Kim Ekstrand

Kim ekstrandProfessor Kim Ekstrand graduated in 1983 followed with a PhD in 1988. He has been teaching in the research areas of Cariology and Endodontics since 1986. Professor Ekstrand has lectured at many meetings internationally in Brazil, Germany, Colombia, Costa Rica, France, Hungary, Poland, Portugal, Russia, Malaysia, The Netherlands, Norway, Sweden, Ukraine, UK and US.

He is a permanent member of ORCA and has participated in 4 ORCA summer schools held in Poland, Hungary, Brazil and Colombia. He is also a member of both the International Caries Detection and Assessment System (ICDAS) and International Caries Classification and Management System (ICCMS) core groups. He has provided training courses in ICDAS in various countries around the world.

Professor Ekstrand’s research has focused on 1) pathogenesis of caries, 2) detection and assessment of activity of caries, 3) risk assessment and 4) non-operative management of caries on individuals and on groups.

He is the author of about 75 peer-reviewed papers in international scientific magazines. As a member of ORCA he has attend all conferences since 1987 to 2013 apart from 3. Thus, he is the author or co-author of more than 50 abstracts published in Caries Research. He was in the ORCA board from 2001-2004, and 2012-2015 and the co-president of ORCA in 2007 where he organized the ORCA meeting in Denmark.

 


Essential of radiographs for caries detection: By Kim Ekstrand

There is unanimous agreement that a) more caries lesions, in particular approximal lesions, can be identified by combining radiographic information with clinical findings, than by visual inspection alone [Mejare, 2005] and b) it is not possible on a single radiograph to judge if a lesion detected is active or arrested. However, if the gingiva next to an approximal lesion is inflamed, it indicates that that particular lesion is active [Ekstrand et al., 1998].  The international caries detection and assessment system (ICDAS) includes both a visual and a radiographic detection system [www. Icdas.org/]. Both are devised to operate with 7 scores, but used in connection for patient examination and management (ICCMS) [Ismail et al., 2015] it is advisable to stage caries lesions into initial, moderate and extensive. In the radiographic detection system initial staged lesions both occlusal as well as on the approximal surface equals radiolucency in enamel or if in dentine limited to the outer 1/3 of the dentine; moderate lesions involve lesions where the radiolucency is in the middle third of the dentine and extensive lesions are classified by the radiolucency reaching the inner third of the dentine or even the pulp. Recent clinical studies have illustrated both in the primary [Floriano et al., 2016, abstract] as well as in the permanent dentition [Pioa et al., 2017, abstract] that initial approximal lesions do in general not harbor microorganisms at the enamel dentine junction, while this is characteristic for moderate- and extensive approximal lesions. Thus, an initial approximal lesion detected on a radiograph where the gingiva next to the approximal lesion is inflamed, requires in general non-surgical treatment, while moderate- or extensive staged approximal lesions, where the gingiva next to the lesion is inflamed, requires surgical interventions.