Visual Examination, Fluorescence-Aided Caries Excavation (FACE) Technology, Bitewing X-Ray Radiography in the Detection of Occlusal Caries in First Permanent Molars in Children

Objectives: To compare the effectiveness of visual examination, radiographic examination and fluorescence-aided caries excavation (FACE) in detecting occlusal caries in first permanent molars in 150 children aged 6–14 years with intact occlusal surface with caries lesions without cavitation, or with darkened or deep fissures that had no clear diagnosis. Study design: Two dentists independently performed a visual oral examination, FACE and bitewing radiography. The inter-rater reliability of each detection method was determined and their specificity and sensitivity. Results: All caries detection methods showed high inter-rater reliability with absolute agreement between raters above 90%. Most caries lesions were detected by visual (75.8%) and FACE (79.1%), while only 28.8% of lesions were detected by radiography. Detection by visual examination was strongly correlated with detection by FACE (X2=37.9, Phi=0.498, p<0.001). A lower, yet statistically significant, correlation was found between visual examination and X-ray radiography (X2=5.53, Phi=0.190, p<0.001). FACE had higher sensitivity (87%) and specificity (65%) for detecting occlusal caries in comparison with radiography (60% specificity and 55% sensitivity). Conclusion: Although visual examination remains the best method to detect occlusal caries in young permanent molars in children, FACE is an effective and accurate diagnostic tool that may aid in detection and treatment decisions.

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Detection of early occlusal caries of the first permanent molar using different techniques (An in vivo study)

Journal of Baghdad College of Dentistry ◽

10.26477/jbcd.v31i1.2570 ◽

2019 ◽

Vol 31 (1) ◽

pp. 1-8

Author(s):

Samah F. Al-Qazzaz ◽

Abeer M. Hassan

Keyword(s):

Sensitivity And Specificity ◽

Visual Inspection ◽

Caries Detection ◽

Occlusal Caries ◽

Clinical Sensitivity ◽

Permanent Molar ◽

Permanent Molars ◽

Early Caries ◽

First Permanent Molars ◽

Better Than

Background: Molars and premolars are considered as the most vulnerable teeth of caries attack, which is related to the morphology of their occlusal surfaces along with the difficulty of plaque removal. different methods were used for early caries detection that provide sensitive, accurate preoperative diagnosis of caries depths to establish adequate preventive measures and avoid premature tooth treatment by restoration. The aim of the present study was to evaluate the clinical sensitivity and specificity rates of DIAGNOdent and visual inspection as opposed to the ICDAS for the detection of initial occlusal caries in noncavitated first permanent molars. Materials and Methods: This study examined 139 occlusal surface of the first permanent molar pooled from fifty patients aged 8-9 years by three methods. The selected criteria include one occlusal site per tooth (first permanent molars) with carious lesions range from 0 to 3 according to ICDASII (gold standard) visual criteria then the clinical sensitivity and specificity of visual inspection according to Ekstrand et al.in 1997 and DIAGNOdent were performed. . Results: the highest correlation was found between the ICDASII and DIAGNOdent. The sensitivity of the DIAGNOdent for the enamel caries detection (D1) was better than that of visual inspection. The sensitivity and the specificity for the DIAGNOdent at D3 threshold were better than the D1 threshold and the visual inspection method. Conclusion: DIAGNOden pen can be used as a tool for early caries detection in cases of difficult diagnosis that provide good additional sensitivity to the visual inspection.

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Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars

Journal of Biomedical Optics ◽

10.1117/1.jbo.17.3.036006 ◽

2012 ◽

Vol 17 (3) ◽

pp. 036006 ◽

Cited By ~ 37

Author(s):

Peter Rechmann

Keyword(s):

Laser Fluorescence ◽

Visual Examination ◽

Occlusal Caries ◽

Permanent Molars

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Results after two years of non-operative treatment of occlusal surface in children with high caries prevalence

Brazilian Dental Journal ◽

10.1590/s0103-64402003000100009 ◽

2003 ◽

Vol 14 (1) ◽

pp. 48-54 ◽

Cited By ~ 34

Author(s):

Marisa Maltz ◽

Berenice Barbachan e Silva ◽

Danusa Queiroz de Carvalho ◽

Alexandre Volkweis

Keyword(s):

Test Group ◽

Basic Program ◽

Control Group ◽

Caries Prevalence ◽

Occlusal Caries ◽

Preventive Program ◽

Permanent Molars ◽

Recall System ◽

Individual Disease ◽

First Permanent Molars

The aim of this study was to describe the 2-year results of an individualized treatment program designed to control occlusal caries in erupting first permanent molars. The sample consisted of 145 five-to-six-year-old students divided into a control group (n=71) and a test group (n=74). All test children received a biannual basic preventive program and a recall system according to individual disease activity. The basic program consisted of 3 (March) and 2 (August) sessions of oral hygiene orientation and toothbrushing with fluoride gel. The analysis of the baseline and 1-2-year data showed a significant reduction in the number of active lesions in the test group. In the control group, there were initially 70 active lesions and after two years 68 surfaces remained with disease and 24 surfaces had been filled. The children in the test group had 80 surfaces with active lesions initially and after two years only 3 surfaces with disease remained. From the 15 cavitated lesions, only 5 surfaces needed to be filled. This program showed that care of erupting teeth on an individualized basis can control occlusal caries.

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Monitoring of Sound and Carious Surfaces under Sealants over 44 Months

Journal of Dental Research ◽

10.1177/0022034514551753 ◽

2014 ◽

Vol 93 (11) ◽

pp. 1070-1075 ◽

Cited By ~ 42

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.

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Comparison of Visual Examination, Bite-wing Radiography, and Fiberoptic Transillumination on Caries Detection

Journal of Contemporary Dentistry ◽

10.5005/jp-journals-10031-1189 ◽

2017 ◽

Vol 7 (2) ◽

pp. 77-81

Author(s):

Beste Inceoglu ◽

Sebahat Gorgun ◽

Halil T Yuksel ◽

Emine S Kursun ◽

Hakan Eren

Keyword(s):

Caries Detection ◽

Missing Teeth ◽

Visual Examination ◽

Occlusal Caries ◽

Carious Lesions ◽

Tooth Surfaces ◽

Molar Teeth ◽

Approximal Caries ◽

Better Than

ABSTRACT Introduction The detection of carious lesions in the initial stages of development is very important to prevent the occurrence of cavitation. Visual examination and the use of a dental probe, bite-wing radiography, and fiberoptic transillumination (FOTI) have long been recommended for this purpose. Visual examination and probing of suspected lesions are useful for detecting occlusal caries, but achieve no gain of sensitivity and might cause irreversible tooth damage. Bite-wing radiography helps to detect approximal lesions better than clinical examination and probing the lesion. But the diagnostic performance of bite-wing radiography at approximal and occlusal sites is different. The FOTI is a quick and inexpensive method that can enhance visual examination of all tooth surfaces. The aim of this in vivo study is to compare FOTI with bite-wing radiography and visual examination in the detection of approximal and occlusal caries. Materials and methods A total of 46 patients without missing teeth and dentures in the posterior region of jaws were examined for the evaluation of all premolar and molar teeth contacts. Three blinded practitioners examined the patients. First one evaluated radiologically, second one visually, and the last one evaluated with FOTI. Results According to statistical results, bite-wing radiograph had the highest sensitivity. However, evaluation with FOTI had acceptable results to detect approximal caries. Conclusion Study of the results has shown that clinically FOTI is an adjunct method for detection of approximal caries. How to cite this article Eren H, Yuksel HT, Inceoglu B, Kursun ES, Gorgun S. Comparison of Visual Examination, Bite-wing Radiography, and Fiberoptic Transillumination on Caries Detection. J Contemp Dent 2017;7(2):77-81.

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Root Canal System Analysis with a Group of First Permanent Molars of Upper and Lower Jaw

Archives of Metallurgy and Materials ◽

10.2478/amm-2014-0103 ◽

2014 ◽

Vol 59 (2) ◽

pp. 629-632

Author(s):

K. Mroczek ◽

K. Szlązak ◽

E. Jodkowska ◽

J. Jaroszewicz ◽

W. Swięszkowski ◽

...

Keyword(s):

Root Canal ◽

System Analysis ◽

Three Dimensional ◽

Canal System ◽

X Ray ◽

Pulp Inflammation ◽

Permanent Molars ◽

Root Canal System ◽

Radiological Image ◽

First Permanent Molars

Abstract A progressive bacteria invasion on tooth tissues leads to pulp inflammation, microabscesses of the pulp, destruction and in consequence inflammation of periapical tissues. Therefore the aim of endodontic treatment is three dimensional debridement of a root canal from the vent in pulp chamber to the physiological narrowing. Therefore the aim of the study is analysis of root canal configuration, number of canals, presence of lateral canals and canal delta with the group of first permanent molars. At the same time the accuracy of the radiological examination (x-ray images) is estimated due to comprehension of X-ray images performed before teeth preparation with root canal system and after observation of transversal cuts by means of light microscopy and microtomography. This establishment is presented through the differences in conventional radiological image and clinical assessment.

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Estimation of Caries Treatment Needs in First Permanent Molars of Lithuanian 5–6-Year-Old Children, Based on Caries Lesion Activity Assessment

Medicina ◽

10.3390/medicina56030105 ◽

2020 ◽

Vol 56 (3) ◽

pp. 105

Author(s):

Vita Mačiulskienė ◽

Jaunė Razmienė ◽

Vilija Andruškevičienė ◽

Eglė Bendoraitienė

Keyword(s):

Dental Caries ◽

Dental Plaque ◽

Cluster Sampling ◽

Treatment Needs ◽

Caries Lesion ◽

Activity Assessment ◽

Caries Treatment ◽

Permanent Molars ◽

Caries Lesions ◽

First Permanent Molars

Background and Objectives: Early detection of dental caries lesions at active stages of development can facilitate their monitoring and reduce needs for restorative dental care. This study aimed to describe the prevalence and caries treatment needs in first permanent molars of pre-school children, based on a caries lesion activity assessment, and in relation to participants’ ages, dental plaque levels and toothbrushing habits. Materials and Methods: Large cross-sectional dental caries survey using multistage cluster sampling was conducted among Lithuanian 4–6-year-old children attending kindergartens. For the present study purpose, all individuals presenting erupted permanent molars were selected. Thus, only 5–6-year-olds (n = 453) took part in this study. They were examined for caries by one calibrated examiner using Nyvad clinical diagnostic criteria that differentiate between active and inactive caries lesions. Dental plaque was assessed by the Silness-Löe index, and parents’ reports about toothbrushing frequency were collected. Results: Overall, 41% of permanent molars were affected by caries; 6-year-olds had more caries lesions than 5-year-olds (p < 0.05). Mean number of decayed and filled surfaces (DF-S) of all participants was 1.79 (SD 2.93), half of lesions were noncavitated, more than one-third were cavitated and fillings comprised less than one surface per child. Majority of lesions were active; prevalence of inactive lesions (all noncavitated) was 1% and 6% in 5- and 6-year-olds, respectively. Prevalence of active lesions increased with age; it correlated with plaque levels and with toothbrushing frequency (<0.001). Likelihood to detect active lesions was up to nine times higher in teeth with abundant plaque (odds ratio (OR) 8.73; confidence interval (CI) 5.35–14.25), and up to seven times higher in individuals brushing teeth irregularly (OR 6.88; CI 2.21–21.41). Conclusions: The obtained data indicate high treatment needs in the erupted permanent molars of the Lithuanian pre-school population and imply that caries management should primarily focus on improved biofilm removal, accompanied with regular use of fluoridated toothpaste.

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Atraumatic Restorative Treatment-Sealed versus Nonsealed First Permanent Molars: A 3-Year Split-Mouth Clinical Trial

Caries Research ◽

10.1159/000506466 ◽

2020 ◽

Vol 55 (1) ◽

pp. 12-20

Author(s):

Daniela Hesse ◽

Camila de Almeida Brandão Guglielmi ◽

Daniela Prócida Raggio ◽

Marcelo José Strazzeri Bönecker ◽

Fausto Medeiros Mendes ◽

...

Keyword(s):

Clinical Trial ◽

Low Income ◽

Cox Regression ◽

Caries Experience ◽

Rank Test ◽

Atraumatic Restorative Treatment ◽

Restorative Treatment ◽

Permanent Molars ◽

Caries Lesions ◽

First Permanent Molars

To investigate the efficacy of atraumatic restorative treatment (ART) sealants vs. no sealant in preventing the development of dentine caries lesions in first permanent molars over a period of 3 years. A total of 187 schoolchildren (aged 6–8 years) from a low-income population presenting the 4 first permanent molars without clinically detectable dentine caries lesions were selected to be part of a split-mouth clinical trial. All 4 first permanent molars were investigated in this trial and the children’s mouth was split vertically into left and right sides; therefore, 2 molars were randomly allocated to receive ART sealants, while the other 2 molars remained nonsealed. All children received toothbrushing instructions and dietary advice every 6 months for a period of 3 years. Clinical evaluations were performed after 3, 6, 12, 18, 24, and 36 months and both sealant retention and dental caries were scored. Kaplan-Meier survival analysis, log-rank test, and Cox regression with shared frailty analysis were performed. A cavitated dentine caries lesion was considered a failure. The cumulative survival rates of dentine cavity-free first permanent molars were 90% for ART-sealed molars and 90.8% for nonsealed molars, with no statistically significantly difference between sealed and nonsealed molars (p = 0.70). The retention of sealants was not associated with the development of cavitated dentine caries and children presenting a higher baseline caries experience had greater chances of developing dentine lesions. In conclusion, the application of ART sealants was not more efficacious than nonsealing in reducing the development of dentine cavitated lesions in first permanent molars.

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Bilateral Symmetry of Number and Size of Dental Caries Lesions among Children

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-45.6.2 ◽

2021 ◽

Vol 45 (6) ◽

pp. 376-379

Author(s):

Nurit Dagon ◽

Sigalit Blumer ◽

Devora Liani ◽

Benjamin Peretz ◽

Tal Ratson

Keyword(s):

Bilateral Symmetry ◽

Second Primary ◽

X Rays ◽

Primary Molar ◽

Caries Lesion ◽

Permanent Molar ◽

Permanent Molars ◽

The University ◽

Caries Lesions ◽

First Permanent Molars

Aim. To determine the bilateral occurrence of caries lesions in 5–12-year-old children, and to assess whether one bitewing photograph can predict caries size and occurrence in the homologous tooth on the other side of the mouth. Study design. The study was carried out on 222 medical files of children 5–12 years old who were first examined in the university dental clinic. The presence and size of the caries lesions in the first and second primary molars and first permanent molars were recorded. Results. No correlation was found when comparing the caries lesion distribution of each tooth’s proximal surface. Seventy-one of the X-rays demonstrated a single caries lesion in a first or second primary molar or in a first permanent molar on one side of the mouth, of which 21.3% demonstrated a single caries lesion in the collateral side, 43.6% demonstrated 2 or more lesions, and 35.21% did not have any caries lesion on the collateral side of the mouth. Conclusion. One bitewing cannot determine the presence and size of a caries lesion on the same site of the homologous tooth.

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Reliability and validity of ICDAS II coding for occlusal caries using magnification: an in-vitro study

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20172031 ◽

2017 ◽

Vol 3 (6) ◽

pp. 149

Author(s):

Sathyanarayanan R. ◽

Carounanidy Usha ◽

Sudhagar R.

Keyword(s):

Visual Inspection ◽

Characteristic Curve ◽

Randomized Study ◽

Reliability And Validity ◽

Caries Detection ◽

Kappa Statistics ◽

Coding System ◽

Visual Examination ◽

Occlusal Caries ◽

Icdas Ii

Background: Pit and fissure caries presents diagnostic challenges due to its anatomical complexity and fluoride exposure. ICDAS II is a coding system for caries detection using clinical visual inspection. It identifies carious lesions by the change in colour, texture and surface integrity. Magnification might facilitate better detection of the lesions by enhancing the visual acuity. Thus, the objective of this study is to compare the reliability and validity of ICDAS II in detection of occlusal caries, with and without magnification, by using histological standard.Methods: This single blinded, randomized study included 334 unrestored extracted human premolars and molars. Two examiners independently scored pit and fissure caries status using ICDAS II criteria without magnification and later under 6 x magnification using surgical microscope. The samples were sectioned and lesions were scored using the ERK histological criteria, under Stereo microscope. The scores of the examiners were correlated with the histological scoring. Kappa statistics and Spearman correlation coefficients were performed. Optimal sensitivity, specificity of visual and enhanced visual examination was calculated by Receiver Operating Characteristic Curve (ROC). Likelihood ratios (LR) were also calculated. Results: The kappa values for Inter examiner reproducibility of visual and enhanced visual examination under microscope were 0.638-0.694 and for histological examination it was 0.979. Intra examiner reproducibility for visual and enhanced visual examination was 0.665 – 0.594. There was a strong relationship between visual, enhanced visual and histological examinations. Spearman’s correlation coefficient of ICDAS-II visual and enhanced visual examination for each examiner, to ERK histological scores was 0.869-0.848. The sensitivity and LR+ for visual and enhanced visual examination was decreased as the ICDAS score was increased and specificity and LR- increased with increased ICDAS score.Conclusions: Reliability and validity of ICDAS scoring in detecting occlusal caries under magnification did not differ from clinical visual inspection.

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