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The non-operative resin treatment of proximal caries lesions Kim Ekstrand Stefania Martignon Azam Bakhshandeh David NJ Ricketts Dental Update 2024 39:9, 707-709.
Authors
KimEkstrand
DDS, PhD
Associate Professor, Section of Cariology & Endodontics and Paediatric Dentistry & Clinical Genetics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
Assistant Professor, Section of Cariology & Endodontics and Paediatric Dentistry & Clinical Genetics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
Epidemiological data show that the prevalence of caries on proximal surfaces in need of operative treatment is very high around the world, both in the primary and the permanent dentition. This article presents two new treatment methods: proximal sealing and proximal infiltration. The indications are progressing proximal caries lesions, radiographically with a depth around the enamel-dentine junction. A small number of studies regarding the effect of sealing and infiltration on proximal caries versus the use of fluoride varnish, placebo treatment and flossing instructions have been carried out. About half of the studies disclose a not significant difference between test and control treatment. In the other half, the therapeutic effect is significant and corresponds to about 30% reduction in lesion progression. However, longitudinal studies of longer duration are lacking.
Clinical Relevance: Proximal sealing and proximal infiltration may have a place in the treatment of non-cavitated proximal lesions. Proximal caries is a problem in both primary and permanent dentitions. Proximal sealants or lesion infiltration are possible treatments.
Article
Scandinavian countries have well organized dental healthcare systems for children and adolescents, which are free of charge.1 That may be one important reason why children and adolescents in Scandinavia have lower caries prevalence, compared to children and adolescents in other high-income countries like France and the USA, or middle and lower income countries like Estonia, China and Cuba.2,3 Despite this, approximately 50% of Danish children develop caries that needs restorative treatment in the primary dentition, mainly affecting the proximal surfaces of primary molar teeth.4 Longitudinal radiographic studies from Sweden5 have shown that about 20% of 11-year-old children had proximal caries, but when the same individuals reached 22 years of age, the prevalence had risen to 70%. Studies from Denmark,6 Sweden,7 China8 and USA9 all show that caries on proximal surfaces continues to develop into adulthood. It can therefore be concluded that dentists around the world spend a considerable time on the preventive management, and unfortunately on the operative management, of proximal caries, in both the primary dentition as well as the permanent dentition.
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