[Comparative assessment of the results of noninvasive and microinvasive treatment of initial caries in permanent teeth in children]

OBJECTIVE

The aim of the study is comparative evaluation of the results of treatment of enamel caries (initial caries) of permanent teeth in children using non-invasive and microinvasive methods.

MATERIAL AND METHODS

The study involved 45 children aged 10-16 years, who revealed enamel caries in 451 permanent teeth. Noninvasive treatment was carried out using toothpaste with a fluoride content of 2800 ppm (group 1, 138 teeth) or 5% fluoride varnish (group 2, 155 teeth). Microinvasive treatment was performed using caries infiltration (group 3, 99 teeth) or amelogenin peptide (group 4, 59 teeth). The observation was carried out for 18 months. The method of laser fluorescence was used to assess the demineralization of enamel.

RESULTS

After treatment, repeated examinations did not reveal carious cavities in groups 1, 2 and 3, and one carious cavity was revealed in group 4 after 18 months. The average values of laser fluorescence after treatment in groups 1, 2 and 4 decreased slightly, in group 3 they corresponded to the values of healthy enamel throughout the observation period.

CONCLUSION

The use of noninvasive and microinvasive methods of treatment of permanent tooth enamel caries in children was effective. However, according to laser fluorescence, only the use of caries infiltration significantly reduced enamel demineralization.

Monitoring the results of enamel demineralization treatment with the caries infiltration method (according to laser fluorescence value)

Relevance. In the actual dentistry a special place takes opportune diagnosis of early stages of dental caries and effective non-surgical treatment. In the recent times new approaches, technologies and methods for diagnosing focal demineralization of tooth enamel have been developed, among which the laser fluorescence method is widely used.

Purpose. To study the results of local enamel demineralization treatment with the caries infiltration method according to laser fluorescence value.

Materials and methods. The method of caries infiltration was applied in 99 permanent teeth with local enamel demineralization in 15 children aged 10-16 years. Laser fluorescence method was used for enamel demineralization assessment before and immediately after the treatment, after 6, 12 and 18 months. Three study groups were formed according to laser fluorescence value before the treatment: the first one – values 14-20 (initial enamel demineralization), the second one – values 21-29 (deep enamel demineralization), the third one – values ≥ 30 (enamel and dentine demineralization). Proportions (%), mean-values and standard errors (M±m) were calculated, significance (p) of differences was assessed according to Students’ criteria (t) at p < 0.05. 

Results. During 18 months after caries infiltration caries cavities forming were not revealed. The mean-values of laser fluorescence were in the first group before the treatment 17.38 ± 0.27, after the treatment 5.00±0.82, after 18 months – 4.82 ± 0.79; in the second group 25.42 ± 0.38, 15.25 ± 0.78 and 13.96 ± 0.75, in the third group 33.08 ± 0.69, 22.54 ± 1.39 and 20.77 ± 1.44 respectively. The differences between the values before and after the treatment were significant statistically (p < 0,001) in all groups. After 18 months the laser fluorescence values corresponding to healthy enamel were revealed in 94.1% cases in the first group, in 50.0% cases in the second group, and in 7.7% cases in the third group.

Conclusions. Local enamel demineralization treatment of permanent teeth in children with the caries infiltration method prevented caries cavity forming. Monitoring laser fluorescence values revealed that the results of the treatment with the caries infiltration method depended on the depth of dental hard tissue demineralization.