Dimensions of Occlusoproximal Cavitated Carious Lesions as a Cut-Off Point for Restorative Decision in Primary Teeth

Helena Scherer; Cleber Paradzinski Cavalheiro; José Carlos Pettorossi Imparato; Rachel de Oliveira Rocha; Fernanda Ruffo Ortiz; Tathiane Larissa Lenzi

Authors

Helena Scherer
Cleber Paradzinski Cavalheiro
José Carlos Pettorossi Imparato
Rachel de Oliveira Rocha
Fernanda Ruffo Ortiz
Tathiane Larissa Lenzi

Keywords:

Decision Making, Dental Caries, Tooth, Deciduous

Abstract

Objective: To investigate whether the dimensions of cavitated dentin carious lesions on the occlusoproximal surfaces of primary teeth could predict the location of cement-enamel junction (CEJ). Material and Methods: Two hundred extracted primary molars were selected and digital images were obtained. The teeth were set in arch models for clinical measurement. The cervical-occlusal (CO) and buccal-lingual/palatal (BL/P) cavities’ dimensions were obtained by digital (Image J) and clinical (periodontal millimeter probe) assessments. The cervical margin location was also determined. The thresholds (cut-off points) were determined by sensitivity, specificity and the areas under the receiver operating characteristics curves (Az) for the two methods. Pearson's correlation coefficient was used to investigate the correlation between clinical and digital measurements. Logistic regression analysis was performed to evaluate the association between the dimensions and cervical margin location. Results: There was a strong correlation between methods for all measurements (CO: r=0.90, VL/P: r=0.95). Cavities with BL/P distance higher than 4.5 mm and CO dimension higher than 3.5 mm had a lower chance of presenting the cervical limit above the CEJ, irrespective of the measurement method. Conclusion: CO and VL/P dimensions could be used to predict the CEJ location and, ultimately, as a clinical parameter for restorative decision-making.

References

Marcenes W, Kassebaum NJ, Bernabé E, Flaxman A, Naghavi M, Lopez A, et al. Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res 2013; 92(7):592-7. https://doi.org/10.1177/0022034513490168

Kassebaum NJ, Smith AGC, Bernabé E, Fleming TD, Reynolds AE, Vos T, et al. Global, regional, and national prevalence, incidence, and disability-adjusted life years for oral conditions for 195 countries, 1990-2015: a systematic analysis for the global burden of diseases, injuries, and risk factors. J Dent Res 2017; 96(4):380-7. https://doi.org/10.1177/0022034517693566

Abdelrahman M, Hsu K-L, Melo MA, Dhar V, Tinanoff N. Mapping evidence on early childhood caries prevalence: complexity of worldwide data reporting. Int J Clin Pediatr Dent 2021; 14(1):1-7. https://doi.org/10.5005/jp-journals-10005-1882

Cagetti MG, Campus G, Sale S, Cocco F, Strohmenger L, Lingström P. Association between interdental plaque acidogenicity and caries risk at surface level: a cross sectional study in primary dentition. Int J Paediatr Dent 2011; 21(2):119-25. https://doi.org/10.1111/j.1365-263X.2010.01099.x

Choo A, Delac DM, Messer LB. Oral hygiene measures and promotion: review and considerations. Aust Dent J 2001; 46(3):166–73. https://doi.org/10.1111/j.1834-7819.2001.tb00277.x

Kidd EAM. How “clean” must a cavity be before restoration? Caries Res 2004; 38(3):305-13. https://doi.org/10.1159/000077770

Schwendicke F, Frencken JE, Bjørndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res 2016; 28(2):58-67. https://doi.org/10.1177/0022034516639271

Northway WM, Wainright RW. D E space--a realistic measure of changes in arch morphology: space loss due to unattended caries. J Dent Res 1980; 59(10):1577-80. https://doi.org/10.1177/00220345800590100401

Patel M, Bhatt R, Khurana S, Patel N, Bhatt R. Choice of material for the treatment of proximal lesions in deciduous molars among paediatric post-graduates and paediatric dentists of Gujarat: A cross-sectional study. Adv Hum Biol 2019; 9(3):258. https://doi.org/10.4103/aihb.aihb_67_19

Laegreid T, Gjerdet NR, Vult von Steyern P, Johansson A-K. Class II composite restorations: importance of cervical enamel in vitro. Oper Dent 2011; 36(2):187-95. https://doi.org/10.2341/10-126-L

Kuper NK, Opdam NJM, Bronkhorst EM, Huysmans MCDNJM. The influence of approximal restoration extension on the development of secondary caries. J Dent 2012; 40(3):241-7. https://doi.org/10.1016/j.jdent.2011.12.014

Pires CW, Pedrotti D, Lenzi TL, Soares FZM, Ziegelmann PK, Rocha R de O. Is there a best conventional material for restoring posterior primary teeth? A network meta-analysis. Braz Oral Res 2018; 32:e10. https://doi.org/10.1590/1807-3107bor-2018.vol32.0010

Tedesco TK, Calvo AFB, Lenzi TL, Hesse D, Guglielmi CAB, Camargo LB, et al. ART is an alternative for restoring occlusoproximal cavities in primary teeth - evidence from an updated systematic review and meta-analysis. Int J Paediatr Dent 2017; 27(3):201-9. https://doi.org/10.1111/ipd.12252

Chisini LA, Collares K, Cademartori MG, de Oliveira LJC, Conde MCM, Demarco FF, et al. Restorations in primary teeth: a systematic review on survival and reasons for failures. Int J Paediatr Dent 2018; 28(2):123-39. https://doi.org/10.1111/ipd.12346

Innes NPT, Evans DJP, Stirrups DR. Sealing caries in primary molars: randomized control trial, 5-year results. J Dent Res 2011; 90(12):1405-10. https://doi.org/10.1177/0022034511422064

Tedesco TK, Gimenez T, Floriano I, Montagner AF, Camargo LB, Calvo AFB, et al. Scientific evidence for the management of dentin caries lesions in pediatric dentistry: a systematic review and network meta-analysis. PLoS One 2018; 13(11):e0206296. https://doi.org/10.1371/journal.pone.0206296

Santamaria RM, Innes NPT, Machiulskiene V, Evans DJP, Splieth CH. Caries management strategies for primary molars: 1-yr randomized control trial results. J Dent Res 2014; 93(11):1062-9. https://doi.org/10.1177/0022034514550717

Vanderas AP, Gizani S, Papagiannoulis L. Progression of proximal caries in children with different caries indices: a 4-year radiographic study. Eur Arch Paediatr Dent Off J Eur Acad Paediatr Dent 2006; 7(3):148-52. https://doi.org/10.1007/BF03262556

Ribeiro JF, Forgerini TV, Pedrotti D, Rocha R de O, Ardenghi TM, Soares FZM, et al. Performance of resin composite restorations in the primary dentition: a retrospective university-based study. Int J Paediatr Dent 2018; 28(5):497-503. https://doi.org/10.1111/ipd.12404

Burke FJT, Lucarotti PSK, Holder RL. Outcome of direct restorations placed within the general dental services in England and Wales (Part 2): variation by patients’ characteristics. J Dent 2005; 33(10):817-26. https://doi.org/10.1016/j.jdent.2005.03.007

Bücher K, Metz I, Pitchika V, Hickel R, Kühnisch J. Survival characteristics of composite restorations in primary teeth. Clin Oral Investig 2015; 19(7):1653-62. https://doi.org/10.1007/s00784-014-1389-9

Nedeljkovic I, De Munck J, Vanloy A, Declerck D, Lambrechts P, Peumans M, et al. Secondary caries: prevalence, characteristics, and approach. Clin Oral Investig 2020; 24(2):683-91. https://doi.org/10.1007/s00784-019-02894-0