No abstract

Infiltration of non-cavitated caries lesions with light-curing resins could lead to an arrest of lesion progression. The aim of this study was to evaluate the penetration of a conventional adhesive into natural enamel caries after pre-treatment with two different etching gels in vitro. Extracted human molars and premolars showing proximal white-spot lesions were cut across the lesions perpendicular to the surface. Corresponding lesion halves were etched for 120 sec with either 37% phosphoric acid gel (H(3)PO(4)) or 15% hydrochloric acid gel (HCl), and subsequently infiltrated with an adhesive. Specimens were observed by confocal microscopy. Mean penetration depths (SD) in the HCl group [58 (37) microm] were significantly increased compared with those of the H(3)PO(4) group [18 (11) microm] (p < 0.001; Wilcoxon). It can be concluded that etching with 15% hydrochloric acid gel is more suitable than 37% phosphoric acid gel as a pre-treatment for caries lesions intended to be infiltrated.

Dental caries is the most prevalent disease worldwide, with the majority of caries lesions being concentrated in few, often disadvantaged social groups. We aimed to systematically assess current evidence for the association between socioeconomic position (SEP) and caries. We included studies investigating the association between social position (determined by own or parental educational or occupational background, or income) and caries prevalence, experience, or incidence. Risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies. Reported differences between the lowest and highest SEP were assessed and data not missing at random imputed. Random-effects inverse-generic meta-analyses were performed, and subgroup and meta-regression analyses were used to control for possible confounding. Publication bias was assessed via funnel plot analysis and the Egger test. From 5539 screened records, 155 studies with mostly low or moderate quality evaluating a total of 329,798 individuals were included. Studies used various designs, SEP measures, and outcome parameters. Eighty-three studies found at least one measure of caries to be significantly higher in low-SEP compared with high-SEP individuals, while only 3 studies found the opposite. The odds of having any caries lesions or caries experience (decayed missing filled teeth [DMFT]/dmft > 0) were significantly greater in those with low own or parental educational or occupational background or income (between odds ratio [95% confidence interval] = 1.21 [1.03-1.41] and 1.48 [1.34-1.63]. The association between low educational background and having DMFT/dmft > 0 was significantly increased in highly developed countries (R (2) = 1.32 [0.53-2.13]. Publication bias was present but did not significantly affect our estimates. Due to risk of bias in included studies, the available evidence was graded as low or very low. Low SEP is associated with a higher risk of having caries lesions or experience. This association might be stronger in developed countries. Established diagnostic and treatment concepts might not account for the unequal distribution of caries (registered with PROSPERO [CRD42013005947]).

The infiltration of proximal enamel lesions with low-viscosity light curing resins could be a viable approach to stop lesion progression. However, penetration of sealant might be hampered by the comparatively highly mineralized surface layers of natural lesions. Therefore, the aim of this study was to compare the efficacy of three different etching gels in removing the surface layer in various etching times. Extracted human molars and premolars showing proximal white spot lesions were cut across the demineralized areas. Ninety-six lesions expected from visual examination to be confined to the outer enamel (C1) were selected. The cut surface and half of each lesion were varnished, thus serving as control. Subsequently, the lesions were etched with either phosphoric (37%) or hydrochloric (5 or 15%) acid gel for 30–120 s (n = 8/group). Specimens were examined using confocal microscopy and transversal microradiography. Surface layer reduction was significantly increased in lesions etched with 15% HCl gel for 90 and 120 s compared to those etched with H₃PO₄ gel for 30–120 s (p < 0.05). No significant differences regarding the depths of erosion in the lesions compared to sound enamel could be observed (p > 0.05). An effective reduction in the surface layer of natural enamel caries can be achieved by etching with 15% hydrochloric acid gel for 90–120 s.

Resin infiltration is an innovative approach to arrest progression of caries lesions. The aim of this randomized split-mouth placebo-controlled clinical trial was to assess whether resin infiltration of proximal lesions is more effective than non-operative measures alone with respect to the inhibition of caries progression. In 22 young adults, 29 pairs of interproximal lesions with radiological extension into the inner half of enamel or the outer third of dentin were randomly allocated to two treatment groups. In the test group, lesions were infiltrated (Icon, pre-product; DMG). A placebo treatment was performed in the control group. All participants received instructions for diet, flossing, and fluoridation. The primary outcome after 18 months was radiographic lesion progression (assessed by digital subtraction radiography). No unwanted effects could be observed. In the effect group, 2/27 lesions (7%) and in the control group 10/27 lesions (37%) showed progression (p = 0.021; McNemar). Infiltration of interproximal caries lesions is efficacious in reducing lesion progression.