Detection of Children’s Molars Based on Noise Filter

Pit and fissure sealant is for children aged seven to twelve years to prevent molars from becoming caries. In this paper, we propose a new detection framework to identify whether children need pit and fissure sealing. We divide the framework into two parts: molar detection and molar classification. According to the characteristics of teeth, we propose to use the clustering method to filter the bounding box in the object detection part. In the region divided by clustering, we only keep one detection frame in the same category. In the classification part, we propose a noise filtering layer based on wavelet transform for feature extraction. We map the training samples to another space in the training process based on metric learning to increase the distance between categories and improve the accuracy of classification.

Comparative effectiveness research of two glass ionomer cements for primary molar fissure sealing

Relevance. A glass ionomer cement (GIC) is the material for primary teeth fissure sealing in children. The research aimed to study the comparative effectiveness of two GIC pit and fissure sealants in primary molars.Materials and methods. Sixty-one children aged 2-5 years (mean 26.99 ± 0.55 months) participated in the study after obtaining the Local Ethical Committee’s permission and the parents’ informed consents. Non-invasive fissure sealing in primary molars was performed according to split-mouth design with two GIC: Fujy-9, GC, Japan (109 teeth, FV-group) and Polyakrilin, TehnoDent, Russia (106 teeth, PV-group). Follow-ups were provided after 6, 12, 18 and 24 months. Complete retention, partial retention or complete loss (%) of the sealants and the frequency (%) of fissure caries development were calculated. The chi-square criterion was used to assess the significance of the differences between the groups at p-value < 0.05.Results. In 6 and 12 months, all the cases demonstrated complete or partial sealant retention and the absence of pit and fissure caries. The following results were found after 24 months: complete GIC retention in 8.6% of molars in FV-group and 1.9% in PV-group, (p < 0.05), partial retention – 78.8% and 79.0% (p > 0.05) respectively, complete loss – 6.7% and 11.4% respectively (p > 0,05). Fissure carious lesions were found only after 18 and 24 months in 2.8% cases in FV-group and 3.8% cases in PV-group, p > 0,05.Conclusions. Both studied GICs for non-invasive primary molar fissure sealing were equally highly effective for pit and fissure caries prevention in children. Annual follow-ups in children are necessary for GIC sealant repair.

Clinical and economic analysis of dental caries prevention using fluorine-containing sealants

Aim. To conduct a clinical and economic analysis of the effectiveness of the program fissure sealing of first permanent molars with fluorine-containing sealants among schoolchildren of 78 years old in six cities of the Republic of Tatarstan. Methods. Between 2007 and 2011, dentists of six cities of the Republic of Tatarstan performed fissure sealing of permanent first molars using a fluorine-containing sealant in 24,394 schoolchildren aged 78 years according to the manufacturer's instruction. A clinical assessment of fluorine-containing sealant retention during tooth eruption was carried out annually, the results were submitted to the organizational and methodological office of the Republican Dental Clinic. The analysis of the complex of signs that have a normal distribution and characterize four degrees of sealant retention on the occlusal surfaces of teeth in children from several cities was carried out by using one-way ANOVA (analysis of variance) with the calculation of a p-value and F-test (according to Ronald Fischer). Statistical data processing was performed using the Microsoft Office Excel 2017 software. The economic analysis was performed by using mathematical modelling. Results. The use of sealants at the age of 78 years ensured the complete safety of the sealant in 80% of children; the development of dental caries in 1.7%; complete and partial loss 14.3%; disturbance of fit without the development of caries in 4.1% of cases [р=0.0095 (0.01); f-test 3.09839]. Clinical and economic analysis using a mathematical hypothesis in sealing with a fluorine-containing composite sealant determined the preservation of the conditionally spent funds for the treatment of 80% of healthy teeth for 4 years of the project in the amount of 6,001,177 rubles. Notional saved costs for the treatment of one tooth with a sealant amounted to 23.7 rubles. Conclusion. Implementation of the program fissure sealing of first permanent molars with fluorine-containing sealants among schoolchildren of 78 years old allows a total of 98.3% of healthy teeth to be preserved and notionally saved costs of sealing fissures to be reduced.

The results of self-etching self-adhesive flowable composite application for primary molars fissure sealing in children

Relevance. The use of light-cure sealants and flowable composites for fissure sealing in children is difficult due to the complexity of the procedure. The research aimed to study the efficiency of self-etching self-adhesive flowable composite for fissure sealing in primary molars in children.Materials and methods. The Local Ethical Committee permission and written informed voluntary consents from the parents were obtained before the study. Non-invasive fissure sealing with self-etching self-adhesive flowable composite (Constic, DMG, Germany) was performed in 48 primary molars in 48 children aged 2-5 years (mean 41.2 ± 1.3 months). After 6, 12, 18 and 24 months, the sealant’s retention (%) and frequency (%) of occlusal caries development, and 95% confidence intervals (CI) were calculated. The significance of the difference was assessed by the Student’s t-test.Results. After 6 and 12 months, complete sealant’s retention was revealed in 75.0% (CI 61.2-85.1%) and 60.4% (CI 46.3-73.0%) molars, p > 0.05; it decreased to 27.1% (CI 16.6-41.0%) and 18.7% (CI 10.2-31.9%), p > 0.05, after 18 and 24 months. Complete loss of the sealant was noted in 8.3-18.7% cases. The first caries lesion (2.1%, CI 0.4-10.9%) on the surface with the lost sealant was revealed after 12 months, after 24 months – 4.2% (CI 1.1-14.0%).Conclusions. In primary molars after non-invasive fissure sealing with self-etching self-adhesive flowable composite, complete loss of the sealant was from 8.3% to 18.7% after 6-24 months post-op, partial loss was from 8.3% to 31.3%. Occlusal caries was revealed in 6.3% cases after the sealant loss.

PRACTICALLY IMPORTANT CLINICAL CHARACTERISTICS OF THE MODERN SILANTEV TO SEAL THE TEETH OF CHILDREN

Annotation. Incomplete posteruptive maturation of the chewing group of teeth in children, along with increased availability of carbohydrate food, deterioration of the ecology and composition of drinking water, as well as features of the morphology of fissure, cause increased susceptibility of occlusal surfaces to caries. It is argued that one of the key methods of preventing caries of the chewing surface of the teeth in children is the sealing of fissures, which is based on modern principles of evidence-based medicine. The advantages of sealing over the use of fluorinated lacquers are analyzed, modern groups of silants are investigated and their practically significant clinical characteristics are revealed. Keywords: fissure sealing, silenty, the chewing surfaces of molars, caries, mineralization of tooth tissues.

Laser Tooth Preparation for Pit and Fissure Sealing

Objectives: Various approaches are available for pit and fissure sealing, including: the use of sealants, with or without mechanical preparation; the use of etching, with or without bonding; and the use of lasers as an alternative to mechanical preparation. The objective of this study is to evaluate pit and fissure sealing by comparing the retention and microleakage of sealants, between mechanical and Er:Yag laser enamel preparation. Methods: Sixty extracted sound third molars are classified into six groups: A, bur mechanical preparation and sealant application; B, bur mechanical preparation, etching and sealant; C, bur mechanical preparation, etching, bonding and sealant; D, laser mechanical preparation and sealant; E, laser mechanical preparation, etching and sealant application; F, laser mechanical preparation, etching, bonding, and sealant. Statistical analysis methods include Fisher’s exact test, a general linear model for one-way analysis of variance (ANOVA) of multiple comparisons, and Bonferroni multiple comparison tests. Results: All the groups showed dye microleakage beneath the sealants. Less microleakage was observed for those that used bur rather than laser, 41 versus 44 specimens, respectively. The number of specimens without microleakage decreased as follows: group E (24), group A (18), groups B and F (17), group C (14), and group D (5). Retention was 100% in all groups except group D. Conclusion: Mechanical preparation increases retention of sealants, especially when etching material is used; additionally, bonding can help the retention. The best technique is mechanical preparation via laser and subsequent use of etching, without bonding prior to application of the dental sealant.

Clinical and economic analysis of caries prevention programs by mathematic modeling

Relevance. Underestimating the importance of economic analysis is the barrier to the implementation of cariesprevention programs.The aim is to study with use of mathematic modeling method the clinical and economic effectiveness of dental caries prevention programs provided for schoolchildren.Materials and methods. The method of mathematic modeling was used to evaluate the clinical and economic efficiency of the caries prevention programs (educational, fissure sealing, fluoride varnish). The cost of prevention program implementation and the expenses for caries treatment without prevention were calculated according to the rate of Volgograd territorial mandatory medical insurance Fund for 2018 year. The differences between the caries prevention program’s cost and the expenses needed for the treatment of “prevented caries” were considered as saving.Results. It was revealed that the Educational Dental Program for the first grade schoolchildren has short duration (2 years) of clinical-economic efficiency. The Continuous Educational Dental Program applied for 6 years by dental hygienists or dentists led to saving (per 100 children) of 99.5-115.0 or 84.0-99.6 thousand roubles respectively. The economic effect of The First Permanent Molar Fissure Sealing Program was revealed after 2 years only when The Program was implemented by dental hygienists. After 6 years of working with this Program the saving were 181.3 or 146.2 thousand roubles per 100 children depending on who implemented the Program, dental hygienists or dentists. The cost of Fluoride Varnish Program implementation was higher than the treatment of “prevented caries”. However, the number of “prevented caries” after fluoride varnish application is higher than after the implementation of the Educational Dental Programs. Moreover, fluoride varnish, in contrast to fissure sealing, prevents caries of smooth surfaces of permanent teeth. Conclusions. The method of mathematic modeling can be used for the development of the caries prevention programs in various regions considering the availability of personnel and financial resources, and for evaluation of the clinical and economic effectiveness of preventive programs implementation.

AGENTS USED FOR ENAMEL REMINERALISATION AND REDUCING DENTIN HYPERSENSITIVITY: A COMPREHENSIVE REVIEW

ремінералізація, гіперчутливість, десенситизація, емаль, дентинRemineralisation agents not only strengthen enamel resistance, but also can occlude dentine tubules, reducing teeth sensitivity. This article provides an overview of various available agents used for enamel remineralisation and dentin hypersensitivity treatment. Conventional fluorides are used in the form of solutions, varnishes, foam, gels, dentifrices, showing low remineralising and desensitising ability as compared to newer fluoride-content products. Deep fluoridation is an effective method for reducing dentin hypersensitivity for a long time; its remineralising potential is used for white spot lesions treatment, caries prevention, and fissure sealing. Most novel fluoride compounds showed higher remineralising and desensitising abilities as compared to conventional fluorides. Deep penetration fluoridation is an effective method for remineralisation and reducing dentin hypersensitivity in long time. Despite of the fact that calcium phosphate systems have demonstrated a benefit over conventional fluorides in remineralisation their desensitising ability was not confirmed by various studies. The use of bioactive glass in remineralisation and desensitisation is quite promising, but further researches need to be undertaken to prove its efficacy. «Curodont» and synthetic nanohydroxyapatite from biomimetic systems showed good results in the above-mentioned treatments, but more researches are required to confirm their clinical efficacy. There is no doubt that iontophoresis with calcium and fluoride substances is still the most effective method in the office remineralisation, however, its potential effect in desensitisation has to be better evaluated. Efficacy of different kinds of lasers alone or in combination with a remineralisation agent has been confirmed mostly in vitro studies, therefore, there is a lack of clinical trials to prove their benefit. In latter studies, dentin sealants and desensitisers occluded dentin tubules were superior to conventional fluorides and synthetic nanohydroxyapatites. Simultaneously, the data about calcium phosphate and deep penetration fluoridation efficacy over such desensitisers as dentin sealants and nerve sensitivity inhibitors are controversial and indicate that additional studies are required to deepen our knowledge of the insufficiently explored area of reducing dentin hypesensitivity. In spite of the new advances, the ideal treatment modality for remineralisation does not exist. Within last decades, dentistry has made significant steps towards the elusive goal of enamel remineralisation and dentin desensitisation, but more long-term сlinical controlled studies are needed to confirm and quantify these findings, as well as to identify additional factors that can potentiate these processes.

FISSURE CARIES: DIAGNOSTIC ASPECTS OF CURATION IN THE SCHOOL DENTAL OFFICE

Subject. The problem of fissure caries remains one of the key in modern cariesology. For individual prevention, the most effective is the method of sealing fissures and fossae of the surface of the teeth. By sealing (sealing) fissures, the creation of a physical barrier for cariogenic factors and microbial plaque, remineralization of hard tooth tissues is achieved. The goal is to evaluate the effectiveness of fissure sealing in 9-year-old children living in Kazan. Methodology. The study was conducted using the clinical method and statistical analysis of the data. In total, 137 children aged 9 years old, studying in the third grades of the gymnasium No. 102 of Kazan, took part in it. The main group included 82 schoolchildren who performed non-invasive fissure sealing (the first permanent molars) with UltraSeal XT plus sealant, the comparison group consisted of 55 students who did not have fissure sealing. Results. After 12 months, out of 165 teeth previously coated with sealant, sealant on 95 teeth was completely preserved (57.6 % of cases), sealant fell out or partially retained (tooth is intact) in 36.4 %, fissure caries at the place of sealant was detected in 6.1 % The effectiveness of fissure sealing, which consists in maintaining a healthy masticatory surface of hard tooth tissues, after 12 months of follow-up was 91.9 % with a reduction of caries of 76.7 %. A comparison of the data clearly showed that the condition of the first molars, which was used to seal the fissures, allows us to talk about the preservation of intact fissures in 88 % of cases, while 56 % of unsealed molars are prone to caries of fissures and only 44 % remain intact after a year. Conclusions. A clinical study confirms that sealing fissures is a reliable and reasonable method for the prevention of fissure caries.