Dentin Regeneration

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66570/2/10.1177_08959374950090030501.pd

Use of ICDAS Combined with Quantitative Light-Induced Fluorescence as a Caries Detection Method

The purpose of this study was to combine a standardized visually based system, the International Caries Detection and Assessment System (ICDAS), with a sensitive fluorescence-based system, quantitative light-induced fluorescence (QLF), to determine the ability to monitor caries lesion progression. This combination (QLF-I) has the potential to increase the sensitivity of the visual method without compromising specificity. A total of 460 children were enrolled and examined at baseline, 8 months and 12 months by ICDAS and QLF by a single examiner. The examiner repeatability for both methods was comparable, varying between weighted kappa of 0.70 and 0.79. The DMFT score was 6.0 (SD 5.8) at baseline and 6.4 (SD 6.3) at 12 months, and both methods were able to follow the increase in incidence. The QLF-I scored more surfaces at the early ICDAS scores (1 and 2) and score 4. Not all lesions progressed at the same rate, differing by score at baseline and surface type

Evaluation Of Three Radiographic Methods For Detecting Occlusal Caries Lesions

Aim: To compare, in vitro, the performance of three radiographic methods for the detection of occlusal caries in permanent teeth. Methods: A total of 96 extracted molars with no apparent occlusal cavitation were selected, they were photographed and radiographed under standardized conditions using conventional E-plus films and two digital systems, CDR and Sidexis. Two examiners analyzed all films and images, recording the presence and lesion depth. One quarter of the teeth were re-examined for intra-and interexaminer agreements. The teeth were subsequently bisected and examined under a stereomicroscope. The intra and interexaminer agreements and the diagnostic performance (sensitivity, specificity, accuracy and the area under receiver operating characteristic, ROC curve) of each method were evaluated. Results: Out of 96 occlusal surfaces, 41 were sound, 31 had lesions in enamel, and 24 had dentin lesions. Weighted Kappa values for intraexaminer agreement varied widely, depending on both the observer and method. The interexaminer agreement was higher for the digital images than for the conventional films. The area under the ROC curve for enamel and dentin caries (at D1 diagnostic threshold) was 0.55 for films, 0.60 for Schick and 0.54 for Sirona, which were not significantly different from each other. Conclusions: Digital images presented better results of interexaminer agreement; however, no additional effect in the diagnostic performance could be observed in comparison to conventional films.826770Analoui, M., Digital diagnostic imaging: today and tomorrow (1999) Dentomaxillofac Radiol, 28, pp. 56-58Attaelmanan, A.G., Borg, E., Gröndahl, H.G., Assessments of the physical performance of 2 generations of 2 direct digital intraoral sensors (1999) Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 88, pp. 517-523Haiter-Neto, F., dos Anjos Pontual, A., Frydenberg, M., Wenzel, A., A comparison of older and newer versions of intraoral digital radiography systems: diagnosing noncavitated proximal carious lesions (2007) J Am Dent Assoc, 138, pp. 1353-1359Hintze, H., Wenzel, A., Influence of the validation method on diagnostic accuracy for caries. A comparison of six digital and two conventional radiographic systems (2002) Dentomaxillofac Radiol, 31, pp. 44-49Wenzel, A., Borg, E., Hintze, H., Gröndahl, H.G., Accuracy of caries diagnosis in digital images from charge-coupled device and storage phosphor systems: an in vitro study (1995) Dentomaxillofac Radiol, 24, pp. 250-254Ashley, P.F., Blinkhorn, A.S., Davies, R.M., Occlusal caries diagnosis: an in vitro histological validation of the Electronic Caries Monitor (ECM) and other methods (1998) J Dent, 26, pp. 83-88Hintze, H., Diagnostic accuracy of two software modalities for detection of caries lesions in digital radiographs from four dental systems (2006) Dentomaxillofac Radiol, 35, pp. 78-82Tyndall, D.A., Ludlow, J.B., Platin, E., Nair, M., A comparison of Kodak Ektaspeed Plus film and the Siemens Sidexis digital imaging system for caries detection using receiver operating characteristic analysis (1998) Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 85, pp. 113-118Landis, J.R., Koch, G.G., The measurement of observer agreement for categorical data (1977) Biometrics, 33, pp. 159-174Galcerá Civera, V., Almerich Silla, J.M., Montiel Company, J.M., Forner Navarro, L., Clinical and radiographic diagnosis of approximal and occlusal dental caries in a low risk population (2007) Med Oral Patol Oral Cir Bucal, 12, pp. E252-E257Chong, M.J., Seow, W.K., Purdie, D.M., Cheng, E., Wan, V., Visual-tactile examination compared with conventional radiography, digital radiography and Diagnodent in the diagnosis of occlusal occult caries in extracted premolars (2003) Pediatr Dent, 25, pp. 341-349Hintze, H., Wenzel, A., Frydenberg, M., Accuracy of caries detection with four storage phosphor systems and E-speed radiographs (2002) Dentomaxillofac Radiol, 31, pp. 170-175Syriopoulos, K., Sanderink, G.C., Velders, X.L., van der Stelt, P.F., Radiographic detection of approximal caries: a comparison of dental films and digital imaging systems (2000) Dentomaxillofac Radiol, 29, pp. 312-318Jacobsen, J.H., Hansen, B., Wenzel, A., Hintze, H., Relationship between histological and radiographic caries lesion depth measured in images from four digital radiography systems (2004) Caries Res, 38, pp. 34-38Pfeiffer, P., Schmage, P., Nergiz, I., Platzer, U., Effects of different exposure values on diagnostic accuracy of digital images (2000) Quintessence Int., 31, pp. 257-260Ekstrand, K.R., Ricketts, D.N.J., Kidd, E.A., Reproducibility and accuracy of three methods for assessment of demineralization depth on the occlusal surface: an in vitro examination (1997) Caries Res, 31, pp. 224-231Hintze, H., Wenze, A., Clinical and laboratory radiographic caries diagnosis. A study of the same teeth (1995) Dentomaxillofac Radiol, 25, pp. 115-118Hugoson, A., Koch, G., Hallonsten, A.L., Norderyd, J., Aberg, A., Caries prevalence and distribution in 3-20-year-olds in Jönköping, Sweden, in 1973, 1978, 1983, and 1993 (2000) Community Dent Oral Epidemiol, 28, pp. 83-89Huysmans, M.C., Longbottom, C., Pitts, N., Electrical methods in occlusal caries diagnosis: An in vitro comparison with visual inspection and bite-wing radiography (1998) Caries Res, 32, pp. 324-329Machiulskiene, V., Nyvad, B., Baelum, V., A comparison of clinical and radiographic caries diagnosis in posterior teeth of 12-year-old Lithuanian children (1999) Caries Res, 33, pp. 340-348Mejàre, I., Källestal, C., Stenlund, H., Johansson, H., Caries development from 11 to 22 years of age: a prospective radiographic study. Prevalence and distribution (1998) Caries Res, 32, pp. 10-16Richardson, P.S., McIntyre, I.G., The difference between clinical and bitewing detection of approximal and occlusal caries in Royal Air Force recruits (1996) Community Dent Health, 13, pp. 65-69Weerheijm, K.L., Groen, H.J., Poorterman, J.H.G., Clinically undetected oclusal dentin caries in 1987 and 1993 in 17 years old Dutch adolescents. Abstract (1999) Caries Res, 33, p. 288Ricketts, D.N., Kidd, E.A., Smith, B.G., Wilson, R.F., Clinical and radiographic diagnosis of occlusal caries: a study in vitro (1995) J Oral Rehabil, 22, pp. 15-20van Amerongen, J.P., Penning, C., Kidd, E.A., ten Cate, J.M., An in vitro assessment of the extent of caries under small occlusal cavities (1992) Caries Res, 26, pp. 89-93Wenzel, A., A review of dentists' use of digital radiography and caries diagnosis with digital systems (2006) Dentomaxillofac Radiol, 35, pp. 307-314Pereira, A.C., Eggertsson, H., Martinez-Mier, E.A., Mialhe, F.L., Eckert, G.J., Zero, D.T., Validity of caries detection on occlusal surfaces and treatment decisions based on results from multiple caries-detection methods (2009) Eur J Oral Sci., 117, pp. 51-57Swenson, E., Hennessy, B., Detection of occlusal carious lesions: an in vitro comparison of clinicians' diagnostic abilities at varying levels of experience (2009) Gen Dent, 57, pp. 60-66Novaes, T.F., Matos, R., Braga, M.M., Imparato, J.C., Raggio, D.P., Mendes, F.M., Performance of a pen-type laser fluorescence device and conventional methods in detecting approximal caries lesions in primary teeth - in vivo study (2009) Caries Res, 43, pp. 36-42Jablonski-Momeni, A., Ricketts, D.N.J., Stachniss, V., Maschka, R., Heinzel-Gutenbrunner, M., Pieper, K., Occlusal caries: Evaluation of direct microscopy versus digital imaging used for two histological classification systems (2009) J Dent, 37, pp. 204-21

Dose–response effect of fluoride dentifrice on remineralisation and further demineralisation of erosive lesions: A randomised in situ clinical study

AbstractObjectiveThe objective was to evaluate the ability of fluoride in a conventional, non-specialised sodium fluoride–silica dentifrice to promote tooth remineralisation and enamel fluoride uptake (EFU), and assess the resistance of the newly formed mineral to attack by dietary acid, across the concentration range used in mass-market dentifrices.MethodsSubjects wore a palatal appliance containing eight polished bovine enamel specimens, each including an early erosive lesion. In a randomised full-crossover sequence, 62 healthy subjects were treated with dentifrices containing four different fluoride concentrations: no fluoride; 250ppm, 1150ppm and 1426ppm fluoride. At each treatment visit, under supervision, subjects brushed with 1.5g dentifrice and rinsed once while wearing the appliance; the appliance was removed after a 4-h remineralisation period and effects on the enamel specimens determined. The primary efficacy variable was surface microhardness recovery (SMHR); others included EFU, relative erosion resistance (RER) and comparative erosion resistance.ResultsHighly significant linear and, with the exception of SMHR, quadratic dose–response relationships were observed between all efficacy variables and fluoride concentration. For SMHR, EFU and RER, values for the different fluoride concentrations were statistically resolved from one another, with the exception of the two highest fluoride concentrations. The degree of remineralisation and the acid resistance of enamel after treatment were closely related to EFU.ConclusionAfter a single brushing, conventional non-specialised sodium fluoride–silica dentifrices promoted remineralisation of early enamel lesions, and imparted increased acid-resistance to the enamel surface, in a dose-dependent manner at least up to 1500ppm fluoride.Clinical significanceEnamel erosive tissue loss is an increasing concern, associated with modern diets. This study demonstrated that sodium fluoride, in a conventional non-specialised dentifrice formulation, can promote repair of the earliest stages of enamel erosion after a single application, in a dose-dependent fashion across the fluoride concentration range used in mass-market dentifrices.This study is registered in the GlaxoSmithKline Study Register (ID RH01299), available at: www.gsk-clinicalstudyregister.com/study/RH01299