Caries detection and characterization in pediatric patients using iTero 5D near-infrared technology.

INTRODUCTION: Near-infrared imaging (NIRI) has been proposed as an alternative to radiographs and uses nonionizing radiation in the near-infrared spectrum to differentially scatter light off tooth surfaces and generate images allowing interproximal caries detection. The new iTero 5D Element Scanner (Align Technology, Santa Clara, Calif) has integrated NIRI capture and viewing technology but has not been specifically studied in a pediatric population. Therefore, this study aimed to assess clinicians' abilities to detect and characterize caries in pediatric patients using this instrument. METHODS: Bitewing (BW) radiographs and an intraoral scan were captured on 17 pediatric patients (344 surfaces were analyzed). Data were randomized and graded by 5 calibrated clinicians individually with 2 different rounds of grading. RESULTS: The reliability of lesion characterization (ie, grade) among examiners was poor to fair in both systems, whereas the reliability of caries detection was moderate. Both systems had a high specificity and low sensitivity. The reliability of the characterization of the combined dataset was moderate to substantial, whereas, for detection, it was substantial. CONCLUSIONS: When using either BW or NIRI analysis, reliability is relatively poor, and clinicians are more likely to correctly identify a healthy tooth surface when compared with a carious surface. There is a small difference in error rate between BW and NIRI systems that is not likely to be clinically significant. When NIRI and BW data are combined, clinician agreement for both lesion characterization and detection increases significantly.

Impact of test-enhanced learning as a study strategy: An exploratory study with first-year dental students.

PURPOSE: Research has demonstrated that learners who practice self-testing have superior long-term retention compared to those rereading the material alone, a phenomenon called test-enhanced learning. This testing effect can be leveraged by spacing out the testing practice over time, a technique called spaced repetition. In 2017, we provided dental students at the school with access to Osmosis, a web-based platform that supports test-enhanced learning and spaced repetition through flashcards. This exploratory study examined students' adoption of self-testing with flashcards and its impact on learning performance in basic sciences. METHODS: Participants were 143 first-year predoctoral students at a dental school in the US. The platform analytics revealed the number of flashcards students answered throughout the first academic year (2019-2020). Regression analyses examined how self-testing with flashcards impacted students' exam scores in basic sciences. Analysis of variance (ANOVA) tests examined the difference in students' exam performance among the non, minimal, occasional, and regular flashcard users who answered 0, 1-99, 100-499, and over 500 flashcards, respectively. RESULTS: Students answered 82,766 flashcards during the year. Additionally, they created 17,973 flashcards using the platform's flashcard authoring tool. Regression analyses showed that self-testing with flashcards correlated positively with students' exam performance in anatomy, biochemistry, nutrition, and physiology. ANOVA results revealed a statistically significant difference in students' exam performance in anatomy, biochemistry, and nutrition among the four groups. CONCLUSIONS: This study is the first in dental education to examine students' self-testing on the Osmosis platform. Results revealed that there was widespread adoption of self-testing with flashcards. The study provided additional evidence to support the value of self-testing for dental students. It has practical implications of how test-enhanced learning can be incorporated into dental education to support student learning. The study contributed to the test-enhanced learning literature in dental education, an area that has been underexplored.