Diagnosis of developmental defects of enamel made from photographs

Knowledge of dental enamel defects amongst undergraduate dental students-a cross-sectional survey

INTRODUCTION/OBJECTIVES

Enamel defects are disturbances in the quantity or quality of enamel, due to disruption or damage to the enamel organ during amelogenesis. The correct diagnosis of enamel defects is critical as diverse management options could be required for different conditions. Difficulties in diagnosis can happen, because these defects may have similar clinical presentations. This study evaluated the diagnostic skills in enamel defects of dental students of a prominent Australasian school.

METHODS

A questionnaire consisting of clinical photographs of the affected teeth/dentition in multiple views and four standardised questions for each case of enamel defect were given to Year 4 and Year 5 students.

RESULTS

Localised/Chronological Hypoplasia had the lowest percentage of correct diagnosis (20.5%), whilst Enamel White Spot Lesions (EWSLs) had the highest (85%). Localised/Chronological Hypoplasia had the lowest aetiology score (20.5%), and the highest was obtained for EWSLs (85%). In regard to which question to ask to gain insight into the conditions, Enamel Hypomineralisation/MIH had the lowest score for both Year 4 and Year 5 respondents (35.4% and 21.3%). Most respondents agreed more teaching in this topic was needed, with further clinical sessions to observe the enamel defects, workshops/seminars, lectures and student-driven presentations suggested.

CONCLUSION

Final-year dental students showed variable knowledge in diagnosis, aetiology and clinical management of enamel defects. Further didactic and clinical teaching should be incorporated in the undergraduate curriculum on this topic .

Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis

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.