1
|
Loomans B, Mendes FM, Vinayahalingam S, Xi T, Opdam N, Kreulen CM, Pereira-Cenci T, Cenci MS. Challenges in conducting clinical research in primary care dentistry. J Dent 2024; 144:104958. [PMID: 38522408 DOI: 10.1016/j.jdent.2024.104958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024] Open
Abstract
The integration of dentistry into primary health care is crucial for promoting patient well-being. However, clinical studies in dentistry face challenges, including issues with study design, transparency, and relevance to primary care. Clinical trials in dentistry often focus on specific issues with strict eligibility criteria, limiting the generalizability of findings. Randomized clinical trials (RCTs) face challenges in reflecting real-world conditions and using clinically relevant outcomes. The need for more pragmatic approaches and the inclusion of clinically relevant outcomes (CROs) is discussed, such as tooth loss or implant success. Solutions proposed include well-controlled observational studies, optimized data collection tools, and the integration of artificial intelligence (AI) for predictive modelling, computer-aided diagnostics and automated diagnosis. In this position paper advocates for more efficient trials with a focus on patient-centred outcomes, as well as the adoption of pragmatic study designs reflecting real-world conditions. Collaborative research networks, increased funding, enhanced data retrieval, and open science practices are also recommended. Technology, including intraoral scanners and AI, is highlighted for improving efficiency in dental research. AI is seen as a key tool for participant recruitment, predictive modelling, and outcome evaluation. However, ethical considerations and ongoing validation are emphasized to ensure the reliability and trustworthiness of AI-driven solutions in dental research. In conclusion, the efficient conduct of clinical research in primary care dentistry requires a comprehensive approach, including changes in study design, data collection, and analytical methods. The integration of AI is seen as pivotal in achieving these objectives in a meaningful and efficient way.
Collapse
Affiliation(s)
- Bac Loomans
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands.
| | - F M Mendes
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands; Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - S Vinayahalingam
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - T Xi
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - Njm Opdam
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - C M Kreulen
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - T Pereira-Cenci
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| | - M S Cenci
- Department of Oral and Maxillofacial Surgery, Radboud Institute for Medical Innovation, Radboud University Medical Center, Philips van Leydenlaan 25, EX 6525 Nijmegen, The Netherlands
| |
Collapse
|
2
|
Kühnisch J, Aps JK, Splieth C, Lussi A, Jablonski-Momeni A, Mendes FM, Schmalz G, Fontana M, Banerjee A, Ricketts D, Schwendicke F, Douglas G, Campus G, van der Veen M, Opdam N, Doméjean S, Martignon S, Neuhaus KW, Horner K, Huysmans MCD. ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I: caries lesion detection and depth assessment. Clin Oral Investig 2024; 28:227. [PMID: 38514502 PMCID: PMC10957694 DOI: 10.1007/s00784-024-05597-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/29/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVES The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection. MATERIALS AND METHODS The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity assessment and (3) forming individualised caries diagnoses. The experts responsible for "caries detection and diagnostic methods" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous Delphi survey. RESULTS Recommendations (N = 8) were approved and agreed upon by the whole expert panel: visual examination (N = 3), dental radiography (N = 3) and additional diagnostic methods (N = 2). While the quality of evidence was found to be heterogeneous, all recommendations were agreed upon by the expert panel. CONCLUSION Visual examination is recommended as the first-choice method for the detection and assessment of caries lesions on accessible surfaces. Intraoral radiography, preferably bitewing, is recommended as an additional method. Adjunct, non-ionising radiation methods might also be useful in certain clinical situations. CLINICAL RELEVANCE The expert panel merged evidence from the scientific literature with practical considerations and provided recommendations for their use in daily dental practice.
Collapse
Affiliation(s)
- Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany.
| | | | - Christian Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Adrian Lussi
- University Hospital for Conservative Dentistry and Periodontology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - David Ricketts
- Unit of Restorative Dentistry, University of Dundee, Dundee, UK
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians Universität München, Poliklinik für Zahnerhaltung und Parodontologie, Goethestraße 70, 80336, München, Germany
| | - Gail Douglas
- Department of Dental Public Health, University of Leeds Dental School, Leeds, UK
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Monique van der Veen
- Departments of Preventive Dentistry and Paediatric Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
- Oral Hygiene School, Inholland University of applied sciences, Amsterdam, The Netherlands
| | - Niek Opdam
- Department of Dentistry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sophie Doméjean
- Centre de Recherche en Odontologie Clinique EA 4847, UFR d'Odontologie, Département d'Odontologie Conservatrice, Université Clermont Auvergne, Clermont-Ferrand, France
- Service d'Odontologie, CHU Estaing Clermont-Ferrand, Clermont-Ferrand, France
| | - Stefania Martignon
- UNICA - Caries Research Unit, Research Department, Universidad El Bosque, Bogotá, Colombia
| | - Klaus W Neuhaus
- Department of Pediatric Oral Health, University Center for Dental Medicine Basel (UZB), University of Basel, Basel, Switzerland
- Department of Dermatology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Keith Horner
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | | |
Collapse
|
3
|
Brondani B, Knorst JK, Ardenghi TM, Mendes FM, Brondani MA. Community and individual socioeconomic inequalities and dental caries from childhood to adolescence: A 10-year cohort study. Community Dent Oral Epidemiol 2024. [PMID: 38402550 DOI: 10.1111/cdoe.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/25/2023] [Accepted: 02/07/2024] [Indexed: 02/26/2024]
Abstract
PURPOSE To evaluate the effect of individual and contextual socioeconomic inequalities in the occurrence of untreated dental caries during the transition from childhood to adolescence. METHODS This 10-year prospective cohort study followed up an initial sample of 639 1-5 years old schoolchildren from southern Brazil. After 7 and 10 years from the baseline (T1), two other reassessments were conducted (T2 and T3), respectively. Untreated dental caries was measured through the International Caries Detection and Assessment System (ICDAS- scores 3, 5 and 6) at T1 and T3. Socioeconomic status (SES) at the contextual and individual level was assessed at T1. At T2, socioeconomic, behavioural and psychosocial characteristics were evaluated as possible pathways of explanation. Structural equation modelling was used to estimate the direct and indirect effects among the variables over 10 years. RESULTS A total of 429 adolescents were reevaluated at 10-year follow-up (cohort retention rate of 67.1%). About 30.6% presented untreated dental caries at T3. Low individual SES at T1 directly impacted a higher occurrence of dental caries at T3. Non-white skin colour at T1 also indirectly impacted a higher occurrence of dental caries at T3 through low individual SES at T1 and lower household income at T2. Contextual SES did not predict, directly or indirectly, dental caries at T3. CONCLUSION There is strong evidence that socioeconomic inequalities at the individual level play an important role on the occurrence of dental caries from childhood to adolescence. On the other hand, there was no evidence that contextual SES influences the occurrence of dental caries over time.
Collapse
Affiliation(s)
- Bruna Brondani
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Jessica K Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Mário A Brondani
- Department of Oral Health Sciences, School of Dentistry, University of British Columbia, Vancouver, Canada
| |
Collapse
|
4
|
Foláyan MO, Ramos-Gomez F, Fatusi OA, Nabil N, Lyimo GV, Minja IK, Masumo RM, Mohamed N, Potgieter N, Matanhire C, Maposa P, Akino CR, Adeniyi A, Mohebbi SZ, Ellakany P, Chen J, Amalia R, Iandolo A, Peedikayil FC, Aravind A, Al-Batayneh OB, Khader YS, Al-Maweri SA, Sabbah W, Abeldaño Zuñiga RA, Vukovic A, Jovanovic J, Jafar RM, Maldupa I, Arheiam A, Mendes FM, Uribe SE, López Jordi MDC, Villena RS, Duangthip D, Sam-Agudu NA, El Tantawi M. Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China. Front Oral Health 2023; 4:1211242. [PMID: 38024146 PMCID: PMC10646161 DOI: 10.3389/froh.2023.1211242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments. Methods We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific. Results Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries. Conclusions The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.
Collapse
Affiliation(s)
- Morẹ́nikẹ́ Oluwátóyìn Foláyan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Nigeria
| | - Francisco Ramos-Gomez
- Division of Preventive and Restorative Oral Health Sciences, UCLA School of Dentistry, Los Angeles, CA, United States
| | | | - Nouran Nabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Germana V. Lyimo
- Department of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Irene Kida Minja
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ray M. Masumo
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Nadia Mohamed
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Nicoline Potgieter
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | | | - Pamela Maposa
- Department of Paediatrics, University of Zimbabwe, Harare, Zimbabwe
| | | | - Abiola Adeniyi
- School of Policy and Global Affairs, Fairleigh Dickinson University, Vancouver, BC, Canada
| | - Simin Z. Mohebbi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Passent Ellakany
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdurrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jieyi Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Rosa Amalia
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Alfredo Iandolo
- Department of Endodontics, Faculty of Dentistry, University of Salerno, Salerno, Italy
| | - Faizal C. Peedikayil
- Department of Pediatric and Preventive Dentistry, Kannur Dental College, Anjarakandy, India
| | - Athira Aravind
- Department of Pediatric and Preventive Dentistry, Kannur Dental College, Anjarakandy, India
| | - Ola B. Al-Batayneh
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S. Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, United Kingdom
| | - Roberto Ariel Abeldaño Zuñiga
- Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
- Centre for Social Data Science, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Ana Vukovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Julijana Jovanovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Ilze Maldupa
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - Arheiam Arheiam
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Fausto M. Mendes
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Sergio E. Uribe
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
- School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
| | | | - Rita S. Villena
- Department of Pediatric Dentistry, School of Dentistry, University San Martin de Porres, Lima, Perú
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - Nadia A. Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Maha El Tantawi
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
5
|
Costa NC, Knorst JK, Brondani B, Menegazzo GR, Mendes FM, Ardenghi DM, Ardenghi TM. Early childhood factors in the development of oral health behaviours in adolescence: A structural equation modelling approach. Community Dent Oral Epidemiol 2023; 51:738-745. [PMID: 35430737 DOI: 10.1111/cdoe.12748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 03/28/2022] [Accepted: 04/06/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Oral health behaviour is a learning process that begins in the early years of an individual's life. The aim of this study was to evaluate the associations between demographic, socioeconomic, and psychosocial factors and oral health behaviours during the transition period from childhood to adolescence. METHODS This was a cohort study with a follow-up of 7 years. The baseline assessment occurred in 2010 with a random sample of 639 preschool children from southern Brazil. Demographic, socioeconomic and psychosocial oral health conditions were assessed at baseline. Oral health habit variables were collected at follow-up and included questions regarding dental care and oral hygiene behaviours. Structural equation modelling was performed to assess the direct and indirect relationships between predictors at baseline in oral health behaviours at follow-up. RESULTS A total of 449 children were re-examined at follow-up (70.3% cohort retention rate). Factors directly related to poorer oral health behaviours (lower use of dental services, dental visits for emergency reasons and lower frequency of toothbrushing) were lower household income, lower maternal education, lower frequency of visits to neighbours or friends, and male sex. Considering indirect pathways, the household income and maternal education at baseline influenced oral health behaviours at follow-up via visits to neighbours or friends. CONCLUSIONS Our findings suggest that household income, maternal education and social capital play an important role in the development of oral health behaviours during the transition from childhood to adolescence. Acquisition of healthy oral behaviours is an important factor to consider in childhood. With this knowledge, public health policies can be developed to intervene in specific causal factors and improve oral health during this transitional period.
Collapse
Affiliation(s)
- Natália C Costa
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jessica K Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Bruna Brondani
- Department of Pediatric Dentistry and Orthodontics, University of São Paulo, São Paulo, Brazil
| | - Gabriele R Menegazzo
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry and Orthodontics, University of São Paulo, São Paulo, Brazil
| | | | - Thiago M Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| |
Collapse
|
6
|
Toledo Reyes L, Knorst JK, Ortiz FR, Brondani B, Emmanuelli B, Saraiva Guedes R, Mendes FM, Ardenghi TM. Early Childhood Predictors for Dental Caries: A Machine Learning Approach. J Dent Res 2023:220345231170535. [PMID: 37246832 DOI: 10.1177/00220345231170535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
We aimed to develop and validate caries prognosis models in primary and permanent teeth after 2 and 10 y of follow-up through a machine learning (ML) approach, using predictors collected in early childhood. Data from a 10-y prospective cohort study conducted in southern Brazil were analyzed. Children aged 1 to 5 y were first examined in 2010 and reassessed in 2012 and 2020 regarding caries development. Dental caries was assessed using the Caries Detection and Assessment System (ICDAS) criteria. Demographic, socioeconomic, psychosocial, behavioral, and clinical factors were collected. ML algorithms decision tree, random forest, and extreme gradient boosting (XGBoost) were employed, along with logistic regression. The discrimination and calibration of models were verified in independent sets. From 639 children included at the baseline, we reassessed 467 (73.3%) and 428 (66.9%) children in 2012 and 2020, respectively. For all models, the area under receiver operating characteristic curve (AUC) at training and testing was above 0.70 for predicting caries in primary teeth after 2-y follow-up, with caries severity at the baseline being the strongest predictor. After 10 y, the SHAP algorithm based on XGBoost achieved an AUC higher than 0.70 in the testing set and indicated caries experience, nonuse of fluoridated toothpaste, parent education, higher frequency of sugar consumption, low frequency of visits to the relatives, and poor parents' perception of their children's oral health as top predictors for caries in permanent teeth. In conclusion, the implementation of ML shows potential for determining caries development in both primary and permanent teeth using easy-to-collect predictors in early childhood.
Collapse
Affiliation(s)
- L Toledo Reyes
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - J K Knorst
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - F R Ortiz
- Atitus Educação, Passo Fundo, RS, Brazil
| | - B Brondani
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - B Emmanuelli
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - R Saraiva Guedes
- Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil
| | - F M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - T M Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| |
Collapse
|
7
|
Balseca Ibarra MC, Medina Vega MV, Souto MLS, Romito GA, Frias AC, Raggio DP, Crosato EM, Mendes FM, Pannuti CM. Impact of gingivitis on oral health-related quality of life in 12-year-old schoolchildren of Quito, Ecuador. Eur Arch Paediatr Dent 2023; 24:211-218. [PMID: 36602708 DOI: 10.1007/s40368-022-00777-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 12/20/2022] [Indexed: 01/06/2023]
Abstract
PURPOSE Evaluate the impact of gingivitis on oral health-related quality of life (OHRQoL) amongst 12-year-old schoolchildren from Quito, Ecuador. METHODS We evaluated 998 school children using the Community Periodontal Index for gingival bleeding and calculus. OHRQoL was assessed with the Child Perceptions Questionnaire 11-14 (CPQ11-14) questionnaire. RESULTS Of the 998 schoolchildren, 93% had gingival bleeding and 73% had dental calculus. Schoolchildren with more than one sextant with gingival bleeding had 1.18 times higher mean CPQ11-14 (RR 1.18, 95% CI 1.11-1.27) than those with none or just one affected sextant. Male schoolchildren presented a 15% lower mean Child Perceptions Questionnaire (CPQ) (RT 0.85; 95% CI 0.76-0.96). Children whose parents had incomplete secondary education had a 15% lower mean CPQ (RT 0.85; 95% CI 0.77-0.94). Bleeding in more than one sextant was significantly associated with worse quality of life in the emotional well-being (RT 1.40, 95% CI 1.03-1.90) and social well-being domains (RT 1.76, 95% CI 1.32-2.34). CONCLUSION Gingival bleeding negatively impacted the OHRQoL of 12-year-old Ecuadorian schoolchildren living in Quito.
Collapse
Affiliation(s)
- M C Balseca Ibarra
- Universidad Central del Ecuador, Quito, Ecuador.,Periodontics Department, University of São Paulo, São Paulo, Brazil
| | - M V Medina Vega
- Universidad Central del Ecuador, Quito, Ecuador.,Periodontics Department, University of São Paulo, São Paulo, Brazil
| | - M L S Souto
- University of São Paulo, São Paulo, São Paulo, Brazil
| | - G A Romito
- Periodontics Department, University of São Paulo, São Paulo, Brazil
| | - A C Frias
- Social Dentistry Department, University of São Paulo, São Paulo, Brazil
| | - D P Raggio
- Paedriatic Department, University of São Paulo, São Paulo, Brazil
| | - E M Crosato
- Social Dentistry Department, University of São Paulo, São Paulo, Brazil
| | - F M Mendes
- Paedriatic Department, University of São Paulo, São Paulo, Brazil
| | - C M Pannuti
- Periodontics Department, University of São Paulo, São Paulo, Brazil.
| |
Collapse
|
8
|
Olegário IC, Moro BLP, Tedesco TK, Freitas RD, Pássaro AL, Garbim JR, Oliveira R, Mendes FM, Raggio DP. Use of rubber dam versus cotton roll isolation on composite resin restorations' survival in primary molars: 2-year results from a non-inferiority clinical trial. BMC Oral Health 2022; 22:440. [PMID: 36217147 PMCID: PMC9552420 DOI: 10.1186/s12903-022-02449-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This non-inferiority randomised clinical trial aimed to evaluate the survival of direct bulk fill composite resin restorations in primary molars using different methods of moisture control: rubber dam isolation (RDI-local anaesthesia and rubber dam) and cotton roll isolation (CRI-cotton roll and saliva ejector). Secondary outcomes included baseline and 2-year incremental cost, self-reported child's pain scores and patient behaviour during the restorative procedure. METHODS A total of 174 molars (93 children) with dentine caries lesions were randomly allocated to study groups (RDI or CRI) and restored with bulk fill composite resin by trained operators. Two blinded examiners assessed the restorations for up to 24 months. Wong-baker faces and Frankl's behaviour rating scales were used for accessing the child's pain and behaviour, respectively. The primary outcome (restoration survival) was analysed using the two-sample non-inferiority test for survival data using Cox Regression (non-inferiority/alternative hypothesis HR > 0.85; CI = 90%). Bootstrap Linear regression was used for cost analysis and logistic regression for pain and behaviour analysis (α = 5%). RESULTS After 2-years, 157 restorations were evaluated (drop-out = 9.7%). The survival rate was RDI = 60.4% and CRI = 54.3%. The non-inferiority hypothesis was accepted by the Cox Regression analysis (HR = 1.33; 90% CI 0.88-1.99; p = 0.036). RDI was 53% more expensive when compared to the CRI group. No differences were found between the groups regarding pain (p = 0.073) and behaviour (p = 0.788). CONCLUSION Cotton roll isolation proved to be non-inferior when compared to rubber dam for composite restorations longevity in primary molars. Furthermore, the latest presented the disadvantage of higher cost and longer procedure time. Clinical Significance The moisture control method does not influence the longevity of composite restorations in primary molars. Cotton roll isolation proved to be non-inferior to rubber dam isolation and is a viable option for restoring primary molars. Clinical trial registration registered NCT03733522 on 07/11/2018. The present trial was nested within another clinical trial, the CARies DEtection in Children (CARDEC-03-NCT03520309).
Collapse
Affiliation(s)
- Isabel C Olegário
- Division of Public and Child Dental Health, School of Dental Science, Trinity College Dublin, Dublin, Ireland.,Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Bruna L P Moro
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Tamara K Tedesco
- School of Dentistry, Cruzeiro Do Sul University, São Paulo, Brazil
| | - Raiza D Freitas
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ana Laura Pássaro
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Jonathan Rafael Garbim
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Rodolfo Oliveira
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto M Mendes
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Daniela Prócida Raggio
- Department of Paediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil. .,School of Dentistry, University Dental Hospital (UDH), Cardiff University, Heath Park, Cardiff, CF14 4XW, UK.
| |
Collapse
|
9
|
Bresolin CR, Marques RPS, Okamura B, Costa C, Moura-Netto C, Lara JS, Mello-Moura ACV, Mendes FM. Efficacy of an iodoform-based filling material for pulpectomy of primary teeth: A 24-month non-inferiority randomized clinical trial. Int J Paediatr Dent 2022; 32:668-677. [PMID: 34856038 DOI: 10.1111/ipd.12945] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/19/2021] [Accepted: 11/28/2021] [Indexed: 11/27/2022]
Abstract
AIM The aim of this non-inferiority randomized clinical trial was to compare the efficacy of an iodoform-based paste (Guedes-Pinto -(GP)) as a filling material in pulpectomies of primary teeth, and a standard material composed by calcium hydroxide and iodoform (CaOH/Iodof paste; Vitapex® ). DESIGN A total of 104 teeth from 61 children (3-8 years old) were randomly allocated to two groups according to filling materials. Children were followed up for 24 months. The primary endpoint was the treatment success rate evaluated through clinical and radiographic examinations at follow-up, and the secondary outcome was the analysis of the canal filling quality. Differences in the proportion of treatment success was calculated based on 95% confidence intervals (95% CI) and with the Miettinen and Nurminen method in the intention-to-treat population, considering a -20% of the non-inferiority limit. RESULTS From 104 randomized teeth, 102 were followed up after 24 months (attrition rate of 1.9%). The success rate of teeth treated with the GP paste was 86.8% (95% CI: 69.9-94.9) and 78.4% (95% CI: 61.8-89.1) with the CaOH/Iodof paste. Consequently, a non-inferiority of the GP paste was observed when compared to the CaOH/Iodof paste (P < .001). CONCLUSION The GP paste has a non-inferior success rate than the CaOH/Iodof paste used as filling material for pulpectomy in primary teeth.
Collapse
Affiliation(s)
- Carmela R Bresolin
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Faculdades Metropolitanas Unidas, School of Dentistry, São Paulo, SP, Brazil
| | - Renata P S Marques
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Bruna Okamura
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Claudio Costa
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cacio Moura-Netto
- Faculty Dental Medicine, Center for Interdisciplinary Research in Health-SalivaTec Lab, Universidade Católica Portuguesa, Viseu, Portugal
| | - Juan S Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Anna Carolina V Mello-Moura
- Faculty Dental Medicine, Center for Interdisciplinary Research in Health-SalivaTec Lab, Universidade Católica Portuguesa, Viseu, Portugal
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
10
|
Knorst JK, Brondani B, Vettore MV, Hesse D, Mendes FM, Ardenghi TM. Pathways between Social Capital and Oral Health from Childhood to Adolescence. J Dent Res 2022; 101:1155-1164. [PMID: 35593509 DOI: 10.1177/00220345221094510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the theoretical pathways by which social capital can influence dental caries and oral health-related quality of life (OHRQoL) of children over time. This 10-y prospective cohort started in 2010 with a sample of 639 preschoolers aged 1 to 5 y from the southern Brazil. Community and individual social capital were assessed at baseline through the presence of formal institutions in the neighborhood and social networks, respectively. In the 10-y follow-up, the individual social capital was evaluated by social trust and social networks. Dental caries was measured by the International Caries Detection and Assessment System (ICDAS), and the short version of the Child Perception Questionnaire (CPQ11-14) was used to assess OHRQoL. Demographic, socioeconomic, behavioral (frequency of toothbrushing and use of dental services), and psychosocial (sense of coherence) characteristics were also assessed. Structural equation modeling was used to evaluate the associations between variables over time. About 429 children were reassessed at 10-y follow-up (67.1% cohort retention rate). High community social capital at baseline directly predicted lower occurrence of dental caries and better OHRQoL after 10 y. Social capital at community level also indirectly predicted lower occurrence of dental caries through sense of coherence, frequency of toothbrushing, and use of dental services. Individual social capital at follow-up was indirectly linked to OHRQoL via the psychosocial pathway (sense of coherence). Community-level social capital was associated with dental caries and OHRQoL over time. The relationship between individual social capital and oral health was mediated through the psychosocial pathway.
Collapse
Affiliation(s)
- J K Knorst
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - B Brondani
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - M V Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - D Hesse
- Department of Pediatric Dentistry, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - F M Mendes
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - T M Ardenghi
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| |
Collapse
|
11
|
Gimenez T, Tedesco TK, Janoian F, Braga MM, Raggio DP, Deery C, Ricketts DNJ, Ekstrand KR, Mendes FM. What is the most accurate method for detecting caries lesions? A systematic review. Community Dent Oral Epidemiol 2021; 49:216-224. [PMID: 33847007 DOI: 10.1111/cdoe.12641] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 03/12/2021] [Accepted: 03/14/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To perform a systematic review and meta-analysis of the performance of different methods for detecting carious lesions in permanent and primary teeth, considering all types of tooth surface. METHODS Two reviewers searched PubMed, Embase, Scopus and other sources up to November 2020 to identify published and nonpublished studies in English. We focused on three caries detection methods: visual inspection (VI), radiographic (RX) and fluorescence-based (LF). We included studies investigating at least one of these methods which (a) assessed the accuracy of the method in detecting caries lesions; (b) considered occlusal, proximal or free smooth surfaces in primary or permanent teeth; (c) used a reference standard other than one of the three methods; and (d) reported data on sample size and accuracy. Multilevel analyses, meta-regressions and comparisons of bivariate summary receiver operating characteristics curves were undertaken. RESULTS Two hundred and forty manuscripts from 14 129 articles initially identified met the inclusion criteria. VI was better than RX on occlusal surfaces at all caries lesion thresholds and proximal surfaces of permanent teeth only at all lesion thresholds in laboratory setting. LF was slightly better than VI for advanced lesions on occlusal surfaces of permanent teeth in the clinical setting and for all lesions on proximal surfaces of permanent teeth in the laboratory setting. Still, LF was worse than VI for advanced occlusal lesions in permanent teeth in the laboratory setting. Although LF showed slightly better performance than VI with advanced lesions, the latter had significantly higher specificity than other methods in all settings. CONCLUSION Visual caries detection alone is adequate for most patients in daily clinical practice regardless of tooth type or surface.
Collapse
Affiliation(s)
- Thais Gimenez
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil.,Graduate Program in Dentistry, Ibirapuera University, Sao Paulo, Brazil
| | - Tamara K Tedesco
- Graduate Program in Dentistry, Ibirapuera University, Sao Paulo, Brazil
| | - Fernando Janoian
- Graduate Program in Dentistry, Ibirapuera University, Sao Paulo, Brazil
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Daniela Prócida Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Christopher Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Kim Rud Ekstrand
- Section of Cariology & Endodontics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.,Section of Pediatric Dentistry & Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| |
Collapse
|
12
|
Pontes LRA, Lara JS, Novaes TF, Freitas JG, Gimenez T, Moro BLP, Maia HCM, Imparato JCP, Braga MM, Raggio DP, Mendes FM. Negligible therapeutic impact, false-positives, overdiagnosis and lead-time are the reasons why radiographs bring more harm than benefits in the caries diagnosis of preschool children. BMC Oral Health 2021; 21:168. [PMID: 33789655 PMCID: PMC8011211 DOI: 10.1186/s12903-021-01528-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 03/22/2021] [Indexed: 02/02/2023] Open
Abstract
Background To evaluate the clinical course and interventions required during two years of follow-up of dental surfaces of deciduous molars diagnosed, and consequently treated, by two different strategies: diagnosis made by clinical examination alone or associated with radiographs. Methods This is a secondary analysis of a two-arm randomized clinical trial with parallel groups related to the diagnostic strategy for caries detection in preschool children. 216 children (3–6 years old) were followed-up for two years. All dental surfaces were diagnosed by visual inspection and later, through radiographic assessment. Baseline treatment was made in accordance with the results obtained by visual inspection performed alone or combined with radiographic method, considering the allocated group. Dental surfaces with no restoration needs, or those restored at the beginning of the study were followed-up for two years. The treatment decision was made according to the allocated group. The outcome was the occurrence of failure (a new caries lesion or a restoration replacement) during the follow-up. Results 4383 proximal and occlusal surfaces of deciduous molars in 216 preschool children were diagnosed and treated according to the abovementioned diagnostic strategies and followed-up for 24 months. The assessment of radiographs made change the initial decision reached by visual inspection in about 30% of the surfaces when all types of interventions were considered. However, most disagreements occurred for initial lesions, where radiographs tended to underestimate them. Discordances between methods occurred in less than 5% of all surfaces when considered lesions requiring operative treatment. For discrepancy cases, the placed interventions guided by following the radiographic results did not present less failures against those made following only visual inspection. As a matter of fact, the use of radiographs in the diagnostic strategy for caries detection in children brought more harms than benefits due to the occurrence of false-positives, overdiagnosis and lead-time bias. Conclusions Simultaneous association of visual inspection and radiographic assessment for caries detection in preschool children causes more harms than benefits, and therefore, visual inspection should be conducted alone in the regular clinical practice. Trial registration Clinicaltrials.gov platform: NCT02078453, registered on 5th March 2014. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01528-w.
Collapse
Affiliation(s)
- Laura Regina A Pontes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Juan Sebastian Lara
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,Department of Cariology, Operative Dentistry and Dental Public Health, Dental Institute, Indiana University School of Dentistry, 1121 W Michigan St., Indiana, IN, 46202, USA
| | - Tatiane Fernandes Novaes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,Cruzeiro Do Sul University, R. Galvão Bueno, 868, São Paulo, 01506-000, Brazil
| | - Julia Gomes Freitas
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Thais Gimenez
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.,School of Dentistry, Ibirapuera University, Av. Interlagos, 1329, São Paulo, 04661-100, Brazil
| | - Bruna Lorena P Moro
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Haline C M Maia
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Daniela P Raggio
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, Faculty of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
| | | |
Collapse
|
13
|
Moriyama CM, Novaes TF, Ferreira FR, Moro BLP, Imparato JCP, Diniz MB, Braga MM, Mendes FM. What diagnostic strategy performs better for caries lesion detection on proximal surfaces of adolescents? Clin Oral Investig 2021; 25:3977-3986. [PMID: 33404759 DOI: 10.1007/s00784-020-03728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 12/03/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the performance of visual inspection alone and associated to radiographic and laser fluorescence (LF) methods in detecting non-evident caries lesions at adolescents' proximal surfaces. MATERIALS AND METHODS Adolescents (12 to 17 years old) were assessed for the presence of caries lesions through visual inspection, radiographic examination, and LF method (DIAGNOdent pen), at non-cavitated (NC) and cavitated lesion (CAV) thresholds. Temporary separation with orthodontic rubbers followed by direct visual inspection was the reference standard method. Two examiners conducted the examinations, and the first examiner reassessed around 20% of the sample, to evaluate inter- and intra-examiner reproducibility, respectively. Sensitivity, specificity, accuracy, and utility values were calculated for the methods alone and combined with visual inspection using two different strategies: simultaneous and sequential combination. RESULTS A total of 834 proximal surfaces (51 adolescents) were included. Visual inspection presented higher reproducibility values (higher than 0.98). Moreover, visual inspection presented higher sensitivity (around 0.51) than those obtained with other diagnostic strategies (varying from 0.09 to 0.20) at the NC threshold. For CAV, visual inspection presented higher specificity (0.996) than the sequential association with adjunct methods (around 0.97), but with lower sensitivity. Accuracy and utility values for combined strategies were similar or lower than those achieved with the visual inspection performed alone. CONCLUSION Visual inspection alone performs better for detecting caries lesions in premolars and molars of adolescents than other diagnostic strategies. CLINICAL RELEVANCE The best diagnostic strategy for caries detection of proximal caries lesions in adolescents is the visual inspection alone.
Collapse
Affiliation(s)
- Caroline M Moriyama
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil.,School of Dentistry, Metropolitan University of Santos, Av Conselheiro Nebias, 536, Santos, 11045-003, Brazil
| | - Tatiane F Novaes
- School of Dentistry, Cruzeiro do Sul University, R. Galvao Bueno, 868, São Paulo, 01506-000, Brazil
| | - Fernanda R Ferreira
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Bruna Lorena P Moro
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Michele B Diniz
- School of Dentistry, Cruzeiro do Sul University, R. Galvao Bueno, 868, São Paulo, 01506-000, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, Brazil. .,Faculdade de Odontologia da Universidade de São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
| |
Collapse
|
14
|
Mendes FM, Braga MM, Pássaro AL, Moro BLP, Freitas RD, Gimenez T, Tedesco TK, Raggio DP, Pannuti CM. How researchers should select the best outcomes for randomised clinical trials in paediatric dentistry? Int J Paediatr Dent 2020; 31 Suppl 1:23-30. [PMID: 33145897 DOI: 10.1111/ipd.12743] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/12/2020] [Accepted: 10/18/2020] [Indexed: 12/16/2022]
Abstract
Randomised clinical trial (RCT) is the best study design to evaluate the effect of the treatment and preventive healthcare procedures. The effects of the tested treatments on patient's health are compared in terms of outcomes, which are used to evaluate the participants' health changes. However, these outcomes should be relevant for the target population. In that way, RCTs represent the type of primary study design that provides the most reliable evidence to implement therapies into the clinical practice. In this review, an outline of some aspects related to the choice of RCTs' outcomes was presented, focusing on the conduction of relevant trials in Paediatric Dentistry. The importance and necessity of defining a primary outcome were addressed, preferentially a clinically relevant endpoint. The patients should perceive this outcome, and changes in this variable should reflect directly patient's health improvement or impairment. Moreover, considerations about the objective or subjective variables, use of surrogate outcomes, and the increasing tendency to develop core outcome sets were also presented in this review. The main idea of this manuscript is the RCTs must evaluate outcomes relevant to the children's oral health in order to contribute to the implementation of treatments in the evidence-based health practice.
Collapse
Affiliation(s)
- Fausto M Mendes
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mariana M Braga
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Bruna L P Moro
- School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Thais Gimenez
- School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Universidade Ibirapuera, São Paulo, Brazil
| | | | | | | |
Collapse
|
15
|
Heiderich CMC, Tedesco TK, Netto SS, de Sousa RC, Allegrini Júnior S, Mendes FM, Gimenez T. Methodological quality and risk of bias of systematic reviews about loading time of multiple dental implants in totally or partially edentulous patients: An umbrella systematic review. Jpn Dent Sci Rev 2020; 56:135-146. [PMID: 33088366 PMCID: PMC7567949 DOI: 10.1016/j.jdsr.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/11/2020] [Accepted: 09/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There are several systematic reviews of multiple implant loading techniques, but results are conflicting. AIM To perform an umbrella review on methodological quality of systematic reviews about techniques for loading multiple dental implants. MATERIAL AND METHODS MEDLINE (PubMed) and Scopus were searched up to December 31, 2019. Unpublished literature was searched through OpenGray and references of included articles were manually verified. Eligibility criteria were: articles had to (1) be about multiple dental implants; (2) mention the moment of loading; (3) be a systematic review. Two independent reviewers participated in the entire process. Qualitative description of included studies as well as methodological quality measurement and risk of bias through AMSTAR and ROBIS were performed. RESULTS 21 reviews were included. Thirteen stated that there was a similarity between loading techniques, two did not affirm which one was more appropriate and six mentioned that conventional technique was better. Eight papers were classified as high risk of bias, twelve as low and one as uncertain risk. CONCLUSION When evaluating only studies with a low risk of bias, there are no significant differences in implant loading time.
Collapse
Affiliation(s)
| | - Tamara Kerber Tedesco
- Graduate Program in Dentistry, Ibirapuera University, Av. Interlagos, 1329, São Paulo, Brazil
| | - Syrio Simão Netto
- Graduate Program in Dentistry, Ibirapuera University, Av. Interlagos, 1329, São Paulo, Brazil
| | | | - Sergio Allegrini Júnior
- Graduate Program in Dentistry, Ibirapuera University, Av. Interlagos, 1329, São Paulo, Brazil
| | - Fausto M. Mendes
- Department of Pediatric Dentistry, School of Dentistry, Av. Prof. Lineu Prestes, 2227, University of São Paulo, São Paulo, SP, Brazil
| | - Thais Gimenez
- Graduate Program in Dentistry, Ibirapuera University, Av. Interlagos, 1329, São Paulo, Brazil
- Department of Pediatric Dentistry, School of Dentistry, Av. Prof. Lineu Prestes, 2227, University of São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
16
|
Al-Sane M, Ricketts DN, Mendes FM, Altarakemah Y, Deery C, Innes N, Rollings S. Reproducibility of subtraction radiography in monitoring changes in approximal carious lesions in children: An in vivo study. Int J Paediatr Dent 2020; 30:587-596. [PMID: 32181942 DOI: 10.1111/ipd.12638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/10/2020] [Accepted: 03/03/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Laboratory studies have shown that digital subtraction radiography (DSR) can be a more effective tool, than conventional radiography, in monitoring changes in carious lesions. The clinical performance of the technique, however, has not been sufficiently researched. AIM To compare the reproducibility of DSR to that of bitewing radiographs, in monitoring changes in approximal caries in the mixed dentition. A secondary aim was to determine whether assessment outcomes differed as a function of the method used. DESIGN Six assessors evaluated 310 lesions first on bitewings, then with DSR. The overall reproducibility was evaluated via intra-class correlation coefficient (ICC). Intra- and inter-rater reproducibility were assessed using weighted Kappa. Paired t test was used to assess differences in the reproducibility across methods. RESULTS The overall reproducibility for DSR was (ICC = 0.47, 95% CI = 0.31-0.56). Intra- and inter-rater reproducibility were 0.65 and 0.44, respectively. The overall reproducibility for bitewings was ICC = 0.45, 95% CI = 0.42-0.57. Intra- and Inter-rater reproducibility were 0.71 and 0.46, respectively. Differences in the reproducibility across methods were not statistically significant. Significantly more lesions were scored as progressed using DSR. CONCLUSIONS The reproducibility of DSR in monitoring changes in approximal caries is comparable to that of bitewings. Additionally, DSR detected higher proportion of progression than bitewing assessments.
Collapse
Affiliation(s)
- Mona Al-Sane
- Faculty of Dentistry, Department of Developmental and Preventive Sciences, Kuwait University, Kuwait City, Kuwait
| | - David N Ricketts
- Section of Operative Dentistry, Fixed Prosthodontics and Endodontology, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Yacoub Altarakemah
- Faculty of Dentistry, Department of Restorative Sciences, Kuwait University, Kuwait City, Kuwait
| | - Christopher Deery
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Nicola Innes
- Department of Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
| | - Sam Rollings
- Aberdeen Dental Hospital and Institute of Dentistry, Department of Restorative Dentistry, Aberdeen, UK
| |
Collapse
|
17
|
Pontes LRA, Novaes TF, Lara JS, Gimenez T, Moro BLP, Camargo LB, Michel-Crosato E, Pannuti CM, Raggio DP, Braga MM, Mendes FM. Impact of visual inspection and radiographs for caries detection in children through a 2-year randomized clinical trial: The Caries Detection in Children-1 study. J Am Dent Assoc 2020; 151:407-415.e1. [PMID: 32450979 DOI: 10.1016/j.adaj.2020.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/02/2020] [Accepted: 02/05/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Visual inspection (VIS) with radiographic examination (RAD) is the recommended diagnostic strategy for detecting caries in children; however, this recommendation is based on accuracy studies. The authors conducted a clinical trial to compare the detection and subsequent treatment of carious lesions in primary molars performed with VIS alone and with RAD. METHODS Children (3-6 years old) were randomly assigned to 2 groups according to the diagnostic strategy used for caries detection on primary molars: VIS or RAD. Participants were diagnosed and treated according to the management plan related to the allocated group. The primary outcome was the number of new operative interventions during the 2-year follow-up period. Other secondary outcomes were also compared. Comparisons were performed with Mann-Whitney test using an intention-to-treat approach. RESULTS Of the 252 children included and randomized, 216 were followed-up after 2 years (14.3% attrition rate). There was no difference between the groups for the primary outcome (P = .476). For the secondary outcomes, the RAD group had more restoration replacements (P = .038) and more restorations performed since the beginning of the study (P = .038) compared with the VIS group. In addition, the RAD group had a higher number of false-positive results than the VIS group (P < .001). CONCLUSIONS Simultaneous use of VIS and RAD for caries diagnosis in primary molars of children who seek dental treatment does not provide additional benefits compared with VIS alone. PRACTICAL IMPLICATIONS Dentists should perform VIS only, not RAD, for detecting carious lesions in preschool-aged children. ClinicalTrials.gov: NCT02078453.
Collapse
|
18
|
Signori C, de Oliveira EF, Mendes FM, Braga MM, Opdam NJM, Cenci MS. Impact of a diagnostic workshop on undergraduate teaching-learning process for the diagnosis and management of tooth restorations-A randomised controlled study. Eur J Dent Educ 2019; 23:304-315. [PMID: 30729631 DOI: 10.1111/eje.12431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 02/04/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the impact of a diagnostic workshop on undergraduate teaching-learning process for the diagnosis and management of tooth restorations. METHODS The first stage of the study was a randomised controlled study with two parallel groups: lecture (L) and lecture coupled with a diagnostic workshop (LW). A pool of cases of tooth restorations including secondary caries and marginal defects was used for training. Theoretical knowledge, perception about the activity and practical abilities were evaluated. The second stage of the study assessed students' theoretical knowledge retention six months following intervention. All students included in the first stage of the study were exposed to LW. Hence, a new control group of students not exposed to LW was selected. One-way analysis of variance, Fisher's exact test, Kruskal-Wallis test and multilevel regression analysis were used as part of statistical analysis. RESULTS The LW group had greater scores for the assignment of lesion severity and activity, presence of marginal defect and treatment indication than the L group (P < 0.05). Multilevel regression analysis showed a positive impact of the workshop diagnosis in the correct assessment of lesion activity (P = 0.03). There was no statistical difference between the LW and L groups in students' perception of the activity. The LW group showed greater knowledge retention after six months than the L group (P = 0.027). CONCLUSION Lecture coupled with diagnostic workshop improved students' practical skills of diagnosis restorations and knowledge retention in the six months following intervention.
Collapse
Affiliation(s)
- Cácia Signori
- Federal University of Pelotas, Graduate Program in Dentistry, Pelotas, Brazil
| | | | - Fausto M Mendes
- University of São Paulo, Graduate Program in Dentistry, São Paulo, Brazil
| | - Mariana M Braga
- University of São Paulo, Graduate Program in Dentistry, São Paulo, Brazil
| | - Niek J M Opdam
- College of Dental Sciences, Preventive and Restorative Dentistry, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Maximiliano S Cenci
- Federal University of Pelotas, Graduate Program in Dentistry, Pelotas, Brazil
| |
Collapse
|
19
|
Monte-Santo AS, Viana SVC, Moreira KMS, Imparato JCP, Mendes FM, Bonini GAVC. Prevalence of early loss of primary molar and its impact in schoolchildren's quality of life. Int J Paediatr Dent 2018; 28:595-601. [PMID: 30105883 DOI: 10.1111/ipd.12416] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/29/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Evidence regarding the impact of premature loss of primary molars on oral health-related quality of life (OHRQoL) is lacking. AIM To evaluate the prevalence of premature loss of primary molars in schoolchildren and its impact on OHRQoL. DESIGN We randomly selected 667 children aged 8-9 years enrolled in public and private schools from Aracaju (Brazil). The presence of untreated dental caries and early loss of primary molars were recorded, and its impacts on OHRQoL evaluated using Child Perceptions Questionnaire (CPQ8-10 ). Influence of some variables on tooth loss and OHRQoL was assessed by multilevel Poisson's regression analysis (P < 0.05). RESULTS The prevalence for early tooth loss was 65.4% (95% confidence interval 51.1%-77.3%). Children with untreated dental caries and attending public schools presented higher prevalence of early tooth loss. Moreover, early loss of primary molars provoked negative impact on OHRQoL considering total score of CPQ8-10 and domains "oral symptoms," "functional limitations" and "emotional well-being." Children presenting early teeth loss presented significantly higher scores of CPQ8-10 , as well as females and children with dental caries in other teeth. CONCLUSIONS The prevalence of early loss of primary molars is high, and it impacts the OHRQoL of children aged 8-9 years.
Collapse
Affiliation(s)
- Aline S Monte-Santo
- Department of Pediatric Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil.,Department of Pediatric Dentistry, University Tiradentes, Aracaju, Brazil
| | - Silvânia V C Viana
- Department of Pediatric Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil
| | - Kelly Maria S Moreira
- Department of Pediatric Dentistry, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil.,Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Gabriela A V C Bonini
- Department of Pediatric Dentistry, São Leopoldo Mandic Institute and Dental Research Center, Campinas, Brazil
| |
Collapse
|
20
|
Signori C, Gimenez T, Mendes FM, Huysmans MCD, Opdam NJ, Cenci MS. Clinical relevance of studies on the visual and radiographic methods for detecting secondary caries lesions – A systematic review. J Dent 2018; 75:22-33. [DOI: 10.1016/j.jdent.2018.05.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 05/22/2018] [Accepted: 05/27/2018] [Indexed: 10/16/2022] Open
|
21
|
Schwendicke F, Elhennawy K, El Shahawy O, Maher R, Gimenez T, Mendes FM, Willis BH. Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany. BMC Oral Health 2018; 18:105. [PMID: 29884157 PMCID: PMC5993995 DOI: 10.1186/s12903-018-0561-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 05/22/2018] [Indexed: 11/17/2022] Open
Abstract
Background Diagnostic meta-analyses on caries detection methods should assist practitioners in their daily practice. However, conventional meta-analysis estimates may be inapplicable due to differences in test conduct, applied thresholds and assessed population between settings. Our aim was to demonstrate the impact of tailored meta-analysis of visual and radiographic caries detection to different settings using setting-specific routine data. Methods Published systematic reviews and meta-analyses on the accuracy of visual and radiographic caries detection were used. In two settings (a private practice in Germany and a public health clinic in Egypt), routine data of a total of 100 (n = 50/practice) consecutive 12–14 year-olds were collected. Test-positive rates of visual and radiographic detection for initial and advanced carious lesions on occlusal or proximal surfaces of molars were used to tailor meta-analyses. If prevalence data were available, these were also used for tailoring. Results From the original reviews, 210 and 100 heterogeneous studies on visual and radiographic caries detection were included in our meta-analyses. For radiographic detection, sensitivity and specificity estimates derived from conventional and tailored meta-analysis were similar. For visual detection of advanced occlusal carious lesions, the conventional meta-analysis yielded a sensitivity and specificity (95% CI) of 64.6% (57–71) and 90.9% (88–93), whereas the tailored estimates for Egypt were 75.1% (70–81) and 84.9% (82–89), respectively, and 43.7% (37–51) and 96.5% (95–97) for Germany, respectively. Conclusion Conventional test accuracy meta-analyses may yield aggregate estimates which are inapplicable to specific settings. Routine data may be used to produce a meta-analysis estimate which is tailored to the setting and thereby improving its applicability. Electronic supplementary material The online version of this article (10.1186/s12903-018-0561-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Karim Elhennawy
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Osama El Shahawy
- Department of Pediatric Dentistry, Cairo University, Giza, Egypt.,Department of Pediatric Dentistry, Cairo University, 11 el Saraya Street, Manial, Cairo, Egypt
| | - Reham Maher
- Department of Pediatric Dentistry, Cairo University, Giza, Egypt.,Department of Pediatric Dentistry, Cairo University, 11 el Saraya Street, Manial, Cairo, Egypt
| | - Thais Gimenez
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, São Paulo, 2227, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, São Paulo, 2227, Brazil
| | - Brian H Willis
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| |
Collapse
|
22
|
Guedes RS, Ardenghi TM, Emmanuelli B, Piovesan C, Mendes FM. Sensitivity of an oral health-related quality-of-life questionnaire in detecting oral health impairment in preschool children. Int J Paediatr Dent 2018; 28:207-216. [PMID: 28833769 DOI: 10.1111/ipd.12328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIM This two-year cohort study evaluated whether the Early Childhood Oral Health Impact Scale (ECOHIS) is responsive to detect changes related to dental caries. DESIGN Preschool children were examined in 2010 regarding dental caries, and their parents responded to the ECOHIS. After 2 years, 352 children (response rate = 73.6%) were re-examined and a new ECOHIS was responded. Children were categorized according to caries increment (no new caries, 1-3 surfaces with new lesions, and four or more decayed surfaces). The outcome variables were related to the decline of quality of life as determined via ECOHIS: decline, severe decline, and differences between baseline and follow-up scores. Effect sizes (ES) were calculated, and the associations were evaluated through Poisson regression. RESULTS ES was small for children with 1-3 new lesions (ES = 0.19) and moderate for children with four or more new carious lesions (ES = 0.61). Children who developed 1-3 new lesions were significantly associated with all outcome variables compared to children with no new lesions, but the associations were stronger for children with four or more new carious lesions. CONCLUSIONS The ECOHIS is sensitive to the deterioration of quality of life due to caries increments in preschool children.
Collapse
Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Chaiana Piovesan
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
23
|
Guedes RS, Piovesan C, Ardenghi TM, Emmanuelli B, Braga MM, Mendes FM. Presence of Initial Caries Lesions as a Risk Factor for Caries in Preschool Children: A Cohort Study. Caries Res 2017; 52:32-41. [PMID: 29232677 DOI: 10.1159/000479824] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/26/2017] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the influence of initial noncavitated caries lesions on cavitated caries increment in preschool children. A 2-year cohort study was designed to include the participants of a survey on dental caries performed in 2010. Preschool children (12-59 months old) were examined for dental caries and classified as children with no caries lesions, with only initial lesions, with at least 1 moderate caries lesion, and with extensive lesions. Socioeconomic data were also collected. After 2 years, 466 children were re-examined (follow-up rate of 72.9%) only for cavitated lesions. Association between caries incidence at 2 levels of severity and caries experience and other variables was evaluated using hierarchical Poisson regression analysis. The children with moderate and extensive caries lesions at baseline presented a higher risk of presenting both outcomes than the children with no caries lesions. Nevertheless, the children with only initial lesions had a higher risk of developing at least 1 new cavitated carious lesion, but not for a more severe increment in caries. Subgroup analysis stratified by the children's age showed that the influence of the presence of initial caries lesions on cavitated caries increment was only observed in children aged 12-35 months. In conclusion, although the presence of moderate and extensive lesions at baseline is a significant predictor for cavitated caries increment after 2 years in preschool children at all ages, the presence of only initial caries lesions is also associated, but with less severe caries incidence.
Collapse
Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
24
|
Mello-Moura ACV, Bresolin CR, Moura-Netto C, Ito A, Araki AT, Imparato JCP, Mendes FM. Use of artificial primary teeth for endodontic laboratory research: experiments related to canal length determination. BMC Oral Health 2017; 17:131. [PMID: 29149844 PMCID: PMC5693584 DOI: 10.1186/s12903-017-0420-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 10/27/2017] [Indexed: 11/23/2022] Open
Abstract
Background Due to the scarcity of exfoliated/extracted human primary teeth with complete roots, artificial teeth were developed as an alternative to be used for educational and laboratory research purposes. This study aimed to assess the feasibility of using artificial primary teeth for conducting laboratory research through an experiment related to canal length determination, comparing artificial teeth with natural teeth. Methods Thirty anterior and 21 posterior artificial teeth, and the same number of natural primary teeth were selected. After preparing the access cavity, the root canal length was determined by two examiners twice using three different methods: radiography and two electronic apex locators. Then, the actual root canal length was measured by inserting a K-file up to the apical foramen (reference standard). Accuracy was calculated using Bland-Altman analysis and intraclass correlation coefficient (ICC). The inter- and intra-examiner reproducibility was also calculated using the ICC. Results The methods using the electronic apex locators showed better accuracy in both artificial and natural teeth. Trends observed with artificial primary teeth were similar to those observed with natural teeth, except for the results in artificial anterior teeth. Conclusions The model of artificial teeth might be a good alternative for educational purposes; however, improvements are necessary to employ these teeth for research purposes when considering experiments for canal length determination. Electronic supplementary material The online version of this article (10.1186/s12903-017-0420-3) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Anna Carolina V Mello-Moura
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Universidade Ibirapuera, São Paulo, Brazil
| | - Carmela R Bresolin
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Cacio Moura-Netto
- School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - André Ito
- São Leopoldo Mandic Institute and Research Center, Campinas, Brazil
| | - Angela T Araki
- School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,São Leopoldo Mandic Institute and Research Center, Campinas, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil. .,Faculdade de Odontologia da Universidade de São Paulo, Av. Lineu Prestes, 2227, São Paulo, SP, 05508-000, Brazil.
| |
Collapse
|
25
|
Novaes TF, Pontes LRA, Freitas JG, Acosta CP, Andrade KCE, Guedes RS, Ardenghi TM, Imparato JCP, Braga MM, Raggio DP, Mendes FM. Responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) is related to dental treatment complexity. Health Qual Life Outcomes 2017; 15:182. [PMID: 28931398 PMCID: PMC5608161 DOI: 10.1186/s12955-017-0756-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/10/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) has varied greatly across studies; hence, we hypothesized that this discrepancy could be related to the complexity of dental treatment received. Thus, we aimed to evaluate the responsiveness of the ECOHIS to changes in oral health-related quality of life (OHRQoL) following dental treatments of varying complexity in preschool children. METHODS Preschool children aged 3 to 6 years were selected; their parents responded to the ECOHIS at baseline. The parents responded to the ECOHIS again and a global transition question 30 days after the children were treated. The type of treatment received by the children was categorized according to complexity, as follows: 1) non-operative treatment only, 2) restorative treatment, and 3) endodontic treatment and/or tooth extraction. Change scores and effect sizes (ES) were calculated for total scores, as well as considering the different treatment types and global transition question responses. RESULTS Of the 152 children who completed the study, the ECOHIS yielded large ES for total scores (0.89). The children showed increasing ES values associated with better perception of improvement, assessed by the global transition question. The magnitude of ES after treatment was related to treatment complexity (0.53, 0.92 and 1.43, for children who received non-operative treatment only, restorative treatment, and endodontic treatment and/or tooth extraction, respectively). CONCLUSIONS Parents whose children required more complex dental treatment are more likely to perceive treatment-related changes to OHRQoL assessed with the ECOHIS.
Collapse
Affiliation(s)
- Tatiane F Novaes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil.,School of Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
| | - Laura Regina A Pontes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil
| | - Julia G Freitas
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil
| | - Carolina P Acosta
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil
| | | | - Renata S Guedes
- School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - Thiago M Ardenghi
- Departament of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - José Carlos P Imparato
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil
| | - Daniela P Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av. Lineu Prestes, 2227, São Paulo, 05508-000, SP, Brazil.
| | | |
Collapse
|
26
|
Pinto VV, Alves LAC, Mendes FM, Ciamponi AL. The nutritional state of children and adolescents with cerebral palsy is associated with oral motor dysfunction and social conditions: a cross sectional study. BMC Neurol 2016; 16:55. [PMID: 27117791 PMCID: PMC4847222 DOI: 10.1186/s12883-016-0573-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 04/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cerebral palsy (CP) is the main cause of severe physical impairment during childhood and has commonly shown oral motor association. It has been considered as the main cause of the high prevalence of problems in children's nutrition. Respiration, chewing, swallowing, speaking and facial expressionare part of the orofacial motor functions and when affected they can interfere in children's well-being. The aim of this study was to correlate two methods of orofacial motor evaluation, analyze the influence of orofacial motor functional impairment on the nutritional status of children and adolescents with CP, and the association between socioeconomic factors. METHODS Seventy children and adolescents with CP were selected, age range 6-16 years and following the exclusion criteria previously determined; 129 normoreactive children (control group), sex and age-matched to patients with CP. For the orofacial motor analysis two evaluation instruments were applied, the "Oral Motor Assessment Scale" (OMAS) and "Nordic Orofacial Test-Screening" (NOT-S). The anthropometric evaluation was based on the World Health Organization (WHO) and followed the criteria recommended by the Brazilian Ministry of Health. RESULTS There was statistically significant correlation between the oral motor methods of evaluation (r = -0.439, p < 0.0001). Concerning the nutritional status evaluation, being overweight was associated with dystonic and mixed CP forms variables (p = 0.034), mother with no partnership (p = 0.045) and mild oral motor impairment (p = 0.028). CONCLUSION It could be concluded that, the weight's gain by children and adolescents might be favored by a better functional oral motor performance and social factors.
Collapse
Affiliation(s)
- Vanessa Vieira Pinto
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo (USP), Avenida Professor Lineu Prestes 2227, SP, São Paulo, 05508-000, Brazil
| | - Levy Anderson César Alves
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo (USP), Avenida Professor Lineu Prestes 2227, SP, São Paulo, 05508-000, Brazil
| | - Fausto M Mendes
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo (USP), Avenida Professor Lineu Prestes 2227, SP, São Paulo, 05508-000, Brazil
| | - Ana Lídia Ciamponi
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of São Paulo (USP), Avenida Professor Lineu Prestes 2227, SP, São Paulo, 05508-000, Brazil.
| |
Collapse
|
27
|
Guedes RS, Piovesan C, Floriano I, Emmanuelli B, Braga MM, Ekstrand KR, Ardenghi TM, Mendes FM. Risk of initial and moderate caries lesions in primary teeth to progress to dentine cavitation: a 2-year cohort study. Int J Paediatr Dent 2016; 26:116-24. [PMID: 25923059 DOI: 10.1111/ipd.12166] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To investigate the risk of sound surfaces, and initial and moderate caries lesions to progress to dentine cavitation in preschool children. DESIGN A cohort study was designed with 639 children (12-59 months old) who had been examined by visual inspection during a survey in 2010. After 2 years, 469 children were re-examined regarding the presence of dentine cavitations. The probability of progression was calculated for sound and carious (initial and moderate lesions) surfaces. Relative risk of progression and 95% confidence intervals for each condition compared with sound surfaces were calculated using multilevel Poisson regression analysis. Association with explanatory variables, including caries experience of the children, was also investigated. RESULTS The higher the initial score attributed to the dental surface, the more likely was the progression. Moreover, children with severe lesions at baseline had higher risk of having a sound surface or a non-cavitated caries lesion progressing to cavitation when compared with caries-free children; however, this increased risk was not observed in children with only initial caries lesions. CONCLUSIONS Initial caries lesions present a low frequency of progression. Moreover, sound surfaces and initial caries lesions in children already presenting cavitations are more likely to progress to more severe conditions.
Collapse
Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - Chaiana Piovesan
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - Isabela Floriano
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Kim R Ekstrand
- Department of Cariology and Endodontics and Clinical Genetics, Faculty of Health Sciences, School of Dentistry, Copenhagen, Denmark
| | - Thiago M Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
28
|
Guedes RS, Ardenghi TM, Piovesan C, Emmanuelli B, Mendes FM. Influence of initial caries lesions on quality of life in preschool children: a 2-year cohort study. Community Dent Oral Epidemiol 2016; 44:292-300. [PMID: 26892250 DOI: 10.1111/cdoe.12217] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/13/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We aimed to assess the impact of the presence of initial and other stages of dental caries on the impairment of oral health-related quality of life in preschool children (COHRQoL) through a cohort study. METHODS During an epidemiological survey, 478 children (12-59 months old) were examined for dental caries using the International Caries and Detection Assessment System (ICDAS), and their parents answered the Early Childhood Oral Health Impact Scale (ECOHIS). Children were categorized based on the presence of dental caries as follows: children with no caries lesions, children with only initial lesions (ICDAS scores 1 and 2), children with at least one moderate lesion (ICDAS scores 3 and 4) and children with extensive lesions (ICDAS scores 5 and 6). After 2 years, 352 children were re-examined for the presence of dentine cavitations, and their parents completed a new ECOHIS questionnaire. Multilevel Poisson regression analysis was performed to evaluate the impact of the presence of different stages of caries lesions at the baseline on COHRQoL impairment at the follow-up, considering two outcome variables: worsening and severe worsening of COHRQoL. Relative risk values (RR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS Worsening or severe worsening of the COHRQoL at the follow-up were observed only in children with moderate lesions (RR = 2.00; 95% CI = 1.30-3.08 and RR = 2.38; 95% CI = 1.31-4.34, respectively) or children with extensive lesions (RR = 1.59; 95% CI = 1.10-2.30 for worsening and RR = 1.88; 95% CI = 1.13-3.12 for severe worsening). On the other hand, the presence of only initial caries lesions was not a significant predictor of COHRQoL impairment. CONCLUSIONS The presence of only initial caries lesions does not impair COHRQoL of preschool children; however, moderate and extensive lesions are risk factors for worsening of the COHRQoL.
Collapse
Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Chaiana Piovesan
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Institute of Dentistry, São Lucas School, Porto Velho, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
29
|
Souza DN, Mendes FM, Nogueira FN, Simões A, Nicolau J. Lithium Induces Glycogen Accumulation in Salivary Glands of the Rat. Biol Trace Elem Res 2016; 169:271-8. [PMID: 26155966 DOI: 10.1007/s12011-015-0434-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/30/2015] [Indexed: 01/25/2023]
Abstract
Lithium is administered for the treatment of mood and bipolar disorder. The aim of this study was to verify whether treatment with different concentrations of lithium may affect the glycogen metabolism in the salivary glands of the rats when compared with the liver. Mobilization of glycogen in salivary glands is important for the process of secretion. Two sets of experiments were carried out, that is, in the first, the rats received drinking water supplemented with LiCl (38,25 and 12 mM of LiCl for 15 days) and the second experiment was carried out by intraperitoneal injection of LiCl solution (12 mg/kg and 45 mg LiCl/kg body weight) for 3 days. The active form of glycogen phosphorylase was not affected by treatment with LiCl considering the two experiments. The active form of glycogen synthase presented higher activity in the submandibular glands of rats treated with 25 and 38 mM LiCl and in the liver, with 25 mM LiCl. Glycogen level was higher than that of control in the submandibular glands of rats receiving 38 and 12 mM LiCl, in the parotid of rats receiving 25 and 38 mM, and in the liver of rats receiving 12 mM LiCl. The absolute value of glycogen for the submandibular treated with 25 mM LiCl, and the liver treated with 38 mM LiCl, was higher than the control value, although not statistically significant for these tissues. No statistically significant difference was found in the submandibular and parotid salivary glands for protein concentration when comparing experimental and control groups. We concluded that LiCl administered to rats influences the metabolism of glycogen in salivary glands.
Collapse
Affiliation(s)
- D N Souza
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes, São Paulo, SP, 2227, Brazil
| | - F M Mendes
- Departamento Ortodontia e Odontopediatria, Faculdade de Odontologia, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes, São Paulo, SP, 2227, Brazil
| | - F N Nogueira
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes, São Paulo, SP, 2227, Brazil
| | - A Simões
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes, São Paulo, SP, 2227, Brazil
| | - J Nicolau
- Departamento de Biomateriais e Biologia Oral, Faculdade de Odontologia, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes, São Paulo, SP, 2227, Brazil.
| |
Collapse
|
30
|
Lenzi TL, Piovesan C, Mendes FM, Braga MM, Raggio DP. In vitro performance of QLF system and conventional methods for detection of occlusal caries around tooth-colored restorations in primary molars. Int J Paediatr Dent 2016; 26:26-34. [PMID: 25604208 DOI: 10.1111/ipd.12154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Secondary caries is the main reason for restoration replacement, and therefore, an accurate detection of this type of condition is fundamental. AIM To compare in vitro the performance of different conventional and quantitative light-induced fluorescence-based (QLF) methods in detecting occlusal caries around resin composite restorations in primary molars. DESIGN Two examiners evaluated independently 42 sites adjacent to tooth-colored restorations using visual inspection (ICDAS-CARS), radiographic examination, and QLF. Histological examination was used as reference standard method. Area under the ROC curve (Az), sensitivity, specificity, and accuracy of the methods were calculated at enamel (D1) and dentin caries (D3) lesions thresholds. Intra- and interexaminer reproducibility were calculated using intraclass correlation coefficient (ICC) and kappa statistics. RESULTS There was no difference among the methods considering Az at D1 threshold. Visual inspection, radiograph, and QLF (scores) methods presented similar sensitivities and significantly higher than those obtained with the QLF (∆F%). At D3 threshold, there were no differences among the methods regarding sensitivities, specificities, and accuracy, except for the examiner 2 with the QLF (∆F%) who achieved a very low sensitivity value. CONCLUSION Conventional methods are similar to QLF methods for detecting caries around tooth-colored restorations in primary teeth.
Collapse
Affiliation(s)
- Tathiane L Lenzi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Chaiana Piovesan
- Curso de Odontologia, Unifra - Centro Universitário Franciscano, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| | - Daniela P Raggio
- Department of Pediatric Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, Brazil
| |
Collapse
|
31
|
Tedesco TK, Calvo AFB, Domingues GG, Mendes FM, Raggio DP. Bond Strength of High-Viscosity Glass Ionomer Cements is Affected by Tubular Density and Location in Dentin? Microsc Microanal 2015; 21:849-854. [PMID: 26137917 DOI: 10.1017/s1431927615013021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study evaluated the influence of tubular density of different dentin depths and location on the bond strength of high-viscosity glass ionomer cements (GIC). A total of 20 molars were selected and assigned into six experimental groups, considering two different high-viscosity GICs-Fuji IX (FIX) or Ketac Molar (KM), and dentin location-proximal, occlusal superficial, or occlusal deep dentin (n=10). Teeth were cut and a topographical analysis of four sections per group was performed to obtain data about the tubular density of each different dentin location and depths by laser scanning confocal microscopy (100×). Polyethylene tubes were placed over the pretreated surfaces and filled with one of the GICs. Microshear bond strength (µSBS) test was performed after storage in distilled water (24 h at 37°C). Failure modes were evaluated using a stereomicroscope (400×). Multilevel regression analysis was performed to compare the results at a significance level set at 5%. The tubule density was inversely proportional to the bond strength for both GICs (p<0.05). Adhesive/mixed failure prevailed in all experimental groups. Proximal (30036.5±3433.3) and occlusal superficial 29665.3±1434.04 dentin shows lower tubule density, resulting in a better GIC bonding performance (proximal: FIX-3.61±1.05; KM-3.40±1.62; occlusal superficial: FIX-4.70±1.85; KM-4.97±1.25). Thus, we can concluded that the lowest tubule density in proximal and occlusal superficial dentin results in a better GIC bond strength performance.
Collapse
Affiliation(s)
- Tamara K Tedesco
- Department of Orthodontics and Pediatric Dentistry,School of Dentistry,University of São Paulo,São Paulo 05508-000,Brazil
| | - Ana Flávia B Calvo
- Department of Orthodontics and Pediatric Dentistry,School of Dentistry,University of São Paulo,São Paulo 05508-000,Brazil
| | - Gabrielle G Domingues
- Department of Orthodontics and Pediatric Dentistry,School of Dentistry,University of São Paulo,São Paulo 05508-000,Brazil
| | - Fausto M Mendes
- Department of Orthodontics and Pediatric Dentistry,School of Dentistry,University of São Paulo,São Paulo 05508-000,Brazil
| | - Daniela P Raggio
- Department of Orthodontics and Pediatric Dentistry,School of Dentistry,University of São Paulo,São Paulo 05508-000,Brazil
| |
Collapse
|
32
|
Mattos-Silveira J, Floriano I, Ferreira FR, Viganó MEF, Mendes FM, Braga MM. Children's discomfort may vary among different treatments for initial approximal caries lesions: preliminary findings of a randomized controlled clinical trial. Int J Paediatr Dent 2015; 25:300-4. [PMID: 25229641 DOI: 10.1111/ipd.12134] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Longer and more complex dental procedures could negatively affect patient's acceptability of minimal invasive techniques. AIMS AND METHODS Therefore, this short communication aims to show the preliminary findings regarding children's discomfort reported after some minimal invasive treatments in treating initial caries lesions on approximal surfaces: flossing instruction, silver diamine fluoride (SDF) application and caries resin infiltration. RESULTS Children allocated in the infiltration group showed higher levels of discomfort than those in the SDF and control groups. CONCLUSIONS These findings suggest that the simplest interventions for approximal initial caries lesions cause less discomfort for children and should be applied where possible.
Collapse
Affiliation(s)
- Juliana Mattos-Silveira
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Isabela Floriano
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fernanda R Ferreira
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Maria Eduarda F Viganó
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
33
|
Ferreira HR, Rosa EF, Antunes JLF, Duarte DA, Imparato JCP, Pannuti CM, Mendes FM. Prolonged pacifier use during infancy and smoking initiation in adolescence: evidence from a historical cohort study. Eur Addict Res 2015; 21:33-8. [PMID: 25358513 DOI: 10.1159/000365351] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 06/19/2014] [Indexed: 11/19/2022]
Abstract
AIM To investigate the association between prolonged pacifier use during childhood and smoking in adolescence and early adulthood. METHODS A historical cohort study including patients from a dental private office was designed. Dental records were used, which contained complete data about sucking habits from 314 children (2-10 years of age) who had attended a private dental office from 1988 to 1994 in Ibiá, Brazil. Then, we collected data about the smoking habits from 261 subjects who were successfully contacted again from 2004 to 2006. Our outcome variable was smoking, and subjects who had smoked more than 100 cigarettes during their lifetime were classified as smokers. Poisson regression analysis matched the association between oral habits and smoking. Incidence rate ratios (IRR) and 95% confidence intervals (95% CI) were calculated. The level of significance was set at 5%. RESULTS We observed a statistically significant association between prolonged pacifier use (more than 24 months) and smoking (IRR = 4.48; 95% CI 2.32-8.65). Breastfeeding, in contrast, was a protective factor (IRR = 0.64; 95% CI 0.42-0.96). CONCLUSIONS Prolonged pacifier use during childhood is positively associated with smoking initiation in adolescence and early adulthood.
Collapse
Affiliation(s)
- Helenice R Ferreira
- Division of Pediatric Dentistry, Cruzeiro do Sul University, São Paulo, Brazil
| | | | | | | | | | | | | |
Collapse
|
34
|
Mattos-Silveira J, Floriano I, Ferreira FR, Viganó MEF, Frizzo MA, Reyes A, Novaes TF, Moriyama CM, Raggio DP, Imparato JCP, Mendes FM, Braga MM. New proposal of silver diamine fluoride use in arresting approximal caries: study protocol for a randomized controlled trial. Trials 2014; 15:448. [PMID: 25409545 PMCID: PMC4255679 DOI: 10.1186/1745-6215-15-448] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Accepted: 11/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Approximal surfaces are a challenge to caries lesions control. Silver diamine fluoride (SDF) is a simple,low-cost and promisor intervention for arresting caries lesions, but it has never been tested on approximal surfaces. Our aim is to evaluate the efficacy and cost-efficacy of SDF in arresting initial lesions compared to resin infiltration and exclusively flossing (control group). Our second aim is to assess discomfort and satisfaction regarding interventions. METHODS/DESIGN This is a randomized clinical trial, double-blinded, placebo-controlled study. Children/adolescents presenting at least one approximal initial caries lesion in primary molars/permanent premolars and molars will be included. Surfaces with advanced dentine lesions identified by radiography and participants who refuse to participate or present negative behaviors will be excluded. A minimum sample size of 504 surfaces will be required for each subgroup. Individuals will be randomly allocated in three groups of interventions: SDF, resin infiltration, and control group. Depending on the allocation, the patients will receive the active treatment and respective placebo therapies. All patients will be oriented to daily flossing the included surfaces. Our primary outcome will be caries progression by clinical and radiographic examinations. Appointments will be timed and costs of materials will be considered to calculate cost-efficacy. Patient discomfort will be assessed after interventions. Parent and patient satisfaction with the treatment will be collected after treatment and in the last follow-up visit. Individuals will be assessed at 1 and 3 months after treatment to evaluate dental biofilm and at 6, 12, and 24 months to assess caries progression by visual examination and/or radiography. Multilevel analyses will be used to verify if the type of treatment influenced on the tested outcomes. Costs will be compared and analyses of cost-efficacy will be performed. Poisson analysis will test the association between intervention and reported discomfort and satisfaction. DISCUSSION Our hypothesis is that SDF is the most cost-efficacious option from all tested interventions. If our hypothesis is confirmed, the use of SDF in private and public contexts could represent an easier and effective option in the treatment of enamel approximal caries in children/adolescents. TRIAL REGISTRATION ClinicalTrials.gov (NCT01477385), Initial release: 11/16/2011: last update: 06/02/2014.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av, Lineu Prestes, 2227, São Paulo, SP 05508-000, Brazil.
| |
Collapse
|
35
|
Floriano I, Bonini GC, Matos R, Novaes TF, Ekstrand KR, Mendes FM, Braga MM. How different do visuo-tactile criteria assess caries lesions activity status on occlusal surfaces? Oral Dis 2014; 21:299-307. [PMID: 24912618 DOI: 10.1111/odi.12265] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2013] [Revised: 05/05/2014] [Accepted: 05/26/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES We tested the association between active caries lesions assessed by two different criteria and clinical features of these caries lesions. MATERIALS AND METHODS Three examiners examined forty-nine 3- to 12-year-old children: one examiner used the Nyvad criteria, another examiner used the International Caries Detection and Assessment System with an additional criteria--Lesion Activity Assessment (ICDAS + LAA), and a reference examiner classified lesions regarding plaque stagnation, colour, lustre, cavities, depth and texture. Logistic regressions were used to test associations. For analyses, we grouped sound sites and inactive lesions vs active caries lesions, but also considering only inactive vs active lesions. RESULTS Active lesions scored by both criteria were similarly associated with different clinical parameters tested, except when the sound sites were excluded from the analysis. In these cases, active lesions according to ICDAS + LAA were associated only with cavitation and texture. Texture was associated with divergences between criteria when differentiating sound or inactive lesions from active ones. Fewer divergences in differentiating active from inactive lesions were observed when lesions present lustre. CONCLUSION Most clinical signs associated with active caries lesions were similar, but texture and severity tend to have a greater importance when using ICDAS + LAA for distinguishing caries activity status. Attention should be given to differences due to texture and lustre when using different indices.
Collapse
Affiliation(s)
- I Floriano
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | | | |
Collapse
|
36
|
Bittar DG, Pontes LRA, Calvo AFB, Novaes TF, Braga MM, Freitas PM, Tabchoury CPM, Mendes FM. Is the red fluorescence of dental plaque related to its cariogenicity? J Biomed Opt 2014; 19:065004. [PMID: 24972357 DOI: 10.1117/1.jbo.19.6.065004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/06/2014] [Indexed: 06/03/2023]
Abstract
It has been speculated that the red fluorescence emitted by dental plaque could be related to its cariogenicity. To test this hypothesis, we designed this crossover in situ study, with two experimental phases of 14 days each. Seventeen volunteers, wearing a palatal appliance with bovine enamel blocks, were instructed to drip a 20% sucrose solution (experimental group) or purified water (control group) onto the enamel blocks eight times daily. The specimens were removed after 4, 7, 10, and 14 days, and the red fluorescence of dental plaque formed on the enamel blocks was assessed using a quantitative light-induced fluorescence device. After the plaque removal, surface and cross-sectional microhardness tests were performed to assess the mineral loss. The comparisons were made by a multilevel linear regression analysis. We observed a significant increase in the red fluorescence of the dental plaque after longer periods of formation, but this trend was verified in both groups. The mineral loss assessed by the microhardness techniques, contrariwise, showed a significant increase only in the experimental group. In conclusion, the red fluorescence emitted by the dental plaque indicates a mature biofilm, but this fact is not necessarily associated with its cariogenicity.
Collapse
Affiliation(s)
- Daniela G Bittar
- University of Sao Paulo, School of Dentistry, Department of Pediatric Dentistry, Av Lineu Prestes, 2227, Sao Paulo 05508-000, Brazil
| | - Laura Regina A Pontes
- University of Sao Paulo, School of Dentistry, Department of Pediatric Dentistry, Av Lineu Prestes, 2227, Sao Paulo 05508-000, Brazil
| | - Ana Flávia B Calvo
- University of Sao Paulo, School of Dentistry, Department of Pediatric Dentistry, Av Lineu Prestes, 2227, Sao Paulo 05508-000, BrazilcUniversity of Campinas, Piracicaba Dental School, Av Limeira, 901, Piracicaba 13414-903, Brazil
| | - Tatiane F Novaes
- University of Sao Paulo, School of Dentistry, Department of Pediatric Dentistry, Av Lineu Prestes, 2227, Sao Paulo 05508-000, Brazil
| | - Mariana M Braga
- University of Sao Paulo, School of Dentistry, Department of Pediatric Dentistry, Av Lineu Prestes, 2227, Sao Paulo 05508-000, Brazil
| | - Patrícia M Freitas
- University of Sao Paulo, School of Dentistry, Department of Restorative Dentistry, Av Lineu Prestes, 2227, Sao Paulo 05508-000, Brazil
| | - Cinthia P M Tabchoury
- University of Campinas, Piracicaba Dental School, Av Limeira, 901, Piracicaba 13414-903, Brazil
| | - Fausto M Mendes
- University of Sao Paulo, School of Dentistry, Department of Pediatric Dentistry, Av Lineu Prestes, 2227, Sao Paulo 05508-000, Brazil
| |
Collapse
|
37
|
Ortega AOL, Dos Santos MTBR, Mendes FM, Ciamponi AL. Association between anticonvulsant drugs and teeth-grinding in children and adolescents with cerebral palsy. J Oral Rehabil 2014; 41:653-8. [PMID: 24824732 DOI: 10.1111/joor.12185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2014] [Indexed: 10/25/2022]
Abstract
The relation between teeth-grinding and the use of drugs acting on the central nervous system of cerebral palsy (CP) patients has not yet been described. The aim of this research was to evaluate the presence or absence of teeth-grinding (sleep and/or awake periods) in normal and in CP children and adolescents, as well as the association of teeth-grinding and use of anticonvulsant drugs. The sample consisted of 207 children and adolescents, divided into three groups: G1, individuals with CP who did not take anticonvulsant drugs; G2, individuals with CP administered medications on a regular basis; and CG, normal individuals. Logistic regression analyses were performed to evaluate the association of teeth-grinding with some variables. No significant statistical differences were observed regarding the presence or absence of teeth-grinding when G1 and G2 were compared. However, compared with the CG, a statistically significant difference was determined, with the CG showing fewer children presenting teeth-grinding (P < 0·001). Among those children/adolescents prescribed drug therapy, the barbiturate group showed a greater frequency of teeth-grinding. CP children and adolescents show a greater and significant presence of grinding of the teeth compared with normal individuals. Subjects taking barbiturate drugs showed greater presence of teeth-grinding, than those who were taking medications from the other groups of anticonvulsant drugs.
Collapse
Affiliation(s)
- A O L Ortega
- Department of Pediatric Dentistry, School of Dentistry of University of São Paulo, São Paulo, Brazil
| | | | | | | |
Collapse
|
38
|
Guedes RS, Piovesan C, Ardenghi TM, Emmanuelli B, Braga MM, Ekstrand KR, Mendes FM. Validation of Visual Caries Activity Assessment: A 2-yr Cohort Study. J Dent Res 2014; 93:101S-107S. [PMID: 24713370 DOI: 10.1177/0022034514531017] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We evaluated the predictive and construct validity of a caries activity assessment system associated with the International Caries Detection and Assessment System (ICDAS) in primary teeth. A total of 469 children were reexamined: participants of a caries survey performed 2 yr before (follow-up rate of 73.4%). At baseline, children (12-59 mo old) were examined with the ICDAS and a caries activity assessment system. The predictive validity was assessed by evaluating the risk of active caries lesion progression to more severe conditions in the follow-up, compared with inactive lesions. We also assessed if children with a higher number of active caries lesions were more likely to develop new lesions (construct validity). Noncavitated active caries lesions at occlusal surfaces presented higher risk of progression than inactive ones. Children with a higher number of active lesions and with higher caries experience presented higher risk of developing new lesions. In conclusion, the caries activity system associated with the ICDAS presents predictive and construct validity in primary teeth in the assessment of occlusal caries lesions, but predictive validity was not observed in smooth surfaces.
Collapse
Affiliation(s)
- R S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - C Piovesan
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - T M Ardenghi
- Departament of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - B Emmanuelli
- Departament of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - M M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - K R Ekstrand
- Department of Cariology and Endodontics and Clinical Genetics, School of Dentistry, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - F M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
39
|
Santos MTBR, Ferreira MCD, Mendes FM, de Oliveira Guaré R. Assessing salivary osmolality as a caries risk indicator in cerebral palsy children. Int J Paediatr Dent 2014; 24:84-9. [PMID: 23551764 DOI: 10.1111/ipd.12030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Salivary osmolality reflects the hydration status of individuals with cerebral palsy (CP) necessary for an adequate unstimulated salivary flow rate. AIM To investigate whether salivary osmolality could serve as a potential indicator of caries risk in children with spastic CP by displaying a stronger association with caries occurrence than salivary flow rate. DESIGN The convenience sample consisted of 65 children with CP aged 6-13 years old. Unstimulated whole saliva was collected using cotton roll, and salivary osmolality was measured using a freezing point depression osmometer. The children's oral motor performance was evaluated during the feeding process using the Oral Motor Assessment Scale. Caries occurrence was also evaluated according the World Health Organization criteria. RESULTS Motor skills were significantly associated with caries experience. Regarding the salivary parameters, osmolality presented a stronger association with caries experience than did the salivary flow rate. Children with worse oral motor performance presented a higher rate of caries occurrence. CONCLUSION Osmolality exhibited a stronger association with caries occurrence than did salivary flow rate. This parameter, therefore, could be a potential caries risk indicator for spastic cerebral palsy children.
Collapse
|
40
|
Piovesan C, Moro BL, Lara JS, Ardenghi TM, Guedes RS, Haddad AE, Braga MM, Mendes FM. Laboratorial training of examiners for using a visual caries detection system in epidemiological surveys. BMC Oral Health 2013; 13:49. [PMID: 24090355 PMCID: PMC3851947 DOI: 10.1186/1472-6831-13-49] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 09/24/2013] [Indexed: 11/30/2022] Open
Abstract
Background In epidemiological surveys, a good reliability among the examiners regarding the caries detection method is essential. However, training and calibrating those examiners is an arduous task because it involves several patients who are examined many times. To facilitate this step, we aimed to propose a laboratory methodology to simulate the examinations performed to detect caries lesions using the International Caries Detection and Assessment System (ICDAS) in epidemiological surveys. Methods A benchmark examiner conducted all training sessions. A total of 67 exfoliated primary teeth, varying from sound to extensive cavitated, were set in seven arch models to simulate complete mouths in primary dentition. Sixteen examiners (graduate students) evaluated all surfaces of the teeth under illumination using buccal mirrors and ball-ended probe in two occasions, using only coronal primary caries scores of the ICDAS. As reference standard, two different examiners assessed the proximal surfaces by direct visual inspection, classifying them in sound, with non-cavitated or with cavitated lesions. After, teeth were sectioned in the bucco-lingual direction, and the examiners assessed the sections in stereomicroscope, classifying the occlusal and smooth surfaces according to lesion depth. Inter-examiner reproducibility was evaluated using weighted kappa. Sensitivities and specificities were calculated at two thresholds: all lesions and advanced lesions (cavitated lesions in proximal surfaces and lesions reaching the dentine in occlusal and smooth surfaces). Results Regarding the reproducibility, the mean (range) of kappa values was 0.781 (0.529–0.927) for occlusal surfaces, 0.568 (0.191–0.881) for smooth surfaces, and 0.844 (0.698–0.971) for proximal surfaces. Considering all lesions, sensitivity and specificity mean values were respectively 0.724 and 0.844 for occlusal, 0.635 and 0.943 for smooth and 0.658 and 0.927 for proximal surfaces. For detecting advanced lesions, sensitivities and specificities were 0.563 and 0.920 for occlusal, 0.670 and 0.985 for smooth, and 0.838 and 0.985 for proximal surfaces. Conclusion The methodology purposed for training and calibration of several examiners designated for epidemiological surveys of dental caries in preschool children using the ICDAS is feasible, permitting the assessment of reliability and accuracy of the examiners previously to the survey´s development.
Collapse
Affiliation(s)
- Chaiana Piovesan
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Av, Lineu Prestes, 2227, São Paulo, SP 05508-000, Brazil.
| | | | | | | | | | | | | | | |
Collapse
|
41
|
Gimenez T, Bittar DG, Piovesan C, Guglielmi CAB, Fujimoto KY, Matos R, Novaes TF, Braga MM, Mendes FM. Influence of examiner experience on clinical performance of visual inspection in detecting and assessing the activity status of caries lesions. Oper Dent 2013; 38:583-90. [PMID: 23617691 DOI: 10.2341/12-067-c] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Our hypothesis was that a method of caries activity evaluation based on the clinical features of the lesions would be less time consuming but more influenced by the examiner's experience than the scoring system used in association with the International Caries Detection and Assessment System (ICDAS). Thus, the aim of this study was to evaluate the performance of three groups of examiners with different levels of experience using two different methods to assess the activity status of caries lesions by visual inspection. A cross-sectional study in a dental office setting was performed selecting 18 children, aged three to eight years, who had sought dental treatment at a dental school. Examinations to detect caries lesions were performed using visual inspection by six examiners with different levels of experience: two undergraduate dental students, two specialists in pediatric dentistry, and two graduate students. The examiners used ICDAS and two different methods to assess caries activity: using an additional score system or considering the examination of clinical features. Two benchmark examiners examined the children in a joint session, and their consensus was considered to be the reference standard. The sensitivity, specificity, and reproducibility were calculated for different thresholds: all, cavitated, and active caries lesions. Multilevel analyses were performed to compare the different methods and examiners. No differences were observed among the examiners, either in detecting all lesions and cavitated lesions or regarding the activity assessment. The methods of assessing activity status performed similarly, but the time spent on examinations was shorter for the method evaluating clinical features. In conclusion, the experience of examiners does not significantly influence the performance of visual inspection, and both methods of assessing activity status result in similar diagnostic accuracy.
Collapse
|
42
|
Reyes A, Ferreira GE, Santos J, Mendes FM, Imparato JCP, Braga MM. Can the individual calibration be modified when laser fluorescence method is used for caries detection? Int J Paediatr Dent 2013; 23:138-44. [PMID: 22512546 DOI: 10.1111/j.1365-263x.2012.01236.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Individual calibration (IC) for caries detection methods based on fluorescence is time-consuming, especially for paediatric dentists, if the calibration has to be performed tooth-by-tooth. However, it is not clear how this calibration actually interfere in laser fluorescence (LF) readings. AIM This in vivo study was to verify the influence of different modes of IC on laser fluorescence (LF) readings. DESIGN Ninety six occlusal and 95 buccal surfaces of 1st permanent molars were examined using LF device after IC performed on control (no IC), the examined teeth, a permanent incisor, a 1st primary molar or a 2nd primary molar. All modes of IC were performed in the same child. Wilcoxon test and Bland-Altman analysis were used to compare the readings. Intraclass correlation coefficients (ICC) were calculated. RESULTS Laser fluorescence readings without prior calibration were higher than readings performed after any mode of IC and resulted in different values of ICC. After other IC modes, the LF readings were statistically similar. CONCLUSION The absence of IC influences LF readings and LF reproducibility, but different IC methods can be considered in clinical practice.
Collapse
Affiliation(s)
- Alessandra Reyes
- Departmento de Ortodontia e Odontopediatria, Faculdade de Odontologia da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
43
|
Novaes TF, Matos R, Gimenez T, Braga MM, DE Benedetto MS, Mendes FM. Performance of fluorescence-based and conventional methods of occlusal caries detection in primary molars - an in vitro study. Int J Paediatr Dent 2012; 22:459-66. [PMID: 22276618 DOI: 10.1111/j.1365-263x.2011.01217.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM This in vitro study aimed to test the performance of fluorescence-based methods in detecting occlusal caries lesions in primary molars compared to conventional methods. DESIGN Two examiners assessed 113 sites on 77 occlusal surfaces of primary molars using three fluorescence devices: DIAGNOdent (LF), DIAGNOdent pen (LFpen), and fluorescence camera (VistaProof-FC). Visual inspection (ICDAS) and radiographic methods were also evaluated. One examiner repeated the evaluations after one month. As reference standard method, the lesion depth was determined after sectioning and evaluation in stereomicroscope. The area under the ROC curve (Az), sensitivity, specificity, and accuracy of the methods were calculated at enamel (D1) and dentine caries (D3) lesions thresholds. The intra and interexaminer reproducibility were calculated using the intraclass correlation coefficient (ICC) and kappa statistics. RESULTS At D1, visual inspection presented higher sensitivities (0.97-0.99) but lower specificities (0.18-0.25). At D3, all the methods demonstrated similar performance (Az values around 0.90). Visual and radiographic methods showed a slightly higher specificity (values higher than 0.96) than the fluorescence based ones (values around 0.88). In general, all methods presented high reproducibility (ICC higher than 0.79). CONCLUSIONS Although fluorescence-based and conventional methods present similar performance in detecting occlusal caries lesions in primary teeth, visual inspection alone seems to be sufficient to be used in clinical practice.
Collapse
Affiliation(s)
- Tatiane F Novaes
- School of Dentistry, Universidade de São Paulo, São Paulo, Brazil.
| | | | | | | | | | | |
Collapse
|
44
|
Piovesan C, Ardenghi TM, Guedes RS, Ekstrand KR, Braga MM, Mendes FM. Activity assessment has little impact on caries parameters reduction in epidemiological surveys with preschool children. Community Dent Oral Epidemiol 2012; 41:204-11. [DOI: 10.1111/cdoe.12004] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 08/11/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Chaiana Piovesan
- Departament of Pediatric Dentistry; Faculdade de Odontologia da Universidade de São Paulo; São Paulo; Brazil
| | - Thiago M. Ardenghi
- Departament of Stomatology; Universidade Federal de Santa Maria; Rio Grande do Sul; Brazil
| | - Renata S. Guedes
- Departament of Stomatology; Universidade Federal de Santa Maria; Rio Grande do Sul; Brazil
| | - Kim R. Ekstrand
- Department of Cariology and Endodontics; School of Dentistry, Faculty of Health Sciences; University of Copenhagen; Copenhagen; Denmark
| | - Mariana M. Braga
- Departament of Pediatric Dentistry; Faculdade de Odontologia da Universidade de São Paulo; São Paulo; Brazil
| | - Fausto M. Mendes
- Departament of Pediatric Dentistry; Faculdade de Odontologia da Universidade de São Paulo; São Paulo; Brazil
| |
Collapse
|
45
|
Siqueira WL, Bakkal M, Xiao Y, Sutton JN, Mendes FM. Quantitative proteomic analysis of the effect of fluoride on the acquired enamel pellicle. PLoS One 2012; 7:e42204. [PMID: 22870302 PMCID: PMC3411614 DOI: 10.1371/journal.pone.0042204] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/02/2012] [Indexed: 12/28/2022] Open
Abstract
The acquired enamel pellicle (AEP) is a thin film formed by the selective adsorption of salivary proteins onto the enamel surface of teeth. The AEP forms a critical interface between the mineral phase of teeth (hydroxyapatite) and the oral microbial biofilm. This biofilm is the key feature responsible for the development of dental caries. Fluoride on enamel surface is well known to reduce caries by reducing the solubility of enamel to acid. Information on the effects of fluoride on AEP formation is limited. This study aimed to investigate the effects of fluoride treatment on hydroxyapatite on the subsequent formation of AEP. In addition, this study pioneered the use of label-free quantitative proteomics to better understand the composition of AEP proteins. Hydroxyapatite discs were randomly divided in 4 groups (n = 10 per group). Each disc was exposed to distilled water (control) or sodium fluoride solution (1, 2 or 5%) for 2 hours. Discs were then washed and immersed in human saliva for an additional 2 hours. AEP from each disc was collected and subjected to liquid chromatography electrospray ionization mass spectrometry for protein identification, characterization and quantification. A total of 45 proteins were present in all four groups, 12 proteins were exclusively present in the control group and another 19 proteins were only present in the discs treated with 5% sodium fluoride. Relative proteomic quantification was carried out for the 45 proteins observed in all four groups. Notably, the concentration of important salivary proteins, such as statherin and histatin 1, decrease with increasing levels of fluoride. It suggests that these proteins are repulsed when hydroxyapatite surface is coated with fluoride. Our data demonstrated that treatment of hydroxyapatite with fluoride (at high concentration) qualitatively and quantitatively modulates AEP formation, effects which in turn will likely impact the formation of oral biofilms.
Collapse
Affiliation(s)
- Walter L Siqueira
- Department of Biochemistry and School of Dentistry, Schulich School of Medicine and Dentistry, Western University, London, Onatrio, Canada.
| | | | | | | | | |
Collapse
|
46
|
Bonini GC, Bönecker M, Braga MM, Mendes FM. Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth. Dent Traumatol 2012; 28:437-40. [PMID: 22364272 DOI: 10.1111/j.1600-9657.2012.01117.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. SUBJECTS AND METHODS A cross-sectional survey was conducted with 376 children aged 36-59 months who attended the National Day of Children's Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. RESULTS The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. CONCLUSIONS Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.
Collapse
Affiliation(s)
- Gabriela C Bonini
- São Leopoldo Mandic Institute and Research Center, Rua Jose Rocha Junqueira 13, Ponte Preta, Campinas, São Paulo, Brazil.
| | | | | | | |
Collapse
|
47
|
Camargo LB, Fell C, Bonini GC, Marquezan M, Imparato JCP, Mendes FM, Raggio DP. Paediatric dentistry education of atraumatic restorative treatment (ART) in Brazilian dental schools. Eur Arch Paediatr Dent 2012; 12:303-7. [PMID: 22122849 DOI: 10.1007/bf03262828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM To evaluate the degree of knowledge, use and teaching of atraumatic restorative treatment (ART) of paediatric dentistry lecturers in dental schools throughout Brazil. METHODS A structured questionnaire was applied, containing questions regarding the use of ART, socio-demographic characteristics and academic degree background. Descriptive analysis and Poisson's regression were conducted in order to verify the association between exploratory variables and ART teaching (α=5%). RESULTS Of the 721 questionnaires sent to dental schools, approximately 40% were returned (n=285). Some 98.2% of the participants teach ART. STATISTICS Concerning dental lecturers who teach ART, in multiple regression model, considering ART indication (emergency versus restorative treatment) the lecturers residents of the Mid-West (PR=1.66; CI:1.13-2.45) and Northeast region (PR=1.33; CI:1.02-1.72) and lecturers who use ART regularly (PR=3.73; CI:2.11-5.59) teach ART as restorative treatment. When the question was about reason for using ART (conservative technique versus other techniques failures/fast treatment), lecturers with a longer period of TG (time elapsed since graduation) (PR=1.30; CI:1.08- 1.56) and also lecturers who use ART regularly (PR=2.87; CI:1.95-4.22), teach it as being a conservative technique. Regarding the patients' age covered by ART (versus without limitation), women (PR=1.26; CI:1.06-1.50) and lecturers who use ART regularly (PR=1.28; CI:1.06-1.54), teach that there is no age restriction. CONCLUSIONS ART has been widely taught in Brazilian dental schools, is regularly used in lecturer's clinical practices and has positively influenced the appropriate teaching of this technique.
Collapse
Affiliation(s)
- L B Camargo
- Faculdade de Odontologia Universidade Paulista, Campinas, São Paulo, Brazil
| | | | | | | | | | | | | |
Collapse
|
48
|
Aldrigui JM, Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bönecker M, Raggio DP. Impact of traumatic dental injuries and malocclusions on quality of life of young children. Health Qual Life Outcomes 2011; 9:78. [PMID: 21943368 PMCID: PMC3186738 DOI: 10.1186/1477-7525-9-78] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Accepted: 09/24/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The presence of traumatic dental injuries and malocclusions can have a negative impact on quality of life of young children and their parents, affecting their oral health and well-being. The aim of this study was to assess the impact of traumatic dental injuries and anterior malocclusion traits on the Oral Health-Related Quality of Life (OHRQoL) of children between 2 and 5 years-old. METHODS Parents of 260 children answered the six domains of the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the OHRQoL (outcome). Two calibrated dentists assessed the types of traumatic dental injuries (Kappa = 0.9) and the presence of anterior malocclusion traits (Kappa = 1.0). OHRQoL was measured using the ECOHIS. Poisson regression was used to associate the type of traumatic dental injury and the presence of anterior malocclusion traits to the outcome. RESULTS The presence of anterior malocclusion traits did not show a negative impact on the overall OHRQoL mean or in each domain. Only complicated traumatic dental injuries showed a negative impact on the symptoms (p = 0.005), psychological (p = 0.029), self image/social interaction (p = 0.004) and family function (p = 0.018) domains and on the overall OHRQoL mean score (p = 0.002). The presence of complicated traumatic dental injuries showed an increased negative impact on the children's quality of life (RR = 1.89; 95% CI = 1.36, 2.63; p < 0.001). CONCLUSIONS Complicated traumatic dental injuries have a negative impact on the OHRQoL of preschool children and their parents, but anterior malocclusion traits do not.
Collapse
Affiliation(s)
- Janaina M Aldrigui
- Department of Pediatric Dentistry and Orthodontics, Dental School, University of São Paulo-USP, São Paulo, Brazil
| | | | | | | | | | | | | |
Collapse
|
49
|
Piovesan C, Mendes FM, Ferreira FV, Guedes RS, Ardenghi TM. Socioeconomic inequalities in the distribution of dental caries in Brazilian preschool children. J Public Health Dent 2011; 70:319-26. [PMID: 20735719 DOI: 10.1111/j.1752-7325.2010.00191.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study assessed the inequality in caries distribution and the association between socioeconomic indicators and caries experience of preschool children in a city in Brazil. METHODS A cross-sectional study in a multistage random sample of 455, 1-5-year-old children was conducted on National Children's Vaccination Day in Santa Maria, Brazil. Calibrated examiners evaluated the prevalence of dental caries and parents provided information about several socioeconomic indicators by means of a semistructured questionnaire. Data were analyzed using Poisson regression model. RESULTS The caries prevalence was 23.5 percent and the means for the decayed, missing and filled primary teeth was 0.8. A high inequality in the caries distribution with Gini coefficient of 0.8 and Significant Caries Index of 2.8 was observed. The oldest children, non-white, with mothers having low level of education and from low household income had the highest prevalence of dental caries. CONCLUSION Socioeconomic factors are strong predictors for the inequality in caries distribution in Brazilian preschool children.
Collapse
Affiliation(s)
- Chaiana Piovesan
- Universidade Federal de Santa Maria (UFSM), Rio Grande do Sul, Rua Acampamento 239/01, Santa Maria, RS 97.050-000, Brazil.
| | | | | | | | | |
Collapse
|
50
|
Abstract
This article reviews the current methods for detection and assessment of caries lesions focusing on applicability for daily clinical practice. The end point is to arrive at a diagnosis for each caries lesion. Visual inspection aided by a ball-ended probe is essential for caries lesions assessment and the method must be used for all patients. Use of indices, for example, the International Caries Detection and Assessment System (ICDAS), can improve the performance of this method. Using visual inspection, the clinician must decide about the presence, severity and activity of lesions. After this process, additional methods could aid the dentist in reaching a more appropriate treatment decision in some cases. The ICDAS, including the activity assessment system or the Nyvad system, seems to be the best option to reach final diagnoses for managing lesions. The radiographic method is the most recommended additional method available for daily clinical practice.
Collapse
Affiliation(s)
- Mariana M Braga
- Department of Pediatric Dentistry, Faculdade de Odontologia da Universidade de São Paulo, São Paulo, SP 05508-900, Brazil
| | | | | |
Collapse
|