Diagnosis and management of recurrent caries

Abstract

Introduction. Dental caries is a biofilm-mediated, diet modulated, multifactorial, noncommunicable, dynamic disease resulting in net mineral loss of dental hard tissues and it is determined by biological, behavioral, psychosocial and environmental factors. But despite the fact that today there are a lot of modern materials to restore the hard tissue affected by caries, a problem remains the appearance of reccurent or secondary caries that has developed adjacent to margins of restorations. So, a vital part is the early detection of recurrent caries that may allow provision of less invasive treatment options like resealing or repairing instead of complete removal and replacement of restorations. Purpose. To assess how to control, detect and treat secondary caries. Material and methods. It was performed the examination of 16 patients, 8 men and 8 women, between the ages of 18-55. Clinical and paraclinical examination have established the diagnosis of recurrent caries for 32 teeth. The treatment was done by cleaning the caries and repairing or replacement of existing restorations. Results. From 32 teeth taken into the study, 22 were maxilla teeth (68,75 %) and 10 were mandibular teeth (31,25 %); 25 were posterior teeth (78,13 %) and 7 - anterior teeth (21,87%). From 45 surfaces affected by recurrent caries, occlusal surfaces were involved in 10 cases (22, 3 %), mesial surfaces in 14 cases (31,2 %), distal surfaces in 16 cases (35,5 %), vestibular surfaces in 4 cases (8,8 %) and oral surfaces in 1 case (2,2 %). According to the treatment methods of recurrent caries, 19 teeth (56,37 %) were treated by using repairing method and 13 teeth (40,63%) by using replacement method. Conclusions. 1.The etiology of recurrent caries is similar to primary dental caries, but accelerated accumulation of biofilm mass is caused my microleakage, poor marginal fit of restoration and overhangs. Proximal surfaces of the teeth are the most affected. 2.The diagnosis of caries is established during visual inspection, tactile sensation with explorer usage and radiographic interpretation. Detected secondary caries can be managed by repair of the defective part of the restoration or its complete replacement. Its depends on the patient and teeth criteria. 3.The prophylaxis of recurrent caries is directed to patient dental care and doctor’s work.