Comparison of two different methods of detecting residual caries

Examining the Efficacy of a 405 nm Wavelength Diode Laser as a Diagnostic Tool in Routine Dental Practice

In recent years, significant advancements in dental and periodontal diagnostics have paved the way for improved care. Among the available approaches, laser fluorescence (LF) is a promising method. This case report explores the utilization of a 405 nm diode laser as a diagnostic tool in the non-surgical treatment of biofilm-induced gingivitis, as well as its application in routine daily practice for diagnosing restorations and dental caries. A 24-year-old male patient and a 21-year-old female patient were included. A 405 nm diode laser (Smart M, Lasotronix, Poland) was used as a diagnostic tool with a tip diameter of 8 mm. In case one, the utilization of the 405 nm diode laser enhanced the patient's ability to perceive the presence and extent of plaque and calculus, aiding in motivation and education regarding supra-gingival dental biofilm control and it assisted the operator in precisely localizing plaque and calculus, thereby enabling more effective mechanical debridement and ultimately improving treatment outcomes. In the second case, the utilization of the laser facilitated the detection of defective composite fillings aiding in both accurate diagnosis for the operator and effective communication with the patient regarding the need for re-treatment. This study illustrates the potential of the relatively new 405 nm diode laser as a promising diagnostic tool in the daily management of periodontal patients and the detection of defective dental fillings in daily practice.

Longitudinal study for dental caries calibration of dentists unexperienced in epidemiological surveys

This study aimed to make a longitudinal analysis of interexaminer calibration reproducibility in diagnosing dental caries in posterior teeth, by examiners without previous experience in epidemiological studies. A group of 11 inexperienced examiners underwent theoretical-practical training and calibration assessments, assisted by a standard examiner. An examiner who did not participate directly in the research selected 5-year-old children with and without caries. The D3 diagnostic threshold was used to evaluate dental caries, based on the World Health Organization (WHO) criteria. The initial calibration (baseline) was performed after the theoretical-practical training session, and consisted of examining 20 children; the second calibration occurred three months later, and involved evaluating another 18 children. The interexaminer agreement was obtained by kappa statistics, and by overall percentage agreement. The paired t-test was applied to compare the values for kappa means and overall percentage agreement between the time points studied. At baseline, the values for kappa (> 0.81) and overall percentage agreement (> 95.63%) were considered high. At the 3-month calibration assessment, all the examiners showed some decrease in both kappa (p < 0.0001) and overall percentage agreement (p = 0.0102). The calibration process currently proposed by the WHO is effective. However, reproducibility was not maintained over time for inexperienced examiners evaluating the posterior teeth of 5-year-old children, under epidemiological conditions.

Current Strategies to Control Recurrent and Residual Caries with Resin Composite Restorations: Operator- and Material-Related Factors

This review addresses the rationale of recurrent and/or residual caries associated with resin composite restorations alongside current strategies and evidence-based recommendations to arrest residual caries and restrain recurrent caries. The PubMed and MEDLINE databases were searched for composite-associated recurrent/residual caries focusing on predisposing factors related to materials and operator’s skills; patient-related factors were out of scope. Recurrent caries and fractures are the main reasons for the failure of resin composites. Recurrent and residual caries are evaluated differently with no exact distinguishment, especially for wall lesions. Recurrent caries correlates to patient factors, the operator’s skills of cavity preparation, and material selection and insertion. Material-related factors are significant. Strong evidence validates the minimally invasive management of deep caries, with concerns regarding residual infected dentin. Promising technologies promote resin composites with antibacterial and remineralizing potentials. Insertion techniques influence adaptation, marginal seal, and proximal contact tightness. A reliable diagnostic method for recurrent or residual caries is urgently required. Ongoing endeavors cannot eliminate recurrent caries or precisely validate residual caries. The operator’s responsibility to precisely diagnose original caries and remaining tooth structure, consider oral environmental conditions, accurately prepare cavities, and select and apply restorative materials are integral aspects. Recurrent caries around composites requires a triad of attention where the operator’s skills are cornerstones.

Does the heat generated by fluorescence-aided caries excavation system effect the pulp temperature of primary teeth irreversibly? An in-vitro evaluation of the temperature changes in the pulp chamber

Background

This study aimed to analyze the effect of the Fluorescence Aided Caries Excavation (FACE) and the remaining dentin thickness on the temperature changes of the pulp chamber.

Material and Methods

Freshly extracted deciduous molars and a pulpal microcirculation model were used in the study. The sample size was calculated according to power analyses (power at 90%) based on previous studies. Thus, 40 samples were needed. Standard cavities (3x3 mm) were designed to obtain a 2 mm distance through to the pulp chamber, and in each tooth (n=10), these cavities were modified to obtain 1.5 mm, 1mm, and 0.5 mm final distance through to the pulp. Coronal parts of the teeth were placed on an acrylic plate with three gaps for feeding and extraction needles and the thermocouple. The temperature changes were recorded from the initial time to 15 s and 30 s,1 min, 1.5 min, 2 min, 2.5 min, 3 min intervals.

Results

The results showed that hence the thickness between cavity floor and pulp chamber was decreased, and application time of FACE was increased, an increase in temperature changes was detected. However, the recorded values were not mean to cause irreversible damages to the pulp chamber.

Conclusions

The recent study showed that Face is an appropriate caries detecting system that does not affect the pulp chamber's health, and it can be safely used in the primary teeth. Key words:Caries assessment, dental caries, dental pulp, pediatric dentistry.