Sealant versus Fluoride in Primary Molars of Kindergarten Children Regularly Receiving Fluoride Varnish: One-Year Randomized Clinical Trial Follow-Up

2015 ◽  
Vol 49 (4) ◽  
pp. 458-466 ◽  
Author(s):  
Sisko Honkala ◽  
Mohamed ElSalhy ◽  
Maddi Shyama ◽  
Sabiha A. Al-Mutawa ◽  
Hanan Boodai ◽  
...  
Keyword(s):  
Retention Rate ◽  
First Grade ◽  
Assessment System ◽  
Fluoride Varnish ◽  
Caries Detection ◽  
Primary Molars ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Caries Lesions

Objectives: The objectives of this study were to measure the caries preventive effect of sealants applied to occlusal surfaces of primary molars compared to fluoride varnish applications, and to assess the retention rate of sealants after 1 year. Methods: 147 first-grade pupils from two kindergarten schools in Kuwait, whose parents gave their written consent, were included. The children were examined by one dentist using the International Caries Detection and Assessment System. After the examination, sealants and fluoride varnish were applied on the selected occlusal surfaces of primary molars by another dentist. The jaw quadrant for intervention was selected randomly; molars on the contralateral side of the mouth received the contralateral intervention. Examinations and intervention were provided on the school premises in the mobile dental unit with a portable spotlight. Moisture was controlled by cotton rolls, suction and air drying. The follow-up examinations were conducted after 1 year. All children received fluoride varnish before and 6 months after the intervention. Results: From 267 matched pairs of occlusal surfaces of primary molars, varnished surfaces were significantly more likely to develop new caries lesions than the sealed ones (odds ratio = 2.92; 95% confidence interval = 1.82-4.71) during the 1-year follow-up. The majority (73.0%) of the sealants were completely retained and 15.1% partially. Conclusions: Sealing fissures seems to be better in preventing occlusal caries lesions in primary molars than applying only fluoride varnish. After 1 year, the majority of sealants were retained sound.

scholarly journals Glass Ionomer Sealant versus Fluoride Varnish Application to Prevent Occlusal Caries in Primary Second Molars among Preschool Children: A Randomized Controlled Trial

2021 ◽  
pp. 1-11
Author(s):  
Phoebe Pui Ying Lam ◽  
Divesh Sardana ◽  
Weijia Luo ◽  
Manikandan Ekambaram ◽  
Gillian Hiu Man Lee ◽  
...  
Keyword(s):  
Preschool Children ◽  
Assessment System ◽  
Fluoride Varnish ◽  
Caries Detection ◽  
Caries Experience ◽  
Primary Molars ◽  
Glass Ionomer ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Significant Difference

Fissure sealant is a recommended preventive measure on permanent molars, but its efficacy on primary molars in preschool children is still in doubt. Sodium fluoride varnish (NaFV) enhances remineralization and is effective in preventing caries in smooth surfaces, but limited information is available regarding its use on occlusal surfaces of primary molars. The present study aimed to compare the efficacy of glass ionomer sealant (GIS) versus topical application of 5% NaFV in preventing and arresting occlusal caries in primary second molars among preschool children. One calibrated examiner examined children aged 3–4 years for visible plaque index (VPI), decayed-missing-filled primary surface (dmfs) index, and extent of carious lesions by the International Caries Detection and Assessment System (ICDAS). Subjects with 1 or more primary second molars that were sound or with incipient lesions (ICDAS 0–1), with distinct visual enamel changes (ICDAS 2), or with localized enamel breakdown (ICDAS 3) were recruited. The children were randomly assigned to either NaFV group – application of 5% NaFV at 3-monthly intervals or GIS group – 1 single placement of GIS. A parental questionnaire was used to collect information on the children’s sociodemographic background and oral health-related habits. Two blinded examiners conducted clinical examinations after 6 and 12 months to evaluate the development of occlusal caries and the retention of GIS. Negative binomial regression using generalized estimating equations was employed to adjust for the clustering effect and evaluate the influence of selected variables on the development of occlusal caries into dentin at 12 months. A total of 323 children with 1,159 primary second molars received the respective preventive measures at baseline. At 12 months, 280 children with 989 molars were evaluated. Caries had developed or progressed into dentin in 7.8% and 8.0% of the molars in the NaFV and GIS groups, respectively, with no significant difference between the groups (<i>p</i> = 0.913). The overall retention rates of GIS were 24.6% and 13.5% at 6 and 12 months, respectively. Regression analyses showed only baseline caries experience, and an ICDAS code had a significant association with occlusal caries progression. Quarterly NaFV application and single GIS placement showed similar effectiveness in the prevention of occlusal caries development among preschool children.

scholarly journals Clinical effectiveness of fluorescence, digital images and ICDAS for detecting occlusal caries

2017 ◽  
Vol 46 (2) ◽  
pp. 109-115 ◽  
Author(s):  
Cristina Dupim PRESOTO ◽  
Tamara Carolina TREVISAN ◽  
Maria Costa de ANDRADE ◽  
Andrea Abi-Rached DANTAS ◽  
Juliana Alvares Duarte Bonini CAMPOS ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Roc Curve ◽  
Digital Images ◽  
Assessment System ◽  
Caries Detection ◽  
Occlusal Caries ◽  
Posterior Teeth ◽  
Occlusal Surfaces ◽  
Discrimination Capacity ◽  
Caries Lesions

Abstract Introduction The detection of small caries lesions is still a challenge for dental professionals who in their clinical practice have a wide variety of methods to detect caries on occlusal surfaces. Objective To clinically assess the effectiveness of the Vista Proof fluorescence camera, the Vista Cam digital intraoral micro camera and the International Caries Detection and Assessment System (ICDAS) visual criterion for detecting caries lesions on occlusal surfaces of permanent teeth. Material and method One hundred and seven posterior teeth from adult patients were examined visually and by means of digital radiographs by an examiner who rated them according to the presence or absence of occlusal caries. The teeth were then assessed by the other examiner using ICDAS, fluorescence and magnified digital images. The effectiveness of the methods was measured based on sensitivity, specificity, positive and negative likelihood ratio. For each method, the Receiver Operating Characteristic (ROC) curve and the Area Under the ROC curve (AUROC) were estimated. Result There was exceptional discrimination capacity for the intraoral images (AUROC=.93) and the ICDAS (AUROC=.91), with no significant statistical difference between them (z=.35, p=.73). The fluorescence exhibited an acceptable discrimination capacity (AUROC=0.78), although it was lower than the others. The positive likelihood ratio for the fluorescence was only 2.32, compared to 20.58 for the intraoral image and 58.11 for the ICDAS. Conclusion Both methods and the ICDAS exhibited an adequate clinical performance, although the ICDAS and intraoral image were more effective than the fluorescence.

scholarly journals Performance of methods for detecting occlusal caries lesions: ICDAS X radiological image

2020 ◽  
Vol 9 (10) ◽  
pp. e1859108490
Author(s):  
Tânia Cristina Simões ◽  
Leonardo Carmezini Marques ◽  
André Tomazini Gomes de Sá ◽  
Sandra Mara Maciel ◽  
Marcelo Lupion Poleti ◽  
...  
Keyword(s):  
Interobserver Reliability ◽  
Assessment System ◽  
Caries Detection ◽  
Kappa Index ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Reliability Method ◽  
Radiological Image ◽  
Caries Lesions

Objective: We investigated the precision and accuracy of methods to detect caries lesions on the occlusal surface in vitro using ICDAS and radiological image. Methodology: Human third molars (n=14) were placed in an acrylic resin base and maintained wet during the study. The occlusal surfaces were visually inspected by three examiners using the International Caries Detection and Assessment System (ICDAS) method. The condition of each tooth was registered by images obtained with Digital Radiography (DR), Microcomputed Tomography (µ-CT) and Histologic Specimen (HS). For each tooth and method utilized in the study, an image was selected based on the largest extension of caries found, wherein the three examiners attributed a score to the lesion in accordance with the visual description of each method. The Kappa index, Fisher’s exact test and the Spearman´s correlation coefficient were used for evaluating reliability and accuracy, with a significance level of 5%. Results: Considerable interobserver reliability values were found for ICDAS (k = 0.701), almost perfect for µ-CT (k = 0.855) and HS (k = 0.920), and reasonable for DR (k = 0.221). Significant statistical difference was observed for ICDAS (p < 0.05), and for DR and µ-CT methods (p < 0.01). The correlation was moderate for ICDAS (r = 0.597), high for DR (r = 0.764) and perfect for µ-CT (1.000). Conclusions: the most reliability method for detecting caries lesions on occlusal surfaces in vitro was µ-CT, followed by ICDAS and DR. The most accurate method was µ-CT, followed by DR and ICDAS.

scholarly journals The Performance of ICDAS-II Using Low-Powered Magnification with Light-Emitting Diode Headlight and Alternating Current Impedance Spectroscopy Device for Detection of Occlusal Caries on Primary Molars

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Timucin Ari ◽  
Nilgun Ari
Keyword(s):  
Impedance Spectroscopy ◽  
Light Emitting Diode ◽  
Clinical Diagnostics ◽  
Caries Detection ◽  
Primary Molars ◽  
Occlusal Caries ◽  
Light Emitting ◽  
Occlusal Surfaces ◽  
Icdas Ii

Early detection of occlusal caries in children is challenging for the dentists, because of the morphology of pit and fissures. The aim of this study was to compare in vitro the diagnostic performance of low-powered magnification with light-emitting diode headlight (LPMLED) using ICDAS-II criteria and AC Impedance Spectroscopy (ACIS) device, on occlusal surfaces of primary molars. The occlusal surfaces of 18 extracted primary molars were examined blindly by two examiners. The teeth were sectioned and examined under light microscopy using Downer’s histological criteria as gold standard. Good to excellent inter- and intraexaminer reproducibility, higher sensitivity, specificity, and AUC values were achieved by LPMLED at D1 threshold. Also the relationship between histology and LPMLED was statistically significant. In conclusion visual aids have the potential to improve the performance of early caries detection and clinical diagnostics in children. Despite its potential, ACIS device should be considered as an adjunct method in detecting caries on primary teeth.

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

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.

scholarly journals Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

2014 ◽  
Vol 93 (11) ◽  
pp. 1070-1075 ◽  
Author(s):  
M. Fontana ◽  
J.A. Platt ◽  
G.J. Eckert ◽  
C. González-Cabezas ◽  
K. Yoder ◽  
...  
Keyword(s):  
Assessment System ◽  
Retention Rates ◽  
Caries Detection ◽  
Major Barrier ◽  
Occlusal Surfaces ◽  
Before And After ◽  
Permanent Molars ◽  
Caries Lesions ◽  
Sealant Retention ◽  
Lesion Severity

Although there is strong evidence for the effectiveness of sealants, one major barrier in sealant utilization is the concern of sealing over active caries lesions. This study evaluated detection and monitoring of caries lesions through a clear sealant over 44 mo. Sixty-four 7- to 10-year-old children with at least 2 permanent molars with International Caries Detection and Assessment System (ICDAS) scores 0-4 (and caries less than halfway through the dentin, radiographically) were examined with ICDAS, DIAGNOdent, and quantitative light-induced fluorescence (QLF) before sealant placement and 1, 12, 24, and 44 mo (except QLF) after. Bitewing radiographs were taken yearly. DIAGNOdent and QLF were able to distinguish between baseline ICDAS before and after sealant placement. There was no significant evidence of ICDAS progression at 12 mo, but there was small evidence of minor increases at 24 and 44 mo (14% and 14%, respectively) with only 2% ICDAS ≥ 5. Additionally, there was little evidence of radiographic progression (at 12 mo = 1%, 24 mo = 3%, and 44 mo = 9%). Sealant retention rates were excellent at 12 mo = 89%, 24 mo = 78%, and 44 mo = 70%. The small risk of sealant repair increased significantly as baseline ICDAS, DIAGNOdent, and QLF values increased. However, regardless of lesion severity, sealants were 100% effective at 12 mo and 98% effective over 44 mo in managing occlusal surfaces at ICDAS 0-4 ( i.e., only 4 of 228 teeth progressed to ICDAS ≥ 5 associated with sealants in need of repair and none to halfway or more through the dentin, radiographically). This study suggests that occlusal surfaces without frank cavitation (ICDAS 0-4) that are sealed with a clear sealant can be monitored with ICDAS, QLF, or DIAGNOdent, which may aid in predicting the need for sealant repair.

scholarly journals Diagnostic Drama. Use of ICDAS II and Fluorescence-Based Intraoral Camera in Early Occlusal Caries Detection: A Clinical Study

2020 ◽  
Vol 17 (8) ◽  
pp. 2937
Author(s):  
Marta Mazur ◽  
Maciej Jedliński ◽  
Artnora Ndokaj ◽  
Denise Corridore ◽  
Antonello Maruotti ◽  
...  
Keyword(s):  
Subjective Evaluation ◽  
Assessment System ◽  
Diagnostic Methods ◽  
Caries Detection ◽  
Kappa Statistics ◽  
Occlusal Caries ◽  
Posterior Teeth ◽  
Invasive Approach ◽  
Occlusal Surfaces ◽  
Icdas Ii

Background: Early diagnosis of occlusal caries is of paramount importance for a minimally invasive approach in dentistry. The aim of the present in vivo clinical prospective study was to compare the diagnostic outcomes of visual subjective evaluation between the International Caries Detection and Assessment System (ICDAS-II) and an intraoral fluorescence-based camera (VistaCam iX Proof, Dürr Dental, Bietigheim-Bissingen, Germany) for the detection of pits and fissures in early caries lesions of posterior teeth. Methods: The study included 1011 posterior teeth in 255 patients aged 13–20 years (mean age 16 ± 2.2 years). Two blinded operators evaluated all the occlusal surfaces and the first assigned an ICDAS-II code, while the second assessed the VistaCam score: sound enamel (score 0–1.2); initial enamel decay (score 1.2–1.5); dentine caries (score 1.5–3). Results: Some 283 (28%) of the assessed teeth were ICDAS-II code 0; 334 (33%) code 1; 189 (18.7%) code 2; 176 (17.4%) code 3; and 29 (2.9%) code 4. The level of agreement between the two procedures was expressed by using Cohen’s and Fleiss’ kappa statistics and performing McNemar’s test. VistaCam assessed in 513 (50.7%) sound enamel; in 292 (28.9%) initial enamel decay; and in 206 (20.4%) dentine caries. Conclusions: This comparative study showed a poor agreement between the two diagnostic methods, especially between ICDAS-II 0, 1 and 2 codes and fluorescence assessments.

Effectiveness of Resin-Based Sealants with and without Fluoride Placed in a High Caries Risk Population: Multicentric 2-Year Randomized Clinical Trial

2018 ◽  
Vol 52 (4) ◽  
pp. 312-322 ◽  
Author(s):  
Michèle Muller-Bolla ◽  
Fréderic Courson ◽  
Laurence Lupi-Pégurier ◽  
Corinne Tardieu ◽  
Shrisha Mohit ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Retention Rate ◽  
Intervention Group ◽  
Assessment System ◽  
Caries Detection ◽  
Control Group ◽  
Caries Risk ◽  
High Caries Risk

A split-mouth randomized clinical trial was carried out to assess the effectiveness of sealants in preventing carious ICDAS (International Caries Detection and Assessment System) 3–6 lesions within a 2-year follow-up. We evaluated the effectiveness of 2 types of resin-based sealants, with and without fluoride, their retention rates, and the caries risk factors related to their outcomes. The study included 663 tooth pairs in 400 children (aged 5–15 years) considered to be at high individual caries risk (ICR) and presenting permanent molars free of caries or affected by ICDAS 1–2 lesions. In the first randomization, molars were either randomized to the treatment group receiving a dental sealant or the control group (nontreatment), and in the second randomization the sealant material to be used in the intervention group was selected. Uni- and multivariate Cox proportional hazard models were employed. At the 2-year follow-up, 483 tooth pairs were assessed: sealed molars had 83% (adjusted HR = 0.17; 95% CI: 0.15–0.20) less risk of developing ICDAS 3–6 lesions than molars without sealant. The magnitude of the protective effect was lower among teeth with ICDAS 1–2 lesions or with occlusal deep fissures than without. If the total retention rate of sealants was 70% at 2 years, sealant loss was not associated with the risk of caries (HR = 1.29, 95% CI: 0.92–1.79, p = 0.14). Sealants allow the prevention of new ICDAS 3–6 lesions or progression of noncavitated carious lesions in children at high ICR, and the effect of the sealant was similar regardless of whether it contained fluoride or not.

In Vitro Evaluation of ICDAS and Radiographic Examination of Occlusal Surfaces and Their Association With Treatment Decisions

2011 ◽  
Vol 36 (2) ◽  
pp. 133-142 ◽  
Author(s):  
MB Diniz ◽  
LM Lima ◽  
G Eckert ◽  
AG Ferreira Zandona ◽  
RCL Cordeiro ◽  
...  
Keyword(s):  
Preventive Intervention ◽  
Early Stage ◽  
Treatment Decisions ◽  
Assessment System ◽  
Caries Detection ◽  
Radiographic Examination ◽  
Occlusal Caries ◽  
Occlusal Surfaces ◽  
Impact On Treatment

Clinical RelevanceIt has been suggested that occlusal caries detection has become more difficult due to the widespread use of fluoride, which slows down lesion progression and delays cavitation. The ability to detect caries lesions at an early stage has a significant impact on treatment decisions, improving the possibility for a successful preventive intervention. In this investigation, the authors found that the International Caries Detection and Assessment System associated with radiographic examination has the potential to support treatment decisions for occlusal surfaces.

scholarly journals Comparison of Laser Fluorescence and Digital Radiograph with International Caries Detection and Assessment System in Primary Teeth (In-vivo study)

2021 ◽  
Vol 17 (14) ◽  
Author(s):  
Rana Kassab ◽  
Nayer Abo Elsaad ◽  
Shiern Badr
Keyword(s):  
Primary Teeth ◽  
Clinical Performance ◽  
Assessment System ◽  
Diagnostic Methods ◽  
Caries Detection ◽  
Occlusal Caries ◽  
Bitewing Radiography ◽  
Diagnodent Pen ◽  
Icdas Ii ◽  
Caries Lesions

Background: There has been an increased incidence of dental caries in children due to recent changes in lifestyle. More sensitive and reproducible diagnostic tools for precise caries detection in children are needed because of the complex occlusal anatomy. Aim: To compare the clinical performance and accuracy of international caries detection and assessment system-II (ICDAS II) versus DIAGNOdent pen and digital bitewing radiograph in the detection of occlusal caries in the primary teeth. Materials and Methods: Fifty children aged 6-11 years were assessed of both gender (29 girls and 21 boys) and 377 occlusal surface of primary teeth were examined by visual ICDAS II, DIAGNOdent pen and digital bitewing radiographic examination at D0 (non caries lesions), D1 (lesions limited to enamel) and D2 (lesions limited to dentin) thresholds. Results: Sensitivity at D0 for ICADS II was 14.23% and 95.95% for DIAGNOdent pen and 87.85% for digital bitewing, radiographs while specificity for both ICADS II and bitewing radiographs were 99.23% but 73.85% for DIAGNOdent pen. At D1, threshold sensitivity of ICADS II and digital bitewing radiographs were higher than DIAGNOdent pen but specificity for bitewing radiographs and DIAGNOdent pen 90.69% - 87.99%. were highly significant than ICADS II At D2, threshold specificity for all diagnostic methods was almost similar with better sensitivity for ICADS II and digital bitewing radiographs. Conclusion: This study showed that ICDAS II, Diagnodent pen, and bitewing radiography are effective for the detection of occlusal caries for primary molars. Digital bitewing radiography correlated stronger with ICDASII than Diagnodent pen and proved to be the best method to detect occlusal lesions within the dentin in primary molars while Diagnodent pen and bitewing radiography are better for detecting enamel caries lesion. In addition, the clinical performance of three diagnostic methods was insufficient to detect occlusal caries lesions separately. Consequently, it is advisable to use a combination of diagnostic methods, especially in unclear cases, as well as in cases of initial lesions and their monitoring.

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