Outcomes 18 years after implementation of a nonoperative caries preventive program – the Nexö‐method – on children in Moscow, Russia

Kuzmina, Irina; Ekstrand, Kim R.

doi:10.1111/cdoe.12155

Cited by 15 publications

(21 citation statements)

References 17 publications

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“…Clinical studies focusing on dental plaque removal and topical fluoride application on the occlusal surfaces of erupting permanent molars found significant differences in the numbers of progressed lesions and sealed and filled surfaces between the test and control groups over time [Carvalho et al, 1992;Ekstrand et al, 2000]. Interestingly, the long-term effect of non-operative treatment was observed up to 18 years after the implementation of the preventive programs: the caries experience as well as the dental plaque levels were lower in those individuals who had participated in the preventive program than in those who had not [Kuzmina and Ekstrand, 2015].…”

Section: Challenges In Diagnosing and Managing Non-cavitated Occlusalmentioning

confidence: 96%

Occlusal Caries: Biological Approach for Its Diagnosis and Management

et al. 2016

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The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most up-to-date knowledge and evidence of the biological principles guiding diagnosis, risk assessment, and management of the caries process on occlusal surfaces. In addition, it considers the whole spectrum of the caries process on occlusal surfaces, ranging from the molecular ecology of occlusal biofilms to the management of deep occlusal caries lesions. Studies using molecular methods with focus on biofilms in relation to occlusal caries should explore the relationship between the function and the structural composition of these biofilms to understand the role of occlusal biofilms in caries development. State-of-the-art measures to evaluate risk for occlusal caries lesion activity, caries incidence, and progression should include the assessment of the occlusal biofilm and the stage of tooth eruption. Careful clinical examination of non-cavitated lesions, including assessment of the lesion activity status, remains the major tool to determine the immediate treatment need and to follow on the non-operative treatment outcome. Even medium occlusal caries lesions in the permanent dentition may be treated by non-invasive fissure sealing. By extending the criteria for non-invasive treatments, traditional restoration of occlusal surfaces can be postponed or even avoided, and the dental health in children and adolescents can be improved. Selective removal (incomplete) to soft dentin in deep carious lesions has greater success rates than stepwise excavation. Selective (complete) removal to firm dentin has a lower success rate due to increased pulp exposure.

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Section: Challenges In Diagnosing and Managing Non-cavitated Occlusalmentioning

confidence: 96%

Occlusal Caries: Biological Approach for Its Diagnosis and Management

et al. 2016

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“…The Nexö programme was successfully tested on a group of children in Moscow from 1994 to 1996 including a randomized control group [Ekstrand et al, 2000]; 18 years after the 2.5-year intervention a follow-up study found a long-term positive effect of the Nexö programme implemented during childhood [Kuzmina et al, 2015].…”

Section: The Public Health Approachmentioning

confidence: 99%

Caries Epidemiology and Community Dentistry: Chances for Future Improvements in Caries Risk Groups. Outcomes of the ORCA Saturday Afternoon Symposium, Greifswald, 2014. Part 1

Splieth

Christiansen²,

Page

2016

Caries Res

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This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with ‘caries epidemiology and community dentistry: chances for future improvements in caries risk groups'. After the caries decline in many countries, there are remaining pockets of higher caries levels, mostly in the primary dentition and/or linked to a low socio-economic status (SES). The review into the evidence of caries-preventive measures clearly points to the use of fluorides, especially toothbrushing with fluoridated toothpaste and collective measures such as water fluoridation. In contrast to several unsuccessful high-risk approaches, community and public health programmes seem to be able to ensure a population-wide access and compliance in risk groups. Their simple and evidence-based measures mostly combine regular plaque removal and fluoride applications via toothbrushing, at least for children and adolescents. For the future, the common risk factor approach which addresses associations between oral health, social deprivation, diet, hygiene, smoking, alcohol use and stress should lead to combined efforts with other community health and education specialists. Further engagement with public policy, community leaders and administration is needed in order to strengthen healthy choices and behaviour, e.g. in ‘healthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors.

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“…Less invasive alternatives to the "drill and fill" approach to manage carious lesions have been advocated [Kidd, 2011;Innes and Evans, 2013;Kuzmina and Ekstrand, 2015]. Non-restorative caries treatment (NRCT; recently called non-restorative cavity control [Innes et al, 2016a]), involving no caries removal, opening up the carious lesion to make it cleansable, effective plaque removal instruction, and fluoride application in individual patient-based scenarios, has shown encouraging results within an efficacy framework (under ideal and controlled circumstances) [Gruythuysen, 2010].…”

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confidence: 99%

Alternative Caries Management Options for Primary Molars: 2.5-Year Outcomes of a Randomised Clinical Trial

et al. 2017

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Less invasive caries management techniques for treating cavitated carious primary teeth, which involve the concept of caries control by managing the activity of the biofilm, are becoming common. This study aimed to compare the clinical efficacy (minor/major failures) and survival rates (successful cases without any failures) of 3 carious lesion treatment approaches, the Hall Technique (HT), non-restorative caries treatment (NRCT), and conventional restorations (CR), for the management of occlusoproximal caries lesions (ICDAS 3-5) in primary molars. Results at 2.5 years are presented. A total of 169 children (3- to 8-year-olds) were enrolled in this secondary care-based, 3-arm parallel-group, randomised controlled trial. Participants were allocated to: HT (n = 52; sealing caries with stainless-steel crowns without caries removal), NRCT (n = 52; opening up the cavity and applying fluoride varnish), CR (n = 65; control arm, complete caries removal and compomer restoration). Statistical analyses were: non-parametric Kruskal-Wallis analysis of variance, Mann-Whitney U test and Kaplan-Meier survival analyses. One hundred and forty-two participants (84%; HT = 40/52; NRCT = 44/52; CR = 58/65) had follow-up data of 1-33 months (mean = 26). Overall, 25 (HT = 2, NRCT = 9, CR = 14) of 142 participants (17.6%) presented with at least 1 minor failure (reversible pulpitis, caries progression, or secondary caries; p = 0.013, CI = 0.012-0.018; Mann-Whitney U test). Ten (HT = 1, NRCT = 4, CR = 5) of 142 participants (7.04%) experienced at least 1 major failure (irreversible pulpitis, abscess, unrestorable tooth; p = 0.043, CI = 0.034-0.045). Independent comparisons between 2 samples found that NRCT-CR had no statistically significant difference in failures (p > 0.05), but for CR-HT (p = 0.037, CI = 0.030-0.040) and for NRCT-HT (p = 0.011, CI = 0.010-0.016; Kruskal-Wallis test) significant differences were observed. Cumulative survival rates were HT = 92.5%, NRCT = 70.5%, and CR = 67.2% (p = 0.012). NRCT and CR outcomes were comparable. HT performed better than NRCT and CR for all outcomes. This study was funded by the Paediatric Dentistry Department, Greifswald University, Germany (Trial registration No. NCT01797458).

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Outcomes 18 years after implementation of a nonoperative caries preventive program – the Nexö‐method – on children in Moscow, Russia

Abstract: The data from this group of Moscow citizens suggest a long-term positive effect of the Nexö-method implemented during childhood.

Cited by 15 publications

References 17 publications

Occlusal Caries: Biological Approach for Its Diagnosis and Management

Occlusal Caries: Biological Approach for Its Diagnosis and Management

Caries Epidemiology and Community Dentistry: Chances for Future Improvements in Caries Risk Groups. Outcomes of the ORCA Saturday Afternoon Symposium, Greifswald, 2014. Part 1

Alternative Caries Management Options for Primary Molars: 2.5-Year Outcomes of a Randomised Clinical Trial

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