primary molar of a cooperative child; 2) an identical lesion, treated under dental general anaesthesia (DGA); and 3) a symptomatic first permanent molar with enamel hypomineralisation (consistent with Molar-Incisor Hypomineralization, MIH) and post-eruptive breakdown. Only responses from dentist treating children were included (final n=765). The majority (47.3%) would have preferred restoration of the extensive primary tooth caries in a normal setting using resin-modified glassionomer cement, and 4.3% by using SSC. The preference of SSC as treatment choice increased to 25.4% upon implementation of DGA. The majority would treat the symptomatic permanent MIH molar with a resin composite restoration (45.0%), while 10.5% suggested SSC. Compared to general dentists, paediatric dentists had a stronger preference for SSCs. Although the respondents emphasised patient cooperation, but also tooth prognosis and material strength behind their treatment decisions, SSC was an uncommon choice.

Prosthetic Rehabilitation of a Patient with Severe Early Childhood Caries: A Case Report

Early Childhood Caries (ECC) continues to be one of the most common chronic diseases in children throughout the world, exerting a negative impact on quality of life. This condition can cause pain, infection, and tooth loss as well as problems with speaking, chewing, and nutrition. The aetiology of ECC is complex and involves socioeconomic, biological, and behavioural factors. Rehabilitation in very young patients is challenging due to difficulties inherent to the age of the child, which limits cooperation, the extent of tooth decay, and the motivation of family members, especially in patients with the early loss of primary teeth. Therefore, paediatric dentists need to plan and implement individualised approaches on a case-by-case basis. This paper reports a case of a three-year-old boy diagnosed with ECC involving extensive carious lesions, root remnants, and multiple abscesses. The treatment plan involved prosthetic rehabilitation with complete dentures. Regular check ups were important to the functional adaptations and proper hygiene counselling. The child adapted extremely well to the dentures. Improvements in appearance, speech, and chewing function enhanced the child’s self-confidence and assisted in establishing proper dietary patterns.

DENTAL CARE TO PATIENTS WITH RARE CLINICAL FIDINGS OF GOLTZ SYNDROME—CASE REPORT

Goltz syndrome or focal dermal hypoplasia is a rare hereditary genetic disease of the dominant X chromosome. Multisystemic manifestations of a wide phenotypic variety with involvement of the maxillomandibular region are observed. A 6-year-old female patient with the syndrome sought a specialized dental service, presenting as main complaint the need for dental treatment for extensive carious lesions. Physical and intraoral examination showed delayed tooth eruption, agenesis, enamel hypoplasia, and atypical anatomy of the teeth as well as unusual clinical findings of the syndrome, such as abnormal tongue morphology and cleft lip and palate. Occlusal and panoramic radiographies were performed. The care plan began with health promotion, followed by instruction in oral hygiene for parents and children, prophylaxis, topical application of fluoride, restorative treatments, exodontia, and laser therapy. Management techniques such as positive reinforcement, voice control, say-show-making, and awards were used. Currently, the patient is being followed up.

Powikłania w zębach stałych w wyniku dużych zaniedbań w obrębie uzębienia mlecznego u 4-letniego dziecka. Opis przypadku

Extensive carious lesions accompanied by oedema and fistula are one of the reasons for reporting children to dental offices. A 4-year-old girl was reported to a private dental practice for oral sanation. The child required extensive treatment. However, active fistulas in teeth 74, 75, 84, and 85 were the main reason for the appointment. Teeth 74, 75, 84 and 85 were extracted. The parents were informed about orthodontic consequences and recommended regular follow-up visits. The child remained under constant dental and orthodontic monitoring. Two years after extraction of primary mandibular molars, eruptive cysts developed in the region of teeth 84, 85, 74 and 75, followed by eruption of teeth 34 and 44, which showed complete hypoplasia and significant mobility. Demirjian system was used for dental age estimation (evaluation of the level of dental mineralisation based on radiographic images), indicating stage E for first mandibular molars. After orthodontic consultation, a decision was made to extract these teeth.

Optimizing function and esthetics in an adult patient with a complete crossbite

AbstractThis case report describes the treatment of a 32-year-old woman with anterior and bilateral posterior crossbite, skeletal Class II and dental Class III relationship, with the removal of widely decayed teeth. Treatment options included orthognathic surgery, rapid maxillary expansion (RME), and orthodontic treatment associated with implant and prosthesis. The patient opted for nonsurgical treatment, without RME, extraction of the affected teeth by extensive caries lesions, closure of the remaining spaces by dental movement, and single-crown implant prosthesis.

Mechanical performance of a newly developed glass hybrid restorative in the restoration of large MO Class 2 cavities

To evaluate the mechanical properties of a glass hybrid (GH) restorative system (EQUIA Forte/GC) and compare it with a microhybrid composite (G-aenial Posterior/GC) by compressive strength (CS) and fracture resistance (FR) tests. Cylindrical specimens were subjected to a CS test (n = 12). There were about 48 mandibular molars were used for a FR test and divided into four groups: Group 1 (positive control), sound teeth; Group 2 (negative control), extended size Class 2 cavities prepared on the mesial surfaces of teeth; Group 3, extended size Class 2 cavities restored with a composite; and Group 4, extended size Class 2 cavities restored with GH. Specimens were subjected to loading until a fracture occurred. Data were analyzed statistically (α = 0.05). The fracture modes were examined by scanning electron microscope (SEM). The CS values of the composite and GH were 278.20 ± 17.34 MPa and 164.62 ± 25.72 MPa, respectively (P < 0.05). No differences were observed between the FR of restored groups (P > 0.05). The GH exhibited sufficient mechanical properties as a restorative material, and could be preferred for extensive caries lesions on posterior teeth.

Presence of Initial Caries Lesions as a Risk Factor for Caries in Preschool Children: A Cohort Study

The aim of this study was to evaluate the influence of initial noncavitated caries lesions on cavitated caries increment in preschool children. A 2-year cohort study was designed to include the participants of a survey on dental caries performed in 2010. Preschool children (12-59 months old) were examined for dental caries and classified as children with no caries lesions, with only initial lesions, with at least 1 moderate caries lesion, and with extensive lesions. Socioeconomic data were also collected. After 2 years, 466 children were re-examined (follow-up rate of 72.9%) only for cavitated lesions. Association between caries incidence at 2 levels of severity and caries experience and other variables was evaluated using hierarchical Poisson regression analysis. The children with moderate and extensive caries lesions at baseline presented a higher risk of presenting both outcomes than the children with no caries lesions. Nevertheless, the children with only initial lesions had a higher risk of developing at least 1 new cavitated carious lesion, but not for a more severe increment in caries. Subgroup analysis stratified by the children's age showed that the influence of the presence of initial caries lesions on cavitated caries increment was only observed in children aged 12-35 months. In conclusion, although the presence of moderate and extensive lesions at baseline is a significant predictor for cavitated caries increment after 2 years in preschool children at all ages, the presence of only initial caries lesions is also associated, but with less severe caries incidence.