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Secondary caries: prevalence, characteristics, and approach

Abstract

Objectives

The objectives of this cross-sectional survey were to determine the prevalence of secondary caries (SC) in general population, to identify patient- and material-related factors which may affect the prevalence, and to describe some clinical characteristics of SC lesions.

Materials and methods

A total of 4036 restorations in 450 patients, who visited the university dental clinic for a regular (half) yearly checkup, were examined clinically (and radiographically) for the presence of SC. Clinical characteristics of the detected SC lesions (size, activity, and location) and the planned treatment were recorded. In addition, patients’ caries-risk status was assessed according to the modified “cariogram” model.

Results

In total, 146 restorations were diagnosed with SC, which gives an overall prevalence of 3.6%. Restorative material, restoration class, patient’s caries risk, and smoking habits were shown to be important factors, as SC prevalence was significantly higher with composites, class II restorations, high-caries-risk patients, and smokers. Restorations’ gingival margins were most frequently affected by SC. The largest number of restorations with SC (72%) was scheduled for the replacement.

Conclusions

Prevalence of SC was higher with composite than with amalgam restorations, irrespective of the patient’s caries-risk status. Gingival margins of class II, including MOD restorations, seem to be the place of less resistance to SC development. Management of SC seems to place a considerable burden on the health care workforce and expenditure.

Clinical relevance

Secondary caries (SC) is considered to be the main cause of dental restoration failure and one of the biggest clinical challenges related to dental composites. Nevertheless, its prevalence in daily practice is still not clear, which impedes an accurate estimation of its impact on health care costs.

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Acknowledgments

We would like to thank all clinical supervisors and master students who participated in this study, especially Leen Theys, Viviane Luyten, and Veerle Lemaitre, and GC Europe for providing Saliva-Check Buffer kit and Tri Plaque ID Gel.

Funding

This research was supported by the Research Foundation—Flanders (FWO) grant G.0884.13.

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Correspondence to Kirsten L. Van Landuyt.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the Medical Ethics Committee, University Hospitals UZ Leuven (approved project S56046), and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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

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Nedeljkovic, I., De Munck, J., Vanloy, A. et al. Secondary caries: prevalence, characteristics, and approach. Clin Oral Invest 24, 683–691 (2020). https://doi.org/10.1007/s00784-019-02894-0

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  • DOI: https://doi.org/10.1007/s00784-019-02894-0

Keywords

  • Prevalence
  • Secondary caries
  • Recurrent caries
  • Caries risk
  • Dental composite
  • Dental amalgam