Success rates of manual restorative treatment (MRT) with amalgam in permanent teeth in high caries-risk Filipino children.

OBJECTIVES: The objective of the study is to evaluate the success rate of amalgam restorations in manually prepared cavities under field conditions within a comprehensive school-based oral health-care program in high caries-risk children. MATERIALS AND METHODS: A total of 1322 restorations were placed in the permanent teeth of 619 high caries risk Filipino children by two dentists and two trained health-care workers. Only hand instruments and an encapsulated amalgam, mixed with a manually powered amalgamator, were used. The restorations were evaluated after a service time of 1 to 5 years using modified atraumatic restorative treatment (ART) criteria. RESULTS: The overall success rate of the amalgam restorations was 95.3% (n = 1260) after a mean service time of 2.7 years (SD = 1.4). Multiple-surface restorations showed significantly higher failure rates (11.4%) than single-surface occlusal (4.7%) and single-surface non-occlusal (2.1%) restorations; 93.6% of large restorations was performed successfully, but had a risk of failure twice to that of small restorations (odds ratio (OR) = 2.141). The score of the decayed, missing, and filled teeth (DMFT) index had significant influence on the success rate. The risk of restoration failure increased by 11.5% for each unit increase in DMFT (OR = 1.148). Neither the operator nor age nor gender of the patient had a significant effect on the success rate of the restorations. CONCLUSION: Amalgam was performed satisfactorily as a filling material when placed under field conditions in manually prepared cavities in the permanent dentition of high caries-risk children. Success of the restorations was influenced by the patient's caries experience (DMFT), restoration size, and service time. CLINICAL RELEVANCE: Manual restorative treatment (MRT) amalgam restorations were performed satisfactorily, but higher dental caries experience and large cavities contribute to lower success rates.

[An index for untreated severe caries]. / Een index voor onbehandelde ernstige cariës.

Hardly any data are available on the clinical consequences of untreated severe caries, because there is no method to quantify the prevalence of oral conditions resulting from untreated caries. In the Philippines, an index was developed which records for (the location of) each tooth whether caries has reached the dental pulp, whether ulceration is present in the surrounding soft tissues due to sharp edges of fragments of a tooth lost due to caries, or whether a fistula or abscess is present. By adding the index to the existing Decayed Missing Filled Tooth index, insight is provided on the extent and the consequences of untreated caries and research may be carried out on its possible impact on the general health and wellbeing of national populations.

PUFA--an index of clinical consequences of untreated dental caries.

RATIONALE: Dental caries is a global public health problem, especially in children. Most caries in developing countries remains untreated. Only limited data are available on the clinical consequences of untreated dental caries because there is no measure to quantify the prevalence and severity of oral conditions resulting from untreated dental caries. OBJECTIVES: To present a new index to evaluate the prevalence and severity of oral conditions resulting from untreated dental caries. To validate the index within the Philippines National Oral Health Survey, 2006. METHODS: The PUFA index records the presence of severely decayed teeth with visible pulpal involvement (P/p), ulceration caused by dislocated tooth fragments (U/u), fistula (F/f) and abscess (A/a). RESULTS: Good kappa values show the reliability of the index. The prevalence of PUFA/pufa >0 was 85% and 56% for 6- and 12-year-olds, respectively. The mean number of teeth affected (PUFA/pufa) was 3.5 and 1.2 for 6- and 12-year-olds, respectively. In 6- and 12-year-olds, 40% and 41% of decayed teeth had progressed to odontogenic infections. CONCLUSION: The PUFA index complements classical caries indices with relevant information for epidemiologists and health care planners.