This study showed that MTA produced a superior marginal adaptation to amalgam, and that LVW conditions showed the lowest gap size. Gap size was influenced by the method of SEM viewing. If only HV SEM viewing conditions are used for MTA and amalgam root-end fillings, a correction factor of 3.5 and 2.2, respectively, may be used to enable relative comparisons of gap size to LVW conditions.

Critics argue that all carious dentine is not removed from the hand-prepared cavity during the Atraumatic Restorative Treatment (ART) procedure, and that the caries process is soon resumed. The aim of this study was to determine the effectiveness of ART in removing carious tissue, by investigating the numbers of mutans streptococci and lactobacilli, with emphasis on the prevalence of Streptococcus mutans and Streptococcus sobrinus strains before, and after ART treatment of dental caries. Two microbiology samples were collected. The first sample was removed from the centre of the carious lesion at the enamel-dentine junction, and the second was collected from the centre of the hard cavity wall above the pulp, after the soft infected dentine had been manually removed. A total of 71 mutans streptococci isolates from 31 children and 40 carious teeth were subcultured, biochemically characterised and genotyped by the arbitrarily primed polymerase chain reaction (AP-PCR). Results showed a significant decrease in TVC (P<0.0001), mutans streptococci (P < 0.0001) and lactobacilli (P = 0.0002) after cavity preparation. AP-PCR identified S. mutans strains that were undetectable during biotyping, and divided clinical isolates into two main clusters. In all, 63% (45/71) of isolates from the carious lesions comprised S. mutans strains. After cavity preparation, this was reduced to 35% (25/71), of which 30% (21/71) were S. mutans and the remaining 6% (4/71) S. sobrinus strains. The number of mutans streptococci strains was below detectable levels in 19 of the prepared cavities. The significant decrease in bacteria after manual cavity preparation demonstrates the reliability of a standardized ART technique, yet the presence of S. mutans strains shows that the effectiveness of the ART procedure can vary during treatment and between dental practitioners.

Dental caries and the severity (depth) and area of erosions of tooth substance were studied in 11 bulimic subjects and 22 matched controls. Erosions were seen in 69% of the bulimics' teeth and in only 7% of the controls' (p less than 0.001). Depth of penetration was greater in the bulimics, extending even into the pulp, and the area of erosion was also larger. Scores for dental caries were higher in bulimics (mean DMFS 27.9, median 36) than in controls (mean DMFS 19.1, median 13.5), although the difference was not statistically significant. This study suggests that when erosions are present on the lingual surfaces of maxillary anterior teeth, as well as on the buccal surfaces of maxillary canines, premolars, and maxillary incisors, a diagnosis of bulimia is likely. Patients with these signs should be referred for medical help.

The aim of this study was to determine the degree of fluorosis in the primary dentition and the accompanying caries patterns in groups of preschool-children in high and low fluoride areas. Among 331 coloured children, aged 1-5 years, living in an area with water F concentrations ranging from 2.2 to 4.1 parts/10(6), 82% were caries free and the dmft values ranged from 0 to 15 with a mean dmft of 0.8 +/- 2.1. Varying degrees of fluorosis in the primary teeth were present in 50.6% of the children. In 177 coloured children of similar ages from an adjacent area with 0.2 parts/10(6) F in the drinking water the dmft values ranged from 0 to 20 with a mean dmft of 5.4 +/- 5.8. Only 28% of the children were caries free. None of the children in this area had fluorosis. The caries prevalence was significantly higher in the low fluoride area than in the high fluoride area. The degree of fluorosis found in the primary dentition in the children from the high fluoride area was higher than had been anticipated and was accompanied by a very low caries prevalence.

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