OBJECTIVE: Caries risk assessment tools operate on the subject level. The aim of the study is to create new caries risk assessment models that functions on the tooth and surface level to assess the risk of caries of single teeth and surfaces. METHODS: Secondary data from the Dental Longitudinal Study was used to evaluate caries symmetry. Teeth were grouped into posterior and anterior teeth. Surfaces were grouped into fissured, proximal, and facial and lingual surfaces. The prediction of future caries on a tooth or a surface by the current caries on a bilateral or adjacent tooth or surface was evaluated. Additional general and oral caries risk factors on teeth and surfaces were adopted from the American Dental Association caries risk assessment tool. Caries on bilateral and/or adjacent teeth or surfaces were augmented with significant oral clinical caries predictor to build the caries risk assessment tools for teeth and surfaces. The models were validated by calculating sensitivities and specificities. RESULTS: 495 subjects with baseline and three year follow up data were included in the study. Caries prevalence and incidence was symmetrical (right and left) on the population level. On the individual level, caries incidence was symmetrical (right and left) and also tends to affect adjacent teeth or surfaces. Baseline caries on bilateral and adjacent teeth and surfaces was predictive of caries at follow up in all groups of teeth and surfaces except posterior teeth. Local oral caries risk factors like visible plaque, interproximal restorations, and xerostomia significantly predicted caries on single teeth and surfaces. Tools of caries risk assessment for anterior teeth and the three groups of surfaces were built. The sensitivities of these tools ranged between 67.33% to 85.51 %, specificities ranged between 38.40 % to 66.11%, and the overall accuracies ranged between 41.95% to 66.27%. CONCLUSION: Dental caries is a symmetrical disease affecting the right and left sides of the mouth equally. Past caries experience is significant in predicting future caries. New models were built to assess caries risk for anterior teeth, fissured surfaces, proximal surfaces, and facial and lingual surfaces with acceptable accuracy. / 2018-09-28T00:00:00Z

This retrospective study’s aim was to examine the success rate of prepared and unprepared sealants at different ages of placement, and to determine if caries risk played a role in the sealants’ success. Data was collected from 1,173 first molars subjects from a private pediatric dental clinic (Children’s Dental World, Winnipeg, Manitoba). These were categorized based on initial treatment types (unprepared sealants (55%), prepared sealants (38%), and non-treated (7%)), and then further analyzed by their initial caries risk (low (27%) or moderate-high (73%)). Treatment failure and success were assessed at 12-months and 24-months post-treatment. Overall, in a 24-month period, both sealant methods were found to be highly successful with an overall average of 97% at 12-months and 93% at 24-months. The prepared sealants method statistically did not have significantly more failures (3.24% and 4.31%) than unprepared sealants (3.67% and 2.71%) at both recall periods. There were more failures for the sealants when placed at age 5, 6, and 7 years (5.54% and 5.88%) at 12-months and 24-months. Initial and change in caries risk status did not seem to have an impact on the overall success rate of sealants. The highest success rate for sealed molars was found when subjects consistently remained at low caries risk over the 24-month period (Group 1 97.60%) but it was found to be statistically insignificant. Overall, both sealant methods are highly successful in preventing occlusal caries on first permanent molars, regardless of caries risk. / October 2015

Dental caries is a very common chronic infectious disease that is preventable and related to dental behaviours. The objective of this study was to develop a parental questionnaire to predict the child’s caries risk without professional evaluation and assess if risk factors worked together and if behaviours changed over time. At baseline, a survey and examination for caries were administered to 100 subjects aged 1 to 3 years old in Winnipeg, Manitoba. Six months later the same survey and examination were administered. Statistical analysis included logistic regression, Pearson Chi-squared, McNemar’s, Fisher’s exact tests and paired T-tests. The main finding was this survey could not predict future caries risk. Parents’ reports of visible cavities/fillings in their child predicted caries. Few risk factors changed significantly over time. A change in developmental delay corresponded to a change in caries. Overall, caries risk was found to be complex and requires further investigation.

No description available.

Purpose: This was a pilot study to assess the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) under general anesthesia in children with early childhood dental caries. Methods: Sixty-six patients completed FMDR and were included in the analysis. At the consultation visit, caries risk assessment (CRA) and dental exam information were recorded, and caregivers completed an oral health knowledge (OHK) questionnaire. Patients returned for a post-surgery and recall visit. Caregivers received oral hygiene instructions in a motivational-interviewing style. Results:At the consultation visit all patients were high risk. At the post-surgery visit, only 47% remained high risk (chi-square P Conclusions: Preliminary data demonstrates that the preventive strategy is effective in reducing CRA level in children following FMDR.

Objetivo Investigar os fatores associados com a falha de restaurações em dentes decíduos e se o reparo pode aumentar a sobrevida de restaurações defeituosas realizadas em crianças com alto risco de cárie. Materiais e métodos A amostra incluiu crianças atendidas em um serviço de atendimento odontológico universitário que necessitavam realizar tratamentos restauradores em dentes decíduos. A coleta de dados se deu de modo retrospectivo a partir de informações coletadas em prontuários clínicos. Informações no nível individual (sexo, idade, IPV, ISG, ceo-d, perfil de cárie) e de tratamento (tipo dental, número de superfícies, tipo de material, tratamento endodôntico), bem como as datas dos procedimentos e da última consulta, foram coletados para análise da longevidade das restaurações e fatores associados à falha. Os resultados foram avaliados em dois níveis: “Sucesso” (Nível 1) – quando qualquer intervenção na restauração foi considerada como falha; “Sobrevida” (Nível 2) – quando restaurações reparadas foram consideradas clinicamente aceitáveis. O teste de sobrevida de Kaplan-Meier foi usado para analisar a longevidade das restaurações. A Regressão Multivariada de Cox com fragilidade compartilhada foi usada para avaliar fatores associados às falha (p<0.05). Resultados Um total de 584 restaurações realizadas em dentes decíduos foram incluídas na análise. A sobrevida de restaurações após 36 meses, quando qualquer intervenção foi considerada falha, foi de 34.8% (TFA 29,6%). Quando o reparo não foi considerado falha, essa sobrevida chegou a 43.7% (TFA 24.1%). Houve um aumento estatisticamente significativo na longevidade das restaurações quando o reparo não foi considerado como falha (p<0.001). Restaurações que envolviam múltiplas faces apresentaram significativamente mais falhas que restaurações que envolviam apenas uma face (HR 1.69, 95 % CI 1.18; 2.41), e dentes tratados endodonticamente apresentaram mais falhas comparados aos dentes vitais (HR 2.22, 95 % CI 1.35; 3.65). Conclusão De modo geral, os resultados do presente estudo mostraram a limitada sobrevida das restaurações em uma população com alto risco de cárie. O reparo aumentou a sobrevida de restaurações primárias defeituosas em dentes decíduos. Relevância Clínica O reparo é um tratamento restaurador menos invasivo e tecnicamente mais simples que aumenta a longevidade de restaurações em dentes decíduos. / Objective We investigated factors associated with failure of primary teeth restorations and whether repair may increase the survival of failed restorations placed in high-caries risk children. Materials and methods The sample comprised children who attended a university dental service to perform restorative treatments in primary teeth. Data was collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: “Success” (Level 1) – when any re-intervention in the restoration was considered as failure; “Survival” (Level 2) – when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p<0.05). Results A total of 584 restorations placed in primary teeth were included in the analysis. The survival of restorations up to 36 months when any re-intervention was considered failure was 34.8% (AFR 29.6%). When repair was not considered as failure, its survival reached 43.7% (AFR 24.1%). There was a statistically significant increase in restoration longevity when repair was not considered as failure (p<0.001). Multi-surface restorations showed significantly more failures than single-surface ones (HR 1.69, 95 % CI 1.18; 2.41), and endodontically treated teeth presented more failures compared to vital teeth (HR 2.22, 95 % CI 1.35; 3.65). Conclusion Overall, the results of the present study showed a restricted survival of restorations in high-caries risk children. Repair increased the survival of primary teeth restorations over time. Clinical Relevance Repair is more conservative and technically simple restorative treatment that increases the suvival of restorations in primary teeth.

No description available.

Objetivo Investigar os fatores associados com a falha de restaurações em dentes decíduos e se o reparo pode aumentar a sobrevida de restaurações defeituosas realizadas em crianças com alto risco de cárie. Materiais e métodos A amostra incluiu crianças atendidas em um serviço de atendimento odontológico universitário que necessitavam realizar tratamentos restauradores em dentes decíduos. A coleta de dados se deu de modo retrospectivo a partir de informações coletadas em prontuários clínicos. Informações no nível individual (sexo, idade, IPV, ISG, ceo-d, perfil de cárie) e de tratamento (tipo dental, número de superfícies, tipo de material, tratamento endodôntico), bem como as datas dos procedimentos e da última consulta, foram coletados para análise da longevidade das restaurações e fatores associados à falha. Os resultados foram avaliados em dois níveis: “Sucesso” (Nível 1) – quando qualquer intervenção na restauração foi considerada como falha; “Sobrevida” (Nível 2) – quando restaurações reparadas foram consideradas clinicamente aceitáveis. O teste de sobrevida de Kaplan-Meier foi usado para analisar a longevidade das restaurações. A Regressão Multivariada de Cox com fragilidade compartilhada foi usada para avaliar fatores associados às falha (p<0.05). Resultados Um total de 584 restaurações realizadas em dentes decíduos foram incluídas na análise. A sobrevida de restaurações após 36 meses, quando qualquer intervenção foi considerada falha, foi de 34.8% (TFA 29,6%). Quando o reparo não foi considerado falha, essa sobrevida chegou a 43.7% (TFA 24.1%). Houve um aumento estatisticamente significativo na longevidade das restaurações quando o reparo não foi considerado como falha (p<0.001). Restaurações que envolviam múltiplas faces apresentaram significativamente mais falhas que restaurações que envolviam apenas uma face (HR 1.69, 95 % CI 1.18; 2.41), e dentes tratados endodonticamente apresentaram mais falhas comparados aos dentes vitais (HR 2.22, 95 % CI 1.35; 3.65). Conclusão De modo geral, os resultados do presente estudo mostraram a limitada sobrevida das restaurações em uma população com alto risco de cárie. O reparo aumentou a sobrevida de restaurações primárias defeituosas em dentes decíduos. Relevância Clínica O reparo é um tratamento restaurador menos invasivo e tecnicamente mais simples que aumenta a longevidade de restaurações em dentes decíduos. / Objective We investigated factors associated with failure of primary teeth restorations and whether repair may increase the survival of failed restorations placed in high-caries risk children. Materials and methods The sample comprised children who attended a university dental service to perform restorative treatments in primary teeth. Data was collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: “Success” (Level 1) – when any re-intervention in the restoration was considered as failure; “Survival” (Level 2) – when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p<0.05). Results A total of 584 restorations placed in primary teeth were included in the analysis. The survival of restorations up to 36 months when any re-intervention was considered failure was 34.8% (AFR 29.6%). When repair was not considered as failure, its survival reached 43.7% (AFR 24.1%). There was a statistically significant increase in restoration longevity when repair was not considered as failure (p<0.001). Multi-surface restorations showed significantly more failures than single-surface ones (HR 1.69, 95 % CI 1.18; 2.41), and endodontically treated teeth presented more failures compared to vital teeth (HR 2.22, 95 % CI 1.35; 3.65). Conclusion Overall, the results of the present study showed a restricted survival of restorations in high-caries risk children. Repair increased the survival of primary teeth restorations over time. Clinical Relevance Repair is more conservative and technically simple restorative treatment that increases the suvival of restorations in primary teeth.

Objetivo Investigar os fatores associados com a falha de restaurações em dentes decíduos e se o reparo pode aumentar a sobrevida de restaurações defeituosas realizadas em crianças com alto risco de cárie. Materiais e métodos A amostra incluiu crianças atendidas em um serviço de atendimento odontológico universitário que necessitavam realizar tratamentos restauradores em dentes decíduos. A coleta de dados se deu de modo retrospectivo a partir de informações coletadas em prontuários clínicos. Informações no nível individual (sexo, idade, IPV, ISG, ceo-d, perfil de cárie) e de tratamento (tipo dental, número de superfícies, tipo de material, tratamento endodôntico), bem como as datas dos procedimentos e da última consulta, foram coletados para análise da longevidade das restaurações e fatores associados à falha. Os resultados foram avaliados em dois níveis: “Sucesso” (Nível 1) – quando qualquer intervenção na restauração foi considerada como falha; “Sobrevida” (Nível 2) – quando restaurações reparadas foram consideradas clinicamente aceitáveis. O teste de sobrevida de Kaplan-Meier foi usado para analisar a longevidade das restaurações. A Regressão Multivariada de Cox com fragilidade compartilhada foi usada para avaliar fatores associados às falha (p<0.05). Resultados Um total de 584 restaurações realizadas em dentes decíduos foram incluídas na análise. A sobrevida de restaurações após 36 meses, quando qualquer intervenção foi considerada falha, foi de 34.8% (TFA 29,6%). Quando o reparo não foi considerado falha, essa sobrevida chegou a 43.7% (TFA 24.1%). Houve um aumento estatisticamente significativo na longevidade das restaurações quando o reparo não foi considerado como falha (p<0.001). Restaurações que envolviam múltiplas faces apresentaram significativamente mais falhas que restaurações que envolviam apenas uma face (HR 1.69, 95 % CI 1.18; 2.41), e dentes tratados endodonticamente apresentaram mais falhas comparados aos dentes vitais (HR 2.22, 95 % CI 1.35; 3.65). Conclusão De modo geral, os resultados do presente estudo mostraram a limitada sobrevida das restaurações em uma população com alto risco de cárie. O reparo aumentou a sobrevida de restaurações primárias defeituosas em dentes decíduos. Relevância Clínica O reparo é um tratamento restaurador menos invasivo e tecnicamente mais simples que aumenta a longevidade de restaurações em dentes decíduos. / Objective We investigated factors associated with failure of primary teeth restorations and whether repair may increase the survival of failed restorations placed in high-caries risk children. Materials and methods The sample comprised children who attended a university dental service to perform restorative treatments in primary teeth. Data was collected retrospectively from clinical records to assess the longevity of restorations. The outcomes were calculated in two levels: “Success” (Level 1) – when any re-intervention in the restoration was considered as failure; “Survival” (Level 2) – when repaired restorations were considered clinically acceptable. The Kaplan-Meier survival test was used to analyze the longevity of restorations. Multivariate Cox regression with shared frailty was used to assess factors associated with failures (p<0.05). Results A total of 584 restorations placed in primary teeth were included in the analysis. The survival of restorations up to 36 months when any re-intervention was considered failure was 34.8% (AFR 29.6%). When repair was not considered as failure, its survival reached 43.7% (AFR 24.1%). There was a statistically significant increase in restoration longevity when repair was not considered as failure (p<0.001). Multi-surface restorations showed significantly more failures than single-surface ones (HR 1.69, 95 % CI 1.18; 2.41), and endodontically treated teeth presented more failures compared to vital teeth (HR 2.22, 95 % CI 1.35; 3.65). Conclusion Overall, the results of the present study showed a restricted survival of restorations in high-caries risk children. Repair increased the survival of primary teeth restorations over time. Clinical Relevance Repair is more conservative and technically simple restorative treatment that increases the suvival of restorations in primary teeth.

Orientadores: Monica Campos Serra, Leonor de Castro Monteiro Loffredo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-07-25T16:16:10Z (GMT). No. of bitstreams: 1 Pinelli_Camila_M.pdf: 4056278 bytes, checksum: 4fff171bfc31ff5c42bfd597a8e4421e (MD5) Previous issue date: 1999 / Resumo: O objetivo deste trabalho foi verificar a eficácia de um teste microbiológico para estreptococos do grupo mutans na avaliação do risco de cárie. Oitenta e um alunos de 6a a 8a séries da rede pública escolar de Piracicaba foram selecionados e se submeteram a um exame clínico odontológico - feito por um pesquisador clínico com experiência no diagnóstico e tratamento de pacientes de alta atividade de cárie - e a um exame salivar, feito com o produto CARITEST SM®, a partir de um mesmo lote de fabricação. Utilizando-se a estatística kappa, a reprodutibilidade do teste microbiológico foi verificada através da concordância interexaminador, na avaliação dos resultados microbiológicos de maneira independente. A validade foi verificada, através da sensibilidade e especificidade, comparando-se os resultados microbiológicos com o critério de validação ("gold standard") da pesquisa. Os valores de kappa, k=0,55 e k=0,78, representaram, respectivamente, uma concordância interexaminador regular considerando a avaliação segundo 6 escores propostos pelo fabricante, e uma concordância boa para a classificação segundo alta e baixa contagem microbiológica,- dada pelo agrupamento dos escores. O valor para a sensibilidade foi de 0,59 e para a especificidade foi de 0,85, mostrando que o teste foi mais específico do que sensível, identificando melhor os indivíduos de baixo risco de cárie. Esse teste microbiológico pode ser considerado um bom auxiliar na avaliação do risco de cárie, porém não é o único fator preditivo a ser avaliado, frente ao caráter multifatorial da doença / Abstract: The aim of this study was to evaluate the efficacy of a microbiological test for estimation of mutans streptococci levels in caries risk assessment. Eighty-one volunteers from 6th up to 8th grades from Piracicaba's public schools were assessed for dental caries. A researcher with great skills in examining and treating patients with high caries activity performed the examinations. The students were then submitted to a salivary test, CARITEST SM® (from the same batch number). Kappa statistics (K) was applied to verify the repeatibility of the simplified test checked through interexaminer agreement, in the classification of the microbiological tests, independently and blind. The validity of the test was verified according to sensibility and specificity, comparing the microbiological results with the gold standard for caries risk. A fair agreement was verified when the examiners classified according to 6 scores (K=0.55) and a good agreement when they classified according to high or low density of unit colonies formation (K=0.78). The sensibility was 0.59 and the specificity was 0.85, showing that there was a moderate ability of the test to identify the subjects with high caries risk and a substantial ability to identify the group of low caries risk. The microbiological test represents an aid for cariesrisk assessment, but it is not the only criteria to be used for caries risk diagnosis, considering the multifactorial character of the disease / Mestrado / Dentística / Mestre em Clínica Odontológica