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Petersen M, Braun A, Franzen R. Thermal Effects on Dental Pulp during Laser-Assisted Bleaching Procedures with Diode Lasers in a Clinical Study. J Clin Med 2024; 13:2301. [PMID: 38673574 PMCID: PMC11050821 DOI: 10.3390/jcm13082301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/09/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Background In the current cosmetics industry, bleaching is often associated with lasers. However, such treatment also harbors risks. Tooth death is observed at pulpal temperature increases ≥5.6 °C. Therefore, it seems important to investigate the effects of using different lasers. The aim of this study was to determine pulpal temperature increases at different laser parameters during bleaching by modeling a realistic environment and to compare the temperature recording using a thermocouple and thermal camera. The authors assumed that there are laser settings for the lasers used at which the pulpal temperature increases are <5.6 °C and that the temperature recordings with thermocouples and thermal cameras differ only minimally. Methods Human teeth were used, which were extracted for dental reasons. During experiment, teeth were bleached conventionally and by laser activation at 940 nm, 445 nm, and 970 nm. The temperature in the pulp was recorded using thermocouples. In a second setup, longitudinally halved teeth were bleached, while the temperature in the pulp was recorded with a thermocouple and thermal camera. Descriptive statistics were used. The significance level is 0.05. Results In addition to conventional bleaching, temperature increases <5.6 °C were observed for bleaching at 940 nm 1.5 W, at 445 nm 0.3 W, and at 970 nm 0.5 W. For bleaching procedures using 940 nm 7 W, 940 nm 2 W, 445 nm 0.5 W, and 970 nm 1 W, the temperature increase was ≥5.6 °C. Significant differences (p < 0.05) were found in the maximum temperature increases (°C) between all groups. Temperature recordings using a thermocouple and thermal camera differed by about 2.3 °C. The working hypotheses were confirmed. Conclusion With laser bleaching, attention must be paid to the type of laser, its power, and the time in order to avoid excessive overheating of the dental pulp.
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Affiliation(s)
| | - Andreas Braun
- Department of Operative Dentistry, Periodontology and Preventive Dentistry, RWTH Aachen University, 52074 Aachen, Germany; (M.P.); (R.F.)
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Wei Y, Wang J, Dai D, Wang H, Zhang M, Zhang Z, Zhou X, He L, Cheng L. Application of a Caries Treatment Difficulty Assessment System in Dental Caries Management. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14069. [PMID: 36360946 PMCID: PMC9656365 DOI: 10.3390/ijerph192114069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/12/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Dental caries is one of the most common chronic diseases caused by progressive bacteria, affecting all age groups. Today, restorative fillings are widely used for dental caries treatment, but the restorative treatment has a high failure rate. Meanwhile, many researchers have discovered the differences of caries risk among populations by using the caries risk assessment and put forward a new standpoint that caries should be treated individually. Therefore, our research group established a Dental Caries Treatment Difficulty Assessment system in a previous study. This time, we combined the caries risk assessment with the caries treatment difficulty assessment, then used Python to design a Dental Caries Management Software. The purpose of this case report is to present a case applying this software in dental caries management and other data collected in Chengdu, China, with this software on the assessment of caries treatment difficulty. Patients with personalized assessment and management can achieve good treatment results, including reducing the risk and treatment difficulty of dental caries. At the same time, other cases show that the software has good application potential in individual management and group information collection. These cases indicate that the software enables dentists to carry out both the risk assessments and the treatment difficulty assessment of patients, and it has the potential as a tool for epidemiological investigation. It also enables dentists and patients to have a basic understanding of the dental health status of patients and create personalized dental caries treatment, so as to achieve the goal of controlling the progression of dental caries and rebuilding the structure and restoring the function of teeth.
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Affiliation(s)
- Yu Wei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jingqian Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Dongyue Dai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Haohao Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Min Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zhigang Zhang
- Department of Stomatology, The People’s Hospital of Dazu, Chongqing 402360, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Libang He
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Operative Dentistry and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
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Emerging Technologies for Dentin Caries Detection-A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11030674. [PMID: 35160127 PMCID: PMC8837049 DOI: 10.3390/jcm11030674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 11/20/2022] Open
Abstract
This systematic review and meta-analysis aimed at assessing the diagnostic accuracy of emerging technologies, such as laser fluorescence (LF), transillumination, light-emitting diode devices, optical coherence tomography (OCT), alternating current impedance spectroscopy, fluorescence cameras (FC), photo-thermal radiometry, and modulated luminescence technology. In vivo and in vitro results of such non-ionizing, non-invasive, and non-destructive methods’ effectiveness in non-cavitated dentin caries detection are sometimes ambiguous. Following the PRISMA guidelines, 34 relevant research articles published between 2011–2021 were selected. The risk of bias was assessed with a tool tailored for caries diagnostic studies, and subsequent quantitative uni- and bi-variate meta-analysis was carried out in separate sub-groups according to the investigated surface (occlusal/proximal) and study setting (in vivo/in vitro). In spite of the high heterogeneity across the review groups, in vitro studies on LF and FC proved a good diagnostic ability for the occlusal surface, with area under the curve (AUC) of 0.803 (11 studies) and 0.845 (five studies), respectively. OCT studies reported an outstanding performance with an overall AUC = 0.945 (four studies). Promising technologies, such as OCT or FC VistaProof, still need well-designed and well-powered studies to accrue experimental and clinical data for conclusive medical evidence, especially for the proximal surface. Registration: INPLASY202210097.
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Diagnostic validity of early proximal caries detection using near-infrared imaging technology on 3D range data of posterior teeth. Clin Oral Investig 2021; 26:543-553. [PMID: 34636940 PMCID: PMC8791888 DOI: 10.1007/s00784-021-04032-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/09/2021] [Indexed: 11/04/2022]
Abstract
Objectives This in vitro study analysed potential of early proximal caries detection using 3D range data of teeth consisting of near-infrared reflection images at 850 nm (NIRR). Materials and methods Two hundred fifty healthy and carious permanent human teeth were arranged pairwise, examined with bitewing radiography (BWR) and NIRR and validated with micro-computed tomography. NIRR findings were evaluated from buccal, lingual and occlusal (trilateral) views according to yes/no decisions about presence of caries. Reliability assessments included kappa statistics and revealed high agreement for both methods. Statistical analysis included cross tabulation and calculation of sensitivity, specificity and AUC. Results Underestimation of caries was 24.8% for NIRR and 26.4% for BWR. Overestimation was 10.4% for occlusal NIRR and 0% for BWR. Trilateral NIRR had overall accuracy of 64.8%, overestimation of 15.6% and underestimation of 19.6%. NIRR and BWR showed high specificity and low sensitivity for proximal caries detection. Conclusions NIRR achieved diagnostic results comparable to BWR. Trilateral NIRR assessments overestimated presence of proximal caries, revealing stronger sensitivity for initial caries detection than BWR. Clinical relevance NIRR provided valid complement to BWR as diagnostic instrument. Investigation from multiple angles did not substantially improve proximal caries detection with NIRR.
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Kapor S, Rankovic MJ, Khazaei Y, Crispin A, Schüler I, Krause F, Lussi A, Neuhaus K, Eggmann F, Michou S, Ekstrand K, Huysmans MC, Kühnisch J. Systematic review and meta-analysis of diagnostic methods for occlusal surface caries. Clin Oral Investig 2021; 25:4801-4815. [PMID: 34128130 PMCID: PMC8342337 DOI: 10.1007/s00784-021-04024-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 06/01/2021] [Indexed: 02/01/2023]
Abstract
AIM This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. MATERIALS AND METHODS A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. RESULTS SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. CONCLUSION The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. CLINICAL RELEVANCE VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.
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Affiliation(s)
- Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany
| | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, Ludwig-Maximilian Universität München, Munich, Germany
| | - Yegane Khazaei
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Alexander Crispin
- Institute of Medical Biometry and Epidemiology, Ludwig-Maximilian University of Munich, Munich, Germany
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, Jena, Germany
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, Aachen, Germany
| | - Adrian Lussi
- Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Klaus Neuhaus
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital-Bern University Hospital, Bern, Switzerland
| | - Florin Eggmann
- Clinic of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine Basel, University of Basel, Basel, Switzerland
| | - Stavroula Michou
- Department of Odontology, University Copenhagen, Copenhagen, Denmark
| | - Kim Ekstrand
- Department of Odontology, University Copenhagen, Copenhagen, Denmark
| | | | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilian University, Munich, Germany.
- Poliklinik Für Zahnerhaltung Und Parodontologie, Klinikum Der Universität München, LMU München, Goethestraße 70, 80336, München, Germany.
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Kühnisch J, Janjic Rankovic M, Kapor S, Schüler I, Krause F, Michou S, Ekstrand K, Eggmann F, Neuhaus KW, Lussi A, Huysmans MC. Identifying and Avoiding Risk of Bias in Caries Diagnostic Studies. J Clin Med 2021; 10:3223. [PMID: 34362007 PMCID: PMC8347423 DOI: 10.3390/jcm10153223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/16/2022] Open
Abstract
Caries diagnostic studies differ with respect to their design, included patients/tooth samples, use of diagnostic and reference methods, calibration, blinding and data reporting. Such heterogeneity makes comparisons between studies difficult and could represent a substantial risk of bias (RoB) when it is not identified. Therefore, the present report aims to describe the development and background of a RoB assessment tool for caries diagnostic studies. The expert group developed and agreed to use a RoB assessment tool during three workshops. Here, existing instruments (e.g., QUADAS 2 and the Joanna Briggs Institute Reviewers' Manual) influenced the hierarchy and phrasing of the signalling questions that were adapted to the specific dental purpose. The tailored RoB assessment tool that was created consists of 16 signalling questions that are organized in four domains. This tool considers the selection/spectrum bias (1), the bias of the index (2) and reference tests (3), and the bias of the study flow and data analysis (4) and can be downloaded from the journal website. This paper explores possible sources of heterogeneity and bias in caries diagnostic studies and summarizes the relevant methodological aspects.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Mila Janjic Rankovic
- Department of Orthodontics and Dentofacial Orthopaedics, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Svetlana Kapor
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Ina Schüler
- Department of Orthodontics, Section of Preventive and Paediatric Dentistry, University Hospital, 07743 Jena, Germany;
| | - Felix Krause
- Clinic for Operative Dentistry, Periodontology and Preventive Dentistry, University Hospital RWTH Aachen, 52074 Aachen, Germany;
| | - Stavroula Michou
- Department of Odontology, University Copenhagen, 2200 Copenhagen, Denmark; (S.M.); (K.E.)
| | - Kim Ekstrand
- Department of Odontology, University Copenhagen, 2200 Copenhagen, Denmark; (S.M.); (K.E.)
| | - Florin Eggmann
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland; (F.E.); (K.W.N.)
| | - Klaus W. Neuhaus
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine UZB, University of Basel, 4058 Basel, Switzerland; (F.E.); (K.W.N.)
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, 3012 Bern, Switzerland;
- Department of Operative Dentistry and Periodontology, University Medical Centre, 79098 Freiburg, Germany
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Vandenberghe B. The crucial role of imaging in digital dentistry. Dent Mater 2020; 36:581-591. [PMID: 32299666 DOI: 10.1016/j.dental.2020.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 03/09/2020] [Indexed: 10/24/2022]
Abstract
One of the recent trends in dentistry - and this in every field from the restorative to the orthodontic one- is the introduction of simplified completely digital workflows. Digital dentistry is supposed to allow dentists to work more efficiently, and this at higher precision, and with the possibility of all-in-one sessions using in-house computerized techniques. In this workflow, one of the major tools for simulating and transferring dental treatments is imaging. Both 3D low dose radiographic as well as optical imaging are playing crucial roles and have been overwhelming the market. Novel design platforms, compact and extremely fast milling and printing units are now also plentiful and rapidly being adopted in practice. Nevertheless, many of the steps in this digital dentistry process, no matter how simplified, present risks that can contribute to reduced precision and clinical difficulties. It is therefore the purpose of the article to briefly describe the role of imaging in this digital workflow, and where the pitfalls can be found that may lead to errors and imprecision.
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Affiliation(s)
- Bart Vandenberghe
- Advimago, Center for Advanced Oral Imaging, Emile Clausstraat 42, 1050 Brussels, Belgium.
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Use of a laser fluorescence device for the in vitro activity assessment of incipient caries lesions. J Orofac Orthop 2019; 80:327-335. [DOI: 10.1007/s00056-019-00194-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 08/03/2019] [Indexed: 10/25/2022]
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Performance of light-emitting diode device in detecting occlusal caries in the primary molars. Lasers Med Sci 2019; 34:1235-1241. [DOI: 10.1007/s10103-019-02717-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/08/2019] [Indexed: 10/27/2022]
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Tagliaferro E, Junior AV, Rosell FL, Silva S, Riley JL, Gilbert GH, Gordan VV. Caries Diagnosis in Dental Practices: Results From Dentists in a Brazilian Community. Oper Dent 2018; 44:E23-E31. [PMID: 30212272 DOI: 10.2341/18-034-c] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this study was to assess practices related to diagnosis of dental caries among dentists (n=217) from Araraquara, São Paulo State, Brazil. Data on sociodemographic information and practitioner characteristics were collected using a pretested questionnaire, and data on practices related to caries diagnosis were gathered by using a translated and culturally adapted questionnaire from the US National Dental Practice-Based Research Network. Descriptive statistics and regression analyses were used for data analysis. Respondents reported using in most of their patients radiographs (Rx) to diagnose proximal caries (59%), explorer (Ex) for the diagnosis of occlusal caries (64%) and on the margins of existing restorations (79%), as well as air jet (AJ) with drying (92%). Magnification (M) (25%), fiber optic transillumination (FOTI; 14%), and laser fluorescence (LF) (3%) were used in the minority of patients. Regression analysis revealed that the following dentists' characteristics were significantly associated (p<0.05) with the use of diagnostic methods on a greater percentage of their patients: advanced degree (Rx, FOTI), higher percentage of patients with individualized caries prevention (Rx, FOTI, M), more years since dental school graduation (Ex, M), and work in an exclusively private practice model (LF). In conclusion, most Brazilian dentists from Araraquara reported they most commonly use visual, tactile, and radiographic imaging for the diagnosis of dental caries. Some dentists' characteristics, such as time from dental school graduation and having a postgraduation course, were associated with the use of certain diagnostic methods.
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