Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Caries Res ; 54(1): 7-14, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31590168

RESUMO

A 2-day workshop of ORCA and the IADR Cariology Research Group was organized to discuss and reach consensus on definitions of the most commonly used terms in cariology. The aims were to identify and to select the most commonly used terms of dental caries and dental caries management and to define them based on current concepts. Terms related to definition, diagnosis, risk assessment, and monitoring of dental caries were included. The Delphi process was used to establish terms to be considered using the nominal group method favored by consensus. Of 222 terms originally suggested by six cariologists from different countries, a total of 59 terms were reviewed after removing duplicates and unnecessary words. Sixteen experts in cariology took part in the process of reaching consensus about the definitions of the selected caries terms. Decisions were made following thorough "round table" discussions of each term and confirmed by secret electronic voting. Full agreement (100%) was reached on 17 terms, while the definitions of 6 terms were below the agreed 80% threshold of consensus. The suggested terminology is recommended for use in research, in public health, as well as in clinical practice.

2.
J Orofac Orthop ; 80(6): 327-335, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31591652

RESUMO

PURPOSE: To evaluate the progression of demineralization during orthodontic treatment, the assessment of lesion activity is important in addition to the detection of lesion extent. This study aimed to evaluate the ability of laser fluorescence measurements to differentiate between active and inactive initial lesions in vitro. METHODS: In all, 63 extracted, permanent human teeth were available for the study. On each occlusal investigation site, surface extent and activity of caries lesions were classified visually using ICDAS/ICCMS (International Caries Detection and Assessment System/International Caries Classification and Management System) criteria, following laser fluorescence measurements. Teeth were hemisected and assessed for lesion depth. Methyl red dye was applied to validate lesion activity on the sections. A Mann-Whitney U-test was performed to evaluate differences between laser fluorescence measurements for active and inactive lesions. For visual and laser fluorescence findings, diagnostic accuracy (Az, sensitivity and specificity) were calculated. RESULTS: A total of 19 sound surfaces and 44 surfaces with ICDAS codes 1/2 were classified visually. The differences in laser fluorescence measurements between active and inactive lesions were not significant for the initial lesions (p > 0.05). Sensitivity/specificity for lesion depth was 90.5/92.3% (Az = 0.894), respectively, for visual assessment and 69.1/76.9% (Az = 0.745), respectively, for laser fluorescence. Sensitivity/specificity for activity assessment was 68.6/85.0% (Az = 0.768) for the visual method. For laser fluorescence measurements, no diagnostic accuracy values could be calculated for caries activity assessment. CONCLUSION: The visual detection and activity assessment of initial lesions was more suitable than the laser fluorescence method. Based on the results of this in vitro study, use of laser fluorescence cannot be recommended for distinguishing between active and inactive initial caries lesions on occlusal surfaces.


Assuntos
Cárie Dentária , Dente Molar , Diagnóstico Bucal , Humanos , Lasers , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
3.
Br Dent J ; 227(5): 353-362, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31520031

RESUMO

This CariesCare practice guide is derived from the International Caries Classification and Management System (ICCMS) and provides a structured update for dentists to help them deliver optimal caries care and outcomes for their patients. This '4D cycle' is a practice-building format, which both prevents and controls caries and can engage patients as long-term health partners with their practice. CariesCare International (CCI™) promotes a patient-centred, risk-based approach to caries management designed for dental practice. This comprises a health outcomes-focused system that aims to maintain oral health and preserve tooth structure in the long-term. It guides the dental team through a four-step process (4D system), leading to personalised interventions: 1st D: Determine Caries Risk; 2nd D: Detect lesions, stage their severity and assess their activity status; 3rd D: Decide on the most appropriate care plan for the specific patient at that time; and then, finally, 4th D: Do the preventive and tooth-preserving care which is needed (including risk-appropriate preventive care; control of initial non-cavitated lesions; and conservative restorative treatment of deep dentinal and cavitated caries lesions). CariesCare International has designed this practice-friendly consensus guide to summarise best practice as informed by the best available evidence. Following the guide should also increase patient satisfaction, involvement, wellbeing and value, by being less invasive and more health-focused. For the dentist it should also provide benefits at the professional and practice levels including improved medico-legal protection.


Assuntos
Cárie Dentária , Dente , Consenso , Assistência Odontológica , Humanos , Saúde Bucal
4.
Clin Oral Investig ; 23(4): 1513-1524, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30790086

RESUMO

OBJECTIVES: The objective of the manuscript is to systematically review the different techniques developed for activity assessment of coronal carious lesions (AACCL) in clinical settings. MATERIALS AND METHODS: A search of PubMed identified original articles in English reporting on the different concepts/tools for AACCL in clinical settings and, when available, data related to their in vivo/in situ validation in terms of sensitivity, specificity, inter- and intra-examiner reproducibilities, area under the receiving operating curve, positive predictive value, negative predictive value, and relative risk of lesion progression. RESULTS: The present review included 25 articles. Four groups of techniques are available (1) systems based on combinations of visual and tactile criteria; devices based on (2) pH assessment, (3) fluorescence, or (4) bioluminescence. The most studied systems are those based on combinations of visual and tactile parameters when bioluminescence suffers from the lack of in vivo evaluation. Validation studies showed a wide disparity among protocols in terms of populations, dentitions, teeth surfaces, study design, the gold standard, and validation criteria. CONCLUSION: There is a need for definition and harmonization of standards for activity assessment-related concepts/tools, as well as further investigations for in vivo validation of newly developed tools. CLINICAL RELEVANCE: Carious lesion activity is an important component to be taken into account when making decisions as to appropriate clinical caries management. The development and use of validated techniques which are easy to use in everyday dental practice are important.


Assuntos
Cárie Dentária , Criança , Cárie Dentária/diagnóstico , Humanos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Sensibilidade e Especificidade
5.
Caries Res ; 53(2): 119-136, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30041245

RESUMO

Toothpastes are the most universally accepted form of fluoride delivery for caries prevention. To provide anti-caries benefits, they must be able to release fluoride during the time of tooth brushing or post brushing into the oral cavity. However, there is no standard accepted procedure to measure how much fluoride in a toothpaste may be (bio) available for release. The European Organization for Caries Research proposed and supported a workshop with experts in fluoride analysis in toothpastes and representatives from industry. The objective of the workshop was to discuss issues surrounding fluoride analysis in toothpaste and reach consensus on terminology and best practices, wherever the available evidence allowed it. Participants received a background paper and heard presentations followed by structured discussion to define the problem. The group also reviewed evidence on the validity, reliability and feasibility of each technique (namely chromatography and fluoride electroanalysis) and discussed their strengths and limitations. Participants were able to reach a consensus on terminology and were also able to identify and summarize the advantages and disadvantages of each technique. However, they agreed that most currently available methods were developed for regulatory agencies several decades ago, utilizing the best available data from clinical trials then, but require to be updated. They also agreed that although significant advances to our understanding of the mechanism of action of fluoride in toothpaste have been achieved over the past 4 decades, this clearly is an extraordinarily complex subject and more work remains to be done.


Assuntos
Cárie Dentária , Cremes Dentais , Cariostáticos , Fluoretos , Humanos , Reprodutibilidade dos Testes
6.
Clin Oral Investig ; 23(1): 187-197, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29582152

RESUMO

OBJECTIVES: Since early childhood caries (ECC) is a major disease in the public health sector, an interdisciplinary prevention concept to avert this disease was developed, launched in a project region, and evaluated. It was examined whether the emergence of ECC could be prevented or curbed with the newly developed program. MATERIALS AND METHODS: The program encompasses seven pulses of information from an interdisciplinary team (gynecologists, midwives, pediatricians, dentists, municipal social services, and the public health office). The primary dependent variables were caries experience and prevalence among the 3- to 4-year-olds who took part in the ECC prevention program, compared to children of the same age without such measures. The effect of the prevention program was assessed by means of a "historical" comparison. The dental diagnoses were performed by two calibrated dentists based on the "ICDAS collapsed." Data on diet and preventive behavior were gathered using a standardized parental questionnaire. The significance was tested using the nonparametric Mann-Whitney U test. RESULTS: There were 661 3- to 4-year-olds in the control group and 706 in the test group. The mean d3-6mf-t for the control group (0.92) was significantly higher than that for the test group (0.46). While 78.8% of the children examined in the control group exhibited predominantly sound primary dentition, this was the case for 86.3% of the test group. The proportion of children with S-ECC was 7.9% in the test group and 14.5% in the control group. The test group differed significantly from the control group both in terms of reported diet and dental hygiene habits. CONCLUSIONS AND CLINICAL RELEVANCE: The interdisciplinary prevention program presented here is an effective concept for preventing ECC and considerably helps reduce problems in the treatment of small children.


Assuntos
Assistência Odontológica para Crianças/organização & administração , Cárie Dentária/prevenção & controle , Prevenção Primária , Pré-Escolar , Feminino , Alemanha , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Dente Decíduo , Resultado do Tratamento
7.
Caries Res ; 52(4): 279-287, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29393160

RESUMO

OBJECTIVE: Assessment of caries lesion activity is usually performed using visual-tactile criteria. A new approach is to use a system consisting of a photoprotein, which is specific for free calcium ions, along with an integrated camera that visualizes the elevated calcium ions on the lesion as a light signal (bioluminescence). This study aimed to evaluate the reproducibility and diagnostic accuracy of a newly developed bioluminescence system to assess caries lesion activity on occlusal surfaces in vitro. MATERIALS AND METHODS: Ninety-four extracted permanent teeth with sound surfaces and both active and inactive caries lesions were included. The extent and activity of the investigation sites were classified visually according to the International Caries Detection and Assessment System. Digital images of the teeth were produced by the bioluminescence system and the images were analyzed for the presence of caries activity (the bioluminescent areas at the investigation sites). The images were reanalyzed after 4 weeks. Teeth were hemisected and methyl red dye was applied on the sections to validate lesion activity histologically. RESULTS: Agreement between the bioluminescence readings was shown by κ values of 0.802-0.917. A significant positive correlation (p < 0.001) was found across all methods (rs 0.618-0.811). Sensitivity and specificity for activity assessment using histology as the gold standard (cut-off: active/inactive) were, respectively, 83.6 and 85.0% for the visual assessment, and 92.5 and 90.0% for the bioluminescence method. Comparison of areas under the receiver-operating characteristic curves showed no significant difference between the visual and bioluminescence systems (p = 0.094). CONCLUSION: The bioluminescence system demonstrated high in vitro reproducibility and good diagnostic accuracy for activity assessment of caries lesions on occlusal surfaces which were not significantly different from the values obtained in the visual assessment.


Assuntos
Testes de Atividade de Cárie Dentária/métodos , Cárie Dentária/diagnóstico , Medições Luminescentes , Cárie Dentária/patologia , Humanos , Variações Dependentes do Observador , Fotografia Dentária , Reprodutibilidade dos Testes
8.
Dentomaxillofac Radiol ; 47(3): 20170292, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29227160

RESUMO

OBJECTIVES: The purpose of this in vitro study was to evaluate the inter- and intraexaminer reliability of digital bitewing (DBW) radiography and near-infrared light transillumination (NIRT) for proximal caries detection and assessment in posterior teeth. METHODS: From a pool of 85 patients, 100 corresponding pairs of DBW and NIRT images (~1/3 healthy, ~1/3 with enamel caries and ~1/3 with dentin caries) were chosen. 12 dentists with different professional status and clinical experience repeated the evaluation in two blinded cycles. Two experienced dentists provided a reference diagnosis after analysing all images independently. Statistical analysis included the calculation of simple (κ) and weighted Kappa (wκ) values as a measure of reliability. Logistic regression with a backward elimination model was used to investigate the influence of the diagnostic method, evaluation cycle, type of tooth, and clinical experience on reliability. RESULTS: Altogether, inter- and intraexaminer reliability exhibited good to excellent κ and wκ values for DBW radiography (Inter: κ = 0.60/ 0.63; wκ = 0.74/0.76; Intra: κ = 0.64; wκ = 0.77) and NIRT (Inter: κ = 0.74/0.64; wκ = 0.86/0.82; Intra: κ = 0.68; wκ = 0.84). The backward elimination model revealed NIRT to be significantly more reliable than DBW radiography. CONCLUSIONS: This study revealed a good to excellent inter- and intraexaminer reliability for proximal caries detection using DBW and NIRT images. The logistic regression analysis revealed significantly better reliability for NIRT. Additionally, the first evaluation cycle was more reliable according to the reference diagnoses.


Assuntos
Cárie Dentária/diagnóstico por imagem , Variações Dependentes do Observador , Radiografia Interproximal , Transiluminação , Humanos , Técnicas In Vitro , Raios Infravermelhos , Reprodutibilidade dos Testes
9.
Clin Oral Investig ; 22(6): 2241-2249, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29288402

RESUMO

OBJECTIVES: Children in a German region took part in regular toothbrushing with fluoride gel during their time in primary school after having received a preventive program in kindergarten. The study aimed at determining the dental health of the students as a function of prevention in kindergarten and at school while taking into account their socioeconomic status and other confounders. MATERIALS AND METHODS: The subjects were in six groups: groups 1 and 2, intensive prevention in kindergarten with and without fluoride gel at school; groups 3 and 4, basic prevention in kindergarten with and without fluoride gel at school; groups 5 and 6, no organized prevention in kindergarten with and without fluoride gel at school. Two dental examinations were performed for assessing caries experience and calculating caries increment from second grade (7-year-olds) to fourth grade (9-year-olds). A standardized questionnaire was used to record independent variables. To compare caries scores and preventive measures of various subgroups, non-parametric tests and a binary logistic regression analysis were performed. RESULTS: A significant difference was found in the mean decayed, missing, and filled tooth/teeth (DMFT) depending on socioeconomic status (no prevention in kindergarten, fluoride gel at school in children with low SES: DMFT = 0.47 vs. DMFT = 0.18 in children with high SES; p = 0.023). Class-specific differences were no longer visible among children who had taken part in an intensive preventive program combining daily supervised toothbrushing in kindergarten and application of fluoride gel in school. CONCLUSIONS: Early prevention, focusing on professionally supported training of toothbrushing in kindergarten and at school, has a positive effect on dental health and is able to reduce class-specific differences in caries distribution. CLINICAL RELEVANCE: Early training of toothbrushing and fissure sealing of first permanent molars are the most important factors for the dental health of primary school children.


Assuntos
Cariostáticos/administração & dosagem , Fluoretos Tópicos/administração & dosagem , Saúde Bucal , Prevenção Primária , Serviços de Saúde Escolar/organização & administração , Classe Social , Escovação Dentária , Cremes Dentais/administração & dosagem , Criança , Pré-Escolar , Feminino , Alemanha , Humanos , Masculino , Inquéritos e Questionários , Resultado do Tratamento
10.
BDJ Open ; 3: 17012, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29607082

RESUMO

Objectives/Aims: Apart from the visual detection of caries, X-rays can be taken for detection of approximal lesions. The Proxi head of VistaCam iX intraoral camera system uses near-infrared light (NIR) to enable caries detection in approximal surfaces. The aim of this study was to evaluate the performance of the NIR for the detection of approximal enamel lesions by comparison with radiographic findings. Materials and methods: One hundred ninety-three approximal surfaces from 18 patients were examined visually and using digital radiographs for presence or absence of enamel lesions. Then digital images of each surface were produced using the near-infrared light. Correlation between methods was assessed using Spearman's rank correlation coefficient (rs). Agreement between radiographic and NIR findings was calculated using the kappa coefficient. McNemar's test was used to analyse differences between the radiographic and NIR findings (α=0.05). Results: Moderate correlation was found between all detection methods (rs=0.33-0.50, P<0.0001). Agreement between the radiographic and NIR findings was moderate (κ=0.50, 95% CI=0.37-0.62) for the distinction between sound surfaces and enamel caries. No significant differences were found between the findings (P=0.07). Conclusion: Radiographs and NIR were found to be comparable for the detection of enamel lesions in permanent teeth.

11.
Clin Oral Investig ; 21(8): 2421-2427, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28000037

RESUMO

OBJECTIVE: The objective of this study was to assess the ability of alternating current impedance spectroscopy technique (ACIST) to monitor sound tooth surfaces and incipient carious lesions. SUBJECTS AND METHODS: Two hundred ninety-two teeth were examined in 30 patients. Occlusal surfaces were classified according to International Caries Detection and Assessment System (ICDAS). Two consecutive ACIST measurements at the investigation sites already visually examined were taken (t1). Examinations were repeated after 6 (t2) and 12 months (t3). Reproducibility of ACIST findings was calculated with the intra-class correlation coefficient. Values of the ACIST measurements were categorized, and kappa values were calculated. Spearman correlation coefficients (r s) were calculated for correlations between ICDAS findings and ACIST measurements. To test whether ACIST detected changes similarly to ICDAS, Wilcoxon's test was used (α = 0.05). RESULTS: Intra-class correlation coefficient values of ACIST measurements ranged between 0.88 and 0.98. Kappa values for ACIST categories were 0.66-0.80. Rank correlation coefficient of ICDAS and ACIST readings was 0.38-0.65 at different time intervals (p < 0.01). Significant differences could be shown for ICDAS findings between t1/t2 (p = 0.001), t2/t3 (p = 0.021), and over the total duration of the study (t1/t3, p < 0.001). No significant differences between the various examination periods were found for the impedance measurements (p > 0.05). CONCLUSIONS: ACIST exhibited in vivo high reproducibility but moderate correlation to visual findings at each time of examination. CLINICAL RELEVANCE: ACIST can be used for monitoring sound teeth and early carious lesions although its suitability as a single detection method is limited since not all changes could be detected with respect to visual findings.


Assuntos
Cárie Dentária/diagnóstico , Espectroscopia Dielétrica , Adolescente , Adulto , Idoso , Dente Pré-Molar , Feminino , Alemanha , Humanos , Masculino , Pessoa de Meia-Idade , Dente Molar , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
12.
Clin Oral Investig ; 21(6): 2101-2107, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27853925

RESUMO

OBJECTIVES: In one region of Germany, a group of children took part in regular fluoride gel applications during primary school following intensified prevention in kindergarten. This observational study aimed to ascertain whether the dental health of primary school children can be improved by introducing a group prevention program based on applications of fluoride gel. MATERIALS AND METHODS: The subjects were distributed among six groups with varying preventive measures in kindergarten and at school. The basis for determining caries experience and calculating the caries increment consisted of dental findings gathered in the second and fourth grade. RESULTS: While second graders without professionally supported daily toothbrushing in kindergarten exhibited an average d3-6mft of 2.17, in those who had enjoyed intensive dental prevention, the corresponding value was 19% lower (d3-6mft = 1.74). The caries increment was significantly lower mainly among children who had received the maximum of group prevention (intensive prevention in kindergarten and gel program at school). CONCLUSIONS: The results show that intensified preventive programs in kindergartens and schools, based mainly on supervised toothbrushing, have a positive effect on the dental health of primary school children. CLINICAL RELEVANCE: Such programs are efficient in reducing caries experience especially in socially deprived areas.


Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Prevenção Primária , Escovação Dentária/métodos , Criança , Feminino , Géis , Alemanha , Humanos , Masculino , Serviços de Odontologia Escolar , Resultado do Tratamento
13.
Clin Oral Investig ; 20(6): 1159-64, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26395351

RESUMO

OBJECTIVES: The aim of the study was to evaluate the effect of an intensified preventive programme in kindergartens. MATERIALS AND METHODS: Two thousand two hundred twenty-eight 2- to 4-year-old children attending kindergartens in two counties in northern Hesse were randomly allocated to two groups. Children in the test group participated in daily tooth brushing with 500 ppm fluoride toothpaste, which was supervised by specially trained dental nurses. Children in the control group received tooth brushing instructions three to four times a year. Caries experience was recorded using WHO criteria. The basic survey was performed from October 2006 to April 2007, with the final examinations between March and July 2009. The statistical evaluation was performed by means of the software package SPSS 17.0. To compare the mean Δdmf values of the test and control groups, Mann-Whitney U tests were performed. RESULTS: Two thousand one hundred twelve children (test group, 1096; control group, 1048) participated in the final examinations. The caries increment of the test group (Δdmf-s = 1.55) was 24 % lower than the increment of the control group (Δdmf-s = 2.02, p = 0.043). Based on Δdmf-t values, the corresponding figures were 0.79 for the test group and 1 for the control group (p = 0.44). High increment values (Δdmf-s >7) were observed in the control group twice as often as in the test group. CONCLUSION: The results show that an intensified preventive programme in kindergartens, based on supervised daily tooth brushing, has a positive effect on the dental health of preschool children. CLINICAL RELEVANCE: It is sufficient to offer such programmes in socially deprived areas.


Assuntos
Cariostáticos/uso terapêutico , Cárie Dentária/prevenção & controle , Fluoretos Tópicos/uso terapêutico , Escovação Dentária , Cremes Dentais/uso terapêutico , Pré-Escolar , Índice CPO , Feminino , Alemanha , Humanos , Masculino , Resultado do Tratamento
15.
Int J Paediatr Dent ; 26(6): 448-456, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26590509

RESUMO

BACKGROUND: Sound teeth and incipient lesions require regular monitoring to detect possible progression of caries early on. AIM: To evaluate the ability of the VistaProof (VP) fluorescence-based camera for monitoring occlusal surfaces. DESIGN: A total of 419 posterior teeth (205 primary molars, 145 permanent molars, and 69 premolars) of 35 patients were examined (average age: 9.1 years). The occlusal surfaces were classified visually according to the criteria of the International Caries Detection and Assessment System (ICDAS). VP measurements were performed at baseline (t1), and the examinations were repeated after six (t2) and twelve month (t3). Correlation between methods was calculated using Spearman's rank correlation coefficient (rs ). Wilcoxon test was used to monitor whether VP identified changes as well as ICDAS (α = 0.05). RESULTS: Correlations between ICDAS and VP were significantly positive (rs : 0.66-0.73, P < 0.001). No significant differences were found between all times for the ICDAS findings. Significant differences for the VP were ascertained for t1/t2 (P = 0.03). Results based on cluster randomization showed significant differences between ICDAS and VistaProof concerning the absence/presence of changes in the finding (P < 0.0005). CONCLUSION: Correlation between ICDAS and VP was strong. The VP supported the findings of visual examination for monitoring occlusal surfaces, although not all changes could be detected with respect to the visual findings.


Assuntos
Cárie Dentária/diagnóstico , Esmalte Dentário/patologia , Fotografia Dentária/instrumentação , Dente Pré-Molar , Criança , Cárie Dentária/patologia , Dentição Permanente , Feminino , Fluorescência , Humanos , Masculino , Dente Molar , Dente Decíduo
17.
Lasers Med Sci ; 30(2): 843-9, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24142047

RESUMO

The aim of this study was to assess the performance of the fluorescence camera device VistaCam iX (VC) for the control of caries excavation compared to visual assessment and bacteriological evaluation. Twenty-three patients with 32 dentinal carious lesions were included in the study. The lesions were classified using the International Caries Detection and Assessment System. Fluorescence images were taken at the surface of each lesion using the VC before excavation (stage 1), during (stage 2) and after excavation (stage 3). At each stage, dentine samples were collected. All cavities were closed after excavation using permanent fillings. Bacteria were counted within each dentine sample using flow cytometry. Significant moderate correlation between the fluorescence readings and the bacteria count was found at stage 3 (Spearman correlation coefficient rs = 0.40, p = 0.027). Area under the ROC curve (AUC) was calculated for fluorescence readings and bacteria count using the clinical status at stage 3 as a reference. AUC was 0.954 for the VC readings and 0.797 for bacteria count. Using the median bacteria count at stage 3 as a reference, the AUC for the fluorescence readings was 0.753. The results indicate that the fluorescence camera appears to be a useful supplementary tool in assessing the endpoint of caries excavation with the advantage of enabling data to be digitally visualized and stored. When an experienced dental clinician determined the excavation endpoint, the performance with respect to remaining bacteria count was good.


Assuntos
Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Preparo da Cavidade Dentária/métodos , Fluorescência , Adolescente , Adulto , Área Sob a Curva , Bactérias/isolamento & purificação , Cárie Dentária/microbiologia , Dentina/microbiologia , Feminino , Citometria de Fluxo , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Dente/microbiologia , Adulto Jovem
18.
Clin Oral Investig ; 18(7): 1757-62, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24287891

RESUMO

OBJECTIVES: The aim of this study was to evaluate the in-vivo performance of the VistaProof fluorescence-based camera (VP) on occlusal surfaces. METHODS: The study was approved by the ethics committee and informed consent was given by the participants. The study included 306 unrestored permanent teeth of 26 patients. The occlusal surfaces of the teeth were examined visually using International Caries Detection and Assessment System (ICDAS) criteria. Then, digital images of the surfaces were made using the VP. The actual depth of the lesions was assessed using radiographs and/or clinically by opening the lesion when appropriate. Correlation between all methods was assessed using Spearman's rank correlation coefficient (r s ). Sensitivity (SE) and specificity (SP) were calculated at D1-(enamel lesions) and D3-(dentine caries) diagnostic threshold and area under the ROC curve (AUC) were assessed. RESULTS: Significant positive correlation was found between ICDAS, VP measurements and the reference standard (r s 0.46-0.71, p < 0.01). SE and SP were at D1-diagnostic threshold level 92.3 and 41.1 %, respectively. At D3-diagnostic threshold, SE was 25.9 % and SP 97.9 %. The diagnostic performance (AUC) was 0.82 (D1) and 0.85 (D3). Combination of VP measurements with ICDAS showed the SE value of 74.1 % at D3-diagnostic threshold. CONCLUSION: The VP showed good diagnostic performance. The combination of VP measurements with ICDAS improved the SE in detecting dentine lesions.


Assuntos
Cárie Dentária/diagnóstico , Fotografação/instrumentação , Adulto , Dentição Permanente , Feminino , Fluorescência , Humanos , Masculino , Radiografia Dentária Digital
19.
Int J Paediatr Dent ; 24(2): 90-7, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23551190

RESUMO

BACKGROUND: In areas with low caries prevalence, indices are needed for caries detection, which can also be used to identify initial lesions. AIM: The aim of this study was to assess the caries prevalence among 12-year-olds using ICDAS criteria and to investigate the influence of independent variables on the findings. DESIGN: The study was conducted in two regions of Germany. In Region 1, children received regular school-based prophylaxis, including fluoride varnish 2×/yr. In Region 2, there was no use of fluoride varnish in schools. Information on different factors influencing the outcome variable of caries experience was collected using structured questionnaires. DF-S values were calculated at different ICDAS cut-off points. To compare the mean caries scores of the subgroups, nonparametric tests were performed. Variables associated with caries were included in a binary logistic regression analysis. RESULTS: At D(1-6) FS and D(1+2) FS level, the differences between the regions were statistically significant (P = 0.005 and P = 0.01, respectively). Regression analysis identified the variables 'use of fluoridated toothpaste', 'fissure sealants', and 'ethnic origin' as factors significant to the prevention of caries at various stages. CONCLUSION: In a population with low caries prevalence, significant differences between subgroups could only be found when initial lesions were included.


Assuntos
Cárie Dentária/epidemiologia , Criança , Coleta de Dados , Humanos , Prevalência
20.
Clin Oral Investig ; 17(9): 2049-55, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23242815

RESUMO

OBJECTIVES: A selective intensified prevention (SIP) was introduced at individual schools in deprived areas in Marburg County (Germany) in 1995. The outcome of the program was evaluated in sixth graders (mean age: 12.06 years) in comparison to a control region. MATERIALS AND METHODS: Caries experience was recorded by applying International Caries Detection and Assessment System (ICDAS) II criteria. Tooth brushing habits and other independent variables were examined psychometrically. To compare the mean caries scores, non parametric tests were applied. The influence of various independent variables on caries experience was assessed by stepwise backward logistic regression analysis. The matching criteria age, gender, ethnicity and maternal education were used to parallelize the samples. RESULTS: ICDAS scores of 2-6 were detected uniformly more often in the control region than in the test group. Combining ICDAS scores 3-6, children from the control region (mean D(3-6)MFT: 1.73) showed roughly double the caries experience compared to the test group (mean D(3-6)MFT: 0.88, p < 0.005). The D(5,6)MFT score of the test group amounted to 0.50, and the corresponding value of the reference group was 0.77 (p = 0.043). Multivariate analysis disclosed fissure sealants, early start of tooth brushing and topical fluoride application to be associated with the prevention of dental caries. High frequency of sugar intake was associated with the presence of dentine lesions. CONCLUSIONS: The results of our study confirm the positive effect of SIP on the dental health of 12-year-old pupils living in deprived areas. CLINICAL RELEVANCE: On the basis of ICDAS II, targeted preventive measures can be applied in children with increased caries risk. Frequent applications of fluoride varnish inhibit the progression of initial lesions in this group.


Assuntos
Cárie Dentária/prevenção & controle , Serviços Preventivos de Saúde/normas , Criança , Alemanha , Humanos , Avaliação de Programas e Projetos de Saúde , Medição de Risco , Fatores de Risco , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA