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Kühnisch J, Aps JK, Splieth C, Lussi A, Jablonski-Momeni A, Mendes FM, Schmalz G, Fontana M, Banerjee A, Ricketts D, Schwendicke F, Douglas G, Campus G, van der Veen M, Opdam N, Doméjean S, Martignon S, Neuhaus KW, Horner K, Huysmans MCD. ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment. Clin Oral Investig 2024; 28:227. [PMID: 38514502 PMCID: PMC10957694 DOI: 10.1007/s00784-024-05597-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection. MATERIALS AND METHODS The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity assessment and (3) forming individualised caries diagnoses. The experts responsible for "caries detection and diagnostic methods" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous Delphi survey. RESULTS Recommendations (N = 8) were approved and agreed upon by the whole expert panel: visual examination (N = 3), dental radiography (N = 3) and additional diagnostic methods (N = 2). While the quality of evidence was found to be heterogeneous, all recommendations were agreed upon by the expert panel. CONCLUSION Visual examination is recommended as the first-choice method for the detection and assessment of caries lesions on accessible surfaces. Intraoral radiography, preferably bitewing, is recommended as an additional method. Adjunct, non-ionising radiation methods might also be useful in certain clinical situations. CLINICAL RELEVANCE The expert panel merged evidence from the scientific literature with practical considerations and provided recommendations for their use in daily dental practice.
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Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany.
| | | | - Christian Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Adrian Lussi
- University Hospital for Conservative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - David Ricketts
- Unit of Restorative Dentistry, University of Dundee, Dundee, UK
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany
| | - Gail Douglas
- Department of Dental Public Health, University of Leeds Dental School, Leeds, UK
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Monique van der Veen
- Departments of Preventive Dentistry and Paediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
- Oral Hygiene School, Inholland University of applied sciences, Amsterdam, The Netherlands
| | - Niek Opdam
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia
| | - Klaus W Neuhaus
- Department of Pediatric Oral Health, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
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Altan H, Yilmaz RE. Clinical evaluation of resin infiltration treatment masking effect on hypomineralised enamel surfaces. BMC Oral Health 2023; 23:444. [PMID: 37400849 DOI: 10.1186/s12903-023-03140-6] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 06/15/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND Resin infiltration is a micro-invasive treatment for molar incisor hypomineralisation (MIH). In this study it was aimed to evaluate the masking effect of resin infiltration treatment (ICON) on hypomineralised enamel surface of permanent anterior teeth by using laser fluorescence, spectrophotometer, and cross-polarisation photography. METHODS A total of 116 permanent central incisors in 37 patients were included in the study. The resin infiltration treatment (Icon®) was applied to the teeth with MIH; the healthy teeth received no treatment (control). Hypomineralised enamel lesions were evaluated by ICDAS II criteria. DIAGNOdent Pen was used to assess the lesions and healthy enamel surface quantitatively. Colour changes in enamel lesions were evaluated by using a spectrophotometer (VITA EasyShare). Each enamel lesion was imaged using a cross-polarization technique before and after treatment. All photos were assessed using Image J to evaluate the changes in lesion size. Enamel lesions were evaluated before; immediately after; 1; 3; and 6 months after treatment. Statistical significance was set as p < 0.05. RESULTS After the resin infiltration, significant decreases were found in the mean DIAGNOdent values for the treatment group (p < 0.05). The colour differences before and after treatment significantly differed in all follow-ups (p < 0.05). In the treatment group, lesion areas decreased significantly after treatment (p < 0.05). CONCLUSIONS The resin infiltration treatment has a masking effect on MIH lesions without cavities, with stable outcomes after six months. The cross-polarization photography technique may be use to evaluate the lesion size instead of photography with flash. TRIAL REGISTRATION NCT04685889 (registered 28 December 2020).
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Affiliation(s)
- Halenur Altan
- Department of Pediatric Dentistry, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey.
| | - Rabia Erağca Yilmaz
- Department of Pediatric Dentistry, Dental Oral and Dental Health Polyclinic, Tokat, Turkey
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Kreher D, Schmalz G, Haak R, Ziebolz D. Laser fluorescence is a predictor of lesion depth in non-cavitated root carious lesions - an in vitro study. Photodiagnosis Photodyn Ther 2022; 41:103243. [PMID: 36565731 DOI: 10.1016/j.pdpdt.2022.103243] [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: 09/19/2022] [Revised: 11/17/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND This in vitro study was designed to compare the assessment of carious root surfaces using laser fluorescence or visual assessment and µCT. METHODS A total of 107 extracted human teeth were included in the study. For the subsequent assessment, a clinical evaluation according to Ekstrand and Nyvad criteria, laser fluorescence measurements (DIAGNOdent-Pen©), and µCT imaging (Bruker Skyscan 1172) of the included root surfaces were performed. For cavitated lesions, the surface was reconstructed on µCT. Target parameters were: clinical appearance, laser fluorescence reading (0-99), and lesion depth in µm (µCT). The statistical analysis included chi² and Spearman-Rho tests. RESULTS Laser fluorescence values were significantly higher (p < 0.01) in leathery non-cavitated (median [IQR]: 73.50 [48.00]) and cavitated (88.50 [29.00]) surfaces than in hard intact surfaces (7.00 [35.00]). In addition, laser fluorescence values showed a significant correlation with lesion depth for non-cavitated surfaces (0.750; p < 0.01). Further statistically significant correlations were not detectable. Regression analysis showed that the laser fluorescence values increased with increasing demineralization depth (β: 0.648, CI95: 0.631-1.053; p < 0.01). CONCLUSION Laser fluorescence measured by DIAGNOdent© is a predictor for the depth of demineralization in carious root caries lesions with intact surfaces. Considering the limitations of this in vitro study, laser fluorescence is suitable for assessing the depth extent of (non-cavitated) root caries lesions and is a tool for clinical diagnosing and assessing the course of lesion development.
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Affiliation(s)
- Deborah Kreher
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Gerhard Schmalz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig 04103, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, Leipzig 04103, Germany.
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Nair MJ, Rao A, Jayaprakash K, Natarajan S, Kumblekar V, Suprabha BS. Effectiveness of laser fluorescence-based device in detecting the extent of re-mineralisation in primary teeth compared to the conventional method: An In vitro study. Indian J Dent Res 2022; 33:292-296. [PMID: 36656191 DOI: 10.4103/ijdr.ijdr_546_21] [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] [Indexed: 01/19/2023] Open
Abstract
Background Laser fluorescence (LF)-based clinical device DIAGNOdent™ is at present being used to detect caries. Can the same be used to detect therapeutic remineralisation of early white spot lesions? Aims To explore the feasibility of using LF-based device in monitoring the changes following remineralisation of demineralised primary teeth. Materials and Method The sample number for the present experimental in vitro study was 10. The LF based device readings were correlated with surface microhardness (SMH) test values to evaluate its efficiency. SMH analysis was performed using a microhardness tester (Tescol-HT1000AD). All the samples were demineralised, followed by remineralisation using fluoride varnish and pH cycling. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 17.0 (IBM SPSS®) software. Paired t-test was performed to compare laser fluorescence readings and SMH test result values at baseline, after demineralisation, and after remineralisation. Pearson's correlation was used to compare the relation between the laser fluorescence and SMH test. Results A good negative correlation was seen between the two methods at the baseline readings even though it was not statistically significant (P = 0.069). A positive correlation between the methods existed following demineralisation which was not significant (P = 0.074). The correlation between the parameters following remineralisation showed a moderate negative correlation but was not significant (P = 0.55). Conclusion DIAGNOdent™ values at baseline, after demineralisation, and after remineralisation was consistent with SMH values. Thus, DIAGNOdent™ can be explored to provide chairside assistance in identifying remineralisation of white spot lesions.
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Affiliation(s)
- Megha J Nair
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - Arathi Rao
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - K Jayaprakash
- Department of Dental Materials, Biomaterials and Research Center, Yenepoya Dental College, Mangalore, Karnataka, India
| | - Srikant Natarajan
- Department of Oral Pathology, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - Vasavi Kumblekar
- Department of Biochemistry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
| | - B S Suprabha
- Department of Pediatric and Preventive Dentistry, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education (MAHE) Manipal, Karnataka, India
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Olgen IC, Sonmez H, Bezgin T. Effects of different remineralization agents on MIH defects: a randomized clinical study. Clin Oral Investig 2021; 26:3227-3238. [PMID: 34821978 DOI: 10.1007/s00784-021-04305-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/28/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to present a comparative evaluation of the long-term efficacy of fluoride varnish and pastes containing CPP-ACP and CPP-ACP with fluoride (CPP-ACFP) in the remineralization of creamy-white and yellow-brown defects in permanent first molars with MIH. MATERIALS AND METHODS The study included 120 teeth with yellow-brown or creamy-white defects in 67 children (37 girls, 30 boys) aged 6-9 years (mean, 7.2) who were newly diagnosed with MIH with no substance loss or caries or prior restorative treatment. The patients were randomly divided into the experiment groups; control (oral hygiene motivation only), fluoride varnish, and pastes containing CPP-ACP and CPP-ACPF, and followed up for 24 months. The evaluations were made based on the ICDAS criteria and the measurements which were performed using the laser fluorescence method (DIAGNOdent, KaVo, Biberach, Germany) in the follow-ups. RESULTS The research was completed with 49 patients (23 females, 26 males; mean age, 7.7) and 90 teeth. All remineralization agents increased remineralization rates in both creamy-white and yellow-brown colored defects without presenting any statistically significant difference at the end of the follow-up period (p > 0.05). However, the effects of fluoride varnishes were late to observe when compared to pastes containing CPP-ACP and CPP-ACPF. CONCLUSIONS Pastes containing calcium and phosphate may be recommended for the longer-term preservation of teeth with yellow-brown defects which showed a post-eruptive breakdown in a shorter time. CLINICAL RELEVANCE There is a lack of studies investigating MIH treatments in which lesion appearance was recorded. This study evaluated creamy-white and yellow-brown MIH defects separately and reported long-term results of different remineralization agents.
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Affiliation(s)
- Irem Can Olgen
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Hayriye Sonmez
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey
| | - Tugba Bezgin
- Department of Pediatric Dentistry, Faculty of Dentistry, Ankara University, Ankara, Turkey.
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Alkahtani A, Anderson P, Baysan A. The performance of SoproLIFE for early detection of coronal caries using the International Caries Classification and Management System - A preliminary laboratory-based study. Photodiagnosis Photodyn Ther 2021; 35:102422. [PMID: 34214688 DOI: 10.1016/j.pdpdt.2021.102422] [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: 02/18/2021] [Revised: 06/06/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
The aim of this laboratory-based study is to evaluate performance of the Light-Induced Fluorescence Evaluator (SoproLIFE) for early detection of coronal caries and to validate the findings using the International Caries Classification and Management System (ICCMS). A total of 56 freshly extracted teeth with coronal carious lesions were included. 74 regions of interest were identified. Visual assessments with International Caries Detection and Assessment Systems (ICDAS), radiographic information and SoproLIFE images were used to classify each region of interest according to the ICCMS as a reference standard. SoproLIFE specificity and sensitivity were calculated at the sound-enamel and dentine lesion levels. Inter and intra reproducibility of ICDAS were analysed and showed a moderate agreement (0.52) and (0.58) respectively. At the sound-initial caries level, the sensitivity and specificity for the SoproLIFE were 90.0%, 95.8% respectively, whilst for the dentine caries level, sensitivity was 100% with specificity of 53.8%. A low proportion of teeth with dental caries were classified as caries-free using the SoproLIFE (false negative=10%). As a conclusion, the performance of SoproLIFE was promising in distinguishing between early enamel carious lesions and sound surfaces. This detection tool could be suggested to be used with ICCMS to assist in the clinical decision-making process.
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Affiliation(s)
- Ashwaq Alkahtani
- Centre for Oral Bioengineering, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, Turner St, Whitechapel, E1 1FR London, UK.
| | - Paul Anderson
- Dental Physical Sciences Unit, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
| | - Aylin Baysan
- Centre for Oral Bioengineering, Institute of Dentistry, Bart's and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
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Sin JH, Ipe DS, Hamlet S, Walsh LJ, Love RM, George R. Fluorescence characteristics of E. faecalis in dentine following treatment with oxidizing endodontic irrigants. Photodiagnosis Photodyn Ther 2021; 35:102344. [PMID: 34033937 DOI: 10.1016/j.pdpdt.2021.102344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/08/2021] [Accepted: 05/17/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION This study aimed to assess changes in the fluorescence characteristics of Enterococcus faecalis in human dentine over a period of 24 h following treatment with endodontic irrigants. METHOD Sterilised, non-functional extracted third molars were embedded in acrylic resin and uniformly sectioned into 2 mm thick dentine sections. After the removal of smear layer, the dentine sections were inoculated with E. faecalis and cultured for 7 days. The infected dentine sections were subsequently treated with different concentrations of sodium hypochlorite (NaOCl) and hydrogen peroxide (H2O2). Bacterial fluorescence readings were assessed at different time points using a calibrated laser device. All data were assessed for normality (Kolmogorov Smirnoff test) and analysed using ANOVA with Bonferroni post-hoc tests. RESULTS Fluorescence readings were quenched when E. faecalis infected human dentine sections were treated with oxidizing irrigants in vitro. Throughout a 24-hour period, fluorescence recovered in part but did not return to baseline level. CONCLUSION The fluorescence quenching effect of these oxidizing agents needs to be considered when using laser fluorescence in assessing the quality of root canal debridement or disinfection.
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Park KJ, Voigt A, Schneider H, Ziebolz D, Haak R. Light-based diagnostic methods for the in vivo assessment of initial caries lesions: Laser fluorescence, QLF and OCT. Photodiagnosis Photodyn Ther 2021; 34:102270. [PMID: 33785442 DOI: 10.1016/j.pdpdt.2021.102270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 02/01/2021] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate different light-based caries diagnostic methods for assessment of non-cavitated initial carious lesions on smooth surfaces. METHODS 39 participants were included. For each participant, three regions of interest (ROI) with ICDAS codes 0, 1 or 2 were defined. All ROIs (n = 117) were investigated/imaged with laser fluorescence (LF, DIAGNOdent 2095; KaVo dental GmbH), quantitative light-induced fluorescence (QLF; Biluminator 2+, Inspektor Research Systems B.V.) and spectral-domain optical coherence tomography (SD-OCT; Telesto II, Thorlabs GmbH). The values of LF, ΔF of QLF, and the lesion extent assessed by OCT were categorized. Frequency distribution of LF-/QLF- and OCT-scores was determined for each ICDAS code included. Inter- and intra-examiner reproducibility of QLF and OCT measurements were assessed by unweighted kappa coefficient (ĸ) and Wilcoxon test (α = 0.05). RESULTS Compared with LF and QLF, OCT showed various manifestations of carious lesions for visually sound ROIs and a larger variation of caries extent in depth within the same ICDAS code groups. Intra-examiner reproducibility ranged between 0.49 and 1.00 for the QLF analysis and between 0.95 and 0.99 for the OCT analysis. Inter-examiner reproducibility ranged between 0.17 and 0.32 for the QLF analysis and between 0.65 and 0.79 for the OCT analysis. CONCLUSION LF and QLF were insensitive to less pronounced smooth-surface lesions while OCT allowed differentiation based on the penetration depth of the carious lesions. This makes OCT a suitable method to complement conventional visual inspection in order to detect and assess (very) early lesions.
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Affiliation(s)
- Kyung-Jin Park
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
| | - Aline Voigt
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
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Trippe LH, Ribeiro AA, Azcarate-Peril MA, Preisser JS, Wang R, Zandona AF. Is Fluorescence Technology a Promising Tool for Detecting Infected Dentin in Deep Carious Lesions? Caries Res 2020; 54:205-217. [PMID: 32580204 DOI: 10.1159/000505643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/02/2019] [Accepted: 12/29/2019] [Indexed: 11/19/2022] Open
Abstract
The purpose of this study was to determine if the degree of fluorescence detected by fluorescence-aided caries excavation (FACE) correlates with dentin bacterial microbiome diversity, as assessed by 16S rRNA gene amplicon sequencing, and with traditional tactile dentin caries assessment. Unidentified human teeth were obtained from a dental facility. The included teeth had a carious lesion two-thirds into the dentin, verified by radiography, and were red-fluorescing (RF) using FACE technology (SIROInspect; Sirona, Bensheim, Germany). Two independent examiners performed visual/tactile assessment of the lesions. RF sites were sampled with a sterile spoon excavator and dentin characteristics were evaluated. Once RF dentin was removed, a second sample of pink-fluorescing (PF) dentin was obtained. After excavation with a sterile round bur to nonfluorescing (NF) dentin, a third sample was collected with a slow-speed round bur. The samples were processed at the UNC (University of North Carolina at Chapel Hill) Microbiome Core Facility. Out of 134 extracted teeth collected, 21 fit the inclusion criteria, yielding 61 dentin samples. RF samples had the highest number of observed operational taxonomic units (n = 154), followed by PF (n = 109) and NF (n = 100). RF carious dentin was primarily "soft," and NF dentin was assessed as "hard" 100% of the time by both examiners (rank correlation χ2: p < 0.001). However, approximately one-third of the tactile assessments of hard dentin still displayed some fluorescence, either pink or red. We concluded that the sampled fluorescing (RF and PF) and NF carious dentin layers displayed diverse bacterial taxa, and tactile assessments of soft, leathery, and hard corresponded with RF, PF, and NF.
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Affiliation(s)
- Leslie H Trippe
- Division of Comprehensive Oral Care, University of North Carolina Chapel Hill School of Dentistry, Chapel Hill, North Carolina, USA
| | - Apoena Aguiar Ribeiro
- Division of Diagnostic Sciences, School of Dentistry at University of North Carolina, Chapel Hill, North Carolina, USA,
| | - M Andrea Azcarate-Peril
- Departments of Medicine and Nutrition, and Microbiome Core, School of Medicine at University of North Carolina, Chapel Hill, North Carolina, USA
| | - John S Preisser
- Department of Biostatistics, Gillings School of Global Public Health at University of North Carolina, Chapel Hill, North Carolina, USA
| | - Rujin Wang
- Department of Biostatistics, Gillings School of Global Public Health at University of North Carolina, Chapel Hill, North Carolina, USA
| | - Andrea Ferreira Zandona
- Department of Comprehensive Care, Tufts University School of Dental Medicine, Boston, Massachusetts, USA
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Dündar A, Çiftçi ME, İşman Ö, Aktan AM. In vivo performance of near-infrared light transillumination for dentine proximal caries detection in permanent teeth. Saudi Dent J 2020; 32:187-193. [PMID: 32405221 PMCID: PMC7211906 DOI: 10.1016/j.sdentj.2019.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 05/27/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 11/17/2022] Open
Abstract
Objective The purpose of this in vivo study was to confirm the detection of proximal caries using near-infrared light transillumination (NILTI) (DIAGNOcam) device, and to compare the diagnostic performance of the device with other caries detection methods, including visual examination using the International Caries Detection and Assessment System (ICDAS), bitewing radiography (BW), an LED-based device (Midwest Caries I.D.), and a laser fluorescence device (LFpen). Methods A total of 974 proximal surface of permanent posterior teeth from 34 patients (19 females and 15 males between the ages of 22–55) were evaluated in the present study. After clinical examination of each proximal surface by an experienced examiner, they were coded according to the ICDAS criteria and subsequently with BW, the NILTI, LED, and LFpen. The proximal dentin caries of 106 were opened based on the combination of visual, NILTI and radiographic assessment and validated; and were treated with restorative materials. The data were analyzed with descriptive statistics and calculation of the sensitivity, specificity, and area under curve (AUC). Results The highest sensitivity values were recorded from NILTI readings (99.1%), followed by BW scores (86.8%). The highest specificity values were recorded from ICDAS (100%). The best AUC values were found from the NILTI readings (0.97), followed by BW (0.93) and ICDAS (0.87). Conclusion The NILTI device exhibited the best performance in terms of detecting proximal dentin caries.
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Affiliation(s)
- Ayşe Dündar
- Department of Restorative Dentistry, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
- Corresponding author at: Department of Restorative Dentistry, Faculty of Dentistry, Akdeniz University, Antalya 07895, Turkey.
| | | | - Özlem İşman
- Vocational High School of Health Services, Gaziantep University, Gaziantep, Turkey
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Kocak N, Cengiz-Yanardag E. Clinical performance of clinical-visual examination, digital bitewing radiography, laser fluorescence, and near-infrared light transillumination for detection of non-cavitated proximal enamel and dentin caries. Lasers Med Sci 2020; 35:1621-1628. [PMID: 32333336 DOI: 10.1007/s10103-020-03021-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/16/2020] [Accepted: 04/16/2020] [Indexed: 11/28/2022]
Abstract
The aim of this study was to compare the clinical performance of clinical-visual examination using the International Caries Detection and Assessment System (ICDAS) II, digital bitewing radiography, near-infrared light transillumination (NIR-LT), and laser fluorescence (LF) for the detection of non-cavitated proximal enamel and dentin caries. The study included 335 patients, aged 12-18 years, with no cavities in the posterior teeth. Clinical-visual inspections of 335 non-cavitated proximal caries were performed by two examiners. For enamel caries, clinical validation included a combination of clinical-visual and digital bitewing radiography assessments. For dentin caries, the clinical validation was opening the cavity. The accuracy rate, sensitivity, specificity, predictive values, and areas under receiver operating characteristic curves were determined. The agreement between the examiners' measurements was calculated using the kappa coefficient. The sensitivity, specificity, and accuracy of the methods were compared using the McNemar test. The significance level was set at p < 0.05. Digital bitewing radiography had the highest sensitivity (0.96) and accuracy (0.96), and LF had the lowest sensitivity (0.38) and accuracy (0.39). After separation of the lesions into enamel and dentin caries, clinical-visual examination had the highest sensitivity (0.98) and accuracy (0.98) for enamel caries, while digital bitewing radiography had the highest sensitivity (0.97) and accuracy (0.97) for dentin caries. The NIR-LT method had a higher sensitivity for enamel caries (0.86). Each method also differed significantly from the others (p < 0.001). Digital bitewing radiography gave the best prediction of proximal enamel and dentin caries. NIR-LT showed good potential for detection of proximal caries.
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Affiliation(s)
- Nazan Kocak
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Mersin University, Ciftlikkoy Campus, Yenisehir, 33150, Mersin, Turkey.
| | - Esra Cengiz-Yanardag
- Department of Restorative Dentistry, Faculty of Dentistry, Mersin University, Mersin, Turkey
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Tassoker M, Ozcan S, Karabekiroglu S. Occlusal Caries Detection and Diagnosis Using Visual ICDAS Criteria, Laser Fluorescence Measurements, and Near-Infrared Light Transillumination Images. Med Princ Pract 2020; 29:25-31. [PMID: 31158839 PMCID: PMC7024861 DOI: 10.1159/000501257] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 06/03/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Current diagnostic tools for non-cavitated occlusal caries are not very reliable. For this reason, newer systems need to be developed. The aim of this study was to compare the performance of visual inspection (ICDAS-II), laser fluorescence (DIAGNOdent pen), and the near-infrared transillumination technique (DIAGNOcam) in the detection of non-cavitated occlusal caries lesions under clinical and laboratory conditions in 90 third molar teeth planned for extraction. MATERIALS AND METHODS Ninety third molar teeth were firstly examined in clinical conditions, scored according to ICDAS-II criteria, and examined with DIAGNOdent pen and DIAGNOcam devices. After finishing the clinical examination, the teeth were re-evaluated shortly after the extractions with the same methods. Then, the teeth were sectioned for histological validation according to Downer's criteria. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic (ROC) curves were calculated based on the histological results. RESULTS For the D0-D1-4 threshold, the area under the ROC curve values ranged between 0.754 and 0.881 for all systems. Sensitivity values ranged between 80.5 and 96.1%, and specificity values ranged between 61.5 and 84.6% for the three caries detection methods. DIAGNOcam had the best correlation value (0.616) according to histological observations and demonstrated a sensitivity rate of 96.1%, a specificity rate of 61.5%, and an accuracy rate of 91.1%. CONCLUSIONS DIAGNOcam was found to be the most effective method for the diagnosis of occlusal caries without cavitation in permanent molar teeth.
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Affiliation(s)
- Melek Tassoker
- Department of Oral and Maxillofacial Radiology, Necmettin Erbakan University, Konya, Turkey,
| | - Sevgi Ozcan
- Department of Oral and Maxillofacial Radiology, Necmettin Erbakan University, Konya, Turkey
| | - Said Karabekiroglu
- Department of Restorative Dentistry, Necmettin Erbakan University, Konya, Turkey
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NouhzadehMalekshah S, Fekrazad R, Bargrizan M, Kalhori KA. Evaluation of laser fluorescence in combination with photosensitizers for detection of demineralized lesions. Photodiagnosis Photodyn Ther 2019; 26:300-305. [PMID: 30914391 DOI: 10.1016/j.pdpdt.2019.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 10/14/2018] [Revised: 02/08/2019] [Accepted: 03/22/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND OBJECTIVES Early detection of caries plays an important role in its prognosis. This study sought to assess the efficacy of laser fluorescence alone and in combination with photosensitizers for detection of demineralized smooth-surface lesions of permanent teeth. MATERIALS AND METHODS This in vitro experimental study was conducted on 60 extracted sound premolars. Four windows measuring 2 x 2 mm were created on each tooth. Forty out of 60 teeth were subjected to demineralization cycle. All teeth were then sectioned and subjected to DIAGNOdent Pen (Kavo, Biberach, Germany) alone and in combination with 0.2-mM tetrakis N-methylpyridyl porphyrin (TMPyP) fluorescent dye, 2% methylene blue and 2% new methylene blue photosensitizers. The results of histological analysis of sections served as the gold standard. The correlation of the results with the gold standard was assessed using the Pearson's correlation coefficient and receiver operating characteristic (ROC) curve. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the four techniques were evaluated as well. RESULTS The correlation between the results of DIAGNOdent laser with TMPyP dye and the gold standard was significant (P < 0.05). Also, this technique had the highest sensitivity while DIAGNOdent laser alone had the highest specificity. CONCLUSION Laser fluorescence with TMPyP fluorescent dye has suitable efficacy for early detection of initial enamel lesions.
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Affiliation(s)
| | - Reza Fekrazad
- Department of Periodontology, Dental School- Laser research center in medical Sciences, AJA University of Medical Sciences, Tehran, Iran; International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Majid Bargrizan
- Associate Professor of Pedodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Abrams TE, Abrams SH, Sivagurunathan KS, Silvertown JD, Hellen WMP, Elman GI, Amaechi BT. In Vitro Detection of Caries Around Amalgam Restorations Using Four Different Modalities. Open Dent J 2018; 11:609-620. [PMID: 29290839 PMCID: PMC5738745 DOI: 10.2174/1874210601711010609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 08/06/2017] [Revised: 10/20/2017] [Accepted: 11/06/2017] [Indexed: 11/25/2022] Open
Abstract
Objective: The aim of this study was to evaluate the ability of PTR-LUM (The Canary System, CS), laser fluorescence (DIAGNOdent, DD), LED fluorescence (Spectra), and visual inspection (ICDAS II) to detect natural decay around bonded amalgam restorations in vitro. Methods: Seventeen extracted human molars and premolars, consisting of visually healthy (n=5) and natural cavitated (n=12) teeth were selected. For the carious teeth, caries was removed leaving some decayed tissue on the floor and or wall of the preparation. For sound teeth, 3 mm. deep cavity preparations were made and teeth were restored with bonded-amalgam restorations. Thirty-six sites (13 sound sites; 23 carious sites) were selected. CS and DD scans were performed in triplicate at 2, 1.5, 0.5, and 0 mm away from the margin of the restoration (MOR). Spectra images were captured for the entire surface, and dentists blinded to the samples provided ICDAS II scoring. Results: Canary Numbers (Mean±SE) for healthy and carious sites at 2, 1.5, 0.5, and 0 mm from the MOR ranged from 12.9±0.9 to 15.4±0.9 and 56.1±4.0 to 56.3±2.0, respectively. DD peak values for healthy and carious sites ranged from 4.7±0.5 to 13.5±2.99, and 16.7±3.7 to 24.5±4.4, respectively. For CS and DD, sensitivity/specificity for sites at 2.0, 1.5, 0.5, 0 mm ranged from 0.95-1.0/0.85-1.0, and 0.45-0.74/0.54-1.0, respectively. For ICDAS II, sensitivity and specificity were 1.0 and 0.17, respectively. For Spectra, data and images were inconclusive due to signal intereference from the amalgam restoration. Conclusions: Using this in-vitro model, CS and DD were able to differentiate between sound and carious tissue at the MOR, but larger variation, less reliability, and poorer accuracy was observed for DD. Therefore, CS has the potential to detect secondary caries around amalgam restorations more accurately than the other investigated modalities.
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Affiliation(s)
| | - Stephen H Abrams
- Quantum Dental Technologies Inc, Toronto, Ontario, Canada.,Cliffcrest Dental Office, Scarborough, Ontario, Canada
| | | | | | | | - Gary I Elman
- Cliffcrest Dental Office, Scarborough, Ontario, Canada
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Yoon HI, Yoo MJ, Park EJ. Detection of proximal caries using quantitative light-induced fluorescence-digital and laser fluorescence: a comparative study. J Adv Prosthodont 2017; 9:432-438. [PMID: 29279762 PMCID: PMC5741446 DOI: 10.4047/jap.2017.9.6.432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 03/12/2017] [Accepted: 03/21/2017] [Indexed: 11/08/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the in vitro validity of quantitative light-induced fluorescence-digital (QLF-D) and laser fluorescence (DIAGNOdent) for assessing proximal caries in extracted premolars, using digital radiography as reference method. MATERIALS AND METHODS A total of 102 extracted premolars with similar lengths and shapes were used. A single operator conducted all the examinations using three different detection methods (bitewing radiography, QLF-D, and DIAGNOdent). The bitewing x-ray scale, QLF-D fluorescence loss (ΔF), and DIAGNOdent peak readings were compared and statistically analyzed. RESULTS Each method showed an excellent reliability. The correlation coefficient between bitewing radiography and QLF-D, DIAGNOdent were −0.644 and 0.448, respectively, while the value between QLF-D and DIAGNOdent was −0.382. The kappa statistics for bitewing radiography and QLF-D had a higher diagnosis consensus than those for bitewing radiography and DIAGNOdent. The QLF-D was moderately to highly accurate (AUC = 0.753 – 0.908), while DIAGNOdent was moderately to less accurate (AUC = 0.622 – 0.784). All detection methods showed statistically significant correlation and high correlation between the bitewing radiography and QLF-D. CONCLUSION QLF-D was found to be a valid and reliable alternative diagnostic method to digital bitewing radiography for in vitro detection of proximal caries.
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Affiliation(s)
- Hyung-In Yoon
- Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Min-Jeong Yoo
- Graduate School of Clinical Dentistry, Ewha Womans University, Seoul, Republic of Korea
| | - Eun-Jin Park
- Department of Prosthodontics, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
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Rams TE, Alwaqyan AY. In vitro performance of DIAGNOdent laser fluorescence device for dental calculus detection on human tooth root surfaces. Saudi Dent J 2017; 29:171-8. [PMID: 29033528 DOI: 10.1016/j.sdentj.2017.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study assessed the reproducibility of a red diode laser device, and its capability to detect dental calculus in vitro on human tooth root surfaces. MATERIAL AND METHODS On each of 50 extracted teeth, a calculus-positive and calculus-free root surface was evaluated by two independent examiners with a low-power indium gallium arsenide phosphide diode laser (DIAGNOdent) fitted with a periodontal probe-like sapphire tip and emitting visible red light at 655 nm wavelength. Laser autofluorescence intensity readings of examined root surfaces were scored on a 0-99 scale, with duplicate assessments performed using the laser probe tip directed both perpendicular and parallel to evaluated tooth root surfaces. Pearson correlation coefficients of untransformed measurements, and kappa analysis of data dichotomized with a >40 autofluorescence intensity threshold, were calculated to assess intra- and inter-examiner reproducibility of the laser device. Mean autofluorescence intensity scores of calculus-positive and calculus-free root surfaces were evaluated with the Student's t-test. RESULTS Excellent intra- and inter-examiner reproducibility was found for DIAGNOdent laser autofluorescence intensity measurements, with Pearson correlation coefficients above 94%, and kappa values ranging between 0.96 and 1.0, for duplicate readings taken with both laser probe tip orientations. Significantly higher autofluorescence intensity values were measured when the laser probe tip was directed perpendicular, rather than parallel, to tooth root surfaces. However, calculus-positive roots, particularly with calculus in markedly-raised ledges, yielded significantly greater mean DIAGNOdent laser autofluorescence intensity scores than calculus-free surfaces, regardless of probe tip orientation. DIAGNOdent autofluorescence intensity values >40 exhibited a stronger association with calculus (36.6 odds ratio) then measurements of ≥5 (20.1 odds ratio) when the laser probe tip was advanced parallel to root surfaces. CONCLUSIONS Excellent intra- and inter-examiner reproducibility of autofluorescence intensity measurements was obtained with the DIAGNOdent laser fluorescence device on human tooth roots. Calculus-positive root surfaces exhibited significantly greater DIAGNOdent laser autofluorescence than calculus-free tooth roots, even with the laser probe tip directed parallel to root surfaces. These findings provide further in vitro validation of the potential utility of a DIAGNOdent laser fluorescence device for identifying dental calculus on human tooth root surfaces.
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Ozkan G, Guzel KGU. Clinical evaluation of near-infrared light transillumination in approximal dentin caries detection. Lasers Med Sci 2017; 32:1417-1422. [PMID: 28653255 DOI: 10.1007/s10103-017-2265-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 01/23/2017] [Accepted: 06/13/2017] [Indexed: 11/26/2022]
Abstract
The objective of this clinical study was to compare conventional caries detection techniques, pen-type laser fluorescence device, and near-infrared light transillumination method in approximal dentin caries lesions. The study included 157 patients, aged 12-18, without any cavity in the posterior teeth. Two calibrated examiners carried out the assessments of selected approximal caries sites independently. After the assessments, the unopened sites were excluded and a total of 161 approximal sites were included in the study. When both the examiners arrived at a consensus regarding the presence of dentin caries, the detected lesions were opened with a conical diamond burr, the cavity extent was examined and validated (gold standard). Sensitivity, specificity, negative predictive value, positive predictive value, accuracy, and area under the ROC curve (Az) values among the caries detection methods were calculated. Bitewing radiography and near-infrared (NIR) light transillumination methods showed the highest sensitivity (0.83-0.82) and accuracy (0.82-0.80) among the methods. Visual inspection showed the lowest sensitivity (0.54). Laser fluorescence device and visual inspection showed nearly equal performance. Near-infrared light transillumination can be used as an alternative method to approximal dentin caries detection. Visual inspection and laser fluorescence device alone should not be used for approximal dentin caries.
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Affiliation(s)
- Gokhan Ozkan
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Adnan Menderes University, Aydin, Turkey.
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18
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Msallam FA, Grawish MEA, Hafez AM, Abdelnaby YL. Decalcification prevention around orthodontic brackets bonded to bleached enamel using different topical agents. Prog Orthod 2017; 18:15. [PMID: 28580541 PMCID: PMC5466901 DOI: 10.1186/s40510-017-0170-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 05/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study was conducted to evaluate the effect of different topical agents utilized for prevention of enamel decalcification around orthodontic brackets bonded to bleached and non-bleached enamel. METHODS Human maxillary premolars (n = 120) were divided into two equal groups. Teeth in group I were left without bleaching while those in group II were bleached with Vivastyle gel. Metal brackets were bonded to all the teeth using light-cured adhesive. Each group was divided into six equal subgroups (A, B, C, D, E, and F). In subgroup A, no material was applied (control). In subgroups B, C, D, E, and F, the following materials were applied respectively: Profluorid varnish, Enamel Pro Varnish, Ortho-Choice Ortho-Coat, GC Tooth Mousse, and GC MI Paste Plus. All teeth were cycled in a demineralization solution/artificial saliva for 15 days. Laser fluorescence was used to measure the level of enamel mineralization. The data were statistically analyzed. RESULTS Regarding the non-bleaching subgroups, all studied material revealed significant demineralization reduction in comparison to the control subgroup (P < 0.05). Ortho-Choice Ortho-Coat revealed the highest significant effect while GC Tooth Mousse showed the least effect. In bleached subgroups, Profluorid varnish, Enamel Pro Varnish, and Ortho-Choice Ortho-Coat significantly reduced demineralization (P < 0.05) while either GC MI Paste Plus or GC Tooth Mousse had no significant effects (P > 0.05). CONCLUSIONS Ortho-Choice Ortho-Coat, and Profluorid and Enamel Pro varnishes could be utilized successfully to reduce enamel demineralization around brackets bonded to either bleached or non-bleached enamel. GC MI Paste Plus and GC Tooth Mousse were effective only in non-bleached enamel.
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Affiliation(s)
- Ferial Ahmed Msallam
- Department of Orthodontics , Faculty of Dentistry, Tripoli University, Tripoli, Libya. .,Department of Orthodontic, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
| | | | - Ahmad Mohammed Hafez
- Department of Orthodontic, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
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Menem R, Barngkgei I, Beiruti N, Al Haffar I, Joury E. The diagnostic accuracy of a laser fluorescence device and digital radiography in detecting approximal caries lesions in posterior permanent teeth: an in vivo study. Lasers Med Sci 2017; 32:621-628. [PMID: 28194533 PMCID: PMC5360861 DOI: 10.1007/s10103-017-2157-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 08/22/2016] [Accepted: 01/20/2017] [Indexed: 10/26/2022]
Abstract
The aim of this in vivo study was to test the diagnostic accuracy of a pen-type laser fluorescence (LFpen) device in detecting approximal caries lesions, in posterior permanent teeth, at the cavitation and non-cavitation thresholds, and compare it with that of digital bitewing radiography. Thirty patients (aged 18-37), who attended the Faculty of Dentistry at Damascus University for a dental examination, were consecutively screened. Ninety approximal surfaces of posterior permanent teeth without frank cavitations, enamel hypoplasia or restorations were selected and examined using the LFpen (DIAGNOdent pen) and digital bitewing radiography. The reference standard was the visual-tactile inspection, after performing temporary tooth separation, using orthodontic rubber rings, placed for 7 days. The status of included approximal surfaces was recorded as intact/sound, with white/brown spots or cavitated. One trained examiner performed all examinations. There were statistically significant differences in LFpen readings between the three types of approximal surface status (P < 0.001). The optimal cut-off values for detecting approximal caries lesions in posterior permanent teeth were >16 and 8 at the cavitation and non-cavitation thresholds respectively. The sensitivity, specificity and accuracy (measured by the area under the receiver-operating characteristic curve) were 100, 85 and 95 and 92, 90 and 95% at the cavitation and non-cavitation thresholds respectively. The intra-class correlation coefficient for intra-examiner reliability was 0.95. The diagnostic accuracy of the LFpen was significantly higher than that of digital bitewing radiography (P < 0.001). The LFpen's diagnostic performance was accurate and significantly better than digital bitewing radiography in detecting approximal caries lesions, in posterior permanent teeth.
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Affiliation(s)
- R Menem
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Mazzeh highway, Damascus, Syria
| | - I Barngkgei
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Mazzeh highway, Damascus, Syria
| | - N Beiruti
- School Health Department, Jisser Alabiad Square, P.O Box 60184, Damascus, Syria
| | - I Al Haffar
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Mazzeh highway, Damascus, Syria
| | - Easter Joury
- Oral Medicine Department, Faculty of Dentistry, Damascus University, Mazzeh highway, Damascus, Syria. .,Population and Patient Health, King's College London Dental Institute, Denmark Hill Campus, Bessemer Road, London, SE5 9RS, UK.
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Melo M, Pascual A, Camps I, Del Campo Á, Ata-Ali J. Caries diagnosis using light fluorescence devices in comparison with traditional visual and tactile evaluation: a prospective study in 152 patients. Odontology 2016; 105:283-290. [PMID: 27655625 DOI: 10.1007/s10266-016-0272-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 01/24/2016] [Accepted: 08/30/2016] [Indexed: 11/26/2022]
Abstract
The objective of the study was to evaluate the in vivo effectiveness of two fluorescence techniques (DIAGNOdent and VistaProof) and of visual and tactile evaluation in the diagnosis of occlusal caries in permanent teeth. A total of 302 teeth (molars and premolars) from 152 patients were studied. The occlusal surfaces were cleaned using pumice mixed with water, followed by application of the diagnostic methods according to the instructions of the manufacturer, and of the visual and tactile methods according to the recommendations. The true extent of the lesions was determined by fissurotomy. The sensitivity and specificity of visual diagnosis were 79 and 72 %, respectively, versus 53 and 98 % in the case of tactile diagnosis. Teeth with caries lesions exhibited significantly higher DIAGNOdent and VistaProof scores than those without caries. Using the optimum cutoff point of 23.5 obtained in our study for DIAGNOdent, sensitivity and specificity were found to be 92.4 and 92.7 %, respectively, while values of 88.1 and 95.1 % were obtained with a cutoff point of 28.5. Sensitivity in the case of the VistaProof system varied between 92.9 % (cutoff point 1.05) and 85.3 % (cutoff point 1.3), with respective specificity values of 95.8 and 88.6 %. The areas under the curve were 0.756, 0.759, 0.954 and 0.965 for the visual and tactile methods and for DIAGNOdent and VistaProof, respectively. The fluorescence-based techniques showed greater internal and external validity than the visual and tactile methods in diagnosing occlusal caries in permanent teeth. VistaProof is the best method for diagnosing caries in its early stages.
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Affiliation(s)
- María Melo
- Valencia University Medical and Dental School, University of Valencia, Valencia, Spain
| | - Agustín Pascual
- Valencia University Medical and Dental School, University of Valencia, Valencia, Spain
| | - Isabel Camps
- Valencia University Medical and Dental School, University of Valencia, Valencia, Spain
| | | | - Javier Ata-Ali
- European University of Valencia, Valencia, Spain.
- Public Dental Health Service, Arnau de Vilanova Hospital, San Clemente 12, 46015, Valencia, Spain.
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Kouchaji C. Comparison between a laser fluorescence device and visual examination in the detection of occlusal caries in children. Saudi Dent J 2012; 24:169-74. [PMID: 23960547 PMCID: PMC3729294 DOI: 10.1016/j.sdentj.2012.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 05/25/2012] [Accepted: 07/20/2012] [Indexed: 11/19/2022] Open
Abstract
UNLABELLED Occlusal surfaces of molars are especially susceptible to the development of caries due to the features, such as pits and deep fissures, of their anatomical structure. AIM To evaluate the efficiency of DIAGNOdent laser fluorescence measurements in comparison with visual examination for occlusal caries detection for first permanent molars in children. METHODS The study involved 156 permanent molar teeth in 40 children aged 7-12 years. A relatively new technology, the fluorescence laser DIAGNOdent pen, was used for detecting and diagnosing caries on the occlusal surfaces of molars. The visual examination of fissures was based on the Ekstrand classification system. RESULTS The results showed a strong relationship between examination with the DIAGNOdent and visual inspection. DIAGNOdent's sensitivity and specificity were 97% and 52%, respectively, indicating that the laser fluorescence DIAGNOdent pen is a reproducible and accurate diagnostic tool that may be very helpful in conjunction with visual examination in the detection of occlusal caries in permanent molars in children.
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Gurbuz T, Yilmaz Y, Sengul F. Performance of laser fluorescence for residual caries detection in primary teeth. Eur J Dent 2008; 2:176-84. [PMID: 19212544 PMCID: PMC2635900] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The aim of this study was to evaluate the performance of a visual-tactile examination and a laser fluorescence device for detecting residual dentinal caries after carious dentin removal with bur excavation, hand excavation and chemomechanical excavation (Carisolv()]. METHODS Thirty extracted coronal caries primary second molars were used. The caries infected dentin has been removed. A blinded examiner checked all cavities for residual caries using a visual-tactile examination and laser fluorescence. Then the teeth were sectioned through the prepared cavities and the two halves of each tooth were processed for light microscopy and Scanning Electron Microscopy (SEM). The presence or absence of residual caries was verified using polarized light microscopy as the gold standard. The cavity floor dentin after removing carious dentin was examined using SEM. RESULTS In among all groups a significant difference is determined between visual-tactile examination and laser fluorescence (P<.05). There was an agreement between laser fluorescence or visual-tactile examination and histological gold standard (P>.05). In addition, SEM images of the surfaces with the caries removed have shown that a vast majority of the tubule openings is observed to be open in the samples of the Carisolv group in opposition to the other groups. CONCLUSIONS The laser fluorescence system could be effective in checking the removal by other methods, such as bur or Carisolv and avoid excessive removal of the sound dentin.
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Affiliation(s)
- Taskin Gurbuz
- Assistant Professor, Department of Pedodontics, Faculty Dentistry, Ataturk University, Erzurum, Turkey,Corresponding author: Taskin Gurbuz, Atatürk Universitesi, Dis Hekimligi Fakultesi, Pedodonti Ana Bilim Dali, Erzurum, Turkey. Phone: +90 442 2311777, Fax: +90 (442) 2360945, E-mail:
| | - Yucel Yilmaz
- Associate Professor, Department of Pedodontics, Faculty Dentistry, Ataturk University, Erzurum, Turkey
| | - Fatih Sengul
- Research Assistant, Department of Pedodontics, Faculty Dentistry, Ataturk University, Erzurum, Turkey
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