Non-operative control of cavitated approximal caries lesions in primary molars: a prospective evaluation of cases

This in vivo study aimed to evaluate the influence of contact points on the approximal caries detection in primary molars, by comparing the performance of the DIAGNOdent pen and visual-tactile examination after tooth separation to bitewing radiography (BW). A total of 112 children were examined and 33 children were selected. In three periods (a, b, and c), 209 approximal surfaces were examined: (a) examiner 1 performed visual-tactile examination using the Nyvad criteria (EX1); examiner 2 used DIAGNOdent pen (LF1) and took BW; (b) 1 week later, after tooth separation, examiner 1 performed the second visual-tactile examination (EX2) and examiner 2 used DIAGNOdent again (LF2); (c) after tooth exfoliation, surfaces were directly examined using DIAGNOdent (LF3). Teeth were examined by computed microtomography as a reference standard. Analyses were based on diagnostic thresholds: D1: D₀ = health, D1-D4 = disease; D2: D₀, D1 = health, D2-D4 = disease; D3: D₀-D2 = health, D3, D4 = disease. At D1, the highest sensitivity/specificity were observed for EX1 (1.00)/LF3 (0.68), respectively. At D2, the highest sensitivity/specificity were observed for LF3 (0.69)/BW (1.00), respectively. At D3, the highest sensitivity/specificity were observed for LF3 (0.78)/EX1, EX2 and BW (1.00). EX1 showed higher accuracy values than LF1, and EX2 showed similar values to LF2. We concluded that the visual-tactile examination showed better results in detecting sound surfaces and approximal caries lesions without tooth separation. However, the effectiveness of approximal caries lesion detection of both methods was increased by the absence of contact points. Therefore, regardless of the method of detection, orthodontic separating elastics should be used as a complementary tool for the diagnosis of approximal noncavitated lesions in primary molars.

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Dye-enhanced laser fluorescence detection on natural caries lesions in primary teeth

Clinical and Laboratorial Research in Dentistry ◽

10.11606/issn.2357-8041.clrd.2015.97501 ◽

2015 ◽

Vol 21 (3) ◽

pp. 145

Author(s):

Fausto Medeiros Mendes ◽

Victor Moreira Leamari ◽

Márcia Turolla Wanderley ◽

Mariana Minatel Braga ◽

Juliana Mattos-Silveira ◽

...

Keyword(s):

Primary Teeth ◽

Fluorescent Dyes ◽

Protoporphyrin Ix ◽

Polarized Light ◽

Laser Fluorescence ◽

Primary Molars ◽

Smooth Surfaces ◽

Occlusal Caries ◽

Occlusal Surfaces ◽

Caries Lesions

Objective: This study aimed to investigate the association of two fluorescent dyes and Laser Fluorescence (LF) device in detecting smooth and occlusal natural caries in primary teeth in vitro.Methods: Measurements were performed with the LF and with LF associated with tetrakis (N-methylpyridyl)porphyrin (LF TMPyP) and protoporphyrin IX (LF PPIX) in 72 smooth (63 primary molars) and 134 occlusal sites (81 primary molars). For validation, surfaces were sectioned and sections obtained were evaluated under stereomicroscope. Smooth surfaces were also evaluated using polarized light microscopy and Knoop microhardness. For both smooth and occlusal surfaces, ROC analyses were performed, and sensitivities, specificities and accuracies were assessed. In smooth surfaces, Pearson’s correlation coefficients between LF values and lesions hardness or lesions depth were calculated.Results: LF TMPyP presented higher correlation with hardness and lesion depth than other methods in smooth surfaces. No differences were observed in other parameters among the methods, in both smooth and occlusal surfaces.Relevance: The LF TMPyP might improve performance in quantifying smooth-surface caries lesions in primary teeth. However, the sensitivity is improved at D2 (caries extending into inner half of the enamel but not to amelodentinal junction) threshold when using PPIX in smooth caries lesions. The association of LF with fluorescent dyes does not improve the performance on occlusal caries.

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Does the addition of a lead foil to digital radiographic receptors influence image contrast and approximal caries lesions diagnosis?

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20190384 ◽

2020 ◽

Vol 49 (4) ◽

pp. 20190384

Author(s):

Rocharles Cavalcante Fontenele ◽

Yuri Nejaim ◽

Amanda Farias Gomes ◽

Hugo Gaêta-Araujo ◽

Francisco Haiter-Neto ◽

...

Keyword(s):

Standard Deviation ◽

Image Contrast ◽

Contrast Variation ◽

Radiographic Images ◽

Posterior Teeth ◽

Diagnostic Values ◽

Caries Lesions ◽

Approximal Caries ◽

Gray Values ◽

Lead Foil

Objectives: To access the influence of the addition of a lead foil to intraoral digital radiographic receptors on image contrast and approximal caries lesions diagnosis. Methods: 40 posterior teeth were distributed in silicone phantoms composed of two premolars, two molars and a non-test canine. Radiographic images of the phantoms were obtained with and without the incorporation of a lead foil, using the Digora Optime and Digora Toto systems. Four observers scored the images for the presence of caries lesions, using a 5-point scale. Images of an aluminum step wedge were acquired with and without the incorporation of a lead foil. Gray values and standard deviation of gray values were calculated in different thickness of the step wedge and, then, contrast variation was calculated. Results: Presence of a lead foil did not influence caries lesions diagnostic values, regardless of the type of digital system (p > 0.05). In general, the objective analysis was not influenced by the presence of a lead foil in any of the tested systems (p > 0.05). However, Digora Toto images showed greater gray values, lower standard deviation of gray values and lower contrast variation, regardless of the presence of the lead foil (p < 0.05). Conclusions: The addition of a lead foil to intraoral digital receptors did not influence image contrast nor caries lesions diagnosis.

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