Clinical efficacy of treatment of immature permanent teeth in children with different risk of caries

Relevance. Nowadays the choice of restorative material and treatment plan for caries of immature permanent teeth in children remains of current interest.

Purpose. To evaluate the clinical efficacy of modified glass-ionomer cement for restoration of permanent immature teeth in children with different risk of dental caries.

Materials and methods. The results of the treatment of immature permanent teeth in children with different risk of caries are proposed in this article. 100 permanent immature teeth in children with a low, moderate and high risk of dental caries with acute and chronic process were treated using modified glass ionomer cement. Remineralizing therapy was carried out in children with acute caries for 2 weeks before restoration. The duration of remineralizing therapy in children with a high risk and chronic caries was 2 weeks, in the acute caries – 4 weeks. Remineralizing therapy included application of calcium and phosphate containing agents. Assessment of the fillings was conducted in 12 and 24 months in accordance with Ryge criteria which take into account the anatomical shape, marginal adaptation, marginal pigmentation, color stability, and surface roughness.
Results. It has been found the high effectiveness of the proposed method of treatment after two years. 100% retention of restorations were revealed. 80-95% fillings were of satisfactory quality, 5-20% of fillings were of acceptable quality and do not require correction or re-treatment.

Conclusions. The modified glass-ionomer cement restorations with previous remineralizing therapy provide the high clinical efficacy for the treatment of caries in permanent immature teeth in children with different risk caries in 85-90% of clinical cases. 

1. Брянская М. Н. Клинико-морфологическое обоснование профилактики и лечения фиссурного кариеса постоянных зубов с незрелой эмалью: Автореф. дис. … канд. мед. наук. Иркутск. 2009:22. [M. N. Bryanskaya. Kliniko-morfologicheskoe obosnovanie profilaktiki i lecheniya fissurnogo kariesa postoyannyh zubov s nezreloj emal'yu: Author. dis. … cand. med. sciences. Irkutsk. 2009:22. (In Russ.)]. https://elibrary.ru/item.asp?id=15942222.

2. Кисельникова Л. П., Кириллова Е. В., Шевченко М. А. Опыт применения метода лазерной флюоресценции для определения степени реминерализации эмали и дентина при кариесе зубов у детей. Стоматология детского возраста и профилактика. 2011;3(38):7-11. [L. P. Kiselnikova, E. V. Kirillova, M. A. Shevchenko. Usage experience of laser fluorescence method for degree definition of enamel and dentine remineralization of caries at children. Paediatric dentistry and prophylaxis. 2011;3(38):7-11. (In Russ.)]. https://elibrary.ru/ item.asp?id=16753219.

3. Кузьмина Э. М., Паздникова Н. К. Сравнительная оценка клинической эффективности различных герметиков, содержащих биоактивные ионы. Dental Forum. 2009;2:16-21. [E. M. Kuz'mina, N. K. Pazdnikova. Sravnitelnaya otsenka klinicheskoy effektivnosti razlichnyih germetikov, soderzhaschih bioaktivnyie ionyi. Dental Forum. 2009;2:16-21. (In Russ.)]. https:// elibrary.ru/item.asp?id=12890252.

4. A. C. Pereira, V. Pardi, F. L. Mialhe et al. A 3-year clinical evaluation of glass-ionomer cements used as fissure sealants. Am. J. Dent. 2003;16(1):23-27. https://www.ncbi.nlm.nih. gov/pubmed/12744408.

5. J. T. Wright. The burden and management of dental caries in older children. Pediatr Clin North Am. 2018;65(5):955-963. https://doi. org/10.1016/j.pcl.2018.05.005.

6. Жаркова О. А. Использование стеклоиономерных цементов линии GC FUJI: теоретические и практические аспекты. Современная стоматология. 2012;2(55):59-62. [O. A. Zharkova. Application of GC Fuji glass ionomer cements: theoretical and practical aspects. Sovremennaya stomatologiya. 2012;2(55):59-62. (In Russ.)]. https://elibrary.ru/ item.asp?id=18928514.

7. Степанова Т. С., Кузьминская О. Ю., Степанов С. В. Применение классических стеклоиономерных цементов для сандвич-техники в постоянных зубах с незавершенной минерализацией твердых тканей у детей. Стоматология детского возраста и профилактика. 2018;1(64):21-25. [T. S. Stepanova, O. Yu. Kuzminskaya, S. V. Stepanov. Classic glass ionomer cements using for sandwich technique filling of permanent teeth with incomplete mineralization of hard tissue in children. Paediatric dentistry and prophylaxis. 2018;1(64):21-25. (In Russ.)]. https://doi. org/10.25636/PMP.3.2018.1.5.

8. Трансо Т., Дельфос К., Левер К. и др. Стеклоиономеры: оптимальный выбор для педиатрической стоматологии? Стоматология детского возраста и профилактика. 2018;3(66):28-34. [T. Trentesaux, C. Delfosse, C. Leverd et al. Glass ionomers: the material of choice in paediatric dentistry? Paediatric dentistry and prophylaxis. 2018;3(66):28-34. (In Russ.)]. https://doi.org/10.25636/PMP.3.2018.3.5.

9. Шумилович Б. Р., Суетенков Д. Е. Состояние минерального обмена эмали в зависимости от способа препарирования твердых тканей зуба при лечении кариеса. Стоматология детского возраста и профилактика. 2008;3(26):6-9. [B. R. Shumilovich, D. E. Suetenkov. Mineral exchange state depending on the preparation method of tooth hard tissue at caries treatment. Paediatric dentistry and prophylaxis. 2008;3(26):6-9. (In Russ.)]. https://elibrary. ru/item.asp?id=11644863.

10. Терехова Т. Н., Кленовская М. И., Мельникова Е. И., Шаковец Н. В. Эффективность применения модифицированного стеклоиономерного цемента при реставрации временных зубов. Стоматология детского возраста и профилактика. 2019;2(70):37-42. [T. N. Terekhova, M. I. Klenovskaya, E. I. Melnikova, N. V. Shakovec. Efficacy of resin modified glass ionomer cement in primary teeth restoration. Paediatric dentistry and prophylaxis. 2019;2(70):37-42. (In Russ.)]. https:// doi.org/10.33925/1683-3031-2019-19-2-37-42.

11. V. P. Mathur, J. K. Dhillon. Dental caries: a disease which needs attention. Indian J Pediatr. 2018;85(3):202-206. https://doi.org/10.1007/ s12098-017-2381-6.

12. M. A. Keels. Personalized dental caries management in children. Dent Clin North Am. 2019;63(4):621-629. https://doi.org/10.1016/j. cden.2019.06.002.

13. J. Schmoeckel, K. Gorseta, C. H. Splieth, H. Juric. How to intervene in the caries process: early childhood caries – a systematic review. Caries Res. 2020;7:1-11. https://doi. org/10.1159/000504335.

14. G. Ryge. Clinical criteria. Int. Dent J. 1980;30(4):347-358. https://www.ncbi.nlm.nih. gov/pubmed/6935165.

15. G. Ryge, M. D. Jendresen, P. O. Glantz, I. Mjör. Standardization of clinical investigators for studies of restorative materials. Swed. Dent. J. 1981;5(5-6):235-9. https://www.ncbi.nlm.nih. gov/pubmed/6949331.