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R AbdELkader A, Hafez Ibrahim S, Elsayed Hassanein O. Reliability of impedance spectroscopy versus digital radiograph and ICDAS-II in occlusal caries detection: a prospective clinical trial. Sci Rep 2024; 14:16553. [PMID: 39019963 PMCID: PMC11255227 DOI: 10.1038/s41598-024-66627-4] [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: 02/29/2024] [Accepted: 07/03/2024] [Indexed: 07/19/2024] Open
Abstract
The traditional methods in early caries detection had many limitations. So, this study aimed to evaluate the clinical performance of alternating current impedance spectroscopy ACIST in comparison with digital radiograph and ICDAS-II in detection of occlusal carious lesions. Occlusal surfaces of molar and premolar teeth from 40 adult participants were examined by two observers using three diagnostic methods: (1) international caries detection and assessment system (ICDAS-II) (2) digital radiograph (DR) and (3) Cariescan Pro device (ACIST). Agreement analysis and the difference in sensitivities and specificities were evaluated. The results showed an excellent agreement in the different groups. The difference from the visual tactile against ACIST scoring for enamel caries detection, was statistically significant (p = 0.012) and the agreement was moderate (k = 0.509). For dentinal caries the difference was not statistically significant (p > 0.05) and the agreement was similarly moderate (k < 0.6). The difference from the digital radiograph against ACIST scoring, for enamel caries, digital radiography had significantly higher sensitivity and specificity than ACIST (p < 0.001) while for dentinal caries detection and overall, ACIST had higher sensitivity and digital radiography had higher specificity and the difference was statistically significant (p < 0.001). Visual-tactile examination is a considered as feasible and valid technique for occlusal caries detection, digital radiography is superior to ACIST in diagnosing enamel caries, but it could underestimate the caries depth, ACIST is a reliable tool for detecting occlusal caries in dentin.
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Affiliation(s)
- Amr R AbdELkader
- Department of Conservative dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt
- Faculty of Dentistry, Ahram Canadian University, Giza, Egypt
| | - Shereen Hafez Ibrahim
- Department of Conservative dentistry, Faculty of Dentistry, Cairo University, Cairo, Egypt.
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2
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Larnani S, Song Y, Kim S, Park YS. Examining enamel-surface demineralization upon exposure to acidic solutions and the remineralization potential of milk and artificial saliva. Odontology 2024:10.1007/s10266-024-00960-y. [PMID: 38904919 DOI: 10.1007/s10266-024-00960-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 06/04/2024] [Indexed: 06/22/2024]
Abstract
The enamel surface may undergo demineralization due to exposure to acidic substances and the remineralization of the etched enamel is crucial to regain or maintain integrity. This study aimed to investigate the erosive effect of 10 acidic solutions on tooth enamel and the remineralization capacity of milk and artificial saliva by measuring surface roughness (Ra), enamel depth, and microhardness. A total of 80 bovine incisor enamel specimens were immersed in 10 different acidic solutions, including four different acidic drinks, three different citric acid solutions, and three different citric acid buffer solutions, for 1 h. After demineralization, the specimens were immersed in milk and artificial saliva for 3 h. Surface roughness, enamel abraded depth, and microhardness were measured before demineralization, in-between time intervals and after remineralization. Data were analyzed using Friedman and Kruskal-Wallis tests (p < 0.05). The results indicate a significant difference in surface roughness between the measurements taken at different time intervals, particularly between the baseline and after 1 h demineralization. Also, the specimens immersed in CAB1 exhibited greatest increase in Ra among other acidic solutions (Δ: 0.18 ± 0.07). Moreover, only the microhardness increased after remineralization (p < 0.05). Enamel demineralization using various acidic solutions revealed increased Ra and enamel abraded depth, and decreased microhardness. The use of remineralization agents, milk and artificial saliva, demonstrated an increase in microhardness. This study provides insights into the effects of different acidic solutions and potential remineralization agents on tooth enamel.
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Affiliation(s)
- Sri Larnani
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Youngha Song
- Department of Preventive Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Soyeon Kim
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Young-Seok Park
- Department of Oral Anatomy and Dental Research Institute, School of Dentistry, Seoul National University, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Center for Future Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
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Hoxie AM, Neves ADA, Moss K, de Vasconcellos AB, Zandona AF, Ribeiro AA. Microcomputed Tomography Mineral Density Profile as Reference Standard for Early Carious Lesion Activity Assessment. Caries Res 2023; 57:220-230. [PMID: 37586341 PMCID: PMC10641798 DOI: 10.1159/000533563] [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: 11/10/2022] [Accepted: 08/08/2023] [Indexed: 08/18/2023] Open
Abstract
Early caries diagnosis is crucial to treatment decisions in dentistry and requires identification of lesion activity: whether a carious lesion is active (progressively demineralizing) or arrested (progressively remineralizing). This study aimed to identify microtomographic (micro-CT) differences between active and arrested smooth surface enamel lesions, to quantify those micro-CT differences by creating thresholds for ex vivo caries activity assessment to serve as a future reference standard, and to validate those thresholds against the remaining sample. Extracted human permanent teeth (n = 59) were selected for sound surfaces and non-cavitated smooth surface carious lesions. Each surface was then examined for caries activity by calibrated individuals via visual-tactile examination using the International Caries Classification and Management System (ICCMS) activity criteria. Each tooth was scanned via micro-CT and the mineral density was plotted against lesion depth. The area under the curve (AUC) was calculated and represented the loss of density for the outermost 96 μm of enamel. AUC thresholds obtained from micro-CT were established to classify sound, remineralized, and demineralized surfaces against the gold standard examiner's lesion assessment of sound, inactive, and active lesions, respectively. The established AUC thresholds demonstrated moderate agreement with the assessment in identifying demineralized lesions (k = 0.45), with high sensitivity (0.73) and specificity (0.77). This study demonstrated quantifiable differences among demineralized lesions, remineralized lesions, and sound surfaces, which contributes to the establishment of micro-CT as a reference standard for caries activity that may be used to improve clinical and laboratorial dental caries evaluations.
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Affiliation(s)
- Adam Michael Hoxie
- Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Division of Craniofacial and Surical Care, Department of Orthodontics, UNC Adams School of Dentistry, Chapel Hill, NC, USA
| | - Aline de Almeida Neves
- Department of Pediatric Dentistry and Orthodontics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Kevin Moss
- Statistics, Division of Oral and Craniofacial Health Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adalberto Bastos de Vasconcellos
- Division of Comprehensive Oral Health, Operative Dentistry, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Andrea Ferreira Zandona
- Department of Restorative and Prosthetic Dentistry, College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Apoena Aguiar Ribeiro
- Division of Diagnostic Sciences, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Carey CM. Remineralization of Early Enamel Lesions with Apatite-Forming Salt. Dent J (Basel) 2023; 11:182. [PMID: 37623278 PMCID: PMC10453125 DOI: 10.3390/dj11080182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/04/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
OBJECTIVES This study sought to evaluate the remineralization of ex vivo human teeth using commercially available artificial saliva, SalivaMAX®, a supersaturated calcium phosphate rinse (SSCPR). METHODS early enamel lesions were artificially induced on ex vivo human teeth by chemical means. The teeth were exposed to the SSCPR for two minutes (experimental) or dH2O (control) four times per day for a total of 35 days. At time points of 0, 2.5, 21, and 35 days, micro-CT was utilized to determine the mineral density profile across the lesion and evaluate lesion depth. The relative percent remineralization was calculated from the initial lesion depth (Time 0) at each evaluation time. Student's t-test was used to compare the extent of remineralization between the SSCPR and control groups for statistical significance at each time. To evaluate the changes in percent remineralization over time, a two-way ANOVA was used. RESULTS At Time 0 and 2.5 days, there was no difference in the percent remineralization between the SSCPR and control groups (p > 0.05). After 21 days, the teeth exposed to the SSCPR remineralized 56.7 ± 3.7%, while the control only remineralized 10.7 ± 11.0% (p < 0.0001). At day 35, the remineralization was 73.7 ± 5.4% and 18.2 ± 10.8% (p < 0.0001) for the SSCPR and control groups, respectively. CONCLUSIONS A marked increase in remineralization occurred with the use of the SSCPR. Notably, the remineralization of the SSCPR occurred deep within the tooth and progressed toward the surface over time.
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Affiliation(s)
- Clifton M Carey
- School of Dental Medicine, University of Colorado, Aurora, CO 80045, USA
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Mohamad Saberi FN, Sukumaran P, Ung NM, Liew YM. Assessment of demineralized tooth lesions using optical coherence tomography and other state-of-the-art technologies: a review. Biomed Eng Online 2022; 21:83. [PMID: 36463182 PMCID: PMC9719651 DOI: 10.1186/s12938-022-01055-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
Tooth demineralization is one of the most common intraoral diseases, encompassing (1) caries caused by acid-producing bacteria and (2) erosion induced by acid of non-bacterial origin from intrinsic sources (e.g. stomach acid reflux) and extrinsic sources (e.g. carbonated drinks). Current clinical assessment based on visual-tactile examination and standardized scoring systems is insufficient for early detection. A combination of clinical examination and technology is therefore increasingly adapted. This paper reviews various procedures and technologies that have been invented to diagnose and assess the severity of tooth demineralization, with focus on optical coherence tomography (OCT). As a micron-resolution non-invasive 3D imaging modality, variants of OCT are now available, offering many advantages under different working principles for detailed analytical assessment of tooth demineralization. The roles, capabilities and impact of OCT against other state-of-the-art technologies in both clinical and research settings are described. (139 words).
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Affiliation(s)
- Fatin Najwa Mohamad Saberi
- grid.10347.310000 0001 2308 5949Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Prema Sukumaran
- grid.13097.3c0000 0001 2322 6764Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, England
| | - Ngie Min Ung
- grid.10347.310000 0001 2308 5949Clinical Oncology Unit, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yih Miin Liew
- grid.10347.310000 0001 2308 5949Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia
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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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Carvalho JC, Mestrinho HD, Aimée NR, Bakhshandeh A, Qvist V. Visible Occlusal Plaque Index Predicting Caries Lesion Activity. J Dent Res 2022; 101:905-911. [PMID: 35412388 DOI: 10.1177/00220345221084664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study was undertaken to appraise the predictive validity of the Visible Occlusal Plaque Index (VOPI) in assessing occlusal caries lesion activity in adolescents. A total of 618 adolescents aged 10 to 15 y were examined at the beginning of the trial and 511 (82.7%) at the 2-y follow-up. Adolescents and parents answered questionnaires about demographics, oral health behavior, and family sociodemographic variables. The VOPI has a 4-point ordinal scale ranging from no plaque to heavy plaque. Molar teeth were assigned to group VOPI 0-1 (no/thin plaque; n = 2,539) and group VOPI 2-3 (thick/heavy plaque; n = 843). At baseline examination, occlusal surfaces at risk of transition (n = 3,382) were either sound (55%), inactive noncavitated lesions (21%), inactive cavitated lesions (1%), active noncavitated lesions (15%), or active cavitated lesions (7%). The relative risk (RR) for caries lesion transition was estimated. Sound occlusal surfaces with no or thin plaque were significantly more likely to remain sound (RR = 1.3; 95% confidence interval [CI]: 1.1-1.4) than those harboring thick or heavy plaque. Inactive noncavitated occlusal lesions presenting no or thin plaque were significantly less likely to progress to active noncavitated lesions (RR = 0.1; CI: 0.0-0.8) than their counterparts with thick or heavy plaque. Active noncavitated lesions harboring thick and heavy plaque had a significantly lowest chance of becoming sound (RR = 0.7; CI: 0.5-0.9) and a highest risk of remaining active (RR = 1.5; CI: 1.1-1.9). Stepwise logistic regression analyses were run according to surface status at baseline and showed that none of the nonclinical predictors were significant for the outcome. The presence of thick and heavy plaque on occlusal surfaces was a predictor for caries lesion development, progression and activity (P < 0.0001). In conclusion, besides being an additional clinical tool for oral hygiene assessment, the VOPI is a predictor for development, progression, and activity of occlusal caries lesion. This is of particular interest for assessment of occlusal lesions undergoing health-promoting transitions.
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Affiliation(s)
- J C Carvalho
- Faculty of Medicine and Dentistry, UCLouvain, Brussels, Belgium
| | - H D Mestrinho
- Faculty of Health Sciences, University of Brasília, Brasilia, Brazil
| | - N R Aimée
- Faculty of Health Sciences, University of Brasília, Brasilia, Brazil
| | - A Bakhshandeh
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - V Qvist
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Agreement of Bioluminescence Measurements and Visual Assessment in Monitoring Occlusal Surfaces of Permanent Teeth. J Clin Med 2022; 11:jcm11020464. [PMID: 35054158 PMCID: PMC8779592 DOI: 10.3390/jcm11020464] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/12/2022] [Accepted: 01/13/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Caries lesion activity is typically assessed by visual–tactile criteria. Regular monitoring is required to detect the transition of lesions and to ensure that the initial assessment was valid. This clinical study aimed to evaluate the agreement of bioluminescence measurements (Calcivis imaging system, Cis) with visual examination to assess caries lesion activity and to monitor occlusal surfaces. Methods: The occlusal surfaces of ninety-one permanent posterior teeth were assessed for the presence or absence of active caries lesions with ICCMS criteria and Cis measurements at three visit times: baseline (t1) and six months (t2) and 12 months (t3) after baseline. Results: At the baseline visit, 70% of the included occlusal sites were assessed visually as active lesions (ICCMS codes 1 and 2). At t3, 64.8% of the sites showed signs of an active lesion. The percentage agreements between the visual and Cis methods were 87.8% (t1), 89.9% (t2) and 88.6% (t3). The corresponding κ-values were 0.71 (95% CI 0.52;0.87), 0.75 (95% CI 0.59;0.89) and 0.77 (95% CI 0.61;0.90), respectively. No significant difference between the visual and bioluminescence systems was found at any visit (p > 0.05). The results based on cluster randomization (generalized estimation equations) showed no significant differences between the visual and Cis findings for all visits (p = 0.108, Wald Χ2 with 1 df = 2.587). Conclusion: The bioluminescence system demonstrated substantial agreement for the activity assessment of occlusal lesions compared to the findings obtained by visual assessment over twelve months.
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AlShaya MS, Sabbagh HJ, El-Housseiny AA. Diagnosis and Management Approaches for Non-cavitated Carious Dental Lesions- A Narrative Review. Open Dent J 2021. [DOI: 10.2174/1874210602115010337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Dental caries is one of the most prevalent diseases. Its detection and management should start with a comprehensive treatment plan, with the goals of the elimination of cariogenic bacteria, the reduction of plaque acidogenicity, the encouragement of tooth remineralization, and the repair of damaged teeth.
Objectives:
The aim of this paper was to review the literature regarding the latest updates on the diagnosis and management approaches of non-cavitated carious dental lesions.
Methods:
Studies regarding the diagnosis and management of non-cavitated carious dental lesions were included.
Results: The subclinical non-cavitated carious lesion might progress to an early enamel lesion, develop into an established dentin lesion, or sometimes end up with a lesion reaching the pulp. The detection and management of caries should be patient-centered, risk-based, and evidence-supported, and should consider the dentists’ expertise and the patients’ needs and preferences. The visual-tactile and radiographic detection of non-cavitated carious lesions are greatly helped by the advances of non-invasive detection tools such as DIAGNOdent, fiber-optic transillumination, quantitative light-induced fluorescence, and DIAGNOcam.
Conclusion:
Accordingly, non-cavitated carious lesions can be arrested by several non-invasive techniques, which are preferred over the invasive options. The clinicians can use sealants plus fluoride varnish on occlusal surfaces, fluoride varnish or resin infiltration on proximal surfaces, and resin infiltration,fluoride gel, or varnish alone on facial or lingual surfaces to manage non-cavitated carious lesions.
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Tellez M, Lim S. ICDAS Is Widely Used as Standardized and Reliable Caries Detection Criteria, but Its Reporting Varies Widely. J Evid Based Dent Pract 2020; 20:101409. [PMID: 32381411 DOI: 10.1016/j.jebdp.2020.101409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Caries reporting in studies that used the International Caries Detection and Assessment System: A scoping review. ElSalhy M, Ali U, Lai H, Flores-Mir C, Amin M. Community Dent Oral Epidemiol 2019; 47(1): 92-102. SOURCE OF FUNDING Alberta Innovates-Health Solutions Grant Award Number RES 0027148 and The Honorary Izaak Walton Killam Memorial Scholarship. TYPE OF STUDY/DESIGN Comprehensive literature review (a scoping review).
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Kobbe C, Fritz U, Wierichs RJ, Meyer-Lueckel H. Evaluation of the value of re-wetting prior to resin infiltration of post-orthodontic caries lesions. J Dent 2019; 91:103243. [PMID: 31730787 DOI: 10.1016/j.jdent.2019.103243] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Assessment of the influence of colour changes during the re-wetting process as a possible predictor for the final result after resin infiltration to mask post-orthodontic white spot lesions. MATERIALS AND METHODS Resin infiltration (ICON; DMG, Hamburg, Germany) was performed according to the manufacturer's recommendation with the exception of repeated, at maximum three etching procedures based on the subjective decision of the dentist during a so called re-wetting process using ethanol. The masking effect by ethanol as well as after resin infiltration was evaluated by digital images taken before, for nine seconds during re-wetting and one week after treatment using CIE L*a*b* colour space. RESULTS Twenty-nine patients (16 female) with a total of 221 lesions (ICDAS 2) were included (mean age 16 years). Mean time after debonding the orthodontic appliances was ten weeks. Colour changes during re-wetting, evaluated in the first ten patients (71 lesions) showed a significant correlation between the minimum ΔE observed during re-wetting and the final ΔE after resin infiltration (r = 0.65, p < 0.001; Spearman correlation). The main drop in ΔE becomes visible after three seconds when performing the re-wetting process. Regarding the 221 lesions, resin infiltration significantly reduced the colour difference between sound and lesion areas from a baseline ΔE (25th/75th percentiles) of 10.9 (8.2/13.2) to a ΔE of 4 (2.1/5.8) after one week (p < 0.001). The number of etching procedures correlated significantly with baseline ΔE (p < 0.05). CONCLUSIONS The minimum ΔE observed during the re-wetting process seems to be a useful predictor for the final result of resin infiltration of post-orthodontic caries lesions. More prominent lesions with higher ΔE at baseline seem to require more erosion of the surface layer. In general, a significant and considerable clinical reduction of ΔE could be observed. CLINICAL SIGNIFICANCE We corroborate that resin infiltration technique is a very useful method to mask caries lesions having developed during treatment with fixed orthodontic appliances. Colour changes while re-wetting the lesions with ethanol seem to be a valuable indicator for the number of required etching procedures.
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Affiliation(s)
- C Kobbe
- Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - U Fritz
- Department of Orthodontics, RWTH Aachen University, Aachen, Germany
| | - R J Wierichs
- Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland; Department of Biohybrid & Medical Textiles, Institute of Applied Medical Engineering, RWTH Aachen University, Aachen, Germany
| | - H Meyer-Lueckel
- Department of Restorative, Preventive & Pediatric Dentistry, University of Bern, Bern, Switzerland.
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Kono T, Watanabe A, Kanno T, Ootani Y, Tamamura R, Sakae T, Okada H. Second Order Differentiation Analysis of Micro FTIR Method Revealed the Variable Erosion Characteristics of Carbonated Soft Drink for the Individual Human Teeth Enamel. J HARD TISSUE BIOL 2019. [DOI: 10.2485/jhtb.28.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Tetsuro Kono
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Arata Watanabe
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Takeshi Kanno
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Yukari Ootani
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Ryo Tamamura
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Toshiro Sakae
- Department of Histology, Nihon University School of Dentistry at Matsudo
| | - Hiroyuki Okada
- Department of Histology, Nihon University School of Dentistry at Matsudo
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