Quantitative Evaluation by Glucose Diffusion of Microleakage in Aged Calcium Silicate-Based Open-Sandwich Restorations

This study compared the in vitro marginal integrity of open-sandwich restorations based on aged calcium silicate cement versus resin-modified glass ionomer cement. Class II cavities were prepared on 30 extracted human third molars. These teeth were randomly assigned to two groups (n = 10) to compare a new hydraulic calcium silicate cement designed for restorative dentistry (Biodentine, Septodont, Saint Maur des Fossés, France) with a resin-modified glass ionomer cement (Ionolux, Voco, Cuxhaven, Germany) in open-sandwich restorations covered with a light-cured composite. Positive (n = 5) and negative (n = 5) controls were included. The teeth simultaneously underwent thermocycling and mechanocycling using a fatigue cycling machine (1,440 cycles, 5–55°C; 86,400 cycles, 50 N/cm2). The specimens were then stored in phosphate-buffered saline to simulate aging. After 1 year, the teeth were submitted to glucose diffusion, and the resulting data were analyzed with a nonparametric Mann-Whitney test. The Biodentine group and the Ionolux group presented glucose concentrations of 0.074 ± 0.035 g/L and 0.080 ± 0.032 g/L, respectively. No statistically significant differences were detected between the two groups. Therefore, the calcium silicate-based material performs as well as the resin-modified glass ionomer cement in open-sandwich restorations

Response to letter to the editor by Jan Kühnisch

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How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement

Aim: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. Methods: A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. Results: Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient’s individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, longterm stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual

How to Intervene in the Caries Process in Children: A Joint ORCA and EFCD Expert Delphi Consensus Statement

This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the individual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia

How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement

Aim: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. Methods: A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. Results: Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient's individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual

Les restaurations esthétiques postérieures en technique directe (concepts actuels)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Analyse du risque carieux (Bilan des techniques)

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Les différents moyens de dépistage de la lésion interproximale

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF

Apport de la fluorescence dans le diagnostic des lésions carieuses

AIX-MARSEILLE2-BU Méd/Odontol. (130552103) / SudocSudocFranceF