Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
J Dent. 2020 Oct;101:103421. doi: 10.1016/j.jdent.2020.103421. Epub 2020 Jun 29.
This cross-sectional study is nested in a randomized clinical trial. It was designed to evaluate the influence of using two different clinical criteria to assess caries lesion around restorations on the decision to replace restorations in primary posterior teeth. Variables that might influence this decision were also considered.
One trained and calibrated examiner assessed 550 restorations of 160 children (3-10 years old). Children were randomized to have their restorations evaluated and subsequently treated according to World Dental Federation (FDI) or Caries Associated with Restorations and Sealants (CARS) criteria. After reaching the treatment decision, the same examiner performed another evaluation using the other criteria. Spearman's correlation coefficients and 95 % confidence intervals (95 %CI) between the scores obtained with both criteria and respective treatment decisions were calculated. Poisson multilevel regression analysis were performed between the exploratory variables related to children, restored tooth and restoration assessment; the outcome variables were decisions related to restoration replacement, any operative intervention and presence of secondary caries.
The strongest correlation observed between the methods was for recurrence of caries. A total of 94 restorations (17.1 %) were indicated for replacement with FDI criteria and 30 (5.5 %) were indicated for replacement with CARS. Besides the diagnostic method used, number of decayed teeth and restorations with two and three restored surfaces were associated with the decision of replacement and presence of recurrent caries lesions.
The decision to replace posterior restorations in primary teeth is influenced by the criteria used for the restorations assessment and also by the children's caries experience and multisurface restorations. The restoration material did not influence the decision of restorations replacement.
The decision to replace posterior restoration in primary teeth is strongly related to the evaluation method and not only by patients' risk factors.
本横断面研究嵌套于一项随机临床试验中。其旨在评估使用两种不同临床标准评估修复体周围龋损对决定更换乳牙后牙修复体的影响。还考虑了可能影响该决定的其他变量。
一名经过培训和校准的检查者评估了 160 名儿童（3-10 岁）的 550 个修复体。儿童被随机分组，根据世界牙科联合会（FDI）或龋病相关修复和密封剂（CARS）标准评估其修复体并随后进行治疗。在做出治疗决定后，同一名检查者使用另一种标准进行另一项评估。计算两种标准得分与各自治疗决定之间的 Spearman 相关系数和 95%置信区间（95%CI）。对与儿童、修复牙和修复体评估相关的探索性变量进行 Poisson 多水平回归分析；结局变量为与修复体更换、任何手术干预和继发龋相关的决策。
观察到的两种方法之间最强的相关性是龋病复发。共有 94 个修复体（17.1%）根据 FDI 标准需要更换，30 个修复体（5.5%）根据 CARS 标准需要更换。除使用的诊断方法外，龋齿牙数和具有两个和三个修复面的修复体与更换和出现复发龋损的决定相关。
更换乳牙后牙修复体的决定受到用于修复体评估的标准以及儿童龋齿经历和多表面修复体的影响。修复材料不影响修复体更换的决定。
更换乳牙后牙修复体的决定与评估方法密切相关，而不仅仅取决于患者的危险因素。
