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do Amaral COF, Kantovitiz KR, de Araújo VC, Marega T, Teixeira LN, Martinez EF. Assessment of dental and periodontal indices and Streptococcus mutans virulence in fragile X syndrome patients. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:1026-1035. [PMID: 38717133 DOI: 10.1111/jir.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/16/2024] [Accepted: 04/11/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION Fragile X syndrome (FXS) is the most common cause of hereditary genetic disorder in a single gene characterised by intellectual disability. Behavioural features such as autism, hyperactivity and anxiety disorder may be present. Biofilm development and pathogenicity of Streptococcus mutans may be altered because FXS renders the dental approach and oral hygiene more complex. OBJECTIVES The purpose of this study was to compare the levels of transcripts for VicRK and CovR of S. mutans isolated from FXS patients with the levels of transcripts for VicRK and CovR of standard strain ATCC, using a quantitative polymerase chain reaction (qPCR). METHODS The caries experience index was assessed by the International Caries Detection and Assessment System (ICDAS), Periodontal Condition Index (PCI) and Invasive Dental Treatment Need Index (INI). RESULTS The clinical index findings revealed a high rate of caries cavities and bleeding on probing of FXS patients. When VicRK and CovR transcript levels were compared with the reference strain, Fragile X patients were found to have significantly higher values. CONCLUSION The present study demonstrated that FXS patients have more adverse clinical conditions, with increased biofilm accumulation and virulence. When combined with behavioural abnormalities, these patients become even more vulnerable to dental caries.
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Affiliation(s)
- Cristhiane Olivia Ferreira do Amaral
- Division of Special Care, Faculdade São Leopoldo Mandic, Campinas, Brazil
- Department of Special Care Dentistry, Dental School, Universidade do Oeste Paulista - UNOESTE, Presidente Prudente, Brazil
| | | | - V C de Araújo
- Division of Oral Pathology, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - T Marega
- Division of Special Care, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - L N Teixeira
- Division of Oral Pathology, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - E F Martinez
- Division of Cell Biology, Faculdade São Leopoldo Mandic, Campinas, Brazil
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Perdiou A, Fratila AD, Sava-Rosianu R, Alexa VT, Lalescu D, Jumanca D, Galuscan A. In Vivo Performance of Visual Criteria, Laser-Induced Fluorescence, and Light-Induced Fluorescence for Early Caries Detection. Diagnostics (Basel) 2023; 13:3170. [PMID: 37891991 PMCID: PMC10606100 DOI: 10.3390/diagnostics13203170] [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: 09/10/2023] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
This study aims to compare the diagnostic reliability of ICDAS-II visual criteria, light-induced fluorescence (using the VistaCam iX, Dürr Dental, Bietigheim-Bissingen, Germany), and laser-induced fluorescence (using the DIAGNOdent Pen, KaVo, Biberach, Germany) on occlusal caries. Permanent and temporary molars were selected according to the inclusion criteria. Out of 160 teeth that met the inclusion criteria, 139 were chosen and examined by two previously trained and calibrated examiners. The kappa value was 0.95 for both VistaCam iX and DIAGNOdent Pen. Results from visual examination and the readings of the two fluorescence devices were computed, lesions being divided into non-cavitated, enamel lesions, and lesions extended to dentin. All statistical analyses were performed using R (version 4.2.2). Spearman's rank correlation was computed to assess the relationship between the scores of diagnostics reliabilities of the three methods mentioned above. There was a positive, statistically significant Spearman's rank correlation coefficient, ρ = 0.25, between VistaCam iX and ICDAS II, and a positive, not statistically significant Spearman's rank correlation coefficient, ρ = 0.11, between DiagnoDent Pen and ICDAS II. Considering the temporary teeth, there was a positive, statistically significant Spearman's rank correlation coefficient, ρ = 0.52, between VistaCam iX and DiagnoDent Pen; a positive, statistically significant Spearman's rank correlation coefficient, ρ = 0.35, between VistaCam iX and ICDAS II; and the lowest, not statistically significant Spearman's rank correlation coefficient, ρ = 0.16, between DiagnoDent Pen and ICDAS II. Conclusions: In conclusion, ICDAS II and light-induced fluorescence are better diagnostic methods than the laser-induced fluorescence devices for detecting occlusal caries. Clinical Significance: This study may support clinicians in selecting the most efficient tool for diagnosing carious lesion in the earliest stages possible. Furthermore, such technologies raise the availability for more preventive approaches, as opposed to invasive procedures.
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Affiliation(s)
- Antonis Perdiou
- Faculty of Dental Medicine, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (A.P.); (R.S.-R.); (V.T.A.); (D.J.); (A.G.)
| | - Aurora Doris Fratila
- Faculty of Dental Medicine, Ludwig-Maximilian-University Munich, Goethestraße 70, 80336 München, Germany
| | - Ruxandra Sava-Rosianu
- Faculty of Dental Medicine, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (A.P.); (R.S.-R.); (V.T.A.); (D.J.); (A.G.)
- Translational and Experimental Clinical Research Center in Oral Health (TEXC-OH), 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
| | - Vlad Tiberiu Alexa
- Faculty of Dental Medicine, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (A.P.); (R.S.-R.); (V.T.A.); (D.J.); (A.G.)
- Translational and Experimental Clinical Research Center in Oral Health (TEXC-OH), 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
| | - Dacian Lalescu
- Faculty of Food Engineering, Banat’s University of Agricultural Sciences and Veterinary Medicine, King Michael I of Romania from Timișoara, Calea Aradului No. 119, 300645 Timișoara, Romania;
| | - Daniela Jumanca
- Faculty of Dental Medicine, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (A.P.); (R.S.-R.); (V.T.A.); (D.J.); (A.G.)
- Translational and Experimental Clinical Research Center in Oral Health (TEXC-OH), 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
| | - Atena Galuscan
- Faculty of Dental Medicine, “Victor Babeş” University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania; (A.P.); (R.S.-R.); (V.T.A.); (D.J.); (A.G.)
- Translational and Experimental Clinical Research Center in Oral Health (TEXC-OH), 14A Tudor Vladimirescu Ave., 300173 Timisoara, Romania
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Khalaf ME, Alyahya A, Qudeimat MA. Management Thresholds for Molars With Occlusal Noncavitated Caries Lesions. Int Dent J 2023; 73:251-258. [PMID: 35896427 PMCID: PMC10023584 DOI: 10.1016/j.identj.2022.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/24/2022] [Accepted: 06/24/2022] [Indexed: 11/05/2022] Open
Abstract
AIM There is sparse research on the effect of factors related to the dentist and patient in the caries management decision-making process. This in vitro study explored the influence of factors related to dentists and patients on the management decision of occlusal noncavitated caries lesions in children. MATERIALS AND METHODS Five investigators in the specialties of dental public health (DPH), paediatric, prosthetic, and operative dentistry and a general dentist (GDP) participated in this study. Initially, the investigators were asked to independently assess the occlusal surfaces of 175 noncavitated permanent molars and choose a management recommendation using 2 caries risk patients' scenarios. After 1 month, investigators were trained and calibrated to use the International Caries Detection and Assessment System (ICDAS) scoring system. Then, they examined the same teeth, recorded the highest/worst ICDAS score, and chose a management recommendation. Two weeks later, the investigators repeated the teeth examination using magnification loupes and again chose a management recommendation. The teeth were sectioned to study the relationship between the presence of caries and the management recommendations. RESULTS For the low- and the high-caries risk scenarios, ICDAS training increased the operative intervention by 20% to 27% and 14% to 22%, respectively, for both the GDP and the paediatric dentist (P < .0001). For the low-caries risk scenario, using the magnifying loupes increased the operative recommendations for the DPH, GDP, and the operative dentist by 5% to 23% (P < .05). Compared to the low-caries risk scenario, teeth for patients with high caries risk received more surgical interventions (9%-30%) at all examination conditions for the GDP and the paediatric and operative dentists (P < .0001). CONCLUSIONS For occlusal noncavitated caries lesions, enhancing dentists' caries detection skills had a significant impact on decisions of surgical intervention. This also influenced the appropriateness of the treatment recommended for the different caries risk groups.
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Affiliation(s)
- Mai E Khalaf
- Department of General Dental Practice, Kuwait University, Kuwait
| | - Asma Alyahya
- Department of Developmental and Preventive Sciences, Kuwait University, Kuwait
| | - Muawia A Qudeimat
- Department of Developmental and Preventive Sciences, Kuwait University, Kuwait.
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Zaazou MH, Zaki DY, Abdelnabi A, Hamdy TM, Saleh RS, Hassan SN, Zaki ZM, Moharam LM. Comparative evaluation of caries prevalence among group of Egyptian adolescents using DMFS and ICDASII methods: a cross-sectional study. BMC Oral Health 2023; 23:39. [PMID: 36694167 PMCID: PMC9873213 DOI: 10.1186/s12903-023-02743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 01/13/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Limited data is available regarding the prevalence of dental caries as a chronic disease among adolescents using different caries assessment indices. The aim of this study was to compare and describe the prevalence of dental caries among group of Egyptian students using two caries assessment indices; DMFS and ICDAS II. METHODS This descriptive, cross-sectional epidemiological study included 2760 public secondary school students with age range from 15 to 18 years with permanent dentition and good general health. Presence of; retained teeth, congenital or developmental anomalies in the permanent dentition, orthodontic treatments, systematic conditions, smoking and general health problems were considered the exclusion criteria in this study. Participants were selected randomly from 8 public secondary schools in the Great Cairo, Egypt. The examination was achieved by 6 trained and previously calibrated examiners using sets of diagnostic mirrors, compressed air, a WHO probe and cotton rolls. DMFS index and ICDAS II system were used as caries detection methods. In DMFS index; the number of decayed (D), missing (M) and filled (F) surfaces was recorded, while in the ICDAS II index, the assessment of both cavitated and non-cavitated carious, missed and filled teeth with restorations /sealants was recorded. The examiners performed the oral examination using both scoring systems in an alternating manner. The collected data were explored for normality using Kolmogorov-Smirnov and Shapiro-Wilk tests. Chi square test was used to analyze the frequencies. RESULTS There was a statistical significant difference between the DMFS and ICDAS II methods results regarding the recorded number of caries affected teeth and cavitated teeth surfaces. The prevalence of dental caries among the investigated secondary school students was (69.56%) and (78.29%) for DMFS and ICDAS II, respectively. CONCLUSIONS The prevalence of dental caries among Egyptian adolescent is high. ICDAS scoring system revealed higher caries prevalence values than DMFS method. ICDAS method is the best choice for the preventive goals, while DMFS is sufficient for clinical purposes.
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Affiliation(s)
- Mohamed. H. Zaazou
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
| | - Dalia Y. Zaki
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
| | - Ali Abdelnabi
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
| | - Tamer M. Hamdy
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
| | - Reham S. Saleh
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
| | - Shahinaz N. Hassan
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
| | - Zeinab M. Zaki
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
| | - Lamiaa M. Moharam
- grid.419725.c0000 0001 2151 8157Restorative and Dental Materials Department, Oral and Dental Research Institute, National Research Centre (NRC), Dokki, Giza, 12622 Egypt
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Monea M, Eşian D, Vlad RE, Bica CI. In vivo effectiveness of visual inspection and laser fluorescence in the diagnosis of early pit-and-fissure carious lesions: A cross-sectional study in a group of Romanian children. Medicine (Baltimore) 2021; 100:e27811. [PMID: 34766591 PMCID: PMC8589235 DOI: 10.1097/md.0000000000027811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 10/29/2021] [Indexed: 01/05/2023] Open
Abstract
General practitioners are still facing great challenges in the management of occlusal caries. Therefore, the development of better diagnostic protocols and assessment of caries activity might improve the results of nonoperative treatment. This study aimed to evaluate the effectiveness of visual inspection based on ICDAS-II (International Caries Detection and Assessment System) and DiagnoDent pen in the detection of pit-and-fissure early lesions in young permanent molars. The evaluation of 237 occlusal surfaces and caries risk assessment were performed in 96 children aged 7 to 15 years. The presence of pit-and-fissure noncavitated lesions was recorded using ICDAS-II scoring system and laser fluorescence. Statistical analysis was performed using McNemar test, with a level of significance of P < .05. The caries risk was measured for all participants. In 109 occlusal surfaces both methods identified enamel changes (46%) and in 62 cases both methods excluded the carious lesion (26.2%). The statistical analysis showed a significant moderate agreement between ICDAS-II code and DiagnoDent pen measurements (McNemar chi-squared statistic 9.5, P = .002 and Cohen kappa coefficient = 0.427). The majority of children (69.8%) had moderate caries risk and the most frequent risk factors recorded were sugar intake between meals, lack of regular dental control and poor oral hygiene. We concluded that ICDAS-II is a valuable and reliable diagnostic tool for early pit-and-fissure lesions and could be used alone during dental examination in children. The evaluation of caries risk should become clinical routine, as parameters belonging to high risk were frequently recorded in our study group.
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Affiliation(s)
- Monica Monea
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
| | - Daniela Eşian
- Department of Pedodontics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
| | - Ramona Elena Vlad
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
| | - Cristina Ioana Bica
- Department of Pedodontics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureş, Romania
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The ADEPT study: a comparative study of dentists' ability to detect enamel-only proximal caries in bitewing radiographs with and without the use of AssistDent artificial intelligence software. Br Dent J 2021; 231:481-485. [PMID: 34686815 PMCID: PMC8536492 DOI: 10.1038/s41415-021-3526-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/16/2020] [Indexed: 11/08/2022]
Abstract
Introduction Reversal of enamel-only proximal caries by non-invasive treatments is important in preventive dentistry. However, detecting such caries using bitewing radiography is difficult and the subtle patterns are often missed by dental practitioners. Aims To investigate whether the ability of dentists to detect enamel-only proximal caries is enhanced by the use of AssistDent artificial intelligence (AI) software. Materials and methods In the ADEPT (AssistDent Enamel-only Proximal caries assessmenT) study, 23 dentists were randomly divided into a control arm, without AI assistance, and an experimental arm, in which AI assistance provided on-screen prompts indicating potential enamel-only proximal caries. All participants analysed a set of 24 bitewings in which an expert panel had previously identified 65 enamel-only carious lesions and 241 healthy proximal surfaces. Results The control group found 44.3% of the caries, whereas the experimental group found 75.8%. The experimental group incorrectly identified caries in 14.6% of the healthy surfaces compared to 3.7% in the control group. The increase in sensitivity of 71% and decrease in specificity of 11% are statistically significant (p <0.01). Conclusions AssistDent AI software significantly improves dentists' ability to detect enamel-only proximal caries and could be considered as a tool to support preventive dentistry in general practice. Enamel-only proximal caries is often missed by dentists when examining bitewing radiographs. The use of AssistDent artificial intelligence software results in a 71% increase in ability to detect enamel-only proximal caries accompanied by a 11% decrease in specificity. Artificial intelligence software could be considered as a tool to support preventive dentistry in general practice.
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Macey R, Walsh T, Riley P, Glenny AM, Worthington HV, O'Malley L, Clarkson JE, Ricketts D. Visual or visual-tactile examination to detect and inform the diagnosis of enamel caries. Cochrane Database Syst Rev 2021; 6:CD014546. [PMID: 34124773 PMCID: PMC8428329 DOI: 10.1002/14651858.cd014546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The detection and diagnosis of caries at the initial (non-cavitated) and moderate (enamel) levels of severity is fundamental to achieving and maintaining good oral health and prevention of oral diseases. An increasing array of methods of early caries detection have been proposed that could potentially support traditional methods of detection and diagnosis. Earlier identification of disease could afford patients the opportunity of less invasive treatment with less destruction of tooth tissue, reduce the need for treatment with aerosol-generating procedures, and potentially result in a reduced cost of care to the patient and to healthcare services. OBJECTIVES To determine the diagnostic accuracy of different visual classification systems for the detection and diagnosis of non-cavitated coronal dental caries for different purposes (detection and diagnosis) and in different populations (children or adults). SEARCH METHODS Cochrane Oral Health's Information Specialist undertook a search of the following databases: MEDLINE Ovid (1946 to 30 April 2020); Embase Ovid (1980 to 30 April 2020); US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov, to 30 April 2020); and the World Health Organization International Clinical Trials Registry Platform (to 30 April 2020). We studied reference lists as well as published systematic review articles. SELECTION CRITERIA We included diagnostic accuracy study designs that compared a visual classification system (index test) with a reference standard (histology, excavation, radiographs). This included cross-sectional studies that evaluated the diagnostic accuracy of single index tests and studies that directly compared two or more index tests. Studies reporting at both the patient or tooth surface level were included. In vitro and in vivo studies were considered. Studies that explicitly recruited participants with caries into dentine or frank cavitation were excluded. We also excluded studies that artificially created carious lesions and those that used an index test during the excavation of dental caries to ascertain the optimum depth of excavation. DATA COLLECTION AND ANALYSIS We extracted data independently and in duplicate using a standardised data extraction and quality assessment form based on QUADAS-2 specific to the review context. Estimates of diagnostic accuracy were determined using the bivariate hierarchical method to produce summary points of sensitivity and specificity with 95% confidence intervals (CIs) and regions, and 95% prediction regions. The comparative accuracy of different classification systems was conducted based on indirect comparisons. Potential sources of heterogeneity were pre-specified and explored visually and more formally through meta-regression. MAIN RESULTS We included 71 datasets from 67 studies (48 completed in vitro) reporting a total of 19,590 tooth sites/surfaces. The most frequently reported classification systems were the International Caries Detection and Assessment System (ICDAS) (36 studies) and Ekstrand-Ricketts-Kidd (ERK) (15 studies). In reporting the results, no distinction was made between detection and diagnosis. Only two studies were at low risk of bias across all four domains, and 15 studies were at low concern for applicability across all three domains. The patient selection domain had the highest proportion of high risk of bias studies (49 studies). Four studies were assessed at high risk of bias for the index test domain, nine for the reference standard domain, and seven for the flow and timing domain. Due to the high number of studies on extracted teeth concerns regarding applicability were high for the patient selection and index test domains (49 and 46 studies respectively). Studies were synthesised using a hierarchical bivariate method for meta-analysis. There was substantial variability in the results of the individual studies: sensitivities ranged from 0.16 to 1.00 and specificities from 0 to 1.00. For all visual classification systems the estimated summary sensitivity and specificity point was 0.86 (95% CI 0.80 to 0.90) and 0.77 (95% CI 0.72 to 0.82) respectively, diagnostic odds ratio (DOR) 20.38 (95% CI 14.33 to 28.98). In a cohort of 1000 tooth surfaces with 28% prevalence of enamel caries, this would result in 40 being classified as disease free when enamel caries was truly present (false negatives), and 163 being classified as diseased in the absence of enamel caries (false positives). The addition of test type to the model did not result in any meaningful difference to the sensitivity or specificity estimates (Chi2(4) = 3.78, P = 0.44), nor did the addition of primary or permanent dentition (Chi2(2) = 0.90, P = 0.64). The variability of results could not be explained by tooth surface (occlusal or approximal), prevalence of dentinal caries in the sample, nor reference standard. Only one study intentionally included restored teeth in its sample and no studies reported the inclusion of sealants. We rated the certainty of the evidence as low, and downgraded two levels in total for risk of bias due to limitations in the design and conduct of the included studies, indirectness arising from the in vitro studies, and inconsistency of results. AUTHORS' CONCLUSIONS Whilst the confidence intervals for the summary points of the different visual classification systems indicated reasonable performance, they do not reflect the confidence that one can have in the accuracy of assessment using these systems due to the considerable unexplained heterogeneity evident across the studies. The prediction regions in which the sensitivity and specificity of a future study should lie are very broad, an important consideration when interpreting the results of this review. Should treatment be provided as a consequence of a false-positive result then this would be non-invasive, typically the application of fluoride varnish where it was not required, with low potential for an adverse event but healthcare resource and finance costs. Despite the robust methodology applied in this comprehensive review, the results should be interpreted with some caution due to shortcomings in the design and execution of many of the included studies. Studies to determine the diagnostic accuracy of methods to detect and diagnose caries in situ are particularly challenging. Wherever possible future studies should be carried out in a clinical setting, to provide a realistic assessment of performance within the oral cavity with the challenges of plaque, tooth staining, and restorations, and consider methods to minimise bias arising from the use of imperfect reference standards in clinical studies.
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Affiliation(s)
- Richard Macey
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Tanya Walsh
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip Riley
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Anne-Marie Glenny
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Helen V Worthington
- Cochrane Oral Health, Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Lucy O'Malley
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Janet E Clarkson
- Division of Oral Health Sciences, Dundee Dental School, University of Dundee, Dundee, UK
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Mazur M, Jedliński M, Ndokaj A, Corridore D, Maruotti A, Ottolenghi L, Guerra F. Diagnostic Drama. Use of ICDAS II and Fluorescence-Based Intraoral Camera in Early Occlusal Caries Detection: A Clinical Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2937. [PMID: 32344544 PMCID: PMC7215869 DOI: 10.3390/ijerph17082937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/17/2020] [Accepted: 04/18/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Early diagnosis of occlusal caries is of paramount importance for a minimally invasive approach in dentistry. The aim of the present in vivo clinical prospective study was to compare the diagnostic outcomes of visual subjective evaluation between the International Caries Detection and Assessment System (ICDAS-II) and an intraoral fluorescence-based camera (VistaCam iX Proof, Dürr Dental, Bietigheim-Bissingen, Germany) for the detection of pits and fissures in early caries lesions of posterior teeth. METHODS The study included 1011 posterior teeth in 255 patients aged 13-20 years (mean age 16 ± 2.2 years). Two blinded operators evaluated all the occlusal surfaces and the first assigned an ICDAS-II code, while the second assessed the VistaCam score: sound enamel (score 0-1.2); initial enamel decay (score 1.2-1.5); dentine caries (score 1.5-3). RESULTS Some 283 (28%) of the assessed teeth were ICDAS-II code 0; 334 (33%) code 1; 189 (18.7%) code 2; 176 (17.4%) code 3; and 29 (2.9%) code 4. The level of agreement between the two procedures was expressed by using Cohen's and Fleiss' kappa statistics and performing McNemar's test. VistaCam assessed in 513 (50.7%) sound enamel; in 292 (28.9%) initial enamel decay; and in 206 (20.4%) dentine caries. CONCLUSIONS This comparative study showed a poor agreement between the two diagnostic methods, especially between ICDAS-II 0, 1 and 2 codes and fluorescence assessments.
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Affiliation(s)
- Marta Mazur
- Department of Oral and Maxillofacial Surgery, Sapienza University of Rome, 00185 Rome, Italy; (A.N.); (D.C.); (L.O.); (F.G.)
| | - Maciej Jedliński
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
| | - Artnora Ndokaj
- Department of Oral and Maxillofacial Surgery, Sapienza University of Rome, 00185 Rome, Italy; (A.N.); (D.C.); (L.O.); (F.G.)
| | - Denise Corridore
- Department of Oral and Maxillofacial Surgery, Sapienza University of Rome, 00185 Rome, Italy; (A.N.); (D.C.); (L.O.); (F.G.)
| | | | - Livia Ottolenghi
- Department of Oral and Maxillofacial Surgery, Sapienza University of Rome, 00185 Rome, Italy; (A.N.); (D.C.); (L.O.); (F.G.)
| | - Fabrizio Guerra
- Department of Oral and Maxillofacial Surgery, Sapienza University of Rome, 00185 Rome, Italy; (A.N.); (D.C.); (L.O.); (F.G.)
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