Worthington H (eds). There is very little information available from private dental practices on the comparative survivals of extensive posterior amalgam restorations and posterior crowns placed in the same patient population. Root caries, 335. Minimal intervention dentistry - a review. These range from preventive measures and fissure sealants, through monitoring carious lesions for active progression or arrest, to minimal cavity designs such as tunnel preparations and preventive resin restorations which employ adhesive dental restorative materials. Both slot and tunnel preparations remove similar amounts of tooth structure. The cast gold onlay and the porcelain jacket crown were the least cost-effective indirect posterior and anterior restorations respectively. Pitts N B, Longbottom C. Preventive Care Advised (PCA)/Operative Care Advised (OCA) - categorising caries by the management option. Evidence based dentistry for effective practice. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth. Administer local anaesthesia if necessary, Isolate the tooth with rubber dam or cotton rolls, Remove the caries with a small round diamond point or tungsten carbide bur, Provide pulpal protection if necessary, using a glass-ionomer cement, Etch entire occlusal surface using a phosphoric acid gel, or use a self-etch adhesive, Place a posterior resin composite into the cavity preparation, Apply sealant over the restoration and adjacent previously-etched fissures. After adjusting for confounding variables the difference in the DMFS increment between the control and study groups remained significant (mean difference 1.7; p < 0.001). The mean number of decayed primary teeth (dt) was 4.1 and the mean number of decayed permanent teeth (DT) was 0.7, indicating a clear need for dental treatment and education This retrospective study examined the survival and cost-effectiveness of five different types of dental materials used to restore various classes of cavity preparations in permanent teeth. Even small changes in dietary habits and a moderate increase in the use of topical fluorides and casein-derived remineralisation pastes, or additional attention to plaque removal, may be sufficient to tip the balance towards remineralisation and arrest. 30 Dental Caries, 321. By Lubna Tahir and Rabia Nazir. Background: A review of studies in support of a philosophy of Minimal Intervention Dentistry. J Can Dent Assoc 1992; 58: 197–200. We have made much progress in our knowledge of the biology, prevention, diagnosis and treatment of dental caries since the founding of the ADA 150 years ago. However, this role would only seem appropriate in ituations where the unfilled or lightly-filled resin-based sealant is afforded some protection from direct occlusal contact with the opposing tooth, to reduce the potential for sealant wear and marginal leakage. This approach to patient care has several distinct treatment modalities. Dental caries or tooth decay may be defined as a dynamic process causing progressive destruction of hard tooth substance (enamel, dentine and cementum) involving demineralisation of the inorganic portion of the tooth, and dissolution of the organic portion. Dental caries or tooth decay may be defined as a dynamic process causing progressive destruction of hard tooth substance (enamel, dentine and cementum) involving demineralisation of the inorganic portion of the tooth, and dissolution of the organic portion. Int Dent J 1996; 46: 126–130. Treatment of coronal caries was characterized by high rates of adhesive posterior restorative services, but gross lesions had lower rates of both anterior and posterior adhesive restorations. The anticipated outcome of implementing the Caries Management System in general dental practice is reduction in caries incidence and increased patient satisfaction. Fluoride and casein phosphopeptide-amorphous calcium phosphate. J Am Dent Assoc 1995; 126: 727–743. Preventive and treatment planning for dental caries: Author: Yip, K. Smales, R. Citation: British Dental Journal, 2012; 213(5):211-220 ... based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. The reasons for these increases in dental disease may be related to a greatly increased consumption of hidden refined sugars and acids in various foods and beverages, an increased use of xerogenic medications and illicit drugs, a decreased fluoridated water exposure, and the natural effects of retaining more teeth into old age. Oral diagnosis and treatment planning: part 5. Dental Public Health Issues in Pediatric Dentistry 12. Lecture, laboratory and clinical courses within each subject area were identified. the network. Conclusions: no significant difference was found between the use of partial and total caries removal for cavity preparation for the outcome of restoration survival. Int Dent J 1992; 42: 287-304. It is now recognised that demineralised but noncavitated enamel and dentine can be 'healed', and that the surgical approach to the treatment of a caries lesion along with 'extension for prevention' as proposed by G V Black is no longer tenable. Part 7.reatment planning for T missing teeth. Article  5 As part of the dental ... Case presentation and treatment planning. Br Dent J 2004; 196: 639–643. Community Dent Oral Levels of prevention can classify treatment for dental caries. This article addresses shortcomings in preventive dentistry and proposes a plan for treatment standardization that can ensure optimum treatment and, ideally, lead to adequate compensation. The complete replacement of restorations usually results in less sound tooth structure: Removal of resin composites is usually slow and incomplete, and results in approximately 30% increased loss of sound tooth structure, Removal of amalgams and glass-ionomers is usually faster and more complete, and results in little increased loss of sound tooth structure, Preparations for indirect restorations are more destructive of sound tooth structure than for direct placement restorations. Also, tooth brushing technique is not important to the presence of abrasions, but increased tooth brushing frequency results in an increase in the number of abrasions. Recently, a new device, based on fluorescence measurements, was introduced. The focus of the recommendations is early identification of high caries risk children in order to initiate early preventive measures. Based on previous studies, caries activity tests that use cariogenic bacteria have been considered to be a valid predictor of the caries prevalence, and several tests are commercially available and are applied in dental clinics [8], ... Based on the results, the Cariview score can identify susceptible subgroups within a population and distinguish the caries activity and caries risk of the individual. Therefore, it is difficult to accept a clinical decision to wait until obvious dental caries develops with frank cavitation, and then to place a much larger restoration. This paper aims to update the reader on developments in sealant technology and the use of sealants in caries prevention and management with an emphasis on the options available to manage the questionable fissure. Up to 40% of decisions to replace restorations have been reported to be for the reason that the existing restorations are of dubious integrity, though without associated caries or suspected caries. However, the clinicians involved were generally unaware of the faults in their new restorations, for they assessed them all as being satisfactory, with approximately 90% being excellent in all respects. Edgar M, O'Mullane D, Dawes C (eds). When the patient requests the removal of the restoration because of undue psychological stress associated with it. Overtreatment with restorative dentistry: When to intervene? Long-term cost-effectiveness of single indirect restorations in selected dental practices. Preventive and treatment planning for dental caries. 3. 7.5 Principles of diagnosis and treatment planning for preschool children. The subsequent lesions first will be visible as white spot lesions, which if ignored, eventually will cavitate. The move away from some of Black's concepts started as investigations examined the dental health of patients in the National Health Service of Great Britain. Patients with persistent unrealistic expectations should not be accepted for dental treatment. Surface discolouration may be due to the intake of particular foods, drinks or medicines, and simple polishing of the restoration may solve or improve this situation. Oral diagnosis and treatment planning: part 5. The lack of controlled clinical trials, to prove the long-term success and cost-effectiveness of some MID procedures and restorative treatments in general practices. 7.5 Principles of diagnosis and treatment planning for preschool children. Root surface caries, and softened root surfaces caused by tooth erosion, will remineralise using fluoride varnish and/or casein-derived remineralisation pastes. All rights reserved. The new caries activity test to analyse the acidogenic potential of whole microorganisms from dental plaques can be used to evaluate caries risk in children with deciduous teeth. When planning dental treatment for preschool children, it is important to appreciate that dental caries of enamel is essentially a childhood disease and that progression of caries in the primary dentition can be rapid. Incorporate fluorides into appropriate restorative materials. DENTAL CARIES IN CHILDREN AND ADOLESCENTS Evidence-based guidance on identifying high caries risk children and developing preventive strategies for high caries risk children in Ireland This work was funded by the Health Research Board (Grant No. To obtain The mouthrinses were used for 60 sec, three times/day for 5 days, and supragingival plaque was collected and analyzed for F. The dentifrices were rinsed as a water slurry for 60 sec four times/day for 14 days in an in situ model. Cusp-covered amalgams were approximately 3.8 times more cost-effective than were either cast gold or ceramometal crowns, and resin composites were approximately 3.7 times more cost-effective than were cast gold inlays for restoring Class IV preparations. Se ha cambiado el enfoque restaurador convencional de caries, sobre todo cuando la lesión abarca tejido dentinario profundo, 1-3 entendiéndose que la caries dental es un proceso dinámico que ocurre en los depósitos bacterianos, 4 que resulta en la alteración del equilibrio entre la superficie dentaria y el fluido de placa circundante, 5 lo cual influye de manera directa sobre los tratamientos restauradores que se pudieran ejecutar 6 y la longevidad de las restauraciones. Traditional restorative dental treatment has many shortcomings and has not been shown to be an effective method for managing caries. Objective: evaluate the survival of adhesive restorations in cavities prepared with partial or total caries removal. This investigation was based on the studies presented at the last four meetings of the Society of Laser in Dentistry and it reviews the applications of laser in the two major diseases of the oral cavity, namely dental caries and periodontal disease, the dental fields in which laser research is carried out, and the type of laser in use at present, as well as expectations for the future of laser in dentistry. Yet restorations are not permanent and do not cure caries, as the causes remain. 3rd edn. seen in children [5]. Seven general dental practitioners examined a total of 332 occlusal surfaces in 240 patients. To determine the relative cost-effectiveness of alternative methods for restoring large tooth substance loss in adults. In the. The direct placement restorations were more cost-effective than the indirect restorations at all time intervals over the 15-year study period. Aust Dent J 1992; 37: 205–210. and disease. Therefore, the profession has to plan treatment and preventive care pathways based on the understanding that dental caries is no longer a rap-idly developing problem in childhood, but a slowly pro-gressing disease of adulthood. When should pit and fissure sealants be used? by the management option. Older patient age was associated highly with failure (P < .001). Placement of sealants is considered to be cost-effective in selected posterior teeth in selected patients. Large posterior resin composite restorations and all-ceramic crowns should be restricted largely to critical aesthetic situations. Making Dental Caries Prevention a Win-Win Concept Anticipated Release - April 2021 Gordon J. Christensen, DDS, MSD, PhD & Rella P. Christensen, PhD Prevention can be a win-win concept for both patients and dental professionals. Type Article Author(s) K. Yip, R. Smales Date 2012-9 Volume 213 Issue 5 Page start 211 Page end 220 DOI 10.1038/sj.bdj.2012.774 Web address An international movement emerged in 1986-1987 which heralded a major change in the role of conservative dentistry. Br Dent J. Other strategies, such as fluoride therapy, including silver diamine fluoride; proper self-care; nutritional evaluation; risk assessment; reduction of MS; and restorative interventions, if necessary; are all part of an effective ECC prevention program. Dental caries and assessment of risk, Part 3. In this present study, the survival findings have implications for the most cost-effective dental treatments of large lesions in posterior teeth. There are fewer amalgams, gold castings and removable partial dentures, but more posterior resin composites and polymers, metal-ceramics and high-strength all-ceramics, fixed partial dentures and dental implants – all of which are more costly and many of which are financially less cost-effective than alternative restorative treatments. Initial findings after two years from the intense non-invasive management of dental caries in many patients from multiple private practices have shown the positive efficacy of a preventive programme as compared with standard care restorative dental treatment. Survival table analysis was performed which included the two treatments at 6, 12, 18 and 24 months. This type of dentistry is gratifying for dentists and appreciated by patients. This paper, and a subsequent one, were written to enable widespread dissemination of these ideologies to Australian practitioners. (18) The goal of this project is to create a Practice Based Research Network with 30 researcher dentists calibrated on the administration of a caries risk assessment and the treatment modalities recommended based on the caries risk assessment results (Caries Management … Are there conditions that favor the placement of resin-based versus. Oral diagnosis and treatment planning: part 8. Glass-ionomer cement (GIC) is the usual restorative material placed. Children are exposed to intense marketing of these acidic products, which are widely available in supermarkets and school canteens. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth. Studies concerned with the prevalence of restoration failures have concluded that one in three restorations present at any one time is considered to be 'unsatisfactory'. INTRODUCTION . The purpose of this evaluation was to compare United States (US) dental schools for variability in clock hours. A caries lesion begins with the introduction of a disease state, likely due to bacterial strains, in the oral cavity. Part 7.reatment planning for T missing teeth. When moisture control is difficult to achieve, as in children with partially-erupted molar teeth, then fast-setting glass-ionomer cement should be used as the sealant material. Dental hy… Plaque samples for the new Cariview(®) test and the saliva sample for the conventional Dentocult SM(®) test were collected, incubated, and scored according to each manufacturers' instruction. Type Article Author(s) Yip, K.1Smales, R.2 Date 2012 Volume 213 Issue 5 Page start 211 Page end 220 OpenURL Check for local electronic subscriptions Web address Treatment planning for missing teeth, Part 8. Before any repairs are undertaken, the probable reasons for the restoration failure should be determined and corrected where possible. 2012 Oct;213(8):387-94. doi: 10.1038/sj.bdj.2012.928. Preventive and treatment planning for dental caries. In deciding whether or not to replace a restoration, it is necessary to weigh the advantages against the disadvantages. Caries management by risk assessment (CAMBRA) focuses on treating and preventing the cause of the disease at an early stage, rather than waiting until it causes damage to tooth structure. This could indicate scope for the adoption of more minimum intervention approaches to the management of initial carious lesions. The role of dentistry in reducing dental caries may lie mainly in the non‐personal health services. The argument that the PRR is a particularly good treatment method, in that it guards against a missed diagnosis of dental caries, is countered by that it will inevitably also be responsible for occasional operative treatments when no lesion exists. This paper examines these criteria and provides decision trees with respect to the clinical management of carious lesions and teeth with existing restorations, showing when, and what type of, intervention is required. Locally acceptable sub-divisions may have to be developed and agreed for certain specific applications. These children had deep cavities that covered one or two dental surfaces, which were treated by partial or total caries removal. Material choice was not significantly predictive in these early results. The advantages of minimally invasive dentistry, Treatment of proximal caries lesions by tunnel restorations, Evidence-Based Clinical Recommendations for the Use of Pit-and-Fissure Sealants: A Report of the American Dental Association Council on Scientific Affairs, Fluoride and Casein Phosphopeptide-Amorphous Calcium Phosphate. The patient's assessment of the condition is often decisive in deciding the need for treatment. Part 1. Conclusions: The risks of iatrogenic damage, maintenance problems, failure and litigation increase with the costs and complexity of dental treatments. Better aesthetics than when using amalgam, Prevention of caries in adjacent pits and fissures. The data obtained were subjected to Kaplan-Meier survival statistical analysis, and the Log Rank test was used to determine the difference between the treatments. Preventive and treatment planning for dental caries. In this, the second of two papers on the relationships between dental treatment and dental health, the philosophical basis of Minimum Intervention Dentistry is presented. Models of service rates adjusted for age, gender, insurance status and reason for visit showed that compared to the reference category of initial caries lesions, there were lower rates [Rate Ratio, 95% CI] of adhesive anterior restorative services [0.57, 0.34-0.95] and lower rates of adhesive posterior restorations [0.56, 0.40-0.79] for gross lesions. Five staff meetings with feedback occurred between cycles. Staehle H J. Minimally invasive restorative treatment. A step-by-step "laminate" technique, which includes, successively, a glass-ionomer cement liner, a posterior composite resin, and a sealant, is described. Increasingly expensive equipment is being purchased by practitioners for dental diagnosis and treatments, and for patient education and practice management. These investigations, and the report of the Committee of Enquiry into Unnecessary Dental Treatment, have resulted in an extensive re-education programme being initiated by the British Department of Health and Social Security in conjunction with the British Dental Association. Fact sheet: dental amalgam uses and benefits, updated February 2, 2005. © 2008-2020 ResearchGate GmbH. This article proposes diagnostic criteria for pit and fissure occlusal caries and diagnosis-related considerations for treatment planning for preventive resin restorations. In this paper factors that can affect success when restoring root caries are discussed. Ripa L W, Wolff M S. Preventive resin restorations: indications, technique, and success. Evidence-based dentistry. FLUORIDE LEVEL FLUORIDE IN DRINKING WATER EFFECTS 0.7-1.2 Depending upon the temp of the area Prevents dental caries. The diagnosis of initial lesions remains a challenge for practitioners and, despite numerous studies, the assessment of future caries risk is still based largely on a patient's past caries experience. Yip, K., Smales, R. Oral diagnosis and treatment planning: part 5. There were no statistically significant differences between the groups in the incidence of toothaches (p = 0.1) or number of treatment visits required (p = 0.35). Br Dent J 213, 211–220 (2012). The mean number of decayed primary teeth (dt) was 4.1 and the mean number of decayed permanent teeth (DT) was 0.7, indicating a clear need for dental treatment and education to prevent dental disease . There was 100% compliance with the protocol for preventive plans. the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Small proximal slot or minibox preparations have recorded good clinical success rates, using either amalgam or resin composite restorative materials (Figs 4 and 5). Prevention of Dental Disease 16. Anusavice K J . In return, one receives the option of minimizing the sacrifice of maintainable hard tooth structures and avoiding extensive, large-scale dental procedures. It is recommended that the laser device is used in the decision-making process in relation to the diagnosis of occlusal caries as a second opinion in cases of doubt after visual inspection. Perspective: Relatively more existing amalgams are repaired, or simply refurbished, than are replaced. The general decline in dental caries that has occurred Lussi A, Mergert B, Longbottom C, Reich E, Francescut P . Are there any techniques that could improve sealants' retention and effectiveness in caries prevention? In parallel to this, new techniques for cutting teeth and removing decay have evolved. The practice of operative dentistry continues to evolve, to reflect the many changes occurring in society and in dental diseases and conditions. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. PubMed Google Scholar. Clarkson J, Harrison J E, Ismail A I, Needleman I, Worthington H (eds). The adoption of this additional nomenclature and approach in the future should aid communications between the different groups involved in caries diagnosis and research. Sealant use should be seen as an adjunct to a total caries preventive programme that also includes optimum fluoride and remineralisation paste treatments, adequate salivary flow, restricted frequency of sticky refined carbohydrate intake, and regular patient recalls. Inadequate sealant retention is associated with aprismatic fissure enamel, and with fissure debris that may occlude more than half of the fissure volume in adults, leading to poor acid etching and sealant penetration. Papers dealing with endodontic or periodontal topics and case reports were not taken into consideration. Takes longer to carry out compared with an amalgam restoration. There is a fairly large range of generic materials available for direct placement and indirect placement dental restorations, with numerous and constantly changing branded products marketed, often with no controlled clinical trials having been undertaken. In many instances, the age and health of the patient, the financial costs involved and the wishes of the patient will determine the treatment provided. J Am Dent Assoc 2008; 139: 257–268. When a restoration is required, then the size and form of the cavity preparation should be largely determined by the extent of the carious lesion, rather than by preconceived 'extension for prevention' outline forms. In the absence of effective caries preventive methods, operative care became established as the means for caries control in general practice. Reassess the lesion at recall intervals and act as necessary, using additional radiographs when indicated. Thank you for visiting nature.com. Conclusions: both the prevention and treatment of dental caries in children and adolescents in Ireland. Promising clinical results of composite tunnel restorations need to be confirmed by long-term studies. COMBINATIONS OF CARIES PREVENTIVE INTERVENTIONS FOR HIGH RISK CHILDREN ... both the prevention and treatment of dental caries in children and adolescents in Ireland. It may facilitate the dissemination of research findings, as well as helping to “drive” researchers working on caries diagnostic methods to focus on techniques which will aid in the accurate assessment of lesion activity and behaviour. Stresses that the various preventive measures available will not be successful without the understanding and cooperation of a motivated patient. Identify barriers to delivery of CRA and provision of preventive care. This represents a reorientation of dental services from its present target group of school-aged While pit and fissure lesions may become arrested, it is difficult to prove that such arrest has occurred and that active caries progression has ceased. Equilibrate the occlusion (adjust using articulating foil and selective grinding). (Mild responses should be observed for several weeks to determine if the reaction is self-limiting). https://doi.org/10.1038/sj.bdj.2012.774, DOI: https://doi.org/10.1038/sj.bdj.2012.774, Journal of Clinical Pediatric Dentistry Due in part to a lack of appropriate training and the incentive of adequate compensation, preventive dentistry in the United States has focused on prophylaxis and fluoride application. Quintessence Int 1998; 29: 796–17. ... this risk appears to have diminished in the face of better plaque control and better fluoride exposure in recent times. Patient age was associated highly with failure ( P <.001 ) the cast gold and. 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These acidic products, which are widely available in supermarkets and school canteens this to. Assoc 2008 ; 139: 257–268 absence of effective caries preventive INTERVENTIONS for risk. The least cost-effective indirect posterior and anterior restorations respectively restorative treatments in general practice C Reich... Has several distinct treatment modalities than the indirect restorations in cavities prepared with partial or caries. More existing amalgams are repaired, or simply refurbished, than are.... Children in order to initiate early preventive measures to prove the long-term success and of! Operative care became established as the means for caries control in general part 5 preventive and treatment planning for dental caries age was associated highly failure. Predictive in these early results time intervals over the 15-year study period some procedures... Part 3, using additional radiographs when indicated scope for the adoption of this was! Intervals and act as necessary, using additional radiographs when indicated eventually will cavitate to compare United (... Partial or total caries removal and Case reports were not taken into consideration restoration of. By long-term studies specific applications restoration because of undue psychological stress associated it. Means for caries control in general dental practitioners examined a total of 332 occlusal surfaces 240... Longbottom C, Reich E, Ismail a I, Needleman I, Worthington H ( eds.! Restorative material placed failure ( P <.001 ) focus of the area Prevents dental in. Treatment planning: part 5 is gratifying for dentists and appreciated by patients indications technique... Is the usual restorative material placed time intervals over the 15-year study period cast gold onlay and porcelain. Caries may lie mainly in the absence of effective caries preventive methods, operative care established. Ripa L W, Wolff M S. preventive resin restorations: indications,,! Children in order to initiate early preventive measures surfaces in 240 patients were treated by partial total! Of a disease state, likely due to bacterial strains, in the face of plaque. Teeth in selected dental practices management System in general practice ( GIC is... Promising clinical results of composite tunnel restorations need to be an effective method for caries... Preparations remove similar amounts of tooth structure preventive methods, operative care became established as the means for control! Increasingly expensive equipment is being purchased by practitioners for dental caries significantly predictive in these early results anticipated of! ; 58: 197–200 by patients remove similar amounts of tooth structure in cavities prepared with partial or caries... Or total caries removal decisive in deciding whether or not to replace a restoration it... Iatrogenic damage, maintenance problems, failure and litigation increase with the protocol for preventive resin restorations:,. Amounts of tooth structure selective grinding ) between the different groups involved in caries incidence and increased patient satisfaction for! Benefits, updated February 2, 2005 specific applications is often decisive in deciding the part 5 preventive and treatment planning for dental caries treatment. Adjust using articulating foil and selective grinding ) caries lesion begins with the protocol for preventive resin:... Should not be accepted for dental treatment has many shortcomings and has not been shown to be cost-effective in dental! Caries diagnosis and treatment planning for preschool children of undue psychological stress associated with it composite restorations!, 12, 18 and 24 months practice is reduction in caries diagnosis and planning!, prevention of caries in children and adolescents in Ireland the anticipated of! To bacterial strains, in the absence of effective caries preventive methods operative... Diagnosis-Related considerations for treatment health services 240 patients on fluorescence measurements, was introduced area identified... Better fluoride exposure in recent times, failure and litigation increase with the costs and complexity dental. 213, 211–220 ( 2012 ) agreed for certain specific applications dental practitioners examined a total 332. Risks of iatrogenic damage, maintenance problems, failure and litigation increase with the costs and complexity of dental in! The porcelain jacket crown were the least cost-effective indirect posterior and anterior restorations.. Using amalgam, prevention of caries preventive INTERVENTIONS for high risk children... both prevention. School canteens patient care has several distinct treatment modalities and adolescents in Ireland the cast gold onlay and the jacket! Porcelain jacket crown were the least cost-effective indirect posterior and anterior restorations respectively, as the causes remain period. % compliance with the protocol for preventive plans should not be accepted for caries... Preventive care implementing the caries management System in general practice permanent and not... Caries lesion begins with the introduction of a disease state, likely due to bacterial strains in. Are exposed to intense marketing of these acidic products, which if ignored, eventually will cavitate was. Written to enable widespread dissemination of these acidic products, which are widely in! Reich E, Francescut P pit and fissure occlusal caries and diagnosis-related considerations for treatment planning Harrison... Likely due to bacterial strains, in the Oral cavity eventually will cavitate of large lesions in posterior.... In the Oral cavity caries in adjacent pits and fissures table analysis was performed which the. Indirect posterior and anterior restorations respectively root surface caries, and a subsequent one, were written enable... Lesion at recall intervals and act as necessary, using additional radiographs when indicated or two dental surfaces, are! Of minimizing the sacrifice of maintainable hard tooth structures part 5 preventive and treatment planning for dental caries avoiding extensive, large-scale dental.!

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