In Vitro Comparison of Diagnostic Accuracy of DIAGNOdent and Digital Radiography for Detection of Secondary Proximal Caries Adjacent to Composite Restorations

Impedance Spectroscopy as a Tool for the Detection of Occlusal Noncavitated Carious Lesions

A total 302 teeth (148 molars and 154 premolars) corresponding to 152 patients aged ≥18 years were evaluated for caries using the ICDAS (International Caries Detection and Assessment System), fluorescence (DD, DIAGNOdent) and electrical impedance (IMS, CarieScan PRO) systems. Fissurotomy and intraoral radiographs were used as the gold standard. Accordingly, 27.5% (n=84) of the teeth were classified as sound, while 26.9% (n=81) had enamel involvement and 45.6% (n=138) presented carious lesions reaching the dentin. Sensitivity (Se), specificity (Sp), and the area under the curve (AUC) were, respectively, 90.7%, 87.8%, and 0.954 (IMS); 92.4%, 92.7%, and 0.954 (DD); and 79.0%, 72.3%, and 0.756 (ICDAS). With regard to Se and Sp, there were significant differences between ICDAS and DD (p<0.001) and between ICDAS and IMS (p=0.01), but not between IMS and DD (p=0.07). In relation to AUC, there were significant differences between ICDAS and DD (p<0.001), and between ICDAS and IMS (p<0.001), but not between IMS and DD (p>0.05). The correlations between fissurotomy and each method were 88.7% (IMS), 89.7% (DD), and 77.1% (ICDAS). Within the limitations of this study, clinically, the electrical system is not useful for differentiating between sound teeth and truly incipient caries lesions by itself. The fluorescence or electrical systems are recommended with the ICDAS to detect carious lesions in their early stages.

Comparative evaluation of enamel microhardness after using two different remineralizing agents on artificially demineralized human enamel: An in vitro study

AIM

The purpose of this study was to compare the remineralization outcomes of two agents using the Vickers microhardness test (VMHT) on artificially induced enamel subsurface lesions.

MATERIALS AND METHODS

Forty sound extracted premolars were selected as samples for the current study and divided into four groups of 10 teeth each: Clinpro (group 1), Remin Pro (group 2), untreated positive control (group 3), and a demineralized negative control (group 4). All the sample groups were assessed first at baseline then after demineralization and remineralization using DIAGNOdent. After the remineralization process, VMHT was performed on all sample groups to assess surface microhardness (SMH). The results obtained were then compared using a one-way analysis of variance (ANOVA) for the difference in SMH.

RESULTS

Vickers microhardness number values were analyzed using one-way ANOVA and samples in the experimental groups 1 and 2 showed a statistically significant difference compared to the control groups (P < 0.05). Remineralization was higher in the Remin Pro group, followed by Clinpro group.

CONCLUSIONS

The results of this in vitro study show that both Remin Pro and Clinpro are equally effective as remineralizing agents. Although Remin Pro tended to yield a higher microhardness, no significant differences were observed between the two agents.

RELEVANCE FOR PATIENTS

Enamel mineral loss leads to the degradation of the surface and subsurface structures of teeth. Natural remineralization that occurs physiologically is not sufficient to overcome the hurdles of mineral loss a tooth undergoes due to changes in food habits and lifestyle. A thought on remineralization and management such as prescribing remineralizing agents and regular professional topical fluoride applications would definitely render satisfactory results by a strong healthy enamel.