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Tan R, Zhu X, Chen S, Zhang J, Liu Z, Li Z, Fan H, Wang X, Yang L. Caries lesions diagnosis with deep convolutional neural network in intraoral QLF images by handheld device. BMC Oral Health 2024; 24:754. [PMID: 38951770 PMCID: PMC11218122 DOI: 10.1186/s12903-024-04517-x] [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: 04/24/2024] [Accepted: 06/21/2024] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES This study investigated the effectiveness of a deep convolutional neural network (CNN) in diagnosing and staging caries lesions in quantitative light-induced fluorescence (QLF) images taken by a self-manufactured handheld device. METHODS A small toothbrush-like device consisting of a 400 nm UV light-emitting lamp with a 470 nm filter was manufactured for intraoral imaging. A total of 133 cases with 9,478 QLF images of teeth were included for caries lesion evaluation using a CNN model. The database was divided into development, validation, and testing cohorts at a 7:2:1 ratio. The accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) were calculated for model performance. RESULTS The overall caries prevalence was 19.59%. The CNN model achieved an AUC of 0.88, an accuracy of 0.88, a specificity of 0.94, and a sensitivity of 0.64 in the validation cohort. They achieved an overall accuracy of 0.92, a sensitivity of 0.95 and a specificity of 0.55 in the testing cohort. The model can distinguish different stages of caries well, with the best performance in detecting deep caries followed by intermediate and superficial lesions. CONCLUSIONS Caries lesions have typical characteristics in QLF images and can be detected by CNNs. A QLF-based device with CNNs can assist in caries screening in the clinic or at home. TRIAL REGISTRATION The clinical trial was registered in the Chinese Clinical Trial Registry (No. ChiCTR2300073487, Date: 12/07/2023).
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Affiliation(s)
- Rukeng Tan
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Xinyu Zhu
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Sishi Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Jie Zhang
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Zhixin Liu
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Zhengshi Li
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Hang Fan
- Guangzhou Stars Pulse Co., Ltd, 239th Tianhe North Road, Tianhe District, Guangzhou, 510610, Guangdong, China
| | - Xi Wang
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
| | - Le Yang
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, 56th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
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Lee HS, Lee ES, Jung HI, Kim BI. Distinguishing discolored caries lesions using biofluorescence and dental bleaching: an in vitro simulation model study: Discolored caries lesion using biofluorescence and dental bleaching. Photodiagnosis Photodyn Ther 2024:104262. [PMID: 38945385 DOI: 10.1016/j.pdpdt.2024.104262] [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: 04/15/2024] [Revised: 06/26/2024] [Accepted: 06/28/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Distinguishing between discoloration caused by caries and organic stains is challenging for dentists in clinical settings. Biofluorescence (BF)-bleaching assesses caries lesions by evaluating BF changes after removing organic stains through dental bleaching, leaving cariogenic discoloration. This study aimed to apply BF-bleaching to a simulation model mimicking cariogenic discoloration and compare the BF color changes between organic staining and cariogenic discoloration. METHODS Thirty artificial caries lesions in bovine incisors were equally divided into three groups: non-stained (NS), organic-stained (OS), and cariogenic-stained (CS) groups. The specimens were treated with bleaching agent, then BF color of each specimen was evaluated using red BF intensity (ΔR), BF hue angle (h°), and hyperspectral BF spectrum. RESULTS The ΔR of CS was approximately 2.74 and 1.73 times higher than that of OS, at baseline and after bleaching for 20 minutes, respectively. After 20 min of bleaching, the h° of CS increased by approximately 8.1° compared to the baseline, while maintaining the red BF hue range (345‒15°). In contrast, the BF hue of OS shifted from orange (15‒45°) to yellow (45‒75°) simultaneously, and the h° change was approximately 21.9°. Both CS and OS exhibited first emission peaks near 515 nm, and CS showed second peaks in the red range (620‒780 nm). After bleaching, the first peaks were restored to the sound enamel direction (peak at 486 nm), whereas the second peak of red BF in CS was maintained. CONCLUSION Applying BF-bleaching to discolored caries lesions allowed differentiation between cariogenic discoloration and organic staining based on BF color changes.
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Affiliation(s)
- Hyung-Suk Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea, 03722, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
| | - Eun-Song Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea, 03722, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
| | - Hoi-In Jung
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea, 03722, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea, 03722, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
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Al-Nerabieah Z, AlKhouli M, Dashash M. Assessment of diagnostic accuracy and reliability of reveal fluorescence dental loupes in detecting molar incisor hypomineralization in children. Photodiagnosis Photodyn Ther 2024; 46:104033. [PMID: 38432500 DOI: 10.1016/j.pdpdt.2024.104033] [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: 12/11/2023] [Revised: 02/24/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Molar-Incisor Hypomineralization (MIH) poses challenges to accurate diagnosis, impacting children's oral health. Traditional methods exhibit limitations, necessitating innovative approaches. This study aimed to evaluate the reliability and diagnostic accuracy Reveal Fluorescence Dental Loupes (RFDLs) for the detection of MIH METHODS: This cross-sectional study, adhering to STRAD guidelines, involved 38 healthy children (age 7-9) with MIH. Ethical approval and informed consent were obtained. Microscope images and Reveal loupes were employed for examinations. Validity was assessed against microscope results, and inter- and intra-examiner reliability were measured using ICC and Kappa coefficients. Sensitivity, specificity, and overall accuracy were calculated, with an AUC-ROC analysis for discriminatory ability. RESULTS Intra-examiner reliability scores were excellent (Examiner 1: ICC 0.92, Examiner 2: ICC 0.94). Inter-examiner reliability (Kappa 0.92) indicated almost perfect agreement. Reveal demonstrated high sensitivity (82.61 %) and specificity (92.59 %), with an overall accuracy of 88.70 %. AUC-ROC analysis supported its robust discriminatory ability (AUC: 0.871). CONCLUSIONS Reveal Fluorescence Dental Loupes emerged as a promising diagnostic tool for accurate MIH detection, particularly in outreach settings. The study highlights the transformative impact of accessible and reliable diagnostic tools on pediatric oral health outcomes. While acknowledging limitations and the absence of a gold standard, the findings contribute to advancing MIH diagnostic capabilities. Further research in diverse populations is warranted for comprehensive validation.
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Affiliation(s)
- Zuhair Al-Nerabieah
- Paediatric dentistry department, Faculty of Dentistry, Damascus University, Syria.
| | - Muaaz AlKhouli
- Paediatric dentistry department, Faculty of Dentistry, Damascus University, Syria
| | - Mayssoon Dashash
- Professor, Paediatric dentistry department, Faculty of Dentistry, Damascus University, Syria
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Mathew VB, Shamsuddin S, Langaliya A, Rathod PT, Gupta B, Ronsivalle V, Cicciù M, Minervini G. Survivability of endodontically treated cracked tooth: A systematic review. Technol Health Care 2024; 32:2023-2037. [PMID: 38517822 DOI: 10.3233/thc-231993] [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] [Indexed: 03/24/2024]
Abstract
BACKGROUND Literature evidence describes various treatment protocols that have been employed for the effectiveness in improving survival and addressing associated symptoms of cracked teeth. OBJECTIVE This systematic review investigates the survivability of endodontically treated cracked teeth and associated assessments, focusing on various treatment protocols. METHODS The PRISMA guidelines were utilised for guiding the article selection framework of this review. A comprehensive search of relevant literature was conducted in May 2023 across various databases, and studies meeting the inclusion criteria were selected. Data extraction, guided by a standardized form, captured crucial details, including study characteristics, treatment protocols, and treatment outcomes, enhancing the consistency and accuracy of information collection. Data extraction and synthesis was done by two reviewers independently. The Newcastle Ottawa tool was used to measure the methodological quality of the study. Six observational studies were eventually included. RESULTS Mandibular molars are particularly prone to developing cracks, with research indicating a heightened susceptibility to this dental issue. Studies reveal that endodontically treated cracked teeth boast robust overall survival rates ranging from 75.8% to 100%. The risk of bias assessment, utilizing the Newcastle Ottawa scale, indicated a moderate risk across studies, highlighting the necessity for careful interpretation of findings. CONCLUSION Endodontically treated cracked teeth show marked success in survival, with the incorporation of crowns post-endodontic treatment significantly enhancing longevity and resilience.
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Affiliation(s)
- Vinod Babu Mathew
- Department of Restorative Dentistry College of Dentistry, King Khalid University, Abha, Kingdom of Saudi Arabia
| | | | - Akshayraj Langaliya
- Department of Conservative Dentistry and Endodontics, AMC Dental College and Hospital, Ahmedabad, India
| | - Priyanka Tikaram Rathod
- Department of Prosthodontics Crown and Bridge and Implantology, SMBT Institute of Dental Sciences and Research, Nashik, India
| | - Bharti Gupta
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Vincenzo Ronsivalle
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, Italy
| | - Marco Cicciù
- Department of Biomedical and Surgical and Biomedical Sciences, Catania University, Catania, Italy
| | - Giuseppe Minervini
- Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai, India
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
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Stănuşi A, Stănuşi AŞ, Gîngu O, Mercuţ V, Osiac E. Stereomicroscopic Aspects of Non-Carious Cervical Lesions. Diagnostics (Basel) 2023; 13:2590. [PMID: 37568952 PMCID: PMC10417311 DOI: 10.3390/diagnostics13152590] [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: 07/17/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Non-carious cervical lesions (NCCLs) represent a form of tooth wear, characterized by the irreversible loss of dental hard tissues at the enamel-cement junction, without the involvement of caries and dental trauma. The aim of this study was to highlight the morphological elements of NCCLs via their stereomicroscopic examination and to confirm the role of this examination in the diagnosis of early lesions. In addition, the association between the morphological aspects identified during the stereomicroscopic examination of NCCLs and their etiological factors was determined. For this study, extracted teeth with NCCLs were examined with a stereomicroscope. The morphological aspects of NCCLs were evaluated at magnifications up to 75×. In wedge-shaped NCCLs, the stereomicroscopic examination allowed the identification and measurement of scratches, furrows and cracks. In saucer-shaped NCCLs, the stereomicroscopic examination highlighted the smooth appearance of the walls. The presented study highlighted the role of stereomicroscopic examination in the assessment of NCCL morphology and in their early diagnosis. The study confirmed, in particular, the role of occlusal overloads and tooth brushing in determining the morphology of NCCLs.
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Affiliation(s)
- Andreea Stănuşi
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Oana Gîngu
- Department of Engineering and Management of Technological Systems, Faculty of Mechanics, University of Craiova, 200585 Craiova, Romania;
| | - Veronica Mercuţ
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Eugen Osiac
- Department of Biophysics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
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Evaluation of the clinical efficacy of quantitative light-induced fluorescence technology in diagnosing cracked teeth. Photodiagnosis Photodyn Ther 2023; 41:103299. [PMID: 36693456 DOI: 10.1016/j.pdpdt.2023.103299] [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: 11/05/2022] [Revised: 01/02/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND This retrospective study evaluated the clinical efficacy of quantitative light-induced fluorescence (QLF) technology for crack detection and the diagnosis of cracked teeth and assessed the possibility of a quantitative evaluation of cracks using QLF technology. METHODS Patients who were clinically diagnosed with cracked teeth over a 1-year period were included. The QLF images of the corresponding symptomatic cracked teeth and asymptomatic contralateral teeth with crack lines were taken with Qraypen C (AIOBIO, Seoul, Korea). Fluorescence loss (ΔF), maximum fluorescence loss (ΔFmax), red fluorescence (ΔR), and maximum red fluorescence (ΔRmax) of the crack line were analyzed. The correlation between these parameters and sex, age, tooth position (1st premolar, 2nd premolar, 1st molar, 2nd molar), spontaneous pain (+/-), percussion test (+/-), cold test (++/+/-), and bite test (+/-) were statistically analyzed. RESULTS A total of 66 patients were included. Twenty-four patients had asymptomatic contralateral teeth with apparent crack lines; thus, 90 teeth were analyzed. The crack lines in 84 teeth observed as red fluorescent lines on the QLF images showed ΔR values higher than the cut-off value set by the analysis program used. The patient's age and the ∣ΔF∣ and ΔR values were positively correlated. However, there was no statistically significant difference in the QLF parameters between the same patient's symptomatic tooth and the contralateral tooth. CONCLUSIONS QLF technology is a useful assistive diagnostic device for diagnosing cracked teeth.
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Diagnosis of cracked tooth: Clinical status and research progress. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:357-364. [PMID: 36425316 PMCID: PMC9678967 DOI: 10.1016/j.jdsr.2022.11.002] [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: 07/06/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
Cracked tooth is a common dental hard tissue disease.The involvement of cracks directly affects the selection of treatment and restoration of the affected teeth.It is helpful to choose more appropriate treatment options and evaluate the prognosis of the affected tooth accurately to determine the actual involvement of the crack.However, it is often difficult to accurately and quantitatively assess the scope of cracks at present.So it is necessary to find a real method of early quantitative and non-destructive crack detection.This article reviews the current clinical detection methods and research progress of cracked tooth in order to provide a reference for finding a clinical detection method for cracked tooth.
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Kakka A, Gavriil D, Whitworth J. Treatment of cracked teeth: A comprehensive narrative review. Clin Exp Dent Res 2022; 8:1218-1248. [PMID: 35809233 PMCID: PMC9562569 DOI: 10.1002/cre2.617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives The term “cracked tooth” is used to describe an incomplete fracture initiated from the crown and progressing towards a subgingival direction. Despite the high prevalence of cracked teeth and their frequent association with symptoms and pulpal or periapical pathoses, there is still no consensus in the literature with regard to their restorative and endodontic management. Therefore, the aim of this narrative review was to evaluate the most relevant research and provide an up‐to‐date comprehensive overview regarding the treatment of cracked teeth. Materials and Methods An electronic literature search was carried out in MEDLINE (via Ovid), Embase (via Ovid), Scopus, and Web of Science as well as several “Grey literature” sources up to February 22nd 2022 using a combination of pre‐specified ‘free‐text' terms (keywords) and “subject headings.” The search process was supplemented by handsearching in relevant dental journals and reference lists. This narrative review focused on clinical follow‐up studies (observational or interventional studies, case series/reports), laboratory studies and systematic reviews written in English language that reported data on treatment of permanent cracked teeth. The selection of relevant studies was carried out by two reviewers (AK and DG) working independently in two consecutive stages: title/abstract screening and full‐text retrieval. Any discrepancies in the study selection were resolved by discussion between the reviewers. Results In total, 64 articles were selected for inclusion in this narrative review. Conclusions Cracked teeth with normal pulp or reversible pulpitis have exhibited high pulp and tooth survival rates by the provision of direct or indirect composite restorations. Besides, recent data favour monitoring, especially in the absence of symptoms or compromised tooth structure. When endodontic intervention is required, current evidence suggests that along with appropriate restorative management, outcomes of cracked teeth may be comparable to those of non‐cracked root filled teeth.
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Affiliation(s)
- Angeliki Kakka
- Dental School National and Kapodistrian University of Athens Athens Greece
- Private Practice Athens Greece
| | - Dimitrios Gavriil
- MClinDent Restorative Dentistry Newcastle University Newcastle upon Tyne UK
- Private Practice Korinthos Greece
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Zhou J, Fu J, Xiao M, Qiao F, Fu T, Lv Y, Wu F, Sun C, Li P, Wu L. New technique for detecting cracked teeth and evaluating the crack depth by contrast-enhanced cone beam computed tomography: an in vitro study. BMC Oral Health 2022; 22:48. [PMID: 35236348 PMCID: PMC8892748 DOI: 10.1186/s12903-022-02085-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cracked teeth may cause various clinical symptoms depending on the extension depth of the crack and the subsequent bacterial infections. However, techniques to reliably determine the extension depths of cracks in teeth before treatment are lacking. The aim of this study was to develop a new technique based on contrast-enhanced cone beam computed tomography (CBCT) to improve the accuracy of crack depth evaluation in vitro. Methods We developed an in vitro artificial simulation model of cracked teeth. Pre-experimental CBCT (pre-CBCT), and micro-computed tomography (micro-CT) were first performed for all cracked teeth (n = 31). Contrast-enhanced CBCT was then performed by infiltrating the crack with ioversol under vacuum conditions. The sensitivities of pre-CBCT and contrast-enhanced CBCT for the diagnosis of cracked teeth were calculated. According to the K-means clusters, crack depths measured by micro-CT were changed into categorical variables. Bland–Altman plot and the intraclass correlation coefficient (ICC) were used to analyze the consistency of the crack depths between the pre-CBCT and contrast-enhanced CBCT, as well as the ICC between the contrast-enhanced CBCT and micro-CT. Receiver operating characteristic (ROC) curves were generated to assess the ability for predicting crack depth in the differential diagnosis using pre-CBCT and contrast-enhanced CBCT. Restricted cubic splines were also used to model the non-linear relationship between the crack depths of contrast-enhanced CBCT and micro-CT. Results The sensitivities of pre-CBCT and contrast-enhanced CBCT were 48.4%, and 67.7%, respectively. The ICC value of crack depth as measured by pre-CBCT and contrast-enhanced CBCT was 0.847 (95% confidence interval [CI] 0.380–0.960; P < 0.001). The areas under ROC curves (AUC) of pre-CBCT and contrast-enhanced CBCT were different: the AUC of pre-CBCT was 0.958 (P = 0.000, 95% CI 0.843–1.074), and the AUC of contrast-enhanced CBCT was 0.979 (P = 0.000, 95% CI 0.921–1.037), and the difference was not statistically significant (Z = − 0.707, P = 0.480). The ICC value of crack depth as measured by contrast-enhanced CBCT and micro-CT was 0.753 (95% CI 0.248–0.911; P < 0.001). Conclusion Contrast-enhanced CBCT under vacuum conditions with a contrast medium can significantly improve the crack detection rate of cracked teeth; however, it cannot measure the crack depths accurately.
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Affiliation(s)
- Jie Zhou
- Department of Stomatology, Wuqing People Hospital, Tianjin, China
| | - Jieni Fu
- Department of Endodontics, Hangzhou Stomatological Hospital, Hangzhou, Zhejiang, China
| | - Mo Xiao
- Department of Endodontics and Restorative Dentistry, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Feng Qiao
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Tiantian Fu
- Department of Endodontics and Restorative Dentistry, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yangyang Lv
- Department of Endodontics, Wuxi Stomatology Hospital, Jiangsu, China
| | - Fei Wu
- Department of Endodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, China
| | - Cuicui Sun
- Department of Endodontics, Tianjin Stomatological Hospital, Tianjin, China
| | - Peng Li
- Department of Radiology, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Ligeng Wu
- Department of Endodontics and Restorative Dentistry, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China.
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Son SA, Kim JH, Park JK. The Effectiveness of a Quantitative Light-induced Fluorescent Device for the Diagnosis of a Cracked Tooth: A Case Report. J Endod 2021; 47:1796-1800. [PMID: 34437880 DOI: 10.1016/j.joen.2021.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/03/2021] [Accepted: 08/16/2021] [Indexed: 12/29/2022]
Abstract
Diagnosing a cracked tooth is a challenge for dental clinicians. This report describes the use of a quantitative light-induced fluorescent (QLF) device that detects fluorescence reactions with visible light (405 nm) to visually identify microscopic tooth cracks during the diagnosis and treatment of cracked teeth that caused pulp disease. Fluorescence images of the occlusal surface, before and after removal of the restoration, and inside of the access cavity for root canal treatment were obtained using an intraoral capture-type QLF device (Q-ray penC; AIOBIO, Seoul, Korea). The device provided visual information such as enhanced magnification and fluorescent images to identify cracks on the exterior of the tooth, around restorations, and inside the cavity after removal of the restoration by a simple image capture process. The device was able to demonstrate the existence of the crack line and to predict the depth of cracks during treatment.The QLF device showed a potential benefit in the diagnosis and characterization, including the location and depth, of tooth cracks.
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Affiliation(s)
- Sung-Ae Son
- Department ofConservative Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea
| | - Jae-Hoon Kim
- Department ofDental Education, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea
| | - Jeong-Kil Park
- Department ofConservative Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea.
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Oh SH, Choi JY, Lee SR, Kim SH. Evaluation of Periodontal Risk Factors with Quantitative Light-Induced Fluorescence Based Fluorescent Plaque Index, in Comparison to Radiographic and Oral Health Habit Scoring: A Retrospective Case Study. SENSORS 2021; 21:s21175774. [PMID: 34502665 PMCID: PMC8434579 DOI: 10.3390/s21175774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/17/2021] [Accepted: 08/24/2021] [Indexed: 12/19/2022]
Abstract
The aim of this study was to evaluate periodontal risk factors with oral health habits and fluorescent plaque index (FPI) using quantitative light-induced fluorescence (QLF) images, and to evaluate their effect on the degree of radiographic bone loss (RBL). Selected were 276 patients over 19 years of age to complete the questionnaire for oral health habit and take QLF images, periapical and panoramic radiographs. Oral health habit score, age, and sex showed a statistically significant correlation with FPI. FPI showed a lower value as the oral health habit score increased and the age decreased. Moreover, females showed lower FPI values than did males. RBL showed a statistically significant positive correlation with age but did not show any correlation with oral health habit scores and sex. There was no correlation between FPI and RBL. The results of this study suggest that the clinical use of QLF allows plaque detection by non-invasive procedures and can aid in a more objective estimation for oral hygiene status.
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Affiliation(s)
- Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (S.H.O.); (S.R.L.)
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
| | - Sae Rom Lee
- Department of Oral and Maxillofacial Radiology, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea; (S.H.O.); (S.R.L.)
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
- Correspondence: ; Tel.: +82-2-958-9390
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Detection of Dental Caries and Cracks with Quantitative Light-Induced Fluorescence in Comparison to Radiographic and Visual Examination: A Retrospective Case Study. SENSORS 2021; 21:s21051741. [PMID: 33802443 PMCID: PMC7959286 DOI: 10.3390/s21051741] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 12/13/2022]
Abstract
The aim of this study was to present an optimal diagnostic protocol by comparing and analyzing a conventional examination and the quantitative light-induced fluorescence (QLF) technique. Selected were 297 teeth of 153 patients to take QLF images and bitewing radiographs. Occlusal dental caries, proximal dental caries and cracks were evaluated and scored using QLF, X-ray and/or visual criteria. The sensitivity, specificity, and area under the curve (AUC) of a receiver operating characteristic analysis were calculated. Two fluorescence parameters (|ΔFmax| and ΔRmax) were utilized to evaluate the fluorescence pattern according to the severity of lesions based on QLF or X-ray criteria. QLF showed higher scores for detecting occlusal dental caries and cracks than the conventional method. ΔRmax increased more clearly than ΔFmax did with occlusal dental caries. The |ΔFmax| values of occlusal dental caries, proximal dental caries and cracks showed good AUC levels (0.84, 0.81 and 0.83, respectively). The ΔRmax of occlusal dental caries showed the highest AUC (0.91) and the ΔRmax of proximal dental caries showed a fail level (0.59) compared to bitewing radiographs. The QLF image could visualize and estimate the degree of occlusal dental caries or cracks. Consequently, the QLF technique may be an adjunct tool to conventional methods for the detection of occlusal caries and peripheral cracks.
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Kim SK, Jung HI, Kim BI. Detection of dentin-exposed occlusal/incisal tooth wear using quantitative light-induced fluorescence technology. J Dent 2020; 103:103505. [PMID: 33080348 DOI: 10.1016/j.jdent.2020.103505] [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: 08/10/2020] [Revised: 09/28/2020] [Accepted: 10/15/2020] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To prolong tooth life expectancy, tooth wear resulting in dentin exposure should be detected early. However, the most objective methods are clinically limited. We validated fluorescence parameters for distinguishing enamel from dentin-exposed wear in clinical images. METHODS Quantitative light-induced fluorescence (QLF) images of 73 adults (age range: 22-48 years, mean: 33.81 ± 7.71 years), including 1949 teeth with varying tooth wear degrees, without restorations, caries, or cusp area fractures, were used to calculate the ΔFwear values. Areas-of-interest (AOIs) were selected from QLF images; the ΔFwear values and the tooth wear index (TWI) were calculated for each tooth. The ΔFwear values were compared according to the TWI scores. The optimum ΔFwear values for distinguishing enamel and dentin-exposed wear were determined using the receiver operating characteristic (ROC) curve analysis. RESULTS Overall, 1949 AOIs were evaluated. The median ΔFwear values for teeth with TWI scores 0, 1, and 2 (5.7 %, 10.3 %, and 17.0 %) differed significantly (P < 0.001). The optimum cutoff ΔFwear values were 12.1 and 14.7 in the anterior and posterior teeth, respectively; the corresponding areas under the ROC values (AUROCs) were 0.86 and 0.93 (sensitivity: 0.79 and 0.85; specificity: 0.79 and 0.85, respectively). The ΔFwear cutoff values for different age groups were within a range (12.7-13.7) and showed high validity (sensitivity, specificity, and AUROC: 0.78, 0.77-0.78, and 0.87-0.88, respectively). CONCLUSIONS At the optimum threshold, the ΔFwear values showed high validity for distinguishing dentin exposure in worn teeth (AUROC: 0.87‒0.93) and could determine pathological tooth wear, particularly in posterior teeth. CLINICAL SIGNIFICANCE We demonstrated the feasibility of using QLF to detect dentin-exposed tooth wear and present optimal thresholds according to age. In addition, we confirmed the possibility using such image data for objective and cost-effective epidemiological investigation and application in tele-dentistry.
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Affiliation(s)
- Sang-Kyeom Kim
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - Hoi In Jung
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea.
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Lee JY, Kim HJ, Lee ES, de Josselin de Jong E, Jung HI, Kim BI. Quantitative light-induced fluorescence as a potential tool for detection of enamel chemical composition. Photodiagnosis Photodyn Ther 2020; 32:102054. [PMID: 33065304 DOI: 10.1016/j.pdpdt.2020.102054] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/22/2020] [Accepted: 10/02/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Little is known about how the chemical composition of enamel affects the optical properties of teeth, but advances in technology allow this to be studied using white-light and fluorescent images. This study aimed to identify the variation in enamel chemical composition that may affect tooth optical properties, such as tooth color and autofluorescence. METHODS Sixty-one specimens of extracted human molars were prepared. Raman spectrometry was used to assess chemical composition of enamel, and tooth color, and autofluorescence from enamel were evaluated by quantitative light-induced fluorescence (QLF) images. Pearson correlation and multiple linear regression analyses were used. RESULTS Enamel fluorescence was related to enamel composition rather than tooth color. The b* value from the fluorescence image had a moderate correlation with crystallinity (full-width at half-maximum: r = -0.433, p < 0.001) and laser-induced fluorescence intensity (r = 0.450, p < 0.001) from Raman spectroscopy. In multiple linear regression analysis, the chemical composition of the tooth had a significant effect on the b* value from the fluorescent image (R2 = 0.433, p < 0.001). In contrast, tooth color values (L*, a*, and b*) were not correlated with chemical composition. CONCLUSIONS The present study revealed that enamel autofluorescence in QLF was related to chemical composition of the enamel, particularly the inorganic‒organic interface. While enamel chemical composition can be detected only in a laboratory environment, enamel fluorescence by QLF may enable estimation in a dental clinic, which has implications for the field of tooth bleaching or esthetic restorative materials.
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Affiliation(s)
- Joo-Young Lee
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Hyo-Jung Kim
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Eun-Song Lee
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Elbert de Josselin de Jong
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea; Department of Health Services Research, University of Liverpool, Liverpool, United Kingdom; Inspektor Research Systems BV, Amsterdam, the Netherlands.
| | - Hoi-In Jung
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| | - Baek-Il Kim
- Department of Preventive Dentistry & Public Oral Health, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Clinical assessment of an automated fluorescent plaque index scoring with quantitative light-induced fluorescence. Photodiagnosis Photodyn Ther 2020; 32:102011. [PMID: 32949788 DOI: 10.1016/j.pdpdt.2020.102011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aims of this study were to evaluate the clinical applicability of a new fluorescent plaque index scoring (FPI) with the Turesky modified Quigley-Hein plaque index (mQH) and to evaluate its relationship with plaque maturity. METHODS In total 69 subjects participated in this study. White-light and fluorescent images of anterior teeth were acquired using a Qraycam (AIOBIO, Seoul, Korea). FPI was obtained from fluorescent images using the proprietary software (Q-Ray v.1.39, Inspektor Research System BV, Amsterdam, The Netherlands). Teeth were stained with a two-tone disclosing agent. mQH was used to manually score the combined red and blue disclosed plaque (Combi-mQH) and blue disclosed plaque (Blue-mQH) with the white-light images. Linear relationships between FPI and Combi-mQH (or Blue-mQH) were evaluated by using simple linear regression analysis. Differences of Combi-mQH (or Blue-mQH) with respect to FPI scores were statistically evaluated by using ANOVA with Duncan post hoc correction. RESULTS FPI showed a moderate positive correlation with Combi-mQH (r = 0.66, P < 0.001) and a high positive correlation with Blue-mQH (r = 0.78, P < 0.001). The model explanatory power (R2) between FPI and Blue-mQH was 60.8 %, which is 16.8 % higher than the explanatory power observed with Combi-mQH (44.0 %). Both Combi-mQH and Blue-mQH increased significantly with increasing FPI score (P < 0.001). CONCLUSION In this study we found that the FPI scoring system can be used to detect plaque and quantitatively distinguish plaque levels. In addition, FPI was determined to be useful in clinic because of its ability to detect and distinguish old and mature plaque.
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