Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, João Pessoa, Paraiba, Brazil, and Faculty of Dentistry, University of Pernambuco, Arcoverde, Pernambuco, Brazil.
Undergraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, João Pessoa, Paraiba, Brazil.
Arch Oral Biol. 2025 Jan;169:106081. doi: 10.1016/j.archoralbio.2024.106081. Epub 2024 Aug 31.
proximal enamel caries lesions (PEC) are believed to initiate and progress to cavitation below the proximal contact area (PCA), but no evidence exists on the location of initial carious cavitation on the proximal surface with functional PCA. This study aimed to test the association of anatomical areas of the proximal surface with the severity of PEC and the frequency of cavitation in PEC in primary molars DESIGN: laboratory, observational, transversal study. Exfoliated primary molars (n = 33) with functional PCA (biofilm-free PCA surrounded by biofilm) had their proximal surfaces (one/tooth) divided anatomically into up to nine areas: 3 areas based on the occlusal/cervical PCA boundaries (areas I, II, and III; occluso-cervically) and 3 areas based on the bucco/lingual PCA boundaries (A, B, and C), with area IIB representing the PCA and area IIIB as the sub-PCA (below the PCA). PEC (ICDAS scores 1 and 2-3) and cavitation in PEC were quantified in all areas using stereomicroscopy and microCT. PEC volume was quantified in areas IIB and IIIB under microCT RESULTS: PEC severity increased occluso-cervically. PCA and sub-PCA presented different PEC severities (higher in sub-PCA) and similar PCE volumes, but the odds of carious cavitation were much higher (Odds ratio = 197.4; 95 % CI: 8.7/4480.7) in the PCA than in the sub-PCA (no cavitation).
PCA presented lower PEC severity and similar PEC volume compared to sub-PCA, but PCA concentrated all cavitations in PEC, supporting a new model for the pathogenesis of PEC.
人们认为近中面龋损（PEC）起始于近中接触区（PCA）下方并向该处进展至龋腔，但在具有功能性 PCA 的近中面，尚无关于初始龋腔在近中面何处发生的证据。本研究旨在检验近中面解剖区域与原发性磨牙 PEC 严重程度和 PEC 中龋腔出现频率的相关性。设计：实验室观察性横断研究。将具有功能性 PCA（被菌斑环绕的无菌斑 PCA）的剥脱性原发性磨牙（n=33）的近中面（每个牙齿）根据解剖结构分为多达 9 个区域：3 个基于牙合面/颈缘 PCA 边界的区域（I、II 和 III 区；牙合向-颈向）和 3 个基于颊舌向 PCA 边界的区域（A、B 和 C 区），其中 IIB 区代表 PCA，IIIB 区代表副 PCA（PCA 下方）。使用立体显微镜和微计算机断层扫描（microCT）对所有区域的 PEC（国际牙科联合会临床龋齿分类系统[ICDAS]评分 1 和 2-3）和 PEC 中龋腔进行量化。在 microCT 下对 IIB 和 IIIB 区的 PEC 体积进行量化。结果：牙合向-颈向的 PEC 严重程度增加。PCA 和副 PCA 具有不同的 PEC 严重程度（副 PCA 更高）和相似的 PEC 体积，但 PCA 中龋腔发生的可能性（比值比=197.4；95%可信区间：8.7/4480.7）比副 PCA （无龋腔）高得多。结论：与副 PCA 相比，PCA 的 PEC 严重程度较低，PEC 体积相似，但 PCA 集中了 PEC 中的所有龋腔，为 PEC 的发病机制提供了一个新的模型。
