This randomized split-mouth controlled clinical trial aimed at assessing the therapeutic effects of infiltration vs. sealing for controlling caries progression on proximal surfaces. Out of 90 adult students/patients assessed at university clinics and agreeing to participate, 39, each with 3 proximal lesions identified radiographically around the enamel-dentin junction to the outer third of the dentin, were included. Lesions were randomly allocated for treatment to test-A (Infiltration: ICON-pre-product; DMG), test-B (Sealing: Prime-Bond-NT; Dentsply), or control-C (Placebo). Primary outcome after 1, 2, and 3 yrs of radiographically observed lesion progression was assessed by an independent examiner blinded to groups, using pair-wise and digital-subtraction readings. No adverse events occurred. In 37 participants assessed after 3 yrs, 10 lesions (A-4; B-2; C-4) progressed deep into dentin and needed operative treatment. The 3-year therapeutic effect, based on pair-wise radiographic readings between infiltration and placebo, was 37.8% (95%CI: 20.5-55.2%) and that between sealing and placebo was 29.7% (95%CI: 20.2-35.0%). One-year follow-up digital-subtraction readings showed significant differences in lesion progression between infiltration and placebo (P = 0.0012) and between sealing and placebo (P = 0.0269). The study showed that infiltration and sealing are significantly better than placebo treatment for controlling caries progression on proximal lesions. No significant difference was seen between infiltration and sealing (ClinicalTrials.gov number CT01417832).

This study aimed to determine the reliability and accuracy of the ICDAS and radiographs in detecting and estimating the depth of proximal lesions on extracted teeth. The lesions were visible to the naked eye. Three trained examiners scored a total of 132 sound/carious proximal surfaces from 106 primary teeth and 160 sound/carious proximal surfaces from 140 permanent teeth. The selected surfaces were first scored visually, using the 7 classes in the ICDAS. They were then assessed on radiographs using a 5-point classification system. Reexaminations were conducted with both scoring systems. Teeth were then sectioned and the selected surfaces histologically classified using a stereomicroscope (×5). Intrareproducibility values (weighted kappa statistics) for the ICDAS for both primary and permanent teeth were >0.9, and for the radiographs between 0.6 and 0.8. Interreproducibility values for the ICDAS were >0.85, for the radiographs >0.6. For both primary and permanent teeth, the accuracy of each examiner (Spearman’s correlation coefficient) for the ICDAS was ≧0.85, and for the radiographs ≧0.45. Corresponding data were achieved when using pooled data from the 3 examiners for both the ICDAS and the radiographs. The associations between the 2 detection methods were measured to be moderate. In particular, the ICDAS was accurate in predicting lesion depth (histologically) confined to the enamel/outer third of the dentine versus deeper lesions. This study shows that when proximal lesions are open for inspection, the ICDAS is a more reliable and accurate method than the radiograph for detecting and estimating the depth of the lesion in both primary and permanent teeth.

Objective: To report (1) the caries experience prevalence and mean, and the caries severity and distribution patterns, expressed clinically and combined with radiographs with the conventional and ICCMS™ systems in young children from Bogotá, Colombia; (2) the contribution of including radiographs to the clinical caries scoring and (3) in which surfaces the radiograph adds to the clinical caries registration. Material and methods: Six hundred children from kindergartens/schools were enrolled: Cohort A: 2-year (n = 200), Cohort B: 4-year (n = 200) and Cohort C: 6-year (n = 200) olds. Radiographs were taken of the 4- and 6- year olds. Children were examined clinically using the Clinical (C) and Radiographic (R) ICCMS™-epi Caries Scoring Systems, staging caries lesions (d) as: Initial (C_epi/R_A), Moderate (C_M/R_B) or Extensive (C_E/R_C). Caries experience including missing (m) and filled (f) surfaces was expressed as follows: clinical conventional (Cd_MEmfs); clinical ICCMS™ (Cd_epiMEmfs); combined conventional (C + Rd_MEmfs) and combined ICCMS™ (C + Rd_epiMEmfs). Results: The prevalence of Cd_MEmfs was: Cohort A: 32%; Cohort B: 59%; Cohort C: 67.5%, increasing to 73.5%, 99.8% and 100%, respectively, with the C + R d_epiMEmfs. The Cd_MEmfs means doubled when initial caries lesions (Cd_epi) and radiographs (R) were included. The d component corresponded to over two-thirds of the caries experience. Findings on the radiographs significantly raised caries experience prevalence and means (p < .02), detecting primarily approximal lesions. Surfaces with highest caries frequency were occlusal/approximal of molar teeth and buccal of upper incisor teeth. Conclusion: Participants’ caries experience was high. The radiographic assessment significantly contributed to caries experience. Molar and upper incisor teeth were most prone to caries.

Accurate determination of the prevalence of erosive tooth wear (ETW) and associated risk factors in adolescents can inform clinical management guidelines. The aim of this analytical cross-sectional study was to estimate the prevalence, severity, and risk factors of ETW in adolescents aged 12–15 years in the municipality of Usaquén in Bogotá, Colombia. Two calibrated examiners clinically assessed ETW using Basic Erosive Wear Examination (BEWE) Index (range: 0–3). All tooth surfaces (excluding proximal) were scored to allow estimation of the Highest (0–3) and Total BEWE (sum of Highest BEWE score per sextant: 0–18) scores per patient. Sociodemographic characteristics, ETW risk factors, and caries severity (ICDAS-epi-merged) were evaluated, and their association with the presence of ETW (indicated by a Highest BEWE score of 2–3) was examined using preliminary analyses and logistic regression models. The study sample included 454 adolescents (mean age: 13.5±1.1 years; female: 61.7%), and the prevalence of ETW was 71.6%. The majority of participants exhibited a Highest BEWE score of 3 (58.0%) and a Total BEWE score ≤8 (84.3%). The preliminary analysis showed an association between the presence of ETW and age, caries, and brushing teeth before eating (p-value < 0.05). Risk factors for ETW included always brushing teeth before eating [adjusted Prevalence Ratio (PRa) 1.31, p-value=0.014], presence of extensive carious lesions (PRa 1.23, p-value = 0.024), male gender (PRa 1.14, p-value = 0.028), and age > 14 years (PRa 1.17, p-value = 0.009). Although ETW was highly prevalent, most Colombian adolescents exhibited low Total BEWE scores. ETW was associated with frequent fruit intake, age, toothbrushing habits, caries lesions, and sex.