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Zhu J, Zhu L, Deng X, Ma L, Jin C, Huang C. Evaluation of direct restorations for pit-and-fissure caries using stamp combined with single-shade composite resin technique: A 12-month follow-up in vivo study. J Dent 2024; 149:105277. [PMID: 39089667 DOI: 10.1016/j.jdent.2024.105277] [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: 06/10/2024] [Revised: 07/28/2024] [Accepted: 07/29/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVES To evaluate the clinical performance of direct restorations for pit-and-fissure caries in molars using stamp combined with single-shade composite resin (S/SCR) technique, and assess the effect of the number of stamp pressing on the trueness of S/SCR technique. METHODS Twenty molars of fifteen patients with pit-and-fissure caries but with an intact or micro-cavitated occlusal morphology were restored using S/SCR technique and were randomly divided into single pressing group (n = 10) and double pressing group (n = 10). Intraoral scans were obtained before treatment (scan 1), after filling (scan 2) and after polishing (scan 3). Deviation distribution maps of pairwise fitting were created including comparison 1 (scan1/scan 2), comparison 2 (scan1/scan 3), and comparison 3 (scan2/scan 3) using Geomagic Control X software. Root mean square (RMS) values were calculated to evaluate the trueness of restorations. Clinical performances including esthetic, functional, and biological properties of all restorations were evaluated according to FDI criteria after a 12-month follow-up. Analysis of variance, independent-samples T test and Wilcoxon rank-sum test were used for statistical analysis (α=0.05). RESULTS RMS values for comparison 1, comparison 2, and comparison 3 were 0.1243 ± 0.0151, 0.0966 ± 0.0136, and 0.0605 ± 0.0137 mm in single pressing group, while 0.0831 ± 0.0140, 0.0741 ± 0.0107, and 0.0475 ± 0.0099 mm in double pressing group, respectively. RMS value of single pressing group was higher than that of double pressing group in the same comparison (p ≤ 0.001). No statistically significant differences were observed between the two groups regarding esthetic, functional and biological properties (p > 0.05). For all properties, all restorations scored within 3, with over 80% scoring 1. CONCLUSION S/SCR technique presents satisfying clinical performances for pit-and-fissure caries in molars after a 12-month follow-up. Besides, double pressing can improve the trueness of restorations compared to single pressing. CLINICAL SIGNIFICANCE S/SCR technique is efficient in direct composite resin restoration for pit-and-fissure caries, with satisfying esthetic, functional and biological properties after a 12-month follow-up. Significantly, double pressing improves the trueness of S/SCR technique, reducing the need for occlusion adjustment.
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Affiliation(s)
- Jiakang Zhu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei 430079, China
| | - Lichan Zhu
- Department of Prosthodontics, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei 430079, China
| | - Xianfeng Deng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei 430079, China
| | - Liya Ma
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei 430079, China
| | - Chunxiao Jin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei 430079, China
| | - Cui Huang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, #237 Luoyu Road, Hongshan District, Wuhan, Hubei 430079, China.
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Campbell F, Goldsmith R, Rogers H. Are we practising what we preach and are we all singing from the same hymn sheet? An exploration of teaching in paediatric caries management across UK dental schools. Int J Paediatr Dent 2024. [PMID: 38590044 DOI: 10.1111/ipd.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 12/17/2023] [Accepted: 02/07/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND The evidence underpinning caries management for children has progressed dramatically over the past 20 years. Anecdotally, this is not reflected in the teaching provided to undergraduate dental students, with the ongoing teaching of outdated methods within some dental schools. AIM To capture the current undergraduate teaching provision and clinical treatment experience requirement relative to caries management in paediatric dentistry in UK dental schools. DESIGN Cross-sectional analysis of current teaching methods on paediatric caries management was obtained using a piloted online data collection form. Question content included current caries teaching methods, assessment of student exposure and competence. The results were analysed descriptively. RESULTS Of the 16 UK dental schools, 14 participated. Discrepancy in teaching content was apparent. Many schools (n = 9) taught biological caries management through therapeutic fissure sealants, yet this was not reflected in assessment and clinical requirements. Some schools (n = 4) taught amalgam placement in children, and most (n = 12) operatively taught treatments that would no longer be routinely provided in general dental practice in the UK, including primary tooth pulpotomy. CONCLUSION There is substantial variation in the paediatric caries management techniques that are taught across UK dental schools, demonstrating a need for a national consensus to address these disparities.
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Affiliation(s)
- Faith Campbell
- School of Dentistry, University of Dundee, Dundee, UK
- Glasgow Dental Hospital and School, Glasgow, UK
| | | | - Helen Rogers
- School of Dental Sciences, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Erkan D, Buedel SK, Soto-Rojas AE, Ungar PS, Eckert GJ, Stewart KT, Hara AT. Objective characterization of dental occlusal and fissure morphologies: Method development and exploratory analysis. Arch Oral Biol 2023; 147:105623. [PMID: 36657276 DOI: 10.1016/j.archoralbio.2023.105623] [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: 09/13/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To develop clinically applicable methods to characterize occlusal topography and assess possible associations between morphology and caries incidence and development. DESIGN In this retrospective clinical study, we evaluated caries presence and severity pre- and post-orthodontic treatment for first molars of 147 patients (384 teeth). These teeth were previously scanned using a clinical intraoral scanner, and the obtained digital elevation models were used to 1) analyze the 3D occlusal surface parameters (n = 384) and 2) quantitatively characterize the mandibular molars' (n = 166) fissure patterns using three novel methods. Pearson correlation coefficients were calculated to evaluate the associations among the measurements, and presence/severity of caries pre- and post-treatment were assessed using generalized linear mixed-effects models. RESULTS Robust quantitative fissure characterizations were developed, and reliable occlusal surface parameters were obtained. In the studied population, none of the parametric measurements (Slope: p = 0.62 for presence, p = 0.96 for severity; Relief Index (RFI): p = 0.36, p = 0.84; Orientation Patch Count rotated (OPCr): p = 0.48, p = 0.13; Dirichlet Normal Energy (DNE): p = 0.91, p = 0.15) or the fissure morphological measurements (Mesial Angle: p = 0.43; Distal Angle: p = 0.86; Average Angle: p = 0.52; Area Difference: p = 0.83; Percent Fissure: p = 0.68) were found to be significantly associated with caries status or severity. CONCLUSION Despite the lack of correlation in the limited studied sample, the tools developed to characterize occlusal surface topography and fissure morphology have the potential to be used in more comprehensive clinical evaluations.
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Affiliation(s)
- Duru Erkan
- University of Arkansas, Department of Biology, Fayetteville, AR, USA.
| | - Sarah K Buedel
- Indiana University School of Dentistry, Department of Orthodontics, Indianapolis, IN, USA.
| | - Armando E Soto-Rojas
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA.
| | - Peter S Ungar
- Department of Anthropology, University of Arkansas, Fayetteville, AR, USA.
| | - George J Eckert
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Kelton T Stewart
- Department of Orthodontics and Oral Facial Genetics, Indiana University School of Dentistry, Indianapolis, IN, USA.
| | - Anderson T Hara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, IN, USA.
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Dental Caries and Its Management. Int J Dent 2023; 2023:9365845. [PMID: 36636170 PMCID: PMC9831703 DOI: 10.1155/2023/9365845] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/03/2022] [Accepted: 12/10/2022] [Indexed: 01/05/2023] Open
Abstract
Objectives In recent years, the management of dental caries has evolved significantly. Caries prevention, early detection, and a diagnosis based on risk indicators and risk factor assessments are the most current practical approaches. Furthermore, as proposed in minimally invasive dentistry, the new management approaches preserve healthy tissue and maintain pulp vitality. This article overviews the latest minimally invasive dental caries management and treatment options. The information will assist the reader in the early detection, diagnosis, and treatment of dental caries. Materials and Methods The PubMed (MEDLINE) search engine was used to gather the most relevant information on dental caries. The search was restricted to five years (May 30, 2018-May 29, 2022), and only English-language studies were accessed. A Boolean search of the PubMed data set was implemented to combine a range of keywords. The following filters were applied: abstract, free full text, full text, clinical trial, randomised control trial, systematic review, meta-analysis, and review. More studies were also obtained by manual searches from Google Scholar and textbooks on dental caries. Results By using this process, 683 articles and studies were obtained. The most relevant published studies were chosen and used in the current review. The selected articles are included in the references list. However, the search extended to cover the last five years as our understanding and management of dental caries have changed significantly. Conclusions Early detection and diagnosis of caries based on risk indicators and risk factor assessments are effective. Furthermore, minimally invasive restorative techniques are beneficial in managing dental caries and preserving healthy tissue and should be used whenever possible. This new information, knowledge, and materials should encourage professionals to implement this method. Having a strategy and system based on patient-centred care is critical, and our dental responsibilities must prioritise patient-centred care.
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Dhanavel C, Sai CK, Neelamurthy PS, Raja SV, Vigneshwari SK, Gokulapriyan K, Usha C. Evaluation of Reliability and Validity of Occlusal Caries Detection by Direct Visual, Indirect Visual and Fluorescence Camera Using ICDAS II (Codes 0, 1, and 2): An In Vivo Study. Int J Clin Pediatr Dent 2023; 16:74-78. [PMID: 37020755 PMCID: PMC10067987 DOI: 10.5005/jp-journals-10005-2513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Introduction Early detection of carious lesions paves the way for the preservation of tooth structures by remineralization strategies. Visual examination using international caries detection and assessment system (ICDAS) II has been validated with the gold standard of histological classification. A fluorescence camera is yet another diagnostic aid for the early detection of carious lesions based on the autofluorescence of the enamel and dentin. This study was done to evaluate the validity of the fluorescence camera (Soprocare and Acteone) in detecting early carious lesions. Materials and methods A total of 690 occlusal surfaces of non-cavitated premolars and molars were examined by examiners 1 and 2, trained in the ICDAS II grading system. The photographs of the occlusal surface and the fluorescence images, which were taken using a Soprocare (Acetone) intraoral camera, were examined by examiners 3 and 4. The scoring was tabulated and correlated. Results The κ values for interexaminer reproducibility of indirect visual was 0.841 (good), and his fluorescence camera was 1.00, which is very good. The correlation analysis revealed that there was a higher correlation between direct visual and indirect visual for both examiners when compared to direct and fluorescence cameras. There was a positive relationship between indirect visual and fluorescence cameras for both the experimenter). The indirect visual method for the detection of carries has high sensitivity and specificity irrespective of the examiner. Examination by fluorescence camera has a low sensitivity and high specificity. Conclusion The specificity of the caries detection method by indirect visual examination based on ICDAS II coding that of the Soprocare fluorescence camera was consistent and reliable, whereas indirect visual examination had a high sensitivity for detecting ICDAS codes 1 and 2. Soprocare showed a very low sensitivity in detecting ICDAS code 1 and 2 lesions. How to cite this article Dhanavel C, Sai CK, Neelamurthy PS, et al. Evaluation of Reliability and Validity of Occlusal Caries Detection by Direct Visual, Indirect Visual and Fluorescence Camera Using ICDAS II (Codes 0, 1, and 2): An In Vivo Study. Int J Clin Pediatr Dent 2023;16(1):74-78.
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Affiliation(s)
- Chakravarthy Dhanavel
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - Chandana K Sai
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - Padmaraj S Neelamurthy
- Department of Conservative Dentistry and Endodontics, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India
| | - S Vijaya Raja
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - SK Vigneshwari
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Institute of Dental Sciences, Puducherry, India
| | - Karuppiah Gokulapriyan
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Carounanidy Usha
- Department of Conservative Dentistry and Endodontics, Indira Gandhi Institute of Dental Sciences, Puducherry, India
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Deep Learning for Caries Detection: A Systematic Review. J Dent 2022; 122:104115. [DOI: 10.1016/j.jdent.2022.104115] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 12/21/2022] Open
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Raja A, White DA, Kerr SE, Dietrich T. Providing sealants at the general anaesthetic assessment visit for children requiring caries-related dental extractions under general anaesthetic: a pilot randomised controlled trial. Br Dent J 2021:10.1038/s41415-021-3220-8. [PMID: 34381177 DOI: 10.1038/s41415-021-3220-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 11/02/2020] [Indexed: 11/08/2022]
Abstract
Introduction Children experiencing a caries-related dental general anaesthetic (GA) are at high risk of developing new caries. It is thus important to maximise opportunities for prevention.Aim To undertake a pilot randomised controlled clinical trial (RCT) to assess the feasibility of delivering and evaluating the effectiveness of sealing sound permanent molars at the pre-GA assessment appointment in children needing caries-related extractions under GA.Methods Children (5-15 years) scheduled for GA extractions at Birmingham Dental Hospital were randomised to control or sealant groups. At the pre-GA assessment appointment, sound permanent molars were sealed. Participants were followed up at two years.Results In total, 132 children were assessed for eligibility and 100 randomised (50 control, 50 sealant). Forty-nine children in the intervention group had sealants applied. At two years, 82 children returned for follow-up (43 control, 39 sealant). Sealants were retained on 93.5% (244/261) of surfaces sealed at baseline. Overall, 42% (n = 18) of control group participants had dentine caries in at least one permanent molar that was sound at baseline compared with none in the sealant group.Conclusion Following caries-related extractions under GA, children are at high risk of developing new caries in permanent molars that were sound at the time of the GA. Sealant placement during the pre-GA assessment visit is feasible and may reduce caries incidence in this vulnerable group. High-risk families were found to be reliable study participants.
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Affiliation(s)
- Abida Raja
- Clinical Lecturer in Paediatric Dentistry, School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK.
| | - Deborah Anne White
- Emeritus Professor of Dental Public Health, School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK
| | - Sally Elizabeth Kerr
- Associate Specialist in Oral Surgery, Birmingham Dental Hospital, Birmingham Community Healthcare NHS Foundation Trust, 5 Mill Pool Way, Birmingham, B5 7EG, UK
| | - Thomas Dietrich
- Professor and Head of Oral Surgery, School of Dentistry, University of Birmingham, 5 Mill Pool Way, Edgbaston, Birmingham, B5 7EG, UK
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Jaafar N, Ragab H, Abedrahman A, Osman E. Performance of fissure sealants on fully erupted permanent molars with incipient carious lesions: A glass-ionomer-based versus a resin-based sealant. J Dent Res Dent Clin Dent Prospects 2020; 14:61-67. [PMID: 32454960 PMCID: PMC7235696 DOI: 10.34172/joddd.2020.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background. The effectiveness of fissure sealants in caries prevention depends on their long-term retention and ability to stop caries progression. This randomized controlled clinical trial compared the retention rate and cariostatic properties of a contemporary glass-ionomer-based sealant (GIS) versus a resin-based sealant (RS) placed on fully erupted permanent molars in a split-mouth design. Methods. The sealants were placed on fully erupted permanent teeth (8‒12 years of age) in 45 children. The evaluation was conducted after one week and three and six months. Results. There was a statistically significant difference in the retention rate and caries transition between the two groups over a six-month clinical evaluation period. The resin-based sealant group showed a better retention rate than the GIS group (75.56% and 48.88%, respectively). The resin-based sealant was superior to GIS in preventing caries progression. Conclusion. Resin-based fissure sealant with fluoride releasing properties might be preferable in preventing caries progression of incipient non-cavitated carious lesions in fully-erupted teeth.
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Affiliation(s)
- Nada Jaafar
- Department of Pediatric Dentistry, Faculty of Dentistry, Beirut Arab University, Lebanon
| | - Hala Ragab
- Department of Operative and Esthetic Dentistry, Faculty of Dentistry, Beirut Arab University, Lebanon
| | - Ahmed Abedrahman
- Department of Pediatric Dentistry and Dental Public Health, Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Egypt
| | - Essam Osman
- Department of Dental Materials, Faculty of Dentistry, Beirut Arab University, Lebanon
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Khattak MI, Csikar J, Vinall K, Douglas G. The views and experiences of general dental practitioners (GDP's) in West Yorkshire who used the International Caries Detection and Assessment System (ICDAS) in research. PLoS One 2019; 14:e0223376. [PMID: 31584966 PMCID: PMC6777823 DOI: 10.1371/journal.pone.0223376] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 09/19/2019] [Indexed: 11/19/2022] Open
Abstract
Objective To explore, through face to face interviews with a selection of General Dental Practitioners (GDPs), their views and experiences of having used the International Caries Detection and Assessment System (ICDAS) within primary care research studies for recording caries. Methods This qualitative study involved one on one interviews with eight GDP’s who had previously used ICDAS on patients in their dental practices as part of a research study. The participants were selected from among those who had taken part in two clinical studies in the UK using convenient, but purposive sampling. The interviews were tape-recorded and transcribed; the data analysis was conducted by thematic analysis. Results GDP’s indicated their beliefs that ICDAS had an important role in caries prevention but reported four main barriers while using the full (6 caries stages) ICDAS coding system in their practices: lack of simplicity of coding, financial implications and time consumption (in both training and use of ICDAS) and inadequate undergraduate training. An overarching theme identified from the GDPS was the willingness to offer potential solutions to their barriers which might improve the utilisation of the system in primary care. Conclusion The GDPs experienced common obstacles in using ICDAS in the primary care setting, many of which have relatively straight-forward solutions which they put forward themselves such as: incentivisation, undergraduate-level training in ICDAS for both dentists and nurses and computerized data entry. Further qualitative and quantitative research is needed on how to facilitate the utilisation of the system in dental practice. It is also recommended to explore the influences of wider agencies on influencing primary dental care professionals’ caries management, including appropriate recording of diagnosis and risk assessment.
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Affiliation(s)
- Maria Ishaq Khattak
- School of Dentistry, University of Leeds, Leeds, United Kingdom
- Institute of Public Health & Social Sciences, Khyber Medical University, Khyber Pakhtunkhwa, Peshawar, Pakistan
- * E-mail:
| | - Julia Csikar
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Karen Vinall
- School of Dentistry, University of Leeds, Leeds, United Kingdom
| | - Gail Douglas
- School of Dentistry, University of Leeds, Leeds, United Kingdom
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Subka S, Rodd H, Nugent Z, Deery C. In vivo validity of proximal caries detection in primary teeth, with histological validation. Int J Paediatr Dent 2019; 29:429-438. [PMID: 30735588 DOI: 10.1111/ipd.12478] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 01/31/2019] [Accepted: 02/04/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND Detection and diagnosis of proximal caries in primary molars are challenging. AIM The aim of this in vivo study was to assess the validity and reproducibility of four methods of proximal caries detection in primary molar teeth. DESIGN Eighty-two children (5-10 years) were recruited. Initially, 1030 proximal surfaces were examined using meticulous visual examination (ICDAS) (VE1), bitewing radiographs (RE), and a laser fluorescence pen device (LF1). Temporary tooth separation (TTS) was achieved for 447 surfaces, and these were re-examined visually (VE2) and using the LF pen (LF2). Three hundred and fifty-six teeth (542 surfaces) were subsequently extracted and provided histological validation. RESULTS At D1 (enamel and dentine caries) diagnostic threshold, the sensitivity of VE1, RE, VE2, LF1, and LF2 examination was 0.52, 0.14, 0.75, 0.58, and 0.60 and the specificity values were 0.89, 0.97, 0.88, 0.85, and 0.77, respectively. At D3 (dentine caries) threshold, the sensitivity values were 0.42, 0.71, 0.49, 0.63, and 0.65, respectively, whereas specificity was 0.93 for VE1 and VE2, and 0.98, 0.87, and 0.88 for RE, LF1, and LF2 examinations, respectively. ROC analysis showed radiographic examination to be superior at D3 . CONCLUSION Meticulous caries diagnosis (ICDAS) should be supported by radiographs for detection of dentinal proximal caries in primary molars.
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Affiliation(s)
- Samiya Subka
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Helen Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Chris Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Yazici AR, Bayazit EO, Kutuk ZB, Ozgunaltay G, Ergin E, Berber A. Clinical Follow-up of a Fissure Sealant Placed Using Different Adhesive Protocols: A 24-month Split-mouth Study. Oper Dent 2018; 43:362-371. [PMID: 29630489 DOI: 10.2341/17-055-c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this study was to evaluate the retention rates of a fissure sealant placed using different adhesive protocols over 24 months. Twenty-four subjects with no restorations or caries received fissure sealants (Clinpro Sealant, 3M ESPE) placed using different adhesive protocols. A total of 292 sealants were placed as follows by two previously calibrated dentists using a table of random numbers (n=73): group I, acid-etch/without adhesive; group II, with a self-etch adhesive (Adper Easy Bond, 3M ESPE); group III, with an etch-and-rinse adhesive (Adper Single Bond 2, 3M ESPE); group IV, with acid + self-etch adhesive (Adper Easy Bond). Two other calibrated examiners independently evaluated the sealants at baseline and at six-, 12-, 18-, and 24-month recalls. Each sealant was evaluated in terms of caries formation being present or absent and retention using the following criteria: 1 = total retention, 2 = partial loss, and 3 = total loss. Pearson's χ2 test was used to evaluate differences in retention rates among the sealants for each evaluation period. At the end of 24 months, total retention rates were 57.5%, 27.4%, 84.9%, and 76.7% in the acid-etch, self-etch adhesive, etch-and-rinse adhesive, and acid + self-etch adhesive groups, respectively. Although there were no statistically significant differences between the retention rates among the adhesive protocols at 6 months ( p=0.684), significant differences were observed at the 12-, 18-, and 24-month evaluations. At 24 months, the lowest retention rates were observed in the self-etch group ( p<0.05). No caries development was observed in any of the groups. The retention rate of sealants placed using self-etch adhesive was poor compared with the other groups.
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Retention rates and caries-preventive effects of two different sealant materials: a randomised clinical trial. Clin Oral Investig 2018. [PMID: 29524027 DOI: 10.1007/s00784-018-2416-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The aim of this study was to compare the caries-preventive effect and the retention rates of sealants prepared with a new modified and a high-viscosity glass-ionomer cement (GIC) in recently erupted first permanent molars. MATERIALS AND METHODS: Fifty-six children (224 teeth) were included in a split-mouth randomised clinical trial. All children had their four first permanent molars sealed with either Clinpro XT Varnish (CXT) or Fuji IX GP FAST (FJ). FJ sealants were placed according to the ART protocol. Retention rates and caries-preventive effect of both materials were assessed clinically after 24 months, and survival curves were created according to the Kaplan-Meier method. For sealant retention rates, analyses were performed according to both the traditional method and modified sealant retention categorisation. RESULTS FJ sealants were retained longer in comparison to CXT sealants (p < 0.05), regardless of the categorisation used. In relation to the caries-preventive effect, no statistically significant differences were observed between materials (p = 0.99). Sealants prepared with the high-viscosity GIC according to the ART protocol survived longer than those prepared with the modified GIC, but both materials were equally effective in preventing cavitated dentine lesions over 24 months. CONCLUSION We concluded that GIC-based sealants are effective in preventing dentine caries lesions.
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Deery C. Clinical Practice Guidelines Proposed the Use of Pit and Fissure Sealants to Prevent and Arrest Noncavitated Carious Lesions. J Evid Based Dent Pract 2017; 17:48-50. [PMID: 28259315 DOI: 10.1016/j.jebdp.2017.01.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Evidence-based clinical practice guideline for the use of pit-and-fissure sealants: A report of the American Dental Association and the American Academy of Pediatric Dentistry. Wright JT, Crall JJ, Fontana M, Gillette EJ, Nový BB, Dhar V, Donly K, Hewlett ER, Quinonez RB, Chaffin J, Crespin M, Iafolla T, Siegal MD, Tampi MP, Graham L, Estrich C, Carrasco-Labra A. J Am Dent Assoc. 2016;147(8):672-82. SOURCE OF FUNDING American Dental Association and the American Academy of Pediatric Dentistry. TYPE OF STUDY/DESIGN Systematic review with meta-analysis of data.
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Abstract
Data sourcesCochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, the US National Institutes of Health Trials Register and the World Health Organization (WHO) Clinical Trials Registry PlatformStudy selectionRandomised controlled trials (RCTs) with at least 12 months follow-up, in which fissure sealants, or fissure sealants together with fluoride varnishes, were compared with fluoride varnishes alone for preventing caries in occlusal surfaces of permanent teeth of children and adolescents.Data extraction and synthesisTwo reviewers independently screened search results, extracted data and assessed risk of bias of included studies. Studies were grouped and analysed on the basis of sealant material type (resin-based sealant and glass ionomer-based sealant, glass ionomer and resin-modified glass ionomer) and different follow-up periods. Odds ratio were calculated for caries or no caries on occlusal surfaces of permanent molar teeth. Mean differences were calculated for continuous outcomes and data. Evidence quality was assessed using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods.ResultsEight RCTs involving a total of 1747 children aged five to ten years of age were included. Three trials compared resin-based fissure sealant versus fluoride varnish. Results from two studies (358 children) after two years were combined. Sealants prevented more caries, pooled odds ratio (OR) = 0.69 (95%CI; 0.50 to 0.94). One trial with follow-up at four and nine years found that the caries-preventive benefit for sealants was maintained, with 26% of sealed teeth and 55.8% of varnished teeth having developed caries at nine years. Evidence for glass-ionomer sealants was of low quality. One split-mouth trial analysing 92 children at two-year follow-up found a significant difference in favour of resin-based fissure sealant together with fluoride varnish compared with fluoride varnish only (OR 0.30, 95% CI 0.17 to 0.55). The evidence was assessed as low quality. Three studies assessed but did not report any adverse effects.ConclusionsCurrently, scarce and clinically diverse data are available on the comparison of sealants and fluoride varnish applications; therefore it is not possible to draw clear conclusions about possible differences in effectiveness for preventing or controlling dental caries on occlusal surfaces of permanent molars. The conclusions of this updated review remain the same as those of the last update (in 2010). We found some low quality evidence suggesting the superiority of resin-based fissure sealants over fluoride varnish applications for preventing occlusal caries in permanent molars, and other low-quality evidence for benefits of resin-based sealant and fluoride varnish over fluoride varnish alone. Regarding glass ionomer sealant versus fluoride varnish comparisons, we assessed the quality of the evidence as very low and could draw no conclusions.
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Affiliation(s)
- Christopher Deery
- Unit of Oral Health and Development, The University of Sheffield, Sheffield, UK
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Holmgren C, Gaucher C, Decerle N, Doméjean S. Minimal intervention dentistry II: part 3. Management of non-cavitated (initial) occlusal caries lesions--non-invasive approaches through remineralisation and therapeutic sealants. Br Dent J 2016; 216:237-43. [PMID: 24603245 DOI: 10.1038/sj.bdj.2014.147] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2013] [Indexed: 11/09/2022]
Abstract
Epidemiological data on dental caries show that prevention and treatment needs have evolved significantly over the past two decades. In younger patients the distribution of caries lesions is mainly found on the occlusal surfaces. The treatment approaches utilised by dentists must evolve to integrate preventive and treatment solutions tailored to the care needs, which are straightforward to implement in the dental office and whose effectiveness is underpinned by scientific evidence. This article aims to describe the principles of non-invasive management of non-cavitated (initial) occlusal caries lesions, based on evidence from recent studies published in the international literature.
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Affiliation(s)
- C Holmgren
- Aide Odontologique Internationale, Montrouge, France
| | - C Gaucher
- AP-HP, Hôpital Albert Chenevier, Service d'Odontologie, Univ Paris Descartes, UFR d'Odontologie, EA 2496, Paris, France
| | - N Decerle
- CHU Clermont-Ferrand, Service d'Odontologie, Hôpital Estaing, F-63003 Clermont-Ferrand, France; Univ Clermont1, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique EA 4847, F-63100 Clermont-Ferrand, France
| | - S Doméjean
- CHU Clermont-Ferrand, Service d'Odontologie, Hôpital Estaing, F-63003 Clermont-Ferrand, France; Univ Clermont1, UFR d'Odontologie, Centre de Recherche en Odontologie Clinique EA 4847, F-63100 Clermont-Ferrand, France
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16
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Formby M. EFFECTIVE CARIES PREVENTION IN A HEBRIDEAN ISLAND POPULATION. Prim Dent J 2016; 4:27-32. [PMID: 26966769 DOI: 10.1308/205016815816682272] [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: 11/22/2022]
Abstract
BACKGROUND The Isle of Islay has a remote-rural population. Two dentists have been responsible for the care of the majority of the school-age children for 15 years. The island affords a unique situation to measure caries prevalence in a relatively static population. AIM This study measures the changes in the dental caries experience of five and 12-year olds exposed to a preventive-based approach to improving dental health, which included a school-based tooth-brushing programme (four to 12-year-olds). DESIGN Data from practice-based records were collected for children aged five and 12 in the years 1999-2003 and 2012-2014. Indices including percentage of children with no obvious caries, decayed, missing or filled teeth (dmft/DMFT) and care indexes were calculated, translated into graphs and compared to Scotland's National Dental Inspection Programme (NDIP) data. RESULTS 478 children were included in the study. The mean number in each year group for five-year-olds was 28 (SD ± 5.65) and for 12-year-olds was 31.75 (SD ± 8.30). The percentage of children caries-free increased from 39% to 85% (five-year-olds) and 31% to 97% (12-year-olds). DMFT decreased from 3.04 to 0.30 (five-year-olds) and 3.74 to 0.03 (12-year-olds). Figures for care index and percentage of first permanent molars fissure sealed were higher than national data averages. CONCLUSION Caries prevalence decreased in children in Islay aged five and 12 years over the period 1999-2014. There was no control group but the differences described above can be associated with the introduction of a preventive approach, however they cannot be assumed to be causative.
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Goodwin M, Emsley R, Kelly M, Rooney E, Sutton M, Tickle M, Wagstaff R, Walsh T, Whittaker W, Pretty IA. The CATFISH study protocol: an evaluation of a water fluoridation scheme. BMC Oral Health 2016; 16:8. [PMID: 26831505 PMCID: PMC4736087 DOI: 10.1186/s12903-016-0169-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 01/25/2016] [Indexed: 11/16/2022] Open
Abstract
Background Tooth decay is the commonest disease of childhood. We have known for over 90 years that fluoride can prevent tooth decay; it is present in nearly all toothpastes and can be provided in mouthwashes, gels and varnishes. The oldest method of applying fluoride is via the water supply at a concentration of 1 part per million. The two most important reviews of water fluoridation in the United Kingdom (the York Review and MRC Report on water fluoridation and health) concluded that whilst there was evidence to suggest water fluoridation provided a benefit in caries reduction, there was a need to improve the evidence base in several areas. Methods/Design This study will use a natural experiment to assess the incidence of caries in two geographical areas, one in which the water supply is returned to being fluoridated following a discontinuation of fluoridation and one that continues to have a non-fluoridated water supply. The oral health of two discrete study populations will be evaluated - those born 9 months after the water fluoridation was introduced, and those who were in their 1st year of school after the introduction of fluoridated water. Both populations will be followed prospectively for 5 years using a census approach in the exposed group along with matched numbers recruitment in a non-exposed control. Parents of the younger cohort will complete questionnaires every 6 months with child clinical examination at ages 3 and 5, whilst the older cohort will have clinical examinations only, at approximately 5, 7 and 11 years old. Discussion This project provides a unique opportunity to conduct a high quality evaluation of the reintroduction of a water fluoridation scheme, which satisfies the inclusion criteria stipulated by the York systematic review and can address the design issues identified in the MRC report. The research will make a major contribution to the understanding of the costs and effects of water fluoridation in the UK in the 21st Century. Its findings will help inform UK policy on this important public health intervention and may have a significant impact on public health policy in other developed countries. There is currently true equipoise in relation to the effectiveness of water fluoridation in contemporary populations and while the biological plausibility is well established, there is a need to examine impact on the changing epidemiological status of dental decay.
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Affiliation(s)
- Michaela Goodwin
- The Dental Health Unit, School of Dentistry, The University of Manchester, Williams House, Manchester Science Park, Manchester, M15 6SE, UK.
| | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, 1.304 Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Michael Kelly
- Institute of Public Health, University of Cambridge, Forvie Site, Cambridge, CB2 OSR, UK.
| | - Eric Rooney
- Dental Observatory, NHS Central Lancashire, Preston Business Centre, Watling Street Road, Fulwood, PR2 8DY, UK.
| | - Matthew Sutton
- Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Martin Tickle
- , Coupland 3 Building, Oxford Road, Manchester, M15 6FH, UK.
| | - Rebecca Wagstaff
- Public Health England, North West, 1st Floor, York House, Ackhurst Business Park, Foxhole Road, Chorley, PR7 1NY, UK.
| | - Tanya Walsh
- , Coupland 3 Building, Oxford Road, Manchester, M15 6FH, UK.
| | | | - Iain A Pretty
- The Dental Health Unit, School of Dentistry, The University of Manchester, Williams House, Manchester Science Park, Manchester, M15 6SE, UK.
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18
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Hilgert LA, Leal SC, Mulder J, Creugers NHJ, Frencken JE. Caries-preventive Effect of Supervised Toothbrushing and Sealants. J Dent Res 2015; 94:1218-24. [PMID: 26116491 DOI: 10.1177/0022034515592857] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
To investigate the effectiveness of 3 caries-preventive measures on high- and low-caries risk occlusal surfaces of first permanent molars over 3 y. This cluster-randomized controlled clinical trial covered 242 schoolchildren, 6 to 7 y old, from low socioeconomic areas. At baseline, caries risk was assessed at the tooth surface level, through a combination of ICDAS II (International Caries Detection and Assessment System) and fissure depth codes. High-caries risk occlusal surfaces were treated according to daily supervised toothbrushing (STB) at school and 2 sealants: composite resin (CR) and atraumatic restorative treatment-high-viscosity glass-ionomer cement (ART-GIC). Low-caries risk occlusal surfaces received STB or no intervention. Evaluations were performed after 0.5, 1, 2, and 3 y. A cavitated dentine carious lesion was considered a failure. Data were analyzed according to the proportional hazard rate regression model with frailty correction, Wald test, analysis of variance, and t test, according to the jackknife procedure for calculating standard errors. The cumulative survival rates of cavitated dentine carious lesion-free, high-caries risk occlusal surfaces were 95.6%, 91.4%, and 90.2% for STB, CR, and ART-GIC, respectively, over 3 y, which were not statistically significantly different. For low-caries risk occlusal surfaces, no statistically significant difference was observed between the cumulative survival rate of the STB group (94.8%) and the no-intervention group (92.1%) over 3 y. There was neither a difference among STB, CR, and ART-GIC on school premises in preventing cavitated dentine carious lesions in high-caries risk occlusal surfaces of first permanent molars nor a difference between STB and no intervention for low-caries risk occlusal surfaces of first permanent molars over 3 y.
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Affiliation(s)
- L A Hilgert
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - S C Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - J Mulder
- Department of Oral Global Health, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N H J Creugers
- Department of Oral Rehabilitation, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J E Frencken
- Department of Oral Global Health, College of Dental Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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Rogers HJ, Morgan AG, Batley H, Deery C. Why, what and how: caries control for erupting molars. ACTA ACUST UNITED AC 2015; 42:154-6, 159. [PMID: 26058229 DOI: 10.12968/denu.2015.42.2.154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This article aims to update the practitioner on the various techniques and interventions available to prevent or control caries during this high-risk period. The evidence to support provision of toothbrushing advice, placement of fissure sealants and fluoride varnish application is considered, along with more novel methods. An evidence-based protocol is suggested to help the practitioner determine when further intervention is required and what action to undertake. Clinical Relevance: This article aims to reinforce the need for rigorous caries prevention in an erupting permanent molar and provides an update on the evidence behind a range of clinical techniques used for this purpose.
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20
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What BDJ readers were reading in 2013*... Br Dent J 2014. [DOI: 10.1038/sj.bdj.2013.1279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Abstract
DATA SOURCES Cochrane Oral Health Group's Trials Register, CENTRAL, Medline via OVID, EMBASE via OVID; SCISEARCH, CAplus, INSPEC, NTIS and PASCAL via STN Easy and DARE, NHS EED, HTA (all to September/ November 2012) and ClinicalTrials.gov (to July 2012). There were no restrictions on language or date of publication. STUDY SELECTION Randomised and quasi-randomised controlled trials of at least 12 months duration comparing no sealant with sealant, or different types of sealants, for preventing caries of occlusal or approximal surfaces of premolar or molar teeth in children and adolescents under 20 years of age. DATA EXTRACTION AND SYNTHESIS Screening of search results, data extraction and assessment of trial quality (using GRADE methods) were by two reviewers independently. RESULTS There were 34 trials of children aged five to 16 years, with 12 trials (2575 participants) comparing sealants with no sealant, 21 trials (3202 participants) comparing one sealant with another and one trial (752 participants) comparing two types of sealant with no sealant.Resin sealants compared with no sealants prevented caries in the first permanent molars of children five to 10 years old (six trials at low risk of bias with two years follow up), (odds ratio (OR) 0.12, 95% confidence interval (CI) 0.07 to 0.19). At 48 to 54 months follow-up, the caries preventive effect was maintained (OR 0.21, 95% CI 0.16 to 0.28) although there were only four trials (two were at low and two at high risk of bias).No conclusions could be drawn as to whether glass ionomer sealants compared with no sealants prevented caries at 2 year follow-up. The mean difference in DFS was -0.18, 95% CI -0.39 to 0.03.The relative effectiveness of one type of sealant compared to a different type of sealant was inconclusive as there was great variation in comparisons, outcomes, times of outcomes and background fluoride levels in the 21 studies. There was insufficient evidence for the relative superiority of glass ionomer and resin sealants (very low event rate in many of the 15 trials). There were inconsistent results for resin-modified glass ionomer sealants compared with resin sealants. No difference in caries increments were found in the two small trials of polyacid-modified resin sealants compared with resin sealants. CONCLUSIONS Sealants compared with no sealants, on the occlusal surfaces of permanent molars in children and adolescents, are effective at reducing caries up to 48 months. There is less evidence for longer term follow-up and little for the relative effectiveness of sealing in less high caries risk children. No conclusions could be drawn on the relative effectiveness of different types of sealants.
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Affiliation(s)
- Chris Deery
- Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Erratum: Corrigendum. Br Dent J 2013. [DOI: 10.1038/sj.bdj.2013.679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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