1
|
The Detection of Dental Pathologies on Periapical Radiographs—Results from a Reliability Study. J Clin Med 2023; 12:jcm12062224. [PMID: 36983223 PMCID: PMC10056324 DOI: 10.3390/jcm12062224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/05/2023] [Accepted: 03/11/2023] [Indexed: 03/17/2023] Open
Abstract
(1) Background: Caries, periapical lesions, periodontal bone loss (PBL), and endo-perio lesions are common dental findings that require an accurate diagnostic assessment to allow appropriate disease management. The purpose of this reliability study was to compare the inter- and intra-rater reliability for the detection of the above-mentioned pathologies on periapical radiographs. (2) Methods: Fourteen dentists (three with more than two years and eleven with less than two years of work experience) participated in a training workshop prior to data acquisition. A total of 150 radiographs were assessed by all raters in two rounds. Cohen’s Kappa (CK) values and a binary logistic regression were calculated. (3) Results: The reliability was found in a moderate and substantial range of agreement: caries (mean inter-rater CK value/first round 0.704/mean inter-rater CK value/second round 0.659/mean intra-rater CK value 0.778), periapical lesions (0.643/0.611/0.768), PBL (0.454/0.482/0.739) and endo-perio lesion (0.702/0.689/0.840). The regression model revealed a significant influence of the clinical experience, and furthermore, periapical pathologies and PBL were identified less reliably in comparison to caries and endo-perio lesions. (4) Conclusions: The dentist’s ability to detect the chosen pathologies was linked with significant differences. Periapical lesions and PBL were identified less reliably than caries and endo-perio lesions.
Collapse
|
2
|
Cascante-Sequeira D, Gaêta-Araujo H, Moura Brasil D, Queiroz Freitas D, Haiter-Neto F. Reproducibility and diagnostic value of a new wedge-guided bitewing image receptor-holding device. Dentomaxillofac Radiol 2022; 51:20210186. [PMID: 34464551 PMCID: PMC8925869 DOI: 10.1259/dmfr.20210186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the reproducibility of a wedge-guided bitewing image receptor-holding device (IRHD-WG) compared to a commercially available bitewing image receptor-holding device (IRHD-XCP). METHODS AND MATERIALS Ten operators randomly acquired bitewing radiographs of four posterior regions (Premolar, Molar 1, Molar 2, Molar 3) distributed in two dry bone skulls and mandibles using 2 IRHDs (IRHD-WG and IRHD-XCP). The radiographs corresponding to the same region and IRHD but acquired by different operators were paired for reproducibility comparison. A total of 360 pairs of radiographs were randomized for analysis. Objective analysis consisted of extracting the pixel values from each radiograph and comparing the values between each pair by intraclass correlation coefficient. For subjective analysis, the IRHDs images were digitally removed. Five oral radiologists blinded for the study conditions classified the radiograph pairs according to their similarity and diagnostic value. The answers' relative frequencies were compared by the chi-square test (α = 0.05). RESULTS The IRHD-WG presented a higher reproducibility (Mean = 0.850; SD = 0.144) than the IRHD-XCP (Mean = 0.615; SD = 0.287) in the objective analysis. Radiographs acquired with the IRHD-WG were more similar than those acquired with the IRHD-XCP (p < 0.001). The diagnostic value of bitewing radiographs acquired with the IRHD-WG was considered superior to those acquired with the IRHD-XCP (p < 0.001). CONCLUSION For the objective and subjective analyses of reproducibility, the IRHD-WG performed better than the commercial IRHD-XCP.
Collapse
Affiliation(s)
- Deivi Cascante-Sequeira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Danieli Moura Brasil
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| |
Collapse
|
3
|
The value of bitewing radiographs in the management of carious primary molars. Br Dent J 2021; 231:575-579. [PMID: 34773029 DOI: 10.1038/s41415-021-3570-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 01/14/2021] [Indexed: 11/09/2022]
Abstract
Introduction Bitewing radiographs (BWs) are under-utilised for children, and reliance on visual diagnosis alone is likely to under-diagnose caries. Quantification of the level of the under-reporting of caries and the vital role of BWs would be beneficial when providing dental care to the paediatric population.Aim To quantify the diagnostic value of bitewings in the management of proximal caries in primary molars.Design Cross-sectional study.Materials and methods Thirty children (mean age 6.2 ± 1.3 years) were recruited. A visual inspection (VI) of the primary molars was carried out and bitewings were taken. Radiographic assessment (RA) for primary molar proximal caries was completed separately. VI and RA were compared statistically against three caries thresholds, using the Fisher's exact test. A p value <0.05 was considered statistically significant. Sensitivity and specificity analyses were performed.Results A total of 480 proximal surfaces were assessed. Bitewings detected 44.6% of additional proximal carious lesions (p <0.0001). At d3 threshold, VI under-reported 51.2% proximal caries (p <0.0001) and 34.1% dentinal proximal caries (p = 0.0012). VI showed high specificity (99%) and low sensitivity (53%).Conclusion Bitewings play a vital role in proximal caries diagnoses of primary molars.
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Şeker O, Kamburoğlu K, Şahin C, Eratam N, Çakmak EE, Sönmez G, Özen D. In vitro comparison of high-definition US, CBCT and periapical radiography in the diagnosis of proximal and recurrent caries. Dentomaxillofac Radiol 2021; 50:20210026. [PMID: 33979235 DOI: 10.1259/dmfr.20210026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To assess the in vitro performance of high-definition (HD) US, CBCT and periapical radiography for the visibility of proximal and recurrent caries in teeth with and without restoration. METHODS A total of 240 molar teeth were divided into eight groups each comprised of 30 teeth. Control groups consisted of teeth without caries (Group 1-4; N = 120), whereas diseased groups consisted of teeth with proximal caries (Group 5-8; N = 120 teeth). Finally, a total of four image sets were obtained as follows: i) PSP periapical radiography, ii) CBCT 0.075 mm voxel size, iii) CBCT 0.2 mm voxel size and iv) HD US images. The image sets were viewed separately by four observers by using a 5-point confidence scale. Intraclass correlation coefficients were calculated. The areas under the ROC curves were compared using chi-square tests. Significance level was set at α = 0.05. RESULTS Intraobserver agreement for both readings for the four observers ranged between 0.848 and 0.988 for CBCT (0.075 mm) images; 0.658 and 0.952 for CBCT (0.2 mm) images; 0.555 and 0.810 for periapical images; 0.427 and 0.676 for US images. Highest AUC values were found for CBCT (0.075 mm) images and lowest for US images. Statistically significant differences were found among CBCT (0.075 mm) images and US images (p < 0.001), CBCT (0.2 mm) images and US images (p < 0.001) and periapical images and US images (p < 0.001) for the detection of proximal caries. CONCLUSION Periapical and CBCT images outperformed HD US imaging in the detection of proximal dental caries.
Collapse
Affiliation(s)
- Oya Şeker
- Restorative Dentistry Department, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Kıvanç Kamburoğlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Cihan Şahin
- Restorative Dentistry Department, Faculty of Dentistry, Mustafa Kemal University, Hatay, Turkey
| | - Nejlan Eratam
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Esra Ece Çakmak
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Gül Sönmez
- Dentistomo Private Diagnostic Imaging Center, Ankara, Turkey
| | - Doğukan Özen
- Department of Biostatistics, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey
| |
Collapse
|
6
|
Jayaraman J, Hoikka A, Cervantes Mendez MJ, Hajishengallis E. Radiographic Diagnosis in the Pediatric Dental Patient. Dent Clin North Am 2021; 65:643-667. [PMID: 34051934 DOI: 10.1016/j.cden.2021.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This article emphasizes the selection criteria for radiographic acquisition in children due to the greater sensitivity of children for radiation compared with adults. Diagnosis of common pediatric dental conditions, including dental caries, periodontitis, dental anomalies, cysts, tumors, and traumatic dental conditions, are discussed with relevant clinical scenarios.
Collapse
Affiliation(s)
- Jayakumar Jayaraman
- Department of Developmental Dentistry, University of Texas Health San Antonio School of Dentistry, 8210 Floyd Curl Drive, San Antonio, TX 78229, USA.
| | - Angela Hoikka
- Department of Comprehensive Dentistry, University of Texas Health San Antonio School of Dentistry, 8210 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Maria Jose Cervantes Mendez
- Department of Developmental Dentistry, University of Texas Health San Antonio School of Dentistry, 8210 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Evlambia Hajishengallis
- Division of Pediatric Dentistry, University of Pennsylvania School of Dental Medicine, 240 South 40th Street, Philadelphia, PA 19104, USA
| |
Collapse
|
7
|
Maguire A, Clarkson JE, Douglas GV, Ryan V, Homer T, Marshman Z, McColl E, Wilson N, Vale L, Robertson M, Abouhajar A, Holmes RD, Freeman R, Chadwick B, Deery C, Wong F, Innes NP. Best-practice prevention alone or with conventional or biological caries management for 3- to 7-year-olds: the FiCTION three-arm RCT. Health Technol Assess 2020; 24:1-174. [PMID: 31928611 PMCID: PMC6983909 DOI: 10.3310/hta24010] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Historically, lack of evidence for effective management of decay in primary teeth has caused uncertainty, but there is emerging evidence to support alternative strategies to conventional fillings, which are minimally invasive and prevention orientated. OBJECTIVES The objectives were (1) to assess the clinical effectiveness and cost-effectiveness of three strategies for managing caries in primary teeth and (2) to assess quality of life, dental anxiety, the acceptability and experiences of children, parents and dental professionals, and caries development and/or progression. DESIGN This was a multicentre, three-arm parallel-group, participant-randomised controlled trial. Allocation concealment was achieved by use of a centralised web-based randomisation facility hosted by Newcastle Clinical Trials Unit. SETTING This trial was set in primary dental care in Scotland, England and Wales. PARTICIPANTS Participants were NHS patients aged 3-7 years who were at a high risk of tooth decay and had at least one primary molar tooth with decay into dentine, but no pain/sepsis. INTERVENTIONS Three interventions were employed: (1) conventional with best-practice prevention (local anaesthetic, carious tissue removal, filling placement), (2) biological with best-practice prevention (sealing-in decay, selective carious tissue removal and fissure sealants) and (3) best-practice prevention alone (dietary and toothbrushing advice, topical fluoride and fissure sealing of permanent teeth). MAIN OUTCOME MEASURES The clinical effectiveness outcomes were the proportion of children with at least one episode (incidence) and the number of episodes, for each child, of dental pain or dental sepsis or both over the follow-up period. The cost-effectiveness outcomes were the cost per incidence of, and cost per episode of, dental pain and/or dental sepsis avoided over the follow-up period. RESULTS A total of 72 dental practices were recruited and 1144 participants were randomised (conventional arm, n = 386; biological arm, n = 381; prevention alone arm, n = 377). Of these, 1058 were included in an intention-to-treat analysis (conventional arm, n = 352; biological arm, n = 352; prevention alone arm, n = 354). The median follow-up time was 33.8 months (interquartile range 23.8-36.7 months). The proportion of children with at least one episode of pain or sepsis or both was 42% (conventional arm), 40% (biological arm) and 45% (prevention alone arm). There was no evidence of a difference in incidence or episodes of pain/sepsis between arms. When comparing the biological arm with the conventional arm, the risk difference was -0.02 (97.5% confidence interval -0.10 to 0.06), which indicates, on average, a 2% reduced risk of dental pain and/or dental sepsis in the biological arm compared with the conventional arm. Comparing the prevention alone arm with the conventional arm, the risk difference was 0.04 (97.5% confidence interval -0.04 to 0.12), which indicates, on average, a 4% increased risk of dental pain and/or dental sepsis in the prevention alone arm compared with the conventional arm. Compared with the conventional arm, there was no evidence of a difference in episodes of pain/sepsis among children in the biological arm (incident rate ratio 0.95, 97.5% confidence interval 0.75 to 1.21, which indicates that there were slightly fewer episodes, on average, in the biological arm than the conventional arm) or in the prevention alone arm (incident rate ratio 1.18, 97.5% confidence interval 0.94 to 1.48, which indicates that there were slightly more episodes in the prevention alone arm than the conventional arm). Over the willingness-to-pay values considered, the probability of the biological treatment approach being considered cost-effective was approximately no higher than 60% to avoid an incidence of dental pain and/or dental sepsis and no higher than 70% to avoid an episode of pain/sepsis. CONCLUSIONS There was no evidence of an overall difference between the three treatment approaches for experience of, or number of episodes of, dental pain or dental sepsis or both over the follow-up period. FUTURE WORK Recommendations for future work include exploring barriers to the use of conventional techniques for carious lesion detection and diagnosis (e.g. radiographs) and developing and evaluating suitable techniques and strategies for use in young children in primary care. TRIAL REGISTRATION Current Controlled Trials ISRCTN77044005. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 1. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Anne Maguire
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Jan E Clarkson
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | | | - Vicky Ryan
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Tara Homer
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Elaine McColl
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Nina Wilson
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Luke Vale
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Mark Robertson
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Alaa Abouhajar
- Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, UK
| | - Richard D Holmes
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Ruth Freeman
- Dental Health Services Research Unit, University of Dundee, Dundee, UK
| | - Barbara Chadwick
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Christopher Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Ferranti Wong
- Institute of Dentistry, Queen Mary University of London, London, UK
| | | |
Collapse
|
8
|
Abdelaziz M, Krejci I, Fried D. Enhancing the detection of proximal cavities on near infrared transillumination images with Indocyanine Green (ICG) as a contrast medium: In vitro proof of concept studies. J Dent 2019; 91:103222. [PMID: 31682898 DOI: 10.1016/j.jdent.2019.103222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/25/2019] [Accepted: 10/28/2019] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The use of near infrared transillumination for caries detection is gaining recognition in daily practice. Differentiation between cavitated and non cavitated proximal lesions is recognized as a threshold for restorative treatment. This investigation focused on the use of a near infrared absorbent dye which may enhance the detection of cavitation on near infrared transillumination images. MATERIALS AND METHODS 1: Natural teeth with artificial proximal cavitation were images with 3 different dyes to establish that near infrared absorbent dye can act like a contrast medium. 2: Natural teeth with natural cavitated lesions were used to investigate the contrast enhancing effect of indocyanine green (ICG) on near infrared transillumination images. 3: Artificial teeth with artificial cavitations were used to determine the best consistency of ICG as a contrast medium. 4: natural teeth with proximal lesions were used to confirm that ICG can differentiate between cavitated and non cavitated proximal lesions. RESULTS 1: ICG enhanced the contrast of cavitations compared to other dyes (ANOVA; p < 0.05). 2: ICG enhanced the contrast of the cavitated area on natural lesions but not significantly (t-test; p > 0.05). 3: ICG in a gel form enhanced the detection of cavitated lesions when compared to liquid ICG (t-test; p < 0.05). 4: ICG gel was able to differentiate between cavitated and non cavitated proximal lesions (ANOVA; p < 0.05). CONCLUSION ICG can potentially be used as a contrast medium to enhance the detection of cavitated proximal lesions in vitro on near infrared transillumination images. A clinical study is required to validate these results in vivo.
Collapse
Affiliation(s)
- Marwa Abdelaziz
- Division of Cariology and Endodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland; Division Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Ave., San Francisco, CA 94143-0758, USA.
| | - Ivo Krejci
- Division of Cariology and Endodontology, University Clinics of Dental Medicine (CUMD), University of Geneva, Rue Michel-Servet 1, 1211 Geneva 4, Switzerland.
| | - Daniel Fried
- Division Biomaterials and Bioengineering, Department of Preventive and Restorative Dental Sciences, University of California, 707 Parnassus Ave., San Francisco, CA 94143-0758, USA.
| |
Collapse
|
9
|
Finucane D. Restorative treatment of primary teeth: an evidence-based narrative review. Aust Dent J 2019; 64 Suppl 1:S22-S36. [PMID: 31144320 DOI: 10.1111/adj.12682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Various methods, with a variety of materials, exist for restoring carious primary teeth. Successful restoration of primary teeth is dependent on accurate diagnosis, knowledge of the caries process, knowledge of dental materials, and treatment choice. The purpose of this evidence-based review is to present evidence that will help clinicians to make an appropriate diagnosis, from which the optimum treatment plan can be made; to explore the literature regarding restoration of carious primary teeth; and to try and draw conclusions as to which materials and methods can be recommended. This review will primarily deal with the restoration of carious cavities in primary molars. A short discussion on restoration of primary incisors is included, with presentation of what limited evidence there is relating to this.
Collapse
Affiliation(s)
- D Finucane
- Hermitage Medical Clinic, Dublin, Ireland.,Faculty of Dentistry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Dublin Dental University Hospital, Dublin, Ireland
| |
Collapse
|
10
|
Dhar V, Mon S, Macek MD. Evaluation of Nonproximal Caries as Predictor of Proximal Caries in Primary Molars. Int J Clin Pediatr Dent 2018; 11:457-461. [PMID: 31303730 PMCID: PMC6611539 DOI: 10.5005/jp-journals-10005-1557] [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] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Most caries prevalence studies are conducted in community-based settings, usually with no radiographs, therefore, it is questionable if visual examination alone captures the true extent of disease. AIM Since it is relatively easy to diagnose occlusal and facial/lingual surface (nonproximal caries) on visual examination, our aim was to evaluate for an association between nonproximal caries (NP) and proximal caries (P), which if present can provide a tool to help decision makers in estimating the true extent of the disease. DESIGN A cross-sectional retrospective chart audit was done using records of 106 children to determine the association between NP and P caries in the primary dentition. RESULTS Our mean dft for NP lesions only was 1.55. Based on our data, the mean dft considering all pit and fissure plus the proximal lesions was 2.54, which is a 63.2% increase from the dft based on NP caries only. We found a significant association between NP caries and radiographically detectable P caries. Proximal lesions were twice as likely to exist on primary molars when non-proximal/pit and fissure carious lesions were present. CONCLUSION The results imply that proximal caries, and thus need for treatment, are being underestimated during visual exams. HOW TO CITE THIS ARTICLE Dhar V, Mon S, Macek MD. Evaluation of Nonproximal Caries as Predictor of Proximal Caries in Primary Molars. Int J Clin Pediatr Dent, 2018;11(6):457-461.
Collapse
Affiliation(s)
- Vineet Dhar
- Department of Pediatric Dentistry, University of Maryland School of Dentistry, Maryland, USA
| | - Soe Mon
- Department of Pediatric Dentistry, Severn Pediatric Dentistry, Maryland, USA
| | - Mark D Macek
- Department of Dental Public Health, University of Maryland School of Dentistry, Maryland, USA
| |
Collapse
|
11
|
Foster Page LA, Boyd D, Fuge K, Stevenson A, Goad K, Sim D, Thomson WM. The effect of bitewing radiography on estimates of dental caries experience among children differs according to their disease experience. BMC Oral Health 2018; 18:137. [PMID: 30092796 PMCID: PMC6085693 DOI: 10.1186/s12903-018-0596-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 07/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Radiography is a regularly used and accepted adjunct to visual examination in the diagnosis of dental caries. It is assumed that not using radiographs can lead to underestimation of dental caries experience with most reports having involved studies of young adults or adolescents, and been focused on the permanent dentition. The aim of this study was to determine the relative contributions of bitewing radiography and clinical examination in the detection of dental caries in primary molars and to determine whether those contributions differ according to caries experience. METHODS A cross-sectional study was conducted, involving examinations undertaken in dental clinics. Bitewing radiographs taken at the time of the clinical examination were developed and read later, with the data from those used at the analysis stage to adjust the caries diagnosis for the mesial, occlusal and distal surfaces of the primary molar teeth. Children's clinically determined dmfs score was used to allocate them to one of three caries experience groups (0 dmfs, 1-8 dmfs, or 9+ dmfs). RESULTS Of the 501 three-to-eight-year-old children examined, nearly three-quarters were younger than six. Caries prevalence and mean dmfs after clinical examination alone and following radiographs were 63.1% and 4.6 (sd, 6.2), and 74.7% and 5.8 (sd, 6.5) respectively. Among children with a dmfs of 1-8, the number of lesions missed during the clinical examination was greater than the number of 106 (25.6%) in children with a dmfs of 9+. In the 185 children with no apparent caries at clinical examination, 124 lesions were detected radiographically, among 58 (46.8%) of those. CONCLUSIONS Taking bitewing radiographs in young children is not without challenges or risks, and it must be undertaken with these in mind. Diagnostic yields from bitewing radiographs are greater for children with greater caries experience. The findings of this study further support the need to consider using bitewing radiographs in young children to enhance the management of lesions not detected by a simple visual examination alone. TRIAL REGISTRATION ACTRN12614000844640 .
Collapse
Affiliation(s)
- L A Foster Page
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - D Boyd
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - K Fuge
- Community Oral Health Service, Hutt Valley Hospital, Wellington, New Zealand
| | - A Stevenson
- Hutt Valley District Health Board, Wellington, New Zealand
| | - K Goad
- Waikato District Health Board, Hamilton, New Zealand
| | - D Sim
- Southern District Health Board, Dunedin, New Zealand
| | - W M Thomson
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| |
Collapse
|
12
|
Kasraei S, Shokri A, Poorolajal J, Khajeh S, Rahmani H. Comparison of Cone-Beam Computed Tomography and Intraoral Radiography in Detection of Recurrent Caries under Composite Restorations. Braz Dent J 2017; 28:85-91. [DOI: 10.1590/0103-6440201701248] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 10/17/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract Secondary caries is the most common cause of dental restoration failures. This study aimed to compare the diagnostic accuracy of conventional and digital intraoral radiography and cone beam computed tomography (CBCT) for detection of recurrent caries around composite restorations. mesio-occluso-distal (MOD) cavities were prepared using bur on 45 extracted sound human molar teeth. The teeth were divided into 3 groups. In the control group, cavities were restored with composite resin after etching and bonding (n=15). In Group 2, 500-μm thick wax was placed over the buccal, lingual and gingival walls and the cavities were restored with composite resin. Group 3 specimens were subjected to pH cycling and artificial caries were created on the buccal, lingual and gingival walls. The cavities were restored with composite. Conventional and digital photo-stimulable phosphor (PSP; Optime) radiographs and two CBCTs images (NewTom 3G and Cranex 3D) were obtained from them. Presence or absence of caries in the cavity walls was assessed on these images. Data were analyzed using Kappa statistic. The diagnostic accuracy of CBCT was significantly higher than that of digital and conventional intraoral radiography (p<0.05). The accuracy was 0.83, 0.78, 0.55 and 0.49 for CBCT Cranex 3D, CBCT NewTom 3G, conventional and digital intraoral radiography, respectively. CBCT has a higher diagnostic accuracy than digital and conventional intraoral radiography for detection of secondary caries around composite restorations.
Collapse
|
13
|
Participant recruitment to FiCTION, a primary dental care trial - survey of facilitators and barriers. Br Dent J 2016; 217:E22. [PMID: 25415040 DOI: 10.1038/sj.bdj.2014.1009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To identify reasons behind a lower than expected participant recruitment rate within the FiCTION trial, a multi-centre paediatric primary dental care randomised controlled trial (RCT). SUBJECTS (MATERIALS) AND METHODS An online survey, based on a previously published tool, consisting of both quantitative and qualitative responses, completed by staff in dental practices recruiting to FiCTION. Ratings from quantitative responses were aggregated to give overall scores for factors related to participant recruitment. Qualitative responses were independently grouped into themes. RESULTS Thirty-nine anonymous responses were received. Main facilitators related to the support received from the central research team and importance of the research question. The main barriers related to low child eligibility rates and the integration of trial processes within routine workloads. CONCLUSIONS These findings have directed strategies for enhancing participant recruitment at existing practices and informed recruitment of further practices. The results help provide a profile of the features required of practices to successfully screen and recruit participants. Future trials in this setting should consider the level of interest in the research question within practices, and ensure trial processes are as streamlined as possible. Research teams should actively support practices with participant recruitment and maintain enthusiasm among the entire practice team.
Collapse
|
14
|
Dorri M, Dunne SM, Walsh T, Schwendicke F. Micro-invasive interventions for managing proximal dental decay in primary and permanent teeth. Cochrane Database Syst Rev 2015; 2015:CD010431. [PMID: 26545080 PMCID: PMC8504982 DOI: 10.1002/14651858.cd010431.pub2] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Proximal dental lesions, limited to dentine, are traditionally treated by invasive (drill and fill) means. Non-invasive alternatives (e.g. fluoride varnish, flossing) might avoid substance loss but their effectiveness depends on patients' adherence. Recently, micro-invasive approaches for treating proximal caries lesions have been tried. These interventions install a barrier either on top (sealing) or within (infiltrating) the lesion. Different methods and materials are currently available for micro-invasive treatments, such as sealing via resin sealants, (polyurethane) patches/tapes, glass ionomer cements (GIC) or resin infiltration. OBJECTIVES To evaluate the effects of micro-invasive treatments for managing proximal caries lesions in primary and permanent dentition in children and adults. SEARCH METHODS We searched the following databases to 31 December 2014: the Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via OVID, EMBASE via OVID, LILACs via BIREME Virtual Health Library, Web of Science Conference Proceedings, ZETOC Conference Proceedings, Proquest Dissertations and Theses, ClinicalTrials.gov, OpenGrey and the World Health Organization (WHO) International Clinical Trials Registry Platform. We searched the metaRegister of Controlled Trials to 1 October 2014. There were no language or date restrictions in the searches of the electronic databases. SELECTION CRITERIA We included randomised controlled trials of at least six months' duration that compared micro-invasive treatments for managing non-cavitated proximal dental decay in primary teeth, permanent teeth or both, versus non-invasive measures, invasive means, no intervention or placebo. We also included studies that compared different types of micro-invasive treatments. DATA COLLECTION AND ANALYSIS Two review authors independently screened search results, extracted data and assessed the risk of bias. We used standard methodological procedures expected by Cochrane to evaluate risk of bias and synthesise data. We conducted meta-analyses with the random-effects model, using the Becker-Balagtas method to calculate the odds ratio (OR) for lesion progression. We assessed the quality of the evidence using GRADE methods. MAIN RESULTS We included eight trials, which randomised 365 participants. The trials all used a split-mouth design, some with more than one pair of lesions treated within the same participant. Studies took place in university or dental public health clinics in Brazil, Colombia, Denmark, Germany, Thailand, Greenland and Chile. Six studies evaluated the effects of micro-invasive treatments in the permanent dentition and two studies on the primary dentition, with caries risk ranging from low to high. Investigators measured caries risk in different studies either by caries experience alone or by using the Cariogram programme, which combines eight contributing factors, including caries experience, diet, saliva and other factors related to caries. The follow-up period in the trials ranged from one to three years. All studies used lesion progression as the primary outcome, evaluating it by different methods of reading radiographs. Four studies received industry support to carry out the research, with one of them being carried out by inventors of the intervention.We judged seven studies to be at high overall risk of bias, primarily due to lack of blinding of participants and personnel. We evaluated intervention effects for all micro-invasive therapies and analysed subgroups according to the different treatment methods reported in the included studies.Our meta-analysis, which pooled the most sensitive set of data (in terms of measurement method) from studies presenting data in a format suitable for meta-analysis, showed that micro-invasive treatment significantly reduced the odds of lesion progression compared with non-invasive treatment (e.g fluoride varnish) or oral hygiene advice (e.g to floss) (OR 0.24, 95% CI 0.14 to 0.41; 602 lesions; seven studies; I(2) = 32%). There was no evidence of subgroup differences (P = 0.36).The four studies that measured adverse events reported no adverse events after micro-invasive treatment. Most studies did not report on any further outcomes.We assessed the quality of evidence for micro-invasive treatments as moderate. It remains unclear which micro-invasive treatment is more advantageous, or if certain clinical conditions or patient characteristics are better suited for micro-invasive treatments than others. AUTHORS' CONCLUSIONS The available evidence shows that micro-invasive treatment of proximal caries lesions arrests non-cavitated enamel and initial dentinal lesions (limited to outer third of dentine, based on radiograph) and is significantly more effective than non-invasive professional treatment (e.g. fluoride varnish) or advice (e.g. to floss). We can be moderately confident that further research is unlikely to substantially change the estimate of effect. Due to the small number of studies, it does remain unclear which micro-invasive technique offers the greatest benefit, or whether the effects of micro-invasive treatment confer greater or lesser benefit according to different clinical or patient considerations.
Collapse
Affiliation(s)
- Mojtaba Dorri
- Bristol Oral and Dental SchoolDepartment of Restorative DentistryLower Maudlin StreetBristolUKBS1 2LY
| | - Stephen M Dunne
- Kings College London Dental InstitutePrimary Dental CareDenmark Hill CampusCaldecot RoadLondonUKSE5 9RW
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Falk Schwendicke
- Charité ‐ Universitätsmedizin BerlinDepartment of Operative and Preventive DentistryCampus Benjamin FranklinAßmannshauser Str 4‐6BerlinGermany14197
| | | |
Collapse
|
15
|
Busanello FH, da Silveira PF, Liedke GS, Arús NA, Vizzotto MB, Silveira HED, Silveira HLD. Evaluation of a digital learning object (DLO) to support the learning process in radiographic dental diagnosis. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2015; 19:222-228. [PMID: 25393811 DOI: 10.1111/eje.12125] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2014] [Indexed: 06/04/2023]
Abstract
AIMS Studies have shown that inappropriate therapeutic strategies may be adopted if crown and root changes are misdiagnosed, potentially leading to undesirable consequences. Therefore, the aim of this study was to evaluate a digital learning object, developed to improve skills in diagnosing radiographic dental changes. MATERIALS AND METHODS The object was developed using the Visual Basic Application (VBA) software and evaluated by 62 undergraduate students (male: 24 and female: 38) taking an imaging diagnosis course. Participants were divided in two groups: test group, which used the object and control group, which attended conventional classes. After 3 weeks, students answered a 10-question test and took a practice test to diagnose 20 changes in periapical radiographs. RESULTS The results show that test group performed better that control group in both tests, with statistically significant difference (P = 0.004 and 0.003, respectively). In overall, female students were better than male students. Specific aspects of object usability were assessed using a structured questionnaire based on the System Usability Scale (SUS), with a score of 90.5 and 81.6 by male and female students, respectively. CONCLUSIONS The results obtained in this study suggest that students who used the DLO performed better than those who used conventional methods. This suggests that the DLO may be a useful teaching tool for dentistry undergraduates, on distance learning courses and as a complementary tool in face-to-face teaching.
Collapse
Affiliation(s)
- F H Busanello
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - P F da Silveira
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - G S Liedke
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - N A Arús
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - M B Vizzotto
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - H E D Silveira
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - H L D Silveira
- Department of Surgery and Orthopedics, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
16
|
Shams N, Panahandeh N, Aghababa H, Shams B, Hemati E. Effects of education and experience on detection of proximal caries on digital radiographs. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0227-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
17
|
Proximal caries lesion detection in primary teeth: does this justify the association of diagnostic methods? Lasers Med Sci 2015; 30:2239-44. [PMID: 26286856 DOI: 10.1007/s10103-015-1798-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 08/10/2015] [Indexed: 10/23/2022]
Abstract
The aim of this clinical study was to evaluate and compare the performance of visual exam with use of the Nyvad criteria (visual examination - (VE)), interproximal radiography (BW), laser fluorescence device (DIAGNOdent Pen-DDPen), and their association in the diagnosis of proximal lesions in primary teeth. For this purpose, 45 children (n = 59 surfaces) of both sexes, aged between 5 and 9 years were selected, who presented healthy primary molars or primary molars with signs suggestive of the presence of caries lesions. The surfaces were clinically evaluated and coded according to the Nyvad criteria and immediately afterwards with the DDPen. Radiographic exam was performed only on the surfaces coded with Nyvad scores 2, 3, 5, or 6. Active caries lesions and/or those with discontinuous surfaces were restored, considering the depth of lesion as reference standard. Sensitivity, specificity, accuracy, and area under ROC curve were calculated for each technique and its associations. Visual exam with Nyvad criteria presented the highest specificity, accuracy, and area under ROC curve values. The DDPen presented the highest sensitivity values. Association with one or more methods resulted in an increase in specificity. The performance of visual, radiographic, and DDpen exams and their associations were good; however, the clinical examination with the Nyvad criteria was sufficient for the diagnosis of interproximal lesions in primary teeth.
Collapse
|
18
|
Deery C, Owen J, Welbury R, Chadwick B. Dental caries in children and the level of repeat general anaesthetics for dental extractions. a national disgrace. ACTA ACUST UNITED AC 2015; 42:305-6. [DOI: 10.12968/denu.2015.42.4.305] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Jayne Owen
- Somerset Partnership NHS Foundation Trust
| | | | | |
Collapse
|
19
|
Koh R, Pukallus ML, Newman B, Foley M, Walsh LJ, Seow WK. Effects of Water Fluoridation on Caries Experience in the Primary Dentition in a High Caries Risk Community in Queensland, Australia. Caries Res 2015; 49:184-91. [DOI: 10.1159/000369864] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2014] [Accepted: 11/09/2014] [Indexed: 11/19/2022] Open
Abstract
Objectives: In December 2008, artificial water fluoridation was introduced for the first time to the Logan-Beaudesert district in the state of Queensland, Australia. The aim of this study was to evaluate the effects of water fluoridation in the primary dentition in this community after a period of 36 months. Methods: Children aged 4-9 years with clinical examinations and bitewing radiographs (BWs) taken before water fluoridation (pre-F) were randomly selected as comparison controls for age matched children who had been exposed to a mean period of 36 months of water fluoridation (post-F). A total of 201 sets of pre-F BWs from children (mean age 6.95 ± 1.05 years) and 256 sets of post-F BWs from children (mean age 7.19 ± 1.23 years) attending schools in the district were randomly selected. Caries experience in the primary dentition was determined as decayed, missing or filled teeth/surfaces (dmft/dmfs). Results: The caries prevalence for the pre-F group was 87% compared to 75% in the post-F group (Odds ratio (OR): 0.44, 95% CI: 0.27-0.72). Overall, there was a 19 percent reduction of mean dmft from 4.54 in the pre-F group to 3.66 in the post-F group (p = 0.005). After fluoridation, the dmfs was reduced from 6.68 to 5.17 (p = 0.0056). The distal surfaces of maxillary first primary molars experienced the greatest reduction (26%) in caries experience after water fluoridation (p < 0.001). Conclusions: After only 36 months of water fluoridation there was a significant drop in caries prevalence from 87 to 75% and a 19% reduction in caries experience in a community with one of the highest caries rates in Australia.
Collapse
|
20
|
IBUSUKI T, KITASAKO Y, SADR A, SHIMADA Y, SUMI Y, TAGAMI J. Observation of white spot lesions using swept source optical coherence tomography (SS-OCT): in vitro and in vivo study. Dent Mater J 2015; 34:545-52. [DOI: 10.4012/dmj.2015-058] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Takahide IBUSUKI
- Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yuichi KITASAKO
- Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Alireza SADR
- University of Washington, School of Dentistry
- Tokyo Medical and Dental University, International Exchange Center
| | - Yasushi SHIMADA
- Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| | - Yasunori SUMI
- Department for Advanced Dental Research Center of Advanced Medicine for Dental and Oral Disease, National Center for Geriatrics and Gerontology
| | - Junji TAGAMI
- Cariology and Operative Dentistry, Department of Restorative Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
| |
Collapse
|
21
|
Ooi G, Townsend G, Seow WK. Bacterial colonization, enamel defects and dental caries in 4-6-year-old mono- and dizygotic twins. Int J Paediatr Dent 2014; 24:152-60. [PMID: 23721206 DOI: 10.1111/ipd.12041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Knowledge of the genetic and environmental influences in caries aetiology has relevance for preventive dentistry. AIMS This classical twin study compared concordance of mutans streptococci (MS) and lactobacilli (LB) colonization, enamel defects, and caries in a cohort of 4-6-year-old mono- (MZ) and dizygotic (DZ) twin pairs. DESIGN The twins were examined for prevalence and concordance of enamel opacities and hypoplasia, oral counts of MS and LB, and dental caries. Bacterial counts were assessed using a commercial microbiological kit. RESULTS Thirty-four MZ and 50 DZ twins (mean gestational age 35.0 ± 2.4 weeks, and birthweight 2.4 ± 0.6 kg) were examined. There were no statistically significant differences between MZ and DZ twins in the prevalence of MS, LB, and enamel hypoplasia. Concordance rates for MS and LB presence and prevalence of enamel defects within MZ and DZ twin pairs were not significantly different. There were more children with caries in DZ compared with MZ twins (18% vs 3%, P = 0.0029), most likely due to increased daily frequency of sugar consumption and less toothbrushing. CONCLUSIONS Concordance data from MZ and DZ twins did not demonstrate any statistically significant difference in susceptibility for enamel defects and colonization of MS and LB.
Collapse
Affiliation(s)
- Gregory Ooi
- Queensland Health, Children's Oral Health Service, Royal Children's Hospital, Herston, Qld, Australia
| | | | | |
Collapse
|
22
|
The additional information of bitewing radiographs in the detection of established or severe dentinal decay in 14-year olds: a cross-sectional study in low-caries population. ScientificWorldJournal 2014; 2014:175358. [PMID: 24574869 PMCID: PMC3915626 DOI: 10.1155/2014/175358] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 11/03/2013] [Indexed: 11/18/2022] Open
Abstract
Aim. To reveal the additional value of radiographic bitewings (BW) in detection of caries and in comparing the occurrence of clinically undetected severe decay between 14-year olds with and without clinically observed dentinal caries in a low-caries prevalence population. Design. The cross-sectional study used 363 pairs of radiographs read by one examiner without knowledge of the clinical findings. The yield was analyzed on a tooth surface level by cross tabulating the clinical and radiographic information and on an individual level by counting the number of yield surfaces for all subjects. Mann-Whitney U test was used. Results. On a tooth surface level, the contribution of BW was the greatest on the occlusal surfaces of the first molars, where established or severe dentinal decay was registered in BW in 11% of clinically sound surfaces and in 40% of established cavitated enamel lesions. On an individual level, 53% of subjects benefited from BW. The subjects clinically DMFS > 0 benefited more than the clinically DMFS = 0 subjects (P = .004), nearly 60% in relation to 47%, respectively. Conclusions. In a low-caries prevalence population a remarkable portion of both clinically DMFS = 0 and DMFS > 0 14-year olds benefit from BW examination. Most of the benefit is obtained on the occlusal surfaces of the first and the second permanent molars.
Collapse
|
23
|
Cruz AD, Esteves RG, Poiate IAVP, Portero PP, Almeida SM. Influence of Radiopacity of Dental Composites on the Diagnosis of Secondary Caries: The Correlation Between Objective and Subjective Analyses. Oper Dent 2014; 39:90-7. [DOI: 10.2341/12-377-l] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
This study aimed to objectively evaluate the radiopacity of different dental composites and their subjective influence on diagnosing secondary caries–like lesions and how these results correlate. For objective analysis, three resin specimens (1 mm thick, with a 4-mm internal diameter) were made with four composites: 1) Charisma; 2) Filtek Z250; 3) Prisma AP.H; and 4) Glacier. Three human teeth were selected and then mesio-distally sectioned (1 mm thick) to make the dental specimens. An aluminum (Al) wedge (12 steps, 1 mm thick, 99.8% purity) was used as an internal standard to calculate the radiopacity. For subjective analysis, 20 human teeth were selected and then prepared with a mesio-occluso-distal (MOD) inlay cavity, with half the teeth receiving a round cavity to simulate the carious lesion. The MOD was restored using the composites at four different times. Standardized radiographs were acquired and then digitized (300 dpi and eight-bit TIFF) for both analyses. A histogram objectively measured the pixel intensity values of the images, which were converted into millimeters of Al using linear regressions. Eight observers subjectively evaluated the images using a five-point rating scale to diagnose the caries. The data were statistically analyzed using the Student t-test, the Kappa test, diagnostic testing, and the Pearson correlation coefficient (α=0.05). All materials showed radiopacity values compatible with dental tissues (p>0.05); Glacier was similar to dentin and Prisma AP.H was similar to enamel, while the remaining materials showed a middle radiopacity. Prisma AP.H and Glacier differed (p<0.05) in relation to their accuracy to caries diagnosis, with Glacier having greater accuracy. There was a correlation between objective and subjective analyses with negative linear dependence. An increase in the material's radiopacity could have a subjectively negative influence on the diagnosis of secondary caries; thus, an ideal radiopacity for a dental composite is closer to the dentin image and produces similar attenuation to X-rays than does dentin.
Collapse
Affiliation(s)
- AD Cruz
- Adriana Dibo Cruz, DDS, PhD, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Department of Specific Formation, Area of Dental Radiology, Nova Friburgo, Rio de Janeiro, Brazil
| | - RG Esteves
- Renata Gama Esteves, DDS student, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Nova Friburgo, Brazil
| | - IAVP Poiate
- Isis Andréa Venturini Pola Poiate, DDS, PhD, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Department of Specific Formation, Area of Dental Clinic, Nova Friburgo, Rio de Janeiro, Brazil
| | - PP Portero
- Priscila Paiva Portero, Dental School of the Fluminense Federal University, Polo of Nova Friburgo, Department of Specific Formation, Area of Dental Clinic, Nova Friburgo, Rio de Janeiro, Brazil
| | - SM Almeida
- Solange Maria Almeida, DDS, MS, PhD, Dentistry School of Piracicaba, State University of Campinas, Department of Oral Diagnostic, Piracicaba, Brazil
| |
Collapse
|
24
|
Akbari M, Zarch HH, Movagharipour F, Ahrari F. A pilot study of a modified radiographic technique for detecting early proximal cavities. Caries Res 2013; 47:612-6. [PMID: 24061285 DOI: 10.1159/000355297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 08/25/2013] [Indexed: 11/19/2022] Open
Abstract
Diagnosing the necessity of cavity preparation in demineralized proximal areas has been considered as a challenge in restorative treatment planning. The purpose of this study was to investigate the clinical performance of a modified radiographic technique for the detection of proximal cavities. The sample consisted of 44 proximal surfaces in 38 dental students. The patients had radiolucent proximal lesions restricted to the inner half of enamel or the outer third of dentine in bitewing radiographs, and there was doubt regarding the presence or absence of cavities in the approximal areas. The suspected surfaces were then examined by secondary bitewing radiographs which were taken after pressing radiopaque material into the proximal areas. Finally, orthodontic elastic separators were placed in the contact areas to provide enough space for direct visual and tactile examination, thus detecting any proximal cavity (reference standard). The sensitivity, specificity and accuracy of the modified bitewing radiography were calculated against the reference standard. Overall, 7 surfaces presented caries cavities according to the reference standard. All proximal radiolucencies observed in the inner half of enamel and 46% of those extended to the outer third of dentine were not cavitated when evaluated by direct visual and tactile examination. The sensitivity, specificity and accuracy of bitewing radiography with opaque material for detecting proximal cavities (n = 7) were 86, 100 and 98%, respectively. The tested radiographic technique displayed good validity in this pilot study for detecting proximal cavities in posterior teeth and should be further investigated.
Collapse
Affiliation(s)
- M Akbari
- Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | | |
Collapse
|
25
|
Davidovich E, Kooby E, Shapira J, Ram D. The traditional practice of canine bud removal in the offspring of Ethiopian immigrants. BMC Oral Health 2013; 13:34. [PMID: 23870074 PMCID: PMC3735433 DOI: 10.1186/1472-6831-13-34] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 07/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The custom of canine bud removal has detrimental consequences on children's general health and dental care. The objective of this study was to assess whether the prevalence of missing primary canines and dental defects in offspring of emigrants from Ethiopia is greater than in offspring of native Israeli parents of similar socioeconomic class. METHODS 477 children of Ethiopian descent and 317 offspring of native Israeli parents, from 21 nursery schools and kindergartens, underwent dental examinations aimed to determine the presence or absence of primary canines and of developmental enamel defects on adjacent teeth to the primary canines. For purposes of analysis, children were classified into two age groups: younger (ages 18-48 months) and older (ages 49-82 months). RESULTS Canines were present in more Israeli than Ethiopian younger children, 87.5% vs. 42.3%, p=0.0001; and in more Israeli than Ethiopian older children, 92.6% vs. 40.4%, p=0.0001. More dental defects were detected in Ethiopian than in Israeli younger children, 32% vs. 3.9%, p=0.0001; and in more Ethiopian than Israeli older children, 31.2% vs. 5.8%, p=0.0001. CONCLUSIONS The prevalence of missing primary canines and dental defects was greater among offspring of parents who had emigrated from Ethiopia 15-20 years earlier than among offspring of native Israeli parents living in the same low socioeconomic neighborhoods.
Collapse
Affiliation(s)
- Esti Davidovich
- Department of Pediatric Dentistry, The Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
| | | | | | | |
Collapse
|
26
|
Ritter AV, Ramos MD, Astorga F, Shugars DA, Bader JD. Visual-tactile versus radiographic caries detection agreement in caries-active adults. J Public Health Dent 2013; 73:252-60. [PMID: 23772747 DOI: 10.1111/jphd.12024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 05/06/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The study aims to determine a) the extent of agreement between visual-tactile caries examination (VTE) and radiographic examination (RE) in detecting presumptive caries lesions on occlusal and proximal surfaces of posterior teeth of UNC Xylitol for Adult Caries Trial participants; and b) the additional caries diagnostic yield obtained by adding RE to VTE. METHODS Data consisted of surface-level visual-tactile and radiographic classification of disease (cavitated and noncavitated caries lesions) or nondisease (sound surfaces). Participants (n = 114, adults with ≥12 erupted teeth and 1-10 caries lesions) received baseline VTE by a trained and calibrated examiner, and had interproximal radiographs obtained within 7 months before or after the VTE. Radiographs were assessed independently by two trained and calibrated examiners masked with respect to VTE results. The diagnostic threshold was surface-level disease/nondisease status. Kappa statistics provided an estimate of VTE-RE agreement on diseased surfaces. The additional diagnostic yield of the RE over VTE was calculated as the additional lesions detected radiographically as a percentage of the total number of lesions detected by VTE. RESULTS Four-hundred ninety-four (51 occlusal, 433 proximal) lesions were detected; of these, 81 (2 occlusal, 79 proximal) lesions were detected by both VTE and RE. Kappa statistics were 0.18 (all surfaces), 0.04 (occlusal), and 0.18 (proximal). The additional diagnostic yield was 69 percent (all surfaces), 55 percent (occlusal), and 71 percent (proximal). CONCLUSIONS There is poor agreement between VTE and RE to detect caries in posterior teeth of caries-active adults. However, an RE performed within 7 months of a VTE adds caries diagnostic yield in a clinical trial, especially on proximal surfaces.
Collapse
Affiliation(s)
- André V Ritter
- Department of Operative Dentistry, University of North Carolina School of Dentistry, Chapel Hill, NC, USA
| | | | | | | | | |
Collapse
|
27
|
Kamburoglu K, Kolsuz E, Murat S, Yüksel S, Ozen T. Proximal caries detection accuracy using intraoral bitewing radiography, extraoral bitewing radiography and panoramic radiography. Dentomaxillofac Radiol 2012; 41:450-9. [PMID: 22868296 DOI: 10.1259/dmfr/30526171] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare proximal caries detection using intraoral bitewing, extraoral bitewing and panoramic radiography. METHODS 80 extracted human premolar and molar teeth with and without proximal caries were used. Intraoral radiographs were taken with Kodak Insight film (Eastman Kodak Co., Rochester, NY) using the bitewing technique. Extraoral bitewing and panoramic images were obtained using a Planmeca Promax Digital Panoramic X-ray unit (Planmeca Inc., Helsinki, Finland). Images were evaluated by three observers twice. In total, 160 proximal surfaces were assessed. Intra- and interobserver kappa coefficients were calculated. Scores obtained from the three techniques were compared with the histological gold standard using receiver operating characteristic analysis. Az values for each image type, observer and reading were compared using z-tests, with a significance level of α = 0.05. RESULTS Kappa coefficients ranged from 0.883 to 0.963 for the intraoral bitewing, from 0.715 to 0.893 for the extraoral bitewing, and from 0.659 to 0.884 for the panoramic radiography. Interobserver agreements for the first and second readings for the intraoral bitewing images were between 0.717 and 0.780, the extraoral bitewing readings were between 0.569 and 0.707, and the panoramic images were between 0.477 and 0.740. The Az values for both readings of all three observers were highest for the intraoral bitewing. Az values for the extraoral bitewing images were higher than those of the panoramic images without statistical significance (p > 0.05). CONCLUSION Intraoral bitewing radiography was superior to extraoral bitewing and panoramic radiography in diagnosing proximal caries of premolar and molar teeth ex vivo. Similar intra- and interobserver coefficients were calculated for extraoral bitewing and panoramic radiography.
Collapse
Affiliation(s)
- K Kamburoglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Konya Yolu, Cankaya, Turkey.
| | | | | | | | | |
Collapse
|
28
|
Torres MGG, Santos ADS, Neves FS, Arriaga ML, Campos PSF, Crusoé-Rebello I. Assessment of enamel-dentin caries lesions detection using bitewing PSP digital images. J Appl Oral Sci 2012; 19:462-8. [PMID: 21986650 PMCID: PMC3984191 DOI: 10.1590/s1678-77572011000500005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 10/26/2010] [Indexed: 12/03/2022] Open
Abstract
Objectives The aim of this study was to evaluate the detection of enamel-dentin occlusal
caries using photostimulable phosphor plates. Material and Methods The ability to detect enamel-dentin occlusal caries in 607 premolars and molars
from 47 patients between 10 and 18 years old, referred to the School of Dentistry
of the Federal University of Bahia, Brazil, was evaluated based on clinical and
radiographic examinations, using the criteria proposed in a previous study. A
total of 156 bitewing digital images were obtained using Digora® (Soredex Medical
Systems, Helsinki, Finland) phosphor plates. The plates were scanned and the
images were captured and displayed on a computer screen. Image evaluation was done
using Digora® for Windows 2.1 software, Soredex®. The radiologists were allowed to
use enhancement tools to obtain better visibility during scoring of the teeth
based on the radiographic criteria proposed in a previous study. Descriptive
analysis and chi-squared proportion tests were done at 5% significance level. Results The results of clinical examination showed a higher prevalence of teeth with a
straight dark line or demineralization of the occlusal fissure (score 1) and a
lower prevalence of sealed teeth (score 5). In the bitewing digital images, 47
teeth presented visible radiolucency, circumscribed, in dentin under occlusal
enamel (enamel-dentin caries lesions). Conclusions Correlating the clinical and radiographic findings, it was found that in the
majority of teeth diagnosed by radiographic images as having enamel-dentin caries,
no caries could be detected by clinical examination.
Collapse
|
29
|
Moreira PL, Messora MR, Pereira SM, Almeida SMD, Cruz ADD. Diagnosis of secondary caries in esthetic restorations: influence of the incidence vertical angle of the X-ray beam. Braz Dent J 2011; 22:129-33. [PMID: 21537586 DOI: 10.1590/s0103-64402011000200007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 02/07/2011] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the accuracy on the diagnosis of secondary caries-like lesions simulated on esthetic restorations of different materials, changing the incidence vertical angle (IVA) of the x-ray beam. Twenty human teeth received MOD inlay preparations. In the experimental group (n=10), a round cavity was made in the floor of the proximal box to simulate the caries-like lesion. All teeth were restored with 3 composite resins (Charisma, Filtek-Z250 and TPH-Spectrum) at 3 moments. Two radiographic images were acquired with 0º and 10º IVA. Ten observers evaluated the images using a 5-point confidence scale. Intra- and interobserver reliability was analyzed with the Interclass Correlation Coefficient and the diagnostic accuracy was evaluated using the area under the ROC curve (A(z)), Friedman test and Wilcoxon test (α=0.05). Higher accuracy values were obtained with 10º IVA (A(z)=0.66, Filtek-Z250>A(z)=0.56, TPH-Spectrum) compared to 0º (A(z)=0.55, Charisma>A(z)=0.37, TPH-Spectrum), though without statistically significant difference (p>0.05). The detection of secondary caries-like lesions simulated on esthetic restorations of different materials suffered no negative influence by changing the IVA of the x-ray beam.
Collapse
|
30
|
Mauthe PW, Eaton KA. An Investigation into the Bitewing Radiographic Prescribing Patterns of West Kent General Dental Practitioners. ACTA ACUST UNITED AC 2011. [DOI: 10.1177/2050168411os1800304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims The primary aims of the study were to investigate the use of bitewing radiography within primary dental care and adherence to guidelines on bitewing radiography by general dental practitioners (GDPs) in the West Kent Primary Care Trust (PCT) area. Within the overall aims, the study had objectives to investigate the use of radiographic guidelines, audit and caries risk assessment, the influence of private and National Health Service (NHS) practice, and the influence of the demographic profile of the GDPs on these variables. Methods Data were gathered via a piloted self-completion questionnaire, circulated to all GDPs listed on the NHS Choices website as practising in the West Kent PCT area. Three mailings and follow-up telephone calls were used. The resulting data were entered into a statistical software database and, where relevant, statistically tested, using the chi-square test. Results Of 223 GDPs, 167 responded (75%). GDPs with a high NHS commitment were significantly less likely to follow Faculty of General Dental Practice (UK) guidance on prescribing bitewing radiographs for adults ( P<0.01) and children ( P<0.05) than were mainly private GDPs. Mainly NHS GDPs were more likely ‘always/mostly’ to follow National Institute for Health and Clinical Excellence guidance (83 compared to 59) ( P<0.05) and also to risk-assess patients (83 compared to 62). Only 115 (71%) had carried out a radio graphic audit or peer review in the preceding three years. Those with postgraduate qualifications were more likely ( P<0.05) to carry out radiographic audit. Conclusions The study confirmed previous research reporting the under-use of radiography for caries detection and also the failure of some GDPs to comply with ionising radiation regulations. West Kent GDPs with a high NHS commitment were less likely to follow radiographic guidance than their private counterparts. This suggests that further efforts to disseminate information on radiographic guidelines and to educate GDPs are necessary to improve adherence with all aspects of radiography within general dental practice. Research into factors that influence GDPs’ decision-making with regards to radiographic prescription may further inform the profession as to the best methods to lead to behavioural change. The dental profession and its regulators need to make a concerted effort to educate and inform GDPs so that this behaviour is modified.
Collapse
Affiliation(s)
| | - Kenneth A Eaton
- University of Kent, Eastman UCL and King's College London Dental Institutes, UK
| |
Collapse
|
31
|
Clinical detection of caries in the primary dentition with and without bitewing radiography. Br Dent J 2009. [DOI: 10.1038/sj.bdj.2009.633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|