1
|
Bakhshandeh A, Ekstrand K, Fiehn NE, Qvist V. Additional information of bitewings to first time clinical examination of caries and restoration status in permanent dentition. Acta Odontol Scand 2022; 80:580-587. [PMID: 35635186 DOI: 10.1080/00016357.2022.2055789] [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: 11/01/2022]
Abstract
OBJECTIVES Identifying additional information obtained by X-rays combined with clinical examination concerning primary caries, caries adjacent to restorations and quality of restorations. MATERIAL AND METHODS A total of 240 adult patients, equally distributed in gender and six age-groups, were randomly selected from an original study population of 4,402 subjects (DANHES). Clinical and radiographical registrations on occlusal and approximal surfaces in posterior teeth were categorized into unrestored surfaces (sound/primary caries) and restored surfaces (without/with caries adjacent to restorations). Material and quality of restorations were also recorded. Chi-square and Fisher-exact tests were used for statistical analyses. RESULTS Of potentially 11,520 surfaces, 3,015 occlusal and 5,112 approximal surfaces were analysed. Occlusal: Of 907 unrestored surfaces, 110 had primary caries and 53% were detected radiographically. A total of 183 of 2,108 restored surfaces had caries adjacent to restorations, and 99% were found radiographically. A total of 190 restorations were over/under-extended, and 89% were registered radiographically. Approximal: Of 2,649 unrestored surfaces 648 had primary caries, and 92% were registered radiographically. A total of 565 of 2,463 restored surfaces had caries adjacent to restorations, and 99% were found radiographically. A total of 638 restorations were over/under-extended, and 98% were found radiographically. For all restorations, material and depth influenced quality of restorations and incidence of caries adjacent to restorations. At least one independent variable (gender/age group/tooth-type/jaw/side/mesial-distal surface) influenced frequencies of primary caries, caries adjacent to restorations and quality of restorations. CONCLUSIONS First-time clinical examination must be supplemented with X-rays to obtain a complete impression of caries status in posterior regions regarding diagnostics of caries, assessment of lesion depth and quality of restorations.
Collapse
Affiliation(s)
- Azam Bakhshandeh
- Department of Odontology, Section for Cariology and Endodontics, Section for Oral Radiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kim Ekstrand
- Department of Odontology, Section for Cariology and Endodontics, Section for Oral Radiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nils-Erik Fiehn
- Department of Immunology and Microbiology, Costerton Biofilm Center, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Vibeke Qvist
- Department of Odontology, Section for Cariology and Endodontics, Section for Oral Radiology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
2
|
Sato H, Da Silva JD, Lee C, Yonemoto H, Kuwajima Y, Ohyama H, Lambert RF, Izumisawa M, Takahashi N, Nagai S. Effects of healthcare policy and education on reading accuracy of bitewing radiographs for interproximal caries. Dentomaxillofac Radiol 2021; 50:20200153. [PMID: 32795199 PMCID: PMC7860953 DOI: 10.1259/dmfr.20200153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Objectives The aim of this study is to assess the accuracy of bitewing radiograph interpretation of predoctoral students, residents and general dentists who work under different core curriculum of dental education and healthcare policy. Methods A total of 118 examiners including predoctoral dental students, residents and general dentists from USA and Japan were tasked with evaluating a series of bitewing radiographs and diagnosing interproximal carious lesions. This study was approved by the Harvard Medical School Institutional Review Board (IRB). Participants graded interproximal aspects of those images and categorized the following criteria; “intact”, “enamel caries <1/2 width”, “enamel caries >1/2 width” or “caries into dentin”. The gold-standard was determined by the consensus of two HSDM full-time faculty. Results There was significant difference in the sensitivity for all three caries levels between the two groups but there was no significant difference on specificity. The positive-predictive and negative-predictive values of the USA group for the enamel caries (<1/2 of enamel) were significantly higher than the Japanese group. The average of AUC (ROC) was significantly higher in the USA group (0.885 ± 0.04) than the Japanese group (0.785 ± 0.08, p<0.01). Conclusion Teaching and adopting BW radiographs for diagnosis of interproximal caries is integral for dental providers to accurately and efficiently use them in their practices. It is critical that all dental educators approach policymakers to explain the importance of BW radiographs and promote their efficacy for prevention and early diagnosis of interproximal caries.
Collapse
Affiliation(s)
- Hiroki Sato
- Research Collaborator, Harvard School of Dental Medicine, Boston, Massachusetts, United States
| | - John D Da Silva
- Associate Professor, Harvard School of Dental Medicine, Boston, Massachusetts, United States
| | - Cliff Lee
- Research Associate, Harvard School of Dental Medicine, Boston, Massachusetts, United States
| | - Hisashi Yonemoto
- Research Collaborator, Harvard School of Dental Medicine, Boston, Massachusetts, United States
| | - Yukinori Kuwajima
- Lecturer, Iwate Medical University, School of Dental Medicine, Morioka, Japan
| | - Hiroe Ohyama
- Assistant Professor, Harvard School of Dental Medicine, Boston, Massachusetts, United States
| | | | - Mitsuru Izumisawa
- Associate Professor, Iwate Medical University, School of Dental Medicine, Morioka, Iwate, Japan
| | - Noriaki Takahashi
- Lecturer, Iwate Medical University, School of Dental Medicine, Morioka, Japan
| | - Shigemi Nagai
- Associate Professor, Harvard School of Dental Medicine, Boston, Massachusetts, United States
| |
Collapse
|
3
|
Carvalho JC, Mestrinho HD, Guillet A, Maltz M. Radiographic Yield for Clinical Caries Diagnosis in Young Adults: Indicators for Radiographic Examination. Caries Res 2020; 54:154-164. [PMID: 32101874 DOI: 10.1159/000505905] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 01/10/2020] [Indexed: 12/16/2022] Open
Abstract
This prospective cohort study investigated the distribution pattern of carious lesions diagnosed by visual tactile and radiographic examinations, assessed the radiographic yield for clinical caries diagnosis, and estimated how accurately commonly used indicators for caries identified young adults who would benefit from radiographs at different thresholds. Overall, 576 patients aged 16-32 years seeking a first consultation were included. Patients were examined for caries and answered a validated questionnaire on sociodemographics and oral health behavior. Almost 10% of clinically sound approximal surfaces presented radiolucency in enamel/dentine. Of the clinically diagnosed noncavitated approximal and occlusal lesions, 22.5 and 17.7%, respectively, presented radiolucency reaching dentine at the radiographic examination. Noncavitated/enamel lesions detected radiographically were mainly at approximal surfaces (73.2%), while at occlusal surfaces these were negligible (0.7%). More than half of approximal dentine lesions were only detected radiographically (61.3%), while more than half of occlusal dentine lesions were only clinically diagnosed (57.1%). The hierarchical logistic regression analysis showed that patient's caries activity, D1MFS scores ≥17, and frequent consumption of soft drinks were significantly associated with detection of approximal enamel/dentine lesions. Also, patient's caries activity and frequent consumption of soft drinks were significantly associated with occlusal dentine caries (p ≤ 0.05). The indicator power of grouping these indicators as a predictor for the presence of radiographically detected lesions showed high sensitivity (0.84-0.91) and moderate specificity (0.64-0.73) for all surfaces and thresholds tested. In conclusion, radiographs increased significantly the number of approximal enamel/dentine and occlusal dentine lesions diagnosed. The ability to identify young adults with approximal lesions from the predictor was satisfactory. Bearing in mind that an essential contribution of bitewing radiographs to clinical examination is the detection of approximal noncavitated/enamel lesions that can be inactivated by nonoperative interventions, our results support the prescription of radiographs in young adults seeking a first consultation. Updating of current guidelines' recommendation of radiographs is warranted.
Collapse
Affiliation(s)
| | | | - Alain Guillet
- Multidisciplinary Institute for Modelling and Quantitative Analysis, UCLouvain, Louvain-la-Neuve, Belgium
| | - Marisa Maltz
- Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
4
|
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
|
5
|
Song IS, Han K, Park YM, Ryu JJ, Park JB. Type 2 diabetes as a risk indicator for dental caries in Korean adults: the 2011-2012 Korea national health and nutrition examination survey. COMMUNITY DENTAL HEALTH 2017; 34:169-175. [PMID: 28872812 DOI: 10.1922/cdh_4113song07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 03/08/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The associations between type 2 diabetes (T2D) and untreated dental caries was examined. This study hypothesized that there would be a positive association between T2D and the prevalence of decayed permanent teeth (DT) in representative Korean adults. METHODS The information was derived from the Korea National Health and Nutrition Examination Survey conducted in 2011-2012. Sociodemographic and lifestyle variables, anthropometric and biochemical status, metabolic health and glucose tolerance status, oral health behaviors, and dental caries index were evaluated. RESULTS The number of DT had a positive association with degree of fasting plasma glucose (FPG) level, and glycated hemoglobin (HbA1c) (p-value = 0.045 and 0.007, respectively). The levels of FPG and HbA1c increased with the number of DT (p for trend = 0.009 and 0.004, respectively). The prevalence of untreated caries uncontrolled T2D participants was about 26% higher than those with normal glucose tolerance levels after adjusting for potential confounders including diets and socioeconomic status (OR [95% CI] = 1.26 [1.02, 1.56]). CONCLUSIONS T2D is an independent risk indicator for untreated caries in Korean adults.
Collapse
Affiliation(s)
- I-S Song
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul, Republic of Korea
| | - K Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Y-M Park
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - J-J Ryu
- Department of Prosthodontics, Korea University Anam Hospital, Seoul, Republic of Korea
| | - J-B Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
6
|
Lara-Capi C, Cagetti MG, Lingström P, Lai G, Cocco F, Simark-Mattsson C, Campus G. Digital transillumination in caries detection versus radiographic and clinical methods: an in-vivo study. Dentomaxillofac Radiol 2017; 46:20160417. [PMID: 28191797 DOI: 10.1259/dmfr.20160417] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This article aimed to evaluate: (a) the agreement between a near-infrared light transillumination device and clinical and radiographic examinations in caries lesion detection and (b) the reliability of images captured by the transillumination device. METHODS Two calibrated examiners evaluated the caries status in premolars and molars on 52 randomly selected subjects by comparing the transillumination device with a clinical examination for the occlusal surfaces and by comparing the transillumination device with a radiographic examination (bitewing radiographs) for the approximal surfaces. Forty-eight trained dental hygienists evaluated and reevaluated 30 randomly selected images 1-month later. RESULTS A high concordance between transillumination method and clinical examination (kappa = 0.99) was detected for occlusal caries lesions, while for approximal surfaces, the transillumination device identified a higher number of lesions with respect to bitewing (kappa = 0.91). At the dentinal level, the two methods identified the same number of caries lesions (kappa = 1), whereas more approximal lesions were recorded using the transillumination device in the enamel (kappa = 0.24). The intraexaminer reliability was substantial/almost perfect in 59.4% of the participants. CONCLUSIONS The transillumination method showed a high concordance compared with traditional methods (clinical examination and bitewing radiographs). Caries detection reliability using the transillumination device images showed a high intraexaminer agreement. Transillumination showed to be a reliable method and as effective as traditional methods in caries detection.
Collapse
Affiliation(s)
- Cynthia Lara-Capi
- 1 Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy
| | - Maria Grazia Cagetti
- 1 Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy
| | - Peter Lingström
- 2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.,3 Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Gianfranco Lai
- 4 Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Fabio Cocco
- 2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.,4 Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Charlotte Simark-Mattsson
- 3 Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Guglielmo Campus
- 2 WHO Collaborating Centre for Community Dentistry and Epidemiology, University of Milan, Milan, Italy.,4 Department of Surgery, Microsurgery and Medical Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| |
Collapse
|
7
|
Geibel MA, Carstens S, Braisch U, Rahman A, Herz M, Jablonski-Momeni A. Radiographic diagnosis of proximal caries-influence of experience and gender of the dental staff. Clin Oral Investig 2017; 21:2761-2770. [PMID: 28233170 DOI: 10.1007/s00784-017-2078-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 02/07/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to examine the influence of experience and gender on the radiographic detection of proximal caries lesions and on therapeutic decisions. MATERIALS AND METHODS A survey of 220 examiners (students and employees at three universities and dentists in the field) was taken using a standardized written questionnaire concerning radiographic diagnosis and therapy planning. An expert opinion of four dentists was determined as radiographic reference. A mixed effect logistic regression model was used for statistical evaluation and the odds ratio and p values were calculated (α = 0.05). RESULTS Examiners with experience had an almost four times greater chance of a correct assessment, if proximal caries lesion was present or not, than examiners with low experience (OR 3.7 (95% CI 2.4-5.8)). No gender-specific differences were discovered (OR women vs. men 0.9 (95% CI 0.6-1.4)). There was a relationship between the severity of the burnout effect on the x-ray and false positive caries diagnosis. Overall, 43% of respondents would plan invasive treatment in the enamel on a patient at low risk of caries and 78% on a high-risk patient. The results showed that the more experienced practitioners would be more likely to postpone restorative therapy on proximal caries until the lesion reached a later stage. CONCLUSIONS The results of this study suggest that examiner's experience influences the radiographic diagnosis of proximal lesions. No gender-specific differences could be found. CLINICAL RELEVANCE Examiner's professional experience is an important factor when radiography is included for detection and treatment planning of proximal lesions.
Collapse
Affiliation(s)
- Margrit-Ann Geibel
- Department of Dentomaxillofacial Surgery, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany.
| | - S Carstens
- Department of Dentomaxillofacial Surgery, University of Ulm, Albert-Einstein-Allee 11, 89081, Ulm, Germany
| | - U Braisch
- Institute of Epidemiology and Medical Biometry, University of Ulm, Schwabstraße 13, 89075, Ulm, Germany
| | - A Rahman
- Department of Conservative Dentistry, Periodontology and Preventive Dentistry, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - M Herz
- Department of Conservative Dentistry and Periodontology, Tuebingen University Hospital, Osianderstraße 2-8, 72076, Tuebingen, Germany
| | - A Jablonski-Momeni
- Department of Pediatric and Community Dentistry, Philipps University, Georg-Voigt-Straße 3, 35033, Marburg, Germany
| |
Collapse
|
8
|
Aljerf L, Alhaffar I. Salivary Distinctiveness and Modifications in Males with Diabetes and Behçet's Disease. Biochem Res Int 2017; 2017:9596202. [PMID: 28321337 PMCID: PMC5339495 DOI: 10.1155/2017/9596202] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/01/2017] [Indexed: 01/09/2023] Open
Abstract
Oral diseases associated with systematic diseases as metabolic and vasculitic have been included in this paper. This will enhance our understanding of the salivary function in promoting healthy oral condition. The study investigates the effects of type I and type II diabetes mellitus in well-controlled diabetic patients, in addition to Behçet disease (BD) on saliva flow rate (SFR), pH, the decay, missing, and filled tooth (DMFT) index, glucose, and major earth-alkaline ions (Ca2+ and Mg2+) compared to healthy males and age-matched controls. Saliva samples were collected from 1403 male human subjects, distributed on 7 levels including 3 control groups, and analyzed. The symptoms and clinical observations were enrolled. A preprandial salivary glucose has illustrated statistically strong significant and positive correlations with HbA1c and blood glucose levels. TIDM saliva showed lower pH, SFR, and Ca2+ but higher Mg2+, caries risk, and poor metabolic control. These led to dysfunction of secretory capacity of salivary glands. TIIDM proved higher SFR, DMFT, and glucose than TIDM patients. DM oral calcium has decreased by age while magnesium sharply slopes at seniority. BD oral fluid is associated with lower glucose and minerals but noticeably with both higher pH and DMFT.
Collapse
Affiliation(s)
- Loai Aljerf
- Department of Life Sciences, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Iyad Alhaffar
- Department of Oral Medicine, Faculty of Dentistry, University of Damascus, Damascus, Syria
| |
Collapse
|
9
|
Jawed M, Khan RN, Shahid SM, Azhar A. Protective effects of salivary factors in dental caries in diabetic patients of Pakistan. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:947304. [PMID: 22778718 PMCID: PMC3388590 DOI: 10.1155/2012/947304] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 05/06/2012] [Indexed: 01/22/2023]
Abstract
Salivary factors have been studied for their effects on the process of dental caries in patients of diabetes mellitus type 2. In this study, protective role of salivary pH, salivary flow rate, and salivary calcium is assessed in the patients of diabetes mellitus type 2 with dental caries. The samples of saliva were collected from 400 patients of diabetes mellitus type 2 and 300 age- and sex- matched controls after getting informed consent. All the subjects were classified into four groups according to age. The severity of dental caries was counted by decayed, missed, and filled teeth (DMFT) score. The salivary pH, flow rate, and calcium levels were found to be low in patients as compared to controls. The levels of fasting blood sugar, HbA1c, and DMFT score were found to be significantly high in patients than controls. The glycemic factors were significantly correlated with salivary factors indicating their influence on progression of caries in diabetes. On the basis of findings, it is concluded that the suitable salivary pH and flow rate may be regarded as main protective factors against dental caries in diabetes. Optimum level of salivary calcium may be responsible for continuous supply of calcium to arrest the demineralization and help reduce the occurrence of dental caries.
Collapse
Affiliation(s)
- Muhammad Jawed
- Department of Biochemistry, Liaquat College of Medicine and Dentistry, Karachi 75290, Pakistan
| | - Rashid N. Khan
- Department of Medicine, Liaquat College of Medicine and Dentistry, Karachi 75290, Pakistan
| | - Syed M. Shahid
- The Karachi Institute of Biotechnology & Genetic Engineering (KIBGE), University of Karachi, Karachi 75270, Pakistan
| | - Abid Azhar
- The Karachi Institute of Biotechnology & Genetic Engineering (KIBGE), University of Karachi, Karachi 75270, Pakistan
| |
Collapse
|
10
|
Kayipmaz S, Sezgin ÖS, Saricaoğlu ST, Çan G. An in vitro comparison of diagnostic abilities of conventional radiography, storage phosphor, and cone beam computed tomography to determine occlusal and approximal caries. Eur J Radiol 2011; 80:478-82. [PMID: 20934291 DOI: 10.1016/j.ejrad.2010.09.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Accepted: 09/15/2010] [Indexed: 11/28/2022]
Affiliation(s)
- Saadettin Kayipmaz
- Karadeniz Technical University, Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Farabi, 61080 Trabzon, Turkey.
| | | | | | | |
Collapse
|
11
|
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
|
12
|
Jawed M, Shahid SM, Qader SA, Azhar A. Dental caries in diabetes mellitus: role of salivary flow rate and minerals. J Diabetes Complications 2011; 25:183-6. [PMID: 20801061 DOI: 10.1016/j.jdiacomp.2010.07.001] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2010] [Accepted: 07/13/2010] [Indexed: 01/08/2023]
Abstract
This study was designed to evaluate the possible protective role of salivary factors like salivary flow rate and adequate level of calcium, phosphate, and fluoride in diabetes mellitus type 2 patients with dental caries. A total of 398 diabetes mellitus type 2 patients with dental caries and 395 age- and sex-matched non-diabetic subjects with dental caries were included as controls, all of whom gave informed consent. All subjects were divided into four groups according to their age. Decayed, missed, and filled teeth (DMFT) were scored to indicate the severity of dental caries. Saliva was collected, flow rate was noted, and calcium, phosphate, and fluoride were analyzed. The blood glucose, HbA1c, and DMFT indices were found to be significantly high in diabetic patients as compared to controls. The salivary flow rate, calcium, phosphate, and fluoride were found to be significantly low whereas no significant difference was found in salivary magnesium in patients as compared to controls. Optimum salivary flow rate is responsible for establishing protective environment against dental caries. Adequate level of salivary calcium, phosphate, and fluoride is also involved in significant deposition of these minerals in plaque, which greatly reduces the development of caries in the adjacent enamel of teeth.
Collapse
Affiliation(s)
- Muhammad Jawed
- Department of Biochemistry, Liaquat College of Medicine & Dentistry, Karachi, Pakistan
| | | | | | | |
Collapse
|
13
|
Chu CH, Lo ECM, You DSH. Clinical diagnosis of fissure caries with conventional and laser-induced fluorescence techniques. Lasers Med Sci 2009; 25:355-62. [PMID: 19259758 PMCID: PMC2946546 DOI: 10.1007/s10103-009-0655-6] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2008] [Accepted: 02/05/2009] [Indexed: 11/30/2022]
Abstract
We studied the in vivo validity of dentinal fissure caries diagnosis by visual examination, bitewing radiography, and use of a laser-induced fluorescence device (DIAGNOdent). A total of 144 and second molars with macroscopically intact occlusal surfaces in 41 Chinese young adults were examined visually, by bitewing radiography, and by DIAGNOdent. Visual examination after pit and fissure opening was used as the reference standard. The sensitivity and specificity of detecting caries that had extended into the dentin were, respectively, 0.89 and 0.44 by visual detection of opacity or discoloration after air drying, 0.13 and 1.00 by bitewing radiography to detect radiolucency extending into the dentin, and 0.70 and 0.84 by DIAGNOdent testing with a cut-off score of 40. Caries detection by a combination of visual examination and DIAGNOdent had a sensitivity of 0.67 and specificity of 0.94. Receiver operating characteristic analysis showed that this combined approach was superior to the other methods.
Collapse
Affiliation(s)
- C H Chu
- The University of Hong Kong, 34 Hospital Road, Hong Kong, SAR, China.
| | | | | |
Collapse
|