A Hands-On Exercise on Caries Diagnostics among Dental Students—A Qualitative Study

According to current care practices, the aim is to prevent the onset of caries lesions and to stop the progression of incipient lesions. A visual lesion assessment system, International Caries Detection and Assessment System (ICDAS), has been developed to promote reliability and repeatability of assessment of different stage caries lesions. The aims of this study were to evaluate the experiences of a hands-on exercise with authentic teeth as an adjunct to lecturing among third-year dental students and to evaluate the learning process during the hands-on exercise measured by qualitative (inductive content) analysis of the given feedback. In 2018, 51 third-year dental students at the University of Oulu, Finland, participated in a hands-on exercise on caries detection, where they assessed the depth and activity of lesions in extracted teeth using the ICDAS classification. After the lecture, students evaluated the exercise, giving feedback according to five given topics, three of which were analyzed using inductive content analysis. The exercise was considered useful and necessary but, overall, also challenging. The diverse activities and materials, as well as observational methods, promoted learning. The classification of lesions, the diagnostic methods, and the fact that there was not enough time to adopt things during the exercise were found to be challenging. For developing the exercise, the students suggested that more time should be scheduled for it and there should be more individual teaching. This qualitative study showed that, despite the challenge in caries diagnostics, dental students perceive the hands-on exercise as both a communal and individual learning experience.

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

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.

Caries: Diagnostics And Treatment

Caries is a process of destruction of hard tooth tissues, which occurs with the participation of cariogenic bacteria in the oral cavity (in the composition of dental plaque), as well as food residues processed by them. The organic acids produced by the bacteria gradually destroy first the enamel of the tooth and then the underlying dentin. As a result, a carious cavity is formed in the tooth, the walls of which are filled with soft decay of decaying dental tissues and a large number of cariogenic bacteria. The following article looks into the reasons leading to dental problems, its diagnostics and treatment methods.

Quality and Findings of Bitewing Radiographs among Twenty-Year-Old Conscripts in Finland

Objectives. Bitewing radiographs are mainly used to confirm clinical findings in caries diagnostics. The objective here was to investigate the quality of bitewing radiographs after short brush-up training and additional findings besides caries in a low-caries population. Methods. The material of this cross-sectional study comprised 377 pairs of bitewing radiographs of 19- to 20-year-olds taken by dentists. Radiography was considered indicated if one dentinal caries lesion was present on clinical examination. A senior oral radiologist evaluated quality and diagnosed the findings afterwards unaware of clinical status. The association between variables was analysed using cross tabulation and chi-squared testing. Results. Almost half of the images were of compromised quality (44.1%). Dentinal caries lesions were detected in 82.3% and enamel lesions in 73.5% of the subjects. On average, the subjects had 1.7 (SD 0.52) dentinal lesions. Fillings were found in 81.8%, fractures/cracks in 11.7%, and attrition in 7.4% of the subjects. Signs of excessive bite force were recorded in 19.4%, whereas marginal bone loss was detected in 6.4%. No significant correlation was detected between fractures, attrition, and excessive bite forces. Conclusions. Effort must be taken to ensure high quality of bitewing radiographs. In addition to caries detection, bitewing radiographs offer additional value, such as detecting excessive bite forces, tooth wear, and marginal bone loss among young adults.

Diagnosis of early forms of dental caries in а primary school children

Relevance. At present the question of finding and applying effective methods and approaches for diagnosing early manifestations of dental caries in the form of foci of demineralization during eruption of permanent teeth in children remains an important and relevant issue. Timely diagnosis at the age of 6-7 years prevents the transition of the initial forms of caries into carious defects and further excludes the use of invasive methods of surgical recovery treatment. The aim is improving the approach of caries diagnostics approach by identifying foci of demineralization and hidden carious cavities in children during teething of permanent teeth.Materials and methods. An epidemiological examination of 380 children in Moscow aged 6-7 years was carried out. Of the total number of children examined by the method of randomization 150 people were selected, which are divided into 3 groups depending on the intensity of caries. Children of each group were diagnosed with caries using various diagnostic methods – visual inspection, vital staining, hardware method (Estus-LED-Alladin Multicolor (Geosoft, Russia).Results. In children 6-7 years of age in Moscow, the average prevalence and intensity of caries was established. However, the epidemiological examination does not take into account the number of foci of demineralization and hidden carious cavities, which can subsequently be transformed into destructive forms and cause an increase in caries. This indicates the need to improve the diagnostic approach using different methods for identifying early forms of caries. When using the hardware method, a greater number of foci of demineralization and hidden carious cavities were revealed on all surfaces of permanent teeth. There was a tendency to an increase in the number of foci of demineralization and hidden carious cavities depending on the intensity of caries.Conclusions. The effectiveness of the hardware method in the group of children DMF = 0 was 40,9% in comparison with the visual method and 36,4% in comparison with vital staining; with DMF = 1-2 – 35,4% in comparison with other methods, with DMF ≥ 3 – 43.3% in comparison with the visual and 40% in comparison with the vital. Diagnosis of early forms of caries made it possible to prescribe treatment and preventive measures in a timely manner and further reduce the growth of caries.