Proximal Caries In Primary Molars Research Articles

Progression of proximal caries in primary molars using the radiographic ICDAS: a retrospective cohort study.

To evaluate the proximal caries progression in primary molars using the radiographic International Caries Detection and Assessment System (ICDAS). A study was conducted on 196 children aged 3-9 years old who underwent the clinical examination and bitewing radiography during baseline and 6-month (and over) follow-up visits. The primary molars bitewing radiographs with initial enamel caries (RA1 and RA2) or outer dentine caries (RA3) of proximal surfaces were included. Caries advancement was scored using ICDAS criteria and statistical analyses with the chi-square test. Median survival time was evaluated using Kaplan-Meier survival curves and log-rank tests. A total of 439 surfaces of primary molars were included in this study and an averaged follow-up period of enamel and dentine caries group were 18.3 ± 9.6 months and 16.5 ± 9.5 months respectively. The progression of proximal enamel lesions significantly differed between primary maxillary and mandibular molars (p = 0.002) and among each patient's primary mandibular second molar and the others (p = 0.002). On the contrary, the outer dentine caries of each group of primary molars was not different. The median survival time of the initial enamel proximal caries (23.30 months) was non-significantly longer than that of the dentine (20.80 months). Progressions of the initial enamel proximal caries were significantly different among primary molars at the average 18.3-month follow-up. The median survival period of the enamel proximal caries was more extended than that of dentine but without statistical difference. These results provide essential information for dentists regarding an appropriate appointment for bitewing examinations.

Comparative Evaluation of the Survival Rates of Zirconia Crown and Stainless Steel Crown for Proximal Caries in Primary Molars: a Retrospective Study

Due to increasing demand for aesthetics, zirconia crowns have become a popular choice for treating primary molars. However, there is limited literature available comparing the survival rates of zirconia crowns with those of other restorative materials. The objective of this study was to compare the 36-month survival rates of zirconia crowns and stainless steel crowns for proximal caries, as well as to analyze failure types associated with each crown type. Electronic medical records and radiographs of 1,061 primary molars from 498 patients treated with 2 types of prefabricated crowns at Chosun University Dental Hospital and 2 private dental clinics between 2017 and 2019 were collected and analyzed. The survival rate of zirconia crowns was found to be lower compared to that of stainless steel crowns. Regarding the groups without pulp treatment, the survival rate of stainless steel crowns was significantly higher than that of zirconia crowns. However, in the groups that received pulp therapy, no significant difference in the survival rates was observed between the two preformed crowns. Notably, abnormal root resorption or periapical lesions were identified as the primary cause of restorative failure in stainless steel crowns, whereas loss of restoration was the predominant cause in zirconia crowns. This study holds valuable implications for clinicians when selecting preformed crowns for primary molars.

Clinical validation of near-infrared imaging for early detection of proximal caries in primary molars

ObjectivesThe aim of this study was to validate the near-infrared imaging (NIRI) in comparison with visual inspection (VI) for early detection of proximal caries in primary molars. MethodsVI and intraoral scans were performed on 126 patients aged 3–12 years with at least one non-cavitied and non-restored proximal tooth surface, who were scheduled for bite wing radiography (BWR) as part of their standard care. Teeth with signs of proximal cavities, restorations or residual caries were excluded in this study. BWR, a gold standard to diagnose proximal caries in primary molars, was used to validate the findings of NIRI and VI. The accuracy, sensitivity, specificity and the area under the curve (AUC) of NIRI and VI were calculated. ResultsThe accuracy, sensitivity and specificity of NIRI were 82.89%, 74.10% and 90.97%, while those of VI were 71.64%, 43.88% and 97.14%, respectively. NIRI showed higher accuracy and sensitivity, and lower specificity (P < 0.001). The AUC of NIRI was higher than that of VI (0.826 vs 0.706; P < 0.05). ConclusionsNIRI showed higher sensitivity and lower specificity compared with VI when detecting proximal caries in primary molars. Therefore, it is recommended to use NIRI in combination with BWR to improve the detection rate of proximal caries in primary molars. Clinical significanceIn children, there is a high incidence of proximal caries in primary molars, which require high technical sensitivity for detection. NIRI shows high sensitivity in detecting proximal caries, which may improve their detection rate in primary molars.The clinical trial registration number: ChiCTR2300070916

Detecting of Proximal Caries in Primary Molars using Pen-type QLF Device

The purpose of this &lt;i&gt;in vivo&lt;/i&gt; study was to assess the clinical screening performance of a quantitative light-induced fluorescence (QLF) device in detecting proximal caries in primary molars. Fluorescence loss, red autofluorescence and a simplified QLF score for proximal caries (QS-proximal) were evaluated for their validity in detecting proximal caries in primary molars compared to bitewing radiography. Three hundred and forty-four primary molar surfaces were included in the study. Carious lesions were scored according to lesion severity assessed by visual-tactile and radiographic examinations. The QLF images were analyzed for two quantitative parameters, fluorescence loss and red autofluorescence, as well as for QS-proximal. For both quantitative parameters and QS-proximal, the sensitivity, specificity and area under receiver operating curve (AUROC) were calculated as a function of the radiographic scoring index at enamel and dentin caries levels. Both quantitative parameters showed fair AUROC values for detecting dentine level caries (△F = 0.794, △R = 0.750). QS-proximal showed higher AUROC values (0.757 - 0.769) than that of visual-tactile scores (0.653) in detecting dentine level caries. The QLF device showed fair screening performance in detecting proximal caries in primary molars compared to bitewing radiography.

Survival Rates of Class II Restoration in Primary Molar with Flowable Resin Composite

The purpose of this retrospective study was to evaluate the survival rate by comparing Class II restoration using flowable resin composite with stainless steel crown in primary molars. Electronic medical records and radiographs of 1,504 primary molars with proximal caries of 590 patients from June 2015 to August 2019 were analyzed. With the collected data, survival analysis was performed using the Kaplan-Meier method. The 1-year survival rate of flowable resin composite in the primary molar was 98.5%, 3-year survival rate was 87.7%, and mean survival time was 39 months. There was no statistically significant difference between flowable resin composite and stainless steel crown (&lt;i&gt;p&lt;/i&gt; = 0.896). Within the limits of this study, Class II restoration using flowable resin composite can be considered a promising option for the treatment of proximal caries in primary molars.

One-year clinical evaluation of two high-viscosity glass-ionomer cements in class II restorations of primary molars.

Little information exists on the clinical performance of restorative materials on primary teeth of preschool children. This study aimed to evaluate clinical performance of compomer, glass-hybrid-added high-viscosity glass-ionomer cement and zinc-added high-viscosity glass-ionomer cement materials in class ΙΙ restorations of primary molars. The study included 251 teeth of 57 patients aged 4-7years with proximal caries in primary molars. The teeth were divided into three groups, and each restorative material was randomly distributed. Dyract XP, Equia Forte and ChemFil Rock materials were placed after cavity preparation and clinically evaluated at 3, 6, 9 and 12months using modified United States Public Health Service criteria. Statistical analyses were performed using chi-square and z tests. At the end of 12months, a total of three restorations in Dyract XP group, 22 in Equia Forte group and 11 in ChemFil Rock group failed in retention criteria. No statistically significant difference existed between retention, colour match and surface texture criteria of all groups at 3 and 6months, but a statistically significant difference was found at 12months (P<0.05). For class ΙΙ restorations of primary molars, the success of compomer material was superior to high-viscosity glass-ionomer materials.

In vivo validity of proximal caries detection in primary teeth, with histological validation.

Detection and diagnosis of proximal caries in primary molars are challenging. The aim of this in vivo study was to assess the validity and reproducibility of four methods of proximal caries detection in primary molar teeth. Eighty-two children (5-10years) were recruited. Initially, 1030 proximal surfaces were examined using meticulous visual examination (ICDAS) (VE1), bitewing radiographs (RE), and a laser fluorescence pen device (LF1). Temporary tooth separation (TTS) was achieved for 447 surfaces, and these were re-examined visually (VE2) and using the LF pen (LF2). Three hundred and fifty-six teeth (542 surfaces) were subsequently extracted and provided histological validation. At D1 (enamel and dentine caries) diagnostic threshold, the sensitivity of VE1, RE, VE2, LF1, and LF2 examination was 0.52, 0.14, 0.75, 0.58, and 0.60 and the specificity values were 0.89, 0.97, 0.88, 0.85, and 0.77, respectively. At D3 (dentine caries) threshold, the sensitivity values were 0.42, 0.71, 0.49, 0.63, and 0.65, respectively, whereas specificity was 0.93 for VE1 and VE2, and 0.98, 0.87, and 0.88 for RE, LF1, and LF2 examinations, respectively. ROC analysis showed radiographic examination to be superior at D3 . Meticulous caries diagnosis (ICDAS) should be supported by radiographs for detection of dentinal proximal caries in primary molars.

Nearinfrared light transillumination for detection of incipient proximal caries in primary molars

To evaluate the practical value of nearinfrared light transillumination (NILT, DIAGNOcam) on detection of incipient proximal caries in primary molars. In this study, 4-9-year-old children with suspicious proximal lesions in primary molars were recruited. The target teeth were examined with clinical examination, bitewing radiograph and DIAGNOcam. And the caries indexes were rated as 0 (no caries), 1 (caries reaching outer 1/2 enamel), 2 (caries reaching inner 1/2 enamel), and 3 (dentine caries). Those primary molars with at least one of the adjacent molars according with the criteria of invasive treatment, i.e. the teeth were diagnosed as caries reaching inner 1/2 enamel or dentine with at least two detection methods, were included. The target teeth with caries index ≥2 accepted the invasive treatment. And the caries status of the adjacent teeth was observed under direct vision and those teeth of caries index ≥2 would also accept the invasive treatment. The relationship of lesions to enamel-dentine junction (EDJ) were recorded and used as reference standard to compare the sensitivity, specificity and accuracy of those three methods in detecting the incipient proximal caries in primary molars. In this study, 36 children with 104 suspicious proximal lesions in primary molars were recruited, of which 5 were diagnosed as no caries, 20 were diagnosed as superficial enamel caries, and 79 accepted invasive treatment, of which 22 were diagnosed as EDJ caries, and 57 as dentine caries. The sensitivity of clinical examination, bitewing radiograph, and DIAGNOcam were 68.69%, 81.82%, 78.79%, respectively. The specificity were 100.00%, 100.00%, 80.00%, and the accuracy were 75.96%, 85.65%, 78.85%, respectively. As for superficial enamel caries, the sensitivity of clinical examination was lowest, only 10%, while DIAGNOcam was 60%, higher than 40% of bitewing radiograph. As for EDJ caries, the sensitivity of bitewing radiograph was highest as 86.36%, followed by DIAGNOcam 72.73% and clinical examination 68.18%. As for dentine caries, the sensitivity of the three detection methods were higher than 85%, of which bitewing radiograph was the highest as 94.74%. The accuracy of DIAGNOcam in detecting incipient proximal caries in primary molars was comparable to that of bitewing radiograph. It was safe, and convenient with no exposure to radiation, which was applicable to be used in pediatric dentistry.

Evaluation of Nonproximal Caries as Predictor of Proximal Caries in Primary Molars.

ABSTRACTBackgroundMost caries prevalence studies are conducted in community-based settings, usually with no radiographs, therefore, it is questionable if visual examination alone captures the true extent of disease.AimSince it is relatively easy to diagnose occlusal and facial/lingual surface (nonproximal caries) on visual examination, our aim was to evaluate for an association between nonproximal caries (NP) and proximal caries (P), which if present can provide a tool to help decision makers in estimating the true extent of the disease.DesignA cross-sectional retrospective chart audit was done using records of 106 children to determine the association between NP and P caries in the primary dentition.ResultsOur mean dft for NP lesions only was 1.55. Based on our data, the mean dft considering all pit and fissure plus the proximal lesions was 2.54, which is a 63.2% increase from the dft based on NP caries only. We found a significant association between NP caries and radiographically detectable P caries. Proximal lesions were twice as likely to exist on primary molars when non-proximal/pit and fissure carious lesions were present.ConclusionThe results imply that proximal caries, and thus need for treatment, are being underestimated during visual exams.How to cite this articleDhar V, Mon S, Macek MD. Evaluation of Nonproximal Caries as Predictor of Proximal Caries in Primary Molars. Int J Clin Pediatr Dent, 2018;11(6):457-461.

Efficacy of resin infiltration of proximal caries in primary molars: 1-year follow-up of a split-mouth randomized controlled clinical trial.

The main purpose of this split month, randomized, controlled clinical trial was evaluate the efficacy of caries infiltration in controlling the progression of non-cavitated proximal lesions in primary molars. Anxiety and time required for the caries infiltration was also evaluated. Fifty healthy children, 5 to 9years, presenting two primary molars with proximal caries lesions (1/2 of the enamel or outer 1/3 of dentin), were included. Lesions were randomly allocated to the test group (fluoridated toothpaste + flossing + infiltration) or to the control group (fluoridated toothpaste + flossing). Caries risk was based on the Cariogram model. The main outcome after 1-year radiographic follow up was assessed by an independent blinded examiner A facial image scale (FIS) was applied to assess dental anxiety and time required to perform the infiltration was recorded. Of the sample, 92.9% corresponded to high or medium caries risk. In 42 patients (1-year follow up), caries progression was observed in 11.9% (5/42) of the test lesions compared with 33.3% (14/42) of the control lesions (p<0.05). Five control and three test lesions progressed to the middle 1/3 of dentin and were restored. No side effects were observed. Anxiety was both low before and after the treatment, and mean time required for the infiltration was 11.29min (±1.16min). Caries infiltration of proximal caries lesions in primary molars is significantly more efficacious than standard therapy alone (fluoride toothpaste + flossing). Caries infiltration is an applicable and well-accepted method be used in children, representing a promising micro-invasive approach.

유구치 인접면 우식 병소 진단에 있어 QraypenTM과 시진 및 구내 치근단 방사선의 비교

2015년 실시한 국민구강실태조사에 따르면 우리나라 만 12세 아동들의 우식경험영구치지수(DMFT index)는 1.9로 주요 OECD 국가들의 평균인 1.6에 거의 근접한 것으로 조사되었다. 본 연구의 목적은 인접면 우식증의 진단에 있어 새로 개발된 <TEX>$Qraypen^{TM}$</TEX>의 효능을 기존의 방법인 시진 및 구내 치근단 방사선 사진과 비교 평가하고, 임상 적용 시의 문제점을 파악하여 차후 <TEX>$Qraypen^{TM}$</TEX>에 필요한 개선안을 제시함과 아울러 치아우식증의 예방 및 초기 우식증 재광화 방법에 대한 기초 연구자료를 마련하고자 하였다. 학교 구강검진을 목적으로 내원한 학령기의 혼합치열을 가진 32명의 어린이들을 대상으로 구강검진 2회, 구치부 치근단 방사선 필름 판독 2회 그리고 구치부 인접면 <TEX>$Qraypen^{TM}$</TEX> 이미지 판독 2회를 실시하고 비교한 결과 <TEX>$Qraypen^{TM}$</TEX> 영상은 변연융선이 파괴되지 않은 유구치의 인접면 우식증의 탐지에 효과적이었다. 또한 방사선 촬영 결과와 비교해 보니 차이가 없음을 확인하였다. 그러나 인접면 우식증이 상아질까지 진행되어 병소가 성숙하여야 뚜렷한 붉은색 형광을 관찰할 수 있었기에 우식 병소의 진행 정도와 붉은색 형광 발생의 관련성을 확인하기 위해서는 향후 발치된 치아를 사용하여 조직학적 검사를 병행한 추가적인 연구가 필요할 것으로 생각된다. 본 연구 결과 <TEX>$Qraypen^{TM}$</TEX>은 유구치의 육안으로 보이지 않은 인접면 우식증을 탐지하는 데 도움을 줄 수 있는 유용하고 간편한 보조장비가 될 수 있을 것으로 기대된다. The purpose of this study was to evaluate the efficacy of the newly-developed <TEX>$Qraypen^{TM}$</TEX> (All In One Bio, Korea) system for the diagnosis of early proximal caries by comparing it with the conventional methods of visual inspection and periapical radiography. This study was carried out from July 2015 to April 2016 targeting 32 children aged 7~12 years who visited Y-Dental Clinic for school oral health examinations. Two investigators selected and examined a total of 153 primary molars that had not undergone restorative treatment. Comparisons were carried out between visual inspections, readings of posterior periapical radiography images, and readings of <TEX>$Qraypen^{TM}$</TEX> images. This study revealed that the percentage of interproximal surfaces of primary molar teeth without caries incidence was 83.7% using <TEX>$Qraypen^{TM}$</TEX> imaging and 84.9% using visual inspection and periapical radiography. The differences between the two methods were not statistically significant. Thus, <TEX>$Qraypen^{TM}$</TEX> is expected to be a useful and convenient auxiliary diagnostic device that can facilitate the detection of hidden proximal caries in primary molars.

Retrospective Study of Survival Rates According to the Type of Dental Restoration of Proximal Caries in Primary Molars

Restorative dental materials have advanced rapidly, with improved physical properties that improve survival rates. Accordingly, various materials can be selected. Amalgam, composite resin, glass-ionomer cement, and preformed stainless steel crowns have all been used widely for the restoration of dental caries in primary molars. The various dental materials used to treat proximal caries in the primary molars have distinct advantages and disadvantages. However, few studies have examined their survival rates. This retrospective study examined the 2-year survival rates of more than 700 class II restorations of proximal caries in primary molars clinically and radiologically according to the type of restoration. The study results should help in the selection of class II restorations for molars, one of the biggest concerns of pediatric dentists.

Detection of Hidden Proximal Caries using Q-ray view in Primary Molars

The purpose of this study was to evaluate the ability of Q-ray view (All-in-one Bio, Seoul, Korea) in detection of proximal caries in primary molars with sound marginal ridges. Thirty two children aged 3-9 years (average years old) were chosen, and two examiners evaluated 100 proximal surfaces of primary molars with sound marginal ridges. The teeth were examined with; (a) visual examination, (b) Q-ray view, (c) DIAGNOdent (KaVo, Biberach, Germany) and (d) digital periapical radiography. Kappa statistic was used to assess the agreement between each examination method and the degree of caries progression. The kappa values for enamel caries were 0.15 (visual examination), 0.10 (Q-ray view), 0.25 (DIAGNOdent) and 0.68 (digital periapical radiography). The kappa values for dentinal caries were 0.34 (visual examination), 0.56 (Q-ray view), 0.44 (DIAGNOdent) and 0.70 (digital periapical radiography). Although Q-ray view showed low diagnostic ability in detection of enamel caries, it was effective in detection of hidden proximal caries extended into dentin. Q-ray view would be a useful and simple device which could aid pediatric dentists in detection of hidden proximal caries in primary molars especially when examining uncooperative children or disabled persons.

Penetration of Experimental Infiltrants with Different Penetration Coefficients and Ethanol Addition into Natural Caries Lesions in Primary Molars

This study evaluated the influence of the penetration coefficient (PC) and ethanol addition on the penetration depth (PD) of experimental infiltrants into proximal caries lesions in primary molars. Caries lesions (n = 45) were randomly treated with 1 of 4 experimental infiltrants (PC63; PC185; PC204; PC391) for 5 min. Lesion depths and PDs were analysed using dual fluorescence confocal microscopy. Lesions were almost completely infiltrated in all groups. Median PDs and percentage penetrations were not significantly different between groups (p > 0.05). When applied for 5 min, all tested infiltrants were able to infiltrate proximal caries in primary molars nearly completely.

A comparison of the performance of a compomer and an amalgam

Objectives To evaluate the clinical performance of a compomer material (Dyract®) in comparison with dental amalgam (Contour®) for management of proximal caries in primary molars in young children. Setting General dental practice, and a dental hospital paediatric clinic. Method This was a prospective study. A split mouth design was used with identical pairs of minimal Class II cavities, of matched tooth type in the same dental arch, usually diagnosed with the use of bitewing radiographs. Seventy-eight pairs of restorations were completed of which 60 pairs were available for evaluation after 24 months. Results Comparable retention rates were observed for both Dyract and amalgam. The retention rates were high for both materials, with only four amalgam and two Dyract restorations failing over 24 months. Significantly better marginal integrity (p < 0.05) was observed for Dyract compared with amalgam with no significant differences between the two materials for recurrent caries, wear or surface texture. Conclusions Dyract seemed to be a suitable alternative to amalgam for proximal restorations in primary molars of young children for use in general dental practice.