Impact of hypomineralized teeth and sociobehavioral aspects on caries development: a prospective cohort study

Aim: This prospective cohort study was to evaluate the independent and mutual effects of socioeconomic, oral health behaviors and individual clinical factors, including enamel hypomineralization, as possible risk factors for increase in caries experience in second primary molar (SPM) over a period of 2-years. Methods: Children (n=216) aged 4-6 years were examined for hypomineralized second primary molar (HSPM) and dental caries in school settings and were recalled every 6 months. The caregivers filled out a semi-structured questionnaire about their socio-demographic and oral health-related behaviors. Data analysis was performed using a hierarchical model with three levels. Multiple analyses were performed at each level and variables with p<0.20 were tested by stepwise multiple Generalized Estimating Equation. Results: At final examination, 33.3% of the children had developed new caries lesions in SPM. The model showed that the number of years of mother’s schooling and the caregiver´s perception about their children’s caries experience played a protective role in the incidence of dental caries. Children who had white spot lesions were more likely to develop new carious lesions in SPM. Children with HSPM showed no higher incidence of caries in their SPM than those without HSPM. Conclusions: Clinical, socioeconomic and behavioral factors impacted on caries development in primary second molars. However, further studies are required to better understand the role of HSPM in caries development in other age groups.

Clinical evaluation of two materials in the restoration of abfraction lesions

Aim: To evaluate the clinical performance of a composite resin (CR) and a resin-modified glassionomer cement (RMGIC) for the treatment of abfraction lesions. Methods: Thirty patients with abfraction lesions in at least two premolar teeth were selected and invited to participate in this study. All restorations were made within the same clinical time frame. One tooth was restored with CR Z100TM (3M, St. Paul, MN, USA), and the other was restored with RMGIC VitremerTM (3M). The restorations were assessed immediately and 1, 6 and 12 months after the restoration, using modified US Public Health Service (USPHS) criteria: marginal integrity, marginal discoloration, wear, retention, secondary caries and hypersensitivity. The statistical analysis was based on Friedman ANOVA test and Mann-Whitney test, considering p<0.05 for statistical significance. Results: Both materials demonstrated satisfactory clinical performance after one year. In the individual analysis of each material, there was a significant difference (p<0.05) in the criteria marginal integrity and wear, for both CR and RMGIC. RMGIC exhibited more damage one year after the restoration. Comparing both materials, it was found a significant difference only for marginal discoloration, while the RMGIC restorations showed the worst prognosis after a year of evaluation. There was no significant difference in the number of retentions, caries or hypersensitivity between CR and RMGIC. Conclusions: It was concluded that CR exhibited the best clinical performance according to the cost-effectiveness and evaluation criteria used in this study.