Secondary caries: prevalence, characteristics, and approach

• Published in: Clinical oral investigations Vol. 24; no. 2; pp. 683 - 691
• Main Authors: Nedeljkovic, Ivana, De Munck, Jan, Vanloy, Anouk, Declerck, Dominique, Lambrechts, Paul, Peumans, Marleen, Teughels, Wim, Van Meerbeek, Bart, Van Landuyt, Kirsten L.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2020; Springer Nature B.V
• Subjects: Composite Resins; Cross-Sectional Studies; Dental Amalgam; Dental Caries; Dental cement; Dental Restoration Failure; Dental Restoration, Permanent; Dental restorative materials; Dentistry; Humans; Medicine; Original Article; Patients; Prevalence; Smoking; Dental amalgam; Caries risk; Prevalence; Recurrent caries; Secondary caries; Dental composite
• ISSN: 1432-6981; 1436-3771
• DOI: 10.1007/s00784-019-02894-0

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.