Reproducibility of electrical caries measurements: A technical problem?

The currently available instrument for electrical detection of occlusal caries lesions {[}Electronic Caries Monitor (ECM)] uses a site-specific measurement with co-axial air drying. The reproducibility of this method has been reported to be fair to good. It was noticed that the measurement variation of this technique appeared to be non-random. It was the aim of this study to analyse how such a non-random reproducibility pattern arises and whether it could be observed for other operators and ECM models. Analysis of hypothetical measurement pairs showed that the pattern was related to measurements at the high and low end of the measurement range for the instrument. Data sets supplied by other researchers to a varying degree showed signs of a similar non-random pattern. These data sets were acquired at different locations, by different operators and using 3 different ECM models. The frequency distribution of measurements in all cases showed a single or double end-peaked distribution shape. It was concluded that the pattern was a general feature of the measurement method. It was tentatively attributed to several characteristics such as a high value censoring, insufficient probe contact and unpredictable probe contact. A different measurement technique, with an improved probe contact, appears to be advisable. Copyright (C) 2005 S. Karger AG, Basel

About article "Construct and predictive validity of clinical caries diagnostic criteria assessing lesion activity."

Letter to the editor about article: Nyvad B, Machiulskiene V, Baelum V (2003). Construct and predictive validity of clinical caries diagnostic criteria assessing lesion activity. J Dent Res 82:117-122. Published in: J Dent Res 82(11):862-863, 200

Precision of In Vivo Quantitative Tooth Wear Measurement using Intra-Oral Scans

Quantitative wear measurement is of increasing interest for measuring tooth wear progression. However, most research on quantitative wear measurement has focused on simulated wear or scanned gypsum casts. A 3D Wear Analysis (3DWA) protocol has been developed that analyzes tooth wear in vivo through intra-oral scanners available to dental clinicians. This study investigated the precision of the 3DWA protocol for measuring wear through maximum height loss (mm) and volume change (mm3). Observational prospective wear data from 55 patients were analyzed after 0-1-, 0-3-, and 0-5-year intervals to determine rates of wear, and convenience samples were chosen to test the protocol's precision on dentitions scanned twice in one sitting and its intra- and inter-rater precision on scans with 0-3- and 0-5-year intervals. Scans were made using intra-oral scanners (IOS) and superimposed using 3D measurement software. T-tests were performed to determine the structural and random error, and trimmed ranges were calculated to interpret the error. For protocol precision, the mean difference was 0.015 mm (-0.002; 0.032, p = 0.076) for height and -0.111 mm3 (-0.250; 0.023, p = 0.101) for volume. The duplicate measurement error was 0.062 mm for height and 0.268 mm3 for volume. The height measurements were precise enough to measure wear after intervals of 0-3 or 0-5 years; however, volume measurements were susceptible to procedural error and operator sensitivity. The 3DWA protocol is precise enough to adequately measure tooth height loss after intervals of a minimum of 3 years or in patients with severe wear progression, but it is not suited to measuring volumetric changes

Effect of drying time of 3-methacryloxypropyltrimethoxysilane on the shear bond strength of a composite resin to silica-coated base/noble alloys

Objectives. In this in vitro study, the effect of various drying (surface reaction) times of a commercial silane, other than that recommended by the manufacturer (at least 5 min), on the bond strength between the resin composite and silica coated base and noble alloys was evaluated. Methods. A total of 112 disc specimens (9 mm diameter and 0.5 mm thickness) were cast out of two types of alloy designed for ceramic firing, one of which was a noble (Degunorm) (gold– silver–platinum) and the other a base alloy (Wiron 99) (nickel–chromium–molybdenum). The specimens were assigned to two main groups according to each alloy type. These two main groups were further divided into seven subgroups, having eight specimens each. The specimens of both alloy types were airabraded with 30 mm silica (SiO2) coated alumina (Al2O3) (CoJetw-Sand, ESPE, Seefeld, Germany). The conditioned surfaces were coated with 3-thacryloxypropyltrimethoxysilane(MPS) and were allowed to react and dry for 1, 2, 3, 4, 5, 6, and 7 min, respectively, before the opaquer was applied. Immediately after the waiting periods for the silane to dry, first opaquer and then resin composite were applied. After storage in water for 30 days at 37 8C and thermocycling (5000 cycles, 5–55 8C), shear tests were performed using the universal testing machine at a crosshead speed of 0.5 mm/min. Results. Analysis of data showed no significant difference in bond strength for any silane drying and reaction period for both base and noble alloys between 1 and 7 min (ANOVA, P ¼ 0:05) (Degunorm: 5.8–7.4 MPa and Wiron 99: 7.2–10.2 MPa, respectively). Bond strengths of resin composite to base alloys were significantly higher than those to noble alloys at 2, 3 and 5 min (P ¼ 0:0045; P ¼ 0:05; P ¼ 0:002; respectively). Significance. In order to optimize the flow of laboratory work, the silane solution drying time might be reduced to 1 min for both base and noble alloys

ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I:caries lesion detection and depth assessment

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.</p

ORCA-EFCD consensus report on clinical recommendation for caries diagnosis. Paper I:caries lesion detection and depth assessment

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.</p