RESUMEN
BACKGROUND: Most studies assessing the sensitivity and specificity of caries detection methods have been performed in vitro using the histological method as the gold standard showing inconsistent values. The aim of this study was to compare the sensitivity and specificity in detecting occlusal caries using the International Caries Detection and Assessment System (ICDAS II) with the radiographic method (RM), while using the Spectra™ Caries Detection System (SCDS) as the reference test. METHODS: One hundred sixty children, ages 7-12 years, participated in the study. Five zones in the occlusal surfaces of 859 primary and 632 first permanent molars were examined visually using ICDAS-II, the RM using bitewing radiographs and SCDS. The descriptive statistics of sensitivity and specificity were calculated and compared. RESULTS: For all molars combined and for primary molars only, the sensitivity of ICDAS II was higher for detecting total caries (p < 0.001), caries in enamel (p < 0.001), and caries in dentin (p = 0.016), but it was not different for detecting caries in the dentin of permanent first molars (p = 0.214), and primary second molars (p = 0.761). The specificity of RM was higher for detecting total caries, caries in enamel for all molars combined and for permanent first molars (p < 0.001). For caries in dentin, the specificity of ICDAS II was higher for all molars combined and for primary molars only (p < 0.001). For total caries in primary molars only, and caries in dentin of permanent first molars only, the specificity was not different (p = 0.156 and p = 0.181 respectively). CONCLUSIONS: The sensitivity and specificity of ICDAS II and RM changes depending on whether the carious lesion compromises the enamel or dentin, and if the caries detection is performed in the primary molars or permanent first molars.
Asunto(s)
Susceptibilidad a Caries Dentarias , Caries Dental , Niño , Humanos , Sensibilidad y Especificidad , Caries Dental/diagnóstico por imagen , Caries Dental/patología , Esmalte Dental/patología , Diente Molar/diagnóstico por imagen , Diente Molar/patología , Reproducibilidad de los Resultados , Dentina/diagnóstico por imagenRESUMEN
The purpose of this retrospective clinical study was to report a 12- to 54-month follow-up, in which a resin-based composite filling material was used in direct contact with a fast-setting zinc oxide eugenol cement to restore the function and anatomy of 51 pulpotomized primary molars in 2- to 11-year-old children who needed a Class I or II restoration. Formocresol pulpotomy using Temrex cement was performed in all cases. The total-etch technique was used with: (1) 35% phosphoric acid; (2) OptiBond Solo Plus bonding agent; and (3) Filtek P60/shade B2 resin-based composite material. The restored teeth were sealed with Embrace pit and fissure sealant, monitored, and evaluated with periodic radiographs and clinical exams at 6-month recall visits. The results revealed that none of the 51 pulpotomized primary molars had evidence of periapical or furcation pathosis, recurrent decay, open margins, or broken restorations. In conclusion, this clinical study demonstrated that resin-based composite restorations--combined with the total-etch technique and a fifth-generation bonding agent and in direct contact with a fast-setting zinc oxide eugenol cement were long-lasting, quality clinical alternatives to restore the anatomy and function of pulpotomized primary molars.
Asunto(s)
Resinas Compuestas , Recubrimiento de la Pulpa Dental/métodos , Restauración Dental Permanente/métodos , Pulpotomía/métodos , Grabado Ácido Dental , Niño , Preescolar , Formocresoles , Humanos , Diente Molar , Cementos de Resina , Estudios Retrospectivos , Diente Primario , Cemento de Óxido de Zinc-EugenolRESUMEN
PURPOSE: The purpose of this in vitro study was to evaluate the: (1) shear bond strength (SBS) of acetone and ethanol-based bonding agents to composite resin 24 hours after being bleached with 35% hydrogen peroxide; and (2) interface morphology and mode of fracture (IMMF) between composite resin and enamel. METHODS: Forty extracted teeth were randomly assigned into 4 groups: (1) group 1: 35% H2O2 + acetone; (2) group 2: H2O2 + ethanol; (3) group 3: acetone; (4) group 4: ethanol. All teeth were acid etched, bonding agents were applied, and a composite resin stub was bonded and stored again in saline for 24 hours. SBS was determined, and scanning electron microscopy (SEM) was used for IMMF evaluation. RESULTS: SBS was significantly lower in bleached than unbleached teeth (P < .001), but SBS did not differ between the acetone-based or ethanol-based adhesives (P = .55) and bleaching did not interact with adhesive treatment (P = .39). IMMF analysis of the unbleached teeth showed a continuous interface between the resin and enamel. By contrast, bleached teeth showed sparse contact between the resin and enamel and the resin was poorly infiltrated into the enamel surface. CONCLUSION: Morphologic changes in human tooth enamel, 24 hours after bleaching, were associated with a reduction in the shear bond strength of adhesives.