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Khalaf ME, Alyahya A, Qudeimat MA. Management Thresholds for Molars With Occlusal Noncavitated Caries Lesions. Int Dent J 2023; 73:251-258. [PMID: 35896427 PMCID: PMC10023584 DOI: 10.1016/j.identj.2022.06.024] [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: 05/06/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
AIM There is sparse research on the effect of factors related to the dentist and patient in the caries management decision-making process. This in vitro study explored the influence of factors related to dentists and patients on the management decision of occlusal noncavitated caries lesions in children. MATERIALS AND METHODS Five investigators in the specialties of dental public health (DPH), paediatric, prosthetic, and operative dentistry and a general dentist (GDP) participated in this study. Initially, the investigators were asked to independently assess the occlusal surfaces of 175 noncavitated permanent molars and choose a management recommendation using 2 caries risk patients' scenarios. After 1 month, investigators were trained and calibrated to use the International Caries Detection and Assessment System (ICDAS) scoring system. Then, they examined the same teeth, recorded the highest/worst ICDAS score, and chose a management recommendation. Two weeks later, the investigators repeated the teeth examination using magnification loupes and again chose a management recommendation. The teeth were sectioned to study the relationship between the presence of caries and the management recommendations. RESULTS For the low- and the high-caries risk scenarios, ICDAS training increased the operative intervention by 20% to 27% and 14% to 22%, respectively, for both the GDP and the paediatric dentist (P < .0001). For the low-caries risk scenario, using the magnifying loupes increased the operative recommendations for the DPH, GDP, and the operative dentist by 5% to 23% (P < .05). Compared to the low-caries risk scenario, teeth for patients with high caries risk received more surgical interventions (9%-30%) at all examination conditions for the GDP and the paediatric and operative dentists (P < .0001). CONCLUSIONS For occlusal noncavitated caries lesions, enhancing dentists' caries detection skills had a significant impact on decisions of surgical intervention. This also influenced the appropriateness of the treatment recommended for the different caries risk groups.
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Affiliation(s)
- Mai E Khalaf
- Department of General Dental Practice, Kuwait University, Kuwait
| | - Asma Alyahya
- Department of Developmental and Preventive Sciences, Kuwait University, Kuwait
| | - Muawia A Qudeimat
- Department of Developmental and Preventive Sciences, Kuwait University, Kuwait.
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Ghotane SG, Challacombe SJ, Don-Davis P, Kamara D, Gallagher JE. Unmet need in Sierra Leone: a national oral health survey of schoolchildren. BDJ Open 2022; 8:16. [PMID: 35701398 PMCID: PMC9194785 DOI: 10.1038/s41405-022-00107-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/29/2022] [Accepted: 05/10/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Sierra Leone (SL), in West Africa, with a population of over 7.5 million people has suffered the effects of a civil war previously, and more recently Ebola & Covid-19. Dental care is very limited, mostly in the capital Freetown and the private sector. No dental education is available in the country. The objective of this research was to investigate the oral health needs of schoolchildren at key ages, to inform future action. MATERIALS AND METHODS This first national oral health survey of schoolchildren at 6-, 12- and 15-years was conducted in urban and rural settings across all four regions using a multi-stage cluster sampling in line with the WHO guidelines, adapted according to contemporary survey methods to include 'International Caries Detection and Assessment System (ICDAS)'. Whilst parents were invited to complete a questionnaire for 6-year-old children, 12- and 15-year-olds self-completed a questionnaire. Data were weighted according to age and regional population and analysed using STATA v.15 and SPSS v.22. RESULTS A total of 1174 children participated across 22 schools from all four regions. Dental caries was prevalent (over 80% of all age-groups having clinical decay; ICDAS score ≥ 2) and largely untreated. No children had fillings and only 4% had missing teeth. Amongst 6, 12 and 15-year-olds, average decay levels at ICDAS > 3 threshold was 3.47 (primary teeth), 2.94 and 4.30 respectively. Almost, 10% (n = 119) of all children reported experiencing pain in their teeth with 7% (n = 86) children having PUFA lesions present. At least one in five children required one or more dental extractions. 'Age' was a significant predictor of dental caries experience and the odds of having dental caries experience was higher in rural areas at D3-6MFT (p < 0.05). CONCLUSION The findings demonstrate a vast unmet oral health need in the children of SL. Using ICDAS as an epidemiological tool in a low-income country provides valuable insight to the pattern of oral disease to inform health service planning. Urgent action is required to address this silent epidemic.
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Affiliation(s)
- S G Ghotane
- Department of Women & Children's Health, Faculty of Life Sciences & Medicine, King's College London, Becket House, 1 Lambeth Palace Road, London, SE1 7EU, UK.
| | - S J Challacombe
- Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, Floor 22, Guys Tower, Guys Hospital, London, SE1 9RT, UK
| | - P Don-Davis
- College of Medicine and Allied Health Sciences, Connaught Hospital, Freetown, Sierra Leone
| | - D Kamara
- Oral Health Department, Connaught Hospital, Freetown, Sierra Leone
| | - J E Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Centre for Host Microbiome Interactions, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK
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Kühnisch J, Janjic Rankovic M, Kapor S, Schüler I, Krause F, Michou S, Ekstrand K, Eggmann F, Neuhaus KW, Lussi A, Huysmans MC. Identifying and Avoiding Risk of Bias in Caries Diagnostic Studies. J Clin Med 2021; 10:3223. [PMID: 34362007 PMCID: PMC8347423 DOI: 10.3390/jcm10153223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Caries diagnostic studies differ with respect to their design, included patients/tooth samples, use of diagnostic and reference methods, calibration, blinding and data reporting. Such heterogeneity makes comparisons between studies difficult and could represent a substantial risk of bias (RoB) when it is not identified. Therefore, the present report aims to describe the development and background of a RoB assessment tool for caries diagnostic studies. The expert group developed and agreed to use a RoB assessment tool during three workshops. Here, existing instruments (e.g., QUADAS 2 and the Joanna Briggs Institute Reviewers' Manual) influenced the hierarchy and phrasing of the signalling questions that were adapted to the specific dental purpose. The tailored RoB assessment tool that was created consists of 16 signalling questions that are organized in four domains. This tool considers the selection/spectrum bias (1), the bias of the index (2) and reference tests (3), and the bias of the study flow and data analysis (4) and can be downloaded from the journal website. This paper explores possible sources of heterogeneity and bias in caries diagnostic studies and summarizes the relevant methodological aspects.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopaedics, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, 07743 Jena, Germany;
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, 52074 Aachen, Germany;
| | - Stavroula Michou
- Department of Odontology, University Copenhagen, 2200 Copenhagen, Denmark; (S.M.); (K.E.)
| | - Kim Ekstrand
- Department of Odontology, University Copenhagen, 2200 Copenhagen, Denmark; (S.M.); (K.E.)
| | - Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland; (F.E.); (K.W.N.)
| | - Klaus W. Neuhaus
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland; (F.E.); (K.W.N.)
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, 3012 Bern, Switzerland;
- Department of Operative Dentistry and Periodontology, University Medical Centre, 79098 Freiburg, Germany
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Alkahtani A, Anderson P, Baysan A. The performance of SoproLIFE for early detection of coronal caries using the International Caries Classification and Management System - A preliminary laboratory-based study. Photodiagnosis Photodyn Ther 2021; 35:102422. [PMID: 34214688 DOI: 10.1016/j.pdpdt.2021.102422] [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: 02/18/2021] [Revised: 06/06/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
The aim of this laboratory-based study is to evaluate performance of the Light-Induced Fluorescence Evaluator (SoproLIFE) for early detection of coronal caries and to validate the findings using the International Caries Classification and Management System (ICCMS). A total of 56 freshly extracted teeth with coronal carious lesions were included. 74 regions of interest were identified. Visual assessments with International Caries Detection and Assessment Systems (ICDAS), radiographic information and SoproLIFE images were used to classify each region of interest according to the ICCMS as a reference standard. SoproLIFE specificity and sensitivity were calculated at the sound-enamel and dentine lesion levels. Inter and intra reproducibility of ICDAS were analysed and showed a moderate agreement (0.52) and (0.58) respectively. At the sound-initial caries level, the sensitivity and specificity for the SoproLIFE were 90.0%, 95.8% respectively, whilst for the dentine caries level, sensitivity was 100% with specificity of 53.8%. A low proportion of teeth with dental caries were classified as caries-free using the SoproLIFE (false negative=10%). As a conclusion, the performance of SoproLIFE was promising in distinguishing between early enamel carious lesions and sound surfaces. This detection tool could be suggested to be used with ICCMS to assist in the clinical decision-making process.
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Affiliation(s)
- Ashwaq Alkahtani
- Centre for Oral Bioengineering, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Turner St, Whitechapel, E1 1FR London, UK.
| | - Paul Anderson
- Dental Physical Sciences Unit, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Aylin Baysan
- Centre for Oral Bioengineering, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Voruganti S, Haricharan PB, Mudrakola DP, Turagam N. Reliability of Caries Assessment Spectrum and Treatment Tool in the Indian Subcontinent. J Int Soc Prev Community Dent 2020; 10:410-414. [PMID: 33042881 PMCID: PMC7523936 DOI: 10.4103/jispcd.jispcd_217_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 11/04/2019] [Accepted: 12/04/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Accurate diagnosis, reporting of caries and its consequences, is absolute mandate for planning an efficient, effective community health-care program. Literature reports indicate shortcomings of existing caries assessment tools. Caries assessment spectrum and treatment (CAST) is novice caries quantification tool, which quantifies the entire spectrum of carious lesions. This tool records give an insight into the status of restorations along with various progressive developmental stages of dental caries. This instrument has been validated for face, content, and construct by an expert group, and currently, its usage is on the rise. AIM The aim of this study was to report the reliability of this assessment tool with regard to the primary and permanent dentition of school children and adults belonging to a south Indian district. MATERIALS AND METHODS A cross-sectional study was carried out by two trained and calibrated examiners by examining 192 school children in the age-group between 4 and 6 years and 262 adults between 19 and 69 years. The study sample was reexamined by the same examiners after a gap of 4 weeks. The κ coefficient values and percent of agreement were calculated for the data recorded from the study subjects. RESULTS The analyzed data showed moderate intra-examiner and inter-examiner reproducibility for either of the dentition as revealed by κ coefficient values (0.80-0.89). Inter- or intra-examiner agreement was found to be substantial to almost perfect (percent agreement above 90%) with respect to both the age-groups. CONCLUSION The CAST tool seems quite promising to be the future for quantifying caries spectrum for a community or an individual.
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Affiliation(s)
- Sreenivas Voruganti
- Department of Public Health Dentistry, Kamineni Institute of Dental Sciences, Nalgonda, Telangana, India
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Lara JS, Braga MM, Zagatto CG, Wen CL, Mendes FM, Murisi PU, Haddad AE. A Virtual 3D Dynamic Model of Caries Lesion Progression as a Learning Object for Caries Detection Training and Teaching: Video Development Study. JMIR MEDICAL EDUCATION 2020; 6:e14140. [PMID: 32441661 PMCID: PMC7275258 DOI: 10.2196/14140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 03/06/2020] [Accepted: 03/23/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND In the last decade, 3D virtual models have been used for educational purposes in the health sciences, specifically for teaching human anatomy and pathology. These models provide an opportunity to didactically visualize key spatial relations that can be poorly understood when taught by traditional educational approaches. Caries lesion detection is a crucial process in dentistry that has been reported to be difficult to learn. One especially difficult aspect is linking clinical characteristics of the different severity stages with their histological features, which is fundamental for treatment decision-making. OBJECTIVE This project was designed to develop a virtual 3D digital model of caries lesion formation and progression to aid the detection of lesions at different severity stages as a potential complement to traditional lectures. METHODS Pedagogical planning, including identification of objectives, exploration of the degree of difficulty of caries diagnosis-associated topics perceived by dental students and lecturers, review of the literature regarding key concepts, and consultation of experts, was performed prior to constructing the model. An educational script strategy was created based on the topics to be addressed (dental tissues, biofilm stagnation areas, the demineralization process, caries lesion progression on occlusal surfaces, clinical characteristics related to different stages of caries progression, and histological correlations). Virtual 3D models were developed using the Virtual Man Project and refined using multiple 3D software applications. In the next phase, computer graphic modelling and previsualization were executed. After that, the video was revised and edited based on suggestions. Finally, explanatory subtitles were generated, the models were textured and rendered, and voiceovers in 3 languages were implemented. RESULTS We developed a 6-minute virtual 3D dynamic video in 3 languages (English, Spanish, and Brazilian Portuguese) intended for dentists and dental students to support teaching and learning of caries lesion detection. The videos were made available on YouTube; to date, they have received more than 100,000 views. CONCLUSIONS Complementary pedagogical tools are valuable to support cariology education. This tool will be further tested in terms of utility and usability as well as user satisfaction in achieving the proposed objectives in specific contexts.
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Affiliation(s)
- Juan Sebastian Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, United States
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Carlos Gustavo Zagatto
- Discipline of Telemedicine, Department of Pathology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Chao Lung Wen
- Discipline of Telemedicine, Department of Pathology, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Pedroza Uribe Murisi
- Department of Pediatric Dentistry, Dental School, University of Guadalajara, Guadalajara, Mexico
| | - Ana Estela Haddad
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
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Combined Near-Infrarred Light Transillumination and Direct Digital Radiography Increases Diagnostic In Approximal Caries. Sci Rep 2019; 9:14224. [PMID: 31578410 PMCID: PMC6775139 DOI: 10.1038/s41598-019-50850-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Accepted: 09/15/2019] [Indexed: 12/03/2022] Open
Abstract
The objective of this study was to evaluate the clinical ability of Near-Infrared Light-Transillumination (NILT) for approximal dentinal caries detection and to compare with direct digital-radiography (DDR), as well as to determine whether the combination of both techniques improves the diagnostic capacity of the lesions. From 88 patients (over 18 years), 138 posterior teeth (76 molars and 62 premolars), that had approximal caries reached into dentine determined by DDR, were included. Lesion extension and DDR images were scored as follows: D0 = sound surface, D1/D2 = caries restricted to the outer/inner-half of the enamel, and D3/4 = caries restricted to the outer/inner-half of the dentin. Opening of the approximal surface using 0.5 mm-in-diameter diamond-bar was used as gold-standard. The lesion extension was then determined by the following criteria: no dentinal caries (D0/1/2) or dentinal caries (D3/4). Seventy-one lesions were D3 and 67 lesions were D4. Sensitivities of overall/D3/D4 were 98.0/95.7/100.0 (NILT) and 100/100/100 (DDR), respectively. Correlations with gold-standard were 0.92 (NILT) and 0.42 (DDR), respectively. The correlation increased to 0.97 (p = 0.045) on combining NILT and DDR. There was no difference in sensitivity between the methods (p > 0.05); but was differences in the correlation (p < 0.01). It can be concluded that NILT showed sensitivity similar to that of DDR and higher correlation than DDR for approximal dentinal caries detection. Accordingly, it may be used to monitor the progression of caries without exposing the patient to ionizing radiation, this being of particular interest in growing patients and in pregnant women. In this respect, NILT can be an effective diagnostic tool adjunctive to bitewing radiographs in detecting approximal dentinal caries. The combination of NILT and DDR represents an increase in the diagnosis of approximal lesions The proposed diagnostic protocol comprises visual examination, followed by NILT and DDR only if the former technique detects approximal caries.
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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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Ismail AI, Tellez M, Pitts NB. A Commentary on Caries Detection, Validity, Reliability, and Outcomes of Care. Caries Res 2018; 52:392-396. [PMID: 29506008 DOI: 10.1159/000480360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 08/11/2017] [Indexed: 11/19/2022] Open
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Silvertown JD, Abrams SH, Sivagurunathan KS, Kennedy J, Jeon J, Mandelis A, Hellen A, Hellen W, Elman G, Ehrlich R, Chouljian R, Finer Y, Amaechi BT. Multi-Centre Clinical Evaluation of Photothermal Radiometry and Luminescence Correlated with International Benchmarks for Caries Detection. Open Dent J 2017; 11:636-647. [PMID: 29290842 PMCID: PMC5738748 DOI: 10.2174/1874210601711010636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 10/25/2017] [Accepted: 11/12/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION A clinical study was initiated to investigate a caries detection device (The Canary System (CS)), based on photothermal radiometry and modulated luminescence (PTR-LUM). The primary objective of this study was to determine if PTR-LUM values (in the form of Canary Numbers; CN) correlate with International Caries Diagnostic and Assessment System (ICDAS II) scores and clinical situations. The secondary objectives of this study were to monitor the safety of PTR-LUM, and collect data to determine how CN values could be used to differentiate healthy from decayed tooth surfaces on a normalized scale. METHODS The trial was a four site, non-blinded study. Data was collected from 92 patients, resulting in 842 scanned tooth surfaces over multiple appointments. Surfaces were assessed according to ICDAS II, and further stratified into five clinical situation categories: 1) healthy surface, 2) non-cavitated white and/or brown spots; 3) caries lesions; 4) cavitation and 5) teeth undergoing remineralization therapy.CN data was analyzed separately for smooth and occlusal surfaces. Using a semi-logarithmic graph to plot raw CN (rCN) and normalized (CN) values, rCN data was normalized into a scale of 0-100. RESULTS Linear correlations (R2) between CN and ICDAS II groupings for smooth and occlusal surfaces were calculated as 0.9759 and 0.9267, respectively. The mean CN values derived from smooth (20.2±0.6) and occlusal (19±1.0) surfaces identified as healthy had significantly lower CN values (P<0.05) compared with the values from the other clinical situation categories. No adverse events were reported. CONCLUSION The present study demonstrated the safety of PTR-LUM for clinical application and its ability to distinguish sound from carious tooth surfaces. A clear shift from the baseline in both PTR and LUM in carious enamel was observed depending on the type and nature of the lesion, and correlated to ICDAS II classification codes, which enabled the preliminary development of a Canary Scale.
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Affiliation(s)
| | - Stephen H. Abrams
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | | | - Julia Kennedy
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Jinseok Jeon
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
| | - Andreas Mandelis
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
- Center for Advanced Diffusion Wave and Photoacoustic Technologies (CADIPT), University of Toronto, Ontario, Canada
| | - Adam Hellen
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | - Warren Hellen
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | - Gary Elman
- Downsview Plaza Dental Office, Toronto Ontario, Canada
| | | | | | - Yoav Finer
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
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Bottenberg P, Jacquet W, Behrens C, Stachniss V, Jablonski-Momeni A. Comparison of occlusal caries detection using the ICDAS criteria on extracted teeth or their photographs. BMC Oral Health 2016; 16:93. [PMID: 27604238 PMCID: PMC5015202 DOI: 10.1186/s12903-016-0291-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 09/01/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Using photographs of occlusal surfaces instead of extracted teeth for the detection of caries can be useful in multicenter studies or education. Using a panel of observers, ICDAS scores on teeth or photographs were evaluated against the histological gold standard. The hypothesis was that both outcomes were equivalent. METHODS Four examiners with different experience in ICDAS scored photographs of occlusal surfaces of 100 extracted teeth on a monitor using ICDAS criteria. Two of the examiners had previously scored extracted teeth prior to photography. Digital images of histological sections of the teeth were observed by all examiners and consensus scores were given for each investigation site (gold standard). Kappa statistics and Spearman correlation coefficients as well as repeated measure ANOVA were performed. ROC curves were constructed for each examiner and the areas under the ROC-curves (AUC) of both scoring techniques (extracted teeth, digital images) were compared (α = 0.05). RESULTS Intra- and inter-rater kappa for ICDAS on teeth were 0.81-0.94 and on photographs 0.54-0.88, respectively. Correlation with histology was 0.58- 0.61 for the teeth and 0.50-0.62 for the photographs. AUC of ICDAS scores of extracted teeth (mean 0.89) were slightly higher than those for photographs (mean 0.84). However, both AUC values were not statistically significant (p = 0.38). CONCLUSION Using photographs to assess occlusal surfaces with the ICDAS criteria was not statistically different from scoring the extracted teeth.
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Affiliation(s)
- P. Bottenberg
- Department of Oral Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - W. Jacquet
- Department of Oral Health Sciences, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Depatment of Educational Sciences EDWE-LOCI, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Ixelles, Brussels, Belgium
| | - C. Behrens
- Dental School, Department of Pediatric and Community Dentistry, Philipps University of Marburg, Marburg, Germany
| | - V. Stachniss
- Dental School, Department of Restorative Dentistry, Philipps University of Marburg, Georg-Voigt-Straße 3, D-35039 Marburg, Germany
| | - A. Jablonski-Momeni
- Dental School, Department of Pediatric and Community Dentistry, Philipps University of Marburg, Marburg, Germany
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Mansour S, Ajdaharian J, Nabelsi T, Chan G, Wilder-Smith P. Comparison of caries diagnostic modalities: A clinical study in 40 subjects. Lasers Surg Med 2016; 48:924-928. [PMID: 26997616 DOI: 10.1002/lsm.22460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2015] [Indexed: 11/12/2022]
Abstract
BACKGROUND AND OBJECTIVES Few studies have been published that evaluate the usefulness of different caries- diagnostic modalities in general dental practice. The goal of this study was to compare the results of screening for coronal dental caries in a general dental practice using clinical observations, radiographs, laser fluorescence (DIAGNOdent™) (LF), and optical coherence tomography (OCT). Diagnostic agreement between OCT and LF versus standard clinical techniques for detecting caries was determined in 40 subjects. STUDY DESIGNS/MATERIALS AND METHODS Forty patients with >1 coronal carious lesion as determined by prescreening using clinical examination and radiographs were enrolled in this study. Subjects with gross caries were excluded. Subsequently each patient underwent a full detailed dental examination by an experienced clinician, using visual examination and radiographs according to standard clinical practice. The coronal surfaces of a total of 932 teeth were examined and charted. Teeth were then photographed, rediagnosed using the LF system, and imaged using OCT. Two blinded pre-standardized examiners reviewed radiographic and OCT images and assigned caries status. RESULTS Based on manufacturer's cutoff values, sensitivity and specificity for coronal caries using LF technique (i) on unaltered tooth surfaces were 73.7% and 94.1%, respectively and (ii) in previously restored or sealed teeth, they were 19.2% and 95.8%, respectively. LF technique was unable to assess tissue health underneath sealants and restorations. Clinician agreement (kappa [k]) regarding caries diagnosis using OCT imaging was overall 0.834 (SE = 0.034). Sensitivity and specificity for caries using OCT technique (i) on unaltered tooth surfaces approximated 74.1% and 95.7%, respectively and, (ii) in previously restored or sealed teeth, they approximated 76.0% and 95.6%, respectively. Although OCT was able to detect lesions beneath many resin restorations and sealants, results varied considerably between materials. OCT imaging was unable to detect caries when caries was >2 mm below the tooth surface. CONCLUSION These findings support the usefulness of LF for primary caries detection, and the clinical utility of OCT for early caries detection and monitoring under dental resin restorations and sealants. Lasers Surg. Med. 48:924-928, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Stephanie Mansour
- Beckman Laser Institute, University of California, Irvine, California, 92617
| | - Janet Ajdaharian
- Beckman Laser Institute, University of California, Irvine, California, 92617
| | - Tasneem Nabelsi
- Beckman Laser Institute, University of California, Irvine, California, 92617
| | - Gregory Chan
- Beckman Laser Institute, University of California, Irvine, California, 92617
| | - Petra Wilder-Smith
- Beckman Laser Institute, University of California, Irvine, California, 92617
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13
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Dikmen B. Icdas II criteria (international caries detection and assessment system). J Istanb Univ Fac Dent 2015; 49:63-72. [PMID: 28955548 PMCID: PMC5573507 DOI: 10.17096/jiufd.38691] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 06/19/2014] [Indexed: 12/22/2022] Open
Abstract
The International Caries Detection and Assessment
System (ICDAS) is a clinical scoring system which
allows detection and assessment of caries activity.
ICDAS was developed for use in clinical research,
clinical practice and for epidemiological purposes.
A recent review of caries detection criteria systems
found that there were inconsistencies among the
research criteria for caries measuring systems.
There is a need to an uniform system which allows
comparison of data collected in different researches.
ICDAS allows detection of caries process at every
stage and characterization of the caries activity status
of lesion. Later, the criteria were modified and ICDAS
II created. The aim of this review is to inform about
the ICDAS II and make a comparison between ICDAS
II criteria and other caries detection systems.
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Affiliation(s)
- Benin Dikmen
- Department of Restorative Dentistry, Faculty of Dentistry, Medipol University, Turkey
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14
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Kramer ACA, Hakeberg M, Petzold M, Östberg AL. Demographic factors and dental health of Swedish children and adolescents. Acta Odontol Scand 2015; 74:178-85. [PMID: 26133545 DOI: 10.3109/00016357.2015.1063160] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To investigate the dental health of Swedish children and adolescents with reference to age, gender and residence. MATERIAL AND METHODS Electronic dental records from 300,988 3-19-year-olds in one Swedish region were derived in a cross-sectional study in years 2007-2009. The DMFT system was used. Age was categorized into 3-6/7-9/10-12/13-15/16-17/18-19-year-olds and residence into 'metropolitan', 'urban' and 'rural' areas. ANOVA, generalized linear regression models and Fisher's exact test were used. RESULTS Among 7-9-year-old children, nine out of 10 were free from fillings and manifest caries, while for 18-19-year-olds; this proportion was one third. Girls (18-19-year-olds) had a significantly lower risk of caries compared to boys of the same age, RR for the DT index = 0.83 (95% CI = 0.81-0.85). This pattern was reversed in 7-12-year-old children. Children and adolescents in metropolitan and urban areas had significantly more caries than subjects in rural areas, for instance the RR for the DT index in metropolitan 7-9-year-olds was 2.26 (95% CI = 2.11-2.42) compared to their rural counterparts. CONCLUSIONS In the permanent dentition, the overall pattern revealed that girls ≤ 12 years had a higher risk of caries, while adolescent girls had a lower risk of caries, both compared with boys of corresponding ages. Living in an urban or metropolitan area entailed a higher risk of caries than living in a rural area. A greater occurrence of dental caries in adolescents than in children was confirmed. The findings should have implications for planning and evaluation of oral health promotion and disease prevention activities.
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Affiliation(s)
- Ann-Catrin André Kramer
- a 1 Public Dental Service, Region Västra Götaland , Sweden
- b 2 Department of Behavioural and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg , Göteborg, Sweden
| | - Magnus Hakeberg
- b 2 Department of Behavioural and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg , Göteborg, Sweden
| | - Max Petzold
- c 3 Centre for Applied Biostatistics, The Sahlgrenska Academy, University of Gothenburg , Göteborg, Sweden
| | - Anna-Lena Östberg
- a 1 Public Dental Service, Region Västra Götaland , Sweden
- b 2 Department of Behavioural and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg , Göteborg, Sweden
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15
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Qudeimat MA, Alomari QD, Altarakemah Y, Alshawaf N, Honkala EJ. Variables affecting the inter- and intra-examiner reliability of ICDAS for occlusal caries diagnosis in permanent molars. J Public Health Dent 2015; 76:9-16. [DOI: 10.1111/jphd.12105] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 05/01/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Muawia A. Qudeimat
- Department of Developmental and Preventive Sciences; Kuwait University; Kuwait Kuwait
| | - Qasem D. Alomari
- Department of Restorative Dentistry; Kuwait University; Kuwait Kuwait
| | | | - Nour Alshawaf
- Department of Restorative Dentistry; Kuwait University; Kuwait Kuwait
| | - Eino J. Honkala
- Department of Developmental and Preventive Sciences; Kuwait University; Kuwait Kuwait
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16
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Corraini P, Lopez R, Vaeth M. Implications of less-than-perfect reliability of clinical parameters for the misclassification of periodontitis. Community Dent Oral Epidemiol 2015; 43:183-92. [DOI: 10.1111/cdoe.12142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 12/14/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Priscila Corraini
- Department of Dentistry; Section of Periodontology; Health; Aarhus University; Aarhus Denmark
- Department of Clinical Epidemiology; Aarhus University; Aarhus Denmark
| | - Rodrigo Lopez
- Department of Dentistry; Section of Periodontology; Health; Aarhus University; Aarhus Denmark
| | - Michael Vaeth
- Department of Public Health; Section of Biostatistics; Health; Aarhus University; Aarhus Denmark
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17
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de Souza AL, Bronkhorst EM, Creugers NHJ, Leal SC, Frencken JE. The caries assessment spectrum and treatment (CAST) instrument: its reproducibility in clinical studies. Int Dent J 2014; 64:187-94. [PMID: 24506822 DOI: 10.1111/idj.12104] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
A new caries assessment instrument, the Caries Assessment Spectrum and Treatment (CAST), was developed. It covers carious lesion progression from no lesion, sealants and restorations to lesions in enamel and dentine, advanced stages in pulpal and tooth-surrounding tissues, and tooth loss owing to dental caries, in nine codes. The objective of this study was to determine the reproducibility of the CAST instrument in primary and permanent dentitions, using three age groups. Two epidemiological surveys were conducted in Brazil, covering three age groups: 2-6-year-old and 6-9-year-old children and 19-30-year-old adults. Four trained and calibrated examiners performed the examinations. Reproducibility was calculated for intra- and inter-examiner at surface and tooth levels and expressed as unweighted kappa-coefficient value (κ) and percentage of agreement (Po) for CAST codes (0-7) and for the categories healthy (0-2) versus diseased (3-7), and non-cavitated (0-3) versus cavitated (4-7) teeth. Using CAST codes (0-7) for the 2-6-year-old age group in primary dentitions, inter-examiner consistency was κ = 0.74 and Po was 98.3%. In the 6-9-year-old age group in primary dentitions, inter-examiner consistency ranged from κ = 0.68 to κ = 0.86 and Po was ≥ 93.7%. In the 19-30-year-old age group inter-examiner consistency was κ = 0.87 and Po was 94.1%. The reproducibility of the CAST instrument for use in the primary dentition of 2-6-year olds and of 6-9-year olds was 'substantial' to 'almost perfect'. The reproducibility for its use in the permanent dentition of 19-30-year olds was 'almost perfect'. The CAST instrument can reliably be applied in epidemiological studies covering these ages.
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Affiliation(s)
- Ana Luiza de Souza
- Department of Global Oral Health, College of Dental Sciences, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Paediatric Dentistry, School of Health Sciences, University of Brasília, Brasília, Brazil
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