Objectives: To: 1) quantify the depths (treatment thresholds) of primary caries lesions on occlusal and proximal surfaces restored by dentists in “The Dental Practice-Based Research Network” (DPBRN; www.DPBRN.org); 2) factors associated with differences in treatment thresholds, particularly for enamel lesions.
Methods: A total of 229 DPBRN dentists recorded information on 8,538 restorations inserted due to primary occlusal or proximal caries lesions on 4,397 patients. DPBRN comprises dental practices from five regions: Alabama/Mississippi, Florida/Georgia, Minnesota, Permanente Dental Associates (PDA), and Scandinavia (SK). Preoperative depths were diagnosed using methods typical in each practice for restorations being placed on previously unrestored surfaces, including: 1) any occlusal surface with no proximal surface involved; 2) any proximal with no occlusal; 3) both occlusal and proximal surfaces. Predictors of enamel lesion surgical interventions were assessed.
Results: Practitioner-investigators restored 4098 occlusal, 2993 proximal, and 1447 occlusal/proximal lesions. About half of restored lesions penetrated into the outer 1/3 of dentin. Enamel restorations were placed for 15.8% of occlusal, 6.5% of proximal, and 4.9% of occlusal/proximal lesions (p<.0001). Enamel lesions were restored more often in AL/MS and FL/GA versus other regions (p<.0001). Percentages of enamel occlusal lesions treated were 24.3% in AL/MS, 16.8% in FL/GA, 5.9% in MN, 11.5% in PDA, and 4.2% in SK. For proximal lesions, enamel restorations were 16.53% in AL/MS, 8.0% in FL/GA, 5.5% in MN, 4.5% in PDA, and 0.6% in SK. For occlusal/proximal lesions, enamel restorations were 8.0% (AL/MA) to 1.3% (SK) of the total.
Conclusion: Actual restoration data collected from DPBRN dentists show that surgical treatment of primary caries occured most frequently after the lesion penetrated the dentin. Restorations for enamel lesions were more likely if the occlusal surface was affected. Significant regional variations existed for enamel treatment. Regression results controlling for other factors will be presented. Support: U01-DE-16746, U01-DE-16747.