Abstract
BackgroundIn the dentistry field, the analysis of dental plaque is vital because it is the main etiological factor in the 2 most prevalent oral diseases: caries and periodontitis. In most of the papers published in the dental literature, the quantification of dental plaque is carried out using traditional, non-automated, and time-consuming indices. Therefore, the development of an automated plaque quantification tool would be of great value to clinicians and researchers.ObjectiveThis study aimed to develop a web-based tool called DenTiUS and various clinical indices to evaluate dental plaque levels using image analysis techniques.MethodsThe tool was executed as a web-based application to facilitate its use by researchers. Expert users are free to define experiments, including images from either a single patient (to observe an individual plaque growth pattern) or several patients (to perform a group characterization) at a particular moment or over time. A novel approach for detecting visible plaque has been developed as well as a new concept known as nonvisible plaque. This new term implies the classification of the remaining dental area into 3 subregions according to the risk of accumulating plaque in the near future. New metrics have also been created to describe visible and nonvisible plaque levels.ResultsThe system generates results tables of the quantitative analysis with absolute averages obtained in each image (indices about visible plaque) and relative measurements (indices about visible and nonvisible plaque) relating to the reference moment. The clinical indices that can be calculated are the following: plaque index of an area per intensity (API index, a value between 0 and 100), area growth index (growth rate of plaque per unit of time in hours; percentage area/hour), and area time index (the time in days needed to achieve a plaque area of 100% concerning the initial area at the same moment). Images and graphics can be obtained for a moment from a patient in addition to a full report presenting all the processing data. Dentistry experts evaluated the DenTiUS Plaque software through a usability test, with the best-scoring questions those related to the workflow efficiency, value of the online help, attractiveness of the user interface, and overall satisfaction.ConclusionsThe DenTiUS Plaque software allows automatic, reliable, and repeatable quantification of dental plaque levels, providing information about area, intensity, and growth pattern. Dentistry experts recognized that this software is suitable for quantification of dental plaque levels. Consequently, its application in the analysis of plaque evolution patterns associated with different oral conditions, as well as to evaluate the effectiveness of various oral hygiene measures, can represent an improvement in the clinical setting and the methodological quality of research studies.
Highlights
Dental plaque is a diverse community of microorganisms located on dental surfaces in the form of a biofilm embedded in an extracellular matrix of polymers from both the host and microbiota [1,2]
The clinical indices that can be calculated are the following: plaque index of an area per intensity (API index, a value between 0 and 100), area growth index, and area time index
Dentistry experts recognized that this software is suitable for quantification of dental plaque levels
Summary
Dental plaque is a diverse community of microorganisms located on dental surfaces in the form of a biofilm embedded in an extracellular matrix of polymers from both the host and microbiota [1,2]. It is known that plaque is directly related to the appearance and progression of common oral pathologies like caries and periodontal diseases [3,4]. Several clinical indices for quantifying dental plaque have been developed over recent decades These have been frequently used by the research community and in the clinical setting to evaluate the efficacy of different oral hygiene products. Most of these conventional indices employ an ordinal scale as part of a simple and semiquantitative method to evaluate surfaces covered by dental plaque Their application, has major limitations, given the great subjectivity inherent in conducting visual examinations. The development of an automated plaque quantification tool would be of great value to clinicians and researchers
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