Skip to main content

Advertisement

SpringerLink
Log in

Approximal morphology as predictor of approximal caries in primary molar teeth

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objective

To evaluate the predictive power of the morphology of the distal surface on 1st and mesial surface on 2nd primary molar teeth on caries development in young children.

Sample and methods

Out of 101 3-to 4-year-old children from an on-going study, 62 children, for whom parents’ informed consent was given, participated. Upper and lower molar teeth of one randomly selected side received a 2-day temporarily separation. Bitewing radiographs and silicone impressions of interproximal area (IPA) were obtained. One-year procedures were repeated in 52 children (84%). The morphology of the distal surfaces of the first molar teeth and the mesial surfaces on the second molar teeth (n=208) was scored from the occlusal aspect on images from the baseline resin models resulting in four IPA variants: concave-concave; concave-convex; convex-concave, and convex-convex. Approximal caries on the surface in question was radiographically assessed as absent/present.

Results

Of the 52 children examined at follow-up, 31 children (60%) had 1–4 concave surfaces. In total 53 (25%) of the 208 surfaces were concave. A total of 22 children (43%) had 1–4 approximal lesions adding up to 59 lesions. Multiple logistic regression analyses disclosed that gender, surface morphology on one of the approximal surfaces (focus-surface), and adjacent-surface morphology were significantly related to caries development (p values ≤ 0.03). The odds ratio for developing caries in the focus-surface/adjacent-surface in the four IPA variants were convex-convex, 1.0; convex-concave, 5.5 (CI 2.0–14.7); concave-convex, 12.9 (CI 4.1–40.3); and concave-concave, 15.7 (CI 5.1–48.3).

Conclusion

Morphology of approximal surfaces in primary molar teeth, in particular both surfaces being concave, significantly influences the risk of developing caries.

Clinical relevance

The concave morphology of approximal surfaces can predict future caries lesions supporting specific home-care and in-office preventive strategies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Nørrisgaard PE, Qvist V, Ekstrand K (2015) Prevalence, risk surfaces and inter-municipality variations in caries experience in Danish children and adolescents in 2012. Acta Odontol Scand 74:291–297

    Article  PubMed  Google Scholar 

  2. Ekstrand KR, Christiansen ME, Qvist V, Ismail A (2010) Factors associated with inter-municipality differences in dental caries experience among Danish adolescents. An ecological study. Community Dent Oral Epidemiol 38:29–42

    Article  PubMed  Google Scholar 

  3. Pitts N (2008) The impact of diagnostic criteria on estimates of prevalence, extend and severity of dental caries. In: Fejerskov O, Nyvad B, Kidd E (eds) Dental caries: the disease and its clinical management, 2nd edn. Wiley Blackwell, Oxford, pp 148–158

    Google Scholar 

  4. Ballantyne H (2000) Identification of infant at high risk to developing dental caries using microbiological and social factors. University of Dundee, Dissertation

    Google Scholar 

  5. Cortes A (2016) Caries in young children from Bogotá, Colombia, and a new risk factor of importance. An epidemiological and clinical investigation. University of Copenhagen, Dissertation

    Google Scholar 

  6. Cortes A, Ekstrand KR, Gamboa GL, Martignon S (2017) Caries status in young Colombian children expressed by ICCMSTM visual/radiographic combined caries staging system. Acta Odontol Scand 75:12–20

    Article  PubMed  Google Scholar 

  7. Almer Nielsen L, Madsen DB (2005) Selektiv brug af bitewing-undersøgelse til diagnostik af approksimal caries i primære molarer. Tandlægebladet 109:370–374

    Google Scholar 

  8. Carlsen O (1987) Dental morphology. Munksgaard, Copenhagen

    Google Scholar 

  9. Bratthall D, Hänsel Petersson G (2005) Cariogram—a multifactorial risk assessmenmodel for a multifactorial disease. Community Dent Oral Epidemiol 33:256–264

  10. Ismail AI; Pitts NB, Tellez M and Authors of the International Caries Classification and Management System (ICCMS) (2015). The International Caries Classification and Management System (ICCMS™) An Example of a Caries Management Pathway. BMC Oral Health (Suppl 1):S9DOI: 10.1186/1472–6831-15-S1-S9

  11. Espelid I, Mejàre I, Weerheijm K (2003) EAPD guidelines for use of radiographs in children. Eur J Paediatr Dent 4:40–48

    PubMed  Google Scholar 

  12. Ekstrand KR, Luna LE, Promisiero L, Cortes A, Cuevas S, Reyes JF, Torres CE, Martignon S (2011) The reliability and accuracy of two methods for proximal caries detection and depth on directly visible proximal surfaces: an in vitro study. Caries Res 45:93–99

    Article  PubMed  Google Scholar 

  13. Petrie A, Sabin C (2009) Medical statistics at a glance. Wiley Blackwell, Oxford

    Google Scholar 

  14. Ekstrand KR, Bruun G, Bruun M (1998) Plaque and gingival status as indicators for caries progression on approximal surfaces. Caries Res 32:41–45

    Article  PubMed  Google Scholar 

  15. Nyvad B (2015) The role of oral hygiene. In: Fejerskov O, Nyvad B, Kidd E (eds) Dental caries: the disease and its clinical management, 3th edn. Wiley Blackwell, Oxford, pp 277–285

    Google Scholar 

  16. Agustsdottir H, Gudmundsdottir H, Eggertsson H, Jonsson SH, Gudlaugsson JO, Saemundsson SR, Eliasson ST, Arnadottir IB, Holbrook WP (2010) Caries prevalence of permanent teeth: a national survey of children in Iceland using ICDAS. Community Dent Oral Epidemiol 38:299–309

    Article  PubMed  Google Scholar 

  17. Braga MM, Morais CC, Nakama RC, Leamari VM, Siqueira WL, Mendes FM (2009) In vitro performance of methods of approximal caries detection in primary molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:e35–e41

    Article  PubMed  Google Scholar 

  18. Mejàre I (2005) Bitewing examination to detect caries in children and adolescents—when and how often? Dent Update 32:588–597

    Article  PubMed  Google Scholar 

  19. Anderson M, Stecksén-Blicks C, Stenlund H, Ranggård L, Tsilingaridis G, Mejàre I (2005) Detection of approximal caries in 5-year-old Swedish children. Caries Res 39:92–99

    Article  PubMed  Google Scholar 

  20. Pitts NB, Rimmer PA (1996) An in vivo comparison of radiographic and directly assessed clinical caries status of posterior approximal surfaces in primary and permanent teeth. Caries Res 26:146–152

    Article  Google Scholar 

  21. Pitts NB, Longbottom C (1987) Temporary tooth separation with special reference to the diagnosis and preventive management of equivocal approximal carious lesions. Quintessence Int 18:563–573

    PubMed  Google Scholar 

  22. Coutinho TC, daRocha CC (2014) An in vivo comparison of radiographic and clinical examination with separation for assessment of approximal caries in primary teeth. Eur J Paediatr Dent 15:371–374

    Article  PubMed  Google Scholar 

  23. Mendes FM, Novaes TF, Matos R, Bittar DG, Piovesan C, Gimenez T, Imparato JC, Raggio DP, Braga MM (2012) Radiographic and laser fluorescence methods have no benefits for detecting caries in primary teeth. Caries Res 46:536–543

    Article  PubMed  Google Scholar 

  24. Lysell L, Magnusson B, Thilander B (1969) Relations between the times of eruption of primary and permanent teeth. A longitudinal study. Acta Odontol Scand 27:271–281

    Article  PubMed  Google Scholar 

  25. Kurol J, Mohlin (2009) Occlusal development, preventive, and interceptive orthodontics. In: Koch G, Poulsen S (eds) Pediatric dentistry a clinical approach, 2nd edn. Munksgaard, Copenhagen, pp 212–232

Download references

Acknowledgements

The authors would like to thank the community department, the dental school at Universidad El Bosque, and the Social District Secretary of Integration, Usaquén for their collaboration in the children location. Cristhian Cardenas is acknowledged for examining the radiographs and Dennis Pipenbring for assistance with the statistical analyses. Staff members at UNICA are acknowledged for support at the clinical examinations and staff members of the kindergartens for their valuable help during the daily running of this study. We are also grateful to the children and their parents involved in the study.

Author information

Authors and Affiliations

  1. UNICA - Caries Research Unit, Research Vice-rectory, Universidad El Bosque, Bogotá, Colombia

    A. Cortes & S. Martignon

  2. Cariology & Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Nørre Allé 20, Copenhagen, Denmark

    A. Cortes, V. Qvist & Kim Rud Ekstrand

  3. Dental Innovation and Translation Centre, Dental Institute, King’s College London, London, UK

    S. Martignon

Authors
  1. A. Cortes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Martignon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Qvist
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kim Rud Ekstrand
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kim Rud Ekstrand.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The study was partially funded by COLCIENCIAS (646–2014), Universidad El Bosque University of Copenhagen and Colgate Palmolive U.K.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cortes, A., Martignon, S., Qvist, V. et al. Approximal morphology as predictor of approximal caries in primary molar teeth. Clin Oral Invest 22, 951–959 (2018). https://doi.org/10.1007/s00784-017-2174-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-017-2174-3

Keywords

Search

Navigation