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Modern Detection, Assessment and Treatment of Initial Approximal Lesions


Información de la publicación

Información de la publicación
Tipo de publicación

Científica

Tipología

Investigación y estudios

Medio de publicación

Impreso: Revista indexada

Resumen

Proper diagnosis and treatment of approximal lesions radiographically located around the enamel-dentin-junction (EDJ) have been a challenge for the clinician. A 3-year split-mouth study on approximal-posterior surfaces is being conducted to compare the efficacy of three preventive procedures (flossing-instructions, sealing-technique, infiltrating-technique) on such lesions.

Objectives: To describe: 1.-A novel infiltration technique. 2.-The ICDAS-II-criteria and the activity-status of approximal lesions in this sample.

Methods: Forty 16- to 31-year-olds participated each with three approximal lesions (n=120) [radiographic scores 3-radiolucency in the EDJ (65%) and 4-outer dentinal third (35%)] in posterior teeth. After a 2-day elective temporary tooth separation elastic bands were removed and the proximal spaces cleaned. Lesions were scored with ICDAS-II criteria (0-sound, 1-first-visual-enamel-change, 2-distinctive-visual-enamel-change, 3-enamel-breakdown, 4-underlying-shadow, 5/6-distinctive/extensive-cavity) and activity criteria: -visual appearance (0-brown-opacity, 1-white-opacity, 2-surface-rupture); -plaque-stagnation area (0-no, 1-yes); -tactile findings (0-smooth/hard, 1-rough/soft). Forty lesions received no clinical treatment (only flossing instructions), 40- sealing (described in: Martignon et al., Caries Res 2006), and 40- infiltration. The infiltration procedure was conducted as follows: rubber-dam isolation, plastic-wedge placement between lesion- and neighboring-surface, positioning of a 50m-transparent applicator between teeth, etching of lesion-surface with 15%-HCl-gel (120s), water-spray (30s), 100%-etanol application (30s), air-drying (30s), infiltrant application (applicator; 5min), air-drying (excesses removal, 30s), light-curing (60s), infiltrant reapplication (1min), light-curing (60s), and surface polishing (polishing strips).

Results: Lesions were scored as first-visual-enamel-change (0.8%), distinctive-visual-enamel-change (89.2%), enamel-breakdown (5.8%), and no assessment possible (4.2%). Regarding activity visual appearance corresponded to white-opacity (65.8%), surface-rupture (25.0%), brown-opacity (4.2%), and no assessment possible (4.2%); tactile findings corresponded to rough (46.7%), smooth (23.3%) and no assessment possible (30.0%). All lesions (100.0%) were located in plaque stagnation areas.

Conclusion: Most radiolucencies around the EDJ were visually classified as distinctive-visual-enamel-change (white opacities) in plaque-stagnation areas and rough. The infiltration technique has been described as a clinically feasible method for treating these lesions.

 

Autores

Martignon S, Meyer-Lueckel H, Tellez M, Paris S.

Registro ISSN

00220345

Fecha de publicación 11 de julio de 2013
Fecha de aceptación 21 de marzo de 2012
Medio indexado (nombre)

Journal of Dental Research (Abstract No1617)

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