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Secondary caries. 总被引:1,自引:0,他引:1
This paper reviews secondary caries which is the major reason for failure of restorations and therefore worthy of attention if operative dentistry is to be cost effective. The basic premise of the review is that the secondary caries process is difficult to diagnose and cannot be permanently treated away by operative management. Preventive therapy, dependent on the patients' self-care, is essential. However, the quality of the restorative material and the skill with which it is handled are also relevant to the prevention of further failure. 相似文献
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Stefanie Amend Roland Frankenberger Susanne Lücker Eugen Domann Norbert Krämer 《Dental materials》2018,34(5):786-796
Objectives
The present study aimed to establish Lactobacillus casei in a completely automated Streptococcus mutans-based artificial mouth model and to investigate secondary caries inhibiting properties of glass ionomer cements / resin composite groups in vitro.Methods
Sixty extracted, caries-free human third molars were used for preparation of standardized class-V-cavities. Specimens were restored with a resin-modified (Photac Fil; PF) as well as a conventional glass ionomer cement (Ketac Molar; KM) and one resin composite bonded with and without conduction of etch-and-rinse technique (Prime&Bond NT, Ceram X mono; C+ERT, C). Following an incubation in distilled water for 28 d at 37 °C, specimens were exposed to 10,000 thermocycles (+5 °C/+55 °C). A completely automated S. mutans-based (DSM No.: 20523) artificial mouth model was extended by establishment of L. casei (DSM No.: 20021). During microbiological loading, demineralization (4 h/d) was caused by acid production resulting from bacterial glycolysis and artificial saliva was used for remineralization (20 h/d). For quantitative margin analysis under am SEM, epoxy replicas were produced from impressions taken after thermocycling and after microbiological loading. Specimens were cut in half perpendicularly to restoration surfaces and demineralization depths at restoration margins and in 500 μm distance from margins were evaluated by means of a fluorescence microscope (FITC filter).Results
After microbiological loading, overall demineralization depths in enamel at restoration margin (EM) and in 500 μm distance (ED) as well as in cementum/dentin at restoration margin (DM) and in 500 μm distance (DD) were measured as follows (μm ± SD): PF: EM 42 ± 15, ED 60 ± 17, DM 83 ± 18; DD 127 ± 16; KM: EM 46 ± 22, ED 62 ± 17, DM 104 ± 21, DD 143 ± 28; C+ERT: EM 67 ± 19, ED 61 ± 17, DM 165 ± 31, DD 176 ± 35; C: EM 65 ± 23, ED 64 ± 17, DM 161 ± 27, DD 166 ± 33. For the glass ionomer cements, the overall demineralization depths at restoration margins were significantly lower than in 500 μm distance from margins (T-test, p < 0.05). Especially at restoration margins in cementum/dentin, the resin composite groups showed significantly larger overall demineralizations than the glass ionomer cements (ANOVA, mod. LSD, p < 0.05). Decreases of marginal quality were detected in all groups after microbiological loading (Friedman-test, p < 0.05).Significance
The refined experimental setup was suitable for production of artificial secondary caries-like lesions. Glass ionomer cements as fluoride-releasing materials may show an inhibition of secondary caries formation to a certain extent. 相似文献7.
Fontana M González-Cabezas C 《Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995)》2000,21(1):15-8, 21-4, 26 passim; quiz 30
This article reviews the prevalence and main causes of restoration failure and replacement. It then focuses on secondary caries, its histopathology, etiology, difficulties in diagnosis, and prevention and remineralization possibilities. This article concludes that although secondary caries is still the main reason for restoration replacement, the development of new technologies for detecting and monitoring these lesions at an early stage should allow for testing new interventions to arrest or remineralize these lesions, which would delay the need for re-restoration. 相似文献
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Ivana Nedeljkovic Jan De Munck Anouk Vanloy Dominique Declerck Paul Lambrechts Marleen Peumans Wim Teughels Bart Van Meerbeek Kirsten L. Van Landuyt 《Clinical oral investigations》2020,24(2):683-691
The objectives of this cross-sectional survey were to determine the prevalence of secondary caries (SC) in general population, to identify patient- and mat 相似文献
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The aim of this study was to assess retrospectively the caries susceptibility of posterior teeth with composite restorations after 18 and 20 years. The sample was selected out of the recall of a dental office. Sixteen restorations were reassessed after 18 and 20 years. All findings have been rated according to the C criteria of the CPM index. For the micromorphological evaluation with SEM, replicas were made using a two-step impression technique. All restorations demonstrated marginal imperfections and a predominant rough surface. At the 18 year-evaluation two restorations exhibited secondary caries. Despite of extended marginal gap formations none of the 12 restorations reexamined at 20 years showed secondary caries. Direct composite restorations can serve over a long period of time despite of poor qualitative parameters. Micromorphological marginal deterioration and clinical gap formation do not necessarily result in a higher risk for secondary caries. 相似文献
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Secondary caries: a literature review with case reports. 总被引:9,自引:0,他引:9
The clinical diagnosis of secondary caries is by far the most common reason for replacement of restorations, but the scientific basis for the diagnosis is meager. The purpose of this article is to review the literature on secondary (recurrent) caries and present case reports to document the problems encountered in the clinical diagnosis of secondary caries. The literature on secondary caries was critically reviewed and subdivided into clinical diagnosis, location of secondary lesions, histopathology, microleakage, and microbiology. The case reports included restorations that were scheduled to be replaced because of secondary caries or stained margins of composite restorations. The lesions were photographed preoperatively and postoperatively. Based on the limited literature available, secondary caries appears to be a localized lesion similar or identical to primary caries. It is most often localized gingivally on restorations. Narrow gaps, crevices, ditches, and "microleakage" do not lead to secondary caries, but wide voids may. Secondary caries is difficult to diagnose clinically. Consistency or hardness and discoloration of dentin and enamel are the best parameters. Secondary caries is the same as primary caries located at the margin of a restoration. 相似文献
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Secondary caries lesions were produced in vitro by immersing human tooth-blocks with amalgam restorations every third day for 4 weeks in glucose- or sucrose-containing broth inoculated with a strain of Streptococcus mutans. The lesions at the cavity walls were related to various standardized micro-spaces (0, 30, 40, 60 and 80 microns) around the restorations. When a thick, sucrose induced layer of plaque covered the margin, dentine caries was found in all cases where a gap was present (30 microns or more). In the presence of a thin, glucose induced layer of plaque, dentine caries was detected only in the specimens with 60 and 80 microns gap-widths. Caries lesions were detected on the outer free enamel surfaces in all specimens. Lesions in the enamel of the cavity walls were observed with polarized light in 46% in the presence of sucrose- and in 21% in the presence of glucose-induced plaque. 相似文献
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SUMMARY The aim of this in vitro secondary caries study was to examine the glass-ionomer liner's effect on wall-lesion inhibition when a conventional and a light-cured glass ionomer liner was placed under amalgam and composite resin restorations. Class V preparations in extracted upper premolars were used and ten restorations were used for each of the following groups: (i) two layers of copal varnish and amalgam; (ii) conventional glass-ionomer and amalgam; (iii) light-cured glass-ionomer and amalgam; (iv) bonding agent and light-cured composite resin; (v) conventional glass-ionomer, bonding agent and light-cured composite resin; (vi) light-cured glass-ionomer, extended 0.3 mm short of the enamel margin bonding agent and light-cured composite resin; and (vii) light-cured glass-ionomer, extended 1 mm short of the enamel margin, bonding agent and light-cured composite resin. The teeth were thermocycled and artificial caries were created using an acid-gel. The results of this study showed that artificial recurrent caries can be reduced significantly ( P < 0.05) with a glass-ionomer liner under amalgam restorations. The results also showed that when the light-cured glass-ionomer liner was placed 0.3 mm from the cavo-surface margin under composite resin restoration, the artificial recurrent caries reduced significantly ( P < 0.05). 相似文献
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Secondary caries in crowned teeth: correlation of clinical and radiographic findings 总被引:1,自引:0,他引:1
STATEMENT OF PROBLEM: The diagnostic value of radiographs for interproximal caries detection on nonrestored teeth is well investigated. However, little is known about the use of radiographs in the diagnosis of secondary caries localized at crown margins. PURPOSE: The aim of this study was to correlate clinical findings with regard to secondary caries with the findings of a radiographic evaluation. MATERIALS AND METHODS: One hundred randomly selected patients who underwent restorations with fixed prostheses and were exhibiting at least one secondary carious lesion were included in the study. A total of 820 restorations (test group, 730 interproximal surfaces of 365 single crowns and 910 interproximal surfaces of 455 fixed partial denture retainer crowns) and 1024 interproximal surfaces of 512 nonrestored teeth (control group) were investigated clinically, with the use of modified California Dental Association criteria, and radiographically for interproximal carious lesions. The extension of the lesions was rated to be initial (with no cavitation), early (with cavitation limited to orthodentin), or deep (with cavitation). The data were statistically analyzed for normal distribution, and the frequency of the findings was calculated in absolute numbers and as a percentage. Statistically significant differences were determined by use of the chi(2) test (P<.05). A linear regression model was applied for the correlation between the percentage of secondary caries and the duration of the crowns in situ. RESULTS: Secondary caries was diagnosed clinically in 11.2% of 1640 interproximal surfaces but only in 8.3% radiographically. In contrast, the frequency of interproximal carious lesions diagnosed clinically in nonrestored teeth increased with the use of radiographs from 3.3% to 4.1%. CONCLUSION: Within the limits of this study, the results confirm that radiographs improve the diagnostic sensitivity for interproximal caries in nonrestored teeth. However, for the diagnosis of secondary caries in crowned teeth, the clinical examination is more reliable than the radiographic evaluation. 相似文献
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DIAGNOdent is now well documented for detection of primary occlusal caries, but not as yet for secondary caries. The aim of this study was to investigate the application of DIAGNOdent for in vitro detection of secondary caries. The material comprised 66 extracted teeth: 48 with amalgam restorations and 18 with tooth‐colored restorations. Digital images of occlusal surfaces were captured for each specimen. The teeth were mounted in groups of 3 or 4 in plaster blocks simulating their anatomical positions. Bitewing radiographs of each block were assessed for secondary caries by 5 observers. The margins of each restoration were carefully scanned with DIAGNOdent; the site of the highest reading was localized in digital images; and the corresponding values were registered. Marginal integrity and staining were also documented. The restorations were then removed and the teeth were hemi‐sectioned. For verification, two observers working together examined all the cavities under a stereomicroscope at 16 x magnification followed by probing. Sensitivity and specificity for DIAGNOdent and conventional radiography were 0.77/0.81 and 0.65/0.81, respectively. Regarding ROC analyses, the A z values were 0.89 and 0.72 for DIAGNOdent and radiography. For DIAGNOdent, the false‐positive fraction included only stained teeth. Cohen's kappa statistics disclosed moderate agreement between the 2 methods, with an agreement of 56%. DIAGNOdent tended to give more positive diagnoses than bitewing radiography. The results indicate that DIAGNOdent may be a helpful tool for detecting secondary caries. 相似文献
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DIAGNOdent is now well documented for detection of primary occlusal caries, but not as yet for secondary caries. The aim of this study was to investigate the application of DIAGNOdent for in vitro detection of secondary caries. The material comprised 66 extracted teeth: 48 with amalgam restorations and 18 with tooth-colored restorations. Digital images of occlusal surfaces were captured for each specimen. The teeth were mounted in groups of 3 or 4 in plaster blocks simulating their anatomical positions. Bitewing radiographs of each block were assessed for secondary caries by 5 observers. The margins of each restoration were carefully scanned with DIAGNOdent; the site of the highest reading was localized in digital images; and the corresponding values were registered. Marginal integrity and staining were also documented. The restorations were then removed and the teeth were hemi-sectioned. For verification, two observers working together examined all the cavities under a stereomicroscope at 16 x magnification followed by probing. Sensitivity and specificity for DIAGNOdent and conventional radiography were 0.77/0.81 and 0.65/0.81, respectively. Regarding ROC analyses, the Az values were 0.89 and 0.72 for DIAGNOdent and radiography. For DIAGNOdent, the false-positive fraction included only stained teeth. Cohen's kappa statistics disclosed moderate agreement between the 2 methods, with an agreement of 56%. DIAGNOdent tended to give more positive diagnoses than bitewing radiography. The results indicate that DIAGNOdent may be a helpful tool for detecting secondary caries. 相似文献
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van Palenstein Helderman WH 《Nederlands tijdschrift voor tandheelkunde》1998,105(9):318-320
This paper reviews the present knowledge regarding methods of caries prediction. The clinician's ability to predict caries by examination and on the basis of knowledge of patient's attitude and background functions relatively well. Bacterial and salivary tests do not contribute significantly to this. The caries present at the moment of examination, the cariesexperience, is the best predictor of caries among children. 相似文献
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abstract In 18 schoolboys, 16 years old, the actual caries development during 1 year was compared with the expected caries activity which was predicted from evaluations of four selected tests: (1) the buffer capacity, (2) the titer of Streptococcus mutans in stimulated whole saliva, (3) clinical evaluation of rate of plaque formation, and (4) a quantitation of a salivary agglutinin reacting with a serotype c strain of S. mutans. According to previous experiences the estimated value for each factor was classified for each individual either as a negative (caries-provoking) or as a non-negative factor. The score of negative factors could thus vary between 0 and 4 for each individual. A good relationship was observed between the caries increment during 1 year and the sum of the scores from the tests representing expected caries activity. This observation indicates the possibility of selecting the most caries susceptible individuals in a population by using the four parameters. A selection can be made from two or three of the tests but then the degree of differentiation becomes lower. No parameter could singly be used as an indication of the potential caries activity in the individual test. 相似文献
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