Lai, Gianfranco (2016) Prevention, diagnosis and minimally invasive treatment of dental caries. Doctoral Thesis.
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Aim: Study the news overtures to prevention, diagnosis and therapy of caries disease.
Methods: We conducted one randomized controlled clinical trial (RCT), one cross-sectional study and one systematic review with meta-analysis. The RCT evaluated the efficacy of the Carisolv and CeraBur. In the cross-sectional study we evaluated the efficacy of a new device to detect caries lesions: DIAGNOcam. The systematic review of the literature was conducted to evaluate efficacy of polyols in caries prevention.
Results: We found a significantly difference in terms of time taken between control group and Carisolv (p<0.001). We found no difference in increment cavity size and in anti-microbial effect between techniques.
In the cross-sectional study we found a higher sensibility of the DIAGNOcam device respect to x-rays to diagnose caries in enamel (k=0.24); no statistically significant difference was found in dentin caries (k=1).
In the meta-analysis we found that xylitol gum showed a good antimicrobial effect against the mutans streptococci than control group (p<0.01); low increment of ΔDMFS at 2 and 3 years follow-up (p<0.01), and low AUC pH than sorbitol gum (p<0.01).
Conclusion: The clinical efficacy of Carisolv and CeraBur seems as reliable as the rotary instruments. The study on DIAGNOcam showed that this new device might be a useful tool in early caries detection. The xylitol gums showed a role in caries prevention.
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