Survey of Croatian dentists' restorative treatment decisions on approximal caries lesions.

AIM: To assess Croatian dentists' restorative treatment decisions on approximal caries lesions, including treatment threshold and restorative methods and materials. METHODS: Croatian translation of the questionnaire assessing restorative treatment decisions on approximal caries, previously validated and used in Norway and Sweden, was distributed to a random sample (n=800) of Croatian dentists. A total of 307 (38%) dentists answered the questionnaire. The assessed variables were treatment threshold for hypothetical approximal caries lesion and the most favored types of restorative techniques and materials. RESULTS: A third of the respondents (39%, 95% confidence interval [CI], 34-44%) would intervene for an approximal caries lesion at the dentin-enamel junction, but a larger proportion (42%; 95% CI, 36-48%) would treat a caries lesion confined to the enamel. For restoration of approximal caries, the majority (66%; 95% CI, 61-71%) would use composite resin. CONCLUSION: Croatian dentists tend to restore approximal caries lesions when the lesions are confined to the enamel and their development can still be arrested.

Caries risk assessment in practice for age 6 through adult.

The aim of this article is to present a practical caries risk assessment procedure and form for patients who are age 6 through adult. The content of the form and the procedures have been validated by outcomes research after several years of experience using the factors and indicators that are included.

Caries risk assessment in an educational environment.

This study was designed to assess, retrospectively using dental records, the impact on the management of dental caries of new caries risk assessment (CRA) forms and procedures introduced into a predoctoral dental school clinic. Of 3,659 patients with a new patient visit (NPV) and baseline exam (BE) in the two-year period of July 2003 through June 2005, 69 percent (n= 2,516) had a baseline CRA. "Visible cavitation or caries into dentin by radiograph" was significantly correlated to most items included in the CRA form, for example, "frequent between meal snack of sugars/cooked starch" (p<0.001), "inadequate saliva flow" (p=0.03), and "deep pits and fissures or developmental defects" (p<0.001). Fluoride toothpaste use (odds ratio, OR=0.7) was negatively related to cavitation risk while "readily visible heavy plaque on teeth" (OR=2.0), "frequent between meal snack of sugars/cooked starch" (OR=1.6), "interproximal enamel lesions or radiolucencies" (OR=11.8), and "white spots or occlusal discoloration" (OR=1.50) were positively related. CRA use at follow-up, the use of bacterial tests, antibacterial therapy, and specific patient recommendations were all very low. While the content and usefulness of the CRA procedures were validated, the study highlighted the difficulties of implementing such programs in educational establishments even with an extensive student didactic program and faculty training.

Leakage associated with intermediate restorative material and glass-ionomer cement retrograde fillings: a human and sheep teeth comparison with 2 different aging procedures.

OBJECTIVES: Leakage around retrograde fillings is an important cause of endodontic surgery. This in vitro study sought to compare the following: (1) methylene blue dye leakage linked to retrofillings in human and sheep teeth with the degree of dye penetration when intermediate restorative materials and Chemfil were used as retrofillings, (2) the apical microleakage in filled with that in unfilled root canals, and (3) 2 storage techniques, incubator-based and subcutaneous implantation in rats. STUDY DESIGN: Tested were 198 human and 196 sheep teeth that were retrofilled with intermediate restorative material or Chemfil, then stored in an incubator or subcutaneously in rats for 10, 20, and 30 days before immersion in methylene blue dye for 24 hours. Linear dye penetration was evaluated, and the results were statistically analyzed by means of analysis of variance. RESULTS: Leakage between sheep and human teeth was significantly different (P <.05). Chemfil had significantly less leakage than intermediate restorative material after storage in rat (P <.05) for up to 20 days, but not after 30 days. No differences were found between leakage of unfilled and filled human root canal teeth. CONCLUSIONS: The sheep incisor is a poor experimental model of the human tooth, and both aging procedures demonstrate extensive leakage of retrofilling materials after long-term storage.

French dentists' restorative treatment decisions.

PURPOSE: Variations in decision-making about restorative treatments have been demonstrated among dentists in several countries. This study sought to assess the restorative treatment philosophies based on a representative sample of French dentists. MATERIALS AND METHODS: A sample (n = 2000) was randomly extracted from a national list (n = 42,000). Each dentist received a questionnaire, illustrations of carious conditions, and a reply-paid envelope. The questionnaire assessed the stage of lesion progression at which the respondents considered restorative treatment appropriate, their choice of restorative technique and dental material. For all questions, an imaginary 20-year-old patient with low caries activity was described. RESULTS: After one reminder, the response rate was 40%. Almost half of the respondents would restore an occlusal lesion confined to enamel and 88% would have prepared a cavity for a proximal lesion at the amelo-dentinal junction. The majority of the respondents would not use the Black concepts for cavity preparation. Their preferred restorative material was composite. CONCLUSIONS: Answers indicated a tendency towards early restorative intervention and showed large variations between the treatment decisions of French dentists.

Restorative treatment strategies reported by French university teachers.

Disparities among dental schools concerning the teaching and practice of cariology and operative dentistry can lead to variations in students' treatment modalities that can have health and economic consequences for patients and third party providers. The purpose of this study was to assess caries management strategies taught in French dental schools employing a questionnaire used in a previous study involving private dentists. The study population consisted of 180 teachers of operative dentistry. Each teacher received a questionnaire and a reply-paid envelope. The questionnaire assessed their treatment strategies, knowledge and beliefs about selected aspects of diagnosis, and treatment of dental caries. After one reminder, the response rate was 49.1 percent. The results illustrate a wide disparity among French teachers concerning restorative treatment thresholds for approximal surfaces, opinions about the rate of caries progression, and the need to monitor lesions near the DEJ. The teachers' attitudes differed from those of private practitioners: they tended to intervene surgically at a later stage, but they would intervene earlier in the treatment of the carious process than would Scandinavian dentists. This study may help in encouraging dental faculties to develop a consensus on issues related to diagnosis and management of dental caries.