Comparison of intra-examiner reproducibility in scoring caries in primary teeth of two scoring systems used to monitor caries progression

The investigation was designed to compare the reproducibility of scoring systems proposed by Pitts (1), and Murray & Majid (2), when used to monitor caries progression in primary teeth. A sub-sample of the posterior bitewing radiographs of 301, 5-yr-old children from a Duraphat clinical trial were re-examined. The difference in the reproducibility of the two methods was not significant (P greater than 0.05). The concern regarding the effect on reproducibility of using scoring systems with subdivisions of enamel when measuring caries progression in primary teeth appears to be unfounded.     

A comparison of the concurrent validity of two epidemiologic diagnostic systems for caries evaluation

ABSTRACT The concurrent validity of two methods of caries diagnosis was evaluated by comparing findings obtained by two observers in independent extraoral examinations of 109 posterior teeth with the histologic appearance of these teeth after sectioning. Diagnosis of pit and fissure caries predilection sites and approximal surfaces was carried out by the first examiner using a visual technique of clinical diagnosis (Method 1), and by the second using a visual-tactile technique, aided by a standardized blunt probe (Method 2). Validity was expressed in terms of sensitivities and specificities of diagnosis. For Method 1, sensitivity was 0.91 for fissure sites and 0.94 for approximal surfaces, the corresponding estimates for Method 2 being 0.92 and 0.93. Specificity estimates for Method 1 were 0.81 for fissures and 0.92 for approximal surfaces, while the corresponding values for Method 2 were 0.85 and 0.97. Comparison of values between methods yielded no statistically significant differences except for the specificities of diagnosis at approximal surfaces. Method 1 returned a significantly higher frequency of false positive diagnoses at these sites than Method 2.     

Effectiveness of Pit and Fissure Sealants for Preventing and Arresting Occlusal Caries in Primary Molars: A Systematic Review and Meta-Analysis

ObjectiveThe use of pit and fissure sealants have been well supported in permanent teeth, but no concrete evidence is available to support this procedure in primary molars. This review aims to systematically assess randomized controlled trials and summarize the evidence on the effectiveness of different sealants in prevention and arrest of the pit and fissure occlusal caries in primary molars of children.Materials and methodsFour electronic databases were searched from inception to March 2018. Seven studies were included in the qualitative and quantitative syntheses. Two reviewers independently selected studies, extracted data, assessed risk of bias using the revised Cochrane risk of bias tool, and evaluated the certainty in the evidence adopting the Grading of Recommendations Assessment Development and Evaluation approach. Odds ratio and retention rate of different sealants were recalculated and analyzed.ResultsThis review identified no significant difference in the overall caries incidence and progression when evaluated over 24 months between (1) resin-based sealant (RBS) and glass ionomer sealants (GIS) or resin-modified GIS; (2) conventional and newly developed RBS; (3) autopolymerized and light-polymerized RBS; (4) RBS with topical fluoride application and topical fluoride alone; and (5) RBS with topical fluoride application and resin infiltration with topical fluoride application. The pooled estimates of the mean retention rates of RBS and GIS on primary molars over an 18-months period were 85.94% and 23.18%, respectively. The certainty in the evidence of each outcome was determined as low or very low mainly because of high risk of overall bias and imprecision.ConclusionThere are currently insufficient well-controlled randomized controlled clinical trials to determine whether sealants are beneficial in preventing or arresting noncavitated occlusal caries in the primary molars.     

Diagnostic performance of the visual caries classification system ICDAS II versus radiography and micro-computed tomography for proximal caries detection: An in vitro study

Objectives

The purpose of this study was: (a) to compare the visual caries classification system ICDAS II with conventional (CR) and digital radiography (DR) for diagnosis of non-cavitated caries on free proximal surfaces, (b) to examine the potential of micro-computed tomography (MCT) to substitute histological examination for the in vitro caries assessment.

Methods

Both proximal surfaces of 20 teeth received classification separately by two examiners by means of the diagnostic modalities examined. The teeth were sectioned and assessed for depth of the lesion. The modalities were compared in terms of degree of inter-examiner agreement, sensitivity, specificity, accuracy, positive and negative predictive value and validity. Two diagnostic thresholds were applied: no caries versus all caries scores (D1), and no dentin caries versus dentin caries (D3).

Results

The weighted kappa values for inter-examiner reproducibility for all diagnostic modalities were 0.51–0.81. Visual examination (ICDAS II) reached significant higher sensitivity (0.92–0.96) and negative predictive value (0.9–1) than radiography. Likewise, the radiographic modalities presented significantly higher specificity (0.93–1) and positive predictive values (0.92–1) than the ICDAS II criteria. The overall accuracy performance of radiographic modalities was related to the diagnostic threshold. MCT did not agree with histological validation at each disease severity scale.

Conclusions

The ICDAS II criteria are a promising tool for caries diagnosis on free proximal surfaces. DR and CR radiography present comparable performance. Furthermore, MCT is not capable of constituting a reliable alternative to histological examination for caries research.     

The influence of zero-value subtraction on the performance of two laser fluorescence devices for detecting occlusal caries in vitro

BACKGROUND: The aim of this study was to evaluate the influence of zero-value subtraction on the performance of two laser fluorescence (LF) devices developed to detect occlusal caries. METHODS: The authors selected 119 permanent molars. Two examiners assessed three areas (cuspal, middle and cervical) of both mesial and distal portions of the buccal surface and one occlusal site using an LF device and an LF pen. For each tooth, the authors subtracted the value measured in the cuspal, middle and cervical areas in the buccal surface from the value measured in the respective occlusal site. RESULTS: The authors observed differences among the readings for both devices in the cuspal, middle and cervical areas in the buccal surface as well as differences for both devices with and without the zero-value subtraction in the occlusal surface. When the authors did not perform the zero-value subtraction, they found statistically significant differences for sensitivity and accuracy for the LF device. When this was done with the LF pen, specificity increased and sensitivity decreased significantly. CONCLUSIONS: For the LF device, the zero-value subtraction decreased the sensitivity. For this reason, the authors concluded that clinicians can obtain measures with the LF device effectively without using zero-value subtraction. For the LF pen, however, the absence of the zero-value subtraction changed both the sensitivity and specificity, and so the authors concluded that clinicians should not eliminate this step from the procedure. CLINICAL IMPLICATIONS: When using the LF device, clinicians might not need to perform the zero-value subtraction; however, for the LF pen, clinicians should do so.     

Full arch digital scanning systems performances for implant-supported fixed dental prostheses: a comparative study of 8 intraoral scanners

PurposeCompare the accuracy of intraoral digital impression in full-arch implant-supported fixed dental prosthesis acquired with eight different intraoral scanner (Ios).MethodsA polymethyl methacrylate acrylic model of an edentulous mandible with six scan-abutment was used as a master model and its dimensions measured with a coordinate measuring machine. Eight different Ios were used to generate digital impression: True Definition, Trios, Cerec Omnicam, 3D progress, CS3500, CS3600, Planmeca Emelard and Dental Wings. Fifteen digital impressions were made. A software called “Scan-abut” was developed to analyse and compare the digital impression with the master model, obtaining the scanning accuracy. The three-dimensional (3D) position and distance analysis were performed.ResultsMean value of the 3D position analysis showed that the True Definition (31 μm ± 8 μm) and Trios (32 μm ± 5 μm) have the best performance of the group. The Cerec Omnicam (71 μm ± 55 μm), CS3600 (61 μm ± 14 μm) have an average performance. The CS3500 (107 μm ± 28 μm) and Planmeca Emelard (101 μm ± 38 μm) present a middle-low performance, while the 3D progress (344 μm ± 121 μm) and Dental Wings (148 μm ± 64 μm) show the low performance. The 3D distance analysis showed a good linear relationship between the errors and scan-abutment distance only with the True Definition and CS3600.ConclusionsNot all scanners are suitable for digital impression in full-arch implant-supported fixed dental prosthesis and the weight of the output files is independent from the accuracy of the Ios.     

Evaluation and comparison of anti-inflammatory properties of ibuprofen using two drug delivery systems after third molar surgery: using chitosan microspheres as a carrier for local drug delivery in to the third molar socket and through the oral route

We undertook this study to assess the analgesic and anti-inflammatory properties of ibuprofen when administered through two drug delivery systems after mandibular third molar surgery. The study was conducted on 100 patients who required the surgical removal of impacted mandibular third molars under local anaesthesia. The study subjects were divided into two groups of 50 patients each. Patients in the study group were given ibuprofen-incorporated chitosan-based microspheres, which were packed into the third molar sockets after removal of impacted teeth. Patients in the control group were prescribed with ibuprofen 400mg tablets that were to be administered orally after the removal of impacted mandibular third molars. All patients were assessed for pain, swelling, and trismus on the second, fourth, and seventh postoperative days, and wound healing was assessed on the seventh postoperative day. Patients in the study group had significantly less pain and comparatively better mouth opening on the second, fourth, and seventh postoperative days, which showed clinically and statistically significant results of p<0.05, respectively, while the assessment of swelling for the study group did not show statistically significant results on any of the three postoperative days. Among 50 patients in the study group, two had wound gaping, and among 50 patients in the control group, four presented with wound gaping and three patients developed dry socket. Ibuprofen-incorporated chitosan-based microspheres (study group) had comparatively better analgesic and anti-inflammatory properties with drastic reduction of pain, swelling, trismus, and also had a reliable wound healing property when compared with the orally-administered ibuprofen (control group) after mandibular third molar surgery.