Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 588
Filtrar
1.
Cochrane Database Syst Rev ; 3: CD010526, 2019 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-30834516

RESUMO

BACKGROUND: Resin-based composite (RBC) is currently accepted as a viable material for the restoration of caries for posterior permanent teeth requiring surgical treatment. Despite the fact that the thermal conductivity of the RBC restorative material closely approximates that of natural tooth structure, postoperative hypersensitivity is sometimes still an issue. Dental cavity liners have historically been used to protect the pulp from the toxic effects of some dental restorative materials and to prevent the pain of thermal conductivity by placing an insulating layer between restorative material and the remaining tooth structure. This is an update of the Cochrane Review first published in 2016. OBJECTIVES: The objective of this review was to assess the effects of using dental cavity liners in the placement of Class I and Class II resin-based composite posterior restorations in permanent teeth in children and adults. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 12 November 2018), the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 10) in the Cochrane Library (searched 12 November 2018), MEDLINE Ovid (1946 to 12 November 2018), Embase Ovid (1980 to 12 November 2018) and LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 12 November 2018). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomized controlled trials assessing the effects of the use of liners under Class I and Class II posterior resin-based composite restorations in permanent teeth (in both adults and children). We included both parallel and split-mouth designs. DATA COLLECTION AND ANALYSIS: We utilized standard methodological procedures prescribed by Cochrane for data collection and analysis. Two review authors screened the search results and assessed the eligibility of studies for inclusion against the review inclusion criteria. We conducted risk of bias assessments and data extraction independently and in duplicate. Where information was unclear we contacted study authors for clarification. MAIN RESULTS: Eight studies, recruiting over 700 participants, compared the use of dental cavity liners to no liners for Class I and Class II resin-based composite restorations.Seven studies evaluated postoperative hypersensitivity measured by various methods. All studies were at unclear or high risk of bias. There was inconsistent evidence regarding postoperative hypersensitivity (either measured using cold response or patient-reported), with a benefit shown at some, but not all, time points (low-quality evidence).Four trials measured restoration longevity. Two of the studies were judged to be at high risk and two at unclear risk of bias. No difference in restoration failure rates were shown at 1 year follow-up, with no failures reported in either group for three of the four studies; the fourth study had a risk ratio (RR) 1.00 (95% confidence interval (CI) 0.07 to 15.00) (low-quality evidence). Three studies evaluated restoration longevity at 2 years follow-up and, again, no failures were shown in either group.No adverse events were reported in any of the included studies. AUTHORS' CONCLUSIONS: There is inconsistent, low-quality evidence regarding the difference in postoperative hypersensitivity subsequent to placing a dental cavity liner under Class I and Class II posterior resin-based composite restorations in permanent posterior teeth in adults or children 15 years or older. Furthermore, no evidence was found to demonstrate a difference in the longevity of restorations placed with or without dental cavity liners.


Assuntos
Resinas Compostas , Forramento da Cavidade Dentária/instrumentação , Restauração Dentária Permanente , Sensibilidade da Dentina/prevenção & controle , Dor Pós-Operatória/prevenção & controle , Condutividade Térmica , Adolescente , Adulto , Cárie Dentária/classificação , Cárie Dentária/cirurgia , Falha de Restauração Dentária/estatística & dados numéricos , Restauração Dentária Permanente/efeitos adversos , Restauração Dentária Permanente/classificação , Sensibilidade da Dentina/epidemiologia , Sensibilidade da Dentina/etiologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Acta Odontol Scand ; 77(4): 315-327, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30727798

RESUMO

OBJECTIVE: To evaluate effects of thresholds on estimates of predictive accuracy of methods for caries risk assessment. MATERIAL AND METHODS: Adolescents, aged 12 visiting two dental clinics, were examined by visual/tactile examination and bitewing radiography at baseline and after one year. Three methods for caries risk assessment were applied: previous caries experience, dentists' risk assessment according to set criteria (presence or absence of caries lesion) and acid tolerance of dental biofilm. The measure for validity (the reference standard) comprised caries lesion progression at 1 year. Predictive accuracy estimates were calculated for several thresholds. RESULTS: Accuracy estimates changed with threshold values of the methods and the reference standard. Patient spectrum differed between the clinics, which resulted in different accuracy estimates for the two samples. Generally, negative predictive values were high while positive ones were low indicating that these methods were more efficient in finding individuals who are at low risk of developing caries lesions than those with increased risk. CONCLUSIONS: As thresholds and patient spectrum affected predictive accuracy, it may be difficult to design a universal model with set thresholds for caries risk assessment. Foremost, a model should consider the level of aspiration for prediction and clinical decisions that will be made based on the risk assessment in the actual clinical setting.


Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária/diagnóstico , Restauração Dentária Permanente/estatística & dados numéricos , Adolescente , Cárie Dentária/classificação , Cárie Dentária/microbiologia , Odontólogos , Feminino , Humanos , Masculino , Exame Físico , Radiografia Interproximal , Medição de Risco/métodos
3.
Histol Histopathol ; 34(4): 353-358, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30251744

RESUMO

The aims of this study were to evaluate the influence (1) of the examiner experience and (2) three histological classification criteria on the reproducibility of two gold standard techniques (non-dye or dye) for validation of the diagnosis of occlusal caries. This study comprised a sample of 210 digital images of 105 permanent teeth (105 rhodamine B dyed and 105 dye-free hemisections) and six examiners. Images were evaluated on a laptop computer and categorised according to three different histological classification criteria (proposed by Ekstrand, Lussi or Downer) and repeated in order to allow reproducibility calculation. For data analysis, the six participants were divided into two groups: G1: examiners with previous experience in histological evaluation and G2: examiners with no experience in histological evaluation. Statistical significance was set at 0.05. Results: The mean intra-examiner reproducibility values in G1 were higher than G2 in all variables. Intra-examiner reproducibility was lower for the dye-free technique in both groups. The mean values of inter-examiner reproducibility in G1 ranged from 0.60 to 0.68, and in G2 values ranged from 0.34 to 0.69. Conclusion: It can be concluded that: (1) the examiners' experience seems to influence the reproducibility of the two gold standard techniques studied and reproducibility tends to be lower when the dye-free technique is used, and (2) the histological classification criterion does not appear to influence the reproducibility for validation of the diagnosis of occlusal caries.


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/classificação , Corantes Fluorescentes , Humanos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Rodaminas
4.
Eur J Paediatr Dent ; 19(2): 88, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30063145

RESUMO

Early childhood caries (ECC) is the most common chronic infectious childhood disease. It is also a major public health problem worldwide [Gomez, 2013]. Although it is not life-threatening, early childhood caries impacts negatively the quality of life when associated with pain. It affects the function, social interactions and cognitive and neurodevelopment of affected children, whose parents also suffer financial and emotional stress [Folayan and Alade, 2018]. Early childhood caries is defined as the presence of one or more cavitated or non-cavitated lesion, missing or filled tooth due to caries in any primary tooth in a child 71 months of age or younger [AAPD, 2008]. The two key parameters here are the age of the child and involvement of the primary dentition. Here is a scenerio. How to classify a case of a child that has had symptoms of pain from a carious primary tooth at age 4 years but only came for treatment at age 6 years? Is this a case of early childhood caries because of the onset at age 4, or it cannot be considered early childhood caries because of late diagnosis? This highlights the challenges posed by the age-related definition of early childhood caries and the timing of diagnosis of this clinical entity. The age bracket used for the definition of early childhood caries entails the assumption that the majority of children of this age group will have only primary teeth in the oral cavity. However, there is growing evidence to suggest an increasing number of children erupt their first permanent teeth at a younger age due to improved nutrition: cases of eruption of the first permanent incisor by age 4 years had been reported [Ilieva, 2002]. Therefore, if a five-year-old child has a single caries lesion on a permanent tooth, what is the diagnosis for this child? Finally, it is difficult to develop a treatment plan for the lesion with the current definition of ECC. While caries can be divided into mild, moderate and severe with corresponding treatment protocol for each lesion, the age-related categorisation of early childhood caries - severe or non-severe [AAPD, 2008] - makes the development of a treatment protocol challenging and difficult. These scenarios highlight the diagnostic challenges that the current definition of early childhood caries poses. It also underscores the challenges associated with identifying early childhood caries as a distinct lesion from caries in general - it has no distinct diagnostic feature from caries. Defining a lesion by the age of the patient and including a diagnostic criteria that is not restrictive to the age group - caries in the primary dentition - encumbers the attempt to make early childhood caries a distinct clinical entity.


Assuntos
Cárie Dentária/diagnóstico , Criança , Pré-Escolar , Cárie Dentária/classificação , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Dente Decíduo
6.
J Indian Soc Pedod Prev Dent ; 36(2): 108-112, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29970625

RESUMO

Background and Objectives: The dental caries status of a population group with permanent dentition is traditionally described using decayed, missing, and filled teeth or surface (DMFT or DMFS) index, and the corresponding index for the primary dentition is dmft or dmfs. dmf value alone has certain limitations; therefore, additional measures to describe dental caries are important. Poulsen and Horowitz in 1997 described a hierarchical method to determine the severity of dental caries. Aim of the Study: The aim of the study was to determine the pattern of dental caries in 3-6-year-old children using Poulsen and Horowitz hierarchical system and to assess the usefulness of this system. Methodology: Data were collected from 500, 3-6-year-old children. Dmfs was recorded according to World Health Organization criteria 2013. On the basis of the caries recordings, the dmfs score of each child was calculated and each child was assigned to one of the six zones of increasing caries severity, ranging from 0 (caries free) to 5 (most severe). Statistical Analysis Used: The collected data were tabulated and analyzed using Student's t-test, ANOVA, and Pearson's correlation coefficient. Results: The overall mean dmfs for the study population was 9.10. The distribution of children according to the severity zones of Poulsen and Horowitz indicates a very low percentage (17.8%) of caries-free children and also a high percentage of children with caries in severity zone 2 (33.4%) and 4 (18.6%). Conclusion: The Poulsen and Horowitz model gives broader aspect for the assessment of severity of dental caries in 3-6-year-old children.


Assuntos
Índice CPO , Cárie Dentária/diagnóstico , Índice de Gravidade de Doença , Criança , Pré-Escolar , Cárie Dentária/classificação , Feminino , Humanos , Índia , Masculino
7.
J Dent Child (Chic) ; 85(1): 16-22, 2018 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-29663970

RESUMO

PURPOSE: To assess pediatric dentists' choice for restoring Class II carious lesions in primary molars. METHODS: A survey with eight cases of class II carious lesions was emailed to American Academy of Pediatric Dentistry members, who were asked to choose either a stainless steel crown (SSC) or composite resin as a final restoration, or no treatment. Treatment decisions were compared to evidence-based treatment recommendations. Repeated measures logistic regression was used to determine factors associated with treatment decisions. RESULTS: The response rate was 11 percent (n=729). Approximately two-thirds of responses aligned with current evidence-based treatment. Both patient and provider characteristics were associated with the treatment plan. Clinically detectable caries and those restored under general anesthesia were treated more often with an SSC. Faculty and residents, along with providers with less than 10 years' experience, chose an SSC more often. CONCLUSIONS: Due to the multifactorial nature of treatment planning for the pediatric dental patient, more evidence-based research is needed to unify treatment planning modalities and increase evidence-based treatment.


Assuntos
Tomada de Decisão Clínica , Cárie Dentária/terapia , Dente Molar , Planejamento de Assistência ao Paciente , Odontopediatria , Padrões de Prática Odontológica , Dente Decíduo , Criança , Pré-Escolar , Cárie Dentária/classificação , Humanos
8.
Implement Sci ; 13(1): 54, 2018 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-29625615

RESUMO

BACKGROUND: This study aimed to identify barriers and enablers for dentists managing non-cavitated proximal caries lesions using non- or micro-invasive (NI/MI) approaches rather than invasive and restorative methods in New Zealand, Germany and the USA. METHODS: Semi-structured interviews were conducted, focusing on non-cavitated proximal caries lesions (radiographically confined to enamel or the outer dentine). Twelve dentists from New Zealand, 12 from Germany and 20 from the state of Michigan (USA) were interviewed. Convenience and snowball sampling were used for participant recruitment. A diverse sample of dentists was recruited. Interviews were conducted by telephone, using an interview schedule based on the Theoretical Domains Framework (TDF). RESULTS: The following barriers to managing lesions non- or micro-invasively were identified: patients' lacking adherence to oral hygiene instructions or high-caries risk, financial pressures and a lack of reimbursement for NI/MI, unsupportive colleagues and practice leaders, not undertaking professional development and basing treatment on what had been learned during training, and a sense of anticipated regret (anxiety about not restoring a proximal lesion in its early stages before it progressed). The following enablers were identified: the professional belief that remineralisation can occur in early non-cavitated proximal lesions and that these lesions can be arrested, the understanding that placing restorations weakens the tooth and inflicts a cycle of re-restoration, having up-to-date information and supportive colleagues and work environments, working as part of a team of competent and skilled dental practitioners who perform NI/MI (such as cleaning or scaling), having the necessary resources, undertaking ongoing professional development and continued education, maintaining membership of professional groups and a sense of professional and personal satisfaction from working in the patient's best interest. Financial aspects were more commonly mentioned by the German and American participants, while continuing education was more of a focus for the New Zealand participants. CONCLUSIONS: Decisions on managing non-cavitated proximal lesions were influenced by numerous factors, some of which could be targeted by interventions for implementing evidence-based management strategies in practice.


Assuntos
Tomada de Decisões , Cárie Dentária/terapia , Esmalte Dentário , Odontólogos/psicologia , Padrões de Prática Odontológica/estatística & dados numéricos , Cárie Dentária/classificação , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa
9.
Caries Res ; 52(5): 359-366, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29510396

RESUMO

Dentin carious lesion is a dynamic process that involves demineralization and collagen denaturation. Collagen type I is the major protein in dentin and it has been investigated based on its optical properties. Multiphoton microscopy (MPM) is a nonlinear imaging technique that reveals the caries process using the collagen two-photon excitation fluorescence (2PEF) and its second-harmonic generation (SHG). Combining the histological and the International Caries Detection and Assessment System (ICDAS) classifications with nonlinear optical spectroscopy (NLOS), 2PEF and SHG intensities of enamel and dentin were highly altered during the caries process. It has been proven that the ratio SHG/2PEF is a relevant indicator of the organic matrix denaturation [Terrer et al.: J Dent Res 2016; 96: 574-579]. In the present study, a series of measurable signals is made to detect early stages of carious lesion according to the ICDAS classification and to explore the relationship between these measures and the ICDAS scale. Comparison of the efficiency of nonlinear optical signals for caries detection with the ICDAS classification is essential to evaluate their potential for clinical application. In our study, the use of the NLOS measured by MPM allowed us to monitor a quantitative parameter (SHG/2PEF ratio) according to the dentin carious lesion state (ICDAS and histological examination). Three coherent new groups were defined (ICDAS 0/1; ICDAS 2/3; ICDAS 4/5/6), where the carious process can be clearly described with a statistically significant decrease of the SHG/2PEF ratio.


Assuntos
Cárie Dentária/diagnóstico , Adulto , Cárie Dentária/classificação , Cárie Dentária/diagnóstico por imagem , Cárie Dentária/patologia , Esmalte Dentário/diagnóstico por imagem , Esmalte Dentário/patologia , Progressão da Doença , Humanos , Microscopia de Fluorescência por Excitação Multifotônica
10.
Caries Res ; 52(5): 397-405, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29506010

RESUMO

The Nyvad classification is a visual-tactile caries classification system devised to enable the detection of the activity and severity of caries lesions with special focus on low-caries populations. The criteria behind the classification reflect the entire continuum of caries, ranging from clinically sound surfaces through noncavitated and microcavitated caries lesions in enamel, to frank cavitation into the dentin. Lesion activity at each severity stage is discriminated by differences in surface topography and lesion texture. The reliability of the Nyvad criteria is high to excellent when used by trained examiners in the primary and permanent dentitions. The Nyvad criteria have construct validity for lesion activity assessments because of their ability to reflect the well-known caries-controlling effect of fluoride. Predictive validity was demonstrated by showing that active noncavitated lesions are at higher risk of progressing to a cavity or filled state than do inactive noncavitated lesions. Lesion activity assessment performed successfully as a screening tool to identify individuals with a poor caries prognosis. Because of their predictive validity, the Nyvad criteria are superior to other current caries lesion descriptors for the detection of changes in the lesion activity status over time. The Nyvad criteria fulfill all the formal requirements for a robust caries lesion classification and are recommended for evidence-based caries management in clinical practice and in research.


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/classificação , Cárie Dentária/patologia , Cárie Dentária/terapia , Pesquisa em Odontologia/normas , Humanos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
11.
Caries Res ; 52(5): 406-419, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29518788

RESUMO

The aims of this study were: (1) to evaluate the overall reproducibility and accuracy of the International Caries Detection and Assessment System (ICDAS) for assessing coronal caries lesions, and (2) to investigate the use of systems associated with the ICDAS for activity assessment of coronal caries lesions. Specific search strategies were adopted to identify studies published up to 2016. For the first objective, we selected studies that assessed primary coronal caries lesions using the ICDAS as a reference standard. A total of 54 studies were included. Meta-analyses summarized the results concerning reproducibility and accuracy (correlation with histology, summary ROC curves [SROC], and diagnostic odds ratio [DOR]). The latter 2 were expressed at D1/D3 levels. The heterogeneity of the studies was also assessed. Reproducibility values (pooled) were > 0.65. The ICDAS mostly presented a good overall performance as most areas under SROC were > 0.75 at D1 and > 0.90 at D3; DOR ≥6. For the second objective, we selected studies investigating activity assessment associated with the ICDAS. The meta-analyses pooled results based on the same methodology and parameters as above. Longitudinal findings regarding caries progression were described to estimate the validity of these systems. On average, the systems for activity assessment of caries lesions showed moderate values concerning reproducibility and overall performance. Active caries lesions were more prone to progress than inactive ones after 2 years. In conclusion, the ICDAS presented a substantial level of reproducibility and accuracy for assessing primary coronal caries lesions. Additional systems associated with the ICDAS that classify caries lesion activity can be useful as they are moderately reproducible and accurate.


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/classificação , Cárie Dentária/patologia , Progressão da Doença , Humanos , Reprodutibilidade dos Testes
12.
Eur J Dent Educ ; 22 Suppl 1: 30-37, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29601679

RESUMO

This study reports on the full-day workshop "The Shape of The Future of Dental Education for Dental Caries-and how we get there" held immediately prior to the May 2017 ADEE/ADEA/King's College London meeting "Shaping the Future of Dental Education." A standardised, evidence-led Core Curriculum in Cariology (CCC) was developed jointly and systematically by ORCA and ADEE, starting in 2010. At the same time, the ICDAS Foundation was developing a comprehensive caries management system, ICCMS™. The workshop reported on what has been achieved on a global basis by many building on these initiatives. The CCC has been, or is currently being, localised in a number of places around the world and has, in some countries, been successfully implemented. There are also other areas which are struggling more with the logistics of introducing it. The workshop presented geographical perspectives and experiences on implementing the CCC from Colombia, the United States and Europe, as well as professional perspectives from hygienists, students and policymakers. The workshop then considered the future of the CCC and the roles of Interprofessional Education, Technology, Global Networking and Assessment in a Global Context in 4 breakout groups. Having had reports back and plenary discussion, it was concluded that the caries world has made good progress towards a "futuristic" curriculum with parallel development of a comprehensive, preventive and tooth-preserving caries management system-ICCMS™. The implementation challenge is now to share even more effectively in order to have these developments more widely accepted and adopted worldwide.


Assuntos
Cárie Dentária/terapia , Educação em Odontologia/tendências , Colômbia , Cárie Dentária/classificação , Higienistas Dentários/educação , Educação em Odontologia/métodos , Registros Eletrônicos de Saúde , Europa (Continente) , Previsões , Política de Saúde , Humanos , Cooperação Internacional , Relações Interprofissionais , Política , Estudantes de Odontologia
13.
Oper Dent ; 43(3): 261-271, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29533716

RESUMO

The purpose of this study was to evaluate a nanofilled and a nanohybrid composite, in combination with manufacturer-recommended etch-and-rinse adhesives, in class IV cavities. Thirty-four patients aged 14-46 years (mean age, 27.1 years) comprised the study group. Twenty-six patients received two class IV restorations and eight patients received four class IV restorations. For each patient, half the number of restorations were performed using a nanohybrid composite (Ceram X duo) and the remaining half used a nanofilled resin composite (Filtek Supreme XT), with two- (XP Bond) and three-step (Scotchbond Multipurpose) etch-and-rinse adhesives, respectively. Two experienced examiners evaluated the restorations for retention, color match, marginal discoloration, wear/loss of anatomic form, caries formation, marginal adaptation, and surface texture to compare the baseline (after placement) and annual recalls over 5 years. The cumulative success rates for the Filtek Supreme XT and Ceram X duo restorations after five years were 86.2% and 89.7%, respectively. Four Filtek Supreme XT and three Ceram X duo restorations failed. There was no statistically significant difference between the nanofilled and nanohybrid composites at any of the evaluation periods for any of the parameters evaluated. Despite the limited number of restorations, all restorations were clinically acceptable regarding retention, color match, marginal discoloration, wear or loss of anatomic form, the formation of caries, marginal adaptation, and surface texture, except the failed restorations. Fracture was the main cause of restoration failure.


Assuntos
Resinas Compostas/uso terapêutico , Cárie Dentária/cirurgia , Restauração Dentária Permanente/métodos , Nanoestruturas/uso terapêutico , Cimentos de Resina/uso terapêutico , Adolescente , Adulto , Cárie Dentária/classificação , Adaptação Marginal Dentária , Falha de Restauração Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
14.
Compend Contin Educ Dent ; 39(2): 79-83; quiz 84, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29388781

RESUMO

Traditionally, testing for whether pit-and-fissure caries should be restored involved probing with a sharp explorer and evaluating resistance to withdrawal (ie, "stick"). Alternative visual methods of evaluation and classification have been proposed, validated, and accepted formally in the core curriculum on caries management in both Europe and North America. This article examines the resistance to occlusal breakdown of fluoridehardened enamel despite progression of underlying dentin caries with accompanying difficulty in diagnosis. Traditional methods of pit-and-fissure caries diagnosis, including radiographs or fissure probing with an explorer, have been shown to be inaccurate and potentially destructive. The clinical process of using the visual/tactile International Caries Detection and Assessment System (ICDAS) and/or the Caries Classification System (CCS) is described and illustrated through case examples.


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/classificação , Humanos , Medição de Risco
15.
J Dent ; 68: 79-84, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29169969

RESUMO

OBJECTIVES: This study aimed to evaluate the quality of posterior restorations (amalgam or composite) placed in adults from a birth cohort and its association with clinical and socioeconomic determinants experienced during their life course. METHODS: A representative sample (n=539) of all 5914 births occurring in Pelotas (Brazil) in 1982 was prospectively investigated. Quality of posterior restorations (satisfactory or unsatisfactory) was assessed at 31 yrs-old, using modified USPHS criteria. Trained and calibrated dentists performed clinical examination. Explanatory variables included demographic and socioeconomic, oral health and dental service utilization patterns during the life course. Tooth related variables (type of tooth, material, size of cavity) were also analyzed. Untreated caries and socioeconomic status were assessed by group-based trajectories analyses. Multilevel Regression models were used to determine factors associated with restoration outcomes. RESULTS: In total 2123 restorations (53% composite) were evaluated of which 107 (5%) were assessed as failed. The main reasons for failure were tooth/restoration fracture (50.5%) and secondary caries (30.7%). Failures in posterior restorations showed a significant association with socioeconomic aspects (lower tertile of income at age 30 - prevalence ratio (PR) 2.21 [95% CI 1.19-4.09]), clinical variables (trajectory of higher untreated caries - PR 2.11 [95% CI 1.23-3.61]) and also with tooth-related factors (Restorations involving three or more surfaces - PR 5.51 [95% CI 3.30-9.19]) after adjustment for each other. CONCLUSIONS: These findings suggest that, although tooth-related variables have an important role in restoration longevity, patient-related factors, such as socioeconomic variables and untreated caries are also associated with failure and should be taken into account when evaluating longevity of posterior restorations. CLINICAL SIGNIFICANCE: This was the first study assessing long-term trajectory of untreated caries, showing an association between higher experience of caries during the life-course and unsatisfactory restorations. The findings suggest that individual related factors should be considered when planning treatment and in future research evaluating the longevity of dental restorations.


Assuntos
Assistência Odontológica/economia , Cárie Dentária/economia , Cárie Dentária/terapia , Restauração Dentária Permanente/normas , Renda , Determinantes Sociais da Saúde/classificação , Adulto , Brasil , Estudos de Coortes , Resinas Compostas/química , Amálgama Dentário/química , Cárie Dentária/classificação , Preparo da Cavidade Dentária/classificação , Materiais Dentários/classificação , Falha de Restauração Dentária , Escolaridade , Feminino , Seguimentos , Disparidades em Assistência à Saúde , Humanos , Seguro Saúde , Masculino , Análise Multinível , Saúde Bucal , Satisfação do Paciente , Fatores Socioeconômicos , Análise de Sobrevida
16.
J Dent ; 69: 83-87, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29138112

RESUMO

OBJECTIVE: Case presentations (vignettes) were completed by dentists in the National Dental Practice-Based Research Network study "Decision Aids for the Management of Suspicious Occlusal Caries Lesions (SOCLs)". The objective was to determine dentists' decision strategies for SOCLs. METHODS: 107 dentists viewed a series of 16 vignettes that represented all combinations of 4 clinical cues: color, luster, lesion roughness, and patient-level caries risk. Each vignette included a patient description and a photograph of a tooth presenting the 4 cues. Dentists were asked to decide the likelihood that a suspected lesion extended into dentin. A lens model analysis was used to examine how dentists use these cues in making their decisions. RESULTS: 86% of dentists had a consistent pattern of cue use that defined their decision strategy. On average, 70% of the variance in their decisions was accounted for by their use of the 4 cues. However, there was considerable variability in the individual cues used by each dentist. The percentages of dentists who used the different cues consistently were: luster (58%), color (48%), roughness (36%), and risk (35%). 14% of dentists reliably used only color, 7% used only luster, 4% used only roughness, and 1% used only risk when making SOCL decisions. CONCLUSIONS: The online vignette system suggests that clinical SOCL decision strategies are highly individualized and dentists do not use all cues available to them to make these decisions. CLINICAL SIGNIFICANCE: Prior to this study, there has been little evidence about how dentists use these cues (either individually or in combination) when judging the extent of caries progression. Such knowledge would be valuable when designing interventions to help dentists maximize the likelihood of appropriate treatment decisions.


Assuntos
Tomada de Decisões , Cárie Dentária/diagnóstico , Odontólogos/psicologia , Adulto , Idoso , Cor , Cárie Dentária/classificação , Cárie Dentária/patologia , Cárie Dentária/terapia , Esmalte Dentário/patologia , Restauração Dentária Permanente/classificação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Odontológica , Propriedades de Superfície , Inquéritos e Questionários
17.
Artigo em Inglês | MEDLINE | ID: mdl-29169512

RESUMO

OBJECTIVE: Although radiation-related caries (RRC) are a well-known toxicity of head and neck radiotherapy, a clinical classification system for RRC has not yet been clinically validated. Therefore, the aim of this study was to assess whether the International Caries Detection and Assessment System (ICDAS) and the Post-Radiation Dental Index (PRDI) were viable methods for the assessment of RRC. STUDY DESIGN: Clinicopathologic data and intraoral digital photographs of 60 patients (833 teeth) affected by RRC were assessed and classified according to the ICDAS and PRDI criteria. RESULTS: A total of 814 (97.7%) teeth presented RRC lesions ranging from early stage to complete tooth destruction. Mean scores for the whole sample were 5 for ICDAS and 3 for PRDI, indicating that RRC were diagnosed predominately in late stages. ICDAS and PRDI criteria underestimate the clinical expressivity of RRC by not including the whole qualitative clinical spectrum of RRC, such as enamel cracks, delamination, dental crown amputation, surface color alterations, and atypical lesions topography (incisal/cuspal caries). CONCLUSIONS: ICDAS and PRDI may not be considered viable for the assessment of RRC. The development of a specific clinical classification system is urgently needed to help clinicians recognize the peculiar patterns of RRC, particularly in incipient cases.


Assuntos
Cárie Dentária/classificação , Cárie Dentária/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Lesões por Radiação/diagnóstico por imagem , Brasil , Cárie Dentária/diagnóstico por imagem , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Fotografia Dentária , Dosagem Radioterapêutica , Estudos Retrospectivos
19.
Infect Immun ; 85(8)2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28507066

RESUMO

The oral microbiota associated with the initiation and progression of dental caries has yet to be fully characterized. The Human Oral Microbe Identification Using Next-Generation Sequencing (HOMINGS) approach was used to analyze the microbiomes of site-specific supragingival dental plaques from children with different caries status. Fifty-five children (2 to 7 years of age) were assessed at baseline and at 12 months and grouped as caries free (CF), caries active with enamel lesions (CAE), and caries active with dentin carious lesions (CA). Plaque samples from caries-free tooth surfaces (PF) and from enamel carious lesions (PE) and dentin carious lesions (PD) were collected. 16S community profiles were obtained by HOMINGS, and 408 bacterial species and 84 genus probes were assigned. Plaque bacterial communities showed temporal stability, as there was no significant difference in beta diversity values between the baseline and 12-month samples. Irrespective of collection time points, the microbiomes of healthy tooth surfaces differed substantially from those found during caries activity. All pairwise comparisons of beta diversity values between groups were significantly different (P < 0.05), except for comparisons between the CA-PF, CAE-PE, and CA-PE groups. Streptococcus genus probe 4 and Neisseria genus probe 2 were the most frequently detected taxa across the plaque groups, followed by Streptococcus sanguinis, which was highly abundant in CF-PF. Well-known acidogenic/aciduric species such as Streptococcus mutans, Scardovia wiggsiae, Parascardovia denticolens, and Lactobacillus salivarius were found almost exclusively in CA-PD. The microbiomes of supragingival dental plaque differ substantially among tooth surfaces and children of different caries activities. In support of the ecological nature of caries etiology, a steady transition in community species composition was observed with disease progression.


Assuntos
Bactérias/isolamento & purificação , Cárie Dentária/microbiologia , Placa Dentária/microbiologia , Microbiota , Bactérias/classificação , Bifidobacterium/isolamento & purificação , Criança , Pré-Escolar , Cárie Dentária/classificação , Esmalte Dentário/microbiologia , Dentina/microbiologia , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Masculino , RNA Ribossômico 16S , Streptococcus/classificação , Streptococcus/isolamento & purificação , Streptococcus mutans/isolamento & purificação , Streptococcus sanguis/isolamento & purificação
20.
Pediatr Dent ; 39(2): 118-123, 2017 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-28390461

RESUMO

PURPOSE: The purpose of this cross-sectional study was to evaluate the impact of untreated caries in different stages on the oral healthrelated quality of life (OHRQoL) of one- to three-year-olds and their families. METHODS: The mothers of 308 children answered the Brazilian version of the Early Childhood Oral Health Impact Scale to determine their perceptions of the OHRQoL of their children. The mothers also answered a questionnaire addressing demographic and socioeconomic characteristics of their families. The children were submitted to a clinical examination for the diagnosis of dental caries using International Caries Detection and Assessment System criteria. Data analysis involved descriptive statistics, Kruskal-Wallis and Mann-Whitney tests, and hierarchically adjusted Poisson regression models. RESULTS: The prevalence of untreated caries was 64.3 percent. Among the children with caries, 53.5 percent exhibited the severe stage of the condition. Negative impact on OHRQoL was significantly associated with severe stage of caries (prevalence ratio [PR] equals 2.80, 95 percent confidence interval [CI] equals 1.90 to 4.12, P<0.001), and a younger age for the mother (PR equals 1.69, 95 percent CI equals 1.27 to 2.25, P<0.001). CONCLUSION: Untreated caries in advanced stages was associated with a poorer quality of life among one- to three-year-olds and their families.


Assuntos
Cárie Dentária , Qualidade de Vida , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Cárie Dentária/classificação , Cárie Dentária/epidemiologia , Feminino , Humanos , Lactente , Masculino , Mães , Análise Multivariada , Saúde Bucal , Prevalência , Índice de Gravidade de Doença , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA