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2.
J Contemp Dent Pract ; 20(10): 1126-1131, 2019 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-31883244

RESUMEN

AIM: Modern clinical caries management involves early stage caries diagnosis and should fit with dental health policy. The objective of this study was to achieve early caries detection in enamel and dentine with a laser-based system (DIAGNOdent™ pen) first and secondary with a new fluorescence intra-oral camera (Soprolife®). A visual inspection with a loupe was used as control. MATERIALS AND METHODS: Following the consolidated standards of reporting trials recommendations, 628 occlusal fissures were included for analysis. RESULTS: The sensitivity and specificity of both devices varied depending on the cutoff threshold of the caries score, and the ROC curve showed higher values for the Soprolife® than for DIAGNOdent™ pen. The values of the area under the curve decreased from 0.81 (Soprolife® in daylight) to 0.79 (Soprolife® in fluorescent mode) and 0.67 for DIAGNOdent™ pen. DIAGNOdent™ pen reproducibility (intra and inter-investigator) showed a wide dispersion, with many values scattered beyond the confidence limits (±2 SD), and the weighted kappa coefficient, which was quite low (0.58), confirmed this tendency. CONCLUSION: Caries prevalence in terms of public health policy is of interest and caries detection increased significantly when using an fluorescence-based intra-oral camera. CLINICAL SIGNIFICANCE: The clinical significance of these findings is that fluorescence could help improve caries diagnosis, reduce clinical misinterpretations, and finally benefit the patients. How to cite this article: Terrer E, Slimani A, Giraudeau N, et al. Performance of Fluorescence-based Systems in Early Caries Detection: A Public Health Issue. J Contemp Dent Pract 2019;20(10):1126-1132.


Asunto(s)
Caries Dental , Salud Pública , Esmalte Dental , Dentina , Fluorescencia , Humanos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad
3.
Clin Oral Investig ; 23(10): 3691-3703, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31444695

RESUMEN

OBJECTIVES: To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. METHODS: Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. RESULTS: Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds. CONCLUSIONS: Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions. CLINICAL RELEVANCE: Carious lesion activity, cavitation and cleansability determine intervention thresholds. Invasive treatments should be applied restrictively and with these factors in mind.


Asunto(s)
Caries Dental/terapia , Esmalte Dental/patología , Dentina/patología , Consenso , Técnica Delfos , Estética Dental , Humanos
4.
J Oral Sci ; 61(3): 454-458, 2019 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-31341119

RESUMEN

The present study compared two pH-cycling models designed to induce subsurface lesions (SLs) with a less demineralized surface layer on teeth, with the aim of developing new technologies for assessment of such lesions by examining the performance of confocal Raman microscopy for detection of white spot lesions (WSLs). Twelve sound premolars were exposed to two sets of model conditions (A, B) designed to induce SLs. Teeth on which white lesions had formed in vivo were used as positive controls. All specimens were inspected using an intraoral camera and Raman microscopy to detect small changes in the appearance and structure of the enamel. Changes in the natural color of the teeth during the treatment were recorded via the camera. Phosphate maps with their spectra were constructed from the phosphate peak at 960 cm-1. The depth of lesions was measured on the basis of variations in phosphate peak intensity. Protocol B was reliable for reproducing SLs in a relatively short period. Both protocols had intrinsic limitations in not completely simulating the complex intraoral conditions leading to WSL formation with respect to lesion depth and preservation of an intact surface layer. Raman microscopy can be considered the gold standard for analysis of hard tissue mineralization.


Asunto(s)
Caries Dental , Diente Premolar , Esmalte Dental , Dureza , Humanos , Fosfatos
5.
IEEE Trans Biomed Eng ; 66(4): 1026-1033, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30130173

RESUMEN

OBJECTIVE: In dentistry, dentists perform many treatments with a few visually magnified information. About deep area of root canals, it commonly relies on exploration carried out with the fingers of the dentist, because the root canal entrance is very small to be observed. In clinical practice, the intraoral camera and endoscopic systems are separate devices, and there are no sensors to capture both pictures of the whole tooth and those inside the root canal. Objective of this research is to combine the intraoral camera and endoscopic system facilitating to use clinical practice. METHODS: We propose an endoscopic system based on the thin image fiber, SOPROLIFE intraoral camera as an image sensor, and a new adaptor to connect the two parts. We observed resolution charts with 50, 25, 10, and 5 line pairs (LP)/mm patterns. The acquired images are processed to both remove fixed-pattern noise using robust principal component analysis and enhance contrast. RESULTS: The acquired images containing all LP/mm patterns were clear and showed higher contrast after processing. Visibility of the processed images is 1.7, 1.6, 2.2, and 1.9 times higher than that of the raw images for 50, 25, 10, and 5 LP/mm patterns, respectively. CONCLUSION: Our fabricated endoscopic system based on the SOPROLIFE intraoral camera could observe 50, 25, 10, and 5 LP/mm patterns. After image processing, the noise was reduced, and high-contrast images were obtained. SIGNIFICANCE: This system can be considered as a further step toward facilitating noninvasive and contactless systems in clinical practice.

6.
Caries Res ; 52(5): 359-366, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29510396

RESUMEN

Dentin carious lesion is a dynamic process that involves demineralization and collagen denaturation. Collagen type I is the major protein in dentin and it has been investigated based on its optical properties. Multiphoton microscopy (MPM) is a nonlinear imaging technique that reveals the caries process using the collagen two-photon excitation fluorescence (2PEF) and its second-harmonic generation (SHG). Combining the histological and the International Caries Detection and Assessment System (ICDAS) classifications with nonlinear optical spectroscopy (NLOS), 2PEF and SHG intensities of enamel and dentin were highly altered during the caries process. It has been proven that the ratio SHG/2PEF is a relevant indicator of the organic matrix denaturation [Terrer et al.: J Dent Res 2016; 96: 574-579]. In the present study, a series of measurable signals is made to detect early stages of carious lesion according to the ICDAS classification and to explore the relationship between these measures and the ICDAS scale. Comparison of the efficiency of nonlinear optical signals for caries detection with the ICDAS classification is essential to evaluate their potential for clinical application. In our study, the use of the NLOS measured by MPM allowed us to monitor a quantitative parameter (SHG/2PEF ratio) according to the dentin carious lesion state (ICDAS and histological examination). Three coherent new groups were defined (ICDAS 0/1; ICDAS 2/3; ICDAS 4/5/6), where the carious process can be clearly described with a statistically significant decrease of the SHG/2PEF ratio.


Asunto(s)
Caries Dental/diagnóstico , Adulto , Caries Dental/clasificación , Caries Dental/diagnóstico por imagen , Caries Dental/patología , Esmalte Dental/diagnóstico por imagen , Esmalte Dental/patología , Progresión de la Enfermedad , Humanos , Microscopía de Fluorescencia por Excitación Multifotónica
7.
Artículo en Inglés | MEDLINE | ID: mdl-29447311

RESUMEN

Treatment of tooth wear has increased over the last two decades. However, the treatments involved have not been satisfactory to most patients, nor have they achieved the expected goal on some worn teeth. New approaches have emerged to reconstruct full arches in a minimally invasive way that take advantage of developments in the field of adhesive dentistry. These new concepts constitute a revolution in dentistry and their application requires adapted techniques and training. The purpose of this article is to suggest a precise and reproducible method that simplifies the treatment of worn dentition. A wax-up and a mock-up are primarily used to design the esthetic outcome and then used as a guide for the preparation of anterior teeth or the occlusal surfaces of posterior teeth. This not only provides the exact new vertical dimension of occlusion but serves as a guide for precisely controlling occlusal preparation simultaneously with buccal preparation. The classical cavity design for a partial bonded restoration on posterior worn dentition is also reviewed. The authors believe that during the preparation of the occlusal surfaces of the posterior teeth surfaces, the marginal ridges must be preserved to reduce the biologic cost and mechanical stress leading to fracture. A new type of thin and reduced restoration called tabletop is presented.


Asunto(s)
Restauración Dental Permanente/métodos , Coronas con Frente Estético , Desgaste de los Dientes/terapia , Recubrimiento Dental Adhesivo/métodos , Técnica de Impresión Dental , Modelos Dentales , Oclusión Dental , Estética Dental , Humanos , Planificación de Atención al Paciente , Dimensión Vertical
8.
J Biomed Opt ; 22(8): 1-8, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28822139

RESUMEN

The separation zone between enamel and dentin [dentin-enamel junction (DEJ)] with different properties in biomechanical composition has an important role in preventing crack propagation from enamel to dentin. The understanding of the chemical structure (inorganic and organic components), physical properties, and chemical composition of the human DEJ could benefit biomimetic materials in dentistry. Spatial distribution of calcium phosphate crystallinity and the collagen crosslinks near DEJ were studied using confocal Raman microscopy and calculated by different methods. To obtain collagen crosslinking, the ratio of two peaks 1660 cm-1 over 1690 cm-1 (amide I bands) is calculated. For crystallinity, the inverse full-width at half maximum of phosphate peak at 960 cm-1, and the ratio of two Raman peaks of phosphate at 960/950 cm-1 is provided. In conclusion, the study of chemical and physical properties of DEJ provides many benefits in the biomaterial field to improve the synthesis of dental materials in respect to the natural properties of human teeth. Confocal Raman microscopy as a powerful tool provides the molecular structure to identify the changes along DEJ and can be expanded for other mineralized tissues.


Asunto(s)
Colágeno/ultraestructura , Esmalte Dental/ultraestructura , Dentina/ultraestructura , Microscopía Confocal/métodos , Microscopía Óptica no Lineal/métodos , Humanos , Diente/ultraestructura
9.
PLoS One ; 12(8): e0182206, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28792965

RESUMEN

In dentistry, 3D intra-oral scanners are gaining increasing popularity essentially for the production of dental prostheses. However, there is no normalized procedure to evaluate their basic performance and enable comparisons among intra-oral scanners. The noise value highlights the trueness of a 3D intra-oral scanner and its capacity to plan prosthesis with efficient clinical precision. The aim of the present study is to develop a reproducible methodology for determining the noise of an intra-oral scanner. To this aim, and as a reference, an ultra-flat and ultra-smooth alumina wafer is used as a blank test. The roughness is calculated using an AFM (atomic force microscope) and interferometric microscope measurements to validate this ultra-flat characteristic. Then, two intra-oral scanners (Carestream CS3500 and Trios 3Shape) are used. The wafer is imaged by the two intra-oral scanners with three different angles and two different directions, 10 times for each parameter, given a total of 50 3D-meshes per intra-oral scanner. RMS (root mean square), representing the noise, is evaluated and compared for each angle/direction and each intra-oral scanner, for the whole mesh, and then in a central ROI (region of interest). In this study, we obtained RMS values ranging between 5.29 and 12.58 micrometers. No statistically significant differences were found between the mean RMS of the two intra-oral scanners, but significant differences in angulation and orientations were found between different 3D intra-oral scanners. This study shows that the evaluation of RMS can be an indicator of the value of the noise, which can be easily assessed by applying the present methodology.


Asunto(s)
Artefactos , Técnica de Impresión Dental/instrumentación , Precisión de la Medición Dimensional , Procesamiento de Imagen Asistida por Computador/métodos , Imagen Tridimensional/métodos , Fotografía Dental/métodos , Humanos , Procesamiento de Imagen Asistida por Computador/instrumentación , Imagen Tridimensional/instrumentación
10.
J Endod ; 41(6): 943-6, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25799536

RESUMEN

INTRODUCTION: Patients often keep their cell phones on and nearby during root canal therapy. Cell phones release electromagnetic interference, which might disturb electronic working length measurements. The purpose of this ex vivo study was to determine the effect of a cell phone (Apple iPhone 5 [Apple, Cupertino, CA] or KP100 [LG, Seoul, Korea]) placed into direct contact with an electronic apex locator (EAL) (Dentaport Root ZX module [J Morita Corp, Tokyo, Japan] or Propex II [Dentsply Maillefer, Ballaigues, Switzerland]) on working length determination. METHODS: Twenty-six human premolars without fractures or carious lesions were used; previously cleaned; and observed under magnification (×15) in order to check for the presence of only 1 apical foramen, the absence of apical resorption, an "open" apex, and accessory canals. The working length measurement was performed with a #15 K-file in the presence of 2.6% sodium hypochlorite under 4 conditions: (1) visually, under the microscope until the file tip reached the canal terminus; (2) electronically, without the cell phone in proximity; (3) electronically, with the cell phone in standby mode placed in physical contact with the EAL; and (4) electronically, with the cell phone activated by a call in the same position. The experimental model for electronic working length determination was a screw top plastic container filled with a saline solution. The measurements were repeated 3 times per canal under each condition. Scores of 1 to 3 categorized the stability of the readings as follows: (1) good stability; (2) unstable reading with minor difficulties determining the working length; and (3) major difficulties or impossible to determine the working length. A 2-way repeated measures analysis of variance (way 1: cell phone type and way 2: EAL model) was performed, and a second repeated measures analysis of variance was performed to seek a difference among the 4 working length determination conditions. RESULTS: Neither the cell phone type nor the EAL affected the measurements (not significant). The electronic working length measurements gave the same results as the visual examination, and this length was not influenced by direct contact with a cell phone (not significant). It was also possible to determine the electronic working length under all the experimental conditions. CONCLUSIONS: Within the limitations of the present study, it can be concluded that patients can keep their cell phones on during root canal therapy without any adverse effect on electronic working length determination.


Asunto(s)
Teléfono Celular/instrumentación , Campos Electromagnéticos , Odontometría/instrumentación , Preparación del Conducto Radicular/instrumentación , Diente Premolar , Electrónica , Humanos , Factores de Tiempo , Ápice del Diente/anatomía & histología
11.
J Biophotonics ; 6(4): 330-7, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22815209

RESUMEN

Multiphoton microscopy has been used to reveal structural details of dentine and enamel at the dentin-enamel junction (DEJ) based on their 2-photon excited fluorescence (2PEF) emission and second harmonic generation (SHG). In dentine tubule 2PEF intensity varies due to protein content variation. Intertubular dentin produces both SHG and 2PEF signals. Tubules are surrounded by a thin circular zone with a lower SHG signal than the bulk dentine and the presence of collagen fibers perpendicular to the tubule longitudinal axis is indicated by strong SHG responses. The DEJ appears as a low intensity line on the 2PEF images and this was never previously reported. The SHG signal is completely absent for enamel and aprismatic enamel shows a homogeneous low 2PEF signal contrary to prismatic enamel. The SHG intensity of mantle dentine is increasing from the dentine-enamel junction in the first 12 µm indicating a progressive presence of fibrillar collagen and corresponding to the more external part of mantle dentine where matrix metallo-proteases accumulate. The high information content of multiphoton images confirms the huge potential of this method to investigate tooth structures in physiological and pathological conditions.


Asunto(s)
Esmalte Dental/citología , Dentina/citología , Microscopía de Fluorescencia por Excitación Multifotónica/métodos , Fosfatos de Calcio/metabolismo , Colágeno/metabolismo , Dentina/metabolismo , Humanos
12.
Clin Oral Investig ; 17(3): 757-63, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22855265

RESUMEN

OBJECTIVES: Our aim was to determine the origin of the red fluorescence of carious dentine observed with the Soprolife® camera. METHODS: We conducted in vitro studies to evaluate the origin of the red fluorescence using acids and matrix metalloproteinase (MMP) to mimic caries and methylglycoxal (MGO) to evaluate the effect of glycation reactions on the red fluorescence. In every step of these models, we detected the changes of dentin photonic response with Soprolife® in daylight mode and in treatment mode. A Raman spectroscopy analysis was performed to determine the variations of the dentin organic during the in vitro caries processes. Raman microscopy was performed to identify change in the collagen matrix of dentine. RESULTS: The red fluorescence observed in carious dentine using a Soprolife® camera corresponds to the brownish color observed using daylight. Demineralization using nitric acid induces a loss of the green fluorescence of dentine. The red fluorescence of carious dentine is resistant to acid treatment. Immersion of demineralized dentine in MGO induces a change of color from white to orange-red. This indicates that the Maillard reaction contributes to lesion coloration. Immersion of demineralized dentine in an MMP-1 solution followed by MGO treatment results in a similar red fluorescence. Raman microspectroscopy analysis reveals accumulation of AGE's product in red-colored dentine. CONCLUSIONS: Our results provide important information on the origin of the fluorescence variation of dentine observed with the Soprolife® camera. We demonstrate that the red fluorescence of carious dentine is linked to the accumulation of Advanced Glycation End products (AGE). CLINICAL RELEVANCE: The study provides a new biological basis for the red fluorescence of carious dentine and reinforces the importance of the Soprolife® camera in caries diagnostics.


Asunto(s)
Caries Dental/patología , Dentina/patología , Fotografía Dental , Colágeno/química , Caries Dental/diagnóstico , Dentina/química , Fluorescencia , Productos Finales de Glicación Avanzada/análisis , Humanos , Reacción de Maillard , Metaloproteinasa 1 de la Matriz , Fotografía Dental/instrumentación , Espectrometría Raman
13.
J Biophotonics ; 6(10): 765-74, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22996995

RESUMEN

The goals of this trial were, first, to produce a Raman mapping of decay and sound dentin samples, through accurate analysis of the Raman band spectra variations of mineral and organic components. The second goal was to confirm the correlation between the Raman signal and the signal of a fluorescent camera, by assaying the concentration of pentosidine and natural collagen fluorescent crosslink using reverse phase high-pressure liquid chromatography. The first correlation assumed a possible relationship between the signal observed with the camera and Raman spectroscopy. The second correlation assumed an association with the Maillard reaction. Absence of a correlation for this trial was that no association could be found between Raman spectra characteristics, fluorescence variation and the HPLC assay. Our results void this absence.


Asunto(s)
Caries Dental , Esmalte Dental/química , Dentina/química , Espectrometría Raman/métodos , Amidas/química , Arginina/análogos & derivados , Arginina/química , Carbonatos/química , Cromatografía Líquida de Alta Presión , Humanos , Lisina/análogos & derivados , Lisina/química , Fosfatos/química , Espectrometría de Fluorescencia
14.
J Endod ; 38(11): 1525-9, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23063229

RESUMEN

INTRODUCTION: The purposes of the present study were to (1) assess the effect of the addition of benzalkonium chloride to sodium hypochlorite on its wetting properties, contact angle, and surface energy; (2) determine the critical micellar concentration of benzalkonium chloride in sodium hypochlorite; and (3) investigate the influence of addition of benzalkonium chloride on the free chlorine level, cytotoxicity, and antiseptic properties of the mixture. METHODS: Solutions of benzalkonium chloride, with concentrations ranging from 0%-1%, were mixed in 2.4% sodium hypochlorite and tested as follows. The wetting properties were investigated by measuring the contact angle of the solutions on a nondehydrated dentin surface by using the static sessile drop method. The pending drop technique was subsequently used to determine the surface energy of the solutions. The critical micellar concentration of benzalkonium chloride mixed in sodium hypochlorite was calculated from the data. When 2.4% NaOCl was mixed with benzalkonium chloride at the critical micellar concentration, 3 parameters were tested: free chloride content, cytotoxicity, and antibacterial effects against Enterococcus faecalis. RESULTS: The contact angle (P < .001) as well as the surface energy (P < .001) significantly decreased with increasing benzalkonium chloride concentrations. The critical micellar concentration of benzalkonium chloride in sodium hypochlorite was 0.008%. At this concentration, the addition of benzalkonium chloride had no effect on the free chlorine content, cytotoxicity, or antibacterial efficiency of the mixture. CONCLUSIONS: The addition of benzalkonium chloride to sodium hypochlorite at the critical micellar concentration reduced the contact angle by 51.2% and the surface energy by 53.4%, without affecting the free chloride content, cytotoxicity, or antibacterial properties of the mixture.


Asunto(s)
Compuestos de Benzalconio/química , Micelas , Preparación del Conducto Radicular , Hipoclorito de Sodio/química , Irrigación Terapéutica , Análisis de Varianza , Antiinfecciosos Locales/química , Compuestos de Benzalconio/toxicidad , Cloro/análisis , Enterococcus faecalis/efectos de los fármacos , Fibroblastos/efectos de los fármacos , Humanos , Hipoclorito de Sodio/toxicidad , Estadísticas no Paramétricas , Tensión Superficial , Humectabilidad , Agentes Mojantes/química , Agentes Mojantes/toxicidad
15.
Eur J Oral Sci ; 120(5): 444-51, 2012 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-22985003

RESUMEN

In clinical situations carious dentine tissues can be discriminated by most caries fluorescence detection tools, including a new fluorescence intra-oral camera. The objectives of this study were: (i) to analyze the Raman spectra of sound, carious, and demineralized dentine, (ii) to compare this spectral analysis with the fluorescence variation observed when using a fluorescence camera, and (iii) to evaluate the involvement of the Maillard reaction in the fluorescence variations. The first positive hypothesis tested was that the fluorescence of carious dentine obtained using a fluorescence camera and the Raman spectra variation were closely related. The second was that the variation of fluorescence could be linked with the Maillard reaction. Sound dentine, sound dentine demineralized in aqueous nitric acid solution, carious soft dentine, sound dentine demineralized in lactic acid solution, sound dentine demineralized in aqueous nitric acid solution and immersed in methylglycoxal solution, and sound dentine demineralized in aqueous nitric acid solution and immersed in methylglycoxal and glucose solutions, were studied using micro-Raman spectroscopy. Modifications in the band ratio of amide, phosphate, and carbonate were observed in the decayed and demineralized groups compared with the sound dentine group. The results indicate that a close relationship exists between the Maillard reaction and fluorescence variation.


Asunto(s)
Caries Dental/patología , Dentina/química , Espectrometría Raman/métodos , Caries Dental/diagnóstico , Dentina/patología , Fluorescencia , Humanos , Reacción de Maillard , Espectrometría Raman/instrumentación
16.
J Contemp Dent Pract ; 11(1): E095-102, 2010 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-20098972

RESUMEN

AIM: A new and innovative therapeutic concept using a light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT) of dental caries based on the imaging and autofluorescence of dental tissues is proposed. The aims of this series of in vivo experiments are to compare and analyze the brightness variations of sound dentin and active and arrested carious dentin illuminated with an intraoral LED camera and to determine if this new device could be helpful in daily practice to discriminate between caries and sound dentin. METHODS AND MATERIALS: A new intraoral LED camera that emits visible blue light was used in this in vivo study to illuminate and photograph 15 teeth at high magnification. The magnified images were examined using the free Image J V version 1.41 software. Four standardized rectangular areas were drawn on each picture that included both healthy and pathologic areas to analyze variations in brightness using a brightness formula: L = 0.299 Red + 0.587 Green + 0.114 Blue. RESULTS: Statistically significant differences in the brightness were found between active and arrested caries processes in an area of infected dentin designated Z2. Within the limitations of this in vivo study, the images created with the intraoral LED camera revealed significant variations in fluorescence between sound dentin and active and arrested caries processes. CONCLUSIONS: The LIFEDT concept provides a therapeutic concept based on these findings of variations in fluorescence between healthy and pathologic tissue. CLINICAL SIGNIFICANCE: This concept defines a pragmatic clinical and therapeutic approach for treating active and arrested carious lesions based on the interpretation of variations of a fluorescence signal and applying the LIFEDT concept to the treatment of dentin carious lesions.


Asunto(s)
Pruebas de Actividad de Caries Dental/instrumentación , Caries Dental/diagnóstico , Dentina/patología , Luz , Fotografía Dental/instrumentación , Caries Dental/terapia , Restauración Dental Permanente , Fluorescencia , Humanos , Semiconductores
17.
J Contemp Dent Pract ; 10(6): E086-94, 2009 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-20020086

RESUMEN

AIM: The objective of this in vivo experiment is to propose an innovative therapeutic concept using a light-induced fluorescence evaluator for diagnosis and treatment (LIFEDT) that is based on the imaging and autofluorescence of dental tissues. BACKGROUND: Processes with the aim of diagnosing carious lesions in the initial stage with optimum sensitivity and specificity employ a wide variety of technologies, but like the conventional diagnosis tools, they remain either inefficient or too subjective. TECHNIQUE: This experiment evaluated a fluorescence light-induced camera that illuminates tooth surfaces within an excitation radiation band of light with a wavelength of 450 nm and facilitates a high magnification image. CONCLUSION: An analysis of 50 occlusal grooves revealed three clinical forms of enamel caries: (1) enamel caries on the surface, (2) suspicious grooves with a positive autofluorescent red signal, and (3) suspicious grooves with a neutral fluorescent dark signal. Two decision-making diagrams were proposed in accordance with international recommendations for preventive dentistry, but modified as a result of the accurate information obtained with this new LIFEDT device. CLINICAL SIGNIFICANCE: The lighting of suspect occlusal grooves with the SoproLife camera enables observation of any variations in the optical properties to refine a caries diagnosis and facilitates more than a 50x magnification of occlusal groove anatomy to provide additional information on the carious potential of the tooth surface.


Asunto(s)
Árboles de Decisión , Pruebas de Actividad de Caries Dental/métodos , Caries Dental/diagnóstico , Adulto , Caries Dental/clasificación , Caries Dental/diagnóstico por imagen , Caries Dental/terapia , Pruebas de Actividad de Caries Dental/instrumentación , Fluorescencia , Fluorometría/instrumentación , Humanos , Masculino , Mandíbula , Maxilar , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Diente Molar , Radiografía Dental , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
18.
J Contemp Dent Pract ; 9(2): 155-65, 2008 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-18264538

RESUMEN

AIM: Within the context of minimally invasive dentistry this article describes the sonic and ultrasonic cavity preparation techniques and assesses their advantages and disadvantages, clinical difficulties of their use, and offers a statement about these devices. BACKGROUND: Ultra-conservative Class 2 restorative techniques require the use of devices such as sonic and the new ultrasonic preparation systems. These systems, featuring a series of sonic and new ultra-sonic inserts, allow for the fabrication of preventive preparations on proximal surfaces without injuring the adjacent proximal surface or damaging the marginal ridge. REVIEW: An ultraconservative approach to the restoration of teeth with proximal caries that lack frank occlusal cavitation is facilitated by the use of slot-style cavity preparations created with sonic and ultrasonic instrumentation, and esthetic restorative materials. SUMMARY: New restorative procedures appear suitable for use in ultraconservative restorative dentistry. More frequent use of these procedures by dental practitioners could prevent the traditional breakdown of the marginal ridge when preparing a Class 2 dental restoration. When cautiously used, these two ultraconservative devices provide alternative operative procedures to treat carious lesions without frank occlusal cavitation and to promote another aspect of preventive dentistry. CLINICAL SIGNIFICANCE: New restorative procedures appear suitable for use in ultraconservative restorative dentistry. More frequent use of these procedures by dental practitioners could prevent the traditional breakdown of the marginal ridge when preparing a Class 2 dental restoration.


Asunto(s)
Preparación de la Cavidad Dental/instrumentación , Instrumentos Dentales , Restauración Dental Permanente/instrumentación , Terapia por Ultrasonido , Humanos , Bandas de Matriz , Procedimientos Quirúrgicos Mínimamente Invasivos , Sonicación
19.
J Contemp Dent Pract ; 7(5): 42-53, 2006 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-17091139

RESUMEN

AIM: The aim of this study was to examine clinically relevant data on four restorative procedures for non-carious cervical lesions using United States Public Health Service (USPHS)-compatible clinical and photographic criteria and to compare different methods of analyzing clinical data. METHODS AND MATERIALS: Fourteen patients with at least one or two pairs of non-carious lesions under occlusion and a mean age of 50 were enrolled in this study. A total of 56 restorations (14 with each material) were placed by three experienced, calibrated dental practitioners. Two other experienced and calibrated practitioners, under single-blind conditions, followed up on all restorations for a period of one year. Three materials were randomly placed: a micro-hybrid composite with two polymerization methods (G1 and G2), a flowable micro-hydrid composite (G3), and a resin-modified glass ionomer (G4). Statistical analysis was performed using the Kruskall-Wallis test (p<0.05) and a Mann-Whitney U modified test with a corrected significance level. RESULTS: At the one year evaluation time, there were no restorations with secondary caries and the retention rates in G1 (IntenS with a hard polymerization), G2 (IntenS with a soft polymerization), G3 (Filtek flow), and G4 (Fuji II LC) were 85.7% (two losses), 92.8% (one loss), 100%, and 100%, respectively. The total visual comparison of the results at baseline (15 days later) showed significant differences only with the clinical acceptance criterion: G1 was different from G2, with a soft polymerization device (p<0.05). In terms of surface quality at one year, G1, G2, and G3 exhibited a statistically significant difference from G4, p<0.05. The digital analysis at baseline showed significant differences only with the clinical acceptance criterion: G1=G2 was different from G3=G4, p<0.05. At one year, only the microporosity criterion showed any statistical differences: G1=G2=G3 was different from G4, p<0.05. CONCLUSIONS: The resin-modified glass ionomer was easier to use and had a high retention rate, but it failed in terms of surface quality (visual mode) and porosity (digital mode) criteria compared to the others groups. Overall results showed no difference between groups G1 (hard-polymerized) and G2 (soft-polymerized), and only G1 was affected by the marginal edge (p<0.03) and integrity criteria (p<0.02) at one year.


Asunto(s)
Resinas Compuestas , Recubrimiento Dental Adhesivo/métodos , Restauración Dental Permanente/métodos , Cementos de Ionómero Vitreo , Resinas Sintéticas , Tecnología Odontológica/métodos , Bisfenol A Glicidil Metacrilato , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Dureza , Humanos , Masculino , Metacrilatos , Persona de Mediana Edad , Transición de Fase , Porosidad , Método Simple Ciego , Estadísticas no Paramétricas , Propiedades de Superficie , Atrición Dental/terapia , Cuello del Diente , Erosión de los Dientes/terapia
20.
Am J Dent ; 16(3): 207-10, 2003 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-12967077

RESUMEN

PURPOSE: To test how the number of sections affects the maximum depth of tracer penetration. MATERIALS AND METHODS: This study was simultaneously performed in three different centers. C-shaped Class V cavities were made on 60 human third molars. The cavities were located across the cementum-enamel junction. One restorative system was used: Scotchbond Multi-Purpose and Z100. After restoration, the samples were thermally cycled 3000 times, between 5 and 55 degrees C with a dwell time immersion of 10 seconds. Silver nitrate was used by two centers and basic fuchsin was used by the third. The teeth were longitudinally sectioned with a diamond saw: 5 sections per tooth provided 10 surfaces for evaluation. The penetration of the tracer was recorded on a scale from 0 to 3. The deepest leakage per restoration was identified for comparison with lesser measured values elsewhere in the tooth. The Spearman test was applied to evaluate the relationship between the reference and data from one, two and three sections (i.e. two, four and six measurements). The Kruskal-Wallis test was applied to compare the three centers. RESULTS: Whatever the study center, the Spearman correlation coefficient (r(s)) increased as a function of the number of sections (S) up to three: Center 1 (1S, 0.47; 2S, 0.68; 3S, 1.0), Center 2 (1S, 0.60; 2S, 0.99; 3S, 0.99), Center 3 (S1, 0.40; 2S, 0.73; 3S, 1.0). No statistically significant difference was found between the three study centers.


Asunto(s)
Filtración Dental/diagnóstico , Microtomía/métodos , Dióxido de Silicio , Circonio , Resinas Compuestas/química , Preparación de la Cavidad Dental/clasificación , Filtración Dental/clasificación , Restauración Dental Permanente , Humanos , Reproducibilidad de los Resultados , Cementos de Resina/química , Colorantes de Rosanilina , Tinción con Nitrato de Plata , Estadísticas no Paramétricas , Propiedades de Superficie , Cuello del Diente/patología
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