scholarly journals Impact of the undergraduate clinical teaching-learning process on caries detection and treatment decision-making

2021 ◽  
Vol 20 ◽  
pp. e211168
Author(s):  
Silas Alves Costa ◽  
ViniciusKrieger Costa Nogueira ◽  
Diego Girotto Bussaneli ◽  
Manuel Restrepo ◽  
Alfonso Escobar ◽  
...  
Keyword(s):  
Clinical Experience ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Dental Students ◽  
Caries Detection ◽  
Permanent Teeth ◽  
Kappa Statistics ◽  
Theoretical Knowledge ◽  
Reference Standard ◽  
The Third

Aim: The aim of this study was to evaluate caries diagnosis and treatment decisions made by undergraduate dental students based on ICDAS or Nyvad criteria. Methods: Twelve students analyzed 90 digital photographs of permanent teeth at different clinical stages of carious lesion development and chose among different treatments in three different assessments: when there was no knowledge of the criteria (described as “No knowledge (N)”; when there was theoretical knowledge of the criteria (described as “Theoretical knowledge (T)” and when there was theoretical knowledge, clinical experience about dental caries and the criteria (described as “Theoretical and clinical knowledge (TC)”. For “T” and “TC” the students were randomized into two experimental groups – ICDAS or Nyvad (experimental units: 6 students/group). The reference standard was established cooperatively by two experienced researchers. Criteria performance was evaluated by sensitivity, specificity, AUC, and Kappa statistics. Treatment decision was described in percentage by contingency tables and Spearman’s correlation with the reference standard. Results: The first assessment demonstrated a high percentage of operative treatment even for initial enamel lesions based on ICDAS criteria and treatment was proposed for both active and inactive lesions, according to the Nyvad criteria. In the second assessment, the students continued recommending treatments for initial or inactive lesions, but less frequently. In the third assessment, treatment decisions presented greater cohesion in relation to the assigned classification criterion. The criteria presented no differences between them in terms of diagnostic in the third assessment. Conclusion: Clinical experience may improve caries detection and treatment decisions with the use of ICDAS and Nyvad criteria.

scholarly journals The Role of Training for Dental Students in Scoring Caries

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zurainie Abllah
Keyword(s):  
Dental Caries ◽  
Dental Students ◽  
Assessment System ◽  
Caries Detection ◽  
Permanent Teeth ◽  
Kappa Statistics ◽  
Baseline Training ◽  
Teaching Learning ◽  
Dental Mirror

Introduction: Training of dental students is an essential part of the teaching- learning activities in order to obtain reliable results in scoring of dental caries. The objectives of this study are to examine consistency in scoring of caries over a 3-month period following baseline training, calibration and retraining. Methods: Three examiners (dental students) received baseline training/calibration by a "gold standard" examiner (lecturer). This was followed by a re-calibration and retraining 3 months later. A set of 20 extracted teeth was used for the baseline training and for the re-calibration purposes. The International Caries Detection and Assessment System (ICDAS) was used to classify the visual caries lesion severity (0-6 scale) of surface of permanent teeth. The examination utilized a clinical light, dental mirror, dental probe and air syringe. Kappa (unweighted: Kappa) statistics were used to determine inter-examiner reliability at baseline and re-calibration. Results: For caries score criteria, the baseline calibration on 20 specimens indicated an inter-rater kappa ranging from 0.37-0.69. Re-calibration on the same 20 specimens 3 months later indicated an inter-rater kappa of 0.79-0.89. Activity kappa was in the poor to good range. All examiners improved with time. Conclusions: Training contributes to the consistency and reliability of dental caries scoring among dental students.

Diagnostic Performance of Different Methods in Detecting Incipient Non-Cavitated Occlusal Caries Lesions in Permanent Teeth

2019 ◽  
Vol 43 (3) ◽  
pp. 173-179
Author(s):  
Murat Ünal ◽  
Arzu Koçkanat ◽  
Seniha Güler ◽  
Esra Gültürk
Keyword(s):  
Intraclass Correlation ◽  
In Vitro Study ◽  
Roc Curves ◽  
Caries Detection ◽  
Permanent Teeth ◽  
Kappa Statistics ◽  
Occlusal Caries ◽  
Diagnodent Pen ◽  
Icdas Ii

Aim: This in vitro study was aimed to investigate the performance of the new caries detection tools on the incipient occlusal caries. Study design: In our study, 100 permanent molar teeth, which were considered to have incipient, enamel caries (D1 and D2 threshold values) according to ICDAS II score. After the visual examination, caries measurements have been applied to all teeth by using DIAGNOdent pen (DP), CarieScan PRO (CP) and SoproLife camera (SC). In addition, in vitro examinations were repeated 2 weeks later. After sectioning and evaluation in stereomicroscope, the lesion depth was determined with histological criteria that are accepted for the gold standard for this research. Sensitivity, specificity, accuracy and area under the ROC curve were calculated at D1 and D2 thresholds. The intra-examiners' reproducibility were analysed using Cohen's kappa statistics and intraclass correlation coefficient (ICC). Results: Intra-examiner repeatability values varied from 0.94 to 0.99 and kappa values ranged from 0.90 to 0.99. While the highest sensitivity and specificity value showed for SC at D1 and D2 thresholds, CP presented the lowest values. The area under ROC curves (Az) varied from 0.70 to 0.99. ICDAS II showed the highest area under ROC curves (Az). Conclusions: ICDAS II, visual diagnostic method by itself is considered to sufficient in order to diagnose incipient occlusal caries. SC may be used as an alternative method for the ICDAS II, since its advantages by displaying caries lesion on the computer monitor, follow-up and motivation of the patients provided.

scholarly journals Restorative treatment decisions for carious lesions: Do Russian dentists and dental students apply minimal intervention dentistry?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sergei N. Drachev ◽  
Alexandra S. Galieva ◽  
Tatiana N. Yushmanova ◽  
Elena A. Polivanaya ◽  
Lina Stangvaltaite-Mouhat ◽  
...  
Keyword(s):  
Dental Caries ◽  
Treatment Options ◽  
Treatment Decisions ◽  
Dental Students ◽  
Permanent Teeth ◽  
Evidence Based ◽  
Carious Lesion ◽  
Restorative Treatment ◽  
Carious Lesions ◽  
Dental Practitioners

Abstract Background The concept of minimal intervention dentistry (MID) includes both delayed restorative treatment and conservative caries removal, and is now recognised as an evidence-based approach for dental caries management. In order to determine if dental professionals in Russia are incorporating this concept into their clinical practice, we investigated the restorative treatment decisions of Russian dentists and dental students, and the factors associated with these decisions. Methods We included 171 general dental practitioners and dental therapists (collectively referred to here as “dentists”) from North-West Russia, and 76 dental undergraduate students from the Northern State Medical University in Arkhangelsk (response rate of 11.5% and 67.9%, respectively). Participants completed a questionnaire, which collected background information (sex, region of work, place of dental school graduation, practice type, years of working experience, working in an urban or rural area, and specialisation in restorative dentistry) and information on restorative treatment decisions for proximal and occlusal carious lesions of permanent teeth. Treatment options in accordance with MID were defined as intervention at dentin level and minimally invasive cavity preparation. Multinomial logistic regression was used for statistical analysis. Results For the proximal carious lesion, 9.4% of participants said they would employ both MID treatment options; 60.7% said they would choose only one; and 29.9% said they would use neither option. For the occlusal carious lesion, the corresponding figures were 37.2%, 52.1%, and 10.7%. No differences in restorative treatment options were observed among general dental practitioners, dental therapists, and dental students. For the proximal carious lesion, dentists from regions outside Arkhangelsk had 4.15 (95% confidence interval [CI] 1.13–15.27) times higher odds of following one versus both MID treatment options. For the occlusal carious lesion, working experience above 15 years was associated with higher odds of using only one versus both MID treatment options (adjusted odds ratio = 3.04, 95% CI 1.33–6.91). Almost all respondents preferred tooth-coloured materials for restorations; more than 75% chose resin-based composite. Conclusions The majority of Russian dentists and dental students do not apply the MID concept when treating dental caries in permanent teeth. Clinical protocols on dental caries treatment and dental school curriculums should be updated to place an enhanced focus on evidence-based practice and preventive strategies. Further studies with larger samples of Russian dentists and dental students and alternative methods of recruitment are needed to validate our results.

Information Behavior Factors Related to Satisfaction with Treatment Decisions in Parents of Children with Cancer (Preprint)

2018 ◽  
Author(s):  
Makiko Watanabe
Keyword(s):  
Health Literacy ◽  
Information Sources ◽  
Information Behavior ◽  
Treatment Decision ◽  
Treatment Decisions ◽  
Medical Institution ◽  
Information Utilization ◽  
Critical Health Literacy ◽  
Satisfaction With Treatment ◽  
Attending Physician

BACKGROUND Information behavior studies in modern medicine are indispensable not only for medical professionals but also in considering health outcomes for patients and health consumers. However, quantitative surveys do not provide sufficient information, and the medical information available on the Internet has not been analyzed in detail. OBJECTIVE The purpose of this study was to examine the relationship between information behavior and satisfaction with treatment decisions in patients and their family members and explore the characteristics of information behavior involved in treatment decisions. METHODS A retrospective, cross-sectional survey was conducted using a questionnaire (58 respondents, response rate 59.2%) for 105 parents of children with cancer at a children’s hospital in Japan. Multiple regression analysis was performed to determine whether information behavior influenced satisfaction with treatment decisions, and correlation analysis was performed to examine the relationships between information behaviors. The analysis included 15 information sources and information behavior measured as the communicative health literacy, critical health literacy, and Shared Decision Making measured using the Functional, Communicative and Critical Health Literacy Scale and the Treatment Decision Satisfaction Scale consisting of 6 items. RESULTS The results regarding the RQ1 showed that the attending physician (P = .044), medical institution websites (P = .038), medical books/scientific papers (including those published in English; P = .020), and communicative health literacy (which reflects information utilization capability; P = .048), influenced satisfaction with treatment decisions. The results regarding the RQ2 showed that parents who used the attending physician as an information source did not receive information from other sources apart from a hospital medical professional. On the other hand, parents who used medical institution websites as information sources received various descriptive information. CONCLUSIONS We identified Internet-based information sources that influenced satisfaction with treatment decisions. We identified that the parent's information behavior tended to have a positive influence on the treatment decision when the attending physician and the medical institution’s Health Practitioner, HP, were the information sources, or when they recognized that there was a high communicative HL and utilized the information. Furthermore, the variables used to measure information behavior were divided into several groups based on association. Regarding satisfaction with treatment decisions correlating with each other, information behavior reflected the possibility of establishing links with information sources with direct influence, related information sources, and information utilization capability.

scholarly journals Diagnostic Value of Fluorescence Methods, Visual Inspection and Photographic Visual Examination in Initial Caries Lesion: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 (3) ◽  
pp. 30
Author(s):  
Mai Thi Giang Thanh ◽  
Ngo Van Toan ◽  
Do Thi Thanh Toan ◽  
Nguyen Phu Thang ◽  
Ngoc Quang Dong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Visual Inspection ◽  
Early Stage ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Caries Detection ◽  
Permanent Teeth ◽  
Visual Examination ◽  
Initial Caries

This systematic review and meta-analysis aimed to investigate the efficacy of fluorescence-based methods, visual inspections, and photographic visual examinations in initial caries detection. A literature search was undertaken in the PubMed and Cochrane databases. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed, and eligible articles published from 1 January 2009 to 30 October 2019 were included if they met the following criteria: they (1) assessed the accuracy of methods of detecting initial tooth caries lesions on occlusal, proximal, or smooth surfaces in both primary and permanent teeth (in clinical); (2) used a reference standard; (3) reported data regarding the sample size, prevalence of initial tooth caries, and accuracy of the methods. Data collection and extraction, quality assessment, and data analysis were conducted according to Cochrane standards Quality Assessment of Diagnostic Accuracy Studies-2. Statistical analyses were performed using Review Manager 5.3 and STATA 14.0. A total of 12 eligible articles were included in the meta-analysis. The results showed that the sensitivity and specificity of fluorescence-based methods were 80% and 80%, respectively; visual inspection was measured at 80% and 75%, respectively; photographic visual examination was measured at 67% and 79%, respectively. We found that the visual method and the fluorescence method were reliable for laboratory use to detect early-stage caries with equivalent accuracy.

scholarly journals Decision Making for Treatment After ACL Injury From an Orthopaedic Surgeon and Patient Perspective: Results From the NACOX Study

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712110050
Author(s):  
Hanna Tigerstrand Grevnerts ◽  
Sofi Sonesson ◽  
Håkan Gauffin ◽  
Clare L. Ardern ◽  
Anders Stålman ◽  
...  
Keyword(s):  
Decision Making ◽  
High Activity ◽  
Treatment Decision ◽  
Acl Injury ◽  
Treatment Decisions ◽  
Activity Level ◽  
Knee Instability ◽  
Acl Injuries ◽  
Patient Reported ◽  
And Function

Background: In the treatment of anterior cruciate ligament (ACL) injuries, there is little evidence of when and why a decision for ACL reconstruction (ACLR) or nonoperative treatment (non-ACLR) is made. Purpose: To (1) describe the key characteristics of ACL injury treatment decisions and (2) compare patient-reported knee instability, function, and preinjury activity level between patients with non-ACLR and ACLR treatment decisions. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 216 patients with acute ACL injury were evaluated during the first year after injury. The treatment decision was non-ACLR in 73 patients and ACLR in 143. Reasons guiding treatment decision were obtained from medical charts and questionnaires to patients and orthopaedic surgeons. Patient-reported instability and function were obtained via questionnaires and compared between patients with non-ACLR and ACLR treatment decisions. The ACLR treatment group was classified retrospectively by decision phase: acute phase (decision made between injury day and 31 days after injury), subacute phase (decision made between 32 days and up to 5 months after injury), and late phase (decision made 5-12 months after injury). Data were evaluated using descriptive statistics, and group comparisons were made using parametric or nonparametric tests as appropriate. Results: The main reasons for a non-ACLR treatment decision were no knee instability and no problems with knee function. The main reasons for an ACLR treatment decision were high activity demands and knee instability. Patients in the non-ACLR group were significantly older ( P = .031) and had a lower preinjury activity level than did those in the acute-phase ( P < .01) and subacute-phase ( P = .006) ACLR decision groups. There were no differences in patient-reported instability and function between treatment decision groups at baseline, 4 weeks after injury, or 3 months after injury. Conclusion: Activity demands, not patient-reported knee instability, may be the most important factor in the decision-making process for treatment after ACL injury. We suggest a decision-making algorithm for patients with ACL injuries and no high activity demands; waiting for >3 months can help distinguish those who need surgical intervention from those who can undergo nonoperative management. Registration: NCT02931084 ( ClinicalTrials.gov identifier).

scholarly journals Educational material of dental anatomy applied to study the morphology of permanent teeth

2004 ◽  
Vol 15 (3) ◽  
pp. 238-247 ◽  
Author(s):  
Selma Siéssere ◽  
Mathias Vitti ◽  
Luiz Gustavo de Sousa ◽  
Marisa Semprini ◽  
Simone Cecílio Hallak Regalo
Keyword(s):  
Acrylic Resin ◽  
Dental Students ◽  
Educational Material ◽  
Permanent Dentition ◽  
Permanent Teeth ◽  
Dental Student ◽  
Large Individual ◽  
Morphologic Characteristics ◽  
Dental Anatomy

The purpose of this report is to present educational material that would allow the dental student to learn to easily identify the morphologic characteristics of permanent teeth, and how they fit together (occlusion). In order to do this, macro models of permanent teeth with no attrition were carved in wax and later molded with alginate. These molds were filled with plaster, dental stone and/or cold-cured acrylic resin. The large individual dental stone tooth models were mounted on a wax base, thus obtaining maxillary and mandibular arches which were occluded. These dental arches were molded with plaster or dental stone. The authors suggest that these types of macro models allow an excellent visualization of the morphologic characteristics of permanent teeth and occlusion. Dental students are able to carve the permanent dentition in wax with great facility when they can observe macro models.

scholarly journals An Evaluation on Deep Caries Removal Method and Management Performed by Undergraduate Dental Students: A Malaysia Experience

2020 ◽  
Author(s):  
Nurin Izyani Othman ◽  
Hanan Umaira Ismail ◽  
Norazlina Mohammad ◽  
Norzalina Ghazali ◽  
Muhammad Syafiq Alauddin
Keyword(s):  
Current Knowledge ◽  
Glass Ionomer Cement ◽  
Dental Students ◽  
Primary Dentition ◽  
Permanent Teeth ◽  
Management Approach ◽  
Removal Method ◽  
Significant Difference ◽  
Caries Removal ◽  
Partial Caries Removal

Abstract Objectives The aim of this study is to investigate the current knowledge and attitude of deep caries removal method among dental students in Malaysia. Materials and Methods A total of 303 students (n = 303) responded to the online questionnaire. The first part of questionnaire was to evaluate the demographic data of the respondents and focused on the technique and management approach used for deep caries lesion. The second part investigated the preferred treatment used for deep caries based on the designated clinical case, while the third part assessed the factors that affected the decision on deep caries management. Statistical Analysis Independent t-test was used to compare difference between the two groups. Results Seventy four percent of the students have the knowledge of the different methods of caries removal, while 25.8% were only familiar with complete caries removal. The preferred method for deep caries removal in permanent teeth was partial caries removal (53%). For primary dentition, 45.6% of the students prefer to perform pulpotomy as compared with other techniques. There was no significant difference in caries removal method for permanent teeth between undergraduate year of study (p > 0.05), which was partial caries removal at 52.7 and 53.5%, respectively. For primary dentition, the preferred caries removal method was pulpotomy for year 4 (39.8%) and year 5 (52%) students. The popular material to restore deep caries was resin composite (42%) followed by glass ionomer cement (23.3%). Conclusions This study showed that partial caries removal was the preferred method despite partial understanding on the identification of the clinical indicators of the technique.

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