Method: Data from the Xylitol Adult Caries Trial ( X-ACT *), on non-cavitated and cavitated caries lesions of crown and root surfaces combined, were available from all four clinical exams over 33 months for 543 caries active subjects aged 21-80 living in fluoridated communities . Over three successive periods of 12, 12 and 9 months teeth were visually assessed using modified ICDAS criteria. Using Boolean logic this analysis classified each tooth surface with at least one transition involving a non-cavitated lesion into a set of Patterns. Then it established a longitudinal Profile for these individual tooth surface patterns across three time transitions.
Result: Intraexaminer reliability weighted Kappa scores for distinguishing sound vs non-cavitated vs cavitated lesions were : Baseline 0.63 , 12 mths 0.84 , 24 mths 0.66 , 33 mths 0.67. Profile types ( n=10,335) expressed as a percentage of all profiles analysed and having a non-cavitated lesion were; Consistently Progressive (demin) 19.7%, Stable 14.0%, Consistently Reversing (remin) 28.7% , Complex (demin/stable/remin in any sequence ) 26.6%, Excluded Profiles 11.0% ( tooth number inconsistency when missing etc, excluded because they were not a part of the caries continuum).
Conclusion: Only one fifth of tooth surfaces included in this analysis exhibited a pattern of consistent progression to or beyond a non-cavitated lesion over 33 months in caries active adults from fluoridated communities. Only 8.0% progressed to cavitation or restoration.
* www.kpchr.org/x-act/public/index.aspx?pageid=1
* ClinicalTrials.gov NCT 0039005
NIDCR support U01DE018038, U01DE018047, U01DE018048, U01DE018049, and U01DE018050