The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial.

This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

Convolutional neural network misclassification analysis in oral lesions: an error evaluation criterion by image characteristics.

OBJECTIVE: This retrospective study analyzed the errors generated by a convolutional neural network (CNN) when performing automated classification of oral lesions according to their clinical characteristics, seeking to identify patterns in systemic errors in the intermediate layers of the CNN. STUDY DESIGN: A cross-sectional analysis nested in a previous trial in which automated classification by a CNN model of elementary lesions from clinical images of oral lesions was performed. The resulting CNN classification errors formed the dataset for this study. A total of 116 real outputs were identified that diverged from the estimated outputs, representing 7.6% of the total images analyzed by the CNN. RESULTS: The discrepancies between the real and estimated outputs were associated with problems relating to image sharpness, resolution, and focus; human errors; and the impact of data augmentation. CONCLUSIONS: From qualitative analysis of errors in the process of automated classification of clinical images, it was possible to confirm the impact of image quality, as well as identify the strong impact of the data augmentation process. Knowledge of the factors that models evaluate to make decisions can increase confidence in the high classification potential of CNNs.

The use of rubber dam in the survival of RMGIC restorations in primary molars: a 30-month randomized controlled clinical trial

Abstract This study was a randomized controlled clinical trial with two parallel arms and the objective was to compare the survival of resin modified glass ionomer (RMGIC) restorations in primary teeth using rubber dam or cotton roll isolation after a 30-month follow-up period. Ninety-two children (mean age 6.8 ± 1.37) and 200 primary molars with occlusal or occluso-proximal cavitated dentin caries lesions were randomly assigned into two groups: cotton rolls and rubber dam. All lesions were restored using RMGIC (RIVA Light Cure) after selective caries removal. Restorative failure and lesion arrestment were evaluated by two independent, trained, and calibrated examiners through clinical and radiographic examinations. The Kaplan-Meier test was used to assess the survival of restorations and Cox regression was used to assess the association of risk factors with restorative failure. There was no significant difference in survival rates between groups (p = 0.17). Older age (HR = 2.81 [95%CI: 1.47-5.44]) and higher rate of gingival bleeding (HR = 0.47 [95%CI: 0.23-0.99]) were associated with restorative failure. No patient had painful symptoms, pulp outcomes, or radiographic changes compatible with lesion progression. The use of rubber dam isolation did not increase the survival rate of occlusal and occluso-proximal restorations using RMGIC in primary molars after 30 months of follow-up. Since the survival is not influenced by the type of isolation, the professional can safely choose the appropriate technique for each case, considering his experience and preferences, as well as those of the patient.

Reabilitação protética bucomaxilofacial: um estudo retrospectivo de base universitária / Maxillofacial prosthetic rehabilitation: an university-based retrospective study

A Prótese bucomaxilofacial (PBMF) é a especialidade da Odontologia que reabilita proteticamente pacientes com perda de estrutura na região da face. Entende-se por PBMFs aquelas utilizadas na reabilitação de pacientes que apresentam deformidades por etiologia congênita, traumática ou patológica. Objetivo: Avaliar retrospectivamente o perfil dos pacientes bem como as características das reabilitações protéticas realizadas em um Projeto de Extensão em Prótese Bucomaxilofacial de uma Universidade no sul do Brasil.Materiais e métodos:Foram analisados 90 prontuários de pacientes atendidos no período de agosto de 2017 a dezembro de 2018, e coletados os seguintes dados: gênero, cor/etnia, idade, etiologia da deformidade, tipo de prótese reabilitadora realizada e referenciamento do paciente ao Projeto. Resultados:Observou-se que pacientes do gênero masculino e cor branca foram os mais frequentemente reabilitados com a maioria dos tipos de prótese, com exceção da prótese nasal. A idade dos pacientes variou de 5 a 81 anos. A prótese ocular foi a mais confeccionada. A etiologia patológica foi a que mais exigiu tratamento reabilitador. Médicos e equipes hospitalares foram os que mais referenciaram pacientes para o Projeto de Extensão.Discussão: A maior prevalência de atendidos foi de pacientes do gênero masculino, etiologia patológica, com idade 60 anos ou mais, o que reforça a sobrevida das pessoas que são diagnosticadas com câncer e necessitam reabilitação bucomaxilofacial. Conclusão: A grande procura por atendimento no Projeto de Extensão em PBMF mostra uma carência desse serviço e poucas pesquisas para esclarecer o perfil do paciente que mais procura atendimento PBMF.

Bucomaxillofacial Prosthesis (BMFP) is a specialty of Dentistry that rehabilitates patients with loss of structure in the face region. BMFP are known to be used in the rehabilitation of patients who present deformities due to congenital, traumatic or pathological etiology. Aim:In retrospect, to assess the profile of patients, as well as the features of clinical cases of rehabilitations performed at the Buccomaxillofacial Prosthesis Extension Project, at the Faculty of Dentistry of the Universidade Federal do Rio Grande do Sul, UFRGS. Materials and methods:from August 2017 to December 2018, 90 charts were cataloged with the following data: gender, ethnicity, age, etiology of the deformity, type of rehabilitation prosthesis, how the patient came to the Project. Results:It was concluded that white male patients were the predominant group to be benefited with prosthesis. The age gap was from 5 to 81 years. Ocular prosthesis was the most prevalent one. The pathological etiology was the one that most required rehabilitation treatment. Doctors and hospital staff were the ones who most referred patients to the Project.Discussion:The prevalence of patients attended was male, pathological etiology, aged 60 years or more, which reinforces the survival of people who are diagnosed with cancer and need oral and maxillofacial rehabilitation. Conclusion:The great demand for care in the BMFP Extension Project shows a lack of this service and little research to clarify the profile of the patient who most seeks BMFP care.

Integrality, absenteeism and resolubility of specialized care for pediatric patients: a cross-sectional study.

Dental Specialties Centers (CEOs) are clinics representing part of the secondary oral health care system of the Brazilian Unified Health System (SUS). Pediatric dentistry is not a requirement for service accreditation. However, the CEO of the Federal University of Rio Grande do Sul (CEO-UFRGS) has provided dental care for children aged 3-11 years since 2017. The utilization rates of health services are influenced by absenteeism. Therefore, evaluation of absences for dental appointments is of primary importance. This study aimed to evaluate referral characteristics, absenteeism, and resolubility of pediatric dentistry appointments at the CEO-UFRGS. This retrospective cross-sectional study was conducted at the Dental Teaching Hospital of the university and analyzed secondary data from referrals and medical records. From August 2017 to December 2019, 167 referrals and 96 medical records were reviewed, from which data of individual variables related to the referral process and treatment were collected. Data were collected by a single trained examiner and analyzed using SPSS software. The main reasons for referral to secondary care were dental caries and pulpal or periapical diseases associated with difficult-to-manage behavior. An absenteeism rate of 28.1% at the first pediatric dental visit and a resolution rate of 65.6% were found. Binary logistic regression analysis indicated that each day of waiting for specialized care resulted in a 0.3% of higher chance of absence for appointment. This also increased the chance by 0.7% in child who attended the first visit to complete treatment, suggesting that the waiting time for attendance was associated with absenteeism and resolubility. Public policies that expand providing child dental care in secondary care are recommended to improve access to and resolubility of services.

Integrality, absenteeism and resolubility of specialized care for pediatric patients: a cross-sectional study

Abstract Dental Specialties Centers (CEOs) are clinics representing part of the secondary oral health care system of the Brazilian Unified Health System (SUS). Pediatric dentistry is not a requirement for service accreditation. However, the CEO of the Federal University of Rio Grande do Sul (CEO-UFRGS) has provided dental care for children aged 3-11 years since 2017. The utilization rates of health services are influenced by absenteeism. Therefore, evaluation of absences for dental appointments is of primary importance. This study aimed to evaluate referral characteristics, absenteeism, and resolubility of pediatric dentistry appointments at the CEO-UFRGS. This retrospective cross-sectional study was conducted at the Dental Teaching Hospital of the university and analyzed secondary data from referrals and medical records. From August 2017 to December 2019, 167 referrals and 96 medical records were reviewed, from which data of individual variables related to the referral process and treatment were collected. Data were collected by a single trained examiner and analyzed using SPSS software. The main reasons for referral to secondary care were dental caries and pulpal or periapical diseases associated with difficult-to-manage behavior. An absenteeism rate of 28.1% at the first pediatric dental visit and a resolution rate of 65.6% were found. Binary logistic regression analysis indicated that each day of waiting for specialized care resulted in a 0.3% of higher chance of absence for appointment. This also increased the chance by 0.7% in child who attended the first visit to complete treatment, suggesting that the waiting time for attendance was associated with absenteeism and resolubility. Public policies that expand providing child dental care in secondary care are recommended to improve access to and resolubility of services.

Acesso e resolutividade na atenção em saúde bucal na primeira infância: uma revisão integrativa da literatura / Access and resolubility in oral health care in early childhood: an integrative literature review

Introdução: A cárie na primeira infância ainda é um problema de saúde pública no Brasil, expresso pelas pequenas reduções no índice ceo-d na idade de 5 anos ao longo do tempo. Esse panorama pode refletir dificuldade de acesso e resolutividade nas Redes de Atenção à Saúde (RAS) no que se refere ao aten-dimento odontológico infantil. Objetivo: Este trabalho apre-senta uma revisão integrativa da literatura sobre o acesso e a resolutividade da atenção em saúde bucal na primeira infância nas RAS do Sistema Único de Saúde Brasileiro. Materiais e métodos: Foram consultadas as bases de dados do Medline/Pubmed, SciELO e Google Scholar e selecionados artigos publicados nos idiomas inglês e português entre 2005 e 2021. Revisão da literatura: Foi observado baixo percentual de uso de serviços odontológicos por crianças em idade pré-escolar, sendo o acesso influenciado por variáveis socioeconômicas e aspectos relacionados aos serviços. Discussão: Adoção da Estratégia Saúde da Família (ESF), realização de busca ativa, inclusão da saúde bucal nas ações programáticas de saúde infantil e adequada comunicação entre os pontos de atenção são fatores positivos ao acesso à saúde bucal. O atendimento odontológico infantil ocorre majoritariamente na atenção básica, havendo pouca expressividade na atenção especia-lizada, porém profissionais generalistas podem apresentar dificuldades em gerir o comportamento infantil durante o atendimento odontológico. Conclusão: Ações de educação permanente em Odontopediatria direcionadas aos profissionais da atenção primária são recomendadas, dada a capilaridade e o caráter familiar desse nível de atenção, porém a inclusão da especialidade de Odontopediatria nos Centros de Especialidades Odontológicas merece investimento e atenção dos gestores.

Introduction: Early childhood caries is still considered a public health problem in Brazil, detected by small reductions in the 5-year dmf-t index over time. This panorama may reflect difficulties in providing access and resolubility by Health Care Networks (HCN) with regards to children's dental care. Aim: This integra-tive review of the literature presents the access and resolubility of oral health care in early childhood in the HCN of the Brazilian Unified Health System. Mate-rials and methods: The Medline/Pubmed, SciELO, and Google Scholar databases were consulted, and articles published in English and Portuguese between 2005 and 2021 were selected. Literature review: A low use rate of dental services by preschool children was observed, and access is influenced by socioeconomic variables and aspects related to services. Discussion: Adoption of the Family Health Strategy (FHS), actively going in search, inclusion of oral health in programmatic actions of children health and proper communication between the points of care are positive factors in the access to oral health services. Children dental care occurs mostly in the primary level, with little expressiveness in specialized care. General practitioners may have difficulties in managing child behavior during dental treatment. Conclusion: Continuing education program in Pediatric Dentistry aiming primary care professionals is recommended, given the capillarity and the familiar pattern of the care level. The inclusion of the Pediatric Dentistry specialty in the Dental Specialties Centers deserves investment and attention from managers.

Caries progression and need for reintervention on occlusal ICDAS 4 lesions after different treatments: a retrospective university-based study / Progressão de cárie e necessidade de reintervenção em lesões oclusais ICDAS 4 após diferentes tratamentos: um estudo retrospectivo de base universitária

Objective: To assess the caries progression and the need for reintervention on occlusal ICDAS 4 lesions after different treatments. Material and Methods: The sample consisted of records of children treated in a public setting who had at least an occlusal ICDAS 4 lesion in primary and/or permanent molars. The radiographic images of ICDAS 4 lesions at the first and last appointments were classified as absence of radiolucency, radiolucent image at the enamel­dentin junction, at the outer half or inner of the dentin. The need for retreatment after different treatments (non-invasive - topical fluoride applications, oral hygiene instructions and dietary guidance, micro-invasive - resin-based sealant, or invasive - restoration) was assessed by reviewing clinical and radiographic records. The need for retreatment was defined as any complication requiring mending (e.g., caries progression, total loss of sealant, or restoration failure). The Poisson regression model was used to investigate the association between individual and tooth-related variables and the outcome. Results: Among the 111 lesions in 81 patients, most (73.0%) lesions were in primary molars. Most lesions (52.3%) did not exhibit radiolucency, whereas 29.7% had radiolucency at the outer half of the dentin. The mean follow-up was 18.8 ± 6.5 months. After follow-up, 82.9% of the lesions did not require retreatment. The prevalence of ICDAS 4 lesions that did not need retreatment was higher among lesions with radiolucency at dentin (p=0.01). Conclusion: Most occlusal ICDAS 4 lesions did not require reintervention, especially those exhibiting radiolucency in the outer half of the dentin (AU)

Objetivo: Avaliar a progressão de cárie e a necessidade de reintervenção em lesões oclusais ICDAS 4 após diferentes tratamentos. Material e Métodos: A amostra consistiu de prontuários de crianças atendidas em ambiente público que apresentavam pelo menos uma lesão oclusal ICDAS 4 em molares decíduos e/ou permanentes. As imagens radiográficas de lesões ICDAS 4 na primeira e última consultas foram classificadas como ausência de radiolucidez, imagem radiolúcida na junção esmalte-dentina, em metade externa ou interna da dentina. A necessidade de retratamento após diferentes tratamentos (não invasivo ­ aplicações tópicas de flúor, orientações de higiene e dieta, micro-invasivo ­ selante resinoso ou invasivo ­ restauração) foi avaliada por meio da revisão dos registros clínicos e radiográficos. A necessidade de retratamento foi definida como qualquer complicação que requer intervenção (por exemplo, progressão da lesão, perda total do selante ou falha na restauração). O modelo de regressão de Poisson foi utilizado para investigar a associação entre as variáveis individuais e dentárias e o desfecho. Resultados: Entre as 111 lesões em 81 pacientes, a maioria (73,0%) das lesões eram em molares decíduos. A maioria das lesões (52,3%) não exibiu radiolucidez, enquanto que 29,7% apresentaram radiolucidez em metade externa de dentina. O tempo de acompanhamento médio foi de 18,8 ± 6,5 meses. Após o acompanhamento, 82,9% das lesões não necessitaram de retratamento. A prevalência de lesões ICDAS 4 que não necessitaram de retratamento foi maior entre as lesões com radiolucidez em dentina (p=0,01). Conclusão: A maioria das lesões oclusais ICDAS 4 não requerem reintervenção, especialmente aquelas que exibem radiolucidez em metade externa da dentina.(AU)

Influence of examiners' experience on the reproducibility of different gold standard techniques and histological criteria for validation of the diagnosis of occlusal caries lesions.

The aims of this study were to evaluate the influence (1) of the examiner experience and (2) three histological classification criteria on the reproducibility of two gold standard techniques (non-dye or dye) for validation of the diagnosis of occlusal caries. This study comprised a sample of 210 digital images of 105 permanent teeth (105 rhodamine B dyed and 105 dye-free hemisections) and six examiners. Images were evaluated on a laptop computer and categorised according to three different histological classification criteria (proposed by Ekstrand, Lussi or Downer) and repeated in order to allow reproducibility calculation. For data analysis, the six participants were divided into two groups: G1: examiners with previous experience in histological evaluation and G2: examiners with no experience in histological evaluation. Statistical significance was set at 0.05. Results: The mean intra-examiner reproducibility values in G1 were higher than G2 in all variables. Intra-examiner reproducibility was lower for the dye-free technique in both groups. The mean values of inter-examiner reproducibility in G1 ranged from 0.60 to 0.68, and in G2 values ranged from 0.34 to 0.69. Conclusion: It can be concluded that: (1) the examiners' experience seems to influence the reproducibility of the two gold standard techniques studied and reproducibility tends to be lower when the dye-free technique is used, and (2) the histological classification criterion does not appear to influence the reproducibility for validation of the diagnosis of occlusal caries.

Effect of erosive challenges on deciduous teeth undergoing restorative procedures with different adhesive protocols - an in vitro study.

To evaluate the effect of erosive challenges on the tooth- restoration interface of deciduous teeth treated with different adhesive protocols. Deciduous molars were cut mesiodistally, then embedded, abraded and polished (n=80). Samples were randomly divided according to the adhesive system used into: G1 (Adper Single Bond2®, etch-and-rinse), G2 (Universal Single Bond®, self-etching), G3 (OptibondFL®, etch-and-rinse with Fluoride) and G4 (BondForce®, self-etching with Fluoride). After standardized cavity preparation (2 mm diameter x 2 mm depth), adhesive systems were applied and samples were restored (composite resin Z350®). Half of the samples were exposed to erosive/abrasive cycles (n = 10, each adhesive group), and the other half (control group; n = 10) remained immersed in artificial saliva. For microleakage analysis, samples were submersed in methylene blue and analyzed at 40x magnifications. Cross-sectional microhardness (CSMH) was carried out (50 g/5 s) at 25 µm, 50 µm, and 100 µm from the eroded surface and at 25 µm, 75 µm, and 125 µm from the enamel bond interface. Regarding microleakage, 7.5% of the samples showed no dye infiltration, 30% showed dye infiltration only at the enamel interface, and 62.5% showed dye infiltration through the dentin-enamel junction, with no difference between groups (p≥0.05). No significant difference was observed in CSMH at different depths (two-way ANOVA, p≥0.05). We did not observe significant changes in microleakage or CSMH after erosive/abrasive challenges in deciduous teeth treated with different adhesive protocols (etch-and-rinse and self-etching adhesives, with and without fluoride).

Effect of erosive challenges on deciduous teeth undergoing restorative procedures with different adhesive protocols - an in vitro study

ABSTRACT Objective: To evaluate the effect of erosive challenges on the tooth- restoration interface of deciduous teeth treated with different adhesive protocols. Material and Methods: Deciduous molars were cut mesiodistally, then embedded, abraded and polished (n=80). Samples were randomly divided according to the adhesive system used into: G1 (Adper Single Bond2®, etch-and-rinse), G2 (Universal Single Bond®, self-etching), G3 (OptibondFL®, etch-and-rinse with Fluoride) and G4 (BondForce®, self-etching with Fluoride). After standardized cavity preparation (2 mm diameter x 2 mm depth), adhesive systems were applied and samples were restored (composite resin Z350®). Half of the samples were exposed to erosive/abrasive cycles (n = 10, each adhesive group), and the other half (control group; n = 10) remained immersed in artificial saliva. For microleakage analysis, samples were submersed in methylene blue and analyzed at 40x magnifications. Cross-sectional microhardness (CSMH) was carried out (50 g/5 s) at 25 μm, 50 μm, and 100 μm from the eroded surface and at 25 μm, 75 μm, and 125 μm from the enamel bond interface. Results: Regarding microleakage, 7.5% of the samples showed no dye infiltration, 30% showed dye infiltration only at the enamel interface, and 62.5% showed dye infiltration through the dentin-enamel junction, with no difference between groups (p≥0.05). No significant difference was observed in CSMH at different depths (two-way ANOVA, p≥0.05). Conclusions: We did not observe significant changes in microleakage or CSMH after erosive/abrasive challenges in deciduous teeth treated with different adhesive protocols (etch-and-rinse and self-etching adhesives, with and without fluoride).

Freio lingual: abordagem clínica interdisciplinar da Fonoaudiologia e Odontopediatria / Lingual frenulum: interdisciplinary clinical approach of Speech Terapy and Pediatric Dentistry

Introdução: O freio lingual é uma estrutura anatômica cujo papel é muito importante para a sucção, fala e alimentação. Um freio curto e aderido pode impedir o movimento da língua e com isso causar impactos anatômicos e funcionais para o paciente. Objetivos: O objetivo deste relato de caso é demonstrar, com olhar clínico interdisciplinar, as ações conjuntas entre a Odontopediatria e a Fonoaudiologia frente à alteração de freio lingual em uma criança com alteração na fala. Foi realizado diagnóstico em conjunto e traçado o plano de tratamento que constou de frenectomia e acompanhamento fonoaudiológico no intuito de monitorar as evoluções e proporcionar tratamento global. Conclusão: O procedimento cirúrgico, realizado pela Odontopediatria trouxe ganhos anatômicos e de mobilidade de língua, entretanto os aspectos alterados da fala permaneceram imediatamente após a intervenção, enfatizando a necessidade do tratamento e do acompanhamento fonoaudiológico.

Introduction: The lingual frenulum is an important anatomic structure involved in the act of suction, speech and feeding. A short and adhered frenulum limits the tongue movement and therefore, can cause anatomic and functional impacts in the patient. Aim: The aim of this case report is to show, with an interdisciplinary approach, strategies implemented by the Speech Therapy and Pediatric Dentistry for alterations in a lingual frenulun of a child with speech problems. This alteration was diagnosed and the treatment plan defined by both professionals and the frenectomy was conducted. Speech therapist followed up the patient in order to provide global treatment. Conclusion: Surgical procedure, conducted by the pediatric dentist improved tongue mobility, however speech alterations still were present after the intervention, emphasizing the need of a speech monitoring and therapy.

Principais índices clínico-visuais para classificação de lesões de cárie e doença periodontal / Main indices for clinical and visual classification of caries and periodontal disease

A organização do biofilme bacteriano e sua atividade metabólica sobre os tecidos bucais podem ter como consequência o aparecimento das doenças cárie e periodontal. Por isso, na prática clínica é importante que essas duas doenças sejam descritas, para que possam ser avaliadas, controladas, tratadas e monitoradas quanto à regressão, estabilização e reincidência. Para esse fim, alguns escores clínico-visuais são sugeridos na literatura e apresentados no presente artigo.

Desempenho e aplicabilidade de métodos para detecção de lesões de cárie cavitadas e não cavitadas / Performance and applicability of methods to detect cavitated and non-cavitated caries lesions

Apesar do declínio da prevalência da doença cárie e da utilização de fluoretos, a detecção das lesões cavitadas e não cavitadas em superfícies oclusais e lisas ainda é uma tarefa difícil na Odontologia. O presente trabalho apresentará alguns conceitos relacionados à doença cárie e aos processos de diagnóstico e detecção das lesões. Além disto, apresentará informações referentes aos métodos convencionais e auxiliares que podem ser empregados neste processo de detecção. Os métodos auxiliares têm como objetivo auxiliar o exame visual e o radiográfico no processo de detecção da doença e determinação do plano de tratamento do paciente. Como métodos auxiliares podem ser citados os métodos baseados na medição da fluorescência induzida pela luz (QLF e Diagnodent). O modo de funcionamento, desempenho e aplicabilidade destes métodos também serão apresentados neste artigo.

The influence of PVC wrapping on the performance of two laser fluorescence devices on occlusal surfaces in vitro.

OBJECTIVE: The aim of this study was to determine the influence of polyvinyl chloride (PVC) wrapping on the performance of two laser fluorescence devices (LF and LFpen) by assessing tooth occlusal surfaces. BACKGROUND DATA: Protection of their tips may influence LF measurements. To date there are no studies evaluating the influence of this protection on the performance of the LFpen on permanent teeth, or comparing it to the original LF device. MATERIALS AND METHODS: One hundred nineteen permanent molars were assessed by two experienced dentists using the LF and the LFpen devices, both with and without PVC wrapping. The teeth were histologically prepared and assessed for caries extension. RESULTS: The LF values with and without PVC wrapping were significantly different. For both LF devices, the sensitivity and accuracy were lower when the PVC wrapping was used. The specificity was statistically significantly higher for the LFpen with PVC. No difference was found between the areas under the ROC curves with and without PVC wrapping. The ICC showed excellent interexaminer agreement. The Bland and Altman method showed a range between the upper and the lower limits of agreement of 63.4 and 57.8 units for the LF device, and 49.4 and 74.2 for the LFpen device, with and without PVC wrapping, respectively. CONCLUSIONS: We found an influence of the PVC wrapping on the performance of the LF and LFpen devices. However, since its influence on detection of occlusal caries lesions is considered for, the use of one PVC layer is suggested to avoid cross-contamination in clinical practice.

The efficacy of laser fluorescence to detect in vitro demineralization and remineralization of smooth enamel surfaces.

OBJECTIVE: The purpose of this study was to evaluate the efficacy of the laser fluorescence (LF) device in detecting in vitro demineralization and remineralization of smooth surface caries-like lesions. BACKGROUND DATA: The early detection of smooth surface caries-like lesions is important to provide proper management of carious lesions, and allows monitoring of them over time. Also, some authors suggest that LF could be useful in monitoring the caries pathological process. MATERIALS AND METHODS: Seventy-eight blocks of bovine teeth were obtained, and then submitted to artificial caries lesion induction and to a pH-cycling process. Superficial microhardness (SMH) and laser fluorescence analysis were performed at baseline, after induction of caries-like lesions, and after the pH-cycling regimen to promote remineralization. RESULTS: Friedman's and multiple comparison tests were performed for all variables. SMH analysis showed significant differences (p +/- 0.05) between baseline (286.77 +/- 1.49 Vickers hardness number [VHN] units), before (38.48 +/- 0.85 VHN), and after remineralization (131.93 +/- 2.63 VHN). Baseline values for LF were extremely low (2.71 +/- 0.05), and a statistically significant difference was observed only after remineralization (3.61 +/- 0.08), as demonstrated by the increase in LF values. CONCLUSION: The LF device did not show efficacy for monitoring in vitro demineralization and remineralization of smooth enamel surfaces.

In vivo evaluation of laser fluorescence performance using different cut-off limits for occlusal caries detection.

The aim of this in vivo study was to evaluate the performance of laser fluorescence (LF) comparing different cut-off limits for occlusal caries detection. One hundred and thirty first permanent molars were selected. Visual examination and LF assessments were performed independently. The extent of caries was assessed after operative intervention. New cut-off limits were established and compared with those proposed by the manufacturer and by Lussi et al. (Eur J Oral Sci 109:14-19, 2001). Similar sensitivity and higher specificity was found at D(2) (considering as disease only dentin caries) when the LF cut-off limits proposed by Lussi et al. and the new one were compared. At the D(3) threshold (considering as disease only deep dentin caries), no statistically significant difference among the cut-off limits for sensitivity was found. However, the new cut-off limits showed higher specificity. The LF device provided good ability to detect dentin caries lesions. Furthermore, the new cut-off limits and the values proposed by Lussi et al. could be suggested for the in vivo detection of occlusal caries.

In vitro evaluation of the influence of air abrasion on detection of occlusal caries lesions in primary teeth.

PURPOSE: The purpose of this study was to assess the influence of cleaning pits and fissures with an aluminum oxide air abrasion system on the detection of occlusal caries in primary teeth using loser fluorescence (LF) and visual examination. METHODS: The sample comprised 65 pit and fissure sites on extracted primary teeth suspected to be carious. The sites were submitted to 2 visual examinations (examiner JAR) and 2 LF readings (examiner TMV). Next, the occlusal surfaces were air-abraded and re-examined thereafter using both methods. The teeth were sectioned, and the histological analysis of the sites with a stereoscopic magnifying lens at X32 magnification was used as the gold standard. RESULTS: Cohen's kappa statistic for LF and visual examination were, respectively, 0.282/0.884 before and 0.896/0.905 after air abrasion. LF showed a sensitivity of 0.28 increasing to 0.49 and a specificity of 0.50 increasing to 0.92. Visual examination showed sensitivity of 0.78 and specificity of 0.73. Both increased after air abrasion. CONCLUSION: The findings suggest that cleaning pits and fissures with aluminum oxide air abrasion increased the accuracy of LF and visual examination for detection of occlusal caries in primary teeth.

Detecção de lesões de cárie oclusal por meio de métodos baseados na medição da fluorescência induzida pela luz / Light-induced fluorescence in detecting occlusal caries lesions

O objetivo do presente estudo foi avaliar in vitro o desempenho dos métodos baseados na medição da fluorescência induzida pela luz para detecção de lesões de cárie oclusal em dentes permanentes. Para tanto, foram realizadas três pesquisas: (1) O objetivo dessa pesquisa foi avaliar a influência da subtração do valor de fluorescência zero no desempenho de dois aparelhos que induzem fluorescência na detecção de cárie. Desse modo, foram utilizados 119 molares permanentes, nos quais três áreas da superfície vestibular (cúspide, central e cervical) das porções mesial e distal foram selecionadas.Além disso, uma lesão de cárie oclusal por dente foi escolhida como “sítioteste”. Dois examinadores mensuraram tanto as áreas nas superfícies vestibulares quanto as lesões oclusais utilizando o DIAGNOdent 2095 (DD,KaVo, Alemanha) e o DIAGNOdent 2190 (DDpen). Foi observada influência da subtração do valor de fluorescência zero no desempenho do DD, com diminuição da sensibilidade. Pode-se concluir que as mensurações com o DD podem ser realizadas sem a subtração do valor de fluorescência zero. No entanto, para o DDpen esse procedimento não pode ser eliminado. (2) Foram selecionados 119 dentes com o objetivo de comparar o desempenho na detecção de lesões de cárie oclusal de três aparelhos que induzem fluorescência, exame radiográfico convencional e sistema ICDAS II. Uma lesão de cárie por dente foi escolhida como “sítio teste”. Dois examinadores realizaram duas medidas independentes utilizando o DD, DDpen, câmera VistaProof (VP, Dürr Dental, Alemanha), além de exame radiográfico convencional e exame visual através do sistema ICDAS II. Conclui-se que cada aparelho variou seu desempenho de acordo com os valores de sensibilidade e especificidade. O sistema ICDAS II combinado ao exame radiográfico convencional apresentou melhor desempenho na detecção de lesões de cárie na superfície oclusal. (3) Essa pesquisa objetivou avaliar a influência de selantes de fossa...

Detecção de lesões de cárie oclusal por meio de métodos baseados na medição da fluorescência induzida pela luz / Light-induced fluorescence in detecting occlusal caries lesions

O objetivo do presente estudo foi avaliar in vitro o desempenho dos métodos baseados na medição da fluorescência induzida pela luz para detecção de lesões de cárie oclusal em dentes permanentes. Para tanto, foram realizadas três pesquisas: (1) O objetivo dessa pesquisa foi avaliar a influência da subtração do valor de fluorescência zero no desempenho de dois aparelhos que induzem fluorescência na detecção de cárie. Desse modo, foram utilizados 119 molares permanentes, nos quais três áreas da superfície vestibular (cúspide, central e cervical) das porções mesial e distal foram selecionadas. Além disso, uma lesão de cárie oclusal por dente foi escolhida como “sítio teste”. Dois examinadores mensuraram tanto as áreas nas superfícies vestibulares quanto as lesões oclusais utilizando o DIAGNOdent 2095 (DD, KaVo, Alemanha) e o DIAGNOdent 2190 (DDpen). Foi observada influência da subtração do valor de fluorescência zero no desempenho do DD, com diminuição da sensibilidade. Pode-se concluir que as mensurações com o DD podem ser realizadas sem a subtração do valor de fluorescência zero. No entanto, para o DDpen esse procedimento não pode ser eliminado. (2) Foram selecionados 119 dentes com o objetivo de comparar o desempenho na detecção de lesões de cárie oclusal de três aparelhos que induzem fluorescência, exame radiográfico convencional e sistema ICDAS II. Uma lesão de cárie por dente foi escolhida como “sítio teste”. Dois examinadores realizaram duas medidas independentes utilizando o DD, DDpen, câmera VistaProof (VP, Dürr Dental, Alemanha), além de exame radiográfico convencional e exame visual através do sistema ICDAS II. Conclui-se que cada aparelho variou seu desempenho de acordo com os valores de sensibilidade e especificidade.

The aim of this in vitro study was to asses the performance of light-induced fluorescence as auxiliary to conventional methods is detecting occlusal caries lesions in permanent teeth. For this reason, three studies were carried out: (1) The aim of this study was to evaluate the influence of zero value subtraction on the performance of two laser fluorescence devices for detecting occlusal caries. 119 permanent molars were selected. Three areas (cuspal, middle and cervical) of both mesial and distal portions and one occlusal site were assessed by two examiners using the DIAGNOdent 2095 (LF, KaVo, Germany) and DIAGNOdent 2190 (LFpen) devices. It was observed an influence of the zero value subtraction in the LF performance: the sensitivity decreased. However, because of the trend, it could be concluded that the LF readings could be performed without the zero value subtraction. Despite of that, it does not imply in wrong results clinically. For the LF pen, the zero value subtraction influences the performance though and should however not be eliminated. (2) This in vitro study compared the performance of fluorescence-based methods, radiographic examination, and ICDAS II system on occlusal surfaces. 119 molars were independently assessed twice by two experienced dentists using the laser fluorescence (LF and LFpen) and fluorescence camera (FC, Dürr Dental, Germany) devices, ICDAS II system and bitewing radiographs (BW). It can be concluded that the performance of each method changes according to the sensitivity and specificity.