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Neuhaus KW, Kühnisch J, Banerjee A, Martignon S, Ricketts D, Schwendicke F, van der Veen MH, Doméjean S, Fontana M, Lussi A, Jablonski-Momeni A, Mendes FM, Douglas G, Schmalz G, Campus G, Aps J, Horner K, Opdam N, Huysmans MC, Splieth CH. ORCA-EFCD consensus report on clinical recommendations for caries diagnosis. Paper II: caries lesion activity and progression assessment. Caries Res 2024:000538619. [PMID: 38684147 DOI: 10.1159/000538619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 02/27/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION This consensus paper provides recommendations for oral health professionals on why and how to assess caries activity and progression with special respect to the site of a lesion. METHODS An expert panel was nominated by the executive councils of the European Organization for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD). The steering committee built three working groups that were asked to provide recommendations on 1) caries detection and diagnostic methods, 2) caries activity and progression assessment and 3) obtain individualized caries diagnoses. The experts of work group 2 phrased and agreed on provisional general and specific recommendations on caries lesion activity and progression, based on a review of the current literature. These recommendations were then discussed and refined in a consensus workshop followed by an anonymous Delphi survey to determine the agreement on each recommendation. RESULTS The expert panel agreed on general (n=7) and specific recommendations (n=6). The specific recommendations cover coronal caries on pits and fissures, smooth surfaces, proximal surfaces, as well as root caries and secondary caries/ caries adjacent to restorations and sealants (CARS). 3/13 recommendations yielded perfect agreement. CONCLUSION The most suitable method for lesion activity assessment is the visual-tactile method. No single clinical characteristic is indicative of lesion activity; instead, lesion activity assessment is based on assessing and weighing several clinical signs. The recall intervals for visual and radiographic examination need to be adjusted to the presence of active caries lesions and recent caries progression rates. Modifications should be based on individual patient characteristics.
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Degraeve M, Beij T, Lammens I, Vagenende T, De Meyer M, Aps J, Jacquet W. A systematic review on 4D images of the upper airway in patients with OSA. Sleep Breath 2023:10.1007/s11325-023-02948-4. [PMID: 38127191 DOI: 10.1007/s11325-023-02948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023]
Abstract
AIM-BACKGROUND In the treatment of obstructive sleep apnoea (OSA), oral appliances are now being recognized as a valuable alternative to continuous positive airway pressure (CPAP). Various static imaging techniques of the upper airways allow for assessment of bone and soft tissue structures. However, static images do not capture dynamic airway characteristics. The aim of this paper was to review 4D imaging techniques in patients with OSA. METHODS PubMed/MEDLINE, Web of Science and Embase were systematically searched for studies published before June 2022. The review was compliant with the PRISMA guidelines. The quality of each eligible study was critically evaluated by all four authors independently. Four unique articles with qualitative analyses were retrieved. All included studies had a clear objective/aim, an appropriate endpoint and sufficiently described eligibility criteria. RESULTS With dynamic imaging (4D) evaluation of the upper airway, the incidence of upper airway collapsibility due to use of a mandibular advancement device (MAD) was reduced, extraluminal tissue pressure was decreased and the space in the upper airway was increased, notably in the retropalatal and retroglossal areas of the airway. These findings suggest that MADs may be effective for OSA regardless of whether or not the obstruction site is in the velopharynx or oropharynx. However, further investigation of dynamic changes in the upper airway is required to explain the efficacy of OSA treatment and the underlying mechanisms.
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Affiliation(s)
- Michiel Degraeve
- Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Ghent, Ghent, Belgium.
| | - Tessa Beij
- Department of Oral and Maxillofacial Surgery, RadboudUMC, Nijmegen, The Netherlands
| | - Inés Lammens
- Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Tim Vagenende
- Department of Oral and Maxillofacial Surgery, Jan Palfijn General Hospital, Ghent, Belgium
| | - Miche De Meyer
- Department of Adult Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Dentistry, Radboud University Medical Center and Radboud Institute for Health Sciences, Nijmegen, the Netherlands
- Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Aps
- Department of Dentistry, Groningen University Medical Center, Groningen, the Netherlands
- OpiniDent BV, Marke, Belgium
| | - Wolfgang Jacquet
- Department of Adult Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Kong J, Aps J, Naoum S, Lee R, Miranda LA, Murray K, Hartsfield JK, Goonewardene MS. An evaluation of gingival phenotype and thickness as determined by indirect and direct methods. Angle Orthod 2023; 93:675-682. [PMID: 37407506 PMCID: PMC10633790 DOI: 10.2319/081622-573.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 05/01/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES To evaluate gingival phenotype (GP) and thickness (GT) using visual, probing, and ultrasound (US) methods and to assess the accuracy and consistency of clinicians to visually identify GP. MATERIALS AND METHODS The GP and GT of maxillary and mandibular anterior teeth in 29 orthodontic patients (mean age 25 ± 7.5 years) were assessed using probing and US by a single examiner. General dentist and dental specialist assessors (n = 104) were shown intraoral photographs of the patients, including six repeated images, and asked to identify the GP via a questionnaire. RESULTS An increasing trend in GT values of thin, medium, and thick biotype probe categories was found, though this was not statistically significant (P = .188). Comparison of probing method to determinations of GT made by US yielded slight agreement (κ = 0.12). Using the visual method, assessors' identification of the second GP determination ranged from poor to moderate agreement (κ = 0.29 to κ = 0.53). CONCLUSIONS The probe method is sufficient in differentiating between different categories of GP. However, further research is required to assess the sensitivity of the probe method in recognizing phenotypes in the most marginal of cases. Assessors using the visual method lack the ability to identify GP accurately and consistently among themselves.
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Affiliation(s)
| | | | | | | | | | | | | | - Mithran S Goonewardene
- Corresponding author: Dr Mithran S. Goonewardene, Orthodontics, Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands 6009, Western Australia, Australia (e-mail: )
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Kong J, Hartsfield JK, Aps J, Naoum S, Lee R, Miranda LA, Goonewardene MS. Effect of craniofacial morphology on gingival parameters of mandibular incisors. Angle Orthod 2023; 93:545-551. [PMID: 37145979 PMCID: PMC10575635 DOI: 10.2319/101122-700.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/01/2023] [Indexed: 05/07/2023] Open
Abstract
OBJECTIVES To investigate the association between the width of keratinized gingiva (WKG), gingival phenotype (GP), and gingival thickness (GT) with craniofacial morphology in sagittal and vertical dimensions. MATERIALS AND METHODS WKG, GP, and GT of mandibular anterior teeth in 177 preorthodontic patients (mean age 18.38 ± 5.16 years) were assessed clinically using a periodontal probe, a Colorvue Biotype Probe, and ultrasound by a single examiner. Patients were grouped into skeletal Class I, II, and III and hyperdivergent, normodivergent, and hypodivergent based on ANB and SN-MP angles. Mandibular incisor inclination (L1-NB) was also measured. Clinical and cephalometric measurements were repeated to assess inter- and intraexaminer reproducibility. RESULTS A significant association was found between thin GP and skeletal Classes I and III for the left mandibular central incisor (MCI; P = .0183). In skeletal Class III patients, L1-NB angle demonstrated a decreasing trend as phenotype thickness decreased. A significant association was found between thin phenotype and normodivergent and hypodivergent groups for MCIs (left: P = .0009, right: P = .00253). No significant association between WKG or GT and craniofacial morphology was found. CONCLUSIONS Thin GP is associated with skeletal Class I and III for the left MCI. Thin GP is associated with hypodivergent and normodivergent skeletal patterns for the MCIs. There was no association between WKG and GT and craniofacial morphology in both skeletal and vertical dimensions. Dental compensations that exist due to different craniofacial morphology may influence the GP.
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Affiliation(s)
| | | | | | | | | | | | - Mithran S Goonewardene
- Corresponding author: Mithran Goonewardene, Department of Orthodontics, Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands 6009, WA, Australia (e-mail: )
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Aps J, Badr N. Narrative review: the evidence for neurotoxicity of dental local anesthetics. J Dent Anesth Pain Med 2020; 20:63-72. [PMID: 32395611 PMCID: PMC7193061 DOI: 10.17245/jdapm.2020.20.2.63] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/13/2020] [Accepted: 03/29/2020] [Indexed: 12/25/2022] Open
Abstract
Dental local anesthesia is performed daily on a global scale. Adverse effects are rare, but the topic of neurotoxicity of local anesthetics deserves to be explored, as publications can be controversial and confusing. Therefore, a need was felt to address and question the evidence for potential neurotoxicity of dental local anesthetics. This review aimed to assess the studies published on the neurotoxicity of dental local anesthetics. A Pubmed® search was conducted between January 2019 and August 2019. This revealed 2802 hits on the topic of neurotoxicity or cytotoxicity of the following anesthetics: lidocaine, prilocaine, mepivacaine, articaine, ropivacaine, and bupivacaine. Only 23 papers were deemed eligible for this review: 17 in vitro studies, 3 reviews and 3 audits of national inquiries. The heterogeneous literature on this topic showed that all dental local anesthetics are potentially neurotoxic in a concentration and/or exposure time fashion. There seems no consensus about what cell lines are to be used to investigate the neurotoxicity of local anesthetics, which makes the comparison between studies difficult and ambiguous. However, the bottom line is that all dental local anesthetics have a neurotoxic potential, but that there is no unanimity in the publications about which local anesthetic is the least or the most neurotoxic.
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Affiliation(s)
- Johan Aps
- Division of Oral Diagnostics and Surgical Sciences, University of Western Australia, Perth, Australia
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Giray FE, Peker S, Yalcinkaya SE, Kargul B, Aps J. Attitudes and knowledge of paediatric dentists' on digital radiography and cone beam computed tomography. J PAK MED ASSOC 2019; 69:205-210. [PMID: 30804585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To determine the frequency and reasons of digital radiography and cone-beam computed tomography usage among paediatric dental practitioners, and to assess their knowledge and need for specific education.. METHODS The cross-sectional study was conducted from January to July 2017 and comprised paediatric dentists present at the European Academy of Paediatric Dentistry Interim Seminar in Turin, Italy, and members of the Turkish Society of Paediatric Dentistry who did not attend the event. Data about sociodemographics and their attitude towards, use of, and knowledge of digital radiography and cone beam computed tomography was collected by means of a 20-item questionnaire that was mailed to all the subjects. SPSS 22 was used to evaluate data. RESULTS Of the 435 questionnaires distributed, 245(56%) were returned, while 194 (45%) were deemed usable. The mean age of the responding paediatric dentists was 35.84±9.10 (range: 24-67 years) and 126(64.9%) were female. Users of digital radiography identified its advantages, such as lower radiation dose 166(85.7%), ease of image storage 150(77.3%), and the possibility to change image settings and to carry out measurements 106(54.5%). Overall, 70(36%) paediatric dentists had no knowledge of cone beam computed tomography. Dental trauma was cited as the reason for using cone beam computed tomography by 70(61.3%) subjects, dental development issues by 138(71%) and pathology in the jaws by 147(75.8%). CONCLUSIONS Digital radiography and cone beam computed tomography users are increasing in the world.
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Affiliation(s)
- Figen Eren Giray
- Department of Pediatric Dentistry Dental School, Marmara University, Istanbul, Turkey
| | - Sertac Peker
- Department of Pediatric Dentistry Dental School, Marmara University, Istanbul, Turkey
| | | | - Betul Kargul
- Department of Pediatric Dentistry Dental School, Marmara University, Istanbul, Turkey
| | - Johan Aps
- Department of Pediatric Dentistry, School of Dentistry, University of Washington, Seattle, USA
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Abstract
The objective of this review was to investigate the efficacy of dental local anesthetics, as it is well known among clinicians that local anesthesia may be challenging in some circumstances. Therefore, the focus of this review was on the efficacy of the products used in dental local anesthesia. In a Pubmed database literature search conducted, a total of 8646 articles were found to be related to dental local anesthetics. After having applied the inclusion criteria (human research, performed in the last 10 years, written in English language, and focus on dental local anesthetics) and having assessed the quality of the papers, 30 were deemed eligible for inclusion in this review. The conclusion of this review is that none of the dental local anesthetic amides provide 100% anesthesia. The problem appears to be more pronounced when mandibular teeth are attempted to be anaesthetized and especially if there is irreversible pulpitis involved. The authors conclude that this finding suggest exploration of more efficient techniques to administer dental local anesthesia, especially in the mandible, to establish a 100% efficacy, is needed.
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Affiliation(s)
| | - Johan Aps
- University of Western Australia, Division of Oral Diagnostics and Surgical Sciences, Perth, Australia
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Rajasekharan S, Martens L, Vanhove C, Aps J. In vitro analysis of extracted dens invaginatus using various radiographic imaging techniques. Eur J Paediatr Dent 2014; 15:265-270. [PMID: 25306142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Dens Invaginatus (DI) is a rare malformation of the teeth, showing a broad spectrum of morphologic variations. The aim of this study was to perform in vitro radiographic analyses of three extracted dens invaginatus (DI) teeth with complex root anatomy using plain radiographs, CBCT, MRI and micro CT techniques. MATERIALS AND METHODS Study design: Three maxillary lateral incisors (A, B and C) from two patients were extracted due to poor prognosis and were radiographically analysed. Initially, conventional two dimensional digital radiographs were taken. Subsequently CBCT, micro CT and MRI analyses were performed. RESULTS According to the Schulze and Brand system of classification, teeth A, B and C were classified as A2, B3 and B2 respectively. To detect the relationship between the invagination to the oral cavity and pulp chamber, conventional two dimensional radiographs were of no help. CBCT and MRI images were found to be complementary to each other but provided lesser structural detail than micro CT images. CONCLUSION Reporting on these three DI teeth, normal conventional radiographs did not provide detailed structural information about the malformation due to geometric distortion and lack of information. Even though Oehlers classification system is the most widely used, classification by Schulze and Brand is more applicable in rare and deviant teeth.
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Affiliation(s)
- S Rajasekharan
- Department of Paediatric Dentistry and Special Care, PaeCaMeD research, Ghent University
| | - L Martens
- Department of Paediatric Dentistry and Special Care, PaeCaMeD research, Ghent University
| | - C Vanhove
- Medical Imaging and Signal Processing, Infinity Lab, Ghent University, UZ Ghent
| | - J Aps
- Department of Pediatric Dentistry, University of Washington, USA
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Raes F, Renckens L, Aps J, Cosyn J, De Bruyn H. Reliability of Circumferential Bone Level Assessment around Single Implants in Healed Ridges and Extraction Sockets Using Cone Beam CT. Clin Implant Dent Relat Res 2011; 15:661-72. [DOI: 10.1111/j.1708-8208.2011.00393.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Martens L, Vanobbergen J, Willems S, Aps J, De Maeseneer J. Determinants of early childhood caries in a group of inner-city children. Quintessence Int 2006; 37:527-36. [PMID: 16841600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE This study aimed to determine the prevalence of early childhood caries (ECC) and severe early childhood caries (s-ECC) in inner-city children in Ghent, Belgium, and to investigate the independent impact of its determinants. METHOD AND MATERIALS In a non-randomized cross-sectional research design, all children between 24 and 34 months of age attending the final consultation at a participating Child and Family Health Clinic were included (n = 385). Data on oral hygiene and caries were collected by oral examination. Caries prevalence and oral hygiene were determined according to established criteria. Data on oral health habits and socioeconomic status were obtained by a validated questionnaire. All analyses were performed with ECC and s-ECC as response variables. RESULTS The mean DMFS was 0.83 (SEM = 0.14). ECC was diagnosed in 18.5% of the children and s-ECC was found in 12.2%. Treatment need was 100%. From the multiple regression analysis it became clear that ethnicity and neighborhood significantly determined ECC. From all oral health-related behavioral variables, only daily use of a bottle with sweetened drinks other than milk or water, frequency of brushing, and quality of oral hygiene as expressed by Plaque Index scores remained significantly associated with ECC. CONCLUSION Children whose mothers had an Eastern European nationality at birth and who live in a deprived neighborhood, daily use a bottle with sweetened drinks other than milk or water, brush less than once a day, and have plaque are at higher risk for ECC and s-ECC.
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Affiliation(s)
- Luc Martens
- Department of Pediatric Dentistry and Centre for Special Care (PaeCaMed), Ghent University, Belgium.
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Reyes R, Kulkarni D, Khan M, Aps J, Goligher J, Gotlieb M. Imprint cytology of core needle biopsy specimens in a one-stop breast clinic: an accurate, reliable and useful method of evaluating breast lesions. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80069-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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