Evaluation of the esthetic properties of developmental defects of enamel: a spectrophotometric clinical study

Objectives. Detailed clinical quantification of optical properties of developmental defect of enamel is possible with spectropho- tometric evaluation. Developmental defects of enamel (DDE) are daily encountered in clinical practice. DDE are an alteration in quality and quantity of the enamel, caused by disruption and/or damage to the enamel organ during amelogenesis. Methods. Several clinical indices have been developed to categorize enamel defects based on their nature, appearance, microscopic features, or cause. A sample of 39 permanent teeth presenting DDE on labial surface was examined using the DDE Modified Index and SpectroShade evaluation. The spectrophotometric approach quantifies L∗ (luminosity), a∗ (quantity of green-red), and b∗ (quantity of blue- yellow) of different DDE. Conclusions. SpectroShade evaluation of the optical properties of the enamel defect enhances clinical understanding of severity and extent of the defect and characterizes the enamel alteration in terms of color discrepancy and surface characterization

Effect of biofilm removal from the occlusal tooth surfaces on fluorescence measurements. A clinical study

Aim: Early diagnosis and monitoring of caries lesions are the most important issues of primary and secondary prevention policies.The intraoral VistaCamiX(DurrDental, Bietigheim‐Bissingen,Germany) uses the fluorescence phenomenon for a non‐invasive, quantitative caries diagnosis. In order to make a precise evaluation the tooth surface must be completely cleaned and without biofilm. The current study aimed to evaluate the effects of biofilm removal, using air‐polishing device (Combi,MectronSpA) with glycine, on fluorescence VistaCam iX camera quantitative measurements of caries. Methods: Patients with complete permanent dentition without any kind of restorative treatments in the lateral and posterior section of upper and lower dental arches were enrolled. The occlusal surfaces of molars and premolars were photographed using the fluorescence terminal Proof of the intraoral camera VistaCam iX before and after air polishing glycine procedures, registering the highest value gained for each occlusal surface. Results:133cuspidate permanent teeth of patients aged between 13 and 25 were analyzed. Descriptive analysis showed an average of 0.82 (SD=0.65; Min=0.00; Max=1.80; Median=1.20) and of 0.93 (SD=0.60; Min=0.00; Max=1.70; Median=1.20) for values before and after treatment, respectively.The scores assigned by VistaCam iX Proof fluorescence based camera to the occlusal surfaces, after the air‐polishing treatment, are averagely higher than those before treatment, especially in the diagnosis of initial tooth decay. Conclusion: Biofilm removal with glycine air‐polishing improves the VistaCam camera accuracy in recognizing healthy tissue from the decayed one, due to the fact that air-polishing treatment increases the decayed tissue reaction to the fluorescence

Dental hypomineralized enamel resin infiltration. Clinical indications and limits

Enamel hypomineralized lesions are often encountered in clinical practice. Among non-operative treatment options with topical fluoride or casein-phosphopeptide amorphous calcium phosphate) resin infiltrative procedure shows predictable results with minimum patient’s compliance. Enamel resin infiltration clinical procedure and inclusion criteria for enamel resin infiltration treatment have been reported

Treatment of developmental defects of enamel

Developmental defects of enamel are encountered daily in our dental practice. The management of enamel hypomineralized lesions may be challenging, especially as esthetic concern around the young population is increasing. Resin infiltration, a new technique firstly proposed to halt caries progression in the posterior segment, showed a strong positive esthetic effect in the treatment of developmental defects with different etiologies. Future in-vivo studies are needed to evaluate the longterm color stability, in order to provide a strong clinical recommendation

Treatment of severe fluorosis by a combined use of: at-home bleaching and at-office resin infiltration. A case report

Introduction: Severe Enamel Fluorosis is frequently found in young adolescents with aesthetic concerns. Colourimetric alterations could vary from diffuse opacities to demarcated brown and white areas. Material and methods: One young patient with a severe fluorosis was treated by a combined use of at-home bleaching and at-office resin infiltration. Results: In all the affected teeth, existing aesthetic enamel alterations, were successfully treated by the combined use of bleaching and Icon® resin application. Given the minimal substance loss due to the erosion infiltration procedure, the patient was extremely satisfied with the results. Conclusions: Our case report show the capability of treating severe fluorosis with bleaching and subsequent Icon® resin infiltration. Longer observation periods in studies with larger patients population are needed to validate the clinical significance found in this case report

Objective aesthetic performance of Icon treatment by deep infiltration: a case report

Enamel hypomineralization is characterized by decreased refractive index of the lesion surface as compared to the surrounding sound enamel. Icon® treatment has been recently successfully used for the cosmetic treatment of enamel demineralizations seen in white spot lesions (WSLs) and developmental defects of enamel (DDE). On the other hand, cases of molar incisal hypomineralization (MIH), deep lesions of traumatic origin, and those associated with severe fluorosis do not have the same response to this type of treatment. The application of a new deep Icon® infiltrative technique is proposed and the aesthetic results are validated by using a spectrophotometric approach as previously described by our group

Clinical procedure in sealing pit and fissure using technological aids: VistaCam iX Proof and Combi

The effectiveness of sealants in preventing pits and fissures decay is currently assessed by retention as principal clinical evaluation criteria. Among the determinants for sealant retention, an incomplete removal of plaque debris can cause lack of adhesion at the sealant-enamel interface. Therefore, in order to optimize the caries prevention outcome, clinical procedures of biofilm detection and cleansing are crucial. Technological aids can help clinicians in these critical phases. A clinical procedure is described of sealant application using VistaCam iX Proof fluorescence camera for quantitative assessment of surface demineralization and Combi air polishing unit for plaque removal. Pre and post air polishing intraoral VistaCam iX Proof images show the effectiveness of glycine airpolish technology in plaque removal. The results encourage technological aided clinical procedures in enhancing sealant application for pit and fissures caries prevention. Further clinical research is needed to validate our preliminary outcomes

Correlation between Vista Cam, ICDAS-II, x-ray bitewings and cavity extent after lesion excavation: an in vivo pilot study

METHODS: The occlusal sites of 20 permanent first and second molars in 14 young adolescents (12±2 y.o.) were examined at 1st Observation Unit of Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome. All the enrolled patients were asked to provide with x-rays bitewing of the studied teeth. The assessment of ICDAS-II and FC was performed by a trained operator. Then a second blind operator removed the carious lesion and evaluated the cavity extent (depth, width, length) after caries removal with a calibrated probe. To correlate FC measurements with bitewing sensitivity, 10 dentists evaluated the presence/absence of caries on the x-rays. RESULTS: All the occlusal sites assessed by fluorescence camera, ranged from 1.7 to 2, indicating in all cases deep enamel lesions with possible extent to dentine with a mean of 1.7+0. In accordance, visual inspection by ICDAS-II showed scores of 3 and 4. By contrast, the radiographic documentation, ie. bitewing x-rays, was evaluated in only 6 cases as presence of caries. The extent of the cavities was determined by three consecutive measurements: depth, width and length, with a mean of 3.5+1.73, 2.8+1.07 and 3.2+1.64 mm respectively. These results confirmed the agreement between FC and ICDAS-II for diagnosis of cavities with extent to enamel and dentine, while showed the low sensitivity of bitewings x-rays, in accordance with the existing evidence in Literature. Moreover, the results of this study for the first time provide information about the cavity extent after caries removal for the occlusal sites with ICDAS-II 3 and 4 scores and FC >=1.7. CONCLUSIONS: X-rays evaluation showed diagnostic accuracy in 6% of the sample. VistaCam measurement of 1.7 was correlated to a cavity with 3.5, 2.8 and 3.2 mm of depth, width and length

I Mediatori in Educazione Speciale

Nella propria attività di insegnamento ogni docente utilizza tutta una serie di metodi e di strumenti per favorire l'apprendimento di contenuti, maturando specifiche abilità capaci di renderli sicuri e operativi.I canali attraverso i quali avviene la comunicazione didattica, i mediatori, si dividono in quattro categorie: attivi, iconici, analogici e simbolici. Passando da una categoria all'altra aumenta il ruolo della simbolizzazione e ci si allontana dal contatto diretto con l'esperienza.Conoscere e saper utilizzare i vari mediatori significa adeguare consapevolmente la propria azione educativa (quella speciale soprattutto) in funzione delle potenzialità insite nel soggetto in sviluppo.In questo volume vengono descritte alcune significative esperienze di laboratorio diversificate per categorie di mediatori - attivate per anni durante i corsi di specializzazione per gli insegnanti di sostegno presso la SSIS del Veneto.L'uso dei mediatori e soprattutto la loro sapiente composizione, studiata per far maturare precise abilità, si rivela la via maestra per aiutare i soggetti diversamente abili. Le maggiori difficoltà in educazione speciale si incontrano nell'attivare processi di simbolizzazione necessari all'inserimento nella cultura e nel contesto civile. Il passaggio continuo da mediatori pre-simbolici a quello simbolico attiva nei soggetti diversamente abili tutti quei pre-requisiti necessari all'integrazione scolastica e umana.Il volume è stato pensato per offrire a insegnanti di sostegno, agli specializzandi, ma pure a tutti gli insegnanti che si imbattono quotidianamente in soggetti con difficoltà di apprendimento, uno strumento agile e di facile lettura cui ispirarsi per impostare una didattica attiva rispondente ai bisogni culturali dei propri allievi. Alcune significative esperienze di laboratorio, attivate durante i corsi di specializzazione per gli insegnanti di sostegno presso la SSIS Veneto, che hanno messo in luce l’importanza dei mediatori nel percorso educativo di soggetti diversamente abili. Un volume per insegnanti di sostegno, specializzandi e insegnanti che si imbattono quotidianamente in soggetti con difficoltà di apprendimento

New diagnostic technology and hidden pits and fissures caries

The accuracy in pits and fissures caries detection is of paramount importance in dental caries primary and secondary prevention. A combination of visual examination and probing is currently the mainstay of occlusal caries diagnosis. Unfortunately, these types of inspection alone may leave a certain number of pit and fissure caries undetected. The Vista Cam iX fluorescence camera (Durr Dental, Bietigheim-Bissingen, Germany) is a novel dental diagnostic tool for quantitative assessment of dental caries with high specificity for carious lesions detection. In the presented cases photographic images, representing the visual diagnostic approach, are applied as integration to VistaCam iX Proof images. A step-by-step sequence of inspection and assessment of operative treatment need is presented in a case of hidden pit and fissure caries on a permanent molar. Based on the reported case, it could be observed that VistaCam iX Proof shows promising results in hidden pits and fissures caries detection and could be considered a non-invasive examination method that facilitate the detection of early lesions and a potential diagnostic aid