Poliklinik für Kieferorthopädie, Präventive Zahnmedizin und Kinderzahnheilkunde
Refine
Year of publication
Document Type
- Article (21)
- Doctoral Thesis (21)
Language
- English (42) (remove)
Has Fulltext
- yes (42)
Is part of the Bibliography
- no (42)
Keywords
- - (19)
- Caries (5)
- Karies (5)
- periodontitis (4)
- Caries epidemiology (3)
- Caries experience (3)
- Children (3)
- Germany (3)
- Caries index (2)
- Consensus (2)
Institute
- Poliklinik für Kieferorthopädie, Präventive Zahnmedizin und Kinderzahnheilkunde (42)
- Institut für Community Medicine (1)
- Institut für Diagnostische Radiologie (1)
- Institut für Klinische Chemie und Laboratoriumsmedizin (1)
- Klinik für Anästhesiologie und Intensivmedizin (1)
- Klinik für Psychiatrie und Psychotherapie (1)
- Klinik und Poliklinik für Augenheilkunde (1)
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie/Plastische Operationen (1)
- Klinik und Poliklinik für Orthopädie und Orthopädische Chirurgie (1)
- Kliniken und Polikliniken für Innere Medizin (1)
Publisher
- S. Karger AG (12)
- SAGE Publications (3)
- MDPI (2)
- Frontiers Media S.A. (1)
- Hindawi (1)
- Wiley (1)
Objectives:
This study investigates the effectiveness of the Cold AP on the alteration of the enamel surface
without using acid etchant by using Conventional photo-activated resin bond to bond the
orthodontic brackets.
Materials and Methods:
One hundred and twenty-five Enamel specimens are prepared from disinfected bovine
mandibular incisors are divided into five groups. Group I: brackets are attached on the enamel
surface with the standard adhesive technique (etch + primer +bond). Group II: the brackets are
attached with the Standard Orthodontic adhesive technique without etching. Group III: the
enamel surface is conditioned with pure Argon Cold atmospheric plasma before the application
of the primer without using an acid etchant. Group IV: the enamel surface is conditioned with
the admixture of Argon Cold atmospheric plasma with 0.5 % Oxygen before the application of
the primer without using acid etchant Group V: after the application of Argon Cold atmospheric
plasma with 0.5 % Oxygen the surface is rewetted by deionized water before the application
of the primer and adhesive. After that, the samples are exposed to thermal cycling. The shear
bond strength of the samples is tested by the universal testing machine which measured the
maximum force at which the brackets are deboned from the tooth surface at a speed of
1mm/minute is measured.
Results:
Significant intergroup differences were found. Group V showed the highest shear bond
strength followed by Group I, VI, III, II respectively. There isn’t a statistical difference in the
values of The Shear bond strength values between Group III and IV.
Conclusions:
this study implies that Cold Atmospheric Plasma is a safe method to change the chemical
surface characteristics of the enamel surface.in addition to the significant importance of plasma
treatment followed by water rewetting, which could enhance adhesion between the orthodontic
attachments and the enamel layer
Potential of nitrous oxide sedation in pedodontics to reduce the need of dental general anesthesia
(2022)
Aim: To investigate the possible reduction of the need for dental general anesthesia (DGA) through nitrous oxide sedation (NOS), when is used in combination with behavior management techniques among patients younger than 12 years of age referred to a specialized pedodontics practice due to the high dental treatment need and poor cooperation level.
Materials and methods: Retrospective analysis was performed of the digital medical records of all children treated under NOS in a specialized pedodontics clinic between 2012 and 2017. The potential reduction of the need for dental general anesthesia was assessed depending on the success rate of NOS on patient-level with relations to multiple related factors such as age, reason of referral and treatment need.
Results: out of 510 patients, 228 meet the inclusion criteria. Nitrous oxide was used in 406 dental treatment sessions on 228 pre-cooperative and/or anxious patients aged 3-12 years (mean 6.4±1.7; 43.4% female). 91.9% of the NOS sessions were successful in achieving the intended dental treatment. Complete oral rehabilitation was possible for 84% of the patients using NOS without the need of DGA. Regarding the age, DGA reduction among pre-school children was lower than in schoolchildren (77.8% and 87.9%, respectively).
Conclusion: A high fraction of anxious or semi-cooperative children with high dental treatment needs can be treated without the use of DGA when a comprehensive concept of caries management is combined with the use of NOS and behavior management techniques. NOS should, therefore, always be considered as an option for dental treatment of semi-cooperative children with high dental treatment needs before making a decision towards DGA.
The aim of this study has twofold. First, to investigate characteristics of paediatric patients seeking emergency dental care and the according treatment in a specialised dental service. The second aim, to propose a data-based guidance for management of dental emergency in children including pain management without traumatizing the child and with a clear differentiation of dental emergency patients.
Records of the demographic and clinical characteristics of 332 children (mean age 8.2 ±4.2 years) who attended the Department of Preventive and Paediatric Dentistry at the University of Greifswald in 2018 without an appointment seeking emergency dental care were collected. Statistical analysis was carried out using descriptive statistics and Chi-square tests. Based on the data a proposal for management of emergency/pain patients was performed.
Pain patients were high caries risk children (mean: 4.59 ±3.65 dmft, 1.65 ±2.73 DMFT). The main clinical diagnoses of pain patients in all different age groups were dental caries and caries-related complications such as reversible and irreversible pulpitis or periapical periodontitis (63.6%), while dental trauma contributed (8.4%). In general, the most frequent treatment was extraction (41.0%), most of these extractions needed to be rendered under either nitrous oxide sedation or general anaesthesia (57.3%).
This study has shown a clear association between the dental emergency management plan (delay of the dental treatment) and other factors such as, the required treatment (invasive or not invasive) P < 0.05, the need of sedation P < 0.05 and child’s previous dental experience (first visit to the dental clinic) P < 0.001. Most of the extraction procedures were not rendered immediately in the emergency/pain visit, rather they were delayed to be performed in the next treatment session (70%), with the majority of these procedures planned to be rendered under sedation. On the other hand, most of the restorations (65.5%) were performed in the emergency/pain visit, with need of sedation for only (8.3%) of these procedures. In addition, the majority of treatments of children who were visiting the dental clinic for the first time were postponed (71.6%; n=63). The correlation analysis shows a higher tendency to postpone the treatment when the required treatment is invasive, need to be rendered under sedation or when
it was the child’s first visit to the dental clinic. These findings indicate the strong impact of child’s cooperation on the emergency management plan.
Based on these data the guidance for management of peadiatric dental emergency patients was developed including pain management without causing negative affect of the child’s future cooperation
Background
Observational and in-vivo research suggested a bidirectional relationship between depression and periodontitis. We estimated the genetic correlation and examined directionality of causation.
Methods
The study used summary statistics from published genome wide association studies, with sample sizes ranging from 45,563 to 797,563 individuals of European ancestry. We performed linkage disequilibrium score regression (LDSC) to estimate global correlation and used Heritability Estimation from Summary Statistics (ρ-HESS) to further examine local genetic correlation. Latent Heritable Confounder Mendelian randomization (LHC-MR), Causal Analysis using Summary Effect estimates (CAUSE), and conventional MR approaches assessed bidirectional causation.
Results
LDSC observed only weak genetic correlation (rg = 0.06, P-Value = 0.619) between depression and periodontitis. Analysis of local genetic correlation using ρ-HESS did not reveal loci of significant local genetic covariance. LHC-MR, CAUSE and conventional MR models provided no support for bidirectional causation between depression and periodontitis, with odds ratios ranging from 1.00 to 1.06 in either direction.
Conclusions
Results do not support shared heritability or a causal connection between depression and periodontitis.
Genetic risk factors play important roles in the etiology of oral, dental, and craniofacial diseases. Identifying the relevant risk loci and understanding their molecular biology could highlight new prevention and management avenues. Our current understanding of oral health genomics suggests that dental caries and periodontitis are polygenic diseases, and very large sample sizes and informative phenotypic measures are required to discover signals and adequately map associations across the human genome. In this article, we introduce the second wave of the Gene-Lifestyle Interactions and Dental Endpoints consortium (GLIDE2) and discuss relevant data analytics challenges, opportunities, and applications. In this phase, the consortium comprises a diverse, multiethnic sample of over 700,000 participants from 21 studies contributing clinical data on dental caries experience and periodontitis. We outline the methodological challenges of combining data from heterogeneous populations, as well as the data reduction problem in resolving detailed clinical examination records into tractable phenotypes, and describe a strategy that addresses this. Specifically, we propose a 3-tiered phenotyping approach aimed at leveraging both the large sample size in the consortium and the detailed clinical information available in some studies, wherein binary, severity-encompassing, and “precision,” data-driven clinical traits are employed. As an illustration of the use of data-driven traits across multiple cohorts, we present an application of dental caries experience data harmonization in 8 participating studies (N = 55,143) using previously developed permanent dentition tooth surface–level dental caries pattern traits. We demonstrate that these clinical patterns are transferable across multiple cohorts, have similar relative contributions within each study, and thus are prime targets for genetic interrogation in the expanded and diverse multiethnic sample of GLIDE2. We anticipate that results from GLIDE2 will decisively advance the knowledge base of mechanisms at play in oral, dental, and craniofacial health and disease and further catalyze international collaboration and data and resource sharing in genomics research.
(1) Background: In Germany, new recommendations for dental examinations of children and the use of fluorides have been introduced. The pediatrician (PA) should refer the patient to the dentist for dental examinations and check-ups (DEs) from the sixth month of age. Therefore, our aim was to determine with a questionnaire the extent to which PAs find DE useful, make referrals for DE and recommend fluoride. (2) Methods: The nationwide empirical survey was conducted with a self-developed and validated standardized online questionnaire. In addition to personal information, 16 items were collected. Agreement with the items was recorded using Likert scales. The data were primarily analysed descriptively. (3) Results: 696 PAs participated in the survey (age: 51.7 (8.4) years, women/men: 428/286 (61.5/38.5%). A total of 11% of PAs found referral by eruption of first tooth very important (important/neutral/unimportant: 13.8/32/43.2%), compared to 70% for complete deciduous teeth (21.3/7.3/1.4%). A total of 48.8% of PAs always recommended fluoridated toothpaste from the first tooth (often/occasionally/rarely/never: 18.3/7.8/8/17.1%) and 50.6% completely refused to recommend fluoride-free toothpaste (always/often/occasionally/rarely: 9.8/9/14.7/15.9%). A total of 44.8% never recommended the use of fluoridated toothpaste if the child cannot yet spit (always/often/occasionally/rarely: 19.2/13.9/7.8/14.3%). (4) Conclusions: Among PAs, referral to DEs was increasingly implemented as children grew older. Specific fluoride recommendations were accepted.
Abstract
Aim
Observational research suggests that periodontitis affects psoriasis. However, observational studies are prone to reverse causation and confounding, which hampers drawing causal conclusions and the effect direction. We applied the Mendelian randomization (MR) method to comprehensively assess the potential bi‐directional association between periodontitis and psoriasis.
Materials and Methods
We used genetic instruments from the largest available genome‐wide association study of European descent for periodontitis (17,353 cases, 28,210 controls) to investigate the relationship with psoriasis (13,229 cases, 21,543 controls), and vice versa. Causal Analysis Using Summary Effect (CAUSE) estimates and inverse variance‐weighted (IVW) MR analyses were used for the primary analysis. Robust MR approaches were used for sensitivity analyses.
Results
Both univariable methods, CAUSE and IVW MR analyses, did not reveal any impact of periodontitis on psoriasis (CAUSE odds ratio [OR] = 1.00, p = 1.00; IVW OR = 1.02, p = .6247), or vice versa (CAUSE OR = 1.01, p = .5135; IVW OR = 1.00, p = .7070). The null association was corroborated by pleiotropy‐robust methods with ORs close to 1 and p‐values >.59. Overall, MR analyses did not suggest any effect of periodontitis on psoriasis. Similarly, there was no evidence to support an effect of psoriasis on periodontitis.
Conclusions
Within the limitations of this MR study, the outcomes supported neither periodontitis affecting psoriasis nor psoriasis affecting periodontitis.
Primary tooth trauma occurs commonly during the development of motor coordination. Its consequences do not only affect the traumatized primary tooth but may affect the underlying permanent successor as well. Its management may involve very high costs on patients and insurance companies and complicated injuries can have negative effects on the quality of life of preschool children. Investigating the causes and patterns of trauma in primary teeth are highly needed to aim for preventive measures. This retrospective study compared the patterns of dental trauma injuries at the trauma center at Greifswald University/Germany for a recent pediatric cohort (2014-16, 103 children) with a historic one before the German unification and the health care system reformation (1974-1989, n=120). The data contained details on etiology, injury types and treatment delivered for 450 injured teeth (247 historic, 203 recent). In both cohorts, the occurrence was more common in males than females (63%/55%, resp.) with an age peak from 2 to 6 years. Maxillary incisors were most affected (89.6%/88.6%, resp.) and periodontal ligament injuries dominated (77.8%/90.3%, resp.).
Almost half of the injuries occurred at home (46.6%), mostly due to falling (48.5%) or during playing (37.8%) in the recent pediatric cohort which provided better forensic data due to insurance issues and potential concern about child abuse. Advice and follow up was the most common approach in the recent pediatric cohort (76%).
Trauma patterns in the primary dentition seem to be rather universal due to the activities of small children and their anatomic conditions. Trauma to primary dentition occurred mostly at home or in the nurseries and possibly is hard to avoid due to falls or accidents during normal playing. Even after 30 years and a change in the health care system due to German unification, the patterns remain similar.
2
Objective: To compare the effectiveness and complications of intraligamentary anesthesia
(ILA) with conventional inferior alveolar nerve block (IANB) during injection and dental
treatment of mandibular posterior teeth.
Materials and Methods: In this randomized, prospective clinical trial, 72 patients (39 males, 33
females) patients scheduled for dental treatment of mandibular posterior teeth, were randomly
allocated to ILA group (n=35) received ILA injection or IANB group (n=37) received the
conventional IANB. Our primary outcome was to assess pain and stress (discomfort) during the
injection and dental treatment, using the Numeric Rating Scale (NRS) from 0 to 10 (0 = no
pain, 10= the worst pain imaginable). Whereas; recording 24 hours postoperative complications
were our Secondary outcomes.
Results: Patients in ILA group reported significantly less pain during injection when compared
with IANB group (p=0.03). While pain during dental treatment was similar in both groups
(p=0.2). Patients in both groups also reported similar low values of discomfort during treatment
(p= 0.7). Although no signs of nerve contact or any other postoperative complications were
observed, five patients in IANB group (none in ILA group) reported temporary irritations
Conclusion: This study showed equivalent effectiveness of both intraligamentary anesthesia
and conventional inferior alveolar nerve block, for pain control during routine dental treatment
of mandibular posterior teeth. Nevertheless, ILA showed significantly less pain during
injection. No major postoperative complications in both groups were observed.
Clinical Relevance: ILA could be considered as an effective alternative for routine dental
treatment.
Non-carious dental lesions such as developmental defects of enamel (DDE) and erosive tooth wear (ETW) are the subject of intensive research. This paper aims to give perspectives on both DDE, including dental fluorosis and molar incisor hypomineralization (MIH), and ETW, presenting epidemiological data from the Americas and associated diagnostic aspects. Besides, it is important to present evidence to guide the clinical assessment process, supporting the clinicians’ management decisions towards better oral health of their patients. The overall increase in the worldwide prevalence of non-carious lesions discussed in this this paper may reflect the need of perceptual changes. Although the number of publications related to these conditions has been increasing in the last years, there is still a need for clinical diagnostic and management awareness to include these conditions in routine dental practice. Besides, it is important to provide recommendations for standardized clinical assessment criteria, improving the process and helping clinicians’ adherence. In this sense, this paper discusses the most commonly implemented indices for each condition. Thus, despite the wide range of diagnostic indices, BEWE is proposed to be the index recommended for ETW assessment, Dean or Thylstrup & Fejerskov indices for fluorosis and preferably the EAPD criteria (or modified DDE index) for MIH. Overall, non-carious lesions are a growing concern, and it is important to implement preventive measures that control their severity and progression, and accurate diagnosis by the dental clinician.
The aims of this study were to 1) determine if continuous eruption occurs in the maxillary teeth, 2) assess the magnitude of the continuous eruption, and 3) evaluate the effects of continuous eruption on the different periodontal parameters by using data from the population-based cohort of the Study of Health in Pomerania (SHIP). The jaw casts of 140 participants from the baseline (SHIP-0) and 16-y follow-up (SHIP-3) were digitized as 3-dimensional models. Robust reference points were set to match the tooth eruption stage at SHIP-0 and SHIP-3. Reference points were set on the occlusal surface of the contralateral premolar and molar teeth, the palatal fossa of an incisor, and the rugae of the hard palate. Reference points were combined to represent 3 virtual occlusal planes. Continuous eruption was measured as the mean height difference between the 3 planes and rugae fix points at SHIP-0 and SHIP-3. Probing depth, clinical attachment levels, gingiva above the cementoenamel junction (gingival height), and number of missing teeth were clinically assessed in the maxilla. Changes in periodontal variables were regressed onto changes in continuous eruption after adjustment for age, sex, number of filled teeth, and education or tooth wear. Continuous tooth eruption >1 mm over the 16 y was found in 4 of 140 adults and averaged to 0.33 mm, equaling 0.021 mm/y. In the total sample, an increase in continuous eruption was significantly associated with decreases in mean gingival height (B = −0.34; 95% CI, −0.65 to −0.03). In a subsample of participants without tooth loss, continuous eruption was negatively associated with PD. This study confirmed that continuous eruption is clearly detectable and may contribute to lower gingival heights in the maxilla.
The Study of Health in Pomerania (SHIP), a population-based study from a rural state in northeastern Germany with a relatively poor life expectancy, supplemented its comprehensive examination program in 2008 with whole-body MR imaging at 1.5 T (SHIP-MR). We reviewed more than 100 publications that used the SHIP-MR data and analyzed which sequences already produced fruitful scientific outputs and which manuscripts have been referenced frequently. Upon reviewing the publications about imaging sequences, those that used T1-weighted structured imaging of the brain and a gradient-echo sequence for R2* mapping obtained the highest scientific output; regarding specific body parts examined, most scientific publications focused on MR sequences involving the brain and the (upper) abdomen. We conclude that population-based MR imaging in cohort studies should define more precise goals when allocating imaging time. In addition, quality control measures might include recording the number and impact of published work, preferably on a bi-annual basis and starting 2 years after initiation of the study. Structured teaching courses may enhance the desired output in areas that appear underrepresented.
National oral health survey on refugees in Germany 2016/2017: caries and subsequent complications
(2020)
Objectives To assess oral health, caries prevalence, and subsequent complications among recently arrived refugees in Germany and to ompare these findings with the German resident population. Methods This multicenter cross-sectional study recruited 544 refugees aged 3–75+ years; they were examined at ten registration institutions in four federal states in Germany by two calibrated dentists. The refugees were screened for caries (dmft/DMFT) and its complications pufa/PUFA); this data was compared to the resident population via the presentative national oral health surveys). Results The deciduous dentition of the 3-year-old refugees had a mean dmft value of 2.62 ± 3.6 compared with 0.48 dmft in the German resident population, and caries increased to 5.22 ± 3.4 for 6–7-year-olds (Germany: 1.73 dmft). Few refugee children had naturally healthy teeth (7% in 6–7-year-olds, Germany: 56%). In the permanent dentition, the gap in caries prevalence between refugees and the German population decreased with age (35–44-year-olds: 10.55 ± 7.1 DMFT; Germany: 11.2), but refugees exhibited more caries defects (35–44-year-olds DT = 3.13 ± 3.0; Germany: 0.5). German residents had more restorations (35–44-year-olds FT = 4.21 ± 4.6). Regarding complications, the 6–7-year-olds exhibited the highest pufa index (0.86 ± 1.4) which decreased in adolescence (13–17-year-olds, 0.18 ± 0.6) and increased in adults (45–64-year-olds, 0.45 ± 0.8). Conclusion The refugees had high caries experience, often untreated caries teeth and more complications compared with the German resident population, especially in children. Closing this gap by extending preventive systems to the refugees would decrease future treatment needs. Clinical relevance European countries should be prepared for the higher dental treatment needs in recent refugees, especially in
children.
For an Organisation for Caries Research/European Federation of Conservative Dentistry consensus, this systematic review is aimed to assess the question of how to manage the caries process in the case of early childhood caries (ECC). Medline via PubMed was searched systematically regarding management of ECC. First priority was existing systematic reviews or randomized clinical trials otherwise cohort studies dealing with management of ECC, primarily with carious anterior teeth. After data extraction, the potential risk of bias was estimated depending on the study types, and the level of evidence was evaluated. Regarding management of ECC, results are presented for silver diamine fluoride (SDF, n = 5), nonoperative caries management (NOCM, n = 10), and restorative approaches (RA, n = 8) separately, as different kinds of studies with different levels of evidence were found for the different aspects in the management of ECC. The 5 systematic reviews on SDF showed a high potential for arrest of ECC on a high level of evidence. In NOCM, a low level of evidence for a moderate effect of fluoride varnish in arresting or remineralizing, especially non-cavitated lesions, was assessed. For RA in carious anterior upper primary teeth, a low level of evidence was found for higher failure rates of glass ionomer cement and composite fillings than composite strip crowns even if placed under general anaesthesia and especially compared to other crowns (stainless steel and zirconia). In conclusions, ECC may be managed successfully with nonoperative (SDF, regular fluoride application) and moderately well with operative approaches, but the decision is affected by many other variables such as pulpal involvement, the child’s cooperation, or a general anaesthesia setting.
In fixed orthodontic treatments debonding of brackets during treatment is an unpleasant occurrence for the clinician and the patients and resultes in an increase in treatment costs and duration. For Damon Q brackets recycling would considered as an economic saving option which could be done with using of in office methods such as the sandblasting.
A sample of sixty sound bovine first upper central incisers, were collected, cleaned, and mounted in acrylic blocks for shear bond strength testing.
The total sample was equally divided into two main groups. Each group had 30 teeth and 30 brackets.
The first group had 30 teeth bonded with metal Damon Q brackets, the second group had 30 teeth bonded with metal Mini-Mono® brackets.The study included bonding and rebonding experiments. Therefore the same brackets with their same teeth were used in bonding and in the rebonding experiments. The bonding and the rebonding procedures were done with using 3M Unitek etching, Grengloo adhasive, and Ortho solo bonding. In addition the rebonding procedure was done after cleaning the teeth and recycling their brackets with sandblasting. All specimens were recycled 5000 times for the bonding and rebonding experiments.
The first and second debonding forces were done in Newton using a Zwick Roell machine.
After that SBS and SRS were computed in MPa. Furthermore all the teeth, after each debonding, were examined under a digital scanning microscope VHX-5000, 50X magnifying, to performe the ARA and ARI.
The collected data was statistically analyzed for descriptive statistics as well as significance of differences among the different bracket types, and their ARI scores, in the bonding and rebonding experiments.
The results showed that SRS was significantly higher than SBS of both types of the brackets, and Damon Q brackets had higher SBS, and SRS than Mini-Mono® brackets, and there was no correlation between SBS, SRS and their ARI, ARA.
Abstract
Background
Knowledge of molar incisor hypomineralization (MIH) has relevance for paediatric dentists.
Aim
To assess final‐year German dental students’ knowledge, attitudes, and beliefs regarding MIH.
Materials and methods
A previously validated questionnaire was posted to the 31 German dental schools. Demographic covariates as well as knowledge regarding
diagnosis and prevalence, and attitudes and beliefs around aetiology and management were collected.
Results
Twenty‐two (71%) dental schools responded and a total of 877 students participated. Most (97%) were familiar with MIH and 88% were aware of the diagnostic criteria for MIH; however, only 42% knew how to implement them. One‐third were able to identify MIH and 16% reported diagnostic confidence when doing so; 90% assumed the MIH prevalence to be <10%. Two‐thirds of the respondents implicated genetic components as the main aetiological factor of MIH. Resin composite (60%) and preformed metal crowns (46%) were the dental materials most often suggested for restorative management. Almost all (98%) respondents were interested in receiving more clinical training.
Conclusion
German students were familiar with MIH; however, they reported low levels of knowledge and confidence regarding its prevalence and diagnosis. Standardized nationwide, up‐to‐date curricula should be implemented to educate future dentists in Germany.
For an ORCA/EFCD consensus, this review systematically assessed available evidence regarding interventions performed and materials used to manage dentin carious lesions in primary teeth. A search for systematic reviews (SRs) and randomized clinical trials (RCTs) with a follow-up of at least 12 months after intervention was performed in PubMed, LILACS, BBO, and the Cochrane Library. The risk of bias tool from the Cochrane Collaboration and the PRISMA Statement were used for assessment of the included studies. From 101 screened articles, 2 SRs and 5 RCTs, which assessed the effectiveness of interventions in terms of pulp vitality and success of restoration, and 10 SRs and 1 RCT assessing the success of restorative materials were included. For treatments involving no carious tissue removal, the Hall technique showed lower treatment failure for approximal carious lesions compared to complete caries removal (CCR) and filling. For the treatment of deep carious lesions, techniques involving selective caries removal (SCR) showed a reduction in the incidence of pulp exposure. However, the benefit of SCR over CCR in terms of pulp symptoms or restoration success/failure was not confirmed. Regarding restorative materials, preformed metal crowns (PMCs) used to restore multisurface lesions showed the highest success rates compared to other restorative materials (amalgam, composite resin, glass ionomer cement, and compomer), and in the long term (12–48 months) these were also less likely to fail. There is limited evidence supporting the use of PMCs to restore carious lesions with single cavities. Among nonrestorative options, silver diammine fluoride was significantly more effective in arresting caries than other treatments for treating active carious lesions of different depths. Considerable heterogeneity and bias risk were observed in the included studies. Although heterogeneity observed among the studies was substantial, the trends were similar. In conclusion, less invasive caries approaches involving selective or no caries removal seem advantageous in comparison to CCR for patients presenting with vital, symptomless, carious dentin lesions in primary teeth. There is evidence in favor of PMCs for restoring multisurface carious lesions in primary molars.
A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough “round table” discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.
A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough “round table” discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.
Long-term nationally representative caries data in the primary dentition are rare, but nonetheless central to assess needs in caries prevention and treatment. This study evaluated the prevalence and trends of caries levels in the primary dentition of 6- to 7-year-olds in Germany as a whole and its federal states individually. In 2016, employing a randomized cluster selection, 6- to 7-year-old first graders were included in the National German Oral Health Survey performed regularly since 1994/95. Children were examined by 482 calibrated dentists in all 17 German regions using the WHO criteria for the decayed, missing, and filled teeth (dmft) including the assessment of initial carious lesions (it). In total, 151,555 6- to 7-year-olds were examined. Caries prevalence in the primary dentition dropped from 65% in 1994 to 44% in 2016, while the mean caries experience dropped from 2.89 to 1.73 dmft (dt = 0.74, mt = 0.19, ft = 0.80). When initial lesions were included, the mean caries experience increased to idmft = 2.12 (it = 0.38). In 2016, 49.7% of the examined 6- to 7-year-olds were caries-free including initial lesions. The Care Index at the tooth level was 57.5%, and the Significant Caries Index was 4.84 dmft. Depending on the German region, the mean dmft varied considerably, ranging from 1.37 to 2.31. In conclusion, despite the overall caries decline in 6- to 7-year-olds in Germany, only minor caries reductions were observed over the last decade, with a still existing high proportion of untreated dental decay. This calls for more effective preventive and restorative efforts with focus on the primary dentition in Germany.