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Table 2 Caries OUT pandemic-adapted CCI-4D interventions at the tooth-surface level with non-AGP for permanent dentition

From: CariesCare International adapted for the pandemic in children: Caries OUT multicentre single-group interventional study protocol

 

4D at the surface level: permanent dentition

ICDAS-merged epi score

Caries OUT modified CCI—Care option

Initial caries

 Inactive

AM

  

 Active

NOC

Fossae and fissure:

Smooth surfaces:

  

Option 1: High-viscosity Glass Ionomer ART sealant + 5% NaF (every 3 m)

5% NaF (every 3 m)

  

Option 2: 30–38% SDF (every 6 m)/5% NaF (every 3 m)

 

Moderate caries microcavity/shadow

 Inactive

AM

  
 

NOC

Fossae and fissure:

Smooth surfaces:

  

Option 1: High-viscosity Glass Ionomer ART sealant

Option 1: 5% NaF (1 time)

  

Option 2: 30–38% SDF (1 time)/5% NaF (1 time)

Option 2: High-viscosity Glass Ionomer ART sealant

 Active

NOC

Option 1: High-viscosity Glass Ionomer ART sealant + 5% NaF (every 3–6 m)

 
  

Option 2: 30–38% SDF (every 6 m) (only in molar teeth)/5% NaF (every 3 m)

 
 

TPOC

If there is a more advanced Moderate lesion and in a High-risk patient: ART

 

When considered it necessary, have a bitewing radiograph taken to assess the depth of the radiolucency and correlate it with the likelihood of dentine infection (in the middle dentine third). Register radiographic score in 2D, and combine it with the clinical score and the individual caries risk to decide in 3D the specific tooth-surface care plan (NOC/TPOC)

Extensive caries

 Inactive

AM

  
 

NOC

High-viscosity Glass Ionomer ART sealant/30–38% SDF (1 time)/5% NaF (1 time)

 

 Active

NOC

30–38% SDF (every 6 m)

 
 

TPOC

ART

 
 

In deep cavities or reversible pulpitis (without other pulp symptomatology): One-Step Excavation + careful ART

  
  1. In case of dental emergency/endodontic treatment need take an x-ray register the detection in 2D and 3D, and treat/refer, excluding that tooth
  2. AM active monitoring, NOC non-operative care, TPOC tooth-preserving operative care, ART atraumatic restorative treatment, NaF sodium fluoride, SDF silver diamine fluoride