Quantitative light-induced fluorescence as a potential tool for detection of enamel chemical composition

Evaluation of EMLA cream with microneedle patches in palatal anesthesia in children: a randomized controlled clinical trial

Palatal injections are considered to be one of the most painful dental procedures. As a result, it was important to find alternatives to this painful injection to improve children's cooperation. The dental literature mentioned using EMLA cream as a possible alternative to conventional injections, but its anesthetic effect was debated. Therefore, it was valuable to research the impact of microneedle patches to enhance the effectiveness of this cream. The purpose of this randomized controlled clinical trial was to compare the effectiveness of different methods of anesthesia and pain levels in children aged 7-11 years. The study compared the use of EMLA cream, EMLA with microneedles, and conventional palatal injections. A total of 90 children were randomly assigned to three groups: Group 1 received conventional palatal anesthesia (control), Group 2 received EMLA cream only, and Group 3 received EMLA with microneedles. Pain levels were assessed using the FLACC and Wong-Baker scales at three different time points: T1(during anesthesia), T2(on palatal probing), and T3(during extraction). The FLACC scale revealed a significant difference in pain between groups only at T1 (P value = 0.000). It was found that the conventional palatal injection group had a higher pain level than the EMLA cream-only group and the group using microneedle patches with EMLA cream (P value = 0.000). However, the other groups did not show significant differences in pain levels during the anesthesia (P value  = 1.00). Similarly, the Wong-Baker scale also demonstrated a statistically significant difference in pain between groups only at T1 (P value  = 0.000). It was found that the conventional palatal injection group had a higher pain level than the EMLA cream-only group and the group using microneedle patches with EMLA cream (P value  = 0.000). However, the other groups did not show significant differences in pain levels during the anesthesia (P value  = 0.091). The study concludes that both EMLA cream alone and EMLA with microneedles can be used as an alternative to conventional palatal anesthesia for children.

Assessment of diagnostic accuracy and reliability of reveal fluorescence dental loupes in detecting molar incisor hypomineralization in children

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.

Tooth Wear and Tribological Investigations in Dentistry

Dental or tooth wear is a physiological process in the life cycle of teeth. Loss of the occlusal surface may cause excessive tooth wear. Several factors may contribute to tooth wear with different intensities and duration in the oral cavity. The oral cavity is generally compared to a tribological system to determine the various types of wear between teeth and restorative materials and assess the amount of dental wear. However, it is challenging to investigate in vitro and in vivo wear owing to the complexity of tooth wear; thus, a clear correlation between in vitro and in vivo data could not be established. This review is aimed at providing an insight into the etiology of tooth wear and tribological investigations in dentistry.

A comprehensive review on LED-induced fluorescence in diagnostic pathology

Sensitivity, specificity, mobility, and affordability are important criteria to consider for developing diagnostic instruments in common use. Fluorescence spectroscopy has been demonstrating substantial potential in the clinical diagnosis of diseases and evaluating the underlying causes of pathogenesis. A higher degree of device integration with appropriate sensitivity and reasonable cost would further boost the value of the fluorescence techniques in clinical diagnosis and aid in the reduction of healthcare expenses, which is a key economic concern in emerging markets. Light-emitting diodes (LEDs), which are inexpensive and smaller are attractive alternatives to conventional excitation sources in fluorescence spectroscopy, are gaining a lot of momentum in the development of affordable, compact analytical instruments of clinical relevance. The commercial availability of a broad range of LED wavelengths (255-4600 nm) has opened up new avenues for targeting a wide range of clinically significant molecules (both endogenous and exogenous), thereby diagnosing a range of clinical illnesses. As a result, we have specifically examined the uses of LED-induced fluorescence (LED-IF) in preclinical and clinical evaluations of pathological conditions, considering the present advancements in the field.

Vibrational Imaging Techniques for the Characterization of Hard Dental Tissues: From Bench-Top to Chair-Side

Currently, various analytical techniques, including scanning electron microscopy, X-Ray diffraction, microcomputed tomography, and energy dispersive X-ray spectroscopy, are available to study the structural or elemental features of hard dental tissues. In contrast to these approaches, Raman Microspectroscopy (RMS) has the great advantage of simultaneously providing, at the same time and on the same sample, a morpho-chemical correlation between the microscopic information from the visual analysis of the sample and its chemical and macromolecular composition. Hence, RMS represents an innovative and non-invasive technique to study both inorganic and organic teeth components in vitro. The aim of this narrative review is to shed new light on the applicative potential of Raman Microspectroscopy in the dental field. Specific Raman markers representative of sound and pathological hard dental tissues will be discussed, and the future diagnostic application of this technique will be outlined. The objective and detailed information provided by this technique in terms of the structure and chemical/macromolecular components of sound and pathological hard dental tissues could be useful for improving knowledge of several dental pathologies. Scientific articles regarding RMS studies of human hard dental tissues were retrieved from the principal databases by following specific inclusion and exclusion criteria.

A novel model to predict tooth bleaching efficacy using autofluorescence of the tooth

OBJECTIVES

We aimed to confirm whether autofluorescence emitted from teeth can predict tooth bleaching efficacy and establish a novel model combining natural color parameters and tooth autofluorescence data to improve the predictability of tooth bleaching.

METHODS

A total of 61 tooth specimens were prepared from extracted human molars/premolars and immersed in 35% hydrogen peroxide for 1 h for tooth bleaching. The changes in laser-induced fluorescence (∆LIF) were assessed using Raman spectrometry. Tooth color and autofluorescence data were obtained using quantitative light-induced fluorescence (QLF) technology. Pearson correlation analyses were used to confirm the relationship between ∆LIF and autofluorescence. Intraclass correlation coefficients (ICC) were calculated to compare the conventional and new prediction models. Decision tree analysis was performed to evaluate clinical applicability.

RESULTS

The yellowness-to-blueness value from fluorescence imaging showed a moderate correlation with ∆LIF (r= -0.409, p = 0.001). The degree of agreement between the actual efficacy and that predicted by our novel model was high (ICC=0.933, p = 0.002). Decision tree analysis suggested that tooth autofluorescence could be a key factor in prediction of tooth bleaching outcomes.

CONCLUSIONS

Our findings showed that autofluorescence detected from QLF images may be used to predict tooth bleaching efficacy. Our proposed model appeared to improve the predictability of tooth bleaching.