International Dental Federation Research Articles

Comparison of Two Clinical Approaches FDI Vs Cars Visual Criteria for Secondary Caries Evaluation in Permanent Posterior Teeth

Background: Secondary caries arise at the contact of a natural tooth and a prosthetic repair. The present investigation employed two clinical methodologies, namely Caries associated with restoration or sealants (CARS) and the International Dental Federation (FDI), to evaluate and manage secondary caries in permanent posterior teeth. Objective: The goal of this research is to compare the diagnostic efficacy of FDI and CARS visual criteria for assessing secondary caries in permanent posterior teeth, to identify the more reliable and effective clinical approach for improved treatment planning and patient outcomes. Method: This was conducted at the School of Dentistry Pakistan institute of medical sciences Islamabad, after approval from the ethical committee. The sample size is 160 patients. In this study, two clinical criteria being assessed included one representing the FDI system which includes the marginal staining, marginal adaptation, and caries’ recurrence, while another one was Caries associated with restoration or sealants (CARS) based on ICCMS (International Caries Classification and Management System) for evaluation and treatment of secondary caries. Results: A total 650 restorations were assessed, with a mean age of 30.83 years (SD±2.68). While comparing, there was a strong correlation to the presence of caries lesions (Rho=0.64), and for Marginal adaptation, it was (Rho= -0.45), which depicts a weak inverse correlation. There was a moderate correlation between the two criteria (Rho=0.64,) The majority of CARS visual criteria decisions recommended no treatment in comparison to FDI criteria Conclusion: It is concluded that the FDI system is a more aggressive approach, suggesting a higher number of restoration replacements than the CARS which is less invasive. As a result, the method used to assess secondary caries may result in more or less invasive suggestions for treatment.

Prolonged application time effects on universal adhesives in non-carious cervical lesions: An 18-month split mouth randomized clinical trial

ObjectiveThis double-blind, split mouth randomized clinical trial aimed to assess the clinical performance of Clearfil Universal Bond Quick (CBUq) universal adhesive under different application times (no waiting and waiting) compared to Clearfil SE Bond adhesive in non-carious cervical lesions (NCCLs) over 18 months. MethodsOne hundred and eighty-three restorations were distributed randomly into three groups based on the adhesive system and waiting time: CUBq without waiting time (CUBq-NW), CUBq with a 20 s waiting time (CUBq-W), and CSE with a 20 s waiting time. After placement, restorations were evaluated after 18 months using the International Dental Federation (FDI) and United States Public Health Service (USPHS) criteria. Statistical analyses involved Friedman repeated measures analysis of variance and Wilcoxon tests, with a significance level set at 5 %. ResultsOver the 18-month period, no restorations were lost across the tested groups. Marginal adaptation evaluation indicated minor discrepancies in 21 restorations (8 CUBq-NW, 6 CUBq-W, and 7 CSE). There were no significant differences observed among the three groups following the 18-month clinical assessment (p > 0.05). Only two restorations showed marginal discoloration after 18 months (1 CUBq-NW and 1 CSE). ConclusionsThe application of Clearfil Universal Bond Quick using either the "waiting" or "no-waiting" technique exhibited excellent clinical results in NCCLs during the 18-month follow-up period, demonstrating comparable performance to Clearfil SE Bond in all assessed outcomes. Clinical significanceThe findings suggest that the new universal adhesive applied using the no-waiting technique demonstrates promising clinical performance when compared to conventional application methods. Trial registrationClinicalTrials.gov identifer RBR-69p7mpr.

Secondary Caries Detection and Treatment Decision according to Two Criteria and the Impact of a Three-Dimensional Intraoral Scanner on Gap Evaluation

This study aimed to evaluate the in vitro performance in detecting caries around composite restorations in permanent posterior teeth and the impact of treatment decisions of two visual criteria: International Dental Federation (FDI) criteria and the Caries Associated with Restorations and Sealants (CARS) system. The correlation among secondary caries and the presence of gap measured with a three-dimensional (3D) intraoral scanner was also aimed. One hundred sixteen teeth were assessed by a trained and calibrated examiner according to the FDI criteria or CARS system. A second examiner measured the gap on the 3D models using specific software. The reference standard was the histological examination performed by a third examiner blind to the other evaluations. Other 30 extracted permanent teeth were used only to assess the reproducibility of the methods. The same random sample was selected for re-examination by all three methods, and there were 7 days between the examinations. Unweighted and weighted kappa tests were conducted to assess intra-examiner reproducibility. Spearman’s correlation coefficient (Rho) and 95% confidence intervals (95% CI) were calculated between the histological examination and scores obtained with FDI criteria, CARS system, and treatment decisions. Spearman’s correlation between the visual and scanner evaluation with the reference standard was performed. Spearman’s rank correlation analyses were conducted independently between the gap evaluated and measured by the visual inspection with the gap assessed using the scanner. The reproducibility of the visual score systems reached high values. Spearman’s correlation coefficients (Rho; 95% CI) between the following variables versus histology were the FDI presence of caries (0.65; 0.53–0.74); CARS scores (0.65; 0.52–0.74); FDI treatment decision (0.46; 0.31–0.59); and CARS treatment decision (0.62; 0.49–0.72). Rho (95% CI) between histology and the gap assessment by the visual inspection was 0.59 (0.45–0.70), the gap measurement by the visual inspection was 0.49 (0.33–0.62), and the gap measured by the scanner was 0.37 (0.18–0.53). Both visual criteria present similar performance in detecting caries. The correlation among treatment decisions is moderate for the FDI and CARS criteria, and both are moderately correlated with lesion depth, with a slight CARS superiority. However, visual examination presents better performance than the 3D intraoral scanner on gap size assessment.

Accuracy of Two Visual Criteria for the Assessment of Caries around Restorations: A Delayed-Type Cross-Sectional Study

The aim of this study was to compare the performance of two visual criteria used for the detection of caries around restorations in permanent teeth. In this delayed-type cross-sectional study, the study sample was randomly allocated to one of two visual criteria for the assessment of restorations as follows: (a) International Dental Federation (FDI) criteria, considers marginal staining, marginal adaptation, and caries recurrence and (b) Caries Associated with Restorations or Sealants (CARS) criteria, defined by the International Caries Classification and Management System. A calibrated examiner assessed the restorations using two reference standards as follows: (i) for restorations requiring operative interventions (repair/replacement), the restoration was partially or totally removed and the presence or absence of carious tissue was assessed; and (ii) for restorations requiring nonoperative intervention, follow-up for a period of 1 year was recommended to allow identification of the presence of new lesions not detected at baseline. The sensitivity, specificity, area under receiver operating characteristic curve (Az), and accuracy of the criteria were assessed. The study included 305 restorations. The FDI marginal staining parameter had the lowest Az value (Az = 0.501), while similar sensitivity was observed between the CARS (62.0%), FDI presence of caries (65.0%), and FDI marginal adaptation (74.0%) parameters. CARS exhibited the highest specificity (88.3%) and accuracy (85.6%). The CARS criteria exhibited better specificity and accuracy in detecting caries around restorations, followed by the FDI criteria for caries recurrence and marginal adaptation. Considering marginal staining or combining multiple marginal features to assess secondary caries resulted in an increased risk of false-positive outcomes and overtreatment.

Clinical Accuracy of Two Different Criteria for the Detection of Caries Lesions around Restorations in Primary Teeth

This is a delayed-type cross-sectional prospective accuracy study nested in a randomized clinical trial. The aim was to investigate the diagnostic accuracy of two visual criteria for caries lesions detection around restorations in primary teeth: the International Dental Federation (FDI) criteria, considering adaptation, staining, and the presence of caries, and the Caries Associated with Restorations and Sealants (CARS) system. For this, one examiner made the diagnosis and subsequent treatment decision using visual assessment in 163 children (3–10 years old) with both FDI and CARS criteria. The order of criteria used was defined by randomization. The reference standard was composed of two approaches: (1) the presence of carious tissue after restoration removal and (2) the presence of caries lesions after 6 and 12 months of follow-up. Sensitivity, specificity, and accuracy parameters were calculated at the dentin threshold. Poisson multilevel regression analyses were performed to evaluate the association of the diagnostic methods and other explanatory variables with the outcomes. Of the 651 restorations included, 480 were evaluated by the reference standard methods and were analyzed. The CARS system presented higher accuracy (0.721) than those obtained with FDI recurrence of caries (0.702), FDI marginal adaptation (0.700), and FDI marginal staining criteria (0.681). The FDI marginal staining showed the study’s lowest sensitivity (0.280) and accuracy (0.681) values. The specificity values of FDI recurrence of caries and FDI marginal adaptation were lower than the CARS system. Restorations assessed after the follow-up period resulted in lower sensitivity but higher specificity than those replaced after initial evaluation. In conclusion, the CARS system is more accurate in detecting caries around restorations in primary teeth than the FDI system, in general. However, the FDI recurrence of caries and FDI marginal adaptation present similar performance to the CARS system when the dentin threshold is considered. On the other hand, marginal staining is not an accurate parameter to evaluate caries around restorations.

Comparison of two clinical approaches based on visual criteria for secondary caries assessments and treatment decisions in permanent posterior teeth

BackgroundThis cross-sectional study aimed to compare two clinical approaches based on visual criteria for secondary caries assessments and treatment decisions in permanent posterior teeth.MethodsThe two clinical visual criteria tested for the assessments of restored teeth were: FDI criteria—based on the caries presence, marginal adaptation and staining criteria, adapted from the FDI (International Dental Federation) criteria and CARS criteria—"Caries Associated with Restorations or Sealants" (CARS) criteria described by the International Caries Classification and Management System. Adults were randomized according to the criteria. One calibrated examiner assessed the restorations and assigned the treatment according to the criteria. The primary outcome was replacement indication.ResultsA total of 185 patients were included, totalling 718 restorations. The strongest correlation founded between the methods was for the presence of caries lesions (Rho = 0.829). A moderate correlation (Rho = 0.420) was founded between the treatment decisions proposed by the CARS and by the FDI criteria. The multilevel regression analysis showed that the FDI criteria indicated five times more replacements when compared to the CARS (< 0.001). Also, using the FDI criteria restorations were 2.7 times more related to caries around restorations (p < 0.001) compared to the other criterion.ConclusionsThe visual criteria used on the restoration's assessment directly influences the treatment decision to intervene or not on the restoration. The use of a minimally invasive based approach for assessing secondary caries may prevent overtreatment.

The effect of two clinical criteria in the assessment of caries lesions around restorations in children (CARDEC-03): study protocol for a diagnostic randomized clinical trial

Introduction: The detection of caries lesions around restoration can be challenging. Therefore, the use of some criteria has been proposed in order to give more objectivity to the diagnosis process. Two of them are the International Dental Federation (FDI) and the Caries Associated with Restorations and Sealants (CARS) criteria. Both methods have a different approach to caries, and it is not possible to know which one of them is the best to use in clinical practice to assess restorations in children. Thus, the present protocol aims to evaluate the effect of the use of the FDI and CARS criteria in the assessment of caries lesions around restorations in primary teeth on outcomes related to oral health in children and costs resulting from the assessments. Methods and analysis: A total of 626 restorations of children from three to 10 years were randomly assessed and are being treated following the FDI criteria (FDI group) or CARS criteria (CARS group). Participants will be followed-up after six, 12, 18, and 24 months. The primary outcome will be the need for a new intervention in the evaluated restorations. This outcome consists of several components, and each of these events will be analyzed separately as secondary outcomes. The changes in children’s oral health-related quality of life and the cost of the restoration dental treatments will also be analyzed as secondary outcomes. The methods will be compared using the Cox regression model with shared frailty. A significance level of 5% will be adopted for all statistical analyses. Discussion: This will be the first randomized clinical study carried out regarding the detection of caries lesions around restorations in primary teeth. Trial registration: The study underwent registration in Clinicaltrials.gov (NCT03520309) on 9 May 2018.

The effect of two clinical criteria in the assessment of caries lesions around restorations in children (CARDEC-03): study protocol for a diagnostic randomized clinical trial

Introduction: The detection of caries lesions around restoration can be challenging. Therefore, the use of some criteria has been proposed in order to give more objectivity to the diagnosis process. Two of them are the International Dental Federation (FDI) and the Caries Associated with Restorations and Sealants (CARS) criteria. Both methods have a different approach to caries, and it is not possible to know which one of them is the best to use in clinical practice to assess restorations in children. Thus, the present protocol aims to evaluate the effect of the use of the FDI and CARS criteria in the assessment of caries lesions around restorations in primary teeth on outcomes related to oral health in children and costs resulting from the assessments. Methods and analysis: A total of 626 restorations of children from three to 10 years were randomly assessed and are being treated following the FDI criteria (FDI group) or CARS criteria (CARS group). Participants will be followed-up after six, 12, 18, and 24 months. The primary outcome will be the need for a new intervention in the evaluated restorations. This outcome consists of several components, and each of these events will be analyzed separately as secondary outcomes. The changes in children’s oral health-related quality of life and the cost of the restoration dental treatments will also be analyzed as secondary outcomes. The methods will be compared using the Cox regression model with shared frailty. A significance level of 5% will be adopted for all statistical analyses. Discussion: This will be the first randomized clinical study carried out regarding the detection of caries lesions around restorations in primary teeth. Trial registration: The study underwent registration in Clinicaltrials.gov (NCT03520309) on 9 May 2018.

The effect of two clinical criteria in the assessment of caries lesions around restorations in children (CARDEC-03): study protocol for a diagnostic randomized clinical trial

Introduction: The detection of caries lesions around restoration can be challenging. Therefore, the use of some criteria has been proposed in order to give more objectivity to the diagnosis process. Two of them are the International Dental Federation (FDI) and the Caries Associated with Restorations and Sealants (CARS) criteria. Both methods have a different approach to caries, and it is not possible to know which one of them is the best to use in clinical practice to assess restorations in children. Thus, the present protocol aims to evaluate the effect of the use of the FDI and CARS criteria in the assessment of caries lesions around restorations in primary teeth on outcomes related to oral health in children and costs resulting from the assessments. Methods and analysis: A total of 626 restorations of children from three to 10 years were randomly assessed and are being treated following the FDI criteria (FDI group) or CARS criteria (CARS group). Participants will be followed-up after six, 12, 18, and 24 months. The primary outcome will be the need for a new intervention in the evaluated restorations. This outcome consists of several components, and each of these events will be analyzed separately as secondary outcomes. The changes in children’s oral health-related quality of life and the cost of the restoration dental treatments will also be analyzed as secondary outcomes. The methods will be compared using the Cox regression model with shared frailty. A significance level of 5% will be adopted for all statistical analyses. Discussion: This will be the first randomized clinical study carried out regarding the detection of caries lesions around restorations in primary teeth. Trial registration: The study underwent registration in Clinicaltrials.gov ( NCT03520309) on 9 May 2018.

'Oral health matters': it is time for a culture change in dentistry.

This opinion is borne out of my involvement in and experience with colleagues at the International Association for Dental Research (IADR), the International Dental Federation (FDI) and the World Health Organisation (WHO), and seeks to provide a strong rationale for the dental profession embracing the advantages of a primary preventive agenda. Five key actions are used to emphasise our role in health and wellbeing, addressing inequalities, engaging more with other healthcare colleagues, being trans-sectoral (beyond health) in our approach and being prepared to embrace change. The thrust of the argument is that dentistry has been significantly undervalued in the healthcare field in the past, and can play a unique and leading role in future health and wellbeing through primary prevention.

Factors related to high dental caries experience in Palestinian pregnant women in the Jerusalem governorate: a cross-sectional study

BackgroundBeliefs about oral health during pregnancy demographic factors, such as level of education and socioeconomic status, are associated with an increased risk of oral diseases during pregnancy. The aim of this study was to assess the oral health status of pregnant women and the relation to the women's oral health knowledge, beliefs, behaviour, and access to dental care. MethodsFor this cross-sectional study, pregnant women visiting pre-natal care clinics at the Palestinian Ministry of Health centres in the Jerusalem governorate were invited to complete a structured interview with questions about beliefs about oral health care and their oral hygiene practices. Screening for oral health conditions was done using the Decayed, Missed and Filled Teeth (DMFT) index to assess the women's dental caries experience, and gingival health indices (plaque, gingival, and calculus) were measured to assess gingival health. Ethical approval was obtained from Al-Quds University Ethics Committee. Findings152 pregnant women agreed to participate in this study. Participants had a mean DMFT score of 15·5 (SD 4·5). Bivariate analysis showed that women who had completed a degree after high school had a lower DMFT score than women who did not (F=4; p=0·024). Women who had visited a dentist in the past 6 months had a higher DMFT score than women who had never visited a dentist (F=2·4, p=0·05). Additionally, women who believed they could lose a tooth just because they are pregnant scored high DMFT scores (t=–4; p=0·037). Results of the multivariable analysis showed that age, level of education, recent dental visit, and the belief that it is unsafe to get routine dental care during pregnancy explained 25% of the variation in the DMFT score. InterpretationWomen in this study had high prevalence of dental disease and knew little about dental care during pregnancy. Faulty beliefs about oral health care and barriers to dental care were major factors in the high prevalence of the disease. FundingThis project was partially funded by 2016 International Dental Federation FDI SMILE Award.

Prevalence of developmental defects of the enamel in primary dentition in a bogotan population

To determine in an area with systemic fluoridation, the prevalence of development of enamel defects in children's primary teeth between 4-6 years old from a public school in Bogota, Colombia. A simple random sample was conducted in 153 students, obtaining 62 healthy children, detailed dental clinical assesment were performed in them. The examiner was calibrated by an expert in the modified index of Dental Enamel Defects from the International Dental Federation obtaining a kappa inter-examiner and intra-examiner measures of 0.9 and 0.8, respectively. An informed consent and approval of the study by the Ethical Committee of the School of Dentistry at the Universidad Nacional de Colombia were obtained. The prevalence of dental enamel defects was 74.2 % (62.1 - 83.4) 95 % CI, distributed in: demarcated opacities 86.9 % (74.3-93.3) 95 % CI, diffuse opacities 76.1 % (62.4-85.7) 95 % CI and hypoplasia 2.2 % (0.4-11.1) 95 % CI. The most frequent combination of defects in an individual was demarcated and diffuse opacities. The most affected maxilla was the superior 54.6 % and the most compromised teeth were the second molar 56 %. The average teeth affected with dental enamel defects per individual was 4.7 ± SD 2.6. The high prevalence of dental enamel defects found, despite low severity, suggests more attention of the health authorities leading preventive programs. More studies should be done with standardized methodologies in order to estimate the overall prevalence of the defects.

Teaching Atraumatic Restorative Treatment in U.S. Dental Schools: A Survey of Predoctoral Pediatric Dentistry Program Directors

The International Dental Federation and World Health Organization have promoted the use of Atraumatic Restorative Treatment (ART) in modern clinical settings worldwide. In the United States, the practice of ART is not believed to be widely used, which may be a result of little attention given to ART training in predoctoral pediatric dentistry curricula in U.S. dental schools. This study investigated the extent of clinical and didactic instruction on ART provided in U.S. dental schools by surveying the predoctoral pediatric dentistry programs in 2010. Of the fifty-seven directors asked to complete the survey, forty-four responded for a response rate of 77 percent. Of these forty-four programs, 66 percent reported providing clinical training on ART, though only 14 percent provide this training often or very often. The types of ART training provided often or very often included interim treatment (18 percent) and single-surface cavities (14 percent) in primary teeth. However, ART was said to be rarely taught as a definitive treatment in permanent teeth (2 percent). Attitude was a major predictor, for clinical training provided and using professional guidelines in treatment decisions were associated with a positive attitude towards ART. These predoctoral pediatric dentistry programs used ART mainly in primary, anterior, and single-surface cavities and as interim treatment. As ART increases access of children to dental care, the incorporation of the ART approach into the curricula of U.S. dental schools should be facilitated by professional organizations.

Topographical presentation of dental wear as arches in a French mediaeval population

The diversity of notation systems for recording dental characteristics and the means used to display them makes comparisons and interdisciplinary collaboration difficult. ObjectiveThe aim of the present study is to propose the use of a method employed by experts worldwide but which may be new to bioarchaeologists. Since 1971 we have used the International Dental Federation (FDI) system, which provides the location of dental characteristics and the morphotype of each tooth at the same time, thus avoiding the need to specify upper or lower, and right or left to state the tooth position in the dental arch. DesignTo demonstrate the use of the FDI system, we applied it to the study of dental wear in a mediaeval Mediterranean skeletal sample from France consisting of 58 paired mandibles and maxillae belonging to 29 female and 29 male adults and divided into two age groups: young or aged 20–30 years, and mature or aged over 30 years. Tooth wear was recorded according to Brabant's index, which consists of four levels and four directions. Data were displayed in the form of curves, according to the FDI and taking age and sex into account. ResultsAnalysis of the results shows a tooth wear distribution that is significantly different between upper and lower horizontal and oblique directions in females and males, and between upper and lower horizontal and oblique heavy wear in females and males. Moreover, a significantly asymmetrical horizontal and oblique distribution of wear was found in the young adult group. Thus, the use of criteria defined by precise reference points for recording data, and displaying results in the form of curves, makes comparison using superimposition easy and reliable and permits a more objective study of tooth wear. ConclusionsFurthermore, using a notation system that is employed worldwide helps to build multidisciplinary projects, and offers the possibility of comparing large amounts of data easily, which should provide enhanced data for bioarchaeology in the future.

P1-367 Adolescent`s oral health: odontological needs raised by community health agents

IntroductionEpidemiological data are essential for the development of public policies aiming at health promotion and prevention of risk situations, including those that compromise oral health.ObjectiveTo present epidemiological data on adolescents'...

Necesidades de tratamiento periodontal en adultos de la región rural Mixteca del Estado de Puebla, México

This study was aimed at determining periodontal treatment needs, as determined by the Community Periodontal Index of Treatment Need (CPITN), in a sample of adults from the Mixteca region of the State of Puebla, in Mexico. This was a descriptive, cross-sectional, single-centre study. Previous informed consent was obtained; 60.0 % of the sample were women whose main activity was housework (46 %), 14.0 % were farmers. Average age was 37.6 ± 13.6. Gingival and Community Periodontal Index of Treatment Need proposed by the World Health Organisation and the International Dental Federation were used; they were implemented by the same, previously-standardised researcher. Means, standard deviations and confidence intervals were calculated for dimensional variables and percentages for categorical ones. The gingival index gave 50.0 % light gingivitis, 32.0% moderate and 14.0 % severe gingivitis. The rear superior sextants commonly showed more 4 to 5 mm pockets, the front sextants calculus and the rear inferior sextants showed calculus and bleeding. 94.0 % of the patients required periodontal treatment (3.6 sextants per patient average). Periodontal treatment needs were high in this study; nine out of ten patients in the Mixteca region of the State of Puebla required periodontal treatment. Efforts must thus be guided towards improving oral health in indigenous communities.

The role of the FDI World Dental Federation in global oral health.

The FDI World Dental Federation is a federation of 157 dental associations in 136 countries, representing more than 900 000 dental professionals worldwide. Its main roles are to bring together the world of dentistry, to represent the dental profession on a global level and to stimulate and facilitate the exchange of information across borders. The idea of forming an international dental federation was first discussed at a meeting of the Copenhagen Dental Society, held in Copenhagen in 1894. In 1900, during a congress in Paris, the Federation dentaire internationale (FDI) was created in order to "forward dental education". As one of the two oral health-related nongovernmental organizations in official relations with WHO, the FDI has a long history of collaboration with the Organization, which is based on the FDI's mission "to promote optimal oral and general health for all peoples". Key activities of the FDI Policy-making In order to contribute to the development and dissemination of policies, standards and information related to all aspects of oral health care around the world, the FDI issues policy statements that set out current thinking on various issues related to oral health, the practice of dentistry and dental public health. These declarations, which are based on evidence where possible and are also the results of consensus among groups of experts, are disseminated to oral health professional organizations worldwide and serve as templates for national policy formulation. Representation Acting on behalf of its member associations, the FDI is the global voice of dentists and other oral health professionals. The legal framework of the practice of dentistry and other professional issues are elements of the FDI's representative functions with WHO, the United Nations and the European Union. The FDI protects the interests of its member associations and promotes the formation of professional organizations in countries where there are none. Adherence to the FDI and access to the support of the international family of health professionals helps such organizations to develop and strengthens their role at the national level. Advocacy Focus on the gaps and inequalities in oral and general health status is a major public health activity of the FDI, which promotes appropriate policies, education and technology. The reduction of risks to health--such as tobacco use and high sugar intake--are on the FDI's agenda for action, as well as the promotion of fluorides to prevent dental decay. Interaction The Annual World Dental Congress organized by the FDI is a major event aiming at information sharing between all stakeholders in international oral health. It is also a major source of income for the Federation. The official relations with WHO and other international organizations are of crucial importance for implication in consensus building, advocacy and policy formulation at the highest international levels. A strong, comprehensive set of ethical guidelines governs these relations, and is important to safeguard the independence and credibility of the FDI. Achievements in FDI-WHO collaboration Global goals for oral health In 1981, the FDI and WHO jointly established global goals for oral health for the year 2000 (1). During the following decades most high-income countries reached or even exceeded these goals, but for many low-income countries they remain a remote aspiration. A joint working group composed of the FDI, the International Association for Dental Research (IADR) and WHO developed new goals for oral health for the year 2020 (2), whose focus draws on the experience and evaluation of the previous goals and acknowledges the recognition of oral health as an integral part of general health. The new goals also encourage a broader view of oral health and indicators by including other diseases and conditions as well as dental caries. …

The role of the FDI World Dental Federation in global oral health

The FDI World Dental Federation is a federation of 157 dental associations in 136 countries, representing more than 900 000 dental professionals worldwide. Its main roles are bring together the world of dentistry, represent the dental profession on a global level and stimulate and facilitate the exchange of information across borders. The idea of forming an international dental federation was first discussed at a meeting of the Copenhagen Dental Society, held in Copenhagen in 1894. In 1900, during a congress in Paris, the Federation dentaire internationale (FDI) was created in order forward dental education. As one of the two oral health-related nongovernmental organizations in official relations with WHO, the FDI has a long history of collaboration with the Organization, which is based on the FDI's mission to promote optimal oral and general health for all peoples. Key activities of the FDI Policy-making In order contribute the development and dissemination of policies, standards and information related all aspects of oral health care around the world, the FDI issues policy statements that set out current thinking on various issues related oral health, the practice of dentistry and dental public health. These declarations, which are based on evidence where possible and are also the results of consensus among groups of experts, are disseminated oral health professional organizations worldwide and serve as templates for national policy formulation. Representation Acting on behalf of its member associations, the FDI is the global voice of dentists and other oral health professionals. The legal framework of the practice of dentistry and other professional issues are elements of the FDI's representative functions with WHO, the United Nations and the European Union. The FDI protects the interests of its member associations and promotes the formation of professional organizations in countries where there are none. Adherence the FDI and access the support of the international family of health professionals helps such organizations develop and strengthens their role at the national level. Advocacy Focus on the gaps and inequalities in oral and general health status is a major public health activity of the FDI, which promotes appropriate policies, education and technology. The reduction of risks health--such as tobacco use and high sugar intake--are on the FDI's agenda for action, as well as the promotion of fluorides prevent dental decay. Interaction The Annual World Dental Congress organized by the FDI is a major event aiming at information sharing between all stakeholders in international oral health. It is also a major source of income for the Federation. The official relations with WHO and other international organizations are of crucial importance for implication in consensus building, advocacy and policy formulation at the highest international levels. A strong, comprehensive set of ethical guidelines governs these relations, and is important safeguard the independence and credibility of the FDI. Achievements in FDI-WHO collaboration Global goals for oral health In 1981, the FDI and WHO jointly established global goals for oral health for the year 2000 (1). During the following decades most high-income countries reached or even exceeded these goals, but for many low-income countries they remain a remote aspiration. A joint working group composed of the FDI, the International Association for Dental Research (IADR) and WHO developed new goals for oral health for the year 2020 (2), whose focus draws on the experience and evaluation of the previous goals and acknowledges the recognition of oral health as an integral part of general health. The new goals also encourage a broader view of oral health and indicators by including other diseases and conditions as well as dental caries. …

Determinants of quality in operative dentistry.

The definition of quality in operative dentistry has often, at least in part, been related to how well a cut preparation compares with an ideal preparation. The ideal preparation follows well-defined design principles. These design principles have their roots in empirical dentistry and scientific evaluations, the latter often being conducted in vitro. Because of the complexity of following these design principles practically, a large portion of dental education consists of perfecting cavity preparations. By focusing on how to cut these cavity preparations as closely as possible to the ideal preparation, dentists with high psycho-motor skills have been able to provide the public with restorative procedures of high standards over the years. However, because of the tendency of relating quality in operative dentistry to the ideal preparation, we found it justifiable to review the literature dealing with the cavity design principles of the Class II amalgam preparation. What triggered this review was a request from the International Dental Federation (FDI) to start a process leading to a scientifically based quality definition of dental restorations, a definition that determines how different factors, including cavity design principles, affect the longevity of both tooth and restoration. From our review, we conclude that patient response and restoration performance over time, rather than how closely a cavity preparation compares with the ideal preparation, will be of more significance in determining the longevity of a Class II amalgam restoration.

Pulp reaction to a tri-cure resin-modified glass ionomer

Objective. This study evaluated the pulp response to a tri-cure resin-modified glass ionomer cement and compared this response to those elicited by a zinc oxide-eugenol cement and a silicate cement. Materials were placed in nonexposed class V cavity preparations on human teeth. Study Design. Sixty premolars were selected in orthodontic patients in a voluntary group of teenagers. All cavities were prepared according to International Dental Federation specifications. Resin-modified glass ionomer and silicate applications were carried out according to the manufacturers' instructions. Result. All teeth were asymptomatic. Pulp responses to the resin-modified glass ionomer cement were slightly greater than to the zinc-oxide-eugenol cement. Bacterial staining attempts were inconclusive with regard to time intervals and pulp responses. No necrotic pulps were seen in any teeth. Conclusion. The tri-cure resin-modified glass ionomer cement elicited a slightly greater adverse pulp response than did the zincoxide-eugenol cement with respect to the healing process of the pulp.