Effect of an acid diet allied to sonic toothbrushing on root dentin permeability: An in vitro study

This study quantified alterations in root dentin permeability after exposure to different acid beverages. Twenty-five third molars were sectioned below the cementoenamel junction, the root segment was collected, and the pulp tissue was removed. The root segments were connected to a hydraulic pressure apparatus to measure the permeability of root dentin after the following sequential steps, with 5 specimens in each: 1) phosphoric acid etching for 30 s (maximum permeability), 2) root planning to create new smear layer, 3) exposure to different acid substances for 5 min (orange, cola drink, vinegar, white wine, lemon juice), 4) toothbrushing with sonic toothbrush for 3 min, 5) toothbrushing with sonic toothbrush plus dentifrice for 3 min. Considering step I as 100%, the data were converted into percentage and each specimen was its own control. Data were analyzed statistically by Kruskal-Wallis and Dunn's post test at 5% significance level. All acidic substances increased dentin permeability significantly after scraping (p<0.05). Toothbrushing after exposure to acid substances decreased dentin permeability and the association with dentifrice accentuated the decrease (p<0.05), except for the specimens treated with cola drink. Thus, it may be concluded that all tested acid fruit juices increased dentin permeability, and toothbrushing with or without dentifrice can decrease root dentin permeability after dentin exposure to acid diet.

Effect of acid fruit juices combined with electric or sonic toothbrushing on root dentin permeability - An in vitro study

The purpose of this in vitro study was to quantify the alterations on human root dentin permeability after exposure to different acid fruit juices and to evaluate the effect of toothbrushing with electric or sonic toothbrush after acid exposure. The root dentin of 50 extracted third molars was exposed with a high speed bur. Crowns were sectioned above the cementoenamel junction and root fragments were used to prepare dentin specimens. Specimens were randomly assigned to 5 groups according to the fruit juice (kiwifruit, starfruit, green apple, pineapple and acerolla). Each specimen was connected to a hydraulic pressure apparatus to measure root dentin permeability using fluid filtration method after the following sequential steps: I) conditioning with 37% phosphoric acid for 30 s, II) root scaling, III) exposure to acid fruit juices for 5 min and IV) electric or sonic toothbrushing without dentifrice for 3 min. Data were analyzed statistically by the Wilcoxon and Mann-Whitney tests at 5% significance level. All fruit juices promoted a significant increase of dentin permeability while toothbrushing decreased it significantly (p<0.05). It may be concluded that all acid fruit juices increased root dentin permeability, while toothbrushing without dentifrice after acid exposure decreased the permeability. The toothbrush mechanism (electric or sonic) had no influence on the decrease of root dentin permeability.

Influence of filler charge on gloss of composite materials before and after in vitro toothbrushing

Objectives: This study evaluated the gloss behaviour of experimental resin composites loaded with different filler percentages, immediately after polishing and after toothbrushing simulation. Methods: Sixteen disc-shaped specimens were fabricated for each different-charged composite (40%, 50%, 60%, 70% and 75%) and polished with SiC abrasive papers. Gloss measurements were made prior to simulated toothbrushing. The specimens were subjected to the simulation for 5, 15, 30 and 60 min using an electrical toothbrush with a standardized pressure while being immersed in a toothpaste/artificial saliva slurry. Results: Baseline composite gloss values ranged from 69.7 (40%) to 81.3 (75%) GU (gloss units) and from 18.1 (40%) to 32.3 (75%) GU after 1 h of brushing. Highest gloss values were obtained by 75%-charged resin, while the lowest values were obtained by the 40%-charged one. Conclusions: All tested materials showed a gloss decrease. However, the higher filler load a composite resin has, the higher gloss it can achieve. Clinical significance: Gloss of resin composite materials is an important factor in determining aesthetic success of anterior restorations, and this property may vary according to the filler charge of the restorative material. Higher filler load of a composite resin results in higher gloss values. © 2013 Elsevier Ltd. All rights reserved.

SURFACE ROUGHNESS AND CANDIDA ALBICANS BIOFILM FORMATION ON A RELINE RESIN AFTER LONG-TERM CHEMICAL DISINFECTION AND TOOTHBRUSHING

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Abrasive wear of two glass ionomer cements after simulated toothbrushing

Introduction and objective: Glass ionomer cement, which was first introduced in Dentistry in 1972, presents good qualities such as aesthetics, fluoride release and adhesion to dental tissues. Because of its preventive characteristics regarding to dental caries, glass ionomer cement has been used for Atraumatic Restorative Treatment (ART), as reported by Frencken and Holmgren [6], meeting the principles announced by the World Health Organization (WHO) for application to large population groups without regular access to dental care. Material and methods: In this present study, the abrasive wear strength of two glass-ionomer cements (Vidrion R® and ChemFlex®) was evaluated through toothbrushing machine. Classic® toothbrushes with soft bristles and Sorriso® dentifrice were also used for the study. Results: Student-t test showed significant difference between both groups, with tobs value = 9.4411 at p < 0.05. Conclusion: It can be concluded that the wear rate caused by toothbrush/dentifrice was higher for Vidrion R® (52.00 mg) than ChemFlex® (5.57 mg).

The influence of mouthrinses and simulated toothbrushing on the surface roughness of a nanofilled composite resin

The aim of this study was to determine the influence of mouthrinses on the surface roughness of a nanofilled composite resin after toothbrushing. One hundred nanofilled composite resin specimens were prepared and randomly distributed into two groups-brushed and non-brushed-and then assigned to five subgroups, according to the mouthrinse solutions (n = 10): Colgate Plax Fresh Mint, Oral B, Cepacol, Colgate Plax, and artificial saliva. Each sample was immersed in 20 mL of the mouthrinses for 1 minute, 5 days per week, twice a day, for a 3-week period. The control group used in the study was one in which the specimens were not subjected to brushing and remained only in artificial saliva. Toothbrushing was performed once a week for 1 minute, for 3 weeks. Surface roughness measurements (Ra) were performed after the immersion period and toothbrushing, by means of a profilometer. Data were analyzed by two-way ANOVA and Tukey's test. Analysis revealed that the association between toothbrushing and Colgate Plax Fresh Mint produced the lowest surface roughness (p < 0.05). All other groups tested (Oral B, Cepacol, Colgate Plax, artificial saliva) exhibited no statistically significant differences between surfaces, whether subjected to toothbrushing or not (p < 0.05). It was concluded that the surface roughness of the nanofilled composite resin tested can be influenced by the mouthrinse associated with toothbrushing.

Impact of filler size and distribution on roughness and wear of composite resin after simulated toothbrushing

Objectives: Nanofilled composite resins are claimed to provide superior mechanical properties compared with microhybrid resins. Thus, the aim of this study was to compare nanofilled with microhybrid composite resins. The null hypothesis was that the size and the distribution of fillers do not influence the mechanical properties of surface roughness and wear after simulated toothbrushing test. Material and methods: Ten rectangular specimens (15 mm x 5 mm x 4 mm) of Filtek Z250 (FZ2), Admira (A), TPH3 (T), Esthet-X (EX), Estelite Sigma (ES), Concept Advanced (C), Grandio (G) and Filtek Z350 (F) were prepared according to manufacturer's instructions. Half of each top surface was protected with nail polish as control surface (not brushed) while the other half was assessed with five random readings using a roughness tester (Ra). Following, the specimens were abraded by simulated toothbrushing with soft toothbrushes and slurry comprised of 2: 1 water and dentifrice (w/w). 100,000 strokes were performed and the brushed surfaces were re-analyzed. Nail polish layers were removed from the specimens so that the roughness (Ra) and the wear could be assessed with three random readings (mu m). Data were analyzed by ANOVA and Tukey's multiple-comparison test (alpha = 0.05). Results: Overall outcomes indicated that composite resins showed a significant increase in roughness after simulated toothbrushing, except for Grandio, which presented a smoother surface. Generally, wear of nanofilled resins was significantly lower compared with microhybrid resins. Conclusions: As restorative materials suffer alterations under mechanical challenges, such as toothbrushing, the use of nanofilled materials seem to be more resistant than microhybrid composite resins, being less prone to be rougher and worn.

Cost-effectiveness of conventional and modified supervised toothbrushing in preventing caries in permanent molars among 5-year-old children

The cost-effectiveness of a modified supervised toothbrushing program was compared to a conventional program. A total of 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In the control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice was carried outfour times per year. With the test group, children also underwent professional cross-brushing on surfaces of first permanent molar rendered by a dental assistant five times per year. Enamel/dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars for a period of 18 months. The incidence density (ID) ratio was estimated using Poisson's regression model. The ID was 50% lower among boys in the test group (p = 0.016). The cost of the modified program was US$ 1.79 per capita. The marginal cost-effectiveness ratio among boys was US$ 6.30 per avoided carie. The modified supervised toothbrushing program was shown to be cost-effective in the case of boys.

The influence of toothbrushing and coffee staining on different composite surface coatings

The aim of our study is to evaluate the performance of surface sealants and conventional polishing after ageing procedures. Eighty circular composite restorations were performed on extracted human molars. After standardised roughening, the restorations were either sealed with one of three surface sealants (Lasting Touch (LT), BisCover LV (BC), G-Coat Plus (GP) or a dentin adhesive Heliobond (HB)) or were manually polished with silicon polishers (MP) (n = 16). The average roughness (Ra) and colourimetric parameters (CP) (L*a*b*) were evaluated. The specimens underwent an artificial ageing process by thermocycling, staining (coffee) and abrasive (toothbrushing) procedures. After each ageing step, Ra and CP measurements were repeated. A qualitative surface analysis was performed with SEM. The differences between the test groups regarding Ra and CP values were analysed with nonparametric ANOVA analysis (α = 0.05). The lowest Ra values were achieved with HB. BC and GP resulted in Ra values below 0.2 μm (clinically relevant threshold), whereas LT and MP sometimes led to higher Ra values. LT showed a significantly higher discolouration after the first coffee staining, but this was normalised to the other groups after toothbrushing. The differences between the measurements and test groups for Ra and CP were statistically significant. However, the final colour difference showed no statistical difference among the five groups. SEM evaluation showed clear alterations after ageing in all coating groups. Surface sealants and dentin adhesives have the potential to reduce surface roughness but tend to debond over time. Surface sealants can only be recommended for polishing provisional restorations.

Toothbrushing after an erosive attack: will waiting avoid tooth wear?

The purpose of this study was to determine if storage for up to 4 h in human saliva results in a decrease of erosive tooth wear (ETW) and in an increase of surface microhardness (SMH) of enamel samples after an erosive attack with subsequent abrasion. Furthermore, we determined the impact of individual salivary parameters on ETW and SMH. Enamel samples were distributed into five groups: group 1 had neither erosion nor saliva treatment; groups 2-5 were treated with erosion, then group 2 was placed in a humid chamber and groups 3-5 were incubated in saliva for 30 min, 2 h, and 4 h, respectively. After erosion and saliva treatments, all groups were treated with abrasion. Surface microhardness and ETW were measured before and after erosion, incubation in saliva, and abrasion. Surface microhardness and ETW showed significant changes throughout the experiment: SMH decreased and ETW increased in groups 2-5, regardless of the length of incubation in saliva. The results of groups 3-5 (exposed to saliva) were not significantly different from those of group 2 (not exposed to saliva). Exposure of eroded enamel to saliva for up to 4 h was not able to increase SMH or reduce ETW. However, additional experiments with artificial saliva without proteins showed protection from erosive tooth wear. The recommendation to postpone toothbrushing of enamel after an erosive attack should be reconsidered.

A randomised, controlled clinical trial comparing chlorhexidine gel and low-dose fluoride toothpaste to prevent early childhood caries

Objectives This randomised, controlled trial compared the effectiveness of 0.12% chlorhexidine (CHX) gel and 304% fluoride toothpaste to prevent early childhood caries (ECC) in a birth cohort by 24 months. Methods The participants were randomised to receive either (i) twice daily toothbrushing with toothpaste and once daily 0.12% CHX gel (n = 110) or (ii) twice daily toothbrushing with toothpaste only (study controls) (n = 89). The primary outcome measured was caries incidence and the secondary outcome was percentage of children with mutans streptococci (MS). All mothers were contacted by telephone at 6, 12, and 18 months. At 24 months, all children were examined at a community dental clinic. Results At 24 months, the caries prevalence was 5% (3/61) in the CHX and 7% (4/58) in the controls (P = 0.7). There were no differences in percentages of MS-positive children between the CHX and control groups (54%vs 53%). Only 20% applied the CHX gel once daily and 80% less than once daily. Conclusions Toothbrushing using 304% fluoride toothpaste with or without the application of chlorhexidine gel (0.12%) reduces ECC from 23% found in the general community to 5–7%. The lack of effect with chlorhexidine is likely to be due to low compliance.

Early Childhood Caries and a Community Trial of its Prevention in Tehran, Iran

Varhaislapsuuden karies ja sen ehkäisy kehittyvän terveydenhuollon maassa Varhaislapsuuden karies on merkittävä kansanterveysongelma varsinkin lapsirikkaissa maissa ja väestöissä. Karieksen hoitaminen vie paljon voimavaroja ja aiheuttaa mittavia taloudellisia seuraamuksia. Karies voi ilmaantua lapselle jo vauvaikäisenä, pian ensimmäisten maitohampaiden puhjettua suuhun. Alle 3-vuotiaiden karieksesta on kuitenkin niukasti tilastotietoja. Maailman terveysjärjestökin suosittaa tietojen keräämistä vasta 3-vuotiaiden ikäryhmästä. Heistä kariesta sairastaa Suomessa 16 %, Yhdysvalloissa 25 %, Englannissa 30 %, Iranissa 46 % ja Saudi-Arabiassa 61 %. Tämä väitöstutkimus selvitti karieksen esiintymistä ja sen vaaratekijöitä 1─3-vuotiailla Teheranissa. Lisäksi tutkimus arvioi perusterveydenhuoltoon sisällytetyn karieksen ehkäisyn tuloksellisuutta. Tutkimuskohteiksi arvottiin Teheranista 18 neuvolaa. Jokaisessa oltiin 4 päivää, jolloin kaikkia rokotuksiin tulleita 1─3-vuotiaita äiteineen pyydettiin osallistumaan tutkimukseen. Kahta lukuun ottamatta kaikki äidit suostuivat, ja aineistoon tuli kaikkiaan 504 lasta äiteineen. Kaikki 1-vuotiaat, 242 lasta äiteineen, valittiin karieksen ehkäisykokeiluun. Sitä varten neuvolat jaettiin kolmeen ryhmään, joista kaksi (A ja B) oli koeryhmiä ja yksi (C) oli vertailuryhmä. Tutkimus alkoi äidin haastattelulla. Siinä selvitettiin perheen koulutus- ja tulotaso sekä lapsen ruokinnasta imetyksen kesto, yösyötöt ja päiväaikaan nautitut makeat. Vielä kysyttiin lapsen ja äidin suuhygieniatavoista ja äidin kokemuksista lapsen suun puhdistamisessa. Sitten hammaslääkäri tutki lapsen suun ja kirjasi karieksen ja hammasplakin esiintymät. Suun tutkimuksen jälkeen äiti ja lapsi siirtyivät rokotushuoneeseen. Koeryhmissä (A ja B) äidit saivat terveydenhoitajalta suunterveyttä koskevan esitteen ja kehotuksen lukea se huolellisesti. Lisäksi ryhmässä A terveydenhoitaja kertoi suun ja hampaiden terveydenhoidosta saman esitteen avulla, ja neuvolan henkilökunta muistutti suunhoidon tärkeydestä puhelimitse kahdesti seuraavan puolen vuoden kuluessa. Vertailuryhmässä äideille ei annettu suunhoidon ohjeita. Kaikissa ryhmissä äitejä muistutettiin seuraavan rokotuskerran ajankohdasta, muttei mainittu tulevaa toista hammastarkastusta. Varhaislapsuuden kariesta sairasti ikäryhmästä riippuen 3─26 % tutkituista 1─3-vuotiaista, ja 65─76 %:lla oli hammasplakkia. Äideistä 68 % harjasi hampaansa päivittäin ja 39 % puhdisti lapsensa suun päivittäin. Mitä useammin äiti harjasi omat hampaansa, sitä paremmin hän huolehti lapsen suun puhtaudesta. Rintaruokinta oli yleistä eikä lisännyt kariesvaaraa. Yöllä pullomaitoa saavilla karies oli 5 kertaa yleisempää kuin muilla. Neuvolassa saatu ohjeistus ehkäisi selvästi karieksen syntyä puolen vuoden kokeessa.

Oral health behaviour, conditions and care among dentate elderly patients in Lithuania: preventive aspects

The present cross-sectional study aimed to assess oral health behaviour, dental and periodontal conditions, dental care, and their relationships among elderly dentate patients in Lithuania. The target population in the study were dentate patients aged 60 and older attending public dental services in Kedainiai, Lithuania. The data collection took place between the autumn of 1999 and the winter of 2001. Data were collected by means of a self-administered questionnaire for all (n=174) and a clinical examination targeting about half of the subjects (n=100). The questionnaire inquired about oral health behaviour, the life-first and also the most recent dental treatments, sources on and self-assessed knowledge of oral self-care, a self-reported number of teeth, and socio-demographic information. The clinical examination included basic dental and periodontal conditions. A total of 82 women and 92 men completed the questionnaire; their mean age was 69.2 and their average number of teeth was 16.2 (CI 95% 15.4-17.1). In all, 25% had 21 or more teeth and 32% indicated wearing removable dentures. The oral health behaviour, the participants reported, was poor: 30% reported twice daily toothbrushing, 57% responded that they always use fluoride toothpaste, 19% indicated daily interdental cleaning, nearly all said they take sugar in their coffee and tea, and 30% indicated going for check-ups. As the main source of information on oral self-care, the subjects indicated health professionals (82%), followed by social contacts (72%), broadcasted media (58%), and printed media (42%). A total of 34% assessed their knowledge of oral self-care as good, and their self-assessed knowledge correlated (r=0.52) with professional guidance they had received about oral self-care. In their most recent treatment, conservative (39%) and non-conservative (34%) treatments dominated, and preventive ones were the least reported (7%). Regarding guidance in oral self-care, 54% reported having received such about toothbrushing, 32% about interdental cleaning, and 33% had been given visual information. Clinical examinations revealed the presence of plaque, calculus, bleeding on probing and deepened pockets in all of the subjects; 70% of the subjects were diagnosed with pockets of 6mm and deeper, 94% with caries, and 73% with overhangs of restorations. Those subjects assessing their knowledge of oral self-care as good and reporting a higher intensity of guidance in oral self-care as received, indicated practicing the recommended oral self-care more frequently. Twice daily toothbrushing was associated with good self-assessed knowledge of oral self-care (OR 4.1, p<0.001) and a university education (OR 5.6, p<0.001). Those subjects with better oral health behaviour had a greater number of teeth. Having 21 or more teeth was associated with good self-assessed knowledge of oral self-care (OR 4.1, p=0.03). Better periodontal conditions were associated with a higher frequency of toothbrushing. The presence of periodontal pockets of 6mm and deeper was associated with the level of self-assessed knowledge of oral self-care being below good (OR=3.0, p=0.04) and the level of dental cleanliness being poor (OR=2.7, p=0.02). To conclude, oral health behaviour and conditions call for improvement in elderly subjects in Lithuania. To improve the oral health of their elderly dentate patients, dentists should apply all the available tools of chair-side prevention and active guidance. The latter would be an effective means of updating the knowledge of oral self-care and supporting recommended oral health behaviour. A preventive approach should be strongly emphasized in countries with limited resources for oral health care, such as Lithuania. Author’s address: Sonata Vyšniauskaite, Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P.O.Box 41, FI-00014 Helsinki, Finland. E-mail: sonata.vysniauskaite@helsinki.fi

Preadolescents and Their Mothers as Oral Health-Promoting Actors : Non-biologic Determinants of Oral Health among Turkish and Finnish Preadolescents

Is oral health becoming a part of the global health culture? Oral health seems to turn out to be part of the global health culture, according to the findings of a thesis-research, Institute of Dentistry, University of Helsinki. The thesis is entitled as “Preadolescents and Their Mothers as Oral Health-Promoting Actors: Non-biologic Determinants of Oral Health among Turkish and Finnish Preadolescents.” The research was supervised by Prof.Murtomaa and led by Dr.A.Basak Cinar. It was conducted as a cross-sectional study of 611 Turkish and 223 Finnish school preadolescents in Istanbul and Helsinki, from the fourth, fifth, and sixth grades, aged 10 to 12, based on self-administered and pre-tested health behavior questionnaires for them and their mothers as well as the youth’s oral health records. Clinically assessed dental status (DMFT) and self-reported oral health of Turkish preadolescents was significantly poorer than the Finns`. A similar association occurred for well-being measures (height and weight, self-esteem), but not for school performance. Turkish preadolescents were more dentally anxious and reported lower mean values of toothbrushing self-efficacy and dietary self-efficacy than did Finns. The Turks less frequently reported recommended oral health behaviors (twice daily or more toothbrushing, sweet consumption on 2 days or less/week, decreased between-meal sweet consumption) than did the Finns. Turkish mothers reported less frequently dental health as being above average and recommended oral health behaviors as well as regular dental visits. Their mean values for dental anxiety was higher and self-efficacy on implementation of twice-daily toothbrushing were lower than those of the Finnish. Despite these differences between the Turks and Finns, the associations found in common for all preadolescents, regardless of cultural differences and different oral health care systems, assessed for the first time in a holistic framework, were as follows: There seems to be interrelation between oral health and general-well being (body height-weight measures, school performance, and self-esteem) among preadolescents: • The body height was an explanatory factor for dental health, underlining the possible common life-course factors for dental health and general well-being. • Better school performance, high levels of self-esteem and self-efficacy were interrelated and they contributed to good oral health. • Good school performance was a common predictor for twice-daily toothbrushing. Self-efficacy and maternal modelling have significant role for maintenance and improvement of both oral- and general health- related behaviors. In addition, there is need for integration of self-efficacy based approaches to promote better oral health. • All preadolescents with high levels of self-efficacy were more likely to report more frequent twice-daily toothbrushing and less frequent sweet consumption. • All preadolescents were likely to imitate toothbrushing and sweet consumption behaviors of their mothers. • High levels of self-efficacy contributed to low dental anxiety in various patterns in both groups. As a conclusion: • Many health-detrimental behaviors arise from the school age years and are unlikely to change later. Schools have powerful influences on children’s development and well-being. Therefore, oral health promotion in schools should be integrated into general health promotion, school curricula, and other activities. • Health promotion messages should be reinforced in schools, enabling children and their families to develop lifelong sustainable positive health-related skills (self-esteem, self-efficacy) and behaviors. • Placing more emphasis on behavioral sciences, preventive approaches, and community-based education during undergraduate studies should encourage social responsibility and health-promoting roles among dentists. Attempts to increase general well-being and to reduce oral health inequalities among preadolescents will remain unsuccessful if the individual factors, as well as maternal and societal influences, are not considered by psycho-social holistic approaches.

Reprodutibilidade de um índice para diagnóstico e avaliação da atividade de lesões de cárie dentária na dentição decídua

O objetivo do presente estudo clínico é verificar a reprodutibilidade intra e interexaminadores de um critério de diagnóstico de cárie dentária (Nyvad et al. 1999) aplicado na dentição decídua, e avaliar o tempo médio necessário para a realização do exame clínico utilizando o referido critério. O mesmo é baseado na combinação de métodos visuais e táteis e propõe a diferenciação entre lesões ativas e inativas, tanto para lesões cavitadas quanto para não cavitadas. A amostra total consistiu de 80 crianças de três a sete anos de idade, de ambos os sexos, estudantes do Centro Educacional Terra Santa (Petrópolis/ RJ). Os responsáveis assinaram um termo de consentimento livre e esclarecido e o trabalho foi aprovado pelo Comitê de Ética em Pesquisa do HUPE-UERJ. Os exames foram realizados após escovação supervisionada, em consultório odontológico sob iluminação artificial, após 3-5s de secagem com ar comprimido, por dois examinadores treinados pelas autoras do índice e calibrados. As concordâncias intra e interexaminadores foram avaliadas pelo percentual de concordância (%) e pelo teste kappa (k), considerando a superfície dentária como unidade de análise e os seguintes pontos de corte: 1) hígida versus cariada; 2) ativa versus inativa; 3) descontinuidade versus hígida; e 4) cavitada versus hígida. O % e o valor de k para confiabilidade interexaminadores para cada ponto de corte foram: 1) % = 0,97 e k = 0,82 (IC: 0,80 - 0,85); 2) % = 0,98 e k = 0,80 (IC: 0,76 - 0,83); 3) % = 0,99 e k = 0,90 (IC: 0,88 - 0,93); 4) % = 99,0 e k = 0,95 (IC: 0,92 - 0,97). O % e o valor de k para confiabilidade intraexaminador para cada ponto de corte foram: 1) % = 0,98 e k = 0,86 (IC: 0,84 - 0,86); 2) % = 0,99 e k = 0,86 (IC: 0,83 - 0,89); 3) % = 0,99 e k = 0,94 (IC: 0,92 - 0,96); 4) % = 0,99 e k = 0,98 (IC: 0,96 - 0,99). O maior % de discordância (65,3% - 158/242) concentrou-se na diferenciação entre supefícies hígidas e lesões não cavitadas: 33,5% (81/242) entre superfície hígida e lesão não cavitada inativa; 26,0% (63/242), entre superfície hígida e lesão não cavitada ativa; e 5,8% (14/242), entre lesão não cavitada ativa e lesão não cavitada inativa. O tempo necessário para realização do exame clínico foi em média 226,5s (128,53). Conclui-se que o índice apresentou reprodutibilidade variando de substancial à quase perfeita e um tempo de exame viável, mostrando-se consistente e reproduzível para a realização de estudos clínicos de cárie dentária na dentição decídua.