Assessment of the efficiency of dental excavation methods using laser speckle imaging.

This paper introduces a novel application of the laser speckle technique in dentistry, focusing on assessing the efficiency of dental excavation methods used to remove decayed tooth structure. The aim is to evaluate the efficiency of two chemo-mechanical agents and the high-speed drill using the laser speckle technique, which offers objective, non-invasive, and real-time evaluation capabilities. Extracted human primary molars with active occlusal carious lesions were sectioned into three parts, with each part allocated to one of three groups: Group 1 (Brix3000®), Group 2 (Papacarie DUO®), and Group 3 (High-speed drill mechanical caries removal). Caries removal was performed using the designated agent or method for each group. After caries excavation, speckle imaging using a 632.8 nm laser was conducted. Additionally, SEM was used to acquire micro-photographs of the surface morphology of the treated samples. The findings reveal insights into the comparative efficiency of the three dental excavation agents and methods using the laser speckle technique. The speckle parameters extracted from speckle patterns generated by treated teeth provide valuable information for evaluating the performance of the excavation methods. The scanning electron microscopy images also offer detailed visual evidence to support the analysis. This paper demonstrates the potential of the laser speckle technique for assessing the efficiency of dental excavation methods. The objective, non-invasive, and real-time evaluation provided offers advantages over subjective visual assessment and manual measurements.

Assessment of physiological disturbances during pre- and early postnatal development based on microscopic analysis of human deciduous teeth from the Late Epipaleolithic site of Shubayqa 1 (Jordan).

OBJECTIVES: To study pre- and early postnatal tooth formation and to analyze the effects of physiological disturbances on enamel and dentin formation in deciduous teeth of infants from the Late Epipaleolithic (Natufian) site Shubayqa 1. MATERIALS AND METHODS: Ten deciduous teeth from six infants (ages at death between 21 and 239 days) were analyzed by light and scanning electron microscopy. RESULTS: Marked prism cross-striations and an abnormal wavy course of the prisms were recorded in pre- and postnatal enamel of all analyzed teeth. Single or multiple accentuated incremental lines were observed in prenatal enamel of nine teeth and in postnatal enamel of eight teeth. Accentuated Andresen lines and broader zones exhibiting an enhanced calcospheritic pattern were recorded in the pre- and postnatally formed dentin of nine teeth. DISCUSSION: The structural abnormalities in the pre- and postnatally formed enamel of the infants are considered indicative of chronic stress that negatively affected the activity of secretory ameloblasts. The structural aberrations in pre- and postnatal dentin denote that odontoblasts were also affected by this stress. The presence of single or multiple accentuated incremental lines in pre- and postnatal enamel is interpreted as reflecting (short-term) impacts of higher intensity superimposed on the chronic stress. Our findings suggest compromised maternal health affecting the late fetus and compromised health in newborns. Although limited by the small number of analyzed individuals, the present study contributes to the knowledge of maternal and early infant health conditions in Late Epipaleolithic populations.

Subtraction Radiographic Assessment of Underlying Dentin After Partial Carious Dentin Removal in Primary Teeth.

PURPOSE: To assess the one-year outcome of glass-ionomer cement (GIC) restorations with partial carious dentin removal in primary molars using digital subtraction radiographs. MATERIALS AND METHODS: Children ages 6-8 years were recruited. Forty-nine primary molars with deep carious lesions were studied. The carious dentin was removed at the dentoenamel junction (DEJ) and restored with GIC. Digital radiographs were taken immediately after restoration, and at 6 and 12 months after restoration. The sets of digital radiographs were subtracted and analysed using Image-Pro Plus software. RESULTS: At the 12-month follow-up, 38 of the original 49 primary molars were analysed. No postoperative pain or signs of pulp pathology were reported. 76% and 87% of molars showed an increase in density of the studied areas compared to control areas at 6- and 12- month follow-ups, respectively. The density of digital subtraction radiographs increased to 5.3 and 8.2 at 6 and 12 months from baseline, respectively. The mean density of the areas under restoration at 6 months and 12 months was statistically significantly higher than at baseline (paired t-test; p < 0.05). CONCLUSION: Using digital subtraction radiographs, GIC restorations with partial carious dentin removal in primary molars showed a high potential for dentin remineralisation after 1 year.

In Vitro Assessment of Enamel Permeability in Primary Teeth with and without Early Childhood Caries Using Laser Scanning Confocal Microscope.

OBJECTIVE: To compare the permeability of the enamel of primary teeth from individuals free of Early Childhood Caries (ECC) with that from individuals affected with ECC by assessment of dye penetration using Laser Scanning Confocal Microscope (LSCM). STUDY DESIGN: Experimental in vitro study. Exfoliated primary maxillary anterior teeth (n = 44) were collected and divided into two groups (n=22 per group): samples with ECC (Group 1) and without ECC (Group 2). The samples were immersed in Rhodamine B dye solution for 1 day, cut longitudinally into 3 sections, observed using LSCM. Dye penetration depths in the incisal, middle, cervical thirds and on labial, lingual surfaces were recorded. Data were analyzed by the Mann-Whitney test (α = 5%, p < .005). RESULTS: The overall mean penetration depth for group 1 (100.6 µm ± 58.48 µm) was significantly higher than that of group 2 (31.55 µm ± 23.40 µm, p < .000). Mean penetration depth in the incisal, middle, and cervical thirds and on the labial and lingual surfaces of group 1 also presented significantly higher scores than in group 2 (p < .005). CONCLUSION: There was significantly more dye penetration in the ECC group than in the non-ECC group. This could be related to a higher level of enamel permeability in teeth affected with ECC.

An in vivo comparison of radiographic and clinical examination with separation for assessment of approximal caries in primary teeth.

AIM: To compare in vivo, clinical examination (CE) and bitewing radiographs (BW) for the detection of cavitations and initial approximal lesions in deciduous molars with validation after temporary separation (TS) and direct visual examination (DE) of the approximal surfaces. MATERIALS AND METHODS: Thirty children aged 4 to 8 years without visual cavitations or restorations and with at least one approximal contact. Two calibrated examiners evaluated 355 surfaces of primary molars, which were then validated through TS and DE. RESULTS: Of the 280 surfaces considered sound by CE, 24.6% were cavitated after separation. Comparing BW and DE, it was observed that, when the radiolucency involved the inner half of dentin, 68.4% of lesions were cavitated. The sensitivity and specificity of CE and BW were 0.14 and 0.43, and 0.80 and 0.75, respectively. CONCLUSION: DE identified a greater number of pre-cavitated lesions and cavities. BW were useful for detection of decayed surfaces, but with low specificity for diagnosis of sound surfaces, while detection of sound or decayed approximal areas by means of CE alone was not possible. The combination of methods was effective in obtaining an accurate diagnosis of caries in the primary dentition.

Radiographic assessment of primary molar pulpotomies restored with resin-based materials.

PURPOSE: The aims of this study were to: (1) retrospectively assess the overall performance of formocresol pulpotomies in primary molars when definitively restored with a resin-based material; and (2) compare the results to previously published studies using more traditional restorative techniques (stainless steel crown, amalgam). METHODS: Records of a 2-operator pediatric dental office using this novel restorative technique were reviewed. Pre- and postoperative radiographs of pulpotomized primary molars restored with Z-100 and with a minimum of 6 months of follow-up were compared to the contralateral nonpulpotomized tooth. Radiographic success was determined by the absence of furcation/periapical osseous radiolucency and internal/external pathologic root resorption. Patient's age, gender, tooth type and arch, follow-up time, ZOE base type used (IRM only or IRM with glass ionomer overlay), and number of surfaces involved were the variables analyzed in the study. Statistical analysis was performed using chi-square analysis. RESULTS: Fifty-nine teeth in 52 patients met the selection criteria. Patient's age at treatment ranged between 44 and 118 months, with an average follow-up time of 21 months (range = 7 to 43). Significant failure rate was found in the mandibular arch (P = .035). When only the occlusal surface was restored, 100% success was obtained. With proximal restorations, 83% (15/18) success was obtained when the base was IRM followed by glass ionomer and 69% (22/32) success for IRM only (P = .259). CONCLUSIONS: Overall, restoration of pulpotomized primary molars with resin-based material was inferior to reported success rates using stainless steel crowns. When proximal surfaces were restored, the failure rate (26%) was comparable to amalgam (23%). Prospective studies with larger sample size are necessary for definitive conclusions.

Paediatric dentistry in the new millennium: I. Quality care for children.

This is the first in a series of articles on paediatric dentistry in the new millennium. The aim of the series is to present a structured approach to the management of children and the common dental problems that are encountered in paediatric patients. Starting with the philosophy of 'quality care', as presented in this article, the series is intended to update readers on modern approaches to both pharmacological and non-pharmacological behaviour management, restorative techniques and the management of common developmental defects that present in both primary and young permanent teeth. Finally, preventive approaches that are easy to administer in a general dental practice will be discussed.

Radiographic assessment of the alveolar bone height in children and adolescents with familial dysautonomia.

PURPOSE: Familial dysautonomia (FD) is a progressive neuropathy, characterized by somatic and skeletal abnormalities, and by a variety of oral and diet disturbances. The purpose of the study was to assess the alveolar bone height at the molar areas of children and adolescents with FD. METHODS: The distance from the cemento-enamel junction (CEJ) to the alveolar bone crest (ABC) was measured on routine diagnostic bitewing radiographs of nine males and seven females with FD (mean age = 122 months) and in those of two matching groups (C1 = 119 months; C2 = 122 months). RESULTS: The mean values for the maxilla were significantly larger than those in the mandible. A positive significant correlation was found between the CEJ-ABC measurements of the primary and the permanent teeth, and between the CEJ-ABC measurements and age. The mean values per patient for the CEJ-ABC distances of the FD group were smaller than the control groups, but the difference was not statistically significant. The CEJ-ABC measurements in the primary and the permanent molars were smaller in the FD group, and in the premolars and permanent cuspids they were larger than those in the two control groups. These differences were not statistically significant. No differences were found between the FD and the control groups in the primary cuspids. CONCLUSIONS: The alveolar bone height of children and adolescent with familial dysautonomia does not differ from that of healthy controls.

Clinical and radiographic assessment of Class II esthetic restorations in primary molars.

PURPOSE: The aim of the study was to access the clinical performance of two esthetic materials (Vitremer and Z100 + Scotchbond Multipurpose) when used as Class II restorations in primary molars, and compare them to amalgam controls. METHODS: A total of 102 restorations were placed in primary molars of 29 schoolchildren; 40 were of Vitremer, 38 of Z100 + Scotchbond Multipurpose, and 24 of amalgam (Dispersalloy). The restorations were evaluated clinically at baseline and after 6, 12, 18, 24 months, or until tooth exfoliation or patient drop-out, following the modified Cvar and Ryge criteria. Radiographs were taken at yearly intervals, and the radiograph of the last examination available was assessed and scored. RESULTS: The majority of the restorations examined clinically up to 18 months was good (Alpha according to Cvar and Ryge), and no statistically significant differences between the groups was observed. However, at the 19-24 months evaluation, Z100 rated better than Vitremer for surface appearance and color match. The prevalence of radiolucent defects at the cervical margin for the Z100 (47%) was significantly higher than for amalgam (11%) restorations (P = 0.002) and for Vitremer (13%) restorations (P = 0.008). CONCLUSION: The three materials evaluated (Vitremer, Z100 and Dispersalloy) presented satisfactory clinical performance during the time evaluated (approximately 2 years). Approximately half of the composite resin restorations presented radiographic defects that might require replacement at a later date. In contrast, glass ionomer and amalgam restorations presented significantly less radiographic defects at the time of the final examination. This study suggests that composite resins are indicated for classII restorations in primary molars that are expected to exfoliate within two years.

The cervical margin of amalgam restorations: a radiographic and clinical assessment.

In a study of the condition of the cervical margin of class II amalgam restorations, a radiographic method of assessment was compared with clinical assessment using mouth mirror and probe. The radiographic method assesses the type of defect of the cervical margin on the one hand, and the degree of defect on the other. In addition, an in-vitro study was performed of forty-six primary molars with multiple-surface amalgam restorations, in order to evaluate the results of the comparative study. Comparison of the results of clinical assessment with those of radiographic assessment revealed that: There is no correlation between the type of defect of the cervical margins of the amalgam restorations and their clinical assessment. There is a correlation between the degree of cervical margin defect and clinical assessment, as long as the defect does not exceed 1.5 mm. There is no significant difference between the clinical and the radiographic methods of assessment. Using both methods, only 20 percent of the cervical margins seemed to show "good" adaptation. The results of the in-vitro study warrant the conclusion that: In this study, too, only 20 percent of the cervical margins showed good adaptation. The restorations of the forty-six shed primary molars were of the same quality as those involved in the comparative study. These two conclusions warrant the postulate that, when only one of the two methods of assessment is used, the results must be divided by two in order to gain an accurate impression of the condition of the cervical margins.