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Sá G, Michou S, Bönecker M, Mendes F, Amarante B, Ekstrand K. Diagnostic validity of ICDAS clinical criteria on digital 3D models. J Dent 2024; 149:105274. [PMID: 39084547 DOI: 10.1016/j.jdent.2024.105274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 07/25/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE To assess the diagnostic validity of ICDAS clinical criteria on 3D dental models from intraoral scanning. METHODS This is a retrospective analysis on part of the baseline sample collected in a cohort study and included 73 participants (12-19 years) from Denmark and Greece. The assessment was made by visual inspection, and then by visual inspection associated with radiographs. All participants were scanned with TRIOS 4 which uses white light to obtain the 3D models with tooth color, as well as blue light source (415 nm) for fluorescence. The 3D models' evaluation was conducted using tooth-color texture and subsequently fluorescence. Two scores were obtained for the 3D model examination: i) ICDAS based on tooth-color information; ii) ICDAS based on tooth-color information supplemented with fluorescence. For the analysis, weighted kappa, sensitivity (SE), specificity (SP) and accuracy (ACC) were calculated. RESULTS Regarding all lesions the values for SE, SP, and ACC were respectively 0.804, 0.801, and 0.802 for tooth-color, and 0.819, 0.808, and 0.810 for tooth-color supplemented with fluorescence. In terms of accuracy parameters for moderate-extensive lesions, the values for SE, SP, and ACC for tooth color were 0.709, 0.948, and 0.944, while for fluorescence they were 0.815, 0.937, and 0.934. CONCLUSION Caries assessment with ICDAS criteria on 3D dental models produces reliable scores. Visual caries analysis using 3D models demonstrates commendable diagnostic accuracy and reasonable consistency with traditional methods. The use of intraoral scanners may be beneficial in evaluating occlusal caries. CLINICAL SIGNIFICANCE The importance of this study is to prove the diagnostic accuracy of caries lesions diagnosis made using and intraoral scanner and to offer greater confidence to professionals who use this diagnosis tool in their daily clinical practice. Intraoral scanners demonstrate to be an accurate tool for diagnosing occlusal caries.
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Affiliation(s)
- Gabriela Sá
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo SP, 05508-000, Brasil; Department of Odontology, University of Copenhagen, Nørre Allé 20, DK-2200 Copenhagen N, Denmark.
| | - Stavroula Michou
- Department of Odontology, University of Copenhagen, Nørre Allé 20, DK-2200 Copenhagen N, Denmark
| | - Marcelo Bönecker
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo SP, 05508-000, Brasil
| | - Fausto Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo SP, 05508-000, Brasil
| | - Bruna Amarante
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Prof. Lineu Prestes, 2227 - Cidade Universitária, São Paulo SP, 05508-000, Brasil; Department of Odontology, University of Copenhagen, Nørre Allé 20, DK-2200 Copenhagen N, Denmark
| | - Kim Ekstrand
- Department of Odontology, University of Copenhagen, Nørre Allé 20, DK-2200 Copenhagen N, Denmark
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Brondani B, Knorst JK, Emmanuelli B, Gasperini MRC, Braga MM, Ardenghi TM, Mendes FM. Do progression rates of initial and moderate caries lesions and sound surfaces of primary teeth increase significantly after 7 years? Int J Paediatr Dent 2024. [PMID: 38741210 DOI: 10.1111/ipd.13202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/11/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Initial caries lesions in primary teeth have presented a low progression rate after 2 years, but it could be higher in longer follow-ups. AIM To evaluate the progression rates of sound surfaces and initial and moderate caries lesions after 7 years. DESIGN This prospective 7-year cohort study included 639 preschool children aged 1-5 years in 2010. In 2017, 449 children were reassessed (70.3% retention rate). Dental caries was collected using the International Caries Detection and Assessment System (ICDAS) in both assessments. Incidence rate (IR) per 100 surface-years estimated the progression rates of sound surfaces and initial and moderate lesions for worse conditions. Cox regression with shared frailty evaluated the possible risk factors. RESULTS IR was 1.0% for sound surfaces, 2.8% and 4.2% for ICDAS scores 1 and 2, respectively, and about 17.0% for moderate lesions. The most significant risk factor for the progression was the presence of cavitated lesions in other teeth. The type of surface and tooth also influenced the outcome. CONCLUSION The progression rate of initial caries lesions in primary teeth remains low even after 7 years, but cavitated caries lesions in other teeth increase this risk. Moderate lesions demonstrate a higher risk of progression when compared to sound surfaces and initial caries lesions.
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Affiliation(s)
- Bruna Brondani
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Jessica K Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mariana R C Gasperini
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
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Antonelli R, Massei V, Ferrari E, Gallo M, Pertinhez TA, Vescovi P, Pizzi S, Meleti M. Salivary Diagnosis of Dental Caries: A Systematic Review. Curr Issues Mol Biol 2024; 46:4234-4250. [PMID: 38785526 PMCID: PMC11120503 DOI: 10.3390/cimb46050258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 04/22/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
The activity of dental caries, combined with its multifactorial etiology, alters salivary molecule composition. The present systematic review was developed to answer the following question: "Are salivary biomarkers reliable for diagnosis of dental caries?". Following the "Preferred Reporting Item for Systematic Reviews and Meta-analysis" (PRISMA) guidelines, the review was conducted using multiple database research (Medline, Web of Science, and Scopus). Studies performed on healthy subjects with and without dental caries and providing detailed information concerning the clinical diagnosis of caries (Decayed, Missing, Filled Teeth-DMFT and International Caries Detection and Assessment System-ICDAS criteria) were included. The quality assessment was performed following a modified version of the Joanna Briggs Institute Prevalence Critical Appraisal Checklist. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, ID: CRD42022304505). Sixteen papers were included in the review. All studies reported statistically significant differences in the concentration of salivary molecules between subjects with and without caries (p < 0.05). Proteins were the most investigated molecules, in particular alpha-amylase and mucins. Some studies present a risk of bias, such as identifying confounding factors and clearly defining the source population. Nevertheless, the 16 papers were judged to be of moderate to high quality. There is evidence that some salivary compounds studied in this review could play an important diagnostic role for dental caries, such as salivary mucins, glycoproteins (sCD14), interleukins (IL-2RA, 4,-13), urease, carbonic anhydrase VI, and urea.
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Affiliation(s)
- Rita Antonelli
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (V.M.); (P.V.); (S.P.); (M.M.)
| | - Valentina Massei
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (V.M.); (P.V.); (S.P.); (M.M.)
| | - Elena Ferrari
- Laboratory of Biochemistry and Metabolomics, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (E.F.); (M.G.)
| | - Mariana Gallo
- Laboratory of Biochemistry and Metabolomics, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (E.F.); (M.G.)
| | - Thelma A. Pertinhez
- Laboratory of Biochemistry and Metabolomics, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (E.F.); (M.G.)
| | - Paolo Vescovi
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (V.M.); (P.V.); (S.P.); (M.M.)
| | - Silvia Pizzi
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (V.M.); (P.V.); (S.P.); (M.M.)
| | - Marco Meleti
- Centro Universitario di Odontoiatria, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (V.M.); (P.V.); (S.P.); (M.M.)
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Lock NC, Gazola ML, Marquezan PK, Zenkner JEDA, Alves LS. Association between Sense of Coherence and Caries Activity and Caries Experience among Male Adolescents from Southern Brazil: A Cross-Sectional Study. Caries Res 2024:1-6. [PMID: 38631320 DOI: 10.1159/000538488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 03/17/2024] [Indexed: 04/19/2024] Open
Abstract
INTRODUCTION This cross-sectional study assessed the association between sense of coherence (SoC) and caries activity (number of active caries lesions) and caries experience (DMFT index) among 18-19-year-old male adolescents who joined the Brazilian Army as draftees for mandatory military service (n = 507). METHODS Data collection included a questionnaire (level of education, family income, and tooth brushing frequency), the Brazilian short version of the SoC scale (SOC-13), and clinical caries examination (noncavitated/cavitated, inactive/active). The main predictor variable was SoC, categorized as low, moderate, or high. Poisson regression models were used for statistical analysis. RESULTS A high SoC was significantly associated with a lower number of active lesions (adjusted rate ratio = 0.85; 95% CI = 0.74-0.98). No association between SoC and DMFT was detected. CONCLUSION A high SoC was found to be a protective factor to caries activity in this population.
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Affiliation(s)
| | - Maria Laura Gazola
- Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | | | - Luana Severo Alves
- Department of Restorative Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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Burian E, Lenhart N, Greve T, Bodden J, Burian G, Palla B, Probst F, Probst M, Beer M, Folwaczny M, Schwarting J. Detection of caries lesions using a water-sensitive STIR sequence in dental MRI. Sci Rep 2024; 14:663. [PMID: 38182726 PMCID: PMC10770403 DOI: 10.1038/s41598-024-51151-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 01/01/2024] [Indexed: 01/07/2024] Open
Abstract
In clinical practice, diagnosis of suspected carious lesions is verified by using conventional dental radiography (DR), including panoramic radiography (OPT), bitewing imaging, and dental X-ray. The aim of this study was to evaluate the use of magnetic resonance imaging (MRI) for caries visualization. Fourteen patients with clinically suspected carious lesions, verified by standardized dental examination including DR and OPT, were imaged with 3D isotropic T2-weighted STIR (short tau inversion recovery) and T1 FFE Black bone sequences. Intensities of dental caries, hard tissue and pulp were measured and calculated as aSNR (apparent signal to noise ratio) and aHTMCNR (apparent hard tissue to muscle contrast to noise ratio) in both sequences. Imaging findings were then correlated to clinical examination results. In STIR as well as in T1 FFE black bone images, aSNR and aHTMCNR was significantly higher in carious lesions than in healthy hard tissue (p < 0.001). Using water-sensitive STIR sequence allowed for detecting significantly lower aSNR and aHTMCNR in carious teeth compared to healthy teeth (p = 0.01). The use of MRI for the detection of caries is a promising imaging technique that may complement clinical exams and traditional imaging.
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Affiliation(s)
- Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany.
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany.
- Department of Diagnostic and Interventional Neuroradiology, Kantonsspital Frauenfeld, Thurgau AG, Frauenfeld, Switzerland.
| | - Nicolas Lenhart
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Tobias Greve
- Department of Neurosurgery, University of Munich, Munich, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Benjamin Palla
- Department of Oral and Maxillofacial Surgery, University of Illinois, Chicago, Chicago, USA
| | - Florian Probst
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital LMU Munich, 80337, Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, Universitätsklinikum Ulm, Ulm, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Julian Schwarting
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
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Arafa A. Household smoking impact on the oral health of 5- to 7-years-old children. BMC Oral Health 2023; 23:1028. [PMID: 38114982 PMCID: PMC10731723 DOI: 10.1186/s12903-023-03715-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 11/25/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Children's exposure to secondhand smoke, particularly by their parents, could adversely affect their oral health. Thereby, this study aimed to assess the oral health status of children subjected to household smoking and the impact of smoking patterns on the severity of oral health deterioration. METHODS A total of 210 healthy children were enrolled in this case-control study and allocated into children subjected to household smoking (HS) and control groups. Participants' guardians were asked to complete a questionnaire regarding sociodemographic characteristics and parental smoking habits. All participants were subjected to clinical dental examination to assess dental caries (ICDAS), hypomineralized primary molars (HSPM), and gingival status (GI). Stimulated saliva samples were collected to assess saliva composition and characteristics. Urine samples were collected and analyzed for cotinine concentration. Data were analyzed using SPSS (v.25) software at a test value of p ≤ 0.05. The t-student test was used to find significant differences between participants' age, gingival index score, saliva pH, flow rate, sIgA, and cotinine level. The Chi-square test was used to test for the significance of parental employment, number of rooms, gender, sweets consumption, brushing frequency, and HMPM. The correspondence analysis was used to test for significance of parents' levels of education, type of house ventilation, ICDAS score, smoking form, frequency, and smoking pattern. The correlation between cotinine level and sIgA was tested for association using Bivariate correlation test. RESULTS The HS group showed a significantly increased risk for dental caries (p < 0.000), HSPM lesions (p = 0.007), and GI score (p < 0.000). A significant reduction in salivary flow rate, saliva pH, and sIgA were evident in HS group (p < 0.000). Parental consumption of more than 20 cigarettes/day was accompanied by increased dental caries activity (p < 0.000) and higher risk for increased severity of gingival inflammation (p < 0.000) of children in the HS group. Children of parents who smoke cigarettes and use the hubble/bubble anywhere in the house found to have greater distribution of HSPM (p < 0.000). Reduced sIgA values were found to be significantly associated with increased cotinine concentrations in HS children (p < 0.000). CONCLUSIONS Frequent exposure to household smoking could be associated with an increased risk of dental caries progression, enamel hypomineralization, gingival inflammation, and saliva characteristics changes in children.
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Affiliation(s)
- Abla Arafa
- Department of Pediatric Dentistry and Orthodontics, Faculty of Oral and Dental Medicine, Misr International University, 28, Cairo, Egypt.
- Department of Preventive Dentistry, College of Dentistry, Umm AlQura University, Makka, Saudi Arabia.
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Porumb (Chifor) I, Leucuta DC, Nigoghossian M, Culic B, Lucaciu PO, Culic C, Badea IC, Leghezeu AN, Nicoara AG, Simu MR. Caries Lesion Assessment Using 3D Virtual Models by Examiners with Different Degrees of Clinical Experience. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2157. [PMID: 38138260 PMCID: PMC10744345 DOI: 10.3390/medicina59122157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/04/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
Background and Objectives: Dental caries is a preventable, reversible disease in its early stages. This study evaluated the intra-rater agreement of International Caries Assessment and Detection System (ICDAS) scores with Medit i500® and Omnicam® scanners versus traditional clinical examinations and the inter-rater agreement using the Omnicam® among senior dentists and dental students and between these two groups. Materials and Methods: A total of 24 patients aged between 21 and 34 years, randomly selected from dental students and interns, underwent four examinations (three intraoral scans and one clinical examination), and the corresponding ICDAS scores were recorded by a randomly selected rater out of the 31 available examiners. The examination team consisted of dental students, dentists with less than 3 years, and dentists with more than 5 years of clinical experience. The following inter- and intra-rater agreement tests for the ordinal data were chosen: Fleiss' kappa coefficient, Cohen's weighted kappa, and inter-class correlations. Results: For all examination techniques, there was statistically significant agreement for the experienced raters (p < 0.05). The highest positive interclass correlation was obtained for inter-rater agreement tests of 288 observations recorded by senior dentists: ICC = 0.969 (95% CI 0.949-0.981). Conclusions: Intra-rater reliability was excellent for Omnicam compared to clinical exams conducted by senior dentists but moderate for Medit i500. Although inter-rater agreement using Omnicam was poor between students and between senior dentists and students, it was excellent among senior dentists.
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Affiliation(s)
- Ioana Porumb (Chifor)
- Department of Preventive Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A Iancu Str., 400083 Cluj-Napoca, Romania; (I.C.B.)
- SC Chifor Meddent SRL, 9 Gh Doja Str., 400068 Cluj-Napoca, Romania
| | - Daniel-Corneliu Leucuta
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, 4 Pasteur Str., 400349 Cluj-Napoca, Romania;
| | - Marion Nigoghossian
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Avram Iancu Str., No 31, 400083 Cluj-Napoca, Romania; (A.-N.L.); (A.G.N.)
| | - Bogdan Culic
- Dental Propedeutics and Aesthetics Department, Iuliu Hatieganu University of Medicine and Pharmacy, 32 Clinicilor Str., 400006 Cluj-Napoca, Romania;
| | - Patricia Ondine Lucaciu
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 15 Victor Babes Str., 400012 Cluj-Napoca, Romania;
| | - Carina Culic
- Department of Odontology, Iuliu Hatieganu University of Medicine and Pharmacy, 33 Motilor Str., 400001 Cluj-Napoca, Romania
| | - Iulia Clara Badea
- Department of Preventive Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 31 A Iancu Str., 400083 Cluj-Napoca, Romania; (I.C.B.)
| | - Alexa-Nicole Leghezeu
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Avram Iancu Str., No 31, 400083 Cluj-Napoca, Romania; (A.-N.L.); (A.G.N.)
| | - Andra Gabriela Nicoara
- Faculty of Dental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Avram Iancu Str., No 31, 400083 Cluj-Napoca, Romania; (A.-N.L.); (A.G.N.)
| | - Meda-Romana Simu
- Department of Pediatric Dentistry, Iuliu Hatieganu University of Medicine and Pharmacy, 400083 Cluj-Napoca, Romania;
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Lin WS, Alfaraj A, Lippert F, Yang CC. Performance of the caries diagnosis feature of intraoral scanners and near-infrared imaging technology-A narrative review. J Prosthodont 2023; 32:114-124. [PMID: 37701946 DOI: 10.1111/jopr.13770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/11/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE To describe and discuss the benefits and drawbacks of various dental caries diagnostic techniques, including the use of intraoral scanners for caries diagnosis based on near-infrared imaging (NIR) technology. MATERIAL AND METHODS A MEDLINE search from 1980-2023 focused on dental caries diagnostic techniques, emphasizing intraoral scanners using NIR technology. Alternative caries detection methods were also evaluated for their advantages and limitations, enabling a comparison with NIR. The review included traditional caries tools, the latest detection methods, and NIR's role in intraoral scanners, drawing from case reports and both in vivo and in vitro studies. Keywords like "caries detection," "intraoral scanners," and "Near Infrared Imaging (NIRI)" guided the search. After screening titles and abstracts for relevance, full texts with valuable insights were thoroughly analyzed. The data was grouped into three: traditional diagnostics, advanced digital methods, and intraoral scanner-based detection. RESULTS This comprehensive narrative review described and discussed the current state of dental caries diagnostic methods, given the insufficient number of clinical investigations suitable for a systematic review. Traditional caries diagnosis techniques have shown variable accuracy dependent on a dentist's experience and the potential over-removal of healthy tooth structures. Intraoral scanners have emerged as a novel caries detection method, because of their integration of NIR technology. Various studies have confirmed the efficacy of NIR in detecting interproximal caries and in the early diagnosis of non-cavitated caries. Specifically, intraoral scanners have demonstrated promising results, proving comparable to established diagnostic methods like bitewing radiography. Nevertheless, while the integration of NIR into intraoral scanners seems promising, the technology still faces challenges, notably its accuracy in detecting secondary and subgingival cavities. However, with anticipated integrations of AI, NIR in intraoral scanners could revolutionize early caries detection. CONCLUSIONS Intraoral scanners with NIR technology offer non-destructive imaging, real-time lesion visuals, and enhanced patient communication. Although comparable to bitewing radiography in some studies, a universally accepted diagnostic tool is lacking. Future research should compare them with existing methods, focusing on clinical outcomes, cost-effectiveness, and patient acceptance.
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Affiliation(s)
- Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Amal Alfaraj
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Frank Lippert
- Department of Cariology, Operative Dentistry, and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Chao-Chieh Yang
- Department of Prosthodontics, Indiana University School of Dentistry, Advanced Education Program in Prosthodontics, Indianapolis, Indiana, USA
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Chabuk MMG, Al-Shamma AMW. Surface roughness and microhardness of enamel white spot lesions treated with different treatment methods. Heliyon 2023; 9:e18283. [PMID: 37539286 PMCID: PMC10395522 DOI: 10.1016/j.heliyon.2023.e18283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/17/2023] [Accepted: 07/13/2023] [Indexed: 08/05/2023] Open
Abstract
Objective To analyse the surface roughness and microhardness of artificial enamel white spot lesions before and after WSL formation, after treatment (Opalsutre™ microabrasion, Sylc® bioactive glass, and ICON® resin infiltration), and after pH cycling with the help of the profilometer surface roughness tester and the digital Vickers microhardness tester. Materials and methods Seventy-five extracted molars were used to acquire one hundred specimens. 50 specimens were randomly assigned to five groups (n = 10) for the surface roughness study: 1) Sound group, 2) WSL group, 3) micro abrasion (MA; Opalustre, Ultradent, South Jordan, UT, USA), 4) bioactive glass 45S5 Sylc powder (Sylc; Denfotex Research Ltd, Inverkeithing, UK), and 5) ICON resin infiltration (ICON; DMG, Hamburg, Germany). An additional 25 specimens were used to obtain 50 enamel slabs for the surface microhardness study, which were also assigned to the same groups. All groups underwent a final stage of pH cycling. Surface roughness and surface microhardness measurements were performed at different stages for all groups. Results Regarding surface roughness, ICON significantly reduced the surface roughness compared to Opalustre and Sylc, with no significant difference between Opalustre and Sylc. In terms of surface microhardness, ICON showed the highest improvement, followed by Sylc and then Opalustre. Both surface roughness and microhardness were significantly affected by demineralization, partially improved after treatment, and then regressed significantly after pH cycling. Conclusion ICON resin infiltrant can be considered as a superior treatment option for improving surface roughness and microhardness, while Opalustre demonstrated relatively the poorest performance compared to the other treatment options. It is noteworthy that the pH cycling procedure had an adverse impact irrespective of the treatment option used.
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Affiliation(s)
- Mina MG. Chabuk
- Corresponding author. Department of Restorative and Aesthetic Dentistry, College of Dentistry, University of Baghdad. Al-Mansour, Baghdad, 10011, Iraq.
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Zhu Y, Wang Y, Zhang S, Li J, Li X, Ying Y, Yuan J, Chen K, Deng S, Wang Q. Association of polymicrobial interactions with dental caries development and prevention. Front Microbiol 2023; 14:1162380. [PMID: 37275173 PMCID: PMC10232826 DOI: 10.3389/fmicb.2023.1162380] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023] Open
Abstract
Dental caries is a common oral disease. In many cases, disruption of the ecological balance of the oral cavity can result in the occurrence of dental caries. There are many cariogenic microbiota and factors, and their identification allows us to take corresponding prevention and control measures. With the development of microbiology, the caries-causing bacteria have evolved from the traditional single Streptococcus mutans to the discovery of oral symbiotic bacteria. Thus it is necessary to systematically organized the association of polymicrobial interactions with dental caries development. In terms of ecology, caries occurs due to an ecological imbalance of the microbiota, caused by the growth and reproduction of cariogenic microbiota due to external factors or the disruption of homeostasis by one's own factors. To reduce the occurrence of dental caries effectively, and considering the latest scientific viewpoints, caries may be viewed from the perspective of ecology, and preventive measures can be taken; hence, this article systematically summarizes the prevention and treatment of dental caries from the aspects of ecological perspectives, in particular the ecological biofilm formation, bacterial quorum sensing, the main cariogenic microbiota, and preventive measures.
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Affiliation(s)
- Yimei Zhu
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Ying Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Shuyang Zhang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Jiaxuan Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Xin Li
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Yuanyuan Ying
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Jinna Yuan
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Keda Chen
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
| | - Shuli Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China
| | - Qingjing Wang
- Shulan International Medical College, Zhejiang Shuren University, Hangzhou, Zhejiang, China
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11
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Brusius CD, Alves LS, Maltz M. Is Patient's Caries Activity Associated with Caries Increment among Adolescents, Regardless of Caries Experience? Caries Res 2023; 57:613-618. [PMID: 37075732 DOI: 10.1159/000530736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/11/2023] [Indexed: 04/21/2023] Open
Abstract
This 2.5-year cohort study investigated whether patient's caries activity is independently associated with caries increment among adolescents, regardless of previous caries experience, in a sample of 801 adolescents from South Brazil. Caries examination was performed at baseline (12 y) and at follow-up (14-15 y). Caries activity was significantly associated with caries increment even after adjustment for sex, socioeconomic status, type of school, and previous caries experience at both cavity and non-cavitated levels. Caries-active adolescents had approximately 2-fold higher risk of caries increment than those without caries activity (cavity level, incidence risk ratio [IRR] = 1.90, 95% confidence interval [CI] = 1.45-2.49, p < 0.001; non-cavitated level, IRR = 2.16, 95% CI = 1.63-2.86, p < 0.001).
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Affiliation(s)
| | - Luana Severo Alves
- School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Marisa Maltz
- Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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12
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Miranda TC, Andrade JFM, Gelfuso GM, Cunha-Filho M, Oliveira LA, Gratieri T. Novel technologies to improve the treatment of endodontic microbial infections: Inputs from a drug delivery perspective. Int J Pharm 2023; 635:122794. [PMID: 36870400 DOI: 10.1016/j.ijpharm.2023.122794] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023]
Abstract
Endodontic microbial infections are still a challenge for an effective treatment for being biofilm-mediated and very refractory to conventional therapies. Biomechanical preparation and chemical irrigants cannot fully eradicate biofilms due to the anatomic structure of the root canal system. Instruments employed in biomechanical preparation and irrigants solution cannot reach the narrow and deepest portion of root canals, especially the apical thirds. In addition, aside from the dentin surface, biofilms can also infiltrate dentine tubules and periapical tissues, compromising treatment success. Therefore, different technologies have been investigated to achieve a more effective outcome in the control of endodontic infections. However, these technologies continue to face great difficulties in reaching the apical region and eradicating biofilms to avoid the recurrence of infection. Here, we present an overview of the fundamentals of endodontics infections and review technologies currently available for root canal treatment. We discuss them from a drug delivery perspective, highlighting each technology's strength to envision the best use of these technologies.
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Affiliation(s)
- Thamires C Miranda
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Jayanaraian F M Andrade
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Guilherme M Gelfuso
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Marcilio Cunha-Filho
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Laudimar A Oliveira
- Department of Dentistry, Faculty of Health Sciences, University of Brasilia, 70910-900, Brasília, DF, Brazil
| | - Tais Gratieri
- Laboratory of Food, Drugs, and Cosmetics (LTMAC), University of Brasilia, 70910-900, Brasília, DF, Brazil.
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13
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MOOSAVİ H, REZAEE F, AFSHARİ S, SEKANDARİ S, AHRARİ F. The effect of minimally invasive treatments on enamel microhardness and resistance to further demineralization. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.1106247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objectives: The present study aimed to compare microhardness of inactive proximal lesions treated by resin infiltration, Er:YAG laser + resin infiltration and Bioactive glass, and investigate the resistance of treated lesions to further demineralization challenge.
Methods: In this in-vitro study, 30 human molars with inactive proximal lesions were selected and randomly divided into three groups of 10. In group 1 (resin infiltration), the lesions were treated by a resin infiltrant (Icon). In group 2, the surface was conditioned by an Er:YAG laser prior to resin infiltration. The specimens in group 3 were remineralized by bioactive glass. The treated specimens were kept in artificial saliva for 1 week and then immersed in a demineralization solution for 8 weeks. Surface microhardness was measured at baseline (T0), after remineralization (T1) and after exposure to the demineralization solution (T2), and the difference in microhardness between time points (ΔVHN) was calculated.
Results: Microhardness after demineralization (T2) was significantly lower than those of other intervals (P0.05). The statistical analysis revealed no significant difference either in ΔVHNT1-T0 or in ΔVHNT2-T1 among the study groups (P>0.05)
Conclusion: Pretreatment by the Er:YAG laser prior to resin infiltration was more effective that other treatments in enhancing microhardness and protecting the tooth against acidic challenge. However, the difference between groups did not reach a statistical significance, implying the need for further studies to achieve more conclusive results.
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14
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Evaluation of different methods for the diagnosis of primary caries lesions: Study protocol for a randomized controlled clinical trial. PLoS One 2022; 17:e0273104. [PMID: 36001544 PMCID: PMC9401102 DOI: 10.1371/journal.pone.0273104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 08/03/2022] [Indexed: 12/01/2022] Open
Abstract
Background According to the World Health Organization (WHO), dental caries is considered one of the greatest pediatric health problems in the world, due to its high prevalence and incidence. Therefore, the early diagnosis of caries lesions is a fundamental procedure for planning treatment aimed at prevention, minimal intervention and promotion of oral health. The present study aims to evaluate, through a randomized and controlled clinical study, which is the best strategy for diagnosing primary caries lesions located in the interproximal region. Materials and methods Eighty patients, aged between 4 and 10 years will be randomized and allocated into 2 groups for analysis and comparison of methods for diagnosing caries lesions. The following diagnostic methods will be analyzed and compared: visual clinical examination using ICDAS (International Caries Detection and Assessment System), the iTero Element 5D System (intraoral scanner with near infrared imaging (NIRI) technology) and bitewing radiography (BWX). All evaluations will be carried out by 02 examiners. Examiners will be trained and calibrated to use the visual and radiographic criteria and also to use the iTero 5D intraoral scanner, following the manufacturer’s instructions. Trial registration NCT04900246 in ClinicalTrial.gov. First released in 05/11/2021 and last updated in 10/06/2021.
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15
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Park SW, Kang SM, Lee HS, Kim SK, Lee ES, Kim BR, de Josselin de Jong E, Kim BI. Lesion activity assessment of early caries using dye-enhanced quantitative light-induced fluorescence. Sci Rep 2022; 12:11848. [PMID: 35831391 PMCID: PMC9279380 DOI: 10.1038/s41598-022-15862-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/30/2022] [Indexed: 11/08/2022] Open
Abstract
We aimed to determine whether dye-enhanced quantitative light-induced fluorescence (DEQLF), wherein porous structure of caries lesions is stained with a fluorescent dye, could quantitatively distinguish between active and inactive caries. A total of 126 bovine specimens were prepared to artificially simulate caries activity. Active caries were demineralized with 1% carbopol solution for 3 (A3), 5 (A5), and 10 days (A10). For inactive caries, half specimens in each group were remineralized with 2% NaF and reallocated into three groups (I3, I5, and I10, respectively). Wet specimens were dried with compressed air for 10 s and then dyed with 100-µM sodium fluorescein for 10 s. Fluorescence images of speicmens were captured with a QLF-digital 2 + Biluminator. Fluorescence intensity (ΔG) was measured in fluorescence images of dyed specimens. ΔG between active and inactive groups was compared using independent t-test, and ΔG among active groups (or inactive groups) were compared using ANOVA (α = 0.05). ΔG in the active groups was 33.7-59.0 higher than that in the inactive groups (P < 0.001). Except between I3 and I5, there was significant differences in ΔG according to the demineralization period (P < 0.001). DEQLF might be used to evaluate early caries activity, and longitudinally monitor changes in lesion activity.
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Affiliation(s)
- Seok-Woo Park
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
- R&D Center, AIOBIO Co., Ltd., Seoul, 06241, Republic of Korea
| | - Si-Mook Kang
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
| | - Hyung-Suk Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
| | - Sang-Kyeom Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
| | - Eun-Song Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
| | - Bo-Ra Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
- Department of Dental Hygiene, Namseoul University, Cheonan-si, 31020, Republic of Korea
| | - Elbert de Josselin de Jong
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea
- Department of Health Service Research, University of Liverpool, Liverpool, L69 7ZX, UK
- Inspektor Research System BV, 1402CG, Bussum, The Netherlands
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, 03722, Republic of Korea.
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, 03722, Republic of Korea.
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16
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Kim CH, Bae K, Lee TY, Song JS, Kim SO, Kang CM. Assessment of dental caries lesion activity status using quantitative parameters obtained from the quantitative light-induced fluorescence method and difference of microbial distribution in primary molars. Photodiagnosis Photodyn Ther 2022; 39:102942. [DOI: 10.1016/j.pdpdt.2022.102942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/06/2022] [Accepted: 05/27/2022] [Indexed: 10/18/2022]
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17
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The value of bitewing radiographs in the management of carious primary molars. Br Dent J 2021; 231:575-579. [PMID: 34773029 DOI: 10.1038/s41415-021-3570-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/14/2021] [Indexed: 11/09/2022]
Abstract
Introduction Bitewing radiographs (BWs) are under-utilised for children, and reliance on visual diagnosis alone is likely to under-diagnose caries. Quantification of the level of the under-reporting of caries and the vital role of BWs would be beneficial when providing dental care to the paediatric population.Aim To quantify the diagnostic value of bitewings in the management of proximal caries in primary molars.Design Cross-sectional study.Materials and methods Thirty children (mean age 6.2 ± 1.3 years) were recruited. A visual inspection (VI) of the primary molars was carried out and bitewings were taken. Radiographic assessment (RA) for primary molar proximal caries was completed separately. VI and RA were compared statistically against three caries thresholds, using the Fisher's exact test. A p value <0.05 was considered statistically significant. Sensitivity and specificity analyses were performed.Results A total of 480 proximal surfaces were assessed. Bitewings detected 44.6% of additional proximal carious lesions (p <0.0001). At d3 threshold, VI under-reported 51.2% proximal caries (p <0.0001) and 34.1% dentinal proximal caries (p = 0.0012). VI showed high specificity (99%) and low sensitivity (53%).Conclusion Bitewings play a vital role in proximal caries diagnoses of primary molars.
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18
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Deep learning for early dental caries detection in bitewing radiographs. Sci Rep 2021; 11:16807. [PMID: 34413414 PMCID: PMC8376948 DOI: 10.1038/s41598-021-96368-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 08/06/2021] [Indexed: 11/08/2022] Open
Abstract
The early detection of initial dental caries enables preventive treatment, and bitewing radiography is a good diagnostic tool for posterior initial caries. In medical imaging, the utilization of deep learning with convolutional neural networks (CNNs) to process various types of images has been actively researched, with promising performance. In this study, we developed a CNN model using a U-shaped deep CNN (U-Net) for caries detection on bitewing radiographs and investigated whether this model can improve clinicians' performance. The research complied with relevant ethical regulations. In total, 304 bitewing radiographs were used to train the CNN model and 50 radiographs for performance evaluation. The diagnostic performance of the CNN model on the total test dataset was as follows: precision, 63.29%; recall, 65.02%; and F1-score, 64.14%, showing quite accurate performance. When three dentists detected caries using the results of the CNN model as reference data, the overall diagnostic performance of all three clinicians significantly improved, as shown by an increased sensitivity ratio (D1, 85.34%; D1', 92.15%; D2, 85.86%; D2', 93.72%; D3, 69.11%; D3', 79.06%; p < 0.05). These increases were especially significant (p < 0.05) in the initial and moderate caries subgroups. The deep learning model may help clinicians to diagnose dental caries more accurately.
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19
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Kapor S, Rankovic MJ, Khazaei Y, Crispin A, Schüler I, Krause F, Lussi A, Neuhaus K, Eggmann F, Michou S, Ekstrand K, Huysmans MC, Kühnisch J. Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. Clin Oral Investig 2021; 25:4801-4815. [PMID: 34128130 PMCID: PMC8342337 DOI: 10.1007/s00784-021-04024-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/01/2021] [Indexed: 02/01/2023]
Abstract
AIM This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. MATERIALS AND METHODS A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. RESULTS SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. CONCLUSION The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. CLINICAL RELEVANCE VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.
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Affiliation(s)
- Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, Ludwig-Maximilian Universität München, Munich, Germany
| | - Yegane Khazaei
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Alexander Crispin
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, Jena, Germany
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Aachen, Germany
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Klaus Neuhaus
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital-Bern University Hospital, Bern, Switzerland
| | - Florin Eggmann
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Stavroula Michou
- Department of Odontology, University Copenhagen, Copenhagen, Denmark
| | - Kim Ekstrand
- Department of Odontology, University Copenhagen, Copenhagen, Denmark
| | | | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany.
- Poliklinik Für Zahnerhaltung Und Parodontologie, Klinikum Der Universität München, LMU München, Goethestraße 70, 80336, München, Germany.
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20
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Qin D, Wang Y, Levey C, Ngan P, He H, Hua F. Protocol for the development of a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). Trials 2021; 22:507. [PMID: 34332635 PMCID: PMC8325281 DOI: 10.1186/s13063-021-05371-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Enamel white spot lesions (WSLs), characterized by an opaque, matt, and chalky white appearance of enamel, are a sign of incipient caries. WSLs are common in orthodontic practice and can affect both the oral health and dental aesthetics of patients. Extensive studies have been conducted to evaluate the effectiveness of prevention or treatment for orthodontically induced enamel WSLs. However, substantial heterogeneity has been found in the outcomes used for the prevention and treatment of WSLs in literature, which prevents researchers from comparing and combining the results of different studies to draw more decisive conclusions. Therefore, we aim to develop a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). METHODS The development of COS-OWSL comprises four phases: (1) a scoping review to identify and summarize all existing outcomes that have been used in trials on the prevention or treatment of orthodontically induced WSLs; (2) qualitative interviews with orthodontic patients without (for prevention) and with WSL-affected teeth (for treatment) and relevant dental professionals to identify additional outcomes relevant to them; (3) Delphi surveys to collect opinions from key stakeholders including patients, dental professionals, and researchers and to reach a preliminary consensus; and (4) a consensus meeting to develop the final COS-OWSL. DISCUSSION The COS-OWSL will be developed to facilitate the synthesis of evidence regarding the prevention and treatment of orthodontically induced WSLs and to promote the consistent use of relevant patient-important outcomes among future studies in this field. TRIAL REGISTRATION Core Outcome Measures in Effectiveness Trials (COMET) initiative (the COS-WSL project) 1399.
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Affiliation(s)
- Danchen Qin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Yunlei Wang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Colin Levey
- School of Dentistry, University of Dundee, Dundee, UK
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, Morgantown, USA
| | - Hong He
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China. .,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China.
| | - Fang Hua
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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21
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Dias-Moraes MC, Castro PAA, Pereira DL, Ana PA, Freitas AZ, Zezell DM. Assessment of the preventive effects of Nd:YAG laser associated with fluoride on enamel caries using optical coherence tomography and FTIR spectroscopy. PLoS One 2021; 16:e0254217. [PMID: 34234361 PMCID: PMC8263272 DOI: 10.1371/journal.pone.0254217] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 06/22/2021] [Indexed: 02/06/2023] Open
Abstract
Objective This in vitro study characterized and monitored, by Optical Coherence Tomography (OCT) and Fourier Transformed Infrared Spectroscopy (FTIR), the effects of the association of acidulated phosphate fluoride gel (APF-gel) and Nd:YAG (neodymiun:yttrium-aluminum-garnet) laser, as sequencial treatments, in the prevention of incipient enamel caries lesions. Methods 120 human enamel samples were randomized into 3 groups (n = 40): APF-gel (1.23% F-, 4 min.); Laser+APF (Nd:YAG laser irradiation—0.6W, 84.9J/cm2, 10Hz, followed by APF-gel); and APF+Laser (APF-gel followed by laser irradiation). The samples were subjected to a 15-day pH-cycling, evaluated by OCT (quantification of optical attenuation coefficient–OAC) and FTIR (analysis of carbonate and phosphate content) before treatments, after treatments, and on the 5th, 10th and 15th days of pH-cycling. The statistical analysis was performed (α = 5%). Results The Optical Attenuation Coefficient (OAC) assessed by OCT increases with the progression of demineralization, and the Laser+APF presented the highest values of OAC in 10th and 15th days of pH-cycling. Nd:YAG decreased the carbonate content after treatment regardless of the application order of the APF-gel, while APF-gel did not interfere in the composition of enamel. The carbonate content was also changed in the first 5 days of the pH-cycling in all groups. Conclusion Nd:YAG laser irradiation before or after the application of APF-gel did not influence the appearance of incipient caries lesions, showing no synergistic effect. Regardless of the application order of the APF-gel, laser irradiation reduces the carbonate content of the enamel, which also changes during the demineralization process. However, irradiation before the application of APF-gel increased the speed of progression of the lesions, which positively impacts public health as it can prevent caries disease, even in high risk individuals. OCT and FTIR are suitable for assessing this effect.
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Affiliation(s)
- Marcia Cristina Dias-Moraes
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Pedro Arthur Augusto Castro
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Daísa Lima Pereira
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Patrícia Aparecida Ana
- Center for Engineering, Modelling and Applied Social Sciences, Universidade Federal do ABC, Sao Bernardo do Campo, SP, Brazil
| | - Anderson Zanardi Freitas
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
| | - Denise Maria Zezell
- Center for Lasers and Applications, Instituto de Pesquisas Energeticas e Nucleares, IPEN—CNEN/SP, Sao Paulo, SP, Brazil
- * E-mail:
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22
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Bahanan L, Singhal A, Zhao Y, Scott T, Kaye E. The association between food insecurity, diet quality, and untreated caries among US children. J Am Dent Assoc 2021; 152:613-621. [PMID: 34147241 DOI: 10.1016/j.adaj.2021.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 03/08/2021] [Accepted: 03/30/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this study was to examine the association between food insecurity and untreated caries among US children and the potential role of diet quality as a mediator in this relationship. METHODS The authors analyzed data for 4,822 children aged 5 through 17 years from the National Health and Nutrition Examination Survey cycles from 2011 through 2014. The authors measured food security as household-level food security status (full, marginal, low, very low) and overall food security status (full food secure, food insecure). They measured diet quality using the Healthy Eating Index. The primary outcome measure was untreated caries (none, ≥ 1). The authors used multiple logistic regression analysis to evaluate the relationships among food insecurity, diet quality, and untreated caries. They conducted mediation analysis using the Baron and Kenny approach. RESULTS Food-insecure children were more likely to have untreated caries compared with their fully food-secure counterparts, after controlling for confounding variables (odds ratio [OR], 1.38; 95% [CI, 1.11 to 1.72). Specifically, children from marginal and very low food-secure households had significantly higher odds of untreated caries (OR, 1.48; 95% CI, 1.10 to 2.01) compared with children from fully food-secure households (OR, 1.59; 95% CI, 1.12 to 2.26). Diet quality was not significantly associated with untreated caries. CONCLUSIONS Food insecurity was negatively associated with untreated caries among US children. Diet quality was not associated with untreated caries. PRACTICAL IMPLICATIONS Social factors such as food insecurity should be taken into consideration when dental clinicians perform caries risk assessment because caries risk is shown to be associated with overall health and dental health.
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Gasqui MA, Pérard M, Decup F, Monsarrat P, Turpin YL, Villat C, Gueyffier F, Maucort-Boulch D, Roche L, Grosgogeat B. Place of a new radiological index in predicting pulp exposure before intervention for deep carious lesions. Oral Radiol 2021; 38:89-98. [PMID: 33954908 DOI: 10.1007/s11282-021-00530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/16/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND During interventions for deep caries lesions without severe symptoms, preserving pulpal vitality is important to ensure treatment success, improve organ prognosis, and decrease cost-effectiveness. Current pre-operative radiographs allow visual estimation but not accurate measurement of lesion depth. PURPOSE Investigate the ability of ratio 'remaining/total dentin thickness' (RDT/TDT, as determined on pre-operative radiographs) to predict pulp exposure during excavation. METHODS This retrospective study (January 2018-June 2020) analyzed data on 360 patients. Four independent raters examined standard pre-operative radiographs and their contrasted versions. Lines put at the dentino-enamel junction, the floor of the carious lesion, and the pulp chamber wall allowed deriving RDT/TDT. Inter-rater agreements and concordance were assessed. A logistic regression accounting for measurement errors provided odds ratios that estimated the ability of the RDT/TDT to predict pulp exposure. RESULTS The median RDT/TDT ratio ranges were 16.8-26.5% on standard and 16.2-24.6% on contrasted radiographs. Inter-rater agreements on RDT/TDT were rather poor and inter-rater reliability was low and similar in standard and contrasted radiographs: the concordance correlation coefficients (95% CIs) were estimated at 0.46 (0.40; 0.51) and 0.46 (0.40; 0.52), respectively. The risk of pulp exposure increased by 2.5 times [odds ratio (95% CI) 2.57 (2.06; 3.20)] per 10-point decrease of the ratio on standard radiographs vs. 4.15 (3.15; 5.46) on contrasted radiographs. CONCLUSION RDT/TDT ratio is potentially helpful in predicting pulp exposure. However, the measurement errors on RDT and TDT being non-negligible and the interrater agreements poor, there is still place for advances through development of an automated process that will improve reliability and reproducibility of pulp exposure risk assessment. CLINICAL TRIAL Trial registration number. ClinicalTrials.gov NCT04607395, October 29, 2020.
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Affiliation(s)
- Marie-Agnès Gasqui
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - Matthieu Pérard
- Faculté d'Odontologie, Université de Rennes 1, Rennes, France
- Institut des Sciences Chimiques de Rennes, UMR CNRS 6226, Rennes, France
- Pôle d'Odontologie, CHU Rennes, Rennes, France
| | - Franck Decup
- Faculté d'Odontologie, Université Paris Descartes, Montrouge, France
- Pathologie Imagerie et Biothérapies orofaciales, EA2496, Université Paris Descartes, 92120, Montrouge, France
- Service d'Odontologie, Assistance Publique des Hôpitaux de Paris, Hôpital Charles-Foix, Ivry, France
| | - Paul Monsarrat
- Faculté d'Odontologie, Université Paul Sabatier, Toulouse, France
- STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, INP-ENVT, Inserm, UPS, Toulouse, France
- Centre Hospitalo-Universitaire, Toulouse, France
| | - Yann-Loïg Turpin
- Faculté d'Odontologie, Université de Rennes 1, Rennes, France
- Pôle d'Odontologie, CHU Rennes, Rennes, France
| | - Cyril Villat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France
| | - François Gueyffier
- Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Hôpital cardiologique, Hospices Civils de Lyon, Lyon, France
| | - Delphine Maucort-Boulch
- Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Laurent Roche
- Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France
- Équipe Biostatistique-Santé, Laboratoire de Biométrie et Biologie Évolutive, CNRS UMR 5558, Villeurbanne, France
- Service de Biostatistique-Bioinformatique, Pôle Santé Publique, Hospices Civils de Lyon, Lyon, France
| | - Brigitte Grosgogeat
- Faculté d'Odontologie, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
- Laboratoire des Multimatériaux et Interfaces, UMR CNRS 5615, Université Claude Bernard Lyon 1, Université de Lyon, Lyon, France.
- Service d'Odontologie, Hospices Civils de Lyon, Lyon, France.
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Gimenez T, Tedesco TK, Janoian F, Braga MM, Raggio DP, Deery C, Ricketts DNJ, Ekstrand KR, Mendes FM. What is the most accurate method for detecting caries lesions? A systematic review. Community Dent Oral Epidemiol 2021; 49:216-224. [PMID: 33847007 DOI: 10.1111/cdoe.12641] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To perform a systematic review and meta-analysis of the performance of different methods for detecting carious lesions in permanent and primary teeth, considering all types of tooth surface. METHODS Two reviewers searched PubMed, Embase, Scopus and other sources up to November 2020 to identify published and nonpublished studies in English. We focused on three caries detection methods: visual inspection (VI), radiographic (RX) and fluorescence-based (LF). We included studies investigating at least one of these methods which (a) assessed the accuracy of the method in detecting caries lesions; (b) considered occlusal, proximal or free smooth surfaces in primary or permanent teeth; (c) used a reference standard other than one of the three methods; and (d) reported data on sample size and accuracy. Multilevel analyses, meta-regressions and comparisons of bivariate summary receiver operating characteristics curves were undertaken. RESULTS Two hundred and forty manuscripts from 14 129 articles initially identified met the inclusion criteria. VI was better than RX on occlusal surfaces at all caries lesion thresholds and proximal surfaces of permanent teeth only at all lesion thresholds in laboratory setting. LF was slightly better than VI for advanced lesions on occlusal surfaces of permanent teeth in the clinical setting and for all lesions on proximal surfaces of permanent teeth in the laboratory setting. Still, LF was worse than VI for advanced occlusal lesions in permanent teeth in the laboratory setting. Although LF showed slightly better performance than VI with advanced lesions, the latter had significantly higher specificity than other methods in all settings. CONCLUSION Visual caries detection alone is adequate for most patients in daily clinical practice regardless of tooth type or surface.
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Affiliation(s)
- Thais Gimenez
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil.,Graduate Program in Dentistry, Ibirapuera University, Sao Paulo, Brazil
| | - Tamara K Tedesco
- Graduate Program in Dentistry, Ibirapuera University, Sao Paulo, Brazil
| | - Fernando Janoian
- Graduate Program in Dentistry, Ibirapuera University, Sao Paulo, Brazil
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Daniela Prócida Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Christopher Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Kim Rud Ekstrand
- Section of Cariology & Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,Section of Pediatric Dentistry & Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
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25
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Pontes LRA, Lara JS, Novaes TF, Freitas JG, Gimenez T, Moro BLP, Maia HCM, Imparato JCP, Braga MM, Raggio DP, Mendes FM. Negligible therapeutic impact, false-positives, overdiagnosis and lead-time are the reasons why radiographs bring more harm than benefits in the caries diagnosis of preschool children. BMC Oral Health 2021; 21:168. [PMID: 33789655 PMCID: PMC8011211 DOI: 10.1186/s12903-021-01528-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/22/2021] [Indexed: 02/02/2023] Open
Abstract
Background To evaluate the clinical course and interventions required during two years of follow-up of dental surfaces of deciduous molars diagnosed, and consequently treated, by two different strategies: diagnosis made by clinical examination alone or associated with radiographs. Methods This is a secondary analysis of a two-arm randomized clinical trial with parallel groups related to the diagnostic strategy for caries detection in preschool children. 216 children (3–6 years old) were followed-up for two years. All dental surfaces were diagnosed by visual inspection and later, through radiographic assessment. Baseline treatment was made in accordance with the results obtained by visual inspection performed alone or combined with radiographic method, considering the allocated group. Dental surfaces with no restoration needs, or those restored at the beginning of the study were followed-up for two years. The treatment decision was made according to the allocated group. The outcome was the occurrence of failure (a new caries lesion or a restoration replacement) during the follow-up. Results 4383 proximal and occlusal surfaces of deciduous molars in 216 preschool children were diagnosed and treated according to the abovementioned diagnostic strategies and followed-up for 24 months. The assessment of radiographs made change the initial decision reached by visual inspection in about 30% of the surfaces when all types of interventions were considered. However, most disagreements occurred for initial lesions, where radiographs tended to underestimate them. Discordances between methods occurred in less than 5% of all surfaces when considered lesions requiring operative treatment. For discrepancy cases, the placed interventions guided by following the radiographic results did not present less failures against those made following only visual inspection. As a matter of fact, the use of radiographs in the diagnostic strategy for caries detection in children brought more harms than benefits due to the occurrence of false-positives, overdiagnosis and lead-time bias. Conclusions Simultaneous association of visual inspection and radiographic assessment for caries detection in preschool children causes more harms than benefits, and therefore, visual inspection should be conducted alone in the regular clinical practice. Trial registration Clinicaltrials.gov platform: NCT02078453, registered on 5th March 2014. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01528-w.
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Affiliation(s)
- Laura Regina A Pontes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Juan Sebastian Lara
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,Department of Cariology, Operative Dentistry and Dental Public Health, Dental Institute, Indiana University School of Dentistry, 1121 W Michigan St., Indiana, IN, 46202, USA
| | - Tatiane Fernandes Novaes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,Cruzeiro Do Sul University, R. Galvão Bueno, 868, São Paulo, 01506-000, Brazil
| | - Julia Gomes Freitas
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Thais Gimenez
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,School of Dentistry, Ibirapuera University, Av. Interlagos, 1329, São Paulo, 04661-100, Brazil
| | - Bruna Lorena P Moro
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Haline C M Maia
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Daniela P Raggio
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
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26
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Thanh MTG, Van Toan N, Toan DTT, Thang NP, Dong NQ, Dung NT, Hang PTT, Anh LQ, Tra NT, Ngoc VTN. Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis. Dent J (Basel) 2021; 9:dj9030030. [PMID: 33800937 PMCID: PMC8000741 DOI: 10.3390/dj9030030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/17/2021] [Accepted: 02/28/2021] [Indexed: 11/16/2022] Open
Abstract
This systematic review and meta-analysis aimed to investigate the efficacy of fluorescence-based methods, visual inspections, and photographic visual examinations in initial caries detection. A literature search was undertaken in the PubMed and Cochrane databases. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed, and eligible articles published from 1 January 2009 to 30 October 2019 were included if they met the following criteria: they (1) assessed the accuracy of methods of detecting initial tooth caries lesions on occlusal, proximal, or smooth surfaces in both primary and permanent teeth (in clinical); (2) used a reference standard; (3) reported data regarding the sample size, prevalence of initial tooth caries, and accuracy of the methods. Data collection and extraction, quality assessment, and data analysis were conducted according to Cochrane standards Quality Assessment of Diagnostic Accuracy Studies-2. Statistical analyses were performed using Review Manager 5.3 and STATA 14.0. A total of 12 eligible articles were included in the meta-analysis. The results showed that the sensitivity and specificity of fluorescence-based methods were 80% and 80%, respectively; visual inspection was measured at 80% and 75%, respectively; photographic visual examination was measured at 67% and 79%, respectively. We found that the visual method and the fluorescence method were reliable for laboratory use to detect early-stage caries with equivalent accuracy.
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Affiliation(s)
- Mai Thi Giang Thanh
- Department of Clinical science, Hadong Medical College, Hanoi 100000, Vietnam;
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Ngo Van Toan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (N.V.T.); (D.T.T.T.)
- Hanoi Medical University Hospital, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Do Thi Thanh Toan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (N.V.T.); (D.T.T.T.)
| | - Nguyen Phu Thang
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Ngoc Quang Dong
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan;
- Department of Plastic, Reconstructive and Cosmetic Surgery, National Hospital of Odonto-Stomatology, Hanoi 100000, Vietnam
| | - Nguyen Tien Dung
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Phung Thi Thu Hang
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Le Quynh Anh
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
| | - Nguyen Thu Tra
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
- Correspondence: (N.T.T.); (V.T.N.N.); Tel.: +84-963-036-443 (N.T.T.); +84-945-786-868 (V.T.N.N.)
| | - Vo Truong Nhu Ngoc
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
- Correspondence: (N.T.T.); (V.T.N.N.); Tel.: +84-963-036-443 (N.T.T.); +84-945-786-868 (V.T.N.N.)
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Kamath KA, Nasim I, Rajeshkumar S. Evaluation of the re-mineralization capacity of a gold nanoparticle-based dental varnish: An in vitro study. J Conserv Dent 2021; 23:390-394. [PMID: 33623242 PMCID: PMC7883789 DOI: 10.4103/jcd.jcd_315_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/28/2020] [Accepted: 09/19/2020] [Indexed: 11/04/2022] Open
Abstract
Background Dental caries is an infectious microbial disease caused by acidogenic bacteria. It leads to the dissolution of enamel, dentin, and cementum. Enamel demineralization is often appreciated as' 'White Chalky lesions or Chalky enamel''. Standard procedures for protection of these teeth are fissure sealing and topical fluoride application. A varnish is generally a material in which a resin such as copal is dissolved within an organic solvent such as ethanol. Gold is one of the most biocompatible dental materials. Gold nanoparticles were biosynthesised using aspartic acid in previous studies. Aim and Objectives To prepare a gold nanoparticle based dental varnish and to evaluate its re-mineralizing capacity. Materials and Methods Gold nanoparticle dental varnish was prepared using all the necessary constituents. This newly prepared dental varnish was compared with G.C Fuji/SnF2 dental varnish. Demineralizing capacity of the dental varnishes were analysed. The tooth specimens were prepared according to methodology and mounted on resin blocks. They were subjected to demineralization remineralization cycles. ICP-OES and Knoop Hardness tests were performed. Results AuNP dental varnish had a satisfactory remineralization effect on demineralised enamel. For calcium analysis, the AuNP group showed significantly more total calcium loss when compared to the SnF2 group (P < 0.05) and was statistically significant. For phosphorus analysis, AuNP group showed significantly greater net phosphorus loss compared to the SnF2 group (P < 0.05) and was statistically significant. It was also observed that the KHN increased more significantly in Group A (SnF2) as compared to Group B (AuNP) and was also statistically significant (P < 0.05). Conclusion AuNP dental varnish showed considerable re mineralizing property; however, it was not superior to dental varnishes like SnF2 dental varnish. Further research needs to be done in vitro to better modify the AuNP dental varnish before proceeding to in vivo studies.
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Affiliation(s)
- K Ajith Kamath
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India
| | - Iffat Nasim
- Department of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India
| | - S Rajeshkumar
- Department of Pharmacology and Nanomedicine, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, Tamil Nadu, India
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28
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Moriyama CM, Novaes TF, Ferreira FR, Moro BLP, Imparato JCP, Diniz MB, Braga MM, Mendes FM. What diagnostic strategy performs better for caries lesion detection on proximal surfaces of adolescents? Clin Oral Investig 2021; 25:3977-3986. [PMID: 33404759 DOI: 10.1007/s00784-020-03728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the performance of visual inspection alone and associated to radiographic and laser fluorescence (LF) methods in detecting non-evident caries lesions at adolescents' proximal surfaces. MATERIALS AND METHODS Adolescents (12 to 17 years old) were assessed for the presence of caries lesions through visual inspection, radiographic examination, and LF method (DIAGNOdent pen), at non-cavitated (NC) and cavitated lesion (CAV) thresholds. Temporary separation with orthodontic rubbers followed by direct visual inspection was the reference standard method. Two examiners conducted the examinations, and the first examiner reassessed around 20% of the sample, to evaluate inter- and intra-examiner reproducibility, respectively. Sensitivity, specificity, accuracy, and utility values were calculated for the methods alone and combined with visual inspection using two different strategies: simultaneous and sequential combination. RESULTS A total of 834 proximal surfaces (51 adolescents) were included. Visual inspection presented higher reproducibility values (higher than 0.98). Moreover, visual inspection presented higher sensitivity (around 0.51) than those obtained with other diagnostic strategies (varying from 0.09 to 0.20) at the NC threshold. For CAV, visual inspection presented higher specificity (0.996) than the sequential association with adjunct methods (around 0.97), but with lower sensitivity. Accuracy and utility values for combined strategies were similar or lower than those achieved with the visual inspection performed alone. CONCLUSION Visual inspection alone performs better for detecting caries lesions in premolars and molars of adolescents than other diagnostic strategies. CLINICAL RELEVANCE The best diagnostic strategy for caries detection of proximal caries lesions in adolescents is the visual inspection alone.
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Affiliation(s)
- Caroline M Moriyama
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Metropolitan University of Santos, Av Conselheiro Nebias, 536, Santos, 11045-003, Brazil
| | - Tatiane F Novaes
- School of Dentistry, Cruzeiro do Sul University, R. Galvao Bueno, 868, São Paulo, 01506-000, Brazil
| | - Fernanda R Ferreira
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Bruna Lorena P Moro
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Michele B Diniz
- School of Dentistry, Cruzeiro do Sul University, R. Galvao Bueno, 868, São Paulo, 01506-000, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil. .,Faculdade de Odontologia da Universidade de São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
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Jung EH, Jun MK. Relationship between an Oral Health Risk Assessment Using a Salivary Multi-Test System and Woman's Subjective Oral Health Symptoms and Sleep Disorder. TOHOKU J EXP MED 2021; 254:213-219. [PMID: 34334536 DOI: 10.1620/tjem.254.213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Saliva is used as a diagnosis and monitoring tool for various diseases because it can maintain the balance of the oral ecosystem and reflect the physiological and pathological state of the body. Because women suffer more fatigue than men because of physiological, psychological, and social factors, individual management strategies are needed to evaluate mental health and oral diseases. Therefore, this study examined the oral health risk level from seven saliva factors using a saliva multi-test system for adult women to confirm the possibility of screening for sleep disorders. The saliva of 83 adult female participants was surveyed along with a self-reported questionnaire consisting of seven subjective oral health symptoms and three questions about sleep disorders. Seven saliva factors were evaluated using the saliva multi-test system (SiLL-Ha ST-4910) to assess the oral health risk levels. In the tooth health risk groups, the acidity was high, while the buffering capacity was low (p < 0.001). The periodontal health risk groups showed significant differences in acidity, occult blood, leukocytes, proteins, and ammonia (p < 0.05). The oral malodor risk group had higher levels of cariogenic bacteria, occult blood, leukocytes, and ammonia (p < 0.05). In groups with 'irregular sleep times' and 'insomnia', the acidity was high, and the buffering capacity was low (p < 0.001). This study confirmed the relevance of saliva factors and sleep disorder. Therefore, an evaluation using saliva was confirmed for oral health risk assessments and as an early screening tool for sleep disorders.
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Affiliation(s)
- Eun-Ha Jung
- Department of Dental Hygiene, Yonsei University
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Berti GO, Abanto J, Cordeschi T, Oliveira GS, Saads T, BÖnecker M. Follow-up interval for dental appointments: a randomized clinical trial with children with low caries risk. Braz Oral Res 2020; 35:e014. [PMID: 33331406 DOI: 10.1590/1807-3107bor-2021.vol35.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/15/2020] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to evaluate the effect of different follow-up consultation intervals on caries incidence in children with low caries risk. The study was composed of 224 children aged between 3 and 5 years and with low risk of caries. The children were randomly allocated into two groups, according to two different follow-up consultation intervals: Group 1 (G1) - 12-month follow-up interval; Group 2 (G2) - 18-month follow-up interval. All oral clinical examinations were performed by a single examiner who was previously calibrated and blinded in relation to the study groups. An external dentist provided the advice on oral hygiene and diet and evaluated the children's socioeconomic conditions. The Chi-square and Mann-Whitney tests were used to evaluate the differences between groups. Poisson regression analyses were performed to assess the association of caries incidence with the other variables. At the end of the study there was a significant difference between the groups regarding initial active lesions (p = 0.012), and children in G2 were at a higher risk of developing initial active lesions than those in G1 (p = 0.047). Children who had a higher number of teeth with initial active lesions in the follow-up consultations were at a higher risk of developing cavitated dentin caries (p = 0.001). Both follow-up intervals are justifiable. Although significant results have been observed for initial active caries lesions within the 18-month follow-up interval, it should be noted that these lesions can be treated using just preventive measures. Besides, different return interval had no effect in cavitated dentin lesions.
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Affiliation(s)
- Gabriela Oliveira Berti
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, São Paulo, SP, Brazil
| | - Jenny Abanto
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, São Paulo, SP, Brazil
| | - Thais Cordeschi
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, São Paulo, SP, Brazil
| | - Gabriela Sá Oliveira
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, São Paulo, SP, Brazil
| | - Thiago Saads
- University of Bern, Department of Restorative, Preventive and Pediatric Dentistry, Bern, Switzerland
| | - Marcelo BÖnecker
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, São Paulo, SP, Brazil
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Gao SS, Chen KJ, Duangthip D, Wong MCM, Lo ECM, Chu CH. Arresting early childhood caries using silver and fluoride products - A randomised trial. J Dent 2020; 103:103522. [PMID: 33166594 DOI: 10.1016/j.jdent.2020.103522] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/31/2020] [Accepted: 11/04/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE The aim of this randomised non-inferiority clinical trial was to compare the effectiveness of semi-annual (every six months) applications of 25 % silver nitrate (AgNO3) solution followed by 5 % sodium fluoride (NaF) varnish to semi-annual applications of 38 % silver diamine fluoride (SDF) solution in arresting early childhood caries (ECC). METHODS Three-year-old children with active cavitated carious lesions were recruited and randomly assigned to two intervention groups. Children in Group A received semi-annual applications of 25 % AgNO3 solution followed by 5 % NaF varnish on carious lesions. Children in Group B received semi-annual applications of 38 % SDF solution followed by a placebo varnish. One trained dentist assessed ECC status at baseline and in all follow-up examinations. An independent operator performed the interventions. The dentist, the children, and their caretakers were blinded to the intervention allocation. Data were analysed using a non-inferiority test. Group A's non-inferiority would be accepted if the lower limit of the 95 % confidence interval (CI) for the difference in the mean number of arrested decayed surfaces (ds) was greater than -0.5. RESULTS At baseline, 1,070 children were recruited, and 535 children were assigned to each group. After 30 months, the mean arrested ds in Groups A (n = 447) and B (n = 433) were 3.7 ± 3.6 and 3.6 ± 3.7, respectively (p = 0.694). The difference in the mean arrested ds between the two groups was 0.088 (95 % CI: -0.351 to 0.526). CONCLUSION Semi-annual application of 25 % AgNO3 followed by 5 % NaF is at least as effective as the semi-annual application of 38 % SDF in arresting ECC. CLINICAL SIGNIFICANCE Silver and fluoride products are effective in arresting caries. As a simple, non-invasive, and inexpensive strategy, it can be used in young children, elderly adults, and people with special needs.
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Affiliation(s)
| | - Kitty Jieyi Chen
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | | | | | | | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
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Miyamoto N, Adachi T, Boschetto F, Zanocco M, Yamamoto T, Marin E, Somekawa S, Ashida R, Zhu W, Kanamura N, Nishimura I, Pezzotti G. Molecular Fingerprint Imaging to Identify Dental Caries Using Raman Spectroscopy. MATERIALS 2020; 13:ma13214900. [PMID: 33142858 PMCID: PMC7662967 DOI: 10.3390/ma13214900] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 12/11/2022]
Abstract
Tooth loss impairs mastication, deglutition and esthetics and affects systemic health through nutritional deficiency, weight loss, muscle weakness, delayed wound healing, and bone fragility. Approximately 90% of tooth loss is due to dental caries and periodontal disease. Accordingly, early treatment of dental caries is essential to maintaining quality of life. To date, the clinical diagnosis of dental caries has been based on each dentist’s subjective assessment, but this visual method lacks objectivity. To improve diagnostic ability, highly sensitive quantitative methods have been developed for the diagnosis and prevention of dental caries and are gradually becoming a mandatory item in modern dentistry. High-resolution Raman spectroscopy is a suitable tool for recognizing the subtle structural changes that occur in dental enamel in already developed or, more importantly, incipient dental caries. Raman analysis could soon emerge as a breakthrough in dentistry because of its high diagnostic sensitivity. In this study, we build upon our previous findings in a new analysis of dental caries using Raman spectroscopy imaging and discuss the possibility of using Raman photonic imaging in support of objective diagnostics in dentistry. Our findings support the Raman method of caries detection in comparison with other conventional or new approaches.
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Affiliation(s)
- Nao Miyamoto
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan; (N.M.); (F.B.); (T.Y.); (E.M.); (N.K.)
- Infectious Diseases, Kyoto Prefectural University of Medicine, Kamigyo-ku, 465 Kajii-cho, Kyoto 602-8566, Japan
| | - Tetsuya Adachi
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan; (N.M.); (F.B.); (T.Y.); (E.M.); (N.K.)
- Dentistry, Kyoto Prefectural Rehabilitation Hospital for Mentally and Physically Disabled, Naka Ashihara, Johyo City, Kyoto 610-0113, Japan
- Correspondence: (T.A.); (G.P.); Tel.: +81-75-251-5641 (T.A.); +81-75-724-7568 (G.P.)
| | - Francesco Boschetto
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan; (N.M.); (F.B.); (T.Y.); (E.M.); (N.K.)
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, Kyoto 606-8585, Japan; (M.Z.); (W.Z.)
- Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, 465 Kajii-cho, Kyoto 602-8566, Japan
| | - Matteo Zanocco
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, Kyoto 606-8585, Japan; (M.Z.); (W.Z.)
- Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, 465 Kajii-cho, Kyoto 602-8566, Japan
| | - Toshiro Yamamoto
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan; (N.M.); (F.B.); (T.Y.); (E.M.); (N.K.)
| | - Elia Marin
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan; (N.M.); (F.B.); (T.Y.); (E.M.); (N.K.)
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, Kyoto 606-8585, Japan; (M.Z.); (W.Z.)
| | - Shota Somekawa
- ShinSei Co., Ltd., Hiramori Okubo-cho, Uji-shi, Kyoto 611-0033, Japan; (S.S.); (R.A.)
| | - Ryutaro Ashida
- ShinSei Co., Ltd., Hiramori Okubo-cho, Uji-shi, Kyoto 611-0033, Japan; (S.S.); (R.A.)
| | - Wenliang Zhu
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, Kyoto 606-8585, Japan; (M.Z.); (W.Z.)
| | - Narisato Kanamura
- Department of Dental Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan; (N.M.); (F.B.); (T.Y.); (E.M.); (N.K.)
| | - Ichiro Nishimura
- Division of Oral Biology and Medicine, The Jane and Jerry Weintraub Center for Re-constructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095, USA;
- Division of Advanced Prosthodontics, The Jane and Jerry Weintraub Center for Re-constructive Biotechnology, UCLA School of Dentistry, Los Angeles, CA 90095, USA
| | - Giuseppe Pezzotti
- Ceramic Physics Laboratory, Kyoto Institute of Technology, Sakyo-ku, Matsugasaki, Kyoto 606-8585, Japan; (M.Z.); (W.Z.)
- Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, 465 Kajii-cho, Kyoto 602-8566, Japan
- Correspondence: (T.A.); (G.P.); Tel.: +81-75-251-5641 (T.A.); +81-75-724-7568 (G.P.)
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Pontes LRA, Novaes TF, Lara JS, Gimenez T, Moro BLP, Camargo LB, Michel-Crosato E, Pannuti CM, Raggio DP, Braga MM, Mendes FM. Impact of visual inspection and radiographs for caries detection in children through a 2-year randomized clinical trial: The Caries Detection in Children-1 study. J Am Dent Assoc 2020; 151:407-415.e1. [PMID: 32450979 DOI: 10.1016/j.adaj.2020.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/02/2020] [Accepted: 02/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Visual inspection (VIS) with radiographic examination (RAD) is the recommended diagnostic strategy for detecting caries in children; however, this recommendation is based on accuracy studies. The authors conducted a clinical trial to compare the detection and subsequent treatment of carious lesions in primary molars performed with VIS alone and with RAD. METHODS Children (3-6 years old) were randomly assigned to 2 groups according to the diagnostic strategy used for caries detection on primary molars: VIS or RAD. Participants were diagnosed and treated according to the management plan related to the allocated group. The primary outcome was the number of new operative interventions during the 2-year follow-up period. Other secondary outcomes were also compared. Comparisons were performed with Mann-Whitney test using an intention-to-treat approach. RESULTS Of the 252 children included and randomized, 216 were followed-up after 2 years (14.3% attrition rate). There was no difference between the groups for the primary outcome (P = .476). For the secondary outcomes, the RAD group had more restoration replacements (P = .038) and more restorations performed since the beginning of the study (P = .038) compared with the VIS group. In addition, the RAD group had a higher number of false-positive results than the VIS group (P < .001). CONCLUSIONS Simultaneous use of VIS and RAD for caries diagnosis in primary molars of children who seek dental treatment does not provide additional benefits compared with VIS alone. PRACTICAL IMPLICATIONS Dentists should perform VIS only, not RAD, for detecting carious lesions in preschool-aged children. ClinicalTrials.gov: NCT02078453.
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De Zutter M, Vandenbulcke JD, Van Acker JWG, Martens LC. In vivo correlation of near-infrared transillumination and visual inspection with bitewing radiography for the detection of interproximal caries in permanent and primary teeth. Eur Arch Paediatr Dent 2020; 21:509-518. [PMID: 32519275 DOI: 10.1007/s40368-020-00538-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 05/03/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate near-infrared light transillumination (NILT) for interproximal caries detection in children by comparing the correlation between both NILT and visual inspection (ICDAS) with bitewing (BW) radiography and by investigating possible differences in caries detection with NILT between primary and permanent teeth. METHODS From 35 patients, 121 and 63 interproximal surfaces in, respectively, primary and permanent teeth were included. NILT images were obtained using DIAGNOcam™ (KaVo) and scored by two calibrated raters. A consensus diagnosis was reached for BW radiography; whereas, the ICDAS scores were obtained by one calibrated rater. Weighted Kappa (wκ) was used to evaluate inter- and intra-rater reliability of NILT and to evaluate the correlation between NILT, ICDAS and BW radiography. RESULTS The correlation between NILT and BW radiography was moderate to substantial for primary teeth [Rater 1: wκ = 0.61 (95% CI = 0.49-0.75), Rater 2: wκ = 0.55 (95% CI = 0.41-0.69)] and fair for permanent teeth [Rater 1: wκ = 0.34 (95% CI = 0.15-0.53), Rater 2: wκ = 0.33 (95% CI = 0.08-0.58)]. The correlation between ICDAS and BW radiography was moderate for primary teeth [wκ = 0.49 (95% CI = 0.35-0.63)] and substantial for permanent teeth [wκ = 0.62 (95% CI = 0.32-0.92)]. No significant differences were found between primary and permanent teeth. CONCLUSION NILT cannot be recommended as a single diagnostic tool for interproximal caries detection in primary teeth. The number of false negatives for dentine caries, especially in first primary molars, was too high. For the use in permanent teeth, NILT could be more accurate than BW radiography.
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Affiliation(s)
- M De Zutter
- Department Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - J D Vandenbulcke
- Department Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - J W G Van Acker
- Department Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - L C Martens
- Department Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
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Hong RY, Kwon S, Steffensen B, Jain S, Levi PA. Diagnosing periodontal and dental indicators with horizontal and vertical bitewing radiographs. J Dent Educ 2020; 84:552-558. [PMID: 32022927 DOI: 10.1002/jdd.12046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/23/2019] [Accepted: 12/17/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE The aim of this study is to compare information provided by the 2 orientations of bitewing radiographs, horizontal (HBW) and vertical (VBW) taken in a dental school. METHODS AND MATERIALS Radiographic records were reviewed at Tufts University School of Dental Medicine (TUSDM) for patients showing posterior bone loss who had both HBW and VBW. 320 records were reviewed with 6 criteria: visibility of crestal bone from the distal of the cuspids to the distal of the most posterior tooth, visibility of horizontal or angular bone loss, the crestal density of bone, visibility of interproximal contact areas, visibility of the entire anatomical crown, and visibility of furcations. RESULTS Significantly higher number of VBW compared with HBW (P < 0.0001) showed the levels of alveolar bone loss (52.81% vs. 3.75%), the type of loss (angular or horizontal) (50.94% vs. 3.75%), the crestal bone density (28.75% vs. 0.63%), the contact areas (20.63% vs. 14.38%), and the furcations (43.44% vs. 1.25%). A greater number of HBW showed the entire anatomical crown compared with VBW. No significant difference was detected in the number of radiographs taken per HBW and VBW set. CONCLUSION For patients with alveolar bone loss, VBW are superior to HBW when assessing bone levels, density, morphology, tooth furcations, and evaluating interproximal contact areas for caries. It is recommended that the vertical bitewing technique be taught as a standard in dental, dental hygiene, and dental assisting schools for adult patients showing evidence of posterior interdental bone loss.
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Affiliation(s)
- Richard Y Hong
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Stephen Kwon
- Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Bjorn Steffensen
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Shruti Jain
- Division of Biostatistics and Experimental Design, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
| | - Paul A Levi
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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de Oliveira Correia AM, Bühler Borges A, Torres CRG. Color masking prediction of posterior white spot lesions by resin infiltration in vitro. J Dent 2020; 95:103308. [PMID: 32112912 DOI: 10.1016/j.jdent.2020.103308] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/22/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To investigate parameters that could predict the color masking effect (ME) of white spot lesions (WSLs) after resin infiltration (RI). METHODS Sixty extracted human teeth with natural WSLs were selected (28 premolars, 29 molars and 3 incisors). At baseline, the laser fluorescence (LF) of surrounding sound enamel (SE) and the WSLs were analyzed with DIAGNOdent. Standardized photographs were obtained under D65 and UV illuminants, from which the CIE L*a*b* color coordinates and natural fluorescence (NF) of the WSLs and SE were obtained. The color difference (ΔE00) and differences of NF and LF between the SE and WSLs were calculated. The lesion dimensions (area, perimeter, width, and height) were determined. After RI, the assessments were repeated. ME was considered as the reduction of ΔE00 values after RI. One-way ANOVA and the Tukey tests were used to analyze the absolute means of the LF and NF values. The t test was used to compare the ΔE00 values and lesion dimensions before and after infiltration. The correlations between all parameters at baseline and ME were analyzed. RESULTS The absolute mean values of LF at the baseline (B) and after infiltration (I) were SE/B-3.98a, WSL/B-13.28c, SE/I-3.36a, WSL/I-7.95b (p = 0.001). The mean values for NF were SE/B-7.93a; WSL/B-6.29b, SE/I-7.93a, WSL/I-7.27a (p = 0.001). The results for ΔE00 were B-11.74a, I-8.66b (p = 0.001). RI significantly reduced lesion dimensions. No correlations were observed between the baseline parameters and the ME. CONCLUSIONS The WSLs presented higher LF and smaller NF than SE, which were respectively reduced and increased after RI. Prediction of the masking effect by the parameters evaluated at baseline was not possible, which could be due to the choice of mainly caries lesions in posterior teeth. Nonetheless, infiltration was found suitable to mask most of the WSL. CLINICAL SIGNIFICANCE The color masking effect of white spot lesions after resin infiltration cannot be predicted by a previous analysis of fluorescence, color, or dimensions of the lesion.
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Affiliation(s)
- Ayla Macyelle de Oliveira Correia
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Alessandra Bühler Borges
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
| | - Carlos Rocha Gomes Torres
- Department of Restorative Dentistry, Institute of Science and Technology, São Paulo State University - UNESP, São José dos Campos, São Paulo, Brazil.
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Angelino K, Yauney G, Rana A, Edlund D, Shah P. Digital reconstruction of teeth using near-infrared light. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:4414-4418. [PMID: 31946845 DOI: 10.1109/embc.2019.8857734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cone beam computed tomography has demonstrated value by offering enhanced conceptualization of features of teeth in the 3D space. However, these systems require higher effective radiation doses to image teeth. Previous research from our group has used non-ionizing near-infrared (NIR) light for diagnosing demineralization and caries in human tooth enamel. However, use of safe NIR radiation for rapid, 3D imaging of tooth anatomy has not been described previously. Here we describe a optical setup to rapidly laser scan teeth ex vivo using 1310nm NIR laser diode. We also detail a novel process that uses laser scanning to create stacks of images of extracted teeth, and construct highly accurate 3D models. Our 3D reconstructive models offer promising starting points to recover anatomical details using pixel intensities within these images as projection data to diagnose carious lesions, and can assist in providing rapid and affordable technology-enabled early caries screenings to patients.
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Ro JH, Bang JJ, Kim YI, Lee DJ, Ko CC, Garcia-Godoy F, Kwon YH. Spectral characteristics of caries autofluorescence obtained from different locations and caries severities. JOURNAL OF BIOPHOTONICS 2020; 13:e201900224. [PMID: 31568652 DOI: 10.1002/jbio.201900224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/12/2019] [Accepted: 09/15/2019] [Indexed: 06/10/2023]
Abstract
Dental caries usually occurs at interproximal and occlusal surfaces. The purpose of the present study was to determine if characteristic spectral factors extracted from autofluorescence (AF) spectra are informative regarding caries detection and the determination of caries stage as compared with DIAGNOdent results. AF spectra were obtained from caries lesions of different severities at two locations using a 405 nm laser. Three spectral factors, that is, spectral slope at 550 to 600 nm, spectral area under the curve at 500 to 590 nm and two-peak ratio between 625 and 667 nm, were extracted. The values of three spectral factors linearly decreased as caries progressed. According to micro-CT images, conventional visual and tactile inspections of lesions under or overestimated (25%-65%) caries states, and brown or thickly stained layer on interproximal or occlusal surfaces, respectively, caused misclassifications of caries stage. Of the spectral factors examined, spectral slope and area under curve for interproximal and occlusal surfaces, respectively, were found to be significantly related to caries stage and showed least data overlap. For interproximal and occlusal surfaces, DIAGNOdent readings of different stages overlapped considerably though their mean values were significantly different regardless of stage.
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Affiliation(s)
- Jung Hoon Ro
- Department of Biomedical Engineering, School of Medicine, Pusan National University; Biomedical Research Institute, Pusan National University Hospital, Yangsan, South Korea
| | - John J Bang
- Department of Environmental, Earth and Geospatial Sciences, North Carolina Central University, Durham, North Carolina
| | - Yong-Il Kim
- Department of Orthodontics, School of Dentistry, Pusan National University, Yangsan, South Korea
| | - Dong-Joon Lee
- School of Dentistry, NC Oral Health Institute, University of North Carolina, Chapel Hill, North Carolina
| | - Ching-Chang Ko
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, North Carolina
| | - Franklin Garcia-Godoy
- Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Yong Hoon Kwon
- Department of Dental Materials, School of Dentistry, Pusan National University, Yangsan, South Korea
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Khattak MI, Csikar J, Vinall K, Douglas G. The views and experiences of general dental practitioners (GDP's) in West Yorkshire who used the International Caries Detection and Assessment System (ICDAS) in research. PLoS One 2019; 14:e0223376. [PMID: 31584966 PMCID: PMC6777823 DOI: 10.1371/journal.pone.0223376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 09/19/2019] [Indexed: 11/19/2022] Open
Abstract
Objective To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries. Methods This qualitative study involved one on one interviews with eight GDP’s who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis. Results GDP’s indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care. Conclusion The GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals’ caries management, including appropriate recording of diagnosis and risk assessment.
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Affiliation(s)
- Maria Ishaq Khattak
- School of Dentistry, University of Leeds, Leeds, United Kingdom
- Institute of Public Health & Social Sciences, Khyber Medical University, Khyber Pakhtunkhwa, Peshawar, Pakistan
- * E-mail:
| | - Julia Csikar
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Karen Vinall
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Gail Douglas
- School of Dentistry, University of Leeds, Leeds, United Kingdom
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Gupta N, Sandhu M, Sachdev V, Jhingan P. Comparison of Visual Examination and Magnification with DIAGNOdent for Detection of Smooth Surface Initial Carious Lesion-Dry and Wet Conditions. Int J Clin Pediatr Dent 2019; 12:37-41. [PMID: 31496570 PMCID: PMC6710936 DOI: 10.5005/jp-journals-10005-1588] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study was to assess the effectiveness and reliability of magnification, DIAGNOdent in detection of smooth surface white spot lesions. Study design Three hundred children aged 5–10 years were examined by two examiners for presence of smooth surface white spot lesions using naked eye and magnifying loupes in wet and dry conditions followed by DIAGNOdent analysis. Data was analysed using Cohen's kappa coefficient, Friedman test and Paired t test. Accuracy was assessed by sensitivity and positive predicted values. Results Significant difference was found between naked eyes and magnifying loupes with and without air drying. While insignificant difference was found between DIAGNOdent and loupes. Conclusion Magnifying loupes with air drying is an effective method in detection of smooth surface white spot lesion. Clinical significance With the increased knowledge about the pathogenesis of dental caries and its ability to be remineralisable if detected early, makes it all the more important for the clinician to be vigilant in detection of early lesion to prevent the avoidable restorative approach for the same. Incorporation of magnification to routine dental examination by general dentist can help in early diagnosis and treatment of dental decay. This could prevent further progression of dental caries and reduces the incidence of tooth decay How to cite this article Gupta N, Sandhu M, et al. Comparison of Visual Examination and Magnification with DIAGNOdent for Detection of Smooth Surface Initial Carious Lesion—Dry and Wet Conditions. Int J Clin Pediatr Dent 2019;12(1):37–41.
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Affiliation(s)
- Noopur Gupta
- Department of Pedodontics and Preventive Dentistry, ITS-CDSR, Ghaziabad, Uttar Pradesh, India
| | - Meera Sandhu
- Department of Pedodontics and Preventive Dentistry, ITS-CDSR, Ghaziabad, Uttar Pradesh, India
| | - Vinod Sachdev
- Department of Pedodontics and Preventive Dentistry, ITS-CDSR, Ghaziabad, Uttar Pradesh, India
| | - Pulkit Jhingan
- Department of Pedodontics and Preventive Dentistry, ITS-CDSR, Ghaziabad, Uttar Pradesh, India
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Effects of Fluoride and Calcium Phosphate Materials on Remineralization of Mild and Severe White Spot Lesions. BIOMED RESEARCH INTERNATIONAL 2019; 2019:1271523. [PMID: 31317022 PMCID: PMC6601497 DOI: 10.1155/2019/1271523] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 05/27/2019] [Indexed: 11/17/2022]
Abstract
Fixed orthodontic treatments often lead to enamel demineralization and cause white spot lesions (WSLs). The aim of this study was to evaluate the mineralization degree of 2 types of WSLs based on ICDAS index and compare the remineralizing efficacy of 3 oral hygiene practices after 1 month and 3 months. 80 mild demineralized and 80 severe demineralized enamel specimens were randomized into three treatments: fluoride toothpaste (FT), fluoride varnish plus fluoride toothpaste (FV+FT), and CPP-ACP plus fluoride toothpaste (CPP-ACP+FT). Microhardness tester, DIAGNODent Pen 2190, and scanning electron microscope were used to evaluate the changes of mineralization degree. Both qualitative and quantitative indicators suggested that the mild and severe white spot lesions were different in the degree of mineralization. Severe WSLs demineralized much more seriously than mild lesions even after 3 months of treatment. Despite the variation in severity, both lesions had the same variation trend after each measure was applied: FT had weak therapeutic effect, FV + FT and CPP-ACP + FT were effective for remineralization. Their remineralizing efficacy was similar after 1 month, and combined use of CPP-ACP plus F toothpaste was more effective after 3 months. In order to fight WSLs, early diagnosis was of great importance, and examination of the tooth surface after air-dry for 5 seconds was recommended. Also, when WSLs were found, added remineralizing treatments were required.
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Turchiello RZ, Pedrotti D, Braga MM, Rocha RO, Rodrigues JA, Lenzi TL. Do undergraduate dental students perform well detecting and staging caries and assessing activity by visual examination? A systematic review and meta-analysis. Int J Paediatr Dent 2019; 29:281-293. [PMID: 30620110 DOI: 10.1111/ipd.12463] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/10/2018] [Accepted: 12/12/2018] [Indexed: 11/26/2022]
Abstract
AIM To assess the undergraduate students' performance in detecting and staging caries and assessing activity using visual inspection. DESIGN Two independent reviewers searched the literature through PubMed/MEDLINE, Scopus, Lilacs databases, and OpenSINGLE. Meta-analyses summarized the results concerning reproducibility and accuracy at D1 (considering all lesions) and D3 (including only cavitated lesions or lesions into dentin) levels. For activity, we considered sound surfaces plus inactive caries lesions vs active lesions. Meta-regression assessed the effect of methodological variables on the outcomes. RESULTS Fourteen studies were included. The mean reproducibility values were ≥0.52, except for interexaminer agreement when assessing caries activity (0.39; 95% CI 0.10-0.67). The intra-examiner reproducibility tended to be higher than the interexaminer reproducibility. Overall, undergraduate students' performance in staging caries lesions using visual examination was good (AUC>0.85 and DOR>25). The sensitivity values were moderate; however, these were associated with excellent specificity values. Despite few pooled studies, caries activity assessment revealed moderate overall performance, with lower pooled sensitivity than pooled specificity. Students' education level and background clinical experience had no influence on the accuracy and reproducibility of the visual inspection. CONCLUSION Undergraduate students' performance in detecting and staging caries using visual inspection was good, although caries activity assessment still requires improvement.
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Affiliation(s)
- Ronairo Z Turchiello
- Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Djessica Pedrotti
- Graduate Program in Dental Science, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Mariana M Braga
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - Rachel O Rocha
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil
| | - Jonas A Rodrigues
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tathiane L Lenzi
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Reliability of colour and hardness clinical examinations in detecting dentine caries severity: a systematic review and meta-analysis. Sci Rep 2019; 9:6533. [PMID: 31024013 PMCID: PMC6484026 DOI: 10.1038/s41598-019-41270-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 02/19/2019] [Indexed: 11/26/2022] Open
Abstract
Dental caries is the most common human infectious disease and is caused by microorganisms producing acids, resulting in changes in dental tissue hardness and colour. However, the accuracy and reliability of dentine colour and hardness as indicators for carious lesion severity has never been assessed in a systematic review. By applying strict criteria, only seven papers (five randomized control trials and two diagnostic studies) were considered for full text qualitative and quantitative assessment. Only three studies produced high quality evidence and only four articles were considered for meta-analysis, as these provided log10 colony forming units (CFU) data from caries biopsies following colour and hardness clinical examinations. When comparing the amount of CFU isolated from carious biopsies from different colour and hardness categories, hardness clinical examination was found to be a statistically more discriminate test than colour clinical examination. Therefore, hardness clinical examination is more specific and reliable than colour to detect dentine carious lesion severity. Further large carefully designed clinical studies are needed to consolidate the findings of this systematic review.
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NouhzadehMalekshah S, Fekrazad R, Bargrizan M, Kalhori KA. Evaluation of laser fluorescence in combination with photosensitizers for detection of demineralized lesions. Photodiagnosis Photodyn Ther 2019; 26:300-305. [PMID: 30914391 DOI: 10.1016/j.pdpdt.2019.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 02/08/2019] [Accepted: 03/22/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Early detection of caries plays an important role in its prognosis. This study sought to assess the efficacy of laser fluorescence alone and in combination with photosensitizers for detection of demineralized smooth-surface lesions of permanent teeth. MATERIALS AND METHODS This in vitro experimental study was conducted on 60 extracted sound premolars. Four windows measuring 2 x 2 mm were created on each tooth. Forty out of 60 teeth were subjected to demineralization cycle. All teeth were then sectioned and subjected to DIAGNOdent Pen (Kavo, Biberach, Germany) alone and in combination with 0.2-mM tetrakis N-methylpyridyl porphyrin (TMPyP) fluorescent dye, 2% methylene blue and 2% new methylene blue photosensitizers. The results of histological analysis of sections served as the gold standard. The correlation of the results with the gold standard was assessed using the Pearson's correlation coefficient and receiver operating characteristic (ROC) curve. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the four techniques were evaluated as well. RESULTS The correlation between the results of DIAGNOdent laser with TMPyP dye and the gold standard was significant (P < 0.05). Also, this technique had the highest sensitivity while DIAGNOdent laser alone had the highest specificity. CONCLUSION Laser fluorescence with TMPyP fluorescent dye has suitable efficacy for early detection of initial enamel lesions.
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Affiliation(s)
| | - Reza Fekrazad
- Department of Periodontology, Dental School- Laser research center in medical Sciences, AJA University of Medical Sciences, Tehran, Iran; International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Majid Bargrizan
- Associate Professor of Pedodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Lee RC, Zhou Y, Finkleman S, Sadr A, Seibel EJ. Near-Infrared Imaging of Artificial Enamel Caries Lesions with a Scanning Fiber Endoscope. SENSORS (BASEL, SWITZERLAND) 2019; 19:E1419. [PMID: 30909442 PMCID: PMC6471210 DOI: 10.3390/s19061419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/12/2019] [Accepted: 03/20/2019] [Indexed: 12/02/2022]
Abstract
Several studies have shown that near-infrared imaging has great potential for the detection of dental caries lesions. A miniature scanning fiber endoscope (SFE) operating at near-infrared (NIR) wavelengths was developed and used in this study to test whether the device could be used to discriminate demineralized enamel from sound enamel. Varying depths of artificial enamel caries lesions were prepared on 20 bovine blocks with smooth enamel surfaces. Samples were imaged with a SFE operating in the reflectance mode at 1310-nm and 1460-nm in both wet and dry conditions. The measurements acquired by the SFE operating at 1460-nm show significant difference between the sound and the demineralized enamel. There was a moderate positive correlation between the SFE measurements and micro-CT measurements, and the NIR SFE was able to detect the presence of demineralization with high sensitivity (0.96) and specificity (0.85). This study demonstrates that the NIR SFE can be used to detect early demineralization from sound enamel. In addition, the NIR SFE can differentiate varying severities of demineralization. With its very small form factor and maneuverability, the NIR SFE should allow clinicians to easily image teeth from multiple viewing angles in real-time.
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Affiliation(s)
- Robert C Lee
- Department of Orthodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Yaxuan Zhou
- Human Photonics Lab, Department of Mechanical Engineering, University of Washington, 4000 Mason St, Seattle, WA 98195, USA.
- Department of Electrical and Computer Engineering, University of Washington, 185 E Stevens Way NE, Seattle, WA 98195, USA.
| | - Sara Finkleman
- Department of Orthodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Alireza Sadr
- Department of Orthodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
- Biomimetics Biomaterials Biophotonics & Technology (B4T) Lab, Department of Restorative Dentistry, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Eric J Seibel
- Department of Orthodontics, School of Dentistry, University of Washington, 1959 NE Pacific St, Seattle, WA 98195, USA.
- Human Photonics Lab, Department of Mechanical Engineering, University of Washington, 4000 Mason St, Seattle, WA 98195, USA.
- Department of Electrical and Computer Engineering, University of Washington, 185 E Stevens Way NE, Seattle, WA 98195, USA.
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Qudeimat MA, Altarakemah Y, Alomari Q, Alshawaf N, Honkala E. The impact of ICDAS on occlusal caries treatment recommendations for high caries risk patients: an in vitro study. BMC Oral Health 2019; 19:41. [PMID: 30845943 PMCID: PMC6407207 DOI: 10.1186/s12903-019-0730-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 02/25/2019] [Indexed: 11/24/2022] Open
Abstract
Background The diagnostic criteria and tools used in caries lesion detection have been shown to affect the decision-making for caries treatment. Compared to other diagnostic criteria/classifications, ICDAS has been shown to provide a more accurate method for the detection of occlusal caries lesions. The influence of using ICDAS on caries treatment recommendations has received increasing attention in recent years. Therefore, the aim of this study was to assess the impact of ICDAS on dentists’ occlusal caries lesions’ treatment decisions for patients at high risk for caries. Methods Five dentists examined the occlusal surfaces of 270 extracted premolars and permanent molars. For a predetermined clinical scenario, the examiners were asked to indicate their treatment recommendations for each tooth. Four weeks later, all the examiners were trained and calibrated for the use of ICDAS. Then the investigators examined the same 270 teeth independently and indicated their treatment recommendations using the same clinical scenario. Histological validation was used to determine the caries lesions detection performance of the examiners using ICDAS and to assess the relationship between the presence of dentin caries and treatment recommendations for each examiner before and after ICDAS training. Specificity, sensitivity, area under the receiver operating characteristic curve (AUC), and Spearman’s correlation coefficients were calculated. The Wilcoxon two-related sample rank test was used to test for differences between treatment recommendations. Results The strongest correlation for inter-examiner reproducibility was found between the ICDAS D2 cut-off point (ICDAS codes 3–6 as dentin caries) and histologic dentin caries. Treatment recommendations among different examiners before and after ICDAS training demonstrated a statistically significant increase in operative intervention and an increase in the percentage of overtreatment recommendations for two examiners. Conclusions The impact of ICDAS on the examiners’ caries lesion treatment recommendations varied among the dentists in this study. Treatment decision-making can be influenced by the caries lesion’s detection and classification system used.
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Affiliation(s)
- Muawia A Qudeimat
- Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, P.O.Box: 24923, Safat-13110, Kuwait, Kuwait.
| | | | - Qasem Alomari
- Department of Restorative Sciences, Kuwait University, Kuwait, Kuwait
| | - Nour Alshawaf
- Department of General Dental Practice, Kuwait University, Kuwait, Kuwait
| | - Eino Honkala
- Institute of Clinical Dentistry, UiT, The Arctic University of Norway, Tromsø, Norway
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Impact of the radiographic method on treatment decisions related to dental caries in primary molars: a before-after study. Clin Oral Investig 2019; 23:4075-4081. [PMID: 30778687 DOI: 10.1007/s00784-019-02844-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 02/07/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To evaluate the impact of radiographic examination on changes of treatment decision related to dental caries compared to decisions guided by visual inspection alone in primary molars. MATERIALS AND METHODS A total of 126 children aged 3-6 years who had sought dental assistance were randomly selected and examined by two calibrated examiners using visual inspection. A treatment plan regarding dental caries was generated based on this assessment. The same examiners then evaluated two bitewing radiographs, creating an additional treatment plan guided by concurrent assessment of both visual and radiographic methods. Occlusal and proximal surfaces of primary molars received a treatment decision as follows: (i) no treatment, (ii) non-operative treatment, and (iii) operative treatment. The frequency of changes in the treatment decision after radiographic examination was calculated, with subsequent Poisson multilevel regression analysis to evaluate variables influencing such changes. RESULTS Changes from "no treatment" decided with visual inspection to "non-operative treatment" after radiographic evaluation occurred in 52 surfaces (3.2%), and changes to "operative treatment" were observed in 46 dental surfaces (2.8%). Furthermore, 50 surfaces (6.2%) had their treatment decision changed from non-operative to operative treatment after radiographic assessment. In addition, changes were significantly more frequent in children with higher caries experience, on proximal surfaces and in 1st primary molars. CONCLUSIONS The impact of radiographic examination on changes in the treatment decision of primary molars made with visual inspection is modest. Changes are more frequent in children with higher caries experience and in proximal surfaces. CLINICAL RELEVANCE The benefits of the radiographic method for detecting caries in children, as a protocol in the diagnostic process, seem to be overestimated; the impact of this method on changes in treatment decision made by visual examination alone is low. Radiographs could be, however, useful in particular conditions, such as in children with high caries experience.
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Gao SS, Duangthip D, Wong MCM, Lo ECM, Chu CH. Randomized Trial of Silver Nitrate with Sodium Fluoride for Caries Arrest. JDR Clin Trans Res 2019; 4:126-134. [PMID: 30931709 DOI: 10.1177/2380084418818482] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES The aim of this noninferiority double-blind randomized clinical trial was to compare the effectiveness of the topical semiannual application of a 25% silver nitrate (AgNO3) solution followed by a 5% sodium fluoride (NaF) varnish with that of a 38% silver diamine fluoride (SDF) solution in arresting caries among preschool children. METHODS Healthy 3-y-old children with active dentine carious lesions were randomly allocated to 2 groups via computer-generated random numbers. Lesions in group A received applications of a 25% AgNO3 solution followed by a 5% NaF varnish semiannually (every 6 mo). Lesions in group B received semiannual applications of a 38% SDF solution followed by a placebo varnish. A trained examiner recorded the status of caries and oral hygiene at baseline and during follow-up examinations. The examiner, children, and their caretakers were blinded to the intervention allocation. This study adopted an intention-to-treat analysis. A noninferiority test was conducted for the data analysis. Group A's noninferiority was accepted if the lower limit of the 95% CI for the difference in the mean number of arrested surfaces was >-0.5. RESULTS A total of 1,070 children were recruited at baseline, with 535 children in each group. After 18 mo, the mean ± SD number of arrested surfaces was 3.3 ± 3.4 in group A (n = 484) and 3.2 ± 3.5 in group B (n = 476; P = 0.664). The difference in the mean number of arrested surfaces between the groups was 0.092 (95% CI, -0.322 to 0.505). Apart from black staining on the arrested lesions, no other significant side effect was observed. CONCLUSION A semiannual application of 25% AgNO3 followed by 5% NaF is no worse than a 38% SDF in arresting dentine caries among preschool children over 18 mo. The Hong Kong Research Grants Council (GRF 17107315) funded this trial, which was registered at ClinicalTrials.gov (NCT02019160). KNOWLEDGE TRANSFER STATEMENT This randomized clinical trial found that silver nitrate solution followed by sodium fluoride varnish is effective in arresting dentine caries among preschool children. As silver nitrate followed by sodium fluoride is a noninvasive and simple protocol, it can be an alternative strategy to manage dental caries among young children, especially in countries where silver diamine fluoride is not available.
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Affiliation(s)
- S S Gao
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - D Duangthip
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - M C M Wong
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - E C M Lo
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - C H Chu
- 1 Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Is it feasible to use smartphone images to perform telediagnosis of different stages of occlusal caries lesions? PLoS One 2018; 13:e0202116. [PMID: 30188900 PMCID: PMC6126822 DOI: 10.1371/journal.pone.0202116] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/20/2018] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study was to compare the performance of two different models of smartphone and a conventional camera with that of direct clinical examination in detecting caries lesions at different stages of progression in deciduous molars. The photographic equipment consisted of two smartphones (iPhone and Nexus 4) and a conventional macro camera setup. First, in the laboratory phase of the study, we compared the images of 20 exfoliated primary teeth having caries lesions at different stages. Then, in the clinical phase of the study, the images of 119 primary molars from fifteen children (3 to 6 years old) were used. All of the photographic images were taken using the previously described devices. In both groups, two examiners, blinded to the photographic equipment used, assessed the images independently on a computer screen, and classified them according to the International Caries Detection and Assessment System (ICDAS). The teeth were then examined directly by two other experienced examiners, and the consensus reached was considered the reference standard. Parameters of validity, such as percentage of correct answers, agreement with the reference standard, sensitivity, specificity and inter-examiner agreement (using the weighted kappa test) were calculated. The examiners performed similarly in both in vitro and in vivo studies. Inter-examiner reliability was approximately 0.7 for all the devices in the laboratory setting, and for the macro camera photography system in the clinical setting, but it was approximately 0.9 for the iPhone and Nexus images taken in vivo. With regard to the percentage of correct answers, the highest values were observed for sound and extensive caries lesions in both laboratory and clinical settings. The percentage of correct answers for initial and moderate lesions was particularly low in the clinical evaluation, irrespective of the camera devices used. Therefore, we concluded that photographic diagnosis using smartphone images is feasible and accurate for distinguishing sound tooth surfaces from extensive caries lesions; however, photographic images are not a good method for accurately detecting initial and moderate caries lesions.
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