Performance of ICDAS II and fluorescence methods on detection of occlusal caries-An ex vivo study.

BACKGROUND: The aim of this ex vivo study was to compare the performance of the visual ICDAS II scale and two fluorescence methods (DIAGNOdent Pen and VistaCam iX) in detecting occlusal caries lesions in permanent teeth using cone beam computed tomography (CBCT) as a reference test. METHODS: One hundred-sixty molars and premolars were qualified for the study. The visual, the DIAGNOdent Pen and VistaCam iX examinations were carried out by two examiners. The actual extent of the lesions was determined using CBCT. For the three methods, inter- and intra-examiner reproducibility was calculated using intraclass correlation coefficient. The sensitivity, specificity, and accuracy of these methods were compared using the mid-P McNemar test. The level of significance was set at p < 0.05. RESULTS: For all data, intraclass-correlation coefficients (ICC) for intra- and inter-examiner reproducibility were high. With regard to the enamel threshold, the sensitivity and accuracy were significantly higher for VistaCam iX and ICDAS II compared with the DIAGNOdent Pen (p < 0.05). The results obtained with the DIAGNOdentu Pen indicated significantly higher specificity values for the enamel threshold (p < 0.05). The results obtained with the VistaCam iX showed the lowest sensitivity but the significantly highest specificity and accuracy for the dentin threshold (p < 0.05). CONCLUSIONS: The ICDAS II is an effective method for detecting early carious lesions, characterized by a higher sensitivity compared with devices using fluorescence. To improve the diagnostic efficiency of the evaluated devices, modifying the cut-off values recommended by the manufacturers should be considered.

Diagnostic validity of the use of ICDAS II and DIAGNOdent pen verified by micro-computed tomography for the detection of occlusal caries lesions-an in vitro evaluation.

The aim of this study is to assess the extent of early carious lesions using the International Caries Detection and Assessment System (ICDAS) II and DIAGNOdent pen compared with microCT examination. Forty-eight molars and premolars were qualified for the study. The visual and the DIAGNOdent pen device examinations were carried out by two examiners. The actual extent of the lesions was determined using micro-CT examination. The optimal cutoff test value was determined using the Youden index. For the two methods, inter- and intra-examiner reproducibility was calculated using intraclass correlation coefficient. The sensitivity, specificity, and accuracy of these methods were compared using the mid-P McNemar test. The level of significance was set at p < 0.05. In terms of the enamel threshold for the ICDAS II scale, insignificantly higher mean evaluated parameters were noticed in comparison with the DIAGNOdent pen device. For the dentin threshold, all the assessed parameters had higher mean values on the ICDAS II scale compared with the DIAGNOdent pen. The optimal cutoff points of the enamel and dentin thresholds are lower than that suggested by the manufacturer. The ICDAS II and the DIAGNOdent pen device were characterized by high inter - and intra-observer reproducibility of the test results. To improve the diagnostic efficiency of the DIAGNOdent pen, modifying the cutoff values recommended by the manufacturers should be considered. After modifying the cutoff values, the combination ICDAS II and DIAGNOdent pen device would be the better choice in order to detect caries on occlusal surfaces.

[Importance of dental care to maintain oral health of children and youth with type 1 diabetes]. / Znaczenie opieki stomatologicznej w utrzymaniu zdrowia jamy ustnej u dzieci i mlodziezy z cukrzyca typu 1.

BACKGROUND: Dental care for children and youth with type 1 diabetes should rely on reliable examination of the oral cavity, early treatment of dental caries and maintenance of the treatment results. This can be achieved through regular control visits consistent with the standards, and also through following the recommendations for prevention of dental caries and periodontal disease. The aim of the study was to investigate whether dental care allows to preserve good oral health of children and youth with type 1 diabetes. MATERIAL AND METHODS: The study included 60 patients with type 1 diabetes, aged 7-17 years, and 30 healthy children and youth within the same age range. There were evaluated intensity of caries, the effectiveness of conservative treatment, periodontal health and oral hygiene. RESULTS: The results of examinations showed significantly lower caries prevalence and better periodontal health in the children and youth with type 1 diabetes. The effectiveness of conservative treatment was significantly higher among patients with mixed dentition. There was no significant difference in oral hygiene between the compared groups. CONCLUSIONS: Diabetes is a risk factor for oral diseases, so children and youth with type 1 diabetes should be provided with special preventive care and curative measures. The main goal of the insulin-dependent diabetes care program is to early classify them to highrisk groups to improve general oral health and thus improve the quality of life. Proper dental care for children and yuoth with type 1 diabetes is a condition to maintain oral health. Med Pr 2018;69(1):37-44.

Direct Pulp Capping in Primary Molars using Mineral Trioxide Aggregate: An in Vivo Study.

OBJECTIVE: To do a clinical and radiographic evaluation of the effectiveness of MTA when used as a direct pulp capping material in primary molars. STUDY DESIGN: Clinical and radiographic follow-up was performed on 30 primary molars with deep caries lesions in 30 patients from 3 to 9.75 years of age. Pulps exposed during cavity preparation were treated by direct pulp capping with MTA. The follow-up clinical and radiographic examinations were carried out at different time intervals: 6, 7-12, 13-18, 19-24, and >24 months after treatment. RESULTS: Twenty-four teeth were evaluated during the entire observation period. Positive clinical and radiographic outcomes were achieved in 19 teeth (13 teeth were saved and 6 were exfoliated). In five teeth, complications were observed only in children under 7 years old. CONCLUSION: Based on these clinical and radiographic results, MTA was found to be successful when used as a direct pulp capping material in primary teeth.

Evaluation of cytotoxicity and pH changes generated by various dental pulp capping materials - an in vitro study.

INTRODUCTION: Various materials are used in direct dental pulp capping method. Their biocompatibility and alkalizing abilities are of primary importance affecting therapeutic effects. The aim of this study was to evaluate and compare the cytotoxicity of various pulp-capping materials on human gingival fibroblasts and investigate the pH changes induced by these materials. MATERIAL AND METHODS: Human gingival fibroblasts were cultured with nine direct pulp materials using culture plate inserts. The cytotoxic effects were recorded by using an MTT-based colorimetric assay after 3 and 24 h. In the second part of the experiment, the materials were inserted in dialysis tubes and transferred into plastic vials containing deionized water. The changes of the medium pH were measured after 3 and 24 h. RESULTS: We showed differences in cell viability of gingival fibroblasts after varied time of exposition for the tested materials. Cell viability after 24 h increased for Dycal, Biopulp, and Calcipro, and decreased for Calcipulpe, Angelus, Angelus White, and ProRoot Regular. Cell viability for ProRoot and Life did not change. Non-setting calcium hydroxide preparations followed by the MTA group and setting calcium hydroxide materials produced the highest pH. All the tested materials significantly increased pH (p < 0.0001) at 24 h. CONCLUSIONS: Currently used pulp capping materials varied in their cytotoxicity relative to human gingival fibroblasts and their alkalizing capacities. Since most likely pH does not affect the viability of cultured cells, further investigations are required to determine physicochemical properties of these materials and the biological activity of the dental pulp.