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Huang X, Qin D, Ngan P, Cao L, Hua F, He H. White spot lesion-related perception of aesthetics and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists. Orthod Craniofac Res 2024; 27:626-634. [PMID: 38466047 DOI: 10.1111/ocr.12776] [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] [Accepted: 03/03/2024] [Indexed: 03/12/2024]
Abstract
OBJECTIVE To investigate the impact of various degrees of white spot lesions (WSLs) of maxillary anterior teeth on the aesthetic perception and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists and to evaluate the differences among the three groups. METHODS A total of 45 orthodontic patients (OP), 45 orthodontists (OR) and 45 other dental specialists (OS) were recruited. Subjective evaluations of perceived aesthetics and treatment satisfaction were performed towards eight digitally generated photographs of maxillary anterior teeth with incremental degrees of WSLs using a numerical visual analogue scale (VAS) from 0 to 100. Data were collected and analysed with descriptive statistics, repeated one-way analysis of variance and multivariable generalized estimating equations. RESULTS A total of 135 valid questionnaires were collected. Regarding aesthetic scores for WSLs, OP gave more positive scores than OR and OS (p < .05) towards excessive white spot formation without colouration and were more tolerant than OR (p < .05) towards excessive white spot formation with slight colouration. The level of treatment satisfaction for slight to severe WSLs without cavitation was higher in OP than OR. Patients with higher education levels had more negative scores for aesthetic perception and treatment satisfaction (p < .05). Patients who brushed teeth more frequently scored lower in treatment satisfaction (p < .05). CONCLUSIONS Orthodontists were the most critical when evaluating aesthetics and treatment satisfaction for slight to severe WSLs without cavitation. For orthodontic patients, better oral hygiene habits and higher education levels were associated with more critical attitudes towards WSLs.
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Affiliation(s)
- Xinliang Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Danchen Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, School of Dentistry, West Virginia University, Morgantown, West Virginia, USA
| | - Lingyun Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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La Rosa GRM, Pedullà E, Chapple I, Pacino SA, Polosa R. The use of quantitative light-induced fluorescence in carious lesions research: A bibliometric review. J Dent 2024; 148:105220. [PMID: 38955259 DOI: 10.1016/j.jdent.2024.105220] [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: 05/22/2024] [Revised: 06/11/2024] [Accepted: 06/28/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE This bibliometric analysis evaluated the top 100 most-cited articles on the application of quantitative light-induced fluorescence (QLF) technology in caries research. DATA The following data were collected: title, authors, country, institution, citations count, title and year of article, study design, topic and keywords. Networks among authors and keywords were constructed by VOSviewer software. SOURCES Scopus database on April 25, 2024. STUDY SELECTION A global citation score of 4633 (average 46.33 citations) was calculated with publication years ranged from 1999 to 2020. Caries Research emerged as the top contributing journal. Pretty IA was the most prolific author (18 %). United Kingdom had the highest number of most-cited papers (32 %), followed by Netherlands and USA (20 % each). Laboratory studies constituted the predominant study design (45 %), followed by randomized clinical trials (20 %) and non-systematic reviews (11 %). The keywords "dental caries" and "fluorescence" had 81 and 79 occurrences, respectively. The main topic was QLF use for caries detection (45 %). CONCLUSIONS This paper provides an update summary of the scientific impact of QLF technology application in caries research. QLF has gained increasing attention worldwide, accompanied by a consistent rise in scientific investigations exploring its application in caries research. CLINICAL SIGNIFICANCE The findings offer valuable insights into the most influential articles in QLF technology for caries assessment, serving as a critical resource for researchers, clinicians, and students. Understanding the trends in this field can aid in informed decision-making and the advancement of evidence-based practices in caries management and prevention.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Iain Chapple
- Periodontal Research Group, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Sebastiano Antonio Pacino
- Addendo srl, Dental Clinic, Catania, Italy; ECLAT Srl, Spin-off of the University of Catania, Catania, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Catania, Italy
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Malin AJ, Wang Z, Khan D, McKune SL. The Potential Systemic Role of Diet in Dental Caries Development and Arrest: A Narrative Review. Nutrients 2024; 16:1463. [PMID: 38794700 PMCID: PMC11124059 DOI: 10.3390/nu16101463] [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: 03/21/2024] [Revised: 04/21/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024] Open
Abstract
Current conceptualizations of dental caries etiology center primarily on the local role of sugar, starch, or other fermentable carbohydrates on tooth enamel demineralization-a well-established and empirically supported mechanism. However, in addition to this mechanism, studies dating back to the early 1900s point to an important systemic role of diet and nutrition, particularly from pasture-raised animal-source foods (ASF), in dental caries etiology and arrest. Findings from animal and human studies suggest that adherence to a diet high in calcium, phosphorus, fat-soluble vitamins A and D, and antioxidant vitamin C, as well as low in phytates, may contribute to arrest and reversal of dental caries, particularly among children. Furthermore, findings from observational and experimental studies of humans across the life-course suggest that fat-soluble vitamins A, D, and K2 may interact to protect against dental caries progression, even within a diet that regularly contains sugar. While these historic studies have not been revisited in decades, we emphasize the need for them to be reinvestigated and contextualized in the 21st century. Specifically, methodologically rigorous studies are needed to reinvestigate whether historical knowledge of systemic impacts of nutrition on dental health can help to inform current conceptualizations of dental caries etiology, prevention, and arrest.
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Affiliation(s)
- Ashley J. Malin
- College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA; (Z.W.); (D.K.); (S.L.M.)
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Zhilin Wang
- College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA; (Z.W.); (D.K.); (S.L.M.)
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Durdana Khan
- College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA; (Z.W.); (D.K.); (S.L.M.)
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Sarah L. McKune
- College of Public Health and Health Professions, University of Florida, Gainesville, FL 32611, USA; (Z.W.); (D.K.); (S.L.M.)
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Ying S, Huang F, Shen X, Liu W, He F. Performance comparison of multifarious deep networks on caries detection with tooth X-ray images. J Dent 2024; 144:104970. [PMID: 38556194 DOI: 10.1016/j.jdent.2024.104970] [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: 09/23/2023] [Revised: 03/11/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVES Deep networks have been preliminarily studied in caries diagnosis based on clinical X-ray images. However, the performance of different deep networks on caries detection is still unclear. This study aims to comprehensively compare the caries detection performances of recent multifarious deep networks with clinical dentist level as a bridge. METHODS Based on the self-collected periapical radiograph dataset in clinic, four most popular deep networks in two types, namely YOLOv5 and DETR object detection networks, and UNet and Trans-UNet segmentation networks, were included in the comparison study. Five dentists carried out the caries detection on the same testing dataset for reference. Key tooth-level metrics, including precision, sensitivity, specificity, F1-score and Youden index, were obtained, based on which statistical analysis was conducted. RESULTS The F1-score order of deep networks is YOLOv5 (0.87), Trans-UNet (0.86), DETR (0.82) and UNet (0.80) in caries detection. A same ranking order is found using the Youden index combining sensitivity and specificity, which are 0.76, 0.73, 0.69 and 0.64 respectively. A moderate level of concordance was observed between all networks and the gold standard. No significant difference (p > 0.05) was found between deep networks and between the well-trained network and dentists in caries detection. CONCLUSIONS Among investigated deep networks, YOLOv5 is recommended to be priority for caries detection in terms of its high metrics. The well-trained deep network could be used as a good assistance for dentists to detect and diagnose caries. CLINICAL SIGNIFICANCE The well-trained deep network shows a promising potential clinical application prospect. It can provide valuable support to healthcare professionals in facilitating detection and diagnosis of dental caries.
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Affiliation(s)
- Shunv Ying
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Feng Huang
- School of Mechanical & Energy Engineering, Zhejiang University of Science & Technology, Hangzhou, 310023, China.
| | - Xiaoting Shen
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Wei Liu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China
| | - Fuming He
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, 310006, China.
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Kühnisch J, Aps JK, Splieth C, Lussi A, Jablonski-Momeni A, Mendes FM, Schmalz G, Fontana M, Banerjee A, Ricketts D, Schwendicke F, Douglas G, Campus G, van der Veen M, Opdam N, Doméjean S, Martignon S, Neuhaus KW, Horner K, Huysmans MCD. ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment. Clin Oral Investig 2024; 28:227. [PMID: 38514502 PMCID: PMC10957694 DOI: 10.1007/s00784-024-05597-3] [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: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection. MATERIALS AND METHODS The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity assessment and (3) forming individualised caries diagnoses. The experts responsible for "caries detection and diagnostic methods" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous Delphi survey. RESULTS Recommendations (N = 8) were approved and agreed upon by the whole expert panel: visual examination (N = 3), dental radiography (N = 3) and additional diagnostic methods (N = 2). While the quality of evidence was found to be heterogeneous, all recommendations were agreed upon by the expert panel. CONCLUSION Visual examination is recommended as the first-choice method for the detection and assessment of caries lesions on accessible surfaces. Intraoral radiography, preferably bitewing, is recommended as an additional method. Adjunct, non-ionising radiation methods might also be useful in certain clinical situations. CLINICAL RELEVANCE The expert panel merged evidence from the scientific literature with practical considerations and provided recommendations for their use in daily dental practice.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany.
| | | | - Christian Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Adrian Lussi
- University Hospital for Conservative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - David Ricketts
- Unit of Restorative Dentistry, University of Dundee, Dundee, UK
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany
| | - Gail Douglas
- Department of Dental Public Health, University of Leeds Dental School, Leeds, UK
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Monique van der Veen
- Departments of Preventive Dentistry and Paediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
- Oral Hygiene School, Inholland University of applied sciences, Amsterdam, The Netherlands
| | - Niek Opdam
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia
| | - Klaus W Neuhaus
- Department of Pediatric Oral Health, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Schierz O, Hirsch C, Krey KF, Ganss C, Kämmerer PW, Schlenz MA. DIGITAL DENTISTRY AND ITS IMPACT ON ORAL HEALTH-RELATED QUALITY OF LIFE. J Evid Based Dent Pract 2024; 24:101946. [PMID: 38401951 DOI: 10.1016/j.jebdp.2023.101946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 02/26/2024]
Abstract
Over the past 50 years, digitization has gradually taken root in dentistry, starting with computer tomography in the 1970s. The most disruptive events in digital dentistry were the introduction of digital workflow and computer-aided manufacturing, which made new procedures and materials available for dental use. While the conventional lab-based workflow requires light or chemical curing under inconsistent and suboptimal conditions, computer-aided manufacturing allows for industrial-grade material, ensuring consistently high material quality. In addition, many other innovative, less disruptive, but relevant approaches have been developed in digital dentistry. These will have or already impact prevention, diagnosis, and therapy, thus impacting patients' oral health and, consequently, their oral health-related quality of life. Both software and hardware approaches attempt to maintain, restore, or optimize a patient's perceived oral health. This article outlines innovations in dentistry and their potential impact on patients' oral health-related quality of life in prevention and therapy. Furthermore, possible future developments and their potential implications are characterized.
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Affiliation(s)
- Oliver Schierz
- Department of Prosthetic Dentistry and Material Sciences, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Christian Hirsch
- Clinic of Pediatric and Preventive Dentistry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Karl-Friedrich Krey
- Department of Orthodontics and Craniofacial Orthopedics, University Medicine Greifswald, Greifswald, Germany
| | - Carolina Ganss
- Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Section Cariology, Philipps-University Marburg, Marburg, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
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Abdelaziz M. Detection, Diagnosis, and Monitoring of Early Caries: The Future of Individualized Dental Care. Diagnostics (Basel) 2023; 13:3649. [PMID: 38132233 PMCID: PMC10742918 DOI: 10.3390/diagnostics13243649] [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: 10/13/2023] [Revised: 11/29/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Dental caries remains a significant global health issue. It was highlighted by the World Health Organization's 2022 reports that despite the efforts and scientific advancements in caries detection and management, the situation has only marginally improved over the past three decades. The persistence of this problem may be linked to outdated concepts developed almost a century ago but are still guiding dentists' approach to caries management today. There is a need to reconsider professional strategies for preventing and managing the disease. Contemporary dentistry could benefit from embracing new concepts and technologies for caries detection and management. Dentists should explore, among others, alternative methods for caries detection such as optical-based caries detection. These tools have been established for over a decade and they align with current disease understanding and international recommendations, emphasizing early detection and minimally invasive management. This narrative review presents the current state of knowledge and recent trends in caries detection, diagnosis, monitoring, and management, offering insights into future perspectives for clinical applications and research topics.
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Affiliation(s)
- Marwa Abdelaziz
- Division of Cariology and Endodontology, Department of Preventive Dental Medicine and Primary Care, University Clinics of Dental Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland
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Lin WS, Alfaraj A, Lippert F, Yang CC. Performance of the caries diagnosis feature of intraoral scanners and near-infrared imaging technology-A narrative review. J Prosthodont 2023; 32:114-124. [PMID: 37701946 DOI: 10.1111/jopr.13770] [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: 05/08/2023] [Accepted: 09/11/2023] [Indexed: 09/14/2023] Open
Abstract
PURPOSE To describe and discuss the benefits and drawbacks of various dental caries diagnostic techniques, including the use of intraoral scanners for caries diagnosis based on near-infrared imaging (NIR) technology. MATERIAL AND METHODS A MEDLINE search from 1980-2023 focused on dental caries diagnostic techniques, emphasizing intraoral scanners using NIR technology. Alternative caries detection methods were also evaluated for their advantages and limitations, enabling a comparison with NIR. The review included traditional caries tools, the latest detection methods, and NIR's role in intraoral scanners, drawing from case reports and both in vivo and in vitro studies. Keywords like "caries detection," "intraoral scanners," and "Near Infrared Imaging (NIRI)" guided the search. After screening titles and abstracts for relevance, full texts with valuable insights were thoroughly analyzed. The data was grouped into three: traditional diagnostics, advanced digital methods, and intraoral scanner-based detection. RESULTS This comprehensive narrative review described and discussed the current state of dental caries diagnostic methods, given the insufficient number of clinical investigations suitable for a systematic review. Traditional caries diagnosis techniques have shown variable accuracy dependent on a dentist's experience and the potential over-removal of healthy tooth structures. Intraoral scanners have emerged as a novel caries detection method, because of their integration of NIR technology. Various studies have confirmed the efficacy of NIR in detecting interproximal caries and in the early diagnosis of non-cavitated caries. Specifically, intraoral scanners have demonstrated promising results, proving comparable to established diagnostic methods like bitewing radiography. Nevertheless, while the integration of NIR into intraoral scanners seems promising, the technology still faces challenges, notably its accuracy in detecting secondary and subgingival cavities. However, with anticipated integrations of AI, NIR in intraoral scanners could revolutionize early caries detection. CONCLUSIONS Intraoral scanners with NIR technology offer non-destructive imaging, real-time lesion visuals, and enhanced patient communication. Although comparable to bitewing radiography in some studies, a universally accepted diagnostic tool is lacking. Future research should compare them with existing methods, focusing on clinical outcomes, cost-effectiveness, and patient acceptance.
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Affiliation(s)
- Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Amal Alfaraj
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Frank Lippert
- Department of Cariology, Operative Dentistry, and Dental Public Health, Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Chao-Chieh Yang
- Department of Prosthodontics, Indiana University School of Dentistry, Advanced Education Program in Prosthodontics, Indianapolis, Indiana, USA
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Amaechi BT, Phillips TS, Perozo BI, Kataoka Y, Movaghari Pour F, Farah R, Obiefuna AC, Farokhi MR. Evaluation of a novel caries detecting oral rinse. BDJ Open 2023; 9:12. [PMID: 36941251 PMCID: PMC10027680 DOI: 10.1038/s41405-023-00134-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/23/2023] Open
Abstract
AIM LumiCare™ Caries Detection Rinse (LC Rinse), a starch-based rinse, illuminates active initial caries (positive response) using dental curing light, thus augmenting the dentist's visual examination. This clinical study investigated if active caries as assessed by the International Caries Detection and Assessment System (ICDAS) were more likely to have positive LC Rinse response than sound surfaces and inactive caries. METHODS 25 subjects participated in the study. Caries was assessed on selected teeth and the entire dentition, firstly using ICDAS and then by fluorescence evaluation after LC Rinse application. Data were statistically analyzed using Diagnostic Odds Ratio (OR) and Chi-square test X2 (α = 0.05). Sensitivity (Se), specificity (Sp), and Diagnostic accuracy (DA) were calculated. RESULTS With selected teeth, active caries were 638.6 times (60.05 with full dentition) more likely to have positive LC Rinse response than sound surfaces and inactive caries combined (X2, p < 0.01) and 191.67 times (18.35 with full dentition) than inactive lesions only (X2, p < 0.01). With combined sound surfaces and inactive caries, Se, Sp, and DA of LC Rinse assessment were 0.94, 0.98, and 0.96 respectively. CONCLUSIONS LC Rinse can distinguish between active caries, inactive caries and hypomineralization, and can augment caries detection with high sensitivity, specificity, and diagnostic accuracy.
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Affiliation(s)
- Bennett Tochukwu Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
| | - Thais Santiago Phillips
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Betty Isabel Perozo
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Yuko Kataoka
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Fatemeh Movaghari Pour
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | - Rayane Farah
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
| | | | - Moshtagh Rashid Farokhi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA
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Al-Asmar AA, Al-Hiyasat AS, Pitts NB. Reframing perceptions in operative dentistry relating evidence-based dentistry and clinical decision making: a cross-sectional study among Jordanian dentists. BMC Oral Health 2022; 22:637. [PMID: 36566180 PMCID: PMC9789303 DOI: 10.1186/s12903-022-02641-0] [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: 06/03/2022] [Accepted: 12/01/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The aim of the current study was to investigate current dental practice in operative dentistry in Jordan, and the relationship between evidence-based dentistry in caries research and decision making in clinical practice in operative dentistry. MATERIALS AND METHODS This cross-sectional study was conducted through a survey of dentists in Jordan. The survey aimed to explore the degree of knowledge and practice of evidence-based dentistry in caries research the dentists possess regarding clinical decision making in operative dentistry. The sample size was composed of (5811) dentists whom registered in Jordan Dental Association database. Descriptive statistics were generated and Chi-square test was used to examine associations between the different variables and the significance level was set at P < 0.05. RESULTS 4000 responses were collected from the web-survey, response rate (68.83%). Nearly half of the surveyed dentists focus on the chief complaint of their patients (n = 2032, 50.8%) rather than doing full mouth assessment. Nearly two-thirds of dentists (n = 2608, 65.2%) treat lesions confined to enamel with operative treatment. Half of dentists use operative treatment when asked about the routine management of radiographically detected proximal caries confined to enamel. When treating incipient lesions, the majority (n = 3220, 80.5%) use preventive treatment. Three-quarters of dentists (n = 2992, 74.8%) treat deep dentinal caries by removing just the soft infected carious dentin, and treated old failed restorations with replacement. CONCLUSION In operative dentistry, the evidence-based research is not implemented clinically. To optimize relationship between evidence-based dentistry and clinical decision-making, dental curriculum has to be updated and modified constantly.
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Affiliation(s)
- Ayah A. Al-Asmar
- grid.9670.80000 0001 2174 4509Department of Restorative Dentistry, School of Dentistry, University of Jordan, Queen Rania St, 11942 Amman, Jordan
| | - Ahmad S. Al-Hiyasat
- grid.37553.370000 0001 0097 5797Department of Conservative Dentistry, School of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nigel B. Pitts
- grid.13097.3c0000 0001 2322 6764Dental Innovation and Impact, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College, London, UK
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11
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Near-Infrared Transillumination for Occlusal Carious Lesion Detection: A Retrospective Reliability Study. Diagnostics (Basel) 2022; 13:diagnostics13010036. [PMID: 36611328 PMCID: PMC9818492 DOI: 10.3390/diagnostics13010036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/24/2022] [Accepted: 12/20/2022] [Indexed: 12/25/2022] Open
Abstract
The aim of this study was to assess the reliability of three diagnostic methods (near-infrared transillumination (NIRT), bitewing radiographs (BW), and clinical images (CI)) to detect occlusal carious lesions in a low caries risk population. This retrospective analysis included one hundred and eighty-eight occlusal surfaces, scored as sound surface, early lesion, or distinct lesion. We evaluated the agreement between and within the methods over time. Kappa statistics tested the correlation between the methods. Examiners detected occlusal early lesions more frequently with visual examination and NIRT and the same lesions were confirmed on the 2-year follow-up. Within the limitations of this study, we were able to establish that early occlusal lesions can be detected and monitored over time using NIRT and visual exam, while BW scores showed mostly sound surfaces at both examinations. NIRT combined with clinical examination can be considered appropriate to detect and monitor early enamel caries on the occlusal surface in low caries-risk populations.
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12
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Jones NA, Bloembergen W, Tenuta LMA, Flannagan SE, Jones GW, Pan LC, Newton M, Clarkson BH, Lahann J, Bloembergen S, González-Cabezas C. Early occlusal caries detection using targeted fluorescent starch nanoparticles. J Dent 2022; 125:104243. [PMID: 35907441 DOI: 10.1016/j.jdent.2022.104243] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/19/2022] [Accepted: 07/22/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES We have previously shown fluorescent cationic starch nanoparticles (FCSNs) penetrate enamel surface porosity of active carious lesions, potentially aiding their detection. Here, we evaluate the in vitro diagnostic accuracy of FCSNs in detecting occlusal caries compared to histologic reference standard. METHODS 100 extracted human teeth were selected with sound (50), or either non-cavitated (25) or cavitated (25) lesions. A region of interest (ROI) on the occlusal surface was assessed for fluorescence by two independent examiners, after immersion in FCSN solution, water rinse, and illumination by dental curing lamp viewed through orange UV-filter glasses. ROIs were sectioned and evaluated by histology (Downer Criteria) as a gold standard for caries presence. Cohen's Kappa was determined for inter- and intra-examiner agreement, and sensitivity, specificity, and area under the curve of Receiver Operator Curves (ROCAUC) were calculated. The analysis was repeated for the subset of "early" lesions, defined as being limited to enamel. RESULTS FCSN use resulted in substantial inter-user (k=0.74±0.07), and high intra-user agreement (k=0.80±0.06; 0.94±0.03, by examiner). Sensitivity, specificity and ROCAUC for FCSNs were 88.9%; 94.6%; 0.92±0.06 for all, and 76.9%, 94.6%, and 0.86±0.10 for early lesions. In post hoc analysis, sensitivity seemed to be greater with the FCSN than the expert visual exam, particularly for early lesions. CONCLUSIONS/CLINICAL SIGNIFICANCE FCSNs are a reproducible and accurate novel technology for occlusal caries detection, with high sensitivity and specificity compared to histology. Future clinical validation is necessary. FCSNs can improve early caries detection and shift treatment towards non-invasive approaches, improving oral health.
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Affiliation(s)
- Nathan A Jones
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States.
| | - Wendy Bloembergen
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
| | - Livia M A Tenuta
- University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Susan E Flannagan
- University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Glenn W Jones
- Saba University School of Medicine, Devens, MA, United States
| | - Li-Chi Pan
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
| | - Mariah Newton
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
| | - Brian H Clarkson
- University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Joerg Lahann
- Department of Chemical Engineering and Biointerfaces Institute, University of Michigan, Ann Arbor, MI, United States
| | - Steven Bloembergen
- GreenMark Biomedical Inc., 1600 Huron Parkway Building 520, Room 2399, Ann Arbor, MI 48109, United States
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13
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Melo M, Pascual A, Camps I, Ata-Ali F, Ata-Ali J. Impedance Spectroscopy as a Tool for the Detection of Occlusal Noncavitated Carious Lesions. Oper Dent 2022; 47:258-267. [PMID: 35604826 DOI: 10.2341/19-149-c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 11/23/2022]
Abstract
A total 302 teeth (148 molars and 154 premolars) corresponding to 152 patients aged ≥18 years were evaluated for caries using the ICDAS (International Caries Detection and Assessment System), fluorescence (DD, DIAGNOdent) and electrical impedance (IMS, CarieScan PRO) systems. Fissurotomy and intraoral radiographs were used as the gold standard. Accordingly, 27.5% (n=84) of the teeth were classified as sound, while 26.9% (n=81) had enamel involvement and 45.6% (n=138) presented carious lesions reaching the dentin. Sensitivity (Se), specificity (Sp), and the area under the curve (AUC) were, respectively, 90.7%, 87.8%, and 0.954 (IMS); 92.4%, 92.7%, and 0.954 (DD); and 79.0%, 72.3%, and 0.756 (ICDAS). With regard to Se and Sp, there were significant differences between ICDAS and DD (p<0.001) and between ICDAS and IMS (p=0.01), but not between IMS and DD (p=0.07). In relation to AUC, there were significant differences between ICDAS and DD (p<0.001), and between ICDAS and IMS (p<0.001), but not between IMS and DD (p>0.05). The correlations between fissurotomy and each method were 88.7% (IMS), 89.7% (DD), and 77.1% (ICDAS). Within the limitations of this study, clinically, the electrical system is not useful for differentiating between sound teeth and truly incipient caries lesions by itself. The fluorescence or electrical systems are recommended with the ICDAS to detect carious lesions in their early stages.
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Affiliation(s)
- M Melo
- María Melo, DDS, MS, PhD, Valencia University Medical and Dental School, University of Valencia, Valencia, Spain
| | - A Pascual
- Agustín Pascual, DDS, MS, PhD, Valencia University Medical and Dental School, University of Valencia, Valencia, Spain
| | - I Camps
- Isabel Camps, DDS, Ms, PhD, Valencia University Medical and Dental School, University of Valencia, Valencia, Spain
| | - F Ata-Ali
- Fadi Ata-Ali, DDS, MS, PhD, private dental practice, Valencia, Spain
| | - J Ata-Ali
- *Javier Ata-Ali, DDS, MS, MPH, PhD, Universidad Europea de Valencia, Faculty of Health Sciences, Department of Dentistry, Public Dental Health Service, Conselleria de Sanitat Universal i Salut Pública, Generalitat Valenciana, Valencia, Spain
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14
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Lin X, Hong D, Zhang D, Huang M, Yu H. Detecting Proximal Caries on Periapical Radiographs Using Convolutional Neural Networks with Different Training Strategies on Small Datasets. Diagnostics (Basel) 2022; 12:diagnostics12051047. [PMID: 35626203 PMCID: PMC9139265 DOI: 10.3390/diagnostics12051047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 02/05/2023] Open
Abstract
The present study aimed to evaluate the performance of convolutional neural networks (CNNs) that were trained with small datasets using different strategies in the detection of proximal caries at different levels of severity on periapical radiographs. Small datasets containing 800 periapical radiographs were randomly categorized into a training and validation dataset (n = 600) and a test dataset (n = 200). A pretrained Cifar-10Net CNN was used in the present study. Different training strategies were used to train the CNN model independently; these strategies were defined as image recognition (IR), edge extraction (EE), and image segmentation (IS). Different metrics, such as sensitivity and area under the receiver operating characteristic curve (AUC), for the trained CNN and human observers were analysed to evaluate the performance in detecting proximal caries. IR, EE, and IS recognition modes and human eyes achieved AUCs of 0.805, 0.860, 0.549, and 0.767, respectively, with the EE recognition mode having the highest values (p all < 0.05). The EE recognition mode was significantly more sensitive in detecting both enamel and dentin caries than human eyes (p all < 0.05). The CNN trained with the EE strategy, the best performer in the present study, showed potential utility in detecting proximal caries on periapical radiographs when using small datasets.
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Affiliation(s)
- Xiujiao Lin
- Fujian Provincial Engineering Research Center of Oral Biomaterial, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350005, China; (X.L.); (D.H.)
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350005, China
| | - Dengwei Hong
- Fujian Provincial Engineering Research Center of Oral Biomaterial, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350005, China; (X.L.); (D.H.)
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350005, China
| | - Dong Zhang
- College of Computer and Data Science, Fuzhou University, Fuzhou 350025, China; (D.Z.); (M.H.)
| | - Mingyi Huang
- College of Computer and Data Science, Fuzhou University, Fuzhou 350025, China; (D.Z.); (M.H.)
| | - Hao Yu
- Fujian Provincial Engineering Research Center of Oral Biomaterial, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350005, China; (X.L.); (D.H.)
- Department of Prosthodontics, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350005, China
- Department of Applied Prosthodontics, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8521, Japan
- Correspondence:
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15
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Oh SH, Choi JY, Kim SH. Evaluation of dental caries detection with quantitative light-induced fluorescence in comparison to different field of view devices. Sci Rep 2022; 12:6139. [PMID: 35414687 PMCID: PMC9005513 DOI: 10.1038/s41598-022-10126-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/28/2022] [Indexed: 11/29/2022] Open
Abstract
This study evaluated dental caries detection ability between the Qraycam and Qraypen on the same dental caries lesions. A total of 178teeth from 61patients were imaged using Qraypen C®(QC) and Qraycam Pro®(QP) devices and evaluated using analysis software (QA2). Occlusal, secondary, and proximal dental caries were evaluated and scored according to International Caries Detection and Assessment System(ICDAS II) and X-ray criteria. Bland–Altman plots were used to compare quantitative light-induced fluorescence(QLF) parameters obtained from the different QLF devices. Sensitivity, specificity, and area under the receiver operating characteristic curve(AUROC) were calculated. The ΔFaver. of the QLF-parameters showed that the mean difference between the two different QLF devices was close to zero and that the ± 5 error value was included in the mean ± 1.96SD range for the detection of dental caries. The accuracies for diagnosing occlusal dental caries were 0.83–0.96 and 0.81–0.82 and the accuracies for diagnosing proximal dental caries were 0.52–0.62 and 0.52–0.71 for the QC and QP devices, respectively. In conclusion, the ΔFaver. obtained from the QP showed diagnostic value mainly for screening of demineralized teeth. For teeth selected through screening, the depth of the lesion must be precisely evaluated using additional QP and radiographic imaging.
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Affiliation(s)
- Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea.
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16
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Sardana D, Li KY, Ekambaram M, Yang Y, McGrath CP, Yiu CK. Validation of clinical photography and a laser fluorescence device for assessment of enamel demineralization during multi-bracketed fixed orthodontic treatment. Photodiagnosis Photodyn Ther 2022; 38:102828. [PMID: 35339722 DOI: 10.1016/j.pdpdt.2022.102828] [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: 12/23/2021] [Revised: 02/19/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
AIM To compare the validity of DIAGNOdent pen™ 2190 and clinical photographs in the diagnosis (presence or absence) and assessment of white spot lesions (WSLs) during multi-bracketed fixed orthodontic treatment. METHODS A total of 1607 readings from 99 patients were obtained using DIAGNOdent pen™ 2190, clinical photographs, and visual assessment criteria to assess WSLs at 6 -, 12- and 18 months after bonding of brackets. Receiver operating characteristic curves were constructed, and areas under the curve (AUC) were calculated to assess the presence or absence of WSLs and distinguish the severity of WSLs as slight or severe. Sensitivities, specificities, and AUC were calculated for outcomes at an alpha of 0.05 and 95% confidence intervals (CIs). RESULTS The values of sensitivity and specificity of DIAGNOdent pen™ 2190 were found to be 0.78 and 0.83, respectively, to distinguish presence/absence of WSLs with good accuracy (AUC= 0.855; 95% CI: 0.820-0.889) and for digital photographs, accuracy was excellent (AUC= 0.973, 95% CI: 0.956-0.991) with sensitivity and specificity of 0.96 and 0.99, respectively. However, the accuracy of DIAGNOdent pen™ 2190 was poor (AUC= 0.543, 95% CI: 0.418-0.668) in delineating slight and severe WSLs with a sensitivity of 0.31 and specificity of 0.83; while the values of sensitivity and specificity for distinguishing slight or severe lesions for clinical photographs were 0.96 and 0.99, respectively with excellent accuracy (AUC=0.978, 95% CI: 0.936-1.000). CONCLUSIONS Clinical photographs had better validity than DIAGNOdent pen™ 2190 in diagnosis and assessment of severity of demineralized lesions during multi-bracketed fixed orthodontic treatment.
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Affiliation(s)
- Divesh Sardana
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R; T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kar Yan Li
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | | | - Yanqi Yang
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Colman P McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R
| | - Cynthia Ky Yiu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong S.A.R.
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Al-Marzooq F, Al Kawas S, Rahman B, Shearston JA, Saad H, Benzina D, Weitzman M. Supragingival microbiome alternations as a consequence of smoking different tobacco types and its relation to dental caries. Sci Rep 2022; 12:2861. [PMID: 35190583 PMCID: PMC8861055 DOI: 10.1038/s41598-022-06907-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 02/02/2022] [Indexed: 12/13/2022] Open
Abstract
This study aimed to assess the effect of smoking different tobacco types on the supragingival microbiome and its relation to dental caries. Forty supragingival plaque samples were collected from smokers of a single tobacco type and non-smokers seeking treatment at the University Dental Hospital Sharjah, UAE. DMFT (decayed, missing and filled teeth) was determined for all participants who were divided into two groups: no-low caries (NC-LC: DMFT = 0-4; n = 18) and moderate-high caries (MC-HC: DMFT = 5-20; n = 22). 16S rRNA gene was sequenced using third-generation sequencing with Nanopore technology. Microbiome composition and diversity were compared. Caries was most common among cigarette smokers. Supragingival microbiota were significantly altered among smokers of different tobacco types. In cigarette smokers, cariogenic bacteria from genus Streptococcus (including S. mutans) were significantly more among subjects with NC-LC, while Lactobacilli (including L. fermentum) were more among subjects with MC-HC. In medwakh smokers, several periodontopathogens were significantly elevated in subjects with NC-LC, while other pathogenic bacteria (as Klebsiella pneumoniae) were more in those with MC-HC. Cigarette and alternative tobacco smoking had a significant impact on the supragingival microbiome. Indeed, further studies are required to unravel the consequences of oral dysbiosis triggered by smoking. This could pave the way for microbiota-based interventional measures for restoring a healthy oral microbiome which could be a promising strategy to prevent dental caries.
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Affiliation(s)
- Farah Al-Marzooq
- Department of Medical Microbiology and Immunology, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates.
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates.
| | - Betul Rahman
- Sharjah Institute for Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Jenni A Shearston
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, USA
- Department of Pediatrics, School of Medicine, New York University, New York, USA
| | - Hiba Saad
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
| | - Dalenda Benzina
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, P.O.Box: 27272, Sharjah, United Arab Emirates
| | - Michael Weitzman
- Department of Pediatrics, School of Medicine, New York University, New York, USA
- Department of Environmental Medicine, School of Medicine, New York University, New York, USA
- College of Global Public Health, New York University, New York, USA
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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions. Curr Osteoporos Rep 2022; 20:90-105. [PMID: 35129809 PMCID: PMC8930910 DOI: 10.1007/s11914-022-00722-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF THE REVIEW Compare pathophysiology for infectious and noninfectious demineralization disease relative to mineral maintenance, physiologic fluoride levels, and mechanical degradation. RECENT FINDINGS Environmental acidity, biomechanics, and intercrystalline percolation of endemic fluoride regulate resistance to demineralization relative to osteopenia, noncarious cervical lesions, and dental caries. Demineralization is the most prevalent chronic disease in the world: osteoporosis (OP) >10%, dental caries ~100%. OP is severely debilitating while caries is potentially fatal. Mineralized tissues have a common physiology: cell-mediated apposition, protein matrix, fluid logistics (blood, saliva), intercrystalline ion percolation, cyclic demineralization/remineralization, and acid-based degradation (microbes, clastic cells). Etiology of demineralization involves fluid percolation, metabolism, homeostasis, biomechanics, mechanical wear (attrition or abrasion), and biofilm-related infections. Bone mineral density measurement assesses skeletal mass. Attrition, abrasion, erosion, and abfraction are diagnosed visually, but invisible subsurface caries <400μm cannot be detected. Controlling demineralization at all levels is an important horizon for cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- grid.257413.60000 0001 2287 3919Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- grid.1008.90000 0001 2179 088XDepartment of Biochemistry and Pharmacology, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Parkville, Victoria 3010 Australia
| | - Paul M. Schneider
- grid.1008.90000 0001 2179 088XMelbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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Emerging Technologies for Dentin Caries Detection-A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11030674. [PMID: 35160127 PMCID: PMC8837049 DOI: 10.3390/jcm11030674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
This systematic review and meta-analysis aimed at assessing the diagnostic accuracy of emerging technologies, such as laser fluorescence (LF), transillumination, light-emitting diode devices, optical coherence tomography (OCT), alternating current impedance spectroscopy, fluorescence cameras (FC), photo-thermal radiometry, and modulated luminescence technology. In vivo and in vitro results of such non-ionizing, non-invasive, and non-destructive methods’ effectiveness in non-cavitated dentin caries detection are sometimes ambiguous. Following the PRISMA guidelines, 34 relevant research articles published between 2011–2021 were selected. The risk of bias was assessed with a tool tailored for caries diagnostic studies, and subsequent quantitative uni- and bi-variate meta-analysis was carried out in separate sub-groups according to the investigated surface (occlusal/proximal) and study setting (in vivo/in vitro). In spite of the high heterogeneity across the review groups, in vitro studies on LF and FC proved a good diagnostic ability for the occlusal surface, with area under the curve (AUC) of 0.803 (11 studies) and 0.845 (five studies), respectively. OCT studies reported an outstanding performance with an overall AUC = 0.945 (four studies). Promising technologies, such as OCT or FC VistaProof, still need well-designed and well-powered studies to accrue experimental and clinical data for conclusive medical evidence, especially for the proximal surface. Registration: INPLASY202210097.
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Cho KH, Kang CM, Jung HI, Lee HS, Lee K, Lee TY, Song JS. The diagnostic efficacy of quantitative light-induced fluorescence in detection of dental caries of primary teeth. J Dent 2021; 115:103845. [PMID: 34637890 DOI: 10.1016/j.jdent.2021.103845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate a quantitative light-induced fluorescence (QLF) caries detection method using a portable device under clinical conditions and present a QLF scoring index (QS-index) for primary teeth. METHODS A total of 878 tooth surfaces (proximal and occlusal) of 44 children were studied. After visual inspection and radiographic examination, images of dental caries captured with the QLF device were classified according to caries progression stages and analyzed with a specialized software. Cut-off values, sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were calculated for the QLF parameters: fluorescence loss (ΔF) and bacterial activity (ΔR). The reliability of logistic regression model to combine ΔF and ΔR was evaluated by the AUROC. RESULTS QLF parameters showed a good sensitivity (0.72-0.91), specificity (0.74-0.96), and AUROC (0.861-0.940). The AUROC of logistic regression model (0.90-0.957) was higher than ΔF or ΔR average alone in all types of carious lesions. Every level of the QS-index was properly defined to represent the progression of dental caries with corresponding statistical significance. CONCLUSIONS The reliability of QLF for dental caries detection in primary teeth was similar to or slightly higher than that of the traditional diagnostic methods of visual inspection or radiographic examination in clinical conditions. CLINICAL SIGNIFICANCE The results of QLF were reliable in detecting all types of dental caries in primary teeth. The QLF method can provide visual images as well as quantitatively analyze the carious lesion.
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Affiliation(s)
- Kyung Hyun Cho
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Chung-Min Kang
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea; Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Hoi-In Jung
- Department of Preventive Dentistry & Public Oral Health, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Hyo-Seol Lee
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
| | - Koeun Lee
- Department of Pediatric Dentistry, Kyung Hee University Dental Hospital, Seoul, Republic of Korea
| | - Tae Yang Lee
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea
| | - Je Seon Song
- Department of Pediatric Dentistry, College of Dentistry, Yonsei University, Seoul, Republic of Korea; Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
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Qin D, Wang Y, Levey C, Ngan P, He H, Hua F. Protocol for the development of a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). Trials 2021; 22:507. [PMID: 34332635 PMCID: PMC8325281 DOI: 10.1186/s13063-021-05371-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 06/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Enamel white spot lesions (WSLs), characterized by an opaque, matt, and chalky white appearance of enamel, are a sign of incipient caries. WSLs are common in orthodontic practice and can affect both the oral health and dental aesthetics of patients. Extensive studies have been conducted to evaluate the effectiveness of prevention or treatment for orthodontically induced enamel WSLs. However, substantial heterogeneity has been found in the outcomes used for the prevention and treatment of WSLs in literature, which prevents researchers from comparing and combining the results of different studies to draw more decisive conclusions. Therefore, we aim to develop a Core Outcome Set for trials on the prevention and treatment of Orthodontically induced enamel White Spot Lesions (COS-OWSL). METHODS The development of COS-OWSL comprises four phases: (1) a scoping review to identify and summarize all existing outcomes that have been used in trials on the prevention or treatment of orthodontically induced WSLs; (2) qualitative interviews with orthodontic patients without (for prevention) and with WSL-affected teeth (for treatment) and relevant dental professionals to identify additional outcomes relevant to them; (3) Delphi surveys to collect opinions from key stakeholders including patients, dental professionals, and researchers and to reach a preliminary consensus; and (4) a consensus meeting to develop the final COS-OWSL. DISCUSSION The COS-OWSL will be developed to facilitate the synthesis of evidence regarding the prevention and treatment of orthodontically induced WSLs and to promote the consistent use of relevant patient-important outcomes among future studies in this field. TRIAL REGISTRATION Core Outcome Measures in Effectiveness Trials (COMET) initiative (the COS-WSL project) 1399.
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Affiliation(s)
- Danchen Qin
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Yunlei Wang
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China
| | - Colin Levey
- School of Dentistry, University of Dundee, Dundee, UK
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, Morgantown, USA
| | - Hong He
- Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China. .,Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China.
| | - Fang Hua
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Centre for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Luoyu Rd. 237, Wuhan, 430079, China. .,Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
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22
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How different time intervals between repeated applications of CPP-ACP fluoride varnish effect smooth surface enamel demineralization? J Dent 2021; 112:103742. [PMID: 34224791 DOI: 10.1016/j.jdent.2021.103742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To evaluate the preventive effects of different time intervals between repeated applications of the CPP-ACP fluoride varnish on enamel demineralization. METHODS Human teeth were sectioned and randomly allocated to three groups: 4-week, 6-week, and 12-week (N = 22/group). Baseline images of the enamel surfaces were obtained using the FluoreCam recording the area, intensity, and impact of baseline enamel demineralization. All groups received fluoride varnish applications at the beginning of the experiment. The varnish was reapplied every 4 or 6 weeks in the 4-week and 6-week groups, respectively. Following each application, the groups underwent thermo-cycling, tooth brushing and pH cycling to simulate the time effect. After 12 weeks, the enamel surfaces were reimaged using the FluoreCam. Within and between-group differences in the area, intensity and impact of demineralization were evaluated. RESULTS At baseline, there were no significant between-group differences for area, intensity, or impact. Statistically significant (p<0.001) enamel demineralization occurred over time within each group. There were significant between-group differences in the changes that occurred in area (P = 0.004), impact (P = 0.022), but not intensity. The 12-week had significantly larger areas of demineralization than the 6-week (P = 0.041) and 4-week (P = 0.001) groups. Changes in impact was significantly (P = 0.007) greater in the 12-week group than 4-week group, but not greater than the 6-week group. There were no statistically significant differences between 4- and 6-week groups in the changes of area, intensity, or impact. CONCLUSION Reapplication of the CPP-ACP fluoride varnish every 4-6 weeks, is more effective in reducing enamel demineralization compared to every 12 weeks.
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23
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Foros P, Oikonomou E, Koletsi D, Rahiotis C. Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis. Caries Res 2021; 55:247-259. [PMID: 34130279 DOI: 10.1159/000516084] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 03/21/2021] [Indexed: 11/19/2022] Open
Abstract
The aim was to appraise the evidence on the performance of various means for the detection of incipient caries in vivo. Five databases of published and unpublished research were searched for studies from January 2000 to October 2019. Search terms included "early caries" and "caries detection." Inclusion criteria involved diagnostic test accuracy studies for early caries detection in permanent and primary teeth. A risk-of-bias assessment was performed using the QUADAS-2 tool. We performed the study selection, data extraction, and risk-of-bias assessment in duplicate. The review protocol was a priori registered in the Open Science Framework. Of the initially 22,964 search results, 51 articles were included. For permanent teeth, when histologic examination was considered as the reference for occlusal surfaces, the sensitivity (Se) range appeared high for the DIAGNOdent Pen (DD Pen) at 0.81-0.89, followed by ICDAS-II at 0.62-1, DIAGNOdent (DD) at 0.48-1, and bitewing radiography (BW) at 0-0.29. The corresponding specificity (Sp) range was: DD Pen 0.71-0.8, ICDAS-II 0.5-0.84, DD 0.54-1, and BW 0.96-1. When operative intervention served as the reference for occlusal surfaces, again, the DD means valued the most promising results on Se: DD 0.7-0.96 and DD Pen 0.55-0.90, followed by ICDAS-II 0.25-0.93, and BW 0-0.83. The Sp range was: DD 0.54-1, DD Pen 0.71-1, ICDAS-II 0.44-1, and BW 0.6-1. For approximal surfaces, the Se was: BW 0.75-0.83, DD Pen 0.6, and ICDAS-II 0.54; the Sp was: BW 0.6-0.9, DD Pen 0.2, and ICDAS-II 1. For primary teeth, under the reference of histologic assessment, the Se range for occlusal surfaces was: DD 0.55-1, DD Pen 0.63-1, ICDAS-II 0.42-1, and BW 0.31-0.96; the respective Sp was: DD 0.5-1, DD Pen 0.44-1, ICDAS-II 0.61-1, and BW 0.79-0.98. For approximal surfaces, the Se range was: DD Pen 0.58-0.63, ICDAS-II 0.42-0.55, and BW 0.14-0.71. The corresponding Sp range was: DD Pen 0.85-0.87, ICDAS-II 0.73-0.93, and BW 0.79-0.98. Se and Sp values varied, due to the heterogeneity regarding the setting of individual studies. Evidently, robust conclusions cannot be drawn, and different diagnostic means should be used as adjuncts to clinical examination. In permanent teeth, visual examination may be enhanced by DD on occlusal surfaces and BW on approximal surfaces. In primary teeth, DD Pen may serve as a supplementary tool across all surfaces.
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Affiliation(s)
- Petros Foros
- School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Elissaios Oikonomou
- School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Koletsi
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Christos Rahiotis
- Department of Operative Dentistry, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
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24
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Abstract
Dental caries is a dynamic, preventable, reversible, complex biofilm-mediated, multifactorial disease that involves a series of demineralization/neutrality/remineralization of dental hard tissue in primary and permanent dentition. An imbalance in the continuum with a net demineralization over time results in the initiation of caries lesions. Visual inspection and intraoral radiographs are vital in caries detection, although they are of suboptimal sensitivity for early caries lesions. Shifting toward a conservative, noninvasive approach to caries management has resulted in the development of innovative-sensitive technologies. These newer techniques may serve as adjunct for the dental practitioner in detecting earliest changes in tooth structure.
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25
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Zhang Y, Huang S, Jia S, Sun Z, Li S, Li F, Zhang L, Lu J, Tan K, Teng F, Yang F. The predictive power of saliva electrolytes exceeds that of saliva microbiomes in diagnosing early childhood caries. J Oral Microbiol 2021; 13:1921486. [PMID: 34035879 PMCID: PMC8131007 DOI: 10.1080/20002297.2021.1921486] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Early childhood caries (ECC) is one of the most prevalent chronic diseases affecting children worldwide, and thus its etiology, diagnosis, and prognosis are of particular clinical significance. This study aims to test the ability of salivary microbiome and electrolytes in diagnosing ECC, and their interplays within the same population. We here simultaneously profiled salivary microbiome and biochemical components of 331 children (166 caries-free (H group) and 165 caries-active children (C group)) aged 4-6 years. We identified both salivary microbial and biochemical dysbiosis associated with ECC. Remarkably, K+, Cl-, NH4+, Na+, SO42-, Ca2+, Mg2+, and Br- were enriched while pH and NO3- were depleted in ECC. Moreover, the dmft index (ECC severity) positively correlated with Cl-, NH4+, Ca2+, Mg2+, Br-, while negatively with pH and NO3-. Furthermore, machine-learning classification models were constructed based on these biomarkers from saliva microbiota, or electrolytes (and pH). Unexpectedly, the electrolyte-based classifier (AUROC = 0.94) outperformed microbiome-based (AUROC = 0.70) one and the composite-based one (with both microbial and biochemical data; AUC = 0.89) in predicting ECC. Collectively, these findings indicate ECC-associated alterations and interplays in the oral microbiota, electrolytes and pH, underscoring the necessity of developing diagnostic models with predictors from salivary electrolytes.
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Affiliation(s)
- Ying Zhang
- School of Stomatology, Qingdao University, Qingdao, Shandong, China
| | - Shi Huang
- Centre of Microbiome Innovation, Jacobs School of Engineering, University of California, San Diego, La Jolla, California, 92093, USA.,UCSD Health Department of Pediatrics, University of California, San Diego, La Jolla, California, 92093, USA
| | - Songbo Jia
- Department of Stomatology, Tianjin Children's Hospital, Tianjin, 300400 China
| | - Zheng Sun
- Single-Cell Center, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong, China
| | - Shanshan Li
- School of Stomatology, Qingdao University, Qingdao, Shandong, China
| | - Fan Li
- School of Stomatology, Qingdao University, Qingdao, Shandong, China.,Stomatology Centre, Qingdao Municipal Hospital, Qingdao, Shandong, 266071 China
| | - Lijuan Zhang
- Department of Stomatology, Women & Children's Health Care Hospital of Linyi, Linyi, Shandong, 276000 China
| | - Jie Lu
- Stomatology Centre, Qingdao Municipal Hospital, Qingdao, Shandong, 266071 China
| | - Kaixuan Tan
- Stomatology Centre, Qingdao Municipal Hospital, Qingdao, Shandong, 266071 China
| | - Fei Teng
- Single-Cell Center, Qingdao Institute of Bioenergy and Bioprocess Technology, Chinese Academy of Sciences, Qingdao, Shandong, China
| | - Fang Yang
- School of Stomatology, Qingdao University, Qingdao, Shandong, China
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26
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Park KJ, Voigt A, Schneider H, Ziebolz D, Haak R. Light-based diagnostic methods for the in vivo assessment of initial caries lesions: Laser fluorescence, QLF and OCT. Photodiagnosis Photodyn Ther 2021; 34:102270. [PMID: 33785442 DOI: 10.1016/j.pdpdt.2021.102270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate different light-based caries diagnostic methods for assessment of non-cavitated initial carious lesions on smooth surfaces. METHODS 39 participants were included. For each participant, three regions of interest (ROI) with ICDAS codes 0, 1 or 2 were defined. All ROIs (n = 117) were investigated/imaged with laser fluorescence (LF, DIAGNOdent 2095; KaVo dental GmbH), quantitative light-induced fluorescence (QLF; Biluminator 2+, Inspektor Research Systems B.V.) and spectral-domain optical coherence tomography (SD-OCT; Telesto II, Thorlabs GmbH). The values of LF, ΔF of QLF, and the lesion extent assessed by OCT were categorized. Frequency distribution of LF-/QLF- and OCT-scores was determined for each ICDAS code included. Inter- and intra-examiner reproducibility of QLF and OCT measurements were assessed by unweighted kappa coefficient (ĸ) and Wilcoxon test (α = 0.05). RESULTS Compared with LF and QLF, OCT showed various manifestations of carious lesions for visually sound ROIs and a larger variation of caries extent in depth within the same ICDAS code groups. Intra-examiner reproducibility ranged between 0.49 and 1.00 for the QLF analysis and between 0.95 and 0.99 for the OCT analysis. Inter-examiner reproducibility ranged between 0.17 and 0.32 for the QLF analysis and between 0.65 and 0.79 for the OCT analysis. CONCLUSION LF and QLF were insensitive to less pronounced smooth-surface lesions while OCT allowed differentiation based on the penetration depth of the carious lesions. This makes OCT a suitable method to complement conventional visual inspection in order to detect and assess (very) early lesions.
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Affiliation(s)
- Kyung-Jin Park
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
| | - Aline Voigt
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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Macey R, Walsh T, Riley P, Glenny AM, Worthington HV, Clarkson JE, Ricketts D. Electrical conductance for the detection of dental caries. Cochrane Database Syst Rev 2021; 3:CD014547. [PMID: 33724442 PMCID: PMC8406820 DOI: 10.1002/14651858.cd014547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Caries is one of the most prevalent, preventable conditions worldwide. A wide variety of management options are available at different thresholds of disease, ranging from non-operative preventive strategies such as improved oral hygiene, reduced sugar diet, and application of topical fluoride, to minimally invasive treatments for early lesions which are limited to enamel, through to selective removal and restoration for extensive lesions. The cornerstone of caries detection is a visual and tactile dental examination, however, an increasing array of methods of caries lesion detection have been proposed that could potentially support traditional methods of detection and diagnosis. Earlier identification of disease could afford patients the opportunity of less invasive treatment with less destruction of tooth tissue, reduce the need for treatment with aerosol-generating procedures, and potentially result in a reduced cost of care to the patient and to healthcare services. OBJECTIVES Our primary objective was to determine the diagnostic accuracy of different electrical conductance devices for the detection and diagnosis of non-cavitated coronal dental caries in different populations (children, adolescents, and adults) and when tested against different reference standards. SEARCH METHODS Cochrane Oral Health's Information Specialist undertook a search of the following databases: MEDLINE Ovid (1946 to 26 April 2019); Embase Ovid (1980 to 26 April 2019); US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov, to 26 April 2019); and the World Health Organization International Clinical Trials Registry Platform (to 26 April 2019). We studied reference lists as well as published systematic review articles. SELECTION CRITERIA We included diagnostic accuracy studies that compared electrical conductance devices with a reference standard of histology or an enhanced visual examination. This included prospective studies that evaluated the diagnostic accuracy of single index tests and studies that directly compared two or more index tests. We included studies using previously extracted teeth or those that recruited participants with teeth believed to be sound or with early lesions limited to enamel. Studies that explicitly recruited participants with more advanced lesions that were obviously into dentine or frankly cavitated were excluded. DATA COLLECTION AND ANALYSIS Two review authors extracted data independently using a piloted study data extraction form based on the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Sensitivity and specificity with 95% confidence intervals (CIs) were reported for each study. This information was displayed as coupled forest plots, and plotted as summary receiver operating characteristic (SROC) plots, displaying the sensitivity-specificity points for each study. Due to variability in thresholds we estimated diagnostic accuracy using hierarchical summary receiver operating characteristic (HSROC) methods. MAIN RESULTS We included seven studies reporting a total of 719 tooth sites or surfaces, with an overall prevalence of the target condition of 73% (528 tooth sites or surfaces). The included studies evaluated two index tests: the electronic caries monitor (ECM) (four studies, 475 tooth surfaces) and CarieScan Pro (three studies, 244 tooth surfaces). Six studies used histology as the reference standard, one used an enhanced visual examination. No study was considered to be at low risk of bias across all four domains or low concern for applicability or both. All studies were at high (five studies) or unclear (two studies) risk of bias for the patient selection domain. We judged two studies to be at unclear risk of bias for the index test domain, and one study to be at high risk of bias for the reference standard and flow and timing domains. We judged three studies to be at low concern for applicability for patient selection, and all seven studies to be of low concern for reference standard and flow and timing domains. Studies were synthesised using a hierarchical method for meta-analysis. There was variability in the results of the individual studies, with sensitivities which ranged from 0.55 to 0.98 and specificities from 0 to 1.00. These extreme values of specificity may be explained by a low number of healthy tooth surfaces in the included samples. The diagnostic odds ratio (DOR) was 15.65 (95% CI 1.43 to 171.15), and indicative of the variability in the included studies. Through meta-regression we observed no meaningful difference in accuracy according to device type or dentition. Due to the small number of studies we were unable to formally investigate other potential sources of heterogeneity. We judged the certainty of the evidence as very low, and downgraded for risk of bias due to limitations in the design and conduct of the included studies, imprecision arising from the relatively small number of surfaces studied, and inconsistency due to the variability of results. AUTHORS' CONCLUSIONS The design and conduct of studies to determine the diagnostic accuracy of methods to detect and diagnose caries in situ is particularly challenging. The evidence base to support the detection and diagnosis of caries with electrical conductance devices is sparse. Newer electrical conductance devices show promise and further research at the enamel caries threshold using a robust study design to minimise bias is warranted. In terms of applicability, any future studies should be carried out in a clinical setting to provide a realistic assessment within the oral cavity where plaque, staining, and restorations can be problematic.
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Affiliation(s)
- Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Janet E Clarkson
- Division of Oral Health Sciences, Dundee Dental School, University of Dundee, Dundee, UK
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28
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Walsh T, Macey R, Riley P, Glenny AM, Schwendicke F, Worthington HV, Clarkson JE, Ricketts D, Su TL, Sengupta A. Imaging modalities to inform the detection and diagnosis of early caries. Cochrane Database Syst Rev 2021; 3:CD014545. [PMID: 33720395 PMCID: PMC8441255 DOI: 10.1002/14651858.cd014545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The detection and diagnosis of caries at the earliest opportunity is fundamental to the preservation of tooth tissue and maintenance of oral health. Radiographs have traditionally been used to supplement the conventional visual-tactile clinical examination. Accurate, timely detection and diagnosis of early signs of disease could afford patients the opportunity of less invasive treatment with less destruction of tooth tissue, reduce the need for treatment with aerosol-generating procedures, and potentially result in a reduced cost of care to the patient and to healthcare services. OBJECTIVES To determine the diagnostic accuracy of different dental imaging methods to inform the detection and diagnosis of non-cavitated enamel only coronal dental caries. SEARCH METHODS Cochrane Oral Health's Information Specialist undertook a search of the following databases: MEDLINE Ovid (1946 to 31 December 2018); Embase Ovid (1980 to 31 December 2018); US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov, to 31 December 2018); and the World Health Organization International Clinical Trials Registry Platform (to 31 December 2018). We studied reference lists as well as published systematic review articles. SELECTION CRITERIA We included diagnostic accuracy study designs that compared a dental imaging method with a reference standard (histology, excavation, enhanced visual examination), studies that evaluated the diagnostic accuracy of single index tests, and studies that directly compared two or more index tests. Studies reporting at both the patient or tooth surface level were included. In vitro and in vivo studies were eligible for inclusion. Studies that explicitly recruited participants with more advanced lesions that were obviously into dentine or frankly cavitated were excluded. We also excluded studies that artificially created carious lesions and those that used an index test during the excavation of dental caries to ascertain the optimum depth of excavation. DATA COLLECTION AND ANALYSIS Two review authors extracted data independently and in duplicate using a standardised data extraction form and quality assessment based on QUADAS-2 specific to the clinical context. Estimates of diagnostic accuracy were determined using the bivariate hierarchical method to produce summary points of sensitivity and specificity with 95% confidence regions. Comparative accuracy of different radiograph methods was conducted based on indirect and direct comparisons between methods. Potential sources of heterogeneity were pre-specified and explored visually and more formally through meta-regression. MAIN RESULTS We included 104 datasets from 77 studies reporting a total of 15,518 tooth sites or surfaces. The most frequently reported imaging methods were analogue radiographs (55 datasets from 51 studies) and digital radiographs (42 datasets from 40 studies) followed by cone beam computed tomography (CBCT) (7 datasets from 7 studies). Only 17 studies were of an in vivo study design, carried out in a clinical setting. No studies were considered to be at low risk of bias across all four domains but 16 studies were judged to have low concern for applicability across all domains. The patient selection domain had the largest number of studies judged to be at high risk of bias (43 studies); the index test, reference standard, and flow and timing domains were judged to be at high risk of bias in 30, 12, and 7 studies respectively. Studies were synthesised using a hierarchical bivariate method for meta-analysis. There was substantial variability in the results of the individual studies, with sensitivities that ranged from 0 to 0.96 and specificities from 0 to 1.00. For all imaging methods the estimated summary sensitivity and specificity point was 0.47 (95% confidence interval (CI) 0.40 to 0.53) and 0.88 (95% CI 0.84 to 0.92), respectively. In a cohort of 1000 tooth surfaces with a prevalence of enamel caries of 63%, this would result in 337 tooth surfaces being classified as disease free when enamel caries was truly present (false negatives), and 43 tooth surfaces being classified as diseased in the absence of enamel caries (false positives). Meta-regression indicated that measures of accuracy differed according to the imaging method (Chi2(4) = 32.44, P < 0.001), with the highest sensitivity observed for CBCT, and the highest specificity observed for analogue radiographs. None of the specified potential sources of heterogeneity were able to explain the variability in results. No studies included restored teeth in their sample or reported the inclusion of sealants. We rated the certainty of the evidence as low for sensitivity and specificity and downgraded two levels in total for risk of bias due to limitations in the design and conduct of the included studies, indirectness arising from the in vitro studies, and the observed inconsistency of the results. AUTHORS' CONCLUSIONS The design and conduct of studies to determine the diagnostic accuracy of methods to detect and diagnose caries in situ are particularly challenging. Low-certainty evidence suggests that imaging for the detection or diagnosis of early caries may have poor sensitivity but acceptable specificity, resulting in a relatively high number of false-negative results with the potential for early disease to progress. If left untreated, the opportunity to provide professional or self-care practices to arrest or reverse early caries lesions will be missed. The specificity of lesion detection is however relatively high, and one could argue that initiation of non-invasive management (such as the use of topical fluoride), is probably of low risk. CBCT showed superior sensitivity to analogue or digital radiographs but has very limited applicability to the general dental practitioner. However, given the high-radiation dose, and potential for caries-like artefacts from existing restorations, its use cannot be justified in routine caries detection. Nonetheless, if early incidental carious lesions are detected in CBCT scans taken for other purposes, these should be reported. CBCT has the potential to be used as a reference standard in diagnostic studies of this type. Despite the robust methodology applied in this comprehensive review, the results should be interpreted with some caution due to shortcomings in the design and execution of many of the included studies. Future research should evaluate the comparative accuracy of different methods, be undertaken in a clinical setting, and focus on minimising bias arising from the use of imperfect reference standards in clinical studies.
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Affiliation(s)
- Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Heatlh Research Services, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Janet E Clarkson
- Division of Oral Health Sciences, Dundee Dental School, University of Dundee, Dundee, UK
| | | | - Ting-Li Su
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anita Sengupta
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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29
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Thanh MTG, Van Toan N, Toan DTT, Thang NP, Dong NQ, Dung NT, Hang PTT, Anh LQ, Tra NT, Ngoc VTN. Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis. Dent J (Basel) 2021; 9:dj9030030. [PMID: 33800937 PMCID: PMC8000741 DOI: 10.3390/dj9030030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/17/2021] [Accepted: 02/28/2021] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Mai Thi Giang Thanh
- Department of Clinical science, Hadong Medical College, Hanoi 100000, Vietnam;
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Ngo Van Toan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (N.V.T.); (D.T.T.T.)
- Hanoi Medical University Hospital, Hanoi Medical University, Hanoi 100000, Vietnam
| | - Do Thi Thanh Toan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam; (N.V.T.); (D.T.T.T.)
| | - Nguyen Phu Thang
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Ngoc Quang Dong
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan;
- Department of Plastic, Reconstructive and Cosmetic Surgery, National Hospital of Odonto-Stomatology, Hanoi 100000, Vietnam
| | - Nguyen Tien Dung
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Phung Thi Thu Hang
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
| | - Le Quynh Anh
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
| | - Nguyen Thu Tra
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
- Correspondence: (N.T.T.); (V.T.N.N.); Tel.: +84-963-036-443 (N.T.T.); +84-945-786-868 (V.T.N.N.)
| | - Vo Truong Nhu Ngoc
- School of Odonto Stomatology, Hanoi Medical University, Hanoi 100000, Vietnam; (N.P.T.); (N.T.D.); (P.T.T.H.); (L.Q.A.)
- Correspondence: (N.T.T.); (V.T.N.N.); Tel.: +84-963-036-443 (N.T.T.); +84-945-786-868 (V.T.N.N.)
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Heck K, Litzenburger F, Ullmann V, Hoffmann L, Kunzelmann KH. In vitro comparison of two types of digital X-ray sensors for proximal caries detection validated by micro-computed tomography. Dentomaxillofac Radiol 2021; 50:20200338. [PMID: 32822231 DOI: 10.1259/dmfr.20200338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES We aimed to compare the diagnostic accuracy of two intraoral digital X-ray sensors-the charged-coupled device (CCD) and complementary metal-oxide-semiconductor (CMOS)-for proximal caries detection in permanent molar and premolar teeth. Micro-CT served as the reference standard. METHODS 250 samples were mounted in three-dimensional (3D)-printed phantoms, and their proximal surfaces were evaluated by ICDAS criteria directly to create a balanced sample. Bitewing radiography was conducted using 3D-constructed X-ray phantoms with a CCD sensor at a 0.08 s and a CMOS sensor at 0.12 and 0.16 s exposure time. Two examiners determined the diagnostic decisions twice at appropriate intervals. Three diagnostic thresholds for sound surfaces and enamel and dentin caries were defined and presented in a cross-table. Sensitivity and specificity values and overall accuracy were calculated, and receiver operating curves were generated and compared. Reliability assessment was performed using linear weighted κ statistics. RESULTS The overall accuracies between the reference standard and different sensors and exposure times were 63.1% (CCD), 67.1% (CMOS sensor at 0.12 s) and 70.7% (CMOS sensor at 0.08 s). High specificity but low sensitivity values were found for all examination conditions at all thresholds. The area under the curve comparison values revealed no significant difference between sensor types and exposure times. Linear-weighted κ analysis revealed almost perfect agreement for all assessments. CONCLUSION No significant difference was found for diagnostic performance of proximal caries detection between the different sensors and exposure times. The increased exposure time did not lead to a significant diagnostic benefit.
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Affiliation(s)
- Katrin Heck
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - Friederike Litzenburger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - Verena Ullmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - Lea Hoffmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
| | - Karl-Heinz Kunzelmann
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-University Munich, Goethestr. 70, 80336, Munich, Germany
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Jung EH, Jun MK. Relationship between an Oral Health Risk Assessment Using a Salivary Multi-Test System and Woman's Subjective Oral Health Symptoms and Sleep Disorder. TOHOKU J EXP MED 2021; 254:213-219. [PMID: 34334536 DOI: 10.1620/tjem.254.213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Saliva is used as a diagnosis and monitoring tool for various diseases because it can maintain the balance of the oral ecosystem and reflect the physiological and pathological state of the body. Because women suffer more fatigue than men because of physiological, psychological, and social factors, individual management strategies are needed to evaluate mental health and oral diseases. Therefore, this study examined the oral health risk level from seven saliva factors using a saliva multi-test system for adult women to confirm the possibility of screening for sleep disorders. The saliva of 83 adult female participants was surveyed along with a self-reported questionnaire consisting of seven subjective oral health symptoms and three questions about sleep disorders. Seven saliva factors were evaluated using the saliva multi-test system (SiLL-Ha ST-4910) to assess the oral health risk levels. In the tooth health risk groups, the acidity was high, while the buffering capacity was low (p < 0.001). The periodontal health risk groups showed significant differences in acidity, occult blood, leukocytes, proteins, and ammonia (p < 0.05). The oral malodor risk group had higher levels of cariogenic bacteria, occult blood, leukocytes, and ammonia (p < 0.05). In groups with 'irregular sleep times' and 'insomnia', the acidity was high, and the buffering capacity was low (p < 0.001). This study confirmed the relevance of saliva factors and sleep disorder. Therefore, an evaluation using saliva was confirmed for oral health risk assessments and as an early screening tool for sleep disorders.
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Affiliation(s)
- Eun-Ha Jung
- Department of Dental Hygiene, Yonsei University
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Carious lesion detection technologies: factual clinical approaches. Br Dent J 2020; 229:432-442. [DOI: 10.1038/s41415-020-2116-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/05/2020] [Indexed: 11/09/2022]
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Jablonski-Momeni A, Nothelfer R, Morawietz M, Kiesow A, Korbmacher-Steiner H. Impact of self-assembling peptides in remineralisation of artificial early enamel lesions adjacent to orthodontic brackets. Sci Rep 2020; 10:15132. [PMID: 32934335 PMCID: PMC7493957 DOI: 10.1038/s41598-020-72185-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022] Open
Abstract
Enamel demineralisation can occur as a side effect during orthodontic treatment with fixed appliances. This study aimed to evaluate the efficacy of the self-assembling peptide P11-4 for remineralisation combined with fluorides, compared to application of fluoride varnish alone. De- and remineralisation was assessed by Quantitative light-induced fluorescence (QLF). Orthodontic brackets were bonded on 108 human enamel samples and white spot lesions were created. The samples were allocated randomly into three groups: Group I received no treatment, group II had a single application of fluoride varnish (22,600 ppm), and group III was treated with P11-4 following a single application of fluoride varnish. Quantitative light-induced fluorescence (QLF) measurements were performed at baseline, after demineralisation and after storage in remineralisation solution for 7 and 30 days. Non-parametric tests (Kruskal-Wallis test and Friedman test) were used for further analysis. After demineralisation, all samples showed a median ΔF -9.38% ± 2.79. After 30 days median ΔF values were as followed: group I = -9.04% ± 2.51, group II = -7.89 ± 2.07, group III = -6.08% ± 2.79). The median ΔF values differed significantly between all groups at all investigation times (p < 0.00001). Application of P11-4 with fluoride varnish was superior to the use of fluorides alone for remineralisation of enamel adjacent to brackets.
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Affiliation(s)
- Anahita Jablonski-Momeni
- Department of Orthodontics, Dental School, Philipps University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany.
| | - R Nothelfer
- Department of Orthodontics, Dental School, Philipps University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
| | - M Morawietz
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - A Kiesow
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - H Korbmacher-Steiner
- Department of Orthodontics, Dental School, Philipps University of Marburg, Georg-Voigt-Str. 3, 35039, Marburg, Germany
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Austin D, JayaKumar HL, Chandra KM, Kemparaj V, Prahladka P. Cross-sectional Study on White Spot Lesions and its Association with Dental Caries Experience among School Children. Int J Clin Pediatr Dent 2020; 13:107-112. [PMID: 32742084 PMCID: PMC7366773 DOI: 10.5005/jp-journals-10005-1716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim To evaluate the association of white spot lesions (WSLs) with existing dental caries experience and other clinical parameters among children aged 7–12 years. Design A cross-sectional comparative study on 407 children using Nyvad's caries diagnostic criteria was performed on the permanent first incisors and molars. Accordingly, they were grouped as cases (presence of caries) and controls (sound). The data pertaining to sociodemographic variables and clinical variables of oral hygiene index (OHI), gingival bleeding index (GBI), decayed, missing, and filled surfaces (DMFS-dmfs), eruption degree of first permanent molars, and number of WSLs were subjected to bivariate analysis and multiple logistic regression to identify the predictor variables for the caries lesion activity. Results Relatively higher DMFS-dmfs scores, the number of WSLs, GBI, and OHI were recorded among the cases. In multiple logistic regression analysis, WSL ≥ 1 (OR = 18.78; CI 9.74–36.21, p = 0.0001), DMFS-dmfs + WSL ≥ 20 (OR = 30.75; CI 1.8–525.28, p = 0.0001), GBI > 0.5 (OR = 8.46; CI 4.05–17.66, p = 0.0001); OHI > 1.2 (OR = 2.83; CI 1.11–7.23, p = 0.03) were found to be significant predictors for the cases. Conclusion It is important to be cognizant of the initiation of caries in children through the initial stages so that efforts can be pooled in towards prevention rather than extensive curative measures. Clinical significance In routine clinical examinations, WSLs are seldom detected. An insight into these lesions can help the dentists’ to strategize the preventive measures enabling a reduction in total dental caries experience, burden of disease, and improved quality of life. How to cite this article Austin D, Jaya Kumar HL, Chandra KM, et al. Cross-sectional Study on White Spot Lesions and its Association with Dental Caries Experience among School Children. Int J Clin Pediatr Dent 2020;13(2):107–112.
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Affiliation(s)
- Deepa Austin
- Department of Public Health Dentistry, AECS Maaruti College of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Hosadurga L JayaKumar
- Department of Public Health Dentistry, AECS Maaruti College of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Krishnaswamy M Chandra
- Department of Public Health Dentistry, AECS Maaruti College of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Vanishree Kemparaj
- Department of Public Health Dentistry, AECS Maaruti College of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
| | - Priyanka Prahladka
- Department of Public Health Dentistry, AECS Maaruti College of Dental Sciences and Research Centre, Bengaluru, Karnataka, India
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Datta S, Chaki N, Modak B. A Systematic Review on the Evolution of Dental Caries Detection Methods and Its Significance in Data Analysis Perspective. INTELL DATA ANAL 2020. [DOI: 10.1002/9781119544487.ch6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ortiz MIG, de Melo Alencar C, De Paula BLF, Magno MB, Maia LC, Silva CM. Accuracy of near-infrared light transillumination (NILT) compared to bitewing radiograph for detection of interproximal caries in the permanent dentition: A systematic review and meta-analysis. J Dent 2020; 98:103351. [PMID: 32380136 DOI: 10.1016/j.jdent.2020.103351] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/16/2020] [Accepted: 04/20/2020] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy of the near-infrared light transillumination (NILT) for the detection of interproximal dental caries in permanent dentition when compared to bitewing X-ray (BW). DATA In vivo studies that detected interproximal primary caries in permanent teeth by using NILT and BW were selected. QUADAS-2 was used to assess the risk of bias. Pooled sensitivity and specificity forest plots were calculated, summary receiver operator characteristics (SROC) curves were constructed. The certainty of the evidence was rated using the GRADE system. SOURCES Pubmed, Cochrane Library, Web of Science, Scopus, Lilacs/BBO and grey literature databases were surveyed. STUDY SELECTION From 1594 retrieved articles, 13 studies were included. Six studies had a low risk of bias and a low level of concern regarding applicability. Four studies had an unclear risk of bias, while three presented a high risk of bias. The meta-analysis of six studies demonstrated that NILT presented good overall accuracy. Of 6110 teeth, 92.3 % (5639) were accurately classified (776 as true positive and 4863 as true negative). The pooled sensitivity was 0.97 (0.96 to 0.98; p = 0.0000; I2 = 93.2 %) with moderate certainty of evidence, and the pooled specificity was 0.91 (0.91 to 0.92; p = 0.0000; I2 = 98.3 %) with high certainty of evidence. Symmetric (0.9837) and asymmetric (0.9836) SROC showed a high discrimination and determination effect of NILT. CONCLUSION The current literature, with moderate certainty and a middling quality of evidence, demonstrates that NILT presents a reasonably comparable accuracy to that of BW for detecting interproximal carious lesions in the permanent dentition. CLINICAL SIGNIFICANCE Since NILT presented good overall accuracy for the detection of interproximal primary caries, it could be routinely used in dental check-ups, especially in high-risk caries populations and in patients where the use of radiation should be reduced, like pregnant women or children.
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Affiliation(s)
| | - Cristiane de Melo Alencar
- Department of Restorative Dentistry, School of Dentistry, Federal University of Para, Belém, Pará, Brazil
| | | | - Marcela Baraúna Magno
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Cecy Martins Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Para, Belém, Pará, Brazil.
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Alkhouli MM, Al Nesser SF, Bshara NG, AlMidani AN, Comisi JC. Comparing the efficacies of two chemo-mechanical caries removal agents (2.25% sodium hypochlorite gel and brix 3000), in caries removal and patient cooperation: A randomized controlled clinical trial. J Dent 2020; 93:103280. [PMID: 31981604 DOI: 10.1016/j.jdent.2020.103280] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION This study compared and evaluated the effectiveness of Brix 3000 and 2.25 % sodium hypochlorite (NaOCl) gel with conventional rotary instrumentation method in caries excavation of primary molars. The null hypothesis: no difference between the two tested chemo-mechanical caries removal (CMCR) agents used in this trial. MATERIALS AND METHODS a randomized controlled clinical trial conducted with 32 children suffering from proximal caries of primary maxillary molars, age ranging between 6 and 9 years old. Subjects were randomly assigned into three groups: Brix 3000, NaOCl gel, and conventional with 10, 12, and 10 teeth in each group, respectively. After isolation of selected teeth, either CMCR agent were applied for two minutes. The application was repeated as needed until a caries-free surface was obtained. The conventional group used low-speed burs to excavate all carious lesions. The time required to obtain a caries-free result for each testing method was recorded. Wong-Baker FACES pain rating scale was used to assess the acceptance of the technique used by the child. RESULTS Conventional treatment required significantly less time for caries removal compared to Brix 3000 (P = .002) and NaOCl gel (P = .000). No significant difference observed between Brix 3000 and NaOCl gel (P = .679). Statistically higher pain scores were observed with conventional treatment compared to both Brix 3000 (P = .000) and NaOCl gel (P = .005). Pain scores were lower with Brix 3000, and NaOCl gel with no significant difference observed between the CMCR agents (p = .690). CONCLUSIONS CMCR agents that are effective in removing the carious dentine of primary teeth without negatively affecting the cooperation of children. CLINICAL SIGNIFICANCE The use of a 2.25 % sodium hypochlorite gel can be an effective and well-tolerated method of removing decay from primary teeth and reduce the trauma associated with conventional rotary caries removal.
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Affiliation(s)
| | | | - Nada G Bshara
- Faculty of Dentistry, Damascus University, Damascus, Syria
| | | | - John C Comisi
- Department of Oral Rehabilitation. Medical University of South Carolina, James B. Edwards College of Dental Medicine, Charleston, SC USA.
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Iranzo-Cortés JE, Montiel-Company JM, Almerich-Torres T, Bellot-Arcís C, Almerich-Silla JM. Use of DIAGNOdent and VistaProof in diagnostic of Pre-Cavitated Caries Lesions-A Systematic Review and Meta-Analysis. J Clin Med 2019; 9:jcm9010020. [PMID: 31861740 PMCID: PMC7019252 DOI: 10.3390/jcm9010020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/13/2019] [Accepted: 12/17/2019] [Indexed: 11/16/2022] Open
Abstract
Objective: To analyse the published evidence of the validity of DIAGNDOdent and VistaProof in diagnosing carious depths in pre-cavitated lesions. Material and methods: A systematic review was carried out after identifying a total of 184 articles, including 27 concerning the qualitative review and a subsequent meta-analysis. The quality of the studies was evaluated by using the QUADAS-2 tool. Results:
For DIAGNOdent, the sensitivity value was 0.77, the specificity value was 0.75 and AUC was 0.81 for the global meta-analyses. In relation to subgroups, the values estimated 0.85, 0.76 and 0.86, respectively, for the in vivo group and 0.71, 0.75 and 0.83 for the in vitro group. For VistaProof, sensitivity was 0.81, specificity 0.75 and AUC had a value of 0.80 in the global meta-analysis. For the subgroups, these were considered at 0.75, 0.81 and 0.89, respectively, for the in vivo group and 0.91, 0.74 and 0.76 for the in vitro group. Neither case presented publication bias when analysing the funnel plot, the classic fail-safe number and Egger’s intercept. Conclusion: Both VistaProof and DIAGNOdent are valid as they offer a moderate to high diagnostic effectiveness for dentine depth in pre-cavitated lesions.
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Park KJ, Kroker T, Groß U, Zimmermann O, Krause F, Haak R, Ziebolz D. Effectiveness of caries-preventing agents on initial carious lesions within the scope of orthodontic therapy. Korean J Orthod 2019; 49:246-253. [PMID: 31367579 PMCID: PMC6658901 DOI: 10.4041/kjod.2019.49.4.246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/18/2019] [Accepted: 01/23/2019] [Indexed: 11/24/2022] Open
Abstract
Objective To evaluate the effectiveness of three different caries-preventing agents on artificial caries in a Streptococcus mutans-based caries model. Methods Sixty-five caries-free human molar enamel blocks were treated with a demineralization solution and a remineralization solution. The specimens were assigned to the following groups according to the caries-protective product applied: group A, chlorhexidine varnish; group B, fluoride-releasing chemically cured sealant; group C, fluoride-releasing lightcured sealant; group D, positive control (specimens that were subjected to de- and remineralization cycles without treatment with any caries-protective agents); and group E, negative control (specimens that were not subjected to de- and remineralization cycles). Samples in groups A–D were stored in demineralization solution with S. mutans and thereafter in artificial saliva. This procedure was performed for 30 days. Average fluorescence loss (ΔF) and surface size of the lesions were measured using quantitative light-induced fluorescence at baseline and on the 7th, 14th, and 30th days. Results After 30 days, group A demonstrated a significant increase in ΔF and the surface size of the lesions, no significant difference in comparison with the positive control group, and a significant difference in comparison with the negative control group. Group B showed no significant changes in both parameters at any of the measurement points. While group C showed increased ΔF after 14 days, no significant fluorescence change was observed after 30 days. Conclusions Both fluoride-releasing sealants (chemically or light-cured) show anti-cariogenic effects, but the use of chlorhexidine varnish for the purpose of caries protection needs to be reconsidered.
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Affiliation(s)
- Kyung-Jin Park
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Tessa Kroker
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Uwe Groß
- Institute for Medical Microbiology, Center for Hygiene and Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Ortrud Zimmermann
- Institute for Medical Microbiology, Center for Hygiene and Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Felix Krause
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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Subka S, Rodd H, Nugent Z, Deery C. In vivo validity of proximal caries detection in primary teeth, with histological validation. Int J Paediatr Dent 2019; 29:429-438. [PMID: 30735588 DOI: 10.1111/ipd.12478] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/31/2019] [Accepted: 02/04/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Detection and diagnosis of proximal caries in primary molars are challenging. AIM The aim of this in vivo study was to assess the validity and reproducibility of four methods of proximal caries detection in primary molar teeth. DESIGN Eighty-two children (5-10 years) were recruited. Initially, 1030 proximal surfaces were examined using meticulous visual examination (ICDAS) (VE1), bitewing radiographs (RE), and a laser fluorescence pen device (LF1). Temporary tooth separation (TTS) was achieved for 447 surfaces, and these were re-examined visually (VE2) and using the LF pen (LF2). Three hundred and fifty-six teeth (542 surfaces) were subsequently extracted and provided histological validation. RESULTS At D1 (enamel and dentine caries) diagnostic threshold, the sensitivity of VE1, RE, VE2, LF1, and LF2 examination was 0.52, 0.14, 0.75, 0.58, and 0.60 and the specificity values were 0.89, 0.97, 0.88, 0.85, and 0.77, respectively. At D3 (dentine caries) threshold, the sensitivity values were 0.42, 0.71, 0.49, 0.63, and 0.65, respectively, whereas specificity was 0.93 for VE1 and VE2, and 0.98, 0.87, and 0.88 for RE, LF1, and LF2 examinations, respectively. ROC analysis showed radiographic examination to be superior at D3 . CONCLUSION Meticulous caries diagnosis (ICDAS) should be supported by radiographs for detection of dentinal proximal caries in primary molars.
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Affiliation(s)
- Samiya Subka
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Helen Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Chris Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Macey R, Walsh T, Riley P, Glenny AM, Worthington HV, Clarkson JE, Ricketts D. Tests to detect and inform the diagnosis of caries. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2018. [DOI: 10.1002/14651858.cd013215] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester; Oxford Road Manchester Greater Manchester UK M13 9PL
| | - Tanya Walsh
- The University of Manchester; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health; JR Moore Building Oxford Road Manchester UK M13 9PL
| | - Philip Riley
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester; Cochrane Oral Health; JR Moore Building Oxford Road Manchester UK M13 9PL
| | - Anne-Marie Glenny
- The University of Manchester; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health; JR Moore Building Oxford Road Manchester UK M13 9PL
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester; Cochrane Oral Health; JR Moore Building Oxford Road Manchester UK M13 9PL
| | - Janet E Clarkson
- Dundee Dental School, University of Dundee; Division of Oral Health Sciences; Park Place Dundee Scotland UK DD1 4HR
| | - David Ricketts
- Dundee Dental School, University of Dundee; Park Place Dundee Tayside UK DD1 4HN
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Tagliaferro E, Junior AV, Rosell FL, Silva S, Riley JL, Gilbert GH, Gordan VV. Caries Diagnosis in Dental Practices: Results From Dentists in a Brazilian Community. Oper Dent 2018; 44:E23-E31. [PMID: 30212272 DOI: 10.2341/18-034-c] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to assess practices related to diagnosis of dental caries among dentists (n=217) from Araraquara, São Paulo State, Brazil. Data on sociodemographic information and practitioner characteristics were collected using a pretested questionnaire, and data on practices related to caries diagnosis were gathered by using a translated and culturally adapted questionnaire from the US National Dental Practice-Based Research Network. Descriptive statistics and regression analyses were used for data analysis. Respondents reported using in most of their patients radiographs (Rx) to diagnose proximal caries (59%), explorer (Ex) for the diagnosis of occlusal caries (64%) and on the margins of existing restorations (79%), as well as air jet (AJ) with drying (92%). Magnification (M) (25%), fiber optic transillumination (FOTI; 14%), and laser fluorescence (LF) (3%) were used in the minority of patients. Regression analysis revealed that the following dentists' characteristics were significantly associated (p<0.05) with the use of diagnostic methods on a greater percentage of their patients: advanced degree (Rx, FOTI), higher percentage of patients with individualized caries prevention (Rx, FOTI, M), more years since dental school graduation (Ex, M), and work in an exclusively private practice model (LF). In conclusion, most Brazilian dentists from Araraquara reported they most commonly use visual, tactile, and radiographic imaging for the diagnosis of dental caries. Some dentists' characteristics, such as time from dental school graduation and having a postgraduation course, were associated with the use of certain diagnostic methods.
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Abufarwa M, Noureldin A, Campbell PM, Buschang PH. The longevity of casein phosphopeptide-amorphous calcium phosphate fluoride varnish's preventative effects: Assessment of white spot lesion formation. Angle Orthod 2018; 89:10-15. [PMID: 30207486 DOI: 10.2319/021718-127.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To test how long casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) fluoride varnish prevents enamel demineralization in vitro. MATERIALS AND METHODS Human molars and premolars were sectioned buccolingually and randomly assigned to two groups. Standardized pretreatment images of enamel surfaces were obtained using FluoreCam. The control group received no treatment, and the experimental group received an application of CPP-ACP fluoride varnish. Over simulated periods of 2, 4, 8, and 12 weeks, specimens were placed in a toothbrushing simulator, thermocycled, subjected to 9 days of pH cycling, and imaged with FluoreCam. Samples were sectioned and polished for polarized light microscope (PLM) evaluation. RESULTS There were statistically significant time ( P < .001) and varnish ( P < .001) effects on area, intensity, and impact of enamel demineralization. The control group showed significant and progressive demineralization over the 12 weeks ( P < .001). The experimental group revealed no significant demineralization during the first 4 weeks ( P > .05) and significant ( P < .001) increases thereafter. Experimental demineralization after 12 weeks was comparable to 2-week demineralization in the controls, with significant between-group differences ( P < .001) in enamel demineralization at all time points. PLM of the control and experimental groups revealed lesion depths of 90 ± 34 μm and 37 ± 9 μm, respectively. CONCLUSIONS Within the limitations of this in vitro study, CPP-ACP fluoride varnish prevents enamel demineralization for at least 4 weeks and limits demineralization up to 12 weeks.
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Abstract
The pace of technological advance across science is staggeringly fast. Our ability to translate some of the potential developments in technology into concepts/products/devices that can assist dentists in caring for patients is key to ensuring that both the profession and the people we care for derive full benefit from these new technologies. This overview will focus in four areas: research and how we gather and interpret data to inform health care; the diagnosis and prevention of disease; planning care; and new concepts in terms of achieving desired health outcomes for patients. Some of the technological advances will be in their infancy and others close to or indeed clinical reality. The objective of this overview is to show where we are in terms of the cutting edge of technology and to whet the appetite for things to come.
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Tatano R, Berkels B, Ehrlich EE, Deserno TM, Fritz UB. Spatial agreement of demineralized areas in quantitative light-induced fluorescence images and digital photographs. Dentomaxillofac Radiol 2018; 47:20180099. [PMID: 29851354 DOI: 10.1259/dmfr.20180099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Previous work has shown qualitatively that detection of demineralized tooth areas (white spot lesions, WSLs) is more reliable in digital photographs (DP) as in quantitative light-induced fluorescence (QLF) images. Based on non-rigid, multimodal image registration, we now quantitatively compare manual and automatic markings in both modalities. METHODS After braces removal, pairs of DP and QLF were acquired from 124 teeth of 31 patients. Three experienced raters marked the WSL on both DP and QLF images, each of which was presented twice in randomized order. For each tooth and each modality, a ground truth (GT) was established using the simultaneous truth and performance level estimation algorithm on the total of six manual markings per image. DP and QLF image pairs were spatially registered, by aligning the outline of the tooth area in DPs to that of the corresponding tooth area in QLF. Between all pairs of markings for all teeth, position and size were compared quantitatively by the Dice coefficient and the novel coefficient of inclusion. RESULTS Our hypotheses: (i) the clinical inspection supported by DP is more sensitive to WSL as that by QLF, disregarding whether the automatic analysis or the experts' manual assessment of QLF is applied, and (ii) detected lesions in QLF are included in those of DP, were confirmed and not confirmed, respectively. CONCLUSION DP and QLF are valuable methods to detect WSL in demineralized teeth. Combining both modalities can provide additional information on early lesion assessment.
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Affiliation(s)
- Rosalia Tatano
- 1 Aachen Institute for Advanced Study in Computational Engineering Science (AICES), RWTH Aachen University , Aachen , Germany
| | - Benjamin Berkels
- 1 Aachen Institute for Advanced Study in Computational Engineering Science (AICES), RWTH Aachen University , Aachen , Germany
| | - Eva E Ehrlich
- 2 Klinik für Kieferorthopädie, Uniklinik RWTH Aachen , Aachen , Germany
| | - Thomas M Deserno
- 3 Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig - Institute of Technology and Hannover Medical School , Braunschweig , Germany
| | - Ulrike B Fritz
- 2 Klinik für Kieferorthopädie, Uniklinik RWTH Aachen , Aachen , Germany
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Influence of the loci of non-cavitated fissure caries on its detection with optical coherence tomography. J Dent 2018; 71:31-37. [DOI: 10.1016/j.jdent.2018.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/09/2018] [Accepted: 01/23/2018] [Indexed: 11/24/2022] Open
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Validation of fluorescence devices for evaluation of white spot lesions in orthodontic patients. Eur Arch Paediatr Dent 2018. [DOI: 10.1007/s40368-018-0327-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Jung EH, Lee ES, Jung HI, Kang SM, de Josselin de Jong E, Kim BI. Development of a fluorescence-image scoring system for assessing noncavitated occlusal caries. Photodiagnosis Photodyn Ther 2018; 21:36-42. [DOI: 10.1016/j.pdpdt.2017.10.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/09/2017] [Accepted: 10/31/2017] [Indexed: 11/16/2022]
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A new screening method to detect proximal dental caries using fluorescence imaging. Photodiagnosis Photodyn Ther 2017; 20:257-262. [DOI: 10.1016/j.pdpdt.2017.10.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/15/2017] [Accepted: 10/16/2017] [Indexed: 11/21/2022]
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Baltacioglu IH, Orhan K. Comparison of diagnostic methods for early interproximal caries detection with near-infrared light transillumination: an in vivo study. BMC Oral Health 2017; 17:130. [PMID: 29145846 PMCID: PMC5689175 DOI: 10.1186/s12903-017-0421-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 11/09/2017] [Indexed: 12/01/2022] Open
Abstract
Background Although numerous studies have used digital intraoral imaging, only a few studies have used photo-optical methods for the diagnosis of caries. Moreover, several limitations exist in terms of observers (experience and specialty) and the caries lesion itself. Hence, the aims of this study were to evaluate the diagnostic capability of near-infrared light transillumination (NILT) and PSP-Bitewing radiographs and to compare the interobserver and intraobserver differences in addition to observers’ experience level to detect early interproximal caries lesions in vivo. Methods A total of 52 untreated posterior teeth with and without varying degrees of early interproximal carious lesions were included. Bitewing radiographs using digital phosphor plates (PSP-Bitewing) and NILT were used to clarify the diagnosis. An oral and maxillofacial radiologist and a restorative dentistry consultant evaluated the images twice. A separate appointment for clinical validation and restoration was made. Kappa coefficients were calculated to assess both intraobserver and interobserver agreements for each evaluation method. Scores obtained from PSP-Bitewing and NILT were compared with the clinical validation via receiver operating characteristic (ROC) analysis. Results No significant differences were found between PSP-Bitewing radiography and NILT for detecting early interproximal carious lesions with high average Az results. Both intraobserver and interobserver agreement values were relatively higher for NILT evaluation. The Az values increased at second evaluations for both caries detection methods. Conclusions NILT examination has an appropriate sensitivity and diagnostic accuracy for detecting early interproximal caries lesions and can be considered as a method of choice for detecting caries without the use of ionizing radiation.
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Affiliation(s)
- Ismail Hakki Baltacioglu
- Department of Restorative Dentistry, Ankara University, Faculty of Dentistry, Besevler, 06560, Ankara, Turkey.
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Ankara University, Faculty of Dentistry, Besevler, 06560, Ankara, Turkey
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