1
|
Hegazy RA, Mahmoud EM, Holiel AA. EFFECT OF LOW-LEVEL DIODE LASER ON DENTIN TOPOGRAPHY AND SYMPTOMATIC NONCARIOUS CERVICAL LESIONS PRIOR TO COMPOSITE RESTORATIONS: A SPLIT-MOUTH RANDOMIZED CONTROLLED TRIAL. J Evid Based Dent Pract 2024; 24:101969. [PMID: 38821658 DOI: 10.1016/j.jebdp.2024.101969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 06/02/2024]
Abstract
OBJECTIVES This study assessed alterations in sensitivity among symptomatic noncarious cervical lesions (NCCLs) following the application of 3 low-level diode laser wavelengths before composite restoration. It analyzed the changes in dentin topography using a scanning electron microscope (SEM). MATERIALS AND METHODS Nine patients with 36 NCCLs were randomly assigned intra-individually to 4 groups based on the laser wavelength: laser simulation, 445 nm, 660 nm, and 970 nm. Cavity preparation, irradiation, and composite restoration were performed for each lesion. Sensitivity to cold stimuli was recorded using a visual analog scale (VAS) before the intervention (baseline) and at 1 day, 14 days, 1-, 3-, and 6-month. Pulp sensibility was recorded using an electrical pulp tester (EPT) at baseline, before treatment, and at 3- and 6-month. Additionally, an in vitro examination was performed on 12 extracted human molars to yield 12 dentin discs. Each disc was randomly divided into 4 quadrants to receive the same laser wavelengths to determine the diameters of the tubules using SEM. Results were analyzed statistically for clinical studies by the Friedman test, while ANOVA (RM-ANOVA) was conducted in-vitro, followed by the Bonferroni test in the case of significance (P < .05). RESULTS VAS readings decreased across all groups, with a significant decrease observed for 660 nm and 970 nm from 14 days to 6-month, while at 445 nm there was a significant decrease at 6-month compared to the control (P < .05). EPT showed a significant decrease in pain threshold levels at 660 nm and 970 nm at 3- and 6-month, while 445 nm showed a significant decrease at 6-month compared to the control (P < .05). The mean tubular diameter at 445 nm decreased, with no significant difference from the control, whereas a significant decrease was found at 660 nm and 970 nm compared to the control (P < .05). CONCLUSIONS Prior to composite restoration in symptomatic NCCLs, diode lasers with a wavelength of 660 nm showed the highest reduction in sensitivity, followed by 970 nm, whereas 445 nm diode lasers showed the least reduction. Additionally, diode lasers with wavelengths of 660 and 970 nm reduced the width of the dentinal tubules (DT) without inducing melting, as viewed under SEM.
Collapse
Affiliation(s)
- Raghda A Hegazy
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Elsayed M Mahmoud
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Ahmed A Holiel
- Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
2
|
Braga AS, Meißner T, Schulz-Kornas E, Haak R, Magalhães AC, Esteves-Oliveira M. Enamel Caries Lesion Depth Obtained by Optical Coherence Tomography and Transverse Microradiography: A Comparative Study. Caries Res 2024:1-9. [PMID: 38763130 DOI: 10.1159/000539406] [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: 09/20/2023] [Accepted: 04/28/2024] [Indexed: 05/21/2024] Open
Abstract
INTRODUCTION Visual imaging of subsurface caries lesions is of vital interest in dentistry, which can be obtained by invasive radiography technique as well as by available non-destructive imaging approaches. Thus, as a first step toward the development of a new innovative approach, Spectral-domain optical coherence tomography (SD-OCT) was applied to detect the lesion depth in comparison to the established reference technique (transverse microradiography [TMR]). METHODS Bovine enamel specimens were demineralized for 5 days, following previous studies. For OCT, the resulting artificial lesions were scanned three-dimensionally (SD-OCT) and semi-automated measured (CarLQuant). For TMR, specimens were sectioned and the lesion depth was manually determined (Inspektor Research System). RESULTS The range of lesion depth detected with OCT was 24.0-174.0 μm (mouth rinse study), 18.0-178.0 μm (toothpastes study) and with TMR 59.2-198.0 μm (mouth rinse study), 33.2-133.4 μm (toothpastes study). We found a strong correlation between both methods in terms of lesion depth (Spearman rankwith outlierp < 0.001, Rho = 0.75, Spearman rankwithout outlierp = 0.001, Rho = 0.79). The two methods produce similar results (Passing-Bablok regression, 1.16). As deeper is the lesion, the smallest is the difference between both methods as indicated by Bland-Altman-plots. CONCLUSION Especially in the case of deep lesions, the values obtained by both methods are in agreement, and OCT can potentially substitute TMR to detect and assess lesion depth with the benefit of being non-destructive.
Collapse
Affiliation(s)
- Aline Silva Braga
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Tobias Meißner
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany
| | - Ellen Schulz-Kornas
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany
| | - Ana Carolina Magalhães
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil
| | - Marcella Esteves-Oliveira
- Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
- Department of Restorative Dentistry and Endodontology, Justus-Liebig-University Giessen, Giessen, Germany
- Department of Conservative Dentistry, Periodontology and Endodontology, University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery, University of Tübingen, Tübingen, Germany
| |
Collapse
|
3
|
Koc Vural U, Meral E, Ergin E, Gurgan S. Sixty-month comperative evaluation of a glass hybrid restorative and a composite resin in non-carious cervical lesions of bruxist individuals. Clin Oral Investig 2024; 28:207. [PMID: 38459231 PMCID: PMC10924002 DOI: 10.1007/s00784-024-05570-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 02/20/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE To compare the clinical performance of a glass hybrid (GH) restorative and a nano-ceramic composite resin (CR) in the restoration of non-carious cervical lesions (NCCLs) of bruxist individuals in a 60-month randomized clinical trial. MATERIALS AND METHODS Twenty-five bruxist candidates having NCCLs were recruited in this clinical study. The depth, height (cervico-incisal), width (mesio-distal), internal angles of the NCCLs, degree of tooth wear (TWI) and gingival index (GI) were measured. One hundred-and-forty-eight NCCLs were restored either with a GH restorative (Equia Forte Fil) or a CR (Ceram.X One Universal). Modified USPHS criteria was used to evaluate restorations after 1 week and 12, 24, 36 and 60 months. Pearson's Chi-Square, Fisher's Exact and Cochran Q tests were run for analysis. Survival rates of the restorations were compared with Kaplan-Meier analysis (p < 0.05). RESULTS After 60 months, 97 restorations in 15 patients were examined. The recall rate was 60.0%. Retention rates were 73.5% for CR and 66.7% for GH. A total of 29 restorations were lost (13CR (26.5%), 16GH (33.3%)). There was not a significant difference between tested restoratives in retention (p = 0.464), marginal adaptation (p = 0.856) and marginal discoloration (p = 0.273). There was no relationship between internal angle, depth, height or width and retention of the GH or CR restorations (p > 0.05). The increase in retention loss and marginal discoloration of both restorations over time were significant (p < 0.001). Sensitivity or secondary caries were not detected after 60 months. CONCLUSION GH and nano-ceramic CR showed similar clinical performances in NCCLs after 60 months in patients with bruxism. CLINICAL SIGNIFICANCE After 60 months, CR and GH materials showed clinically acceptable performances in restoration of NCCLs in patients with bruxism.
Collapse
Affiliation(s)
| | - Ece Meral
- Hacettepe University, Ankara, Turkey.
| | | | | |
Collapse
|
4
|
Schulz-Kornas E, Tittel M, Schneider H, Bemmann M, Pellino M, Meissner T, Fuchs F, Hannig C, Tetschke F, Park KJ, Strumpski M, Haak R. Tooth-composite bond failure with a universal and an etch-and-rinse adhesive depending on mode and frequency of application. Dent Mater 2024; 40:359-369. [PMID: 38143188 DOI: 10.1016/j.dental.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/09/2023] [Accepted: 12/11/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To evaluate the effect of an additional layer of universal adhesive on the interfacial enamel/dentin-composite gap formation in relation to application mode and aging, via spectral domain optical coherence tomography (SD-OCT) and scanning electron microscopy (SEM). METHODS In vitro class V cavities in 114 caries-free premolars were restored by applying one or two layers of a universal adhesive (Scotchbond Universal, SBU) in self-etch (se) and etch-and-rinse (er) mode or the reference adhesive OptiBond FL (OFL-er). The restorations were imaged by SD-OCT (six groups, n = 8) and SEM (n = 3) directly after filling (t1), water storage (t2, 24 h), embedding (t3), and thermo-mechanical loading (t4, TCML). The interfacial gaps were quantified using 26 parameters and analyzed using principal component analysis and linear mixed effect models. RESULTS Gap formation at enamel and dentin was significantly influenced by the adhesive, the application mode and number of layers (p < 0.001). This was due to the influence of the SBU-er mode (p < 1e-05), which showed significantly more gap formation and a greater range of variation with double application when compared to SBU-se and OFL. The fewest interfacial gaps occurred with one or two applications of OFL-er and one layer of SBU-er. SIGNIFICANCE Adhesive application mode and the number of adhesive layers are relevant factors in the tooth-composite bond failure. Double application worsened the adaptation of SBU to freshly prepared dentin conditioned with phosphoric acid.
Collapse
Affiliation(s)
- Ellen Schulz-Kornas
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany.
| | - Mathilde Tittel
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Maximilian Bemmann
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Marco Pellino
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Tobias Meissner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Florian Fuchs
- Department of Prosthetic Dentistry and Dental Material Science, University of Leipzig, Leipzig, Germany
| | - Christian Hannig
- Policlinic of Operative Dentistry, Periodontology and Pediatric Dentistry, Faculty of Medicine Carl-Gustav-Carus, TU Dresden, Dresden, Germany
| | - Florian Tetschke
- Department of Clinical Sensoring and Monitoring, Faculty of Medicine Carl-Gustav-Carus, TU Dresden, Dresden, Germany
| | - Kyung-Jin Park
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Michaela Strumpski
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Leipzig, Germany
| |
Collapse
|
5
|
Schierz O, Hirsch C, Krey KF, Ganss C, Kämmerer PW, Schlenz MA. DIGITAL DENTISTRY AND ITS IMPACT ON ORAL HEALTH-RELATED QUALITY OF LIFE. J Evid Based Dent Pract 2024; 24:101946. [PMID: 38401951 DOI: 10.1016/j.jebdp.2023.101946] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 02/26/2024]
Abstract
Over the past 50 years, digitization has gradually taken root in dentistry, starting with computer tomography in the 1970s. The most disruptive events in digital dentistry were the introduction of digital workflow and computer-aided manufacturing, which made new procedures and materials available for dental use. While the conventional lab-based workflow requires light or chemical curing under inconsistent and suboptimal conditions, computer-aided manufacturing allows for industrial-grade material, ensuring consistently high material quality. In addition, many other innovative, less disruptive, but relevant approaches have been developed in digital dentistry. These will have or already impact prevention, diagnosis, and therapy, thus impacting patients' oral health and, consequently, their oral health-related quality of life. Both software and hardware approaches attempt to maintain, restore, or optimize a patient's perceived oral health. This article outlines innovations in dentistry and their potential impact on patients' oral health-related quality of life in prevention and therapy. Furthermore, possible future developments and their potential implications are characterized.
Collapse
Affiliation(s)
- Oliver Schierz
- Department of Prosthetic Dentistry and Material Sciences, Medical Faculty, University of Leipzig, Leipzig, Germany.
| | - Christian Hirsch
- Clinic of Pediatric and Preventive Dentistry, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Karl-Friedrich Krey
- Department of Orthodontics and Craniofacial Orthopedics, University Medicine Greifswald, Greifswald, Germany
| | - Carolina Ganss
- Department for Operative Dentistry, Endodontics, and Pediatric Dentistry, Section Cariology, Philipps-University Marburg, Marburg, Germany
| | - Peer W Kämmerer
- Department of Oral- and Maxillofacial Surgery, University Medical Center Mainz, Mainz, Germany
| | | |
Collapse
|
6
|
Haak R, Stache G, Schneider H, Häfer M, Schmalz G, Schulz-Kornas E. Effect of the Adhesive Strategy on Clinical Performance and Marginal Integrity of a Universal Adhesive in Non-Carious Cervical Lesions in a Randomized 36-Month Study. J Clin Med 2023; 12:5776. [PMID: 37762718 PMCID: PMC10531668 DOI: 10.3390/jcm12185776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/29/2023] Open
Abstract
The effectiveness of a universal adhesive applied in three application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA) over 36 months. In 50 patients, three (n = 21) or four (n = 29) non-carious cervical lesions (NCCL) were restored with Venus® Diamond Flow (Kulzer GmbH, Hanau, Germany). The adhesive iBond® Universal (iBU, Kulzer, Germany) was used in self-etch (SE), etch-and-rinse (ER), or selective-enamel-etch mode (SEE). The etch-and-rinse adhesive OptiBondTM FL served as a control (OFL, Kerr GmbH, Herzogenrath, Germany). The restorations were clinically assessed (FDI criteria) at 14 days (BL), 6, 12, 24, and 36 months. Additionally, QMA was conducted on all restorations of 11 randomly selected patients. FDI criteria and marginal gap and perfect margin were compared between and within groups and recalls using McNemar, Wilcoxon, or Mann-Whitney U-tests (α = 0.05). Starting with 12 months, cumulative failure rates were lower in iBU-SE (0.0%, p = 0.016) and iBU-ER groups (2.1%, p = 0.07) compared to OFL (16.7%). At two years, iBU-SEE also showed fewer failures (0.0% SEE vs. 34.6% OFL, p = 0.016), as did iBU-SE compared to iBU-ER after 36 months (2.2 and 19.6%, p = 0.039). From BL, the iBU-SEE group always had the fewest marginal gaps and the highest percentage of perfect margins. From BL, iBU-SEE (0%, p = 0.008) and iBU-ER (0.2%, p = 0.027) showed significantly fewer marginal gaps compared to OFL (2.5%) and more perfect margins were found with iBU-SEE starting at 6 months (p = 0.054). The SEE and ER modes ensured the most excellent marginal quality, with differences from the control appearing earlier with QMA than clinically. In restoring NCCls, iBU showed superior clinical performance over OFL, especially in modes SE and SEE.
Collapse
Affiliation(s)
| | | | | | | | | | - Ellen Schulz-Kornas
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstraße 12, 04103 Leipzig, Germany
| |
Collapse
|
7
|
de Freitas BN, da Silva PO, Pintado-Palomino K, de Almeida CVVB, Souza-Gabriel AE, Corona SAM, Geraldeli S, Grosgogeat B, Roulet JF, Tirapelli C. Patients´ satisfaction concerning direct anterior dental restoration. Braz Dent J 2023; 34:82-93. [PMID: 37466529 PMCID: PMC10355263 DOI: 10.1590/0103-6440202305260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 03/20/2023] [Indexed: 07/20/2023] Open
Abstract
The objective of this study was to observe patients' satisfaction with their in-service direct anterior dental restorations and to compare it with clinical evaluation using FDI (Federation Dental International) criteria. Patients scored their own anterior dental restorations regarding satisfaction (satisfactory /dissatisfactory). If dissatisfaction was mentioned, then, they would be interviewed about the complaint. In the same session, the dental restorations were clinically evaluated by two dentists using FDI criteria (1-5 score) concerning esthetic, functional, and biological domains. Descriptive statistics were used for frequencies of scores attributed by patients and clinicians. In order to compare patients' to clinicians' frequencies, the Chi-square test was applied (p ≤ 0.05). A total of 106 restorations were evaluated by patients and clinicians. Patients reported 52.8% of restorations satisfactory and 47.8% dissatisfactory. Overall, clinicians reported the same restorations as 82,3% satisfactory and 17,6% dissatisfactory. Patients' most frequent complaints referred to color, followed by anatomical form, fracture of material and retention, and approximal anatomical form. Comparing patients' satisfaction and dissatisfaction rates to clinicians' evaluation per criteria, there was no difference regarding esthetics. The frequency of dissatisfactory restorations by clinicians was significantly lower when functional and biological properties were compared with patients' opinions. Direct anterior dental restorations were more frequently reported as satisfactory by patients and clinicians, being the main complaints related to esthetic issues. When clinicians and patients' evaluations were compared, it was observed that the frequencies of satisfactory restoration by patients and clinicians were similar regarding esthetic properties, and significantly different regarding functional and biological properties.
Collapse
Affiliation(s)
- Bruna Neves de Freitas
- Department of Dental Materials and Prosthodontics, School of
Dentistry of Ribeirão Preto, University of São Paulo. Ribeirão Preto, SP,
Brazil
| | | | | | | | - Aline Evangelista Souza-Gabriel
- Department of Restorative Dentistry, School of Dentistry of
Ribeirao Preto, University of São Paulo. Ribeirão Preto, SP, Brazil
| | - Silmara Aparecida Milori Corona
- Department of Restorative Dentistry, School of Dentistry of
Ribeirao Preto, University of São Paulo. Ribeirão Preto, SP, Brazil
| | - Saulo Geraldeli
- East Carolina University, School of Dental Medicine, Department of
General Dentistry Greenville. Greenville, NC, United States of America
| | - Brigitte Grosgogeat
- Faculté d’Odontologie, Laboratoire des Multimateriaux et
Interfaces, UMR CNRS 5615, France
| | | | - Camila Tirapelli
- Department of Dental Materials and Prosthodontics, School of
Dentistry of Ribeirão Preto, University of São Paulo. Ribeirão Preto, SP,
Brazil
| |
Collapse
|
8
|
Stănuşi A, Iacov-Crăițoiu MM, Scrieciu M, Mitruț I, Firulescu BC, Boțilă MR, Vlăduțu DE, Stănuşi AŞ, Mercuț V, Osiac E. Morphological and Optical Coherence Tomography Aspects of Non-Carious Cervical Lesions. J Pers Med 2023; 13:jpm13050772. [PMID: 37240942 DOI: 10.3390/jpm13050772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Non-carious cervical lesions (NCCLs) are considered the irreversible losses of dental hard tissues at the cemento-enamel junction, in the absence of acute trauma and dental caries. The aim of this study was to highlight the presence of NCCLs in cervical areas based on specific macroscopic aspects in order to establish their clinical form, size and location and to confirm the role of optical coherence tomography (OCT) examination in the early diagnosis of these lesions. For this study, 52 extracted teeth were used, which did not have endodontic treatments, fillings or carious lesions in the cervical area. All teeth were examined macroscopically and OCT was used to evaluate the degree of occlusal wear, the presence and clinical form of NCCLs. Most NCCLs were identified on the buccal surfaces of the premolars. The most frequently encountered clinical form was the wedge-shaped form, with a radicular location. NCCLs present most frequently in the wedge-shaped form. Teeth that presented several NCCLs were identified. The OCT examination is an adjunct method to evaluate the clinical forms of NCCL.
Collapse
Affiliation(s)
- Andreea Stănuşi
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | - Monica Scrieciu
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Ioana Mitruț
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | | | | | | | | | - Veronica Mercuț
- Department of Prosthetic Dentistry, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Eugen Osiac
- Department of Biophysics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| |
Collapse
|
9
|
Ma KSK, Wang LT, Blatz MB. Efficacy of adhesive strategies for restorative dentistry: A systematic review and network meta-analysis of double-blind randomized controlled trials over 12 months of follow-up. J Prosthodont Res 2023; 67:35-44. [PMID: 35691823 DOI: 10.2186/jpr.jpr_d_21_00279] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE The efficacy of etch-and-rinse, selective enamel-etching, and self-etching protocols for universal adhesives in follow-ups of over 12 months was compared in a network meta-analysis. STUDY SELECTION Randomized controlled trials (RCTs) published from 1998 to 2022 that compared marginal staining, marginal adaptation, retention and fractures, post-operative sensitivity, or recurrence of caries that took place over 12-months post-restoration were selected. A network meta-analysis determined the performance of each adhesive protocol. RESULTS After screening 981 articles, 16 RCTs were subjected to data extraction. Of which, 674 patients with 2816 restorations, were included in the network meta-analysis. The pooled risk of marginal discoloration following self-etching was significantly higher than that following etch-and-rinse at over 12, 24, and 36 months, which was time-dependent. The pooled risks of unfavorable marginal adaptation and unfavorable retention and fractures following self-etching were also significantly higher than that following etch-and-rinse, with the rates of unfavorable retention and fractures in non-carious cervical lesions increasing in a time-dependent manner. The pooled risks of marginal discoloration, unfavorable marginal adaptation, retention and fractures were similar between etch-and-rinse and selective enamel-etching protocols. Post-operative hypersensitivity and recurrence of caries were not significantly different among etch-and-rinse, selective enamel-etching, and self-etching protocols. CONCLUSIONS In follow-ups over 12 months, esthetic and functional outcomes of restorations completed with an etch-and-rinse adhesive protocol were superior to the ones achieved with a self-etching strategy without selective enamel-etching. Selective enamel etching is recommended for self-etching systems. Biological responses were similar for all three adhesive strategies.
Collapse
Affiliation(s)
- Kevin Sheng-Kai Ma
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Li-Tzu Wang
- National Taiwan University (NTU) Hospital and College of Medicine, NTU, Taipei, Taiwan
| | - Markus B Blatz
- Department of Preventive and Restorative Sciences, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
10
|
Al-Ali M, Camilleri J. The scientific management of deep carious lesions in vital teeth using contemporary materials—A narrative review. FRONTIERS IN DENTAL MEDICINE 2022. [DOI: 10.3389/fdmed.2022.1048137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
AimThe aim of this article is to review the scientific evidence for deep caries removal in permanent vital teeth and the choice of dentine replacement material and restoration of the teeth to maintain long term tooth vitality and function.MethodThe two position statements namely the European Society of Endodontology and the American Association of Endodontists position statements on vital pulp therapy will be scrutinized and compared with regards to the deep caries removal strategy and assessed for evidence of best practice. The properties of materials used to manage vital pulps and the best way to restore the teeth will be reviewed and guidance on the full management of vital teeth will be suggested.ConclusionsPromoting new treatment modalities for reversible and irreversible pulpitis allowing for pulp preservation should be considered. Although debatable, cases with deep caries should be managed by complete non-selective caries removal which will allow for pulpal management if needed and a more predictable outcome can be expected when using the new materials and treatment modalities of vital pulp therapy.
Collapse
|
11
|
Clinical Outcomes and Quantitative Margin Analysis of a Universal Adhesive Using a Randomized Clinical Trial over Three Years. J Clin Med 2022; 11:jcm11236910. [PMID: 36498485 PMCID: PMC9737201 DOI: 10.3390/jcm11236910] [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: 09/29/2022] [Revised: 11/15/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
The effectiveness of a universal adhesive applied in different application modes for the preparation of Class V composite restorations was evaluated both clinically and by quantitative marginal analysis (QMA). In each of the 22 patients, four non-carious cervical lesions (NCCL) were restored with Filtek™ Supreme XTE (3M). The adhesive Scotchbond™ Universal (SBU, 3M) was applied in self-etch (SE), selective-enamel-etch (SEE) or etch-and-rinse (ER) modes. The etch-and-rinse adhesive OptiBond™ FL (OFL, Kerr) served as a control. The restorations were clinically evaluated (FDI criteria) after 14 days (BL), 6, 12, 24, and 36 months. Additionally, QMA was conducted on all restorations of 11 randomly selected patients. The FDI criteria and marginal gap were statistically compared between the groups at each recall as well as for the time periods between recalls. The cumulative failure rate was non-significantly higher in the OFL group when compared to all of the SBU groups. Marginal adaptation in the OFL and SBU-SE/ER groups was significantly decreased (BL-36 m, p: 0.004) in comparison to the SBU-SEE group (BL-36 m, p: 0.063). More marginal gaps were found in the OFL group than in the SBU-SEE (BL to 36 m, p: 0.063-0.003) and SBU-ER (24/36 m, p: 0.066/0.005) groups as well as in the SBU-SE group when compared to the SBU-SEE (12-36 m, pi ≤ 0.016) and SBU-ER (24/36 m, p: 0.055/0.001) groups. SBU-SEE performed most effectively. The clinical evaluation and QMA corresponded, yet QMA detected group differences earliest after 6 months and is thus a valuable extension to clinical evaluations.
Collapse
|
12
|
Thalacker C. Dental adhesion with resin composites: a review and clinical tips for best practice. Br Dent J 2022; 232:615-619. [PMID: 35562453 DOI: 10.1038/s41415-022-4144-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 02/10/2022] [Indexed: 11/09/2022]
Abstract
Modern restorative dentistry would not be possible without the ability to bond to tooth structure. The development of dental adhesives has a lengthy gestation, from the beginnings around 1950, to the latest generation: modern universal adhesives, which were introduced during the 2010s. The foundation for these developments was a deeper understanding of the mechanisms of adhesion to the tooth structure, and to restoration materials. Typically, the performance of an adhesive does not depend on the use of a single ingredient, but on an overall balanced and optimised formulation that contains various components with different roles, such as functional adhesive monomers.While a wealth of literature exists on adhesives that have a long and successful clinical history ('gold standards'), some universal adhesives have also accumulated a lot of scientific evidence while offering benefits like ease of use, low technique sensitivity and versatility.To achieve reliable results with a modern adhesive, several tips should be kept in mind regardless of the product, which result in a homogeneous adhesive layer, proper cure and ultimately high bond strength. Although high performance is already achieved with the adhesives currently available, this is still an exciting area of ongoing research.
Collapse
Affiliation(s)
- Christoph Thalacker
- Oral Care Solutions Division, 3M Company, ESPE Platz, Seefeld, 82229, Germany.
| |
Collapse
|
13
|
Thapa D, Welch R, Dabas RP, Salimi M, Tavakolian P, Sivagurunathan K, Ngai K, Huang B, Finer Y, Abrams S, Mandelis A, Tabatabaei N. Comparison of Long-Wave and Mid-Wave Infrared Imaging Modalities for Photothermal Coherence Tomography of Human Teeth. IEEE Trans Biomed Eng 2022; 69:2755-2766. [PMID: 35196221 DOI: 10.1109/tbme.2022.3153209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The ability to detect dental caries at early stages lies at the heart of minimal intervention dentistry, enabling the curing or arresting of carious lesions before they advance to the cavity stage. Enhanced truncated-correlation photothermal coherence tomography (eTC-PCT) using mid-wave infrared (MWIR) cameras has recently been shown to offer tomographic visualization of early caries. The tomographic slicing ability of such systems, however, is believed to be limited by direct radiative thermal emission through the translucent dental enamel in the 3-5 m MWIR spectral range. Such radiative emissions can dominate the delayed conductive thermal contributions needed for tomographic reconstruction of internal dental defects. It has been hypothesized that long-wave infrared (LWIR) eTC-PCT systems may offer better tomographic performance by taking advantage of the intrinsic attenuation of direct radiative emission by dental enamel in the LWIR spectral range, enabling more effective delayed conductive thermal contributions from subsurface caries. More than an order of magnitude lower cost of the system is another key attribute of LWIR eTC-PCT which can open the door for downstream translation of the technology to clinics. In this report, we offer a systematic comparison of the performance/effectiveness of caries detection with LWIR and MWIR eTC-PCT systems for detecting natural caries, bacterial caries, and artificially demineralized enamel surfaces. Our results suggest that the low-cost LWIR based eTC-PCT system provides 3D visualization and 2D slice-by-slice images of early caries and internal micro-cracks similar to those obtained from the more expensive MWIR-based eTC-PCT system, albeit with ~1.3dB lower signal-to-noise ratio.
Collapse
|
14
|
Josic U, Mazzitelli C, Maravic T, Radovic I, Jacimovic J, Mancuso E, Florenzano F, Breschi L, Mazzoni A. The influence of selective enamel etch and self-etch mode of universal adhesives’ application on clinical behavior of composite restorations placed on non-carious cervical lesions: A systematic review and meta-analysis. Dent Mater 2022; 38:472-488. [DOI: 10.1016/j.dental.2022.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 01/05/2022] [Accepted: 01/19/2022] [Indexed: 12/16/2022]
|
15
|
Dreweck F, Burey A, de Oliveira Dreweck M, Fernandez E, Loguercio AD, Reis A. Challenging the Concept that OptiBond FL and Clearfil SE Bond in NCCLs Are Gold Standard Adhesives: A Systematic Review and Meta-analysis. Oper Dent 2021; 46:E276-E295. [PMID: 34919728 DOI: 10.2341/20-059-lit] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2021] [Indexed: 11/23/2022]
Abstract
PURPOSE The following PICO (Patient/Population, Intervention, Comparison, and Outcomes) question was proposed: "Are retention rates of composite resin restorations in noncarious cervical lesions (NCCLs) when using adhesives considered "gold standard" (OptiBond FL and Clearfil SE Bond) higher than those obtained with other adhesives brands"? METHODS A search was performed in February 2019 (updated in November 2019) in the PubMed/MEDLINE, EMBASE, LILACS, BBO, Web of Science, Cochrane Library, Grey Literature, and IADR abstracts (1990-2018); unpublished and ongoing trial registries, dissertations, and theses were also searched. Only randomized clinical trials (RCTs) conducted in NCCLs that compared either OptiBond FL or Clearfil SE Bond adhesive with other commercially available adhesives were included. The risk of bias (RoB) was applied by using the Cochrane Collaboration tool. A meta-analysis was performed for retention rates at different follow-up times using a random effects model for both the adhesives. Heterogeneity was assessed with the Cochran Q test and I2 statistics. Grading of Recommendations: Assessment, Development and Evaluation (GRADE) assessed the quality of evidence. RESULTS After removal of duplicates and noneligible articles, 25 studies remained for qualitative synthesis, as one study was common to the two adhesives, of which 9 studies were used for the OptiBond FL meta-analysis and 14 for the Clearfil SE Bond meta-analysis. No significant differences were observed for retention rates in follow-up periods of 12-24 months (p=0.97), 36-48 months (p=0.72), or 108-156 months (p=0.73) for OptiBond FL; and for 12-24 months (p=0.10) and 36-48 months (p=0.17) for Clearfil SE Bond. A significant difference was only found for OptiBond FL at 60-96 months (p=0.02), but only three studies were included in this meta-analysis. CONCLUSIONS The evidence from available RCTs conducted in NCCLs that compared OptiBond FL or Clearfil SE Bond does not support the widespread concept that these adhesives are better than any other competitive brands available in the dental market.
Collapse
Affiliation(s)
- Fds Dreweck
- Fabiana Dias Simas Dreweck, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, PR, Brazil. Adjunctive professor, Campos Gerais Higher Education Center- CESCAGE, Ponta Grossa, PR, Brazil
| | - A Burey
- Adrieli Burey, DDS, MS, PhD student, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, PR, Brazil
| | - M de Oliveira Dreweck
- Marcelo de Oliveira Dreweck, MS, assistant professor, Medicine Department, State University of Ponta Grossa, Uvaranas, PR, Brazil
| | - E Fernandez
- Eduardo Fernandez, DDS, MS, PhD, professor, Restorative Dentistry Department, Faculty of Dentistry, University of Chile, Santiago, Chile; Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile, Providencia, Chile
| | - A D Loguercio
- Alessandro D. Loguercio, DDS, MS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, PR, Brazil
| | - A Reis
- *Alessandra Reis, DDS, PhD, professor, Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, PR, Brazil
| |
Collapse
|
16
|
Scholz KJ, Tabenski IM, Vogl V, Cieplik F, Schmalz G, Buchalla W, Hiller KA, Federlin M. Randomized clinical split-mouth study on the performance of CAD/CAM-partial ceramic crowns luted with a self-adhesive resin cement or a universal adhesive and a conventional resin cement after 39 months. J Dent 2021; 115:103837. [PMID: 34624421 DOI: 10.1016/j.jdent.2021.103837] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/24/2021] [Accepted: 09/29/2021] [Indexed: 01/21/2023] Open
Abstract
Objectives To determine the clinical performance of partial ceramic crowns (PCCs) luted with a conventional resin cement combined with a universal adhesive without or with selective enamel etching or luted with a self-adhesive resin cement. Methods In a split-mouth design, each three CAD/CAM-PCCs (Vita Mark II, Cerec) were placed in 50 patients. Two PCCs were luted with a conventional resin cement (RelyX Ultimate) combined with a universal adhesive (Scotchbond Universal) without (SB-E) or with (SB+E) selective enamel etching. The third PCC was luted with a self-adhesive resin cement (RelyX Unicem 2; RXU). Chi-square tests (α≤0.05) were applied. Based on clinical failures (complete debonding or need for replacement of the restorations), Kaplan-Meier survival analysis was performed. Results 31 patients were evaluated clinically using FDI criteria at 39 months. Clinically acceptable results were detected over time, except for "fracture of material and retention" (inacceptable fractures and debondings). Within materials, statistically significant differences (p ≤ 0.003) between baseline and 39 months were found for "marginal adaptation" and "marginal staining". At 39-month, SB+E and SB-E showed significantly better results compared to RXU in "marginal adaptation"(p ≤ 0.021) and "marginal staining"(p ≤ 0.013). Kaplan-Meier analysis showed higher survival rates after 39 months for SB+E (96%) and SB-E (88%) compared to RXU (69%) with statistically significant differences between RXU vs. SB-E (p = 0.022) and RXU vs. SB+E (p ≤ 0.001). Conclusions After 39-months, PCCs luted with the self-adhesive resin cement exhibited a statistically significant inferior survival rate compared to restorations luted with the conventional resin cement combined with a universal adhesive without or with selective enamel etching. Clinical significance Currently, self-adhesive resin cements cannot be recommended for luting partial ceramic crowns. However, the standard adhesive luting procedure comprising a universal adhesive and luting composite yielded good clinical results for more than 3 years irrespectively of application of a selective enamel etching step.
Collapse
Affiliation(s)
- Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany.
| | - Isabelle M Tabenski
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Private practice, Regensburg, Germany
| | - Vanessa Vogl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Private practice, Regensburg, Germany
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany; Department of Periodontology, University of Bern, Bern, Switzerland
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Marianne Federlin
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| |
Collapse
|
17
|
Challakh N, Palsa D, Bemmann M, Merle CL, Haak R, Schulz-Kornas E, Ziebolz D. Assessibility of different CAD/CAM ceramics with optical coherence tomography. J Dent 2021; 114:103836. [PMID: 34624422 DOI: 10.1016/j.jdent.2021.103836] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/16/2021] [Accepted: 09/29/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To investigate the light penetration depth of various CAD/CAM ceramics and luting agents by spectral-domain optical coherence tomography (SD-OCT). METHODS Six CAD/CAM ceramics: lithium disilicate (LS2), zirconia-reinforced lithium silicate (ZLS), lithium aluminosilicate (LAS), polymer infiltrated (PIC), feldspar (FEL) and zirconium oxide (ZRO) and five common luting agents, two self-adhesive and three adhesive materials, were included. SD-OCT wavelengths (1310/1550 nm) and frequencies (5/28 kHz) that are particularly suitable for these materials were investigated. Subsequently, a clinical simulation was performed with an adhesively or self-adhesively inserted partial crown made of a ceramic that had an OCT penetration depth of > 1.0 mm. RESULTS Best SD-OCT penetration was obtained at 1550 nm and 28 kHz. For ZLS, LS2 and LAS, SD-OCT light penetration depth of > 4 mm was shown. In contrast, the penetration depth of ZRO, PIC and FEL was less than 1 mm. Adhesive and self-adhesive luting agents could be visualized up to ≥ 0.9 mm. All clinically relevant areas (ceramic restoration, luting area, interfaces and adjacent tooth structures) can be imaged when SD-OCT-suitable ceramics are used. CONCLUSIONS SD-OCT can be used to analyze CAD/CAM ceramics based on ZLS, LS2 and LAS, whereas ZRO, PIC, and FEL had insufficient penetration depth for clinical application. The type of luting agent or its thickness played an insignificant role. With suitable ceramics, SD-OCT can be recommended as a non-invasive examination tool. CLINICAL SIGNIFICANCE This study indicates that SD-OCT is a useful non-invasive examination method for monitoring lithium silicate-based ceramic restorations and adjacent structures.
Collapse
Affiliation(s)
- Nadia Challakh
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany.
| | - Dennis Palsa
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Maximilian Bemmann
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Cordula Leonie Merle
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Ellen Schulz-Kornas
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Germany
| |
Collapse
|
18
|
Two-year randomized clinical trial of different restorative techniques in non-carious cervical lesions and MMP activity in gingival crevicular fluid. Clin Oral Investig 2021; 26:1889-1902. [PMID: 34505916 DOI: 10.1007/s00784-021-04166-2] [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: 12/14/2020] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate different restorative techniques for non-carious cervical lesions (NCCLs) and the activity of matrix metalloproteinases (MMPs) in gingival crevicular fluid. MATERIALS AND METHODS Two hundred restorations were performed in 50 patients using resin composite restorative system without (I) and with selective enamel conditioning (II) and resin-modified glass-ionomer cement without (III) and with EDTA pretreatment (IV). Gingival crevicular fluid samples were collected in 15 patients. Restorations were evaluated using USPHS criteria at baseline and after 2 years. Percentages of MMP activity were assessed by zymography as a surrogate outcome. Equality tests of two proportions, logistic regression analysis, survival analysis, ANOVA repeated measures, and Fisher tests were used. RESULTS No differences in clinical performance were found among groups. Group I had lower retention at 2 years than at baseline. Decreased alpha scores for marginal integrity and marginal discoloration were observed for all groups after 2 years. MMP-2 decreased after 1 year, and its activity increased back to the initial level after 2 years, mainly for groups I, II, and III. MMP-9 increased after 1 year, and it was reduced to the initial level after 2 years, mainly for group I. CONCLUSIONS All restorative techniques performed similarly in NCCLs after 2 years with initial marginal defect alterations. MMP-2 reestablished its initial levels after 2 years, and MMP-9 had few alterations over time in crevicular fluid. Clinical relevance The different restorative techniques are equally successful in NCCLs after 2 years of clinical functioning and have similar effects on MMPs present in crevicular fluid.
Collapse
|
19
|
Is clinical behavior of composite restorations placed in non-carious cervical lesions influenced by the application mode of universal adhesives? A systematic review and meta-analysis. Dent Mater 2021; 37:e503-e521. [PMID: 34481667 DOI: 10.1016/j.dental.2021.08.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/08/2021] [Accepted: 08/17/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To answer the following PICOS question: "Is the risk of retention loss, marginal discoloration, marginal adaptation and postoperative sensitivity (POS) equal for etch-and-rinse (EAR) compared to self-etch (SE) or selective-enamel etch (SEE) mode when restoring non carious cervical lesions (NCCLs) with universal adhesives?". METHODS PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Scientific Electronic Library Online, LILACS, OpenGrey and Google Scholar™ were searched. Randomized controlled clinical trials in which resin composites and universal adhesives were used for restoration of NCCLs were considered. Cochrane Risk of Bias Tool was used to assess the risk of bias. Meta-analyses were performed using Revman; random-effects models were applied, and heterogeneity was tested using the I2 index. The significance level was set at p < 0.05. Certainty of evidence was assessed by GRADE tool. RESULTS After screening, 20 articles were included in qualitative, while 14 articles were used for quantitative synthesis. Twelve studies ranked as "low", while 8 studies scored as "unclear" for risk of bias. At 12- and 18/24-months the risk for retention loss was higher for SE than for EAR groups (p = 0.005; RR = 0.22, 95% CI [0.08, 0.63],[moderate certainty of evidence and p = 0.0002; RR = 0.32, 95% CI [0.17, 0.58], moderate certainty of evidence, respectively). No significant differences were observed for marginal discoloration and adaptation (p > 0.05). The probability of POS occurrence was less in SE than in EAR groups (RR = 2.12, 95% CI [1.23, 3.64], moderate certainty of evidence). The certainty of evidence for other outcomes was scored as "low" or "moderate", depending on the follow-up period. SIGNIFICANCE Using universal adhesives in EAR or SEE mode provides more predictable retention, while SE strategy reduces the risk of POS occurrence.
Collapse
|
20
|
Zhang A, Ye N, Aregawi W, Zhang L, Salah M, VanHeel B, Chew HP, Fok ASL. A Review of Mechano-Biochemical Models for Testing Composite Restorations. J Dent Res 2021; 100:1030-1038. [PMID: 34365857 DOI: 10.1177/00220345211026918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Due to the severe mechano-biochemical conditions in the oral cavity, many dental restorations will degrade and eventually fail. For teeth restored with resin composite, the major modes of failure are secondary caries and fracture of the tooth or restoration. While clinical studies can answer some of the more practical questions, such as the rate of failure, fundamental understanding on the failure mechanism can be obtained from laboratory studies using simplified models more effectively. Reviewed in this article are the 4 main types of models used to study the degradation of resin-composite restorations, namely, animal, human in vivo or in situ, in vitro biofilm, and in vitro chemical models. The characteristics, advantages, and disadvantages of these models are discussed and compared. The tooth-restoration interface is widely considered the weakest link in a resin composite restoration. To account for the different types of degradation that can occur (i.e., demineralization, resin hydrolysis, and collagen degradation), enzymes such as esterase and collagenase found in the oral environment are used, in addition to acids, to form biochemical models to test resin-composite restorations in conjunction with mechanical loading. Furthermore, laboratory tests are usually performed in an accelerated manner to save time. It is argued that, for an accelerated multicomponent model to be representative and predictive in terms of both the mode and the speed of degradation, the individual components must be synchronized in their rates of action and be calibrated with clinical data. The process of calibrating the in vitro models against clinical data is briefly described. To achieve representative and predictive in vitro models, more comparative studies of in vivo and in vitro models are required to calibrate the laboratory studies.
Collapse
Affiliation(s)
- A Zhang
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - N Ye
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - W Aregawi
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - L Zhang
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.,The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - M Salah
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.,Faculty of Dentistry, Ain-Shams University, Cairo, Egypt
| | - B VanHeel
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - H P Chew
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| | - A S L Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
21
|
Follak AC, Ilha BD, Oling J, Savian T, Rocha RDO, Soares FZM. Clinical behavior of universal adhesives in non-carious cervical lesions: A randomized clinical trial. J Dent 2021; 113:103747. [PMID: 34273442 DOI: 10.1016/j.jdent.2021.103747] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 06/07/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES This randomized, double-blind clinical trial, , evaluated the behavior of two universal adhesives used in etch-and-rinse (ER) or self-etch (SE) approach in non-carious cervical lesions (NCCLs). METHODS Two hundred and eleven NCCLs were selected in 54 participants and randomly allocated into four experimental groups: Scotchbond Universal Adhesive - SBU (3M Oral Care) and Prime & Bond Elect - PB (Dentsply Sirona) used in ER and SE modes. Two trained operators placed all resin composite restorations (Filtek Z250, 3M Oral Care). Restorations were evaluated at baseline and after 6 months using both FDI and USPHS modified criteria by a blinded calibrated examiner. Kruskal-Wallis and Mann-Whitney U non-parametric tests were used to compare the restoration failures among experimental groups. RESULTS Statistically significant differences were found among groups regarding failures (p=0.000 for both FDI and USPHS criteria). PB-SE presented more failures (p<0.05) than other experimental groups. No significant difference was found between any other pair of groups (p>0.05). CONCLUSIONS The etch and rinse approach affected the clinical performance of Prime and Bond Elect. For this material, the self-etch approach generated lower criteria scores after a six-month follow-up. The bonding strategy did not influence Scotchbond Universal Adhesive clinical performance. (RBR-2GQMVF) CLINICAL SIGNIFICANCE: The clinical behavior of mild universal adhesive Prime & Bond Elect depends on the bonding strategy. The etch-and-rinse approach is recommended for this adhesive system. Scotchbond Universal Adhesive can be used in both bonding strategies without impairing clinical performance.
Collapse
Affiliation(s)
| | - Bruna Dias Ilha
- Postgraduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, Brazil
| | - Julia Oling
- School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Thais Savian
- School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | | |
Collapse
|
22
|
Sato T, Takagaki T, Hatayama T, Nikaido T, Tagami J. Update on Enamel Bonding Strategies. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.666379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Optimal strategies for the application of an adhesive differ between enamel and dentin because of the differences in their composition. The development of adhesive systems has mainly focused on the bonding of dentin, rather than on the enamel, by etching with phosphoric acid (PA). Dental adhesive technologies continue to rapidly advance, and various adhesive systems have been developed since the study of Buonocore in 1955. He introduced the enamel acid-etch technique. Then, the etch-and-rinse (ER) system was developed, and subsequently, the self-etch (SE) system. Universal adhesives are a new generation of one-bottle SE adhesives that can be applied with either ER mode or SE mode, or a combined system involving selective enamel etching mode. Since the combination of PA etching and the SE system differs from conventional ER systems, the enamel bonding strategy should be carefully considered. This concise review of the literature on reliable enamel bonding strategies should prove helpful to clinicians to choose an appropriate adhesive system to achieve optimal clinical outcomes.
Collapse
|
23
|
Adhesive strategies in cervical lesions: systematic review and a network meta-analysis of randomized controlled trials. Clin Oral Investig 2021; 25:2495-2510. [PMID: 33661448 DOI: 10.1007/s00784-021-03844-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 02/16/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES A network meta-analysis (NMA) was performed to assess which adhesive strategy is most clinically effective in treating non-carious cervical lesions (NCCLs). MATERIAL AND METHODS Studies were identified by a systematic search of electronic databases including MEDLINE via PubMed, Brazilian Library in Dentistry (BBO), Cochrane Library, EMBASE, Latin American and Caribbean Health Sciences Literature database (LILACS), Scopus, and Web of Science without restrictions on publication year or language. The grey literature was also consulted. Only randomized clinical trials that compared different adhesive strategies in NCCLs in adult patients were included. The risk of bias was evaluated by using the Cochrane Collaboration tool. A random-effects Bayesian mixed treatment comparison model was used to compare adhesive strategies (3ER, 2ER, 2SE, and 1SE) at different follow-up times. The surface under cumulative ranking curve (SUCRA) was estimated for each strategy. Heterogeneity was assessed by using the Cochran Q test and I2 statistics. The quality of evidence was evaluated using the GRADE approach. RESULTS A total of 5058 studies were identified, 66 of which met the eligibility criteria and of these 5 were judged "low" risk of bias and 57 were meta-analyzed. We did not observe significant differences in the NMA analysis for any two pairs of adhesives, except for the shortest follow-up for 2ER vs 3ER. The material 2SE ranked highest, although it differed only slightly from the other bonding strategies. CONCLUSIONS No bonding strategy is better than the others. CLINICAL RELEVANCE Adhesive efficacy cannot be characterized by its bonding strategy.
Collapse
|
24
|
Şen S, Erber R, Orhan G, Zingler S, Lux CJ. OCT evaluation of orthodontic surface sealants: a 12-month follow-up randomized clinical trial. Clin Oral Investig 2021; 25:1547-1558. [PMID: 32789656 PMCID: PMC7878257 DOI: 10.1007/s00784-020-03462-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/10/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this single-center randomized controlled trial (NCT03753256) was to assess orthodontic surface sealant layer thickness and integrity in vivo during a 12-month follow-up by optical coherence tomography (OCT). MATERIALS AND METHODS Using a split-mouth design, quadrants of 20 patients treated with fixed orthodontic appliances were included. Quadrants were randomly assigned to the sealants Pro Seal® (PS) or Opal® Seal™ (OS). OCT scans were performed immediately after the application of the sealants and after 3, 6, 9, and 12 months. Sealant layer thicknesses and their integrity were determined at 5 regions of interest (ROIs) known for high risks of demineralization. Sealant integrity loss was determined using a self-developed scale. RESULTS A total of 16 patients successfully completed the study. The studied sealants showed significant differences in initial layer thickness. Mean layer thickness was significantly lower for PS (67.8 μm, (95% CI, 56.1-79.5)) than for OS (110.7 μm, (95% CI, 97.3-124.1)). Layer thickness loss was significant after 3 months for PS and after 6 months for OS. Sealant integrity was compromised in more than 50% of the ROIs already after 3 months for both sealants. CONCLUSIONS Patients treated with fixed orthodontic surface sealants lost the integrity of the protective layer in more than 50% of cases after 3 months, and the layer thickness of the sealants was significantly reduced after 3-6 months. CLINICAL RELEVANCE The protective effect against demineralization lesions of orthodontic sealants in patients treated with fixed appliances appears to be limited in time. Further preventive measures should be investigated. TRIAL REGISTRATION ClinicalTrials.gov (NCT03753256).
Collapse
Affiliation(s)
- Sinan Şen
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
| | - Ralf Erber
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Gül Orhan
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| |
Collapse
|
25
|
Bakhsh TA. Optical comparison between micro-CT and OCT in imaging of marginal composite adaptation: Observational study. J Microsc 2021; 282:136-145. [PMID: 33236773 DOI: 10.1111/jmi.12988] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 10/17/2020] [Accepted: 11/22/2020] [Indexed: 11/30/2022]
Abstract
Dental composite is the most used aesthetic restorative biomaterial worldwide. However, it undergoes polymerisation shrinkage that could lead to loss of the interfacial seal between tooth and resin in some circumstances. This demands high-resolution imaging technologies to detect these defects. This study carried out a comparison between microcomputed tomography (micro-CT; Shimadzu, Japan) and swept-source optical coherence tomography (SS-OCT; Santec, Japan) in the detection of marginal adaptation defects at the tooth-resin interface. Unlike in micro-CT, it was possible to outline interfacial gaps along with tooth-resin interfaces with SS-OCT, which was attributed to the Fresnel diffraction of light. This in vitro comparison demonstrates SS-OCT has great potential in dental imaging to effectively assess dental composite adaptation and marginal defects when high resolution is desired in real time. LAY DESCRIPTION: Detection of tooth-colored restoration defects had been assessed by different radiographic methods. However, most of these methods are either invasive or suffer from low-resolution. In this study, a comparison has been carried out between two different high-resolution imaging systems; microcomputed tomography and optical coherence tomography, to explore their potentials in detecting restorations defects. The results showed optical coherence tomography has a great accuracy in locating the underlying defects when the obtained images were validated against confocal laser scanning microscopy images.
Collapse
Affiliation(s)
- Turki A Bakhsh
- Faculty of Dentistry, Restorative Dentistry Department, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Restorative Sciences, Cariology and Operative Dentistry, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
26
|
Haak R, Siegner J, Ziebolz D, Blunck U, Fischer S, Hajtó J, Frankenberger R, Krause F, Schneider H. OCT evaluation of the internal adaptation of ceramic veneers depending on preparation design and ceramic thickness. Dent Mater 2020; 37:423-431. [PMID: 33288325 DOI: 10.1016/j.dental.2020.11.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/19/2020] [Accepted: 11/27/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES In-vitro evaluation of the influence of preparation design and thickness of ceramic veneers on the interfacial bond using optical coherence tomography (OCT). METHODS Sixty-four central incisors were randomly assigned to four preparation designs differing from no to complete dentine exposure (n = 16 each): non-prep (NP), minimal-invasive (MI, no dentine exposure), semi-invasive (SI, 50% dentine) and invasive (I, 100% dentine). Ceramic veneers (IPS InLine Veneer) of two thicknesses (0.2-0.5 mm (T1) and > 0.5-1.2 mm (T2)) were etched, silanized, and adhesively luted (Optibond FL, Variolink Veneer). After water storage (37 °C, 21d), thermocycling (2000 cycles, 5°-55 °C), and mechanical loading (2 + 1 million cycles, 50 + 100 N) specimens were imaged by spectral-domain OCT (Telesto II, Thorlabs). Adhesive defects at the ceramic-composite and tooth-composite interfaces were quantified on 35 equidistantly distributed OCT B-scans (length, %). Statistical differences were verified with Wilcoxon-/Mann-Whitney-U-test (α = 0.05). RESULTS Adhesive defects appeared in all groups at both interfaces, albeit to differing extents (0.1 - 31.7%). NP and MI veneers showed no significant differences at the interfaces (pi > 0.05). In groups, SI and I, significantly more adhesive defects appeared at the tooth-composite compared to the veneer-composite interface (pi ≤ 0.039). The following preparation designs and veneer thicknesses showed differences (pi ≤ 0.021): Veneer-composite: NP-T1 < I-T1, MI-T1 < I-T1, I-T1 > I-T2; Tooth-composite: NP-T1 < SI-T1, NP-T1 < I-T1, NP-T2 > MI-T2, MI-T1 < SI-T1, MI-T1 < I-T1, SI-T1 < I-T1, MI-T2 < SI-T2, MI-T2 < I-T2. SIGNIFICANCE The interface adhesion of ceramic veneers was influenced by the preparation design and the veneer thickness. A ceramic thickness of at least 0.5 mm and a preparation without exposing dentine is advantageous for the interfacial bond.
Collapse
Affiliation(s)
- Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| | - Juliane Siegner
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| | - Uwe Blunck
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Aßmannshauser Str. 6, 14197 Berlin, Germany.
| | - Sabine Fischer
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany
| | - Jan Hajtó
- Private practice, Brienner Str. 7, 80333 Munich, Germany.
| | - Roland Frankenberger
- Department of Operative Dentistry, Endodontics, and Pediatric Dentistry, Medical Center for Dentistry, University Medical Center Giessen and Marburg, Campus Marburg, Georg-Voigt-Str. 3, 35039 Marburg, Germany.
| | - Felix Krause
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| | - Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr. 12, 04103 Leipzig, Germany.
| |
Collapse
|
27
|
Won J, Huang PC, Spillman DR, Chaney EJ, Adam R, Klukowska M, Barkalifa R, Boppart SA. Handheld optical coherence tomography for clinical assessment of dental plaque and gingiva. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200255R. [PMID: 33244918 PMCID: PMC7690845 DOI: 10.1117/1.jbo.25.11.116011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/30/2020] [Indexed: 05/04/2023]
Abstract
SIGNIFICANCE Optical coherence tomography (OCT) offers high spatial resolution and contrast for imaging intraoral structures, yet few studies have investigated its clinical feasibility for dental plaque and gingiva imaging in vivo. Furthermore, the accessibility is often limited to anterior teeth due to bulky imaging systems and probes. AIM A custom-designed, handheld probe-based, spectral-domain OCT system with an interchangeable attachment was developed to assess dental plaque and gingival health in a clinical setting. APPROACH Healthy volunteers and subjects with gingivitis and sufficient plaque were recruited. The handheld OCT system was operated by trained dental hygienists to acquire images of dental plaque and gingiva at various locations and after one-week use of oral hygiene products. RESULTS The handheld OCT can access premolars, first molars, and lingual sides of teeth to visualize the plaque distribution. OCT intensity-based texture analysis revealed lower intensity from selected sites in subjects with gingivitis. The distribution of the dental plaque after one-week use of the oral hygiene products was compared, showing the capability of OCT as a longitudinal tracking tool. CONCLUSIONS OCT has a strong potential to display and assess dental plaque and gingiva in a clinical setting. Meanwhile, technological challenges remain to perform systematic longitudinal tracking and comparative analyses.
Collapse
Affiliation(s)
- Jungeun Won
- University of Illinois Urbana–Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois Urbana–Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Pin-Chieh Huang
- University of Illinois Urbana–Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois Urbana–Champaign, Department of Bioengineering, Urbana, Illinois, United States
| | - Darold R. Spillman
- University of Illinois Urbana–Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Eric J. Chaney
- University of Illinois Urbana–Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Ralf Adam
- Procter & Gamble Company, Clinical Operations, German Innovation Center, Kronberg, Germany
| | - Malgorzata Klukowska
- Procter & Gamble Company, Oral Health Science Center, Mason, Ohio, United States
| | - Ronit Barkalifa
- University of Illinois Urbana–Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
| | - Stephen A. Boppart
- University of Illinois Urbana–Champaign, Beckman Institute for Advanced Science and Technology, Urbana, Illinois, United States
- University of Illinois Urbana–Champaign, Department of Bioengineering, Urbana, Illinois, United States
- University of Illinois Urbana–Champaign, Department of Electrical and Computer Engineering, Urbana, Illinois, United States
- University of Illinois Urbana–Champaign, Carle Illinois College of Medicine Champaign, Illinois, United States
- Address correspondence to Stephen A. Boppart,
| |
Collapse
|
28
|
Diagnosis of Occlusal Tooth Wear Using 3D Imaging of Optical Coherence Tomography Ex Vivo. SENSORS 2020; 20:s20216016. [PMID: 33113981 PMCID: PMC7660331 DOI: 10.3390/s20216016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/09/2020] [Accepted: 10/21/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study was to assess the utility of 3D imaging of optical coherence tomography (OCT) for the diagnosis of occlusal tooth wear ex vivo. Sixty-three extracted human molars with or without visible tooth wear were collected to take digital intraoral radiography and 3D OCT images. The degree of tooth wear was evaluated by 12 examiners and scored using 4-rank scale: 1-slight enamel wear; 2-distinct enamel wear; 3-tooth wear with slight dentin exposure; 4-tooth wear with distinct involvement of dentin. The degree of tooth wear was validated by the histological view of confocal laser scanning microscopy (CLSM). The sensitivity, specificity, and area under the curve (AUC) of receiver operating characteristic analysis were calculated. Diagnostic accuracy was compared with the agreement with CLSM observation using weighted kappa. The results were statistically analyzed at a significance level of α = 0.05. Three-dimensional OCT showed significantly higher sensitivity (p < 0.05) for all the diagnostic thresholds of enamel wear and dentin exposure than digital radiography (0.82, 0.85, and 0.79 vs. 0.56, 0.52, and 0.57, respectively). Three-dimensional OCT showed higher AUC and kappa coefficients than digital radiography (p < 0.05), where mean AUC and Kappa values were 0.95 and 0.76 for OCT and 0.92 and 0.47 for radiography, respectively. No significant difference of specificity was observed (p > 0.05). Three-dimensional OCT could visualize and estimate the degree of tooth wear and detect the dentin exposure at the tooth wear surface accurately and reproducibly. Consequently, a new guideline for tooth wear assessment can be proposed using OCT.
Collapse
|
29
|
Schneider H, Ahrens M, Strumpski M, Rüger C, Häfer M, Hüttmann G, Theisen-Kunde D, Schulz-Hildebrandt H, Haak R. An Intraoral OCT Probe to Enhanced Detection of Approximal Carious Lesions and Assessment of Restorations. J Clin Med 2020; 9:jcm9103257. [PMID: 33053724 PMCID: PMC7600310 DOI: 10.3390/jcm9103257] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/18/2022] Open
Abstract
Caries, the world's most common chronic disease, remains a major cause of invasive restorative dental treatment. To take advantage of the diagnostic potential of optical coherence tomography (OCT) in contemporary dental prevention and treatment, an intraorally applicable spectral-domain OCT probe has been developed based on an OCT hand-held scanner equipped with a rigid 90°-optics endoscope. The probe was verified in vitro. In vivo, all tooth surfaces could be imaged with the OCT probe, except the vestibular surfaces of third molars and the proximal surface sections of molars within a "blind spot" at a distance greater than 2.5 mm from the tooth surface. Proximal surfaces of 64 posterior teeth of four volunteers were assessed by intraoral OCT, visual-tactile inspection, bitewing radiography and fiber-optic transillumination. The agreement in detecting healthy and carious surfaces varied greatly between OCT and established methods (18.2-94.7%), whereby the established methods could always be supplemented by OCT. Direct and indirect composite and ceramic restorations with inherent imperfections and failures of the tooth-restoration bond were imaged and qualitatively evaluated. The intraoral OCT probe proved to be a powerful technological approach for the non-invasive imaging of healthy and carious hard tooth tissues and gingiva as well as tooth-colored restorations.
Collapse
Affiliation(s)
- Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (M.S.); (C.R.); (M.H.); (R.H.)
- Correspondence: ; Tel.: +49-341-97-212-63; Fax: +49-341-97-212-19
| | - Martin Ahrens
- Institut für Biomedizinische Optik, Universität zu Lübeck, 23562 Lübeck, Germany; (M.A.); (G.H.); (H.S.-H.)
- Medizinisches Laserzentrum Lübeck GmbH, 23562 Lübeck, Germany;
| | - Michaela Strumpski
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (M.S.); (C.R.); (M.H.); (R.H.)
| | - Claudia Rüger
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (M.S.); (C.R.); (M.H.); (R.H.)
| | - Matthias Häfer
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (M.S.); (C.R.); (M.H.); (R.H.)
| | - Gereon Hüttmann
- Institut für Biomedizinische Optik, Universität zu Lübeck, 23562 Lübeck, Germany; (M.A.); (G.H.); (H.S.-H.)
- Medizinisches Laserzentrum Lübeck GmbH, 23562 Lübeck, Germany;
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23562 Lübeck, Germany
| | | | - Hinnerk Schulz-Hildebrandt
- Institut für Biomedizinische Optik, Universität zu Lübeck, 23562 Lübeck, Germany; (M.A.); (G.H.); (H.S.-H.)
- Medizinisches Laserzentrum Lübeck GmbH, 23562 Lübeck, Germany;
- Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23562 Lübeck, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, 04103 Leipzig, Germany; (M.S.); (C.R.); (M.H.); (R.H.)
| |
Collapse
|
30
|
Shimada Y, Yoshiyama M, Tagami J, Sumi Y. Evaluation of dental caries, tooth crack, and age-related changes in tooth structure using optical coherence tomography. JAPANESE DENTAL SCIENCE REVIEW 2020; 56:109-118. [PMID: 33033549 PMCID: PMC7533308 DOI: 10.1016/j.jdsr.2020.08.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/07/2020] [Accepted: 08/22/2020] [Indexed: 11/27/2022] Open
Abstract
Optical coherence tomography (OCT) is an imaging technique that can visualize the internal biological structure without X-ray exposure. Swept-source OCT (SS-OCT) is one of the latest version of OCT, wherein the light source is a tunable laser that sweeps near-infrared wavelength light to achieve real-time imaging. The imaging depth of OCT is highly influenced by the translucency of the medium. The medium that does not transmit light and the deeper structure beyond the range of light penetration depth are not relevant for OCT imaging. In OCT, sound enamel is almost transparent at the OCT wavelength range, and enamel and dentin can be distinguished from each other as the dentin-enamel junction (DEJ) appears as a dark border. Demineralized enamel and dentin are imaged as bright zones because of the formation of numerous micro-porosities where the backscatter of OCT signal is increased. In cavitated caries at interproximal or occlusal hidden zone, the upper margin of the cavity reflects the signal showing a distinct bright border in the SS-OCT image. SS-OCT is capable of determining crack penetration depth even when the cracks extended beyond the DEJ. SS-OCT has a high degree of sensitivity and specificity for the detection of dental caries and tooth cracks. SS-OCT is also capable of detecting non-carious cervical lesions and occlusal tooth wear in cross-sectional views to estimate the amount of tooth structure loss.
Collapse
Affiliation(s)
- Yasushi Shimada
- Department of Operative Dentistry, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Japan.,Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masahiro Yoshiyama
- Department of Operative Dentistry, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Japan
| | - Junji Tagami
- Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasunori Sumi
- Department for Advanced Dental Research, Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
31
|
3D imaging of proximal caries in posterior teeth using optical coherence tomography. Sci Rep 2020; 10:15754. [PMID: 32978464 PMCID: PMC7519687 DOI: 10.1038/s41598-020-72838-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/07/2020] [Indexed: 11/08/2022] Open
Abstract
Optical coherence tomography (OCT) can create cross-sectional images of tooth without X-ray exposure. This study aimed to investigate the diagnostic accuracy of 3D imaging of OCT for proximal caries in posterior teeth. Thirty-six human molar teeth with 51 proximal surfaces visibly 6 intact, 16 slightly demineralized, and 29 distinct carious changes were mounted to take digital radiographs and 3D OCT images. The sensitivity, specificity and area under the receiver operating characteristic curve (AUC) for the diagnosis of enamel caries and dentin caries were calculated to quantify the diagnostic ability of 3D OCT in comparison with digital radiography. Diagnostic accuracy was evaluated by the agreement with histology using weighted Kappa. OCT showed significantly higher sensitivity, AUC and Kappa values than radiography. OCT can be a safer option for the diagnosis of proximal caries in posterior teeth that can be applied to the patients without X-ray exposure.
Collapse
|
32
|
Scholz KJ, Hinderberger M, Widbiller M, Federlin M, Hiller KA, Buchalla W. Influence of selective caries excavation on marginal penetration of class II composite restorations in vitro. Eur J Oral Sci 2020; 128:405-414. [PMID: 32749026 DOI: 10.1111/eos.12726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2020] [Indexed: 11/29/2022]
Abstract
Selective caries excavation may support pulp preservation. This in vitro study investigated the influence of selective removal of demineralized dentin on marginal integrity of composite restorations as determined by dye penetration. Dentinal caries-like lesions were produced in the approximal surfaces of 40 extracted human molars (ethylenediaminetetraacetate, 0.5 M, 96 h). The following test procedures were established: complete excavation, selective excavation, and caries-free control. Two class II cavities with enamel at the cervical margins were prepared per tooth and demineralization volume was determined by micro-computed tomography for the purpose of a stratified distribution to receive complete excavation or selective excavation. After complete or selective excavation (30 cavities each), adhesive composite restorations were placed. Cavities without demineralized dentin (20 cavities) served as control. The marginal integrity of restorations was evaluated by dye penetration with and without thermocycling or mechanical loading. Results were analyzed by non-parametrical statistical tests (Mann-Whitney U Test) with an α = 0.05 level of significance. Dye penetration did not differ significantly among completely excavated, selectively excavated, or undemineralized teeth, but was increased by thermocycling and mechanical loading in all experimental groups. Selective caries removal did not increase marginal penetration in class II restorations. The presence of remaining demineralized dentin surrounded by sound dentin did not impair marginal integrity of restorations with margins placed in sound enamel.
Collapse
Affiliation(s)
- Konstantin J Scholz
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Michael Hinderberger
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Marianne Federlin
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany
| |
Collapse
|
33
|
Park KJ, Pfeffer M, Näke T, Schneider H, Ziebolz D, Haak R. Evaluation of low-viscosity bulk-fill composites regarding marginal and internal adaptation. Odontology 2020; 109:139-148. [PMID: 32519114 PMCID: PMC8526473 DOI: 10.1007/s10266-020-00531-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 06/02/2020] [Indexed: 11/11/2022]
Abstract
This study aimed at evaluating the marginal and internal adaptation of low-viscosity bulk-fill composites to enamel and dentin using a self-etch or an etch-and-rinse adhesive without and with artificial ageing. Hundred and twenty-eight MOD cavities in extracted molars were assigned to eight groups (n = 16), restored with the adhesives OptiBond FL (OFL) or Xeno V+ (X) and two low-viscosity bulk-fill composites SDR or x-tra base, covered with Premise. Tetric EvoCeram Bulk Fill and Premise served as a control. n = 8 per group were subjected to prolonged water storage (180 days) and thermocycling (2500×). Scanning electron microscopy was used to determine marginal gaps (MG) and interfacial adhesive defects (IAD). There were no significant differences between composite types in 44 out of 48 (MG) or 43/48 (IAD) comparisons. More MG were observed with X than with OFL (14 out of 16 comparisons, two significant), while in 16 of 16 comparisons with X more IAD were observed (14 significant). After artificial ageing, MG generally increased (9/16 significant), compared to IAD (one significant). The performance of the investigated composite types concerning the integrity of the tooth-composites interface was comparable. Compared to the 1-step self-etch system, the bond with the 3-step etch-and-rinse adhesive was raised.
Collapse
Affiliation(s)
- Kyung-Jin Park
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr.12, 04103, Leipzig, Germany.
| | - Manon Pfeffer
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr.12, 04103, Leipzig, Germany
| | - Thomas Näke
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr.12, 04103, Leipzig, Germany
| | - Hartmut Schneider
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr.12, 04103, Leipzig, Germany
| | - Dirk Ziebolz
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr.12, 04103, Leipzig, Germany
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University of Leipzig, Liebigstr.12, 04103, Leipzig, Germany
| |
Collapse
|