Aplicação do Laser na Cariologia: diagnóstico, prevenção e tratamento

Nas últimas décadas, um dos grandes avanços na Área da Saúde foi o desenvolvimento dos aparelhos de Laser, que possibilitou uma nova abordagem nos procedimentos odontológicos. A Laserterapia tem diversas aplicabilidades na Cariologia, seja como método de diagnóstico, como auxiliar nas medidas preventivas ou como tratamento da cárie dentária. Portanto, o objetivo desta revisão é proporcionar uma leitura atualizada da aplicabilidade da Laserterapia na Cariologia e, para tanto, foi realizada uma revisão literária sistematizada, na base de dados MEDLINE – Pubmed, abrangendo os últimos anos. Mediante esse estudo literário e considerando a evolução dos estudos científicos, ainda existem controvérsias a respeito da eficácia clínica do Laser na Cariologia.Descritores: Lasers; Cárie Dentária; Flúor.ReferênciasSichani AV, Javadinejad S, Ghafari R. Diagnostic value of DIAGNOdent in detecting caries under composite restorations of primary molars. Dent Res J. 2016;13(4):327-32.Montedori A, Abraha I, Orso M, D'errico PG, Pagano S, Lombardo G. Lasers for caries removal in deciduous and permanent teeth. Cochrane Database Syst Rev. 2016;26(9):CD010229.Nagata JY, Hioka N, Kimura E, Batistela VR, Terada RS, Graciano AX et al. Antibacterial photodynamic therapy for dental caries: evaluation of the photosensitizers used and light source properties. Photodiagnosis Photodyn Ther. 2012;9(2):122-31.Bahrololoomi Z, Fotuhi Ardakani F, Sorouri M. In vitro comparison of the effects of diode laser and co2 laser on topical fluoride uptake in primary teeth. J Dent (Tehran). 2015;12(8):585-91.Nokhbatolfoghahaie H, Alikhasi M, Chiniforush N, Khoei F, Safavi N, Yaghoub Zadeh B. Evaluation of Accuracy of DIAGNOdent in Diagnosis of Primary and Secondary Caries in Comparison to Conventional Methods. J Lasers Med Sci. 2013; 4(4):159-67.Melo M, Pascual A, Camps I, Del Campo Á, Ata-Ali J. Caries diagnosis using light fluorescence devices in comparison with traditional visual and tactile evaluation: a prospective study in 152 patients. Odontology. 2017;105(3):283-90.Gimenez T, Braga MM, Raggio DP, Deery C, Ricketts DN, Mendes FM. Fluorescence-based methods for detecting caries lesions: systematic review, meta-analysis and sources of heterogeneity. PLoS One. 2013;8(4):e60421.Kositbowornchai S, Sukanya C, Tidarat T, Chanoggarn T. Caries detection under composite restorations by laser fluorescence and digital radiography. Clin Oral Investig. 2013; 17(9):2079-84.Rosa MI, Schambeck VS, Dondossola ER, Alexandre MC, Tuon L, Grande AJ, Hugo F. Laser fluorescence of caries detection in permanent teeth in vitro: a systematic review and meta-analysis. J Evid Based Med. 2016; 9(4):213-24.Heravi F, Ahrari F, Mahdavi M, Basafa S. Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries. J Clin Exp Dent. 2014;6(2):e121-26.Mang TS, Tayal DP, Baier R. Photodynamic therapy as an alternative treatment for disinfection of bacteria in oral biofilms. Lasers Surg Med. 2012;44(7):588-96.Fornaini C, Brulat N, Milia G, Rockl A, Rocca JP. The use of sub-ablative Er:YAG laser irradiation in prevention of dental caries during orthodontic treatment. Laser Ther. 2014;23(3):173-81.Karandish M. The efficiency of laser application on the enamel surface: a systematic review. J Lasers Med Sci. 2014;5(3):108-14.Twetman S, Axelsson S, Dahlén G, Espelid I, Mejàre I, Norlund A et al. Adjunct methods for caries detection: a systematic review of literature. Acta Odontol Scand. 2013;71(3-4):388-97.Bahrololoomi Z, Lotfian M. Effect of diode laser irradiation combined with topical fluoride on enamel microhardness of primary teeth. J Dent (Tehran). 2015;12(2):85-9.Ramos-Oliveira TM, Ramos TM, Esteves-Oliveira M, Apel C, Fischer H, Eduardo CP et al. Potential of CO2 lasers (10.6 µm) associated with fluorides in inhibiting human enamel erosion. Braz Oral Res. 2014;28(1):1-6.Souza-Gabriel AE, Turssi CP, Colucci V, Tenuta LM, Serra MC, Corona SA. In situ study of the anticariogenic potential of fluoride varnish combined with CO2 laser on enamel. Arch Oral Biol. 2015;60(6):804-10.

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Laser fluorescence of caries detection in permanent teeth in vitro: a systematic review and meta-analysis

Journal of Evidence-Based Medicine ◽

10.1111/jebm.12227 ◽

2016 ◽

Vol 9 (4) ◽

pp. 213-224 ◽

Cited By ~ 5

Author(s):

Maria I Rosa ◽

Vilson S Schambeck ◽

Eduardo R Dondossola ◽

Maria CM Alexandre ◽

Lisiane Tuon ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Laser Fluorescence ◽

Caries Detection ◽

Permanent Teeth

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Systematic review and meta-analysis of diagnostic studies of proximal surface caries

Clinical Oral Investigations ◽

10.1007/s00784-021-04113-1 ◽

2021 ◽

Author(s):

Mila Janjic Rankovic ◽

Svetlana Kapor ◽

Yegane Khazaei ◽

Alexander Crispin ◽

Ina Schüler ◽

...

Keyword(s):

Systematic Review ◽

Clinical Studies ◽

Meta Analysis ◽

Laser Fluorescence ◽

Caries Detection ◽

Index Test ◽

Dentin Caries ◽

Diagnostic Studies ◽

Caries Diagnostics

Abstract Aim This systematic review and meta-analysis aimed to assess the diagnostic accuracy and reliability of commonly used caries detection methods for proximal caries diagnostics. Visual examination (VE), bitewing radiography (BWR), laser fluorescence (LF), and fibre-optic transillumination (FOTI) were considered in detail. Material and methods PRISMA guidelines for the reporting of systematic reviews and meta-analyses were applied. The mnemonic PIRDS (problem, index test, reference test, diagnostic and study type) concept was used to guide the literature search. Next, studies that met the inclusion criteria were stepwise selected and evaluated for their quality with a risk of bias (RoB) assessment tool. Studies with low/moderate bias and sufficient reporting were considered for meta-analysis. The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR), and area under the ROC curve (AUC) were calculated. Results From 129 studies meeting the selection criteria, 31 in vitro studies and five clinical studies were finally included in the meta-analysis. The AUC values for in vitro VE amounted to 0.84 (caries detection) and 0.85 (dentin caries detection). BWR ranged in vitro from 0.55 to 0.82 (caries detection) and 0.81–0.92 (dentin caries detection). LF showed higher AUC values for overall caries detection (0.91) and dentin caries detection (0.83) than did other methods. Clinical data are limited. Conclusion The number of diagnostic studies with low/moderate RoB was found to be low and indicates a need for high-quality, well-designed caries diagnostic studies. Clinical relevance BWR and LF showed good diagnostic performance on proximal surfaces. However, because of the low number of includable clinical studies, these data should be interpreted with caution.

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Systematic review and meta-analysis of diagnostic methods for occlusal surface caries

Clinical Oral Investigations ◽

10.1007/s00784-021-04024-1 ◽

2021 ◽

Author(s):

Svetlana Kapor ◽

Mila Janjic Rankovic ◽

Yegane Khazaei ◽

Alexander Crispin ◽

Ina Schüler ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Performance ◽

Meta Analysis ◽

Diagnostic Methods ◽

Laser Fluorescence ◽

Caries Detection ◽

Detection Level ◽

Dentin Caries

Abstract Aim This systematic review and meta-analysis aimed to assess the diagnostic performance of commonly used methods for occlusal caries diagnostics, such as visual examination (VE), bitewing radiography (BW) and laser fluorescence (LF), in relation to their ability to detect (dentin) caries under clinical and laboratory conditions. Materials and methods A systematic search of the literature was performed to identify studies meeting the inclusion criteria using the PIRDS concept (N = 1090). A risk of bias (RoB) assessment tool was used for quality evaluation. Reports with low/moderate RoB, well-matching thresholds for index and reference tests and appropriate reporting were included in the meta-analysis (N = 37; 29 in vivo/8 in vitro). The pooled sensitivity (SE), specificity (SP), diagnostic odds ratio (DOR) and areas under ROC curves (AUCs) were computed. Results SP ranged from 0.50 (fibre-optic transillumination/caries detection level) to 0.97 (conventional BW/dentine detection level) in vitro. AUCs were typically higher for BW or LF than for VE. The highest AUC of 0.89 was observed for VE at the 1/3 dentin caries detection level; SE (0.70) was registered to be higher than SP (0.47) for VE at the caries detection level in vivo. Conclusion The number of included studies was found to be low. This underlines the need for high-quality caries diagnostic studies that further provide data in relation to multiple caries thresholds. Clinical relevance VE, BW and LF provide acceptable measures for their diagnostic performance on occlusal surfaces, but the results should be interpreted with caution due to the limited data in many categories.

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

Dentistry Journal ◽

10.3390/dj9030030 ◽

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.

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Bond Strength of Self-Adhesive Flowable Composites and Glass Ionomer Cements to Primary Teeth: A Systematic Review and Meta-Analysis of In Vitro Studies

Materials ◽

10.3390/ma14216694 ◽

2021 ◽

Vol 14 (21) ◽

pp. 6694

Author(s):

Flavia Iaculli ◽

Alessandro Salucci ◽

Gianni Di Giorgio ◽

Valeria Luzzi ◽

Gaetano Ierardo ◽

...

Keyword(s):

Systematic Review ◽

Bond Strength ◽

Primary Teeth ◽

Meta Analysis ◽

Deciduous Teeth ◽

Glass Ionomer Cements ◽

Glass Ionomer ◽

Significant Difference ◽

Flowable Composites

Background: Conventional composites are largely used in pediatric restorative dentistry and demonstrate successful clinical outcomes. However, the need for simplification of operative steps in young or uncooperative children demands reliable alternatives. Therefore, the aim of the present systematic review and meta-analysis was to evaluate the in vitro bond strength of glass ionomer cements (GICs) and self-adhesive flowable composites (SFCs) on deciduous teeth. Methods: A comprehensive literature search according to the PRISMA checklist was manually and electronically performed by two independent reviewers through the following databases: MEDLINE/PubMed, Google Scholar, Scopus, and Embase, to include in vitro studies comparing GICs and SFCs bond strength values of restorations on primary teeth. In addition, three groups of meta-analyses were conducted using random-effects models. Results: Three articles meeting the inclusion criteria were selected and subjected to both qualitative and quantitative assessment. No statistically significant difference was found between SFC versus GIC; however, both groups significantly differed with conventional flowable composites (CFs). Conclusions: Despite the absence of significant difference in bond strength values, SFCs may be considered a valid alternative to GICs in the restoration of deciduous teeth, although CFs proved better in vitro performances.

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Dental caries in primary and permanent teeth in children’s worldwide, 1995 to 2019: a systematic review and meta-analysis

Head & Face Medicine ◽

10.1186/s13005-020-00237-z ◽

2020 ◽

Vol 16 (1) ◽

Author(s):

Mohsen Kazeminia ◽

Alireza Abdi ◽

Shamarina Shohaimi ◽

Rostam Jalali ◽

Aliakbar Vaisi-Raygani ◽

...

Keyword(s):

Systematic Review ◽

Dental Caries ◽

Sample Size ◽

Primary Teeth ◽

Meta Analysis ◽

Permanent Teeth ◽

Significant Difference ◽

The World ◽

Review Study ◽

Meta Regression Analysis

Abstract Background Early childhood caries (ECC) is a type of dental caries in the teeth of infants and children that is represented as one of the most prevalent dental problems in this period. Various studies have reported different types of prevalence of dental caries in primary and permanent teeth in children worldwide. However, there has been no comprehensive study to summarize the results of these studies in general, so this study aimed to determine the prevalence of dental caries in primary and permanent teeth in children in different continents of the world during a systematic review and meta-analysis. Methods In this review study, articles were extracted by searching in the national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between 1995 and December 2019. Random effects model was used for analysis and heterogeneity of studies was evaluated by using the I2 index. Data were analyzed by using the Comprehensive Meta-Analysis (Version 2) software. Findings In this study, a total of 164 articles (81 articles on the prevalence of dental caries in primary teeth and 83 articles on the prevalence of dental caries in permanent teeth) were entered the meta-analysis. The prevalence of dental caries in primary teeth in children in the world with a sample size of 80,405 was 46.2% (95% CI: 41.6–50.8%), and the prevalence of dental caries in permanent teeth in children in the world with a sample size of 1,454,871 was 53.8% (95% CI: 50–57.5%). Regarding the heterogeneity on the basis of meta-regression analysis, there was a significant difference in the prevalence of dental caries in primary and permanent teeth in children in different continents of the world. With increasing the sample size and the year of study, dental caries in primary teeth increased and in permanent teeth decreased. Conclusion The results of this study showed that the prevalence of primary and permanent dental caries in children in the world was found to be high. Therefore, appropriate strategies should be implemented to improve the aforementioned situation and to troubleshoot and monitor at all levels by providing feedback to hospitals.

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Effect of Cut-Off Points on Performance of Laser Fluorescence for Detecting Occlusal Caries

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.32.1.g4n5274h20184535 ◽

2007 ◽

Vol 32 (1) ◽

pp. 33-36 ◽

Cited By ~ 5

Author(s):

Mariana Braga ◽

Fausto Mendes ◽

José Carlos Imparato ◽

Célia Rodrigues

Keyword(s):

Primary Teeth ◽

In Vitro Study ◽

Vitro Study ◽

Laser Fluorescence ◽

Permanent Teeth ◽

Primary Group ◽

Occlusal Caries

This in vitro study aimed to evaluate the influence of cut-off points on the performance of laser fluorescence(LF) in detecting occlusal caries in permanent and primary teeth. The use of different cut-off points influenced the performance of LF device in detection of occlusal caries in both kind of teeth, but the performance in permanent teeth suffered more influence from variation of cut-off points scales than in primary group.

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