Effectiveness of risk-based caries management among Chinese preschool children: a randomized controlled single-blind trial.

BACKGROUND: Early childhood caries (ECC) remain a serious oral health problem on a global scale. Risk-based caries management (RBCM) implemented in some parts of the world has been effective in preventing ECC. However, there is a lack of prospective research on the application of RBCM among Chinese children, and little is known about its effectiveness. The purpose of this study was to evaluate the effectiveness of RBCM in preventing caries among children aged 3-5 years in Wanzhou District, Chongqing Municipality, China. METHODS: Three- to five-year-old children from four kindergartens in Wanzhou were randomly selected for baseline dental examination and caries risk assessment (CRA) and randomly assigned to the experimental group (EG) or the control group (CG) according to the kindergarten. The EG received caries prevention measures of different intensities based on the child's caries risk level. The CG received full-mouth fluoride twice a year according to standard prevention, regardless of their caries risk. One year later, another dental examination and CRA were conducted, to observe changes in the decayed, missing, and filled teeth (dmft) index and caries risk, and to analyze potential factors that may affect the incidence of new caries. RESULTS: Complete data were collected from 291 children (EG, N = 140, 84.8%; CG, N = 181, 83.4%). A total of 25.7% of the EG and 50.3% of the CG children developed new caries, with newly added dmft scores of 0.54 ± 1.12 and 1.32 ± 1.72, respectively (P < 0.05). Multivariate logistic regression indicated that children living in rural areas, assigned to the CG, and rated as high-risk at baseline were more likely to develop new caries (P < 0.05). The proportion of children with an increased caries risk in the EG was significantly lower than that in the CG (P < 0.05). CONCLUSIONS: RBCM effectively prevented new caries in 3- to 5-year-old Wanzhou children and reduced the proportion of children at increased risk of caries. It is an effective approach for preventing ECC. CLINICAL TRIAL REGISTRATION: This trial was registered in the Chinese Clinical Trials Register. The registration number was ChiCTR230067551 (11/01/2023).

[The relationship between centric relation-maximum intercuspation disharmony and temporomandibular dysfunction in class II patients].

OBJECTIVE: To investigate the relationship between the degree of displacement of centric relation-maximum intercuspation (CR-MI) and temporomandibular dysfunction (TMD) in Class II patients. METHODS: The questionnaire and clinical examination were administered in 107 Class II patients and students, using the Helkimo index (Di and Ai). The differences in condylar position between CR and MI in all three spatial planes were measured using the Condyle Position Indication (CPI). RESULTS: Di positively correlated with degree of CR-MI displacement in all five displacement (P < 0.05), while Ai positively correlated with degree of CR-MI displacement except horizontal displacement. Di and Ai significantly correlated with degree of CR-MI discrepancy in all five displacement (P < 0.05); With the increasing of Di and Ai rank, the degree of CR-MI displacement and CR-MI discrepancy increased. Also, symptoms of TMD were significantly correlated with the degree of CR-MI displacement and CR-MI discrepancy except horizontal displacement (P < 0.05). Severer CR-MI displacement and CR-MI discrepancy were observed in patients who had TMD symptoms. CONCLUSION: In Class II patients, degree of CR-MI displacement is an important factor of TMD, and correlated with the severity of TMD.