Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography methods.

BACKGROUND: Dental caries is a global public health concern, and early detection is essential. Traditional methods, particularly visual examination, face access and cost challenges. Teledentistry, as an emerging technology, offers the possibility to overcome such barriers, and it must be given high priority for assessment to optimize the performance of oral healthcare systems. The aim of this study was to systematically review the literature evaluating the diagnostic accuracy of teledentistry using photographs taken by Digital Single Lens Reflex (DSLR) and smartphone cameras against visual clinical examination in either primary or permanent dentition. METHODS: The review followed PRISMA-DTA guidelines, and the PubMed, Scopus, and Embase databases were searched through December 2022. Original in-vivo studies comparing dental caries diagnosis via images taken by DSLR or smartphone cameras with clinical examination were included. The QUADAS-2 was used to assess the risk of bias and concerns regarding applicability. Meta-analysis was not performed due to heterogeneity among the studies. Therefore, the data were analyzed narratively by the research team. RESULTS: In the 19 studies included, the sensitivity and specificity ranged from 48 to 98.3% and from 83 to 100%, respectively. The variability in performance was attributed to factors such as study design and diagnostic criteria. Specific tooth surfaces and lesion stages must be considered when interpreting outcomes. Using smartphones for dental photography was common due to the convenience and accessibility of these devices. The employment of mid-level dental providers for remote screening yielded comparable results to those of dentists. Potential bias in patient selection was indicated, suggesting a need for improvements in study design. CONCLUSION: The diagnostic accuracy of teledentistry for caries detection is comparable to that of traditional clinical examination. The findings establish teledentistry's effectiveness, particularly in lower income settings or areas with access problems. While the results of this review is promising, conducting several more rigorous studies with well-designed methodologies can fully validate the diagnostic accuracy of teledentistry for dental caries to make oral health care provision more efficient and equitable. REGISTRATION: This study was registered with PROSPERO (CRD42023417437).

Comparison of Three types of Tooth Brushes on Plaque and Gingival Indices: A Randomized Clinical Trial.

OBJECTIVE: To compare clinical results of three types of manual tooth brushes on plaque removal efficacy and gingivitis. METHOD: This study is a single blind randomized trial with crossover design which involved 30 periodontaly healthy individuals. Professional plaque removal and oral hygiene instruction were performed for all the participants in the first step of our study followed by asking them to avoid brushing for 2 days. Thereafter plaque and gingivitis scores were measured using plaque and gingival indices (PI and GI). Then subjects were instructed to use Pulsar tooth brush for a two-week period and then, GI and PI indices were assessed again. After passing one-week period for wash out, subjects didn't brush for 2 days and indices were recorded again. The same procedure was done for CrossAction, and Butler 411 tooth brushes respectively and at the end of the study these variables were analyzed using SPSS software ver.16. Repeated measurement ANOVA test was used to compare the scores between different brushes. RESULT: Finding of this study reveals that using all three types of tooth brushes resulted in significant plaque and gingivitis reduction compared to baseline levels. Pulsar tooth brush was significantly more effective in diminishing PI and GI than Butler tooth brush (p=0.044 and 0.031 respectively). CONCLUSION: According to our findings all 3 types of tooth brushes are effective in reduction of plaque and gingivitis and this reduction is significantly greater for Pulsar tooth brush compared to Butler and CrossAction tooth brushes.

Evaluation of Plasma Isoprostane in Patients with Oral Lichen Planus.

STATEMENT OF THE PROBLEMS: Lichen planus is a chronic inflammatory disease. Free radicals and reactive oxygen species play important roles in pathogenesis of oral lichen planus (OLP). Isoprostanes show oxidative stress and are formed by free-radical mediated lipid peroxidation of arachidonic acid and cell membrane phospholipids. PURPOSE: This study was conducted to evaluate the plasma level of 8-isoprostane in patients suffering from erosive and non-erosive forms of OLP. MATERIALS AND METHOD: In this case-control study, 31 patients with OLP and 30 control subjects were enrolled. Plasma samples were obtained and the level of 8-isoprostane was measured with Sandwich enzyme-linked immunosorbent assay (ELISA) in both groups. The data were analyzed by using two-sample t-test, chi-square and ANOVA tests. RESULTS: The results showed significant increase in the plasma level of 8-isoprostane in OLP group compared with the control group. The results of independent t-test revealed no significant correlation between the plasma level of isoprostane and sex, smoking, or previous treatment. CONCLUSION: Based on the findings of this study, oxidative stress was increased in patients with OLP, reflected by higher concentrations of 8-isoprostane in plasma.

Oxidative stress factors and C-reactive protein in patients with oral lichen planus before and 2 weeks after treatment.

OBJECTIVES: Oral lichen planus (OLP) is an inflammatory disease with an unknown origin. Oxidative stress is suspected to play a role in its pathogenesis. The aim of this study was to evaluate serum levels of oxidative stress factors and C-reactive protein in patients with OLP. MATERIALS & METHODS: In this case-control study, 25 patients with OLP and 23 control subjects were enrolled. Serum levels of C-reactive protein (CRP), malondialdehyde (MDA), and total antioxidant capacity (TAC) were investigated in both groups. In case group, all these factors were re-evaluated after 14 days of treatment. The characteristics of the lesions were also recorded at each visit. RESULTS: Serum levels of MDA were significantly higher (P = 0.009), and TAC was significantly lower (P < 0.001) in patients with OLP. There were no significant differences between serum levels of TAC, CRP, and MDA in patients with OLP before and after treatment (P = 0.174, P = 0.556, P = 0.194, respectively). However, the difference in serum levels of TAC between erosive and atrophic patients with keratotic OLP was significant (P = 0.024). CONCLUSION: We concluded patients with OLP have increased of serum MDA and the decrease of serum TAC compared with the healthy subjects, and 14-day treatment of OLP did not have any effect on serum levels of oxidative stress factors.