In vivo study of different methods for diagnosing pit and fissure caries

Background: In recent years the early detection of such caries has gained importance, since it may avoid unnecessary dental tissue damage and allow minimally invasive dental treatment. A study is made of 5 systems for diagnosing caries: traditional visual and tactile methods, DIAGNOdent, VistaProof and CarieScan. Material and Methods: A prospective study was made in the Department of Stomatology, Dental Pathology and Therapeutics Teaching unit of the University of Valencia (Valencia, Spain), involving the analysis of 32 teeth (molars or premolars of both arches scheduled for filling or for use as posts in dental bridges) in 28 patients. The following caries diagnostic methods were applied: visual, tactile, DIAGNOdent (KAvo, Biberach, Germany), VistaProof (Dürr Dental AG, Bietigheim-Bissingen, Germany) and CarieScan (IDMoS Dental Systems, Dundee, Scotland, United Kingdom). Fissurotomy was subsequently performed for histological validation. Results: Visual inspection showed an area under the receiver operating characteristic curve (AUC-ROC) of 0.75, with a sensitivity and specificity of 0.75. Tactile diagnosis in turn showed AUC = 0.714, with maximum sensitivity (100%) and a specificity of 42.9%. DIAGNOdent (cutoff point 22.5) and VistaProof (cutoff point 1.1) showed AUC = 0.969, while CarieScan (cutoff point 21.5) presented AUC = 0.973. These latter three methods all had a sensitivity of over 92%. The specificity of DIAGNOdent was maximum, while that of CarieScan and VistaProof was 75%. Conclusions: The emergent methods in the diagnosis of caries (DIAGNOdent, VistaProof and CarieScan) yielded similar results, and in all cases proved superior to the traditional visual and tactile methods. DIAGNOdent was seen to be the most effective technique, followed by CarieScan and VistaProof

Accuracy of the estimation of dental age in comparison with chronological age in a Spanish sample of 2641 living subjects using the Demirjian and Nolla methods.

Age estimation is an important procedure in forensic medicine and is carried out for a number of reasons. For living persons, age estimation is performed in order to assess whether a child has attained the age of criminal responsibility, in scenarios involving rape, kidnapping or marriage, in premature births, adoption procedures, illegal immigration, pediatric endocrine diseases and orthodontic malocclusion, as well as in circumstances in which the birth certificate is not available or the records are suspect. According to data from the UNHCR (United Nations High Commissioner for Refugees), the number of people seeking refugee status continued to increase in the last years, driven by the wars in Syria and Iraq, as well as by conflict and instability in Afghanistan, Eritrea and elsewhere. The objective of this study is to compare the accuracy of estimating dental age versus chronological age using the Nolla and Demirjian methods in a Spanish population. A final sample of 2641 panoramic X-rays corresponding to Spanish patients (1322 males and 1319 females) between 7-21 years of age was analyzed. Dental age was assessed using the Nolla and Demirjian methods, establishing comparisons with mean chronological age based on the Student t-test for paired samples, followed by the generation of a linear regression model. Both methods showed slight discrepancy between dental and chronological age. On examining the reproducibility of the Nolla and Demirjian methods, technical errors of 0.84% and 0.62%, respectively, were observed. On average, the Nolla method was found to estimate an age 0.213years younger than the chronological age, while the Demirjian method estimated an age 0.853years older than the chronological age. Linear combination of the mean Nolla and Demirjian estimates increased the predictive capacity to 99.2%. In conclusion the Nolla and Demirjian methods were found to be accurate in estimating chronological age from dental age in a Spanish population. The error was found to be greater in males than in females, and involved an over-estimation of age with the Demirjian method and under-estimation of age with the Nolla method. Combination of the Nolla and Demirjian methods for estimating chronological age from dental age affords a predictive capacity of over 99%, and is fast and easy to perform, and inexpensive.Sin financiación1.974 JCR (2017) Q2, 5/16 Medicine, LegalUE

Caries diagnosis using light fluorescence devices in comparison with traditional visual and tactile evaluation: A prospective study in 152 patients

The objective of the study was to evaluate the in vivo effectiveness of two fluorescence techniques (DIAGNOdent and VistaProof) and of visual and tactile evaluation in the diagnosis of occlusal caries in permanent teeth. A total of 302 teeth (molars and premolars) from 152 patients were studied. The occlusal surfaces were cleaned using pumice mixed with water, followed by application of the diagnostic methods according to the instructions of the manufacturer, and of the visual and tactile methods according to the recommendations. The true extent of the lesions was determined by fissurotomy. The sensitivity and specificity of visual diagnosis were 79 and 72 %, respectively, versus 53 and 98 % in the case of tactile diagnosis. Teeth with caries lesions exhibited significantly higher DIAGNOdent and VistaProof scores than those without caries. Using the optimum cutoff point of 23.5 obtained in our study for DIAGNOdent, sensitivity and specificity were found to be 92.4 and 92.7 %, respectively, while values of 88.1 and 95.1 % were obtained with a cutoff point of 28.5. Sensitivity in the case of the VistaProof system varied between 92.9 % (cutoff point 1.05) and 85.3 % (cutoff point 1.3), with respective specificity values of 95.8 and 88.6 %. The areas under the curve were 0.756, 0.759, 0.954 and 0.965 for the visual and tactile methods and for DIAGNOdent and VistaProof, respectively. The fluorescence-based techniques showed greater internal and external validity than the visual and tactile methods in diagnosing occlusal caries in permanent teeth. VistaProof is the best method for diagnosing caries in its early stages.Sin financiación1.458 JCR (2017) Q3, 51/91 Dentistry, Oral Surgery and MedicineUE

Demirjian and Cameriere methods for age estimation in a Spanish sample of 1386 living subjects

The aim of the study is to determine the validity of two methods based on mineralisation of the third molar to predict the ages of majority of individuals in a Spanish population. Orthopantomographies of 636 men and 750 women were analysed. The Demirjian and Cameriere methods were used, and each tooth was assigned a value according to the degree of mineralisation and maturation. The Cameriere method has a predictive capacity of 88%. For other proposed age ranges (14 and 16 years), both methods were useful in determining the actual age of individuals, with the Demirjian method having a sensitivity of 97.5% with and Cameriere having a predictive capacity of 95%. Both methods can be used with high reliability to determine the age of individuals where reliable documentation is unavailable. The combination of the two methods does not substantially increase predictive ability.Sin financiación4.997 Q2 JCR 20211.005 Q1 SJR 2021No data IDR 2021UE

Combined Near-Infrarred Light Transillumination and Direct Digital Radiography Increases Diagnostic In Approximal Caries

The objective of this study was to evaluate the clinical ability of Near-Infrared Light-Transillumination (NILT) for approximal dentinal caries detection and to compare with direct digital-radiography (DDR), as well as to determine whether the combination of both techniques improves the diagnostic capacity of the lesions. From 88 patients (over 18 years), 138 posterior teeth (76 molars and 62 premolars), that had approximal caries reached into dentine determined by DDR, were included. Lesion extension and DDR images were scored as follows: D0 = sound surface, D1/D2 = caries restricted to the outer/inner-half of the enamel, and D3/4 = caries restricted to the outer/inner-half of the dentin. Opening of the approximal surface using 0.5 mm-in-diameter diamond-bar was used as gold-standard. The lesion extension was then determined by the following criteria: no dentinal caries (D0/1/2) or dentinal caries (D3/4). Seventy-one lesions were D3 and 67 lesions were D4. Sensitivities of overall/D3/D4 were 98.0/95.7/100.0 (NILT) and 100/100/100 (DDR), respectively. Correlations with gold-standard were 0.92 (NILT) and 0.42 (DDR), respectively. The correlation increased to 0.97 (p = 0.045) on combining NILT and DDR. There was no difference in sensitivity between the methods (p > 0.05); but was differences in the correlation (p < 0.01). It can be concluded that NILT showed sensitivity similar to that of DDR and higher correlation than DDR for approximal dentinal caries detection. Accordingly, it may be used to monitor the progression of caries without exposing the patient to ionizing radiation, this being of particular interest in growing patients and in pregnant women. In this respect, NILT can be an effective diagnostic tool adjunctive to bitewing radiographs in detecting approximal dentinal caries. The combination of NILT and DDR represents an increase in the diagnosis of approximal lesions The proposed diagnostic protocol comprises visual examination, followed by NILT and DDR only if the former technique detects approximal caries.Sin financiación3.998 JCR (2019) Q1, 17/71 Multidisciplinary Sciences1.341 SJR (2019) Q1, 9/148 MultidisciplinaryNo data IDR 2019UE

Impedance Spectroscopy as a Tool for the Detection of Occlusal Noncavitated Carious Lesions

A total 302 teeth (148 molars and 154 premolars) corresponding to 152 patients aged ≥18 years were evaluated for caries using the ICDAS (International Caries Detection and Assessment System), fluorescence (DD, DIAGNOdent) and electrical impedance (IMS, CarieScan PRO) systems. Fissurotomy and intraoral radiographs were used as the gold standard. Accordingly, 27.5% (n=84) of the teeth were classified as sound, while 26.9% (n=81) had enamel involvement and 45.6% (n=138) presented carious lesions reaching the dentin. Sensitivity (Se), specificity (Sp), and the area under the curve (AUC) were, respectively, 90.7%, 87.8%, and 0.954 (IMS); 92.4%, 92.7%, and 0.954 (DD); and 79.0%, 72.3%, and 0.756 (ICDAS). With regard to Se and Sp, there were significant differences between ICDAS and DD (p0.05). The correlations between fissurotomy and each method were 88.7% (IMS), 89.7% (DD), and 77.1% (ICDAS). Within the limitations of this study, clinically, the electrical system is not useful for differentiating between sound teeth and truly incipient caries lesions by itself. The fluorescence or electrical systems are recommended with the ICDAS to detect carious lesions in their early stages.Sin financiación2.937 JCR (2021) Q2, 42/92 Dentistry, Oral Surgery & Medicine0.702 SJR (2021) Q1, 28/142 Dentistry (miscellaneous)No data IDR 2021UE

The Influence of Friction on Design of the Type of Bracket and Its Relation to OHRQoL in Patients Who Use Multi-Bracket Appliances: A Randomized Clinical Trial

Background and objectives: The aim of this study was to evaluate the influence of friction on design of the type of bracket, patients’ perception of pain and the impact on their oral health-related quality of life. Materials and Methods: A randomized clinical trial was carried out with 90 patients (62.2% women and 37.8% men) with three kinds of fixed multi-bracket appliances: Conventional (GC), fixed multi-bracket low friction (GS) and self-ligating (GA). The VAS (Visual Analogue Scale) was used to determine pain during the first seven days of treatment at different points in time. The patients were also given the OHIP-14 (Oral Health Impact Profile) questionnaire to analyse their oral health-related quality of life (OHRQoL) after the first 30 days of treatment. The ANOVA test was used for the analysis of the variables and the post hoc Bonferroni test for the comparison between groups. Results: Maximum pain was observed between one and two days after the start of treatment. The GC group showed the greatest degree of pain, with maximum values (4.5 ± 2.0) at 24 h. The self-ligation brackets show lower impact on patients’ oral health-related quality of life (0.8 ± 2.2, p < 0.01). Conclusions: Friction in the type of bracket influences pain and the Oral Health-Related Quality of Life of patients who use multi-bracket fixed orthodontics.Justificación y objetivos: El objetivo de este estudio fue evaluar la influencia de la fricción en el diseño del tipo de bracket, la percepción del dolor por parte de los pacientes y el impacto en su calidad de vida relacionada con la salud bucal. Materiales y Métodos: Se realizó un ensayo clínico aleatorizado con 90 pacientes (62,2% mujeres y 37,8% hombres) con tres tipos de aparatología fija multibrackets: Convencional (GC), fija multibrackets de baja fricción (GS) y autoligado (GA). Se utilizó la EVA (Escala Visual Analógica) para determinar el dolor durante los primeros siete días de tratamiento en diferentes momentos. Los pacientes también recibieron el cuestionario OHIP-14 (Perfil de Impacto en la Salud Oral) para analizar su calidad de vida relacionada con la salud oral (OHRQoL) después de los primeros 30 días de tratamiento. Se utilizó la prueba ANOVA para el análisis de las variables y la prueba post hoc de Bonferroni para la comparación entre grupos. Resultados: El dolor máximo se observó entre uno y dos días después del inicio del tratamiento. El grupo GC presentó el mayor grado de dolor, con valores máximos (4,5 ± 2,0) a las 24 h. Los brackets de autoligado muestran un menor impacto en la calidad de vida relacionada con la salud bucal de los pacientes (0,8 ± 2,2, p < 0,01). Conclusiones: La fricción en el tipo de bracket influye en el dolor y en la Calidad de Vida Relacionada con la Salud Bucal de los pacientes que utilizan ortodoncia fija multibracket.Sin financiación1.205 JCR (2020) Q3, 107/165, Medicine, General and Internal0.530 SJR (2020) Q3, 1255/2446 Medicine (miscellaneous)No data IDR (2020)UE

Eagle syndrome compared with stylohyoid syndrome: complete ossification of the stylohyoid ligament and joint

A 65-year-old man presented with a history of type 2 diabetes, chronic obstructive pulmonary disease, and non-alcoholic fatty liver. He had had no injuries to, or operations on his neck, but had had right submandibular and retroauricular pain for years. Computed tomography with 3-dimensional reconstruction (Figs. 1 and 2) showed elongation of both styloid processes associated with pseudoarticulation of the hyoid bone on the right side. This confirmed the complete ossification of the stylohyoid ligament, but the patient did not want an operation to resolve it.Sin financiación1.260 JCR (2017) Q3, 65/91 Dentistry, Oral Surgery & Medicine, 138/200 SurgeryUE

Effectiveness of lingual versus labial fixed appliances in adults according to the Peer Assessment Rating index

Introduction: The purpose of this study was to compare the effectiveness of lingual treatment and labial fixed appliances in the treatment of adult orthodontic patients. Methods: We conducted a retrospective study of 72 patients. The Peer Assessment Rating (PAR) index was measured at the start (T0) and end (T1) of treatment. Significant differences between treatment means were determined by means of analysis of variancewith the Bonferroni correction or with the use of Fisher exact test. Results: The lingual group had a mean pretreatment age of 28.6 ± 6.7 years, and the labial group had a pretreatment age of 26.6 ± 9.5 years. This difference was statistically not significant. The mean pre- and posttreatment PAR scores in the labial group were 22.9 ± 6.2 and 2.1 ± 2.3, respectively, and the mean pre- and posttreatment PAR scores in the lingual group were 26.5 ± 8.3 and 2.3 ± 2.5. There were no significant differences between the treatment groups. Conclusions: Lingual and labial appliances produced similar reductions in PAR scores. There was no difference in the posttreatment PAR scores between the lingual and labial treatment groups. Further studies involving larger sample sizes and longer follow-up periods are required to confirm the results obtained.Sin financiación1.960 JCR (2019) Q3, 36/91 Dentistry, Oral Surgery & Medicine1.136 SJR (2019) Q1, 1/24 OrthodonticsNo data IDR 2019UE

Evaluation of the maxillary midline, curve of the upper lip, smile line and tooth shape: a prospective study of 140 Caucasian patients

Background: A number of reference patterns such as the interincisal line, curve of the upper lip, width of the smile or shape of the teeth have been studied in different populations. Determining the frequency of different smile aesthetic parameters in a European Caucasian population and exploring possible gender differences is important in order to obtain predictable treatment outcomes. Methods: Photographs were obtained under resting and forced smiling conditions in 140 individuals (70 males and 70 females) with a mean age of 20.1 ± 4.3 years. Different variables were recorded, including the position of the maxillary interincisal midline in relation to the facial midline, the arc and width of the smile, and the shape of the teeth. The data were processed using the SPSS version 15.0 statistical package, with application of the chi-squared test and a confidence level of 95%. The statistical power was 80%, and the level of significance 5% (α = 0.05). Results: A total of 94.3% of the sample presented a maxillary interincisal midline coinciding with the facial midline, and 80% had a consonant smile line. The curve of the upper lip was upwards in 47.1% of the cases, followed by a straight curve in 41.4%. Most of the subjects (84.3%) presented a medium smile line with tooth exposure to the second premolar (61.4%). There were no significant differences between males and females. Conclusions: The integration of aesthetic criteria is needed in order to guarantee satisfactory and predictable dental treatment outcomes. There were no statistically significant differences between males and females. The maxillary interincisal midline coincided with the facial midline, with a consonant smile arc and a medium smile line, upward lip curve and oval tooth shape.Sin financiación2.757 JCR (2020) Q3, 35/92 Dentistry, Oral Surgery & Medicine0.868 SJR (2020) Q1, 23/141 Dentistry (miscellaneous)No data IDR 2020UE